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_-,(
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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 '
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APPROVED BY
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DATA
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■ - 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 �,
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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
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OFFICE LOCATION: ®��OE sO(/��®l SLING ADDRESS:
Town Hall Annex ® P.O. 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