The URL can be used to link to this page

Home My WebLink AboutTR-6702 . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction _ 70nstructed L Project complete, compliance inspection. . . TERMS AND CONDITIONS The Permittee Mark Hansen. residing at 680 Private Road #2. Southold. New York, 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 South old 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 South old. 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 iffuture operations of the Town of South old 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 Permittt;e 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. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 22, 2007 Mr. Ronald Hansen 34 Guilford Road Port Washington, NY 11050 RE: MARK HANSEN 680 PRIVATE ROAD #2, SOUTH OLD SCTM# 87-4-3 Dear Mr. Hansen: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 22, 2007 regarding the above matter: WHEREAS, Ronald Hansen on behalf of MARK HANSEN 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 4,2007, 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 August 22,2007, 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, 2 . . 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 MARK HANSEN to replace the existing 82 linear feet of timber bulkhead in-place using vinyl sheathing and a 9' return extension with the condition of a 15' non-turf buffer along the bulkhead, and as depicted on the project plans prepared by James E. Fitzgerald, Jr., dated July 20, 2007 and received on July 23,2007. 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, ~07~ James F. King President, Board of Trustees JFKleac . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 (YIo..'~jo7 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: (Y/()J b.l:b.n'3en Please be advised that your application dated fYl:::c been reviewed by this Board at the regular meeting of and your application has been approved pending the compl following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) Yz 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 ofthe above. COMPUTATION OF PERMIT FEES: . r::7'l ~ TOTAL FEES DUE: $ ~~ BY: James F. King, President Board of Trustees " -;" . . '- 4I....~ .R ~~..... .I .._ ,. 't;'!'" -.. ~ ". , . .. . , .-' -. - I 1""-= ;t - i l. . . .; t' . r .. 100 ..,. . ;. . . ." . ',. , . ," ..,. I- ,.. ~~ e-~ . .. ..~ . . . .. L - -..",.. ....--.-..,....... ... . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: ~./ \ 3 - 0 I MARK HANSEN requests a Wetland Permit to replace the existing bulkhead in- place with vinyl sheathing. Located: 680 Private Rd. #2, Southold. SCTM#87-4-3 ~J. ~~" Aa.,v.-r TYI3e of area to be impacted: .JiSaltwater W etland _Freshwater Wetland Sound _Bay Distance of proposed work to edge of above: P3J1 of Town Code proposed work falls under: .iChapt.275 _Chapt. 111 _other Type of Application: / W etland _Coastal Erosion _Amendment _Administrative _Emergency _Pre-Submission _Violation Info needed: / Q \-:;:<. ('e:f-vv" I <S 2. I kn.5 ~ \\c. \".LcJ ('.x.1:LJ. :s I \~WlvY Modifications: \ SIno f\ -h"r-l- l,~ Conditions: \S I V'o" 1vrS ( "01'1 ~i s~,^rl.,\",,,,-) \:,..~ , ~-v/~ ~t/ P~t Were: _J.King _lDoherty _P.Dickerson_D. Bergen_ B. Ohosio, Jr _H. Cusack_D. Dzenkowski _Mark Terry_other MailedIFaxed to: Date: Env~ronmeIi.tal Technician 41 ReView . - )<1, ; ~ jc./Vl.aJ ~(Ar.~' Uhlk ~ J L... {~ II I..... "'~ rv~~~ 1,^~ W,,,,,, b(,1( k-I-u-J /T~' j ~. . . Telephone (631) 765-1892 Town Han 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Mon., June 11,2007, the following recommendation was made: MARK HANSEN to replace the existing bulkhead in-place with vinyl sheathing. Located: 680 Private Rd. #2, Southold. SCTM#87-4-3 The CAC did not make an inspection, therefore no recommendation was made. . . ,. - ';'^. .:;..~~ , ~. ." f" J~-<-- Q~ '->, U"J f rUf--,) . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD .'1, S ~hc t'1 ~::.. ,,/\ \ ,) jV-) C_'0h~ ~!J:' Southold Town Board of Trustees Field Inspection/Worksession Report I"L ("2..'1 (0(; I I A fI'\ I '-A I / Date/Time:~ ')" ./ k3; ~, 'C '-,~ ,"~ ~J ~ VJv)., ( , Name of Applicant: mt,J:- +\"CU-uer0 'V I, 6??O P (\ \Ja+ K) ~f4r jl-,/~ W>lffl~ &f .\gerrr:- Property Location: SCTM# & Street Brief Description of proposed action: Type of area to be impacted: ./ Saltwater Wetland _Freshwater Wetland _Sound Front ~ay Front Distance of proposed work to edge of above: Part of Town Code proposed work falls under: )(Chapt.97 _Chapt. 37 _other Type of Application: )':.. Wetland _Coastal Erosion _Amendment _Administrative _Emergency Info needed: c-"".( '" M f L,: r . k Modifications: Conditions: S. -: r t. ,'... k, ~I :., r/<:. c;..~ ~ ~ c.. _ _q (f'.. kJ f ...~~ i...~c ~: .pC. l}u-tC. ~'__._,. _ t Present Were: V;K.ing VI.Doherty _p.Dickerson~ Be~ Other: -;-k .,tJ-,t.... C<-0 {.f d::.. ~BOb Ghosio, Jr. MailedIFaxed to: Date: Comments of Environmental Technician: ~ BA YV/EW ROAD ~ J. . II ~Q' , ....\~ cf' O~ ~'rod $' <( .\\ o~ <Yo..t '04. ~or 's:' \.00. . i;JS..\~. .\0 z". ~>~o,' ",",' ~(~ ~;> _f'\O~ \. o. / 1~'Ii~ ~/ . ,/ 1!~~. , ~\.. q.~i ct!~~ " ..!o~ 0\<< ~ '~ ~.\ ~~ ~ ofJ " ~ \~ \ ~& ,.~ ~e cY ~i' ~.~ lP ...~ l' ~V'r- . ":>' Pi ..f / \0 ,<< J \ ~,O ~ f' ~~~~~t ~~~~~~ 0> ~(j (j, ~<l ~ ~ '/!>~ . \0 .<,'y~ / ,<< '<"" / ~\O . ~. , ~ f)O ~ "0 .-<;'6;j~ " . ~6~. ~. ,o'b' ~ o. f't ~. 40,2." I Ir I:> y. loW bv!'l9~ (0<//<>7' ) o t, o ;.~ ~ ~ \, i O. "" ....... ~ S- . .,. ~ .. '? '" ~ ~ 0\'& ~ ~.<(,.. ~'\ '.<. .. r" 1- ~ SURVEY FOR RONALD HANSEN AT BA YVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 87 - 04 - 03 Scale: 1" = 30' Aug. 23, 1996 AREA = 10,030 sq.ft. to tie line STREET 1/97/ ANY AL 7m4 TION OIl ADDITION TO THS SU1\IEY IS A II10LA TION OF $ECTION 7209 OF TIE NEW YGYlK 'Ti67E' EDUCA TION LAW,-... EXaPT AS PfR $ECT/ON ~ Z. ALL CERTTlCAIIVI'Ili "011 AIlE "AUl FOR THS MAl' AID QllIIP T1EREOF OIL Y F SAD MAl' OIl COI'E8 I1EAR TIE IItIf'REIe .tE"AL OF TIE .5lR\lE'YOII lIMlSE' .... TIllE AJW:ARS 1E1/ErI( ADOITIDNALLY..TOJ:lJMf'L r rlTH SAD LA" TIE TEIlII 'AL TEREO BY" 1IJST-.1/E.JJ$ED.&r..A/I(..AJI),ALL Sl.fr\IE'YlRS lJTlJZM A COI'Y OF ANOTIER sunOQrS MAI'. TERMS 8IJQI AS 'ffSI'F:CTW AID 'BIiOUSHT-ro-DA1E'" AIlE NOT 1/ COMPI.JANCE IfITH TIE LAII'. 96 - 208 . ~~1ir"_-T ~ :M:AR INE CONTRACTING . DOCK BUILDING JETTIES FLOATS BULKHEADS PILINGS P.O. Box 1611, Mattituck, NY 11952 631-298-5412 (FAX) 631-298-1814 Job ProDOsal/Estimate Phone: 516-944-8121 Job Name and Location Ron Hansen Date: 9/5/06 Koke Drive Southold, NY Job Soecifications Remove and replace existing bulkhead totaling 102 linear feet Hang 2-B"x6" stingers Stringers are joined together with a 4' butt block and fasten with 4-3/4"x12" machine bolts 8"x14' piles 6' on center %"x12' tie rods 8"x?' backer piles 8" lay logs 3"x6" top clamp C-LOC series 9000 vinyl sheathing 12' in length Sheathing secured with 3/8" lag bolts 2" CCA cap Stringers treated with 2.5 CCA Piles treated with 1.0 CCA Hardware hot dip galvanized Install 20 cubic yards of fill Total Cost $28,000.00 Dump fee additional Pavment to be made as follows: $500.00 on signing, $9,000.00 on start up, $9,000.00 on installation of piles and stringers and balance due on completion AI Ol8Ierilllls guaranteed as to be as specified. A1IW(1l'k to be completed In 8 wortmanllke manner acconIlng to standard pracllces. Any alterations or delillllionS from above spectfIcBtIons InvlllW1l:l exIra cost wll be exeaJIed only upon written rnOef!l. and wi. become an extra d'lalgl) over the above eslImale. All agreements contingent upon strikes, acddents Of" delays beyond our <M1lrol. Owner to cao1er fire, tornado and Oilier ne0ess81) IIlSUl1mce. Authorized Signature ~~ Date: 9/5/06 'We may withElfaw-thi5-jlrGflGsalif-Rat-aooepted-withift-30 days "Total cost subject to change after 30 days Acceotance of Prooosal: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do th~ ,?rk as specified. Payment will be made as outlined above. Signatur(p' ~ Date of Acceptance:/V-O ~oot' , ~ '. " \ t" "i'~';. :_j~F-~.~~.' :F~~r~1 :<;[.l:,ot' .i~{tr . ~~;,;,.. , -fJ(" . -g~.;.~ li1i~. ~ \~i~ ,. Please tear off and rebm1 to the Trustee Office. Board Of <;m rthl"lf rf . T I"IUlM . ,:"",- . ,. -, <~j:~:;,/!, T.............I""II__ " r I ;,,:. . . C__. ., " .., '- ~ .... TERMS llnd CONOmONS . .' ..~:... .' The Pumittee Gertrude Kuck ,-' ..'.;~ . :=:""'g.. Bavview Road, Southold ~._.._._""'~_ N. y~ .....,'~ . ~ of the coosideratioo for .the issuao<e of' the PoaUlt dc.os unclc.-s=d and p=ibc,tg tb= !c!-' ....,..,:, . lowiog: 1..That the Trustee Pennit IlOst)Je prominently displayed on the premises effected thereby durin; the period of \oiOrk under the peoni.t..' "'. '. 1. That the 52id Baud of T_8Dd the Town of Southold axe released hem my 8Dd all .damages, or cWms for damages, of .suits 8rlsiog directly or indirectly as .. result of my opet'- , , o.tioo performed' pwsuaot to this .pemUt,8Dd. the soid Permittee will, at his or bet own expease, '::,,~';~::;, defthend my 8Dd all sucbsuiu lnitialo!d by third Pardes,u~-,theofsoid Petmiofttellthe.......... ~~~~:7.'.r1c. wi _peer thereto, to. th~ complete aclusio. . n of .the~..}~ '. :C>WIl. '" of.............. '. . .' '...",..... ;(.~!i#i:: ,.' .....'_.c...,. "._' -. .', .' .' ....., "., .... ...,.....~... "_'. "'-'-~'''':1>~,.''dtL~I:' 2. 'that this Potmit' is valid for . period of . . 12 . . mos. .;.hich Is ~ to be ;be,}~~:. estimalo!d time tequired to complete the wo.rk involved, but should ~ WIttOltt, nqueot'':- f<'I ".,' lor an cxceosioa _y be msde to the Boatd at . later dace. ., . '.,:; ...,~;k;: . .: ._....' " ,_,.. " ,- .. ." I,: '..; . ';:''''.}.x~i~~ . ~..l:i' ,-; . ':,'h", '._ '~'.tq,.,." .. '''-i,:,>..l~'r~:~;,l-'.;'':,.;.: ......)>~:::::?-'Y( ., 3. That this Penuit should be tetained indefmitely, or as long as the said Peanittee Wlshc;.' . to . ~.ain the .~ Ot, project involved, to ptovide e\'ideace to anyoae coocemed that~~,;~}( !!f, onzauoa was Otlginal1y obtaiaed. ,"'. '., .. '. '.' .' ...."*W.~._~. ; . "~':::<-;,I'.w~"';~"i':".),-.....~..: ': -' .:,. . ,:,,,~'~"Jo,f;,,~I;';'" - .~.":.-;.~.'..' :.~-';':..; . -:-:i'J~~~~{ 4. That dle wotlc involved will be subject to the lnspectioa aad approwl of dle Board ci:'.f,'>~\~:" Us ageolS, and Don-compliaoa: with the prtnisioDS of the originating application, may be """" for '."?n',~"; tevootion of this Petmit by :esolutioa of the saill Baud. . ..",..i ,...;t.~;:<Jt~.. . , . i< .~'j~~1:ii1Z( ~"- ' , ~ 5. 'thar thete will be DO nareasooable interferooce with navigatioa as . result of .the wodc' ':,. ' herein authorized. ~,',. ~.~-';r':"~~', :." -" .'.... ": ,",' .: -, '~,~'.;" :,' "'.1 '~:"~~~<~~~m"'r'-:~;':" 6. That there shaI1 be DO interl'ecence with the right of the poblic to pass 8Dd repass a1..,g '\ "::;itii. the beach betWOOO high ~Iow~ ~,':';:".:' ~. . d""" .::.:q?J}~E1~~~ 7. 'l'bar iI future opotatioas of the Towa of Southold require the l:OmOYlLl amI/or a1toWlons ,.,ia;~'/~.. in the locatioa of the work berein mthodxed, or iI, in the oplnioo of the Boaed of Tmstees, the work shall cause unreasooable obsttudloo to hee navigation, the said PeDnitt.. will be requhed, upon clue oodce, to tomo... or alter this wed< or project berein stated without expenses to the T~':' . of Southold. .' . . . . ,"", '." .', . .::' .,~i;~':!-:?11(" 8. That the said Board will be aotified by tbe Petmiu.. 01 the 'completion of the wo.rk anth~ \!,;;;UX. o~.' , . >.:.:.... }:~:~~-::-.:>' .;,}'.~~~'i;,~.:.~t{i~1::~ 9. 'that the Penui.lee will obtain all other pemnu ~ comeau &at ""'1 be required snp-;;1,~,,9i~ plemeotal to this J!OmftI wbich may be subject to revoke upon failure to obtain same. . ........::~'.;;{y.;~>.~. (See tear off sheet.),. ",.". .... ..... .... ". . " ..... .'. '. . , ~.' ..~~::-:::':.~.~~~~t;!f:~~"\. ~'~ ~;~;A\~~~~.. ,.,.... .~:;~!:~~~~~~:,J: .~.~;'~~~t~~~~~~~~,~~?~:;~~..~.~%:i#~~ ~~r:~~ -;. " '. "';. " ':'\~~t;2' ,:T~/"';r '. i~';1~~r~",~1';',~fiI~~;~'~:;::i';~~!~:~:~; ~: . . .....' .7.....,. ........- . . G.(' lto "-~;-'-. , = " . ./S . '-' ." ~. ~()--r{) Name of Creek: "~' 1l>LEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 GRANDFATHER APPLICATION. 'hc.d-*heM.. 1. Name of Applicant: /;!p/, f/'udp, f( uck 2. Address of Applicant: BK2/"v/ ;;/~ /?~ ,Qul-lJt7/cL /0 -S-rQ/Je/-l-e/19.e,I'<'t/, /YJAN J1;I:L~,pj iVY IIOo~ 3. Telephone Number: fa a '7 - 5:':.:'3. \? - 4. Year of Construction: /9(", q . 5. - Sketch of the work including sizes: //()I 6. Mark off on the map attached, where your property is located using an x. J .... jj ~ Signature: ~~k ~ ! . Please note that there is a $5.00 filing fee, which is a one time fee, for this application. Moorin fee ch lica ewal . . . Board of Trustees - August 28, 1985 - Page 24. 4. Walter J. Cowan, Jr. to secure a permit for a ramp, dock, and bulkhead in Corey Creek, Soutnold. 5. R. Duane Horton to secure a permit for a catwalk, ramp and float in Richmond Creek, peconic. 6. Roger W. Lamour to secure a permit for a Bulkhead in Goose Creek, SOl.lthold. 7. Lois R..Golder to secure a permit for a dock in Jockey Creek, Southo. 8. Otto W.Kosel to secure a permit for a dock in Goose Creek, Southold 9. . Raymond W. Terry., Jr. to secure a permit for a bulkhead and dock ii1:Jockey Creek, Southold. 10. Wilma Solomon to secure a permit for a dock in Goose Creek, Southold .11. Leslie Gazzola to secure a permit for a bulkhead in Corey Creek, Southold. 12. Angela M. Bergen Koepisch to secure.a permit for a bulkhead in Corey Creek, Southold. 13. 14. 15. ~6. 17. 18. 19. George McFadden to secure a permit for a dock in Jockey Creek, Southold. Agnor & Elaine Benson to secure a permit for a bulkhead and dock in Jockey Creek, Southold. Margaret G. Sacco to secure a permit for a Dock in Jockey Creek, Southold. Gertrude Kuck to secure a permit for a bulkhead in. Corey Creek, Southold. Albert Rodenburg. to secure a permit for a dock in Jockey Creek, Southo1d. Lewis R. Perlman to secure a permit for a dock in Goose Creek, Southold. Thomas J. Zukas to secure a permit for a float in Goose Creek,. Southo1d. 20. James J. Young to secure a permit for a float and bulkhead in Corey Creek, Southo1d. ".,,-., ".".", ",1-0 ".".DO "."." 01-1>-0 ",.".. ,."., .."., ,."." L- .' . , ~ 1',0."'8 '.D. ~J ~ !lECK 'M ~t- -, C" " . ~ ~ --" @ 'i> ii . --~~ ~ - ~ [~ : a'r-:-r . rn , _IJ SOUTHOLD srCTIOIlNO L ___"~,,,.. E ____ C_~,,,,,, ~ <-'''''' o ..'"~ -"0-- ......~""--"-- ........""'.... _..'....,,~ --,-- ..__...._"'1__ 'm~""'.._ __.....,.... _. .__ :::7::: ..._~""'..,..-..-- "'...".''''' --.-- --, : ".:C ,":' '~~ ri~".';;" ",TO- """'-~ :::"-",,,,~..m..""_ NOTICE ...."IUhtl:,"-,,,,,....,,,,,,, ;",~~, ~:, ':"i: :,:"" "''''''.''''".............."". .."-"'","""","'",,, COltlTY OF SUFFOLK @ G)RedProperty ilmServ1ce Aoeocy &oi.rllltontt(~~ll1!11 . ',.. .""-'~"H'.. . PROPERTYM1f' --i'-- _.~"",._~ 1211 -- ~...- ".1 ""12~; .~~~ ::.-: '--- -. 087 (E1lIIt1111 1000 """""",.."'....."",,, -,~. ..~.....;:.~.~~".~- . ,. ~ o I- .... 00 0 ::J :;: 0:: >- I- Z C!ll- _ ZW~ 5wO:: -0::< -'1-"- ",NlZlLlJ ,. ili" c f'oo.a::'I""">- c:ow'l"'"":C elf::: OO:s: .g:::J~W .....C)<.oz ;1 ::< . :"\ ,=-> ;,--':: :~ \..'-D Il" ~ \VJ [E ~I 100Q-87 -4-3 MARK HANSEN 34 GUILFORD ROAD PORT WASHINGTON, NY 1105 Southhold Town AP ROVED BOA D OF TRUSTEES TOW OF SOUTHOLD DATE ~/3/ 07 g;( W Z ::::; ~ W "- o 0:: "- "- W 0:: 1-", Zr-- W'" u~ w;: o::-'z w= ~C!l~W ouQ CDoOO S5a:::o:::Z oW-q-< ol-..,.W OW'VU .......a..C'\IO W Z ::::; >- li2 W "- o 0:: "- ~cc ~_~'1\~;~VT ~.~A~,~/ ;;;, I'm/' . ~/ ,cC //( .:--- .. -- _ --f17Il!Ji' , c 82' r=~ --", "-"/STlNG BUL/(HEOAO EXISTING ROCKS TQP_ OF BANK , ,:;t"'1.c,:< --AHW /.:._-~~ /lL' - -', S. AL TERN/FLORA ; j, 1...!.,.-/ .E 1. .. , _#' . --..--- STREET ADDRESS OF PROJECT SITE: 680 WINDY POINT LANE PRIVATE ROAD #2 c SOUTHOLD, NY 11971 ----------Al3N AHW AND ALW ARE AT BULKHEAD WETLANDS DELINEATED BY JAMES E. FITZGERALD, JR. ON 7/12/07 W 0:: o OI 1-00 .+iW cd::: "'00 COo "- "- o 20f CU. YDS. OF CLEAN SAND FILL FROM AN UPLAND SOURCE WILL BE USED TO BACKFILL AS NECESSARY BEHIND THE NEW BULKHEAD, RETURN AND RETURN EXTENSION COREy CREEK Ffooo ~ SCALE: 1" = 20' PROJECT PLAN Application regarding the property: 680 Windy Point Lane, SCTM #1000-87-4-3 Drawn by James E. Fitzgerald, Jr. P.O. Box 617, Cutchogue, NY 11935 631-734-5800 CORPS OF ENGINEERS DATA PURPOSE: Replacement of existing bulkhead and return, and extension of existing return, to maintain adequate erosion control. IN: Corey Creek COUNTY: Suffolk DATUM:MLW AT: Southold STATE: New York July 20. 20(}7 . ELEVATION OF TOP OF EXISTING BULKHEAD LINE OF SEAWARD FACE om"r~'"~"~ ~-v )Ll~ i~ ~ W [E ~.r. . r- , " ' : l\' U u: . ~. - S thhold Town nard of Trustees / /I ' , , 1/;).: I' GMO , ., LAY LOGS B"d. TIE RODS ';."x 12' AHW -.- '" ~ 2 - , 'l" _AbY::!.____ TYPICAL SECTION OF WASH-OUT AREAS TO BE FILLED, 3'f DEEP AT THE BULKHEAD TRINGERS 6X6 . .. ~ t--l. _' I t-- to Q .' 1:-- Q , (0. BACKER PILES B"d. x 7' FENDER PILES B"d. x 14' VINYL SHEATHING C-LOC SERIES 9000 12' LONG MATERIALS TO BE USED FENDER PILES B" d. x 14' 1.0 CCA-TREATED' 6' o.C. BACKER PILES B" d. x 7' 1.0 CCA-TREATED STRINGERS 6"x 6" 2.5 CCA-TREATED TOP CLAMP 3"x 6" CCA-TREATED CAP 2"x CCA-TREATED; S4S SHEATHING 12' C-LOK SERIES 9000 VINYL LAY LOGS B"d. CCA-TREATED TIE RODS %"X 12' HOT-DIPPED GALVANIZED BOLTS 3/B" HOT-DIPPED GALVANIZED SCALE: 3/8" = l' CORPS OF ENGINEERS DATA IN: Corey Creek COUNTY: Suffolk DATUM: MLW AT: Southold STATE: New York SECTION VIEW Application regarding the property: 680 Windy Point Lane, SCTM #1000-87-4-3 Drawn by James E. Fitzgerald, Jr. P.O. Box 617, Cutchogue, NY 11935 631-734-5800 PURPOSE: Replacement of existing bulkhead and return, and extension of existing return, to maintain adequate erosion control. July 20, 2007 o -z.. o ''S o ;, '\ ~ ~ '\ i O. "'" ........ ~ ~ , .,. " .. ~ ~ !J ~ 8A YVIEW ROAD ~ t. #.~~~~t )J~~~~ "" ~(j , ~'< ~ '<~\\~'(. " ~ .p~\,~ ./ ~\O~ .~. .{ .'JO .:/ ';'" ~":J~ ~/. , . C< ~ ~. ~. "c. <"xl q"o ~ "'\ O\~ ~ ~C(,._ ~ ~"<p ~ 1- ~ II ~Q' , ...\.'\ ~ O~ $', :{ <( ; '0 ...\.(' ~o <l' ~ O. 00 ~v e ,~ oo,.x~ f;~ l?-, "..;' \ """ '<;~ v-. 0'" , , ~.;- _<"\e~ \. o. / ~"'*' 1/, / : " ,V ~'i> t- , ~"'<, ~i v~r,~ '\,\ "Yoi> \ 0\'< ~\)<f; ~~. ~~ ~ 09 '. ~ \~ \ ~~& cI" ~"'. ~.~ . ,~.</ ~~UU H~ /\ \'< ~ \ ~\O 4-0.1 ' I !r If> y. 10,," bl//'I90'- (of..I<'^f'J ~ J. , South hold Town Board of Trustees SURVEY FOR RONALD HANSEN AT BA YVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NY. 1000 - 87 - 04 - 03 Scale: 1" = 30' Aug. 23, 1996 AREA = 10,030 sq. ft. to tie line ANY AL TERA TION OR ADDITION TO THS Sl.fiVEY IS A VIOLA TION OF SECTION 7209 OF 71E NEW YORK STA TE EDUCA TION LAW, D<<:El'T AS PE1I SECTION 7209-SUBIJ/II/8/ON 2. ALL CERTFICA T10NS 1DE0N ARE IIALD FOR T1IS MAl' AID CfII'IES T1EREOF IX Y F SAIJ MAl' OR COPIES BEAR 71E Ilif'fIES6C SEAL OF 71E st.R\lf'YGI'I WHOSE SlIIIWA Tl.fIf: APPEARS IDEON. ADDITIONALLY...TO..aJJI'/..Y f/TH SAIJ LAW 71E TERM "ALTERED BY" 1otJ$T.8E./.J$ED.B:r..AN/r.AIIJ.ALL SUM:1'GI'IS UTI./ZIiG A CQI'Y OF ANOTHER-IIIIfI'IEY MAP. TEllIS SUCH AS 7/Sf'ECTED" AM) 'Bf/OUfiHT-TO-OATE" ARE NOT IN COII'/.JANCE WITH T1IE LAW. 'PECONIC S (516) 765 - 5 P. O. BOX 909 1230 TRA VELER STREET SOUTHOLD, MY. 1/97/ OR _ "nQ Proper- T Permit Services P.O. Box 617, Cutchogue NY 11935 Fax: 631-734-7463 Phone: 631-734-5800 MEMORANDUM DATE: July 23, 2007 TO: Lauren - Trustees' Office FROM: Jim Fitzgerald SUBJECT: Ron Hansen; SCTM #1000-87-4-3 Attached are four copies each of the Project Plan and Section View drawings Mr. Hansen asked that I prepare for this application. He asked that I give them directly to you, in anticipa- tion ofthe review of his project at the Trustees' meeting on Wednesday. ~J; CG ~ II ~1 It~ffiI irul ;,',' ::,,! IJ!, SlJutllold Town BOJrd of Tr~step.s . . OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY ~~ \'If SOlJl/t ~ ~.~\ . . ~ ~ ~. ~) '?'-fCOU~ MAIUNG ADDRESS: P.O. Box 1179 SouthoId, NY 11971 Telephone: 631765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTHOLD MEMORANDUM From: Mark Terry, Principal Planner L WRP Coordinator ~.~ fE ~.. fE_ ~ ~JLrm l'" '" ! L' . --' I .__._J : So\'ti10id To'~..n I Fc",d of TniS!?'s ...J To: James King, President Town of South old Board of Trustees Date: June 4, 2007 Re: Request for a wetland permit for MARK HANSEN. SCTM#87-4-3 MARK HANSEN requests a Wetland Permit to replace the existing bulkhead in-place with vinyl sheathing. Located: 680 Private Rd. #2, Southold. SCTM#87.4-3 The in/like 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 South old Town Code 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". The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the 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 LWRP review. ..". . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 Office Use Only ~oastal Erosion Pennit Application :~Wetland Pennit Application _ Administrative Pennit / _ Amendment/Transfe IE tension V Received Application: tI. r> 7 :zReceived Fee:$ c? ' _Completed Application _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ _Coordination:(date sent) ~LWRP Consistency Assessment Form 51~Jo1 - ,cAC Referral Sent: $1'6')01 ..l.fflte oflnspection:----k/, 3 NJ _Receipt ofCAC Report: _Lead Agency Detennination:_ Technical Review: Aublic Hearing He~ Resolution: ~~(cIEIWIEW I f ,~\i n.^, ,. : - 4 LuG7 0 Soulhhold Town Board of Trustees NameofAPPlicant~Dr \<' 8anst'-I'1 Address ~4 Gu.lltb(d~ I/)CLSh, ()~n ( J.J'f IDS-O PhoneNumberF/~ ql/-I./-- ~/;)'I ~7/-'-/ -3 <Y>~ Suffolk County Tax Map Number: 1000 - Lj1?J g g 9 Property Location: iPgO Pr/va.J-~ Rd,.:#' J. AGENT: RDnctld fr (fY~ Q ~ ,,,,,f) T ,;/1 ....... ~rd of Trustees APPlicati~ GENERAL DATA Land Area (in squarefeet): /0. (J --~O s~ 1)1, ( ~ Area zoning:_R {J ~ I'J e f7 f1aJ Previous use of property: Q.e~ I'J en+i a..-/ Intended use ofproperty:_K e s ('de nt- i' Q I Prior permits/approvals for site improvements: Agency Date _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or susP/ed by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): ty,.t's+i() CJ bu I k h eQ d - G V'a(\d2aih e ( {Ilau 6 e. :tt dO (p 5" M7;/ r:.4oo YElJ./e.P roo/) ~A/.>'i jl;k~~c 1rJ.I It- ), l?/V~/j ..... ~rd of Trustees APPlicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:~( o..c e ~ (1- i s t 1(")5 bu\ ~hpo A Area of wetlands on lot: J () t-/ square feet Percent coverage of lot: I % Closest distance between z,earest existing structure and upland edge of wetlands: 5 feet Closest distance between nearest proposed structure and upland edge of wetlands: to5 feet Does the project involve excavation or filling? No / Yes If yes, how much material will be excavated? '-I D cubic yards How much material will be filled? ;) 0 cubic yards Depth of which material will be removed or deposited: (p 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): 'lIIf' ~rd of Trustees APPlicati~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Re fLl a (" P DllLkh~~J e,,/,us-t/()3 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? 4-0 (cubic yards) How much material will be filled? dO (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation ofthe project as proposed. (Use attachments if necessary) PART 1 . PROJECT INFORMATION I- SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by Applicant or Project Sponsor) . I PROJECT ID NUMBER STATE 617.20 APPENDIX C ENVIRONMENTAL QUALITY REVIEW SEQR 2. PROJECT NAME 3.PROJECT LOCATION: Municipality County Su+> 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks 5. IS PROPOSED ACTION: D New D Expansion ~MOdification I alteration 6. DESCRIBE PROJECT BRIEFLY: e{!p{ace €.-r.[' ~-f inCj bu t kh e.Q d' /VI 711 f/;f/Y/" Jl#p/1T!liI"t' /' 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? E:fves D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY [iZf Residential D Industrial D Commercial OF PROJECT? (Choose as many as apply.) DAgriculture D Park J Forest I Open Space DOther (describe) 1~. D ES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER AG CY (Federal, State or Local) Yes D No If yes, list agency name and permit I approval: Ve: C- GOVERNMENTAL l1~S ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR ~Yes DNa If yes, list agency name and permit I approval: -ioWA G,q..i1~~er PerMI'ttl dl..O&5" APPROVAL? 12 AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? es DNa I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature Date~~CI) Applicant f Sponsor Name 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 ITo be comoleted by 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. DYes DNa 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 another involved agency. DYes DNa 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: I I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or fauna, fish, shellfish or wildlife species. significant habitats, or threatened or endangered species? Explain briefly: I I C4, A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: I I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I I C6. Long term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: I I C7. Other impacts (including chan es in use of either quantity or tvpe of enerav? Explain briefly: I I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If yes, explain briefly: 1 DYes 0 Na I E, is THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes eXPiainl DYes DNa I PART 111- 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 (Le. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, 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 one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL 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 actio 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 Pnnt or Type Name of Responsible Officer In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Pre parer (If different from responsible officer) . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, If. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, /VI "i ~ h H'1" J ~ , , residing at <- ~ i..-;&,> L<;1t' A/ ",.,..)- ( fh 57 It!'> IV '7 being duly sworn, depose and say: 1/7c-] . . That on the "3 day of "514'1 c , 2007, 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 ofthe public hearing. Date of hearing noted thereon to be held Dated; /07<:- ~ v/ L- /. (signature) ~ ~ Sworn to biDfi e me this :)'- dayo~ OOr yq -c JANO&GELLEN NOTARY PUBLIC. State of New Yolk Nu.493366B Notary Public Qual1lled In Westchester CounlY Certificate Aled In New York CountY Commission ExpIr8l August 15, 2010 . . PROOF OF MAILING OF NOTICE ATTACH.cERTIFIED MAIL RECEIPTS Name: Address: ST ATE OF NEW YORK COUNTY OF SUFFOLK f1qr fL H'7J?.Jc'I ,residing at2:? 1-.'0-'" ..i.'He. VI- - H u-!!)'i~7/""u/Y.7--J/74? uu,lLeingd!l1xswomL~hmQ!l'<~_l\Ild~ays that on the 'l.- I day of fVJ47 ,2007, deponent mailed a true copyoftheNotice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town 0{ Southo1d; that said Notices were mailed at the United States Post Office at fp...J- /Y'--:,v",,,N" ~ that said Notices were mailixI to each of said persons by (certified) (registered) mail. / 'Y ~h~ .- ~ Sworn to before me tins. c>lt ~ Day of '-111 tr ' 20 ~ ..~ ~~ fkfiJiJ N tarypubliV INGRID G. THIEL NOTARY PUBLIC STATE OF NEWYOflI( NO. OHH6000750 QUALIFIED IN SUFFOLK COUNTY -" tl COMMISSION EXPIRES DEC. 22, v / Town of South old . . 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 South old 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 South old Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the L WRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listine both supportine and non- supportine facts. If an action cannot be certified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. A copy of the L WRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM#~- q J PROJECTNAME 1<flh/JDF B1. JI/T//V/J. ~jJ;(;J~/flJJ J1joJ'jf JlilhQ1!/j1J1! The Application has been submitted to (check appropriate response): \ Town Board D Planning Board D Building Dept. D Board of Trustees @J 1. Category of Town of South old agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) D D (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: D Nature and extent of action: 'J{ eJ'),/J(}j; Y//l'Ij, JlllnTII/IVt' . I:X/J#7//Vt1 15(/),,1' /lfi'?A~, 11//711 , Location of action: . l <to 10/11'-0\/'7/7/10 ~D , , . .10177/10111> Site acreage: Present land use: n EP /l) e 4/1 L. Present zoning classification: 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: 'l<fJ/'"lfhb (b) Mailing address:, fJl t: t/ If., f'@!J , fl.)\; / JOt)O I . )/;,.N.Jer 7J..J) II~ /VI?JJ/II/VUt./V I (c) Telephone number: Area Code ( )(f'J t) 9 Jj ~ I?J cR / (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes D NoKJ, 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 m~ni~izes adverse;lffe ts of development. See L WRP Section III - Policies; Page 2 for evaluation crIterIa. DYes D No. Not Applicable 1Jrj..J ,p;:!(J,/I ~ 1././1 E C/;::' t!<J -/,f?;; l.. J.. LIt? /7 ~/J/L- Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See L WRP Section III - Policies Pages 3 through 6 for evaluation criteria DYes D No ~APPlicable 1l1~- /= I/b- - tl{. -.II ~JY;71/rl ~ ~~~~41(1,eL Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of South old. See L WRP Section III - P~ Pages 6 through 7 for evaluation criteria DYes D No E::J Not Applica~ ----.t2lt>7 -e-iT Jd-e ~ J ~ 7<..~ CI-f2EJ Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See L WRP Section III - Policies Pages 8 through 16 for evaluation criteria DYes D No ~ot Applicable tv 1fT tffi;a!' 7) e.' C/ uP U? J J:::h IJ J77 A 0(1" I ]-vi/if eJ? () JI / () ^ Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See L WRP Section III - Policies Pages 16 through 21 for evaluation criteria DYes D No UJ;;ot Applicable /~(/v;; jv-hU:~ av;tJ../7)/ 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. D D g Yes No . -Pn{JTP{f/ C>LU/Fi!"f-; ~/'r&/l--{!7f()1v 6~ 71k ~/l/~/ Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. DYes D No u.:t'Not Applicable Thc:Tl2~{ .q- / m7A-C/Vb 11-1"" CUd; 1- J ''1 Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. DYes D No ~ot Applicable I mll"/!lJ/:lE 1:?1'-//'jJ2 f/I'-J'?J;:-""TIII- DE/JyJ-4/)/Y711#h C.r:- A/ nT r.12 ,fl PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See L WRP Section III - Policies; Pages 38 through 46 for evaluation criteria. DYeD No ilJ Not Applicable ~j{a J</JTIf/""L uJ.? vr fv7JTtfl. If Attach additional sheets if necessary WORKING COAST POLICIE_ . Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See L WRP Section III - Policies; Pages 47 through 56 for evaluation criteria. DYes 0 No ~ot Applicable __ /vj? )t../ Iv 11' T?Jl. 7J..;;;7' B f" P ~r-t Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria. DYes 0 No @NotAPPlicable, 1 /.f.taI IJ Iv / IV t- 17l1/J11rv~ 7<E.Yo../llaj; .)' Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See L WRP Section III - Policies; Pages 62 through 65 for eva~ion criteria. DYes 0 No [H' Not Applicable .-- f[lf;~ 19/JJlI t!YJ.7';{2'f'1- A /'h-.. /) II Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See L WRP Section III - Policies; Pages 65 through 68 for evaluation criteria. DYes 0 No d Not Applicable t7F J:7I'-'PA Il)/-r /?;?/~~~9<.f!:?,~11j;f l/J./i- tj-b,pt-'$AF?#lPY' PREPAREDBy~~cd~ TITLE~ ,h}{/el'r DATE.1;-=~07 .~..<..... : .- .oard of Trustees. APPlicatW AUTHORIZATION (where the applicant is not the owner) I, JJo(\< Hansen (print owner of property) Ikt Wash /fJg1ofl fJ1110S{)dO hereby KMYlrJ UOflSen residing at.9~ (9ull+vrd r<d (mailing address) authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ;~~- - (OWner's ~nature) 8 . . APPLICANT/AGENTnREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of South old's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emDlovees. The nuroose of this Conn is to orovide information which can alert the town of oossibte conflicts of interest and allow it to take whatever action is necessarv to avoid same. YOUR NAME: (Last name, first name.-I11iddle initial, unless you are applying in the name of someone else or other entity, such as a company. Uso, indicate the other person's or company's name,) NAME OF APPLICA nON: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning 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 emplo e has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 50ft of the shares. 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, paren~ o(child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applic\ll1t (when the applicant is a corporation); _B) the legal or -beneficial own~r of any interest in a non...c;orporate 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 Signature. Print Name 200 :) :,I Fonn TS I " ~ Board of Trustees A~ication , County of Suffolk State of New York Mc,r k I-hl'Jf~'1 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 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 REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~1- :!K Signattffe SWORN TO BEFORE ME THIS 2- DAY OF !//c-""..4~ ~ ,200t: JANO~ GalEN NOTARY PUBLIC, State of New lbrIl No. 4933888 Qualllled In We8fl:lle8\er CcIunIJ Certlflcata FlIed In New lbrIl County commIsslonF~~1911t1"20~~ Notary Pu he --z.,1.--{ Crt\ J ,r- \i,... , ~,' ~" I' (' ': ,~ . .' "