The URL can be used to link to this page

Home My WebLink AboutTR-6341 James F. FAng, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 June 4, 2007 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Mr. Steven Kramer, P.E. 120 Shore Road West Mt. Sinai, NY 11766 RE: LAWRENCE HOLFELDER 6340 PECONIC BAY BLVD., LAUREL SCTM#126-'11-I Dear Mr. Kramer: in response to your letter dated May 9, 2007, the Southold Town Board of Trustees issued Wetland Permit #6341 on April 19, 2006 to reconstruct the bulkhead using C-Loc vinyl sheathing. This permit is valid for two (2) years. At this time, no further information is required from you. Please contact our office when the work described in the permit has been completed and arrange for a final inspection. Please feel free to contact our office if you have any further questions. Very truly yours, Jam, F.~King, Presid~t Board of Trustees JFK:lms Steven James Kramer'° Licensed Professional Engineer May 9, 2007 Town of Southold Board of Trustees Main Rd Southold, N.Y. 11971 Re: Lawrence Holfetder Bulkhead Replacement, 6340 Peconic Bay Blvd, Laurel, N.Y. Dear Sir or Madam: I am writing you to inform you that the Holfelder Property Bulkhead, as mentioned above, has suffered a total collapse of its bulkhead, as a result of this last Northeaster, after waiting nearly a year for the New York State, DEC, to generate a permit. As a result of this snag and collapse, the cost of the bulkhead increased from $50,000 to an estimated $100,000+. There was no reason for this delay. The only way we got it the permit so soon, was to ask the State Assembly to intervene. I include a copy of my most recent letter to Mr. Peter Scully and a few, before and after pictures, of the site. We are currently trying to find a good dock builder, who might complete the job, in a timely manner and save the structure from future storms. We are concerned that we will lose the house, in the next storm. Please let me know if you require any additional plans from me and let us know if any aid is available. We intend to replace the bulkhead in kind and in place. Thank you and please contact me if you require any additional information at 473-2430. Sincer_e_e~ Steven Knuner, P.E. 120 Shore Road West · Mt. Sinai, New York 11766 * (516) 473-7307 SouthhoM Towa - Board of Trustee~ St vcn James Hrarn r May 9, 2007 New York State Department oi' Environznental Conservation Building 40 SUNY Campus Stony Brook, N.Y. 11790-2356 Attn: Peter Scully, Director Re: Holfelder Bulkhead, 6340 Peconic Bay Blvd, Laurel, N.Y. Application# 1-4738-03617/00001 Dear Mr. Scully: I am writing you, on behalf of my client, Dr. Lawrence Holfelder, in an efibrt to advise you of developments, relating to the replacement of his bulkhead. My original letters to you indicated our concerns regarding the collapse o1' his entire bulkhead and the subsequent urgency lbr review and permitting. This project was not new work, but merely the replacement of an existing bulkhead, on house which has been there since the 1930's. Well, our worst lears have been realized. During the recent storm, we lost our entire bulkhead, and some of our land has lhllen into Peconic Bay. This has changed the price tag of this project from $50,000 to more than $125,000 and put the home in peril, ri'his has also put my client into a financial crisis. He is retired and now has to incur the expense ora mortgage. 120 Shore Road West · Mt. Sinai, New York 11766 · (516) 473-7307 Holfelder Bulkhead I am not sure what additional plans are required to move ahead on this project. We are now looking for a dock builder who might service us in a timely manner. Please let me know what is required from your organization, regarding plans, if they are necessary. I am including before and after photos of this project for your review. Thank you for your assistance. VerY/t~y your/s~ Steve Kramer, P.E. Cc: Assemblyman Allessi James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 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 1st day of construction ¼ constructed Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO ....... ~..~ ~l I ...... DATE: ,A-.P.'!:~.~-.?: ,~.~....~06 LAWRENCE HOLFELDER ISSUED TO .......................................... ~ .......................................................................................... Pursuant to the provisions of Ohapfer .61~. ?f ~e Law. s.,of the State of New York, 1893; and CJmpter 404 o~ the ¥.ws ot me State of New York 19~2; and the Southeld Town Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUO~C) ~NS IN AND ON TOWN WATERS AND PUBUC LA,IDS and' the REMOVAL OF SAND, P VEL-OR OTH.ER LANDS .UNDER TOWN WATERS:.'?. and m accordance wi~ 'the Resolution of The Board adopted et a meeting held on 250.00 i ' .2(~(~.'.., end Jn consideration of the sum of $ ............................. pa d by Lawrence Holfelder Laurel "' Y. and subject ~o the Terms°f ........................................................................................ and Conditions listed on there' reverse sl~e here°f, of Southeld Town Trustees authorizes end permlts the folJowlng: Wetland Permit to reconstruct the existing'bulkhead using C-Loc vinyl sheathing, with. the c~ndition.the remnants of the jetty are removed, and as depicted on the plans prepared by Steven.J. Kramer, P.E. last dated Feb. 26, 2006. all in aCcordance with the detailed specifications as presented in .the originating appl'~.afio~. IN WITNESS WHEREOF, The seld Board Of Trustees here- to be a~xed, and these.~.resents fo by causes its Corporate Seal of t.~satd Board .as of thru darn. IT:RidS ,nd CONDITIONS ~l~m~ee. Lawrence Ho. lfetder 6340 Peconic Bay Blvd., Laure~ ....... . L That dm u~ .,Ba~d e~ Tumees ami the Town d 8a~diold am zdeued f~mn aay emi ~ dami~ts, of ,,4,.I,.. ~ec ',~,M~t~,, o~ ~ ..thi~. dhetdy m ~ -, a tva:lc of ,ay opec- That dxe wo~ tavolved ~ be ntbject to the lm~ectton n~l apj?zoval o~ ~he Eottd o~ t~vuc~on of this P,M~t by tesoludo~ of th~ ~id ~ ~~~le~f~~ ~ a~t~. ~ ~ ~e ~ ~T~ o~~ James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 April 19, 2006 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Steven Kramer, P.E. 120 Shore Rd. West Mt. Sinai, NY 11766 RE: LAWRENCE HOLFELDER 6340 PECONIC BAY BLVD., LAUREL SCTM#126-'11-1 Dear Mr. Kramer: The Board of Town Trustees took the following action during its regular meeting held on April 19, 2006 regarding the above matter: WHEREAS, Steven Kramer, P.E. on behalf of LAWRENCE HOLFELDER 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 March 6, 2006, 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 April 19, 2006, 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, 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 LAWRENCE HOLFELDER to reconstruct the existing bulkhead using C-Loc vinyl sheathing, with the condition the remnants of the jetty are removed, and as depicted on the plans prepared by Steven J. Kramer, P.E. last dated February 26, 2006. 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, President, Board of Trustees JFK/Ims James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route 25 P.O. Box :1179 Southo]d, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: - · ~/~ / 04, has been and the (_ V~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 Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees James F. King, President JilI M. Dohe~ty, Vice-President Pegg~ A. Dickerson Dave Bergen John Itolzapfel 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 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: Name of Applicant: Name of Agent: Property Location: SCTM# & Street Brief Description of proposed action: Type of area to be impacted: __Saltwater Wetland Freshwater Wetland SoundFront (~B~yFront Distance of proposed work to edge of above: Part of Town Code proposed work falls under: __Chapt.97 Chapt. 37 other / Type of Application: 'c//Wetland __Coastal Erosion __Amendment __Administrative __Emergency Info needed: Present Were: __J.King __J.Doherty __P.Dickerson __ Other: D. Bergen__J.Holzapfel Mailed/Faxed to: Date: 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., April 12, 2006, 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 LAWRENCE HOLFELDER to reconstruct the existing bulkhead using C-Loc vinyl sheathing. Located: 6340 Peconic Bay Blvd., Laurel. SCTM#126-11-1 The CAC recommends Approval of the application to reconstruct the bulkhead within 18" with the Condition a berm and swale is installed at the top of the bank and the slope is vegetated with natural vegetation only. Vote of Council: Ayes: All Motion Carried 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 Coastal Erosion Permit Application ~,'Wetland Permit Application Amendment/Transfer/Extension ..'"Received Application:~l 1~- v/Received Fee:$ e).~.~ .."Completed AppliCation i~_q~a_ Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent). ~LWRP Consistency Assessment Form ~ [I.~ __CAC Referral Sent: ~-'Date of Inspection: q- 11~-109 __Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~Public Hearing Held: q!lqlt% Resolution: Office Use Only __ Administrative Permit Name of Applicant Address ,:-~7-r./r'c L.. //~/ PhoneNurnber:( ) '-/73-2'4 Suffolk County Tax Map Number: 1000- /~ ~ -- ] / -- ~) Property Location: {:~ z//i/ (provide LILCO Pole #, distance to cross streets, and location) AGENT: ~5"7/'-~'~r' e ,O ,4::/"~,--,~ er5 ,,~.~ (If applicable) Address: /.~ O r_~ /'~ 0 re I~d. ~/tC~5 r of Trustees Applicati~ GENERAL DATA Land Area (in square feet): Area Zoning: /~_ z_/~) Previous use of property:, f~¢ ~ / ~-de//Ti"/o~ / Intended use of property: Prior permits/approvals for site improvements: Agency Date /1/0 ~/ No prior permits/approvals 'for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~No Yes Ifyes, provide explanation: ,5'e,4-,-"c~ 0,-c- 7~o,.w,,n Project Description (use attachments if necessary):. ,O. ce o_o /~p4 In,~,, Z'o~w~,-- '-7-7er'.expec4ee/. eoard of Trustees Applica~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purposeoftheproposedoperations: ~ C O ,g S r r~) c / Area of wetlands on lot: EPA/Z~~ square feet Percent coverage of lot: ~) % Closest distance between nearest existing structure and upland edge of wetlands: 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: (2) feet Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated? /-/00 cubic yards How much material will be filled? z-/'~/'O cubic yards Depth of which material will be removed or deposited: ~ Proposed slope throughout the area of operations: (~ o 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): ird of Trustees Applicati COASTAL EROSION APPLICATION DATA Purposes &proposed activity: Are wetlands present within 100 feet of the proposed activity? ~ No Yes Does the project involve excavation or filling? No )~ Yes If Yes, how much material will be excavated?< ,Z/(~O(cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: O~wt:~w~. t. tJ/ oo ._w, '/e- Describe ~e nature ~d extent of ~e enviro~ental impacts reasonably ~ticipated resulting ~om implementation of the project as proposed. (Use attac~ents ifneccss~y) PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only SEQR PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1 APPLICANT/SPONSOR 12. PROJECT NAME 3.PROJECT LOCATION: ~,.~q O Municipality g. i~.~ c-~_~[_. ) PRECISE L CATION; Street Addess and Road Intersections. Prominent landmarks etc -or provide map 5' IS PROPOSED ACTION: r~ New E~] Expansion ~Modification , alteration 6. DESCRIBE PROJECT BRIEFLY: --Fo '¢,~..~ ,,~ 2.0 p,' / ; s 7. AMOUN OF LAND AFFECTED: Inflially~. (~ ~. acres ~, (~ 2 ~ Ultimately acres 8. VVI~_L PROPOSED ACTION COMPLY VV~TH EXISTING ZONING OR OTHER RESTRICTIONS? Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~'Residentiai r--]Industrial []Commercial r-~Agriculture r--]Park/Forest/OpenSpace J~Other (describe) 10, DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ,~Yes [] No If yes, list agency name and permit/ approval: ~ ¢,4~,~ O'~ ~.~(~) C/'~/'-) 11 DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes ~'~No If yes, list agency name and permit / approval: 12E]YesAS A RESULTj~JNo ~,~POSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MOD FICATION? Applicant Signature I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Sonso ama Date: If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 6t 7.47 If yes, coordinate the review process and use the FULL EAF. [~Yes []No B. Will ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS N 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency~ [~] Yes r~No C. COULD ACTION RESULT IN ANy ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwd[ten, if legible) C 1 Exisgng air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or floodi?g problems? Explain briefly: C2. Aesthetic, agr~ultural, ~;chaeological, hi~'tt~dc, o~ other ;atural or oultur~i resources; or ¢;mmul~ity or ~eighborhood ~haraci;~ Ex¢i~in bH;f~/: c3 egetatlon or fauna, fish shellfish or wddhfe species s~gnlflcant habitats or threatened or endangered spec~es~ Explain briefly C4,A community's existing plans or goals as Officially adopted, or a change in use or iniedsit~ Of use of land or oiher nat~r~i re~ur~s~ ~x~iai~ ~ri;fiyi O owth ~ubsequent dove opment or related acb¥~hes hkely to be ~nduced by the proposed *cfion? Explain bnefiy C6.Long term, short term, cumulabve or other effects no denbfied ~n C1 C57 Explain briefly Otherimpacts (includin chin es in use of either uanti or t e ofener ? Ex lain briefl ' D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? IIf ~'es, explain briefly,: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? f es ex lain' PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) . geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed, if question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULl EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed acfior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessa~, the reasons supporting thi., determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS STATE OF NEW YORK COUNTY OF SUFFOLK , being duly sworn, deposes ~d says that on the ~ *h day of ~ O ~ ' L ,20 O 6, deponent mailed a tree copy of the Notice set fo~h in ~e Bo~d of Trustees Application, directed to each of~e above nmed persons at the ad~esses set opposite ~ere respective n~es; that the ad~esses set opposite the nines of said perso~ ~e the ad&ess of s~d persons ~ sho~ on the c~ent ~sessment roll of~e To~ of Southold; that said Notices were m~led at the United States Post Office at ~, I le~ ~c ~ ~ :~.., that s~d Notice~ere mhled to each of said persons by (ce~ified) (registered) mail. ~,.' Sworn to before me t~s ~ of ~,~ ,2~ ' ~- Not~ Public James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING l'~r-~-'~ fl~'r~e'~Z~,residing at /~0 ~ ~ ~ being duly sworn, depose ~d sa~ &~ y ~ ,200~ Iper~nallyppsted the prope~y~own~ Thaton~e da f / Dated: Swom to before me this ]d~ d/ay ofP(~tt.-200 ~ Nothry Public '/(si~'~ure) Board of Trustees Application County of Suffolk State of New York ~-7-'.~/,Q ~:x_o-~ ~ r-' BEING DULY 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 HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH 1N 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. ~--~ ~ -- / It Signature SWORN T0 .EFORE ME THIS DA¥OF ,20 ¢ Notary Publ'~) U~LANIE DOROS/{I NOTARY PUSUC, State of New YoU( No, 01D04634870 Oualffied in Suffolk County _ Conmtiasmn Expires Septembm'~'O,d~:~ of Trustees ApplicatiO AUTHORIZATION (where the applicant is not the owner) II (print owner of property) (mailing address) do hereby authorize S-V~uc~ (~o-~t~ (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethias orohibits conflicts of interest on the nat of town officers and emnlovees. '[he nuranse of this form is to orovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action Js necessary to avoid same. (Last name, first name, x~iddle initial, unless you are applying in the name of someone else or other enlity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance ~ Building Variance /~z~. Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood~ marriage, or business interest. "Business interest" means a business, including a partnership, in which the town 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 shaves. YES NO .~ lfyou answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ___C) an officer, director, parmer, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this ~::?~ day of. ~A:Lz''c fi~ _.200~ Signature ~'~-t.~_~~ ~, ~-~ Print N~o- ~' ~ ~j ~" ' Tbwn of Southold LWRP CONSISTENCY ASSESSMENT FORM 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 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 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 detaii~ listing both supporting and non suooorfiw, 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#/26 // t~) / PRoJeCT c t Jo I The Application has been submitted to (check appropriate response): TownBoard ~'~ Planning Board ~ Building Dept. ~ BoardofTrustees~ 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) ~-~ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Locationofacfion: (~o ~ a_~ O '~c:15>c~, c. -'~ ~ '-~[ u~-4, {_~, ,r~.~Q_ Site acreage:. O, (o C¢ A- Present land use: Present zoning classification: 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: L (b) Mailing address: L i I (c) Telephone number: Area Code ((:~_ ~-i 7 3 Z ~A ~ O (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~ No ~ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~-~ Yes [~ No'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 [] NotApplicahle 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 Appliea~ e 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 [] Yes ~No ~NotApplieable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. ' ' ¥~s No Not App 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. YesX~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 [] 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. [] Ye~-~ No ~Not Applicable Attach additional sheets if necessary WORKI/~IG COAST iPOLICIE~l~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [] Yes R5 No 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 LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. [~ Yes ~ No ~ Not Applicuble Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [] Yes Y 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 _ - ---.=__~ =~==.==_:: ...... /if;rS /¥' Notes: 1 ) EXISTING BULKHEAD COMPONENTS ARE TO BE REPLACED TO INCLUDE PILINGS, LAY LOGS, STRINGERS/WHALERS AND NEW VINYL SHEATHING. 2) ALL HARDWARE WILL BE HOT DIPPED GALVANIZED (l-Ii)G) J) VINYL SHEET PILE SHALL BE "C' LOC OR EQUIVLENT' 4) VINYL SHEET PILE SHALL BE A MINIMUIvl OF 16' IN F1NAL CUT LENGTH. 5) VINYL SHEET PILE SIIALL BE DRIVEN AND CUT FLUSH AT FINISHED ELEVATION. 6) VINYL BULKHEAD CORNERS SHALL BE INSTALLED AS REQUIRED. 7) EXISTING ~¼" GALVANIZED BOLTS SHALL BE REMOVED FOR THE INSTALAT1ON OF VINYL SHEET PILING AND REINSTALLED WITH NEW ! .0 DIAMETER HDG ROD AND BOLTS. 8) PROPSED 2" DIAMETER WEEP HOLES SHALL BE BLUE MARLIN, FILTER FABRIC IS MARAFI WEAVE #SRW 300 OR APPROVED EQU1VELANT. WEEP HOLE LENGTH SHALL BE DETERMINED IN FIELD. APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD Survey for: Lawrence A. Holfelder Described Property Laurel Town of Southold, Suffolk County New York Suffolk County Tcx Map D,,t 1000 So,:t 126 Blod 11 Lu[ 01 1. Area = 50,149,49 Sq. Ft. Or 0,69 Acres 2. N.G.V,D. 1929 Datum ~ el,= Exlstfng Spot Elevation SURVEYORS CERTIFICATION WE HEREBY CERTIFY TO LAWRENCE A. HOLFELDER ~IAT TI-IlS SURVEY WAS PREPARED IN ACCORDANCE WITH THE CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIA~ON OF LAND SURVEYORS JOHN SCHNURR. NYS LS JOHN SCHNURR PROFESSIONA£ LAND SUBVEYOR, PLLC Date November 25. 2003 Scale 1"= 30' Job No. 2003-196