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HomeMy WebLinkAboutTR-10318A =.7 Glenn Goldsmith, President ®��®v SQ���p®� Town Hall Annex 1 A. Nicholas Krupski,Vice President .� 54375 Route 25 IL P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly G � Telephone (631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 4jAr, it), 2.01 INSPECTED BY: EV%ZabVkh �ee�les Ch. 275 Ch. 111 INSPECTION SCHEDULE a Pre-construction, haybale line/silt boom/silt curtain 1 st day of construction % constructed Project complete, compliance inspection COMMENTS: Prbi vl- i5 cann0li n4 WR-k p rmi} #" IO-5ISA Okay It itsuL CttAclx� c�' Cannn�ia�tilc� i CERTIFICATE OF COMPLIANCE: i e Glenn Goldsmith,President ®f S®(/�� Town Hall Annex A. Nicholas Krupski,Vice President ® ' ®� 54375 Route 25 °� ® P.O. Box 1179 Eric Sepenoski J�i Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 Conti 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 J( St C1}U rvp tNWe0-kfTV FtksT�uT QF Pitt % constructed When project complete, call for compliance inspection; 1 Glenn Goldsmith,President w`�A``OF SO(/711 Town Hall Annex `v A.Nicholas,Krupski,Vice President ,® 54375 Route 25 P.O. Box 1179, Eric Sepeinoski Southold,New York 11971 Liz'Gillooly CA ,r G @ Telephone(631) 765-1892 Elizabeth Peeples �Ol �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF.SOUTHOLD Permit No.:' 10318A Date of Receipt of Application:,-,March 1, 2023 Applicant; William,A. Erhardt & William D: Boltz SCTM#': 1000-54-5-46.2 Project,Location: 11985'Soundview Avenue, Southold Date:of'Resolution/Issuance: March 15, 2023 Date of Expiration:, March 15, 2025 Reviewed by: Elizbeth Peeples,.Trustee Project`Description: Remove/trim weeds and brush, replace with native plants/grasses', remove existing wooden dock.; and fora Ten (10) Year Maintenance Permit to'hand cut Common Reed (Phragmites Australis) to not less than 12" in height by hand, as needed. Findings: They project meets all the requirements for issuance of an Administrative Permit set forth,in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit-allows for the'operations as indicated on the project plan prepared by William A. Erhardt, received on March 1, 2023, and stamped approved on March 15, 2023; and'the planting plan prepared by William Erhardt, received on March 9, 2023, and stamped approved.on March 15, 2023. § 276-5 Permit procedures. (i)_ Cutting-of common reed (Phragmites australis)'to within 12 inches of the soil surface landward of the wetland boundary. This does not include mowing to ground level. .Special Conditions: Do not disturb native vegetation during.the hand`cutting of Comi on Reed (Phragmites ausiralis), including but not limited'to; Eastern Red Cedar. (Juniperus,virginiana)'; Northern Bayberry (Myrica pensylvanica), Marsh Elder(Iva frutesceris), and Groundsel Bush (Baccharis halimfolia). Establish and perpetually maintain a 20' wide non turf, vegetated buffer along 'top of bank. The Permittee_is required to.provide evidence that a'copy of this Trustee permit has been recorded with"th'e Suffolk County Clerk's CQffice,-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 approved operations must be commenced.;within two (2),years from the'date of the ' resolution. Thepermittee is required to provide the Trustees,with before and,after photos of the area within this time period before any further maintenance is . conducted: 1 f If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees Ciienn Goldsmith,President ��S�I COGy Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �y • 0�� Southold,NY 11971 Elizabeth Peeples � �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: L Completed infield by: Q17AJ+ Pe-ales WILLIAM A. ERHARDT & WILLIAM D. BOLTZ request an Administrative Permit to remove/trim weeds and brush, replace with native plants/grasses, remove existing wooden dock; and for a Ten (10) Year Maintenance Permit to hand cut Common Reed (Phragmites australis) to not less than 12" in height by hand, as needed. Located: 11985 Soundview Avenue, Southold. SCTM#: 1000-54-5-46.2 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: V/ Chapt.275 Chapt. 111 other Type of Application: V1 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.: FU.jy s i+rtcytpSe of �6r v�4e ►�cd bvF ea/ b ZD`A" a1 sunelu n�av►li►�9► alaxft Present Were: G. Goldsmith N. Kyupski E. Sepenoski L. Gillooly �/ E. Peeples NO. DIS-MICT: 7000 SCCTON: 54 OLOCK: 6 l�•;. MAR e 1 2023 11 �l� 1� r� l �\y '�\`I�Vk vIYA77 AND A(lJl-1i 1::C)N _ (� LAND "Zr I o{ MO V S/AGES M N. X14�6A % r • � Y 1- w K \ PPROVED BY f+II+L _ BOAR® OF "i RUSTEES TOWN OF SOUTHOLD � 9 -3 T. t ®ATE - l.11 �s ZDz3 [.laNf1 _N/F 3 � 1 J rJ � MANOS ta I u] "-on, 9,NIT' C'r) - •L^bl•OO'•JT •[Z. ' SOUNIDVIEW AVENUE THL- WA TEN Wf,-LLS ANf> CC:i=:F'UCJL LOCATIONS SA410l1Tf ANE lwOM I-ICLO ONSEJ7 VA TIUN!; ANO OK OATA OF37'A/NEO FROM Ufl/EN.S. Ah'L_A' 46.503.5 f SOFT_ or 7.07 ACRES f1,1 VA 11U" tlA TUM, - I/NAV At IFMA//UN CW AL>UJT/UN TO 71115 "iV{?VCY 1S A 1,74LATJQN OF SEC7/CJN 72U✓ OF THC NCbi+ YONK t;TAll- EOGJCAf/CJN /.AW, CCJI�/!:"i Uf 111— "V, MAA1 N07 f7F'AN/NG /111" LANG SVRVf-YOR'S' I:ML�OSS/."O SC_AA. �iNALL NCJT Fll: CON51Of_NL"U /O dL• A VAJ.IO Mur COf+Y fi-IJANAN%F L'� ICA JLU 11C.YT/'CJN :':"At, CJNI,Y TO 1HE !f_"h'SUN 1.01.• K"GIA4 IHL' i'UNVEY /S- I, &WAN4-0 ANO ON HIS 4fEHAf. TO THC TI TLC GOM/MANY, GC7 K/tNM{NTAL. AC.'F.NC'Y ANO I.f'NUfNC: 1N:.`/1111//1JN l/1:!/U H!-%l/"0N, ANU JU TF/C A.?f:IUNI"/5 0l- 71lC LC.'NtlINC /NST/TLI T/ON, GUAI7AN Tt-!-S ANF NUT 1NANiF I//C Of'l-WI : U/a• O/Mf N.S'/UNS Sl'IOWN f1F.10170" fWOM 7//C f+RUF+EFITY LINOS TO Tl/E S!{?IJC Ttlllf;S A{1L {UN A iACC/l%C J+llNP 051' ANLJ IJ-f- fJfV••1./017.' 11.11 Y .lr./ NNLL/Oh'- /f' TO /IMfh/LJl1/.NfNON TOU FER ' r?U4 Oft AO 0JLC? /AW W O W Ml _ :/'M//' IN f! 7F0U . N AN J ;ilJf3:iVh'%Af:L Vii!/1VCTU/?E.ri ?!.'CCN?OEU 0f•' LINNf.CUf7L7L.0 Al?L' NUl CVA/?ANJf lTI UN(f-SS a+11 Y�/G ALLY 1.F+fU%NT UN r'F/L iIAVMISI-_. AT fill- IIMf CJI .I Jr:V.• Y tiVitvl Y Of OESCR[QEO PROPCRfY CER71F'IE_IJ ICJ: WILLIAM OOLTZ: WIt_L,fnM C{2!-In/i`f)1, MAI+ ()I F_f_p_Et-ITY N_A7i0_N_AL TfTLC fNS _CO - _:i I V A[ti f) Al' SOUT"OI_p 'l UWN of SOUTh/OLO KENN�TH_,M__. 690YCHY.TK-_ I+_S_ SUI-1 Pf_K CUVN I'Y, MEW YpIIK X--.1 Survoyimmg nmmd Dcaigmm - _ �// „11,1 p_0_ Hoa 3. Edniti 6e1c1C. 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AC;F"r_.Y AIV" 1"SIfIt'llo- I mll 11 10 rAff-- ASf;lt'"j-j!7 OX- 7ttr ARF' "e�r _,"ry Lt"Cg rC, rAIC Ole 'CCff_fC ';I It/C all-I sf 11. cNe NS/ONS SA-10 KW I M.-f?lre)lv JAlCM4 7f/C "R10AW A"y 0 A :rF "Uh?i"GISe: AIVI- U Ito/'/tel./CJ/W_' I'll Y AAY 01* rC.7 AfC.WUAWl-"f 7�ft: �MOAII.'HIY 111VI-S C7" 7`0 CUADF.- r",r f.7f,11.CT?0" 041- rV.'1VCVr. A0z:ljrlc;)"-4I M-UCrU"I.-S OAP ANO e�rt ICA, m,IV 1`� 1,A!;1'111 124-COHOLL7 0" U"~,COrl01:W "0; VUAieA-Ill 11 u"ll-SU ON f%./( 1,111- 11"f CW •./J1:V.• SURVI-V Of':' OrscRieco I-Rc>j­-l:Rry CERTIVIVE> TU: WILLIAM 130 Wit.L.MMV1,1f.tAlklm. IIIID ..JF-M0RC;AJ`4 Zi IASL—BANKN. IOWN CIT V C:)L.K CC>L)Nf*Y. "[-VV YORK ft" ID--Ag- DO= n. Mwtlllt.11L.cI.. rq3- 'Vox,31c. 115132 SCA(F: 7 f3A'fE:Af-FZfL 2?. 2072 Pno"E (631) 200-1500 FAX (031) 000-1500 f OFFICE LOCATION: ®'*0 ® ® MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) c� Southold, NY 11971 �� Telephone: 631 765-1938 ®l�C®U ,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: March 15, 2023 Re: LWRP Coastal Consistency Review for WILLIAM A. ERHARDT &WILLIAM D. BOLTZ SCTM# 1000-54-5-46.2 WILLIAM A. ERHARDT&WILLIAM D. BOLTZ request an Administrative Permit to remove/trim weeds and brush, replace with native plants/grasses, remove existing wooden dock; and for a Ten (10) Year Maintenance Permit to hand cut Common Reed (Phragmites australis) to not less than 12" in height by hand, as needed. Located: 11985 Soundview Avenue, Southold. SCTM#: 1000- 54-5-46.2 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 and the records available to me, I recommend that the proposal is CONSISTENT with LWRP Policies and with the LWRP. It is recommended; 1. that the planted area be established as a vegetated buffer; and 2, condition no reconstructed or new docks are permitted in Lilly Pond, regardless of permit status. 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 ? �~ F so Town Hall Annex Glenn Goldsmith,President � 't�1; ski,Vice President ', 54375 Route 25 A.Nicholas Kru p Y ` P.O.Box 1179 Eric$epenoski Southold,New York 11971 Liz Gillooly cn + G 4' Telephone(631) 765-1892 Elizabeth Peeples � �` orf Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For C - Office Use Only ) a f ? `TCoastal Erosion Permit Application 1F�q I j Wetland Permit Application E't.# ) fnj°r MAR X Administrative Permit 2023 Amendment/Transfer/Extension Received Application: 3•� �3 Received Fee: Completed Application: 3-1-20 Incomplete:_ SEORA Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: oordination:(date sent): -11ZLWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: —X—Public /Technical Review: ✓ Public Hearing Held: Resolution: Owner(s)Legal Name of Property (as shown on Deed): William A Erhardt, William D Boltz Mailing Address: 11985 Soundview Avenue, Southold, NY 11971 Phone Number: 631-876-5134 Suffolk County Tax Map Number: 1000-473889 54.-5-46.2 Property Location: Soundview Avenue between Horton's Lane and Kenney's Road (If necessary,provide LILCO Pole 4, distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Email:bbbe2003 gmail.com Board of Trustees Application GENERAL DATA Land Area(in square feet): 46609 Area Zoning:Residential Previous use of property:Single Family Residence Intended use of property: Single Family Residence Covenants and Restrictions on property? —ayes _ _No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? gYes W1 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? g_Yes - No If"Yes", please provide copy of decision. Va.luhis projectany demolition as per Town Code or as determined by the Building Dept.? re Yes ✓ No Does the structure(s) on property have a valid Certificate of Occupancy? Yes-E]_No Prior permits/approvals for site improvements: Agency Date ✓❑ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?-a Nog Yes If yes, provide explanation: Project Description(use attachments if necessary): 0 Rerv1o11%Tr1n1 Wec 6 eArKJ 4rv�S1,, len/r,�e*C- wl nuAy� ��/�nfs��r�g5�5. V Rerylov eXIShk7ck /y xe-t- MC- 1n1-cl%tpice. fc,-hnly -cs 4- /��n✓'a�iYJ/7 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: (1) Removal of weeds and brush at pond edge (2) Removal of rotting deck (3) 10 year Phragmites maintenance plan Area of wetlands on lot: 4000 square feet Percent coverage of lot: 10 % Closest distance between nearest existing structure and upland edge of wetlands:2p0 _feet Closest distance between nearest proposed structure and upland edge of wetlands:_ feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 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): None anticipated 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 I -Project and Sponsor Information Name of Action or Project: Pond Front Rehabilitation Project Location(describe,and attach a location map): At edge of Lilly Pond (see attached map) Brief Description of Proposed Action: I (1) Removal of existing rotting wooden deck (2) Removal of weeds and brush at pond edge (cat briar, raspberry, poison ivy) (3) Replanting of pond edge with native plants and grasses (e.g. rosa rugosa etc) (4) 10 year Phragmites maintenance plan Name of Applicant or Sponsor: Telephone:631-876-5134 William A Erhardt E-Mail:bbbe2003@gMaii.com Address: 11985 Soundview Avenue City/PO: State: Zip Code: Southold I NY 111971 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2..If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: r;� ❑ 3.a.Total acreage of the site of the proposed action? 0.1 acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned ' or controlled by the applicant or project sponsor? 1.01 acres 4. Che I land us at occur on,adjoining an ar the propq=4 action. Urban Rural(non-agriculture) Industrial Commercial ®Residential(suburban) Forest ❑Agriculture VAquatic QOther(specify): Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ✓ b.Consistent with the adopted comprehensive plan? V/ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is the,site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: Z ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO. YES b.Are public transportation service(s)available at or near the site of the proposed action? ✓ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ✓ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ El 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: Z ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: n F1 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ✓ b.Is the proposed action located in an archeological sensitive area? ✓ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ✓ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? _ ✓ ET If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. ntify inForest the typic bitat types that oc n;or are likely to be found on t�roject site. Check all that apply: Shorele Agricultural/grasslands Early mid-successional ✓ Wetland HUrban ✓Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? ✓ 16.is the project site located in the 100 year floodplain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO If Yes, a. Will storm water discharges flow to adjacent properties? ❑NO ❑YES Z El b.Will storm water discharges be directed to established conveyance systemsff an m drains)? If Yes,briefly describe: UNO ES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO I YES water or other liquids(e.g.retention pond, waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: a ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: Z ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spo sor name:William A. Erhardt Date:2/2 7/2023 Signature: M A Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ D regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ a 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or El 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 EJ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? S. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage El E-1problems? 11. Will the proposed action create a hazard to environmental resources or human health? Q Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT I Page 4 of 4 Board of Trustees Application AFFIDAVIT William A Erhardt BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF ,20 Z✓� Notary Public DIANE DISALVO NOTARY PUBLIC-STATE Of NEW YORK No. OID1475593 Qualified in Suffolk County My Commission Expires April 30, 204 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: William A Erhardt (Last name,first name,ipiddle 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 F-1 NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/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): f2A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); E B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi ��day of 203 Signature I(/wo A• _ Print Name William A Erhardt Foran TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt .minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail,, listing both supporting and non- 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# - - PROJECT NAME Erhardt Pond Front Project The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board Building Dept. ❑ Board of Trustees ❑ 1. Category of Town of Souihold 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: ❑ Nature and extent of action: Removal of existing wooden deck. Removal of existing plants and weeds. Replant] with native plants and grasses. 10 year Phragmites maintenance plan. Location of action: 11985 Soundview Avenue, Southold, NY 11971 Site acreage: 1.01 Present land use: Single Family Residential Present zoning classification:Residential 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: William A Erhardt (b) Mailing address: 11985 Soundview Avenue, Southold, NY 11971 (c) Telephone number: 631-876-5134 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 LVVRP Section III—Policies; Page 2 for evaluation criteria. ✓❑Yes ❑ No ❑ Not Applicable By removing the existing wooden deck, we will return the pond front to its natural state. We will replar�a with native plants which encourage native animal and insect life. We will trim invasive pharmities to minimize the impact of these invasive plants. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑✓ Yes ❑ No❑ Not Applicable See above 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 S through 16 for evaluation criteria ❑ Yes ❑ No FY(] 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 ❑Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section IH—Policies; Pages 22 through 32 for evaluation criteria. R Yes ❑No ❑ Not Applicable By planting the shoreline with appropriate native plants, we will support and enhance the natural appep and water quality of this pond. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑✓ No❑ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes Z No ❑Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. n F-1YewNo❑Not Applicable Attach additional sheets if necessary 1 ` WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑Yes Z 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 0 No 11 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑Yes ❑ No❑ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No ✓❑ Not Applicable PREPARED BY i0wc A, CSC TITLE OW W21'" DATE 3 / 0 1 ' Glenn Goldsmith,President �q ®UjtTown Hall Annex 111 is 64376 Route 26 A.Nicholas Krupski,Vice President { i j P.O.Box 1179 Eric Sepenoski £ } t Southold,New York 11971 Liz Gillooly . ; p l�� Telephone(631)765-1892 Elizabeth Peeples Fax(631) 765-6641 UUPn�� �t� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OTHER STATE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Environmental Conservation (DEC) SUNY at Stony Brook 50 Circle Road Stony Brook, NY 11790-3409 (631) 444-0355 Wednesday & Friday only during the hours of 8:30a.m. —Noon & 1 p.m. —3p.m. Email: r1depCa..gw.dec.state.ny.us Suffolk County Dept. of Health Services Office of Wastewater Management 360 Yaphank Avenue, Suite 2C Yaphank, NY 11980 (631) 852-5700 Email: WVVM@suffolkcountyny.gov U.S. Army Corps. of Engineers, N.Y. District Attn: Regulatory Branch 26 Federal Plaza, Room 1937 New York, NY 10278-0090 (917) 790-8511 Website for applications & helpful information: http://www.nan.usace.army.mil/Missions/RegulatorV.aspx N.Y.S. Department of State Division of Coastal Resources Consistency Review Unit One Commerce Plaza 99 Washington Ave, Suite 1010 Albany, NY 12231-00001 (518)474-6000 Website: www.nvswaterfronts.com OISTRIfu T: 7000 SCC71044: 54 OLOCK: 6 LOTCS): ,1�r/`•1�� � \ LUNO N rU J' 'r" !✓-(v''(• ��(Y j`• /� \ Ff Yn JT ANU A!017"1 ti C)N _ SAJ r POND _ MON. d.2� _.. _. _ _._ .._.• ... CANU N/F MOt OF SGS .4— _ m L � ?� 80.:1' cf3' LANO fANO N/F OF CnPELI.VTO 0_ v �_ � COtiG. �. O N � f LIX:t: Of VAVVML'N i' SOITNDVIEW AVENUE THr. 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