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HomeMy WebLinkAboutTR-7916A g, ��p�Og�yFFQ(�-cpG Town Hall,53095 Main Rd. James F.Kin President Bob Ghosio,Jr.,Vice-President P.O.Box 1179 4 Dave Bergen w -a Southold,NY 11971 John Bredemeyer • Telephone(631)765-1892 Michael J.Domino Qj �'ap! 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 1st day of construction Y2 constructed Project complete, compliance inspection L A N p { O p ! MAP OF P20PE27'Y t N i Su._VE YE D F'o 2 ,, S '� �v, THz�ococE L),4,CLE7NE- _-5TEPIVO WSKY 143.71 �g A7- r r,bo I To w of Soul-"oL o —N.Y. 1 pool - _d 4L X ! ; OCT 4. 20i2 l •A o v ZG, �AA Sr` h4� n �sv U97 ►� �- v +. ! Scale : 50 - 1 � : d z APPROVED BAY- ;moo., p-per BOARD OF TRUS*M ' /. 9 acres 'f�. i 1 Q 0t,,Q TOWN OF SOUTHOID gA a wc» DATE �E / , gq X a4. N Q \�_ r um — TtST HOLE h. 5.93 -!'j / qt 140r4fe4%+ GoeHer -of pY�t+tisaers, . 160.64 _ - S 6/'D G�.aro.rfced 4-0 Hfa �ctj";�t "TTl/e . Gva✓anf Corrr�•c►►�/ vrt fa 7-/re /Yp,-i,4 !r o• � t3Arr iG T✓u s parr/j Z- .4,VD OF 01L-4-42D "" James F.King,President *QF SO(/ry Town Hall Annex Bob Ghosio,Jr.,Vice-President 54375 Main Road P.O.Box 1179 Dave Bergen 1S Southold,New York 11971-0959 John Bredemeyer G • Q Telephone(631) 765-1892 Michael J. Domino 'Q Fax(631) 765-6641 �y�4UNTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7916A Date of Receipt of Application: October 4, 2012 Applicant: Theodore & Darlene Stepnowsky SCTM#: 97-8-14 Project Location: 3300 Skunk Lane, Cutchogue Date of Resolution/Issuance: October 17, 2012 Date of Expiration: October 17, 2014 Reviewed by: Board of Trustees Project Description: To complete the removal of one Black Locust tree to be cut off 2" below grade and removal of 5 overgrown shrubs; complete removal of one Honey Locust located about 5 feet off of the deck; reseed area near deck disturbed by removal of Locust tree; reseed approx. 22'x24' area south of house where Black Locust tree was removed; relocate approx. 1 cy of top soil to fill in area where tree was removed and reseed area; reseed area topsoil was removed from. 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 project plan prepared by Theodore& Darlene Stepnowsky, received on October . 4, 2012, and stamped approved on October 17, 2012. Special Conditions: No other landscaping waste be put-on adjacent property, all to be kept on own property 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. James F. King, President Board of Trustees �����UFFOt�-LPG James F.King,President Town Ha11.Annex Bob Ghosio,Jr.,Vice-President 4 54375 Route 25,P.O.Box 1179 Dave Bergen .f• �' Southold,NY 11971 John Bredemeyer Q1 `ad Telephone(631)765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: + Day- Please be advised that your application dated I D 2- has been reviewed by this Board at the regular meeting of t / Z and your application has been approved pending the completion of he following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) '/z Constructed ($50.00) Final Inspection Fee ($50.00). Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon.completion of the above. COMPUTATION OF PERMIT FEES: Fna l TnS fe c.-Nw ----� 5z). oD TOTAL FEES DUE: BY: James F. King, President Board of Trustees o-) �� d lv � Ig �IZ S11F FOZ,� James F.King,President P.O.Box 1179 Bob Ghosio,Jr.,Vice-President � Gy Southold,NY 11971 Dave Bergen y Telephone(631 765-1892 John Bredemeyer O Fax(631)765-6641 Michael J.Domino 'F Southold Town Board of Trustees Field Ins pection/Worksession Report Date/Time: t c�) !D THEODORE & DARLENE STEPNOWSKY request an Administrative Permit for the removal of one Black Locust tree to be cut off 2" below grade and removal of 5 overgrown shrubs; complete removal of one Honey Locust located about 5 feet off of the deck; reseed area near deck disturbed by removal of Locust tree; reseed approx. 22'x24' area south of house where Black Locust.tree was removed; relocate approx. 1 cubic yard of top soil to fill in area where tree was removed and reseed area; reseed area topsoil . was removed from. Located: 3300 Skunk Lane,.Cutchogue. SCTM# 97-8-14 Type of area to be impacted: altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ,,A_,Chapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion Amendment Administrative_Emergency Pre-Submission_ Violation Info needed: Is T , Modifications: Con itirWIVC:>ns: CC,�� Present Were: J. King B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date- 1 . 300 Skunk Lane.Cutchogue L.1 Pit �-� - •• ♦ ,'.r`c ,�►. a .,. I 1 i s s 'P; fi Theodore 8 Darlene Stepnowsky 300 Skunk Lane,Crrtchogue rt a �r CTM4 97-8-14 0i10:12 ow- 14 IIR�- �' 1.�w�.•y „ _ _.: - .t.- '' �. JIFF - ���-,� •: ;� _ ?". � i � d J w � �t..�4��� •* a 1i•F ;fir s --�+1w.' -r.ice.• .� l°.. Y.�.,♦ Theodore 8 Darlene StepnoAskV Y 3300 Skunk Lane, Cutchogue SCTFv1=97-8-•14 '° y�+ ]«*•'* " +' '" " `qr • 04 it • tea• �f /. -"y •' M t AD v •r+ a ,�.,,,�a�� � -fie. 1 ...w.- .. •, *err . .. y .bs`- ,�.p`f r, ,. • - .. .ter`.. .. '. Al , _n >c ci ✓ , « i - i. O i ZAN TWA.4 i . nr _ 4 rI� � ;4 � �,.�v tr s�.�J�•� • s yw{�yY� f !rj7r. v 4,� r /ail.' ��i r ,r �• wY 1� ..��t�i1� ,tt�v ++14 .. '.� � .. :�. �� C� rr►r! 4 ..>��..� ill ��'.r Y> r . .r - i "II 9,yyrla - e WffiBB SEE SEO NO.05e SEE SM W. %1b1B • 4 p0.t 9] - WTCM UNE WTCN UNE rural _ur.E � s 4 WTCn _�___ �_�___ __�UNE u Nanom Q� FOP PCL N0. .ye® FOP PCL NO. FOR— NO. O0.PCL NO. 111Bc0 1212 �` ESEC.N6 ,iN\A SEE SEC.NO. SEE SEG NO. •'. 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J ,Mp e w�� Eva� w',, ♦9 ^'♦ I� eP 4 3 +� ':` � a �: ANT,EP�`' tJm re e EJ .' o �-•- s a 5 FOflP NO. ,qf n%�v ,uH r W rur�J p% �a SEC.NO. � �P ti�E9Fn�jq 2�` •` __•fi' ax _ �yr ec seo 5 OR' O�N „ ��f_�__LINE.4 p 4 V��♦ wttx—�^tom 0 EM f] ,e? m~� n MATCMZ urvEF•�'of pO wm�i �' ��N � ry ryebv O ' _ NOTICE aou COUNTY OF SUFFOLK © K w of 3F eouTno,n swT N NO Real Property Tax Service Agenq \E•—�— _ O -- -- -- E _a.•._ us '� —_— >� --,-- m�--•-- r corvPTwnm]Rlnr,me,nYttm, M 97 0 ---- �r --•-- °°"'--'�-- P ,mc+uo ,000 PROPERTY MAP OFFICE LOCATION: so MAILING ADDRESS: Town Hall Annex ,`O lO P.O. Box 1179 54375 State Route 25 Southold; NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 CARQ Telephone: 631 765-1938 Fax: 631 765-3136 olyIrou LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM OCT 16 2012 E __�To: Jim King, President sc���hhc's Tows ' Town of Southold Board of Trustees yBo<.r of Tr;istees { From: Mark Terry, Principal Planner LWRP Coordinator Date: October 16, 2012 Re: Proposed Wetland Permit for THEODORE & DARLENE STEPNOWSKY SCTM#1000-97-8-14 THEODORE & DARLENE STEPNOWSKY request an Administrative Permit for the removal of one Black Locust tree to be cut off 2" below grade and removal of 5 overgrown shrubs; complete removal of one Honey Locust located about 5 feet off of the deck; reseed area near deck disturbed by removal of Locust tree; reseed approx. 22'x24' area south of house where Black Locust tree was removed; relocate approx. 1 cubic yard of top soil to fill in area where tree was removed and reseed area; reseed area topsoil was removed from. Located-, 3300 Skunk Lane, Cutchogue. SCTM#97-8-14 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this -department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore, CONSISTENT with the LWRP provided that the Board clarify that the "5 overgrown shrubs" to be removed are located:adjacent to the deck and not within the wetland buffer.. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F.King,President QF S0 Town Hall Annex Bob Ghosio,Jr.,Vice President 54375 Main RoadP.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer � �Q Telephone(631) 765-1892 Michael.J.Domino Fax(631) 765-6641 �yCOUNTY,� i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application L OCT - .4 2012 Wetland Permit Application _14__ Administrative Permit Amendment/Transfer,/Extension Received Application: Received Fee:$ tA5 Completed Application /O _Incomplete _SEQRA Classification: Type I Type II Unlisted _Coordination:(date sent) �C LWRP Consistency Assessment Form /O _CAC Referral Sent. Date of Inspection: �01 Recpipt of CAC Report: Lead Agency Determination: _Technical Review: Public Hearing Held: /0 1 7 Resolution: Name of Applicant lJp 2L D pq �e L EA)Z . IJ D t.�951��1 Address 3 0o sKu a(Z r�-9)� �� �ec-�pC�.cxL Phone Number*a6 7 3 q-5 9 b 3 Suffolk County Tax Map Number: 1000 - 7 8 97 97- 6 I q Property Location: (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: Bc, I of Trustees Application, GENERAL DATA Land Area(in square feet): i Area Zoning: Previous use of property: A) Intended use of property: j I Covenants and Restrictions: Yes x No If"Yes", please provide copy. I Does this project require a variance from the Zoning Board of Appeals Yes ,JC No If"Yes", please provide copy of decision. i Will.this project require any demolition as per Town Code or as determined by the Building Dept. Yes x° No Does the structure(s) on property have a valid Certificate of Occupancy__X___Yes No Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X_No Yes If yes,provide explanation: Project Description(use attachments if necessary): PROJECT DESCRIPTION Removal of 1 Black Locust to be cut off 2"below grade and removal of 5 overgrown shrubs. Removal of 1 Honey Locust which is about 5 feet off of deck, is overgrown, and messy. Reseed area near deck from cut down locust tree,prefer to remove if possible. Reseed area south of house,area of black locust. AREA 22X24 about 528 sq. ft. Moved 1 cu. yd. of top soil (on site)used for black locust to be cut 2 ins. below grade. Reseed this area which is 24X30 about 720 sq. ft., where 1 cu. yd. ,of top soil was removed. Bc I of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: r10 Is9-cue: `f-6L D ID D0 i Area of wetlands on lot: )VO A) square feet Percent coverage of lot: Al 0 111 E:' % Closest distance between nearest existing structure and upland edge of wetlands: 41 feet Closest distance between nearest proposed structure and upland edge of wetlands: A1D/yE feet Does the project involve excavation or filling? X No Yes If yes,how much material will be excavated? N b kL—:cubic yards How much material will be filled? NO cubic yards Depth of which material will be removed or deposited: �!� feet Proposed slope throughout the area of operations: SO e7r1i _ SoL>rN voc5 Manner in which material will be removed or deposited: 174 O-Q4 110 L 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): Al 0NL' PROJECT ID NUMBER 617.20 SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PR ECT NAME IWIDDOW.E 4-D(-2.-CNL erENDu-'sky 3.PROJECT LOCATION: 00 Municipality l.V ������/ �' 7 l 'Q 3 S County 4.PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map 5.IS PROPOSED ACTION: c New ❑Expansion ❑Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: R U &- 0'f- a -reC--C-s /-WD PEs0cb 14 r-o'+s P 0 ED, 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ®Yes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ®Residential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/Open Space El Other (describe) 10.'DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) Q�io k 0l ©F 76 W 6\J -re USTE� Yes ❑No If yes, list agency name and permit / approval:N 7bWN DF SOQT%-ol--D VALID PERMIT OR APPROVAL? ❑Yes ZNo If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ❑Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant ///Sponsor Name Tl-�E-o��(�L 31�P�c�t_e�SK� Date: SignatursjiJ If the action is a Costal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART-1-1- IMPACT ASSESSMENT To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617A? If yes,coordinate the review process and use the FULL EAR Yes a.No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another involved agency. Yes E]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible) C1. Existing air quality,surface or groundwater quality or quantity,noise levels,existing traffic pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: C3. Vegetation or fauna,fish,shellfish'or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: C4. A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural resources?Explain briefly: . C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: C6. Long term,short term,cumulative,or other effects not identified in C1-05? Explain briefly: C7:Other impacts indudin than es in use of either quantity or t e of ever ? Explain briefly.- D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA? If .es,explain briefl : QYes a No E. IS THERE,OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ex lain: ❑ Yes a No PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above,determine whether it is substantial,large,important or otherwise significant Each effect should be assessed in connection with its(a)setting(i.e.urban or rural);(b)probability of occurring;(c)duration;(d)irreversibility;(e) geographic scope;and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain - sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes,the determination of significance mustevaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur.Then proceed directly to the FU EAF and/or prepare a positive declaration. Check this box If you have determined,based on the information and analysis above and any supporting documentation,that the--proposed actin WILL NOT result in any significant adverse environmental Impacts AND provide, on attachments as necessary,the reasons supporting thi determination. Board of Trustees p i/!L'1 t� — Name of Lead Agency/ > Date President p Print or Type Name off Responsible Officer in Lead Agency Title of Responsible Officer Z" Signature of Responsible Officer ead Agency Signature of Preparer(If different from responsible officer) i Bc 4 of Trustees Application County of Suffolk I State of New York eys BEING DULY SWORN DEPOSES AND AFFIRMS THAT H /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 TOWN TRUSTEES j 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(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signatu e SWORN TO BEFORE ME THIS 7 DAY OF 124 /,P- tary Public JANET V.STEWART NOTARY PSUFFOLKuBLJC STATE COUNTY OF NEW YORK N0,52-46M485 COMM,EXPIRES November 30,2� I APPLICANUAGENUREPRESENTATIVE 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: S-!P1)0 c0S K� ��'�� O C> (Last name,first name,ipiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance _ 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 )C 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 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 -4day of(VCT OOE-C 200 2 Signature 's Print Name Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS I. 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 si ngmfic_ant 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# D/ 04 -�(�I3 g 9 - • 9`7- 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:Rp,&PE�T �e-a4,0064- c� A ­Oe FES 4 iU L) )W[C o-ro ��� p Location of action: 3366 S K L3 M K I-AK3 0 yTe L4 0 G.u 4 Site acreage: Present land use: E�S 10 CPCG Present zoning classification: C s r D cm r( 41 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: 7'H rt)D o iu .1, E) A-P- �=PAJ [)LO S k� (b) Mailing address: '� ` O® S K y O LJ4, OOTC, tab C---,u�-, A). l l (c) Telephone number: Area Code (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 1Z 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 n No M 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 ❑M 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 ®Not Applicable Attach additional sheets if necessary Policy 6. Protect and 'restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 . through 32 for evaluation criteria. ❑ ❑ [M Yes No Not ApF� ble 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 ® 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. ❑ Yer—] No W Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE! 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. El Yes El No 19 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 110te"""""C �b � TITLE�'` �2 DATE 0--`{-0f 2—