HomeMy WebLinkAboutTR-6227
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
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
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
1 sl day of construction
Y, constructed
/ Project complete, compliance inspection.
.
TERMS and CONOI11QNS
ne PerDlitUe
Robert Keller
East Marion,
~dlogat . ..... N. Y.. &S
J'a". of the wosidention for the lsS..,~ of <<he PCtmlt docs lJII&a~ .:M plC$Cribe to the fol.
lowing:
1. That the said JJoatd of Trustees and the Town of Soudlold ate rdeued from w.y and
aU damages, or daims for .daIoages, of suits ad$iog diRcdy or tocIiftdiy &S . ~ of w.y opet-
.rloa.petfoaued .punIlaot'(O.ihh.~t, ~.!hCl.~. ~~~_~ldsorber own. ~.
defend ...y and all $UCh sWu-.ln1tl.f.e<!by Ihhd f'attles, and the said J>-nI- __ full llabllity
with m~ <<hereto, to.tb~p1eteexclusl()Q of thI:. &ud of Tru$lta. of the Town of Soutbold
. 24
2. That this fletlDit It. ~d for _ perlod of . IDO$. -wbld1. is ~ to be the
estimated time. required CO coInplctc the work lnyol1'CCl, butihoold dw~~ warraor, tcqucst
lor w. cxteI15ion .may be made to <<he B<wd at a lIlU .we.
3. That this PeQIIir should be retained indef"wtc1y, or as long as the ,akI PcrmilttC ~
to. maintain the muaure or project involved, to provide cvidcoce to anyone ooncerncd m.r outh.
.orlzation was ori8lnilly obtained.
4. That the work involved will be ..wject to the ~ and approYal of the Boatd or
lu &8C"lS, w.d QOCl<OlIlpUance with the provisiolH of the orlgl.....1ng applicatioa, may be ause for
IeVocation of this Permit by resolution of the said Board.
S. That tbcrc will be no ~le interference with navigatioa as a result of the wad::
.
.
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
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
October 19, 2005
Ian Crowley
P.O. Box 618
Greenport, NY 11944
RE: ROBERT KELLER
380 KNOLL CIRCLE, EAST MARION
SCTM# 37-5-11
Dear Mr. Crowley:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, October 19, 2005 regarding the above matter:
WHEREAS, Ian Crowley as agent for ROBERT KELLER applied to the Southold Town
Trustees for a permit under the provisions of Chapter 97 of the South old Town Code,
the Wetland Ordinance of the Town of Southold, application dated September 21, 2005,
and
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 October 19, 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,
WHEREAS, the structure complies with the standards set forth in Chapter 97 of the
Southold Town Code,
2
.
.
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,
RESOLVED, that the Board of Trustees approve the application of ROBERT KELLER
to remove and replace approx. 97' of deteriorated creosote seawall with new vinyl seawall.
Existing platform, ramp, and float to be removed and reinstalled following construction. Backfill
new wall with 20 cy. clean fill in area 10' behind bulkhead. Re-use existing gravel and stepping
stones, plant area behind with Cape American Beachgrass, Bar Harbor Juniper, and Rosa
Rugosa to create a 10' non turf buffer, with NO CCA treated wood used, and a floating turbidity
screen used during construction and all as depicted in the plans prepared by Ian Crowley last
revised 8/7/05.
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.)
This is not a determination from any other agency.
Fees: $50.00
Very truly yours,
b~,1- 9- ~.(}
Albert J. Krupski, Jr.
President, Board of Trustees
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Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Ronte 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
~., ~b~ k~(leJL
Please be advised that your application dated q (;J I ( O!;"
reviewed by this Board at the regular meeting of 101 ("Ilo~
following action was taken:
TO:
-:t:.U\.l\
C("l)<.,Jle'l
has been
and the
~ Application Approved (see below)
'-) Application Denied (see below)
'-) Application Tabled (see below)
If your application is approved as noted above, a permit fee is now due. Make check or
money order payable to the Southold Town Trustees. The fee is computed below
according to the schedule of rates as set forth in the instruction sheet.
The following fee must be paid within 90 days or re-application fees will be necessary.
COMPUTATION OF PERMIT FEES:
~IV'\
TOTAL FEES DUE: $ So
SIGNED:
~.j 9- 479fL-i' (}.
PRESIDENT, BOARD OF TRUSTEES
.
.
Telephone
(631) 765-1892
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Wed., October
12, 2005, the following recommendation was made:
Moved by Don Wilder, seconded by Jennifer Mannino, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the
Wetland Permit application of'ROBERT KELLER to remove and replace approx. 97' of
deteriorated creosote seawall with new vinyl seawall. Existing platform, ramp, and float
to be removed and reinstalled following construction. Backfill new wall with 20 cy. clean
fill in area 10' behind bulkhead. Re-use existing gravel and stepping stones, plant area
behind with Cape American Beachgrass, Bar Harbor Juniper, and Rosa Rugosa.
Located: 380 Knoll Circle, East Marion. SCTM#37-5-11
Vote of Council: Ayes: All
Motion Carried
Oct. 13 , 2005 Field Inspection.
.
Oct. 13 , 2005 Field Inspectio.
.
Oct. 13 , 2005 Field InspectiOl.
.
,
Oct. 13 , 2005 Field Inspectio.
.
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Robert Keller
380 Knoll Circle
East Marion, New York 11939
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Robert Keller
380 Knoll Circle
East Marion. New York 11939
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Photos taken 512012005
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380 Knoll Circle
East Marion, New York 11939
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East Marion, New York 1\939
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UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOL&..TION or
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.
COPIES Of THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKm SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID ~RU:: COPY
--r---'---
--------
BiU:VIEW _ DRIVE
SURVEY OF
LOTS 25 & 26
MAP OF
GARDINER'S BAY ESTATES
SECTION TWO
FILE No. 275 FILED SEPTEMBER 23, 1927
SITUATED AT
EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-37-05-11
SCALE 1 "=20'
DECEMBER 31, 1998
FEBRUARY 10, 1999 ADDED WETLANDS AS FLAGGED & LATH PRO:). DECK CORNERS
AUGUST 31, 1999 ADDED LIMIT OF NYSDEC JURISDICTICN LINE
SEPTEMBER 8. 1999 ADDED CONC. WALL ON lOT TO n..E WEST
OCTOBER 28, 1999 REVISED PROPOSED DECK
FEBRUARY 26, 2004 ADDED PROPOSED AODJTlON~;
MARCH 3, 2004 ADDED PROPOSED STEPS
MAY 20, 2004 REVISED PROPOSED ADDITIONS
JUNE 2, 2004 REVISED PROPOSED ADDITIONS
JULY 14, 2004 LOCATE WETLAND FLAGS & LATH ADDITION FOR NYS.D.E.C. INSPECTION
MARCH 8, 2005 REVISED PROPOSED ADDITIONS
MARCH 24, 2005 UPDATE SURVEY & ADDED PROP, 2nd STCRY ADDITION
. 'So
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AREA = 11.574.20 sq. ft.
NOTES: (TO TIE LINE) 0.266 ac.
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM
EXISTING ELEVATIONS ARE SHOWN THUS:'
EXISTING CONTOUR LINES ARE SHOWN THUS:
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CERTIFIED TO:
FIRST AMERICAN TITLE
OF NEW YORK
ROBERT KELLER
BARBARA KELLER
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INSURANCE COMPANY
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N.Y.5. Lie. No. 4-9668
Joseph A. Ingegno
Land Surveyor
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Title Surveys - Subdivisions - Site Plans ~ Construction Layout
'.....
PHONE (631 )727 -2090
Fax (631)727-1727
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THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASElolENTS OF RECORD. IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND :)"'l HIS BEHALF TO THE
TITLE COMPANY, GOVERNMEI'lTAL AGENCY AND
LENDING INsrlrUTlOt>; LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTi-
TUTION, CERTIFICATIONS ARE: NOT TRANSFERABLE
OFFICES LOCATED AT
322 Roanoke Avenue
Riverheod, New York 11901
MAIliNG ADDRESS
P.O. Box 1931
Riverhead. New York 11901-096:i
.
9SU689i
.
.
MAltiNG ADDRESS:
P.O. Box 1179
Southold, NY 11971
PLANNING BOARD MEMBERS
JERILYN B. WOODHOUSE
Chair
WILLIAM J. CREMERS
KENNETH L. EDWARDS
MARTIN H. SIDOR
GEORGE D. SOLOMON
OFFICE WCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
South old, NY
Telephone: 631765-1938
Fax: 631 765-3136
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
To: Town of South old Board of Trustees
From: Mark Terry, Senior Environmental Planner
L WRP Coordinator
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Date: October 17, 2005
OCT 1 8 2005
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Re: Request for Wetland Permit for Robert Keller
SCTM#37-5-11
Q, :1 ,~; ilid':f:S
Ian Crowley on behalf of ROBERT KELLER requests a Wetland Permit to remove and
replace approx. 97' of deteriorated creosote seawall with new vinyl seawall. Existing platform,
ramp, and float to be removed and reinstalled following construction. Backfill new wall with 20
cy. clean fill in area 10' behind bulkhead. Re-use existing gravel and stepping stones, plant area
behind with Cape American Beachgrass, Bar Harbor Juniper, and Rosa Rugosa. Located: 380
Knoll Circle, East Marion. SCTM#37-5-11
The reconstruction of the bulkhead, in-kind, is an exempt Minor Action and not subject to
LWRP review pursuant to Chapter 95 of the Town of South old Town Code. This review will
address the backfilling of the bulkhead with 20 c. y. of clean fill.
The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the
Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based upon the information provided on the L WRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation
that the proposed action is generally CONSISTENT with the Policy Standards and
therefore is CONSISTENT with the L WRP provided the following best management
practice is applied;
1. To further the intent of the L WRP and the policies. assess the proiect area for the
use of a noatin!! turbidity screen silt/boom durin!! re-construction of the structure to
minimize turbidity in the water column.
Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing
its written determination regarding the consistency ofthe proposed action.
.
.
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-~"'blll
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_ 9>astal Erosion Pennit Application
~ etland Pennit Application _ Administrative Pennit
AmendmentITransfer xtension
~eceived Application: lOr-
..Ateceived Fee:$ :J. ~-
~mpleted Application <] (~/ 10!
_Incomplete
SEQRA Classification:
Type I_Type II_ Unlisted_
_ Coordination:( date sent)
......eAC Referral Sent: ~O~
~ate ofInspection: 100la/o~
_Receipt ofCAC Report:
_Lead Agency Determination:_
Technical Review:
::::Public Hearing Held: ,0/19/0 r-
Resolution:
LW .......
Name of Applicant Ro8tflef k~J/p1l
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Address 3ii'o ~ADII uu/tr
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Phone Number:~) "" - DZOO
Suffolk County Tax Map Number: 1000 - 17 - OS - , I
Property Location: !gO ftlqfl Oull'
Ehf' ,;f/lrJm Ai'! //?~i
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(provide LIL 0 Pole #, distance to cross streets, and location)
AGENT: ~
(If applicable)
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Address: ~ i50f
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Phone(pd R'!/- 17/4
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Board of Trustees
.
Application
GENERAL DATA
Land Area (in squarefeet): /I! 51l/ 1D 1;UtlU F<<{
Area Zoning: Ke"t./tAl71ItJ
Previous use of property: I&rItJ/=NiIIt'J
Intended use of property: A-stIJVNT71r1
Prior permits/approvals for site improvements:
Agency
Date
/' No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspen<!yd by a governmental agency?
~No_Yes
If yes, provide explanation:
Proj~ct Description (use attachments ifnecessary):,&"u JI/(J I!ttpItIfr ~Aj:/"'t1Aj
71 OF ~t1l:It:l~ t1'6'll107T !GUt. R~4a' "",111 mw /JII/.,/ \e1IIMfI1
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t1AshtJ;,71 . &eM,!/ #loti w"h VII/tit Ii. Sf. t l<A4l ,''''
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/0' f'htI~"7IIt{ illll'R6. 41, ~/thdn i Rt--q~ ,;.t'S/11 ('IIk/ Atid sh;1J~
~€11 'fftl1( hteA &/1"'4 WI!tr {~/.N1tIC"" JkhI '41/5S1 Kit1t ~Id"fl ~ I ~ Irq lC'r~'
4Itoard of Trustees ApPlica~n
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:, SlfIiA,hv Ifttil
fjtfccwJ{ 7() "7 Amll)
Rtfll~ eh:T1Nq ~JI'I./AIft (!v/~~ .'
Area of wetlands on lot: j'T)
square feet
Percent coverage oflot: 2
%
Closest distance between nearest existing structure and upland
edge of wetlands: 2' feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 2'S feet
Does the project involve excavation or filling?
No ,/' Yes
If yes, how much material will be excavated?!O cubic yards
How much material will be filled? )0 cubic yards
Depth of which material will be removed or deposited:
Proposed slope throughout the area of operations: 3 k /
t feet e...,.l4Ifl / /'O.r A-p.s(~
Manner in which material will be removed or deposited: .sI11191i ~.
IINt' JtII1I f3dJIJlJA 71/1. /MI/I "",1/ b. ~ flit,,, 'it. J7" h7ItJ.JA!
/
I( '7iJ: r#A/( !he HI/ wi/ /11uv ""- ifI4J j, 6&ki1I/ II!tJW 5e1wH/
7J 1MiJC, I dtlot ,~ Wi/I /;t; I1q.J/I1,A In iht iJre>> /J/1#Tl1y IJJJ1Ib'$ j/k ~ WIt'II
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):
-then/( VI'/ / btr
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wi!! ~ ~III:O
/11/111",111 d1:Nrr IJtV '/Irt WitT;""",> ",}"ct, I-v4!J ~
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.
.
.
Albert J. Krupski, President
James King, Vice.President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Han
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-~tafoIIl
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application
of
______~(J-~-~-~1-----------------------------
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
, residing at /6?r" #11'# Lk..
I,
That on the 10 day of tY~, 20O:S:1 person lly posted the property known as
lJ (
by placing the Board of Trustees official post 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 the public
hearing. Date of hearing noted thereon to be held Zr. led. oct r 11, rl('{JS~ -
Ol'l O'lo6ci...t:f 1~ PM
D,too 1ft)
Sworn to before me this /1'1"1/
day of Oc[. 2005'
~~d~
Notary Public
STANTON S. ROLLER, JR.
Notary Public, Slale of II.. York
No.01R04917131
Quelllled In Suffolk County p7
Commllllon Explna.lan 23, 20-
.- .
817.20
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
.
.
Municipality ftf6f 4t!bW Counly
~. PRECISE LOCATION (51_1_ and mad intersections, prominent landmarks, etc., or provide map)
S(){J
filii (fM
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~
//15
5. PROPOSED ACTtON IS:
o New 0 Expansion BlModilicalionlalteralion
6_ DESCRIBE PROJECT BRIEFLY: f(~Mcr;e Jpj) ft7J/ifre- {rf~Jt"'/ff/;-7'1 '14' INthtA/4 I wlf/r III.!V/,:I.''1./
Sl!Awtft. fl!tkttlll to tl/fllJS rrf ~/I ~I PV<t//tJIt {oll/sru.f]MJ. ~,11/(/ Rtt,v;71I 1lJ1/1U/7
{Ur/!,W!tT1f1tl I!i Htrn rt' . r; 3b I ~ 1. h /b' M" (vI! 'tb a . wtII
7. AMOUNTOFU\tl~CTED:
Initially . ~ acnIS UttimeIeIy ecraa
a WIU. PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING lAND USE RESTRICTIONS?
~ 0 No II No. describe briefty
9. WHAT IS PRESENT lAND USE IN VICINITY OF PROJECT?
~ 0 1_ 0 Commett:ial 0 Agrialllura 0 PerklForaatIOpen Speoe 0 Other
Deacribe: r:t1/NJ1Akti!.5 6H ai$:s / f)J~ftlOlVf ,5vt/Jllllt/OIII / !J:,&lU17# 1I4PP,f/1\I&, OF
1le5'f$ fJJI Jfe!dti ~ ,
10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY
(FEDERAL. STATE OR LOCAL)?
S Yes 0 No "lfYes.list agency(s) name and penniUapprovals:
NIJIJEt . M $ftk; OWJ/I Or 6;"
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
D Yas ~ IrYas.list agency(s) name and pennlUapprovals:
12. AS A RESULT OF P OPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
Yas
7
Signelura:
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
1
.' lReslit.
~T 11- IMPACT ASSESSMENT
com Ieted b Lead A
A. DOES ACTION EXCEED ANV TYPE IlHRESHOLD IN 6 NYCRR, PART 617.4?
Dv" 0 No
B. WlU ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NVCRR, PART 617.6? II No, a_live
declaration may be superseded by anolhar involved _.
Dv.. 0 No
C. COULD ACTION RESULTlN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOUOWING: (Answers may be han_n. illegible)
C1. Existing air quality, aurfaoa or groundwater quaJlIy or quanlily, noiseleveis, existing traffic paUom, solid wasto production or disposel,
potonIiaIlor _, dra"- or Hooding proIHms? Explain briefty:
.
fi yos, COOIdinaIo tho re_ process and use the FUU EAF.
C2. Aesthetic. agricuflurat. archaeological. historic. or other nabual or cuttural resources; or oommunlty or neighborhood character? Explain briefly:
C3. Vogolalion or ralna. fish, BheRfish or _e speel.., Bignlfanl habllais, or threalaned or endangered apecioa? Explain briefty:
C4. A community's existing plans Of goals as officially adopted, or a change In use or Inlenslty of use of lend or ollter natural resources? explain brlefty.
CS. GmwIh, subsequent _pmenl, or reIaIad acIivitios likely 10 be induced by Ihe proposed action? Explain briofty:
ce. Long farm. short ..on, all11Ulafive, or olhar oftacIa not identified in Cl-<:5? Explain briofty:
C7. Other impacla (induding cha_ in use or eilher quentily or type or energy)? Explain briofty:
D. WlU THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA (CEA)?
o V.. D No II V... explain briofty:
E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
Dyes 0 No fiYes, explain briofty:
PART 81- DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each adverse _ identified above. delannine whethar il is substantial. large, important or Olharwisa significant. Each
sfrect should be ass_ed in connection with I1s (a) setting (i.a. urban or rural); (b) probabillly of occurring; (c) duration; (d) Irravarslbllily; (a)
geographic scope; and (f) magnltude. If necassary, add attachments or reference supporting malarials. Ensure thaI explenations conlain
sufIlcient detaH 10 show that all ",'evant adverse impacts have been idanlified and edequataly addrassed. If question 0 of Part II was chacked
yes. the detanninalion ofslgnlficence mus\evalue\e tha potantial impact olthe proposed action on tha envIronmenlal characteristics of the CEA.
o ClIeck!his box I you have identified one or mom poIantially large orsignificant adverse impacts which MAY ocalf. Thon proceed directly to tho FUll
EAF and/or prapare a posltive declaration.
o Check this box if you havedelarmined, besedon lha infonnalionand analysis above anda~supporting documenlalion, thollhe proposed action WIll
NOT r&sull in any significanl adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination
Name of Leed Agency
Dala
Pool or Typo Neme or ResponSIble Olficer in Lead Agency
Tile of Responsible Officer
Signature of Responsible Officer Dl Lead Agency
SIgnature or Prepe..... (If dilleranl from responsible olfar)
Reset,
.;.i',."..,.,.J..:..... .
. .
Board of Trustees Application
County of Suffolk
State of New York
R. IJf1.1 Kt u-t It.... BEING DOL Y SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF IllSIHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN TillS 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 TIllS
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 TIllS APPLICATION.
r~~
SWORN TO BEFORE ME TIllS
111 $1'
DAY OF J>(Pf~&!~ ,20 ot
JOSEPH W. IRWIN
Notary Public, SlIIle 01 New YoIlc
No. 4921106, SulIoIk Coun1)l
Term Explres May 16, 200b.
~ROWLEY MARI~
CONTRACTING CORP.
BULKHEADING . DECKS · DOCKS · BEACH STAIRS
Po. BOX 618
GREENPORT, NY 1I944
TEL.lFAX (631) 323-1772
CELL (631) 831-1740
~ 350 JUHL.i..
I tt)1J beT /<' ~ owner of CoI tL in G. /III A'Z' It) Ai authorize
. Name address city, state
Ian Crowley and to act as agent in applying for the permits that are necessary for work to be done on my property
described above.
fl!...~:fl-cij
.
.
APPLICANT/AGENTIREPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics orohibits conflicts ofinterest on the Dart aflow" officers and ernolovees. The Durnase of
this form is to orovide information which can alert the town of DOssible conflicts of interest and allow it to take whatever action is
necessarY to avoid same. .
YOUR NAME:
first name, .qliddle initial, unless you are applying in the name of
someone se or other entity, such as 8oompany. If so, indicate the other
person's or company's name.)
NAME OF APPLICA nON: (Check all that apply.)
Tax grievance
Variance
Change of Zone
Approval of plat
Exemption from plat or official map
Other
(Jf"Other", name the activity.)
Building
Trustee
Coastal Erosion
Mooring
Planning
V"
Do you personally (or through your company, spouse, sibling, paren~ or child) have a relationship with any officer or employee
of the Town of Southold? "Relationship" includes by blood, marriage, or bus-ioess interest. "Business interest'~ means a business,
including a partnership, in which the town officer or employee has even a partial ownership of (or 'employment by) a corporation
in which the town officer or employee owns more than 5% of the shares.
YES
v
NO
If you answered "YES", complete the balance of this fonn and da:;:':: where indicated.
Name of person employed by the Town of Southold -J.I!II
Title or position ofthat person s.r~tJtSdfl. .
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 ollicer or employee or his or her spouse, sibling, paren~ 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 RELA TlONSHIP
&"'*"1<
/'1 ~ !I!W
S~b::~~ this /3
Sign. J
Print Name ~
d",,:' ~.
~I
200S-
Fonn 1'S 1
Town of South old
.
.
A.
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INSTRUCTIONS II SEP 2 1 20 I:'
I. All applicants for permits* including Town of Southold age ies, joh~l1 ('(\m~l,.t,. ~:i' J~ for
proposed actions that are subject to the Town of Southold Wate ont Consti~fMll~r~ew Law. s
assessment is intended to supplement other information used y a own 0 ou 0 a y 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.
LWRP CONSISTENCY ASSESSMENT F
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of South old 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 L WRP policy standards and conditions contained in the consistency
review law. Thus. each answer must be eXDlained in detail. listine both sUDDortine and non-
sUDDortine facts. If an action cannot be certified as consistent with the L WRP policy standards and
conditions, it shall not be undertaken.
A copy of the L WRP is available in the following places: online at the Town of Southold ' s
website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 1000 - '57 - oS- - II
PROJECT NAME 1?~7?r kdiblt- 6tYJ"'.,(J
"e7 aIKTIl f/ l- 71 dIU
The Application has been submitted to (check appropriate response):
TownBoard 0 PlanningBoardD BuildingDept.D 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)
o
o
(b) Financial assistance (e.g. grant, loan, subsidy)
(c)
Permit, approval, license, certification:
[J;f
Nature and extent of action:
Rt!1I1t!l1lC IAI\ Ret1jtln-
I
~k
,,, tI1l
K/Mle
IOCMlM . '17 I i?vl/&<<7W) M ,(JLrI11 !JvtJ
7J
~ ~ In 1/td /0' 1~M1 /thv
/<F-hJ f1l!ifr<, leiSl ~~ I~ ~ Jlrlfd.
6sr rldtiwr
~. ~Mtr
)0
,j41f rMfII
tlt/!ll: jNJ<;
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AN tl1g7
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Nameofapplicant:_~~..-.:. kerlk.
(b) Mailing address:--RJDffiff ~lbV~~
~ S~o-u- iN\( 11'70lt
(c) Telephone number: Area Code ((,"31) (Nt, - 0..0-0
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes ~ No D If yes, which state or federal agency? P1sfJQ.. .,u~f.f;os. ,f(!q;:-
1 .
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 I. 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 L WRP Section III - Policies; Page 2 for evaluation
criteria.
0Yes D No D Not Applicable
":7 t:r;J:.~::V i~:~f1n:,: N,,~f ~;fPt7~./~' !; =NH~~;:::1
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
L WRP Section III - Policies Pages 3 through 6 for evaluation criteria
DYes D No ~otAPPlicable
.
.
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
L WRP Section III - Policies Pages 6 through 7 for evaluation criteria
DYes D No c;:::(Not Applicable
-r~""" ~ '~i rr/~ ()lI,lflllf'7' '1ltt $'~ IS IJL#I~ !Jet; jhJ.
~
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
o y ~ D.. No 0 Nol A'i1':.''''
-1JI :;; .tMcWid ~ ~ ~~~ ~/
II?
dlSt ,NIJ/"'j' 1f~ IfI::W 1fAf!
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
- Policies Pages 16 through 21 for evaluation criteria
o Yes D No DNotAPPlicable thll
I: ~Rlj~ ~t AM;:~F;:'t ;~rJ;: ~/d: 2'1:: ~&
"~k
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 L WRP Section III - Policies; Pages 22
th~gh 32 ~ eval;n criteria.
Yes
~ .
t s: ~tbl ~ ~ % /411~ ~!:! ~~~J Ik ~ /1M
II III If"''''') fA'] &..I r>> :1
No ~cable
~
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.
DYes D No@ Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and w~ See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
DYes D No I!LI 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 L WRP Section III - Policies; Pages 38 through 46 for evaluation
criteria.
DYeD No W' Not Applicable
1kSl;"'<.I~
~mJ I
~
1 ~
q,1t#~
lIa .,teJ
Attach additional sheets if necessary
WORKING COAST POLlCtI
.
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. S, L WRP Section 111- Policies; Pages 47 through 56 for evaluation criteria.
DYes D No U2l Not Applicable
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 L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria.
[Jd"'Yes D NoD Not Applicable . .L
~ ~~ ':tUJ' wt ;1' ~ "IN ~~ ~f.~ b&16S ,~ - ~
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.
DYes D NO~NotAPPlicable
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.
DYes D No ~otAPPlicable
PREPARED BY .:lit
~
TITLE &./ fltWiJiL
DATE-#==-