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TR-8687
Michael J.Domino,President ��0f SU(/lTown Hall Annex John M.Bredemeyer III,Vice-President �� lQ 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith G � � Telephone(631) 765-1892 A.Nicholas KrupskiO Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1432C Date: December 8, 2017 THIS CERTIFIES that the repair of sections and replacement of sections of damaged foundation of an existin1,045 q ft cottage; and to replace the two existing cottage landings; At 65490 Route 25, Breezy Shores Cottage#3, Greenport Suffolk County Tax Map #1000-53-5-12.6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated September 24, 2015 pursuant to which Trustees Wetland Permit#8687 Dated October 21, 2015,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 repair sections and replace sections of damaged foundation of an existing 1,045 sq ft cottage; and to replace the two existing cottage landings. The certificate is issued to ELENA COLOMBO owner of the aforesaid property. y , Authorized Signature rry Michael J.Domino,President �Zf soTown Hall Annex O� Ol0 John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith • �� Telephone(631) 765-1892 A.Nicholas KrupskiCnUm� Fax(631) 765-6641 e BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: -75 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction / Y2 constructed �l Project complete, compliance inspection. INSPECTED BY: Y�� ~� COMMENTS: OIL D CERTIFICATE OF COMPLIANCE: John M. Bredemeyer Ill, President p�pg11�FQ(,�c Town Hall,53095 Main Rd. �G P.O. Box 1179 Michael J_ Domino, Vice-Presidentp James E. King o Southold,NY 11971 a 631 hone le Charles J. Sanders y ~ p�� Telephone( )765-1892 , Dave Bergen ��l 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, silt fence 1St day of construction % constructed Project complete, compliance inspection WR11" BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK p- X DATE: OCTOBER 21,2015 PERMIT NO. 8687 ISSUED TO: ELENA COLOMBO PROPERTY ADDRESS: 65490 ROUTE 25,BREEZY SHORES COTTAGE#32 GREENPORT SCTM# 1000-53-5-12.6 AUTHORIZATION A Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 21,2015,and in consideration of application fee in the sum of$250.00 paid by Elena Colombo and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to repair sections and replace sections of damaged foundation of an existing 1,045 sq.ft. cottage; and to replace the two existing cottage landings; and as depicted on the site plan prepared by Robert I. Brown Architect,P.C.w/Fairweather Design Associates, Inc., dated on October 20, 2015, and stamped approved on October 21, 2015 IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Lp John M. Bredemeyer III Absent V41. cc ca > TERMS AND CONDITI®NS The Permittee Elena Colombo residing at 65490 Route 25 Breezy Shores Cottage#3, GreenportNew York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of.the originating application may be cause for revocation of this Permit by,resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. John M.Bredemeyer III,President ��'zf SOUTyo Town Hall Annex 54375 Main Road Michael J.Domino,Vice-President P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee ® a� Telephone(631) 765-1892 Charles J.Sanders,Trustee �I�COUN11,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 21, 2015 Robert Brown Architect, P.C. 205 Bay Avenue Greenport, NY 11944 RE: ELENA COLOMBO 65490 ROUTE 25, BREEZY SHORES COTTAGE #3, GREENPORT SCTM# 1000-53-5-12.6 Dear Mr. Brown: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 21, 2015 regarding the above matter: WHEREAS, Robert Brown Architect, P.C. on behalf of ELENA COLOMBO applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 24, 2015, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and,- WHEREAS, the LWRP Coordinator issued a recommendation that the application be found-Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 21, 2015, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ELENA COLOMBO to repair sections and replace sections of damaged foundation of an existing 1,045 sq.ft. cottage; and to replace the two existing cottage landings; and as depicted on the site plan prepared by Robert I. Brown Architect, P.C. w/ Fairweather Design Associates, Inc., dated on October 20, 2015, and stamped approved on October 21, 2015. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Michael J. Domino Vice-President, Board of Trustees MJD/dd 1— 'ej EX1STI NG DKICR PIED.TO UMA N. LEVEL FLOCK AND 5HIM AS IMM55AKY. F \_ NEW BRINK PIER TO MATCH I:X 1:5TI 11 G T) FOU TO i rE M_ 10 DIA. C2 SONOTi TO 0 Plrm OVE 15TING WOOr, PIER plfpLJ\cF WITH 8`x5`P T, 1`05T ON C)"L.A„ cin Lu EX1,13THG 5KICrl< 2'x2'�M PIER TO IZENAIN. a, f 0OTING@ LEVEL;LOO,', AND SHIM AS DELOW GFADF, N ECES 51A.ply, ON ........ ....... U-41)57URBIE7 NEW LANDINI- j I j \ AND 5TEP5 TO REPLACE 0 EX15TRIG [L—.--- ----E— � C:= '111 L _7 c t'l IA. fl)1; D LD 7" LLI HEW LANDING N EW 10 DIA. 7v AN[) C TE:15 TC 50NOTi1'O I Fli 30' 1 APPROVED BY_ EX15THIG GFAi FEMOVE COARD OF I RUSTEES ® FXl,5TI1,lG PIFIR, >/\N 1) PROVIDE TOWN OF SOUTHOLD LLI NEVI TO MATCH A5 5HOV/N DATE z( ZC451 < C)F P LA N Ri ✓'l," TH,IG "T D f ElXIc.)TII,IG i f-OUNDATION PLAN FIER TO REMAIN, LI _T_ G EYCEfIr _._. -` 1 / AND SHIM As LEVEL FL AS NOTED FOR i MIffc:Ife5Aply, 0 ARD IASPHAL, POAM 2Af'3E: EOLA.E* ————————————---— ——————---—— ---.----————-- k, A! OCT 2 0 2015 J N ;;,',`` :j(. - E E3AZIF-D ON 11AAR IN ILLSA Eo'o SITU A'jEDATi,.,C!T7AGr 1, TREEn. ' VICRF'S' G I HNIPORiT, TOVIN.10F SOUTHU D Ei SY: VOUNG rx YOUNG, LAND SURVEYOR DAJED JAIN 10,2013 ILLI '0 TAG E #3 E5F)TH: 2) C 3 1 T E F L A N 4b 1LL. ALL L.4,11, ILLI -y' 1,j EXIS'TINIC Bl:P__DNi3oiJ' DXISTING :r rte, _7 I ILLI Pik DE"',1CRIBE'D PRR OPETY SH —————---————————————---— --- — — — CV/ ELTER 18-AN111 SOUNiD •` -- --r iI 1� �� —.�—:--.i_.—L..J._ �—,=.—�—L- -————————— FL ————————--- —————— ————---———— — ————— —————————— ————— John M. Bredemeyer 111, President 4�OenfFO(,�-c Town Hall Annex Michael J. Domino, Vice-President �� �Gy 54375 Route 25, P.O. Box 1179 James F. King C* Southold,NY 11971 Charles J. Sanders Qy • Telephone(631)765-1592 Dave Bergen Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Please be advised that your application dated � � '�J� has been reviewed by this Board at the regular meeting of 'fit! 2-61-5_ and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Silt Fence Inspection Fee ($50.00) 1St Day of Construction ($50.00) Y Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold7own Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive,your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ ��� BY: John M. Bredemeyer III, President Board.of Trustees (1)UNAUTHORIZED ALTERATION OR AODITON TO THIS SURVEY IS A VIOLATION OF SECTIOti 7209 OF THE NEW YORK STATE EDUCATION LAW (2)DISTANCES SHOWN HEREON FROM PROPERTY LINES TO EASTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USEL,TO ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES.(3)COPIES OF THIS SURVEY NAP NOT SEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT DE OONSIDERED TD DE A VALID TRUE COPY (4)CERTIFICATTCN INDICATED HEREON SHALL RUN ONLY TO TRE PERSON FOR VMOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL ACENCY AND LENDING INSTITUTI0.4 LISTED HEREON,ANO TO THE ASSIGNEES OF THE LENDING INSTITUTION'CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAI INSTITUTIONS OR SUBSEQUENT OWNERS (S)THE LOCATION 0�HELLS(W),SEPTIC TANKS(ST)k CESSPOOLS-(CP)SHOWN HEREON ARE FROM FIMO ONERVATICNS AND OR DATA OBTAINED FROM OTHERS ® � 400 Ostrander Avenue,Riverhead,New York 114101 tet.(531,121-250'a fox.admin®youngengin51121.0144 ®ng.cam 4?r _ A Howard W.Young,Land SUrveyor �r — "' Thomas G.Wolpert,Profosstonal Engineer g4 Q �r 3�p ` W h Douglas E.Adams,Professional Engineer Robert G.Tast,Arohltect` rz) T�;09r4; - ,� 1 0 0 � I rr CIO4 �w/ 1 $ ����. �� �Qi \ � 3$S LI SEP 2 4 205 o rYI v) So.Ithc" ,turl I aQ.; 9i r ��,� xa, // fig, SRV4Y0RT9 CERTIFICATION Cr An E'•Zl� r!� ry��` � ���`�. / ! '.•''�.:��'�'}'��v�a� `fit r. '�'�t •... � 7-7 , .1"4.31 \ i`r /4Tp�,., 4y HOWARD W.YOUN6,N.Y.S.L. .NO.•458W� �*�,��`!s l �T 3j�� ,,sem, ', oa FO:r 4, 47 TT Eg,E SURVEY FOR I rr ELENA OOLOMBO _ _ r COTTAGE 5, 13REEZY SHORES"53 �CL, '77 - at Greenport, Town of Southold Q auffolk County, New York BUILDING PERMIT'SURVEY y� County Tax Map DI9LrICT I000 se.TfOn 53 BIceH 05 LoL P/D 12.6 ti 4E MAP PREPARED JAN. IO,2018 4 / \ Record of Revisions, � RECORD OF REVISIONS DATE PLAN! 30 O 15 30 60 d , SCALE: I' e 3p Stole: 30' VERTICAL DATUM = NAVO IGI&O JOB NO,2012-0210 ON6.2010_0203_navd88\20I0_0203_cottage_0003 OF I C7 = MONUMENT SET ®= MONUMENT FOUND Q= STAKE SET. ®= STAKE FOUND (1)ONAUTHORQED ALTERATION OR AMMON TO T16S SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW (2)DISTANCES SHOWN HEREON FROM PROPERTY,UNES TO EXISTING STRUCTURES ARE FOR A SPECIFlC PURPOSE ANT)ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES.(3)COPIES OF THIS SURVEY NAP NOT BEARING THE LAND SURVEYOR'S IKKED SEAL CR EUBOSSED SEAL SHALL NOT SE CONSIDERED TO BE A VALID TRUE COPY (A)CERTICICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOP WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO ThE TITLE COM-ANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON,AND TO THE ASSIGNEES OF INE LENDING MSTITUTION CERTIFICATIONS ARE NOT TRANSFERABLE TO AODITIONAL INSTITUTIONS OR SUBSEOUENT OWNERS (5)THE LOCATION OF WELLS(W).SEPTIC TANKS(5T)h CESSPOOLS(CP)SHOWN HEREON ARE FROM nELO ODSCRIIATIONS AND OR DATA OBTAINED FROM OTHERS 400 Ostrander Avenue,Riverhead,New York 11901 tel.631.1272303 fax.631.T2"f.0144 adminegoungenglneering.com 9 1 O,k 6 Howard W.Young,Land Surveyor Thomas G.Wolpert,Professional Engineer v @,®�'�, %/ 380 ®•ia,�r��{� ` ` 1 V,f d�� {' v Douglas E. Adams,Profeaslonal Engineer G.Tast,Archltect 14 Mry � r SEP 2 4 2015 SOutl?Old 9Fiil { 7 fi�, SJRVE'trOR'S CERTIFICATION $ X34 a, q / e'er , 7-7 �Q � / (�•��.`fir '\ -\ ��''t -j= '{,,p�¢^ I !$�, � � / r�/� ` \\ • ��,. "'s '•4. �y'y1 S,IvM+1nsA3dr 1� +4,51 HOWARD W.YOUNG,N.Y.5.L, 'NO.4581 ) mro% 4.6 SURVEY FOR ELENA 00LOM 0 Cq ` GOTTA6F- 5, "SREEZY SHORES" .7 at Groompport, Town of Southold 5uffolk County, New York a p� \ l 3A SUILVIN6 PERMIT SURVEY �' t46 `' � _ I County Tax Map Dl9triCi 1000 section 53 3I0.1,05 Lot P/O 12.6 MAP PREPARED JAN.10,2018 � Record of Revisions � RECORD OF REVISIONS DATE ISO \7, _ O C r Ip�!'�1`4 30 O 15 30 60 0- I + SGALE7 1'-= 30' � Scale-. 1" = 30' VERTICAL DATUM = NAVO 10188 JOB NO.2012-0210 DWG.2010_0203_novdbD\2010_0203_cottage_0003 ' OF 1 O = MONUMENT SET ®= MONUMENT FOUND = STAKE SET ®= STAKE FOUND John Bredemeyer, President �oSUFFnt� Town Hall Annex Michael J. Domino, Vice-President a° °�y� 54375 Route 25 James F. King y P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen y�Os ,� �a Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time:0 � Robert Brown Architect, P.C. on behalf of ELENA COLOMBO requests a Wetland 1 Permit to repair sections and replace sections of damaged foundation of an existing 1,045sq.ft. cottage; and to replace the two existing cottage landings. Located: 65490 Route 25, Breezy Shores Cottage #3, Greenport. SCTM# 53-5-12.6 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound v/Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: v6apt.275 Chapt. 111 other Type,of Application: ✓Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: 'iP Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: Present Were: J. Bredemeyer °'M. DominoyJ. King Bergen Sanders Bay Constable Other Form filled out in the field by Q • J Mailed/Faxed to: Date: y, i oo� t ;a +. 0 e t _ s f s - ► ' � li h 4g2k .- ' i i s I� 1 5 w t a , 4 �'�i. !c • ., A tr� '�ln !�� J �� �Yi � � y`,'� J�� � � � ` ItI' y.t�R�, �� ;,y � _.• c \ k. F `\a.! , '� •a. y' f'a`_ tr , °! Y < r ' , I P"� a y�. i / �i 4'.��r1 ,u-re $ ^yam, _� •�' � yr. t'�� I �� c � s• I 41 fi I � I /4 e i II i 1 � � f' d �r�•-�s�r -��'� �-��� t ,y. `.y__� ' a.,,._._. i_-mow. `h.t�8e''�:I,'�`. �•_. _. :' `. ti- -.+.� _._ ��-+.+ter-� r � Ar A ,a' �{ — a 7 A l r i `F a � J L� i I - �� " — _ � `, �_. ' vex• "� � —�1+g� 9 S 1 �t•. •1 .'{.. Y N � .L L ,r d . R r . Town of Southold Tax Map Inquiry Page 1 of 1 : o Town of Southold Tax Map Inquiry �W �. ^... e ♦!fir `�► � �; http://tos.maps.arcgis.com/apps/Solutions/s2.httnl?appid=Ib4d46Ia4ebc440ba19d25e98eb3fa9O 9/23/2015 SEE SEC.No.015 t Lr wj SEE SEC.NO. uNe SO wTtll —�— • _ _ _�—_ � 11Nc1 SSEC.Iq. !<I V i t e� Tom OF sartxan a i-p-\ / 3 ♦ ',�T� • FOR WE. NO No / k j e WE WE. 9]A r I / � 1.eNU s.s O / COUNfY/O/F SUFFOIA 'w tO.M TOWNbF SOUTHIX➢ 11 TOMM OF SOLrrHOLD • ;. N P/PE-S, I 11 /r 9.9NU y •/ N °] ♦ 112A(q 11 I sOUTHow / ] 2.1 '`' ♦ CAUNtt OF SUfFOIrC M _ 25A •12 13.3 ,1 3 19 y 15.1 h m ± _ i �' l 3J y r1 IsourHOLD �''• •rY �r ,1:NU 3 r O TOW++oF souTHOLu . kfRW% 3!• ,i♦�� wDPA6e«",+oN a•`� r. t% ,29,y .♦,'' —� TOWN OF SOU,HOLD CREEK PIP— IF z 3A p4 ♦ y .•� ° • r '� a ,s .�'•. ,f ,�^ rioNEiraA�n .a ,�;1�` ,♦ 4] ro Ly,:y, •h f E f d t pt°r �? '+: 4'a St y e .y ♦,,`t��s Jk ]Q p r aat+� TAA 3 .1' • tis 4„� y d' t, e�� � � y, a O.W I• 9 ' xto © e♦ Z ! 11,2A7 r • ♦ 4.'r1 ♦ "yr ^ V129 j A9.9 a.31 LIM •l 5 �� SEE SEC.NO. �-—___.— -----1111E --- ---- -- 111E i • e X21, `� m \ • OSI-0fAY.] - � � b'' ti.� m,.• •.M1•• 8 ----- with --- ------ WE sec.NO,09 in on seE S .NO. OR ° SEE SEC.NO orr wy` SECTION I NOTICE ; COUNTY OF SUFFOLK © E a5° "° souTNOLD ---- ••+`— — -- °"""' --"-- m bN.w•a t_ Real Property Tax Service Agency r 0. 053 ..�....... —�— .,..—,.W �1) O ..e...W --•-- we..u. --•-- � � loxn.�c �f u.mr rnFo1 os1 ov unr.wr1,A..1.N �rr—..... _____—. v6...s —�-- wi•i/r1Y--•-- �a '�`� w,xOV,Y,Yr,W.•wWYlO,>.,{ me e m m as 1090 PROPERTI . / SEE SEC NO 050 MATCH _LINE OFFICE LOCATION: ®�*®f S® MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) c� Southold, NY 11971 Telephone: 631765-1938 com LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: October 21, 2015 Re: Proposed Wetland Permit for ELENA COLOMBO SCTM# 1000-53-5-12.6 Robert Brown Architect, P.C. on behalf of ELENA COLOMBO requests a Wetland Permit to repair sections and replace sections of damaged foundation of an existing 1,045sq.ft. cottage; and to replace the two existing cottage landings. Located: 65490 Route 25, Breezy Shores Cottage#3, Greenport. SCTM# 1000-53-5-12.6 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 Policy Standards and therefore is CONSISTENT with the LWRP provided that the Board requires the following: 1. Clarify if the structure is compliant with FEMA floodplain regulations. 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 Peter Young,Chairman ti Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., October 14, 2015 the following recommendation was made: Moved by Peter Meeker, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the application of BREEZY COTTAGE #3-ELENA COLOMBO to repair/replace the foundation and landings. Total square footage of the footprint of the cottage including porch and landings is 1,045 sf. Located: 65490 Route 25, Greenport. SCTM#53-5-12.6 Inspected by: Doug Hardy, Peter Meeker The CAC Supports the application with the Condition the project conforms with FEMA and Suffolk County Health Dept. standards. Vote of Council: Ayes: All Motion Carried John M. Bredemeyer III, President %Z� S®UTjyO Town Hall Annex l54375 Main Road Michael J.Domino,Vice-President P.O.Box 1179 James F. King,Trustee IF Southold,New York 11971-0959 Dave Bergen,Trustee Telephone(631)765-1892 Charles J.Sanders,Trustee �Oly�'oUNTY Fax(631) 765-6641 BOARD OF TOWN TRUSTEES _ I+ TOWN OF SOUTHOLD SEP 2 r 2015 I I� To: Southold Town Building Department Re: Verification of Building Department Permit Requirements j SCTM#: Property Owner Name: ' �'lft1 � idtcv�t D � ��- GbLa � Date Sent to Bldg. Dept.: q `�` The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from oning Board of Appeals?., Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: ® -7 f� Signature of R viewer or Date �,3x < . t r 1 1\\\ Eli _ V BREEZY SITORI;S COMMUNITY INC Sage Blvd. SEP 2 5 2015 `` � , Greenport.NY 11944 L Southold iL:gn August 3l,2015 The Board of Directors of Breezy Shores Communiiy Inc. (BSCI) 2014/2015, consisting of Elena Colombo, President (recused); Jim Sage, VP; E ob Welp, VP; David Nelson, Treasurer; and Kathleen O'Neill, Secretary, hereby affirm that we have reviewed the repair and renovation proposal for COLOMBO,cottage 3, which was prepare I by: Fairweather Design Associates,Inc.&Robert I. Bro?vn,Architect P.C. 205 Bay Avenue Greenport,New York 11944 Phone: 631-477-97521 Fax: 631-477-0973 and have no objections thereto. It is approved. Thank you, Kathleen O'Neill, Secretary: on behalf of the Board of Directors BREEZY SHORES COMMUNITY, INC. P.O. IAC K 925 MATTITUC , NY 11552 1 c John M.Bredemeyer III,President � S® �® Town Hall Annex Michael J.Domino,Vice-President h® lO 54375 Main Road P.O. Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee 6 Telephone(631) 765-1892 Charles J. Sanders,Trustee �+DUa� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application _Administrative Permit / Amendment/Transfer/E tension V Received Application: a :f� Received Fee: $ IL Completed Application: a f SEP 24 213 i _Incomplete: _SEQRA Classification: K Southold To��n Type I Type II Unlisted �Y-- io Coordination:(date sent): /4a qa/$-- �LWRP Consistency Ass ssment Form: 1�� CAC Referral Sent: ✓_Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: Do Zia/ Resolution: Name of Applicant: 84 e6fdz RIF- Mailing Address: -2D57 Phone Number: 2-11 — 3j -� � Suffolk County Tax Map Number: 1000 - Property 000 -Property Location: :R Z� •P (provide LILCO Pole#, d' tance to cross streets, and location) AGENT: kr W MdK6rAO& (If applicable) Address: ��� ✓� , Phone: - Tqq5 Z_ � 1 and of Trustees Applicati GENERAL DATA Land Area(in square feet): GCS Area Zoning: Sl� Previous use of property: Intended use of property: l/ Covenants and Restrictions on propwenrtjy9 c� Yes No i/ If"Yes",please provide a copy. l`� t �� *fid e � D(/ Will this project require a Building Permit as per Town Code? k 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 \,,_No If"Yes", please provide copy of decision. Will this project require any demolition as per own Code or as determined by the Building Dept.? Yes —�o �M P_t06 1"(,AC i� f0000 D�1� LA W`D l0q,5 � � l Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date TCuwr6es- zs/ - '1701-3 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: ?C Project Description (use attachments if necessary): lin s /1, z/S_ All s� T' rd of Trustees Applicatic WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: 140zp square feet Percent coverage of lot: ' 06 % Closest distance between nearest existing structure and upland edge of wetlands: sg- feet Closest distance between nearest proposed structure and upland edge of wetlands: 531 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? A. cubic yards Depth of which material will be removed or deposited: LA feet Proposed slope throughout the area of operations: N 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): 6l 7.20 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 c% ome part of the application for approval or funding,are subject to public review,and maybe 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 Action lor^Project: Wkw Project Location(describe,and attach a location map): Brief Description of Proposed Action: uF 7A4C 60Tl6&, )FVT1AR1 A-27_ 6' 6077-A6&' A,-A)Z:) /S /O V!s_ _54, FT ,4V57 b®U 741 Name of Applicant or Sponsor: f S Telephone: ;C S f-s E-Mail: Address: O_ City/PO: State: Zip/Code: 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordina ce, 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. 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: 'd'4�7p���- 3.a.Total acreage of the site of the proposed action? r 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? V041V', 6, acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑UrbanRural (non-agriculture) Industrial Commercial Residential (suburban) ❑Forest MAO ❑ griculture Aquatic ❑Other(specify): OParkland Page 1 of 4 ' - ' . . . . . � Page 2of4 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,darn)? 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: . _ 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: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE, n I C Applicant/sponsor name- '`rVyZ�JTK � � �— Date: Signature: Part 2-Impact Assessment. The Lead Agency'is responsible for the completion of Part 2. Answer all of thewfollowing 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? El 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 coinrnunity? 4. Will the proposed action have an impact on the environmental characteristics that caused theEf _l establishment of a Critical Environmental Area(CEA)? I_l_ 1 5. Will the proposed action result in an adverse change in the existing level of traffic or El affect existing infrastructure for mass transit,biking or walkway? ---y-- 16. Will the proposed action cause an increase in the use of energy and it fails to incorporate Q reasonablyavailable energyconservation or renewable energy opportunities? LJ 7. Will the proposed action impact existing: Ll a. public/private water supplies? ^ b.public/private wastewater treatment utilities? I � 8. Will the proposed action impair the character or quality of important historic,archaeological, (� architectural or aesthetic resources? EA �.--1 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, 127 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 1:1problems? 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 nvironmental 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 to 34 Name of/ d Agency � Date /Iu �e e rr President Print or Type a e of Respon Offi r in"Lead Agency Title of Responsible Officer Sign i e of Responsi le Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 rn Er r ?c�rrrre �R MATT f KR Y f 951 qq' ' D1 (( [UP I- Certified Mad Fee ( r-1 $ 1 , $3.45 rn EXtra services&Fees(checkt ",add lee as appropnate) ❑Return Receipt(hardwpy) $ 0 ❑Return Receipt(electronic) $ -It•' C�stfn r3 ❑Certified Mail Restdcted Delivery $ Here • I,I 0 ❑Adult Signature Required $ O� MAILING OF NOTICE ❑Adult Signature Restricted Delivery$ o Postage w 1IFIED MAIL RECEIPTS $ $0.49 10/91701 0 Total Postage and Fees �yy $ $6.74 Ln Sen a jjf-- r , Q O $iieeiandApt--o�orP ou'- --- ------------------ Address: Ctry;3ta3'Zf + ��� `C J o o• G4�ux�fn txgea9ry Matf STATE OF NEW YORK COUN"TY� OF SUFFOLK KfN 7zCZc�T�� -moi, residing at ?-C)S— being duly sworn, deposes and says that on the h day of (tjp��� , 20(�, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at iSo c,L that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. i Sworn to before me this ay of id I Notary Pu c CYNTHIA M.CUSATi Notary Public,S=.ato of New York No.01clib2co507 Quallnad in Suffolk Cot;rlbj Commission Expires Oct 20 14' John Bredemeyer, President °suFFotkc Town Hall Annex Michael J Domino, Vice-President ��° °ate 54375 Route 25 James F. King P.O. Box 1179 Dave Bergen ® g Southold, NY 11971 Charles J. Sanders y�ol � Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of ELENA COLOMBO COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS residing at/dba114 �/� / ✓1 eing duly sworn, depose and say: That on the Y fday of 6G°Z`e�X'__ , 2016I personal y posted the prope y known as 1 by placing the Board of Trustees offici 1 poster where it can ea ily be seen, and that4l have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, October 21, 2015. Dated: ( ' atu e) Sworn to before me this ' y of CO- 20 1'�; to y Public _) Nolai CYNTHIA StRe of Nev,York r10.0,cl!s 100507 Commission Expires+Oct 20 11UTIL 't UF HLAKIllu NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: ELENA COLOMBO SUBJECT OF PUBLIC HEARING : To repair sections and replace sections of damaged foundation of an existing 1 ,045sq.ft. cottage; and to replace the two existing cottage landings. Located: 65490 Route 25, Breezy Shores Cottage #3, Greenport. SCTM# 53-5-12.6 TIME & DATE OF PUBLIC HEARING : Wednesday, October 21, 2015 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Board of Trustees Application f . • i - i # AFFIDAVIT i �i e'o l>d P, ® BEING DULY SWORN DEPOSES AND AFFIRMS THATIHE/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 SdUTHOLD 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, INCLUDING 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. f G' i Signature of Property Owner i f i SWORN TO BEFORE ME THIS DAY OFS T- ,201 S w ,9 Commonwealth of Pennsylvania NOTARIAL SEAL LAURIE A HUGHES' UGHES Notary Public City of SCRANTON, Lackaw i My Commission Ex fires Anna County Expires October 29,P018 Notary Public .• i Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) P, C-A L-0 $® residing at 27 PC\J G . (print name of owner of property) (mailing address) V----1 rl tJ14 i 1?A S do hereby authorize (Agent) -bt�L�J -1 �NT5to a I pply for permit(s)from the Southold Board of Town Trustees on my behalf. tLel (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The nuMose 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. 66� r YOUR NAME: � G��(J�IGC 10A� ) U (Last name,first 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 Ifyou 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 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 Signature Print Na e Form TS I � NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SCTM# /e;� •� �j YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: lorlp 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 4 _k&,_3 . 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: 6 MAILING ADDRESS- PHONE #: 9 �3 AGENT: ��a 9Ps MAILING ADDRESS: �l I PHONE Enc: Copy of sketch or plan showing proposal for your convenience. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ' that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of ,20 Notary Public 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 2UIained in detail, listing both supportinLF 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# 05 PROJECT NAME L�i/n -— 4 E V� 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: Nature and extent of action: _L)U.AT&TQQ 1&mwo�,,� e2E ✓�:DT C-- l .&'A77' lS J ' P Location of action: - , Abet--, , 9-EO ACT . Site acreage: T� 4 , 660 Z�! s4E� -�,®-L 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: J AA)D4 M/---S (b) Mailing address: MCI— (c) Telephone number: Area Code 7r 97i (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ❑ No [] Not Applicable AXr 19 / -fit„ A2 A92-M 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� Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No ❑ Not Applicable x .�' J l / /Arl �lnTn s�' L�f� 7 ��Jla/ n�1 fS—/o' "h't�¢/, , r3U7� Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ NI Yes No Not Appl.-'--Nle Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy S. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ YeD No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES- r, Y 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 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No�qNot 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 B TITLE DATE3��