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Home My WebLink AboutTR-10961A Glenn Goldsmith,President �oSUFF04,��D� r Town Hall Annex A.Nicholas Krupski,Vice President �� 54375 Route 25 Eric Sepenoski y x P.O.Box 1179 Liz Gillooly p �. Southold,NY 11971 Joseph Finora Telephone(631)765-1892 Ol far 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 % constructed Project complete, compliance inspection Glenn Goldsmith,President �QF SOUTH, Town Hall Annex P 54375 Route 25 Nicholas Krupski,Vice President ,`O� �� P.O. Box 1179 Eric Sepenoski l Southold,New York 11971 Liz Gillooly Q Telephone(631) 765-1892 Joseph Finora Fax(631) 765-6641 COUNTr,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10961A Date of Receipt of Application: April 22, 2026 Applicant: ALDAC LLC SCTM#: 1000-54-6-10 Project Location: 380 Hickory Road, Southold Date of Resolution/Issuance: May 13, 2026 Date of Expiration: May 13, 2029 Reviewed by: Board of Trustees Project Description: Install 8' high deer-fence along rear-yard perimeter. 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 Andrew Baranello, received on April 22, 2026, and stamped approved on May 13, 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. POLY, Glenn Goldsmith, President Board of Trustees LOT AREA = 12,650 SQ.FT. 15-272 16-175 .:a'V E,.. BOARD OF I R� S TOWN OF SOT, D DATE Al G ribbon7\ \ _ 12-17-2014 ribbont} edge of standing water I ribbon8 edge of standing water/ n bo� \ y s rib bong 3-17-2014 / -� freshwater wetlands as flagged by nbbona I ribbon3 THOMAS W CRAMER, ASLA, 12-14-2014 t NOW OR FORMERLY FISHER (,►6� fo ,Q�v S 44°12'00"E 100.06° PIPE i� MOM V05'W N 0.4'S C6 (D N 0) C 8'dia. # 12'deep v�° n Y w/high dome buried eF propone _ tr C O tank c o2) 0 0 drywell wd landing o a 3'x6' & } steps -r >- 0' FC + 48.0' o.2'S 0 o drain 2 STY FR 4 O T ;� DWELL M 4.s' o G o °� x oD GAR] o Z $ O o m '� [dwell z er 3 N 12.5' p Y 21.2' aj 16' 4.01 rn �_ 30.0' 6 U 43.5' 42' s d z o, m roofed over 2 .5' 'f- conc stoop Ip 3.7 x12.5' FD .. G 591.87' MON $ m FD N 42"10'20"W °role 100.00' PIPE HICKORY ROAD 0 O Lit Z NOTE: CESSPOOL, SEPTIC TANK & WATER n SERVICE LOCATIONS BY OTHERS. 7-7-2016 FINAL SURVEY 1-26-2016 LOCATED FOUNDATION 12-17-2014 LOCATED FRESHWATER WETLANDS AS FLAGGED, 10-21-2014 REVISED LOCATION OF PROPOSED DWELLING RELOCATED STANDING WATER, AND LATHED 8-7-2014 REVISED LOCATION OF PROPOSED DWELLING PROPOSED BUILDING CORNERS 7-10-2014 ADDED SILT FENCE & LEACHING POOLS 6-23-2014 REVISED SANITARY SYSTEM DETAIL DATUM ASSUMED (41.0) FINISHED GRADE 5-2-2014 REVISED SANITARY SYSTEM DETAIL THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE THE EXISTENCE OF RIGHT OF WAYS AND OR EASEMENTS PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT JOB No. 14-38 FILE No. 956 F OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. INTENDED TO GUIDE THE ERECTION OF FENCES. RETAINING WALLS. POOLS, PATIOS, PLANTING AREAS. ADDITION To BUILDINGS OR ANY OTHER CONSTRUCTION. SURVEYED FOR CURTIS WINKLER & RITA WINKLER UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SITUATED AT SOUTHOLD SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y. LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITU IONS OR SUBSEQUENT OWNERS. SCALE 1 40' DATE 3-13-2014 COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR " = r E I V E EMBOSSED SAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. FILED MAP No. DATE CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-54-6-10DISK 2014 CURTIS WINKLER & RITA WINKLER 2 2 2026 GUARDHILL FINANCIAL CORP. HAROLD F. TRANCHON JR. P.C. FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC. LAND SURVEYOR P.O. BOX 616 uthold Town Board of Trustees 1866 WADING RIVER—MANOR RD. WADING RIVER, NEW YORK, 11792 N.Y. LIC. No. 048992 631-929-4695 HAROLD F. TRANCHON JR. PENN. LIC. No. 2115—E SOUT TRUSTEE. S HOLD No. 109(plA. Issued To Address 3go )40'ocar� Q�00'6 , SOJI�01A THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF SOU7'HOLD SOUTHOLD, N.Y. 11971 TEL.: 765.1892 Glenn Goldsmith,President vosuF C Town Hall Annex ��O Gym A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski y # P.O.Box 1179 Liz Gillooly �y�• �_4�f' Southold,NY 11971 Joseph Finora W �` Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report �o Date/Time: 5 6 Completed in field by: F�v A ALDAC LLC requests an Administrative Permit to install 8' high deer-fence along rear- yard perimeter. Located: 380 Hickory Road, Southold. SCTM# 1000-54-6-10 Ty a of area to be impacted: altwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment _-\,f�i�dministrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: l Sv IN /� giac�o _Z ljkul "C LI,i5 ejq/2 V4120, rnt=z ayz-E arz Present Were: G. Goldsmith N. Krupski E. Sepenoski L. Gillooly ',�J. Finora LOT AREA = 12,650 SQ.FT. 15-272 16-175 n'bbon7\ \ 12-17-2014 ribbon edge of standing water I ribbon8 i edge of standing water/ ~� bony ribbons 3-17-2014 .--� freshwater wetlands as flagged by nbbon4 ribbon3 THOMAS W CRAMER, ASLA, 12-14-2014 NOW OR FORMERLY FISHER S 44'12'00"E 100.06' PF E FID I MON �Fc 0.5'w CV 0.4'S 06 �- 8'dia. x 12'deep o' s � w/high dome buried c o N Pr O opak One - tan c � f 0 0 9 a drywell W3,la5ndi g o 0 '^ steps 48.0' 22.0' 02 6 S U7 o drain 2 STYo '` DWELL C4 _ o G o i7 0 of M 4 8' 3 LLI 3 M � o Q 0 O o GAR dwell � z z :F 3 v i. 12.5' O L rn 30.0' 21.2' �i 4.0' (T� s 16' O a �, m 43.5, 42' s d d z rn roofed over 2 'S� d� conc stoop Ip N m M 3.7 x12.5' ZFD3 G 591.87' MON FD N 42'1 O'20'W 0 Pole 100.00' PIPE HICKORY ROAD 0 a 0 LL) z NOTE: CESSPOOL, SEPTIC TANK & WATER SERVICE LOCATIONS BY OTHERS. �\ 7-7-2016 FINAL SURVEY 1-26-2016 LOCATED FOUNDATION 12-17-2014 LOCATED FRESHWATER WETLANDS AS FLAGGED, 10-21-2014 REVISED LOCATION OF PROPOSED DWELLING RELOCATED STANDING WATER, AND LATHED 8-7-2014 REVISED LOCATION OF PROPOSED DWELLING PROPOSED BUILDING CORNERS 7-10-2014 ADDED SILT FENCE & LEACHING POOLS 6-23-2014 REVISED SANITARY SYSTEM DETAIL DATUM ASSUMED (41.0) FINISHED GRADE 5-2-2014 REVISED SANITARY SYSTEM DETAIL THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE THE EMSTENCE OF RIGHT OF WAYS AND OR EASEMENTS PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT JOB No. 14-38 FILE No. 956 F OF RECORD. IF ANY, NOT SHOWN ARE NOT GUARANTEED. INTENDED TO GUIDE THE ERECTION OF FENCES. RETAINING WADS, POOLS. PATIOS, PLANTING AREAS.ADDITION TO BUILDINGS OR ANY OTHER CONSTRUCTION. SURVEYED FOR CURTIS WINKLER & RITA WINKLER UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY. GOVERNMENT& SITUATED AT SOUTHOLD AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE `i1 L--: LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y. tl 1V OR SUBSEQUENT OWNERS. UU COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR SCALE 1" = 40' DATE 3-13-2014 APR2 2 2026JEMB ED OSS SEAL SHILLL NOT BE CONSIDERED TO BE A VALID TRUE COPY. APR 2 2 2026 FILED MAP No. DATE CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-54-6-10 DISK 2014 CURTIS WINKLER & RITA WINKLER Southold Town GUARDHILL FINANCIAL CORP. HA ROLD F. T RA NCHON J R. P.C. Board of Trustees FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC. LAND SURVEYOR P:O. BOX 616 1866 WADING RIVER—MANOR RD. WADING RIVER, NEW YORK, 11792 HAROLD F. TRANCHON JR. PENN. LICN 8 No. 21159 631-929-4695 E lollMORE 'y r� • r� �r 1 sk r � •i!�.I Y �1 �� 1 �. S•�� y e�'N� i .r ':��; r' Ham•• , +. l �( AV 's of ILL 'r �'4' .� a '`'� 1 t' � \ ! � .� _'�� till , """'_ t t. '' _"�+f�F��`Z� r t'�'�y, � � �„r'�/` 'J�'k 6.!�' t .. '+i Sf �yk�Ll�"�'.��,# '1 j►~�;�.- '� �,�•.�.- a ' 4lov�--�� ,a1 ' F4ii' �� rA�J,+4A t'i�i T ;di �j ter A�• r'y �-. ,j t T". ^, it •1 �ak►S s �, �i•aY• •� .'41 ;� / r �/�,'I a t � � ice. z � / •per,.•tl .-_ � '� „�I •�• ram.. 'Y• •3 Flenst � xo^� �, .•� •.Z�... �� °I �°1 1� �i�Ac) � � , �fluu.'$:\ r� as° ...... 12 ^$� .. 3% _ .\, 2a;, v'* � y�, � �'tr ""°'„ +' y a.�.e�Q!y ;b/� �4✓ i. :�5 x r z�T,, X, xaz � _ \,�a `3� �% y.��' �Ta w�'s F� ✓3d 'Pj'�.. xvnas�rxr�.onrey. 'e+/� aQ i. SC$m �' .fy Qalier �c f V i a ei ol '\\ �`` *t'�'"\\'\3ak* ^a� r*'v\Vy j r\,�X ;i'};`A A. ', O L z gl,S�' .`K'n ( 1 6✓ '..q a ..$ y r. 46 h a� •� "�is !.' .'� i 14,r\ ; _s��,\� Y�a �'��.... .-,��U�+A arq r}g.�? ___� a, w ��. ,b a,,+. i� r.P z+ n •t '4 9 k �+ \�''\\\s� 4:4 ig X S a J`_ 0 �� &I P i9 a �'�i `` � y '. 6°' ien •\ a \ ',� *°^ A v Vvv` VA swcf S\a u'v� '' v"vC e r a. w _j-' �? d ^� Pure c a '� e y vwl \A V A� - � IN, - :€ .�y`"w '8t >Mr f�'\\\,,. 3.r, a f ,y"' as c°. _\`'�• `x\; �\ r �xx' , \, ✓ \� s ---- e _,. _,.-• -. ,». COUNTY OF SUFFOLK�J r, - y — ..a_�--, _ __ •:•,' U •.. R al AopectyT S e 1ge .�r „ i.,«—u_— —— —— —— ,„, —_— �•� „" M ^' r ter.,i m„.a...(no rrvur u W wrro�K courtr*u ww °v sarto M Iwa « apuiMan 054 OFFICE LOCATION: ��OF SO(/ryO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold,NY 11971O • Q Telephone: 631 765-1938 MUMy,�� 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: May 12th 2026 Re: LWRP Coastal Consistency Review ALDAC LLC, SCTM# 1000-54.-6-10 This application is to install an 8' high deer-fence along rear-yard perimeter. 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 includes actions which are consistent with the "Administrative Permit" requirements of Chapter §275-2 A of the Wetlands Law of the Town of Southold which qualify under Chapter§275-5 (B)(2)(p) Deer fences, if located a minimum of 25 feet landward of the wetland boundary line or bulkhead line, whichever designated line is most landward. Under no circumstances are deer fences permitted in a nondisturbance area. 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. 2 Glenn Goldsmith,President taOF SOUTy � Town Hall Annex A.Nicholas Krupski,Vice President ,`off l�ro 54375 Route 25 P.O.Box 1179 Eric 5epenoski 7 I t Southold,New York 11971 Liz Gillooly cn ac Elizabeth Peeples p Telephone 651892 Y Fax(631) 765-6641 �lyCourm,�� ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only rAPREEIV, E Coastal Erosion Permit Application Wetland Permit Application Administrative Permit _Amendment/Transfer/Extension 2 2 2026 Received Application: Received Fee: $ SoutholdTown Completed Application: Board of Trustees Incomplete:_ SEQRA Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec. 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 Property (as shown on Deed): ALDAC LLC Mailing Address: 40 Combes Drive, Manhasset NY 11030 Phone Number: 347-236-8076 Suffolk County Tax Map Number: 1000 - 054.00-06.00-010.000 Property Location: 380 Hickory Road, Southold (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: 380 Hickory Road, Southold Phone Number: 347-236-8076 Email:andrewbaranello@gmail.com __ Board of Trustees Application GENERAL DATA Land Area(in square feet): 14,000 SF Area Zoning: Residential Previous use of property: Residential Intended use of property: Residential Covenants and Restrictions on property? Yes _ _No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? E—Yes _nNo 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 _2 _No If"Yes", please provide copy of decision. his project re any demolition as per Town Code or as determined by the Building Dept.? Yes IVI No Does the structure(s) on property have a valid Certificate of Occupancy? Yes F-1_No Prior permits/approvals for site improvements: Agency Date RINo prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?jkl-No F-1 Yes If yes, provide explanation: Project Description (use attachments if necessary): Deer Fence at rear yard perimeter. 8 feet high. Attached is a marked survey showing fence line Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To keep Deer and Turkeys out in an effort to control the tick population on the property Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: 100 feet Closest distance between nearest proposed structure and upland edge of wetlands: 50 feet Does the project involve excavation or filling? 0 No _-_Yes If yes, how much material will be excavated? 0 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations: no change Manner in which material will be removed or deposited: no removal 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): there will be no affect to the wet lands 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -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 Andrew Baranello Name of Action or Project: Deer Fence Installation Rear Yard Project Location(describe,and attach a location map): 380 Hickory Road, Southold Brief Description of Proposed Action: Install deer fence with wooden posts, 10' on center, mounted in concrete footings, with 6x6 welded wire fabric netting, 8 foot high, to keep wildlife off the property. Fence will return to the north and south face of the home to form the enclosure Gates in the north and south sides of fence will be provided for access Name of Applicant or Sponsor: Telephone:347-236-8076 Andrew Baranello E-mail:andrewbaranello@gmail.com Address: 380 Hickory Road City/PO: State: Zip Code: Southold NY 111917 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes, list agency(s)name and permit or approval: ❑ ❑ 3.a.Total acreage of the site of the proposed action? .33 acres b.Total acreage to be physically disturbed? 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? •33 acres 4. Che 1 land us at occur on,adjoining an ar the prop action. Urban ✓ Rural(non-agriculture) Industrial Commercial ❑✓Residential(suburban) FV Forest ❑Agriculture ✓Aquatic [:]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: Z ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? ✓ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? V 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 "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. ntify the typic bitat types that oc n,or are likely to be found on t)�e-project site. Check all that apply: Shoreline ✓ Forest Agricultural/grasslands Early mid-successional ✓ Wetland Urban ✓Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? ✓ 16.is the project site located in the 100 year flood plain? NO YES IZU17.Will the proposed action create storm water discharge,either from point or non-point sources? NO If Yes, ZN ^ ❑ a. Will storm water discharges flow to adjacent properties?. ✓ O ES b.Will storm water discharges be directed to established conveyance systems Off an¢—fm drains)? If Yes,briefly describe: ✓ O IL 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)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor • Andrew Baranello Date:04/15/2026 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 I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflictwith an adopted land use plan or zoning Elregulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3, Will the proposed action impair the character or quality of the existing community? ❑ 4. 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 El ❑ 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 El ❑ 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, El ❑ 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 Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ ❑ problems? 11. Will the proposed action create a hazard to environmental resources or 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. EICheck 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. 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 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 Board of Trustees Applicat.Lon AFFIDAVIT I Andrew Baranello BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/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. 1 l 1 Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF , 20 i i Notary Public i CHEVAIS BROOKS Notary Public,State of New York No.01 BR5073385 Qualified in New York County--) commission Expires May 3,20._._ I 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. YOUR NAME: Andrew Baranello (Last 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.)Deer Fence Application 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 F1 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): f2A)the owner of greater than 5%of the shares of the corporate stock of the applicant _n (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 1,5, day of ARM I 20 26 Signature Print Name An rew Barctnello Foan TS I 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. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 1000 -054.00 06.00-010 PROJECT NAME 380 Hickory Road, Southold, Deer Fence Application The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑✓ Board of Trustees ❑✓ I. 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 iransaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Proposed installation of 8'-0" high Deer Fence at rear of property perimeter. • Location of action: 380 Hickory Road, Southold Site acreage: .33 Acres Present land use: Residential Present zoning classification: 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: Andrew Baranello (b) Mailing address: 380 Hickory Road, Southold 11917 (c) Telephone number: 347-236-8076 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 ❑ 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 0 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 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 ❑ No ONot 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 ❑No❑✓ 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 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. ❑ Ye❑ No 0 Not 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 ❑ No❑✓ 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 0 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 ❑ No❑� Not Applicable PREPARED BY Andrew Baranello TITLE Owner DATE 04/15/2026