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HomeMy WebLinkAboutTR-9609 r �r��guEFucKco Town Hall Annex Michael J Domino, President John M. Bredemeyer, III, Vice-President {jo 1 54375 Route 25 Glenn Goldsmith N = P_O. Box 1179 A Nicholas Krupski3 y ;�`Y Southold, NY 11971 Greg Williams 1 , �4��� Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES J 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 project complete, call for compliance inspection; BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 9609 DATE: DECEMBER 11,2019 ISSUED TO: JANE SEETH IRREVOCABLE TRUST &DOUGLAS SEETH REVOCABLE LIVING TRUST PROPERTY ADDRESS: 175 MESROBLAN DRIVE,LAUREL SCTM# 1000-145-4-13 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on.December 11, 2019, and in consideration of application fee in the sum of$250.00 paid by Seeth Trusts and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to remove and replace existing 160 linear feet of timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 1211 above existing top cap elevation, and an 8 linear foot bulkhead return on north section; remove and dispose of existing wood deck landward of bulkhead on southern end of property; remove and replace existing 61x8' fixed dock on northern end of property in same location as existing which is part of an existing property right-of-way; remove existing I fixed dock adjacent to residence and replace with an 81x151 fixed dock in a slightly southerly location; all decking and top caps to be un-treated lumber or composite material; and to install and perpetually maintain a 51 wide non-turf buffer along the landward edge of the proposed bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, dated October 18, 2019 and stamped approved on December 11,2019. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of the I I th day of December,2019. Ira 1 L'1\1VIO H1\11 l-lJl\ill l lkyl\0 The Permittee Seeth Trusts, residing at 145 Mesrobian Drive, Laurel, 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. 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. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. Thdt the'Permittee wilt 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. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. Michael J.Domino,President SO�rTown Hall Annex John M.Bredemeyer III,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith J [ 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 December 13, 2019 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH REVOCABLE LIVING TRUST 175 MESROBIAN DRIVE, LAUREL SCTM# 1000-145-5-13 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 11, 2019 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH 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, application dated November 4, 2019 and, WHEREAS, said application was referred-to-the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application December 11, 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 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 JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH REVOCABLE LIVING TRUST to remove and replace existing 160 linear feet of timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 12" above existing top cap elevation, and an 8 linear foot bulkhead return on north section; remove and dispose of existing wood deck landward of bulkhead on southern end of property; remove and replace existing 6'x8' fixed dock on northern end of property in same location as existing which is part of an existing property right-of-way; remove existing fixed dock adjacent to residence and replace with an 8'x15' fixed dock in a slightly southerly location; all decking and top caps to be un-treated lumber or composite material; and to install and perpetually maintain a 5' wide non-turf buffer along the landward edge of the proposed bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, dated October 18, 2019 and stamped approved on December 11, 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: $554.00 Very truly yours, 0 Lo ;'e.v Michael J. Domino President, Board of Trustees MJD/dd t ��gl1FFQLkc-;,, Michael J. Domino, President Air�o� y�� Town Hall Annex John M. Bredemeyer, III, Vice-President y z 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A Nicholas Krupski Southold, NY 11971 Greg Williams Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: SEETH TRUSTS c/o JEFF PATANJO Please be advised that your application dated November 4, 2019 has been reviewed by this Board at the regular meeting of December 11, 2019 and your application has been approved pending the completion of the following items checked off below. Pre-Construction Hay Bale Line Inspection Fee ($50.00) — (Silt boom) 1 St Day of Construction ($50.00) 'h Constructed ($50.00) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) xx 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: DOCK FEES: 6'x8' 48 sq. ft. x $3.00 = $144.00 8'x15' 120sq.ft. x $3.00 = 360.00 TOTAL FEES DUE: $_554 00 BY: Michael J Domino, President Board of Trustees t I SURVEY OF PROPERTY ` SITUATE: LAUREL TOM-s SOUT 4OLD W E a BUFF®LK COUNTY, NY SURVEYED 08-07-201 Q S ( R.O.W. ADDED 10-16-201a SUFFOLK COUNTY TAX # 1000 - 145 - 4 - 13 I CERTIFIED TO: i OR FORMERLY OF, f ® DOUGLAS SEETH 9� Lp,ND NOw SGNLESINC�ER { of -) kA 0 bil 00010011F— ®®®O1 F— _ ob�' -ice. p rn i3- NOV 4 2019 p ®�� ��®6�✓�®��� ® per) 2�� L-o i�p �+ j Q� X32 a 79 l � c I 61 ND SUS'�N G'�/LM '`'L E 1/� �t F m�'U wtho tzadticansed lrntl sr�syo s soma ` / 1 4 / N..Y-k wb-d d--b of the G OW Nzw York Slate ECWcatbn Law' NOTE✓: � �� 'OM1Iy copies ffom the orl Mol of!h6 sVrvey O L�N ,QS� N ��11� ? F� ri?? , r.� 4.` kea wlm�o gtr al«ane lana>o veya 7 stamped Beal sholl be coreldered to tae vallaco five �,y+la �1��'.;�"*-'��, i} "GerllFlcatlore IMlcatea hereon slynl(that Nls MONUMENT FOUND y was propane ,3L colo of 5t&,e for Lard of Fr>pao l t'�y the Now Tork Stake Assoelotkm of Pfofesskmal La I.`aurveyar> Sala cerNFlcaliorts>hall rvn only yy rl {«t to the per>on for vbwm the survey K prepared `t'".'•� J� tad on his behalf L.the 011e=aoYerfvnem `:�_'/���=(JLC} _ ' :✓ tal agency and lerdfrg Nstituibn ftt (ae-I and AREA = 17,500 SF OR 0.40 ACRESbxi aseky eez o the b di g Mst1tVllon CertlF co- tian>are nattran>tefawe!a addltI—I IrottevtI GRAPHIC SCALE 1 30' JOHN C. E tk� LAND SURVEY® 6 EAST MAIN STREET N.Y.B.IIC.NO.50202 RIVERHEAD,N.Y. 11901 631-369-8288 I REF.C:\Usm\Yobn\Dropbox\19\19-148 fie yt NOV 4 2019 V_ PROPOSED 8 LF VINY L BULKHEAD RETURN in VA-7 45 --�5 mesrob/ion DfIv@' A 0-�41� I REMOVE AND REPLACE ENISTING 6' X 8' FIXED DOCK 100-E 157.81' ENSTING FENCE TO REMAIN WITH 3' X 4' STEPS IN SAME LOCATION AS EYISTING Bmshs'P N83*00 DOCK IS PART OF A RIGHT OF WAY EASEMENT ACROSS THE T-1 LAND FILED AS LIBER 5758, PAGE 335 ON JUNE 9, 1965 I vD 0- EMOVE AND DISPOSE OF EXISTING FIXED DOCK AND STEPS. RELOCATE TO DIRECTLY SOUTH OF ENSTING PROPOSED 8' X 15' FIXED DOCK WITH 3' X 4' STEPS (120 SF) LOCATION MAP ITH ,--REMOVE AND REPLACE 160 LF EASTING BULKHEAD W '130 00 VINYL BULKHEAD IN SAME LOCATION AS EXISTING AND N.T.S. 4- S1 55.00 RAISED HEIGHT OF 12' ABOVE EXISTING. SEE DETAILS 00 #175 I STORY PARENT M.H.W. & M.LW ALONG FACE OF BULKHEAD FRAME RESIDENCE 19 lr,,,, 01' li- PROPERTY OWNER: DECK ROPOSED 5' WIDE NON—TURF BUIFFER JANE SEETH IRRV TRUST -t"-A P P R\O V E D B Y DOUGLAS SEETH REV. LIV. TRUST -,BOARD OF 1 RUSTEES 19 C/O PAUL SEETH & RANDALL SEETH 34 HOLLYROOD MANOR TOWN OF SOUTHOLD OAKLAND, CA 94611 DATE PREPARED BY: JEFFREY PATANJO EXISTING CONCRETE WALL P.O. BOX 582 TO REMAIN BOHEMIA, NY 11716 REMOVE & DISPSOSE OF EXISTING WOOD DECK 631-484-9332 JJPATANJO@GMAIL.COM NOTES: REMOVE&REPLACE DaSTING S.76464crN 1. LOT AREA: 17,500 S.F. 0.401 ACRES BULKHEAD IN SAME DWT LOCATION PROPOSED FIR TIMBER TOP CAP PROPOSED BULKHEAD PILE AS EIGSTING WITH RAISED TOP CAP ELEVATION OF 12"ABOVE EXISTING PROPOSED 3"X6' PROPOSED 16' LONG 10"BUTT 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: TO MATCH NEGHBORING BULKHEADS, REAIR WALE PROPOSED 3'X�V CIA TREXIED TIMBER PILE, 6' STEPS TO DOCK D.C. PROPOSED 8'VVIDE FIXED JOHN C. EHLERS LAND SURVEYOR DOCK 6 EAST MAIN STREET, RIVERHEAD, NY 11901 PROPOSED B*PILE 0 8*D.C. SURVEY LATEST DATED 08-07-2019 --PROPOSED 6'x6'CCA I TOP&BOTTOM WALE L APPRIX01MOUIEWILW.B.225i APPRM2M MLLN a.Qft APIRMOM HJUIL EL 2.0 PROPOSED 8"TIP CCA LAY—LOG PILE APPRIZOM ILLV a.Oak DGSTIN BULKHEAD G t PROPOSED 8-TIP CIA PIM 6' 'TO BE REMOVED IN D.C.01' LENGTH.BOLTED TO ITS ENTIRETY. SCALE: LAY—LOG WITH 3/4- N\ X S\N Proposed Permit Plans 0 W GALVANIZED THRU-90, 1"=,30' N PROPOSED 16' LONG 11'OLA. PROPOSED PLAN, SECTION DATE: 1\ \-, W -'-� F I GALV.TIE ROD, 6'D.C. L & LOCATION MAP 10-18-19 175 MESROBIAN DRIVE VPROPOSEO W LONG CLOC LAUREL, TOWN OF SOUTHOLD TYPICAL SECTION BULKHEAQ 99W VIM SHEETING TYPICAL SECTION DOC SUFFOLK COUNTY, JVY SHEET: N.T.S. N.T.S. TAX MAP NO. 1000-143-4-13 1 OF 1 Michael J. Domino Pres! n SVFFO(/� ' � �Q C� � Town Hall Annex John M. Bredemeyer III,Vice-President ��© Gym 54375 Route 25 Glenn Goldsmith y z P.O.Box 1179 A.Nicholas Krupski -Pry Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: )26/19 SO Completed infield by: Jeffrey Patanjo on behalf of JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH REVOCABLE LIVING TRUST request a Wetland Permit to remove and replace existing 160 linear feet of timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 12" above existing top cap elevation, and an 8 linear foot bulkhead return on north section; remove and dispose of existing wood deck landward of bulkhead on southern end of property; remove and replace existing 6'x8' fixed dock on northern end of property in same location as existing which is part of an existing property right-of-way; remove existing fixed dock adjacent to residence and replace with an 8'x15' fixed dock in a slightly southerly location; all decking and top caps to be un-treated lumber or composite material; and to install and perpetually maintain a 5' wide non-turf buffer along the landward edge of the proposed bulkhead. Located: 175 Mesrobian Drive, Laurel. SCTM# 1000- 145-4-13 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment ✓ Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: �ecoric�ec a ro.�S% coq S�ca�a�T �oc../acr� ce��o,ceren�. I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: ✓ J. Bredemeyer M. Domino ✓ G. Goldsmith N. Krupski /G. Williams Other � . �• � ''fit `��,,. ,� • ,. . � .4 f�yyyllyyy_ . r`�� ,_ ��'M1..ty__._•�'w!?.y..�:A- ,q_ .L�ir�� �.µ _ °.: � _ � �.�� �'.�� �, 1 i,;. ti }- i - ,r � .. p �► �. ,. •- �� _ �. �� �l'l1., ..a�� ,�,� ,� ` �i � _ _ '- ���r . ... �,.� �, -:,: � -:, ��.::++� ice'. � "` ,. _ , -� _ _ __ ,� . - "i`� .. � y f. +�' ,� ° r /'� -aim � as .i t�+ +�'�• Photo 2 i •i' { Photo 3 s • • / o / / 0 � t . � ♦ /' ery ' / ems ♦�` :�' . R .o O/y // • �/ - A •o GW ,PL �o OG�yo �^P F 1s _. COUNTY O K to is iawxav SOUTHOLD SECTION NO COU F SUFFOLK cxPm. w...wSernce r Agency ,m OFFICE LOCATION: ®�0 S®Ur�� MAILING ADDRESS: Town Hall Annex `� ® P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold,NY 11971 a� Telephone: 631 765-1938 ® Fax: 631 765-3136 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: December 9, 2019 Re: LWRP Coastal Consistency Review JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH REVOCABLE LIVING TRUST SCTM# SCTM# 1000-145-4-13 A Wetlands Permit 1710 (Grandfathered) was issued for a bulkhead and dock in 1983. Jeffrey Patanjo on behalf of JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH REVOCABLE LIVING TRUST request a Wetland Permit to remove and replace existing 160 linear feet of timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 12" above existing top cap elevation, and an 8 linear foot bulkhead return on north section; remove and dispose of existing wood deck landward of bulkhead on southern end of property; remove and replace existing 6'x8' fixed dock on northern end of property in same location as existing which is part of an existing property right-of-way; remove'existing fixed dock adjacent to residence and replace with an 8'x15' fixed dock in a slightly southerly location; all decking and top caps to be un- treated lumber or composite material; and to install and perpetually maintain a 5' wide non-turf buffer along the landward edge of the proposed bulkhead. Located: 175 Mesrobian Drive, Laurel. SCTM# 1000-145-4-13 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 CONSISTENT provided the following is considered to further LWRP Policy 6: 1. Require turbidity controls during construction. 2. Verify the need for the 8'width of the fixed dock. 3. Require a vegetated, non-turf buffer landward of the bulkhead. 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 ��L�ggfFQE,I.c�2E Peter Young,Chairmany Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., December 4, 2019 the following recommendation was made:' Moved by Caroline Burghardt,'seconded by John Stein, it was RESOLVED to SUPPORT the application of JANE SEETH IRRVECABLE'TRUST, DOUGLAS SEETH REVECABLE LIVING TRUST for the removal and replacement of existing 160 If. timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 12" above existing top cap elevation and an 8 If. bulkhead return on north Section. Remove and dispose of existing wood deck landward of bulkhead on southern end of property. Remove and replace existing TX 8' fixed dock on northern end of property in same location as existing which is part of an existing property ROW, remove existing fixed dock adjacent to residence and replace with 8'X 15' fixed dock in slightly southerly location. All decking and top caps to be untreated timber or composite material. A 5' wide non-turf buffer provided landward of proposed bulkhead. Located: 175 Mesrobian Dr., Laurel. SCTM#145-4-13 Inspected by: James Abbott, Peter Young, Caroline Burghardt The CAC Supports the application with a 10' vegetated non-turf buffer and the roof run=off is addressed. Vote of Council: Ayes: All' Motion Carried , r Michael J.Domino,`President F� �/,®f S0U�y� �+r Town Hall Annex John M.Bredemeyer III,Vice-President � �� l0 ', 54375 Route 25 P.O.Box 1179 Glenn Goldsmith ! Southold,New York 11971 A.Nicholas Krupski `��l ® O Telephone(631)765-1392 Greg Williams 4�o�y �� �4 Fax(631)765-6641 OW BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only ID � C� � � �'� '= _z:Coastal Erosion Permit Application ` Pn Wetland Permit Application INOV - 4 2019 Administrative Permit Am endment/Transfer/Extension Received Application: Southold To4:n -/Received Fee: $ ® Bar of Trustees ompleted Application: Ili 1 Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): fD ate of Inspection: 12� Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Tunes _See-t'h z 9-0W Owner(s)Legal Name of Property (as shown on Deed): P ow aSee+M_ A" L w `cx5esT Mailing Address: 1 S S 1 5 W 3 ra CT. �"o/L+ �-u ��rOQ� FL 333/ Phone Number: H 1 S — r 19—G s8b Suffolk County Tax Map Number: 1000 - I q 5- — q- 1_3 Property Location: 1 -75- M esrod eein b/2 . L a�. -eL , ^j l 1 q r S-e.c toe_ufi®n Mu,P (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): J_e Mailing Address: P. O • asX 5�C�_ 1gvAein'4_, N%l lt7J4 Phone Number: 6 31• y p y• 1-; 3x 10 a� Board of Trustees Application GENERAL DATA Land Area(in square feet): / -71 6,00 Area Zoning: &e-s - Previous use of property: e 5 (LGS Intended use of property: Covenants and Restrictions on property? Yes ✓ No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes ✓No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ✓ No If"Yes",please provide copy of decision. Will this project requ��o demolition as per Town Code or as determined by the Building Dept.? Yes Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date ,Ad y1 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ✓ No Yes If yes, provide explanation: Project Description (use attachments if necessary): 4ck Paul Seeth &Randall Seeth 175 Mesrobian Dr Laurel, NY 11948 SCTM No.: 1000-145-4-13 PROJECT DESCRIPTION: The project includes removal and replacement of existing 160 LF timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 12"above existing top cap elevation and an 8 LF bulkead return on north section. Remove and dispose of existing wood deck landward of bulkhead on southern end of property. Remove and replace existing 6'x 8'fixed dock on northern end of property in same location as existing which is part of an existing property R.O.W., remove existing fixed dock adjacent to residence and replace with 8'x 15'fixed dock in slightly southerly location.All decking and top caps to be un-treated timber or composite material.A 5'wide non-turf buffer provided landward of proposed bulkhead. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: See oc44 ez e,Ae V Area of wetlands on lot: square feet Percent coverage of lot: N A % Closest distance between nearest existing structure and upland edge of wetlands: 1 00 feet Closest distance between nearest proposed structure and upland edge of wetlands: 100 feet Does the project involve excavation or filling? ✓ No Yes If yes, how much material will be excavated? N h cubic yards How much material will be filled? N k cubic yards i Depth of which material will be removed or deposited: A feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: N .� 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): -' ht,re- wilt 6e oL- r0' sef-ive— eWt:e,'f &A �✓c -�l�neQs O►,µC 'E'o i('�G(.uG� �GQt�Lvl�'"�.'f"/®,r. /y'F lt�q'��.�S �'�!'Ot�q ,�ro Qt� vL kh to cQ . Short Environmental Assessment Form Part 1 ®Project Information Instructions for Completing Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1—Project and Sponsor Information Name of Action or Project: 175 Mesrobian Drive-Laurel Project Location(describe,and attach a location map): See attached location map Brief Description of Proposed Action: Remove and replace 160 LF of existing timber bulkhead with new vinyl bulkhead and 8 LF bulkhead return in same location as existing.Remove and dispose of existing landward deck adjacent to bulkhead.Remove and replace existing 6'x8'fixed dock in same location as existing.Remove and replace existing fixed dock with new 8'x 14'fixed dock in slightly south location along existing bulkhead. Name of Applicant or Sponsor: Telephone: 415-819-6586 Paul Seeth E-Mail: mattftuckll@aol.com Address: 34 Holyrood Manor City/PO: State: Zip Code: Oakland CA 94611 1. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other government Agency? NO YES If Yes,list agency(s)name and permit or approval:NYSDEC/Town of Southold Trustees/NYSDOS 3. a.Total acreage of the site of the proposed action? 0.401 acres b.Total acreage to be physically disturbed? 0 024 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.401 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: 5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial ® Residential(suburban) ❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ® ❑ b. Consistent with the adopted comprehensive plan? ® ❑ ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? M 21 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES Name:Brushs Creek,Name:Peconic Bay and Environs,Reason:Significant coastal fish&wildlife habitat, If Yes,identify: Reason:Protect public health,water,vegetation,&scenic beauty,Agency:Southold,Town of,Agency:Suffolk County,... NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? 21 ❑ b. Are public transportation services available at or near the site of the proposed action? Fv� ❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed 0 ❑ action? 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: 21 ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: a 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the R1 ❑ Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑ ❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑ 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: existing dock replacement of 6'x8'and 8'x14'total of 120 sf Page 2 of 3 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 information contained in Part 1 and other materia' rmitted by the project sponsor or otherwise available to tl`• iiewer. When answering the questions the review_ __:)uld be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" 1 No,or Moderate small to large impact impact may may occur occur I Will the proposed action create a material conflict with an adopted land use plan or zoning I regulations. V 2. Will the proposed action result in a change in the use or intensity of use of land? I 3. Will the proposed action impair the character or quality of the existing community? 1 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of 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 � El reasonably available energy conservation or renewable energy opportunities? �__,_f 7_ Will the proposed action impact existing: 1:1a a.public/private water supplies? 14 1 l_J b.public/private wastewater treatment utilities? i 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, I waterbodies,groundwater,air quality,flora and fauna)? f 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? I_:.__I ❑ 11. Will the proposed action create a hazard to environmental resources or human health? ❑ Part 3-Determin:ation of significance. The Lead Agency is responsible for the completion of fart 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 as!,cssed 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, I! t iat the proposed action may result in one or more potentially large of significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the rnforntation and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date I —q ® __,_P President r Print My"pe 1me o esp iii r t Agency Title of Responsible Officer „frz V �i_,, Lead ncv Sio.nature of Prepater(if different from Responsible O(ficer) Board of Trustees Applici,-- ',on AUTHORIZATION (Where the applicant is not the owner) IlW e,_ �a n et'd 1 _S c c+4 _ pa,a C-—S ci+b -- - - owners of the property identified as SCTM# 1000- 14 5-- '-t—13 in the town of V!`G(. ,New York,hereby authorizes "f e! P Ta n to act as my agent and Handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF 320 PLEASE SEE ATTACHED NOTARY CERTIFICATE Notary Public TIM.",TV,, CJ19"r"W"",n1.11 It•C I( t '" L`a. ...]It\I`I(....T`„Ili\'1. \'1.11 It\T•Yl'ltnl Illi\C.1 t,lr\T I(,It t'I•JLItA TYII 1'YY N,'1•II1HA'1 F California Jurat Certificate A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ; s.s. County of -fes Subscribed and sworn to (or affirmed) before me on this �—day of ©c4-0r� , ti,antn 20 by Ra -and - - Name of Giones(1) E proved to me on the basis of dame of S,gner(2) satisfactory evidence to be the person(s) who appeared before me. sLISIMr.AMA - E COMM 03M3 S,gnatura of Netarj Public ,y NDTA&YPUELICCAI IFORNIA ALAMFDA COUNTY zz- 1E�3 COMMISSION�APIi,32D72 For airier rac'sre<I,nfonnrat;on(Nclary t%,arno•commission Na (i,c.) Sea; OPTIONAL INFORMATION Although the in,`orniat'orn in this section is not required by law,it could prevent fraudulent removal and reattachment of this jurat to an unauth«dzed document and may prove useful to persons relying on the attached document. Description of Attached Documentw <=, ;;; WOS ;R F The certificate is attached to a document titled/for the purpose of Method of Affiant Identification II n AA� -- Proved to me on the basis of satisfactory evidence:-_ Oq Y�1 WS AT 1 ,C��"�, O form(s)of identification Q credible wtness(es) F n �_ _SIJ I Notarial event is detailed In notary journal on* Page# Entry# - Notary contact E containing pages, and dated Other [] Affiant(s)Thumbprint(s) E] Describe N♦ ,I Ili\9r \C.Yt'lt it tY.' It 7., r!1 H\, ,Td t•H\' ,1• I PIt Yf\'1. Crl .It Yt i\' 1 ,P 2009-2015 No'^ary I eamiing C,-rater-All Rights Reserved You car purchase colas of this form t;c`il our web site a: "mw TheNo;ar}sStjre com 1 Board of Trustees Applam' _r®e AFMAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT IMSHE IS TM APPLICANT FOR THE ABOVE (DESCRIBED PERMIT(S)AND THAT ALL S'T'ATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/ER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE A ANNER 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 SOU HOLD 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,INCLUIDIrdG 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 1bIY 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'. Signature of Property Owner Signature of Property Owner SWOP TO BEFORE ME THIS �� DAY OF (�C� ,20� Notwy Public �y p SHANICE BARNETT Notary Public,State of Florida Commission#GG 244504 My comm expires Aug 1 2022 Board of Trustees Applic;} `.on AFFIDAVIT uL S_ct-rh_ t.ncQa Sca-rh 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. Signature of Property O r Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF ,20 PLEASE SEE ATPACHED NOTARY CERTIFICATE Notary Public 9 ri9+u'n n+.r n nr ar nnx w•.u,e\rn •rux. Juu w'rx 9r,\9•n avrJue w•Jcx\r.m Vr IUN\9'1[91 YI'JI,:\r Jr,u ar rrr irr a9 JxreuJr e\r,rr u\rn California .Jurat Certificate A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate Is attached,and not the truthfulness,accuracy,or validity of that document F State of California F S.S. County of A a►-„��,, C Subscribed and sworn to (or affirmed) before me on this 1 !K—day of r-k' Mont 20 ( , by and Name of:;,aner(1) C _ proved to me on the basis of Name d Signer(2) satisfactory evidence to be the person(s)who appeared before me. F ' susHmALjimii e • J Signature of Warr Pub•,cNOTKRYPUBUCCCAUFORMA ALA.BWACOUNN c�,r,�,a �►4.,�¢, Cep.,.,,. 2 23 1-&1_? co7+utinloNh+�APR7S7D72 For other r:cE,ro(I informnt;on(14olary Name,Gornnv<,.&on No etr,) Seal OPTIONAL INFORMATION Although the information in this Section is not iequired by law,it could pnevent fraudulent removal an€1 reaiiachmenf of 'his jurat'io an unaufhorizod documenl;and r ay prove useful to nersrsns relying on the aii-ac lied dorcrrnent, Description of Attached Document The certificate Is attached to a document titled/for the purpose of Method of Affiant Identification Proved to me on the basis of satisfactory evidence. Q form(s)of identification 0 credible wntness(es) �o UU Notarial event is detailed in notary journal on Page# Entry# Notary contact containing pages,and dated Other [) Affiant(s)Thumbprint(s) Describe .r r.u\ \9' r,x yr •Jr n ru r u rrr\9r xu'n \, t C_}2009-2015 Notarry Learning Center-All R€gihts Rese^-fed Yo,1 car p6rchase coY es of this yorm fron7 our web sere a-, v..w,TheNorar~ysStore ccm Board of Trustees Appllc".--on AUMORUATION (Wbere the applicant is not the owner) s c c-�- t� v C— Sc•� , owners of the property identified as SCTM# 1000- 14 S- s-i-1-3 in the town of _New fork,hereby authorizes ft �dt to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF 20� V pG SHANICE BARNETT lt)tary Piib C o o� Notary Public,State of Florida Commission#GG 244504 My comm expires Aug 1,2022 APPLICA UAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The puroose of this form is torovide information which can alert the town of possible conflicts of interest and allow it to tale whatever action is necessary to avoid same. YOUR NAME: 5 ee--t6 . (Last name,fust name,Middle initial,unless you ate applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling;parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5°l%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 21 y� 20 Signature Print Name - h �' ✓ Form TS I 'FRANSAMOTN DiSr-LOSURF,FORM The Town of gonthold`s C,rle of 1 t1i cs rsahil?its Con to 3m of oit]cnnfI cis of interest and alba it YR tale'Wlaai+rer:�LItRi4 s this form is iR rorirle infam�ahanzehich can alert the necsan to avoid tcam8. Y013R NAIbIE � v (Lare a i in in the name of L astnatne,frrsiname,gijdme initial,intless You pp y $ est. a else or other entity,such as a company.If soj indicate the other person's or company's name,) NAM OF APpLICATIDN: (Check all that apply) BmI ing Tax grievance Trustee -- Vm lance - — CoasW Erosion _ Change of?one ---' Imooring Approval of plat Planning Exemption from plat OrOflicial map Other (If"Other,name the activity—)-- Officer or child)has>e a relationship 11ith n Da you personally for through-Vour nipan},spuww.sibling,p,,1Tent- ny fficer or employ of the Town of S1,ulhold? "Rc{nuonshipr includes b}blood nyarriaget or bvsitscss iris n�L"l3usin interni ky 2 c corporation o business including a partnership.in whish the 10%,..n officer or ernplo}�has even a partial o1"Wr%MP of(ter L Ploy D t bv)a in w hick She town DITcer or employee 0,.,, ,more than 3%of the shares- YES — NO l fyDe answered "4'ES;complete the butane of this form and date and sign where;indicated_ Name of person employed by the Toevn of Soutbold --— Title or position of that person— — Describe the relationship beween yourself(the applicant!agentirepresentafiave)and the town officer nr employee.Either check the appropriate line A)through fl)andlor describe in the space provided. The town officer or employee or his or her spouse,sibling parent or child is(check all that apply): d�)the owner of greater than 546 of the Shares of the corporate stock of the applicant (%when the applicant is a corpuration)- $) neficial ownerofany interest in anon-corporate entity(when the the legal or be applicant is not a corporatian): G1 sn officer,director.partner,or IMPIPYee of the applicant;or D)the actual applicant DESCRWfION OF RELATIONSHIP Bubutit#sd this a�da of d C*, 211 r $��tntura Prins Name Fount TS I TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town bffrcers and employees.The purpose of this form is to provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. 1 YOUR NAME: T 6,46L ti (Last name,first name,ipiddle initial,unless y u am applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,njarringe,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 ° day of 20 11 Signature �.—211 i. Print Name r-e.4ra-. P-41- Form T'S l Postal ■ , CERTIFIED MAILO I ■ Im a. Domestic Mae Iru . . ru . e . . G FriC A,, OF F C AL U3 � r` Certified Mad Fee C`- Certified Mad Fee C3 / gy �� $ $ =-_= '" C3 Extra Servlces&Fees checkbox,add fee as a ro Extra Services (check box,add fee as approp atL „� 1 �' ( pp pdafe) a �g I r'I ❑Return Receipt(hardcopy) $ U ❑Return Receipt(hardcopy) $ ®�• ❑Return Receipt electronic $ , n Return Receipt electronic $ %� r, p( ) Postmar v p ❑ p( ) r",Postmark x 0 ❑Certified Mall Restricted Delivery $ Here 0 ❑Certified Msll Restdcted Delivery $ 'Here ffl C3 E]Adult Signature Required $ lW r3 []Adult Signature Required $ C�� �. ❑Adult Signature Restricted Delivery$ .9 1 S ❑Adult Signature Restricted Delivery$ O Postage 1 L l o Postage CE) $ cc - - --- ---\ ruTotal Postage On'. Total Postage Postageanc ruSCTM#1000-145-4- 2x1 $ SCTM#1000-145-4-7 $Sent TO Grillo Joseph Sent To v sireeiand �.i� ose h J Sr Rev Trust Schlesinger,Alan R r-9Grillo,Susan Rev Trust SireeiandApENd PO BOX 493 r� ctiyst ia;2ia+4; Laurel, NY 11948-0218 crysiaie;ziP+a, 3 Versailles Ct ' Glen Head, NY 11545 U.S. Postal Service' ■ j CE RTIR ® o ■ Ia • N • _a ru ru i;- U SD—EE r� 0 µ -I # � �'�'` r%- Certified Mad Fee , Certified Mail Fee ® $ C�C� 1 `- Extra Servlces&Fees(check box,add fee as appropnate) O Extra Services&Fees(check box,add fee as a pro ate)r }+ ❑Return Receipt(hardcopy) $ ❑ lk'A 6y."5 �7 Return Receipt(hardcopy) $ - �' y rq ❑Return Receipt(electronic) $ 'Postnal�rk OE]ReturnReceipt(electronic) $ � P s e k C3 ❑Certlfled Mail Restricted Delivery $ f,H%re f 0 ❑Certified Mall Restricted Delivery $ -�H C3 []Adult Signature Required $ C'rZ0 1 C3 []Adult Signature Required $ []Adult Signature Restricted Delivery$ []Adult Signature Restricted Delivery$ C p Postage ` O Postage CEI Z I 03 is -�- ru Total Postage ani ru Total Postage an ru ti SCTM#1000-145-4-8 $ SCTM#1000-145-3-12 Isenrro Harrington,Jo -J r SentTo HOlfelder Family Trust C3 Street andApE N StreefandApf.Nt 2775 Whisponeringhn WayCir 10 Starr Ln cl----i-i---- a Prescott,AZ 86303 cliy�iaie;zir�+d' Bethel,CT 06801 :11 1 11 111•1 J' I - I I I I it 'I I I PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: � L15-- 185-- 3 - ia f 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 MAILIRETURN RECEIPT. Sworn to before me this Day of 120 Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: SCTM#1000-145-4-7 SCTM#1000-145-4-12.1 Schlesinger,Alan R Grillo,Joseph J Sr Rev Trust PO Box 493 Grillo,Susan Rev Trust Laurel, NY 11948-0218 3 Versailles Ct Glen Head, NY 11545 SCTM#1000-145-4-8 SCTM#1000-145-3-12 Harrington,John J Jr Holfelder Family Trust 2775 Whispering Way Cir 10 Starr Ln Prescott,AZ 86303 — — Bethel, CT 06801 STATE OF NEW YORK COUNTY OF SUFFOLK Jeffrey Patanjo , residing at PO Box 582,Bohemia,NY 11716 being duly sworn, deposes and says that on the 2b day of November ,20 19 , 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 �(n��,, , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this 2-& Day of November ,2019 S MARILYN S. HICKS NOTARY r PUBLIC,STATE OF NEW YORK Registration No.01 HI6365489 Not Public Qualrfied in Suffolk County Commission Expires,October 10,2021 Michael J. Domino,President y�¢'O�0 L'OG Town Hall Annex John M.Bredemeyer 111,Vice-President v'A 11 54375 Route 25 Glenn Goldsmith N z N P.O.Box 1179 A.Nicholas Krupski tom' Southold,NY 11971 Greg Williams '1,japp' i}' 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 JANE SEETH_IRREVOCABLE TRUST &DOUGLAS SEETH REVOCABLIE 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 SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, Jeffrey Patanjo ,residing at/dba PO Box 582,Bohemia,NY 11716 being duly sworn, depose and say: That on the 30 day of November ,2019 , I personally posted the property known as 175 Mesrobian Drive,Laurel,NY SCTM#1000-145-4-13 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,December 11,2019. Dated: II'3° 'Ig �A� /Signkure) Sworn to before me this 30 day of Nov.2019 EMARILYN S. HICKS TATE OF NEW]2021 o.01 HI63WBSuffolk CountyNotary ublices October 10 , NOTICE OF HLm.1AR1NC 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: JANE SEETH IRREVOCABLE TRUST & DOUGLAS SEETH REVOCABLE LIVING TRUST SUBJECT OF PUBLIC HEARING : For a Wetland Permit to remove and replace existing 160 linear feet of timber bulkhead with new vinyl bulkhead in same location as existing and raised height of 12" above existing top cap elevation, and an 8 linear foot bulkhead return on north section; remove and dispose of existing wood deck landward of bulkhead on southern end of property; remove and replace existing 6'x8' fixed dock on northern end of property in same location as existing which is part of an existing property right-of-way; remove existing fixed dock adjacent to residence and replace with an 8'x15' fixed dock in a slightly southerly location; all decking and top caps to be un-treated lumber or composite material; and to install and perpetually maintain a 5' wide non-turf buffer along the landward edge of the proposed bulkhead. Located: 175 Mesrobian Drive, Laurel. SCTM# 1000-145-4-13 TIME & DATE OF PUBLIC HEARING : Wednesday, December 11, 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 LWRIP 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 sigawcant 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. Thins, each answer must be explained ha detail, listing both supporting and non- supporting fa'ets. 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. 1B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# f yS PROJECT NAMEE 115- 1A e 3 r-#bt c..v% 11 n. - Le. v P G L- 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: S to 4+4-a c,�cef A Location of action: t 15-- AA C 5 r o 1614,A ,PR-Site acreage: ® . L4 C Present land use: !2'e'S Present zoning classification: �5 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: �a� L S-e c 4-k (b) Mailing address: _` 14 6 1 ti vd, ^®Q— (c) Telephone number: Area Code (d) Application number,if any: J) 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? N H 5 0 FL I N-Is 0 of 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. DE VE LOPE D COAST 1POI,fCY Policy 1. ]Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes effaciernt use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LAW Section]III—Policies; Page 2 for evaluation criteria. ❑✓ Yes ❑ Ho ❑ Not Applicable ro PfCA fn w .e-AeFie�kG n G®a -W toau -f!o„) anD ',l o,-& .frr e-o n 4-P r),,eS .teeecs —tc w«-t-et.4 . Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—p"Policies Pages 3 through 6 for evaluation criteria 0 Yes 1:1 No [ 1Not Applicable Attach additional sheets if necessary Policy 3> Enhance visual quality and protect scenic resources throughout the Town of Southold. See ILWRF Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No ❑ Not Applicable Pio i.cc-E IDvc S Z inc w ucsw 4t1�, d"�(Gc Fes. � Co�.�� srfcsr� �,c-E4 ✓1 eral,b®�/na Pi,�cr-resS. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4> lfinimm ize loss of life, structures, and natural resources from flooding and erosion. See ILS Section al—Policies Pages 8 through 16 for evaluation criteria 1�f Yes ❑ No ❑ Not Applicable c -f' 4A At n I-*3 5 a 4,1 n z arn .. -t-za5l A2,LQCA�40 Attach additional sheets if necessary Policy 5e Protect and improve water quality and supply in the'frown of Southold. See LWRP Section HH —Policies Mages 16 through 21 for evaluation criteria 2/yes M leo ❑Not Applicable fv .e L rp v cA3 Fb1;&A- a.46-1L IG he a 49 -f ka, S'e'a s� fMGyv�G /e✓1 &"A -ev" IoA .2fr e.1Al2 S Attach additional sheets if necessary Policy 6e Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LVVRP Section REN—Policies; Pages 22 through 32 for evaluation criteria. El' o a Yes No Not Applicable ref'ee;c- w %tt oftA . -tv ,vew h✓L'�i�'L C4 Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LVW Section III - Policies Pages 32 through 34 for evaluation criteria. F] Yes [:] No Not Applicable pro iec-4 `hos n •tEC-i�e-, 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 0 No I-=I 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. u Ye�] No[-] Not Applicable Attach additional sheets if necessary WOREING COAST PQ CIMS ' Policy Ro. Protect Southold's water-dependent eases and promote shiang of new water-dependent uses in suitable locations. See LWRP Section M—Policies; Pages 49 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy M Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LVRP Section Policies; Pages 59 through 62 for evaluationcriteria. ❑Yes ❑ No U Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LVRP Section IIIc—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ leo U Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LVW Section ILII—Policies,- Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No iJ Not Applicable (PREPARED BY � ' ��+a I I 'PuILF evi+ DATE Z 0— le-11 ' r October 29, 2019 Town of Southold Trustees ]nD FC E � V Town Hall Annex Building 54375 Rte. 25 NOV - 4 2019 P.O. Box 1179 Southold, New York 11971 Southold Town RE: 175 MESROBIAN DR. —LAUREL Bard of Trustees SCTM No. 1000-145-4-13 APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, . PA�� Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716