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TR-8714
Michael J.Domino,President ��0f S®!/j�® Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O. Box 1179 Charles J. Sanders Southold,New York 11971 Glenn Goldsmith G ® Telephone(631) 765-1892 A.Nicholas Krupski O Fax(631) 765-6641 0017 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1383C Date: August 28, 2017 THIS CERTIFIES that the installation of a 16'x32' in-ground swimming pool; install 3' wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to construction; with the condition that the dWyell be constructed at least one to two feet above ambient ground water level; At 37900 Route 25, Orient Suffolk County Tax Map#1000-20-3-9.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated November 17, 2015 pursuant to which Trustees Wetland Permit 48714 Dated December 16,2015,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 the installation of a 16'x32' in-ground swimmingpool• install 3' wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to construction; with the condition that the drvwell be constructed at least one to two feet above ambient ground water level. The certificate is issued to PETER NATHANSON owner of the aforesaid property. I - e Authorized Signature *rjf SO(/T Michael J.Domino,President ��� y�lO Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.SandersCA Southold, New York 11971 Glenn Goldsmith Telephone (631) 765-1892 A.Nicholas Krupski g'COU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TO O SOUTHOLD DATE OF INSPECTION: �o Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: Gil CERTIFICATE OF COMPLIANCE: John M Bredemeyer 111, President p�pguFFQ(,Yc Town Hall, 53095 Main Rd. �G P.O Box 1179 Michael J Domino, Vice-President o =� ...�.� James F. King �_ z Soutnviu,N <v 11071 ohone Tele 631 765-1892 Charles J. Sanders P ( ) Dave Bergen 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 V Project complete, compliance inspection - ' Foy , POOL'DIMENSIONS _ A p C,-0. Fds7T IS'C' =1'd i 'd i3 m- w 'iE�,Trio - ` • 1ik74 Ko' bi' 'i i-)' )(m TA550 sa Woo DIVII IG BOARD A +'LONG WELDS ON } i - • SIDE DFPAWL n'anmToaasorrow aag+ommocagm ------------- �- OVERWELOSWITH TT-r------------- wLUIWUM au -- 1 _ B ' POOL- PLAN or ' -----------—— TYP. PANEL STIFFNER � '. ` ,�fi�V ` _ MW.2'THICK VERMICULITE ,a�cvrsefOwLu,GSCREWS AGGREGATE TAMPERED - cONE:RETE oR w000 DEcrc UP TO _ � p sLOFIDwwwrFR9LIPOMP —� — — �.�a ;Z- s gX=lER ALtIFMMM COPlIG H - G F E i - � 00 VLONG VP.AL &V .drrP.ALUWMIY cowTTr,G SECTIONS 4AR ID - AL vwVL LRER 1 / WFRAM NOW 0 6788 WALL PANEL ]/E•-,EAA'BOLT.NUT,r1)WASHHiS . - SIEELANOLE •DRlYE STAID - - - . , D (��' S Ql.Fr.CONCRETE - " �- = :M '.\� I S o HAR S rrVERI�MCLLJiE AGGRE�iATE MDL' SI1Q'oIO�CARRIl1[,E!♦DLTS - - E.. ANGLE r/WASHE R 8 KIM TOP COMM pl--', -_ - _ . _ RUBBERFIlEQ3.. - L ! N V 1 7 15 `L "al - - - o 1-1 1 T1CAL FaLER 3V REINFORCING ROD PAD K L M it ~ - - - ,fr'LONG STEEL RSWORCING ROD ' /r - WaSnNAWa EAM - FARTH THROU N p1RVED FYl ER PATD HOLES IN BarMM� 18 as..ve llHiR BOLTM - ►� N.T.S. TYP{CAL WALL SECTIONA�' 'q�FRAME �� " :'= _� POOL TYPE: AGLE REV. SCALE N.T.S. CORNER CONNECTION DETAIL POOi'co"nm$ T"" 04.APMWQ- OURKP.E.OSM, DATE' DESIGN LS ACC�148Lf FOR 6ER PATH DRAWING NUMBER - ALLCDAIMOK C01mo1710I'!S MATftK NEW YORK 11952 OF Novi 9 201 1 { {,...•s.. IAC-`_ r'�`T�?�jP.c�: ....� I t 4y,5•9 (N -ROAD 12j8�t 0 MAIN �5p.00' X4.4 sl ,N•62051,30" m ,\`moo 1 \400 0 5 ll OgCK o- 6 m 243 y m O CL O Zai�- 231 o O T__ w, p 2toSE f3 GAR ' qp.0�` Q. O W. 237, 0 24 e• aL' m a3 24.3 � 38•�� , U1 G N O CA N co 1 IA EpGE tc: DF wET7.ANDS l•s '�'" .97..99 0.0 0.0 rEsr MOLE w t�:�•G--' -64o46,40 w /.o roPSo/L _ S• �• $•Zg0?�,� LOAM s 3 9.90 rden 6RAVEL - I �.o • fiormerly Nervy now Bu , now or SAND B qq. GRAVEL 0 2A 5� /by.l•g �•465k5� 6.0 � F 11+AYER 1r J`ng - SURVEY FOR PETER NATHANSON 81 -SANDRA NATHANSON MAY 1 , 1987 JAN. 9, 1986 AT ORIENT DATE: MAY 2, 1983 TOWN OF SOUTHOLD SCALE: I"= 50' SUFFOLK COUNTY, NEW YORK No. 83-204 k UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED T0: 5URVEY IS A VIOLATION OF SECTION 7209 OF THE SOUTHOLD SAVINGS BANK NEW YORK STATE EDUCATION LAW *COPIES OF THIS SURVEY NOT SEARWG THE LAND CHICAG ANCE COMPANY SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL Of MEW )• NOT BE CONSIDERED TO BE A VALID TRUE COPY '6� O NGUARANTEES INDICATED 'HEREON SHALL RUN ONLY TO GiA �• lY® ��' HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- M NEAREST WATER MAIN.MI.F II SOURCE OF WATERS PRIMITE_PU6LIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED p M PUFF CO. TA7IMAP DIST.100o SECTION oao SLOCK o3 LOT 9.2 HEREON,AND TO THE ASSIGNEES OF THE LENDING , It THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT / L ' N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS o ' WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT T DISTANCES SHOWN HEREON FROM PROPERTY LINES o TO EXISTING STRUCTURES ARE FOR A SPECIFIC � 9 Q USED TO ESTABLISH AP LEAANT PROPERTY LINESOR FORTHEERECTION SERVICES. ARE NOT T EPURPOSEAND FENCES ADDRESS '°• � _ TEL. 400 YOUNG ve OU NG RRHCAD,NEW YORK DER E ■= MONUMENT 0= STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER AREA = 41033 S.F. AND LAND SURVEYOR N.Y-S.LICENSE NO.12845 HOWARD W.YOUNG, LAND SURVEYOR THE LOCATION OF WELL(W),SEPTIC TANK(ST)a CESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893 ARE PROM FIELD OBSERVATIONS AND OR DATA OBTAINEO FYP W OTHERS BRANDIS & SONS, INC. 1618 . : NOV 7 Zo�SApRO ED BY ,•,, :` r ..fir... .� ,.+^�. � i \ r RD'OF Taj '' -1 yr. - SOuthc1d TCtwn NYs 251 'ROAD 12j8 n� A IN a art s•I j5p.00� Ep,b.4 N 6250„E r 1 % % Sn o I1 ��` �;'• N •rt 00 ,N• X1011- w ` It wOgCKCL p (psi 2q3%. 237 0 1 �(L Z am_ o 2slow�yS GAtz qo.0 - CL 7uxv— r 23T, 0 2A.� -a HC OF *0011y, I 1 -r1�� �QJG � 4.3 w 24.3 � '�L'I �• l.E-' l n aL IJ4 Poo( yLC D / r_'�Pd5 dr- ���/ l's B Of IyfrLAND9 0.0 TEST HOLE ir'l' �``/G-- 164°46,40 W ropson �,, g, 1.0 R $.Z9 o?T'E LOA./R j 9.90 Orden GRAVEL 1 _ HenrY W B :.o or formerlY now SAND f? GRAVEL 0 2A'S bl.l•S 5a65h5 sa MATER 1� n SURVEY FOR PETER NATHANSON a SANDRA NATHANSON MAY 1 , 1987 JAN. 9, 1986 AT ORIENT DATE: MAY 2, 1983 TOWN OF SOUTHOLD SCALE: I"= 50' SUFFOLK COUNTY* NEW YORK NO. 83-204, M UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO: SURVEY IS A VIOLATION OF SECTION 7209 OF THE SOUTHOLD SAVINGS BANK NEW YORK STATE EDUCATION LAW *COPIES OF THIS SURVEY NOT BEARING THE LAND CHICAG ANCE COMPANY SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL pf NEIM1 y R NOT YE CONSIDERED TO BEA VALID TRUE COPY 5% O NGUARANTEES INDICATED HEREON SHALL RUN ONLY TO gAP TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED HEALTH DEPARTMENT-DATA FOR APPROVAL TO ON HIS BEHALF TO THE TITLE COMPANY,,GOVERN- 7 �I NEAREST WATER MAIN_MI.± MSOURCE Of WATER: Pf11VATE_.PU6LIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED r- p M SU:F CO. TA%MAP DIST/000 SECTION oao BLACK o3 LOT 9.2 HEREON,AND TO THE ASSIGNEES OF THE LENDING *THERE ARE NO DWELLINGS' WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE OTHER THAN THOSE SHOWN KEREON. TwNE01S10NAL INSTITUTIONS OR SUBSEQUENT w N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR-THIS-RESIDENCE- —*DISTANCES SHOWN HEREON FROM PROPERTY LINES WILL CONFORM TO THE,sTANOAROS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC 90 �Q OF LIECAHT SERVICES. PROPERTYPURPOSE ALINESND RORNFOROT TTHEEERECTION OF FENCES USED TO ESTABLISH 012APP8�� ADDRESS �± 400 OST�RANDER AVENUE TEL. YOUNG YOUNG V U�VV RIVERHEAD, NEW YORK ■s MONUMENT 0= STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER AREA = 41033 S.F. AND LAND SURVEYOR N.Y.S.LICENSE NO.12845 HOWARD W.YOUNG, LAND SURVEYOR *THE LOCATION OF WELL(W),SEPTIC TAHK(ST)B CESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893 ARE FROM FIELD O"ER%TIONS AND OR DATA OBTAINED FROM OTHERS oo�nlnlC L Cf1NC INS` 1Ci18 7V BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK p 2 PERMIT NO. 8714 DATE: DECEMBER 16,2015 A ISSUED TO: PETER NATHANSON PROPERTY ADDRESS: 37900 ROUTE 25, ORIENT SCTM# 1000-20-3-9.2 AUTHORIZATION 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 December 16,2015, and in consideration of application fee in the sum of$250.00 paid by Peter Nathanson 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 install a 16'x321 in-ground swimming pool; install 31 wide decking N around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to constfi:tcii6n; with the--c6fiditiah-that'-the--s & itaoabove ambient ground waterlevel; and adepicted on the survey prepared by Young& Young, received November 17, 2015, and-staTped approved on December 16- 2015. a 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. James F. V4" Absent co coo Z Lt K, TERMS AND CONDITIONS The Permittee Peter Nathanson residing at 37900 Route 25,Orient,New 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 ��®� 50(/r/fo Town Hall Annex 54 Main Road Michael J. Domino,Vice-President '`® l® P.O..Box 1179 James F.King,Trustee J19 Southold,New York 11971-0959 Dave Bergen,Trustee ® a Telephone(631) 765-1892 Charles J.Sanders,Trustee yCOUN1 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 16, 2015, Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: PETER NATHANSON 37900 ROUTE 25, ORIENT SCTM# 1000-20-3-9.2 Dear Mrs. Moore: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 16, 2015 regarding the above matter: WHEREAS, Patricia C. Moore, Esq. on behalf of PETER NATHANSON 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 November 17, 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 recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policies 5 & 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the condition that the drywell be constructed at least one to two feet above ambient ground water level; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 16, 2015, at which time all interested persons were given an opportunity to be heard, and, 2 i WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 263-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of PETER NATHANSON to install a 16'x32' in-ground swimming pool; install 3' wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to construction; with the condition that the drywell be constructed at least one to two feet above ambient ground water level; and as depicted on the survey prepared by Young & Young, received November 17, 2015, and stamped approved on December 16, 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: $ 100.00 Very truly yours, doe, &hk-� John M. Bredemeyer, III President, Board of Trustees JMB/dd ,l John M. Bredemeyer ill, President �'�"gUfFG1 -C Town Hall Annex Michael J. Domino,Vice-President ,��� �Gy 54375 Route 25, P_O. Box 1 179 James F. King Southold,NY 11971 Charles J. Sanders w • Telephone(631)765-1892 Dave Bergen y�Ol � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 1 zo n10 TO: ice- NATT-t A-AIWAI 7 0 PAT-9-I&A- (2-t 4400 E6- Q. Please be advised that your application dated MOVr - 17 2016- has been reviewed by this Board at the regular meeting of PEZC-A'IP &, mels- 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) / Y2 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 Southold Town 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 John , Town Hall Annex edemeyer Michael J..rpomino, Vi er-President °°�O$�rf�c�cO°s 54375 Route 25 James F. King y P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen y�O1 ,�' �a Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: ��-�(� /'f J�/ j Patricia C. Moore, Esq. on behalf of PETER NATHANSON requests a Wetland Permit to install a 16'x32' in-ground swimming pool; install 3' wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to construction. Located: 37900 Route 25, Orient. SCTM# 1000-20-3-9.2 Type area to be impacted: /Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland 0120 Part of Town Code proposed work falls under: k' ;hapt.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: onditio � V� %11 ' Present Were: J. Bre demeyer M. Domino J. King D. Bergen C. Sanders Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: _ b ,tic .F �h 0 ° � T x,79 w' Y bru NATHANSON SCTM: 1000-20-3-9.2 r a r ........... .. . . is FF FF F[ -�4 .......... ......... .. ' F ,x y� �. .. • .: - .. , ' r - f 4 x r 4 Cay i 7 7711 NATHANSON �� � . �,. � _,, ��� . i • , . � , k.�` ,� SCTM: 1000-20-3-9.2 �' '}• t p >t i� "' � ' �._< 7 'zt�f SP.s � ..P � :•r L'i' .dic,.7 � ,� „ ,,�,x��, r'At.eG t ' + -�" ty� ,,E r°� p�. v '9 • r ��! 'i} .�1�V.l •t: 4 `SJ�� 7, � `f' r y,y5s• .++. ,!r" ,N.?r'. -s Y �* I 1000-20-3-9.2 ,_• .• ,.r ' � ..�-` -, �` ,� - .. •�A OL Go.- 00 •le earth meter 100 NATHANSON p, 1000-20-3-9.2V Q�..,...� 2.:-ar. �z,alalor r:,a ,��R ,�..,..,. li F.�._t r•..,�v..reA w,xoul vn nc zv sEN�c cxcxE �� �� A ST-T 10 1000 P 2 V 1J2 0] PROPER YMAP Nw.:re R^u v.RUP rv- Rv - SEE SEC.NO 015 43 - NATCN LINE 3 9 O m q.� o � \ 121 33 a I 3oa r„ „5 5�j 1j,. 1 LOn�i[x Rax C, < X SONG 12.7 FH v 5.1.) 71 RQv � \ s1A Q1 14 5. V t2 I WO \ a,ata a ` 4aa 3. ,,At 7A 72 i 1P \ 02 12 .ata STATE OF ■ l \ �) {�/ ) ` .—Oft. LIMTCN �--_1 I 1ONE.SEE SE[C!p 0]0 /) / l L V1,14 .11aF SECTION NE � _�_ �') --1-- � asNOTICE COUNTY OF SUFFOLK © earw, sx„11oLoc - � �` Real Property Tax Service Agency Y Ec.R,..wv.mueNv,+w, 20 MO r..+w. ar1].1N,Iv1].rAo..eu. --•-- osuu.--xw-- y1yY' A P PROPERTY MAP OFFICE LOCATION: ®��®f S® lMAILING ADDRESS: Town Hall Annex ® P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) rs, Southold,NY 11971 ® �p� Telephone: 631765-1938 Ti i 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: December 15, 2015 Re: Local Waterfront Coastal Consistency Review PETER NATHANSON SCTM# 1000-20-3-9.2 Patricia C. Moore, Esq. on behalf of PETER NATHANSON requests a Wetland Permit to install a 16'x32' in-ground swimming pool; install T wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to construction. Located: 37900 Route 25, Orient. SCTM# 1000-20-3-9.2 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 INCONSISTENT with the Policy Standards 5 and 6 and therefore is INCONSISTENT with the LWRP. 1. The water supply to the residence in private well. Public water in this area is unavailable. 2. The pool (bottom,elevation) would be located within groundwater found at 6' in 1987. 1 suspect that groundwater levels are closer to the surface elevation presently. 3. The bottom of the drywell could be located within groundwater (NO SPECIFICATIONS ARE SHOWN) 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 Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 ��0�` 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., December 9, 2015 the following recommendation was made: Moved by Doug Hardy, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of PETER NATHANSON to install an in-ground swimming pool 16'X 32' located 80' from edge of wetlands, 4.5' pool fence, drywell for pool backwash, 3' of deck around proposed pool, and the installation of hay bales and silt fence. Located: 37900 Route 25, Orient. SCTM#20-3-9.2 Inspected by: John Stein, Peter Meeker, Keith McCamy, Doug Hardy The CAC Supports the application with the Condition drywells are installed to contain the pool backwash. Vote of Council: Ayes: All Motion Carried _3 John M. Bredemeyer III, President �*o� SOUTyO Town Hall Annex Michael J. Domino,Vice-President �O l0 54375 Main Road P.O.Box 1179 James F. King,Trustee Southold, New York 11971-0959 Dave Bergen,Trustee G §s �� Telephone(631) 765-1892 Charles J.Sanders,Trustee Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To:" Southold Town Building Department I� 1 Re: Verification of Building Department Permit Requirements :� SCTM#: °w 3— q' a, Q&WP_ NA-T4"60AI Property Owner Name: ' Date Sent to Bldg. Dept.: 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 ill the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals?, Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: C Signature of WiE6er r Date John M.Bredemeyer III,President SO Town Hall Annex Michael J.Domino,Vice-President ® 54375 Main Road P.O.Box 1179 James F.King,Trustee en Southold,New York 11971-0959 Dave Bergen,Trustee ® aOQ Telephone(631) 765-1892 Charles J. Sanders,Trustee ���'oU �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Applications E d� 7Wetland Permit Application �P I _Administrative Permit Amendment/Transfer/Extension eceived Application: I a 7'e� Nov 1 7 2015 Received Fee:$ P-SV,&0 Completed Application: 1515 _Incomplete: Guth°fid I° n _SEORA Classification: Nard of T F Type I Type II Unlisted Coordination:(date sent): LWRP Consistency Assessment Form: CAC Referral Sent: I I-19" 55- ►6ate of Inspection: IRA/-,5 _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: «� Resolution: Name of Applicant: re--#7.r Mailing Address: ( © 1 cl® 1 (91 S_7 Phone Number: Suffolk County Tax Map Number: 1000 - 2c� S _ Property Location: (provide LILCO Pole#, distance to cross streets, and location) AGENT: TC'1_+CL'C_kL� C j p O-✓`e- (If applicable) v Address: Sl o'Z-0 mCA'\vim o1 t--y Phone: l 14 j a(i C �J , � ] rd of Trustees Applicatic GENERAL DATA Land Area (in square feet): H Area Zoning: C_ Previous use of property: I4 o u Intended use of property: t hct un o 1yid Roo I cvw p a �z_ 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 �No If"Yes",please provide copy of decision. Will this project require ny demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? ✓ Yes No Prior permits/approvals for site improvements: Agency Date ZNo 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): edq e nj � La. AAs (ew, r3vrct-e� X41 C e ] rd of Trustees Applicatic' WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 66—VL5' Area of wetlands on lot: r 1 oo�r square feet Percent coverage of lot: I % Closest distance between-nearest existing structure and upland edge of wetlands: 90 feet Closest distance between nearest proposed structure and upland edge of wetlands: ca D feet Does the project involve excavation or filling? No %1X Yes If yes, how much material will be excavated? C c9®O cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Pct 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): � O I 61 Z20 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 l 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 or Project: Project Location(describe,and attach a location map): Brief Description of Proposed Action: ar 2— l VX 2:U s'l cSC� � tM� cal� �OG � Name of Applicant or Sponsor: Telephone: 92—b,_ 1 iC �s✓ l g - COY E-Mail: , f jiNd15 r- Address: ce a']s® City/PO: State: Zip Code: 0r1f-4"A- C I q,57 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 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: R ( ❑ la.Total acreage of the site of the proposed action? , acres b.Total acreage to be physically disturbed? C X acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses tha ccur on,adjoining and near the proposed action. ❑Urban ural(non-agriculture) ❑Industrial [—]Commercial ❑Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page I of 4 5. 1s the proposed action, NO YES 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? ❑ ff 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ET ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES T 11 b.Are public transportation service(s)available at or near the site of the proposed action? (A ❑ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action?l ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: I r( 14 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? F-1b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,,or are likely to be found on the project site. Check all that apply: ❑Shoreline El Forest Agricultural/grasslands El Early mid-successional ❑ Wetland El 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? Z ❑ 16.is the project site located in the 100 year flood plain? 'F0111 ZO"— NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a. Will storm water discharges flow to adjacent properties? R?NO DYES ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and stor rains)? If Yes,briefly describe- NO ES Page 2 of 4 1 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)9 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? 11 If Yes,describe: Er ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor na Date: 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? ❑ 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 ❑ establishment of a Critical Environmental Area(CEA)? 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? 7 Will the proposed action impact existing: 1:1a.public/private water supplies? Er b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, /❑ architectural or aesthetic resources? [n'I 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 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, th t the proposed action may result in one or more potentially large or significant adverse impacts and an vironmental 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 environments impa�ts. Town of Southold-Board of Trustees ��/ 66, Name of Lead Agenc Date ,J 671m ev President Print or Typ ame of Respon*le O f1 er in Lead Agency Title of Responsible Officer Signa ire f Respons4K Officer in Lead gency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK ---------------------------------------------------------------x In the Matter of the Application of AFFIDAVIT OF NATHANSON MAILING Applicant's Land Identified as 1000-20-342 ---------------------------------------------------------------x COUNTY OF SUFFOLK) STATE OF NEW YORK) I, Betsy Perkins, residing at Mattituck, New York, being duly sworn, depose and say that: On the day of December, 2015, deponent mailed a true cop of the Notice set forth in the Board of Trustees Application, directed to each of the persons listed on the attached list at the addresses set below their respective names; that the addresses set below 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 Southold, New York, that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Attached hereto is the white receipt ost-marked by the S thold Post Office on said date. Ietsy Perkin ( °ignature) Sworn to before me this day of Dee (Notary Public) PATRICIA C. MOORE ' (Votary Public,State of New York Suffolk County-No.486166S Commission Expires.lune I6,- 4 John Bredemeyer, President �osuFFockco Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 James F. King y P.O. Box 1179 Dave Bergen t$ • Southold, NY 11971 Charles J. Sanders y�ai ,�, �a°� 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 PETER NATHANSON COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING O BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR NOT LESS THAN SEVEN DAYS � residing at/dbaI ( D� d being duly sworn, depose and say: That on the day of , 201- , I personally posted the property known as 3`) 9 CD m -i.o rzJ. cmc�- by placing the Board of Trustees official poster where it can easily be seen, and that I 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, December 16, 2015. Dated: \a — V j (signature) Sworn to before me thhi day of 1� O S r kA ary u g SY PERKINS Notary Public,State ot E6130636wYotk No.0 L Qualified in Sl ly 1u Commission Expires NATHANSON SCTM: 1000-20-23-9.2 Neighbor List ARYEH SPERO SCOTT L HARRIS 4755 W TILGHMAN STE 179 37800 RTE 25 ALLENTOWN PA 18104 ORIENT NY 11957 SCTM: 1000-15-2-18 SCTM: 1000-20-3-9.1 AMELIA'S SOUND PROPERTIES INC PO BOX 36 GERALYN DIMANGO ORIENT NY 11957 JILL NARDO SCTM: 1000-15-2-17.6 65 FREEBORN ROAD EASTON CT 06612 SCTM: 1000-3-9.3 NYS DEC ATTN: BUREAU OF REAL PROPERTY SUNY BUILDING 40 STONY BROOK NY 11790 SCTM: 1000-20-3-7.2 SCTM: 1000-20-3-14.4 --�____.-------------�-�_ ._-- ---_� RECEIPT RECEIPT � RECEIPT RECEIPT ! 7104 2438 8090 0000 6558 7104 2438 8090 0000 6572 7104 2438 8090 0000 6589 i 7104 24838 8090 0000 6596 7104 2438 8090 GOOD 6602 I FROM• F . I FROM: I FROM: FROM. FROM:I Moore Law Office Moore Law Office Moore Law Office, Moore Law Office , Moore Law Office RE nathanson trustees RE nathanson-trustees I RE nathanson trustees i RE nathanson trustees i RE nathanson trustees I i SEND TO SEND TO. I SEND TO ! SEND T0. SEND TO' , AMELIA'S SOUND PROPERTIES SCOTT L HARRIS GERALYN DIMANGO I NYS DEC ARYEH SPERO 755 W TLGHPO BOX 36 37800 E 25 11957 65 JISUNY BUILDING FREEBORN ROAD LL NARDO I EAU40REAL ORIENTPROPE� AILLENTOWN PA 8104 179 I ORIENT NY 11957 I EASTON CT 06612 I STONY BROOK NY 11790 I I I� FEES- FEES: FEES: I FEES' FEES o485 + Postage 0 485 1� Postage 0 485 I Postage 0 485 Postage 0 485 I Postage 330 Certified Fee 330 Certified Fee 3 30 Certified Fee 3 3 Certified Fee 3 30 Certified Fee 2 70 I Return�ceipt__ 270 Return Receipt 2 70 I Return Recei�t�� 2 70� Return e t 2 70 I Return t Re t icf t��y7 'r Resta ie Restncted�y�( _' Res gas n� � 1 r � Ay�,, i iA :ti (� /T 6.485 TP 85 To \1;wl TOTA ®`, �$,5I TOT ` $ ' \�D TE ! (f? STMAR IDD j MARK 0 \AT I P �1/IAR E P MARK E OSTMAF����, I ,y� NUTIL 'I: Ulm HEARING , 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: PETER NATHANSON SUBJECT OF PUBLIC HEARING : For a Wetland Permit to install a 16'x32' in-ground swimming pool; install 3' wide decking around pool; install 4.5' high pool enclosure fencing; install a drywell for pool backwash; and install a line of silt fencing and/or staked hay bales prior to o construction. Located: 37900 Route 25, Orient. SCTM# 1000-20-3-9.2 TIME & DATE OF PUBLIC HEARING : Wednesday, December 16, 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 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 F, -d of Trustees Applicatio' County of Suffolk State of New York PETER NATHANSON BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION,I 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. Sw%.Notary me thi da15 A. P RKINS ,State of New York No.01 PE6130636 Qualified in Suffolk Co Commission Expires July 1 guq. . W; rd of Trustees Applicatic;�.r- AUTHORIZATION (where the applicant is not the owner) PETER B.NATHANSON, as owner of premises 37900 Rte 25, Orient,NY 11957 (sctm: 1000-20-3-9.2)residing at 37900 Rte 25, Orient,New York do hereby authorize my attorney, Patricia C. Moore,to apply for permit(s) and appear before the Southold . Board of Town Trustees on our behalf. (Owner's signature) APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) ' The Town of Southold's Code of Ethics prohibits conflicts of interest on the part 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: NATHANSON,PETER,AND MOORE,PATRICIA (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company. If so,indicate the other person or company name.) NATURE OF APPLICATION:(Check all that apply.) Tax Grievance Variance Special Exception If"Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other Trustees X 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 Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself(the applicant) and the Town officer or employee. Either check the appropriate line A through D(below)and/or describe the relationship 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 thi day ofV Signature: Peter Nathanson �CMoore 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 Lwhich 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# C20 PROJECT NAME 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: Rr Nature and extent of action: A ` iC c� � l/1� �bv/IC� SGt��df'1rr1�iY9 /ROW i` Location of action: Site acreage: Present land use: �l lel 2e'e Present zoning classification: All 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: Z4�41 ✓tictA1 a42 s&'�'l c� (b) Mailing address: O 6"",- (c) "",(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 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. RYes ❑ 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—Polic' s Pages 3 through 6 for evaluation criteria ❑ Yes 11 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 Ej"�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 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 t;Notgh 1 for evaluation criteria F-1Yes 1:1 No 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 IH—Policies; Pages 22 through 32 for evaluation criteria. Yes No Not App )le 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 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wZVVApplicable ee LRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes 1:1 No 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 u Not Applicable Attach additional sheets if necessary WORIING COAST POLICIEL 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 E 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 forevaluation criteria. ❑ Yes 1:1 No u 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 L Not Applicable PREPARED BYPdI7?cic� TITLE DATE