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HomeMy WebLinkAboutTR-9245A Michael J. Domino, President � FFD[,(00Gy� Town Hall Annex John M. Bredemeyer, III, Vice-President o 54375 Route 25 Glenn Goldsmith H 2e P.O. Box 1179 A Nicholas Krupski �y • �� Southold, NY 11971 Greg Williams �'Ol ,� dao 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 '/2 constructed Project complete, compliance inspection; O�� Uj�ol Michael J.Domino, President QF SOTown Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �p� Telephone (631) 765-1892 Greg Williams �l�`,ou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9245A Date of Receipt of Application: May 11, 2018 Applicant: 470 Lloyds Lane, LLC c/o Andrew Drazic SCTM#: 1000-99-3-4.3 Project Location: 470 Lloyds Lane, Mattituck Date of Resolution/Issuance: June 20, 2018 Date of Expiration: June 20, 2020 Reviewed by: Board of Trustees Project Description: Prune the existing black cherry trees; remove all down debris; remove invasive vines; and re-vegetate with bayberry (1 gallon potted) in all exposed areas within the 25' wide non-turf buffer area. 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, received on May 11, 2018 and stamped approved on June 20, 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 SURVEY FOR 470 LLOYD'S LANE LLC tI� LOT 3 'I MAP OF 5 215 HONEYSUCKLE HILLS f �p FILE No. 7019 FILED OCTOBER 16, 1981 �D g' SITUATE y` Saathcid ia�><�n 110 Bm B MATTITUCK TOWN OF SOUTHOLD A SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-99-03-4.3 r• :. ! s y �!.;r w° i%A6ED AA 10 SCALE I"=40' gER SCgL APRIL 14, 2015 3. D PROPOSED HOUSE SEPTEMBERS17, 20155 RELOCATED PROPOSED HOUSE n� g �OIO i' //j //j/// ART` OCTOBER 20, 2015 REVISED MAP A 0 1 10 // /// 1' APRIL 9, 2016 ADD 50' BLUFF SETBACK MAY 20, 2016 ADD 25' NON—TURF BUFFER & ASSOCIATED PROP. FENCE di �i6 49 AREA = 34,126 sq. ft. 0.783 ac. 56 CERTIFIED T0: 470 LLOYD'S LANE LLC a0. STEWART TITLE INSURANCE COMPANY NATIONAL LAND TENURE COMPANY, LLC /i / // //////// //i i�J/�� i /i 1� / / 66 J\ NOTES: ///// ///// j /j / /�$ NQ 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM /// //// /j j / / / ////// / 12 EXISTING ELEVATIONS ARE SHOWN THUS: 95.0 16/ / 'Z-, ////// // // / /aY / / // // >• /13 �+ PROPOSED ELEVATIONS ARE SHOWN THUS: q4A \g / // / // / // A EXISTING CONTOUR LINES ARE SHOWN THUS: ———95——— / / // //// / - /1 0+ 2. ZONING USE DISTRICT: R-40 / / �'� (_ (; 15 3. MINIMUM SEPTIC TANK CAPACITY FOR 6 BEDROOM HOUSE IS 1,500 GALLONS. 5�/_ 1 TANK; B' DIA., 5' LIQUID DEPTH 14, %/ MINIMUM LEACHING SYSTEM FOR 6 BEDROOM HOUSE IS 400 sq ft SIDEWALL AREA. / // / j/ / / �W* / `• ('- •,•,•••••1 1 POOL. 16' DEEP, 8' dia. / // �.•. / Q,-.••.• - PROPOSED SOX FUTURE EXPANSION POOL 5 �'/ / / / / �'%'.'.•�/f,,0'�•••• ®PROPOSED 8' DU. X 16' DEEP LEACHING POOL WITH 8' REINFORCED TRAFFIC / / / / / / .•.•� •/.�.: e�1 :�;%� I /19 COVERS AND HEAVY DUTY LOCKING CAST IRON COVERS TO GRADE 51 j/ /L ' qJ�/.'' /80 0)PROPOSED 1,500 GALLON SEPTIC TANK wrIH 8' REINFORCED TRAFFIC ••.�•' .�!'.• / 1 O COVERS AND HEAVY DUTY LOCKING CAST IRON COVERS TO GRADE 5p/ / •;••;C,� •� ,••/ 4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD AP P 0 9 6 / r•• OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. I ��'"" r •1:'.''��•�'_y�}' � 0� -< 02 THERE ARE NO DOMESTIC WATER WELLS WITHIN 150 FEET OF PROPERTY. %'. O JfLE / / //0' 6. IF CLAY IN THE LEACHING POOL AREA IS FOUND, IT MUST BE 6A EXCAVATED AND REPLACED WITH CLEAN SAND. BOARD OF 1 RUSE �� / ti � ��///� / 7. PROPOSED DRYWEIIS FOR ROOF RUN—OFF ARE SHOWN THUS:; 86 TOWN OF SOUS 4 TEST HOLE DATA ®ATE —89 (TEST HOLE DUG BY M AONA,n ON MAY 15,2015) DIRK BROWN SANDY LOAM OL os' ^ i/ BROWN AND PALE BROWN SILTY Sura SM x •004 � 01� i / / / / � \ \ •�y. G< so— PALE BROWN FINE SAND SP < eve / /a \\ \ _ I o PALE BROWN SILTY SAND� Su w ``e \ F 1 -\ \ •• \�j\ s \ I PALE BROWN FINE SAND SP / \ �y Q�r° I :tb q�.0 / 2r may:: T 010— vtoke \ \ A ► , °o 5� ro6x ► O\ 5 o � I �-\ I _::r •:. gip • ' ! OVIL S s\y 1 I � •I / / VE\. W LA ® OFT �E 01 i �765T OLEy UTHOLO N - \ / +Q�o�' •,L�' a/ Day�PtER PR POSED ' TE RETMING DETAIL TO- + / — �—— - ----- 1 �� Is GRADE j -I G�rS�R FREPA _;9•I V CE°iWnH MINIMUM Eli 1 Ve G 0. STI�NOAROS•FOR�RL SURVEI'SL•AS ESTABLISHED -. No. 5 REBAR ' I Q 1 t\ 0 ,/�FBY-SNE°CI L'SNANDFAPPRp�{Ep D ADOPTED • O 12'O.C. ov VG 1 FOI�SUChcUSE'SY THE L•IE�YOR ATE LAND —No. 5 REBARWATERPROOFING PRIOR 3 •• O 12 D.C. O V5�5 Q\1B t� ,ASSDCIAnON. TO BACKFlWNG oy Cr' �L •�1 7- I r ' 4 +.' 7 � z FINISHED GRADE _ 30'SPLICE ^ Y No. 5 REBAR O 12'0. 4. w �p,\Y„Q� cc'•7 w 1 C G V1 o a JG Y ':• a �>`�QJ0v J `J N.Y.S. Lic. No. 50467 �A m z Jy6`' • Av ' TO THIS ALIS A MN M ADDITION Nathan Taft Corwin III To THIS suR+/EY Is A vlounoN of SECTION TI OF THE NEW YORK STATE !Land Surveyor 12' EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING NOTES: THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED 1. CONCRETE: 3,500 pal air Intralned TO BE A VALID TRUE COPY. 2. STEEL' 60 kai epoxi coated Successor To: Stanley J. Isaksen, Jr. L.S. 3. ENGINEER OR ARCHITECT TO INSPECT REINFORCING CERTIFICATIONS INDICATED HEREON SHALL RUN Joseph A. Ingegno L.S. PRIOR TO PLACING CONCRETE. ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED,AND ON HIS BEHALF TO THE Title Surveys —Subdivisions — Site Plans — Construction Layout TITLE COMPANY,GOVERNMENTAL AGENCY AND SANITARY SYSTEM AND RETAINING WALL DESIGN BY. LENDING ASSIGNEES OF TLENDING INSTITUTION SNE HEREON,AND TO PHONE (631)727-2090 Fax (631)727-1727 a JOSEPH FISCHETTI, PE TUITION CERTIFICATIONS ARE NOT TPMSFERABLE OFFICES LOCATED AT U41UNG ADDRESS 1725 HOBART ROAD THE EXISTENCE OF RIGHT OF WAYS 1586 Main Road P.O. Box 16 SOUTHOLD, NEW YORK 11971 ANY/Olt NOT SHEMENTS OF OWN ARE RECORD, IFTEED. Jamesport, New York 11947 Jamesport, New York 11947 Michael J. Domino, Presii_ O$11FF0(�'G Town Hall Annex John M. Bredemeyer III, Vice-Ormaent a �l 54375 Route 25 Glenn Goldsmith o P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams y �r Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 6/19A9' 5.36 Completed in field by: /dIsM;4 , Suffolk Environmental Consulting on behalf of 470 LLOYDS LANE, LLC, c/o ANDREW DRAZIC requests an Administrative Permit to prune the existing black cherry trees; remove all down debris; remove invasive vines; and re-vegetate with bayberry (1 gallon potted) in all exposed areas within the 25' wide non-turf buffer area. Located: 470 Lloyds Lane, Mattituck. SCTM# 1000-99-3-4.3 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: I II Unlisted Action Type of Application: Pre-Submission YAdministrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: y'K L ,I have read & acknowledged the foregoing Trustees comments: gent/Owner: resent were: J. Bredemeyer M. Domino /G. Goldsmith N. Krupski G. Williams Other 470 LLOYDS LANE, LLC Property Situate: 470 Lloyds Lane • Mattituck ■ New York SCTM #: 1000—099 —03 - 004.3 (Photograph taken on February 13, 2018) r ` v . •_ .iy +. —, may.. ` y .. ........... 19L .�e �P 1 Photograph indicating the location of the required Non-Turf Buffer (arrows) that is to be established 25' seaward of the existing split-rail fencing. Photograph taken from the northerly half of subject property, facing north, overlooking Long Island Sound. 470 LLOYDS LANE, LLC Property Situate: 470 Lloyds Lane ■ Mattituck ■ New York SCTM #: 1000—099—03 - 004.3 (Photograph taken on February 13, 2018) - - — _ --------- 17 ---7 E n.a r . +,dap Photograph indicating the location of the required Non-Turf Buffer (arrows) that is to be established 25' seaward of the existing split-rail fencing. Photograph taken from the northerly half of subject property, facing northeast, overlooking Long Island Sound. I— --N - I..I -- --.I--, F --- . --- 7—------------- pely Tax Se�wicc Agen r Real P10 cy�I 098 low 40110 J, 0 01 eT 9.4 4ALA(l) 0 11b 2L&W jr 40 ­A4c) 4D 26 4b &IA V NO I-WBATE OF NEW YOIK�n . 0 19 _TT� DISTRICT A• I IA a, w 4) 4 2 IA(C) 16 No SEESEC SEESECHO I. MATCH —Z——————L.W- 41 (5 No.1. 5 IS m.C NOTICE COUNTY OF SUFFOLK K SOUTHOLD SECTION NO E Real Property Tax Se-ice AgenCy y myilNi m 099 A P im �1• c l , r OFFICE LOCATION: ®��®� ® 1 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 Fes: 631 765-3136 C®U 9 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: June 14, 2018 Re: Local Waterfront Coastal Consistency Review for 470 LLOYDS LANE, LLC, c/o ANDREW DRAZIC SCTM# 1000-99-3-4.3 Suffolk Environmental Consulting on behalf of 470 LLOYDS LANE, LLC, c/o ANDREW DRAZIC requests an Administrative Permit to prune the existing black cherry trees; remove all down debris; remove invasive vines; and re-vegetate with bayberry (1 gallon potted) in all exposed areas within the 25' wide non-turf buffer area. Located: 470 Lloyds Lane, Mattituck. SCTM# 1000-99-3-4.3 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the ' Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided: 1. Soils disturbance other than digging and installing bayberry in 1 gallon pots is kept to a minimum to further Policies 4 and 6. 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 ev S� SOLIp. Michael J.Domino,President ;;S=am Town Hall Annex "� G?�e 54375 Route 25 John M.Bredemeyer III,Vice-President r 4. x P.O.Box 1179 Charles J.Sanders , Southold,New York 11971 ° 5 Glenn Goldsmith .aa�'��' Telephone(G$i)76�1892 A.Nicholas Krupsld m" � d Ull 0', Fax(631)765-6641 Office Use Only Coastal Erosion Permit Application Wetland Permit Application X Administrative Permit Amendment/Transfer/Extension Received Application: Received Fee:$ 100' +_ ,. Completed Application: 51/9119 Incomplete: 1 ° MAY 1 2013 ` .y SEQRA Classification: i e_ Type I Type II Unlisted_ Coordination(date sent) V�l Assessment Form: Consistency Asses men Date of Inspection: &'13[ x Receipt of CAC Report: Lead Agency Determination Technical Review: Public Hearing Held: cL Resolution: Name of Applicant 470 Lloyds Lane, LLC c/o Andrew Drazic Address 122-11 15th Avenue, Collel;e Point, NY 11356 Phone Number: (718) 321 - 0117 Suffolk County Tax Map Number: 1000—099—3—4.3 Property Location: 40 Lloyds Lane, Mattituck,New York 473 east of Sound View Avenue (provide LILCO Pole#, distance to cross streets, and location) AGENT: BRUCE A. ANDERSON(a Suffolk Environmental Consulting, Inc. (If applicable) Address: P.O. Box 2003: Bridgehampton,NY 11932 Phone: (631) 537—5160 Board of Trustees Application GENERAL DATA Land Area(in square feet): 34,126 square feet± Area Zoning: R-40 Previous use of property: Residential Intended use of property: Residential Covenants and Restrictions: Yes X No If"Yes",please provide a copy. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes X No Prior permits/approvals for site improvements: Agency Date Trustee Permit# 8803 May 18, 2016 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation: Project Description(use attachments if necessary): Applicant proposes to prune the existing black cherry, remove all down debris, remove invasive vines and revegetate with bayberry(1 gallon potted) all exposed areas Activities to take place within pre-approved 25'Non-Turf Buffer established pursuant to Trustee Permit#8803 dated May 18, 2016 . i Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purposes of proposed operations: Enhance established 25-foot non tuff buffer Area of wetlands on lot: 0 square feet Percent coverage of lot: 15.0 % Closest distance between nearest existing structures and upland edge of wetlands: >200 feet Closest distance between nearest proposed structures and upland edge of wetlands: N/A feet Does the project involve excavation or filling? X No Yes If Yes,how much material will be excavated? N/A (cubic yards) How much material will be filled? N/A (cubic yards) Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A Statement of the effect, if any,on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): No impact to the wetlands are anticipated as the pro-ject seeks to enhance a non-f=turf buffer. Short Environmental Assessment Form Part I -Project Information Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 470 LLoyds Lane,LLc Project Location(describe,and attach a location map): 470 Lloyds Lane,mattituck,NY Brief Description of Proposed Action: Applicant proposes to prune the existing black cherry,remove all down debris,remove invasive vines and revegetate with bayberry(1 gallon potted)all exposed areas. Activities to take place within pre-approved 25'non-turf buffer establised pursuant to Trustee Permit#8803 dated May 18,2016. Name of Applicant or Sponsor: Telephone: (718)321-0117 470 Lloyds Lane,LLc c/o Andrew Drazic E-Mail: adrazic@atjelectdcal.com Address: 122-13 15th Ave. City/PO: State: Zip Code: College Point NY 11356 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑� F] may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ ❑ 3.a.Total acreage of the site of the proposed action? 0.783 acres b.Total acreage to be physically disturbed? 0.06 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.783 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial [:]Commercial ©Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑✓ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 0 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: Z ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? W1 ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? R] ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ ❑✓ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ NIA 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑✓ ❑ b.Is the proposed action located in an archeological sensitive area? ❑✓ ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑✓ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑✓ ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ©Shoreline ❑Forest ❑Agricultural/grasslands 0 Early mid-successional 23 Wetland El Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? W-1 ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties.? ❑NO DYES b.Will storm water discharges be directed to established conveyance systems runoff and storm drains)? If Yes,briefly describe: NO ❑YES Page 2 of 3 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor na e:Bruce A.Anderson-Suffolk Environmental Consulting,Inc. Date:May 11,2018 Signature:�� . PRINT FORM Page 3 of 3 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) We, Lloyds Lane, LLC c/o Andrew Drazic at 122-11 15''Avenue, College Point,NY 11356 do hereby authorize Suffolk Environmental Consulting, Inc. to apply for permit(s) from the Southold Board of Town Trustees on our behalf. i (Owner' gnature) 1 Board of Trustees Application County of Suffolk State of New York 470 Lloyds Lane,LLC clo Andrew Dradc BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS TIME APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF EIIS/IIER 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 HARMELESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY BIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TRIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF 2p" ,20 /Y YEVGENIYA KHAIT NOTARY PUBLIC-STATE OF NEW YORK No. 01KH6193736 Qualified In Kings County My Commission Expires September 22, 20p Notary Public AI'PLICAl®T/AGENT/R EPRESENTATIV7E TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the town officers and employees. The pgmse of this form is to Provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same_ YOUR NAME: 470 Lloyds Lane, LLC c/o Andrew Drazic (Last name, first name,middle initial, unless you are applying in the name of someone else of other entity,such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,"name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest.`Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered "YES,"complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse, sibling,parent,or child is(check all that apply): A) the owner of greater then 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitte 's f 201 Signa e Print name 0 Llo ds Lan �cloAn�drewDe LLCrazic _ The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the town officers and emnloyees. The numose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Bruce A.Anderson (Last name,first name,middle initial,unless you are applying in the name of someone else of other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,"name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest.`Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES," complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse, sibling,parent, or child is (check all that apply): A) the owner of greater then 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C) an officer, director,partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Brother in law 40 Submitted this //0' day of 201 _ Signature _ Print name Bruce A. Anderson Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies,shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C,the preparer of this form should review the exempt minor action list,policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered"yes",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus,the action should be analyzed in more detail and,if necessary,modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net),the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 099 - 3 - 4.3 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Dept. ❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) ❑ (c) Permit, approval, license, certification: Nature and extent of action: Applicant uroposes to prune the existing black cherry, remove all down debris, remove invasive vines ands revegetate with bayberry(1 gallon potted) all exposed areas Activities to take place within pre-approved 25'Non-Turf Buffer established pursuant to Trustee Permit#8803 dated May 18, 2016 . Location of action: 470 Lloyds Lane,Mattituck,New York Site acreage: 0.783 acre f Present land use: improved Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency,the following information shall be provided: (a) Name of applicant: 470 Lloyds Lane c/o Andrew Drazic (b) Mailing address: 122-11 15`h Avenue,College Point,NY 11356 (c) Telephone number:Area Code(718)321—0117 (d) Application number,if any: N/A Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No ® If yes,which state or federal agency? 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 As indicated within Policy 1 "Development that does not reinforce the traditional land use pattem of the Town of Southold would result in a loss of the community and landscape character of Southold.". this proposal is to enhance a previously established buffer 25-foot non-turf area. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Policy 2 is not applicable in that subject lot and the surrounding neighborhood cannot be deemed a substantial historic and/or archaeological resources. Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LVV" Section III—Policies Pages 5 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal will not adversely impact the visual quality of the surrounding area because the application seeks to enhance a previously established 25-foot non-turf buffer. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life,structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subiect proposal seeks to enhance a previously established 25-foot non-turf buffer. Attach additional sheets if necessary Policy 5.Protect and improve water quality and supply in the Town of Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal seeks to enhance a previously established 25-foot non-turf buffer. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands.See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subiect proposal seeks to enhance a previously established 25-foot non-turf buffer and therefore is consistent with this policy. Attach additional sheets if necessary Policy 7.Protect and improve air quality in the Town of Southold. See LWRP Section III-Policies Pages 32 through 34 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 7. Attach additional sheets if necessary Policy 8.Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 8. Attach additional sheets if necessary PUBLIC COAST POLICIES Policy 9. Provide for public access to,and recreational use of,coastal waters,public lands,and public resources of the Town of Southold. See LWRP Section III—Policies;Pages 38 through 46 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 9. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III—Policies;Pages 47 through 56 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 10. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound,the Peconic Estuary and Town Waters. See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subiect proposal is not applicable to Policy 11 Attach additional sheets if necessary Policy 12. Protect agricultural hands in the Town of Southold. See LWRP Section III—Policies;Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Subiect proposal is not applicable in that the proposal does not involve agricultural lands (i.e. the conversion of farmland the establishment and/or maintenance of new coastal agricultural production, etc ) 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 Subject proposal is not applicable in that the proposal does not involve the conservation of energy resources on a commercial level and/or the promotion of alternative energy sources,proper maintenance of fuel storage facilities and/or the extraction of mineral extraction Attach additional sheets if necessary Created on 5125105 11:20 AM r Suffolk Environmental Consulting, Inc. Newman Village,Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President HAND DELIVERED May 11, 2018 EC1 , Mr. Michael Domino, PresidentDD Board of Trustees Town Hall MAY 1 1 2018 P.O. Box 1179 Southold, NY 11971 Southold Fown 80 rd of Truitoes Re: 470 Lloyds lane LLC Property Situate: 470 Lloyds Lane• Mattituck SCTM#: 1000-099-03-4.3 Dear Mr. Domino, This Firm represents the owner of the property referenced above, who propose to prune the existing black cherry, remove all down debris, remove invasive vines and read vegetated with Bayberry(1 gallon potted ) all exposed areas. All proposed activities will take place within the preapproved 25 foot non- turf buffer established pursuant to Trustee Permit#8803 dated May 18, 2016. This is a request for an administrative permit. Please find enclosed herewith for your review: (1) Town of Southold Trustees Wetlands Permit Application (original and three [3] copies); (2) Local Waterfront Revitalization Program application(original and three [3] copies); (3) Short Environmental Assessment Form(original and three [3] copies); (4) Photos of the property indicating the staked out locations of the proposed improvements therein (four(4] sets); (5) Survey prepared by Nathan Taft Corwin, III May 20,2016 (four[4]copies);and (8) Check made payable to the Town of Southold in the amount of$100.00 covering the requisite application fee. By way of this correspondence,and on behalf of the owners, I request that you commence review of this application and schedule for discussion and permit issuance at the next available Trustees Board meeting. Thank you in advance for your cooperation. Yours truly, Bruce A.Anderson enc. cc: A. Drazic