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TR-8503A
John M. Bredemeyer 111, President gu1 F0( c Town Hall, 53095 Main Rd. Michael J. Domino, Vice-President a�0 �Gy P.O. Box 1 179 James F. King N Southold,NY 11971 Charles J. Sanders � Telephone� �� P ( )765-1892 Dave BergenOl �a0 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 Y2 constructed Project complete, compliance inspection 0 0 Soar John M. Bredemeyer III, President �� y�l Town Hall Annex Michael J. Domino,Vice-President ~ O 54375 Main Road P.O. Box 1179 James F. King,Trustee Southold, New York 11971-0959 Dave Bergen, Trustee • COQ Q Telephone (631) 765-1892 Charles J. Sanders,Trustee �y�Our ,, � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8503A Date of Receipt of Application: September 25, 2014 Applicant: Leslie & Clifford Cohen SCTM#: 27-3-5 Project Location: 1455 Narrow River Road, Orient Date of Resolution/Issuance: October 22, 2014 Date of Expiration: October 22, 2016 Reviewed by: Board of Trustees Project Description: For a 10 Year Maintenance Permit to cut down the phragmites to not less than 12" in height; to hand pull all mile-a-minute vines; to uproot autumn olive, multiflora, and other invasive shrubs; to trim the dead wood from all native vegetation; and to re-vegetate with native plantings where possible; all work to be done on an as needed basis. 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 Lillian Ball, received on September 25, 2014, and stamped approved on October 22, 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 0 0 John Bredemeyer, President �s0fFOL,� Town Hall Annex Michael J. Domino, Vice-President ha° °os 54375 Route 25 James F. King g P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen yea` ,F �a°! Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field InspectionMork Session Report Date/Time: Lillian Ball on behalf of LESLIE & CLIFFORD COHEN request an Administrative Permit for a 10 Year Maintenance Permit to cut down the phragmites to not less than 12" in height; to hand pull all mile-a-minute vines; to uproot autumn olive, multiflora, and other invasive shrubs; to trim the dead wood from all native vegetation; all work to be done on an as needed basis; and to re-vegetate with native plantings where possible. Located: 1455 Narrow River Road, Orient. SCTM# 27-3-5 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 Notice of Hearing card posted on property: Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: Present Were: -"J" Bredemeyer . Domino -J. King C. Sanders D. Bergen Bay Constable Other Form filled out in the field by ✓ � ��_.. Mailed/Faxed to: Date: u� i If SEP 2 5 2014 R 4 y s��` 4 � .a .`;�'�\*�@;" k .f'!°'..1. � ,A ,r ::.:.;Zsti j'.�' n. y ?��. ��� -��} �s.^4�'•,� .t.' i - t,''�� j; • 1... a" t: ,�, s.s �:+L�r�'. 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(FOUR BEDROOMS) ` ,�Y 1000-27-0--05 SCALE 1*=60' [[i)1,000 GALLON SEPTIC TANK Ayes JANUARY 14,2014 [3]4'DEEP x 8'DIAMETER LEACHING POOLS po 5 one X JANUA]31.01201 7A�iFD ;�MU1�1 MARCRAIN RUNOFF CALCULATIONS _ APRIL 4,2014((PROPOSED HOUSE) HOU00 SE h POOL HOUSE=3,330 sq. ft. 00 0,0 3.261 x 1 x 0.17= 566 cu. ft. nor 'I a xl 566/42.2= 13.4 VF NI PROVIDE 3 DRY WELLS 8'DIAMETER x 5'DEEP i OR EQUAL ©=PROPOSED CONTOUR ` N a Zone j � Zone 'ALL \ �� AE 6 �/ AE 7 o I I I i I •� R ^�x, a \ S 1 k Zbne \X I I F W V 4041 • 10 651.0f opo I , SI� y I Pry toe 00 AKA N►,nn- /1SOf N Y �(i"�GrY' X47`. \� � i 6'�•,1 M/D�y1K y �m TAB VPG�j +0, tot., KNp/f x N�. 1z �� �*6w y5` �yd�0� +.0y Q r t� 4 `� its, a66641 In><MONI/AGENT 1= REILAND FLAG LANDWARD EDGE OF TIDAL NERANDS AS DETERMINED BYTEST HOLE DATA SUFFOLK ENNRQVMENTAL CONSULTING INC. ON DECEMBER 24, 2013 BY Mc 1/20DAL/14 :50PM NQ ONGEOSII I om familiar with the STANDARDS FOR APPROVAL a AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ar a and wM abide by the conditions set forth therek,and at the permit to construct. ewwi rec m maz eNo wm w x a%rez w The lacotim sv webs and csaapaols shown hereon ore Ira - s • n FNld obserwtans and a Gram data obtained born others, rwz ewx«ne[n eawa elver v FZOOD ZONES FROM FIRM CERTIFIED TO: Y.S.. UC. NO. 49818 ANY AL RFA71pW OR AatW/Kw 7C 716 AIrED R A NQLAW a v - zr COVIC S P.C. tr A-Cnw 7"OF INE AEW last srA1E EDUCATION ulE 36108Lti08BN SEPT 251 2009 CLIFFORD COHEN EXCEPT AS PER SECIKW 7201-AMM-VON z ALL CERR9C1 DOW wIa r rNz wow we m ca+A><wo*' LESLIE COHEN (831) 765-5020 FAX(6J1)765-1797 HOMIOW ARE VALID Pat 7115 MAP AND COPIES THEREOF Oft F ELEVATIONS AND CONTOUR LINES ARE P.O.BOX 909 SAN YAP GafS��711E/11^RE33ID 71C W INSIGNIA NATIONAL TITLE AGENCY,LLC 1230 1RAVELER STREET WKSE SGM nA E APPEARS tERIEW REFERENCED TO NAM DATUM. n SECURITY TITLE GUARANTEE CORPORATION OF BALTIMORE SOUINOLO,N.Y. 11971 13-299 • 6 John Bredemeyer, President °�OFF0��.4o Town Hall Annex Michael J. Domino, Vice-President �� ay 54375 Route 25 James F. King P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen ol ,� �a Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees /Field Inspection/Work Session Report Date/Time: 1/Z/d Lillian Ball on behalf of LESLIE COHEN request a Pre-Submission Inspection for a proposed driveway; proposed pruning and/or removing of invasive vegetation within Trustees jurisdiction; and inspect the line of flagged wetlands for a landward edge of wetland boundary determination. Located: 1455 Narrow River Road, Orient. SCTM# 27-3-5 Type of area to be impacted: —Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland V g LA,� Part of Town Code proposed work falls under: _ZChapt.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 Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: / Present Were: J. Bredemeyer M. Domino J. King C. Sanders D. Bergen Bay Constable J Other Form filled out in the field by Mailed/Faxed to: Date: sEE sEc.K °,e m,Pw o w zaa - we Rsz? — FOR 13� o,ew o..mmt • ^ eEE SEC12 . max-n te.mo,.s 13 VA v� 3,NU A u s +Pmnu F.D.25`. ]a ].� �T as m as O3 zz a� c +zN° aN to a a+ ow ss j ' au 73 mere or \ /r' to .ae1q , t �' ve.Y. ,,, •. ... \ ci Cr o i CR �. ,_WU ® \� ].]e(U ,/�.t.. � \ O n1}� TOvm Oi SOUTMID 7 ..»CCu0) 27A � o \ -- ,D,,— cOs \ Srn-ECF—YORK vs a see W. FiVT Hgq@pR\ ,a gS p` tm- - NOTICE .a" COUNTY OF SUFFOLK © K SOUTHOLD SECT—NO J'E o--e- -�— _ R+12 —_ "�,_ __.-- Real Pro�TaaSem Agency Y27 r' v.Yu1v� 1000 PROPERTY WPr N.I tzu `. w. rwe r.rrtrwm Pa • 0 OFFICE LOCATION: �*OF SO(/T�O MAILING ADDRESS: Town Hall Annex O l0 P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) N _hc Telephone: 631 765-1938 Southold, NY 11971 �� Fax: 631765-3136 ��yCOUNTY,Nc� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President u Town of Southold Board of Trustees OCT 1 5 20M From: Mark Terry, Principal Planner LWRP Coordinator Roz' e!Lu Date: October 15, 2014 Re: Proposed Wetland Permit for LESLIE & CLIFFORD COHEN SCTM# 1000-27-3-5 Lillian Ball on behalf of LESLIE & CLIFFORD COHEN request an Administrative Permit for a 10 Year Maintenance Permit to cut down the phragmites to not less than 12" in height; to hand pull all mile-a-minute vines; to uproot autumn olive, multiflora, and other invasive shrubs; to trim the dead wood from all native vegetation; and to re-vegetate with native plantings where possible; all work to be done on an as needed basis. Located: 1455 Narrow River Road, Orient. SCTM#27-3-5 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 are 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 John M.Bredemeyer III,President *OF SU�j • 0 Town Hall Annex Michael J. Domino,Vice-President '`� lQ 54375 Main Road James F. King, Trustee 4 P.O.Box 1179 Southold,New York 11971-0959 Dave Bergen,Trustee �, �Q Charles J.Sanders,Trustee �Qa�� Telephone(631) 765-1892 �'ouM`►,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicatio _Wetland Permit Application Administrative Permit _A mendment/Transfe /E ten ion eceived Application: 25 4completed eceived Fee:$ t fez�d �6-deC 22g,Application 5 yl _Incomplete _SEQRA Classification: SEP 2 5 2014 Type IType II Unlisted Coordination:(date sent) i.._ ZLWRP Consistency Assessment Form CAC Referral Sent: 9_"L�Ll Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: echnical Review: Public Hearing Held: b ZZ _Resolution: Name of Applicant 1 h ,tANl Mailing Address Phone Number:( ) Suffolk County Tax Map Number: 1000 - 27 r n — 5 t Property Location: r (provide LILCO Pole #, distance to cross streets and location) AGENT: (If applicable) Address: Phone: "! 7 �ard of Trustees Applicati� , GENERAL DATA Land Area(in square feet): Pf Area Zoning: Previous use of property: { J Intended use of property: l 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 _�'_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 _X_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'�X_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): V/I UAM �1� WA Bd of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: h i'o ' Pro kN Area of wetlands on lot: square feet Percent coverage of lot: /o Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: 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: NA 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): n 0 f�h fC4� 6-6 617.20 Appendix B Short Environmental Assessment Form Instructions for Complcting Part l -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 I 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 Name f Action or Project: �� t Project Location(describe,and attach a location map): 1'4 55 fl�"&W q("o W 1\12 Bri f Description of Proposed Action: iN.'-ft&tt- '5�p 0 WW1 M - Name of Applicant or Sponsor: Telephone: r J� E-Mail & W41 MIL Address: f City/PO State: Zip Code: 5nd� � 19 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinanck NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that V ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 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? 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? nacres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural (non-agriculture) ❑Industrial ❑Commercial Residential(suburban) El Forest ❑Agriculture ❑Aquatic 00ther(specify): 64 A(V ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES I N/A a. A permitted use under the zoning regulations? ❑ 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 VES 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? El IK ❑ 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? T40 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: INA fel ❑ IV �J 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: (\//A\ � ❑ 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? :a F-1 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? v❑� 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 JAgri cultural/grasslands Early mid-successional .FKJ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES 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, Ela. Will storm water discharges flow to adjacent properties? ®NO ❑YES b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: r]NO ❑YES 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: rVIIX I ❑ 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: N ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE s , Applicant/sponso nL , 13 Date: �V 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? 2. Will the proposed action result in a change in the use or intensity of use of land? FR F-1- 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ( 1 F]establishment of a Critical Environmental Area(CEA)? �J 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 reasonably available energy conservation or renewable energy opportunities? L15U tt�-JJ 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? LJ 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,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 ® E]problems? 11. Will the proposed action create a hazard to environmental resources or human health? IKT 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. L Town of Southold-Board of Trustees Name oHwd Age/�y Date `&A Glob V/ President Print or Type ame of Responsible Officer in Lead Agency Title of Responsible Officer Sig of Respoi e Officer in Ladd Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 BWd of Trustees Application v� AUTHORIZATION (where the applicant is not the owner) I residing at z 0,�- ( a (print owner of property) (mailing address) �hUbk �k 2-0 do hereby authorize �� k�. " 6`9-0 �ti . N� (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. L\ X-CA� (Owner's signature) d of Trustees Application �Y County of Suffolk State of New York LA t1 e BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)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 Property Owner SWORN TO BEFORE ME THIS_�, DAY OF <:�p -m&r- ,201LI_ ANMEW MoNSuuR NOTARY Pumic.,Suft d mm y4* Na 01M0o2Q2M Qnftd kk Q=M CM* CMWW mq*"MW 20,26" Notary Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE.FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the cart 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. YOUR NAME: (Last name,First kame,xpiddle initial,unle s you are applying in the name 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 X 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 applicant/agent/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 applic4nt (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 G1 idav of 20¢ Signature Print Name Forth TS l } 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 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# PROJECT NAME CO hM 010 W k- 1 I fAbZ61d ljzP The Application has been submitted to (check appropriate response): 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: 1�4 Nature and tent faction: ro al aAk v 'Ft . nd�2f 4 f 6 4 v4ffi m4a, Location of action: t � Site acreage: Present land use: 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: t (b) Mailing address: Cl (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ NoN 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 ❑ 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 1:1No� Not Applicable Now 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 1 LL].- Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes ❑ No A 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 A*able • f 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[A'Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous s istances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes ❑ No �K Not Applicable UhlSk(MV W12f& 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. ❑ Ye0 No I&Not Applicable Attach additional sheets if necessary WORKING COAST POLICIEO 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 Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No L/2*4 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 M No® 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 r ,Not Applicable PREPARED BY TITLE DATE r 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 Leslie Cohen 207 Congress Street Brooklyn, NY 11201 Lesliecohen207@gmail.com June 2, 2014 JUN - 9 2.014 Trustees- To whom it may concern, I am writing to notify you that we grant permission to the members of the Southold Town Trustees to meet on our property at 1455 Narrow River Road in Orient and that Lillian Ball is acting as our agent We would like the Trustee presubmission conference to help define an appropriate course of invasives removal, and an effective driveway route, to prevent their spread further into the property. Please note that the permit paperwork will be submitted by Bruce Anderson at the appropriate time. If you have any questions, I can be reached at Lesliecohen207@gmail.com or 917-743-7721. Many thanks for your time,`-- C o '--, Leslie Cohen Cantrell, Elizabeth From: Lillian Ball <lillianball@waterwash.org> Sent: Tuesday,lune 03, 2014 4:04 PM To: Cantrell, Elizabeth Cc: Lillian Ball; Leslie Cohen; Niall Carroll Subject: 1455 Narrow River Rd, Orient Attachments: 13-299.PDF Dear Elizabeth, Here is the information we have been discussing about the property/wetlands in Orient for the presubmission meeting. Enclosed please find Leslie Cohen's letter along with the site plan, let me know if the document comes through OK. She is sending a hard copy along with the $50 check. Please note the driveway position is still in question so we would welcome feedback on the concept of locating it along invasive infestation and/or flood zone lines. Our main goal is to get the trustees approval on the flagged wetland boundaries so we can prune appropriately to save native plants and remove invasives like mile-a-minute, autumn olive, and multiflora rose. At the moment, phragmites control doesn't figure into our management plan. i 0 9 iX00 .NY t12ra To u-"tvm it may oonc rn,. I am w"MV to Mly pbu#hat we grarA pwmm*n to tt*rreqnbem at me Southold Town:Trus'tO rack txa aur awoo^a#14:•5 Narmw Rwer Road�-07 m ani mat U fiar ftli tv ami g as ow agent We would We the TiLm"rhesubrrss.mn co(ft ane.zrs t*4l ane are aWop iate +kmuse Of vrtvaslwas rerne+.al,area an e8foct ve d eway route,to prevern.their wead EtvLtax into ow pramly. Rsaim rvie maa tt pww paperwwtt wW be submmed by S Ce Anoefsw at f-e app€og uwe . 4 you rsave arri ,f Cast be reafael a: W 917-743-7721. Many l hw*s f0f your rill'*, 1 I Please let me know if there is anything further that you might need. We look forward to seeing the trustees at the site on Wednesday, June 11th. I will check in later this week for the exact time. Best, Lillian LILLIAN BALL STUDIO 2045 Lake Drive Southold,NY 11971 631.765.3495, 917.453.5040 mobile littp://www.lillianball.com ballstudio.r thin .net WATERWASH®Projects http:Hwaterwash.org i l l i an b al l riahvate rw ash.ori Reorient Film's Bronx River WATER WASH Documentary trailer: www.mediafire.com/watch/3x5hnrd3rxg>?4l]/WATERWASH ABC. trailer.mov 2 9 n \1 S,Z� �" Zone. 11 Zone AE I If' 1AE 7APPROVED BY �� �► i , .1 BOARD OF TRUSTEES: g / TOWN OF SO UTHOLD 1 J \`Zone\ X I -i : ",e law 1 � � �� �,� , ,rfll"�'�''� • ' •off' 1 • GSA ®�� �� i 1�- �' • long term Invosives Management Plan St4VD0 t `: ► ',� "a t Handpull milerminute entire site s d u Of P" ut Phrogmites to V ROOD) Uproot Autumn Olive/Multiflora shrubs 10 Trim deadwood to save natives NMS T SE 5tA vPGPNi �►/ _ QTR E� 0101T �V- v 10 Nt, ti 'FO ew., ZonZon jwN AE 6 j AN I oil Zon6 X I O\ Long term 1i Hawpull m A; 3* Uproot Ault d doodw SO or rPE!77 - C"C, ll, 1� r- I %J L 4. 1 ZQ ov a 3 , 3 a � o3 ca 11 p p a °• o ° 3 a a� �V� O' o � � y 2 Rt �`O�jp% �pO Cb Q+ y n S Z ��1� C .< t n ? u) Z 2 G� � O ct in'N OOn y ° o p o Z 2 ��� y"co o� 0 'arca � a y g�a�� - ZaoZ n o co rp i 'o' O O r O Z �oScn� � � C)$ C-n 3 ° a � � � a cin N� o o ? 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