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TR-10564A
Glenn Goldsmith, President ®� SO �,� Town Hall Annex ®� ®� 54375 Route 25 A. Nicholas Krupski,Vice President ® P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone (631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction '/2 constructed . When project complete, call for compliance inspection; Glenn Goldsmith, President ®F SO Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ®� ®�® P.O. Box 1179 Eric Sepenoski ! Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � Fax(631) 765-6641 C®Um,�° BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10564A Date of Receipt of Application: April 15, 2024 Applicant: Cutchogue-New Suffolk Park District— Nassau Point Beach SCTM#: 1000-104-8-6.1 Project Location: 9430 Skunk Lane, Cutchogue Date of ResolutionlIssuance: May 15, 2024 Date of Expiration: May 15, 2027 Reviewed by: Board of Trustees Project Description: Install modular unit children's playground equipment. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by David Bergen and Ken Quigley, received on April 15, 2024, and stamped approved on May 15, 2024. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. 4 Glenn Goldsmith, President Board of Trustees 'I'S 0%LD T RUSTEIES �oa lo. S & 4h k: Issued To �wt�,,.� - u�w sw��w� � afe AddLress' -.9-41-0' S KunK Lena. C tri C,t%0 uc ' THIS. NOTICE RAIIST �E DIS�LAY�D Dt1RBN(a COFIS7°RIJCTIOIJ TOWN TIt1157'EES OfrFBCEeTOWVN OF SOUTFIOLD SOUTHOkDo NoYo 11971 TE L.r 765-1 892 - LOCATION PLAN u' C NASSAU PERGOLA OVER Im POINT WOOD DECK !I # -_ _ LITTLE Z ~` ✓ PEGONIE r T U.P. ' O !I s F' i x/ ``x x x x `1 Im t r v % NASSAU PT BEACH 2 I j�- t x x\i I t I' ii CUTCHOGUE,NY • \�':; it � _l r^5 lax x x\ '�srr• iR� ,xx '� —1 \ D 0pD101 BJ 531 Aaa lit SWING I w x xI x\\ ease zss. �' R ;I Y NEW SUFFOLK,NY c r T SET ! - IA I x x 00 o: � o= I I V PROJECT DESCRIPTION O 25-�" x ■■ ■x x\Ip I '� NN Y �`xx N' `x x\ >" rood Pc I ADD-ADDITIONAL CHILDREN'S PLAYGROUND EQUIPMENT \ \ •.: 1 j \x x a x x�\ o' I ¢ PLAYGROUND OVERALL FOOTPRINT WITH PROPER CLEARANCES-2Tx45' x x\\\ :� e� I z ALL AS PER DRAWINGS DATED APRIL 15,2024 I • I CD _ BROADVATER COVE-^- •^'- x x" -C x\\1. -,.000Fy If _ Z. D APR 1 5 2024 W.V. i Nh, j Southold Town 1tl Board of Trustees kA § NOTES 1 EQUIPMENT LOCATION � � � � ix"I � Al Scale:1"=30'-0" N ��N jx 11 I N 1 MEAN LOW WATER-MLW IS DEFINED TO BE 0,0 AS INDICATED ON SITE 0' 15' 30' 60' J 5t y SURVEY DRAWINGS BY KEN WOYCHUK LAND SURVEYING,PLLC k`xl% li 2.. .,. ..,.. .r-. -.,,. .r... .ram ..x.. ndl; � .6•n�_a,,,,m'wa -^ Z � N N ► °° = CUTCHOGUE and ~ x� F �$m NEW SUFFOLK PARK DISTRICT 2 Site �, Al Scale:, ,00'-0" �� ,>r PWULL 101&9 _ c ��� NASSAU POINT BEACH o' so' 100' zoo' - ;-� ! t 6�I, II w N W a 81 ' �� Playground Addition Project N Nassau Pt, Road, Cutchogue, NY 11935 0 P it - SCTM - 1000-104-8-6.1 W CAUSEWAY BEACH DISTRICT PARK ;x x 'Xy'"� I Prepared b David Bergen and Ken Quigley be o m m ro =xX l x) ,� M P Y 9 w A6Eh w {83.932 MR..or 1f.16 ACRES • - ���a Ix " Construction Scope Plans n "� Date-APRIL 15, 2024 Drawing: ° vK,IDESORiBED PROPERLY j j f£ATREO 1R 01USEWAY BFACH Ot3fWOl PMN; _ ,wm R�5* a�,m.r.EUfCH000E "' "� Scale:As Noted � SIm30UTHOLD �iN6fR Y�oYeflu[lw,m cE,va�,..p,y0 // J FFpI(DWNLY.REP',9RK 1,�. .11.�A :.a, ..� . Y=P / A 1 6 P.0.IW 1W 9ueDeNru lu Ybf Ya' ' ei Wrote RlE/su-isl swe r.6o•MLE rmv.2i.rou to,ua-w , APPROVED BY __— BOARD OF TRUSTEES TOWN OF. SOUTHOLD U) DATE LA o CS 12 u rr- O 0— o cB Q Cf)m 0 T i• • ® O l Ln coo o s' L o Vaw w U > ~ Qa Q _ w = w d V) C) ~ m Q Z O LLI H w ¢ w (n QwG_ w U) QD � j J 7Z) D Of r � 0H (n N_ O r J � 02 QQZF- M )- w Q fr F- w � w Q z m Burke® h 21 Marc , 2024 SERIES Basics, Nucleus Nassau Point Beach (#49948) BCI Burke Company, LLC Top View 1 1 9-1 79962-1 DRAWN BY: Tugce Raasch BCI Burke Company, LLC PO Box 549 Fond du Lac, Wisconsin 54936-0549 Telephone 920-921-9220 C" vO O N C a n C N Z C v CD O D re ' H ! .64: 24 48 s - N z r • n H -4 3 G z o C 0 . � m O, zto rt Cf W C • 45' Area: 1 ,215 SQF D NOTE: ALTHOUGH ALL ATTEMPTS HAVE 3 BEEN MADE TO PROVIDE AN ACCURATE SITE ® E C E O IT MAY NOT TRULY REPRESENT THE AREA o G WHERE THIS STRUCTURE IS TO BE PLACED. • �' ' APR 1 F 2024 M 0 n _ c v Q 00 Southold Town cQ - o Board of Trustees IV 0 - n O OVERALL BOUNDING OF USE ZONES "The space PLAYGROUND ACCESSIBILITY (Provided/Required) The use and layout of play requirements shown 0 Area: sq.ft. q • •• OF components identified in this plan C Perimeter:142.4 ft. here are to ASTMEVENTS :ACCESSIBLEEVENTSGROUNDEVENTSEVENTSEVENTS conform to the CPSC guildelines. A STRUCTURE SIZE:26' 7'k44'8" standards.Requirements U.S.CPSC recommends the for other standards may 14 7 /4 4 /0 0 /0 7 / 2 4 / 2 separation of age groups in POST SIZE(S):3.5" be different. playground layouts. ITEM COMP. DESCRIPTION �_ K•—•- =y� 1 290-0103 TRAPEZOID PLATFORM Cn 0 2 390-0101 24"TRANSITION STAIR W/BARRIERS O H J � � o 3 290-0102 SQUARE PLATFORM N z C 4 390-0304 STRAIGHT HORIZONTAL LADDER,SYNERGY m cD p 5 390-0311 LIL NOVO BALANCE BEAM LINK -n 6 390-0225 SYNERGY LAUNCH PAD O 7 290-0104 OFFSET ENCLOSURE a 8 290-0099 CRESCENT TRANSFER PLATFORM vrni 9 290-0101 8"CLOSURE PLATE 10 290-0110 1 CLIMBER ENCLOSURE 11 390-0298 MESA CLIMBER 12 590-0152 RAIN CRESCENT PANEL 13 590-0094 BUG PANEL,ACCESSIBLE REACH 14 390-0125 FIERCE CYCLONE SPINNER • • 15 390-0324 FORMIS LADDER 64 LA. I16. 490-0144 VELO SLIDE 64"-72" 17 490-0141 SLIDE SIT DOWN BAR 18 540-0112 3-IN-A-ROW PANEL,ABOVE PLATFORM 10 3 15 10 21 10 3 7 22 22 19 49M137 LUGE SLIDE 48"-56" 12 10 20 49MI38 DOUBLE SLIDE SIT DOWN BAR 16 21 560-2709 1 EKO BUNDLE 17 122 560-2705 1 EKO SOLO v Z c 48 24 z O0 c (Q (D O 13 g Z rt - W 18 W p 14 11 20 19 2 1 Cn = 10 5 4 6 a 3 cD o � 0 • Ec r'APR 15 2024 c V fD co -O N n O N = Southold Town Q p < Board of T rustees t O a c n rt N N o 3 °2 o N ~ i Lf7 't7I- J-O � O Q Ln O See XY Footing details on pg .4 for below grade depth • LINE-SynergyBurke-:a Burke-Basics ELEVATION 1 GROUP: Nassau Point Beach 02/08/2024 Structure ;t Cutchogue, NY 11935 American Recreational Products DESIGNED FOR AGES: 119-179962-1 . 5 to 12 �urke PLAY THAT MOVES YOU " Designer:Tugce Raasch Type Label X Y Hyp/Diag 288 247 Post 115C 1 5'6" 3'6" 6'6" Post 115C2 5'11" 0'7" 6'0" p cn Post 123C1 0'2" TO" SO" H n Post 123C2 3'2" 3'2" 4'6" ZPost I 123C3 8'11" I'll, 9101, m O Post 123C4 9'11" -4'10" 11.0" v T Post 127C 1 0'0" 019, 0101, O Post 127C2 3'8" 0'2" 3 8" D Post 139C 1 4'0" 0'4" 6 0" M y Post 139C2 -5'10" 3'4" 6 9" Post I 143C 1 -7'0" 0'6" 9.01. Post 143C2 -8-10" 3'6" 9'6" Post 99C1 8'5" 4'0" 9'4" 3 4 - Non-Post 1 13'11" -7'11" 16 0" 15 Non-Post 2 -7-11" -7-4- 10'19, 14 12 11 10 16 Non-Post 3 -7 7" 6'1" 9191, 13 99cl Non-Post 4 -5-10" 6'9' 8'4" 143C2_ 139C2 115C1---' __ Non-Post 5 13'8" 2'4" 13'10" I 1 3C1____-------123C2 Non-Post 6 -15'0" 2'6" 17 2" 6 5 Non-Post 7 3'1" 4 0" 6191, Non-Post 8 V 3" -6'1" 6'2" 1230 Non-Post 9 2'9' -11 9. 3'7" � 143C1__ 139C1 �27C2 115C2-�' Non-Post 10 3'6" 4'10" 6'0" • �`�— 12 Non-Post 11 2'6" NY 5'1" Non-Post 12 V S" 4'7" 4'10" M Non-Post 13 0'S" 4'2" 4'3" Non-Post 14 016, 4'10" 4'10" Non-Post 15 5'4" 5'2" 7'S" 9 Non-Post 16 7'9' 4'7" 8'4" • • aCA 123C4 V C • 8 7 C O _ (O C m O" 2 Z O� rn rn n C E V E APR 15 2024 �- Southold Town 535 Board of Trustees n M 0 n Resilient Ground Cover Resilient Ground Cover Depth Resilient Ground Cover Q' Depth Maximum 12" Maximum 12" Depth Maximum 12" (D .0 O 3"Earth Backfill !J Mounting Plate A to prevent flare 33"depth dimension may vary for: C1 N out and heave Nature Play Tree Trunk posts 00Anchor Bolt Voldo posts 33 Shade Canopy posts ---- _ 24"to 40" W O (Size and Depth may vary I I — — =III=I I Depending on Event O to Alpine Climber posts � N 1,, for each installation.) ° °° °, Taper to of concrete for I ° 3 1/2"Arch Swing Legs, 3"Earth Backfill (Refer to Specific Component's O G p p 9 9 )J=� ° I _ Installation Instructions p Concrete water drain away from post I Evolution posts —III— I I=11 ) -w -see installation instructions 1LI-III II-III 3 FOOTING LEGEND Surface Mount Detail Concrete II-1�1= III=11 c II li _ 1u=1�1 Q. Use cement paver or red tube cap ANCHOR FEATURE MAY BE =to prevent post from sink in before A CRIMP OR A PROFILE HOLE III=I C q1 Support Post Identifier&Footing NOTES: g 11=111=1 I11=III= concrete H 1.)Dimensions are for locations for footing holes,not exact placement concrete footing has been poured — Crushed Rock —I1=J11=1I Of equipment. Optional Crushed Rock 12"Minimum Diameter NP1 Nature Play Tree House Post Identifier q pment. Post support 12"Minimum Diameter 2. Assemble, lumb,andlevelequipment before pouring concrete. (28"Min.Diameter for Shade Canopy x36"deep-see install) (28"Minimum Diameter PP 9 (18"Minimum Diameter for Tree Clmbers) for Shade Canopy) O Component Footing 3.)Dimensions are rounded to nearest whole inch. (30"Min.Diameter for FS Shade Canopy x 54"deep-see install) Support Post Footing Detail (28"Min.Diameter for Evolution-see install.instruct.) Component Footing Detail Glenn Goldsmith,President _w`�®1- Sig Town Hall Annex 54375 Route 25 A.Nicholas Krupski,Vice President ®Vv ®�® P.O. Box 1179 Eric Sepenoski J Jf Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � a� Fax(631) 765-6641 1000 ,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10564A Date of Receipt of Application: April 15, 2024 Applicant: Cutchogue-New Suffolk Park District— Nassau Point Beach SCTM#: 1000-104-8-6.1 Project Location: 9430 Skunk Lane, Cutchogue Date of Resolution/Issuance: May 15, 2024 Date of Expiration: May 15, 2027 Reviewed by: Board of Trustees Project Description: Install modular unit children's playground equipment. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by David Bergen and Ken Quigley, received on April 15, 2024, and stamped approved on May 15, 2024. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. 4�L 4" Glenn Goldsmith, President Board of Trustees .. - I'S 0 LD , TRUSTEES No. A c) S & LIN ,. - rw ��Issued T ate., 5 Addy�s� �► 43 � SKu�K" .Lana C�'�ct,oa �,e Na TFIIS NOTICE .MAST BE DisPLAYED DURING COIJSYRIJCY'IOPI TOVllld TItlJ5TEE5 OFFICE.TOWN OF SAUTFIOLD SOUTHOLDo N.Y. 11971 TE L.: 765•1 892 Glenn Goldsmith, President ®� s®c�,� Town Hall Annex ®� ®� 54375 Route 25 A. Nicholas Krupski,Vice President ® P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone (631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 c®U TI,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF'TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction '/2 constructed When project complete, call for compliance inspection; ►a z I I s� L�1 EOCE OF PAVEMENT � I MD. C• �.. �.. .. �- ..• - � v•' N 87°0:'70"F:• `-• �• � 336.09' EDGE OF PAVEMENT- " .BAY AVENUE. r EDGE OF PAVEMENT " - -- - `- °—GUY W.V. . + .. U.P. 690.69' U.P.° sGR J. U.P. .P. P MLANTER 1ICUARO RAIL ^�U P U. ^ es 6g�'f•O? I �+= ,�-,. •�` I CONIC. • `-•P. ROOF OVER NI ° U.P. 4 LAND N/F C` -' I PERGOLA OVER OF MARTENS CA-VANT- $ WOOD DECK WOODED - -VACANT- d -„ ✓� WOODED • rz it .i-,,,. U.P. Scxx x`, >il X X �-NG g vNb10 x x x X ` - `CIE Ala s�1 x x x `�C`, S \AA x X\ 7C�., s�*• /R`._...c'i \�X Jo 81000-104-M.1 iI x �o, 227264 S.F. x� 5.22 Acres \ �zp, #1000-104-8-4 v' s ...�... .r... \\X"'1'X 485,952 S.F. T.� ga �I ,✓`.... X X``� 11.16Aaes `\x x s s� X x\\ s s s f 4\\X x X a\ ° U. ^� \ v x x` �,� ;I x x� X i\\ C.CURB x Say ``\x U) .I ✓�-.. .�.r ,n -.� .... .r�.n ,n ✓�... '^ \\X X`,`\ _9' 'U.P. \X X`\ W000 DECK ;_ x x.\ r� ✓�-.. �,n., -^... .n.. �.�-.. -i`n \` x 1`\ '7i• o it BROADWATER COVE �~ \XX \ r� w z \X ,)\ ° o. \ U.P. (D \ x .\ o X ._ v -VACANT- + H .� -,. '�-^ ✓�.. s \ X, \NDs- WOODED 7 �tit" ...�.,. s \x o s vc '11 a f Kz1i� US s ` 'AI X 1X U.P. s A x'1,1 ✓�-.� -r -.� .�... ,.. ✓�..� ;'I m U.P. lx;Iw N N86°29'S�_. GUARD RAIL S 86°39'00'W c I f '�"� .,` ✓`-� r '..-^ z I 101.11, U.P. NEST TF.^',•�'� APR 15 2024 -�-� -�..�~ -^•� I-$I N1000-104-8-9 '` s.I (}_� 37379 S.F . ,I n {` 0.86 Acres - „ ?_ Southold Town ^s ix / #1000-104-9-8.1 y 11 g° 60052S.F. II Board of Trustees ��� ~ % W P-47 -VACANT- g 1.38 Acres /^!p WOODED s� CAUSEWAY BEACH DISTRICT PARK 'X X •1 RED d °P. I ^� X ;I 60 0 30 60 120 240 /x 0c1`ary� ' `-• 5 .0440 p 9'W /x X ' - -U.P. 2.9AS4 ... -X.- X i 4• E io I 3.05 e I AREA:485.952 SOFT. or 11.16 ACRES �� •1. •��� ��E. 6 I UNAUIN64/IID ALD RARON W ADOIDW W IONS SURVEY IS A WOLARON OF SECRON T209 W ME NEW/tNK STAIE EDUCARON LAN: COPIES OF MS SURVEY �� xs� Q M U.P YAP NOT BEAPoNG WE LAND MRIEYWS EMBOSSED SEAL SHALL NOT NOT BE CONSIDERED TO SE A VALID TRUE COPY O/ARMTEES INDICATED HEREON SHALL RIM ..• � ,°•• ONLY R)THE PERSON FW NNW WE WRW Y IS PREPARED AND ON HIS BEHALF TOME RTLE CWPANY,WWRNNENTAL AGENCY AND LENDING INS"WoONUSI THE D�rsDR DIUMSIW To S SHOWN EONOVmr"WE vl YY LINES TO INE STR�R/��FOR A SPEORC PURPOSE AND USE THEREFORE 7NEY ARE NOT INIENDED IO MWUIO'NT WE PRO°ERTY LINES W TO GUIDE WE ERECRON W FENCES ADDIRONAL SIRUCIVIZES OR AND OTHER WFY?0 MIS EASEMENIs AND/W SUB6VH'AO:SMWTURES REG'OPDED W UNRECO®ED AW NOT GUMAN)IM UNLESS PN/9GLLY ENDENT ON THE P.HIUSES AT THE RME OF SURVEY SURVEY ORDESCRIBED PROPERTY OF NEW CERTIFIED TO:CAUSEWAY BEACH DISTRICT PARK; MAP OF.. tiP 5Nt>P'- FlIFD: SI1l1ATEU AT:CUTCHOGUE Tom MSOUTHOLD SUFFOLK COUNTY,NEW YORK °Fy aW KENNETH M NOYCHUK LAND SURVEYING, PLLC s 06066 J9- Proteeal0ael Lnd 9ury ylns end Oe11 WE WATER SUPPLY,K£LLS WY19US AND CESSPOOL / N P.O.Box 153 Aquebosue,Near York 11831 LOCA ROVS SNOW ARE FROM FIELD OBSUVA77ONS FILE 8 222-157 SCALE: 1'=60' DATE:NOV.21,2022 NY.s use Na oaoeez Mon Ual)a9e-16m PAZ(eal)eee-16e6 AND W DATA OBTAINED FROM OTHERS Glenn Goldsmith,President r COGy.► Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 0 Eric Sepenoski a ,? P.O. Box 1179 Liz Gillooly �y • o�� Southold,NY 11971 Elizabeth Peeples �01 + �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: s b1zq �P\ Completed in field by: David Bergen on behalf of CUTCHOGUE-NEW SUFFOLK PARK DISTRICT, NASSAU POINT BEACH requests an Administrative Permit to install modular unit children's playground equipment. Located: 9430 Skunk Lane, Cutchogue. SCTM# 1000-104-8- 6.1 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: V Chapt. 275 Chapt. 111 other Tye of Application: Wetland Coastal Erosion Amendment W 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 y N. Kru ski E. Se enoski P p L. Gillooly E. Peeples EkwkeNASSAU POINT BEACH PROPOSAL q: 119-179962-1 MAY TMT 01,10VES YOU NEW COLOR KEY AMERICAN Ire ^J r R f co MANN • y WL N 06tt.YP � 1 � .a,o�i zc.xO lr \S m � ' • t LITRE pub^5�6�'— i �2-taw Qr' t W • O ?� Y O > � P e P�� t• +t l ttNL ��yl 316w f. ;a�cl .s N m �wN• '9 ab o.t) ��.e> N �`. y, za tea r ,b• 2 a °4 0 y 1- t 1 2 1 • 2 `+ +2+ ` ,P+> �1>' +• BROADWATERS COVE m c� >a •e` ,. a wy. 2?� TOWN OF gSOUTHOLD \ 2]�ycl f 9 HAYWATER COVE 4 ° +a C • � E w � '-^� ♦ Q9 � yr +21 r� '� _—_— COUNTY OF SUFFOLK © K w p SEC troR Ro a l Real Property Tax Service Agency v ..��. R e...�,n... -vim: r�� . �.. —_— ,.w,u __t__ �__.__ 9 OPnOYwriurMrw•M.RY11M1 M 104 P1000 PROPERTY WP i OFFICE LOCATION: �0��0� SU(/r�,OlO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) G Q Telephone:Southold, NY 11971 � • �O Te P c4UNT`(,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: May 14, 2024 Re: LWRP Coastal Consistency Review for CUTCHOGUE-NEW SUFFOLK PARK DISTRICT, NASSAU POINT BEACH SCTM# 1000-104-8-6.1 David Bergen on behalf of CUTCHOGUE-NEW SUFFOLK PARK DISTRICT, NASSAU POINT BEACH requests an Administrative Permit to install modular unit children's playground equipment. Located: 9430 Skunk Lane, Cutchogue. SCTM# 1000-104-8-6.1 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 CONSISTENT with LWRP Policy 6 and, therefore, CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Honorable Lori Hulse, Attorney Glenn Goldsmith,President QT Town Hall Annex A.Nicholas Krupski,Vice President ,r�J. 54375 Route 25P.O.Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631 765- Elizabeth Peeples .; �. x1) s5F,66 BOARD OF TOWN TRUSTEES APR 55 2024 TOWN OF SOUTHOLD gotithod Town . This Section For Office Use Only Board of Trustees Coastal Erosion Permit Application -:,rWetland Permit Application Administrative Permit ,A-mendmentPTransfer/Extension Received Application: jig of Received Fee:$ Completed Application: Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination-(date sent): . =LWRP Consistency Assessment Form Sent: CAC Referral Sent: _Date of Inspection: S a Receipt of CAC Report:. _Technical Review: _Public Hearing Held: a Resolution: Owner(s)Legal Name of Property (as shown on Deed): Cutchogue New Suffolk Park District Mailing Address: Box 311, Cutchogue, NY 11935 Phone Number: 631-734-6719 Suffolk County Tax Map Number: 1oo0- 104.-8-.,G o__ 9H30 Property Location: Bay Ave (Skunk Lane), Cutchogue, NY 11935 (Nassau Point Beach) (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable):David Bergen Mailing Address:Box 1008, Cutchogue, NY 11935 Phone Number: 516-848-6438 Email:.davebergen78@gmaii.com Board of Trustees Application GENERAL DATA Land Area(in square feet):_ 2�1, 16 Area Zoning: ... Previous use of property:recreational Intended use of property: recreational Covenants and Restrictions on property? —ilYes _ ✓�_No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? LLYes -allo 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 _Z_No If"Yes", please provide copy of decision. s project 71��7Y demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on-property have a valid Certificate of Occupancy? Yes__Z__No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permittapproval ever been revoked or suspended by a governmental agency?]a No_Ja Yes If yes,provide explanation: Project Description(use attachments if necessary):to install a modular unit-children's playground equipment Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Provide recreational and fitness area for children Area of wetlands on lot: 12 [cJ 0,000 square feet Percent coverage of lot:. 1 1kS'Q,% Closest distance between nearest existing structure and upland edge of wetlands: 1 2 feet Closest distance between nearest proposed structure and upland edge of wetlands: ..?Z) feet Does the project involve excavation or filling? 0 No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? a. 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: machinery used for work will include a bobcat, front loader and skid loader Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason,of such proposed operations (use attachments if appropriate): none 61 Z20 Appendix S 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 l 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 lnformMion Cutchogue New Suffolk Park District Name of Action or Project: Nassau Point Park Children's Play Area Project Location(describe,and attach a location map): Nassau Point Beach, end of Bay Ave (Skunk Lane) Brief Description of Proposed Action: Install a modular children's play area to promote healthy recreational and fitness needs Name of Applicant or Sponsor: Telephone:516-848-6438 Boad of Commissioners/Cut. New Suff. Park District E-Maii:davebergen78@gmail.com Address_ Box 311 City/PO: State: Zip Code: Cutcho ue NY �11935 I.Does the proposed actiori 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 0 3.a.Total acreage of the site of the proposed action? Z. acres b.Total acreage to be physically disturbed? c..1:.... .. acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? J$ acres 4. Che&a 11 land us at occur on,adjoining an ar the prop action. Urban Rural(non-agriculture) Industrial Commercial ❑Residential(suburban) Forest agriculture ✓Aquatic 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 ,/ ❑ ❑little econlc a S. 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? V/ 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 T YES . If No,describe method forproviding potable water: ri ❑ ❑ 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: 14.-Identify the typic bitat types that oc n,or are likely to be found on tiMroject 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 I00 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? PNO . If Yes, a. Will storm water discharges flow to adjacent properties? ❑NO DES �✓ ❑ b.Will storm water discharges be directed to established conveyance systems ff an drains)? If Yes,briefly describe: riO ES 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: 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: a ❑ . I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE / Applicant/sponsor napa� C-d e` ..C o�!r�vt o 1 Date: f z. I Signature: . . .� Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all ofthe following questions in Part 2 using the information contained in Part 1 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. Will the proposed action have'an impact on the environmental characteristics that caused the Elestablishment 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? El 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: El ❑ a.public/private water supplies? b.public./private wastewater treatment utilities? El El 8. Will the proposed action impair the character or quality of important historic,archaeological, a architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑. waterbodies,groundwater,air quality,flora and fauna)? El 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 problems? El 1:1 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 occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Board of Commissioners- Cutchogue New Suffolk Park District owners of the property identified as SCTM# I 000-1 04.-8-4 in the town of Southold .New York,hereby authorizes David Bergen 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 Sign a Property Owner's Signature SWORN TO BEFORE ME THIS 1S" P' DAY OFF,,, ,20. i`L Notary Public JOHN A. MAKI Notary Public.State of New York No.01 MA6164838 Qualified In Suffolk County My Commission Exp.04/30/2027 l Board of Trustees Application AFFIDAVIT David Bergen, Chairman-Board of Commissioners 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 O er Signature of Property Owner SWORN TO BEFORE ME THIS �S DAY OF r. / �,.20 JOHN A.MAKI Notary Public-State of New York No.01 MA6164838 Qualified in Suffolk County Notary Public My Commission Exp,04/30/202.7 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southotd's Code of Ethics urotiNts conflicts of interest on the part of town off!gkrs and moloyees,,_The mine a of this form is to provide information which can alert the town of 66ssible conflicts of interest and allow.it 10 take Wjkl everaetion is necessarvto avo d} same• YOUR NAME: David Berqen (Last name,first name ipiddle initial,unless you are applying in the name of someone else or.other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval ofplat Mooring Exemption from plat or official map Planning Other (if"Other`,name the activity.) Do you personally ,_(orthrough-your,company,spouse;sibling,parent,or dhild)have a relationship:with any officer:or.employee of the Town ofSouthold? "Relationship"includes-by blood,marriage,or business interest`Business interest.'.'means.a_business, including a partnership;io which the town officer or employee:has even a partial ownership of(or employment by)a corporation in which the tbwnofficer or employee owns more thsm.5%�oft he shares. YES n.. NO Fy I ... If you answered"YES,complete the balance ofthis form and date and sign where indite. 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): —EIA)the owner of greater than 5°70 of the shares of the corporate'stock of the applicant � (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity.(when the applicant is not a corporations C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this _day of 20 2 Signature Q. H-, Print Name Davld-1e'gen Form IS 1 '• i 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 sighifi6afit beneficial and:adverse effects uaon 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 emlained in detaih..Jisting both supnortink and non- sunportine: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# 1000 _104.-8 4 PROJECT NAME Nassau Point Park Childrens Play Area Unit The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept ❑ Board of Trustees a 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: Nature and extent of action: Install a modular.chitdren's recreational and fitness unit.... t Location of action: Nassau Point Beach Park at end of Bay Ave (Skunk La) Site acreage: Present land use: recreational- park Present zoning classification: 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:.Cutchogue New Suffolk Park District (b) Mailing add: Box 311, Cutchogue, NY 11935 (c) Telephone number. 631-734-6719. . Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes n No❑ if yes,which state or federal agency?NYDEC 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. FV Yes n No ONot Applicable ..provides recreational.and fitness opportunities for children 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 L_._! Yes ❑ No R] 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 Wil.l,have a low impact on visual quality Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑. Yes ❑ No❑ Not Applicable Atkch-additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold.See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria r ❑ Yes ❑ No RINot Applicable - chafttional sheets if necessary - Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ Yes ❑No Fvll 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. Yes ❑No❑✓ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ 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. ❑ Ye❑ No❑Not Applicable Provides recreational and fitness opportunities,for children 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 provides fitness and recreational`opportunities Joucbildren at an-eMblished pubiie park Attach additional sheets if necessary +.Policy 11. Promote sustainable.use of living marine resources in Loug.+Island Sound, the Pecouic Estuary and Towni waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria ❑Yes ❑ No Lr!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 FV1 Not Applicable i Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies;Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No❑✓ Not Applicable PREPARED BY David Bergen ALE Chairman_ DATE 1 L14 Box 1008 Cutchogue, NY. 11935 April 15, 2024 Southold Town Trustees Town Hall Annex APR 15 2024 54375 Rt. 25 Southold, NY. 11971 Southold Town Board of Trustees Dear Trustees: I am respectfully submitting to you the attached application packet for an Administrative permit for the installation of a children's playground area located at the Nassau Point Park.. Enclosed you will find: Administrative Permit Application Short Environmental Assessment Form Authorization Form Owner Affidavit Applicant Transactional Disclosure Form Agent Transactional Disclosure Form LWRR Consistency Assessment Form Site construction plans Manufacturer's drawings Property survey Color photographs We are requesting a waiver of the application and final inspection fees. The Cutchogue New Suffolk Park District is a public, taxing.agency within Southold Town. All revenue is obtained from property taxes. We appreciate your consideration to support this request to the Southold Town Board. 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, 'd-. Q David Berg ,.Chairman Board of Commissioners Cutchogue New Suffolk Park District