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HomeMy WebLinkAboutTR-9852A Glenn Goldsmith, President �QF so(/Ty Town Hall Annex A. Nicholas Krupski,Vice President ,`O ��� 54375 Route 25 P.O. Box 1179 John M.Bredemeyer III Southold,New York 11971 Michael J.Domino G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 olyc4UM`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ,SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72-HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF - BELOW INSPECTION SCHEDULE Pre-construction,`haybale line/siltboom/silt curtain 1St day of construction- % constructed When project complete, call for compliance inspection; Glenn Goldsmith,President �QF sorry Town Hall Annex A. Nicholas Krupski,Vice President ,`O ��� 54375 Route 25 John M.Bredemeyer III P.O. Box 1179 Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams �'0 �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9852A Date of Receipt of Application: March 30, 2021 Applicant: Southold Yacht Club Inc. SCTM#: 1000-71-1-3 Project Location: 165 North Parish Drive, Southold Date of Resolution/Issuance: April 14, 2021 Date of Expiration: April 14, 2023 Reviewed by: John M. Bredemeyer, III, Trustee Project Description: Install a seasonal 6.5x75' "Mobi-Mat' polyester boat ramp to be attached to the ground with stakes. Findings: The project meets all,the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit.allows for the operations as indicated on the project plan prepared by Gregory Young, received on March 30, 2021 and stamped approved on April 14, 2021. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees Temporary Ramp dimensions—6.5'W X 751 \ O Temporary Ramp is approx.20'feet away from high tide mark Vegetation Starts start.5"from e C current concrete ramp Vegetation Start rt om the current con r MAR ti Southol '',,j, _ is e ;µ O 3 i% =� rr• ``� ..tom r oc""`u• Ar w Landfill of clean sand-10 Yards for leveling '? purposes.Fill area approx.19'Long x 10'wide x 2' Current Concrete Boat Ramp is 112'L before the oz a"' deep Mobi-Mat will start.Mobi-Mat ends 20'L before "y the high-tide mark b .p r �\ P P R 1.../ Y...2 " g ARD,,,' i USTEES`. �. A N,"OF SOUT-HOLD UA IC ' E mol, tt,.26Z1 MAR 3 0 Southold Town��Stee sSYC TemporaryBoat Ramp — The S • Our Yacht club met with Southold Town Trustees on March 10th during field inspections. It was decided during that meeting that the Club was best off purchasing a temporary boat ramp. Ramp could be rolled out at the beginning of the season(June) and rolled back up in December. • We have researched several temporary boat ramp providers and have decided on Dechamps Mob-Mat Boat ramp solution. We plan on purchasing a 65W x 75'L ramp. • Mobi-Mat® Boat-Ram pTM is a roll out polyester mat, designed for creating boat launches and accommodating light and medium vehicle traffic on supporting but unstable grounds like sand and gravel on the shoreline or lakes. • Mobi-Mat° Beach Access MatTM is a 100% recycled polyester roll and its production contributes to the environment by utilizing recycled plastics and is also recyclable. • Boat-RampTM can easily be installed on the ground surface with minimal ground preparation. Boat-RampTM weighs 0.34 lbs/sgft. Only 2 people and 15 minutes time are required to install a 75' long roll. Boat-RampTM is attached to the ground with stakes inserted through eyelets. Boat-RampTm requires little or no maintenance under normal conditions. The product can be swept with a broom or leaf blower. SUFFU(,� Glenn Goldsrr President �O �, Town Hall Annex A. Nichola_ . -jpski, Vice-President �� y�' 54375 Route 25 John M. Bredemeyer, III P.O. Box 1179 Michael J. Domino o Southold, NY- 11971 Greg Williams y O� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: yl Completed in field by: Gregory Young on behalf of SOUTHOLD YACHT CLUB INC. requests an Administrative Permit to install a seasonal 6.5'x75' "Mobi-Mat' polyester boat ramp to be attached to the ground with stakes. Located: 165 N. Parish Drive, Southold. SCTM#: 1000-71-1-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice o/Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey :5 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner.- Present gent/Owner:Present were: ZJ. redemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other SURVEY OF PROPERTY ELE✓A77ONS k CONTOURS ARE REFERENCED TO NA VV'66 AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-71-01-03 A/ 0 SCALE 1'=30' a \\ < DECEMBER 16, 2014 d JUNE 1,2015(ITTHXrIES ADDED) ^-- '''I^^ ���j(] TEST HOES DATA M � X ma¢ v EL&� MAR 30 \ IN ,�9AN0 L� 20Z1- GREIM BROW MAY CL 59'PA,£eRo"NEv,ESANO� Southold Town �� °A/ NAMR IN PALE BROW Board of Trustees_.- �, �J ? EL ar ME SAND SP o b OAF rF� (9 --- y�y NOTE WATER ENCCI'MTET3D 39'SEEOW SURFACE W / i RaE \ '£a\ 0 3* Ruw cgYf ' Z ASPHALT , 323 Et��)a < / ST T �\ "1ns law V m SOS 23w i m I ' lij a -01VE iy--- X --- a --�' 0 i o 0 1 a 20>v f AE 12200 �= � SEC ' °'� �_ 6) / P - ---- 6 V 'a- L)WE (UB CLW4T R ( PUBLIC WANG / ER) FLOOD ZONE FROM Aall RM MAP NUMBER 36103C0166H l ANY ALMRAIM OR ADDIMV TO 7WS SURVEY ISA MARav / , N u NO 49618 OF SEC17OV 720W THE NEW MW STATE EDUCARON LAIC PECONIC SURVEYORS; PC SIMPT AS PER SECRav 7209-SUBA'NSIaV 2 ALL CERA170ATTONS AFEA 833N SO.Fr. (631) 765-5020 FAX(631) 765-1797 HEREON ARE VAUD fae TW MAP AND CCW,ES THERELF ONLY F , SAID MAP aP Ca9'ES MAR PC D,PRIMM SEAS CF THE SURIEM P.O. BOX 909 WKW 9aVAWR£APPEARS HEREa`E TO 77E LINE t23O TRAVELER STREET SOUTHOLD, N.Y. 11971 14-128 Temporary Ramp dimensions—6.5'W x 75'L y ` O Temporary Ramp is approx.20'feet away from high tide mark Vegetation Starts start.5"from � current concrete ramp Vegetation Start rt om ��. the current con r MAR 3 a. J --F��aAt�y Southol , ' f - ? tq' Board of MI re 0 4 b Landfill of clean sand-10 Yards for purposes.Fill area approx.19'Long x 10'wid�x2l' leveling 1+ Current Concrete Boat Ramp is 112'L before the '� e--' Mobi-Mat will start.Mobi-Mat ends 20'L before deep the high tide mark A s v H r mss. eze, e; SH • \Y /y srcns I I - ' • O 1 , ? j IDN f �D V E MAR 3 G Southold Town��SteP sSYC TemporaryBoat Ramp — The • Our Yacht club met with Southold Town Trustees on March 101h during field inspections. It was decided during that meeting that the Club was best off purchasing a temporary boat ramp. Ramp could be rolled out at the beginning of the season(June) and rolled back up in December. • We have researched several temporary boat ramp providers and have decided on Dechamps Mob-Mat Boat ramp solution. We plan on purchasing a 6.5'W x 75'L ramp. • Mobi-Mat' Boat-RampT"' is a roll out polyester mat, designed for creating boat launches and accommodating light and medium vehicle traffic on supporting but unstable grounds like sand and gravel on the shoreline or lakes. • Mobi-Mat° Beach Access MatTM is a 100% recycled polyester roll and its production contributes to the environment by utilizing recycled plastics and is also recyclable. • Boat-RampT" can easily be installed on the ground surface with minimal ground preparation. Boat-RampT`" weighs 0.34 lbs/sgft. Only 2 people and 15 minutes time are required to install a 75' long roll. Boat-RampT'" is attached to the ground with stakes inserted through eyelets. Boat-RampT"' requires little or no maintenance under normal conditions. The product can be swept with a broom or leaf blower. SYC Temporary Boat Ramp — The Solution • Our Yacht club met with Southold Town Trustees on March 101h during field inspections. It was decided during that meeting that the Club was best off purchasing a temporary boat ramp. Ramp could be rolled out at the beginning of the season(June) and rolled back up in December. • We have researched several temporary boat ramp providers and have decided on Dechamps Mob-Mat Boat ramp solution. We plan on purchasing a 6.5'W x 75'L ramp. • Mobi-Mat° Boat-Ramp'm is a roll out polyester mat, designed for creating boat launches and accommodating light and medium vehicle traffic on supporting but unstable grounds like sand and gravel on the shoreline or lakes. • Mobi-Mat' Beach Access MatTM is a 100% recycled polyester roll and its production contributes to the environment by utilizing recycled plastics and is also recyclable. • Boat-RampTM can easily be installed on the ground surface with minimal ground preparation. Boat-RampT"^ weighs 0.34 lbs/sgft. Only 2 people and 15 minutes time are required to install a 75' long roll. Boat-RampTM is attached to the ground with stakes inserted through eyelets. Boat-RampTm requires little or no maintenance under normal conditions. The product can be swept with a broom or leaf blower. SYC Temporary Boat Ramp — The Plan • The ramp would be rolled out by members in early June and rolled back up in late September. The ramp will be rolled out on Southold Yacht Club property. • 10 Cu Yards of clean sand would be purchased with the purpose of filling in the trench at the start of the ramp pictured below. • The ramp would be secured with ground stakes and staples every year. The start of the ramp would be secured to the concrete and run 75ft north/east to Southold Bay. The ramp would end 20 ft before the High tide mark. Looking North — Start of Ramp Looking South- End of Ramp NOW V a +i- _.. _ tisem- -•.. neyx y r a S �L4e... .� s C Y _ *y}if:�•�4✓,,-�` _- • ',,` .�/�%1*�,�,�•'t�,-y.. \ .;,�`�'\ \��<�.i. rjs�i"�` eta_ ti.,,.�Y„`fy{•^�c,.��r/r�,,V,...-•, �� �'S?••",•/j��j!,il•'f,!',j'�•�\ .�/ {�ji��.i `� �y .. • ��•�-�� -�'�% ,%1'./,.'C'`•+"'!/,n✓'� � � w�v�'IY,S!"�.r"�v. � '* fir!^'" . �• . .�. _� �/ ;CVS •/ �C •••!ll... -mat" Mobi-Mat-Boat Ramp-type AFX Available widths:5,6.5'and 10' Create your own permanent or temporary boat ramps with Mobl-Matportable roll-up mats. MULTI-PURPOSE REVERSIBLE SURFACING Mobi-Mat'AFX grade surfacing design features • a pedesDAwheelc friendly A non-slip DAJABA!AODADA access surfacing. (a •a corrugated surface that provides traction to wheeled vehicle and prevents"spin out'in wet or slippery conditions. :~+hilt LIGHT VEHICLE TRAFFIC Theblobi-Mat-roll-up mattingwithstands light vehicle traffic including golf carts, quads,4WD,small tractors. T _ I r � AZu EASY INSTALLATION It is lightweight for easy installation for temporary outdoor events and is ideal for permantly reinforcing the ground. • Landfill : A large portion of the current concrete boat ramp is cracked & buried by sand making it ^ --- - difficult for members to haul their sailboats to & from Southold bay. • Current dimensions of the fill is 19'L x 10'W x 2' deep v : • 10 yards of new clean sand is _ planned to dumped in this location to provide proper grade for Mobi- Mat solution m ,y t 71"w 1A �3 .�, u.4 `,. Vegetation near Boat Ramp will not be 'T Impacted by implementation of temporary ramp y The Current Concrete Boat is 10' wide -�. and is clear of all vegetation >> The Mobi-Mat is 6.5' wide and will sit • # - directly where the current concrete ramp extends t. r There is Vegetation near the ramp: Y • On the Left side(West Side) — the Vegetation starts .5" off the current t e concrete ramp • On the Right side(East Side) — the _' • Vegetation starts 3' off the current Right ; • - concrete ram ' L ► • . OFFICE LOCATION: ° �� �� MAILING ADDRESS: Town Hall Annex ��� sw P.O. Box 1179 54375 State Route 25 R^ Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) 02 Southold NY 11971 fi � Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Heather Lanza, AICP, Town Planning Director on behalf of Mark Terry, LWRP Coordinator&Assistant Town Planning Director Date: April 12, 2021 Re: Local Waterfront Coastal Consistency Review Southold Yacht Club SCTM# 1000-71-1-3 The application referenced above is for a Wetland Permit for the installation and use of a temporary boat ramp material, Mobi-Mat, to be rolled out at the existing concrete boat ramp in June and rolled back up in late September. The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP. 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 Glenn Goldsmith,President �(if SQ(/r� Town Hall Annex A.Nicholas Krupski,Vice President ,�Q ��4 54375 Route 25 John M.Bredeme er III P.O.Box 1179 York Y � J�[ Southold,New York 11971 Michael J.Domino G Telephone(631) 765-1892 Greg Williams Y� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Us Coastal Erosion Permit Application D C Wetland Permit Application __x__Administrative Permit MAR 3 0 2021 Amendment/Transfer/Extension Y. Received Application: 3•'1"d194 X Received Fee: $ 10 JO Southold Town k Completed Application: 3 31.21 Board of Trustees Incomplete: SEQRA Classification: Type I Type H Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): V—LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: q,7-2-1 Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Owner(s)Legal Name of Property(as shown on Deed): S IXA-'O k Mailing Address: O ��K S4 SOO-AN-10)CQ 113 1 Phone Number: q n (05 4� Suffolk County Tax Map Number: 1000 - Property Location: _ � � (If necessary,provide LILCO Pole#,distance to cross streets, and location) AGENT(If applicable): c � Mailing Address: -- Phone Number: `11 "�� �'�5`� , Email: Board of Trustees Applicatmon GENERAL DATA Land Area(in square feet): Area Zoning: Previous use of property: SGA I!�S c\`,k 3 uses) -A-o ,4- Intended use of property: See 106 %q1p\X1 _ Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior'to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes No If"Yes",please provide copy of decision. Will this project 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? `� Yes No Prior permits/approvals for site improvements: Agency Date y/ 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): cylcp �Sp - - Met"1 S G210 —� Board of Trustees Applicauion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ZOS- -PJI%DA Area of wetlands on lot: � 1-dVVO square feet Percent coverage of lot: 2'S ° % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands:_ 3 feet Does the project involve excavation or filling? No ✓ Yes If yes, how much material will be excavated? 'J cubic yards How much material will be filled? t® cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: �eSS -1✓hr t"® Manner in which material will be removed or deposited: AV myole ecs 'R Ac 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): 61 Z20 Appendix B Short Environmental Assessment Form 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: Project Location(describe,and attach a location map): I cis t4.T1 wu S A fou � N I 119 0 Brief Description of Proposed Action: oIF l c�Sn�.Xi� �X * we p -moi �u+Ac �Se G L's 1 l� '-f�J° 1r v�ca� � o,�, Mph -�n�TI ,sc -"v-e- t Co°fo-.�o1rSj- A­3 V) �s 4QS;\� (t�11eil�off-Vow ko &.P�er"3eu. 3oh'` a✓� � yew. +�ouic� $e etl� Fac,w� Name of Applicant or Sponsor- Telephone: G ©a'L-\ �JC E-Mail:- Address: -Mail:Address: \230 OAIK- ---DvL\ve City/PO: State: Zip Code: t h--+ 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? ❑ If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and pen-nit or approval: _ 3.a.Total acreage of the site of the proposed action? .017 acres b.Total acreage to be physically disturbed? _s,011: _acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. M' E]Urban EJ Rural(non-agriculture) ❑Industrial ❑Commercial I�Residential(suburban) ❑h rest ❑Agriculture ❑Aquatic ❑Other(specify): Parkland Page 1 of 4 5. Is the proposed action, NO YES ,N/A a.A permitted use under the zoning regulations? ❑ ❑ 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 Environmental Area? NO O YES If Yes,identify: ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? OA YES b.Are public transportation service(s)available at or near the site of the proposed action? Rr ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 9 ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:_ _ El 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? V, ❑ b.Is the proposed action located in an archeological sensitive area? ❑„ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? 'F 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: 14. Ide�ytify 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 mid-successional ❑ Wetland El Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES, by the State or Federal government as threatened or endangered? ❑ 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, Er E]a.Will storm water discharges flow to adjacent properties? �O ❑YES b.Will stofm water discharges be directed to established conveyance systems(Lunoff and storm drains)? If Yes,briefly describe: 0 DYES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 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: Ff E] 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: 2A , 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 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 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? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate El available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: In, a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ 0 architectural or aesthetic resources? L 1 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, (—f 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? El 11. Will the proposed action create a hazard to environmental resources or human health? a/ 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. aCheck 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. ElCheck 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 Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT ] Page 4 of 4 i =,)ard of Trustees ApplicatioL'- AFFIDAVIT 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 PERNIITM 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 TAE 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 PERNIIT. Sign of perry Owner Signaturi of Property Owner SWORN TO BEFORE ME THIS DAY OF 20 0 Notary Public 01MITRIOS SKRETAS Notary Public, Stets of New-yOd( No,01 SK6066331 is"Qualified in Queens Cp fY ,Coffmission Expires Nousmt c,�3 APPLICANT/AGENT/REPRESENTATM TRANSACTIONAL DISCLOSURE FORM T o _ the YOURNAI1tIE• am in ilre name of (i,estname,firstnaise,spiddle uii al,unless YMWW � someone elm or other a ty,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 AffprbM of plat Mooring E;"Mpwn Wom plat or ofFidw map Planning _ Other (If"Other=',name the activity-) ��ppspnally(ort6rough y'orrran�,sparrse,-siblurg;parte.�pr"chFld)')rave a rela'tiiinship TNitl1�iy vffic�r or tiftlte`I`01V[r�f_.'�`Qut�lQld?'� 18ti0(i"�11�`'�u1Clild�,4�iy l►lOOtly,n�*'Or 11tlS1tICS`#illtef25�.{`�USjnE lIIleif�'D IDeai119 S�113$MCSS. iiicitidhngn�ip,in which the Iowa officcrtir eaitploye�rias tsven a pal ownership oY'(or cmploya�a►#-by)a cotlio�vn in whhclt the town©ffm orcrtipiayee gWgs mare than 5°!o vftta+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. D scdbgthc-rclationshipbdwo nyciWMV(� g�idative)and thefawnofficer orempbyee Either check the appropriate line A)through D)ardkr dm*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•bf greater than 5%of tlWAM es of to corporate stock of the applicca_t (z the,applicant is a euglorafia4) en when the A)the legal of korlrcaai o of Say harea in-a non-corporate fq( appticaitt,is sat$corion)f a otftcer,director,partner:of employee offheapp1ic ant;or D)the a ctual,applicant. (DESCRIPTION OF RELATIONSHIP Submitted thi ' PrintName Form IS I APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE F0RM The Town of Sbuth6ld's Code of Ethics prohibits,conflicts of interest on the part off town nfflcers and emaloveijs.'The purpose-of this form is to provide,inforntatiom.which can,alert-the.town,ofpossible'corifliots,ofinterestand'allow-it;.ib,takewhateyer-action is necessary tolavoid_same, YOUR NAME:. (Last name,first name,iriddle initial,unless you are applying'in;th'e 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 T Planning Other (If"Other-,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO 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/agcnt/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 aQ1 day of 1"' 200 Print Name C'srtec�e�ta 1I nu�c� Form TS 1 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 .prop_osed .action will.be evaluated as to its si_n_ificant 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- .supWortint facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it-shall.notbemndertaken. 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#- 0 000 PROJECT NAME Se,9156J\V3A 1I�� ,\ 0� The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees LJ 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) 13 (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit, approval,license,certification: Nature and extent of action.j_VIP- �c l �r b.� C, ' u-� l Q.- obi--vIAVA- o,:�- �� � S�►����w�e �� �o�� � Me�r '' �.� t.A l�o-ire �e,�le.,�R� `C�•e �� ��L9 + ® �'.✓z w�e� u2s ko �GS� ceSS C4- A Location of action: Site acreage:, Present land use: SPA Q,`\]US Present zoning classification: 2. If an application for the proposed action has been filed-with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (S-(� (b) Mailing address: l '�-3000k,�wz 3 t,,3 11 11 c\ (c) Telephone number: Area Code(►�- 4 —U54A (d) Application number,if any Will the action—bye directly undertaken,require funding,or approval by a state or federal agency? Yes 0 No LJ If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best.Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. .DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ❑ No ❑ Not Applicable 1C& Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No [Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ 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 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria 1-1Yes ❑, No L-1 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. No LNot YesApplicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LW12P Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy S. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes ❑ No [" Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. U Ye�] No❑ Not Applicable ���'�\cak,�,r� Q� '� �e�•por�y _R��o ��\\ �c\\ov,� occesS � ��-l'r�ol� `tom �o�. �.�•o��\ 2eac�.�5 �g�� �u�ic0 `(�c�,k- el��� cz5� ' C Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III-Policies; Pages 47 through 56 for evaluation criteria. 1-1Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town wate s. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No Not Applicable s Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III-Policies; Pages 62 through 65 forevaluation criteria. ❑Yes F] No P1 Mot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III-Policies; P ges 65 through 68 for evaluation criteria. ❑,Yes ❑ No Not Applicable PREPARED BY �w .� TITLE Y Ice C6(-,4-\W-)0 C9 BATE C)LQ'3 SOUTHOLD YACHT CLUB --�- � � P.O. Box 546 ' North Parish Drive ' Southold, New York 1 �71 E �"�-1`-�' til E 631-765-5629 www.southoldyachtclub.com MAR 3 0 2021 Southold lown March 29,2021 Boa!of Trusieps Board of Town Trustees 53095 Main Road PO Box 1179 Southold,NY 11971 Re:Application for An Administrative Wetland Permit Dear Trustees: We enclose a completed Application for an Administrative Wetland Permit and request that this Application be considered at the next(April) Town Board meeting. We enclose: (1) The original application packet and one photocopy of the completed application packet. (2) An original Affidavit,Applicant/Agent/Representative Transactional Disclosure Form,and Agent Authorization Form, (3) Articles of Incorporation, (4) 4 copies of the latest survey of the property(please see note below), (5) One original and three copies of the site plan depicting the proposed project,including (6) Current photos of the subject area, (7) Application fee of$100,and (8) As-built fee of$200. IDWOVEP CK4 ?1(o3 P9M 6.YWA16-- We are sorry to report that our attempts to obtain an original stamped survey from Peconic Surveyors,P.C.were unsuccessful. Phone calls were made daily and a message was left on the one day there was an answering machine. A written request brought no response We respectfully request that you accept copies of the latest survey for the purposes of this administrative permit. Please note that the Application was prepared by a team of volunteers. We are neither engineers nor permit expeditors but we did our best to answer all questions completely and accurately. Please e-mail or call me at(917)847-6541 if you have any questions regarding this application or if you require additional information. Please notify me in writing(at the above PO address)or via e-mail to greglVoung81@gmail.com to confirm that the permit has been granted. Thank you for your kind attention to this matter. Sincerely, Greg Young Vice Commodore Southold Yacht Club