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HomeMy WebLinkAboutTR-8583AJohn M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King Charles J. Sanders Dave Bergen BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 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, silt fence 1St day of construction '/ constructed Project complete, compliance inspection John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8583A Date of Receipt of Application: April 7, 2015 Applicant: Anthony & Dorothy DeMaula SCTM#: 106-6-38.2 & 38.3 Project Location: 800 North Drive, Mattituck Date of Resolution/Issuance: April 22, 2015 Date of Expiration: April 22, 2017 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 install a 12' wide bluestone pervious driveway in order to connect to the existing dirt road located near the seaward side of property; and remove 3-4 trees as necessary in order to install the road. 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 Anthony DeMaula, received on April 7, 2015, and stamped approved on April 22, 2015. 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. 4v- `� & _= Jo n M. Bredemeyer III President, Board of Trustees John Bredemeyer, PresidentgUFF0 Michael J. Domino, Vice -President ��oGy� James F. King : Charles J. Sanders • Dave Bergen Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time:j�.�Q 1"s , ANTHONY & DOROTHY DEMAULA request an Administrative Permit to install a 12' wide bluestone pervious driveway in order to connect to the existing dirt road located near the seaward side of property; and remove 3-4 trees as necessary in order to install the road. Located: 800 North Drive, Mattituck. SCTM# 106-6-38.2 & 38.3 Typeof 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 Typ of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre -Submission Violation Notice of Hearing card posted on property: Yes _ Storm Water Management Review: Yes No Info needed: Modifications: Conditions: 40 4 Present Were Bay Constable other No Not Applicable Not Applicable Bredemeyer V/M. Domino 4J. Kings Sanders k -D. Bergen Form filled out in the field by Mailed/Faxed to: Date: Other SCDHS REF # R10 - 98 - 0022CERTIFIED TO, N/Q/F- ISLAND EAST SERVICING CORP. MA TT1J'UCK its successors and or assigns ' HOLp�NG FIDELITY NATIONAL TITLE INSURANCE COMPANY vAc OF NEW YORK. COl�JpgNj, i ANTHONY J. DEMAULA, JP,. S. 89"48'40" E. l ALIT �l1/C. DOROTHY A. DEMAULA 42.60' 1 Sy 80°6-6p0-\ 30\ 125\ ASTORIA FEDERAL SAVINGS AND LOAN ASSOCIATION 15610, E. � S 84'0/30" E. 6-7.34'\S8'2415 1 I 1 No GENS to N,&p L4 X (\j //08"2'x/6" E. qj WELL i - i �• ` b ' 4.o. 1STY. ��� !! p 20 CGI, l S DIRT DRI YEII'AY m 1 \ \ l STONE ai �1: \� Z i WO6 d� _ -, / 1•Pb :+�P77C-aE9 � — 25 / / , / 4llf ® b� ' SYs7F]/ �T • r" i ay t1 ins I I X57. �� K ° PIPE N.87'48'00" 452.06''\ I N. 87'48 OC" W , m -30$ 1 / � VACANT iO ,� \ � A0 LOTOO APR - 7 2015 i Southold 7oirrn I am familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by /he conditions set forth therein and on the permit to construct. The locallons of wells and cesspools shown hereon are from field observations and or from data obtained from others. ELEVATIONS ARE REFERENCED TO N.G. V.D. CONTOURS LINE ARE REFERENCED TO FIVE EASTERN TOWN TOPOGRAPHIC MAP & NG.VD. BAY VIEW DRIVE AREA = 45,231 sq ft. or 1. 038 ac. to tie line ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209 -SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING q COPY S�RVC Y V� OF ANOTHER SURVEYORS MAP. TERMS SUCH AS 7NSPECTI=D- AND 6R000HT-TO-DA TE' ARE NOT IN COMPLIANCE WITH THE LAW.. pF NE{gr k rr, -r.,t�o�4'P� an .LIC. 1 'n. 49618 PECOM, � P. C. (6317 76 n AX 161!' P. 3C;C 09 1230 7,R4.'c"-E'zi 5 T .zEF SOU -IOL, N. Y. 197f r 97 - 299f LOT P "MAP OF SHORE ACRES" FILED JAN. .3 , 1914 .PIE NO. 41 TEST HOLE A T MA T TITUCK TOWN OF SOLI THOL D LOM OL SUFFOLK COUNT Y., N. 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Town Re: Local Waterfront Coastal Consistency Review for ANTHONY & DOROTHY DEMAULA SCTM# 1000-106-6-38.2 & 38.3 ANTHONY & DOROTHY DEMAULA request an Administrative Permit to install a 122' wide bluestone pervious driveway in order to connect to the existing dirt road located near the seaward side of property; and remove 3-4 trees as necessary in order to install the road. Located: 800 North Drive, Mattituck. SCTM# 106-6-38.2 & 38.3 The proposed actions have 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 -Fbrm.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 Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee pf SOUr�o yCOUNT`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD _Coastal Erosion Permit Application _Wetland Permit Application _Amendment/Transfer/Extension _Received Application: _Received Fee:$ _Completed Application _Incomplete _SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) LWRP Consistency Assessment Form _CAC Referral Sent: _Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: _Public Hearing Held: Resolution: Office Use Only Administrative Permit Town Hall Annex 54375.Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 V -r i APR -*12015 t Southold Town —_, Name of Applicant_V I1/ 1 !�-J Q AI6 -t' 0 O R d7 Q� � A UL i4 Mailing Address 90 0 QI 6 'RT P 19 %Ii , i� �%�1 �/ r Te A/ 93) — s�� —,�j a,��J Phone Number:(6 Y 'Suffolk County Tax Map Number: 1000 - Property Location: Q (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ird of Trustees Applicati GENERAL DATA Land Area (in square feet)ly : ,< 3 Area Zoning: Previous use of property: Intended use of property:" 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 __�CNo 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 X_* 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? V.. No If yes, provide explanation: Yes Project Description (use attachments if necessary):. B< i of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: v� / s-f't Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: O -f- — feet co ekk�c� 1✓�,c�.oz a Closest distance between n6drest proposed structure and upland edge of wetlands: fly' A 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? 0-6 cubic yards Depth of which material will be removed or deposited: XaA c� feet Proposed slope throughout the area of operations: a . 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): 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing 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 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 Name of An or Project: Project `Location (describe, and attach a location map): �LLJ v"I -/-, �'l-a— Brief Description of Propos ction: Name of Applicant or Sponsor: Telephone: 93 E -Mail: F7 L Address: Li Oct City/PO: State: Zip Code: 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and.the environmental resources that NO YES 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? If Yes, list agency(s) name and permit or approval: NO YES ❑ 3.a. Total acreage of the site of the proposed action? acres b. Total acreage to be physically disturbed? 0 o 3"M , a -b c. Total acreage'(project site and any contiguous properties) owned 9/ 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 EXResidential (suburban) ❑Forest ❑Agriculture ❑Aquatic ZOther(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ❑ Do ❑ ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural - landscape? NO YES ❑ IM 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? b. Are public transportation service(s) available at or near the site of the proposed action?IRI c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? NO YES ❑ D ® 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: NO YES 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable water:) A' NO YES ❑ ❑ 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: _ VA NO YES ❑ ❑ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic Places? b. Is the proposed action located in an archeological sensitive area? NO YES ® ❑ ❑ ❑ 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain 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: NO YES ❑ ®. ❑ 14. Lentify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: [4 Shoreline El Forest ❑Agricultural/grasslands El Early mid -successional [X Wetland ❑ Urban ❑ Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES ❑ ❑ 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? If Yes, Will storm water discharges flow to adjacent properties? � NO DYES b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: ®NO DYES NO YES 1-1 Ela. Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: NO YES � F-1 to large impact- impact- mpactmay may 19. Has the site of the proposed action or an adjoining property been the location of an active or closed' solid waste management facility? If Yes, describe: NO YES j ti/� ❑ regulations? 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES � F-1 ❑ 3. Will the proposed action impair the character or quality of the existing community? D E 4. Will the proposed action have an impact on the environmental characteristics that caused the El I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE ��77 M(l� ,, �pp � Applicant/sponsorname: n� �,V O�d ��/ I/�' 1Pt4l}'ate: Signature:Qn9g, VQ - 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?" Page 3 of 4 No, or Moderate small to large impact- impact- mpactmay 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? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? D E 4. Will the proposed action have an impact on the environmental characteristics that caused the El 1:1establishment of a Critical Environmental Area (CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or El 1:1affect 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 El 1:1reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: El a. public / private water supplies? E b. public / private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic, archaeological, El El or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, 1:1 Elwaterbodies, groundwater, air quality, flora and fauna)? Page 3 of 4 1 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 Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency President Date Title of Responsible Officer Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 No, or Moderate small to large impact impact may may occur occur 10. W ill the proposed action result in an increase in the potential for erosion, flooding or drainage ❑ ❑ problems? 1 l . 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 Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency President Date Title of Responsible Officer Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 'rd of Trustees Applicatic County of Suffolk State of New York DEPOSM AND AFFIRMS THAT BEING DULY SWORN 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 BOARD OF 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, INCLUDING THE CONSERVATION ADVISORY COUNCIL, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Property Owner SWORN TO BEFORE ME THIS _FH DAY OF tiw-v Notary Public DENISE KING Notary Public, State of New York Registration #01K16041757 Qualified in Suffolk County My Commission Expires May 15, 2aL_S APPLICA.NT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the wart 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 tape whatever action is newssM to avoid saw.^ YOUR NAME:' V� (L first i;ame,.9,iddle uAii . unf you arc a�plyiag :.. use n someone Ise or other entity, such as a co pany. if so, indicate, the:oiher person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town ofhSouthold? "Relationship" includes by blood, marriage, or buiiness iilterest. "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 LA Title or position of that person T'A tz 9 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 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 da of AP > L— 200 t Signature Print Name a E —1119 Form TS I L4e, %yf A v LA 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- supportin*g 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 res orse • Town Board ❑ Planning Board ❑ Building Dept. ❑ Board of Trustees Pq 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 extenMf action: C.-- 2. Location of action: E Site acreage: Present land use:t 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) Name of applicaj (b) Mailing address: (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 ❑ No b< 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 M inimizes adverse effects of development. See LWRP Section III — Policies; Page 2 for evaluation criteria. ❑ Yes ❑ No A 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 IX Not Applicable f 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 M 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 S through 16 for evaluation criteria F] 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 ❑ YesEl No K 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. K y Yes No r Not Applicable 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 R 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.. - FV - -Yes- -- --No ---- - Not Applicable-- PUBLIC pPlicable- 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. Yell No fV Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water -dependent uses and promote siting of new water -dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No X 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 IX Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural Jands. in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 -for evaluation criteria— ❑ Yes El-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 Not Applicable PREPARED BY TITLE DATE 7 SCDHS REF # R10 - 98 - 0022 N/O/F tijq TJ/TOCK I HOLDING -° q� COQ fP,g/VY vc I / VACANT ' S. 89'48'40' E. S. 80IS6100- zs N. 78'12 42.60' I' S6 S06 0p" E. ; S 84 0130" E. �� 6 7.3 / 1 3/.25' S i8 24 s Oct Q — --- — / CERTIFIED TO, ISLAND EAST SERVICING CORP. its successors and or assigns ' FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK ANTHONY J. DEMAULA, JP,. DOROTHY A. DEMAULA ASTORIA FEDERAL SAVINGS AND LOAN ASSOCIATION rNt12vj No v 1-6 Er�15 /O N' 11!11/ S. //0e!t5- eIN , a\ 15 // �/ WELL LOT OP � ' - _ -�_� °� h les• ie3i�. zo �o �- O S� 0 O I STY. FR. lo \ \ �� • ate/ �` �� p u 20 Q7 �l s DIRT VRiVEWAY l STONE - Cd r ,STY. fR ( `l i ,\ \ S" ,roes/oc• L[pJ�� ro 3Alb1iL� ?ag CANr _ I o b� o ` J 0 CMF.— — 25 / / CMF ®� SY57FJ/ ttry �� 1 I Q- \� `�O j) - $T 'Y - - . , `\ hl 1 \ PIPE,}1 r� N.�87°48'00" W. i.. j, T°w .::;,.APPROVED4 06"\ I N 87�4a 00" w n1 -30 10 VACANT RD OF R USTIK401 LOT OO �-�,� } �0 Mum"�. �, " f�. i ANY.. AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLA TION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209 -SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF ct v4 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR l.. am familiar with the STANDARDS FOR APPROVAL; r :'� G WHOSE SIGNATURE APPEARS HEREON. AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTEr?ED BY' �'i ' ;; ` MUST BE USED BY ANY AND ALL SURVEYORS UT q COPY and will abide by /he conditions set forth therein and on the s' F, j ` '' OF ANOTHER SURVEYORS MAP. TERMS SUCH AS lNSPEC*r"ED' AND permit to construct. ; BROUGHT -TO -DATE- ARE NOT IN COMPLIANCE WITH THE LAW. SUPI��� t �� �lifYti j•s - .. - The locations of wells and cesspools shown hereon are from field observations and or from data obtained from others. ELEVATIONS ARE REFERENCED TO N.G. V.D. CONTOURS LINE ARE REFERENCED TO FIVE EASTERN TOWN TOPOGRAPHIC MAP 8 NG -VD. 3A Y VIEW DRIVE r AREA = 45,231 sq ft or 1. 038 ac. to tie line LOT P "MAP '-0F SHORE ACRES" FILED JAN. 3, 1914 .P.€ NO. 41 TEST HOLE AT MA T TITUCK TO WN OF SOU THOL D LOOAND AM °L SUFFOLK COUNTY, N. Y. r 1900 - 196 - OS 38.2 YELLOW SCALE 1" = 40' 'SAND SW Nov. 5 1997 4 kM Y 26t, 199&• (pe cp, hse.. J SAND & ME OCT. 21,-1998 l !,,undation) GRAVEL SW OCT.. 27, 1998 (CERTIFIED) MAR. I, 200C flnol ) Mor. 14. 20CC (ADDITIONS) -� 17 LIC. P-;0- 49618 PECOAPQ trr P. C. (6311 76 ter- AX t6 l ' P. t-_ .3L;C 09 1230 `R:l 57-E SOU' SOL r, N.Y. 97-2991