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HomeMy WebLinkAboutTR-6623John M. Bredemeyer IIl, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee May 20, 2015 Joe & Linda Sciotto 8380 Peconic Bay Blvd. Laurel, NY 11948 pF SOUryo� ` COUNTI BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: 8380 PECONIC BAY BOULEVARD, LAUREL SCTM# 126-11-20 Dear Mr. & Mrs. Sciotto: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, May 20, 2015: RESOLVED, that the Southold Town Board of Trustees APPROVES the request for a Transfer of Wetland Permit #6623 from Robert H. Dexter to Joe & Linda Sciotto, as issued on June 20, 2007. If you have any questions, please contact our office at (631) 765-1892. Sincerely, John M. Bredemeyer III President, Board of Trustees JMB:amn John Bredemeyer, President OFFD( Michael J. Domino, Vice -President James F. King y z Charles J. Sanders Dave Bergen Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: %- 4'1 1 V 16' s y JOE & LINDA SCIOTTO request a Transfer of Wetland Permit #6623 from Robert H. Dexter to Joe & Linda Sciotto, as issued on June 20, 2007. Located: 8380 Peconic Bay Boulevard, Laurel. SCTM# 126-11-20 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: e�_Chapt.275 Chapt. 111 other` Type of Application: Wetland Coastal Erosion Amendment���af�� Administrative Emergency Pre -Submission Violation __ Notice of Hearing card posted on property Storm Water Management Review: Info needed: Modifications: Yes No 'Not Applicable Yes No --plot Applicable Conditions: /yd W&d d -rvel= Present Were: J. Bredemeyer M. Domino "J. King C. Sanders D. Bergen Bay Constable Other Form filled out in the field by t /cr x/°�° Mailed/Faxed to: Date: DATEnYL/ IcS, o�D lS OWNER LJ(Ja`t/h& cSGJD PHONE MAILING ADDRESS��d recon <c: ,� blvde� ll9�f�' Ate" PHONE PROPERTY LOCATION ��c l�� CP�f Alyd • bwzd /I9yr TAX MAP NO: �� d I/We c (gP al -d &1212 CSQ&1*2 request a Transfer of Permit# .3 from 2dAt # - A�r' �cS'CT�/1 %6-1100 Signed By: OF S®Ur� John M. Bredemeyer III, President �lO Town Hall Annex �®�� Michael J. Domino, Vice -President 54375 Main Road P.O. Box 1179 James F. King, Trustee Southold, New York 11971-0959 Dave Bergen, Trustee G Q Charles J. Sanders, Trustee �I'M Ti Telephone (631) 765-1892 Fax (631) 765-6641 (i J BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD APR 5 2015 APPLICATION FOR A TRANSFER OF A WETLAND PERMIT—;'..-....... s .. DATEnYL/ IcS, o�D lS OWNER LJ(Ja`t/h& cSGJD PHONE MAILING ADDRESS��d recon <c: ,� blvde� ll9�f�' Ate" PHONE PROPERTY LOCATION ��c l�� CP�f Alyd • bwzd /I9yr TAX MAP NO: �� d I/We c (gP al -d &1212 CSQ&1*2 request a Transfer of Permit# .3 from 2dAt # - A�r' �cS'CT�/1 %6-1100 Signed By: ].,,---.,rd of Trustees Applicatic County of Suffolk State of New York y o h �C i C5 V^� 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 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 BOARD OF 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, INCLUDING THE CONSERVATION ADVISORY COUNCIL, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. SWORN TO BEFORE ME THIS Notary Public DAY OF 1r -t I ,20 ( VICKI TOTH Notary Public Stg of New York MANE 0696 Qualified in Suffolk County Commission Expires July 28, 20 U James F. King, President ���f SDi�%y Jill M. Doherty, Vice -President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Q �ycoum,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 CERTIFICATE OF COMPLIANCE # 0246C Date September 7, 2007 THIS CERTIFIES that the mer timber retaining wall, lower vinyl bulkhead and 10' non -turf buffer landward of the retaining wall At 8380 Peconic Bay Blvd. Laurel, Suffolk County Tax Map # 126-11-20 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 5/21/07 pursuant to which Trustees Permit #6623Dated 6/20/07 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 upper timber retaining wall, lower vinyl bulkhead and 10' non -turf buffer landward of the retaining wall. The certificate is issued to ROBERT H. DEXTER owner of the aforesaid property. )Z*0" 0 " �0 Authorized Signature 9 James F. King, President Jill M. Doherty, Vice -President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. r� Of SOCn UTyo� X40 �1�00UNTV,� BOARD OF TOWN TRUSTEES Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax(631)765-6641 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" day of construction Y2 constructed Project complete, compliance inspection. 0 BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6623 DATE: JUNE 20, 2007 ISSUED TO: ROBERT H. DEXTER PROPERTY ADDRESS: 8380 PECONIC BAY BOULEVARD, LAUREL SCTM# 126-11-20 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 June 20, 2007, and in consideration of application fee in the sum of $250.00 paid by Robert H. Dexter and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: To replace the upper retaining wall using timber and the lower bulkhead using vinyl sheathing, with the condition of a 10' non -turf buffer landward of the retaining wall, and as depicted on the plans prepared by Robert H. Dexter, received on June 20, 2007. 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. 0 0 TERMS AND CONDITIONS The Permittee Robert H Dexter, residing at 8380 Peconic Bay Boulevard, Laurel, New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 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 Jill M. Doherty, Vice -President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. June 20, 2007 Mr. Robert H. Dexter 197 Kensington Road Garden City, NY 11530 0 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: 8380 PECONIC BAY BOULEVARD, LAUREL SCTM# 126-11-20 Dear Mr. Dexter: Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax(631)765-6641 The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 20, 2007 regarding the above matter: WHEREAS, ROBERT H. DEXTER 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 May 21, 2007, 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 Exempt from the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 20, 2007, 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 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 ROBERT H. DEXTER to replace the upper retaining wall using timber and the lower bulkhead using vinyl sheathing, with the condition of a 10' non -turf buffer landward of the retaining wall, and as depicted on the plans prepared by Robert H. Dexter, received on June 20, 2007. 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, ry'` v 0'4e�'�'r James F. King President, Board of Trustees JFK/eac 0 E c E � v MAY 2 1 2007 D Board APPROVED BY BOARD OF T"USTEES TOWN OF UTHOLD DATE ad .4 . =MAM/ArEM FOWVa O.SfIA•E Sl*r ca T.IX AWP &Srjqq0 SFCT. /p6 BL.I/L07P0 I..aPPppO Yl[YlW w Nlwaq q RR PR.e. P . Pe..a..es ar aw.Rs res. or .s[ an .aar amt TRRers w mNea a .Ao aaarn w R. esurR ..e e.ao PPK.✓s sags atY w rwHare arr aau w R soRsw ro R e Ru reR wre OR. NI .Y HI.aY NI PIOY PS fTR. R tiAYa..O w.IO RAY. ro ..e mae wsras., swewRSRL VeR.' .w lfY RIRIIRl� {q.p RRVISIOM 0+. ® j e�G YOUNG R YOUNG IOD OSTRANDER AVENUE, RIVERHEAD. NEW YORK ALDEN W. TOU" W,WARD M1Kr[RMYNAL •IIP.NKN ANO HOWARD ARD W. u Py� II.r1 NC NO. .2NA. SURV y NV.arC. . — -JOSEPH 6. CMSHOLm 6 J��.R" M a►RD R:. L MAMT!/CM c E � w JUN 2 u "/^07 Bead /M,,tW ,V, 7/1 r4c/Cf_ CAVIC A4 -4 Vel, P,Q�GPf.Q% Y DIFlNE,� Rome 47 fi G12 X TE/I 77A K' N4,-" 4739B9 /26-11-20 J7�GK 2 SroAy v7 U 24' "OT._ APPROVED-fW ca4WAPR'--TRUSTEES ,0/,;Z -jokes V� li£ PATE 6 p261d % O• ;e!% -_ V 1QEC�S.S QDCU7E — - � 1xz V d C, ti � p 1QEC�S.S QDCU7E — - 0 James F. King, President Jill M. Doherty, Vice -President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. TO: n BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1592 Fax (631) 765-6641 Please be advised that your application dated M!24 di, aCb% has been reviewed by this Board at the regular meeting df JZxnr_r:20, Qwq and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre -Construction Hay Bale Line Inspection Fee ($50.00) 1" Day of Construction ($50.00) % Constructed ($50.00) `�/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: TOTAL FEES DUE: $ SO BY: James F. King, President Board of Trustees �C� i James F. King, President Jill M. Doherty, Vice -President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. • BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Work session Report Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax(631)765-6641 Date/Time: lP - 6-P'7 ROBERT H. DEXTER requests a Wetland Permit to replace the upper and lower bulkheads using vinyl sheathing. Located: 8380 Peconic Bay Blvd., Laurel. SCTM#126-11-20 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland _Sound _Bay Distance of proposed work to edge of P� of Town Code proposed work falls under: ✓ Chapt.275 _Chapt. 111 _other Type of Application: ✓ Wetland _Coastal Erosion _Amendment Administrative _Emergency _Pre -Submission Violation Conditions: Present WereY J.King _U.Doherty _P.Dickerson _D. Bergen_ B. Ghosio, Jr H. Cusack_ D. Dzenkowski _Mark Terry_other Form filled out in the field by Mailed/Faxed to: Environmental Technician. Review clk6c 4-- Secw 61k-4j&j . ►l/ IK4A 1// t 11 � 11 11Telephone (631) 765-1892 111 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 At the meeting of the Southold Town Conservation Advisory Council held Mon., June 11, 2007, the following recommendation was made: Moved by Don Wilder, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit application of ROBERT H. DEXTER to replace the upper and lower bulkheads using vinyl sheathing. Located: 8380 Peconic Bay Blvd., Laurel. SCTM#126-11-20 The CAC Supports the application with the Condition CCA treated lumbered and a 15' non -turf buffer is installed landward of the bulkhead. Vote of Council: Ayes: All Motion Carried r• � 9 � � � urn .n �� � � Miq i M � E COUNTY DF SUFFOLK © Real Property Tax Service AM E, r SOUTHOLD I IEcTiox xo N ... •. r..,. a wnr rn. a�wrco4xr mm 6 126 eM �_ ... ,_ rwr,. P.,„'0A1 10 00 PROPERTY MOP 0 0 OFFICE LOCATION: o��OF SOUryol MAILING ADDRESS: Town Hall Annex O P.O. Box 1179 54375 State Route 25 J Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) N Southold, NYTelephone: 631 765-1938 OQ i Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTHOLD tl�::►1 1/l To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner Wd LWRP Coordinator Date: June 8, 2007 Re: Request for Wetland Permit for Robert H. Dexter SCTM #126-11-20 ROBERT H. DEXTER requests a Wetland Permit to replace the upper and lower bulkheads using vinyl sheathing. Located: 8380 Peconic Bay Blvd., Laurel. SCTM#126-11-20 The in-kind replacement of and/or removal and disposal of existing timber bulkhead is an exempt Minor Action and not subject to LWRP review pursuant to Chapter 268-3; Items A and B of the Town of Southold Town Code. 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 exempt from review pursuant to Chapter 268-3, Exempt Minor Actions, item B which states. "Replacement, rehabilitation or reconstruction of a structure or facility, in kind, on the same site, including upgrading buildings to meet building or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures may not be replaced, rehabilitated or reconstructed without a permit". E ,E6A,44) Ov- ro w. c9 dF 7710 4 0 0 /6 Zoo/. RcFEMAYI 007 D roCd,N,oGtT� /y1Y �4P,oL/CiI i/�.� 10�9•4 A die <Q�iOLAGf /1'iY �%/i fd1 AG F/! 4 T e5'3,9'G ,aEG6,c,/G t/.fv¢ rM4 foCGOWJ�Lj. • /f rel, FZ62:> *Y 7NI40 X774W7- 70, Cov?,rC-T /k'Y X,77'F "0 P(t,4 5"i Xd v1 sE /f �PO!>i7<eoaA� I•��,Q.u.RTla,c� �arcr fl E�7�R 6J(o Z4.8 74e F, n LJ James F. Hing, President Jill M. Doherty, Vice -President Peggy A. Dickerson Dave Bergen John Hohapfel n L BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only oastal Erosion Permit Application Wetland Permit Application _ Administrative Permit _Amendment/Transfe /E tension t/ eceived Application: 3 1 _Received Feel �S(-) Completed Application_WjALW _Incomplete _SEQRA Classification: Type I_Type II_Unlisted Coordination:(date sent) ,<WRP Consistency Assessment Foran 310') SAC Referral Sent _Bate of Inspection: 0 _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: !Public Hearing Held: o Resolution: Town Hall 53095 Route 25 P.O. Boa 1179 Southold, New York 11971-0959 Telephone(631)765-1892 Fax(631)765-6641 Name of Applicant_,/ WyExre R Address If % /(ENCS/,(/6TG,(i 860, 44,01"Y 417.1, /(/)/ POO Phone Number:( ) S/6 ?4.6 TyG 9 Suffolk County Tax Map Number: 1000- 4 738e9 12.,10.- //- 20 Property Location: 8325D yeE/T /+4lJ/G 8*/ Y I d. �6 Sd; 3 3 Td 1W.U��t,�.c1T dit( /11DR7'}/. /NEST (provide LILCO Pole #, distance to cross streets, ana location) (If applicable) Address: Phone: Y.4(/E Oard of Trustees Applicads GENERAL DATA Land Area (in square feet): <9GO S/- Area TArea Zoning: �£SIdZIJ714 L Previous use of property: 7142 Intended use of property: K-�Tm I - Covenants and Restrictions: Yes t/ No If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ✓ No Yes If yes, provide explanation: Project Description (use attachments if necessary): ,P f9,41A 419 )d D,4 dF eGA4k,Z,4,P„ Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: A %.(�f 1k ✓d6 ✓Ep Area of wetlands on lot: Z4,40 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? No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: 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): 4Lrd of Trustees Applicatie COASTAL EROSION APPLICATION DATA Purposes of proposed activity: 6Z,04he ///d 6f 1EP'1 I46 .WIWT d< S70A.a 04ak-2-d l3UGk 7 E,aDS 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? U (cubic yards) How much material will be filled? %Q M, (cubic yards) Manner in which material will be removed or deposited: B�GKf%A G6 v7 4AGTo,e 141-95 NGT 4S YZZ FZZ,u S ZZZZ" t /144f, -6,2E 7-" /AiAN4E.2 lWr I W- ,4S Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) J7'/+'F /'.t'bJ�G! !�i'r:-t- 'u!-�/"'' ii`/d% �.ii`>r.�•'i' o,',,,f,: ;a ��Qt>S/ON NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SPD/";r f-/ de -x 'E,,) sCTM# 47J669 %Zeo-I/-& YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: ,CEPAIR o,Q RfP�4E E�c/�T/,i��s islaav ,dU�KNE�I�s J7.G.t+rAGEv d y 7#,C Auric /S'`'� S7aa r►c 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: B366 121, Cd.0/c 04Y 64s112. 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on:. You may contact the Trustees Office at 765-1892 or in writing. The above -referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: _ MAILING ADDRESS: PHONE M Enc: Copy of sketch or plan showing proposal for your convenience. 6 !\ W v n a � � � a 0 0 9 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: IVA ,14WA,1111 'T G{AVeAL7404 --!�/uTi`/ 64Z-A,v 1044 IkATi/L,ee N AJL�,,4 / STATE OF NEW YORK COUNTY OF SVPF@tK OAS Av 1iT/6iyLA,Uv ,BfAGN, �L. 33��7 8Z,�16 j94 Y AI -V4 X/y //4 �'f �B BST 'a 2 residing at (5 -t ��� g 90t& L4 11 a being duly sworn, deposes and says that on the 24j day of 20n, deponent mailed a true copy of the Notice set forth in the Board ofTrustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at yMAWA1 C/7Y A/that said Notices were mailed to each of said persons by (certified) (registered) mail. � /iC/ Sworn to before me this Day of _,20 0-1 WAYNE ULRICH Notary Public, State of NewYork ` No. 9411880 kJJR_ Qualified in Nassau County Notary Public Commissron Expires Sept. 30, 2010 SU,uueR bks IDeAlcE fs' y�Gd SAY/-✓/) z,4a, ,eke /(/Y // y*z PROJECT 10 NUMBER 61720 SEQR 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 I SPONSOR 2 PROJECT NAME >6FeEI((7 ;kX7Zk .&WXHEAO >P.E?AM 3.PROJECT LOCATION: Municipality 1-461 eL County .�UFFOL� 4. PRECISE LOCATION: Street Addess and Road IMe"Nedpns, Prannat landmarks ale -or movide map B3B0 lz2EG4I(//G SAY JL✓lj ('Sri - SEE5.IS 5. ISPROPOSED ACTION: ❑ New ❑Fxpansion ON10dillicationtaftFation 6. DESCRIBE PROJECT BRIEFLY: iQ4P4/,2 4W 0Q /cEpLALE �� cEdT OF U1�lJlr AU0 LGW6R 7. AMOUNT OF LAND AFFECTED: initially acres eOb Sr' Uaimately aces 86d J F 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? 0 Yes ❑ No 8 describe briefly: no. AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as merry as apply.) F9. Residential ❑lmustdal OComnetcial ❑Agcuk,9 ❑ Park) Fomat I Open Space ❑Other (describe) to. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AG (Federal. State or Local) 0i 0Yes ❑ No 8 yes, rot agency name and permit / appmval: G 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Elyes ❑Nu If yes, list agency nano and pemtt I appmv*. 1r2.. LAS A RE ULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? L_Ires No I CERTIFY THAT THE INFOR TION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant I Sponsor Name Date: zwmz/ Signature If the action Is a Costal Area, and you are a statoagency, complete the Coastal Assessment Form before proceeding with this assessment 0 PART II - IMPACT ASSESSMENT o be coinnipleted by Lead A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617A? N yes, coordinate the review process and use the FULL EAF. ❑ Yes El No B. 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 anollsr involved agency. E] Yes El No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be hantlaaltlon, if legible) Ct. Exis6g aagrraft, menace or grourdwaferquaW m quwdly,noise levels. eAsft trait pattern, solid waste production or disposal, potential foreresior. drainage orfloodfng problems? Explain briefly: C2. Assflafic, agricultural. archaeological. historic. or other natural or cultural resources; or community or neighborhood character? Explain briefly. C3. Vegetation or fauna, fish, staMsh or wildlife spades. significant habitats, or threatened oro endangered species? Explain briefly. CN. Acomoun' sexisti qy' ung plans rw geNs as om�ratiy edoPr4 or a change in use a iMer�ry of use of Intl or other reiaal resources? Explain bdeay C5. Growth, subsequent devdopmen . or related activities Maly to be induced by On proposed action? Explain briefly. C6. Lag term. short Gann, aanliadve, or other elleds not iderdfied in C1-05? Elan bdW. _ .Explain .... C7. Oflnar Qnclud- in use of either quantity or of energy? D. VALL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? iffM.In lode _ El Yes Li No - -.. OR IS THERE ❑ N, 17, LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex ain: - _ _ 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 (I) 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, thedetermination 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 ora ormom potentially large orsigdfcent adverse inpactswhich MAY occw, Then proceed d'aectiy to the F EAF and/or prepare a positive declaration. Check this lox If you have determined, based on the Information and analysis above and any supporting documentation, that the proposed ai WILL NOT result in any significant adverse environmental impacts AND provide, on alladwrents as necessary, the reasons supporting determination. Name of Lead Agency Print or Type Name of Responsible icer in Lead AgenkyTitle of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer Of different from responsible officer) 0 Town of Southold A. B. 9 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. 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 ifing t cant 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. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 720 - // - 26 PROJECT NAME K rAeJ)4 BIIZ4 14Ad The Application has been submitted to (check appropriate response): �-�( Town Board ElPlanningBoard ❑ Building Dept. El Board of Trustees IJ 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: 0 9 Location of action: 832) fECo4//G ZdY JLVO Site acreage: Gf 711 �iG,Pi S Present land use:rs/,���c!<`/AL Present zoning classification: A7ES1V1-1ir1-#L 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: 16,&-,e 7- W Z2zx rER (b) Mailing address: /97 ,7Q 4rxiusa C/7Y. ;'t1/ //S3e (c) Telephone number: Area Code( ) S-14 ?� 7,10 f (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? �2C 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 [6 Not Applicable ,CiGf P�2Lfuey 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 1:1l ' I Yes 0 No Not Applicable 't'� xdel cy &Afl k o� .37a� r*1AAGid d",ctl E,tA,J Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section IH — Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No[� Not Applicable c Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III — Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III — Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No 1Not Applicable I*OrEGT il"�A/v6 7 �,f Oso o n_ 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 Not Applicable ,Q671417s 4X/&87` es40sltlt - 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 le o7, <rs A6.y+usr �,�os�mw 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 [A Not Applicable FOGA/►�sT X.Q6616,0 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. �j ElYe� No � • � Not Applicable l�,Qo7o ecT 46:4/NeT Attach additional sheets if necessI 0 WORKING COAST POLICIES 0 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 Aoz-,t67s A4dzv57 jfo.9/m,U Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town aters. See LWRP Section III — Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No Not Applicable f�iQ�T�Gl�f /9a<jl/tit % �'.�68lbs� 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 M 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 oo /f�m7��iS AGA/�sr �.CI�S/bv PREPARED BY Kddf.Q T `/ degre-a TITLE OWWfr2 DATElZ G7 0 U APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM neeejASafy to avoid same, YOUR NAME: 0,f--XTER KGWe4 /,/ (Last name, fnstt naar, ippme m14 unless you are apphyuw in the name of someone else mother 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 - Variance B Change of Zoe Truslee Erosion Approval of plat MooringCoastoastal al Exemption from plat m official map Placing Other (if "Other", name the activity.) .PEPA/,Q dE 6V1 -1e K,4 -0S Do you personally (m [hough Your company, sponse, s'Withg, parnt, or c iIQ have a ncktiotahip with any officer of employee f the e Town of SoNrold? "Relatio�shir iueludcs by blood, amarine, m business mWest.'Busiuess Tfemmst' mantas a business, g lxmme" hips in which the Iowa of m memployee has even a partial ownership of (m employment by) a corporation in which the town officer m msp employee owns oa than 5%ofthe ans, YES NO 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 ootporafe stock of the applicant (when the applicant is a mrporation); - _B) the legal or bcnefmcial owner ofany ban T a non -cape aft entity (whea Ste applicant is not a corporation), - _C) an officer. director, partner, or emmdoyce of the applicant; m _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 2.3 ay ofVIA 200Z Print Name PP6fXA7- he£/1 Form TS I ` 0 0 Board of Trustees Application County of Suffolk State of New York /C D8t ,QT WdE X TL 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 IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOI.D 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. ,05 SWORN TO BEFORE ME THIS Z\ DAY OF A ('P -N ` 200=1 Notlry Public WAYNE ULRICH Notary Public, State of New York No. 94118%, Qualified in Nassa4County Commission Expires Sept. 30, 2010 E c E JUN 20 2001 m!d Town of Trustees XA�r W 0, 7// At kf 8 3e9« ,QPoPEkTY OwNE,I Qaa� �r fi (J£X 7Z11 7,4 Y. M4 P 473989 /26-/1-20 i. � a n N 2 STcY G) APPROVED BY ._ BOARD OF TRUSTEES ScY&WN OF SOUTHOLD 7f7 UZ71: D`6 aa Ole) o� kN � Q �� _ 4 ,Qc«ss .QDu�.E ih'E 01W41) KA7/!4EEIV P/Z1,4� &,4S �46R�EII r MAY 2 1 2007 Southhold Town Board of Trustees Q w_ s O � o L £ v V � � 9 z • � a � Q ,f_ Opo f �� _ 41 Z •a I~✓' M.f�u . t1 a 71. C? • ;�\ �o moi: i .. •• .. ..�� b — APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE %AlOV YOUNG 4 YOUNG C g, rits� M7 400 OSTRANDER AVENUE, RIVERHEAD. NEW YORK DECDa, _ �� AIDFM W, YOUNO HOWARD W. eMOAOI"rFpAY0 •y ��eeA ua.. uN0 •umply OsyrAAT: SURVEY FOR. N.T.•. u N0' ,rvwo „aww w www w .A/irC C4 TAX MAP me ,w.v v . wRmw a. carne.E asr102Es£cr. @81,1/ Lor etcr�Q •d• > • •• w+.,ea a..qN,. dOSEPN 9. CNI.SMOLM 8 LM DiPAO W. a.ea � w •ww. w w, ww. awn. car N,e. .. e; oAeeaw w N • wua wa va AT eN.w.a.. ,�� w e,e.'►e MATT/TGf^K U "* 6 ww.,e ws.a•w.aw To`m SoumoLD uN•ec o. s.a. a ,awwe, w w w aa.r• / m ma +vu wwAawawe,ea �q[ .�av w ura.wm•w wao i s,-lj—�1 f�''l