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Cedars Golf Club, LLC
=fit t 0F01 YZ;� Michael J. Domir; r psident O�QS ' C. Town Hall Annex John M. Bredemeyer III,`Vice-President �P 54375 Route 25 Glenn Goldsmith y a P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams � ® p! Telephone(631)765-1892 ��1 �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: /� �� Completed in field by: CEDARS GOLF CLUB, LLC, c/o PAUL PAWLOWSKI requests a Wetland Permit to make the existing ponds larger in order to create a better ecosystem by digging the ponds 1-2 feet deeper while removing the Common Reed (Phragmites australis) that is in and around the ponds; the three ponds that currently exist will be excavated in order to create one large pond which will allow the ponds to circulate better with the creek to the south and improve drainage; no large trees will be removed; all fill is to remain on site; and any disturbed areas around ponds will be revegetated with native plant material. Located: 305 Cases Lane Extension, Cutchogue. SCTM# 1000-109-5-16.3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: �et✓ q,iSo WWI a � �l✓� a G✓a/j �ecn'Vg �1Per 4- &PAJ . wo ld 14 �0 'j"+(&r DPS be C,S1a✓. I have read & acknowledged the foregoing Trustees comments: Agent/Owner: _ Present were: J. Bredemeyer M. Domino V G. Goldsmithy N. Krupski "-" G. Williams Other i N _ SURVEY OF PROPERTY AT T TOWN OFSOUTHOLD SUFFOLK COUNTY, N.Y. 1000-109-06-16.1 SCALD 1'=60' OEM*"24 2005 JIAJE 26.2006(REVISION) P,9 jx CEDARS ROAD i sz�s 359.7J' DEED h I .°i DE►ELOPfENT RKil15 EASEIENT N A,/D/F Haft 6 Z as \ 17975. avo C�WWXD 70.1 ��•� � 5 �A& ?VM OFSOU7FKL0 1 SIFWART T/RE R� % DEVELOPMENT R/QH7S EASEMENT 5.6984 ACRES S9< RESERVED AREA 1.0600 ACRES AREA OF FIVE PONDS& TIDAL WETLANDSTL =0.6736 ACRES OR 291340 SO.FT. ANY u IMADM CR Amnw m 7W"WY 5 A aae MW % N.CS UC. NO. 4618 OF Mcnav 71v9OF FW NEW MW STALE ELvrli uw COIWC £YOR$ P.C. cMPTJVWMAs rE gcnav n"AP CCF z. 7A FaCV?mOW nays AREA-6.7586 ACRES OR R60.!BOX gpy20 FAX(631) 765-1797 I�FIEFa.�ARE Ca- SCBE,NSC 4 AND ED SE AE11Ea�as r i l2J0 TRAVELER STREET SAD YAP ON OW A EAR nr YNBES3D SEN a-itC 9RK1'cle .Nag va+Anaa APPEARS N[nEov. 294,404 SO.FT. SOURIOLD. N.Y. 11971 06-2M J N SURVEY OF PROPERTY - AT CUTCHOGUE TO OF' SOUTHOLD �'�� � � SUFFOLK COUNTY; N. Y. J: IOW-109-05-161 SCALA 1'=602 DECEMIMER 2$ 2005 JUNE 26, 2006 (REVISION) -4Y CEDARS ROAD 1 �OQ00, S89-202400E 359.73' DEEDA N8970'40 124.3S' �" EDW OF PAYE711 r �! tAWN N/O/p- y T tph rw cam i' O ryN � 9 u Par ; ry DMCTPUBVT RIGHTS EASEMENT mows ` k , ,y�� 2 GOLF COURSrI i ry 225,00' l POLE ARK4 fry / z a `< moon ROW CF ARWRWAC ,`„ j GOLF COLOME �80�5'-gAcr 79.75 ,t, •*,` ,,� 4 P ' ctt CERTIf M TO.- 70101 t.70101 OF SOU NOLD ,S7EWrAR'T TME w O DEVELOPMENT RIGHTS EASEMENT 5.6984 ACR S XTJ; RESERVED AREA 1.0600 ACRES AREA OF FIVE PONDS & TIDAL WETLANDS. 0.6736 ACRES OR 29,340 'SQ. FT. ANY AL TERA AON M ADD/TONY TO THIS SURVEY IS A VIOLA TION / N. Y.S UC NO. 49618 OF SEC7XW 7209OF INE NEW YVRK STATE EDUCAn01V LAW. FCONIC YORE P.C. EXCHD?M As PER ID F ON NIS MAP CO 2. ALL EOF ONLY F A m6•7 ACRES oR (631) 765-5020 FAX (631) 765-1797 HEREf11V ARE VALID FOR 7Nt5 MAP AND CAR/ES 7HEREt71F' ONLY tF . . SAID MAP OR COPIES BEAR THE tMPRESS�ED SEAL OF ME SYl�RVE'YAR - � POBOX 909 2 , � SCS. �. 1230 TRA vELER STREET � wftoSE StGWATURE APPEARS HEREON. SOUINOLfl, N.Y. 1)971 105-2681 2,6 .202 N SURVEY OF PROPERTY AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-109--05-16.1 SCALE• 1'=60' MW 26, 006 2005 CEDARS ROAD 1 T S8920'40'E 359.73' DEED - 8 7M m¢a v.Kiw T.rua N/0� -"MKT 6 r � my cnwsc LI h h DE4£LOp1"T RIGHTS EASEWVT At°" 8 I a 'jo-r `' X 4 17975- 4__ 7975' o J �T 551 C 01ED TO. \ � Z TOW OF SOWN= STEWART TIME RD A DEVELOPMENT R1dH7S EASEMENT 5.6984 ACRES LiZ RESERVED AREA 1.0600 ACRES AREA OF FIVE PONDS& TIDAL WETLANDS =0.6736 ACRES OR 29,340 SO,FT. N.Y.S UC. NO. 49618 or C RFA MM LHP PC PE V ro nas TA IF E r A A LA nav CGWC EYDRS, P.C. E EPT AS 170AL1�)GV AEa' SM WS LZ A MW UIK emrT As v[x V FOR rWS� ArNsav z Au tomo AF ATEA-6.75M ACRES OR P60.1 BOX-'FAX(631) 765-1797 PdOMSAV AAC vA((1 rix"WS YAv AAV ED-W nc,J tKY i S'�D camas��nc �' 1Ne"WKW 294,404 SO-FT,. 12JO TRAVELER STREET rY o scriA rt rre HozEa.. SOUTNOLD• N.Y. 11971 —�W e 1: /,, 8,/2019 12 ' 35 Cedars Golf Club,LLC c/o Paul Pawlowski 305 Cascs Lane Ext.,Cutchoguc SCTM#: 1000-109-5-16.3 1/8/19 i .s • 12 * 35 i;,�TI .31 '^ ® _ 777 `ick:, . .01 qr 1 / 8 /2019 12 : 35 Cedars Golf Club,LLC do Paul Pawlowski �. 305 Caves Lane Ext,CuWlogue t 4. CTM#: 1000-109-5-16.3 f' 1/8/19 r ,.• .N .y' ,f 3 ish 1 � •e �, �� A a � . '!• °Y': ,. - ...c. � Ass `;�. :� }-x ` r - y �°:� �•�'T�t 4 7 .. � ` jA� ,p • '�' ,,_. - _"� ,. ' . :T. x'� , '�•lam :.a��s�;ti�" hYit '� f ,s � � - , _ _i' 'i�' ,,rte v f �. r "'.'✓',.tea: •? i Y ^0.PZ'riKrx`i:•�.c •�- M' - ti �-,. .� - y '. ,!'""4. 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"# WON v� OFFICE LOCATION: 0��rjf SU(/rMAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 �O Telephone: 631765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator Date: January 9, 2019 Re: LWRP Coastal Consistency Review for CEDARS GOLF CLUB, LLC, c/o PAUL PAWLOWSKI SCTM# 1000-109-5-16.3 CEDARS GOLF CLUB, LLC, c/o PAUL PAWLOWSKI requests a Wetland Permit to make the existing ponds larger in order to create a better ecosystem by digging the ponds 1-2 feet deeper while removing the Common Reed (Phragmites australis) that is in and around the ponds; the three ponds that currently exist will be excavated in order to create one large pond which will allow the ponds to circulate better with the creek to the south and improve drainage; no large trees will be removed; all fill is to remain on site; and any disturbed areas around ponds will be revegetated with native plant material. Located: 305 Cases Lane Extension, Cutchogue. SCTM# 1000-109-5-16.3 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 action is INCONSISTENT with the Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold's ecosystem. The existing ponds provide important "nutrient sink" functions for nitrogen and phosphorus fixation. In addition, the action would result in the physical loss of mature, wetland habitat, wildlife and other wetland function and values. The following needs to be clarified: 1. Will the action dredge existing ponds or only expand the ponds through excavation of upland? 2. The cubic yards of material excavated and disposal location has not been provided. 3. The slope of the littoral zone post excavation has not been provided. 4. The spacing, density and survivability of planted vegetation have not been provided. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Melissa Spiro, Land Preservation Coordination Y gg+�fFO�,k Peter Young,Chairman ti 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., January 9, 2019 the following recommendation was made: Moved by John Stein, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of PAUL PAWLOWSKI/CEDARS GOLD COURSE LLC to increase the size of the ponds, remove the phragmite and dig the ponds deeper to allow them to have a better ecosystem. Dig the ponds 1-2' deeper while removing the invasive phramite. Replace phragmites with native plant material. Located: 305 Cases Lane Ext., Cutchogue. SCTM#109-5-16 Inspected by: John Stein The CAC Supports the application with the requirement of an updated survey. The CAC questions whether this project has the approval of the NYSDEC. It is also unclear as to who the agent is for this project. Vote of Council: Ayes: All Motion Carried OFFICE LOCATION: MELISSA A. SPIRO _``�QF S0 Town Hall Annex LAND PRESERVATION COORDINATOR �OVv Ol0 54375 State Route 25 melissa.spiro@town.southold.ny.us (corner of Main Road& Youngs Avenue) Southold, New York Telephone(631)765-5711 CA MAILING ADDRESS: www.southoldtownny.gov P.O. Box 1179 Southold, NY 11971-0959 DEPARTMENT OF LAND PRESERVATION TOWN OF SOUTHOLD D EC EME To: Michael Domino, President AN Southold Town Board of Trustees i 0 2019 From: Land Preservation Committee southoid Tmn Board of Trus e s Date: January 10, 2019 Re: Cedars Golf Club, LLC 305 Cases Land Ext., Cutchogue SCTM #1000-109.-5-16 At its regular meeting held on January 8, 2019, the Land Preservation Committee members reviewed the Wetland Permit application presented to the Trustees by Cedars Golf Club, LLC requesting approval to dig out, remove all phragmites and enlarge three ponds that exist on the property in order to create one larger, wider pond upon' land on which the Town holds a Conservation Easement. As per the project description.included in the Trustee application, it appears that this application is to'improve drainage on the property. The LPC reviewed the recorded easement and the following motion was presented and passed by the Committee'members: " MOTION made by Eric Keil, seconded by Lillian Ball, that the actions described in the Wetland Permit application submitted to the Southold Town Board of Trustees by Cedars Golf Club, LLC, to-dig out, remove all phragmites and enlarge three ponds that exist on the property in order to create one larger, wider pond is consistent with the terms of the recorded easement. The Land Preservation Committee's action does not mean that such proposed uses and activities will be approved or permitted by other Town Departments or agencies. This easement consistency review allows the applicant to proceed with pursuing any applicable approvals that are required by Town Code. Michael J. Domino,President �Qf SO(/�y Town Hall Annex John M.Bredemeyer III,Vice-President ,`O� Ol0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q Telephone (631) 765-1892 Greg Williams �� Fax(631) 765-6641 �l to.UNTY,Nc� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Norman McCullough, Chairman Land Preservation Committee FROM: Michael Domino, President Southold Town Board of Trustees DATE: December 21, 2018 RE: Cedars Golf Club, LLC 305 Cases Lane Ext. Cutchogue SCTM# 1000-109-5-16 The Board of Trustees received a Wetland Permit application for the above referenced property to dig out, remove all phragmites and enlarge three ponds that exist on the property in order to create one larger, wider pond. As this property has a Southold Town Conservation Easement, the Board of Trustees are forwarding you a copy of the . , application in order to determine if it will need to be formally reviewed by your Committee prior to this Board's review. Currently, this application is scheduled for our January 16, 2018 public hearing date. If you require any additional information, please don't hesitate to ask. Attachments John M.Bredemeyer III,President �%qf SQ(Jr/f/� Town Hall Annex Michael J.Domino,Vice-President '�O l© 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G Telephone(631) 765-1592 Charles J.Sanders,Trustee I eoumi Fax(631) 765-6641 BOARD OF TOWN TRUSTEES D E CCS E � V E TOWN OF SOUTHOLD Office Use Only NOV 2 6 2018 oastal Erosion Permit Application Wetland Permit Application Administrative Permit Southold Town /Received -Exte sion ar a Truste Received Application: Received Fee:$ 26A-60— C 60,D(7 Completed Application 11. D _Incomplete_ _SEQRA Classification: Type 1 Type 11 Unlisted oordination:(date sent) LWRP Consistency Assessment Form DAC Referral Sent: �2•Z�. ate of Inspection: + _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Name of Applicant Paul Pawlowski Cedars GolF do-16,1,LCz Mailing Address 305 Cases Lane Ext. Cutchogue NY, 11935 Phone Number:( ) ( 6 31) 445-4348 Suffolk County Tax Map Number: 1000- 0109-05-016416J1, Property Location: South of Cedars Rd in Cutchogue, NY and immediately West of the Salt Air North Dike System _ (provide LILCO Pole #, distance to cross streets, and location) C. (If applicable) A Phone. Cedars Golf Club Ponds Project description With the ponds at Cedars Golf Club over the years the phragmites have taken over the pond, the ponds have had soil silt in them overtime which has effected the ponds and the overall health of the wetlands. Recently this past storm the dike was breached that was just south of them causing debris and soil to silt in at a rapid rate. Not only are the ponds to shallow for normal tidal movement they have also become a drainage issue for the areas around them and basically every rainfall they are overflowing. We would like to make the ponds larger, remove the phragmite and dig the ponds deeper to allow them to have a better ecosystem. We would dig them 1-2 foot deeper while removing the invasive phragmitie. There are currently 3 ponds that we would like to make one pond. Please see attached rendering showing the basic size increase. . By doing this this will allow the ponds to circulate better with the creek to the south,will allow for more wetland species to live and multiply. This will improve the drainage in the area while reducing lawn area and adding to the pond size. NO large trees need to be removed during this process; all fill will stay onsite and not removed from site. Around the pond we will plant native plant material in place of the phragmities Board of Trustees Application GENERAL DATA Land Area(in square feet): 9,400 SF Disturbance/ 250,885 SF Parcel Area Zoning: agricultural Conser Previous use of property: Golf Course Intended use of property: Golf Course Covenants and Restrictions on property? Yes x ~No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes x 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 x 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 x No Does the structure(s)on property have a valid Certificate of Occupancy? Yes n/a No Prior permits/approvals for site improvements: Agency Date Southold Trustees 07/x/2014 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No Yes If yes, provide explanation: Project Description(use attachments if necessary): �C� `Z � Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: The purpose of the proposed actions is to prevent flooding during storms surges. Area of wetlands on lot:Approx 26,5 0 Osquare feet Percent coverage of lot: 10 % Closest distance between nearest existing structure and upland edge of wetlands: Approx 2 6 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? T•B•D• cubic yards (Garbage on surface will be removed as necessary) How much material will be filled? cubic yards Depth of which material will be removed or deposited: T•B•D feet(Garbage on surface will be removed as necessary) Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: utilizing low ground pressure equipment. 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): Will prevent freshwater wetlands from flooding with salt water during severe storm events (see plans) Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: We are proposing to rehabilitate the area damaged by Are wetlands present within 100 feet of the proposed activity? No X Yes Does the project involve excavation or filling? No X Yes If Yes,how much material will be excavated? T.B.D(cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: utilizing low ground pressure equipment. Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed,including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) There will be no environmental 'impacts bebause the proposed work includes measures to protect from soil erosion u• John M.Bredemeyer III,President ,rjF SObTy� ' Town Hall Annex Michael J.Domino,Vice-President O `� 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G Telephone(631) 765-1892 Charles J.Sanders,Trusteedl,f• Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30-YEAR MAINTENANCE AGREEMENT EROSION PROTECTION STRUCTURES CHAPTER 111-IS OF THE SOUTHOLD TOWN CODE l(We) Paul Pawlowski The owners of record of property at: 305 Cases Lane Ext. , Cutchoaue SCTM#1000- 0109-05-016.& in applying for a Coastal Erosion Permit for an erosion protection structure do hereby agree to a 30-Year Maintenance program for a structure as described: Cedars Golf Club Dike as shown on the attached licensed survey and/or site plan for the approved structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years and/or equivalent to the original approved structure. Any maintenance which involves more than 50% of the length of this structure requires approval of the Board of Trustees. We further understand that failure to maintain the structure could result in a requirement to post a bond and/or have the repairs ordered as a lien against the property upon a finding by the Board of Trustees that said lack of maintenance would risk life, property or important natural resourc features. Notarize signature of owner of record Notary Public CONNIE D. BUNCH Notary Public,State of Now York No.01 BU61 85050 Qualified in Suffolk County Commission Expires April 14,2Qd\_ This maintenance agreement shall only be valid upon the attachment of a licensed land survey/and or site plan made within one year of the original construction and validated to show the final approval of the administrator. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: 1-11121tv Cedars Golf Club Rehabilitation Project Location(describe,and attach a location map): See location map Brief Description of Proposed Action; After Superstorm Sandy hit Long Island's coast, approximately four and a half miles of levees/ dikes were severely damaged. The proposed work will rehabilitate these dikes to higher elevations to prevent overtopping in the future. The project will also include a maintenance plan for these dikes. In the past, large woody vegetation was blown over during storms and their root mass cleated weak spots in the dikes. The maintenance plan will allow the dikes to remain trimmed in such a manner that the risk of tree's overtopping will be low, due to to maintained low profile of vegetation. Name of Applicant or Sponsor: Telephone: 631-445-4348 Paul Pawlowski(Owner of Cedars Golf Club LLC) E-Mail: pawlowskibiz@gmail.com Address: 305 Cases Lane Ext City/PO: State: Zip Code- Cutchogue NY 11935 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 TI 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: ❑ a NYS Department of Environmental Conservation US Army Corps of Engineers 3.a.Total acreage of the site of the proposed action? 5.75 acres b.Total acreage to be physically disturbed? 0.2 acres c.'Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 6 . 8 acres 4. Check all land uses that occur on,adjoining and near the proposed action. E]Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ❑Residential (suburban) ❑Forest ❑Agriculture El Aquatic ®Other(specify): Golf Course ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 1:1a 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: D ❑ 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? X❑ ❑ 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 El 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: _ a ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: _ a ❑ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ EJb.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? El ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres; 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ ❑ 16. is the project site located in the 100 year flood plain? NO YES X 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ ❑ a.Will storm water discharges flow to adjacent properties? ❑NO YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? I f Yes,explain purpose and size:W ❑ ❑ 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: i Ffll ❑ 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? I f Yes,describe: ❑ ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Appi icant/sponsor name: Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 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?" T No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? G. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, E]waterbodies,groundwater,air quality, flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may cony occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? [4 11. Will the proposed action create a hazard to environmental resources or human health? R I� 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 imps ts. Town of Southold-Board of Trustees Name of Lead Agency Dat Michael J. Domino President Print or T e Nam of Resp nsible Officer-in Agency Title of Responsible Officer Signature of Respol sAeOfEer inLead Agency Signature of Preparer(if different fromResponsibleOfficer) PRINT Page 4 of 4 Board of Trustees Application County of Suffolk State of New York BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN 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(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Property Owner SWORN TO BEFORE ME THIS c�.6 4 DAY OF)Jtj" ,20z Notary Public CONNIE D. BUNCH Notary Public,State of Now York No.01 BU6165050 Qualified in Suffolk County Commission Expires April 14,2Qa►D Board of Trustees AppT ation AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID 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 264 DAY OF ftffpaeffiz_ , 20 �g 114f* Notary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. O1 D1475593 Qualified in Suffolk county My commission Expires April 30. 202 i + + TA APPLICANT/AGENTlREPREST;N .TIVF TRANSACTIONAL DISCLOSURE FORM Thr Town d0oudiold's Code o Ethic;nrohibitr conflicts of interest oil the part of towns officers and cmnlnyees The purpose of this form is to provide iia ination which can aierl the town of posrible cgOfliets of nntcrost and allnw it to take whataver action is necessary to avoid same.//�� / �,,A YOUR NAME: zq� l -� ✓/ ' "`�`� 4 _ (Last name,first name,aaiddle 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 TrusteetiC� i • Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (]f"Other',name the activity.)�_�__ Do you personally(or through your company,spouse,sib]ing,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 intcrest'+means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by).a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated.' Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the"appligInt (when the applicant is a corporation); B).the legal or beneficial owner of any interest In a non-corporate entity(whefi the applicant is not a corporation); C)'an officer,director,partner,or employce-of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 0 day of 200�� Signature G �__. Print Name Form TS 1 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK ��iaw��•' ,residing at being duly sworn, deposes and says that on the e9k day ofd , 201Ldeponent mailed a.true copy of the Notice set forth in the Board of Trustees Applica ion, directed to each of the above named persons at the addresses set opposite there 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 at /�-r/e G�,�-�- ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of D `Yl.� 20�� Notary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. OID1475593 Qualified In.Suffolk County �/ My Commission Expires April 30, 20�ZV SE&ION COMPLETE THIS SECTION ONIDE.LIVERY r A- na re 10`=Com lete�items"1,2,and 3. ■`Print;yoiir riame..and:address'on the reverse_ D Addressee, so:that,we:canreturn the card to you. s i Attach'thls'card'to the•back of the,ma'ilepiece, B. eceived (Printed"Name}; C.'Qate of Delivery Aron the.front ifspace permits:' fl "a :. `m''.:;• '. ;,, ,deliverydress d'ifferent'from item.l? . 3 Yes„ ES;.entec delivery'address below:; ❑No'"- . James &Phyll b--, rA . is,�u 745 Cases Lane Ext •,f { Cutchogue,NY 11935 ❑Prio Mao Fxfin ss(� ,I L.I'I I I I I I'I IMI Adult�Signat rhe Restrictedjf9elivery:'`: Regis red Mail,Restrrctea II�IIII�I��IL�III�IIIIIOIIIII . [],Adult S9n Delivery :'': •:: ;. `.:. . Q Certified MarKel'';,--.' 8590 9403,0380.5.163 6186 04..'_,.. ,' ❑,Certified Mali Restwed Delivery <. a,Retum Recelptfix { ❑Collect on Delivery:;.:' Merchandise OCollectgnDelivery:Restricted"bdivery:',OSignatureConfuniation ' •;2i:.Atticle:Number/Transfer'from serdce'%ahe11�`°_'.:``.: . -'_ rfv;, ._.,.:;',,.pSignature`Conivery, fl�7 l Q i p Q 4 $ 6.5-- 21t�L' StriCte� Restjictecl Delivery, s Doritesti ,Retum;ReoeipY is PS Form'381.1,April 2015 PSN 76807,77 -02=000=9053 1.Yti t 's • • • SENDER;. • . 'Com leteitems.l':2"and3: A" r are' ?. l�A ent' L 't e :17........ .. ... ......... Pnnt.yourna me'and'ad dress on.the rev m so tHat. 1:.o Addressee i we'Canreturn the card,to-you.; . '�%B;.Received'by.(Prtnfed"Name)�'';,,.n.. C.Qate of Delivery: . ■ Attach this card to'the.°back of the;mailpiece;. , or arf the froht'if;space permits: delivery.address yea t th �• if YES,Cttter delivery:address.belR ; '❑No Wichae'i`1loldings, LLC .J Wickham ohn L Rd .1�1'�?52 Harford :sc rm MD 2105 7 Gt A t dolt Si n tore%:,, . °:"-.'%;;t;.4 ?.'.;:.`❑Rns ttYered Matpre ,`., il I IIS 1111 11��ll'.; 1111t'l.��I'II'�'IIII'��.��III � r.:'O;AduitSigfiature;Restrtctedi�elivery,;' `?'Q Re�gisteted,MaiiPestrio4ed 9580 9403 0380 5163 6186 42 Q certified Mail,. Dolrvery M.Certified Mail R®st[Icted DeUvery:. pettirri Receipt for tt� ❑'EollectonDefivery. .." '. =! ::;. ,-''`•-" `.CgileMy h liv estrldted�f)eliSignaturr:.Confirrr�tion�"^ ' E-Anccle u1'r*�eT4rr erSron�ervice-�a 1e�'—� j j j a� •' tyyt ❑ rgnatiireCoofitmatton,;,% :+ 7 15 ' d 6 L7 ' 0 0 7' `5 6 5 '4 2 5 tl'w j I I t'' aicite;Delive ' estrlot ed,Delivery ( 11 i{2015 PSN 7530-U2AQ0-J053" s r "'` tic Retum Revel k PS:Form:38 ',Apr t.:. :Gomes i?. .. . -- 1 ' +i • • SECTION 0:Com Rlete�iti m§1 2",And 3: A.;Signature P.. , , D.A e.. S.• nt 4 ..�� Pr'nt..'oiirname''andaddress on he re � j 9 #h'at w ".carr return the card to ou::;- ' '""'^r'' •'='„`„}' `;' Addressee. y :.... _.: . - - . IR:-Attach:this;oardto`the.back:bfthe'mailpipce; B:''Received,6y(Printed'Namej C:'D te.ofpelivery,;{ �ar onAhe#rout ifws ace: ermits:: P?�09 P.. I?. 1._ArEicle Addre§sed to: ___ _ `D:':Is,deliveryaddress iiifferen#;fFom`item:l?;:..�Yes, If YES;enter delivery address:belouv:,`,-;.p No:: Bridget T Carey&Ata Dinlenc 300 E 56th St.,Apt. 21C New York,NY 10022 (I,v'I'�'I I'I�1�III'III'IILI�I•�II II,IIIII IIIII'I SII i 13 '6its;Type "11FIegiitered.MI, Q Adutt Signature ❑Registered MadT"r 1 ❑AdultSignatureRestrictedQelivery O;RegisteredMail.Restrlcted( 9590°9403'0380;5163618611 , DCertifiedMia; : :.neuvery, I O Certified Mail Restricted Delivery.'•; ' q:Retum Receipt far- ❑Colleot on Delivery' Merchandise 2 n.tt�iP�N„ ' ' ysransfsic tnrri : 1!__ i tS t Ll.Collecivo D 1�yRestiietedDeii' Q'.Signature.Confirmation- mbar'06401 i,l 1 1 � l 1, ' t ! !! a$igriature"Confirmation 7 015 6 4[l 0 0 01 5 0 6 5 4 2 2,$ ,.,;.;.;; rail Restrloted Delivery Restricted Delivery { PS Form 3811,,April 2015 PSN 7530-02=000-9053" Domestic Return Receipt: -7, COMPLETE THIS SECTION ON DELIV:713Y -ETEIHIS SECTIOA: SignatorN SE COMPL W Agent" IN Print your niame.and address Addre' .,x t3, 'tthat�Aq fiini the card W:y6u! -so ti rated C.Date of Delivery backof&M611pldce, .,o Attach'Ahis'daid-to the 'or on the:fronfit'spacie perm)S., 'D.',Is,delive�yaddreo:dif�*nfrqmjitem 17 Cl: Yes. 'del Wdryaddrbss,.below: -Rubin James&Phyllis 745 Cases Lane Ext I Cutchogue,NY 11935 E1AdultSlgnature',.,,`-'�, 0=nature Rest 'iry,:tt_,A]Ftegistb'red Mail Restricted 11 U 5_S6rVice:ry Restricted MIN, tw ,.-W11 ry Mail® ` ye E3 9590 903 0380 5163 6186x73Certified Ma I F�t `0 Return Receipt for Marchand on Delivery- , - , ""I"Z I Merchandise' _ ❑.Collect on Delivery 0 Collect ry..O'Signa vre Cbnfinn4ii. 2�_Aificle Ndr6b&Mhansferlrom service' U$ignature,0 A oel!yeq, -5 42 0 6 4 0 06 onfirmation : ', 7 .30D71 R A 3:8�.1,;'Qpfi12015`PSN 7530-02-00Q-9053. Domestic R,etdrn ece PS'Foitn COMPLETE THIS SECTION ON DELIVERY SENDER"COMPLETE THIS SECTION A.Siq Fe X��Cornpjete itbfnS,1,2,and 3.`.'�:: t:,�,! Y .13,Agen t e'revepse, )t,.Prjnty oqr,n�mqand adirpss;on [J'Ad ressee nreiurri,theCardt6�y . .. .. '60,4,wppan , , -, , by I.e. Da of_b���Rec64d `11l.Attach'Ahis ceirdis '16theback of thiefirlailpi .6ronlhk ront q pace permi s,-tt, f-S `D.,16deliveiy�edd '0 Yes ress�cfi#6ri ffrom-it' JAjtk� to::- 9M If YES;enter delivery::address beliivr:' [2 No James B.Ray,Jr,Thomas Ray, Maureen Ray,John Ray 10 Huron Ave.,ON Jersey City,NJ 07306 A Type ; E3Pdofity ai, VW9 OAdulltsiSignature ngtura II"Regis n atureReitricted Man IF16sirl' 9590:9403.0380 5163 61,87 03 ❑cert,ered Mali® Deliveryt pt for Merchandise- ff Delivery S[gqat6re.Con -El Signature ponfirinait4h astricted DellixTY --Re -D x P5 Farm^381•},'Qpfi12015:PSN 7530 02=000=9053;: 777777� X.— SENbER: COMPLETE THIS SECTION' COMPLETE tHIS SECTION ON DELIVERY. 2, 4 f::,jiPr1n y6ur`n!rn6 and atddresis-�h',6l1'1" Add''.'s;e? p card t t to the backof ecilv6dbj P &'Atta'c`fi'-thiSb`a' E %int6d' C.Da of D iv6 Ar e,. l"Y" pace Ml 06 t 7 llt�o e,ront.if s I ron,th f' 1§deflyery� -4doiesi,dilidrerit irbrniftern j? Yoe's IfYES,6nWr deflVo&id&es,6 below: '..pNo Raymond&Elizabeth Hulbert 170 Cedars Rd. i Cutch6gue,NY 11935 3. Service�TYP 0 [3 Priority Mail a(iini6so. `+`` 4II'fI�III 0 Adult Signature `,QRegistered*Mail-* 0 1616d'd�111;*iY', ':"O R69ISteed Mail Restricted NDE 771 x I'I(I III ....... IL I'I�I II I I(L Adulrsignqi4re R* -Deliverycted • 9590940$0380.51.636186 28>": 0 Ctirllfied Mail® : El Certifidd.Mall Restri 0 Refurn Receiptfor Callectain Delivir�,t`,,,t,- Marchand! J13 se atu onfirmation- "Z'Mcle- service L 4 D'al :Numt)er roe Q, I t nt, 08* is qs�ig atuniConfirmatidn Delivery Del 7015 '06 gni '5 4 2 3.5 ailh64il, ty,,,:t`, Restricted 40 6 FS Form:381"1 'Apri12015.(?SN:753Q=b2=000=9053• D omes 10'Fletui ' t �n Receipt SENDER- - IS SECTION C' _E THISSECT16N ON DELIVERY .• 'Complete:itertis"12,and 3.' ■,Print•your name and address`on.the re"verse t ' ❑Agent . so-that we�can:return the card to you._ ::-; Ad" essee ■ Attach this card.to the"back of tie mailpiece, . fdelved slivery or ori:the front if-space permits. "" �/l ►d: i 1_ Reticle AiidrP�codanc - �•" I D. Is delivery"address different f6rn'iterii.l2 0 Yes';: If YES.einter,deliveryaddress:b"eldw: p No:. j Raymond.&Elizabeth Hulbert 1 170 Cedars Rd. i i Cutchogue, NY 11935 t ..II��'!'II"'Illall"IIlI11IIl II I�f,I'll`I:"IIhI�I: ' OAdplt/Sgn ture = '- 1'' t"`P"',y Rrioseredit,FxprMess®. O Adults=gnature ResMcted Delivery t.Q Registered Mail'Restricted j 5J0 9403'0380 163,8.186.97. O certified snail® : : Delive q'Ceitified Mail Restdoted Deliv'." ry ery; >';:•f9'Return Receipt for; 0 Collector"Delivery. Merchandise .. .":2.Article.tVuinber.(TSansfer.frolTtrSerYCe;l36BU.`_.[";..;.," t fb GIleto�ngliveA 4strictedVDgli � � atiireConigmationTM '' 7 D}],5 d,0 4 D DDD 7` }5 D 6 5 3 D�. • ,}Mail Restricted Delivery::,,,_ kiestricted Delivery: �•.w"" .a0) . i PS.FpTni;38.11:;"Aprii 2015 PSN'7530-02-000=9053' omestic Return RecF7 DELIVERY eipt,",� �E�NIPER:COMPLETE 'THIS S ECTION COMPLETE THIS SEC-rjON ON r,Cotnplete'itetiis,1;;2,and..3. tf1ig 'lure:. 777777 'Pr1nt;'iiur n' y ` ' 5.r ,: Y - arrte.and.address on theaeverse;; so that:iive:can"return'the card"to; ".;•�l Attach this c&d.1oahe,back of fhe rri rip` Red" d b N Ad ressee.f B: y(Printed' ameJ:`^: C: tiv t; Or on,the.frorit if sp" . permits. '< of. ry_> ace ) ":1,:--Articles°Addressed.t ��N;". 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Cutchogue,NY 11935 .______ Cutcho ue NY 11935 PS Form 31300,April r rr - PostalPostal © RECEIPT CERTIFIED . . o RECEIPT j°" •. Iti L RJ• i M Ln GL �' PV 1 L U in . 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OWNER(S) OF RECORD: CEDARS GOLF CLUB, LLC, c/o PAUL PAWLOWSKI SUBJECT OF PUBLIC HEARING: For a Wetland Permit to make the existing ponds larger in order to create a better ecosystem by digging the ponds 1 -2 feet deeper while removing the Common Reed (Phragmites australis) that is in and around the ponds; the three ponds that currently exist will be excavated in order to create one large pond which will allow the ponds to circulate better with the creek to the south and improve drainage; no large trees will be removed; all fill is to remain on site; and any disturbed areas around ponds will be revegetated with native plant material. Located: 305 Cases Lane Extension, Cutchogue. SCTM# 1000-109-5-16.3 TIME & DATE OF PUBLIC HEARING : i 1 Wednesday, January 16, 2019 — at or about 5:301P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior 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 eaSUlk Town of Southold CAI Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM 116 PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A */O, yl' STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN sir c, set on oc — o—t CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within 2 5 0 r 8 8 5/5 .7 5 Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (T"IS item will include all run-off created by site b. What is the Total Area of Land Clearing (s.F./Acres) clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 9,400/0.2 Site Improvements and the permanent creation of construction activity? impervious surfaces.) Z Does the Site Plan and/or Survey Show All Proposed — PROVIDE BRIEF PROJECT DESCRIPTION (ProvldeAddkloneiPasoeseNeedod) Drainage Structures Indicating Size&Location?This X Item shall include all Proposed Grade Changes and The proposed project is to make Slopes Controlling Surface Water Flow. improvements to an existing donm 3 Does the Site Plan and/or Survey describe the erosion X and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards El — MEN" of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface/ LLJ — 6 Is there a Natural Water Course Running through the El — Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Raguiremonts: or within One Hundred(100')feet of a Welland or Submission of a SWPPP Is required for all Construction activities Involving soil Beach? disturbances of one(1)or more acres; Including disturbances of less then one acre that 7 Will there be Site preparation on Existing Grade Slopes — are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to El including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit Is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ® X 1.The SWPPP shall be prepared prior to the submittal of the NOT.The NO]shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any X constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder — — compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?IThIs Item will NOT Include the Installation of Driveway Aprons.) Identity potential sources of pollution which may reasonably be expected to effect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice In a Box and the construction site disturbance is between 5,000 S.F.&1 Acre In area, component shall be prepared by a qualified Design Professional Licensed In Now York a Storm-Water,Grading,Drainage&Erosion Control Plan Is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. (NOTC: A Check Mark(4)and/or Answer for each Question Is Required for a Complete Applicatlon) i STATE OF NEW YORK, COUNTY OF...........................................SS That 1,.. .... t�`'1.... ��...` '""`�..n ...................being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of Ind;viduai signing Document) Andthat he/she is the ....... L........ ..... ... .... ..... . ..... ....... .............................................................. (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed die said work and to make and file thio application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in die application filed herewith. Sworn to before me this; .......D.64. day ........... ,20.18Notary Public: ..` c=•-•--.. ................... NNIE D.BUNCH (Signature of Applicant) FORM - 06110 Notary Public,Stater of "IeW Y ur K 1 No.01 B06165050 Qualified in B WI<COur"[W Commission ExpireB Aran" ,1� 10 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 hi detail,-listing both sunnortina and nor►- sunporting 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# 0109 _ 05 - 016 . 03 PROJECT NAME Cedars Golf Club 410b Rehabilitation Project The Application has been submitted to(check appropriate response): Town Board ❑ Planning 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: 0 Nature and extent of action. We are proposing to rehabilitate the area damaged by • Location of action: Cedars Golf Club, Cutchogue NY Siteacreage: 5.75 Parcel Area/0 .2 Distributed Area Present land use: Golf Course Present zoning classification: Agricultural Conservation 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: Paul Pawlowski (b) Mailing address: 305 Cases Lane Ext. , Cutchogue NY (c) Telephone number: Area Code( ) 631-445-4348 (d) Application number,if any.: N/A Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No FAI If yes,which state or federal agency.? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. X]Yes ❑ No ❑ Not Applicable The proposed action will stabilize the area, remove garbage and provide protection to the golf course and residential dwellings in the area from f lood-ing 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 The area is to be planted in a manner that will make the aft more aesthetically pleasing a ErQate a better fun tioninc� y. O Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑X Yes ❑ No ❑ Not Applicable This project' s main goal and purpose is to protect property from flooding and erosion ,P_/� � _ Z Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria 0 Yes ❑ No ❑Not Applicable This project will prevent salt water from contaminating freshwater wetlands and wells that service resi den i nl dwel 1 i ngs in the crag 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. 0 ❑ ❑ Yes No Not Applicable This project includes wetland restorations 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 ❑ NoX❑ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. 0 Yes ❑ No ❑ Not Applicable This project includes the' removal of garbage from the area. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. Ye�] No❑ Not Applicable By protecting the golf course, the proposed work will help maintain pu is access to the recreational area. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No 0 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. Q Yes ❑ No X❑ 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 This project indirectly protects the salt air farm trom t1ood waters moving around the Salt Air Dike system. 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 Q Not Applicable PREPARED EY TITLE DATE LKMA Project : Cedars Golf Course Dike Repair Permit#8472 Date 11/5/18 Dear board of Trustees, C I would like to renew permit#8472 that was issued as part of the larger Dike repair project for the creek to the South of the golf course and bordering Wickham's farms. When we purchased the course in 2014 we were asked by the neighbors to get the permit to finish the end of Dike repair that is on our property and the head of the creek. The DEC permit is still valid till 8/20/19 and to be honest we didn't realize the Trustees permit had already expired. We did not do the repair right away because we just had purchased the course and did other improvements. We are now able to afford to do the project and would like to do it this winter in the offseason and prior to the DEC permit expiring. Please let us know if we are able to renew this permit for another 6 months as we will get the work done. We have no choice as with this last storm last week the creek breached onto the golf course carrying a ton of debris as we are at the head of the creek. Attached is a photo the morning after the storm,the water basically went from the creek all the way to the road that splits cedars. We have since cleaned up the debris and the course is functional again but we would like to reform the dike as to the standards in the original approval. I would like to also schedule an onsite meeting with the trustees to review the ponds as they were filled in and the fragmitties are taking over. I am away until November 15th so if we can schedule a site visit any day after that it would be appreciated. Thank You Paul Pawlowski iL G'- - � NOV - 5 2018 L Sc�il:�!d ix;;t Board Cedars Golf Club <\ Cedars October 27 5. 34 PM ...,.� - z CgESpS LANE EX TAX LOT 94.46 r��S1pN _~ 'N f 5'02'30" E o am — (26O.0O DEED) co 257.92' OHS CD Z , Z'v 240.01 S �_— "o i om E O `m c I C; Mo Mo o CA q0 O O 4 � Zm • C3 �° W M p ` m � O o < N n n n,n IW m D Zm o.:,. o —0° :,.�;:: E N a r b,-n M,.;.• m D M N 23.0' IA PROPOSED ^' X o Q ADD►nON STORY ° A 88' BUILDING GARAGE +� NO. 305 UNDER N O m V $' 60.2' I -+ O co 90.8' ` •:'CoMCRE#E'.�:. O N Y D 3 0 D� Z 0` m� m NN °ADA Zia EX3 NGNRRp 0� \ AmD V ° c9L� (D a o CC 0 m V Z ° v a c: °mss (0 I ' ❑ Dir ZZ O o �,o y ' ;0'= m NCS ='c oPSA <NA vcn m 'n am NCI AT 0o m O k -(mm DD On I _ 0 W �N ZZ S 15*02'3— =o B A> cmc mmm r- �— N �Z Cm "� -. m 257.92' — 8 D A°� N m A (260.00' DEED) a N / 'm� oi�z m