The URL can be used to link to this page

Home My WebLink AboutTR-7523A Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen 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 CERTIFICATE OF COMPLIANCE # 0687C Date September 14, 2011 THIS CERTIFIES that the removal of Locust stumps; re-vegetation of area with native plants; permeable stone patio; and relocation of deer fence At 750 Trtunan's Path, East Marion Suffolk County Tax Map #31-12-3 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 4/5/11 .pursuant to which Trustees Wetland Permit #7523A dated 4/20/11 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 removal of Locust stumps; re-vegetation of area with native plants; permeable stone patio; and relocation of deer fence. The certificate is issued to EDWARD FORTE owner of the Aforesaid property. ' Aut~h'orlzed Signature Jill M. Doherty, President Bob Ghosio, ,Ir., Vice-President Jm'nes F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain __ Ist day of construction ~ constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. FAng Dave Bergen 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 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 ~ constructed Project complete, compliance inspection Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375Main 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 Permit No.: 7523A Date of Receipt of Application: April 5, 2011 Applicant: Edward Forte SCTM#: 31-12-3 Project Location: 750 Truman's Path, East Marion Date of Resolution/Issuance: April 20, 2011 Date of Expiration: April 20, 2013 Reviewed by: Board of Trustees Project Description: To remove Locust stumps and re-vegetate area with native plants; install permeable stone patio; and relocate the existing deer fence. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Creative Environmental Design, last dated March 24, 2011 and stamped approved on April 20, 2011. Special Conditions: None. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Board of Trustees JMD:eac Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen 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 TO: Please be advised that your application dated ~)6, I .~"~ oqO ~1 has been reviewed by this Board at the regular meetin~ of [-~,Pr; J o~0., o90 ~1 and your application has been approved pending the completion of the 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) __ ~ Constructed ($50.00) /~ 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: $ .~C__~ o._~o BY: Jill M. Doherty, President Board of Trustees Jill M. Dohe~ly, President Bob Ghosio, Jr, Vice-Presidenl James F Krug Dave Bergen John Bredemeyer 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: /-/-1'~'~ l/ Creative Environmental Design on behalf of EDWARD FORTE requests an Administrative Permit to remove Locust stumps and re-vegetate are with native plants; install permeable stone patio; and relocate the existing deer fence. Located: 750 Truman's Path, East Marion. SCTM#31-12-3 Type/of area to be impacted: ~,S~ltwater Wetland Freshwater Wetland Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Sound Bay Type of Application: Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Modifications: Conditions: ese,~C,Were: J. Doherty B. Ghosio . ~/JBredeme~r D. Dze-nkowski other -- Form filled out in the field by (~D/Bergen, Mailed/Faxed to: Date: · ~?EOVED :~F,~D OF ":re OWN OF SOUTHOLD SURVEY O~F PROPERTY $1TUAT£D AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-51-12-05 · Soulhhold Town Board o! Trustees Jill M. Deherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone i631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7401A Date of Receipt of Application: August 31, 2010 Applicant: Edward Forte SCTM#: 31-12-3 Project Location: 710 Truman's Path, East Marion Date of Resolution/Issuance: September 22, 2010 Date of Expiration: September 22, 2012 Reviewed by: Board of Trustees Project Description: To tdm down evasive locust trees at specific areas on the bluff with the condition that no roots are being removed. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the application prepared by Creative Environmental Design, received on August 31, 2010. Special Conditions: No tree mots are to be removed. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jill~.'Doherty, ~ Board of Trustees JMD:eac OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: From: Mark Terry, Date: April 20, 2011 Re: Jill Doherty, President Town of Southold Board of Trustees Principal Planner LWRP Coordinator Proposed Wetland Permit for EDWARD FORTE SCTM#1000-31-12-3 Creative Environmental Design on behalf of EDWARD FORTE requests an Administrative Permit to remove Locust stumps and re-vegetate area with native plants; install permeable stone patio; and relocate the existing deer fence. Located: 750 Truman's Path, East Marion. SCTM#31-12-3 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 depadment, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney BOARI) OF [ ()X~' N i RUSI EES T~ )V,.'N {)l,' :'4t }["['II¢)LI) ~-. Oflice Us,v Only _ _Phone Nunlbcr:( APR - 5 20~1 )ard of Trustees Applicat Land Area (in square feet): Area Zoning: (~'--% Previous use of property: Intended use ofprope~y: GENERAL DATA Covenants and Restrictions: Yes v' No If "Yes", please provide copy. Prior permits/approvals for site improvements: ~ Agency Datc '74Ol __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspe~o' a govemmentatyes agency? If yes, provide explanation: Project Description (use attachments if necessary): ,ard of Trustees Applicat: WETI. AND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: ~d2>O square feet Percent coverage of lot: , O~ % Closest distance between nearest existing structure and upland edge of wetlands: (z; ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~9 5' feet Does the project involve excavation or filling? If yes, how much material will be excavated? .~ cubic yards How much material will be filled'? ---~ cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout tile area of operations: Manner in which material x~ill be removed or deposited: Statement of the effect, if any, on tile wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 617 20 PROJECT ~O NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Apptica¢.t or Project Sponsor) APPLICANT,SPONSOR~_~-.~'~"II,/~'"'~"'7~I/' ~-'-'-'-'-'-'-'-'~"~/~;'~/~ 2 PROJECT NAME 3 PROJECT LOCATION SEQR IS PPOPOSEO ACTION j~'New [] Expansion [] Modification, allerabon AL1OUNT OF LAND AFFECTED 8 WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS~ 9 ~,~.hAT iS PRESENT LAND gEE IN VICJNI~ OF PROJECT~ (Cnoose as many as apply ) 1{ DOES ACTION ~NVOLVE A PERMIT APPROVAL OR FUNDING NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fedetat Sta[eor Local) ~',es ~ tf hs~ agency name and permg, approval les. ;; DDE~ AN'f ASPECT OF THE ACTION HAVE A CURRENTL'~ 'vALiD PERMIT OR APPROVAL? [~es t~jNo If yes list agencf name and permd , approval %; -~5 :. RESULT OF PROPOSED ACTION WILL EX~STING PERMIT APPROVAL REQUIRE MODIFICATION? · M'f KNOWLE GE CERTIFt THAt file ;NFORMArION PROVIDED ABOVE IS TRUE TO THE BEST (DF 'LE~)GE, I! If th~ action is a Co~tal ~roa, and you aro a stato agency, complete the Coastal Assessment Form geforo proceeding with this Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATIOa: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN ~ Distuct Section BIo¢:k Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORKASSESSMENT ] Yes No a. What is the Total Ama of the Ploject Parcels? ~ I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within ~(~/OdO~ '/~Zfl .J2._. Generated by a Two (2') Inch Rainfall on Sits? the Scope of Work for Proposed Construction) (This item will include all mn-off created by site b. What is the Total Area of Land Cleadng (S.F. / Acres) · ' clearing and/or construction activities as well as all and/or Ground Disturbance for the pmpeseq .~,¢jc..~.sq F~- /~*,4-~ ~ ~;ita Improvements and the permanent creation of consbuction activity? impervious surfaces.) <e.F. ~^~) 2 Does the Site Plan and/or Survey Show Ail Proposed PRO¥1DE B~JEF PRO.~C~ DESCR[YI'[ON (Provide Ada~aa~ Pages as Nee~d) Drainage Structures Indicating Size & Location? This I Item shall include all Proposed Grade Changes and {/<,qe4',~7~ w /Y~-7~)e ,~[a,4'/3 3 Does the Site Plan and/or Survey descdbe the erosion · and sediment control practices that will be used to control site erosion and storm water discharges. This ~,~,.//~/---~, ~--j~'~o~ ~/~/~/~ fl~/?~'~e~ itemmustbemaintainedthroughouttheEntire Construction Peded. · "~ . /~(J [/.,'~,3 / ~' ~./...%'?~, ~,,..~ ~_~ C"-~'7~ rZ~/y/_~ , 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural I I Existing Grade Involving more than 200 Cubic Yards V of Matedal within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thcusand v (5,000 S.F.) Square Feet of Ground Surface?~ -- 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustaes jurisdiction General DEC SWPPP Requirements: Or within One Hundred (1 Off) feet of a Wetland or~-- -- Submission of a SWPPP is required for all Conslmction activities invctvir~ soil Beach? disturbances of one (1) or more acres; inctudlr~j disturbances of lass than one acre that 7 Will there be Site preparation on Existing Grade Slopes ampariofalamercomrnonplanlhatwillultimateiydisturboaeorrrmreacresofland; which Exceed Fifteen (15) feet of Vertical Rise te I I "~ including Const~Jction actN'i6es iovok'ing so~ disturbances of loss than one (1) acre where One Hundred (100') of Horizontal Distance? the DEC has detenmined that a SPDES permit is required for storm water discharges. SWPPP'$ Shatl meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious ~ storm Water Discharges from Construction activity, permit No. GP-O.t 0-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.3'ne SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town flght-of-w;~y? 2. The SWPPP shall desc~be the erosion and sediment conb~ practices and where 9 Will this Project Require the Placement of Matadah STATE OF NEW YORK, COUNTY OF ........................................... SS That I, ....~...~...~..t...~..~...~...~....~....O...~...!...C.'..~......}..... being duly sw6m, deposes and says that he/she is the applicant for pem~t, And that he/she ~s the ....... ./-dc~l&<~.'.t.....: ................................................................................................................................. Owner and/or representattve of the Owner or Owners, and ~s duly authorized to perform or~lit[~, .~t~4Ja¢ tl~t,~.rk and to make and file this application that all statements contained in this application ~re me to the bc~4~hi~edl0? and beliefi and that the work will be performed zn the manner set fo~da n the apphcaao ) filed heremth. C0,ql, ~,:~ ::;!;i'ea ;,pr 19, Sworn to befor~e~,L~/lthis; .......................... ~ .................... ...~......-- ..... ;.......5;... day of ...0~...4~.~.t .................. 20//... FORM - 06/10 ~ '~ Board of Trustees pp ica~on County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE IRUE TO THE BEST OF HIS/I-[ER 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 ~t.ICAT1ON Signature ~ SWORN TO BEFORE ME THIS ~" DAY OF ,2o tl l'~t'ary Public LAUREN M. STANDISH Notap! Pub!lc, S~ate of Now York No. 01 ST6164008 Qualified ir* ;Suffg~k County Commission D:~,,ires ~pril 9,204¢~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Soulhold's Code of Ethics t~rohibits conflicts of intercs{ on the Dart of town officers and employees. The ouroose of this form is to vrovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is I~ast name, ~qrst n'a~e, middle initiat, unles~ you are applying in the name of someone else or other entity, such as a company. If so, indicate the otber person's or company's name.) NAME OF APPLICATION: (Check all inat apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if"Other", name the acli~ity.) .................................... Do you personall) (or through )'our company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? ' Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in ~ hicb thc town officer or employee has even a partial ownership of(or employment by) a corporation in ~hich the town officer or employee owns more than 5% of the shares. YES NO V~' If ;,ou ans~ered "YES". complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold l'itle or position of that person Describe the relationship belween yourself (the applicantJagent/representative) and the town officer or employee. Either check the appropriate line A } through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shaves of the corporate stock of the applicant (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 REI~ATIONSHIP Form TS I Submi~of~./h~ L 20~I _L S ignatu re .--'}~.~.~-.t'ff Print Name~ 'Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for pen'nits* 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. *£x'cept minor exempt actions including Building Per,tits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before zmswering the questions in Section C, the preparer of this tbrm should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Progrmn, 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- supporling facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A cop>' of the LWRP is available in the follovAng places: online at the Town of Southold's website (southoldto~xn.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 The Application has been submitted to (check appropriate response): · o,,'n oard [] Pl nin oar E] uildi .ept. F1 oardofTrustees 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) Permit, approval, license, certification: Site acreage: , q~ 3 Presentlanduse: 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: (b) Mailing address: (c) Telephone number: Area Code (). (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No [~"~lfyes, 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 u~e of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of developmen't. 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~[~Not'Applicable Attach additional sheets if necessar~ Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section I11 - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No [~Not Applicable Attach additional sheets if necessa%' NATURAL COAST POLICIES Policy ,I. 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 I~Not Applicable Attach additional sheets il' necessaE, Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through/21 for evalttation criteria Yes [] No [ ~'~NotApplicable .-\uach additional sheets if necessar.~ l'olicy 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 Not A~licable Altach 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 f--~ot 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 111 - Policies; Pages 34 through 38 for evaluation criteria. [] Yes R No ~NoI applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public hands, and public resources of the Town of Southold. See LWRP Section Ill - Policies; Pages 38 through 46 for evaluation criteria. ~N~t A [] Yes~] No pplicable ..\l~ach additional sheets if necessary WORKING COAST POL Policy I0. Protect Southold's water-dependent uses and promote siting of new ~vater-dependent uses in suitable Iocations./See LWRP Section ill - Policies; Pages 47 through 56 for evaluation criteria. ~j Yes [] No [~N~N'ot Applicable Auach 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~N~t~pplicable Attach additional sheets if necessaD' Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section Ill - Policies; Pages 62 through 65 fur evaluat on criteria. [] Yes [~ No [~Not Applicable Attach additional sheels if nccessar) Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section !11 - Polic~5 through 68 for evaluation criteria. I I Yes ~_j Nol t~ Not .Applicable TITLE q]) .?~ A~o t~ I)ATE~L~_ PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc),/ DOES ACTION EX ED ANY TYPE I THRESHOLD N 6 NYCRR, PART 617 40 If yes, coordinate the review process and use the FULL EAF B W~LL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617 6? If NO, a negative C5 Long term. shod term. cumulative, or other effects not identified in C1-C57 Explain briefly: C7 Other impacts tincludin~ cnan~es in use of either (]uantib/or ~¥pe of energy? Explain briefly: i/Mo D WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL/~EA fCEA)'~ [] Yes r'--~ ~ ~ (if yes. explain brief]~ r E IS THERE.O~o iELiKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? Ifyesexplain ] Yes / PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenfi~edab~ve~determioewhetheritissubstantia~iarge~imp~rtant~r~herwisesignificant Each effecl should be assessed in connection with its (a) selling (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; {e) geograDhic scope: and (f) magnitude If necessary, add attachments or reference supporting materials Ensure that explanations contain sufficient detail to show that all relevant adverse impacls have been identified and adequately addressed, if question d of part ii was checked yes. the de,er ruination of s~gm fica nce musl evaluate the potential impact of the proposed action on the environmental characteristics of Ihe CEA Check this box if you have idemified one or more potentially large or significant adverse impacls which MAY occur Then proceed directly to the F ULt EAF andlor prepare a positive declaration Check th~s box ~f you have determined based on the informabon and analysis above and any supporting documenla~ion, that [he proposed ac~io~ WILL NOT result in any significant aaverse enwronmerdal impacts AND provide, on attachmenls as necessary, the reasons supporting determination Name of Lead Agency, ~ T~e Officer in Lead Agency '"'"-~'ignature oT'~es.~.~.~ Officer ~n Lead Agency Title of Responsible Officer Signature of Preparer (If different from responsible officer) QUESTING PERMIT FOR; 1. IVIQVAL VE~TATtON £ 5. OF LOCUST STUMPS Ah~ RE WiTH NATIVE PLANTINGS, INSTALL PER~,GLE STONE PATIO f~owos~ ~ F~qCE PROP(~. ~ERM, S-~CSE PAiiO ~SIDENCE %~vl #- 1000-51-I2-03 Revision #: Scale: Landscape Plan' 3-24-11 Lands~pe Design by: David Cichanowicz Date: 4/5/2011 1" = 10' Forte Creative Environmental Design