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TR-9145A
QF SU�j� r Town Hall Annex Michael J.Domino,President O�� y�l 54375 Route 25 John M.Bredemeyer III,Vice-President '` P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski • �Q Telephone(631) 765-1892 Greg Williamsy00UNT`I, Fax(631) 765-6641 � �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1443C Date: January 29, 2018 THIS CERTIFIES that the asbuilt 16'x26' (416sq ft) attached seaward side deck with 4'x23' (92sq.ft.) steps toround; At 1345 Lona Creek Drive, Southold Suffolk County Tax Map #1000-55-3-30 Conforms to the application for a Trustees Permit heretofore filed in this office Dated November 29, 2017 pursuant to which Trustees Administrative Permit#9145A Dated January 17, 2018,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the as built 16'x26' (416sq ft) attached seaward side deck with 4'x23' (92sa.ft.) stens toground. The certificate is issued to WILLIAM H. PRICE & SUSAN P. ANDERSON owners of the aforesaid property. 0 0 Authorized Signature r Michael J.Domino,President hO��OF S�UjyOlO Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 J J [ P.O.Box 1179 Charles J.Sanders CP Southold,New York 11971 Glenn Goldsmith • �O� Telephone(631) 765-1892 A.Nicholas KrupskiCOUNTI, 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 '/2 constructed Project complete, compliance inspection Michael J.Domino,President SOUT'yo� Town Hall Annex � O 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Charles J.Sanders C Southold,New York 11971 Glenn Goldsmith • �O� Telephone(631) 765-1892 A.Nicholas Krupski lij'�+oUN�'� 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 '/z constructed Project complete, compliance inspection Michael J.Domino,President o��q SOUj�ol Town Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • �� Telephone(631) 765-1892 Greg Williams 27e, ,tea Fax(631) 765-6641 g �OUNT`1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9145A Date of Receipt of Application: November 29, 2017 Applicant: William H. Price & Susan P. Anderson SCTM#: 1000-55-3-30 Project Location: 1345 Long Creek Drive, Southold Date of Resolution/Issuance: January 17, 2018 Date of Expiration: January 17, 2020 Reviewed by: Board of Trustees Project Description: For the as-built 16'x26' (416sq.ft.) attached seaward side deck with 4'x23' (92sq.ft.) steps to ground. 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 January 17, 2018. 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. 0 Michael J. Domino, President Board of Trustees Michael J. Domino,Presid o�OgOFFU(�.0, Town Hall Annex John M. Bredemeyer III,Vice-Presiaent �� y� 54375 Route 25 Charles J. Sanders cz z P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ?�O® �apl� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: I Completed in field by: Suffolk Environmental Consulting, Inc. on behalf of WILLIAM H. PRICE & SUSAN P. ANDERSON requests an Administrative Permit for the as-built 16'x26' (416sq.ft.) attached seaward side deck with 4'x23' (92sq.ft.) steps to ground. 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 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer VIM. Domino v11G. Goldsmith '/N. Krupski _/6 ceders Other Page 1 of 2 Michael J. Domino,Presic O�0otfF04-ra Town Hall Annex John M. Bredemeyer III,Vice-President � 54375 Route 25 Charles J. Sanders c P.O.Box 1179 co Glenn Goldsmith 'T► Southold,NY 11971 A.Nicholas Krupski 4,1 �apl� 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 & SUSAN P. ANDERSON requests an Administrative Permit for the as-built 16'x26' (416sq.ft.) attached seaward side deck with 4'x23' (92sq.ft.) steps to ground. 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 'P �� � ASURVEY OF PROPERTY BOAR® OF I RUSTEEs A T SO UTHOLD TOWN OF souTHOI® TOWN OF SOUTHOLD ®ATE ToJ [7, SUFFOLK COUNTY, N. Y. A '° 1000-55-03-30 Y2-20 NO - 12-12-2018 , SCALE. 1'= 30' JANUARY 24, 2017 CR.E'E'K » "LANDWARD EDGE OF THE f e N8�•Qrj�Q E TIDAL WETLANDS AS DETERMINED DY _ 5UFFOLK ENVIRONMENTAL CON5ULTING, INC. 65a� 55 ON 5EPTEMER 27, 2016 Eti 0.,e — — � TIE LINE BOTTOM -_-EL--3.4- # -�- ti��� i 10 , ECEIVE �'°` `�vim • , ``� a 1�a ,�� ----INE NOV 1 4 2017 �\�V// � ,•rte � ---- ----�GL�ZQ�E LINE___ (n � Southold Town 0 Board of ' ISG O Tip T ' l �1C.1OY "'TOS pEU` Cn 8 ' Wpm W►TN i4 g, cow s e� f a N ,,gyp- F1N• � O AA� �e CpW70 ac� � Z AOAo � OR �Rw�W Z o• �� 28� 16 to O I s �1 tL � �'• T O W� - • m 12 - W r s \10 /6 l6 ci ti ■ • MONUMENT ' = WETLANDS FLAG C+, FLOOD ZONES FROM FIRM 36103C0158H srt, J MAP EFFECTIVE DATE- 5EPTEMDEK 25, 2009 ELEVATIONS AND CONTOUR LINES ARE REFERENCED TO NGVD �p LOT NUM15EK5 REFER TO "MAP OF YENNECOTT PARK" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON OGTODEK 9, 1968 AS FILE NO. 6173 > LIC. NO. 491 ANY ALTERATION OK ADDITION TO THIS SURVEY 15 A VIOLATION OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. PECONIC SURVEYORS, P.C. EXCEPT AS PER SECTION 7209-5UDDIV1510N 2. ALL CERTIFICATIONS AREA=,23,840 sq.ft. (631) 765-5020 FAX (631) 765-175 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.0, BOX 909 SAID MAP OR COPIES DEAR THE IMPRESSED SEAL OF THE SURVEYOR t0 TIE LINES 1230 TRAVELER STREET PRICE ■ ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold ■ New York SCTM #: 1000—055 —03—030 (Photo taken on February 27, 2017) , f r i y F e� 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 east. PRICE ■ ANDERSON Property Situate: 1345 Long Creek Drive • Southold ■ New York SCTM #: 1000—055 —03—030 (Photo taken on February 27, 2017) i 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 ■ ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold ■ New York SCTM #: 1000—055—03—030 (Photo taken on February 27, 2017) �M1/ r I L . . 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 northwestern section of the property, facing northeast. PRICE ■ ANDERSON Property Situate: 1345 Long Creek Drive ■ Southold ■ New York SCTM #: 1000—055 —03 —030 (Photo taken on February 27, 2017) Vr I - u S5 7�! 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. R-- SEE SEC NO 015 UH 1112 9B MATCN at9-91 ---�— h �' SEE SEG NO � 015 z- o3-t9ao -- n aunt SEESEGNO 051NWMw Rev6iofN MATCH 0&t1-98 P 12-698 080&91 d] p FOR PCL NO � t 18A(c) SEE SEG NO\ 12-2-99 01-2301 NO 4 d +a 22A(c) • 5 all-01 8yyr 0't n � 1 dMcl 061004 �H 1a\ 25.1 25A 5S id e £ 43 062604 L e N yds g 22A(n) 204 re IIA -• 1 Sac) 01-0608 3, 1, 61 £ 2a-M 1 M(q 3 9t 3 VOttO 9!4K1-09 10.2398 m m M CA(.) 03;.2301 9 a y, ° y a2 98-81-1 £- 5'1 38ypI�) o • 43 ' 2 c m BB SNc)obr "° A4 5 n-28-t 912 d9 Fl £ Ra 9 a m w ox- ! s3 pg '° �� 13A za4 w z1 � 9. ,o�cREEB • 9 3 n9 `' 45 � 35 o vr:afA � yaa� e 1 m w, 34 ✓ 9a 2 ® m � at6�� OtsOw�.rwt+rrn , 5 °9 92 nn @ 4� a im a' a �, w91d w ^m &10 ® 19 22A g e 18 • 9 &13 S9 t OA m - 111 a w 141 79 38 R,ou-nvaFstf/✓-0ut `g -r�6 m ` 12W-) oOanHrB/r2crnT m O y0 ? j Yom' \ ,� 9J 3 1.Bf. 104 g 19A(c) 1.2 5 vrmt 1f• 9 % P 205A 'S5 � o soman �' Q �m0ms) 9 1z 11 9 14 118 1�?P ,0 � 11 mN1,ECOTr a 35 ® B m 5oA(c) 242 1 A 3� y 15 e 29 5 7AA(c) m ' p 3 41$ 94 w rIONNOFSWRaO • a y nm Pa, Fl, 11A1\ B nrle.avtmAa/+sl a m B .m s 1�\5 5 ,m n 4 181A �•, tOPll ^� r 1-161me i 9J \ OEtB.OcvBYI PoCNI l ry 4.8f1\ Fl Fl 1511 4512 45m 011' e + 9 p^ ' Noxmccs9utNan \\ ry e 11. m 1z.1 � a Fl 159 4591s25 s9 �P +`�40^" n^ � `w �F y atu¢ONevr/n1+N9 \ Aec 40 10� �.158 1518 a 4'?P1 m � 0 c^ -P 1&E0pj55q 1`+� e 1BA 193A • m Ot:113.otverrwlu051 \ ( 53 a1' LL m \'613 101 1 1Am •• 152 5 515.a B 11F 45r` g 162 w 153815w ryca ^ 20A(W 10 3 e.Fl, 1531 15.38 '• w o \e 9 1 aAld z0A 1 14 GA(c) e 16 LO OF b W\ m o P S1A 9 1iP11 S011r"OW N1y g .5 16 N+uSI O a 41 �,6y"c „y 6 wo tOtA 2 \ Z 92 11 y t� N• 22 317 t3 9/1 R� 1 Sac) 5 £19� g 3•`P rmnn AOR g '^' •^ - w g g p 1 .0�„tp' S SEE SEC NO 4 2] £26 c ,a •` _ a m w Nna 31ac) 31 .�_-------_UNE �(rymrNs0uNan MATH m C A wOrny SEE SEC NO OB3 -y( ,•y F ... Yygt9n r- K os0 mt Dsz 1tmN on SOtJiF10ID BECTON NO Nonce COUNT)"Tax SUFFOLK © E Real Property Tax serv)ce Agency v�, A�� 5..__ OFFICE LOCATION: S® y®l® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) cs, Southold, NY 11971 l ® �� Telephone: 631 765-1938 ® Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: January 16, 2018 Re: LWRP Coastal Consistency Review for WILLIAM H. PRICE &SUSAN P. ANDERSON SCTM# 1000-55-3-30 Suffolk Environmental Consulting, Inc. on behalf of WILLIAM H. PRICE &SUSAN P. ANDERSON requests an Administrative Permit for the as-built 16'x26' (416sq.ft.) attached seaward side deck with 4'x23' (92sq.ft.) steps to ground. Located: 1345 Long Creek Drive, Southold. SCTM# 1000- 55-3-30 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 INCONSISTENT with the below listed Policy Standards and therefore is INCONSISTENT with the LWRP pursuant to: 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 deck was not constructed with the benefit of Board of Trustee review and,permit. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. -- ✓ O l� „-, J4-5/0 1Vtam t(030 M,chael J Oc,mino. V,cc-Pres,dcnt P O Sox 1179 James F ting- Trustee 4C ''S -',old Ncw Yock 11971-0959 Oa,e Bergen- Trustee l � �O Telephone(63L) 765-L892 Charles J- Sandcrs.Trustee ��� F`a-K (631) 765-6641 COUM-'t A - B O AI.D O F TO WN TRUSTEES _�PD TOWN Of-SO UTHO GD 7_1 k DD To- SOuthold.TOWri wilding O�partment DEC Re-_ Verification of Building Department Permit Requirements �® TOWINOFESOLTY11OLD SCTM#: _ Property Owner Mame- PR lCE A-NDSag Date Sent to Bldg_ Dept-: 1-7 The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated befow: YES NO will the proposed.project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any-part of this application be considered as Demolition as 'described under Town Code? COMMENTS_ Date gture of Reviewer na J Y I ' Jahn M.Bredeme er III,President Town Hall Annex ' 54375 Main Road Michael J.Domino,Vice-President P.O.Box 1179 James F.King,Trustee `1° Southold,Now York 11971-0959 Dave Bergen,Trustee, Charles J.Sanders,Trustee Telephone(631) 765-1892�� ��� 4''� �� . ' l Fax(631)765-6641 ~-�� ' t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application E C E V E Wetland Permit Application Administrative Permit Amendment/Transfer/Extension Received Application: 11,2q-11 NOV 2 9 2017 Received Fee:$ 248,00 As—POICT Completed Application: Incomplete: Southold Town SEQRA Classificati Board of Trustees Type I Type II Unlisted Coordination:(date sent) �LWRP Consistency Assessment Form: h-519 CAC Referral Sent: Date of Inspection: Receipt of CAC Report: 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 the reconstruction 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 the reconstruction of the 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 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 aSrD DAY OF 1 eS2,i:�A-rte.� ,20_U N a Public ELEYIBE r H J FAMISH Notary Public.sta'.e o""1-w York No 01 oualtiied in SuJlk GGUnty / Corr-rn:- on Expires Oct. 15,20 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) t 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 pWose 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 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 r �--- 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 Std> day of 2017 Mpf-,i�pw Signature Tde� r (• York n �.'• �, Print name: William Wrilce, Jr 22, 20 11 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 DAY O201_L o ary Public P1:—'; v D Ivans York Con m ss�, E;.,:, cs ,1:.!u,a!y 22, 2011 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. 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 'Be 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 /v EI ,-- 2017 Signature Print name: u P. derson fro+a;•'n" "� n; 4M1%York QLal,�c it Su ,cla County Comm; "o^ 22, 201q 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: 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 fv;a}t,ew n Iv2,is Submitted this 377r" d y of 2017 York Signature Gu-�, r„ m ;� r (aunty Print name Bruce A. Anderson cr,gii,usb,D,, L.j:i;d:. JGCUdfy, 22, 201 617.20 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 for the reconstruction of 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.(vans-Suffolk Environmental Consulting,Inc. E-Mail: mdtvans@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 ❑✓ ❑ 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: 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? <01 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 E]Rural(non-agriculture) ❑Industrial ❑Commercial 0Residential(suburban) ❑Forest ❑Agriculture ZAquatic ❑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: ❑✓ ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑✓ ❑ 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: 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? Fv_71 ❑ b.Is the proposed action located in an archeological sensitive area? FV71 ❑ 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? Z ❑ 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: m Shoreline ❑Forest ❑Agricultural/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? 7 ❑ 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, a.Will storm water discharges flow to adjacent properties? ❑NO DYES ❑✓ ❑ b.Will storm water discharges be directed to established conveyance systemsrunoff and storm drains)? If Yes,briefly describe: IN 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: 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: Mat Iva olk Environmental Consulting,Inc Date: November 29,2017 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning Elregulations? M/ 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,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. ❑ 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 i pa ts. ame of Aad jency Date Print or Type NanW of Respo sib Officer in Lead Agency Title of Responsible Officer S' nature of Resporaibfe Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 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 for the reconstruction of 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 Subject 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 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 F ;Ep November 13 2017 .n. �i Mr. Michael Domino I NOV 1 4 2n'7 1 Board of Trustees k SoutholdTawn Town Hall Board of Tru-'c s P.O.Box 1179 Southold, NY 11971 Re: PRICE■ANDERSON Property Situate: 1345 Long Creek Drive Southold ■New York SCTM #: Dear Mr.Domino, This Firm represents the owners of the above referenced property, who applied for and received a permit-from your-agency-to Iegahze-an_�existing-rear deck_and steps that were constructed in the late 1970's. The deck and stairs were reconstructed as to comply with-the requirements of the -New `York State -Building Code. Accordingly, I hereby request an administrative permit authorizing the reconstruction-of-the=deck and steps. _-Please--note that the attached deck measures 16' x 26' (416 s. f. ) and its connecting steps measure 4' x 23' (92 s.f.) Enclosed herewith please find: (1) Survey of subject property, prepared by P_ECONIC SURVEYORS, P.C., last dated January 24, 2017, indicating the project-specifications (four [4] sets); and (2) Check made payable to the Town of Southold in the amount of$100 to cover the requisite application fee. 1 Kindly review these items and schedule for the next available Board of Trustees' meeting at the earliest,-opportunity. Should-you-hav-e-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. Yours truly, Bruce A. Anderson attach. oECEIVE I, NOV 1 4 2017 Southold Town Board of Trus es