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HomeMy WebLinkAboutTR-7737A• John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee February 18, 2015 Mr. Arthur Leudesdorf PO Box 1275 Southold, NY 11971 • pF SO�jyo� �4UNV i* BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: ARTHUR LEUDESDORF 1700 HYATT ROAD, SOUTHOLD SCTM# 50-1-5 Dear Mr. Leudesdorf: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, February 18, 2015: RESOLVED that the Southold Town Board of Trustees grants the Last One -Year Extension to Administrative Permit #7737A, as issued on February 22, 2012. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, r 40 John M. Bredemeyer III President, Board of Trustees JMB/amn • i L •mss r 77-P ,c4 79e� h Ir L John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King Charles J. Sanders Dave Bergen February 19, 2014 Mr. Arthur Leudesdorf 1700 Hyatt Road Southold, NY 11971 at BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: ARTHUR LEUDESDORF 0 Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 1700 HYATT ROAD, SOUTHOLD SCTM# 50-1 -5 Dear Mr. Leuilesdd'rf`.` � � � h' '' ` • ' The following action was taken by the SdUtFiold Town Board of Trustees at their`I#egular Meeting held on Wednesday, February 19, 2014: RESOLVED that the Southold ,Town Board of Trustees grants a One -Year Extension to Administrative Permit #7737A, as issued on. February 22, 2012. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, ov— +'% John M. Bredemeyer III President, Board of Trustees JMB/amn • • John Bredemeyer, President gUFFO(tell Town Hall Annex Michael J. Domino, Vice -President � 54375 Route 25 James F. King ; P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field InspectionMork Session Report Date/time: I& /� ARTHUR LEUDESDORF requests a One -Year Extension to Administrative Permit #7737A, as issued on February 22, 2012. Located: 1700 Hyatt Road, Southold. SCTM# 50-1-5 Type of area to be impacted _Saltwater Wetland _Freshwater Wetland _Sound /Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 _Chapt. 111 _other Type of Application: Wetland _Coastal Erosion _Amendment _Administrative _Emergency _Pre -Submission _Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed: Modifications: Conditions: s2— u 1d Present Were: J. Bredemeyer ✓ M. Domino J. King C. Sanders Bay Constable Other Form filled out in the field by%A" Mailed/Faxed to: Date: r r n .. ...,.. James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino 0 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 0 Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE -CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre -construction, hay bale line 151 day of construction % constructed V Project complete, compliance inspection / 1 IN S /`s*'3010°, alp ebb � Bolqy.- O/W QO C%?K 1i r 1 i SURVEY OF PROPERTY SITUATED AT HORTON POINT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-50-01-05 SCALE 1Na50' JUNE 19, 2000 AREA - 38.792.79 w• T,. (M M U O 0.991 W. TEST HOLE DATA (TEST HOLE DUO BY y'9^^ 'A' Q ArwnMCE ON JUNE 3. 2000) wt IRNN iaN a OWN ILWr O4Kt MK K {I1OAH aIAKI RHO K — b• NOP N NgNN pANN WID K Oky„ APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE z z z C12 c --7'l �Wip N NpN, IIR W CD,IIN: iVD lW 1P TM, L.LC . .- fl TME NiBURANCE COMPANY Of NEW YORK IrESW. DORf I. ELLYNIN—a rTO�SA�/3L OATON -------- Bda 6' OAR TO 4 IMMON HOUK IS 1,000 GALLONS. O 3. 1N ' SEriiEdlall FORA 1 TO { BEDROOM HOUSE d 70 p H {wu EWAAREA. rI #SWA 0R'IPINIION FOOL ® 180VOS[0 IEACNIN{ FOOL -NIOROEM SWM TAW. ♦. THE OgVDR/L ��S,MNA.LL K p/(OpyEL ONO OUT, OM TO A a T ANO OkAVG. FO A gAY[TSR SIX ({) I[Ei {, M 1ERi9 AlID �pN 1 m ARE FROM HEAD _zx/ ANOfOR DATA E011pt. UKWn DI�tly2R[O�ALTIMAMON 0AMIION 7�� 7000�1NE N[W ,pIN 3�TGAT�ENp Joseph A. Ing®gno of TM{ NW WL d1 Land Surveyor °{E ° ,� TuwT TWO arvAp " a"yalaw — SIN Fbw +,.qwwbuouwLlym AMD PHONE Z95Yp47-1009 ft (631)727-1727 Is ,RvdmN.[. 01 7CC4 LOO1= AT 94UX ADDRESS RtO F 1}pp Art7wE V.O. eOE1931 ,NOor T AIIE NOT o1MiAANTEED. RNFRHEM"wYmk 1,901 RIw hwd. New Yak 11901.0968 Sys rsl;. W SOUND VIEW AVENULr 4 O� James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino Permit No.: 7737A BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date of Receipt of Application: February 8, 2012 Applicant: Arthur Leudesdorf SCTM#: 50-1-5 Project Location: 1700 Hyatt Rd., Southold Date of Resolution/Issuance: February 22, 2012 Date of Expiration: February 22, 2014 Reviewed by: Board of Trustees E Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax(631)765-6641 Project Description: To trim trees and plant native vegetation within the area seaward of the top of bluff, as needed in order to maintain the present view of L.I. Sound. 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 received on February 8, 2012 and survey stamped approved on February 22, 2012. Conditions: The installation of a 10' non -turf buffer planted with native vegetation along the landward side of the top of bluff. 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. Jame King, Preside Board of Trustees James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino TO: �Q��gUFFO(�-co Town Ball Annex N 4 S 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated M I V has been reviewed by this Board at the regular meeting of rD 11 a. 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) 1 st Day of Construction ($50.00) ''/z Constructed ($50.00) V 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: $ SQ,n(D BY: James F. King, President Board of Trustees 9 James F. King. President Bob GhoSw, .h'_ % icc-Pi c,idmi Da,e Bcrecn John Biedomcvcl Michael J_ Domino 0 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: I" i P.O. Box 1179 Southold_S 1 11971 Telephone 1631 765-1892 Ftx16311765-6641 ARTHUR W. LEUDESDORF requests an Administrative Permit to trim trees and plant vegetation within the area seaward of the top of bluff, as needed, in order to maintain the present view of the Sound. Located: 1700 Hyatt Rd., Southold. SCTM#50-1-5 Type of area to be impacted: _Saltwater Wetland _Freshwater Wetland /Sound _Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion _Amendment _Administrative_Emergency Pre -Submission Violation Info needed: Modifications: Cond Present Were: J. King B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: I jr IRK' '®r dvl-lpff I MRX N OFl- �*W !Amiza :r a-- SOIL AND MATER CONSERVATION DISTRICT FAX.(631)727-3160 February 21, 2008 Town of Southold Board of Appeals 53905 Main Road, P.O. Box 1179 Southold, NY 11971-0959 Attention: Gerard P. Goehringer . WWAI&� yr AVrr-VLlt u :Yi34?Y za Steve Levy SUFFOLK COUNTY ERECUTIVI RE: ZBA File Ref. No. 6138 (Ragusa) Dear Mr. Goehringer: Thomas J. McMahon DISTRICT MANAGER (631)727-2315 FEB 2 6 2003 BOARD OF APPEALS We have completed a site inspection of the above parcel as you have requested. The house is in the midst of being built. At this time, the lot behind the house is bare as is the lot area surrounding the house. Roof runoff exits onto the ground surface at this time. Pipes are installed at the house corners for what appears to be drywell access. There is a line of Straw Bale Sediment Barriers installed along the bluff top edge. This line ends at the parcel comers and is open at the stairwell. The bluff face is well vegetated with grasses, shrubs and trees. There are two existing old ravines, one at each comer of this parcel. The rear lot slopes towards the bluff face and these two corners so surface water runoff flows over the bluff face. A stairwell exists down to the beach level. It appears to be in fair condition and has had some recent repairs. The bluff is high and very steep. Some trees are dead and lying down and many others are growing throughout the bluff face. No toe stabilization exists on this lot or on any adjoining lots. High tide appears to come within fifteen feet of the toe. Storm level tides apparently reach the toe. There are exposed glacial erratics embedded in the bluff face along the toe in . several spots. We recommend that the roof water runoff be directed to gutters and downspouts leading to drywells. The lot surface at this time is bare and can have severe erosion problems from stormwater runoff. Upon finishing the lot grading it should be planted to either a permanent sod cover or a ground cover. The best time for planting grasses is in the Spring, April 15`h through May 15`h or for a fall planting, September 15`h through October 15`h. The Straw Bale Sediment Barriers are not installed properly and there are open spots that the water can and will flow onto the bluff face causing an erosion problem. The bales should have been partially dug down beneath the ground surface about four inches deep to keep soils and water from getting under the bales. They also should be double staked. One stake should be installed vertically and the other at an angle to keep the bale from moving. The straw bales should have been continued up slope at the corners to contain surface runoff, instead of allowing it to flow around the ends. The stairwell should also have been blocked by the straw bales. Enclosed is a Standard for Straw 423 GRIFFING AVENUE SUITE 110 RIVERHEAD, NY 11901 Bale Sediment Barriers and Silt Fencing. There is a proposed Terrace between the house and pool area that is not mentioned in your letter. This area will increase surface water runoff greatly. Proper drainage for this area should be considered. Due to slopes on this lot, a Sediment and Erosion Control Plan would have been recommended to protect soils. Bare ground should have been covered temporarily with straw mulch to further enhance protection. Trees on the bluff face can cause an erosion hazard as they are undermined due to high winds traveling up the bluff face thereby loosening the root ball and eventually toppling the tree along with large amounts of soil attached to the root mass. Trees already downed should be removed from the bluff face as they can slide or roll and also smother existing vegetation. Live trees should be cut down and removed, leaving the root systems intact so as not to disturb the soil. Leaf litter and grass clippings should not be strewn onto the bluff face as this will also smother exiting vegetation. Bare areas if they exist should be planted to Cape American Beachgrass during its dormancy period from November through March. The installation of a pool has the same effect as the house. It adds a tremendous weight load on the soils. As erosion continues to cut back the bluff the house and pool will eventually become endangered. Without a hardening structure at the toe of the slope, erosion will continue at an unknown rate. If the pool is allowed to be installed, measures should be taken to prevent pool water from flowing onto the bluff face. It should be diverted away from the bluff or directed into a drywell system. If you have any further questions regarding this site inspection, please feel free to contact us again. Respectfully, Paul A. TeNyenhuis, Senior Soil District Technician GALS BOARD MEMBER* Gerard P, Goehringer, Chairman James Dinizio, Jr. Lydia A. Tortora Lora S. Collins George Horning BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS, and DETERMINATION MEETING HELD OCTOBER 5, 2000 Southold Town Ha.. 53095 Main Roac P.O. Box 1179 Southold, New York 11 i71 ZBA Fax (631) 765-9t)6-1 Telephone (631)765-'�0) Appl. No. 4858 — ARTHUR AND FRANCES LEUDESDORF/W. MANDEL Street and Location: 1700 Hyatt Road, Southold 1000-50-01-005 Date of Public Hearing: September 14, 2000 FINDINGS OF FACT PROPERTY FACTS- The subject property consists of 38,792.79 sq. ft. with 100.03 feet frontage on Hyatt Road in Southold. The property is 100.03 ft. x 395.67 ft. deep and fronts along the L.I. Sound. BASIS OF APPLICATION• Building Inspector's Notice of Disapproval dated August 18, 2000 states that the proposed house is located at less than 100 feet from the top of the bluff or bank of the L.I. Sound, as required by Code Section 100-239.4A.1. AREA VARIANCE RELIEF REQUESTED: Applicant requests a variance authorizing location of a new dwelling at 70 feet from the top of the bluff at the northeast corner and at 81 feet from the top of the bluff at the northwest comer as shown on the site plan prepared by David H. Sherwood, Architect, dated August 5, 2000 and survey map prepared by Joseph Ingegno, Land Surveyor, dated August 28, 2000. REASONS FOR BOARD ACTION DESCRIBED BELOW: On the basis of testimony presented, materials submitted and personal inspection, the Board m tkes the following findings: On the basis of testimony presented, materials submitted and personal inspection, the Board makes the following findings: (1) The subject lot is totally undeveloped. The land slopes away frori the bluff. The top of the bluff runs at an angle across the lot, leaving property that is 81 +- ft. deep behind the bluff at its westerly side and 70+- ft. deep at its easterly side. Applicants wish to locate their house with a greater bluff setback than existing houses on adjacent lots to the east and west. A deep depression exists between the roadway and the higher elevation. All the properties enjoy an unobstructed view of the L.I. Sound, and a water view cannot be obtained for this waterfront parcel without variance relief from the 100 -foot bluff setback requirement. (2) Applicants ask to place the house approximately 70 feet and 81 ft, from the northeast and northwest corners, respectively, from the top of the bluff. Page 2 — October 5, 20 • Southold Town Board oNWeals 1000-50-1-5 Mandel/Leudesdorf at Southold (3) The report of September 13, 2000 from the Suffolk County Soil and Water Conservation District states that no visible problems exist with the house location as proposed; that the proposed house is behind the high point of the bluff; and that the bluff appears to be stable. (4) A tremendous amount of fill would be required to achieve the benefits in locating a new dwelling in any other area; the Coastal Erosion Hazard Line as shown greater than 100 feet from the proposed dwelling location. (5) The applicant has agreed to landscape for adequate drainage and agrees to accept the conditions to mitigate concerns, such as drainage onto neighboring lands. (6) Grant of the relief set forth below will not produce an undesirable change in the character of the neighborhood or detriment to nearby properties because location of the house will be consistent with the setb9cks on neighboring properties. The action set forth below is the minimum necessary and adequate to enable applicant to enjoy the benefit of a dwelling with a waterview, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION/ACTION: On motion by Member Dinizio, seconded by Member Horning, it was RESOLVED, to GRANT the variance as applied for subject to the following CONDITIONS: (1) All roof drainage and surface water from this site shall be directed away from the bluff and retained in dry well (s) on this property. (2) Hay bales shall be placed at 45 feet from the top of the bluff for the entire width of the property; Re -grading activities shall be limited to that applied for and referred to on Architect's site plan dated August 5, 2000. (3) No further bluff setback reduction. (4) The foundation overcut shall not extend more than 15 feet around the house and no closer than 55 feet from the top of the bluff. No land disturbance (such as excavating for retaining walls, pools, or other structures) shall take place within 55 feet from the top of the bluff. Page 3 — October 5, 20 Southold Town Board of eels 1000-50-1-5 Mandet(Leudesdorf at Southold 46 (5) Machinery and related activities shall be as confirmed in the Septem- ber 20, 2000 letter to the Town of Southold from Scott Jones Construction, Inc. VOTE OF THE BOARD: Ayes: Members Homing. This Resolution was duly adopte GERARD , and GOUKiV OF SUFFOLK ll—' �oumu e Rae[PmV TUS Agenq [ Y .«mss 0 �"t 0 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 r 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: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: February 22, 2011 Re: Proposed Wetland Permit for ARTHUR LEUDESDORF SCTM# 1000-50-1-5 ARTHUR LEUDESDORF requests an Administrative Permit to trim trees and plant vegetation within the area seaward of the top of the bluff, as needed, in order to maintain the present view of L.I. Sound. Located: 1700 Hyatt Rd., Southold. SCTM#50-1-5 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 the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. The existing vegetation serves as a buffer between parcel development and the bluff area. It is recommended that the existing vegetation be maintained. E. Maintain buffers to ensure that adverse effects of adjacent or nearby development are avoided: 1. Maintain buffers to achieve a high filtration efficiency of surface runoff. 2. Avoid permanent or unnecessary disturbance within buffer areas. 3. Maintain existing indigenous vegetation within buffer areas. 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 s8 i t 'i, 'Z i f ll P r ARTHUR LEUDESDORF requests an Administrative Permit to trim trees and plant vegetation within the area seaward of the top of the bluff, as needed, in order to maintain the present view of L.I. Sound. Located: 1700 Hyatt Rd., Southold. SCTM#50-1-5 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 the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. The existing vegetation serves as a buffer between parcel development and the bluff area. It is recommended that the existing vegetation be maintained. E. Maintain buffers to ensure that adverse effects of adjacent or nearby development are avoided: 1. Maintain buffers to achieve a high filtration efficiency of surface runoff. 2. Avoid permanent or unnecessary disturbance within buffer areas. 3. Maintain existing indigenous vegetation within buffer areas. 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 Jill M. Doherty, President James F. King, Vice -President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 0 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application _Wetland Permit Application _/Administrative Permit Amendment/Tran er/ 1, sion ✓Received Application: V -/Received Fee:$ Completed Application Type Classification: Type I_Type H Unlisted Coordination:(datsent) I ,� ✓LWRP Consistency Assessment Form CAC Referral Sent: _ Date of Inspection: 14 Receipt of CAC Report: Lead Agency Determination: Technical Review: _ Public Hearing Held:'� Resolution: Name of Address l 0 Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 r - J E 2012 �Phone Number:(, 46 S -, o 3 o Suffolk County Tax Map Number: 1000 - Property Location: / ZDU WyIt-TT )C47g¢1., `�vide LILC *M4o-4J AGENT: (If applicable) Address: cross streets, O.4 M.Lj i4Dr2TR ALS Phone: Ad of Trustees Application • GENERAL DATA Land Area (in square feet):_.38 Area Zoning:72s tl;,w I A -L Previous use of property: 4�- J T .4/ 2) Intended use of property:_��1� y Covenants and Restrictions: X Yes No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes X No If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes _ }(No Does the structure (s) on property have a valid Certificate of Occupancy Yes No Prior permits/approvals for site improvements: Date 141AXIIT f Y 2-0 40 0 / No pLno per6iits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? J_ No Yes If yes, provide explanation: Project Description (use attachments if 4Z) Wof Trustees Applicatio0 LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: 9:0&v square feet Percent coverage of lot:% Closest distance between nearest existing structure and upland edge of wetlands: .f- en�J feet Closest distance between nearest proposed structure and upland edge of wetlands: X;O— feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? /j, cubic yards How much material will be filled?/_ /fcubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER • 617'20 • SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. PLICANT/SPONSOR 2.P OJECT NAME 3.PROJECT LOCATION:/7'rOO Municipality-5or, , L County 4.PR E LOCATION: Street'dQoss nd Road Inters ctions. Prominent landmarks etc or provide mao�./' 5. IS PROPOSED ACTION: ® New ❑ Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY' _ ,. _ 4 r 4,,L-q:-rg6 7 '0g�" �j'0rl !Ct 7. AMOUNT OF L ND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? 'RiYes ❑ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ® Residential ❑ Industrial ❑ Commercial ❑Agriculture ❑ Park / Forest / Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) mYes r-1No If yes, list agency name and permit / approvaall:: KW� � / ZGd T OR APPROVAL? ❑YesLEYNo If yes, list agency name and permit / approval: A RES LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? 12. ass ass No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant h-Gpawr— HamA Date: Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment 0 0 PART 11- 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 EAE. Yes [Z] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative decoration may be superseded by another Involved agency. ❑ Yes a No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, It legible) C1. Existing ah quality, surface or groundwater quality or quantity, noise levels, extsfing 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. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly. C4. A community's existing plans of goals as of drolly adopted, or a change in use or Intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long tern, short term, cumulative, or other effects not identified in C1-05? Explain briefly: C7. Other impacts (including Changes in use of either quantity or type of enefg . Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA? If es,e lainbriefl: Yes W1 No I- —J E. IS THERE, OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL ENTAL IMPACTS? If yes lain: No r77 ,• r no - u r cr`rnuvc r rvn yr arvmrrriAPlric t to ne cO(npleted by Agency) . INSTRUCTIONS: Foreach adverse effect Identified above, determine whetherk Is substanilaL large, linportantorotherwise significant. Each effect should be assessed in connection with its (a) setting (.e. urban or rural); (b) probabft of occurring,- (c) duration; (d) hregerskliCdy: (e) geographic scope: and (f) megnibrde. If necessary, add attadunents or reference suppoldng materials. Ensure Olaf explanations contain suffidentdetall to show that d relavent adverse impacts have been identified and adequately addressed. OquesOon d of partilwas dredred yes, the determhabonofstrificsimmustevaluatemeposinOalimpadoWlepmposedacdonondie emlkalmentaldlarader oftheCEA. ChadrOAeboxifyouhave lderrtifiedone ormorepolerlgagylsrgeorslgMggamadvergekryredsW"MAYoccut. Ttrenprooeeddkedgrtoara EAF and(or prepare a posifiVne declaration. Check Ods box IfYou have dete rained, based on the Information and analysis above and any supponirg docamer ation, that the proposed a WILL NOT result In any significard adverse environmental Impacts. AND provide, on attachments as necessary, the reasons supportingI deteffninsfion. . Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in ead Agency Title of Responsible Officer Signature of Prepaw In different from responsible officer) 0 9 e�tTown of Southold Erosion, Sedimentation & Storm -Water Run-off ASSESSMENT FORM Y? "� PROPERTY LOCATION: S.c.T.M. p: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Q Q�j STORM -WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN on B oT Td� CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION rrEM # / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm -Water Run -Off (Include Total Area of all Parcels located within Generated by a Two (2") Inch Rainfall on Site? the Scope of Work for Proposed Construction) (S.R l Acres) (This item will include all run-offcreated by site ❑ It. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? Impervious surfaces.) / 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE B12ff.F PROJECT DESCRIPTION Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and ❑ Slopes Controlling Surface Water Flow. / 3 Does the Site Plan and/or Survey describe the erosion ✓—// F-1and sediment control practices that will be used to control site erosion and storm water discharges. This Item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? ❑ 5 Will this Application Require Land Disturbing Activities F]Encompassing an Area in Excess of Five Thousand (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 Trustees jurisdiction or within One Hundred (100') feet of a Wetland or General DEC SWPPP Requirement: Submission of a SWPPP Is required for all Construction activities involving soll Beach? disturbances of one (1) or nom acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes part of a larger common pan that will ultimately disturb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to El including Concoction activities involving sol disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance? / the DEC has determined that a SPDES pemdt is required for storm water discharges. ( SWPPP's Shall meet the Minimum Requirement of the SPDES General Permit for Storm Water Discharges from Construction activity • Permit No. GP.040.001.) 8 Will Driveways, Parking Areas or other Impervious ❑ Surfaces be Sloped to Direct Storm -Water Run -Off 1. The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be — into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. Will this Project Require the Placement Material, 2. The SWPPP shall describe the ereslon and sediment central practices and where 9 of J required, postconstrucllcn storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutant in storm water discharges and to assure ❑ — Item Within the Town Right -of -Way or Road Shoulder compliance with the tome and conditions of this permit. In addition, the SWPPP shall Area? Ohl. item win NOT rectae the rmmlwl.n rn pdw •a, APram') identify potential sources of pollution which may reasonabty be expected to affect the quality of stem water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3. All SWPPPs that require the pustcenstmctbn storm water management practice in a Box and the concoction aft. disturbance Is between 5,000 S.F. b 1 Acre in area component shall be prepared by a qualified Design Professional Licensed in New York that Is knowledgeable in the principles and practices of Storm Water Management. a Storm -Water, Grading, Drainage S Erosion Control Plan Is Requkad by Ow Town of Southold and Must be Submatd for Review Prior to Issuance of Any Building PermiL (NOTE: Ached WM (J) andt.r Answerforead Wesdmis Pe WredbraC pit Apel omI STATE OF NEW YORK, SGc�FFdP ..............................- SS .Fr. ,C,O,LUNTYO/F / That I, .a"'''1AfiL(!(..:....Y being duly swom, deposes and says that he/she is the applicant for Permit, / (Name of Individual signing Docemenl) Andthat he/she is the ....... .L.0A)._ .r1 Z............................................................................................................................ (Owner, Contractor, Agent. Corporate Officar, etc.) Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Swom to before me this; ...zo.liS ....... NvIEfVE S�r........... , �... : G It:RY..FJSLIC,.STATE.OFNEW.Y.03K........t. ........................................ ......4;(S.g 1 CA5009515 SUFFOLK COU NTY natura aAppi FORM - 06/10 TERM EXPIRES MARCH 15, 20 Board of Trustees Applicati• County of Suffolk State of New York �fi cc lz Ly �GLCcQiSGCo,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 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 THIS APPLICATION. . Ge Signature SWORN TO BEFORE ME THISDAY OF 6 eu qr 20 17, NotaryP� ublic {� STEVEN G.CARROLL NOTARY PUBLIC, STATE OF NEW YORK NO.OICA5009515 SUFFOLK COUNTY TERM EXPIRES MARCH 15, 20 `� APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM YOURNAME:e, first - (Las[namname, griddle initial, wless you are applying yin the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other"', name the activity.) Building Trustee �C Coastal Erosion Mooring Planning Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% 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 person Describe the relationship between yourself (the applicanUagenUrepresentative) 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 shares 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 RELATIONSHIP Submitteds day of 20j Signature _ Print Name 4 Form TS 1 Town of Southold A. INSTRUCTIONS E • LWRP CONSISTENCY ASSESSMENT FORM 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 sigaificant beneficial and adverse effects upon the coastal area (which includes all of Southold Town) 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non - supporting 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 SCTM# -S O - V/ - 0 S PROJECT fid 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 ❑ construction, planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: 0 Nature and extent of actior�---�— Location of Site Present land use:,��yf� Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of (b) Mailing address: Jf (c) Telephone number: Area Code lr— p (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No N 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. R 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 0 0 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 [:1 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 11 No 0 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 E]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. End Yes No Not Applicale • Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III — Policies; Pages 34 through 38 for evaluation criteria. ® Yes ❑ No ❑ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III — Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye,0 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 Peconic Estuary and Town waters. See LWRP Section III — Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ 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 Q Not Applicable PREPARED BY / TITLE DATE O O /y 0