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500 Broadwaters, LLC
Glenn Goldsmith,President �o�O �oGy Town Hall Annex A.Nicholas Krupski,Vice President � '`� 54375 Route 25 0 Eric Sepenoski 4 ,? P.O. Box 1179 Liz Gillooly �y • ��� Southold,NY 11971 Elizabeth Peeples ��! '�a Telephone(631)765-1892 Fax(631)765-6641 Southold Towm Board of Trustees Field Inspection Report Date/Time: 26 Completed in field by: Lr I (A LIJ4 0 Costello Marine Contracting Corp. on behalf of 500 BROADWATERS, LLC requests a Wetland Permit to construct a 4'x30' landward ramp leading up to a 4'x30' catwalk to a 4'x30' ramp down onto a 4'x57' dock (4'x147' total); install a 3'x14' aluminum ramp at seaward end of dock leading onto a 6'x20' floating dock situated in an "U configuration and secured with two (2) pile dolphins. Located: 500 Broadwaters Road, Cutchogue. SCTM# 1000-104-10-5 Typ�of area to be impacted: / ✓✓ Saltwater Wetland Freshwater Wetland Sound ✓ Bay Part of Town Code proposed work falls under: 275 Chapt. 111 other Type of Application: ✓ Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: y Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: + -e-P -e !C r �t 0. Cc,Celil L1 Present Were: v G. dsmith N. Kr ski ZE. Se enoski p .✓ . L. Gillooly E. Peeples a • CUTCHOGUE STATION PROJECT LOCATION WATERVILLE ( ` CUTGHOGU New Suffolk Ave y R �L APPLICANT:500 BROADWATERS LLC ADDRESS:138-32 227TH STREET �FAUG LAURELTON, NY 11413 PREPARED BY: KS • CMCC VICINITY MAP 1 JOB SITE:500 BROADWATERS ROAD AM WEBER ASSOCIATES, LLC N410 0' 42.2" W720 26' 56.8" CUTCHOGSCTM#:000 104U0 5Y 11935 P.O. BOX 2753, SETAUKET, NY 11733 Su ti .: ..:. (631) 484-9164 (AMWEBER2012@OPTI MUM.NET) (SHEET I OF 7) , , ,r.., ,_ DATE:07/23/25 1 1 GI ADJACENT PROPERTY OWNERS - 1 CUTCHOGUE MAzt HOLDINGS LLC NEW SUFFOLK 1 149 DDSORI$ LANE PARK DISTRICT ` QI GLEN COVE, NY 11542 (530 BROADWATERS ROAD) (SCTM# 1000-104-10-4) JEFFREY R. & ANCA LEMLER boa y G ` A 1289 LEXINGTON AVENUE, 8A 02 NEW YORK, NY 10028-1463 �� �• a , (320 BROADWATERs ROAD) (SCTM# 1000-104-10-6) `� �� 2 CRAIG & ANNIE CANTELMO \ v 255 BROADWATERS ROAD BROADWATERS j O3 COVE CUTCHOGUE, NY 11935 :1 (255 BROADWATERs ROAD) r_ (SCTM# 1000-104-12-7) f PROJECT j 1 LOCATION j '1 RAHUL SHARMA & VEENA ISSAC 345 E. 69TH/ STREET, #14EF '~•� -r 04 NEW YORK, NY 10021 (155 BROADWATERS ROAD) j (SCTM# 1000-104-12-8.1) �; 1 �I 2 i••—/ � BROA041,AT 1 j � t a E G E � V E b APPLI CANT:500 BROADWATERs LLC 'DDRESS:138-32 227TH STREET PREPARED BY: KS • CMCC LOCATION MAP AUG 1 3 2025 500LAU BROADWATERs NY Rs R JjOB SITE:500 BROADWATERS ROAD AM WEBER ASSOCIATES, LLC N410 0' 42.2" W720 26' 56.8" SCTM#:000H04U0-5Y 11935 P.O. BOX 2753, SETAUKET, NY 11733 Southold Town (631) 484-9164 (AMWEBER2012@OPTIMUM.NET) (SHEET 2 of 7) Board of Trustees DATE:07/23/25 ( 1 PROPOSED • CONSTRUCT A 4'x30' RAMP LEADING UP TO A 4'x30' CATWALK TO A 4'x30' RAMP DOWN ONTO A 4'x57' DOCK. • INSTALL A 3'xl4' ALUMINUM RAMP AT SEAWARD END OF DOCK LEADING ONTO A 6'x20' "L" FLOAT SECURED IN PLACE WITH (2) TWO PILE DOLPHINS. MATERIALS: CATWALK & DOCK: PILING: B"/O'O- CCA EXTERIOR STRINGERS: 6 X6"- CCA INTERIOR STRINGER: 4 X6"- CCA CAPS: 6 X6"- CCA DECKING: THRU-FL OW(50% OPEN SPACE) 5 %4 v6 HARDWARE: /"H.D. GAL V. BOL TS& STN.STL. SCREWS RAMP: 3 x/4'ALUM/NUM FLOAT: DECKING: 5/4'X6"- IPE FRAMING: 4"x6" - CCA PILING: (2) 2-PILE 10"0 ANCHOR DOLPHINS k FLOATATION: PLASTIC FLOATATION rAUG L i�HARDWARE: H.D. GAL V 90L TS 8 STN.STL. SCREWS ACCESS:BY WATER VIA BARGE AND BY LAND THROUGH APPLICANT'S PROPERTY 33 2025 APPLICANT:138 BRO27TH STREET LLC ADDRESS:138-32 227TH STREET LAURELTON, NY 11413 PREPARED BY: KS • CMCC Southold Town JOB SITE:500 BROADWATERs ROAD AM WEBER ASSOCIATES, LLC Board of Trustees CUTCHOGUE, NY 11935 P.O. BOX 2753, SETAUKET, NY 11733 SCTM#:1000-104-10-5 (631) 484-9164 (AMWEBER2012@OPTIMUM.NET) (SHEET 3 of 7) DATE:07/23/25 r r 8R pAD y�,ASbUNO/NGsTE R co VE RL7��1�umpo I 2025 x,7o• southoldTown FLOAT Board of Trustees x-� g X24• x-q- x-24• x-24• x--18. x-18' Sc �i h x-lr e x.1r x1s• B0�WE�ANo IWE xe. OARY E 7FD 8Y ���s r4e�71 AUO 5,.2021'9yls p '1p SHORELINE X. -�- -- n M x16 / AREq Pqp _ H NOV.���Y MD - --'-- —9lRK EL 3.0 _-----------MFIW— -- PIPE r5•6/YE� 60'Wo r. r �QOU TONE N m LOT 184 i«� 0 02.T C 20/y£X m -A LOT 185 Cf ANH FLOOD ZEE 13.0' pD 2O/yE X 18.9' POOL -P. a :;<v'lNCROUND '' 6.5' �r� LOT 1 I 83 WOOD DECK cl) 26E WOOD DECK 16.4' m:yj;:•?}:.'•: {2::j•i:::•}1v CrIlE ......... 10 4wEtyN cf:`':•'i:s ..................................................lro::;..:.:.:<N AIR PUMP K7 .... ..::::::.....:.:::::::: NDOW ............................ ...... COMB DL PAREL wElL `•icow . ?:is ii:i?:5:'r?i::` �OVpI i Ly C.O. O O CAC y�V OP I I I � I • °N 010 ftl COV10 i I O A I I ®0 I I p O RAIN :;:j21.3•:i'•i:;:I I I ti w v a NClAka Ewgy 14.7' o I � I P. I ' G'°SC.d i � MON I \ ) jo U P� W f O 1 f M I W.V• MLw 0.0 •� A�oN O � a ass o2 � NOTE: INFORMATION IN THIS SITE MAP WAS REFLECTED FROM RAYNOR, MARCKS & CARRINGTON SURVEYING DATED 04/05/25 APPL(CANT:500 BROADWATERs LLC SITE MAP ADDRESS:138-32 227TH STREET LAURELTON, NY 11413 PREPARED BY: KS • CMCC 0 40' JOB SITE:500 BROADWATERs ROAD AM WEBER ASSOCIATES, LLC CUTCHOGUE, NY 11936 P.O. BOX 2753, SETAUKET, NY 11733 V=40' SCTM#:1000-104-10-5 (631) 484-9164 (AMWEBER2012@OPTIMUM.NET) (SHEET 4 OF 7) DATE:07/23/25 o � P/ 6'x2O' `ER`Ne 30'_ FLOAT � B�DAD — e„ TfITA DER — _ CD VE X_3o" 3'X14' Fcoar SOUNDINGS REFERENCE 14LW AL UM N. 0.0 X 16''3" RAMP FLOAT n X-2s" T a � o a W 5 6'_2„ a Z X-24• J X_27. 3 J W _ W X•?q" V •?4" � J 0 LL L O n o Q A U G 1 3 CUC7 W '12" O j X 12• a W V101d TOWn u- SOU o, W Board of Trustee ADAs X� Z , BOUNOW�ANO ~ Y Sgg"TIEL/N 0 X6' N W LlN 81°Ol 71.92, EN- EO gy ��MLWo.o__ tl AUQ C5N2021ANTS n o X ML 0.0 —— Z INTERTIDAL SHORELINE M X1.6 MARSH OTyERWME P Z J X1,7 NOV, 16,99 yT£0 W 13— ARSH\ O Q —SHW EL3.0 `Uj U— --MHW _ -- Q ---SHW—_ — HIGH MARSH 0 N Li ZONE _w FE � ®—__ .6E 5 E _ AEA L a- (L PIP _ O Ile ' 6" LIMIT OF MODERATE AVE ACTION ZONE AE�EL 7� 2 DOD ORE B z o rn 2 F1 C �� � O T 184 � z 0.2g C ZOA k I '�0 hANDE AAN LOT 185 A FLOOD 1.sE O OOD D� I SITE PLAN 13�°' uN-•* z —*-->< tOT 183 0 30' b.9 POOL EQP. APPLICANT:500 BROADWATERS LLC 1"=30' ADDRESS:138-32 227TH STREET D POOL s j`T LAURELTON, NY 11413 PREPARED BY: KS • CMCC AM WEBER ASSOCIATES, LLC JOB SITE:500 BROADWATERS ROAD P.O. BOX 2753, SETAUKET, NY 11733 SCTM#:1000-1CUTCHOGUE NY 11935 OGUE, 5 (631) 484-9164 (AMWEBER2012@OPTI MUM.NET) (SHEET 5 of 7) DATE:07/23/25 E CQ E � V E 8"-10" 0 PILINGS ! f 8"-10" 0 PILINGS 4' 10, O.C. - CCA ► i 4- � lo' O.C. - CCA AUG 1 3 2025 V s/4"x6" DECKING - IPE THRU-FLOW DECKING (50% OPEN SPACE) TOP of DOCK "' 6"x6" EXTERIOR ' STRINGERS - CC Southold Town r �n EL. +5.5'± Board of Trustees TOP OF CATWALK EL. +8.0'± 6"x6" EXTERIOR ' STRINGERS - CCA 6"x6" CAPS - CCA :o 6"x6" CAPS - CCA 4"x6" INTERIOR 4"xb" INTERIOR STRINGER - CCA SHW+-mL- - STRINGER - CCA — --mHW+•ZL 4' MIN. 8"-10" 0 PILES 10' O.C. - CCA INTERIOR VEGETATED WETLAND AREA — MLW 0.0 — — �' — BOTTOM MHW J NOTE: NOTE: 0 HARDWARE: H.D.GALV. & STN. STL. FASTENERS • HARDWARE: H.D,GALV. & STN. STL. FASTENERS • ONE INSIDE PILE ON DOCK BENTS AFTER • THRU FLOW DECKING UP TO OFFSHORE SIDE OF WETLAND AREA WETLAND GRASS CATWALK DETAIL A-A DOCK DETAIL B-B 0 5 0 5' ill=5' ill=5, 165'-6" OVER ALL LENGTH 3'x14' 30' RAMP UP 30' CATWALK 30' RAMP DOWN 57' DOCK ALUM. 6'x2O' "L" FLOAT 6"-10"0 PILING RAMP I� GRADE EL. +5.5' 4' 6' 6'-5' 6'-5" = M H W — --- --- —`— --- -- --z-6- ---------MLW--- - - VEGETATED TIDAL WETLAND AREA 91'-7" MLW TO SEAWARD END - 125-9—MHW--T-0 SEAWARD END OPEN GRATE DECKING - - -- --- ELEVATION APPLICANT:5O0 BROADWATERs LLC ADDRESS:138-32 227TH STREET PREPARED BY: KS • CMCC o zo' LAURELTON, NY 11413 AM WEBER ASSOCIATES, LLC JOB SITE:5O0 BROADwarERs ROAD . P.O. BOX 2753, SETAUKET, NY 11733 ill°20' CUTCHOGUE, NY 119354-10-5 1(631) 484-9164 (AMWEBER2O12@OPTI MUM.NET) SCTM#:1000-10 (SHEET 6 of 7) DATE:O 00-10 5 I 20' 4' • 4"x6" STRINGERS, zo CAPS & CROSS PILE HOOP OR CHAIN • Q BRACING aao I I II o cn 5/4'x61 L` IPE DECKING 0 0 911— 1 1 1 1 1 1 1 1 10"0 ANCHOR PILE HOOP OR CHAIN DOLPHIN - CCA i 10"O ANCHOR DOLPHIN - CCA I 4"x6" END CAPS DECKING WATER I LINE I PLASTIC 4"x6" EXTERIOR STRINGERS FLOATATION 4"x6" INTERIOR STRINGERS BOTTOM l.µK � - }.:•. t:t•-?•~ v~:S a:' •.Y.•. a.H �.� :.:J4'S,"J.— .'f... `I— ��'\.y •:S1^ I I I I I I I I I NOTE: 1 1 1 I I • HARDWARE: H.D.GALV. & STN. STL. FASTENERS j � C E V/ a2::�) APPLICANT:500 BROADWATERS LLC FLOAT DETAIL AUG 1 3 2025 ADDRESS:138-32 227TH STREET LAURELTON, NY 11413 PREPARED BY: KS • CMCC 0 5' Southold Town I JOB SITE:500 BROADWATERS ROAD AM WEBER ASSOCIATES, LLC Board of Trustees CUTCHOGUE, NY 11935 P.O. BOX 2753, SETAUKET, NY 11733 SCTM#:1000-104-10-5 (631) 484-9164 (AMWEBER2012@OPTIMUM.NET) (SHEET 7 OF 7) DATE:07/23/25 S.C.T.M.# DISTRICT 1000 SECTION 104 BLOCK 10 LCT 5 BROADWATER COVE SOUNDINGS REFERENCE MlW 0.0 o FLOAT x-30" o x30" v v x-29" x-24" x-P7" v x D x-24 x-24" n x 18" x-18" x-12" x-12" a x8" x-6" TIE LINE y�0 0•-- a�•.- -�0 mow- x TIDAL WETLAND � x1.0 SHORELINE BOUNDARY AS xt 7 DELINEATED BY O INTERTIDAL MARSH EN-CONSULTANTS [� x1.6 AUG. 5, 2021 - '----------____ --- FENCE OTHERWISE PROTECTED ------ -�HW- L 3.0 `- ��/ 5.6'E AREA BOUNDARY NOV. 16, 1991 6.0'W®,, ZONE AE(EL 7) • WP`IE � o / X ZONE AE(EL 7) z133 4 "0) T; m O /7��v2a o X m U° �cA LOT 184 o / ZONE X 1.5'E X / 0.2% CHANCE ANN AL FLOOD LOT 185 �e,�0 ZONE X 13.0' X POOL FOP• LOT 183 N •:::':::; 20.2 a WOOD DECK 2.6'E m WOOD .. m DECK cn':'::::.•::::`•: m X 1.4'E 25.5,;;.•.•:':'::;:..;.:. ry GATE 16.4' 43';::::;:;::2 STY FRAME WELL a DWELLING.:;:::: EFL 17.0:;:; :::;:..•:: BALC. OVER :'::::::::::::::::• '::::::::'::::;::'::N CONC. STOOP WE WELL :::'13.9':'•:;;':'::::;::::.o� AlR PUMP CONTROL PANEL ,0 15 1y6" f 20.1 .A.,1�5.2'�:':: I m C.O. I SANITARY LOCATION BALL OVER POINT"A" POINT"B' w °o CONC. stoop I m FUJI 17' 45.5' o ° FUJI CEN10 " I 4- D.P. 24.5' 49' M LP10 D.P. I LP 1 24 58 0 N ::::::2?:3.::: I i o_ LP2 40' 67' o ®DRAIN CD m LP2 •'�::�•�. � (2)1 O'$x1 'DEEP :•'::ao :;:;:;:i+t9 m GRAVEL �:�:;:.:o m:'::�;`.::• I I DRIVEWAY 14.7' 0 m III L.P. GAS 1 m I 0 o� � D Lo m :F:z I m r mz z MOH. i m z z 1� m m m FpG 22� I /mJ RECORD DEPTH SOUNDINGS/SHORELINE ELEVATIONS 03-26-25 f ;` r w ; T j�j / 0.1'E 0 UPDATE 11-20-24 W.MREVISED SANITARY LOCATION 07-20-24 W.V. REVISED 05-31-24 ,; r FINAL SURVEY 05-07-24 �� 1 3 211 U.P �� MOH. f, 46g 02, FOUNDATION LOC. 01-08-24 ' REVISED 05-30-23 FIELD INSPECT/UPDATED 03-22-23 FEMA MAP#36103CO164H MLW 0.0 AREA: 32,105 S.F. or 0.74 ACRES ELEVA77ON DATUM: UNAUTHORIZED ALTERATION OR ADD177ON TO THIS SURVEY IS A WOLA77ON OF SEC77ON 7209 OF 7HE NEW YORK STATE EDUCA77ON LAW. COPIES OF 774S SURVEY MAP NOT BEARING 7HE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO 7HE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS7I7U770N LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS77TUAON, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO 7HE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE 774E EREC77ON OF FENCES, ADD177ONAL S7RUC7URES OR AND OTHER IMPROVEMENTS FASEMEN75 AND/OR SUBSURFACE SMUC77)RES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON 774E PREMISES AT 174E 77ME OF SURVEY SURVEY OF: LOT 184 CERTIFIED TO: TERRY-ANN BURRELL MARILAND LLC; MAP OF:AMENDED MAP A OF NASSAU POINT FILED: AUG 16, 1922 No. 156 SITUATED AT: CUTCHOUGE TOWN OF: SOUTHOLD SUFFOLK COUNTY, NEW YORK KENNETH M �POYCHUK LAND SURVEXING, PLLC Professional Land Surveying and )esign THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL ,} P.O. Boa 153 Aquebogue, New York 11931 LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77ONS FILE #221-198 SCALE: 1"=30' DATE: OCT. 15, 2021 N.Y.S. LISC. NO. 050882 PHONE (631)298-1588 FAX (831) 298-1588 AND OR DATA OBTAINED FROM OTHERS 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 we x 0 1111•• • • • • •M72 U11 F w '•4i� f y�'-• S. 4 u' 1 � 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 r r • •• ,ock nritinn � ,., ! ' . ''�' ti �y�, ,y�:y��. ♦ `w ih � v4s."+�., �ti'' T r,r +•^4.",v 3r "�` � ..rrA; .A ) 1�; t+i� 1 : • fir., w.1 A `ID` t�l,� -L _ .... -1-7 y�,�•k .� Ft�r.'� 4 t,.�.,�r JS r � ��,.. �, _. FE :: � ;:�y ty��C®,�' '+r� �F.-;elu�` r "�'lf�ls r T. AA �� ;; ^ ' rt l�r �� R,...- _. _ q� F�° 1'. "S'�3$a t rY� fir• �Or4t s' ,,, M € r,ss.' � y- i{/, �Sy +�� � �J 4, y r;�r s Rat 4• {' d�l ry1�4r� >: 1 �� ,1X �'� . =-- iji s a at 'A r rJ• Er �9t 1 n¢ ��11 . r 1.411 ' (+.,'4¢� ' ¢Y�,as�ti yf� r y7i e. 1' 1 ¢. .+. y� ^ Ai- �° �.� r1 a.l�tl�!`.S .��d�ll�;�'1 - •-u.. . ?�,1 rt�ali� �i�e':�f. ��'IMP�1��3a".'�krn„t1�.v2 ���E '�.�i4,...Iri�ti�� .k`:. +♦�77"� ]aE ._ 2 Page 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 west Docks to :ram 4 � � r r r yip All J i 4 { 1/ �I , ♦ C 31 M,i '' 4 t '` l�F� Pap ta,4 •�!• ,'�' d _ j� e�' S t • dS' i ..6?.�f�11, i •� 'y�ili y;r r i�.4 t ter �..,. �.ei .F•'���`� c �4 �ti•. 3 Page 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 }� 3`: 'b +a.,_t'�r{t ! •a :' "'•rj ^4'gr:._. ey`r W •.` .zI y' o All Docks to east Alt a r A r� ` „�t., � � bra •.o. y _- •s F 4 0. • +Pol4nrfl�M"Yj' !� , 9 !• i�f.- r, ,• _.. ♦ \t C fAli 1 y tl A� `t" f4..:" •� V�.ii� i��. �t .,.t: '_� -'ai .� �: at '£ �F ., �n t •�' � `_' "L-....• ,., ti �i rr�`at .t ..tt. �1"��4�'.f�'��'�r •j� {" q r�:5'. t` ,� ii �i t t,fir 1 n ^'Rri�.h• �� 7� t..,,• 1 't ..,a 1• �'- �j a. t 9`dt'�1�' �,Z,L�•.�r y yr � � -R: k.{�.`^F 's:'�1 e '. , y, 1 sra-. ��-�" E' �t.. a � :i it ✓ ;n.� _ ... - , ►1t }4.yl�/�-.� .� - `;`•,� ply:.. �, a i :�• ti i _ ' ;.�,r � ,• y j•\` u t �'�t'.'✓`",`k �. �a t �, r ¢... r �, -,� Ilya►• 4 Page 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 Docks Proposed dock west 77 - - " V, AVA t a i .p' y Aili j y jKx ,v + rt4W {-+�p�1 '. — '�'��� J�; aci.Y '.s.�. i'. �:=5:� :':�I.'."!,a i.:.t. �.L.�"S�.Sk.� 1.1r' .'t'fY�n��G: Y'aa rZw.a=i.fq�f:���'/� �." .•.r• .P� f.:�i...�. :� 5 1 P a g e 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 i Proposed dock � a � � �. �! �' �l� • jt ,, ° ,ram. I +•:���� ne� Ll��. _` rr1e -� - f �'�. r �♦ S'`d,, �.. Ay, _.a.ri'4'r�•.. - rye} �Y' 7' /• 1 1 ,fii�Gp i l lk tf�{+T: / •r _11 v'.�Y tl +[ 31 ` "`R*s ,� jh'`ti•'7 `"".z4f'� �if rf�. 1 '� s' Nrtit' {. hl! 1 b".:'v�� ?':: i!}:@cb1�-I.3..iRJ!'1..: .1 ._ a, =.Y-r.,».w0.�:.0` (/ r � I_3'.=.ate, .., �:_ -�• 61Page 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 JV AV M f.. e ti• - i Wv S i i,r J{,�✓ t a ! f ll p .4�f/ar - 1„t, ��• y r _ .,� 'r�f.l •w F-,� e h'"..,,°� �/,r r _ 'SS'w. +�,5� �p i y�r *C .i... , ;iSyyy�lyyy •� .•I 'S y, `' ! 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Wax. � . . _: "� .'r� - • . 500 Broadwaters LLC 500 Broadwaters Road Cutchogue, New York Install 4'x140' open pile dock consisting of upland 4'x30' thru flow decking upland ramp up to 4'x40' elevated thru flow decking catwalk elevated a minimum of 4' over grade over vegetated tidal wetlands, to a 4'x 70' IPE decking over open pile catwalk/dock to 3'x14' aluminum ramp to 6'x 20' Float anchored by two 10" CCA pilings Photos June 2, 2025 1730 {� rw i�•. 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SJaU• 1 4r' M1 d 't 4 591� •m � peE t �. t _. ° O P t i ee t+� t, t•15 xao) N ei211) I1-011i N "e+p1 '�' 'L, ♦ w M �' ' li O pIE. �wa�iinx \_ s 1"+ Z + °� "♦+"+ ]1? wt �+ BROADWAlERS COVE J 1 TOWN OF gSOUTHOLD 1. 12 1 q u a ^� t VS `\ J 5 I � a e ° « q ' �.a__,� \ - .�\� •'ihi "r-i,� ° t try t� �. r.Q!`.,. r ( M♦ HAYWATER COVE � � i et•J rc e „�Q \. o. Y ♦ + E —iz— NOTICE J>u�y COUNTY OF SUFFOLK © E °F adRlpLD SECT10k N0 c �,,, __,__ _..,.,_ _ Reel Property Tax San'ice Agency r E u� M --- _ u _ _ —_ -- -- ` C«NNc«NPo«Nw.Nr„M Ma 104 rtn P f00° VROPERTYYW p Hobson, Thomas From: Hobson,Thomas Sent: Wednesday, September 10, 2025 9:41 AM To: 'Permits@CostelloMarine.com' Subject: RE: 500 Broadwaters LLC -500 Broadwaters Road, Cutchogue Hi Jane, This is exactly what we needed. Thanks! From: Permits@CostelloMarine.com <permits@costellomarine.com> Sent:Wednesday,September 10,2025 8:58 AM To: Hobson,Thomas<thomash@southoldtownny.gov> Subject: RE: 500 Broadwaters LLC-500 Broadwaters Road, Cutchogue Tom- Attached is the Operating Agreement for 500 Broadwaters LLC. Will this documentation suffice? Jane Costello Marine Contracting Corp. PO Box 2124 Greenport,NY 11944 Phone (631)477-1199 Fax(631)477-0005 From: Hobson,Thomas<tho mash @southoldtownny.gov> Sent:Tuesday,September 9, 2025 8:35 AM To: Permits@CostelloMarine.com Subject:500 Broadwaters LLC-500 Broadwaters Road, Cutchogue Hi Rob, I was reviewing the 500 Broadwaters LLC application for possible inclusion on the October agenda. We will need articles of incorporation, or other documentation, showing that Terry-Ann Burrell is an authorized signer for the LLC. No rush, but we'll need that before October. Thomas Hobson Administrative Assistant Town of Southold Board of Trustees Phone: (631)765-1892 Fax: (631) 765-6641 i Glenn Goldsmith,President Town Hall Annex A.Nicholas Krupski,Vice President _, 54375 Route 25 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 This Section For Office Use Only --�— 1ELF ( EPj Coastal Erosion Permit Application �1 Wetland Permit Application 1� Administrative Permit AUG 1 3 2025 —Amendment/Transfer/Extension Received Application: N4CReceived Fee: $ Southold Town Completed Application:. _Z.� Board of Trustees Incomplete:,. _ SEQRA Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: _ _Coordination:(date sent): __�_LWRP Consistency Assessment Form Sent: aai _CAC Referral Sent: 1 - k Date of Inspection: o Receipt of CAC Report:_�_ __Technical Review:_ _ „ Public Hearing Held: 1 1�Z Resolution: Owner(s) Legal Name of Property (as shown on Deed): 500 Broadwaters LLC Mailing Address: 138-32 227th Street, Laurelton, NY 11413 Phone Number: (347) 623-7986 { Suffolk County Tax Map Number: 1000 - 104-10-5 Property Location: 500 Broadwaters Road, Cutchogue, NY 11935 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable):Costello Marine Contracting Corp._ Mailing Address: P.O. Box 2124, Greenport, NY 11944 Phone Number: (631) 477-1199 Email:permits @ costellomarine.com &CLat �l3 / t Board of Trustees Appli_�._ _ion GENERAL DATA Land Area(in square feet):,32,105 soft Area Zoning: R-40 Previous use of property: Residential Intended use of property: No use change Covenants and Restrictions on property? Yes ✓ No 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. Will this project require 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 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): Construct a 4'x30' ramp leading up to a 4'x30' catwalk to a 4'x30' ramp down onto a 4'x57' dock. Install a 3'x14' aluminum ramp at seaward end of dock leading onto a ft20' "U float secured in place with (2) two pile dolphins. Board of Trustees Appli_ =ion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To provide the property owner with the ability to engage in water-dependent activities such as boating, fishing, and swimming, as well as providing the means for safe boarding & unboarding of the owner's vessel during all tidal ranges. Area of wetlands on lot: 0 _ square feet { Percent coverage of lot: 10 % Closest distance between nearest existing structure and upland edge of wetlands: 109 feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet t Does the project involve excavation or filling? No Yes If yes, how much material will be excavated?N/A cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A 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): Our proposal to install a fixed dock with a floating dock at the end will not have any adverse effects on the adjacent wetlands or tidal waters of the Town of Southold. Any environmental impacts during construction will be temporary and the area is expected to recover immediately after construction is complete. Y ') J 6I Z20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 500 Broadwaters LLC Dock Construction Project Location(describe,and attach a location map): 500 Broadwaters Road,Cutchogue,NY 11935 Brief Description of Proposed Action: Construct a 4'x30'ramp leading up to a 4'x30'catwalk to a 4'x3o'ramp down onto a 4'x57'dock.Install a 3'xl4'aluminum ramp at seaward end of dock leading onto a 6'x20'"L"float secured in place with(2)two pile dolphins. Name of Applicant or Sponsor: Telephone: (347)623-7986 500 Broadwaters LLC E-Mail: terryanndavisCicloud.com Address: 138-32 227th Street City/PO: State: Zip Code: Laurelton NY 11413 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 ppermit or approval: ❑ Permits are required from NYSDEC,NYSDOS,Army Corps of Engineers,and Town of Southold Wl 3.a.Total acreage of the site of the proposed action? 0.74 acres b.Total acreage to be physically disturbed? o.ol acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.74 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial [:]Commercial mResidential(suburban) ❑Forest ❑Agriculture mAquatic El Other(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? El ❑✓ 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:Peconic Bay and Environs-Protect public health,water,vegetation,and scenic beauty. ❑ ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ✓❑ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? ✓❑ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ✓❑ ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ✓❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ✓❑ ❑ Potable water is not necessary for our proposal. 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ ❑ Our proposal does not involve the production of wastewater. 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 typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: m Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional m Wetland El Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑✓ ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will stone water discharges flow to adjacent properties? m NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and stone drains)? If Yes,briefly describe: m NO AYES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? 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: Z ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: Z ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applican or .Terr nn Burrel,Owner Date: �'� "k Signa re: 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 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 ❑ ❑ 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 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? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, El El 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 ❑ ❑ 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 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. Name of Lead Agency Date 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 AppliL—r..ion AFFIDAVIT TertAnn Burrell for 500 Broadwaters LLC, BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE Y 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. 2 DignatuyGyProperty Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF 20 2tS� SREEWA 'T1 G1 'N Notary Public,State of t.eRbrk 3�e-gisiration Ncb.01G06212588 Notary Public G�uaiificd in Bronx County 1,t,jv Co nnn�ssion Expires 10:13-2025 COSTELLO MARINE CONTRACTING CORP DOCKS • BULKHEADS • ROCK REVETMENTS • JETTY REPAIR • DECKS • BLUFF STAIRS • PILE INSTALLATION To: Town of Southold AUTHORIZATION The undersigned, as owner of property located at 500 Broadwaters Road, Cutchogue,NY 11935, SCTM #1000-104-10-5,hereby authorizes Costello Marine Contracting Corp. to act as agent to process all permit applications needed to construct a dock at my property. Dated: a Sign ere: . Printe "Leo d Name: A"Z-'L& eL SWORN TO BEFORE ME THIS DAY OF )4-- 9 tr'f 20.2 s� n�E'�lic2 Q C-aOb16V ;itary Public Signature �`'9i<<ratlon�,rar�°r N York 4 C'L- 1iflad in B 07G 6212- 1Y CGronx "'T14SSiOn Exoiras 10,County 25 JOHN A. COSTELLO, President JACK F. COSTELLO, Vice President JANE R COSTELLO, Secretary 423 FIFTH STREET• P.O. BOX 2124•GREENPORT, NY 11944.631.477.1199(o) •631.477.0005(f) •OFFICE @COSTELLOMARINE.COM t APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM :The Town of Southold's Code of Ethics.prohibit§-conflicts of.interest on the part oftown officers and,emolovees.The nurmse of: this,form,is'towovide information which can alert-the town of possible conflicts of interest and allow-it'to.take whatever action is necessary to avoid same. YOUR NAME: Terterson's nn Burrell st name,first name,iitddle initial,unless you are applying in the name of meone else or other entity,such as a company.if so,indicate the other or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally'(or through your company,spousei sibling,parent;or child)hive 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 offrccr.or employee has even.a partial'ownership of employment by)a corporation in which the town officer or,employee.owns more than.5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than`5%0 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 corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 'y of 6 4 20"IJ Signatur P _ _ rint Na er Ann rrell Form T'S I APPLICANT/AGENT/REPR'ESENTATIVE TRANSACTIONAL DISCLOSURE FORM The.Town-of Southold's Code;of-Ethics prohibits conflicts of..-interest-on.the cart of town officers an&emolovees.The purpose of .this form is'to provide information which cart aka the town of possible conflicts.of interest and allow.it to take whatever action is necessary to avoid same. YOUR NAME: Costello Marine Contracting Coro. (Last name,first name,ipiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) •. Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally'(or through;your:company,spouse;sibling,parent;or.child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes'by blood„marriage,or business interest."Business interest"means a business, including a,partnership,in.which the town offieer or employee has even.a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than.5%6f.the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the,shares of the corporate-stock of the 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 corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi ,5 day of _eP) 20 Signature_ `_ Print Name, ne P. Coste o Cz orporate Secretary Fortn IS I a Board of Trustees Application PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: ADDRESS: Aj 'Ctcen-� Ora erAl 5:s /ay - 1v - y /o (-/ /o - (� leL/ A) �/- 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. NOTICE 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: 500 BROADWATERS, LLC z SUBJECT OF PUBLIC HEARING-: For a Wetland Permit to construct a 4'x30' landward ramp leading up to a 4'x30' catwalk to a 4'x30' ramp down onto a 4'x57' dock (4'xl47' total); install a 3'x14' aluminum ramp at seaward end of dock leading onto a 6'x20' floating dock situated in an "L" configuration and secured with two (2) pile dolphins. Located: 500 Broadwaters Road, Cutchogue. SCTM# 1000-104-10-5 TIME & DATE OF PUBLIC HEARING: Wednesday, October 1% 2025 — 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 r , 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 asp to its siAuf cant beneficial,and adverse effects upon the coastal.area(which includes all-.of-Southold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. ,Thus, each.answer.must.be explained in detail-,'listing both supporting-and non- supportins 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 1 , SCTM# 104 -10 _-5 PROJECT NAME 500 Broadwaters LLC Dock Construction The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: R Nature and extent of action: Construct a 4'x30'.ramp leading up to a 4'x30' catwalk to a 4'x30'_ramp down onto-a 4'x57' dock. Install a.3'xl4' aluminum ramp at seaward end of dock leading onto a 6'x20' "L" float secured in place with (2)two pile dolphins. Location of action: 500 Broadwaters Road, Cutchogue, NY 11935 Site acreage: 0.74 acres Present land use: Residential Present zoning classification:R-40 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: 500 Broadwaters LLC (b) Mailing address: 138-32 227th Street, Laurelton, NY 11413 (c) Telephone number: — — Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes 0 No❑ ff yes,which state or federal agency?NYSDEC, USACE, 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. Yes ❑ No ❑✓ Not Applicable Our proposal is to construct a fixed dock and float which is consistent with much of the surroundina area and will not have.any effect on.the community character, open space, or use of infrastructure.. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable Our proposal will have no influence on the historic and archaeological resources of the Town of 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 Our proposal to construct a dock and float will provide the property owner with access to engage in water-dependent activities. The visual quality and scenic resources will not be negatively impacted. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages S through 16 for evaluation criteria Yes ❑ No ❑ Not Applicable Our proposal to construct a dock and float will not cause any erosion nor will it have any impact on ' marine life or the natural resources in area. Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ONot Applicable Our proposal will not influence the water quality of the water supply of the Town of Southold. Attach additional sheets if necessary " Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages_22 through 32 for evaluation criteria. ❑ Yes ❑No FV] Not Applicable During construction, Best Management Practices will be used to protect the wetlands and waterways from construction debris. Our proposal will not have any influence on the restoration or protection of the ecosystem. - Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑No❑ Not Applicable Our proposal will not have any effect on the air quality in the Town of Southold. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous t substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. r ❑Yes No ❑✓ Not Applicable Our proposal does not involve solid waste and/or hazardous substances. 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. ❑ YeEl No 0 Not Applicable Our proposal to construct a dock and float will provide the property owner with access to engage in water-dependent activities. There will be no change in public access to or recreational use of coastal waters, public lands, or public resources. Attach additional sheets if necessary ti 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 Our-p-oposal is consistent.with•much of the surrounding area_ The proposed dock and float construction will provide the proper owner with the ability to engage in water-dependent activities as . well as l2rovide..safe boarding & unboardingof their essel durin�_all tidal-ranges.--. 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 ❑ No❑ Not Applicable ` Our.proposal will not have any influence on the living marine resources in-the.Long-Island Sound, Peconic.Estuary or Town waters. Once construction is complete,.the area will have not changed in the sustainable use of marine resources. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. Yes ❑ No❑ Not Applicable Our proposal will not influence agricultural lands in the Town of Southold. 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 Our proposal will have no influence on the use_or development-of energy or mineral resources. PREPARED BY Robert Lehmann ALE Permitting Assistant DATE 8/11/25 for Costello Marine Contracting Corp. Office: (631)477-1199 Fax: (631)477-0005 Cl I PO Box 2124 __ • 423 5th Street, Greenport, NY 11944 COSTELLO MARINE CONTRACTING CORP. Office@CostelloMarine.com August 13, 2025 Southold Town Trustees rBoard 2 A P.O. BOX 1179 Lam, ISouthold,New York 11971 9 3 2025 Re: InitialApplication Submittal for:S00 Broadwaters LLC—Dock Construction uthold Town 500 Broadwaters Road, Cutchogue,1VY11935 of Trustees SCTM: #1000-104-10-5 Dear Trustees: We are requesting authorization to construct a 4'x30' ramp leading up to a 4'x30' catwalk to a 4'x30'ramp down onto a 4'x57' dock. Install a 3'x14' aluminum ramp at seaward end of dock leading onto a 6'x20' "L" float secured in place with(2)two pile dolphins. Enclosed you will find a complete application consisting of the following: - Agent Authorization(4 copies) - Southold Town Wetlands Application(4 copies) - LWRP Assessment Form(4 copies) - - Short Environmental Assessment Form(4 copies) - Project Plans (4 copies) - Property Survey (4 copies) - Site Photographs (4 copies) - Check in the amount of$1,250 made payable to the Town of Southold,representing the application fee Please feel free to contact me if there are any questions or concerns. Sincerely, Robert Lehmann Permitting Assistant Enclosures JOHN A. COSTELLO, President JACK F.COSTELLO, Vice President JANE P. COSTELLO,Secretary