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TR-7384
I s I � , on and, N3 P CL Ips Q) % -NEW 0-0'DIA X 4'-0' STOzm DRAINAGE RING SC MR 10 EXISTING FRAME GARAGE EL 18 84, Ti U) d !EST HOLE _ WIRES CONNECTED TO TREE 70 ANliq 8'-0'DIA X 4'-0' STORN DRAINAGE RING (MUST BE 20'AWAY FROM 01 8'-0'D x IV-01--- STORM DRAB E RING EX15TIW.SANITARY) (Er B)EXi� SANITARY -E(15TING CELLAR STAIK:5 TO BE RE110VED AND RELOCATED PROPOSED PORC"— UNDER COVFREV FORCII too -EXISTING ROOF TO BE REMOVED AND E135TING 5ECORD FLOOR q,-As4io5 ce;vcj, WOOD FRAME TO BE EXPANDED RE51DENCE -IN FLOOR EL 2190 311' EfISIWG Woo lacv ib scda T oD E i —TIMBER RETAINING WALL jUll 2 CD $outholO In e DIE .13EP LE \t � r �. � �. `� M T:, � 1 r_� �' �� � -���. Y f r� Y^ *• .e4 - jj k f !' _ '�� � � ` 6 _ f t! i � �i I � . i � i �ti� � li \`�� � - - �� '��� ��:. / ., yl, t/ . �v y�.. �d �- ._ i�.- - :� � , i 1 __ a T.—,p'� X11' y... �� _ f _ ��.� r � �� �" � �" �o'. � ,r .- t �11" _ � -� ��' .- - - _1 � . �� rail i � i w i • . I � I r p — I ,u t �I rr T7 I , X r r i i a � ,• r � — + Ai,� \' = � \\ t'n, Y, 1. • lI \ T •1� 1 �.. yv LL � 4L.r� ,yam ' ION, - i. 1 i Ir ` +#� •.' fT' M� rJt� �r `, 71. ' I�, +�� rN!1��^�)l� d+1 r «. ?r, `I )IJ6ii MT y� 1 1 I � I d� d IL Y �• F � M Y OIr � . �r •.,�,, ,� � C �`!�; ���I � ISI "►,./ v t, yr +� - . IWO 1 Petr M E 1 - ,l oan Shannon t 7080 Great Peconic Bay Blvd., Laurel SCTM# 126-11-7 7/10/13 - ! y �.E 1 __ _ _ - -_ �� . , _ _` . �_ �u Y _ s __,.= . . , .z _ _ - __ ,�.� :- �---- _ _-=- _ -_ <,_._ , /// ' / / 1 '/ i rV / ! � /j/ / ' /� / �� r¢�.._.. .. ._. +����.t � �i :�� _ � � ''s#.' �� „ r -v r ��;� � � r 4 �,v C i�.�'� f � 'ice �� e%r, r _ �r -, � �; j' � � � � , � �ppsuFFoc�. James F. king,President ��QV Cp_ P.O.Box 1179 Bob Ghosio.Jr.,Vice-President a Z� Southold,NY 11971 Dave Bergen � Telephone(631 765-1892 John Bredemeyer ,�, m Fax(63 1)765-6641 Michael T Domino y Southold Town Board of Trustees Field Inspection/Work Session Report Dateffime: Jl) -- /0 D e') 3 JOAN SHANNON requests an Administrative Amendment to Wetland Permit #7384 to remove approximately 900sq.ft. of decking on upper deck and install cedar decking over existing framing, and replace existing railing with cedar railing; realign existing stairs; on the lower deck, remove approximately 1,800sq.ft. of decking and replace with cedar decking over existing framing; furnish, install and straighten framing as necessary on lower deck; repair existing shower area and rebuild walls around shower; straighten lower seawall and re- secure; install sand and fill for beach and tie wall area. Located: 7080 Great Peconic Bay Boulevard, Laurel. SCTM# 126-11-7 Type of area to be impacted: _Saltwater Wetland _Freshwater Wetland _Sound Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Z�Chapt.275 Chapt. 111 _other Type of Application: _Wetland _Coastal Erosion _Amendment �ffministrative_Emergency _Pre-Submission Violation Info needed: Modifications: iLJOs'u >> �?jjv1/t✓ ;. � Nf rvr �. x rz < Conditions: Present Were: J. King _B. Ghosio D. Bergen, ✓. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: t r . / �� ��� r � • - 111 �/i � - 4� r ��_ _ • _ �*`� � '�. . i a i , '� ss i � S� ,� J I 1 1 , 1 ., �11111IIII ► , ' �. . �i��• � S e�=y Sp i. f l •i �[ d, (�,q�{ i} �hy'ij` d '�1 ��'• 441, IP r 4f � �� 1 M r � 4 aim 11 +u r mo. i xs ,•3, y�i +t� e��1% New York State Department of Envir Conservation _ Division of Environmental Permits, Region � SUNY 0 Stony Brook,50 Circle Road,Stony Brook, 0-3s Phone:(831)444-0483 • RAX:(831)444-0380 _ webOW.www.demstate.ny.us JUN 2 8 2013 axrw.re.or.nna CaMnMsanrr Tmm LETTER OF NON-JURISDICTION: TIDAL M TLANDS ACT April 2, 2008 Jam Shannon I J__, P.O_ Box 151 Laurel, NY 11948 Re: Shannon Property 7080 Great Peconic Bay Blvd. Laurel, NY 11048 DEC#1-4738-08420!00001 -- — --- — — Dear Ms. Shannon: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: The portion of your property which is located landward of the twenty foot(MSL)elevation contour on a gradual,natural slope,as shown on the surrey prepared by Stanley J. Isaksen,Jr,last revised June 12, 2007, is beyond the jurisdiction of Article 25(Tidal Wetlands). Therefore,in accordance with the current Tidal Wetlands Land Use Regulations(6NYCRR Part 861) no permit Is required under the Tidal Wetlands Act . Please be advised, however, that no construction,sedimentation,or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary,as indicated above,without a permit. It Is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include mak►taining adequate work area between the tidal wetland jurisdictional boundary and your project (Le. a 15' to 20'wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly your i Laura Scovaao Permit Administrator cc: Robert Stromeki, Searles, Stromaki, Associates SUFFOLK COUNTY DEPARTMENT I OF CONSUMER AFFAIRS WE HOMEIMPROVEMENT CONTRACTOR RANDALL S CLEMENT t L.� This certifies that the bearer is duty CLEMENT CARPENTRY licensed by the County of Suffolk 47966-H s 10 R.Gr.P An 1" m C...,n.- 09/01/2014 oECEVED JUN 2 8 2013 Southold Town r f Tr t STAT NEW YORK WORKERS' COMPENSAT OARD CERTIFICATE OF N WORKERS' COMPENSATION INSURANCE COVERAGE In.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of Insured Work Location of Insured(Only required ifcoverage is specifically limited to certain locations in New York State, i.e., a Wrap-Up Ic.NYS Unemployment Insurance Employer Policy) Registration Number of Insured Randal Clement Po box 287 ld.Federal Employer Identification Number of Insured Jamesport ny 11947 or Social Security Number 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) FARM FAMILY CASUALTY INSURANCE CO 4 3152w8879 Town of Southold 3b.Policy Number of entity listed in box"1 a" 53095 Main Road c. Policy effective period Southold NY 11971 3 03/05/2013 to 03/05/2014 3d. The Proprietor,Partners or Executive Officers are ❑ included. (Only check box if all partnerstofricers included) ■ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "la" for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"T'. The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment ofpremiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for oneyear after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c r',whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent o 7JU r r e nn above and that the named insured has the coverage as depicted on this form. \� Approved by George Formes � (Print name of authorized representative or licensed agent of insurance ca ry :2:20]13 - 1 8 2013 j � � Southold sown Approved by: 6/ f Tr (Signature) (Date) Title: AGENT Telephone Number of authorized representative or licensed agent of insurance carrier: (631) 722-4100 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) www.wcb.state.ny.us Alii L® DATE 27/2 /13 `/ CERTIFICATE OF LIABILITY INSURANCE 06/27/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER GEORGE FORMES NAMEACT LINDA SZYMCZAK (u o at:631-722-4100 1116 MAIN ROAD P"," Np),631 722 4500 E-M�iIL -- -- PO BOX 2336 ADDREss.LINDA SZYMCZA�ARM-FAMILY.COM AQUEBOGUE, NY 11931 INSURERS)AFFORDING COVERAGE CO_ �NAICa _ INSURER A. FARM FAMILY CASUALTY INS. CO. I_ 120___ INSURED INSURER B: RANDALL CLEMENT INSURER c: PO BOX 287 INSURER D: JAMESPORT, NY 11947 INSURERS INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE /NSR SUBR POLICY EFF POLICY EXP r A GENERAL LIABILITY N-O} POLICY NUMBER (MM/DDrYYYV)I(MM/DD/YYYVJIr_. LIMITS �13101L7692 08/31/2012I08/31/2013I EACH OCCURRENCE $ _ ___ 1,000,000 XX COMMERCIAL GENERAL LIABILITY ADDL p-MAI ES(Ee omurtence) $ 50,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 - PERSONAL BADV INJURY I $ INCLUDED GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS COMP/OP AGG $ 1,000,000 AUTOMOBILES _.1 JER8T 1 LOC - $ -- POLICY i LIABILITY - -_. - -_ - _- - Mccid�SrNGLE LI $ _.. Ea ANY AUTO BODILY INJURY(Per person) $ ALL pWNED gCHEDULED - AUTOS AUpTOpSS BODILY INJURY(Per accident) $ HIRED AUTOS hUTOSWNED PROPERTY A MAGE -- - - (Per accident) $ _ I UMBRELLA LIAR ! OCCUR EACH OCCURRENCE _ - -ACLAIMS-MADEi, EXCESS LB AGGREGATE E LIAB $ _ __ _ _ � DED A AND EMPLOYERS' 3152W8879 3152W8879 03/05/2013103/05/2014 WCsrnru- — OTH- ANDEMPLOVERS'LIABILITV YIH 1T9RV LIMITS L. ER -_ANY PROPRIETOR/PARTNER/EXECUTIVE A I N I A E L EACH ACCIDENT $ 100,000, OFFICERIMEMBER EXCLUDED? 11 --- - IMandatory In NH) - E L DISEASE EA EMPLOYEES 100,000 Lyes,describe under - -- - - DESCRIPTION OF OPERATIONS below _ _ _ E L DISEASE POLICY LIMIT $ 500,000 I DESCRIPTION. OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 701,Additional Ransil Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SOUTHOLD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 MAIN ROAD ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1179 AUTHORIZED REPRESENTATIVE SOUTHOLD NY 11971 �J 61988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD { w. OF TOWN OF SOUTHOLD PROPERTY RECORD CARD iJ OWNER STREET 7 VILLAGE. DIST. SUB. LOT. FOOMIER OWNER N L E S W� TYPE FBUILDINGa � FARM B. MISC. Mkt. Value ES. 2 �d SEAS. VL. COMM. C ..Q.lo�9Qtite�.4Wvca ' LAND IMP. TOTAL DATE REMARKS <`�y �y� 6a ipfp °_—, Z 14Ke.j witPavy w '• ' o Q � n �- � r.� Fr•edJ e - �3a o0 TRY- �, Y" , j a - L! _75S' 9s�"rr; ✓ ShGnnt�n _ ,a�r-o0 ,o. 10 C, ej 2-60 ^ 0 e7 b # 0LNVic+ &I rn4•tog r:Ct AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable l Tillable 2 Tillable 3 Redland Swampland FRONTAGE ON WATER 8rushlond FRONTAGE ON ROAD j House Plot DEPTH �L BULKHEAD DOCK ''rvA' Total NONE■ ■■■■/■■■n■/■■■■■■i■ MEMOS ■■■■■■■®fAPIN ■■■■■i■i 1!/■■� ����ca�/i.�nr_.�/Mtn■■■fi■ NOON ■Ilfififi�■■■/fi■■■■■■■■■i ■■■■ ■i /■fi'/■■/■�1■■■■■■■ffi■■ ■■■■�/1 ■fil/'�!�fa!■/■h■■■lfififi■■� '• ■■■■■■ftf ■/i`iilifi/I■■/fii■!'/©�ffit: //NOfif■!!f�iiiii■fry MORE■■■ �r,►�!�r±� ■■fi■■■ If�ifi■Ififi�fil/■f�L�J/NOON/■fel mi MEN Ma ■/■■■■■ ■■111,x, !fi■■■■�fifiQ��o� FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector E C 2 # V E Town Hall I-C, Southold, N.Y. PRE EXISTING JUN 2 8 2013 CERTIFICATE OF OCCUPANCY Southold Town Board of Trustees No Z-22968 Date APRIL 27, 1994 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 7080 GT. pECONIC BAY BLVD. LAUREL, NSW YORK House No. Street Hamlet County Tax Map No. 1000 Section 126 Block it Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22968 dated APRIL 27_L 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ie ONE FAMILY DWELLIOG * The certificate is issued to DAVID_* BRIGIT'TE PELMER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHIN1�L # UNDERWRITERS CERTIFICATE NO. NIA PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. "�L 9L /('x'ild1ng Inspector Rev. 1/81 DING DEPARTMENT • T WNOF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 7080 GT. PECONIC BAY BLVD. LAUREL, N.Y_ number A street - municipality SUBDIVISION HAP NO. LOT(s) NAME OF OWNER (s) DAVID A BRIGITTE PALMER OCCUPANCY SINGLE FAMILY OWNER D E 'r - p type owner-[emn[ v1�� ADMITTED BY: DAVID C. PALMER ACCOMPANIED BY: DAVID C. PALMER V KEY AVAILABLE SUPF.CO. TAY MAP NO. IOW=TZb- - JUN SOURCE OF REQUEST: - DAVID C. A BRIGITTE PALMER DATE: DEC. 30, 1993 JUN Z 2013 DWELLING: a0uihold 7oWD l,� J TYPE OF CONSTRUCTION WOOD PHALB3 - 6 STORIES 1-1/26 EMITS f Tr FOUNDATION CONCRETE CELLAR FULL CRAWL SPACE TOTAL ROOMS: LST FLR. A 2ND FLK. 1 3RD FLR. BATHROOM (s) 2 TOILET ROOM (s) UTILITY ROOM PORCH TYPE _ DECK, TYPE FRONT WOOD PATIO BREEZEWAY FIREPLACE 2 - GARAGE DOMESTIC HOTWATER II TYPE BEATER LILCO GAS AIRCONDITIONING TYPE HEAT on WARM AIR YY HOTWATER OTHER: SHOWER STALL. ATTACHED TO FRONT DECK, CLOSED FRONT ENTRYWAY ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST_ 2 CAR WOOD FRAME STORAGE, TYPE CONST. SWIMMING POOL , CUEST, TYPE CONST. OTHER: ACCESSORY DECK IN REAR (WOOD) VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE - LOCATION DESCRIPTION ART_ SEC. REMARKS- ORIGINAL FIREPLACE IN HAD CONDITION - DAMPER MISSING ON NEWER ONE. INSPECTED BY _ '�__ DATE_ OF INSPECTION JAN. 11, 1994 TIME START 9:30 AM END 10:00 AM D / D 'eAl ID�, rM�' j JUN 2 R 2!'13 % , e c � MAP OF PROPERTY SURVEYED FM Southold Town wt c�� � B2IGITTE PALM, aa, rhu ' e i v� a.Af�aa�: h Ia AT LAUREL � } 1 /A • ; G m TOWN OF SOUTHOLO NY VraJ/ r I-•I rte, •a�� I I i I W i wl 1 i .l f .¢ �. m O O„cP. •m ;I 11i / EI-MONUMENT O•PIPE z : 0•:TAICE 4c+ AREA•0.512 AC. l f.yJ4i+i4�5 �p Ip S j 1 1 AS SL}RVEYEO MAY 111 3 20DERICK VAN TY L.P,C, .SUFF''CO.TAY MAP DATA_1000-126.11-7. , UC"LAAIO SURVEYORS - GM PORT N.Y o Wfvf c Town of Southold Annex 7/19/2011 a 54375 Main Road Southold,New York 11971 J1JN CERTIFICATE OF OCCUPANCY 2 g 2013 Southold Towo No: 35071 Date: 7/19 r of Ste s THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 7080 GREAT PECONIC BAY BLVD LAUREL, SCTM#: 473889 Sec/Block/Lot: 126.-11-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/27/2010 pursuant to which Building Permit No. 36058 dated 11/30/2010 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: alterations and addition, including covered porch and second story balconies,to an existing one family dwelling as applied for per ZBA#6214, dated 11/13/08- The certificate is issued to Shannon,Joan (OWNER) - -- --_ of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED —4utho4Signature t� ',U 2i _ 012-11-07 Re 1 Ow 144 i J1�J N.Y.S. D.E. F77ETPY. ,Wn.I DDW Comments I ®07-17-08 Is! STOW NM Dept. for re QPARW4E•\,' P.Y "at W W AWAY FROM ' EXrTM SMTARr) 0 67WG I2dA`D SEPTIC ' NK wnm 5OV GALLON O PACR'f , t _cawt sruRs TO O P.Y.C.1 UNUM covetw Fa".M AW T® O OPOS®CWBt®PORf]I aRA11681RG aY ,A O 3mg Op O i( tX6TN^i ROLE TO BE RB1aVFD WOOD FRAME aro OMMING O G WM RDD O RESIDENCE To 5E WANOEO. MAN FUGM 9.MAO O as SEAL #A.sanw FIaaRDIV" CK d' 1 ,I D cw.x,'-v 177 AtMNAiE RNG �5T tff W AWAY IM 1)(1577 VARY) Op _ 1 CdC g. AA m*qMW"7705.7 ]751 .A.aao , a...N, W � Ye,l Brame Eduutlen 4w 'R ( „ �� r Lvu.e.e. W M 40 L p..psayddc A.�Wc. T7,. — TIMBM RFrMMM WALL O �H MOIEO NO MEGIVE 2013 ownt REM c-rc aA.x r-v :. STIXYt ORAEN(E RML ' Y TM To � ff EXISTING FRAME a GARAGE n z Ll � b -u D � D N z a TEST NOTE mft5 TfNtCTFOJ O TO TREE f i A i STORMOMNKE RMG ITEM e'4 DVL N 1'4 / (TUST m m"Y R STRWI ERARIEGE RRK \ EXLSTM SMRMT) grOtl T EXISIWE s 1\ E Tm CEllm STNAi to BE Rfl IWEOM M¢ Tm PRWo5FD EOmm 151m1 IRbER EtNEREP fAKN. r. i 4T � IF •°' nn fIOSM RWF TOM REI'tivEO KWD FRAME Im EXISEXVTIM�FLOOR� RESIDENCEK rfUN FlDOR¢n.M eY v IS r, n x r o ill EC � � V ' H. � f JUN 282013 hr, Southold Town U.) C —➢MBER RVMWR WAIL F¢T�� m V� O T / - w vor +� ` - j- IAO-3 JUL 19__2013- ;I Burd of Tro,'e2s f II 0 0 James F. King, President �pf SOUK, Town Hall Annex Bob Ghosio,Jr.,Vice-President `O� OlG 54375 Main Road P.O. Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer G Q Michael J. Domino . �� Telephone(631) -6 41892 O���DUNPI ax(631) 765-6641 1 V BOARD OF TOWN TRUSTEE JUN 2 82013 TOWN OF SOUTHOLD APPLICATION FOR AN AMENDMENT TO A WETLAND PERMI DATE _)iiA/E 4� .2�3 A-1 OWNER%AQPAQ/�DrIJ PHONE ADDRESS TU g� €Cy(y//�'_,&y Iylt > AGENT PHONE ADDRESS PROPERTY LOCATION �D&D ��C'O/✓/e 19y 2 ✓✓� TAX MAP NO. I/We request an Amendment to Permit#--I � to f1 v E E s�E �Tr�cH3 Signed By: i""� 0 NY SI1� P�c'/r�gNs Clement Carpentry P.O. Box 287 Washington Avenue 631806-8261 /V,q pe6/2 b Jamesport,New York 11947 To: Joan Shannon Date: 05/28/13 7080 Peconic Bay Boulevard Mattituck,New York Estimate# CCO5281333 Re: Decking Replacement Dear Joan, We propose to furnish the labor and material to do the following; 1-Upper Deck: A: Remove approx. 900sq. ft. of decking. B: Furnish and install 5/4x6 STK cedar decking, over existing framing. C: Furnish and install new cedar railing to match existing. Total Estimated Cost of Item#1............................ 2-Realign Stairs: A: Straighten existing stair set. Total Estimated Coat of Item#2............................5441M 3-Lower Deck Rebuild: A: Remove approx. 1800sq. ft.of 2x10 cca deck boards. B: Furnish and install new 5/4x6 STK cedar decking over existing framing. C: Furnish and install/straighten existing framing as necessary. D: Repair shower area and rebuild walls around shower. E: Straighten lower sea wall and resecure. Total Estimated Cost of Item#3...........................5 4-Backfill Tie Wall &Beach: A: Furnish and install sand and fill for beach and tie wall area. Total Estimated Cost of Item#4...........................S Total Estimated Cost of Work..........5"� 0 0 Board of Trustees Application County of Suffolk State of New York BEING DULY SWORN .DEPOSES AND AFFIRMS THAT IWSHE 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 WILLBE 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, HARts ESS AND FFSEEFROM.ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID-PERiff.(S);.IF.GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY:AU TIi1QR.IZE THE TRUSTEES, THEM AGENT(S)OR REPRESENTATTVES(S) TO ENTER ONTO MY PROPER TO INSPECT THE PREMISES IN'CONJUNCTION WITH REVIEW OF 9 APPLICATION. l / /Mgnattire SWORN TO BEFORE ME THIS (s DAY OF VCM ,20 Notaty Public CONNIE D. BUNCH Notary.Public,State of Now York No.01BU6185056 Qualified in Suffolk County Commissich.Expires April 14, 2-Mo - - PROJECT ID NUMBER 617.20 SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME 3.PROJECT LOCATION: Municipality 7 ((f or L_1 County F L 4.PRECISE LOCATION: Street Addess and Road Mrsections. Prominent landmarks etc -or provide map 77090 ` g0 6)q/c �A Y & ✓b GJg�-0'r- 5.IS PROPOSED ACTION: 0 New Expansion RModification/alteration 6.DESCRIBE PROJECT BRIEFLY: 1�SJ Sri r4�ACCJ�E/� 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? IX I Yes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) residential 0Industrial 0Commercial �Agriwlture Park/Forest/ Spam (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local FTYes [--I No If yes, list agency name and permit / approval: 11.DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? FYes r�No If yes, list agency name and permit / approval: - 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E]Yes FkIN, I CERTIFY THAT TH INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name gDate: Signatures a If the action is a Costal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment 0 9 IVY sr� l{/d / Ns Clement Carpentry q IV1314 f-r/ P.O.Box 287 !✓ Washington Avenue 631806-8261 /YU pedes b Jamesport,New York 11947 To: Joan Shannon Date: 05/28/13 7080 Peconic Bay Boulevard Mattituck,New York Estimate# CC05281333 Re: Decking Replacement Dear Joan, We propose to finish the labor and material to do the following; 1-Upper Deck: A: Remove approx. 900sq. & of decking. B: Furnish and install 5/4x6 STK cedar decking,over existing framing. C: Furnish and install new cedar railing to match existing. Total Estimated Coat of Item#1............................3119111W 2-Realign Stairs: A: Straighten existing stair set. Total Estimated Cost of Item#2............................9111JIM 3-Lower Deck Rebuild: A: Remove approx. 1800sq.8.of 2x10 ccs dock boards. B:Furnish and install new 5/4x6 STK cedar decking over existing fiaming. C:Furnish and install/straighten existing framing as necessary. D:Repair shower area and rebuild walls around shower. E: Straighten lower sea wall and resocure. Total Estimated Cost of Item#3...........................5 XFJM 4-BadM Tie Wall&Beach: A: Furnish and install sand and fill for beach and tie wall area. Total Estimated Cost of Item#4...........................5 IIW Total Estimated Cost of Work .........5 Allow PART 11 - IMPACT ASSESSMENT a completed by Lead Agency) 9 A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAR Yes ❑� No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another involved agency. Yes 0 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible) C1. Existing air quality,surface or groundwater quality or quantity,noise levels,existing traffic pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: C4. A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural resources?Explain briefly: C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: C6. Longterm,short term,cumulative,or other effects not identified in C1-05? Explain briefly: C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSEDITHE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA)? ❑ Yes ❑✓ No If Yes,explain briefly: E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes F,(1 No If Yes,explain briefly: PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its (a)setting (i.e. urban or rural);(b)probability of occurring; (c)duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. El Check this box if you have identified one or more potentially large or significant adverse impacts whfoh MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box if you have determined,based on the information and analysis above and any supporting documentation,that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide,on attachments as necessary,the reasons supporting this determination Board of Trustees Name of LeadAgency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature 3TIresponsible Officer in Lead Agency Signature of Preparer rent from responsible officer) A • ST.IXUN%.E RMG Y .N II EXISTING a FRAME GARAGE z EE IG." � � z d ZI z yam, 'EST HOLE a+i6 ! 11Y1� IA UIYYwM11 P� TOl ', I roll e•-a wn x a•a '-- a / \�J\ STQW taANKE RING M5TT BE]a NUY fRQt Nedw %R4 5TMRG \ Q'ISTINv SMIITMr) MNITMY)w T \\( I fFwl QISiRY \ EYSTING CEIIAR 5TAIA3 i0 1 W REl10VEO IWO RBLOCATEU FRCPoSm 0.'2]1 LWXR C PREP M W IXIsiRL RCOi ro BE RFro✓FD � E%SiIxG RW TO WOOD FRAME e TO BE tYPMbEcLED GL LTi E.r�t�E-CY '� RESIDENCE ,e .ulx ELaoR n n ro es' Iv c x1, � p-> /—TIMBER REINNVIL WILL JUN 2 0 013w c / ,15 �Ap � , "Rt, fR ��II CD �� ti I - i3rnw�la.c 1 Icµ✓za G0.EAT ? ONIC BAY m mam 3 1 Lw rs� tt O \ u 4wE r. ti s. ii ya\\g GREAT -'�\ PECONIC BAY Enoss sEcnoN r aa�n>�crtF_PLAN XTM Y 10061]6-11.0] (p� ECEIVE D �] D 1 JUN 2 82013 Southold Town baW of Trustees JENNIFER B. GOULD Attorney at Law 4- I 2c� IZ J(1Q JOG11 S[NA IInU � SClcll # 12b - fl l J po , / �C-, P v3 t lr'1 53740 Main Road,2nd Floor PO Box 988 Southold, New York 11971. Tel:631-765-8375 Fax 631-765-8036 Email: lawjbg@aot.com • • CC# : C12-10960 COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK 1, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 03/15/2012 under Liber D00012687 and Page 807 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 03/15/2012 SUFFOLK COUNTY CLERK (/ JUDITH A. PASCALE SEAL I IIIIIII IIII VIII VIII VIII VIII VIII VIII VIII IIII IIII 1111111 VIII VIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 03/15/2012 Number of Pages : 5 At: 03 :22 :24 PM Receipt Number : 12-0030984 LIBER: D00012687 PAGE : 807 District: Section: Block: Lot: 1000 126.00 11 .00 007 . 000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $25 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15 .00 NO TP-584 $0 . 00 NO Notation $0 . 00 NO Cert.Copies $6.25 NO RPT $30 . 00 NO Fees Paid $101 .25 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County A 012 Number ofes 4 1 r Pag TORRENS Serial# Certificate# Prior Ctf.# Ned .Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee 02 1 — Mortgage Amt. _ Handling (g 00 1.Basic Tax — 2.Additional Tax _ TP-584 Sub Total _ NotationSpec./Assit. — � or EA-5217 (County) Sub Total s Spec./Add. — TOT.MTG TAX _ EA-5217 (State) Dual Town— Dual County— Held for Appointment — R.P.T.S.A. — Transfer Tax Comm. of Ed. 5. 00 Mansion Tax — e Affidavit Z0_.66t The property covered by this motgage is or will be improved by a one or two Certified Copy ;4 S family dwelling only. � ! L Reg. Copy Sub Total f t � � YES or NO If NO, see appropriate tax clause on Other L.— Grand Total ( � page# of this instrument. 4 District1000 Section 126.00 Block 11.00 Lot _007.000 5 Community Preservation Fund Real 1000 12600 1100 007000 Consideration Amount $ Property Tax Service DDA CPF Tax Due $ A encg Y Improved Verification Vacant Land _ 6 Satisfaction/Discharges/Release List Property Owners Mailing Address TD RECORD &RETURN TO: Jennifer B.Gould,Esq. TD PO Boa 988 Southold,NY 11971 TD 7 Title Company Information Co.Name Fidelity National Title Ins. Co. Title# p 0— L(TC 8 ; Suffolk County Recording & Endorsement Page This page forms part of the attached Declaration of Covenants made by: (SPECIFY TYPE OF INSTRUMENT) Joan E. Shannon The premisis herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the Township of Southold Board of Trustees of the Town of Southold In the VILLAGE or HAMLET of Mattituck BOXES 6 THROUGH 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING (over) DECLARATION OF COVENANTS THIS DECLARATION made this �54"' day of FPbruary 2012, by JOAN E. SHANNON residing at 7080 Peconic Bay Blvd. , Laurel, NY, 11948, hereinafter referred to as "DECLARANT" : W I T N E S S E T H WHEREAS, DECLARANT is the owner of certain real property located on 7080 Peconic Bay Blvd. , Laurel, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 126, Block 11, Lot 7 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required a five foot (51 ) "non-turf buffer" between the lawn area and the upper deck, and as depicted on the site plan prepared by Mark Schwartz & Assoc. dated July 28, 2010 and stamped approved on August 18, 2010; NOW, THEREFORE, the DECLARANT does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained a five foot (5' ) "non-turf buffer", ("non-turf buffer" as defined by Chapter 275 of the Town Code, ) between the lawn area and the upper deck, and as depicted on the site plan prepared by Mark Schwartz & Assoc. dated July 28, 2010 and stamped approved on August 18, 2010; and 2) These covenants shall run with the land and shall be binding on the DECLARANT, her heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner has duly executed this instrument this day of FPbeuaey .l5 2012. JO E. SHANNON 2 STATE OF NEW YORK: ss: COUNTY OF SUFFOLK On the .25-l"day of F?bru" in the year 2012, before me the undersigned, a Notary Public in and for said State, personally appeared JOAN E. SRANNON, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity, and that by her signature on the instrument, the individual or the persons on behalf of which the individual acted, executed the instrument. M 0 Nd&ary Public JENNIFER B.000LD Notary Public,State of New York No.02005024640-Suffolk County Commission Expires Marcb 14,20 3 SCHEDULE `A' ALL THAT CERTAIN plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the southeasterly side of Great Peconic Bay Boulevard distant 675 feet more or less southwesterly from where the southwesterly side of Bray Avenue intersects the southeasterly side of Great Peconic Bay Boulevard, said point being where the same is intersected by the southwesterly line of land nor or formerly of Brady; RUNNING THENCE along land now or formerly of Brady, south 21 degrees 15 minutes 40 seconds East, 337.28 feet to the record high water mark of Great Peconic Bay; THENCE along the record high water mark of Great Peconic Bay, South 39 degrees 56 minutes 10 seconds east, 74.75 feet; THENCE along land now or formerly of Coulter, North 21 degrees 24 minutes 40 seconds West, 338. 46 feet to the southeasterly side of Great Peconic Bay Blvd. ; THENCE along the southeasterly side of Great Peconic Bay Blvd. , North 41 degrees 02 minutes 50 seconds East, 75.0 feet to the point or place of BEGINNING. 4 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 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOVgN 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 Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7384 DATE: AUGUST 18, 2010 ISSUED TO: JOAN SHANNON PROPERTY ADDRESS: 7080 PECONIC BAY BLVD. LAUREL SCTM#126-11-7 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 August 18.2010 in consideration of application fee in the sum of $250.00 paid by Joan Shannon and subject Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and following: Wetland Permit to to install six (6) new pilings at highest elevation; attach tie rods with turn buckles; pull existing two-story deck and existing bulkhead plumb and straight, with the condition of a 5' non-turf buffer between the lawn area and the upper deck, and as depicted on the site plan prepared by Mark Schwartz & Assoc. dated July 28, 2010 and stamped August 18, 2010. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee, Joan Shannon, residing at 7080 Peaonic Bay Blvd., Laurel, NY, 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 circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant anddeed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 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 August 18, 2010 · BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Gerald Lang 3480 Ole Jule Lane Mattituck, NY 11952 RE: JOAN SHANNON 7080 PECONIC BAY BLVD., LAUREL SCTM#126-11-7 Dear Mr. Lang: The Board of Town Trustees took the following action during its regular meeting held on Wed., August 18, 2010 regarding the above matter: WHEREAS, Gerald Lang on behalf of JOAN SHANNON 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 July 28, 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, 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 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 APPROVES the application of JOAN SHANNON to install six (6) new pilings at highest elevation; attach tie rods with turn buckles; pull existing two-story deck and existing bulkhead plumb and straight, with the condition of a 5' non-turf buffer between the lawn area and the upper deck, and as depicted on the site plan prepared by Mark Schwartz & Assoc. dated July 28, 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, JMD/Ims Jill M. Dohefly, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemcyer 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 TO: 'q, hr) Please be advised that your application dated reviewed by this Board at the regular meeting of lag [1(~ has been ~'[}~ ]10 and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) V/ 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 Southotd 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 Page 1 of 1 Standish, Lauren From: Ray Gaddis [gaddiray@optonline.net] Sent: Tuesday, August 17, 2010 1:50 PM To: Standish, Lauren Subject: Joan Shannon Proposal for Retention Wall System Per our discussion last week, please pass this to the Board of Trustees meeting on 8/18/2010. I, as a neighbor, am not opposed to the proposed retention wall modification by Ms. Shannon. However, I am concerned about the cantilevered deck on the second level of her property near the proposed retention wall. Has it ever been inspected or an application applied for and received? It hangs out above a lower deck, and I'm wondering if it is a safe construction. I'm sure that if it has been inspected and a permit has been issued, that it is safe, and properly constructed. Please inform me of your findings. Thank you. 8/17/2010 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., August 11,2010, the following recommendation was made: Moved by Greta Schiller, seconded by Doug Hardy, it was RESOLVED to NOT SUPPORT the Wetland Permit application of JOAN SHANNON to install six (6) new pilings at highest elevation; attach tie rods with tum buckles; pull existing two-story deck and existing bulkhead plumb and straight. Located: 7080 Peconic Bay Blvd., Laurel. SCTM#126-11-7 Inspected by: Greta Schiller, Doug Hardy, Peter Young The CAC does Not Support the application based on the following: · Location of the existing structure is inconsistent with the public trust doctrine with over-whelming intrusions of public space; · The structure is not in compliance with the Town code; and · The structure is in violation of shoreline best management practices. Vote of Council: Ayes: All Motion Carried Jill M Doherty, President James F, King, Vice-President Dave Bergen 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: ,~//3//'¢ JOAN SHANNON requests a Wetland Permit to install six (6) new pilings at highest elevation; attach tie rods with turn buckles; pull existing two-story deck and existing bulkhead plumb and straight. Located: 7080 Peconic Bay Blvd., Laurel. SCTM#126-11-7 of area to be impacted: Type Saltwater Wetland Freshwater Wetland Sound Z/Say Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ~L/Chapt.275 Chapt y 1 other Type of Application:¢/~^t,Wetland __Coastal Erosion ~Amendment __Administrative__Emergency __Pre-Submission Violation Info needed: Modifications: ~?/)~£ Conditions: Present Were: L~.King __J.Doherty __J. Bredemeyer B.Ghosio, D. Dzenkowski __other Form filled out in the field by ~), Mailed/Faxed to: Date: D. Bergen__ 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 JOAN SHANNON SCTM#1000-126-11-7 Gerald Lang on behalf of JOAN SHANNON requests a Wetland Permit to install six (6) new pilings at highest elevation; attach tie rods with turn buckles; pull existing two-story deck and existing bulkhead plumb and straight. Located: 7080 Peconic Bay Blvd., Laurel. SCTM#126- 11-7 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 "A" 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, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application I-~etland Permit Application __ Administrative Permit Amendment/Transfer/Extension ~eceivved Application:~ .~[~_ ~.eceived Fee:$~ ~ompleted Application~,~ ~,~fnc omplet e~[~~ ~1~ __SEQRA Classification: Type I Type II Unlisted __Coordination:(datesent). . tJ[J[- 2 ~ ~-'~'~ ~.~zzWRP Consistency Assessment Form {]!~10 : ~. ~i~AC Referral Sent: ~)I~BI l-~ ~__~..~ ( ' ~ - ateoflnspection: ~![I !lC} i ~:' · Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~P-ublic Hearing Held: 55'0_ !~~ Resolution: Name of Applicant Address '") O ~ ~ Phone Number:{~ ~/)r Z t~g. Suffolk County Tax Map Number: 1000 - /2---~ ~ tt / Property Location: 2 O ~-~::9 ~i~-~.~.~ec.. ~_ ~, (provide LILCO Pole #, distance to cross streets, and location) AGENT: ~ ~;'~'/f'-r..~ /~-~r t~ ~ (If applicable) of T~us~ees Land Area (in square feet): Area Zoning: ~ Previous use of property: Intended use of property: Covenants and Restrictions: GENERAL DATA Yes ~' No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If"Yes", please provide copy of decision. Prior permits/approvals for site improvements: Agency Yes Date t~/g rt.-- ?~ No ~No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? .~ No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~oard of Trustees ApplicaOn WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 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 structure and upland edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? ~ cubic yards How much material will be filled? ..--?(5~> cubic yards 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: 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): Ioard of Trustees Applica COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No /~Yes Does the project involve excavation or filling? No /'~Yes If Yes, how much material will be excavated? .~cSP (cubic yards) How much material will be filled? (cubic yards) Manner 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) PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME SEQR 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [-~ New [~] Expansion [~odification / alteration DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially ~ acres ~ Ultimately ~' acres ~ 8. WiLL PROPOSED ACTION COMPLY-W~TH 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 ["--1Commercial r~Agriculture [~]Park/Forest/OpenSpace ['-~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) es ~j~o If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes []No If yes, list agency name and permit / approval: 12 AS a RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~]Yes F~No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ~ ~.~g'~lT~ ~,,of.-/[/~..( Dale: ~'- Signature/'- ~/~'~'~ If ~e 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 1114RESHOLD IN 6 NYCRFL PART 617.47 ff Yas, eomdlnato the mdew process and uas the FULL EAF. Elias Ig]"0 B. WILL ACTION RECEIVE COORDINATED REVIEWAS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, a ongathm EI - 171.o C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Amwem may be beedwfltfan, If legrole) Cl. E~ng air qonity, sutlace or grou~ qonllty or quantity, ~4ce levels, existing tr~ palfam, solM w~ ~ ~ ~1. C3. V~ _..A_-_:_.'~ or fauna, fish, ~%~r~, or .r,,;l;r. spedas, -;a,,;-...,i habr, ats, or threatened or endangered species? F~ 0,5. C;~.,~,., subsequent d~,m,L or rdated activlA~es likely to be Induced by the pr'"~Cr _ _'--ed_ _ acaon? F..,..~ brlmly: I"° C6. Longtofm. sh~rlMrm, cumulative, orofhoreifectsnof~,iil;udthCl.CS? Expfalnbdefly: I C7 Other J,=-~ _-~.~. ~thcludi~ c~,qf~. In use of 6,'~.,~ quant~ or type of,~,., ? F,,..i,, edefl I D. WILL'I~IE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABUSHMENI' OF A CRITICAL ENVIRONMENTAL AREA (CEA) ? (If yes, expfain bdelly: PART Iff - ~C ~ ~:~dlNATION OF 81G~ii~icANCE (To be cofl~leted by Agency) INSTRUCTIONS: F~reachadver'=eeff~ct~denti~edab~ve~determ~newhe~h~ritis~ube~antia~'brge~imp~rtant~r~theMises~gn~ca~L Each effect should be assessed in ¢onn~tion with its (If} setting (i.e. "¢oan or rural); (b) probability of o~urltng; (c) duration; (d} Irmverslbll~, (e) geographic ~oe; and (f) magnitude. If neceasaw, add altachments or reference supporting materials. Ensure that explanations contain · ufficlent detail to show Ilmt all relevant adveme impacts have been iden~lied and adequately addressed. If queslton d o~part # was checked )'es, the determination of sig ni~a r~e must evaluate Ihe potential impact of the proposed ~ on the environmental characMC~cs of the CEA. WILL NOT ret, uff th any algnir~ant adveme envflonmefifal impacts AND provide, on attachmeflfa as neceasa~y, the reaaons suppo~ng th/ detormlna6on. Board of Trustees Name of Lead Agenc~ Jill M. Doherty - ' I~dnt or Type N~ of Rej~onsib,~ Offi~' in Lead Agency Dale President Title of Responsible Officer Signalum of Preparer (If different from responsible officer) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER~ GRADING; DRAINAGE AND EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITI~I[# / WORKASSF~SMENT I Yes No a. What is the Total Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within the Scope of Work for proposed Construction) ~2- 2.} ~ ~"~,~ Generated by a Two (2') Inch Rainfall on Site? ~ (S~F. I ~:.~) (This item will include all mn-off created by site b, What is the Total Area of Land C~eadng cleadng and/or construction activities as well as all -- and/or Ground Disturbance for the proposed ~.-~(~..~- Site improvements and the permanent creation of construction activity? impervious surfaces.) ts.F.,,~,-) 2 Does lhe Site Plan and/or Sorvey Show All Proposed PROVIDE B~ PROJECT DESCRIFIlON (P.~ ~Page* a~ Ne~) Drainage Structures Indicating Size & Location? This I ~'~ Item shall include all Proposed Grade Changes and -- ~"-t~-~_~-~ "i~/'~'~O~l-~ ~/~ 3 OoestheSitePlanand/orSurvoydoscdhatheorosion r~ and sediment control practices that will ha used to contr~ site erosion and storm water discharges. This -- · Construction Pedud. 4 Will this Project Require any Land Filflng, Gradingor Excavation where there is a change to the Natural I ~ Existing Grade involving more than 200 Cubic YardsL~ ~ of Matehal within any Parcel? 5 Wit/this Application Require Land Disturbing Activities D .~ Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? 6 is there a Natural Water Course Running through the ~ Site? s th s Project w h n the T...~ms ees iufisq~iction General DEC SWPPP Requirements: or within One Hundred (100')~feet of a Wetland or STATE OF NEW YORK, ~ r c Owner mid/or representative of fine Ovmer or Owners, and is duly aufinorized to perform or have performed die said work and to make m~d file this application; finat alt statements contained in finis application ~,Bi~.~Jp~T~,~[,~I~ Dmwledge and belief; and ..... , Jbhc ~Iate 0T New york finat fine work will be performed m fine manner sci ford~ m the al)phcanon filcd~'~emrer~.OISI61gaO08 ...... ' ~fUa!i~i'~J in 8uff01'~k Count o( , 9old FORM - 06/10 Board of Trustees Application County of Suffolk State of New York 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 THI~-~,PPLICATION. SWORN TO BEFORE ME THIS ,..~0/- DAY OF,_;4-- to/ ,20 / ~(' Public --h~ LAU~EN M. STANDISH Notary Publlc,"b~te of Now York No. 01ST6164008 Oualifled in Suffolk Courftv Commission Expires Apl'il 9,20_/_/_ Board of Trustees Apl AUTHORIZATION (where the applicant is not the owner) I, ~~/~/~ residing at ~ ~A//~ (print owner of property) (mailing address) ,~.~. ~ /~/~~ //.~ do hereby authorize (Agent) ~r ~~F~ to apply for ps,it(s) fro~ the Southold Board~n Trustees on my behalf. /Js signature) 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the oart of town officers and emelovces. Thc oorneso of this form is to nrovidc info,nation which can alert the town of cossible conflicts of intem~t and allow it to take whatever action is necessary to avoid same. (Last name, fu~t name, ~niddle initial, unless you are applyin~ in the name of someone el~e or other entity, such as a company. If so, indicate thc other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Tmstce 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 rel~onship with any officer or employee of thc Town of Southold? "Relationship" includes by blood, nntrriage, 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 shams. YES NO /~ lfyou 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 (rite applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) thc owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); __B) thc legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a coq)oration); __C) an officer, director, partner, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this~_da~/~ 0"0'~- ~ Signature ff~ff~/. ~e~r/'f~zz~-.~ 20~_ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK , being duly sworn, deposes ~d says that on ~e ~ day of ~ ~ ,20/O, deponent mailed a tree copy of the Notice set fo~.in the Bo~d of Trustees Application, directed to each of the above nmed persons at the ad~esses set op~site there resp~tive nines; that the addresses set opposite ~e nines of shd persons ~e the ad&ess of said persons ~ sho~ on ~e c~ent ~sessment roll of the To~ of Sou~old; ~at said Notices were mailed at the U~ted States Post Office at ~ ~o~ ~ ~ ~, , that said Notices were mailed to each of said pemons by (certified) (registered) mail. Sworn to .l~fore me this c~ ~ Day of~ ,20/0 Notary Public LAUREN M. STANDISH Notary ..Public, State of New York r~o. 01ST6164008 Oualified n Suffolk Coun~ t, Commission Expires Apfi 9, 20//_ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: SCTM# /~'~'' /C- ~'- 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: ,7.O,,,r~tf ~-Z..-~'/¢,'~VM 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 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: 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: -.~Oz~, ~' MAILING ADDRESS: PHONE#: ~r?- 6~; ~'Z- 2--,~' ~' AGENT: MAILING ADDRESS: PHONE #: ~",..?/'° Enc: Copy of sketch or plan showing proposal for your convenience. 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 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 JOANSHANNON COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING residing at/dba --~0a~ ~ ~being duly sworn, depose and say: That on the3~i~da~.y of ~-c~ ~c~ T'~, 2010, I personally posted the property known as 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.wom to before me this ///'-day ofOJt% 20Gt;0 Notary Public LAUREN M. STANDI~ No. 01515164008 Qualified in Surfak County Commission Expires &lidl 9~20/j' 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 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 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- SUl~l~ortinfl 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 Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# { 2~ ~/te PROJECT NAME ¢ ~"~r"'/~'Tc'c/qt"t 9'/f~' The Application has been submitted to (check appropriate response): TownBoard [] Planning Board ~-~ Building Dept. [] BoardofTrustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capilal construction, planning activity, agency regulation, land Wansaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: 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) Name of applicant: ~"~,~e~e'~ ~--e~t~' ~ (b) Mailing address:, ~-~ t9 /~y ,~_-- eed/4~(-?- rFo'~t~___ /{F~. (c) Telephone number: Area Coda~ ~d' 3' ~'~(~,5'~ (d) Application number, if any:_ Will the action be directly undertaken, require fixnding, or approval by a state or federal agency? Yes [] No []~ If yes, which state or federal agency?. C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. Yes ~ No~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section Ill - Policies Pages 3 through 6 for evaluation criteria Yes [--] No [~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section HI - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No ~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~'~ Yes [-~ No ~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southoid. See LWRP Section Ill - Policies Pages 16 through 21 for evaluation criteria [] Yes No NotApplicahle 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 ~plicable 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 ~Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section II1 - 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 III - Policies; Pages 38 through 46 for evaluation criteria. ~ yes~ No ~-~qot 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 lauds 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 ~ No ~P Not Applicable PREPARED BY~ 5 DATE REVISIONS. EXISTING CONDITIONS ",~ SCALE: 1" = 20,-0, SOIL SCREW RETENTION WALL SYSTEM L~ELIFT SYSTEMS, INC. Ph. 301-369-3400 -NOTES- _ .......................................................................... ~ EXTENSION EX~N$1ON EXTENSION ~ii ~: : PARTIAL SITE PLAN ~CTM ~ 1000-126-11-07