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HomeMy WebLinkAboutTR-8790A „=” SUFFOLK John M. Bredemeyer III, President -Fp.4 oo';, Town Hall Annex Michael J. Domino, Vice-President ;`- ��'1,, 54375 Route 25 Glenn Goldsmith ti-,, a _ P.O.fi' Box 1179 A. Nicholas Krupski `y ','o - Southold, NY 11971 Charles J. Sanders _?iol` _,�.1 Telephone (631) 765-1892 -_, ;- Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction /V2 constructed Project complete, compliance inspection John M.Bredemeyer III,President ®� Town Hall Annex ' - 8 ® : 54375 Route 25 Michael J.Domino,Vice-President ' E t P.O.Box 1179 Glenn Goldsmith `` kSouthold,New York 11971 A.Nicholas Krupski 11(' c .z OSS Telephone(631) 765-1892 Fax(631) 765-6641 Charles J. Sanders �'�C®UNV I�is''�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8790A Date of Receipt of Application: May 11, 2016 Applicant: Peter & Sheila Izzo SCTM#: 1000-111-10-18.1 & 18.2 Project Location: 805 Meadow Beach Lane, Cutchogue Date of Resolution/Issuance: May 18, 2016 Date of Expiration: May 18, 2018 Reviewed by: Board of Trustees Project Description: Take soil from the landward side of the vacant property, and place it and grade out a slope in two areas on the seaward side of the two properties in order to lessen the angle of existing slope. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by L.K. McLean Associates, P.C, last dated May 11, 2016, and stamped approved on May 18, 2016. Special Conditions: The area located on the bluff/bank is to be planted/revegetated with native and natural vegetation. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. /96.4_ 6,1410,70_x- John M. Bredemeyer III, President Board of Trustees MEADOW BEACH ROAD 1.,77: ';: ., : �.. _ ___ ___ . . • - r . 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' x2.45 x387 x515 �: L 0 x 2.23 • I I II CD GI SITE LEGEND: PROPOSED EAST SIDE TIN VOLUME o PROPOSED NORTH-WEST SIDE TIN VOLUME o Base Surface "Existing" Base Surface "Existing"' --- PROPERTY LINE Comparison Surface "Prop East" Comparison Surface Pro North-West" �, p P -�1o) PROPOSED CONTOUR • Cut Volume = 1 ,544.45 Cu. Yd. r Fill Volume = 383.98 Cu. Yd. - - - -' " - - EXISTING CONTOUR PROPOSED SOUTH-WEST SIDE TIN VOLUME `I' `l' PROPOSED SEEDING & TOPSOIL o Base Surface "Existing" NOTES: Comparison Surface "Prop South-West" Fill Volume = 1 ,077.44 Cu. Yd. 1 . EXISTING TOPOGRAPHY FROM FIELD SURVEY OF OCT. 22, 2015 BY L.K. McLEAN ASSOCIATES, P.C. 3/1 1 /16 LMY ADDED ANNOTATION CFD . ci., TOTAL FILL VOLUME = 1 ,461 .42 Cu. Yd. 2. HORIZONTAL DATUM & COORDINATES ARE IN N.Y.S. PLANE - EAST LONG DATE I BY DESCRIPTION APPROV. BY z ISLAND ZONE NAD83 (CORS 96) MEASURED IN FEET. '. REVISIONS • o 3. VERTICAL ELEVATIONS & DATUM ARE TO BE MEASURED IN FEET 805 MEADOW BEACH m (NAVD88). NASSAU POINT, TOWN OF SOUTHOLD E o 7:'•. ; ' IZZO PROPERTY TOPOGRAPHICAL SURVEY (75 o EARTHWORK PLAN in 10 oo L. K. McLEAN ASSOCIATES, I .C. o 0 o CONSULTING ENGINEERS 437 SOUTH COUNTRY RD., BROOKHAVEN, NEW YORK 11719 CN o Warning: THE EDUCATION LAW OF THE STATE OF NEW YORK PF'OHIBITS ANY F< 0 40 80 PERSON FROM ALTERING ANYTHING ON THE DRAWINGS AND/OR THE Designed By: CFD Scale: AS NOTED Sheet No. ,___ tFeet LICENSEDNYING PROFESSIONALATIONSENGINE , WHERE'SUCH ALTERATIONSACCOMPA , UNLESS ITS UNDER THECTION ARE MADE, �_ c THE PROFESSIONAL ENGINEER MUST SIGN, SEAL, DATE AND DESCRIBE THE Drawn By: LMY Date: OCT. 2015 S C A L E •• 1 " =- 2 0 ' - FULL EXTENT OF THE ALTERATION ON THE DRAWING AND/OR IN THE SPECIFICATION (NYS ED. LAW SECTION 7209-2). Approved By: RGD File No. 151 17.000 40 EXISTING GRAD STORMWATER STORMWATER MANAGEMENT CONTROL NOTES: 30 PROFOSED GRAD I,."__ ..._..,,, SEE SHEET#3 FOR PROPOSED SURFACE TREATMENT, DRAINAGE & 20 ,�''- - STORMWATER MANAGEMENT CONTROL DETAILS. .....,. _,_.__ _�.____,_."_,_., SEE SHEET#3 FOR CROSS SECTION A-A. 10L _ - -- ..--N\ 0 FILL AREA#1 ( • 1 DATUM ELEV -10.000 N in 00 on0) o 00 Oa p (71 r r r N ..---- CROSS .- 0+20 0+40 0+60 1 - CROSS SECTION A A MEADOW BEACH ROAD SCALE: =20' \ \ I ■ FILL AREA# 1 A_ --- /IIS• µ ; ! ` `t \ \ „, -,»..„„.,. ..`.^,"..„ `�,,,^. TM`"`" 4'' ^. ( v.,. A r €f I 1 �, x 26.,9 ",ten ,r', ry --.-,.. - ,.","`w.., ---111 IA� 1 , - { �- µ _ _� x'' '��' ? ��� SEE SHEET#3 FOR TEMPORARY STABILIZED CONSTRUCTION ENTRANCE DETAILS 111 I, I oar # ,..---'" ( " ----" ® • yI ,,'6. 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IZZO �. \\ �` e : _ ' ' J3 (S,C,T.M,#1000-111.0-10, LOT#18.2) t \ , \ _' ¢ *A`" ' , ; I j{/ , x 4`9,67 j''`e x ,,4 , - 1 f 'S '`L \ *K 37.90 x 61.16 , {( �, x 54.02 , `I' S'" \fr .I, , . . { I M x 85.39 / : 4ti .,\ ., a7 W ..`'' ...:.., V V/ ' Lo �c 201 _ II i 3 # £ f .� �- ., " ♦ W ."., E / R 18.96 +,,, •,", lif ANN HARRISON & PATRICIA HARRISON ' ` '��r=�-'� �" �,�_• �_ 4 x 275 X 570 FILL AREA#2 `-'60045 # (S,C.T,M.#1000-111.0-10, LOT#17) BORROW R R OW AREA • / x1'8 m� 12' WIDE TEMPORARY x2.4„ x397 f x515 ../.', �. ACCESS ROAD SITE LEGEND: SITE PLAN DATA: NOTES: 0 -- PROPERTY LINE PROPERTY OWNER: PETER M. IZZO & SHEILA IZZO 1 . EXISTING TOPOGRAPHY FROM FIELD SURVEY OF OCT. 22, 2015 BY L.K. DATE BY DESCRIPTION APPROV. BY z 1 o PROPOSED CONTOUR PROPERTY ADDRESS: 805 MEADOW BEACH ROAD McLEAN ASSOCIATES, P.C. SUFFOLK COUNTY TAX MAP No.: REVISIONS - -- -- -H .0 - - EXISTING CONTOUR DISTRICT#1000,MAP#1 1 1 .o,BLOCK#10,LOT#18.2&#18.1 2. HORIZONTAL DATUM & COORDINATES ARE IN N.Y.S. PLANE - EAST LONG 805 MEADOW BEACH 0 `i' PROPOSED SEEDING & TOPSOIL TOTAL SITE AREA/ACREAGE: ISLAND ZONE NAD83 (CORS 96) MEASURED IN FEET. °° LOT#18.1 = 57,420 SQ. FT. (1 .32 ACRES) : ( tp,-1‘ NASSAU POINT, TOWN OF SOUTHOLD LOT 18.2 = 39,930 SQ. FT. 0.92 ACRES) 3. VERTICAL ELEVATIONS & DATUM ARE TO BE MEASURED IN FEET Q � PROPOSED SILT FENCE TOTAL AREA WITHIN CLEARING LIMITS: 21 ,675 SQ. FT. (NAVD88). IZZO PROPERTY TOPOGRAPHICAL SURVEY -• PROPOSED BALE DIKE STORMWATER MANAGE ENT o STORMWATER DRAINAGE CALCULATIONS: PROPOSED IMPERVIOUS AREAS = 0.0 SQ. FT. CONTROL PLAN oo PROPOSED PERVIOUS AREA (GRASS) = 36,560.0 SQ. FT. (Q=ACI) (.° CW= (36,560 x 0.2) = 7,312 L. K. McLEAN ASSOCIATES, P.C. 0N 80 7,31 2 x 2"/12"(RAINFALL)= 1 ,218.7 CU. FT. CONSULTING ENGINEERS 437 SOUTH COUNTRY RD., BROOKHAVEN, NEW YORK 11719 Warning: THE EDUCATION LAW OF THE STATE OF NEW YORK PROHIBITS ANY 0 40 PERSON FROM ALTERING ANYTHING ON THE DRAWINGS AND/OR THE Designed By: CFD Scale: AS NOTED Sheet No, ACCOMPANYING SPECIFICATIONS, UNLESS IT'S UNDER THE DIRECTION OF A -. Feet LICENSED PROFESSIONAL ENGINEER, WHERE SUCH ALTERATIONS ARE MADE, L La "" �' II . ,L • THE PROFESSIONAL ENGINEER MUST SIGN, SEAL, DATE AND DESCRIBE THE Drawn By: LMY Date: MARCH 1 1 , 201 6 0 SCALE : 1 = 20 FULL EXTENT OF THE ALTERATION ON THE DRAWING AND/OR IN THE 2 SPECIFICATION (NYS ED. LAW SECTION 7209-2). Approved By: RGD File No. 151 17.000 80 I 1 I ! I BORROW ATEA I E _ 70 - al 11111 _ __ .�. __ _._.r.._ _ _,._ � _ w PROPOSED GRADE I E 60 IMMOOMMO -1 --i---' , I all 4 ____ ___ __ I ------- I 7 1.1 _ _ _ _40 _ OROPSED BASN#3 —` III I EXIST'V _GRA __� _ _ __30 . 1 } PROPO ED GRADE I € I � l ------.- _ _.___.. 10 - __ _... _. . . __ _..w. __ {E6 r __-TILL AREA2 _ mal, DATUM ELEV i I I I , -10.000 U7 co d 00 O co O O O LOcy, N In (0 r N CO 00 Cr) O O O rn 17 O O Cr) O_ 00 O d 1\ N Cr) in N d- N N O O N co N N O 0 0 O O O O O • 0) O CO_. co N N F 17 U? c�0 N N 0 0 in .-- (Cj CO I'`� •p • N CV d- • co ( • 00 00• O O N N d r< 0) a) O O• O d- d-• a0 00• r •Ir• d • d- d= Uj U7 N N N N N N N N M I� M M M 1 0 d u7 ° in 0 (0 O ( , O O (0 O co O co (0 0+20 0+40 0+60 0+80 1+00 1+20 1+40 1+60 1+80 2+00 2+20 2+40 2+60 2+80 3+00 3+20 3+40 3+60 3+80 4+00 4+20 4+40 4+60 CROSS SECTION B - B SCALE: 1 " =20' PAVEMENT/SURFACE SCHEDULE SYMBOL SECTION/DESCRIPTION REMARKS `L `l/ .u:._ . _.u.._ . _.u.._ . .u.._._...: HYDROSEED AS SPECIFIED ,Y• . 4"(MIN.) DEPTH OF TOPSOIL !r ; : : ;. : ,.' . • GRASSED AREAS —Hill—Hill ) III—I i 1 11 1 1 (ALL DISTURBED IIII--II I COMPACTED SUBGRADE SURFACES) I= I I I II I II I I I II 1/ ►ilitiaO���C7AO����! ., " SEE TEMPORARY }L� �)�� 6 DEPTH AGGREGATE AS NOTED ILIZED —III I f I I I—III ICONSSTATRUCTION • '• . I I—I I .—I I I —I I I 11- COMPACTED SUBGRADE ENTRANCE DETAILS 0 I C 0 0_ �I + SILT FENCE DETAILS TEMPORARY STABILIZED CONSTRUCTION ° ENTRANCE DETAILS FLOW -WOVEN WIRE FENCE (MINIMUM 14-1/2 GAUGE, MAXIMUM 6" MESH SPEAKING) j0' MIN. _EXISTING Mme• CENTER TO CENTER = " MIN. PAVEMENT L� 10'-0" 3' u 4" VERTICAL FACE 36" MIN. FENCE 1-- -- — � 5:1 I-i_I 14- POSTS, DRIVEN MIN. a° ��14 16" INTO GROUND oI BEDDING DETAIL T '=, *.UU �� ':•-'•••.• �� ��dini inn FILTER CLOTH MOUNTABLE BERM , NOT TO SCALE :::•.�:.: ...e.::,.•o:; �:❖,-= - ...,vas... PROFILE (OPTIONAL) wo•.•':-:' ::•ii:%ii i•�:'4*:::•';M:'•i • !�•4 i�:7 � :O•:! :44,,....•�.a:•4 K.MiN v ❖.MO4•: ,:k.:•:•!.: " EXISTING NOT TO SCALE DRAINAGE AREA NO MORE THAN 1/4 ACRE PER 100 FEET ••: ; ==• •' %••• "'' HEIGHT OF FILTER FABRIC 16 kir >�,0•V.: � :'s:- • ..❖:g GROUND O • OF STRAW BALE DIKE FOR SLOPES LESS THAN 257 I;I.� *11601 W •''i y.. . �'1 .,.., • :::cRA�E MINIMUM W W W 8" MINIMUM ANGLE FIRST STAKE Its " W W W W . 50' MIN. TOWARD PREVIOUSLY LAID BALE p� ��� W W . W 1. Vm \ -. . W W W F�O� Kf FLOW \ PERSPECTIVE VIEW z o j NOT TO SCALE cn ' EXISTING 4hatitWOVEN WIRE FENCE (MINIMUM 20 MIN. rPAVEMENT C y 14-1/2 GAUGE, MAXIMUM 6" -' 1 I/1111' BOUND BALES PLACED MESH SPACING) WITH FILTER III 0 W� � N ON CONTOUR CLOTH OVER 0» IN. PLAN VIEW 10' MIN. --1 —REBAR STEEL PICKETS OR 2"x2" COMPACTED 2 M �I Z -407: STAKES DRIVEN 1 i' T 2' IN GROUND. SOIL UNDISTURBED NOT TO SCALE 111 \ DRIVE STAKES FLUSH WITH BALES. GROUND I'' FLOW CONSTRUCTION SPECIFICATIONS D yy��- 6" 1. AGGREGATE SIZE - USE 2 INCH STONE OR RECYCLED CONCRETE AGGREGATE. � ,�_ 16» MIN.1 EMBED FILTER CLOTH SILT FENCE SECTION 2. LENGTH: AS REQUIRED, BUT NOT LESS THAN 50 FEET (EXCEPT ON A SINGLE RESIDENCE LOT WHERE A 30 DATE BY DESCRIPTION I APPROV. BY Z CONSTRUCTION NOTES FOR FABRICATED BALE DIKE MINIMUM G6" INTO ROUND --J4"I� NOT TO SCALE FOOT MINIMUM WOULD APPLY). 1. BALES SHALL BE PLACED AT THE TOE OF A SLOPE OR ON THE CONTOUR AND IN A ROW WITH ENDS TIGHTLY CONSTRUCTION NOTES FOR FABRICATED SILT FENCE 3. THICKNESS: NOT LESS THAN SIX (6) INCHES. REVISIONS ABUTTING THE ADJACENT BALES. U 805 MEADOW BEACH 4. WIDTH: 12 FOOT MINIMUM BUT NOT LESS THAN THE FULL WIDTH OF POINTS WHERE INGRESS OR EGRESS 1. WOVEN WIRE FENCE TO BE FASTENED SECURELY TO FENCE POST: STEEL EFT }iER T OR 'U' OCCURS. 24 FOOT MINIMUM IF THERE IS ONLY ONE ACCESS TO THE SITE. 2. EACH BALE SHALL BE EMBEDDED IN THE SOIL A MINIMUM OF (4) INCHES, AND PLACED SO THE BINDINGS ARE POSTS WITH WIRE TIES OR STAPLES. TYPE OR 2" HARDWOOD HORIZONTAL CO 5. FILTER CLOTH: TO BE PLACED OVER THE ENTIRE AREA PRIOR TO PLACING OF STONE. � ' NASSAU POINT, TOWN OF SOUTHOLD 3. BALES SHALL BE SECURELY ANCHORED IN PLACE BY EITHER TWO STAKES OR REBAR DRIVEN THROUGH THE 2. FILTER CLOTH TO BE FASTENED SECURELY TO WOVEN WIRE FENCE: WOVEN WIRE, 14-1/2 GAGE, ;r E BALE. THE FIRST STAKE IN EACH BALE SHALL BE DRIVEN TOWARD THE PREVIOUSLY LAID BALE AT AN ANGLE FENCE WITH TIES SPACED EVERY 24" AT TOP AND MID 6" MAX. MESH OPENING 6. SURFACE WATER - ALL SURFACE WATER FLOWING OR DIVERTED TOWARD CONSTRUCTION ENTRANCES SHALL BE TO FORCE THE BALES TOGETHER. STAKES SHALL BE DRIVEN FLUSH WITH THE BALE. SECTION. PIPED ACROSS THE ENTRANCE. IF PIPING IS IMPRACTICAL, A MOUNTABLE BERM WITH 5:1 SLOPES WILL BE it t FILTER CLOTH: FILTER X, MIRAFI PERMITTED. IZZO PROPERTY TOPOGRAPHICAL SURVEY -0 4. INSPECTION SHALL BE FREQUENT AND REPAIR REPLACEMENT SHALL BE MADE PROMPTLY AS NEEDED. 3. WHEN TWO SECTIONS OF FILTER CLOTH ADJOIN EACH OTHER 100X, STABIUNKA 0THEY SHALL BE OVERLAPPED BY SIX INCHES AND FOLDED. T140N OR APPROVED 7. MAINTENANCE - THE ENTRANCE SHALL BE MAINTAINED IN A CONDITION WHICH WILL PREVENT TRACKING OF 5. BALES SHALL BE REMOVED WHEN THEY HAVE SERVED THEIR USEFULNESS SO AS NOT TO BLOCK OR IMPEDE EQUAL. SEDIMENT ONTO PUBLIC RIGHT-OF-WAY OR STREETS. THIS MAY REQUIRE PERIODIC TOP DRESSING WITH S T 0 R M W A T E R M A N A G E E N T I''-) STORM FLOW OR DRAINAGE. 4. MAINTENANCE SHALL BE PERFORMED AS NEEDED AND ADDITIONAL AGGREGATE. ALL SEDIMENT SPILLED, DROPPED, OR WASHED ONTO PUBLIC RIGHTS-OF-WAY MUST BE 0 MATERIAL REMOVED WHEN "BULGES" DEVELOP IN THE SILT PREFABRICATED UNIT: SEOFAB. REMOVED IMMEDIATELY. I LO FENCE. ORVPPROVE CONTROL DETAIL S O STRAW BALE DIKE DETAILS EN APPROVED 8. WHEN WASHING IS REQUIRED, IT SHALL BE DONE ON AN AREA STABILIZED WITH STONE AND WHICH DRAINS INTO AN APPROVED SEDIMENT TRAPPING DEVICE. � N.T.S. EQUAL. ��// P.C.� 9. PERIODIC INSPECTION AND NEEDED MAINTENANCE SHALL BE PROVIDED AFTER EACH RAIN. L. h. Iv icLEAN ASSOCIATES, f O N 00 CONSULTING ENGINEERS 437 SOUTH COUNTRY RD., BROOKHAVEN, NEW YORK 11719 Warning: THE EDUCATION LAW OF THE STATE OF NEW YORK PROHIBITS ANY 1- - PERSON FROM ALTERING ANYTHING ON THE DRAWINGS AND/OR THE Designed By: CFD Scale: AS NOTED Sheet No. 4 ACCOMPANYING SPECIFICATIONS, UNLESS IT'S UNDER THE DIRECTION OF A In LICENSED PROFESSIONAL ENGINEER, WHERE SUCH ALTERATIONS ARE MADE, THE PROFESSIONAL ENGINEER MUST SIGN, SEAL, DATE AND DESCRIBE THE Drawn By: LMY Date: MARCH 1 1, 201 6 FULL EXTENT OF THE ALTERATION ON THE DRAWING AND/OR IN THE J SPECIFICATION CL (NYS ED. LAW SECTION 7209-2). Approved By: RGD File No. 151 17.000 John M. Bredemeyer Ill, PresidentyoSUF 0(kC,4, Town Hall Annex Michael J Domino, Vice-President - �� 4 54375 Route 25 Glenn Goldsmith o "" tArt P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J Sanders : 4540 = '�p�, Telephone (631) 765-1892 d �' Fax (631) 765-6641 -xuzrao BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 5/11/14, Completed in field by: PETER & SHEILA IZZO request a Pre-Submission Inspection to determine whether the proposed project is within Trustee Jurisdiction to take soil from the landward side of the vacant property, and place it and grade out a slope in two areas on the seaward side of the property in order to lessen the angle of existing slope. Located: 805 Meadow Beach Lane, Cutchogue. SCTM# 1000-111-10-18.1 & 18.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=I Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: -QerM,-i fe covolw 4,4 IL) I Dot A`1/ 1 ow I v Am -ivy 7 Present were: Bredemeyer (7M---. Domino G. Goldsmith N. Krupski /C. Sanders Other Page 1 of 2 John M. Bredemeyer Ill, President .1W0 ' Town Hall Annex Michael J. Domino Vice-President 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A. Nicholas Krupski :o Southold, NY 11971 Charles J. Sanders 4 dao Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: PETER & SHEILA IZZO request a Pre-Submission Inspection to determine whether the proposed project is within Trustee Jurisdiction to take soil from the landward side of the vacant property, and place it and grade out a slope in two areas on the seaward side of the property in order-to lessen the angle of existing slope. Located: 805 Meadow Beach Lane, Cutchogue. SCTM# 1000-111-10-18.1 & 18.2 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposedactivity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. 5_25% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 Peter&Sheila Izzo 805 Meadow Beach Lane,Cutchogue SCTM#: 1000-111-10-18.1&18.2 5/11/16 i • =. y i p ,fir T1 - - "�"t +ar -11" i' - . '° letillikt , WI. • u . i. f.,. - ,. , - i . -.„ , . !Sol% • ./ . , ;. }i r.:4„,'” .. ,I • p'4- v it. if y vif ; I 1 / 4111 ,- alb 1110011111116 '.....' - .a.� ^•• - ..-i- i„-,�„�u. -_a. �'�'n'yr' C-1 County Centur line...N T 11901 M Stu _ur 1/I) o aw .w,...�aw.� -""' �no-.uu vw.rewren ''.•,.'..,:,,,`,' s � r— 134 =_ . 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'� ,- `� _ 182 E o. ,\ 6 loll& ia :ip 10 00.k,,,,‘ 4*P oA ® � 'P' -\m^ O ,5 ,.ode) j eye) - � � :11. 2 `) ' s� '. ,�.+"" y _, ` 3317 A t'3' 1 IA ay a n, ✓ \s Nkcoa.���• � a \ ]tic) 1w , '''S'E' dI�L\�' ` v o� ✓ a 9/ .0.6•Nt9ck. 41, (5p) c .. , m m 6 �� \� .ti ill �, t3�n(q m d iia - 02 \ 10 nB01-0 . lWE It."NE. _ d n d , - -- - ® §' , �aWWETAFSOC1NO0 •Q z.enkSCHL0�_ 's.Y..w�mr. on) �w _�_— �� n_ ....4....4=:,.....„°,,„,„, NOTICE .pqU COUNTY OF SUFFOLK © K ti taw of SOIRNOLD SECTION NO a..o...« O— -- n....d.,�..- eN"" OPSTRIBUTIOR MANY PORTION OF TIE a RealPropertyTaxSernceAgency v no" r. P County Cantor , 171 V v�.•na sale Domes o uw o.uv_ . r.�vo.wu. M SCAM 3 o.,.ti, a o.ex���z,Ngat]u r...u. �o.nu,. --.—= w....m..�— rwr +s..•wQ rsrt.nrtx NnT ra nr 200 am A DISTRICT o 1000 oer.sr ,],AK) "'^". spm..... —.— REAL PROVE ♦v SERVICE lCC P P no PROPERTY MAP OFFICE LOCATION: t oi ®� ®(/170 MAILING ADDRESS: Town Hall Annex ��� ® ; P.O. Box 1179 54375 State Route 25 J alliSouthold, NY 11971 (cor. Main Rd. &Youngs Ave.) % Southold, NY 11971 ` AZ' Telephone: 631 765-1938 �I COUNT`I,N , 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: May 16, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for PETER & SHEILA IZZO SCTM# 1000-111-10-18.1 & 18.2 PETER & SHEILA IZZO request a Pre-Submission Inspection to determine whether the proposed project is within Trustee Jurisdiction to take soil from the landward side of the vacant property, and place it and grade out a slope in two areas on the seaward side of the property in order to lessen the angle of existing slope. Located: 805 Meadow Beach Lane, Cutchogue. SCTM# 1000-111-10-18.1 & 18.2 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 LWRP Policy 6 and therefore INCONSISTENT with LWRP. The action proposes to fill a protective natural feature (bank/bluff) and eliminating existing vegetation. The purpose of the placement of fill is unclear.` 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: Stephen Kiely, Assistant Town Attorney O'SOUT John M.Bredemeyer III,President ,�i � y©l: Town Hall Annex Michael J.Domino,Vice-President ��`' 54375 Main Road P.O.Box 1179 James F.King,Trustee Z Southold,New York 11971-0959 kct Dave Bergen,Trustee ` Charles J.Sanders,Trustee O Telephone(631)765-1892 ="litCCO ,`Y. Fax(631) 765.6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application _Wetland Permit Application Administrative Permit // Amendment/Transfer/E tension /Received Application: 5;1111 Received Fee: $ t/ Completed Application: �S�12�( 9 rte• ETV Incomplete: r ` "- �' _SEQRA Classification: ' Ir Type I Type II' Unlisted U ,�! Coordination:(date sent): { MAY 1 2016 I LWRP Consistency Assessment Form: j CAC Referral Sent: Sot.lf, ; Tom _Date of Inspection: 0'�///p7T/(o S . _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: b M Resolution: Name of Applicant: �s/I/L4 Mailing Address: Pd , a Ya o ' A_ v J � Phone Number: (0a/- c3 V'3s S7 J / O Suffolk County Tax Map Number: 1000- �/l /g Property Location: 8706- /' JD ---?)E Re-4 - CtAd by s Gc.e (7 6 (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: rd of Trustees Applicatio GENERAL DATA Land Area(in square feet): 3,1 /4G12e5 Area Zoning: 3e5 / c3pK 4 Previous use of property: �G�S ✓C��/, i Intended use of property: R€'p dah Covenants and Restrictions on property? Yes x No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes )C No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes _ X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes yNo Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: FV 2 � Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ( No Yes If yes,provide explanation: Project Description(use attachments if necessary): ReS �� f)/4a/ /1)/Hi O /ic 45 iNe,7-u2c -riot wit- Alam larreet,oe it ,' 5 ' o f tiocep,S ,sicW°Pe° C9 ng P kue.—e (r` rl -rOf e o LA--( Ci SY a pe in-74, a a l ee Or) sea coag S 1 i)-e ( 14d p-�'1 l/'1 !0 02-0-e i- i /e' .S`e r 6"k_ rs /0l2.1z_- } ] rd of Trustees Applicatio._ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 4ti/O6 Area of wetlands on lot: square feet Percent coverage of lot: 0 Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet /VO 5 wC-fae Pe®/d5f 6 Does the project involve excavation or filling? No 7 Yes If yes,how much material will be excavated? 1b5cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 0€ -ff70 C n pi&c-e- C n Fred r 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): PIS Board of Trustees Application AFFIDAVIT 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."I RT R AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY P'OPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDI ION OF • ' Y WETLAND . ' COASTAL EROSION PERMIT ISSUED BY T : BO• ' I► OF TRUSTEES ) ' NG THE TERM OF THE PERMIT. Si a .°- of Propertyne SWORN TO BEFORE ME THIS I2 DAY OF 4.4 , 20 �((� NANCY,C, HARTMANN G Notary Public•State of New York J� No.O1HA6286007 N Public Qualified in Suffolk County My Commission Expires July 22,2017 ,1 - ti . APP LICANT/AGENT/REP RESENTATIVE TRANSACTIONAL DISCLOSURE FORM 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 low it to take whatever action is necessary to avoid same. _I /1 YOUR NAME: Z%2-d l S`1 eiat- I J ��i 2v • (Last name,first name,.gniddle initial,unless you are applying id 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,partnei,-or employee of the applicant;or . D)the actual applicant. • DESCRIPTION OF RELATIONSHIP • • r Submitted ' da, of •A Signature � • �,r �� ,' Print Name - 'f� : '/( Form TS 1 E rd of Trustees Applicatiol .AFFIDAVIT She i Ia T2z C) 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. 44144)(- Signature of Property i wner th SWORN TO BEFORE ME THIS � I PAY OF M 0y 20 I l� J/7, ± , di- O Notary Public i TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2f 18 • • APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics.prohibits cenflicts•of interest on the part of town officers and'emplovees,The purpose of this form is to-provide information'which can`alert-tlie town of possible conflicts of interestand allow it to take whatever action is necessary to avoid same. YOUR NAME: Zfl / Dien II— (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's or company's name.) NAME OF APPLICATION: (Check all that apply.) ' ' • Tax grievance Building • ° • Variance Trustee Change of Zone Coastal Erosion - Approval of plat Mooring Exemption from plat or official map Planning - - - Other (If"Other",name the activity.) — • Do you personally(or through your company,spouse,sibling,parent,or child).have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business'interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial;ownership,of,(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person • Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(wheat 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 th da _'` 2" 0/ Signature f Print Name / Z4 Form TS 1 617.20 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 1 based on information currently available. if additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part I. 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: z2.0 - Project Location(describe,and attach a location map): 005 nit-iti b o L,0 3ei ( l 13- ��c- 1 3 c Brief Description of Proposed Action: ° '8eco 2 i D �--hs2 f5ep10_6_4 �1 f�� ve S CBCs k s e,2, C/1-11-) , BSG I&ss 612.e-e i S SS t� Ay 0-e r✓i s ft 'L Re ��e rf S 1z(4 (- Name +of Applicant or Sponsor: Telephone: ro S/_3c(� S^�S/ �Z-71) E-Mail: • svie/LL;+ZZ-22e) Q Aly/. -- Address: City/PO: State: Zip Code: Qo � � � ��� ��� f i53, 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 [ ! i Q 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: n - 3.a.Total acreage of the site Of the proposed action? acres b.Total acreage to be physically disturbed? / acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 3 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban 0 Rural(non-agriculture) ❑Industrial ❑Commercial , tesidential(suburban) ❑Forest DAgriculture ❑Aquatic DOther(specify): ❑Parkland Page 1 of 4 _ 1 5. Is the proposed action, - - - NO YES 'N/A a.A permitted use under the zoning regulations? n [31 b.Consistent with the adopted comprehensive plan? l 1 1 X 'L_1 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:_ „ ;) 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES i® n. 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? 0, 9.Does the proposed actionmeetor exceed the state energy code requirements? 0 YES If the proposed action will exceed requirements,describe design features and technologies: fl 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: i(! [1 II.Will the proposed action connect to existing wastewater utilities? NO 1IYES _ If No,describe method for providing wastewater treatment: , a; 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic "NO YES Places? ,',El ❑- 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? CI X ; b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? (i (l` If Yes,i if the wetlan or Ovaterbp y extent of alterations in squarefeet or acres: II 11 tt____!I L D/ /� C/l6T� '- 1f5> $ -e(R— tio 5J fie. 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline 0 Forest ❑Agricultural/grasslands ❑Earlymid-successional [? Wetland 0 Urban 0 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? ® a 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. Will storm water discharges flow to adjacent properties? [ NO nYES I ed1' I 1' b.Will storm water discharges be directed to established conveyance systemsrunoff and storm drains)? If Yes,briefly describe: ENO FIVES 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: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFO,RiMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE / Applicant/sponsor name: y �3 �` + Date: 5////a /� Signature: l� .Y:47jjj !!!!f 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? I �I ❑ 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)? I�G 5. Will the proposed action result in an adverse change in the existing level of traffic orEl ❑ 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? b.public/private wastewater treatment utilities? ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 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 may may 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? 1 Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. 0 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, ' LLJJ that the proposed action may result in one or more potentially large or significant adverse impacts and an 0 environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 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-explainedin 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# firOV _ 11 1 _ 10 - A / 4( 4S.d- PROJECT NAME2'74) The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board LI 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) n (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: e s 2A o& pt Lki g)Ii i' 1141 d( CCS %'e Sa/L- F/la4 the wgR ), ';de d-9`ikte62-Jl4 fro Vktel ,'d p 4C.(0 Slade D C.e Gi S4a-c e4 c &yore( J'I Oic 'Rye /4 o!1)e l 7 Le5Sef *q,2$IeR-4, �' n ;/a P--e_ P . Location of action: dc Gds co et k_ 6(14 1 1 I Site'acreage: 3 . I l'-Lc dP S Present land use: �S n )4 a I Present zoning classification: 11-e S 1-/a_ 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: ' kJ CO '1-2-11) (b) Mailing address:_ \)..0 , 1-20‘.( OSLAK v')'k l lc)S c (c) Telephone number: Area Code( ), Co 1 (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 TO Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 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 n Yes n,, No I rl 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 n Yes ❑ No 3 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 lNot 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. ❑ n OKI Yes No \A,Not AppL:... 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. I Yes n:No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes n No EP-Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yen No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. n Yes n No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. H Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY tt. '`� `� TITLE DATE 5 III lgoi& . - Or '1� 1_ '; : .--7_4 _(46f., -7/07W77- S;e-f /V;7-47-/:A'"64-- C6-°"J /27 // a)1/___‘____ '77l G.�?��6/(-- - ._ " f ` i cei 7e.,,/,,c.e_._ / A I ie ,,e'.., ,.,e 01' 'A.-= ( .3______CL6)__ 6`L ' ' 44111- (-4 C --4-'?___Cfr' /1/1-- -- . 41'1 /,- I a- ;.`.� /� `� � ` ! e___„:04 Il rc,74. . -(-- _______,,2v_h_e_ _ . 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