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Home My WebLink AboutTR-6814 . . TERMS AND CONDITIONS The Permitte.e Debra LaChance, residing at 514 West 29th Street 2nd Floor, New York. NY 10011 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 Pennittee 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 Boh 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 February 27,2008 Mr. Robert Lehnert Peconic Permit Expediting 32645 Main Road Cutchogue, NY 11935 RE: DEBRA LACHANCE 630 RUCH LANE, GREEN PORT SCTM# 52-2-26 Dear Mr. Lehnert' The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 27,2008 regarding the above matter: WHEREAS, Peconic Permit Expediting on behalf of DEBRA LACHANCE 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 January 17, 2008, 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, the LWRP Coordinator issued a recommendation that the application be found 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 February 27,2008, 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 have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of DEBRA LACHANCE to rebuild the existing steps to the water in-kind; replace existing deck at top of stairs with new 30 square foot deck, with the condition of a 10' non-turf buffer along the top of slope, the platform to be made with untreated lumber, the steps to be made with an open-grated material or untreated lumber, and as depicted on the site plan prepared by Peconic Permit Expediting, last dated March 3, 2008, and received on March 4, 2008. 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, ro?~ :James F. King President, Board of Trustees JFK/eac . . 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 sl day of construction % constructed ~ Project complete, compliance inspection. . . 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 De-bra. LQ{j,o.n~ TO: Please be advised that your application dated SCVlua.r has been reviewed by this Board at the regular meeting of vloI ~ 7, dCOO and your application has been approved pending the completio 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) Y:z Constructed ($50.00) ~Finallnspection 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: - aU TOTAL FEES DUE: $ !:J()-- BY: James F. King, President Board of Trustees . ~ Donald Wilder, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southo1d, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., February 13, 2008, the following recommendation was made: Moved by Glen McNab, seconded by Don Wilder, it was RESOLVED to SUPPORT the Wetland Permit application of DEBRA LACHANCE to rebuild the existing steps to the water in-kind. Replace existing deck at top of stairs with new 30 sf. deck. Located: 630 Ruch Lane, Greenport. SCTM#52-2-26 Inspected by: Glen McNab, Jack McGreevy The CAC Supports the application with the Condition open-grated materials are used on the decking, a 10' non-turf buffer with natural vegetation is installed landward of the top of the bluff, and measures are taken to control erosion at the bottom of the bluff during construction. Vote of Council: Ayes: All Motion Carried . . 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: DEBRA LACHANCE requests a Wetland Permit to rebuild the existing steps to the water in-kind. Replace existing deck at top of stairs with new 30 sf. deck. Located: 630 Ruch Lane, Greenport. SCTM#52-2-26 Type of area to be impacted: ../ Saltwater Wetland Freshwater Wetland Sound _Bay Distance of proposed work to edge of above: Part of Town Code proposed work falls under: JChapt.275 _Chapt. 1l1_other Type of Application: ./ W etland _Coastal Erosion _Amendment _Administrative _Emergency _Pre-Submission _Violation _Planning Info needed: Modifications: ~(~J IN i D' ,1 ( "p t ' -.... \ C)Il- Conditions: Present Were: _J.King ~oherty _P.Dickerson_D. Bergen~GhOSiO, Jr _H. Cusack_D. Dzenkowski _Mark Terry_other Form filled out in the field by Mailed/Faxed to: Date: Enviro~tal Technician Review as prev/iJl{.J/l-J cy r 11-<:), r I1A S tG0 oJ k2J -f1sv .f I tM--h";} f 10, r1 "Yj f"'L <' ~ .1 ~ Ii i=- ~ f=::- f- t --, , ~ ~I -i=' :, ~-----i!-- """"'-.on """0."'. .....,......, /\ i -N- 'i I' I Ii ,I ! lL. r' 1 .- J' 0- 'C+. " " "'C J'~~Q.? ~, , ,~" ?,(() 'Q,,/?, "', ." ". / / ~/ ,,'l{,:'v /'" ",.'''''''''....0 ""","~" ",," ) , "'.."0' @"<'~ ~I "".c.'" { " ...",,,, , \i --')') -;' lr;~t) 0.:<tl,o " . " iI -. '",""c..., ",,,,-0."'. ,...".... , . ; ~, >i'_"" --~--""~-- -------r---,... '""" .1 , 'I "I "c."'.," ~i::~':":':" -T-- =~::~~.. ::= ~;.= ~ . COUNT; OF SUFF~LK CD ~ TxServlceA(Jency .-, ReolProperty a ",",o,"'l1'Ol .~j:: ,,,,..,,,con,:.,,:;,.,'{,, -- ~~..- ,..." SOUTHOLD .~l'ONNO "r:f" .,,, ~ I , '" ." ~ I, :;: ~. ~.~"";- '~~~~~~i:,~~~_ 052 NOTICE --' __,~ -'000 . . OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTH OLD MEMORANDUM To: James King, President ~ Town of Southold Board of Trustees Mark Terry, Principal Planner L WRP Coordinator ~~f: ~5DUW From: Southhold Town Board of Trustees Date: February 22,2008 Re: Request for Wetland Permit for DEBRA LACHANCE SCTM# 52-2-26 Peconic Permit Expediting on behalf of DEBRA LACHANCE requests a Wetland Permit to rebuild the existing steps to the water in-kind. Replace existing deck at top of stairs with new 30 s.f. deck. Located: 630 Ruch Lane, Greenport. SCTM# 52-2-26 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review ofthe Town of South old Town Code and the Local Waterfront Revitalization Program (L WRP) Policy Standards. Based upon the information provided on the L WRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the below 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. . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Coastal Erosion Pennit Application :z Wetland Pennit Application _ Administrative Pennit Amendment/Transfer x!~ion L~eceivedApplication: I /70)5 -LReceived Fee:$ ........-completed Application I . _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) _~ Consistency Assessment Form / J~~t:)a _eAC Referral Sent: -M,~O'& _".mile ofInspection: ~/~Y5 _Receipt ofCAC Report: _Lead Agency Detennination:_ Technical Review: _-Public Hearing Held: :lJiJ.IJ~'i; _Resolution: Office Use Only ~~J~,,~llW~~ Scu~'~'i\lQjd lown rl"~rd d Trustees Name of Applicant Oe brei( Address Sf " Iv! , tOrJ// tv~,,+A La ?4dl? c..e ?-I-r~j. 2nd.. Floor -' Alerv Yo,. k , Phone Number:( ) Suffolk COW1ty Tax Map Number: 1000 - S.2 - 2 - 2 0" Property Location: 63 tJ fveA I-RI1e I c:r<:-&l1nor f , . (provide LILCO Pole #, distance to cross streets, and location) AGENT: fJeconlc P-crml..}- E~jJ(A,I-,,,,<j , (If applicable) Address: 3.2- (" 4 ~ /V1c;;/Y'I /fA , ~v./-"h pc,/.I:e J 1/"/ / -, Phone: 73 tJ - &'3 rr / C~(\~ ~~l\9.6'\o j ~ard of Trustees APPlicati~ GENERAL DATA Land Area (in square feet): 7, t:f! 3 5,F, - Area Zoning: f( - If () Previous use of property: 12 -? 5/ d ('v) c L Intended use of property: !? C'5/d-r.n C€: Covenants and Restrictions:_ Y es If "Yes", please provide copy. X No Prior permits/approvals for site improvements: Date -pumrl-4t (in":3~Pr ~/J3IlJ 1- ~~~Bldjbept: _permrrl:t 3~Fl0 Z 1lJWN CJ=~/d 6Id~ T:xpt'" pe-Ylltlt-tt: 31"1-5 J Agency ff'fMl"> tl~7DWtJ Wlh~ 10/3D/Dr Ih1/~ , _ 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): I? e. bllt JJ.. -eXI5I,Yl<; "'.)CA5 +0 WPiI-?/' IYI kJt1d. - , f( -Cf I tff? t:- eX /'5/"75 PI. ~c f ~ f j., fI 0 I -5h:rIl'S vI_oj/, nt:w 3tJ 5P ~~ck. '. ~ard of Trustees APplicat~ WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Rdlll/j ex. 1'5 ,i, n7 ~ ,L-(A~ f .fCJ IV,,; ./-c r 1ft KInd , I?Mh~t:.- eXI~.)"'5 dak , -'fl- f,:,1' pf ?ku/5 );vI)). nt."f,/ '50 ~F t1~ck Area of wetlands on lot: 0 Percent coverage oflot: I 'If S- square feet % Closest distance between nearest existing structure and upland edge of wetlands: 7 tf.,; S- feet Closest distance between nearest proposed structure and upland edge of wetlands: IV / fr feet Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? IV/,4 cubic yards How much material will be filled? N / I/- cubic yards Depth of which material will be removed or deposited: AI/If feet Proposed slope throughout the area of operations: !/ /1}- Manner in which material will be removed or deposited: !oJ I ,4 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): Th e rc- VV" ).~I'~ -eX J7-l w,// be fhe. no 7.Jt'~? , /I ~ ov &: tI-e" I- l c1~~/'\ tin -hovY} CldY~III/y a.~ ~ard of Trustees APPlicati~ COASTAL EROSION APPLICATION DATA Purposes of pro posed activity: 1<&-6(// J) ell J'S .J,n5 '5 ~-'s b 'A1i;kr In kind, f((l'lt!?t(;. e:Xli.fln5 Jklc.r-t /ClI',1 ?f~l'~ .,., H 1'I.e.., "3 # $ J:; Al'e& k, Are wetlands present within lob teet of the proposed activity? No X Yes Does the project involve excavation or filling? x No Yes If Yes, how much material will be excavated? ~ (cubic yards) How much material will be filled? o (cubic yards) Manner in which material will be removed or deposited: J..I / /J Describe the nature and extent ofthe environmental impacts reasonably anticipated resulting from implementation ofthe project as proposed. (Use attachments if necessary) There VVI / / C () n., {rve .)./6>7 Mp} 'ft" if y 1 I v , t.e (J/t'ft'e a & v Yf elt )../ Y / p.e- /10 (fI1M.-I?" I CornLJ Ie It) ,4.? y t?1 fit-/:- J!/tJO,5Qj 15 , , 5' In-.dvle Ik, /- 15 eXJ1/U15' -r-.J.kr /'7 14e.. fo . I . I PROJECT ID NUMBER PART 1. PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by Applicant or Project Sponsor) SEaR 1. APPLICANT I SPONSOR [}epr"l [", ?htffYJ Cc. 3.PROJECT LOCATION: Municipality ~.t? r./f, A <1 J. 2. PROJECT NAME j, 0 t'h " n c '-- 5"v XI k 6'.f.-t' ~ County . 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ete - or provide map 63CJ 1? Vc k lane.) Gr~el'l~lIr f / p,/ 5. IS PROPOSED ACTION: 0 New D Expansion ~Odification I alteration 6. DESCRIBE PROJECT BRIEFLY: R~/;{/dJ ..e)()1 j) 17~ '5ltp~ 1(1 w",./.cr In k mA , f{~)ao-e. e Xl5 f,n5 Auk 41- /-"1' pI '5f</~ wI./h ne'V 3,5F )~C I\, 7. AMOUNT OF LAND AFFECTED: Initially ? acres Ultimately I / tf acres B. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS7 ~ Yes D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY ~ Residential 0 Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) DAgriculture D Park I Forest I Open Space D Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) DYes ~ No If yes, list agency name and permit I approval: 11. DOES DYes ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR J:,;8[NO If yes, list agency name and permit I approval: APPROVAL? 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? []v es No Applicant I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF 7't- t~~ 1/ fr r MY KNOWLEDGE Date /-/15 -ol? 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 ITa be comDleted bv Lead Aaencv) 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 ONe 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 ONe 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 " ^. ^^ M^.^~ ~ _MM. I C6. Long term, short term. cumulative, or other effects not identified in C1-C5? Explain briefly: I I C7. Other impacts (including chanQes in use of either quantity or type of enerav? ExDtain brieflv: 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: I DYes 0 No I E. IS THERE, OR IS THERE liKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: j DYes ONe I 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 othelWise 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, 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 tD 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 Preparer (If different from responsible officer) r James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. ~ BOARD OF TOWN TRUSTEES OWN OF SOUTHOLD CJ CJ CJ CJ Retum Recelpt Fee {Endorsement Required) c:J Restricted Delivery. Fee ....=t (Endorsement RequIred) r'l rn -, ' postm~ .~\ Here \' ~ " !~) \ \ ~~ ,/ / ,~/ ,,,,-,,jj..'/ eertIf\9CI fee $0.00 $5.21 Total postage & Fees U1 CJ CJ ['- o Agent o Addressee C. Date of Delivery '8SS different from item 1? 0 Yes ellvery address below: 0 No o Express Mail o Return Receipt for Merchandise " OC.O.D. .ry'? (Extra Fee) 0 Yes ~765 3532 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 ~ [F~ ~ 2" U ~ South hold Town Board of Trustees J?.). 1 0259S.Q2-M-1540 f known as . .........- .,,,,,,c;,J G,~e" LJ,j1'7- by placing the Board of Trustees official poster where it tan 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 illxl. '1P(" oJ\ dD~ - 1), on (On 0 DLl fLo){XJ 'fl/, Dated: Sworn to before me iQis 2tMp,ay offDJ 200 J> '''I... Me..ffY\' IfOfAly 'U'lIC"Mq OF NEW yor No. 02MC6J3) 514 QUOIHieelln . My C. U"O/k Coun,y ornm'Sllon f .. .""e. Augu., Q, n , .;... . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: ~'[f~ ~2U U@ South hold Town Board of Trustees STATE OF NEW YORK COUNTY OF SUFFOLK tzi1;J~;""r ., day of ',6 , 20118 , deponent mailed a true copy of the Notice 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 of South old; that said Notices were mailed at the United States Post Office at C"/'r.!,,,?t:.. , that said Notices were mailed to each of 'd persons by (certified) (registered) mail. ,residing at "~I"IS- /I11i11J fd , being duly sworn, deposes and says that on the swom~~s 13771 Day of , 209r.- QfL t;g.4-- ... t. MC..m ~ "*Ie...... Of NIW YOlK Mo. tIlIIlCtlII1l4 "'0Il11H 1lI1uffol1l CQ\lllly ._ ~''''lIlJ1'.n ..... o\u8UIt... ,DOt Town of South old . . LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS I. 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. listinl!: both supportin!!: and non- suooomn!!: 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# 52 2 - 2. If' PROJECT NAME t,lf ~J, A nit.. 5' .)~.d ~ , The Application has been submitted to (check appropriate response): Town Board 0 Planning Board 0 Building Dept. 0 Board of Trustees .181 I. 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) o o (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: ~ Nature and extent of action: In dl ki (II}"- '5 h",~ , /(ebIJl/) /I.~f/,MC- IN/fA eX)'} /'05 '7 t9'7~ ~xJ111n..J d~~1r ".f JtJ ~0 deck +0 IN'" .)1:''- fOJ? , ne-v . Location of action: tf3~ l?ubA tan~ Site acreage: " I g a crc5 Present land use: R ~5J(/1t"f) (-e Present zoning classification: t - 4 tJ . ) tf"r-t!!~I1-/t" f 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: /Vr:w o e /;/" 1ft ~/" W:;'1- Ih I All', J ~~J) , /..-",c ?/'4nCe "ihce f J ~ 'riA I PIt/Dr J (a) Name of applicant: (b) Mailing address: 'It; r A (c) Telephone nwnber: Area Code ( ) (d) Application nwnber, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes D No~ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See L WRP Section III - Policies; Page 2 for evaluation criteria. DYes D No []f Not Applicable 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 ~ 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 DYes 0 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 L wRi> Section III - Policies Pages 8 through 16 for evaluation criteria DYes 0 No JZ1 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 evalnation criteria DYes 0 No IZlNot 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 L WRP Section III - Policies; Pages 22 through 32 for evaluation criteria. o o ~ " Yes No Not AP!able . Attach additional sheets if necessary Policy 7. Protect and improve air qnality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. DYes D No ~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. DYes D No IZJ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See L WRP Section III - Policies; Pages 38 through 46 for evaluation criteria. DYeD No IZI Not Applicable Attach additional sheets if necessary " . . WORKING COAST POLICIES 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 ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria. DYes 0 NoL81 Not Applicable 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 evaluation criteria. DYes 0 No i:8l 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. DYes 0 No @ Not Applicable PREPARED BY Rob &.1- ,t~"tr.J-- TITLE ~~... f DATE I-JP-CJ.R ., . . APPLlCANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of South old's Code of Ethics orohibits conflicts of interest on the Dart artoW" officers and emolovees. The numose of this fonn is to nrovide information which can alert the town of DOssible conflicts of interest and allow it to take whatever action is necessarv to avoid same. R ~ b<f' f t<hm,. t- (Last name, first name, -I1liddle initial, unless you are applying in the name of someone else or other entity, such as a company. Ifsa, indicate the other person's or company's name,) YOUR NAME: NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (Jf"Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning ')(. Do you personally (or through your company. spouse, sibling, parent, or child) have a relationship with any officer or employee afthe Town of Southold? "Relationship" incJudes 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. X NO YES If you answered "YES", complete the balance of this fonn and date and sign where indicated. Name of person employed by the Town of South old 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 herspouse, sibling, parent, or child is (check all that apply): ~) 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 S~bmilted~~ 200.? Stgnature . Print Name ,.. II"... r Form TS 1 aoard of Trustees APPlica_n AUTHORIZATION (where the applican.t is not the owner) I, O-ebr;t.. (print i~ ?J,~I? C~ owner of property) residing at 5"/ f- WL/f-l;' ~ he-e-~ (mailing address) /11-&>1/ x'r k. , NY , . do hereby authorize (Agent) Pt:?"" 1(; fJ~on/1- ~'Yc./, ~~to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ~ "C~~ , (Owner's ~ignature) 8 . . Board of Trustees Application County of Suffolk State of New York R 0 /; -e,..1- /..-e h n~,. +- 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 illS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TillS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING TillS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TillS APPLICATION. /~ SWORN TO BEFORE ME TillS I JO.; DAY OF . -1';:;"'~ ,20 tJf fJd::c 12. -UI~ Notary Public ..". .. Me"'''' NOMftIUlLIC.I"''11 Of NEW YOlK No. QIMC.UllU . ......-a In IuItOIl& County .",'CI T ''''In..... ......' .., lOOt SURVEY OF PROPERTY SITUA lEI ARSHAMOMAGUE TO~: SOUTHOLD SUFFOLK COUNTY, NY ~ ~ J~H ~ : ~~ ~ SUFFOLK COUNTY TAX # 1000 - 52 - 2 - 26 CJaRTIFIBD TO: Debra laChance Southhold Town Board of Trustees N W+E S SURVEY 01-26-2006 UPDATE 0<1-05-2006 DIM. H.M. 10-le-2006 :'<." o t">i':'''' ",(/Jl 0' ,(/J '< U 0' 0" V! O~& ~() ~!:' &,~c:' v ~\~&.fJ " 0 ^ <"0 ~~eJflJ0 ,~'lt:? v:T,~Qj0 ~6-~0 .>: sllJ00 o 00 '-' Ii/" ~~ ..... b~ .....',,~ ..... .... ........... " , ....... ' ..... ...... .....' , .... .Ill ...... , '-" ~'... ... ....-..,',.... , " ,...,..." ..... .... ...... ....... c: ~ '. " "', " "', ",-........... co~ '-" ~,~a' ..." ',"'" ..................... ........ ql,..$,.: ~ \ ... -06 .k-'" "... ...... ......... ...... ('... "', .... ... .. " ... ~~%"'..." ... ................... - ,;:". " .~ (::) ... ...... -... ... ....... -~~ ~~ ~~~"", s< ............ ',,- O'r' , "~~~ "'~ - ..... ..' -~ ...........~ .... :<,; ".I.~ ... I!!S " ...." ... -... &') -~ ... - ~ '...." ... .... - - ...... .............. A... ..., ... " ........ .- ... -- ~ ........... '.......... '1"-: , '-,-- 41" ~.t.9~ I~"'" ..... - - ~ ~--, ~ItQ 1t.9~~~',<_, ~"'O"" ~.to~.J -'-- ~9ve ~ O"'q' ~ :'<." o 2'~ l",(/J 0' & ' '< (!J 0' lJ' l!:,(/J ~.{ l) (J v NOTES. . --_...._""''''o~ """'1o.~~~:;:,.";:"",lt:. -y----~,. o MOi'UMENT FOUND PIPE FOUND \\ ~-r:.~;r:~--., ~- _ t. ..--...'" ~ =e: -' ELEVATIONS REFERENCE N6VD';2<l ZONED R-40 ~~~':::: ~Gc>doI;,r~;:f"'I.Qod~-,- 1"!I1Iw_T_!t<Q...........""''''__ ~~~."""~urt~~~ :..;.:;~~-~:-.""'Q~ l<>t=.~..:.:-~== AREA = 1.<leB sf or o.le acres 6RAPHIG sc..ALE ~ 1"= 20' I JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. llC. NO. 50202 RlVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF. \\Compaqserver\pros\03\03 238.pro