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HomeMy WebLinkAboutJaklevic g11FF0(k , . Glenn Goldsmith,-President COGy., Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 Eric Sepenoski y ,z P.O.Box 1179 Liz Gillooly �y • �!� Southold,NY 11971 Elizabeth Peeples �Ol �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Completed in field by: J.M.O. Environmental Consulting on behalf of ROBERTA F. JAKLEVIC requests a Wetland Permit to remove and replace in-place the existing bulkhead using vinyl sheathing and raise the height an additional 26" to match existing bulkhead; and backfill with clean sand from an upland source. Located: 900 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-21.2 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 - I VE APR 1 SouGlo!d Town -,+of Thisfi t SURVEY OF GUARANTEES NVOMATED HERE ON SHALL RUN DESCRIBED PROPERTY ONLY TO THE PERSON FOR *HCW THE SURVEY IS PRFPARED, AND ON NS BEHALF To THE SITUATE LENDCOMWANY GOVERNLIS70LALEW, NEW SUFFOLK TOWN OF SOUTHOLD LENmWYO rNsnTUTrow, !F usT£D HET2£ON. AND , ro THE IUS AEES T THE' W WAB IN TVTUTTON S U FFO L K COUNTY, N.Y. GUARANTEES ARE NOT TRANSFERABLE 7n ADWnWJAL MSTTTURONS OR SUBSEQUENT OMNERB LMUMMZED ALXWATFW OR AM"ON TV THIS SURVEYED FOR: WILLIAM J. JAKLEVIC THE NEW YO STATE E TN OF iau w°g OF O ROBERTA JAKLEVIC CORES OF INS SURVEY MAP NOT BEARM THE LAND SVRWYCRS ELBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. Uf1L POLE., sF 61 GUARANTEED WILUAM J. JAKLEVIC FF•pp ti'�� CA4 ROBERTA JAKLEVIC COMMONWEALTH LAND TITLE INS. CO. Um. TM# 1000-117-05-021.1 POLE r �� �c,� N/F ENDEMANN 0 cl JK ,�'►� N/F KWIT A/' APPROX. HIGH WA7FR LINE THIS DATE 1. S 24 59'06"W 3.30' N 87'55'00"W 2. S 6056'20"W 27.79' 23 J. S 1420'23"E 24.10' Pa 4. S 7238'46"E 28.50' 5. S 33 09'31"E 10.07' 6. S 30 27'05"E 66.14' 7. S 3027'09"E 47.45' 8. S 2338'38"W 9.42' 9. S 2522'07"W 11.91' 10. S 81 41'16"W 21.37' '6 Z 12. N 8476 40"W 85.58' 13. N 62' 51'07"W 25.21' 14. N 28 25'29"W 66.32' o� N/F RAYNOR N N/F WICKHAM 'v BULKHEAD S 87'55'00 'E 110.00' •unL ��� M POLE cm FRAME �p0 0� \ GARAGE N/F LOCKWOOD s P. 0• el�Z�,�p�� �a I S 87'55'00"E 108.82' G$� calm wooD �_ 5 N BO�THOUSE O, RAMP �L uLkHfAD o N \9'O,o IP \\ 2G) 6�6. Lill�"� \ BULKHEAD Q \ O N87'S7'00"W ' 0 14 WATER -9N a LINE it rIo EXISTING WOOD DOCk SURVEYED: 17 SEPTEMBER 2002 AND WALKWAYS SCALE 1"=40' I SCHO O��]'O r r� /'v AREA = 42.7029R.37 S.F. =1 (� 0.981 ACRES SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW SUFFOLK. N.Y. 11956 631-734-5835 I LICENSED LAND SURVEYOR NYS Lic. No. 49273 02C 1172 Applicant: Roberta F. Jaklevic Purpose: Bulkhead reconstruction Datum: Apparent low water ' Location: 900 Old Harbor Road Locus: 40°59' 41.604" N --72Q283 25.248" W S.C.T.M.No. 1000-117-05-021.1 ' E ' E ! V E APR 1 �24 `:� � I Souawld Town T —06 1 ' t Applicant proposes to reconstruct In kind and in place and raise the height by 26" to match existingbulkhead ad of approximately 90' of timber bulkhead and to backfill structure with approximately 10 cy of clean P�[ ` sand from an upland source. + •ram. �q F t� 1 LJ 10 cy of clean sand form an upland - L Ocs( 0 I St J 1100y AA/0 NS S SEE?' I OF3. JMO Environmental Consulting P.O. Box 447, Quogue, NY 11959-0447 Applicant: Roberta F. Jaklevic C `/ Purpose: Bulkhead reconstruction Datum: Apparent low water APR 16 2024 Location: 900 Old Harbor Road Locus: 40's 59' 41.604" N Southold Tom —72'2W 25.2.4859 W of S.C.T.M.No. 1000-113t-05-021.1 EX.BLK C. -- _ EX. L p, TORE .REC ON 14 H W+2.5, M L tiV Q' Applicant proposes to reconstruct . In kind and in place and raise the height by 2*6" to match existing bulkhead of approximately 90' of timber bulkhead and to backfill structure With approximately 10 cy of clean sand from an upland source. 10 cy of clean sand form an upland SHE T 2 OF 3 JMO ENVIRONI NTAAL CONSULTING D E0EIVE , APR 16 2024 SouMofd Town .20 of Trustees F® 35 - CA P G D 10 CY OF CLEAN .S APB D T I E ROD 'FOR BACK E1 LL AH W+2,5 A DEADIMAW ALW O` /YNYL BOTTO -116 SHEATilING Pl L E Applicant: Roberta F. Jaklevic Purpose: Bulkhead reconstruction Datum: Apparent low water Location: 900 Old Harbor Road Locus: 40059' 41.6041 N --7r28' 25.248'1 W S.C.T.M.No. 1000-11105-021.1 Applicant proposes to reconstruct In kind and in place and raise the height by 26"' to match existing bulkhead of approximately 90' of timber bulkhead and to backfill structure with approximately 10 cy of clean sand from an upland source. 10 cy of clean sand form an upland EET JMO EN. VIR.ONM NTAL CONSULTING JL g4 Awe fee 1 V r )o C�tA-Uor-4mc" �fy or �, a m� N/F LOCKWOOD •�sue. � �, � �'��� o �� � s �► \ ��� °' �, 2��0�� l S 87'55'00"E z� om smap RAMP 4. 5 !P 6" '� \ SULKHM N87'57'00"W 13.2V \� Z }4 \ \ WATER EXISTING WOC SCHO j y� Relis— , a ILL RD. lw N y ', O yjµ 5 d ay 1M d� Q O w t2 ��aeEc ra ° O10e1 H 5) 22A Ix.' tq to J te' 1I3 1.2Mc1 6 r m e.e 0.a 12, ' _ •e ,�,A B 1 j' rs & zsT mz >w - ° �I: CUTCHOGUE ro 1aMQ y °# 'b HARBOR . 21 c _`:♦ ^I, a ,�, 4 ACT +>n a1 22Mcl ee.a. ,aMq i8 J k. � PB1e:R RwrG wy+ �i y ipe a R 2 ) t BNcI >t d y t e y y )AM-I J�. OAQ 1 ,.KW• l5m 1°,. $ , „'� 3° e-s o it ,e m..R"", yTµQ f;, te.0 NtW e 1° •©w 2, x me -"' x�a�o. � w° _1°. 11 2 n \ 1a d 164 2 MEW 9UFWM1 NEE 12 5.1 1 .95MQ ry� t 1]MQ at RAM4 ;¢ 2MJClO I H .-,tg m 35 c ), .."w' w A u e JKxapM � n '. 1 t 2 2J.s ' RAMj 2,Hc1 teycl �i . �.a` .,� �_•3' - �� BAY — PECONIC .-.- GREAT - - 6 COUNTY OF SUFFOLK © E gDUrNDLp secrioM NO Real Property Tax Service Agency Y ID w..,s xa ... +x+ w�ya r —�_— u..u. --.-- uru.--,H-- run�xw ... 4`K�w p mc,w 1�0/ PROPERTY MAP Caroline Burghardt,Chairperson =� Town Hall,53095Main Rd. Lauren Standish,Secretary ult P.O.Box 1179 +�► �` Southold,NY 11971 4'. , Telephone(631)765-1889 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held on Wed., July 10, 2024, the following recommendation was made: Moved by John Chandler, seconded by Maggie Merrill, it was RESOVLED to SUPPORT the application of ROBERTA F. JAKLEVIC to reconstruct in- kind and in-place and raise the height by 26" to match existing bulkhead of approx. 90' of timber bulkhead and to backfill structure with approx. 10 cy . of clean sand from and upland source. Located: 900 Old Harbor Road, New Suffolk. SCTM#117-5-21.2 Inspected by: John Chandler The CAC Supports the application with a 10' non-turf vegetated buffer landward of the bulkhead. Vote of Council: Ayes: All Motion Carried OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971 OWN LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: July 10, 2024 Re: LWRP Coastal Consistency Review for ROBERTA F. JAKLEVIC SCTM# 1000-117-5-21.2 J.M.O. Environmental Consulting on behalf of ROBERTA F. JAKLEVIC requests a Wetland Permit to remove and replace in-place the existing bulkhead using vinyl sheathing and raise the height an additional 26"to match existing bulkhead; and backfill with clean sand from an upland source. Located: 900 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-21.2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the LWRP. Turbidity controls are required. 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 } Town Hall Annex .. Glenn goldsmith,President ,' ' IK A.Nicholas Krupski,Vice President +►' © 9, 54375 Route 25 P,O.Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Tel ePP3 1 Elizabeth Peeples x (63 76 I APR 16 2024 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town This Section For Office Use Only �J`Ces Coastal Erosion Permit Application Wetland Permit Application _Administrative Permit _ Amendment/Transfer/Extension YJ Received Application: �_� Received.Fee: S Completed Application: a` Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: _ Coordination:(date sent): LWRP Consistency Assessor nt orm Sent: 7 CAC Referral Sent: ate of Inspection:_D _ 9 Receipt of CAC Report:_ _ Technical Review: _Public Hearing Held: i UZI___ Resolution: Owner(s)Legal Name of Property (as shown on Deed): Roberta F.Jaklevic _ Mailing Address: P.O. Box 613, New Suffolk, NY 1.1956-0613 Phone Number: 631-872-0093 Suffolk County Tax Map Number: 1000- 117.05-021.31 Property Location: 900 Old Harbor Road, New Suffolk (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): JMO Environmental Consulting/Glenn E. Just Mailing Address: P.O. Box 447, Quogue, NY 11'959-0447 Phone_ Number: 631-653-0607 Email: Gjust10215@aol.com f!�S e/1� Applicant proposes to reconstruct in kind and in place and raise the height by 26" to match existing bulkhead of approximately 90' of timber bulkhead and to backfill structure with approximately 10 cy of clean sand from an upland source. Board. of. Trustees. Applica.__ n GENERAL DATA Land Area'(in square feet):::42 729.37 Area Zoning: R-:40 Previous use of property:'Single family`dwelling Intended use of.property::Single family dwelling _ Covenants and Restrictions.on.property?. Yes 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 ElevationTlansmill be requited... Does this project require a variance from the Zoning Board of Appeals? Yes �_No If"Yesl% please.provide copy of decision: . his project Fe any 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=No Prior permits/approvals.for'site.improvements: Agency Date Town.Trustees mod10 N.Y.S D.E.C. : El No prior permits/approvals•for site improvements. .Has any permit/approval ever been revoked or suspended by a governmental agency?�No Yes If yes;provide explanation:... .Project Description.(use attachments if necessary): Please see attached Board. of Trustees` Applica _ , :�n WETLAND/TRUSTEE LANDS APPLICAT ION:.DATA; Purpose of the proposed operations: Bulkhead reconstruction Area of wetlands on lot: 3;200 square feet Percent coverage of lot: na ._ . /o Closest distance.between nearest existing-structure and.upland,edge of wetlands: 36.2 feet "Closest:distance between nearest proposed structure and upland edge of.wetlands 36.2 feet Does the project involve excavation or"filling? No ✓ Yes :n If yes, how:much material will be excavated? 10. cubic yards How much material.will.be.filled? �.0 cubic.yards Depth of which material will be removed-or deposited: 4 6'.: feet Proposed.slope throughout the area of operations 1 :1 1Vlanner in which material will be..removed or deposited Crane On barge 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): As proposed there:should be no negative:irripacts upon the wetlands or tidal waters of the Town: 617.20. Appendix-B Short-Environmental Assessment Form . Instructions for Comnletin�. . Part*l -Projeet:lnformation: The applicant or project sponsor is responsible for the'completion of Part I.:Responses_ become part ofthe applicatiogfor approval or funding,are.subject to public.review,and may be subject.to further verification. Complete,Part`].based on information currently available.,afadditional.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 inay 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. `Parf 1 P.rojecf and Sponsorinformation Name of Action or Project: : . Roberta:F. Jaclevic . Project Location(describe,'and attach a location map): 90o Old Harbor Road, New Suffolk Brief Description of Proposed'Action'., Please see attached Name of Applicant or Sponsor:''. ' Telephone:6/0.631-872-0093, Roberta F. J.aclevlc E IvlaiI- Gjust1021,'5@aol:com ,Address:...... RO. Box_ 613 City/PO:`. _ : State: : :. . Zip:Code:. New Suffolk: NY.. . 11956-06.13: 1.Does the proposed action`only involve the legislative adoption of a plan;local law,ordinance; 1,0. YES'. administrative-rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and,the environmental resources that ma be affected in the munici ality and,proceed to Part 2: If no,continue to.question 2. ' Y I? 2: Does the proposed action.require a permit,approval or funding from any otlier`governmenfal Agency?: NO' YES If-Yes, list agency(s)name and permit or:approval: Southold Town Trustees, N.Y:S.D.E.0 , N.Y &D.O:S. & U.S.A.C.O.E ❑ 3.a.Total.acreage.of the site of the proposed action? 0.98 ___acres b.Total_acreage to be physically disturbed? n: acres C. Total acreage.(project site and any contiguous properties)owned or controlled by the:applicant or project sponsor? 0:981 acres on-a 4., Ch.e I1and us af.occur on,'adjoining an ar the prop action. Urban .LZJRural(n griculture) Industrial ,Commercial QResidential (suburban) Forest ❑Agriculture Aquatic QOther(specify): Parkland Fage I 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. ls'the proposed action consistent with the predominant character of the existing built or natural NO YES'. , landscape? t, 7.' Is the site.of the:proposed.acti h Qated"in,or does it adjoin,a state listed Critical Environmental Area? NO YES::.; If Yes,identify:. �econic Bay . �. n $. a..lWill:the proposed action result in a substantial increase in traffic above present levels? NO" YES" b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site.of the proposed action? 9,,Does the proposed action meet or exceed.the state energy code requirements? `.N:O.:' YES: If the proposed action will.exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an exisfingpublic/private water supply? NO ;;YES If No,describe method for providing potable water:" nn l].Willthe,proposed action connect to existing wastewater utilities? NO . `..YES . If No,describe method for providing.wastewater treatment:..na g NO YES 12. a.Does the site contain astructure that is listed on either the.State or National,.Re Regis Historic Places? " b.Is the proposed action located in an archeological sensitive area? B.a.Does any portion ofthe 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 Shoreline Forest pes that oc Agricultulral/1 rass fy found oria roject site: Check all that apply': ✓ g lands " �6arly mid-successional: " - ✓ Wetland Urban Suburban 1 S.Does the site of the proposed.aciion 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 l 00 year flood plain? NO" YES 17.Will the proposed.action create storm water discharge;either from point or non=point sources? NO If Yes; a Will storm water discharges flow to adjacent.,properties? O. ES ❑ u'" b'.Will storm water discharges be directed to established conveyance.systems ff an m drains)? ' .if Yes,briefly describe: JO YES Page 2 of 4 1.8.•Does the proposed,actionJnclude construction or'other activities thaf result in the,impoundment "of NO. `YES, water or ether liquids(e.g.retention pond,waste lagoon,damj? ` f Yes,,explain purpose and size: RREI —-- 19.Has ihe,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 o ftlie proposed action or.an adjoining,property been the subject of remediation(ongoing or . NO . ':..YES completed)for hazardous`waste? 1f Yes,describe: ........... CI `D f AFFIRM, THAT THE INFORMATI PROVIDED ABOVE IS TRUE AND ACCURATE.TO THE BEST OF MY: KNOWLEDGE Applicantlsponsorname:.�?I. Cl: .JU Dater _. � ... Signature:.; Part 2:Impact Ass ssment. Th ead Ageticy is responsible for the comple6on'ofPart 2..Answer all ofthe following questions in Part 2 u ' g.the i rmation 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 i. Will the proposed acti0;create a material conflict with an adopted land use plan or zoning regulations? El. 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? a o .4. Will the proposed action Have an impact on the environmental characteristics that caused the establishment of.a Critical-Environmental Area(CEA)?: � ID 5. Will the-proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit bikingor walkway? 6. Willahe proposed action cause an increase in the use of energy and it fails to incorporate reasonably available.energy conservation:or renewable..energy opportunities? a" 7. Will the proposed action impact,existing:- 4- a. public/private water supplies? a 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, waterbodies,groundwater,air quality;flora and fauna)? �< E.' Page 3 of 4 No,or: Moderate ; small.' to large impact impact may'. may. occur occur b, Will the proposed action result in an' increase in the potential for erosion;flooding or drainage; problems? j 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 rhay:occue,;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;:lon'g-terin and cumulative impacts. EJ Clieck`this iioz ifytiu have determined,,basetl on tiieinforriiation:and analysis above,and any supporting.d6ceuiiientation, ? that the proposed action.may resulfin 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 ihe.proposed action will not result in any significant adverse environmental impacts. Town of Southold-.Board of,Trustees Name of Lead Agency.:.- bate President Print or Type Name of Responsible Officer in Lead Agency Title.af Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer). PRINT Page 4 of 4 f - ,B oard.,bf Tres tees ' ion,Appl Cet AFFIDAVIT �d2vi BEING:DUI,YSWORN : `:. .DEPOSES;AND:AFFIRMSIRAT HE/SHE IS:THE.APPLICANT FOR.:THE ABOVE: . .. DESCRIBED PERIVYIT(S}NAND THAT:ALL STATEMENTS CONTAINED:HEREIN .ARE TRUE T.O.THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE D,ONE:IN THE.MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE.APPROVED BY THE SOUTHOLD TOWN.BOARD OF..: THE APPLICANT AGREES T.O HOLD.TH-TOWN:OF.SOUTHOLD AND THE BOARD OF TRUSTEES:HARMLESS:AND FREEIFROM AN.Y AND ALIr.DAMAGES AND CLAIMS:ARISING UNDER OR'BY VIRTUE OF.SAID PERMIT(S),IF GRANTED. .IN COMPLETING.THIS.APPLICATION,X HEREBY AU THORI7E THE' TRUSTEES-THEIR:AGENT(S) OR REPRESENTATrVES,INCLUDING:'. : CONSER'V�ATION ADVISORY COUNCIL;TO ENTER ONTO MY PROPERTY.TO INSPECT TIIE PREMISES IN CO NJUNCTION.WITH.THIS APPLICATION,; INCLUDING ''FIN, YNSPECTION:. :I FURTHER AUTHORIZE THE BOARD OF.`.:: TRUSTEES ENTER O.NTO.MY PROPERTY AND AS REQUIRED TO INS .1 COMPLIANCE WITH ANX CONDITION OF ANY WETLAND'.OR..COASTAL. EROSION PERMIT.ISSUED BY THE BOARD OF TRUSTEES..DURING:THE..TERM: OF THE:PERMIT: x Signature 0 Y(Owner. :.Signature of Property Owner SWORN TQ.BEFORE ME THIS __ DAY OF zp 77 .. ouwAFRAP4M.; N .. PUb�1C . NOTARP PUBLJC,STATE OF NEW PORK. Reg' don k O FR6288691 Qualified h S,ufiolk Ccurrty My Commission Expir�.September 09,.2o APPLICANT/AGENUREPRESENTATIVE. TRANSACTIONAL DISCLOSURE;F:.ORM The Townof.Southold'sCade.oflrthics:protiibitsconflicts.of:intereston.tHe'aart'oftown:off loyees.rcers and:.emD The nur�ose of Allis orm'isio' iovid `l f©rinat... wh`c :' ale t:I ` -t w"'of- §i6te c`o fli s o iri e` eri a ow.'t `>ake wha ever acti n is. necpssnry to 'daarne::. YOUR.NAME•.. . T%�Ofnf%C, : �fo:1�r1..� (Last.name,first riame;ipiddle initial;upless you are applyinginahe name of.. someone'else or other entity,such as a company:If so;indicate:the other pers6,n's or company's name:) NAME OF APPLICATIONr(Check all that apply.). - :Tax .grievance Building Variance Trustee ✓ Change of Zone Coastal Erosion Approval;of plat Mooring Exemption.from plat or.official map. Planning Other (lf""Other",name the activity.) o you'persanally'(or througti:.your com anY..Po e3 g.. r :,..-,.:co p: s us siblin parent,or child)aiave.'a rel5tionship':iNith any offcec Qr;einptoyee of the Town:of.Southold? Relationship":mcludes:hy:blood,marriage,ar business'ihterest "B:ustness mteteSf'meansa_bustness; including.4::p3ifEieiship,;in which theyown:ofticer:or employee has'even a.part+al ownership,of,(oremployment:by).a coiporation in.which theaoWn officer:or employee owns•more than 5*%ofti a shares. YES n . NO I`V . If you answered`.`YES',complete the balance of this form and date.and,sign,where indicated: . Name ofperson employed by,the Town of Southold Pr Trtle.or position-of that person ,N Describe the relationship between yourself(the applicanUagenUrepresentative)and the town officer.or employee.Either check the:appropriate line A)through D)'andJor describe in the space provided: : The town officer.or employed.or his or her spouse,-sibling,.parent,:or,child is(check all that apply): �A)the owner ofgreatcrthan 5%ofthr<§hares?of the corpprat6-.s ofthe appfictuit. (when the applicant'is a,corporation); B)the.legaToc beneficial owner of any interest in anon-coiporate.enbty(when the applicant is not a corporation), C)an officer,director,partner,or employee of the-applicant;or D)the actual applicant.. DESCRIPTION OF RELATIONSHIP" : Submitted this 5 da C 20 Spgnature _ : PrintNariie: �D Form TS l. . . Soard 'of Tru tees Application. AUTHORIZATION (Where the applicanf'is,not.the owner) . I/We;' Ian �. J44�ev% �. owners of the property identified as SCTM# 100.0-117705=021.1 -. i.n the town of NeW Suffolk w ork; hereby aut es Glenn`E ..Just_: Ne Y horiz_ '. JMO Environmental Consulting 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. i - Property. Signature Property Owner's:Signature . N.T METH S DAY OF:SWORO BEFORE I .. I' Ci` / 20. 7" . . . 1000, otary Public NOTARY PUBWP,STATE OF NEW YOAK Registration No.05FR6288691 Ouarffled In Suffolk County My C mntssim Fxpues September 0%20.r,� APPLICANT/AGENT/REPRESENTATIVE.,:. TRANSACTIONAL DISCLOSURE FORM` e Town o:Sou o d. Code:ofEthic`"" ibit:c licts. <'ntere `onthe` a `f"own`•o freers and ein to " s.:The " se:of tlii form tstoprov�de irifoixiiatFon'whicKcan alert the Owl)of Rossitiie conflicts of in eresrend atiow it tq,take""wh neveractioW S. 6e6essaiv to ovoid sami.: YOUR NAME::.Just Glenn, E._; .(Last:name,first name,jiuddle initial,unless you are applyinO.O.the.name of someone else or other entity,.such as a company.If so,;indicate the.other Orson'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 persgniiily;(or.through:your>company„spouse,sibltrigi parent;or child);have,a relationship';with;:any:officQr or'emp[oyee of the Town of Southold?'"Retatioriship"includes by blood mar171age,ar basiness;Inttrest:"Business snterest"means:a business; including a partnership,iri which.the t6wn officer or employe has even a;partial:ownership of..(or:employin ht::by):a corporation in which ttie lown officer dr employee:owns;more thiin.S"..1 6ffhe"shares. YES n . If you answered"YES",complete the balance of this forth and date and sign where indicated. Name of Orson employed.by.the:Townof Southold. " Title:or position of.that person Describe the relationship between yourself(the.applicanttagentlre.presentative)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): fIA)the owner of greater than3"lo ofthd shares of the corporate::stock of the appli.w.t (when the"appliaarit is a dorpotatioo);. . B)the legal or beneficial owner of any interest in a non-corporate entity.:(w4heii;the; applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant: DESCRIPTION OF RELATIONSHIP Submitted this. signature_ ... — Print Name I. :n. Just.' " • Form TS 1 __'bard of Trustees Applicat" PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: 117- 3 - 7 S= s/.l 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.MAILIRETURN RECEIPT. Signature Sworn to before me this Day of 120 Notary Public INOTICE OF HEARING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: ROBERTA F. JAKLEVIC - SUBJECT OF PUBLIC HEARING: For a Wetland Permit to remove and replace in-place the existing bulkhead using vinyl sheathing and raise the height an additional 26" to match existing bulkhead; and backfill with clean sand from an upland source. Located: 900 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-21.2 TIME & DATE OF PUBLIC HEARING: Wednesday, July 17, 2024 — 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.:CCA F for proposed:actions that are subject to the Town of Southold Waterfront Consistency Review Law. assessment is intended,to supplement other`information used, by.:a Town of Southold agency: iri making,a determination of consistency. *Except minor exempt actions including Building Perm:ts andother ministerial permits not located within the Goastdl Erosion.Hazard Area. 2. Before,answering .the questions in Section C; the prepares 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 smuficant lienefieial and adverse effects upon the coastal:area(which includes:all of Southold T'own�: 3 If,any question.in Section Con 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.ansxver. mast:6`e ex lained n detai -'::Mott both.au d-tin ::and non'- supyortina;faets -If an action cannot be certified as.consistentwith the:LWRP policy standards and conditions,;itahall n6t:be:.undertaken: A copy.of the LWRP is.available in the following places::online:at:the Town-of Southold's ivebsite(soutli61dtown.northfbrk.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 3CTM# 1 7 . :05. . : 021:1 . . PROJECT NAME. Bulkhead.reconstruction The.Application has been submitted.to (check appropriate,response): Town:Board El Planning Board❑ _Building Dept.: ❑ . Board of Trustees 1. Category of Townof'Southold agenc action, check a ro r iate res onse Y ( Pp p P )� . . (a) Aetionundertaken directly by Town agency fe.g.capital construction;planning activity;agency regulation;land transaction) nn (b) Financial assistance(e:g::grant;aoan;.subsidy) (c). Permit,approval,license,certification: 0 Nature and extent of action: . ase:se.e.attached Location of action, 900 Old Harbor Road, New Suffolk Site acreage: 0.98.1 Single Tamil dwellin Present land use 9 r� Y 9 :.Present zoning classification:: R-40�.. . 2: If;ari application for the proposed actiori has:been filed with the:Town of Southold agency, the following information shall'be provided (a) Name of applicant:.Roberta F.Jaklevic (b) Mailing address:_P�O:Box 613 New,Suffolk, NY 1,195&0613 (c) TO number. c/o 631-872=0093 Will the action be directly undertaken,requirefunding,or approval by a state or.federal.agency?.: Yes Fv 1 No.M If yes,which state.or federal agency?"'S°E.°.:.N:Y.S.°.°.S.&us:a.c:o_E, C. ;Evaluate the.project to the following policies by analyzing how the project will further isupporf or not support the policies: Provide all proposed Best:Management Practices that will further.each po icy. 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 euhances community character,. preserves open:space makes efficient use of infrastructure,:makes benefiiciat use:of a coastal location' and minimizes adverse effects of development See:LWRP:Section'III-Policies; Page 2 for evaluation criteria. ✓ Yes No t ot Applicable 0 . There will.be no impact upon the character of;the.communi or open, ace: -71 Attach additional sheet,if necessary . Policy 2. Protect and.=.preserve historic' and archaeological resources of the Town:of:Southold,: See. . LWRP Section III-:Policies -3through 6.for.evaluation criteria. a Yes ❑ No ❑ Not Applicable There will be no impact.upon any known historic or archaelogica(resources. Attach ad —t al sheets xf necessary. Policy 3. . Enhance visual quality and protect scenic resources throughout the ,Town of.Southold: See. LWRP Section III-Policies Pages b through 7 for evaluation criteria . Yes Fl No ❑ Not.Applicable There will be no impact upon.scenic resources or the visual quality of the Town. Attach a itional 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 1:6 for evaluation criteria Yes E No Not Applicable There will.be no impact upon life,structures or natural resouces due to flooding or erosion. Attach additional sheets if necessary Policy 5. Protect improve water,quality and supply in the Town of Southold.See LWRP Section III Policies Pages.16 through 21 for evaluation.criteria. V Yes 0 No I Not Applicable There will be no i,pact upon water quality or supply. ....... ..........:......:................ ttac a rtiona sheet i 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 HI-Policies; Pages 22 through 32 for.evaluation.criteria. Yes No: Not Applicable a . o There will be:nQ impact upon the.Town's ecosystems incuding.Significant Coastal:Fish:and Wildlife.Habitats or Wetlands. Attach additional sheets ifnecessary. Policy.7: . Protect and improve air quality n the Town of.Southold. See LWRP:Seetimn IIh= Policies. Pages 32'through 34 for evaluation criteria. Yes No o Not Applicable a � There will be no impact on air quality.-, . 71 7-7 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 0`.No.Z Not Applicable .The project does not:involve solid,waste or hazardous substances and wastes. PUBLIC COAST POLICIES Policy. 9. Provide for.public access to, and recreational use of,.coastal waterer public lands, and public resources of the Town of Southold. See LWRP Section III—:Policies; Pages.38 through.,46'for.evaluation criteria. YeD No 0 Not Applicable ; There will be no impact upon the public's access.to, or the recreational use of; coastal waters;.public le 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 ILI--.Policies;Pages 47 through 6 for evaluation criteria. ✓ .Yes,. No NotAPPlicable e.will: e=n - - Attach.additional sheets ifnecessary 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 61 for evaluation criteria:. . �✓ Yes 0 No F_1.N6t.Applicable y There will be.no im act upon:the.uses of living.marine resources in the Peconic Ba estuary, 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 0 Not Applicable The.project does not involve agricultural lands.:. 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:eva III ation criteria. Yes []ND Not Applicable The. ro'ect�does.not.invoive ener or mineral resources PREPARED BY Glenn E.-Just TITLE.Agenfi DATE`-