HomeMy WebLinkAboutTR-10812A Town Hall Annex
�Z� $o��st�® 54375 Route 25
Glenn Goldsmith, President p p Box 1179
Vice President �®
A. -Nicholas Southold, New York 11971
Eric Sepenoski Telephone (631) 765-1892
Liz Gillooly
• a0 Fax (631) 765.6641
Elizabeth Peeples
�P/IUNTi,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SOUTHOLD TOWN BOARD OF TRUSTEES
YOU ARE R EQUIRED TO CONTACT THE OFFICE OF THE ES RD OF TRUSTEES OFF
72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVIT
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;
t
Glenn Goldsmith, President ®� S®��� Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President ®� ®�®
P.O. Box 1179
Eric Sepenoski J Southold,New York 11971
Liz Gillooly G Telephone(631) 765-1892
Elizabeth Peeples • y0 Fax(631) 765-6641
®lyC®U ,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 10812A
Date of Receipt of Application: June 13, 2025
Applicant: High House Woods Inc.
SCTM#: 1000-86-7-7.1
Project Location: 7134 Indian Neck Lane, Peconic
Date of Resolution/Issuance: July 16, 2025
Date of Expiration: July 16, 2028
Reviewed by: Board of Trustees
Project Description: Install two (2) HVAC units beside east wall of dwelling.
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 High House Woods Inc., received on June 13, 2025, and
stamped approved on July 16, 2025.
Special Conditions: None.
Inspections: Final Inspection.
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 not a determination from any other agency.
4"*- 494,ty -
Glenn Goldsmith, President
Board of Trustees
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SUFFOLK COUNTY. NFW YORK yP� ososa2 y¢'t Laud Surroy6q and Dr alga
P.D. Box S. Natlutuck.Now York. 11962
FILE y 12-33 5CALE:1-46 DAZE:FEB. 1. 2012 PSM(ASS)2M-100 IAS(031)208-IND
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THIS. NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD, N.Y. 11971
TEL.: 765-1892
Glenn Goldsmith,Pre)— t C19, Town Hall Annex
A.Nicholas Krupski,Vice President o < 54375 Route 25
Eric Sepenoski ? P.O.Box 1179
Liz Gillooly A
,NY 11971
Elizabeth Peeples oy�Cl �a� Telephone 631 765 1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Timejoly 15, Uo S Completed infield by: ai2,a.6-r,4 Ey4leS
HIGH HOUSE WOODS INC. requests an Administrative Permit to install two (2) HVAC
units beside east wall of dwelling. Located: 7134 Indian Neck Lane, Peconic. SCTM#
1000-86-7-7.1
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/Modifications/Conditions/Etc.:
�}rai,i aln�-Fo Y w�,►-�
Present Were: G. Goldsmith N. Kr ski E. Sepenoski
L. Gillooly 7E. Peeples
S.C.T.M. N0. DISTRICT: 1000 SECTION: 86 BLOCK: 7 LOT(S): 7.1
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THE WATER SUPPLY,IIELIS AND CESSPOOL
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AREA:194,303 SQ,FT, or 4.46 ACRES ELEVA77 DATUM: NAVDBB
UNAUTHORIZED ALTERATILW OR ADDITION 70 TITIS SURIEY IS A WOLA71ON OF SECTION 7209 OF THE NEW YORK STATE EDUCARON LAW. COPIES OF THIS SURVEY
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LAND SURVEYORS EMBOSSED SE11.SHALL NOT BE CONSIDERED TO BE A VAUD 7RVE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO TINE PERSON FOR ONOM THE SURVEY IS PREPARED AND ON I BO _TO THE TITLE CGIPANY,GOVERNMENTAL AGENCY AND LENDING INSRRIRON
LISIED HEREON,AND 70 THE ASSONE£S OF THE LENDING INSRTI/TION,GUARANTEES ARE NOT TIRANSIM&E,
TILE OFFSEIS OR DIMENSIONS SHOW HEREON FROM 7IE PROPERTY LINES ID THE SRwuG7URES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE TIIEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FEN=ADDITIONAL SMCRIRES OR AND OFIER IMPROVEMENTS EASEMENTS
AND/OR SUBSURFACE SRRU=RES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY ENDENT ON TIE PREM/SFS AT THE TIME OF SURVEY
SURVEY On DESCRIBED of NEW CERTIFIED TO: WENDY PRELLWITZ:
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SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DECLARATION Recorded: 01/30/2025
Number of Pages : 10 At: 09:34:38 AM
Receipt Number : 25-0014224
LIBER: D00013282
PAGE : 141
District: Section: Block: Lot:
1000 086.00 07 . 00 007 . 001
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $50. 00 NO Handling $20 .00 NO
COE `$5. 00 NO NYS SRCHG $15. 00 NO
TP-584 $0 . 00 NO Notation
$0 .00 NO
Cert.Copies $6.50 NO RPT $200. 00 NO
Fees Paid $296.50
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
VINCENT PULEO
County- Clerk, Suffolk County
0
Sa\aOVENANTS
.��e aQ -
' THIS DECLARATION made this day of Gb ,2025,by High House
Woods,Inc.,whose mailing address is 3 '/2 Wendell Street,Cambridge,MA 02138,hereinafter referred to as
"DECLARANT": P
WITNESSETH:
WHEREAS,DECLARANT is the owner of certain real property located at 7134 Indian Neck Lane,
Peconic, Town of Southold, County of Suffolk, State of New York,described in the Suffolk County Tax Map as
District 1000, Section 86,Block 7,Lot 7.1,which is more particularly bounded and described as set forth in
Schedule"A" annexed hereto, hereinafter referred to as the Property; and
WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the
Town of Southold(hereinafter the"Trustees")pursuant to Chapter 275 of the Town Code of the Town of
Southold or its successor, and various activities conducted upon the property may thus be subject to the
regulation and approval of the Trustees prior to being conducted; and
WHEREAS,the DECLARANT therefore made application to the Trustees for a permit pursuant to the
Wetlands Law of the Town of Southold to undertake certain regulated activities;and
WHEREAS,on June 12,2024,the Trustees approved the application and issued a permit with terms and
conditions;and
WHEREAS,the issued pemut,'terms and conditions of the permit,as well as the project plan prepared by
En-Consultants,last dated June 22,2024,and stamped approved on June 28,2024,upon which the permit is based,
are filed in the office of the Town of Southold Board of Trustees as Permit No. 10590,and annexed hereto as
Schedule`B;'and
REAS, as a condition of the granting of a Wetlands'Permit to undertake such regulated activities,
the Trustees required that the existing wooded/natural areas situated between the dwelling/studio and top of
b
bank,and a 12'wide area landward of the bulkhead,be'established and perpetually maintained as naturally '
vegetated"non-turf buffer"areas,as depicted on the project plan prepared by En-Consultants,last dated June 22,
2024,and stamped approved on June 28,2024;and j
WHEREAS,the DECLARANT has considered the foregoing and have determined that the same will be
in the best interests of the DECLARANT and subsequent owners of the Property.
}
NOW,THEREFORE,the DECLARANT does hereby covenant and agree as follows:
1) Upon the substantial completion of the aforementioned permitted activities, the existing
wooded/natural areas situated between the dwelling/studio.and top of bank, and a 12,
wide area landward of the bulkhead, as depicted on the project plan prepared by En-
Consultants,last dated June 22,2024,and stamped approved on June 28, 2024,shall be established
and perpetually maintained as naturally vegetated"non-turf buffer"areas,as defined by Chapter
275 of the Town Code;
1
2) The DECLARANT shall at all times comply with the Terms and Conditions of the permit,a copy
of which is filed in the office of the Town of Southold Board of Trustees,and attached hereto as
!
Schedule`B."
3) These covenants shall run with the land and shall be binding on the DECLARANT,their heirs,
assigns,purchasers,or successors in interest and may be modified only upon resolution of the
Board of Trustees.
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OFFICE LOCATION: MAILING ADDRESS:
Town Hall Annex P.O.Box 1179
54375 State Route 25 > ; Southold,NY 11971
(cor.Main Rd. &Youngs Ave.)
Southold, NY 11971 r �p Telephone:631 765-1938
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
To: Glenn Goldsmith, President
Town of Southold Board of Trustees
From: Mark Terry, AICP
LWRP Coordinator
Date: July 11, 2025
Re: LWRP Coastal Consistency Review for HIGH HOUSE WOODS INC.
SCTM# 1000-86-7-7.1
HIGH HOUSE WOODS INC. requests an Administrative Permit to install two (2) HVAC units beside east wall
of dwelling. Located: 7134 Indian Neck Lane, Peconic. SCTM# 1000-86-7-7.1
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of
Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based
upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as
well as the records available to me, it is my recommendation that the action is 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
Presid; ' . Sol�� --. . Town Hall Annex
Glenn Goldsmith, ��
A.Nicholas Krupski,Vice PrC,__,`-nt 4:� �-
54375 Route 25
P.O.Box 1179
Eric 5epenoski Southold,New York 11971
Liz Gillooly i 1 Telephone(631) 765-1892
Elizabeth Peeples ` �►
_ � . Fax(631) 765-6641
oil '
BOARD OF TOWN-TRUSTEES
TOWN OF SOUTHOLD
This Section For Office Use Only �v G
DEuEIVE
Coastal Erosion Permit Application
Wetland Permit Application
k Administrative Permit JUN 1 3 2025
Amendment/Transfer/Extensio /
_Received Application: I I f soutno►d_foft
?t Received Fee: $ a�-60 Board of Trustees
Completed Application:
Incomplete:
SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
Lead Agency Determination Date:
Coordination:(date sent):
LWRP Consistency Assessment Form Sent: �3 as
CAC Referral Sent:— ��
Date of Inspection: 'r 1"11'_MS
Receipt of CAC Report:_
_ Technical Review:
Public Hearing Held�67��
Resolution:
Owner(s)Legal Name of Property (as shown on Deed): High House Woods Inc,_Wendy Prellwitz
Mailing Address: 3 1/2 Wendell St, Cambridge, MA 02138
Phone Number: 617 448-3605
Suffolk County Tax Map Number: 1000- 86,473889.-7-7.1
Property Location: 7134 Indian Neck Lane, Peconic, NY 11958
(If necessary,provide LILCO Pole#, distance to cross streets, and location)
AGENT(If applicable):Wendy Prellwitz, owner
Mailing Address:local: Box 75, Peconic, NY 11958
Phone Number: 617 448-3605 Email:wendyprellwitz@gmail.com _
yard of Trustees Applicat.,
GENERAL DATA
Land Area(in square feet): 194,303 _
Area Zoning: residential
Previous use of property: residential
Intended use of property: no change, residential
Covenants and Restrictions on property? ✓ Yes No r
If"Yes", please provide a copy. 0✓l fi I �1h l It��Y'P �-F(�Gt41�
Will this project require a Building Permit as per Town Code? AYes J�J_No
If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review
and Elevation Plans will be required.
Does this project require a variance from the Zoning Board of Appeals? Yes _21_No
If"Yes", please provide copy of decision.
is project recp=q- 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
Y1 • (II1510v1 �
Prior permits/approvals for site improvements: ,9 betloJep
Agency Date
Town of Southold, Bukhead repVVXr1Vh 2024
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?_a Nog Yes
If yes, provide explanation:
Project Description(use attachments if necessary):
,,card of Trustees Applicat
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: two split system HVAC exterior units
Area of wetlands on lot: app 12,000 square feet
Percent coverage of lot: app 6% %
Closest distance between nearest existing structure and upland edge of wetlands: 50 feet
Closest distance between nearest proposed structure and upland edge of wetlands: 50 feet
Does the project involve excavation or filling? No EJ Yes
If yes,how much material will be excavated? WA cubic yards
How much material will be filled? OA cubic yards
Depth of which material will be removed or deposited: feet
Proposed slope throughout the area of operations: UA
Manner in which material will be removed or deposited: NA
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):
no effect
61 Z20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part l based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item.
Part 1 -Project and Sponsor Information
Name of Action or Project:
two HVAC units sitting on blocks '�'(��.L ILI 0T5;
Project Location(describe,and attach a location map):
next to east side of house, on grade
Brief Description of Proposed Action:
two HVAC split system units, 13 x 37 x 35"h each, set on blocks and 17 1/2" x 38" thin plast�G
Name of Applicant or Sponsor: Telephone:617 448-3605
Wendy Prellwitz E-Mail:wendyprellwitz@gmail.com
Address:
3 1/2 Wendell St local: Box 75, Peconic, NY 11958
City/PO: State: Zip Code:
Cambridge MA 02138
1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES
If Yes, list agency(s)name and permit or approval: Fv] ❑
3.a.Total acreage of the site of the proposed action? 4.46 acres
b.Total acreage to be physically disturbed? nogg acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 4.46 acres
4. Che 11 land us at occur on,adjoining an ar the prop action.
Urban Rural(non-agriculture) Industrial Commercial Residential(suburban)
✓ Forest [:]Agriculture ✓Aquatic QOther(specify):
Parkland
Page 1 of 4
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations? ✓
fJ
b.Consistent with the adopted comprehensive plan? IVI FT
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: R] ❑
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? v, El
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method forproviding potable water: Z ❑
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: ❑
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? ✓
b. is the proposed action located in an archeological sensitive area?
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency? ✓
b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody?
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: _
14.gWetland
ntify the typic bitat types that oc n,or are likely to be found on t"roject site. Check all that apply:
Shoreline Forest Agricultural/grasslands Early mid-successional
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? ✓
16.Is the project site located in the 100 year flood plain? NO YES
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO lu
1f Yes, a ❑
a. Will storm water discharges flow to adjacent properties? ✓❑NO DYES
b. Will storm water discharges be directed to established conveyance systemsg
anm drains)?
If Yes,briefly describe: pff O ES
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e,g.retention pond,waste lagoon, dam)?
If Yes,explain purpose and size: ❑ ❑
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: P-1 ❑
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe: ❑
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name:Wendy Prellwitz _ Date6 June 2025
Signature:
Part 2-Impact Assessment. The Lead Agency is responsible forthe 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 sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?"
No,or Moderate
small to large
impact impact
may may
occur occur
I. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑
regulations?
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? El El
4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ ❑
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or El El
existing infrastructure for mass transit, biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities? El E
7. Will the proposed action impact existing:
a. public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological, ❑
architectural or aesthetic resources? EL
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ a
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑
problems?
11. Will the proposed action create a hazard to environmental resources or human health? 0
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and
cumulative impacts.
Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
EICheck this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Town of Southold-Board of Trustees
Name of Lead Agency Date
President
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of 4
�.,s,�ard of Trustees Applicat� i
AFFIDAVIT
Wendy Prellwitz BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE,
DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT
ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION
AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES.
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE
BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES
AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF
GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE
TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE
CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, .
INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF
TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
t �
4ATO lug
i nature Pr perty Owner ignature Pr kpe Owner
SWORN TO BEFORE ME THIS---11�==--DAY OF , 20_
J .
otar ublic
=My
L DA SILVJA&I�S
PUBLICwealth ofhusillon
29,
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 nronosed' action will be evaluated as to its .significant
beneficial and adverse effects upon the coastal area(which,includes all of Southold Town).
3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, each. answer must be explained in details_IistinP both supporting and non-
supporting 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.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 1000-86, Z_7-7.1
PROJECT NAME Prellwitz HVAC units
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) Permit,approval,license,certification: ❑
Nature and extent of action:
2 HVAC units installed beside existing house
Location of action: Peconic, NY
Site acreage: 4.46
Present land use: residential
Present zoning classification:residential
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: Wendy Prellwitz
(b) Mailing address: 3 1/2 Wendell St, Cambridge, MA 02138
local: Box 75, Peconic NY 11958
(c) Telephone number: 617-448-3605
Will the action be directly undertaken,require funding,or approval by a state or federal agency?
Yes ❑ No 0 If yes,which state or federal agency? _
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and
minimizes adverse effects of development. See LNV" Section III—Policies; Page 2 for evaluation
criteria.
❑Yes ❑ No ❑ Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LNM Section III—Policies Pages 3 through 6 for evaluation criteria
❑ Yes ❑ No 0 Not Applicable
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
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
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 I'' INot Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22
through 32 for evaluation criteria.
❑ Yes ❑No 0 Not Applicable
l
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
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 evaluatiop criteria.
❑Yes ❑ No ❑Not Applicable
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation
criteria.
❑ YeLl No 0 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 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 0 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.
❑Yes ❑ No 0 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 ❑ No 0 Not Applicable
PREPARED BY Wendy Prellwitz TITLE Owner DATE 6 June 2025