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Home My WebLink AboutTR-6988 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 CERTIFICATE OF COMPLIANCE # 0474C Date: October 2 2009 THIS CERTIFIES that the demolition of existing building and construction of new 1 ½ story garage/storage building At _5520 Narrow River Road, Orient, New Yofl~ Suffolk County Tax Map # 27-2-4 Conforms to the applications for a Trustees Permit heretofore f'ded in this office Dated _9/24/08 pursuant to which Trustees Wetland Permit # .6988 Dated .10/15/08 was issued and conforrus 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 demolition of existing building and construction of new 1 ½ sto _ry ara e/stora e buildin The certificate is issued to FRED DACIMO owner of the aforesaid property. Authorized Signature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: ~/// Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 ~ day of construction ½ constructed /- ~" Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Gho$io, 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 ½ constructed __ Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6988 ISSUED TO: FRED DAcIMO DATE: OCTOBER 15~ 2008 PROPERTY ADDRESS: 5520 NARROW RIVER RAOD~ ORIENT SCTM# 27-2-4 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 October !5, 2008, and in consideration of application fee in the sum of $250.'00 paid by Fred Daeimo and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trnstees authorizes and permits the following: Wetland Permit to demolish an existing one-story storage building 18'x26' and replace it with a new 1 ¼ story garage/storage building 20'x40' in the same location, with the condition of the installation of gutters, ~!~aders and drywells to contain roof runoff and in accordance with Chapter 236 of th~ TOwn Code-Storm Water Ru..noff, and as depicted on the site plan prepared by Robert H. Fox, last dated August 31, 2008, and received on Sepgember 24, 2008. IN WITNESS WHEREOF, the said Board of Trnstees hereby causes its Corporate Seal to be aff~xed, and these presents to be subscribed by a majority of the said Board as of this date. James Absent TERMS AND CONDITIONS The Permittee Fred Dacimo, residing at 5520 Narrow River Road, Orient, New York 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 Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involve4, 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 fight of the public to pass and repass along the beach between high and low 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 cousents that may be required supplemental to this permit, which may be subject to revoke upon failure ~p 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) 765-5641 October 15, 2008 BOARD OFTOWNT~USTEES TOWN OFSOUTHOLD Mr. Garrett A. Strang, Architect P.O. Box 1412 Southold, NY 11971 RE: FRED DAClMO 5520 NARROW RIVER ROAD, ORIENT SCTM#27-2-4 Dear Mr. Strang: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, October 15, 2008 regarding the above matter: WHEREAS, Garrett A. Strang, Architect on behalf of FRED DAClMO 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 September 24, 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: 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 October 15, 2008, at which time all interested persons were given an opportunity to be heard, and, 2 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 FRED DACIMO to demolish an existing one-story storage building 18'x26' and replace it with a new 1 ~ story garage/storage building 20'x40' in the same location, with the condition of 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 site plan prepared by Robert H. Fox, last dated August 31, 2008, and received on September 24, 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: $ 50.00 Very truly yours, oherty._ /. __ esident, Board of Trustees JMD/eac James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095Route 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: o Please be advised that your application dated .,,~~ ~/"//c~7(:~O(~'has been reviewed by this Board at the regular meeting 6f (~)c.,~x- I~ olC~O,~ and your application has been approved pending the completion of f~he following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) t///'Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees 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., October 8, 2008, the following recommendation was made: Moved by Jack McGreevy, seconded by James Eckert, it was RESOLVED to SUPPORT the Wetland Permit application of FRED DACIMO to demolish an existing one-story storage building 18'X 26' and replace it with a new 1 ~ story garage/storage building 20'X 40' in the same location. Located: 5520 Narrow River Rd., Orient. SCTM#27-2-4 Inspected by: Jack McGreevy The stakes did not line up with the plans, however, the CAC Supports the application with the Condition drywells and gutters are installed to contain roof run-off. The CAC notes that the building may be historic. Vote of Council: Ayes: All Motion Carried James F. King, President Jill M DoheCty, 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: FRED DACIMO requests a Wetland Permit to demolish an existing one- story storage building 18'X 26' and replace it with a new 1 1/2 story garage/storage building 20'X 40' in the same location. Located: 5520 Narrow River Rd., Orient. SCTM#27-2-4 T~Se of area to be impacted: altwater Wetland Freshwater Wetland Distance of proposed work to edge of wetland ~of Town Code proposed work falls under: hapt.275 Chapt. 111 other Type of Application: /Wetland __Coastal Erosion __Administrative__Emergency Pre-Submission __ Sound Bay __Amend ment Violation Info needed: Modifications: Conditions: Present Were:__~J.King __~J.Doherty. __P. Dickerson ~D.. Bergen__ B.Ghosio, __ D. Dzenkowski MarkTerry other Form filled out in the field by Mailed/Faxed to: Date: Environmental Technician Review- Plan of Property tlap Prepared; 05-09-05 :,mended: 06-19~08, 08-31-08 ;CT# 1000-27-2-4 ~ituate: Odent ;own: Southold .;uffolk County, NY }arum: MSL NGVD'29 / S83°14'48"E 126.81' ~ / R~ERT H. FOX OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Scott A. Hilary, LWRP Coordinator ~ Date: October 6, 2008 Re: Chapter 268, WATERFRONT CONSISTENCY RFVIEiW .... ._ ........... Wetland Permit for FRED DACIMO SCTM#27-2-4 Garrett A. Strang, Architect on behalf of FRFD DACIMO requests a Wetland Permit to demolish an existing one-story storage building 18'X 26' and replace it with a new 1 72 story garage/storage building 20'X 40' in the same location. Located: 5520 Narrow River Rd., Orient. SCTM#27-2-4 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 us, it is our recommendation that the proposed action is INCONSISTENT with LWRP policy standards and therefore is INCONSISTENT with the LWRP. 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 SouthoM Town Board of Truslees 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. C. Jurisdiction: The following areas are subject to protection under Chapter 2 75 of the Code of Southold. (1) Any freshwater wetland tidal wetland, beach, bluff dune, fiat, marsh, swamp, wet meadow, bog, or vernal pool; D. Setbacks. 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. The distance from the bulkhead to the proposed action is approximately 88 feet; a minimum setback distance of 100 feet from the wetland boundar~ (bulkhead) is required pursuant to Chapter 275-3. Findings~ purpose; iurisdiction; setbacks. Please require that the applicant amend the application to meet the above policy to the greatest extent practicable. If the agency, Board of Trustees makes a contrary determination of consistency~ the agency shall elaborate in writing the basis for its disagreement with their recommendations Pursuant to Chapter 268 Waterfront Consistency Review. § 268-5. Review of actions. In the event the LWRP Coordinator's recommendation is that the action is inconsistent with the LWRP, and the agency makes a contrary determination of consistency, the agency shall elaborate in writing the basis for its disagreement with the recommendation and state the manner and extent to which the action is' consistent with the L WRP policy standards. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. ,James F. King, President J ill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, 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 Coastal Erosmn Permit Application ~7'Wetland Permit Application ganendnlent/Trans fer/Extens km ec~d Application: ~q]oF Rcccivcd Fee:$ ~,. ' 0 ~omplctcd Application ~ ~ql ~ [nconlplete ~SEQI~ Classification: Type I__Type I1 Udisted Coo[dination:(date sentM ~C Retired Sent:~ ~ale of I~pection: I~ ~l~ ~Receipt of CAC Repo~: __Lo d Agency Determination:__ TecNfical Review: ~tblic llearing Held: I Oitgi Resolution: Name of Applic~t ~ ~ Address ~f~ ~ ~ Office Use Only Administrative Permit 7 Phone Number:( ) ~'.~5/- 7J~ -~- ddc9 Suffolk County Tax Map Number: 1000- ~ ~ ~-- -- '~ Property Location: ~'~"5~L'~ ,//ff~/z--z'/z42 ,/~,'~/¢'7,~/JZ7 (provide LILCO Pole #, distance to cross streets, and location) (If applicable) Address: ~ ~ ,'/)~- / ,~ / 2'/ Z~'~?.~ 7%z7~,~' ~ /L.9.,.,'~ //7,7/ of Trustees Applicatio0 GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: / - · Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes ,-/'/"No Prior permits/approvals for site improvements: Agency Date t/ No?R~'permits/approvals for site improvements. Has any permit/approval ever been revoked or suspende~ a governmental agency? //' No Yes If yes, provide explanation: Project Description (use attachments if necessary): of Trustees Applicatioe WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: Percent coverage of lot: ~9 cubic yards cubic yards ~/ -~ ?c'~ square feet Closest distance between nearest existing structure and upland edge of wetlands: ~- ~- 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ ' feet Does theproje c involve, e~gt/y~iOn or filling? If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: 3 Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: feet 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): ~7~20 $~QR PROJECT ID NUMBER APPENDIX C STATE ~N'¢iRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSME~ FORM for UNLIS~O AC~NS O~ly PA~ ~ · ~JECT INFORMATION ( To be c~plM~ by Ap~l~ or Pro~ Sponsor} Sr~_~OPOSED ACTION COMPLY WfrH EXISTING ZONING OR OTHER RESTRiCTtONS? L.~JYe$ [] No It tto,~i~scribe~'ieEy: IS PRESEN3 LAND U~E IN VI¢IN!TY OFr~P~JECT? manyasappiy.) ..i~e,l . AS A ,..~,,vRE~NnT OF PROPOSED ACTION WILL EXISTING PERMIT? APPROVAL REQUIRE MODIFICATION? I CERTIFY T~T THE INFORMATION PROVIDED A~VE ~$ TRUE TO ~ ~EST ~ ~ KNOW'GE If the action Is a COstal Ama, an~ you are a stale age. y, complete the Coastal Assessment Form b~ore proce~lng 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 617.47 If yes, coordinate the review process and use the FULL EAF. F-~ Yes r-]No WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another invoived agency E~] Yes [~No COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WiTH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface 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: C3 C4. C5. Vegetahonorfauna fish shellflshorwddl~fespec~es s~gn~ficanthab~tats orthreaenedorendangeredspeces E pa b e y 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: Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. C7. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: i!~er !r~p~ts !!ncludie~ c~anges in use of either quanfity or type of energy? Explain briefly: D. WiLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL-ADVERSE ENVIRONMENTAL IMPACTS? If y~ e~lain: I-qr-qNoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. 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, Ir 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, 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 FULI. 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 actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi., determination. Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Date Title of Responsible Officer Signature of Preparer (If different from responsible officer) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK ~ ~--'.~ day of Oer~6e,~ , being duly sworn, deposes and says that on the ,200~, 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 roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~'oO/"O~Oj ~ , that said Notices were mailed to each of said persons by (certified) ~ mail. Sworn to before me this Dayof Oewo~a~,t_, 20Og Barbara A. Strang NOTARY PUBUC, New York No. 4730095 Qualified - Suffolk County Comm. Expires July 31, _~-~/~ 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 . ~ i ...... BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) 0(;? i b ~ %C~ AFFIDAVIT OF POSTING I, ~ ,t~, residing at /2 ~o ~'~ [/~g~ ~[~'~lL~'~'r' being duly sworn, depose and say: That on the:;j~d_ay of ~'~/l~ 200~, I personally posted the vroperty known as by placing the Board of Trustees official poster where it can easily be seed, and that I have checked to be sure the poster has remained in place for eight days pn?r to the date of the public hearing. Date of hearing noted thereon to be held (Jd0at. trd)C f. [~l 8(10~' J . Dated: Sworn to before me this day ot~,,'r' 2001' ~arbara A. ~trang ;'JOTARY PUBLIC, New York No. 4730095 · ';:!ualified - Suffolk County rr,~n. Expires July 31, 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 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. 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- suonortine 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 SCT , 27 Z- The Application has been submitted to (check appropriate response): Town Board ~ Planning Board [~ Building Dept. [] Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital F-~ construction, planning activity, agency regulation, land transaction) [~ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: E~ Nature and extent of action: Present land use: 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: ~ ~-$~' ~/q~r~''~ ~ (b) Mailing address: (c) Telephone number: Area Code ( ) (d) Application number, if any: Will the action be dire/ytly undertaken, require funding, or approval by a state or federal agency'? Yes [] Nol~Wl Ifyes, which state or federal agency? 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 LWRP Section III - Policies Pages 3 through 6 for evaluation criteria . [-~ Yes [-~ No [~NotApplicable 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/Ill - 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 [-~ot 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. Sec LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not App~l~ble Attach additional sheets if necessary Policy 7. Pages 32 through 34 for evaluation criteria. ~ Yes ~] No [-'-~Not Applicable Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous s~es and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [] 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 /-7% c ' x 175 Attach additional sheets if necessary Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in s lOCations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ~ No ~-] Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~] Yes [--] No V--~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 ~-3 No V--~Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP S~eslII - Policies; Pages 65 through 68 for evaluation criteria. [] No ~ Not Applicable Board of Trustees Application County of Suffolk State of New York 4~&~ .~,~/P/~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TillS 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 SA/D 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. SWORN TO BEFORE ME THIS ~'~ Signature Barbara A. Strang NOTARY PUBLIC, New York No. 4730095 Qualified - Suffolk County Comm. Expires July 31, 20/4, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics owhibits conflicts of interest on the hart of town officers and employees. The nuroose of this form is to nmvide information which can alert the town of ~osslble conflicts of intarest and allow it to take whatever action is necessary to avoid same. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entiW, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tt~x grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Othar", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee o f 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% of the shares. YES NO )0 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 yourself(the applicant/agent/representative) mid 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 granter than 5% oftbe 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 RELATIONSHIP Form TS 1 Submitted this ~.~ da~ff/..~ .,t ~r/&¢n. 200~__ Signature n;,,~-~ _ ..ff"~[~., Print Name g~:,t~.{-'~ J),a ¢1~ L~TTER OF AUTHORIZATION RE: Premises, Orient, N~ SCTM #1000-27-02-04 I, ~ >~6[~O ,PROPERTY OWiqSR AS NAMED ON THE DEED, HEREBY AUTHORIZE GARRETT A. STR/kNG, ARCHITECT 7'0 ACT ON MY BEHALF WHEN ~KING APPLICATION TO THE UNITED STATES OP AMERICA, STATE OF NEW YORK, COrlqTY OF SUFFOLK, TOWN OF SOUTHOLD OR ~NY OTHER GOVERNMENTAL AGENCY IN CONNECTION WITH THE A~OVE REFERENCED PROJECT, Signature: ~~J--~ Sworn to before me ~his NoKary Public State of New York , 2008 ROE~IN L ORA'I'rAN N~aty Public, StYe Of New Y~I( NO. 01GR§11710~' Garrett A. Strang Architect 1230 Traveler St., Box 1412 Southold, New York 11971 Telephone (631) 765-5455 Fax (631) 765-5490 September 24, 2008 James King, President Southold Town Board of Trustees POB 1179 Southold, NY 11971 Re: Dacimo Premises, 5520 Narrow River Road Orient; SCTM #1000-27-02-04 Dear Mr. King and Members of the Board: Enclosed for your review please fine the following with respect to the above referenced premises: Application for wetlands permit, short EAS, LWRP, owner authorization letter and fee in the amount of $250.00 Four copies of the Survey/Site Plan One copy each of five photos of the affected area of the site One copy of the site plan showing the direction of photos taken The nature of the proposed work is demolition of an existing one story storage building and construction of a new replacement 1-1/2 story garage/storage building in the same location. The existing and proposed buildings are landward of other existing buildings on the site which are between the proposed work and the edge of wetlands. If, you have any questions regarding this matter, please feel free to contact my office. Thank you for your courtesy and cooperation in this matter. Very truly yours, .5, / Garrett A. Strang, R.A. Architect Encs. Plan of Property Map Prepared: 05-09-05 Amended: 06-19-08, 08-31-08 SCT# 1000-27-2-4 Situate: Orient Town: Southold Suffolk County, NY Datum: MSL NGVD'29 NOTES Existing Elevations sho~n thus (5.1) are reFerenced ko HSL N®Vo'2q Flood Zone onnoboted From FIRH Hop # D610:~C0068 ® Parcel resides oubslde the Coastal Erosion Hazard Area Reference Deed L. Lof. Area (to tie Lines) = -/D.SDb sF ldetland Area = 6,4-/0 sF Upland Area = 6-L086 sF N Impermeable % Coveraqes Exlsting Bulldin~s = -/~TO sF Pool, E~neds, Patio = 2,ql8 5~ To~¢l Exis~In9 = IO,288 Existing Lot Coverage ?15.54% s Proposed I~lldin9 Exp. Total Proposed Eot Covecoqe = IOhDe'sF or 15.86% roof