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TR-9641
Glenn Goldsmith,President �QF SU(/j,�, Town Hall Annex A. Nicholas Krupski,Vice President ,`O� ��� 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III J Southold, New York 11971 Michael J.Domino G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 olyCOU BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1825C Date: June 23, 2021 THIS CERTIFIES that the construction of a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a"T"configuration,both the catwalk and dock will have un-treated timber decking,• and for a Ten(10)Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk(total 12' wide area)by hand methods-down to not less than 12" above ground level twice per calendar year; At 320 Glenn Road, Southold Suffolk County Tax Map#1000-78-2-21 Conforms to the application for a Trustees Permit heretofore filed in this office Dated December 30,2019 pursuant to which Trustees Wetland Permit#9641 Dated February 12,2020 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a"T"configuration, both the catwalk and dock will have un-treated timber decking-, and for a Ten(10)Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk(total 12' wide area)by hand methods down to not less than 12"above ground level twice per calendar year. The certificate is issued to ANNA M.ten NAPEL owner of the aforesaid property. 4�L - V Authorized Signature Glenn Goldsmith, President �Q� so(/ry Town Hall Annex A.Nicholas Krupski,Vice President ,`O ��� 54375 Route 25 JohnP.O. Box 1179 M. Bredemeyer III Southold,New York 11971 Michael J. Domino G • Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 �ycoUIVT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: INSPE CT : Ch. 111 INSPECTION SCHEDULE I Pre-construction, haybale-line/silt, boom/silt curtain 1St day of construction '/ constructed Project'complete, compliance inspection COMMENTS: ��L _ �✓� 1 �IA-n CERTIFICATE OF COMPLIANCE: f i 1 Glenn Goldsmith, President Michael J. Domino, Vice -President John M. Bredemeyer III A. Nicholas Krupski Greg Williams BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 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-construcilo'n,'tiW bale linelsilt boorrf/silt curtain 1St day of construction % constructed When project complete, call for compliance inspection; F_-- ----- i i I I j PERMIT NO. 9641 BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK ISSUED TO: ANNA M. ten NAPEL DATE: FEBRUARY 12, 2020 ! PROPERTY ADDRESS: 320 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-21 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 February 12, 2020, and i in consideration of application fee in the sum of $250.00 paid by Anna M. ten Napel 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 construct a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a "T" configuration; both the catwalk and dock will have un- treated timber decking; and for a Ten (10) Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk (total 12' wide area) by hand methods down to not less than 12" above ground level twice per calendar year; and as depicted on the site plan prepared by Jeffrey Patanjo, dated December 2, 2019 and stamped approved on February 12, 2020. 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 12th day of February, 2020. �o�OgUFFO(�-cOG X-0co y� y ZI: O GA. Nichdlas Krupski — Naye r' TERMS AND CONDITIONS The Permittee Anna M. ten Napel, residing at 320 Glenn Road, Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 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. 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. 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. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 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. 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. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Glenn Goldsmith, President Michael J. Domino, Vice -President John M. Bredemeyer III A. Nicholas Krupski Greg Williams February 13, 2020 Jeffrey- Patanjo. P.O. Box 582 Bohemia, NY 11716 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: ANNA M. ten NAPEL 320 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-21 Dear Mr. Patanjo: , Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 Telephone (631) 765-1892 Fax (631) 765-6641 The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 12, 2020 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of ANNA M. ten NAPEL, 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 December 30, 2019, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 12, 2020, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered Iall 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 ANNA M. ten NAPEL to construct a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a "T" configuration; both the catwalk and dock will have un -treated timber decking; and for a Ten (10) Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk (total 12' wide area) by hand methods down to not less than 12" above ground level twice per calendar year; and as depicted on the site plan prepared by Jeffrey Patanjo, dated December 2, 2019 and stamped approved on February 12, 2020. 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: $602.00 Very truly yours, Custer lnsutute lnc® g- eu�a nu_�__,t _ �$ , p1 TheWar8tore / R Ellis House P and 8 z ' i• Dart s Tree Farm®'Y..— bella Vineyards t r 320 Glenn Road ry / N / Croteaux Vineyards ry �3P '-=— Goose Neck - O St Patnck's Cemetery" �.--r1° r ~ ' ebb r✓ North Fork Weddings . _ ® South Fork Weddings,/ eddings/ ^� at Patnckschurch, i southold ny LOCATION MAP ��p�cy ��1411 N.T.S. N —2s WATER DEPTH REFERENCED TO MLW AS / MEASURED BY JOHN GERD HEIDECKER, L.S. / f / I / VEGETATED WETLANDS AS IDENTIFEIED BY JOHN HEIDECKER, LS. ON AUGUST 15, 2019 PROPOSED TRIMMING OF EXISTING PHRAGMITES FOR 4' WIDE ti DE OF PROPOSED DOCK (TOTAL 12- WIDE) THIN ER OF GROUND ANE DONE BY D DONEE2 TIMES PERS AND CUT TO SEASON _ 2/ 1-0 " 1-e 10 `d2\\` PROPOSED 4' WIDE X 28' LONG FIXED CATW W/ THRU-FLOW DECKING OVER WETLANDS PROPOSED 6' WIDE X 20' LONG FIXED DOCK W/ UNTREATED TIMBER DECKING \ I --,C4, V 4L 10 8 6 4 2 0 —2 ti.......... •rye, PROPERTY OWNER: y�.•' ANNA M. TEN NEPAL 1 DEEPDALE ROAD ROCKY POINT, NY 11778 0022' 41� �. \ .APPROVED BY BOARD OF 1 RUSTEES e TOWN_ OF SOUTHOLD r I DATE ;RVAq. , 12 t 2ozo " t EXISTING PREPARED BY: JEFFREY PATANJO P.O. BOX 582 BOHEMIA, NY 11716 631-484-9332 JJPATANJO©GMAIL.COM NOTES: 1. LOT AREA: 21,557 S.F. / 0.495 ACRES \ 2 `6 Imo. L DEC 3 0 2019 � f 1' � --,fl _v � PROPOSED 28' LENGTH X 4' WIDE FIXED ELEVATED CATWALK WITH THRU-FLOW DECKING PROPOSED 8"0 CCA PILES (TYP.) PROPOSED 6 WIDE X 20' LONG FIXED DOCK 28' M.L.W EL. O.Ot TYPICAL SECTION N.T.S. PORTIONS OF PLAN FROM SURVEY PREPARED BY: JOHN GERD HEIDECKER, L.S. 42 CROWN STREET kINGSTON, NY 12401 SURVEY LATEST DATED SEPTEMBER 17, 2019 Proposed Permit Plans SCALE: 1 "=30' PROPOSED PLAN, SECTION & LOCATION MAP DATE: 12-2-19 320 GLENN ROAD SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY TAX MAP N0. 1000-78-2-21 SHEET: 1 of 1 /En=:x HEIDECKER LAND SURVEYING 1\ POINT OF BEGINNIN 1" PIPE FOUNn 0 O J O W O O N Y O O J z X W Q� O N coo O Q 0') J J CD W DO U O -t' 00 m 1 JrnO O I- N O wr- Oj Z Q Q O ��g z Y m D 0 (n —tw F- z -I U W LL W N (n I i - O oz O W f � Q U Y �z 0 i� N N N 0 0 XWir (L _• 0 W �W � 3 0 b v GLENN ROAD (50' WIC7E TOWN ROACH) S_66'31'3 " E _ 100.00' } 3/4" PIPE FOUND" 3 AREA= 21,557 SQ. FT. a OR 0.495 ACRES 15.5' CONC7777_7R WALK OPEN PORCH 1 4.. 70 GARAGE #320 / 1 STORY RESIDENCE HIMNEY 14.5' 15.3' DECK DISTRICT 1000 -SECTION 078.00 BLOCK 02.00 -TAX LOT 021.000 N/F ANNA M. TEN NAPEL LIBER 12984 -PAGE 122 w FILED MAP NO. 3848 -LOT 5 Z _1 w iU CONCRETE O fpGF OF GF �F ' I X90 Z 0 � NYYI DD IN -MEAN HIGH TIDEN LINE 2.76' Z 2.62' ��..� 2.47' 2.38' .-0.38, -0.33' EDGEF WATER �2� �.. EDGE OF WATER ___.. . -0.41' -0.39' _,j . -0.29' N 62"45'40 ISI . -2.55' D�y 0. ' L" Er j �J19 . -2.57' . -2.60' 0 22 I . -2.69' -2.94' -3.54'CANAL, -3.49' " —3.75' r —3.93' .-3.83' 'JOHN GERD HEIDECKER N.Y. STATE LAND SURVEYOR UC. # 050719 42 CROWN STREET KINGSTON, NEW YORK 12401 (845)-901-7629 j heidecker®heideckerls.com UTILITY POLE in DO 06 N r O 0 O N N O f- Y O Q J 0 X z la_ OY o I-= 0 N< D00 O (/1 O - C_n Y -U CD 00 W O ��00 Co c�3 1 N � m�Q O0� Lj W m O >- _j W _J U [If D W 1n L,_ 1 -3 O O � oz F- U_ IY H Cn 0 Unauthorized alteration or addition to this survey is a violation of section 7209, subdivision 2, of the New Yorl, State Education Law. Copies a this survey map not bearing the land surveyor's inked or embossed seal shall not be considered to be a valid copy. 1. FIELD WORK WAS CONDUCTED AUGUST, 2019 BY HEIDECKER LAND SURVEYING, PLLC AND ALL MEASUREMENTS WERE TAKEN ON THE GROUND. 2, PROPERTY LINES, BEARINGS, do NORTH ARROW ARE BASED UPON DEED FILED WITH THE SUFFOLK COUNTY CLERK IN LIBER 12984—PAGE 122. 3. INDICATED UNDERGROUND UTILITIES ARE SHOWN FROM SURFACE EVIDENCE AND AVAILABLE EXISTING MARK -OUTS. UNDERGROUND LINE LOCATIONS ARE APPROXIMATE AND ALL UNDERGROUND UTILITIES ARE NOT SHOWN. PRIOR TO CONSTRUCTION THE CONTRACTOR SHALL CALL "CALL BEFORE YOU DIG" AT 811 AND HAVE ALL UTILITY LOCATIONS MARKED ON THE GROUND. 4. THE BUILDING TIES SHOWN ARE BASED UPON THE SIDING OF THE STRUCTURE. 5. THIS IS NOT A TITLE SURVEY AND IS SUBJECT TO ANY STATE OF FACTS A FULL AND CURRENT TITLE REPORT MAY REVEAL. 6. ELEVATIONS SHOWN REFERENCE MEAN LOW WATER (MLW) VERTICAL DATUM. O n 00 _ N , 2.78' N MEAN HIGH TIDE LINE y -0.45' . -2.99' . -2.77' 2 . -2.60' -3.75' -3.54' -3.13' SURVEY PREPARED FOR: L019 ANNA MN NA A i F DATE: PROJ. NO. SEPTEMBER 17, 2019BATHYMETRIC/BOUNDARY SURVEY 19Hma5 DRAWN BY: B.M. #320 GLENN ROAD SHEET NO. CHK BY: J.H. F 1 TOWN OF SOUTHOLD CAD OFILE: SCALE: 1"= 20' SUFFOLK COUNTY. NFW YORK I 19HLS85FP.DWG M -g11FF0(q Glenn Goldsmith, President .,�o�, oI, Town Hall Annex Michael J. Domino , Vice -President y< 54375 Route 25 John M. Bredemeyer, III ti ? P.O Box 1179 A. Nicholas Krupski y ® ��' Southold, NY 11971 Greg Williamo( Telephone (631) 765-1892 'r✓`" Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ANNA M. ten NAPEL c/o JEFF PATANJO Please be advised that your application dated December 30, 2019 has been reviewed by this Board at the regular meeting of February 12, 2020 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre -Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) x Final Inspection Fee ($50.00) — X Dock Fees ($3.00 per sq: ft.) 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: 4'x16' catwalk = 64 sq. ft.x $3.00 = $ 192.00 6'x20' fixed dock= 120 sq. ft. x $3.00 = 360.00 TOTAL FEES DUE: $602.00 , BY: Glenn Goldsmith President Board of Trustees �!•�" Glenn Goldsmith, President Michael J. Domino, Vice -President John M. Bredemeyer III A. Nicholas Krupski Greg Williams February 13, 2020 pF SOUT,�o h O G • �@ oly�OUNTI BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Jeffrey Patanjo P.O: Box 582 Bohemia, .NY .11716: RE: ENVIRONMENTAL DECLARATION OF SIGNIFICANCE PURS,Q NT,.TO NEW YORK STATE ENVIRONMENTAL QUALITY REVIEW ACT NYCCR PART 617 ANNA M. ten NAPEL 320 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-211.;_%, Dear Mr. Patanjo: The Southold Town Board of Trustees adopted the following Resolution at a meeting held on Wednesday, February 12, 2020: Jeffrey Patanjo on behalf of ANNA M. ten NAPEL requests a Wetland Permit to construct a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a "T" configuration; both the catwalk and dock will have un -treated timber decking; and for a Ten (10) Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk (total 12' wide area) by hand methods down to not less than 12" above ground level twice per calendar year. Located: 320 Glenn Road, Southold. SCTM# 1000-78-2-21 S.E.Q.R.A. NEGATIVE DECLARATION OF ENVIRONMENTAL SIGNIFICANCE: WHEREAS, the Southold Town Board of Trustees are familiar with this project having visited the site on February 5, 2020, and having considered the survey of property by Heidecker Land Surveying dated September 17, 2019, and having considered the plans for this proposed project submitted by Jeffrey Patanjo dated December 2, 2019 at the Trustee's February 10, 2020 work session, and WHEREAS, on February 12, 2020, the Southold Town Board of Trustees declared itself Lead Agency pursuant to S.E.Q.R.A., and WHEREAS, on February 12, 2020 the Southold Town Board of Trustees• classified the application as an unlisted action under S.E.Q.R.A., and WHEREAS, in reviewing project plans submitted by Jeffrey Patanjo dated December 2, 2019 it has been determined by the Board of Trustees that all potentially significant environmental concerns have been addressed as noted herein: • Navigation: The proposed dock meets standards and does not extend beyond 1/3 across the water body. Depths for the dock terminus are within Town Trustees, New York State Department of Environmental Conservation and United States Army Corps. of Engineers guidelines and there is no recognized Federal/New York State/Town navigation channel in the immediate vicinity of the proposed structure. • Scope: The proposed dock is comparable to docks on neighboring properties in an area where docks historically are used for commercial and recreational purposes • Scope in relation to the riparian rights of shell fishers: The plan allows a standard fixed dock design that will not impede access for those seeking shellfish and crustacea in season. • Scope in relation to view shed: The seaward end of the proposed dock will not extend appreciably beyond existing docks. As such the perspective will not be discernibly different from the existing view. • Environmental upkeep: The dock design projects a usual lifespan of 30 years with limited pile replacement so as to minimize disturbance of the bottom. THEREFORE, according to the foregoing, the Southold Town Board of Trustees Approve and Authorize the preparation of a Notice of Negative Declaration pursuant to SEQRA for the aforementioned project. If you have any questions regarding the above, please contact this office. Very truly yours, t�Ltg" Glenn Goldsmith, President Board of Trustees GG/dd BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: :�_, 5'/ )10 14) Completed in field by: 14-t - Jeffrey Patanjo on behalf of ANNA M. ten NAPEL requests a Wetland Permit to construct a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a "T" configuration; both the catwalk and dock will have un -treated timber decking; and for a Ten (10) Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk (total 12' wide area) by hand methods down to not less than 12" above ground level twice per calendar year. Located: 320 Glenn Road, Southold. SCTM# 1000-78-2-21 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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 Type of Application Survey <_ 5 years: Y/N Pre -Submission Coastal Erosion Wetland Line by: Administrative Emergency _ Setback Waiver Required Unlisted Action _Amendment Wetland Violation Non -Jurisdiction Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: 14 Bredemeyer G. Williams Other C.E.H.A. Line Domino 'G. Goldsmith f/ N. Krupski nna M. ten Napel 20 Glenn Road, Southold CTM#: 1000-78-2-21 _ 2/5/20 i� 1 Y P 10, t i .0 �\\ ��r 1 1�,• Photo 1 (10-10-19) - ,• 1 'Vi!k Elr,* 4 t ell �Pww I • Photo 4 (10-10-19) ..-.,.._ ..w,.. i -.e: � «..;:y.: "'" :.' � __ e_ Y1{C3 LRTY ?k✓? n v T fOrwawww ,uu.+.x, e.�-. ."'". • :. __.—. «« .w.�.-,rx, a.;-e:._....56dw..w.«r 9MS.iaAw:Ifua�IbG - �FIL.ii1ti gii1�M low SLEEPY » HOLLOW to.tx �C'r./�" �. .� •: .�lf'�i / / ° - z 1o.13 ^ M10 ( { { + 1 ,� t0.a �• � m 1.d1(c) tt0a111/c) e O a 10.15 �b1 ♦ ;� ° 1'• to12m r to.• u�',cl. •n y5 1.M(c) \, TOWN OF l.•A nr ; r 1010 rn^ SOUTH" { nn �s • g °' y Wel } O /J"' ° m 10.1as mi 'ff W1 �1J vNK '� V - b.t ra xn e w n•r A m» y � fi IP hoirwuw y\j , 2 v 17 M 19 A Tt � a nn w �• ° '¢ _�� �e/ 7= ]a >• \ \ l ° r e xe' - , • Q SEE SEC. NO- 077 �e _1w 19 z1 zz b N zsIA(c)mN ulm OE 41 1J w to r44:t � e � /9 L -j 1. 171 SEE SEC. 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Nv „w, N ae wAOEae 078 N a_.rm. ^^'•' u. —__— o.ru. _—r—_ pv�._—.w-- arm�ce�iv>FHc A P T� PROPERTY MAP OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-19 38 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: February 7, 2020 Re: LWRP Coastal Consistency Review for ANNA M. ten NAPEL SCTM#1000-78-2-21 ANNA M. ten NAPEL requests a Wetland Permit to construct a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a "T" configuration; both the catwalk and dock will have un -treated timber decking; and for a Ten (10) Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk (total 12' wide area) by hand methods down to not less than 12" above ground level twice per calendar year. Located: 320 Glenn Road, Southold. SCTM# 1000-78-2-21 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 common dock is CONSISTENT with the policies and therefore CONSISTENT with the LWRP provided the Board determines the following. 1. The dock complies with § 275-11. Construction and operation standards for docks. Verify the channel width with a vessel and adequate navigability of the channel. 2. A vegetated buffer is required landward of the wetland line to help protect water quality of Deep Hole Creek. 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 ���QgUFFOt�.C�� Peter Young, Chairman 4 Lauren Standish, Secretary ,cei�, Conservation Advisory Council Town of Southold Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1889 Fax (631) 765-1823 At the meeting of the Southold Town Conservation Advisory Council held Wed., February 5, 2020 the following recommendation was made: Moved by John Stein, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of ANN M. TEN NAPEL for the removal and construction of a proposed 4'X 28' catwalk with steps down to a 6'X 20' fixed dock in a "T" configuration. Both the catwalk and dock will have untreated decking. Also included is the trimming of phragmites 4' wide on either side of proposed catwalk by hand down to 12" above ground level twice per calendar year for a 10 -Year Maintenance period. Located: 320 Glenn Rd., Southold. SCTM#78-2-21 Inspected by: John' Stein, Peter Meeker The CAC Supports the application with thru-flow 'decking. Vote of Council: Ayes: All Motion Carried -�r Michael J. Domino, President John M. Bredemeyer III, Vice -President Glenn Goldsmith A. Nicholas Krupski Greg Williams BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension Received Application: Z • 9 . Received Fee: $ ZSb Completed Application: �� •20 Incomplete: / SEQRA Classification: Type I Type II v Lead Agency Determination Date: Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 Telephone (631) 765-1892 Fax(631)765-6641 (__-- Unlisted Negative Dec. VCoordmation:(date sent). I.31.20 LWRP Consistency Assessment Form Sent: CAC Referral Sent: 1' 224-0 Date of Inspection: 2 -S•20 Receipt of CAC Report: Technical Review: =Public Hearing Held: 2 •�� Resolution: t� DEC 302019 f Positive Dec. Owner(s) Legal Name of Property (as shown on Deed): Ann M -rev, /i% ae e C Mailing Address: 1 17eepeta(e. Or. IcneVq Pyen4- , Ny ) 1-77e Phone Number: 6 51 - 3 35- - 9 o r Suffolk County Tax Map Number: 1000 - 7 8 - 2 - Z / Property Location: 3 cl-®r, /er7n 12m&Z 'See Coe't4t v/) M-1 (If necessary, provide LILCO Pole #, distance to cross streets, and location) AGENT (If applicable): 'J e fl: req KA -rt Mailing Address: P- 0 - 13ox s$�- 90 4"t"i a, #4j y //?lip Phone Number: 6-3/- L/ p y- 9 3 3 Board of Trustees Application GENERAL DATA Land Area (in square feet):_, -1) S-5-7 Area Zoning:., . Re S Previous use of property: f&S. Intended use of property: /CcS• 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 If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Does the structure (s) on property have a valid Certificate of Occupancy? V"Yes No Prior permits/approvals for site improvements: Agency Date ✓ 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): See_g•}-� �, c� ccQ Anna M. Ten Napel 320 Glenn Road Southold, NY 11971 SCTM No.: 1000-78-2-21 PROJECT DESCRIPTION: The project includes the removal and construction of a proposed a 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a T configuration. Both the catwalk and dock will have un -treated timber decking. Also included is the trimming of phragmites 4' wide on either side of proposed catwalk by hand methods down to 12" above ground level twice per calendar year for a 10 year maintenance period. { Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: See - Area « Area of wetlands on lot: So o square feet Percent coverage of lot: 6 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: / feet Does the project involve excavation or filling? `� No Yes If yes, how much material will be excavated? /" 4 cubic yards How much material will be filled? N 14 cubic yards Depth of which material will be removed or deposited: 'V A feet Proposed slope throughout the area of operations: "'14 Manner in which material will be removed or deposited: N A 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): -7-here, will ;,e A� e®Sttwe- c4��ref tv,% wc-t-1+r7A0S nnn t se. rj*)aiea.lw(�Ir►y 'T�itovy%, We-tler,X5, to y�ciy itceCSS +o Wa�-cRS Short Environmental Assessment Form Part 1- ProjectInformation 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: Proposed dock 320 Glenn Road - Southold Project Location (describe, and attach a location map): See location map Brief Description of Proposed Action: Construct proposed 4'x25' fixed catwalk with thru-flow decking, 4' wide x 3' steps up and down with un -treated decking and 6' wide x 20' long fixed dock with untreated decking. All to be supported with 8" dia. timber piles. Maintenance trim existing phragmites 4' wide on both sides of proposed catwalk as shown on plan by hand methods to within 12" of existing grade. Name of Applicant or Sponsor: Telephone: 631-335-9105 E -Mail: m6apples@aol com Anna M Ten Napel Address: 1 Deepdale Dr. City/PO: State: Zip Code: Rocky Point NY 111778 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, administrative rule, or regulation? NO YES If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that be affected in the municipality and proceed to Part 2. If no, continue to question 2. a 1:1may 2. Does the proposed action require a permit, approval or funding from any other government Agency? If Yes, list agency(s) name and permit or approval: Town of Southold Trustees, NYSDEC, Army Corps, NYSDOS NO YES ❑ 3. a. Total acreage of the site of the proposed action? 0.495 acres b. Total acreage to be physically disturbed? 0 01 acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? 0 495 acres 4. Check all land uses that occur on, are adjoining or near the proposed action: 5. ❑ Urban ❑ Rural (non -agriculture) ❑ Industrial ❑ Commercial m Residential (suburban) ❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑ Parkland Page I of 3 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ❑ ✓❑ ❑ ❑ i ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? Name:Goose Creek, Name.Pecomc Bay and Environs, Reason:Signrficant coastal fish & wildlife habitat, If Yes, identify. Reason:Protect public health, water, vegetation, & scenic beauty, Agency:Southold, Town of, Agency -Suffolk NO YES ounty, D.. ❑71 8 a. Will the proposed action result in a substantial increase in traffic above present levels? b. Are public transportation services available at or near the site of the proposed action? c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed NO YES NO ❑ ,11 ❑ 71, 1-1action? 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: NO YES ❑ 0 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable water: NO YES 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: NO YES Z ❑ 12. a. Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district which is listed on the National or State Register of Historic Places, or that has been determined by the Commissioner of the NYS Office of Parks, Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b. Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory? NO YES ❑ Z 1-1 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain 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: Proposed pier and 6' wide x 20' long fixed dock. 120 S F NO YES ❑ ❑ ❑ 14. Identify the typical habitat types iccur on, or are likely to be found on the project site. Ch( that apply: 21Shoreline ❑ 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 by the State or Federal government as threatened or endangered? NO YES ❑ ❑ 16. Is the project site located in the 100 -year flood plan? NO YES ❑ Z 17. Will the proposed action create storm water discharge, either from point or non -point sources? If Yes, a. Will storm water discharges flow to adjacent properties? b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: NO YES ❑1 ❑ Fv-,1 ❑ ❑ 18. Does the proposed action include construction or other activities that would result in the impoundment of water or other liquids (e.g., retention pond, waste lagoon, dam)? If Yes, explain the purpose and size of the impoundment: NO YES ❑ ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: NO YES 20.Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES El I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/name: �„��� f�j�J Date: 1Z Signature: Anna M Ten Napel Title: Owner PRINT FORM Page 3 of 3 EAF Mapper Summary Report Monday, December 02, 2019 10:48 PM Disclaimer: The EAF Mapper Is a screening tool Intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form (EAF) Not all questions asked In the EAF are answered by the EAF Mapper Additional information on any EAF question can be obtained by consulting the EAF Workbooks Although the EAF Mapper provides the most up-to-date digital data available to 4 de -1. DEC, you may also need to contact local or other data sources in order d rFt to obtain data not provided by the Mapper Digital data is not a substitute for agency determinations i1111 Lit SIM 0i y ' Scurces Esrij;i..EkE, Garmin, USGS, i Intermap, R•18PEh4ENT F, NP.Csn, Esn _ Japan, tOETI, Esri Chins I Hcrn3 ICcng). Esri ICcies,EsriITha0nc), ',GQC Io) Cpen"9trestt:dsp r ntributc>, am the GIS r_ Usa Scmmunlb; r Part 1 / Question 7 [Critical Environmental Area] Part 1 / Question 7 [Critical Environmental Area - Identify] Part 1 / Question 12a [National or State Register of Historic Places or State Eligible Sites] Part 1 / Question 12b [Archeological Sites] Part 1 / Question 13a [Wetlands or Other Regulated Waterbodies] Part 1 / Question 15 [Threatened or Endangered Animal] Part 1 / Question 16 [100 Year Flood Plain] Part 1 / Question 20 [Remediation Site] Yes ra1ontr0l1 " Tctonto ."•I' Null dr 4-�I?aihal_r F,lletr4lt - " 6frton �.IrvdY>fel Erj ;;f'rcti�ld�nce Fattabcught ; rsclrceB"� irl,rFEPE. Garmin, i= nC:GInIflbIIG USS, latte,es CR INE10ENT F„NP..PUCan, Esri Jap r„taETI, ainnni7 iNa 61f..s;HcrgKcng),,E_n' Name.Goose Creek, Name.Peconic Bay and Environs, Reason -Significant coastal fish & wildlife habitat, Reason:Protect public health, water, vegetation, & scenic beauty, Agency.Southold, Town of, Agency:Suffolk County, Date:3-9- 90, Date:7-12-88 No No Yes - Digital mapping information on local and federal wetlands and waterbodies is known to be incomplete. Refer to EAF Workbook. No Yes No Short Environmental Assessment Form - EAF Mapper Summary Report r Part 2- Impact A went. The Lead Agency is responsible for the i letion of Part 2. Answer all of the following questions in Part 2 ; the information contained in Part I and other ma s 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 I Moderate 9. Will, the proposed action result in an adverse change to natural resources (e.g., wetlands, I 7_11 /1 I (� waterbodies, groundwater, air quality, flora and fauna)? � l --J 10. Will the proposed action result in an increase in the potential for erosion; flooding or drainage ❑ problems? -- 1 1. Will'the proposed action create a hazard to environmental resources or human health? LJ Part 3 -Determination of significance. The Dead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered "moderate to large impact may occur", or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part J. 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 considerthe potential for short-term, long-term and cumulative impacts. j� Check this box if you have detern-rined, based on the information and analysis above, and any supporting documentation, ll!! that the proposed action may result to one or more potentially large or signi icattl adverse impacts and an environmental impact statement is required. Check this box if you have determined, based on the information and analysis above. and any SUpporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold - Board of Trustees_ Name of Lead Agency � Da e 0o1�5lhr President l� I�R Title of Responsible Officer i Print orType "i'ype Name of Responsible Officer in Lead Agency P nrra.i„fA 4Aapn„ ,SinnatureofPreoarer(if different from Responsible Officer) I small impact to large impact may may occur occur I. 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? 1 3. Wil I the proposed action impair the character or quality of the existing community? n 4. Will the proposed action have an impact on the environmental characteristics that caused the (� } establishment of a Critical Environmental Area (CEA)7 �___1 I 5. Wil I 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. Wil''I 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: El a. public / private water supplies? 1L b. public / private wastewater treatment utilities? g_ Will the proposed action impair the character or quality of important historic, archaeological, architectural or aesthetic resources? L� L1 9. Will, the proposed action result in an adverse change to natural resources (e.g., wetlands, I 7_11 /1 I (� waterbodies, groundwater, air quality, flora and fauna)? � l --J 10. Will the proposed action result in an increase in the potential for erosion; flooding or drainage ❑ problems? -- 1 1. Will'the proposed action create a hazard to environmental resources or human health? LJ Part 3 -Determination of significance. The Dead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered "moderate to large impact may occur", or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part J. 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 considerthe potential for short-term, long-term and cumulative impacts. j� Check this box if you have detern-rined, based on the information and analysis above, and any supporting documentation, ll!! that the proposed action may result to one or more potentially large or signi icattl adverse impacts and an environmental impact statement is required. Check this box if you have determined, based on the information and analysis above. and any SUpporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold - Board of Trustees_ Name of Lead Agency � Da e 0o1�5lhr President l� I�R Title of Responsible Officer i Print orType "i'ype Name of Responsible Officer in Lead Agency P nrra.i„fA 4Aapn„ ,SinnatureofPreoarer(if different from Responsible Officer) _,rd of Trustees Application AFFIDAVIT ii n,na- +M -ren NaP<<- 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 Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF '�JQ.CWPXVI.IJQR 20 Nolry Public ,( t C10'v a'LI'Ac State of P6:•rr %�r w NO. O1 FL614?7~i QUallfier! ',-I Suffolk P:q;� C r •'i SSIi fl Ee cid,- 3��lCIUa� drd of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Anna. M . Ten LJA p---1 owners of the property identified as SCTM# 1000- 7 8 - 2 - '2-1 in the town of $ ow New York, hereby authorizes 'I Nt"a n 1 a to act as my agent and handle all I necessary work involved with the application process for permit(s) from the Southold Town Board of Trus tees for this property. i 'i Property Owner's Signature Property Owne ' ignature�� i SWORN TO BEFORE ME THIS 04 -1 -DAY OF 1 de -m buo-r , 20 i al Notary Public DEBBIE HARRIS Notary Public, State of New York No.01 HA6178636 Qualified in Suffolk Coin 3 Commission Expires APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The 7 own of Srnuhold s Code of Etl» cs prohibits conflicts of interest on the se art oftown offic�rc and cr tnlovecs, The tal a wh ver nc oris YOUR NAME: e L Ah n a- M -r'-n ,(Last name, first name,ipiddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that aPPIY•) Tax grievance Building Variance Trustee �— CCoastal Erosion Change of Zone Mooring Approval of plat 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 ou nership 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 th' 4 day of 20 Signature �w Print Name TC Form TS I APPLICANT/AGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM YOUR NAME• ._ Nq. i A h 1 o J--' F'F r e- (Last name, firsf name, tpiddle initial, unless yGu are applying in the name of someone else or other entity, such as a company. If so, indicate the other j person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Taxevance Building Variance I Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other 4 (If "Other', name the activity.) Do you personally (or through yobr-company, spouse, sibling, parent, or child) have a relationship with any officcr,or employee- of mployee of the Town of Southold? "Relationship" includes by blood; marriage, or business interest. `Business interest' means -a business, including a-partnerIship, in which the town officer or employee has,evcn a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% ofthe 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 I i Describe the relationship between yourself (the applicanttagent/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) theapplegal,or beneficial -owner of any`interest ina non -corporate entity (when the licant is nota corporation); C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. OF RELATIONSHIP Form TS li I Submitted this ay of Pee- 2011 Signature Print Name t!Aa� Glenn Goldsmith, President {,I��Su1 F0(,�cOGy? Michael J. Domino, Vice -President Q 1 John M. Bredemeyer III C A. Nicholas Knupski Greg Williams -_ j* BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ANNA M. ten NAPEL COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (63 1) 765-6641 THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLA CE FOR A T LEAST SEVEN DA YS 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 Z day of February , 2020, I personally posted the property known as 320 Glenn Road, Southold. SCTM# 1000-78-2-21 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, February 12, 2020. Dated: Z— 11-20 Sworn to before me this Z day of Feb. 2020 MARILYN S. HICKS NOTARY PUBLIC, STATE OF NEWYORK Registration No. 01H16365489 Qualified in Suffolk County Commission Expires October 10, 2021 Name: SCTM #1000-78-2-20 Kosel, Irene A 220 Glenn Rd. Southold, NY 11971 SCTM #1000-78-2-14 Simon, Robert K 379 Wood Ln Peconic, NY 11958 STATE OF NEW YORK COUNTY OF SUFFOLK PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: SCTM #1000-78-2-22 Blume, Jeffrey E Kondak, Melissa T 60 Water St. Apt 311 Brooklyn, NY 11201 SCTM #1000-78-2-15.2 Toman, Robert D & Susan A 3485 Main Bayview Rd Southold, NY 11971 11 Jeffrey Patanjo , residing at PO Box 582 Bohemia, NY 11716 being duly sworn, deposes and says that on the if Z9 day of ianuary , 20 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 !&" tG,_ , that said Notices wereto each of said persons by CERTIFIED MAEURETURN RECEIPT. /I D/ mai ed Sworn to -before me this Zq Day of. January 22020 S No ary Public MARILYN S. NICKS EeY PUBLIC, STATE OF NEN YORK gistration No. 01816365489 �ual'fied in Suffolk County ,tctot>er 10, 2021 mission E, �_�— February; 3, 2020 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 320 GLENN ROAD - SOUTHOLD, NY SCTM No. 1000-78-2-21 AFFIDAVITS Dear Trustees: Attached, please find original affidavits of posting and mailing 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 ours, Je ey Patanjo P. Box 582 Bohemia, NY 11716 Postal CERTIFIED o ■ { r- a.me§tic Mj.jl Ojily M I r` Certified Mall Fee N. rp $ tS O Extra Services & Fees check box, add fee as ( appropnate) ^ ❑ Return Receipt (hardcopy) $ 0 r� (�I I.O�O ❑ Return Receipt (electronic) $ CS3 \ �%StlYllark 0 []Certified Mail Restricted Delivery $ J Here C3 ❑Adult Signature Required $ ❑ Adult Signature Restricted Delivery , �..._-/yC) C3 Postage t}5 C0 $ rNu Total Postage anc - - — - - ---- $ SUM #1000-78-2-15.2 Ir a sentro Toman, Robert D & Susan A N Stieeiand-ApGM 3485 Main Bayview Rd cry,-siate;ziP+'a Southold, NY 11971 I r% - CO M r%- .11 C3 r -i C3 0 0 a Co ru ru Er� ri O r- SCTM #1000-78-2'°14 0 �• U M1 Certified Mad Fee '-0 $ Extra Services & Fees (chackbox, add fee es appropdate) A � T 7 y Ll Return Receipt (hardcopy) $ % I O❑ Retum Receipt (electronic) $ 6' Q 11 Certified Mall Restricted Delivery $ -- PostmarK\1O $ MVV i d ❑Adult Signature Required � ❑ Adult Signature Restricted Delivery$ C3Postage i ru Total Postage - Ir $ SUM #1000-78-2-2D I Sent To Kosel, Irene A 4 srrieeiandApiN 220 Glenn Rd. crh state,ZtP+d Southold, NY 11971 Postal'Service TM CERTIFIED Domes1jc Mail• nlv o RECEIPT S' r r` (00 Certified I"aa.j17 L O Mall Fee t j r -j Extra Services &Fees (check box, add fee as appropriate) ❑ Return Receipt (hardcopy) $ _ r3 Q ❑ Return Receipt (electronic) ❑ Certified Mall Restricted Delivery $ _ $ �wl,r 1' ti Pere O e ❑Adult Signature Required $ ere �9d_ ❑ Adult Signature Restricted Delivery $ 0Postage — +'C !!JJ tiTotal Postage anc SUM #1000-78-2-22 - a Sent To Blume, Jeffrey E C3 5----i irdApf Kondak, Melissa T city 60 Water St. Apt 311 stare ziP+d Brooklyn, NY 11201 I r% - CO M r%- .11 C3 r -i C3 0 0 a Co ru ru Er� ri O r- SCTM #1000-78-2'°14 0 �• U M1 Certified Mad Fee '-0 $ Extra Services & Fees (chackbox, add fee es appropdate) A � T 7 y Ll Return Receipt (hardcopy) $ % I O❑ Retum Receipt (electronic) $ 6' Q 11 Certified Mall Restricted Delivery $ -- PostmarK\1O $ MVV i d ❑Adult Signature Required � ❑ Adult Signature Restricted Delivery$ C3Postage i ru Total Postage - Ir $ SUM #1000-78-2-2D I Sent To Kosel, Irene A 4 srrieeiandApiN 220 Glenn Rd. crh state,ZtP+d Southold, NY 11971 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: 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 MAIL/RETURN RECEIPT. Sworn to before me this _ Day of , 20 Notary Public NOTICE OF HEARING 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: ANNA M. ten NAPEL SUBJECT OF PUBLIC HEARING: For a Wetland Permit to construct a proposed 4' wide by 28' long catwalk with steps down to a fixed 6' wide by 20' long fixed dock in a "T" configuration; both the catwalk and dock will have un -treated timber decking; and for a Ten (10) Year Maintenance period to trim the Phragmites 4' wide on either side of proposed catwalk (total 12' wide area) by hand methods down to not less than 12" above ground level twice per calendar year. Located: 320 Glenn Road, Southold. SCTM# 1000- 78-2-21 TIME & DATE OF PUBLIC HEARING: Wednesday, February 12, 2020 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor 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 sipuficant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting- and non - supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# -78 - 2 - 21 PROJECT NAME 3 2 G Cv It n n jL®A aQ S o -� • 1 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board ❑ Building Dept. ❑ Board of Trustees PY 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) a (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: P Location of action: -320 C len n tZd- — S o„ d -k - l d Site acreage: D 4 4 S Present land use: Res Present zoning classification: Rats 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: Ann -%- M Te n A)^ pe- i— (b) Mailing address: 1 ®Cepdu D IL (LO cILy �o � n -f , �►1 � 11.7 � (c) Telephone number: Area Code () !� 3 / • 3 3 S - R ! v S (d) Application number, if any: _�l Ig Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes FVT No ❑ If yes, which state or federal agency? N `I 5 b *- LN `(s.8 cps 1AAAA Y dvA.IO S 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. Poster 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. 9Yes ❑ No ❑ Not Applicable an Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III —ZApplicable Pages 3 through b for evaluation criteria 1:1 Yes F-1No Pro i -ee-1 hks 40 a C -Fc 04 W 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 ZI"YesF] No ❑ 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 14ot Applicable AraI eg-4 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 1:1 Yes 1:1 No u Not Applicable Pr(4e--i 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. o ❑ o' Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LUMP Section III — Policies Pages 32 through 34 for evaluation criteria. 1-1 Yes F No Not Applicable Prd.t `+ k %$ Aa t 4ecA Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LN6W Section III — Policies; Pages 34 through 38 for evaluation criteria. Yes No EJ Not Applicable eryI'CA k is eLc- t "ee,F 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. n No 1-1 Not Applicable Attach additional sheets if necessary WORHING COAST POLICIES Policy 10. Protect Southold's water -dependent uses and promote siting of new water -dependent uses in suitable locations. See LWRP Section M— Policies; Pages 47 through 56 for evaluation criteria. Yes ❑ No ❑ Not Applicable F—Ire, /fi-` IS 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 eevalluuation criteria. � ❑ Yes ❑ No Not Applicable (�tee, hws- n o e �cf Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section M — Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No 2/Not Applicable PREPARED BY r TITLE_ 14U, 41 DATE 1, Z-1 L -1 { December 16, 2019 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box .1179 Southold, New York 11971 a j ! DEC 3 0 ?m9 RE: 320 GLENN ROAD - SOUTHOLD, NY SCTM No. 1000-78-2-21 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, Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716