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Home My WebLink AboutSchultheis, GerardJill M. Doherty, President James F. K/ng, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7341A Date of Receipt of Application: June 10, 2010 Applicant: Gerard Schultheis SCTM#: 117-5-46.3 Project Location: 1640 First Street, New Suffolk Date of Resolution/Issuance: July 21, 2010 Date of Expiration: July 21, 2012 Reviewed by: Board of Trustees 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 landscape, install landscape ties, and construct a trellis. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Gerard Schultheis, received on June 10, 2010, and stamped approved on July 21,2010. 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. ji~U~J[M'. Doherty) p re'si ent Board of Trustees JMD:eac Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7341A Date of Receipt of Application: June 10, 2010 Applicant: Gerard Schultheis SCTM#: 117-5-46.3 Project Location: 1640 First Street, New Suffolk Date of Resolution/Issuance: July 21, 2010 Date of Expiration: July 21, 2012 Reviewed by: Board of Trustees Project Description: To landscape, install landscape ties, and construct a trellis. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuan, ce of an Administrative Permit allows for the operations as indicated on the site plan prepared by Gerard Schultheis, received on June 10, 2010, and stamped approved on July 21,2010. 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. Ji I[VM. Doherty, President Board of Trustees JMD:eac eriC. fpo rc~ OARD OF TRU$~L,~3 OWN OF $OUTHOLD /c_.) 6/, ¢//o SCHOOL, N 87' 57 $0" N 04' 45' 10' 34.86 N 25' 33' 20' W~ 15. 20' N/F TUTHILL '~ 1 STORY RESIDENCE BLUESTONE DRI VEWA Y 2 CAR AVG. EL. =Z5 GARAGE TM I000-I17-05-46.,~ 49' 70" ? / OAD ORCHA~o~~ GUARANTEED TO GERARD H. SCHUL THEIS CAROL ~1 M. SCHUL THAIS HOUSE N 82.67' N N/F $CHUL TH~IS 19NOVOI ADD FIRMDATA CREEK 191.19' U sUR v~r O~ DETSCRIBED PROPER TY SITUAT~ NEW SUF~'OLK, TOWN OF ~OUTHOLD S~FFOLK COUN~ N. ~ SUR~YED ~OR: GERARD H. SCHUL~DS CAROL YN M. SCHUL THEIS SURVeYeD 09 OCTOBER, 2001 SCALE I'=JO' AREA= 12o017 SF OR 0.276 ACRES THIS PIIRCEL I$ FOUND ENTIRELY IN FLOOD ZONE ,~E -8 [EL. 8,) SOURCE: FEA~,4 I~AP No. 3~10~ C 0501~ D~TED M4Y 4~1998. ~HE NEW YC~* STATE El. EVA DONS SHOI~V HEREON ARE IN 1929 NGVD. SOURCE BENCH No. 8 19,~$ EL. 5.69 SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW SUFFOLK, NY 11956, Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 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 ½ constructed I~Project complete, compliance inspection. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 7654641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ~Oe,/O, ,~2)/O has been reviewed by this Board at the regular meeting of ~.~(q o~'/, o':O/c) and your application has been approved pending the completio~ of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ 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 Southotd 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: Jill M. Dohedy, President Board of Trustees Jill M Doheny, President James F. King. Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/VVorksession Report Date/Time: GERARD SCHULTHEIS requests an Administrative Permit to landscape, install landscape ties, and construct a trellis. Located: 1640 First St., New Suffolk. SCTM#117-5-46.3 Type/of area to be impacted: t=,zS'altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of.Town Code proposed work falls under: ._~./C~pt.275 Chapt. 111 other Type of Application: ~/Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: ¢~¢_.~& ~'~¢L~'~ Modifications: Conditions: BPresent Were: t~J.King .Doherty __ edemeyer .Ghosio, D. DzenEowski other Form filled out in the field by Mailed/Faxed to: Date: OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jill Doherty, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 19, 2010 Re; Proposed Wetland Permit for GERARD SCHULTHEIS SCTM#117-5-46.3 GERARD SCHULTHEIS requests an Administrative Permit to landscape, install landscape ties, and construct a trellis. Located: 1640 First St., New Suffolk. SCTM#117-5-46.3 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 from 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 Jill M Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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 Office Use Only Coastal Erosion Permit Application Wetland Permit Applicatio~ ~'Administrative Permit Amendment/Transfer/Extension ~"Received Applieation:_~l~ .en~ceived Fee:$ .~'"O~ Completed Application TypeI Type II Unlisted__ Coordination:(date sent) LWRP Consistency Ass~nn CAC Referral Sent: ,.-D~te of Inspection: Q Receipt of CAC Report: ' - Lead Agency Determination: Technical Review: .,4~hblic Heating Held: ~ ,~-~0 Resolution: NameofApplicant C.~'e, Or~-4 t'-~. 5Ckul~L'~%e(.~ Address[DO [30X Z~_) 1 4o S+,/ ~_~ 11~ PhoneNumb~:~¢l) 734--7Zg~ Suffolk Co~ty T~ Map Nmbe: 1000- j I ~ ~ q¢ '3 Prope.yLocation: lg4o M 5o4 IL g ~rohde LILCO Pole ~, dist~ce to ~oss s~eets, ~d location) AGENT: (If applicable) Address: Phone: Board of Trustees Application Land Area (in square feet): Area Zoning:. IV1 1 [ GENERAL DATA !%. o'~7 _~? ~ Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes V'/No Prior permits/approvals for site improvements: Agency ~,4. ~ ~7~ 41,olo3 Date 41,olo __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a goffemmental agency? PR~.5~.MI'L¥ I~ :SOOlq~-~IE COURT No v" Yes -ghcrcd,. Or} rd/t~l~t ~ o.~,.,a ,,n t. la..[9..o ,n. ~ . ~I" ,'>, ProJect Description (use attachments if necessary): ~r ~ Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ] C~r~ ~¢~ggt,~, ' Area of wetlands on lot: (~) square feet Percent coverage of lot: C) % Closest distance between nearest existing structure and upland edge of wetlands(c~.,~k) ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: /V'/~ feet Does the;roject involve excavation or filling? ./ X/ No Yes If yes, how much material will be excavated? cubic yards How much material ~vill be filled? cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: D0 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 'mason of su~i pr~p~o~d' op~ati~n~ (use ~tta~eri~S ~f ~pprop~iat~i 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 ~isC ~1~ct~~1'7 ~)'~ ~j~ ~', ~ 8TORM'WATER~ GRADINGI DRAINAGE AND EROSION CONTROL PL.AN section Block Lot CI'K ~ IrU=U BY A DESIGN PROFESSIONAL IN THE SI'ATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITISM # / WORK_ASSESSMENT [ Yes No a. What is the Total Area of the Project Parcels? (InciudeTofal^reaofalIParcelsiocatedwithin 02-7{ ~ Will this Project Retain AiI Storm-Water Run-Oif the Scope of Work for Proposed ConstmolJon) * ~ Generated by a Two (2') Inch Rainfall on Site? (S.F. / Aoes) (This item will include all mn-off created by site ~X/~1 I b. What is the Total Area of Land Clearing clearing and/or construction actJviites as well as all and/or Ground Disturbance for the proposed J O0 ~[ ~ Site Improvements and the permanent c~eation of construction actMty? O~I~l, impervious surfaces.} ! (S.F. I Acres) 2Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DF~CEIPT][ON (P,~,~e ~ p~. ~ Drainage Structures Indicating Size & Location? This V' rII item shall include all Proposed Grade Changes and PI.. 3 s,opes controlling surface water Flow. .J --~ Does the Site Plan andlor Survey descdbe the erosion ° and sediment control practices that will be used to y ~ conl3'ol site erosion and storm water discharges. This item must be maintained thrpugbei&the En~,'~ 4 Will this Project Require any Land Filling, Grading or "*Excavation where there is a change to the Natural r-ii Existing Grade Involving more than 200 Cubic Yards of Mafadel within any Parcel? 5 Will this Application Require Land Distudoing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requiraments: or within One Hundred (1 Off) feet of a Wetland or disturba~es of one {1) or more acres; including disturbances of less than one ac~e that 7 Will there be Site preparation on Existing Grade Slopes are pait Of a larger common plan that will ultimatsly dts~rb one or more acms of land; wbich Exceed Fifteen (15) feet of Vertical Rise to including Construction activities inv(~ving soil disturbances of less than one (1) acm where One Hundred (100') of Horizontal Distance? SWPPP'$ Shell meet the Minimum Requirements of the $PDE$ C-eneral Permit 8 Will Driveways, Parking Areas or other Impervious I'I.II 2. The SWPPP shall descdbe the erosion and sediment con~ol practices and where 9Will this Project Require the Placement of Material, required, posbconstmction stoml water management practices that w~ll be used and/or Removal of Vegetation and/or the Constn~ction of any IIII STATE OF NEW YORK, ~ r r-,, .................. t , ~ ........................................................................... being duly sworn, deposes and says that he/she is the applicant for Permit, And that he/she is the C) ~' e~ ............................................ 16~$ ~; ~r;~;.; ~ ~i; .~.;~ib. ~,~,. [;t;~j ................................................................ 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 tiffs application; that all statements contained in this application are hue to the best of his knowledge m~d belief; and that the work will be performed in the mvaluer set forth in the application ftied herewith. Sworn to before me this; ................ .~.....~.......v~ ...c~. ............. day of .....~..: .................. , ~20.t...O. m / / /-~, ^ Notazy Public: ...~...._~..:...~ ............ ..avami..-- .~..-.~..d~ ............... .......... ~ ~ (S'gnature of Applicant) FORM - 06110 PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR Gcr&r Municipality 3.PROJECT LOCATION: . 4. PRECISE LOCATION: Street Addess and Road intersections 617.20 STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME County 5~01~//. Prominent landmarks etc-or provide mad ON: ~ New [] Expansion [] Modification / alteration SEQR DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially · ~) I ~ acres Ultimately .'(~ J ~O acres 8, WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? NYos [] NO If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) []Residential [~lnOustfla, '~Commercial E~Agriculture ~Park/ForestlOpenSpace ~Olher (describe) 10.'DOES ACTION iNVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, S~/e or Lo~l) ~Ye* ~.o If yes. list agency name and pe=il / approval: 500¢0ij ~4~; 11, uubS ANY A~PEGI OF INN ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~No If yes, list agency name and permit / approval: 12. AS A RE~;ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLE~)GE Applicant / Sponsor Name ~((~ ~/~~ H- ~.~Signature ~ Date: If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If ~es, coordinate the renew process and use Ihe FULL EAF. r-I 171.o B. WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative E3 e, 12:].0 C. COULD ACTtON RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answe~ may be handwFdtes, If leglbfa) C3. ¥'~a~-i~., or fauna, fish, ~.~,"~,ah or wildfire sped, es, slgntf~ant habitats, or thmatmmd or eadangemd species? Explain Ixtu6y: L ' C6. ongtemi, sho~tteml, cumuladve, ocothereifectsnotide~UfladlnCl.C,5? Explalnbde~y: D. WiLL THE PROJECT HAVE AN IMPACT ON 'I~IE ENVIRONMENTA ~L CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAl. ENVIRONMENT, ed. AREA(CEA)? (if yes, explain Ixiell)c El,e, [71"eI E. IS THERE, OR IS THERE LIKELY TO SEt CONTROVERSY RELATED TO'pOTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? PART Itl - Dc I ~I~III~ATION OF SIGNIFICANCE (To be complatsd by AGency) IN~'II~UCTIONS: For each adverse effect identified above, determine whether It is substantial, large, Impoftont.or othenvise signifiCant. Each effect should be assessed in connection with its (a) netting (i.e. U~an or mini); (b) pmbebllity of occuning; (o) duraSon; (d) Irrevendbility; (e) geographic scope; and (t) magnffude. If nece___-~ary, add attachments or reference eupporllng materials. Ensure fbat emplanaitons contain mdficlant detail to show that all mlavent adverse Impacts have been idenli6dd ond adequstely addressed. If question d of part Ii was cbecked y~, tbe,determlnaticn of Mgnificence must evaluate the potential impact oflhe prapo~dd action on the envlronrnontal characteris~cs oftbe CEA Cbeck 6lis box If You have identified or, e or more pofentlally large o,- slgfllfloent adverse impacts wldch MAy occor. Then pracead dfreclly to ine FULl EAF and/or prepare a positive decfaratlon. WiLL. NOT result in any s~gntflcent adverse environmental Impacts ANO provide, off Mtacholenfa es nece~___$9~y, the masons sup~ng in~ Board of Trustees Name of Lead Agency Jill M. Doherty Print or Type Name of Responsible Officer in Lead Agency President Title of Responsible Officer Signature of Preparer (1~ different from responsible officer) Board of Trustees AppliOlon County of Suffolk State of New York G-,r d 5 1-ol BEINGD YSWO 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 H/S/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH 1N 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. ~gnature SWORN TO BEFORE ME THIS /O DAY OF d{.'~ ~ ,20 / 0 5t/ary Public {/ PENNY BEOE. L.L. . v · ta Public State or rqew YOrR No rYNo 01'¢E6099317 Qualified in Suffolk County Commission Expires Sept. 29, ~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics omhibits conflicts of interest on the Dart of town officers and employees. The numose of this form is to vrovide information which can alert the town of ~ossible conflicts of interest and allow it to take whatever action is YOURNME: .fCh I 44, (Last name, first name, ~aiddle initial, unless you are'applying la 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 Building Variance Trustee Change of Zone Coastal 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 bu.4iness 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 this form and date and sign where indicated. Name of person employed by the Towp of Southold ' Title 0r position o f that person Describe the relationship between yourself(the applicant/agent/representstive) 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 o~vner of greater than 5% of the shams 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-co~orate entity (when the applicant is not a corporation); __C) an officer, director, partnei', or employee of the applicant; or X D) the actoal applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted thi~___~ay o~n~ ~O,,l~,, 200 .._~010 Signature , /~ · Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* includ'mg 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 significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suooortin~ 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 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) Co) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: I Location of action: ~ t~0 Site acreage: Oo ~. Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: ~--~CarO~ S.LoI+k~'~ (b) Mailing address: ~0 ~)0X ~t~q Ne,,jS~j4~o~- ~.y I/qy/ (c) Telephone number: Area Code6i2> [ '"/~4 ~ 7Z ~,~ (d) Application number if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] Now If yes, which state or federal agencyT 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 IH - Policies; Page 2 for evaluation criteria. Yes ~ No ~ Not Applicable Atlach 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 ifnecessmy 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.l~ 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 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~plicable 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 ~ NoJ~ 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 IIl- Policies; Pages 38 through 46 for evaluatiOn criteria. D Ye~ No~NotApplicable Attach additional sheets if necessary WORKING COAST POLIOS 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 Peconie 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 ~-~ NoR 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 Not App,ieable PREPARED BY ~'¢r~ ~ck,, ~'-~-~l'-~ TITLE DATE ~/~/10