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HomeMy WebLinkAboutTR-7292 A • ` t NEW SUFFOLK WATERFRONT FUND creating the future of our waterfront Board of Directors Barbara Butterworth Re: Permit no. 7292Oltr� Joel Itzkowitz � gaff , Russ McCall Issued to: New Suffolk Waterfront Fund,Inc I Pat McIntyre property Address: 650 First Street,New Suffolk Joe McKay Gary Osborne SCTM# 117-8-18 Gregg Rivara Joan Robbins Dear Board of Trustees, Barbara Schnitzler -— The 4 foot wide walkway construction approved in the above permit was Michael Simon severely damaged in storms last year. In fact the walkway in the area from the Andy Torgove former travel lift dock to the Galley Ho Building was completely washed away. Angela Tese-Milner See attached picture. Tom Wickham We are asking for permission to fill in the area up to the level just below the top of the bulkhead with oversized(1.5—2 inch) gravel as a temporary solution until we have the docks rebuilt in the next several years. We looked into the use of Thru-Flow decking but it is considerably more expensive than wood and a lot more than the temporary solution proposed above. Eventually there will be appropriate wood or Thru-Flow decking used there. Thank you for your consideration, Barbara Butterworth Vice Chair New Suffolk Waterfront Fund 734-6680 P.O. Box 146, New Suffolk, NY 11956 ❖ www.newsuffolkwaterfront.org New Suffolk Waterfront I r i r y - • ` +S C f 'r f This shows the area where we will rebuild the frame and fill with stones. E 2010wntees tz "IX I�We ve W�a -1�- Guest/ eg/ P4-xd, 6c, nc� Ce,�l s 63] 55~3- 9(o I T 'd 991GfrEGTE9 ouel ilea BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7292 DATE: APRIL 21 2010 ISSUED TO: NEW SUFFOLK WATERFRONT FUND~ INC. PROPERTY ADDRESS: 650 FIRST STREET~ NETM SUFFOLK SCTM# 117-8-18 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 21~ 2010, and in consideration of application fee in the sum of $250.00 paid by New Suffolk Waterfront F~t)d~ ~nc~. 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 for the existing 4'x280' dock, eight (8) 3'x20' long finger extensions and approximately 165' long western walkway; 4'x90' lower walkway on the southwest side; 5'x60' floating dock with a 3'x10' ramp off the bulkhead; in-kind repair of winter storm damage consisting of replacing and securing approximately eight (8) 4' wide walkway planks using approved materials; replacing three (3) stringers supporting the planks and one 6'x6' girder supporting the stringers; and replacing one (1) 12" diameter piling to support the girder; replace girders, stringers and 4' long walkway planks for the farthest 58' of total rebuild of the dock; and fill not mor~ than 125 cubic yards of sand behind the bulkhead over a 75' reach starting on the north side of Main Street Extension; and as depicted on the survey prepared by Nathan Taft Corwin III, last dated May 27, 2010, and stamped aPproved on June 4., 2010. IN WITNESS WHEREOF, the said Board of Trustees hereby can~es 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 Peconic Land Trust, Inc., residing at 650 First Street, New Suffolk, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 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 cimumstances 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 Permit. tee 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 Permittee 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. 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) 765-1892 Fax (631) 765-6641 Apdl 21, 2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Dion Lynch P.O. Box 295 New Suffolk, NY 11956 RE: NEW SUFFOLK WATERFRONT FUND, INC. 650 FIRST STREET, NEW SUFFOLK SCTM# 117-8-18 Dear Mr. Lynch: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 21, 2010 regarding the above matter: WHEREAS, Thomas Wickham on behalf of NEW SUFFOLK WATERFRONT FUND, INC. 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 March 31, 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, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on April 21, 2010, 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 have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of NEW SUFFOLK WATERFRONT FUND, INC. for the existing 4'x280' dock, eight (8) 3'x20' long finger extensions and approximately 165' long western walkway; 4'x90' lower walkway on the southwest side; 5'x60' floating dock with a 3'x10' ramp off the. bulkhead; in-kind repair of winter storm damage consisting of replacing and securing approximately eight (8) 4' wide walkway planks using approved materials; replacing three (3) stringers supporting the planks and one 6'x6' girder supporting the stringers; and replacing one (1) 12" diameter piling to support the girder; replace girders, stringers and 4' long walkway planks for the farthest 58'of total rebuild of the dock; and fill not more than 125 cubic yards of sand behind the bulkhead over a 75' reach starting on the north side of Main Street Extension; and as depicted on the survey prepared by Nathan Taft Corwin III, last dated May 27, 2010, and stamped approved on June 4, 2010. 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, Jill I~. Doherty President, Board of Trustees JMD/eac 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 ½ constructed 'V/~' Project complete, compliance inspection. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bm&meyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ~/~_K'~l ~-~]. c~O/O has been reviewed by this Board at the regular meeting of /~0 .¢~' ! o~ ( ,' c:~O~) and your application has been approved pending the compi~etlon of ti~e following items checked off below. /~0,x~ Revised Plans for proposed project __ Pre-Construction 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 Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 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., April 14, 2010, the following recommendation was made: Moved by Audrey Horton, seconded by Peter Young, it was RESOLVED to SUPPORT the Wetland Permit application of NEW SUFFOLK WATERFRONT FUND, INC. for the existing 4'X 340' dock, five (5) 20' long finger extensions and approx. 165' long western walkway; in-kind repair of winter storm damage consisting of replacing and securing approx, eight (8) 4' wide walkway planks using approved materials; replacing three (3) stringers supporting the planks and one 6'X 6' girder supporting the stringers; and replacing one (1) 12" dia. piling to support the girder; replace girders, stringers and 4' long walkway planks for the farthest 58' of total rebuild of the dock; and fill not more than 25 cy. of sand behind the bulkhead over a 75' reach starting on the north side of First St. extension. Located: 650 First St., New Suffolk. SCTM#117-8-18 Inspected by: Jack McGreevy, Audrey Horton, Anne Trimble, Greta Schiller, Doug Hardy The CAC Supports the application with the Condition a plan submitted depicting the needed repair of the walkway and a 4'-6' wide lateral public access boardwalk is constructed across the breadth of the property. Vote of Council: Ayes: All Motion Carried Jill M. Dohe~ly. President James F. King, Vice-President Dave Belgen Bob Ghosio, Jr. John Bredemeyer 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: NEW SUFFOLK WATERFRONT FUND, INC. requests a Wetland Permit for the existing 4'X 340' dock, five (5) 20' long finger extensions and approx. 165' long western walkway; in- kind repair of winter storm damage consisting of replacing and securing approx, eight (8) 4' wide walkway planks using approved materials; replacing three (3) stringers supporting the planks and one 6'X 6' girder supporting the stringers; and replacing one (1) 12" dia. piling to support the girder; replace girders, stringers and 4' long walkway planks for the farthest 58' of total rebuild of the dock; and fill not more than125 cy. of sand behind the bulkhead over a 75' reach starting on the north side of First St. extension. Located: 650 First St., New Suffolk. SCTM#117-8-18 Type g,f.,erea to be impacted: _~.,¢~water Wetland Freshwater Wetland Sound Distance of proposed work to edge of wetland P~a Town Code proposed work falls under: pt.275 Chapt. 111 other Type of Application: ¢'~Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: · ' , V D. en~wski -~ther Form filled out in the field by D~. Bergen~ Mailed/Faxed to: Date: Board o,f I'd 90IL~ELIE9 eue] OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. 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: MarkTerry, LWRP Coordinator Principal Planner Date: April 20, 2010 Re: Proposed Permit to Wetland Permit for NEW SUFFOLK WATERFRONT FUND, INC SCTM#1000-10-1-9 Thomas Wickham on behalf of the NEW SUFFOLK WATERFRONT FUND, INC. requests a Wetland Permit for the existing 4'X 340' dock, five (5) 20' long finger extensions and approx. 165' long western walkway; in-kind repair of winter storm damage consisting of replacing and securing approx, eight (8) 4' wide walkway planks using approved materials; replacing three (3) stringers supporting the planks and one 6'X 6' girder supporting the stringers; and replacing one (1) 12" dia. piling to support the girder; replace girders, stringers and 4' long walkway planks for the farthest 58' of total rebuild of the dock; and fill not more than 25 cy. of sand behind the bulkhead over a 75' reach starting on the north side of First St. extension. Located: 650 First St., New Suffolk. SCTM#117-8-18 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 CONSISTENT with the below Policy Standards and therefore is CONSISTENT with the LWRP; provided that the proposed action meets or furthers the policies and sub-policies outlined below. 6.3 Protect and restore tidal and freshwater wetlands. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The applicant must demonstrate that the followin.q dock standards pursuant to .~ 275-11. Construction and operation standards have been met. (d) Review and approval of dock applications. Before issuing a permit for a dock structure, the Trustees shall consider whether the dock will have any of the following harmful effects: [5] Whether the dock will cause degradation of surface water quality and natural resources; [12] Whether adequate facilities are available to boat owners and/or operators for fueling, discharge of waste and rubbish, electrical service and water service. In the event that the action is approved it is recommended that the application be amended to meet the following Chapter 275 regulations to further Policies 5 Protect and improve water quality in the Town of Southold~ 6.3 Protect and restore tidal and freshwater wetlands and Policy 11. Promote sustainable use of living marine resources in the Peconic Estuary and Town waters. § 275-11 Construction and operation standards. A. General The following standards are required for all operations within the jurisdiction of the Trustees: (2) Erosion control. Installation of an erosion control structure is necessary during any building, grading, landscaping or site work activity within Trustee jurisdiction. This structure may include, but is not limited to, installation ora silt fence, hay bales, wood chip berm and silt booms. The placement of the erosion control structure(s) shall be determined by the Trustees or their designee. All intertidal construction and excavation requires the installation of a silt boom that will retain all suspended sediments within the immediate project area. It is recommended that the silt boom be deployed durin.q the construction of the dock structures. [3] In order to prevent the re/ease of metals and other contaminants into the wetlands and waters of Southold, the use of/umber treated with chromated copper arsenate (also known as "CCA"), commercial copper quat (CCQ), creosote, penta products or homemade wood preservatives is prohibited for use in sheathing and decking. Similarly, the use of tropical hardwoods is prohibited unless it is certified by the Forest Stewardship Council or similar organization. Materials used for structural components shall be determined at the discretion of the Trustees. Minimize the use of CCA treated wood in the marine environment. f2/ Commercial docks (marinas, yacht c/ubs and restaurants). [b~ Construction of new marinas and additions to existing marinas shall require establishment of a pump-out facility for vessel sanitary waste. It is recommended that the establishment of a pump-out facility for vessel sanitary waste be required. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney 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 (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~TJ2wOaStal Erosion Permit Application etland Permit Application Administrative Permit Amendment/Transfer/Extension Rece~ved Application: ~ 3~oL~v~~ ;~Received Fee:$o~ %"-0 E,~ ~'~Completed Application ~.'t?~! ! ~ __Incomplete __SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~TWRP Consistency Assessment Form t]/~ ro ~7,-Ac Referral Sent: t/I.~ 1~ ~Date of Inspection: '~H ~l ID __Receipt of CAC Report! ' .... __Lead Agency Determination: __Technical Review: ~.~d:rlic Hearing Held: ' 1o411o ~Resolution: Name of Applicant Address ¢ a9, Suffolk County Tax Map Number: 1000 - Property Location: ~ .~ 0 ~ll' Vt 4 (provide LILCO Pole #, distance to cross streets, and location) (If applicable) Address: Phone:Cell; ~D ~'¥'-- ~c~ P rd of Trustees Applicatio~ GENERAL DATA Area Zoning: Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Prior permits/approvals for site improvements: Yes 9'//No Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend/ed by a governmental agency? No Yes If yes, provide explanation: Project Description: This project seeks (1) a dock permit for the entire 4-fi wide by 340-ft long subject dock, its five 20-ft long finger extensions a~d its approximately 1,65-ft long Western walkway; (2) in-kind repair of winter storm daraage, consisting of replacing and better securing approx eighty 4-ft ft wide walkway planks using Town-approved materials; ~placing three stringers supporting those plan~s and one 6x6 girder support/ng the stringers; and replacing one 12" diameter piling to ~pport the girder; and replacing girders, stringers and 4-ft long walkway planks for the fattest 58 ft of total rebuild of the dock; and (3) fill not nlore than 25 cu yd8 of sand behind the bulkhead over a 75 R reach starting on the North side of First St extension. 0~/01/2010 20:3? ~31 ~5~ WIO<HAM PAGE 01/83 Fax for Elizabeth C, Trustees 765-664], From Tom Wiekham, 734-5454 Apr 2 Re. New Suffolk Wamrfront -- final rcvisi0~ Pro. jec~ Description: This project seeks (1) a dock permit for the entire 4-fl wide by 340-fl long subject dock, its five 20-tt long finger extensions and its approximately 165-ft long Westcra walkway; (2) in-kind repair of winter storm damage, cor~isting of replacing and better securing approx ~ighty 4-ft fl wide walkway plauks using Town-approved materials; replacing threc stringers supporting those planks and on~ 6x6 gilder supporting the stringers; and replacing one 12" diameter piling to support the girder; and replacing girders, stringers and 4-fl: long walkway planks for the farthest 58 fl of total rebuild of the dock; and (3) fill llot more than 25 eu yds of sand behind the bulkhead over a 75 fl: reaoh starting on the North side of First St extension. Project Description: This project seeks (1) a dock permit for the entire 4-ft wide by 340-ft long subject dock, its five 20-ft long finger extensions and its approximately 165-f~ long Western walkway; (2) in-kind repair of winter storm damage, consisting of replacing and better securing approx eighty 4-fl: fl: wide walkway planks using Town-approved materials; replacing three stringers supporting those planks and one 6x6 girder ~upporting the stringers; and replacing one 12" diameter piling to support the girder; and replacing girders, stringers and 4-ft long walkway planks for the farthest 58 fl: of total rebuild of the dock; and (3) f'dl not more than 25 ca yds of sand behind the bulkhead over a 75 ft reach starting on the North side of First St extension. of Trustees Applicatio0 WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: Percent coverage of lot: square feet Closest distance between tl~ea~est existing structure and upland edge of wetlands: ~JA feet Closest distance between ne.arest proposed structure and upland edge of wetlands: ~) t~ feet Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated? o cubic yards How much material will be filled?~-~'/~,)~ ,~3r cubic yards Depth of which material will be ~ deposited: ~ ~ _g Proposed slope throughout the area of operations: ~ - oc ~ Manner in which material will be ~ deposited: ~'-~'~? 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): Schedule for proposed activities: We propose to complete all work on the dock within one month of having approved permits. We expect to complete filling behind the bulkhead by Oct 31 2010 (provided all permits approved by then) because we intend to use sand dredged up at the neighboring property by Costello/L.Bacon/Robins Island and that dredging will probably not be undertaken until Sept-Oct 2010. of Trustees ApplicatioI COASTAL EROSION APPLICATION DATA Are wetlands present within 100 feet of the proposed activity? ~No Yes Does the project involve ~x, ea~a~filling? No ~""~Yes If Yes, how much material will be~texcavated ~_~(cubicl~lr, yards) How much material will be filled? ~/k ~- ~ (cubic yards) Maimer in which material will be removed or deposited: ,,~ Describe the nature and extent of the environmental impacts reasonably anticipated resulting fi.om implementation of the project as proposed. (Use attachments if necessary) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: COUNTY OF SUFFOLK r~7~. /~,~./TC_L&l.~lkfT, residingat' ~ ~7 ~ /"~*"~ ~Q 'e C.~t-(~ ,~ (D~/ , being duly sworn, deposes and says that on m I d. -~.rl[avof ~ ~ ,20/~,deponentmailedatmecopyoftheNotice ~th- '4e"Bo~rd ot~TJustees Application, directed to each of the above named persons at the addresses set opposite there respective names; tt~the addresses set opposite the names of said persons are the ~Idress of said p~{~6ns as shown on the current _ assessment roLl^of the Town,o~ S, quthold; that said Notice~/w6re mailed at theflg. Jci~xl States t'ost Office at },~)~'~ ' ~v/,,~{ ~, ,that said Notices Ke~ mailed tof(acht//d persons by (certi~/, (r~aislerq~, ma~l. ;/ ~,,/// Sworn to before me this Day of /¢~ / ,20 (~ N~ota ublc~ PENNY BEDELL Notary Pub/ic~S.ta_[e~of New ~ Coumy _ -----,.. ,-v~res Sept. 29, ~oard of Trustees Application County of Suffolk State of New York "x~,~c~ ~' '~\<~"-~ BEINGDULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH 1N 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 ~UN~piER OR BY VIRTUE OF SAID PERMIT(S), IF Cfl~NTED IN COMPLETING THIS PLICATION, I HEREBY AUTHORIZE THE TRJ~EES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY ~OPERTY TO I~SPECT THE PREMISES INCONJUNCTION WITH REVIEW,~;, THI~iP~5/TION' Signature SWORN TO BEFORE ME THIS 'b'\ DAY OF f'c'¥~-..3,~ ,20 \~ Notary Public ALIC~A WALKER · 6153064 ~ Q. uqflfie9 in Suffolk County ~,anlm~s.~o~ I:.xpites Sept. 25, of Trustees ApplicatiO AUTHORIZATION (where the applicant is not the owner) owner of property) (mailing ~ddress) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. .~( Ow~s signature ) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Thc Town of 8outhold's Code of Ethics prohibits conflicts of interest on the oart of town officers and cmnlovecs. The ouroose of this form is to orovide information which can alert thc town ofoossible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name, ~diddie initial, unless you arc 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", nan~c the activity.) Do you personally (or through your company, spouse, sibling, patent, or child) have a relationship ~vith any officer or employee oftbe Town of Sonthold? "Relationship" includes by blOOd, ntarriage, or bu.4inass 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 yourself (the applicant/ageat/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space progided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __:&) the owner of greater than 5% of the shares of the corporate stock of the applic~t (when the applicant is a corporation); __.B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partnei', or employee oftbe applicant; or __.D) the actual applicant. DESCRIPTION OF RELATION SHIP Form TS I Submitted this Signature Print Name 617.20 PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART I - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 3.PROJECT LOCATION: Municipali~ ~ ~, SEQR 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide maa 5.1S PROPOSED ACTION: [] New []Expansion 6. DESC{~ l~oj~ Tlfis project seeks (1) a dock permit tbr the entire ~-ft wide by 340-fl long subject dock, its five 20-ft long finger extensions and it,q approximately 165-ft long Western walkway; (2) in-kinfl repair of winter storm damage, consisting of replacing and better securing approx eiglaty 4-t"t f~ wide walkway planks using Town-approved materials; replacing three stringers supporting tho~ planks and one 6x6 girder supporting the stringers;' and replacing one 12" diameter piling ~O support the girder; and replacing girders, stringers and 4-ft long walkway planks for the farther 58 ft of total rebuild of the dock; and (3) fill not mom than 25 cu yds of sand behind the bulkhead over a 75 ft reach starting on the North side of First St extension. 7. AMOUNT OF LAND AFFECTED: ~ Initially acres Ultimately acres (~ t O ~ 8. VVILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~]~Yes r~ No If no, describe bdefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~]Residential ~]lndustrial []Commercial r--]Agriculture [~Park/Forest/OpenSpace [~er (desc,,'ibe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~'Ges ~ yes, agency name permit approvaJ: No list and / 11. DOES ANY ASPECT OF THE ACTION HAVE A ~.~RRENTLY VALID PERMIT OR APPROVAL? [~Yes ~ If yes, list agency name and peri'it / approval: 12. AS A RESU.~'"'O~ PROPOSE~ ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E es / // Applicant / Sponsor Name r / f/ ~ 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 Agency) A. DOES ACTION EXCEED ANY TYPE l THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review proness and use the FULL EAF. r-lyes rFINe B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative de~tsra~Jna may be superseded by anathef involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WiTH THE FOLLOWING: (Answers may be handwritten, if legible) C1. E.xtsting air quality, surface or groundwater quality o~' quantity, n~se levets, existing traffic pabem, solid waste production o~ dlspoaal, potential to~ erosion, drainage or floobtng problems? Explain bK~lly: C2. Aesthe6~., agflcultural, archaeological, historic, or other natural ~ cultural resources; or community or onlghbo~nond character? Explain brielly: C~. ¥~l~et~ion or tsun*, ~h, ahallfish or ~ldl~ a~cio,, ,*d4t~l~cant hat~tut~, or th~at~:l or enden~r,nd ~p~? F~pl~ln I,::, ~M.. A cemmunit¥'~ esi~tinfl ~lan~ o~ ~o~is a~ ofl~all~ ado~l, o~ a ~aar~ In u~ or Intes*ly o~ a~ o~ ~and or oth~' natural reso~r~? I C5. Growth, subsequent development, or tainted activities likely to be induced by the pro~ action? Explain briefly: ~. Long tona, ~hod t~na, cemulaflve, or oth~' e~t~ nat id~ntifi~d in Ct 42:$? C7. Other Impacts~(inctudi~ changes In use of either quanflt}/or type of enorl[I}~? E~lain brtutt~/: ° D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTA IL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICA E. IS THERE, OR IS THERE LIKELY TO BEI CONTROVERSY RELATED TO'poTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If )~e$ explain: PART III - Dc I ~=RMINA'I1ON OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadveraee~ectidenti~edabeve~detarminewhetherltissubstantia~a~;~e~important~r~then~isesigni~canL Each effect should be assessed in connection with its (a) setling (i.e. urban or rural); (b) probabili{y of occuntng; (c) duration; (d) irreversibili{y; (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 ac~on on the environmental characteristics of the CEA. Check this box if you ha~ idendfind one or more pole~Jally large or slgntlicant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive dedaralton. Check this box if you have determined, based on the information and analysis above and any suplxxti~g documentation, that the proposed actle ~NILL NOT result in any significant adverse envimnmentsl impacts AND pm~.ide, on attachotents as seceocaly, the masons suppa,'ling thl determination. Board of Trustees Name of Lead Agency Jill M. Doherty Print or .j/T~,~N~ame~ Lead Agency ~i~natore °f Res~°nsible Offi~lln Lead Agency Date President Title of Responsible Officer Signature of Preparer (If different fi'om respons/btu officer) Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. 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 Permitg 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 significant 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, listing both supporting and non- suooorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Sonthold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Depaslment, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCT # - - The Application has been submitted to (check appropriate response): TownBoard ~ Planning Board F--] Building Dept. F'~ Board ofTrustees Co) (c) Nature ~ 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) Financial assistance (e.g. grant, loan, subsidy) Permit, approval, license, certification: Prqiect Description: This project seeks (1) a dock permit for the entire 44t wide by 340-fl long subject dock, its fiw 20-ft long finger extlm,qions arid its approximately 165-fl long Western walk-way; (2) in.kind repair of winter storm damage, consisting of replacing and better sectu'ing approx eighty 4-fl fl wide walkway planks using Town-approved material~; replacing thr~ stringers supporting those plalxks and one 6x6 girder suppo~ng the stringers; and replacing one 12" diameter piling to support the girder; and replacing girders, stringers and 4~f~ long walkway plankz for the farthest $$ ft of total rebuild of the dock; and (3) fill uot more than 25 cu yds of sand b~hilxl the bulkhead over a 75 fl reach starting oI~ the Nortl't side of First St extensiort. Location of action: Site acreage: Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: t~ ~-~'/~- ff-.~-rah, f .rl~'~, ~'"**- (c) Telephone number: Area Code (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency9 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. [~es ~ No ~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southoid. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~Yes ~ No ~ Not Applicable AR,ach 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 Ill - Policies Pages 8 through 16 for evaluation criteria ~Yes ~ No ~ Not Applicable · Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 th~.~21 for evaluation criteria ~] Yes V~ 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 Applle Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~No~tApplicable 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 HI - Policies; Pages 34 through 38 for evaluation criteria. ~] Yes [] No ~N~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 Southoid. See LWRP Section III - Policies; Pages 38 through 46 for evaluation 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 Peconic 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 Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. Yes NoApplicable SURVEY OF PROPERTY SITUA TED A T NEW SUFFOLK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-117-08-18 SCALE 1 "=,30' JULY 6, 2005 NOVEMBER 19, 2005 ADDED AREA OF NEW YORK STATE LAND GRANT OCTOBER 25, 2006 ADDED LOW WATER MARK NOVEMBER 21, 2007 UPDATE SURVEY MARCH 17, 2009 ADDED GRADE ELEVATION MAY 27, 2BlS ADDED ADDITIONAL NOTES KING N/O/P S 83'29'29" PHILIP LORIA 83"47'30" E ]38.22' 113.47' FRAME BUILDING T pOLE E :¢/o/~ ROBIN ISI~VS HOLDINGS LLC. N 83"05'30" W CONC ',iON 204.43' L APPROVED BY F~OARD OF TRUSTEES TOWN OF SOUTHOLD S.C. TAX No. 1000-117--8-18 AREA -- 149,324.97 sq. ff. (TO TIE UNE 3.428 ac. & BULKHEAD) TOTAL NEW YORK STATE LAND GRANT AREA 105,000.00 sq. fl, 2,410 New YORK STATE LAND GRANT LESS = 93,174.69 sq. ff. P/O S.C. TAX No. 1000-117--8-18 AREA 2.159 TOTAL NEW YORK STATE LAND GRANT AND = 242,499,66 sq. fl, S,C, TAX No. 1000-117--8-18 AREA 5,567 ac, CERTIFIED TO: FIDELITY NATIONAL TITLE INSURANCE COMPANY OF PECONIC LAND TRUST NEW YORK 8 04 o.e.° 8 29"07'10" E 35.11' S 81'15'12" 91.8, --5.36 E S 74'46'.39. 62.60' .I N 88'4:5'35" W 176.[ NOTES: 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. EXISTING ELEVATIONS ARE EXISTING CONTOUR LINES 1929 DATUM SHOWN THUS:,~ ARE SHOWN THUS: ...... / TEST HOLE B1 TEST HOLE B2 THE EXISTENCE OF RIGHT OF WAYS N.Y.S. Lic. No. 50467 Nathan Taft Corw n III Land Surveyor PHONE (631)727-2090 Fax (631)727-1727 27 431z~