HomeMy WebLinkAboutTR-9060A Michael J. Domino, President *0� SOUTy� Town Hall Annex
John M. Bredemeyer III,Vice-President �� l0 54375 Route 25
P.O.Box 1179
Charles J.Sanders Southold,New York 11971
Glenn Goldsmith ® Telephone(631) 765-1892
A.Nicholas KrupskiyCoU
O Fax(631) 765-6641
INTY,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 1407C Date: November 1, 2017
THIS CERTIFIES that the removal of the existing 560 sq ft structure including existing
sanitary ystem and drainage structures; and restore the area with clean fill grass, and natural
vegetation;
At 4730 Blue Horizon Bluffs, Peconic
Suffolk County Tax Map#1000-74-1-35.54
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated July 21, 2017 pursuant to which Trustees Administrative Permit#9060A
Dated August 16, 2017,was issued and conforms to all of the
requirements and conditions of the applicable provisions of law. The project
for which this certificate is being issued is
for the removal of the existing5_60 sq ft structure including existing sanitary system
and drainage structures; and restore the area with clean fill grass and natural vegetation.
The certificate is issued to ROSE CURTO owner of the
aforesaid property.
Authorized Signature
�oF S0
Michael J.Domino, President � yplo Town Hall Annex
John M. Bredemeyer III,Vice-President 54375 Route 25
JIF P.O. Box 1179
Charles J.Sanders
00 � Southold, New York 11971
Glenn Goldsmith ® yQ Telephone(631) 765-1892
A. Nicholas Krupski f/`oum Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: Lot-3411
V Ch. 275 -----Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1 st day of construction
Y2 constructed
Project complete, compliance inspection.
INSPECTED BY: 4;�4:
COMMENTS:
CMGsA. C�r
CERTIFICATE OF COMPLIANCE:
J
�QF SoUTy l
Michael J. Domino, President Town Hall Annex� Ol0
John M. Bredemeyer III, Vice-President P.O. Route 25
JAM
Charles J.Sanders O P.O. Box 1179
Southold, New York 11971
Glenn Goldsmith ® yo@ Telephone(631) 765-1892
A. Nicholas Krupski if'COU � \ 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
Y2 constructed
Project complete, compliance inspection
1
Michael J.Domino,President ��0f S0!/T�o Town Hall Annex
John M.Bredemeyer III,Vice-President �O �® 54375 Route 25
P.O.Box 1179
Charles J.Sanders Southold,New York 11971
Glenn Goldsmith G
® � Telephone(631) 765-1892
A.Nicholas Krupski O a CouFax(631) 765-6641
l� �m,��'
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 9060A
Date of Receipt of Application: July 21, 2017
Applicant: Rose Curto
SCTM#: 1000-74-1-35.54
Project Location: 4730 Blue Horizon Bluffs, Peconic
Date of Resolution/Issuance: August 16, 2017
Date of Expiration: August 16, 2019
Reviewed by: Board of Trustees
Project Description: Remove the existing 560sq.ft. structure, including existing
sanitary system and drainage structures; and restore the area with clean fill,
grass, and natural vegetation.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Jenna Principi Design, dated July 20, 2017, and stamped
approved on August 16, 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 nota determination from any other agency.
Michael J. Domino
President Board of Trustees
Michael J. Domino, Presi 11 d1�OS�FFQ(�-COG ` °Town Hall Annex
John M. Bredemeyer 111,Vice-President~;` �,, 54375 Route 25
Charles J. Sanders P.O.Box 1179
Ze
Glenn Goldsmith "7 Southold,NY 11971
A.Nicholas Krupski ??;470� �p!� Telephone(631)765-1892
ffJ Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: Completed in field by:
Richard Principi, Jr. on behalf of ROSE CURTO requests an Administrative Permit to remove the
existing 560sq.ft. structure, including existing sanitary system and drainage structures; and restore
the area with clean fill, grass, and natural vegetation. Located: 4730 Blue Horizon Bluffs, Peconic.
SCTM# 100074-1-35.54
CH. 275-3 - SETBACKS
WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required
1. Residence: 100 feet
2. Driveway: 50 feet
3. Sanitary Leaching Pool (cesspool): 100 feet
4. Septic Tank: 75 feet -
5. Swimming Pool and related structures: 50 feet
6. Landscaping or gardening: 50 feet
7. Placement of C&D material: 100 feet
TOP OF BLUFF:
1. Residence: 100 feet
2. Driveway: 100 feet
3. Sanitary leaching pool (cesspool) 100 feet:
4. Swimming pool and related structures: 100 feet
Public Notice of Hearing Card Posted: Y / N
Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action
Type of Application: Pre-Submission Administrative Amendment Wetland
Coastal Erosion Emergency Violation Non-Jurisdiction
Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line
Additional information/suggested modifications/conditions/need for outside
review/consultant/application completeness/comments/standards:
Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski
C. Sanders Other
Page 1 of 2
Michael J. Domino, Presid!' ` O�QSUFFt?j/(COG ( Town Hall Annex
John M. Bredemeyer III,Vice-President � 54375 Route 25
Charles J. Sanders ro = 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: Completed in Work Session by:
Richard Principi, Jr. on behalf of ROSE CURTO requests an Administrative Permit to remove the
existing 560sq.ft. structure, including existing sanitary system and drainage structures; and restore
the area with clean fill, grass, and natural vegetation. Located: 4730 Blue Horizon Bluffs, Peconic.
SCTM# 100074-1-35.54
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
JUL 2 1 2017 DESIGNER
MEAN WATER MARK . . . . . .
J E N N A
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phone:(516)852-0651
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APPROVED BY, JIM DEERKOSKI, PE
phone:(631)298-7116
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26 SILVER BROOK DRIVE WELL AND C.l. COVER ON LOT 3 ARE PHYSICAL FIELD LOCATIONS nrd of Tru AR
FLANDERS, NEW YORK
11901 N CURRENT ZONING RR&R-40
TEL:(631)-369-8312-FAX.(631)-369-8313 RR:31,587 SQ.FT.
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OFFICE LOCATION: ®�►�®f ® y®� MAILING ADDRESS:
'Town Hall Annex ® P.O. Box 1179
54375 State Route 25 Southold, NY 11971
(cor. Main Rd. &Youngs Ave.)
Southold, NY 11971 a� Telephone: 631765-1938
®�-c®U
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: Michael Domino, President
Town of Southold Board of Trustees
From: Mark Terry, LWRP Coordinator
Date: August 14, 2017
Re:, Local Waterfront Revitalization Program Coastal Consistency Review for ROSE CURTO
SCTM# 1000-74-1-35.54
Richard Principi, Jr. on behalf of ROSE CURTO requests an Administrative Permit to remove
the existing 560sq.ft. structure, including existing sanitary system and drainage structures; and
restore the area with clean fill, grass, and natural vegetation. Located: 4730 Blue Horizon
Bluffs, Peconic. SCTM# 1000-74-1-35.54
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the
Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based,upon the information provided on the LWRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation
that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT
with the LWRP.
Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in
preparing its written determination regarding the consistency of the proposed action.
pF Spy
John M.Bredemeyer III,President ®� T��OF, Town Hall Annex
Michael J.Domino,Vice-President �' 54375 Main Road
P.O.Box 1179 '
James F.King,Trustee Southold,New York 11971-0959CIO
d
Dave Bergen,Trustee
Telephone(631)765-1892
Charles J.Sanders,Trustee ( � Q
�v®uMy� 'Y Fax(631)765-6641
BOARD OF TOWN TRUSTEES '
TOWN OF SOUTHOLD
Office Use Only
_Coastal Erosion Permit Application
etland Permit Application
Administrative Permit 1
4 �Amendment/Transfer/Extension Pi�l
C1� Received Application: 7,21.17 Received Fee:$ 106,0®Completed Application:_Incomplete: ZJUL2 1 2017
_SEQRA Classificat}6n:
Type I Type H V Unlisted
Coordination:(date sent): IIII Southold Town
V LWZP Consistency Assessment Form: g`r`1' Board of Trusteed
CAC Referral Sent:_
'r&te of Inspection: V4,17
_Receipt of CAC Report:
_Lead Agency Determination:
_Technical Review:
Public Hearing Held:
_Resolution:
Name of Applicant: Rose Curto {
Mailing Address: 431 Lenox Rd., Huntington Station, NY 11746
Phone Number: (631) 423-1562 r
Suffolk County Tax Map Number: 1000- 74-1-35.54
Property Location: 4730 Blue Horizon Bluffs, Peconic, NY 11948
County Rd. 48 & Henry's Rd. '
(provide LILCO Pole#, distance to cross streets,and location)
AGENT: Richard J. Principi Jr.
(If applicable)
Address: PO Box 1248, Southold, NY 11971
.y
Phone: (516) 852-0651
t
4730 Blue Horizon Bluffs
Project Description
July 21 , 2017
The applicant proposes to remove existing $ 0 sqft structure including
existing sanitary and drainage structures and restore areas with clean fill,
.grass and natural vegetation.
Hoard of Trustees Application
GENERAL DATA
Land Area(in square feet): 54,014
Area Zoning: RR/R40
Previous use of property: Seasonal Residence
Intended use of property: Same as Above
Covenants and Restrictions on property? Yes X No
If"Yes",please provide a copy.
Will this project require a Building Permit as per Town Code? 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 copy of decision.
Will this project require any demolition as per Town Code or as determined by the Building Dept.?
X Yes No
Does the structure(s)on property have a valid Certificate of Occupancy? Yes X No
Prior permits/approvals for site improvements:
Agency Date
X 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): Remove existing
residence, sanitary and drainage structures, and restore areas with
natural vegetation and grass.
Board of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: Remove existing residence, sanitary and
drainage structures, and restore areas with natural vegetation and grass.
Area of wetlands on lot: 4793 square feet
Percent coverage of lot: 8.87 %
Closest distance between nearest existing structure and upland
edge of wetlands: 21 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 125 feet
Does the project involve excavation or filling?
No X Yes
If yes,how much material will be excavated? 0 cubic yards
How much material will be filled? 250 +/- cubic yards (Fill in existing foundation.)
Depth of which material will be removed or deposited: 1 +/- feet
Proposed slope throughout the area of operations: 1:4 Max
Manner in which material will be removed or deposited: Material to be removed
and deposited by an excavator and by hand.
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 negative impacts to the wetlands or tidal waters of the Town of Southold
are anticipated.
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:
4730 Blue Horizon Bluffs.
Project Location(describe,and attach a location map):
4730 Blue Horizon Bluffs, Peconic, NY 11948
Brief Description of Proposed Action:
Remove existing residence, sanitary and drainage structures, and restore areas with
natural vegetation and grass.
Name of Applicant or Sponsor: Telephone: (631) 423-1562
Rose Curto E-Mail:
Address:
431 Lenox Rd.
City/Po: State: Zip Code:
New Huntington Station NY 111746
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 El 1:1may 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: ❑
Southold Building Dept.
3.a.Total acreage of the site of the proposed action? 7 acres
b.Total acreage to be physically disturbed? 2e acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 124 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
E]Urban ❑Rural(non-agriculture) ❑Industrial []Commercial [Z]Residential(suburban)
❑Forest ❑Agriculture El 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? 1/HI ✓
IE]
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? aTT
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: W1 ❑
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NOe YES
b.Are public transportation service(s)available at or near the site of the proposed action? v
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? d
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: ❑ ❑
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water: On-Site Sub-Surface private Well 1:1to be approved by Suffolk County Health Department.
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: Private ort-Site wastewater ❑
tre#=-at to—be-appSuffolk County Health D-epartrr_e_nt,
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? r
b.Is the proposed action located in an archeological sensitive area? V/
] 9
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: 1/ _
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
0 Shoreline ❑✓ Forest ❑Agricultural/grasslands ❑Early mid-successional
0 Wetland El Urban ❑Suburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO 6YEby the State or Federal government as threatened or endangered?16.Is the project site located in the 100 year flood plain? NO
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO ❑YES Z ❑
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: ❑NO ❑YES
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: 7 ❑
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: F-71 ❑
1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applican or nape: Date: 7•��• [
Signatur
Part 2-impact Assess ent. 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 Pari l 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
occut 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? El
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or ❑
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate D
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? E
8. Will the proposed action impair the character or quality of important historic,archaeological, 1:1architectural 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)? 0
Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur, occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage 1:1problems?
0
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 environmental nn its.
Town of Southold-Board of Trustees5-17117
ANamlof Lead AgenDate
t C el {/T r d V^'t 'a President
PrIht or Type Name 9f Responsib e Offic in Lead Agency Title of Responsible Officer
l;ignature of Responsible fficer in Lead Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of
Board of Trustees Application
AFFIDAVIT
R-05E C-uRrl-o BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PE IT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE BEST OF//ISMER KNOWLEDGE AND.BELIEF,AND THAT
ALL WORD WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION
AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES.
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE
BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES
AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF
GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE
TRUS'T'EES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE
CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION,
INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF
TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
C' ,
Signature of Property Owner
SWORN TO BEFORE ME THIS 0'0 _DAY OF 7' ,2017_
Notary Public
JEANNE M.CONDON
MAW Pubft.Stets of NOW Yo*
No.01 coama9a
Qualified in Suffolk County
Commission Expires September 1S,20,,.2-0
Board of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
residing at L/31 2 0 4
(print name of owner of property) (mailing address)
_14 qN 5 i� c � _ do hereby authorize _
Richard J. Principi Jr. d
-to apply for permits)from the
Southold Board of Town Trustees on my behalf.
(Owner's signature}mm� �
APPLICANUAGENURE PRESENTATIVE
TRANSACTIONAL DISCLOSURE k+'()RM
Thr, own of Snuthold's Code 17Ethic prn iib's cn flirts n e e'st n e. �irt`of to vn'nfli ers toed o olovecs.Thy rMfoo-sic of
nfurr''ati•'it vhicl`4:ntrale o vn opposAs TIe conflicts nicres_4UdADpw it to take wh tc vc raction is
nee ssa to avoid ame. J I r `
YOUR NAME* _ tJ l� IInd$2 {/ r
(Last name,first name,diddle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION. (Check all that apply.)
Tax grievance Building
Variance Trustee 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 it relationship with any officer or employee
of the Town of Southold? "Relationship"includes by blood,rnarriage,or business interest:•"Business interest"means a business,
including a partnership,in which the town officer or employee has even a paqial ownci;chip yf(pr employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES _ NO X
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agentlrepresentative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
A)the owner of greater than 5%of the shares of the corporate stock of the applicgnt _
(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 Or RELATIONSHIP
14,
Submitted this 20 day of _ 200�7
Signature
Print Name t�z 0 S e L U �"d
Form TS 1
i
APPLICANUAGENUREPRESENTAB'IW
TRANSACTIONAL DISCL®SURF,FORM
The'rown orSouthold's Code of Ethics prohibits conflicts of interest on the rri of town officers and employees.Tile nuriwse 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.
YOURNAME: Richard J. Principi, Jr.
(Last name,first name,tpiddle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee _ 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 NO X
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee,Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
A)the owner of greater than 5%of the shares of the corporate stock of the applic@int
(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
Submitteds day o U 20!3
Signature
Print Name
Form TS l
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORINT
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 Doll-
suyipordns 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# 74 - 01 - 35.54
PROJECT NAME 4730 Blue Horizon Buffs
The Application has been submitted to(check appropriate response):
Town Board ❑ Planning Board❑ 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:
Remove existing residence, sanitary and drainage structures, and restore with
grass and natural vegetation.
m
Location of action: 4730 Blue Horizon Bluffs, Peconic, NY 11958
Site acreage: 1.24
Present land use: Seasonal Residence
Present zoning classification: R R/R40
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:Vincent Curto
(b) Mailing address:431 Lenox Rd., Huntington Station, NY 11746
(c) Telephone number:Area Code( )
(d) Application number,if any:
Will the action be directly undertaken,require funding,or approval by a state or federal agency?
Yes ❑ No W1 If yes,which state or federal agency?
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY'
Policy 1. poster 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.
7Yes ❑ No ❑Not Applicable
Existing structure 21 feet from the bluff will be removed.
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
0 Yes ❑ No ❑ Not Applicable
Area near bluff will be restored to natural conditions.
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
LWRP Section III—Policies Pages 6 through 7 for evaluation criteria
0 Yes❑ No ❑ Not Applicable
Existina structure 21 feet from the bluff will be removed.
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
_Existing structure 21 feet from the bluff will be removed
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 W1Not Applicable
Proiect will have no neaative impacts to water aualitv.
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 W1NotApplicable
Proiect will have no negative impacts to town ecosystems.
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 0 Not Applicable
Proiect will have no negative impacts to air quality
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 evaluatiop criteria.
❑Yes ❑ No ❑✓ Not Applicable
Proiect will have no neqative impacts on the environment.
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.
❑ Ye❑ No Z Not Applicable
Prnipr iw ll havBiao imractm public access.
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria.
❑Yes ❑ No 0 Not Applicable
Project will have no negative impacts on water-dependent uses.
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 0 Not Applicable
Project will have no negative impacts on marine resources.
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 0 Not Applicable
Project will have no negative impacts on agricultural lands.
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 0 Not Applicable
Project will have no negative impacts on marine resources.
PREPARED BY Richard J. Principi, Jr. TITLE DATE7/21/17