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HomeMy WebLinkAboutTR-10089A Glenn Goldsmith,President SOUjTown Hall Annex A. Nicholas Krupski,Vice President ,`O� �l0 54375 Route 25 P.O.Box 1179 Eric Sepenosi Southold,,New York 11971 Liz Gillooly G Q Telephone(631) 765-1892 Elizabeth Peeples • �� Fax(631) 765-6641 IrUUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10089A Date of Receipt of:Application:.February 23, 2022_ Applicant:'Town of Southold SCTM#: _1000-1-24-4.4: . Project Location: West of.-Silver Eel Cove entrance channel, Fishers Island Date of Resolution/Issuance: March 16, 2022 Date of Expiration: March,16 2024 Reviewed:by: Glenn Goldsmith,'.President Project Description: Change a 70'x70' parking area to a "green space by adding dredge spoils from Silver Eel•Cove'to existing parking"surface. The sand will be the foundation for planting with'native'plants i.e., American Beach grass. 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 George ..& Cook, received on February 23, 2022, and stamped approved on March. 16, 2022. 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 isnot a determination from any other agency. a Glenn Goldsmith, President . Board of Trustees Glenn Gol �'iith, President �0 p Town Hall Annex A Nicholas KruN;�Kj, Vice-President „�� _ ` G2,, 54375 Route 25 Eric Sepenoski o P.O. Box 1179 Liz Gillooly Southold, NY 11971 Elizabeth Peeples P, �0 TelephoneFax 765-6641 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:_ 212SIZ2 .3%00 Completed in field by: George B. Cook on behalf of TOWN OF SOUTHOLD requests an Administrative Permit to change a 70'x70' parking area to a "green space" by adding dredge spoils from Silver Eel Cove to existing parking surface. The sand will be the foundation for planting with native plants i.e., American Beach grass. Located: West of Silver Eel Cove entrance channel, Fishers Island. SCTM#: 1000-12-1-4.4 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 x/ 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: S-�ca-a�� �o�'v✓rac.l� I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: E. Peeples L. Gillooly ✓ G. Goldsmith N. Krupski E. Sepenoski Other APPROVED BY . r Notes A 1.. topography sketch 4 .efl l Y A a �(.. µW 3 _ c ,� Ut!WA6TeMand ferry Park DESIGN CALCULATION FOR SEWER FLOWS / EXISTING TEST HOLE DATA • l� \ \ J BUILDING QB TEST HOLE DATA OFFICE USE- 3550 X 0.06 G/D/SF = 213 G/D BY: R. STROUSE P.E.,L.S. - NOVEMBER 15, 2018 \ BUILDING® FERRY FREIGHT BUILDING- NOT CURRENTLY CONNECTED TO WATER OR SEWER GG GG NO WATER OR SEWER CONNECTION PROPOSED FOR FIRST FLOOR-NO CHANGE IN USE f I JHERJ SITE •� Co SHED- NO CURRENT WATER OR SEWER USE 0-3" PROCESSED GRAVEL O \ \ 2 0 0 ISLAM:) � - � � .. o \ PROPOSED BUILDING CAS 15"125"STOPSOIL p � � \ = V •`� U _°o F APARTMENT 1- 1055 SF = 225 G/DI I�I d ,� LL o W APARTMENT 2- 830 SF 225 G/D 25"-48" COMPACT SILTY SAND }+ -a APARTMENT 3- 575 SF 150 G D 48"-60" LOAM \� \ �/ SOUNC)�� / \ LU m E �' ) o 6' APARTMENT 4- 575 SF 150 G/D \ \ /� e - / 60" 120" COMPACT SAND O \ ` �� (n i .> U E APARTMENT 5- 585 SF - 150 G/D D WATER AT 72 ELEV. 0± p� p\ �� o LU Q �o -a E APARTMENT 6 1250 SF 300 G/ \ / SOIL CLASSIFICATIONSo Q ' cru \ 'to = N = - OFFICE USE- 213 G D 8 \ O I � (jW MN BUILDING© Cu6- cut and fill land- gently sloping \ O e 36, �O! O FIRST FLOOR BUILDING®- RENOVATED TO OFFICE, STORAGE AND FERRY FREIGHT p l� W M \ I C o 3o 6830 SF ® 0.06 G/D/SF = 410 G/D \ O \ / < Q i ao ._ N TOTAL DESIGN FLOW = 1,823 G/D- DISCHARGE TO COMMUNITY SYSTEM-FISHERS \\ O� \ M 00 W ISLAND SEWER DISTRICT NOTE: p p \ SHED (590± SQ. FT.) NO WATER OR SEWER SERVICE EXISTING OR PROPOSED THERE ARE NO WELLS OR SEPTIC SYSTEMS O WITHIN 150' OF THIS PROPERTY. PROPERTIES AREJ O ' I 1 j DRAINAGE CALCULATIONS CONNECTED TO MUNICIPAL WATER AND COMMUNITY \ EL I ZA5r=7H e p INFILTRATION BASIN 1 SEWER SYSTEM (FISHERS ISLAND SEWER DISTRICT \ • \ ) � I �I � 1 NEW ROOF = 6,830 SQ. FT. ��� ` /� L REQUIRED = 6,830 SQ. FT. X 1.0 X 2/12 = 1,140 CU. FT. p� �pJ o / A I RFOpI` IT 1140/ 1.5 = 760 SQ. FT. REQUIRED PROVIDED- 900 SQ. FT. INFILTRATION BASIN 2 NEW STONE PARKING AREA= 1,440 SQ. FT. AND EXISTING ROAD = 3,270 SQ. FT. `O / p �4v `� \ LOCATION MAP SCALE 1 =400 1 ,\1 MEAN HIGH WATER & �6"�° PAVED PARKING / REQUIRED = 4,710 SQ. FT. X 1.0 X 2/12 = 785 CU. FT. 1LIMITS OF TIDAL WETLANDS- 0 // � MAP REFERENCES 785/1.5 = 524 SQ. FT.. REQUIRED INDICATED BY CME / 4161 v PROVIDED 1,050 SQ. F-f. STAFF AT TIME OF / / 1. PLAN OF A PORTION OF THE FORMER FORT H.G. WRIGHT PROPERTY FOR THE SURVEY. p / / / RACE POINT CORPORATION FISHERS ISLAND- TOWN OF SOUTHOLD, NEW YOUK TYPICAL PLANTING AND SEEDING FOR INFILTRATION E3ASINS / / / SCALE 1 = 40 FT. CHANDLER & PALMER, ENG RS NORWICH, CONN. DECEMBER o 000 /20• E 1��'� / f C) 1966. 1.SEED MIX - NEW ENGLAND COASTAL SALT TOLERANT GRASS MIX, \ CLOsj •°j `''''/ 2. FIRM-FLOOD INSURANCE RATE MAP FOR SUFFOLK COUNTY NEW YORK, TOWN NEW ENGLAND WETLAND PLANTS, INC. p ��/ // / "� OF SOUTHOLD 360813- PANEL 18 OF 1026 MAP SUFFIX H, MAP NUMBER 2.MEDIUM SHRUB - BAYBERRY, MYRICA (MORELLA) PENSYLVANICA �g0/ 52A'�2 / °� *�i 36103CO018H SEPTEMBER, 25, 2009. 3.MEDIUM SHRUB - SWEET PEPPERBUSH CLETHRA ALNIFOLIA 4.LOW GROUNDCOVER - BEARBERRY ARCTOSTAPHYLOS UVA-URSI / � goy d°� 5.MEDIUM GROUNDCOVER - SWEET FERN COMPTONIA PEREGRINA _ O / / p'f°f NOTES COASTAL EROSION / p // / // MEAN LOW WATER- HAZARD LINE ///// NIF 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED INDICATED BY CME (SEE SHEETS 36-Fl //%�� / / UNITED STATES OF AMERICA HEREON. ANY EXTENSION OF THE USE BEYOND THE PURPOSED AGREED TO STAFF AT TIME OF AND 49-Fl OF 49) �,W BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE M� ' / / COAST GUARD STATION 0 SURVEY. � /� / S 42'2900" E ENGAGEMENT. z 47.13' 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS Cn Ro, EXIs�eTIN ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN 112- �✓ Q 0� ///j//� 1 STORY ITEM IN ANY WAY. r 0 BRICK BUILDIN OFFICE USE S 4731'00" W i O 12.00 / 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYORS 3550± S.F. U SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF THE LAND SURVEYOR. W (�' j EMT 3.5w T.O.F,6. 6 � > L 10.74 �, t� 0_' Y IRON PIPE c __- __����-_-� \s J � 0 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC z z oLr- / (FOUND) ��� ��� �i�� O• CHAIN LINK „ „ O -'-- \ \ FENCE SURVEY TRIANGULATION STATION PROS w SEWER MH HAIN LINK �� ce J J � J T.O.F.=5.21' s ENCE -!� �, / \ I r.o.F=s.8s� 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP 1000, 0 O m w z BENCHMARK: CP MAG5023 POLE SECTION 12, BLOCK 1, LOT 4.4. z LL_ � z • �- EL=5.79 3 -.- s��• o Ej> o FLOODZONE VE16 /ice / -.5 6.)6.) TOTAL AREA = 4.68± ACRES (203,861 f SQ. FT.). p � z ~ z PAVED PARKING Off• N 219.25 J Q �- W FLOODZONE /� / 15 PARKING W 6140.83 W w AE13 / w I �� �� SPACES) F 7.) BASE FOR ELEVATION- NAVD 88 Ibi t z - WOOD FRAME , -� / / a�w 0 � 07 / RESIDENTIAL x / POLE / 8.) SITE IS LOCATED IN ZONING DISTRICT B. W g w LI.J BUILDING RR sP";E \ CLEAR, STRIP & GRADE AREA--, w / X 6,3 1008 T.0.171=6.3 0 1= Y o 2 LL / p (N07 F0 NO) GRAVEL AREA GRADE TO INFILTRATION BASIN A OX. EXISTING 9.) PERCENT OF LOT COVERAGE-EXISITNG AND PROPOSED- 5%. z In r / /NOTE: LOAM AND SEED 6" WATER MAIN / 7 W / WOOD FRAME o°ry / ALL DISTURBED AREAS / lb / oy� CL o_ • ry / RESIDENTIAL STOCKPILE PROVIDE INFILTRATION BASIN (#1) `' i �° L C. SITE AREAS BUILDING "� AREA FOR ROOF DRAINAGE- 900± SQ. FT. �,t'S� �p �f 0.F.=5.92 Q MAINTAIN 1.5'± DEPTH (SEE DETAIL). O S PAVED AREA ,� g �� 1. TOTAL SITE AREA- 203,861± SQ. FT.� p �, • / / 43 2. SITE AREA WITHIN 300 REGULATED AREA- 190,105± SQ. FT. _ 3 PROVIDE NEW WATER 3. TOTAL AREA OF BUILDINGS ON SITE- 10,480± SQ. FT. ._I ^ �'�� X - N/F X SERVICE AND FIRE ADJUST MH / / / ti z / `� o�� 4. AREA OF BUILDINGS WITHIN 300' REGULATED AREA- 7,605± SQ. FT Q TOWN OF 1 z LINE-COORDINATE _ w /�g� 5. TOTAL ON SITE PAVED AREAS 46,200± SQ. FT. WITH FISHERS ISLAND FRAME TO MATCH 6 // �wQ,� `\\` - o�w N, 6.CHMARK: CP MAG5024 6. ON SITE PAVED AREAS WITHIN 300' REGULATED AREA- 42,500± SQ. FT. -j \ SOUTHOLD WATER WORKS \PROPOSED GRADE /� /� mP�= / \ EL=6.88 / SMH 0 TLST HOLE ~ / �o� o�' � �� X6.2 W PERCENT OF IMPERVIOUS AREAS- 0N/F �- o J / POIE \ EXISTING- SITE TOTAL- 10,480 + 46,200/203,861 = 27.8% ( T.O.F._5.68' 11-15-2018 / I �°+ / X7. O ��2 - cn c FISHERS ISLAND ORDNANCE LLC INV. = 1.93 CONTRACTOR 1 / I 'X20 1 77 _ EXISTING- WITHIN 300 REGULATED AREA- 7,605 + 42,500/190,105 - 26.3% > _ MUNICIPAL WATER-COMMUNITY PROVIDE_A CONTINUOUS STORAGE PROVIDE SEALED I _ o*��J�h h ^ PROVIDE PAINTED PAVEMENT PROPOSED- SITE TOTAL- 10,480 + 46,200/203,861 = 27.8% m f LINEiOF SILT FENCE SLEEVE AT WATER zlo��°�ry' DUPLEX PROPOSED- WITHIN 300' REGULATED AREA- 7,605 + 42,500 190,105 = 26.3% SEWER AREA - -� �o / MARKINGS (TYP)-8 SPACES RESIDENCE / MAINTAIN THROUGHOUT MAIN AND SEWER a CONSTRUCTION CROSSING_ - �Q \ / MUNICIPAL WATER N z z (n Z z O.F.=5.18 LD LJ Exso -� / 3�J��,Q�ry'e�'� ca 1 / / COMMUNITY SEWER z a Q It 32 \S PROVIDE NEW MH X7.7 `�o o� - o mi o o_ Q T.F. ELEV. 6.1± .oxime o 0 5 F.- . J O N o 0 0 o INV. 3.60 CIO �����oa o . / \\ - o W Cn _L 0 EMT TO U325 1� > �'<' 7 0 V 575 O sTo �o���,��0 / PROVIDE 1 PAVED HANDICAPPED _ � 0 0 <v T s PROVIDE 60 LF. N'�a Q '�o _ �i V 10.03 �� X13 NEW 6" SEWER O 1$ / �S, ^�, ���FR MH �/� Na ��' h°'� SPACE W/MARKINGS AND C� Z con ��ON ZO/ o�w ---- 6 -- s F.=7.32�� 2 200, BUILDING MOUNTED SIGN F� > / v o tii 0000 �w cti �'� P�12 - y PROVIDE 114 F. 4�00� (SEE DETAIL) MAX. GRADE �� I q2 NEW 6" SEWER O 1 S a X �Q X00 ONE, I OF PAVING 1/8 /FT UO W Uj 0 0 0 iy POLE \ 02 � N N N \ F'p PROVIDE WYEhE N o � CONNECTION TO s �� / 00 � i i i �w EXISTING sPIKe 1� 1� `� PROVIDE 8" PVC o ° 6" PVC SEWER SMH 99 S �g �y`'�' `� PIPE FOR ROOF DRAINS (SEE DETAILS T.O.F.= S �• ; PROVIDE STONE PAD T � C E I Y E Z NV. = 2.45 2.45 �s ��' � INFILTRATION BASIN OU 1�TLET D /jy 32 8 5. CONTRACTOR sMHfweR f 6 PALE STORAGE EXISTING T.O.F.=5.77' s Oo• o FEB Z 3 2022 0� ? 6" WATER MAIN INV. = 2.54 v L �`� Sp ___ o�j✓ 325 00,00, AREA Q) �, �' sMH /�� CLEAR, GRADE AND PROVIDE SCHOOL Sou!hnldTown ~ c' 471 T.O.F.=5.42' 8 PARKING SPACES (STONE) MUNICIPAL WATER Board-of TrJst^e' Q (SEE DETAIL)- GRADE TO COMMUNITY SEWER LEGEND N/F s2• �°f �\��'c ��'�J f/ p�.1� INFILTRATION BASIN 00 00 \ / X00• �0 p0\ �\�-1 GOA �s v \ PROVIDE INFILTRATION BASIN (#2) PROPERTY LINE 0 0 TJS ENTERPRISES, INC. 1 00 00 CONTRACTOR OFFICE FOR NEW PARKING-1050± SQ. FT. ABUTTERS LINE -- m o I o P� Q MAINTAIN 1.5'± DEPTH (SEE DETAIL) O , MUNICIPAL WATER- �,� a0�\° J�' f r EDGE OF PAVEMENT 00 0w 0 COMMUNITY SEWER �� `' +` { G O s w z z Y 0 " / QP doe o� o / N4I�: EDGE OF GRAVEL ------------------ o o F Q w o W N 38.10 00 E �G ti e�S�O / s 1. VERIFY LOCATION AND DEPTH OF ALL EXISTINGm o w o = 0 J / 40.00' ^° J� UTILITIES AT START OF CONSTRUCTION Il m o U U OVERHEAD WIRES 0/w N / 2. ALL SEWER PIPES AND FITTINGS SHALL BE 6" NOW OR FORMERLY N/F DATE: 08/21/2018 �I �5v�� FOR PVC SEWER P PEE WITH A MINIMUM SDR35 4 UTILITY POLE -�- } / 5 RATING SCALE: 1 " = 40' N 6714'00" W �F, CQ�Q / BOUNDARY POINT 0 QUALITY CONTROL CERTIIFICATION 25.00' ��5 � / 3. MANHOLES SHALL BE 4' DIA. PRECAST PROPOSED CONTOUR 5 PROJECT: #2018803 7.56 7.71 Q CONCRETE IN ACCORDANCE WITH ASTM C-478 GROUP REVIEWED DATE N/F \ EMH 4. CROSSING OF NEW SEWER SERVICE AND WATER EXISTING CONTOUR 5 PROJECT MANAGER FISHERS ISLAND o / ' � / MAIN PER SCDHS REQUIREMENTS. PROPOSED SPOT GRADE X 6.1 SURVEY DEVELOPMENT CORP ENVIRONMENTAL / (BUILDING 98 0 / 40 20 0 40 5. PROVIDE AIR TESTING AS OUTLINED IN SECTION EXISTING SPOT GRADE X 5.2 SHEET COMMUNITY CENTER) 215-43 H.(2) OF THE TOWN CODE. PROPOSED UNIT NUMBER 10 OF 2 CIVIL MUNICIPAL WATER- / GRAPHIC SCALE IN FEET STRUCTURAL / COMMUNRY SEWER ARCHITECTURAL / O f K � ,/ICI f3j;I p��n p L�/°I I L Z .J ✓ cJ J 1 L0� ►�n ���� ��J� SJvv z N ., _ - ��� 40 it ,� a r xwd I c+ t'zY,l x.Ncl �ry. i,. r lr eY .... i✓ ,, ,we tT.W4 SEEM / i�\�j, I � �i.. �� OOF AMERI ns SWq \ �7_✓ `e o M-1 OF SMTNOtn F�/ � pti F.D.27 SDUND ISLAND iK 1 / _ - BLOCK F E � � _�_ ` Rt) m NOTICE +igclrj�ry COUNTY OF SUFFOLK © E a gpUTNOLO BECTON NO G ______ _ _ _ _ _ _ t Real Property Tax Service Agency r r� Ur...r^ ^ry» ,x 4•r Yr u -_� o..0 --r-- rwu--r-- rer. 5� ee ty Gnar rurrMaCONY11aN_ A ta0 � u 072 P p. x 1� PPOPEr11Y MAP OFFICE LOCATION: 0f SyO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 G • Q Telephone: 631765-1938 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: March 14, 2022 Re: LWRP Coastal Consistency Review for TOWN OF SOUTHOLD SCTM# 1000-12-1-4.4 George B. Cook on behalf of TOWN OF SOUTHOLD requests an Administrative Permit to change a 70'x70' parking area to a "green space" by adding dredge spoils from Silver Eel Cove to existing parking surface. The sand will be the foundation for planting with native plants i.e., American Beach grass. Located: West of Silver Eel Cove entrance channel, Fishers Island. SCTM#: 1000- 12-1-4.4 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 proposed action is CONSISTENT with the Policy Standards and therefore 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 RESOLUTION 2022-2.i ADOPTED w_ DOC ID: 17830 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2022-231 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON FEBRUARY 15,2022: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs the Southold Town Supervisor Scott A. Russell to execute an administrative permit application to the Southold Board of Trustees on behalf of the Fishers Island Ferry District for the proposed ferry park adjacent to the Ferry Terminal, subject to the approval of the Town Attorney. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P.Evans,Justice SECONDER:Jill Doherty, Councilwoman AYES: Nappa,Doroski, Mealy, Doherty, Evans,Russell Glenn Goldsmith,President '��(3�so U Town Hall Annex A. Nicholas Kru ski,Vice President d T�C� 54375 Route 25 p °`' � `i P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly G Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit ApplicationD 6 C E ' V 6 Wetland Permit Application X Administrative Permit Amendment/Transfer/Extension FEB 2 3 202 ��Cornpleted Received Applicaton: iReceived Fee: $ 00,Application: Z• .ZY Southold Town Board of Trustees Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Detennination Date: �Coord ination:(date sent): LWRP Consistency Assessment Form Sent: AC Referral Sent: Date of Inspection: Receipt of CAC Report: Technical Review: Public Hearing Held: �/ •2 Resolution: Owner(s) Legal Name of Property (as shown on Deed): I oi,'t_ n Mailing Address: 9-3 0°I� iZ'ate ?�, �o� ��•��� , r��/ 119 -7 � Phone Number: Co Suffolk County Tax Map Number: 1000 - 12--- Property 2—r'Property Location: 1\6411 'Zf 1�4 coc.J �v S���i�-� , "e-f ¢ �� tr- cil cove, e''1�L,hct (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Ge o r�)\_ �. ����) Co 6 I C e Mailing Address: Z6 I �ry A— '�)r:V L � f�dx f, Q'� Phone Number: 2,0 3 0 Y, Email: q co QIC � r`�Q,—/'�( C 0 Z--N- Board of Trustees Application /GENERAL DATA Land Area(in square feet): Area Zoning: �� a Previous use of property: `��� ^�i Intended use of property: ��� Z 6 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 v' No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No VIA Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. / Has any permit/approval ever been revoked or suspended by a governmental agency?_/No No Yes If yes, provide explanation: Project Description (use attachments if necessary): 'y►-� o✓k o. U ,,J.z W C '�U `i-I'-( kLJi f,,Lj l x� C/' �/ t1 1^ !✓` Sco-4 J 1 .� �`. !v r (i'!i I !!i d J4. v I ✓� S �i Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: `o c.rec- �c, c� 5----`1 r� 'V © •v '�'ti� '� I �n� 21G i J 1%�(n °1�G✓� `amu b !�- a,re-,, P-3 0'J L Cl o� � S,A �C,L� r(, ►��� ( lL4 ca o � a,- cve-e- eJarq ej- c,-X ,VatiJe, avc�-��,e Area of wetlands on lot: ® square feet Percent coverage of lot: p % Closest distance between nearest existing structure and upland edge of wetlands: ® feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? cubic yards aade� How much material will be f4 d? L 00© cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: - a p Manner in which material will be removed or deposited: i thrit G. C.r r1t C�V V%f.,f I c i_I%-CV (j, 1 h 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): rJ /A Board of Trustees Applin ,ion AUTHORIZATION (Where the applicant is not the owner) I/We,. t.�r owners of the property identified as SCTM# 1000-- 17- _"1 -� in the town of gg � 6t New York,hereby authorizes- 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 wner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS Aa rd DAY OF. Q,�1(L1DlUl,I - -_ 20 Notary Public LAUREN M. STANDISH Notary Public-State of New York No. 01 ST6164008 Qualified in Suffolk County Vomminion Expires April 9, 2023 ' Board of Trustees Applin .ion .AFFIDAVIT 6 BEING DULY SWORN DEPOSES AND AFFIRMS THATAUNHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND Tif,,CT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owner,-,-- Signature of Property Owner . SWORN TO BEFORE ME THIS . o�a .._ . DAY OF. !!t-byy(14.,1...__ ; 2Qola - NotaryTubfic `e LAUREN M.,,STANDISH Notary Public-State of New York No. 01 ST6164008 Qualified in Suffolk County Commission Expires April 9, 2023 APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The.Town,df Sautltol'd's Code'o€Ethics:prohibits conflicts of interest on tire. art of town rit�icers and em to ees.Thep u `o s Qf` this form is of Riovfde information which can dlert the town df nossibte conflicts of ihtciest and allow.ittd_take v}i'atever aetiait'is neceaagMto avdid some YOURNAME: (Last name,first name,-gfiddle initial,unless you are applying n°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 Othero✓k.rh� klt/ " (If"Other`,name the activity.)_ nGh(�-a of VS'L_ Rift^©V,1 ® )q P J -i "Po Do yod-peisonally.(or through your company,spouse,sibling,_.parept,or,child)'have a Mationship with any;officer or employee of the To��n of'Southold? "Relationship"includes by blood,rnan iage,or-business rnterest "Business_intetese?means a business, including a partnership,in which the town offWO or employee has even.a_'partial ownership of[or employment by)a corporation in which the tawn offi'c r or employee-ownsxmore_than`5%0 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 &4 ur ' 1 (3 - Coal(— Title oal(— Title br position of that person O.6&.e+ r / S lt,�c 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(whets the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or �D)the actual applicant. DESCRIPTION OF RELATIONSHIP ,W Ll.f Lb�,_...� .. !'W 1/. G,.- C"ns 6r'1j Submitted is /0 da of e 6�w 20 Signature ti11 c v") Print Name_ Form TS I 617.20 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 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 1 -Project and Sponsor Information /(A wt's Lx( �t It ,t'— Name of Action or Project: �lr TC r� Project Location(describe,and attach a location map): n N/0 r � o 1p Q-0 as+Go [i:' 1;4 n 5���%11-1 1`t 1 Coi-c l t s� -c �S �c ti cy'ri y Brief Description of Proposed Action: r•� C_1 e -t c� L( el d® s \'��+.-�/J �..\ c+ 7 Ajv- �c.l C'o Z �,y ry L'J.(1 S'•a'—c C.c - �c-�L V e e fi s, tl Name of Applicant or Sponsor: Telephone: tozAV�r �t(5 • _ J, �// E-Mail: P , �G C"� f��� . c �►'� Address:: &0 l'v'.1 NVQ, r CitylPO:� State: Zip Code: 1.Does the proposed action only involve the legislative adoption of plan,local law,ordinance, NO FYES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources thatrA ❑ 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: ❑ US 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? 11 L 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. r-1 Urban El Rural(non-agriculture) nindustrial ❑Commercial El Residential(suburban) ❑Forest ❑Agriculture Aquatic 3ODther(specify): Wy V^ti ❑Parkland .7 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? ❑ ❑ LCJ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ R 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: L1J ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES IVI b.Are public transportation service(s)available at or near the site of the proposed action? 11 c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 15,71❑ 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: 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: ❑ 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? a I3.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YE wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: X Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland El Urban ❑Suburban I5.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? Llni 16.Is the project site Iocated 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? M NO ❑YES El V�l b.Will storm water discharges be directed to established conveyance systems-(runoff and storm drains)? If Yes,briefly describe: n [NO ❑YES ' w,��. dt�s��:o✓ � �'8 �Ivv o v - 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 I 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 ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor a e: ��0�--c��� � �L13) CO �1L _ Date: 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 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the LJ 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? �J 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? El b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, 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 a problems? 0 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. {�11!!// I r D al Qs r O h r 1 Pry F 2 v L f v1�Lt r�E A d'1N11�firG�'Ci n Check this box if you have determined,based on the information and analysis above,and any supporting documentation, L_t that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. 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- Town of Southold LWRP CONSISTENCY ASSESSMENT.FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action .will be; evaluated_as to its -significant beneficial and adverse:effects upon the coastal area(wbich:includes'allof-Southold Tows); 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- sunyorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,-if shall.-notbe-undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 17— PROJECT NAME The Application has been submitted to(check appropriate response): ] Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees U 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑. construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit, approval, license,certification: PIRI Nature and extent of action: 0 en, kt 12 0,- 16-1 Jo fIX1 a1I� e-t Gc- G.� n d-,e At. I D Location of action: °44 01/1" Site acreage: t 1 f P Present land use: Present zoning classification: 1/ Ot J'r 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: tl 0 (a) Name of applicant: (b) Mailing address:. _ (c) Telephone number: Area Code( ) (d) Application number,if any:_ _ Will the action be directly undertaken,require funding, or approval by a state or federal agency? . If yes,which state or federal ag Yes ❑ Noency?' 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. M Yes ❑ No ❑ Not Applicable �p�lY.L r 1 y �.✓ �G L.C.l. 1 ��.t _�vJ�-(i'G(n 4" �S Iii Tk i ll - lin / J/n V GSC ^ ! 2.^� G f- �.- S ✓ems - . I Cc9,Pe, ..- C 6 Attach additional sheets if nec s� 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 0 YesVNJ No 1:1 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 W Yes ❑ No ❑ Not Applicable _ hk 1ArG�G '�'(�✓ �� vJe• I V[. p� cA Pi 0--J r u .% v.3r1-_ 4 v! ✓1.�d. I L 1 tt o- i 1IC`— 0v( a ?ea�L.m s (^t�1 1G.✓ c`� V oJ' +. ' x.e (`-d �. ( -1 he. -' (t .I(:h�1 1 Ci Y� �')G.� 6e—. C 1 d' d/c C n a iZ b V-1 n Attach additional sh ets 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 ❑ 1:1 Not Applicable 12-0.13 O l y f.. I I V C-- V G c✓e/ •�1 D • { ' h 0' 17 S/`OP-1 11[i., l n c. I `'- 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 0 Yes ❑ No XNot 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. F -❑ 0 Yes No Not Aa_ .- cable s by fo o- � S J'c c o- ✓J•-. /' r S v/' � G l.. o G.'aL('J �wr c Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. 0 Yes ❑ No ❑ Not Applica//ble V., l 01d� t.D.�.� Ll:r•' /"��-'t �l4ij�/ l�lf� /if .^/ °�� o a rr 'N a 5 i SeA ov 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. 4] No❑ Not Applicable �i v'a, w i � �� e'►o a�+.a,. t �'s 6B> O l� G-CG e�� �S � ,..r_ �.. �. .�e Q.- -F e- j-s t r c 1 o d f 6 1 t. -C ` o Attach additional sheets if necessary WORKING COAST POLICI..r,' Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section M Policies; Pages 47 through 56 for evaluation criteria. Y Yes ❑ No ❑ Not Applicable 1 e 1 A0, Gti w Feii /' Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes :❑ No Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. 1-1 Yes ,0 No u Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY- TITLE r ��• �� �m c _ GIOIG, _ DATE "'Y 10