HomeMy WebLinkAboutHarbor View Cottages, LLC ��o��g{1FFQ��.cpG
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John G.Stein,Chairperson y Town Hall,53095 Main Rd.
Lauren Standish,Secretary - P.O.Box 1179
• '� Southold,NY 11971
Telephone(631)765-1889
Fax(631)765-1823
Conservation Advisory Council
Town of Southold
1
At the meeting of the Southold Town Conservation Advisory Council held on Wed., August
9, 2023, the following recommendation was made:
Moved by John Stein, seconded by John Chandler, it was
RESOLVED to SUPPORT the application of HARBOR VIEW COTTAGES, LLC to
demolish an existing two-story single-family dwelling and porch, total footprint (1,010 sf.)
and remove existing sanitary system; construct a new two-story single-family dwelling
(1,590 sf.) second floor and porches 1,860 sf., proposed garage (1,400 sf.); 69' retaining
wall (5'-6') at highest; install leader and.gutters leading to drywells; gravel drive and new
1/0 OWTS system.
Located: 520 Sterling Street, Fishers Island. SCTM#10-9-6
Inspected by: John Stein
Vote of Council: Ayes: All
Motion Carried
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Board of Trustees
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PROPOSED SITE PLAN 10 APRIL 2023
A�&TARCHITECTS 1 ' — 30 N
33 Union Street 4th Floor Boston,MA 02108 SHILLO-STERLING STREET
617-451-5740 ARTarchitcct&com FISHERS ISLAND,.NEW YORK
WESTDrawing Copyright®2015
I HARBOR
400 Capital Boulevard,Suite 301
\ I Rocky Hill,CT 06067
860-885-1055 I www.chacompanies.com
COASTAL EROSION
HAZARD LINE~\ \ / �� SITE
PER MAP REF. 4 �--
• � Rocks \ .� � I TOPOGRAPHIC MAP
PARCEL 2 �,\��� \ (TY'•) \ F�'�/� ��\ PREPARED FOR:
FLOOD ZONE LINE I
PORTION OF STERLING STREET DISCONTINUED ON JULY 9, 1963 ZONE VE (ELEV 14) p �� 2 % THOMAS SHILLO
PER MAP REF. 3 / •�y2
PER REFERENCE MAP #1
AREA=1,427f SF
520 STERLING STREET,
MERE5TONE y, ��, \�� I �S FISHERS ISLAND,
(FOUND) //� '�• ly 'lij,\ F i I
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MAP REFERENCES
Q-166.53 h� �"1 1 \��9� 3AKAPE 1. PLAN OF A PORTION OF STERLING STREET AT FISHERS ISLAND,
� E:-166.53 O �y ` �A E \ AK �
i \ o w�.�. COASTAL EROSION NEW YORK TO BE ABANDONED BY THE TOWN OF SOUTHOLD SCALE:
27.14
�'o ( O '�°'T �� HAZARD LINE 1"=40' DATE: JANUARY 28, 1963 BY CHANDLER & PALMER ENG'RS
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N 85*01'16* W j POLE 1 2. PROPERTY ON FISHERS ISLAND IN THE COUNTY OF SUFFOLK,
STATE OF NEW YORK DATE: AUGUST 1922 IT IS A VIOLATION OF LAM FOR ANY PERSON.t Ess THEY ARE
?0y� / ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL
PARCEL 1 • 1( \ OR 7 A ER AN ITEM
LANDSCAPE W .F AN nR OR wro
SURVEYOR TO ALTER AN ITDN N ANY MAY.F AN nEM BEARING THE
q\ AREA = 33 400f SF 3. FEMA FLOOD INSURANCE RATE MAP FOR SUFFOLK COUNTY, NEW STAMP OF A LICENSED PRO> SIONAL IS ALTM,TIRE ALTERING
YORK, PANEL 19 OF 1026, MAP SUFFIX: H, MAP NUMBER SURRVEEM S AAU STENGINEM AMP nIE`ANDSCAPE W DOCUM►RT"T AM iNa M TFIE
1 � \ 36103CO019H, MAP REVISED SEPTEMBER 25, 2009, SCALE: 1"=500' DATE OF�Su�hERATIION.A►°MNDND s SIC DESCRIPTION
fy \� ( Oct i 8 C'S'9 /y 24.38 BY
24.40 S 2030'42" W OF THE ALTERATION.
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r-24.7 �G1. 164 t \ 4. COASTAL EROSION HAZARD AREA MAP, TOWN OF SOUTHOLD,
RI T/OF�WAY� \ \� �" QO SUFFOLK COUNTY, NEW YORK, SHEET 47-FI OF 49, SCALE: 1"=200',
1 0 f6R ORI�'ANC,E� N/F DATE 8/29/1988
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1 APLE 1$/ ",PAGE /411 , ` MARTHA ELI� TORRANCE NOTES
LPI E / ,-o ` LUCIE TODD TORRENTINE
1. r !.PIPE 1. THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE
F
(FOUND) / INDICATED HEREON. ANY EXTENSION OF THE USE BEYOND THE
`/ N:148 .88 ` ,� / PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR
M�PL o W:168.45 �?6 S�OPo // EXCEEDS THE SCOPE OF THE ENGAGEMENT.
/ 5 26� r '�J T`O• `L� / 2. IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY
PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED
l o o. ~MAP�E/ ` Tob / qL,� �,� LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY.
3. ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND
i RQ BRUSH LINE \\ 0' SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL
�CytE Y "24" ARE THE PRODUCT OF THE LAND SURVEYOR.
�-- HOLE TWIN No. Submittal I Revision App'd. By Date
l FOUND) ASA 4. COORDINATE DISTANCES ARE MEASURED
FROM U.S. COAST AND
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�n stoN L MAPLE ( o GEODETIC SURVEY TRIANGULATION STATION PROS"
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�FOI�N 0 5. SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX
' 4- N/F MAP 1000, SECTION 10, BLOCK 09, LOT 06.
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� \ 2 I� "1 16" I I.PIPE ANN EMMETT
No �, � � / 6. TOTAL AREA = 0.77t ACRES (33,400t SF)
,W On,
32" 26 ion /N ASH 1 (FOUND)'rASq � / / � 7. SITE IS LOCATED IN ZONING DISTRICT R-40.
t-,,'/� 8. VERTICAL DATUM IS BASED ON NAVD88.
MACE 1MafLE
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` os //`L\\ o/ EDGE OF PAVEMENT
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\ � •y �� /`I' EDGE OF GRAVEL ^\ \ N N/F STONE RETAINING WALL
N SUZANNE & FREDERICK BRUSHLINE
N/F \ DRILL \` BANCROFT OVERHEAD WIRES o/w
MEREDITH PHELPS RUGG
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SOPHIA YARNELL PAYNE LPIPE rµ�-:, ^r- BOUNDARY POINT o
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Designed By: Drawn By: Checked By:
ZONING SETBACKS i;: IRON PIN OSETBACK JUL Z 4 2023 I�� MERESTONE ® -- ZBC CB/RHS
YARD ROCK G Issue Date: Project No: Scale:
/ LENGTH _._-
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FRONT YARD 40 sc;i?;,li ; ;II HYDRANT
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REAR YARD 50 -----
SIDE YARD 15 Drawing No.:
SIDE YARD 20
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GRAPHIC SCALE IN FEET
Goldsmith,President ��5�0 COGy� Town Hall Annex
A.Nicholas Krupski,Vice President <� 54375 Route 25
Eric Sepenoski * ,x P.O.Box 1179
Liz Gillooly �y • �� Southold,NY 1�1971
` Elizabeth Peeples col ��� Telephone(631)765-'1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: 2 2u Completed in field by: �o za to Pec0kV4S
J.M.O. Environmental Consulting on behalf of HARBOR VIEW COTTAGES, LLC
requests a Wetland Permit to demolish existing tow-story single-family dwelling and
porch having a total footprint of 1,010sq.ft., and remove existing sanitary system; ,
construct new two-story single-family 1,590sq.ft: dwelling with a 900sq.ft. second floor;
270sq.ft. of porches for a total footprint of the first floor and porches to be 1,860sq.ft.;
construct a proposed 1,400sq.ft. detached garage; construct a 69' long retaining wall
(5'-6' at highest) landward of dwelling; install a gravel driveway; install gutters to leaders
to drywells to contain roof runoff; install a new I/A OWTS system; install an in-ground
swimming pool. Located: 520 Sterling Street, Fishers Island. SCTM# 1000-10-9-6.1
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
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No Not Applicable
Info needed/Modificat
ions/Conditions
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Present Were: ✓ G. G ldsmith �N. Krupski ✓ E. Sepenoski
✓L. Gillooly E. Peeples
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Glenn Goldsmith,President Town Hall Annex��'��' .U�,��,�,
A.Nicholas Krupski,Vice President' p��to 54375 Route 25
. P.O.Box 1179
Eric Sepeno.ski 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 Application
-1_Wetland Permit Application
Administrative Permit
__Amendment/Transfer/Extensiol.Z4.23
X Received Application:
Received Fee: $
'Completed Application: -7
Incomplete:
SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
Lead Agency Determination Date: 1; - E
Coordination:(date sent):
LWRP Consistency Assessment Form Sent:9AC
~ ,�Referral Sent: I JUL 2 4
Date of Inspection: 2023
Receipt of CAC Report: _
_ Technical Review: Southold Tovin
V7"—Public Hearing Held: '
Board of Trustees
Resolution:
Owner(s)Legal Name of Property (as shown on Deed): Harbor View Cottages, LLC.
Mailing Address: P.O. Box 161, Fishers Island, NY 06390-0161
Phone Number: 631-788-7857
Suffolk County Tax Map Number: 1000 - 10-09-06 0
Property Location: 520 Sterling Street, Fishers Island, NY
(If necessary,provide LILCO Pole#, distance to cross streets, and location)
AGENT(If applicable): JMO Environmental Consulting/Glenn E. Just
Mailing Address: P.O. Box 447, Quogue; NY 11959-0447
Phone Number: 631-653-0607 Email: Gjust10215@aol.com __ __
Board of Trustees Application.
GENERAL DATA
Land Area(in square feet) 33,400
Area Zoning R 40
Previous use of ro ert Single farnily dwelling
P p Y ._
Intended use of property. .SiIe farnlly.dW Iling�,
Covenants and Restrictions:on.property? YeslNo
If"Yes",please provide a.copy:
Will this project require a Building Permit as:per Town Code? YesNo
If"Yes",be advised this application will be-reviewed by the'Building:Dept.prior to a.Board of Trustee review
and Elevation.Plans will be4 required.
Does this project require a variance from the Zoning Board of.Appeals? Yes ✓ No
If:"Yes",.please provide copy of decision.
✓ his 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?�✓ _YesNo
Prior permits/approvals for site improvements:
Agency Date
Southold Town Trustees (dock) 2021.
(.
N Y S D.E.0 dock 2021::.;
❑ No prior permits/approvals for Site improvements,
Has any permit/approval ever been revoked or suspended by a governmental agenc No�Yes
If yes..4 provide explanation:
Project Description(use attachments if necessary) Please see .attached .
Applicant proposes to demolish an existing two story single family
dwelling (735 sq. ft.) and porch (275 sq. ft.), total footprint (1,010
sq. ft.) remove existing sanitary system; construct a new two story
single family dwelling (1,590 sq. ft.); second floor (900 sq. ft.);
porches (270 sq. ft.), total footprint (first floor and porches 1,860
sq. ft.); proposed garage (1,400 sq. ft.); 69, of retaining wall (5'-6')
at highest); install leaders and gutters leading to dry wells: gravel
drive and new I/O OWTS system.
Board. of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION.DATA
New sln le family dwellin
Purpose of lie proposed operations: g Y 9
Area of wetlands on Tot 300 square feet
Percent coverage of lot n/a .
Closest distance between nearest existing structure'and:upland edge of:wetlands; 21: feet
Closest distance between nearest proposed structure and upland edge of Wetlands:..50 ,:feet
Does the mbiect involve excavation or filling? 0 No Yes
If yes;how much.material will be excavated? 150 .cubic yards
How much,material.Will be filled 15Q cubic yards.
Depth,of which material will be removed or deposited: 8 feet`
Proposed slope throughout the area of operations 1:1
Manner in which-material:willbe-removed or:deposited
Backhoe
Statement of he effect,:if any,on the wetlands and tidal waters of the town that may sesult'by.
reason:of such proposed operations (use attachments if appropriate):
As proposed there should be.no negative impacts upon the wetlands or tidal waters of the Town.
61 Z 20
Appendix B
Short Environmental Assessment Form
Instructions f r Completing. .
Part 1 -Project.lnformation .The applicant or.project sponsor is responsible.forthc compietiod of Part 1. Responses'
become part of the.application for approval or funding,are subject to.public review,and may be subject to furtherverification; .
Complete Part..based on information currently.available..If additional research.or investigation would be needed to.fully
respond to any item,please answeras thoroughly as possible based on current;inform ation.
Complete:all items in Part 1. You rriay.also.pro vide any additional information whichyou believe will,be needed by'or useful.
to the lead agency;attach additional pages as necessary to supplement any item
Part 1 -Fro�ect a.nd$pops;;Information
Name of'ActionorProject:
Propsed,single family dwelling
Project Location(describe,and attach a location map):
520 Sterling Street; Fishers Island; NY, location map enclosed
Brief Descriptionof Proposed Acfion
Please see attached
Name of Applicant or Sponsor;. ,,Telephone:
H arbor View Cottages,, LLC. Gjust10215@aol:com
Address:
P.O. Box 161
City/PO. State: Zip Code:
Fishers Island NY . ` 0639070161
7:Does the proposed action only involve the leg;slative adoption ofA plan,local law;ordinance, :M.,:, 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 I,
2.'5oW the proposed action require a permit,approval;;funding from any other.governmerital Agency? NO . VPSs
If Yes, list:agency(s)name and permit or approvalk.
Southold Town Trustees, Southold Town Building Department & N.Y.S.D.E.C.
3.a:Total acreage of the site of the.proposeo action? 0 77 acres..
b.;Total acreage to be physically disturbed? 01 acres
c.Total.acreage(project.site and any contiguous:properties)owned.
or controlled by the.applicant or project sponsor? 0•77 acres'
4: Che ka 11 land us at occur on,adjoining an tit the propqsr4 action.
Urban Rural(non-agriculture) Industrial Commercial ❑Residential(suburban).
Forest Agriculture Aquatic: . QOther(specify)
1-1�
Parkland
Pa -1 of 4
i
Applicant proposes to demolish an existing two story single family
dwelling (735 sq. ft.) and porch (275 sq. ft.), total footprint (1,010
sq. ft.) remove existing sanitary system; construct a new two story
single family dwelling (1,590 sq. ft.); second floor (900 sq. ft.);
porches (270 sq. ft.), total footprint (first floor and porches 1,860
sq. ft.); proposed garage (1,400 sq. ft.); 69, of retaining wall (5'-6')
at highest); install leaders and gutters leading to dry wells: gravel-
drive and new 1/0 OWTS system.
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 YES. .
landscape
7`. 15 the site of th opos e pred action.located'i n,ordoes it adjoin,a state listed.Critical Environmental Area? NO YES. :'
If Ye%identify Fishers Jsland Sgund - ✓
8. a.Will the-proposed action result in asubstantial 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 ofthe.proposed:action?
9.Does the proposed action.meet or exceed 7he state energy code requirements NU YES
If.the proposed action will exceed requirements,describe design features and technologies
1-0. Will the proposed action connect to an existing public/private:water supply? NO YES.
If No;describe method for providing potable water:
11:Will ihe.proposed action connect to existing wastewater utilities? NO .;�: YES:
If No,describe method for providing wastewater treatment:.:. n �/
12. a Does the"site contain a.structure that its listed on.either the.State or National Register of Historic Nb YES
Places?
b.Is the proposed action located in an archeological sensitive area? ✓
yp p P J g.. P p...
osed
13.a.Does an ortion of the site of the' ro osed action,or lands ad oinm `the ro action,contam NO YES
Wetlands or other waterbodies'regulaied by a federal;state or local agency? ✓1-1
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 toracres __
14. ntify the typic it types that oc h,or are likely to be found on t ro�ect ii ..: Check all that apply:
Shoreline Forest Agricultural/grasslands Early mi.d-successional
✓ Wetland Urban Suburban
15.Does the site of the.proposed action contain any species of animal,or associated habitats, listed NO" YES
by the State or Federal..government as threatened or endangered?
IG;is the project site located in the l"QO year flood plain? NO YES
17.Will the proposed action create`storm water discharge either from pomt or non=point sources NQ.
If Yes,
a. Will storm_water discharges flow to adjacent properties? ONO ❑YES ❑ ❑✓
b. Will storm water discharges be directed to established conveyance systems 5iff an drains)?.
If Yes,briefly describe 0 ES
Page.2.of 4
18..,Does the proposed action include construction or other activities that result in the impoundment'gf: NO' YES
water 9r'other
aiquids.(e,g retention pond,waste.lagoon, dam).
]fYes,explain purpose and size: ❑
W
ql
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 �___ n ❑
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 I RIVIATION-PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST 01+ MY
KNOWLEDGE
Applicant/sponsor.name :in USi.: Date
Signature:
Part 2 Impact A§sessment. The Lead Agea;s- onsible for the completion of Part2 Answer all:ofthe following..
questions in':Part 2:using theinformation contained;in Part l°and other materials submitted by the project sponsoror
otherwise available to the reviewer W heq answering the questions the reviewer should be guided by the concept `Have my`
response.s'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 co;flictwith an adopted land use pIan;or zoning
regulations?
2. Will the proposed action result i`n a change in the use or intensity of use of land?
3. W ill the proposed action impair the character or quality of the existing community?
4. Will the proposed action have an impact on the`env ironmenta[characterisdcs thatcaused:the
establi hment.of a Critical Environmental Are' 'eEA)? a
5 Will the proposed action in an adverse change in tlieexisting level of traffic of
affect-existing irfrastructure for mass transit, biking gr walkway?
n result
6. Will the proposed action cause an increase m the use of:energy and it fails to incorporate.
reasonably.available energy conservation or renewable,energy opportunities?
o a
7: W ill the proposed action impact_existing
a;public/private water supplies? ❑'
b::public./,pnvate.,wastewater treatment utilities?
8 .` W ill the proposed action impair the character 6r.qualrty.of important historic,archaeological,
arch tecturalor;aesthetic resources
9 Will the proposed action result in an adverse change to natural resources(e g,wetlands;`
waterbodies,:groundwater,air-duality;flora and.fauna)?
Page 3 of 4
APPLICANT/A GENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The T wn of`So thof`' C de`o Eth cs oh bus nfltcts of me a the (town officers and em In :`s Th se of
th arm is to provide informaiiori which can alert the town o f bnssible conflicts of intetest and allow't to take whzteyer action is
ecess avoid same
YOURNAME .1USt, Glenn. E:
(Last name,first name,"piddle i iitiA'u{iless you are applymg;tn the name of .
someone else or
other entity,such as a company.;Ifso,indicate the.o er
person's or company's:name
NAItiIE OF APPLICATION•:(Check A that apply.)
Tax grievance Building
Variance Trustee
Change of Zone Coastal Erosion
Approval of plat Mooring e-
Exemption f, plat or official map Planning44
Other
(lf:"Other;name the activity.)
Do you personally(orYhrough;your company,spouse sibling,parent or child)have a reiattoiship with any officer or employee;
ofthe Town.:of Southold "ReiaUanship'includes by blood,marriage,ar business interest "$cisiness'interest".>meansabusirresS,
inciittling a partnership in which the town officer or emp(oyce has even apa1.rtial ownership of(or employmentby).a corporation
in which the:town-officer or employee.owns ino[e thon 5%0 of shares
YES . .. NO n
If`you answered'YES",complete the 6alance:ofthis form and date andsign where:indicated
Name of person employed by the Town:of Southold :
Title or position of that person
Describe the relationship between yourself(the,applicant/ageni/representative)and the town officer.or employee Eithercheck
the:appropriate line:A).through D)and/or describe in the space provided.
The town officer or employee orhis or her spouse,sibling,parent,or child.is(check.ai that apply)
A)the owner of greatec.than 5°la of the shares of the corporatc stock of the applicant:;
(when the appWarit`is a corporation);
B)the legal or beneficial owner'of any interest in rate.a non corpo entity(whenthe
applicant is not a corporation),
C)an ofFtcerl director,oattner,or employee of the applicant or
b)the,actual a' icanf:
DESCRIPTION OF.RELATIONSHIP:
Submitted this tp( '
Signature
Print Name.:
5t
Form TS:1
Board of Trustees Application
AUTHORIZATION
(Where the applicant is not the owner)
I/We, Thomas Shillo
owners of the property identified as SCTM# 1000-10-09-06-_ in the town of
Fishers Island New York, hereby authorizes JMO'Environmental
Consulting to act-as my agent and handle all
necessary work involved with the application process-for permit(s).from the-Southold Town
Board of Trustees for this property.
Property Own Signature Property Owner's Signature
SWORN TO BEFORE MP-THIS / DAY OF , 20 23
Notary Public #55w' 7 P d 2Y z.
-Aoi 1,2 22--S-443
Board of Trustees Application
AFFIDAVIT
Thomas Shillo BEING DULY SWORN
DEPOSES AND AFFIRMS THAT.HE%SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED.PERMIT(S)AND THAT ALL STATEMENT'S'CONTAINED IIEI2.EIN
ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT
ALL.WORK WILL'BE.DONE IN THE MANNER SET TORTH 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 of perty Owner Signature of Property Owner
SWORN TO BEFORE ME THIS j
DAY OF ai
/ (� 1 2023
ary Public rcx porZq.Zj
APPLICANVAGENUREPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town ofSouthoid's Code ofEthics prohibits conflicts of interest on the Part of town officers and employees The nuraose of
this form is to Provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same,
YOURNAME: ShIIIo, Thomas
(Last name,first name,Aniddle 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'piator.offteial map Planning
Other
(If"Other name the activity.)
Do you persohally(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 coMbration
in which the town officer or employee owns more than 5%of the shares.
YES 1 NO _�_
If you answered"YES",complete the balance of this form and date and signwhere'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):
_aA)the owner of greater:than 3%of the shares of the corporate stock of the applicant
=
(when the applicant is a corporation);
13)the legal_or beneficial owner of any interest in a non-corporate entity(when the
� .applicant is not a corporation);
C)an officer,director,partne,or employee of the applicant;or
D).the actual applicant.
DESCRIPTION.OF RELATIONSHIP
Submitted this day g �#42o.?,?
Signature ( —
Print]lame
Fonn TS I'
Town of'Southold
L TP 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 pol cy;conWned in the Town of Southold Local ,
Waterfront Revitalization Program. A. proposed action wiiI be >evaluated si as> to its. 'fcant
beneficial and adverse;>effectsupon'the coastal area(which mcludes all of Southold Town1
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 Thns,`each answer must::6e.exnlamed in detail, Iistin both supportih and non .
subnortina.facts. If an action cannot be certified as consistent with the LWRP policy standards and
conditions,rt Ball notbe undertalten:
A copy of the LWRP is available in the following places online at the Town of Southold Is
webste,(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# 't o ;cos .106
PROJECT NAME..:New single family dwelling
The Application has.been submitted to (check appropriate response)
.Town Board ❑ Planning Board❑ :Building Dept. ❑, Board of Trustees .❑✓
1. Category of Town of Southold agency.action(check appropriate response):.
(a) . Action undertaken.directly by Town agency(e.g.capital ❑
construction,planning activity,agency regulation,land transaction)
(b) Financial assistance(e g,:grant,loan,subsidy)
(c) Perin approval;license,certification:
Nature and extent of action:
Please see.attache.d....
f
Applicant proposes to demolish an existing two story single family
dwelling (735 sq. ft.) and porch (275 sq. ft.), total footprint (1,010
sq. ft.) remove existing sanitary system; construct a new two story
single family dwelling (1,590 sq. ft.); second floor (900 sq. ft.);
porches (270 sq. ft.), total footprint (first floor and porches 1,860'
sq. ft.); proposed garage (1,400 sq. ft.); 69, of retaining wall (5'-6')
at highest); install leaders and gutters leading to dry wells: gravel
drive and new I/O OWTS system.
Location o€action: 520 Sterling Street, Fishers Island
Site acreage: 0.77
Present.land-use: Existin single farnil dwelling
Present zoning classification: R 40
. 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: Harbor View Cottages, LLC
(b) Mailing address;.P.O.Box 161
Fishers'Island; NY 06390-0161
631-788-7857
(c) Telephone number• — _
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?N.Y.S.D.E.C.
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,thatthe form be returned for completion.
DEVELQPEID Cg T.PQLICY
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
..The project will have no impact upon the character;of the.community :..It.is,felt that this:. rpiect is consistent with.this.policy.._
Attach additional sheets if necessary
P01icy 2. Protect and preserve. historic and.archaeological .resources ,of the Town. of Southold. See .
LWRP Section III-PoliciesPages 3 through 6.for evaluation criteria
Yes ❑ No ❑ Not Applicable
r
There shall be no Impact upon any known historic or archaeoloical resources.
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
LWRP Section III—Policies Pages 6 through 7 for evaluation criteria
✓❑ Yes ❑ No❑ Not Applicable
THere will be no impact upon scenic resources or the visual quality of the Town.
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP
Section III—Policies Pages 8 through 16 for evaluation criteria
Yes ❑ No ❑ Not Applicable
The project will not impact structures or natural resources by flooding or erosion.
Attach additional sheets if necessary
Policy S. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III
=Policies Pages 16 through 21 for evaluation criteria
0 Yes ❑ No LJNot Applicable
There will be no impact upon the quality or supply of water.
Attach adaitionil 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 Yes ❑No ❑ Not Applicable
I
The.We...hpUuMdeeuaCry eMeyuee..l m.T.un.—S)V rs-M"MSIgn.9eemC.WA Flan and Wagle NaMlm.TM InuUudm alanaeeu n.nemow OMeraen.wwNabea xe9.
Attach additional sheets ifnecessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria.
❑✓ Yes ❑No❑ Not Applicable
There will be no impact on the quality of the air
Attach additional sheets if necessary
Policy S. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
❑Yes ❑ No F Not Applicable
The project does not involve solid waste or hazardous substances and wastes.
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.F YeO No❑ Not Applicable
There will be no impact upon the public-access to, or the receational use of, coastal waters, public lanc
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
There will ben a of new to r- �endent Ut
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria.
❑✓ Yes ❑ No❑ Not Applicable
There will be no impact upon the sustainable use of living marine resorces in West Harbor or the Fishers Island Sound.
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.
0 Yes ❑ No❑ Not Applicable
The project does not involve agricultural lands.
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.
Rj Yes ❑ No❑ Not Applicable
The project does not involve the use or development of enemy or mineral resorces.
PREPARED BY Glenn E. Just TITLE Agent DATES k(-�-