HomeMy WebLinkAboutNiamonitakis, Michael DiSalvo, Diane
From: Jeffrey Patanjo <jpatanjo@optonline.net>
Sent: Wednesday, August 30, 2017 6:52 PM
To: DiSalvo, Diane
Subject: RE: Niamonitakis
They pretty much abandoned the idea because it would require a ZBA hearing and there was no guarantee they would
get approval. I reached out to him a while back with no response so I'd assume it's a dead file.
From: DiSalvo,.Diane [mailto:diane.disalvo@town.southold.ny.us]
Sent: Wednesday, August 30, 2017 9:27 AM
To: 'Jpatanjo'
Subject: Niamonitakis
Jeff:
I am going through the"pending" drawer. See that the denial letter for the Coastal Erosion permit and the Wetland
permit are still here.
Just waiting for the$50.00 which was due. What do you want me to do with this?
DLCf VLf AL s� vc
Southold To-vN,,n Trustees
Torn Hall :'annex/First door
54375 Route 2;
11.0. lox 1179
Southold.NIS 11971-0959
(631) 765-1892
Fav (631) 765-66=11
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BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD,NEW YORK
PERMIT NO. 8709 DATE: NOVEMBER 18,2015 rt
ISSUED TO: MICHAEL NIAIV[ONITAKIS red 10,e-vED
PROPERTY ADDRESS: 13220 MAIN ROAD,EAST MARION
I SCTM# 1000-31-14-12
AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in
accordance with the Resolution of the Board of Trustees adopted at the meeting held on November 18,2015,
and in consideration of application fee in the sum of$500.00 paid by Michael Niamonitakis and subject to the
Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits
the following:
Wetland Permit for the as-built 4'x70' fixed timber pier; as-built water and electric
services on the fixed pier; with the conditions that a 101 wide non-turf buffer is to be
installed and subsequently maintained along the landward edge of the bulkhead; and
the irrigation system is to be removed from within the 101 wide non-turf buffer area;
and as depicted on the site plan prepared by Jeffrey Patanjo,last dated January 13,
2016, and stamped approved on January 21, 2016.
IN WITNESS VvrgEREOF,the said Board of Trustees hereby causes its Corporate Seat to be
and these presents to be subscribed by a majority of the said'Board as of this date.
FOt
James F. King
Dave Bergen
TERMS AND CONDITIONS
The Permittee Michael Niamonitakis residing at 13220 Main Road, East Marion,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.
John M.Bredemeyer III,President so Town Hall Annex
Michael J.Domino,Vice-President ~ O 54375 Route 25
i[ P.O.Box 1179
Glenn Goldsmith Southold,New York 11971
A.Nicholas Krupski y0 Telephone(631) 765-1892
Charles J.SanderssriV Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 18, 2015
Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
RE: MICHAEL NIAMONITAKIS
13220 MAIN ROAD, EAST MARION
SCTM# 1000-31-14-12
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, November 18, 2015 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of MICHAEL NIAMONITAKIS 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 September 23, 2015, 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 recommended that the proposed application be
found Inconsistent with the LWRP, and,
WHEREAS, the Board of Trustees has furthered Policies 4.1, 6.1, (A.2 and A.3), 6.2,
9.3(A) of the Local Waterfront Revitalization Program to the greatest extent possible
through the imposition of the following Best Management Practice requirements: the as-
built 4'x70' fixed timber pier was issued a Wetland Permit by the Board of Trustees on
April 29, 1987; the 10'x12' pier extension onto the seaward end is denied; a 10' wide
non-turf buffer is to be installed and subsequently maintained along the landward edge
of the bulkhead; the irrigation system is to be removed from within the 10' wide non-turf
buffer area; and
2
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on October 21, 2015 and on November 18, 2015, 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,
WHEREAS, the Board has considered all the testimony.and documentation submitted
concerning this application, and,
WHEREAS, the structure in part, complies with the standards set forth in Chapter 275 of
the Southold Town Code,
WHEREAS, the Board has determined that the proposed 10'x12' pier extension would
have a detrimental effect upon the health, safety and general welfare of the people of
the Town, and,
NOW THEREFORE BE IT,
RESOLVED, that for the mitigating factors and based upon the Best Management
Practice requirement imposed above, the Board of Trustees deems the action in part to
be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter
268-5 of the Southold Town Code, and,
RESOLVED, that the Southold Town Board of Trustees DENIES in part, the request to
add a 10'x12' pier extension onto the seaward end of the pier, and,
RESOLVED, that the Board of Trustees APPROVES in part, the request for the as-built
4'x70' fixed timber pier; as-built water and electric services on the fixed pier; with the
- -- - -conditions that a 10' wide non-turf buffer is to be installed-and subsequently maintained
along the landward edge of the bulkhead; and the irrigation system is to be removed
from within the 10' wide non-turf buffer area; and as depicted on the site plan prepared
by Jeffrey Patanjo, last dated January 13, 2016, and stamped approved on January 21,
2016.
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
V truly yours,
n M. Bredemeyer III
President, Board of Trustees
John M. Bredemeyer III,President �\\of SID UTyo Town Hall Annex
h0 l0 54375 Main Road
Michael J.Domino,Vice-President P.O.Box 1179
James F.King,Trustee Southold,New York 11971-0959
Dave Bergen,Trustee G OQ
.c` a Telephone(631) 765-1892
Charles J.Sanders,Trustee ��'��DUNV Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 18, 2015
P' J
�5
Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
RE: MICHAEL NIAMONITAKIS
13220 MAIN ROAD, EAST MARION
SCTM# 1000-31-14-12
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, November 18, 2015 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of MICHAEL NIAMONITAKIS applied to the
Southold Town Trustees for a permit under the provisions of Chapter 111 Coastal
Erosion Hazard Areas of the Town Code of the Town of Southold, application dated
September 23, 2015, 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 recommended that the proposed application be
found Inconsistent with the LWRP, and specifically Inconsistent with the following
coastal policies pursuant to Chapter 111 Coastal Erosion Hazard Areas of the Town
Code: Policy 4.1-minimize losses of human life and structures from flooding and erosion
hazards, Policy 6.1-Protect and restore ecological quality throughout the Town of
Southold, Policy 6.2-Protect and restore Significant Coastal Fish and Wildlife Habitats,
Policy 9.3-Preserve the public interest in and use of lands and waters held in public trust
by the state and the Town of Southold, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on October 21, 2015 and on November 18, 2015, 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,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure, as applied for is located in a nearshore area as per the
Definitions in Chapter 111 Coastal Erosion Hazard Areas of the Town Code and
governed by Section 111-11 (C)-All development is prohibited in nearshore areas
unless specifically provided for in Chapter 111, Section 111-6 Definitions Unregulated
Activity-docks, piers, wharves or structures built on floats, columns, open timber piles or
other similar open work supports with a top surface area less than 200 square feet or
which are removed in the fall each year, and,
NOW THEREFORE BE IT,
RESOLVED, for the foregoing reasons, and because the proposed action is located
entirely within the Coastal Erosion Hazard Area and in a nearshore area, and because
the proposed action is not permitted in such areas pursuant to Chapter 111 of the Town
Code, that the Trustees deem the as-built 4'x70' pier, and as-built water and electric
services on the fixed pier to be impermissible under Chapter 111, and,
BE IT FURTHER,
RESOLVED, that for the foregoing reasons, the Board of Trustees DENIES the Coastal
Erosion Permit application of MICHAEL NIAMONITAKIS for the as-built 4'x70' fixed
timber pier; as-built water and electric services on the fixed pier; and to add a 10'x12'
pier extension onto the seaward end; and as depicted on the site plan prepared by
Jeffrey Patanjo, last dated January 13, 2016, and stamped approved on January 21,
2016.
This determination should not be considered a determination made for any other
Department or Agency, which may also have an application pending for the same or
similar project.
Very truly yours,
John 4MBredemeyer III
President, Board of Trustees
JMB/eac
l
Cantrell, Elizabeth
From: Jeff Patanjo <jpatanjo@optonline.net>
Sent: Tuesday, February 02, 2016 12:23 PM
To: Cantrell, Elizabeth
Subject: RE: Niamonitakis application
Ok thanks.
Sent via the Samsung Galaxy SOS 6;an A 1'&T4G LTE srnartphone
-------- Original message --------
From: "Cantrell, Elizabeth" <elizabethc@town.southold.ny.us>
Date: 2/2/2016 12:00 PM (GMT-05:00)
To: 'Jeff Patanjo' <jpatanjo@optonline.net>
Subject: RE: Niamonitakis application
Unfortunately by the Ch.111 code regulations,the Trustees are not permitted to approve a dock larger than
200sq.ft. You will have to go through the Town Board for an Appeal, not ZBA. After this new trustee meeting and the
trustees make a determination,you must apply to the Town Clerk, Elizabeth Neville within 30 days of that Trustee
meeting. The Town Clerk's office is at the Main Town Hall, and there is an application and fee that you must
complete. There will be a hearing for this application with the Town Board. What they decide,the Trustees will then
have to follow. If approved by Town Board,the trustees will issue a CEHA Permit. So in the end,you will have a trustee
wetland permit, a Town Board appeal determination letter, and a trustee coastal erosion permit(if town board
approved the appeal).
From: Jeff Patanjo [mailto:jpatanjo@optonline.net]
Sent: Tuesday, February 02, 2016 11:45 AM
To: Cantrell, Elizabeth
Subject: RE: Niamonitakis application
Ok so that will get him approval for the existing dock. But I'll most certainly get rejected and need to go to
ZBA for approval right
i
• Y
Sent via the Samsun;Galaxy SCR 6.an Alm i 4G LTE:smarlphone �
-------- Original message --------
From: "Cantrell, Elizabeth" <elizabethc(c�r�,town.southold.n�us>
Date: 2/2/2016 11:33 AM (GMT-05:00)
To: 'Jeff Patanjo' <jpatanjo a,optonline.net>
Subject: RE:Niamonitakis application
Ok. Per Town Atty. Once I Bredemeyer approves your revised plans,the property owner has a Wetland Permit for said
dock. As a Coastal Erosion Permit is a requirement in this location. The property owner or you as the agent must re-
apply to our office for a CEHA permit. Fees, plans, and paperwork all required (as if you are applying for the first time
for a dock). You will only apply for the one permit,so the fee is$250, but the paperwork, etc. requirements are the
same.
Our next available Public Hearing meeting is scheduled for March 23`d. The application submission deadline for that
hearing date is Friday, February 191h.
Elizabeth
From: Jeff Patanjo [mailto:jpatanjo(cboptonline.net]
Sent: Tuesday, February 02, 2016 10:24 AM
To: Cantrell, Elizabeth
Subject: RE: Niamonitakis application
Oh man. I thought we only needed to do the appeal if we wanted to go for the dock extension. My mistake on
that, can you let me know what you hear from the Town Attorney and see how I need to proceed.
Sout via the Santaung Galaxy S E 6.an AT&T 4G LTE smartphone
-------- Original message --------
2
From: "Cantrell,Elizabeth" <elizabeinc a,town.southold.ny.us>
Date: 2/2/2016 9:59 AM (GMT-05:00)
To: 'Jeff Patanjo' <ipatanjogoptonline.net>
Subject: RE:Niamonitakis application
Unfortunately, no. As per our previous emails, I informed you that you and he needed to apply for a Coastal Erosion
Permit Appeal with the Town Board which needed to be done within 30 days of the Trustees CEHA denial. As this was
not done,there is now the problem of a denied dock in the water. Given that you can no longer perform the appeal, I
believe you have to begin this application process all over again for the Coastal Erosion Permit Application portion. I
have a call into the Town Attorney on the protocol as this has never happened before.
I
From: Jeff Patanjo [mailto:jpatanjo@optonline.net]
Sent: Tuesday, February 02, 2016 9:54 AM
To: Cantrell, Elizabeth
Subject: RE: Niamonitakis application
i
Good morning. I spoke to him and sent ink revised plans taking off the proposed dock extension and showing
the proposed 10'buffer. Thought that wase all we needed to get it finalized?
i
i
Sent via the Samsung Galaxy S(R.,6;an AT&T 4G LTE smanplione
-------- Original message --------
From: "Cantrell, Elizabeth" <elizabethcktown.southold.nv.us>
i
Date: 2/2/2016 9:49 AM (GMT-05:00)
i
To: 'Jeffrey Patanjo' <jpatanjo@optonline.net>
Subject: RE:Niamonitakis application
Good Morning Jeff,
I
3
I don't know if perhaps you have heard from Mr. Niamonitakis since your las rel nail to me,but John
Bredemeyer asked I contact you to see if you could try to contact Mr. Niarnonitakis one last time to make him
aware that he was denied by the Board of Trustees due to State Regulations (Ch. I 1 l-Coastal Erosion
reps.). Mr. Niamonitakis either needs to remove said dock or re-apply, and failure to do so may result in
possible violations.
i
Could you please let me know your results;with this request.
Thank you,
I
i;lizabeth
I
From: Jeffrey Patanjo [mailto:jpatanjo@optonline.net]
Sent: Monday, January 04, 2016 9:42 PM
To: Cantrell, Elizabeth
Subject: FW: Niamonitakis application
l
I
Hi Liz, Hope you had a great Christmas and New Year. I've been trying to get in touch with the client on
this one and I have no response. I'm thinking I'm just going to send you revised drawings showing the pier
as existing with the changes discussed at the hearing and leave it at that. I'll be in touch shortly.
Thanks.
Jeff
I
I
From: Cantrell, Elizabeth [mailto:elizabethc@town.southold.ny.us]
Sent: Tuesday, December 01, 2015 3:35 PM
To: Jeff Patanjo
Subject: Niamonitakis application
i
Hi Jeff,
f
i
4
I
Hope you had a nice Thanksgiving tday�: This email is because I
ndam requesting the revised plans for the
Niamonitakis dock and the buffer. If you or the homeowner wanted to apply for an Appeal of the denial for a
Coastal Erosion Permit to the Town Board I need to write up the denial letter a.s.a.p. as you only have 30 days -
from November 181h to apply for the appeal.
Senior Clerk Typist
Town of Southold
Board of Trustees
631-765-1892
C
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V,
ell
BOARD OF SOUTHOLD TOWN TRUSTEES 3
t _1SOUTHOLD, NEW YORK
PERMIT NO. 8709 DATE: NOVEMBER 18,2015
IT
ISSUED TO: MICHAEL NIAMONITAKIS
PROPERTY ADDRESS: 13220 MAIN ROAD, EAST MARION
'M
SCTM# 1000-31-14-12
M AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in
accordance with the Resolution of the Board of Trustees adopted at the meeting held on November 18,2015,
Q and in consideration of application fee in the sum of$500.00 paid by Michael Niamonitakis and subject to the
Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits
the following:
Wetland Permit for the as-built 4'x70' fixed timber pier; as-built water and electric
services on the fixed pier; with the conditions that a 101 wide non-turf buffer is to be
M! installed and subsequently maintained along the landward edge of the bulkhead; and
the irrigation system is to be removed from within the 101 wide non-turf buffer area;
and as depicted on the site plan prepared by Jeffrey Patanjo, last dated January 13,
2016, and stamped approved on January 21,2016.
affixed,
IN WITNESS WqERE0F,the said Board of Trustees hereby causes its Corporate Seal to be
and these presents to be subscribed by a majority of the said'Board as of this date.
t. iv
' A
James F. King
C4 Dave Bergen
2 Lbo-
f'• Q4a 14
rM,
l_
TERMS AND CONDITIONS
The Permittee Michael Niamonitakis residing at 13220 Main Road, East Marion,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.
John M.Bredemeyer III,President o��QF S0 01 Town Hall Annex
Michael J.Domino,Vice-President ~ O 54375 Route 25
P.O.Box 1179
Glenn Goldsmith CA Southold,New York 11971
A.Nicholas Krupski ® a0� Telephone(631) 765-1892
Charles J.SandersFax(631) 765-6641
�COUNTI',��`
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 18, 2015
Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
RE: MICHAEL NIAMONITAKIS
13220 MAIN ROAD, EAST MARION
SCTM# 1000-31-14-12
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, November 18, 2015 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of MICHAEL,NIAMONITAKIS 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 September 23, 2015, 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 recommended that the proposed application be
found Inconsistent with the LWRP, and,
WHEREAS, the Board of Trustees has furthered Policies 4.1, 6.1, (A.2 and A.3), 6.2,
9.3(A) of the Local Waterfront Revitalization Program to the greatest extent possible
through the imposition of the following Best Management Practice requirements: the as-
built 4'x70' fixed timber pier was issued a Wetland Permit by the Board of Trustees on
April 29, 1987; the 10'x12' pier extension onto the seaward end is denied; a 10' wide
non-turf buffer is to be installed and subsequently maintained along the landward edge
of the bulkhead; the irrigation system is to be removed from within the 10' wide non-turf
buffer area; and
2
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on October 21, 2015 and on November 18, 2015, 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,
WHEREAS, the Board has considered all the testimony,and documentation submitted
concerning this application, and,
WHEREAS, the structure in part, complies with the standards set forth in Chapter 275 of
the Southold Town Code,
WHEREAS, the Board has determined that the proposed 10'x12' pier extension would
have a detrimental effect upon the health, safety and general welfare of the people of
the Town, and,
NOW THEREFORE BE IT,
RESOLVED, that for the mitigating factors and based upon the Best Management
Practice requirement imposed above, the Board of Trustees deems the action in part to
be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter
268-5 of the Southold Town Code, and,
RESOLVED,, that the Southold Town Board of Trustees DENIES in part, the request to
add a 10'x12' pier extension onto the seaward end of the pier, and,
RESOLVED, that the Board of Trustees APPROVES in part, the request for the as-built
4'x70' fixed timber pier; as-built water and electric services on the fixed pier; with the
conditions that a 10' wide non-turf buffer is to be installed and subsequently maintained
along the landward edge of the bulkhead; and the irrigation system is to be removed
from within the 10' wide non-turf buffer area; and as depicted on the site plan prepared
by Jeffrey Patanjo, last dated January 13, 2016, and stamped approved on January 21,
2016. -
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
;Vvetruly yours,
M. Bredemeyer III
President, Board of Trustees
r'
John M. Bredemeyer III, President of SO(/T�®l® 54375 Main Road Town Hall Annex
�®
Michael J. Domino,Vice-President P.O.Box 1179
James F.King,Trustee Xr Southold,New York 11971-0959
Dave Bergen,Trustee G
,c► �� Telephone(631) 765-1892
Charles J.Sanders,TrusteeFax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 18, 2015
Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
RE: MICHAEL NIAMONITAKIS
13220 MAIN ROAD, EAST MARION
SCTM# 1000-31-14-12
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, November 18, 2015 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of MICHAEL NIAMONITAKIS applied to the
Southold Town Trustees for a permit under the provisions of Chapter 111 Coastal
Erosion Hazard Areas of the Town Code of the Town of Southold, application dated
September 23, 2015, 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 recommended that the proposed application be
found Inconsistent with the LWRP, and specifically Inconsistent with the following
coastal policies pursuant to Chapter 111 Coastal Erosion Hazard Areas of the Town
Code: Policy 4.1-minimize losses of human life and structures from flooding and erosion
hazards, Policy 6.1-Protect and restore ecological quality throughout the Town of
Southold, Policy 6.2-Protect and restore Significant Coastal Fish and Wildlife Habitats,
Policy 9.3-Preserve the public interest in and use of lands and waters held in public trust
by the state and the Town of Southold, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on October 21, 2015 and on November 18, 2015, at which time all interested
persons were given an opportunity to be heard, and,
l
2
WHEREAS, the Board members have personally viewed and are familiar with the
premises in question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure, as applied for is located in a nearshore area as per the
Definitions in Chapter 111 Coastal Erosion Hazard Areas of the Town Code and
governed by Section 111-11 (C)-All development is prohibited in nearshore areas
unless specifically provided for in Chapter 111, Section 111-6 Definitions Unregulated
Activity-docks, piers, wharves or structures built on floats, columns, open timber piles or
other similar open work supports with a top surface area less than 200 square feet or
which are removed in the fall each year, and,
NOW THEREFORE BE IT,
RESOLVED, for the foregoing reasons, and because the proposed action is located
entirely within the Coastal Erosion Hazard Area and in a nearshore area, and because
the proposed action is not permitted in such areas pursuant to Chapter 111 of the Town
Code, that the Trustees deem the as-built 4'x70' pier, and as-built water and electric
services on the fixed pier to be impermissible under Chapter 111, and,
BE IT FURTHER,
RESOLVED, that for the foregoing reasons, the Board of Trustees DENIES the Coastal
Erosion Permit application of MICHAEL NIAMONITAKIS for the as-built 4'x70' fixed
timber pier; as-built water and electric services on the fixed pier; and to add a 10'x12'
pier extension onto the seaward end; and as depicted on the site plan prepared by
Jeffrey Patanjo, last dated January 13, 2016, and stamped approved on January 21,
2016.
This determination should not be considered a determination made for any other
Department or Agency, which may also have an application pending for the same or
similar project.
Very truly yours,
ohn M. Bredemeyer III
President, Board of Trustees
JMB/eac
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MAIN ROAD (N.Y. S . RTE . 25 )
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EXISTING 70' LONG X 4' WIDE TIMBER PIER TO REMAIN 2
EXISTING WATER AND ELECTRIC SERVICES TO REMAIN PROPERTY OWNER: REVISED PLANS PER TOWN OF SOUTHOLD TRUSTEES
MICHAEL NIAMONITAKIS
134 76TH ST. FEAST
ER PERMIT PLANS SCALE:
BROOKLYN, NY 11209 1"=30'
PREPARED BY:
3� JEFFREY PATANJO PROPOSED PLAN DATE:
ORIENT HARBOR 106 HEWITT BOULEVARD 11-17 5
11-17-15
CENTER MORICHES, NY 1193413220 MAIN ROAD 1-13-16
I 631-484-9332
az' ao" MARION, TOWN OF SOUTHOLD
JPATANJO@OPTONLINE.NETSUFFOLK COUNTY, NY SHEET:
MAP N0. 1000-31-14-12 1 OF 2
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EXISTING PIER TO REMAIN
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REVISED PLANS PER TOWN OF SOUTHOLD TRUSTEES
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N.T.S.
OPOSED SECTION &
DATE:
2000ft e�;. LOCATION MAP 8-25-15
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11-17-15
13220 MAIN ROAD 1-13-16
PROJECT LOCATION MAP MARION, TOWN OF SOUTHOLD -
SUFFOLK COUNTY, NY SHEET:
N.T.S. MAP N0. 1000-31-14-12 2 OF 2
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'toYoung Young
400 Ostrander AvenueRiverhead, New York 11901
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% DIVISION OF FIDELITY NATIONAL TITLE <
INSURANCE COMPANY & GREENPOINTI?
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FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE
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ASSOCIATION OFPRO
PROFESSIONAL LAND.SURVEY
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MIKE NIAMONITAKIS 4
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At East Marion, Town of Southold
Suff0Ik County,unty, NewY York s
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Q•MONTIT SET O a MOMJI•mN7 FOUND Q. •STAKE SET_, ND e a 5TAKE FOUNDC•CHIMNEYRO a ROOF OVER .5•STOOP GE a CELLAR ENlRAGGE _. ., .JOB NO. 2005-0482
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DWG. 2005-0482—te
John M. Bredemeyer 111, President %NN FOLcoG Town Hall Annex
Michael J. Domino, Vice-President
54375 Route 25
Glenn Goldsmith ^ C= P.O. Box 1179
A. Nicholas Krupski Southold, NY 11971
o
Charles J. Sanders Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
T 11�(dlcie-( A)fCc m 0o 14z�db
Please be advised that your application dated3� cZ/-5— has been
reviewed by this Board at the regular meeting of Z 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)
Y2 Constructed ($50.00)
Final Inspection Fee ($50.00)
Dock Fees ($3.00 per sq. ft.)
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: $_
BY: John M. Bredemeyer 111, President
Board of Trustees
John Bredemeyer, President gOFFo(,tc Town Hall Annex
Michael J. Domino, Vice-President 54375 Route 25
James F. King y P.O. Box 1179
Charles J. Sanders o • Southold, NY 11971
Dave Bergen y�o! ! Telephone (631) 765-1892
Fax (631) 765-6641
Southold Town Board of Trustees
Field Inspection/Work Session Report
Date/Time:
Jeffrey Patanjo on behalf of MICHAEL NIAMONITAKIS requests a Wetland Permit and
a Coastal Erosion Permit for the as-built 4'x70' fixed timber pier; and to add a 10'x12'
pier extension onto the seaward end. Located: 13220 Main Road, East Marion.
SCTM# 1000-31-14-12
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
Distance of proposed work to edge of wetland
Part of Town Code proposed work falls under: /Chapt.275 Chapt. 111 other
Type of Application: Wetland Coastal Erosion Amendment
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No Not Applicable
Storm Water Management Review: Yes No Not Applicable
Info needed:
Modifications:
Conditions: U '
Present Were: Bredemeyer/""M. Domino J. King D. Bergen C. Sanders
Bay Constable Other
Form filled out in the field by cJ Ar'
Mailed/Faxed to:
Date:
r
John Bredemeyer, President �ognFFntTown Hall Annex
Michael J. Domino, Vice-President °° °°,� 54375 Route 25
James F. King y P.O. Box 1179
Charles J. Sanders s Southold, NY 11971
Dave Bergen �1 �a Telephone (631) 765-1892
Fax (631) 765-6641
Southold Town Board of Trustees
Field Inspection/Work Session Report
Date/Time:
Jeffrey Patanjo on behalf of MICHAEL NIAMONITAKIS requests a Wetland Permit and
a Coastal Erosion Permit for the as-built 4'x70' fixed timber pier; and to add a 10'x12'
pier extension onto the seaward end. Located: 13220 Main.Road, East Marion.
SCTM# 31-14-12
4e of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound b'IBay
Distance of proposed work to edge of wetland -0
Part of Town Code proposed work falls under: C'hapt.275 _Chapt. 111 other
Type of Application: Wetland _/_Coastal Erosion Amendment
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: /Yes No Not Applicable
Storm Water Management Review: Yes No V Not•Applicable
Info needed:
Modifications: 'p%�l�l �
tie
Conditions: g-t-,*,A _64-41-41vl� dd �yy
Present Were: XBredemeyer . Domino / J. King yD. Bergen C. Sanders
Bay Constable Other
Form filled out in the field by_,- ' (2-11
Mailed/Faxed to:
Date:
r
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02 ,.
. _ y 10/ 14/2015 9 5 ;
TOWN OF SOUTHOLD
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD,NEW YORK
WETLANDS PERMIT
This Wetlands Permit No. ,,,404 has been granted by the Town Trustees according to
information furnished in Application No....509...........filed by Applicant...RSttL Mc1WX-Y..............
................................. on .,April, 29:.......... 19.87..... A map of the proposed work will be kept
on file in the Trustee Office under the application number given.
Permit granted to do the following work....To..construct a grivate dgcl(„]Q„ >r,,,.lang„ :..wdJda.
.................................................................................................................................................................
»...............................................................................................................................................................
Location of property on which work to be done....13220 Main Road, East Mario;,,,,,,,,,,,,,,,,,,,,,,,,,,
»...............................................................................................................................................................
.................................................................................................................................................................
Creek,Ba or Harbor frontin property Orient,HatAg;..............:...............
Y 9 P P ty ................
.................................................................................................................................................................'
Sizeof work: Length...........70-f t...impa...........................................................................................
4 ft. wide
Width ..:..........................................................................................................................
HeightAbove High Water .........3..ft.:..........................................................................
DepthBelow Low Water .............u./.................................................................................................
Yardsto be Excavated.................n/a..............................................................................
Yards to be Filled n/a
.........................................................................................................
Manner in which material is to be removed or deposited ...,n/a
.................................................................................................................................................................
Intendeduse of property.....Private......................................................................................................
_...............................................................................................................................................................
Conditionsif any..............-..--......--.---.......-..-..-.....--..--...-...--......................................................................................
.................................................................................................................................................................
Expiration Date ,April 29. 1988 if work has not commenced by„sal.d„4.41g
.... .... .... .... .... ............
Number of Inspections Required.�;Trustees are to be notified upon comgletion,.of the work
...... .... .... .................. .... ...............
Inspection Fees10:00 paid,,,,,,,,,,,,,,,,,
..............................................................................................
Liability Policies in the Amount of .........................................................................................................
The validity of this permit is or may be subject to the approval of other governmental or municipal
authorities. The Town accepts no responsibility in applying for or obtaining such approval. In the
event that such approval is necessary, the holder of this permit shall not commence operations here-
under until such approval has been obtained in writing.The failure to obtain such other approval when
required shall subject this permit to immediate revocation by the Trustees upon receipt by the.
Trustees• of written notice from such other governmental or municipal authorities of its refusal or
disapproval.
The applicant does by the acceptance of this permit, assure all responsibility for operations under-
taken pursuant to this permit,and shall take all precautions for the prevention of injuries to persons
and property resulting from such operations.By such acceptance,the applicant also agrees to indemni-
ty and save harmless the Town, and its officers, agents and employees from any and all claims arising
from operations under this permit and any and all acts or omissions of applicant, his agent and
employees.
The applicant and the owner and occupants of the premises upon which the operations authorized by
this permit are being conducted, do, by the acceptance of this permit,give consent to the Town,and
its officers and employees to enter upon the premises where such operations are being conducted to
make such inspections as the Town may deem necessary to insure that such operations are being con-
ducted in conformity with this permit.
This operation will not substantially:
A. Adversely affect the wetlands of the town.
B. Cause damage from erosion,turbidity or siltation.
C. Cause saltwater intrusion into the fresh water resources of the town.
D. Adversely affect fish,shellfish or other beneficial marine organisms,aquatic wildlife and vege-
tation or the natural habitat thereof.
E. increase the danger of flood and storm-tide damage.
F. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town.
G. Change the course of any channel or the natural movement or flow of any waters.
H. Weaken or undermine the lateral support of other lands in the vicinity.
I. Otherwise adversely affect the health,safety and general welfare of the people of the town.
Signed
Fresid t
Board of Southold Town Trustees
Date... �f Q.,l� ..............................
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January 16, 2016
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25 EE: V � `
P.O. Box 1179 01
Southold, New York 11971 I i�
';✓„_.,.,. psi � F.r
RE: 13220 MAIN RD. EAST MARION, NY JAN 2je 2016
SCTM NO. 1000-31-14-12
REVISED DRAWINGS Sa t�cfd Ta�zn
Board Tustiees
Dear Trustees:
Attached please find revised drawings based on the recent public hearing. Plans have
been revised to reflect the removal of the proposed dock extension, added non-turf
buffer and show electric and water services to remain.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-484-9332.
Very truly yours,
Jerey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
t.
OFFICE LOCATION: ®� s® MAILING ADDRESS:
Town Hall Annex ® P.O.Box 1179
54375 State Route 25 Southold, NY 11971
(cor. Main Rd. &Youngs Ave.)
Telephone: 631765-1938
Southold,NY 11971 � a® P
COU�TV
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: John Bredemeyer, President
Town of Southold Board of Trustees
From: Mark Terry, Principal Planner
LWRP Coordinator
Date: October 19, 2015
Re: Local Waterfront Revitalization Program Coastal Consistency Review for MICHAEL
NIAMONITAKIS
SCTM# 1000-31-14-12
Jeffrey Patanjo on behalf of MICHAEL NIAMONITAKIS requests a Wetland Permit and a Coastal
Erosion Permit for the as-built 4'x70' fixed timber pier; and to add a 10'x12' pier extension onto the
seaward end. Located: 13220 Main Road, East Marion. SCTM# 1000-31-14-12
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 us, it is our recommendation that the proposed action is
INCONSISTENT with below LWRP policy standards: 4.1, 6.1 (A.2, and A.3), 6.2, 9.3 (A), and therefore
is INCONSISTENT with the Local Waterfront Revitalization Plan.
L-
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Figure 1. Subject parcel (white arrow).
4.1 , Minimize losses of human life and structures from flooding and erosion hazards.
The dock and proposed extension is located within the Coastal Erosion Hazard Area. The
threat of repetitive loss from storm and ice is high.
The location of the proposed dock is within the Coastal Erosion Hazard Area (CEHA) and will be
constructed in the nearshore. All development is prohibited in the nearshore area pursuant to §
111-11 unless specifically provided for by Chapter 111, COASTAL EROSION HAZARD AREAS.
Pursuant to § 111-6, allowable activities within the nearshore area may include "docks... built on
floats, columns, open timber piles or other similar open work supports with a top surface area of
less than 200 square feet. The dock, as proposed, is prohibited in the nearshore area pursuant
to Chapter 111, COASTAL EROSION HAZARD AREAS. The proposed fixed portion of the
dock equals 280 square feet and the extension would equal 120 square feet for a total of
400 square feet. The dock is not proposed to be removed each year as required in the Coastal
Erosion Hazard Area, therefore the structure is a regulated activity.
§ 111-11. Nearshore area.
C. All development is prohibited in nearshore areas unless specifically provided for by
this chapter.
§ 111-6. Definitions.
UNREGULATED ACTIVITY -- Excepted activities which are not regulated by this chapter
include but are not limited to elevated walkways or stairways constructed solely for pedestrian
use and built by an individual property owner for the limited purposes of providing
noncommercial access to the beach; docks, piers, wharves or structures built on floats,
columns, open timber piles or other similar open work supports with a top surface area of less
than 200 square feet or which are removed in the fall of each year; normal beach grooming or
cleanup; maintenance of structures when normal and customary and/or in compliance with an
approved maintenance program; planting vegetation and sand fencing so as to stabilize or
entrap sand in primary dune and secondary dune areas in order to maintain or increase the
height and width of dunes; routine agricultural operations, including cultivation or harvesting;
and the implementation of practices recommended in a soil and water conservation plan as
defined in § 3, Subsection (12), of the Soil and Water Conservation Districts Law; provided,
however, that agricultural operations and implementation of practices will not be construed to
include any activity that involves the construction or placement of a structure.
6.1 Protect and restore ecological,quality throughout the Town of Southold.
The role of the Southold Tonin Board of Trustees in the protection and management of the
Town's ecosystem, particularly as it relates to surface waters is recognized by the Town
(LWRP).
6.2 Protect and restore Significant Coastal Fish and Wildlife Habitats.
The action is located in the; Orient harbor COASTAL FISH & WILDLIFE HABITAT area.
Construction of shoreline structures, such as docks, piers, bulkheads, or revetments, in areas
not previously disturbed by development (e.g., natural beach or salt marsh), may result in the
loss of productive areas which support the fish and wildlife resources of Orient Harbor.
9.3 Preserve the public interest in and use of lands and waters held in public trust by the state and
the Town of Southold.
A. Limit grants, leases, easements, permits or lesser interest in lands underwater in accordance
with an assessment of potential adverse impacts of the proposed use, structure, or facility on
public interest in public lands under water. Use the following factors in assessing potential
adverse impact:
1. environmental,impact,
2. values for natu.�al resource management, public recreation, and commerce,
3. size, character, and effect of the transfer in relation to neighboring uses,
4. potential for interference with navigation, public uses of waterway, and riparian
rights,
5. effect of the transfer of interest on the natural resources associated with the
lands,
6. water-dependent nature of use,
7. adverse economic impact on existing commercial enterprises,
8. consistency with the public interest for purposes of navigation and commerce,
fishing, bathing, and access to navigable waters and the need of the owners of
private property to safeguard development.
A private, dock structure in this location would extend into public waters resulting in a net
decrease in public access to public underwater lands and the nearshore area. Further the
single family residence requesting the private, dock is not a water dependent use.
The LWRP does not support the construction of docks or structures in Orient Harbor and recommends
alternatives such as the mooring of boats and mooring in nearby marinas.
Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its
written determination regarding the consistency of the proposed actions.
Cc: Lori Hulse, Assistant Town Attorney
• 1
i
Peter Young,Chairman Q - 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., October 14, 2015
the following recommendation was made:
Moved by Doug Hardy, seconded by Peter Meeker, it was
RESOLVED to SUPPORT the application of MICHAEL NIAMONITAKIS to construct a 10'X 12'
timber pier extension at seaward end of existing fixed pier and for the as-built existing 4'X 70'
timber dock.
Located: 13220 Main Rd., East Marion. SCTM#31-14-12
Inspected by: Doug Hardy, Peter Meeker
The CAC Supports the application, however, there is a concern with the fertilized lawn and a 10'
non-turf buffer should be installed along the landward side of the bulkhead. There are no docks in
the area and the exiting dock could be impacted by a northeast storm. The docking facility should
not restrict the public right-of-way.
Vote of Council: All: All
Motion Carried
��SpU�
John M.Bredemeyer III,President •'��,-�-' --�--->.+�f�, Town Hall Annex •
Michael J.Domino,Vice-President '�� Q' 64375 Main Road
P.O.Box 1179
James F.King,Trustee Southold,New York 11971-0969
Dave Bergen,Trustee G'
`' •_- �.• Telephone(631)765-1892
Charles J.Sanders,Trustee Fax(681)765-6641
BOARD OF TOWN TRUSTEES =
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
Wetland Permit Application Administrative Permit
/ _Amendment/Trans�r/Extension ��'
v ReceivedApplication:
Received Fee:$ 10
L
_Completed Application_ -_ . SEP 2 3 2015 1 ,f
_Incomplete
_SEORA Classification:
Type I Type 11 Unlisted , So:;tht k.T�a,rr G
Coordination:(date sent)
iTLWRP Consistency Assfpssment Form .
ECAC Referral Sent: "�• ���
Date of inspection: 10.1zb('S
_Receipt of CAC Report:
_Lead Agency Determination:
Technical Review:
►Public Hearing Held: 1 I�Iigl��
Resolution:
Name of Applicant AA t e �a e L tiJ �" ^' m n t fc- ic's
Mailing Address 13 y 7 6-n S+. re,6 n ,j\ l 12 0
Phone Number:(
Suffolk County Tax Map Number: 1000-
Property Location: l 301 a-° nJ1� n ao a. A.E.r i o A
(provide LILCO Pole#,distance to cross streets,and location)
AGENT: —Te"r e. d Pa a e l a -
(If applicable)
Address: I t7 (� Hew tt--r- 1 u - AAortc hcS,
/y L( L q 3 Phone: 6
10
board of Trustees Application
GENERAL DATA
Land Area(in square feet): �'4t `7y 3 5 F
Area Zoning: (Ze S .
Previous use of property: -CS -
Intended use of property: R-e-S -
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 X 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. '
E
Will this project require any demolition as per Town Code or as determined by the Building Dept.?
Yes No
Does the structure(s)on property have a valid Certificate of Occupancy? Yes No
Prior permits/approvals for site improvements:
Agency Date
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): 6,— v' x 1.) '
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Bc4m.&1 of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: nry c f o' x 19' C+ ao s t
bcr PteiL 5eliw4r&Q .ehA -IC
-CXtS4-(An.cf ft XleA P!t/1. . 45-13vc L+ {vlL —kuSTt.vy,
-41 w«Qc het G�,�S �sfLA-7 -Ee�btr �Qe�IL.
Area of wetlands on lot: o square feet
Percent coverage of lot: O %
Closest distance between nearest existing structure and upland
edge of wetlands: PJ)A, feet
Closest distance between nearest proposed structure and upland
edge of wetlands: feet
F
Does the project involve excavation or filling? fi
e
X No Yes y
If yes,how much material will be excavated? J it cubic yards
How much material will be filled? cubic yards
Depth of which material will be removed or deposited: N i4 feet
Proposed slope throughout the area of operations: N),t
Manner in which material will be removed or deposited: i✓�A
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):
b•c Bio Ncyt-t'i✓G e( Cc-� 0/1 wCt'lun�s
P(o)e4 Cor-A-b„n urt& ::!,Ipe oF- v,.9/LU-.
eooa:: of Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: 4 N s-rr v e-,t t
1l/n6er t,,(�� 'l �eX e-k+e V*,, a-- Sea,t�urce fL4a V,(- pct St,1V1
AS-a,,t-'^l fwc, -P—ktst-'J� "ac )C -7d ` (-""3 e
ty -�CM�[Il t�0eit
Are wetlands present within 100 feet of the proposed activity? J a
X No Yes
Does the project involve excavation or filling?
X' No Yes
If Yes,how much material will be excavated? �" 4 (cubic yards)
How much material will be filled? t-,1,00r (cubic yards)
Manner in which material will be removed or deposited: nJ A-
Describe the nature and extent of the environmental impacts to the subject property or
neighboring properties reasonably anticipated resulting from implementation of the project as
proposed,including erosion increase or adverse effects on natural protective features. (Use
attachments if necessary)
T h{ r e w t l to rl p ,v e-7 2 V1 %J f r o ow4 evl+a,
t^ ee4r_- "S 4c, Proj ec-+ t'Lt�-P's
(.'V cit I I&--(oil m F St '�'t M b 2 P&60 a n t-
Co.vS-rrve--rtA ePf 5,rLtnie.ps antes Irrdegrs
aba-,c 4k htc� � w ti Lcne .
aog� � Town of Southold
Erosion, Sedimentation & Storlm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.c.T.M.4: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
01. I ocv 31 1 a{ 1 z— STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN
sTif�lTcl— ee on oT cr T— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No
a. What is the Total Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off
(Include Total Area of all Parcels located within yon 71;g op-q!g4 Generated by a Two(2")Inch Rainfall on Site?
the Scope of Work for Proposed Construction) (This Item will include all run-off created by site
b. What is the Total Area of Land Clearing
(S.F.I Cres) clearing and/or construction activllies as well as all
and/or Ground Disturbance for the proposed 1 A op,oD 2r. Site Improvements and the permanent creation of
construction activity? impervious surfaces.)
(I
/•Acres)
2 Does the Site Pian and/or Survey Show All Proposed
PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages as Needed)
Drainage Structures Indicating Size&Location?This
Item shall include all Proposed Grade Changes and ,
Co a►Stu GT l o` X 1 Z ` �1;1 o S f j Slopes Controlling Surface Water Flow.
3 Does the Site Plan and/or Survey describe the erosion
4�,Xt k p,,t/L R x+e/IS to of and sediment control practices that will be used to
control site erosion and storm water discharges. This
Scu-,t ct r k e-m A 0 k l STriv y item must be maintained throughout the Entire
Construction Period.
Qi
4 Will this Project Require any Land Filling,Grading or
Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards — ;
of Material within any Parcel? 9
r
5 WIII this Application Require Land Disturbing Activities 6
Encompassing an Area in Excess of Five ThousandF-1
?�
(5,000 S.F.)Square Feet of Ground Surface?
6 Is there a Natural Water Course Running through the
Site? Is this Project within the Trustees jurisdiction 2<—] —
General DEC SWPPP Requirements or within One Hundred(100')feet of a Welland or
Submission of a SWPPP is required for all Construction activities involving soil Beach?
disturbances of one(1)or more acres; including disturbances of less then one acre that 7 Will there be Site preparation on Existing Grade Slopes F-1are pert of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to
Including Construction activities Involving soil disturbances of less then one(1)acre where One Hundred(100')of Horizontal Distance?
the DEC has determined that a SPDES permit is required for storm water discharges.
(SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other impervious
for Storm Water Discharges from Construction activity-Permit No.612-040-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑
1.The SWPPP shall be prepared prior to the submittal of the NOI.The Not shell be Into and/or In the direction of a Town dght-of--way?
submitted to the Department prior to the commencement of construction activity.
2.The SWPPP shag describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, E] i
required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any
constructed to reduce the pollutants In storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder
compliance with the terns and condltions of this permit.In addition,the SWPPP shall Area?(This Item will NOT Include the Installation or Driveway Aprons.)
Identify potential sources of pollution which may reasonably be expected to effect the
quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark
3.All SWPPPs that require the post-construction storm water management practice Ina Boz and the construction site disturbance Is between 6,000 S.F.81 Acre In area,
component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage 6 Erosion Control Plan Is Required by the Town of
that Is knowledgeable In the principles and practices of Storm Water Management, Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit.
(NOTE: AChock Mark(,J)and/or Answer for each question is Required for a CompleteApplicallon)
STATE OF NEW YORK,
COUNTY OFk6BI
...................................SS
That I,...f..:.4 I.......y C �.... ��(c:rpi1�..... G. ..being duly sworn,deposes and says that he/she is the applicant for Permit,
(Name of InW17ining Document)
And that he/she is the �CU k'�0(
(Owner,Contractor,Agent,Corporate Officer,etc.)
Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have perfo ed the said work and to
make and file this application;that all statements contained in this application are hue to ie b st of hi towledge and belief;and
that the work will be performed in the manner set forth in the application filed herewi .
Sworn to before me this; ( � Il
e&.................day of 4RAI-POLMS
T!rn 20/$'
Notary Public: ...................... /:L-e ; ........5..........•Nota{'y Public $� •, •�...
•(Sign lure of Applicant)
of Nalm r.
5 1 00'0
FORM - 06!'10 1�udlffied in Kiat tl G�utlty
�@fflffflggl®Ft ���{a
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item.
Part 1-Project and Sponsor Information
Name of Action or Project:
13a• �-0 /Muth 12zk . F. AAaelan Pier Ek+er,SJov)
Project Location(describe,and attach a location map):
1,n4P
Brief Description of Proposed Action:
co,STrvGT ��' 1 Pi-e2 -e—X +,e4 SIvr7 A-l- 5ect&,j& ek 4
e
rt
.en tQ o� RA sTt.vcJ ft x e A_ 10,clL.
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F,
a
Name of Applicant or Sponsor: Telephone: qr t 7, g 0 5 - !0 7 g
E-Mail:
� tPit"tt�� �t0./VLf9n1 A.�l•s M11 IY1Dt7 �� ��h
Address:
13y -7 b 7t-b 5-E
City/PO: State: Zip Code:
0 roole-l I r) /v `( I ) 2D 9
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 Er
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: ❑
t-411sDscl� TruS+cts I Arvt-j 44 S1 4J%I50oS
3.a.Total acreage of the site of the proposed action? 0.134 acres
b.Total acreage to be physically disturbed? 0.001 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? IM MO acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban [:]Rural(non-agriculture) [-]Industrial ❑Commercial esidential(suburban) _
❑Forest DAgriculture El Aquatic ❑Other(specify):
❑Parkland
Page 1 of 4
5. Is the proposed action, NO I YES N/A
a.A permitted use under the zoning regulations? ❑ I Z ❑
b.Consistent with the adopted comprehensive plan? ❑ F7 ❑
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? ❑ 9
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: Er ❑
8. a.Will the proposed action result in a substantial increase in traffic above present levels? (NOO,� YES
L".l ❑
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? ❑
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: ❑
r
11.Will the proposed action connect to existing wastewater utilities? NO YES
C c
If No,describe method for providing wastewater treatment: �'` ❑
N
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? Er ❑
b.Is the proposed action located in an archeological sensitive area? a. ❑
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? ❑
91,
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑
Er
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: s y
1ao sr- - orieA-r 14&am6e-
14. IdeglKy 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 EKuburban
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? Er ❑
16.Is the project site located in the 100 year flood plain? NO YES
T71 FT
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes, ❑
a.Will storm water discharges flow to adjacent properties? ❑NO DYES
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: ONO ❑YES
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the inipoundn,-----4.f NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size: R,
❑
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: Er ❑
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: Er ❑
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor na e: ��kaL /v Date: R t d •I�
Signature-
Part 2-Impact A sessment. The ad Agency is responsible for the completion of Part 2. Answer all of the following r
questions in Part 2 using the info tion contained in Part 1 and other materials submitted by the project sponsor or u k
otherwise available to the reviewer When answering the questions the reviewer should be guided by the concept"Have my l
responses been reasonable considering the scale and context of the proposed action?"
s No or Moderate
2 f - small to large
impact impact
�, � �-� '�.� .� '� $ -� _ ; •���� ����' may may
1. Will the proposed action create a material conflict with an adopted land use plan or zoning 1:1regulations?
2. Will the proposed action result in a change in the use or intensity of use of land? I� ❑
3. Will the proposed action impair the character or quality of the existing community? ❑
4. Will the proposed action have an impact on the environmental characteristics that caused the ❑
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or Elaffect existing infrastructure for mass transit,biking or walkway? LJ
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing: ❑
a.public/private water supplies?
b.public/private wastewater treatment utilities? ❑
8. Will the proposed action impair the character or quality of important historic,archaeological, ® ❑
architectural or aesthetic resources? -
9. Will the proposed action result in an adverse change to natural resources(e.g,,wetlands, ❑
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
i, 4 ;� � -. _ 1•• �.— - .�F r ;' � ',` No,or Moderate
small to large
mw
impact impact
may may
y
occur occur
F,�"�i-si'e+ f `�K ^�, 14" 'zFi�.e•'� af�.Nr.... -:.x-- - �.-Sx�ticly"�`=s�._...,s .ec._.-.,rky
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage (� ❑
problems? �J
11. Will the proposed action create a hazard to environmental resources or human health?
El-
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and
cumulative impacts.
C
1
k
i r
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
vironmental 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 ill not result in any significant adverse environmental impacts.
Name of Lead Agenc� Date
!� G� /,�N /J/
Print or yp N e Re sible ffiicer in Lead Agency Title of Responsible Officer
re of Re onsi le Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of 4
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: Address:
V0�I dtl Vv r
C-6 yon
STATE OF NEW YORK
COUNTY OF SUFFOLK
c.l - ew PUko 0 , residing at i® to w)'t 43 �� (W
n,q I �®t , being duly sworn, deposes and says that on the
day of ) r , 2016, 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 JOM& )q%
Yl"S that said Notices were m ' ed to each of said persons by
CERTIFIED MAIL/RETURN RECEIPT.
Sworn to before me this
Day of 20
Notary Public
Nota p onann Patan10
ryc,ubGc S Thew York
Quaffed i ?A k'County
Commission if,
�b7/2010
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John Bredemeyer, President �OguFFo(tc Town Hall Annex
Michael J. Domino, Vice-President ��° °°� 54375 Route 25
James F. King 5 P.O Box 1179
Dave Bergen o • Southold, NY 11971
Charles J. Sanders moi ! 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
MICHAEL NIAMONITAKIS
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS
7WOO I.0 , residing at/dba Ino "B Cbu tb�'_ ftd e
C +cr MDy1i✓he51 � e1q
being duly sworn, depose and say:
That on the I I day of p6Tb19CK_ , 201 , I personally posted the property known as
15= MaLy, M -
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, October 21, 2015.
Dated:
( (gna e)
Sworn to before me this -
� � day ofa--f-20}�J
Notary Public
Lo6ann Patan oew Yolk
Notary Public Stat of c
Qualified in Sulk County
No.01PA6150861
COM14ibn Expires 081071208
,NUTILt: Ulm Ht: AKING
NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of
Trustees at the Town Hall, 53095 (\/lain Road, Southold, New York, concerning this property.
OWNER(S) OF RECORD: MICHAEL NIAMONITAKIS
i
SUBJECT OF PUBLIC HEARING :
For a Wetland Permit and a Coastal Erosion Permit for the as-built 4'x70'
fixed timber pier; and to add a 10'x12' pier extension onto the seaward end.
Located: 13220 Main Road, East Marion. SCTM## 31 -14-12
TIME & DATE OF PUBLIC HEARING :
Wednesday, October 21, 2015 — 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 B a.m. and 4 p.m.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892
i
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town f Southold's Code of Ethics omhibits conflicts ofinterest on the part of town ot�icers and cmalovees.The purpose of
this farm is to provide information which can'alerl on is
necessary to avoid same-, r f
YOUR NAME: N r e4 M o A I +e.ICL .5 � �� ��►a, -e L f
(Last name,fust name,jpiddle 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 i
Other
(If"Other,name the activity.) '
if
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee r
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 ownpisitip,of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares. i
YES NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
• l
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant(agont/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): f
A)the owner of greater than 5%of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
B)the legal or beneficial owner of any interest in a non-corporate entity(when the
applicant is not a corporation);
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted this of s� 201'I r
Signature
Print Name ,/ S
Form TS ] /�
Bca+:1 of Trustees Application
County of Suffolk
State of New York
A -t-"iL"S BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLA S ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN CO LETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES THEIR A NT(S)OR
REPRESENTATIVES(S),TO ENTER ONTO MY OPE Y TO IN ECT THE n
PREMISES IN CONJUNCTION WITH REVIE F TH AP IC ION.
5
Signature o Property I
SWORN TO BEFORE ME THIS DAY OF ,24
KOUL A P®LrnS
Notmy Public,Mats Of mew y( ria
pa6llfiia�I� olg
I�� burtty Zp
-I'lu goffiffilma
Notary Public
Saj_- 1 of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
I, "\i e k wc L residitig at l 39- -7(-
(print
7(-(print owner of property) (mailing address)
a(eo iel n �, < <Z�� do hereby authorize
(Agent)
F6.-t -t n I a to apply for permit(s)from the
Southold Board of To n Tru ee n my behalf.
h
(Ow i ature)
R
I
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
,beneficial and adverse effects upon the coastal.areaLwhich includes•all of gouthold 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. Thos,•each•answer-must be-,explained in-detail, lMins 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# 31 - I q
PROJECT NAME 13 a g o 9-sr ,Ae. n
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: / n
)Cld� [ �3o Sf, �'�M bel I'Ir/L �X'�"t/►5/mvl
a-F- S��w�rrk Zvi s f 4-XL S't'lAf y 6 x-eA P«2
r
Location of action: 13 2.3 o p a,n Qo - ek s-r AAa r i o n
Site acreage: • q 3 6 C-
Present land use: e Si oQ en+,"..L
Present zoning classification: c s eA4,,..(,
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: AA i c kms,� L IJ lk7 m /i i -✓ ti IC[s
(b) Mailing address: 134 -7 6 -tLa S T• Q
(c) Telephone number:Area Code( ) q - 0 0 Sd, 7 ty
(d) Application number,if any:
i
Will the action be directly undertaken,require funding,or approval by a state or federal agency?
Yes 0 No❑ If yes,which state or federal agency? r-''t-a 6 c 1✓s A c v e I+_, i n o S
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.
❑X Yes ❑ No ❑ Not Applicable
Qrbiec-i mA VxS ben;&lcr•�l ✓Sc of eyuSTSI
ho�t®w,jeAS ✓SG o f PrpepSeS Pi�/L -ems I'cnS[o/1 /L $�-t'�t"� my .c•1r�
F s h�n �Cft v[f'rC Go.�S �S?�r�'►7' ..✓t t� tltc Svr Pmi,/1 r.Q[.eta
Ntchh ®r'hr9ad�
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
ElYes ❑ No LJ Not Applicable
i
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
Q Yes ❑ No ❑ Not Applicable
(fropee-A eLc-% .Jot loneac-l- o/cSva.L L 1 erg $Ce•-cc /IsSou�G�1 .
Attach additional sheets if necessary
NATURAL COAST POLICIES
1
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 b
ElYes ❑ (
No u 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 R1 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.
❑ ❑ IJ
Yes No Not Applicable
Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria.
❑ Yes [:] No® Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
❑Yes ❑ No YNot 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. (�'
1:1 WED No U Not Applicable
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section 111—Policies;Pages 47 through 56 for evaluation criteria.
0 Yes ❑ No ❑ Not Applicable
Ptojee-F QCo sLUeS �.,meow,G/L &X tL+tD,, -,L vSe o(-
ww't'c2S u� —f-►►cs rt Scr.�Chc.e .
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria.
❑ Yes ❑ No❑ Not Applicable
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages
62 through 65 for evaluation criteria.
❑ Yes ❑ No[evNot 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 TITLE A g e n DATE $-5 0-1 S
September 20, 2015
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179
Southold, New York 11971
RE: 13220 MAIN RD. EAST MARION, NY
SCTM No. 1000-31-14-12
APPLICATION FOR PERMIT
Dear Sir/Madam:
We hereby submit one original and three (3) copies of the proposed plans, application,
check, photographs and required data 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,
,48��r7
Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
September 20, 2015
NYS Dept. of Environmental Conservation
SUNY @ Stony Brook
50 Circle Road
Stony Brook, New York 11790-2356
Attention: Duty Analyst
RE: 13220 MAIN ROAD, EAST MARION, NY
SOTM No. 1000-31-14-12
APPLICATION FOR PERMIT
Dear Sir/Madame:
We hereby submit four(4) copies of the proposed plans, applications, check,
photographs and required data 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 631-464-9332 or e-mail at jpatanjo@optoniine.net.
Very truly yours,
Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
cc: Town of Southold
NYSDOS
Army Corps of Engineers
Mr. Michael Niamonitakis
IOINT APPLICATION FORM
For Permits/Determinations to undertake activities affecting streams,waterways, [Ell
waterbodies,wetlands,coastal areas and sources of water withdrawal.
US Army Corps of
New York You must separately apply for and obtain separate Permits/Determinations from Engineers(USACE)
State each involved agency prior to proceeding with work.Please read all instructions.
APPLICATIONS TO
1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart-
General Services ment of State
Check all permits that apply: Check all permits that apply:
❑Stream Disturbance ❑Coastal Erosion ❑Section 404 Clean Water Act Check all permits that Check if this
Mt aPPIY; plies:
anagemen
❑Excavation and Fill in ❑Section 10 Rivers and Harbors
Navigable Waters ❑Wild,Scenic and pit State Owned Lands Coastal
Recreational Rivers L^`�,T Under Water Consistency
ecreaonavers
❑Docks, Moorings or Nationwide Permit(s)-Identify ❑Utility Concurrence
Platforms ❑Water Withdrawal Number(s): Easement
❑Dams and Impoundment ❑ Long Island Well (pipelines,
Structures ❑Aquatic Vegetation Control .3 conduits,
❑401 Water QualityAquatic Insect Control cables,etc.)
❑ ❑
Certification Preconst ion Notification-
Docks
❑Fr shwater Wetlands ❑ Fish Control Lti Y / ❑ N Moorings or
❑Incidental Take of Endan- Platforms
Tidal Wetlands gered/Threatened Species
,../ S I am sending this application ❑ I am sending this I am sending
l"I am sending this application to this agency. to this agency. application to this this application
a enc . to this agency.
5. Name of Applicant(use full name) Appiiica must be: 6. Name of Facility or Property Owner(if different than - —
L�3"Owner Applicant)
/vii e{�aeL !Ji amour-Fo.K�s ❑Operator
Mailing Address ❑Lessee Mailing Address
(check all that apply)
13 4 -7 t`' S+
Post Office City Taxpayer ID(If applicant Post Office City
is NOT an individual):
StateN Zip Code 112,01 State Zip Code
Telephone(daytime) Email Telephone(daytime) Email
417- 805- 676'I rl 1',A -A on by @ aOL-C--rl
7. Contact/Agent Name B. Project/Facility Name Property Tax Map Section/Block/Lot Number
139-ac, maa'n (Lost.cQ - / 000- 31 - 1y—IX
Company Name Project Location-Provide directions and distances to roads,bridges and bodies of waters:
nn Ste l,ocw+ro.� MwP
d-C FC f`a fa n e
Mailing Address Street Address,if applicable Post Office City State Zip Code
NY
IDB flewA ✓cf? 13aan M A.,n 4--k E, AAa!'ion 1Iq-3
Posstt Office City n Town/Village/City County
Caen+er' 1AvnGACS SO✓+1-+014 S v 4:-FoQC-
State Zip Code Name of USGS Quadran le Map Stream/Water Body Name
/V y 1,1193 y 5 44, c 7�I+n� erierlT Dr i en
'7� -(- 14 r,bot-
Telephone(daytime) 631 c� 9 330 - Location Coordinates: nter NYTMs in kilometers,OR Latitude/Longitude
Email NYTM-E NYTM-N Latitude Longitude _
J Pa-!'an� d l�D(�f�nliAe..t/e(- 'ti'I�o7� °o77N 72 `)9.641
30INT APPLICATION FORM 02/13 This is a 2 Page Application Application Form Page 1 of 2
Both Pages Must be Completed
P APPLICATION FORM-PAGE 2 OF 2
SUL__--,_his completed page as part of your Application.
9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose.Attach 77structures
ge(s)if
necessary. Include: description of current site conditions and how the site will be modified by the proposed project;structureserials to
be installed; type and quantity of materials to be used (i.e., square ft of coverage and cubic yds of fill material and/ s belowordinary/mean high water) area of excavation ordredging, volumes of material to be removed and location of dredged mateor use;work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compesource
impacts;and where applicable,the phasing of activities. ATTACH PLANS ON SEPARATE PAGES.
CDn,7srruG-r 1 c" X Ja' e1CIL QieFeel Sto^ t-(— C/1Q PIC --Xt stNNd
�'c irr G t r Ft )<c k P 1 l/L• 4e t 9 h+ to yn,.-t-c l'1 -e_X 1 S 7,^iP
Proposed Use: Private ❑ Public []commercial Proposedl a ` l Estimated
Start Date: Completion Date:
Has Work Begun on Project? ❑Yes ErNo If Yes,explain.
Will Project Occupy Federal,State or Municipal Land? ❑Yes No If Yes,please specify.
t
' d
l -
10. List Previous Permit/Application Numbers(if any)and Dates:
11. Will this project require additional Federal,State,or Local Permits including zoning changes? Eryes ❑No If yes,please list:
Tow.v m� Snvtdtol rk 'rrr•b'r�CS I ArM,� aAPs 9 DS
12. Signatures.If applicant is not the owner,both must sign the application.
I hereby affirm that information provided on this form and all attachments submitted herewith Is true to the best of my knowledge
and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law.
Further, the applicant accs full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered,
arising out of the prole escribed herein and agrees to indemnify and save harmless the State from suits,actions,damages and
costs of ev . na a description resulting from said project.In addition,Federal Law,18 U.S.C.,Section 1001 provides for a fine
of..,yy�I t} $ 00 imprisonment for not more than 5 year , o both where an applicant knowingly and willingly falsifies,
cfnce I co e p a erial fac or kn winglym es or uses a f Is ,fictitious or fraudulent statement.
Signatur pplic % P 'nte Na Title Date
t i O✓ �) c�.►e!� g I a I s
natu of 0ner Prrnte a e Title Date
S-6F1c. PA-t-a1j Aient
94ndureofAafrit 11 Printed N me Title Date
ME
r'
F • - ,� ca -.- _ .� s... , _ 'ria_ _ 1
]DINT APPLICATION FORM 02/13 Application Form Page 2 of 2
New York State
Department of Environmental Conservation _
PERMISSION TO INSPECT PROPERTY
By signing this permission form for submission with an application for a permit(s)to the
Department of Environmental Conservation("DEC"),the signer consents to inspection by DEC
staff of the project site or facility for which a permit is sought and, to the extent necessary, areas
adjacent to the project site or facility. This consent allows DEC staff to enter upon and pass
through such property in order to inspect the project site or facility, without prior notice,between
the hours of 7:00 a.m.and 7:00 p.m.,Monday through Friday. If DEC staff should wish to conduct
an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate
consent for such an inspection.
Inspections may take place as part of the application review prior to a decision to grant or
deny the permit(s)sought. By signing this consent form,the signer agrees that this consent
remains in effect as long as the application is pending, and is effective regardless of whether the
signer,applicant or an agent is present at the time of the inspection. In the event that the project site
or facility is posted with any form of"posted"or"keep out"notices, or fenced in with an unlocked
gate,this permission authorizes DEC staff to disregard such notices or unlocked gates at the time
of inspection. C
k6
The signer further agrees that during an inspection,DEC staff may,among other things, i
take measurements, may analyze physical characteristics of the site including, but not limited to,
soils and vegetation(taking samples for analysis),and may make drawings and take photographs.
Failure to grant consent for an inspection is grounds for,and may result in, denial of the
permit(s)sought by the application.
Permission is granted for inspection of property located at the following address(es):
130La0 nlla;rl �oa�L was+ n�ar-tmn , � Y li'g3q
By signing this form, I affirm under penalty of perjury t at 1 am a orized to give consent
to entry by DEC staff as described above. 1 understand tyqt false's ements made herein are
punishable as a Class A mise eanor pursuant to ction 0.45o, Penal Law.
G I ( /it01111G � ��/� q • �a tS
Print Name and Title Si& ature Date
*The signer of this form must be an individual or authorized representative of a legal entity that:
• owns fee title and is in possession of the property identified above; -
• maintains possessory interest in the property through a lease,rental agreement or other legally binding agreement;or
• is provided permission to act on behalf of an individual or legal entity possessing fee title or other possessory interest in
the property for the purpose of consenting to inspection of such property.
Permission to Inspect Property Application Supplement 12/08
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part I 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:
132 v /A1 ett✓1 12 J_ F- A-Aae,ton Fief Ex...I-eoSiovi
Project Location(describe,and attach a location map):
Seen Lo C"_i_boi1 r�4P
Brief Description of Proposed Action:
P ie t Z-X -(-.e/1 .5 10 r? a-t- Sect w a r c.Q
eVl D� •e/Xl S?tNrJ Ft K e f tC2. h a
Name of Applicant or Sponsor: Telephone: q.1 -- g o 5 -!�-7 8
.elu.P_L. 1JtaAndni _f0ll1-tS E-Mail: A1Genorl64 eQoL.c
Address:
City/PO: State: Zip Code:
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 Er F]
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: 111-•►1 S D6 C,I-r'ot,.�.,, .,p sou A 6 v ek Tr us4-ee S 1 ArNLI 44 S l J)J 4 s 0�s Er
3.a.Total acreage of the site of the proposed action? 0.1311 acres
b.Total acreage to be physically disturbed? 0.001 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 0.936 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban []Rural(non-agriculture) ❑Industrial [-]Commercial 21 residential(suburban)
❑Forest ElAgriculture El Aquatic ❑Other(specify):
❑Parkland
Page 1 of 4
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations? ❑
b.Consistent with the adopted comprehensive plan? ❑
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? ❑
al
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify: Z ❑
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
1 11
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? Er ❑
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies: ❑
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water: ❑
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: E'` ❑
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? Rr ❑
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? EL 91,
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:
I D o s F — o r i e i-r 14,L ambo v—
14. Ide 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 B suburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered? ❑
16.Is the project site located in the 100 year flood plain? NO YES
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? [I NO E]YES ❑
r n,:•
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? s;s `,'::''
If Yes,briefly describe: []NO AYES fv A
Page 2 of 4
IS.Does the proposed action include construction or other activities that result in the impoundmGm of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size: ❑
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: ❑
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe: Er ❑
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsorna e: NI !,-bni-rale,'s Date: Q Id • I�
Signature:
Part 2-Impact Assessment. The ad Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the info tion contained in Part 1 and other materials submitted by the project sponsor or r
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my t
responses been reasonable considering the scale and context of the proposed action?" f
No,or Moderate
:'}. r., '�" �5�� '�d,'�a gib;�- »"-•,�'° - _ .,n'•�z�C _,�F'�-'Y•..•
small to large
13 '
impact impact
may may
occur occur
lam. Will the proposed action create a material conflict with an adopted land use plan or zoning El ❑
regulations?
2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑
3. Will the proposed action impair the character or quality of the existing community? ❑ ❑
4. 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 El El
existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing: ❑ ❑
a.public/private water supplies?
b.public/private wastewater treatment utilities? ❑ ❑
8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑
architectural or aesthetic resources? -
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ ❑
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
ifs � �� � e`��:�.. ���' •��� ��="`t, c.� .,.;��� No,or Moderate
small to large
: y' iS• dG .'14 K Nr`` _ . , �_ impact impact
�. •� = - ", �` may may
occur occur
%1 "�`S-Ct N � .f+t+. 4`Jau�Fi" � u f�:. Y_.::�• �7.7 v
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ ❑
problems?
11. Will the proposed action create a hazard to environmental resources or human health? El
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and
cumulative impacts.
r
t
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 impacts.
Name of Lead Agency Date
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of 4
NEW YORK STATE DEPARTMENT OF STATE
COASTAL MANAGEMENT PROGRAM
Federal Consistency Assessment Form
An applicant,seeking a permit,license,waiver,certification or similar type of approval from a federal agency which
is subject to the New York State Coastal Management Program(CMP),shall complete this assessment form for any
proposed activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to
assist an applicant in certifying that the proposed activity is consistent with Nev York State's CMP as required by
U.S. Department of Commerce regulations(15 CFR 930.57). It should be completed at the time when the federal
application is prepared. The Department of State will use the completed form and accompanying information in its
review of the applicant's certification of consistency.
A.APPLICANT (please print)
1. Name: A,c,�*--r-L tJ 1 4„ti m n L't-4.I(-IS
2. Address: 13 Li -76 h a4- 9 r Pc K1-r i
3. Telephone: Area Code( ) q 1-7- $c T- 67 S.`f
B.PROPOSED ACTIVITY
1. Brief description of activity: r
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2. Purpose of activity: aa np
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3. Location of activity:
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County City,Town,or Village Street or Site Description
4. Type of federal permit/license required: A"4A-W y(�S
5. Federal application number,if known:
6. If a state permit/license was issued or is required for the proposed activity,identify the state agency and
provide the application or permit number,if known:
C.COASTAL ASSESSMENT Check either"YES"or"NO"for each of these questions. The numbers following
each question refer to the policies described in the CMP document(see footnote on page 2)which may be affected
by the proposed activity.
1.Will the proposed activity result in any of the following: YES/NO
a. Large physical change to a site within the coastal area which will require the preparation
of an environmental impact statement? (11,22,25,32,37,38,41,43)
b. Physical alteration of more than two acres of land along the shoreline,land ❑
under water or coastal waters? (2, 11,12,20,28,35,44)
c. Revitalization/redevelopment of a deteriorated or underutilized waterfront site? (1) ❑
d. Reduction of existing or potential public access to or along coastal waters? (19,20) ❑
e. Adverse effect upon the commercial or recreational use of coastal fish resources? (9,10) ❑ [r
E Siting of a facility essential to the exploration,development and production of energy r�
resources in coastal waters or on the Outer Continental Shelf? (29) ❑ I�
g. Siting of a facility essential to the generation or transmission of energy? (27) ❑
h. Mining,excavation,or dredging activities,or the placement of dredged or fill material in ❑
coastal waters? (15,35)
i. Discharge of toxics,hazardous substances or other pollutants into coastal waters? (8,15,35) ❑ �_
j. Draining of stormwater runoff or sewer overflows into coastal waters? (33) ❑
k. Transport,storage,treatment,or disposal of solid wastes or hazardous materials? (36,39) ❑ 4
1. Adverse effect upon land or water uses within the State's small harbors? (4) ❑
2.Will the proposed activity affect or be located in,on,or adjacent to any of the following: YES/NO
a. State designated freshwater or tidal wetland? (44) �Q
b. Federally designated flood and/or state designated erosion hazard area? (11, 12,17) ❑ [�
c. State designated significant fish and/or wildlife habitat? (7) Q r/
d. State designated significant scenic resource or area? (24) ❑_
e. State designated important agricultural lands? (26) Q 9,'
f. Beach,dune or barrier island? (12)
g. Major ports of Albany,Buffalo,Ogdensburg,Oswego or New York? (3) El
h. State,county,or local park? (19,20) Q
i. Historic resource listed on the National or State Register of Historic Places? (23) ❑
3.Will the proposed activity require any of the following: YES,/N,�O/
a. Waterfront site? (2,21,22) [1L�
b. Provision of new public services or infrastructure in undeveloped or sparsely populated Elsections of the coastal area? (5)
c. Construction or reconstruction of a flood or erosion control structure? (13, 14, 16)
d. State water quality permit or certification? (30,38,40)
e. State air quality permit or certification? (41,43) ❑ r
4.Will the proposed activity occur within and/or affect an area covered by a State-approved local waterfron❑ -
revitalization program,or State-approved regional coastal management program? (see policies in program
document*)
D.ADDITIONAL STEPS
1. If all of the questions in Section C are answered"NO",then the applicant or agency shall complete
Section E and submit the documentation required by Section F.
2. If any of the questions in Section C are answered"YES",then the applicant or agent is advised to
consult the CMP, or where appropriate, the local waterfront revitalization program document*. The proposed
activity must be analyzed in more detail with respect to the applicable state or local coastal policies. On a separate
page(s),the applicant or agent shall: (a)identify,by their policy numbers,which coastal policies are affected by the
activity,(b)briefly assess the effects of the activity upon the policy; and,(c)state how the activity is consistent with
each policy. Following the completion of this written assessment,the applicant or agency shall complete Section E
and submit the documentation required by Section F.
E.CERTIFICATION
The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved
local waterfront revitalization program,as appropriate. If this certification cannot be made, the proposed activity
shall not be undertaken. If this certification can be made,complete this Section.
f
"The proposed activity complies with New York State's approved Coastal Management Program, or with the
applicable approved local waterfront revitalization program,and will be conducted in a manner consistent with such
program." e
Applicant/Agent's Name: t IC-Fr GSI
Address: I o 6 }-I e..v l✓GQ . Ct n't-e r- 11 f1 o r i c.H e 5,
Telephone: Area Code( ) b'31- q $ q. q 3 3 ;L
Applicant/Agent's Signature:_)�O)ZzZ7 Date: ' 3 0-15--
F.
'1SF.SUBMISSION REQUIREMENTS
1. The applicant or agent shall submit the following documents to the New York State Department of State,
Office of Coastal, Local Government and Community Sustainability, Attn: Consistency Review Unit, One
Commerce Plaza-Suite 1010,99 Washington Avenue,Albany,New York 12231.
a. Copy of original signed form.
b. Copy of the completed federal agency application.
C. Other available information which would support the certification of consistency.
2. The applicant or agent shall also submit a copy of this completed form along with his/her application to the
federal agency.
3. If there are any questions regarding the submission of this form,contact the Department of State at
(518)474-6000.
*These state and local documents are available for inspection at the offices of many federal agencies, Department of
environmental Conservation and Department of State regional offices,and the appropriate regional and county planning agencies.
Local program documents are also available for inspection at the offices of the appropriate local government.Revised 10/04/1010
ENVIRONMENTAL QUESTIONNAIRE
This is intended to supplement ENG Form 4345, Application for Department of the
Army Permit, or the Joint Application for Permit used in the State of New York.
Please provide complete answers to all questions below which are relevant to your
project. Any answers may be continued on separate sheets)of paper to be attached
to this form.
PRIVACY ACT STATEMENT
The purpose of this form is to provide the Corps of Engineers with basic information
regarding your project. This information will be used to facilitate evaluation of your
permit application and for public dissemination as required by regulation. Failure
to provide complete information may result in your application being declared
incomplete for processing, thereby delaying processing of your application.
GENERAL—APPLICABLE TO ALL PROJECTS
1. Explain the need for, and purpose of, the proposed work. s
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2. Provide the names and addresses of property owners adjacent to your work site
(if not shown on the application form or project drawings).
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(Please note that depending upon the nature and extent of your project, you maybe
requested to provide the names and addresses of additional property owners
proximate to your project site to ensure proper coordination.)
3. Photographs of the project site should be submitted. For projects in tidal areas,
photographs of the waterway vicinity should be taken at low fide. Using a separate
copy of your plan view, indicate the location and direction of each photograph as
well as the date and time at which the photograph was taken. Provide a sufficient -
number of photographs so as to provide a clear understanding of conditions on and
proximate to your project site.
4. Provide a copy of any environmental impact statement, or any other
environmental report which was prepared for your project.
5. Provide a thorough discussion of alternatives to your proposal. This discussion
should include, but not necessarily be limited to, the "no action" alternative and
alternative(s)resulting in less disturbance to waters of the United States. For filling
projects in waters of the United States, including wetlands, your alternatives
discussion should demonstrate that there are no practicable alternatives to your
proposed filling and that your project meets with current mitigation policy (i.e.
avoidance, minimization and compensation).
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DREDGING PROJECTS
Answer the following if your project involves dredging. k
1. Indicate the estimated volume of material to be dredged and the depth (below
mean low water) to which dredging would occur. Would there be overdepth
dredging?
2. You can apply for a ten-year permit for maintenance dredging. If you wish to
apply for a ten-year permit,please provide the number of additional dredging events
during the ten-year life of the permit and the amount of material to be removed
during future events.
3. Indicate of your drawings the dewatering area(if applicable)and disposal site for
the dredged material (except landfill sites). Submit a sufficient number of
photographs of the dewatering and disposal sites as applicable so as to provide a
clear indication of existing conditions. For ten-year maintenance dredging permits,
indicate the dewatering/disposal sites for future dredging events, if known.
4. Describe the method of dredging(i.e. clamshell, dragline, etc.) and the expected
duration of dredging.
5.Indicate the physical nature of the material to be dredged(i.e. sand, silt, clay, etc.)
and provide estimated percentages of the various constituents if available. For
beach nourishment projects, grain size analysis data is required.
6. Describe the method of dredged material containment (i.e. hay bales,
embankment, bulkhead, etc.)and whether return flow from the dewatering/disposal
site would reenter any waterway. Also indicate if there would be any barge overflow.
MOORING FACILITIES
Answer the following if your project includes the construction or rehabilitation of
recreational mooring facilities.
1.It is generally recommended that any fixed piers and walk ramps be limited to four
feet in width, and that floats be limited to eight feet in width and rest at least two feet
above the waterway bottom at mean low water. Terminal floats at private, non-
commercial facilities should be limited to 20 feet in length. if you do not believe your
proposal can meet with these recommendations,please provide the reason(s).
2. Using your plan view, show to scale the location($), position(s) and size(s)
(including length,beam and draft)of vessels) to be moored at the proposed facility,
including those of transient vessel(s) if known.
3.For commercial mooring sites such as marinas,indicate the capacity of the facility
and indicate on the plan view the location(s) of any proposed fueling andlor sewage
pumpout facilities. If pumpout facilities are not planned,please discuss the rationale
below and indicate the distance to the nearest available pumpout station.
4. Indicate on your plan view the distance to adjacent marine structures, if any are
proximate and show the locations and dimensions of such structures.
5. Discuss the need for wave protection at the proposed facility. Please be advised
that if a permit is issued,you would be required to recognize that the mooring facility
may be subject to wave action from wakes of passing vessels, whose operations
would not be required to be modified Issuance of a permit would not relieve you of
ensuring the integrity of the authorized structure(s)and the United States would not
be held responsible for damages to the structure(s) and vessel(s) moored thereto
from wakes from passing vessels.
BULKHEADING/BANK STABILIZATION/FILLING ACTIVITIES
Answer the following if your project includes construction of bulkheading (also
retaining walls and seawalls) with backfill, filling of wafers/wetlands, or any other k ,,
bank stabilization fills such as riprap, revetments, gabions, etc.
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1. Indicate the total volume of fill (including backfill behind a structure such as a
bulkhead)as well as the volume of fill to be placed into waters of the United States.
The amount of fill in waters of the United States can be determined by calculating the
amount of fill to be placed below the plane of spring high tide in tidal areas and
below ordinary high water in non-tidal areas.
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2. Indicate the sources) and type(s) of fill material.
3. Indicate the method of fill placement(i.e. by hand, bulldozer, crane, etc.). Would
any temporary fills be required in waterways or wetlands to provide access for
construction equipment? If so, please indicate the area of such waters and/or
wetlands to be filled, and show on the plan and sectional views.
The foregoing requests basic information on the most common types of projects
requiring Department of the Army permits. it is intended to obviate or reduce the
need for requesting additional information;however, additional information may be
requested above and beyond what is requested in this form.
Please feel free to add any additional information regarding your project which you
believe may facilitate our review.
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