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Cantrell, Elizabeth From: jjpatanjo@gmail.com Sent: Tuesday,June 9, 2026 9:55 PM To: Cantrell, Elizabeth; Hobson, Thomas Subject: 5015 Vanston Road - McBurnie Attachments: 5105 Vanston Road 6-2.pdf;Trustees Revised 6-2-26.docx Good morning, As you know the mail is often a bit behind (to say the least) as such, I wanted to ensure you received this minor plan revision for this application. We extended the retaining wall an additional 16' to the north. Plans and updated description attached, and I'll bring another set of plans and descriptions with me at hearing tomorrow. Thanks !! Jeffrey Patanjo P.O. Box 27 Farmingdale, NY 11735 M: 63L4 7.529 JJPatanjo@gmail.com ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. 1 0 PROPOSED 48"TALL ALUMINUM ESTATE FENCE N J L i N i 00 rn i IQ I N W W W W N N N� N OI �g.301 I00 II 1•I 00 a I M CO it I I II . II 00 II II I �I II II I / I / I I I I II rr1 N O N 8r0500 II ---L— I\ II II II I j I II j I / jl I I II II fll f PROPOSED EMB DDED PILT FENCE NTII PERM/NENT STABILIZATION IS ACHI�VED m PROPOSED q1 LF LANDSC E REI AININ WALL- ! \ I 1 1 I I 3�MAXIMUM HEIGHT AFTE MINO G I ING P I GRAVEL DRIVEWAY \r^ II I I I I PROP)RED 36"BALL NAtiIVE P TINES ALONG SEAW� D FAC OF PROPOSED DSCAPEI RAA I II I/ II I I I II •II I 7j I II 20' o / / '/ I AOPOSdD 16'X 361 IN-GROiJNO SWIMMINq POOL I II I I I I I I A 1IVJ 2'WIDE NATURAL STONE PATIO SURROI ND r� I /C) � P4OPOSEb POOL E UIPMENT AND BACAWASr \ I I I I I I II Ln o I DYWELLI Z 1 �70< �T� HWJ I I II I I 172 , ✓ I m / i I I I I I I I \I I I I 29 6•1 4 00 40' N O �I N No co rn C) \1 I I I N ° n' ! / ❑ I I 00 a' N O CA CA 00 N I rn S � N 00 �,__ III Nssat� Paint PROPOSED PLAN N.TS. utchoguo t' �e NOTES: LOCATI N 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 2. LOT AREA: 29,345 S.F. 0.674 ACRES 3. PORTIONS OF SURVEY FROM SURVEY PREPARED BY: PECONIC SURVEYORS, PC Tr SOUTHOLD, NY SURVEY DATED MAY 2, 2012 PROPERTY OWNER: SHAWN MCBURNIE FTAX ed Pool Permit Plats SCALE: Ift Now Suffolk �, t� � JUN 1 ® DEVON ANNABEL 1"=30' J7 9 5015 VANSTON RD. ©2012 MapQuest • Portions©2012 f+;&TEQ,Interm, CUTCHOGUE, NY 11935 DATE: . 4f�I oid.row n D PLAN & LOCATION MAP 04-20-26 V-';ard cif Trustees PREPARED BY: 06-03-26 JEFFREY PATANJO 5015 VANSTON ROAD PROJECT LOCATION MAP P.O. BOX 27 OGUE, TOWN OF SOUTHOLD FARMINGDALE, NY 11735SUFFOLK COUNTY, NY SHEET: N.T.S. JJPATANJO®GMAIL.COM MAP NO. 1000-111-14-03 1 OF 1 ,� �_ :�., Glenn Goldsmith,President � \OgUFFO[ COP, Town Hall Annex A.Nicholas Krupski,Vice President . 54375 Route 25 0 Eric Sepenoski ,? P.O. Box 1179 Liz Gillooly �y • o�� Southold,NY 11971 Joseph Finora l '�� Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: & Completed infield by: L ' G�' (�k:dn Jeffrey Patanjo on behalf of SHAWN McBURNIE & DEVON ANNABEL requests a Wetland Permit to construct a 16'x36' in-ground swimming pool with 2' wide natural stone patio surround; install a pool backwash drywell and pool equipment area; install a 76 linear foot long landscape retaining wall to be a maximum height of 36" tall; install 76 linear feet of native plantings for screening along the retaining wall face; install 48" high pool enclosure fencing with gates; with silt fencing installed surrounding the work site prior to and during construction. Located: 5015 Vanston Road, Cutchogue. SCTM# 1000-111-14-3 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 of Application: VWetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/M difications/Conditions/Etc.: -f 4m 5 4o 6e omo✓-d 3 ' r� a►h WU H( ����t< aoGts �z, 6, arc_ CCry 1oy I` s ati 16j" Present Were: `� G. Gfaidsmith �N. Krup�lci E. Sepenoski ✓ L. Gillooly J. Finora 115, •y.. Wk 31 • `• _�F jam' --.� - t.. ��� � '�'• ��� r�'� s 9. Y f 'Shawn McBurnie & Devon Annabel ue l if.�,.4 {�Jw*Yy+a.'r.ii µ�a �. }"'J'!'!',{ �• ;.• � •� _ `• �.i I� �Y�''1`I S ' ' re� � f f Ff a � �j ��,� �}t;,l! f^ �Rti c>;,�;'�r. ,,_ ,s.'�'`� '�iti,► *y;;:.'f, , k• , r R F r�C ,• ' IL.4A. imp 'Shawn McBurnie & Devon Annabel 16- 2�©?6 6_ 3 12 15015 Vanston Road, Cutchogue ' �. SCTM# 1000- i f .71 •'c ,` (v~..` �. � .k! ya ~ .J` y kSti +j'r.. r i1 • .� i . 'W Xj- •d 1 ( Devon Annabel i'.'• , c i• , 15 Vanston Road, ' / / PROPOSED 48"TALL ALUMINUM ESTATE FENCE � N I N 00 (A LA W N f N N N W 0 0 a4. 61 'P I I I I O Cyi 00 N o `Z N g •05'00" I 1 1. 11\ I I I I I I I I I I I ► 1 / I I I j I NI o PEORMI�NENT STBDDZAnON ISILT IL �CHIVETD I 1 I II / / I I 11 I I I I fn ►►� PROPOSED 6 LF LANDSCA�E R AININ WALL �• I GRAVEL DRNEWAY I 11 I 11 1 I I I 3�MAXIMUM HEIGHT AFTE I MINOt GRING i i I i i i 1 II I II I .�'i P•d rn PROPO ED 36"71ALL WIVE PDND$CAPEI TIN68 ALONG I I / I I 1 I 1 C) SEAW�D FACgFyOF PROPOSE I I I 1O �v / I I RETAI�lING WAI I I I I I I I I I I 1 I I o 11 I I I II 20� OROPOS�D 16'X 4 IN-GRO�IND SWIMMINGI POOL b Z WIDt NATURPIL STONfj PATIO SURROyND 1 I I I I I I I I I I I N 00 P OPOSEb POOL E UIPMENT AND BACIMASN I I I I I I I DkELL I I 11 I I I I I I I I i nn" I vcm, orb I II/ j i I I I W` I I �F I i I 172 co H 11 1 I I I q I ( 1 I I I j I I I I ►296•14� CD p ' I ITQ OD `A O' i e+ W I I N p co LA N O O S S0`n�0'3b o co °' E c�n ar Nassau Point MAY 8 2026 PROPOSED PLAN Southold Town �1� i N.T.S. Board Of Trustees utchoguo`: s NOTES: 4 1t' Ili ti S LOCATION 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM I 2. LOT AREA: 29,345 S.F. / 0.674 ACRES r I� 3. PORTIONS OF SURVEY FROM SURVEY PREPARED BY: t,�" ` ' �'' N s;�� }�• :` Q PECONIC SURVEYORS, PC SOUTHO' 1 a NY SURVEY LD,TED' MAY 2, 2012 Lo PROPERTY OWNER: - SHAWN MCBURNIE FTAX sed Pool Permit Plans SCALE: oNovt,Su[folk DEVON ANNABEL "=30' �p 5015 VANSTON RD. ©2012 MapQuest Portions©2012 M1kFTC,1 Inform; CUTCHOGUE, NY 11935 DATE: - D PLAN & LOCATION MAP 04-20-26 PREPARED BY: JEFFREY PATANJO 5015 VANSTON ROAD PROJECT LOCATION MAP P.O. BOX 27 HOCUE, TOWN OF SOUTHOLD FARMINGDALE, NY 11735SUFFOLK COUNTY, NY SHEET: N.T.S. JJPATANJO@GMAIL.COM MAP NO. 1000-111-14-03 of ADDRESS= 5015 VANSTON RO. LOT J47 313.30' N N m OI IA � I Of OI A N I W W W N OI I IFMrOW. I l I I I E. .rs � � I:� o.e' N. 82'05'00 N o 1� 1 1 1z'`� ' _`.1 1 c 1r.g / i o.4 sr° I c 1 l eecK�}' PILE Z "INwboo 1 sraeRs I ) � ) I m �.. OWL1 } } I 1 1 1 I I I I I I l / 1 / I I I I ro0b - Frto. / o.T &B� cum ,.a• I } I} l l 11 : 1 i I I / 1 f 1 I I I I II DOCK i _� I l c I I!; 1 I I ► 1 1 1 ! c-,C / 239 L Il I IVrn. ro / I J l I I 1 , I I I O , 1 z l i mha rri ,D II DRIVE o-, J 1 l I I I I ) } I ! / �C! / 1 1 I r m J 1 c:r B. B.G GR00 a. CURB 4.4' it �! I--rsm I I J I I I. I f I , �, 9s• O LOT Qn O N Z cn c c,� o ! / j 1 , J I I } 1 1 I I 1 I I °p I y �m� ro �nD ~ x < m Nam''' o'I I / I I 11 � J II 1 i I II 1 � ► Ifl''°• I I ) I � 1 m I N O � — '-x A' �� O BIZ' ❑� ' � m i ". D O r CH lac,uMT 1 1 ) I N — $rl A �f I � 1 ! , 1 . N � N � 1 E ' I N 1 ) 1 I t A } � J I r I I � , a v m S. so940'30' w. o LOT 249 MAY 8 2026 1�U A Southold Town N `. Board of Trustees I SURVEY OF PROPET Y i< AT NASSAU POINT TOWN OF SOUTHOLD CERTIFIED • VANSTON PARTNERS, LLC ' ; SUFFOLK COUNTY, N. Yfr VISTA LAND SERVICES s-` 1000 _ 111 _ 14 _ 03 CHICAGO TITLE SERVICES �� L 0 T NUMBERS REFER TO "AMENDED MAP A OF Scale: 1 = 30 NASSAU POINT' FILED IN THE SUFFOLK COUNTY r, CLERK'S OFFICE ON AUGUST 16, 1922 AS FILE NO. 156 I May 2, 2012 at FLOOD ZONES FROM FIRM 36103C0502 H 9/25/09 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION I ~N OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209 - SUBDIVISION 2 ALL CERTIFICATIONS 'HEREON ARE VALID FOR TFpS MAP AND COPIES THEREOF ONLY IF NO. 49618 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. CON S R VE YOBS, P.C. (63IJ 765 - 5020 FX (631) 765 . 1797 AREA = 29,345 sq.ft. to tie lines P.O. BOX 909 ELEVATIONS & CONTOURS ARE REFERENCED TO N.A.V.D '88' 1230 TRAVELER STREET 1 SOUTHOLD, N.Y. 11971 �2 — 173 7-7" 1.JI B _ • F ` '1117 y�% M P- *'Ta i • � Ct,`�vs.Y J Photo 1 (4-26) 7. a �7 C- \ IT- r ,� j Photo 2 (4-26) 1 1t x Photo k 1 III•• � ( 0 _.. - (R y.� ti. 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S A 1C1j o ,a ,x fo1 it ,e z .° b as fi z'e ax" �•'� .,c' t x 4 . s+ �,^.� \ ,'�i�., t,s a * � \ a c1 +.sure uN:,.,w l •�kY ��. p' x.L�l e m 5: �:.n 7 &.K 9 _ ^l3. .wR �: a, '' ,PyY �f+` t1S.a•t O -.. t .Ct�J k` 4 f',P•�.w a '� izi 2 I x, l a� Y+1 • !"fir,O sjO• ,IMaI i'f-''�� ^ � tb ¢•`�1 t [ •5 • ! s i° y'a<�A"�p\ a,�r{Yti:IW 1 i �� a ".,� '. \\ \ \F � • � Wr,�.��6.��+•' f ���J IM,r. ,x�� t � °F t��:, xW1 4t§ 'Y��"i'� , 1y o ' 3 x �" 't Pik l ems' ,0 1z e . m � x .._..._ 9'p6 .'. •�`� �ayc\ P '.::y t s�alcl Z i<) £�'.. A - 1 _ p.,3�1 ei c, EwetA cr, c u Pcwn �-,4 � x'a+acn }� • aN)�$ C _ g , ♦4 S; •.-., a Lan, - ��. "�\. �. N - .ri>, � Real P,.p-t O.S—i" Kcn w N xlewu.. iav wn smnarep sournofD sE'ior:v; w E o�u.� •.. t .,CIYy�, ,\:+ u¢wc,m 100a OFFICE LOCATION: f S 0 MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971utm , 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: June 10, 2026 Re: LWRP Coastal Consistency Review McBurnie, SCTM #1000-111.-14-3 This application is to construct a 16'x36' in-ground swimming pool with 2' wide natural stone patio surround; install a pool backwash drywell and pool equipment area; install a 76 linear foot long landscape retaining wall to be a maximum height of 36" tall; install 76 linear feet of native plantings for screening along the retaining wall face; install 48" high pool enclosure fencing with gates; with silt fencing installed surrounding the work site prior to and during construction. 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 INCONSISTENT 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 action is inconsistent with Policy 6.3A, which states that actions must comply with the Southold Town Board of Trustees laws and regulations in Town Code Chapter 275. The proposed pool is to be placed on the top of a bank, defined in Town Code Chapter 275-2, as land inclined adjoining a body of water, wetland and/or beach and does not comply with Town Code Chapter 275-2D(a)[5] that states a pool must be placed 60ft from the wetland boundary. If a pool is to be built in the future, it is recommended to retain the existing trees in the development area to the extent practical, and to retain native vegetation and trees within the Trustees' jurisdiction. 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 f�{' �V Sol/)y `�` Town Hall Annex jr � 54375 Route 25 A.Nicholas Krupski,Vice President 3S l� X ly P.O.Box 1179 enoski p Eric Se { t .�qr Southold,New York 11971 Liz Gillooly c fib; Telephone(631) 765-1892 Elizabeth Peeples O� _� ,.��'yrt Fax(631) 765-6641 yOC1NT!t ��'� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use OnlyJ.-..� Coastal Erosion Permit Application L ----_- i. Wetland Permit Application Administrative Permit i L MAY 8 2026 __Amendment/Transfer/Exten io Received Application: (5 19-o Received Fee: $ �'- Southold Town Board of Trustees Completed Application: Incomplete: , SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): LLWRP Consistency Assessment Form Sent: CAC Referral Sent: EEDate of Inspection:0- Receipt of CAC Report: _ _ Technical Review: Public Hearing Held: _(n 110 Resolution: Owner(s) Legal Name of Property (as shown on Deed): Shawn McBumie&Devon Annabel Mailing Address: 5015 Vanston Road-Cutchogue, NY 11935 Phone Number: 631-353-1910 Suffolk County Tax Map Number: 1000 - 111-14-03 Property Location: 5015 Vanston Road-Cutchogue See location map (If necessary,provide LILCO Pole 4, distance to cross streets, and location) AGENT(If applicable): Jeffrey Patanjo Mailing Address: P.O. Box 27 Farmingdale, NY 11735 — Phone Number: 631-487-5290 Email: JJPatanjo@gmail.com RE: SHAWN MCBURNIE& DEVON ANNABEL 5016 VANSTON ROAD -CUTCHOGUE, NY SCTM No. 1000-111-14-03 PROJECT DESCRIPTION Project includes the construction of proposed 16'x36' in-ground swimming pool with 2' wide natural stone patio surround, proposed 76 LF landscape retaining wall which will be maximum of 36" tall, planting of 76 LF worth of native plantings to screen seaward side of retaining wall, proposed 48" tall aluminum pool fencing and temporary silt fence surrounding work site. yard of Trustees Applicai ' i GENERAL DATA Land Area ,(in square feet} 29,345 Area Zoning Res Previous use of property: Res. Intended use of property .Res. 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: WrTis project re 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 Trustees Dock. 2042. . Ell No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?�No�Yes If yes, provide explanation:.; . Project Description(use attachments if necessary) See attached description mrdl.of Trustees Applicat i WETLAND/TRUSTEE.LANDS APPLICATION DATA See attached descri tlon . Purpose of the.proposed operations.. P Area of wetlands on lot: 920 square feet Percent,coverage of lot Closest distance between nearest existing structure and upland edge of wetlands 20 _:feet Closest distance between nearest:proposed structure and upland edge of Wetlands:. 1:.2o feet Does the:pro�ect involve excavation or filling? ❑ No ✓ Yes: If yes,how much material:will be excavated? 125 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited 6 feet Proposed slopethroughout the area of operations 2-10 Manner in which material will be removed,or deposited; Excavator, Statement of the effect, if any, on the wetlands and tidal waters ofthe town that may result by reasgn of such proposed operations fuse attachments if appropriate): There will be no effecYon.wetlands due to.installation of silt fencing and pro per damage measures during construction Short Environmental Assessment t"orm Part 1 -Project Information Instructions for Completing Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1—Project and Sponsor Information Name of Action or Project: 5015 Vanston Rd-Cutchogue Project Location(describe,and attach a location map): See attached Brief Description of Proposed Action: See attached description Name of Applicant or Sponsor: Telephone: 631-353-1910 Shawn McBurnie&Devon Annabel E-Mail: multimcburnie@gmail.com Address: 5015 Vanston Rd City/PO: State: Zip Code: Cutchogue NY 11935 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 government Agency? NO YES If Yes,list agency(s)name and permit or approval:Town of Southold Building Dept. ❑ 3. a.Total acreage of the site of the proposed action? 0.67 acres b.Total acreage to be physically disturbed? .03 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.67 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: 5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial m Residential(suburban) ❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ✓❑ ❑ b. Consistent with the adopted comprehensive plan? ❑ ✓❑ ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, If Yes,identify: Agency:Suffolk County,Date:7-12-88 ❑ F NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? ❑ b. Are public transportation services available at or near the site of the proposed action? ✓❑ ❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed ❑ action? 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 project site contain, or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the ❑ Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑ ✓❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 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: Page 2 of 3 14. Identify the typical habitat types t' :ccur on,or are likely to be found on the proj - Je.Check all that apply: m Shoreline ❑ Forest ❑Agricultural/grasslands ❑ Early mid-successional m Wetland ❑ Urban m Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES Federal government as threatened or endangered? Common Tern,Least Tern,Pi... ❑ 16. Is the project site located in the 100-year flood plan? NO YES 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, 0 ❑ a. Will storm water discharges flow to adjacent properties? 0 ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑ If Yes,briefly describe: 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon, dam)? If Yes,explain the purpose and size of the impoundment: ❑ ❑ -19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES 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 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/name: Shawn McBurnie&Devon Annabel Date: 04-15-2026 Signature: Zi Title:Owners PRINT FORM Page 3 of 3 2.Anwaragofdo f000wft "sdcftl4PMt2=bigft midoo Cal whW fit pwl i e d od w Motorms a p spansoror ;' ��l4�lrl____Jr wlfG'!answm'fttgshe�th8t�ttelvtx t;ttldedbyt�eencept"Haaro� r�an�bwrewmofdedn�1� f881t�ilDRE�7lt�'itt�pJO�IASC{�BCtlOtt� Not or lVte F , $MR to brp � mayMay i aecafr ocew l t. win tba pcopasad action aeato a rtmisrfal a actopte3 Wise planar n1t� Wfuft adtoof+esaitio admp in t&e a moriate mky of twofbun � S. Will the proposed tow impoir the dodowa oft Otte clofte commwho. 14. Will WW act u fmve on ia4t Qtt ffie ernrfrtawnenta!d oterlstics thm mr wf: ealxWWWO t afa Cditaf f MdMv wvW A�(CRA)? 0 S. WIN do pmpoaed action cult in an advema ahm o in the exhft of'um"h 140NUmbftf$rnamV bliftorWalbw _ _ 0 0 6. Wit tbo pmpoud amiota oatom an h o mm io die ase ofeneW sad it#bile k=f*mc ��{{.. �`''''� avat�Wean watioa orrw+aweble a porlanitla5'f ► lr..t l.,..,� i� 7- VM*eFMpoMd=ft f mitt isstat�O.,au�dyvow 61u�o•-pyto aMvW=olu"= ti 10. Wp�l�pii BCtfw tasSUlt hl ab tnn�s�tta� f fpFr��rgg 11. Wfff tba pmpumd sWo cleans ford to 4avkomnoMresounaes ar hvmmt f 1d 7 : Part3-Q�of s oiEBwnus 'fllm 1t d A��y ihr ft of f%rtX FarvoW qu iw in FeFe dmtwaa wavered`hood fri ltgge MW sate;ar lMn I#a Dead to eicpfaf»vdhy a per kWw # etemet+t�f thm ltpovo l a�lcn cn�,y wdit nct�+esuts iA si oAnt adven�a�rnrkoan,e!<imt lmppoL p1gu a oMples pot& lit 9 ahwld,fn wf6alahtd QM*the bu PApqy pg MW=M=M ord9sfV fife s ft fmae peon bmiuded by the p j, epos ioavofd ar emtaee inipocb. Bert a ahoatd a explsdtt imeuv the lead wed tlmt Me [ d tfon, *=Id f�, .�o€seeistsiv # dvn*n yr ltnpaets, pblo scope mad made Alm wasideethe potehdat fi f Shag ,%Wttft GW f� st 17 ,R 1 If i this box if ynu flame detennf s4 leased an the ham wd a is Ao*anti my iu—p—jw*i6ida*nmdWM that ttas pmposed eatfan My re *invnoormore pote ewty!W or s 1pf kM-,vdvasee lmpads and an orn�f �fired. 00k this bOx Vyttu bM dMM*md.bated tin the 40MA110 Md wAMb 00*.and shy aupporlfOgdocamt tlmt iba pt d aodw WOT not result fir VW sWdlunt*dvetse environment!impom To+s�ria��s�ptotd-eaardteitZtusl¢es Name Of tMaAqMq �l gene MW nrTyps Name of f{espoMR Land A l6 of Rgpomt"bft Si of Reapwaibfe C1ff er in Lad kgatioy SJV OWN aCPtepmee(if di neat&Onr Responsible 0 EAF Mapper Summary R&rt Way, May 5,2026 9:42 PM Disclaimer: The EAF Mapper is a screening tool intended to assist 11 1N project sponsors and reviewing agencies in preparing an environmental assessment form(EAF).Not all questions asked in the EAF are 1'I 1 l G 1 11c 1 1 11 answered by the EAF Mapper.Additional information on any EAF 11 1 1 2;�, 11 J 1 L 2 E question can be obtained by consulting the EAF Workbooks.Although i r the EAF Mapper provides the most up-to-date digital data available to DEC,you may also need to contact local or other data sources to 11 1 145.3 confirm data provided by Mapper or to obtain data not provided by the Mapper. 11l 14-29 111 -,1 4 t3�u+c } ' fAonlpa SOUth0ld _ r , Fi � r 111.c'J44 2 + AlU ny. 1.1.-1.0 14 r HERE Gkr i I ,S IIt rrr� II REt4�fI s,_ S�Gr s fsri, HERE G=�t ul IJ'Sr�,s�, l,�Ye l tup IP icf k` ^E:eIT P l�Fc� Es 113}„rl t lr r E,I ;f r st s r f pa4f ,1 It 1 5511 liiJ i� p.. Cl 1 ;: H r;F;�rrl E rl t �rA ;r Iidflc�l,Ly I ar, 1 :1YPr r�t�r sif tal,rti�tr+ t,r.' a� Is t�z" P(��. liar, r 4tRtap cc,rtiri t f Us Part 1 /Question 7 [Critical Environmental ;Yes Area] _. , r.... v Part 1 /Question 7 [Critical Environmental 'Name:Peconic Bay and Environs, Reason:Protect public health,water, ;Area- Identify] `vegetation &scenic beauty,Agency Suffolk County, Date 7 12-88 _ _ . .._ _..._._ Part 1 /Question 12a [National or State No ,Register of Historic Places or State Eligible Sites] Part 1 /Question 12b [Archeological Sites] ;Yes _ ... _._ _ ... _ _ _..... .. Part 1 /Question 13a [Wetlands or Other Yes-Digital mapping information on local, New York State, and federal Regulated Waterbodies] 'wetlands and waterbodies is known to be incomplete. Refer to the EAF Workbook. Part 1 /Question 15[Threatened or Yes Endangered Animal] Part 1 /Question 15 [Threatened or Common Tern, Least Tern, Piping Plover Endangered Animal-Name] Part 1 /Question 16 [100 Year Flood Plain] Yes Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report I and of..Trustees .Applicat� AFFIDAVIT Shawn McBurnie & Devon Annabel 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 OFHIS/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 PROPEATY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION; INCLUDING:A FINAL INSPECTION. I_FURTHER:AUTHORIZETHE:BOARD.OF TRUSTEES TO ENTER ONTO:MY PROPERTY AND AS:REQUIRED.TO'INSUIM COMPLIANCE WITH_ANY CONDITION OF ANY WETLAND.OR COASTAL EROSION PERMIT 1SSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE:PERMIT Signature of Property Owner Signature of Property.Owner S WORN TO BEFORE ME THIS . ..DAY OF 1(� .2777 of Publlc �\�..i� STATE ��% _ OF NEW PORK uBm 01GE64t9131 � i `R RE \ !iN:EX� �. . �//llllll.11 yard of Trustees: Applieat AUTHORIZATION (Where the applicant is not the owner) I/We, Shawn McBurnie & Devon Anna be : owners of the property identified:as SCTM# .1000 111 14 03 in`the town of Cutchogue New York, hereby authorizes Jeffrey Patanio to aet'as my agent and handle.: a11: necessary work involved with the application process for'permrt(s)from the Southold Town :Board of Trustees far:this.property Properfy Owner s_.Signature Prgperty:Owier's Signature:..:.: SWORN TO BEFORE ME THIS 5 DAY OF rl'L_ ?20 bhc ♦��� oeft, ♦ r ♦�b�i :STATE. : `.: OF :lypM APPLICANUAGENDREPRESENTATIVE TRANSACTIONAL DISCLOSIRR FORM. The Tow `,of Sou thld' Co of l thic rot ibit _Cori 'cos of i latest a"the a ' town o �cer5:and em to es'The f> Phis form is`.to provide-informatronwhich cea-alert the:town oPtinssibte'conflicts of mteres�and allow�4 to take wfiztever action is p_eees ary to`avohd same YOUR NAME.,.McBurnie, Shawn (Last:name,f ist riame;.j d e initial,ujiless you are applying to the name.of someone else or other entity,such as a company.If so,indicate:ihe.other person's orcompany'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: (lf"Other" name the_activi, ty-) Do you personalty{or`through your company,spouse;;sibling;parent,or:child)have a relatnonshrp::with any.ioflicer or amployee. . of the Townof Southold? "Relationship"includes by blood t`Business ustetesf%means a business, including a:partnersfiip to which the own officer or employee has even:;a partiaGownershp of(ocemployment by):.a corporation: in which thedown,-o.Jcer or`employee;owns;more than:S%oftl a shares.` YES _ NO .. n .:... lf.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 betweenyourself(the applicant/agent/representative)and the town o,.fEicer 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 the owner of greafei than S%ofthc:shares of the corporatc.stock fthe appltctuit (when the applicant is a corporation); n B)the legal or beneficial owner of any interestin anon-corporate:entity.(when the I� applicant is not a corporation); G).an.officer,director,partner,or employee of the applicant;or D)the actual applicant: DESCRIPTION OF RELATIONSHIP Submitted this day.of 20 Signature_ o — PrtntNart Shawn:McBurri Fonn IS 1 . APPLICANT -PRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofSouthold s Code of Ethics Qrohibtts conflicts of interest on the Hart`of town offieers`and emaloyees The puroose of this€orm is to�rovc information vi%hieh can°alert the-town�f'ossibie conBretsf interest•and.allow�t•to take:.whateVer action ls riecessary fo avoid'-wine: YOUR NAME: .Annabel,Pevon (Last name,fiisf name,.griddle initial,unless you are applying inahe name of someone else or other entity,such,as a-company.if so,indicate ft other. person's or company's name,) NAME OF APPLICAT30N (Check all that apply:)' Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat. Mooring Exemption from plator: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.aown officer or employee owns more than 5%�of the shares. YES NO --- lf 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 orposition,of thatperson 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 oc employee or his or her spouse;sibling,parent,or child is.(check all that apply): 0— 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 orbeneficial 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 04/05%2026 - Signature:. :. PC1RtNa a bevon:Mnabel,. F40rrM TS] APPLICANT%AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town.of Southoid.s Code of Ethics arohibtts conflicts ofinterest on t e par"f town crfficers_and enialovees The auroose of' thtsform isao-t)roviif6 infar nation which can alert thesown of'poss�bfe conflid ffnterest and allow it to.take.whateyer action rs;: necessary t©;ayotdsaine`:: YOUR.NAME: Fatanjo,Jeffrey (Last name;first name,.griddle.initral;unless you are applying in the name of someone else;or otherentity,such as a company.If soy indicatethe other person's or company's name,) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building: Variance Trustee ✓ Change ofZone 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,rnarriage,or,business interest"Business.interest"means a business, including.a partnership,in which the townofficer 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. Y$S IJ _ 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): DA)the owner of greater than 5%of the shares of the corporate stock of the applicant _E1 (when the applicant-is a corporation); 13)the legal or beneficial owner of any interest in.a non-corporate entity:(wheat 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 5/202 StgnatuPe :..:. . Print Name.erne a tanlo Form TS L >ard of Trustees Applicat: PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: ADDRESS: STATE OF NEW YORK COUNTY OF SUFFOLK , residing at , being duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Signature Sworn to before me this Day of , 20 Notary Public f I i June 2, 2026 Town of Southold Trustees f Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971x , RE: SHAWN MCBURNIE& DEVON ANNABEL ; is 5015 VANSTON ROAD -CUTCHOGUE, NY JU1\ ` 202 SCTM No. 1000-111-14-03 AFFIDAVIT OF MAILING s0 — - -p W. y hoard niTrw,le- Dear Trustees: Attached please find Affidavit of Mailing and certified receipts for the above referenced project. i I If you should have any questions or require anything further, please do not hesitate to call me on 631-487-5290. f Very truly yours, Jeffrey Patanjo P.O. Box 27 Farmingdale, NY 11735 i I Board of Trustees Application PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#:C� OcRo(`nI e .- 10()o{� 11 .1 q U� NAME: ADDRESS: 1000-111-14-2 Bofill David Bofill Colleen 1000-111-10-14 5785 Vanston Rd Vanston Bear LLC Cutchogue, NY 11935 c/o Archway Technology PO Box 17754 Denver, CO 80217 1000-111-14-4 Vanston Bear LLC c/o Archway Technology , PO Box 17754 Denver, CO 80217 i STATE OF NEW YORK COUNTY OF SUFFOLK u , residing at , D being duly sworn, deposes and says that on the - day of w h 20 �, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at S1r{nkale , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. ignature Sworn to before me this �- %, Day of �tt"le--- . 202.(.o �O�NS7,4 i NOTq/Zy Y�RK i o�aH,1�y p(/g/ co��O'GE6'8131 tc +l No ry P c ��'ss�O'1' ► s \\\�� M rq ttl U t rq Certified Mail Fee nj1.11i JI rn $ p Extra Services&Fees(check box,add fee pro ate) r-q Return Receipt(haldcopy) $ E3 [:]Return Receipt(electronic) $ stmark M El Certified Mail Restricted Delivery $ 1.7 L-]Adult Signature Required $ C3 El Adult Signature Restj icted Delivery$ Postage U, . '2 t fl 0 1000-111-14-2 ti AI 2/.2 U C3 BOfill David ru 0BOfill Colleen 5785 Vanston Rd Cutchogue, NY 1.1935 WENUMM M MU.-"I..I MIm-M- M-W� 0 117- ISr up a�"vf"t,14 J 77 rq Certified Mail Fee f M $ Extra Services&Fees(check box,add fee--ApDroo- El Return Receipt(hardoopy) $ KTO- to 0 El Return Receipt(electronic) C3 r I El Certified Mail Restricted Delivery POStimark 0 E]Adult Signature Required $ : ZL�Adult Signature $ H j- C:3 Restricted Delivery$'J3 stage M 1000-111-10-14 2'U 2 6 4" 0 -yanston Bear LLC ru C3 c/o Archway Technology PO Box 17754 -_______________ Denver, CO 80217 0 me Ln 1 , yxljjfvj� 11,111'', r I 11:1bil I :Vii i Certified Mail Fee 7 S.I, M $ Extra Services&Fees(check box,add fee a El Return Receipt(hardeopy) $ E]Return Receipt(electronic) $— Postmark M re Certified Mail Restricted Delivery $— Hq Adult Signature Required $ Adult Signature Restricted Delivery$ rq -111-14-4 Im Vanston Bear LLC c/o Archway Technology PO Box 17754 ----------------- Denver, CO 80217 ------------------- MEE= June 10, 2026 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: SHAWN MCBURNIE & DEVON ANNABEL 5015 VANSTON ROAD -CUTCHOGUE, NY SCTM No. 1000-111-14-03 AFFIDAVIT OF POSTING Dear Trustees: Attached please find Affidavit of Posting for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me on 631-487-5290. Very truly yours, Je ey Patanjo P.O. Box 27 Farmingdale, NY 11735 i ,1lIl i 20�6 o3Ct1[ilt>>ta o3jf(j rffni Ifs t dfFp(�`Glenn Goldsmith, President � l Town Hall Annex "N� C��?'" A. Nicholas Krupski,Vice President 54375 Route 25�y,� moo,�j Eric Sepenoski "`'i P.O. Box 1179 Liz Gillooly Southold,NY 11971 Joseph Finora ���� ��`�� `' Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ------------------------------------------ In the Matter of the Application of j ,I U 1�1 i 0 02�6 SHAWN McBURNIE & DEVON ANNABEL y _� COUNTY OF SUFFOLK �t STATE OF NEW YORK ��� AFFIDAVIT OF POSTING DO NOT COMPLETE THIS FORM UNTIL THE POSTING HAS REMAINED IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE— COMPLETE THIS FORM ON EIGHTH DAY OR LATER residing at/dba being duly sworn, depose and �G That on the -)- day of Tvv)e, , 202 I personally posted the property known as by placing the Board of Trustees official noticing post where it can easily be seen from the street, and that I have checked to be sure the noticing poster has remained in place for a full seven days immediately preceding the date of the public hearing. Date of hearing noted thereon to be held Wednesday, June 10, 2026. Dated: ( 'gn ure) Sworn to before me this `,�`;��g�GA %�''%,� 0 day of3 okaO 2-(0 •' STATE ®N OF NEW YpRK Nor �` 01°" ; IiAOTICE U-1 HEARIiIG NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Peconic Community Center Auditorium, 1170 Peconic Lane, Peconic, New York, concerning this property. OWNER(S) OF RECORD: SHAWN McBURNIE & DEVON ANNABEL SUBJECT OF PUBLIC HEARING: For a Wetland Permit to construct a 16'x36' in-ground swimming pool with 2' wide natural stone patio surround; install a pool backwash drywell and pool equipment area; install a 76 linear foot long landscape retaining wall to be a maximum height of 36" tall; install 76 linear feet of native plantings for screening along the retaining wall face; install 48" high pool enclosure fencing with gates; with silt fencing installed surrounding the work site prior to and during construction. Located: 5015 Vanston Road, Cutchogue. SCTM# 1000-111-14-3 TIME & DATE OF PUBLIC HEARING: Wednesday, June 10, 2026 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available online at www.southoIdtownny.gov and/or in the Trustee Office until to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES *TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold W.RP CONSISTENCY ASSESSMENT FORM A._ INSTRUCTIONS 1 All applicants for permits*, including Town of Southold agencies, shall complete his 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 malang a determination of consistency *'Except minor exempt actions including Building Permits and other ministerial permas not located within the Coastal Erosion Hazard Area. 2.: Before answering the questions ui Section C the prepares of this;form::should retnew the exemwt minor`action list; policies and explanations of each policy contained in:the.Town of Southold Local Waterfront Revitalization Program. A :proposed action v�nll be evaluated as to its si "ficant bencficzal: adverse:effects;:upon the coastal area(which mcludes all of Southold Town) If any question in Section C on this form. s answered:"yes";or "no", then the proposed action v�nll affect the achievement of the LWRP policy standards and'conditions contauied m the consistency review law Tltus, each answer musk be exntawted in dew Iisrin both supportui� and non sunpoxtui' facts If an action cannot be:certified as consistent v�nth the I.WRP policy standards and conditions,itshatl 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 Plannug Department, all 4. local libraries and the.Town Clerk's office. B DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 111 14:. 03 PROJECT NAME 50T5 Vanston Rd 7 .=CutcF ogue,:.. . The Appcatonh beeumtoli b (check appropriate responses Town Board ElPlanning Board❑ Buldi 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) (4. Pemut,approval;license,certification a Nature and extent of action. See,attached description Location Of action 5015 Vanston:Road Gutchogue Site acreage FF 067 Present land use: Res ; Present zo.'* classification: R 40 2.. If an application for the proposed action has been filed with the Town of Southold agency,'the.following information shall be provided: (a) Name`Of applicant .Shawn McBurnie&Devon Annabel (b);Mailing-Address. 5015 Vanston Road; Cutchogue, NY 11935 (c) Telephone number: 631-353 191 t) Will the action be directly undertaken,require funding,or:approval`by a state or federal:agencyQ Yes ❑✓ No❑ If yes;which state or federal agency NYspEc te. Evaluate the project to;the-following policies by analyzing how'the project will further:support or ` not:support the policies Prdvide`all.proposed Best`Management Practices that will further eaclll..policy. Incomplete answers-will require.thatthe'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 infirastructure, 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 Appl>tcable .:Project is.corisistentwith neighboring;properties aiid.makes_beneficial.use of.land for.personal enjoyment:and liesure 74. Attach additional sheets tf necessary Policy 2.: Protect and preserve historic and archaeologieal;resources of, the :Town.,of Southold See: LWRP'Section'III Policies Pages 3.through 6 for evaluation:criteria esLl No 7 Not Applicable: No effect. Attach additional sheets Y necess 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 No effect Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4.. Minimize loss of.life, tructures, and natural resources from flooding;and,erosion. See LNNW Section III Policies Pages 8 through,16 for evaluation criteria Yes ❑,No'❑� Not Applicable No effect Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of:Southold See LWRP:Section in: Policies Pages 16 through.21 for evaluation criteria Yes No ❑✓ Not Applicable No effect.. rim Attach aMmonal 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. F.Yes 7No 7 Not Applicable . No'effect' .. Attach additional sheets:itnecessary Policy:7. Protect and improve air quality in the Town of Southold. See LW. RP Section III -Policies Pages 32 through.34 for evaluation criteria F Yes ❑No 7 Not Applicable . No effect. Attach additional sheets:tf neces'sary 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: 0 Yes '0 No 0✓ Not Applicable Noe ect. PUBLIC COAST POLICIES Policy, 9.: Provide`fo.r 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. Yell No% Not Applicable No effect 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 evaluatiowcriteria. ❑;Yes ❑ No Not Applicable No effect:.:: . 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 M_: ,Policies, Pages 57ahr6ugh 62 for evaluation criteria. ❑Yes ❑ No 0 Not Applicable No effect; Attach additional slieets 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 0 No❑ Not Applicable No effect.. . 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 No.effect. PREPARED BY J. :Patanjo TITLE Agent DATE Q4-05-26 i April 30, 2026 IN C U Town of Southold Trustees MAY ' 8 2026 Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 ^ . Southold To Board of Wn Southold, New York 11971 Trustees RE: SHAWN MCBURNIE& DEVON ANNABEL 5015 VANSTON ROAD-CUTCHOGUE, NY SCTM No. 1000-111-14-03 APPLICATION FOR PERMIT Dear Trustees: Attached please find four copies of proposed plans, application package, survey, check and photos for the proposed project. If you should have any questions or require anything further, please do not hesitate to call me on 631-487-5290. Very truly yours, J /rey Patanjo P.O. Box 27 Farmingdale, NY 11735