HomeMy WebLinkAboutTR-8712 Glenn Goldsmith, President `�®F sou Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President ,`®V� ®�®
P.O. Box 1179
Eric SepenoskiB Southold,New York 11971
Liz Gillooly Telephone(631) 765-1892
Elizabeth Peeples Fax(631) 765-6641
COU
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
#2115C Date: January 4, 2024
THIS CERTIFIES that the demolition of existing dwelling with foundation to remain;
construct a two-story(1 140sq ft first floor, 786 25sq ft second floor)dwelling with a 110.5sg.ft. second
story deck onto foundation; remove and reconstruct concrete stoop on southeast corner of dwelling, add
two (2) cellar windows airways to south side of foundation-, and install gutters to leaders to drywells to
contain runoff;
At 5218 Great Peconic Bay Blvd, Laurel
Suffolk County Tax Map#1000-128-2-22
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated September 2,2015 pursuant to which Trustees Wetland Permit#8712
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 demolition of existing dwelling with
foundation to remain; construct a two-story(1 140sq ft first floor, 786 25sq ft second floor) dwelling
with a 110 5sq ft second story deck onto foundation;remove and reconstruct concrete stoop on southeast
corner of dwelling; add two(2) cellar windows airways to south side of foundation; and install gutters to
leaders to drywells to contain runoff.
The certificate is issued to Rick Nappi owner of the aforesaid property.
= Authorize Signature
c 1
Glenn Goldsmith, President _``,,�q� so��� Town Hall Annex
®V"
A. Nicholas Krupski,Vice President a ® 54375 Route 25P.O. Box 1179
Eric Sepenoski Southold,New York 11971
Liz Gillooly cn
G Telephone(631) 765-1892
Elizabeth Peeples ® �® Fax(631) 765 6641
C®UM, ,
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: 1/y/Z4
INSPECTED BY:
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, haybale line/silt boom/silt curtain
1 st day of construction
% constructed
X Project complete, compliance inspection
COMMENTS:
o K 90< C 61� C.
�u; 1� ;� accacao,�c�o w;�L. �cr.;$ � g��2 aid plates a;aaco�of 12/6/S -
CERTIFICATE OF COMPLIANCE:
C
President p�pgllFFQC,� Town Hall, 53095 Main Rd
John M. Bredemeyer 111,
�G P.O Box 1179
Michael J Domino, Vice-President �� y�
o r t a rry 971
James F. King N z �1
Telephone(631)765-1892
Charles J.Sanders p
I
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
Project complete, compliance inspection
TERMS AND CONDITIONS
The Permittee Rick Nappi residing at 5218 Great Peconic Bay Boulevard,Laurel,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 Pennittee
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 ��®� S®Ujy® Town Hall Annex
Michael J.Domino,Vice-President �® �® 54375 Main Road
P.O.Box 1179
James F.King,Trustee jW Southold, New York 11971-0959
Dave Bergen,Trustee G
Telephone(631) 765-1892
Charles J. Sanders,Trustee COUNTi Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
December 16, 2015
Michael A. Kimack
321 Riverside Drive
Riverhead, NY 11901
RE: RICK NAPPI
5218 GREAT PECONIC BAY BOULEVARD, LAUREL
SCTM# 1000-128-2-22
Dear Mr. Kimack:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, December 16, 2015 regarding the above matter:
WHEREAS, Michael Kimack on behalf of RICK NAPPI 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 2, 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, 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,
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,
2
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 approve the application of RICK NAPPI for the
demolition of existing dwelling with foundation to remain; construct a two-story
(1,140sq.ft. first floor, 786.25sq.ft. second floor) dwelling with a 110.5sq.ft. second story
deck onto foundation; remove and reconstruct concrete stoop on southeast corner of
dwelling; add two (2) cellar windows airways to south side of foundation; and install
gutters to leaders to drywells to contain runoff; and as depicted on the site plan
prepared by LPA Architects, LLP dated November 10, 2014, 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: $50.00
Very truly yours,
John M. Bredemeyer III
President, Board of Trustees
JMB/dd
John M. Bredemeyer 111, President gUEFQ(,�c Town Hall Annex
Michael J. Domino, Vice-President �� �Gy 54375 Route 25, P.O.Box 1179
c Southold,NY 11971
James F. King US z
Charles J_ Sanders y • �� Telephone(63 t)765-1892
Dave Bergen " Fax(63 l) 765-6641
BOARD OF TOWN TRUSTEES _
TOWN OF SOUTHOLD z
TO: RICK NAM 40
MO*oL At 9,A4,q_K
Please be advised that your application dated 0EP- 2' :�-0I S has been
reviewed by this Board at the regular meeting of Din !�4 2O/� 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)
% 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
s=,
t'
John Bredemeyer, President �ogUFF91,t Town Hall Annex
Michael J. Domino, Vice-President 54375 Route 25
James F. King ti = P.O. Box 1179
Charles J. Sanders • Southold, NY 11971
Dave Bergen �1 ,[. �a°! Telephone (631) 765-1892
Fax (631) 765-6641
Southold Town Board of Trustees
Field InspectionNMork Session Report
Date/Time:
Michael Kimack on behalf of RICK NAPPI requests a Wetland Permit for the demolition
of existing dwelling with foundation to remain; construct a two-story (1,140sq.ft. first
floor, 786.25sq.ft. second floor) dwelling with a 110.5sq.ft. second story deck onto
foundation; remove and reconstruct concrete stoop on southeast corner of dwelling; add
two (2) cellar windows airways to south side of foundation; and install gutters to leaders
to drywells to contain runoff. Located: 5210 Great Peconic Bay Boulevard, Laurel.
'SCTM# 1000-128-2-22
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
Distance of proposed work to edge of wetland
Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other
Type of Application: Wetland Coastal Erosion Amendment
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No , Not Applicable
Storm Water Management Review: Yes No Not Applicable
Info needed:
Modifications:
Conditions:
Present Were: J. Bredemeyer. M: Domino J. King D. Bergen C. Sanders
Bay Constable Other
Form filled out in the field by
t
Mailed/Faxed to:
Date:
Jr_
° 1
John Bredemeyer, President SUFF011( Town Hall Annex
Michael J. Domino, Vice-President 54375 Route 25
James F. King ti x P.O. Box 1179
Charles J. Sanders • Southold, NY 11971
Dave Bergen O1 ,F �a Telephone (631) 765-1892
Fax (631) 765-6641
Southold Town Board of Trustees
Field Inspection/Work Session Report
Date/Time: 9 C- I" � Y I � f 9.' do
Michael Kimack on behalf of RICK NAPPI requests a Wetland Permit for the demolition
of existing dwelling with foundation to remain; construct a two-story (1,140sq.ft. first
floor, 786.25sq.ft. second floor) dwelling with a 110.5sq.ft. second story deck onto
foundation; remove and reconstruct concrete stoop on southeast corner of dwelling; add
two (2) cellar windows airways to south side of foundation; and install gutters to leaders
to drywells to contain runoff. Located: 5210 Great Peconic Bay Boulevard, Laurel.
SCTM# 1000-128-2-22
Type of area to be impacted:
dSaltwater Wetland -- Freshwater Wetland Sound ay
Distance of proposed work to edge of wetland 4 7l�_
Part of Town Code proposed work falls under: 4,-'Chapt.275 Chapt. 111 other
Type of Application: Wetland Coastal Erosion Amendment
Administrative Emergency Pre-Ss-nubission Violation
Notice of Hearing card posted on property: SuYes No Not Applicable
Storm Water Management Review: Yes No Not Applicable
Info needed: 1,4SS
Modifications: 9 L?ujr\ /'yew czw"��g2
Conditions:
Present Were: J. Bredemeyer � M. Domino King _ D Bergen C. Sanders
Bay Constable Other
Form filled out in the field by J
Mailed/Faxed to:
Date:
Yra�f
Rick Nappi
r
5210 Great Peconic Bay Blvd.,Laurel
SCTM#: 1000-128-2-22
10/14/15
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To whom it may concern,
I am writing this letter to state that after the Worior d'ernoftior,was completed al,the Nappi rel:,Iderlts al
b21 8 Pnconir,6�jy Boulevard NY,that the exterior walls on the east %vest and south side of the 110Wse I-ad
extensive termite and water darnp9ci, Once thatwis disIccvered my professio.-al ano PYperl Opini0f) aft0l
I)ein':in husin(I"Is for twenty ip�us puirs,was inal those walls noedec;to be rohwlt Ic.in oraer to hold now
2nd iiioor addition,
Pleas,)[eel free W contact my office with ariv cluestions I or concerns you may have egarding th!S
3,ncerply,
Mr Mi:am Fitzbinimuns
ip ubder-ii
DEC 1 6 2015
BOARD MEMBERS Of $BUT Southold Town Hall
Leslie Kanes Weisman,Chairperson �� �p 53095 Main Road•P.O.Box 1179
�O !O Southold,NY 11971-0959
Eric Dantes Office Location:
Gerard P.Goehringer G Q Town Annex/First Floor,Capital One Bank
George Horning �® I�4Z4` 54375 Main Road(at Youngs Avenue)
Kenneth Schneider coUN'iY,�'�v Southold,NY 11971
http://southoldtown.northfork.net --
ZONING BOARD OF APPEALS ( E
TOWN OF SOU HOLD C.
I
Tel.(631) 765-1809•Fax(i 31)765-9064 NOV 2 5 2015
I
Southold ioNn
FINDINGS,DELIBERATIONS AND DETE
MEETING OF FEBRUARY 19,2015
MEETING NOVEMBER 19,2015(AMENDED DETERMINATION)
ZBA FILE: 6828 Amended
NAME OF APPLICANT: Rick Nappi SCTM#1000-128-2-22
PROPERTY LOCATION: 5218 Peconic Bay Boulevard(adj.to Great Peconic Bay)Laurel,NY.
SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this
application and determines that this review falls under the Type II category of the State's List of Actions, without
further steps under SEQRA.
SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk
County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its
reply dated December 29, 2014 stating that this application is considered a matter for local determination as there
appears to be no significant county-wide or inter-community impact.
LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency
review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. The LWRP Coordinator issued a recommendation dated January 28, 2015. Based upon the information
provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records
available to us, it is our recommendation that the proposed action is CONSISTENT with LWRP policy standards
and therefore is CONSISTENT with the LWRP.
PROPERTY FACTS/DESCRIPTION: Subject property is a non conforming 10,890 sq. ft. lot in the R40 Zone
District. It is improved with single family dwelling, accessory shed and is bulk-headed. It is accessed from a 15
foot right of way off the south side of Great Peconic Bay Boulevard, it has 88.79 feet on the north property line,
147.93 feet on the east property line, 103.79 feet on Great Peconic Bay and 178.31 feet on the west property line as
shown on the survey dated June 19,2014 prepared by Wallace T. Bryan,LLS.
BASIS OF APPLICATION: -Request for Variances from Article XXIII Section 280-124 and Article XXII
Section 280-116B and the Building Inspector's December 3,20141 Notice,of Disapproval based on an application
for building permit for additions and alterations to a pre-existing neon-conforming single family dwelling, at; 1)
less than the code required front yard setback of 35 feet, 2) less than the code required minimum single side yard
setback of 10 feet, 3) less than the code required bulkhead setback of 75 feet.
RELIEF REQUESTED: The applicant proposes to build a second floor addition and make alterations to the
existing first floor of the pre-existing single family dwelling, requiring variances for; 1.) a front yard setback of
33.5 feet where the code requires a minimum of 35 feet, 2.) a single side yard setback of 8.5 feet where the code
requires a minimum of 10 feet and, 3.)a 55 foot bulkhead setback where the code requires a minimum of 75 feet.
Page 2 of 4—November 19,2015
ZBA##6828—Nappi
SCTM##1000-128-2-22
FINDINGS OF FACT/REASONS FOR BOARD ACTION:
The Zoning Board of Appeals held a public hearing on this application on February 5,2015 and on November 5,
2015 to hear the amended and renewed application, at which time written and oral evidence were presented. Based
upon all testimony, documentation,personal inspection of the property and surrounding neighborhood,and other
evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings:
1. Town Law 4267-b(3)(b)(1). Grant of the variances will not produce an undesirable change in the character of
the neighborhood or a detriment to nearby properties. Nonconforming bulkhead, front yard and side yard setbacks
of one and two story dwellings are characteristic of this neighborhood. The dwelling has existed in its location
since prior to zoning and the footprint will not change.
2. Town Law V61-b(3)(b)(2). The benefit sought by'the applicant cannot be achieved by some method, feasible
for the applicant to pursue, other than area variances. The dwelling pre-exists in its present non-conforming
location and proposed additions and alterations upon the pre-existing first floor and foundation will require
variance relief.
3. Town Law 4267-b(3)(b)(3). The variance granted herein for a 33.5 foot front yard setback is not
mathematically substantial,representing 4%relief from the code.The variance granted herein for a single side yard
setback of 8.5 feet is mathematically substantial, representing 15% relief from the code. However, the pre-existing
dwelling is not parallel to the subject side property line which creates a nonconforming single side yard setback to
only a corner of the dwelling and this side yard setback increases along the side property line to a conforming
setback. The variance granted herein for a bulkhead setback of 55+/- feet is mathematically substantial,
representing 27% relief from the code. However, there are other dwellings in this neighborhood that have similar
and lesser setbacks to the bulkhead.
4. Towri Law V67-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential
community will have an adverse impact on the physical or environmental conditions in the neighborhood. The
applicant must comply with Chapter 236 of the Town's Storm Water Management Code.
5. Town Law V67-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the
Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the
limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase.
6. Town Law §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the
applicant to enjoy the benefit of constructing additions and alterations to a single family dwelling upon the pre-
existing foundation, while preserving and protecting the character of the neighborhood and the health, safety and
welfare of the community.
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under
New York Town Law 267-B, motion was offered by Member Schneider, seconded by Member Dantes , and duly
carried,to
GRANT, the variances as applied for, and as shown on the Survey of Property prepared by Wallace T. Bryan,
L.S., dated June 19, 2014 and the architectural drawings prepared by LPA Architects, LLP, dated Nov. 10, 2014.
Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays
and/or a possible denial by the Building Department of a building permit, and may require a new application and
public hearing before the Zoning Board of Appeals.
I
=• 1
Page 3 of 4—November 19,2015
ZBA#6828—Nappi
SCTM#1000-128-2-22
Any deviation from the variance(s)granted herein as shown on the architectural drawings, site plan and/or survey
cited above, such as alterations, extensions, or demolitions, are not authorized under this application when
involving nonconformities under the zoning code. This action does not authorize or condone any current or future
use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses,
setbacks and other features as are expressly addressed in this action.
The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does
not increase the degree of nonconformity.
Pursuant to Chapter 280-146(B) of the Code-of the Town of Southold any variance granted by the
Board'of Appeals shall become null and void where a Certificate of Occupancy has not been
procured, and/or a subdivision map has not been filed with the Suffolk County Clerk,within three
(3)years from the date such variance was granted. The Board of Appeals may, upon written
request prior to the date of expiration, grant an extension not to exceed three (3) consecutive one
(1)year terms.
Vote of the Board: Ayes:Members Weisman(Chairperson), Schneider,Dantes. (Absent was:Members Horning and
Goehringer) This Resolution was duly adopted(3-0).
(Signed, adopted and filed under Original Decision),
Leslie Kanes Weisman, Chairperson
Approved for filing / /2015
AMENDED DETERMINATION:
ZBA FILE: 6828 Reopened and Amended
NAME OF APPLICANT: Rick Nappi SCTM#1000-128-2-22
PROPERTY LOCATION: 5218 Peconic Bay Boulevard(adj.to Great Peconic Bay)Laurel,NY.
BASIS OF APPLICATION: Re-Opened by Board Resolution-Request for Variances from Article XXIII Section
280-124 and Article XXII Section 280-116B and the Building Inspector's December 3,2014,AMENDED
September 22,2015 Notice of Disapproval based on an application for building permit for
to Demolition of existing single family dwelling and construction of a new single family dwelling, at; 1)less than
the code required front yard setback of 35 feet, 2) less than the code required minimum single side yard setback of
10 feet, 3)less than the code required bulkhead setback of 75 feet.
RELIEF REQUESTED: The applicant proposes to demolish the pre-existing single family dwelling down to the
pre-existing first floor platform decking and construct a new single family dwelling upon the pre-existing
foundation, requiring variances for; 1.) a front yard setback of 33.5 feet where the code requires a minimum of 35
feet, 2.) a single side yard setback of 8.5 feet where the code requires a minimum of 10 feet and, 3.) a 55 foot
bulkhead setback where the code requires a minimum of 75 feet.
FINDINGS OF FACT/REASONS FOR BOARD ACTION:
The Zoning Board of Appeals held a public hearing on this application on November 5,2015 to hear the amended
and renewed application, at which time written and oral evidence were presented. Based upon all testimony,
documentation,personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning
Board finds the following facts to be true and relevant and makes the following findings:
Page 4 of 4—November 19,2015
ZBA#6828—Nappi
SCTM41000-128-2-22
1. The agent for the applicant stated at the public hearing that during the construction of additions and
alterations, the builder found that the pre-existing exterior walls had extensive termite and water damage
which required their complete removal. Consequently, this added sufficiently to the amount of structure
removed from the original dwelling to require the Building Department to determine the construction to be
a demolition.
2. The Building Department placed a stop work order on the project because it exceeded the scope of the
variance relief granted for additions and alterations and issued an amended notice of Disapproval on
September 22,2015.
3. A letter dated November 9, 2015 from the applicant's builder confirmed that due to the extensive damage
from termites and water in the pre-existing non-conforming dwelling, it is his professional and expert
opinion that the first floor walls had to be rebuilt in order to hold the new second floor addition.
4. The new dwelling has been constructed on the pre-existing non-conforming foundation using the same
architectural plans and setbacks as in the relief previously granted in this Appeal 46828 dated February 19,
2015.
5. The applicant's agent testified that the subject waterfront property is such that there is no location where a
new dwelling could be built without requiring some variance(s).
6. The Board reviewed evidence that the existing structures, dwelling and boat house on the subject property
are pre-existing.
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under
New York Town Law 267-B, motion was offered by Member Schneider, seconded by Member Goehringer, and
duly carried,to
GRANT, the variances as applied for, and as shown on the Survey of Property prepared by Wallace T. Bryan,
L.S., dated June 19,2014 and the architectural drawings prepared by LPA Architects,LLP, dated Nov. 10,2014.
Vote of the Board: Ayes: Members Weisman (Chairperson), Horning, Dantes, Schneider, Goehringer. This
Res ll tion was duly dopted(5-0).
eslie Kanes Weisman, Chairperson
Approved for filing �J / �; /2015
Peter Young,Chairman H 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 John Stein, seconded by Doug Hardy, it was
RESOLVED to SUPPORT the application of RICK NAPPI for the demolition of the first floor as a
result of finding extensive termite damage and reconstruct dwelling in accordance with Wetland
Permit#8593.
Located: 5218 Great Peconic Bay Blvd., Laurel. SCTM#128-2-22
Inspected by: John Stein, Keith McCamy
Vote of Council: Ayes: All
Motion Carried
a
i
John M. Bredemeyer III,President \\Zf S®Ul'yD Town Hall Annex
O l 54375 Main Road
Michael J.Domino,Vice-President '` ® P.O.Box 1179
James F. King,Trustee Southold,New York 11971-0959
G
Dave Bergen,Trustee
�� Telephone(631) 765-1892
Charles J.,Sanders,Trustee O�yC®u �A Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD SEP 17 2015
To: Southold Town Building Department
Re: Verification of Building Department Permit Requirements
SCTM#:
Property Owner Name: ' Cier
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
Will 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? r
COMMENTS:
0)
Signature of kreviewer Date
-
i r ,
John M.Bredemeyer III,President � �oUjyO Town Hall Annex
Michael J.Domino,Vice-President l0 54375 Main Road
ames:F King;_ -rus e� v� =7. �... -. -=----.b.�"_.--S1179
buthiild;New York 11977=09
Dave Bergen,Trustee ® �O�
Charles J.Sanders,Trustee 0 Telephone(631) 765-1892
lycoUMrl, Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD -
Office Use Only
Coastal Erosion Permit Application
i;?'Wetland Permit Application
_Administrative Permit ' SEA - 2 2015
/ _AmendmendTransf r/Extension
y Received Application: icy�n
Received Fee: $ Ode AS-NIL -
TCompleted Application: ,Z-( it �Jli esc
Incomplete:
_SEQRA Classification:
Type I Type II Unlisted
Coordination:(date sent): q,`
LWRP Consistency Asse,,s sment Form.-
CAC Referral Sent: 7,30(6—
Date of Inspection: 10 d! t L5
_Receipt of CAC Report:
_Lead Agency_Determination:
Technical Review:
Public Hearing Held:
_Resolution: �^e
Name of Applicant: A/,C�-1
Mailing Address: 6'_W, A11Z To(J RZ,# E 6A O V,25--_ �y
Phone Number:
Suffolk County Tax Map Number: 1000 - /;7,P—
Property Location: M )5� CDN`L' gA AFL UO L,4161P, e
(provide LILCO Pole#, distance to cross streets, and location)
AGENT: ,4 Aez&_� C/G 6; y�Y ��.C�yl1ZZ
p t5. ,�o�C / 6 7 Z-
Address:f1y"/MW/_VY B/?0/ /`W 27j- WC AIY f
63 7z7- l Phone:
o�
I_ :d of Trustees Applicatio `1
GENERAL DATA
Land Area(in square feet): 4'��--7
Area Zoning: - 40
Previous use of property: 9CO a6&VA L
Intended use of property: .9ECz W z-
Covenants and Restrictions on property? Yes No
If"Yes",please provide a copy. 15--/ W I A E R 6tV W( pNG �J'T,�/2A,/ eDU/✓OAW S/
Will this project require a Building Permit as per Town Code? _ C 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 Town Code or as determined by the Building Dept.?
No
Does the structure(s) on property have a valid Certificate of Occupancy? X Yes No
Prior permits/approvals for site improvements:
Z�ti A-145Agency Date 2 2 ,/
NXFP,6c!z ram. or /Zo
A I GM- cf VR1r,V1CT710N
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency? No K Yes
If yes,provide explanation: &-P6 Aoe / AG6 0/2
Project Description (use attachments if necessary): d✓11 .2/ pE ,J'/"/ ,'-Jk>57 '
(Iv I vApowsl o Dom s,4�✓� ./'G,dl�lil� - r=rav� x�: %�v� c oN�:�`f-aop-fin Q
LL (iI,BJV17 U!/�
A1R WAYs r'6 JvlllwLn�1 aF bl®Us�• c e1.�/rnWC)-PRY vv�zc 'Py
,4..VA P C ay.rr w22v
Ord of Trustees Applicatici y
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: V/�5 1y G .d 6 , D/yS
iJ 1-.,,,5Jer11N7,WAZZA RPZ4 onVL . WO . V.0 ?1VW 4Z d01 W/
pal R)ed-� IX W it M YlMZ, Ak1/12 &&--rZZAI(,
Area of wetlands on lot: —d — square feet
Percent coverage of lot: —0— %
Closest distance between nearest existing structure and upland
edge of wetlands: g//) feet
Closest distance between nearest proposed structure and upland
edge of wetlands: /VVP feet
Does the project involve excavation or filling?
,>C No Yes
_ _If_yes, ho_w much.material_will_be_excavated?____A//,O___ cubic yards----
How much material will be filled? /(/,�2 cubic yards
Depth of which material will be removed or deposited: feet
Proposed slope throughout the area of operations: (�c11 —W41-Z,y
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):
6I Z20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part I based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item.
Part 1 -Project and Sponsor Information
Name of Action or Project:
Project Location(describe,and attach a location map):
C
Brief Description of Proposed Action:RZV C�/� OOyLS
Amp Dt oowvp y/-/7-'y�/..,A5yer .4iv'V/NT W141 t -S X/_F M 0®'_ z'_/17,z
�rM / . /p�L�/�o •�r)�
N,X- EST ttiCN�JD�I/.S; D vons.�1a+�� J1X)1A/(�• esG"6VO OXT CONC. P o�
2 ddil J,� f"o!U1JE/2 U�' ID G!>�c a✓G ba rw o /W ��"LL.�1>2 IevIAW d
?w4Y.P r0 ./�0VrIs�f'lI� 0�P � r C 6�!✓'J"/2UC� nny �//�L L mil' l J
Name of Applicant or_Sponsor:_ Telephone: �_ z 3
Address:
z/
City/PO: State: Zip Code:
i V115AAA064AV &Y I 9 of
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 agenc (s name and ermit or approval:
3.a.Total acreage of the site of the proposed action? S616cres
b.Total acreage to be physically disturbed? .-0 - acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? :-We acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban El Rural(non-agriculture)_ ❑Industrial ❑Commercial residential(suburban)
❑Forest ❑Agriculture ❑Aquatic ❑Other(specify):
❑Parkland
Page 1 of 4
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations? cal( ❑ ❑
b.Consistent with the adopted comprehensive plan?
6. is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? ❑
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify: �0 ❑
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
b.Are public transportation service(s)available at or near the site of the proposed action? ® ❑
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action?
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies: ❑
Uc dA/ w
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: QM1—_J'J f5
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? IM ❑
-b.is the proposed.action located-in an archeological sensitive area? __ _ __
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency? ET 9
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: 0 EL
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 ❑Earlymid-successional
❑ Wetland ❑Urban Suburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered? ❑
16.Is the project site located in the 100 year flood plain? NO YES
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes, {�
a.WilI storm water discharges flow to adjacent properties? XNO ❑YES ❑ �I
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe- ]NO YES
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size:
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: L/N I ❑
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe:
1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name: CC_ 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
l. 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? D ❑
3. Will the proposed action impair the character or quality of the existing community? Ey
4. Will the proposed action have an impact on the environmental characteristics that caused the ❑
establishment of a Critical Environmental Area(CEA)? LJ
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:
a.public/private water supplies? a
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological; ❑
architectural or aesthetic resources? LJ
9. Will the proposed action result in an adverse change to natural resources(e.g,wetlands, ❑
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
No,or Moderate
small to large
impact impact
occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and
cumulative impacts.
Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Town of Southold-Board of Trustees /-0
_ Name of Lead Age cy / Date
President
Print or Typ acne of e ponsible Officer in Lead Agency Title of Responsible Officer
Sign re of Ne nsible Officer in L&dd Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of 4
i
' e Postal
CERTIFIED MAILo ■ ® MA M
■ EQEIPT
CO (Domestic oniy;No insurance .
Domesticb
to N
LAUREL MW � C 0 A L U ,� I1 -0 MERRICSx P .L-�
cc
Postage $ 3.45 N Postage $ f3.45
Certified Fee 0 ® �' I Certified Fee ^c
Postmark
p Return Receipt Fee . Here p Return Receipt Fee
p (Endorsement Required) C] (Endorsement Required)
p Restricted Delivery Fee / g ((��(( �3_ O Restricted Delivery Fee
(Endorsement Required) �1 (Endorsement Required) I?;
p 3/Z�� p r
ru 1 p 149 YV°f
r:1 Total Postage&Fees $ ?_ I M Total Postage&Fees
ru
Sent To LSe4ToStreet&Apt NO, �f /�G^ Y ��+ �/ QJ pt.No.;or PO Box ir No. �Y __ l_5�1f`/.__�lr4dN� �� oxNo. --------------------City,State,ZIP State,ZIP+4
L, Al- l/ b
- PostalTM
aDomestic Mail Only
N
'm $3.45
r Postage $
rq
Certified Fee i
p Return Receipt Fee r
CJ (Endorsement Required) ® y
p Restricted Delivery Fee /p (Endorsement Required) 1/13Q15�
ru � 11333
rl Total Postage&Fees
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Sent TO
a -----------------------
' Street& pt.No.,
or PO Box No. ---------------
f
John Bredemeyer, President °gOFF9j* Town Hall Annex
Michael J. Domino, Vice-President ��° ash 54375 Route 25
James F. King y P.O. Box 1179
Dave Bergen oy . Southold, NY 11971
Charles J. Sanders 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
RICK NAPPI
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS
I, M/6V xL 04, &! ,l , residing at/dba
being duly sworn, depose and say:
That on the y/Z day of' O P7V6'6A , 201l,I personally posted the property known as
lIZ/00 CON/C' .X4Y ACW ZA4,&�L
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, October 21, 2015.
Dated:
(signature)
Sworn to before me this
a')•}'� day of Otf 20 (j
Lon
Notary Public
CONNIE D.BUNCH
,Notary Public,State of New York
No.01 BU6185050
Qualified In Suffolk County
Commission Expires April 14,2_Q�
1
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: Address:
C OCAIS' y,O/O/2tXc- eVY/l�G
URA/W
I z?- Z-!7 �g*'�Tn-4n P�rf�j2foA1 �tH l°f'rd NY L1�'-5
UA/a B , /qF .5�aoo �/P�.�r I'�Cv�//C ,C��7Y � •
STATE OF NEW YORK
COUNTY OF SUFFOLK
&/('hW�-1 A 6/AWQ�residing at fz1 R1 V,,Fq=� X.
e2/Vfiew6w NY (/pU/ , being duly sworn, deposes and says that on the
1:?IA day of dCjT , 20/4';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 foee d Z o , that said Notices were mailed to each of said persons by
CERTIFIED MAILIRETURN RECEIPT.
L i
Sworn to before me this
Day of , 20_15-
Notary Public
CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185050
a Qualified in Suffolk County
Commission Expires April 14,
,NUTILL U :!� HtA 'KING
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: RICK NAPPI
SUBJECT OF PUBLIC HEARING :
For a Wetland Permit for the demolition of existing dwelling with foundation to remain;
construct a two-story (1 ,140sq.ft. first floor, 786.25sq.ft. second floor) dwelling with a
110.5sq.ft. second story deck onto foundation; remove and reconstruct concrete stoop on
southeast corner of dwelling; add two (2) cellar windows airways to south side of foundation;
and install gutters to leaders to drywells to contain runoff. Located: 5210 Great Peconic Bay
Boulevard, Laurel. SCTM## 1000-128-2-22
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 8 a.m. and 4 p.m.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892
Board of Trustees Application.
AFFIDAVIT
K Nan, 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
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.
SAure of P perty Owner
SWORN TO BEFORE ME THIS DAY OF , 2p
No ary Public
Board of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
I, AP/QK &ALVZ1 residing at__
(print owner of property) (mailing address)
—do hereby authorize W-1 14,/� C�
(Agent.'
mv PAV/,U ;rAN- azz/ —to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner's signature)
-
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics12rohibits 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: V10 d
(Last name,first name,giiddle initia,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance _ ' Building
Variance Trustee
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(If"Other',name the activity.)
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee
of the Town of Southold? "Relationship"includes by blood,Marriage,or business interest."Business interest"means a business,
including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the 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 is 311 day of 2005
Signatur
Print Name �&to ZA Af0.Jt�
Form TS 1
AP-P-LICANUAGENTMPRESENTATIVE
TRANSACTIO1- A.L DISCL0SURKF0RMT- �-
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The pumose 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: AI RA C16 ./mil f A&
(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
-if you-answered"Y-ES'%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 of/!VG IJ S 20�/
Signature
_-
Form TS 1
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area(which includes all of Southold Town).
3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, each answer must be explained in detail, listing both supporting and non-
supRorting 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# LZP - 2 - ZZ
PROJECT NAME"Bp> 9-'/�,�Jt/� A5/16 VAV4Al
The Application has been submitted to (check appropriate response):
Town Board ❑ Planning Board❑ Building Dept. M Board of Trustees
I. 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:
¢�YrGl�6/1V_r
Nature and extent of action: � ��'� 'e b 6}' , . WAILS. A,��yoVVG
1j7.;l)r OXT Wi�LL S.4/led !/ITT 4 _VWt
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Location of action: ,�2/� p CG/VJ e /gL Ili,, /�U12.9 L
Site acreage:
Present land use:
Present zoning classification:
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicant:
(b) Mailing address:
(c) Telephone number: Area Code( ) �/6 91—q— -7,4¢
(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 g Not Applicable
97 dAl /LL D C
45A1 Y1 A C _
vq L v C a vo Div
Attach additional sheets if necessary
Policy_-2._=P-rotect=andresee-historic-and—ar- hlogial- esouce -ofte' on—of:Soth-p a old_—See-
LWRP - -
Section III—Policies Pages 3 through 6 for evaluation criteria
❑ Yes ❑ No K Not Applicable
r ; '
C4 L.
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 Z Not Applicable
11A 77,6/IJ A= l,Ddl�
y .0 woe ;0tB1,e51-1 ZA1-6 Wle l I1 A M 4Z�1,4
O)e- Al D 1A2;eA Of Oti QU�Z'Y Aoe:-
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 0—Not Applicable
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III
—Policies Pages 16 through 21 for evaluation criteria
❑ Yes ❑ No XNot Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish"and Wildlife Habitats and wetlands. See LWRP Section III=Policies; Pages 22
through 32 for evaluation criteria.
❑ ❑
Yes No Not Applicable
Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria.
Yes [] No[] Not Applicable
O .f72W&
J'
aVM2l -
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
- - - -----Yes -O--No 1- -Not Applicable - - -
- -- - - - - - --- - --- --- ------ ---- ------ -- - - --- -- -
W/G L 1
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.
YeJ0 No Not Applicable
�2.4�5d/2 ,�
AA- IL
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section III—Policies;Pages�47 through 5G f_or 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 9 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 ❑ NoJSJ Not Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III—Policies; Pages 65 through 68 for evaluation criteria.
❑ Yes ❑ No, Not Applicable
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