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HomeMy WebLinkAboutTR-8759A Michael J. Domino,President ��0f SU!/lTown Hall Annex John M. Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold, New York 11971 A. Nicholas Krupski G • Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 UNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1455C Date: March 15, 2018 THIS CERTIFIES that.the Ten(10) Year Maintenance Permit to remove dead, diseased, and overgrown or invasive vegetation and trees; maintain lawn and current planting beds; re-plant dead or destroyed trees shrubs and flowers,• and the addition of new Alantin beds,eds,plants, and trees; At 1505 Yennecott Drive, Southold Suffolk County Tax Map #1000-55-4-25.3 Conforms to the application for a Trustees Permit heretofore filed in this office Dated March 14, 2016 pursuant to which Trustees Administrative Permit#8759A Dated April 20, 2016, was issued and conforms to all of the requirements and vonditions of the applicable provisions of law. The project for which this certificate is being issued is for the Ten(10) Year Maintenance Permit to remove dead, diseased, and overgrown or invasive vegetation and trees,• maintain lawn and current planting beds; re-plant dead or destroyed trees, shrubs and flowers; and the addition of new planting beds, plants, and trees. The certificate is issued to Kristen Frohnhoefer owner of the aforesaid property. AuthorizWd Signature. all4401 Michael J. Domino, President �*0f SyO Town Hall Annex John M. Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold, New York 11971 co A. Nicholas Krupski • Telephone(631) 765-1892 Greg Williams O�y00UNT`I, Fax(631) 765-6641�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: a )5 , �4C1 /Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/2 constructed 7Project complete, compliance inspection. INSPECTED BY: COMMENTS: Lo`� CERTIFICATE OF COMPLIANCE: John M. Bredemeyer III, President ;J'�� 0 -4 Town Hall Annex Michael J. Domino, Vice-President s= y�A, 54375 Route 25 Glenn Goldsmith s P.O. Box 1179 A. Nicholas Krupski . oy Southold, NY 11971 Charles J. Sanders �' 0l ,6�� Y 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 / % constructed V Project complete, compliance inspection John M.Bredemeyer III,President ®�'�'®f S® � Town Hall Annex ®l � ® 54375 Route 25 Michael J.Domino,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 G A. Nicholas Krupski � �O Telephone(631) 765-1892 Charles J. Sanders ®�yCoUFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8759A Date of Receipt of Application: March 14, 2016 Applicant: Kristen Frohnhoefer SCTM#: 1000-55-4-25.3 Project Location: 1505 Yennecott Drive, Southold Date of Resolution/Issuance: April 20, 2016 Date of Expiration: April 20, 2018 Reviewed by: Board of Trustees Project Description: Ten (10) Year Maintenance Permit to remove dead, diseased, and overgrown or invasive vegetation and trees; maintain lawn and current planting beds; re-plant dead or destroyed trees, shrubs, and flowers; and the addition of new planting beds, plants, and trees.- 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 revised project plan prepared by Kristen Frohnhoefer, dated April 29, 2016, and stamped approved on May 5, 2016. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. John M. Bredemeyer III, President Board of Trustees -Y> t -"-�_.__ '•..� i' i'� Z-,_;�; it Project: 1505 Yennecott Drive,Southold, NY APR 2 9 2016 f Application for: 10-year Maintenance Permit i t Date: April 26, 2016 _ �Sotit`,dd Town Maintenance Plan See attached plan summary for an overview of existing features and areas, as well as potential future improvements. 1. Maintenance of existing and future planting beds and gardens, including, but not limited to addition of new plant material, plant removal (excluding native wetlands plants in wetlands area),fertilizing, compost application, mulching and pruning. 2. Installation of additional planting beds and/or vegetable gardens adjacent to house,throughout yard and/or in any existing cleared or lawn areas. 3. Maintenance of existing and future lawn areas, including, but not limited to mowing,fertilizing, thatching, aerating,and re-seeding. 4. Installation of lawn in any existing or future cleared area. 5. Removal of dead, diseased, invasive and overgrown vegetation and trees. 6. Planting of trees, shrubs,flowers,grasses and similar in any existing cleared, lawn or planting bed areas. 7. Maintenance of vegetation and removal of dead, diseased,overgrown and/or invasive vegetation which originates on neighboring community-owned lot, but encroaches upon our lot. 8. Maintenance of existing and future trees, including, but not limited to pruning and disease treatment. 9. Establishment of a composting site. 10. Maintenance of existing and future irrigation system elements. 11. Expansion of irrigation system as needed to support existing and future planting beds,gardens and trees. 12. Maintenance of driveway, existing decks and exterior of house. 13. Hand application of Round-up or similar on emerging non-native and non-wetlands vegetation 14. Any other generally accepted horticultural practices. 15. In Wetlands areas: Cutting back or removal of the following: a. Multiflora Rose b. Honeysuckle I. 1 C. Black Locust d. Domestic grasses e. Cat Briar f. Privet g. Russian and Autumn Olive h. Other confirmed non-native and non-wetlands vegetation in wetlands areas. The following vegetation will NOT be cut back or removed: a. Viburnum b. Sedge c. Red Maple d. Rushes e. Native Wildflower f. Smart Weeds g. Native holly h. Any other confirmed native and wetlands vegetation s S.C,T.M. N0, DISTRICT: 1000 SECTION: 55 BLOCK!, 4 LOT(S): 244. L�� 22 n` ` R®I-0-98— 1 5® P%0? I �• .i.K CLN7"Y cFFAll?T ..WTor. F-EALTJI SERVICES7E re7 1 P)taQ.()V sL �''C�3h'i7°To '�° r r �' i_ .c�,�t SINGIX PA FOR V H.S. 6'dc;'. i,le,• ® � /� � �3 � , ���.�.`�.., �.'t►�/;:X°� 9 k UPAiy faeilifiC2 a Bhi,S 1 .. bem �1 C' TtCry VoiZ y ols A' a e. r oir►er ;ae.•aei:�es:y fotmd g,.um, OF X11 L Z; �. Sl be" ® r .as%P.�.� chief Offer of tiN®° .1 t% MIl P055 btQ &S4"1 �5 �Tr nP0 W� \ X—/ cyN 30 a S� FR- p,� 6L CrI�.LAR � EL 35.3 y Ga. EL 32.7 ai r e. 4 r 10.74 4 POND LA Hm. P ROVED BY, s� 141 10' R OF 1 RUSTEES s' •' N F SOUTH �L �.o9 D P\ PL' ' `f• - J• SC yENN _ >. �1 28.40 UL X712 ub FINAL SURVEY 5-17—: ,REQ. 35,659.0 S.F. OR 0.82 ACRES o'I a-� ,,I01 tOCAT, UNAU7.10RIZED AL TERA nom OR ADDITION TO MS SURVEY IS A WOLA 17O N OF S£CnOAi 7209 O' THE fv£w YORK STAT EDUCA TaOry LAw, c MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CO NSWR£D TO BE A VALID TRUE COPY. GUARANTEES lWWA r -- d•- ---- - - t John M. Bredemeyer III, President r �pS�FFU(q'CO ' Town Hall Annex Michael J. Domino, Vice-President ;• Gy '° 54375 Route 25 Glenn Goldsmith r '` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders ti Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:' ��'� Completed in field by: - KRISTEN FROHNHOEFER requests an Administrative Permit for a Ten (10) Year Maintenance Permit to remove dead, diseased, and overgrown or invasive vegetation and trees; maintain lawn and current planting beds; re-plant dead or destroyed trees, shrubs, and flowers; and the addition of new planting beds, plants, and trees. Located: 1505 Yennecott Drive, Southold. SCTM# 1000-55-4-25.3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual'Footage or OK=q 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: 1 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: Present were: /J. Bredemeyer ✓M. Domino G. Goldsmith N. Krupski C. Sanders Other `" Page 1 of 2 S.C.T.M. N0, DISTRICT: 1000 SECTION: 55 BLOCK: 4 LOT(S): 24Z !' 4 L01r- RO10-98- 150 P/0 LI DE?A R T yr NT nr F£EALTFI SERVICES �� �`t L F'Cf3N_yTT.�1Ci:..Is�';GP.N.) h'(?R '� and ►y.�:::r UPAIy fac;ltcles i.•tti�c: c 0t this (OC2ilClA h•I3�C been nifie�by this 7cP e. r otr►er �aeaci:s ar.; x: ,:al5tictcry t�Oit AXI aid OF found to •�' ;- Q stXher r. OSt%p.E.. Chief Office of Wa, ' %lWewater r P/o nor 28 /Q GO a a 20. za.o' 1,.0• AR q EL 32.7 Gm, EL ts.T R 10.78 6. r 20' K ° L � POND Q � o O . _..! 141 10' 29.09 77 DR Ec MAR 14 2016 to OTT O YEN S�ut`�;!u l'orrn u28.40 UL 112 FINAL SURVEY 5-17-2 kREA: 35,659.0 S.F. OR 0.82 ACRES iL,1 9-20-99 rOWDflON tocxTX •UNAUTHORI2ED AL T£RA770N OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OJT' THE NEW YORK STA TE EDUCATION LAW. C MAP NOT BEARING_THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATF S.C.T.M. N0, DISTRICT: 1000 SECTION: 55 BLOCK: 4 LOT(S): 24 Lol �2 R070-98- 750 Pj®� .. _. _ 1uj L' nNr"Y DEPART-MrWTor ,�`o PEA SBRVIC .S 'S �� 7EP Ta AL 0F c •1 "'1NGI.E�'A l;ffr.i ft.a�rGRK� F()R H.S. rtef. 1,1�• O i$D s�^�,•t =d ►"t" �uPPIY faciliti �w at this by this i7c tocElian t'a ,.e been "AXIIioFpC& roirer ;oeui:sarrfaundio � KDRUOt, �n � Sl hv • G �`� - asts,P.E., Chief a Office of Wat ''ulewmer DATA �� \- ���' 0� X = bus ap o Jf' o � � LOT 28 Q 19. 2020 '. f Z STY Flt' /ECHE C�LL4R q EL 32.7 EL r 4• pgp(jl v d sem• POND N v Ln Q o O . tY �.tP, 41 10' 29-09 Ec ........................................ . ................ `- MAR 14 2016 [_ t�ECOTT yENSojjthdl� 'lawn CL 2a.4Q UL 12 S.F. p Q ACRES SURVEY 5-17—; AREA: 35,659.0 SOR 0.82 ACRc S LIL 9-20-99 FDUMMnON LOCAD UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OP- THE NEW YORK STA TF EDUCATION LAW. L MAP NOT BEARING THE LAND SURVEYOR'$ EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICAT, w... .• ►_ -.- ____ - - John M. Bredemeyer III, President I ) �gUFFOIk�, I Town Hall Annex Michael J. Domino, Vice-President ` °� oGy� 54375 Route 25 Glenn Goldsmith o ` P.O. Box 1179 ar A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders 'y Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN,OF SOUTHOLD Date/Time: Completed in Work Session by: KRISTEN FROHNHOEFER requests an Administrative Permit for a Ten (10) Year Maintenance Permit to remove dead, diseased, and overgrown or,invasive vegetation and trees; maintain lawn and current planting beds; re-plant dead or destroyed trees, shrubs, and flowers; and the addition of new planting beds, plants, and trees. Located: 1505 Yennecott Drive, Southold. SCTM# 1000-55-4-25.3 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 proposed activity 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. :525% 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 New'York State Department of Environmental Conserration Bureau of Habitat, Region One 50 Circle Rd., SUNY, Stony Brook, New York 11790-3409 Phone: (631)444-0275 - April 28, 2008 Alexander B.Grannis Commissioner Mr. and Mrs. Joseph and Kristen Frohnhoefer 1505 Yennecott Drive Southold, NY 11971 RE: NYS Regulated Freshwater Wetlands near 1505 Yennecott Dr, Southold, NY SCTM# 1000-55-4-25.3 Dear Mr. and Mrs. Frohnhoefer: In response to your letter dated April 21, 2008 and as a follow up to our meeting on April 18, 2008 1 am writing to inform you that the pond located on the adjacent lot( ;CTM#1000-55-4-25.4),west of the above referenced property is-NOT a New York State Regulcited Freshwater Wetland. In addition, the nearest New York State Regulated Freshwater Wetland is located greater than ' one hundred (100) feet from the above referenced property. Please be aware that this letter does not relieve you of your responsibility to obtain any necessary permits from this or any other agency. Please feel free to contact me at (631) 444-0208 if you have any questions. Sincerely, Kevin Jennings Biologist James F. King,President ��QF S0 P. Town Hall Jill M. Doherty,Vice-President 53095 Route 25 ,`® l® A P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen co Bob Ghosio,Jr. nk I Telephone 765-1892 Fax(631)1) 76 765-6641 COMM, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6869A Date of Receipt of Application: April 21, 2008 Applicant: Kristen Frohnhoefer & Joseph Frohnhoefer, III SCTM#: 55-4-25.3 Project Location: 1505 Yennecott Drive, Southold ti Date of Resolution/Issuance: May 21, 2008 Date of Expiration: May 21, 2010 V Reviewed by: Trustee James F. King, President Project Description: Remove dead, diseased and overgrown or invasive vegetation and trees; rake and level area; add compost and re-plant with trees, shrubs, flowers and grass. 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 Kristen Frohnhoefer, received on April 24, 2008. Special Conditions: None. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. cz't7--r' James F. King, President Board of Trustees JFK:eac fwp '• S.C.T.M. N0, DISTRICT: 1000 SECTION: 55 BLOCK-.' 4 �yXyW _�QT�S�:�� _ O1 22 ROIO-98- 150 Z' L.// r• - 'tee � ja � ;. . ,� ;.K -�'LN7Y L-1 EMR, r FW n.F!EALTFIi � = SERVICLS 0�'� I T �• � • ::)NCi.E PA r;1fr.�'EGf'\K.� tinR O� . . r�►o. O -- �� CK15�?� 'Mi/c.-.ercirca by thi, y ilttit;., at this foc2tian ha;•c been T►�ee ; >t ,::fiist�. Awe. r oltt:r ;•• . zcccrY t 0i2 �,+�, Jyi OF acnci.s ar:;, found to ) a. �c u.r - s� . .�.......... 1 hf7' r°stl�,P.E. Chief Office of Way ''LSUW Ar Mane 'Clea►`� r G� n P1uTU Rt ntedC4 j l F QJ -Tn S`fd-! -` X10 n tl ry Ne V61 .0 o � �f✓ , ov x - •h P/0 LOT 28 00 uL6 Cg:LLAR 2 SW FR.E jS.3 r a � EL 32.7 + rly ,By 4,0.E�'` 1J. pop °' z3,.s' POND N L '0 h cy— V" 141 10 • E—cj 29.09 CIE APPI;FOVED BY D OARD OF TRUSTEES APR 2 4 2008 TO u28-40 YEN WN OF SOU Southhold Town DATE S� %i"2 Board of Trustees "1 REA: 35o659.0 S.F. OR 0.82 ACRi>> - FINAL SURVEY 5- 17-; -_ 9-20-99 FDIWDAMM LOGITN UNAUTHORIZED AL MRA 7I0JV OR ADDI AON TO THIS SURVEY IS A KOLA 17ON OF SFC7)ON 7?09 q�- THE A1EW YORK STA T EDUCA TION LAW. C MAP NOT BEARING_ THE LAND SURVEYt�IR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICA 72 YENNECOTT BARK Covenants and Restrictions Owned By Donald E. & Lorna E. Tuthill Southold, New York A I. All of the premises hereinabove 7. No animals, livestock or poultry organized, the sums provided for in described shall be known and designat- of any kind shall be raised, bred or this paragraph shall be payable to such ed as residential plots. maintained on any lot, except for dogs, association. Such charges shall be pay- 2. No structure shall be erected, cats, or other household pets, pro- able ,by the owners of each lot, their altered, placed or permitted to remain vided they are not raised, bred, or heirs, and assigns, on the First day on any lot other than one detached maintained for any commercial pur- of May in each and every year, and single-family dwelling not to exceed pose. the lot owner by the acceptance of the two stories in height.No dwelling shall S.No lot shall be used or maintain- deed to any such,lot shall vest in the be erected, placed or permitted to re- ed as a dumping ground for rubbish Declarant, his heirs and assigns, the trash,main on any lot unless it has an ash, or garbage. All rubbish, trash right and power to bring'all actions enclosed garage, attached or unettach- or garbage shall be kept in closed against the owner of any such lot for ed, for not less than one (1) car, and sanitary containers, which containers the collection of such charges.The pro- all such garages and accessory build- shall be kept out of the public view trances. Ings must conform in architectural ex- and in the rear of the premises. visions of this paragraph shall impose terior design with the dwelling. 9. No building, wall, pier or any no obligation-on the Declarant, his 3.No dwelling, having a ground other structure shall be erected, alter- heirs and assigns, other than to apply floor area of the main floor structure ed, or moved cnto any lot, nor shall any moneys so collected to the main- of less than one thousand two hund- any preliminary grading to any portion tenance of said park, signs and en- red (1,200 sq. ft.) square feet, exclusive of any lot be donne, without the prior 17. Declarant, for himself, his heirs Of shall One-stOrY erected, porches and garage, written approval of the Declarant, , and assigns, agrees that, upon form- be , placed or permitted his heirs,and assigns.No mobile homes ation of an association of owners of a to remain on any lot. ' will be approved. majority of the lots, title to the park, 4. No dwelling shall be erected or 10. No fence, wall or hedge of over signs, and improvements at the en- placed within fifty (50) feet of any four (4) feet In height shall be per- trances shall be conveyed to said front lot line, except that the front mitted within ten (10) feet of a side association, on condition that the lot line setback requirement shall be line nor within fifty (50) feet of any association maintains the park, signs forty-five (45) feet as to Lot No. 58, street line or water front. and improvements at the entrances. forty (40) feet as to Lot No. 59, and 11.No clothesline, or other such 18 If an thirty-five (35) feet as to Lot No. 60; clothes drying implements, shall be y lot owner, his heirs or nor within thirty-five feet of any side maintained other than in the �rear assigns' shall violate or attempt to street line;. nor within twee yard area of the violate any of the covenants herein, t5 (20) 12. No more than fifty it shall be lawful for any other per- feet of any side lot line, except that ty (50) per- son or persons owning any real pro- the side lot line requirement for Lot cent of the existing trees on a lot may No. 13 and Lot 14 shall be such as to be removed without the prior written Pew situated in said subdivision, to conform with the then effective zoning approval of the Declarant, his heirs prosecute any proceedings at law, or ordinance of the Town of Southold. and assigns. In equity against the persons violat- 13. No major external construction Ing or attempting to violate any such 5.No trade ti business of any kind on any structure on the premises shall covenant to prevent him or them from shall be advertised from or transact- so doing, or to recover damages or ed on the premises, except that this be permitted on Sundays. other reef for such violation. covenant shall not prevent a la 14. Lots Nos. 8, 22 and 29 shall be accountant physician, dentist, o -mer' subject to the twenty (20) foot drain- 19. Invalidation of any of these age easement as-shown on Map of covenants by judgment or court order rist, chiropractor, chiropodist,, optoto- metrist or any other member of the Yennecott Park. shall in no way affect any of the other medical, dental, accounting, legal or 15. The entire Lot No. 28 shall be provisions, which shall remain in full allied occupation or profession from subject to a drainage easement. force and effect. carrying on his occupation or pro- 16. All lots shall be subject to an 20. These covenants are to run with fession on said premises provided such annual owe in such an amount as the land, shall be binding upon all Person„also resides on said premises. will be fixed by the Declarant, his parties and all persons claiming under 6. No si heirs and assigns, not however exceed_ them for a period of twenty-five (25) gns of any kind shall be Ing in any year the sum of displayed to public view on any lot, $10.00 P-r years from the date these covenants lot, for the Purpose of maintaining, are recorded, after which time said except that one sign of not more than and improving the park, signs, and covenants shall be automatically ex- one (1) foot square, upon which shall entrances to the subdivision from be inscribed the name, and occu tended for successive periods of ten a- Bo,sseau Avenue and Laurel Avenue tion or p . (10) years, unless an instrument is profession of the occupant of The assigns of the Declarant may in- recorded in the Suffolk County Clerk's the premises, and signs used by the clude a property owners' association Office signed by the then owners of a builder to advertise his property dur- that may hereafter be organized for majority of the lots designated on the Ing the construction and sales period, the purpose referred to in this para- shall be permitted. said map; agreeing .to graph, and in case such association is change said covenants in whole or in part. S C T.M NO DISTRICT: 1000 SECTION:55 BLOCK' 4 LOTS):24 22 !'L_C':_IVED C01iT`I 1' R010-98-150 F/I.O, j--, "LOT 29 V 30 Ut;10:20 r-OUNTYbCPA.47v!�WTOrMALTilSERViCr.S IT,,L'i;"J"JImICEiSlpprOVALOFCOMSrPJC1�D "Off"SFOR AL!,IRNCIE,A,,, " I&H FES.Ref,lqc,. &L 0 150 dkr,xrt:redbl and yjhI,D,,,. cVrolI;.^j p."c.Icjc5 err found t, Cn x,:nstztxory FORJ �AX%!UM Op El Root.— Aofli 0 SO cOSE%*px_chief friceorwa, "UstemArm ---------- -------- A, P/O LOT 29 lb &ry \511 P/O LOT 26 LOT 30 P/O LOT 28w 2 Sly Fp_W/TULI CCLLAR EL C,,q.l L 32 7 7; WOVM 2. Ir e0 I '7' im s S POND 0 < 0 % I LP Li _j 141 10' ............. ................... '20. 9. 73 382. S 7430'0Cf' W DW{. yENNECOTT 2640 LIL 112 ES__ OL FINAL SURVEY 5-17-2000 AREA: 35,659.0 S.F. OR 0.82 ACR 9-26-29 mawmaxi tccanom ALI D R ADD A �A 7209 THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY 0' myINS VE 5 VIOL "IN F SECTION O� M EMBOSSED m" SE 5 SH N 'Or CONSIDERED 70 BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN TION U N TH IIZE ALTERATION 1 0 01 SUR Y I 0 1 0 MAP NOT BEARING THE LAND SURVEYORS OS D EA' ALL 0 ONLY , TO THE PERSON FOR W4D" ME SL`R�'IS PREPARED AND ON HIS BEHALF To THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON. AND To THE ASSIGNEES0' 'r LENDING""""no, GUARANTEES ARE NOT TRANSFERABLE. "r 7 SHORN H, , , " OP""LINES To THE STRUCTURES NO, , "M M DN'MrNT W ME'mw EPROPERTY U,E TH ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE TENDED ' ME PROPER LINE OR m c D r ERE TION V ..CES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRUCTURES R U.... 'or GUARANTEED TEE,UNLESS I R RECORDED 0 R00 A, A A LESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME Or SURVEY PUBLIC WATER AVAILABLE [:) KfLL WATER El INDIVIDUAL SANITARY SYSTEM ❑ ELEVATION DATUM. SURVEY OF: P/O -LOT 28 & P/0 LOT 29 CERTIFIED TO: PETER DFNICOLA: MAP OF.YENNECOTT PARK AT SOUTHOLD PECONIC ABSTRACT,• PECONIC COUNTY FILED OCT. 9, 1968 AS '151'87 CONSULTING CORP.,• SITUATED AT.SOUTHOLD TOWN OF, SOUTHOLD KENNETH M. WOYCHUX L.S. SUFFOLK COUNTY, NEW YORK Land Surveying and Design Calverton, New York 11933 FILE # 98-77 SCALE- 1 30'DATE AUG. 8. 19 (516) 727-5127 918 N Y.S.UC NO 50277 maintaining the records of Robert J.Henneway I I ' J .v S C T.M. NO DISTRICT: 1000 SECTION:55 BLOCK!4 LOT(S):24 �O'( 22 !=,_Cr Iv[L1 r71_i(Cftl I"IT�l ROIC-98-150 F/o i'.or z9 _ s W I9AY 30 T. (0:20 ;:•'rC:i.K C('UMDCPARTMENTIJPILMgLT11SERViCLS �jDcPT C='tl::Lill".it'IICES an, OLAF CPi�r v OJy;TJ t1Ct�L 1YJ2KS GFOR '� t JNCLE IFAR1fI,Y R?siDTt:l 6 \11, / ' H.S.Ref.lta3(09 1'• +-..a.^,c Ets?'nt wd wntcT%%ply facilitic at this tocetfna t nvc yew / O 1e:r';a'.q C'IiYcr� iir,ed6 this x uaist9cicry POA Oma'" r oU 1 co ot.-s v„fond w / O B ROOK_ / o a / o owe, • Cost4 P E Chief I m OTIIce of W4� ''esteWotet M4r�e�- -- / P/0 LOT 29 a� R 1n P/0 LOT 28 I / °v. LOT 30 P/0 LOT 28 I/ / sdo Iqavti 19.1.2A: ccLLap q 2 sTM cl` � r T w�• ler sgta� 3 � I , s0 I j6.7r, fit. yepc O w� POND 0 O % I `P w J d 141 10 382.20' 5 74 30'OCr W211.09 R�V Etx 29.64 j YENNECO UL 112 UL FINAL SURVEY 5-17-2000 AREA:35,659.0 S.F. OR 0.82 ACRES Ill ,.-28-119 10EWDAI N LMUN UIVAUTHOR12ED ALTERATION OR ADDITION TO THIS SURREY IS A VIOLATION OF SECTION 7209 a'-THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING )HE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOINJ HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCE$ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE DME OF SURVEY PUBLIC WATER AVAILABLE ❑ ItELL WATER ❑ INDIVIDUAL SANITARY SYS7EM ❑ ELEVATION DATUM: ASSU40 SURVEY OF: P/0 LOT 28 & P/0 LOT 29 CERTIFIED T0: PETER DFNICOLAm MAP OF.YENNECOTT PARK AT SOUTHOLD PECONIC ABSTRACT; PECONIC COUNTY FILED, OCT. 9, 1968 AS #5187 CONSULTING CORP.; SITUATED AT:SOUTHOLD TOWN OF: SOUTHOLD KENNETH M. WOYCHUK L.S. SUFFOLK COUNTY, NEW YORK Land Surveying and Design Ile r Calverton, New York 11833 FILE M g8-77 SCALE: 1"=30'DATE: AUG. 8, 1998N r.s uc No �022� (516) 727-5127 m�InUlnlne IEe Mold.of 6oUert J.Nennenr. _ ___ __' -_-------r-- OFFICE LOCATION: ®��®F S® MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 ® �Q Telephone: 631765-1938 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: April 12, 2016 Re: Local Waterfront Coastal Consistency Review for KRISTEN FROHNHOEFER SCTM# 1000-55-4-25.3 KRISTEN FROHNHOEFER requests an Administrative Permit for a Ten (10)Year Maintenance Permit to remove dead, diseased, and overgrown or invasive vegetation and trees; maintain lawn and current planting beds; re-plant dead or destroyed trees, shrubs, and flowers; and the addition of new planting beds, plants, and trees. Located: 1505 Yennecott Drive, Southold. SCTM# 1000-55-4-25.3 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 policies and therefore INCONSISTENT with the LWRP provided the following: The proposed action doesn't comply with Policy 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction The site plan does not identify the location of regulated features (wetlands) and fails to identify the setback to the wetlands. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. �Of U�y John M. BredemsoTown Hall Annex eyer III, President �� 54 Main Road Michael J. Domino,Vice-President ~ ® P.O..Box 1179 James F. King,Trustee 4-C Southold,New York 11971-0959 Dave Bergen,Trustee Telephone(631) 765-1892 � Charles J. Sanders, Trustee io"uW , Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application Wetland Permit Application i/ Administrative Permit _Amendment/Transfer/ xtension Received Application: 31 o4,« ;�- `ti _• ;," Received Fee: $ Completed Application: _Incomplete: I _SEQRA Classification: ; MAR 1 4 2016 ` Type I Type II Unlisted i Coordination:(date sent): LWRP Consistency Assessment Form: t Soot,r•! Ta1u� t _CAC Referral Sent: -,----_.`�"'?`' `./ Date of Inspection: d3jI& _Receipt of CACReport: _Lead Agency Determination: Technical Review: Public Hearing Held: 20e Resolution: Name of Applicant: Erl's' -�en Mailing Address: Phone Number: �� —®" 1 (SJ✓I �� ✓'` " Suffolk County r Tax Ma Number: 1000 - 55 " –as, Property Location: Dr- , ,Sbftd (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: Boa' of Trustees Application t GENERAL DATA Land Area(in square feet): Area Zoning: �es& 1 a D r Previous use of property: Intended use of property: es 10,1 v n-h a#, Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes XNo 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 No Does the structure•(s) on property have a valid Certificate of Occupancy?—X-Yes No Prior permits/approvals for site improvements: Agency Date M M No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): ID Uear-_9DLnk fXrOf ' Remove d (� InV�l vo �- � - oc 0\,To e+ftfion CA\1n01freC____,> Mal A c lctwn C� 2) J n nki P'n �oe �_ Or OV_15tyD h mbS 1 � "` f . w Boa' fof Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: e.n n n 6 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 betwee nearest proposed structure and upland edge of wetlands: feet no pDoosw Does the project involve excavation or filling? No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? 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: 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): k 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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: I e Y� �l Perm& (� f1neCm Project Location(describe,and attach a location map): 5-br- � �� �� N Brief Description of Proposed Action: Io qeo, r rm�r encxnu pe mUVL11 Com, cats 3'r) dergWl o�� nW3l u� V\R) mcx_� _YrarLt - !� &�(zs-n1 a4+re�lc I aft or � -6 +revos,'2sh�u,� qowyxs ,"�kr) 1IL- Name of Applicant or ponsor: Telephon r E-Mail: Address: _ City/PO: 7�e�/ Zip Co e:3c)� l 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO VES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that f] F]may be affected in the municipality and proceed to Part 2. If no,continue to question 2. y� 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: ❑ 3.a.Total acreage of the site of the proposed action? Q9V 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? awy _acres 4. Check all land uses t at occur on,adjoining and near the proposed action. ❑Urban Wural(non-agriculture) ❑Industrial ❑Commercial *esidential(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? ❑ ❑ 191 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: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES TU 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: An' N ❑ 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: � v ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ 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? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline El Forest ❑Agri cultural/grasslands El Early mid-successional ❑ Wetland ❑Urbanjo�u_ burban 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? 51 ❑ 16.is the project site located in the 100 year flood plain? LNO 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 []YES ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: E]NO [-]YES Page 2 of 4 lk 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e g.retention pond,waste lagoon,dam)9 If Yes,explain purpose and size: ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponso name: Date: ' l T Signatur AA 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 I. Will the proposed action create a material conflict with an adopted land use plan or zoning El 1:1regulations? 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 El 1:1establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or El 1:1affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? El 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, ❑ Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 }i 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 El 1:1problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. ElCheck 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. ElCheck 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 c Boa of Trustees Application 1 AFFIDAVIT r BEING DULY SWORN DEP SES AND AFFIRMS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF 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 TRU EES DURING THE TERM OF THE PERMIT. ("Signature of P perty Owner SWORN TO BEFORE ME THIS DAY OF , 20_[_�2 CaS�n Notary Public CARRIE ANQ R N Notary Public -Stdts of Now York, NO.01AN617"52 -Qualified In Suffolk County Mr-Comrhisslon Expires ►a-3�`�5 u APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The 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 t - necessary to avoid same. r YOUR NAME: rflAmh 1) � (Last name,first name,qrt d e 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 ofSouthold? "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 Kapplicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted t is 3 day of��20d dY Signatu Print ame 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- 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# �7� - - •� PROJECT NAMEm - The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees t'lz 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g. grant, loan,subsidy) (c) Permit, approval, license,certification: l�e and extent of action. I n a oCrtnl r b OM-o dp-od !d oest - MaTMW Win I S\-)MA Y-,fA Pf k�d t�-n 'NOW _ _ \_11 U I loo�js �� C 0-,S,l , ` 1 f Location of action: 'bf, �6 Site acreage: Present land use: s Present zoning classification: S 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: ��'5-�en >h 1 ? -Q— (b) Mailing address: �� !�A �� SoAhb(d (c) Telephone number: Area Code( 1 � � CI X I 3 70 Abl how (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III–Policies; Page 2 for evaluation criteria. ❑Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III–P licies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Not Applicable .1 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 of Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 thro gh 21 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evalu ion criteria. ❑ ❑ Yes No Not Applical, c` `i Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes [] No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No of 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. 1:1Ye n O No t Applicable Attach additional sheets if necessary , y WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No of Applicable Attach additional sheets if necessary Policy 11.• Promote sustainable, use of living marine resources in Long Island Sound, the Peconic Estuary and Townters. See LWRP`Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No of 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 ev luation criteria. ❑ Yes ❑ No of Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Polici • Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY r %" 1 \ � �� TLE r DATE