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HomeMy WebLinkAboutTR-9272A o��oF so�ryol Town Hall Annex Michael J.Domino,President John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski �O� Telephone(631) 765-1892 Greg Williams cou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1538C Date:November 16,2018 THIS CERTIFIES that the installation of a 4' high fencing running from the northeast corner of existing dwelling to east property line then south along the property line towards the wetlands the fence will then run along the south side of the property coming no closer than five feet landward of the landward edge of wetland vegetation to the west property line, and then run north until it reaches a point parallel with the northwest corner of the house, turn and run to that corner of the house; At 2750 Glenn Road, Southold Suffolk County Tax Map #1000-78-2-42 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 22, 2018 pursuant to which Trustees Administrative Permit#9272A Dated July 18, 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 installation of a 4' high fencing running from the northeast corner of existing dwelling to east property line then south along the property line towards the wetlands the fence will then run along the south side of the property coming no closer than five feet landward of the landward edge of wetland vegetation to the west property line and then run north until it reaches a point parallel with the northwest corner of the house turn and run to that corner of the house; - - -- - - - ---- - i The certificate-is-issued-to Silvirio Fafti ly TfuA owner of t1re-af6resaid the-aforesaidproperty. - - Authorized( Michael J. Domino, President *OF SO(/TyO Town Hall Annex John M. Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski C/> Q Telephone(631) 765-1892 Greg Williams �COUNT`I, O Y Fax(631) 765-6641 � �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: V✓ Ch. 275 Ch. 111 L INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed complete,lete liance inspection. 1 p com p p INSPECTED BY: r C MMENTS: zv z jet CERTIFICATE OF COMPLIANCE: Michael J Domino, President �o�o cooyt Town Hall Annex John M. Bredemeyer, III, Vice-President < 54375 Route 25 Glenn Goldsmith ` y x A, P.O. Box 1179 A Nicholas Krupski �y • �� Southold, NY 11971 Greg Williams �ol , �a 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 When project complete, call for compliance inspection; OF ar Michael J.Domino,President soTown Hall Annex�o�� y�lO John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski yp Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date: September 11, 2018 Permit No.: 9272A Date of Receipt of Application: June 22, 2018 Applicant: Silvino Family Trust SCTM#: 1000-78-2-42 Project Location: 2750 Glenn Road, Southold Date of Resolution/Issuance: July 18, 2018 Date of Expiration: July 18, 2020 Reviewed by: Board of Trustees Project Description: To install 4' high fencing running from the northeast corner of existing dwelling to east property line, then south along the property line towards the wetlands, the fence will then run along the south side of the property coming no closer than five feeflandward of the landward edge of wetland vegetation to the west property line, and then run north until it reaches a point parallel with the northwest corner of the house, turn and run to that corner of the house. 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 Kenneth M. Woychuk, Land Surveying, PLLC, received on September 11, 2018 and stamped approved on September 11, 2018. Special Conditions: Fence to be installed where flags were placed. 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. d Lou-'-'-o Michael J. Domino, President Board of Trustees S.C.T.M. N0. DISTRICT- 1000 SECTION: 78 BLOCK: 2 LOT(S): 42 U P. °W V. L BELG. BLK EDGE OF PA�fME-NT ®17 b APRON U.P. — J — MON S 80030'00 , 121.88 MON O m N LOT 25 o O Q, zm O o 34 5 in 30 2 ° N Y 0 p Y n Np a C.0 Z N m 0_ CONC/SLATE 40 PORCH V%. y 2 ZpNE X m `. LOT 24 101 44.2 STY ba ba ; rq 1 pWEIL I Z N #2750 361 o; 71,9' Wppp DECK i NE X D�K D SP CON f E PATIo 1\3 90 OA ® Y R'L f1RM ZpNE BpNN DRAIN DRAIN PE`E�61 N pNE O Ln Ln O � D BOUNDARY AS FIAGGED 6Y -- AS TIDAL WOWN OF SOUTHOLD— — EDGE OF LAWN r - 3 U ' MHW LINE - - - - - - - - - _ — — — — o o �o S 86°41'50„ W12`7.06' V � , I[ 7 �;I Ll= OAT I FLOATING EDOCK / CREEK SEP 1 1 2018 'J • - APPO�;��:�:: ,� 60MD OF t:S Southold Town -TOWN OF SCA) Boar Dt Tnlstees - , QATE s^ THE WATER SUPPLY, WELLS, DR YWELLS AND CESSPOOL FEMA MAP 36103C0166H LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS AREA. 27;446.91 SO.FT. or 0.63 ACRES -_ --` -- --- ELEVATION DATUM-- -------------------------- UNAUTHORIZED --------------------------UNAUTHORIZED ALTERATION OR ADDITION TO``THIS-SURVEY /S-A-LIVIOLA•TION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT-BE CONSIDERED TO BEM VALID TRUE-COPY. GUARANTEES 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 TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY'LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL' STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRUffURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: LOT 25 CERTIFIED TO: NICHOLAS J. SILVINO; MAP OF: WEST 'CREEK ESTATES JULIE MEYER SILVINO; NICHOLAS J,. SILVINO & FILED: AUGUST 19, 1963 No. 3848 JULIE MEYER SILVINO, AS TRUSTEES OF SILVINO FAMILY TRUST; SITUATED AT: SOUTHOLD FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC; TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK F Professional Land Surveying and Design P.O. Box 153 Aquebogue, New York 11931 FILE 17-73 1"=30' MAY 25, 201 7 PHONE (631)298-1588 FAX (631) 298-1588 # SCALE: DATE N.Y,S 'LISC. NO 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk Michael J. Domino, Pi lent ,� oGy� Town Hall Annex - John M. Bredemeyer, iii;Vice-President x 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A Nicholas Krupski �y�jo ao�� Southold, NY 11971 Greg Williams 1 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: SIL Lgo Fftt -rtU5 - 4o IQDfi�'iIU"Al �f*g Please be advised that your application dated RYAS A91 has been reviewed by this Board at the regular meeting of �(! Z019 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) '/2 Constructed ($50.00) 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: $ ` BY: Michael J. Domino, President Board of Trustees Michael J. Domino,Presid �Q CO ' Town Hall Annex John M. Bredemeyer III,Vice-PiG„uGnt ��� G��r 54375 Route 25 Glenn Goldsmith o ''` P.O. Box 1179 W Zz A Nicholas Krupski 0 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 field by: Robert Wilson on behalf of SILVINO FAMILY TRUST requests an Administrative Permit to install 4' high fencing running from the northeast corner of existing dwelling to east property line, then south along the property line towards the wetlands, the fence will then run along the south side of the property coming no closer than five feet landward of the landward edge of wetland vegetation to the west property line, and then run north until it reaches a point parallel with the northwest corner of the house, turn and run to that corner of the house. Located: 2750 Glenn Road, Southold. SCTM #1000- 78-2-42 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Z. I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredeme er M. Domino /G. Goldsmith N. Krupski X G. Williams Other 'Y r l` ��• '� � ,,.�,�•� `� a 41,E R r J � �, 41 .116 "r . . _ mammon "Woovw e ti- 7/ 11 /2018 10 : 28 a Taken from east 6/22/2018 l �0 t 6/22/2018 Obert Wilson ` '' ilsoln r F;y a' om the northeast 6/22/2018 Taken from the ar hWest 6/22/2018 art Wilson by Robert Wilso �, kp 4 OWN im r F 4 mss, 9�. � 'k'j'r . y y Yom_ 40 -•.- �� -� 'o` 'MI,.'�� , ^..".ref- t.�., ,,.. - � 1 � •K 10 t f wo vis 7 i , sEE s c.rro.B)o _ uNE 12 IJ _ SLEEPY HOLLOW ''-wc) w m 's 3 w 1)Se a 1�t) i n m 10.,5 \ / ' •+ y e � lo.. m � P .fo.. �µ� a A yi .n ,a4`) TOWN OF 8 i m 1 M s 39 ozo 4otnttotn p✓' i ��a 15x7 >S e D Ir r �V 22 'NW co suprouFFoLor f ` w / 41 J) C �4wU 13 M 01e2 ipw 142 / , 41 ' A, +rt \ SEE mc.NO.on � � � °� "0 \ p � 'A 183 D ,awX � + � nw n. .. sJ gP �,){cl o • ) 3 '° ` b�gTF a y �' fe m _ 1e., fez fe.s B a a 2r RL�� b+ � K eAYV1EW1 'S + •� w,1 J � � � Ji� DRQ � ,),.8 v fro. w N"e'1 ,e2 3 m . 39 r '"qfz- � I Ins �_ OI Tin � m.e � sow +. uBE1Try -T) HSP +B ." y S •� m ��- � ' e i)) 4° 2ze s � w �.B I 1' _ � � nB n a w B z 35 ''^rU N .B 1411 �; a„ - ?q� a3 �fy{1 � �� M �� � ,S p e 21 f�♦ I"' f�� 4 -&3 Pk f ���. 3D.1 bF 3i.17 31.1 f.� 2�° � �'3 fe _ +a+ , r s lo. ry , '• �. RD. .0 V t507 ra 0 Q • . ��- � SEE SEC.NO. L NOTICE o�+;. COUNTY OF SUFFOLK © K® wo °' SOUTHOLD SELTK7N NO E --zZ— "••�••�+ R,) O2 P—�- --•-- ""'� --"-- ` Real Pro pertyTax Service Agency v a Nw�.i"e.— �• _ u. —_— u.vu. —_ -- '�-- WnfYCMYrPowH1Y°.XY 11R1 ® A WS ®OA U7� D �. a r�R1N.I.,tu '� —__— mu. --.-- s.ru.--wv-- �. r. Y'� P VVI a„ecr xo 7000 PROPEf[iY aMP t� OFFICE LOCATION: ®�*®f S®(/ryOl MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) cis S ® �p� Telephone: 631 765-1938 Southold,NY 11971 O Fax: 631 765-3136 lyC®UNT`I,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD 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 SILVINO FAMILY TRUST SCTM# 1000-78-2-42 Robert Wilson on behalf of SILVINO FAMILY TRUST requests an Administrative Permit to install 4' high fencing running from the northeast corner of existing dwelling to east property line, then south along the property line towards the wetlands, the fence will then run along the south side of the property coming no closer than five feet landward of the landward edge of wetland vegetation to the west property.line, and then run north until it reaches a point parallel with the northwest corner of the house, turn and run to that corner of the house. Located: 2750 Glenn Road, Southold. SCTM #1000-78-2-42 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: 1. Clarify the-setback distance from the fence to the regulated feature. 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 Michael J.Domino,President j� `tT, Town Ball Annex 54375 Route 25 John M.Bredemeyer III,Vice-President r r •;��. ,�,•a t����, P.O.Box 1179 Charles J.Sanders , ,.• �� Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski °�� Pax(631) 765-6641 130ARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Pen-nit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Exten 22l ''\r r 7Received Appli j* n• �=— =' —� Received Fee: $ �i I completed Application: JUN 2 2 2018�— Lt �' Incomplete:.__ . _ SEQRA Classification: Type I_ Type II Unlisted Lead Agency Determination: ' S0,Choi'for>n Coordination:(date sent): p L Boa.r pf 7'6- LWRP Consistency Assessment Form Sent: 0 2tCAC Referral Sent: Date of Inspection: Receipt of CAC Report: =Technical Review: Public Hearing Held: Resolution: Legal Name of Property Owner(s): Silvino Family Trust Mailing Address: 106 Via Sevilla Redondo Beach, CA 90277 Phone Number: (631)504-8842 Suffolk County Tax Map Number: 1000- 78-2-42 Property Location: 2750 Glenn Rd. Southold NY 11971 1250' East of Shephard Dr. (If necessary,provide LILCO Pole#,distance to cross streets, and location) AGENT(If applicable): Robert Wilson Mailing Address: PO Box 49 Southold NY 11971 Phone Number: (631)504-8842 Board of Trustees Applic, on GENERAL DATA Land Area(in square feet): 27,444sq. ft. Area Zoning: R-40 Medium density residential Previous use of property: Single family residential Intended use of property: Same 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 __�L Into 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 ___No Does the structure(s) on property have a valid Certificate of Occupancy? _Yes No Prior permits/approvals for,site improvements: Agency Date Southold,Town Building Department August 2nd. 1988 Southold Town Building Department August 18th 1987 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? V No Yes If yes,provide explanation: Project Description(use attachments if necessary): Install a 4' high fence comprised of wood posts and top-rails and wire mesh. Fence to run from northeast corner of existing house to east property line, then south along the property line towards the wetlands. The fence will then run along the south side of the property coming no closer than five feet y from the,,,edge, . of the wetands to the west property line. It will then run north, until it reaches a point parallel with the northwest corner of the house, turn and run to that corner of the hgp,5e, 1 Board of Trustees Applic - .on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Obtain a permit to construct a fence enclosing the rear and side yards of the existing house. Area of wetlands on lot: 6098 square feet Percent coverage of lot: 22 % Closest distance between nearest existing structure and upland edge of wetlands: 59' feet Closest distance between nearest proposed structure and upland edge of wetlands: 5' _ feet Does the project involve excavation or filling? ✓ 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: Flat 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): The proposed project will have a minimal or no impact on the wetlands. The project is a fence with wood posts and top rails, and wire mesh. No part of the fence will be more than 4' high, and no part o it will come closer than 5'tp theedge of the wetanobea__ barrier to light, views, or water during storms or floods. Board Of TrUSteea Application AUTHORIZATION (Where the applicant is not the o%mer) J/We, Nicholas J, Silvino and Julie Ann Silvino owners,of the Property identified as SCTM# j()00- 78-2-42 in the town of Southold New York hereby authorizes Robert Wilson 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 Ow d'a--S-i-g--n---46--r e SWORN TO BE-FORE ME THIS 5T DAY OF 20 - NICH04AS 7. f3aI A10a, Aj y" Notary Pow--Cant eta 0try;�� 4a lie Los Ar*zWo G M Comm.Est Ire$ion M.00 T9 ytv )ard ®f Trufft®es AppliCat: AUTHORIZATION (Where the applicant is not the owner) Owe' and Julie Ann Silvino owners of the property identified as SCTM# 1000- 78-2-42 in the town of Southold New York,hereby authorizes Robert Wilson 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. dVerrty Owner's Signature 0� Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF_ J' , 2010 otary Public TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.OIDW6306900 QUALIFIED IN SUFFOLK COUNTY,,�,,� COMMISSION EXPIRES JUNE 30,2��� oared of Trustees Applicat _ �x AFFIDAVIT 1446keh"A --A Julie Ann Silvino BEING DULY SWORN DEPOSES AND AFFIRMS THAT TIE/SITE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRITE TO TIME BEST OF HIS/HER KNOWLEDGE AND BELIEFS AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLID TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO)MOLD THE TOWN OF SOiUTHOLD 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 THEREBY 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 TIME TERM OF THE PERMIT. S' tore of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS 6� St DAT'OF 1i'l� ,20 otary Public TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2gZB Board of Trustees Application AFFIDAVIT Nic as J. Siivino and Julie Ann Silvino BEING DULY SWORN DE OSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS.CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS.ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTER. 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 REQUIREID 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 P erty Owner SWORN TO BEFORE ME THIS _ » _ DAY OF ,20-- Notary Public APPILICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM `lte Town caf fioutlaaid's C;acle oftliiesnralaibits c nfl3ci� fin =res on re rt o n ci ce rind ein la � Th� a o a t i' 'fo is to do a inatio ich t . err e t i of ossible c n is to rir allow it,to 6 e vrg�afcvci t3cras i:r necessary to avold same. -YOURNAME: Robert Wilson (Last name,first name,ipiddle 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.) µ 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.) DOyeti personally(or through your-cnm0by,spouse;sibling,parent,or child)have a rblationship`with any officer or employee ril'.4he Iirivrt ot`Sorrthttld? "ltetatianslaip'`:iircludcs by blotiit,marriage,or busiinasa:imeiuiS'a business, itrotutlin;a pat tnerslrip,ln,.Nvlricia the folvil officer or ernployce has.evcn a partial ownerslup,of(ore}nploymelit by)4 corporatioci in N.viiich the fawn of#1Ccr dr enrployce_owns irrore than 5of the shares. YES NO v' If yriu 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$ctwcen yourself(the,appiicat)t/rrgcutlrepresentative)and the townofficer or employee.Either check the appropriatc line A)tbrough,D)andlor 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).tlrer owner of greater than 5%«-ofhhe sharres of'the corporate.stock,of the hppplirtint (when,the applicatu is.a corporatiati); the-lej tl or•6eneficidi owner of€ury interestin a no*torporate entity-(when the -applicant is not corporation); __.C)'mf oiflerr,director,parmc`r,or,"�cmployeeYtif the applicant;fir D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of 20_ Print Name Form TS 1 APPLI+CANUAGENUREPRESENTATIVE TRANSACTIONAL DISCL®SUU FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and-employees.The purpose of t is f i o rovide igf qrinalipn which can alert thp town of IMssible co fli o 'rte st d allow it to a whale-ormlionis necessary to avoid same. YOURNAME: Silvino, Julie Ann (hast name,first name,Middle 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 ctnployec 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 ---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 appliont/agcnt/reptesentative)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)Owe 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 die 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 A I dair of SCG" 20 Signature Print Name „ S Form TS I APPLICANT/AGENT/REPRESENTATIVE TRANSAMONA.L DISCLOSURE FORM The Town of Soudtold's Code of gLhig§tirghlbits conflicts of interest on the pat of town officersand c;nl2lgyM The ripmor of this form is to provide information which can alertft p9M o ss' 1 is f' d ow it ot ateyar action is nssarvt_avoid same. YOUR NAME: Silvino, Nicholas J. (Last name,first name,ipiddle 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 9 Trustee Change of Zone Coastal Erosion Approval of plat _ Mooring Exemption from plat or official map __ Planning Other (If"Other",name the activity.) i)o you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of tie Town of Southold? "lielationship"includes by blood,marriage,or business interest."Business interest"means a business, including d partnership,in which the town officer or employee has even a partial ownership of(or empioymem by)a corporation in which the town officer or employee owns more than 5%of the shams. YES _ .4_ 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(iic relationship between yourself(the applicattUagentImpresentative)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)die owner of greater than 5%of the shares of the corporate stock of the applicant , (when the applicant is a corporation); _13)the legal or beneficial owner of any interest in it non-corporate entity(when cite applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP r Submitted this - day of 20> Signzture y Print Name Form TS I 617.2© Appendix B Short Environmental Assessment Form -InSfructiotis,f'ctr Con>ipledna 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 I 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 i -Project and Sponsor Information Name of Action or Project: Silvino Fence Project Location(describe,and attach a-location map): 2750 Glenn Rd. Southold NY 11971 SCTM:1000-86-6-20 Brief Description of Proposed Action: Construct a wood and wire fence to enclose the rear and side yards of the existing house. Name of Applicant or Sponsor: Telephone: (631)504-8842 Robert Wilson E-Mail:pressSTARTpermits@gmail.com Address: -- PO Box 49 City/PQ: � State: Zip Code: - _ Southold _NY 11971 „ 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 ofthe-intent'ofthe proposed action and the environmental resources that !__J 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 finding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 00�''} lam.t 1.:�1 3.a.Total acreage of the site of the proposed action? � 063 acres b.Total acreage to be physically disturbed? 0 oos" acres approx 420 linear feet offence. c.Total.acreage(project site and any contiguous properties)owned 121 sq ft disturbed area or controlled by the applicant or project sponsor? 0.63 acres 4'.''Check all land uses that occur on,adjoining and near the proposed action. E]Urban, ❑Rural(non-agriculture) ❑Industrial ❑Commercial UResidential(suburban) ❑Forest ❑Agriculture, ❑Aquatic ❑Other(specify): []Parkland Page l of 4 S. Is the proposed action, NO /A. a.A permitted use under the zoning regulations? E] Ed F] b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES' landscape? 7. Is the site of the proposed action located in,or does it adjoin,-a state listed Critical Environmental Area? NO YES If Yes,identify: 2 ET` S. a.Will the proposed action result in a substantial increase in traffic above present levels? NO J YES � . b.Are public transportation service(s)available at or near the site of the proposed action? M- c. c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action2 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: T0: Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: The project in question is a fence. No water supply will be hooked up LYJ L_.1 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: The project in.question is a fence (- j No wastewater will be generated, 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 1;�I 1 b.Is the proposed action located in an archeological sensitive area? Mr 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? (w',j b.Would the proposed action physically alter,or encroach into,any existing wetland or,waterbody? L.`O If Yes,identify the wetland or waterbody•and extent of alterations in square feet or acres: ► " , Cli^—a 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: [A Shoreline El Forest ❑Agricultural/grasslands ❑Early mid-successional Wetland ❑Urban 0 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? EZ LJ - 16.ls,the project site located in the 100 year flood plain? -NO YES 17.Will the proposed action create storm water d isch arge,'either from point or non-point sources? NO YES If Yes, a.Will storm�,vater-discharges flow to adjacent properties? ❑NO ®YES !.__.! b.Will stoomi water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,brielly,describe: ❑NO []YES Page 2,of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)?, 1f Yes,explain purpose and size: R,, 19.Has the site of the proposed action or an adjoining property been the'location of an active or closed NO I VES solid waste management facility? If Yes,describe: Y .._. _. ,f --------------- 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or .NO NES completed)for hazardous waste? If Yes,describe: _ 2 El I AFFIRM TiIA`1'THKINFORMATI®N.PROVIIDIED ABOVE IS TRUE AND ACCURATE TO THE BEST OF ICY KNOWLEDGE Applicant/sponsor name:__Robert Wilson _ Date: June 22nd 2018 Signature'______ Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will.the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? �^ El 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? (� 5. 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? - vi El 7. Will the proposed action impact existing; a.public/private water supplies? b.public/private wastewater treatment utilities? � 8. Will'the proposed-action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? _ �9. Will the proposed.action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or V 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 ( l problems? L_._..l 11. Will the proposed action create a hazard to environmental resources or human health? EJ Pail 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. ( � Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 0 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 impacts. Town of Southold-Board of Trustees7-Ma �y Name of Lead Agency Dat -^� - INI-c ael-J.-D®siert# -- President Print or Type Name o Responsi le Weer in ead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) .PRINK" Page 4 of 4 f Town of Southold I; !rQNSISTENCY 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 VMMsed -action, will .be-, erraltta#ed ns_ o ;its.sig.nfficsnf beneficial and advetse-effec�ts ppon.the as giirea wfich includes all.of-Southold T6j6nq . 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. Whirs each ausNver�-armust.be.-ex lainM,iii def , lis'tin ` bath su Ortin and "An- S11hgortigig,facts: If an action cannot be certified as consistent with the LWRP policy-standards and conditions,it-shallnofbc'undorhken. A copy of the LWRP is available in.the_following places: online at the Town of Southold's website(southoldtownmorthfork.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# 078 2 42 PROJECT NAME Silivino,Fence The Application has been submitted to:(check appropriate response):' Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees .Q] 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: Construct a fence to enclose the rear and side yards of the existing house. The fence will-be 4'-high,and approximately 420 feet in total length. The fence will be com 6sed of wood posts and top rails with wire mesh. . f, Location of action: 2750 Glenn Rd. Southold NY 11971 SUM, 1000-078-2-42 Site acreage: 0.63 Acres Present land use: Single family residential Present zoning classification. ,,, R-40,Medium density,residential 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: -Robert Wilson (b) Mailing address: PO-Box 49 Southold NY 11971 (c) Telephone number: Area Code( (631)504-8842 (d) Application number,if any: Will the action be directly undertaken,require.funding,or approval by a state or federal.agency-? Yes ❑ -No Q 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. 111 El( dD ED 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 benefcial,use of a coastal location,and minimizes adverse effects of development. See LMW Section III—Policies; Page 2 for evaluation criteria. . Q Yes ❑ No ❑ Not Applicable No part of the fence will be more than 4'high. The type offence was chosen specifically so as not to block light,views or water during storms or floods. No part of the fence will come closer than 5'feet of the existing wetlands. Due to the heavily vegetated wetlands seaward of the propsed fence the fence will be nearly,invisible from the water. Attach additional sheets.if necessary ' Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold: See L ] P Sections III—Policies Pages 3 through 6 for evaluation,criteria Yes ❑ No ❑ Not Applicable There are no known historic or archaeological sites present on or adjacent to the site of construction. 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 The fence was designed specifically to protect the scenic resources in the area. No part of the fence is higher than four feet wich is lower than the vegetation in the adjacent wetlands..It will be com rised,of wgod osts and to -rails with wire mesh so as to block as little views as possible. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRIP Section III—Policies Pages 8 through 16 for'evaluation criteria -10 Yes 1:1 No ❑ loot Applicable The fence is designed to allow water to pass through freely during storms or floods so as to not impact erosion. No part of the fence encroachs on the wetlands. Attach-additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section IH —Policies Pages 16 through 21 for evaluation criteria Yes �] No [—]Not Applicable The fence w1l have no effect on the quality or supply of water in the Town of Southold. 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 The project will have no effect on the marine habitat in,the town of Southold. 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 E No 0, Not Applicable The'propsed construction will have no impact on air quality in the Town of Southold. _ 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 The project itself will generate no solid or hazardous waste. Any waste generated during construction will be removed and disposed of appropriately. 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. Ye❑ lido❑ Not Applicable The proposed construction will have no effect on the access to or use of any coastal waters. 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 LVVRP Section III Policies; Pages 47 through 56,for evaluation criteria. Yes ❑ No ❑ Not Applicable The propsed construction will have no effect on Southold Town's'Water-dependent uses." 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. L 1 Yes D No❑ Not Applicable � _The proposed construction will have no effect on the sustainable use of living marine resources. 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 There are no agricultural lands that will be effected by this project. 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 The proposed construction will have no effect on the development and use of energy or mineral resources. PREPARED $Y Robert Wilson < TITLE Permit Expediter DATE 6/22/2018