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Michael J. Domino, President opo oo� Town Hall Annex John M. ,,Bredeme erIIIVice-President yam` y t � <� 54375 Route 25 Glenn Goldsmith H x k P.O. Box 1179 ♦Y �A+ A Nicholas Krupski y • ol�,�;r Southold, NY 11971 Greg Williams ��( ,� ��;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 Whenro'ect complete, call for compliance inspection; p J TERMS AND CONDITIONS The Permittee Peconic Land Trust, at 36960 Main Road, Orient,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 '�\rjf soo Town Hall Annex V` y John M. Bredemeyer III,Vice-President 54375 Route 25 O l0 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski Telephone(631) 765-1892 Greg Williams �Q Fax(631) 765-6641 c4UNT`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 19, 2019 Bruce Anderson, President Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932-2003 RE: PECONIC LAND TRUST 36960 MAIN ROAD, ORIENT SCTM# 1000-20-3-6.2 Dear Mr. Anderson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 19, 2019 regarding the above matter: WHEREAS, Suffolk Environmental Consulting on behalf of PECONIC LAND TRUST 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 14, 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 issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on 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, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVE the application of PECONIC LAND TRUST to construct a 144sq.ft. public-viewing platform with attached 457.5sq.ft. access ramp; and as depicted on the survey prepared by Peconic Surveyors,.P.C., dated March 12, 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 r MJ D/dd rxu� fy �%\IfF0( Michael J Domino, President �o� . oG� Town Hall Annex John M. Bredemeyer, III, Vice-Presidenty 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A Nicholas Krupski ,y�jo ao! „ Southold, NY 11971 Greg Williams " � �`err Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: PECONIC LAND TRUST c/o SUFFOLK ENVIRONMENTAL Please be advised that your application dated May 14, 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. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50 00) 1st Day of Construction ($50.00) '/z 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 e4l,l " BY: Michael J. Domino, President Board of Trustees • SURVEY OF PROPERTY 1 - AT ORIENT y.� TO WN OF SOUTHOLD P%;oeBpNNING 14AY 14 2019 SUFFOLK CEJ UN. T Y, NY J• 1 COORDINATES FROrII �+ NEW YORK STALE PLANE COORDINATE SMMW 1000-20-03-6.2 l \� LONG ISLAND ZONE SCALE: 1'100' APPROVED BY JULY 24, 2015 Q0 �5��5y? ti�5' Ck a BOARD OF TRUSTEES JULY 30, 2015 (REVISIONS) TOWN OF SOUTHOLD APRIL 9, 2018 (WETLANDS FLAGGING) SEPTEMBER 12, 2018 (VIEWING PLATFORM) DATE :�WF I Q 201�f SEP TEMBER 26, 2018 REV. WEW/NG PLA TFORM oe°op" - ? MARCH 12 2019 REV. RAMP TO PLA ( TFORM) os �o POND �y �O \\ POND 11 \1 �1 rO°� ��ST oN F°15 � r` 7 PEc°"'� Geo cp G i K/O � oD • od RAMP o PLATFORM To '1756•W , S -01 PROPOSED 12' X 12' � `a NIEWNG PLATFORM � .55 KEY C2 X = REBAR ® = KELT. • = STAKE e = TEST HOLE L %. • = PIPE ■ = MONUMENT = WETUND FLAG LANDWARD EDGE OF nDAL WETLANDS AS DETERMINED BY SUFFOLK ENNRONMENTAL CONSULTING INO ON JANUARY 29, 2018. nFTm�TO: /N OBER 1161 PAGES 5,7, 54, AN UNDEVELOPED PEDESTRIAN RIGHT OI`"ACCESS �;:. r- r r �aTOWN OF SOL}17/ 10 THE SHORE OF UTILE BAY fOR THE BENEFIT OF 7H OWNER, HORS tp�h fir r ;t` SUCCESSOTS AND ASSIGNS IS MEN77 NED. THE LOCA77ON/N NOT DEF)NED AND ��,'PECONIC 1D ZRUSt CORPORATED THEREFORE NOT SHOWN HEREON. IN j `t ` !' dNA IN OBER ff3O9 PAGE 529, A 15 FOOT R1GHT OF WAY lO NYSOEC/S MENnONED. NA 7R�ST INSURANCE COMPANY� ; THE LOCAnON IN NOT DEFINED AND THEREFORE NOT SHOWN HEREON, DEVFELOPMENT RIGHTS EASEMENT AREA 70 BE ACQUIRED BY THE TOWN OF SOUTHOLD = 99,930 SOFT. OR-2O.935O ACRES ANY ALTERATION DR ADDInCN TO THIS SURVEY/S A VIOLAnON 1TI.Y.S LIC. N0. 49618 OF SEC7ION 72O9OF THE NEW YORK STATE EDUCAnON LAW. PROPERTY AREA = 991,930 SO.FT. PECON� EXCEPT AS PER SEC77ON 7209-SUBDIVISION 2. ALL CERTInCAnONs `� c:SUR VE yoRs, P.C. HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF OR = 20.945 ACRES 631)76.55-'5020 FAX (631) 765-1797 SAID MAP 014 COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR SIGNATURE APPEARS HEREON 230 TRAVELER STREET WHOSE SOUTHOLD, N.R 11971 TRE15 158 1 f t MAY 1 4 2019 � 1 � 12,_0" 10122 Slope Ramps used as,pert of a means of egms&shell have a running elope not deeper than one ung vertices In 12 ural"hnrimntal(8-percent slope) The slope of other pedeshl temps.hal not be steeper than one unit vertical In eight unite horizontal(12.Spercent slope) 20'-0" 1012 4 Vertical Rise The rise for any romp nm shall be 30 Inches mexlmum to1z61math and Capacly 0 15'-0" 5'-0" Thaminbnumwldth end mqubad capacity of a means of agrees mmp fV - 6/4'OECIONG fTVP1 shag be not less than that required for conMom by Section 10202 The el 6(hem grade) clear wldin of a ramp between hand.H.,If praNded,or other permissible pmfeclone shell be 36 Inches mWmum. 1012.6 Landings Ramps shell have landings at the bottom and by of each mmp,points of turning Lendings shall comply with Sections 101261 through 101265 4r-0e T-0" 112BsoPE 1012 6 2 Width The lending width shall be not lees than the width of the widest mrnp mn adjoining the lending LANDING i0 101263 Length e1375 The lending length&hall be 60 Inches minimum. _ 1012 7 Ramp Oonswclan Ramps shall be built of materials wndetent with the types pemdtted forthe - RAME type of construction of the building,ascept that wood hendmis shall be 112 SLOPE permitted for all types of construction 1012 7.1 Ramp Surface I The surface of ramps snail be of elipaesistant metorWs thet ere saaaey attached LANDING .125 101210 Edge Protection � N Edea protection sde of mmp rune and eith tch aide or ll nWNea 2 shel he provided an each ZD eAme 1014,2 Height tD Handrall heleht messumd above finish suria.of rorty slope,droll be udtorm,not 1.12 SLOPE lase than 34 bid—and nat mora than 36Inchee 1014 3 Handral Gmspabdity 10 Required handralls shell mmplywithSection 10143 1 or shall pmvido equivalent LANDING gmspablity, eI 125 10143 1 Typal Handmlls with a cl—lor=.a section shal have an outside diameter of not lase then 11/4 Inches and not piaster Nen 2Inch..Whom the handrail la not d—lar.It shalt Car 0(grade) Q IM have.perimeter dimension of nm lase then 4 inches and not greater than 6114 Indies N '` 1.125LOPE with a mashnum sass-sectional dimension of 21/4 inch and mWmum crass--U-1 domnalon of 1 Inch Edges shall have a minimumredds of 0 01 Inch 5'-0" t E[9 l f Michael J. Domin t o�pS0FOI)r Town Hall Annex John M. Bredeme er III ice-President ` 54375 Route 25 Glenn Goldsmith o ' P.O. Box 1179 00 z A.Nicholas Krupski %�b Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 6 �Y q Completed in field by: Suffolk Environmental Consulting on behalf of PECONIC LAND TRUST requests a Wetland Permit to construct a 144sq.ft. public viewing platform with attached 457.5sq.ft. access ramp. Located: 36960 Main Road, Orient. SCTM# 1000-20-3-6.2 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 d Ch. 111 SEQRA Type: 1 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: �J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other IL PECONIC LAND TRUST Property Situate: South side of S.R. 25 • Orient ■ New York SCTM 9: 1000 - 020 - 03 - 006.002 SITE SITE PECONIC LAND TRUST Property Situate: South side of S.R. 25 ■ Orient • New York SCTM #: 1000—020—03 —006.002 (Photograph taken on October 18, 2018) t o_y pct" Jn S�d xi r J f c`}* $°�$i"`rad.d sp° a�•z t '� YZFu P . l / d s Photograph indicating the staked out location of the proposed Public Viewing Platform within subject property. Photograph taken from the southerly section of the property, facing west. PECONIC LAND TRUST Property Situate: South side of S.R. 25 • Orient ■ New York SCTM #: 1000—020—03 —006.002 (Photograph taken on October 18, 2018) p�• ^ r� •' l�r. i�' ` fir t,:r ,..-" .*�,� c d � � "4141 t y "a1y ,�., rq � '�at; _ Y,�__.✓�4� ����':k.!"3.�iiiK:•. -- �dg e. w .•�!� � .��a cl��.�v'�f',�>t�%�s'�i �:4. Photograph indicating the staked out location of the proposed Public Viewing Platform within subject property. Photograph taken from the southerly section of the property, facing west. AMP PECONIC LAND TRUST Property side , • York 000 006.002 • (Photograph taken on ctober 18, 2018) ti t; u :t •' s � � r !'ter♦ .'� . r Photograph indicating the flagged wetlands boundary (circled) within subject proper. Photograph taken from the southerly section 1f the 1roperty, facing west. PECONIC LAND TRUST Pr Situate: South side of S.R. 25 • Orient SCTM #: 1000-020 - 03 - 00 . (Photograph takers ori October l8i, . ''^ y+. ..}Ye • '.kyr-'S�'' ^ }.�`yy'y f' Z d V. tea/ 6 Via^ e h �.',iA a ��� �\`E.�,�♦ � w!AM 4'.r, 41m a!'`k; ►F �� � fWq) !•''f x �Sr�', yN r `,$` t ����4 .��`1,. 7�`�..,�p.-*l�f'k�,,A�1f� ,,r t., ;�k y �rry f '�v rMA * i l-, a • l • • . • t { }�.A3 ri d sP ': Kra �:�, dk•.P , t v r ar�� 1 oa r F . o t jf �t • m b { �1 indicatim; the flacl wetlands bounCi ly, F c reled� ithiri subject ,property. Phot% raph taken from the southerIv section of the pi-c>Pe t%,,-facinc t le creck—to the cast. PECONIC LAND TRUST Pro ty Situate: South side of S.R. 25 • Orient • New Y SCTM #: 1000 - 020 -03 - 006.002 + (Photograph taken mi Octo bcr :18, 201S) t r r llvIt 14 i Y Tk 1 a �. } ,+ .1 �� � �`., iii •�..-?f� �'„ '�� + a .�. o `ndicatit �'the Hagg F ( ' in subject grope t r t f the proper V.IaCIIIKwest. PECONIC LAND TRUST Property Situate: South side of S.R. 25 ■ Orient ■ New York SCTM #: 1000—020—03 —006.002 (Photograph taken on October 18, 2018) w ' WWI � xy "Y Vl`Ry t 14..! � ,� ,�F` �q`}.�*��• �� � �•� y U k�,y,S r��, e' k �.1, vl t ✓w a } q� +�y"►��'� ,v .t�,4�' � �„ �; a,�. �1�,�r ` �"` s�_ ,fir r . y CAN, 'iso Ole,, t� a �p i s Photograph indica1� . ws� g A • (circled) within • i J' • • !,� • •• • Il o00 w rvr Hr yr a*Eo scn. „t M ab u n m �A o m...r rzt N•t °+'� ror.r _— '' s ..-, PROPEItTy 1NP SEE SEC.W.015 (I^ a8 R• \� � ,2.1 oET�xT Z��mvmoi0 rtlSiOaFM Ir+/Iy � � •\\ `\ i p, s• \ 13 aA �\ N ,5 3.10 ].t 16.M•, O S.aNcl 1,1 x ,.�� sa 13 412 MAW �\ Mp, 72 N � J x. o ,; az LM % � I S L.�.. .Wq. 101A �y � L F01, � PMCEL � SEE41.3 wT1Nc) � SiA]E OF q L— WT7C—. H w SEE SEC.NO Oa COUNTY OF SUFFOLK © K " ,s ,a,,,,, �pLD secrror+Ro NOTICE E e — — ur r pt) O .-•,- --•-- ^—°- Real Property Tax Service Agency Y ,w,,,oE„ 020 G ,��, _ e,ru. --,•-- e..u.--,.,-- wmv c.crr Rl..,nue.Hr,ttn m� oa E F ,a oarunro t000 PROPERTY MAP HD .. • �` --•-- sr,r--w— w xcr "�!1°y a,N•1 PECONIC LAND TRUST Property Situate: South side of S.R. 25 ■ Orient ■ New York SCTM #: 1000—020—03 —006.002 (Photograph taken on October 18, 2018) ,,gibp Stf �yYY Photograph indicating the staked out location of the proposed Public Viewing Platform within subject property. Photograph taken from the southerly section of the property, facing west. PECONIC LAND TRUST Property Situate: South side of S.R. 25 ■ Orient ■ New York SCTM #: 1000—020—03 —006.002 (Photograph taken on October 18, 2018) � � � ♦r < x P4 x w A • � cy; "i _ n, -"� 7 rj,,' .. r• t �� � Ff A_ �� .rI s 61, Jr Or t g �� `Y '�. S L N >�. '� !' �+W' ,f�•�;''.r .,y i lc�"L.. :3g' r i'g t.: 'G 'M'p K x. • f Y Photograph indicating the staked out location of the proposed Public Viewing Platform within subject property. Photograph taken from the southerly section of the property, facing west. PECONIC LAND TRUST Property Situate: South . • Orient 000 006.002 • (Photograph taketi on ctobcr 18, 2018) b s, -47 q i r" Photograph indicating the flagged wetlands boundary (circled) within subject property. Photograph taken from the southerly section of the property, facing west. Ap ECONIC LAND TRLIS . ' Situate: South side of S.R. 25 • Orient' , SCTM #: 1000 - 020 - 03 -40 �` (Photograph taken t 0 t s ✓tie .-i f ;� 3 � . .� � � .�•. y r a � qtr e NO AL � s '.�c. ear # �„ � }r§� ,8k c � .' A. xlab "" v.; f !^ ' • .. ( � � :�+aa y. (,V1}ter' _ t+i: � may, i \ 4v Ilio ogra h indicating-the Hagg i Vtlands boundary (circled) to iii soblect propert',, 'Photog►r t 400 the southerly section of the prope ty, f lainglthe-creek, e ' PECONI C LAND TRUST Property Situate: South side of S.R. 25 . Orient ■ New Y SCTM #: 1000 - 020 - 03 -006.002 Whotograph to cu curl ncto bcr 18, 201S) • i, it µ s tia '� E • �� �� ��.r rA, r , ' '! , a i tea, :. � �' +,� ♦ ,' r J• � i a �� 'fad' - , '�T v • +Mk J � a `ndicatiri*"'the flagged ti { in siaect pi o DI+v v �- f the pro efacilwest. PECONIC LAND TRUST Property Situate: South side of S.R. 25 ■ Orient ■ New York SCTM #: 1000—020—03 —006.002 (Photograph taken on October 18, 2018) t W �d z i Al � R.;� .��• < �, (► � � " �� `I �.(moi R .'. Vi i �,�,�'`y�,� '""wa ,�. � t;�� "{��� �`� .► , {. ��� �.�,�f 'i9k� fig'' r� ',�., t�'!����#�`` �." r` ► � �+��r`'!c's� �� �1�MMMMM�-i4i11 V , 4*1 AL rjj- ✓ ., t �t�if ���� �A .��. ✓" i l 14 7f Photograph indic(circled) within s • 1 • • t . • • • . v 1 southerly • of ► e a t PECONIC LAND TRUST Property Situate: South side of S.R. 25 ■ Orient■ New York SCTM #: 1000 —020—03 —006.002 SITE SITE Real ,WW ... aearm vaso, oalm �? 12-12-0s see sec No.o,s A3,Ioe ,m WTCNzz-- ------zz-----IME o?9t I 3.0 x2 2.M � I a,o � C \ 11] \ IpE18O9B/l �. \. \ 1O1A(r3 ,. v az sa � 21.0yQ MAW J ` a;M21 / az t \ 1 T3\ jJ i SEE MC.NO y 1.3 MTAIQ O I , � SZATE oc �1 NEW'0-ry 2L WTd,—iZ--- li--•��—llE SEE SEG Mp 020 NOTICE cou Real Pr( p wry. a .. n,ya>,:u �— —__— o..� --•-- o...u.--...-- n Affix+ x Q OFFICE LOCATION: OF SOy® MAILING ADDRESS: Town Hall Annex �® lQ P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold,NY 11971 • �Q Telephone: 631765-1938 ®lyc®UNTY,� ' 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 14, 2019 Re: LWRP Coastal Consistency Review for PECONIC LAND TRUST SCTM# 1000-20-3-6.2 Suffolk Environmental Consulting on behalf of PECONIC LAND TRUST requests a Wetland Permit to construct a 144sq.ft. public viewing platform with attached 457.5sq.ft. access ramp. Located: 36960 Main Road, Orient. SCTM# 1000-20-3-6.2 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 on the new submittal and my assessment, the proposed action is recommended as CONSISTENT with the LWRP. 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 Og+�FFQ�+Y Peter Young,Chairmany 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., June 12, 2019 the following recommendation was made: Moved by Carol Brown, seconded by Peter Young, it was RESOLVED to SUPPORT the application of PECONIC LAND TRUST to construct a public viewing platform, 144 sf. and accessed by a ramp, 457.5 sf. Located: Route 25, Orient. SCTM#20-3-6.2 The CAC Supports the application using best management practices. Vote of Council: Ayes: All Motion Carried ToAm Hall Annex Michael J.Domino,President Y 54375 Route 25 John M.Bredemeyc ar III,Vicc-President P.O.Box 1179 'low York 11971 Charles J.Sanders New Glenn Goldsn-dth Telephone(6SU 765-18D2 A.Nicholas Krupski Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only MAY 14 2019 Coastal Erosion Permit Application X Wetland Permit Application Administrative Permit Amendment/Transfer/Extensio of �c Received Applicatioij: a,/ -/q Received Fee: 2-Q,--60— Completed Application: 5Zq.lq rP Incomplete: SEQRA Classificatio Type I—Type II Unlisted Coordination:(date sent) M AY # 2019 kl- 7 LWRP Consistency Assessme Form: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: hocrd of Trin–--- Lead Agency Determination Technical Review: le� Public Hearing Held. .17 lq Resolution: Name of Applicant Peconic Land Trust Address P. O. Box 1776 m Southampton • New York - 11969 Phone Number: (631) 283-3195 Suffolk County Tax Map Number: 1000— 20—3 —6.2 36%0 Property Location: Main Road (Rte 25) - Orient-New York (provide LILCO Pole#, distance to cross streets, and location) AGENT: Bruce A. Anderson - Suffolk Environmental Consulting, Inc. (If applicable) Address: P.O. Box 2003;Bridgeham.pton,NY 11932 Phone: (631) 537—5160 Board of Trustees Application GENERAL DATA Land Area(in square feet): 991, 930 square feet± Previous use of property: Vacant Intended use of property: Install Viewing Platform for Public Use. Covenants and Restrictions: X Yes No If "Yes", please provide a copy. Will this project require a Building Permit as per Town Code? X 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 X No If"Yes",please provide a decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? Yes N/A No Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): Applicant propose to construct a Public Viewing Platform (144 square feet) accessed by (457.5 sq. ft.) Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purposes of proposed operations: Applicant propose to construct a Public Viewing Platform (144 square feet) accessed by ramp (457.5 square feet). Area of wetlands on lot: 50, 000± square feet Percent coverage of lot: 6 ± % Closest distance between nearest existing structures and upland edge of wetlands: N/A feet Closest distance between nearest proposed structures and upland edge of wetlands: 56.4 feet (Public Viewing Platform) Does the project involve excavation or filling? No X Yes (footings) If Yes, how much material will be excavated? < 1.0 (cubic yards) How much material will be filled? 0 (cubic yards) Depth of which material will be removed or deposited: 5.0± feet Proposed slope throughout the area of operations: 0% Manner in which material will be removed or deposited: Construction largely by hand. 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): No impact to the wetlands anticipated due to substantial setbacks from the wetlands boundary, and the benign nature of the structure. Board of Trustees Application COASTAL EROSION APPLICATION DATA N/A Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) A ppendix B Short EnWroulkea-mal Astsessmew Form Instnictiorks rar Completing Part I -P rojoc't Information. The Appil-cant or proje-a sponsor Is responsible for the completion,Gr Kurt I. Responses bef;GrAe Par.orlitt wpplicoilon for approval of fwndiug.art subjecl to Public rear ww.and may be subject to rurilier veri-rication, Complete Pit'rl I bai ed on iol'boaMion cum'n1LN'4Y;1fl able. 11fadAiMl reseflt&OT investigation Avould be needed io fully rup*,A 10 any item,please aas,�ver as thoroup)dy as possible Lwed on current inrbrmeianl Coanpfelc ill items in Part 1. You may also proyidir any udditional infamatiGn whidi you I)clieve witJ be oe-c4cti by or usoruj to the[wd agency;oftitth m4dffivrial pages as necessary to supplement any item, PA rt I�Projictmkd Spains6r 16formuloin Name orArtion or PmJect: Peconic Land Trust Property Project t.ocalion(describe.m-4 zaaA a location okaft Main Rd. (Rte. 25) * Orient,New York • 11957 Brief Description of Proposed Action-, Construction of a public Viewing platform.please see attached plan for all Project specifications. Name a rApplFcant or SponsGr. Robert W.Anderson—Suffolk Environmental Consulting,Inc.. (631)-537 -5160 Robert Address, P.O.Box 2003 J SWCO: Zip Code: Bridgehampton, New York 11932 I_D=dic proposed action a,nly inwive-the lep,414five adoption of a plu,lo"M law,ordinarim-, 0 *1FS adralmi,strative rule,or regulation? If Yes,arm-ch a nur2tive description of the InteK Of1he proposed action and the emiroantiental resources that FRI D may be aflietted in the muRicipmlhy and proceed to Pari I Irmo,conilnucloqueslion2, 2. 15a7ej-- tine proposed amion require a permit,mppraval"tunding from any o4her sov4mimmal Agoncy? pib YES IfYes,list dgcncy(sl namt:and peTmit or approval: 3AL TWE amage of&4 site 617 the Prop wod fiction? Total stege to lis physicall --2D_q45—auu-4 b. y dblurk. d? <0.1± acres c�Talat acreage(projcci site and any comfigtious propertim)v%med or contro5) d by the appficAnf or praj-tef sponsoO 20 45 _.a,,.m 4Check all land uw, ;brat occur oro„Kohiingand near lite ptopmd action. MUtbaii 0 Rural L314ilmstdal Olboramtr;ifal KIResideniial(subuiban) 0170rest MAgriculture QAquatic Q01her(specIfyi, Page 1 of 4 5. l's the proposed actiod, l(o 4L A pern,ittcd use undee the zaaiinp,rceulations? b,Comiileot.wsth the adopled cortapreehemsiye plarsl 6. is the propascd a6on wn'5 stent ww hh llrre predoati inarti daracter of the eatisting bui'll:m--nmtural NO VIK' lnodsca,ptQ X Is the site of the prapased aixfon locdted in,or dots ii-,Wjoia,a state listed Critu-ml F-nvirohaiclitttl Arca? N If'Y Ce idend6'. JLoLig Beach Bay ' - X C a-Will t3 a purposed action ri:suli in,a subskentiel incsczc in traffic:4hovv,-preient leets! NO- ` M . b.Are public trinsportaiiair of or near the site ar the proposed action? (� c.�,re eay'pea4esir`ian a cca..mma�dstions far bieyele ro4tl ovail-ibie on-or bear site ofth ropow F oclion? L_� qw Bods the prQposcd actian`mec-i areXceed the slate�itfgy NO YES" I t t1w proposed aciiarr w!I I exEced requirernenlF,4escti4c design feamms storm`l hno0giesm 10. t''iil titiz pro,pose i action c6nnecd to ani 6xtstinj pubWprivate water sulpplyT NO YES If No,& ribo inedwd for providing polable water:�.N/A Public Viewing Platform l 1. V/ill the prolpo.5e4,antion connecu, t!tiWin vvaslet"tir Wi itf ? M0. 'VE-5_ It No,describe method for providing wastewater trealment. N/A Public Viewing PlET atform 9�'j l a.Cyacs t5oc site c ntalaa a sfxuctuie`tlaat i. lista eitl q tkrc taie grr h aki nal ltcgister of Hivtrasie NO I YES`. Places? b.is the propoed action located in nn archc[ological sensilivo atea? , i 4.a.001:3 any portion®l the siia N0 VEL . �yw 1rvtds or ocher ewa1erb odies rcgula rt d by n f aleaal,sinte or IoM a eney? br WDina th.,proposed action 47hysimkll� alter,or encmach irons,any exlstia wetland o�wbalerbody9 Cryes,lid&Wry the wtiellsrad or wwer avd otcient ofalterMioaz in square feel ar acm, Q] 14. Identify the typi t'hibilot types that nccaron,'or are lit ely°to be f6wnci on&jarvjert shier. Check SR that-opply Whorcliv-- 0rurest landsBird xnid-svicce}isioi K) '4ttealEgnd 0Urban ®SatDurban 15.Docs shc.sild of tirp pm06_scd"ion wntairt any spt4ies of animal.or imsectaled It-abitats,l istaby the Bugle or Federal govern mems as thceateaed or endaragated? I&is the pii3�eei�Ft�I'ocsited in the 1 ryll y ear f[aad,plain? � YE TIM17,Will the pcbpsed aceloh erLatL tastti water clisch rgc,either lrtfen polrat arrtoa €rat carr os x.�. N . YES l l'r'css a�Will sum grater diachngs flog to ad ace--ttt properties? NO ONTS ElX b,Will'strart`ri wniei JighoTeigs b-&'diteoed to esiabl;ishtA conveyance systems(runoff and storax►dr.unsp if Yes,bri�:il}dese'tibe: Eltats dyes i Page 2'o!` 1 .lees.tate p-tap ed action inctude cmaitruetion or o(hef acriviiies iital result In the impoundment of t ° ��rater or rather liquids(e.g.rete.ntion pond, waste lagpkm,dant', 1f'des,expIaifi pur��e and sI ze 19-l the is Of tier opo d action of n inin A pert,bee tits( ti n€� n ai tiara�r rl ANO YE solid Wasic manage-men',facility? (i l'Yes,de-scri . 20_Has the silt of tibe pr9pwd action or all ft joilaino proptoy bein the avlbject orrem diation iaa inn 0r NO YES, cgmpfetedj for hazardous waste? If Yea,d 9 Li I AIFFIRqMg '+�T��*AT THE ItNFOR��ATION MOM)ED Al!OVE IS' AUE ATPD AC��)i��T _6TH ��i �� �� \I����F9..A�l:�i_i WT 9:t A ppiir�aa�rl ouil or Robert W.Anderson-Suffolk Environmental Consulting Inc.. Date, O A()ZOO 'Port 2 a I'm lin et Assessment. The Lead Agency i�rw4ponsible dtar the completion rar Par rt 2. Answer alI of the foliowrn quesdons in Part 2 using the it'tfmiation contained in F'3rt 1 aild oth W rtmaWS su-m itte+d by the project sponspr oa otherwise availablc to the mvie ver. Whep arrstvcrinp the quiations ilte t imkIer�hould Im guided 6y die concept`Have,my respo su been ressonable considering,the scale,ard coa QxI of iltt propowd Miura?' l dw a r Itlo&rate 510211 to 1 argc itrtExam Itaaptrct may tnaa' occur aa';Cur 1. %VilI the proposed Taction create at material can:tlic.t.with an adopted farad ease plait ct zotl Ing (� megulatlons`d L� 2. Will Elie propQscd adlaii mult in o+alr„trige in llae use or rntengiky of use of land? 3. Will the pay ed ac6oa impair the.claatrme-r or qu:314 of the existing cctrtaaat ttibily? k' 1ra RI ilia pwposed rtcdon hams on im-plat ai1c evirontuowal characteristics first caused the Wblishmoit olfa Critical Envrirontn*nwl Area(CEA)?- 5. CEA)?5. ,Wilt the proposed action resutt taiCN-Ontl dl[M&in the OgisAirlg litV0 Of tralrIc G1 � M affcet exisliatg intlastructura=for m=transit,hWag or%v;5lkway? 6. Will tree proposed action cause an incre-ase in the use cifeneW nand it fails Io in orpmla rt; on 6l a etii b riser c�rattser�ration or rcncvr&Ic crtet o ppod i<ties? 7, Will late proposed action Implick txisting: - a,public d prjaile water suppli��? b.public$pre'caw,Wast,twider trea,lmcni utilities? El- 9, NVli l the prqme4 actloa impair ti chmdcror qw-dityt of important hisloric,archaeological, ar0t[tecturnl-or maghetic m ou s? El Will tlic ptopwsd as6cin .restilt in an advcm change.to natumt r•esoul-cats(c.g., NvIartds, %vaterbodies,groundwater, air r&rNalily,Rom and fmtna)? Piga'3 ol-4 No,or Moderate srnaEf to large 1FrtpAct impaci BUY MAY ocean° Accu r 10, Will the proM� cd gallon rc ptlt in as iacre2se ire ttte;F'r)tcalt131 for C-rasion,Nod iaig€ir drainage prohl=ns; t 1. Will the proposed aciion crom a h to hcatth? L -C T I- Part 3-Determi.n2tioas nE sc„�iEic�s�c , The Lend Agency is resp€rnsUe Ear the coo pletEDu of Part 3. For ever question in Part 2 that was enswvcred"jremk to large iimpki may oican ,or if there is as need to explain why a particular element ortho proposed a c6on mmr or will not result in a signiFicam idversc envi ctnm ental ihipacl,pit-ase co i�plett Puri I Fart 3 shaotd,in sufficient detail,identi6,the impact,including any measures ardc�i a�,t el'cments lital included by dw project sponsor to avDid of it-duce impacts. Part 3 mould also explain hr}ty the lei a8errmy detmlina Thal the impact niay or will nol ht s,igniiicant.Each paterrtial impact should be mue�:.�ed considering Us setting„,probabllity of occunn g, 4-uraftn,irraversibilitg,ge6graphic acme and n isude_ also consider the potenOal foT,s ort-tc 1 long-term and cuartulative Impacts. MCheck this box ifyou hue determined„based on the information and aay3as above,and any suppGrting documentation, that the proposed action may mauls in one or roars poteiitieRY taige or Significam adverse impairs and an cnviroitaicntal impact siatg.m4ail is nquircd. Cheek!hi$box if yogt havo rt:lcrsnined,bircd ctrl the inrorm4tiorn end.milysis abover and any suppartinp,diacumcniationg ibil the pmposed action%vill skit result in any sir ciiea.�l adve �revi.rotitleent=t rnp Tgno of Soo if r Board of Duslew; (d Name of Lead Agcncy Date - Michael J. Domino Fri�.Kce Type Na arRcsg�;ns` Ce tT icer in lad Agency Title affiespcnsihle Officer i-naMai or Resp' sibtc Off-icer in Lead A gtnor Signature€af Pupwer(ifdifiereni 6�rn fficor) PRINT Fagg 4 of 4 Board of Tums$ses Applge aftm County of Suffolk Statc of New York Johne H.tda&M President—Eecom c Land Trasi ' BEING DULY SWORN DEPOSES AND AFFMM THAT I AM THE APPLICANTS FOR THE ABOVE DESCRIBED PERMT(S), AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF,AND'T'HA'I' ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOTT HOLD TOWN BOARD OF TRUSTEES. TIS APPLICANTS AGREE TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE •OF SAE D PERMIT(S), IF GRANTED. IN CONTLiETING THIS APPLICATION, WE HEREBY'AUTHORIZE THE TRUSTEES, 'SIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO OUR PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME TffiS 62 DAY OF 20 ` U Notary Pubp WIVISERLY QUARP Kday Public,State of Neav Yobs No.01 OU6249267 Qualified in Suffolk Cour @amffdssicn E*ms octobw 3,2019 ' I • • , 1 , I 1 Board of Tnmteea AppHastion AUTHORUATION (where the applicant is not the owner) I, John v.L.Halsey,President,Peconic Land Trust residing at 296 Lampton ltoad/P.®. Box 1776 a Southam ton s NY o 11969 do hereby authorize Suffolk Enviromnental Consulting.Inc.To apply for permit(s)from the Southold Board of Town Trustees on behalf of the Peconic Land Trust. J hn V.L.Halsjj APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the town officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Bruce A. Anderson (Last name, first name, middle initial,unless you are applying in the name of someone else of other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other," name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest. "Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO X 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 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 then 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 Brother in law Submitted this day l-- 201 Signature % _ Print name ruce A. Anderson Town of Southold logr Michael J. Domino,President 'O�Q 014,10 � Town Hall Annex John M.Bredemeyer III,Vice-President b]ti� G��,E� 54375 Route 25 a � . .> 1� Glenn Goldsmith N ;� : a P.O. Box 1179 A.Nicholas Krupski .= p`„< Southold,NY 11971 Greg Williams Q gyp! Telephone(631)765-1892 1 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of PECONIC LAND TRUST COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE I,_�Q.l y t l , residing at/dba SUFFOLK ENVIRONMENTAL CONSULTING,INC P.O.BOX 2003 BRIDGEHAMPTON,NY 11932.2003 being duly sworn, depose and say: 0— That on th7v'day of -.3�"� , 2011, I personally posted the property known as 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: signature Sworn to before me this day of-rv0r1-_20( _ MATTHEW D. IVANS NOTARY PUBLIC-STATE OF NEW YORK NITublic No.01IV6053859 Qualified in Suffolk County MY Commission Expires 01-22 PROOF OF MAILI,[NG OF NOTICE ATTACa CERTIFIED MAIL RECEIPTS Name: Address: Suzanne M.Egan Peconic Land Trust Inc. P.O.Box 501 296 Hampton Road Orient,NY 171957 P.O.Box 1776 SCTM#:1000-20-1-3.10 Southampton,New York 11969 SCTM#:1000-20-3-5.1 Edward J Wysocki 37455 Route 25 NYS Departmentof Environmental Conservation Orient,New York 11957 Bureau of Real Property SCTM#:1000-20-1-3.8 SUNY Bldg.40 Stony Brook,Newyork 11790-2356 Bunn Roberti?Jr SCTM#:1000-20-3-7.2 Bunn Carolyn M 100 GreenwayE NYS Departmentof Environmental Conservatibn Orient,NY 11957 Bureau of Real Property SCTM#:1000-15.-2-21 210 SUNY Bldg.40 Stony Brook,New York 11730-2356 SCTM#:1000-20-3-6.3 STATE OF NEW YORK COUNTY OF SUFFOLK Bruce A. Anderson, residing at Suffolk Environmental Consulting, Inc, P. O. Box 2003, Bridgehampton, NY 11932, being duly sworn, deposes and says that on the 9"' day of January, 2018, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application,directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Bridgehampton, that said Notices were mailed to each of said persons by CERTIFIED NI IL/RETURN RECEIPT. Sworn to before me this Day of Tu%v%e 2011 000 MATTHEW D. IVANS NOTARY PUBLIC-STATE OF NEW YORK Notary Public No.01 IV6053859 OUGIIfled In Suffolk County MV CoMmIssion Expires 01-224M 204e 3 © ■ =112 II Ila o1 Er �. 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OWNER(S) OF RECORD: PECONIC LAND TRUST SUBJECT OF PUBLIC HEARING : For a wetland Permit to construct a 144sq.ft. public viewing platform with attached 457.5sq.ft. access ramp. Located : 36960 Main Road, Orient. SCTM## 1000-20-3-6.2 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) 765-1892 I 12'-0" 10122S1ope Ramps used as part of a means of agrees shag have a running dope t steeper than one unit vertical In 12 units horlrnntel(&pi n cent slope) The dope of other pedestrian ramp..hal not be steeper than one unit vertical In eight unila horizontal(12 5-percent dope) 1012 4 Vedical Wee 201-0" { The rise for any ramp run shall be 30 inches maximum 1012.6 1 Wdth and Capacity 4 151-0" The minbnum wldlh and required capacity of a means of egress ramp N 514'DECKING TPI shell be not lase glen that required for ranidorc by Section 10202 The clear width of a ramp hetween hendrals,If provided,or other permissible ( grade) projections shall be 36 Inches minimum. 1012.6 Landings Romps shell have landings at the bottom and top of each ramp,pointe of _RAMP turning Landings shil4'-0"l comply with Sections 1012 61 through 1012 6 5 1 IME 1072 6 2 Width T-0" The lending width shall be not lova glen the wldih of the widest ramp run adjoining the lending LANDING in ! O P 1012 6 3 Length el 3 75 The lending largth shell be 60 Inches Mnlmum 1012,7 Ramp Construction Ramp"¢heli be built of materials consistent with the types pemdaed for the '112 BAb1E type of construction of the building,except that wood handrmb"call be 1 12 SLOPE permitted for all types of consauctlon. 1012.71 Ramp Surface tot0 The surface of romps shall be of.lipaesistant materials that are securely attached LANDING tQ 1012 10 Edge Protection el 2 6 N Edge protection complying win Section 1012101 of 1012.102 shag be provided on each side of ramp ran"and at each aide of ramp landings ED 1014 2 Height 1 12 SLOPE Handrail height measured above Inlsh surface of ramp slope,shall be uniform,not less than 34 Inches and not more than 36 Inches 10143H mindi Dreepabi ly iO Required handrage shell comply with Section 1014 3 1 or shell provide equivalentlAdP LSppP grespabllity e .ld9 O 10143.1 Type) Hmndmlls vAh a circular cross eaWun anal have an outside diameter frot lase than 1114 Inches and not greater than 2"as Whom the hendrel Is not circular,It shag ggme have ahmperimeter dimension of not lata than 4 Inches and not greater than 6114 inches i0 IMP SLOPE with a maximum cross-""Won"dimension of 2114Incies and minimum onose-sectional t dendon of 1 Inch Edge.shall have a minimum radius of 0 01 Inch jlkg: 15'-0" V-0. k� p4 t Ea C C 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 area(which includes all of Southold Town). 3. If any question in Section C on this form is answered"yes",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus,the action should be analyzed in more detail and,if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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# 77 - 02 - 2 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Dept. ® Building Dept/ZBA. ❑ 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: Applicant propose to construct a Public Viewing Platform (144 square feet) accessible by ramp (457.5 square feet). Attach additional sheets if necessary Location of action: South side of S.R.25.Orient■New York Site acreage: 20.945 acres Present land use: Vacant—Land Rights Present zoning classification: R-200 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: PECONIC LAND TRUST (b) Mailing address: P.O.Box 1776■Southampton■New York■ 11969 (c) Telephone number: Area Code(631)283-3195 (d) Application number, if any: N/A Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No ® If yes,which state or federal agency? 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 coastaflocation,and minimizes adverse effects of development. See LWRP Section III—Policies;Page 2 for evaluation criteria. ® Yes ❑ No ❑ Not Applicable The construction and use of a Public Viewing Platform for purposes of wildlife viewing will enhance community character, makes beneficial use of a coastal location, and because the property itself is preserved lands, will promote the idea of preserving open space and minimizing the adverse effects of development. Consequently, this project will comply with this Policy. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A 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 5 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable The construction and use of a Public Viewing Platform for purposes of wildlife viewing will help in educating the public in promoting the idea of protecting scenic resources available within the Town of Southold, and thereby enhancing the visual quality of the area. Consequently, this project will comply with this Policy. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life,structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A 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 ❑ Yes ❑ No ® Not Applicable N/A 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 N/A Attach additional sheets if necessary Policy 8.Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable N/A Attach additional sheets if necessary 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 ® Yes ❑ No ❑ Not Applicable The construction and use of a Public Viewing Plafform for purposes of wildlife viewing will obviously provide public access to public lands and resources. Consequently, this project will comply with this Policy. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III—Policies;Pages 47 through 56 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A 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 N/A 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 ® Not Applicable N/A 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 N/A Attach additional sheets if necessary r-� r� Suffolk Environmental Consulting, Inc. Newman Village,Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President *Hand Delivered'* May 10, 2019 [ - Southold Town Board of Trustees P.O. Box 1179 1 4 7019 Southold, NY, 11971 = sA� { Re: Peconic Land Trust-Public Viewing Platform Situate: South Side of S.R. 25 • Orient • New York • 11957 SCTM#: 1000—020-03—006.002 To whom it may concern, This firm represents the property referenced above,who are seeking any and all regulatory approval to construct a viewing platform for public use at the property listed above.Attached herewith you will find: 1) Tidal Wetland Application original and four[4] copies; 2) Short Environmental Assessment Form original and four[4] copies; 3) Authorization Form original and four [4] copies; 4) Agent Authorization original and four[4] copies; 5) Applicant/Agent/Representative transactional disclosure forms, original and four[4] copies; 6) LWRP consistency assessment form, original and four [4] copies; 7) Survey prepared by Peconic Surveyors on March 12th, 2019, original and four [4] copies; 8) Project Plans prepared by Joe Fischetti P.E. 9) Photographs of current site conditions original and four[4] copies and; 10) Check made out in the amount of two hundred and fifty dollars($250.00). Made payable to Southold Town. Thank you in advance for your anticipated cooperation. Yours truly, Robert W.Anderson Michael J. Domino, President . copy Town Hall Annex John M. Bredemeyer, III, Vice-President o 54375 Route 25 Glenn Goldsmith co ,at P.O. Box 1179 A Nicholas Krupski y • Southold, NY 11971 Greg Williams ��l , c dao Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF'fRUS L_z___ ,___ 1111L, OCIF 2018: TO: SOUTHOLD TOWN BUILDING DEPARTMENT RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT UEQUIREMENTS��� SCTM#: 00- 3 - � � Property Owner Name: Date Sent to Bldg. Dept: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination / from the Zoning Board of Appeals? V Will any part of this application be considered a Demolition as described under Town Code? COMMENTS: rC SSd� i'!,(Clmr-e_S f76 �� AM A.1"llf Ift" 3L hq-�:- Signature of Reviewer Date :p off, ,, Michael J.Domino,President � � ' � TUVGm Hall Annex ane �r IXI Vice-President 54375 Route 25 y , P.O.lox 1179 John M.Bsede Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Telephone(631.)765-1592 il �;"�' ., Fax(631) 765-6641 A. Nicholas.Kmpski � -400 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application X Wetland Permit Application Administrative Permit Amendment/Transfer/Extension !o Received Application: 10,29, 0 Received Fee:$ 2-5-0j 0 Completed Application: Incomplete: SEQRA Classification: Type I Type H Unlisted LCoordination:(date sent) j I LWRP Consistency Assemt rm: l 0�/g OCT 2 9 2018 CAC Referral Sent: 7. i Date of Inspection: Receipt of CAC Report: S0f1i1i` Lead Agency Determination Board o. Technical Review: Public Hearing Held: Resolution: Name of Applicant Peconic Land Trust Address P. O. Box 1776 - Southampton New York • 11969 Phone Number: (631) 283-3195 Suffolk County Tax Map Number: 1000— 20—3 —6.2 Property Location: Main Road(Rte 25) • Orient•New York (provide LILCO Pole#, distance to cross streets, and location) AGENT: Bruce A. Anderson - Suffolk Environmental Consulting,Inc. . (If applicable) Address: P.O. Box 2003; Bridgehampton,NY 11932 Phone: (631) 537—5160 Board of Trustees Application GENERAL DATA Land Area(in square feet): 991, 930 square feet± Previous use of property: Vacant Intended use of property: Install Viewing Platform for Public Use. Covenants and Restrictions: X Yes No If "Yes", please provide a copy. Will this project require a Building Permit as per Town Code? X 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 X No If"Yes",please provide a decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? Yes N/A No Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation: Project Description (use attachments if necessary): Applicant propose to construct a Public Viewing Platform (144 square feet) accessed by Stairs (40 square feet). J Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purposes of proposed operations: Applicant Propose to construct a Public Viewing Platform (144 square feet) accessed by Stairs (40 square feet). Area of wetlands on lot: 50, 000 ± square feet Percent coverage of lot: 5 ± % Closest distance between nearest existing structures and upland edge of wetlands: N/A feet Closest distance between nearest proposed structures and upland edge of wetlands: 80.00 feet (Public Viewing Platform) Does the project involve excavation or filling? No X Yes (footings) If Yes, how much material will be excavated? < 1.0 (cubic yards) How much material will be filled? 0 (cubic yards) Depth of which material will be removed or deposited: 5.0± feet Proposed slope throughout the area of operations: 0% Manner in which material will be removed or deposited: , Construction largely by hand. 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): No impact to the wetlands anticipated due to substantial setbacks from the wetlands boundary, and the benign nature of the structure. Board of Trustees Application COASTAL EROSION APPLICATION DATA N/A Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) 617.20 AppeitAx B Shoi-I E itpiroititientalAwessniml Foiwi 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 iteR,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 useftd to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Infotmation 77 Name of Action or Project: Asn . 711 J EAND Project Location(describe,and attach a loeation map): sidet ''GreehWay, Okien&N , :oma e N. Brief Description of Proposed Action: !Cbristrikton.of'VuVii '-VPidtfokr .�. hovin P ,g ecificatiOns,., Name ofApplicant or Sponsor: re lone. M Bruce A.Anderson @ Suffolk Envirorunental Consulting,Inc. al I. nthent I I-- -- onsu -- -- ---I Address: C State. ;77 7 .39 1.Does the proposed action only involve the legislative adoption of aplan,local law,ordinances NO YES administrative rule,or regulationT If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that Fv� may be affected in the municipality and proceed to Part 2. If no,continue to question 2. Ln�j Li 2. Does the proposed action require a permit.approval or funding from any other govemmental Agency[]? NIO YES -JfXC&I ist.agency(s),naine and.,permit,pr,approval, 6,,w,-,Y'ik.Sigi6D6i)artriibftt.ofE ii6riihent I`C nservation",-," LA Oz 3.a.Total acreage of the site of the proposed action? b.Total acreage to be physically disttubedT L,5 f)o acres C.Total acreage(project site and any contiguous properties)ownC4 or controlled by the applicant or project sponsod 4R,77acres 4. Check all land uses that occur on,adjoining mid near the proposed action] OUrban ORural(non-agriculture) 01ndustrial []Commercial MIResidenfial(suburbap).__, J El rorest 1JAgriculture ElAquatic ED Other(specify): OParkland Page 1 of 4 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: 12 EJ 7, 7-, 7,2FIT-, j V P 11, 77' 19:-Higlfii�4616f`tk -a-W 'adjo—W-ingp rioipei NO YES solid waste management facility' • 7,7', -7- El EJ 20.Has the site of the proposed action or an adjoining property been the subject ofremediation(ongoing orl NO YES completed)for hazardous waste'] If es. escribe: r7,-,l I AFFIRM THAT THE INFORMATION PROVIDED ABOVE, IS TRUE AND ACCURATE TO THE BEST OF My KNOWLEDGE Applicant/sponsor name.1 Natyv�ans, @ Suffolk Environmental Consulting,Iftte; 06tob6r,25;,.2018_x:, 7--77--1 Part-2-InipactAssessmen4 The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted 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 kale and context of the proposed action`?" No,or Moderate small to large, impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoningl regulations) El El 2. Will the proposed action result in a change in the use or intensity of use of landl El- 1777q LJ 3. Will the proposed action impair the character or quality of the existing communityEl El' 4. Will the proposed action have an impact on the environmental characteristics that caused they r-771 establishment of a Critical Environmental Area(CEA)7 LIJ, 5, Will the proposed action result in an adverse change in the existing level of traffic o4 M-71 affect existing infrastructure for mass transit,biking or walkway? LJ El 6. Will the proposed action cause an increase in the use of energy and it fails to'incorporatel reasonably available energy conservation or renewable energy opportunitiesl El El 7. -Will the proposed action impact existingi a.public/private water supplies? El b.public/private wastewater treatment tifflitiee? El E] 8. Will the proposed action impair the character or quality of important historic,archaeological) architectural oraesthetic resources" Li7 El- 9. Will the proposed action result in an adverse change to natural resouices(e.g.,wetland4 waterbodics,groundwater,air quality,flora and fauna)y Li Page 3 of 4 ^_ No,or Moderate small to large impact impact may may >r, occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage, rainage E! 0 problemsl 11, Will the proposed action create a hazard to enAronmental resources or human health? El 0 Part 3-Determination of significance) The Lead Agency Is responsible For the completion of Part 3. For every question in Part 2 that mas 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 Dart 3. Part 3 should,in sufficient detail,identify the impact,including any measures or deign,elements that have been included byj 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 assured considering its setting,probability ofoccurringl duration,irreversibility,,geographic scope and magnitude. Also consider the potential for short-term,long-term and) cumulative impacts) , I; -x f. "fir - i'a? '_�,• Y3 ..{ ' . r - - 4• S - - 1" 4:- _ - @V { ; J., 4 _ - d Vc , �a .9 {, 'y lyti'- _ :Sf n;tz .r f , Yv 11 W 4 - f _ .�u.ru.w.,,.,:t:.:,.,.�,.", _,._.:...,,..,.,_w._,._».�_-........u»................P..:.,._.,. .c......0.,,.�......,..,,,..w.....,.v_........,......_.. ._,.,.,,.a.^"i',.,.:'..�:.,_•._._..,.,..._.....__."-✓'»._.,..,_,.�. .,,.�s,,.,.,s.a r:...P.:.-;e:.md._.,.,.,.._.x_.:3 Check this box if you have determined, based on the information and analysis above,and any supporting documentation, LJ that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. E] Check this box if you have determined,bused 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 head Agency Signature of Preparer(if different from Responsible Officer) FORINT Page 4 of Board of Trustees Application County of Suffolk State of New York Johne H.Hq&M President—Peconic Land Trust BEING DULY SWORN DEPOSES AND AFFIRMS THAT I AM THE APPLICANTS FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF MY 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 APPLICANTS AGREE TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN 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, WE HEREBY AUTHORIZE THE TRUSTEES, TEEM AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO OUR PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. �.[ Signature SWORN TO BEFORE ME Tffis �� DAY OF a0 ! 8 otary Publi 101UIBERLY QUARRY Notary Public,State of New York No.01 OU6249267 Qual'fied in Suffolk County Commission Expires October 3,2019 Y� Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, John v.H.Halsey,President,Peconic Land Trust residing at 296 Hampton Itoad/P.O. Box 1776• Southampton• IVY• 11969 do hereby authorize Suffolk Environmental Consulting.Inc. To apply for permit(s)from the Southold Board of Town Trustees on behalf of the Peconic Land Trust. --- 1,bMn V.H.Hal r l - APPLICANTIAGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics Prohibits conflicts of interest on the part of the town officers and cmnlovee�e. The purpose of this form is to psQvi¢e information which can alert the town of possible conflicts QrinLeimg and allow it to take whatever action is numm to avoid same. YOUR NAME: John v.H.Halsey,President Peconic Land Trust (Last mune,first name,middle initial,unless you are applying in the name of someone else of other entity,such as a company.If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,"name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X 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 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 then 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 30 day of October ,2018 Signature .r. Print name John v.H. Hal y Form TS I APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the town officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Bruce A. Anderson (Last name,first name, middle initial,unless you are applying in the name of someone else of other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other," name the activity.) Do you personally(or through your company, spouse, sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest. "Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO X 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 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 then 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 Brother in law Submitted this day I--- 201 Signature Print name -Bruce A. Anderson 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 area(which includes all of Southold Town). 3. If any question in Section C on this form is answered"yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus,the action should be analyzed in more detail and, if necessary, modified prior to making& determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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# 77 - 02 - 2 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Dept. ® Building Dept1ZBA. ❑ 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: Applicant propose to construct a Public Viewing Platform (144 square feet) accessed by Stairs (40 square feet). Attach additional sheets if necessary Location of action: South side of S.R.25■Orient■New York Site acreage: 20.945 acres Present land use: Vacant—Land Rights Present zoning classification: R-200 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: PECONIC LAND TRUST (b) Mailing address: P.O.Box 1776■Southampton■New York■ 11969 (c) Telephone number: Area Code(631)283- 3195 (d) Application number,if any: N/A Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No ® If yes,which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern,of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies;Page 2 for evaluation criteria. ® Yes ❑ No ❑ Not Applicable The construction and use of a Public Viewing Platform for purposes of wildlife viewing will enhance community character, makes beneficial use of a coastal location, and because the property itself is preserved lands will promote the idea of preserving open space and minimizing the adverse effects of development Consequently, this project will comply with this Policy. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A 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 5 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable The construction and use of a Public Viewing Platform for purposes of wildlife viewing will help in educating the public inpromoting the idea of protecting scenic resources available within the Town of Southold and thereby(enhancing the visual quality of the area. Consequently, this project will comply with this Policy. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life,structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A 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 ❑ Yes ❑ No ® Not Applicable N/A 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 N/A Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable N/A Attach additional sheets if necessary 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 ® Yes ❑ No ❑ Not Applicable The construction and use of a Public Viewing Platform for purposes of wildlife viewing will obviously provide public access to public lands and resources. Consequently, this project will comply with this Policy. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria ❑ Yes ❑ No ® Not Applicable N/A 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 N/A 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 ® Not Applicable N/A 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 N/A Attach additional sheets if necessary I Suffolk Environmental Consulting, Inc. Newman Village,Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President HAND DELIVERED October 25, 2018 Mr. Michael Domino, President Board of Trustees Town Hall - -; --- - - - P.O. Box 1179 - Southold, NY 11971 OCT 2 9 2018 Re: PECONIC LAND TRUST Property Situate: South side of S.R.45. Orient■New York SCTM#: 1000—020—03—006.002 -- ---- ==- - —-- Dear Mr. Domino, This Firm represents Peconic Land Trust, who are seeking all required regulatory approval to construct a Public Viewing Platform within the southern section of the above referenced property. In that the property is burdened by wetlands, approval from your Board is required. Please find enclosed herewith for your review: (1) Town of Southold Trustees Wetlands Permit Application (original and three [3] copies); (2) Local Waterfront Revitalization Program application (original and three [3] copies); (3) Short Environmental Assessment Form (original and three [3] copies); (4) Photographs of subject property, indicating the staked out location of the proposed Public Viewing Platform and the surrounding wetlands boundary (four [4] sets); 2 (5) Location Map of subject property (four [4] copies); (6) Survey of subject property, prepared by PECONIC SURVEYORS, P.C., last dated September 26, 2018, indicating the current conditions thereon (four [4] prints); (7) Viewing Platform Plans, prepared by JOSEPH FISCHETTI, P.E., dated September 23, 2018, indicating all existing &proposed conditions (four [4] copies); and (8) Check made payable to the Town of Southold in the amount of$250.00 covering the requisite application fee. By way of this correspondence, and on behalf of the applicants, I request that you commence review of this application and schedule before the next available Trustees Board meeting for discussion and subsequent permit issuance. Should you have any questions regarding this matter, or require additional information, please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely, Matt D. Ivan " R� enc. cc: Peconic Land Trust