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HomeMy WebLinkAboutTR-9497A Michael J. Domino,President *QF SOUrTown Hall Annex John M.Bredemeyer III,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith [ Southold,New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams '� �� Fax(631) 765-6641 �y�DUNTY,�c� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1652C Date: October 15, 2019 THIS CERTIFIES that the removal of existing 6'x8' platform located at top of bluff and replace with 8'x12' platform using untreated timber decking, At 3300 Sound Drive, Greenport -Suffolk County Tax Map#1000-33-1-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 24, 2019 'oursuant to which Trustees Administrative Permit#9497A Dated July 17,2019,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 for the removal of existing 6'x8' platform located at top of bluff and replace with 8'x12' platform using untreated timber decking. The certificate is issued to Mary Beth Henson owner of the aforesaid property. Authorized Signature Michael J. Domino, President 0f S0(/r�O Town Hall Annex John M. Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q � O Telephone (631) 765-1892 Greg Williams10OU O Fax(631) 765-6641 NTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /0// / _ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: �Gj�!� C MMENTS: ,� o it Jr L1/11 CERTIFICATE OF COMPLIANCE: /Z/) / ��Og�FFQ( Michael J. Domino, President ��oN oma,, Town Hall Annex John M. Bredemeyer, III, Vice-President "= y�N 54375 Route 25 Glenn Goldsmith r N ,z P.O. Box 1179 A Nicholas Krupski R y • Southold, NY 11971 Greg Williamsol , �a°fes" Telephone (631) 765-1892 K= 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 1 St day of construction % constructed When project complete, call for compliance inspection; Michael J.Domino,President �QF sorry Town Hall Annex John M.Bredemeyer III,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9497A Date of Receipt of Application: May 24, 2019 Applicant: Mary Beth Henson SCTM#: 1000-33-1-6 Project Location: 3300 Sound Drive, Greenport Date of Resolution/Issuance: July 17, 2019 Date of Expiration: July 17, 2021 Reviewed by: Board of Trustees Project Description: To remove existing 6'x8' platform located at top of bluff and replace with 8'x12' platform using untreated timber decking. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Jeffrey Patanjo, dated May 7, 2019, and stamped approved on July 17, 2019. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees $O��v PROPERTY OWNER: PREPARED BY: : MARY BETH HENSON JEFFREY PATANJOa� 130 E. 75TH ST. — APT 7C P.O. BOX 582 5 % y NEW YORK, NY 10021 BOHEMIA, NY 11716 e % 631-484-9332 :13300Sound Dnve snm JJPATANJO@GMAIL.COM.0 dop 6g " NOTES: / ; 1. LOT AREA: 29,581 S.F. / 0.6791 ACRES a E "n � `\ 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: s�Eas EJOHN C. EHLERS LAND SURVEYOR SWIM PLATFORMS TD REMAIN Y a. \ g� 6 EAST MAIN STREET, RIVERHEAD NY 11901 Inlet Pond a' �oF % 'SURVEY LATEST DATED MAY 1, 2013 County PorkREMOVE parkar Rock t'Q PROPOSED iIr X S'PLATFORM EX 8*X 2'PLATFORM MIDI �r No to Foiir Google w UN—TREATED TIMBER DECM % ' LOCATION MAP N.T.S. % .­- 'AP -ROVED-BY 0 -OF TRUSTEES _ �% TOWN-OF--SOUTHOLD ` \ DATE JT'oc� i7 2o(q_ `\ 2 STORY - - FRAME RESIDENCE ° 16.P8' O-° MAY 2 4 2019 STONE DRIVEWAY Southold Town SOUND DRIVE Bud Ttl e}ceeg , w \ o h I Proposed Permit Plans SCALE:40' q PROPOSED PLAN AND DATE: LOCATION MAP 5-7-19 Z 3300 SOUND DRIVE CREENPORT, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: FU� TAX MAP N0. 1000-033-01-06 1 OF 1 5URVEY OF LOT IO-T MAP OF 115EGTION FOUR, EA5TFRN 5HORF511 N FILED MARCH I IQ66 FILE No. 4556 51 TUATE: 6REER06RT W E TOWN: 5OUTHOLD 5UFFOLK COUNTY, NY S SURVEYED: JUNE 4, 2010 UPDATE JAN. 18, 2013 PROP. ACTIONS MAY 1, 2013 SUFFOLK COUNTY TAX # 1000 - 33 - 1 - 6 CERTIDFO TO: MARY BE'Il9EII HENSOIY cg000 IVOI , vho I ta OV f " y w TOP/BLUFF t(Q s tfd� ,ry�i� J S ?OLIV00"W 15.29' POLE SHM DATA: DESOM AREA: IIDTCOVIERAGB: PROPERTY. 29, 581 S.F. - BUILDABLE LAND: PROPERTY LANDWARD OF CEHL LINE 14, 330 S F _ EXISTING HOUSE 1, 216 S F. 8.48% V2 ;; _ I ' ff�� 4;'Yy -• EXISTING SCREEN PORCH 342 5 F 2.39% z TOTAL EXISTING LOT COVERAGE 1, 558 S.F. 10 87% LU PROPOSED POOL & HOT TUB 250 S.F 1.74% MAY 2 4 2014 PROPOSED PLANTER 3B S.F. 0.27% p � G I EXISTING 6 PROPOSED LOT COVERAGE: 1861 S.F 12.88% ® Board�f �r lg(P.LS �e . r-W) sa,o,rmorl:ee olterotbn a oddltlon o sn,.,ey mop eeorug a nursed IorN�eyars seol to 0 vlolelbn of settlor 1209•sub-dNlslon 2,of tha NOTES: "e�York Slate FdranlNn 'Only copses Ram the orlggrl of this survey ked 1 on orlyl-1 of Na 1a surveyors MONUMENT FOUND stm qed soul mall be core dared to valet ee •CcrtifNatlorr,,dicoted hereon slgitlyy fha!Nb smey nes prepared In ouordarce will t/x:ex- st,g code or r�octme im Ind s..veys odoptee Area = 29,581 S. F OR 0.6791 ACRES TO AVERAGE HI6H WATER MARK �'I� SON ellflca onsP shall run'onlyl b"n person for rJiom lha srvey is prned, orN on nu eenon to the"tle oomymy, tal GEHL ANNOTATED FROM NY5 DEG COASTAL EROSION HAZARD !lorais oerKo.ynaon!dRlmemsftrerdk"sledhto,e=1 Istowd ml=W115 15,d AREA MAP, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK PHOTO No. 53-595-83 SHEET 13 OF 49 JOHN C. EIMLER �a LAND� T T SDt EYOR ELAVATONS SHOWN REFERENCE N6VD '29 6 EAST MAIN STREET o N.Y.S.LIC.NO.50202 GRAPHI G SGALE I"= 40' RIVERS EAD,N.Y. 11901 369-8288 Fax 369-8287 REF.C:\UsersVohn\Dropbox\10\10-133 update 01-12-2013.pro A n•a,,�n c. o-en of-n-lob DiSalvo, Diane From: Jeffrey Patanjo <jjpatanjo@gmail.com> Sent: Thursday,June 13, 2019 11:27 AM To: Bredemeyer,John Cc: DiSalvo, Diane; Mary Beth & Danielle Subject: RE: Henson Deck justification of thru-flo Diane, Please be advised my client would like to keep the project as originally submitted utilizing un-treated timber decking. We greatly appreciate the opportunity to review the project revisions and the Boards comments but at this time we feel the use of thru-flow style decking would become too much of a maintenance problem for the long term. As we understand, we should be on the hearing schedule for July. We look forward to meeting with the board to discuss the project further. Thanks, Jeff Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 631-484-9332 From: Bredemeyer,John Sent:Wednesday,June 12, 2019 6:58 AM To: iipatanio@gmail.com Cc: DiSalvo, Diane Subject: Henson Deck-justification of thru-flo Hi Jeff, Not trying to over-think this one:-) My thoughts on Ms. Henson's deck were to encourage continued robust vegetation, realizing that the slightly larger deck probably not creating an erosion problem for water wind-driven over the edges. Poison ivy will likely be seeded in any disturbed soils, in any case, as it is carried by bird droppings. btw: poison ivy considered a wetland indicator in several states, thankfully not here! Fully seasoned/shrunken hardwood/tropicals with a narrow spacing,that will not catch women's heels but let some water pass works as does treated lumber similarly spaced, not specifically forbidden on decks unlike docks. One thought in favor of thru-flow is that it may be functionally safer than wood decking as it is not inclined to be slippery with light frost and or surface algae/mold that tends to grow on certain woods.. Feel free to discuss with Ms. Henson and leave word with Diane/Elizabeth if she decides to go with thru-flo. One thing I feel strongly about: DO NOT USE WEED BARRIER ON ANY BLUFF, I AM UNSURE OF THE UNINTENDED CONSEQUENCES AS IT DEGRADES OVER TIME AND MAY FAIL IN UNEXPECTED WAYS! 1 DiSalvo, Diane From: Bredemeyer,John Sent: Wednesday,June 12, 2019 6.59 AM To: jjpatanjo@gmail.com Cc: DiSalvo, Diane Subject: Henson Deck justification of thru-flo Hi Jeff, Not trying to over-think this one:-) My thoughts on Ms. Henson's deck were to encourage continued robust vegetation, realizing that the slightly larger deck probably not creating an erosion problem for water wind-driven over the edges. Poison ivy will likely be seeded in any disturbed soils, in any case, as it is carried by bird droppings. btw: poison ivy considered a wetland indicator in several states, thankfully not here! Fully seasoned/shrunken hardwood/tropicals with a narrow spacing, that will not catch women's heels but let some water pass works as does treated lumber similarly spaced, not specifically forbidden on decks unlike docks. One thought in favor of thru-flow is that it may be functionally safer than wood decking as it is not inclined to be slippery with light frost and or surface algae/mold that tends to grow on certain woods.. Feel free to discuss with Ms. Henson and leave word with Diane/Elizabeth if she decides to go with thru-flo. One thing I feel strongly about: DO NOT USE WEED BARRIER ON ANY BLUFF, I AM UNSURE OF THE UNINTENDED CONSEQUENCES AS IT DEGRADES OVER TIME AND MAY FAIL IN UNEXPECTED WAYS! John Bredemeyer DiSalvo, Diane From: Jeffrey Patanjo <jjpatanjo@gmail.com> Sent: Wednesday,June 05, 2019 11:28 AM To: DiSalvo, Diane, Mary Beth & Danielle Subject: RE: Henson - 3300 Sound Drive, Greenport Good morning Diane, I spoke with the client and we both have concern with the poison ivy any vines that creep up the bluff and will grow under the platform in addition to other invasive weeds if it were to have thru-flow decking installed. One recommendation would be to install weed-block fabric but that defeats the whole purpose of installing the thru-flow decking in my opinion.The entire platform starts at the top of the bluff and extends landward,therefore there will no portion hanging over the bluff.This being said,what is the specific reasoning for utilizing Thru-flow in this location? My client certainly wants to be a good steward to the property but has concern with the endless maintenance involved. Let me know what you think. Thanks, Jeff Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 631-484-9332 From: DiSalvo, Diane Sent:Tuesday,June 4, 2019 9:52 AM To: 'Jeffrey Patanlo' Subject: Henson- 3300 Sound Drive, Greenport Trustee Bredemeyer has reviewed the above Administrative application request and visited the property on May 4, 2019. He wonders if you would be agreeable to speaking to the owner to see if she would be willing, as the work will be done right on the bluff, to the option of the use of thru-flow. If so, please modify your project description accordingly. Thank You DEPoe DiSG2LVO Southold Towv, Trustees 54S75 Route 25 (P.D. gox 1171 SOuthow, NY 1171 (G31) ((031) 7�5--x(041 1 'Michael J. Doman, S1�FFQ(/�C Town Hall Annex John M. Bredemeyer III,Vice-President 41�1�� y,4 , 54375 Route 25 Glenn Goldsmith ra 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: a. a ! a'"� �� Completed in field by: ire�C�Y ey �r Jeffrey Patanjo, on behalf of MARY BETH HENSON requests an Administrative Permit to remove existing 6'x8' platform located at top of bluff and replace with 8'x12' platform using untreated timber decking. Located:- 3300,Sound Drive, Greenport. SCTM##: 1000-33-1-6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank- 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland 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: - 1 I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: Bred emeye r M. Domino G. Goldsmith, N. Krupski G. Williams Other • 3300 Sound Drive Photos April 2019 2 ' xM _ N FOR PLL.N0 1 SEE 5 µ a EC 0 r 61501-0x1 --moi O a 5 " 5 x5] .aNcl 8 r 'ti 1 J 2xMc1 .P� � a .p •� �'� ,'$F • sG a 'P / � `�'a \vY \\n \vs ♦Pe' S a',,r r�•��Z �Pr .gr r ° .P dr j , � a� �� a \v �� \ � P� d Ry �•t � r4 � , 4 \9\' \0 5 A• / r� °�`yOJ�O•, ,� 4, p °rA t9 tP.� \^`,4P� e'`° vE°� �'�' e"' S "�.�, i • � �„� O n' "^ '� • � e� ♦` ' \syn 33 A, O,y{cl LES PpN p n, ao `iM a 15 or O% f a �\ I � I � • f ,.Y[�• �l .tan ,� Q� ti - P,� 6 of � !L to° �n •¢ � „ � ry .\t � \B i I �aaa ay ° a� awa a ,omagc ta_ •fl y It 1 x �eE••r eEi•♦ 8j �s a �yS "2?U.E� --- NOTICE COUNTY OF SUFFOLK © E wo SOUTHOLD SECTION NO '^ Iz •— — _ +�+�+ al Property Tax Service Agency Y . ._ ,o a Caunq C♦nur alwMP<.HvttW1 o9 R 033 N P W� ae�acr 1000 PROPER,V AMP " Yi OFFICE LOCATION: ®��®F so(/jyO MAILING ADDRESS: Town Hall Annex l® P.O.Box 1179 54375 State Route 25 Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) G Telephone: 631765-1938 Southold, NY 11971 • a0 P Q Fax:•631 765-3136 l�C®iJNT` 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: July 16, 2019 Re: LWRP Coastal Consistency Review for MARY BETH HENSON SCTM# 1000-33-1-6 Jeffrey Patanjo on behalf of MARY BETH HENSON requests an Administrative Permit to remove existing 6'x8' platform located at top of bluff and replace with 8'x12' platform using untreated timber decking. Located: 3300 Sound Drive, Greenport. SCTM#: 1000-33-1-6 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Codeand the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the 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. ®� Michael J.Domino,President �� Sig Town Hall Annex�® John M.Bredemeyer III,Vice-President '`® l® , 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold, New York 11971 A.Nicholas Krupski O Telephone (631) 765-1892 Greg Williams Fax(631) 765-6641 05 BOARD BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only-,-•.-- d Coastal Erosion Permit Application Wetland Permit Application MAY 4 201 Administrative Permit Amendment/Transfer/Extension Received Application: Received Fee: $ 100,60c�rd a iC LF gli Completed Application: 5.2qlq Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: _/ Coordination:(date sent): _LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: 76 10.1 Receipt of CAC Report: Technical Review: Public Hearing Held: o Resolution: Owner(s) Legal Name of Property (as shown on Deed): /�a t c'�h )4e^S v n Mailing Address: S 0 1". 7 S"tA 5 . -A P+ '7 6 IV cw y n,f K 1 Phone Number: -Z m -7-79, --740& Suffolk County Tax Map Number: 1000 - 3 3 Property Location: 3,300 S c k 0 2 i v-e - (5r e-c A P o r 4- S -e e__ C o«,.-H®v, 14a1 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): 7Te 4Wfey Mailing Address: 19.0 . I?o x S a- jSy A_e--A i -f_, ^)I 1 171 6 Phone Number: $1. g r y• q 3 3 Board of Trustees Application GENERAL DATA Land Area(in square feet): Area Zoning: Previous use of property: S Intended use of property: _ (Lc S Covenants and Restrictions on property? Yes ✓ No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes ✓ 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 `1—r"1.-r-t•c.. 911 a O l7 Q.iitny / SilA Loot,Se Zco-It-13 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): f2 m o-c evc Is+tn9 G ',� ` P1,4#4Iwn p�C.LLt n H . Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: sto0 Q,n s- ( �s.Gt wi't h $ X 1�' P l t f �ointi e� ✓.J -^t r s4 fi —t"A&er decl4o y Area of wetlands on lot: y square feet Percent coverage of lot: A % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: N I� feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? A cubic yards How much material will be filled? _ r/lot cubic yards Depth of which material will be removed or deposited: &I t- feet Proposed slope throughout the area of operations: 4 S-2 f- Manner in which material will be removed or deposited: N 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): rlo .c(�LtcAr oeve— 4-o prmjee,+ t-r-&Ti oQ AFFIDAVIT AAA,e -8t k g e s so n 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. Lj��- Signat f Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS ZU DAY OF Iia , 20 t q_ Notary Public JASMIN GRISEL PARKA Notary Public-State of New York No.01PA6137018 Qualified in New York County My Commission Expires February 17,20 L7 Z AUTHORIZATION (Where the applicant is not the owner) I/We, Mary a-c+tj #eASon owners of the property identified as SCTM# 1000- 3 3 - / -G in the town of New York,hereby authorizes 4�rl,c u Para�.1 a 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. Prope er's Signature Property Owner's Signature SWORN TO BEFORE ME THIS 2u44"' DAY OF 20 l Notary Public JASMIN GRISEL PARKA Notary Public-State of New York No.01 PA6137018 Qualified In New Yoit County My Commission Expires February 17,2012 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emnlovees.The nurnose of this form is toRrovide information which can alert the town ofpossible conflict-.of iiuerest and allow it to take whatever action is necessary to avoid same. YOUR NAME: jit n S o n, A a r N `�1 e4h ( name,first name,— ipi d ilial,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 Trustee = ding Variance 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,trtarriage,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 applicanVagent/repmsentative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided_ The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); l3)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not it corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 0 dof APwA 20 I�1 Signature Print Name taSow Form TS 1 APPLICANT/AGENT/REPRESENTATM TRANSACTIONAL(DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The ptn'pose of this form is to provide information which can alert the town of Wssible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: a,Ta v 4 l (Last name,first trame,diddle initial,unless 3bu are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,Marriage,or business interest."Business interest'means a business, including a partnership,in which the town officer or employee h 7 even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%oft 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 applic@int (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 d day f 20� Signature Print Name -T,4Freu �► w� Form TS 1 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: 3300 Sound Drive-Greenport Project Location(describe,and attach a location map): See location map Brief Description of Proposed Action: Remove existing 6'x 8'platform and install new 8'x 12'platform with un-treated decking at top of bluff. Name of Applicant or Sponsor: Telephone: Mary Beth Henson E-Mail: 3300sound@gmail.com Address: 130 E.75th St. -Apt 7C City/PO: State: Zip Code: New York INY 110021 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 government Agency? NO YES If Yes,list agency(s)name and permit or approval: R1 ❑ 3. a.Total acreage of the site of the proposed action? 0.679 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? 0.679 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: 5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial [0 Residential(suburban) ❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ 1-V-1 ❑ b. Consistent with the adopted comprehensive plan? ❑ Fv] ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? ❑ ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: Fv-] ❑ NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? ❑ F-1- b. b. Are public transportation services available at or near the site of the proposed action? ❑ ❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed Elaction? 21 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: Fv1 F-1 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ ❑ 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the ❑ Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it, located in or adjacent to an area designated as sensitive for ❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 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? ❑ RI b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? 21 ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: P} Page 2 of 3 14. identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑ Forest ❑Agricultural/grasslands ❑Early mid-successional ❑Wetland ❑ Urban 0 Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats, listed by the State or NO YES Federal government as threatened or endangered? ❑ ❑ 16. Is the project site located in the 100-year flood plan? 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? b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑ If Yes,briefly describe: 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: ❑ ❑ 1.9. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES 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: I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MV KNOWLEDGE Applicant/sponsor/n e: Mary Beth Henson Date: Signature: Title:Owner PRINT FORM ]Page 3 of 3 Part 2-Impact Asse �'nt. The Lead Agency is responsible for the con ion of Part 2. Answer all of the following questions in Part 2 using"tne 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 scale and context of the proposed action?" - No,or Moderate I 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 ❑ i regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? o 3. Will the proposed action impair the character or quality of the existing community? El 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ k establishment of Critical Environmental Area(CEA)? F1 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? h El 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ED ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: Ll a.public/private water supplies? b.public/private wastewater treatment utilities? El E 8. Will the proposed action impair the character or quality of important historic,archaeological, LJ architectural or aesthetic resources? iJ 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, (� (� waterbodies,groundwater,air quality,flora and fauna)? Ll F] 10 Will the proposed action result in an increase in the potential for erosion; flooding or drainage r` ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Dead 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 Part3. 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, n,El 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 — Nme of Lead Agency Date a President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer sible Officer) Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Respon EAF Mapper Sumr' y Report ' __.} Monday, May 13, 2019 10:20 PM Disclaimer: The EAF Mapper is a screening tool intended to assist ''' ';n project sponsors and reviewing agencies in preparing an environmental 3600-'106--16000 r:i fi „j:: assessment form(EAF).Not all questions asked in the EAF are ON,3344-104:150p,0'; answered by the EAF Mapper.Additional infomfation on any EAF ' %\N question can be obtained by consulting the EAF Workbooks. Although x.. the EAF Mapper provides the most up-to-date digital data available to ;.,,-' ,.',y, .•s - _�t,,�:;'�•}' 3{14`:1 -.i 04 �`,, °',� ,; ,.a,: ',�4 DEC,you may also need to contact local or other data sources in order "iv;N'i+,r, E3 i+F. `' ' r3300400-11,200a' 3300-- 00 2' af) to obtain data not provided b the Mapper.Digital data is not a i`,�.,s+ `'`','';i;0� %6 ,�.,, „'�, 4 r,,.:�Ha „y.,�, P Y PP 9 4 { r substitute for agency determinations. 90 ., by 3.00'-1130-11440 r * 334(,,-240-2500 3340,10(?-10044 , '', 3300''=14 0-7004 -- ,Y, r- 330©r-244,-2.it104Y„ 334(1-;! 0043300-:I00-9043(}0-200-2000-�� - r,: :Ott is ratontreai 'S`'' 1�t3.44=1t30dt0131 .a�•ct ' (!3 -,.. ;. .` 1, .-, '�.vi ''{A t" L.� �,�.ik':,i P :_�^ S. 'tin•, ,'M�, - _ .�x.. 40 .'t�°.��,:.,4,��' "'• �t�r . a��.=�' �°"3f3f�04=.r1'0„0°,-x:w#.4i,4`0 �~� i .� 4-644-3 C4-.,�4000.'�,33fl0'i44S44 ,3300= ; tir �. ,I$`r 330 {10-7-40-0 t(, 'ti:- �.-i'y= _ €�;u; €,�� .,r. •' ;,�.,°,�:�." °.r',`' i E1-x " '.a��:�' �J�_:�• 'b', Ra",'r.�t�as®r -z�� _ `� ~`z-. _ _ _�t,ti-":...--•' - `f3tlfl:3lta Fd ` ``3304=1 � (04 4 ° `e.r•�•:" s.s iC?11�k' rxml ,,:t`,n.�°< `.,}7,Y},, tl.,�..tli�,1.['�u.d,. - _ •Y,^.'�� _ ,.1;?r;�. F„ _ Vy"t :R ,. •,,,, ;: In r�G�l �v l=F1t ttiR£�n"Es�ti d^, A .'"s' ;',w � - � ))i+�r 4--,64" fu1ETlori Ghm , ! 1ci t_ES'ri.,° 1^'4 F;` 5t�ufian;E�ERE;tCsrmin; ;.1.000=1'00-2 -; i, �- rix =3ti0y4. -,-,Columbus `Pit bisQh', USL ►Ism, ritap ,runty s <3Feii�t}eetl fatr�i 1S} 1�2l�if? fCfS`)0o '"'` :q, Itic�EtvtEi`tT'R„NKC.3, 3344-$0 -1d}40t3 cinnate,� b':X,•>+• $_ ,k,,',. ;llsercrruQL�`3004 4r,4�; 'bJ`,1;errrryTEl I.Esr,t;Giina, ,r.. a tit�,:`<,'x.A,:� `Sri„f!�`.g.,. _fie ti�-- -�ti� �'�4: - �.g;R1FY5e. `}°.,w, ,uWe� p. ;Part 1 /Question 7 [Critical Environmental fNo ,Area] i ,Part 1 /Question 12a [National or State No ,;Register of Historic Places or State Eligible I Sites] i Part I /Question 12b [Archeological Sites] !Yes Part 1 /Question 13a[Wetlands or Other ;Yes-Digital mapping information on local and federal wetlands and ,,Regulated Waterbodies] Iwaterbodies is known to be incomplete. Refer to EAF Workbook. ;Part 1 /Question 15 [Threatened or 'No ;Endangered Animal] ,,Part 1 /Question 16 [100 Year Flood Plain] )Yes Part 1 /Question 20 [Remediation Site] No I Short Environmental Assessment Form- EAF Mapper Summary Report 1 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 sinificant beneficial and adverse effects upon.the coastal area(which includes all of Southold Town}. 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 3 3 - 1 - 6 PROJECT NAME 3 3 0 0 S o me r+,A �b�.tv�c -- ��ir-e t H ,p o r 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: �.r�► v •e.,>LlSfirety L ' X '0r to &Q Alp l'afie w�-r1� � r x !a� Pla-f-Fr�tin ir�-t� ✓�-Ttt�'fedt �r�rt'Se/Z ottGILi ny Location of action: 3 3 0 0 S 0. eq r t en,p Ocf- Site acreage: d ._,6-7 9 Present land use: (Le S. Present zoning classification: (ZcS 2. If an application for the proposed action has been filed with the Town. of Southold agency, the following information shall be provided: (a) Name of applicant: AA a r N &e 114 t n S o el (b) Mailing address: 130 67 . -7 S"M A PT -7 e-- 1v N C t4.. /y y v p.I (c) Telephone number: Area Code{ ) a- t a -7-7 a --7 10 6 (d) Application number,if any: /V/ 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? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy l.. 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 LVVRP Section 111-Policies; Page 2 for evaluation criteria. ❑Yes 0 N [ "Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Towyn of Southoid. See LVW Section M-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No [ lot Applicable Attach additional sheets if necessary Folncy 3> Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRIF Section III—]policies Pages 6 through 9 for evaluations criteria ❑ Yes ❑ No ENot Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 40 Minimize loss of life, structures, and natural resources from flooding and erosion. See LWI? Section III—Policies Pages g through 16 for evaluation criteria ❑ Yes ❑ No RNot Applicable Attach additional sheets if necessary Policy 5e Protect and improve water quality and supply in the Town of,Southold. See LNV"Section III —Policies Pages 16 through 21 for evaluation criteria 1-1 `Kes ❑ No �I"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 LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No lr__r'Applicable Attach additional sheets if necessary Policy 9. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Mages 32 through 34 for evaluation criteria. ❑ Yes ❑No Eg"Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See 1LVVR P Section III—Policies; Pages 34 through 38 for evaluation criteria. El Yes ❑ No U Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access tog and recreational use off, coastal waters, public lands, and public resources of the Town of Southold. See LVVRP Section IYI—Policies; Pages 38 through 46 for evaluation criteria. WE] leo E PVot ApplicabRe Attach additional sheets if necessary WORIaNG COAST P 1CIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No [91�ot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in bong Island Sound, the Peconic Estuary and Town waters. See LRP Section III—Policies; Pages 57 through 62 for evaluation criteria. El Yes F] No �► Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See I.,'6WIIP Section III — Policies; Pages 62 through 65 forevaluation criteria. 1:1 Yes El No u Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and nnineral resources. See 1L P Section H1—Policies; Pages 65 through 68 for evaluations criteria. ❑ Yes ❑ No L"! No$Applicable PREPARED BY �'f a �" rA w i o 'TITLE A t,n 4- DATE May 21, 2019 Town of Southold Trustees ^