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TR-8813A
John M.Bredemeyer III,President �rZI So(/l/y® Town Hall Annex Michael J.Domino,Vice-President l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski ® a@ Telephone(631) 765-1892 Charles J. Sanders COU Fax Fax(631) 765-6641 - BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1249C Date: August 1, 2016 THIS CERTIFIES that the as-built 8'x38' first-floor deck attached to seaward side of dwelling; At 1440 Kimberly Lane, Southold Suffolk County Tax Map#1000-70-13-20.10 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 19, 2016-pursuant to which Trustees Administrative Permit#8813A Dated June 22, 2016,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the as-built 8'x38' first-floor deck attached to seaward side of dwelling. The certificate is issued to LESLIE &ROSEMARIE WINDISCH owners of the aforesaid property. Authorized Signature 1 John M. Bredemeyer III, President Yom 0 F Town Hall Annex Michael J. Domino, Vice-Presidents yam`, 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A. Nicholas Krupski u ® f P.O. Southold NY 11971 Charles J. Sanders �'-.4,, o1 Telephone (631) 765-1892 =R� Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: �/�/1c9 0- 60,rc --r Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection. INSPECTED 13Y.- COMMENTS: Y:COMMENTS: OK A's &u'1f' Dec% - No ossvRS (vr ir')Aee CERTIFICATE OF COMPLIANCE: Y John M. Bredemeyer Ill, Presidento�� xoom .; Town Hall Annex Michael J. Domino, Vice-President ti` r f ti 54375 Route 25 Glenn Goldsmith %. ;. _ P.O. Box 1179 A. Nicholas �' Southold, NY 11971 Charles J. Sanders `o ,l r, iso Tele phone 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 1/2 constructed / V Project complete, compliance inspection S®llp John M. Bredemeyer III,President �.'®4‘ "q. - Town Hall Annex • *-t 54375 Route 25 Michael J. Domino,Vice-President 4 -'+.,yINE :-1143; P.O. Box 1179 Glenn Goldsmith y 5, "' :4 Southold, New York 11971 f4-re ck• A.Nicholas Krupski �` Telephone(631) 765-1892 � .® ® 1 Charles J.Sanders I • of Fax(631) 765-6641 . o BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8813A Date of Receipt of Application: May 19, 2016 Applicant: Leslie & Rosemarie Windisch SCTM#: 1000-70-13-20.10 Project Location: 1440 Kimberly Lane, Southold Date of Resolution/Issuance: June 22, 2016 Date of Expiration: June 22, 2018 Reviewed by: Trustee A. Nicholas Krupski Project Description: As-built 8'x38' first-floor deck attached to seaward side of dwelling. 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 Robert Barratt PE, dated May 15, 2016, and stamped approved on June 22, 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. , "04— Avt,‘ et461,..„704u. John M. Bredemeyer, III President Board of Trustees Client: Daniel Gale: Agent: Mariah Mills: Owners: Mr and Mrs. Leslie Windisch ' 1.1; w114.4":":771.2"-::: ."" ' ' ---_,,,r Property Address 1440 Kimberly Lane, Southold, NY 11971 SCTM# 1000-70-13-20.10 Pim-t�ctsT tic. sIN4C.E FAt�t�c y HousE A A Survey: Peconic Surveyors, John Metzger dated Sept 16 2013 'T - - ----'---_. 4 6r .,,, Qq Vic, REEK DR' . - \ _ - '�.�,,a.�r=z^„,`Y----. 1. i -` �r 1 \,:. ate,-: WadeTs 5-,:z.;:-„ EQVr�/ — �� 11 I r•� _ :•;Iockey Cr�- = L.. diiig - `'4 t '� ,,� ` — ' �, ”. - - E4 sults 1 ' - it g I iiz jr&-4-.----- oLin4 Tr_l:aP4r !i _ f itn`, GL �}V` z 7, 44'7`07 3 - 14 y, ANN? $ o I zw4. G� '�6zP \titer.. P,. .-}_. R'es, Q� C4` "..I ,ti •Southold �,,� : 13 Goose p `-# E o ,5. . o opf o .C� `,. d e • 1 • �� 4+ - -- -- L..f�— - �— Y ECJ-�5_k ,'• yr'r� c� r O • SCNOa 'may. I R i v V O P _ 3$� - ,� �(+'Jf/ GREAT HOG. r�.l" E�: .,.. _.,I . _ > L 13 � wl 1:4,,z,a. N r TrECK r� Q��Qr® � a <n/ JR ir � ' AS- tv ler D Ex._K A 2.$+A . • 310 $•S slr 44- - . Lcz> A-�- M P-•P a Sclace , 1t1 = cps mites _i Au.C Aas 4,3•'15 '—' t 11 II II Il ,. 1..L._ I It I! — - jr 14i-5Loort. EL.E�tA-T(° /J r{ II-II - - -- 11 .11 II I • 1 ' Ill - / r it w L t 2�E AP4aox 1) , _ — ---Z" - ' . FIF",7., . ii! i �_ _� f : ` ` BOARDOFI 1USTEE ` 1 9 2016 <'FOtictNt'�S \i' - . Li 1 wry%T StcE G_Li= vA-tEor4 _ - .. _ 'OWN OF SOOT 'Ste"r� stye Erre art? ,>+ Southold Town Bill of Materials for first floor deck .�_ - DATE -VAIE 2Z, 2-016 ',' L . .. Titi tcQ. i - Footing pads, poured concrete approx. 6in thick with four pieces of#4 rebar / j Soil around footing pad shall be tamped down around each support post hid _/ ; Caution: when using treated lumber, use galvanized fittings ;' : : ^'"`� 140515 Rev 0 Dated Ma 15, 2016 General Arrangement Posts: 6in x 6in ACX Treated lumber or Builder's choice on 8ft centers or equivalent. Design conditions, ice/ , .r Title: First floor rear deck . Beams /Girders: 2 x 2in x 8in -Doug Fir or equivalent Live load 40 psf ��pF NEW- ,''X,-;-:,- Joists: 2in x 8in oc 16in-DougFir or equivalent Dead load 10 psf :�P o -' Ledger board 2 x 10in- Dou Fir or equivalent Snow load 45 psf _ - �� o ' ��"" �� � Robert Barratt PE. 4295 Vanston Road Cutchogue, NY -11935 g g- p " - �„ Tel 631 875 0275 robertbarrat*�a'Ptcnline net 5/8in x 4in carriage galv bolts to fasten ledger board to avoid internal services Wind Speed 120 mph * (4',1,,,- ,-:,a.,,_ `. Floor boards: 2in x 4in Timbertech or equivalent atl '� { ` These plans are an instrument of the se vice and are the property of the Termite Moderate 1 ..w. \%\- 4�1 1�! ,'� ' dese fneSa iXed ilcreta. InfringementsTecos and 1/2in gale lag bolts shall be used throughout Decay Probability Slight +`!=.� �, P , ZMAX 6inx6in wet post anchors Weathering Severe LP p81 1 prosecuted to the fullest extent of file !aN Contractor steall verify all fic'd 1 responsible for field fit. The , Railings and balusters, etc. clients choice Seismic Design C iORpF �,�� conditions and dimensions and be solely respans� Stormwater management: Firm Panel g 36103C 0166H E Sto design Professional assumes no liability for omissions due to unknown or . The house is equipped with conventionalgutters and leaders. Flood Zones X and VE el8 $ �� � unforeseen`"teld conditions and or additions based upon comments not formally acknowledged as revisions to these plans. 39. IA N og����.2 5� ,� SURVEY OF PROPERTY . . . r \ AT SOUTHOLD ,�, TOWN OF SOUTHOLD :- ;, _ ;, ,� r EL:"9.2' - •SUFFOLK COUNTY, N. Y. • Ir -; r ��, 1000-70-13-20.10 . ` t 1) VI f - SCALE: 1'=40' i MAY 19 2016 t o • . NOVEMBER 7, 2012 •+ , R= 60.00 - Dec. 4, 2012 (addition) r - • Southold Town ' L- 35.37 % JAN. 17, 2013 (prop.pool) , - `,p\`�;.vi I�:1 ��' ` FEB. 5 2013 (prop pool revisions) L_...._. _ _-4Qinn uriz sir _." .. 1 •. o�` �\ MARCH-6, 2013 (revisions) i -Po4� o Nv MARCH 7, 2013 (revision) • ��`�,. — '' - APRIL 8, 2013 (revisions) s EL. 9.6' \ �!�,►, N. JUNE,14, 2013 (revisions) \ , 03 JULY 30, 2013 (revisions) • \ A SEPT. 16, 2013 (PROP. POOL) \ ' , MAY 14, 2016 (REVISIONS) \ PAST g�R N E - \ 414. a . \\ ��� • LOZ 9 30,c);--1-9" °/ '\ by \\ 'ii �� ` o 14 - - COs \'`,83 , 9`F \ cif. - k. ,—' TOP bLKU. I ty \ c0 DRIVEWAY xpeN r- EL. 8,4 \\ • y 'u'• s '22.20"E �_ _ ,.. - o \� �� BB CURB 1454_�BN- _ \ ` ►Q- . \ N \\ y 1O 3. 01 - v. \ W EL- PRS• Q' • w 0VJa' 'ate \ ' - • . c§ \\ O ST O gi - �' I A \\ �� 34.9'• '(xjt l ow ij�' 'i _ W00p 0 • W J y .o 'M''.4- n- .1 -p (7 ,- - W W I LOT COVERAGE \\ 0 , �'-n r. y '`s.,;:o'x.. = - Z O -' RAMP Z CI F • EXISTING o\ 00 P O*.N•�, ' =Is° 1 ,T1 cn N I HOUSE - 3540 sq.ft. �\ IM -- 1 o m�V'y`4-ci - .A '5' In •'o , SHED - 102 s .ff. _ N\ - . RS .✓i.� r " , 0 3642 q �.\ !e4 P `, o 1'. ` ✓s mG'c 4.e'„ir'. r 1 I 3642/58505 = 6.2% °�\\ T a O �- m I— PROP. POOL - 570 sq.ft.u - »z ►— TOTAL 4212 s .ft:' \ N ;�`� -a_ o ¢” O 0 0 } 4212/58505 = 7.2% va \ 0 3 >. a CO o O �\ 39.1's04011'-.� Zti $ FLOOD ZONES X 8 VE (eI 8) \ ��`�����.✓`�����✓�►✓✓���.. o W ti I M FfRM 36103C0166H , `, ,0%4`��ei 4. +14 " = r by-b. _`�A** VERS 1041 4Va rn z 1 N ' `�lpl`.1 P A `�' 4)- \'TT% 63'•3'_ — —36 • W c/� 5 LOT NUMBERS REFER TO "MAP OF PARADISE BY THE BAY' ��`����4`��✓I�,�'4``0��• \ SHE — W o FILED NOV. 4, 1976, FILE N0. 6463 AT THE OFFICE OF THE �'�`�=��✓���✓� I - ;= `t - of to ��f SUUFOLK COUNTY CLERKS. i..to \ , _!� 0, Lo TOP BLKD. / %,,-b�.IAP L AREA= 58,505 SQ. FT. To Tie Line EL. 6.6' .. �`rr ��, EL. 8.4 'N • • —X—'�=• _ _ _ _ _ N79 35 20 W is;�, <,•. ;f- ELEVATIONS ARE REFERENCED TO N.G.V.D. • N7935'20"W x �- 187.70 " 78.85 .* �; 0 p,0 f% m ;r.�� ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION �1p'`Zb O0 ' ,� 4V°1t Ll �44 49618 OF SECTION 72090F INE•ANEW YORK STATE EDUCATION LAW. 2 . �P CONIC• ��q�S ,o, si EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERT7FICA77ONS NORTH ' ' A 'VIEW ROAD (631) 76 ;: • tf.dOfk,76 '''1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF �� P.a BOX 9 ;PN)S'-..>• SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF 774E SURVEYOR 1230 TRAVELER "StRELTp'p• 88-675 WHOSE SIGNA 7URE APPEARS HEREON. SOUTHOLD, N.Y. 11971 _�� , John M. Bredemeyer Ill, President rSSuff°L t Town Hall Annex Michael J Domino, Vice-President �� G 54375 Route 25 � yam,, ° Glenn Goldsmith P.O. Box 1179 A. Nicholas Krupski r, ^+; Southold NY 11971 Charles J. Sanders ,1 h` p�` Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: (10/17/16. 13! 00 , in field by: IVa Robert Barratt on behalf of LESLIE & ROSEMARIE WINDISCH requests an Administrative Permit for the as-built 8'x38' first-floor deck attached to seaward side of dwelling. Located: 4296 tton-Rcod, Cutchogue. SCTM# 1000-70-13-20.10 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=/ 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 1 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: Chck- w f Bob B 0(i0,4f bo`v- a s c ��fie ill p ecV. up arifo_+ art, �J o (eql tsstes. Present were: I" J. Bredemeyer M. Domino d G. Goldsmith v N. Krupski !`/ C. Sanders Other Page 1 of 2 John M. Bredemeyer Ill, President pSUFFO��� 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 �,�oao Telephone (631)'765-1892 rf� Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: - Completed in Work Session by: Robert Barratt on behalf of LESLIE & ROSEMARIE WINDISCH requests an Administrative Permit for the as-built 8'x38' first-floor deck attached to seaward side of dwelling. Located: 4295 Vanston Road, Cutchogue. SCTM# 1000-70-13-20.10 Ch. 275-12 - STANDARDS FOR ISSUANCE OF F 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. 5525% 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 lik. , 1\ii ) li Ili Looking east from center of deck /4frow by 0r/104 ,.- / --.....„ 1 Looking north from deck /4/0040IiillK. 11 j Looking south-east from deck down steps to grade /V00 Ae. oC/tft` Neal V'roperty Tax Service Agency .... I::_, 7.-7-,: ::-.7,1._-_-.!..r---__-7--7:..- --,..- --_,,--- ,- ;,- - . m'i•-" -- -=---'':=, = T-,.-. .-.7.--,--.- -...;_..;,-;.:,-..•- --,1.-,4_,' - ,--- -- ,-,--77-. 'irALc''''' '.:' ''.ft."rut.' --••''''' '--:' '-'"-----.'''",-- ' A'. - -"-fr'' ''' '• ' "OOO - PERMAP ' -- ' '-----'--,-"..1-_-'-----=- _ „,,l,:,,,i', -,-1,-- -,-;;-*,--"--- -41'''''''''''." --.-----'...::'.''' ' -';-` ,Z,‘•,:::;''' .."-; ,'":i'''''''''':'.'''' _ 214.3T MATCH SEE SEZC- NO 063 UNE C'R ;.;..:zT—o—wpn--ItC-47- -1Z;77 ....:,1 ' 1* ,-, - 6 TOWN 0E30111110M 66 22.3A(c) S Mi..17111.111621'AM 232 •%, 40'c ., . '#,I,' „.,,, . ., . -----... ' ' CALV'ES4:5ECi ,. /,. ,„____/ ILMEMO2rn tnr. 1 eft in(J)MP= SOU-THOU)SCHOOL DISTRICT NO 5 (' 0” 18. .401441/Steti LA. ME . 0 JASMINE , . ..,-"' .• 0 ___ , ____ _____ __, . ? .._.„ .. , „L._ k' _ ___,........_—_,....j. (.. -...._ ......--\ 1 I -4. • ----_ \ 12,,, / SrA(c) N..... / ' N 7-......_ .--..., , i 4111114r j A. m ,---. 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""1 41113111111111/111P1'idlil litigifili SOLMi0O1 gia r. .27 „:26 I 25,. i 2: -8 2: In 0 illa ." "s culrER . . * • 1329 ,i 30 32 i.1 _34 ,20 ,,,,. ,,,, 25 71 00 VS %V, „,0 .212. 0114 I., . 8 RA cmc 18 . Zia 1 : : : ..--- 4 , - _24..6.,,..8.1 1A-cy 2111 ,..6c 6',i3O., ' " " ". • m, 2,1•.. 001 11101310 'UR,litt 11011 Ulla Illatir:111114 1!1, 151 1 ill.74. 13+31 dk ' T. ammo sairk111101111111131**ilk: ' 1 , -.- - -.'----;;„:.....35 q_....__- --: I' 1"IVIP 26 7g :. 19 - ,_.2111111:842 Ii8 888 438 -" ••62 : liphstOfilf In MEIS 1111111445 6 ----- r wirmack...57---:\ 4 2A ' VIS . ss 1 - acAR"Ew.. .AME .. 7.. : 7^ 7 .-t-'':',„,30;2 1 0, 60.64r ____„ REE.,...2./ _.,,,/-/j)1 8. 9 46 . gam 45E2s.: • 12A e. SOUTHOLD Wit '-'-',- '.----,,s:2-. --.-:•-..-:.-L---°• - II 24 I: - 53 E. 125 \.n .r—F.2-/ nil no RI Fr LTow-Torsournot.n S - - MATCH LINE ! P137,1 -.' ''-'" '• ,0,,,,..77 •--,.. , ! -. - ,........u. --...--1.......... -.-- ''''''''''''''''''''''-1,1_,..._____ „NOTICE t mem,.mem sm.*. P, emu. ... s...••E..... (21) ® m mm m. ——.—— mm)mme. ——m—— 0,,o, , Ing nn.n.InIOAINGOSInnTS .. SECTION NO ,e`"w1")-t ReaCIO4NpTYerty0TFa:LsWenTcLeKAgeOncy r'ili.' 0.3 %- -....", - souThoLD WOAD.SALE On c yam 42 PS TILIRMON Of AM/4.02110,4 OF RE ,. , , ......'.• --,...--,+..-. ,....,......... wrap wt...of. county Cam,ilwernma.N 7 11901 070 SI.FinLN COWRY DR YAP 13 PROVEBTED . , on... . ,1,,,,,,,,,,,, ,....y. ----- , nn.--. SCRE PI FUT PA AD Ko A c......... 1,1461 8..8'. P ors oisNaCT NO ino PROPERTY MAP . COMO..OlnE.1.A.Ana _ - . . ,_,__, .„.". -=-,.....7=--,-,- ,..-....,,,,-2:7t".;:::,;-.7-::.*-T'.,7:.::,--,74-'::::',-,:'::,1.71-z,:,,,,,,,-,,,,-_._ . 1„ .,= John M. Bredemeyer III, President ��f� �o�: a�T. ./0e• Town Hall Annex Michael J. Domino, Vice-President I -. ;:.'#°els 4 54375 Main Road .K, tts'. ,btSg .t" • P.O. Box 1179 James F. King,Trustee % s•:„+;, �5.1'4%'y ye % Southold, New York 11971-0959 .y&.b z•, •"moi Dave Bergen,Trustee • G �:r^''•P 3 , �� Charles J.Sanders,Trustee � '�• OD •••1:2:'.:•.”' �� 0 Telephone(631) 765-1892 �,yG,oU �ot Fax(631) 765-6641 BOARD OF TOWN TRUSTEES20 L ©{ U [V TOWN OF SOUTHOLD D To: Southold Town Building Department JUN 6 2016 Re: Verification of Building Department Permit Requirements BUILDING DEPT. TOWN OF SOUTHOLD SCTM#: 70-13 - 0_0, 10 Property Owner Name: ' Date Sent to Bldg. Dept.: . (4°`(4 - The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? - Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: • or +, ,' eviewer Date 10 i e e er -_ .;._ 1pf SOUtz,- OFFICE LOCATION: 11 ® MAILING ADDRESS: Town Hall Annex �� ``® ' P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold NY 11971 ctc Telephone: 631 765-1938 ®��c®UNT`I,� '11 ��... •,S 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: June 20, 2014 Re: Proposed Local Waterfront Revitalization Program Coastal Consistency Review LESLIE & ROSEMARIE WINDISCH SCTM# 1000-70-13-20.10 Robert Barratt on behalf of LESLIE & ROSEMARIE WINDISCH requests an Administrative Permit for the as-built 8'x38' first-floor deck attached to seaward side of dwelling. Located:1440 Kimberly Lane, Southold. SCTM# 1000-70-13-20.10 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 actions is INCONSISTENT with the Policy Standard (Policy 6.3) and therefore is INCONSISTENT with LWRP which states: 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 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. A Wetland Permit for the deck was not located within the town's records. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. • .ii 2. i John M.Bredemeyer III, President o'���J� esojhQ Town Hall Annex / ,`O �O : 54375 Route 25 Michael J. Domino,Vice President "� • P.O.Box 1179 Glenn Goldsmith G :f., t. % Southold,New York 11971 A.Nicholas Kru ski • QP . ,c` „ , ,O I Telephone(631) 765-1892 Charles J.Sanders ' cool�' uN --A,�1°. Fax(631) 765-6641 �•°i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicatio Wetland Permit Application Administrative Permit Amendment/Transferxtension Received Application: %.5t(7t I V Received Fee:$ 2QOtC -- IZ,-614,4t Completed Application C.(a 1i -Y :`.- Incomplete (''" � ., _I�.4._.�_-�._"_ _ - SEQRA Classification: Type I Type II Unlisted ii,-.,., ' 1rµ,' , '1,Coordination:(date sent) , MAY 1 9 2016 LWRP Consistency Assessment Form CP,7/Lf i CAC Referral Sent: , Date of Inspection: 'i/5;/(p i h Soe'FT.l t ,r6:6 } _Receipt of CAC Report: L,_ __._Bv^'•ra lrr ___ ,.i Lead Agency Determination: Technical Review: r V Public Hearing Held: Co.ZZi(�i Resolution: Name of Property Owner(s) LE S it 8 Zr RO S C— MA(Z l I, W o N o) S el-{ Address 144 O K-1 M 8 E2 -( LANE t So vrt--tcrt!D t tV•f I I q7'I Phone Number:( ) ( .®3) 53$ S'4s%4 Suffolk County Tax Map Number: 1000 - 0'10— IS, "2-4:::Y•o‘ 0 Property Location: 1it.tvC. E ASI O•q Mt L E S 0 N Pi r.EI f MGCIC R dA 1> TupiJ LEt;;r Amo, Dfl."J 0-31,,IR.Gs, Sovc—O ja Pg.o)PER.Ty . (provide LILCO Pole#, distance to cross streets, and location) AGENT: 'Rolla1LT f3Aizv .Ain T (If applicable) Address: 42:9 5 VAN 'Tota IRo A 0 , , , CvT 0044s <,d e t NY I f g"3; Phone: 10,11!"-/SLI -21 %0 Board of Trustees Application 3 GENERAL DATA Land Area(in square feet): S`$, S:<,5- 1 , Area Zoning: RE,S I bexit't At, Previous use of property: Ci, L 'E tzA-M 1 t,Nq 14,t44-C-: Intended use of property: SING Le F-A.M ti o OK Covenants and Restrictions on property? Yes ✓ No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? I Yes No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes \/ No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Does the structure(s) on property have a valid Certificate of Occupancy? ✓ Yes No Prior permits/approvals for site improvements: Agency Date Sou-r e_D, TRUS i EES ti/Gr St,oIPeMIA1Ce 9001.. No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? f No Yes If yes,provide explanation: Project Description (use attachments if necessary): INSTALL- R.FA2. tST FLoort. pECIc. SEE :s10‘.044 14051 g ELY O DATEb S/15/14 Aa'p SO Rv DATED 5/14/ 1( ATT AC 14 ED -. A CL = ePs38 aof Trustees Application_ _3=ttt�==; 4 WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Pt t D E P 0.-Q.A, `o y g -AstJ Ftiz osCii I' ,,, < I_ _,c_ } / ) f"., it t-,c_ Area of wetlands on lot: ® square feet Percent coverage of lot: 0 Closest distance between nearest existing structure and upland (Wm®a IAtANgeab)- edge of wetlands: ►Z,tz) feet (TIE_ Closest distance between nearest proposed structure and upland edge of wetlands: i 9 5 feet Does the project involve excavation or filling? v� 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): 4 ;,tee•c'Ji,-'=. .:c. _,,_._w a :3:L=-'-"__.171'•.-.-7- -- - -`- ------_= ------- 7.7.- _�` :'''-'•, ,..,,� ":'•" - -: �.=-.:_., __-_.:=_� _,:__ .___,1717_..,_.... S 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 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 1 N�t/�J LL 12E A i2 t�E C IC:. -- C V 12._12E/Q1 O w ra ere__ Name of Action or Project: NS'c A U..• c12s-c b.1rC(L ' Project Location(describe,and attach a location map): 1440 0 Kl1 13,E:2 LY,o t LA KKi." PA/44-*k c 4- OSi,5' Ev 4,ou Brief Description of Proposed Action: 1 0 145.-r , 7T-c) ,1-}ovs E STEPS' To I i i ! Name of Applicant or Sponsor: Telephone: <' 203 S 23 r8 S (W, t-C.S LUE 143S W'I ni IN, SCK E-Mail: 11101k Wt A oke ScA Z,oM Address: 44. KIIM l3EtiL-/ AAP City/PO: State: Zip Code: Sk>V113o c.D-) N,•yr tt 9? 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 n n 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: ❑ rl 3.a.Total acreage of the site of the proposed action? 0: o O`i acres b.Total acreage to be physically disturbed? p. p p`7• acres c.Total acreage(project site and any contiguous properties)owned l or controlled by the applicant or project sponsor? 1. 3 C f acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial !Residential(suburban) ❑Forest ❑Agriculture El Aquatic ElOther(specify): ❑Parkland Page 1 of 4 6 5. Is the proposed action, _ NO YES N/A a. A permitted use under the zoning regulations? I,, b.Consistent with the adopted comprehensive plan? X 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: x n 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES >C, ❑ b.Are public transportation service(s)available at or near the site of the proposed action? El n c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? n 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: x n 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: El n 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: El 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: IN Shoreline EI Forest 0 Agricultural/grasslands ❑Early mid-successional 0 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? El 16.Is the project site located in the 100 year flood plain? NO YES ix 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? DNO nYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: n NO nYES 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 INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n e: LE$ L-1 E W!NO/ Sed-1 Date: /l l / KGs Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: 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? 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. • nCheck 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. nCheck 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 -- Bork_ -of Trustees Application AFFIDAVIT LE C LA-is /VI)! S C H 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. `21V.,C5Z/1 Signature of Property Owner SWORN TO BEFORE ME THIS artik DAY OF , 20 /J Notar' _ r PATRIC A.PETRO NOT YPUBLIL' f Wit Commispm Exite,s 1:oe of Trustees Application 5q AFFIDAVIT ROSE m ' ', /(a eA)/A)4. I V C k/ 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. 144e44tA,. .0.4.;¢,e1 Signature of Property Owner ---A,_ SWORN TO BEFORE ME THIS /X DAY OF 7 ,20 i ' o_ary Public -.. PATRICI A.PETRO ; -- / ` NOTARY PUBLIC v Corsnnissioo Expires 4� . L/, - _rs.±±'o-e ,-o-f' Trustees Application- _ - _ _ :77'" tO AUTHORIZATION (where the applicant is not the owner) I, LE5L.d& iJ iiO s H residing at 45 EDW IIJ CT (print name of owner of property) (mailing address) C U t L.FoR.0 CT 04 431 do hereby authorize RO&Ea.T' (Agent) $A R2A TT to apply for permit(s) from the Southold Board of Town Trustees on my behalf. t r (1 • *Z---e-tr-e...A€ (Owner's signature) Boa; of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Rosa NAME WgaA,s 14 residing at 4S EOWIN Cr. (print name of owner of property) (mailing address) e.o.m.. FORD , CT 04 437 do hereby authorize kot3ELT (Agent) 6AIL,L TT to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) I 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.Thepurpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: L.E L F 'E W / N 64 N ,C H, (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 If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP l�, a N - - - - - - Submitted this ,ei ay of AI Ay 2006 4, Signature Print Name LE-,..s•LP a Lv t ry i�i.d"C Form TS 1 (4-1( ficive/er-c) r--4-it 5); e� - riee " s _3 Tei,17\-As� I 10. • • APPLICANT/AGENT/REPRESENTATIV1 TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethicsj,rohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is • necessary to avoid same. - YOUR NAME: R.'O)S M A-iti( UJ I C - (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 interests'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 prodided- 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(whefi the' applicant is not a corporation); • . - C)an officer,director,partneF,.or employee of the applicant;or - D)the actual applicant. DESCRIPTION OF RELATIONSHIP No.N • • • Submitted th' I�' day of i�R 2fl IL Signature _id ch.zei Print Name 'DSt live Q. 10 9 I Form TS 1 Town of Souihold 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# '1(C - IS - 20- tc PROJECT NAME I44C ILIM?>�Gft'.,Ly/ The Application has been submitted to (check appropriate response): Town Board Planning Board Building Dept. Board of Trustees X 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity, agency regulation,land transaction) (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: INSYFLEA(_ FI2.St FL (Z '( K. ,,T (CZ A R.. OF Sr,ntc LC F-P M;aL'-( i-41):we' Dlvc-iC t: ->" '3$ Location of action: RE;a, o) s%C Site acreage: 19 4. Arc& v Present land use: S'tud.LC AtitnL l t+oML Present zoning classification: t2.EX,1 4: nii t I3TL 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: 1-_,€; LAG t ewe. MA at W t N'A t S(k (b) Mailing address: 144o k l M g, L.( LtAt.)E So crAkea-357 NY n lI (c) Telephone number: Area Code( ) (?0 3)— 5 IS — 5 S 8 Co (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. I)' Yes No Not Applicable Tye b Ect& •W c e e., MU A4 AO C :7 144EOW N €R'fS C P'c'2-I A xtC4Cr o,r- O''W' '86Au-) FVL. Q4 r . Fko,sji Mdoit4 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 I'% Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes No X Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes No 0 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes No X Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ E^ Yes No N1' Not Applicar' 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 )X 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 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. YeJ No k Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES r__ �6 Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes ❑ No X Not Applicable ` .1 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 evaluationevcriteria. Yes ❑ No lx 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 IC Not Applicable PREPARED BY 'Rce>=R.r .Qa R,L4Tr TITLE AC,gN1' DATE 511/116