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TR-9370
Michael J.Domino,President �Q� SU!/rTown Hall Annex John M. Bredemeyer III,Vice-President ,`O� �1 54375 Route 25 Glenn Goldsmith l� � P.O.Box 1179 Southold, New York 11971 A.Nicholas Krupski G • Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD o CERTIFICATE OF COMPLIANCE 1642C Date: October 6, 2019 THIS CERTIFIES that the construction of 15 linear feet of rock revetment alongstorm torm erosion line utilizing 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment; At 1436 Great Peconic Bay Boulevard,Laurel Suffolk County Tax Map#1000-145-2-18 Conforms to the application for a Trustees Permit heretofore filed in this office Dated October 9, 2018 pursuant to which Trustees Wetland Permit#9370 Dated December 12,2018,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of 15 linear feet of rock revetment along storm erosion line utilizing 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment The certificate is issued to Laurelwood Estates Property Owners Association owner of the aforesaid property. Authorized Signature CC# : C19-46206 COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 10/09/2019 under Liber D00013031 and Page 919 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Cout this 10/09/2019 SUFFOLK COUNTY CLERK JUDITH A.PASCALE l� �;-S-EAL �� IIIIIIIIIIIIIIillllllllllllllllllllllllllllllllllllllll I IIIIII VIII ILII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 10/09/2019 Number of Pages : 6 At: 12 : 04 : 18 PM Receipt Number : 19-0191422 LIBER: D00013031 PAGE : 919 District: Section: Block: Lot: 1000 145 . 00 02 . 00 018 .000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $30 . 00 NO Handling $20 .00 NO COE $5 . 00 NO NYS SRCHG $15 . 00 NO TP-584 $0 . 00 NO Notation $0 .00 NO Cert.Copies $7 .50 NO RPT $200 . 00 NO Fees Paid $277 .50 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County ti " PEC RDED Number of pages J IC 1 i N A. PA:=CPLE CLERK OF This document will be public L vOoai::031 record. Please remove all Social Security Numbers prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Reco ding/Filing Stamps 3 1 FEES Page/Filing Fee �- Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. ,®. or EA-52 17 (County) Sub Total o Spec./Add. EA-5217 (State) TOT.MTG.TAX Dual Town Dual County — Held� 00 �"7� Held for Appointment Comm. of Ed. 5. 00 Transfer Tax Affidavit $ •�, � Mansion Tax The property covered by this mortgage is -Certified,Copy or will be improved by a one or two NYS Surcharge 15. 00 tJ� family dwelling only. Sub Total YES or NO Other Grand Total - If NO,see appropriate tax clause on age# of this instrumen . 4 1 Dist. 3970605 1.000 14500 0200 01.8000 5 Community Preservation Fund Real Property P T S I III WI I' Consideration Amount $ Tax Service R LPA A W u Agency 09-OCT-1 CPF Tax Due $ Verification - - - - Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Vacant Land L6„Per woad �,z,�r.��-amu, TD G4u<'-PL n((/ TD TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# 8 Suffolk CountRecordin & Endorsement Page This page forms part of the attached //�c/CL rq made by: (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY,NEW YORK. - TO In the TOWN of `� P0,) o /��/� In the VILLAGE or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104..10/08kk (over) DECLARATION OF COVENANTS p THIS DECLARATION made this day of October, 2019, by ! Laurelwood Estates Property Owners Association, residing at P.O.Box 505 Laurel NY 11948, hereinafter referred to as "DECLARANT(S) ": W I T N E S S E T H WHEREAS, DECLARANT (S) is/are the owner (s) of certain real property located or*436 Great Peconic Bay BLVD. Laurel NY 11948, Town of Southold, County of Suffolk, State of New York, described 'in the Suffolk County Tax Map as District 1000, Section 145, Block 02, Lot18 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; i WHEREAS, the Property is situated on lands within - the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT(S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a 10' wide non-turf buffer along the landward edge of the revetment. WHEREAS, the DECLARANT has considered the foregoing and has determined that the same will be for the best interests of the DECLARANT and subsequent owners of the Property. NOW, THEREFORE, the DECLARANT (S) do/does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned-,-permitted activities there shall be established and perpetually maintained 101 "non-turf buffer" as defined by Chapter 275 of the Town Code, to wit: "A designated area where turf grass, pesticides and fertili2ers are not r M permitted." and as depicted on the site plan dated September 26,2018 and stamped approved December 12,2018, see Exhibit "B" attached; and 2) These covenants shall run with the land and shall be binding on the DECLARANT(S) , his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner(s) has/have duly executed this instrument this day of October, ( ,2019. OWNER'S G TORE OWNER'S SIGNATURE STATE OF NEW YORK ) COUNTY OF Suffolk) ss: On the "/ day of , in the year 201 %, before me the undersigned, a Not ry Pub is in and for said State, pens pally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the individual (s) whose name (s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity, and that by his/her/their signature (s) on the instrument, the individual or the persons on behalf of which the individual (s) acted, executed the instrument. Notary Public FHELEN COSTER UBLIC,STATE OF NEWYORK tration No.OIC04509624 ified in Suffolk County My Commission Expires: G 023 __ � 2 . j ,y S.mdnd N.Y.0.T_U Faro SOW•7.71-IOM-Quirelum Decd-Indmdu.1 m C IP"-IWD (.ln,k&M) ' COIMf&,r YOU!LAVs=D1M0)•t SlaMM THS MSTRumBIT TIM MSTMDltllt W 51400 LD U USM By LAV"M ONLY- . TM DIDENIUR%made the day of A� •nineteen h 1 6 undred and Eighty MARION FCX. residing at .40 � �4.Iw aat.� tflV�., &t a.n49j Pr hui qak- ff999 ROBERT WEGLICKI residing at 658 Manhattan Avenue, Brooklyn, New York 11222, and EUGENE WEGLICKL residing at.370 Ocean parkway. Apt. UK, Brooklyn, New York 11218, being the sole distributees and heirs at law of MARTIN WEGLICKL* party of the first part,and LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION INC., a New York, Not-for-Profit Corporation, 'having its principal place of business at(no number) Laurelwood Drive, Laurel, New York U948 DISTRICT SECTION IRL®CK LOT 000 party of*a secoAd part, Ig 17 21 Zb1 NrMESSErH,that the party of the first part,in consideration of ten dollars paid by the party of.the second part,does hereby realise,release and quitclaim Miro the party of the second part, the heirs or suoetssors and is4w of the party,of the second part forever, AIL that certain plot,piece or pacer]of land,with the buildings and impmernenta therm erected,situate, o Wing and being bmdK at Laurel. Town of Southold. Suffolk County, New York, shown and designated as the "Park and Playground" on a certain map known as O Laurelwood Estates, filed in the Suffolk County Clerk's Odfice'as Map No. 5595 on May 17. 1971. *Deceased, who died a resident of the County of Kings. Brooklyn, New York on o November 17, 1979 and being the sole distributees and heirs at law of c p STELLA WEGLICKI, Deceased. who died a resident of the County of Kings, Brooklyn. New York on O , -19821 Q ' RECEIVE . F_.. LiEB TATE Q 1981R Tr;X LKTY TOGETHER with all right.-tide and interest,if any,of the party of the fust part in and to any streets and :� '• roads•abutting the above described premises to the center lines thereat:TOGETHU,with theappurtenances party VE AND TO �..;y**• and all the estate and sights of;the of the first far! in and to said premises; TO liA HOLD the preriieses herein granted unto the party of the second part,the heirs or successors and assigns of p the party of the saouid part-forever. I O a AND the party of the,fust p6rt,in compliance with,Sextion 13 of the Lien Law,hereby,covenants that'the krty e �y� of the fust part will receive the mnsideiatioa;for this conveyance and will hold the right to reeeive.sueh msrsld- i r eration as a trust.fund to be a lel first for the purpose-of'paying'the-cost-of the improvement and`vM' y the same first to the payment of the cost of the improvement before uamg any,part-of the total of the aaElm any other pupw- Tim word"pasty"shall be construed as if it read "pwtie e'whenever the sense of this fmteature so re Td—. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the dad*and year first above rrlssettea OF., e - err , (Marion Fos) V (Robert eglickl) e Wegli -- -V-r-- • ARTHUR J. FWCE RECORDED FEB 9 1981 Clerk of Suffolk CouuiY 1 , �U N0 1 4 60 c { o cp 2 STORY FRAME ? c HOUSE NO.- 1400 N 0 I I � { SC TAX.N0. 1000-145-02-17 SC TAX.NO. 10DO-145-02-1 VACANT LAND VACANT LAND { I EXISTING 15'WIDE R.O.W. I I o PROPOSED 10'WIDE I ( NON-TURF BUFFER PROPOSED 15 IF ROCK REVETMENT TO CONSIST OF BOULDERS CONSISTING OF LOWER COURSE 4-5 TON AND UPPER COURSES 2-3 TON SIZES o I LIMOS OF STORM EROSION AND PLACED IN M INTERLOCKING MANNER caUNE OF PROPOSED ROCK REVETMENT CONSISTENT WITH NYSOEC AND 59U1HOL0 TOWN c AS SUBMITTED UNDER NEIGHBORING APP. SPECIFICATIONS AND REQUIREMENTS. I . I { — —kitty— S65'57'10"W 99.98'® B66"09'40"W 100.00' T� APPR0 EDGY— — — MLW.— BOARD OF I 12USTEEST TOWN OF$ UTHOLD RE00 OF EX=NG BLOCK WALL { P TO BE REMOVED UNDER NEIGHBOWNG APP. DATE i ; SC TAX. NO. 1000-145-02-18 { VACANT LAND GREAT PECONIC BAY PROPERTY OWNER LAURELWOOD ESTATES POA ,—, F 11 ; ; "I ROCK REVETMENT PERMIT PLANS scALE; P.O. BOX 505 _•_ _is ' . LAUREL, NY 11948 PREPARED BY OCT —9 2018PROPOSED PLAN DATE: JEFFREY PATANJO s—zs—ia P.O. BOX 582 ( y436 PECONIC BAY BOULEVARD BOHEMIA, NY 11716 �" ' ' ------ HOLD 631-484-9332 LAUSUFFOLK COUNTY, LREL, TOWN OF UTFY 6HEET• JJPATANJO®GMAILCOM TAX MAP NO. i000-195-02-18 1 OF 2 F-2 _c• Q�L ¢\ya c^ 0 h DIU311s P61 0 mar Z43b Peccnic J . } �Ql1yQpvlC•VE7rEj PROJECT LOCATION MAP N.T.S. cm.ORAAE Vic; .+..�✓i✓i.f<�/.�..c�.�,n�,?✓nfi•�/.,+�'<s:\;\/�.;5 --- "wosn I=Rotmlxr To case d ✓�.c� ona�s w n wm atnA 4M,164 1M WftA C 15 f-0 Mn At6 /�`1,, AMO PI/iTO LV 171 OCFT7JOCRYK NVCkO ti\ \`< � NEW OF ROCK 70 VARY '?'✓,:`•! RERVEIOJ'4'&O'ABOVE GRAOE AT DMIM BECH. NOT To EXCEED W umr,or iXWhfWH K u'm ro mum? µs d RP •t an vcas CUM T�tmroJ > VOEDsm]X1 TA=1JwE8 Jul }/�'\.'t�li 1!• ',��`v/l:.... f� \ \ K1'ACm1DC URN.d tei P Jw4wwacDlt \�\,y v: .},\rti`��'i/`1 N7'i',4c'4a W.W EL Oct -°.AY:E To wEW 1x�s fEAil a�ro:a To But a seal TYPICAL SECTION A-A N,T.S, 'A ROCK REVETMENT PERMIT PLANS SC4LE: •• N.T.S. ` OCT -g P018 TYPICAL SECTION & DATE. YI LOCATION ANAP 9-26-18 1436 PECONIC BAY BOULEVARD LAUREL, TOWN OF;SOUTHOLD SUFFOLK COUNTY, NY SHEET, TAX MAP NO. 1000-145-02—I8 2 or 2 Michael J.Domino, President q soUTyo Town Hall Annex John M. Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold, New York 11971 A.Nicholas Krupski • Telephone (631) 765-1892 Greg WilliamsyCoUNT`l, O Fax(631) 765-6641 � �c� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: i0A�)�i Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: 0K �� CC 9370 anA p6r,6 dah�� 9/zd/►�'. CERTIFICATE OF COMPLIANCE: „xr e;� Town Hall Annex Michael J. Domino, President crpr a . John M. Bredemeyer, III, Vice-President � yam'>�, 54375 Route 25 Glenn Goldsmith y, x P.O. Box 1179 4 0 • jh Southold NY 11971 A Nicholas Krupski y o� , Greg Williams �k�ol , Telephone (631) 765-1892 ��z ¢`' Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction constructed When project complete, call for compliance inspection; i b - ii-•-•r- - ..*i•``..,yyp. .:'-rr-'frSq%.," i rY••: � � C.CPO' v ,' vPJY'r`riY.-._,- �+ -e;./•aSys. _ illl 1ll'I•• '"' •' 1! •l'7 • � 1111 111 '01`1.1l'ria,. iih 11 1`Ijr• i�l 11 1 ';�' I '^' 'rH 5a ,nla+^.R'S)r7al¢R422T!�T3'^fiaTSVOR'?mN)'3r.,0JR?,K•2>,n�''!1h5+�"S"41Y7�lnrpr ���;'aMlOJ9lronw�,AG2.x^-'TiTS`.1;='h�bT.27t'.va;?S97dLnmxunar�+A,a,+y`kSCvn) .'319:�?Z7:4b}Yydl�;,a�C2XRr�:7�rSN<'earixRzcNX':an;.>z¢fFt4;R?3rN.rrrrga7.s�',R�/ Y "`Still �,•+1'\'• �.. Mtn �d'�• BOARD OF SOUTHOLD TOWN TRUSTEES � '+tih• ' s SOUTHOLD,NEW YORK V PERMIT NO. 9370 DATE: DECEMBER 12, 2018 ISSUED TO: LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION ^p PROPERTY ADDRESS: 1436 GREAT PECONIC BAY BLVD., LAUREL , ` SCTM# 1000-145-2-18 ` — r ` AUTHORIZATION a Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in a " accordance with the Resolution of the Board of Trustees adopted at the meeting held on December 12, 2018, and in consideration of application fee in the sum of$250.00 paid by Laurelwood Estates Property Owners Association and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of >� Trustees authorizes and permits the following: f Wetland Permit to construct 15 linear feet of rock revetment along storm erosion line utilizing _ r 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment; and as depicted ' ?' on the site plan prepared by Jeffrey PatanJo, dated September 26 2018 and stamped approvedr'r. on December 12,2018. -0ol IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of the 120'day of December,2018. guFFOt coo �'llgl • �, Gree Williams-Recused •ti 111 1 -ni I I�i. — ,(/!rr Y,ouf�e;virtu'uvi+.Znn�,una(Cur„a�Y7n.,uW,uaSiix��utiY.75'fai�?1t,ti uu,u> ,�,R>ra6rmitixS',iia..pX,�U.s✓a,.Sttiiurrl}Yaa i16r6,ni)aP"r,Ral:Jaa'»�.raiiu�.erxinrnr vio;nraraC,xiavavSaSSbnwi. «ra;,caa,z3'�ri.te+ai.,xa7aa�uFru�r�Sd7?oau"uem >��) �: =� ,�:1• = `a`�.i` �'.s;,m�.Cj= u�ti✓_ e'•:�.,,�: ��v = `,t '�` e'.�,,�_ � e .r;• ,V+,' •,i/ 11: •s II a1.. �I !\O. / 1 4. '4e,ff m�»r�Q ���� 1�h����^�'rrrf� 6 f.••- '�Stlr/ N��i:. .;ef1A !ra:. .: 0 0lri.t `sf I! (f,.i:• i.�4� �1::•-, fsl'��•,�is1\B. .�!1 Iflf..�.a.1L TERMS AND CONDITIGrmld The Permittee Laurelwood Estates Property Owners Association 1436 Great Peconic Ba By lvd. Laurel, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Michael J.Domino,President �OOF SUUjyOlo Town Hall Annex John M.Bredemeyer III,Vice-President v` 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Telephone (631) 765-1892 Greg Williams • �� Fax(631) 765-6641 �yCUUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 12, 2018 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION 1436 GREAT PECONIC BAY BLVD.; LAUREL SCTM# 1000-145-2-18 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 12, 2018 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION, applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated October 9, 2018, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 12, 2018, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVE the application of LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION to construct 15 linear feet of rock revetment along storm erosion line utilizing 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment; and as depicted on the site plan prepared by Jeffrey Patanjo, dated September 26, 2018, and stamped approved on December 12, 2018. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd V� 44 �o � �L �jp� X40 LSV Age p.�Cpl� . NO�SF Na , . 460 z I o W o 2 STORY FRAME c iv HOUSE NO. 1400 c c t� . I I SC TAX. NO. 1000-145-02-17 SC TAX. NO. 1000-145-02-16 VACANT LAND VACANT LAND I EXISTING 15' WIDE R.O.W. I I c PROPOSED 10' WIDE NON-TURF BUFFER PROPOSED 15 LF ROCK REVETMENT TO CONSIST OF c BOULDERS CONSISTING OF LOWER COURSE I I LIMITS OF STORM EROSION 4-5 TON AND UPPER COURSES 2-3 TON SIZES No AND PLACED IN AN INTERLOCKING MANNER - C' LINE OF PROPOSED ROCK REVETMENT CONSISTENT WITH NYSDEC AND SOUTHOLD TOWN c AS SUBMITTED UNDER NEIGHBORING APP. SPECIFICATIONS AND REQUIREMENTS. I M.H.W. — .. 99.98' S66009'40"W 100.00' S65-57'10"W APP BY— M.L.W.— —M.L.W. B®AR® OFI RUSTEES TOWN �F S UTHpL® REMAINS OF EXISTING BLOCK WALL I TO BE REMOVED UNDER NEIGHBORING APP. ®ATE A 112 2ol$ j SC TAX. N0. 1000-145-02-18 VACANT LAND GREAT PECONIC BAY PROPERTY OWNER: LAURELWOOD ESTATES POA ROCK REVETMENT PERMIT PLANS SCALE: P.O. BOX 505 LAUREL, NY 11948 1"=30' PREPARED BY: OCT m 9 2018 i PROPOSED PLAN DATE: JEFFREY PATANJO _ _ 9-26-18 j I P.O. BOX 582 1436 PECONIC BAY BOULEVARD � "T., . �� '�� ��� BOHEMIA, NY 11716 631 -484-9332 LAUREL, TOWN OF SOUTHOLD SHEET: SUFFOLK COUNTY, NY JJPATANJO@GMAIL.COM TAX MAP N0. 1000-145-02-18 1 of 2 WUZN� Pole 1436 Pecopic PROJECT LOCATION MAP N.T.S. EXIST. GRADE -- - PROPOSED ROCK REVETMENT TO CONSIST Of •/\/\ - BOULDERS CONSISTING OF LOWER COURSE �/\//\ 4-5 TON AND UPPER COURSES 2-3 TON SIZES '�\//\\/ AND PLACED IN AN INTERLOCKING MANNER CONSISTENT WITH NYSDEC AND SOUTHOLD TOWN SPECIFICATIONS AND REQUIREMENTS. / HEIGHT OF ROCK TO VARY BETWEEN 4' & 6' ABOVE GRADE AT EXISTING BEACH. NOT TO EXCEED 6' LIMITS OF REQUIRED TO NVSTALL AND STATION IS ACK ROCK ANY EXCESS FILL WILL BE UTILIZED BETWEENBOULDERS REVETMENT SYSTEM TE A TIGHT COMPACTED \ \ PROPOSED SILT FABRIC UNDER ALL \ /\\//\\// / \\%\\//\// / APPROXIMATE M.H.W. EL 2.5f REVETMENT SYSTEM. \/\\/\\/\\/\\/ /\\/\\/\\/\\/\\/\\ \ APPROXIMATE M.LW EL 0.0t DISTANCE TO M.H.W VARIES FROM 10'TO 20'TO BASE OF ROCK TYPICAL SECTION A-A N.T.S. ROCK REVETMENT PERMIT PLANS SCALE: N.T.S. OCT d 9 zols =-' TYPICAL SECTION & DATE: l LOCATION MAP 9-26-18 1436 PECONIC BAY BOULEVARD Boarri of Trust:cs � LAUREL, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: TAX MAP N0. 1000-145-02-18 2 of 2 Michael J. Domino, President fiyc�o r °��t Town Hall Annex John M. Bredemeyer, III, Vice-President y k 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A Nicholas Krupski tih oo�, Southold, NY 11971 Greg Williams �l Telephone (631) 765-1892 Fax (631) 765-6641 dZ zodf BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: LAURELWOOD ESTATES POA c/o JEFFREY PATANJO Please be advised that your application dated October 9, 2018 has been reviewed by this Board at the regular meeting of December 12, 2018 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) xx The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 50 00 BY: Michael J. Domino, President �� Board of Trustees Michael J. Domino, Pr( _ lit O�QofFQ( Town Hall Annex John M. Bredemeyer I11,Vice-tresident V_ 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 1215 I1 g 2' 3o Completed in field by: �'o fads�n► Jeffrey Patanjo on behalf of LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION requests a Wetland Permit to construct 15 linear feet of rock revetment along storm erosion line utilizing 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment. Located: 1436 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2-18 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card-Posted: Y / N Ch. 275 ✓ Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment ✓Wetland Coasta'I Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line- Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 4 ` 1 COs, v al' 6 nes Uo n rn W n0A 'S $O+Rn Doric_«4p ihzn1I NJ I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: /J. Bredemeyer //M. Domino ✓ G. Goldsmith . Krupski -1/G. Williams Other r 1436 Peconic Bay Blvd. Laurel, NY- Existing Conditions June 2018 ' L 3 w � Suffolk County Clerks Office 67 1'03s 181S 170s 71 A VE. 3 (23) 11 107S 2RD. 141 '191 Brushes 200 2.1 s 50 200 (2) 8 23s (var.vvidth) 4 0 TOWN OF N1�35 140 225s Mss,;8�DBIAM SOUTHOLD 150 130 (11) 90S 1.4A(5)� (16) 14.2 3 2 s--(3) (3) 16 6 165S 2 15'46 (L I 5816 7 (UNDERM�TER 40 6 S (17) S. (10) 6 7 L.D A-6 130 6Q5 93 14.1 150 6>) 14* 4 L D.47 -V00, 72 130 89 (18) (9) 405 I lor 70S 65 7 LAND) 1505 165 6514 130 68 ."168 689s 1 3 13.0 (5) IL (17) 65 W. 5 Cr 3 15 "'176 130 65 20 - 13 -�'IIVNNAMED Sr. 14 11ZA 2.2 6613 130 581, 95' 4553 (7) \ 1 (16) 78 65 DR. 1 (6) 150 60 5 455S N65 99 .52,1�3.1 65 12 130" 80�5s 50>\�__8 76 SOS 218 (6) RD. 30A. 100 7'is) 130 9 30 11 5 (7) 282 4.3 65 130 12.1 (5) X200 (14) X is 130 65 10 130 (121 23 200 (P .130 10 1 1 (13) 1 547 13011-**�5 65 CA .63 345s' It t\ 841" 100Z 65(12) 130 (1) 334s (a) 120 163 523 (2) 2 163 200 6 .130 17.1 10S 16, 16 101 266 (3) 6 95S -------—-–--------– 200 163 256s (4) H.W.M. 120 7.1 320 19 295 SHORELINE 1001Z BAY Q / / � Y � / 0 loll e / s`O � ♦ � 0py 0 G � m ,P o oG>, Fob O / rr•uw �, ru+ ______ we.uu. --tw— w.w�.. --"-- NOTICE COUNTY OF SUFFOLK © °' OLD L .w.w. '�' wor E E m...,> ...�--�-.- t2tl O ^•�� —'— ""�""'"' —_M_ Real Property Tax Service Agency r of SE145 souTH G -- CeumyCmurturxnra,Nrttrot ,x �w,µ�m�a. .JJ�ttJJW++ E — tom. u. —i— rro...... • — E xr M om we r ar mtr w m wrrva tt["cEae t[o � - "s '�,k r�r r.:'E,[TA i t1."".�,�tt`., i.: � r..._ —•.- w�..a....,,�. -....._— �...a ___ —w— � .N.. ��� P sra crxo 1000 PROPERTY MM row�w�o.o.re•,90..�0.. 4 ,7 r ' OFFICE LOCATION: of S® �® MAILING ADDRESS: Town Hall Annex �® l® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 ® �� Telephone: 631 765-1938 U0, LOCAL LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator = Date: December 6, 2018 Re: Local Waterfront Coastal Consistency Review for LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION SCTM# 1000-145-2-18 Jeffrey Patanjo on behalf of LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION requests a Wetland Permit to construct 15 linear feet of rock revetment along storm erosion line utilizing 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment. Located: 1436 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2-18 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. It is recommended that the Board. 1. Maintain adequate and safe public access to the park/beach in design. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 !► �` Southold,NY 11971 ��/�� �' Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., December 5, 2018 the following recommendation was made: Moved by James Abbott, seconded by Peter Young, it was RESOLVED to SUPPORT the application of LAURELWOOD ESTATES, P.O.A. to construct a 15 If. rock revetment along storm erosion line utilizing 4-5 ton lower course and 2-3 ton upper course stone. Provide 10' wide non-turf buffer landward of revetment. Located: 1436 Peconic Bay Blvd., Laurel. SCTM#145-2-18 Inspected by: James Abbott, Peter Young The CAC Supports the application with a vegetated buffer and recommends the displaced concrete block is incorporated into the hardened structure. Vote of Council: Ayes: All Motion Carried � SOUty Michael J.Domino,President p'F��� d�O Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders CA Southold,New York 11971 Glenn Goldsmith y� Telephone(631) 765-1892 A.Nicholas Krupski �►�U�6 i► Fax(631)765-6641 BOARD 01F TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application D V Administrative Permit -Afiiendment/Transfer/Extensiorx- Received Application: /01%/?/? t�`\I/ OCT - 9 2018 Received Fee: $ �®®® t^'1 Completed Application: P Sout Incomplete i�old ioxn SEQRA Classification: Type I_ Type lI Unlisted J ) Boar'of irus ees Lead Agency Determination: Coordion:(datesent): 7latl LWRPConsistency AssessTit orm Sent: CAC Referral Sent: 11 1 /`` Date of Inspection: IZ-5.19 Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Legal Name of Property Owner(s): z0f ..Crc 1w oop rs-t-4+;C S P-0-A. Mailing Address: P- (&°x .5-vs- L n Cct, >J I 11 q y D' Phone Number: 6 3 I• g.7 S - 7q/3 Suffolk County Tax Map Number: 1000- I V S` y a - 18 Property Location: l Y.?6 pecan« I?" (31✓d2- GK�r�( • C '��� "�" �a"`t, So✓+k off- AOJseS J'i'D� 19�dD (if necessary,provide LILCO Pole#,distance to cross streets,and location) AGENT(If applicable): �� Pa tQ�►i o Mailing Address: Q f ox 5d'a- j3v 4e n L a., tJ t it-7 b Phone Number: 0�- Board of Trustees Appy_. 'tion GENERAL DATA Land Area(in square feet): 0.5- 0 Area Zoning: Re 5 Previous use of property: *n f Intended use of property: V a c fay► t Covenants and Restrictions on property? Yes ✓No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes ✓No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes No If"Yes",please provide copy of decision. Will this project requireappy 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 N A 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): C a-srr v 1-r IS- Li: ,20-AL tle✓e+--Keh.f- - sf-ofm eres ia-4 Lc n.e- V till z�-, n G ou.elL QnCk a -3 -Eon ✓ppUr eovfs< s-f'cne . ,Provide Loe -✓«QQ ✓l 0.1 -4Lr�-- b✓C mer .r'r I-eve.+-At"t Board of Trustees Appl, .tion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: �`��Sf-r� F /S L.F 54-rm etO sto4 L,Ae v tt 11 q,� n N -S �'�� Lo.-'c2 e'.4+-'!'Se ®vrSe o•�UP-0 /of vv ccQ2 Y10,7 -+off- b✓f�e� 1�6e�+�wli.rel� d tLvef-vhta-�f Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: /y a feet Closest distance between nearest proposed structure and upland edge of wetlands: /o D feet Does the project involve excavation or filling? '� No Yes If yes,how much material will be excavated? /-'1.4 _cubic yards How much material will be filled? N 1 cubic yards Depth of which material will be removed or deposited: --v 1,+ feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: "I,+- 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): -rAx" r��ll bC SE+'V t� 1'44,01 e,Q Short Environmental Assessment Form Part I -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: 1436 Peconic Bay Blvd Rock Revetment Project Location(describe,and attach a location map): See location map-Vacant land south of 1460&1400 Peconic Bay Blvd. Brief Description of Proposed Action: Stabilize storm damaged bank with 15 LF of rock revetment landward of the MHW line. Name of Applicant or Sponsor: Telephone: 631-298-7918 Laurelwood Estates POA E-Mail: jgs22@optonline.net Address: P.O.Box 505 City/PO: State: Zip Code: Laurel NY 11948 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: ❑ ❑ NYSDEC-Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.350 acres b.Total acreage to be physically disturbed? 0.01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.350 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial OResidential(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? ❑ Pq ❑ b.Consistent with the adopted comprehensive plan? ❑ 171 ❑ 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:Name:Brushs Creek,Name:Peconic Bay and Environs,Reason:Significant coastal fish&wildlife habitat, Eleason: ro ec public health,water,vegetation, scenic eau gency: ou o own of, 9—i .- f nik6nmtc ... 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? W1 ❑ 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: 21 ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 7 ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? � ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ Z 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. Identify the typical habitat types that occur on,or are likely to be found on the 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? Northern Long-eared Bat ❑ Z 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ F-1a.Will storm water discharges flow to adjacent properties? ❑NO AYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO []YES Page 2 of 3 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: r7l ❑' 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: R 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 me: Date: Signature• PRINT FORM Page 3 of 3 EAF Mapper Sue....airy Report Tuesday,July 24, 2018 5:33 PM Disclaimer: The EAF Mapper is a screening tool intended to assist i29E50-f00-?,00 0 I'Vi00-inn-tntjn i,nf!-,r0i) 'l200 Protect sponsors andrewewmgagencies inprepannganenvironmental art �ttn t, ('�u4r0 I GQ-7000 l questions asked in the EAF are 1�F500-2©0=I'4L'+0014 100,'3,00-2002 assessment�'"; answered byfthe AFMapper lAdditonal information on any EAF 12',A 1 G� I a-. 1 d 01,-10 0-1300.1 i question can be obtained b consulting the EAF Workbooks. Although ' ,� .' 1-1.500-'.•00-3701' -- ', • 9 Y 9 9 r f`. `;,, - •,: the EAF Mapper provides the most up-to-date digital data available to I Z�o'`•I,Cr0+5+� i i 14,960-4-0 1 0"1>!J DEC,you may also need to contact local or other data sources in order 12 900 100-5 0 Erg 'I 4.560-2 00-17003 '14-5 00-300-4'20;'r to obtain data not provided by the Mapper Digital data is not a 145,t�0-200-t 5f100 substitute for agency determinations. i45r30-200'I200r3 "1450V 300 50,00 12tit00-100-41300 tr� o 14 uu- UC1 90Cr I otlay a 1�1o7o-rnl 14500 200 004' .�Oldttl0�a 4,500 30r� Gsa00.. '14500-200- 000 1.1509-200-11000 14583-2+ p^� Tot :itc 12 101,_1003G02 I >`i00-2 01)19nr,�.' 1450 ,�-7i?i;lIyr- E 1I:iO(-2CG-�uGlQv1-{500-200-10000 'ru�trn Scums Esrr,HERE;`Germin,0SGS, s^t?vr::atti 14,900-200-7600 4, Interniap,IN;CRENIEt;T F,t;.FCan„Esri ' 145 00-200-;,+0010 Japan,'MET.I;csri china. �r. <^ri Earn dti^ t� .E`sri,Y`Er�E,Gsrmrn, 1 {5 00-20,,j-0,100 �GC� "g''�'r;�.0 I'' Pitt: ur L'aGif i1r:d_ rt�p.,IPt�REhlFN'T {acres,E;YiiThailand'tvGCC„J C„ b `Jt' L }, luml,rr: i Cper..St; tlu92pn`f i�utcrs„sna th�:GlB I'' t.RCa 1.150G-200-500•i F, n,E3rila)an,tvtETl, 1-12=Ccmrnunrty; cinn.at� :I �'Ja :<[11ra{Hcng Kcrgj,Esn Part 1 /Question 7 [Critical Environmental Yes Area] Part 1 !Question 7[Critical Environmental Name:Brushs Creek, Name-Peconic Bay and Environs, Reason:Significant Area- Identify] coastal fish&wildlife habitat, Reason:Protect public health,water, vegetation, &scenic beauty,Agency:Southold, Town of,Agency:Suffolk County, Date:3-9- 90, Date:7-12-88 Part 1 /Question 12a [National Register of No Historic Places] Part 1 /Question 12b [Archeological Sites] Yes Part 1 /Question 13a [Wetlands or Other Yes-Digital mapping information on local and federal wetlands and Regulated Waterbodies] waterbodies is known to be Incomplete. Refer to EAF Workbook. Pali 1 /Question 15[Threatened or Yes Endangered Animal] Part 1 /Question 15[Threatened or Northern Long-eared Bat 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 1 vun.r—ov arauaory w ,— ----6.r...y,.w.. ,,.,a"— a. — o guru v.,r",—+.,y ,,...,a.u.rw,.< r e.ae -'J responses been reasonable considering the scale and context of the proposed action?" - No,or Moderate small to large impact impact may may occur occur 1, Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 10 1:1 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? M4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? J 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 41 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 f-�j problems? 1� 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. Patz 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 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 impact/s. Town of Southold-Board of Trustees _ j�/ 5/1 � i Name of Lead Agency [[[ Date C J ® � President Print or Type Names o sporisible ffcet• neo Agency Tithe of'Responsible Officer Signature of Responsibfe Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) L PRINT Page 4 of 7 Board of Trustees Appl'_,-_-',tion A]FIRDAVIT J m,in<s r✓1 p� P s �a�t-E- BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR TIME ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF ITIS/ITER KNOWLEDGE AND BELIEF,AND THAT ALL WORD WIlLL BE DONE IN THE FANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLID TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD TIME TOWN OF SOUTHOLID 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 gDURING THE TERM OF THE PERMIT. S' 1-,e-- ature of ertywner Signature of Property Owner SWORN TO BEFORE ME TkfIS DAY OF 001-0� ,20 Notary Public MA.P®x mb6'ftt®otN"y Ns,®ia 1z73-sem comb"Evkm ®. ..ani Board of Trustees Apel' Ltiosa AUTHORIZATION (Where the applicant is not the owner) UWeZ G S f Lh. we-Iw�a� 45'f'a-t'e owners of the property identified as SCTM# 1000- f y S- a a - /T* in the town of New York,hereby authorizes —J;7 4,-c�l ®CA't--f✓7 to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. 011*Owner's ignature Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF ®CAS' .. ,20 Notary Public USA A.FOX Notary Pu*-,Stat®ofNoym No.01R)WIM-sum Gwrdsslon March S, -Of q i APPL11C-AN�/t1V71L'r19 A/A6E RI(LtiYE 8ATI V E TRANSACTIONAL DISCLOSURE FORM The'Town of Southold's Code of hthics prohibits coulliels of interest on the mrt of town officers and emnloyeeti; a M!rpose of this form is to provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever aclion is neeessnry to avoid same. YOUR NAME: S'f'�..+P� n2�S (Last name,first name,.gtiddie 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 yon 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,trtarriate,or business interest."Business urtcrest"mems a business, including apartnership,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 50 of rc shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the appliennl/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(treater than 5%ofthe shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a noncorporate entity(when the applicant is not a corporation); _Q an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day f� 20 I� Signature Print Name Al _ Form TS t A�PLICANUAGENURE-PRESENTATIVE TRANSACTIONAL D10CLOSIOU FOR � i The Town of SoutholdIs Code of Ethics prohibits conflicts of interest on the part of town officers and emplovees ' is puroose of this form is to provide inforination which can alert the town of possible conflicts of interest and allow itto take whatever action is necessary to avoid same. T YOUR NAME: �e 'f-ei •, J - /eve (Last name,first e,jpiddle initial,unl ss 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.) I 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 imy officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including aparinership,in which the town officer or employee his even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO ✓/ If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title br 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%oftlie shames of the corporate stock of the applicpnt (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a noircorporate entity(when the applicant is not a corporal ion); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 20 day ofP ZO t Signature Print Name Jef+.,.,r,, Form TS 1 SCTM#1000-145-1-2 SCTM#1000-145-2-14 Mehalakes, Marc& Mehalakes, Regina McCarthy, Christopher M 1475 Peconic Bay Blvd. 1460 Peconic Bay Blvd Laurel, NY 11948 Laurel, NY 111948 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: SCTM#1000-145-3-6 Laurel Property Trust SCTM#1000-145-2-19 SCTM#1000-145-2-17.4 j c/o Kenneth Childs,Jr Krom,Ann Perillo,Thomas V Jr.&Perillo,Christopher 605 Old Dutch Road PO Box 545 87 Old Country Road Bedminster, NJ 07921 Laurel, NY 11948 Melville, NY 11747 SCTM#1000-145-2-17.3 SCTM#1000-145-2-16 SCTM#1000-145-2-15 Perillo,Thomas V Jr.&Perillo,Christopher McCarthy, Patricia F McCarthy, Patricia F 87 Old Country Road 1460 Peconic Bay Blvd 1460 Peconic Bay Blvd Melville, NY 11747 Laurel, NY 111948 Laurel, NY 111948 STATE OF NEW YORK COUNTY OF SUFFOLK Jeffrey Patanjo, residing at P.O. Box 582,Bohemia,NY 11716 being duly sworn,deposes and says that on the - .9 day of-December 20_18 ,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 there 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 at - �{3o�+c In►a� that said Notices were mail to each of said persons by CERTIFIED MAIL/RtEETURN RECEIPT. Sworn to before me this 3 Day of, December ,20 18 S MARILYN S. HICKS otary, ublic KGraRY PUBLIC,STATE OF NEW YORK , Registration No.01HI6365489 e Qualified in Suffolk County Commission Expires October 10,2021 December 6, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 1436 PECOW BAY BLVD- LAUREL SCTM No. 1000-145-02-18 AFFIDAVITS Dear Trustees: Attached please find proof of mailing and posting affidavits for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, J rey Patanjo P.O. Box 582 Bohemia, NY 11716 Michael J.Domino,President O�pS�EFl71,��'OG Town Hall Annex John M.Bredemeyer III,Vice-President %A 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams 'y + p� 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 LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE I, Jeffrey Patanjo residing at/dba PO Box 582,Bohemia,NY 11716 being duly sworn, depose and say: That on the 3 day of December ,2018 , I personally posted the property known as 1436 Great Peconic Bay Boulevard,Laurel. SCTM# 1000-145-2-18 by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,December 12,2018. Dated: ►a-3-1 (S✓g re) Sworn to before me this 3 day of Dec. 2018 N�A t 01 (' MARILYN S.HICKAo �Jur'b (WARY PUBLIC,STATE OF N Notary blic Registration No.O1H1636 puatified in Suffolk Co Commission Expires Octobe JTU-S. Postal Service'" PostalTM CERTIFIED , p ■ ■ ru I •nly © RECEIPT rp � Iti Domeitid Mail On 51 7C.,hfi.dM2e . Er lyFru 7 �rrl0 F P L U!Er V 1 Certrfied Mail Fee _ Extra Services&Fees(checkbox,add fa ppate) - $ O ❑Return Recelpt(hardtopyy EMra Services&Fees(check box,add fee as appropriate) O ❑Return Receipt(electronic) $ Postmark ❑Return Receipt(hands. $ O El Certified Mall Restricted Delivery $ Here [I Retum Receipt(etectrontc) $ - _ POstma 0 []Adult Signature Required $ OO ElCertHied Mall Restricted Delivery 1$ -- _ Here ❑Adult Signature Restricted DeW ery$ ❑Adult Signature Requtr64, 0 Postage O []Adult Signature Restricted Delivery N 0 $ —----- - ----- p Postage Total Postage and CID $ $ .A Total Postage and - -- SCTM#1000-145-1-2 o $ --� sent To l Mehalakes SCTM#1000-145-2-15 SYreerartd gaoMarc& Mehalakes Regina ina �o SentTo g o 1475 Peconic Bay Blvd. i' o StreetanrlApt'No McCarthy, Patricia F CM)stafe,27PW Laurel' y NY 11948 r` 1460 Peconic Ba Blvd �ry�'t"etre;ZiP+4a 1 �• �. - - Laurel, NY 111948 Postal -777' ■ . stal Serv.i e o ■ PT MAILRECEIPT ®• estic Mall Only M I• 0 117O -inkil0- /� . .- j} (/% . . {¢](- e . . .- - kpt'; . )j (��/y . jj +i;. {l.'tE �.. .j Al ru 1-111 Certified Mal Fee + i •N �_' Certified Mail Fee` $ 1 s $ , Ln ExtraSeNlCes&FeeS\(ehe bax,addfeeasappropriate) J Ln Extra Services&Fees(checkbox,add(aeasappropdate) ❑Return Receipt(hardcopy $ ❑Return Receipt(hardeoPY) $ C3 ❑Return Receipt(electro^1c) '' Postmark O ❑Return Receipt(electronic) $ Postmark p []Certified Matt Restricted DeOv Hare ❑Certified Mall Restricted Delivery $�_ Here C3 []Adult Signature Signature Required $�_� 0 []Adult Signature Required $ ❑Adult Signature Restricted Delivery$ � ❑Adult Signature Restricted Del"$ M Postage Postage $ CE3 Total Postage ant .A Total Postage ant -- --- O co Sent To SCTM#1000-145-2-17.3 $rfl Sent To SCTM#1000-145-2-17.4 " ! Perillo,Thomas V Jr.&Perillo,Christopher j ,a I Perillo,Thomas V Jr.&Perillo,Christopher Street andApi No p Street andAp[NZ 87 Old Country Road I r%- 87 Old Country Road cry,siaie; %P+41 Melville, NY 11747 �rii srete;ziP+a Melville, NY 11747 �4 i Postal ■ CERTIFIEDService ostal ■ ■ © RECE ■ ECEI CE1 MA ■ p9mestic Fail 9nly r` • _• i v ru ru Ln Certified Mall Fee \ -- - Certified Mail Fee I Ln Extra Services&Fees(checkbox,'"add fee asappropdale) 1.1'1 $ ❑Return Receipt(hardcopy] `�� $ Extra Services&Fees(checkbox,a fee as appr�opdate) 0 \ ❑Return Receipt(hardcopy) �S�7— r�'� 0 ❑Return Receipt(electronic) $_T_ Postmark ❑Return Receipt(electronic) $1 r Postmark O ❑Certified Mail Restricted Deilvery�$ Here � []Certified Mail Restricted Delivery $ Here ❑Adult Signature Required �. $ �i t*�" 0 — Adult Signature Restricted Deihiery$"-'-"�� ❑Adult Signature Required $ ❑ - {]Adult Slghature Restricted DelNery$ O Postage O Postage °O $ _ Co `3 Total Postage am •n $ E3 � O Total Postage and SCTM#1000-145-3-6 SCTM#1000-145-2-14 Sent To $ Laurel Property Trust r-� McCarthy, Christopher M , c0 Sent To I S'treetandA"pf.Na I c/o Kenneth Childs,Jr N 1460 Peconic Bay Blvd C3 G-tFiR fid-Apr'ifa, 605 Old Dutch Road ciry�sraie;21P+41 Laurel, NY 111948 civ Sime, lXj4 Bedminster, NJ 07921 J 1 — Postal Postal CERTIFIED. , MAIL" ■ ■ CERTIFIED MAILP RECEIPT ErI. I-ofily Ln I• • rp M ' Sft 1 Certified Mail Fee" ;err??:�'C Er M Certified Mall F1 5;i' r^�, ''c- $ t E $ i i V � N W^ Extra Services&Fees'(check box add fee Ba appropdate) r� Extra ServiCes'&Fees(checkbox,add fee as appropriate) 0 ❑Retrlm Receipt(hardcopy) $ C-3 ❑Retum Receipt ardcepy) �$ ❑Retum Receipt(eleotronicl $--_ Postmark k ❑RetrrmrReceipt nlc -_ $ Postmark 0 ❑CeNfied Mail Restricted peM6ry�$,"" Hare C ❑Certified MW eS(d6�1Re11very s$ Here C3 []Adult Signature Required $4 iC ❑Adult Signature Required--��y,$ ❑Adult Signature Restrlcted Dellvery$ i ❑Adult Signature Restricted Delivery$ C3 Postage O Postage r- $ - -—- - — — $ C3 L Total Postage and t SCTM#1000-145-2-16 $ SCTM#1000-145-2-19 17=1 McCarthy, Patricia F r' sent To to Krom,Ann } o 1460 Peconic Bay Blvd SatenJApt a- PO BoX 545 Laurel, NY 111948 cciLaurel, NY 11948 — :oe � .r PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 2C , 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 there 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 at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 i Notary Public ,NUTILI: U1 HLAKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: LAURELWOOD ESTATES PROPERTY OWNERS ASSOCIATION SUBJECT OF PUBLIC HEARING : For a wetland Permit to construct 15 linear feet of rock revetment along storm erosion line utilizing 4-5 ton lower course stone and 2-3 to upper course stone; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the revetment. Located: 1436 Great Peconic Bay Boulevard, Laurel. sCTM# 1000-145-2-13 TIME & DATE OF PUBLIC HEARING : Wednesday, December 12, 2016 — 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 for inspection prior 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 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 Water6ont 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 Ron- 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# M 5- PROJECT PROJECT NAME t`i 3 6 P.ce-P-'c- 04`1 91,k- The 1,k-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: L.J Nature and extent of action: 0On.St'fvl4- I SLe (OG16 t S•fo/M Pfolicel Line- bwcrll 1f-S:-- J 4*0-v S74•oei LoweA— eoune- ariP a -3 fo.1 t4fer C�airS� f�,vL�C , �lr..to2a IV wL[J�e- norl-�v/'iL �u PTR-- Gu�tPw.t/a� d � fCytt'•vetei'f'. i ' a - Location of action: IW (VCACaaif te-ico Site acreage: P. r o Present land use: V Present zoning classification: 12'r- 2. `k2. 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: La v rc lw 0 061 P p.a (b) Mailing address: P-0- 60r- 5-0-5- It °S (c) Telephone number:Area Code( ) �v 3l• a9 S --7 q!$ (d) Application number,if any: 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? N 1 s D6-c- 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. DlEVFLOPE,D 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. [JYes ❑ No ❑ Not Applicable P/nieaf Pim f'ra-i'i E.l.� finer sAd��lnc a ►,.11 n G�6Lon�y PloPa!{-cis Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LMW Section RI—Polici s Pages 3 through 6 for evaluation criteria 1-1Yes ❑ No ATot Applicable Attach additional sheets if necessary Policy 3. Fnhande visual quality and protect scenic resources throughout the Town of Southold. See lLWR P Section lei—Policies Pages 6 through 9 for evaluation criteria Eryes ❑ No ❑ Not Applicable Pro ` e4- S+o-tiCc Shmrdi nc wt 44 re-1-44 lep Sa.ti' . Attach additional sheets if necessary NATURAL COAST POLICIES ]Policy 4. A inimize loss of life, structures, and natural resources from flooding and erosion. See LWFj? Section M—Policies Pages 8 through 16 for evaluation criteria Yes ❑ No ❑ lot Applicable of ,e '-o Cfoito-� ei.t� S�orMf Attach additional sheets if necessary Policy S. Protect and improve grater quality and supply in the'Town of Southold. See LUMP Section In —Policies Pages 16 through 21 for evaluation criteria �4 EKes ❑ No Y ❑Not Applicable , tc+ i.t a►i.w -f---S ed ,,Se-&4 RatcO 'StA-ma -7 tta-bez-2 -�' `„a t{-c-4 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 LMIRP 9ectien III—Policies; Pages 22 through 32 for evaluation criteria. F] F] 2" Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section M -- Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑No Q,--Not Applicable Attach additional sheets if necessary Policy S. IOUnimize environmental degradation in Town of Southold from solid waste and hazardous substances and w;Not . S a LVVRP Section 1H—Policies; Pages 34 through 38 for evaluation criteria. 1-1Yes ❑ No 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. nn �YeO No❑ Not Applicable ProJcu4 �toviaP./S c��fit.c� LtC�lS .-f-o (7CGfG�' R,/s0. rcSt�Qtn-ES , � G��rofwcocQ Attach additional sheets if necessary WGRE ING COAST POLIS 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 [:1 No Q of 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 F ] No 2 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LVVRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑Yes F] No LJ Mot 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 � `tk �"� n TITLE �q end- DATE - t� v October 3, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 ® E C E I V E Southold, New York 11971 RE: 1436 PECONIC BAY BLVD- LAUREL OCT e 9 2018 SCTM No. 1000-145-02-18 APPLICATION FOR PERMIT Southold Town Boad of Trustees Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716