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HomeMy WebLinkAboutTR-8986A Michael J.Domino,President �*OF SQUjyo Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 3 J3 P.O.Box 1179 Charles J.Sanders CA Southold, New York 11971 Glenn Goldsmith ® a@ 'Telephone(631) 765-1892 A. Nicholas Krupski lij'C®U 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/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection C0,1 nom-{- ('cp r✓ so-PR,11C_ nv1Y01\6v1e_14r_-,( / 7//Jr/1- _ f _ *pf SO(/jy Michael J.Domino,President Town Hall Annex�O� Ol0 John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith ® y0@ Telephone(631) 765-1892 A. Nicholas Krupski ®u 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/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection SOF S01142, Michael J.Domino,President � Ol0 Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A. Nicholas Krupski Fax(631) 765-6641 ®U 5 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8986A Date of Receipt of Application: March 23, 2017 Applicant: William H. Price, Jr. & Susan P. Anderson SCTM#: 1000-55-3-30. Project Location: 1345 Long Creek Drive, Southold Date of Resolution/Issuance: April 19, 2017 Date of Expiration: April 19, 2019 Reviewed by: Board of Trustees Project Description: For the as-built 16'x26' (416sq.ft.) attached deck,with 4'x23' (92sq.ft.) steps.). . 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 survey prepared by Peconic Surveyors, P.C., dated January 24, 2017, and stamped approved on April 19, 2017. 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. Michael J. Domino, President Board of Trustees SURVEY OF PROPERTY - A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK; COUNTY, N. Y. z^i�0PINO 1000-55-03-30 SCALE. 1'= 30' JANUARY 24, 2017 ' .G'F�E'EK ++ •LANDWARD EDGE OF THE ��, fee) Ngo-0555 E � _ TIDAL WETLAND5 A5 DETERMINED DY 5UFFOLK ENVIRONMENTAL CON5ULTIN6, INC. 2 6 5a 5 ITE UNE ON 5EMIOEK 27, 2016 10 a co : ���"� 4-• 11.°1 E LINE---- ' 12- - -- -- - -- 1� �- / �0 l ►c�'' O T 14 X15 T!O pR1 co*- 01 WOCO W1 pE(.K cmf � -o N � A. O- �-C qg r 16 �' O O -1 O W W�- �► ---- ------ -- \ O 0 o �s \10 100 p0, I S V e , 10 /6 1� LL 16 `r 77 �6 N � e r• APPROVED BY CO � BOARD OF 'i-RUSTEES y TOWN-:OF SOUTHOLD DATA vIc ■ - MONUMENT , = WETLANDS FLAG _ p ECUVE FLOOD ZONE5 FROM FIRM 36103G0158H MAP EFFECTIVE DATE- 5EPTEM15EK 25, "'1I MAR 2 3 2017 0 El EVATION5 AND CONTOUR LINE5 ARE REFERENCED TO NGVDf+ LOT NUM15EK5 REFER TO "MAP OF YENNECOTT PARK" Southold`awn 1 �' C,• H OE FILED IN THE SUFFOLK COUNTY CLEKK'5 OFFICE 6 rd iTruste ; = ON OGTODEK 9, 1968 A5 FILE NO. 6173 < �° ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION LIC. NO. 49618 OF 5ECTION 7209OF THE NEW YORK STATE EDUCATION LAW. PECO RVEYORS, P.C. EXCEPT A5 PER 5ECTION 7209-5UDDIV1510N 2. ALL CEKTIFICATION5 AREA=23840 s .ft. (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR TH15 MAP AND COPIE5 THEREOF ONLY IF ' sq.ft. BOX 909 SAID MAP OR COPIE5 DEAR THE IMPKE55ED SEAL OF THE 5UKVEYOK t0 TIE LINES 1230 TRAVELER STREET SOUTHOLD, N. Y. 11971 16-110 Michael J. Domino, Presides` QSEFUj�� ,' '1Town Hall Annex John M. Bredemeyer III,Vice-President ��,�Z �} 54375 Route 25 Charles J. Sanders r P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: � `,S 1���1 Completed in field by: cA AVLO �, sa Suffolk Environmental Consulting, Inc. on behalf of WILLIAM H. PRICE, Jr. & SUSAN P. ANDERSON request an Administrative Permit for the as-built 16'x26' (416sq.ft.) attached deck with 4'x23' (92sq.ft.) steps. Located: 1345 Long Creek Drive, Southold. SCTM# 1000-55-3-30 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 y 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/NWetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: r Present were: J. redemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 Michael J. Domino,Presides; ' o�QSUFFr71�COG r Town Hall Annex John M. Bredemeyer III,Vice-President �� yJ, �j 54375 Route 25 Charles J. Sanders = P.O.Box 1179 co Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ?' p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Suffolk Environmental Consulting, Inc. on behalf of WILLIAM H. PRICE, Jr. & SUSAN P. ANDERSON request an Administrative Permit for the as-built 16'x26' (416sq.ft.) attached deck with 4'x23' (92sq.ft.) steps. Located: 1345 Long Creek Drive, Southold. SCTM# 1000-55-3-30 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 PRICE m ANDERSON • - Situate: 1345 Long Creek Drive - Southold New York 1000 i (Photo taken on February 27, 2017) 14�«• s �, �l,M � � ,fff f • � t Photograph PRICE ■ ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold ■ New York SCTM #: 1000—055 —03 —030 (Photo taken on February 27, 2017) 4 Y Photograph indicating the existing Decking& Stairway located off the northerly side of the existing dwelling. Photograph taken from the northern section of subject property, facing south. -PRICE m ANDERSON Situate: 1345 Long Creek Itrive - Southold New York 111 1 1 030 (Photo taken on February1 Ak Photograph •icating the conditions within the n1 1 of subjectproperty, • the bank elevationand flagged wetlands boundary (yellow 1 northwestern1 of the property, ' northeast. PRICE ■ ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold ■ New York SCTM #: 1000—055 —03—030 (Photo taken on February 27, 2017) i J Photograph indicating the conditions within the northern section of subject property, specifically the bank elevation and flagged wetlands boundary (yellow circle). Photograph taken from the existing deck, facing north across Long Creek. PRICE ■ ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold • New York SCTM #: 1000-055 -03 -030 Gardener's Bay Country club er • 15 � 1345 Long Geek Or— Ed tg18t O ' *14, Slrher Island e r, as2— P-- Raphael Pec— Raphael Q H.- cellars 11345 Long Creek Drive Lyle EiSenieig,RPH 0 Safety Quest SEE SEC NO 051 SCE�scenu os o MATCH __�_--ONE cu—� v � '- t WC) FOR PCL NO SEE\ WORTH b R 052 5-06001 EC O\ f�G m 14 22A(c) no R 14A(cI m �'y �� ♦3(\ 2s.t _ s � .6 F .° e � aim a 2p `�` BOGS e �` t.�c 2Wc1 200 " 1 to 54 , P 45 15n(c) e G cF i0A ye -� 6 Lbi 114p,{o\ 41 i 2 O3 y 20 OA a e` ry♦ etOtt �(c 42 „51 ?DAA(.) 4' fit ytNc\ yz5s H1 D B Deskc) ^.� t9 c3 1 Y - t 96 (c) 20A id d s3 G 812 6s 90 73 20A 1 m • 616 'A (rouNfvocsvfiout -w 21-R �' ONG SEK 6 ♦s OE1aLot•'uENrPo[:Nls) ~ '' $ 7 13A 3 w 615 ,7 a 6 s ® '� S ♦9 e e e 103 A-worts 0 11 5.4 S SOP .moi` S` BSA m ? ~ - (cOmrrrOFsaruA L w to t 2 ma0warwcNry ' w _ 36 13A O C i,54 V ® 12cA(c) t0A J$ F� , f . 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Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) �s Southold,NY 11971 a� Telephone: 631 765-1938 ® Fax: 631 765-3136 C®U�fiY,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM . To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: April 13, 2017 Re: Local Waterfront Coastal Consistency Review for WILLIAM H. PRICE, Jr. & SUSAN P. ANDERSON SCTM# 1000755-3-30 Suffolk Environmental Consulting, Inc. on behalf of WILLIAM H. PRICE, Jr. & SUSAN P. ANDERSON request an Administrative Permit for the as-built 16'x26' (416sq.ft.) attached deck with 4'x23' (92sq.ft.) steps. Located: 1345 Long Creek Drive, Southold. SCTM# 1000-55-3-30 The proposed actions have 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 below Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 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 The as-built structures were constructed without a Wetland Permit. A setback should be shown from the top-of-bluff/bank. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Michael J Domino, /ice-Presiderw'"� UWN 54375 Main (toad P O Box t 179James F King, Trusteelthold, New York 11971-0959 Dave Bergen,Trustee Telephone(631)765-L892 Charles J- Sanders, Trustee Fax(631) 765-6641 BOARD OF TOWN TRUSTEES D TOWN Or SOUTHOLD v D To: Southold-Tow6-Building Department MAR 2 7 2017 Re: Verification of Building Department Permit Requirements BUII.DIl�G DE 'T. TOWN OF SO OLD SCTM#: Property Owner Name: Date Sent to Bldg- Dept-: 3 ` -7, l' The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Departibenfs permitting requirements stated belovr_ YES NO Will the proposed project require a Building Pen-nit? .7`��Wlf the proposed project require a variance determination from e Zoning Board of Appeals? W[[ any part of this application be considered as Demolition as 'described under Town Code? COMMENTS: Signature of Reviewer Date John M.Bredemeyer III,President � � +�a Town Hall Annex Michael J.Domino, Vice-President 64375 Mein Road s P.O.Box 1179 James F.King,Trustee Southold,Now York 11971-0959 Dave Bergen,Trustee a �i Tele 631 -1 2 Telephone P Charles J.Sanders,Trustee " �° ' ( ) 765 39 � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application .`Yet!and Permit Application Administrative Permit Amendment/TransfedExteS,sion Received Applic tion: 7'23' ' Received Fee:$ I K00 le� Completed Application: -.--.- r Incomplete: IL SEQRA Classification:Type I Type II Unlisted :i Coordination:(date sent) `'` MAR 2 3 2017 d LWRP Consistency Assessment Form: .7.1 CAC Referral Sent: ✓ Date of Inspection: Suulho{dsvn Receipt of CAC Report: L-BRrd olhus`pos Lead Agency Determination Technical Review: Public Hearing Held: Resolution: Name of Applicant William H. Price, Jr. and Susan P. Anderson Address P. O. Box 149, Greenport, NY 11944 Phone Number: ( 631 ) 477 - 1016 Suffolk County Tax Map Number: 1000—55—03—30 Property Location: 1345 Long Creek Drive - Southold (provide LILCO Pole#, distance to cross streets, and location) AGENT: Bruce A. Anderson-Suffolk Environmental Consulting, Inc (If applicable) Address: P.O. Box 2003;Bridgehampton,NY 11932 Phone: (631) 537—5160 Board of Trustees Application GENERAL DATA Land Area (in square feet): 23,840 square feet+ Area Zoning: R-40 Previous use of property: Residential Intended use of property: Residential Covenants and Restrictions: Yes X No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? X 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 X No If"Yes",please provide a decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? X Yes_ No Prior permits/approvals for site improvements: Agency Date 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): Applicant proposes to legalize a 16' x 26' (416 s. f. ) attached deck and its connecting 4' x 23' (92 s.f.) steps. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purposes of proposed operations: Legalize attached deck and steps. Area of wetlands on lot: 500 square feet Percent coverage of lot: 10.1 % Closest distance between nearest existing structures and upland edge of wetlands: 18.0± feet (driveway) Closest distance between nearest proposed structures and upland edge of wetlands: 35.0± feet (legalize steps) Does the project involve excavation or filling? X No Yes If Yes, how much material will be excavated? N/A (cubic yards) How much material will be filled? N/A (cubic yards) Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A 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): No impact to the wetlands are anticipated as structures have existing in harmony with wetlands for 37 years (construction occurred circa 1980). Board of Trustees Application COASTAL EROSION APPLICATION DATA N/A Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No Yes 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) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) i PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: Susan Anderson and Judith P. Ham 2265 Long Creek Drive (SCTM#:1000-55-3-3 1) Southold, NY 11971 Christopher McGlynn 1320 Hillhurst Road (SCTM#1000-55-3-29) Oakville, Ontario, Canada L6J1X5 Clifford H Utz, Jr 353 N Royal Bell Dr (SCTM# 1000-55-4-13) Green Valley, AZ 85614 Larry and Indilla Salmiery 1300 Long Creek Dr (SCTM# 1000-55-4-12) Southold, NY 11971 STATE OF NEW YORK COUNTY OF SUFFOLK Bruce A. Anderson, residing at Suffolk Environmental Consulting, Inc, P. O. Box 2003, Brid eh�ampton, NY 11932, being duly sworn, deposes and says that on the , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Bridgehampton, that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 Notary Public i 1 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: William H. Price, Jr. and Susan P. Anderson SCTM# 1000-055-03-30 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to conduct regulated activities: A1212licantyroyoses to legalize a 16'x26' (416 s.f. ) attached deck and its connecting 4'x 23' (92 s.f., steps. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1345 Long Creek Drive, Southold,New Yorkl 3. That the project which is subject to Environmental Review under Chapters 96, 111 and/or 275 of the Town Code is open to public comment on: DATE: You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: William H. Price, Jr. and Susan P. Anderson MAILING ADDRESS: P. O. Box 149, Greenport, NY 11944 PHONE #: 631-477-1016 AGENT: Bruce A. Anderson a- Suffolk Environmental Consulting Inc. MAILING ADDRESS: P. O. Box 2003, Bridgehampton, NY 11932 PHONE #: 631-537-5160 Enc: Copy of sketch or plan showing proposal for your convenience. F ' Board of Trustees Application County of Suffolk State of New York William H. Price Jr. BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signat e SWORN TO BEFORE ME THIS a 3 DAY OF 1 e�� ,207 rD� N a Public ELIZA3ETH J.FAR;IISH Notary Pubic. s[-'.e o,flew York No. 01FA41)',2?moo / Qualified in S.CiJ{k County Corrnm;sston Exoi.es Oct.15,20 t Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, William H. Price Jr. residing at P. O. Box 149, Greenport, NY 11944 does hereby authorize Suffolk Environmental Consulting Inc. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORINT The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the 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: William H. Price, Jr. (Last name,first name,middle initial,unless you are applying in the name of someone else of other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion r 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 X 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 -e Title or position of that person � al rr- Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check 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 then 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 X D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of 2017 � N^ -thP��4' D its Signature fvatc _ Yr rk Print name: William rice, Jr i - : tV Ct, �.., r; 22, 201 1 Board of Trustees Application County of Suffolk State of New York Susan P. Anderson BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) - OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS `D DAY OF t2Gi� ,201-7 o ary Public D ivans York vJ:1gty Comrrnse o; E),,-,, LL j; .i waiy 22, 20 i`( Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Susan P. Anderson residing at P. O. Box 149, Greenport, NY 11944 does hereby authorize Suffolk Environmental Consulting, Inc. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. vh14__ wner's signature) TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the 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: Susan P. Anderson (Last name, first name,middle initial,unless you are applying in the name of someone else of other entity, such as a company.If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X 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 X 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 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 then 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 X D) the actual applicant. DESCRIPTION OF RELATIONSHIP Sister to Hon. William H. Price, Jr., Esq. Submitted this of f�� 201 � Signature Print name: u P. derson r - �do'a�, `, "I ' c.` York I� J J,: U QuaL c i , 5u 10 k county JLi,Uar� 22, 201q l APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the 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: Bruce A. Anderson (Last name,first name, middle initial,unless you are applying in the name of someone else of other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X 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 X 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 William H. Price,Jr. Title or position of that person Town Justice Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check 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 then 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 Brother-in-law [v,p, ,e v n Ivens Submitted this 2 d y of �(�'�� 2017 r' i,:__,, York Signature 9 r o,nty Print name I Bruce A. Anderson jGn;,ai} 22, 201 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# 055 - 03 - 30 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Dept. ❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) ❑ (c) Permit, approval, license, certification: Nature and extent of action: Applicant proposes to legalize a 16' x 26' (416 s. f. ) attached deck and its connecting;4' x 23' (92 S. f.)steps. Location of action: 1345 Long Creek Drive, Southold,New York Site acreage: 0.547 acres Present land use: Residential Present zoning classification: R-40 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: William H. Price,Jr.,and Susan P.Anderson (b) Mailing address: P. O. Box 149,Greenport,NY 11944 (c) Telephone number:Area Code(631)477-1016 (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? NYSDEC 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 Subiect proposal is consistent with the policy in that the of the proposed improvements are typical development activities consistent with the character of the area which currently consists of many similarly-improved residential lots with similar accessory structures (i.e. attached deck) Accordingly, we believe that this project is consistent with this policy. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable 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 5 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal will not adversely impact the visual quality of the surrounding area in that the surrounding area is currently comprised of properties improved with similar appurtenances(i.e. attached deck) Accordingly, this proposal will comply with Policy 3. 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 through 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 evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal will maintain the quality of the surrounding ecosystem in that the deck has existed harmoniously with adjacent with adjacent wetlands. 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 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 Not Applicable. Attach additional sheets if necessary 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 ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III—Policies;Pages 47 through 56 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound,the Peconic Estuary and Town Waters. See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies;Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary 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 Name of Action or Project: PRICE Project Project Location(describe, and attach a location map): 1345 Long Creek Drive;Southold,New York Brief Description of Proposed Action: Applicant proposes to legalize a 16'x 26'(416 s.f )attached deck and its connecting 4'x 23'(92 s.f.)steps Name of Applicant or Sponsor: Telephone: (631)537-5160 Matt D Ivans-Suffolk Environmental Consulting,Inc E-Mail: mdivans@optonline.net Address: P.O Box 2003 City/PO: State: Zip Code: Bridgehampton NY 11932 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 Z 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: F-1 ❑ New York State Department of Environmental Conservation Tidal Wetlands Permit and/or Letter Of Non-Jurisdiction;Town of Southold Board of Trustees Wetlands Permit,Town of Southold Building Permit. 3.a.Total acreage of the site of the proposed action? 0.55 acres b.Total acreage to be physically disturbed? <0.1 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 55 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial m Residential(suburban) ❑Forest ❑Agriculture ®Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ ❑ 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: FV1 ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑✓ F-1— b. 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: F-1 FVI 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ N/A 11. Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: ❑ N/A 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? z ❑ 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: Z Shoreline ❑Forest [I Agri cultural/grasslands ❑Early mid-successional m Wetland ❑Urban m Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? ❑✓ ❑ 16. Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, z 1:1a. Will storm water discharges flow to adjacent properties? E]NO ❑YES b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO DYES 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: Z 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: Z I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: M (vans-Suffolk Environmental Consulting,Inc Date: March 3,2017 Signature: i Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the 1:1establishment of a Critical Environmental Area(CEA)? EJ 5. Will the proposed action result in an adverse change in the existing level of traffic or El 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 r .r 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. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmenta impa ts. Name of Lead Agency Q Date Print or Type Nai,,e of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Resaoonsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Suffolk Environmental Consulting, Inc. Newman Village,Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President Hand Delivered March 3, 2017 Mr. Michael Domino MAR 2 3 2017 Board of Trustees 1 Sonthold'own } Town Hall Board __1 P.O.Box 1179 Southold, NY 11971 Re: PRICE ■ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold ■ New York SCTM #: 1000—116—01 -006 Dear Mr. Domino, This Firm represents the owners of the above referenced property, who wish to legalize an existing rear deck and steps that were constructed in the late 1970's. In that the property is burdened by wetlands, approval from your Board is hereby requested. Consequently, please find enclosed: (1) Town of Southold Trustees Wetlands Permit Application(original and three ¢ [3] copies); (2) Short Environmental Assessment Form (original and three [3] copies); (3) Town of Southold Local Waterfront Revitalization Program Application (original and three [3] copies); (4) Location Map for reference (four [4] copies); (5) Photographs of the site indicating current conditions thereon(four [4] sets); (6) Survey of subject property, prepared by PECONIC SURVEYORS, P.C., last dated January 24, 2017, indicating the project specifications (four [4] sets); and (7) Check made payable to the Town of Southold to cover the requisite application fee. Kindly review these items and schedule for the next available Board of Trustees' meeting at the earliest opportunity. Should you have any questions regarding this matter, or require additional information, please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely, Matt D. Ivans attach. cc: W. Price S. Anderson