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HomeMy WebLinkAboutTR-10497 12 Glenn Goldsmith,President '�fFO(,�c0 Town Hall Annex O G a A.Nicholas Krupski,Vice President �� y<� 54375 Route 25 Eric Sepenoski y ,? P.O.Box 1179 Liz Gillooly ��. • 0��r' Southold,NY 11971 Elizabeth Peeples lc��¢,�'� Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Completed in field by: David Bergen on behalf of 100 PARK AVENUE CORP., c/o PAUL PAWLOWSKI requests a Wetland Permit remove and replace in-place the functional wood groin beginning at Mean Low Water and extending landward to proposed terminal end; new groin to be ±60' in length; elevation to be no more than 18" above grade on down drift (west side); groin to include 6' vinyl C-Loc sheathing with 10" diameter piles, 10' in length with 10" batter piles on down drift (west) side of groin, 6"x6" stringers and aluminum grate cap; terminal seaward end to include four (4) 10" dimeter pilings. Located: 100 Park Avenue, Mattituck. SCTM# 1000-123-7-3 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: Present Were: G. Goldsmith N. Krupski E. Sepenoski L. Gillooly E. Peeples 1-10"PILING TO BE -24"ABOVE MHW (1)NEW 6"X6"WALERS DOWNDRIFT SIDE LOCATION PLAN 4-GROIN END PILINGS TO BE 10"DIA NEW 10"PILINGS-TYP-UNLESS OTHERWISE NOTED PERFORATED FIBREGLASS CAP NEW CORRUGATED VINYL SHEATHING �RESTSTRUCTURE-,W �wT ENTIRE LENGTH NEW 10"BATTER SUPPORT PILINGS oH P « 1. NAS I I DOWNDRIFT SIDE ONLY �,� YA>Kn a. TTITUCK,NY�� POIN I I (2)NEW 6"X6"WALERS TERMINAL END OF NEW GROIN fiaaaoa� .,,. _-_ UFFV rn 17`0"'I TO BEGIN AT CORNER OF 12 00 W � UP-DRIFT SID N °31'00"E a�wqq / O rrP EXISTING BULKHEAD °;i3Op«E 120.00 1 �. r f�Tl _.... __._ ,r,° LAND NIF OF 4 aa�ora AY g PATRICIA CAREY i - y.7 100 PARK AVENUE 2 q a O MATT f TVP EXISTING BULKHEAD N a f $ PROJECT DESCRIPTION s � 1 PROPOSED GROIN PLAN REMOVE AND REPLACE IN PLACE FAILING,FUNCTIONAL WOOD GROIN IN Al Scale:5=1'-0" 0' 5' 10 ITS ENTIRITY.THE NEW GROIN SHALL BEGIN AT MLW AND EXTEND LANDWARD TO CURRENT TERMINAL END AS DEFINED BY cow LAND WF OF VEGATATION. ELEVATION OF NEW GROIN TO BE NO MORE 1N1 r MARY EISENSTEIN THAN 18"ABOVE GRADE ON DOWNDRIFT(EAST)SIDE. GROIN TO TUBE=+�-0'1 INCLUDE 6 FT"C-LOC"VINYL SHEATHING WITH 10 INCH PILES,10 INCH Q AMN TONFJ�EST STRUC m BATTER PILES,10 FT IN LENGTH,6 FT ON CENTER,6"X 6"STRINGERS ON 6'40• M66 BOTH SIDES, WITH FIBREGLASS GRATED CAP ENTIRE LENGTH. e o I aw r om WATERSIDE END OF GROIN TO INCLUDE 4-10 INCH PILINGS. MHW 2.5' ALL AS PER PLANS DATED-OCTOBER 1,2023 -- - MLW - 0,0 I LAND WF OF ARCHIVIST CAPITAL RE 70 PARK LLC II II II II II II II II II 1 I , ,v1 (V) 1V) 1VI V G VM ORWWAY V 0.1w -,163 ,PTE _2� PROPOSED_ GROIN CROSS VIEW " V 9g� LAND "'FO NOTES Al Scale:5-1-0 DEIRDRE SOV Q' S' 10 6 31 PPTK) _.octf ._. � 1. MEAN LOW WATER-MLW IS DEFINED TO BE 0,0 AS INDICATED ON SITE o SURVEY DRAWINGS BY KENNETH WOYCHULK LAND SURVEYING,INC 04 fi> V 3 T 5��IE 190' PPTb 2. LITTORAL DRIFT GOES EAST TO WEST 3. LANDWARD END OF PROPOSED GROIN TO NEAREST STRUCTURE IS 162'-0"+/- 40.6 SEAWARD END OF PROPOSED GROIN TO AHW IS 17'-0"+/- MEAN HIGH WATER-MLW(AHW)TO NEAREST STRUCTURE IS 199'-0"+/- BEACH GRASS `� BEACH GRASS EL 6.0 er00 n.7 nn, kTw.5. II BW s.1 BULKHEAL RW51 WOOD BULKHEAC $ 4 I` TERMINAL END OF NEW GROIN + PIPE WOFavxSMOFuM OR ,j Z + TO BEGIN AT CORNER OF 0 �Top OF OF LOW — o5 OCT - 5 2023Im a O EXISTING BULKHEAD 7w 5.5 ' A Bw5.o m wso m _ �R-.- -.. O STAIRS EE csOwc _ — �,/ TWNa I\ 0 STEPS �__ —.._+_ 10E QiBNK C« -_._., ,,.-- -.._. �� mCE0fa4�>Z4S5 SOItthOidTown --- — —,4.6 L.Board ofTnlstees MHW 2.5 # LU N .INE END OF NEW GROIN TO INE 10.71 $ni1 O STOP AT MLW AS DEFINED ` =1 ------\ —_ BY SITE SURVEY 100 PARK AVENUE ORP ---- -- ----------A —_ LL ----- ,w.. ----MLW 0.0 z3--------------- -s2'3o^W __ - - -; � MLW 0.0 -- �,,-"" -- ,�� Izo.7o' 1a_ vs 120.55 --L--k ------------� n•± S Bw-o.o -"23 ���_•� 587°2410 W 8---- -Kwoo---------'�; -�-- m 3.5 17195 - GROIN Construction N O ow.1.0 N I ________________ Y. 100 Park Avenue Mattituck, NY 11956 o e— BW-'.B -� SCTM - 1000-123.00-07.00-003.000 Li Al Prepared b David Bergen and Ken Quigleyg /LITTORAL DRIFT /LITTORAL DRIFT /LITTORAL DRIFT PROJECT P y g s EAST TO WEST EAST TO WEST EAST TO WEST111 SCOPE AREA Construction Scope Plans a Z �3� PROPOSED GROINPLAN 4 EXISTING GROIN PLAN Date- OCTOBER 1, 2023 Drawing: Al scale:20'=V-0" Al Scale:20•=l' 5 SITE Y_ _ Scale: As Noted w 0' 10' 20' 0' 10' 20 Al Scale:40'=1'-0" A 1 U 0' 20' 40' 80' Q O E C ' i V --� 1„ OCT - 5 2023 L) S.C.T.M.# DISTRIVT—"' D SECTIO 123 BLOCK 7 LOT 1, 2 & 3 oard o ,3e GRAVEL 11 WAY PARK AVENUE GATE BELG.BIL CURB 0ewM. N 85°31,00"E 120.00' wld. o rw 1046.99' 12 .00' N 85°31'00°E PIKE 169.5 5' :" O 'Y. N 85°31'00„E L _o LAND N/F OF O tias�$ PATRICIA CAREY .� GRAVEL DRIVEWAY g 'Z ":rS;:i ...... 36.7 m .:::.:;;o:;::• _ )E _ 2 •z COURTTENLAND N/F OF MARY EISENSTEIN LAND N/F OF ARCHIVIST CAPITAL RE 70 PARK LLC m LAND N/F OF SUSAN NORRIS 81W 14' Cl CD�GEAfH 08'E O.TW 73':.. 212 BELG BLOCK CIftO —� 143.. GATE LAND N/F OF �TpNUn DEIRDRE SOKOL KITCHE 388 N y., p PATIO 3 3D � ' CAiE ST213:: PATIO dE OI'IE GRAVEL DRIVEWAY O' EOG' NOR . 01NI0 46.3• POOL DECK 40.6' 4 COVERED PORCH ...'f 6•E^i: DRAIN 9•) I"3F::rit"�?'''''3iSii/:.p. ILCO 1' '1 ':.':':2 SN FRAME iY;"s":' :i;'if''i-,B 71 i%.%%.:::::...may:::DWELLING i:::.:'ti::;:'::..,..... :............... 20'W 0.8E ) .: '.`n:.i'T:.::::::::o:.' PATIO O O_ PIPE TDP OF RANOEDGE OF LAWN COVE 2ND FUR 'Iw WOW DECK S1LC OVER DECK TOP OF BASEDGE OF LPA 3.5E WOOD- Dm—OF STEPS """ _.._.._.�.e.._.._.._._.._ $ STAIRS To,O"B rO£of RAN 'oo t.._.._.._.._. 7�CIF BANK � .._.._.._..�I,I............._.. EDGE O BEACH GRASS LANDING ' J EDGE OF BE GRASS Via. 0 d Egg t0E GP gAt WOOD BUKHEAD 120.55' _-- S 87°52'30"W tIE UAE I-T.70 ���+$5w---171.95 S 87124'10"W -- - - - ---- --- o TIE � Mwoo- - ^• -------------Q ---- `�' - SS 8406'4_2'W TIE LINE I MLwoo----°o GREAT PECONIC BAY THE WATER SUPPLY, HELLS, DRYNELLS AND CESSPOOL LOCA77ONS SHORN ARE FROM FIELD OBSERVA77CNlS AND OR DATA OBTAINED FROM OTHERS AREA: ELEVATIMON DA MLW 0.0 W , UNAUTHOw2ED ALTERATION OR ADDITION TO THIS SURWY IS A WOLA 77ON OF SECTION 7209 OF THE NEW YORK STATE EDUCA770IN LAW. COPIES OF TINS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED 70 BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN eo ONLY TO THE PERSON FOR WHOM THE SURVEY/S PREPARED AND ON HIS BEHALF 70 THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE FAEC77ON OF FENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/CR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY ENDENT LW THE PREMISES AT THE DME SURI£Y SURVEY OF: CERTIFIED TO: MAP OF: FILED: SITUATED AT: TOVM OF: KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design P.O. Hoz 153 Aquebogue, New York 11931 FILE I SCALE_ DATE: N.Y&USG Na mew PHONIC(831)8911-15811 YAi(831)296-15811 loo �aie' < e ql ld13 (7p; f-s'Pfri Aftl Wulf 14 -,W- qa 'YL - - � rte• �. �;� �.�—i "S. �a�, 5r t, � '�� - ,3�`,k, f _ 9/29/23,8:11 AM 50 Park Ave-Google Maps Gtr gle Maps 50 Park Ave Pond New Suffolk Ave Lave Lane Kitchen: {Ncrth Fir tock Ave •r Doughnut Company N�Sld c Q Mattitucke � Mo k The North Fork$t°� Mattltuck Airport-21 N Community Theatre NeW SuHotkAv ' t nr�n n P`nred Lorraine Fic Epic N811 a a Plan Teledyne Mattiuc and PJe Services Teroporaniy closed c G, Blue Sa h N s llrrscricnn Grill Pd comms OIL �, E,ipyi�ArR Kr4uye{ld O .. n�d.9lt1 n Magic Fountain , / Mello Tile " � O Strong's Marine Y '( Fish The Fork Go gle ti Map data 02023 500 ft ht4m://Www.google.com/maps/place/50+Park+Ave,+Matdtuck,+NY+11952/@40.9870567;72.5247838,15.99x/data-!4m6!3m5!1 sOx89e891e2617d14bf:Ox404cl7fa9789798c!8m2!3d40.9824056!4d-72S193504!16s%2Fg%2F1lc5dm_ a,aa ,P90a $ 06.Oea SEE SEC NO,15 SEE SEC NO t10 �!\ SEESEC NO,15 P1x 90 $ O'i;60' BwTCX - LINE - 3A WTCH ONE i T 33 . �ysEE sEc xe I,s 8, '� W FOR PCL NOso e f u W.10W S11SW NO ry _ of-mw 1T F 1� ry I,A `W WWa FOR PCL NO i a 4x ea(cl ' 164(cl ,dl'1 11,5M SEE EEC NO x SWTHOLD 4 3964 a B ,0 i�.we+s.rzr..vn Ouep.3µcl 0 ,w - CREEK 1p x5 'm sx � °-LA � as e,o ,e ,ppb v ,•.,�P/c \ l ,1M°l ,BNI�BXI° - et u 8 e+A .uRA wry '- � 9 PAR SJ 0 '. eaHcl � ate\ 5' ey . s ry0 CONICosegPv 1 PE i - w g e E �, _ �^R�M 1�1 ^' eau_^ _ _ WSW w,,,,� NOTICE COUNTY OF SUFFOLK © E 1' aaunatn SECTION NO �_ Real Property Tax Service Agency v M r.,.... a..M... w=... . .wo.au. w eeunN am«RI,.9..e.NY„ea III 1 uct ec 123 'yxJ• P 1N xc�ra tea PROPERTY MAP Glenn Goldsmith,President ,{r � Town Hall Annex A.Nicholas Krupski,Vice President ?` �¢ k 54375 Route 25 Eric$ enoski P.O.Box 1179 eP Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples `. �► Y4 t Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application ►! Wetland Permit Application Administrative Permit Amendment/Transfer/Extension OCT — 5 2023 K Received Application: 10!F Received Fee:$ — SuU;hBid Completed Application: Bcsxd of Tr s ees Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): X LWRP Consistency Assesment Foran Sent: a3 _CAC Referral Sent: lU aZja )(___._Date of Inspection-, 1 • •23 Receipt of CAC Report: _Technical Review: )C Public Hearing Held: �L Resolution- Owner(s)Legal Name of Property (as shown on Deed): 100 Park Avenue Corp c/o Paul Pawlowski Mailing Address: Box 783, MaMuck,NY 11952 Phone Number: 631-445-4348 Suffolk County Tax Map Number: 1000- 123.-7-3 Property Location: 100 Park Ave, Mattituck, NY (If necessary,provide LILCO Pole'4, distance to cross streets,and location) AGENT(If applicable): David Bergen Mailing Address: Box 1008, Cutchogue, NY 11935 y Phone Number: 616-848-6438 Email: P i V G a3 ►off Board of Trustees Application GENERAL DATA Land Area(in square feet): 1.7 ae 74,052 sq. ft Area Zoning: R lo Previous use of property: residential Intended use of property: reSidential Covenants and Restrictions on property? __aYesNo If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes �✓ No If"Yes",please provide copy of decision. is project r any demolition as per Town Code or as determined by the Building Dept.? Yes I V1 No Does the structure(s)on property have a valid Certificate of Occupancy?_C✓ _Yes_D_No Prior permits/approvals for site improvements: Agency Date Trustees#8833 6/22/16 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?_Z_No_a Yes If yes,provide explanation: Project Description(use attachments if necessary): see attached 100 Park Ave Corp Project Description Remove and replace in place functional wood groin beginning at MLW and extending landward to proposed terminal end. Elevation of new groin to be no more than 18"above grade on downdraft(west)side. Groin to include 6 ft. Vinyl C-Loc sheathing with 10 inch piles, 10 ft in length,with 10 inch batter piles on downdraft(west) side of groins, 6"X 6" stringers and alu- minum grate cap. Terminal seaward end to include 410 inch pilings. All as per plans dated October 1,2023.. t Board of Trustees ApplIcatlon WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To provide shoreline protection;prevent beach erosion and protect bluff from erosion Area of wetlands on lot: OC-1h 606> square feet Percent coverage of lot: ( 2-. % Closest distance between nearest existing structure and upland edge of wetlands: f 6.Z _feet Closest distance between nearest proposed structure and upland edge of wetlands: 44 . feet Does the project involve excavation or filling? No 0 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): will have a positive effect to prevent beach erosion and provide beach material stabilization plus bluff stabilization l 61Z20 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 I Project and Sponsor Information 100 Park Avenue Corp Jetty Reconstruction Name of Action or Project: 100 Park Avenue Corp Jetty Reconstruction Project Location(describe,and attach a location map): 100 Park Ave, Mattituck, NY Brief Description of Proposed Action: Remove and dispose of existing functional, but failing jetty. Construct new jetty starting at MLW and going landward Mfeet, in place �o Name of Applicant or Sponsor: Telephone:631_445-4348 100 Park Ave Corp C/O Paul Pawlowski E-Mail:paulmpawlowski@gmail.com Address: Box 783 City/PO: State: Zip Code: Mattituck NY 11952 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: NYDEC, NYDOS, USACE, Southold Trustees R FRI 3.a.Total acreage of the site of the proposed action? 1.7 acres b.Total acreage to be physically disturbed? < 1 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsof? 1.7 acres 4. Che 11 land us at occur on,adjoining an ar the prop action. Urban Rural(non-agriculture) Industrial Commercial ❑✓ Residential(suburban) Forest ❑Agriculture MAquatic 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? `/ 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:. � ❑ 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? 4✓ 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: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water. ❑ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ✓ b. Is the proposed action located in an archeological sensitive area? 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? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: proposed work is reconstruction of a functioning exisitincl structure in 171ace - 14. ntify the typic bitat types that oc n,or are likely to be found on t[Mroject 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,Iisted NO YES by the State or Federal government as threatened or endangered? F1 El 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO If Yes, []NO � a a.Will storm water discharges flow to adjacent properties? ES ✓ b.Will storm water discharges be directed to established conveyance systems If an drains)? If Yes,briefly describe: N0 YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: _ _ oa 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: 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: oa I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE-TO THE BEST OF MY KNOWLEDGE ! Applicant/sponsor name:. .. .. . ,c . Lam. . . Date: 101f 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?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. W ill the proposed action have an impact on the environmental characteristics that caused the Q ❑ 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 existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? El 0 b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, F] a architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,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 o problems? 11. Will the proposed action create a hazard to environmental resources or human health? ❑ ❑ Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occar",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-Hoard of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Applic4 on AUTHORIZATION (Where the applicant is not the owner) I/We, owners of the property identified as SC I M# 1000- ( 23 a—.7 — in the town of New York, hereby authorizes��✓� �� to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME`l"HIS C DAY OF 20 � Notary Public �`gSATEpc.,, Debor8hOrlo%sk N� Notary Public,State ofNew York * Pueuc = No.01OR6280392 0;. ' ' Qualified in SuffACounty / %,,�V Y..... Commission Expires 05/13/20 Board of Trustees Application AFI+IDAVIT A� � l BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERNIHT(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 N AbNNER 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 HARIILESS 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 AGEN'T(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO NTY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO INTER 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 TERINI OF TI4E PERMIT. 1grlature Property Otivner Signature of Property Owner SWORN' TO BEFORE ME THIS DAY OF ����-' ' 20_,73 Notary Public Debomborlowski _ , '`•; Notary Public,State of New York * `� *= No.01OR6290392 Qualified in Suffolk-County '%,N;w�a?;;.`' �nim�tSeioO Facpi�s 03/13/20a� ------------ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM I'he'I'own of Soutlrold's Coda of Ethics nrohibire conflicts of interest on the Hart oftown off icers and emnlovices.Thenurrnse of this form is to provi Ic information which can olert the town of possible coallicts of irtteryst and allow it to take wilmever action is liecessna to avoid same YOUR NAME: r / — (Last name,first name,Middle 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`Lone _ Coastal Erosion Approval of plat iblooring Exemption from plat or official map Planning Other (If"Other",name the 8'ivity.) Do you personally for 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 employe owns more than 5%of the sh YES _F1 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 r4rson Describe the relationship between yourself(the applicandaeenthepresentative)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 tial apply): f2A)the owner Cif greater than S%of the shares of the corporate stock of the applicant n (when the arTi%aant is a corporation); ._U_f3)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,dirrmr,partnci,ot'cjt±ployt,'c of IM applicant;or D)the actual grpllcant. DESCRIPTION OF RIA-AT10NSHIP $Om4ted this _day of _ 20 Fonn TS i i APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics wohbits conflicts of interest on the Part oftown officers and emnlons,LThe numose of this form is to provide information which can alert the town of Possible conflicts of interest and allow it take whatever action'is necessary to avoid some. YOUR NAME: David Bergen (Last name,first name, middle 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 ofZone Coastal Erosion Approval ofplat Mooting Exemption from plat or official map Planning Other (!f"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 employce has even a.partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%ofthe shares. YES !WlNO 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 self Title or position of that person Boat Operator Describe the relationship between yourself(the applicant/agent/mpresentative)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): f,A)the owner of greater than 5%of the shares of the cerporatestock of the apptievat f2 (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a nondate entity(when the . j4applicant is not a corporation); C)an officer,director,partr�,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF REELATIONSHER Submitted this day of 20-20 Signature f Print Name David Bergen Form IS 1 ' Board of Trustees Applicz:.,—)n PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: ia - 7— 3 03- 7 2® 3 / a ,3 - 7- p3 — / — ae � 03- STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Signature Sworn to before me this Day of . 20 Notary Public INUTILt U '1= H 'LAKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: 100 PARK AVENUE CORP., c/o PAUL PAWLOWSKI SUBJECT OF PUBLIC HEARING: For a Wetland Permit remove and replace in- place the functional wood groin beginning at Mean Low Water and extending landward to proposed terminal end; new groin to be ±60' in length; elevation to be no more than 18" above grade on down drift (west side); groin to include 6' vinyl C-Loc sheathing with 10" diameter piles, 10' in length with 10" batter piles on down drift (west) side of groin, 6"x6" stringers and aluminum grate cap; terminal seaward end to include four (4) 10" dimeter pilings. Located: 100 Park Avenue, Mattituck. SCTM# 1000-123-7-3 TIME & DATE OF PUBLIC HEARING: Wednesday, November 15, 2023 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available online at www.southoldtownny.gov and/or in the Trustee Office until to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold 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 REMsed action. will :be evaluated, as to.its sinifmcant beneficial and adverse effects upon the coastal area(whichincludes'all of Southold Town). 1 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.answ* er must.be amlained in detail,;listing both sunpoctinu and non- suanorting 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 I s website(southoidtown.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# 1000- ,.123:7 :.3 PROJECT NAME 100 Park Ave Corp Jetty Reconstruction The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Categoryof 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: Nature and extent of action: remove.existing,functional but failing jetty.and replace in place.with new jetty Location of action: 100 Park Ave,Mattituck, NY Site acreage: 1.7 ac Present land use: residential Present zoning classification: R 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 applicarit: .100 Park AVe Corp c?o_Paul Pawlowski (b) Mailing address. Box 783, Mattituck,NY 11952 (c) Telephone number: 1-445-4348 Will the action be directly undertaken,require funding,or approval by a state or federal agencp? Yes 0 No❑ If yes,which state or federal agency?USAGE,DEC, DOS 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. W✓ Yes F] No n Not Applicable Project will enhance the prope.[ty owner's ability to engage in water related.activitie5 such as fishing and swimming along the shoreline_. The project will maintain the integrity pt the,beach through erosion protection Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRRP Section III—Policies Pages 3 through 6 for evaluation criteria U Yes❑ No 21 Not Applicable ' 1 Attach aMtional sheets if necess 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 ✓1 Yes 0 No F-1 Not Applicable It will not impact the visual quality as it is replacement of a structure already in place,but will support the prevention of shoreline erosion hence protecting scenic resource. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria �. Yes 1:1.No 1:1 Not Applicable The exisiting jetty has been in place for a significant number of years. The area beach and dune has acclimated to the existence of the Sfiructure: Our proposal is fo'maintain the structure,which will not cause any increase'in erosion or flooding at the site. Attach-additional sheets ff necessary Policy 5. Protect and improve water quality and supply in the Town of Southold.See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria 0. Yes 0 No I Not Applicable �y ttac o >fnece 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. n Yes ONO n Not Applicable Attach additional sheets ifnecessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. El Yes nNo ✓❑ 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 0 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. 0 YeD No❑Not Applicable Project will maintain beach resulting in a net gain of beach access and enjoyment for the homeowner and individuals walking the beach below the high tide mark. 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 ❑Not Applicable The .. o'ect:will allow th esidenW to engay r dependent adyffieshshoreline 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 ElNo W Not Applicable Attach additional sheets ifnecessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III--Policies; Pages 62 through 65 for evaluation criteria. ❑Yes ❑ No FV]Not Applicable Attach additional sheets ifnecessary 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 BY David Bergen Tr'I,E Agent DATE tri Y Z Box 1008 Cutchogue, NY. 11935 October 4 , 2023 ® ESouthold Town Trustees Town Hall Annex OCT 54375 Rt.25 - 5 2023 Southold, NY. 11971 Southold Town Board of Trustees Dear Trustees: 1 am respectfully submitting to you the attached application packet for the replacement of functional groins for 100 Park Avenue Corp located at 100 Park Ave, Mattituck, NY . Enclosed you will find: Wetland Permit Application Short Environmental Assessment Form Authorization Form Owner Affidavit Applicant Transactional Disclosure Form Agent Transactional Disclosure Form LWRP Consistency Assessment Form Site construction plans Property survey Color photographs Site location map -Application Fee in the amount of$1250.00 Thank you for your consideration of this application. Please do not hesitate to contact me at 516-848-6438 should you have any questions. Sincerely, David Bergen, gent for 100 Park Avenue Corp% Paul Pawlowski