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Home My WebLink AboutTR-5759Board Of $outhold Town Trustees SOUTHOLD/NEW YORK PERMIT NO DATE: ...Mau 21, .2.0.03 ISSUED TO ............. ~.. Ll~.c~c?.h~. ~;S.O~!AT!Q~ ..................... Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 18931 and C~apter 404 of the Laws of the State of New York 19521 and the Southokl Town Ordinance titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERSI!.'. and in accordance with the Resolution of The Board adopted at a meeting held on .gq.~.~.,., and in consideration of the sum. of $.-~0~,4)0 paid by · ·Mark'Mc"'Drt'f'fe-e'6~i b~'E'/ilf 57 The'L~i{"""X~[i~i~ ..... of ......... ~..u.~g. bgg~ N. Y~. and Sublect to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit for a Ten (10)' Year Maintenance Dredge entrance channel to -5' MLW place dredge material down b~ach. all in accordance with the detai~ed specifications es presented in the or~glnating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs Corporate Seal fo be affixed, and these presents fo be subscribed by a majority of the sald Board as of this date. TERMS and CONDITIONS The Lagoon Association residln~k~rth of Ahown T.nne - South Bricge Lanc Cutchogue,~ N. Y. ~s p~n' of the consider~don Eot ~he ~ o[ d~e P~r,~k do~s understsod ~nd p~'~0~ to the fol- lowly: 1. That the said Boazd of Trustees and the Town of ,Soutbold axe released fram any sad all damag~ ot ~-~,,~ fat damages, of suits arising dizectly oe indlt~dy as s result of any ope~- with respect thereto, m d~e cae~lete exdusioa of the Board of T~r'~__ of the Town ¢~ 2. That d~s Pem~/s v~kl for a ~'/od of 120 moe. wbJd~. ~ eomklemd to be the es~mted gme requi~d m ,_~nplete the wod~ lavolved, but shoed ~,,,-~ wsma~ tequ~ for an exr~s!on may be made to the Board at a late~ da~. 3. That this Permit should be retained iaddiaJtely, or as Ion& as the said pormi~ee wishes to mei~i~, the structure or project involved, to pmvi& e~4dmce to ~u~oae eom:e~ed ~,,t aud~- odzation was originally obtained. 4. That the work involved will be subject to the in~ and approval of the Bo~d its agents, and non-compliance with. the provisions of the otiginat~ application, may be cause revocation of this Permit by resolution of tlxe said BoarcL 5. That there will be no unteasooable interference with tmvigatlo~ as · ~__,k of the wedt he~e~ authorized. 6. That there shall be no iatede~ence with the right of the pulgic to pass and repess along the beach between high a~d low water m~rks. 7. Thtt if future operations of the Town of Soudxold requite the removal ~i/or akeradoas inthe location of the wo~ hete/n nudmdzed, or if, in the op/ai~ of dm Bo~! o/Tmstees~ the work ~,11 al. use unre~cso~able obst~uctwn to free navigatlo~, the said Petm~ee will be Vec~eds upoo due notice, to remove or alter this work or project here/a stated widmut exl~ns~ to the Town 8. That the said Board will be notified by the Permittee ot the completion of the wedt such- orlzed. 9. '[hat the Petmlttee will obtain all other permits and consents dutt may be requited sup- plemental to this permit which may be subject to revoke upon faibue to obtain same. T ! ' I 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) 765-1366 May 27, 2003 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD The Lagoon Association c/o Mack Mc Duffee 175 Clearwater Lane Cutchogue, NY 11935 SCTM#118-2-11.4 The Lagoon Association North of Abbrn Lane - South of Bridge Lane Nassau Point Cutchogue, NY Dear Mr. Mc Duffee: The Board of Town Trustees took the following action during a Regular Meeting, held on May 21, 2003 regarding the above matter WHEREAS, The Lagoon Association applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated April 15, 2003 WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 21, 2003 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 2 concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 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 approved the application of The Lagoon Association. Wetland Permit for a Ten (10) Year Maintenance Dredge entrance channel to -5' MLW place dredge material down beach. North of Aborn Lane - South of Bridge Lane - BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Fee must be paid, if applicable and permit issued within six months of the date of this notification. Inspections are required at a fee of $5.00 per inspection. (See attached schedule). FEES: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJlC/cjc cc DEC Telephone (631) 765-1892 Town H'.dl. 5:~095 ~ Road P.O. Box gout, hold, Ne~ York 11971 $OU'rHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, May 13, 2003, the following recommendation was made: Moved by Bill Cook, seconded by Meivyn Morris, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit application of THE LAGOON A$8OCIATION for a 10-Year maintenance dredge permit to dredge the entrance to the channel -6' MLW and place dredge material down the beach. Located: Nassau Point, Cutchogue. SCTM#118-2-11.4 Vote of Council: Ayes: All Motion Carried 4 APPROVr..~ ,~ ~OAI~D OF TitUSTE ~< New York State Department nvironmental Conservation Division of Environmental Permits Rm 121, Building40-SUNY . Stony Brook, New York 11790 2356 Telephone (631) 444-0365 Facsimile (631) 444'aa-~0360 Lagoon Association C/O Mark McDuffee 175 Clearwater Lane Cutchogue NY 11935 C F. 111 ir. RE: Permit # 1-4738-00298/00009 Maq 2, 2003 Erin M. Crotty Commissioner Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6 NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, Matthew R. Penski Encon Program Aide MRP Enclosure NEW YORK STATE DEPARTMENT OF ENVIRONMENTA~CONSERVATION DE~ PERMIT NUMBER ~ ~ EFFECTIVE DATE 1-4738-00298/00009 P~IT~ May 2, 2003 FACILITY/PROGRAM N-u/~BER(S) EXPIRATION DATE(S) Un,er the Environ~ental Conservation Law May 1, 2013 TYPE OF PEP=MIT · New · Article 15, Title 5: Pro- tection of Waters [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] Modification [] Permit to Construct [] Permit to Operate [] Renewal · 6NYCRR 608: Water Quality Certification ~ Article 17, Titles 7, 8: SPDES ~ Article 19: Air Pollution Control ~ Article 23, Title 27: Mined Land Reclamation ~ Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management 0 Article 34: Coastal Ero- sion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control pERMIT ISSUED TO Lagoon Association, C/O Mark McDuffee ADDRESS OF PERMITTEE 175 Clearwater Lane, Cutchogue NY 11935 CONTACT PERSON FOR PERMITTED WORK Ma~k McDuffee, 175 Clearwater Lane, Cutchogue NY 11935 NA~E AND ADDRESS OF PROJECT/FACILITY South Lagoon Entrance Maintenance Dredging LOCATION OF PROJECT/FACILITY Southeast of Bridge Lane and Northwest of Aborn Lane, Cutchogue NY COUNTY TOWN WATERCOURSE Wunneweta Pond South Suffolk Southold Lagoon Description of Authorized Activity (631) 73~-7799 TELEPHONE NUMBER (631) 734-7799 NYTM COORDINATES Maintenance dredge the entrance to the South Lagoon to a depth of 5-feet below apparent low water with resultant approximate 550 cubic yards of dredged material to be placed above apparent high water on the beach to the northwest. This is a 10-year maintenance dredging permit. All work shall be performed in accordance with the plans stamped NYSDHC approved on 5/1/03. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 - Bldg. #40, S , Stony Brook, NY 11790-2356 Jo~A and (MRP) ~'/ Page 1 of 4 -- May 2, 2003 OW YORK STATE DEPARTMENT OF ENVIRONMENTAL ~'~ERVATION SPECIAL CONDITIONS 1. All dredged material shall be disposed on an approved upland site and be retained so as to not re-enter any water body, tidal wetland or protected buffer area. and haulage. Dredging shall be accomplished with a clam shell or other closed "bucket" equipment. 3. Excavated sediments shall be placed directly into the approved disposal site or conveyance vehicle. No sidecasting (double dipping) or temporary storage of dredge material is authorized. 4. Dredging is prohibited from June 1 - September 30 of each year to protect spawning shellfish and / or spawning finfish. 5. Dredging shall be undertaken no more than once in any calendar year unless specifically authorized by this Department. 6, A filter fabric curtain weighted across the bottom and suspended on floats shall be positioned to enclose the work site before commencing dredging. The curtain shall remain in place and functional during all phases of the dredging operations and remain in place for two hours after dredging termination. 7. For maintenance dredging projects, permittee shall submit a Notice of Commencement prior to each dredging occurrence, specifying the disposal site (including an updated site plan), Upon completion, a Notice of Completion specifying the amount of dredged material deposited at the approved disposal site must be submitted. 8. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the tidal wetland boundary. 9. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 10. This permit authorizes a one time placement of dredged spoil in the area shown on the approved plans. Due to the amount of material existing in the approved spoil placement area, a new area for disposal of future dredged material may be needed. Please contact the Department prior to conducting any future dredging operations. DEC PERMIT NUMBER I J PAGE2 OF4 1-4738-00298/00009 NEW YORK STATE DEPARTMENT OF ENV'RONMENTAL CONSERVATION .TIFICATION OF OTHER PERMITTEE O~.. ATIONS · Item A: Permittee Accepts'E~gal Responsibility and Agrees to Indemmfication The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permlttee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to pedorm the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401 (3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region < > <street>, <city>, <state> <zip>, telephone: < > General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds for modification, suspension or revocation include: a) materially false or inaccurete statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERMIT NUMBER I IPAGE'3 OF 4 NEW YORK STATE DEPARTMENT OF ENVTRONMENTAL CONSERVATION ADDITIONAL GENERAL'~NDITIONS FOR ARTICLES 15 (TITLE 5{,{~4, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS ) If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watemourse. No claim shall be made against the State of New York on account of any such removal or alteration. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable intederence with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 9. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 10. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plane were prepared by: Sea Level Mappin(~ on 4/2/03 and stamped NYSDEC approved 5/1/03. DEC PERMIT NUMBER I IPAGE 4 OF 4 1-4738-00298/00009 Albert J. Krupski, President James I~ng, 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) 765-1366 April 30, 2003 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD The Lagoon Association cio Mark McDuffee 175 Clearwater Lane Cutchogue, NY 11935 RE: Lagoon Association Nassau Point, Cutchogue SCTM#118-2-11:4 Dear Mr. McDuffee: The following action was taken by the Southold Town Board of Trustees at their meeting held on Wednesday, April 30, 2003: RESOLVED, that the Southold Town Board of Trustees Approve the request of THE LAGOON ASSOCIATION for an Emergency Wetlands Permit to dredge the entrance to the channel to -6' MLW, and place dredge material down the beach, with the condition that a new wetlands permit to dredge is applied for by May 1,2003. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Very truly yours, · up i, Jr. ?'''~''p President, Board of Trustees AJK:lms Southold Town Board of Trustees Dear Trustees, Mark McDuffee Lagoon Assoc. of Nassau Point 175 Clearwater Lane Cutchogue, NY. 11935 4/10/03 This is a plea for your help with our continuous Maimenance Dredging Permit. Our permit application is atthe DEC and approval is expected between now and May 19. The DEC was initially expected to approve in the 90 day period between 2/4/03 and 5/4/03. I was waiting for this permit to then apply to you for your permit. On Monday Matt Penski of the DEC told me that there was no need to rush..., that you have issued permits without the DEC permit. This morning Lauren told me that I would not be able to get your permit until the end o May. That means the Lagoon will be closed for navigation this summer. I had started the process on lan~ 24, visited the DEC with my application twice between then and Feb. 3--- Made corrections and turned in what I thought was a final application on Feb. 3. I then received a Rejection with a request for information ....which I felt was in the original. I was told on the phone the original couldn't be read. I then hired a consultant, Cathy Mesiano recommended by Latham Sand & Gravel, who told me repeatedly that she would have the process finished by the end of March. She said she could not do it o~t March 20 but sent meto Bob Fox-- -who did. a great job (copy of his map enclosed. I took the application revision to the DEC and he told me it was perfect on 4/4 but then Tuesday received the letter saying up to another 45 days. I called and told him that I could not wait that long since I still had to go to you. He said that a DEC permit is not required to go to you. Hence, we are stuck... Unless you can grant a special extension and 1 would start the new Town process immediately. Please extend any help to remedy the Southold Permit portion that you can. I am looking forward to hearing positive news from you. Kindest regards, . ~ Mark McDuffee tJv P.S. The DEC applicxati~ # 1-4758-00298-00009. The Army Corps. Permit is 95-10930 which expires May 8 2006. APR Board of Tr~ Albert J. Kmpski, President John Holzapfel, Vice President Jim King Martin H. GarrelI Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD M?LRCH 26, 1997 LAGOON ASSOCIATES 37070 MAIN ROAD CUTCHOGUE, NY 11935 LAGOON ASSOC ~ SCTM~ll8- 2-11.1.2 DEAR I~R. MCDUFFEE: The following action was taken by the. S~uthold Town Trustees on Wednesday March 26,1997, at t~eilc regular meeting. RESOLVED that the Southold Town Trustee~ grants fO~' an extension of their dredge pez~nit to run with DEC, May 8: 2002~ This approval does not constitute approvals from a~f other agency. If you have any questions, please feel free to contact our office at 755-1892. SINCF~ELY, .ALBERT J. KRUPSKI JR. PRESIDENT, BOARD OF TRUSTEES AJK/djh Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO..-~7.]~4.T.8.gT.1],.ST2-11.2 DATE: J. uly Z8,...1959 ISSUED TO LAGOQN .A,S. SQClA~.ION ................ Authorization Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893: and Chapter 404 of the Laws of the State of New York 1952; and fha Soufhold Town Ordinance en- tiffed "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted et a meeting held on Suly..27, 19..~...., and in consideration of fha sum of $ ............. paid by of .......................................................................................... N. Y. and subject to the Terms and Conditions llsfed on the reverse side hereof, of Soufhold Town Trustees sufhorlzes end permits the following: Maintenance dredge bulkheaded area to the Lagoon , spoil to be placed north of inlet to provide nourishment. Property located at Nassau Point, Cutchogue, N.Y. all'in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs Corporate Seal fo be affixed, and these to be subscribed by a majority of )~gf said Board as date. · ' Pdbert J. Krupski, President [/ames King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Applicat~6n --Wetland Permit Application V Major __ Minor Waiver/Amendmen~/~Ch~ges Received Application: ~l(g[0 Received Fee:$ g~ 7 - Completed Application L~ l. I c~[ Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date se.nt/)~4 ~ Date of Inspection: ~t{{[O.~ Receipt of CAC Report: ' Lead Agency Determination: ._ Technical Review: ~//g, 10 Public Hearing Held: Resolution: NameofApplicant y~h¢ L~ ~oo,t ,qssooi a't' , , .~ Phone Number:( ) g3i. 73q-~&5 + 73q - 17fq SuffolkCountyTaxMapNumber: 1000- It~ ~ &-/l' ~ Property Location: .~o~ 6 v~ ~,~ ~ ~ ~o.'~ o~ g~:d~ A~.~ (provide LILCO Pole ~, dist~ce to cross streets, ~d l&ation) AGENT: (If applicable) Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: Agency Date ~ No prior pe~its/approvals for site improvements. $ ~ ¢ _ ~-/~1o ~e ~ ,*.c~ ~/*~- 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): WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: / Area of wetlands on lot: ~ square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: /(~ feet Closest distance between nearest proposed structure and upland edge of wetlands: /& feet Does the project involve excavation or filling? No ,/ Yes If yes, how much material will be excavated? ~5-0 cubic yards How much material will be filled? 6-~0 cubic yards Depth of which material will be removed or deposited: J'~- & Proposed slope throughout the area of operations: /, ~//6 Manner in which material will be removed or deposited: feet 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): Name: STATE OF NEW YORK COUNTY OF SUFFOLK C ,., t c ~..~ ,,.~ ,4/y , being duly sworn, deposes and says that on the I F ~tday of ,,4¢,' ,'l ,20o_~_3, deponent mailed a tree 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 there 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 Towr~ of Sou/hold; that said Notices were mailed at the United States Post Office at ~50 ~ 'f- ,~o/o_~ , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this Dayof ,200 Public JO~CE M. WIIJql~ ,m ~ir~ Ju~ ~ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: ~.-~ ~<~,, /~e~., SCTM#1000- YOU ARE HEREBY GIVEN NOTICE: 1, That it is the intention of the undersigned to request a Permit from the Board of Trustees to: 2. That the property which is the subject of Environmental Review--is located adjacent to your property and is described as follows: , / ~'~ .~.~ .' 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on: You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: ;-c)' oo ,.~ MAILING ADDRESS PHONE %: ~ ~i'- 7 Enc.: Copy of sketch or plan showing proposal for your convenience. Albert J. Krupski, President James King, Vice-President Henry Smith Artie Fester Ken Poliwoda Town Hall · 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application STATE OF NEW YORK) AFFIDAVIT OF POSTING I, ,'1~,,'~ /.'~[5~ , residing at {?~ (~7je~'' ~7ce~ /-~ being duly ~worn'; depose and say: That on the /~ day o~ ~ , 200~, I. personally posted th~ ~/,kz~ property known as ~',~ +~c~ C&¢4-~/- ~ ~ e~ ~ - ~& ~ ~ by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of~ publiq %earing. Dat~ of.hearing noted thereon to be held ~ signature) Sworn to before me this ~/ day of v~ 200 Notary Public LINDA J. ~OOPE~ Notary Public, State of New York (Owner --ROM FAX ( Agent ) for Pex~it(~) from the Board of Trustees Applicati'on County of Suffolk State of New York .r/c BEING DraY SWOKN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE 1N 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 TOWN 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(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS /C- v^v OF ~ ,20,~ % JOYCE M. WILKINS Notary Publk~, State of New N_o. 4952246, .Suffolk APb , 6003 S0uth01d Town Board of Trust. S 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS OnJy PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) i NAME 1. APPLICANT /SPONSOR 2, PROJECT 3. PROJECT L~'CATION; 4. PREC:SE LOCATION (Street a~ress and to. intersections, ~romin~nt Janomar~s, e~c., or ~rowoe 5. IS PROPOSED ACTION: ~ New ~ Expansion ~oeificationialteration ~. DESCRIBE PROJECT ~RIEFLY: / SEQ 7. AMOUNT OF LA. ND AFFECTED: 10. DOES ACTION 'NVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, 11. DOES ANY ASPECT OF THE ACTZON HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~ No If yes. ~ist agency name and ~ermit/aporoval 7 Co.. s 9 -/o If the action is in the Coastal Area, and you are a state a~ency, complete the Coastal Assessmen: Form Defore proceeding with this as=sessment OVER t PART II--E:NVIRONME 'SSE.SSMF.:'~T ,~-o -~e ~' .... ~ '~ c2. PART III--DETERMINATION OF SIGNIFICANCE ~TO se completed by Agency) INSTRUCTIONS; For each &averse effect identified zOove, determine w~etl~e¢ it is substantial, large, imoor~an~ or omercvise signific EeC2 e/leo: s~ould be Assessed in connection w~th its (a) setting ¢.e. urDan or rural); (b) probability of occ~g; (c) duration [rrevermbHity: (el geographic sc=~e; and (f) magm~ude. If necessa~, adq alt~cnments or reference supposing m~[eria~s. Ensure exclanations con,am sufficient de~aii (o snow that aH rmevant adverse impacts nave ~een identified ~nd adequately ~Cdressec. Checx ;his ~ox if you have identified one or more potentially large or significant acverse imcac:s whic~ occur· Theft groceeo ~irec:ly !o :ne FULL E.AF ~ndlor preeare a positive' aeclara, tion. ChecX mis box f you nave determined, based on [he inffrmadon ;[rtd analysis above and any sucoortinc_ oocumentamort. :i~at ;he 2rooosed action Y/iLL NOT result in.~.!ny Signific~nt adverse enwrcnmental A/~D drovlc8 art :3.[*.acnmef~ts as necessary, [he reasons supcorting trtis determination: The Town o~ $~u~hold'n Code of Ethics Prohibits conflicts o~ lnteresb un the parb of town olficers and employees, The purpose of this form is to provide lnformetion vhich can ~lert the town of possible conflicts o£ interest and alice it to take whatever action is necessary to avoid same. (Last name, ~irst name, mid'd.le init{al, unless other entity, such ps a company. I~ so~ indicate the other person's or compeny*e name.) Tax ~rievanee Variance Change of sene ~x~p~ion [rum pla~ or o~[iuial map Other which 6he town officer or employee has ~ven a partial If ?ou answered '~,' uumpl~te the balanc~ o~ ~h{s'~urm and date and sign uhere fndiuated. Name o~ porson employed by ~h~ Town or Title ur position o~ that person D~scribm ~ho rmla~iunship bo~wo~n youraolf (~h~ and ~ho ~ovn o~ficor or employee. Either chock ~ho appropriate line A) through D) and/or describe in the provided. parent, or child is (uheuk ail ~ha~ apply)~ A) the owner of grea~et t~a~ 5% cE the shares o~ the corporate stock o~ the applio~nt (when the . ia a uorpora~ion)l B) the legal or b~neglcial owner of a~y i~tore~t in noncorporato'entity (whoa th~ applican~ ia not a corporatiun)l C) an o~iu~r~ dir~ctor~ partner or ~mploy~ of tho appiican~ or D) ~he au~ual applican~. DE~CRXPTION OF RELATIONSHXP