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Licata, Stephen
James F.King,President �Qg11fF0(,fc Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President z�� P.O.Box 1179 Dave Bergen H Southold,NY 11971 John Bredemeyer Telephone( )631 765-1892 y � ! Michael J.Domino �Ol 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 I.st day of construction %constructed: Project complete, compliance inspection ''tiC'vj �,� sst:w,rc�"p�„ '�.�y �l etira. � � ���'�n�nnxpF•.mas �✓, � -nX'tx'"• .w.� •i �!�'�.�w�,r'�t;�rrrr� •'�stto�t ..rrr.> .�- � �. f���� ��� �� �w�l �jr��.�,�� �' "' �L=_,�,��,1"' ���.tj.•tr✓��\ �9��. r I� -���y..f�\'%���,�'�- �� ��j:�-,n.�� �.j;�� 1�',,�, '.. _ Ail. TRUSTEES BOARD OF SOUTHOLD TOWN SOUTHOLD9 NEW YORK r � ;f} PERMIT NO. t _ 1 i PROPERTYeXOR 11 ' 670 OLD ROAD, � 1 � y j 5 T c\ SCTM# 144 AUTHORIZATION W 1 Y 9 Pursuant totheprovisions of .• oftheTown Codeofthe Townof South.o.J..nd, _ ?. accordance with the Resolution of the Board of Trustees adopte�at the � x consid ration of applicationof$500.00 •. • 1 • C. • • subject • • Conditions • • • Southold, Town C•• • •aorizes and permits y _ uth tWetland Permit to add two dormers onto roof of existing two-story dwelling; j . L rebuildexisting' I 1 porch 1 add deck 1 roof; • 1 1 1 I I patio,, 1 . foot 1 . 1 1 . I per' gola,, to .e e establish 1 subsequently maintain a 10' 1 1 1n-turf landscapeftbAkffPrlandward 1 1 1 as depicted on the survey prepared 1 11 1 d ' 1 • j Surveyor,' datedSeptember I 1 stampedapproved 1 October 1 2013. r\_ IN WITNES&WHEkEOF,the said Board of Trustees hereby causes its Corporate.Seal to be affixed, and these presents to-be subscribed by a majority of the said;Board as of this date%, / !. C I,i }` �! }, •L,y^li.� � 11 ` � lig ® 5 "'� '���y,' Z ! S ervmnrvnw r :...r tiwi.r ..mr rm�s Krns - .x�swmrr w m+- �m r ~ � , ._.�r .•Nnt- k..`SW-03 L AiawS i�u �s Y• �• •��t'V. �,�t\`•' .-r.�t.��ul ,.\•- �Yw;u Vs�"'X w iu!i:t.•'� k''�� Y�. .r �Vi I�X tY.�" . '✓".? .2\z-'3,;;1: TERMS AND CONDITIONS The Pennittee Stephen &Amy LiCata residing at 670 Old Salt Road Mattituck, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: l. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims-for damages, of suits arising directly or indirectly as a result of any operation perfonned pursuant to this permit, and the said Permittee will,at his or her own expense,defend any and all such suits initiated by third parties,and the said Permittee '.' assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. ;.. ,.;� 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That thework involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. .l.- 5. That there will be no unreasonable interference wiih navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beachbe6veen high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice c06anf and.deed restriction to the deed of the subject parcel. Such evidence shall be provided-within ninety(90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the complefon°of the work ;.. authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. ELEVATIONS REFERENCED TO N.A.V.D 1988 N UNLESS NOTED SURVEY OF PROPERTY _ FLOOD ZONE FROM FLOOD INSURANCE RATE MAP A T MA TTIT UCK MAP NUMBER 36103CO482H SEPTEMBER 25, 2009 TOWN OF SO UTHOLD SUFFOLK COUNTY, MY 1000-144-05-13 APPROVED BY SCALE. 1 z0' BOARD OF TRUSTEES JULY 2, 2013 AUGUST 2, •2013 (REVISION) TOWN OF SOUTHOLD AUGUST 27, 2013 (LOCATED M.L.W.) SEPT. 1392013 (additions) DAN (p 14' 3 M • F ROAD. P LD 100.009 E M Q� - •�5iool'E-; :;.^ El .:8:1'>' 8 8 ARB Oµ SEP 19 2013 N79- El.,7•8! a"S 14MA uthold Town a m VD EL. 8.7 g LOT ZLA 0 EL,•8.8' 206 21.5' FlENCE —�9— — N Gam, 8.8' N Cp UR s - (N.GV•p 25.1 m � sad 1.1'E Z � ESGpApGE 16.0 � � O 13.9 EL 8.2 Ln O p `d+ 1*0 gTORY \ O FIR Hoo 6SE o F-F. EU W 29.6 -- - -- v - - - \25.2' SCREENED nL 20.6' 24.6 O PORE. ERGOEA , r V -X r _X L X WOE FE►dC EL 9.5 El it .2E AT GRADE I PA110 Q1.6' WAIT \ I.8 ST Tw. TVI \ dL IIA EEII.S P1 w o UR - \ / rn 2 \ w �? F:AG GRAVEL O } g �. WOOD BULKHEAD u �. � . _ S841�1 27, W ONE UNE V 23.63 MEAN NIGH HEADR W►ttE� EN C3 �El ALONG BUIX�E�vo ZQg� T � o^ ��63.3 95� STAIRS S rte+ iQ� O 11 7. 11 i' SIE UNC � 6 � 1�'NI�' i MEAN HIGH WATER _ 3331.W ,��p NE�I- 135 -NEMT of WAU S73 BAY g ��7.M�TZC pECONIC L 0 T NUMBERS REFER TO "MAP OF SALT LAKE OLLAGE" PLATE N0. 1 OF 2. FILED r /N THE SUFFOLK COUNTY CLERK'S OFFICE N IoW WAR `< ON MA Y 10, 1940 AS FILE NO. 1310. MEA ��f� 49'5* NO sU AIT AL TERA 77ON OR ADDITION TO THIS SURVEY IS A VIOLA 77ON YS. L/C. NO. 49618 OF SECTION 7209OF THE NEW YORK STA TE EDUCA 77ON LAW. ECONIC YORS, P.C. EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERT7f7CAT/ONS AREA 17 079 SQ. FT. P60. 1 BOX 90920 FAX (6.31) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR TO TIE LINE 1230 SOU7HOLD, NLER STREET WH .Y 11971 13_196 OSE SIGNATURE APPEARS HEREON. James F. King, President ��oF S0 , Town Hall Annex Bob Ghosio,Jr.,Vice-President �� 0. 0 54375 Main Road P.O. Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer Tel (631) 765-1892 Michael J. DominoO�yCOUFax(631) 765-6641 NTY, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 16, 2013 Mr. William Gorman PO Box 1447 Mattituck, NY 11952 RE: STEPHEN & AMY LICATA 670 OLD SALT ROAD, MATTITUCK SCTM# 144-5-13 Dear Mr. Gorman: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 16, 2013 regarding the above matter: WHEREAS, William Gorman on behalf of STEPHEN & AMY LICATA applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 19, 2013, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit on structures; a 10' wide non-turf landscaped buffer to be established and subsequently maintained landward of concrete seawall; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 16, 2013, at which time all interested personswere given an opportunity to be heard, and, i 2 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of STEPHEN & AMY LICATA to add two dormers onto roof of existing two-story dwelling; rebuild existing 11'x30' screened porch and add a deck on its roof; and for the as-built 30'x50' patio, 68 linear foot x 2' thick stone walls, 7'x8' fire pit, and 8'x20' pergola, to establish and subsequently maintain a 10' wide non-turf landscaped buffer landward of concrete seawall; and as depicted on the survey prepared by John T. Metzger, Land Surveyor, last dated September 13, 2013, and stamped approved on October 16, 2013. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, )AP-" 0 James F. King President, Board of Trustees JFK/amn glliF���QG James F.King,President y Town Hall Annex Bob Ghosio,Jr,vice-President 0 54375 Route 25,P.O.Box 1179 Dave Bergen .y Southold,NY 11971 John Bredemeyer �/j ,Q Telephone(631)765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: b0d.h-avy) Lyman L S + Amy U Please be advised that your application dated Q ( lj3i has been reviewed by this Board at the regular meeting of 3 . and your application has been approved pending the completion-of tfie following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) , 15t Day of Construction ($50.00) % Constructed ($50.00) Final Inspection Fee ($50.00). Dock Fees($3.00 per sq. ft.). Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed.below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees wilt be necessary. You will receive your permit upon completion of the above. COMPUTA-nQN OF PERMIT FEES: TOTAL FEES DUE: $ S BY: James F. King, President Board of Trustees JamsuFFo1�.es F King,President �� 04 P O Box 1179 Bob Ghosio,Jr.,Vice-President jOy Southold,NY 11971 Dave Bergen y ? Telephone(631 765-1892 John Bredemeyer Fax(631)765-6641 Michael J Domino y 'F Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time- William ate/Time William Gorman on behalf of STEPHEN & AMY LiCATA requests a Wetland Permit to add two dormers onto roof of existing two-story dwelling; rebuild existing 11'x30' screened porch and add a deck on its roof; and for the as-built 30'x50' patio, 68 linear foot x 2' thick stone walls, 7'x8' fire pit, and 8'x20' pergola. Located: 670 Old Salt Road, Mattituck. SCTM# 144-5-13 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Pa"f Town Code proposed work falls under: _Chapt.275 Chapt. 1�11 other Type pp T e of Application: " Wetland _Coastal Erosion Amendment Administrative_Emergency Pre-Submission Violation Info needed: Modifications: ,�/O�F — /SGL D�� �f ✓���� 1 Conditions: f 0 ,dd,J -1'02F gofe^/2 o�'S 4-1. Present Were: _,King B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: Page 1 of 1 r rPS9 2013T� r, http://mail.aol.com/38065-11 I/aol-6/en-us/mail/get-attachment.aspx?uid=300973 80&folde... 9/19/2013 Page 1 of 1 Iry no to 7oi no _. http://mail.aol.com/38065-1 I I/aol-6/en-us/mail/get-attachment.aspx?uid=30097382&folde... 9/19/2013 Page 1 of 1 1 http://mail.aol.com/38065-11 I/aol-6/en-us/mail/get-attachment.aspx?uid=30097400&folde... 9/19/2013 P IWO A., 5 ID-Lb COUNTYOFSUFFOLK K C.ON ReW Property Tax Service Agercy Y 144 A p PROPEM vM BOARD MEMBERS �F sOUr Southold Town Hall Leslie Kanes Weisman,Chairperson O�� y�l 53095 Main Road-P.O.Box 1179 O Eric Dantes Southold,NY 11971-0959 • Office Location: Gerard P.Goehringer Town Annex/First Floor,Capital One Bank George Homing Ol • �� 54375 Main Road(at Youngs Avenue) Ken Schneider �'C� Southold,NY 11971 http://southoldtown.northfork.net D E C E I VE ZONING BOARD OF APPEALS TOWN OF SOUTHOLD SEP 2 6 2013 Tel.(631)765-1809-Fax(631)765-9064 uthoId Town Roard of Trustees FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF SEPTEMBER 19,2013 ZBA FILE: 6679 NAME OF APPLICANT: Stephen Licata PROPERTY LOCATION: 670 Old Salt Road,(adj.to Peconic Bay)Mattituck,.NY SCTM#1000-144-5-13 SEORA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated August 13, 2013 stating that this application is considered a matter for local determination as there appears'to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred forreview under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated August 28, 2013. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to us, it is our recommendation that the proposed action is INCONSISTENT with LWRP policy standards and therefore is INCONSISTENT with the LWRP. The LWRP notes"as built"pergola, patio, stone walls and fire pit were constructed without the benefit of review or permits. However, the Board finds that with the conditions imposed herein, (a landscaped buffer and Trustees review/approval if required) the application is CONSISTENT with the LWRP. PROPERTY FACTS/DESCRIPTION• Subject property is zoned R40 and contains 17,079 square feet. It is improved with a two story framed house with attached garage, rear patio, screen porch and pergola. It has 100.00 feet of frontage on Old Salt Road, 160.06 feet along the east property line, 99.86 feet on the Peconic Bay and 179.70 feet along the west property line as shown on the survey dated July 2, 2013 last revised Sept. 13, 2013 prepared by John T.Metzger,LLS. BASIS OF APPLICATION: Request for Variance from Article XXII Code Section 280-116(B) based on an application for building permit and the Building Inspector's June 28, 2013 Notice of Disapproval concerning a permit to construct additions and alterations to an existing single family dwelling, at; 1) proposed construction at less than the code required bulkhead setback of 75 feet. i Page 2 of 3—September 19,2013 ZBA#6679—Licata SCTM#1000-144-543 RELIEF REQUESTED: The applicant requests variances to a construct additions and alterations to the existing i dwelling (dormers and a second story deck over an existing screened porch) and to legalize the existing pergola located at 56 feet from the bulkhead where the code requires a setback of not less than 75 feet from the bulkhead. ADDITIONAL INFORMATION:The LWRP Coordinator found the pergola,patio,stone walls and fire pit, ' were constructed without benefit of review by the Board of Trustees. At the hearing the Agent for the applicant was asked to go back to the Building Inspector to determine if the noted structures needed to be included in variance relief. The Building Dept. stated the existing stone walls, patio on grade and fire pit did not need a building permit. The "as built" pergola addition will need a building permit and was noted as the closest setback from the bulkhead at 56 feet. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on September 5,2013 at which time written and oral evidence were presented. Based upon all testimony,documentation,personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. _Town Law 4267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood. The dwelling is located within the 75 foot bulkhead setback and has.existed in the present location since prior to zoning. The "as built" pergola is an open addition held up with columns. The proposed additions/alterations are within the existing foot print of the dwelling. 2. Town Law 4267-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area-variance. Due to the current location of the existing dwelling, any additions within the footprint will require variance relief from the bulkhead. 3. Town Law 4267-b(3)(b)(3). The variance granted herein is mathematically substantial,-representing 25%relief from the code. However,the proposed alterations to the home are all to be constructed within the existing footprint of the home and there is no front yard or side yard encroachment being proposed. 4. Town Law §267-b(3)(b)(4) Evidence has not been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code and the conditions imposed herein. 5. Town Law 4267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law 4267-b. The Grant of this variance is the minimum action necessary and adequate to enable the applicant the benefit of additions/alterations and to legalize the "as built" pergola while preserving and protecting the character of the neighborhood and the health,safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Goehringer, seconded by Member Weisman (Chairperson), and duly carried,to GRANT, the variance as applied for and as shown on the plans dated 03.07.2013, last revised 04.12-2013 prepared by Anthony M. Salvati, RA and the survey dated July 2, 2013 last revised Sept. 13, 2013 prepared by John T. Metzger,LLS. ; Subject to the following conditions; Page 3 of 3—September 19,2013 ZBA#6679—Licata SCTM#1000-144-5-13 1. Applicant must apply to Southold Town Trustees for further review and approvals of the non-conforming bulkhead setback for the as built pergola. 2. Applicant must install, per recommendation of the LWRP coordinator, a perpetual landscaped buffer 10 feet in width landward of the concrete seawall. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s)granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features-as are expressly addressed in this action. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. ,. Vote of the BoardAyes: Members Weisman (Chairperson), Goehrin er Schneider, Dantes. Absent was Member Horning. This Resolution was duly adopted(4-0). I Leslie Kanes Weisman,Chairperson Approved for filing 71,23 /2013 i i OFFICE LOCATION: O"Of soyo1 MAILING ADDRESS: Town Hall Annex ti O P.O. Box 1179 54375 State Route 25 J Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971Telephone: 631 765-1938 i0 Fax: 631765-3136 olyCOU I LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM � � � I� V� E D - OCT 1 6 2013 101 To: Jim King, President Town of Southold Board of Trustees �outl old T��r ---Board of Trusitei From: Mark Terry, Principal Planner LWRP Coordinator Date: October 16, 2013 Re: LWRP Coastal Consistency Review for STEPHEN & AMY LiCATA SCTM# 1000-144-5-13 William Gorman on behalf of STEPHEN & AMY LiCATA requests a Wetland Permit to add two dormers onto roof of existing two-story dwelling; rebuild existing 11'x30' screened porch and add a deck on its roof; and for the as-built 30'x50' patio, 68 linear foot x 2' thick stone walls, 7'x8' fire pit, and 8'x20' pergola. Located. 670 Old Salt Road, Mattituck. SCTM# 144-5-13 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 proposed actions are INCONSISTENT with the denoted following LWRP Policy Standards as outlined below and therefore is INCONSISTENT with the LWRP. 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 structures described were not constructed pursuant to a Town of Southold Board of Trustees review or permit. In the event that the action is approved, it is recommended that the applicant provide certification that the as-built structures meet Chapter 236 of the Southold Town Code. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney pg�FFO�,� o� 00 Peter Young,Chairman y Town Hall, 53095 Main Rd. Lauren Standish, Secretary P O Box 1 179 • 'F Southold,NY 11971 y'�Ql �OT Telephone(631)765-1892 Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town. Conservation Advisory Council held Wed., October 9, 2013 the following recommendation was made: Moved by Jack McGreevy, seconded by John Stein, it was RESOLVED to SUPPORT the application of STEPHEN & AMY LICATA to add dormers to existing roof, add deck to re-built screen porch roof, as-built patio, stone walls, fire pit, pergola, rebuild screen porch with roof deck. Located. 670 Old Salt Rd., Mattituck. SCTM#144-5-13 Inspected by: Peter Young, John Stein, Jack McGreevy The CAC Supports the application with the Condition of a drainage plan to include the patio and a non-turf buffer to align with the abutting properties to the east. Vote of Council: Ayes: All Motion Carried a j James F. King, President �*0 SoUly� Town Hall Annex Bob Ghosio Jr.,Vice-President h0 l0 54 Main Road ' P..O.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer G Q Michael J. Domino �OIyC Telephone Fax(6311)) 65-1892 7 765--66641 �UNV BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ! oastal Erosion Permit Application Wetland Permit Application Administrative Permit AmendmendTranf xtpnsion eceived Application: Y,Received Fee:$ D �YJ E I g n E _ Completed Application 3 L5 �J Incomplete ) _SEQRA Classification: J Type I Type II Unlisted SEP 19 2013 --,Coordination:(date sent) 123 3 Southold Town 4NEW e _Lead Agency Determination: echnical Review: i ublic Heanng Held: Resolution: Name of Property Owner(s) 57115bfff� � GI ( +T;q Address 70 blb 5� k!P? WAZL?!zJ Ck Phone Number:((Qf Suffolk County Tax Map Number: 1000- — �— 13 r Property Location: AGT,_0S5 i (provide LILCO Pole#, distance to cross streets, and location) OlLiAANDA, 9B -V4AGENT: (If applicable) � Address: F© F-7�D� Phone: Z 5�� (( �'S coq �l I ^-,ard of Trustees Applicatin,- GENERAL DATA i I Land Area(in square feet): 1-71 0- b Q.._r Area Zoning: Previous use of property: Sf l�Cr �"�!MlL kc Intended use of property:Sck&t6 Covenants and Restrictions on property? Yes V/ No If"Yes", please provide a copy. i I Will this project require a Building Permit as per Town Code? 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 No If"Yes",please provide copy of decision. Will this project requi any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure (s) on property have a valid Certificate of Occupancy? V/ Yes No i Prior permits/approvals for site improvements: Agency Date o/0-? V No prior permits/approvals for site improvements. Hasanpermit/approval roval ever been revoked or suspended b a governmental agency? v No Yes Y P pp P Y g If yes,provide explanation: I' I Project Description (use attachments if necessary): #NAO i7d�SN��c h-5 lo C30 Y.So U.Fr x 2 ?4�ck� <� u8 �� 92.D 7 F----d of Trustees Application, WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: D 13 TJwk AJ 'F�' V-W<-s Area of wetlands on lot: 1300 square feet Percent coverage of lot: Z. �i % Closest distance between nearest existing structure and upland edge of wetlands: .Z7 feet Closest distance between nearest proposed structure and upland edge of wetlands:_ L If feet Does theprojectinvolve excavation or filling? ✓ No Yes If yes,how much material will be excavated? cubic yards How much material will be filled?X11-cubic yards Depth of which material will be removed or deposited: /J feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 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): 617.20 SEQR PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM I � for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) I 1 APP}ICANT/SPONSOR 2.PROJECT NAME k 3.PROJECT LOCATION: I Municipality � County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 470 61.b SALT ;b 5.IS PROPOSED ACTION- ❑ New ❑Expansionodification/alteration i 6.DESCRIBE PROJECT BRIEFLY � � ,4D� DDRWI (*S Ta y5ZG� (mF, /� b T� R �v t 1rT SCS-t' if6k-e- D'4TA LAJ T 16 i 7 AMOUNT OF LA.410 AFFECTED: it Initially acres Ultimately acres 8.i��YeSFI� OSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? 44 I � No If no,describe briefly- I i 9. AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply) Residential ❑Industrial ❑Commercial Agriculture ❑Park/Forest/Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGEN Y (Federal, State or Local) ^ � � Yes ❑No If yes, list agency name and permit / approval: it I 11 DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes 2[No If yes, list agency name and permit / approval: I 12. AS A RES OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? Dyes No I CERTIFY THAT THE INFORMATION PROVIDED ABO V IS TRUE TO THE BEST OF MY KNOWLEDGE [ll A�U►'l �l �N Applicant / S sor am ` Date I Signature I If the action is a Costal Area,and you are a state agency, I complete the Coastal Assessment Form before proceeding with this assessment i i Jaoujo ansuodsad)o aAu 17ua6 ea,-,)J4 a uE' - tl P juap►saJd l wo alq)suodsaa)o aweN a(Ulo)uud y a)ep �ua6y peak)o aweN /oZ 4 saa;srul;o pjeo8 •uo9e W-*)9P ltg k)PDddns suoseau alll 'kOSS90au se S pe)ls uo 'aptnoid oll I� u)I!� NV Speduuua aslMlt pe m)pAs Atm ul w)s*j iom -nim PmdOld a41 P�11'uo�P Am pus ahmp s Ap m pus uopsu x4q aj#uo Pamq'Pa<quu p mMrg3I n9 sp)pogo a<ll of�!P Paaoald uatLL moo ANIf9 4�IM cul aslar►pelusagp►b1s�o aHlei plod amulloauoepap ak&wd a aledaud opus W3 • Y��1� ��1>� uNuaa�qu�luogoepasode�ds�q��wil'�2odq�a�►a�snw.eoue�Jl��� P�t'� Pip=►g pdjoP jl WMJPPB OP PW PaJPM uaaq OABq siaeCkul P PMP CJPaP OOPW4 444=MPUBOM PM alt►st9 IMPOWU&Mmcklris u b spmtutpq8 ppl3' su;" ',MU&W 0)pug uxbw BWB (a)*JIB(P)WOORAM(s)*"Mo p ftpqw(N*Wru m uvgm'a'!) (e)q top Uopmw 14 P eq kimis»a!W ��"a�l1BAo sl1l galN+�l 9aP'a Pa p!# as�anpla4�aa .SNOLi.OA'! m V%abb.(q pW{chuoo aq 01)30iQt►9k71AlRJl3 do MUVNIYII>MIM-M JWIJ dWl-nrlt�wNc�arnra -nnLN3tod of o3 Lvl3a of A la�ln 3>�lli©'amu a . al)g ► L vjar►�,+1rr�wNoalnNa lV3wdo V jo 11J3WHSnSV1S3 3HA O3Snvo.Lvm SoL siml3vuv"D wlN3WNo>IWJ3 3Hl NO 13Vdwl NV 3AVH 1o3foMd 3H1 TtIM'Q �j,=)o adCl Alquerib jaill)a)o asn)u sa uetp BuIpApug Sped�ul fyau9 ule1 3 /-S3-tD u!.PaY)lUaW.)ou spa!)a Ja4)o 1o'and)elnwrb'w)a)pot's'wral'Cwo-I '9c) :AUauq ule)&3 iuolloe pasodoid ay)6q peonput pg.o)AlaMll sa!mpe pa)elaj to Juawdolanap luanbasgnS'4ln+oxo 'So :AUapq utel&x3 js7-- sai lem)eu jay)o m pu )o asn)o!=L)10 asn ul•aBtimp-e jo'pa)dope 6p."o se sleoe jo sueld 6unspra sAlunwwoo V po :Appq ulq&3 LSQPWS Pa)a6uspu0 eo paualeaup io's)aWge4)uvoWuBIS'sapad&! pkm J0: sljp4S Nsy'I-Wel uorle;OftA TO :Ap1►q ule*3 1,*pwB1p jo io:sa xw--Ai pmm jo R.In eu Jaw)o`polspl 1ealtioloaetla,B'i 11 N�'aA�llsall ZJ ¢sods �o uo -APAv!e)g Lmomoid�ootj jo�)wp'wtso�1 lenuo 1 IP PnPad OPm phos'waned oWR4&qMa's)anal os)ou•6y-luenb)o•Apjenb ialeMptm6 io eonm'%enb jle&jliw3 -f o (alm6m p'uaWmpue4 oq Attu wmsW):JNIMoTIOj MU HUM(MVK)OSSV S133jj3 3S213AGV JINN NI I-M3H NOLLOV M000 3 ON D Sak 0 k�uase pa pA q,a4pue Aq papowadns aq AM uo9WWQP MOBBOu a'oN)1 LWL t91HVd'UB3M 9 N1 SNOLL3V o3isnNn 2)Oj o301AOad SV M31A38 o31VNiaHoo0 3Ar--�o3'!1 Nouzv ti1M '8 ata -jV3 llllj am.pue ssaoaud ma ON saA 3 !!��Il aleU.N�'Sa�11 LV'119121Vd'2l2YJJIN 9 NI oloHS321FL1�3dJl11lIJV 0333X3.NOWON S300'N JAOU06V.Pea-) .q.pada) oo aq o .LR3w8S3SSV 13VctWj -11 JHVd ado lr Town of So�rriL.iold c Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM o g PROPERTY LOCATION: S.C.T.M.fr: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Nu STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN WsUrc-t- acts -Woe- Tot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. ! f SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No I a. What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (S.F. /Acres) (This item will include all run-off created by site ✓ D b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? (S.F/Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show Ail Proposed PROVIDE BRIEF PROJECT DESCRIPTION (ProvideAdditionaiPegeaa-Neeead) Drainage Structures Indicating Size&Location?This � � Item shall include all Proposed Grade Changes and — Ot« Rw� DOFLµ kS -m 6 Xfsl u *� Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion 5Tr-A)C- 'VF-.lR AU p PIMP V-)4cg- and sediment control practices that will be used to — _ control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or 'A 5 -m V�LT" �G �A Excavation where there is a change to the Natural ❑ — F�� Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? /y 5 Will this Application Require Land Disturbing Activities ❑ Encompassing an Area in Excess of Five Thousand V/ (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the F-1Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or v/- Submission of a SWPPP is required for all Construction activities involving sol Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to F including Construction activities involving sol disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1 The SWPPP shall be prepared prior to the submittal of the NOI.The NO[shag be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. j 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder i compliance with the tensa and conditions of this permit.In addition,the SWPPP shag Area?(T,y item will NOT Include the Installation of Driveway Aprons.) identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice In a Box and the construction site disturbance is between 5,000 S.F.81 Acre in area, a Storm-Water,Grading Erosion Control Plan Required by the Town component shall be prepared by a qualified Design Professional Licensed in New York Drainage t that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior Issuance of Arty Building Permit (NOTE: A Check Mark(.�)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, COUNTYOF...........................................SS That 1,....!N.. .f4v ....v. .f Ax ............being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) Andthat he/she is the .................................'........................................................................ (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained ut this application are true to the best of his knowledge and behef;and ; that the work will be performed in the manner set forth in the application filed herewith. ` Sworn to before me this; ...............................................day of............................................,20..... NotaryPublic: .......................................................................................... ............................................................................ (Signature of Applicant) i FORM - 06/10 i PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: 5 S Why LL c Ax,'�- Address: 4c.72 0 OLb 'SALT— &902N91&- AL,T— R� � f/i &rr(-(-u C k N STATE OF NEW YORK COUNTY OF SUFFOLK residing at 3 7�l`I S�!�'t�v/C� �b 6 kj 6-00-1— being duly sworn, deposes and says that on the day of 6Cfa(3�� , 2015, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set T opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of So old; that said Notices were mailed at the United States Post Office at Lt) that said Notices we ed to each of said persons by CERTIFIED MAILMT RN CEIPT. i Sworn to before me this A Day of Notary Public CONNIE D. BUNCH Notary Public, State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2.CLL(,. ��o�OgpFFO�,��oG James F King, President h Town Hall; 53095 Main Rd. Bob Ghosio.Jr , Vice-President by , PO Box 1 179 Dave Bergen • Southold;NY 11971 John Bredemeyer ; SOT Telephone(63 1)765-1892 Michael J Domino 1 �' Fax(63 1)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of STEPHEN & AMY LiCATA COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS, I, W�l fi�i�-�I/( , residing at/dba 574( 5 m&iltl 4' !�XL_ being duly sworn, depose an say: `f. That on the rday of bc,T M, 2013I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, October 16, 2013. Dated: gnature) Sworn to before me this day ofC)C+ 20 1aj Notary Public CONNIE D. BUNCH Notary Public, State of New York No. 01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2 I NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD:. SUBJECT- OF PUBLIC HEARING: Add two dormers onto roof of existing two-story dwelling; rebuild existing 11'x30' screened porch and add a deck on its roof; and for the as-built 30'x50' patio, 68 linear foot x 2' thick stone walls, 7'x8' fire pit, and 8'x20' pergola. TIME & DATE OF PUBLIC HEARING: 1 #4 MUXYJ 04*_06W 160* 01013- o& or If you have an interest in this project, you are invited to view the Town file(s) which are available for insection rior to the day of the hearing during normal business days between the ours o 8 a.m and ,4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 Hoard of Trustees Application " t AUT$ORI Z ATIOR Nhere the applicant is not the -owner) C5Az.r I, residing at I/.C.1 print owner- of property) (mad-ling address} MAAIr_'6C_6C)K, do hereby authorize .(Agent) to apply for permit(sj from the Southold Bo of Town Trustees on my behalf. ' a gnata e) - Y Board of Trustees Application County of Suffolk State of New York 9O— tfE� L�C�q— 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 PRO RTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF S APPLICATION. Sign r of Property Owner h SWORN TO BEFORE ME THIS ll9fi DAY OF ( 201 P�pLYN P O®��..Exn. oiy9 Notary Pu lic � 40� 0�0 `��� APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the Hart of town officers and employees The puivose of this form is to provide information which can alert the town ofpossible conflicts of interest and allow it to take whatever action is n_ecessary to avoid same. YOURNAME: (Last name,first name,1piddle 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 C` Change of Zone Coastal Erosion I Approval of plat Mooring i Exemption from plat or official map Planning Other (If"Other",name the activity.) i 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. V i YES NO I 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. i 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(when the applicant is not a corporation); i C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. i DESCRIPTION OF RELATIONSHIP i Submitted thi Signature. Print Name Form TS 1 :r :i I i 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 si ilk ficant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 1 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. E C E Q ly/ 2 B. DESCRIPTION OF SITE AND PROPOSED ACTION l� SCTM# 01 W - Ak - C r --- 13 1 SEP 1 9 2013 PROJECT NAME Lt CA-t—k RAS L W E�--V Southoid Town Bpardot Tru Sl:Cs The Application has been submitted to(check appropriate response): Town Board ElPlanningBoard ElBuildingDept. 1r 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: Location of action: 7 0 DOD lis 5 d I L7- " i "` T l ( J a<1 Site acreage: L-7_0 e-i 9 S Q `5-1 Present land use: S l,B3GJ J1A2- Present zoning classification: 2. If an application.for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: C9V (a) Name of applicant: 1� F—Mr7') (b) Mailing address: �?D I3C7 X 1 44 7 WL-T-T ( t'J 04�- �J S Z (c) Telephone number: Area Code 14-6 (d) Application number,if any: Will the action be directly undertaken,require funding,.or approval by a state or federal agency? Yes ❑ No 1�1 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 LWRP 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,N"Not Applicable 1 , 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 Pa es 8 through 16 for evaluation criteria ❑ Yes 11 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 1:1Yes ❑ ( No u 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. ❑ ❑ 9 Yes No Not App. _ de 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 ErNot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastesZotApplicable See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes 1:1 No A lic le 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. ❑ YeF-1 No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE&.._ 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 2//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 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 PREPARED BY 144M— 42 TITLE_ Jlbn � DATE / /3