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HomeMy WebLinkAboutTR-10928A Glenn Goldsmith,President O�Qvsffol/rea Town Hall Annex A.Nicholas Krupski, Vice President �� y` 54375 Route 25 $ric Sepenoski y = P.O.Box 1179 Liz Gillooly Southold,NY 11971 Joseph Finora ?� apt Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction Y2 constructed XProject complete, compliance inspection *050 Town Hall Annex Glenn Goldsmith,President U�y Nicholas Krupski,Vice President ,`O� ®l 54375 Route 25 0 P.O. Box 1179 Eric Sepenoski l Southold, New York 11971 Liz Gillooly G Q Telephone(631) 765-1892 Joseph Finora • �O Fax(631) 765-6641 ol�cnil BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10928A Date of Receipt of Application: February 18, 2026 Applicant: Joseph & Heidi Battaglia SCTM#: 1000-64-3-3.2 Project Location: 2000 Hobart Road, Southold Date of Resolution/Issuance: March 18, 2026 Date of Expiration: March 18, 2029 Reviewed by: Board of Trustees Project Description: Remove top row/layers of boulders from existing rock revetment and move off-site. 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 site plan prepared by Land Use Ecological Services, received on February 18, 2026, and stamped approved on March 18, 2026. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. i i� Glenn Goldsmith, President Board of Trustees �Nl stin ul" '3R 16� BUFFER RESTORATION SPECIFICATIONS "All MYRUM11,11 , -4738-03884/00001 Area of Buffer per NYSDEC Permit # I f ��J (2/27/2009) is 10 840 SF. Area of Buf er to be Preserved is 4 300 SF. Area of Buffer to be Planted is 6 540 SE J, 1 . Buffer Plantings: As per discussions with NYSDEC staff, 17 all cleared buffer areas beneath the existing tree canopy ',W� and landward of the top of scarp will be planted with the following native shrubs Pe T 101, Morella pensylvanica (Bayberry) 11 2 ` 5 4 flex glabra (Inkberry) aa p, Total 175 shrubs to be min. 5 GAL containers installed in 72 clump" formation on 6 FT centers. 21 4 ii, WK 2. Proposed Boulder Relocation: Existing rock revetment to have its top row of boulders removed offsit at -h -b�ce-d­in­a­-sing-k-f- ow­o, --e t& th in scarp to OFF FT r-p. Dead tree stump be remov C ed. `-77T A"'A 77 ­4 OL ju 5 A-41 is ownered by Hobart Road Wx Note: Lot I (adjacent west) 0a now' ! LLC with members Joseph and Heidi Battaglia. Lot I is 7971111� also subject to a NYSDEC Article 25 violation settlement process. D BY APPROVE. BOARD OF ) CZUSTEES Ra FEB 1 8 2026 TOWN OF SOUTHOLD DATE Prepared By: Land Use Ecological Services, Inc. Project: BUFFER RESTORATION PLAN DATA SOURCES 1 . Property boundary, wetlands, and buffer digitized from As-Built Survey prepared by Nathan 570 Expressway Drive South For: Joseph + Heidi Battaglia I in — 30 ft Suite 204 At: Lot 2 - Hobart Road, Southold oam' Taft Corwin 11-1 last revised 2/20/2013 . Survey georeferenced to 2025 Nearmap aerial. Medford, NY 11763 SCTM # 1000 - 64 - 3 - 3 .2 2. Landward limit of tidal wetlands flagged June 2022 by R. Herman were digitized from survey. 0 10 20 40 3. Base aerial is ,4/9/2025 Nearmap image. Date : 5/29/2025 Revised: Scale: As N-oted Sheet: RP-HL2 S- - OU TRU TEES THOLD , . S No. i o°[ IS A . 105ePM + Ht�4: ClIssued TDate Address ao�c, 1-lob�f; 6z�.d, sn.��►�,.oId THIS. NOTICE MUST BE DISPLAYED DURING CONSTRUCTION .TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 Glenn Goldsmith,Presi: p��SUF O � y Town Hall Annex A.Nicholas Krupski,Vice President ��� y< r ' 54375 Route 25 CM Eric Sepenoski y ? P.O.Box 1179 A Liz Gillooly �y s �!�r Southold,NY 11971 Joseph Finora # � r Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Uo Completed infield by: L• 611(oo f�j JOSEPH & HEIDI BATTAGLIA request an Administrative Permit to remove top row/layers of boulders from existing rock revetment and move off-site. Located: 2000 Hobart Road, Southold. SCTM# 1000-64.-3-3.2 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound Bay ✓Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other Type Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No ✓ Not Applicable Info needed/Modifications/Conditions/Etc.: 3" e-4 Present Were: G. Ggtdsmith N. Krupski E. Sepenoski V L. Gillooly J. Finora SURVEY OF PROPERTY t SIT UA TE DRAINAGE SYSTEM CALCULATIONS_i HOUSE ROOF AREA: 5,300 sq. ft. + S 0 UTH 0 LD_ 01 c . ft. X . = 9 cu. ft. FED Or' TOWN Of SOUTHOLD 901 cu. ft. / 42.2 2 = 22 vertical ft. of 8' dia. teaching pool required � I • PROVIDE (4) 8' dia. X 6' high STORM DRAIN POOLS � � �� � S U F FO L K COUNTY, PROPOSED 8' DIA. X 6' DEEP DRYWELLS FOR ROOF RUN-OFF ARE SHOWN THUS: NEW Y 0 R K 14Aao4 qq S.C. TAX No. 1000-64-03-03 �E� EyE GAR1,020AGE RsgF ft. :0 1,008 172 ft ft. r SCALE 1 "=30' F 172 cu. ft. / 42.2 = 5 vertical ft. of 8' dia. leaching pool required MAY 28t 2008 �d" PROVIDE (1) 8' dia. X 6' high STORM DRAIN POOL JULY 10, 2008 ADDED TEST HOLE & PROP. LOTS ��$ E E• '00• PROPOSED 8' DIA. X 6' DEEP DRYWELLS FOR ROOF RUN-OFF ARE SHOWN THUS: ��4 DECEMBER 9, 2008 ADDED PROPOSED HOUSE S Cif$ DECEMBER 29, 2008 LATH PROP. HOUSE FOR SITE INSPECTION $ L� DRIVEWAY AREA: 4,333 s ft. JANUARY 12, 2009 ADDED TOPOGRAPHICAL SURVEY FEBRUARY 9, 2009 ADDED WETLAND BUFFER A 4,333 sq. ft. X 0.17 = 737 cu. ft. MARCHPRIL 17,22009R EVISEVISED HA YBBALELLINE 737 cu. ft. / 42.2 = 18 vertical ft. of 8' dia. leaching pool required APRIL 18, 2009 UPDATED WETLAND LINE w \ INE ' PROVIDE (3) 8' dia. X 7' high STORM DRAIN POOL JANUARY 14„ 2010 REVISED PROPOSED HOUSE \ PROPOSED 8' DIA. X 7' DEEP DRYWELLS WITH OPEN GRATES FOR DRIVEWAY RUN-OFF ARE SHOWN THUS: (� ! APRIL 15, 2010 ADDED FLOOD ZONES JUNE 10, 2010 FOUNDATION LOCATION DECEMBER 1„ 2010 ADDED PROPOSED DRIVEWAY 7• \ \ d�. \ DECEMBER 16, 2010 ADDED PROPOSED RIP-RAP o\y \ 1 \ ��j\,\ i MARCH 12, 2011 REVISED PER N.Y.S.D.E.C. NOTICE FEBRUARY 23, 2011 00.\ % TOTAL AREA = 101,022 sq. ft. (TO TIE LINE) 2.319 ac. E$ G LOT COVERAGE UPLAND AREA = 94,481 s . ft. ERAGE OVER LOT 2 q 11 I \\ 53,208 sq. ft. UPLAND AREA _CERTIFIED TO: F ^^ DESCRIPTION AREA X LOT COVERAGE FED� u ?:,,:., � , JOSEP H BATTAGLIA HOUSE PORCHS, GARAGE HEIDI BATTAGLIA & CONNECTING ROOF 6,308 sq. ft. 11.9X PECONIC ABSTRACT, Inc. DRIVEWAY 4,333 sq. ft. 8.1% FIDELITY NATIONAL TITLE INSURANCE COMPANY / I TITLE No. FNP-01504 10,641 sq. ft. 20.OX �• / / I \ , \ I X, I i �, NOTES: •�� / l \ 1 I I I I TEST HOLE DATA 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:.�s (TEST HOLE DUG 8Y McDONALD GEOSCIEN-CE ON JULY 3, 2008) I� EXISTING CONTOUR LINES ARE SHOWN THUS: -—— —-lo- — —- - w \ / I X\I ` 1 ��s I 1 / / I / env. 122' wow snNo a Guava w' - WAGE- •a�i i X I I xs.$ X 1 / / I / ��5 Y� �. O.W. - BOTTOM of WAIL. I I I I 2. FLOOD ZONE INFORMATION TAKEN FROM: I I I SILT ML FLOOD INSURANCE RATE MAP No. 36103CO166 H 5 e�`'�' 1 1 I -max 1 � /� MINED AL \ \ I I x-1U I ' I I I \\ I ZONE VE: COASTAL FLOOD ZONE AE: BASE FLOOD �WITH VELOCATIONS ITY HAZARD (WAVE ACTION); °1 ' I \ \\ \\ I X * BASE FLOOD ELEVATIONS DETERMINED \? \ i I \ \ I �► " I, ZONE X*: AREAS OF 0.2% ANNUAL CHANCE FLOOD; AREAS OF 1% ANNUAL CHANCE FLOOD PALE BRaW FINE SP WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WiTH DRAINAGE AREAS LESS THAN /�' a- \v'�M \\ \ i \` \ \ \ \ \; '� TO MMUM SANG ! 1 SQUARE MILE; AND AREAS (PROTECTED BY LEVEES FROM 1% ANNUAL CHANCE FLOOD. ZONE X: AREAS DETERMINED TO BE OUTSIDE THE 0.2% ANNUAL CHANCE FLOODPLAIN. 3. MINIMUM SEPTIC TANK CAPACITIES FOR A 6 BEDROOM HOUSE IS 1,500 GALLONS. \ \\ QWUu 11 e' 1 TANK; 8' DIA. 5' LIQUID DEPTH t°°/ \ \ \ X I X iQ.4 \ ` \ \ 1 — 4. MINIMUM LEACHING SYSTEM FOR A 6 BEDROOM HOUSE IS 400 sq ft SIDEWALL AREA. '� �e \ I \ I \ \ \ �� \\ \ 3 POOL; 6' DEEP, 8' dia. a \ \\ / 1 X \ \ \ L 11 \ •�i'' WATER M PALE BROMM FINE sP � 5 \ 1 LO� ��• \ \ X MEdUM S�wD i PROPOSED EXPANSION POOL . . \���� �' \ �\\ \•\ \\ 1 I �f PROPOSED LEACHING POOL y � ...•, PROPOSED SEPTIC TANK 1 CP , `9 \ 't� 5. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD Os �� 1010 •�ls��. \ �L� t .1.,.,Q ' i `• \ OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. AL \ \ \ F {\ 1: :,. f. ' \`\ \ � °_12 l 6. EXISTING SEPTIC SYSTEM STRUCTURES SHALL BE PUMPED CLEAN AND A I'., :;1i:;:;:; :. • "' , ` e \ REMOVED IN ACCORDANCE WITH S.C.D.H.S. STANDARDS. ::::. oil 10. r anti .s�,�,. \ \ ,lX , : 11\. � •'. \ / 1 0*0 PROPOSED CROSS SECTION OFF to \ r \ \ \ \ 4 i \ \ SA RIP RAP PLACEMENT CE\ :: M ENT Cp, .:... i \ _ \ o \ : .p. � �. � SCALE 1• 10 O xr \ \ y '�?� �Ir F o?zw PROPOSED S CU. ds. OF CLEAN FILL FOR BA�GKI`I 0.�� \\ \ �G \ o :: 04F : o? =�'s TO BE TRU(SKED IN FROM AN UPLAND 50URGE \ r � \\� F PROPOSED RIP RAP \ :f:::;: • (1/2 TO i TON BOULDERS .................................................... ...... % X \ S HIGHER HIGH WATER V I I _ EX15TiNG GRADE -- .::..... 3 -4 die. •,� :'Q.... lh::^:\:ii}t{:•:l. HIGH WATER h 'r \ e PROPOSED 1=I LTER CLOTH TO BE LOW WATER \ ::: PLACED LANDWARD OF BOULDERS4. — I — Iry 0 �, * '� /X / I �., Xis\ h� fit ' / - PLANTING LEGEND \\ X' // ROSA RAGUSA ® 2 GALLON POT, 3' O.C. Al . '1' S \\malt / R 2,� �OS`9 BLUE GRASS 0 2 GALLON POT, 3' O.C. ' ���,w4 ooJ BAYBERRY • 2 GALLON POT, 2' O.C. PREPARED IN ACCORDANCE WITH THE MINIMUM J STANDARDS FOR TITLE SURVEYS AS ESTABLISHED �\ w ° h BY THE LULLS. AND APPROVED AND ADOPTED r T��t 0"'0 Idf '\ �+ 4.04?o' FOR SUCH CIATIOBY- NEW PORK STALE LAND TITLE ASSOCIATK)�,,z 89 \ r `'''"+ ;i;..."• !.',':` �GON` �� _— -;3�, � 0�� G) I �y� r -j' v° gjy �(�aFT © ` fit` I�'�F` sJ ^•�'' � o�j '�' CT, 0 73 22 W oar •82' �, i z l mop y 7 ,,�, sT \ `' ���/,11haJ CUB' a�Bp�y ty i N.Y.S. Lic. No. 50467 �vO UNAUTHORIZED ALTERATION OR ADDITION ■ V y SE TIO SURVEY IS A VIOLATION OF a' than Taft Corwin III 2 'Q ! � SECTION 7209 OF THE NEW YORK STATE Q EDUCATION LAW. Land Sur •1C �,�,' COPIES OF THIS SURVEY MAP NOT BEARING Surveyor ram/ THE LAND SURVEYOR'S INKED SEAL OR 7 EMBOSSED SEAL SHALL NOT BE CONSIDERED 3• TO BE A VALID TRUE COPY. �U CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. isaksen, Jr. L.S. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. IS PREPARED, AND ON HIS BEHALF TO THE TiTLE COMPANY, GOVERNMENTAL AGENCY AND Ttle Surveys — Subdivisions — Site Plans — Construction Layout Yy TTO TIE INSTITUTION OF THE IEENNDING INSiiI- PHONE (631)727-2090 Fax (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF G 1586 Main Road P.O. Box 16 OMCES LOCATED AT M41UNG ADDRESS AND/OR EASEMENTS RIOF GHT RECORD, WAYSORD, IF i ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 ` .. ��a�` � .;�,. �+ � � � ��• � i-fir. !•:. _,. •+w•� ,^..�.�' ,� -K ; .. 1-DR'_ �. t� rN 41*' icy".. �' :��'�` o �,. 4 •�O I�, i Y"i'' i ��'/ -= bpi•. z y� . ` ,� • �_ _ IL � �r�- `' Y"S�.l�'r1 L" t 1 * -.t �;' • M �M 1��l yM" � � Z.� y, _ .w ♦: r ,vmt its .� �\ �`\• `�,: •��•f' , -. \-+�`,� Oe tt�j "•.F;.,�'�' .. .. �' �y '�w ��'�A '" �� � fir' :, .' �`.'.�' M.•� ,� .. 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COUNTY OF SUFFOLK C� NOTICE K iwc.w t000 SECT—NO o �$ _ _— •,••�°`�_ __ O -- , Real(-p-ly Taa Scivkc Ag—y +>eaalon arcwe v "' 'N e a""' : aounaln 064 127) m�Mrfnrie•aaaaT6M p oa $ 9pb1F.MBCY. OFFICE LOCATION: *of SU(/I MAILING ADDRESS: Town Hall Annex ,`O l0 P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 G • Q Telephone: 631 765-1938 'r0 i MuMv,��' LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees Cc: Honorable Lori Hulse, Attorney From: Heather Lanza, AICP, Planning Director LWRP Coordinator Date: March 10, 2026 Re: LWRP Coastal Consistency Review JOSEPH & HEIDI BATTAGLIA, SCTM# 1000-64.-3-3 This application is to remove top row/layers of boulders from existing rock revetment and move off-site. 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 proposed action is CONSISTENT with the policies of the LWRP as follows: Policy 6. Protect and restore the quality and function of the Town of Southold's ecosystem. 6.3. Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction. The proposed plan involves removal of existing rock revetment stones to an offsite location and is consistent with the requirements of Chapter §275-2 A of the Wetlands Law of the Town of Southold. During this operation, a project limiting fence and a silt fence with hay bales should be installed to contain disturbance and to ensure that such operations will not have an undue adverse impact on the wetlands and tidal waters of the Town. It should be noted that the proposed work is consistent with town code based'on the removal of the stones and relocation offsite and would NOT be consistent if the work involved relocation of the stones on this property or placement of the stones near the shoreline on an adjacent lot. Such work would require an additional application and further review. 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. C E P E D WAR - 3 2 February 27, 2026 `:vr Southold Tows :r To Town of Southold Board of Trustees: Board ofTru t This letter is to inform the Southold Town Trustees that Joseph Finora who resides in Southold is not allowed to do any field inspections on any of the waterfront properties we own which include 1750 Hobart Road 2000 Hobart Road. ® E 2200 Hobart Road all in the Town of Southold VAR - 2 He is not permitted to trespass on any of these properties. Southold Towne For reasons and facts included below. Board of Trust eag Reason 1 — On October 2025 there was a public hearing for a Town Trustees pool permit. Mr. Finora attended and erroneously stated that a permit should not be issued because a C of O was not completed on the 1750 Hobart Road property. Please see attached C of O which was issued many weeks before the public hearing. Also, he claimed that a plan showing clearing limits for subdivision should have been filed with the pool permit pertaining to clearing limits. We have never had an issue with clearing limits on 1750 Hobart Road during construction and subdivision. There has never been a violation to substantiate that comment. Reason 2— Conflict of Interest Mr Finora lives directly across from our project at 1750 Hobart Road Reason 3- We appreciate the guidance the Trustees have given us with our projects in the past and thank you for your time in to this matter If you need to further discuss with me I can be reached at 631-678-6546. Joseph and Heidi Battaglia paC� �oAs v� /►�cS /c#cr— I- rt t �.., 0 Town of Southold2s�P.O. Box 1179 WAR ' ' 53095 Main Rd �ourrt Southold, New York 1197 7.. n CERTIFICATET�fY� r-UPAN t n s No: 46466 Cr THIS FIES that the•btii�ding GLE FAMILY F" , Location of ropert k .' y 1750 obart Rd Southold y c„. Sec/BIock/Lot Conforms substantially to th' Apphcadon fqr Building'P. 0 ;Q812a23 Nr$uant to Wkich Building l'erinit No'49359 andn� ,` o 4 yseP was - {, y , y anc conforins'to all'of the recluireirl ok a avi , Te',occuFcr for which.this cerfificate is issue*`$ Slagle-family dweWn with an unfinlz" '` porch 2nd floor balcon n .cover"ed front' es, rear covered m. ., _. - y, 4sunkeu�eou �tlndi iA siai ae6ed garage with unfinished attic above ffor storage,only)-a,,"-plied for' , , ' tie— L The cert icate is issued t4 Hobart Riaad:lbL , '4 - � qg,�11 i ��,;' t 7q �''' '''£.�,r+u3"' ,'C1 _ 4 �•� �"� ..�lx, 'A�h'#�7: -�� I- � ., ' [✓O R�MEN�Y;OI w )� � 224559 Ol2%OS/2025 7 .:• a r _ ru 02.4:,r N ll t • �•^ . 1 y x �r Glenn Goldsmith,President w��®F SOU, Town Hall Annex 01 Nicholas Krupski,Vice President ,`Ovv ®I® P.O. Route 25 P.O. Box 1179 Eric Sepenoski l J�[ Southold, New York 11971 Liz Gillooly coa AN= Telephone(631) 765-1892 Joseph Finora �@ Fax(631) 765-6641 CU BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD J This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit ApplicationLz -- Administrative Permit Amendment/Transfer/Extension Received Application: F E B 1 8 2026 y` Received Fee: $ Completed Application: Incomplete: So-Aidd Tovai SEQRA Classification: Type I Type II Unlisted Negative-Dec. B—Vositiv l-Bec--�--- Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Owner(s) Legal Name of P71L-,,; (as shown on Deed):`✓r��5��� &PJ'xel�l'c Mailing Address: i ` �` ����. 7� Phone Number: Suffolk County Tax Map Number: 1000 - � ��J � t Property Location: ;;2 o o 0 •90 64 2 f ,50L)4-ko 1-�> i4l-`-/` / M-71 (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): Mailing Address: Phone Number: Email: f and of Trustees Applicati GENERAL DATA Land Area (in square feet): 57 F0 Area Zoning: 4 �0 Previous use of property: f'L�✓���✓� /�/ ��� `� J l Intended use of property: Saw rz 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 requir y 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 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? VIINo Yes If yes,provide explanation: ( tion Descr Project i use a chments if necessary): �Ca�l��i %U� L6Z,) Ole" p and of Trustees Applicati WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: o �� d : e� l/� c5'o`r� pxu) 11��a 2� /do h,rn B Area of wetlands on lot: square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: ;;� �feet Closest distance between nearest proposed structure and and edge of wetlands: �_feet Does the project involve excavation or filling? " No Yes If yes, how much material will be excavated? IVI cubic yards How much material will be filled? A/ W cubic yards Depth of which material will be removed or deposited: /W//4- feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): All, c C' 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Na of Action or Project: Nod/�f�'v �t%�°�� Project Location(describe,and attach a location map): 0700- '�Yqgg'� "klcl Briieff.Description of Proposed Action: Name of plicant,o(rr Sponsor: Telephon E L%l- Addre CJ - 01 cityC e� State: • Z�Ce 1.Does the proposed action only involve the legislative adoption of a plan,local law,ocdinanc , 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 YES If Yes,list agency(s)wme and permit or appr val: ❑ 3.a.Total acreage of the site of the propo ed action? 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? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial residential(suburban) ❑Forest ❑Agriculture P94,Nquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ' ❑ b. Consistent with the adopted comprehensive plan? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ -; 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: X ❑ 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? ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 54 ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ , 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. mtify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline El Forest qAgricultural/grasslands El Early mid-successional Wetland ❑Urban 19suburban 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? ❑ ICU 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, p/K a.Will storm water discharges flow to adjacent properties? VML ❑YES 1 El b.Will storm water discharges be directed to established conveyance systems u off and storm drains)? If Yes,briefly describe: NO AYES 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: K ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: X-21 ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE �- Applicant/sponsor ame: (7665� ✓ G Date: /17 /.W _ 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 El ❑ 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 community? EL 4. Will the proposed action have an impact on the environmental characteristics that caused the El ❑ 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? 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? 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, ❑ Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ Elproblems? 11. Will the proposed action create 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. 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. ElCheck 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 Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 oard of Trustees Applicat i AFFIDAVIT es�mw �� �/-' BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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. nature of Property weer Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF , 20 otary Publ MADISON MESSINA NOTARYFUBLIC,STATEOFNEWYORK Registration No.OIME0002865 Qualified in Suffolk County Commission Expires March 17, ' APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. .wry YOUR NAME: /�� 7 �1'1 (Last name,first name,.qiiddle 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 e Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship.with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial.ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES _ NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of 200_ Signature f Print Name Form TS 1 1 a , Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DES/CRIPTION OF SITE AND PROPOSED ACTION SCTM#. PROJECT NAME 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:�/�„���� /!� � M Location of action: 0 �' /��� ✓p Site acreage: 1., 2 Present land use: &x✓QI/ Present zoning classification: A 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: :Zqs p u -I� �'a lam!✓` (b) Mailing address: (c) Telephone number: Area Code / (d) Application number,if any: N" Will the action be directly undertaken,/require funding, or approval by a state or federal agency? Yes No❑ If yes, which state or federal agency?C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No X Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No I 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 �j Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No4 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 ❑ No Pot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ 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. ❑ Yes ❑ NoN Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye�] NoYDNot Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No�Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ NoN Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No�Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ NoxNot Applicable PREPARED BYg /OsAa4l �r�"l r"� TITLE �(/�"�d6�v�, DATE - 1,_?