HomeMy WebLinkAboutTR-7902A James F. King, President
Bob Ghosio, Jr., Vice-President
Dave Bergen
John Bvedemeyer
Michael $. Domino
Town Hall, 53095 Maia Rd.
P.O. Box 1179
Southold, NY 11971
Telephone (631) 765- t 892
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
v/
__ Pre-construction, hay bale line
__ Ist day of construction
~ constructed
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.: 7902A
Date of Receipt of Application: September 4, 2012
Applicant: Cleaves Point Condominiums
SCTM#: 38-7-14 & 15
Project Location: 2820 Shipyard Lane, East Marion
Date of Resolution/Issuance: September 19, 2012
Date of Expiration: September 19, 2014
Reviewed by: Board of Trustees
Project Description: To install three signs at locations along the property Fines.
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
project plan prepared by Chades Gueli, received on September 4, 2012, and
stamped approved on September 19, 2012.
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.
James F. King, President
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 ~'/~)2-~ / has been
reviewed by this Board at the regular meeting of ~l/Iq/.[,~- and
your application has been approved pending the completi6n 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)
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:
BY:
James F. King, President
Board of Trustees
,lames F Kmg, President
Bob Ghosio, Jr, Vice-President
Dave Bergen
John Bredemeyer
Michael J. Domino
P.O. Box 1[79
Southold, NY 11971
Telephone (631 765-1892
Fax (631)765-6641
Southold Town Board of Trustees
Field InspectionNVorksession Report
Date/Time:
CLEAVES POINT CONDOMINIUMS requests an Administrative Permit to
install three signs at locations along the property lines. Located: 2820
Shipyard Lane, East Marion. SCTM# 38-7-14 & 15
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:
Conditions:
Present Were: __J. King __B. Ghosio__
J. Bredemeyer___ Michael Domino
Form filled out in the field by
D. Bergen,
D. Dzenkowski other
Mailed/Faxed to:
Date:
.4-
N
38.02
OFFICE LOCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
Southold, NY 11971
MAILING ADDRESS:
P.O. Box 1179
SouthoId, 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
8EP 1 ,; 2012
From: Mark Terry, Principal Planner
LWRP Coordinator
Date: September 13, 2012
Re: Proposed Wetland Permit for CLEAVES POINT CONDOMINIUMS
SCTM#1000-38-7-14 & 15
CLEAVES POINT CONDOMINIUMS requests an Administrative Permit to install three signs at
locations along the property lines. Located: 2820 Shipyard Lane, East Marion. SCTM# 38-7-
14 & 15
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 EXEMPT from LWRP review pursuant to:
§ 268-3. Definitions. MINOR ACTIONS item "G" which states:
G. Minor temporary uses of land having negligible or no permanent impact on coastal
resources or the environment;
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
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
Office Use Only
Coastal Erosion Permit Applicatioj}
--Wetland Permit Application V Administrative Permit
/ Amendmenffrransfcr/~xtension
V/Received Application:~ .~. ,~
~Received Fee:$ .~. ~t~
~Completed Application~
Incomplete '
SEQRA Classification:
Type I Type II Unlisted___
~L°°rdinati°n:(date sent)
WRP Consistency Assessment Form
--CAC Referral Sent: t~//~ t
Date of Inspection:
Receipt of CAC Report:_
Lead Agency Determination:___
Technical Review:
~-Pubtic Hearing Held: q It~ II~
Resolution: I
,~/¢.,~' ,,~"
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
Boar~of Trustees Application
Land Area (in square feet):
Area Zoning:
Previous use of property:
GENERAL DATA
~/No
Intended use of property: - .
Covenants and Restrictions: Yes
If "Yes", please provide copy.
Does this project require a variance from the Zoning Board of Appeals __
If "Yes", please provide copy of decision.
Yes ~No
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 v'~Yes __No
Prior permits/approvals for site improvements:
Agency Date
__ No prior permits/approvals for site improvements,
Has any permWapproval ever been revoked or suspended by a governmental agency?
I/' No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):~ff,~l.,~a:~:=~.~__
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose ofthe proposed operations: T~ t6,~ ~
Area of wetlands on lot: 2 ~' ~ _square feet
Percent coverage of lot: [ %
Closest distance between nearest existing structure and upland
edge of wetlands: '~. ~> ~ feet
Closest distance between nearest proposed r0.zaOa~ and upland
edge of wetlands: i ~' feet
Does the project involve excavation or filling?
No Yes
If yes, how much material will be excavatedg~
cubic yards
How much material will be filled?(~' cubic yards
Depth of which material will be removed or deposited[
Proposed slope throughout the area of operations: _..~ ·
Manner in which material will be removed or deposited:
feet
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
PROJECT ID NUMBER
617.20
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. APPLICANT / SPONSOR 2. PROJECT NAME
SEQR
3.PROJECT LOCATION: County
Municipality
4. PRECISE LOCATION: Sffeet Addess and Road intersections. Prominent landmarks etc -or provide ma~
5. IS PROPOSED ACTION: [~New r~F. xpansion r-[Modification/alteration
6. DESCRIBE PROJECT BRIEFLY:
7. AMOUNT OF LAND AFFECTED:
Initially ~ acres Ultimately ~ acres
8. WIL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RBSTRICTIONS?
~Yes [] No If no, describe briefly:
9 W AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply)
[~Residential []Industrial [~Commercial E~Agriculture [~ Park / Forest / Open Space [~Other (describe)
10. DOESACTIO~NACTIO INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Feder~--State or Local)
---]Yes ~/]No If yes, list agency name and permit / approval:
1~. uub5 ANY_~_.~EL;I L)P I h~. AL;I ION HAVE A CURRENTLY VALID PERMIT 0M APPROVAL? [~]Yes L._~No If yes, list agency name and permit / approval;
12. AS A RESULT OF PROPOSED ACTION WiLL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
PART Il - IMPACT ASSESSMENT (To be completed by Lead A~lency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? ff yes. coordinate the review process and use the FULL FAF.
I--I
B. V~LL ~*CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.6? If No, a negative
dectamtion may be supemeded by another involved age~y.
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. F-xisti~g sir quality, sur[ace or gmendwater quality or quantity, noise levels, existing traffic pot{em, solid waste pmductien or disposal.
potenUal for erosien, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agdcut{ural, archaeological, historic, or other natural or cultural resources; or community or neight)othend character? F-~ain bfie6y:
I
C3. Vegetation or fauna, r~sh, shellfish or wildlife species, significant habitsls, or threatened or endangered species? Explain b[ietiy:
I
C4. A cornrnent{y's existing plans or goals as off. ally adopted, or a chenge in use or intensity of use of land or Diner natural resoumes? Explain Ixiefly:
Cfi. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
C6. Long ten'n, shod ten~. cumulative, or other effects not iden¢ified in C1 -C57 Explain bdefly:
C7. Other im
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA
[~] Yes r~No
E. IS THERE, OR IS THERE LIKELY TO BEr CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL MPAC'rS? If yes
PART III - DI= I I=RMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: Foreach advemeeffec{identifled above, determinewhelheritissubstantial, la~ge impertent or otherwise significant Each
effec~ should be assessed in connection with its (a) setting (i.e. urban or mini); (b) probability of o(~cun'ing; (c) duration; (d) irreversil~ility; (e)
geographic scope; and (0 magnitude. If necessary, add attachments or reference suppo~ng materials. Ensure that explanations contain
suffictent deteil to show that all relevant adverse impacte have been identified and adequately addressed. If question d of part ii was checked
yes, the determination of significance must evaluate the potential impac~ of the proposed adzion on the envimnmentel characteristics of the CEA.
Check this bex if you have Identified one or mom potent{ally large or signEmant adverse impacts whleh [%tAy occur. Than proceed directly to the FUU
FAF and/or prepare a posi'dve doolamtion.
Check thts box If you have date~mleed, based o~ the information and analysis atx)ve and any supp~ documentation, that the proposed actler
WILL NOT result in any slgnl~cent adveme environmental Impacts ANO provide, on attachments as necessac~', Ihs masons suppoding thi.~
determination.
Board of Trustees ~ .~j~ ~ ~_g / ~.
Name of Lead Agency . Date
'n~ ype Name of Responsible Officer in I,.ead Agency Title of Responsible Officer
Signatu~ of Responsible Officer in Lead ,~'e ncy Signature of Preparer (if different from responsible officer)
Town of Southold
~ Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
STORM-WATER,, GRADING,, DRAINAGE AND EROSION CONTROL PLAH
District sscuon e~ck cot CERTIFIED BY A DESIGN PROFESSIONAL iN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUuI'ION ITEM# / WORKASSE~SMENT [ Yes No
a. What is the Total Ama of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off
(include Total Area of all Pameis located within ~ ~ ~'~" Generated by a Two (2") Inch Rainfall on Site?
/,-
the Scope of Work for Proposed Const~cf~on) (This ftem will include all run-off created by site r~
b. What is the Total Area of Land Cleating (S.F. /^cres) clearing andlor co~structon actvities as well a~ all
and/or Ground Distu~oance for the proposed Site Improvements and the permanent creation of
construction activiiy? ~;~ impervious surfaces.)
(a.F.t ^~,,,) 2 Does the Sita Plan andlor Survey Show AIl Proposed
PROVIDE BRW~' PROJ~J~r D~CI~F]3ON (;~';d.~.,~e~.NeK~ DminageStructureslndicatingSize&Locaton?This
Item shall include all Proposed Grade Changes and --
Slopes Controlling Surface Water Flow,
$ 3 Does the Site Plan andlor Survey descdbe the erosion
I...Ot2.~t-,.~d.t ~//~.,~.~ [~r. Jr, t.~..~_~ andsedimentcontrol~rac~ce, thaiwill.osedto
contro~ s~e erosion and storm water discharges. This --
~/~)~ A~ '/X~J~ c~J ~'/Z~'~ ~:~Z.,~. itemrnustbemaintainedthroughouttheEntira
/ Construction Pedod.
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
Encompassing an Area in Excess of Five Thousand
U
(5,000 S.F.) Square Feet of Ground Surface?
6 is there a Natural Water Coume Running through the
Site? Is this Project within the Trustees jur;sdicton
General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or --
Submission of a SWPPP is required for all Construction activities involving soil Beach?
dislurbances of or~ (1) or more acres; including disturbances of h~ss than one acre that 7 Will there be Site preparation on Existing Grade Slopes
are part of a larger common plan that will ultimately disturb one or more acres of lind; which Exceed Fifteen (15) feet of Vertical Rise toI I
including Construction activities invoh'ing soil disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance?I~1 --
the DEC has determined that a SPDES permit is required for storm water discharges.
SWPPP'$ Shall meet the Minimum Requirements of the SPDES Generel Pemlit 8 Will Driveways, Parking Areas or other Impervious I--"--I
for Storm Water Discharges from Construction activity - Permit No. GP-0.t0-001.) Surfaces be Sloped to Direct Stom'~Water Run-Off
1. The SWPPP aha# be prepared pdor to the subr~ttal of tl~ NOI. TF~ NOI shell he into and/or in the direction of a Town right-of-way? --
submitted to the Depar~ent pdor ts the commencemeat of construction activity.
2. The SWPPP shall descdhe the ems/in and sediment control practices and where 9Will this Project Require the Placement of Material,
required, post-constmctis~ strum water management practices that will be used aed/or Removal of Vegetation and/or the Construction of any
constructed to reduce the pellofants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder~ __
compliance with the terms and conditions of this hermit. In addition, the SWPPP shall
STATE OF NEW YORK,
COUN2~' OF ........................................... SS
That I,. ............................................................................... being duly sworn, deposes and says that he/she is the applicant for Permit,
And that he/she is the ............................................ (~;'~'~YK~;;('Ed~'4'~'~;;~i ................................................................
Owner and/or representative of the Owner or Owners, m~d 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 fried herewith.
Sworn to before me this;
............................................... day of ............................................. 90 .....
Notary Public: ..........................................................................................
FORM - 06110
Cleaves~Po~nt Condominiur~s
2820 Shipyard Lane
East Marion~ N.Y. 11939
631.-477-8657
cleaveSpOintC~optonl'mc.net
Septembe~ 5,.2012
'. To:SOuthold Bqai'd of Trustees
Main St.
· . Southold, NY
R~ ... Adding Si~nage
· ·2820 Shipyard Lane, East Mar~on - - '
To w~laa it rs~y ooI1~/1,
· Tiffs is to i~form you that Charles G-ueli, t~e Property Manager at. Cleaves Point Condominixma~,
is authorized'to submit applications for permits on'b~ha]f of our c6mmunfiy.. Plea~ let ns how
if you reqtti~ any further authorization.
~ 'Mcm~r dfthe'BO~d of Dircc~rs
Cleave.point Condominiums
~0/~0 39~d
~ O INIOd S3A~B3D
Z§98LLD~£9 90:~I ~O~/GB/GO
Boar~of Trustees Application
County of Suffolk
State of New York
~,~/_ ~r~ ~'~,~e~ / 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 1N CONJUNCTION WITH REVIEW OF THIS APPLICATION.
Signature
SWORN TO BEFORE ME THIS
DAY OF ~)/~ ,20 / ~
Notary Public
VICKI IOTH
Notary Public. State of New York
No. o1'ro6190696
· Qua f ed in Suffolk County J.
Commission Fx~ires July ~8, 20J_~
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics orohibits conflicts of interest on the tort of town officers and emolovees. The ouroose of
this form is to provide information which can alert the town of~ossible conflicts of inter~st and allow it to take whatever action is
necessary to avoid same.
(Last name, fl'mt name, rgiddle initial, unless yOU are applying in the name of
someone else or other entity, such as a company. If so, indicate the other
peraon's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(1 f "Other", name the activity.) '~'/~.~d.~
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 interesL "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% oftbe shares.
YES NO
lfyou answered "YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Toxvn of Southold
Title Or position of that person
Describe the relationship between yourself (the applicanffagenffrepresentative) 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):
__?) the owner of greater than 5% oftbe shares of the corporate stock of the applic0nt
(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
Signature
Print Name
__day of 200
Town of Southold
INSTRUCTIONS
1.
SEP 4 2012
All apphcants for permits* including Town of Southold agencies,! shal! complete this CC~ for
proposed actions that are subject to the Town of Southold Waterfront!Con~i~l~ReOiew-I;a~/i This
assessment is intended to supplement other information used by alawnot?Sauti/old agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of Southold Town).
If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus~ each answer must be explained in detail~ listin~ both sunoortin~ and non-
sum}orting 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.
scm# :5%
PROJECT N.adVIE
DESCRIPTION OF SITE AND PROPOSED ACTION
The Application has been submitted to (check appropriate response):
TownBoard ~'~ Planning Board ~ Building Dept. ~ BoardofTrustees
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: F-~
Nature and extent of action:
Location of action:
Site acreage:
Present land use: ~s~ Zn)/t~ ~'r {,
Present zoning classification: /~tx/?ti'-~ ~///~
If ~ application for ~e proposed action h~ been filed M~ ~e To~ of Sou~old agency, ~e follo~ng
~o~ation sh~l be prohded:
(a) N~eofapplic~t: ~c~g ~r~T ~~/~'t~
¢) M~ling address: 2 ~ ~ o ~ ~~ ~
(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 ~/ If yes, which state or federal agency?_
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation
criteria.
~ Yes ~ No ~/NNot Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section III - Po)icies Pages 3 through 6 for evaluation criteria
[] Yes ~] No~LKI 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 Pa,ges 8 through 16 for evaluation criteria
[-~ Yes [~ No[~'' Not Applicable
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
- Policies Pages 16 through 21 for evaluation criteria
~ Yes ~-~ No [~Not Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
through 32 for evaluation criteria.
Yes No Not Applic~
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 waste. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
[~ Yes ~ No[~1~ 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.[] J-~ ~t/N
Ye~ , No otApplicable
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 Peeonie
Estuary and Town wa/ters. 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 evaJaation criteria.
~-~ Yes ~-] No[~[-E3 Not Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Polic~ages 65 through 68 for evaluation criteria.
Yes I I No M Not Applicable
DATE
Z
m
,/
APPROVED BY
BOARD OF TR! !$TFFq
TOWN Of
NO
TRESPASSING
35456
PROPERTY PROTECTION SIGNS
No Trespassing / Private Property
Keep unwanted persons out
40712 44538 40710 40713 79456
40706 42922 42924 43354 42923 '
35q34i '. '- :-~433~-! i ~ 35458 79436
:~ "20]2
Su rveillan~e~ ~rCl~inle Watch
~eter crimperS.:', :; .....
440O3
mmU.Am CRIME
mu.~ WATCH
44326
~hat s a sign ~
I without a~po~?
on a Post ~hen yOU buyl
any ~Giant Message Sign.
'Must ship track not UP~.