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Home My WebLink AboutTR-6368 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 CERTIFICATE OF COMPLIANCE # 0267C Date: October 4. 2007 THIS CERTIFIES that the construction of an in-ground pool with drvwell and a 20' non-turf buffer landward of the wetland line At 2700 Arrowhead La1].e. Peconic. New York Suffolk County Tax Map # 98-2-20.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 04/25/06 pursuant to which Trustees Permit # 6368 Dated 05/17/06. 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 construction of an in-ground pool with drywell and a 20' non-turf buffer landward of the wetland line. The certificate is issued to JOHN CHAPMAN owner of the aforesaid property. r~~ Authorized Signature . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 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 sfCfG1 d ~ ;2.~ 1 sl day of construction % constructed .,,/ Project complete, compliance inspection'IO\3~1 ~ ~'( . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 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 151 day of construction Y, constructed ./ Project complete, compliance inspection. ( TERMS AND CONDITIONS The Permittee John Chapman. residing at 2700 Arrowhead Lane. Peconic. NY, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of South old are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation ofthis Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That iffuture operations of the Town of South old require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 May 17, 2006 Mr. Theodore Angell Alpha Consulting P.O. Box 447 Greenport, NY 11944 RE: JOHN CHAPMAN 2700 ARROWHEAD LANE, PECONIC SCTM#98-2-20.1 Dear Mr. Angell: The Board of Town Trustees took the following action during its regular meeting held on Wed., May 17, 2006 regarding the above matter: WHEREAS, Theodore Angell on behalf of JOHN CHAPMAN applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated April 25, 2006, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, in accordance with Chapter 268, said application was found to be Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 17, 2006, 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, 2 . . 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 275 of the Southold Town Code, 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, RESOLVED, that the Board of Trustees approve the application of JOHN CHAPMAN to install an in-ground swimming pool 75' north of the wetlands with the conditions of a 20' non-turf buffer landward of the wetland line, a dry well for pool backwash, and a line of hay bales during construction, and all as depicted on the plan prepared by Alpha Consulting last revised January 3,2007. 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.) This is not a determination from any other agency. Fees: $100.00 Very truly yours, ~07~ James F. King President, Board of Trustees JFK/hkc . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 TO: =!oA.n fhflrm4n. Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: 'I /~Sl bb ,'1l11) Jb(", . has been and the ~ Application Approved (see below) L-) Application Denied (see below) L-) 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 Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: Ml\. k>a.~ t)f\Q. tN)~cio() -~Sb,OO ,- 'B(\()J \1\S{let-tOf'l- .!f SO, 00 - l?1Q\..l(~d P 1.0. \\ u.)\ ~Ol no l\-'\u.r~ \') TOTAL FEES DUE: $_IOO,OD '(. BY: James F. King, President Board of Trustees . . Telephone (631) 765-1892 Town Hall 53095 Route 25 P,O, Box 1179 Southold, New York 11971-0959, CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., May 10, 2006, the following recommendation was made: Moved by Don Wilder, seconded by Jack McGreevy, it was RESOLVED to recommend to the Southold Town Board ofTrustees APPROVAL WITH CONDITIONS of the Wetland Permit application of JOHN CHAPMAN to install an in- ground swimming pool 75' north of the wetlands. Located: 2700 Arrowhead Lane, Peconic. SCTM#98-2-20.1 The CAC recommends Approval of the application with the Condition drywells are installed to contain the pool backwash, the installation of a 30' non-turf buffer, and new trees are planted to compensate for the trees cut down for the pool installation. Vote of Council: Ayes: All Motion Carried May 10, 2006 . . ~^""'" -Fool 10/ non <t\.1r+ b",~f<.a- l..oAvnrJ o~ L<t+I..Lr{"t:J/(,4(Wd May 10, 2006 . . C}-V,,"!,""") SITE PLAN ~ I/~~ 241.0 ~~ /.ME , N 2'lDO AR~wll&lW LoWE., PabUIC, tJl{ 119St'> ~qw~:~ ~ ~ o f.. ~ t AN1iflrJ K\JL.l- 76.3 A.......... C) PIEN .&PAeB. -AI '-. >?O' "1'ItJ "v'7u e--~~ ~ aU. "" (1", Ii< ~ ~;>-(. ........ ~ , JM! _ j ...."'~ <<Jlu~~p ~ '0 &.INe: CF~~"lFq f ~ ~~~~~~. 2 Rot.dS ~~ S'lHqll EifiIllItrPPS , k / .......... dl Prepared by: ALPHA 'II CONSULTING Date: 11- I!.- 03 Scale: ,..;: ",,0' SCTM# 9.8-2.-.:l.0./ REVl.56.D: .2-.z~-""" s-u.-~ I - 03 - 07 NOTE: ~s: OF WliTl-Io."ll)S DEuAlSA'TEd> BY pSJ::oo.J I Co !;UR.lIEiYlJR.5: 5-2.3-01 A,tJp "GRJFl~ fl'/ -r. A-A/t;6:s-L- A-J.PHA C()AJ9.tL.TIN'i : q-/$-D3 SITE PLAN ~ 11M.) ~ 241D~.w;p ~&. , N 2100 ~Wl#fUW UIIJE ,~IC,t.J" '.f95l!. :{"ClHfJ CI-/APMAtJ : ()WIo ~R ~ ~ o 'f.. ~ t ANT"oJ KLLt- 76.3 AroAco. o PIZN JlPIleIl. ...( ------ >:'0' '", e-~~ OF> ~ 8U~- Iv<!!,., __ ~ ~~ JA N - 3 2007 ""'q,." me... ::Jt ~~p , o ~INE. CJF ~ ~I'LF~ I ~ PURI"'li ~~IOl\J ,i . ~\ ::z Rouls s.~ ~/1/-Ir;1I8A?f/~ , . ~ / ......... dl Prepared by: ALPHA III CONSULTING Date: 1I-1~- 03 Scale: '''.;:-40' SCTM# 98-2.-20., REVI.s~, 2-.2"--...... S -1$- of{; I - 03 - 07 NOTE: ECo:tD: OF I.IIGTUo."IJ)S PeUIVSATSlP BY f'EL:oAJ/C ~VEyDR5: S-:z.~o, AlIP IIGRJR@ BY To A-A//iE:J-L- A-s-PHA ~A/SI.ILT7Nq ! q-/:5-D3, . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel . 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 Southold Town Board of Trustees Field Inspection/W orksession Report Date/Time: 51x loG, 101,1) ~~ Name of Applicant: Name of Agent: Property Location: SCTM# & Street ~ {'\..r' ():lWl ~~ q~ ' d. - ;:La . I ::27Do ^,'YtJ,,-,~ L" L., , Brief Description of proposed action: f (10 I Type of area to be impacted: L Saltwater W etland _Freshwater Wetland _Sound Front _Bay Front Distance of proposed work to edge of above: Part of Town Code proposed work falls under: _Chap!.97 _Chap!. 37 _other Type of Application: / Wetland _Coastal Erosion _Amendment _Administrative _Emergency Info needed: fJ 1\ . ~ \'-€&4o,-e ;...0' re~rf l:....-f+.v- t!Yj{f~.~:t h;~~ k~ \ cv-J '-'~ "-( Modifications: ~~ Conditions: Present were:\..f.r.King /J.Doherty _P.Dickerson ~. Bergen-.dHolzapfel Other: \\. Cv.Sr...ol/... Mailed/Faxed to: Date: . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen . 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 April 11, 2006 Mr. Ted Angell Alpha Consulting P.O. Box 447 Greenport, NY 11944 Re: JOHN CHAPMAN 2700 ARROWHEAD LANE, PECONIC SCTM# 98-2-20.1 Dear Mr. Angell: The Board of Trustees has received your request to extend the permit for the above referenced site. The permit was issued on October 22, 2003 and expired October 22, 2005. The Board understands that you have been waiting for other permits for this project but we must deny the request for an extension ofthe Trustee permit. The Board has guidelines that are established and are followed consistently for each application. Please submit a new application by the April 26 deadline to be considered at the May meeting. Very Truly Yours, ~~ }L.~ ~ames F. King, P~ Board of Trustees JFK/hkc . - MAIliNG ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE WCAll0N: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765.1938 Fax: 631 765-3136 KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: James King, President Members of the Board of Trustees q Ie From: Mark Terry, Senior Environmental Planner L WRP Coordinator Date: May 12, 2006 Re: Request for Wetland Permit and Coastal Permit for JOHN CHAPMAN SCTM# 98.-2-20.1 Alpha Consulting on behalf of JOHN CHAPMAN requests a Wetland Permit to install an in-ground swimming pool 75' north of the wetlands. Located: 2700 Arrowhead Lane, Peconic. SCTM#98-2-20.1 The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (L WRP) Policy Standards. Based upon the information provided on the L WRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is generally CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Please contact me at (631) 765-1938 if you have any questions regarding the above. . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel . 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 _ ~stal Erosion Permit Application ~etland Permit Application ~ Administrative Permit Amendment/Transfer/Extension ~eceived Application:~ vReceivedFee:$ d'S'\'>- _..-completed Application 1.\ \~ro.lo _Incomplete _ SEQRA Classification: Type I~Type II~Unlisted__ /;IJi! Coordination:( date sent) ~WRP Consistency Assessment Form ~J,SlC)/.o ~AC Referral Sent:~ \gs-IO/o ~ate ofInspection: ~1()1\'(n _Receipt of CAC Report: _Lead Agency Determination:_ Technical Review: -,.Jublic Hearing He~ Resolution: . ~ili::Jt.-.1 ('. HAPM.q-t\.1 A-a< (('Dt..- )f"t12:A f) LAN ,-; Name of Applicant Address C)70D P~C<>Nl<=- W V- I Phone Number:( ) ?~- ZZ-3-S-8;?,j 98- 02.-- /~ - I Property Location: ;170'0 ARRclWm"i:..A <) LftNf'.. V7fce,NI <' N V If qSB (provide LILCO Pole #, 'distance to doss streets, and location) IlLPI1/J Suffolk County Tax Map Number: 1000- AGENT: (If applicable) Address: p.o. I5dV Cmvs...u C J 11..1 r1 VV7 6k1ZtJr?/t 6 Phone: r;-:s ( - ~ ~~~\& ~\ I NY If iI/if ifll - OyfV'V ~ Board of Trustees APp~tion GENERAL DA T A Land Area (in square feet):. {/~I ",,7/ ~~.FT. Area Zoning: Re,-. Previous use of property: 2. 6:.. ~ . Intended use of property r<. i: ~ Prior permits/approvals for site improvements: Agency Date _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~No_ Yes If yes, provide explanation: Project Description (use attachments if necessary) /A 1_ ~ RO(JJUJ) -'LJ'MIlA.I Alt:; rt>OL- 7-' I NtJre;-ft- tJF WE:.rL~o ~ _ t..~3. 3..r I IN~I OF ~,?nu.J~..-Al> ~ Board of Trustees App~tion WETLAND/TRUSTEE LANDS APPLICA nON DATA Purpose of the proposed operations: I #1-6 ~ru 11--10 oCt.. 11 M..... I k1t:l _p tl t'H_ ~~ R.~\~n''''''TiAL-- u~~ Area of wetlands on lot: o - square feet Percent coverage of lot: a- % Closest distance between nearest existing structure and upland edge of wetlands It, q feet Closest distance between nearest proposed structure and upland edge of wetlands: 7 r feet Does the project involve excavation or filling? No Y Yes If yes, how much material will be excavated? /3'3 cubic yards How much material will be filled? - 0 - cubic yards I ; Depth of which material will be removed or deposited: '3 - t,; feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited:--=:JO 13 s:. .-.-: l~uc\J\'i.O A1NA~1 UPON 12 G:.M 1) 1/ A- L 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) }JD F~.r-r- (JAJ W&7Z..I4Mf) r .4-u9 --rI f)~ L.I jQ.. TkP-s 14-16.4,(2/87'1_ Tex! 12 .,. I PROJECT 1.0. "UMBE" . .617.21 Appendix C State Environmental Ouamy Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Oniy PART I-PROJECT INFORMATION (To be completed by Aoplicant or Praieet sponsor) SE( 3. PROJECT LOCATION: Munic!palily 2. PROJECT NAME ~/lf4N County ..r I/FFo '-K.. ~r€cT 4. PRECSE LOCATION (Street address and road intersections, prominent landmarks. etc., or proviae mao) ~70D /k f2<J eJ H1UJ..f) Llh-JIL .foul rkJl.[) I ~'/ 5. IS PROPOSED ACTION: g New 0 Excansion 6. DESCRIBE PROJECT 8RIE1=LY: o MOdificatloniaiteration / J\.I r../i4-t..,,q.. 77 ()AJ O'F / AJ- 6120u '" !) .c"V / N7ll11 "../(/ 'PO 0 l... 7. AMOUNT OF l..P.NO AF;:ECTED: Initially - 0 - acres UltimatelY _ ^ _ acres a. WILL ,:::RO?QSEiJ ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING '-AND USE RESTriICTIONS? '"f!yes 0 No If No, describe brieily 9. VJHAT IS PRESENT LA~~O USe IN VICINITY OF PROJECT? ~F1eSjdential O,!naus:rial 0 Commercial Desc,lbe: o Agriculture : I Park/ForestJOoen space UOttJer 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE On LOCAL)? ~ Yes 0 No It yes. fist agency(sl and permit/apProvals N.Y. "--II4-TIL Di$.e- 11. DOES ANY ASPECT OF THE ACTIOr~ HAVE A CURRENTLY VAllO PERMIT OR APPROVAL? ~Yes' 10 If yes, Jlst agency name and permit/approval N,/~J)t::C - /- L/7>?-7Y].'}o:>/oaoo/ 'r 12. AS A RESULT OF PROPOSED ACTION WiL!.. EXISTING PERMJT/APPROVAl F1EOUIRE .YlQDIFICATION? o y" ~o I CEiiTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE 7"0 THE 3EST OF MY :",NCWL.=DGE ApplicanUsponsor name: ,,~ Ddle: -0- z t/-O~ Slgna1ure: If the action is in the CO~5tal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this a~~essment OVER . . PART II - IMPACT ASSESSMENT (To be completed bv Lead Aaencvl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. DYes 0 No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 II No, a negative declaration may be superseded by another involved agency. DYes 0 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, jf legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, rtential lor erosion, drainage or flooding problems? Explain briefly: ~ C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: I I C5. rowth' subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I C6. long term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: I I C7. Other impacts including chanaes in use of either quantity or type of enerav? EXDlain brieflv: II D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If yes, explain briefly: DYes ONO I E, IDH~:sE, 00 ~~lE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? I Ilyes explain 1 PART III- DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important orothelWise significant. Each effect should be assessed in connection with its (a) setting (Le. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, thedetermination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL EAF and/or prepare a positive declaration. Check this box if you have determined, 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 necessary, the reasons supporting thi determination. Name of Lead Agency Date Pont 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) . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of _____~t\.r:l--<=-~-~~~-------------------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING ~;c,Q: ~~~.nSiGiHgat 4:prhI- G71ll,f"(/L(I;./q' ~ O. 'Bo~ '-f \.{ 7 61:::ruw?c:l~ ~'-/ / I (j(/V being duly sworn, depose and say: ' , ./ ;T~ ,,-I That on the 8 day of PVf'/Jf ,2006, I personally posted the property known as ;1.70,,", Ai.\<.o~J\-\-iZl>o<'j) l..A.J~ I 91l riZ/^" c... N'/ , by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held U lent ,~ I? I a ((l(.. - IOn. (Y/ oorut (p,'30 Pf'0, Dated: ~~d;/ ~orn to before me this to'..... day of ~200~ ~w~'^ h. N tary Public BONNIE J. DOROSKI NllIary Public. Stale Of New 'Ad No. 01006095328. Suffolk Countr Term Expires July 7. 20 ~ . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS STATE OF NEW YORK COUNTY OF SUFFOLK ~ a L-L , residiag at 4 LPrf7+. G;J::;ut-T/AJ 0/ 72 a tf (2(being duly sworn, deposes and says that on the /0 day of , 2oob, deponent mailed a true copy of the Notice , set forth in the Board of rustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll ofthe Town of Southold; that said Notices were mailed at the United States Post Office at &'12E&if.Rt1l!!7 NV , that said Notices were . d toafsaid persons by (certified) (f\~~~t\1red) mail. / Name: C Ptav{eJ ~YtA2ev Yd~ #oyf~ ;fJ$dtl#/~ I!kt~ ~ Sworn to before me this it) Dayof_~ ,20~ j. ~ l-. /lAM,. In Not Public BONNfE J DORO Notary Public Sta SKI No. 01006095328 I; ~ NewYort Term Expires JUly'7, ~O ~~-tly ~;!JrYmfeaJ L~r ~.: /JI po. 130/ 30(, 2~,c-' NI 5tf E; 9'/S'IJ#~d,j//~ ;Jv/. )/j. . . , . , 4ItBoard of Trustees APplic~n " AUTHORIZATION (where the applicant is not the owner) I, T 0+ftJ ~A-k.l (pr~nt owner of property) residing at ().7oo 1w..(<<M~ LA-tJ1L. (mailing address) ??:tCo ~ Ie:.. , , N~ll I do hereby authorize (Agent) J\-LPH-~ GtJ<;,uC/ifJC:1 to apply for permit(s) from the southold Board of Town Trustees on my behalf. 8 4It Board of Trustees APPliC~ion County of Suffolk State of New York /It-~ C";,WL II;; BEING DULY SWORN DEP ES AND AFF RMS HAT HE/SHE IS THE AP LICANT 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 TOWN 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(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF I P ION. Signature 'JS~ DAYOFlrd 2006 '- SWORN TO BEFORE ME THIS ~(lk BONNIE J. DOROSKl Notary Public. Slate Of New Yort No. OID06095328.SuffOlk~nlJ Term Expires July 7, 20 D . . Board of Trustees Application County of Suffolk State of New York ~ -J~ Q..rA-PM~ BEING DULY SWORN DEPOSES AND AFFIRMS mAT 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 mAT 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 TOWN 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(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH RE W OF S APPLICATION. SWORN TO BEFORE ME THIS Q0\'-- DAYOF Odl!':,..~ 200 '- ~ L- -2l^",~ Notary Public __IUSAN I. GIWIT -~NoPubllc. Slallt of New"", "'_oii:~ OtGR6062309 eon.iiiiii:'=I:.~ Town of South old . . 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 South old Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. 'Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action 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 L WRP policy standards and conditions contained in the consistency review law. Thus. each answer must be explained in detail. listine both supportine and non- supportine facts. If an action cannot be certified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. A copy of the L WRP 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# ~g 02- - ;)0.1 C f::l:t\ f' Y!1 ~ q(j2 () ~ rr cT PROJECT NAME The Application has been submitted to (check appropriate response): Town Board D Planning Board D Building Dept. D Board of Trustees jgJ 1. Category of Town of South old agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) D D (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: w Nature and extent of action: / jt/ STA-l- L / tJ- (jRauNJ) clWI "^ '" I AJ, ~(!) L ~ ..;(I{ D . Location of action: d 70 D . ActzdlNrtrr-.A-f) LlttJrL heat-he..- /J! Site acreage: /. D7 h D tlr: Present land use: reA I de.--. -h J Present zoning classification: 12 ~ L- oI-e..:r \ ...j) 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: - Jch..I....r-.J (' >t+ &-f> "'" ~ hlZow JJfZ ,"? LlsNlL I ?llCPA/tC- ;II Y (b) Mailing address: ~;oD (c) Telephone number: Area Code ( ) foR... 725 - S88 ( (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes D No[k) 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 L WRP Section III - Policies; Page 2 for evaluation criteria. DYes D No ~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See L WRP Section III - Policies Pages 3 through 6 for evaluation criteria DYes 0 No 0 Not Applicable . . Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L WRP Section III - Policies Pages 6 through 7 for evaluation criteria DYes D No [XI 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 DYes D No [}1 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See L WRP Section III - Policies Pages 16 through 21 for evaluation criteria DYes D No [ilNotAPPlicable 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 L WRP Section III - Policies; Pages 22 through 32 for evaluation criteria. D D ~ Yes No ~~ . 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. DYes 0 No 51 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. DYes 0 No [S(l 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. DYeD Nol}t Not Applicable Attach additional sheets if necessary WORKING COAST POLIa . 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. DYes D No L:lI 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 L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria. DYes D No EtI Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See L WRP Section III - Policies; Pages 62 through 65 for evaluation criteria. DYes D No [Sf 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. DYes D No [)1 Not Applicable PREP~", :;:Z;? (.;;M~ITu ;I/;-u I DATE ~ 2;>-0",