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HomeMy WebLinkAboutTR-2059Jill M. Doherty, President James F. King, Vice-President Dave Bergen Rob Ghosio, Jr~ John Bredemeyer Town Hail Annex 54375 Main Road P.O. ROx 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 February 17, 2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Joan Chambers Environment East, Inc. 2885 Indian Neck Lane P.O. Box 197 Peconic, NY 11958-0197 RE: THOMAS & ISABEL WACKER 760 OLD PASTURE RD., CUTCHOGUE SCTM#103-11-20 Dear Ms. Chambers: The Southold Town Board of Trustees reviewed the survey prepared by Nathan Taft Corwin III last revised February 1, 2010 and determined the proposed increase in the size of two roof dormer~ on the existing dwelling to be out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the TOwn Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111 ) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary er seaward of the coastal erosion hazard area as indicated above, or within 100' landward from the top of the bluff and/or wetlands jurisdictional boundary, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary best management practices are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Since[ely, Board of Trustees JMD:lms Page 1 of 1 Map of 760 Old Pasture Rd Cutchogue, NY 11935-2003 Notes MARQUESS. Tee Ln O2010Map0ue~tlne. 600 ft Map [~ta O2010 N&VTEQ All riahts reserved Use subject to L cense/Copyr flh I MaD Leaend Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or expeditiousness. You assume all risk of use. MapOuest and its suppliers shall not be liable to you for any loss or delay resulting from your uss of MapQuesL Your use of MapQuest means you agree to our Terms of Use http://www, mapquest.com/print 2/8/2010 Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 20,2010 David Worthington Olsen Attorney at Law 32495 Main Rd. P.O. Box 706 Cutchogue, NY 11935-0706 RE: PREZIOSA TO WACKER 760 OLD PASTURE RD., CUTCHOGUE SCTM#103-11-20 Dear Mr. Olsen: The following action was taken at the Southold Town Board of Trustees Regular Meeting held on Wed., January 20, 2010: RESOLVED, that the Southold Town Board of Trustees APPROVES the request for a Transfer of Wetland Permit #2059 from Louise Preziosa to Thomas S. & Isabel J. Wacker, as issued on August 1, 1985 and Amended on December 16, 2009. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Jill M. Doherty President, Board of Trustees JMD:lms James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0499C Date December 16, 2009 THIS CERTIFIES that the 4'X 64' fixed dock including an 8'X 10' portion at the seaward end At 760 Old Pasture Rd.~ Cutchogue Suffolk County Tax Map #103-11-20 Conforms to the application for a Trustees Permit heretofore filed in this office pursuant to which Trustees Wetland Permit #2059 dated 8/1/85 was issued and Amended on 12/16/09 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a 4'X 64' fixed dock including an 8'X 10' portion at the seaward end. The certificate is issued to LOUISE PREZIOSA owner of the aforesaid property. Authorized Signature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 16, 2009 Ms. Geralyn Lang P.O. Box 817 Cutchogue, NY 11935 RE: LOUISE PREZIOSA 760 OLD PASTURE RD., CUTCHOGUE SCTM#103-11-20 Dear Ms. Lang: The following action was taken at the Southold Town Board of Trustees Regular Meeting held on Wed., December 16, 2009: RESOLVED, that the Southold Town Board of Trustees APPROVES the request for a Transfer of Wetland Permit #2059 from Margaret White to Louise Preziosa, as issued on August 1, 1985, and, BE IT FURTHER RESOLVED, that the Southold Town Board of Trustees APPROVES the Amendment to Permit #2059 to increase the size of the seaward end of the fixed dock from 8'X 8' to 8'X 10'. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Jam F~.King ~ President, Board of Trustees JFK:lms I I I ,~ h J 1 BOARD OF TRUSTEES PAGE 84 MARIL Y/V ZANG REALTY P.O. Box 817 Cutchogue, /V. Y. ~ ~ $3~ '0 James F. King. President Jill M, Doherty. Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio. Jr. PO. Box 1179 Southol& NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Date/Time: Southold Town Board of Trustees Field Inspection/Worksession Report LOUISE PREZIOSA requests a Transfer of Permit #2059 from Margaret White to Louise Preziosa, as issued on August 1, 1985. Located: 760 Old Pasture Rd., Cutchogue. SCTM#103-11-20 OK FOR CERTIFICATE OF COMPLIANCE? Type of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion ._Amendment ._Administrative__Emergency __Pre-Submission Violation Info needed: Modifications: Conditions: __ D. Dzenkowski other Form filled out in the field by ~/~ Mailed/Faxed to: Date: D. Bergen~.Ghosio, ALL MOORINGS AND ~TAKES MUST DISPLAY VISIBLE MOORING NUMBERS ALL DOCKS AND BULKHEADS MUST DISPLAY VISIBLE PERMIT NUMBERS Board Of $outhold Town Trustees SOUTHOLD, NEW YORK Mooring # N/A PERMIT NO......2....0..~.9. ................ DATE: .~.5~.......~.~......~.?. 85 ISSUED TO ....... .~.5~.g..~E..e...~.~.~.~..; ............... !L ............................................. i .......... Aulhor zalian Pursuant to the prov;sions of Chapter 615 of the Laws of fha State of New York, 1893; and Chapter 40~ of the L?s of. th® State of New York 1952; and the Southold Town Ordinance en- titled "RE~ULATIN~ AND THE PLACIN~ OF OBSTRUCTIONS " IN AND ON TOWN WATERS AND PUBLIC LANDS and fha REMOVAL OF SAND, ~RAVEL OR OTHER IdATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance :with the Resolution of The Board adopted afa meeting held on .~.y....2~.~...: . :.19~:~.i.~ and ~n consideration of the sum of $......EI.E~.~.O.O_:..,, paid by ......................... ~..~,.a.~.e..~....~,,t.,,e. ........................................................... ::_.......~_." of __,~c..~_t_°.k°..~.~,e. .............................................. N. Y. end subject to the Terms and Condltlons listed on the reverse slde hereof, of Southold Town Trustees authorizes and permits the following: ' Application approved to secure a permit for a 6,4.'. x 4,' dock (8'x8' at.end) ~in. Wickham Creek, Cutchogue, a~l in' accordance with the application submitted. all in accordance with the detailed specifications as presented in · the originating application. IN WITNESS WHEI~EOF, The said Board of Trustees here- by Causes its Corporate Seal to be affixed, and these presents to be subscribed by a .majority of the as of this Pl~m~m tm~r nfl mhd r~.turn to th~ Trustees .¸% TOWN OF SOUTHOLD BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK WETLANDS PERMIT This Wetlands Pcrmlt No..._~..~3: .......... he~ hPen granted bv the Town Trustees according to lnfo~'ation furnished in Application No..~.[i ............ filed by Applicant .~.~...r~.9.~.e.~....~.. ~,.'~.~ .......... ........................................ on ..H..a...~..c..~....~..8./, ........ 19..8...5..... A map of the proposed work will be kept on file in the Trustee Office, under the application number given. Permit granted to do the following work ~...~.~.~.~..q~...~..~.~...~...~...~,~;...~.~...~..~.[...i~.- the end) in Wickham Creek, Cutchogue, all in accordance with ~ application submitted. Lecation of property on which work to be done ...O.~.d....~..a.§~.BK.~...[Q.~.~n..~.~h~Ug~ .............. ~ .... Creek, Bay or Harbor fronting properly ....~...q~..h.i~,~..~X. gf~, ........... ....~ .............................................. Width ........ .4..'....~.o...c..~.,.,., .8.. ~..., .~..o..c. ~ ............................................................................ Height Above High Water ...2..'. ................................... Depth Below Low Water .......5..'. ....................................................................................... Yards to be Excavated ....... .~.~..~.T.:~..??.~'...~ .~.~.~,~.. ............................................................ Yards to be Filled' ................................ ;. ..................................................................... Manner in which material is to be removed or deposited ........................................................................ Conditions if any ..................................................................................................................................... of the work. Inspection Fees .......... .~.~.:.9 ~ ............................................................................................................... -'Liability Policies in the Amount of ......................................................................................................... Th~ validity of this permit is or may be subject to the approval of other governmental or municipal author[des. The Town accepm no respons[biliw in applying for or obtaining such approval. In the '~ent that such approval is necessary, the holder of this permit shall not commence operations her~ under until such approval has been obtained in writing. The failure to obtain such other approval when required shall subject ~is ~ermit to immediate revocation by the Trustees upon receipt by the Trustees. of written not[ce from such other governmental or municipal authorities of i~ refuel or disapproval. The applicant does by the acceptance of this permit, assume all responsibility for operations under- taken pursuant to this permit, and shalt take ail precautions for the prevention of injuries to persons and property resulting from such operations. By such acceptance, the applicant also agrees to indemni- fy and save harmless the Town, and its officers, agents and employees from any and all claims arising from operations under this permit and any and all acts or omissions of applicant, his agent and employees. The applicant and th~ owner and occupants of the premises upon which the operations authorized by this permit are being cond~jet,d, do. bv ~-he acceptance ~-f this permit, 01Ye ~ons~nt to the Town, and its ofticers and emplovees to enter upon the premises where such ooerat[ons are DOing conducted to make such insoecfions as the Town may deem necessary to insure that such operations are beinc, con- ouctea in conformity with this permit. This.operation will not substantial[v: A. Adversely affect the wetlands of the town. B. Cause damage from erosion, turbiditv or siltation. C. Cause saltwater intrusion into the fresh water resources of the town. D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife and vege- tatlon or the natural habitat thereof. .. E. 'Increase the danger of flood and storm-tide damage. F. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town. G. Change the course of any channel or the natural movement or flow of any waters. H. Weaken or undermine the lateral support of other lands in the vicinity. Io Otherwise adversely affect the health, safety a,nd general welfare of the people of the town. Board of Southold Town Trustees Date ..~...~..~,~ ~.--~.~,'~,,-'-.-..,-~ .... I I I , I~t fi I ~ J //1 ' / MARILY/V L4NG R~4L Ty P.O. Box 817 Cutchogue, ~ y. 11535 Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1t 79 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~Coastal Erosion Permit Application ~Wetland Permit Application __ Administrative Permit Amendment/Transfer/Extension t~e~vved Application'~?/~ "%.~4~q O0 ~ Received Fee:$ ~ {.'t , Completed Application Incomplete SEQRA Classification: Type I Type 11 Unlisted Coordination:(date sent) LWRP Consistency Assessment Form CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Lead Agency Determination:__ Technical Review: Public Hearing Held: Resolution: Name of Applicant Address Phone Number:( ) Suffolk County Tax Map Number: 1000 - P~operty Location: ¢Je, sree, s,3 ~r_a0 o L~JPc{Cr~ ~ ~cc~o ~ (provid~ LILCO Pol~ ~, dist~ce to ~oss s~eets, ~d location) q I -/-30 (,:,-'7 04(o oF Or-D. FA-crve.~ ¢..o, (If applicable) ^ddress: , . ~ard of Trustees Application Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: GENERAL DATA q R-4o Covenants and Restrictions: Yes x~ If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency No Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? )g No Yes If yes, provide explanation: Project Description (use attachments if necessary): [ Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: -[--0 [/q C ~-.~/[~ ~ Area of wetlands on lot: ~:~/3 t~ square feet Percent coverage of lot: Jla, 2- % Closest distance between nearest existing structure and upland edge of wetlands: ~:b t feet Closest distance between nearest proposed structure and upland edgeofwetlands: [~-----~ feet (MO ~'~c~A~SlaI,3 Does the project involve excavation or filling? ~,J~ No Yes If yes, how much material will be excavated? ~J ~ cubic yards How much material will be filled? '~] ~ cubic yards Depth of which material will be removed or deposited: /k] & feet Proposed slope throughout the area of operations: ~,J ~ Manner in which material will be removed or deposited: Statement. 0~ the ?ff_ec_tz if any, on th? wet_l~s an~.tid~l_.w~t_ers 0fthe town_ [h~:t..~Z r~e~s_ult by reason of such proposed operations (use attachments if appropriate): fL. ,.bo P,.ene¢,,3 o r4 ¢,.c)o F PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality C iJ '"~J~ 617.20 APPENDIX C { STATE ENVIRONMENTAL REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Ap )licant or Project Sponsor) 2. PROJECT NAME County SEQR 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks otc -or provide map 5. IS PROPOSED ACTION: [-~ New [~Expansion ~ModiflcatJonlalteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: r-~-i 2 ~ ~ ~,~--I~,~--~ '" ~ 0 ~ O ~J { [-,'~.~ ~ ~- Initially acres Ultimately acres A~ ~::~'~C ~-'~'D - 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ,~'es [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) '~esidential [~ Industrial E~ Commercial [~Agriculture ~] Park / Forest / Open Space [~ OIher (descdbe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ]~es [] No If yes, list agency name and permit / approval: 11. UO~5 ANY~tA 'PECI OP IHE AC[ION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~o If yes, list agency name and pe~it / approval: 12. AS A ~T OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~Yes I CERTI.~-~HAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicantsignature / Sp°ns:~e ~ v~~ '-~-:'~L')~J~-~---~ If the action is a Costal Area, and you are a state agency, ~- complete the Coastal Assessment Form before proceeding with this assessment tCTt~ rd. PART II - IMPACT ASSESSMENT {To be completed by Lead A~enc¥) A. DOES ACTION EX~CEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL gAF. [~Yes B. ~~LL AcTI~N RECE~VE C~~RD~NATED REViEW AS PR~V~DED F~R UNL~STED ACT~~NS ~~ 6 NYCRR~ PART 617~6? IfNo, anegative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be han~twritten, if legible) C1. Existing air quality, sudace or groundwater quality or quantity, noise levels, existing baffic pattem, solid waste production or disposal, potengal for erosion, drainage or flooding problems? Explain briefly: ¢2. Aesthetic, agdcultural, arohaeologicel, historic, et other natural or cultural m$oorc~s; or community or neighborhood charact~O Explain briefly: C$. Vegetation or fauna, fish, shellfish or wildlife species, significant babitat~, or threatened or endangsmd species? Explain briefly: 0 C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or ether natural resources? Explain briefly: C§. Growth, subsequent development, or related activities litiely to be induced hy the proposed ac§on? [xplain C6. Long te~, shoR te~, cumulaave, or other effects act identified in Cl-C57 ~plain bdefly; G7. ~hsn~? i~se of eider c WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? tf },es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti§edab~ve~determinewhetheritissubstantia~'targe~imp~rtant~r~therwisesign~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked ~,,~_~, the d e!~m!.-,_.3t!c.-, c f $i~.'.'^.c3~ ~ce Check this box if you have identified one or more potentialF/large or significant adverse impacts which MAY occur. Then proceed directly to the FULI FAF and/or prepare a positive declaration. Che~k this b~'~,~ave deta-rr~¥h~(~', b~sed on the ~nf~rmat[on and analysis ~bove and' a~; ~upporting doc~me~t~tionl tha~h~op~s~l- ~' WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the masons supporting thi determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signatura of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Board of Trustees Application "(p~int owner of property) AU'I%IORI ZATION (where the applicant is not the owner) (mailing address) Southold Board of Town Trustees on my behalf. do hereby authorize (Agent) to apply for permit(s) from the Owner ' s signature) Board of Trustees ApplicOn County of Suffolk State of New York BE ODU Y SWORN DEPOSES ~ ~F~S THAT ~/S~ IS T~ ~PLIC~T FOR ~ ~O~ DESC~ED PE~T(S) ~ t~t ~L STATE~S CONWED ~ ~ TR~ TO T~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ T~T ~L WO~ ~L BE DO~ ~ T~ ~R SET FOR~ ~ ~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSSES. ~ ~PLIC~T AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSSES ~ESS ~ F~E ~OM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~RT~ OF S~ PE~T(S), ~ G~TED. ~ CO~LET~G ~S ~PLICATION, I ~BY AU~O~E T~ ~US~ES, T~ AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~TH ~W OF ~S ~PLICATION SWORN TO BEFO:: THIS : DAY OF J~ CON STANCE LISOW¥ 14ot,qry Public, State of New Y~ No. 01L16110900 Qualified in Suffolk Co~m~/ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nmhibits conflicts of interest on the oart of town officem and emolove~s. The nurcose of thj~ form is to orovide information which can alert the town of nossible conflicts of interns1 and allow it to take whatever action is n~:cessarv to avoid saran. (Last name, first name,~niddle initial, unless you are applying in the name of someono els~ or other entity, such as a company. If so, indicate thc other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, r0arriage, or business interest "Business interest" means a business, including a partnership, in which the town officer or employee has even ~ partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% oftbe shares. YES V~ 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 ~:~ D[~--~ Title Or position of that person ~ O~ '('~' · 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. his or her spou~)arent, or ~hild is (check all that apply): The town A) the owner of greater than 5% of the shares of the corporate stock of the applic~nl (when the applicant is a corporation); __B) the legal or beneficial own~ of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, parlne~', or employee: of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Signature ~ I / ~ {J Print N~ ~_ ~ . _ Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 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. 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 (which includes all of Southold Town). 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- sunoortim, facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCT # i 0 0 t) PROJECT NAME 10'3 Jl - 'zO- The Application has been submitted to (check appropriate response): TownBoara Plann gBoara[] Buila gDept. oa o, Truste. Category of Town of Southold agency action (check appr. opriate response): (a) Action undertaken directly by Town agency (~.g. capital construction, planning activity, agency regulation, land txansaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Nature and extent of action: Permit, approval, license, certification: Location of action: (t90 O I---~ID ~ ~'- ' Site =reage: '¢. 2 -78 Present land use: ~-~Z._~- ~i den Present zonMg cl~sificafion: Ce S [~ If ~ application for ~e proposed action h~ ~en filed M~ ~e Tom of Sou~old agency, ~e follo~g ~o~afion sh~l be provided: (a) N~e ofapplic~t: ~ t ~0~ m ~ (c) Telephone number: Area Code ( ) ~)~1 '"~'-~ ~'--74'-~'~C-' (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ No [~ If yes, which state or federal agency?. 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 . . 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 o A ee{AGoc-o c4c blO" /k c 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 Yes No fNotApplicablc OOf{. JF_.CT t_,Ulbb ¢-tTtOu /'40 tryxpAc'c' 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. Yes Attach additional sheets if necessary Policy 7. Pages 32 through 34 for evaluation criteria. ~ Yes ~ No~ Not Applicable h'~' ~ ~o Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. Yes Iq No b4 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. ~ Ye~ No~ NotApplicable Attach additional sheets if necessary 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. [] Yes ~-] 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 waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Yes D No ~ Not Applieablc A~ch additional shee~ if necess~ Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. Yes [] No'Not Applicable Attach additional sheets if necessary Policy 13. Section III - Policies; Pages 65 through 68 for evaluation criteria. V es N No[3 Not Applicable Promote appropriate use and development of energy and mineral resources. See LWRP DATE Environment East, Inc. 2885 Indian Neck Lane P.O. Box 197 Peconic, New York 11958-0197 631-734-7474 Fax: 631-734-5812 Wacker Residence 760 Old Pasture Rd. Cutchogue NY February 8, 2010 Please find attached our application for an administrative permit for the above mentioned property. Please contact me if there is anything else you require. Thank-you. Joan Chambers OLSEN (~ OLSEN> L.L.E ATTORNEYS AT LAW GARY FLANNER OLSEN ATTORNEY AT LAW DAVID WORTHINGTON OLSEN ATTORNEY AT LAW 32495 MAIN ROAD · EO BOX 706 · CUTCHOGUE, NEWYORK 11935-0706 PHONE 631 7-34-7666 FAX 631 734~7712 olsenlaw@optonline.net December 17, 2009 Re: Preziosa to Wacker Our File 9432 Premises: 760 Old Pasture Rd. Cutchogue, NY 11935 To Whom It May Concern: Enclosed please find a check in the amount of $50.00 for the fee for dock permit transfer. Please transfer into the names of: Thomas S. Wacker and Isabel J. Wacker and forward same to my office. Thank you. Very truly yours, DWO:lmk Enclosure Southold Town Trustees P. O. Box 1179 Southold, NY 11971 DXVID %VORTHllklGTe~ OLS~'~ PAGE James F. King, President Jill M. Doherty, Viol-President Peggy A. Dickerson Dave Bergen $olm Holzapfcl Town H~l 53095Route25 P.O. Box 1179 Southold, New York11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT 12/0~/~009 PAGE ALL MOORINGS AND STAKES MUST DISPLAY VISIBLE MOORING NUMBERS ALL DOCKS AND BULKHEADS MUST DISPLAY VISIBLE PERMIT NUMBERS Board Of $outhold Town Trustees SO'UTHOLD, NEW YORK ~,.ooring ~ N[A .... ISSUED TO z~a~are'c :White .; .......... · Pursuant fe fhe pz'oW.~ons of Chaplet 615 of the Laws .of the Sfafe O~ New YorE, 1893, end C. hapfer 404 of the ,L~.ws of. fhe ' Sfafe ef New York 1952; end the Southold Ta~ Oral,hence en- fWled "RE~U~N~ AND THE P~CIN~ OF OBSTRUCTIONS ' IN AND ON TOWN WATERS AND PUBLIC ~NDS a~ the REMOVAL OF SAND, ~RAVEL OR O~ER MA~RIA~ FROM ' ~NDS UNDER TOWN WA~RS:" end Jn eccord~nce :wffh the ~esal~on of Th~ B~rd ~dop%ed et · meeting held an Te~ ~nd ~nd~f~ns Bs~ed on the ~e~e *~de hereof, ~f Seuth~ld To~ Tru~ees adhoe~zes and perm~ %he Application apDroved to secure a permit for a' · 6,4.'..x 4/ dock .(8'x8! at.end) .in. Wickham. Cr?k., . . · Cutchog~e, ali in' accordance s~mit~e~. .~ in .~cord~e with the det.i~d spe~cat;an~ the m~n~tlne eppfieefion IN WffNESS WHEREOF. %e s~d Bo~ ~ Tmste~ ~re- by cauls ~s Carpor~ ~1 ~ be ~ffixed, end fhe~ ~/~nts to .be mb~ed by a .majori~ ~ es of thzs 12/08/20B9 14:58 765664 BOARD OF P~GE 02 Board of Trustee~ Application County of SuiT°lk State of New York ~POSES/AND AFFIRMS J~IAT HFJSHE IS ~ APPLICANT FOR THE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINI~D HIiREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN TIIE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THIi SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGP,~ES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSI'~S HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERIV[IT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY ALrrHOKIZE THE TRUSTEES, THEm AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONIUNCTION WITH REVIEW OF THIS APPLICATION. "/'] / Signature · ~ONSTANC~ LI~O~ NO~'y Publl~ Sta~ of N~ No. OILI~I ~ .ualifi~t in Suffolk ion E3~ob.u Juu 01.2013 17 Davison Ave. East Rockaway, NY 11518 November 23, 2009 Town of Southold P.O.Board Box of 11 Trustees 79 J /" ~ ".""1~'£3 '" Southold, NY 11971 L RE: Dock, 780 Old Pasture Rd. Cutchogue, NY -~'~ Tax Map: 1000-103-11-20 Trustees; I am requesting a compliance inspection on my dock which was built in 1985. There is a permit. I have enclosed my check for $50.00 for the fee. Thank you. ~ Sincerely, 17 Davison Ave. East Rockaway, NY 11518 November 23, 2009 Town of Southold Board of Trustees P.O. Box 1179 Southold, NY 11971 RE: Dock, 780 Old Pasture Rd. Cutchogue, NY Tax Map · 1000-103-11-20 Trustees; I am authorizing Geralyn Lang of Geralyn Lang Realty, PO Box 817, Cutchogue to act as my agent on the above matter. You may contact her at 631-734-6472, or her cell 516-375-8468. Thank you. Louise Preziosa TOWN OF SOUTHOLD BOARD OF SOUTHOLD TOWN TRUSTEES $OUTHOLD. NEW YORK WETLANDS PERMIT -., p 22:1 . . has been granted bv the Town Trustees according to :n.~ Wedands Permit No inf~)~:a(i0n furnished in Application No..~&~. ............ filed by Applicant .......... ........................................ on ..M..a...~..c..h....~..8.~. ........ 19..8...5. .... A map of the proposed work will be kept on file in the Trustee Office under the application number given. ,. Permit granted to do the following'work~...Eg.G~.~.~.%...~..~.&.~..,~...&~...~n.c~.-.~~.~,--~-..¢-~.-.a'~'- ~he end) in Wickham Creek, Cutchogue, all in accordance with the application Submitted. -.- .... ~. '--' - . ..... Location of property on Which work to be do~e ..~.~..~,~.~'.~...~.q~.,...~.~.~hD.U~.a .............. ~ .... Creek, Bay or Harbor fronting property .....W,,i...c,.k...h..a.,m.....C..r..~..e..,k, ........... .....~ ...................... . ........................ Size of work: Length ..... ..6.~ ..... .d..o..g..k.....;.~ ..... .qt.9..~ ............................................................................... Width 4 dock 8 dock ..................... Height Above High Water ..,2..'. .................................... ~ ....................... ~ ...................... :... 5' Depth Below Low Water ................................................................................................. Yards to be Excavated ..................................................................................................... Yards to be Filled' ' Manner in which material is to be removed or deposited ......................................................................... J Residential '-:- Intended use of prope~y .................................................................................................. ~ ...................... . Conditions if any ..................................................................................................................................... ........................................................................................................................... ; .............. 2.' .... ; ................ - Expiration Date ~`~`a~`2~`9``~;]~9~8~5~`i~f`~WD~;~bD~`n``~``t`~c`~~~D~.~ ................. ; ..... Number of Inspections Requ ired ~..2....~.T..r..u~.~s~.t.~e..e''s~.~.a...r..e.~...t'.~'.b.'e.~.~'n.'~..t..i...f.~i.~e~.~d.~u.~.~n~ .c...o,.m.P'.l..e..t..¢© of the work. Inspection Fees $5.00 ........... · 'Liability Policies in the Amount of ......................................................................................................... Th~ validity of this permit is or may be subject to the approval of other governmental or municipal .authorities. The Town accepts no responsibility in applying for or obtaining such approval. In the · event that such approval is necessary, the holder of this permit shall not commence operations here- under until such approval has been obtained in writing. The failure to obtain such other approval when required shall subject this permit to immediate revocation by the Trustees upon receipt by the Trustees. of written notice from such other governmental or municipal authorities of its refusal or disapproval. The applicant does by the acceptance of this permit, assume all responsibility for operations under- taken pursuant to this permit, and shall take all precautions for the prevention of injuries to persons and property resulting from such operations, By such acceptance, the applicant also agrees to indemni-, fy and save harmless the Town, and its officers, agents and employees from any and all claims arising from operations under this permit and any and all acts or omissions of applicant, his agent and employees, F. G. H. The applicant and the owner and occupants of the premises upon which the operations authorized by this oermit are beina cond~mtpd rtn b,~ ~h~ ~'rtanfnnep nf thN n~rmit C~iv¢, n~nsent to the Town, and its officers and employees to enter upon the premises where such operations are being conducted to make such inspections as the Town may deem necessary to insure that such operations are being con- ducted in conformity with this permit. This.operation will not substantial[y: A. Adversely affect the wetlands of the town. B. Cause damage from erosion, turbidity or siltation. C. Cause saltwater intrusion into the fresh water resources of the town. D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife and vege- tation or the natural habitat thereof 'Increase the danger of flood and storm-tide damage. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town. Change the course of any channel or the natural movement or flow of any waters. _ Weaken or undermine the lateral support of other lands in the vicinity. Otherwise adversely affect the health, safety a,nd general welfare of the people of the town. Board of '~outhold Town-Trustees ALL MOORINGS AND ~STAKES MUST DISPLAY VISIBL~ MOORING NUMBERS ALL DOCKS AND BULKHEADS MUST DISPLAY VISIBLE PERMIT NUMBERS Board Of $outhold Town Trustees SOUTHOLD, NEW YORK Mooring # N/A PERMIT NO ..... .2....0...5...9.. ................ DATE: ..A...u....g'...'.......!...:......!...9. 8 5 ISSUED TO Margaret: Whit·e .......................................... Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of. the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance :with the Resolution of The Board adopted at a meeting held on .198.5.::i., and in cons;derafion of the sum of $.....8...~......0.0...:.....paid by ':._.' · Margaret White ...::. ........... i...:.. o~ ....... ..?..,u,.~...e.h.°.l..u....e. .................................................. N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Application approved to secure a permit for a 64'. x 4,' dock (8.'x8' at.end).in Wickham Creek., Cutchogue, all in accordance with the application submitted. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees kere- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a .majority of the as of this d and return to th~ Trustees r~siding at Old Pasture Road, Cutchoque, New York ,. part of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1. That the Southold Trustees Permit must be prominently displayed on the premises effected thereby during the period of :-v: '?., That the said Board of Trustees and the Town of Southold are released from any and work '""~ q. } all damages, or d.~im~ for damages, of suits arising directly or indirectly as a re~mlt of any oper- -'~ ~2.tion performed pursuant to this permit, and the said Permit-tee will, at his or her own expeme, the '~.'defend any and all such suits initiated by third parties, and the said Permittee assumes full liability perm±~ with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Soutlaold 3. That th~ Permit is valid for a period of 1 ~ _ mos. which is considered to be the sufficient time required to complete the work involved, but should ciro,m~tances~ warrant, request for an extension may be made to the Board at a later date. - 4.~ 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 auth- orization was originally obtained. 5 :. That the work invol~ed 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. 6. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 7. That thoro'shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 8. 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 obstructmn to free navigation, the said Permktee will be required~ upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 9. That the said Board will be notified by the Permittee ot the completion of the work autho orized. (See tear off sheet.) 10. That the Permittee will obtain all other permits and consents that may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. HENRY P. SMITH, President JOHN M. BREDEMEYER, Vice-Prbs.' PHILLIP J. GOUBEAUD ALBERT KRUPSKI. JR. ELLEN M. LARSEN BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, $3095 Main Road P.O. Box 728 Southold, New York 11971 December 24, 1986 TELEPHONE (5i6) 765-1892 Mrs. Margaret L. White P. O. Box 790 Old Pasture Road Cutchogue, New York 11935 Re: Permit Extensions - Permits No.'s 2059 and 221 Dear Mrs.-~h~ite: Your recent request to extend the above referenced permits have been reviewed at the Trustee meeting held on December 23, 1986. Your request has been approved by resolution, adopted at this meeting, for a period of six months. Your permits will expire on August 1, 1987. This letter is an amendment to the original permit and as such, shall be attached thereto. All other terms and conditions remain as written in the original permit. Very truly yours, Henry P. Smith, President Board of Town Trustees HPS:ip cc: Robert A. Greene, D.E.C., Stony Brook Commissioner Henry G. Williams, D.E.C., Albany Stephen Mars, Army Corps of Engineers Thomas Hart, Coastal Management Conservation Advisory Council Bldg. Dept. Board of Appeals File On motion made by Marty Garrell, seconded by John Tuthill RESOLVED to recom~end to the Town Trustees approval of the wetland application ~253 submitted by Mr. John. & Catherine Dempsey providing the catwalk be constructed to a height of 2' 6" above reedgrass and a width of 3' because of the nature of the grasses. Vote of Council: Ayes: Ail On motion made by Robert Hood, seconded by Marty Garrell RESOLVED to recommend to the Town Trustees approval of the wetland application #254 submitted by The Chesterfield Association Inc., for John Loretto to construct bulkhead to prevent bluff erosion. Glenn Ct. Cutchogue. Vote of Council: Ayes: Ail On motion made by Rachel buell, seconded by Marty Garrell ~~VED to recommend to the Town Trustees approval of the ~ /wet~la~d application ~255 submitted by Margaret White to replace st of the existing dock. Cutchogue. ~ Vote of Council: Ayes: All On motion made by Rachel Duell, seconded by John Tuthill RESOLVED to recommend to the Town Trustees approval of the wetland application #256 submitted by En-Consultants, Inc. for Louis Jahier to construct a timber dock, walkway, ramp. East Marion, NY. Vote of Council: Ayes: Ail On motion made by John Tuthill, seconded by Betty Wells RESOLVED to recommend to the Town Trustees approval of the wetland application #257 submitted by Reydon Shores Property Owners Association to maintenance dredge at mouth of cut. extend return at mouth of cut. Repair or replace as necessary; bulkheading sheathing, piles. Vote of Council: Ayes: Ail Respectfully submitted, Jane Rousseau Secretary The regular meeting of the Conservation Advisory Council was held at 7:30 p.m. on March 26, 1985 at Southold Town Hall~ Main Road, Southold. Present were: Frank Cichanowicz - President Robert Hood John Tuthill - Betty Wells Martin Garrell On motion made by Frank Cichanowicz, seconded by John Tuthill RESOLVED to recommend to the Town Trustees approval of the wetland application ~248 submitted by En-Consultants~ Ind. on behalf of Mattituck Inlet Marina to replace bulkhead and backfill. Mill Road, Mattituck. Vote of Council: Ayes: Ail On motion made by Betty Wells, seconded by John Tuthill RESOLVED to reco~nd to the Town Trustees approval of the wetland application #249 submitted by John Kerbs to construct fixed catwalk to floating dock for access to navigable wake. James Creek, Greenport. Vote of Council: Ayes: Ail On motion made by Rachel Duell, seconded by John Tuthill RESOLVED to recommend to the Town Trustees approval of the wetland application ~250 submitted by Eh-COnsultants, Inc. for John Dempsey to construct a timber dock consisting of a elevated walkway, ramp and float. Haywater.s Drive, Cutchogue, NY. Vote of Council: Ayes: All On motion made by Marry Garrell, seconded by John Tuthill RESOLVED to recommend to the Town Trustees approval of the wetland application ~251 submitted by En-Consultants, Inc. on behalf of Kearnsport, Ltd. to remove existing docks and install similar docks consisting of ramp off bulkhead, floats, and to dredge. Greenport. Vote of Council: Ayes: All On motion made by Frank Cichanowicz, seconded by John Tuthil! RESOLVED to recommend to the Town Trustees approval of the wetland application ~252 submitted by Peter T. Neyland~ II.to maintenance dredge. East Marion. Vote of Council: Ayes: Ail Town Of Southold Town Clerk's Office $oudmld. N. Y. APPLICATIOh' FOR W'ETLZA'DS PERSIIT Identity of Zapf[coat MARGARET WHITE Address of Applicant ...... Q~.C,..,EflD. g~.~..~....~..o...a,.c],.,....~QkO, g.UC.~....~].¢~..~.Qr~ ..... 13.9.3.5. ............. INSTRUCTIONS FOR PERMIT A. This application is to be completely ill[ed in by typewriter or ink and submitted to the 'Town Clerk in~ accompanied by writter permission from the owner of the prcper%, if-not the same as the applicant. B. Pilot Plan must be drown to scale on the reverse *id~_ ~ of this application showing the Ioc~,,:_n~"~ of property, the names and locations of owners of adjoining properties,, and o detailed description of prcoosed prciect. (Note: Copies of the Pilot Plan may be mode by a copy machine and *--~- · at .....ed Io the Permit Application.) (~i No operation shall be in/dared by the applicant until alt permits that ore required ore ssued. D. A detailed statement of the rehabilitation and proposed condition of the premises after the' work is completed must be given, including a survey if required. E. If permit is being sought for a more sizeable exscvation than the construction of a private single dock or jetty, then this application must be accompanied by a survey and topographical map certified by a registered land survey or Professional Engineer. The horizontal control of survey shall be based upon an approval Iocal coordinate system. The vertical control for elevation and sound- ings shall be based upon United States Coast and Geodetic Survey and/or United States Geologic=l .Survey datum. ' F. A statement must accompany the application describing any known prior operations conducted on the premises in question and whether any prior licenses or permits have been issued to erect structures or to dredge or deposit fill on said pram:sas and whether any such permits or licenses were ever revoked or suspended by a governmental agency. ?~t~¢~¢~-. G. A filing fee of $50,00shall accompany the application. This filing fee includes one inspection. there is a $5.00 fee for each additional inspection. H. The Town Board upon request_r..rf' ~e applicant for a permit, may waive in whole or in part. lhe provismns of ArC/cie II, Secti0n¥-~--~-'~.,/subdivisions (~ and ',~'r where it finds tha't nature of '~he proposed operations are such that the reauirement~ of such provisions are not necessary far a prater ccns:derarion of a permit application. I. Upon co2roval of this c.~piication th~ Town Clerk will issue o permit ro the appticcnn Such ~erm~r shail be available for inspection at any time, upon request. Approved ....................................... ~ ........................ ~ Disc2proved ........................................................... Examining B~dy ..................................................................................................................................... Signature of Choirman '-t .............................. : .............................................. : ...... : ................................. APPLICAT;ON IS HEREBY MADE to the Town Board of.the Town of Southo~d, Su~a!k. Ccun~, New York. far the ' · ~ssu ..... of ¢ permit pursuant to the L~ws, Ordinances and Regulations lng th~ Ca:stol and Interior Wetiands, FJaod Pi~ins and Drainage Areas of the Town Permit requested to ..~~L~LD.~ ....................... ~.....~ ........ .~....~.! ......... ~ .... ...... ..... bLL .... ..... ................................................................... Lc:ct[on of prcp~y for which permit w~nt~d...~.~...~.~...~9~.~z...~.~.~D,~2.g.z....~ ..... ~Z935 ........ ~ ~.~.~ ~.O. fl ~m ~.0.~ z.~ ~z. ~.0. ............................................................................................................ Home address of permk c~lic:nt if different fram e{ore~c~d lcccden .............................................. Old Pasture Road, Cutcho~et New York 11935 Wickham Creek Creek, Bcv or ~c~bcr [rcnr[mg pro~e~ ................................................................................................. Size o~ proposed work: Height Above High Wote.r ..................................................................................................................... Depth Below Low Water ..........................................................................................~ ............................. Yards to be Excavated ~~ Yards to be Filled ' ~~ ............ Width of ccnel creek or bay f~onting prope~'. ...... ~.~e~.~.. bu~d~ea ~ Depth ar Law Tide ......... .1....~...o..o...t.....~.~¢ ....................................... . ......................................................... Avercg~ Ri~e in Tide 3 feet .'\ret icm~c ..... l'..A..':.....R..e..s...i..d.,ential & Agricultural ' Nicnner ;n which mq,'¢rie[ will be removed cr deposited ..... .N./..A. ....................................................... intended use of pro;erty Private recreational %'V'ri,'.ten ccnsent cf owner of prcpcrt3z, if not the s~me os the cppiiccr, t ........................................ CCUNTY OF Sbx~-w~.~ . ) SS: STAT5 OF NEW YORK ) ........ ......... , ........................................................................................................... geine duly sworn and s~ys that ......'-'~ is t~, a::licant., for the above described ~erm~t, ~ ' and thst ctI statements ccn:c!ned c,,d _,~,, ..... the work wiil dane in ,._ manner fcr:'h in this application and os may b~ cmcrcved ky. the Tc,,,,,n Board of the Town TF.e c;piiccnr ccrees_ to ham the ?own of Southcid cr.d the Town =c:rc~ "hornless and free tram' c ..... ?_ sn= =i~ims arising under cr by virtue of s:id ~= '~ if granted. Sworn to k¢:~.¢ me "' i¢~ · Nctcry Fubl[c - TO¥ff~ OF SOUTtlOLD SH©'~T £I.!VIRO~I,~,IE~IT.',.L ASSESSLi~FIT I t,'S T ?.UCTI OHS: ~,a) In Order to answer the.que".L£ons in LhZ~ short E/,F it i= OSsur the preparer wiZ1 use cu~renLLy avaLLab!e 1nFormatLon conc:rnLng pz~]ect and the Zikely impacts of the actZon. It Ls not expected that additional studies, research or at'her inva:tlgations wiTM ~z be undertaken (b) If any question has been answerc:d Yes the pro;,.~L mc7 be ~ignificant and a completed Environmental Assessment Form is necessary. (c) IF all quest&ohs have been answered No it 1: 11kely that this p:'o]ect $s not s/gnificant .. (d) E~vironmen~al Assessment .-z.:. -. }'. W111 project ~esuZL-&n a 1,~rge physZca/ change .to the p~o~ec¢ site or physically aZtez more then 10 ac~es of land° ......................... Yes/' No 2. ¥/11i ~heze be a ma)or change to any unZque o~ - · - unusua! land form Found on the siteo ' Ye~ 3. ¥/111 p~o3ect al te~ or have a large .effect existing body of waterg :' 4. ¥1i~ project have a patc:ntLa~y la,ge impact '~ .on grouRdwate'~ quaZityo ' ~No 5. ¥11~ p~o3ect signZFZcantLy effect dzainag.. Flo¥~ on adjacen~ sZte-~ ........... ' ................ Yes No 6. 1'ti~1 pro}eeC aFFec~ any thr(:aLened or ~ '' endangered pZdnt e~ animaZ species? ....... :'-.. Yes 7. ~1111 pro}ec~ res'ult Ln a ma]or adverse effect ~-- on air quaZLty?.~ ............................. Yes' 8. IVi!i .project have a major affect on visual " - chareciar of ~ha community or scenic vic:?: visits 'known to be impor¢an% ~o the community? Yes ~. ¥Iill praise% adversely impact any size or ~ ' ' slruc%ure of his~oz'ic,-prell.islam-ia or paleontological impor%anca or any site dasignalad as a critical enviror,m,.~nLal area by a local agency?... .......... ~:'"¥~"~""'"'"''~' 10. ~'till projac¢ have a major eff~:c~ on existing or Futura recraaliona! oppor%uni~i ~ es .......... 1i. ~'Ii!1 p. rojec~ resul¢ ir, mujor %raffic problems -~ or cause a major effect to exis%ing 12. ¥/il! pro joel regularly cau_~e objec~ionab!u ~ .... od~r:, .noise, g-late, vibration, or e!ec%ricat di=~urba'nce as a resul~ of the projec%'s operalion? ........ ' · ...... · ........... 13. Will projec¢ have any impac~ on public hea!%h ~ o~- safety? ~N '''''*''' .... '' ...... * Yc-a o 14. .Wi!i p~ojcct effect tNe cxistZng comn~uni~y by ~ directly causing a growth in pc~mc:nu~tt "' populaLion of more than 5 percent over a one year parred or have a ma]or negative effect on the chara~er of th,.~ communZty or noighborho -~o " ' . ' ..... /~ _ !S Is there p ; ...... .-.: ..... ____ s_ o ubZ~c con,,cvc~.X concerning the ............... ' ................ Y~:5 I I ! / WF~ ~Tf. ....... ~. .... ~1 6** ~o ~o~o~ , ~ ~ ~0 ?/, ...% ........ /:7 JNAUTHOIIIZ£D AI-TE,~ATION OR rD THIS SURVEY IS A VIOLATION OF $t~CTION 7209 OF THE NEW YORK EDUCATION LAW. COPIB OF THIS SURVEY MAP NOT BEA. RlflG THE LAND ~U~V[yO~,S INi(~ SEAL EMBOSSED SEAL SHALL NOT ~ CONSID~D TO BE A VALID T~U~ COPy. ~UARANTEES iNDICATED HEREON SHALL RUN ONLY TO THE Pb,SON FOR WHO~ IS PREPARED, AND ON HIS B~HALF TITLE COMPANY, GOVerNMeNTAL ~NC~ AND LENDING INSTITUTION LISTED rO THE ASSIGNEES OF TH~ L~DI~ ~TI- TUTION. GUARANTES ARE NOT SURVEY OF PROPERTY SITUA T£ CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-105-11-20 SCALE 1"=$0' DECEMBER 2, 2009 FEBRUARY 1. 2010 ADDED TOPOGRAPHICAL SURVEY AREA = 99,217 sq. ff. (TO TIE LINE) 2,278 <lC. CERTIFIED TO. THOMAS S. WACKER ISABEL J. WACKER FIDELITY NATIONAL TITLE INSURANCE COMPANY NO TES' 1. UPLAND AREA (ADJACENT AREA) 93,078 sq. 2. TOTAL IMPERVIOUS LOT AREA = 3,961 sq. OR 4.3% OF UPLAND LOT AREA. NOTES: 1. ELEVATIONS ARE REFERENCED TO N.GV D 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:~ EXISTING CONTOUR LINES ARE SHOWN THUS: 4, PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED NYS Lic No 50457 2010 Nathan Taft Corwin III Land Surveyor PHONE (651)727-2090 Fox (651}727 1727 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVE~ IA A VIOLATION OF SECTION 7209 OF THE NEW yORK STA~ THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED, 5 % ;gg-uDgt