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Home My WebLink AboutTR-7042 Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: ~-~Ch. 275 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain __ 1st day of construction ~ constructed V//Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 South°Id, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0622C Date: March 10, 2011 THIS CERTIFIES that the replacement of existing wood bulkhead and wood retaining wall utilizing PVC bulkheading At 575 Beachwood Road, Cutchogue, New York Suffolk County Tax Map # 116-4-21 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated 12/22/08 pursuant to which Trustees Wetland Permit #7042 Dated 3/18/09 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 replacement of existing wood bulkhead and wood retaining wall utilizing PVC bulkheading The certificate is issued to MARY R. RAYNOR owner of the aforesaid property. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghost. o, 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 POSSIBLEREVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ¼ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMYF NO. 7042 DATE: MARCH 18~ 2009 1SSUED TO: MARY R. RAYNOR PROPERTY ADDRESS: 575 BEACHWOOD ROAD~ CUTCHOGUE SCTM# .116-4-21 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 11 l of the Town Code of the Town of So~thold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on March 18~ 2009, and in consideration of application fee in the sum of $250.00 paid by Mary R. Raynor and subject to the Terms and Conditions as stated in the Resolution, the Southold ToWn Board of Trustees authorizes and permits the following: ,Wetland Permit to replace the existing wood bulkhead and wood retaining wall as exists utilizing PVC bulkheading, with the condition that a silt boom is deployed prior to and during all intertidal operations, and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated August 18, 2008, and received on December 22, 2008. 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. TERMS AND CONDITIONS The Permittee Mary R. Raynor, residing at 575 Beachwood Road, Cutchogue, 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 ai'ising 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. 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. 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. 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. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 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. 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 Pennittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. 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 Annex 54375M~n Road P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fsx(631) 765-6641 March 18, 2009 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Ms. Mary R. Raynor 575 Beachwood Road Cutchogue, NY 11935 RE: 575 BEACHWOOD ROAD, CUTCHOGUE SCTM# 116-4-21 Dear Ms. Raynor: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 18, 2009 regarding the above matter: WHEREAS, MARY R. RAYNOR 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 December 22, 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, 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 March 18, 2009, 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 MARY R. RAYNOR to replace the existing wood bulkhead and wood retaining wall as exists utilizing PVC bulkheading, with the condition that a silt boom is deployed prior to and during all intertidal operations, and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated August 18, 2008, and received on December 22, 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, 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 Please be advised that your application dated '-~P..ce~oe.¢,~. been reviewed by this Board at the regular meeting of 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) __ 1st Day of Construction ($50.00) ¼ 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: BY: James F. King, President Board of Trustees Donald Wildcr. Chairman Laura Sta ds ,Sccrca~ Town Hall, 53095 Main Rtl. P.O. Box I 179 Southold, 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., January 14, 2009, the following recommendation was made: Moved by Peter Young, seconded by Don Wilder, to TABLE the Wetland Permit application of MARY R. RAYNOR to replace the existing wood bulkhead and wood retaining wall as exists, utilizing PVC bulkheading. Located: 575 Beachwood Rd., Cutchogue. SCTM#116-4-21 Inspected by: Peter Young, Doug Hardy The CAC Tables the application and recommends a comprehensive engineered plan for the mouth of the creek. Vote of Council: Ayes: All Motion Carried James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. P.O. Box 1179 Southold, NY 11971 Telephone(631) 765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: / MARY R. RAYNOR requests a Wetland Permit to replace the existing wood bulkhead and wood retaining wall as exists, utilizing PVC bulkheading. Located: 575 Beachwood Rd., Cutchogue. SCTM#116-4-21 Type/ef area to be impacted: ./- jc/S'altwater Wetland Freshwater Wetland __Sound [,/Bay Distance of proposed work to edge of wetland Part o.~Town Code proposed work falls under: _~,~hapt.275 Chapt. 111 other Type of Application: ~etland Coastal Erosion__Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: / Present Were: __J.King VJ.Doherty__P.Dickerson __ __ D. Dzenkowski__Mark Terry other Form filled out in the field by D. Bergen__ B.Ghosio, Mailed/Faxed to: Date: Environmental Technician Review- ?ECONIC 116 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Scott A. Hilary, LWRP Coordinator Date: January 12, 2009 Re: Chapter 268, WATERFRONT CONSISTENCY REVIEW Wetland Permit for MARY R. RAYNOR SCTM#116-4-21 MARY R. RAYNOR requests a Wetland Permit to replace the existing wood bulkhead and wood retaining wall as exists, utilizing PVC bulkheading. Located: 575 Beachwood Rd., Cutchogue. SCTM#116-4-21 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 us, it is our recommendation that the proposed action is EXEMPT; provided that a silt boom is deployed prior to and during all intertidal operations pursuant to § 268-3 GG. § 268-3. Definitions. MINOR ACTIONS -- Include the following actions, which are not subject to review under this chapter: GG. Bulkhead to replace existing bulkhead on the applicant's proper~y in the same location with a silt curtain employed during construction. 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 Permit Application ~Vetland Permit Application Amendment/Transfer/Extension ~ece~vved Applicatio..~n:~ ~q~eceived Fee:$ ~'~ , · .~5ompleted Application __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent). ~v~3/RP Consistency Assessment Form ] ~----G'AC Referral Sent: i ~ .~,,~)~ ' -,_tSate of Inspection: ' t ] I ZReceipt of CAC Report:' I ' __Lead Agency Determination:__ Technical Review: --d~lic Hearing Held: I [ '~1 Resolution: Office Use Only Administrative Permit Name of Applicant Address ~P) ~'~ Phone Number:( ) (o~\- O'3q- Suffolk County Tax Map Number: 1000- I I b - 6 q - 2~ Property Location: ~Q~ ~_7'~ ~; g ~g rovlde LiLCO Pole ~5i::~5~ ~(k~l ~'~ (p ' , ' e to cr;'~ streets, ~d lo~ation) AGENT: (If applicable) Address: Phone: ~ard of Trustees Applica{ ~n GENERAL DATA Land Area (in square feet): I 0 q ~ ~ Area Zoning: '~ e~ ~t,e_fX.'~ {' 0,.-~ Previous use of property: Intended use of property:. Covenants and Restrictions: If "Yes", please provide copy. Yes No Prior permits/approvals for site improvements: 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 ncc essary): OBoard of Trustees ApplicOn WETLAND/TRUSTEE LANDS APPLICATION DATA Propose ofthe proposed operations: Ce ~\C~t ~ ~,,/t' %~[,~'/qCl Area of wetlands on lot: ('~-~ square feet Percent coverage of lot: ~' % Closest distance between nearest existing structure and upland edge of wetlands: ] OC~ feet Closest distance between nearest proposed structure and upland edge of wetlands: [ O ~ feet Does the project involve excavation or filling? x~ No Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed 6i d,~vcg~tod: cubic yards cubic yards feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): Board of Trustees ApplicOn COASTAL EROSION APPLICATION DATA Purposes ofproposed activity: l'-el'N\Ck, ~ ~-__'~'~"~",5. ~e wetl~ds present within 100 feet of the proposed activity? No ~ 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? Manner in which material will be removed4md~/msi,tad~ (cubic yards) Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) Board of Trustees Application County of Suffolk State of New York [~~ ~ (~(2K_~ I'~( BE1NG DULY SWORN DEPOSES AND"A-~FFIRMS THAT i~ISHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATE NTS CONT ED REIN, E TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVI]~W OF THIS APPLICATION. '~i~/~ Signat~re/~ SWORN TO BEFORE ME THIS ~[~,.j DAYOF ~)~cem~,,r- ,20 OD Notary Public , ~ar~ Ful)llc, S~te d Neet York r~o 01014635190 o ~1~01~ C,o~nv, m~ ~ Oct. PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 61720 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) ~('~(~.~--f~, ~- ~:2~___.t,~ ~-C'[,f~- 2. PROJECT NAME SEQR 1 APPLICANT / SPONSOR 3.PROJECT LOCATIO~.~ ~ County PRECISE LOCATIQN: Street Addess and Road Intersections. Prominent landmarks etc - or provide map IS PROPOSED ACTION: r~ New [] Expansion [] Modification / alteration DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially ~.5 acres Ultimately acres 6. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? C~es [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply) E~esidential J--] Industrial g~ Commercial [~Agriculture [~ Park / Forest / Open Space E~ Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~Yes ~ No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? E~Yes ~Z]No If yes. list agency name and permit / approval: 12. AS A RRE.~;ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE ~S TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name /.~ /'~ Da : Signature '~/'~'/'L"~.~(-~ /'~-- /~"'~,, '~]"~ ~;~tel '~'-/ ~ Jif the action is a Cost'al Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. E~TM E]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, exislJng traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2 Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3 Vegetation or fauna, fish, shellfish or wiidlge species, significant habitats, or threatened or endangered species? Explain briefly: 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 C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6, Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: C7. Other impacts (including changes in use of either quan!i~ Or !~/~oe of e?r~¥? Explain briefly: D WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA {CEAt? (If }~es, e~x~!~? briefly: E. IS TH ERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS'~. If,/es explain-. F'-~ Yes r'--] NoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidentifiedab~Ve~detarminewhetheritissubstantia[~Iarge'imp~rtant~r~therwisesignificant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f} magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur Then proceed directly to the FULL EAF and/or prepare a positive declaration Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the masons suppoding thi.~ determination Name of Lead Agency Date Tige of Responsible Officer Signature of Preparer (If different from responsible officer) Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ..... ........................ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn~, depose and say: That on the/~ay of ~3et¢~'.200 ~,, I personally ~osted the property known as by placing the Board of Trustees official poster where iPc~ easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of heating noted thereon to be held ~; ~a~, ~ I~ ' Dated: 'J~,~r~j .C, 900 q Sworn to before me this day (sigi~ature) d Notary Public Nora,',/Public, State ot N~,~ York ~mis~ ~ ~. o ~-~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: $ $0,42 Return Recep Fee Restricted Oelivew Fee Address: duly sworn, deposes and says that on the ~', deponent mailed a true copy of the Notice tion, directed to each of the above named ,~ respective names; that the addresses set e 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 "C ~.k~x~ q ~_~ t '~' ~ , that said Notices were mailed to each of said persons by (certified) (registered) ~tail. Sworn to before me this Day of ~-)"~m'~q ,20 Notary Public BARB,U:IA Dl&OmON No~uy Pubic, ~ ~ N~ Yo~ No OlD~51~- ~, ~m~ ~r~ ~. ~ ~ o Town of Southold LWRP CONSISTENCY ASSESSMENT FORM INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located u, ithin the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. _A proposed action will be evaluated as to its significant. beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- ~. 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 The Application has been submitted to (check appropriate response): TownBoard [-I Planning Board [i] Building Dept. ~ BoardofTrustees 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) (c) Financial assistance (e.g. grant, loan, subsidy) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: x} Present land use: ~' ¢5-~"I ~ q~."~ clx ~ Present zoning classificatiom {'c~ ~'~', ~¢ r~¢~/ 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: (b) Mailing address: (c) Telephone number: Area Code (d) Application number, ifa.ny:__ Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~ No [~ If yes, which state or federal agency?_ C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. []Yes ~ No ~Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [--] Yes [~ No [~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~-q Yes [] No ~ Not Applicable Al/ach 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 gq Yes 7q No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section II1 - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~-~ No ~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section I11 - Policies; Pages 34 through 38 for evaluation criteria. Yes [] mo 7gmot Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~ Yes~ No [~ 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 LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ~ Yes ~ No ~_ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peeonie Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [-~ Yes [~ No ~ Not Applicable Atlach 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 TITLE APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the t~art of town officers and emnlovees. The ouroose of this form is to omvide information which can alert the town ofl~ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, fi~t name, ~iddle initial, unless you~ase applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ 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 youmelf (the applicant/agen~dmpresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __A) the owner of greater than 5% of the shares of the corporate stock of the applicgnt (when the applicant is a corporation); __B) the legal or beneficial owner of any interest in a non.~orporate entity (when the applicant is not a corporation); __C) an officer, director, panner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this I ~day of .f~,..~a..~ 200 ~ Signature ~ /~'J, ~ ~-- PrintName ~o. 0~ ~,~, ~'~'~ July 11, 2008 Mr. James King, President Southold Town Trustees Town Hall Annex Southold, N.Y. 11971 Dear Jim, Regarding our conversation of today, I would like to request a pre-application meeting at 575 Beachwood Road, Cutchogue, N.Y. We would like to remove our failing bulkhead/jetty and replace same, in the same location. Please advise me when your board can meet with us. My home number is 734-5110, and cell is 484-6162. Thank you for your consideration. Henry Ray~ PERMIT I ~'e~r~ary 1.51 '~014 Man~ R. RaZor ADDRESS DF DER~ml]CFEE 575 Beechwoar~ Ro~d, ~lcho~e NY 11035 Raynor Pro~,effy, 5?5 Beech~,ood R~cl; Cut~ho~ue CO~JNTY I TOWN WATE~COUPJ~ Buff-olk I Bouthold Gmat Peo~nic Bay T&LEPHONE NUMBER [~LEPHONENUMH~R E:710,2 N;4540.5 Remove and replace in-place t15 linear feet of bulkheadtretaining wall (90' & 18' seetl~l$ of bulkhead;15' saction r~aln]n~l wall) and place ,rap tO 40 cubic yards of olean back'fill. AIl work ?,hall be pem~ormed In acr..ordaace with the plans prapamcl by JohR T. MeLz~er last revised on ~i'1~08, and sram p*~:l NYBDEC approq~ed on 2tlTlgg- SPECIAl. £~(}NDITI()NS 1. ~'he storage of construction equipment and materials shall be con.ed with ~ the proje~ ~ area, uplaf~ areas 9reeler thio 75 lUmar feet trom the ~al ~tland boundaPf, and of within a barge, 2. Prior to a ay (~nstruct~n or removal of bulkheads or other shom~ne s~b I zat on s~c~ res, all backfill mt,st be ex~t~ andward or the ~traclure end retai~ed so as ~ot to enler the ~te~ay, tidal wetla~s or protecled buffer areas. 3. All peripheral be~s ~erdams, rock revetments ~awells gabions bulkheads or uther app~ shore ne ~ abili~ ion stre~ures she ~ competed pr or ~o p acemet~t ~f any fill material ~hind such 4, ~e n~ bulkhead shall be constructed in place of the existing bulkhead with ~ seaward exte~ion of · e oute~ost bulkhead face. 5. Bulkh~ds ~nstmc~ dire~ly adjacent to ~getat~ tidal w~lands shall be hand ddven ~jet~ in with no d stu~bance h) Ihe lidel wetland Tmechir~9 is stdctly prohibited, 6 ~re sh~ll ~ no di~har~e of runoff or other effluent over or ~ugh any bulkhead or stabilization stru~ure or ~nto ~idal ~lle~d or prorated buyer area. 7. Equipmem open,ion ~ (seaward oO apparent h~h water is std~!y prohibited ~. All fill sha!l ~Rsist of ~c!ean" ~a~d, g ra~l or ~il (not asphelt~ slag, ~yash, bmke~ co~crete or demolition debris). 9. ~ ~cava~n el the beach is auth~ for the pu~ of obtaining ~ll or stone mate~al. 10. N! fill must be graded to mat~ I~ elevation of ~e land immediately adjacent Io ihe ~lkh~d. 11. NO dmd~ing e~vati~ or o ~r a ~em~n o~ he ~hom ne or u~e~ter areas s authodz~ by th ~r~iL nor s~lHs~uan~ ~is ~it ~ ~ns~ to suggest that ~ ~dment w ssue a ~rm~ for SUCh actimties tfl the lutum 12 A~ areas of soil dis~rban~ resuming from the approved pmje~ shall ~ s~biliz~ wi~ approved native vege~t~n immed~tely follo~ag proj~t completion or p~r t0 permit ~iration, whiche~r c~mes first, Plea~ ~ntact Marine Hab~at Pro~ti~ at (631)4~0295 ~r a list of appm~d s~s and p ant ng ~nsitles. It the pmj~t site m~}atns i~acfive lor more than ~ houm or p~nti~ is impmcti~l d~ to the ~ea~n. Ihen the area shall be stabiliz~ w th slmw or hay mulch or ju~ ma~ing until weather ~ndltto~ lavor germination, 13. I1 plantin/seeding s mprac~ble due ~ ~e time of ~aL a tem~rary mul~ shall be a~li~ and s~ding pedormed at the eediest op~uni~ when wee her ~m germl~llo~ aad ~row~, but not mom than six month~ after project complain, 14 NI disturb~ ames where soil ~11 be tam.redly expos~ or sD~p ~d for ~n~er than 48 houm shall be ~ntained by a ~ ~uous line of stak~ haybal~ / slit ~Ra~s (or other NYS~EC aphid de~s} pla~ on ~ ~ s~e ~een lhe fill and the wetland o~ pmtect~ buyer area, Tarps am aulhorizee m supp~ment the~ appro~ meth~s, 15. The u~ ol ~od t~a~d ~th penffi~lom~ol e o her ~od reatment not sp~ y appmv~ by the Depart~nt for u~ in ~tla~s a~or mari~ waters, Is st~ly p~lbi~d in the construcEon structures thal will be in ~ntacf with lidat w~lers, 1~ ~ere shall ~ ~o distu~nce to vege~t~ Bdal ~[lend~ ~ pr~ecl~ buyer ~reas e6 e result of permi~ed aca~ties, 17 Any debris or excess matedel ~mm ~nslp~tio~ of ~is proje~ shall be completely removed 1rom the adjecen[area and remo~d to a n a ppm~ upland area for dispo~L No debris is ~il~d in ~at wetland~ or prorated buffer areas. 18, At least 48 hours p~r to commencement of ~ prOJe~ the ~rm I~ a~d con rector she Sign and return the ~op ~n of the e~cl~ notifi~tion fo~ ce~yiP~ that they a~ ~lly a~ re of. and und~nd ~.te~ a~ ~ndi~ons of, this p~it Wi~in 30 days of ~ ~ompietion ~ ~e pro. cl, ~ bosom o ~e ~orm must also be sign~j a~ld mtum~ along with photographs of the ~mplet~ DEC PERMIT NUMBER ] PAGE 2 OF 4 1 ~17,'~i-00351 ~08~4 I STREET ADDRESS: 575 BEACHWOOD ROAD ~. SURVEY OF PROPERTY ~.,.wA T CUTCHOG UE ~' TO'tN OF SOUTHOLD ~ ~ SUFFOLK COUNTY, N.Y. (~) i000--116--04--21 FR. ,._) /z,5' = e~ gT.Z SCALE: i'--20' MARCH 15, 2005 Sept Z, 2005 riot coveragel Sepl. 16~ ~005 (revidons) Sept. ~3, 2005 EXISTING FINISHED FLOOR £L. 9.4 MEETS FEMA REC4JLA T~.WS 2005 BOTTOM OF FOOTINGS ~L: 3.1 M~ETS N.Y.S. BUILD/~/G CODE OF J' FLOOD ZDNE AE fei 81 FIRM 36tD5C0482 ELEVATIONS ARE REFERENC&D TO N,G. V.D FILL REQUIRED = 0 yds. LOT COVERAGE AFTER CONSTRUCTION · DWELLING CONFORMS TO FEMA REGULATIONS /ST FLOOR ELEVATION ' 9.4' PROPOSED IST FLOOR ELEVATION - 9.4' CERllFIED TO: MARY RA YNOR CHICAGO 7ITLE INSURANCE. COWPANY N APPROVED BY BOARD OF TRUSTr-ES TOWN OF $OUTHOLD DATE SSI ':55' STREET ADDRESS: 575 BEACHWOOD ROAD CERTIFIED TO: MANY RA YNOR CHICAGO TITLE INSURANCE COMPANY 2008 SURVEY OF PROPERTY AT CUTCHOGUE TO'tN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE' 1'---20' MARCH 15, 2005 APRIL 7. 2005 (ELEVATIONS) MAY 17, 2005 (PROPOSED ADDIIIONS) JUNE 27, 2005 (ADDITION) SEPTEMBER 2, 2005 (LOT COVERAGE) SEPTEMBER 16, 2005 (RE~4SIONS) SEPTEMBER 2J, 2005 SEPTEMBER 27, 2005 (ADDItiONS,) APRIL 24. 2006 (REWSIONS) S80'1 TYPICAL X-~CTION SCALE ; 1" = 10' GREAT PECONIC BAY AREA=lO, 490 SO. FT. TO TIE LINES ELEVATIONS REFERENCED TO N.G, LIC. NO. 4961~ (651) 765-1797 F~O, 12.30 TRAVELER STREET