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HomeMy WebLinkAboutTR-9760 Glenn Goldsmith,President �QF SBUrTown Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III J�[ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams D �� Fax(631) 765-6641 1y�,0UNT1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFIEE OF THE BOARD OF TRUSTEES 7Z HOURS'PRIOR TO'COMMENCEMENT OF THE ACTIVITIES CHPCKEb10EF -`FBEL:ONU ; INSPECTION SCHEDULE - - Pre-construcfi~on;•hbbale=li6e/siltVo6m/tilt-�(if#6in 1St day of construction '/ constructed j o' ct com fete call•for Oona'-Iiance ins ,ectibh; When pr fie., p p . . -. P. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK t_7 !3 f. PERMIT NO. 9760 DATE: NOVEMBER 18,2020 ISSUED TO: ANITA M. SAMUELS,TRUSTEE CREDIT SHELTER TRUST PROPERTY ADDRESS: 155 FISHERMAN'S BEACH ROAD, CUTCHOGUE E SCTM# 1000-111-1-8.4 1_4 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 November 18, 2020 and in consideration of application fee in the sum of$250.00 paid by Anita M. Samuels 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 repair existing 5'x18',90sq.ft.=b lower dock,with stringers raised at north end,level with existing adjoining dock,using existing pilings; repair two wood steps from basin wharf to dock,with handrails between upper and lower decked areas; existing 96 linear foot bulkhead,including pilings, stringers and deadmen to remain; replace 518 square feet of existing wharf decking on existing structure, in-kind with 2x6 treaded wood boards around basin; and there is to be no excavations nor filling of property; and as depicted on the site plan prepared by Samuels&Steelman Architects,dated September 21,2020,and stamped approved on November 18,2020. 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 18fl,day of November,2020. & v �r �v I i �''le; WA;"ff"f";; .0 TERMS AND CONDITIONS The Permittee Anita M. Samuels, residing at 155 Fisherman's Beach Road,Cutcho ue, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Glenn Goldsmith,President ,QF SO!/jTown Hall Annex Michael J.Domino ,`p� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III l�t Southold, New York 11971 A.Nicholas Krupski G Nc Telephone(631) 765-1892 Greg Williams �O �� Fax(631) 765-6641 Comm il- BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 24, 2020 Thomas C. Samuels Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 RE: ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER TRUST 155 FISHERMAN'S BEACH ROAD, CUTCHOGUE SCTM# 1000-111-1-8.4 Dear Mr. Samuels: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, November 18, 2020 regarding the above matter: WHEREAS, Samuels &Steelman Architects, on behalf of ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER 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 September 22, 2020, 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 recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit for the structures; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on November 18, 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 all the testimony and documentation submitted concerning this application, and, 2 WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, and, 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 for the mitigating factors and based upon the Best Management'Practice requirement imposedabove, the,Board of Trustees deems the action to be Consistent with'the 'Local Waterfront Revitalization Program pursuant to Chapter 268_-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees-approve the application-'of ANITA M: SAMUELS; TRUSTEE CREDIT SHELTER TRUST to -repair existing 5'x18',�90sgft,t lower-dock, with stringers raised at north end, level with existing adjoining dock, using existing pilings; repair two , wood steps from basin wharf to dock, with handrails between upper and lower decked areas; existing 96 linear foot bulkhead, including pilings, stringers and deadmen to remain; replace 518 square feet of existing,wharf decking on existing structure,'in-kind with_2x6 treaded wood boards around basin; and there is to be no excavations nor filling of property; and as depicted on the site plan prepared by Samuels & Steelman Architects, dated September 21, 2020, and stamped approved on November 18, 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: $50.00 ry truly you s, '6Glenn Gowsmith President, Board of Trustees GG/dd NEW 5TA I R5 4 HANDRAIL BETWEEN UPPER 4 LOWER DECKING EXISTING BULKEAD TO REMAIN. EXISTING 5" TIMBER PILINGS TO REMAIN --. , P 2 ' 2020 NEW TR. WD. DECKING EXI5TING/NEW 6x8 TR. WD. TIMBER GIRDERS - - - RE-ATTACHED TO P I L I NG5, LEVEL w/ADJACENT DOCK AVERAGE WATER LEVEL Uj >.Z ui W AVERAGE LEVEL OF GREEK BOTTOM = I— O F_ _ APENEENPROVED BY Q � BOARD OF 1 TRUSTEES � U TOWN OF SOUTHOLD A um! SIDE ELEV A4 TIOIN VIEW at 0 west side ® basin IT EDATE tjovow- r8,zoo 0)13 COVEo � a w °oa RE-ATTACH EXISTING OR NEW \ m $ TR. WD. 5TRIN67ER5 TO EXI5TINGUs! Y) PILI NGS, w/NORTH END LEVEL Q Z w/ADJAGENT DOCK. PROVIDE O. Q CIO sf NEW 2x6 TR. WD. DECKING S1 It UAoAW E W SCTM # 1000-111-01-8.4 � :rRE-BUILD EX 1ST I NG STEPS � vi/NEW RAILING PROPERTY: 155 Fisherman's Beach Road Cl) Cutchogue, NY 11935 EXISTING op \Q © 'S 8501931 " OWNER: Anita M. Samuels WETLANDS yo E 4 3 . 98 5 155 Fisherman's Beach Road _ Cutchogue, NY 11935 _\ __ � TEL. #631 734 6098 \ �O u \ -TIE LINE 01 y�0 O : � o SITE: 3,211.94 sf= 0.074 ac 0\x \J_\ .SC, y �Q ^ AREA �� Jv MAINTAIN EXISTING c16 LF ZONING: R-40 oaBULKHEAD, INCLUDING Drs Z. o Ftio �° PILINGS, SHEATHING AND FLOOD: AE 7 ,O 3A5 s�F DEAD MEN ZONE N Q. CD � M op� \ \\ SURVEYOR: Nathan Taft Corwin III -j �' N o 0 PROVIDE NEW NON-TUBE moo\\\ \ ;\\ REPLACE 518 SF EXISTING PO Box 1931 w _j• W V- W x BUFFER, APPROXIMATELY u \ \ ;\ DETERIORATED DECK Riverhead, NY 11901 _ _ Z LL 265 sf, TO BE PLANTED BOARDS w/MATGHING 2X6 W• a o w/BEACH 6RA55 , � \ \\ .� \ DATED: 4/4198 M w• " �� •, ,\ \ ry \\' TREATED WOOD DECKING \ \\ \ s�'�� a ~• v yri \ •20` \ 4 0�13 LIC� T MAP LOCA�10pm Q)* r rodwaters Al _X10 v Creek Qj O V4 7 V40 a r 0 EXISTING O O �' S� TE C ;Y� ° _c _ 20 v / LAWN \ u ... : Co O �' O I TE • G ' o �[ Cutchogue Harbor �O ' tov, PROJECT NO: O "� X A ` N S a ' v�� ° DRAWN BY: ,(� OD , CO �o 0TS a 0. \ \ ` ` �� A) �o� CHECKED BY: C4 DIRT & GRAVEL DRIVEWAY7 DATE: �o� e 9/21/20 \ ,o SCALE: SHEET TITLE: F � \ SITE \ PLAN \ cc- SCALE: SCALE: V = 10' - 0" goo q�F a a 0 < A 3 TSF FOc/ qUF� SHEET NO: NG FtiT F TRUSTEE APPLICATION Glenn Goldsmith, President ��o oy Town Hall Annex Michael J. Domino o 54375 Route 25 John M. Bredemeyer, III o ® P.O. Box 1179 A Nicholas Krupski Southold, NY 11971 Greg Williams 0� ' Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ANITA SAMUELS c/o SAMUELS & STEELMAN Please be advised that your application dated September 22, 2020 has been reviewed by this Board at the regular meeting of November 18, 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) 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) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit., Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 50.00 � 2 BY: Glenn Goldsmith, President Board of Trustees Glenn Goldsmith,Pn /�it SVFFO�kC 'r Town Hall Annex Michael J. Domino ��� GAJ; 54375 Route 25 John M. Bredemeyer III y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams 4,1 dap! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 1 110ho Completed in field by: �• �n.�Sf/�; Samuels & Steelman Architects on behalf of ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER TRUST requests a Wetland Permit to repair existing 5'x18', 90sq.ft. ± lower dock, with stringers raised at north end, level with existing adjoining dock, using existing pilings; repair two wood steps from basin,wharf to dock, with handrails between upper and lower decked areas; existing 96 linear foot bulkhead, including pilings, stringers and deadmen to remain; replace 518 square feet of existing wharf decking on existing structure, in-kind with 2x6 treaded wood boards around basin; and there is to be no excavations nor filling of property. Located: 155 Fisherman's Beach Road, Cutchogue. SCTM# 1000-111-1-8.4 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 c/ Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application/completeness/comments/standards: ll 2X O. Cu„i (gft4p Flo d r)ot.S dL� ti eco _e e I ssjfS I have read & acknowledged the foregoing Trustees comments: Agent/Owner:'= Present were: V J. Bredemeyer M. Domino v"'-G. Goldsmith N Krupski `/'G. Williams Other k ` SEP 2 2 2' l s E 5" DIAMETER X 20' LONG TREATED WOOD PILIN65 AT VON CENTER 2x6 TREATED WOOD DECKING 4x5 TREATED WOOD DECK JOISTS VA 4x5 TREATED WOOD GIRDERS BOLTED ° SECURELY TO FILINC75 AVERAGE WATER LEVEL APPROXIMATE BOTTOM I I-III-III-III-III-III III III-I I I-I I I-I -III-III-III-III-III-III-III-III III-III-III-III-I I �" �T I ON DOS FL o :I W DIAMETER X 20'LONG TREATED WOOD PILIN65 AT 6'ON CENTER Q 2x6 TREATED WOOD DECKING ON 2x8 TREATED WOOD JOISTS,w/4x4 TREATED WOOD POSTS POR SUPPORTS _ 6x8 TREATED WOOD STRINGER �—I I El I I—I I I — El M -I 11—I 11-1 1-1 III-I 11=1 I I-I 11=1 5/4'6ALV.STEEL TIE ROD,CONNECTED =III=III-III 1 I-III-III-III_ TO 6' DIAMETER x V LOCU5T DEADMAN -11 I—I I I—III—I III—I 11=1 _—I I=1 =1 11=1 11 I I=1 I =1l1-III EXI5TIN6 TREATED WOOD SHEATHING -III -III- 1=1I1-1I1-1 -1 I 11= -III-III-III -III AVERAGE WATER LEVEL —I El11—III—III—I I I—I —III I—I 11— 11—� 11—I 11-1II-1II 6x8 TREATW WOOD STRINGI=R -11II-1 I I—III=III—IIMIII-1 I I—I =III 1 I —III—III-1 I 11II—II1 -1II—III =1 11=1IMi I Ml I 1=111—I —I 11—I I I I-1II—I 11—I I I—IIEd I -III—III III—I I I—I I MI MI 11—I �—II I—II 1 I-1 I I—I 11-1II-1II-1II -III—III I—III—III—III=1 I I—III—I APPROXIMATE BOTTOM - -I 11=1 I I—I 11=1 I iI—I 11=i1 I I-1 11=1 I I—I I I I I I I I=111=111=1 11=1 11=1 11=1 11=1 11=1 11=1 11 1 I M SEC,TION @ 5UL<HEAD SEP 2 2 2020 SURVEY OF PROPERTY SITUATED AT NASSAU POINT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000- 111 -01 -8.4- 1000- 111 -01 -40 000- 111 -01 -8.4-- 1000- 111 -01 -40 1000- 111 -01 -41 HAYWATERS SCALE 1 "=20' COVEAPRIL 4, 1998 3 AUGUST 10, 2020 UPDATE SURVEY S 85°19'17" E s°pp 43.98' `�r°�°�° ��• � � T�TIE LINE � g °ky� J Ose y X43 -. /� 4l ', Oma' 'o j� 4j_>' -iY ° 5 c`�' S.C. TAX No. 1000-111-01-8.102 de seFy ci RF . ) 6) • S ' �! � •ate a �� � °w� �� / A) QQ 'J� DIRT & GRAVEL DRIVEWAY \ S pp, O2 d � SO4S/SA '• a '• •� SA° y�c�� � O-SQply�' .Q .,100 O L i RON � l NA4 o a •. • WOOo D v ��2 A z " (O41 O / CO VO, WO ' v 4 . •" O••4�'• // ^ R���pNC \ \ hp OD•TI DGING ` • N U \ S 87*30'00=E —_ �9 o O 422j 3 H,fp A` TIE LINE _65.00 f � 5•8 PENCE a (V q ROS, CO O C\4 OD .:. ,•. Op OfOk N• O 2 I3� .o', U '• w Wp00 hof O O o ad RgOUsE W�°Ali o 'y o.s• rr•s' tib 3B. G� „o �� N r GP•t $� v .s f 3 fOk c�NyOU�s ?o.r NG � � � a�::;.:•... �fPSWOpo 4r SPS Wp °p Ck U2 rB+ WpOp \ W 1 .0 W O N LOT 3O gl -Po�G C LOT02 S.C. TAX No. 1000-111-01-40 S.C. TAX No. 1000-111-01-41 W O N Z w \ LOT AREA DATA (AREAS TO TIE LINES) S.C. TAX No. 3,212 sq. ft. 44,F 1000-111 -01-8.1 0.074 ac. \ S.C. TAX No. 16,857 sq. ft. \ 1000-111 -01-40 0.387 ac. S.C. TAX No. 18,003 sq. ft. 66, arm w 1000-111 -01-41 0.413 ac. ..71, TOTAL 38,072 sq. ft. 0.874 ac. Aloe s N NOTE: 1�� \ LOT NUMBERS SHOWN THUS: LOT 2Q REFER TO 66 0� SUBDIVISION MAP PECONIC BAY PROPERTIES, INC.FILE IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON APRIL 5, 1931 AS FILE No. 786. CERTIFIED TO: BRIDGEHAMPTON NATIONAL BANK THOMAS E. SAMUELS ANITA SAMUELS UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS„hIiSr T3CL5!'ED j, ■ BY THE L.L USE AND E NEW,'ED�`A aD (OOP�jEU��f\ Y 'a' C f r I FOR SUCH USE BY THE NEW YQRIC,ST ZL.I,J1(VD r h ll TITLE ASSOCIATION. Land Surveyor Title Surveys — Subdivisions — Site Plans — Construction Layout Q r, PHONE (631)727-2090 Fax (631727-1727 ".� OFFICES LOCATED AT MAILING ADDRESS .1ysNo. 50467 1586 Main Street P.O. Box 16 Jamesport, New York 11947 Jamesport, New York 11947 98-203C I k f � f AN w��� e+: ti, • ir .., x Tom+ �.' �1� ♦••N. a w -two`r•`_ +�+j .JI p';.._�. 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IO 1A •ys 1�Ac<i ------ ��� --�— NOTICE COUNTY OF SUFFOLK © K 101 1 � Sq)7}gLp SECTION NO x' ut -. ,_ •-••` .. ....�„ f2eal Property Tax ServiceAgency Y TWI x ,x OFFICE LOCATION: � �e MAILING ADDRESS: Town Hall AnnexE P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) ¢� � � Telephone: 631 765-1938 Southold, NY 11971 ') 41 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: November 17, 2020 Re: LWRP Coastal Consistency Review for ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER TRUST SCTM# 1000-111-1-8.4 Samuels & Steelman Architects on behalf of ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER TRUST requests a Wetland Permit to repair existing 5'x18', 90sq.ft. ± lower dock, with stringers raised at north end, level with existing adjoining dock, using existing pilings; repair two wood steps from basin wharf to dock, with handrails between upper and lower decked areas; existing 96 linear foot bulkhead, including pilings, stringers and deadmen to remain; replace 518 square feet of existing wharf decking on existing structure, in-kind with 2x6 treaded wood boards around basin; and there is to be no excavations nor filling of property. Located: 155 Fisherman's Beach Road, Cutchogue. SCTM# 1000-111-1-8.4 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 action is INCONSISTENT with the Policy Standards and therefore is INCONSISTENT with the LWRP based upon: 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The as-built structures were constructed without a Wetland Permit. 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 01/ Michael J.Domino,President , Dy Town Hall Annex John M.Bredeaneyer 1H,Vice-President ' 54375 Route 25 F P.O.Box 1179 Charles J.Sanders C/, Southold,New York 11971 Tenn Goldsmith �,kA " _ y� Telephone(631)765-1892 A.Nicholas Krupslu � ,, U � r Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application =-- Administrative Permit F ;.~ h :_, I�-� Amendment/Transfer/Exterr��,,Sion Received Application: 'I-ZZ-,?D � C� eceivedFee: $ ZSfl-� `� SEP 2 2 2020 omplcted Application: 10.2-.2-0 Incomplete: - --------� SEORA Classification: Type I` Type II Unlisted Lead Agency Determination: zCoordination:(date sent):__ MWRP Consistency Assessment Form SAC Referral Sent: folg-ld-b of Inspection: 1.1.210 Receipt of CAC Report: Technical Review: Public Hearing Held:--j1-I T-W Resolution: Legal Name of Property Owner(s): Anita k Samuels Mailing Address: 155 Fisherman's Beach Road, Cutchogue, NY 11935 Phone Number: 631734-6405 Suffolk County Tax Map Number: 1000- 111-01 12,0 Property Location: Fisherman's,Beach Road, Cuthogue, NY 11935 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Tom Samuels, Samuels & Steelman Architects Mailing Address: 25235 Main Road, Cutchogue, NY 11935 Phone Number: 631734-6405 1/ •1 Board of Trustees Appl'��ation GENERAL DATA Land Area(in square feet):_ 3,211.94 sq. ft. Area Zoning: R-40 Previous use of property: Residence,- Single Family _ Intended use of property: Residence - Single Family Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes x No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. 1 Does this project require a variance from the Zoning Board of Appeals? Yes x No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: r 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 Attached Samuels and Steelman Architects 25235 Main Road, Cutchogue, NY 11935 REPAIRS TO THE DOCK AT SAMUELS RESIDENCE 155 Fisherman's Beach Road, Cutchogue, NY 11935 SCTM# 1000-111-1-8.4 PROJECT DESCRIPTION Repair existing 5' x 18', 90 sf+/- lower dock, with stringers raised at north end, level with existing adjoining dock, using existing pilings. SEE DETAIL; Repair two wood steps from basin wharf to dock, with handrail between upper and lower decked areas; Existing 96 linear feet bulkhead, including pilings, stringers and dead men to remain. Replace 518 square feet existing wharf decking on existing structure, in kind with 2x6 treated wood boards around basin. See DETAIL. There will be no excavations nor filling of property. Board of Trustees Applzuat;ion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Repair decking at dock and around basin. Area of wetlands on lot: square feet. f Percent coverage of lot: ( ^�% Closest distance between nearest existing structure and upland edge of wetlands: 1 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? n- cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations: 0% ; Manner in which material will be removed or deposited: na 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): na Scott Aa Russell Ir�� ST0]KI'\�l WA\T]E K SUPERVISOR � ��[A\N ASG 1EM1EN T SOUTi1OLD TOWN HALL-P.O.Box 1179 1 53095 Main Road-SOUTHOLD,NEW YORK 11971 1*1 Town of Southold 0 CHAPTER 236 - ST®RMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) I DOES THIS ]PROJECT INVOLVE .ANY ,OF 'I['IH[]E FOLLOWING- — tCHECK ALL THAT APPLY) Yes No ❑�(A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑�JB. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ C, Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ® E. Site preparation within the one-hundred-year floodplain as depicted I on FIRM Map of any watercourse. , ®� F. Installation of new or resurfaced impervious surfaces of 1,000 square i feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town-and- the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date 8-County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICAiNT (Property•Ott ner,Design Professional,Agent.Contractor,Other) S•C.T.M. 1000 Date ,p-„ 'c ' 'Section Block Lot M* VOR BUILDING DLPAR'I ML:N"I- USL ONLY **�� Contact Infoimauoa i T6-ph- Reviewed By: — — — — — — — — — — — — — — — — j - - _ - - - - -Date_ Property Address/ Location of Construction Work: — — — — — — — e /J Appimed for processing Building Permit. — It �� dr7S!'l(ih4YlL�i1�1 ' �iG� " El Stormwater Management Control Plan Not Required. ElStorm\\•ater Management Control Plan is Required. (Forward to Engineering Depaitment for Review.) - TTTIII FORM-# SMCP-TOS MAY 2014 APPLICANT S.0 T.M.#: 1000 SU CHAPTER 236 (Property Owner,Design Professional,Agent,Contractor,Other) o �— b04"� Stormwater Management Contr61 Plain CHECK LIST NAME: �& J��Gle`� section Blocs: Lot o � S M C P -Plan Requirements Provide ONE copy of the Building Permit Application 7c�i� l9*6 Date �yi 3 * The applicant must provide a Complete Explanauon and/or Reason for not providing z Z0 all Information that has been Required by the following Checklists Sgnaiula Trkjl N..h4 1. A Site Plan drawn to scale Not Less that 60'to the inch MUST If You answered No or NA to any Item, Please Provide Justification Herel YE NO NA If you need additional room for explanations,Please Provide additional Paper. show all of the following items: P P a. Location& Description of Property Boundaries 00 b. Total Site Acreage. 0� c. Existing-Natural &Man Made Features within 500 L.F. 4 of the Site Boundary as required by§236-1710(2) d. Test Hole Data Indicating Soil Character istics&Depth to Ground Water. 0 e. Limits of Clearing &Area of Proposed Land Disturbance. 00 f Existing&Proposed Contours of the Site (Minimum 2'Intervals) g Location of all existing& proposed structures, roads, driveways,sidewalks, drainage improvements& utilities. h. Spot Grades&Finish Floor Elevations for all existing& proposed structures. I Location of proposed Swimming Pool and discharge ring 0 j. Location of proposed Soil Stockpile Area(s). k. Location of proposed Construction Entrance/Staging Area(s). 1. Location of proposed concrete washout area(s). 0 M. Location of all pi oposed erosion&sediment control measures. 0 2. Stormwater Management Control Plan must include Calculations showing that the stormvater improvements are sized to capture,stoi e,and infilti ate on-site the i un-off from all impervious surfaces generated by a two(21 inch 00 rainfall/storm event. 3 Details&Sectional Drawings for stormwater practices ate required for approval Items requiring details shall include but not be limited to: a. Erosion&Sediment Controls. 0� b. Construction Entrance&Site Access. 0 c. Inlet Drainage Structures (e.g.catch basins,trench drains,etc) d. Leaching Structures (e. .infdtiation basins,swales,etc.) **** FOR ENGINEERING DEPARTMENT USE ONLYi D Additional Information is Required. Reviewed & I Stormwater Management Control Plan is Not Complete. Approved By: — — — — — — — — — — — — — — — — — — — — — — — ❑ Stormwater Management Control Plan is Complete. Date: SMCP has been approved by the Engineering Department. FORM # SWCP Check List-TOS MAY 2014 617 20 Appendix B Short Etzvironmental Assessment Form Instructions for CAMP eting Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully ' respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: Samuels Rip (fence Project Location(describe,and attach a location map): 155 Fisherman's Beach-Road. Cutch®.ue� NY Brief Description of Proposed Action: Repair decking at dock and around basin using existing pilings; replace two wood steps With handrail between upper and lower decked areas; replace approximately 20 individual 5' long deck boards with new/matching ACQ boards Name of Applicant or Sponsor: Telephone: 3J_7_3 _6A05.. Anita M. Samuels E-Mail: Address, 155 Fisherman's Beach Road City/P`o: State.; Zip Code: Cutchogue NY 11935 �I.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 thatRr D = may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental.Agency? NO YES If Yes,list agency(s)name and permit or approval: JCC ✓�tCd `l�[ ��- L__J 3.a.Total acreage of the site of the proposed action? _.0.074____.acres b.Total acreage to be physically disturbed? T acres c.'Total acreage(project site and any contiguous properties)owned or controlled by the applicant'or project sponsor? _o-0_74___-acres 4. Check all land uses that occur on,adjoining and near the proposed action. [Urban []Rural(non-agriculture) Olndustrial [_—]Commercial Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page I o F 4 i 5. Is the proposed action, NO YE N/A a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Envirodmental•Area? NO YIES If Yes,identify: S. a.Will the proposed action result'in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? El c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 4.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑. 10. Will the proposed action connect to an existing publiclprivate 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: ❑ 12. a.Does the site contain a structure that is listed on either the State or National,Register of Historic NO YES Places? _❑ b. Is the proposed action located in an archeological sensitive area? 3 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO Y 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? e ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: �14. Id tify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: _ Shoreline ❑Forest agricultural/grasslands El Early in id-successional EJ Wetland ❑Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed , NO _YES by the State or'rederal government as threatened or endangered? ❑ 16.Is the project site located in the 100 year flood plain? � � NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a. Will storm water discharges flow to adjacent properties? ❑NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: []NO ❑YES Page 2 of 4 ` v f I 18.Does the proposed'action include construction or other activities that res;, _,i the impoundment of NO YES water or,other.liquids(e.g,retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 19.Has the site of the proposed'action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for'hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABODE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Tom Samuels,Ataent .__ _ . Date: March 12,2020 Signature: Part 2-Impact Assessment. The lead Agency is responsible for the completion of Part 2, Answer all of the following questions in Part 2,using the information contained in Part I and other materials,submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept",Have my 'responses been reasonable considering the scale and context of the proposed action?" ' No,or Moderate small to targe impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning D regulations? El_ 2. Will the proposed action result-in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? _ r 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed,action result in an adverse change in the existing level of traffic or (�`J affect existing infrastructure for mass transit biking or walkway`? �J El 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities. 7. Will the proposed action impact existing: a.public/private water supplies? b^public/private wastewater treatment utilities? S. Will the proposed action impair the character or quality of important historic,archaeological, _ _ architectural or aesthetic resources? 9. Wil l the proposed action result in an adverse change to natural resources(e.g;,wetlands, D waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or,_ �Moderate small to large, impact impact: may may occur occur 10. Will the proposed-action result in an increase in the potential for erosion,flooding.or drainage problems? _ 11. Will the proposed action create a-hazard to environmental resources or human,health? ULS Part 3-Determination of significance. The Lead-Agency is responsible for the completion of Part 3, For every question in Part 2 that was answered`moderate to large impact may occur",or if there is a need to explain why a'particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by, the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and rriagnitude. Also consider the potential for short-term,long-tern and cumulative impacts. a ( Check this box if you have determined,based on the information-and analysis above,'and any supporting documentation, that tite proposed•action may result in one or more potentially large or significant adverse impacts and an G 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 /' l _ v._ . Name epof Lead Agency Date w_ 121err l�al r?i.7t'` �_ President 'Print or y 'e Nam of Responsible Officer in Lead Agency Title of Responsible Officer - ignattn of Responsible Officer in Lead Agency Signa4ure of Preparer(if different from Responsible Officer), _ PRDRt Page 4 of 4 8 202 i SEP 2 Soto J & DR Family Trust —S ,.5oldMw n 90 Haywaters Road B and of Tr s.:res Cutchogue, IVY 11935-2606 July 2?, 2020 To whom it may concern, We hereby give authorization to Tom and Anita Samuels to seek all necessary regulatory approval permits to tie their dock into our own, as has been the case historically. Our dock is located on Fisherman's Beach Road on SCTM# 1000-111-1-9. Respectfully submitted, Trustee i Trustee Board of Trustees Apl:e__Itat:iora AUTHORIZATION (Where the applicant is not the owner) �lI/We, owners of the property identified as SCTM# 1000 `l� �'r in the town of .New Fork,hereby auth®rizes 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 l 20 Z O NotaryPublic p�REN M,MCKisSICK t4otary Nob01 state Of MC6342308�Y OU Qualified in S�M May County Commission Board of Trustees Appl` .'ktion AFFIDAVIT BEING DULY SWORN DEP OS SAND 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 i SWORN TO BEFORE ME THIS _ DAY OF , 20—z— LAUREN M.IVICKISSMIC N011Notary Public No OIMC6342308w Yok Comm Qualified May A 2ON No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. F] Check this box if you have determined, based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. F1Check 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 Date President -w zrr Print or TCpName;of t,_irs91fficer in Lead Agency - -Title of Responsible Officer SiYdStL&&--Respoii`ibld"@f-rr;.*?r in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 F .. S f e APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSUR&FORM i. The Town of Southold's Code of Ethics-.prohibits conflicts of interest on the Dalt of town-officers and------fes.The auroose of this form is to provide information which can alert die town of possible conflicts of interest and allow it to take whatever action is necessamto avoid same. YOURNAME: (Last name,first name,Viddle initial,unless you are applying to 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 j Coastal Erosion r 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 than5% the shares. YES NO i S If you answered"YES",complete the balance of this form and date and sign where indicated. t Name of person employed by the Town of Southold Title or position of That person Describe the relatiohship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate linejA)through D)and/or describe in the space provided. The town officer o 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 tor beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an ofFice'r director,partner,or employee of the applicant;or D)the actu�I applicant. DESCRIPTION OF RELATIONSHIP - d i 1 ' Submitted this&, _day of' ��Z(!� 2MSignaturev S Print Name Form TS 1 i - s f i APPLICANT/AGENT/RE-PRESENTATIVE TRANSACTIONAL DISCL®SURF,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the pari oft—own officers and employees The auroosc of this form is to provide infarmation which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid sameI dl. YOUR NAME: (Last na e,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) _ -- Do you personally(or through your company,spouse,sibling,parent,or chill)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 501( of the shares. YES NO Fy/ 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 � 2el_4Al Signature r Print Name f� S Form TS 1 a Glenn Goldsmith,PresidentOO COG Town Hall Annex Michael J Domino =� y� 54375 Route 25 John M.Bredemeyer III (CM P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 r BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 30, 2020 Tom Samuels Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 Re: Board of Trustees Application of Anita M. Samuels, Trustee Credit Shelter Trust 155 Fishermans Beach Road, Cutchogue SCTM# 1000-111-1-8.4 To Whom It May Concern: You are receiving this letter as notice that, in accordance with the Governor's Executive Order 202.1, this application is now scheduled to be heard by the Southold Town Board of Trustees, via videoconferencing on Wednesday, November 18, 2020 beginning at 5:30 P.M. Please continue to check the Town's website as the meeting date approaches for the latest meeting agenda and videoconferencing information. Also enclosed is an informational notice regarding the videoconferencing meeting and how to accessithe online meeting. Please mail a copy of the informational notice along with all other required paperwork to each of the adjacent property owners. Please keep a copy of said informational notice for your records so that you can access the meeting in order to have a conversation with the Board during your application review. ry Tr my o Glenn Goldsmith, President Board of Trustees i I, o�UfEO( Town Hall Annex Glenn Goldsmith, President ,r �, O Michael J. Domino54375 Route 25 John M. Bredemeyer IIIv z 7 P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams �lr Telephone(631)765-1892 arm Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD WORK SESSION & PUBLIC HEARINGS WEDNESEDAY, NOVEMBER 18, 2020 5:OOPM & 5:30PM A Regular Work Session and Public Board Hearings of the SOUTHOLD TOWN BOARD OF TRUSTEES will be held on Wednesday, November 18, 2020 with the Work Session beginning at 5:OOPM and Public Hearings beginning at 5:30PM. Pursuant to Executive Order 202.1 of New York Governor Andrew Cuomo in-person access by the public will not be permitted. Town residents are invited to attend the public meetings virtually via the Zoom online platform. Written comments`may also be submitted via email to the Trustees Clerks at elizabethc@southoldtownny.gov and diane.disalvo@town.southold.ny.us. Said comments will be considered at the public hearing provided that they are submitted no later than 12:00 P.M. (Prevailing Time) on the day of the public hearing. The public will have access to view and listen to the meeting as it is happening via Zoom. If you do not have access to a computer or smartphone, there is an option to listen in via telephone. Further details about how to tune in to the meeting are on the Town's website at https://www.southoldtownny.gov/calendar or call the Board of Trustees office at (631) 765-1892 Monday through Friday between the hours of 8:OOAM —4:OOPM. Options for public attendance: - • Online at the website zoom.us, click on "join a meeting" and enter the information below. Zoom Meeting ID: 962 8115 2407 Password: 299051 • Telephone: Call 1(646) 558-8656 Enter Meeting ID and Password when prompted (same as above). In order to "request to speak" when the application you are interested in has begun, please press *9 on your phone and wait for someone to acknowledge your request. When prompted to unmute your phone press *6. To view the application files please visit: https://www.southoldtownny gov At the bottom of the picture on the main screen click on the second button from the right "Town Records, Weblink/Laserfiche"; go to bottom of page and click on "pg. 2"; click on "Trustees" folder; click on "Applications"; click on "Pending"; all files are listed by name in alphabetical order. Click on the name of the application,to view the file. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: ,'' '� - _; ,•.^- _ �- ,,'`� }i Ji ILL. _ i�;'w: .r.3�`- � •.�:ter. -_'���`'^�l?z"+.nt*i...R',--�}i.,- '�FKi'°V'`� -? �� -•f.3,,,'��s,. - `�s` �`at�`.t`. ^=fa d,;'M*.ek`F.[ -'.`':t;s-�'T3W�17" %;:x;,i:a?'��-- «r,'�T�,rv"Y.ft,t�i,""=9���'�'^�` ,��:?})"�pj�"�{;�%a'$i.,�_s�5zw..-+.'•ar`,�Yj�,y 1+�`,+' '�i•s' Y'd�;�='�S�K�L'..s 'i;h:.s�i�h;a''et$w:.$U;;^ .a:a^`_' ��".'�,$.. 3""'y.:'«..'"r:e;.s, Pri c 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 P 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 Glenn Goldsmith,President �Q FFQ�`�C� Town Hall Annex Michael J.Domino ��� Gy1 54375 Route 25 John M.Bredemeyer III y P.O.Box 1179 A.Nicholas Krupski 0 ry Southold,NY 11971 Greg Williams p!.rY 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 ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER TRUST COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING DO NOT COMPLETE THIS FORM UNTIL AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE I, ,f e117�i/'d^i�� , residing at/dba 2 235-44A 4 /0X-,g , being duly sworn, depose and say: That on the day of �( , 20 k, I personally posted the property known as by placing the Board o Trustees official noticing poster where it can easily be seen from the street, and that I have checked to be sure the noticing poster has remained in place for seven days immediately preceding the date of the public hearing. Date of hearing noted thereon to be held Wednesday, November 18, 2020. Dated:�� , (si nature) Sworn to before me this /7day f)4zV 20.E • Deborah Orlowski N 'Notary Public,State of New York :*= No.01OR6280392 Otar Public -' Qualified in Suffolk County y ��'%y�v"voA�,.�� Commission Expires 05/13/20,2f PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: &f'g to 47g 1t w�fzrr ki, at_C11v p4 ,, IV 1111 S_ , 4wrers -- ,lor S*�7r 7hi5 1(1"3 We %eeo� sa�nG /woe l STATE OF NEW YORK COUNTY OF SUFFOLK 4?7� )m Camresiding atza3rAii,/Z /C�•i k1efle- bein duly sworn,deposes and says that on the /7 ' day of /f 120�, 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 r94 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/RE RECEIPT. e r Sworn t efore me this Day of 20 _g Notary Public Deborah Orlowski Noraar' Notary Public,State of New York No.01OR6280392 Qualified in Suffolk County Cotwnission Expires 05113120A2—( cao 'c ■ Complete items 1 2 and 3. A. Signature N) ■ Print your name and address on the reverse ❑Agent 7 o O so that we can return the card to you. � � o �0 I ■ Attach this card to the back of the mailpiece, y(Printed Name El Addressee B. Received b h'J1 or on the front if space permits, p ) C. Date of Delivery 1. Article Addressed to: D. Is delivery address different from item 17 ❑Y o ' — — ` , 1, D (>070 r��/� If YES,enter delivery address below: 1@ si-= /Vy VR I 3. Service Type a¢ m "✓jzI�IIIIII�II�I11111111111111111111 ❑Adult Signature ❑Registered MaMail-ss� ❑Adult Signature Restricted Delive ❑Registered MaiITM ❑Certified Mail® Delivery ❑Registered Mail Restricted 6 i m �a 9590 9402 6020 0069 5206 42 Delivery ❑Certified Mail Restricted Delivery ❑Return Receipt for a © g¢ m O1° v m ❑Collect on Delivery Merchandise v a a ����;� 2, Article Number(Transfer from service labeQ ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation- 02 -_� ❑.Insured Mail I I ❑Slgnature Confirmation J N 6 aC U Q Q .�. d ❑❑ ❑a_ �, �,�; �'`;� 7 015 0 6 4 0 0 0 0 4 _9 0 3 8 8 3 7 7over$500)il Restricted Delivery Restricted Delivery f'_t'_E 9 Q E 0 6 h 0 0 0 0 h 9 0 S`C O Z i PS Form 3811,July 2015 PSN 7530-02-000-9053 _-_- -- ____ - Domestic Return Receipt , - c}35 ® o i3 -- �' F i, a cam.+ - ■ Complete items 1,2,and 3. A. Signature - ■ Print your name and address on the reverse - r �jt Agent so that we can return the card to you. r t1�'s� z '• a = ■ Attach this card to the back of the mail iece, y(Printed Name Addressee I\ p B. Received b ) '—.Pate of Delivery or on the front if space permits. Arte ( cle Addressed to: n 7 D. Is delivery address dif enf tom ite 1 Q 1:1 Yes If YES,enter delivery atldressbeloEl No _ 'C1,9 D �� 0 Sl o /� N V 90 �+ z lle3Lin Ile�1011ll�011l�l���lsl����101�III�IIIIO��IIII 3. Service Type ®µ o tt? a �- ❑Priority Mail Express( O ❑Adult Signature ❑Registered Mailrm r�� N g ` e d y7 4 e ❑Adult Signature Restricted Delivery ❑Re ❑Certified Mail( Delivery XL 52'6 �t+� 'o gistered Mail Restricted m ¢ o 9590 9402 6020 0069 5206 35 ❑Certified Mail Restricted Delivery ❑Retum Receipt for ri mad E e m '2 i T _ ❑Collect on Delivery Merchandise 2. Article Number,(Transfer from service label ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationM a: ' ami E E 03 � — ) n'^-ured Mail ❑Signature Confirmation t E. a W 7015 0640 0004 9038 8360 er ured Oj it Restricted Delivery Restricted Delivery' t �„t 0 01111 o a .19- ,� as,Form 3811,July;2015 PSN 7530-02-000-9053 ` --- ------ --—- _ Domestic Return Receipt 09E9 9E06 h000 0+190 S20L -- - ----- -- ---- -------- - ----- -------- ------ - I -- ---- - -- ------- ----- -- ------------- - NOTICE OF HEARING L NOTICE IS HEREBY GIVEN that a Public Hearing concerning this property will be held by the Southold Town Board of Trustees via the online Zoom platform. OWNER(S) OF RECORD: ANITA M. SAMUELS, TRUSTEE CREDIT SHELTER TRUST SUBJECT OF PUBLIC HEARING: For a Wetland Permit to repair existing 5'x18', 90sq.ft. ± lower dock, with stringers raised at north end, level with existing adjoining dock; using existing pilings; repair two wood steps from basin wharf to dock, with handrails between upper and lower decked areas; existing 96 linear foot bulkhead, including pilings, stringers and deadmen to remain; replace 518 square feet of existing wharf decking on existing structure, in-kind with 2x6 treaded wood boards around basin; and there is to be no excavations nor filling of property. Located: 155 Fisherman's i Beach Road, Cutchogue. SCTM# 1000-111-1-8.4 TIME & DATE OF PUBLIC HEARING: Wednesday, November 18, 2020 — at or about 5:30P.M. — To access the Zoom meeting please see the meeting agenda located in the Trustees section of the Town website. If you have an interest in this project, you are invited to view the Town file(s) through the Southold Town website. To view the application files please visit: https://www.southoldtownny.gov At the bottom of the picture on the main screen click onathe second button from the right "Town Records, Weblink/Laserfiche"; go to bottom of page and click on "pg. 2"; click on "Trustees" folder; click on "Applications"; click on "Pending"; all files are listed by name in alphabetical order. Click on the name of the application to view the file. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold LME CONSISTENCY ASSESSMENT I4'�12NI AA 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 Flaaard Area. 2. Before answering the questions in Section C, the preparer of this forth 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 sig cant beneficial and adverse effects u on,the coastal area ewbich_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. Thus2r eaeh artsw t� must be a laitaeil in detail listht- both su ortin and non" su 9 or :acts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the MRP is available in the following places: online at,the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office,the Plating Department,all local libraries and the-Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION ; PROJECTNAME a eJe The Application has.been,submitted to(check appropriate response): Town Boaid El Planning Board❑ Building Dept. ❑ Board of Trustees I. Category of Town of Southold agency action(check appropriate'ressponse): (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: see attached r c / Location of action: 155 Fisherman's Beach Road, Cutchogue, NY 11935 0.074 acres Site acreage:— Present land use; single family residential Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided- (a} Name of Applicant- Anita M. Samuels � 7TWs- 74e P_ (b) Wiling address: 155 Fisherman's Beach Road, Cutchogue, NY 11935 } (c) Telephone number: Area Code(6 734-6405 (d) Application number,if any: - Will the-action be directly undertaken,require funding,or approval by a state or federal agency? Yes)nd No If yes,which state'or federal agency? _p 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 wifffurther each policy. Incomplete answers will require that the form be returned for completions. t t DM P COAS', POI 1CY ; Policy 1. Poster a pattern of development in the Town of Shuthold that enhances community character, preserves open space,mares efficient use of infrastructure,makes beneficial use of a coastatlocation,and minimizes adverse effects of development. See LWRP Section III–Policies; Page 2 for evaluation criteria. Yes leo 0 Not'Applieable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III–Policies Pages-3 through 6 for evaluatiow criteria Yes o No 0 Not Applicable i There-is-no historic or archeological structures on property. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes No,0 Not Applicable Attach additional sheets if necessary r NATURAL COAST POLIS Policy 4. Minimize loss of life, Structures, and natural resources from flooding and erosion. See LWII,P Section'M—Policies Pages 8 through 16 for evaluation criteria Y Yes No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the,Town of Southold. See L Section In —Policies Pages 16 through 21 for evaluation criteria Yes ] No ®Not Applicable Attach'additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Not Applicable I , Yes No Not Applicable No development will take place in the " xotected" or,"natural indigenous.environment" r _ . r 117 t Attach additional sheets if necessary. Policy 7. Protect and improve air quality in the Town of Southold.-See LViRP Section 111� Policies Pages 32 through 34 for evaluation criteria. Yes No Not Applicable Attach additional sheets-if necessary Policy 8. Minimize environmental degradation in 'Town of Southold from solid waste and hazardous substances and wastes. See LNVR.P Section III—Policies; Pages 34 through 38 for eealuati p criteria. ' lYes No,® Not Applicable PUBLIC COAST POLICYRS Policy 9. Provide for public access to, and recreational use of, oustal graters, public lands, and public resources of the Town of South®Ido See.LWRP Section'III—Policies; Pages 38 through 46 for evaluation criteria. Ye�] No® Not Applicable No public land involved. Littoral access unimpeded. Attach additional sheets if necessary WORIONG OAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new, water-dependent uses in suitable locations. See LWRP Section'III•—Policies; Mages 47 through 56 for evaluation criteria. Yes ❑ No Not Applicable There are no p ublic or commercial activities or uses on site. Historically this property and neighboring pro erties are residential in use and will remain residential. ; .Attach additional sheets if necessary Policy 11.. Promote sustainable use of living marine resources in Long Island, Souand� the Peconic Estuary and Town waters. See LNVRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ ® Not Applicable -'.[]'Yes _ No t -- Apaft o Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP'Section III—Policies; Mages 62 through 65 for�evaluatiion criteria. Yes No® Not Applicable , There are no agricultural lands on site. .Attach additional sheets if necessary Policy 13. ProYmote ,appropriate use and development of energy and,mineral resources. See I. Section III—Tolicies9-Pages 65 through 68 for evaluation criteria. Yes ❑' No ❑ Not Applicable, ment ap6rovedln deral oyern�ment -Th -nrnip- PREPARED BY Tom Samuels TITLE Architect IRATE 1VO r" SAMUELS & STEELMAN ARCHITECTS 25235 Main Road, Cutchogue, NY 11935 lid E c September 21, 2020 r SEP 2 2 2020 Southold Town Board of Trustees Town Hall Annex Southold 766 n ' Main Road B and of 1rusices Southold, NY 11971 RE: REPAIRS TO THE DOCK AT SAMUELS RESIDENCE 155 Fisherman's Beach Road, Cutchogue, NY 11935 SCTM# 1000-1114-8.1 Dear Sir/Madam: I hereby request a WETLANDS PERMIT for the above reference project, for maintenance to an existing boat basin, attached dock, and surrounding decking. At this time, only work to dock and decking are necessary, but we would like to be approved for all required maintenance., For your review we are submitting the following documents: 1. Application 2. Project Description 3. Detail Section of Existing and Proposed Work 4. Short Environmental Assessment Form 5. Application Affidavit' 6. LWRP Consistency Assessment Form 7. Erosion, Sedimentation & Storm-Water Run-Off Assessment Form 8. (5) Copies of SITE PLAN with NEIGHBORHOOD MAP 9. Stamped current Survey 10. Letter of authorization from Owner, 11. Property Deed 12. Last Will and Testament of Thomas E. Samuels, establishing'Credit Shelter Trust 13. Four(4) photographs of existing site conditions 14. Transactional Disclosure Form,Trustee 15. Transactional Disclosure Form,Agent 16. Check for$250.00 Please call us with any questions or concerns. If complete, please place project on the agenda of the Trustees next available Public Hearing. Sincerely, SAMUELS &STEELMAN,ARCHITECTS Vel Thomas C. Samuels