HomeMy WebLinkAboutTR-6199 James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr~
Town Hail Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0421C
Date April 27, 2009
THIS CERTIFIES that the enclosure of the existing patio and conversion of the existing
garage into living space
At 345 Meadow Beach Lane, Mattituck
Suffolk County Tax Map #115-5-4&5
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 8/17/05 pursuant to which Trustees Wetland Permit #6199 Dated 9/21/05 was
issued and conforms to all of the requirements and conditions of the applicable provisions
of law. The project for which this certificate is being
issued is for the enclosure of the existing patio and conversion of the existing garage into living
space.
The certificate is issued to OTTO FERCHAU owners of the
aforesaid property.
Authorized Signature
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line
1st day of construction
½ constructed
~'x Project complete, compliance inspection,
Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
DATE: ...s.e.~ ~... 2.]:.~... ~,p05
ISSUED TO ........ o. ~.o..~c...~...g. ........................................................................................
nt'lt ri ati n
Pursuant ~o ~he provi~ion~ of Chapfer 615 of ~e ~ws of
the Sfe~ of New Yor~, 1893, ~nd ~pter
Stale of New Yore 19~2: and the So.hold To~n OrdinanCe eh-
filled ."~U~TIN~ AND .~E.P~OIN~ OF OBSTRUO~NS
IN AND ON TOWN WATERS AND PUBLIO ~NDS
RE~OVAL OF SAND, GRAVEL. OR OTHER ~ATERIA~OM
~NDS .UNDER TOWN WA~RS:~. and in aCc~an~ with 'the
ResoJ~ion of ~e Board adopted at a meetlng held on ~.~.~..:..,,~,~..~ ....
. 2~g~.., and in consideration of the sum of $..~.~.~.~ ...... paid by
0~o
.............................................................. ~.......~ ................................................................... : ........... : .........
of ........... ~.~ ............................................ N. Y. and subject
Terms and ~ndifions llsied on the revere slde hereof,
of ~uthold Town' Tr~ees aufhorlzes and permi~ the following:
~nB~Z~n~ ne~ ~n~o~8 ~nd 8 ne~ ~oo~, and ~ ~8 depicted on
~e s~vey p~egs~ed by S~nZey 3. Z~sksen, 3~. dbmed ~/28/05.-
all in accordance wHh the detai~d sp~icatlons as pre. riled
. ~e ~glnafin9 appendix.
IN WITN~S WHEEl, ~e sald Board Of Tmdees ~re-
by ~u~, its ~r~raf~ S~aJ ia be a~xed, and ~e~ ~esen~
be ,u~ed by ~'mal~ of fha sa~d ~rd .as of thls date.
Alb&rt Krupski, Jr.
TERMS ~nd CONDITIONS
~ [~rm~ttee Otto Fercha,u
t~mt. 345 Meadow Beach Lane, Mattituck
, ,, .., ,~, N. Y~ 'Is
5. Tl~t (bLs p~rm;t should be ~ inde~u~tdy, ot as lon~ as the s~J Petagttee ~
to ~ tim sm~cmce o~ pcoject ~nvoived, to pm~dde e~id~ce eo ~nyone eoncemed .I,,~ emh-
4. T~t the wod~ involved ~ be sub, eot to d~e i ..,,~ec~n and a~pto~l ~ ~e ~ et
l~ ~ems, and no~coa~U_-,,,~_ wkb ~e pto~Ls~ons of the ~ tppHc~doa, n~y be c. use for
tevocatlon ofd~s Petmk by tesolu(~on of the s~b~ Board.
5. ~ there will be no unte~so~le interference w~b mv/g~c~ a~ a result of d~e wo~c
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
September 21,2005
BOARD OFTOWNTRUSTEES
TOWN OFSOUTHOLD
Mr. Otto Ferchau
70 Peter Lane
New Hyde Park, NY 11040
RE: 345 MEADOW BEACH LANE, MATTITUCK
SCTM#115-5-4&5
Dear Mr. Ferchau:
The Board of Town Trustees took the following action during its regular meeting held on
Wed., September 21,2005 regarding the above matter:
WHEREAS, OTTO FERCHAU applied to the Southold Town Trustees for a permit
under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance
of the Town of Southold, application dated August 17, 2005 and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council for their findings and recommendations, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on September 21, 2005, at which time all interested persons were given an
opportunity to be heard, and,
WHEREAS, the Board members have personally viewed and are familiar with the
premises in question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 97 of the
Southold Town Code,
2
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of OTTO FERCHAU to
enclose the existing patio and to convert the existing garage into living space by
removing the door and installing new windows and a new floor, and all as depicted on
the survey prepared by Stanley J. Isaksen, Jr. dated January 28, 2005.
Permit to construct and complete project will expire two years from the date the permit
is signed. Fees must be paid, if applicable, and permit issued within six months of the
date of this notification.
Inspections are required at a fee of $50.00 per inspection. (See attached schedule.)
Fees: $50.00
Very truly yours,
Albert J. Krupski, Jr., President
Board of Trustees
AJK/Ims
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, NewYork 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Please be advised that your application dated
reviewed by this Board at the regular meeting of
following action was taken:
has been
and the
/-
( '")Application Approved (see below)
( )Application Denied (see below)
( )Application Tabled (see below)
If your application is approved as noted above, a permit fee is now due. Make check or
money order payable to the Southold Town Trustees. The fee is computed below
according to the schedule of rates as set forth in the instruction sheet.
The following fee must be paid within 90 days or re-application fees will be necessary.
COMPUTATION OF PERMIT FEES:
TOTAL FEES DUE:
SIGNED:
PRESIDENT, BOARD OF TRUSTEES
Telephone
(631) 765-1892
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Wed.,
September 14, 2005, the following recommendation was made:
Moved by Tom Schlichter, seconded by Jack McGreevy, it was
RESOVLED to recommend to the Southold Town Board of Trustees APPROVAL of the
Wetland Permit application of OTTO FERCHAU to enclose the existing patio and to
convert the existing garage into living space by removing the door and installing new
windows and a new floor.
Located: 345 Meadow Lane, Mattituck. SCTM#115-5-4&5
Vote of Council: Ayes: All
Motion Carried
COUNTY OF SUFFOLK SOUTHOLD
S 83'22'JO"E;ir,
200.00'
TM 1000 J15-05-04
AREA=20,O00 SF
FILE MAP LOT #39
N 85'22'10"W
S 85'22'10"E ..'
200.00'
TM 1000-115-05-05
AREA=20,O00 S F.
FILE MAP LOT #40
N 83'22'?0"W
200.00'
LOT .36
200.00'
N/F MATIITUCK
ESTAT£S,
LOTS 59 5- 4CI
MAP OF SUBDIVISON FOR
MA'FI-ITUCK ESTATES, /NC.
SITUATE
MA-i-FITUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR: OTTO FERCHAU
KARL FERCHAU
TM# AS SHOWN
SURVEYED ~Y
STANLEY J ISAKSEN, JR
P O E~OX 294
NEW S~jFFOLX lq ~ 11956
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone(631) 765-1892
Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
__~,~eastal Erosion Permit Application
tland Permit Application
Amendment/Transfer/Extension
-~I~ece~vved Application:
~-Received Fee:$ c~"
~--C-olnpleted AppliCation _~ [! Q/OW
__Incomplete
__SEQRA Classification:
Type I Type II Unlisted
__Coordination:(date sent).
LWRP Consistency Assessment Form
~,AC Referral Sent: ~ll
~_~ate of Inspection: q [!
~Receipt ofCAC Repo~:""
__Lead Agency Determination:__
Technical Review:
--,.-~fublic Hearing Held:~
Resolution:
Administrative Permit
$outhold Town
Board of,Trustees
Name of Applicant c~ "F 7'0 fr.~ r~e t4,0 o
Phone
SuffolkCountyTaxMapNumber: 1000- t / ff r~,k o..4¢ ~ - ,,,ta a ~ 7y - ~ c;{
PropertyLocation: 2~ q,.¢ P1,,~,¢ 90~,
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
of Trustees Applicati
GENERAL DATA
Land Area (in square feet): iLoo t 2-o~
Area Zoning:
Previous use of property:
Intended use of property:
Prior permits/appr?_als for site improvements:
Agency
Date
__ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
y No Yes
If yes, provide explanation:
Project Description (use attachments if necessary): g~, ~ /~-~ -
~d of Trustees Applicati~
WETLAND/TRUSTEE LANDS APPLICATION DATA
purpose o~thepr°p°sed operations:. ~ ~ ~ ~
~rea of wetlands on lot: ~_~ /,-~ square feet
Percent coverage of lot:_ Or I I o/o %
Closest d/stance between nearest existing structure and upland
edge of wetlands: _,/0 feet
Closest distance between nearest proposed structure and upland
edge of wetlands:__ t~t> feet
Does the project involve excavation or filling?
~ No Yes
If yes, how much material will be excavated? '--' cubic yards
How much material will be filled? ~ cubic yards
Depth of which material will be removed or deposited: ,-~ feet
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
0
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):
PROJECT ID NUMBER
617.20
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor)
1 APPLICANT/SPONSOR 2. PROJECT NAME
3.PROJECT LOCATION:
Municipality ~1~'~"~'1~'OC-I~- County 3' ~/FO L ~
4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc - or provide map
SEQR
5. IS PROPOSED ACTION: ~"] New [] Expansion [~todification/alteration
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
[~Yes [] No ~f no, descdbe briefly:
9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
![~Residential E~lndustrial r--]Commercial r~Agriculture E~Park/Forest/OpenSpace E]Other (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
I AGENCY (Federal, State or Local)
' E~Yes~[~No If yes, list agency name and permit / approval:
11 DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? E~Yes [~No If yes. list agency name and permit / approvak
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
E~]Yes E~No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant / Sponsor Name Date:
Signature
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
PART II - IMPACT ASSESSMENT Tobecom leted b Lead A eec
,. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 tf ye%, coo~dirtate the review process and use the FULL EAF.
[]]Yes
S. WILL ACTION RECEIVE COE)RO~NATEO REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 ~f No, a negative
O. CO'~'~LD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED W[~H THE FOLLOWING: (Answers may be handwritten, if legible)
Ct. Existing air quality, sun'ace er groundwater quality or quantity, noise le~els, e×isEng tr~c pattern, solid waste production or disposal,
potential for erosion, drain, age or flooding problems? Explain briefly:
C2. Aesthetic, agricultural, archaeological, hi's{ori~, or eihe~ natural 0r 'cultural 'reSource's;' or community or neighborhood character? Explain briefly:
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain b~efiy:
m [ys gp g s s ye Dp o a a g nas nntens y f see (andorohe naura resources Expla~nbrlefly
C5. Growth, subsequent ...... dove opmen i or re a ed acfiv' t""'es likely' ........ to be 'Induced by the proposed act,on' , Explain' briefly:
C~ Long term, short term, cumulafive, or other effects not identified in
C7. oth. e.[ impa~ts innuding cha~.~~ in use o~ eit.~e..[ ~u~nti~ o[ ~Tpe of ener~ ~2J~i~ ?~flz~
D. WiLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHA~CTERfSTICS THAT CAUSED THE ESTABLISHMENT OF A CRiTICaL
ENVIRONMENTAL AREA (CEA)? ~lf yes, ex~lain brie~: ,,
E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? if yes explain:
PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS; F~reachad~ersee~ectiden~ifiedab~ve~determ~n~whet~erit~~s~bstantia~~Iarge~imp~rtant~r~therwisesigni~cant~ Each
effect should be assessed in connection with its (a} setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility;
geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all teleran[ adverse impacts have been identified and adequa[ety addressed. If question d of part ii was checked
yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
C hock this box if you ha ye identified one or more potentially large or sJgni~cant adverse impacts which MAY occur. Then proceed directly to the F U LI
EAP and/or prepare a positive declaration.
Check this box if you have deterrnided, based on the information and analysis above and any supporting documentation, that the proposed actio~
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necesss~, the reasons supporting thi
determination.
Name of Lead Agency
Tgle of Responsible Officer
Print or Type Name of Responsibie Officer in t.ea~J Agency
Signature of Responsible Officer in Le~d Agency Signature of Preparer (If different from responsible officer)
Board of Trustees Application
County of Suffolk
State of New York
,-c t a o BEPSG DULY SWO
DEPOSES ~ ~FI~S THAT ~/S~ IS T~ ~PLIC~T FOR T~ ~O~
DESC~BED PE~T(S) ~ T~T ~L STATE~NTS CONTenD ~ ~
TRUE TO T~ BEST OF ~S~R ~OWLEDGE ~ BEL~F, ~ T~T ~L WO~
WILL BE DO~ ~ T~ ~R SET FORTH ~ T~S ~PLICATION A~ AS MAY
BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSTEES. ~ ~PLIC~T
AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSTEES
~ESS ~ F~E FROM ~Y ~ ~L DAMAGES ~ CL~S ~S~G
~DER OR BY VIRT~ OF S~ PERMIT(S)~ IF G~TED. IN CO~LET~G THIS
APPLICATION, I ~BY AUTHO~E T~ ~US~ES, T~IR AGENT(S) OR
~P~SENTATI~S(S), TO EN~R ONTO MY PROPERTY TO ~SPECT T~
P~SES ~ CON~CTION ~TH ~W OF THIS ~PLICATION.
SWORN TO BEFORE ME THIS I ~ DAY
Notary Public
THOMAS C. SIEGMANN, JR,
NOTARY PUBLIC, State of New York
Ne. 01SI5012884
Qualified in Nassag Coun~
Commission Expires ~-15'° ~
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliweda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, NewYork11971-0959
Telephone (631) 765-1892
Fax(631) 765-,1,~(~0q]
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application of
COU~NTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTiNG
I, ~ /~,-~..,-~ , residing at
being duly ~;ose ~d say: '~'
That on thc day of ,200 , I personally posted the propc~y ~own as
by placing thc Bo~d of Trustees official poster where it c~ easily be seen, ~that I have
checked to bc sure thc poster has remained in place for eight days prior to thc date of the public
hearing. Date of hc~ing noted thereon to be held
Dated:
Sworn to before me this
I ~day
Notary Public
N THOMAS O. SlEOMANN, JR.
OTARY PUBLIC State of NewYo~
No. 01S 5012884
Qualified In Nassau Cou,.~t~_
Con~isslon F.~r~ _~.,, -4~-or,' _
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: Address:
Return ReCeipt Fee Here
~fl~d De ve~ Fee
z.6 m/0s
~~ii~!~i~~s~ti~i~ent~ 2-- ~ ~ t :tuly sworn, deposes and says that on the
~~: __ ~',~:t old; that said Notices were mailed at the.Ufiit6d States Post
sase ~a~c.~R~/iC.[$ 2 30 , that smd Notices were mailed to each of said persons by
5,34
Subtotal 5.34
lotal
20,34
Cash
Chenge Due 15.00
Cash
Number of Items Sold: 2
lhank You
Please come again!
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics emhibits conflicts of interest on the oart of town officers and emnlovees. The ~uruose of
this form is to provide information which can alert the town of~ossible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME:
(Last name, flint n~me, raiddle 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.)
, TI ·
NAME OF APPLIC. ON. (Check all that apply.)
Tax grievance
Variance
Change of Zone
Approval of plat
Exemption from plat or official map
Trustee
Coastal Erosion
Mooring
Planning
Other
(lf "Other", name the activity.)
Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee
of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business,
including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation
in which the town officer or employee owns more than 5% oftbe shares.
YES NO 'X~
If you answered "YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title Or position of that person
Describe the relationship between youmelf (the applicant/agent/representative) and the town officer or employee. Either check
the appropriate line A) through D) and/or describe in the space provided.
The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply):
A) the owner of greater than 5% oftbe shams of the corporate stock of the applicant
(when the applicant is a corporation);
B) the legal or ~neficial owner of any interest in a non-corporate entity (when the
applicant is not a corporation);
__.C) an officer, director, partner, or employee of the applicant; or
__.D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
Form TS 1
Submitted this ~day of ~ ,.4~' 200-5~'~
Signature t~i,[ fl x~,./ [ --
PrintName _ .g~, t0 ..~?Rahl~.'t/
Town of Southold
A. INSTRUCTIONS
1.
LWRP CONSISTENCY ASSESSMENT
All applicants for permits* including Town of Southold age~
proposed actions that are subject to the Town of Southold Waterf
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.
Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of Southold Town).
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 detail, listine both suooortine and non-
suooorfin~ 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
PRO'CT N~
The Application has been submi~ed to (check appropriate response):
own.o r
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:
Location of action:
Site acreage:
Present land use:
Present zoning classification: r(~
If ~ application for ~e proposed action has been filed wi~ ~e Tom of Sou~old agency, ~e following
i~o~ation sh~l be provided:
(a) N~e ofapplic~t: ~ TT~
(b) M~ling address: ~ o
Will ~e action be directly ~de~en, req~re ~d~g, or approv~ by a state or feder~ agency?
Yes ~ No ~ If yes, w~ch state or federfl agency?
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation
criteria.
~-~Yes ~] No ~] Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LVOIP Section III - Policies Pages 3 through 6 for evaluation criteria
~] Yes [] No ~ 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 Sonthold. See LWRP Section III
- Policies Pages 16 through 21 for evaluation criteria
[] Yes [] No ~NotApplieable
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 ~le
Attach additional sheets if necessary
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 evaluation criteria.
[~ Yes [] No ~ Not Applicable
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public [ands, and public
resources of the Town of Southold. See LWRP Section IIl- Policies; Pages 38 through 46 for evaluation
criteria.
~] YeJ'~ No [~ Not Applicable
Attach additional sheets if necessary
WORKING COAST POLICI~
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 Pcconic
Estuary and Town waters. Sec LV, rRp Section III - Policies; Pages 57 through 62 for evaluation criteria.
~ Yes [] No ~-~ Not Applicable
A~tach 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 ~ 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 [-~ Not Applicable
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