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HomeMy WebLinkAboutTR-9218A Glenn Goldsmith,President Q� so(/jy Town Hall Annex Michael J.Domino,Vice-President ,`o ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 COUNTY,Nct� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1737C Date: August 13,2020 THIS CERTIFIES that the construction of a 6' wide covered walk to a 20'x13' (260sq.ft.) ramadas with concrete footings and a slate roof— At oof .At 2000 Hobart Road, Southold Suffolk County Tag Map#1000-64-3-3.2 Conforms to the application for a Trustees.Permit,heretofore filed in-this office Dated February 23, 2018 pursuant to which Trustees Administrative Permit#9218A Dated May 16, 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 construction of a 6' wide covered walk to a 20'x13' (260N.ft.) ramadas with concrete footings and a slate roof. The certificate is issued to Joseph Battaglia owner of the Xoiesai ro rty. Authorized Signature Glenn Goldsmith, President SUUjTown Hall Annex Michael J.Domino,Vice-President hQ� �l 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �O �� Fax(631) 765-6641 -"- - - � eOUNT`I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: INSPECTED'BY:'"' `A A7U'.� ✓vCh:-275-- f r' Ch. 111 ;� . .. . _ INSPECTION SCHEDULE Pre-coristruDtiont"hayb:ate;lihefsilt�boro-rrf-silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection COMM TS' �.} CERTIFICATE OF COMPLIANCE: r OgpfFO(,��, Town Hall Annex Michael J. Domino, President �� y John M. Bredemeyer, III, Vice-President � � 54375 Route 25 Glenn Goldsmith H ' F" P.O. Box 1179 A Nicholas Krupski �y • o�� Southold, NY 11971 Greg Williams X01 ,� 'Ta Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction 'h constructed Project complete, compliance inspection; -- r Michael J.Domino,President *OF SOUr�o Town Hall Annex John M.Bredemeyer III,Vice-President �O l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G • Telephone(631) 765-1892 Greg WilliamsyCOU 'O Fax(631) 765-6641 � NTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9218A Date of Receipt of Application: February 23, 2018 Applicant: Joseph Battaglia SCTM#: 1000-64-3-3.2 Project Location: 2000 Hobart Road, Southold Date of Resolution/Issuance: May 16, 2018 J Date of Expiration: May 16, 2020 Reviewed by: Board of Trustees Project Description: To construct a 6' wide covered walk to a 20'x13' (260sq.ft.) ramadas with concrete footings and a slate roof. 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 Nathan Taft Corwin, III Land Surveyor last dated April 17, 2018 and stamped approved on May 16, 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. Michael J. Domino, President Board of Trustees Michael J. Domino, Presic Q C f Town Hall Annex John M. Bredemeyer II1,Vice-Presiaent ��Q� OGy� 54375 Route 25 Glenn Goldsmith o P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams y '! 1 Telephone(631)765-1892 ��l 1a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: :Completed in field b N Y JOSEPH BATTAGLIA requests an Administrative Permit to construct a 6' wide covered walk to a 20'x13' (260sq.ft.) ramadas with concrete footings and a slate roof. Located: 2000 Horbart Road, Southold. SCTM# 1000-64-3-3.2 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 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 M. Domino G. Goldsmith N. Krupski G. Williams Other Page 1 of 2 Michael J. Domino,Presii o��000F01Jlr Town Hall Annex John M. Bredemeyer III,Vice-Pre"siaent ,ice ��q 54375 Route 25 Glenn Goldsmithy P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams 4,- p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: JOSEPH BATTAGLIA requests an Administrative Permit to construct a 6' wide covered walk to a 20'x13' (260sq.ft.) ramadas with concrete footings and a slate roof. Located: 2000 Horbart,Road, Southold. SCTM# 1000-64-3-3.2 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 G. Williams E. Cantrell D. Di Salvo Other Page 2 of 2 SURVEY OF LOT 2 MAP FOR JOSEPH & HEIDI BATTAGLIA FILE No. 11840 FILED DECEMBER 22, 2011 SI T UA TE SOUTHOLD 01�1J' TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S . C. TAX No . 1000 - 64-03 -3.2 SCALE 1 "=20' / DJ FEBRUARY 209 2013 APRIL 17, 2018 ADD PROPOSED SEATING AREA ,� � �,' //�/ • 2����� ' � TOTAL R EA INE ) 17327 a a. ft. To / UPLAND AREA = 53,208 sq. ft. A v-o 1 .221 ac. '0' I WETLAND AREA = 4,601 sq. ft. i �p O (TO TIE LINE) 0.106 ac. uo \, O \� �/ \\ _' i �`� 0 WNER: oQ \ o�,LJ��P� JOSEPH BATTAGLIA �j <:1)1b0\ \ HEIDI BATTAGLIA , \ \ \ 28 WILTON ROAD 32 / 0'o Gti �F COLD SPRING HARBOR, NEW YORK 11724 '�� lT�o \ 0 ° 01, I s \\ �'� • \ \ h 79, O h RCN v / CESSPOOLO �F 9�F` PROPOSED BUILDING COVERAGE \\ F ` ` / Q��G , OVER UPLAND AREA sJ DESCRIPTION AREA % LOT COVERAGE \ °G9�9�y� \�'-� w &OIJ rn 0 2 CESSPOOL A� �o J, EXIST. HOUSE 4,648 sq. ft. 8.7% �J \ c,°s SE 9�F , J & G,q • �F EXIST. GARAGE 768 sq. ft. 1.5% OJT ,�\ EXIST. (3) PORCHES 903 sq. ft. 1.7% 9cG, \ \ �sF° \ ` 3 CESSPOOL 00 ,� � � PROP. SEATING AREA 324 sq. ft. 0.6% 91 9' 24, 7 6. TOTAL 6,633 sq. ft. 12.5% ,� \ ::::::::: . O\ \ • • , Fo Q �"6N 80, \ OOF \ �'6,�� `\��c d O /3 :::::' SE4Tj GD �,�o� SEPTIC SYSTEM TIE DISTANCES N, COVER HOUSE CORNER"A" HOUSE CORNER"B" SEPTIC TANK , , 0 L 0 T 2 £ �O/N \ �,o OUTLET COVER 17 19 oG� ���\\�\ �Cyc • 9'� \ \ NV�PE \ \ �� ° o�F CESSPOOL 35.5' 30' SF•�O /f i 9�'�r-��'L�. �I!\\ \ � \ °��cy /y COVER 1 Q�OQO Y Q o'L��oy\ • ��� \ Go��' RS'�O COVERCESSP02L 36' 45.5' �0 9 qA `� 20>> 9 \g�9 •�F CESSPOOL COVER 3 20.5 37 ooti� alr, \ y 0 � F /w �y�� \` \ • 0" /1/00 \ oil �'4 S6 4AI PO �F cFl ✓ 9 'i! 20 F i ,� a APR 1 a Oa k Fac s� I u F C�_ \ Fac • ///' / ��oP�� Nc• OJ \ FSC �--E�� 9 • — P� a� � � �\ 4 � �. � � � APPROVED BY 9 a �P - BOARD OF TRUSTEES � O� PREPARED IN ACCORDANCE WITH THE MINIMUM ya ^ ° v STANDARDS FOR TITLE SURVEYS AS ESTABLISHED 4 .09' kili O O O TOWN OF SOUTHOLD BY THE LI.A.L.S. AND APPROVED AND ADOPTED N • o , \ ` \ O9� loll, � O� ���/���� TITLE FOR SUCH USE B�ASSOCIATION SOCIATION. HE.•NEW`YORK STATE LAND O S �, _ ° � O O \, DATE . O '�p� Y \, W6 V wook "?r. :• t CTS .6 W, e0gR0 ,�00�� nth'7 N.Y.S. Lic. No. 50467 I UNAUTHORIZED ALTERATION OR ADDITION •Q / �Q TO 'MIS SECTION SURVEY OFIS VIOLATI NEW ON OF YORK STATE Nathan T of t Corwin I I I EDUCATION LAW. Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isaksen, Jr. L.S. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INST- PHONE (631)727-2090 'ax (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF THE EXISTENCE OF RIGHT WAYS 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 28-160P IF 11 APR 1 9 2018 r ZZ i p - --1A " EACH END OF I a X 20 G'O C I Sd NAILS AT GAGE STRAP G"O.0 WITHIN 48"OF ` O.C.WITH A CAPACITY RIDGE VENT RIDGE. OF 800 LBS. TOP RAFTER= 1"ABOVE RIDGE } SECURESfOE NAIL)ROOF RAFTERS TO RIDGee W/4- I Gd NAILS. (zb—----_ VARIES(SEE ELEV.) MIN IECLEAR Zakary Hagemann Associa1 SPACE AT RIDGE BEAM VAULT D SECURE TOGETHER 34 A u Tey Avenue ' PER MANUFACTURER. NOTE: Oyste r Ba y, N.Y. 11771 - REFER TO PLANS FOR SIZES OF: Tel. 516--922-5680 ROOF RAFTERS, RIDGE BEAMS AND COLLAR TIES. Fax, 516-922-5683 TYPICAL RIDGE TEN51bN STRAP DETAIL Revisions No. . Date Description 071 L 31E N _ E atpiT - - 11 n6`4 Project_= Project Title: - Jo i r - HCl - _ __---- - __ -- i I --- - - - --- -- -- r-1- 1: , APR 1 9 2018 __ • PrP Y oseph Battaglia 000 Hobart Road,Southold _ t CTM#: 1000-64-3-3.2 y 5/9/l 8 Al k -77 IA Ali It 4 6 _` _ Acv , �" \��• t r . +,' d .,°'" � ♦sew '-� _ _ 1 .,...; v� ' - - '�T ✓8°t e�/�� � ., y• _j�� z:. 'fir 6 s� "� �J w�I••, Ii.'.4 11111 I �, r01�� 11116 r. trial ..i: i'M " .�}J�.�T �� ^�,� � 1°l �,. — — 1 "`, �'�� ,�;� �- .: - - - ry _ _ y - � � � ��. � . .� „. IM `y4"��. \,' �alp C *` ` • iV✓ �� ;; ,:� `: a r�. -� F �'�' �_� _.iia i �t �I ,M U , � �� 'N � �__ _ � wy �w f Y �.:. ;1 t ..c i n r PROPE ae P O 00 W2 It 7 ` P to �Gy` 14.5 3 O I P m 'a ,�, P ,e P P 0 ^ 14.6 t 1 •. �'' C .I 147 j .. . z+ 1 of s a ° f ® a zs w mo B e P 9 ma \^ s )3 ,m ° Y \ ♦4 ig r' m �!► � � tea' i -LL \ g . •� g +,a� ^\ nq g I ,z j NOTICE mwy� COUNTYOF SUFFOLK © E 50117NOLD SECTION NO Real Property Tax Service Agency v c, su .0 ----- o. . � ceunry LmM RIwrMM,NY ttfet M 0OY ..d... a r v.,NQs uu u. —_-- ye�< --.-- oiru.--w-- g A 00 rn�cr ew 1000 P ptp PROPERTY MAP r" OFFICE LOCATION: '0if S® �® MAILING ADDRESS: Town Hall Annex �® �® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 �® Telephone: 631 765-1938 ® ` Fax: 631 765-3136 #7 LOCAL LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: May 10, 2018 Re: Local Waterfront Coastal Consistency Review for,JOSEPH BATTAGLIA SCTM# 1000-64-3-3.2 JOSEPH BATTAGLIA requests an Administrative Permit to construct a 6'wide covered walk to a 20'x13' (260sq.ft.) ramadas with concrete footings and a slate roof. Located: 2000 Horbart Road, Southold. SCTM# 1000-64-3-3.2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. 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: Damon Hagan, Assistant Town Attorney Jamcs C= King. TrLLSLCC _ Jouu to to- tv cw r0CK L1S1/l-V7J7 Oa,e Bergen. Trustee O elephonc (63U 765-L892 Charles J. Sanders- Trustee Fae (631) 765-6641 __ ���oU Y• `` S 1 ,e4� , BOARD OF TOWN TaUSTLES D [EC[E0V[E TO WN O f SO LITHO LD D To_ Southold.Tow6 Building Department APR 2 0 2018 Re_ Verification of Building Department Permit Requirements BUIELDINGDEPT. TOWN OF SO ®LD SCTM#: 3 — Property Owner Mame: ' PAeTAC-U A- Date Sent to Btdg_ Dept_: The: Office of the Board of Trustees is forwarding the above referenced applicadoa for verification of the Building Department`s permitting requirements stated below: YES NO Will the proposed project require a Building Permit? IZWill the proposed project require a variance determination from the Zoning Board of Appeals? - I/ Will any part of this application be considered as Demolition as described under Town Code? . COMMENTS: Sl nature of Reviewer -Date a 1 Joseph Battaglia 2000 Hobart Road Southold, New York 11971 631-678-6546 April 18,2018 To Whom It May Concern Southold Town Board of Trustees: 1,Joseph Battaglia,am notifying the Board of Trustees that 1 plan to add a 260 square foot extension to my existing porch. The extension will be constructed with a 20'by 13'concrete footing and a slate roof as provided per the plan. Please refer to the plan for further details. Also important to please contact me a day in advance for a site inspection so I can make arrangements for someone to secure guard dog inside house.Thank you. Joseph Battaglia ` APR 1 9 2018 w� i Michael J.Domino,President ��rjf SO!/Ty� Town Hall Annex John M. Bredemeyer III,Vice-President �� lQ 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q � O Telephone (631) 765-1892 Greg Williams �CUU O Fax(631)765-6641 NT`I,�� BOTOWN TOWN O OUT OLDTEES DLF ,� To: Southold Town Building Department 3D MAR 1 2 2018 Re: Verification of Building Department Permit Requirements jj?JV,.a^u'r5.1'V�'T s.�.�{er • SCTM#: TOWN OF SOUTHOLD �� —� � �� � Property Owner Name: p� Date Sent to Bldg. Dept.: la J 1 The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from ZheZoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS. ignature of eviewer Date t Soo" Michael J.Domino,President "' V '� Town Hall Annex fid" 54375 Route 25 John M.Bredemeyer III,Vice-President gar `.k - P.O.Box 1179 Charles J. Sanders Southold,New York 11971 Glenn Goldsmith '� �+' ` y�?' Telephone(631) 765-1892 A. Nicholas Krupski / Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Th1s Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application ,, Administrative Permit 4`,a'' =- _���- _- l'in! _Ain endment/Transfer/Extension _Rcceived Applica°to n: '����� `' FEB 2 3 Received Fee: $ l ®�(� 2��8 Completed Application:. �- Incomplete: SEQRA Classification: Type I_ Type II Unlisted Lead Agency Determination: 2tCoordination:(date sent): LWRP Consistency Assessment Form Sent: /_CAC Referral Sent: . , V Date of Inspection: .. Receipt of CAC Report: Technical Review: Public Hearing Held: ► Resolution: Legal Name of Property Owner(s): ® ��.� �-A �rT'T-A �—� P� Mailing Address: __ , t ( 1TU N - cot 0 �C, ►-�g(Z N •`Pe � Phone Number: (05q-6 Suffolk County Tax Map Number: 1000- Property 000-Property Location: . aO O OC2 J, WkCL t (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Board of Trustees Applicazio:a GENERAL DATA Land Area(in square feet): Area Zoning: Previous use of property: Intended use of property: Covenants and Restrictions on property? Yes /No If"Yes",please provide a copy. 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? Yes No Prior peimits/approvals for site improvements: Agency Date prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No V Yes If yes,provide explanation: Project Description (use attachments if necessary): 4M—A��,�_ f /� ��. 0A 611AVC (.�✓US7/11101_i, w (?c� ` Board of Trustees Applicaz5.on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: —776) Area of wetlands on lot: ` �J(� square feet Percent coverage of lot: , /I? Fi% r Closest distance between nearest existing structure and upland edge of wetlands: , feet Closest distance between nearest proposed structure and upland edge of wetlands: s feet Does the ject involve excavation or filling? No Yes If yes,how much material will be excavated? © cubic yards How much material will be filled?_ _cubic cubic yards Depth of which material will be removed or deposited: 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 Appendix B Short Environnmental Assessment Form Part I -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 l -Project and Sponsor Information Name of Action or Project: Project Location(describe,and attach a location map): Brief Description of Proposed Action: Alt, 'Name of Applicant or Sponsor- Telephone: se pa r/�14 01414 Address:= City/PO: Stated:J ) Zip Code: 1.Does the propos dc� 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 yeYES If Yes,list agency(s)name and permit or approval: ❑ '3.a.Total acreage of the site of the proposed action? __ acres b.Total acreage to be physically disturbed? /00 s �7�acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? /-0 acres _ _ fc. i.__-._..___-___ _/Residential 4. Check all landusesthat occur on,adjoiningandnear the proposed action. ❑Urban ❑Rural (non-agriculture) ❑Industrial ❑Commercial (suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YE N/A a. A permitted use under the zoning regulations? �. Vg b.Consistent with the adopted comprehensive plan? µ ❑~ 6. Is the proposed action consistent with the predominant character of the existing built or natural_ NO YE landscape? 7. Is the site of the p'roposed action located in,or'does if adjoin,a state listed Critical Environmental Area?— 'NO YES If Yes,identify:,.__,._,__ Ln 8'."'a.Will fie proposed action result in a substantial increase in traffic above present levels? - 1V0 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 meef or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies, ; E 10. Will the proposed action connect to an existin=g-public/private water supply? NO� YES If No,describe method for providing potable water- 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment; 12. a.Does the site contain a structure that its listed on either the State or National Register of Historic i NO� YES Places? b.Is the proposed action located in an archeological sensitive area? 13.'a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain ` JNO YE wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically after,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:, 0 14. Id ify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline El Forest ❑ ricultural/grasslands El Early mid-successional ❑ Wetland' ❑Urban TfSuburban I5.Does the site of the proposed action contain any species of animal;or associated habitat`s,listed .NO YES by the State or Federal government as threatened or endangered? 16.Is the projeef site located in the 100 year flood plain? NO_ YES 17.Will the proposed action create storm water discharge,either from point or non-po t sources? — NO ES-_ If Yes, a.Will storm water discharges flow to adjacent properties? NO . FJYES 00 b.Will storm water disehanges be directed to established conveyance systems(ru ft and storm drains)? If Yes,briefly describe: NO AYES ------------ Page 2 of 4 I$:Does-the-proposed action include construction or oiher activities that result in the uilpoundinenit of t 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 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO, . ES- completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFO I ''ION N Off'l'' ED _ ISTRUE AND ACCURATE TO T BEST OF MY.' KNOWLEDGE Applicant/sponsor name: - Date:,. 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 Pail I 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 3 < may may 'occur occur 4'L Will the proposed action create a material-conflict with an adopted land use plan or zoning regulations? El 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.V4 Will the proposed action have an impact on the environmental characteristics that caused the 13establishment of a Critical Environmental Area(CEA)? 15. 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? j l c6. Will the proposed,action cause an,u crease in the use of energy and it fails to incorporate. (—"( reasonably available energy conservation or renewable energy o portunities? (--1 7. Will the proposed action impact existing: In 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, f i architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 ; I No,or Moderate small to large . impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or hurrah 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.F.ach potential impact should be assessed considering its setting,probability of occurring; duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-terns,long-term and cumulative impacts. a t s f Check this box ifyou have determined,based on the inforination 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 acts. Town of Southold-Board of Trustees G� Name of Lea en 'Ute v _ h^-If..VIN President Print or Type Nameof Resp ns• e Wicer in Lead Agency Title of Responsible Officer 'ignatui•e of Res`ponsib e Offieer-in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 - APPLICANUAGENUREPRESEI+NATIVE TRANSACTIONAL I)ISCLOSYJI2L.F® 'The'I'�n of Stiutiiald's'C`:ode`rif tlsicg raliitiitG cdriflicts afinter�st•ozz the part of town ti ficer5 and cm{ata s;7'lic,Moose of 't{1{s`Tfari is fa'°tirovic�e iforiiiltticio,wvliich'can aleft{lie#iaryn`oCpossible cnpflicts of Iziteres!�ncl.allow°iCtotal n ztthntevoc"'acticin is, YOUR NAME: •(Las(name,firs ame,-ipiddle initial,t7nless you are applyin-g'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 Tr _ Variance Trustee . Change of Zone - - e Coastal Erosion Approval of plat Mooring Exemption from plat or official map _ _ Planning Other (If"Other',name the activity.), Dp,yoiipci3iitlitl,ly(fir tiittintftti-`ytttir eeiulp nl'y,sjlanse,sitaIing;piu•ent;or,child)have it reiationsiii'p lyi't{rany ol'licer or cn7ployee, ' of 1he'Cown iil';Stiuttiglti? "ltel;.tt{atlzilii{i"iitclude~s.by.Mood;mart nage,or busjttcss ifiterest:"Ii'usiiiess:iritcn•st"merii7s a'lit7s{itt:s ; inclurling.tt'partnersll7{5,Iti'1Y131C1Ythe.taSil111fttCCr l7r,dt17plU}«C'17i7S 4't 11 i1 partlal;(31it1erS�lij)(7f(a i'Lnlpla}fi1eill.t7y)a Ct}rp(3f Flflf}il in`iniliicli'tlteataivti iiilit7 r i.Er etrtiilbyee oivn's'mre:ttiatl',5"'o ti, lie sllnrc YES 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/ageat/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all'that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(whets the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION'OF RELATIONSHIP' Submitted t ' da of 200 g ;Signatin Print Name (A— Form TS I Joseph Battaglia 2000 Hobart Road Southold, N.Y. 631-678-6546 February 12, 2018 To Town of Southold Board of Trustees: I;Joseph Battaglia grant permission to a designated Town of Southold Board representative to have access to my property at 2000 Hobart Rd., Southold to inspect the site where the pergola/ramadas will be constructed. However due to the guard dog on premises an appointment must be arranged with me prior so that the dog can be restrained by the trainer or myself. This notification constitutes that the owner of 2000 Hobart Rd and adjacent LLC cannot be held responsible for personal injury by the guard dog if access to the property is gained without an agreed prior arrangement and in the presence of Joseph Battaglia or appointed family member. Please contact me at the above phone number so we can establish a date and time for inspection. Thanks again for your continued cooperation. Sincerely, Joseph Battaglia Y `I Board of Trustees Application AFF'IDAVI'T' pS,r �✓� ��} l-.r _ _BEING DULY SWORN DEPOSES ANI➢ AVFI FIRMS 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/PIER KNOWLEDGE AND BELIEF,AND THAT ALL WORD WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL,DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF E GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE TIME TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO 'INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOA OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF TIME PERMIT. t ignature of Pr caner t SWORN TO BEFORE ME THIS l a DAY OF Ari' Notary Public THOMAS M HICKEY Notary Public,State of New York No.01H16224731 Qualified in Suffolk July 12.2 rS F_('_ kT7"1F4�LD LP T11 F-� Commission Expires July 12,2018 4.— and of Trustees Applicata AFFIDAVIT P I ( � BEING DULY SWORN DEPOSES AND AFFIRMS THAT hBOSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signatur of Property wner Signature of Property Owner SWORN TO BEFORE ME THIS (04+1 DAY OF MOS-6) , 2011� Notary Public CONNIE D. BUNCH Notary Public,State of Nov York No.01 BU6185050 QuaAfied in Suffolk County Commission Expires April 14,2-�7a,J) AFF;.ICANT/AOENT/RE pRE SENTATI VF TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics rohibits conflicts of interest on the part of town officers and employees.The purpose_of this form is to provide information which can alert the town of Mssiblerconflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,first name,1n ) initial, less you are applying in the name of someone else or other such as a company.If so,indicate the other person's or company's NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee _ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than,5%of/the shares. YES NO V If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(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 Submitted this 4day of �'! v�20� Signature Print Name Form TS l g Town of Southold LW-RP-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. r 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 be :evaluated., as-'to�`its sip-nificant= :'bdneficial and.•advei,se effecis i tinathe co6§ta1 6i�6 `wliiel)i tides all of.86ut.11old'TOW' rJ 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. Thys .each-41rrsIver"nnnnnst. lie-ex fainedln ddail'1istitr '.both saa ortirn<x .nnd'-noan- �n oa-t,ing-facts. If an action cannot be certified as consistent -with the LWRP policy standards and conditions,'it shill'iiot'bc.cyxcicrt�.dcen. 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 PROJECT NAME The Application has been submitted to(check appropriate response): Towns Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital =construction;planning activity;agency�regulation,land transaction) (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit, approval, license,certification: Nature and extent of action: � Q i Location of action: Cr�D �d��w, d`-� <SC)c)�1) 0 Site acreage: �e y Present land use: "g N FU P- < 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: (a) Name of applicant:. I/� A,6 (b) Mailing address:__ �� , e C'! 1-7 c Telephone number: Area Code (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes O No XP 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 Pest 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 F] Not Applicable Attadli additional sheets--if necessary " Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See L WI--I��P Section III—Policies Pages 3 through 6 for evaluation criteria �1 Yes El No KNot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes,E] No PPNot Applicable f Attach additional sheets if necessary^ - NATURAL COAST POLICIES k Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages S through 16 for evaluation criteria Yes No FNot Applicable Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of Southold. See LWRP Section Ill —Policies Pages 16 through 21 for evaluation criteria �. Yes . No of 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 Ill—Policies; Pages 22 through 32 for evaluation criteria. Yes No 7%,-/No Applicable Attach additional sheets if necessary - Policy 7. Protect and improve air quality in the 'down of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. f ; Yes=.a"No'N)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. k 1� Yes ; No Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources-of the 'Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. Y,ezll No rNot Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. 11 '1'1,,Yes ;U No K)Not Applicable Aitach additional sheets if necessary } Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic IE��s-�t--uary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. .,U Yes ,0 No RNot Applicable N 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 s0 No9Not 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. of Applicable PREPARED BY\0 �P ' 'i'j LA- TITLE_�(/V 0 F� DATE 5 � = -- - LI