Loading...
HomeMy WebLinkAboutTR-10794A S0 Town Hall Annex Glenn Goldsmith, President �� ®� 54375 Route 25 ® P.O. Box 1179 A. Nicholas Krupski, Vice President Ago Southold, New York 11971 Eric Sepenoski Liz Gillooly Telephone (631) 765-1892 Fax (631) 765-6641 Elizabeth Peeples �O �CDUNV,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OFTIH ES BOARD OF D OFFTRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE AC BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction '/2 constructed When project complete, call for compliance inspection; Glenn Goldsmith,President ``�QF S®(/,� Town Hall Annex A. Nicholas Krupski,Vice President ��V� ®�® 5 Route 25 P..O.O. Box 1179 Eric.Sepenoski J l Southold, New York 11971 Liz Gillooly G Q Telephone(631) 765-1892 Elizabeth Peeples • �O Fax(631) 765-6641 C®UM°I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10794AA Date of Receipt of Application: May 20, 2025 Applicant: Andrea Spinaris SCTM#: 1000-59-6-26 - Project Location: 3175 Kenneys Road, Southold .Date of Resolution/Issuance: June 11, 2025 Date of Expiration: June 11, 2035 Reviewed by: Board of Trustees Project Description: Ten-Year Maintenance Permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed; and to trim the bamboo. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows.for the operations as indicated on the site plan prepared by Peter V. Brabazon, PLS, received on June 4, 2025, and stamped approved on June 11, 2025. § 275-5 Permit procedures: (i) Cutting of common reed (Phragmites australis) to within 12 inches of the soil surface landward of the wetland boundary. This does not include mowing to ground level. Special Conditions: No other vegetation is permitted to be cut on the property without further review. Do not disturb any native vegetation during the hand cutting of Common Reed (Phragmites australis), including but not limited to; Eastern Red Cedar (Juniperus virginiana), Northern Bayberry (Myrica pensylvanica), Marsh Elder (Iva frutescens), and Groundsel Bush (Baccharis halimfolia). Inspections: The approved operations must be commenced within three (3) years from the date of the resolution. The permittee is required to request a Trustee inspection upon completion of the initial cutting. 2 If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is of a determination from any other agency. Glenn Goldsmith, President. Board of Trustees LEGEND r7NOTES NS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, FENCE LINE EHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND/OR LENDING INSTITUTION LISTEDTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. LOT LINES 2) SURVEY INTENDED FOR TITLE PURPOSES ONLY.NOT TO BE USED AS THE BASIS OF DESIGN,CONSTRUCTION, PERMITTING,OR ANY OTHER USE. PROPERTY LINE 3) THE EXISTENCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD IF ANY,NOT SHOWN ARE NOT CERTIFIED. ROAD LINE 4) THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED.IF ANY UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS EXIST OR ARE SHOWN,THE 100 LOT NUMBER IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS CERTIFICATE. OHSW OVERHEAD SERVICE WIRE 5) PROPERTY CORNER MONUMENTS WERE NOT PLACED AS A PART OF THIS SURVEY. 6) OFFSETS SHOWN HEREON ARE FOR A SPECIFIC PURPOSE AND SHOULD NOT BE USED TO GUIDE CONSTRUCTION CONC. CONCRETE OF FENCES OR OTHER STRUCTURES. n //�� //�� A 7) BUILDING OFFSETS AND DIMENSIONS ARE TO FINISHED EXTERIOR UNLESS OTHERWISE NOTED. STORM DR/-'t I NAIJE Gf�LG: PLAT' PLATFORM 8) STREET WIDENING IF ANY,NOT SHOWN ARE NOT CERTIFIED. I. RUNOFF GOEFFIGIENTS: PAVER = 1.00 2. PROVIDE STORAGE FOR 2" RAINFALL =.161 PAVER DRAINAGE GALGULATION5: AREA OF I. PAVER (LP): PHRAGMITE5 TO BE 1&0 5F PAVING x .167 x 1 = 130.26 OF TRIMMED AND MAINTAINED. U5E (2) 6 PIA. x 4' DEEP STORM POOL = I18.6 GF PHARMITE5 TO BE 15.0' VE6ATATIVED HAND TRIMMED TO NON TURF BUFFER 12" HIGH. EX. S.C.T.M. S.C.T.M. GATTAIL5 TO BE 1000-059-05-30 1000-059-05-26 PRESERVED. ` Y o N/F GEORGE W. SMITH & SONS, C. -� S 47049'40" W 75' ± (DEED LD) 13't MEASUR MOW 0.3W WATER LINE LOCAT 01/13/20 o /MAINTAIN WOOD STOOP 3' X APPROX 18 5F o / S.C.T.M. 1000-059-05-25 ^ GRAVEL CURB DRIVEWAY I� /\ 11 GRAVEL PAT NOTE: � O EXI5TIN6 WOOD �' 39.8' PLATFORM Aso CONC. TO BE REMOVED ` GARAGE IN ITS ENTIRETY //��y o00 ci J W m 15.0' VE6ATATIVED NON TURF BUFFER � FRAME DWELLING z. o #3175 g _ O o 04 4.2 RCH O �T� W0*4 TRENG Z HOT 10't MEASURED 6�1 TUB AREA OF BAMBOO �/ s. UU CLEARING TO BE Z(g I5.0 � MAINTAINED TO 7 h 6'm� 0 O j PREVENT SPREADING sic ���� WI E FENCE o PROP05ED �OF PAVER5 ON GRADE MON MON /'HED E MON 180 5F INGLUDES F�°J O•IEO.1N S 47049' 0" 110.00, ONSW HOT TUB WITH LOGKABLE GOVER S.C.T.M. LAND CONVEYED BY GEORGE W. SMI H & SONS, INC. TO ARVA M. D'ANTONIO 1000-059-06-25.1 FUJ I T5U b F03014R55JAA c� PROPANE HEAT LOT EXGLUDED HATER LINE = 10,445.0 SF PUMP EXISTING I STORY SINGLE FAMILY HOUSE = 1,368.0 SF 4" DIA. FRONT PORCH = 40.3 SF 51?R-35 PIPE AG UNIT = 4.0 SF NP HOT TUB = F TOTAL LOT GOVERAGE = 14. % /ArrKU,*CW BOARD &-1pRbty6fi,443.0 sf = 0.140 X 100 TOWN OF SOUTHOLD i CERTIFIED TO: -FIRST AMERICAN TITLE INSURANCE COMPANY DATE 0 I� UUN 4 2025 -INTEGRITY ABSTRACT CORPORATION *0� � �4 -ANDREW SPINARIS a 1 �/ -EMBRACE HOME LOANS,INC. ® lJ Southold Town Board of Trustees — ------ -- 0 20 40 60 S.C.T.M. DISTRICT: 1000 SECTION: 59 BLOCK: 06 LOT(S): 26 SURVEY OF PROPERTY IN SOUTHOLD PETER V. BR P.O.BOX 83 BOX 483ABAZ , PLS 0� gRAO,p TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, STATE OF NEW YORK �4e EAST ISLIP,NY 11730 A, t= 0 PVBSURVEY@GMAIL.COM DESCRIBED PROPERTY (631)277-1726 L 13054 P 140 COPYRIGHT 02022 BY PETER V.BRABAZON,PLS ALL RIGHTS j RESERVED.UNAUTHORIZED ALTERATION OR ADDITION TO /\ SCALE. SURVEY DATE: SURVEY NUMBER: THIS SURVEY MAP IS A VIOLATION OF SECTION 7209, l SUB-DIVISION 2,OF THE NEW YORK STATE EDUCATION LAW. Z 1"=20' 04/18/2024 S-1000-059-06-26 ti 0510ti� `C COPIES OF THIS SURVEY MAP NOT BEARING THE LAND A BY: TITLE NUMBER SURVEYOR'S SIGNATURE,AND INKED SEAL OR EMBOSSED PB IA 2116322 SEAL SHALL NOT BE CONSIDERED A VALID TRUE COPY. S 0'LD T R T E'�'E US: . S, "OUTH . No. lo ti A : Issued 'To., A-mAre. o . ' sp-s-na'r ;s Date., 011 /15 . Address 31 �5 ke��ews . Roa�, s�u�o�a .THIS. NOTICE MUST BE DISPLAYED DURING CONSTRUCTION .TOWN TRUSTEES OFFICE JOWN OF SOUTHOLD 50UTFFOLD, N.Y. 11971 TEL.i 765.1892 Glenn Goldsmith,Pr�1ueat �A �� CO � Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 co Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �y �ol�� Southold,NY 11971 Elizabeth Peeples �¢{v Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: .y_n2�2-5 Completed in field by: �l u.�o-e�-I-In P U-bl 65 Tim Cloughen on behalf of ANDREA SPINARIS requests an Administartive Ten-Year Maintenance Permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed; trim bamboo. Located: 3175 Kenneys Road, Southold. SCTM# 1000-59-6-26 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/Modifications/Conditions/Etc.: ��'Y0.14�1�'�-bYW NAY-t71 Present Were: G. Goldsmith N. Krupski E. Sepenoski L. Gillooly ✓ E. Peeples ObZ1-Ba 1 i 1� J •� \ �_ � �+/'> >� B V 3 '#r sm.No.O51 Ti— - - - Z Do-,as ` ,.. ��b � •E��D a�"' A!� C,�. e. to O �,;��� e m �� 7��'-4 �,�� 80- �� ys)), uaaal ".a'' h e ! a Ja ,f a, q3..Q-r q A A era )�raurwu ;lTta A a�a• *,:�'� / a, a�•c@a,o.,B fi b � M1 A. •@ z m g ^°9v�,t� t a ,® � � ox zza) ,.v0 ,g O A a @ t^ a �•> A p un °,a A A s 0 as o . e NA � • � .r 1s .�1 9J t 15A � 2 ^s.t Tovw ocsoumao g _ /�k/ ,g^P pt j0 roRPa.NR �=. bQ1 GREniPoND • -� -Ab I 'Ee ox .+ nttlyixu.W •e am^o� y0 oM1 J -9 !4 a x. ^y`c 7 ��CO + 'O. .•^',�.e• A^0 'e�Y'e �_ to O l � 4.,3 COUNTY Ci (} 4 e at M1�'� 0 4`.B aiw sa. 'I', EVtvv o a s ]al zp, a ,N '� ., rLR PCE.N0. •g �`�- €" "' —c- - - - - - -cam- - - - '-" a LINE `� 9EE SEGNQ008 k iR£SEG N0— {j COUNTY OF SUFFOLK p S rwrIce N tdoa seGnaN w, — -:,p•.`�.- O �••�...� —.�— •• ,.ulr<iln Real Property Tax Service Ageney wanea�ie+ranraeuew v N �e mc .o. W osusrrtwuau cmm aT rNxNwCNRw nn ov Ne souTHow 059 (27) e..s .e VIrtI1Pn nRTBl PH0.65oN6nE p S RFALPR£90Y TRI(sHh EK81Y OFFICE LOCATION: O `;. MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) ;G • ae �' ►� ;�� Telephone:631765-1938 Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: June 10, 2025 Re: LWRP Coastal Consistency Review for ANDREA SPINARIS SCTM# 1000-59-6-26 Tim Cloughen on behalf of ANDREA SPINARIS requests an Administartive Ten-Year Maintenance Permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed; trim bamboo. Located: 3175 Kenneys Road, Southold. SCTM# 1000- 59-6-26 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is 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: Honorable Lori Hulse, Attorney PRECIS'---)N ,DES(1GN Timothy M.Cloa; __, 3 Manorview Way,'Manorville,NY 11949 631-255-7845 Southold Board of Trustees Southold Town Hall Annex 54375 Main Rd. � f E I V Southold, NY 1197 L Lull, JUN 4 2025 June 4, 2025 Southold Town Board of Trustees To whom it may concern, The owner,Andrea Spinaris, met with the Board of Trustees on June 3, 2025 regarding the required vegetative non turf buffer. During the meeting Mr. Spinaris requested that he add bamboo clearing to prevent the spread of the evasive species. The board stated that they will allow this as part of our clearing application. Attached are the revised plans showing the area of clearing for the phragmites and the bamboo. The survey also shows the as-built gravel driveway and all 44 wood tie have been removed from the waterway as witnessed by the board of trustees. ALL wood ties remaining are cedar not pressure treated. If you require further information, please contact my office at 631-255-7845 Best regards, Timothy Cloughen Precision Design and Expediting Services 631-255-7845 CC:Andrea Spinaris Hobson, Thomas From: Hobson,Thomas Sent: Tuesday, May 27,2025 10:16 AM To: 'tm.cloughen@gmail.com' Subject: 3175 Kenney's Maintenance Permit Hi Tim, I was reviewing the application for a 10-year maintenance permit for 3175 Kenney's Road, Southold. You need to submit a survey or plans highlighting the area where you are requesting to trim the phragmites. ,The area can be hand drawn,but we need something that specifies the area. Also,don't submit one that was previously stamped received or approved by the Trustees. Thomas Hobson Administrative Assistant Town of Southold Board of Trustees Phone: (631) 765-1892 Fax: (631) 765-6641 1 Town Hall Annex Glenn Goldsmith,President ` ~" 54375 Route 25 A.Nicholas Krupski,Vice President ! P.O.Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly ' Elizabeth Peeples ®, Telephone(631) 765-1892 ' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only - x Coastal Erosion Permit Application Wetland Permit Application " _ Administrative Permit Amendment/Transfer/Extension MAY 2 0 2025 Received Application: Received Fee:$ Southold Town Completed Application: Board of Trustees Incomplete: SEORA Classification: Type I Type II 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: . Resolution: - Owner(s) Legal Name of Property (as shown on Deed): Andrais Spinaris Mailing Address: P•O. Box 3112 - Farmingdale NY 11735 Phone Number: 516-220-9848 . Suffolk County Tax Map Number: 1000- 59-06-26 Property Location: 3175 Kenneys Road - Southold NY 11971 175' North of Soundview Ave (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable):Timothy Cloughen (Precision Design Expediting) Mailing Address:3 Manorview Way Manorville NY Phone Number: '631-255-7845 Email:.tm.cloughen@gmail.com •�oard of Trustees Applcat, GENERAL DATA Land Area(in square feet) 10,443 sf Area Zoning NON CONFORMING LOT- LESS THAN 20,000 SF Previous use of,property:Single Family Residence Intended use of property: Single Family Residence Covenants:and Restrictions on property? —ayes ✓�No If"Yes", please provide a copy,, Will'this project require a Building l.'ermit as pei 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 Zoriing Board of Appeals. Yes ✓ No If"Yes";please provide copy of decision. his project re any demolition as per Town Code or as determined bythe Building Dept 9 . Yes No Does the structure(s)on propertyhave a-valid Certificate of Occupancy. Yes No Prior permits/approvals for site improvements: Agency. -Date Certificate of.Occupancy 08 07-1972 hermit 4797 ❑.No prior.permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a:governmental agency?�No `Yes If yes, provide explanation Project Description(use attachments if necessary),: 10 year mamtenance permit trim phragmite son ly.. .,}oard of Trustees. Appl icat -i WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: See survey, . Area of wetlands on lot: 24. square feet Percent coverage of lot 002. .,ova Closest distance between nearest existing structure and upland edge.of wetlands: 14 78 feet Closest distance between nearest proposed structure and upland edge of wetlands: 1 4 78 ..:feet Does the project involve excavation;or filling.. 0 No Yes If yes, how much material will be excavated? N/A _ cubic yards How much material will be filled NSA cubiayards Depth of which material will be removed or deposited: NSA .feet Proposed slope throughout the area of operations: A ' Manner,in which,material will be removed or deposited: N/A 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 2.61 `::Appendix B: , Short Envirownental.9ssds toenf F_ orm` I[IStI'uct►blis fnr Completing. Part 1. Project Information. The applicant or project sponsor is responsible for the coimplition of Part l Responses become part of the application for approval or.funding,are subject to public review,and.may be subject.to further verification. Complete Part F based:on information currently available. If additionakresearch`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.Put 1 ::You may also provide any additional information whicl..you believe will be needed by.or useful to the lead agency;attach additional pages as necessary. `to supplement any item:. Part Project Iand Sponsor Information 3175 Kenneys Road Protect Name of Action or Project: Coastal permitto trlm::phragmltes Project Location(describe,and attach a location map): 3175 Kenneys Road:-.Southold 11971 T.Brid Description of ProposedActioti;. 10 year rhalntenance permit trim°`phragmites only. Name of Applicant or Sponsor Telephone :Ti rriothy Cl en E_Mau tin cloughen@gmal coin Address 3'Manorviow Way Ciry/PO State Zip Code. 7. Manorville d NY 11949 1 Does the proposed action only involve the legislative adoption ofa plan,local law,ordinance; No YES admmistrative rule;or regulation? If Yes,attach a narrative description"of the intent of the proposed action and the environmental resources that ::may be affected m the municipality and proceed to Part 2.r,if no,continue to question:.2. 2. Does the-pro posed action require a permit,approval'or funding from any otter governmental;Agency� NO; YfES If Yes list agency(s):name and permit or approval: 3.a.Total acreage ofthe site of the-Oroposed acpon? acres b Total:acreage to be physically disturbed? acres <: c Total acreage(project site.and any contiguous properties)owned Or controlled by the applicant or project sponsor? : acres 4. Che 19and us at occur on,ad�oming an ar the prop action:' Urban ..Rural(non=agriculture)...VAquat Industrial Commercial ©Residential(suburban) Forest ❑Agriculture ic ❑Other(specify) Parkland Pape 1 of 4 4.5. 15 the proposed action; NO YES ',NIA a. A permitted-use under the zoning regulations? ✓ b..Consisfent with`the adopted comprehensive plari? 6.is the proposed.action consistent with the predominant character of the existing built or natural NO YES landscape?, ✓ 7. lsthe site ofthe proposed:action:aocated in;or does it adjoin,a state listed Critical Environmental Areas 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? NQ YES:: If the proposed action will exceed requirements describe design features and technologies " ✓ 10: Will the proposed action connectto,an existing public/private.wafer supply? If No describe method for providing potable water; n L,J 11.Will the proposed action connect to existing wastewater utilities? NO IVES If No,describe method for providing wastewater treatment 12::a.Does•the site`contam a structure that is listed on either the State orNafional Register of Mistonc ' NO YES.`: Places?qT ✓ b Is the proposed action located in an archeological sensitive area? 1�.a.Does any portion ofthesite of the proposed action,or lands adjoining the proposed action,contain 'wetlands or other waterbodies regulated bya 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 ocSAg or are likely to be found on t1Mroject site. Check all that apply Shoreline Forest rcultwaYgrasslands Early mid-successional ✓ Wetland Urban uburban 1S. Does the site of the proposed'action'contain anyspecies of animal;'orassociated habitats,listed NO YES. by.the State or Federal government as threatened or endangered? . g g 16 Is the project site..:located in the 100 year flood plain? NO YES ✓ I7.'Will the proposed action c�eafe storm water discharge,either from point or`non-point sources? 'NO If Yes, a:Will storm water discharges flow to adjacent properties? ❑✓ NO ❑YES �✓ ❑ b.Will storm water discharges be directed to established conveyance systems ffan m drains) If Yes,briefly describe: �I NO �� T, Page 2 of 4 . 18:Does the proposed action include constructwn or o the ractivities'that result+n the;impoundment of NO YES water or other liquids'(e:g.,retention pond, waste lagoon,dam)? 1fYes explain purpose and size 1.9:Has the site of the proposed action or an adUoming property been tfie location.of an active or closed NO. YES solid waste management facility? If Yes describe 4. 20.'Has the site of the proposed action or an adJoi_ning property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe I AFFIRM.THAT THE INFORMATION::PROVIDED A:BOVE7S TRUE:AND ACCURATE TO THE.BEST KNOWLEDGE, Applicant/sponsor name.Al1C(fEyll.:Sp1narls Date 5gn.:ature 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 I 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 Jo large impact : impact may :. may occur. . occur 1 Will the proposed action create a material conflicf 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? 3:: Will:the proposed action impair the character or quality of the existing community? X Q 4. Will the proposed actionhave animpact'on the environmental characteristics that caused the establishment of Critical Environmental Area(CEA)? El S 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 inthe use of energy and it fails to incorporate reasonably available energy conservation_orrertewable.energy:o portuitities. 7. Will the proposed action impact existing: x a.:public/.private water supplies? b public/private wastewater treatment utiliti.es? LJ a 8: Will the proposed action impair the character or quality of important historic,archaeological, L.1j architec.tural.or.aesthetic,:resources�. ' t 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 an increase in the potential for:erosion,.flooding or drainage problems]] Will the,proposed action create a hazard to environmeritah:resources or human health`s x Part 3 Determination dt'significance. The Lead Agency is responsible for the completion of Part 3. Eor every qutsfion rn Part 2.that was answered:°°moderate to large impact.may occur",or if there is a need to explain Ay a particular element of the,proposed action may or will not result in a significant adverse.environmental impact,plea se.complete Part3. Part;3 should;in sufficient detail,identify the impact,including any measures or design elements"that:have been ineluded by the proaect 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"considermg its setting,probability of occurring; duration,irreversibility,geographic scope and magnitude. .Also consider the.potential for short-term;long-term and cumulative:iinpacts Checic`this box if you have determined;based on the information'and analysis above and any supporting documentation, hat the proposed action may result in one or.more potentially large:or significant adverse,impacts and an talmpact"statmtq :edenvironm i 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:sign adverse environmentaF impacts: Town:of Southold Hoard of Trustees. . .::....:. Name of tiead Agency Date President . .:. Print"or Type Name of Responsible Officer in Lead"Agency, Title of Responsible.Offcer tur y S re are e"of Respons ble•Officer to Lead Agencignature of Pr(if different_66in spons Signa ible"Officer) PRINT Page:4 of 4 aoard of Trustees Applicat:&'�a. AFFIDAVIT. Andrew Spinaris BEING DULY SWORN DEPOSES AND 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,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 OYTRUSTEES DURING THE TERM OF THE PERMIT. i 'r i i Signature of Pro erty Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF ----------- 2021 No 'c R&M. BF, Notary; e of 'aew York , { 0l6669 nuerii ,in Su n s + com EXpires %0— EN �ANDI Notary PU$Itc•S'P of,New York Nu..02SR5016869 Quabfi6d'in Suffolk°county Contm�ss�ori Expires 8/23/20 -Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Andrew Spinaris owners of the property identified as SCTM# 1000-59- 06 -26 _ _ _ _ in the town of Southold ,New York, hereby authorizes Timothy Cloughen (Precision Design Expediting) 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 Owner's Sig ature Property Owner's Signature SWORN TO BEFORE ME THIS ' _DAY OF A320 2� y Public ENZA M. BRANDI Notary Public- State of New York No. 02BR5016869 'Qualified in Suffolk County. Commission Expires 8/23/202�, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM a Tow .a of`' Code: f Et tc' o ibiE'co f icts a me s Fla n o ce a dem io s. he' ' s of ,t " 'form is to vide foam"'t o .vuhith c het tivn of.possible* "'nflic .a `t ttd a low:"t o.ta a whatetie rei:ess tit vaid same. YOUR NAME S inans Andrew (Last name,firstname, ptddle 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 inap'; Planning Othei (lf.`1Qther ,name the activity.) Do you personally{or through your company,spouse,sibling,parent,architd)halve n relationship with':any officer or employedE of the Town of 5outhofd) "Relationship'mcicies lty blood tnarrtage,or:busuieba interest "8stness ntterest":mesnsa 6ustness, inciudmg a partnershtp ►n which the tow,n officer or empioyce has even.a parttaf ownership of(or employment ly)a carpo(atiori in which the t(Wn officer or'employee owns more.than 5%apftl�e'shares. YES If you answered"YES V.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 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 ttie space provided: Thetown officer or.empioyee.orhis or her spouse,sibling,parent,o child.is{check all that apply) �A)the.'owner of greaterthan S6ln taftlt�shares of the`cot;iotate stock ofthe apptrvnt (when the:applteantis a cotporatltin), B)theaegal or l eneficiaf owner of any Interest in a non coiporate entity(when. e applicant is not a corporation); C)an officer,director,partner,oremployee of the;applicanf;or D)the actual applicant. DESGRIPTIQIV OF RELATIONSHIP <. Submitted this. .p day of ( ' 20 Z Signatuie -_- ^ Print Name �lndrt?W elrlarlS Fortn TS { APPLICANT/AGENT/REPRESENTATWE . TRANSACTIONAL DISCLOSURE FORM e Tow o' So old- C tle'fit is"' ro ib r o rnte a t officers. d em'10'=e . tre se f thi ornr Is toZtour einformatIon wh`ch -a het sun o .Dftst 1e Cdn ict9b iftt sl and a low't o.ta'e wh,teve actroio is ' �ssary s avaidsarnie YOUR NAME S�Inans; Andrew {Lastname,firstname,4ii'ddle initial unlessyoa are applying lithe 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 al[that apply.) Tax grievance .Building Variance Trustee Change of:Zone Coastal Erosion oval ofplat Mooring., Appr Bxemption'fiiom platoroffcial:map' " Planning Other (If"Other';,name the activity.). Do you perso#rally{or:through.youc company,spciuse,srtit4ng,parent,or eliitd)have a relat-onship with'airy officer of employee,: of the Town ofSouthold� "Relationship,..'includes try blood marriage,or ti srne�s ststerest "$t�scness i rteres ;means a husrrress, including a pr+trtershtp in which'the town offictr'or employee has ecn a partial ownership of{or employment.tiy)a corporation in which the town officer oremployee owns more than.5°oofthe_shares,. YES n NO ' n If you answered"YES';complete the balance of this form and date and sign where indicated.` Name of person employed by:fhe.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 app[opriate Iine.A)ihrough D)and/or describeinthe space provided. The town officcef or employee or his ocher spouse,sibling,parent;oi•child is(check alf that apply): �A)the owner of.greater;than 94 ofthoshares of the.corporate stock4. of lire appi►ctriat (when the applicant is a ctrtporatton), B)the legal or.beneficial owner of any interest in a non corporate entity{whet the applicant is not a corporation); C)an officer,director,partner or employee of the:applaeant;or, D)the actual applicant:. DESCRIPTIPN OF RELATIONSHIP;_. Submitted this day of j 20 Stenattfce PrmtNatne Andrew.SpinariS Fonn TS 1: Town of Southold LWRP CONSISTENCY'ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* :including Town of Southold agencies, ahall complete this:CCAF for proposed actions that are subiect to the Town of Southold Wafer&ont Consistency Review Law. This assessment is intended to supplement other information used by a Town:of Southold agency in making a detertmation of consistency. *Except'minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 1 Before answering the questions in:Section C; the preparer.of'this forth 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 wti be evaluated as to its snifieant beriefxcial.and adverse effects Ii on the coa `al area which includes ai `of Southold I own <. 3 ' If any question:in Section C on this foirnis answered "yes" or "no." then the proposed action_will affect the achievement;of the:;LWRP polic standazds and conditions coritamed in the consisi Y Y review law. Thus .each answer must.be>ex lathed tilt deta' .Irstirt both su orhn ';and non suaaortit► facts. Ifari action cannot be certified as corisistent`with the LWRP policy standards'and conditions,tt shall not be undertakEn . A copy of the LWRP` s available in the following places• online at the Town of Southold's website(southoldtown northfork:net), the.Boaid:of Trustees Office,the Plaming.Department, all The libraries and the:Town Clerk's`office: B DESCRIP'TION OF SITE AND PROP05ED ACTION SCTM#59066. PROJECT NAME 31: Kennet's Road Proiect S�� nC— r The Application has been submitted to (check appropriate response)i 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(eg.grant,loan,subsidy) (c) : Permit,approval,license,certification Nature and'extent of action. Location of action. 3175 Kenneys Road`_- Southold NY 91971 site-acre e, Present land use; Residential single family use PresentzonuigclassificationNON CONFORMING LOT LESS THAN 20,00.0 SF 777* 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 ap l�Gant ,Timothy Clo pg.hen (h) Mailing address: 3 Manorview'Way Manorville NY,11049 (c) Telephone number:` 631;=255-7845 Will the action be directly undertaken;require funding,or approval by a state or federal agency? nn If yes, which state.or federal agency? C. ;Evaluate the project to the following policies by analyzing how the project wdl 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 Poliicy 1. rostera pattern of development m 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 ad. effects of development See LWRP Section 1II' Policies; Page.2 for evaluation criteria. ❑Yes '�.No Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of he Town `of Southold:'See MRP Section III Policies'Pages 3 through 6 for evaluation criteria FT Yes ❑ No❑✓ Not Applicable 77 Attach additional sheets ifnecess arY: .. 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.: N Yes o ✓ Not App ca lible ❑ . ❑ Attach additional s.sets if necessary NATURAL COAST:.P®LIMES 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 77 Attach additionaf sheets if necessary; Policy 5. Protect and improve water quality and supply in the Town of 56uthold.'See LWRP Section:III -Policies Pages 16 through 21 forevaluation criteria Yes'❑:NO4,r ONot.Applicable Attac ad ihona s eets 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 Sect ion'III-Policies;Pages 22 through 32 for evaluation criteria. _ 10 ;Not Applicable ❑ Ye s ❑ ❑ Attach additional sheets. mcessary Policy 7. Protect and improve :air quality in the Town of Southold. See.LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. No� N cl . .Yes pplibeAE] .:6 6Attach additional sheets if neces9 6sary Policy 8.' Minimize°environmental degradation in Town of Southold from solid waste and .hazardous substances and wastes;; See LWRP Section III—Policies; Pages 34 th:rough'38.for evaluation;criteria. Q l� abeUe s '. oppc 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.,. . 0 'Y . e No Not Applicable Attach additional sehets 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. ❑YeFJNQ. :Z Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Pecomc Estuary and Town waters.See LWRP Section III Policies; Pages 57 through'62 for evaluation criteria. Yes 0. No 0 Not Applicable 77 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. Yes :❑ No Z. Not Applicable At 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. :0 Yes ;0 No❑✓ Not Applicable PREPARED BY Timothy Cloughen TITLE Agent DATE