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HomeMy WebLinkAboutTR-6429 James F. King, President O_``~OF SOUry~ Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen 4 Southold, New York 11971-0959 John Bredemeyer N Q Michael J. Dominoes Telephone (631) 765-1592 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 309C & 0923C Date: October 28, 2013 THIS CERTIFIES that the extension of the existing westerly return an additional 60' landward, with the condition that a 10' wide non-turf buffer to be subsequently maintained alone the landward edge of the bulkhead. At 530 South Oakwood Drive. Laurel, New York Suffolk County Tax Map # 145-3-6 Conforms to the application for an Amendment heretofore filed in this office Dated November 26, 2012 pursuant to which Trustees Amendment to Wetland Permit #6429 Dated December 12, 2012 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the extension of the existing westerly return an additional 60' landward, with the condition that a 10' wide non-turf buffer to be subsequently maintained along the landward edge of the bulkhead. The certificate is issued to KENNETH & KATHRYN CHILDS owner of the aforesaid property. )X000 Authorized Signature James F. King, President o~$0fF01¢~O Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President =y6y P.O. Box 1179 Southold, NY 11971 Dave Bergen at W John Bredemeyer G _01 Telephone(631)765-1892 Michael J. Domino Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE S3F INSPECTION: .`C T I 'L i ) Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 151 day of construction %z constructed Project complete, compliance inspection. i INSPECTED BY: J, I ( / "t" G' COMMENTS: ;CC 7V (Z CERTIFICATE OF COMPLIANCE: suFFOC,~ James F. King, President ~~p~ ~'pGy Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President P.O. Box 1179 Dave Bergen = Southold, NY 11971 John Bredemeyer Telephone (631) 765-1892 Michael J. Domino ~Olp 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 constructed Project complete, compliance inspection James F. King, President aSf so~Ty Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen l~[ Southold, New York 11971-0959 John Bredemeyer G p~ Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-6641 ~y00UNTY,~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 12, 2012 Mr. Kenneth Childs 605 Old Dutch Road Bedminster, NJ 07921 RE: KENNETH & KATHRYN CHILDS 530 SOUTH OAKWOOD DRIVE, LAUREL SCTM# 145-3-6 Dear Mr. Childs: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, December 12, 2012: RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit #6429 to extend the existing westerly return an additional 60' landward due to storm damage; and as depicted on the revised survey prepared by Robert H. Fox, last dated November 25, 2012 and stamped approved on December 12, 2012. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK:amn ~o~gSUFFp(~-cO 5 James F. King, President C2 Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Route 25, P.O. Box 1179 Dave Bergen 4, Southold, NY 11971 John Bredemeyer '~Oj Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: P,~1nt? - h Chi 1~I Please be advised that your application dated has been reviewed by this Board at the regular meeting of I 2 Z and your application has been approved pending the completion of he following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 s` Day of Construction ($50.00) Y2 Constructed ($50.00) V Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: Final TnSpec-k'6n 4e-15 p, D~ TOTAL FEES DUE: $ SU . BY: James F. King, President /i Board of Trustees tOXQa 122),12- 0.6, req_uesked ppgpF F0(,~ James F. Kfne. President DY C P.O. Box 1179 Bob Ghosfo. )r., Vice-President Southold, NY 11971 Dave Bergen Telephone (631 765-1892 John Bredemeyer Fax(631)765-6641 -Ift Michael. Domino y~01 ~ 1a0' Southold Town Board of Trustees Field Ins pection/Worksession Report gro s Date/Time: z o / L KENNETH CHILDS requests an Administrative Amendment Wetland Permit #6429 to extend the existing westerly return an additional 60' landward due to storm damage. Located: 530 South Oakwood Drive, Laurel. SCTM# 145- 3-6 Type of area to be impacted: ~Itwater Wetland -Freshwater Wetland -Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __~j~apt.275 _Chapt. 111 -other Type of Application: _ Wetland -Coastal Erosion -Amendment ~!Administrative_Emergency -Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: C/ J. King L-B. Ghosio 4-~_D. Bergen, ---J. Bredemeyer -`Michael Domino D. Dzenkowski other Form filled out in the field by ' JC/ Mailed/Faxed to: Date: BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6429 DATE: Aueust 23, 2006 ISSUED TO: KEN CHILDS PROPERTY ADDRESS: 530 SOUTH OAKWOOD DR., LAUREL SCTM#145-3-6 AUTHORIZATION s Pursuant to the provisions of Chapter 275 and/or Chapter I I I of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on Aueust 23, 2006, and in consideration of application fee in the sum of $250.00 paid by Ken Childs. and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to remove and replace the existing bulkhead 1' higher and with vinyl sheathing, with the condition of a 10' non-turf buffer landward of the bulkhead and the concrete footing on the seaward side of the bulkhead, on the western end, is removed, and all as depicted on the plan prepared by Robert H. Fox last dated June 4, 2006. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. t) ,_Q 'y~{fFOIA' s ol NOV 2 6 2012 SUN-14-2006 09:21- FROMt70HN C EHLERS - 633 369 6287 TU:79064roibaC w Flan View Applicant: Kathryn Childs W. Bulkhead Reconstruction SCT# 1000-145-3-6 Situate: laurel 120' Town: Southold Q) Suffolk County, W dr ~eWOy Datum: Low Water Garage / I 5L Tide Range: 2.5'+/- Prepared: May 4, 2006 / I Amended: June 2006 1' = 30' V o P a v G O "t peivA.i 4. Lt 7- 5~ p tiousel extend blkd• # 530 a 10, north South OakWOI of <gx 1 /G----------- Ortvt; 5"1' to exist. bl w ^ 55' to prop. blk1 rn m new 1 l~„~,~ I `-o X o fl ~ return -Q to :(k h ,lpio n a~ 7 o tied IktlecId exift. timbe 1 blxa. I bNkheaa 12Q' Land of: Ravatone 215. steps Realty Corp. y~tland roundary at Euldbead ahwm R, Fox -May 'O6 P e c o In i c B ci y alwm ~~.:,;r Section V=lop 41nl5hed Reconstruct Bulkhead (1' higher) 2612 Lawn ode within property boundaries (190 +/-I.f.) m o 3/4' remove existing bulkhead c ` gaiv tie 4" x °Fo rods stringers SEA HW Wetland Boundary - LW L E V E L new at bulkhead exist. M A P P I N G sheathing R. Fox May '06 grades 631.7223390 P.O. Box # 638 b" dla. remove Riverhead 11901 Iles existing ROBERT H. FOX bpo.c. timber All mates lol must be NY$ PLS# 60197 from ap:)roved list ereaooa 6.O ,42AH G\SLMCnilas po y 1' f~] + V i ~ ~ ~ t~Si Sr •~~iyti ^ s 1 'CD cn R , ~ I1 R a t~ ~ ' e~i bw p` 1 _ a• I 'T41 , Ix J~t 40 40 ij 09, ft .04 ~ jo'', CD 80 .f 4~ ,.y M Tk, 1 / f o-J wit, Zid. ~r. 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A9n¢Y Of~ .u.w °o SE145 OFFICE LOCATION: q $o(/jyOl MAILING ADDRESS: Town Hall Annex O P.O. Box 1179 54375 State Route 25 # # Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) H :*c Southold, NY 11971 • 0 Telephone: 631 765-1935 Fax: 631 765-3136 OOUNTY,~ LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM - To: Jim King, President DEC 1 0 2,012 Town of Southold Board of Trustees From: Mark Terry, Principal Planner r,.. LWRP Coordinator Date: December 10, 2012 Re: Proposed Wetland Permit for KENNETH CHILDS SCTM# 1000-145-3-6 KENNETH CHILDS requests an Administrative Amendment Wetland Permit #6429 to extend the existing westerly return an additional 60' landward due to storm damage. Located: 530 South Oakwood Drive, Laurel. SCTM# 145-3-6 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King, President ~OF sooty Town Hall Annex O 54375 Main Road Bob Ghosio, Jr., Vice-President P.O. Box 1179 Dave Bergen 1~[ l~ Southold, New York 11971-0959 John Bredemeyer G C Michael J. Domino ) 765-1 oUTelephone J~- - - O~yC Fa~f631}765fi64- - . BOARD OF TOWN TRUSTEES NOV 2 6 2O1Z TOWN OF SOUTHOLD APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT DATE ~OyeN~be,~ 'Z o OWNER (<A~k+ yYt (2 b; Ir~S PHONE I:>Q,/ qq ADDRESS ~O©5 (`LLD p(A:k-'~ Rc~• f~c~ w~ n S~Pr ~1.~- ~xra l AGENT PHONE ADDRESS PROPERTY LOCATION 530 S-OQOv- LAiii Z]. TAX MAP NO. 3-0 I/We Kp~n w2i~ G~ 5 request an Amendment to Permit # to ~x h cQ1~0 ~ ZAi jWa.rA42rizc'L0L) Signed Fay: Board of Trustees Application County of Saffelk- S o w. r c3 e+ State of Neo -Yft Ne4~ ~~rs 1`2nhe_4uv BEING DULY SWORN ..DEPOSES AND AFFIRMS THAT HEISHE 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 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 2 DAY OF NOV e4w0e_r 20 { 2 Notary Public JUDITH A. SULLNAN NOTARY PUBLIC OF NEW JERSEY My Commission Ezp m August 3, 2015 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The 2=sb of this forth is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: ['kA-i1S l~ (Last name, first name, Middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building }A Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if "Other', name the activity.) - Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town 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 NO L If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicantlagentlrepresentative) 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%ofthe shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, partner.or employee of the applicant or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of UV 201,7- Signature w.-e ~f, Print Name ~-Jw Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its si fig~iicant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting 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 :Flanruigg. Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION NOV 2 6 2012 SCTM# 5 cl ! PROJECT NAME &a'~5i Ex 15+1 lam-",( bit )P-Ae v ~ Lt,40u J 6171 iQPfar~) Ta(w-5 .`5 per PC'hMC~~--i# 6tl2y - 14w~ 3, 2o The Application has been submitted to (check appropriate response): Town Board ? Planning Board El Building Dept. ? Board of Trustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ? construction, planning activity, agency regulation, land transaction) ? (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: GX Ckvrtz~ +6tiaT~ yl;;Q 4w4_16d ' beef 1a 4 9.2qd Location of action: 530 S. E KE D r. 1. e1 No u - Site acreage: ACIz 4-7 Present land use: Qcs ; Ae -A t <xrL Present zoning classification: R rs ; aQ 1 r~ 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: 6k~ e4 L S (b) Mailing address:~~ S 0& D (),,t.- ct,, a zQuuus lrr. C) W-2- (c) Telephone number: Area Code ( )5-/4- ' gQq- S-6 L/ I/- (d) Application number, if any: Z/ 02 7 (ov; giy-J Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes El No IN 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. ? Yes ? No Not Applicable 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 F] No ® Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ? Yes ? No ® Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ? Yes El No 50] Not Applicable 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 El No W Not Applicable 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. ? ? n Yes No Not Applipable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ? Yes ? No ® Not Applicable 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 El No FX1 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. ? YeO No © Not Applicable Attach additional sheets if necessary WO3KING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ? Yes ? No ® Not Applicable 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 V91 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ? Yes ? No [~J Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ? Yes ? No © Not Applicable PREPARED BY_zj~7 t/`~TITLE 6)a-~ket' DATE z/ Plan View W s E Kenneth & Kathryn Childs SCT# 1000-145-3-6 Situate: Laurel R O W Town: Southold Suffolk County, NY Prepared: May 4, 2006 Amended: June 4, 2006 d `~eWay O July 22, 2006, Garage Sept. 12, 2006 70 Nov, 25, 2012 C) 30' -o CD I~ - t W ROVED BY k CA BOARD OF TRUSTEES OF SOUTHOLD DA play house I House relocated # 530 b'T during gouth constructbn I Oakwood Drive 0 I I ~ S ~ I i ~~TT bulkhead - steps Land of: Ravotone Realty carp. Wetland goundaq HW at Bulkhead P e r o n i r B a y Section 1"= 19 Extend Sheathing 4inifQae north 60 If Lawn q- (within PLs) x 3/4" S E A gale 4" x 6' o~\\o tle L E V E L stringers 0 0 rods NOV 2 6 2012 MAPPING P.O. Box # 366 xi Aquebogue new sheathing grades NY 11933 ROBERT H. FOX NYS PLS# 50197 James F. King, President ~pf sours Town Hall Jill M. Doherty, Vice-President ~Q~ 06 53095 Route 25 Box Peggy A. Dickerson Southold,, New 1179 w York 11971-0959 Dave Bergen G Q • ~O Telephone (631) 765-1892 Bob Ghosio, Jr. OI~~DONI~ ~y~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0309C Date Apri123.2008 THIS CERTIFIES that the vinyl bulkhead and 10' non-turf buffer landward of the bulkhead At 530 South Oakwood Dr.. Laurel Suffolk County Tax Map #145-3-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 7/6/06 pursuant to which Trustees Wetland Permit #6429Dated 8/23/06 was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the vinyl bulkhead and 10' non-turf buffer landward of the bulkhead. The certificate is issued to KEN CHILDS owner of the aforesaid property. Authorized Signature 6 0 James F. King, President "OF SO!/jyo Town Hall Jill M. Doherty, Vice-President 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson # Southold, New York 11971-0959 Dave Bergen G ~ John Holzapfel Q i~ Telephone(631)765-1892 ~~~Cl7U 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 1s' day of construction '/2 constructed Project complete, compliance inspection. 1/I-7/6B /0 j n 0 e s-I~bl is ~ e.w~ ~{'a3[68 Q44.~ • • James F. King, President f4F SO~lyo Town Hall Jill M. Doherty, Vice-President P.O. Route 25 0 53095 1179 Peggy A. Dickerson Box Southold, , New York k 11971-0959 Dave Bergen G Sr John Holzapfel AS Telephone (631) 765-1892 NV'~ 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 %constructed Project complete, compliance inspection. ESPON BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6429 DATE: August 23, 2006 ISSUED TO: KEN CHILDS PROPERTY ADDRESS: 530 SOUTH OAK WOOD DR, LAUREL SCTM#145-3-6 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on August 23, 2006, and in consideration of application fee in the sum of $250.00 paid by Ken Childs, and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to remove and replace the existing bulkhead 1' higher and with vinyl sheathing, with the condition of a 10' non-turf buffer landward of the bulkhead and the concrete footing on the seaward side of the bulkhead, on the western end, is removed, and all as depicted on the plan prepared by Robert H. Fox last dated June 4, 2006. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. ~~guFftll~.~ ~ Wit TERMS AND CONDITIONS The Permittee Ken Childs, residing at 530 South Oakwood Dr., Laurel, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President QF so~ryo Town Hall Jill M. Doherty, Vice-President 53095 Route 25 P.O. A. Dickerson . Box 1179 Southold, New York 11971-0959 Dave Bergen John Holzapfel Telephone (631) 765-1892 lyCow Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 23, 2006 Mr. John C. Ehlers 6 East Main St. Riverhead, NY 11901 RE: KEN CHILDS 530 SOUTH OAKWOOD DR., LAUREL SCTM#145-3-6 Dear Mr. Ehlers: The Board of Town Trustees took the following action during its regular meeting held on Wed., August 23, 2006 regarding the above matter: WHEREAS, John C. Ehlers on behalf of KEN CHILDS applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 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, in accordance with Chapter 268, said application was found to be Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on August 23, 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, 2 • w 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 275 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 KEN CHILDS to remove and replace the existing bulkhead 1' higher and with vinyl sheathing, with the condition of a 10' non-turf buffer landward of the bulkhead and the concrete footing on the seaward side of the bulkhead, on the western end, is removed, and all as depicted on the plan prepared by Robert H. Fox last dated June 4, 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, Ja s F. King President, Board of Trustees JFK/Ims James F. King, President of soUryo Town Hall Jill M. Doherty, Vice-President ~O 53095 Route 25 P.O. A. Dickerson .O. Box 1179 Southold, New York 11971-0959 Dave Bergen John Holzapfel .'2 Telephone (631) 765-1892 ~IYCOU'~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: 401 C rlt j. " Please be advised that your application dated 0 )ipjao has been reviewed by this Board at the regular meeting of F IaaI 1-v(o and the following action was taken: (3Z) 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: t TOTAL FEES DUE: $ SC),D3 BY: James F. King, President Board of Trustees 0 James F. King, President ~~Of SUUj~, Town Hall Jill M. Doherty, Vice-President 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold, New York 11971-0959 Dave Bergen A Q John Holzapfel % Telephone (631) 765-1892 ~fcourm, Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/WorksesSion Report I I Date/Time: b o 6 Name of Applicant: Ken C~ , S Name of Agent: ~Sokn Property Location: SCTM# & Street 3 S > b Sc~n~1~ 0Ukwa l 1>nl Z~ ie~ Brief Description of proposed action: ' na (e (uCem enk o (l k I ut~N~Type of area to be impacted: -Saltwater Wetland Freshwater Wetland Sound Front Bay Front Distance of proposed work to edge of above: Park of Town Code proposed work falls under: _Chapt.97 _Chapt. 37 -other Type of Application: /Wetland -Coastal Erosion -Amendment -Administrative -Emergency Info needed: Modifications: / oli Tr//e-F i Fk K~wOtl'd- OLb C's x~T t-oClG- F~d7~aJL Conditions: Present Were: _J.King _J.Doherty _P.Dicketso1 _D. Bergen_J.Holzapfel Other: I i Mailed/Faxed to: Date: I I I ~O~gpFfO(,~~o Telephone Town Hall (631) 765-1892 W T 53095 Route 25 O P.O. Box 1179 'f~ol ~a~t Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., August 16, 2006, the following recommendation was made: Moved by Peter Young, seconded by James Eckert, it was RESOVLED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of KEN CHILDS to remove and replace the existing bulkhead 1' higher and with vinyl sheathing. Located: 530 South Oakwood Dr., Laurel. SCTM#145-3-6 Inspected by: James Eckert, Peter Young The CAC recommends Approval of the application with the Condition of a 10' non-turf buffer. Vote of Council: Ayes:All Motion Carried ~a a o S ~V A\ a A\a - d2~R \ ISdiF k £ ~ a'1 ~ ae ~s~fle 0 \ a 3 \ \ Si ~k9P~ \ ~ F v 5 i I 4~a iF~ll ~ °d I VIII vv v EaHEpO ~ S i 1 6 t 1 ~fom.. a iO III ep . ~H. tOMH 5 5 ; e l ? 351 qp _ a 6 S. j 9 5 y 5 6 51 n °R W _ _ Plan View E _ _ O . Applicant: Kathryn Childs 3 W. _ Bulkhead Reconstruction . R----= SCT# 1000-145-3-6 Situate: Laurel ,i Town: Southold Suffolk County, NY lvewoy APPROVED B Datum: Low Water Garage I Tide Range: 2.5' BOARD OF TRUSTE Prepared: May 4, 2006 I Amended: June 4, 2006 TOWN OF SOUTHOL ~ e~ 1. 30' TE 0 W O 0 = House 0~ Xtenci north ly # 530 jo~ South Oakwood Drive to exist. bl ; 555' to prop. bl c~ " rn cp 10, U1 R~ bul o x fl fl return o S o o tied to VAItin (1' hi q - Lf~ ° ' 9 " . existing bolgldw but~hegd exist. ~ruii:eoa ' blkd. 120' Land of: Ravatone 2's. ePs Realty Corp. ylgtlAnd ahwm T~ i Peronic Ba Section JUL 6 2006 1'=10 piniyhed Reconstruct Bulkhead (1' higher) Lawn ade within property boundaries (190 +/-I.f.) - o Q 3/4" remove existing bulkhead o ga1v tie 4" x 6. o rods stringers SEA Wetland Boundary LW LEVEL new at bulkhead exist. MAPPING sheathing R. Pox May '06 grades 631-722-M P.O. Box # 538 8" dla. remove Riverhead 11901 Iles existing ROBERT H. FOX bpo.c. timber All material must be NYS PLS# 50197 from approved list 6/5/2a 8i0 .42AM c:~si-Mcnnaspro Plan View Applicant: Kathryn Childs Bulkhead Reconstruction - SCT# 1000-145-M 0 Situate: Laurel Town: Southold Suffolk County, W arweWOy Datum: Low Water Garage I Tide Range: 2.5'+/- Prepared: May 4, 2006 I Amended: June 4, 2006 v o N 1' = 30' 711 Q 0 O I i 3 ! I w O 0 House 0 extend blo. # 530 n. 10' north South Oakwood -6X - Drive 0 51, to exist, bl w 55' to prop. bl x m - l0°flt:: new 10 bul X fl ° return 543 tied exlstlnc Bxbt. limber bulkhead steps Anf%l Land of: Rovatone 2-5. s?Realty corp. _ yyetiar~i ahwm R,Fox- Ob P e c o n I c B o y Section 1'=1a finisod Reconstruct Bulkhead (1' higher) / Lawn within property boundaries (190 +/-U.) ~o Q 3/4" remove existing bulkhead 9 galy We 4-x b" rods stringers °~i=•-,,... - - HW SEA Wetland Boundary- LW LEVEL new at bulkhead exist. MAPPING sheathing R. Fox May lob grades P o 17 538 an dia. remove Riverhead 11901 piles existing ROBERT H. FOX b o.c. timber All material must be NYS PLS# 50197 from approved fist eianooe =114]An G:~SLFI~Chllas~r0 0 MAILING ADDRESS: PLANNING BOARD MEMBERS P.O. Box 1179 JERILYN B. WOODHOUSE OF SaUljyO Southold, NY 11971 Chair hOV` co lOFFICE LOCATION: KENNETH L. EDWARDS Town Hall Annex MARTIN H. SIDOR f/+ 54375 State Route 25 GEORGE D. SOLOMON ,per (cor. Main Rd. & Youngs Ave.) JOSEPH L. TOWNSEND 0 Southold, NY ~y~UUNTV Telephone: 631 765-1938 Fax: 631 765-3136 PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: James King, President Town of Southold Board of Trustees From: Mark Terry, Senior Environmental Planner-,~ LWRP Coordinator A J ? r Date: August 21, 2006 Re: Request for Wetland Permit for Ken Childs SCTM# 145-3-6 John C. Ehlers on behalf of KEN CHILDS requests a Wetland Permit to remove and replace the existing bulkhead F higher and with vinyl sheathing. Located: 530 South Oakwood Dr., Laurel. SCTM#145-3-6 The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP 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 LWRP. Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. CC: Sean Kiernan, New York Department of State Division of Coastal Resources a James F. King, President ~~OF soUTyo Town Hall Jill M. Doherty, Vice-President 53095 Route 25 P 1179 .O. A. Dickerson 41 41 Box T Southold, New York k 11971-0959 - Dave Bergen n C Holzapfel Telephone (631) 765.1892 John Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application /Wetland Permit Application _ Administrative Permit -Amendment/Transfer/Extension ,,Received Application: 91 b lap -,Received Fee:$ SO' ,Campleted Application 11100j6 -Incomplete _SEQRA Classification: Type I_Type II-Unlisted _Coordination:(date sent) J U L 6 200( 0 LTVRP Consistency Assessment Form ~Ig1 10<° C Referral Sent: 11Ip Itio __,CA P 1 ,Date of Ins ection: 1 b t14 Receipt of CAC Report: - -Lead Agency Determination: -Technical Review: __,8ublic Hearing Held: 31_T Resolution: 'FO Name of Applicant-b>° {'1 ~ Y1 t d S Address l 0 5 01 d 'T') +Ch Q, Rc~ ~lt'r'1'(111D'l ' 01q-I Phone Number:~l Suffolk County Tax Map Number: 1000- j1-} 55 <'Oavu%~d Property Location: it~~5t SlAe O[ t JUi.I 11` U,F.1(~(1()~ 1-~t. (provide LI`LiC~O`Pole distance to cross streets, and location) AGENT: ' W V~ 11 ~r L ~~'s i Ill ht~ S) I~ V q o r (If applicable) r L\`~~ Address: L S~~~ S11 ` ` ~P~c Nq ~iq0 t Phone: ~o3I ' 3(GC('52~~ Board of Trustees Application GENERAL DATA Land Area (in square feet): 19,55 -7 2 Area Zoning: La -C Previous use of property: ;'C S' C1e nti CL I Intended use of property: `(Q S 1 e VV~ CkJ Prior permits/approvals for site improvements: Agency Date ~IS 161-5 C e A%, I No prior pennits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): Zn & cu la I c ent • Board of Trustees Applic,on I . WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: i i i I Area of wetlands on lot: square feet Percent coverage of lot: % 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? V No Yes If yes, how much material will be excavated?_ J cubic yards How much material will be filled? U cubic yards Depth of which material will be removed or deposited: pJ/A feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 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): • Bo* of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: 01\ 2PICi C e eckA Are wetlands resent within 100 feet of the proposed activity? -No Yes Does the project involve excavation or filling? -No X Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: t: Describe the nature and extent of the environmental impacts reasonably antic from implementation of the project as proposed. (Use attachments if necess< 617.20 • SEQR PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NA" d 1. 1`Jl.l ihe n e(nf~l.l 3.PROJECT LOCATION: Municipality e)cl At' L'd County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or Provide map 5 `Jowtt~ f~-~WOf~ ~25~ `~tc~Z Of- SC)~Lk~c^C~ 'a h of Te 5. IS PROPOSED ACTION : 0 New 0 Expansion EJ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: Zc f' ICt C~ `t h ~ ~vtcl a G lace ~Y_ t, b~.t~-Gad . i;~ ``H1 v i ~l L lad cuood . ?.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? UYes ? No If no, describe briefly: 9. WHAT W HAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential F Industrial Commercial ?Agriculture ElPark / Forest / Open Space Other (describe) Inli 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, Stateor Local) y~Lr~ i VYes ?No if yes, list agency name and permit / approval: Nys 4,c C_Pn1 1lcc 1 on Pe{' M5 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ?Yes [JNO If yes, list agency name and permit / approval: 1~2. IA,~S A R ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? aps 1XINO I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Dale: Applicant / Sponsor 3 a~ Signature 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 b Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. Yes ? No S. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. ? Yes E] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or achange in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long tens, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energ ? Ex p lain briefl : D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? If es, explain briefl : El Yes ? No 17 , OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es explain: ? No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important orotherwise 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 (1) 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 actin WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Print or Type Name o Responsible Officer in Lead Agency Title of Responsible Officer Signature a Responsible Officer in Lead Agency Signature o Preparer (If different from responsible officer) • 0 James F. King, President so~lyo Town Hall Jill M. Doherty, Vice-President 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold, New York 11971-0959 Dave Bergen co John Holzapfel Telephone (631) 765-1892 IyCOU' Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of n_C h ~1 COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, JAP I~ l~ lE~f residing at v1 Q~^ ` S a ('a In [ ue r~ rrGl N y being duly sworn, depose and say: f That on the I day of />tquf I' , 2000 I personally posted the property known as 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 the public hearing. Date of hearing noted thereon to be held (I bA- Au j,& cl 3 wrap on'~~ibc-tt&,30 Dated: 0 l1 b rJ~ (signal r Sworn to efore me this ( day o 200b Notary Public y 714 yXk Oaf .11, U • Board of Trustees Application AUTHORIZATION / (where the applicant is not the owner) I, Ca`~i~r S-CL) U5 residing at Sad S-d)KWOCe-Dr- /(print O~ner of property) (mailing address) L19l~/LGL '11-1!9 do hereby authorize (Agent) ~n h P ~ (/!/j to apply for permit (s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) 8 • Board of Trustees Appli&ion County of Suffolk State of New York k) Pal - C,IA C ~rQS 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/BER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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 PREMI SES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF Mal-c h 120 Oho Notary Public X M A. 3ULUYAR ROTARY PU" OF NEW JUM *1 CwabWu Don AWd 3.2010 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Town f Southold s Code of Ethws o 'Sits conflicts of interest on the Dart of town off cers and emolovees The nuroose of this fo is to orovide information which can alert the town of ssible conflicts of tempt and allow n to take whatev r action s nece to void s me. //t y YOUR NAME: t nhA 1hlel s (Last name, first name, ,ittddle initial, unless you are applying to the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Building Tax grievance Trustee Variance Coastal Erosion Change Zone Mooring Approval l of plat Planning Exemption from plat or official map 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 I in which the town officer or employee owns more than 5% of the shams. YES NO i' If you answered "YES", complete the balance of this form and date and sign where indicated. ' Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); _B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of 200 _ Signature - Print Name ~_t Form TS 1 Town of Southold • • i, LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting 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 % F AUG - 4 2006 SCTM# 145 -~_-_6 PROJECT NAME A Q n (t ICI5 The Application has been submitted to (check appropriate response): Town Board ? Planning Board El Building Dept. ? Board of Trustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ? construction, planning activity, agency regulation, land transaction) ? (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: "rQ Location of action: J'30 SARK eo.6 y- 0o 0 Site acreage: 101 i SS7 ' gr 1-1 n. q A-e Present land use: ; r{pti" Present zoning classification: R - 4 o 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: pThQ.NAJ r,kZ"7S p ^ (b) Mailing address: ~~p ~~L hAh K4w1 fYQ Ilan d ~ C.. nt- tP'!~j V 119 (c) Telephone number: Area Code ( ) l (a - s-`{ s cs (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes x No El If yes, which state or federal agency? -DAL C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ? Yes ? No 0 Not Applicable 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 JNeKJ1 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ? Yes ? No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages S through 16 for evaluation criteria ? Yes ? No 9 Not Applicable 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 F] No ONot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. ? ? Yes No Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ? Yes ? No tZ 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 JS 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. ? Yen D Noo Not Applicable Attach additional sheets if necessary t WORKING COAST POSES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent ases in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ? Yes ? No K 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 Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ? Yes ? No [;01 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 1~7 Not Applicable PREPARED BY p~N . p t TITLE , d~Qr ~ynr DATE c~ 3-01P