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TR-8238A
fames F. King, President O~a~ff0~,rco Town Ha]l, 53095 Main Rd. Bob Ghosia, Jr., Vice-President ~6y P.O. Box 1179 Dave Bergen ~ Southold, NY 11971 W John Bredemeyer ~ Telephone (631) 765-1892 Michael J. Domino 1 ~ ~ 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 APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line _ 1n day of construction constructed Project complete, compliance inspection James F. King, President ~QF SQU~y Town Hall Annex Bob Ghosio, Jr., Vice-President 0~ 54375 Main Road h O P.O. Box 1179 Dave Bergen ~ ~ Southold, New York 11971-0959 John Bredemeyer N ~ Telephone (631) 765-1892 Michael J. Domino ~ Fax (631) 765-6641 ~y00UNT'1,~`~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8238A Date of Receipt of Application: July 11, 2013 Applicant: Anne & Robert Piscioneri SCTM#: 135-1-10 Project Location: 21925 Soundview Avenue, Southold Date of Resolutionllssuance: July 17, 2013 Date of Expiration: July 17, 2015 Reviewed by: Board of Trustees Project Description: To add an overflow cesspool landward of existing cesspool. 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 Morris Cesspool, received on July 11, 2013, and stamped approved on July 17, 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 gpFFQ(,~ .lames P. 6ing, Presfdcnt p~ CQG P.O_ Uos 1179 Bub Ghosio, Ir.. Vlce-President d tl Southold.NY 11971 Dave Bergen ~ ~ ~ Telephone (G31 765-1892 .bhn Rredemeycr T ~ Fas (631) 765-6641 Michael l Domino ~ 'Z'~ syo1 } ~,,a. Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: Morris Cesspool Service on behalf of ANNE & ROBERT PISCIONERI requests an Administrative Permit to add an overflow cesspool landward of existing cesspool. Located: 21925 Soundview Avenue, Southold. SCTM# 135-1-10 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 D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by MailedlFaxed to: Date: 08 saa~aua r OOZ ~aa~ u~aea . -F • a, ~Y^; • mow, ya * d}.-.. pia ~ ~ ~p::~ :a y , . ~ i ~~e 1~~. ~~1.:` w a~ t~'~`~e ~ ,~r ,b,•°j '~'!K~ a ~ ' 1- ~ .g ~ W' }d , ter. ; 'ii . t~ ' .?t~ x P~ ~ , p$.'; Y' r . a !'k ~ < - k~F~ e ` eS,... .~'b e. 1. .,k, ..aY e:. 7°~`Bp- '.4 F ~ ~ ~ e x. ,,ma_ R ~ ~ - ~ d '°u,~s;~.~ ~ «{~r"~ ~d r6..~+$yF i,.~k 1. ~ ~ s-v+nr ..,P-M~+....:~ s b < oa ~ #,s,- ~ ~ , q t i .,fir `fit ~ 't 2» 0 a _ . _ _ , i ~ ~ k r 3 ` ~ ra Y l§ ° S ~ * .-w. ~o a- ~ ~ a ~ ^.A 3 ~ s ~';~f ~ 'x 1' z~ J °a * N F .w/4` ~ de ~M ~ ~ ~ ~ ~ ; ,k •"s Fs p. ~ , Ti~ O~~'` i ` ~~"y . n~~_.~ ' 9 r'''w> C f~~ ; ~N" ~ F-~'~~ l~ i Je _ ~ iry ~ . • ' '**e'~a~"~!`' r ~ ~ •.d l s~' "t , .x k1" ~ti. M ° s ~ ` y, ~l i~~? c~-~~ ` ,fir ' « .;~€e~} ~ bfi.~~"s~j t'fYl~w ~'~"`~~'i•T , - ~A' 4 x:'. - ? o a x ~i" i. !fig ?M` 4 . x ` "lie ~ ' .,.ww~..«.`~ ; - dim` , r ,a .ti • ~ ~ ~ _ _ k ~ ' ~ i F "k a• • g' ~ ~`g m ~ , ~,..r`, ~ ~.3~ ~ ~ _~...a. ~ d ~ a ~ ''s.,,~~.~ ` - ~ y ktk '3`fi = 'C~~, fir' S 3b a ~ . e - _ t Red. ~ ~ ~y?~ . _ °P N ° Lora oo ,ol n, ~o.ae L.o.~ ~ s ~ b~ ~ F i i o s F O ~a~ ° N~ ~ v f ~P ' ~ ° / I PA I w ~ O m.,.a...e. a ~'b ~ '.k i ~ l imp I ~ a ~ wa.ro,... we i ~ a e Y' ~ / v'i CqE~ ~ 4 i ~ ~ p,J~ M. ~.u..m ~DV1fM T ~ / Y ua d y _ nn _ xonce (AUNTY OF SUFFOLK © i e cmx James F. King, President ~OF SO(/jy Town Hall Annex Bob Ghosio, Jr., Vice-President ~O~ 54376 Main Road P.O. Box 1179 Dave Bergen ~ #t Southold, New York 11971-0959 John Bredemeyer i Q Michael J. Domino %.2` ~ Telephone (631) 765-1892 ~~COU~'~~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only D E C E I V E -Coastal Erosion Permit Application , -Wetland Permit Application ~ Administrative Permit JU _AmendmenUTransfer/E tension ~ 1 1 2013 Received Application: / I /3 -Received Fee:$ Sou d -Completed Application 3 ~ -Incomplete _SEQRA Classification: Type I_Type IIUnlisted Coordination:(date sent) _LWRP Consistency Assessment Fonn ~ 9 /har~T-easy 7/i~~i 3 -CAC Refertal Sent -Date of Inspection: -Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: 1 Resolution: Name of Applicant ~j~ f sq[ , a n s ~ a Mailing Address S D " e~~ y ~T ~~aa~l /Uric Ua ~ vy Y ~ ~ 361 Phone Number:( ) ~ 3 S~ 7 ~ d ~y Suffolk County Tax Map N/umber: 1000 - ~3) ' ~ / ~ Property Location: ~ l 251 ~S ~„~,~l~~w ~Y ~~.~,T Gl~ N / /~7~ (provide LILCO Pole distance to cross streets, and location) AGENT: /Y10 R2•s ~h=sS~OvI ~Iz/L /OL'L (If applicable) Address: ~ ~fD ~ ~/~i?N~ ~ ~ ~ 9k Gc^-I rGn//-aC l~' y 7 / Phone: ~(pS~ 5 ~rd of Trustees Applicati~ G~ gGENERAL DA7TA Land Area (in square feet): / ~ / Y p I Area Zoning: K - yU Previous use of property: ~ I= S. ; ~T~ nT~, ~ Intended use of property: F~ S Covenants and Restrictions on property? Yes No If "Yes", please provide a copy. / Will this project require a Building Permit as per Town Code? Yes V No 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 Boazd of Appeals? Yes No If "Yes", please provide copy of decision. Will this project requir any demolition as per Town Code or as determined by the Building Dept.? Yes No / Does the structure (s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?~No Yes If yes, provide explanation: Project Description (use attachments if necessary): jj ?,fR ~,(0 4i C~.ss0~61 S~d of Trustees Applicatioa. WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:__ ~ ~J~K ~'~o C!~ 5~~~~ Area of wetlands on lot: squaze feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: 2 O feet Closest distance between nearest proposed structure and upland edge of wetlands: ~S feet Does the project involve excavation or filling? No._~_ Yes If yes, how much material will be excavated?\_ cubic yards How much material will be filled? V cubic yards Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the azea of operations: ~ 0 n J; Manner in which material will be removed or deposited: ~u.c K 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): ~,~~L2 PROJECT ID NUMBER 617.20 ~ SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME (h.U , s C~.9s o: I ;5'ce. ~r~ 3.PROJECT LOCATION: Municipality (j County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landm etc - or provide map o~/`j,2s ~~ww~~iw~) Sa~lur~- N~ l/~~( 5. IS PROPOSED ACTION : ? New ~ Expansion ? Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: ~~rZa- Flow ~ F sS~o~~ S'rLti d r'u 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? O Yes ? No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ? IndusMal ? Commercial ?Agriculture ? Park /Forest! Open Space ? Other (describe) 10.~DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fe1deral, State or Local) ?Yes M/ INo If yes, list agency name and permit /approval: LLJJ N L D PERMIT OR APPROVAL? ?Yes No If yes, list agency name and permit /approval: 1ff2~~. LLA''S A RE LT 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 / Sp sor ame ~ ~ ate: Signature / / If the action is a Costal Area, and you are a state agency complete the Coastal Assessment Form before proceeding with this assessment s 13, July 2013 To; Board of Trustees Southold N.Y. Enclosed is the original, notarized copy of the application E- Mailed to you on 12, July 2013. Also enclosed is the authorization for D. Morris to act on our behalf for This application. Ve truly yours, Robert J. Piscioneri p ECEIVE D D JUL 1 7 2013 hold ovm ROBERT a. PISCIONERI, Architect 50-52 194 Street -Flushing, NY 1 1365 - Phone (718) 357-2014 - Fax(718) 357-2014 Board of Trustees Application County of Suffolk State of New York R~~ J ~t~tc~~R ~ _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 IiEREBY 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. f ature of Property Owner SWORN TO BEFORE ME THIS__~Z~ __DAY OF___ $Uty ,20 ~ Notary Public ~ KI BANG Notary Public, Stale of New York No.018A621S038 OuallNeo in Nasaau County COMMISSfON EXPIRES 02/22/2014 ~rd of Trustees Application AUTHORIZATION (where the applicant is not the owner) 1, ~°piding at 5O- 52 l4~ ST. (print owner of property) (mailing address) { ~f ~.1.~,~do hereby authorize (Agent) ~oR~15 to apply for permit(s) from the So hold B and of Town Trustees on my behalf. er s signature) • Board of Trustees Application CaunTy afSuffolk Sta±e of New York __~.C~f~' I i~..7~~C~N.~R I _BEING DULY SWORN DEPOSES AND AFFIRMS T'HAT' HEfSHE IS Tt-IE APPLICANT FOR THE ABOVE I3ESCRI'BED FERMIT{S) AND THAT ALL STA'PEMENTS CONTAINED HEREIN ARE I"RtIE T'O `PETE BEST OF HIS,'HER I<.NOWLEDGE AND BILIEF, AND THAT AI.L, WORK WILL BE DONE IN THE MANNER SET FORTH TN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOI,D TOWN BOARD OF TRUSTEES. THE APPLICAN"T AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES IiAR1vILESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER. OR BY VIRTUE OF SAID PERMI'Z(5}, IF' GRAIN"I kD. IN COIvRPLE"PING 'I'RIS APPLICATION, i HERF.;BY AUTIIOI2I~E T'HF,. TRUSTEES, 'T'HEIR AGENT{S) OR REPRESENTATIVES(S), TO ENTER ONT{1 MY PROPERTY TO INSPECT THE. PItEMTSP_S TN CONJUNCTION WITIi REVIEW OF THIS APPLICATION. ~ e .Si , taiure of Properly Owner SWORN T"O BEFORE- ME THIS ~ DAY OI~ ~"v~y ...__._>~Q..~ Notary Public K $ANu" Natary Pnbflc, 5m:a of NewYarEt NoA12A6218O38 4naMified fn Nassau Oounty COMMISSION `c%PtRES O2tg2?YOIA licacsoa Board p£ TYUeteea 1?pP • • AUTHORIZATION (where the applicant is not the owner) g4 5r. idinbat_g~'gZ ~ 1, _ (mailing address) (Pent pwncr of pmpe~y) , _ do hereby authorize. (A~--- 9 to apply for permit(s) from the So hold 8 and of Town Trustees on my behalf. e s signaiure) g•d of Truateea Application AUTHORIZATION (whe+'e the applicant is not the ow~.ner~)p~, t ~~-residin~at_r~Q,~~~l~-~' !(prnt(p~nt owner of property) pnailing address) ~p~n ~q,~~~Y~`~ hereby authorize, ~~5~rz:-~c~-= (Agent) - to apply for penttit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethic prohibits conflicts of interest on the Dart of torn of5cers and employees The purpose of this form is to arovide information which can alert the [own of possible conflicts of interest and allow it to take whatever action is necessarv to avoid same//.yy~~ n YOUR NAME: I I I b RQ.IS ~Ot~ RS ~ t (ast name, trst name,aprddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name J NAME OF APPLICATION: (Check all that apply.) - Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval ofpiat Mooring Exemption from plat or official map Planning Other / ~ (If"Other', name theactivityJ D[l'6~ ~Auw C ~i Sf~oo/ 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 ofTicer or employee owns more than 5%o a 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 Town of Southold Title or position of that person Describe the relationship between yourself (the applicanUagentfrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of Ne applicant . (when the applicant is a corporation); B) the legal or beneficial owner of any interest in anon-corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of [he applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this / day of --s~U~ 200 Signature ~j]q~ Print Name f 1~~~. > Form TS 1 Town of Southold • • LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that aze 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. 2. Before answering the questions in Section C, the prepazer 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 nronosed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Townl. 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 standazds and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listine both supportive and non- Snpportine faetS. 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 Boazd of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# ~3T - ) PROJECT NAME ~~sc~DiU~ sv' The Application bas been submitted to (check appropriate response): ~y Town Board ? Planning Board ? Building Dept. ? Board of Trustees CI 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: /)!/,te ~LUr,~ ~'sfPaa/ Location of action: ~ ~1 S ,~D<a,a~ Jf f~ ~ f+ v ~o ~..f~ c ~J NY 9 7 / Site acreage: ~ 6C7 9 f~` y ' Present land use:~~' ~ S+'ed~ .r t,b / Present zoning classification: ~j ' ~a 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: ~/j E2.e.~ ~(fC~pnY S % (b) Mailing address: ~V - S .Z ~ 7 y S/ ~Q~ Ski ~~tF-~ a~ 9V y 9~~~~ (c) Telephone number: Area Code ( ) 7/~ ,J .S ,7 z~ (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 LW12P Section III -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 LW1tP Section III -~-P~o(licies Pages 3 through 6 for evaluation criteria ? Yes ? No Imo( 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 Sectiou 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 Ap~able 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 dNot 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. ~ j ? Ye~ No 'Not Applicable Attach additional sheets if necessary WORKING COAST POLICII~ 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 I1. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town~wj aters. See LWRP Section III -Policies; Pages 57 through 62 for evaluation criteria. ? Yes ? No u Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III -Policies; Pages 62 through 65 for evaluation criteria. ? Yes ? No ~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Polic~ie-s~;/Pages 65 through 68 for evaluation criteria. ? Yes ? No IU/ Not Applicable PREPARED BY TITLE DATE OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Environmental Conservation (DEC) SUNY, Bldg. 40 Stony Brook, NY 11790-2356 (631) 444-0355 Mon., Wed., Fri., 8:00 AM-3:00 PM Suffolk County Dept. of Health Services 360 Yaphank Ave., Suite C Yaphank, NY 11980 852-5700 U.S. Army Corp. of Engineers New York District 26 Federal Plaza New York, NY 10278 917-790-8007 N.Y.S. Dept. of State Coastal Management 99 Washington Ave. Albany, NY 12231 518-474-6000 STREET ADDRESS: 21925 SOUNDVIEW AVENUE N SURVEY OF PROPERTY roxa ~ovxn A T SO UTHOLD ~ TOWN OF SO UTHOLD X39. _ 9; SUFFOLK COUNTY N. Y. N~, #s.4+_~ ~ ~ _ ~ a ro~rss-of-io' > ~ ~ Z SCALE'.' 1 =20' - cn to ~ otlNE 5, 2013 Z~~~~p,~el ~ i~ ---s------- _ _-s- n ~ ~ ~ ~ ~ ~ ' ~ ~ IIJnS~ 8,,,~~-'~-,;'? ~ ~ - ,,,moo _ ~ $ JUL 1 1 2013 Z e 1 ~ SouUwld Town y iZ l Z ~ o , - ~~N•~ APPROVED BY ~ ftooo zo ~ ~ ~S. p,f. 4" ~ ~ s ~~2•,~ ~ Na''~ j BOARD OF TRUSTEES ~ ~ s ~El ~ TOWN OF SOUTHOLD ~ ~ ~?E x ~ ~ DATE ~ I ~ 13 't r 56.1 ~~11 ~ ~ pp W 11 ~ ~S,t S 4'~ 11 ~ N y~ 1 `F.~ ELEVATIONS REFERENCED TO N.A.V.D. 1988 ~ ~J• ~ FLOOD ZONE FROM FIRM RATE MAP NUMBER 36103C0158H ~ °F P~ AQ~vF' SEPTEMBER 25, 2009 V;~ COASTAL EROSION HAZARD LINE FROM COASTAL EROSION HAZARD AREA ~~OFNEH,y N0. 55-581-83 Oja~T. MEr2C ~Qf, ~ w ANY ALIERAnON OR ADDInON TO THIS SURb£Y lS A waAnON lv. r. s. uc. No. 49s1e A OA=~} ~ of sECnDN 72osOF IHE NEW YORK STATE EDUCAnON LAW. ~ ONIC SU YORS, P. C. C NEREQNT AARE VA D FOR 7N1~ AP AaD CgoIES IHE RLI~ qyL Y ~S ~^D y"' - P. O.~ BOX 909 20 FAX (631) 765-1797 ~E SA/D MAP OR COPIES BAR THE IMPRESSED SEAL OF THE SURI•£YOR NHOSE SIpyATURE APPEARS HEREpy_ SOUTHOLD~N. ~ ,isii r 13-180