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HomeMy WebLinkAboutTR-7378Jill M. Dohe~:y, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631) 765-1892 Fax (63t) 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 I st day of construction ½ constructed v~ Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7378 DATE: AUGUST I8~ 2010 ISSUED TO: JOHN PEARSON PROPERTY ADDRESS: 3575 WELLS AVENUE~ SOUTHOLD SCTM# 70-4-5 AuTHORiZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code 0fthe Town of Southold and in accordance with the Resolution of the Board of Tmstee~ adopted at the meeting held on Auansi 1~8.2~)10, and in consideration of application fee in the sum 0f $250.00 paid bY John pearson and sfbj~ci to the Terms and ConditiOns as stated in the Resolution, the Sodth0id Town Board of Trustees authorizes and permits the following: Wetland Permit to construct apProximately I01 linear feet df vinyl bulkhead in place of (and +/-6" to +/-12" higher than) existing timber bulkhead and backfill with approximately 25 cubic yards sand to be trucked in from and upland source; construct 4'x8' wood walk to existing dock in place of existing walk behi!~d bulkhead; and as depicted on the site plan prepared by EN-Consuitants, Inc. last dated July stampedapproved on August 18, 2010. IN WITNESS WHEREOF, the said Board of Trustees hereby caus~ 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 Pennittee John Pearson. residing at 3575 Wells Avenue, Southold, 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 Trnstees 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 Permittec assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject tot he 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 fight 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 tha~ may be required supplemental to this permit, which may be subject to revoke upon failure io 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 August18,2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann EN-Consultants, Inc. 1319 North Sea Road Southampton, NY 11968 RE: JOHN PEARSON 3575 WELLS AVENUE, SOUTHOLD SCTM# 70-4-5 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 18, 2010 regarding the above matter: WHEREAS, EN-Consultants, Inc. on behalf of JOHN PEARSON applied to the Southoid 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 July 27, 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 August 18, 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 ail 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 JOHN PEARSON to construct approximately 101 linear feet of vinyl bulkhead in place of (and +/-6" to +/-12" higher than) existing timber bulkhead and backfill with approximately 25 cubic yards sand to be trucked in from and upland source; construct 4'x8' wood walk to existing dock in place of existing walk behind bulkhead; and as depicted on the site plan prepared by EN-Consultants, Inc. last dated July 12, 2010, and stamped approved on August 18, 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, President, Board of Trustees JMD/eac Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 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., August 11, 2010, the following recommendation was made: Moved by Jack McGreevy, seconded by Doug Hardy, it was RESOLVED to SUPPORT the Wetland Permit application of JOHN PEARSON to construct approx. 101 If. of vinyl bulkhead in place of (and +/-6" higher than) existing timber bulkhead and backfill with approx. 25 cy. sand to be trucked in from an upland source; construct 4'X 8' wood walk to existing dock in place of existing walk behind bulkhead. Located: 3575 Wells Ave., Southoid. SCTM#70-4-5 Inspected by: Jack McGreevy, Doug Hardy, Audrey Horton The CAC Supports the application with the Condition the bulkhead is not raised and is constructed in-place with rip-rap within 12" on top of the bulkhead and landward, designed to minimize reflective wave energy, and with a 6'-8' landward return on the west end of the new bulkhead. Vote of Council: Ayes: All Motion Carded Jill M Dohe~ly, President James F. King, Vice-Pres/dent 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: ~.// // JOHN PEARSON requests a Wetland Permit to construct approx. 101 If. of vinyl bulkhead in place of (and +/-6" higher than) existing timber bulkhead and backfill with approx. 25 cy. sand to be trucked in from an upland source; construct 4'X 8' wood walk to existing dock in place of existing walk behind bulkhead. Located: 3575 Wells Ave., Southold. SCTM#70-4-5 aarea to be impacted: ter Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part o, gjf/TOwn Code proposed work falls under: ~,~hapt.275 Chapt. 111 other Type of Application: /----"'~etland __Coastal Erosion __Administrative__Emergency Pre-Submission __ ~Amendment Violation Infoneede , , , 13 Modifications: Conditions: e re "~'. ;nzge ~sD~iih e rty J~B re d e m eye r other Form filled out in the field by D. Bergen__ Mailed/Faxed to: Date: JOHN PEARSON~ 3575 WELLS AVENUE~ SOUTHOLD Figure 1. Looking nortbwest westerly half of ~ + ..... _101 timber bulkhead to be replaced (in-place) wtth vtnyL Figure 2. Looking northeast at easterly half t~f ex. ~-101 ' timber bulkhead to be replaced (in-place) with vinyl JOHN PEARSON, 3575 WELLS AVENUE~ SOUTHOLD Figure 3. Lookhtg west along top of westerly half of em +_101' timber bulkhead to be replaced (in-place) with vinyl Figure 4. Looktng east along top of easterly half of ex~ _101 ttmber bulkhead to be replaced (in-place) with vinyl. 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 Date: August 16, 2010 Re: Proposed Wetland Permit for JOHN PEARSON SCTM# 1000-70-4-5 En-Consultants, Inc. on behalf of JOHN PEARSON requests a Wetland Permit to construct approx. 101 If. of vinyl bulkhead in place of (and +/-6" higher than) existing timber bulkhead and backfill with approx. 25 cy. sand to be trucked in from an upland source; construct 4'X 8' wood walk to existing dock in place of existing walk behind bulkhead. Located: 3575 Wells Ave., $outhold. SCTM#70-4-5 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 Policy Standards and therefore is CONSISTENT with the LWRP provided the following best management practice is required pursuant to: § 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 of a 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 proiect area. 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 Brederneyer 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 Office Use Only _~voastal Erosion Permit Application etland Permit Application Administrative Permit Amendmenl~Trans fer/F~xten sion ,~eceived Application: ~1~ ~']~'eceived Feel~ _~ompleted Application ' Incomplete __SEQRA Classification: Type I Type II Unlisted Coordination: (date sent). ~WRP Consistency~, .__ ~ _Assessment Form ~AC Referral Sent: ~ ~ate of Inspection: _ _ _ __Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~Public Hearing Held: ~~__ ~Resolution: Name of Applicant JOHN PEARSON Address 3575 WELLS AVENUE, SOUTHOLD, NY 11971 Phone Number: (631) 765-6941 Suffolk County Tax Map Number: 1000 - 70-4-5 Property Location: 3575 WELLS AVENUE, SOUTHOLD (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, INC. (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 Board of Trustees ApplJtion GENERAL DATA Land Area (in square feet): 20,493 SQ. FT. Area Zoning: R-40 Previous use of property: RESIDENTIAL, 1-FAMILYDWELLING Intended use of property: NO CHANGE Covenants and Restrictions:_ If "Yes", please provide copy. Yes X No Does this project require a variance from the Zoning Board of Appeals If "Yes", please provide copy of decision. __ Yes X No Prior permits/approvals for site improvements: Agency Date __ 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): Construct approximately 101 linear feet of vinyl bulkhead in place of (and +/-6" higher than) existing timber bulkhead and backfill with approximately 25 cubic yards sand to be trucked in from an upland source; construct 4' x 8' wood walk to existing dock in place of existing walk behind bulkhead, all as depicted on the project plan prepared by Eh-Consultants, Inc. dated July 12, 2010. Board of Trustees Applltion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To maintain existing bulkheaded shoreline. Area of wetlands on lot: 0 _square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? NO X Yes If yes, how much material will be excavated? N/A How much material will be filled? +/-25 cubic yards Depth of which material will be removed or deposited: <2 Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: cubic yards feet Approximately 25 cubic yard clean sand fill will be tracked in from an upland source and dumped & graded as backfill to be vegetated landward of new bulkhead. 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): The project entails the ordinary and routine maintenance of a bulkheaded shoreline through the in-place replacement of an existing treated timber bulkhead with new untreated, vinyl-sheathed bulkhead. As the existing vegetated embankment behind the bulkhead will be restored through native plantings and maintained as a nonturf buffer, the project will have no adverse impact on the adjacent tidal wetlands or waters of the Town. PR(~JECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 1OHN PEARSON BY EN-CONSULTANTS, INC. 3. PROJECT LOCATION: Manicipality SOUTHOLD 617.20 1~[ APPENDIX ~ STATE ENVIRONMENTAL QUT[LITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by P ,licam or Project Sponsor) 2. PROJECT NAME DEARSON BULKHEAD REPLACEMENT County SUFFOLK 4. PRECISE LOCATION: Street Address and Road Intersections. Prominent landmarks etc - or provide map SEQR J575 WELLS AVENUE, TOWN OF SOUTHOLD, SCTM #1000-70-4-5 5.1SPROPO EDACTION: 6. DESCRIBE PROJECT BRIEFLY: Construct approximately 101 linear feet of vinyl bulkhead in place of (and +/-6" higher than) existing timber bulkhead and backfill with approximately 25 cubic yards sand to be trucked in from an upland source; construct 4' x 8' wood walk to existing dock in place of existing walk behind bulkhead, all as depicted on the project plan prepared by En-Consultants, Inc. dated July 12, 2010. 7. AMOUNT OF LAND AFFECTED: lni~y 0.47 acres Ultimately 0.47 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes ~ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~Residential [~Industrial ~Commercial ~Agricult~re [~ Park / Forest / Open Space [~Other(describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~Yes ~ No If yes, list agency name and permit / approval: DEC, COE, DOS 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ["~]Y es [~No If yes, list agency name and permit / approval: I~S A PhF~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I lyes IXINo 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ROBERT E. HERRMANN, COASTAL MANAGEMENT SPECIALIST Date: JULY 16, 2010 Signature If the action is a Coastal 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 i THRESHOLD iN 6 NYCRR, PART 617.47 If yes, ceoedthate the reV~w process and u~e the FULL EAF. B. WILL ACTION RECEIVE COORDINATED REVIEWAS PROVIDED FOR UNMSTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a ne~stlve C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOIMNG: (Answe~ may be Imndw~t(en, If isgiide) boten~M fo~ erosion, drainage or lloading problems? Explain b~. I I I ° (:5. Growth, subsequent de~;u~,,e~L or related aciiv~,es likely le be Induced by the proposed ac~? r:y..~!,~ bdeiiy: C6. Long term, shod term, cumulative, or other elfects not identified In C1-C57 Explain bdeiiy: Yes ~ Ne ! ~ ~ I )'er expI brioflr: I I E I$ THERE, OR IS THERE UKELY TO BEt CONTROVERSY RELA'I'~D TO'POTEN'T~1AL ADVERSE ENVIRONMENTAL IMPACTS? If PART ffl - DEIERMiNATIoN OF $1GNIFICAIfiCE (To be completed by Agency) INSTRUCTIONS: F~reachadve~ee~ectidenU~adab~ve~delem1~newhetheritissubstantiel~arge~m~r~$~n~nL Each effe~ should be assessed in connection with its (a) seffing (i.e. Urban or mrel); (b) pmbebifity of occurring; (C) duration; (d) irre~mrslbifity; (e) geographic scope; and (0 magnitude. If necessary, add attachments or mfefen~e supporting matadals. Ensure that exp~nations (x~tsin mdficient detail to show that ell relevant adverse impacts have been identified and adequately addressed. If question d of part Il was checked ye~, the,detarminaflon of significance must evaluate the potential impact of the proposed action on the em~onrrm~el characteristics of the CEA. Che¢k this box if you have ideal, ad o~te or mom potm~al[y large or slgrflfl~mt adverse impa;in wflk:h MAY ocoj~, ltmn proceed dim~ to the FUU EAF and/or prepare a positive declarati(m. Check this box if you have detmmined, based o~ the infommIion and anal'./ds above taxi any suppndl~g docume~Iion, that the pmposad ac~of WILL NOT result in any slgniiicant adverse eftvlror~mental Impa~in AND provide, o~ affachraents as necessary, the mas~'~$ suppmllng thl~ determination. Board of Trustees Name of Lead Jill M. Doherty ~." sl~,~a[u~of Respo~lbie Officer in Lead ,~eecy Date President 'i-~le of Responsible Officer 81gna[ure of Preparer (If different from responsible officer) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTYLOCATION: S.CT.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 1000 70 6 32 STORM-WATER, GRADING, DRAINAGE AMP EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW'YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT I Yes No a. What is the Total Area of the Project Parcels? 1 Will this Project Retain AIl Storm-Water Run-Off (include Total Area of all Parcels located within Generated by a Two (2") Inch Rainfall on Site? the Scope of work for Proposed Construction) 20,493 SQ. FT. b, What is the Total Area of Land Clearing (s.~4 A~s)) (This item will include all run-off created by site cleating and/or construction activities as well as all -- and/or Ground Disturbance for the proposed Site improvements and the permanent creation of construchon activity? I$.E / ^ores) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional rages as Needed)) Drainage structures Indicating Size & Location? This 12q item shall include all proposed Grade Changes and -- Construct approximately 101 linear feet of vinyl bulkhead Slopes Controlling Surface Water Flow, 3 Does the Site Plan and/or Survey describe the erosion in place of (and +/-6" higher than) existing timber and sediment control practices that will be used to X control site erosion and storm water discharger. This bulkhead and backfill with approximately 25 cubic yards Item must be maintained throughout the Entire Construction Period. sand to be trucked in from an upland source; construct 4' x 4 Will this Project Require any Land Filling, Gradinff or Excavation where fhere is a change to the Natural 8' wood walk to existing dock in place of existing walk Existing Grade involving more than 200 Cubic Yards of Material within any Parcel? behind bulkhead, all as depicted on the project plan 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand I I prepared by Eh-Consultants, Inc. dated July 12, 2010. (5,000 S.F.) Square Feet of Ground Surface? 6 ls there a Natural Water Course Running through the Site? Is tins Project within the Trustees jurisdiction General DEC SaArppP Requirements: or within O~e Hundred (10ft) feet of a Wetland or Submission of a SWPPP is reainred for all Construction activities tuvolving soil Beach? ale imrt of a target c°nmm~ Ptan that 'Ma ulUm~mlY distttff° °ne °r mm:e acl'es cfi lands; which E xceed Fifteen (15)feet ° f Vertical Rise t° Including Ccrt~a~'d°n activgies in'lying scSI c~tutheares c/1~ than °ne 0) ac~e where One Hundred (100') of Horizontal Distance? the DEC has deternimd that a SPDES pern~t is required for storm water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other impervious tot Storm Water Discharges from Consnuction activay - Permit No. GP-0-10-001.) Surfaces be Sloped to Direct Storm_Water Run_Off ~ X 1. The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2. The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required, post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any ~ X constructed to reduce the pollutants in storm water discharges and to assure Item Withill the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit, in addition, the SWPPP shall quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark that is knowledgeable in the privciples and pracEces of Storm Wa ret Management. ~ A O~ck Mink ~X) ar~ Ans~ f0~ each Question is ~ for a ~ ApFlioEc~. COUNTY OF SUFFOLK That I, .I~?~-[~T-~-HERRMANN being duty sm deposes and says that he/she is the applicant for Permit, AGENT FOR OWNER And that he/she is the (O,~r, Crrmorr, ~ Cc~crae or, r, etc make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed, in the manners set forth in the application filed herewith. Notary Public .................. (signature of Applicant) FORM - 06/10 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 Tclcphone (631 ) 765- [ 892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of JOHN PEARSON COUNTY OF SUFFOLK) STATE OF NEW YORK) I, Robert Herrmann 1319 North Sea Road, AFFIDAVIT OF POSTING , rl~t~l{~:~llr/dba En-Consultants, Inc. Southampton, NY 11968 being duly sworn, depose and say: That on the { lCday of August ,2010, I personally posted the property known as 3575 Wells Avenue, Southold by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed.~ August 18~ 2010 on or about 6:00 PM. Dated: (s]gnatU~r~/~' Sworn to before me this day of f~,~. 20~ t~ Notary"Public - ' NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: John Pearson SCTM# 1000-70-4-5 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct approximately 1 O1 linear feet of vinyl bulkhead in place of(and +/-6" higher than) existing timber bulkhead and backfill with approximately 25 cubic yards sand to be trucked in from an upland source; construct 4' x 8' wood walk to existing dock in place of existing walk behind bulkhead, all as depicted on the project plan prepared by En-Consultants, Inc. dated July 12, 2010. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 3575 Wells Avenue, Southold 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: August 18th, 2010 ~ 6:00 P.M. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: John Pearson MAILING ADDRESS: 3575 Wells Avenue, Southold, NY 11971 PHONE#: 631-765 -6941 AGENT: EN-CONSULTANTS, INC. MAILING ADDRESS: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. 1' = 40' I ¢ t t/~ STORY FRAME HOUSE AND GARAGE 101 L.F. OF CONSTRUCTED IN THAN) EX. VEGETATED & AS NONTU ADJ. BLKHD. AHW EX. WALK TO DOCK BE REPLACED (IN-PLACE) ~OCKEY OF (AND ~ioo' ALW DOCK TO REMAIN CP~EK ADJ. BLKHD. TH 5b~J~Cf NECK :~FOH XdT PROPOSe.[) BLLIq-IF::AP ~PL. AC~Mt~NT (IN PLACF_..) FOR JOHN PP.-AI~f~2N ON JOCKEY CRU~K, .f;,OIJ1'HOL~2, 5tJff:ObK COUNTY, NY ~F.~'FI Of I 7/12/I0 Name: RITA & JOSEPH DeNICOLO JOAN & TOR TORKELSON ATHINA & STEVEN SKOPELITIS JENNIFER & MICHAEL KOKE Address: 3 VALENTINE DRIVE ALBERTSON, NY 11507 P.O. BOX 511 SOUTHOLD, NY 11971 P.O. BOX 1535 SOUTHOLD, NY 11971 P.O. BOX 1035 SOUTHOLD, NY 11971 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERTE. HERRMANN doing business at EN-CONSULTANTS, INC. 1319 NORTH SEA ROAD SOUTHAMPTON, NY 11968 , being duly sworn, deposes and says that on the 23rd day of JULY ,20 10 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above naraed persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at SOUTHAMPTON , that said Notices were Mailed to each of said persons by (certified) i~) mail. /%~ ROBER COASTAL MANAGEMENT SPECIALIST Sworn to before me this day of JULY ,20 10 23rd Postage Certified Fee SE Jennifer & Michael Koke P.O. Box 1035 Southold, NY 11971 Rita & Joseph DeNicolo ] Valentine Drive '] .............. ii,P--,.~,- m Postage ru CeWfied Fee E:] Return Receipt Fee D (RnOorsemer~t Required) rm Restricted Delivery Fee D (Endorsement Required) t'rl ru Total Postage ~ m ~ Sent To tx. or PO Box No. Athina & Steven Skopelitis P.O. Box 1535 Southold, NY 11971 OFFiCiAL USE Joan & Tor Torkelson P.O. Box 511 Southold, NY 11971 Board of Trustees Applic n AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at. ~[-7 F Pl/~/)~' (mailing address) /~ 'x~'0~J~}']*q~t/~ do hereby authorize ~br/¢4~ (Agent) ~1-1~ ['~'/14 ~ O~ to apply for pe~it(s) from the Southold Board of Town Trustees on my behalfi (Owner's signature) Board of Trustees Application County of Suffolk State of New York -~2 0 /I/k ['~ ~'[ ~4 ~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS ~ DAY OF ]~ pM' I ,20 l (I Notary Public DEBORAH L KELLY Notar/Public, State of New York No. 01KE60~7198 C~rat~lon Expires Febn.~y 14, 20/_~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the oart of town officers and emolovees. Th~ purpose of this form is to orovide information which can alert' the town of r>ossible conflicts of interest and allow it to take whatever action necessary to avoid same. ,~ (Last name, first name, middle initial, unless you are 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 ali that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other", name the activity.) }"f_ ~/)1(~(.~ /.~{~ ~ /-It'&. Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agentJrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); __B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __ C) an officer, director, partner, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this ~ of_/~'(3~' ~, 200 [ O Signature q~_~tSc-'t ' ,~. PrintName ~ljl~ [/~J- ~40~1 EN-CONSULTANTS, INC. ENVIRONMENTAL CONSULTING 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com July 19, 2010 Mark Terry, LWRP Coordinator Planning Board Town of Southold P.O. Box 1179 Southold, NY 11971 Re: John Pearson~ 3575 Wells Avenue~ Southold Dear Mr. Terry: Attached please find a copy of an application being filed with the Board of Trustees for a Town Wetlands Permit to replace an existing timber bulkhead with a vinyl bulkhead in the same location, as depicted on the project plan prepared by En-Consultants, Inc., dated July 12, 2010. Pursuant to Town Code §268-5 ("Review of Actions") and the corresponding definitions of "action" and "minor action" by §286-3 ("Definitions"), the project meets the following definition of minor action and is thus not subject to waterfront consistency review pursuant to Chapter 268: "GG. Within all Town creeks, replacement of existing bulkhead on the applicant's property in the same location with a silt curtain deployed prior to and during construction." Therefore, I have not filed an LWRP Consistency Assessment Form with the Trustees. Should you determine the project is not exempt from waterfront consistency review, however, please let me know and I will file the form with your office immediately. i - Coastal Management Specialist cc: Lauren Standish, Board of Trustees EN-CONSULTANTS INC. ENVIRONMENTAL CONSULTING 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www.enconsultants.com July 16, 2010 Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Re: John Pearson 3575 Wells Avenue, Southold SCTM # 1000-70-4-5 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including: a) Short Environmental Assessment Form; b) Authorization & Disclosure Forms; c) project plans; and d) survey. One (1) set of site photographs. Application fee of $250.00 wetlands. I trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Sl~ ~l~' Herrm ann Coastal Management Specialist ~Jls Enc.