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Home My WebLink AboutTR-8377A John M.Bredemeyer III,President �•I *0f S004o Town Hall Annex Michael J.Domino,Vice-President �,�' '`� l0 �L 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee ‘‘ G Q '�► 0 1 Telephone(631) 765-1892 Charles J.Sanders,Trustee Fax►� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0972C Date: April 25,2014 THIS CERTIFIES that the removal of 12 dead pine trees within an established lawn area At 1020 Glenn Road, Southold,New York Suffolk County Tax Map# 78-2-28 Conforms to the application for a Trustees Permit heretofore filed in this office Dated March 17, 2014 pursuant to which Trustees Wetland Permit#8377A Dated March 19, 2014,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal of 12 dead pine trees within an established lawn area. The certificate is issued to JOHN&JUDITH LYNCH owners of the aforesaid property. drit' iets#6204,4 Authorized Signature 0 1110 John M.Bredemeyer Ill,President ��,4l�' FO(,rc_` Town Hall,53095 Main Rd. ' �G P.O. Box 1179 Michael J. Domino,Vice-President �,+Py` y�;, James F. King ; § • 1 Southold,NY 11971 Dave Bergen �• � Telephone(631)765-1892 g `t* `�il,i'�1 Fax(631)765-6641 Charles J.Sanders 4 *,, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: -2-5/ 2/_3 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '2 constructed Project complete, compliance inspection. - INSPECTED BY: 1t )4:2- • COMMENTS: CERTIFICATE OF COMPLIANCE: sa. 4o i . 4 , MAR 1 7 2014 $ud~lwu UYUI ~ ' 2 Fier c ..rte ~ vo , r a. nom' ~jG,F.OGYe moo. HAG3TRoi`t . ~ ay 7~~ 3coo p~cK 7 ~G~tous ? a. (a ~E~ C- ES o o t. yA)C H o $6 , 3-17-201n- o ...Ff,Tr...-'- . APPROVED BY ¢ BOARD OF TRUSTEES p TO" ~F SOUTHOLD bl ...I' ~yo 3' DATE L . 4 t~ae p?v GAW of moo C9O ~ F 3. Z410 Ire PuRP°sr:ERc6~oN GoNT/40< ~ P!~ f vAT~ i3 o A T Qo u< . R l.L C.loo4 T . Gx G R-E050'rAZ -ATEp PRdPO~EO . iJVLKH~AO ANq WORK .SI ra. /oo'Zo a4--'niJ R40A0,~~+rNeta OR'aOG/NG Fo2 SC T i`1i /000 '7B -a28 HPPRaX f33GY'SFINOY3pau toBE'C!a£4 J40Hlf LYNCH( FoR 13A4K1=11-1- - a0y owe. CANAL M AOdA«7Y i" oui/GRS:/. O.HAH4ER Sou r lyc~.4~. $uFroai< ~!(Y oZ. L. ToR K~L Son' TEs"r"r - - SHC'~ T Ia.=~ S/78/96 '1. GALf_o John M. Bredemeyer 111, President gpFF01,r Town Hall, 53095 Main Rd. O Michael J. Domino, Vice-President P.O. Box 1179 James F. King d°+ x Southold, NY 11971 Charles J. Sanders Gy Telephone (631) 765-1892 Dave Bergen ~Ol 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 %constructed V/ Project complete, compliance inspection John M. Bredemeyer III, President QF SOUlyO//__ Town Hall Annex Michael J. Domino, Vice-President 54375 Main Road P.O. Box 1179 James F. King, Trustee T Southold, New York 11971-0959 Dave Bergen, Trustee Q Charles J. Sanders, Trustee • Telephone (631) 765-1892 ~yCOUrm Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8377A Date of Receipt of Application: March 17, 2014 Applicant: John & Judith Lynch SCTM#: 78-2-28 Project Location: 1020 Glenn Road, Southold Date of Resolution/Issuance: March 19, 2014 Date of Expiration: March 19, 2016 Reviewed by: Board of Trustees Project Description: To remove 12 dead pine trees within an established lawn area. 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 Judith Lynch, received on March 17, 2014, and stamped approved on March 19, 2014. 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. John M. Bredemeyer III, President Board of Trustees John Bredemeyer, President $ocroj~. Town Hall Annex Michael J. Domino, Vice-President ° 54375 Route 25 James F. King ; P.O. Box 1179 Charles J. Sanders Southold, NY 11971 Dave BergenOi,p°~ Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: bt'14-'A / fJ La 7`f' JOHN & JUDITH LYNCH request an Administrative Permit to remove 12 dead pine trees within an established lawn area. Located: 1020 Glenn Road, Southold. SCTM# 78-2-28 Type of area to be impacted: -Saltwater Wetland -Freshwater Wetland -Sound !/Bay Distance of proposed work to edge of wetland 70 - yo 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 Notice of Hearing card posted on property: Yes No Not Applicable Info needed: Modifications: Conditions: /2 o(e a eQ a.~ •Q al-n-stis. ~O Present Were: J. Bredemeyer ?M. Domino J. King C. Sanders Bay Constable Other Form filled out in the field by A vi . Mailed/Faxed to: Date: MAc IV I w s a o y a> m Q j. aaq.w . n n s .mil ,up pv,E y P a y ° eawrvw w ~ ..n q w b y 9 `44 v..ryq O P AVM > o ` . i y •°w t4 A 1 ~ q a i d q Ma ~ 3 I p dd q q Mil la i M nn y` i i Z. I p A . a?° ~ W ~ n d m 'w. ~ tl Qs /.T V 'd I I M~ Y M >,1~ T n i i ry p ql I q y sy M YFGP" • }n° ilr i q • \ [pw '1"4 ,YW ®1 {~I q M ,°r„+ T s y y P p d ~ +.'ye q' 3 I le.• q' n~ u.a.a ~ Y• .y o d ~ ~ ' F ,]vN Y> n Y TT q O ..V / • •If a qh Ca r~ yF4 ~ q M P ayp V[r ) I/ r S nL_ ha ( .If ''4Vy ' y r,jW ha ,Y,° T y y. y „ro _ ra' ~ • I 5 L I!7 'a' a~ a C +wn T Y y'3 H~ IrI q .n .u E w _ u ~ r un. R,1 O n _ • _ M1R 6 o LECimvvD E rru °m ~ WNMGID o ,.r.. - ate.....,...... SPIKY 78 q SO//ryo OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) G Q Southold, NY 11971 Telephone: 631 765-1938 OUH('I,Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM 0 ~ r To: John Bredemeyer, President Town of Southold Board of Trustees MAR 1 8 2014 From: Mark Terry, Principal Planner LWRP Coordinator Date: March 17, 2014 Re: Proposed Wetland Permit for JOHN & JUDITH LYNCH SCTM# 1000-78-2-28 JOHN & JUDITH LYNCH request an Administrative Permit to remove 12 dead pine trees within an established lawn area. Located: 1020 Glenn Road, Southold. SCTM# 78-2-28 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore, CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King, President ~oF sou Ty Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen #t # Southold, New York 11971-0959 John Bredemeyer CO% Michael J. Domino _ Telephone (631) 765-1892 O~~CO Fax (631) 766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only a „ 1 9 n , .'ca SW ..y Coastal Erosion Permit Application -Wetland Permit Application V/ Administrative Permit _Amendment/rransfer/E nsion MAR 1 7 2014 ?Received Application: / / q Completed Application ~ 7 ~ $uui11U~J lc»r. -Incomplete oard of Trustees _SEQRA Classification: Type I_Type II-Unlisted oordination:(date sent) LWRP Consistency Assessment Form ~AC Referral Sent: M_ ? Date of Inspection: -Receipt of CAC Report: -Lead Agency Determination: .Technical Review: -Public Hearing Held: Resolution: Name of Applicant q u ' 4 h Mailing Address I O;1O d d So a f~ 0 Id Phone Number:(8() p 1 1 0 _7 Suffolk County Tax Map Number: 1000- O o? -o2 Property Location: 10 d 0 G l P A n Ed, So a f h r> I d 4 IVIa a~/ V t.J (provide LILCO Pole distance to cross st er ets, anlocation) AGENT: (If applicable) Address: Phone: Ward of Trustees Applicat• / GENERAL DATA Land Area (in square feet): I J + 7O A-fle s Area Zoning:_ 0 Previous use of property: Intended use of property: ~C S I deAf, Q 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 Board of Appeals? Yes ? No If "Yes", please provide copy of decision. 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? ? Yes No Prior permits/approvals for site improvements: Agency Date --a-~ l K~ r~ o d T~q 6 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?L No Yes If yes, provide explanation: Project Description (use attachments ffifnecessary): l EP nv o V P_Q d P1,0 P fih e e el 'Wd of Trustees ApplicatioO WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: t ' /0 % square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: /1/ 11 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? 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 deposited: 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): do Ne 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 - Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 - Project and Sponsor Information r (WO 0 1P 4-co I d Irte pees Name of Action or 'Project: Project Location (describe, and attach a location map): 10 a0 Brief Description of Proposed Action: 'Remove -Pea i>-rhPes 0i) Name of Applicant or Sponsor: Telephone: 7 6 S I V t7 Yl1 C E-Mail: IP h O I I i 0 et- Address: I O-R O ~z City/PO- State: Zip Code: socfihd N 1 l q-7/ 1. Does the proposed acticia only Involve the legislative adoption of a plan, local law, ordinance, NO YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no, continue to question 2. KI JEJ 2. Does the proposed action require a permit, approval or funding from any other governmental Agency? NO YES If Yes, list agency(s) name and permit or approval: ? ? 3.a. Total acreage of the site of the proposed action? -7 GI acres b. Total acreage to be physically disturbed? acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on, adjoining and near the proposed action. ?Urban ?Rural(non-agriculture) ?Industrial ?Commercial 0511esidential(suburban) ?Forest ?Agriculture ?Aquatic ?Other(specify): ?Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ? ? a b. Consistent with the adopted comprehensive plan? ? ? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ? ? 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO YES If Yes, identify: 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES b. Are public transportation service(s) available at or near the site of the proposed action? ? ? c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ? 9. Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements, describe design features and technologies: ? 10. Will the proposed action connect to an existing public/private water supply? NO YES If No, describe method for providing potable water: EJ ? 11. Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: ? 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ? b. Is the proposed action located in an archeological sensitive area? 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain NO YES wetlands or other waterbodies regulated by a federal, state or local agency? b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody? ? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: ?Shoreline ?Forest ?Agricultural/grasslands ?Earlymid-successional Wetland ?Urban ?Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed NO YES _ff by the State or Federal government as threatened or endangered? ? 16. Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge, either from point or non-point sources? NO YES If Yes, ? a. Will storm water discharges flow to adjacent properties? QfNO YES b. Will storm water discharges be directed to established conveyance systems (pff and storm drains)? If Yes, briefly describe: runNO S Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes, describe: ,--y, ? 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or NO YES completed) for hazardous waste? If Yes, describe: ? 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: +:J-d i~7, Date: a~a6,- `T 17, 2) o i Signature: Part 2 -Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the, following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept "Have my responses been reasonable considering the scale and context of the proposed action?" No, or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ? regulations? w 2. Will the proposed action result in a change in the use or intensity of use of land? ? 3. Will the proposed action impair the character or quality of the existing community? 0- ? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area (CEA)? - I2 ? 5. Will the proposed action result in an adverse change in the existing level of traffic or ? affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ('may ? reasonably available energy conservation or renewable energy opportunities? L"J 7. Will the proposed action impact existing: ? ? a. public / private water supplies? El- b. public / private wastewater treatment utilities? ? 8. Will the proposed action impair the character or quality of important historic, archaeological, ~y ? architectural or aesthetic resources? u 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, ? waterbodies, groundwater, air quality, flora and fauna)? Page 3 of 4 No, or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage ? problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3 - Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered "moderate to large impact may occur", or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold - Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 Iwd of Trustees Applicatio* County of Suffolk State of New York T u n IT ii L x A 1 f H BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMrr(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 IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Prop y Owner SWORN TO BEFORE ME THIS 1 r~ DAY OF_& (Q 1 ,20 ( AL Notary Public CONNIE D. BUNCH Notary Public, $We of New York No.01BU8185060 OueNfled in 8uMo8c County Commiealon Expires April 14, APPLICANUAGENU/REPRESENTATWE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the Dart of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. 1 YOUR NAME: Y IU CH ( J U 17 I `r H E (Last name, fast name, ipiddle 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.) 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 business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO If you answered "YES", complete the balance of 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 applicantlagent/representative) 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 the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of A ~ C t+ 201 Signature G Print Name `emu vt ~ to g k~ uU c1'F Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for per mits* 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 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 significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting 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 SCTM#! li-- D, -a PROJECT NAME Re rno o e d e Ct n e, C h 2 S a~ The Application has been submitted to (check appropriate response): ~y Town Board ? Planning Board El Building Dept. E] Board of Trustees IJ 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: E Nature and extent of action: KfM0611= (oZ PiFfi7 I lZtES Location of action: 10 a0 G. a tcA Site acreage: . 7o Present land use: 1 S 1 C40 411.0 Present zoning classification: Q - 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: 1 v v i T H h iU C H (b) Mailing address: l D a D G C E ty L) (c) Telephone number: Area Code (b4 b 5 i I 0 1 (d) Application number, if any: Will the action ~-b7e. directly undertaken, require funding, or approval by a state or federal agency? Yes ? No I !J 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 0 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ? Yes ? No 51 / Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LW" Section III - Policies Pages 6 through 7 for evaluation criteria ? Yes ? No Er 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 El No 0 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 E] 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. ? ? Q Yes No Not Apf fable 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 E] No [v Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ? Yes ? No 9Not 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. ? YesD No 2 Not Applicable Attach additional sheets if necessary WORKING COAST POLICIP 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 u Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ? Yes ? No Ef 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 El No LJ 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 ff~Not Applicable PREPARED BY ;:U,) L-7 (TI-1 L. k) CN TITLE Oy,-ice2 DATE 3-17-aofq