Loading...
HomeMy WebLinkAboutTR-9521 Glenn Goldsmith, President �'QF so(/ly Town Hall Annex 54375 Route 25 Michael J.Domino ,`O l0 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski v' G � Telephone(631) 765-1892 Greg Williams �O �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1781C Date: December 7, 2020 THIS CERTIFIES'that'the demolition and removal, if necessary, of rubble from concrete piers and damaged concrete seawall,• replace with approximately 68 feet of 12"x16' lop Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles three (3) 8"x8"whalers one (1) 6"x8"follower, 3/4" galvanized machine bolts and 1" galvanized tie=back helical screws, new .-bulk-head-to-matchhei��it/elevation of adjoiriiri�;-bulkheads;-arid-to"install a'retracta�le-aluitYiimx�n - _-,.,�.__-w......_,_._. ladder to beach; At 20275 Soundview Ave., Southold' Suffolk County Tax Map#1000-51-4-8 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 17, 2019 pursuant to which Trustees Wetland Permit#9521 Dated August 14, 2019, and Coastal Erosion Permit 9521 C Dated August 14, 2019 was issued and conforms to all the requirements and conditions of the applicable provisions'of law. The project for which this eertificate is being issued is for the demolition and removal, if necessary of rubble from concrete piers and damaged concrete seawall; replace with approximately 68-feet of 12"x16' long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles three (3) 8"x8"whalers one (1) 6"x8" follower,3/4"-galvanized machine bolts and 1" galvaniz&d tie-back helical screws• new bulkhead to match height/elevation of adjoining bulkheads• and to install a retractable aluminum ladder to beach. The certificate is issued to T Bruestle Kumra Revocable Living Trust&V. kumra Revocable Living Trust owneof the afor said property. Authoriz d Signature Glenn Goldsmith,President SO(/�y Town Hall Annex Michael J.Domino,-Vice-President ,`QOl0 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III [ t Southold;New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 olyCOU ,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 210 I NS•PECT8D',BY:�' Ch =25- k ,r= Ch. 111 , :!ia� t.,,` ..1 INSPECTION SCHEDULE Pre-corTstrttctionr hay,t3alelin-elsilty-booM/r silt curtain 1St day of construction %2 constructed X Project complete, compliance inspection CQMMENTS; ; CERTIFICATE OF COMPLIANCE: Michael J. Domino, President S�FFO(04 Town Hall Annex John M. Bredemeyer, III, Vice-President "_� y� 54375 Route 25 Glenn Goldsmith r NP.O. Box 1179 A Nicholas Krupski �'' Southold,,NY 11971 Greg Williams � Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed When project complete, call for compliance inspection; S 11M.1151M. Fi BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 9521 & 9521C DATE: AUGUST 14,2019 ISSUED TO: T.BRUESTLE-KUMRA REVOCABLE LIVING TRUST &V. KUMRA REVOCABLE LIVING TRUST PROPERTY ADDRESS: 20275 SOUNDVIEW AVENUE, SOUTHOLD SCTM# 1000-51-4-8 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter I I I of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on August 14,2019 and in consideration of application fee in the sum of$500.00 paid by T.Bruestle Kumra Rev. Liv Trust&V.Kumra Rev.Liv.Tr. and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"x161 long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles, three (3) 8"x8l� whalers, one (1) 6"A" follower, 1/4" galvanized machine bolts and I" galvanized tie- back helical screws; new bulkhead to match height/elevation of adjoining bulkheads; and to install a retractable aluminum ladder to beach; and as depicted on th site plan e prepared by Jim Deerkoski, PE, dated June 9,2019, and stamped approved on August 14,2019. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, th I . I and these presents to be subscribed by a majority of the said Board as of the 14 day of August,20 9. Q� FFDtlr 00 TERMS AND CONDITIONS The Permittee T.Bruestle-Kumra Revocable Living Trust&V.Kumra Revocable Living Trust,residing at 20275 Soundview Avenue, Southold,New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Scan2.TIF 2,550x3,300 pixels 8/25/19,11:17 AM Michael J.Domino,President Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski Telephone(631)765-1892 Greg Williams Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30-YEAR MAINTENANCE AGREEMENT E=ROSION PROTECTION STRUCTURES CHAPTER 111-15 OF THE SOUTHOLD TOWN CODE I (We) T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST&V. KUMRA REVOCABLE LIVING TRUST The owners of record of property at: 20275 SOUNDVIEW AVENUE, SOUTHOLD SCTM#: 1000-51-4-8 in applying for a Coastal Erosion Permit for an erosion protection structure do hereby agree to a 30-Year Maintenance program for a structure as described: to demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"06' long Shore Guard 950 vinyl sheet piles with 12"diameter,20'long cca piles.three(3)8"x8"whalers,one (1)6"x8"follower,%"galvanized machine bolts and I"galvanized tie-back helical screws: new bulkhead to match height/elevation of adioinina bulkheads: as shown on the attached licensed survey and/or site plan for the approved structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years and/or equivalent to the original approved structure.Any maintenance which involves more than 50%of the length of this structure requires approval of the Board of Trustees.We further understand that failure to maintain the structt.lre could result in a requirement to post a bond and/or have the repairs ordered as a lien against the property upon a finding by the Board of Trustees that said lack of maintenance would risk life, property or important natural resource features. (_(ARfA Noi Anzed signature of owner of record 4SAQECT�E Sworn to before me this KUNPA �6ay of August, 2019 *_4 laa_ez ��a4 z No ary Public This maintenance agreement shall only be valid upon the attachment of a licensed land survey/and or site plan made within one year of the original construction and validated to show the final approval of the administrator. MICHAEL A.IGMACK NoWy Public,State of NewYkrk No.MrJ Guallfied In Nassau County Commission Expires M"1:4.= , https://webmail.spectrum.net/index.php/mailJviewmes'sage/getattachme...ameOriginal/Scan2.TIF/filenameModified/Scan2.TIF?folder=SU5CT1g%3D Page 1 of 2 < i]E 6-72plERI-7 ge, S 03023'00" W 231.660' 0.818W «intoevcbFr�rr� x Ix PLARM 10. 3.7 A 0 EXISTING lD X GARAGE 43.7 7- 1,6 JIM DEERKOSKI, PE f 9.28 1+7 j N= LLj phone: (631) 298-7116 1.05 PIER 1 CL 2' 1.03 PIE I sN 0) REMOVE ALL PIERS AND DAMAGED Cy) SEAWALLTO BE REMOVES AND lj-A. x Co REPLACED WITH PROPOSED BULKHEAD 44.03 EXISTING UJI 6.32 PIER U) U I t-6 1 STY. 0 4 7.56 PIER Ji HOUSE 0 00 !Li > Ln ;7 in o < 0 11.31 TW2 /C-WALL 1 I z D _j z 5,7R I�WMPM,T?_ x 126.5' 0 j j V) GRANITE&STONE ROCK BACKFILL(TYP x— GRAVEL DRIVEWAY on x (D 0 x -:rl 6 wx V) 44.25 x z 0 x- m 4; 1�I -�' I N 03023'00" E 231.680' NEW SEAWALL TO MATCH x r, ELEVATIONS OF NEIGHBORS COASTAL EROSION HAZARD LINE SCALED FROM C.E.H.MAP PHOTO 2 No.55-578-83 SHEET 10 OF 49 49 SITE PLAN SCALE: 1" =20'-0" Q w 0P4 < 29.16 TW6+7/OUr W0.67 > L'Of'A s' Lg-OFA 29.=22 TW61-7 25"42 TW3+71OUT Wo 9 1-9 -too + N\1 0 L.-f L 25.sg TW2- 1� ZI-74 TW3-7 X 25.70 W3-7 I 2146 TnWVI-7 Ln kD ------- --- i va C60\1,(,OIL+IENN r1% F4 kq ----------- m cl*4 TwiT�/-07LIf 21.61 sq L-.V-%, CD WOX7-ii 6T---------- cc Uj V4 f+l 0 Z L 13.04 mAGS/W WAS OOffijL+Tv4 66 u- Y 651.1 U tz < z en < cr- U 5i 0 R 4- c1l (9 0 ON Y� m $' cn S 8205115111 E 66s6401 x 1,e LST113.03 ........... CL DAMAGED STEEL lL57STEPI-7P STEM Lsn- N 10-98 11.76 Mi MIII-78 10 .84 Ml+7/RAM 10.80 "1 + 17j' LI(HEAf BULKHEAD 0xLLTV4 STEP M11155 mcoo L+ FLOW LK -Il..16 RU 10-94 W2-7MI-7 7/GAB - 1.45, -ii-17MI +lw% �z cs -k-63_yl. M112.16 0 jI -------- ---�i----- _LSI%'3 EXISTING BULKHEAD ------ iSt1got L-Z -InSDW X ------U-39 ------- . , —� : I , P------------ ry DAM ED "I --------- ------------------------ SEA IPPRAP -------------------- ----- 7AI 11.51 --- ALL __ __________________LD +:f�z zs'Ol z ----------- ------------------ __j + ------ ------------- 4 r�-z U-1by + < 9E-9 071D ZAU :rq cr a:i w ------------ X 20 00:E: -)�e :.6 C4 m cn U 0 ----------J:cc 00 OX 1 CQ LcQ Ui �4 4 *bi '- S7R 3S + --------- 6 " 114, r-4 m l7 CC 00 cli 0 0 LU j < Ln G39VV4VC' co o cyi U w U-1 w 00 a- �4 z -j LL DRAWN BY: JD r-1 CL (D cl m E-L E: 0 -jLL Nof m < z< NtD Ln U nM Lr! m 0) + co tD r- rl� 04 z LLI Ln Uj 0 6/9/2019 In > 0 (n — q0 Lu In ?: 0 LU < CL Z (/) 0 SCALE: SEE PLAN Or Uj W APPROVED BY UJI co a- cl. R m � I BOARD OF 1 RUSTEES __j 7 r __j PARTIAL SITE PLAN w < LONG ISLAND TOWN OF SOUTHOLD SHEET NO: > SCALE: 1" = 10'-0" 0 < U DATE :E w 15 U LU ILn 2aq Jull, 7 CL Llj cr: SOUND =r —,,f T—,in b V � + �x�Myry C, W � 'Ode � 3 A 3 � c� F L— z 3 z s, � * S 03023'00" W 231.660' ��y�p a ISR♦)�6L 13 fib 43' EXISTING JIM DEERKOSKI, PE X GARAGE � __� --o phone: (631) 298-7116 43.7 0 w w 100.2 rn Lr) to m o 11 V c-I 4403 EXISTING k6 o 1 STY. Q s HOUSE 00 e _ > Lo z j M z1 Q J zx 126.5 N O (n GRANITE&STONE Q RoacBAcxnLLOW) GRAVEL DRIVEWAY N 0 t¢y>, � R Q Z ./ , � X o z Ooo ' 44.25 o � J � pEl U3E xw = :x xw N 03023'00" E 231.680' c�sox(R% 9 a " Mt1LW 1L�1Mi- an � S � £A~5 NEW SEAWALLTO MATCH ELEVATIONS OF NEIGHBORS ,'�, sQ ; € COASTAL EROSION HAZARD LINE Y Y 3 g w i SCALED FROM C.E.H.MAP PHOTO No.S-57"3 SHEET 100F49 PROPOSED SITE PLAN � o � w fx W SCALE: 1"=20'-0" Q O W � z 8x8 CCA A " WALE V ■ ■ ■ ■ �....` O 6X8 CCA Ln FOLLOWER L� N cc N ss o ss 1"GALVANIZED TIE BACKS HELICAL SCREWS m 12"dia 20'long o CCA PILE 12"x 16'long ZD SHORE GUARD 950 VINYL SHEEY PILES 3/4"MACHINE BOLTS DRAWN BY: JD 6/9/2019 SCALE: SEE PLAN F-� SHEET NO: JUN 1 ) PROPOSED BULKHEAD SCALE: 3/8" = 1'-0" O SURVEY OF A PORTION OF PROPERTY SITUATE AT SOUTHOLD SONG /SL,gND JUN 1 7 2019 TOWN OF SOUTHOLD SOUND SUFFOLK COUNTY, NY �o�° �� SCTM NO. 1000 - 51 - 04 - 08 a ��- �-_ 41DAMAGED ° ,, Sautho�d rows SEAWALLS�V h��eh�e\w tix\G y6QQ�� R o P��R1�� Q =EEDETA/L "A"HEREONg r a Trustees 8� s a x1 6.72 PIERI+7` EXISTIN a,l¢ ; TwzCiDa2 IER Q �1 HEAP c w?° nt 5z •,� o a2$F' .�ryx0.81 BW K M1 11.60 gUL TW2+7/C- Zn Mi w :t:/3@g� �. .7 toss wAuwO .a�o�3� 'rn ti g� n_ r M1+7ANSIDEBULKHCAD1151 , ' fa�7 F��., rof /`ST/NG ps�� SCALE. 1 = 20 AIf.7M'OOD WAL x 1 f S 3`_ N10 00 BNS 1 M1 CLO 11.6 Bob tan 11.76A41� noaMac�SS '� �` 7 e TYPICAL - � , GABBION BV�KH 7� +r N��6e/o�, MAGS/W WASHER 11.61 �� 1 B/FST/ ` W1EALr,B H&'f,/RAMP cBy RV 0 B90 M2+7 BULKHEAD OUTSIDE y� 70a•-,. STEff qts M1-7 '°° �,.�% ''�rS 82051,51" +``Lsr' M1+7/FLO 1098 BIB Mf*7 BULKNEAD � a 1 O M1+7/WOOD WALK 11.59 ^��J �i 6f,64 �� ` ow -'o Bt ^�ro N/TE 8,STONE pct` TW2+7/OUT WO 5017.27 TW217.35 W TW217.55 16;86 gW KB'4CKF/LL TyP/CAS 'a MADSWWASNER at TW3+7/OUT W0 50 23.12 TW32120 216nw 3�Dur�etap 2t a Tw., .tS1� M10.6 1 � a7BTTy�.7 � � aT4W ,y y t7 21$66 • � � TW4+7/OUT W0.50 28.72 7w� 7o�a 7 •L'7na+ do �c ?asB7x2•T �.. (n D TW42BBB y W W 2b.427W2 a7/OUTW067 �� TW5 7 28.46 TW2+noUr wo e728.58 ?Bz?TWB-7 • '?� `-, /V` W W O TVl5+7/OUT W0502&72 .t 1 Tb TW8+7/bU WO 07 • ��/�, I Z �•• �• W Y W •Y W W •L W •Y r'AA _M "aO•} � Y W •Y W •Y W •v � O O•f• r r I 'x -'x -x C rY^1 �x CO V B A IAND Sl4R(/BJ/J1V67.7Ne. W 44.03 c RF b^ �0 PETER A. GROBEN R6 r��� °m°°zzSzK' LAND SURVEYOR NY LIC. 50869 x 4.25 2 -'' y n P.O. BOX 704 RIDGE, NY 11961/ ®®7 17.7 cr x43 *pox N o 3 631.849.4750 13.6 12.6 J 1/1)� �, L 1 6 v D r: tea' 6.45 TW2 clq 1 STORY I. 2 Q AOI 0�0°9 x ��H 6D FRAME w ole, FRAME DWELL. a 3 O °� NOTES: J c a 10.4 NO. 20275 AC:ASPHALT a a p FF=45,3 9.8 11.6 w y I^off' w� b• A,F�;�%�. 19 AP:ANGLE POINT C Q % m 2 O 111 �� �� >058p/ER> sI '% BC:BEG. CURVE Q W co � A C a n �' I �� v` � �� �/ BG: BEGIN =W Z v N o -x- � �� I '%` Ol BLD:BUILDING o o M w ® Q 71p I m N g �'7 O BLDR:BOULDER ti z oo C E. 3 r 2 ~ �x CE: CELLAR ENTRY W °� ao 23.9 2 r (1I x e ` 8 47P1ER7-7 I �i0 CL:-CENTERLINE o �` _ -I �� - y - I a _ c 3 '; .� .., FH: PIKE HY©RANT � e"3 L "R.O. �P Q- '�i ;13_ zncee�c `sb' -; - tiQ N - -- -� 5 I aim .:� ► '°i �- FF:FINISH FLOOR to FS:FINISH SURFACE co GS: GAS SERVICE ,°� o I v 0 OH' OVERHEAD Q ccs ., OVERHEAD m Z N PCC: CONCRETE O 3 4. O j o N,� •ow' RO:ROOF OVER W a 18.5 � W SL T:SLATE TC: TOP OF CURB �O o° Z �Lu TS: TOP OF STAIR TW: TOP OF WALL a O �'� v y 0, PERGOLA �l N W I' my;, -, U/L: UPPER LEVEL W W 3 OVER SLATEV � ^ to O c 3 C PATIO I �n o 81 7 44 p��R'I Z l�ll1 Z , r 100.'vw'�• .. - c V 40.98 ��� !• ' roe?P�� RcCT x Q w o�clew•�V n g 2 W o SCTM LOT 08 .� o :, co N n ` J U. O J..T ; N .N m� ti 00 111 111 V o Z ti v and y :: 9 % y 111 Ss > y AI Z O ro Z ~ y � .. Ia n (Zl o. l co ti } SURVEYED: 12 AUG 2016 UPDATE: 18 AUG 2016,ADJOINERS UPDATE: 20 APRIL 2019,STORM DAMAGED SEAWALLS,PIERS 184,1g NOTE:ELEVATIONS HEREON ARE BASED UPON A GARAGE FLOOR ELEVATION OF 41.90 AS SHOWN ON NATHAN TAFT CORWIN Ill, NYPLS 50467 SURVEY, DATED 20, JAN 2014. SAID ELEVATION /S STATED TO BE N.G.V.D. 1929 DATUM. V N 820 s THE OFFSETS OR DIMENSIONS SHOWN HERON FROM THE PROPERTY LINES TO 53,0 W 66 64 THE STRUCTURES ARE FOR A SPECIFIC PURPOSE&USE.THEREFORE,THEYARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OFFENCES,ADDITIONAL STRUCTURES OR ANY OTHER IMPROVEMENT. ■ :GRANITE MONUMENT UNAUTHORIZED ALTERATIONS OR ADDITIONS TO THIS SURVEY IS A VIOLATION OF SECTION 7209 SUBDIVISON 20 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEA VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON THEIR BEHALF TO THE TITLE COMPANY,GOV- ERNMENT AGENCY AND LENDING INSTITUTION LISTED HERE ON. CERTIFICATIONS SOUND ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS VIEWAVE" NO RESPONSIBILITY IS ASSUMEDBY'THE UNDERSIGNED FOR ANY SURFACE, SUB- SURFACE, AERIAL EASEMENTS,SUB-SURFACE UTILITIES AND/ OR STRUCTURES IN OR OUT OF EASEMENTS IF SO PROVIDED. Michael J.Domino,President a`�QF SOUjTown Hall Annex John M.Bredemeyer III,Vice-President ,`OOl0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith l�[ L Southold,New York 11971 A.Nicholas Krupski G Telephone (631) 765-1892 Greg Williams i0 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT COASTAL EROSION PERMIT#9521 C Applicant/Agent: Michael Kimack Permittee: T. Bruestle-Kumra Revocable Living Trust & V. Kumra Revocable Living Trust SCTM#: 1000-51-4-8 Project Location: 20275 Soundview Avenue, Southold Date of Resolution/Issuance: August 14, 2019 Date of Expiration: August 14, 2021 Reviewed by: Board of Trustees DESCRIPTION OF ACTIVITY: Demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"x16' long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles, three (3) 8"x8"whalers, one (1)6"x8"follower, '/" galvanized machine bolts and 1" galvanized tie-back helical screws; new bulkhead to match height/elevation of adjoining bulkheads; and to install a retractable aluminum ladder to beach; and as depicted on the site plan prepared by Jim Deerkoski, PE, dated June 9, 2019, and stamped approved on August 14, 2019. INSPECTIONS: Final Inspection SPECIAL CONDITIONS: None. In accordance with Chapter 111-15 Erosion Protection Structures: xx A maintenance agreement is attached hereto and is a necessary special condition of this permit. Michael J. Do mo, President Board of Trustees Michael J.Domino,President QF S0 Town Hall Annex �► 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Jt Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 Greg Williams Ol Fax(631) 765-6641 �cOU � BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 14, 2019 Michael A. Kimack P.O. Box 1047 Southold, NY 11971 RE: T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING TRUST 20275 SOUNDVIEW AVENUE, SOUTHOLD SCTM# 1000-51-4-8 Dear Mr. Kimack: The Board of Town Trustees took the following action during its Regular meeting held on Wednesday, August 14, 2019 regarding the above matter: WHEREAS, Michael Kimack, on behalf of T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING 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, and Chapter 111 of the Southold Town Code, Coastal Erosion Hazard Areas, application dated June 17, 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, 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, 2 WHEREAS, a Public Hearing.was held by the Town Trustees with respect to said application on August 14, 2019, at which time all interested persons were given an opportunity to be heard, and, i WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 and Chapter 111 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 T. BRUESTLE- KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING TRUST to demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"x16' long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles, three (3) 8"x8"whalers, one (1) 6"x8" follower, 3/" galvanized machine bolts'and 1" galvanized tie-back helical screws; new bulkhead to match height/elevation of adjoining bulkheads; and to install a retractable aluminum ladder to beach; and as depicted on the site plan preparednby Jim Deerkoski, PE, dated June 9, 2019, and stamped approved on August 14, 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. Do no, Vice-President, Board of Trustees MJ D/dd - rr�ogUFFat/ Michael J. Domino, President Town Hall Annex John M. Bredemeyer, III, Vice-President o M 54375 Route 25 k to z.;�:� �r Glenn Goldsmith o .'° P.O. Box 1179 A Nicholas Krupskiy�j©� fool; Southold, NY 11971 Greg Williamsr Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: T. BRUESTLE-KUMRA REV. LIVING TRUST c/o MICHAEL KIMACK Please be advised that your application dated June 17, 2019 has been reviewed by this Board at the regular meeting of August 14, 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) 1 sc Day of Construction ($50.00) °/2 Constructed ($50.00) xx Final Inspection Fee ($50.00) Dock Fees ($3 00 per sq. ft.) xx 30-Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code The following fee must be paid within 90 days or re-application fees will be necessary You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $.50.00 BY: Michael J Domino, President Board of Trustees Michael J. Domir;' 'esident �Q �'�, " Town Hall Annex John M. Bredemeyer III,Vice-President ��a ���,,�� 54375 Route 25 Glenn Goldsmith z P.O. Box 1179 co 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: ?J6 I , Completed infield b p Y Michael Kimack on behalf of T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING TRUST requests a Wetland Permit and a Coastal Erosion Permit to demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"x16' long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles, three (3) 8"x8" whalers, one (1) 6"x8" follower, 3/" galvanized machine bolts and 1" galvanized tie-back helical screws; new bulkhead to match height/elevation of adjoining bulkheads; and to install a retractable aluminum ladder to beach. Located: 20275 Soundview Avenue, Southold. SCTM# 1000-51-4-8 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 osted: Y / N Ch. 275Z Ch. 111 � SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: ok -��o e� �� - cJS� (1044 6i WAi,s P-0&eee( y / VOJ yl I have read & acknowledged the foregoing Trustees comments: Agent/Owner: , Present were: J J. Bredemeyer `' M. Domino G. Goldsmith N. Krupski G. Williams Other r. Jul r 44 ;low, wit 8 / 6/2019 9 : 34 SURVEY OF A PORTION OF PROPERTY SITUATE AT SOUTHOLD TOWN OF SOUTHOLD LONG ISLANp S pVN p JINN 7 2019 SUFFOLK COUNTY, NY ,o`' SCTM NO. 7000 - 51 - 04- 08 �4 o �P `�_- o Southold Town DAMAGED 0Q Q� -1\G F� '� G1' V r of ni�tees '�.,2 SEAWALLSe h- ,% ,D1 aiy y6Q� Q�4'� 1�� Q1ER� 4=EE DE q/L q HEREON- sn ;fie �R1} 2� 6.72 PIER1+7 EXISTING bN,',a :,:� Tia p e ;`,$ ,��. a,.; 41 X 0.81 BW D Z8 a p BVL „ - '� �� - '� i77s 2. •••- �.q� r� .9.77+�.rp�sEn �'�0 ��, ��� / M1 11.60 rwz.T�w rwza r:f m s q ti Hitch u �n+ Earls77 SCALE: 1"=20' Mi-MISMEBULKHEAU 11 [ TippW i1X 7.f5Mi 1135M1- fAM f21� •�� 7� �Mf.• ~ ^���p�0 M, B� '• G 0 _- Mf' BW 10.77 �5 r r f�M AIf!ri / h �D 1� M1 CLO 11.6 11.76 ?� GABBION TYPICAL 1191 ` mss UVCKHEgpA6 7 B�AttN W1�R(/ MAGS/W WASHER 11.61 290r 7 's7csrr-ynA 7 s '7?S�rms M1.7HU KHEAp nE S 0-A30 MG+7/OULKHEAD OUT51 M7-7 1 10.98} Azs $7�E c 'a x�rff M1+7/F[owTHRU I M1+71WOOD WALK 11.59 �� =�Q Ami 82°$ ' G V _ 4- �`.��� WAIK +7/OUT WO-5017.27 n5f { \GRq /TEeI�S - TW2 TiN217.3 7. RO TONE , _ TW217.55 16.86 g1y KB'9CKF/LL A��s�WAs ER �- 23.12 aAf �. 7YP/CAL TW3+7/OUT W0.50 TM27T5 2f 517N9 D �r ovT i o707w�a t�. w W 6r 971t7hY0:6Z'366 ( G)r,T7 •(�y1 7w4+7/OUT W0.50 28.72 mn-72856 Lo 193 2A59ng7a y y n 7TWWS+57/O7TW92ABS 'Ton7u,bsUr Wo 67 2846 Two -cT28Iro58 -r UT Wo So I 28.72 ■ 1� *TWs.7/bUTM67 m z 0 10 ED N � �8 A LAND S*Rl/0J/�7Wg.7W40, W 44.03 W }n + �lb C " PETER A.,GROBEN �e `; 86 F �� � LAND SURVEYOR NY LIC. 508692s y C P.O. BOX 704 RIDGE NY 11961 8097 631.849.4750 co 17.7 c-4 S _ W it a' N13.6 1 STORY 72.6^ i ¢ O I ���D9ti�° n r. �45nW FRAME DWELL. 46 a 3 O ��0�a° vN T�> Eo NOTES: ?o a 10.4 NO. 20275 - °W° n Z ��°� . q• `S AC:ASPHALT a a o FF=45.3 9.8 11.6 I^oa 4'� •< /�R' �'`90 AP:ANGLE POINT a 2 00 m ,�1' 1Q58P1ER1 6 /0 BC:BEG. CURVE Q Z W a, AC a n I y� v\ 7j ,p ��C, BG:BEGIN =W= (3N L C�BLD:BUILDING p0 N - $ rO I mc � BLDR:BOULDER C.E. Z x c- PlER1-7 I W °D ` r " 23.9 z I' m o „ . 94� �, CE: CELLAR ENTRY , CL: CENTERLINE - a �.�. llt "t a r. v ;s 'may'"4 '�•Y �r S�4w"'"�.s�`���t�, .��; V�*�♦ -SYf► �^"�'''yg� '� ` (1)Kumra Residence t Taken June 13,20 19 Looking North y. i- (2)Kumra Residence Taken June 13,2019 Looking NNE s `F t* , i A Hio t P of mr �.. 'a► lit-S 444 i►. `�� x;/ �A 1 -1. Ku :description a residence Legend Write for your map. 20275 Soundview Ave la !� a � XPP r ;K w d r � . 'MF. "'I ,K a g • f• � � '• ` .,w � ���a�� ���il�:�y i'�V'Twp, _ rA $r a• � r N F i p tt� y+ Y SOUND EEE sEC.NO.,m ISLAND , { zi+ FwslwnRa•E9 �mwwNawl LONG t 0 'J 43 P.D.70 +{ +'' G z „ _AVE. 27 ,11 EC. N 51 6 7 • \ ,9 SEE SNQ36 1 I .. FD 1+o SCM.D 5 +� • ° w e a ," ^ .' 3le at 111y 10 tW'1 ,aN �i a 9 zz 1e/+� a a PDR PCLNa x,19 m ilE 3,8 w 'xp �1A rm i,)- E a °�ry, 652JI6C°t I ] \` 11{; 9URGiNDYL,a 3.xa x�L1 ry� S � 19 191 y1w _�+ IZ 3� ilJ' 311 all 33' �r ^' 3 yd1LOBERR'�+yiB 11 ,y1x 1�� PELONM:IAND TRUST,INC. 0 O Ts ^O 1{ q F� , O nox �xn SOJt� w +19• iio ,x�s 'y1{ • .t' O y\° 110 E 3E,w ^ a +all. w w ♦ S QO' ^Il- � a 9.9 y 129 y m W Orrt'lav�Mm,a/rsl } � m d M1 I 0 M1, $ may. d? xl v N 10A i� +a \\ � � Q� ,11,• �p I u� 03 97N.) s9FFFp1` © b Iu w �pll 69 1 FOR PLL NO SEE EEG No. 4 ,.G 3A w ry8 1M ^ ) m \ ` 055.03 L.NZo. \ {is 2.5 INq E 29A 9 w {M m 31 l C COUNTY OF SUFFOLK © K a SOUTHOLD SECTION NO L .".u. ur _ —_ o..... —_._— NOTICE WAFT E ,vow E µ7Z-- �"'.', I R9 —Q— �� _•__ _��--�-- c....x.,c». �1., Reay POPue.,rrtYuTaxwS�N,a+A9en� Y ,is ou mwaa 0$1 N P 9•n mms °ye 9,smn 99 1000 PROPERTY MAP OFFICE LOCATION: ®��®g S®ur�®l MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) 44C G Telephone: 631 765-1938 Southold, NY 11971 , �® P LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD I MEMORANDUM a I To: Michael Domino, President Town of Southold Board of Trustees .From: Mark Terry, AICP LWRP Coordinator j Date: August 8, 2019 j Re: LWRP Coastal Consistency Review for T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST &V. KUMRA REVOCABLE LIVING TRUST SCTM# 1000-51-4-8 Michael Kimack on behalf of T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING TRUST requests a Wetland Permit and a Coastal Erosion Permit to demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"x16' long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles, three (3) 8"x8" whalers, one (1) 6"x8" follower, 3/" galvanized machine bolts and 1" galvanized tie-back helical screws; new bulkhead to match height/elevation of adjoining bulkheads; and to install a retractable aluminum ladder to beach. Located: 20275 Soundview Avenue, Southold. SCTM# 1000- 51-4-8 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information 1provided on the LWRP Consistency Assessment Form submitted to this department, as well asIthe records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP proved the following is considered to further Policy 6. 1. Require the installation of a vegetated, non-turf buffer landward of the bulkhead. I Pursuant to Chapter 268, the'Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Peter Young,Chairman Town Hall,53095 Main Rd. fig Lauren Standish,Secretary 5 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 Thurs., August 8, 2019 the following recommendation was made: Moved by John Stein, seconded by Peter Young, it was RESOLVED to SUPPORT the application of KUMRA REV. LIVING TRUST to demolish and remove, if necessary, rubble from concrete piers and damaged seawall; replace with approx. 68 ft. of 12"X 16' long Shore Guard vinyl sheet piles with 12" dia. 20' long CCA piles and walers. New bulkhead to match height elevation of adjoining bulkheads and install retractable aluminum ladder to beach. Located: 20275 Soundview Ave., Southold. SCTM#51-4-8 Inspected by: John Stein, Peter Young Vote of Council: Ayes: All Motion Carried 1 S Town Hall Annex Michael J.Domino,Presidents � • 54375 Route 25 John M.Bredeme er III Vice-President Y �. � P.O.Box 1179 Glenn Goldsmith a' Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 Greg Williams � j � w � t Fax(631) 765-6641 A s ' •�-:zzzz•�,�`�`r BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension Received Application: t_17`!9 _ Received Fee: $ scmzu Completed Application: b - Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: rr n" Coordination:(date sent): - ��j 1 !� L P LWRP Consistency Assessme t orm Sent: 9,24 CAC Referral Sent: 7� Date of Inspection: �q7xim Receipt of CAC Report: Technical Review: :21 Public Hearing Held: Southold Tovr:i Resolution: Boar of?rust�z��.•,____..._.: TB/2lJ�STL�"kVi��,� RAX L l Y. �vs7_ Owner(s) Legal Name of Property (as shown on Deed): V K/>f eA 9E V L V r - Mailing Address: �7� C'��i� ��� BX DO�LY/V my z,2-3 ,1 If Phone Number: /,:E:— .x,52 Suffolk County Tax Map Number: 1000 - _117 - 41- 8 - Property Location: 2d1,�� 5'06"✓1,6 W AVE �`QU_Z7 L�U�✓Z Z, (If necessary,provide LILCO Pole#, distance to cross streets, and location) 4 AGENT(If applicable): Ml Ce A 41 12M UK Mailing Address: H ax 10q-7 Phone Number: _rz (P' ` Board of Trustees Application GENERAL DATA Land Area(in square feet): 41 QL14 Area Zoning: 4k7— 4 O Previous use of property: RETZ��Al.�/�W4E 6-4111/G V Intended use of property: �51® /f�,�j � Covenants and Restrictions on property? Yes X _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 _X_Nb 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 _N0 Does the structure(s) on property have a valid Certificate of Occupancy? _Yes No Prior permits/approvals for site improvements: Agency Date Ze lS' g N G. 6 0 /Ozz D If AV-P©614 �Zo L2 n'Pl/,S r45-T /7-- all04 7 �z 017 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: Pro'ect Descr, on(use attachments if necessary): ; �,�/ �1�0_ EJ%a?✓�;1�` �C�S'S IRY )PIZ s o AI& C C,4 RIZ-r-T, 7' A iEtVp 64Z -7 14/6 ,d!/L/���iaaS. l���CL P��T�'iSI cT.�1,�3�'-�G-U�'J ��4mm•�.� .�'a � � Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:' ;?�'Q , no!! �CV1 C01-4AEFZ V& V//1/ Y4 Hm f gz�" 70ZrAAF14/Z — )!�749oH 9As,� of W0QD &Z�rA IMQW-L­7 OA64, ra m5 v H0z'ey6Ax0 Area of wetlands on lot: a square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: /V�� _ feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? A41A cubic yards How much material will be filled? - !cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited:, 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): S' C Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: "CEHQIZ &A Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? _ y No Yes If Yes, how much material will be excavated? A/LA (cubic yards) w)How much material will be filled? }�(��g (cubic yards) l vvp,r,�elflou Manner in which material will be removed or deposited: 900" /1 O V40 2S'I C W A-4 Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) 2W4e5 e &a&5,42� 7 7W4 J=AST 4r �tJJ Sr IN /ymg C , T L/Tr"LA-S 00 e'I/ 617.20 Appendix B Short Environmental Assessment Forn: Instructions.for Completing Part l -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 frilly 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: vsAI U ;° Project Location(describe,and attach a location map): Z 02 7 �,.V/4EId .S'D��l�� l Brief Description of Proposed Action: '�A .W04JS�`i�N,t' A/0 V!: 1AC P✓ CONC. 11dW-5' AAV 49.41- 644 COAX,5,5A U.14 [, ;' P49CiAM /Z � �� CA/C� 1!�o,2zIJ �D �., VINYL 6Z7 P/LAS ®e� 6cs lr�04l641.4c1 ?14 /' 6441/. -J/�o4epC/�dlf/ �� 4yVB/�'/68407G ILC/ E-Mai l 1 � L Address: P. C3. 047 _ City/PO: State: Zip Code: / 197 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES 1f Yes, list agency(s)name and permit or approval: ❑ 9 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? 0.(jam acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? age4 acres 4. Check all land uses that occur on,adjoining and near the proposed action. u ❑Urban ❑Rural(non-agriculture) [—]Industrial ❑Commercial tesidential(suburban) ❑Forest ❑Agriculture F-1 Aquatic ❑Other(specify): _ ❑Parkland Page I of 4 5. Is the proposed action, NO ES .'/A a.A permitted use under the zoning regulations? El 9� ❑ b.Consistent with the adopted comprehensive plan? ❑ 9 ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: — _ _ � El 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? q Fdfl ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? IV 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 technologief_ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: l 19 ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? V _ ❑ b.1s the proposed action located in an archeological sensitive area? F- 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? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: w 14. ntify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Id Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional [] Wetland ❑Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? Wr ❑ 16.is the project site located in the 100 year flood plain? NO YES TTV- 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES 1 f Yes, a.Will storm water discharges flow to adjacent properties? FINO YES ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? lfYes,briefly describe: ONO YES Page 2 of 4 18 Does the proposed action include constriction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.flas the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ...... F] I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: � e' Date: _ Signature: Part 2-Impact Assessment. 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 scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan of zoning ® ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? © ❑ 3. Will the proposed action impair the character of quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the (� ❑ establishment of a Critical Environmental Area(CEA)? U 5. Will the proposed action result in an adverse change in the existing level of traffic of- affect raffect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate_�_ ❑ reasonably available energy conservation or renewable energy opportunities? LUUJ 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, rj( ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, (�1 Elwaterbodies,groundwater,air quality,flora and fauna)? LL��ll Page 3 of 4 Moderate small to large i impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any suppoi ting documentation, that the proposed action will not result in any significant adverse environmental im acts. Town of Southold-Board of Trustees �+ Name of Lead Agency Date Michael J. bornino President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer T i nature of Respon le�fiW�jadgency Signature of Prepares(if different from Responsible Officer) PRINT Page 4 of 4 rtf ( ji` Town Hall Annex Michael J.Domino,President 54375 Route 25 John M.Bredemeyer III,Vice-President r P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski "� iy Telephone(631) 765-1892 Greg Williams tc r Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30-YEAR MAINTENANCE AGREEMENT EROSION PROTECTION STRUCTURES CHAPTER 111-15 OF THE SOUTHOLD TOWN CODE The owners of record of property at: 2®Z�'3- SdUilW—WeW in the town of -7061-904P ., New York, SCTM#: 1000- in applying for a Coastal Erosion Permit for an erosion protection structure do hereby aqree to a z � � �- 30-Year Maintenance program for a structure as described:_ r , by I ftlk!�� 01����- arii I r c is e-e (`50 I kXVi 0r\ O-Clj as shown on the attached licensed survey and/or site plan for the approved structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years and/or equivalent to the original approved structure.Any maintenance which involves more than 50% of the length of this structure requires approval of the Board of Trustees.We further understand that failure to maintain the structure could result in a requirement to post a bond and/or have the repairs ordered as a lien against the property upon a findi by the Board of Trustees that said lack of maintenance would risk life, property or impory4nt na ral resource features. i TmA�r- — 4wv",/ SignatVrofowner of record Signa a of owner of record V/ �e �V)WA ��t'll�y'� 3'`� ,rah �A>U*SPY, V vLk; �� ofZ0U 7VIYo 7gRl�'T!.e-kOl e.4 AFI t�I���t'USr Notary Public MICHAEL&14MACK Notary Public,State of New York No.02145056823 This maintena c lid upon the attachment of a licensed land survey/and orf@ Rr nd year of the original construction and validated to show the final approval of the administrator. Board of Trustees Application AFFIDAVIT VI JAY kU"If--4 , 7-R615 —65E $9' r ,4117 ,, Sj-L —a IM:fi A, 7RtI 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. gna'ure of Property Owner Signatur f Property Owner I! 74NJ.4 8.t'UES16 6 V KV"RA ROV- 41V, TR UST 7-'�'�PU€sr --� A;"' . I-IV 7;PUST SWORN TO BEFORE ME THIS / __DAY OF_ �j , 20_Z?_ Notary Public MICHAEL A.IOMACK Notary Public.State of New York No.02KI5056823 DAMed In Nassau County Commission Expires March 11,2022 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) ee �LLc Ay kU ., -7TU-9=5 59 &-TA owners of the property identified as SCTM# 1000-_5S_1 8 in the town of .20 127-1V 02W =New York,hereby authorizes 1<2"A GA—'—*'- 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. p Owner's Signature Pro Owner's Signature ✓��iq KUh��4 'us T,q �PIJ� ► —�f/r�l�P.4, (JSP V 6lUi�i ,�17 4/V �KUS� 7 SFA .45Yte IeOeRA � L,/Il. USS SWORN TO BEFORE ME THIS DAY OF �� _ ,2019— Notary Public MICHAEL A.IQMACK Notary Public,State of New York No.02IC5056823 Qualified in Nassau County Commission Expires March 11,2022 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofSouthold's Code of Ethics Prohibits conflicts ofinte cst on the part of town 6fficer5 and emnioyecs.The nurpose 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: A (Last name,first name,Middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',nixie the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage;or business interest 'Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO �. If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the appticant/agi�nt/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 ant (when the applicant is a corporation); B)the legal or Beneficial owner ofany 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 `day of �� ZO SignatureI Ede Print Name e Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibiLc eanflletss ofinterast on the part of town officers and employees The purpose of this form is to provide infori»ation which can afert the town ofnossible conflicts ofutterest and allow it-to take whatever action Is necessary to.avofd same. YOUR NAME: ame, f ( ast name,first niddie initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance _ Trustee Change of Zone Coastal Erosion Approval of plat Mooring _ Exemption from plat or official map Planning Other (If"Other",na3ne the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock ofthe applicant (when tho applicant is n corporation); 13)the legal orbeneficfal ownerof any interest in a non-corporate entity(when the applicant is not acorporation), C)an officer,director,-partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted t i ?day of Cl 20 Signature Print Name Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORINT The Town of Sout o d's Code of Ethics prohibits c nf11ct5 ofintgrgst on the part.of town of c rs a d e to ecs.The purpose,of this form is to provide inforination which can alert the town of possible contlicts ofinterest and allow it to take whatever action Is necessary to.avoid same, ' YOUR NAME: / ST?�^KUMrpA 7%�itlr7'/� (Last name,first name,ipiddle initial�unless you are applying in the name of someone else or other entity,such as a company.if so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee _ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if"Other*',nape the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employce of the Town of Southold? "Relationship"includes by blood,nturiage,or business interest `Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)'a corporation in which the town officer or employee owns more than 5%of the shares. YES _ NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the 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 d f _ 200/0 Signature Print Name Form TS 1 rte' Michael J.Domino,President t0��S�FF(1(kco Town Hall Annex John M. Bredemeyer I11,Vice-President liy:21 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 cn �..,. A.Nicholas KrupskiSouthold,NY 11971 Greg Williams �� p�,Y Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING 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, HMMA154 A ]WHA C16 , residing at/dba R 0,B69 1 1W-7 16012Y 048 N,, //?7./ being duly sworn, depose and say: That on the67lday of,406PU5r , 2019, 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, August 14, 2019. Dated: (signature) Sworn to before me this )'64�) day of)kU�20 I I OONNIE I?.BUNCH Notary Public,State of New Toric No.01 BU6185050 Qualified in Suffolk County yvr Commission Fmires Aioril 14, 0 Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 4,14 �W- BAqi 1 a C11971 ,rd�ryo�v, N y v: V oL4NPW Al. .. 1 /Las Z ?- 2Z 30 ' '�oz, STATE OF NEW YORK COUNTY OF SUFFOLK cle , residing at -, being duly sworn, deposes and says that on the day of AV&&Sj' , 2V?, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at �`U[J�01. , that said Notices were mailed to each of said persons by CERTIFIED MAEURETURN RECEIPT. Z'ld'wz-91--el Sworn tp before me this I Day of 20�_ VV ` 1 \1v VV Notary Public CONNIB D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2-Cj�Z 'U.S. Postal Service -i iU.S. Postal Servi CeTMC3 CERTIFIED - o ■ . i GERTIFIEDo . Ln IECEIPT ru D,mesticMail •nly -0 '• Q' fU mestiq Mail only i rr .- I nj s0u . P 1L7,1 �, ao 1�6 L U, ru W j r-1 Certified Mall Fee $3.50ta I 3 ertifted Mall Fee $3. � t jun $ c 0971 0971 Extra Services&Fees(checkboz add ree y�eepp qa 02 Extra Services&Fees(checkbox add lea �p� qe 02 El Return Receipt(hardcopy) $ t t.U4J te) ❑Return Racalpt(hardocpY) $ te) I C7 ❑Return Receipt(electronic) 0 ❑Return Receipt(electronic) $ $a C3 ❑Certified Mail Restricted Delivery $ g— t'y ty� Postmark - ❑CertRied Mail Restricted Delivery $ Postmark Here I C7 ❑Adult Signature Required Here C] ❑AduttSignatureRequlred $_wry L,y $— -R,$— ❑Adult Signature Restricted Dellvery$_ ❑Adult Signature Restricted•pellvery$ ccl-00 Total O.S.�I i CO Postage 55 0 Postage and F$e�.8$ 08/06/2019 C3 Total Postage and Feb 85 08/06/201-9 f $ $ �O Sent To CO Sent To Stieet an Ad�t No-pr p-�B_NI' __ _C------ i o _P011T0 �p - -- -- ( to to ry 0 SOL I crit'szit�+d Y :11 , 9�/ . N•y. 0r3%6 --- 1 1 111•, _-- •� � 1 1 111•1 TM U.S. Postal Service CER �- o RECEIPT o i AST .for _r- Domestic Mail On Er t-Or deliVery in _ OD C3 CO Q V� Q N' rt O tp r ru A, � 1 s o = iV y mID N N I. Certified Mad Fee $3.$� _e LVJ w� Co $ 0971 `` C3 , N CL j C] p C ln0 � O .Nt w Extra Services Cc Fees(checkbox,add fee 02 ' s D. N (3 El Return Receipt(hardcopy) cn $ �°—a are (JI, (p 3 (Jt 0 ❑Return Receipt(electronic) $ � ,y,1 C9 „3n 3 ° O N ^�w '�Q mw mea Q ❑Certified Mall Restricted Delivery $ Postmark z L-j u W fA O ❑Adult Signature Required $ Here 1'1„3 ? wIn ❑Adult Sl nature ` •mv `�t�� 1 0 y C7 9 Restricted Delivery$ O � � O Postage ,ry @ ,a p tb ` 3 G.Or C3 D C7 Total Postage and Fes 08/06/2019 o $ $a.85 Cc r-1 Sent=o w W n' C:1 S__ _ Street d } (D o., r P o• s City, 1 tate"-1 q - _ ❑O El O❑ ❑m ------------------------ m O 111,1 _ fAG O..mi:i����� �' � • _1� - �mp»3�cco mm �.tb 7 SM oco '2 Q � Y" m ��-"• N 1 Q K QQ I m o o Q m •Z � w m Z CL a ' m aw13 rOO❑ m 3. I ,Cy, •yro�Kjo0M T O N m n "00o � �»m_ p,., 7d mom-' mwt� Z'C Vo y coo i '2wm j m Qro m oo' G• v� m .�. ° ® �CD I PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: S1 - L4 y L4 3 1- /q STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at that said Notices were mailed to each of said persons by CERTIFIED MAEURETURN RECEIPT. Sworn to before me this Day of , 20 Notary Public NIUTILL Ulm HLAKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD : T. BRUESTLE-KUMRA REVOCABLE LIVING TRUST & V. KUMRA REVOCABLE LIVING TRUST SU BJ ECT OF P U B LI C H EAR I NG : For a Wetland Permit and a Coastal Erosion Permit to demolish and remove, if necessary, rubble from concrete piers and damaged concrete seawall; replace with approximately 68 feet of 12"x16' long Shore Guard 950 vinyl sheet piles with 12" diameter, 20' long cca piles, three (3) 8"x8" whalers, one (1) 659x8" follower, 3/4" galvanized machine bolts and 1" galvanized tie-back helical screws; new bulkhead to match height/elevation of adjoining bulkheads; and to install a retractable aluminum ladder to beach. Located: 20275 Soundview Avenue, Southold. SCTM# 1000-51 -4-8 TIME & DATE OF PUBLIC HEARING : Wednesday, August 14, 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 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 exemptlactions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its significant beneficial and adverse.effects upon the coastal area(which includes all of Southold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- giMorting 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# PROJECT NAME 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: J920—#V CVXPV 01fRAOVCVXf IiC/V'E C aNC• Z** #4ND AO COW C'VA/C, SAAl�AV4 � 0,0&AW W/��'/Abx 68,0T d���/6 GONG ,r/-M& UA o v/ yc cC/.� If ��LlJhi OA G L "xd'',0oa OUI J-All Gam/. HACAMAO AMTS, ,4#D GAZi/. r'/6 8A .M51/C41 = r. / 1 Location of action: 202 7.S ro mAzo V/SUI R1/,�-SSD?aW Site acreage: Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: rBRCOJVr1 Y IeURRW RXV aVA/61ZZ S'r (a) Name of applicant: (b) Mailing address: /ZZ C44I&RC CL S'T. ,8iLO9&--YX N•Y �/Z,3 f (c) Telephone number: Area Code( ) 917 " 4Z 4T2 Z (d) Application number,if any: /6 _ Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No D4 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 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 ,,:i�otApplicable_ ___ __ _ __ . - -- CD/�iST.dr„�D C.4T/� Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—��pPolicies Pages 3 through 6 for evaluation criteria 11Yes El No 1/7i Not Applicable I hys Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No D< Not Applicable �QU Me I ,Aeor_ a4AN 7T M/S RZOOFc - 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 Attach additional sheets if necessary Policy S. 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 c o [. t arjecr 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 POSY (o Al D T MAZ• 7D Mf 0MC1' Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes [:] No� Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No Ix Not Applicable _ 7-AVS PPedT,�C'l" 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. ❑ Ye❑ No® Not Applicable PW cY 9 pilo r Apa 7V rA&J ' PgOTFc, Attach additional sheets if necessary �I WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No X Not Applicable r lj A107- ,4M- 7T 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 54 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable 01 D c. 45 /-Or .469L. T2s 71.x' "am er PREPARED BY_jjA AQ/y%4C&- TI.TL �(�/�� TATE