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TR-7504
1 Glenn Goldsmith,President �OF SOy� Town Hall Annex Michael J.Domino ,`O l0 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 .�► Greg Williams 0 Fax(631) 765-6641 �yOUNTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 19, 2020 Christopher& Heather Masotto 12 Warner Court Huntington,'NY `11743 RE: 55915 COUNTY ROAD 48, SOUTHOLD SCTM#1000-44-1-17 - Dear Mr. and Mrs. Masotto: The following action was taken by the Southold Town Board of Trustees at their Regular= Meeting held on Wednesday;.November=1,8;,2020:, RESOLVED, that the Southold Town Board.of Trustees APPROVE the request for a . Transfer of Wetland Permit#7504 and Coastal Erosion Permit#7504C from Lazaros Laskos to Christopher Masotto & Heather Masotto, as issued on March 23, 2011 and amended on May 18, 2011. Any other activity,within 100' of the wetland boundary requires a permit.from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, i4, ruelsligdent Board of Trustees GG/dd Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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 % constructed __ Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK pERMIT NO. 7504 DATE: MARCH 23~ 2011 ISSUED TO: LAZAROS~LASKOS PROPERTY ADDRESS: 55915 COUNTY ROAD 48, SOUTHOLI~ SCTM# 44-1-17 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 March 23. 2011, and in consideration of application fee in the sum of $500.00 paid by Lazaros Laskos and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorize~ and permits the following: Wetland Permit to remove existing armor stone used to secure void left by storm- and reserve stone for use on north side of property; install 25~ of bulkhead on southwest side of property to secure void left by storm; install one (1) row of 1-3 ton armor stone on the north side of existing bulkhead; and as depicted on the site plan prepared by Jeffrey T. Butler, P.E., P.C. last dated March 23, 2011, and stamped approved on March 23, 2011. · IN W1TNESS 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 Lazaros Laskos, c/o Lynn Laskos, residing at 1026 Inwood Terrace, Fort Lee, New Jersey 07024 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 Pemfittee 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. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permitiee 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 Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT COASTAL EROSION PERMIT #7504C ApplicantJAgent: Butler Engineering Permittee: Lazaros Laskos SCTM#: 44-1-17 Project Location: 55915 County Road 48, Southold Date of Resolution/Issuance: March 23, 2011 Date of Expiration: March 23, 2013 Reviewed by: Board of Trustees DESCRIPTION OF ACTIVITY: Coastal Erosion Permit to remove existing armor stone used to secure void left by storm and reserve stone for use on north side of property; install 25' of bulkhead on southwest side of property to secure void left by storm; install one (1) row of 1-3 ton armor stone on the north side of existing bulkhead. The Coastal Erosion Management Permit allows for the operations as indicated on the site plan prepared by Jeffrey T. Butler, P.E., P.C. last dated March 23, 2011, and stamped approved on March 23, 2011. INSPECTIONS: Final SPECIAL CONDITIONS: (apply if marked In accordance with Chapter 111-15 Erosion Protection Structures: X A maintenance agreement is attached hereto and is a necessary special condition of this permit. BY: ~' Jill M. Do Presid Board of Trustees Jill M. Doherty, President Bob Ohesio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 BOARD OF TOW~N' TRUSTE, ES TOWN OF SOUTHOLD 30-YEAR MAINTENANCE AGREEMENT EROSION PROTECTION STRUCTURES ~ CHAPTER 111-15 OF THE SOUTHOLD TOWN CODE Telephone (631) 765-1892 Fax (~). 765-6641 APR - 4 2011 ,(wo) g L s o_% The owners of record of property al: ,~-5' ~ / 5 SCTM#1000- I..~ l.I - I - I ~ in applying for a Coastal Erosion Permit for an erosion protection structure do hereby" agree to a 30-Yeer Maintenance program for a slrecture as described: as shown on the attached licensed survey of the as-built structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years and/or equivalent to the original approved structure. Any maintenance which involves more than 50% of the length of this structure requires approval of the Board of Trustees. We further understand that failure to maintain the structure could result in a requirement to post a bond and/or have the repairs ordered as a lien against the property upon a finding by the Board of Trustees that said lack of maintenance would risk life, property or important natural resource features. I~lp,,.ta r~ Public DEBRA L DESOTTO NOTARY PUBLIC OF NEW JERSEY My Commission Expires May 13, 2016 Notar~ signature of ov~l~r of record This maintenance agreement shall only be valid upon the attachment of a licensed land survey made within one year of the original construction and validated to show the final approval of the administrator. Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town H~I Annex 54375MainRoad P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 March 23, 2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTH©LD Ms. Me!issa Butler Butler Engineering 206 Lincoln Street Riverhead, NY 11901 RE: LAZAROS LASKOS 55915 COUNTY ROAD 48, SOUTHOLD SCTM# 44-1-17 Dear Ms. Butler: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 23, 2011 regarding the above matter: WHEREAS, Butler Engineering on behalf of LAZAROS LASKOS 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, and Chapter 111 of the Southold Town Code, Coastal Erosion Hazard Areas, application dated February 28, 2011, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on March 23, 2011, 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 and Chapter 111 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 LAZAROS LASKOS to remove existing armor stone used to secure void left by storm and reserve stone for use on north side of property; install 25' of bulkhead on southwest side of property to secure void left by storm; install one (1) row of 1-3 ton armor stone on the north side of existing bulkhead; and as depicted on the site plan prepared by Jeffrey T. Butler, P.E., P.C. last dated March 23, 2011, and stamped approved on March 23, 2011. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Jill ~1. Doherty {/ President, Board of Trustees JMD/eac Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated .~jo£~o_r-y' ~<~//~ I/ has been reviewed by this Board at the regular meeting of and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pro-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ~ Constructed ($50.00) ,/~ Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. fl.) Permit fees aro now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or to-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 New York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0359 Fax: (631) 444-0360 Website: www.dec.ny,,qov Joe Martens Commissioner Ms. Mary Laskos 1026 Inwood Terrace Fort Lee, NJ 07024 RE: Permit #1-4738-01074/00009 Dear Pemfittee: March 28,2011 In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuouCy ~;ted at the p?oi~ct site and protected from the weather. /' ' ~inccrelf k' Pe~it Administrator JAW/dj Enclosure NEW YORK STATE DEPARTMENTOF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-01074 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all as part of this permit. Permit Administrator: JOHN A Address: Deputy Administrator Date¢ .), .'~ [/ Authorized Signature: MELISSA BUTLER Habitat - TW JOHN A WIELAND [ Permit Components ] NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS, APPLY TO ALL AUTHOR[ZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS; WATER QUALITY CERTIFICATION; EXCAVATION & FILL IN NAVIGABLE WATERS 1. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. 2. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. Page 2 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facilily DEC ID 1-4738-01074 3. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 4. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 5. Storage of Equipment, Materials The storage of construction equipment and materials shall be confined to the upland area landward of the bulkhead or on a barge. 6. Clean Fill Only All fill shall consist of clean sand, gravel, or soil (not asphalt, slag, flyash, broken concrete or demolition debris). 7. No Beach Excavation For Fill No excavation of the beach is authorized for the purpose of obtaining fill or stone materials. S. Backfilling All peripheral berms, cofferdams, rock revetments, seawalls, gabions, bulkheads or other approved shoreline stabilization structures shall be completed prior to placement of any fill material behind such structures. 9. No Equipment below Apparent High Water Equipment operation below (seaward) apparent high water is strictly prohibited. 10. Bulkhead Height The new bulkhead height shall not exceed the height of the adjacent bulkheads. 11. Contain Exposed, Stockpiled Soils All disturbed areas where soil will be temporarily exposed or stockpiled for longer than 48 hours shall be contained by a continuous line of staked haybales / silt curtains (or other NYSDEC approved devices) placed on the seaward side between the fill and the wetland or protected buffer area. Tarps are authorized to supplement these approved methods. 12. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation (grasses, etc.) immediately following project completion or prior to permit expiration, whichever comes first. If the project site remains inactive for more than 48 hours or planting is impractical due to the season, then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor germination. 13. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Jeffrey T. Butler, P.E., P.C., last revised 3/23/11 and stamped NYSDEC approved on 3/24/11. 14. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury, to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue fi.om any such damage. ts. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may Page 3 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-01074 require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 16, State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation &said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 17. Precautions Against Contanfination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project~ WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS 1. Water Quality Certification The NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302,303,306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all &the conditions listed herein are met. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility. Inspection by The Department The permitted site or fhcility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative duhng an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Page 4 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-01074 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. A~y renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOKI50 CIRCLE RD STONY BROOK, NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Excavation & Fill in Navigable Waters, Tidal Wetlands, Water Quality Certification, S, Permit Modifications, Suspensions and Revocations by the Department The Department reserves the fight to modify, suspend or revoke this permit. The pounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity, 6. Permit Transfer Permits are transl~rrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. Page 5 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION '~ Facility DEC ID 1-4738-01074 NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittec's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extand to any claims, suits, actions, or damages to thc extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming thc DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permlttee's Contractors to Comply with Permit The permittec is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed ibr the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permiL Page 6 of 6 LOOATION FLAP: NOT TO ~C, ALE ~ ~.,~¢HII~RY ~ 15 PRO~:~O FROH C,O.~T~ ROAP 4~ TO LOPOSED E¢~ION CONSOL P,L~N: )A~ AT: ~THOLO, N( qN OF ~THOLO FOLK ~UN~, N~ ~ NO.~ 1000-44-t-I~ ~ ~E~IOENTIAL ~A FLO00 ZONE: ~A = ~ATA ~ PLAN BASED ON ~R~Y T SEOOAFIO0 ~D, 12/15/06 Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., March 16, 2011, the following recommendation was made: Moved by Doug Hardy, seconded by Meaghan Burke, it was RESOLVED to NOT SUPPORT the Wetland Permit and Coastal Erosion Permit applications of LAZAROS LASKOS to remove existing armor stone used to secure void left by storm and reserve stone for use on north side of property; install 25' of bulkhead on southwest side of property to secure void left by storm; install two (2) rows (one seaward of other) of 1-3 ton armor stone on the north side of existing bulkhead. Located: 55915 County Rd. 48, Southold. SCTM#44-1-17 Inspected by: Meaghan Burke, Audrey Horton, Doug Hardy, Peter Young The CAC does Not Support the applications because the toe armor appears to be on public property and blocking public access, the proposed new bulkhead is prohibited under Chapter 275, and perpendicular bulkhead will increase erosion on the neighboring vacant lands. Vote of Council: Ayes: All Motion Carried Jill M. Dohe~ly, Pres/dent Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bmdemeyer 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: LAZAROS LASKOS requests a Wetland Permit and Coastal Erosion Permit to remove existing armor stone used to secure void left by storm and reserve stone for use on north side of property; install 25' of bulkhead on southwest side of property to secure void left by storm; install two (2) rows (one seaward of other) of 1-3 ton armor stone on the north side of existing bulkhead. Located: 55915 County Rd. 48, Southold. SCTM~44-1-17 T~y~e of area to be impacted: ~' ~_Saltwater Wetland Freshwater Wetland l//S°und Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chap~)~-~_ .other Type of Application: ~//Wetland Coastal Erosion __Administrative__Emergency Pre-Submission __Amendment __.Violation Info needed: Modifications: Conditions: BPresent W~re.~/ J. King ~//J. Doherty C/~J. Bredemeyer ~{,/~D. Bergen~/,-'"~"~ .Ghosio, ~_/ D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: © © OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To~ From: Jill Dohedy, President Town of Southold Board of Trustees Mark Terry, Principal Planner LWRP Coordinator Date: March 14, 2011 Re~ Proposed Wetland Permit for LAZAROS LASKOS SCTM#1000-44-1-17 LAZAROS LASKOS requests a Wetland Permit and Coastal Erosion Permit to remove existing armor stone used to secure void left by storm and reserve stone for use on north side of property; install 25' of bulkhead on southwest side of property to secure void left by storm; install two (2) rows (one seaward of other) of 1-3 ton armor stone on the nodh side of existing bulkhead. Located: 55915 County Rd. 48, Southold. SCTM#44-1-17 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. 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 Town of Southold Board of Trustees Application Office [[se Only .~Coastal Erosion Permit Application ~\Vetland Permit Application Administrative Permit ~Re Amcndment/Tra~fcr'Ext~:nsion ceived Application: ~'_Received Fee:$~___~'--- ..,"k%mpleted Application c~lo~:'} Incomplete __SEQRA Classification: Type I T3pe I1 Unlisted Coordination:(date sent) ../~WRP Consistency Assesslilent Dorm ~.~_ AC Referral ~.-'Date of Inspection:_ 3~.~10/] Il _ Receipt ofCAC Rep~:r[:I ' Lead Agency Determinalion: Technical Review: ~'lSublic Hearing Resolution: Name of Applicant. IA7 .-t~'t~')~ Address [_fro /026 SuflblkCounty Fax MapNumber: 1000- ~- [ ~ I~ Property I.ocation:5~qt% ~al~ ~' ClX, ~M~O~ (provide LILCO Pole #, distance to cross streets, and location) }lq01 Phone: of Trustees ApplicationO GENERAL DATA Land Area (in square feet): x~. q/~0 t~t. ~--'r', Area Zoning: ('~ Previous use of property: Intended use of property: Covenants and Restrictions: If"Yes", please provide copy. Yes ~ No Does this project require a variance from the Zoning Board of Appeals Yes x)~ No lf"Yes'L please provide copy of decision. Prior permits/approvals for site improvements: Agency , Date Dac r.m ..a7 __ No prior permits/approvals lbr site improvements. Has any permit/approval ever been revoked or suspeuded by a governmental agency? ,,~ No Yes If yes, provide explanation: Project Description (use attachments ir neccssary):,~___~/~t/~'_ of Trustees ApplicationO WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: -t~/2/9~_ C.4~ Dtg.~&52~(~/"//] ~- ' / Area of wetlands on lot: 0 square feet ?ercent coverage of lot: ,2-~. t.~ % Closest distance between nearest existing structure and upland edge of wetlands: I~ feet Closest distance between nearest proposed structure and upland edge of wetlands: .5~_z:::5 feet Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated? ,..~0 cubic 3ards How much material will be filled'? -~O cubic yards Depth of which material will be removed or deposited: i 2.. feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited:, ./'~l¢/d~/-///i]_~_ /A/..JLL 1_..~_~ !~'~--05~'.~0 .ff--4'~r_~' Statement of the effect, if any. on the wetlands and tidal waters of the town that ma3' result by reason of such proposed operations (use attachments il' appropriate): of Trustees ApplicationI COASTAL EROSION APPLICATION DATA I 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 ~ill be excavated?~(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 resuhing fi'om implementation of the prqject as proposed. (Use attachments if necessaD9 PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT ! SPONSOR 3,PROJECT LOCATION: 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 PRECISE LOCATION: Street Ad,less and Road Intersec§ons. Prominenl landmarks etc -or p[ovlde map SEQR 5 IS PROPOSED ACTION [] New ~Expansion '~odi§caaori/altemtion 6 DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially I ~ acres Ultimately t I acres § VV~LL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~'Yes [] No If no, describe bristly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [] Resic~ential r--] Industrial E~ Commercial [~Agnculture [--1 Park / Forest / Open Space ~r~ther (ciescrlbe) 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 permil / approval: 11 DOES ANY~ASPECT OF THE ACTION HAVE a CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~No yes, agency name and permit / approval: list 12 AS A R~ULT OF PROPOSED ACTION WILL ~ISTtNG PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE iS TRUE TO THE BEST OF MY KNOWLEDGE AppJicant / Sponsor Name Date If the actior{ is a Costal Area, and you are a stale agency, complete the Coastal Assessment Form before proceeding with this assessment PART I! - IMPACT ASSESSMENT (To be completed by Lead AgenCy) · A. ~a:a~_~ ACTION EXCEE~ ANY Type i THREStiOt. D iN 6 Ny(~a.R. PART 617.47 ff Ye~, coordinate the re~ p~ an~ use the FULL EAF. r-1¥., . B. WILLACTION F-~C-~7~¥ECa:Ka.~..M,,IA~ ~ p~ F~ U~A~iN 6 ~ P~617~. [fNo, aneg~ve PART III - ia::, ~,iAl'lOfl OF SlGNIFICAHCE (To be oompleted by ~'t~uG~n°l~s: F~ e~ch advenm effec~ldenUllecl e~ve' G~e!mlne v'hetller i~ Es su~ntJ~l, I~r~e, irnlx~t~nLoro~ ~n~nL effe~ *1~. ~ be a88es~ecl in ~Qflflec~on with b (a) 8e(~ng (L®. u~n or rural); (b) pm~d~ll~y of c)onurff(~)~ (~) clumtlon: (d) in'everd~iflty; W~LL NOT result In any ~g~ll~ant adverse eflvkordnefltal Impaels AND prodde, on attadmlonts on _nec~___ep/, the re~s determination.. ..Board of Trustees Name of Lead Agency Jill M: Doherty " P,f~nt or Type Name of ReSlX)Pslbie Officer In Lead Agency lib President Title of Responsible Of~cer 81gna~e of ~,upa,ur (1~ different from re"oponslble olficer) Town of Southoid Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM =ROPERTY LeCATION: $+C.T.M.#: THE FOLLOWING AC?IONS MAY REQUIRE THE SUBMISSION OF A No a. What b the Total Area of the P~je~ Parcels? ~~ I ~nemted by a Two (2.) inch Rain~,, on Site? and/or Ground Dislu~a~ce lot the proposedII ,~ Site Im~ovements a~d the pe~a~ creaaon of item shall include all Pro~s~ Grade Changes and / 3 Does ~e Site Plan and/or Su~ey ~s~be ~e erosion ~ ~/~' ~0 ~ ~ ~ ~ and sediment contro~ pmcti~s ~at will ~ used to conEol site erosion and stem water dis~arges. This ~ [P~ Al, ~ ~ ~. ~ ~ 4 wi, ~is Project Require any Land Fi;li~, Grading or ~ ~ ~ ~J. ~ ~ ~ ~ Existing Gra~ InvoMng ~ore ~an 200 Cubic Y~s of Materia[ wi~in any Parcel? ~ ~ ~ J~ ~ ~ ~ (5,~0S.F.)SquareFeetofGrou~Su~ce? ~ ~ ~ ~ ~~ ~ 6 Is there a Natural Water Coume Running ~r~gh the ~V - > ~ ~ ~Si[e? Is ~is Project within ~e Trustees jurisdJ~io~ S~PP's Shall ~et ~e Minimum R~uiremon~ of ~* SPDES Ge~ral Pe~it 8 Will Driv~a~, P~i~ Areas ~ o~er Impious ~ U STATE OF NEW YO~, ~M~ , ~ ~ q~at I, ................ b~ d~fly sworn, deposes ~d says fl~at he/she is 0~e applic~t for ~d lhat he/she is 0~e ............ ~.~.~.~ .......................................................................................................................... O~er ~or representative o[ fl~e Ore,er or O~me~, ~d is duly au0~o~ed Io pedbm~ or have pedbm~ed ~e s~d wo~ m~d to m~e ~d [de ~s application; ~at ~1 statemen[s cohered in fl~is application m-e ~e m ~e best o[ his kno~edge ~d belie[; ~md d~at fl~e work mil be perforated in ~e m~ner ~et fo~ in ~e app~mfion [ded hereM~. Sworn to before n e dfis ~qZqfo5 ~ FORM - O 611 O NOTARY PUBLIC OF NEW My C0mralaslon ~'~p~ros July 14, Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of LAZAROSLASKOS COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose ~d say: ~at on the .~ ~ay of ~ ,201 i, I personally posted the propeay known as by placing the Bo~d of~mstees ~fficial poster where it c~ easily be-seen, ~nd that I have checked to be sure ~e poster has rmained in place for ei~t days prior to ~e date of the public hemng. Date of hearing not~ thereon to be held Wed~ March 23~ 2011 on or about 6:00 PM. (signmure) Sworn to b~fore me this -~day offS, 20/'/ ~¢ary Public ~ JANET M TOOKER Nota~ Public.State of New York No Ou~lified ~mmission Expires November ~3, 20~ PROOF OF MAILING OF NOTICE CERTIFIED MAIL RECEIPTS 0901 639 Main Street Greenport, ~Y 11944 COUNTY OF SUFFOLK Address: '~q~-a1[O/.~ a~,--- D i , being duly sworn, deposes and says that o~n the ]~I_'D~ dhyof~4-,2011, deponent mailed a true copy ofthe Notice set ford: in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment r;cql of the Town of Southold; that said Notices were mailed at the United States Post Office at I/~._lC//zFdt],~cO , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. _~..~ ..,-~-> Sworn to be~'e me till: Notary Pu I~H[I M. 100dER Nota~ Public, State of New Yo~ No. 01TO~a51905 Qualified in ?~folk County 20~ ~mmission Expire. November 13, 1000-44-1-16 David Corwin 639 Main Street Greenport, NY 11944 1000-44-1-18 Hirant Candan 88-30 51st Ave. Elmhurst, NY 11373 1000-44-3-4.2 Dorothy Snyder 18 Skips Point Lane Belle Terre, NY 11777 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD in the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: {,l* nonil ,dd¢ *>1 prop,.'n? L hl;tZd] 25 Ii. bt, lkh¢ad on southwest side of property to seoutk' void letk b) 2. That the prope~y which is the subject of Environmental Review is located adjacent to your pmpe~y and is described as follows: SotLthotd, NY k 1~171 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 $outhold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: k~z~r2.o~ [.f~-j~,?_~ I¥IAILINGADDRESS: ~3fl15 rtgu~,~ ~. ~l~, .~?~..~n ,~ PHONE ~: f~),,]'~z' .~_~;~ I ' '- I MAILING ADDRESS: ~Of~ L.l/df~.d ~. ~b~i~ ~/ ~lqo~ PHONE ~: (CSi) 'ZO~-~¢~', ' ~ Eric: Copy of sketch or plan showing proposal for your convenience. of Trustees ApplicatioJ AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at 6~)ql6 ~___. (mailing address) ' do hereby authorize (Agent) to apply tbr permit(s) from the Southold Board of Town Trustees on my behalf. (O,~ner's signature) of Trustees Applicati¢ County of Suffolk State of New York l_.rhzLt3CO_q r7 LP6Ko-5 BEING DULY SWORN DEPOSES AND AFFIRMS THAT nE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND TItAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/IIER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILl., BE DONE IN TttE 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 ]'OWN 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. SWORN TO BEFORE ME THIS Iff Si.nature .20i / Notary Public SO,~!A A. V}LLATORO NO'U, RY PUbLiC OF t4EW JERSE~ My C~mmisslon ~pJr~ Ju~' ~4, 2014 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM 1he Iown of Soulhold's Code of Ethics prolfibils conflicts of interest on Ihe part of toxxn officers and emplo',ces. 'lbe purpose of this tbrm is to prox idc JnJbmlaliot~ xx hich can alert the Iox,,n of possible conflicts of i~llerest and allow it to take XX[latex er aclion is neccssar; to avoid same. (~,~t'nanlc~ first ~{an~. ln~ddle initial unless you are appl> ii~g in tile name of someone clsc or other emit3, such as a compan.',. I f so. indicate Ibc other pcrsoWs or compan3 's name.) lax grie', ance Building Variance Trustcc Change of Zone Uoastal Erosion Approval of plat Mooring Exemption Ii'om plat or official map Planning Other (lf"Other". name thc actix it3.) Do you personalb (or through 3 our cmnpan3, spouse, sibling, parent, or child) bare a rclationsbip with any otlicer or employee of the 'I'ok~n of Soutbold? "Relationship" includes b3 blood, marriage, or business interest. -Business interest" means a business. [nchlding a partnersbip, in M~ich the tox*n officer or employee has exert a partial ox~ncrship of(or emplo3 merit b) ) a corporation in xxhiclt lhe to~n officer or employee oxxns more Ihan 5% of thc shares. YES NO K If3ou answered "YES". contplelc thc balance of this lbrm and date and sign M~ere indicated. Describe e re a s pbc x cc ~ rse '{ e app c /agcn/rcprcsentalixe) and the town officer or entplo~cc. Either check lite approprialc linc A) tlu'ougb 1)) and/or describe in tile space proxided. I'hc toxin officer or mnplo.xcc or his or her spouse, sibling, parent, or child is (check all that apply): A) the ox~ner of greater than 5% of the shares oPthc corporate stock o['tbe applicant (xq~cn the applicant is a corporadonl: B) the legal or benelicial ovmer of an3 inlcresl in a non-corporate entity (when tile applicant is not a corporation): C) an officer, director, parlncr, or employee ol'the applicanl; or I)) the actual applicant. DES;CRll I ION OE RELA I IONSHI[ Form TS I Submitted thi~, .)~" day of_ j~J4;~/l ~- ',/ 20¢1 PrmtName q ~*~F 4 ~_~.._~ Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF lbr proposed actions that arc 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. *Exeepl minor exempt acliom including BuiMing Permit*' and oilier ministerial permits not located wilhin the Coaslal 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 Waterfi'ont 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 lbrm is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessa~, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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 The Application has been submitted to (check appropriate response): To~n Board [] Planning Dept. [] Building Dept. [~ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: ,.~q/4tO ,~-~/. Present land use: Present zoning classification: ~ ~ 0 If an application lbr the proposed action has been filed with the Town of Sonthold agency, the following information shall be provided: (a) Name ofapplicant: (b) Mailing address: (c) Telephone number: Area Code (d) Application number, if any:_ Will the action be directly undertaken, require funding, or approval b3 a state or federal agency'? Yes ~-~ No~]' If yes. which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances communi~ 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 Ill - Policies; Page 2 for evaluation criteria. []Yes [] No [] Not Applicable Attach additional sheets if uecessary 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 III - Policies Pages 6 through 7 for evaluation criteria J~Yes [] No [] Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section Ill - Policies Pages 8 through 16 for evaluation criteria ~ Yes [] No [] Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section Ill - Policies Pages 16 through 21 for evaluation criteria ~ Yes [] No [~Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. [] Yes [] No~ Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section !1I - 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 Ill - Policies; Pages 34 through 38 for evaluation criteria. [] Yes [] NoJ~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southoid. See LWRP Section 111 - Policies; Pages 38 through 46 for evaluation criteria. [] Yeti No~l~, Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section I II - 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 Ill - Policies; Pages 57 through 62 for evaluation criteria. ["--~ Yes [] No.~.Not Applicable Attach additional sheets ifnecessar~ Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section 111 - Policies; Pages 62 through 65 for evaluation criteria. [] Yes [] No [J~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section ill -Policies; Pages 65 through 68 for evaluation criteria. Created on 5/25/05 11.'20 AM Town of Southold Board of Trustees Application Coastal Erosion Permit Application Wetland Permit Application Amen dmentFFrans f!er/F~'xt~en si°n eceived Application: 1o,~ eceived Fee:$ __Completed Application __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent) __LWRP Consistency Assessment Form __CAC Referral Sent: __Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination: __Technical Review: __Public Hearing Held: __Resolution: Administrative Permit NameofApplicant L znro s E Z~S ~oJ Address /~ ~"()O00d Ten-, Phone Number:( Suffolk County Tax Map Number: 1000- ~ 9 ' (provide LILCO Pole #, distance to cross streets, and location) (If applicable) ' Phone: ~.- of Trustees ApI~lication0 Land Area (in square feet):_ Area Zoning:_ GENERAL DATA Previous use of property: Ix-IOF~ & Intended use of property: ~ ~ (vq ~. Covenants and Restrictions: Yes ~/No If "Yes", please provide copy. Does this project require a variance fi.om the Zoning Board of Appeals __ lf"Yes", please provide copy of decision. Prior permits/approvals for site improvements: Agency Date Yes F' No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspected by a governmental agency? / No Yes If yes, provide explanation: Project Description (use attachments if necessary): f~a,~/ o] V ~rd of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: .square feet Percent coverage of lot: % Closest distance betweenjtearest existing structure and upland edge of wetlands: / feet Closest distance between~ nearest proposed structure and upland edge of wetlands: c~LdJ 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? /~' cubic yards Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the area of operations: _~ ~2 Manner in which material will be removed or deposited: 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): of Trustees Application0 COASTAL EROSION APPLICATION DATA Purposesofproposedactivity: c~,/~l,.~ ~,,'o~,aa ~7~ f / Are wetlands present within 1 O0 feet of the proposed activity? No / Yes 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? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT I SPONSOR 3,PROJECT LOCATION: 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL A~SESSMENT FORM for UNUSTED ACTIONS Only ( TO be completed by Ap )licant or Project Sponsor) 2, PROJECT NAME 4. PRECISE LOCATION: SUeet Addess and Road InterseclJo~s. Prom/ne~t lagxlmark~ etc -or ixovide ma~ 5'6'q 15' C_~.~,k4 -R~- q E' SEQR ;'.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres .. ..O.OSED AC.,O. COMFY ... OR CT.ER 9. W~AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Ct~x~easrnany~sepply.) E~ResIdential E]Indusbtal r']C-merci, E~]AGtic~lture E~Par~lFomstlOpenSpace DOther (des~ibe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL ~..~_EN~'-(F,~,,~, S~o~ ,~) L.~'es [] No If yes. list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURJ~ENTLY VALID PERMIT OR APPROVAL? [~]Yes If yes, list agency name and permit / approval: PART Ii - IMPACT A~E$$MENT ~1'o be completed b)r Lead Age~y) A. ~EG A~ ~C~ ~ ~ I T~E~O~ IN 6 ~R, P~ 6t7.47 ~, ~ ~ ~ p~ ~ u~ ~ FULL ~F. B. WILLACTION ~I~C~RDI~D ~I~O~DEDFORUNLISTEDACTI~SIN6~CRR. P~T617,67 If~.a~a~e d~am~ ~y ~ s~ed by a~ Invo~ a~. ~Yes ~ C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS A~OClATED WITH TIE FOLLOWING: (Ar,~vmm may be haadwfltt~l, if tsglb~) Cl. Exlst~g air qualk~, surface or ga3undwatsr quallb/or quantsy, noise levels, ex~ng ~ paP. em, soJicl waste pn3ducaon or disposal, potsnfiat for erosion, drainage or Iloedlng pm~ems? Explain bdefly: l I C2. Aesthe'dc. ag~oJifurai, archaeotoglcal, historic, Or Other rlalulal or cuifu~al l~4xJrce$; or cofmllanity or ~ character? Explain briefly: I I C4. A commuaHy's exJ~J~ plans or go~ as ~ adopted, (3fa change In u~e Or bd~n~y of use of land or mci. ns~Ural mseumes? Expla~t b~lafly~ I Cfi. Growth, sufaseflnaflt beve~oflment, or related activities likely to be induced by the proposed ac'dm? Explain briery: I I D. WILL THE pROtECT HAVE AN IMPACT ON TIE ENVIRONMENTAL C~TERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAl. AREA (CEA~? ~if ~ ex~n bde~: I-lYes ~lNo E. I$ THERE. OR 18 THERE LIKELY TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ff ./es explain: PART III - DETERMINATION OF SIGNIFICANCE {To be c~ by A~ency) INSTRUCTIONS: Fo~'eacl~advemeeffectidenllfledabove.determinewhether #lssut~tanital. large, imlx~antorolbenviseslgnificanL Each effect should be assessed in connection with Its (a) sedthg (Le. urban or rural); (b) probability of occurring; (c) dural'mn; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments Or reference supporting materials. Ensure that explanations contain sufficient detsil to show Ihat all relevant advorse impacts have been identified and adequately addressed. If questlo~ d of part ii was checked yes, the detefminaiton of significance must evaluate the po~entiaJ impact of the proposed action on the env[ronmental chamctmisflm of the CEA. Check this box if you have Identified one or mom po~ntlally large or significant ~dverse impacts which MAY occur. Then pm<:eed dimly to the FULL FAF and/or prepare a pa~ifiye decbratien. Check this box i~ yo~ have determined, based ~ the ~nfo~rnadon and analysis above and any supposing documentation, thai the propo~ad actior WILL NOT result in any significant adverse environme~te~ impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. N~me ~ LemJ ~genoy Signature of Revf)ons~nte Olrmer in Lead Agency Signature of Preflare~ (If di~erent from mspm3sibM of~ of Trustees Apl~lication0 County of Suffolk State of New York L'-'~.~'rh L ~[~%~y 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, 1 HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO My/PROPEJ~TO INSPECT THE PREMISES IN CONJ UNCTION WI~~~PLICATION. L./y - Signature SWORN TO BEFORE ME THIS ~.~'~ DAY OF~ Cc~-~. ,20iD Notary Public ~IE D. BUNCH NotaoJ Pt~ ~lSte o~ Now York No. 01~18~ ~rd of Trus~ Alalalication0 AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at /O~G ...~d (mailing address) do hereby authorize (~A~en2 ~'~a5/~a~ to apply for permit(s) from the Southold Board of Town Trustees on my behalf. signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics omhibits conflicts of interest on the hart of town officers and ersolovees. The ouroose of this form is to on)vide information which can alert the town of cossible conflicts of intore~t and allow it to take whatever action is necessary to avoid same, /~- (Last name, fit~t nam'e,~alddle initial, unless you are applying iff the name of someone else or other entity, such as a company. If so, ndieate, thC other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ~ Change of Zone Coastal Erosion Approval of plat Mooting Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sil~ling, patent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Busines~ interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a coq)oration 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/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 ail 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 ownqr of any interest in a non-cQrpomte 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 I SURVEY OF DESCRIBED PROPERTY SITUATED AT ARSHAMOMAQUE, TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ~°.4 ~E. ~ ~ T. R'.EL.2~O O' I~.Ft',EL.I?.O' 0,2'E, S.C.T.M. NO. 1000-44-1-17 AREA = 3,940 SQ. FT. ELEVATIONS ARE IN N.G.V.D. DATUM CI. E4RING AREA = 3,790 SQ. FT./96.2`~ LOT COVERAGE -- 1,157 SQ. FT./2`9.4~g / S 900.57' ~ ~ ..J ~.It'.EL.I?.O' -- B. IF. EL. 14,1 ' EL'IS'I° ' IFOOD WALL E.R.~ [ I E.R. EL. 14.1'~ NORTH ROAD (C.R. 48) c.~.,~..~.a' (VAR. lrlDTH) .... ~ E.R. EL. 14.4' E.R. EL. 14.2' ~J~'l 4~8 NOT BEARING THE C4ND SURI~E~ORS SIGNATURE AND RED iNK OR EMBOSSED SEAL SHALL ~'ILE NO. T50706 SCALE: 1" = 20' DATE: 12/15/2,006 PAT T. SECCAFICO PROFESSIONAL LAND SURVEYOR, P.C. - SUCCESSOR TO - //" ' DONALD rASE, L.S. R/CHARD WILHELM ~ND ASSOC~.S NORTHSTAR SURVEYING, P.C. PAUL T. CANALIZO, L.S., ROBERT A. KART, L.S. GOOD GROUND SURVEYORS, P.C. 328A Main Street 107-5 W. Montouk Highway Center Moriches, NY 11954 Hampton BaYs, NY 11946 Phone: (6,51) 878-0120 Phone: (6~1) 728-5550. Fax: (651) 878-7190 Fax: (651) 728-6707 N.Y.S. LIC, NO. 049287 COPYRIGHT - 2006 PAT T. SECCAFICO P.L.S., P.C. EL, I~O' EL, 120' EL, lo O' EL. EL. 6.0' EL. EL. 4~' SECTION 'A' - ELEVATION DETAIL 5CALL, all&": I'-0" w',wv.dlg net nycll.com EX. 2 5Tf PR DhJ_G ON PIERS EL. 12~' EL, I0.0' EL. ~,.0' _E®ENP: PROPERTY LINE EXISTIN~ TO BE .................. REHOVED/RELOCATED EL. 4.0' EXCAVATED FOR REHAIN TIE PROP. B~LKHEAD TO EXIOTIN~, ~T (T'(P ~ PLAC, ES)· VIEH 'C' - ELEVATION DETAIL 5GALE, D/l&" = I'-O" IO"e Cr-,A I~"~xlOtG ~b II I II VIEH 'D' - PLAN DETAIL SCOPE OF HOP. K: 5cAL~, ~ac": I'-o' EXISTIN~ BULKHEAD TO REMAIN REMOVE TEHFORARY I-5 TON ARMOR STONE, (APPROX. 20 TON5 OF 5TON~ AND RELOCATED FOR USE IN FABRICATION OF PROPOSED >PERMANENT APJ~ STONE HALL · NOR~ 51DE OP PROPERTT. REHOVE FILT'~R FABRIC FROH THIS LOCATION. FOP. HOP. K. IN THIS AREAl FP. OFOEED A~OR STONE HALL (SEE SECTION 'A', THIS DRAHING) FOR HORK IN THIS AREA: REMOVAL O~ STONE HALL SEE PARTIAL OEHOLITION PLAN (THIS DRAHIN¢) ~OR HORK IN THIS AREA, J pROpOSED BULKHEAD (SEE SECTION 'B', THIS DRAHliC5) EL, EXISTING DHELLIN~ KJE¥ PLAN 5GALE~ P = 2.O~.-O" EL. 14Z)' LOCATION FLAP: NOTE, HACHINE~Y ~ IS PROPOSED FROM C~TY ROAD 4E, TO 51fL. /~L HORK HILL BE PEltED ~Y MACHINE I]EE,NqD FROM EROSION (IN FRONT yARD) PROPOSED EROSION CONTROL PLAN: 51'DJATE AT, 50UTHOLD, NY TOP'[N OP 50UTHOLD SUFFOLK C4DUNTY, NEJ4 ¥OP-K 50TF'I NO.~ 1000-44-1-11 ZONIN~ DISTP. IGT, N/A TO~"¢'N O~ ~OU'J'~O[Fj U~E~ RESIDENTIAL ~ - ~---------__.~ FEMA FLOOD ZONE, N/A PAT 5ECCAPI60 AP?EOVED BY gOARD OF TRUSTEEs REHOVAL ~NERAL NOTES LOCATION OF EXISTIN~ E~JLKHEAD TO REMAIN 2 BTOR¥ FRAME DHL~ ON PIER5 F,F. EL=Ib,B' EXtSTIN~ 2 5TORY FRAME PNb~ ON PIER5 F.F. EL.:IS~,' 6.F. EL:II.O' 16 HALE EXTENSION TO BE RIPF~[ TO ENSURE PLAGEHENT OF PROP. LINE,BULKHF-'AP HITHIN ~ ~ I 14 HALE VINYL SHEET PILII'~,-- BUOREGUARD 625 EXISTIN® EARTH ~RICK PP~P. SNOP, E~:~JARD BULKHEAD HALL TO P~-SIDE HITHIN PROPER'rY LINE· SEE 5EOTION5 AND VJE~5 FOR CONSTRUGTION DETAILS. SECTION 'B' - ELEVATION DETAIL ,o ~ o Io ~o ~o PARTIAL DEI"4OLITION PLAN PAm E: 1 oF I