Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
TR-9286
a Michael J. Domino, President 06, Town Hall Annex John M. Bredemeyer, III, Vice-President s1 54375 Route 25 Glenn Goldsmith y P.O. Box 1179 A Nicholas Krupski may • �� Southold, NY 11971 Greg Williams �( , 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 % constructed Project complete, compliance inspection; I TERMS AND CONDITIONS I • The Permittee Bayshore Road LLC 3345 Bay Shore Road, Greenport, New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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 performed 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. i 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 the work 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. 5. That there will be no unreasonable interference with 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 beach between 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. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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. I 10. No right to trespass or interfere with riparian rights. This permit does)not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. ,I OF ar Michael J.Domino,President so hO�� y�lTown Hall Annex O John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn GoldsmithCIP Southold,New York 11971 A.Nicholas Krupski �O Telephone(631) 765-1892 Greg Williams yFax(631) 765-6641��UNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 18, 2018 Michael A. Kimack P.O. Box 1047 Southold, NY 11971 RE: BAYSHORE ROAD, LLC 3345 BAY SHORE ROAD, GREENPORT SCTM# 1000-53-6-9 Dear Mr. Kimack: The Board of Town Trustees took the following action during its Regular meeting held on Wednesday, July 18, 2018 regarding the above matter: WHEREAS, Michael Kimack on behalf of BAYSHORE ROAD, LLC 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 June 11, 2018, 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 issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on July 18, 2018, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 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 the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of BAYSHORE ROAD, LLC to repair the existing 100' long concrete seawall by stabilizing two (2) vertical cracks, repairing spauled areas and pouring support footings under first concrete step; re-stone existing 42sq.ft. concrete landing; replace steel handrail with aluminum o/e; and parge concrete as needed; and as depicted on the survey prepared by Nathan Taft Corwin, III Land Surveyor, dated April 26, 2018, and stamped approved on July 18, 2018. 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: $50.00 Very truly yours, —�7u�j Michael J. Domino President, Board of Trustees MJD/dd { �$ U o� Zy� SURVEY OF 153 o� LOTS 58 & 59 o� 57 o *93- �;9F AMENDED MAP A PECONIC BAY ESTATES NSE o� q oy� � \ 1 FILE No. 1 124 FILED MAY 19, 1933 cO� O SITUATE ? ARSHAMOMAQUE ``°�� TOWN OF SOUTHOLD E N SUFFOLK COUNTY, NEW YORK �y1 G � � S.C. TAX No. 1000-53-06-09 o�N{GJQ`9 V•O� 0 0 �a5 9� / / � Y�P�� O 6 p�,5� 5 ME w / \ SCALE 1 "=20' • • QP�G�a SCE `�E. �• k o FRRPGE / / �--� SEPTEMBER 12, 2017 K g�pcK k k k �C'o / APRIL 26, 2018 UPDATE SURVEY ° d• D' e�QG� ELG� k k k k k k oLc+ o �$5 / / ° k k k kk k k k kk k 4 kp�J Zm AREA = 14,772 sq. ft. k k k / G1 D • • kk \`k kk k kk k kk k kk k k kk k/mak k B / e 511;0sO� \ `/ (TO TIE LINE) 0.339 ac. �f • k k k k 364 k k k k / ZO Nv \ Z p k k k k k k k / � '�• CV � �'n o N / •ro ••D• D O JO5,T\c sF Ok B<ka kCG�kBCk k k k,k P kkk kk mkC0k . 0�gy � 3 o O v1• ` CERTIFIED T0•N � a $ O%k � LO RE ROAD LLC LO`r OLD REPUBLIC NATIO NAL TITLE INSURANCE COMPANYNok k • _ \ t"'l P. / / k k k k R CKp5 O' < I\• O • ► D M��a / / k kk k k eR� $' l Z� `� •s o• L �j / f{� 5 kk k k k k k kk !y ?, I CONC AWIW 9ZOi k tP LA k BRICK 7 WALK `n�?a.r •�Nl�ep - • D y. to Q! 1 O i k k k k k t � �y7 � MpN. 1 K� �y wY,G�p Y k k k k O O GANG t• % O k k k k 61� O�yC� PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.IA.L.S. AND APPROVED AND ADOPTED �J k k� FOR SUCH USE BY THE • \ % k k �,3 "�pE R I�'' _ 1 =' ii —1;i TITLE ASSOCIATION. w OF. irK LAND v • k k kk k O . D k k k k k kk k k kk 1'0 ? L JUN 1 201 i 01 • • k k k k k k k -�OARRROVW -BY i S!'IF i d Tov,I1 gcs I • _ __. �- Boardf Qfi'IIS+�2S V p O k k k S" • .' - -BOARD'OF T RUSTEE`S' k V�J �o k TOWN,-OF,`SOUTHOLD ' °D • p� VR9 _ e�opKP� Y.S. Lic. No. 50467_ O DATE �- �g .Z�lg i •< q f TO-THIS'SURVEY ISUNAUTHORIZQ AA VIOLATION OF RATION OR ON o gLV O SECTION 72LA OF THE NEW YORK STATE Nathan T Corwin III EDUCATION LAW. aft ° ° • D ! ""`W COPIES O SURIVEYORRS INKED MAP NOT BEARING e TO BE A VALID TRUE COPL OR EMBOSSED SEAL SHALL Y.BEECONS DERED Land Surveyor CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND Title Surveys — Subdivisions — Site Plans — Construction Layout O THE IGNEES OF THE NG TTUTION. CESRTIFICATIONS ARE NOT TRANSFERABLE. PHONE 631 727-2090 I S LAND VIEW LANE ( ) Fax (631)727-1727 OFFICES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHTS OF WAY 1586 Main Road AND/OR EASEMENTS OF RECORD, IF Jamesport, New York 11947 Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. P.O.Jamesport, New York 11947 38-148 Michael J. Domino, :=;�sident V�° Gym'.; Town Hall Annex John M. Bredemeyer, III, Vice-President o 42, z 54375 Route 25 Glenn Goldsmith , P.O. Box 1179 A Nicholas Krupski �.g oo�y�� Southold, NY 11971 Greg WilliamsTelephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD -7,94 TO: BAYSHORE ROAD, LLC c/o MICHAEL KIMACK Please be advised that your application dated June 11, 2018 has been reviewed by this Board at the regular meeting of July 18, 2018 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project— Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30- Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant 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. 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 will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES- TOTAL FEES DUE: $_50.00 BY: Michael J. Domino, President / Board of Trustees . `' � 'yuFFQ( � Michael J. Domino, F, NQS �C � Town Hall Annex John M. Bredeme er III Vice-President �� Gy 54375 Route 25 Y /� Glenn Goldsmith y z P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed infield by: Michael Kimack on behalf of BAYSHORE ROAD, LLC requests a Wetland Permit'to repair the existing 100' long concrete seawall by stabilizing two (2) vertical cracks, repairing spauled areas and pouring support footings under first concrete step; re-stone existing 42sq.ft. concrete landing; replace steel handrail with aluminum o/e; and parge concrete as needed. Located: 3345 Bay Shore Road, Greenport. SCTM# 1000-53-6-9 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� 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:0/ N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: --�� edemeyer / M. Domino G. Goldsmith N. Krupski Williams Other ayshorc Road,LLC 345 Bay Shore Road,Greenport CTM#: 1000-53-6-9 `+R r r r _ a�.rr „•Ie •.�'�" .,ABY y. ,O'C'm �,*,'-;,'.e 211,N-1 ._-.••f .Y �t�_ �Yanti t y� s s � T"1 ��r .s '� yqP.,�' �� i� �. � i � h-+ ,. Y'`�,,` - 'i:,'Y ��+^. - _ ,' ji .fit ii�.�,or- - 4•� �3T,4 r''ajJ _`�ry��.: � � ,t.,t.. ;t,.- � r. �r.;b� r Q �•�!ri4�e... .dbr � ,�`, r -'* �,,� '► ""fir' - -�'� * �.. �...� �ca :-�,,.� y. �r +► ,�y ! i } ,. .� ✓ 1IK lllTKKKa � ©1 1 �1 o e �� �"•�,°11'l'-:.✓� '"� ••.T �'� ` j�. may., �I '.r. � ,,•,trg� '•-+,�� '�'� +�:!� ��ary 1�� � �4.- •l� _ .i y+�, �✓ dY `; �' +� '7 t' + t +-?L._ s •y.'' s.' ,�!••�y.�J �t r- d _,� y �.�,,.r�j Lib. y,, ,�� i - ;. .- �k'�� ,r4'• - � A�r ; .39, + --..� ,e'. ,.. •4►' '. rt+4 :'s . , -a•.�•. .. ` r oa , 0 09 PECE FILE EEN S• °hyo ocnlr � � ,cp. i, f / T SUFFq 4 o 0y9 •t -kkp5 •� / 9R�GQs qenoy 6.8• � 8 5'(E u'.�c' �-�y k/E k k /nO X32 •S• A� \ vaO J t Ny Z - t CERTIFIED k (p� 2� •� - \ aN COk k k QR/kk kk kk C9y / 7•Vs g� �. N �� OLD REP I( e C� 5Q k k k CG RN / N Cfl k Z `NO - p• ,kvw` k R r: / / k k k •k k ROOF / k k k k R(L\C� `y •S y GONG• �� � co 2�• � S �O O k k k k BRICK 5g k kk k k wnLK24.x• y��� � '�,.r•' oN• 1 Qct 0 k �y LO k k k k k k k k k / nOn� �� PREF k k k k -6�% �yc� ` B Ate FOR k k � TITLE k k �k k k k 60 k k 1 k k k LO k ..r VA +' �s' ='�., �5� u r.^ �"�•sy .a` pair (1) Bayshore Road LLC Taken June 4,2018 Looking South � a z .. r (2)Bayshore Road LLC \ Taken June 4,2018 Looking NW WWI �` 1 44 m-� (3) Bay shore Road LLC ' Taken June 4,2018 Looking WSW ♦i PF Ni h 7 r TTT " " (4) Bayshore Road LLC Taken June 4,2018 Looking WSW may'. Y L - , I r T At tl (5) Bayshore Road LLC 1t Taken June 4,2018 Looking WSW 6 41 R 1u ♦♦ r :r a. 1 z .. w Y r t ,p� (6)Bayshore Road LLC '14 Taken June 4,2018 Looking NW i .s a A. • s K+.- ' Y Y (7) Bayshore Road LLC Taken June 4, 2018 Looking WSW _At s .f 'r x _ . r (8) Bayshore Road LLC �r Taken une 4, 018 J 2 s,. _ Looking WSW sLegend 3345 Bay Shore Rd Pipes • Greenport NY s old. I r�; } , 4� V4 { s a� s s ¢ �3 � �;. •" om S . ty WWI € ar, ' k rvc .�* gEs 6 �+ 'e '54 ,¢. �JJ ftt'4�+5� �ea. i•. T �'3^Sr"��' 1 b $ d%4� �;� N SEE SEC NO.916 •'.: .. • WTCN ——Z' u 3 n SEE BEC.No oG WTCN _ UME 1. FOR�WO SE1FSEC NO 8W 110 D o1SO5UW •�/ / Q�/ / JA 2 a TaNU ! e "••iVCP 1 SEE sEc.No. a2 O 9aS9S99)3 Q j COIINTY�SUFFIXX • / /-NO / IVVM SOUTIKILU tqa♦ 1WE1 OF 9FSO / e 1IIIIoID eu�O�t9 Or• 7 t V 13,NO soumoln / CWNry OI suFFauc 2N=) O Isar. 3 ° • E , p „° ;��m IIQI ' x91iI1,N90F 12-t1] 11 19 Y N• (1�� (A _ N l 11 fr!1 h2�'� a 1•.1 " O D _ 4v it 2" EEK . ! PpES �p €p el t.Wel e d yy 2'e ' a ,Q tt19 a BB d•'O♦r o 0 11.w •� �' , f rp Y 8�, ATN .1rI� 'Qf7 n,� '4 Q e• y �, N,� 6 7 4 •( A �� � e(� �a 4 y' PJGuS • �,b kr d Ie Ia P 7 • �� y.� A F. �AW In • yd �jN s° 4� •� A Oy'A y ♦ � F`,�2it'I •K e ya ydJ A ,� A '•y � y A �� �J. ,p'� y ♦ d O xb F NANO O e i yd yp ♦ '� ♦ 4,0 y� ♦ d✓ A � � A` 4� 9 y yv y �• A � N '••r,,, 9 ' Ia • y'•A ��' td'A*'t 1 ,�S p I . • �1., zy 6 _ 2B 2M IS a or- x 7 6A \.N J \ I FOR PCL NO. 9' �'a• +. 3 SEE SEC.NO . _ 3 t -- * \i: -. - �• Yt••' . o61afa3e4k s 71' 1 ex Ye xtn,e �__---unE prz• SEE SEC.No.W SEE SEC.No.,163 SEE SEC.NO w. ...,.,: ------ e NOTICE COUNTY OF SUFFOLK © E o. so133110�o sec3loN No Real Pro Tax Service A 053 gency y w... xxxrex.,Kc.Krex..,�.ra a. ,v..,..a.. M -_ - ... _ .w.: ,....• _._. way .f' .... ci x �rxm .` _ ` �I t•� J`� t��f' J. \�� ��/P' \\ �I \ / \ \Gyre 4 , OFFICE LOCATION: �®f ®��� 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: 631765-1638 COFax: 631765-3136 9 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUT11OLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: July 12, 2018 Re: Local Waterfront Coastal Consistency Review for BAYSHORE ROAD, LLC SCTM# 1000-53-6-9 Michael Kirnack on behalf of BAYSHORE ROAD, LLC requests a Wetland Permit to repair the existing 100' long concrete seawall by stabilizing two (2) vertical cracks, repairing spauled areas and pouring support footings under first concrete step; re-stone existing 42sq.ft. concrete landing; replace steel handrail with aluminum o/e; and parge concrete as needed. Located: 3345 Bay Shore Road, Greenport. SCTM# 1000-53-6-9 Note that a Wetlands Permit was not found in Town records. Most likely the structure predates Board of Trustee requirements. 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 that the Board: 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 t%)FF0(,��a Peter Young,Chairman H Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 �, �► �'� Southold,NY 11971 7/ Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., July 11, 2018 the following recommendation was made: Moved by Peter Meeker, seconded by Caroline Burghardt, it was RESOLVED to SUPPORT the application of BAYSHORE ROAD, LLC for the repairs to the existing 100' concrete bulkhead, which includes stabilizing two (2) vertical cracks, repairing spalled areas and pouring support footing under first concrete step.'Re-stone existing 42 sf. concrete landing. Replace steel handrail with aluminum as needed. Located: 3345 Bayshore Rd., Greenport. SCTM#53-6-9 Inspected by: Peter Meeker Vote of Council: Ayes: All Motion Carried so ,�° ` `;; Town Hall Annex Michael J.Domino,President ? 1 54375 Route 25 John M.Bredemeyer III,Vice-President i >s P.O.Box J 179 Charles J.Sanders Southold New York 11971 Tenn Goldsmith Telephone(631) 785-1892 A. Nicholas KrupskiFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal F,rosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension Received Application: 61 lisp_ Received Fee: $. Z._...•..eQC7 �ompleted Application:—, , Incomplete: JUN 1 2018 '�~ _`_SEORA Classification: Type I_ Type I1_ Unlisted Lead Agency Determination: oordmation:(date sent):_ 1,64 WRP Consistency Assessment Form Sent: . L-- Boar at T, AC Referral Sent: &,2Z Date of Inspection: _ZU&I Receipt of CAC Report: Technical Review: Public Hearing Held:_ Resolution: Legal Name of Property Owner(s): A19 L/ C Mailing Address: /�6 �� Y ,P '/I/ 'r Phone Number: �6 6 SQ - Z4_ _ Suffolk County Tax Map Number: -1000- 6�?- 2,6 -D 9 Property Location: ._- 4-�y Q, _,f eM2 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): � /� �L A���/ Mailing Address: P- a H6V 1017 _ wMaZ ' /_Aly Phone Number: --_...._, '6 6 ® o cadSt('l1 Board of Trustees Application GENERAL, DATA Land Area(in square feet): —774 Area Zoning: Previous use of property: Intended use of property: � 1 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 require any demolition as per Town Code or as determined by the Building Dept.? No Does the structure (s) on property have a valid Certificate of Occupancy? _Yes No ZOO✓?T_ gyc,-PO,eal Prior permits/approvals for site improvements: Agency Date _ e 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: /00 CoAl C �,w4 L t-- Project Project Description (use attachments if necessary): -S .� �� 7 C ON O_,� i,+z C'o'/1C. 5 , - 57r'®/1&6 fix_ >�r �G 4?s c®AJC. LA/(W1V&- )?A rtzd'LNCC5 57_25eZ� hIAVPR,41Z- Gv� "4zU/10 0/,r- �,Iq�ng cew Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: �_P._.-,,� IT-1416 296&49� 11,6V_77 Area of wetlands on lot: Q square feet Percent coverage of lot: O % Closest distance between nearest existing structure and upland edge of wetlands: `_feet Closest distance between nearest proposed structure and upland edge of wetlands: N�7 feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated?_ < _cubic yards How much material will be filled? < 0 cubic yards Depth of which material will be removed or deposited: _ feet Proposed slope throughout the area of operations: Al Manner in which material will be removed or deposited: eW(� ,rUf)Po,e1' F—,o o 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): HO /-116P 1-1,44 72W41A_14 , 4ZZ �� s 617.20 Appendix B Short Envirorrrrrental Assessment Form Instructions for Completing 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 of investigation would be needed to frilly respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You tnay 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 I -Project and Sponsor Information -- Name of Action or Project: .��y.I`�0�� Project Location(describe,and attach a location map): Brief Description of Proposed Action: I�E/�•a/mss 7"0 �C�.J`r�il/G rV oiVctU��S sr��l�/zl�lG 7WO 1125Rrl"W cam/-�clams, AN 1: ®URIN6 )5!6. 61A1,06e �`/ZS'r C'01'V C, ZANP/NG- R25PZA C9 SrZ5Z 11WAV A4/L /KGAr-, Name of Applicant or Sponsor: Tel ephone'/� _64907 Address: 170 .f _�D47 City/PO: m State: !F -4)Code. SED U7WOr,/7W® _ ___ - .11.- I.Docs the proposed action only involve the legislative adoption of a plan, local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YI,_S_ If Yes, list agency(s)name �and fpermit or approval: 0 A/V vL�C 3.a.Total acreage of the site of the proposed actions d3 acres b.Total acreage to be physically disturbed? ( _acres c.'Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 4 3 acres 4. Check al!land uses that occur on,adjoining and neat the proposed action. ❑Urban F-1 Rural(non-agriculture) ❑Industrial ❑C:ommereial Wesidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑other(specify): ❑Parkland Page I of 4 5. Is the proposed action, NO YES _N/A a. A permuted use under the zoning regulations? 0 _ ❑ b.Consistent with the adopted comprehensive plan? LL Z ❑-1 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ry ❑ 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? IV ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code jequirements? NO VES 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 LlIf No,describe method for providing potable water: /v 11. Will the proposed action connect to exist i ng'wastewater utilities? -NO YES If No,describe method for providing wastewater treatment: w _ //?__ 12. a. Does the site contain a structuie that is listed on either the State or National Register of I listoric 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 YE 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 ❑Early mid-successional ❑ Wetland ❑Urban (Suburban 15. Does lite site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? �/(- ❑ 16. Is the project site located in the 100 year flood plain? j-NO YES_ ITWi11 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 ❑YES �I U b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ❑YLS Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 19 1 las the site of the proposed action or an adjoining piopetty 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:__ __.- _ --- ___ _,_..,. _ _. _ ... - ___-- ❑ 1 AFFIRM THATTHE INFORMA'T'ION PROVIDED ABOVE,IS TRUE.AND ACCURATE TO I'HI: BEST OF MY KNOWLEDGE Applicant/sponsor name: Signature: Part 2-Impact Assessment. The L.eaci Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 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 illy responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impaet impact may may ocelli, occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community9 4 Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CF,A)? F-1N 1 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? L J ILI 7 Will the proposed action impact existing: ( r� ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9 Will the proposed action result in an adverse change to natural resources(e.g.wetlands, (� waterbodies.groundwater,air quality, flora and fauna)? L I Page 3 of 4 No,or Moderate shall to large impact impact Inay rrlay (lCCllr• occur 10 Will the proposed action result in an increase in the potential for erosion,flooding or drainage I problems? _ _ 1:1 11, Will the proposed action cteate a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the Completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Pail 3 should,in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting;probability of occuuring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. L_ I Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may Iesult 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 pact/ s Town Of Southold-Board of Trustees l�. t6 _ Name of Lead Agency � — � v Date _M i c h a e I.J.-Domino- .. President Print o Type Nantc c f Responsible Officer to Lead Agency Title of Responsible Officer Signature of Responsi e Officer in Lead Agency Signature of Preparer(it'different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Application AF'FIDAVI'T' )2A6WA gAj-I Z/CLQ &e—SH� BEING DULY SWORN DEPOSES AND AFFIRMS THAT Hf/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)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. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF—(,1/1�,� , 20 B Notary Public MICHAEL A.KIMACK Notary Public,State of New York No.02KI5056823 Qualified in Nassau County Commission Expires March 11,2022 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) owners of the property identified as SCTM# 1000- in the town of New York, hereby authorizes � CZ to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS� _2 DAY OF��/� 120 Ig Notary Public MICHAEL A.KIMACK Notary Public,State of New York No.02KIS056823 Qualified in Nassau County Commission Expires March 11,2022 i APPLICAlvIT/AGENUREPRES]ENTATIVE TRANSACTIONAL DISCLOSURE FORM T e-Town of Southold's Cade of Fthies pro hih"Lts conflict of interes n the part of town officers anti emp] yges.The nurnose of this foci, ns to_nmywg information which can alert'tfie town of si e conflicts of interest and allow it to take whgtever action is necessarmto avoid same. YOURNAME. �� Al - — (Last name,first name,4iiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building ` - Variance Trustee Change of Zone _ _ Coastal Erosion _ Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other'',name the activity.)_ Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with tiny off icer or employee of the Town,of Southold? "Relationship"includes by blood,marriage,or husiness interest."Business interest'means a business, including it partnership,in-which the town officer or employee hers even a partial ownership of(or employment by)a corporation in which'tllc town officer or crnployce owns more than 5%of the shares. 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/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 50A of the shares of the corporate stock of the applicprit (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 ZN-Dday of fT'L�IU� 20 Signature Ili) Print Name 't)cL� Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tile Town of,o tholrl'S C de of E hies r 1'b's canflict f'nterest on the Dart of town-officers n em I ccs.The nurnosc at' this form is to pavide in nation which can alert the,town of possihle onfliets of interest and alltZv it to take wl�atevcr action is i necessaa to avoid same.d/ YOUR NAME: (Last name,first name,4iiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _ Variance _ ...___ Trustee __.___..._ Change of Zone ._. Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning _. Other (If"Other,name the activity.) Do you personally(or through,your company,spouse,sibling,parent,or child)have'a relationship with any officer or employec of the Town of Southold? "Relationship"includes by blood,nlarriage,or business interest."Business interest"nncans a business, including a partnership,in which the town officer or employee has even a partial ownership of for employment by)a corporation in which the town officer or employee owns more than 5%of the shares. 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 -- I)escribc the relationship between yourself(the applicant/ageilt/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 da of U r 20/ Signature _ 1 Print Name__z� .. ..... Form TS 1 COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3. A. S& ture p ■ Print your name and address on the reverse X / 3 Agent so that we can return the card to you. W (` Addressee ■ Attach this card to the back of the mailpiece, 4. Re ived byPrint d Name) C. ate of ,e'y ry or on the front if space permits. 2P �`�Gt"? 1. Article Addressed to: D. Is delivery address different from item 1? ❑Y 4XIMIA14 ? I!/N6L5Nr If YES,enter delwery address below: ❑No j 1-JoNT25K0,-A'Y RA II I IIIIII Jill 111111111111111111111111111111111 E3. Service Type 0 3 Adult Signturre ElRregis Registered lTh! ❑ dult Signature Restricted Delivery 11 Registered Mall Restricted 9590 9402 2472 6306 2699 62 Certified Mad® ✓Delivery ❑Certified Mail Restricted Delivery i9 Return Receipt for ❑Collect on Delivery Merchandise 2- Article Number(transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmatlon7m ❑Insured Mail ❑Signature Confirmation 1,5 0640 DDD 1 5428 9 3 6 7, ❑Insured Mail Restricted Delivery Restricted Delivery (over$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt � d m — rqUA gm Ln C�fGii JICD G�G�[]L° GCCOGu 117 w d Ir � o . � - o o rn �SA , , JAI9E5r +lYixi73l7j � a4W) Liz c�txm�3D� fL Certified Mad Fee -• � - 17 t 613 ��o = $3.45 C19�1 Co � � e�rr �I L � � RJ-1 �:� E LO $ 7 er09i( Here/ Certified Mall Fee $3.45 0971 Extra SeMces&Fees(checkbox,add fee ggpr�, ate) $ � i'9 ❑Retum Receipt(hardcopy) $ S - Lf'J M C-+- 1 3 ❑ p( ) $ fJ' 1 ma `�" Extra Services&Fees checkbox,add lee ayp n'�ypte 77 Retum Recei t electronic ❑Return Receipt(hardcopy) $ itsLrtr ,� ❑certified Mail Restricted Delivery $ $0.00 'a" '� ❑ ❑Return Receipt(electronic) $ (' Postmark El Adult Signature Required $ $i r ii r j CO ❑ ❑Certified Mail Restricted Delivery $ �if t_t Irl ���\ �H6 ❑Adult Signature Restricted Delivery$�G.OCr— t` ti (� re Postage d 0f El Adult Signature Required $ �� $171.5101 \ E]Adult Signature Restricted Delivery$ $ Tr.70 t17}til�/ ) e �"`� -0 Postage $11,51j Total Postage and F s $ Total Postage and F P t 07�-9/2018 Sent To I $ T 70 =�� r� , o �tn//�d,�1YA__ V/iV_S' T_, i 3'lC/C�------------ "� Sent To Street and Apt No,or PO Box Nfo!. /� rq ropy // �}-�t C •, [�/ �/ ----- _d ,�L_/aLieG d dl , E=l StreetandApt o.,or%u ' ti,State,ZIP+4° --- 8 N t/ /U�1/-7—e 2;�--1? �ll�� _L 1/1/ N-------------------------- s Ctty State ZIP+4° PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: �d�aC' Pr';, ,. : ?fir S 5-3 _ 60' ,5-3- 6 - 10 (b '3 53 - 6 _ 3�-. a� STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20___, 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 opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 I i i Notary Public P J PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: s!"C aA�,�S,N?'. ®/��o -6/o GvlaS/tea / q�ytitflY 24 Op n�ro�✓ �,t1u Al !�"6 - 1122- /y �3O C(l v/a LAY, Al, OQMNp117611 �c.10N?', 96P, 2-Z V/NCA r ,g. S'/L/C� SZ STATE OF NEW YORK COUNTY OF SUFFOLK '5'1CVAzeZ A e),igg c& residing at D. FOX /097 _PDUr_/,1dCZ24 Aly , being duly sworn, deposes and says that on the day of 0-UL /,�_, 20 , 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 opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at—TO liTlsloG/> , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. I Sworn to before me this f Day of TV 20jj_ I i Notary Public DIANE DISALVO NOTARY PUBLIC-STATE Of NEW YORK No. OID1475593 Qualified In Suffolk County My Commission Expires April 30, 209 l Michael J.Domino,President o��SUFFQt�'�o Town Hall Annex John M.Bredemeyer III,Vice-President �� Q. G��� 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 zr A.Nicholas Krupski 0 - �ySouthold,NY 11971 Greg Williams ' p�.tY Telephone(631)765-1892 �Ol Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of BAYSHORE ROAD, LLC COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, CjVN,6L /J. hy,"4 Ve , residing at/dba R__ D. Af!QX /®4 ,1'00 M OLI) being duly sworn, depose and say: That on the 7 day of ✓-04 Y , 2016, I personally posted the property known as 27 61 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,July 18, 2018. Dated: V_P/ Y Ar Z-Olap Aoez�(z z�vmo (signature) Sworn to before me this A day of Tvq 2019. 4 ' ""r DIANE DISALVO NMARY PUBLIC-STATE OF NEW YORK Notary Public No. O1 D1475593 QUOli ied in Suffolk County 14 CGIMMission Expires April 30, 2022"' NUTILI: U I I= H t I AKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: BAYSHORE ROAD, LLC SUBJECT OF PUBLIC HEARING : For a Wetland Permit to repair the existing 100' long concrete seawall by stabilizing two (2) vertical cracks, repairing spauled areas and pouring support footings under first concrete step; re-stone existing 42sq.ft. concrete landing; replace steel handrail with aluminum ole; and parge concrete as needed. Located: 3345 Bay Shore Road, Greenport. SCTM# 1000-53-6-9 TIME & DATE OF PUBLIC HEARING : Wednesday, July 18, 2018 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold I.,WRP 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 signilirant beneficial and adverse effects upon the,coastal Brea(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Titus, each aanssWer must lie explained in detail, listing both supportinit and non- su�n miline facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# PROJECT NAME e4AZ2, Z-Z_ e' COV C: &JZ D LCP.4f The Application has been submitted to(check appropriate response): Town 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: ;016 �X/S,�f/d/(s CDiV C'• ✓�CIUL?�S 57-4,p- LAWE P,49645 COAD c, AS- NZ,150 A Location of action: Site acreage: Present land use:��? V a��lVAA J-1N6GE �i eZZ V .�.. 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: RA � (b) Mailing address: 52 HOW-722AP_ ST" Tom, '<Z, )V. Y / - ��1� (c) Telephone number: Area Code( ) ��6 93-0— V-76 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes E] No M 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. DE'VELOPE1) COAs,r 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 LWRF Section III-Policies; Page 2 for evaluation criteria. ❑Yes ❑ No R1 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section IIn-- III-Policies Pages 3 through 6 for evaluation criteria 1:1Yes LNo Z Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the 'Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No ® Not Applicable 0610 rh-l"rvZ IAI C4 '014: Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from,flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes 1:1 No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LVVRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ 0 19 Yes No Not Applicable 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. D Yes ❑ Noo Not Applicable Attach additional sheets if necessary Policy g. 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 0 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. ((�� ElYeO No® Not Applicable x v c r4C(L'C.7s. ego Z5 C25: Qts �01R334/C CCeSEF 7-4 Attach additional sheets if necessary I 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. ❑ Yes ❑ No,nj Not Applicable A10 1 / Cr AMMffS --- 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 1:1 NoM�(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 ,NO 46r1_,11 ��', .UG -role-,;, Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LVVRP Section III—Policies; Pages 65 through 65 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable PREPARED BYE /� elf TITLE 4& DATE4h0/_/C?