Loading...
HomeMy WebLinkAboutTR-9489 Glenn Goldsmith,President �QF SO(/rTown Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III #[ Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 eoutm BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1680C Date: January 27, 2020 THIS CERTIFIES that the removal'and replacement of pre-existing ramp and float with new 30"wide by 16' long aluminum ramp and 6' wide by 20' longfloating oating,dock with un-treated decking situated in an"I" configuration supported by two(2) 10"diameter CCA piles; At 240 Windjammer Drive, Southold Suffolk County Tax Map#1000-71-2-11.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 3, 2019 pursuant to which Trustees Wetland Permit#9489 Dated June 19, 2019,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is removal and replacement of pre-existing r, amp and float with new 30"wide by 16' long aluminum ramp and 6' wide by 20' longfloating oating dock with un- treated decking situated in an"I"configuration supported by two(2) 10"diameter CCA piles. The certificate is issued to 240 Windjammer,LLC owner of the aforesaid property. AuthdKzed Signature Glenn Goldsmith, President QF SUET Town Hall Annex Michael J.Domino,Vice-President ,`O� y�1 54375 Route 25 P.O. Box 11 John M. Bredemeyer III Southold, New York 11971 A. Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 couff`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: INSPECTED BYLLN. V'Ch.,275 Ch. 111 •. INSPECTION SCHEDULE Pre-construction; haybale line/silt-boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection COMMENTS_: 6.Jr- Ali Alp, . CERTIFICATE OF COMPLIANCE: �y pvffQ(,�c�� Michael J. Domino, President `��o� o� Town Hall Annex John M. Bredemeyer, III, Vice-President ,"� yam' 54375 Route 25 Glenn Goldsmith N z C- P.O. Box 1179 Av A Nicholas Krupski y • o���;Y Southold, NY 11971 Greg Williams Ol ,� f�;. Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed When project complete, call for compliance inspection; BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK R PERMIT NO. 9489 DATE: JUNE 19,2019 'w9`. ISSUED TO: 240 WINDJAMMER,LLC PROPERTY ADDRESS: 240 WINDJAMMER DRIVE,SOUTHOLD SCTM# 1000-71-2-11.2 S 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 June 19, 2019, and in consideration of application fee in the sum of$250.00 paid by 240 Windjammer, LLC 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 to remove and replace pre-existing ramp and float with new 30"wide by 16' long aluminum ramp,and 6'wide by 20' long floating dock with un-treated decking situated in an "I"configuration,supported by two (2) 10" diameter CCA piles; and as depicted on the site plan prepared by Jeffrey Patanjo dated April 22,2019,and stamped approved on June 19, 2019. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, 1h i and these presents to be subscribed by a majority of the said Board as of the 19 day of June,2019. 14 4%3f F �z J V TERMS AND CONDITIONS The Permittee,240 Windjaammer,LLC 240 Windjammer Drive, Southold,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. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Michael J.Domino,President �OQF S0!/�yOlo Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith J [ Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 �lyC4UNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 19, 2019 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: 240 WINDJAMMER, LLC 240 WINDJAMMER DRIVE, SOUTHOLD SCTM# 1000-71-2-11.2 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 19, 2019 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of 240 WINDJAMMER, LLC 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 May 3, 2019, 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 Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit for the structures; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 19, 2019, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees APPROVE the application of 240 WINDJAMMER, LLC to remove and replace pre-existing ramp and float with new 30" wide by 16' long aluminum ramp, and 6' wide by 20' long floating dock with un-treated decking situated in an "I" configuration, supported by two (2) 10" diameter CCA piles; and as depicted on the site plan prepared by Jeffrey Patanjo dated April 22, 2019, and stamped approved on June 19, 2019. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd 0 5 10 15 LOCUS METERS HEIDECKER LAND SURVEYING FEET 0 10 20 30 40 GRAPHIC SCALE 1" = 10' SHELTER ISLAND SOUND Q z v PROJECT SITE •-2.62 -3.77, -3.87, Q -4.23, _4.59, Q, ANCHOR LA ��- NE -3.03 -2.64 -4.77 +-2.84 " -4.01 , -3.98, � -3.27 -4.09" -4.21 , FLOATING DOCK (N I • ,-3.21 , -4.08 N.T.S. -2.69 -3.85 -3.97 "-2.79 .-2.81 ` -3.13 , -4.51 , -4.36, -3.33. CV l -2.80 -4.33, -4.03, ,-2.49 -3.67 -3.97, -3.21 , ,-2.62 ' -4.71 EO n ,-4.83 ,-2.48 I. 1000-71-2-11.2 -277, _342, -4.11 -4.69, -4.47, -4.51 , -4'78• 240 WINDJAMMER LLC Y FLOATING DOCK 9g, `-4.80 -3.14 _ -2.81 , --3.28, -4.09, _4.71 -4.59, -4.23, -3.87, -3.04, -2.62, 1p `j -3.58 -4.76 -4.92 -3.98 -3.14, -2.59, -4.11 + -4.30, -3.82, L z N g I OD -3.94, -4.31 , -4.71 , -4.86, -4.68, -3.54, -2.57, W X -4.25, U N p O O z •-4.17 .-2.68 N 0) t -4.10 , -4.33, 9, -4.74, -4.44, 1000-79-4-80 O . , . C3 ` oW ZARA / KASNIA O 1 FLOATING DOCK 60 -4.43 -2.97 N t0 � N -3.77 -4.39, -4.71 , <-4.84 -4.87, -4.21 , -3.77 N + 1 -3.79 + " -2.81 Z N -3.58 C i -3.69 -4.27, -4.74• 4.81 -4.76, -4.56• _4.48, -3.22, ,I - , N U FO N o -3.68 1 U p -5.10 0t - 00- 7910 C) -4.61 -4,79, -4.85, -4.46, 0a o -3.51 . , ZARA KASNIA DOCK v2-, -4.70 • FLOATING '.-3.70 -2.79. 3.28 -3.02 - -4.19 -4.53 4.79 , ` 2.79 -4.07 -3.47 " + - • -4.50 -4.10 , -2.39 -2.77 -3.48 -4.11 -4.04 -4.49. -4.89. -4.55. -4.13 , -3.51 , Cf) Y -3'27• NOTES � 00 -4.10 , 25 d r p • 1000-71-2` -2 73 1. FIELD WORK WAS CONDUCTED OCTOBER 17, o, LLC _' U -3.56 -3.91 . -3.83, -413, -4.33, -4.31 , HEIDTMANN 2018 BY HEIDECKER LAND SURVEYING, N AND ALL MEASUREMENTS WERE TAKEN ON Q , FLOATING DOCK ,_3 02 THE GROUND. 2. NORTH ARROW IS BASED UPON GPS o = O 60 -4,30 OBSERVATIONS CONDUCTED BY HEIDECKER U LAND SURVEYING, PLLC. p 3. ELEVATIONS SHOWN REFERENCE MEAN D! LOWER LOW WATER (MLLW) VERTICAL DATUM. O -2.34 -2.79 -3.68 -3.83, -3.67, -4.03, -4.26, -3.87, -2.77, -2.99, 92 -2,99. -3.29. -2.56, -3.21 , -3.42, -3.38, -3.25, -3.15 , 1000-79-4-5.1 -2.14 -1,79 RHODE / CROWELL -3.22. FLOATING DOCK -2.61 ` -3.40 -3.45 -2.63, -2.47" -2.44 -1.92, -2.87, -3.62. _ -1.77 -1.44 -2.00, -2.64, -3.12 . -3.21 , -3.32, -2.44, -2.01 , 1,1 Ay 3 2019 -2.51 -2.15 , " -2.88. x ...__.•_.e_:......._�.._.. -2.51 , -1.98 1.82 5 FLOATING DOCK -2.16 1000-79-4- SALADINO -1.52 REVISED APRIL 30, 2019 ATE: Unauthorized alteration or JOHN GERD HEIDECKER N.Y. STATE LAND SURVEYOR LIC. # 050719 DATE: BATHYMETRIC SURVEY SHEET NO. OCTOBER 19 addition to this survey is a 1 OF 1 violation of section 7209, 751 COATES AVENUE , 2018 subdivision 2, of he New York ANCHOR LANE, WINDJAMMER DRIVE, PROJ. N0. t StaTOWN OF SOUTHOLD te Education Low. Copies k HOLBROOK, NEW YORK 11741 DRAWN BY: B.M. & SCHOONER DRIVE 18HLS125 this survey map not bearing (631)-772-9604 CHK BY: J.H. CAD FILE: the land surveyor18H1S125FP.DWG s inked or embossed seal shall not be jheideckerCheideckerls.com SCALE: 1"= 10' SUFFOLK COUNTY NEW YORK considered to be a valid copy. HARBOR LoMffs r sox DROVE P/0 LOT 42 ,-=TIP11=1 ,z dt S 64TI51 0' Z 285.50' — — ® ®, — — — — — — — — — — — w no 'm P/0 LOT 42 5 84V5,10, E W. im'-w 22E7 PAUZ G�Z .4 0 a STORY DWELLING 6 two No. 3-oc el*m + fo M3V o im 1� W r In 4 C, + a e eq 4. + 15 OK IL �I .1 F Ir z + r Ix 3 64'0.9*10' E 50.00* D L STORY P/11 LOT 42 511) E 50 Y uN a 'n 'tEl Fig N r P Cg C)w0 IV 02 La L uw mr 331o MAP OF HARBOR UGHTs ESTATES, SEC71ON ONE MAY3 2019WW AV 14 ckt.)w w Ewa 211 Barrett ga — Bonacci & Van Weele, K QVII Enqmmrs Plannefs ] ,3, —Wet 1w Tea Mop V5MICTIOW SECnON71 ftioccci LEGEND NOTE& T,y TOP/BOTTOM OF WALL I. LOT AREA — 53.098 SOUARE FEET. PROPERTY FAB—T7-00249 S TOP/SOTTOM W CURB 2. ELEVATIONS Rr-FTR TO N.A.V.D. issa. SPOT ELEVATION 3. THE PROPERTY APPEARS AS PART CF LOT 42 ON SOUTHOW ON MAI' OF HARBOR LIG TS ESTATES. SECTION Tj f scurrm H CER I rx- ?a SiITFOTE{COSAdtY NY. FILED JULY 26, 1966 FILE N0. 4681 290 VANUJAMMF-R LLC COUNSEL ABSTRACT, WC. FIRST AMERICAN TITLE INSURANCE COMPANY SURVEY p b-'r u,0: I NOVEMM 28.2017 r"L A$ S PROPERTY OWNER: PREPARED BY: . 240 WINDJAMMER LLC JEFFREY PATANJO -' HARBOR LIGHTS DR C/O ALAN BERNSTEIN REALTY SERVICES P.O. BOX 582 155 W. 72ND ST. - SUITE 506 BOHEMIA, NY 11716 NEW YORK, NY 10023 631-484-9332 JJPATANJO@GMAIL.COM o 0 NOTES: S 64.05'10"E _ _ — — — 285.50' 1. LOT AREA: 33,096 S.F. / 0.76 ACRES _ - 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: 'Wo I ----------------- ti BARRETT, BONACCI AND VAN WEELE, P.C. - 175A COMMERCE DRIVE, HAUPPAGUE NY 11768 o w I q SURVEY LATEST DATED NOVEMBER 28, 2017 ° I ASPHALT DRIVEWAY S 64005'10"E Q W 50.00' I / Co ——————— � 2 STORY DECK / e FRAME RESIDENCE I W CANAL �°"'°'°°°°' H� ' i 5' WIDE RIGHT OF WAY � � I APPARENT M.H.W. do M.LW ALONG S 64'05'10"E FACE OF BULKHEAD W 50.00' I CO3— � J PROPOSED 30" X 16' LONG ALUMINUM RAMP ❑ IN SAME LOCATION AS EXISTING CQ m 14 ASPHALT DRIVEWAY PROPOSED 6' X 20' LONG FLOATING DOCK SHED 61' CM 14i � SUPPORTED WITH 2 — 10e DIA. PILES 4�0 IN SAME LOCA EXISTING — hA 9s' N 64.05'10"W 865.42' E PROPOSED 30'X IV ALUMINUM RAID 70 I• �� I ,.,a.• REPLACEDOSDNO •C,:; " PROPOSED 10'DIAMETER CCA PILES TO REPLACE EIOSIINO uU=UGnCE WIN TEDMOONOTOREPLAMAY 3 2019 ' E10SIIN0 f Suuthold loWn =-- e30ardofTrustees APPRO10 21%EXISTI1,10 BULKHEAD, 'AP ROVED"BY Wmdjammerodve Z APMETE M1,W EL 0 :BOARD-OF,TRUSTEES Y U� _ 'TOWN, OF SOUTHOL'D �i�/ice//%//�/�� / h $ e $ Aeras CWlur�O stei /\/\/\\ // \�\r� / s e DATE'_ 41 1Q �� !� P ro sed Dock Permit Plans SCALE: Q 1"=30' ED FLOATING DOCK PLAN , DATE: r'M ®AweIXmthe Woods - f! TION & LOCATION MAP 4-22-19 ..y 8 d �•>q Hog Neck g Bedaed Orewa51 , 40 WINDJAMMER DRIVE THOLD, TOWN OF SOUTHOLD LOCATION MAP TYPICAL DOCK SECTION SUFFOLK COUNTY, NY SHEET: N.T.S. N.T.S. MAP NO. 1000-71-02-11.2 1 of 1 I Michael J. Domino, President �i��o Gamli� Town Hall Annex John M. Bredemeyer, III, Vice-President 1, 54375 Route 25 Glenn Goldsmiths " P.O. Box 1179 A Nicholas Krupski .�`��� �o�.}� Southold, NY 11971 Greg Williams =µY Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: 240 WINDJAMMER, LLC c/o JEFFREY PATANJO Please be advised that your application dated May 3, 2019 has been reviewed by this Board at the regular meeting of June 19, 2019 and your application has been approved pending the completion of the following items checked off below. Pre-Construction Hay Bale Line Inspection Fee ($50.00) — (Silt boom) 1 St Day of Construction ($50.00) % Constructed ($50 00) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30- Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $_50.00 BY Michael J. Domino, President Board of Trustees Michael J. Domino,*Pres, ` t O��Offal ! Town Hall Annex John M. Bredemeyer III,Vice=rresident ��� 54375 Route 25 Glenn Goldsmith y P.O. Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD Date/Time: ` ! y Completed in field by: Jeffrey Patanjo on behalf of 240 WINDJAMMER, LLC requests a Wetland Permit to remove and replace pre-existing ramp and float with new 30" wide by 16' long aluminum ramp, and 6' wide by 20' long floating dock with un-treated decking situated in an "I" configuration, supported by two (2) 10" diameter CCA piles. Located: 240 Windjammer Drive, Southold. SCTM# 1000-71-2-11.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275__(ZCh. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: L.14 2- I I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: J. Bredemeyer fill. Domino t./G. Goldsmith U--/N. Krupski /. Williams Other 41 Windjammer Drive Photos 2018 f� © i ?1M: �,'.. ' 1 1 .1 Y ly^_� '� r � +� .�. �, ��� �J�' �✓ .�: ` " r .. �ti. K '_ '�: ;... �� : � , 4r a " .. 41 Windjammer Drive Photos 2018 i.: JR 1Y 1.i � - �" i ; ... ..,.t� ,, �� �,. 9�` .i ,�1� ��. .�b'� ',- -ate vNEW Department of Office of Department TATE Environmental General Services of State Conservation US Army Corps of Engineers a JOINT APPLICATION FORM For Permits for activities activities affecting streams,waterways,waterbodies, wetlands, coastal areas, sources of water, and endangered and threatened species. You must separately apply for and obtain Permits from each involved agency before starting work. Please read all instructions. 1. Applications To: >NYS Department of Environmental Conservation 0 Check here to confirm_-you sent this form to NYSDEC. Check all permits that apply: ❑Dams and Impound- 0 Tidal Wetlands ❑ Water Withdrawal ❑ Stream Disturbance ment Structures ❑Wild, Scenic and ❑ Long Island Well ❑ Excavation and Fill in ❑401 Water Quality Recreational Rivers Navigable Waters Certification incidental Take of F—] Coastal Erosion Endangered/ ❑ Docks, Moorings or ❑Freshwater Wetlands Management Threatened Species Platforms >US Army Corps of Engineers [7] Check here to'confirm you sent this form,to USAGE. Check all permits that apply: ❑Section 404 Clean Water Act ❑Section 10 Rivers and Harbors Act Is the project Federally funded? ❑ Yes ❑ No If yes, name of Federal Agency: General Permit Type(s), if known: 3 Preconstruction Notification: ❑Yes ED, No >NYS Office of General Services ❑ Check hereto confirm you'sent this form.to NYSOGS. Check all permits that apply: ❑ State Owned Lands Under Water ❑ Utility Easement(pipelines, conduits, cables, etc.) ❑ Docks, Moorings or Platforms >NYS Department of State ❑✓ Check here to confirm you sent this form to NYSDOS. Check if this applies: ❑✓ Coastal Consistency Concurrence 2. Name of Applicant Taxpayer ID if applicant is NOT an individual 240 Windjammer LLC Mailing Address Post Office/City State Zi C/O Alan Bernstein Realty Services New York [NY] 10023 155 w.72nd St.-Suite 506 Telephone 646-271-7335 Email I albernrealty@gmail.com Applicant Must be (check all that apply): k Owner ❑ Operator ❑ Lessee 3. Name of Property Owner if different than Applicant) Mailing Address Post Office/City State Zi Telephone Email ForAgencv,UseOnly. ' Agency'A lication.Number: JOINT APPLICATION FORM 08/16 Page 1 of 4 JOINT APPLICATION FORM—Continued. Submit this completed page as part of your Application. 4. Name of Contact/Agent Jeffrey Patanjo Mailing Address Post Office/City State Zip P.O.Box 582 Bohemia NY 111716 Telephone 631-484-9332 Email I JJPatanjo@gmail.com 5. Project/Facility Name Property Tax Map Section/Block/Lot Number: 240 Windjammer Drive-Southold 1 11000-71-2-11.2 Project Street Address, if applicable Post Office/City State Zi 240 Windjammer Drive Southold NY 11971 Provide directions and distances to roads, intersections, bridges and bodies of water See location map Town I Village City County StreamM/aterbody Name Southold I I Suffolk Dredged Canal Project Location Coordinates: Enter Latitude and Longitude in degrees, minutes, seconds: Latitude: 41 [K=' 58.13 " Longitude: 72 ° 24 19.17 " 6. Project Description: Provide the following information about your project. Continue each response and provide any additional information on other pages.Attach plans on separate pages. a. Purpose of the proposedproject: Remove&replace existing floating dock and ramp in same location as existing b. Description of current site conditions: Existing ramp and float were demolished during storms and removed during bulkhead construction c. Proposed site changes: New ramp and float in same location as previously existed. d. Type of structures and fill materials to be installed, and quantity of materials to be used (e.g., square feet of coverage,cubic yards of fill material,structures below ordinary/mean high water, etc.): 30"x 16'long aluminum ramp and 6'x 20'floating dock with un-treated timber decking. e. Area of excavation or dredging,volume of material to be removed, location of dredged material placement: N/A f. Is tree cutting or clearing proposed? 01 Yes If Yes, ex Iain below.' No Timing of the proposed cutting or clearing (month/year): Number of trees to be cut: Acreage of trees to be cleared: JOINT APPLICATION FORM 08116 Page 2 of 4 JOINT APPLICATION FORM—Continued. Submit this completed page as part of your Application. C. Work methods and type of equipment to be used: All work to be preformed by barge h. Describe the planned sequence of activities: Install new piles, ramp and float. i. Pollution control methods and other actions proposed to mitigate environmental impacts: None anticipated j. Erosion and silt control methods that will be used to prevent water quality impacts: None anticipated k. Alternatives considered to avoid regulated areas. If no feasible alternatives exist, explain how the project will minimize impacts: The no-build would not all for the use,,of waters as previously enjoyed I. Proposed use: ❑✓ Private ❑Public ❑Commercial m.Proposed Start Date: 6-1-19 Estimated Completion Date: 6-2-19 n. Has work begun on project? �—�° Yes If Yes, explain below. El No o. Will project occupy Federal, State, or Municipal Land? Yes If Yes, explain below. No p. List any previous DEC, USACE, OGS or DOS Permit/Application numbers for activities at this location: 1-4738-04623/00001 for bulkhead replacement q. Will this project require additional Federal, State, or Local authorizations, including zoning changes? Yes If Yes, list below. No Town of Southold Trustees JOINT APPLICATION FORM 08/16 Page 3 of 4 r JOINT APPLICATION FORM—Continu`ed. Submit this completed page as part of your Application. 7.Signatures. Applicant and Owner(If different)must sign the application. Append additional pages of this Signature section if there are multiple Applicants, Owners or Contact/Agents. I hereby affirm that information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. Permission to Inspect- I hereby consent to Agency inspection of the project site and adjacent property areas. Agency staff may enter the property without notice between 7:00 am and 7:00 pm, Monday- Friday. Inspection may occur without the owner, applicant or agent present. If the property is posted with"keep out"signs or fenced with an unlocked gate, Agency staff may still enter the property. Agency staff may take measurements, analyze site physical characteristics,take soil and vegetation samples, sketch and photograph the site. I understand that failure to give this consent may result in denial of the permit(s)sought by this application. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45of the NYS Penal Law. Further,the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered,arising out of the project described herein and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said project. In addition, Federal Law, 18 U.S.C., Section 1001 provides for a fine of not more than $10,000 or imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conceals, or covers up a material fact; or knowingly makes or uses a false,fictitious or fraudulent statement. Signature ovalicant Date Y Ap cant Must be (check all that apply): Owner ❑Operator ❑ Lessee Printed Name Title 240 Windjammer LLC c/o Alan Bernstein Owner Signature of Owner if different than Applicant Date Printed Name Title Sig at re kf Cont4t/ gent Date 2- Pr' ted Name Title Jeffrey Patanjo Agent For Agency Use Only: :DETERMINATION-OF:NO°PERMIT=REQUIREDn i u bei:= Y .k Age `'ARP` licat oriN m`y .9. . m'f;i tf, o Per I s. �: en 'Name tias�,detemined ha N , li'ati rl i€'this"a� c o r`'e�t�desc bed li -t :for,t{ie o c brewired=from his`A eric q 9 ,Y, - _ rt, 3•. e"'re fative` �A� enc R sen ,y _ <9 P - z„ - Printedtle-" {t' h. .Name?:: - , Dat - i 9 _ - Ye JOINT APPLICATION FORM 08/16 Page 4 of 4 0 ob Short Environmental Assessment Form Part I -Project Information Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 240 Windjammer Drive Dock Project Location(describe,and attach a location map): 240 Windjammer Drive-Southold,See location map Brief Description of Proposed Action: Replace previous 30"x 16'aluminum ramp and 6'x 20'floating dock in original locations Name of Applicant or Sponsor: Telephone: 646-271-7335 240 Windjammer LLC c/o Alan Bernstein Realty E-Mail: albemrealty@gmail.com Address: 155 W.72nd St-Suite 506 City/PO: State: Zip Code: New York NY 10023 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 R1 ❑ 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: El FV-1 /Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.75 acres b.Total acreage to be physically disturbed? 0.01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.75 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban E]Rural(non-agriculture) ❑Industrial ❑Commercial OResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Pagel of 3 0 a 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ I—t/1 ❑ b.Consistent with the adopted comprehensive plan? ❑ Z ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ RI 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, Agency:buffolk County,Date 1-12-88 F1 ✓❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑✓ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? Fv-1 ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? I El 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: � F-1 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: R1 ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? Ft/1 ❑ b.Is the proposed action located in an archeological sensitive area? ❑ Rl- 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ Z b.Would the proposed action physically alter,or encroach into,any existing wetland'or waterbody? ❑ R] If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 6'x70'floating dock and 30"x16'aluminum ramp 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional 21 Wetland ❑Urban ❑✓ Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? Tiger Salamander,Piping PI.. ❑ R] 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? ❑NO YES b.Will storm water discharges be directed to established conveyance systems runoff and storm drains)? If Yes,briefly describe: t:]NO ❑YES Page 2 of 3 0 a 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: Fv] F 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: F I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: 0 1ndjaTrn L c/o Alan Bernstein Date: 7 Signature: PRINT FORM Page 3 of 3 Part 2-Impact Ass The Lead Agency is responsible for the c�i n of Part 2. Answer all of the following questions in Part 2 use he The contained in Part 1 and other mate bmitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" 1 No,or Moderate I small to large impact impact may may occur occur L Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? DF] 3. Will the proposed action impair the character or quality of the existing community? I 0 4. Will the proposed action have an impact on the environmental characteristics that caused tine El establishment of Critical Environmental Area(CEA)? �___f 1 5. Will the proposed action result in an adverse change in the existing level of traffic or 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 ❑ F] reasonably available energy conservation or renewable energy opportunities? T Will the proposed action impact existing: El a.public/private water supplies? ' b.public/private wastewater treatment utilities? I LJ L 8. Will the proposed action impair the character or quality of important historic,archaeological, F n architectural or aesthetic resources? L_I 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, (� waterbodies,groundwater,air quality,flora and fauna)? �l 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? ISM 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 clement 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. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, 1—! that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees — Name of Lead Agency Date President 1 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) i 0 40 EAF Mapper Summary Report Monday, July 30, 2018 5:31 PM Disclaimer: The EAF Mapper is a screening tool intended to assist { ;F } j • ' /f� project sponsors and reviewing agencies in preparing an environmental 40=15040 • assessment form EAF Not all questions asked in the EAF are 7140=140=1.6041,;} ;z®o:aaa0 c E 174=100-26 (1 -"I0(7100-20;-1001 • �' i answered by the EAF Mapper Additional information on any EAF 3, { ••._ , F 7100,_1'007._ 00 .7140-266_404Q;g44=2 4^1441 1 question can be obtained b consulting the EAF Workbooks Although 71.00-100-27440` ;� ' _'` ' '� { # ` � "` te EAF Mapper provides the most up-to-date digital data available to _ j A. , 7100 2 70-100 00-20o=64o0I7100-200-1002`--,, p 9 t' -"pct o0>1.00=20040 fi.' j DEC,you may also need to contact local or other data sources in order y . _ "" 7*d0=260=200(77'100-207-16000 -. � - � 2100;1.00=18�t7oo� _, _ t+ + �- r t 7 to obtain data not provided by the Mapper Digital data is not a [417 100-2200" .-°' 79 00:20"i=,14 0 7tY]0 200-t 1000 -7f 0Q-iQ4;°19 OIQa-2GQ-8®o(i ' 'r - substitute for agency determinations Ick ti r 7100-200=10000 T`'r •..� �- 7900=340=5400` j e 710�.2+a(i 9S}S?i 17100-200_-131700, - ti 790 = 74=1040 -`°7101?-200=1�`40� =::.,�,�7900-300.1002` a :7104:200 11'Ob � „ d , 1 300-600071- }� --- _ ,,�.8000-100,'-2.0 02 1 r 0-•404-8000f 1 tert ):- .�.j� 77p0(9 300-700o_79Q4�t0 7 1041 "� '`*,f "`"- t�04-400 5000 € 79 0=000 1100f- _�79t}0' 4174-15 © )C 79.02.1*00z7004 �, : 7904-X170-39 06-7900- V406 460'60 _ 0940-344 X4440 =7900 6009 , `To(onlo # x , 7J;9•9if 0p7 4-n""�Fl3-_40=33,o-�1i0 _ .;F�#y-` � `O .-_Sr74.9010 302-6 ,007t9,0-0,z5-�4s`000 318r-000'r-7 7..9.'�f0"�>1 0{-4d0-0t�-: 179037 ' 0=400-150007900-4.00-1100 , "af'O 7910= 00- 8000 x xUd...t"`rWC _t — 79 � 0700-#o9-1Oi32000 r',a syx ?ra Jyt.Et aTnP G� >790)30o 71 900X00-'70257904G174ri,H .,CsrmiI n..,q°J ,79004 =1Qr js%i . nu ,, -3000 IQ✓iEh7Et-IT 00umbuc_ � ,,. - 4'177940-1dibanf7900-3035000 r. , 7so 79)00 ? t!ng) Eri.#00=17Q1iersg7904 - Part 1 /YQuestion 7 [Critical Environmental T1Yes PArea]_ art 1 /Question 7 [Critical Environmental IName:Peconic Bay and Environs, Reason:Protect public health, water, j ;Area- Identify] ;vegetation, &scenic beauty, Agency:Suffolk County, Date:7-12-88 I Part 1 /Question 12a [National Register of !No ;Historic Places] IPart 1 /Question 12b [Archeological Sites] 1Yes �......-<..,.....,-....,,d..���v.-.,..,.....,_..-a......._..,.....,..».-.,.ea. .,...,«m.,-..- .-«��...__ _-_--..->.R.�..aa... --..,..-.,..-.-...n..�®eF.�.a..,�,_......,.«m..a.�m_.-��..�.- �..-.....e..-n..a.....�.-��� :Part 1 /Question 13a [Wetlands or Other 1Yes-Digital mapping information on local and federal wetlands and jRegulated Waterbodies] _ waterbodies is known to be incomplete. Refer to EAF Workbook. !Part 1 /Question 15 [Threatened or 3Yes iEndangered Animal] Tart 1 /Question 15 [Threatened or iTiger Salamander, Piping Plover { ;Endangered Animal- Name] Part 1 /Question 16 [100 Year Flood Plain] -iYes i IPart 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 1 7r V, I Ir ZO Ns9 up !L INSERTA • SOUTHOLD BAY 43 3 P 14A(C) 4 6 6 7 aB 9z t6a 11a N.PAMSH 36 N m az m Is 10 4 16 14 INSERT V SOUTHOLD SE-ON NO NOTICE COUNTYOFSUFFOLK @ L r E Real Property Tax Service Agency y G 071 RR oA PROPERTY MAP M 4,, OFFICE LOCATION: ®� �®� MAILING ADDRESS: Town Hall Annex '` ® P.O.Box 1179 54375 State Route 25 Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 ® Q Telephone: 631765-1938 ®l�C®U�T`I LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: June 19, 2019 Re: LWRP Coastal Consistency Review for 240 WINDJAMMER, LLC SCTM# 1000-71-2-11.2 Jeffrey Patanjo on behalf of 240 WINDJAMMER, LLC requests a Wetland Permit to remove and replace pre-existing ramp and float with new 30" wide by 16' long aluminum ramp, and 6' wide by 20' long floating dock with un-treated decking situated in an "I" configuration, supported by two (2) 10" diameter CCA piles. Located: 240 Windjammer Drive, Southold. SCTM# 1000-71-2-11.2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with LWRP Policy 6.3 and therefore, INCONSISTENT with the LWRP 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 9. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. Town laser fiche records indicate that the structure was constructed without Southold Board of Trustees review or issuance of a Wetland Permit. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney �11%ofFO�,��� Peter Young,Chairman y Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 W Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 12, 2019 the following recommendation was made: Moved by Caroline Burghardt, seconded by John Stein, it was RESOLVED to SUPPORT the application of 240 WINDJAMMER LLC to.remove and replace pre-existing 30" wide X 16' long aluminum ramp, 6' X 20' floating dock with untreated decking supported with 2-10" CCA piles. Located: 240 Windjammer Dr., Southold. SCTM#71-2-11.2 Inspected by: Caroline Burghardt The CAC Supports the,application using best management practices. Vote of Council: Ayes: All Motion Carried S U P �z Town Hall Annex Michael J.Domino,President John M.Bredemeyer III,,Vice-President °e® {O , 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski ® Telephone(631) 765-1892 Greg Williams dl� ���j Fax(631) 765-6641 cOU� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application ! t ?; 1 E Wetland Permit Application Administrative Permit Amendment/Transfer/Extension 4; MAY 2019 Received Application: S'3•l q '• Received Fee: $ 250.0 n .�._.,. Soa,lie��l lo;; Completed Application: �� ! Bo�rr o+Trn�Fee� Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): VLWRP Consistency Assessment F rm Sent: ~CAC Referral Sent: 52 •�� Date of Inspection: 2�1 Receipt of CAC Report: Technical Review: Public Hearing Held: •� •� Resolution: Owner(s)Legal Name of Property (as shown on Deed): yD k✓ LLL- Mailing Address: G Alan 13eens+fctrL Q.eLL. Services 1S75— W. -79L-ixt 5T-5vvf-e ,110E Phone Number: ig q&- A-71 --7335- rJ-e-w `do�1::-, N`I loo a-3 Suffolk County Tax Map Number: 1000 - -71 - A - I i - ;L- Property Property Location: .2 q o w,n aQ i t en M e-Y— ®eL• - S 0,j+h a I zk (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): '-Fe rifer-esd ,�a+.A a 1 s Mailing Address: >< -� �- °he^''`�� n.1 ( l 7l 6 Phone Number: b 3 j' g eq -9 3 3�- rA 3 \� �� Board of Trustees application GENERAL DATA Land Area(in square feet): 3 3 0 9 6 Area Zoning: (4S- Previous 4S-Previous use of property: 4S Intended use of property: S Covenants and Restrictions on property? Yes V No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes ✓ No If"Yes", be advised this application will be reviewed by the Building Dept, prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ✓ No If"Yes", please provide copy of decision. Will this project 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 I rL, ttt q3a$ 'IV - t-7 - t No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ✓ No Yes If yes, provide explanation: Project Description (use attachments if necessary): a a tt "'7" t o c c P f e-�ek' S,i n1 3 0 w Late- 3< tA i ti t a'C"t n y o L l- p-1,441 ri-'f"���.-��� ejeejc r n 5 le $ Board of Trustees Application WETLAND/TRS TEE LANDS APPLICATION DATA Purpose of the proposed operations: rte lk e4 P re'W'547.19 30 " ,wtdt.- K 1b ' L-Al sFG•�tnw,� ����, G twit& X 0 With a — ion �t� GC.4 e,les Area of wetlands on lot: square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: vo feet Closest distance between nearest proposed structure and upland edge of wetlands: too feet Does the project involve excavation or filling? `"' No Yes If yes, how much material will be excavated? m A cubic yards How much material will be filled? N �cubic yards Depth of which material will be removed or deposited: 0J t,4 feet Proposed slope throughout the area of operations: N 1.4 Manner in which material will be removed or deposited: P.,1.4 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): -'h t 4C I G 4a C 4-fec t .P., w a -Short Environmental Assessmaent Form Pant I -Project Information Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 240 Windjammer Drive Dock Project Location(describe,and attach a location map): 240 Windjammer Drive-Southold,See location map Brief Description of Proposed Action: Replace previous 30"x 16'aluminum ramp and 6'x 20'floating dock in original locations Name of Applicant or Sponsor: Telephone: 646-271-7335 240 Windjammer LLC c/o Alan Bernstein Realty E-Mail: albemrealty@gmail.com Address: 155 W.72nd St-Suite 506 City/PO: State: Zip Code: New York NY 10023 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: NYSDEC/Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.75 acres b.Total acreage to be physically disturbed? 0.01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 75 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial [:]Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic [I Other(specify): ❑Parkland Page 1 of 3 18.Does the proposed acti�,....t'clude construction or other activities that resul'. Jhe impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: F] I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: 0 indjamme L 9 c/o Alan Bernstein Date: 6 Signature: PRINT FORM Page 3 of 3 Part 2-Impact Assessment. The Lead Agency is responsible for the completion of fart 2. Answer all of the totJowmg questions in Part 2 using. -,information contained in Part I and other materials =bmitted by the project sponsor or otherwise available to tl viewer. When answering the questions the review bold be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed at-",m?" No,or Moderate t small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? _ Z,­ El 2. Will the proposed action result in a change in the use or intensity of use of land? f 3. Will the proposed action impair the character or quality of the existing community9 1 4. Will the proposed action have an impact on the environmental characteristics that caused the r `} i establishment of Critical Environmental Area(CEA)? LL�rll 5. Will the proposed action result in an adverse change in the cxisting level of traffic or s affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate LJ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: g a,public/private water supplies? b,public/private wastewater treatment utilities? i U 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)? �p 10 Will the proposed action result in an increase in the potential for erosion flooding or drainagej'j i ❑ problems? �J 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part J. 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. Check this box if you have determined,based on the information and analysis above,and tory 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 environmenta!limpacts. (+ Town of Southold-Board of Trustees (' 17/ G( --- Name of Lead Agency r Cate i President $ htPrint Xe *stt9d �fr� U•Agency Title of Responsible Officer �, JsibP,0'&ffic�e,in Lead Agency Signature of Preparer(if different from Responsible Officer) --- — 'r—"/A%F Mapper Surna ,I Rep®ek Monday, July 30, 2018 5:31 PM Disclaimer: The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental - i r _ L7 1"0-1 71!G_I GO.1 rOG 1 71 G 0 2�6-71006assessment form(EAF) Not all questions asked in the EAF are i --- - - - , answered by the EAF Mapper Additional information on any EAF 10 G 10 2u�J.+0,7 I 00=1 00-'1 7 GGO '!100 200 -.irC1�7100 200 1001 question can be obtained by consulting the EAF Workbooks Although , the EAF Mapper Prowdes the most up-to-date digital data available to 10Cr10G 270000 '100200•'I G _riG) 7'Irr2CC_1r02 1' I OCi=100-20000 DEC,you may also need to contact local or other data sources in order I - !`- 3.I Q0 2f)G 200rYi00 200-1G000i Y Y 7 its i I n0 1 00 I°00?_ -_ + I to obtain data not provided by the Mapper Digital data is not a IC 1 00-22 00 0 r I 1 71 R72' 0—'30x,0 71"00-2002'1700 6 ••? , 7-'1 U I u C",I vul G 7,1 U,.-2 GG-800 G '`r' 7 tr- II,•_-f substitute for agency determinations. r r' r, 71 UO-200-I0OCOt `} -=' l <...�: Y f I 1 7900:300-5000 _ Q_=--7" 2 ' 9 7 1OCr-200-13000-___ ;' I 0'100- OQ•..OQO -�� 7 rGU=?Oriti4002 ' 7`'Ci�3�{JQ=1000 7.100 200 I IUE,2'_ 1_ ? itOG-:000-•Ii800!," Ott:rira a, Montreal "80000:'100-20002 c. 11 i1}i'i-{rr)0 300 30+i01C' , ` -_ w'_ ..•r - 7--9 0r 01400 =dnO- 150-0- 01 0-300-7 000-- 10-300-7000.- ?') �. 7_QG-40Q00 I , 7 Ids7906,-WG,7G0G I J + 7900_400 3900079G01470•4,60W 0 6 _ Toronto7904 r•-f '7900-400-47.001:1t '- 0796'1 104 '1 4c G0 900 400-12.00079QG-r}00-33Grk, r cG- 'I 00 7r,,, •�0 150067900 •EOG-I'IOCiG , I 1.�.._._-- ��---I-- Alhan r, �' 'f 7966=•1u01130+007906 AGO IriiGO-a-�i 7966-400-4-3000 i-_._ D�hoit - Bwtat 900-300 32000 0790U--ILO0 1700 1 7c n � 4; rr-_ 7900.400-17G2u c� Esr'.hf��, uq��rmn. SCti.-- �---.- l;l rrti9den�� -a n-3 -�; 79R0 400 Ilntt� C+oSfJ �EIo�ILla1"P•�'drRL�eSi - 0; OC+ :, 000 „�t__7900 }_ ,� 7w }_ }n r Irk i 1 f' r _-J par�,4tJ��1,Esri Chins{ �r g 1�an�1,�Sr, Sctr Es:t�ii,WP,E.Garmin, 74'1)6 'GC+ 34100 7900-400-17008 o r) rt ( „Pittsbtugh ,a fCrs k,- L— i(7h�i`�t��+.12',��.� '1�------- Colunthuc USGGullir1L�Wtztp, INCREHE;;T 7gOn_1006-1,7 enSlreellh5� _Q is r' F, N0Car,E_ri Ja>ar., fc4E71, 7;9(l 500=35066 r 74x79004r � 0. 9520i1i+h`Q��l clnnalr Va tirtWs INc^g c ng). Esn. Part 1 /Question 7 [Critical Environmental Yes Area] Part 1 /Question 7[Critical Environmental Name:Peconic Bay and Environs, Reason:Protect public health,water, Area- Identify] vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 Part 1 /Question 12a [National Register of No Historic Places] Part 1 /-Question 12b [Archeological Sites] -Yes Part 1 /Question 13a [Wetlands or Other Yes- Digital mapping information on local and federal wetlands and Regulated Waterbodies] waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15 [Threatened or Yes Endangered Animal] Part 1 /Question 15 [Threatened or Tiger Salamander, Piping Plover Endangered Animal- Name] Part 1 /Question 16[100 Year Flood Plain] Yes Part 1 /Question 20[Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 1 Board of Trustees Appli `,ion AFFIDAVIT a q° 4.),lk! . a^1M c�e— "LLL— BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Sign a of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF , 201_ DEBRA N fMER Notary Public State of New York No.01146225827 a u Qualified in Bronx coup Term Expires July 26.20 ^� Board of Trustees Appli :ion i AUTHORIZATION (Where the applicant is not the owner) I/We, a y a w c n cQ i&„"na,c.e_ u-L G'�a 414"t 13ef K s-fcc� owners of the property identified as SCTM# 1000- -71 - -11 . in the town of 4 New York,hereby authorizes --r �q to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property/owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF 20 DEBRA N MNER Notary Public State of New York No.01 VJ6225827 No P lic Qualified in Bronx Count Term Expires July 26,20 APPLiCANT/AGF,NTrR'EPRESENTATIVF, TRANSACTIONAL DISCLOWU FORM le 13UM—OS-0 The Towu of SoutV de mformahon which r alert the town of OW Its conflicts of tossibie coerest oil nflicts of ie Par[Of nterest awn nd allow t to take whatever laction s this farm is tO r� necessary to avoid same. YOUR NAME: !s C r1% s,-f e,r1 Ate.✓x (Last name,first name,*iddle initial,unless you are applying in the name o 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.) Building Tax grievance -- Trustee Variance Coastal Erosion Change of Zone Mooring Approval of plat Planning �— Exemption from plat or official"map Other (If"Other',name the activity.) Do you personally(or through your'company,spouse,sibling.parent,or child)have a relationship with any officer or employee D D the Town of Southold? "Relationship''includes by blood,rraarriage.or bushmss interest."i3usiness interest"means a business, including a partnership,in which the town officer or employee Ens even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5�/�shares. YES �_- NO if you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the appiicant/ageni/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (wite7 the applicant is a corporation); I3)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 1/0 Submitted this d y f 20� Signature Print Name �'A A"( ye Form TS I APPLI .rA 7 1l/AGE 3/REPRF,SEL A A Y 1 7 Sia TRANSACTIONAL IDIS CLOSUM P®I3M The Town of Southold's Code of Ethics rohibits conflicts of interest on the part of town officers and emuloyees.The purpose of this farm is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: _ P0. "�" w.n�C, (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other',name the activity.) – Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant(agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the appliePt (when the applic.utt 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 oqq day of At 201 Signature �— Print Name �' N Form TS 1 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS IIPTS Name: Address:' SCTM#1000-71-2-1.1 SCTM#1000-71-2-10 SCTM#1000-71-2-11.3 SCTM#1000-79-4-40 Harbor Lights POA Theodore J Jr& Kathryn K Bucci Simon Living Trust Rose, Dina PO Box 1327 200 Harbor Lights Drive 5 Lucille Lane 355 Windjammer.Dr. Southold, NY 11971 Southold, NY 11971 Old.Bethpage, NY 11804 Southold, NY 11971 SCTM#1000-79'-4-39 SCTM#1000-71-2-11.4 SCTM#1000-71-2-20 SCTM#1000-71-2-11.5 Nilliams, Robert&Williams, Margaret Harbor Lights POA Douillet, Nicole Theodore,J Jr& Kathryn K Bu( 100 Baker Court Ct #4 PO Box 1327, 125 N 101h Street Apt N3D 200 Harbor Lights Drive island Park, NY 11558 Southold, NY 11971 Brooklyn, NY 11249 Southold, NY 11971 SCTM#1000-79-4-8.1 SCTM#1000-71-2-19 Zara, Leah & Kasnia Richard Douillet, Nicole Street Apt N3 ch th 10 W. 74 Street #7F 125 N 10 STAVE OF NEW YORK New York, NY 10023 Brooklyn, NY 11249 COUNTY OF SUFFOLK Jeffrey Patan)o , residing at P.O. Box 582, Bohemia,NY 11716 being duly sworn, deposes and says that on the S day of November , 20 18 ,deponent mailed a-true copy of the Notice set forth in the Board of Trustees Application,directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were availed at the United States Post Office at f5 o h t,".— , that said Notices were availed to each of said persons by ECIEIRTI MI ED NAI[L/)RIETU RN REC EILPT. Sworn to before me this—0 Day of 1 - 20/ f MARILYN S. HICKS r®t ' public NOrARYPUBUd,STATE OF NEW VOW - Registration No.01 HI6365469 Qualified in Suffolk County Commission Ex ires-october i Q,2021 1 I 1 ® a I f ® ® s a t3 ® e Ln Cc 43 "� D • Fl R 4 t°'ax o •E °, o • t f, f, �x I rt,. iw r i fid �( t.: t1 C" Ia � k r I b a CO = CO Certified Mad Fee i Certified Mad Fee ,i Ln $ Off` u1 $ _-r - Extra Services&Fees(checkbox,add fee as appropriate) Extra Services&Fees(check box,add fee as appropriate) ® ;_ J' ❑Return Receipt(harrloopyi $ y I ❑Return Receipt(hardcopy) $ sx_ (� 4 '/AqV, = �, O ❑Return Receipt(electronic) $ - JUN -POSTO,s� 0) , J O ❑Retum Receipt(electronic) $ Posiiww p•-+ O ❑Certified Mall Restricted Delivery i$ Here 1 O Certified Mall Restricted Delivery $ ',' Here �O�J C '- ❑Adult Signature Required $• ( O ❑Atlutt Signature Required $ - ❑Adult Signature Restricted Delivery$ ' ❑Adult Signature Restricted Delivery$ 'Postage [/� Postage' .. w „ / -\7 Q' $ �^�PS jEr,1 M Total Postage and Fees____ O Total Postage and -- - - • -�_ _. _ -- - -----=-------------- $ SCTM#1000-71-2-19 m $ SCTM#1000-71-2-11.5! w sent To ca Sent To 1 to , Douillet„Nicole.. .. to ' Theodore J Jr& Kathryn K Bucci 0 StreelandApt IVI j p -I�eetandA t IVa n I r- 125 N 10th Street Apt N3D r%- 200 Harbor Lights Drive CrryI I 'sf{e;2�PW Crry;siare,"ziP+4 Southold, NY 11971 Brooklyn, NY 11249 .DD I :DD I � m ® ! D s s ` D■ - d a p i p D f '•1 j z I fil^ti 9 Y1 (E £ 77 r `I] e • rl s® r a i ! �j i �wtx L z1 ;' �9 F°t �1 ru Co Certified Mad Fee FM r C13 Certified Mad Fee �r Extra Services&Fees(check box,add fee as appropriate) a� = =Y ' � Extra Services&Fees(check box,add fee as appropriate) O ❑Return Receipt(hardcopy) , ,$ ❑Return,Recel p L I E3 ❑Return Receipt(electronic) $ ® a Pt(hardcoPY) $ Q Stcrl�Ki®� O ❑Retum Recelpt(electronle) $ r J Q ❑Certifled Marl Restricted Delivery, $ °' Here i CI Postmark J % 1i Return Mail Restricted Delivery $ Here ❑Adult Signature Required $ O ❑Adult Signature Required $ []Adult Signature Restricted Delivery$ '•� ❑Adult Signature Restricted Delivery Livia, - 0 Postage ®.�p Cj 'Postage Er 1 O Total Postage and` - - - _ - "" O Total Postage and M $ m,.$ - - Sent To SCTM#1000-71-2-20 sent To SCTM#1000-79-4-40 City$fate; Douillet, Nicole I a Rose Dina p Street and Apt No. J C St�eetandApt IVa r` 125 N 10th Street Apt N31) I r%- ty_ 355 Windjammer Dr. ZIP+4® C� ,State-Z%P+4! Brooklyn, NY 11249 Southold NY 11971 ' ®DLO A Cc rD .a � Certified Mad Fee � Extra Services&Fees(checkbox,add fee as appropriate) ❑ Return Receipt(hardcopy) $ 0 ❑Return Receipt(electronic) $ lUN O- ❑Certified Mail Restricted Delivery $ eJ POSfitarK ; E-3 ❑Aduk Signature Regwred $-- Here ❑Aduk Signature Restricted Delivery$ - O Postage )r $ 66 C3 Total Postage and Fees rY 1 $ - co Sent To SCTM#1000-79-4-39 p St�eetandApt No Williams, Robert&Williams, Margaret r� . City State ZIP+�I 100 Baker Court Ct #4 - - Island Park, NY 11558 � Jl_ j ° { ° • 1 7CERTIFIED IV,IAIL'5 RECEIPT 171Ismestic • /o • I117 „.-a• [',:..za { IQ Irzx xaa i '"� •.5xa", • ( y, §p§,, r^i j' 33 e ! t, {• z • e } .rd li ea L JM Certified Mad Fee Certified Mall Fee Q $ __ _4. � Q Extra Services&Fees(checkbox,add fee as appropriate) 1Ayic� Extra Services&Fees(checkbox,add fee as appropriate) �---- __ - �I a ❑Return Receipt(hardcopy) $ .r r `= � A N ❑Retum Receipt(hardcopy) $ o 2019 A n.( ❑Return Receipt(electronic) $- POS ' RReturnQ Receipt(electronic) $ ® POStr ydu q®1 J Q E] p� t� a j ❑Certified Mall Restricted Delivery $ Here, Q E]Candied Mad �Restricted Delivery $ ,u{'t Her Q -,-- i []Adult Signature Required $ Q ❑Adult Signature Required $ Q []Adult Signature Resincted Delivery$ ' E]Adult Signature Restricted Delivery$ Q Postage Q Postage M Total Postage and --- - ,U�� - - i co Total Postage and �- — — — - ----- w sent To SCTM#1000-71-2-10 I co $ ent To SCTM#1000-71-2-1.1 ra Kathryn Q I Theodore J Jr& Kath K Bucci Harbor Lights POA [� StreefandApt:No: p0 BOX 1327 Q Sheet an�IApC No. r- 200 Harbor Lights Drive I cr sura;ziP+a� Crry"S[afe;Z/P+4a Southold, NY 11971 I ry Southold, NY 11971 Me ° • ® ® A O ■ ■ i co I. Only m Er „, Lt. Y Certfied Mall Fee M Certified Mad Fee u 1 $ �Ov 11-11l $ ' �I Extra Services&Fees(checkbox,add fee as appropriate) Q [I Return Receipt(hardcopy) ,$ ,� ' Extra Services&Fe es(checkbox add fee as appropriate) '•° Q ❑Return Receipt(eiectronle) $ �r ol/Cyn 1 ❑Return Receipt(hardcopy) $ ®� .- "'" �9+!7 w 1 rU ❑Return Receipt(electronic) $ - -' ,\;. j Q ❑Certifled Mall Restricted Delivery $ Here Q Q ❑Adult Signature Required $ ' El Certified Mail Restricted Delivery $ Q �� Q ❑Adult Signature Restricted Delivery$ Q []Adult Signature Required $ ❑Adult Signature Restricted Delivery$ Ig 0) r3: Postage ®� Q Postage Q' $ f� i M Q Total Postage and ------ --"'-_-�� � Total Postage and '� $ v MSent To ' I SCTM#1000-71-2-11.4 ' $ SCTM#1000-71-2-11.3 i ,�� Harbor Lights POA. ra sent To Simon Living Trust Q Sf�eefandApt Na g Q SfieeiandAli W PO BOX 1327 5 Lucille Lane Southold NY,11971 �Crry;sta"re;ziP+4� Old Bethpage, NY 11804 ! - ru I o • r` co •^tM .Zp a E) VY.."..".i I )F nJ I c[3 Certified Mad Fee Ln Extra Services&Fees(checkbox,add fee as appropriate) 7 ❑Return Receipt(hardcopy) . $ Q ❑Return Recelpt(electronic) $ Postmark= i OQ ❑Certified Mail Restricted Delivery $ re w Q [I Adult Signature Required $ i r! �9 i ❑Adult Signature Restricted Delivery$ I Q Postage = O" $ Q Total Postage and rt"I I $ ep Sent To, SCTM#1000-79-4-8.1-" ra i Q �Zara Leah & Kasnia� Richard Street and Apt IVb � r` 10 W. 74th Street #7F � City State;ZlP+4a - e e New York, NY 10023 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: 0-0 7`/ STATE OF NEW YORK COUNTY OF SUFFOLK , residing at , being duly sworn, deposes and says that on the day of I 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said person's as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of 20 Notary Public 1l June 13, 2019 Town of Southold Trustees ® E C E 0 V E Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 JUN 1 7 2Q19 Southold, New York 11971 Southold Town RE: 240 WINDJAMMER DR. -SOUTHOLD SCTM No. 1000-71-2-11.2 AFFIDAVITS --- Dear Trustees: Attached, please find affidavits for posting and mailing as required for public hearing. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, J rey Patanjo P.O. Box 582 Bohemia, NY 11716 Michael J.Don President O�QS '�eln Town Hall Annex John M.Bredemeyer 111,Vice-President �� yJ, 54375 Route 25 Glenn Goldsmith ti a P.O.Box 1179 A.Nicholas Krupski a 7 Southold,NY 11971 Greg Williams 4y p� Telephone(631)765-1892 �0� a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ------------------------------------------------- ------------- In the Matter of the Application of 240 WINDJAMMER, LLC COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DA YS PRIOR TO THE PUBLIC HEARING DATE I, Jeffrey Patanjo , residing at/dba PO Box 582,Bohemia,NY 11716 being duly sworn, depose and say: That on the 0 day of June , 2019 , I personally posted the property known as 240 Windjammer Drive, Southold. SCTM# 1000-79-4-8.1 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, June 19, 2019. Dated: 6 W 11 (s'bnatt e) Sworn to before me this 0 day of June 2019 MARILYN S.HICKS �� NOTARY PUBLIC,STATE OF NEW YORK Registration No.01H16365489 Notary Pt 1 is Oualified in Suffolk County Commission Expires October 10,2029 NUTILL Uim HL: AKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD : 240 WINDJAMMER, LLC SUBJECT OF PUBLIC HEARING : For a Wetland Permit to remove and replace pre-existing ramp and float with new 30" wide by 16' long aluminum ramp, and 6' wide by 20' long floating dock with un- treated decking situated in an "I" configuration, supported by two (2) 10" diameter CCA piles. Located : 240 Windjammer Drive, Southold. SCTM# 1000-71 -2-11 .2 TIME & DATE OF PUBLIC HEARING : Wednesday, June 19, 2019 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1692 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 Mon.the coastal area(which includes all of Southold Town)._ 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will _ affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be Mlained in detail, listing both supporting and Ron- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 71 PROJECT NAME S 4 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: AA& r!!j[&ea Pre -x-X[sfi�►y �o �. e,,r�cQe tc l� � Lon y 61 �v�r+inyr.. tteen�P (o `&Veale %e 2®` L®ny 00411A �o944- �,.L�n redtteO GQt soD 0rttip �✓� E'L� a — le" ¢ eft fJ. ��i 1 Location of action: 2`l o w ti& ,,.,/ e2 �/L - 5�•• 1�A Site acreage: '� s Present land use: Present zoning classification: d-t-S' 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: aq o w L n&R J d~X� e C U-/— o Ata (b) Mailing address: o SS w. 7 3.1 61 Sr- - S a-&"c 5-0 ^New q.21t+ /►�� ��� 'S (c) Telephone number: Area Code( ) L - a -7 t --7 3 3 (d) Application number,if any:` Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes FrNo❑ If yes,which state or federal agency? "`I S Q E' 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 amswers 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 I NVRP Section III-Policies; Page 2 for evaluation criteria. EfYes ❑ No [:] Not Applicable PX01ezA a. k R.c,�l4c�.r,u.,•� aDF �t � �-ri vQvc.�L Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the 'Town of Southold. See 1[WRF Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No P IiTot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See I,Vh RP Section All—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No � Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See IJWIiP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No E]- l-ot 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 LVVW Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ Yes No P _ _ applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the ToWn of Southold. See LWR? Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No[J"Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wasKt esSee LVVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. El Yes ❑ No Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal wagers, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. a YeO leo❑ Not Applicable Proite,4 Gd oi+t a a-va lA ce eJS -e,® w m t'e.c_-s A w e'o Oro C'V�r n t_ Attach additional sheets if necessary WORIaNG COAST PC ;IES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. Fly.. ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No E�iNot 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 ONO 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 �' �'� w ^� TI'T'LE fl ye nDATE April 30, 2019 Town of Southold Trustees E Q V E Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 MAY 3 2019 Southold, New York 11971 Southold Town RE: 240 WINDJAMMER DR. -SOUTHOLD Bar ofTius o s SCTM No. 1000-71-2-11.2 APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Ve trul ours, J rey Patanjo P.O. Box 582 Bohemia, NY 11716