Loading...
HomeMy WebLinkAboutTR-9115A y �QF S®(/Ty Town Hall Annex Michael J.Domino, President John M.Bredemeyer III,Vice-President 54375 Route 25 lfS P.O.Box 1179 Charles J.Sanders 00 Southold,New York 11971 Glenn Goldsmith � ® a0 Telephone(631) 765-1892 A.Nicholas Krupski i9l 70Um 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 Michael J. Domino, President ®f SOy® Town Hall Annex John M.Bredemeyer III,Vice-President ,`O l® 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Q Telephone(631) 765-1892 A.Nicholas KrupskiO a Fax(6 31) 765-6641 1�COWNT`I,�' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9115A Date of Receipt of Application: August 30, 2017 Applicant: Mary Beth Henson SCTM#: 1000-33-1-6 Project Location: 3300 Sound Drive, Greenport Date of Resolutionlissuance: November 15, 2017 Date of Expiration: November 15, 2019 Reviewed by: Board of Trustees Project Description: Ten-Year Maintenance Permit to cut choke cherry trees on the bluff down to 2'-3' in height, leaving the trunk and roots intact; remove invasive species and poison ivy (leaving the roots, cutting back and painting the stems); and to plant native plantings such as seaside goldenrod, bayberry, and Montauk daisy. 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 project plan prepared by Mary Beth Henson received on August 30, 2017, and stamped approved on November 15, 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 LOT 101 MAP OF "SECTION FOUR,EASTERN SHORES" FILED MARCH 1,1466 FILE No.4586 N SITUATES GREENPORT TOM SOUTHOLD W E SUFFOLK COUNTY,NY ter®.ALIOWT 1%2010 3 SUFFOLK WIWI`TAX• 1000-33-1-6 ®tT Fmm MARY8E11 MMON 666- CI"r;es (e S-V�"l 5001`0 invaS��IP«sow ►�o1y , Ox'01 yd 1010 ��e O 1 are ydis W kre Levv ,,e►e• W•�� 1 64L aCQ&Lj -' /.- TO BE REMOVEDJ { ( � APPROVED B ! r �, t� '� k�c����ti BOARD OF i-R TOWN-,OF SOnwwmd DATE Motfe ,. !$; 2017 1 �roT OWEwv.ro- STM '4V SOS DR][ H ` t9TOte�Y%Lw SnEDATA: 71L time ze 69f s F��� FOL Q fiUILOA6IE LAra a9wmrc To TOF of 10-�o-v fa ass s F Foos � d EXI6TIN6 19NFl L 331 9 F 9 3Ii N9 2 HAS 3D e F MMWNA90NBY NAi[O 354 B F 2 40i D[I9TIN6 1OT N9 Qi FAIL f09 9 F TOTLL IXIBIINO LOi=ENSE 23]6 5 F f4 49i rrA� N009E 6 6OIEEN V 1 900 9 F I1 m- Od �FYO]fY5E0 OFJ]t 012 9 i 03!TT felOM6m FmL 6 IqT TLII E30 5 F OX�Et 1 OMIX5E0 9100(5 ANp efEa3 113 s i Of 3R 1Fry�)�_ (/^'' ��.j///j//� 4M1NPOSEO LOT pOVENAGE 290!0 P ,]59i D E 14 A E C ti E MAINA6E SYSTEM CALCULATIONS, BVI HOU�aFgGbP AF('.h 19W p ft ItI t3�TJ�w,Flt142�-9S v tW U 01 a'-1,.hlg pool regr d i PROJIPE QJ V C x V STO 11% ]N F I AUG 3 0 2017 NOTm IIIMONIl03R FOIROJ I area-2%M S.F.OR Oxen ACRES TO AVERME e1EH MTM MARK SoutholdTown CEM.ANND(ATFD FROM Nis DESS coASTAL arOSION 1V17ARD ez.=�Z.� ARFJA MAP.TANS OF SOI1fHOLD.SI.FFOLK COUHIY.NFYI YORK Fle�ro No.�-sa3-ea sI�T D OP 4aBoardru a -� EIR/ATONS SH"REFHBYE NWD'29 1R,O `��T"..^.- -__� - eOUR+OI.D T"RFSID@YE zOtre �--.._. VKIJPI P pJ I Ik2"IN I JOIN C.EBLERS LAND SURVEYOR GRAPHIC SCALE I4=W. 6E&WhfAII'snumE N.YS IICNO SMfQ RNPBNBAAD.N.Y.11901 B9F�149c®mb IO>d Set1�lDwea{My�IM7IDIfpbmU W 0-133 fa R��Pe Michael J. Domino, Presi," o�QS�FF011( G r Town Hall Annex John M. Bredemeyer I11, Vice-president may` yam, 54375 Route 25 Charles J. Sanders ro z P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski �?� p!� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 1 Date/Time: 10/10/1+7 9"1,5 Completed in field by: G. MARY BETH HENSON requests an Administrative Permit for a Ten-Year Maintenance Permit to cut choke cherry trees on the bluff down to 2'-3' in height, leaving the trunk and roots intact; remove invasive species and poison ivy (leaving the roots, cutting back and painting the stems); and to plant native plantings such as seaside goldenrod, bayberry, and Montauk daisy. Located: 3300 Sound Drive, Greenport. SCTM# 1000-33-1-6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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: I II Unlisted Action Type of Application: Pre-Submission ✓ Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: ��s�ti y�fUt1,P1� �a 2 vgga� pas:mi#. Present were: V/J. Bredemeyer ✓ M. Domino G. Goldsmith //N. Krupski C. Sanders Other Page 1 of 2 Michael J.Domino,Presi o��S11fFQ(,��oG Town Hall Annex John M. Bredemeyer I11,Vice-President �� yam, 54375 Route 25 Charles J. Sanders N x P.O.Box 1179 Glenn Goldsmith 0 "� 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: MARY BETH HENSON requests an Administrative Permit for a Ten-Year Maintenance Permit to cut choke cherry trees on the bluff down to 2'-3' in height, leaving the trunk and roots intact; remove invasive species and poison ivy (leaving the roots, cutting back and painting the stems); and to plant native plantings such as seaside goldenrod, bayberry, and Montauk daisy. Located: 3300 Sound Drive, Greenport. SCTM# 1000-33-1-6 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 Photos , I • of choke cherries • , bluff from east 1 August 1 I I s^ . f • or � wA�r ... _.. ?�� r �� . �° �� .. ... ,pr's' ��. � ��� � I i 50 FOR PCL NO SEE SEC NO 1`l l o r � 01 1 1 �$` / o w p '9 �,o ,� ° 5°a` a591 S• r° O,P�f g �10. / �„ of '� +97A ,P O� ,9 � +'�� y Y B�'•s,��`� FP � °a„e �� �a'�A a+e B5 B° +\' +� M1 6 '` +9\°' ,�. 0 A Q .Ip p1� a5 y\A •g�A p\G 'p'' CPQ nml +g1 ,° ,9 J A '4'•"p nm iy n�&°��r 'Q� nA n r e N 15 u,sa . �i.O ",® •y nn 'I S°" +91° nq A +��P N1° m 2 `9` J`� �m � � $n>n &, 1 � ,94 0rs'B ,� � 's`';t °� � °^'``•o.m ._J / m B p 5, r � 0 .ems � _ ✓ 4 3 m O n• m 8 1 e A +, O E B+Y• —p n m > 9+ 9 +,P 3 x nw B a ,0 °° 6 nn Pfn�VRTE' � � iyp(n) G� ppNpm � •P +9 3A TPMJOF rJ �9 5 r� rvJ3m�y, F ,M"p � oA o nm r �� � \3 mea rP i �,' RQ• `q\ � I a 0 s ` I L--- .n 2 Y 1se, > ++ A •'� ffi`' y 5 , app' -pm -,a ,' —�--� — —SUN MATCH UNE nw A (ZD ------ NOTICE COUNTY OF SUFFOLK © K TomN OF SOUTHOLD SECTION NO Real Property Tax Service Agency v m NLLAGEO n13 1 OFFICE LOCATION: so MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main'Rd. &Youngs Ave.) Southold,NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: October 24, 2017 Re: LWRP Coastal Consistency Review for MARY BETH HENSON SCTM# 1000-33-1-6 MARY BETH HENSON requests*an Administrative Permit for a Ten-Year Maintenance Permit to cut choke cherry trees on the bluff down to 2'-3' in height, leaving the trunk and roots intact; remove invasive species and poison ivy (leaving the roots, cutting back and painting the stems); and to plant native plantings such as seaside goldenrod, bayberry, and Montauk daisy. Located: 3300 Sound Drive, Greenport. SCTM# 1000-33-1-6 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 action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided the following in considered to further Policy 6. 1. Clarify the scope of work to prevent over-clearing in the future. 2. Require high density of plants used to re-vegetate the area where non-native and invasive plant species are removed to achieve soil stabilization. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. .PJB y`ti Afporjauk �' Town Hall Annex John M.Bredemeyer III,Presidenty �� 54375 Main Road Michael J.Domino,Vice-President ;* - P.O.Box 1179 James F.King,Trustee .. _w '^ k Southold,New York 11971-0959 Dave Bergen;Trustee Telephone(631)765-1892 Charles J.Sanders,Trustee :ate r^v {,^ �l Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application _ Actland Permit Application t( Administrative Permit / Amendment/Transfer/Extension t/ Received Application: 8"30411 2 Received Fee:$ ADO,®D _ D E C IS � V Completed Application: $ .17� Incomplete• ' _SEQRA Clasficaton: AUG 3 0 2017 Type I Type II Unlisted -Coordination:(date sent): V' WR Consistency Assessment For— m: 1�'b-1 Southold Town CAC Referral Sent: I BoardfTrustees Date of Inspection: 1040-1 _Reeeipt of CAC Report: -- _Lead Agency Determination: Technical Review: /Public Hearing Held: Resolution: Name of Applicant: Mary Beth Henson Mailing Address: 130 East 75th Street,Apt. 7C New York,NY 10021 Phone Number: 212-772-7906 Suffolk County Tax Map Number: 1000-- 33.-1-6 Property Location: 3300 Sound Drive Greenport,NY 11944 about 500 ft.west of intersection of Sound Drive and Westwood Lane (provide LILCO Pole#, distance to cross streets, and location) AGENT: none,but Shamrock Tree will do the work (If applicable) Address: =_ " Phone: Board of Trustees Applic� on GENERAL DATA Land Area(in square feet): 29,581 s.f. Area Zoning: residential Previous use of property: residential Intended use of property: residential Covenants and Restrictions on property? X Yes No' There's a requirement for a 10' If"Yes",please provide a copy. non-turf buffer at the to of the bluff. r Cdr���'d n� Will this project require a Building Permit as per Town Code? Yes X 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.? 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 multiple ZBA and building permits 2011 -2013 for renovation of house and construction o pool 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): Admin.permit sought for 10 years for maintenance. Cut choke cherry trees on the bluff down to 24(leaving trunk and roots intact). Re-move invasive species and poision ivy(leaving roots,cut back and paint the stem). Plant native plants such as seaside goldenrod, bayberry, montauk daisy. Board of Trustees Applicr lon WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: we've been advised by Shamrock Tree that the chokecherry trees are easily blown down in the wind,which has the potential of destabilizing the bluff. Removing invasives and poison ivy is routine maintenance. .Area of wetlands on lot: none square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: n��feet Closest distance between nearest proposed structure and upland N/A edge of wetlands: n !a feet Does the project involve excavation or filling? X No Yes If yes,how much material will be excavated? zero cubic yards How much material will be filled? zero cubic yards Depth of which material will be removed or deposited: n/a .feet Proposed slope throughout the area of operations: S6f Manner in which material will be removed or deposited: roots will be left intact for chokecherry trees. For invasive vines,they will be cut back and painted with roundup. Native plants,primarily bayberry and goldenrod will be planted 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 effect seen. 617.20 Appendix B Short Environmental Assessment Form Instructions for Comnletina 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: Bluff maintenance Project Locatiofi(describe,and attach a location map): 3300 Sound Drive Greenport,NY 11944 -bluffs Brief Description of Proposed Action: Cut choke cherry trees on the bluff down to 2-3' (leaving trunk and roots intact). Remove invasive species and poision ivy(leaving roots,cut back and paint the stem). Plant native plants such as seaside goldenrod,bayberry,montauk daisy. Name of Applicant or Sponsor: Telephone: 631-477-2191 Mary Beth Henson E-Mail: 3300sound@gmail.com Address: 3300 Sound Drive City/PO: State: Zip Code: Greenport NY 11944 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 0 FJ 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: ® ❑ 3.a.Total acreage of the site of the proposed action? .10 acres b.Total acreage to be�physically disturbed? none acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? .69 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) []Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture r-1 Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 3. Is t e—proposed action, ` NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ El- b.Consistent with the adopted comprehensive plan? ❑ ❑ 0 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑. ni Is t e site of the propose 'action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: �jke 141ac� -50Ui1J © ❑ 8 a Wr11 the proposed action result in a substantial increase in traffic above present levels? NO YES 0 ❑ b.Are public transportation§&Riice(s)available at or near"the site of the proposed action? a ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 0 I ❑ 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: N/A ❑ ❑ 0. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: no connection needed R-71 ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment• no connection needed ® ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ ❑ b.Is the proposed action located in an archeological sensitive area? ® ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? Long Island Sound ❑ 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: W Shoreline ❑Forest ❑Agricultural/grasslands F-1 Early mid-successional ❑ Wetland El Urban ❑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 protect site located in the 100 year flood pain? NO YES 17.Will the proposedaction create storm water isc arge,either from point or non-point sources? NO YES_ If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO ❑YES © ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ❑YES Page 2 of 4 18.Doe`s the peoposed 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: a ❑ 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: a ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicanf/sponsor name: _ } Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following que§tioii§in Paft 2 using the infofination contained in Part 1 and other materials-submitted by the project§06iis6f of 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 (� establishment of a Critical Environmental Area(CEA)? LJ 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage Elproblems? 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. F] 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`imp ets. Town of Southold-Board of Trustees ame of LAgency I Date 1ad10. YV" /t,v President Print or Type Name f Respo ibleOff- icer in Lead Agency Title of Responsible Officer Signature of Responsi a Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 i Board of Trustees Applic' on AFFIDAVIT Mary Beth Henson BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER'KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I-FURTHER AUTHORIZE_THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO IN, COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. gign)ha of Property Owner SWORN TO BEFORE ME THIS �9 DAY OF kj"wJ ,20 /* U &4v - Nofar}i Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. OID1475593 Qualified In Suffolk COun1Y My Commission Expires April 30, 20I V i r 1 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.'Che purpose of this form is lo_provide information which can alert the town of possible conflicts of interest-mid allow it to take whatever action is necessary to avoid same. Mary Beth Henson YOUR NAME: (Last name,first name,.rpiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood, marriage,or business interest."Business interest"•means a business, including a partnership,in which the town officer or employee has even a partial ownership of(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/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(whet the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this gqA, day�ot Signature- Form TS I Print Name � ws off r 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 non- supgorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shZ 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# 33. - I - G PROJECT NAME Bluff maintenance at 3300 Sound Drive, Greenport The Application has been submitted to(check appropriate response): El - Town Board t_.�- Planning Board Building Dept. ❑ Board of Trustees 0 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: Permit requested for routine maintenance of the bluff for 10 years. 1 Location of action: -;300 So t"'4 -,Drv e- iJy 11 -144- Site 1 -144- Site acreage: .69 acres Present land use: residential Present zoning classification: residential 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: Mary Beth Henson (b) Mailing address: 130 East 75th Street,Apt. 7C New York,NY 10021 (c) Telephone number:Area Code( } 212-772-6906 (d) Application number,if any: t�1 I A, Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No© If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LW"Section III—Policies; Page 2 for evaluation criteria. [—]Yes ❑ No © Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages-3 through 6 for evaluation criteria ❑ Yes ❑ No © Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No © Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria © Yes ❑ No ❑ Not Applicable C'hokeshertytrees_gr9wing on the bluff are a eas lv toppled by the wind,which would&s-abilize the bluff. Attach additional sheets if necessary Policy 5. Protect and-improve water quality and supply in-the-Town-of.Southold. See LWRP Section IH- -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', s2plicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑No❑ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental ,degradation in Town- of Southold from solid waste and hazardous substances and wastes. See LMW Section III=Policies; Pages 34 through 38 for,evaluation criteria. ❑Yes ❑ No ® Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye❑ No© Not Applicable Attach additional sheets if necessary WORIUNG COAST POL)'' ..':S r Policy 10. Protect Southold's water-dependent uses-and promote siting-of new-water-dependent uses in suitable locations. See LWRP Section III•—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No © Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources. in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III--Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No ® 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 0 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 ❑ NoFxNot Applicable PREPARED BY TITLE_ DATE a I