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TR-9578A
-0S�fr�c� tib. Michael J. Domino, President `,o�o �oGy` Town Hall Annex John M. Bredemeyer, III, Vice-President 54375 Route 25 Glenn Goldsmith r N �?$ P.O. Box 1179 A Nicholas Krupski y o�,4r 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 '/2 constructed When ro'ect complete, call for compliance inspection; P J Michael J.Domino,President QF so Town HallAnnex John M.Bredemeyer III,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams '� �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9578A Date of Receipt of Application: October 7, 2019 Applicant: Reilly Family Revocable Intervivos Trust SCTM#: 1000-37-5-13 Project Location: 300 Knoll Circle East Marion Date of Resolutionlissuance: November 13, 2019 Date of Expiration: November 13, 2021 Reviewed by: John M. Bredemeyer, III Vice-President Project Description: Remove and replace in-place approximately 811f of existing timber bulkhead with vinyl, remove and replace in-place most seaward 281f of existing +/- 42'westerly timber return with vinyl, and remove and replace in-place +/-13' easterly timber return with vinyl; backfill with approximately 15cy clean sand/loam fill to be trucked in from an approved upland source; establish and perpetually maintain 10'wide non-turf buffer adjacent to 811f vinyl bulkhead.. 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 En-Consultants, dated September 27, 2019 and stamped approved on November 13, 2019. Special Conditions: The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit 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 5uffolk Cou,ty Hagstrom Map 50 1" - +20001 --- - _- /l " J\P 1 � � 0 aA �y (�1 �s re6 OCT 7 2019 0 �.oQ PIfyE P( N y ,� SCL'tf1Uf:1_To vi,n of Trustees 511'F(ACa55 VIA 50J�CT FPOf' m' & rn J 519pIN6 POMP PY PAP,6Q --� �� Notes; 1) Purpose;feplace and maintain exlstmq functional bulkhead for flood&erosion control ® CONSULTA��TS 2) Vatum;MLW- 0'-0" O ®y 5) Approx,15 cy clean sandy fill to 6e trucked in from 1319 NORTH SEA RD. 3Q Q- an approved upland source and used as backfill SOUTHAMPTON, NY 1168 �� 4) New bulkhead to 6e constructed with vinyl sheathing, Y 77 _ s treated structural timbers,and hot-dipped O > — ,2 O galvanized steel hardware 631-'�*ftVED B 5) Project plan based on land survey prepared 64 Q Peconic Surveyors,PC,,dated November 9,2018 DOAK® ®� I >�UST�E 3 J 6) Plan and crossview diacfams are schematic in nature and are Intended only to establish project location,scope, and basic construction details for permittinq purposes 'TOWN OF SOUTH and are not intended to serve az or substitute for engineering or construction plans for construction purposes ®ATE Nom. 13,20/Q 1 ST 1) Property location 300 Knill Circle,Past Marion; N06Y FR 5CfM#1000-31-5-13 0'4R GE& V_ V_j V a P'4 T10 V_ V_ � ti \ � V A�0 0 tioti/ 7j 01 +28' SECTION OF EX. +42' TIMBER RETURN TO BE REM'D & REP'D (IN-PLACE) WITH VINYL RETURN \\ o EX. +13' RETURN TO BE x \ \ REM'D & REP'D (IN-PLACE) 7' \ WITH VINYL RETURN APPROX. 81 L.F. OF EX. TIMBER ADS. BLKHD BULKHEAD TO BE REMOVED & REPLACED (IN-PLACE) WITH VINYL BULKHEAD PPZOPO51�19 DU.HAn VI.AaWNT SPRING POND FOP\ P&LLY FAMILY P VOCA[31,1� TP\U5f (N/01F GARDINERS BAY ESTATES CLUB) ON 5FF\IN6 PON19, �W MAPION, 1"0. 0 5OUTHOLP, 5UFFOLK CO,, NY 5111�1�1'I OF 2 9-21-19 d .l I �;I►I OCT 7 2019 Sou gold Town Bgrd of lrusloes 5�CTION TNI?U IN-FI ACS PUI,KNFA19 FPC AC�M�NT 1" - 10' var.) —{ � I o APPF?OX,XP A OF BACKFILL/PPOP.NON-tUP.F 6L1FFEp w -10' 1 3" x 6" fOP CLAMP 2" CAP MM- 2' -6" (3) 6" x 6" WALES MLW- 0' -0" EX,GSE 10" LAYLOG +14' PEN. F7WMAN PLOP,VINYL BLILkfAp IN 035" x 9" x 16' VINYL 51-fATHIN6 PLACE OF EX.fIMBEt BLKNI7. 10" x 20'PILE5 E N m CONSULTANTS 1319 NORTH SEA RD. SOUTHAMPTON, NY 11968 631®283-6360 KOPO51�19 PUI.K M? PLACMW FOP, SILLY FAMILY PVOCAPL. VU5T ON 5RIN6 POW, �A5T MApION, T0, 5OUTNOL12, 5UFFO.K CO., NY 51-11�1�T 2 OF 2 9-2-7-I9 Michael J. Domino"'Pi' ,nt QSUFF014-C Town Hall Annex off, OG John M. Bredemeyer III,'Vic.".=.'.'esident �� ��, 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams 4,- ®� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �'� 9 �, l Completed in field by: En-Consultants on behalf of REILLY FAMILY REVOCABLE INTERVIVOS TRUST requests an Administrative permit to remove and replace in-place approximately 811f of existing timber bulkhead with vinyl, remove and replace in-place most seaward 281f of existing +/-42' westerly timber return with vinyl, and remove and replace in-place +/-13' easterly timber return with vinyl; backfill with approximately 15cy clean sand/loam fill to be trucked in from an approved upland source; establish and perpetually maintain 10' wide non-turf buffer adjacent to 81 If vinyl bulkhead. Located: 300 Knoll Circle, East Marion. SCTM#: 1000-37-5-13 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 V/ Ch 111 SEQRA Type: 1 II Unlisted Action Yp 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: Id r,2 1.4 au/ An,, t, 41/1 �P I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: �J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other SURVEY OF PROPERTY A T EAST MARION N S31 42,50 E� TO WN OF SO UTHOLD 5.00 , �C CURB SUFFOLK COUNTY, N. Y. i r� _'_� n'' f r; 1.2'EI �`�o 1000-37-05-13 `=—_--t j 1 7 * 1� 'on • CC SCALE: l!--20 NOVEMBER 9 2018 OCT 7 2019 M , M I `WATE Sruthold lows I METER Board of Trusiees FE•END• ----- t I 0.37E I N En •P I o� Ln CURB m �," O 1.7'E �Qy rn STEPS o2�\ 0.4'W I P/0 LOT 28 REEWALL I 6.81 POST & 1.5'E I RAIL FEN. POST & RAIL /�� 11.4. C FENCE ALONG / o Q pNQ CE FE..EE D. RET .WALL 3�' I '� UNDER 7 9' I 15.x• 13,4• FE.COR. O RET.WALL M M 1.1'E N I 0.8'W S v l� BLKHEAD. ' I HQUS ;uPR m X /� ONS E I G'gRq E dc I v LOT 30 m X Tpp 14. I OUT ►� ��.43</fy ? a 6 SHOW R I 0.3'W� AG I a: 3 . X </rh�O S 9, �6 9 Cp INTEHR_ P/0 LOT 28 I N` PAnp 1.27E TOP BLKH. o • EL=5.0' I STONE o I CONC. RET.WAL. m ° I STEPS 0.3'W FE.END. KEY FLAG I M 0.8'E POLE I LOT 297 N 0 = REBAR BLKHEAD' 0.5'N I ® = WELL EL=3.8' I A = STAKE = TEST HOLE 2`328 p � OF Nett' • = PIPE � CO �X4 T.mrc% G.�y ■ = MONUMENT WETLAND FLAG �Q, = U1ILITY POLE BLKHEAD. y 'd :}� ' ` ► 8 0.1'w - E 40 LOT NUMBERS REFER TO "MAP OF SEC77ON TWO, GARDINER'S o.L BAY ESTATES" FILED IN THE SUFFOLK COUNTY CLERK'S OFF7CEI4'[7 .Y.S. LIC. NO. 49618 ON SEPTEMBER 23, 1927 AS MAP NO. 275. BLKHEAD.." PECONIC SURVEYORS, P.C. 0.2'E (631) 765-5020 FAX (631) 765-1797 -ANY ALTERATION OR ADDITION TO THIS SURVEY IS A WOLA77ON OF SEC77ON 7209OF THE NEW YORK EL=3.9' AREA=7,808 SO. FT. ST47E EDUCA770N LAW. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CERTlF7CA77ONS HEREON - P.O. BOX 909 ARE VAUD FOR TRIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR,COPIES BEAR THE IMPRESSED TO TIE LINES 1230 TRAVELER STREET 18_172 SEAL OF 7RE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, MY 11971 I N 1 Board Of Southold Town Trustees SOUTHOLD, NEW YORK , �` 1-1.77 14. DATE: ..9J.Z5/97 PERMIT NO. . ISSUED TO . PAUL..AEI14,Y Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893-, and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the 'Resolufion of The Board adopted at a meeting held on .9/Z4/9.7 19. 97-, and in consideration of the sum of $.100,..Q.0 paid by PAT ..... ... ...... of ......East n Mart and subject to the Marion,....•...... N. Y Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Grandfather Permit for an existing 811 timber bulkhead with a 451 return and a 101 return. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and theseesents to eta x be subscribed by a majority of the said Board as of Zis date. ....... ............. . ...... .. .......... .. . ..... CM 'A ...... .... .... ......... .......................... ... '14 REILLY FAMILY REVOCABLE INTERVIVOS TRUST,300 KNOLL CIRCLE,EAST MARION loll a t 1 � Figure 1.Looking northwest at existing+81'timber bulkhead to be removed and replaced(in-place)with vinyl bulkhead. r Figure 2. Looking southeast at existing±81'timber bulkhead to be removed and replaced(in-place)with vinyl bulkhead. REILLY FAMILY REVOCABLE INTERVIVOS TRUST 300 KNOLL CIRCLE EAST MARION � I l ° a .., M � ,• s� s i�1'a\e,t'L4 " \Y ',�t �a.,""•.y _ ,s t f A �, �� Y �fS i i i r. Y J',•� R s1��°Z �� ���geu•'� tq v Fi It i �:. a?s� i ►+- �e''.*'�_/�iv-R. Figure 3.Looking north toward adjacent bulkhead to west over top of±28'section of existing westerly return to be removed and replaced(in-place)with vinyl return. 7 x Figure 4. Looking east from adjacent bulkhead to west at_+28'section of existing westerly return to be removed and replaced(in-place)with vinyl return. ` F 1• 9 Yr t U. ir t �300-Knoll Cir _ Asit `� '�'�,' `� ��#"�:'�#`►*� .,.amu �_. N , r r P ,A, $° 4 �+,• I ' r r r I enrnew � t " r z, � �O fa,` ♦ �- ----+-- e 5 / b + "µc, ` ee e ORIENT iwq ZU(q �Y I iMROpe �A r .�� �„ ,. ,�, NOTICE COUNTY OF SUFFOLK © x mf a+. *�+� SOUTHOID SECTION NO E �,._�. —�— lzl l O ^—- — —— �_— —_—_ Real Property Tax Service Agency Y E arruu. M:--- arr. _ ___ _—�-- a.rrr--M-- Cevwy farrYfRMrIW,NY11fOt M Wi O3/ y+ rr rriv uarxleUrgv oFwvr Povr�orvff rvE "^ mora aw —__— 41. uWr •r �� w.sswccouvry ru wviswwai,n h,.r •y y m! Hatt xO ...�� a ...� arwn.w.0 r•— ...ter.. --.-- .��a..�--ter-- .�.,.� �.e..+a wrxaurwarr,ry oExarw+w a,rive r e s� A P 7000 PROPERTY MM 04 0 OFFICE LOCATION: ®� S® ® MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 • �Q Telephone: 631 765-1938 O Fax: 631765-3136 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: November 7, 2019 Re: LWRP Coastal Consistency Review for Reilly Family Revocable Intervivos Trust SCTM# 1000-37-5-13 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is EXEMPT from LWRP review pursuant to Chapter 268 Waterfront Consistency Review§ 268-3. Definitions, B: B. Replacement, rehabilitation or reconstruction of a structure or facility, in kind, on the same site (inplace), including upgrading buildings to meet building or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures may not be replaced, rehabilitated or reconstructed without'a permit and shoreline erosion control structures (including, but not limited to, groins,jetties, bulkheads, filled piers) located within Great Peconic Bay, Cutchogue Harbor, Little Peconic Bay, Hog Neck Bay, Noyack Bay, Southold Bay, Shelter Island Sound, Pipes Cove, Orient Harbor, Gardiners Bay, Long Island Sound, Fishers Island Sound and Block Island Sound(excluding all creeks); 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 Michael J. Domino �sident Town Hall Annex John M.Bredemeyer III,Vice-President �Og,VfFOJ�.0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith ��O ��� Southold,New York 11971 A. Nicholas Krupski Telephone (631) 765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit �_���_Amendment/Trans fer/Extension Re Applicati°�n: 10.7• q Received Fee: $ Completed Application: t®,7.( Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Assessment Form Sent: 1�•�•1% �` ;= !{�' , , 8 ' —�� AC Referral Sent: �'-- Date of Inspection: Receipt of CAC Report: OCT 2019 Technical Review: Public Hearing Held: s(�- Resolution: Seeiimld Toti^m Board of 7rt�si.z� Name of Applicant Reilly Family Revocable Intervivos Trust c/o Paul Reilly,Trustee Address 10305 SW 99th Street,Miami,FL 33176 Phone Number: Q951 279-8901 Suffolk County Tax Map Number: 1000 - 37-5-13 Property Location: 300 Knoll Circle,East Marion (property located on south side of Knoll Circle,+/-370'east of Bayview Drive) (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road,Southampton,NY 11968 Phone:631-283-6360 Board of Trustees A, lication GENERAL DATA Land Area(in square feet): 7,808 sf Area Zoning: R-40 Previous use of property: Residential,single-family dwelling Intended use of property: No change Covenants and Restrictions: Yes X No If"Yes", please provide copy. Will this project require a Building Permit as per Town Code? Yes X No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by Building Dept. Yes X No Does the structure(s) on property have a valid Certificate of Occupancy X Yes No Prior permits/approvals for site improvements: Agency Date Southold Trustees#4796 (bulkhead) 9-25-97 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): Remove and replace(in-place)approximately 81 linear feet of existing timber bulkhead with vinyl bulkhead,remove and replace (in-place)most seaward 28 linear feet of existing+/-42'westerly timber return with vinyl return,and remove and replace(in place) +/- 13'easterly timber return with vinyl return;backfill with approximately 15 cy of clean sand/loam fill to be trucked in from an approved upland source;and establish 10'wide non-turf buffer adjacent to 81 if vinyl bulkhead,all as depicted on the project plan prepared by En-Consultants,dated September 27,2019. Board of Trustees App] Xtiori WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Flood and erosion control through replacement/maintenance of existing bulkheading. Area of wetlands on lot: +/-45 sf square feet Percent coverage of lot: +/-0.6 °% Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? N o X Yes If yes, how much material will be excavated? N/A cubic yards How much material will be filled? +1- 15 cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: Approximately 15 cubic yards of clean sand/loam fill from an approved upland source will be delivered to the project site by barge and dumped and graded behind the new bulkhead as backfill. 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): The subject property has been unproved with and protected from flooding and erosion since prior to 1959 by the existing bulkheadmg,which was permitted by the Board of Trustees in 1997 pursuant to Grandfather Permit No.4796. There is no viable non-structural alternative to the proposed in-place replacement of the existing bulkhead and returns,which tie into the bulkheads on the adjoining properties,for protecting the subject and neighboring properties from flood and erosion damage and loss. The project thus seeks only to maintain the historically existing,permitted condition of the property's shoreline without causing any change in or significant adverse impacts on the adjacent tidal wetlands or waters of the Town. 3 t Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Paul Reilly,Trustee,Redly Family Revocable Intervivos Trust dated 11/30/94 I owners of the property identified as SCTM## 1000- 37-5-13 in the town of 9 7 Southold New York,hereby authorizes F A 2 En-consultants to act as my agent and handle all necessary work involved with the application process for pennit(s)from the Southold Town ]hoard of Trustees for this property. C r N/A ropeyv nni ks S' ature Property Owner's Signature Paul Redly,Trustee Reilly Family Revocable Intervivos Trust dated 11/30/94 SWORN TO BEFORE ME THIS 2 -7 DAY OF + ,20 q i i o�0 .0, U91A L.GONZALEZ•FADUL = c Notary Public State of Florida p Commission#GG 336073 Notary Public My comm.expires May 19,2023 I Board of Trustees Application County'of Suffolk State of New York Paul Reilly,Trustee,Reilly Family Revocable Intervivos Trust dated 11/30/94 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 I WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES E 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(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SigIlature Pa I Reill , to Reilly Family Re ocable Intervivos Trust dated 11/30/94 SWORN TO BEFORE ME THIS 2-71 -DAY OF� S UBIA L.GONZALEZ-FADUL v A Notary Public,State of Florida " Commission#GG 336073 My comm.expires May 19,2023 Notary Public P33�. 4-.Z k;ap zpxza ' Lu z:.n'm n'.ji"' iap mp mma:rulno a'-'&kdmin:I?o 1=!''p ee-C.mr,,- vom""�4�Tm�'Ia�dazq zonza's no-o'rxg V'4qrtd:l Fz 'jqm lllin;es' : A x'� r*,%nif-ue" "T^Nr= 'MO GIj rev x V21 a Zf! 9 MIRUT mewT ml -PZ, 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 employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same YOUR NAME: Hermann- Rnharr F. (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 XX Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest "'Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"'YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person_ Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check 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 43Cday of Sept anber 20 19 Signature Print Name E. Her=ann Form TS 1 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I-Project Information.The applicant or project sponsor is responsible for the completion of Part 1.Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1 You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project Reilly Family Bulkhead Project Location(describe,and attach a location map)- 300 Knoll Circle,East Marion,Town of Southold,SCTM#1000-37-5-13. Property located on south side of Knoll Circle,+/-370'east of Bayview Drive(location map attached). Brief Description of Proposed Action- Remove and replace(in-place)approximately 81 linear feet of existing timber bulkhead with vinyl bulkhead,remove and replace(in-place)most seaward 28 linear feet of existing+/-42'westerly timber return with vinyl return,and remove and replace(m place)+/- 13'easterly timber return with vinyl return;backfill with approximately 15 cy of clean sand/loam fill to be trucked in from an approved upland source;and establish 10'wide non-turf buffer adjacent to 81 if vinyl bulkhead,all as depicted on the project plan prepared by En-Consultants,dated September 27,2019. Name of Applicant or Sponsor: Telephone: 305-279-8901 Reilly Family Revocable Interivos Trust c/o Paul Reilly,Trustee E-Mail: paul8901@att.net Address: 10305 SW 99th Street City/PO: State. Zip Code. Miami FL 33176 1. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation9 If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that X may be affected in the municipality and proceed to Part 2. If no, continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes, list agency(s)name and permit or approval: X DEC,COE,DOS 3.a.Total acreage of the site of the proposed action? 7,808 sf b. Total acreage to be physically disturbed? <5,000 sf c Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 7,808 sf 4. Check all land uses that occur on,adjoining and near the proposed action. ❑ Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial ® Residential(suburban) ❑ Forest ❑Agriculture N Aquatic ❑ Other(specify) ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify- Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation& scenic beauty,Agency: Suffolk County,Date:7-12-88 X 8. a Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 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: N/A 10 Will the proposed action connect to an existing public/private water supply9 NO YES If No,describe method for providing potable water- N/A 11 Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment N/A 12.a Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places9 b. Is the proposed action located in an archeological sensitive area? X X 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? X b.Would the proposed action physically alter, or encroach into,any existing wetland or waterbody? X If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 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 ® 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? X 16 Is the project site located in the 100 year flood plain? NO YES X 17 Will the proposed action create storm water discharge,either from point or non-point sources? YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO❑YES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: I X 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: X 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: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Robe Herrmann,Coastal Mgmt. Specialist Date: September 30,2019 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 or 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 or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b. public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic, archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality, flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may 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 I 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 supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 :z v" 7 is appfixximalely 2,000 -4,000 5,000 Feet' �,50 0 Scale 1:24,006:1 o" m 7?'Ia'00" 72-21'G, U3' fl� '�24'4!V :3�- '53 t V, V T E PS k>- Cam East Marlon 4j Orient Park 4,44 Central xz Cam 7 -7 YC 0 lent'A 17— Socl us — sr G P1,F tmd ,\j %ti2 FT A EAS lulm 4 25 3 9 90 oy PS sy Alarion Lik-e 5uffolk County Hm5trom Map 50 .111 = 2000' % 0 RA D 42 P P ti -7 R Qa 59 C ACC�55 VIA c— A T 2 5KIN6 POW PY PAP\6Q Y, '0 Cleves Pt Long Bea 0 LH gs Pt Yot Hay Beach Pt ri 41 LA LH RD-- dfl CUP �Comehus Pt Da E wik I/ wooftiv H Elm Y W / ay Gardeners Bay De Ing Pt cc DERING W)o RD -40 R Gt\ ,r AA R\ri nn Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1, All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 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# 37 - 5 - 13 PROJECT NAME Reilly Family Revocable Intervivos Trust The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 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: Remove and replace(in-place)approximately 81 linear feet of existing timber bulkhead with vinyl bulkhead,remove and replace (in-place)most seaward 28 linear feet of existing+/-42'westerly timber return with vinyl return,and remove and replace(in place)+/- 13'easterly timber return with vinyl return;backfill with approximately 15 cy of clean sand/loam fill to be trucked in from an approved upland source;and establish 10'wide non-turf buffer adjacent to 81 if vinyl bulkhead,all as depicted on the project plan prepared by En-Consultants,dated September 27,2019. All policies have been checked"Not Applicable"because pursuant to Town Code§268-5 ("Review of Actions")and the corresponding definitions of"action"and"minor action"by§286-3 ("Definitions"),the project meets the following definition of a minor action and is thus not subject to waterfront consistency review pursuant to Chapter 268: "GG.Within all Town Creeks,replacement of existing bulkhead on the applicant's property in the same location with a silt contain deployed prior to and during construction." Location of action: 300 Knoll Circle,East Marion Site acreage: 7,808 sf Present land use: Residential,single family dwelling Present zoning classification: R-40 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: Reilly Family Revocable Intervivos Trust (b) Mailing address: c/o Paul Reilly,Trustee 10305 SW 99th Street,Miami,FL 33176 (c) Telephone number: Area Code 305-279-8901 (d) Application number, if any: 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? NYSDEC,NYSDOS,USACE 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 ® Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III- Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable 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 1:1No ® Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria [—]Yes 1:1No ® Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. [—]Yes ❑ No ® Not Applicable I I 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 ® Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ❑ Yes FIN o® Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect South61d'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 ® Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No ® 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 PREPARED BY TITLECoastal Management Specialist DATEseptember30,2019 Robert E. H rm n Amended on 811105 EN-CONSULTANTS i - - ','October 4 2019 i IL Mike Domino, Chairman OCT 7 2019 F Board of Trustees �. Town of Southold P.O. Box 1179 Southold, NY 11971 Boar G t.f h:..1ru_� .._,.._......_.... J Re: Reilly Family Revocable Intervivos Trust,300 Knoll Circle, East Marion, 1000-37-5-23 Dear Mr. Domino: Please find enclosed an application for a Administrative Wetlands Permit to remove and replace (in-place) approximately 81 if of existing timber bulkhead, a 13 if return, and a 28 if portion of an existing 42 if return with vinyl bulkheading and returns; and to establish a 10' wide non-turf buffer adjacent to the reconstructed bulkhead. We are requesting an Administrative Wetlands Permit because the existing bulkheading is permitted pursuant to Trustees Permit No. 4796; and Section 275-5 (B)(2)(i) allows for consideration for administrative review "the construction of a permitted bulkhead, as per§275- 11, which is to replace an existing functional bulkhead, subject to the following: [That the new bulkhead is constructed substantially similar to the design and measurement of the existing bulkhead; [27 new bulkhead is in the same location as the existing bulkhead; and LjLAny such operations shall require the addition of a nonturf pervious buffer area." Should you have any questions or require any additional information in support of our applications, please let me know. Resp tfully yours, Ro e . Herrmann Coastal Management Specialist Enclosures 1319 North Sea Road I Southampton,New York 11968 p 631.283.6360 1 f 631.283.6136 www.enconsultants.com environmental consulting EN-CONSULTANTS September 30,2019 OCT 3 Town of Southold =� U I 7 2019 �--� Board of Trustees 54375 Main Road Post Office Box 1179 Southold,New York 11971 card Trusgees. Re: Reilly Family Revocable Intervivos Trust 300 Knoll Circle,East Marion SCTM#1000-37-5-13 Dear Board of Trustees: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Authorization&Disclosure Forms; b) Short Environmental Assessment Form; c) LWRP Consistency Assessment Form. 2. Project plan prepared by En-Consultants, dated September 27,2019. 3. Survey prepared by Peconic Surveyors,P.C., dated November 9, 2018. 4. One(1) set of site photographs. 5. Copy of Permit#4796. 6. Application fee of$250.00. I hope this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. Sincerely, d�- Robert E.He ann Coastal Management Specialist /khs Enc. 1319 North Sea Road I Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com environmental consulting