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Home My WebLink AboutTR-6271 James F. King, President Bob Ghosio, Jr., Vice~President Dave Bergen John Bredemeyer Michael J. Domino Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0727C Date February 22, 2012 THIS CERTIFIES that the removal and replacement (in-place) approx. 135 If. of existing timber bulkhead with vinyl bulkhead; dredge approx. 30 cy. of sand/silt spoil from an area up to 10' off bulkhead to a max. depth of-4' ALW; and restoration of disturbed portions of existino 50' buffer At 4340 Ole Jule Lane, Mattituck Suffolk County Tax Map #122-4-30 Conforms to the application for Trustees Permit heretofore filed in this office Dated 11/30/05 pursuant to which Trustees Wetland Permit #6271.dated 12/21/05 was issued and conforms to all of the requirements and Conditions of the applicable provisions of law. The project for which this certificate is being issued is for The removal and replacement (in-place) of approx. 135 If. of existing timber bulkhead with vinyl bulkhead; dredge approx. 30 c¥. of sand/silt spoil from an area up to 10' off bulkhead to a max. depth of-4' ALW; and restoration of disturbed portions of existing 50' buffer. The certificate is issued to OLE JULE, LLC owner of the Aforesaid property. Authorized Signature James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 l) 765-1892 Fax (631 ) 765-664 t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction ½ constructed L/Project complete, compliance inspection. INSPECTED BY: COMMENTS: 3, CERTIFICATE OF COMPLIANCE: New York State Department of Environmental Conservation Division of Fish, Wildlife & Marine Resources, Region One Marine Habitat Protection Building 40 - SUNY, Stony Brook, New York 11790-23§6 Phone: (631) 444-0295 FAX: (631) 444-0297 3/17/2006 Notice of Violation Robert Villani Ole Jule Inc. 189 Old Westbury Road Old Westbury, NY 11568 Denise Sheehan Commissioner Date of Violation: On or before 3/14/2006 Location of Violation: 4340 Ole Jule Lane, Mattituck Tax Map ID# - - - Permit # (if applicable): Dear Sir/Madam: Records of this Department indicate that you are in violation of the Environmental Conservation Law (ECL): Article 15, Protection of Navigable Waters Section 15-0505.1 6NYCRR Part 608 Article 15, Wild, Scenic and Recreational Rivers Act Section 15-2709.2 6NYCRR Part 666 Article 13, Protection of Marine Waters Section 13-0345.2 Article 17, Prohibition Against Pollution of Marine Waters Section 17-0503.2 Article 24, Freshwater Wetlands Act Section 24-0701.1 6NYCRR Part 662 Article 25, Tidal Wetlands Act Section 25-0401.1 6NYCRR Part 661 Page 1. ~mitted to be caused. Insta York State Regulated ,v~,~_, ~,.v.cu unveway and 2 - -aved -,~,,- -~u,~ wetland without the ben~, _~-,u~wa. ys m an Adjacent Are~ ,~-[ m a permit to do so. - [,, ,t r~ew Contravention of this/these Article(s) of the ECL is a violation and/o punishable by a fine of no more than $10,000 per violation Penalties ma ~reaas~};~m~an°r that the violation continues.·''Yd or each day P/ease be further advised that violations of the ECL which are not resolved may be the subject of an administrative hearing pursuant to Title 6 of the Official Compilation of Codes, Rules & Regulations of the State of New York (6NYCRR, Part 622). You are hereb advised to cease our o eration at the referenced location immediatel . Please contact the following office within thirty (30) days of receipt of this letter, so that we may attempt to resolve this matter. Failure to contact this office within this time period will result in this matter being referred to the Department's Regional Attorney for further enforcement action. To schedule an appointment for a compliance conference in this matter, please contact The Compliance Unit at (631) 444-0295. Compliance Manager of Marine Habitat Protection. conferences will be held with the Regional Very truly yours, Charles T. Hamilton Regional Supervisor of Natural Resources Stony Brook Certified Mail #~_4:VS~lJ>ovO NOV# 06CTH92 Page 2. Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ¼ constructed Project complete, compliance inspection. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO..~c~.l ....... DATE: ..h¢.c.,. ,.2,1. o. _20.05 Pursuant lo t~ provisions of Cflapter 615 of ~e ~ws of the SIa~ of New Yor~ 1893~ and ~apter ~ of fha ~ of ' State of New York 1952: end the Souiflold To~n Ordinance t~led ?~E~U~TIN~ .AND ~E-P~CIN~,.OF: IN AND ON TOWN WATERS AND PUBLIC ~NDS EE~OVAL OF SAND, GRAVEL.-O~ OTHER MATE~IALS~F~OM ~NDS .UNDER TOWN WA~RS;,. ~nd in a~c~dan~ wlf~ Eesol~ion of The Board ~dopfed afa meeilng held on . .~g.g.~ and Jn c0nstderetion of ihe sum of J ........ %~.9~90... paid by of ........... ~.E~EY ...............' ...................... H. Y. and subject to Terms end ~ndilions listed on the revere side ~reof, ~~t~ ~Tow.' Tr~n~ .uthorlzes end permi~ the following: ' r t o emove and replace (in-pl~ce) approx.' 135 lf. of existing timber bulhkead with vinyl bulkhead; dredge-approx. 30 cy. of sand/silt spoil an area up to 10' off bulkhead to 5 max. depth of -4'ALW; use approx. 15 as backfill; truck remaining spoil to an approved uplan~ location;and restore .disturbed portions of existing 50' buffer, all as depicted on the plan prepared {nconsu ~ts Inc. dated N~ e r ' · the originating appfi~ti~. IN WITNESS WHERE', ~e s~id Board Of T~dees ~re- ~u~s its ~r~rafe Se~l ~o be a~xed, nn~ ~ese presen~ su~ed by a 'maj~ of the sai~ ~ard .as of this date, AZber t J. TERIdS ,.nd CONDITIONS .. Ole Jule, LLC c/o Robert Villani 189 01d ,Westburv Rd. L We~th.r.y . -,~ ....... N, Y~ ~ That ~h;; Pemnit should b~ ~ indef'm~tel_y, or as long ~ ~ze sakl Pe~mlttee wi~he~ ~*~-~ain th~ ~m~u~e or pm~e~ involved, to p~o~ide evidence ~o aayoae conceded d~ auth- 4. T~t ~he wock involved wlil be mbject to the ~ and ai, l,t~al of ~he Bo~ ~ It* egen~ *nd ao~-eom~ll,~ wlcb the provislom of the od~6ttiag appllcatto~ may be cause f~ teVocttion of this Permit I~ resolution of tl~ ~id BO~L, xL 5. ~ ~ ~ be no uncea,sooable intecfex"e~ vdth mvt~zm ~ · result of the wock beagn ~dtbodzed. ' utx~ du~ n°tke, to m~o~e or ,trot t~s wod~ or l~oj~ I~ m~l ~ ~ to ~o 'ro~~ 8. That d~ ~aid Board w~ll be notified I~ the Pec~ttee ol the ~ib~ tl~ wodc m~b. Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 December 21, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: OLE JULE, LLC 4340 OLE JULE LANE, MATTITUCK SCTM#122-4-30 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on December 21,2005 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of OLE JULE, LLC applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated November 30, 2005, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 21,2005, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of OLE JULE, LLC to remove and replace (in-place) approx. 135 linear ft. of existing timber bulkhead with vinyl bulkhead; dredge approx. 30 cy. of sand/silt spoil from an area up to 10' off bulkhead to a maximum depth of-4' ALW; use approx. 15 cy. spoil as backfill; truck remaining spoil to an approved upland location; and restore disturbed portions of existing 50' buffer, all as depicted on the plan prepared by En-Consultants, Inc. dated November 29, 2005. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/Ims Telephone (631) 765-1892 Town H~l 53095Route 25 P.O. Boxl179 Southold, New York l1971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., December 14, 2005, the following recommendation was made: Moved by Jack McGreevy, seconded by Don Wilder, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland' Permit application of OLE JULE, LLC to remove and replace (in-place) approx. 135 linear ft. of existing timber bulkhead with vinyl bulkhead; dredge approx. 30 cy. of sand/silt spoil from an area up to 10' off bulkhead to a maximum depth of-4' ALW; use approx. 15 cy. spoil as backfill; truck remaining spoil to an approved upland location; and restore disturbed portions of existing 50' buffer. Located: 4340 Ole Jule Lane, Mattituck. SCTM#122-4-30 The CAC recommends Approval of the application with the Condition the buffer is maintained and a pervoius wallkway to the water. Vote of Council: Ayes: All Motion Carried 12/21/2005 13:23 FAX 6312836 EN-CONSULTANTS,INC, 002 Alber~ J, Ir~upski, President James King~ Vice~President A.rt/e Foster Ken Poliwoda Peggy A. Dickenmn ?ov~ Hall ,'~09~ Route 25 P.O, Box 1179 Southeld, New Y~rk 11971-0959 Telephone(881) 76&1892 F~xi6~D BOARD OF TOWN TI~USTEES TOWN OF SOUTHOLD BOARD OF TRUSTBBS: TOWN OF SOUTHOLD In thc Matter of the Application of ...... ............................ oF su Fo x) STATE OF iXq~W YORK) AFFIDAVITOFPOSTING d/b/a I, Robert E., Herrmann ,~En-Consultants, Inc., 1319 North Sea Road, Southampton, NY being duly sworn, dcposc and say: That on the~day of ~e~., 200~, [ personally posted thc property known as by placing the Board of Trustees o/Scial poste~ where it can easily be seen, and that I have checked to be sum thc poster ha~ ~emained in place,for eight days prior to the date of the public heafing, Da/eofhearingnotexlthereontobeheld /J_J~. ,~F~(, .,1¢.~0~)1' , ~.. . Da~ed: (si~ature~ Sworn to before me this ~7.,~ dayo. f~e_200 ~' 121 ~lne per F~ed map 5BCTIQN fklRU PULKHBAI2 .~×, POLIS~, -_~72 (MIN,)- A QP PlSl'IJRT~R',.10~/ ( -e I~ CY?Ok) e"¢~^Y',.o~ 5~ X6 TOPCI.AMP PROP, I/4" xg" ×1~' C-LOC VINYb .ed~AfHING IN PLACE OP ~×1511Nd Ill ~ ': ZI--j ~ EN-CONSULTAI~ITS INC. SOU~AMPTON, N.~ 11968 ~ Z 631'283-6360 ~P~K COUP, NBW Y~ ~BTI OP 11/2~/OS SCDI~? Rd. # ~/0' 00-0/69 AR~A = ~.09~ to tie i~o~ NO TE' SUBSURFACE SEWAGE DISPOSAL SYSTEM DESIGN BY' dOSEPH FISCHETTI, P.E. HOBART ROAD SOUTHOLD, iV. Y. 11971 (631) 765 - 2954 PROPOSED SEWAGE DISPOSAL SYSTEM 6 POOLS WITH CLEAN SAND 5' COLLAR lEO0 GAL. PR£CAST CONCRETTE S~pTIC TANK BOTTOM OF LEACHING POOLS TO B6 2' GROUND ~ATER. SEPTIC MEASUREMENTS 'A' 1 'B' ST 30' 28' L.P I . 26' 43' L.P. 2 Z4 ' 4¢' CROSS SECTION- SEPTIC SYSTEM I ~m £cmRIcn wlth the STANDARDS FOR APPROVAL AND CONSTRUCTION DF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES end wi(t chide by the conditions set ¢orth therein and on the permit to constnuct, The toco. tlon o¢ weUs and cesspoots shown her'eon are Crom ?ieLd observations and or dc, to. obtained ?rom others, ELevations are reCerenced to N,G.V.D. 59 '\5.V' 5. SURVEY OF PROPERTY A T MA TTITUCK TO,tN OF SO UTHOLD SUF?OLK COUNTY, YORK 1000-122-04-30 SCALE: 1"=40' AUG. 13, gOOg DF.C. ~: 2_002 ( orop h,~e. ) dAN /3, 2003 (reW"siC¢ } Dec. I0, 2003 (Bdf~rl APRIL /4~ 2005 ffound~tfoN OCT. 20~ 2_005 (FINAL) ADDRESS OF PROPERT~ OLEUULE LANE~ LL C 4540 OLEJULE LANE MA T~TUCK, ~ ~ ' TEST HOLE fie 2ECTIQN 7809 UP THE NEM YURK STATE EDUCATION LAM, (63D 765 - ~e~~-i/y/ J EXCEPT AS PER SECTIUN 7Bog-SuBDIVI$IBN ~, ALL ~R~(CI~A~UNS P, 0, BOX ~09_ _ _~-~ Albert J. Krupski, President James King, Vice-President Henry Smith Attic Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fex (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application ~"Wetland Permit Application ~/- Major Waiver/Amendment/Changes ~l~eceived Application: r~eceived Fee:$ e~ompleted Application Incomplete SEQRA Classification: Type 1 .Type II Unlisted Coordination:(date sent) ~CAC Referral Sent: /! r~Date of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: ,/Public Hearing Held: Resolution: , Minor NOV 3 Name of ApplicantOLE JULE? LLC Address CIO ROBERT VILLANI, PRSIDENT; 189 OLD WESTBURY ROAD, OLD WESTBURY, NY 11568 Phone Number: 917-922-5176 Suffolk County Tax Map Number: 1000 - 122-4-30 Property Location: 4340 OLE JULE LANE, MATTITUCK (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, INC. (If applicable) Addre s s: 1319 NORTH SEA ROAD, SOUTHAIVlPTON, NY I 1968 Phone: 631-283-6360 Board of Trustees ApplicOon Land Area (in square feet): 18,093 Area Zoning: R-40 GENERAL DATA Previous use of property: SINGLE FAMILY RESIDENTIAL Intended use of property: NO CHANGE. 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? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): REMOVE & REPLACE (IN-PLACE) APPROXIMATELY 135 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD; DREDGE APPROXIMATELY 30 CUBIC YARDS SAND/SILT SPOIL FROM AN AREA UP TO 10' OFF BULKHEAD TO A MAXIMUM DEPTH O.F -4' ALW; USE APPROXIMATELY 15 CUBIC YARDS SPOIL AS BACKFILL; TRUCK REMAINING SPOIL TO AN APPROVED UPLAND LOCATION; AND RESTORE DISTURBED PORTIONS OF EXISTING 50' BUFFER, ALL AS DEPICTED ON THE PROJECT PLAN PREPARED BY EN-CONSULTANTS? INC., .DATED. NOVEMBER 29, 2005. ~oard of Trustees WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: MAINTAIN EXISTING EROSION CONTROL sTRUCTURE AND ADEQUATE DEPTH FOR DOCKAGE OF WATER CRAFT ADJACENT THERETO. Area of wetlands on lot: 0 Percent coverage of lot: 0 .square feet % Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? +/-30 cubic yards How much material will be filled? +P15 cubic yards Depth of which material will be removed or deposited: -4' ALW feet (MAXIMUM) Proposed slope throughout the area of operations: 0% Manner in which material will be removed or deposited: APPROXIlviATELY 30 CUBIC YARDS SAND/SILT SPOIL WILL BE DR~nGED VIA BACKHOE FROM UP TO 10' OFF BULKHEAD (TO MAXIMUM DEPTH OF -4' ALW), APPROXIMATELY. HALF OF WHICH WiLL BE RETAINED.ON-SITE AS BACKFILL, AND HALF OF WHICH WILL BE TRUCKED OFF-SITE TO AN APPROVED UPLAND SOURCE. 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): THE PROJECT, WHICH ENTAILS THE ORDINARY MAINTENANCE AND REPAIR OF AN EXISTING EROSION CONTR.O. L STRUCTURE, WILL HAVE NO SIGNIFICANT ADVERSE IMPACTS ON THE ADSACENT TIDAL WATERS. t 4-16-.4 (2/~7)--Texl ~2 PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT For UNLISTED ACTIONS Only PART I~PROJECT INFORMATION (To be completed by ,akoplicant or Project sponsor) ' I APPLICANT/SPONSOR~:)LE J~E, LLC' BY I 2. PROJECT NAME EN-CONSULTANTS, INC. I $ PROJECT LOCATION: Municipality I%'[A TT[TUCK County SUFFOLK 4 PRECISE LOCATION (Street address ~nd road intersections, prominent landmerks, etc, or pro~ide map) FORM SEQR 4340 OLE JULE LAN~, MATI]TUCK, TOWN OF SO ,L~IOLD, SC,T~4 1000-122-4-30; MAP PROVIDED 6 DESCRIBE PROJECT BRIEFLY: REMOVE & REPLACE ON-PLACE) APPROXIMATELY 135 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD; DREDOE APPROXIMATELY 30 CUBIC YARDS SAND/SILT SPOIL FROM AN AREA UP TO 10' OFF BULKHEAD TO A MAXIMUM DEPTH OF -4' ALW; USE APPROXIMATELY 15 CUBIC YARDS SPOIL AS BACKFILL; TRUCK REMAINING SPOIL TO AN APPROVED UPLAND LOCATION; AND RESTORE DISTURBED PORTIONS OF EXISTING 50' BIJI~'vI/IL ALL AS DEPICTED ON THE PROJECT PLAN PREPARED BY EN-CONSULTANTS, INC., DATED NOVEMBER 29, 2005. 7. mOUNT OF L~4O AFFECTED Initially 18,093 S.F. a~t~, ummately 18,093 S.F. acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Re.identia, [] Industrial [] Commercial [] Ag~fcultum [] Park Forest/Open space ]Other ]o. DOES ACTION INVOLVE A PERMITAPPROVAL, oR FUNDNG, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] NO If yes, list agency(s) and permit/approvals NYS DEC TIDAL WETLANDS 1 ~. DOES ANY AS~EdT OF THE ACTION HAVE A CURRENTLY VALID PERM'FF OR APPROVAL? []Yea [] NO If yes, list agency name and permit/approval I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name ROBER~ HERRMANN, COASTAL MANAGEMENT SPECIALIST DATE NOVEMBER 29, 2005 [ Signature: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment ' ' OVER ' AUTHORIZATION (where the applicant is not the owner) (print owner of DropertY) (mailing do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. Board of Trustees AppliCon County of Suffolk State of New York DEPOSES ~ ~F~S THAT ~/~ IS ~ ~PLIC~T FOR ~ ~O DESC~ED PE~T(S) ~ ~T ~L STA~NTS CO~D ~ ~ TK~ TO ~ BEST OF ~S~R ~O~GE ~ BEL~F, ~ ~T ~L WO~ ~L BE DO~ ~ ~ ~R SET FOR~ ~ ~S ~PLICATION ~ AS MAY BE ~PRO~D BY ~ SO--OLD TO~ BO~ OF TRUSSES. ~ ~PLIC~ ~o~STO ~o~ ~TO~ O~ SO~O~ ~ ~ TO~ ~U~S ~S~,TI~(~). ~O ~, O~TO ~O~O ~ ~ ~S~, ~ ~OS~CTIO~ ~~/~*~O~. SWORN TO BEFORE ME THIS [~ DAY OF O~,'--/" ,20 ~ ~" Notary Public VINCENT C. NEWMAN Notary Public, State Of New York No. 31-4675121' Qualified In New York County Commission Expires March $0, 200~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southo]d's Code of Ethics orohibits conflicts ofinte~st on the cart of town officers and ore,lewes. The uuroosc of this form is to orovide information which can alert thc town ofoossibla oonffiets of interest and allow it to take whatever action is necessary to avoid same. (Last name, ~rst name, middldinitial, unless you are applying i~ the name of sera,one else or other antity, such u a company. Ir'so, ihdicate tho oth~r persun's or company's narn~.) NAME OF APPLICATION: (Check all that apply,) Variance Change of Zone Approval of plat Exemption from plat or official map Other (If"Other", name the activity.) Do you personally (or ~rough your company, spouse, sibling, parent, or child) have a ralationship with any officer or amployec of tM Town of $outhold? "Relationship" includes by blood, marriage, or business intare~t. "Busines,s interest" meam a b~iness, including a parmership, in which the town officer or amploy~ has even a partial ownership of(or employment by) a corporation in which the town officer or amploy~ ova~ more than 5% of the shares. YES NO If you answered "YB". complete thc balan~ of this form and date and sign where indicated. Name of person employed by the Town of$outho, ld Title or position of that person Describe the relationship between yourself(the applicant/agent/repre~antafiva) and the ~own officer or employee. Bithar check thc sppropriatc linc A) through D) and/or describe in the space provided. Thc town officer or cmploycc 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 tho applicant is not a corporation); C') an officer, dir~tor, pa'mar, or ¢mploye~ of the applicant; or D) the actual applicant. DESCRIPTION OF R]~LATIONSHIP Signatur Print EN-CONSULTANTS, INC. 1319 No~h Sea Road Southampton, New Yo~ 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL CONSULTING November 29, 2005 Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Re: Ole Jule, LLC 4340 Ole Jule Lane, Mattituck SCTM #1000-122-4-30 NOV 3 u 2005 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including a) Short Environmental Assessment Form; b) LWRP Consistency Assessment Form; c) Authorization & Disclosure Forms; d) project plans; and e) surveys One (1) set of site photographs. Application fee of $250.00 wetlands. I ~rust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Coastal Management Specialist /]fhs Enc. Town of Southoid LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 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. Before an~qwering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 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 detai[ iistin~ both suooorfln- end non- suDoortine 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# 122 4 30 PROJECT NAME 01e Jule, LLC The Application has been submitted to (check appropriate response): Town ~oard ~ P~.uin~ ~oard ~ Bo.din~ Oep~ ~ ~o,~ ofT~te~ ~] CategoD' 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 ande~entofaction: Re~pve and replace (in-place) aooroximately 135 l~near f~mt of existing timber bulkhead with vinyl bulkhead: dredge approxi- mately 30 cubic yards sand/silt spoil from an armm ,,? to 10' off bulkhead to a maximum depth of -4' ALW; use approximately 15 cubic yards spoil as backfill; truck remaining spoil to an approved upland location: and restore disturbed portions of existing 50' buffer, all as depicted on the project plan prepared by En-Consultants, Inc., dated November 29, 2005. Location of action: 4340 ole Jule Lane, Mattituck Siteaereage: +/- 0.42 acres Present land use: Residential, one-family dwelling Present zoning classification: R- 4 0 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: (b) Mailing address: (c) Telephone number: Area Code ( ) (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ No[-'~ Ifycs, which state or federalagency?. C. Evaluate the project to the following policies by analy~ing 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 HI - Policies; Page 2 for evaluation criteria. ~-~ Yes ~--~ No ~'~ Not Applicable Attach additional sheets if necessa~-y Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~-~ Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~ Yes ~ No ~'~ Not Applicable 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 Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southoid. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ~-~ Yes ~-~ No ~-~ Not Applicable At~aeh 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 HI - Policies; Pages 22 through 32 for evaluation criteria. Yes ~-] No ~] Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air qualily in the Town of Southold. See LWRP Section Ill - 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 E 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. [-~ Yes ~ No ~ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's w~l~l'-dependent uses and promote sitid~16f new water-dependent suitable locations. See LWRP Section HI - Policies; Pages 47 through 56 for evaluation criteria. [] Yes [--] NO [] Not Applicable uses in Attach additional sheets if necessary Policy ll. Promote sustainable use of living marine resources in Long Island Sound, the Peeonie Estuary and Town waters. See LWRP Section IH - Policies; Pages 57 through 62 for evaluation criteria~ ~-~ Yes ~-~ No [] Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section HI - Policies; Pages 62 through 65 for evaluation criteria. ~-~ Yes [-~ No [] Not Applicable 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 Ro rrraan~ Amended on 8/1/05 TITLE Coastal Mgmt. SpecDATEll/29/05