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HomeMy WebLinkAboutTR-7857A James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 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 ¼ constructed v// Project complete, compliance inspection James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 Permit No.: 7857A Date of Receipt of Application: July 2, 2012 Applicant: Paul Ragusa SCTM#: 86-6-2.3 Project Location: 165 Wood Lane, Peconic Date of Resolution/Issuance: July 18, 2012 Date of Expiration: July 18, 2014 Reviewed by: Board of Trustees Project Description: To construct a second story deck addition over existing 1% story roof with access to deck from a door from the existing 2nd story master bedroom. 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 July 2, 2012 and project plan stamped approved on July 18, 2012. 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,, Pres~id~ Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 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 r~ I,~ [ 13- has been reviewed by this Board at the regular meeting of' '~ !' ! ~'J I~- 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) __ Ist Day of Construction ($50.00) __ ½ Constructed ($50.00) Y" Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or m-application fees will be necessary. You will receive your permit upon completion of the above, COMPUTATION OF PERMIT FEES: TOTALFEES DUE:$~ BY: James F. King, President Board of Trustees James F. King. President Bob Ghosio, Jr, Vice-President Dave Bergen John Bredemeyer Michael J. Domino P.O Box I 179 Southold, NY 1197l Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: John Bertani Builder, Inc. on behalf of PAUL RAGUSA requests an Administrative Permit to construct a second story deck addition over existing I 1/2 story roof with access to deck from a door from the existing 2"d story master bedroom. Located: 165 Wood Lane, Peconic. SCTM#86-6-2.3 Type of area to be impacted..; __Saltwater 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 /'Administrative__Emergency __Coastal Erosion Pre-Submission ~Amendment Violation Info needed: Modifications: /~ ,, ~,~ff- Conditions: Present Were: vJ~ing __B. Ghosio__ J. Bredemeyer___ Michael Domino Form filled out in the field by Mailed/Faxed to: Date: D. Bergen, D. Dzenkowski other ~0'~cE I~ COUN~ OF SUFFOLK ~ 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 To: MEMORANDUM Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 13, 2012 Re: Proposed Wetland Permit for PAUL RAGUSA SCTM#1000-86-6-2.3 PAUL RAGUSA requests an Administrative Permit to construct a second stow deck addition over existing 1 ~ story roof with access to deck from a door from the existing 2nd story master bedroom. Located: 165 Wood Lane, Peconic. SCTM#86-6-2.3 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 department, 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 Office Use Only Coastal Erosion Permit Application Wetland Permit Application t/"Administrative Permit AmendmentyTransfer/Extension ~ Received Applica il~n;- ~Received Fee:$ ~k.) ' ~--'~ompleted Application __Incomplete __SEQRA Classification: Type 1 Type Il Unlisted · sent)_ ~---'LWRP Consistency Assessment Form · __CAC Referral Sent: cD'ate of Inspection: ~ !il I IS- _Receipt of CAC Report: __Lead Agency Determination: __Technical Review: ~'Public Hearing Held: Q .~ __Resolution: Name of Applicant ~q I O0 ~.~ Phone Number:( ) Suffolk County T~ Map Number: lO00- .rope~ Location: (provide LILCO Pole g~ ~t~ce to cross streets, and location) (If applicable) of Trustees Application Land Area (in square feet): Area Zoning:. GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes X No Does this project require a variance from the Zoning Board of Appeals __ lf"Yes", please provide copy of decision. Yes ~ Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes X No Does the structure (s) on property have a valid Certificate of Occupancy X' Yes __ Prior permits/approvals for site improvements: Agency Date No No __ No prior permits/approvals for site improvements. Has any permiffapproval ever been revoked or suspended by a governmental agency? >< No Yes If yes, provide explanation: Project Description (use attachments if necessary): o~ '?- xf~-otCc/ ~,~ 'o{c~ bc dcoo B~ of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: { I ~19~ g square feet Percent coverage of lot: /~,~' % Closest distance between nearest existing structure and upland edge of wetlands: -'/I I feet Closest distance between nearest proposed structure and upland edge of wetlands: r/I ~' feet Does the project involve excavation or filling? x/x No Yes If yes, how much material will be excavated? /~ [t'4 cubic yards How much material will be filled? h~/~ cubic yards Depth of which material will be removed or deposited: N ] iq Proposed slope throughout the area of operations: /~ ] ~ Manner in which material will be removed or deposited: /X/}/q 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 Botd of Trustees A~plication COASTAL EROSION APPLICATION DATA Purposes ofproposed activity: cQ h~ d3q~ ~¢~.~ o~t~d',+ioa.3 Are wetlands present within 100 feet of the proposed activity.'? No ~ Yes Does the project involve excavation or filling? X No Yes If Yes, how much material will be excavated? ~O~ (cubic yards) How much material will be filled? ~xc~rxe.~ (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) PROJECT ID NUMBER SEQR PART 1 - PROJECT INFORMATION APPLICANT / SPONSOR 3.PROJECT LOCATION: 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Apglican! or Pro~ect Sponsor) 2. PROJECT NAME 4. PRECISE LOCATION: Slreet Addess a~d Road IntersenlJons. Prominent landmarks etc -or or•vide mad 6. DESCRIBE PROJECT BRIEFLY: ?. AMOI. INT OF LAND AFFECTED: InltJa~ { (~ ~ enres Ultimately [ (o ~ acres 8. IMLL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ]~'~Yes [] No If no, descfibebtie6y: 9l WHAT IS PRESENT LAND USE IN VlClNll~' OF PROJECT? (Choose as meW es apply,) l~Resl~entia, l'--IIfldustrlal [~lComrllerclal l~IAgricullure l-l'IPark/F.$t/OpeoSpene --] OIImr (desc~be) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, Slate or Local) r'~Yes [-~No If yes, list agency name and permit / approwi: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? '--]Yes If yes, list name and / a No agency permit approval: I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sp ~ens/~r Name Date' If the action It a Costal Area, and you ar'~s state aglmcy, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥) A. DOES ACTION EXCEED ANY TYPE t THRESHOLD ~N 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF. r-]Yes [~]No B. 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 involved agency, [~Yes [~]No C. COULD ACTION RESULT iN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, sudace or groundwater quality or quantity, noise levels, existing traffic pa6ern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly; I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: I C3. Vegeta on or fauna, fish, she fish or w dfe species, s gmficant habdats, or threatened or endangered species. Exp am bnefly: I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain bdefly: I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I C6. Long term, shod term, cumulative, or other effects not identified in C1-C57 Explain briefly: I C7. Other impacts {includth~ D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA {CEA}? {If ),es, explain bhefl¥: [~Yes ~-lNo E. IS THERE, OR IS THERE LIKELY TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? lf)'es explain: [~Yes r~No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: Foreach adverseeffectidentified above, determinewhetheritissubstantial, large, important orotherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. ud3an or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that alt relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of sig nifica nce must evaluate the potentia~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 FULl EAF and/or prepare a positive declaration, Check this box if you have determined, based on the information and analysis above and any suppoding documentation, that the proposed acfiol WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. Board of Trustees Name of Lead Agency Print or Ty~e Name of Responsible Officer in~l, ead Agency $i~ture of Responsible Officer m Lead ~o~rncy [] d d~ ~ Date President [] Title of Responsible Officer Signature of Preparer (If different from responsible officer) B~d of Trustees Al~plication County of Suffolk State of New York k~ t~__~-., f~. 13d,"~Lo. th: 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), 1F 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 DAY OF LYNDA M NOTARY PUBLIC, State of New York NO 01BO6020932, Suffolk CouBI,.~ Term Expires March 8, 20~ Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) (print owner~f property) residingat oCg [M. 7t{'r/".-[~ (mailing address) ~¢tO ~or'~-, ~L~ 106,,2~3 doherebyauthorize (Agent) ._~ln [/~/'3'(~'~ ~/~,.~__rte,..... to apply for permit(s) fromthe Southold Board of Town Trustees on my behalfi (Owner's signature) J JUL - 6 2012 ~ ~,']rd of Trustees Board of Trustees Ap~l£cation AL1THORlZATION (where the applicant is not the owner) (print owner of pq6,.~erty) (mailing address) (Agent) apply for permit(s) fi'om the Soutbold Board of Town Trustees on my behalf. (O4vnefs signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the rvart of town officers and emolovees. The purpose of this form is to orovide information which can alert the town of possible conflicts of interest and allow it to take whatever action is neeessarv to avoid same. (Lust nam~Jhrst name~ middle initial, unless you are applying in the name of someone ~se or other entity, such us a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coustal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of 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 ~( If you answered "YES", complete the balance of thls 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/agentJrepresentafive) 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% oftbe 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 Form TS I Submitted this I v~ day of Signature (~'*'t.~Lc... c~, Print Name t~,n&r~, O. Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (631)765-1594 FAX (631) 765-3916 July 1,2012 Re: Paul Ragusa Residence, 165 Wood Lane, Peconic, NY 11958 Mr. James King, President Southold Town Trustees P.O. Box 1179 Southold, NY 11971 Dear Mr. King, We are submitting an acplication for an administrative permit for Mr. Paul Ragusa He has a~ existing two stc~//one and one half story one family dwelling at 165 Wood Lane in Peconic. He is proposing to erect a second story deck addition over the existing one and one half story podion of his home with access to it from a door leading from an existing master bedroom in the second story portion on the home. See attached elevations. Mr. Ragusa's existing home is 74 feet from wetlands. There will be no excavation required and there will be no impact to the existing wetlands or to neighboring properties. Thank you. Sincerely, Linda D. Bertani Vice President JL!i_ s! 2012 A. . INSTRUCTIONS ~---.-._~ar00fTrm;;~ I~°~BS°Uthhold~°~-~-~' , 1. All applicants for permits* including Town of Southold agencies, shall comp~ 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 Water~ont Revitalization Program. A proposed action will be evaluated, as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3~ If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suooorting 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 f611owing 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# ~'~ - d/. - 7_. ~ ~. . The Application has been submitted to (check appropriate response). TownBoara [] Planning Board [--] BuildingOept. [] aoardofTrnsteea [] Category of Town of SOuthold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ~ coastmction, planning activity, agency regulation, land transaction) [-] (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: 0 RIGHT ELEVATION SCALE: 1/4": 1'-0" Location of action: Site acreage: Presentlanduse: Otl~ 420.mllt~ dme~ll~r,'ct_ Present zoning classification: I~- GtCO (f 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 10033 (d) Application number, if any:. Will the action be directly tmdertaken, require funding, or approval by a state or federal agency? Yes [] No ~ If yes, which state or federal agency?_ C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. FOster a pattern of development in the Town of S0uthoid 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 HI - 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 necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~ Yes ['~ No [] Not APplicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from~flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~-] Yes ~] No [~] Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ~ Yes [] No [-~ Not Applicable Atlach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Applicable 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~ 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 V~ No [] Not Applicable ' Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southoid. 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 HI - Policies; Pages 65 through 68 for evaluation criteria. [--] Yes ~'] No ~-] Not Applicable DATE q/3//~ APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE RIGHT ELEVATION SCALE: 1/4" = 1'-0" ~0~~ L × CITE DATA AREA = I.&DO¢ AC, R`E5 OR. ~l,Oeq 5~. ~T. CUI~'CtE'I"OP-,.'¢ C,t--P-,TIFIC. ATION 5L)P..VE'r' FOR PAUL RA¢UZ, A ot P¢conic, To~n of 5outhold BOUNIDAP-,"r' f~¢corc~ oF f~¢vl~lon~ 5cc~lm I" = 40'