HomeMy WebLinkAboutTR-10192 Glenn Goldsmith,President �Q� ®f/�� Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President ,�®� ®�®
P.O. Box 1179
Eric Sepenoski AW
Southold, New York 11971
Liz Gillooly Telephone(631) 765-1892
Elizabeth Peeples Fax(631) 765-6641
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BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
June 13, 2024
John Londono and Courtney Kelso
55 Hudson Street, Apt 7E
New York, NY 10013
RE: 4328 WESTPHALIA ROAD, MATTITUCK
SCTM# 1000-113-9-11
Dear Mr. Londono and Ms. Kelso:
The following action was taken by the Southold Town Board of Trustees,at their Regular
Meeting held on Wednesday, June 12, 2024:
RESOLVED that the Southold Town Board of Trustees grants a One (1) Year Extension
to Wetland Permit#10192, as issued on July 13, 2022.
This is not an approval from any other agency.
If you have any questions, please do not hesitate to contact this office.
Sincerely,
r ,a�
Glenn Goldsmith, President
Board of Trustees
GG/ec
Glenn Goldsmith, President ® �Q � , Town Hall Annex
A. Nicholas Krupski, Vice President �� ��� 54375 Route 25
P.O. Box 1179
Eric Sepenoski Southold, New York 11971
Liz Gillooly
Elizabeth Peeples � ® � Telephone (631) 765-1892
Fax(631) 765-6641
00UNTI,�,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SOUTHOLD TOWN BOARD OF TRUSTEES
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF
BELOW
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1St day of construction
% constructed
t� When project complete, call for compliance inspection;
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BOARD OF SOUTHOLD TOWN TRUSTEES
' SOUTHOLD, NEW YORK
r PERMIT NO. 10192 DATE: JULY 13,2022 '
'. " ISSUED TO: JOHN LONDONO & COURTNEY KELSO
PROPERTY ADDRESS: 4328 WESTPHALIA ROAD,MATTITUCK
SCTM#: 1000-113-9-11
AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in ti
k� accordance with the Resolution of the Board of Trustees adopted at the meeting held on July 13, 2022, and in
-� consideration of application fee in the sum of$250.00 paid by John Londono & Courtney Kelso and subject to
the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and 1` ;f
permits the following:
a-, P g'
Wetland Permit for the removal of the existing deteriorated fixed dock and timber ramp and
relocating the existing 8' x 20' floating dock in same general location as existing. Construct new
H`r 4'wide x 114' long fixed dock in same general location as existing dock. A new 30"wide x 14'
9 long aluminum ramp will be installed and the existing relocated 8' x 20' floating dock will be
repositioned and supported with 4—10 diameter cca piles. The entire proposed fixed dock
will have thru-flow decking installed. The existing deteriorated timber bulkhead will be
removed and disposed of; and as depicted on the site plan prepared by Jeffrey Patanjo,last
dated July 6,2022,and stamped approved on July 13,2022.
IN WITNESS WHEREOF,the said.Board of Trustees hereby causes its Corporate Seal to be affixed,and these
presents to be subscribed by a majority of the said Board as of the year and day first above written.
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TERMS AND CONDITIONS
The Pennittee John Londono & Courtney Kelso residing at 4328 Westphalia Road,
Mattituck,New York as part of the consideration for the issuance of the Permit does
understand and prescribe to the following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto,to the complete exclusion of the Board of
Trustees of the Town of Southold.
2. That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved,but should circumstances warrant, request for
an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved,to provide evidence to anyone concerned that
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in
the location of the work herein authorized, or if, in the opinion of the Board of Trustees,
the work shall cause unreasonable obstruction to free navigation,the said Permittee will be
required, upon due notice,to remove or alter this work project herein stated without
expenses to the Town of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work
authorized.
9. That the Pennittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
10. No right to trespass or interfere with riparian rights. This permit does not convey to the
permittee any right to trespass upon the lands or interfere with the riparian rights of others
in order to perform the permitted work nor does it authorize the impairment of any rights,
title, or interest in real or personal property held or vested in a person not a party to the
permit.
I
I � I
I
/ PROPOSED 30"WIDE X 14'LONG
Fxisrin/G i ALUMINUM HINDGED RAMP PROPOSED T WIDE X 114'LONG FIXED DOCK
W/THRU-FLOW DECKING ON ENTIRE DOCK
I
RELOCATED 8'WIDE X 20'LONG EXISTING CATWALK TO BE REMOVED
PROJECTION LINE OF / FLOATING DOCK SUPPORTE W/]- :
NEIGHBORING DOCKS / 10 DIA.PILES z
APPROX. M.H.
_ _ .. _„_„_„_„_„_,. \ EXISTING GRADE
wa ' _.._.._.._
y y S 27°08'00” E 562.28' —••_.._.._.._.._..— 30 M
•� y y '�N:' VEGETATED WETLANDS
vi +N t � c4
TO M.L.W.
#uui •h #vl •A xN #`G FO y y y y y
1EXISTING 8'Y�0 FLOATING DOOKTO BE RELOCA D PROPOSED 10”0 CCA PILE-TYP 4
f� .� +� ;� ✓✓✓✓✓✓O y y REMOVE EXIS1NG DETERIORATED BULKHEAD
IN ITS ENTIRETY BY VIBRATION METHODS
,o ( TYPICAL SECTION
EXISTING 4'WIDE X 83'LONG CATWALK TO BE REMOVED N.T.S.
EXISTING 10'X 8'PLATFORM TO BE REMOVED
I I y y y
TOTAL CREEK WIDTH 238' LOCATION MAP
�N
PROPOSED DOCK LENGTH 43'(18%)
N.T.S.
i N d Ya PR OSED 4'WIDE}(114'LONG FIXED DOCK o c�
.m I� (INCLUSIVE OF STEINS ON LANDWARD END)
y 1I ttifucI{Cre4f{�
.a �� 4j.D*30'WIDEDC 14'LONG ALUMINUM DECK ?t rr
i f n c4 d I I y y HINDGED RAMP
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I I y y FLddddATING DOCK SUPPpRTED WITH 4-NEW 10” ° 4
w y'DI CCA PILES . 1
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TOP OF BANK
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TIDAL WETLANIP BOUNDARY AS
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SCALE: n
SCALE: =40�y y y y { DELINEATED BY EN—CONSULTANTS
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APPROVED- BY
J U L 1 1 2022
B OF i tZUS,TEES
/ TOWN OF-SOUTH'OLD Southold Town
®ATE Board of Trustees
PROPERTY OWNER:
/ JOHN M. LONDONO
COURTNEY KELSO Proposed Dock Permit Plans SCALE:
121 READE ST. APT. 8M 1”=40'
NEW YORK, NY 10013
PREPARED BY: PROPOSED PLAN & SECTION DATE:
4-18-22
Qis /
JEFFREY
F BOXP5T82NJO 4328 WESTPHALIA ROAD 6-2-22
O
t/ MATTITUCK, TOWN OF SOUTHOLD 7-6-22
HG000� I / BOHEMIA, NY 11716 SUFFOLK COUNTY, NY
631-487-5290 SHEET:
JJPATANJO®GMAIL.COM TAX MAP N0. 1000-113-9-11 1 OF 1
Glenn Goldsmith,President ®� s®(��� Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President ®� ®�`�
P.O. Box 1179
Eric Sepenoski d�L Southold,New York 11971
Liz Gillooly Telephone(631) 765-1892
Elizabeth Peeples y® Fax(631) 765-6641
®l�C®URIT`1,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
July 14, 2022
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
RE: JOHN LONDONO & COURTNEY KELSO
4328 WESTPHALIA ROAD, MATTITUCK
SCTM# 1000-113-9-11
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, July 13, 2022 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of JOHN LONDONO & COURTNEY KELSO
applied to the Southold Town Trustees for a permit under the provisions of Chapter 275
of the Southold Town Code, the Wetland Ordinance of the Town of Southold,
application dated May 16, 2022, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council and to the Local Waterfront Revitalization Program Coordinator for their findings
and recommendations, and,
WHEREAS, the LWRP Coordinator recommended that the proposed application be
found Consistent with the LWRP, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on July 13, 2022, at which time all interested persons were given an
opportunity to be heard, and,
WHEREAS, the Board members have personally viewed and are familiar with the
premises in question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
2
WHEREAS, the structure complies with the standards set forth in Chapter 275 of the
Southold Town Code,
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that for the mitigating factors and based upon the Best Management
Practice requirement imposed above, the Board of Trustees deems the action to be
Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5
of the Southold Town Code, and,
RESOLVED, that the Board of Trustees approve the application of JOHN LONDONO &
COURTNEY KELSO for the removal of the existing deteriorated fixed dock and timber
ramp and relocating the existing 8' x 20' floating dock in same general location as
existing. Construct new 4' wide x 114' long fixed dock in same general location as
existing dock. A new 30" wide x 14' long aluminum ramp will be installed and the
existing relocated 8' x 20' floating dock will be repositioned and supported with 4 — 10"
diameter cca piles. The entire proposed fixed dock will have thru-flow decking installed.
The existing deteriorated timber bulkhead will be removed and disposed of; and as
depicted on the site plan prepared by Jeffrey Patanjo, last dated July 6, 2022, and
stamped approved on July 13, 2022.
Permit to construct and complete project will expire two years from the date the permit
is signed. Fees must be paid, if applicable, and permit issued within six months of the
date of this notification.
Inspections are required at a fee of$50.00 per inspection. (See attached schedule.)
Fees: $1355.00
Very tr ours,
Glenn Goldsmith
President, Board of Trustees
GG:dd
P
S'
ohn Londono&Courtney Kelso
328 Westphalia Road,Mattituck
CTM#: 1000-113-9-11 '•
/6/22
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John Londono&Courtney Kelso
4328 Westphalia Road,Mattituck
SCTM#: 1000-113-9-11
7/6/22
ti
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Glenn Goldsmith, President Town Trustees
A Nicholas Krupski, Vice-President 54375 Route 25
Eric Sepenoski o ® P.O. Box 1179
Liz Gillooly y�j0 ao! { Southold, NY 11971
Elizabeth Peeples Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
TO: JOHN LONDONO & COURTNEY KELSO c/o JEFFREY PATANJO
Please be advised that your application dated May 16, 2022 has
been reviewed by this Board at the regular meeting of July 13. 2022 and
your application has been approved pending the completion of the following items
checked off below.
Revised Plans for proposed project
Pre-Construction Hay Bale Line Inspection Fee ($50.00)
1St Day of Construction ($50.00)
Constructed ($50.00)
x Final Inspection Fee ($50.00) -
x Dock Fees ($3.00 per sq. ft.)
Permit fees are now due. Please make check or money order payable to Town of
Southold. The fee is computed below according to the schedule of rates as set forth in
Chapter 275 of the Southold Town Code.
The Permittee is required to provide evidence that the non-turf buffer condition of the
Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant
and deed restriction to the deed of the subject parcel. Such evidence shall be provided within
ninety (90) calendar days of issuance of this permit.
The following fee must be paid within 90 days or re-application fees will be necessary.
You will receive your permit upon completion of the above.
COMPUTATION OF PERMIT FEES:
4'x60' fixed catwalk = 240 sq. ft. x $3.00 = 720.00
30"x14' ramp = 35 sq. ft. x $3.00 = 105.00
8'x20' float = 160 sq.ft. x $3.00 = 480.00
TOTAL FEES DUE: $ 1355.00
BY: Glenn Goldsmith, President ?/�y
Board of Trustees
July 6, 2022
Town of Southold Trustees 2 !! E2
Town Hall Annex Building C 15 V
54375 Rte. 25 R ['
P.O. Box 1179 1 1 20222
Southold, New York 11971
RE: JOHN LONDONO&COURTNEY KELSO Sauthoild Town
4328 WESTPHALIA RD. -MATTITUCK
Ooard of Trvstess
SCTM No. 1000-113-9-11
REVISED PLANS
Dear Trustees:
Based on comments at todays site inspection, please see revised plans and project
description to reflect new dock location.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-487-5290 or email JJPatanjo@gmail.com.
Very truly yours,
J111i reyy Patanjo
P.O. Box 582
Bohemia, NY 11716
RE JOHN LONDONO&COURTNEY KELSO
4328 WESTPHALIA RD. -MATTITUCK
SCTM No. 1000-113-9-11
PROJECT DESCRIPTION -REVISED
Project includes the removal of the existing deteriorated fixed dock and timber ramp and
relocating the existing 8' x 20' floating dock in same general location as existing.
Construct new 4' wide x 114' long fixed dock in same general location as existing dock.
A new 30" wide x 14' long aluminum ramp will be installed and the existing relocated 8'
x 20' floating dock will be repositioned and supported with 4 — 10" diameter cca piles.
The entire proposed fixed dock will have thru-flow decking installed. The existing
deteriorated timber bulkhead will be removed and disposed of.
_ ECEPM
JUS. 1 1 2022
South;@ Town
Board of Trustees
PROPOSED 30"WIDE X 14'LONG
/ ALUMINUM HINDGED RAMP PROPOSED 4'WIDE X 114'LONG FIXED DOCK
" W/THRU-FLOW DECKING ON ENTIRE DOCK
EXISTING CATWALK TO BE REMOVED
RELOCATED 8'WIDE X 20'LONG
FLOATING DOCK'SUPPORTE Wl 4-
PROJECTION
-PROJECTION LINE OF 10"DIA.PILES
I
NEIGHBORING DOCKS / 2
APPROX. M.H.W. w
EXISTING GRADE
W v v ri N m a�
APPROX. M.L.W.
" a
S 27°0800" E 562.28
W " ' '
30"MIN. VEETATD WETLANDS
r r„ r TO M.L.W.
STING 8' FLOATING". m.�
v a r 6s r
w
vr i
w DO KTD BE RELDCAID PROPOSED 10"Q1 CCA PILE-TYP 4
ra rr r w a
REMOVE EXIS NG DETERIORATED BULKHEAD
IN ITS EIVTIIET BY VIBRATION METHODS TYPICAL SECTION
rn e o i W EXISTING 4'WIDE X 83'LONG CATWALK TO BE REMOVED N.T.S.
a
EXISTING 10'X&PLATFORM TO BE REMOVED
� w
TOTAL CREEK WIDTH 236' LOCATION MAP rN r< � � � �. w
PROPOSED DOCK LENGTH 43'(16%) r * * � N.T.S.
PRC qw
a a ra MM �N ao a, y (I LUST O STE S ON LANDWARD END)
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I I y F ATING DOCK SUPPpRTED WITH 4-NEW 10" II
w 0 CCA PILES I
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I UL 1 1 2022
ISouthold Town
Board of Trustees
�'4 & PROPERTY OWNER:
/ JOHN M. LONDONO
COURTNEY KELSO Proposed Dock Permit Plans SCALE:
/ 121 READE ST. APT. 8M 1"=40'
/ NEW YORK, NY 10013
PROPOSED PLAN & SECTION DATE:
/ PREPARED BY: 4-18-22
JEFFREY PATANJO 6-2-22
P.O. BOX 582 TITU WETOWN OF ROAD 7-6-22
I / BOHEMIA, NY 11716 MATTITUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY
631-487-5290 SHEET:
/ JJPATANJO@GMAIL.COM TAX MAP N0. 1000-113-9-11 1 of 1
Glenn Goldsmith, President0.
Town Hall Annex
A.Nicholas Krupski, Vice PresidentGs54375 Route 25
Eric Sepenoski � P.O.Box 1179
Liz Gillooly " � +� Southold,NY 11971
Elizabeth Peeples , Telephone 631 765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: 7/ . ' Completed infield by: G, G®1'd'SM)A
Jeffrey Patanjo on behalf of JOHN LONDONO & COURTNEY KELSO requests a
Wetland Permit to remove the existing deteriorated fixed dock and timber ramp, and
relocate the existing 8'x20' floating dock; construct a new 4' wide by 125' long fixed
dock in similar location as existing; install a new 30" wide by 14' long aluminum ramp;
and the existing 8'x20' floating dock to be repositioned into an "L" shape configuration
and supported with four (4) 10" diameter cca pilings; the entire proposed fixed dock to
have Thru-Flow decking installed; and the existing deteriorated timber bulkhead to be
removed and disposed of. Located: 4328 Westphalia Road, Mattituck. SCTM# 1000-
113-9-11
Typ of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
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
Notice of Hearing card posted on property: Yes No Not Applicable
Info needed/Modifications/Conditions/Etc.: R7C
Present Were: f G. Goldsmith -/N. Krupski ✓ E. Sepenoski
IL. Gillooly AE. Peeples
. ........_.....________
PROPOSED 30'WIDE X 14'LONG
ALUMINUM HINDGED RAMP -- PROPOSED 4'WIDE X 114'LONG FDOED DOCK
WI IHRU+T.OW DECKING ON ENTIRE DOCK
RELOCATED 8'WIDEX20'LONG EXISTING CATWALK TO BE REMOVED
t FLOA" D Wt 4-
- / 10'DIA PILES 2
110M OPox000CIB k.
t " PX M tit-- sEXISTING GRADE
ATR-0 A.L W
0 a -- WETLANDS
V�c1 TATEO WETLANDS
S 2708'00" E 56228' _ 3€PM11�._ _._
o .. a
TO M.L.W.
T +. PROPOSM t0'O CCAPILE-TYP4
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a ' - - A'ihX6Tii3NO1'3STWAIXTT#B@
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TWALCNFEKPAOIHZW LOCATION 1IA'
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E I v E
PROPERTY OWNER:
y JOHN M. LONDONO
COURTNEY KELSO Proposed Dock Permit Plans
/ � 121 READE ST. APT. 8MSauftidT
NEW YORK, NY 10013 -
�GtTfus tees PROPOSED PLAN & SECTION 'T
/ - PREPARED BY: 4-18-22
JEFFREY PATANJO 6-2-22
P.O. BOX 582 4928 WETOWN OF ROAD 7-6-22
BOHEMIA, NY 11716 NATTJT FF TOWN NT SOUTHOLD
SUFFOLK COUNTY, NY
631-487-5290 S1tEErt
/ JJPATANJO®GMAIL.COM TAX YAP N0. 1000-113-9-11 1 OF 1
RE: JOHN LONDONO&COURTNEY KELSO
4328 WESTPHALIA RD. -MATTITUCK
SCTM No. 1000-113-9-11
PROJECT DESCRIPTION -REVISED
Project includes the removal of the existing deteriorated fixed dock and timber ramp and
relocating the existing 8' x 20' floating dock in same general location as existing.
Construct new 4' wide x 114' long fixed dock in same general location as existing dock.
A new 30" wide x 14' long aluminum ramp will be installed and the existing relocated 8'
x 20' floating dock will be repositioned and supported with 4 — 10" diameter cca piles.
The entire proposed fixed dock will have thru-flow decking installed. The existing
deteriorated timber bulkhead will be removed and disposed of.
I1 E DD;
JUL2022
omrdOfT
Glenn Goldsmith,President o\�SprrU(�CpG Town Hall Annex
A.Nicholas Krupski,Vice President c� y� 54375 Route 25
Eric Sepenoski y x
P.O.Box 1179
Liz Gillooly �y • 0�� Southold,NY 11971
Elizabeth Peeples �Od '� ��'' Telephone(631)',765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: Completed in field by:
Jeffrey Patanjo on behalf of JOHN LONDONO & COURTNEY KELSO requests a
Wetland Permit to remove the existing deteriorated fixed dock and timber ramp, and
relocate the existing 8'x20' floating dock;construct a new 4' wide by 125' long fixed
dock in similar location as existing; install a new 30" wide by 14' long aluminum ramp;
and the existing 8'x20' floating dock to be repositioned into an "L" shape configuration
and supported with four (4) 10" diameter cca pilings; the entire proposed fixed dock to
have Thru-Flow decking installed; and the existing deteriorated timber bulkhead to be
removed and disposed of. Located: 4328 Westphalia Road, Mattituck. SCTM# 1000-
113-9-11
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
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
Notice of Hearing card posted on property: Yes No Not Applicable
Info needed/Modifications/Conditions/Etc.:
Present Were: G. Goldsmith N. Krupski E. Sepenoski
L. Gillooly E. Peeples
p � CEI E nn
—�-W
P �l Nil 1 6 WOO luul
SURVEY OF:
PROPERTY LOCATED AT MATTITUCK
TOWN OF SOUTHOLD SoDtholdTown
SUFFOLK COUNTY. NEW YORK Board ofhustees
S.C.T.M. u 1000-113-9-11
AREA = 117,670.1 SF. = 2.70 ACRES
SCALE: 1"=40'
TEST HOLE DATA
NOTE: THE EXISTENCE OF RIGHT OF WAYS. (NOT TO SCALE[
WETLANDS AND/OR EASEMENTS OF RECORD BY: MCDONALO GEOSC[ENCE
IF ANY, NOT SHOWN ARE NOT GUARANTEED.
4/17/2819
UPLAND AREA OF PROPERTY - 106,808.8 SF. MIXED SAND AND LOAM 0.5'
COVERAGE CALCS: MA PES
EXISTING COVERAGE = 9336 SF.- 9% CREEK BROWN SILTY SANG
PROPOSED COVERAGE = 9336 SF = 9% 2'
WELL AND SANITARY
LOCATION BY OTHERS
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ELEVATIONS REFER TO 1988 NAVO 17'
\ NO WATER ENCOUNTERED
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CERTIFIED TO: PAUL BARYLSKI LAND SURVEYING
JOHN LONDONO
PATCHOGUE NY 11772
COURTNEY KELSO PHONE 631-294-6985
INSIGNIA-BNT NATIONAL TITLE AGENCY FAX 631-627-3186
OLD REPUBLIC TITLE INSURANCE COMPANY PAULBARYLSKIpYAH00.COM
BANK OF AMERICA. N.A.. ISAOA.ATIMA
NOVEMBER 23, 2016
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HEIDECKER LAND SURVEYING D ' Q E this my map not beadnq tha
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NOTES
` WORK WAS CfE
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EMBIE D 2021 BY HEIEIDECKER LANG
OF NEWS , SURVEYING.PLLC AND ALL MEASUREMENTS
\ �'✓ O WERE TAKEN ON THE GROUND•
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METERS JOHN GERD HEIDECKEV N.Y.STATE LAND SURVEYOR UC.#050719 DATE: BATHYMETRIC SURVEY SHEET NO.
FEET 751 COATES AVENUE DECEMBER 20, 2021 1 OF 1
020 40 60 80 HOL9ROOK,NEW YORK 11741 DRAWN BY: B.M. SECTION 113—BLOCK 9—TAX LOT 11 PROJ. NO.
GRAPHIC SCALE 1" = 20' LSIIO
(Bat)-772-9604 cHK BY: J.H. #43UC KrESTPHALIA ROAD 2tHRLE:
jheidecher®heidecicerls.com —SUFFOMATTITLK
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OF SOUTFIOLD CAD TILE:
scALE: t"= 20' SUFFOLK COUNTY NEW YORK 2+HioFP.Pwc
I '
PROPOSED 30"WIDE X 14'LONG
/ ALUMINUM HINDGED RAMP PROPOSED 4'WIDE X 125'LONG FIXED DOCK
DOCK W/THRU-FLOW DECKING ON ENTIRE DOCK
EXISTING CATWALK TO BE REMOVED
/ RELOCATED 8'WIDE X 20'LONG
FLOATING DOCK SUPPORTE W/ 4-
PROJECTION LINE OF / (� 10"DIA.PILES
INEIGHBORING DOCKS
4 APPROX. M.H.W. .. ,.\� EXISTING GRADE
+ +N +a + +N +� +� APPROX. M.L.W. ......
S 27°08'00" E 562.28' _.._.._. _.._ .— 30"MIN:' VEGETATED WETLANDS
W� TO M.L.W.
+ +� +�M + N EXISTING 8'J�0 PATINGOKTO BE RELOCA 1 D PROPOSED 10"0 CCA PILE-TYP 4
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IN ITS ENTIRE]BY VIBRATION METHODS
, TYPICAL SECTION
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i' , a T
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PROPERTY OWNER:
��
COURTNEY K EDLS000 Proposed Dock Permit Plans SCALE:
121 READE ST. APT. 8M 1"=40'
I
NEW YORK, NY 10013 PROPOSED PLAN & SECTION DATE:
PREPARED BY: 4-18-22
EIiSI / JEFOF REY BOXP5T82NJO 4328 WESTPHALIA ROAD
�N�oo I / BOHEMIA, NY 11716 MATTITUCK, TOWN OF SOUTHOLD
c� SUFFOLK COUNTY, NY
631-487-5290 SHEET:
/ JJPATANJO@GMAIL.COM TAX YAP N0. 1000-113-9-11 1 OF 1
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" 113
OFFICE LOCATION: �� r MAILING ADDRESS:
Town Hall Annex P.O. Box 1179
54375 State Route 25 Southold, NY 11971
(cor.Main Rd. &Youngs Ave.) Aur
Southold, NY 11971 Telephone: 631 765-1938
UN'11
ter„ r0
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: July 6, 2022
Re: LWRP Coastal Consistency Review for JOHN LONDONO & COURTNEY KELSO
SCTM# 113-9-11
Jeffrey Patanjo on behalf of JOHN LONDONO & COURTNEY KELSO requests a Wetland Permit to
remove the existing deteriorated fixed dock and timber ramp, and relocate the existing 8'x20'
floating dock; construct a new 4' wide by 125' long fixed dock in similar location as existing; install a
new 30" wide by 14' long aluminum ramp; and the existing 8'x20' floating dock to be repositioned
into an "L" shape configuration and supported with four(4) 10" diameter cca pilings; the entire
proposed fixed dock to have Thru-Flow decking installed; and the existing deteriorated timber
bulkhead to be removed and disposed of. Located: 4328 Westphalia Road, Mattituck. SCTM#
1000-113-9-11
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 provided that the applicant demonstrate that the following dock standards pursuant
to § 275-11. Construction and operation standards have been met.
(d) Review and approval of dock applications. Before issuing a permit for a dock structure, the
Trustees shall consider whether the dock will have any of the following harmful effects:
(1] Whether the dock will impair navigation or be located in areas of high vessel traffic or
vessel congestion;
(2] Whether the dock will unduly interfere with the public use of waterways for swimming,
boating, fishing, shellfishing, waterskiing and other water-dependant activities;
[5] Whether the dock will cause degradation of surface water quality and natural resources;
[11] Whether the cumulative impacts of a residential and commercial dock will change the
waterway or the environment and whether alternate design, construction, and location of
the dock will minimize cumulative impacts; and
[12] Whether adequate facilities are available to boat owners and/or operators for fueling,
discharge of waste and rubbish, electrical service and water service.
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: Honorable Lori Hulse, Attorney
John G.Stein,Chairperson �" Town Hall,53095 Main Rd.
Lauren Standish,Secretary P.O.Box 1179
Southold,NY 11971
Telephone(631)765-1889
Fax(631)765-1823
Conservation Advisory Council
Town of Southold
At the meeting of the Southold Town Conservation Advisory Council held Wed., July 6,
2022 the following recommendation was made:
Moved by John Chandler, seconded by Inga Van Eysden, it was
RESOLVED to SUPPORT the application of JOHN LONDONO & COURTNEY KELSO
for the removal of the existing deteriorated fixed dock and timber ramp and relocating the
existing 8'X 20' floating dock in same general location as existing. Construct new 4'X 125'
fixed dock in same general location as existing dock. A new 30"X 14' long aluminum ramp
will be installed and the existing relocated 8'X 20' floating dock will be repositioned and
supported with four (4) 10" dia. CCA piles. The entire proposed fixed dock will have thru-
flow decking installed. The existing deteriorated timber bulkhead will be removed and
disposed of.
Located: 4328 Westphalia Rd., Mattituck. SCTM#113-9-11
Inspected by: John Stein, Caroline Burghardt, Carol Brown, John Chandler, Maggie
Merrill, Inga Van Eysden
The CAC Supports the application with the Condition the docking facility, including the
vessel, does not extend beyond the neighboring docks.
Vote of Council': Ayes: All
Motion Carried
Glenn Goldsmith, President Z� sQ(/��o Town Hall Annex
54375 Route 25
A. Nicholas Krupski, Vice President P.O.Box 1179
John M.Bredemeyer III Southold,New York 11971
Michael J.Domino Telephone(631) 765-1892
Greg Williams Fax(631) 765-6641
Qum
BOARD
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
This Section For Office Use 1v
Coastal Erosion Permit Application
p E C E I V E
SC Wetland Permit Application
__Administrative Permit MAY 16 2022
Amendment/Transfer/Extension
'Received Application: 5��(o•2?i
K. Received Fee: $ ZSVZV Southold Town
k Completed Application: Board of Trustees
__Incomplete: _
__SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
__Lead Agency Determination Date: _
_—�- oordination:(date sent):
WRP Consistency Assessment Form Sent:_� 41,1Z Z'_ AC Referral Sent: (0 a APS
_�_ ate of Inspection: is,&,?1�_
__Receipt of CAC Report:
'clinical Review:
Public Dearing Held: •Z
Resolution:
Owner(s) Legal Name of Property (as shown on Deed): John Londono & Courtney Kelso _
Mailing Address: 55 Hudson Street, Apt. 7E, New York, IVY 10013
Phone Number: 917-434-1028
Suffolk County Tax Map Number: 1000 - 113-9-11
Property Location: 4328 Westphalia Rd - Mattituck
See location Map
(If necessary, provide LILCO Pole#, distance to cross streets, and location)
AGENT (If applicable): Jeffrey Patanjo
Mailing Address: P.O. Box 582 Bohemia, NY 11716
Phone Number: 631-487-5290 Email: JJPatanjo@gmail.com
ccd z
Board of Trustees Applic ion
GENERAL DATA
Land Area(in square feet): 117 9 7® — — _ -- —
Area Zoning: e s°
Previous use of property: nes.
Intended use of property: Res.
__ --- — -- —
Covenants and Restrictions on property? 1:1 Yes _Fv-1 No
If"Yes", please provide a copy.
Will this project require a Building Permit as per Town Code? _1:1 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 RV 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 [Z] No
Does the structure (s) on property have a valid Certificate of Occupancy? Yes_O_No
Prior permits/approvals for site improvements:
Agency Date
X No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency? 0 No ❑ Yes
If yes, provide explanation: _
Project Description(use attachments if necessary):
RE: JOHN LONDONO&COURTNEY KELSO
4328 WESTPHALIA RD. -MATTITUCK
SCTM No. 1000-113-9-11
PROJECT DESCRIPTION
Project includes the removal of the existing deteriorated fixed dock and timber ramp and
relocating the existing 8' x 20' floating dock in same general location as existing.
Construct new 4' wide x 125' long fixed dock in same general location as existing dock.
A new 30" wide x 14' long aluminum ramp will be installed and the existing relocated 8'
x 20' floating dock will be repositioned and supported with 4 — 10" diameter cca piles.
The entire proposed fixed dock will have thru-flow decking installed. The existing
deteriorated timber bulkhead will be removed and disposed of.
Board of Trustees Applin —'' ion
I
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
See attached
Area of wetlands on lot: 11429 square feet
Percent coverage of lot: 9.7 %
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? i_No ❑ Yes
If yes, how much material will be excavated? n/a cubic yards
How much material will be filled? n/a _cubic yards
Depth of which material will be removed or deposited: n/a feet
Proposed slope throughout the area of operations. 0-4
Manner in which material will be removed or deposited: n/a
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
There will be no effect on wetlands due to installation of thru-flow decking to allow for light transmission
through fixed dock and promote wetland growth below and ultimately allow for flora & fauna life.
Short Environmental Assessment Form
Part I -Project Information
Instructions for Completing
Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the
application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on
information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as
thoroughly as possible based on current information.
Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the
lead agency;attach additional pages as necessary to supplement any item.
Part 1—Project and Sponsor Information
Name of Action or Project:
4328 Westphalia Rd-Mattituck
Project Location(describe,and attach a location map):
See location map
Brief Description of Proposed Action:
Construct 4'wide x 125'long fixed pier to replace deteriorated existing dock and extend further into waterway.Relocate existing 8'wide x 20'long
floating dock and provide new 30"wide x 14'long aluminum ramp.
Name of Applicant or Sponsor:
Telephone: 917-434-1028
John Londono&Courtney Kelso E-Mail:
john.m.londono@gmail.com
Address:
112 Reade St-Apt 8M
City/PO: State: Zip Code:
New York NY 10013
1. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 1:1may 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 government Agency? NO YES
If Yes,list agency(s)name and permit or approval:NYSDOS/Town of Southold Trustees/Army Corps ❑
3. a.Total acreage of the site of the proposed action? 2.70 acres
b.Total acreage to be physically disturbed? 0.01 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 2.70 acres
4. Check all land uses that occur on,are adjoining or near the proposed action:
5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial m Residential(suburban)
❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify):
❑Parkland
Page I of 3
5. is the proposed action, NO YES N/A
a. A permitted use under the zoning regulations? ❑ � ❑
b. Consistent with the adopted comprehensive plan? ❑ rv-� ❑
6. is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
if Yes, idem fy: ❑
Fv
p NO YES
8. \ i'il tyle proposed action result in a substantial increase in traffic above present levels? ❑ ❑
b. ' -e;public transportation services available at or near the site of the proposed action? Z ❑
c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed � Elaction?
9. lois the proposed action meet or exceed the state energy code requirements? NO YES
If the pr<;1;..« 'action Nx.111 exceed requirements,describe design features and technologies:
10. "Will .it-.:proposed action,connecv to an existing public/private water supply? NO YES
No,describe method for providing potable water: (�
tl" l
' ❑
IL Will me proposed action connect to existing wastewater utilities? NO YES
i� if No,describe method for providing wastewater treatment:
j i2. a. Does Elie project site contain,or is it subsiantialiy contiguous to,a building,archaeological site,or district NO YES
1 which is listed on the National or State Register of Historic Places,or that has been determined by the ❑
Cornmissiol-er of the:SYS Of ice of Parks, Recreation and Historic Preservation to be eligible for listing on the
State Registy r of 1-listoric Places?
I b. is t e project site,or any portion of it, iocated in or adjacent to an area designated as sensitive for ❑ ❑
arclaeoiogic t i sites o; the N'x"Srat: Flistoric Preservation Office(SHPO)archaeological site inventory?
13. a. lr)z es any ipo:,,-tion of the site of the proposed action, or lands adjoining the proposed action,contain NO YES
_:etla Acis or other waterbodies regulated by a federal,state or local agency? ❑
he orocused action,p ivsically;iter,or encroach into,any existing wetland or waterbody?
if Yes, ? ; ti y he wetland or water body and extent of alterations in square feet or acres:
Floating Dock'!60 S.F.,Ramp 35 S.F.&pier 216 S.F.
i
Page 2 of 3
14. Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply:
ElShoreline ❑ Forest ❑Agriculturaligrasslands ❑ Early mid-successional
Wetland ❑ Urban 2 Suburban
15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES
-cera! ooverninent as threatened or endangered? ❑ ❑
16. is the nrcject site located in the 100-year flood plan? NO YES
17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
1fYas, ❑ ❑
a. water discharges flow to adjacent properties? ❑
b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
1f Yes, breti;.-describe:
1 S. Does the proposed action inciude construction or other activities that would result in the impoundment of water NO YES
i or-,Aei iirauids(e.g., retention pond;waste lagoon,dam)?
i if Yes,expl,' !,the purpose and size of the impoundment:
9. has tl:; s; s 'sfts.-fwuposed action or an«cljoining property been the location of an active or closed solid waste NO YES
I It Yes,iic i:;itis:
h
20.1 .s o`r the p_oposed a;coni or an adjoining property been the subject of remediation(ongoing or NO YES
f cornpleiec? _ : liazat6oF3s waste?
❑ ❑
N PROVIDE D ABOVE IS TRUE AND ACCURATE TO THE BEST OF
i
Applic:z:t p nsorl;?ante: John Londono&Courtney Kelso Date: / �2 Z
Title:Owners
t 4 � + Page-I Of'
i
.... – ---t—t raaawaru va/e. A.#.u-,ea.—&--j .,._..,...--......--— _—--I-r--------........-- --......... ——......v...-.. ..d
questions in Part 2 using 'n bi-mation contained in Part I and other materials-—1-nitted by the project sponsor or
otherwise available to thi !ewer. When answering the questions the reviewe uid be guided by the concept"Have my
responses been reasonabie considering the scale and context of the proposed action-c'
No,or Moderate '
small to large
impact impact
may may
occur occur
I Will the proposed action create a material conflict with an adopted land use pian or.zoning El 13l
regulations.
2. Will the proposed action result in a change in the use or intensiq of use of land? ❑ I (�
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 S-1 ❑
establishment of Critical Environmental Area(CEA)? L_I
15. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway? ❑ ❑
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing: j—► ❑
a.public!private water supplies? tt�_tt
b.public 1 private wastewater treatment utilities? ❑
S. 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,
waterbodies,groundwater,air quality,floe and fauna}?
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
It. 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!tow the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also considerthe potendai for short-term,long term and
cumulative impacts.
rCheck this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
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
t Print or Type Name of Responsible Officer in Lead Agency Titte of Responsible Officer
mf RacnnncihlP 01`�innr in Lead Agenev Signature of Preparer(if different from Responsible Officer)
EAF Mapper Su mo Repon Tuesday, April 19, 2022 10:15 PM
ended to assist
project sponsors and reviewr: The EAF ing ier is a npreparinglIan environmental
9 9
l t i �$y�t�a`f; i F •�'.t � 't i� e-c'c assessment form(EAF).Not all questions asked in the EAF are
answthe EAF Mapper.Additional information on any
question caed n be obtained by consulting the EAF Workbooks. Although
�; ' the EAF Mapper provides the most up-to-date digital data available to
DEC,you may also need to contact local or other data sources in order
rr to obtain data not provided by the Mapper.Digital data is not a
substitute for agency determinations.
-
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tom# r .- �r - i+rnz� i� 3i.,.' iF ti? .,t7rit pi ` in1 s kuii. + tip �J
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Part 1 /Question,7 [Critical Environmental No
Area]
Part 1 /Quos%ion 12a [National or State No
Register of Historic Places or State Eligible
Sites]
Pali !Q ;ns 112b [Ar choologicai Sites] No
Part 1 /Question-13a rVVetlands or Other Yes- Digital mapping information on local and federal wetlands and
Regulates nfaterbodies is known to be incomplete. Refer to EAF Workbook.
Pali 1 /Question 15 threatened or No
Endangered Animal]
iimal]
Part 1 /Question 16[100 Year Flood Main] Yes
Part i /Ques,;ior4 204 [Remediation Site] No
i
Short Envirc-nmentai Assessment Form - EAF Mapper Summary Report 1
Board of Trustees Applin `pion
AUTHORIZATION
(Where the applicant is not the owner)
I/We, John Londono Courtney Kelso
.
owners of the property identified as SCTM# 1000- 113-9- 11 in the town of
IViattituck ,New York, hereby authorizes Jeffrey Patanjo
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.
t
Property O er Signature Prerty Owner's Signature
G`
SWORN TO BEFORE ME THIS I DAY OFOkA
, 20 2
i
7LINDSAYALTNotary of New York929Quas CountymmMay 20,2023
otary P
Board of Trustees Applin' 1J on
AFFIDAVIT
John Londono & Courtney KelsoBEINGDULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT
ALL WORK WILL BE DONE IN THE FANNER 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.
(JAn
Signature of PrTi—
Owner Signature of Property Owner
SWORN TO BEFORE ME THIS �01 DAA' OF ,20 2
=Stateof
EWALT
Notte of New York391929ens CountyMy Cores may 20,2023
Notary Public
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of
this form is to provide information which can alert the town of possible-conflicts--of interest and allow it to take whatever action is,,
necessary to avoid same.
YOUR NAME: Londono,John
(Last name,first name,.middle initial,unless you are applying in the name of
someone else or otherentity,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 e/
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,marriage,or business interest_"Business interest"means a business,
including a partnership, in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES D NO W
If you answered"YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,of child is(check all that apply):
O—A)the owner of greater than 5%of the shares of the corporate stock of the applicant
EL (when the applicant is a corporation);
B)the legal or beneficial owner of any interest in a non-corporate entity(when the
applicant is not a corporation);
_C)an officer,director,partner,or employee of the applicant;or
9—D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted t 's d of L4 'I 202
Signa[ure 'N�� p{�=
Print Namegohn Londono
Form TS l
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town ofSouiholds Code of Ethics prohibits-conflicts of interest-on-the-part of town-officers and emnloyees.The nuroose of
this.form is to provide information which can alert the-town-of-possible-conflicts-of-interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME: Kelso,Courtney
(Last name,first name,:giiddle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance --- Building _
Variance Trustee ✓ ^
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(If"Other",name the activity.)_ —
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee
of the Town of Southold? "Relationship"includes by blood,marriage,or business interest_"Business interest"means a business,
including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES NO —I—l�—
if you answered"YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
0—A)the owner of greater than 5%of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
F-1 B)the legal or-beneficial owner of any interest in a non-corporate entity(whets the
Lapplicant is not a corporation);
C)an officer,director,partner,or employee of the applicant;or
=D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted this 04/18/2 22 _
Signature— ( i U I I IV wjv; hpj,�Q
Print Name Courtnejelso _
Form TS 1
APPLICANT/AGENT/REPRESEIvTTATIV
TRANSACTIONAL DISCLOSURE FORM
TheTosvi ofSouttiold s Code of Ethics nioh bats conflicts of interest on the,pa[of town ofl-ieers and etiioloyees The ouroose of...
this fann is to orouide in matiot-yvhiehlcan>alerf:the tftq�*bossible�ts-of uiterest and allow�t to lake wkiateyer action�s
necessacv�to avoid='same;~ ,
YOUR NAME: .:Patanjo,Jeffrey . ,..
(Last name,first name,.middle initial,unless you are applying tii:the name;of
someone else or otherentity,such as a company.If so;indicate he 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 officeror employee .
of the.Town of Southold? "Relationship'includes.by blood,marriage,or.business interest."Business;interesf'means a business,
including.a,partnership,in which the town officer or employee has even a partial ownership of(or.employment by)a,corporation
in which the town officer or employee owns.more than 5%of the shares.
e
n
YES __❑ NO 1 ..
If you answered"YES",complete the balance of this form and date and sign where indicated
Name of person employed by the Town of Southold
Title or position of that person
Describe the'relationship between yourself(the:applicantlagent/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)..
0,_A)the owner.of greater than 5%of the shares of the corporate stock of the,applicant
EL (when the applicant is a corporation);-
B)the legal or beneficial owner of any interest in a non-corporate entity,(when►the
IRapplicant is not a corporation);
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION'OF RELATIONSHIP
Submitted th' 0 /18/20
Stgateire: _
. .Print Name P& P_-t P
Form TS l
Board of Trustees Appli.' ion
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
APPLICATION NAME & SCTM#:
NAME: - - -
MJ c�Ce117L ��� erg•�'
1 �3
// 3 - 9 - 13
STATE OF NEW YORK
COUNTY OF SUFFOLK
residing at
being duly sworn, deposes and says that on
the day of , 20 , deponent mailed a true copy of the
Notice set forth in the Board of Trustees Application, directed to each of the above named
persons at the addresses set opposite their respective names; that the addresses set opposite the
names of said persons are the address of said persons as shown on the current assessment roll of
the Town of Southold; that said Notices were mailed at the United States Post Office located at
, that said Notices were mailed to
each of said persons by CERTIFIED MAIL/RETURN RECEIPT.
Signature -
Sworn to before me this
Day of . 20
Notary Public
July 13, 2022
Town of Southold Trustees E o V E
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179 JUL 15 2022
Southold, New York 11971
Southold Town
RE: JOHN LONDONO&COURTNEY KELSO Board of Trustees
4328 WESTPHALIA RD. -MATTITUCK
SCTM No. 1000-113-9-11
AFFIDAVIT OF POSTING
Dear Trustees:
Attached please find affidavit of posting for the above referenced project.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-487-5290 or email JJPatanjo@gmail.com.
Very truly yours,
0.,pok--- -
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
Glenn Goldsmith,President ��gUfFO(,�co Town Hall Annex
A.Nicholas Krupski,Vice President ,�� Ge 54375 Route 25
Eric Sepenoski y P.O.Box 1179
Liz Gillooly G • Southold,NY 11971
Elizabeth Peeples ?'��l �,a0! Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application of
JOHN LONDONO & COURTNEY KELSO
COUNTY OF SUFFOLK
STATE OF NEW YORK
AFFIDAVIT OF POSTING
�Vjffla tr$! Y' D . . ,�UI�T „I 1 QS'7ING AS RE1�VdAIN D
--
� .PLAE
%j;,= 61 ). 7, +�4 'T,�StiEESl'RIORTQ m E PU ,I�C
residing at/dba?C)JJ-�< r,5 7 dry ca,
IyP_(A) 1-4Qr JA\ 1)-11to
being duly sworn, depose and say:
That on the 5 day ofd�\V� , 202-2, 1 personally posted the property known as
J r�r� 1-t�� ; ►�� '014 l 1 q`S2_
by placing the Board of Trustees official noticing poster where it can easily be seen from the
street, and that I have checked to be sure the noticing poster has remained in place for a full
seven days immediately preceding the date of the public hearing. Date of hearing noted thereon
to be held Wednesday,July 13, 2022.
Dated:`�1?j 20'2-Z
(sig/ate)
Sworn to before me this jw ku
day of 13 2022 JESSICA L. GEREMINA
NOTARY PUBLIC-STATE OF NEW YORK
No.01GE6418131
oualified in Suffolk County
MY Commission Expires 06-01-2025
y blic
July 5, 2022
Town of Southold Trustees --
Town Hall Annex Building D E C E P V E
54375 Rte. 25 U
P.O. Box 1179
Southold, New York 11971 JUL 1 1 2022
RE: JOHN LONDONO&COURTNEY KELSO
4328 WESTPHALIA RD. -MATTITUCK Southold Town
Board of Trustees
SCTM No. 1000-113-9-11
AFFIDAVIT OF MAILING
Dear Trustees:
Attached please find affidavit of mailing along with certified receipts.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-487-5290 or email JJPatanjo@gmail.com.
Very truly yours,
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
Postal ServiceTw %
RECEIT
- --- -
CERTIFIED MAILo . Postal
Domestic mail only CERTIFIED o RECEIPT
Ir ca Domestic Only
Co
11:11 110
11 jfjl�
Certified Mail Fee s 65 h w C vy" ru • , F• r � cc P ��� L
c0 Certified Mail Fee S
Extra Services&Fees(check box,add tee es a � $ '
Q ❑Return Receipt(hardcopy $ rP(` 9(�C O Extra Services&Fees(check box,add fee as approprl e
Q ❑ReNm Receipt(electronic) $ 9QZ Po tm Q E]r Q ElReReturnReceipt(hardcopy) $ :.. .7 J
Q El Certified Mail Restricted Delivery $ 7 (� He 0� RetumRecelpt(electronic) $ �" G7 P me
Q []Adult Signature Required $ Q El Certified Mail Restricted Delivery $ G�z
1-3 Postage
❑i duulltt Signature Restricted Delivery$'�� hjOI)> O- E]pdult Signature Redult Signature stricted Delivery$Er —
— Postage 7
M oral' 1000-113-9-13 - _-
$ Swotkewicz Frank
M T 1000-113-9-12 `i,
Sans Swotkewicz Justine w s Barnett Michael
' s�`ef Pp Box 607 0 Barnett Lynne
ciy, Mattituck, NY 11, ►- 4 675 Point Pleasant Rd
-----------
z Mattituck, NY 11952
1 1pri , PSN 7530-1 111
Postal Postal Service
ru CERTIFIED MAILP RECEIPT CERTIFIED
o RECEIPT
117 Domestic Mail Only Ln
U coil _
ru
'� Certified Mail Fee ppp v ru • delivery • "' E E9
Lr) p iy I cO Certified Mail Fee ,\�\
Extra Services&Fees(check box add t as propdate ! I $ M
)ere
QRetum Receipt(hardcopy $ 11 fljExtraServices&Fees(checkbax,addtee asa p pde❑Return Receipt(hardoopy $ � �,Q ❑Retum Receipt(electronic) $ �. �, ti Q Posjrltark ❑Retum Receipt(electronic) $ \-�� orkQ ❑Certified Mall RasMcted Delivery $ �. !�-� , d Here f Q ❑Certified Mall Restricted Delivery $ � � ``, !
Q ❑Adult Signature Required $ Q b'Q9 p
Q E]Adult Signature Required $
[]Adult Signature Restricted Delivery$ E]Adult Signature Restricted Delivery$
Er 117
Postage O Postage
M s = -- -- - - - —.I o 1000-114-1-9 -- —
1000-114-1-8.4 "' McPhillips Thomas
90 Ford Aaron W a McPhillips Mary
N 210 Fairview Rd ----------------- Q 18 Coleman Dr
Palm Beach, FL 33480
!' t ---------='--=-- r East Williston, NY 11596
3800,April 2015r, r,.•,.
Postal
a
CERTIFIED MAILP RECEIPT
Domestic
Cert'rfied Ma0il Fee . �. � U._
ul $
�- sasn
Extra Services&Fees(check box,add fee as appropdat Y
Q ❑Retum Receipt(hardcopy $_��
0 ❑Retum*Receipt(eiectronlc) ,$ do POStma
Q 1:1 Certified Mall Restricted Delivery $
Q []Adult Signature Required $
❑Adult SlgnatureRestricted Delivery.$_ b--V
Q Postage
Er
�_ ,�7
C-3 r
O1 1000-113-9-10.1 ��NBW��� 1
to $
e. 4326 Westphalia LLC
C3 c/o Richard Klein Esq
5173 Merrick Rd
cn Massapequa Park, NY 11762 ;--------------
Lr r rr,•r.
J
Board of Trustees Application
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
APPLICATION NAME & SCTM#: 1 13•Cl—I1
NAME: ADDRESS:
1000-114-1-9 1000-113-9-10.1
McPhillips Thomas 4326 Westphalia LLC
McPhillips Mary c/o Richard Klein Esq
18 Coleman Dr 5173 Merrick Rd
East Williston, NY 11596 Massapequa Park, NY 11762
1000-113-9-13
Swotkewicz Frank 1000-113-9-12
Swotkewicz Justine Barnett Michael
PO Box 607 Barnett Lynne
Mattituck, NY 11952 675 Point Pleasant Rd
Mattituck_ Nv 11952
1000-114-1-8.4
Ford Aaron W
210 Fairview Rd
Palm Beach, FL 33480
STATE OF NEW YORK
COUNTY OF SUFFOLK
residing at?O I x ,58z_2p�Ia— k Y4
i 1711 LO , being duly sworn, deposes and says that on
the C� day of Jul , 20,22-, deponent mailed a true copy of the
Notice set forth in the Board o rustees Application, directed to each of the above named
persons at the addresses set opposite their respective names; that the addresses set opposite the
names of said persons are the address of said persons as shown on the current assessment roll of
the Town of Southold; that said Notices were mailed at the United States Post Office located at
that said Notices were mailed to
each of said persons by CERTIFIED MAIL/RETURN RECEIPT.
OiLl ,
bnare
Sworn to before me this Jcr
Day of 720 )-2
JESSICA L. GEhEMINA
NOTARY PUBLIC-STATE OF NEW YORK
No.01 G E6418131
Qualified in Suffolk County
N Public MY Commission Expires 06-01-2025
, NOTICE OF HEARING
NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of
Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property.
OWNER(S) OF RECORD: JOHN LONDONO & COURTNEY KELSO
SUBJECT OF PUBLIC HEARING: For a Wetland Permit to remove the existing
deteriorated fixed dock and timber ramp, and relocate the existing 8'x20'
floating dock; construct a new 4' wide by 125' long fixed dock in similar
location as existing; install a new 30" wide by 14' long aluminum ramp; and
the existing 8'x20' floating dock to be repositioned into an "L" shape
configuration and supported with four (4) 10" diameter cca pilings; the entire
proposed fixed dock to have Thru-Flow decking installed; and the existing
deteriorated timber bulkhead to be removed and disposed of. Located: 4328
Westphalia Road, Mattituck. SCTM# 1000-113-9-11
TIME & DATE OF PUBLIC HEARING: Wednesday, July 13, 2022 — at or about
5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which
are available online at www.southoldtownny.gov and/or in the Trustee Office until to the day
of the hearing during normal business days between the hours of 8 a.m. and 4 p.m.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892
Town of Southold
IMRF CONSISTENCE'ASSESSMENT FORM
A. INSTRUCTIONS
I. 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
snaking 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 See-Lion 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 sigmificant
beneficial and adverse effects upon the coastal'area(which includes all of Southold Town).
3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thaw, each answer must be explained in detail, listing both supporting- and non-
supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and
conditions,it shall not be undertaken.
A copy of the LWRP is available in the following places: online at the Town of Southold's
website (southoldtown.northfork.net), the:board of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 113 U9 - 11
PROJECT NAME 4328 Westphalia Rd ® Matt tuck
The Application has been submitted to (check appropriate response):
Town Board ❑ Flnuning Board❑ Building Dept. ❑ Board of Trustees
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: Fv
Nature and extent of action:
See attached
0
Location of action:4328 Westphalia Rd - Mattituck
Site acreage:2.70
Present land use: Res.
Present zoning classification:Res. _
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
in-formation shall be provided:
(a) Name of applicant:John Londono & Courtney Kelso
(b) Mailing address:55 Hudson Street,Apt. 7E New York, NY 10013
(c) Telephone number: Area Code 917-434-1028
(d) Application number, if any:
Will the action be directly undertaken,require funding, or approval by a state or federal agency?he
Yes L 1 No❑ If yes, which state or federal agency? NYSDEC NYSDOS
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 CAST 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.
V-1yes F] No ❑ Mot Applicable
Project is consistent with neighboring area and makes beneficial use of coastal property.
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the 'Town of Southold. See
LWRP Section Ili—Policies Pages 3 through 6 for evaluation criteria
1-1 Yes 1:1 No V] Not Applicable
No Effect. y �� %
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
V] Yes ❑ leo❑ Not Applicable
Project provides new visually appealing dock consistent with neighboring properties.
Attach additional sheets if necessary
NATUR.A 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
Project protects against loss of existing dock due to deterioration.
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
—Policies Mages 16 through 21 for evaluation criteria
❑ -Yee ❑ No ®loot Applicable
No effect
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 ❑iso 1PINot Applicable
1 ,
No Effect.
Attach additional sheets if necessary
Policy `l. Protect and improve air quality in the 'Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria.
Yes ❑NOE Not Applicable
No Effect.
Attach additional sheets if necessary
Poflicy 8. Minimize environmental degradation in 'Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section IHI—Policies;.Pages 34 through 38 for evaluation criteria.
Yes F-1 No E Not Applicable
No Effect.
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.
YeD No❑ Not Applicable
Project allows for continued access to waters for boating, fishing and recreation activities.
Attach additional sheets if necessary
VV ORIUNG COAST P®L,_,,_., ES
Policy M 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.
Fl
yes F] No J In Not Applicable
No Effect.
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. Sec LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria.
❑'des ❑ NO FV—] Trot Applicable
No Effect.
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 F] NoW-1Not Applicable
No Effect.
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 H Not Applicable
No Effect.
PREPARED BY Jeffrey Patanjo TITLE Agent DATE 04/18/22
May 2, 2022
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179 E C E I V E
Southold, New York 11971
RE: JOHN LONDONO&COURTNEY KELSO MAY 16 29
4328 WESTPHALIA RD. -MATTITUCK
SCTM No. 1000-113-9-11 Southold Town
APPLICATION FOR PERMIT Board of Trustees
Dear Trustees:
We hereby submit one (1) original and three (3) copies of the proposed plans,
application, and check for permit approval for the above referenced project.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-487-5290 or email JJPatanjo@gmail.com.
Very truly yours,
J ffrey Patanjo
P.O. Box 582
Bohemia, NY 11716