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Home My WebLink AboutTR-7622A James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 CERTIFICATE OF COMPLIANCE # 0752C Date May 31, 2012 THIS CERTIFIES that the table and bench mounted on concrete piers or blocks and an informational sign on the south edge of the trail passing through FNPOA property; fill approx. 200 sf. area flush with the trail to make a pad for entrance seating; 20 c¥. unsereehed beach sand fill; removal of invasive brash to prepare site for sand fill; and removal/replacement of Town barrier at end of the road to allow passage of sand track, per the Southold Town Dept. of Public Works and/or Southold Town Highway Dept. At 800 East Rd., Cutchogue Suffolk County Tax Map #110-7-25 Conforms to the application for Trustees Permit heretofore filed in this office Dated 8/9/11 pursuant to which Trustees Wetland Permit #7622A was issued on 8/24/11 and conforms to all of the requirements and Conditions of the applicable provisions of law. The project for which this certificate is being issued is for The table and bench mounted on concrete piers or blocks and an informational sign on the south edge of the trail passing through FNPOA property; fill approx. 200 sf. area flush with the trail to make a pad for entrance seating; 20 cy. unscreened beach sand fill; removal ofinvasive brush to prepare site for sand fill; and removal/replacement of Town barrier at end of the road to allow passage of sand truck, per the Southold Town Dept. of Public Works and/or Southold Town Highway Dept. The certificate is issued to FLEET'S NECK PROPERTY OWNERS ASSOCIATION owners of the Aforesaid property. James F. King, President Bob Ghosio, .Ir., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction '~ constructed JProject complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: 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 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 Permit No.: 7622A Date of Receipt of Application: August 9, 2011 Applicant: Fleet's Neck POA SCTM#: 110-7-25 Project Location: 800 East Rd., Cutchogue Date of Resolution/Issuance: August 24, 2011 Date of Expiration: August 24, 2013 Reviewed by: Board of Trustees Project Description: To place a table and bench mounted on concrete piers or blocks and an informational sign on the south edge of the trail passing through FNPOA property; fill approx. 200 sf. area flush with the trail to make a pad for the entrance seating, using approx. 20 cy. unscreened beach sand fill; remove invasive brush to prepare site for sand fill; remove Town barrier at end of the road to allow passage of the sand truck. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the plan stamped approved on August 24, 2011. Conditions: A Town Property Access Permit Form must be submitted and approved by Southold Town Dept. of Public Works and/or the Southold Town Highway Dept. Inspections: Final inspection If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the $outhold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jill ~oherty, Pr~ Board of Trustees 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 ~1 o~ I ([ has been reviewed by this Board at the regular meeting of ~'i,~qi~l and your application has been approved pending the comple~ion 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) ~ Constructed ($50.00) "'//'Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code, The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: BY: Jill M. Doherty, President Board of Trustees Red Cedar Octagon Walk-In Picnic Table Page 1 of 3 Six Shops. One Checkout. Live Customer Serv~e 1-888-293-2339 Outdoor Decor I Customer Service 525 Off~ + Free Shipping En~eromoce~e~Tabtes~a~Ched~x~ Specifications Shipping, Assembly & Policies Additional information Our Red Cedar occagonal Walk-In Picnic Table with Attached Benches is a http://www.cedarstore.com/detail.aspx?ID=453 Lift, and No Tilt \ -. ~11 Quantity: ~1 ~tto C*~ J quantity: rT. ,~atec~ ] Jill M. DohelW, Pl~sident Bob Ghosio, Jr, Vice-Plesident James F. King Dave Bergen John Bl~demeyer P.O. Box 1179 Soufl~old, NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: Ray Huntington on behalf of FLEET'S NECK POA requests an Administrative Permit to place a table and bench mounted on concrete piers or blocks and an informational sign on the south edge of the trail passing through FNPOA property; fill approx. 200 sf. area flush with the trail to make a pad for the entrance seating, using approx. 20 cy. unscreened beach sand fill; remove invasive brush to prepare site for sand fill; remove Town barrier at end of the road to allow passage of the sand truck; and install a well for manual lift pump. Located: 800 East Rd., Cutchogue. SCTM#110-7-25 T~aOf area to be impacted: ItwaterWetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 __Chapt. 111 other Type of Application: ~/Wetland __Coastal Erosion ~Ad ministrative__Emergency Pro-Submission __ __Amendment Violation Info needed: Modifications: Conditions: Present Were: JJ. Doherty B. Ghosio ~/~King_ L,,,~Bredem~yer.__ D. Dzenkowski __other Form filled out in the field by D. Bergen, Mailed/Faxed to: Date: 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 17, 2011 Re: Proposed Wetland Permit for FLEET'$ NECK POA SCTM# 1000-110-7-25 Ray Huntington on behalf of FLEET'S NECK POA requests an Administrative Permit to place a table and bench mounted on concrete piers or blocks and an informational sign on the south edge of the trail passing through FNPOA property; fill approx. 200 sf. area flush with the trail to make a pad for the entrance seating, using approx. 20 cy. unscreened beach sand fill; remove invasive brush to prepare site for sand fill; remove Town barrier at end of the road to allow passage of the sand truck; and install a well for manual lift pump. Located: 800 East Rd., Cutchogue. SCTM#110-7-25 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 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 __Wetland Permit Application )~ Administrative Permit __AmendmentFl'rans fer/IExtension X Received Application: ~t Received Fee:$,~'-~-'¢~ ,/~ Completed Application Incomplete SEQRA Classification: Type I Type I1 Unlisted Coordination: (date sent). ~0111 ,/ILWRP Consistency Assessment Form _ CAC Referral Sent: ,~ate of Inspection: ~ !lq Receipt of CAC Report: Lead Agency Determination: Technical Review: ..~l~fiblic Hearing Held: ~ Resolution: $outhhold lown Board of Trustees NameofApplicant ~'L, IE~"['~ d~"Cl~_ Address ~ ~O~ 5~, a~dEz~y Phone Numbs:( Suffolk CountyTax Map Number: 1000- Prop~y Location: ~ ~T (pro~idc LILCO Pole fi, dist~ce to cros~ st{eet~, and loc3tion~ - AGENT: (If applicable) Address: rd of Trustees ApplicatloO Land Area (in square feet): Area Zoning: ~-qO GENERAL DATA Previous use ofproperty: %//n~.4k~ (fi~A¢~)~ 0~ use of property: ~]~EA~T (l~'A-t5~ ] Intended Covenants and Restxictions: Yes 2( 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 Date Yes X No /X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?. X No Yes If yes, provide explanation: Project DescriPtion (use attachments if necessary): ~ A_'~TO~_IM¥,~OT ~. Fleet's Neck Property Owner's Association Beach Entrance [Attachment 1 ] Proiect Description: Purpose of the project is to improve delineation of private property while maintaining the natural appearance and function and enhancing stewardship. It is proposed to place a table/bench and an informational sign on the south edge of the trail passing through the FNPOA property leading from East Road to the beach at East Creek. (See sketch FNPOA-A) The trail has a 1 in 10 slope and is about 10 to 15 feet above the wrack line. Since the trail is elevated about 2 to 3 feet above the trail's edge, about 200 fi2 of plan area is to be filled flush with the trail to make a pad for the entrance seating. It will take about 20 yds3 of unscreened beach sand fill. No cribbing would be employed, relying instead on the natural angle of repose in the same manner as the adjacent area. The table/bench will be mounted on small concrete piers or blocks and secured to thwart vandalism. Some invasive brush will be removed to prepare the site to receive the sand fill. Some oriental bittersweet, wild olive and sumac covering less than 200 square feet will be manually cleared. A few cedar branches that may interfere may be trimmed. The Association routinely trims the shoulders (mainly ragweed) of the trail from the road end to bench site. Also, part of the Town barrier at the end of the road will be temporarily removed to allow passage of the sand truck - this in the same manner as that done by the SCDPW to allow passage of the truck supporting dredging operations. Option: It is anticipated that the bench/table will serve a second purpose - that of providing a way point seating area for older folks and to change shoes. There is interest in installing a well point for a future manual lift pump to provide water for foot washing. The well point may be driven before sand filling to reduce the labor required. BeachEntrancePurpose. doc 8/5/2011 }ard of Trustees Applicati¢ WETLAND/TRUSTEE LANDS APPLICATION DATA Area of wetlands on lot: squTM feet Percent coverage of lot: ~ [ % Closest distance between nearest existing structure and upland edge of wetlands: feet ~..&~l' ~1,"~. Closest distance between nearest proposed structure and upland edge of wetlands: feet ~ ~l"fgtd~'~ l~.l~,~'l:~ 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: ~ ~ Proposed slope throughout the area of operations: .~ I I~ IO feet Manner in which material will be removed or deposited: Statement of_t~e. ~ffect, if any~ 0._n the wetlands am[tidal waters of tl?_e, town that max r__e_s_ult by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 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 3.PROJECT LOCATION: PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide mad 5. IS PROPOSED ACTION: ~-~ New [] Expansion [] Modification / alteration DESCRIBE PROJECT BRIEFLY: Purpose of the project is to iatp~ve deliocation of lnivate property while maintaining the natural appearance and function. It is proposed to place a table/bench and an informational sign on the south edge of the trail passing through the Fleet's Neck POA property le~dln_o from East Road to the beach at East Creek. (See sketch FNPOA-A) Since the trail is elevated about 2 to 3 feet above the trail's edge, about 200 f~ of plan area is to be filled flush with the trail to make a pad for the entrance seating. This will take about 20 yds~ of unscreened beach sand fill No cribbing would be employed, relying instead on the natural angle of repose in the same manner as the adjacent area. The table/bench will be mounted on small concrete piers or blocks and secured to thwart vandalism. It is anticipated that the bench/table will serve a second pta'pose - that of providing a way point seating area for older folks and to change shoes. 7. AMOU~T OF LAND AFFECTED: Initially e 00~ acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~lYes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Chcose as many as apply.) [~Residentia, []Industrial [~Commercia, I---1Agricult.re [~]ParklForestlOpenSpace [--~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) E~Yes I~No If yes, list agency name and permit / approval: 11. IJL)E5 ANY ^SPECI rjr- iHE ACTION HAVE A CURRENTLY VALI~ PERMIT OR APPROVAL? r~Yes r~No If yes, list agency name and permit / approval: 12. AS a RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFtCATION? I CERTIFY THAT THE iNFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sp0.~or~lame ~"'~'~'~ ~.~."~._~-, ~, Date: If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL FAF. [~] Yes ['~"] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative dectamtion may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) Cl. Existing air quality, surface m' gmondwater quality or quantity, noise levels, e,~lsfleg traffic paltem, solid waste pnxluc~on or disposal, potential for erosion, dminege or floodieg problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or onitural resources; m' community o~ neighbodtond character? Explain briefly: I C3. Vegetation or fauea, fish, Shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I C4. A community's existing plans or goals as officially adopted, or a change in use or Inte~sity of use of land o~ other natural resources? F. xp~ln briefly: I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: CS. Loeg term, ~hort term, sumulative, or ofber e~acta not ident~:~ in C1 ~:57 F~piale bfiaity: I, C7. ~ther impacts Iincludir~l chanties in use of either quanti~/or type of euer~'? Explain bdell~/: / D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEA~? IIf ~'es, ex,)lain briefl),: F-I Ye, I E. IS THERE, OR IS THERE LIKELY TO BEr CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: , PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) . INSTRUCTIONS: F~reachedversee~ectidentifiedab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~the~visesigni~cant~ Each effect should be assessed in connection with its (a) se{ting (i.e. urban or rural); (b) probability of occorfing; (c) duration; (d) irmvemibility; (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 ident~fi~ed and adequatsly addrassed. If question d of part ii was checked yes, the determination of significar~e must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA Chec~ this box If you have iden81tnd one er more potentially large or slgnltk;ant adverse Impacts which MAY occur. ~ proceed dirocSy Io the FULl FAF and/or prepare a poefllve declaration. Check this box if you have determined, based on the information and analysis above and any supbo~ting documentation, that the proposed ac~o~ WILL NOT result In any significant adverse enidronmontul impacts AND proVUe, on attachments as ne,',~__~ry, the masons suppo~lleg thl~ determination. Board of Trustees Name of Lead Agency Date Jill M. Dohert¥ President PHnt or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preporer (If different from responsible officerl 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-WATEI~ GRADING, DRAINAGE AND EROSION CONTROL PLAN District Section Block LO! CE~¥iFi~-~' BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. sCOpE oF WORK - PROPOSED CONSTRUCTHON l'l'I~l# / WORKASSESSM~,NT I Yes No a. Whet is the Total Ama of tho Project Parcels? (include Total Area of all Paw. els located within ~. (; ACP..e"S I w/ti this Project Retain ~ Stocm-Water Run-off the Scope of Work for Proposed Construction) Generated by a Two (2') Inch Rainfall on Sits? (S.F./Ac~) (This item will include all run-off created by site V b. What is the Total Ama of Land Cleadng clearing and/or construction activiUes as well as all -- and/or Ground Disturbance for the proposed ,;~2,~1~} ~'~' Site Improvements and the permanent creation of construction activity?~.. impervious sulfaces.) ;PROVIDE B1CI]~ PROJ'F~rT DESCRIPTION (Pm,~e~diaon~;'.~N~,a~l 2 Does the Site Plan and/or Survey Show,NI Proposed Drainage Structures Indicating Size & Location? This item shall include all Proposed Grade Changes and -- Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey descdbe the erosion and sediment control prac~ces that will be used to control site erosion and storm water discharges. This -- item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filting, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards1~1 of Mateda within any Parcel? 5 Will this Application Require Land Disturbing Activities r~ Encompassing an Area in Excess of Five Thousand1~1 (5,000 S.F.) Square Feet of Ground Surface? -- 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requlremenfo: or within One Hundred (1 Off) feet of a Weitand or -- Submission of a SWPPP is required for all Construction activities involving sot/ Beach? disturbances of one (1) or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes am part °f a le~2er c°mm°n plan that will ultimaiolY disturb °ne °r m°re acres of land; which Exceed Fiffaen (15) faet of Vertical Rise ts r~[ including Construction activities involving soil disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance?I~1 the DEC has determined thai a SPDES permit is required for storm water dis~aarges. SWPPP'$ Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious r~ [or storm Water Discharges from Construction acflvlly - Permit No. GP-0-t0-00t.) Surfaces be Sloped ts Direct Stsrm-Water Run-Off 1. The SWPPP shall be pcepareq prior to the subm~Sal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? STATE OF NEW YORK, COUNTY OF ........................................... SS That I ................................................................. being duty sworn, deposes and says that he/she is the applicant for Pemait, ,~md that he/she is the Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the sa~d work and to make and file this application; that all statements contained in this application axe true to {he best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ............................................... day of ................................... ~,0 ..... Not.:~ry Public: .......................................................................................... FORM - 06/10 of Trustees Applica~n County of Suffolk State of New York /~y~,'/'~/ffZ9 ~. ~'"/,~"~O~,/ BEING D~Y SWO~ DEPOSES ~ ~F~S THAT ~/S~ IS T~ ~PUC~T FOR T~ ~O~ DESC~ED PE~T(S) ~ T~T ~L STATE~NTS CONT~D ~ ~ TR~ TO T~ BEST OF ~S~R ~OWLEDGE ~ BEL~F, ~ T~T ~L WO~ W~L BE DO~ ~ T~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOU~OLD TO~ BO~ OF TRUSTEES. T~ ~PLIC~T AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSTEES ~ESS ~ F~E FROM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY VIRT~ OF S~ PE~T(S), ~ G~D. ~ CO~LET~G T~S ~PLICATION, I ~BY AUTHO~ZE T~ ~US~ES, T~ AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~MISES ~ CON~CTION ~TH ~F T~S ~PLICATION. DAYOF ~ SWORN TO BEFO~ ~ THIS Notary Public CONNIE D. BUNCH Notary Public, Sta~e 0{ New Yod( No, 01BU6185050 Qualified in ~uffolk County Commission Expires Apri 14, ~ FLEET'S NECK PROPERTY OWNERS ASSOCIATION P.O. Box 554 · Cutchogue, NewYork 11935 August 5,2011 Southold Board of Town Trustees PO Box 1179 Southold, NY 11971 Reference: Administrative Permit Application dated August 5, 2011 by Fleet's Neck Property Owners Association, SCTM# 1000-110-7-25,800 East Road, Cutchogue, NY 11935 Dear Trustees: The referenced application is in accordance with the intentions of the Fleet's Neck Property Owners Association plans for stewardship of its beach property. Further, it is in accordance with the ideas discussed at the time of the Tmstee's site visit of March 2011. Sincerely, Carl E. Vail III, President Fleets Neck Property Owners Association Officers, Directors and Committee Chairs Cad Vail (734-6525) President * Paul Sllansky (860-305-7985) VP Issues · Anna Howard (734-2616) and Tom Lambert (734-2644) VP Events ~avid Howe (734-2675) VP Mernbetship· Chuck Mogul (734-5751) Treusurer · Ray Huntington (734-4227) Secretory · Roy Schurnacher (981-3493) Trust·{ '~ David Allison (734-6428) * Ray Annabel (734-70:14) · Peter Bell (734-5758) · John Garvey (734-5422) · Evafl Glnlger (212-209-1175) John Heckmann (734-7692) · Trtcla Howe (734-2675) · Joe Lemedse (298-gB34) · Wally McGahan (734-5472) · Lauren Mullln (734-2802) Tom Wetzel (734-5623) · Ell·eh Schumacher (98:1-3493) Recording Secretory · Leslie Pearl (734-7837) and Bill Miller (734-7837) 8·=ch Ray Huntington (7~4-4227) and Mary Anne Huntington (734-7750) Tidings · Tom Lambert (7~-2644) Distribution Bill Miller (734-7837) Website Manager · Mike Furst (734.8079) E-Communicaffon Coordinator · Clare Sledz (734-7728) Member Welfare ard of Trustees Applicat~ AUTHORIZATION (where the applicant is not the owner, (print owner of property) residing at (mailing NoT do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officers and emolovees. The oumose of this form is to vmvide information which can alert the town of ~ossible conflicts of interest and allow it to take whatever action is - (--L~i n~me, first name, oliddle initial, u01ess you are a~plying in thc name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Appmval of plat Mooring Exemption from plat or official map _ Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, nlarriage, or buginess 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 mom than 5% of the shares. YES NO If you answered "YES". complete lhe balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position o£ that person Describe the relationship between yourself(the applicantIagent~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 ~hild is (check all that apply): __.A) the owner of greater than 5% oftbe shares of the corporate stock of the applicant (when the applicant is a co.oration); __,B) the legal or beneficial ownqr of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 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 Waterfzont Revitalization Program. A proposed action will be evaluated as to its significant beneficial and advm'se 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 ~nswer must be explained in detail~ listing both supporting and non- sum~ortin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. OB. 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. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# ~OOO .-- {rid ~ 7 - 2~ PROJECT NAME The Application has been submitted to (check appropriate response): Town Board ~] Planning Board ~-] 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: Locafionofaction: ~' ~ I~'"~T ~:>A'O ~,OaoO~' Io0' panOk.} ~-/2c:n~ -~ I2o~,~ Site acreage:. ~ '~' /~¢IZ-L~t~ L-~,~,-~.D. Present land use: ~I~C4 lOIN Present zoning classification: ~- q O If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: ~ ~a~ ~)-O~-i~f t~l,O~..l~i2~ ~ca2)C.; (b) Mailing address: ~) ~ ~{ ~--OT~[7, r~' (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~-~ No ~-] If yes, which state or federal agency?. OC. 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 III - Policies Pages 3 through 6 for evaluation criteria D Yes mo mot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~] Yes ~ 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 Southold. See LWRP Section III - 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 Ap~l~ble Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Sonthold. 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 III - 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 [] Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE~ 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 oPolicy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ~ Yes ~-] No ~-] Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~ Yes [] No ~ Not Applicable PREPARED TITLE D A T E ~/¢~[/~