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Home My WebLink AboutTR-6883BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6883 DATE: MAY 21, 2008 ISSUED TO: JACK CIPRIANO PROPERTY ADDRESS: 8150 MAIN BAYVIEW ROAD, SOU~H~H~OLD.~ SCTM# 87-5-23.6 AuTHORIzATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on May 21. 2008. and in consideration of applicatinn fee in the sum of $250.00 paid by Jack Cipriano and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a mo-story, single-family dwelling, driveway, sanitary system, and public water, with the conditions of a 60 foot Non-Disturbance Buffer from the edge of the creek landward, a line of staked hay bales installed prior to construction, the installation of gutters, leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the survey prepared by Kenneth M. Woychuk, L.S., last dated April 5, 2007, and received on May 21, 2008. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall 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 April 21, 2010 Ms. Patdcia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: JACK CIPRIANO 8150 MAIN BAYVlEW ROAD, SOUTHOLD SCTM# 87-5-23.6 Dear Ms. Moore: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, April 21,2010: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #6883, as issued on May 21, 2008. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, President, Board of Trustees JMD:eac James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghos±o, 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 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 9//~ constructed roject complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6883 DATE: MAY 21, 2008 ISSUED TO: JACK CIPRIANO PROPERTY ADDRESS: 8150 MAIN BAYVIEW ROAD~ SOUTHOLD SCTM# 87-5-23.6 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on May 21~ 2008, and in consideration of application fee in the sum of $250.00 paid by Jack Cipriano and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a two-story, single-family dwelling, driveway, sanitary system, and public water, with the conditions of a 60 foot Non-Disturbance Buffer from the edge of the creek landward, a line of staked hay bales installed prior to construction, the installation of gutters, leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the survey prepared by Kenneth M. Woychuk, L.S., last dated April 5, 2007, and received on May 21, 2008. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Jack Cipriano, residing at 19 Hawthorne Avenue, Central Islip, New York 11722 as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold 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. 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. That this Permit should be retained indefinitely, or as long as the said Pemfittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 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 of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and Iow water marks. That if future operations of the Town of Southold 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. That the said Board will be notified by the Permittee of the completion of the work authorized. 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 obi[ain 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 May 21, 2008 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Ms. Vicki Toth 425 Jacobs Lane Southold, NY 11971 RE: JACK CIPRIANO 8150 MAIN BAYVlEW ROAD, SOUTHOLD SCTM# 87-5-23.6 Dear Ms. Toth: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 21, 2008 regarding the above matter: WHEREAS, Vicki Toth, on behalf of JACK ClPRIANO 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, 2008, 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, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: a 60 foot Non-Disturbance Buffer from the edge of the creek landward, a line of staked hay bales installed prior to construction, the installation of gutters, leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 21, 2008, 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 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, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of JACK CIPRIANO to construct a two-story, single-family dwelling, driveway, sanitary system, and public water, with the conditions of a 60 foot Non-Disturbance Buffer from the edge of the creek landward, a line of staked hay bales installed prior to construction, the installation of gutters, leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the survey prepared by Kenneth M. Woychuk, L.S., last dated April 5, 2007, and received on May 21, 2008. 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: $100.00 Very truly yours, James F. King President, Board of Trustees JFK/eac Donald Wilder, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., May 14, 2008, the following recommendation was made: Moved by James Eckert, seconded by Don Wilder it was RESOLVED to SUPPORT the Wetland Permit application of JACK ClPRIANO to construct a two-story, single-family dwelling, driveway, sanitary system, and public water. Located: 8150 Main Bayview Rd., Southold. SCTM#87-5-23.6 Inspected by: Jack McGreevy Vote of Council: Ayes: All Motion Carried James F. King President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765 - 1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: JACK CIPRIANO requests a Wetland Permit to construct a two-story, single- family dwelling, driveway, sanitary system, and public water. Located: 8150 Main Bayview Rd., Southold. SCTM#87-5-23.6 Type of~,area to be impacted: .~Seltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland. Part,,pf"Cown Code proposed work falls under: (.L~hapt.275 Chapt. 111 other Type of Application: U,'~etland __Coastal Erosion __Administrative__Emergency __Pre-Submission __ Amendment Violation Info needed: Modifications: Conditions: P rese ntDW[~zr::n~ng ~Theerr~tPh e irC ~e ~j~°.n- Form filled out in the field by L~. Bergen~ B~.Ghosio, Mailed/Faxed to: Date: Environmental Technician Review- OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY MAIl.lNG ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTHOLD To: Jim King, President Town of Southold Board of Trustees From: Scott Hilary, LWRP Coordinator Planner Date: May 7, 2008 Chapter 268: Waterfront Consistency Review Wetland Permit for JACK CIPRIANO SCTM#87-5-23.6 Vicki Toth on behalf of JACK CIPRIANO requests a Wetland Permit to construct a two-story, single-family dwelling, driveway, sanitary system, and public water. Located: 8150 Main Bayview Rd., Southold. SCTM#87-5-23.6 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 proposed action is INCONSISTENT with LWRP policy standards and therefore is INCONSITENT with the LWRP. The distance from the attached structures of the proposed residence is 90'from the landward limit of tidal wetlands and therefore is inconsistent with LWRP policy 6 pursuant to § 275-3 Findings; purposel iurisdiction~ setbacks. Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. § 275-3 Findings; purpose; jurisdiction; setbacks D. Setbacks. [21mended 10-11-2005 by L.L. No. 17-2005] (1) The following minimum setbacks apply to any and all operations proposed on residential property within the jurisdiction of the Board of Trustees: (a) Wetland boundary. [1] Residence: l OO feet. 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 Office Use Only ~_____~wOaStal Erosion Permit Application etland Permit Application Administrative Permit AmendmentJTrans fer/E~,}t~en~ion ~ece~vved Application: I/Received Fee:$,~'-~~ ! ~---'Completed Application __Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~EWRP Consistency Assessment Form ~"'CAC Referral Sent: ~ate of Inspection: .5"~./St/~ 1' __Receipt of CAC Report: __Lead Agency Determination: ___Technical Review: ..~ublic Hearing Held: __Resolution: Name of Applicant Jack Cipriano Address 19 Hawthorne Avenue~ Ce,~tral Islip, New York 11722 Phone Number:~31) 234-0164 Suffolk County Tax Map Number: 1000 - 87-5-23.6 Property Location: (NYT ~71 & 72) S/S Main Bayview Road 861' E/O Corey Creek Rd~ Southhold (provide LILCO Pole #, distance to cross streets, and location) (If applicable) ^ad ss: "-~0~ ~/~ O/Q/ //~y //qY/Phone: of Trustees Applicatio~ GENERAL DATA Land Area (in square feet): Area Zoning: ~' Previous use of property: Vacant Intended use of property: fltngl e Fa'm't I y Re.qidenaa Covenants and Restrictions: Yes X~ No If "Yes", please provide copy. 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? x No__ Yes If yes, provide explanation: Project Description (use attachments if necessary): Con.qtruat'lon of new S'[r'gle f~-mi!y .q,-,o~,-~, o ~ .... ~n' ~ qo' ,~h ~a septic system, public water line and driveway Be of Trustees Application COASTAL EROSION APPLICATION DATA Purposes ofproposed activity: gingla family r~,~cl~.nea Are wetlands present within 100 feet of the proposed activity? No × Yes Does the project involve excavation or filling? '1~ No ~ Yes If Yes, how much material will be excavated? iD How much material will be filled? Manner in which material will be removed or deposited: (cubic yards) (cubic yards) 0_~t[ S0il Describe the nature and extent of the environmental impacts reasonably anticipated resulting fi.om implementation of the project as proposed. (Use attachments if necessary) Should be no evironmental impact PROJECT ID NUMBER PART I - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: County Municipality Southold Suffolk 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc - or provide map S/S Main Bayview Road 861' E/O Corey Creek Road in front of NYT # 71 & 72 5. IS PROPOSED ACTION: r~ New ~'~ Expansion ~ Modification / alteration DESCRIBE PROJECT BRIEFLY: Construction of a new 2 story 50' X 90' single family residence with associated septic system, public water line and driveway. 7. AMOUNT OF LAND AFFECTED; Initially .~9 acres Ultimately ,~9 acres 8. WILL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS? ~']Yes [] No If no, describe bdefly: 9. WHAT IS PRESENT LAND USE iN VICINITY OF PROJECT? (Choose as many as apply.) ~-'~Residential r~lndustrial r~commercia~ [~Agriculture r~ Park / Forest / Open Space Condominiums ~- ~i'~t~ &f~'~ ~0- --']Other (descdbe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal. State or Local) [~]Yos ~]No If yes, list agency name and permit/ approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~--~Yes [~[No If yes, list agency name and permit / approval: ~'[-~3 ~jOf~ ~ ._~ b~-~.~ ~ C 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /~,ame J.a~,pria-o Date:4:,~/~./~/~" Signature ~'~.( ~. I ~,~ ~ 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 (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF, ~]Yes r-]No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 61767 If No, a negative declaration may be superseded by another involved agency. E~] Yes r-]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwriUen, if legible) C1. Existing air quality, sun'ace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for 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 _ C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A commungy'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: C5. Growth, subsequent deve opmen, or rela ed ac ivities likely to be induced by the proposed acbon. Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in CI-C57 Explain bdefly: C7. Other impacts (including changes in use of eith~"(]uanti~ or t¥~e of energy,? Explain briefly,:' D. WILL THE PROJECT HAVE AN iMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? If yes, ex~lain briefly: _ I--lYes E3No[, E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ~'es explain: F-] Yes I--tNoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadVersee~ectidenti~edab~ve'determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesignificant~ Each effect should be assessed in connection with its (a) setting (i.e. 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 adequate[y 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. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the F U Lt EAF and/or prepare a positive declarafion. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons suppoding thi~ determination. Name of Lead Agency Date Title of Responsible Officer Signature of Preparer (If different from responsible officer) Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Ir. 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 _tmm__do: ............................ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POST1NG I, (,]1 (..¢__.X '-[-C~Fh , residing at qc~ -~1~2t3 ~_ being duly sworn, depose and say: That on the/~ day of 1OqOc../ ,2008 1 personally posted the property known as 2/5'0 z')'l z tn by placing the Board ~f Trustees official poster where it c~ 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 heating noted thereon to be held ~L~ Dated: (signature) Swom to before me this day of/~"(200~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Namc: Russell Hillman The Cove at Southold Suffolk County Richard Norklun John Richardson Address: 8340 Main Bayview Road, Southold, New York 11971 7930 Main Bayview Road, Southold, New York 11971 330 Center Drive, Riverhead, New York 11901 800 Private Rd #21, Southold, New York 11971 59 West 71st Street, New York, N.Y. 10023 STATE OF NEW YORK COUNTY OF SUFFOLK ~:CPl~--~dayof ~O~ , residing at~.~L~ ~. ,~.t4~}d _ , being duly sworn, deposes and says that on the ,2008 , deponent mailed a true copy of the Notice set forth, in the Board of Trustees 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 [_oj1 of the Town of Southold; that said Notices were mailed at the United States Post Office at --5, . ' that said Notices were mailed to each of said persons by (certified) 6~)mail. '----~'~" '~ Sworn to before me ths 2[ Day_o f Ha-( , 20oM fcu Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfi'ont Consistency Review Law. TNs 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, listing both supporting and non- sunoorfin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be tmdertaken. 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 87 5 - 23.6 PRO CTN O fl(,'rmo , roi 'k The Application has been submitted to (check appropriate respo~e): TownBoard ~ Plann~gBoard~ Building Dept. ~ BoardofT~stees ~ 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: New construction - single family residence 50' X 90' 2 story with associated ~*ptie ~ymtem: public water ltne mhd driveway. Locationofaction: S/S Bayview Road 861' E/O Corey Creek Raod, Snuthnld Site acreage: 40~500 (.87) Present land use: vacant Present zoning classification: 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: Jack Cipriano (b) Mailing address: lq glawthr~rn~ lv~n,,~: Contra1 X~ltp: l',lo-.a Ynrk 11777 (C) Telephone number: Area Code6(31) 234-0166 (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No ~-~ If yes, which state or federal agency?. 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 . .__ , J -. - j Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP 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 Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ~ Yes ~ No [~ Not 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 x Not Appli~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 r-~ 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 lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes~ No [-~ 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 Pcconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~-~ Yes R No ~-~ 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 [] 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 DATE~/<~ 5 .' TITLE of Trustee~ Applicatio~ (print owner of property) AUTHORIZATION " (where the applicant is not the owner) ~4~ ~c]~ residing at /~ ~//~::~.~ t~Z/'.~ /~Y ( mailing address) //7~-do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ~ ~/~k~wner ' s signature ) 8 Board of Trustees Application County of Suffolk State of New York Jack Cipriano 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 WlLL 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 V1RTUE 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 THIS APPLICATION. Signature SWORN TO BEFORE ME THIS ~ DAY OF ~/0/~l~-- ,20 08 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emvlovees. The ouroosc of this form is to orovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is necessary to avoid same, YOURNAME: CIPRIANO. Jack (Last name, first name,~niddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other Demon'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 map Planning Other (1 f "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 thc 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% of the 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 Demon Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __A) the owner ofgroater than 5% of the shares of the corporate stock of the applicont (when the applicant is a corporation); B) the legal or'beneficial 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 RELATION SHIP Form TS I Submitted this ~f day Signatur~ ~_~'~ er~.~.,~,t. PrintNam¥'-~ Jack Cipriano 200/5 DWELLINGS S.C.T.M.# DIST:IO00 SEC:87 BLK:5 LOT:23.6 W/PUBLIC WATER #RI0-05-0198 ',' t~A¥ 21 2008 MAIN BAYVIEW ROAD CL 15.60 CL 11.94 24'~ ASPHALT PAVEMENT - TOWN MAINTAINED CL 17.57 CL 16.7,] ...................................... EXISTING WATER MAIN 16 185.00' f f 861.00 e o.2's 10 'MIN ~ .eL(12.0) sm-s 59.9' PORCH 59.9' ¸10 "TB E CONDOMINIUM COMMON AREA LAND N/E OF COVE AT SOUTHOLD" 8 04-02-06 PROPOSED LIMITS OF 2 IWELLING CRAWL(9.O) CLEARING 8 DWELLINGS W/PUBLIC WATER 150' LAND N/F OF JANICE HILLMAN SNYLES EL 2,2 EL~/, 16.6 BROWN ~ANDY LOAM 0,8' BROWN 6 DWELLINGS W/PUBLIC WATEF Subject Property: Jack Cipriano Main Bayview Road Southold, NY 11971 x TOTAL LOT AREA: 40,500 SQ.FT. OR 0.93 ACRES UPLAND LOT AREA: 58,610 SQ.FL OR 0.89 ACRES ALLOWABLE IMPERVIOUS SURFACE 5,791 S.F. OR 15% LOT COVERAGE: PROPOSED HOUSE 2,608 S.F OR 6 75% PROPOSED DECK & STEPS 210 S.F. OR PROPOSED FRONT & REAR STEPS 59 S.F. OR 0.15~ TOTAL PROPOSED LOT COVERAGE : 2,877 S F OR DRAINAGE CALCULATIONS: BLDG. FOOTPRINT = 2,608 SO.FT. 2,608 x 0.166=432.9 < 455cf REQUIRED (2) 8'DIA x 5' DEEP DRYWELL=441cf PROVIDED CHANGE HOUSE 04-05-07 REVIDED 11-28-05 OrIAST/~,L B/~RRIER BOUN,O,~RY IDENTIFIED 1I-I6-90 60' BUFFER / N64°07'00"~~ ~ ~ % CONDOMINIUM~ COMMON AREA LAND N/F OF '~i-HE COVE AT SOUTBOLD" __ --HH~/ x x x 115. O0'(ACTUAL)' CI LOCKING ~/4"-~. GROUND WATER EL 2.2 APPROVEDBY NOTE: SILT SCREENING WITH HAY BALES ARE REQUIRED ALONG APPROVED LIMITS OF CLEARING NVGD 1929 ELEVATION DATUM: SURVEY OF, DESCRIBED PROPERTY CERTIFIED TO. JACK CIPRIANO; SaU^T~ ^~: BAY VIEW ~-ow. OF SOUTBOLD /~I~I~'l~I ~. ~OYCII~Z L.S. SUFFOLK COUNTY, NEW YORK ~/.,~---~--~ P.0. Box 3. M.tUtuck. New York 11952 ~ Phone (631) ~98-1588 F~ (631) ~-1585