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HomeMy WebLinkAboutTR-8157A James F. King, President ~OF SQUly Town Hall Annex Bob Ghosio, Jr., Vice-President h0~ 54375 Main Road P.O. Box 1179 Dave Bergen J~[ # Southold, New York 11971-0959 John Bredemeyer G Q ~ ip Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-6641 ~ycvurm BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0867C Date: June 21.2013 THIS CERTIFIES that the installation of a monolithic septic tank in same location as existing replacement and relocation of (31 three 2'x8' leachins; Wools further landward of sentic tank At 4573 Wickham Avenue, Mattituck. New York Suffolk County Tax Map # 107-4-5 Conforms to the application for a Trustees Permit heretofore Tiled in this office Dated 4/24/13 pursuant to which Trustees Administrative Permit #8157A Dated 5/15/13, was issued and conforms to all of the requirements and conditions of the applicable provisions of Iaw. The project for which this certificate is being issued is for the installation of a monolithic sentic tank in same location as existing; replacement and relocation of (31 three 2'x8' leachingpools further landward of sentic tank. The certificate is issued to ALBERT LEUTWYLER & DIANA DELUCIA owners of the aforesaid property. Authorized Signature James F. King, President O~gOff~(,rcG Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President ~Ys ~ P.O. Box 1179 O Dave Bergen ~ x Southold, NY 11971 John Bredetneyer ~ Telephone (631) 765-1892 Michael J. Domino ~~01 ~ ~~O Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE/OF INSPECTION: ~~_~~13 V Ch. 275 Ch. 111 fNSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 15t day of construction Yz constructed Project complete, compliance inspection. INSPECTED BY: ~J. /~/iv ~ COMMENTS: CERTIFICATE OF COMPLIANCE: James F. King, President ~~p~~~C~ Town Hall, 53095 Maio Rd Bola Ghosia; Ic, ~co-President a. y Dave Betgar K ~ P.O. Boa i L79 John Bredeme er p Southold, IrI" l l47 k_ X y Telephone (631) 765-1892 Michael J. Domino ~'P,(~ Fax (63 q 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 APRE-CONSTRUCTION WSPECTION:. FAILURE TO` DO. SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMtT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 ~ day of construction constructed Project complete, compliance Inspection James F. King, President ~DF SOVTy Town Hall Annex 0 54375 Main Road Bob Ghosio, Jr., Vice-President ~O P.O. Box 1179 Dave Bergen l~t # Southold, New York 11971-0959 John Bredemeyer en ~c ~ p Telephone (631) 765-1892 Michael J. Domino ~ Fax (631) 765-6641 ~~OOUNf'I,Nct~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8157A Date of Receipt of Application: April 24, 2013 Applicant: Albert Leutwyler & Diana DeLucia SCTM#: 107-4-5 Project Location: 4573 Wickham Avenue, Mattituck Date of Resolution/Issuance: May 15, 2013 Date of Expiration: May 15, 2015 Reviewed by: Board of Trustees Project Description: To install a monolithic septic tank in same location as existing; replace and relocate three 2'x8' leaching pools further landward of septic tank. 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 Scott Albrecht, received on April 24, 2013, and stamped approved on May 15, 2013. 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 gyFFO(,~ .lames F. king, President Cp- P.O. Box 1179 Bob Ghosio. .I r., Vice-President ~ Vd Southold, NY 11971 Dave Bergen ~ ? Telephone (631 765-1892 John Bredeme}'er ~ T Fax 1631) 765-6641 Michael J. Domino ~ ~ y~o1 # ~a0~'. Southold Town Board of Trustees Field I /nspectionNVork Session Report Date/Time: 5/~ /3 Scott Albrecht on behalf of ALBERT LEUTWYLER & DIANA DELUCIA request an Administrative Permit to install a monolithic septic tank in same location as existing; replace and relocate three 2'x8' leaching pools further landward of septic tank. Located: 4573 Wickham Avenue, Mattituck. SCTM# 107-4-5 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: D Modifications: Conditions: Pre e~xYWere: King ~B. Ghosio "D. Bergen, J. Bredemeyer /iK/lichael Domino D. 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P I`s ~ ~~,.~..m may. • I i e p \ ' y` f n b' n Q b~ 1'\ ~ ~ P ; a P Q`~ y n ~ ~ ' . _ I / \ w ~ D n 9 y D~ ~i8i ~/\\p~~ ~ / Yr R ~Y f ~ I ~ 3 ~ ~uM n / i i uxe ~ _ ~M~ ~ ' ~ ~i` S acin C ~~H ~~s ~ ivn ~~u - COUNTY OF SUFFOLK © ~ aolmglo c*e+e ~ _-J _u - - Real PlweM Tae Servim Rpmq i ,a. «i~n„ c.~~.veom.. ® e na .n iWO emeserr me OFFICE LOCATION: ~~OF SOUTyo MAILING ADDRESS: Town Hall Annex h0 l~ P.O. Box 1179 54375 State Route 25 ~ ~ Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) r/+ ~c Telephone: 631765-1938 Southold, NY 11971 ~ ~ ~O Fax: 631 765-3136 o~yCOU~,~~ LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM D ~ ~ ~ ~ ~ ~ `~I MAY ~ 4 20i3 U To: Jim King, President Town of Southold Board of Trustees outhald irnvn From: Mark Terry, Principal Planner oar of rruste s LWRP Coordinator Date: May 13, 2013 Re: Proposed Wetland Permit for ALBERT LEUTWYLER & DIANA DELUCIA SCTM#1000-107-4-5 Scott Albrecht on behalf of ALBERT LEUTWYLER & DIANA DELUCIA request an Administrative Permit to install a monolithic septic tank in same location as existing; replace and relocate three 2'x8' leaching pools further landward of septic tank. Located: 4573 Wickham Avenue, Mattituck. SCTM# 107-4-5 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 actions are CONSISTENT with the Policy Standards and therefore CONSISTENT with the LWRP provided: 1. That the correct setbacks are determined by the Board. My measurements indicate that the tank is 69' from the wetland line. 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 ~,oF soury~~, Town Hall Annez Bob Ghosio, Jr., Vice-President ,~0~ 54375 Main Ttoad Y.O. Box 1179 Dave Bergen # ~ Southold, New York 17971-0959 John Bredemeyer Gn ~ p~ Telephone (631) 765-1892 Michael J. Domino 'p , Fax (631) 765.6641 ~y~OUM'~,N~ BOARD OF TOWN TRUSTEES 'TOWN OF SOUTHOLD O[ticc []se Only Coastal Erosion Pemrit Applicano Wetland Perini[ Application Administrative Permit __Amendmentll'ransC r/Ex erasion vReceived Application:_~~~3 - ~ ~ -~kteceived Pee:$ / ~ ~ ~ ~ n -?Compleled ApplicationAl13 IIIhInUll'/11 ~J Incomplete. SEQRA Classification APR Type I .Type lr__Unlisted - 2 4 2013 Coordination:(date sent) 4 I ~I~ t~LWRP Consistency Assessment Conn l"~-'' =F'-3 CAC Referral Sent: Southold Town Date of Ittspection:_ Oar f Tna;_ec Receipt of CAC Report:. _ _ I,cad Agency Determination: Technical Review: Public Hearing t7eld~j Resolution: Name of Applicant ~~G~ ~U~/j /'(j~LJ~~C~/~, ~j /~/!11N~ Q~/1/~/if~ Mailing Address-~~ / .~/i/?~c~r/~/jf~a//~ - /~•~rI/Pr/1.~,/~:f~l/I~huneNumber:( I)-x(0.;71 Suffolk County Tax, MQap Number: 1000 - ~d~ Property Location: ~ ~ IU ~S % OF ~O L (provide LILC Pale N, distance to cross streets, and location) ~i p / - 1 - AGENT: V ~4 T T C.o It `C ~ 7~L ~G LNS ~C ~ 3 7 ~P~~'' (1fapplicable) r Address: ~(9~0~ /yf.Q/d/ ry ~ ~Ji¢TT! T1~LfL ~J - _ - - - - ----Phone: C~ ~1 7.ga ~ S3 GQ • # Board of Trustees Application GE(N~lRAL DATA Land Area (in square feet): / Z ~~0 t/ / Area Zoning:... ~~C~- Previous use of propetty:_ ~i /~L Intended use of property: L~~-~S y - Covenants and Restrictions on property'? ___-Yes ____No If "Yes", please provide a copy. Will this project require a Building Pemtit as per Town Code? _ _ Yes ~o If "Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? _ Ycs _ t/ No If "Yes", please provide copy of decision. Will this project require quy demolition as per Town Code or as detzrntined by the Building Dept.'? Yes -Y-No Does the stmcture (s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agcucy Datc No prior permits/approvals for site improvements. Has any permiUapproval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessar Jj~ , _ I'~-~~ _ / e Jn/y' • Board of Trustees Application WETLAND/TRUSTEE LANllS APPLICATION DATA D ~ ~ Puurpose of the proposed operations:_ /JE~/'fLf ~ if Area of wetlands on lot:_~ s b ~ __syuare feet Percent coverage of lot:.__ °~a Closest distance between nearest existing strucmre and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wctlandx___ _ __feet Does the project involve exc vation or filling? No Yes If yes, how much material will be exca/vated? ~2 cubic yards 1Iow much material will be filled?_ Nm'~ ~ cubic 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 depnsited:_ 8~M' LIJ /1~0'~ /Rv~ ~ - - Sfatemeut of the effect, i f any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 617.20 PRO.IECT ID NUMBER APP[NDIX C SEAR STATE ENVIRONMENTAL QUALNY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To bo cornpleted Gy Applicant or Project Sponsor) 1. PLICANT/SPONSOR 2 PROJECT NAME Q©,T 9o2fc Uf ~ 1. ~vYk% ® !/G i ~ 3.P_R{],y~E_T L3/yC/yTl%N:,f/~~ %L~ ~v~r C~C M/7uLniVLCipali7ty ~Y (/~/Jr(~~~T`yC County /-Li 4.PRFCISE LOCA7-ION: Street AUdess and Road Intersections. Prominent landmarks etr, -or provide map cJ ~61n lc ~tS 06tt3d ~ S, IS PROPOSED ACTION: ? New ?Expansion odifcation/alteration 6. DESC IBE P OJECT BRIEFLY ` ~ / ~ a s (mss ~ ~ 7. AMOUNT OF LAND AFFE(:'IEO. /f ~ ~ ~ ~ Q / Initially acres Ultimately acres 7 8. WILL PROPOSED ACTION COMPLY WITH E%ISTING CONING OR OTIIL RESTRICTIONS? ?Yes ? No U no, dascrlbe bric0y 9 AT IS PRESENT LAND USE IN VICINITY OF PKOJECT7 (Choose as many as apply) Residential ?pidustrial nCommercial ?Ayricullure ?Parhl Forest/Open Space ?Other (tlescribel IQDOES ACTION INVOLVE A PERPAIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fetler Slate or Local) ?Yes ~o If yes, list agency name and permit / apPra~al: 11 D III ECT OF THE""ACTTON-flA~,~~DFtRERT~YT/A[fD pERMIT~OR APPROVAL? ~ - ?Yes No If yes, list agency name and permit /approval: 1ff2--77A''S A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT! APPROVAL. REQUIRE MODIFICATION? LJres ?NO _ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant J Spon6of'ye Date; / Signature - ` ~ 2 If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART 11-IMPACT ASSESSMENT To be com feted b Lead A enc A, ODES AC(lON EXCEED ANY TYPE tTHRESHOID IN 6 NYCRR, PART 617.4? dyes, coordinate the review process and~use the FULL EAF. Yes Q No B. WILL ACT10N RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 6i7.6? If No, a negative dedaradon maybe superseded by arrottter vtvdved agency. Yes Q No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOGATEO WITH THE FOLLOWING: (Answers may be handwdtten, d legible) Ct. Bdsdrtg air Wally, surfers «grormdwater quality «quantity, nose levels, exLStatg traffic pattern, solid waste production «disposal, . pMendal for erosion. drobtage or hooding problems? Explain brtesy: rz. Aesthed0. agrialturai, ardteeobglcal, hlstodc, «other natural «cultural reso«oes; «communNy «neighboritood dtaradeR Etgflakt bdefly: C3. Vegefafion «fauna, tish, sheflfish-«wildldespecies, significant habitats, or threatened «endargered spedes? Explain briefly: C4. A community's existing plans or goals as offidaay adopted, or a change in use or intensity of use of land or otirer natural resources? Explain briefly: _ C5. Growth, subsequent developmenQ or related adivities likely to be induced by the proposed adion7 Explain briefly: C6. Long term, short term, cumulalrve, or other effeds~no( identified in C7-CS? Ezplain bnefly - - - C7. Other impads ndudin than es in use of either uantit or t e of ener ? Ex lam briafl . - ~ - D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ' ENVIRONMENTAL AREA CEA 7 If es, ex lain briefl : Yes Q No E IS TNERE, OR IS THERE LIKELY TO 8 Y RELATFJ7 TO POTENTIAL A E Fs1VIRONMENTAL IMP If Yes Q No PMT IU - DEitRMM1Al10N OF STOti1FICANCE (To be oortglleted by Agenq) WISTRUCiIONS: Foreadtadverseeffectiderdifiedabove,delertninewhelherdissubstaotial,large,importantorothelwisesignificant Eedt eHed should be assessed in cotttrteetin«t wilt its (a) selling (Le. urban or ntre9: (b) ProbebifdY of ocarrdng; (c) dtlratian; (d) imaverebifdy; (e) peoglapltic scope; and (f) magnNude. If tlacessary, add attachments a referenda supporting materials. FJrewe that etq~lertations contain - sufiiGerttdelaN to show that ~ relevant adverse impads have been identified and adequaley addressed. Uquestion d ofpart N was dteclted yes, the deBemtinadon of signifiwnoe must evaluate dte potential knpadvf the proposed adbn an the ernirqutten(ai aharacterisdcs of tits CFA EAFa~ ~dyou haveione«morepoterNiady large«significantadverse hrpadswNdt NVIYOdax. Tflen proceed diredlyto die prepare a positive dedaraflan. Check tltu box Ifyou'have detelmdted, based on die Informaddn and analysis above and any supporting documerdation, that the proposed a Will NOT result Irt any significant adverse envirommental impads AND provide, on adachmenis as necessary, dte reasons supporting dti determination. Board of Trustees Name of Lead Agency Date President ~ Pnnt ar Type Name of Responsible Officer m Lead Agenq Tdle of Responsible Officer Sgnature of Responsible Officer in Lead Agenq Signature of Preparer (If different from responsible officer) • Board of Trustees Application County of Suffolk State of New York LL.1,t,~I,J er BEING DULY SWORN DEPOSES AND AFFIRMS HA'i' HE/SHF IS THE APPLICANT FOR THE ABOVL' DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OP 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 SOUTHOI,D AND TIME 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 IIEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRF.SENTATIVES(S), TO ENTER ONTO MY PROPERTY "CO INSPECT THE PREMfSES 1N CONJUNCTION Wl"i'H REVIE,#Y Q~ THIS PLICATION. Sign~turc of Propzrty Owncr SWORN TO BEFORE ME THIS~~l DAY OP~I` ,20~_ Notary Public pENNY_O~DELL Notary Nablic Staff of Now York No. O1~F_ I7 qualified in n1y~j~~ Commission Expires Sept 2 , s Board of Trustees Application AUTHORC'LATiON (where))he applicant is not the owner) _ residing at___ (print owner of property) (mailing address) do hereby authorise V t~~-~T /~C^~/jreC~/7~~ (Agent) _to apply for perrnit(s) from the Southold B/oard Town ru. stets on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTA'I'IV E TRANSACTIONAL DISCLOSORF, FORM The'Cowngf Soulhold's Codc of Ethics prohibits conflidggfjnt •rst on the part of [own officers and emplovecs The oumosC of this Conn is to omvide information which can nler h • town of oossible conflicts of interest and allow it to take w} atever action is e a avoids YOUR NAM ~ ~ ~J ~ ~L~~ ~G~~~ (Last nefne, first n e, ~[iddle initial, tmless you are applying in the name oC someone else or other entity, such as a company. If su, indicate the other person's a~ company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance _ Trustee Changcof%une Coastal Erosion_ Approval oCpiv[ , Mooring _ _ Rxemption Isom plat or official map_ _ Planning_____~.. Other (If "Other", name the ac[iviR~.) Do you persomdly (er through your company, spouse, sibling, parent, or child) have a mletionship with any uCGcer ur empluyee of the Town of Southold? "12elationship' includes by blood, marriage, or business interest "Business interest" means a business, including a partnership, in which the tc~m officer or empluyee has even a partial ownership of (nr employment 6y) a corporation in which the [mvn officer or employee owns more than 5% Cthc shares. YBS NO _ - 1(ynu answered "YLS'~, complete the balance of this form and datz and sign whero uulicnlai. Name of person employed by the'Ibwn of Southold _ _ 'title or position of that person Describe the relationship behvecn yourself (the applicantlagCnVrepresentative) and the [own officer ur employee. L'ither Check ' the appmpriatc lint A) through D) andlor describe in the space proJided. The town otfwer or employee or his or her spouse, sibling, parent, or child is (chzek 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 eorpuralion); _B) the legal or beneficial owner of any interest in a pan-corporals entity (when We applicant is not a corpomticn);, ~C) an officer, director, parblcr, or employee of the applicmu; or p) the actual applicant. , DESCRIPTION Of RELATIONSI IIP Submitted this d~ of 28~ ~ 3 Signature_ PrintNamc ~ f Form TS 1 Town of Southold • • LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for pennits* 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 i and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. 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 sigmficant 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 detaih listin¢ both supportin¢ and non- supportinH facts. If an action cannot be certified as consistent with the LWRP policy standards and i 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 Plannin Department, all local libraries and the Town Clerk's office. n ~ ~ ~ ~ ~ ~ n B. DESCRIPTION OF SITE AND PROPOSED ACTION IIULnJ~If -~I~ SCTM# ~ ~ / ~ APR 3 0 2013 ~ PROJECT NAME ~ 'fV ~ !J~ / Southold Tmvn i The Application has been submitted to (check appropriate response): I Town Board ? Planning Board ? Building Dept. ? Board of Trustees 1. 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: Nature and extent of action: - ' Location of action: ~~P ~~~~'~i ~ • • Site acreage: ~ ~G 0 CJ , Present land use: e / 2/V l~ 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 applicant:~G~,~~ ~ ~~'Tw y/~~ ~ ~/.f/Y~ ~iC~/!iC (b) Mailing address:- ~j L(/~C~ f~'.~/ri d~y~ /~/~Tf~/~~~C- (c) Telephone number: Area Code ( ) l - ~ 3 (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 crate a. Yes ? No ? Not Applicable e ~ I Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LW12P Section III -~Poli~cies Pages 3 through 6 for evaluation criteria ? Yes ? No Lam' Not Applicable . Attach additional sheets if necessary Policy 3. Enha ce visual quality and protect scenic resources throughout the Town of Southold. See LWRP Sectio II -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 - Poli ' s 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 i Yes ~ No ~ Not Applicable i Attach add~Uonal sheets ~f 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 i thr~h 32 for evaluation criteria. ? ? ~QS Yes No Not Applica~ • 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 fo aluation criteria. ~ ' i ? Yes ? No Not Applicable ~ i i Attach additional sheets if necessary Policy 8. Minimize environ ental degradation in Town of Southold from solid waste and hazardous substances and wastes. a 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; Pa es 38 throw h 46 for evaluation criteria. ~ g g b ? Ye~ No Not Applicable i 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 RP 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 E( ~st}u/ary and Town waters. See LWRP Section III -Policies; Pages 57 through 62 for evaluation criteria. I=I 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 evalu ion criteria. ? Yes ? No Not Applicable i i Attach additional sheets if necessary Policy 13. Promote ap ropriate use and development of energy and mineral resources. See LWRP Section III - Policies; P ges 65 through 68 for evaluation criteria. ? Yes ? No Not Applicable I' f I PREPARED BY TITLE DATEa~Ga~~GQ~ REF ONLY: 1000-107-04-005 SEC. SHD JOB 11218 v~e~ss;;s~ vm~m~m ~m ~'m nmoo»~°z°~ o ~~~q~~N.~~ F ~ ~ ° ~ q ~ a ~ MAP OF WOLF PIT POND ESTATES m o3 m'ovwe~a sa 3 ~ o a (ro HwL) "'~~a°= m S 84°35'00" E 146.5' FND »m / MON 'n w w~ R o n o~ioo~e°n_ ~ 26.1 3om§~S~ MON ? 6 2 \ o~'O3~s ~ ~ ~ O mom.-g m$W ~ ~ .\.y. O ry 3 2 0 m a c mo~ m 3 ~ 0 ~~~=ae~o m V ~r Sys ~~;m~~mo ~ rn Qy 2a-z~ m ; o ~ a o v =tv ~ ~ ~ i Sly 53,3„ Emm~_CN O -•J / ~ ^nRoe2o ? O ~mms`~os N ti~ / r~/o~~~3~ m h °3o a'o»m m FND %J~'~l.%~~~ FND ~ as a la.a' MON MON ^m _ v 2=_ ~ ~ N 84°35'00" W 153.0' ~a~' ~ s (70 HWL) 5 T°i ~ F i ? ~ in \ u s° n o° m a-m° a ~ m 2 ~ ~ ~ \ h~ ~ o ~ m ~ a Y ~ °o~ o ~ a m o 3 1 o mvo 1 °m m o?~ s ~ . m i v, o_ n ~R° 1 ED 3'° ' 1 m ~ 1 ~ ~ ti~ -mss APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD ~ ~p DATE S I S 13 "9~ s~ ~ EN~~ M v P PPO~ i~G~~~M~O~~~ SURti~'Y OF PROPERTY V Situated ai MA~JCK Surveyed N by TORN OF SOUTHOLD Smith, Jung & Gillis o SUFFOLK COUNTY n ~ ~ ~ ~ Y 6 Professional Land Surveyor NEW YORK Ilfllnll~ll 120 Medford Avenue 9 Scale: 1 30' APR 2 4 2013 ~ Phone~9631 475 3192 Survey Certified To: ALBERT LEUTWYLER uthald sown DIANA DELUCIA ar tTmstees o FIDELITY NATIONAL 71TLE INS. CO o #06-7404-65787-BUFF m NORTH FORK BANK J Dates Surveyed: JULY 31, 2006 LEUTWYLER-DELUCIA