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HomeMy WebLinkAboutTR-10733 l 1 Glenn Goldsmith,President ���\O COGy., Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 0 Eric Sepenoski P.O.Box 1179 Liz Gillooly �y ��� Southold,NY 11971 Elizabeth Peeples �Cl �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: L- Completed in field by: Timothy Cloughen on behalf of 5415 SKUNK LN, LLC requests a Wetland Permit to construct a proposed fixed dock consisting of landward steps up to a 4' X 60'9" fixed dock with a 4' X 17'6" fixed "T" section off seaward end. Located: 5380 Skunk Lane, Cutchogue. SCTM# 1000-138-2-16 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: V 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 Not Applicable Info needed/Modifications/Conditions/Etc.: .51rh 'W 'N"A -OW a v� V". Present Were: ✓G. Goldsmith / N. Kru ski L.,,/ E. Sepenoski L. Gillooly E. Peeples dG(�C�G^10 �G1G[1(�]g L^QoDoG^ao •. IaL�C�G�104CG4 M9) Qoc OM12 6%d19HUM I 630Mmmgm)D,Hu 9 9 m I r M oMo&SM I z rn I o 0 36�C X a `o>> o g8 xl X X 3} 3� X 3� 3/ X "FLOW THRU" DEGKINC ON OOGK 1 6 _q„ REFER TO DOGK NOTES FOR I ADDITIONAL INFO. I14 I 3 X .3IS/ SAX X �2 6 x o x 3>3 I o 11 I � BALDW I N'S CREEK I a/ x .o 00 8 x x IX, X, / x °~ rz y x3 �3S �3 I .16 o,S r rn 9g 6 00 I I fj D C7 z rn r, ` ... OCTEl -c 1 M24 I PROPOSED So jam I WALKWAY DOCK SWOW I FOR JOSEPH DAIDONE 5415 I ANE CUTCHOGUEN I NY11935 I I FI T I L O I P L A N I PLOT FLAN 09-27-24 J� SGTM 1000-138-02-0-1 016 , OF 4 /she\ 4'-0" d C lFlF 1%. TANK,, &.0. 10 IaLRMDUMV M0 R@L%L @1919&WIE ]UIE L oMimEMD,m7 99J09 6�39 oa�ao0�44 ECE IV E 1`! 0 CT 1 2024sowwwT gmfdofTnEM CD pj -I 4KYllDEDOC / >o I I II II II II II II II II II II II II II II II N II II II II II II II II II II II II PROPOSED II II II II II II II II II II II II WALKWAY DOCK I I I I I I I I I I I I I I I I I I I I I I I I FOR JOSEPH DAIDONE II II II II II II II II II II II II 5415 SKUNK LANE Ll U u Li L u L L Li U U LJ CUTCHOGUE NY 11935 2 S G T I O N T !mil�c l�l Y O G WALKWAY DOCK PLAN AND AND SECTION 09-27-24 SGTM 1000-138-02-01 016 2 OF 4 IVE OCT 1 2024 owlp Lao Z'Aaafl a"ooLa" LQG3C moul04 Soutlu,,,.,awn 290 R L^m o@1TE LWEHU19 BoamofTrustees mowmG3C,I a ,(vv 99sm 6�39 0�71��00�44 4'-,0" 60'-9° BEACH GRASS "FLOW THRU" (AMMOPHILIA OPEN DECKING BREVILIGULATA) 2-3 GOLUMNS PER R. PLANTING HOLE 12" O.G. MAX. _ o i � It) 2x8 GGA JOISTS 4'-0" HIDE I I GGA PILES ry DOCK I I W/ MIN. 8'-0" I I I I I I PENETRATION I I I I I I �� II II II II II II II II I I I I I I I I I I I I I I I I I I fiyD _ > 21 � - 1I I I I I I I I I I I I I I I I I I IO2 u u u LJ Li u u LJ PROPOSED WALKWAY DOCK FOR JOSEPH DAIDONE 5415 SKUNK LANE CUTCHOGUE W 11935 1�1L.. GD fi�1.._ 1�! cT J�IL. I�IY DOGS ENLARGED PLAN AT WALKWAY DOCK SCALE: 114' = I'—V 09-27-24 J� SGTM 1000-138-02-07 0I6 2 OF 4 - Yet ;j l Lok 108, 1 PLAS¶G_ME5H — w STORY. �: FRAlAE PPOPOSED 521 SF N$2�q $' ;O. r1 tIALT oTi,oewAY GARAGE DECK ` 21,2 UL _ ASP L1 FRAM USE- O'co �I I ', • ^ N 3 O� -3.66 .:.v J.79.3.:4 �`1 "�p W •�1 - Q_,_,i;.ST . 109 ORY Lot WELL: ��.. i �'� !�• FRAME- [� J.Ss3 I3 D_ 0-.. 250.0 Gt Y _WAY ASH ALT•DRI 1. l _ 1 •�z172'�2.Is ': T^ 49.50' } � :❑ ml 1 ss2'pp'�o.w ..�oREUNE o DATE: JULY 28, 2021 JOB N0:2023- 291 -CERTIFIED T0: g 5415' SKUNK LANE, LLC� D :,, LC IU 0 CT 1 2124 Survey .for: „ n -t ard DT:�aste BD es LL NK LANE.f 5 _SKUJ ' ` Lot 'M6'; ".Nassidu P&rms At . C2GtCh og2Le DAVID-H. FOX„ L:S;"P:C: N.Y.S.L:S. OQ234 NOTES__ TOW.fi Of FOXA SUND SURVEYI AVENUENG ASd'�th—old WESTHAMPTON'.B BCH::`N.Y. 11-978' 1. TOTAL.'AREA- (007.000) -= '17,5.10 S.F SUffoIK Co"tarty; New York: 631 28 =00?2 TOTAL AREA (016.60) 1 242- S.F: (. . .)' UNAUT4OR12F.0'A0ERAT{ON OR-ADOISiON TO TNIS SURVEY' 2'. ■ MONUMENT FOUND, STAKE FOUND. Is A VIOLATION OFSECTION 720E-0F THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURu<Y'MAP NOT BEARING 3. SUBDIVISION MAP "NASSAU FAR : 8. MS" FILER: 07 1000-1-38:00=02.00=D .000. & 016.000 THE LAND SURVEYOR'S.INKEO.SEAL'OR EMBOSSER 'SEAL SHALL NOT.BE CONSIDERED '10 BE A VALID TRUE.COPY. IN':THE OFFICE-OF THE CLERK OF SUFFOLK' •0 46 .CERTIFICATION h24OICAAD HEREON SHALL.RUN ONI.Y TO THE COUNTY 'ON MAR. 28, 1:935,AS:FILE NO. 1119. 4n PERSON FOR WHOM THE SURVEY—IS—PREPARED AND ON HIS Y 4. WATER DEPTHS SHOWN AS + =2.94. REFERENCED' TO M.L.L: REHALF'.TO THE.4ITLE COMPANY. GOVERNMENTAL AGENC W. =- — AND LENDING INSTITUTION LISTED,HEREON , AND-TO THE ASSIGNEES OF THE LENDING]NSTI IUTION.CER:IFICA?IONS M:L.L:W. IS RECORDED TO:BE.1:41 BELOW ZERO N.A.V.D.- '(.1988}. SCALE:1 =40' ARE.NOi TRANSFER ADLE TO ADOI_,0NAL INSTITUTIONS ION. OR SUOscQuc-NT OWNERS. a DWG: 2023-241 I 4 t 1 Lot 108 I � Z50.00' M£SN BOCK PLnsnc °'-*s --- - m �-- N O $ U1 ° STORY O �� 1 E tt.0' j.�82'00�10 FRAM "E `� CA N82 00 � GARAGE v 21.25 Vy FLpLT bRlvt:WnY O W b\? N L,�5TME0 5E O -P-3.as `7I332:877. �i 2 N tat ', N_��---70.0 CIO $ 1� I ! + �J793.�q'3.?S; 2t1 �� " t gTORY !f i tat 109 WELL u+ Cl aP Lfl FRAME } air �t� �L' � HOtSSE -2 9 O' • -3 al J.S'gJ.7J , Z 00 S N 2�Q.o Q " cr o WM °0t w 00 i i V, ''3 S• 2. 7�2.89'7.99 t U7 " ASHPAL7 bR{YEWAY ' S82 S82 O'16��W 110 s 3-99^3.56 -3.00 !1�7.g�• i p "'O L . i rn 00'10''N � ! � S82' � Ln � SFIORELtNE z � t p j DATE: JULY 28, 2023 j JOB NO:2023--291 ! CERTIFIED TO: WOOD BOCK 5415 SKUNK LANE LLC I Lo , E EfVE R { OCT 1 2024 NG P G ER`'1 Survey for: 5415 SKUNK LANE LLC SODUWld Town Board ofTmstees Lot 109, "Nassau Farms" At Cutchogue DAVID H. FOX, C:S;-P:C:- N.Y.S.L.S. #50234 NOTES: Town Of FOX LAND SURVEYING 64 SUNSET AVENUE 1. TOTAL AREA (007.000) = 17,510 S.F. Southold WESTHAMPTON BEACH, N.Y. 11978 TOTAL AREA (016.00) = 1,242 S.F. Suffolk County, New York (631) 28s-0022 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY I 2. ■ = MONUMENT FOUND, ® = STAKE FOUND. IS A VIOLA710`J OFSECTION 7209 OC THE NEW YORK STATE 3. SUBDIVISION MAP "NASSAU FARMS" FILED S.C.T.M.: 1000-138.00-02.00-007.000 & 016.000 THE LAND S EDUCATION LAW. ci.YOR'S OPIEs OF THIS SURVEY MAP NOT REARING URV INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE n VALIi) TRUE COPY. IN THE OFFICE OF THE CLERK OF SUFFOLK 40 0 40 CERTIFICATION INOlCATEO HEREON SHALL. RUN O.�SLY F0 THE COUNTY ON MAR. 28, 1935 AS FILE NO. 1179. ! i I PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS 4. WATER DEPTHS SHOWN AS + -2.94 REFERENCED TO M.L.L.W. BEHALF W TFIE TITLE ON LISTED GOVERNS-AND AGENCY r `"- AND LENDING INSTITUTION CO LISTED GOVERN TA TO THE M.L.L.W. IS RECORDED TO BE 1.41 BELOW ZERO N.A.V.D. (1988). SCALE:1I'=40' ARE NOT TRANSFERABLEGNE S OF THE "TO'ADDITION L NSTITUTIONS y OR SUDSF.•OUCNT OWNERS. DWG: 2023-291 gg �. Vk, k �a • j A 5� y k •r a`yY� it I��,�+'�t 4����+ xzfi.'�"`r�t�?F� v{•�"w. '" .��� �,�y:�ra����"�3rFT,.��'y�����, :� �kfi t � �`� �r . f qM j ;r a Y r N• `-�. $i�.e A'{z is�a i" F!.�t��` *,�p��`yy�� � �� � r' °�� :a,� �� r� �� , �•� � 1ST .',4 f � :Y PY "' y{" ' a � 1 y,1 3 1 P�,f.� 1 `•:• ��• � F �'�5n+�'rNkl .� �:. 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" r•'F ':-iy. i;t"'1 S"� 5���� �,�. ��S• 'Y. `°�"�.r<,�r. ,y �' � �@s�},�.3.r�.�� .3.: ��1 �T�y �r'� �� �'� 9 ���,� '�'� fit` i JIwumr d f�'"• !.. F � :�'' �'� ��� r�.a?r ,�h � :�s � ��-���•. �fi•- ^�, w;; \_ r,r �_ Jy "S` Y S 1t °4� t� �Y14PS� �. b\� ��= '�.; r '� r '� 4 x'Y��ty� •� ,s�� � ���'h I 4 f c� �y-; 6 V/ I F yff ^ � ,.�.i �� Fri.�..R.•.e—^"R. h- i ` '•fit •A \VCC ff !yS t e • � ;�� 5 ems: s I , � 4 r .. w,yge a•:. - - - i Sys ,.asoa b _ I 6 O � , 2 s a ry ,e 7 # a ye r a p N Yy 1y py mw�o � §lam o t ++...r, �. �- — -- --a— s—,- --•-- NOTICE COUNTY OF SUFFOLK © x �' �o,a,,,o,n SEC7KIN NO E —�— - 1211 Q2 •-�. —_—_'--_ •�"_—_—_'—_—_ ]] Real Prop"Tax Service AQe11CY r 'p E N rrr o—.�. awu. xllt3 fl w..0 n .� +ti v u. —___ rr --.-- ru.—�-- ervr E c• Y`�t p b 1M F'ROPER,Y a41V Glenn Goldsmith,President 6��*�y�Q+ � to ' Town Hall Annex 54375 Route 25 A.Nicholas Krupski,Vice President . enoski P.O.Box 1179 Eric SeP Southold,New York 11971 Liz Gillooly ac Telephone(631) 765-1892 Elizabeth Peeples "�'.c+`;. Q•. Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only E C E I V E `—'D Coastal Erosion Permit Application D _Q�Wetland Permit Application Administrative Permit OCT 1 M4 Amendment/Transfer/Extgnsio a Received Applica�ioon Received Fee: —7,V' Completed Application:-"'AI �? BoeNofTrostees Incomplete:, SEQRA Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec..,_ Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Asses sme t Form Sent: 11 3_ 25 CAC Referral Sent: `T •Z�, Date of Inspection: - 7 Receipt of CAC Report:_ _Technical Review: _Public Hearing Held: 1 / a-- Resolution: LI-c Owner(s)Legal Name of Property (as shown on Deed): JOSEPH DAIDONE Mailing Address:3415-SKUNK LANE CUTCHOGUE NY 11935 Phone Number: 631-318-2095 Suffolk County Tax Map Number: 1000- 138-02-'K&016 5-3f5t Property Location: 544Z SKUNK LANE CUTCHOGUE NY 11935 (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Timothy Cloughen Mailing Address: 3 Manorview Way-Mannorvill NY 11949 Phone Number: 631-255-7845 Email; tm.cloughen@gmail.com _ Board of Trustees Applii, ion GENERAL DATA. Land Area(in square feet):..1241.sf _ Area Zoning:; R80 Previous use of property:: vacant lot Intended use'of property: proposed dock.- 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 .JJNo 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. is project re 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? Yes 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? No-0—Yes If yes,provide explanation:,,. . Project Description(use attachments if necessary);; Proposed 60'-9':x 4'-0",Dock-= 251 sf and proposed tee dock of 17'-6".X 4'-0" = 70 sf. Total 321 sf of dock Board of Trustees Appli< Lon WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations. Proposed.60'-9' x 4'-0 .dock = 251 sf and proposed tee,dock,of 1T-6" X 4'-0" = 70 sf. Total 321 sf.of dock Area of wetlands on lot: 1241 sf square feet Percent coverage of lot NSA CIosest distance between nearest existing structure and upland edge of wetlands: feet feet Closest distance between nearest proposed structure and upland.edge of wetlands: :08: feet Does the-project involve excavation or filling? ❑ No ✓ Yes If yes, how much material will be excavated? 4 cubic yards How much material:will be filled? 4 cubic yards Depth of which material-will be removed or deposited: 4..., . feet Proposed slope throughout the.area of operations: LESS THAN 1 Manner in which material will be removed or deposited: MATERIAL WILL BE TEMPERARLY PLACED ON SITE AND .BACK FILLED WHEN EXCAVATION IS COMPLETE 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): 617 20 . Appeni[ix B Short Environmental.Assessment Form InstructionsToir 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 L. 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 Timothy Cloughen -.sponsor Name of Action or Project: Proposed.dock and bulk head Project Location(describe,and attach a location map): 5415.SKUNK LANE CUTCHOGUE NY 11935 -....... .... Brief Description of Proposed Action:. Proposed 60'-9' x 4'-0" Dock = 251 sf and proposed tee dock of 17'-6" X 4'-0" = 70 sf.. Total 321 sf of dock Name of Applicant or Sponsor: Telephone: . ....... 6.31:-255=7845: ,.. Timothy Cloughen E-Mail: tm.cloughen@gmail.eom 3 Manorview Way City/Po. Stater Zip Code: Manorville NY 11949 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 question2. 2. Does the proposed action require a permit,approval or funding from any other governmental.Agency? :Ni YES Af Yes,list agency(s)name and permit or approval: a. o 3.a:.Total acreage of the site of the proposed action? 0.02$ acres . J. b.Total acreage to be physically disturbed? 1JUVW. acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? . 0�028.. acres 4. Che I land us at occur On,adjoining an ar the prop action: Urban Rural(non-agriculture) Industrial_tcommercial ✓QResidential(suburban) Forest -❑Agriculture Aquatic ❑Other(specify): Parkland Page 1 of 4 S. Is the proposed action;' NO. YES N!A a. A permitted use under-the zoning regulations? Vi b.Consistent with.the adopted comprehensive plan? '6. Is the proposed action consistent with the predominant character of the existing built or natural NO, ::YES landscape? 7. is the site of the proposed action located in,.or does it adjoin,a state listed Critical Environmental Area? NO...: YES.. If Yes,identify 8.. A.Will the proposed action result in a substantial increase in traffic above present levels?' V/ : : 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 ofthe 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: proposed co extT0.'Will the to ingpublic/private water supply? NO: :YE$:. If No,describe method for providing potable water:' nn 11.Will the proposed action connect to existing wastewater utilities? NO YES: If No,.describe method for providing wastewater treatment:,; n 1?, a.Does the site contain a structure that is listed on,either the State or National Register of Historic lVO_" YES . Places? b. Is the proposed action located in an archeological sensitive area?. 13.a.Does any portion ofthe site of the proposed action;or lands'adjoining the posed.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�AgriCU n,or are likely to be found on t roject site. Check all that apply: ✓ Shoreline Forest ltural/grassIands. JEarly mid-successional Wetland Urban Suburban 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? lu l6.Is the project site located in the 100 year flood plain'? NO YE9 17.Will the proposed action create storm water discharge,either froin.point or non-point sources? NO If Yes, a.Will storm water discharges flow to adjacent.properties? WINO ❑YES ❑ b,Will storm water discharges be directed to established conveyance systemsZ* ff an m'drains)? If Yes,briefly describer O10ES Page 2 of 4 i 18.Does the proposed action:includei.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 19.Has,the site of the proposed action or-an adjoining property been the.location of an active or closed_ 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 completed)for hazardous waste? If Yes,describe:."-.,,.---; AFFIRM,THAT THE INFORMATION:PROVIDED ABOVE IS'TRUE.AND ACCURATE TO THE BEST OF MY'`. ` KNOWLEDGE Applicant/spons r na : Tif71Ot. U hen Date:09-27-24 » ., Signature: ' Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all ofthe,,following questions in Part'2 using the information contained in Part l'and other materials submitted by the project sponsoror 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• w. to large Eimpact impact may may occur occur l. Will the proposed action create a material conflict with an adopted_land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? XEl i: . Will.the proposed action impair the character or quality of the existing community? t' i is t 4. Will the proposed,action have an impact on the environmental characteristics that caused the' X establishment of a.Critical Environmental Area(CEA)? .5. Will the proposed action result in an adverse change in the existing level.of traffic oi- X 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 X reasonatily.availabte energyeonservatjon or.renewable,energy o _ unities? _ �.: Q 7. Will the proposed action impact existing: X a.public/private water supplies? . ` . ...a.. b.public/private wastewatertreatment utilities? El 8. 'Will the proposed action impair the character or quality of important historic,archaeological,. architectural or aesthetic resources? El :E1 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 . I 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 resour ces or human health? Part 3 Determination of significance. The Lead Agency is responsible for the completion-of Part3. 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. Part3 should,insufficient 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 signifcant.: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 im pact.statement is.required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, El that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Narrie ofLead Agency . Date President. Prigf:orType 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 ::. Board of Trustees Appli,. ,.ion AUTHORIZATION (Where the applicant is not the owner) i I/We,,JOSEPH DAIDONE , i owners of the property identified as SCTM# 1000-_138-02-07&0.16 _ in the town of CUTCHOGUE Timothy Clou hen New York,hereby authorizes Y 9 to act as my agent and handle all R necessary work involved with the application process for permits)from the Southold Town Board of Trustees for this property. � 4 II 4 k } :% Prej-b- Wner-'-9 Signature Property Owner's Signature SWORN TO BEFORE ME THIS .. DAY OF . r : 20.E Notary Public LUIS FASRICIO RU810 otary Public State of New'York NO 01RU628A520 Qualified in Nassau County My Commission Expires Aug 25.2025 APPLICANT/AGENTIREPRESEN`]CATIVE TRANSACTIONAL DISCLOSURE FORM The. own of Southold!sfQdcof.tibics,tr-ohibiLLc�,-oiiflicts of injgEg n,the,nartftb4n4ficers and empl23jes.The pgMse of this form is to Provide information which:can alert the town of possible conflicts ofinterest and'allow it 6.1ake whateveraction is necessary to ayoiddsame. YOUR NAME: 5415 skunk lane LLC_:JOSEPH DAIDONE(member), (Last name,first name,*Iddle 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 employce 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 n , 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): 12A)the owner of greater'than 5%of the shares of the corporaie'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 day of 20 2J "Signature _ Form TS 1 �! LUIS FABRICIO R0810 /zt/. y Public-State of New York NO.01RU6284520 Qualified in Nassau County ommissionn Expires Aug 25,2025 .A" APPLICANT/AGENT/IRE-PRESENTATIVE TRANSACTIONAL DISCIL09URFFORM 'The Towri 6f"Southold's-Code of Ethics pr6hi6iis-conflicts 6tintei66h the bdrf()rtdwii:6ffi6ersiijfd,bm61o*6s.'The nuipose of 1his,form is'.6-pnoVide information whicfi'caiiOeit-ihe town.ofoosAW c6riflicis'df interest aifdlill6w i0dJak6what6veriiction is, YOURNAME: JOSEPH DAIDONE (Last name,first fiame,*iddle 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 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 persbfiaiIy'(o1r through,your.company,�pouse,siblingi parent,or child)ll';iv Ie;a rel-ati6nSfi'jp with dny;officer-dr,eMploy,66 of the Town of Southold? "RdlttioishiV'inclad6siby,,blood,.ma mpgebrbusinesslntardsl,''Business inteiesf'means.a-,bqslqess, including p parlin,ership'jnw'hich the town Officer or qmployde-haseven.a partial ownership 617(or,employment by).a corporation in which the ko*mofficeror employee owns-mope tb % ,6n.5of'thie 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 pro%dded. The town officer or employee or his or her spouse,sibling,pare or child is(check all that apply): fjA)the owner of g!e"4&r than 5%of the shares of the corporate stock of the applicant. (when the applicant is a corporation); B)the legal orberieficial owner of any interest in a non-'corporate entiW.(wh6ithe 14 applicant is not a corporation); C)an officer,director,partnei,or employee of the applicant or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day 20 20 Signature Form TS I Pri fit IN e Public LUIS FABRICIO RUBIO otary -State of New York NO,01RU6284520 Qualified in Nassau County m mis" My Cam Ission Expires Aug 25,2025 Board of Trustees Applic, on PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: ADDRESS: /3Fr- � - � 7 STATE OF NEW YORK COUNTY OF SUFFOLK , residing at , being duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Signature Sworn to before me this Day of . 20 Notary Public NOTICE OF HEAR- ING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWN ER(S) OF RECORD: 5415 SKUNK LN, LLC SUBJECT OF PUBLIC HEARING: For a Wetland Permit to construct a proposed fixed dock consisting of landward steps up to a 4' X 60'9" fixed dock with a 4' X 17'6" fixed "T" section off seaward end. Located: 5380 Skunk Lane, Cutchogue. SCTM# 1000-138-2-16 TIME & DATE OF PUBLIC HEARING: Wednesday, January 15, 2025 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available online at www.southoldtownny.gov and/or in the Trustee Office until to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 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::.3Nill..be,eyaluated. as ao.,its.signifcant beneficial anif adverse effecfs;Upon the toastal.area fwhb%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,..:eA&:.aitswer:must:'.tie>.ex lamed `in detail .Iistiiu" both su bi tin'':::and non-: suntloobta 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. i B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 138 .,02 . 16 72� PROJECT NAME. Proposed dock �� SV�,,,,,V` � � L L'C 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 appropriateresponse): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation, land transaction) n (b) Financial.assistance(e:g:grant;loan,subsidy) (c) Permit, approval,license,certification: Nature and extent of action: Location of action: 5415 Skunk Lane LLC Site acreage: 0.028 ACRES Present land use: Vacant land: .. Present zoning classification: R80 2. If an application for the proposed action has been filed with the:Town of Southold agency, the following information shall be provided: Timothy Cloughen (a) Name ofapplicant:.. . .. .,; Mailing address; 3 Manorview Way-Manorville NY 11.949 (c) Telephone number: 631-255a845 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ NoZ. 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. 'DEVEL©P.EDgOAST POLICX PolicyY:'Foster a pattern of development.in the Town of Southold that enhances community character, preserves r 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 ❑ No7 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 'YesEl No❑✓ Not Applicable necessary Attach additional sheets if Policy J. 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 ttac a ihonaYsheets 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.0 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 ✓ONot Applicable Attach a dihona 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 Fl No V F Not Applicable Attach additional.sheets ifnecessary s` Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section'III_- Policies Pages.32 through 34 for evaluation criteria. ❑ R.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. D:Yes'0:No D 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. ❑ YeEl No Z Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III--Policies; Pages 47 through 56 for evaluation criteria. ❑'Yes ❑ No ✓❑ Not Applicable . Attach additional sheets if necessary Policy 11. Promote sustainable use: of diving 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. 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. E]Yes 7 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;:Pages 65 through 68 for evaluation,criteria.. Yes ElNOW Not Applicable r PREPARED BY /.iN1O7fi�Y: GLOv�1. TITLE ._.. DATE '