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Home My WebLink AboutTR-4138 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 OFSOUTHOLD APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT DATE ADDRESS AGENT ADDRESS PHONE PROPERTY LOCATION ~TF~ TAX MAP NO. ~-~ ~ /aaa I/We f~.)f//dA/ f. /~/~/,~'~'r request an Amendment to Permit # zT~/.~ oc~ to ,,~¥ /:'.z ~'~T /;,Y,z,v.,r- ,,~,rT,'O/zr z./_-- ~ t~ ~' -~/~ ~.0 ~'-,./~,,,.,/~ / Signed By~~ ~ Jill M. Doherty, Prcsidcnt Bob Ghosio, Jr., Vice-President Jmnes 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of STEPHEN LATHAM COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING 1, -'~7-,~'/¢'~/,J ~:, /~0T, CAt~/, residing at/dba being duly sworn} depose and say: That on the/? ~ay of ,.,~7/,z y ,20 Ii} I personally posted the property known as by placing the Board of Tmst~es official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place tbr eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed~ July 20~ 2011 on or about 6:00 PM. Dated: Sworn to before me this MARILYN Notary Public, ~tate of New York No. 01DA61.130~7 Qualified in Westchester Cotmly Commission Expires July 19, PROOF OF M~II,LNG OF NOTICE ATTACH CERTIFIED MAI1, RECEIPTS Nalile' Address: 7.}"/ / t 9 '7/ STATE OF NEW YORK COUNTY OF SUFFOLK .61~ II ¢ 7/ , being duly sworn, deposes md says ~at on ~e //~ day of ~O2 V ,20//, deponent m~l~ a ~e copy of~e Notice set f6~.in ~e Bo~d of Tmste~ Application, &r~ted to each of the above nm~ perso~ at ~e ad.asses set opposite ~ere red.five nm~; ~at ~e ad~s~ set opposite ~e nines of s~d persom ~e ~e M~ess of s~d perso~ ~ shom on ~e c~ent ~se~sment roll of ~e Tom of Sou~old; ~at s~d Nofic~ were mail~ at ~e Uffit~ States Post Office at ~ff~x ~, ~ ~ itg?l, ~at s~d N~~ to ~ch of said pemons by Swom~o~efore me ~s / ~ Day o~20 It Not~ Pu~ic MARILYN DALY Not~ry Public, State of New York No. 01DA6113067 Qualified in Westchaster County Commission Expires duly 19, 20g~ . ~~'(~AL USE I $2.85 $2.30 ?6 07/I1/2011 $ $5.5~ 07/11/2011 J2.30 ~ IO.O0 $5.59 ~'/11/'~)11 Henry J. Latham Beixedon Estates Shoreline Restoration Dru Associates, Inc. 40 Hitching Post Ln. Glen Cove, NY 11542 516-676-7107 Revised: 4-16-2011 Prepared: 1-12-2011 Scale: 1"= 60' Lot 8 n/o/f James F. Travers Lot 7 ~ Lot 6 n/off ~ / n/o/f Henry J. Latham :. ~ Joan Kuchner B Existing Rock Armor at bulkhead to be rehabilitated APPROVED BOARD OF TRUSTEES TOWN OF SOUTHOLD L~ATE Beach sand replenishment area = 10,000 sf Sand volume approx. 2000 cyds \ JUL 22 2011 souTHOLD APPROVED AS PER TERMS AND CONDITIONS OF / -- PERMIT NO./'//ZT'-~- ~ 77Z/~/~ DATE '., ~/~//~1 Su~ey by Nathan Taft Corwin III February 11, 2008 Sections by Dm Associates Inc. October 2010 by T~ansit Level Beixedon Estates Shoreline R~torahon 40 Hitching Post Ln Glen Cove, NY 11542 516-676-7107 Scale: 1 "= 20' 4 , Typical section: Latham Property ,/ AppROVED pERMIt' NO '~--~ 200 Feet ~-~nNS OF / ~ Feet S~vey by Nathan TaR Corwin Ill February 11. 2008 Sections by D~u ASSociates Inc October 2010 by Transit Level New York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0362 Fax: (631) 444-0360 Website: www.dec.ny.qov May 24, 2011 Joe Martens Commissioner Mr. Stephen G. Latham P.O. Box 595 Southold, NY 11971 Re: Permit No.: 1-4,738-00773/00005 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions please contact ',is at the above address. Also enclosed is a permit sign which is to be conspicuously posted atthe project site and protected from the weather. Sincerely, MacKinnon Agency Program Aide MAM/Is NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-00773 am, PERMIT Under the Environmental Conservation Law (ECL) Permittee and Facility Information Permit Issued To: STEPHEN G LATHAM PO BOX 595 SOUTHOLD, NY 11971 (631) 765-360t Facility: LATHAM PROPERTY 845 ROGERS RDISCTM#0-1000-66-2-4 SOUTHOLD, NY 11971 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Southold Facility Principal Reference Point: NYTM-E: 717.641 NYTM-N: 4549.32 Latitude: 41°0Y57.7" Longitude: 72o24'34.9'' Project Location: 834 Rogers Road - Watercourse - Great South Bay Authorized Activity: Rehabilitate the rock revetment seaward of the bulkhead by installing a single row of stone approximately 1,000 pounds in size and underlain with filter fabric. Replenish the beach area with compatible (equal or larger) grain size sand. No sand shall be placed seaward o£the mean low water. All work must be in accordance with the two page plan prepared by Dm Associates Inc., dated 1/12/I I last revised 2U16/11 and stamped NYSDEC approved 5/24/11. (MAM) Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-00773/00005 New Permit Effective Date: 5/24/2011 Expiration Date: 5/23/2016 Water Quality Certification - Under Section 401 - Clean Water Act Permit ID 1-4738-00773/00006 New Permit Effective Date: 5/24/2011 Expiration Date: 5/23/2016 Excavation & Fill in Navigable Waters - Under Article 15, Title 5 Permit ID 1-4738-00773/00007 New Permit Effective Date: 5/24/2011 Expiration Date: 5/23/2016 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: JOHN A WIELAND, De~ermit ~ator Address: NYSDEC REG1ON 1..~/HEADgUARTERS ~ SUI~ ~) STOb~/~ROOKJ~0 CIRCLE RD / S3(~1' B ~:~P./'NY.~O-3409 ~ Auth°rized Signature' x' //(~(,~' ([,,. ~-. /'Date~-/~7/~}/ -'~..__..--~Page I of 5 NEW Y~RK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-00773 Distribution List Habitat - TW MARY A MACK1NNON Permit Components NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERM1TTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS; WATER QUALITY CERTIFICATION; EXCAVATION & FILL IN NAVIGABLE WATERS 1. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. 2. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Dm Associates Inc. dated 1/12/11 last revised 4/16/11. 3. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 4. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 5. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other Page 2 of 5 ~EW Y2)RK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-00773 modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove ali or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 6. Precautions Against Contamination of Waters Ail necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 7. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 8. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for dispQsal. No debris is permitted in wetlands and/or protected buffer areas. 9. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the p~rmitted activities. 10. Storage of Equipment, Materials The storage of construction equipment and materials shall be confined to the upland area landwm:d of the bulkhead or on a barge. 11. No Beach Excavation For Fill No excavation of the beach is authorized for the purpose of obtaining fill or stone materials. 12. No Dredging or Excavation No dredging, excavating or other alteration of shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 13. Bulkhead Armoring The authorized bulkhead armoring shall consist of a single row of stone approximately 1,000 lb: in size and underlain with filter fabric. 14. Material All material deposited on the beach shall be of compatible (equal or larger) grain size to the naturally-occurring beach. No sand shall be placed seaward of mean Iow water. WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS 1. Water Quality Certification The NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302,303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. Page 3 of 5 hEW Y~)RK STATE DEPARTMENT OF ENV1RONNIENTAL CONSERVATION Facility DEC ID 1-4738-00773 GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted io: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOKI50 CIRCLE RD STONY BROOK, NY 11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Excavation & Fill in Navigable Waters, Tidal Wetlands, Water Quality Certification. 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the fight to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; Page 4 of 5 51QRK STATE DEPARTMENT OF 'NEW ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-00773 am, noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This~permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Page 5 of 5 Henry J. Latham Beixedon Estates Shoreline Restoration Dru Associates, Inc. 40 Hitching Post Ln. Glen Cove, NY 11542 516-676-7107 Revised: 4-16-2011 Prepared: 1-12-2011 Scale: 1"= 60' Lot 8 n/off James F. Travers Lot 7 n/o/f Henry J. Latham B Lot 6 n/off Joan Kuchner Existing Rock Armor at bulkhead to be rehabilitated A ·~u Beach sand replenishment area = 10,000 sf Sand volume approx. 2000 cyds SOU'fHoLD BAY NYSDEC APPROVED AS PER TERMS ^.D co.omo.$ oF / F~rua~ 11, 2008 ~ions by Dm ~so~ates Inc. ~r 2010 by Tmn~t Level Beixedon Estates D~u Associates, Ino 40 H~chmg Post Ln Glen Cove, NY 11542 516-676-7107 Prepared 1-12-201t Scale~ 1"= 20' ^ +4 i Typicalsection: Latham Property -1 I / ..... :~ ..................... 200 Feet NYSDEC APPROVED AS PER TERMS 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 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 20, 2011 Mr. Stephen Latham P.O. Box 595 Southold, NY 11971 RE: 845 RO(~ERS RD,, SOUTHOLD SCTM~86-2-40 Dear Mr. Latham: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., July 20, 2011: WHEREAS, STEPHEN LATHAM applied to the Southold Town Trustees for an Amendment to Wetland Permit #4138 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated June 22,2011, 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, the project complies with the standards set forth in Chapter 275 of the Southold Town Code, and, WHEREAS, the Board has determined that the project will not affect the health, safety and general welfare of the people of the town, and, NOW THEREFORE BE IT, RESOLVED, that the Southold Town Board of Trustees APPROVES the Amendment to Wetland Permit #4138 to replenish the beach with approx. 400 cy. of sand, as depicted on the site plan prepared by Dru Associates, Inc. last revised April 16, 2011 and stamped approved on July 20, 2011. This is not a determination from any other agency. Sincerely, Jill M.~herty, I~res~ BoarG/of Trustees JMD:lms 3ul 20 ]! 01:52~ p.1 Suffolk Environmental Consulting, Inc. Newman Village, Suite E. 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003 (631) 537-5160 Fax: (631)537-5291 Bruce Anderson. M.S., President VIA FAX July 20, 2011 ' 11' JUL20 2011 Southhold Town Board of Trustees Ms. Jill Doherty, Chairwoman Board of Trustees Town Hall P.O. Box 1179 Southold, NY 11971 Re; Situate: KUCHNER PROPERTY 1726 Arehamomaque Ave., Southold BALL PROPERTY t890 Arshamomaque Ave., Southold BEIXEDON ESTATES ASSOCIATION, INC. Amhamomaque Ave. Right of Way, Southold LA THAM PROPERTY 84,5 Arshamomaque Ave., Southold ILIBASSI PROPERTY 1728 Arshamomoque Ave. Southold Dear Ms. Doherty, This Firm represents Mr. John Nickels, who resides in Beixedon Estates and reoeived various Notices in connection with the proposed Wetland Permit Amendments referenced above, i understand that each property owner proposes to replenish a beach area with 400-500 cubic yards of sand which sand would be substantially placed on top of the existing toe armor installed along the continuous bulkhead line. I also understand that the deposited sand would be monitored by the NYSDEC and a private consultant representing the property owners. I presume that the purpose for monitoring of the deposited sand is to determine whether or not the sand remains over time and, if the deposited sand it is lost to storm erosion, where it settles out. It is in the latter that I suggest that a marker be introduced into the deposited sand so that lost sand can be tracked in the r~ld. Jul 20 11 01:53p p.2 Cc. J. Nick, les Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., July 13, 2011, the following recommendation was made: Moved by Derek Bossen, seconded by Audrey Horton, it was RESOLVED to SUPPORT the application of STEPHEN LATHAM to Amend Wetland Permit #4138 to replenish the beach with approx. 400 cy. of sand. Located: 845 Arshamomaque Ave., Southold. SCTM#66-2-40 Inspected by: Audrey Horton, Derek Bossen The CAC Supports the application with the Condition the beach, approx. 15' in width, is planted with Cape Amedcan Beach Grass to protect the shoreline. Vote of Council: Ayes: All Motion Carried Jill M Dohetly, President Bob Ghosio. Jr, Vice-President James F. King Dave Bergen John Bredemeyer P O. Box 1179 Soulhold. NY 11971 Telephone(631 765-1892 Fax(631)765-664[ Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: 0-(,~'~ ff SlEPHEN LAIHAM requests an Amendment to Wetland Permit~ ~[to replenish the beach with approx. 400 cy. of sand. Located: 845 Arshamomaque Ave., Southold. SClM#66-2-40 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland __ Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 __other Type of Application: Wetland __Administrative__Emergency __Coastal Erosion __Amendment Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: ~JJiDohe~y~d}r'k'' ~'~ c'// ~. Ghosio ' J.~/Q~ King __ D. Bergen, f,_,J'. Bredemeyer D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: Jill M Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. 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 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction /2 constructed ' reject complete, compliance inspection. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1692 Fax (631) 765-6641 June 16, 2010 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Mr. Stephen Latham P.O. Box 595 Southold, NY 11971 RE: 845 ROGERS RD., SOUTHOLD SCTM#66-2-40 Dear Mr. Latham: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., June 16, 2010: WHEREAS, STEPHEN LATHAM applied to the Southold Town Trustees for an Amendment to Wetland Permit #4138 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated April 29, 2010, 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, 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 Southold Town Board of Trustees APPROVES the Amendment to Permit #4138 to install rip-rap ~ to 1 ton stone armor in front of the existing bulkhead, and as depicted on the survey prepared by Nathan Taft Corwin III dated May 14, 2010. This is not a determination from any other agency. Sinc~re. ly, / Jill .~Doherty, ~rosi~d t Boa~d of Trustees JMD:lms Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Soothold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated /~[] <:~ o-90/0 has been reviewed by this Board at the regular meeting of~'~,~'-~e_ld, ,-~l::>/tb and your application has been approved pending the completion of t~e following items checked off below. __ Revised Plans for'proposed project __ PreLConstruction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ 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: Jill M. Doherty, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 9, 2010, the following recommendation was made: STEPHEN LATHAM to Amend Wetland Permit #4138 to install rip-rap % to 1 ton stone armor in front of the existing bulkhead. Located: 845 Rogers Rd., Southold. SCTM#66-2-40 Inspected by: Audrey Horton, Doug Hardy The CAC determined that there is insufficient information to make a final recommendation. There is an indication that an environmental impact statement should be developed addressing the impact of the existing jetty and public access. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer PO. Box 1179 Southold, NY 11971 Telephone(631)765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~ ,~'~- (9 STEPHEN LATHAM requests an Amendment to Wetland Permit #4138 to install rip-rap 1/2 to 1 tOn stone armor in front of the existing bulkhead. Located: 845 Rogers Rd., Southold. SCTM#66-2-40 Typ~of area to be impacted: l=,zSaltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part/of Town Code proposed work falls under: %,,~'hapt.275 Chapt. 111 other Type of Application: v,'~Wetland __Coastal Erosion __Amendment ~Ad ministrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: ,,..,lng __:J.Doherty__J. Bredemeyer __ B.Ghosio, D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: 4/28/2010 18:16:38 1 of 1 4/28/2010 18:15:55 1 of 1 Albert I. Kmpsld, President John Holzapfel, Vice President William G. Albertson Martin H. Gm'mil Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 ' October 28, 1994 Eh-COnsultants Roy Haje 1329 North Sea Road Southampton, NY 11968 Re: Henry Latham SCTM %66-2-40 Dear Mr. Haje, The following action was taken by the Board of Trustees at their regular meeting of October 27, 1994: RESOLVED that the Southold Town Board of Trustees grant an Amendment to Permit %4138 to place 100-300 lb. armor stone immediately seaward of 57' of bulkhead. Located 845 Rogers Road, Southold. If you have any questions, please call our office. .Very truly_yours., Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. CAC Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO 4138 ...... DATE: ,..4.~29/9~ ...... ISSUED TO ......H~'..~A~.~M. .......... ' Authorization Pursuant to the provisions of Chapter 615 of the Laws of the State of New York. 1893: and Chapter 404 of the Laws of the State of New York 19!~2; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on ....~/.~.? ....... 19... ~, and in consideration of the sum of $ paid by of ........................................................ N. Y. and sub?ct to 'the Terms and Conditions I;sted on the reverse s~de hereof, of Southold Town Trustees authorizes and permits the following: Grandfather Permit to replace bulkhead within 18". all in accordance with the detai~ed specifications as presented in the originating application. IN WITNESS WHEREOF. The said Board of Trustees here- by causes its Corporate S.e. al to be at,xed, and these p.resents to be subscribed bye majority of(d~e/~ald Board as of this ~ate. ...................................... .................................. .PJ4 [ T NUMBER ~-OO?~/0000t -0 .TL iTY/PROGRAM ArticLe 15, TitLe 5: Protection af geters ArticLe 15, TitLe 15: Uetar Supply Article 15, TitLe 15: geter Transport ArticLe 15, Title IS: Lo~g IsLand gaLLs ArticLe 15, TitLe Z?: gild, Scenic end Re~resttonii Nivera Other: PERNIT ISSUED TO ADDRESS OF PERNITTEE IT Refl~oocl Rd Garden Cit¥~ NY 11530 CONTACT PERSON FOIl PENN! ?TED VORK En-Cormuttlmts 1329 North Sea Rd. Southampton, NY 11968 NAI4E AND ADDRESS OF PROJECT/FACILITY LBthem Property 86,5 Rogers Rd. LOCATION OF PROJ£~T/FACiL/TY SouthoLd PE IT Under the Envirallr~t r'--'---mtion Lam 14edification O Permit to CQMtru~t 61yCNR 608: ~ter ~J~tlty Cirri f Je~tim ArtLcte 17, TitLes T, 8: AKtLCLe 19: Air PoLLution Control ArticLe ~t, TitLe 2To #ined Lind RecL ieetl on ArticLe 2&: Fresh,iLar ~ettends ArticLe 25: TIdlL Vetiindl IEFFECTIVE DATE EXPZI~TION DATE(S) 8/31/96 ~Perlljt to a I ArticLe ZT, TitLe 7; MYCRR SoIId VesteHinegement ArticLe Z?, TitLe 9; 6MYCRR #lzIrdMgiltl ArticLe ~: ~lstat ErolJ~ ArClct~ I, 3. 1T, 19, MYeR 380: ~Ii~ C~tr~L TELEPHONE NUI4RER COUNTY I TD~d SuffoLk SouthoLd V&TERCOURSE Place 100-300 Lb ar~or atone Large, LateLy sas.etd of s new 57' portion of bulkhead. existing stair.ay. INYT# COORDINATES Stone will be placed east of the ALL WORK SHALL BE DONE IN ACCORDANCE WITH THE NYSDEC APPROVED PLAN. By acceptance of thio permit, the permitted agrees that the pen. it ti contingent ~ strict compliance with the ECL, alt ipptLcabte regulations, the G~KO[ C~JtJ~8 s~ifi~ (~N ~ 2) ~ ~ S~cia[ C~itJ~ f~t~ as ~rt of this ~mit. OEPUTY REGII~IAL PERHIT A~MINISTRA- TQR: Roger Ev~ns AUTHOi~IZED SIGNATURE IADORESS BLdg. 40, SUNY, ROC4~ 219, Sto~y Rrook, NY 11790-Z356 tOATE 6/27/94 I Page I of~ 066 THO OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To; Jill Doherty, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner ...... ~.~ ......... .. ~ ~ ' LWRP Coordinator ~_...,, ~r..,~,, ·. Date: June 14, 2010 Re: Proposed Wetland Permit for STEPHEN LATHAM SCTM# 1000-66-2-40 STEPHEN LATHAM requests an Amendment to Wetland Permit ff4138 to install rip-rap % to 1 ton stone armor in front of the existing bulkhead. Located: 845 Rogers Rd., Southold. SCTM#66-2-40 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "EE" which states: A. Maintenance or repair involving no substantial changes in an existing structure or facility; Cc: Lori Hulse, Assistant Town Attorney Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone(631) 765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only __Coastal Erosion Permit Application ~Ametland Permit Application Administrative Permit endmenffFraxts let/Extension ~'l[eceived Application~ qhcfll0 · .4~eceived Fee:$ ~ ' --'~ompleted AppliCation ~%~..2'](~ __SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~--'L'TWRP Consistency Assessment Form Referral Sent:~ -° - ' ~"Date of Inspection: ~ [21 Receipt of CAC RepOrt! ' ' __Lead Agency Determination: Teclmical Review: "~Public Hearing Held:~ Resolution: Name of Applicant Address ['.0.~ ~'gS~/~'~ / PhoneNumber:0%'/) 2~.g-- ~ g6~ / Suffolk County Tax Map Number: 1000- ~4 ~ ~ 8~ d'e/.'-~-'~ /-/& PropertyLocation: ~q_q~ ,~7&~£~ /2d.z')./ ~TJc,'2r) AgH (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ~oard of Trustees Applica~n Land Area (in square feet):_ Area Zoning:. GENERAL DATA 2 _,:..c5 ~/)~,,..L ~--oo Previous use of property: Intended use of property: Covenants and Restrictions: Yes If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency No ~/~te / __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? /X. No Yes If yes, provide explanation: Project Description (use attachments if necessary): /~u~/¢~mTO of Trustees Applica~n WETLAND/TRUSTEE LANDS APPLICATION DATA Purposeoftheproposedoperations: ///~/~' f~',r~Z, tr/tf ?~/ Wa';zz-~/~u& Area of wetlands on lot: .square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structm'e and upland edge of wetlands: feet Does the project involve excavation or filling? J 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 or deposited: cubicyards cubicyards ~et 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): PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ~ART 1 - PROJECT INFORMATION ( To be completed bY Applicant or Project Sponsor) 1. APPLICANT / SPONSOR 2. PROJECT NAME Municipality County 4. PRECISE LOCATION: Street Addess and Read Intersections. Prominent landmarks etc -or provide mad 5. IS PROPOSED ACTION: ~'~ New j'~ Expansion [-~ Modification / alteration SEQR DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes [] No If no, describe briefly: ReIS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) dential [~lndustrial [~Commercial [~Agricutiure ['--] Park / Forest / Open Space [~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENC (Federal, Stateor Loc, al) ~es [~No If yes, list agency name and permit / approval: oot~O/-- 0 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [--~Yes [~o If list name and permit / approval: yes. agency 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THaT THE ~NFORMATION PF~OVIDE~ ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor N~a~ ~") Date: ,~/~/ Signature ~) If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - iMPACT ASSESSMENT (To be completed by Lead A~lency) · A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 ff yes, ceordlnste tbe renew process and use the FULL EAF. EIb- 171.o B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTED ACTIONS IN 6 NYCRR, PART 6t7.67 If No, a negative r-I - 171.0 C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answem may be handwritten, if legible) Cl. Existing air quality, surface or groundwater quality or quantity, ~ levels, exl~ng traffic paifem, sofkJ waste praductio~ or disposal, pofenhal for erosion, dralange or ticuding pint,ems? Expleln bdetiy: I"° I · Aesthetic, ngdcultural, archaeological, Nstedc, or other natural or Culteml resources; or community or ~ character? Explain briefly:. C3. ¥',~,~dv,i ~' fauna, fish, shalash or wildlife species, slgnl~cent habitats, or fhreatefled or endangered species? E~plaln briefly: C4. A ,.,~,,,,,mlt,/'s exls~ng plans or finals as officlaffy adopted, or a change in use or Intend/y of use of and or other natural resources? ~= .~q~n briefly: Gn:r,~h, cu'o,~qnant d~ol~nent, or related actMtia~ Ii1~1¥ to I~ Indu~l I~ tho ~op~l action? E~ain bristly: C6. Long term, shed term, cumulative, or other effec~ not Identified in C!-C57 Explain briefly: I.° 0. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABUSHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If }~esr explain bdeti),: I E. IS THERE, OR IS THERE LIKELy TO BE~ CONTRovERsY RELATED TO'POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If }~es e~?,,!m PART Ill - DJ- lt=R~iNA'I1ON OF SIGNIFICANCE (To be completed by,P~W) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substanffel, large, impo~tentor otherwise s~3nificent. Each effect should be assessed in connection with its (a) setting (i.e. Urban or rural); (b) pmbebiiity of occurring; (c) dumffen; (d) irrevendbility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporUng me/er'mis. Ensure that explanations contain suffident detail to show that afl relevant adverse impacts have been Idse~ed and adequately addressed, ff quseffen d of part ii was checked yes, Ihe,determinaffen of significance must evaluate the potenffel impact of the pmpcoed action on the environmental characteristics of the CEA Cbeck fids box If you harm Idenfflisd o~e or more pofe~ally large o~.~offcent adve.,se impacts wtdch MAy occer. Then pmcead directly te fha FUU FAF and/or prepare a pcelth~.dedamtion. Ch~dx this box if you have delarmteed, based on the Information and analysis above and any supporting documentation, that the IXOpoSad ac~o~ WILL NOT result In any s~gn[flnant adverse envffermenlel Impacts ANO provide, on attachments as n~esce~,, the reasons supporting thl~ delerminatkm. Board of Trustees Name of Lead Agency Date Jill M. Doherb/ Pallor Type Name of ~.~pTible/Officer in Lead Agency "S~gnature of Re~n~bla ~ In Lead President Title of Responsible Officer Signalure of Preparer (ff differen{ from mspons/bla officer) Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of STEPHEN LATHAM COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, ¢'~t~/-/~AJ ,g,aT>~o~r,residingat/dba ~o' /~OC~x ?tOry, being duly swom, depos[ and say: That on the Z.'~ay of ,Tr~t ~ ,2010, I personally posted the prop~y ~own as by placing the Board of Trustees official post~ where it c~ easily be seen, ~d that I have checked to be sure the poster has remained in place for eight days prior to the date of the public he~ng. Date of heating noted thereon to be held Wed.~ June lC 2010 on or about 6:00 PM. Dated: ~ Sworn to before me this t I~day of'~ r,~20~o N~ltary Public PROOF OF MAll p~ .~ c~ oo Domestlo Retum Receipt ~- ~ {u~?aim"~ thatonthe ~ of thc Notice · Complete Items 1, 2, and 3. Also complete item 4 if Rest~cted Delivery is clasimcl. m Print your name and address on the reverse so that we can return the ca[d to you. ~-. ;~!tach this card to the back of the mallplece, or on the front If space permits. ). Rec~ved by (~eO t~e) is de~lve~ address different from Item 17 [] Yes If YES, ether delNe~y address below: r-I No ~-]~,~,~9 ~T~¢/,~ [ ~ ~ ~m R~ ~ M~dl~ ~ I~ M~I ~ C.O.D. [4. ~ ~1~ ~ ~) ~Y~ 2.~lc~Num~ 7009 2250 0001 4978 4295 own on the current at the United States Post ~ach of said persons by ,,1 - PS Form 3811, February 2004 Domest~ Retum Receipt 102ses-O2..M-ls40 Board of Trustees AppliCon County of Suffolk State of New York +epk ,o 6. BErNGmmYSWOR DEPOSES AND ~F~S ~T ~/S~ IS ~ ~PLIC~T FOR T~ ~O~ DESC~ED PE~T(S) ~ T~T ~L STA~NTS CO~D ~ ~ ~ TO T~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ ~T ~L WO~ ~L BE DO~ ~ T~ ~R SET FORTH ~ ~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSSES. T~ ~PLIC~T AG~ES TO HOLD ~ TO~ OF SOUTHOLD ~ ~ TO~ TRUSTEES H~ESS ~ ~E ~OM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~ OF S~ PE~T(S), ~ G~D. ~ CO~LET~G T~S ~PLICATION, I ~BY AU~O~E T~ ~US~ES, T~ AGENT(S) OR ~P~SE~ATI~S(S), TO EN~R ONTO MY PROPERTY TO ~SPECT ~ P~SES ~ CON~CTION ~ ~W ~S ~I~TION. ~fiature SWORN TO BEFORE ME THIS o~?/~ DAYOF ~)fi,';/ ,20/o Notary Public DORIS D. MOORE NOTARY PU~:UC, STATE OF NEW YORK QUALIFIED IN SUFFOLK COUNTY NO. O1M0466~99 MY CONNIPTION F.~IRE$10-20- 2<9 ( 0,. April 12, 2010 To Who it May Concern: I hereby give approval for the Beixedon Estates Association and Steven Latham to install "rip/ap" against the bulkheads located on parcels known as Plo! A & B on the Filed Map of Beixdon Estates, Southold, New York. Jo~./~?s /~ - ~ ~ '"' For I'i~mselfand tile Estate of O. R. Lewis APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officors and emnlovees. The t>umos* of this form is to nrovide information which can alert the town of nossibl¢ conflicts of interest and allow it to take whatever action is nee~ssarv to avoid same. YOUR NAME: ~-~/~/; ,' 5~/~ff/~/~/~/C'/ ~' (Last name, first namo;',~aiddle initial, unless you are applying in the name of someone else or other entity, such as n company. If so, indicate the other pomon'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 interestn means a business, including a partnership, in which the town officer or employee has even a partial ownerehip 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 0r position of that person ¢ .¢~ ,'d F,- Zz~c. 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 deser~be in the space provided. The town officer or employee or his or her spouse, sibling, parent, or ~hild is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicont (when the applicant is a corporation); ___B) the legal or beneficial ownqr of any interest in a non-corporate entity (when the applicant is not a co~oration); ___C) an officer, director, partne?, or employee oftbe applicant; ___D) the actual applicant.. DESCRIPTION OF RELATIONSHIP Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt · minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its si..oniflcant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 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, li~finR both sfloDortin~ and non- suooorfin~ facts, ff 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 Deparlment, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# ._._.~ ~.. ~0 PROJ Cr NAM L A-FN A M The Application has been submitted to (check appropriate response): TownBoard ~] Planning Board [--] BuildlngDept. [] BoardofTrusteas~'~ 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) Co) Financial assistance (e.g. grant, loan, subsidy) (c) Nature and extent of action: Permit, approval, license, certification: ( - Location of action: Site acreage:. Present land use: ~e~/~e~'o~ l Present zoning classification: ~- t4 0 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: ,.~-[7~]~'-]x] ~. (b) Mailing address: -~O-~O~ 5-q~5'~ ~ $ouTNOLD ~ Id ¥ IIq'7/ (c) Telephone number: Area Code ( ) & ~ I - 7/~ ~' - 2~ {P O I (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes[~ No[~ Ifyes, which state or federal agency?. NVS1)~-C I-q'YScd-O0773~oool 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 HI - Policies; Page 2 for evaluation criteria. [] Yes [] No [-~ Not Applicable ARach 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 71 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 D No ~7~ Not Applicable At~ach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section HI - Policies Pages 8 through 16 for evaluation criteria ~ Yes ~'~ No ~ Not Applicable Attach additional sheets if necessa~ Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section HI - Policies Pages 16 through 21 for evaluation criteria [-~ Yes [] No ~Z~Not Applicable Atlach 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 HI - Policies; Pages 22 through 32 for evaluation criteria. Yes No ~ Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section IH - 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 hazardons substances and wastes. See LWRP Section IH - Policies; Pages 34 through 38 for evaluation criteria. [] Yes ~ No [] Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section HI - Policies; Pages 38 through 46 for evaluation criteria. Ye? No Not Applicable Attach addifionalsheetsifnecessary V~ORKING COAST POLI~S Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section IH - Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~] No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section IH - Policies; Pages 57 through 62 for evaluation criteria. ~'~ Yes ~ No F~ Not Applicable ~ Attach additional sheets if nt~r~,u y Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section IH - Policies; Pages 62 through 65 for evaluation criteria. F~ Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section IH - Policies; Pages 65 through 68 for evaluation criteria. [] Yes ~ No ~ Not Applicable PREPARED BY S~,/.- ATT'//~ TITLE APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the nmi of town bfficers and emulovces. The uurneso of this form is to nmvidc infi~rmation which can alert the town of uossible conflicls of inter~st and allow it to lake whatever action aneessarv to avoid same, (Last name, first name, ~iddle initial, unless you am appiying in the nmnc of someone cis~ or other entity, such as a company. If so, indicat~ th~ other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grlcvance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Otber', name the activiB,.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship ~ith any officer or employee of the Town of Southgld? "Relationship" includes by blo6d, marriage, or bus'mess interest. "Business interest~ means n business, including a pannership, 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 pers0n employed by the Town of Southold Title br position of that person 5~'/P~.~A~ 9- 3.'Cctr74C. L~'~'~ ./90.LfC/_--' Describe the relationship between yourself(the applieant/agant/r~presentative) and thc town off~cer or emplOYee. Either cheek the appropriate lin A) through D) and/or desedhe in tl~ space provided. Thc town officer or employee or his or her spouse, sibling, parent, oi' child is (check all that apply): __.A) the o~,ner ofgrsuter than 5% of the shaws of the coq~orate sleek of the applic~ant (when the applicant is a corporation); B) ~ legal or beneficial owng' of any interest in a non-corporate antity (when applicant is not a corporation); __.C) an officer, director, p~tnei', or employee of thc applicant; or __.1)) the acteal applicant.. DESCRIPTION OF RELATIONSHIP Form TS 1 . Print Name~''' ,,% EXI5TIN~ BULKHEAD APPROVED SOARD OF TOWN OF SOUTHOLD PLAN FOR PLACEMENT OF 1/2 to 1 TON STONE RIP RAP LOT ? MAP OF BEIXEDON ESTATES BLOCK ? $ITUATE SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-66-02-40 SCALE 1"=40' MAY 14, 2010 AREA = 11,765 sq. ff. (TO BULKHEAD) 0.270 OC. NO TES: 1. ELEVATIONS ARE REFERENCED TO HIGH WATER BEING ELEVATION 0.0' EXISTING ELEVATIONS ARE SHOWN THUS: 5.o T.B TOP OF BULKHEAD B.B. -- BOTTOM OF BULKHEAD KJ. TOP OF JETTY PROPOSED CROSS SECTION RIP RAP PLACEMENT SCALE 1"=10' OF F:~.OPOSEO RIP RAP 0 I TON ROOK,) HI®H J,~T~R Land Surveyor PHONE (631)727-2090 Fox (631)727-1727 TOPOGRAPHICAL SURVEY OF BEACH SITUATE $OUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SCALE 1"=40' FEBRUARY 11, 2008 NOTES: 1. ELEVATIONS ARE REFERENCED TO HIGH WATER BEING ELEVATION 0.0' EXISTING ELEVATIONS ARE SHOWN THUS: ~ -0.06 · -2.33 soUTt4OLD N.Y.S, Lic. No. 50467 Nathan Taft Corw~n III Land Surveyor PHONE (651)727-2090 Fox (631)727-1727