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Home My WebLink AboutTR-7648 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 CERTIFICATE OF COMPLIANCE # 0714C Date December 15, 2011 THIS CERTIFIES that the removal and reconstruction of the existing bulkhead in-place utilizing vinyl sheathing; removal and replacement of a timber platform and stairs to be serviced seasonally; in-place replacement of return on east side and termination armored with I 0 yards core stone; 26' replacement in-place return and termination armored with 10 yards core stone; and installation of a 10' non-turf buffer along the landward side of the bulkhead At 2 Sunset Lane, Southold Suffolk County Tax Map #88-6-12 Conforms to the application for Trustees Permit heretofore filed in this office Dated 8/31/11 .pursuant to which Trustees Wetland Permit #7648 dated 9/21/11 was issued 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 removal and reconstruction of the existing bulkhead in-nlace utilizin~ vinyl sheathine: removal and replacement of a timber platform and stairs to be serviced seasonally; in-place replacement of return on east side and termination armored with 10 yards core stone; 26' replacement in-place retum and termination armored with 10 yards core stone; and installation of a 10' non-turf buffer along the landward side of the bulkhead. The certificate is issued to STEVEN H. KRAM owner of the Aforesaid property. u~t~orized Si)~atu~re MARTIN D. FINNEGAN TOWN ATTORNEY martin.finnegan@town.southold.ny.us JENNIFER ANDALORO ASSISTANT TOWN ATTORNEY jennifer.andaloro@town.southold.ny.us LORI M. HULSE ASSISTANT TOWN ATTORNEY lori.hulse@town.southold.ny.us SCOTT A. RUSSELL Supervisor Town Hall Annex, 54375 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1939 Facsimile (631) 765-6639 OFFICE OF THE TOWN ATTORNEY TOWN OF SOUTHOLD Bruce Anderson Suffolk Environmental Consulting, Inc. Newman Village, Ste. 2322 P.O. Box 2003 Bridgehampton, NY 11932-2003 DeCember i15, 20t t RE: Steven H. Kram, Wetlands Permit No. 7648 Dear Mr. Anderson, I have reviewed the Declaration of Covenants draft you submitted to this office with respect to the above referenced applicants concerning the ten foot wide non turf buffer to be established and maintained along the landward edge of the bulkhead. The covenants and restrictions document must be executed and filed with the County pursuant to §275-10(K) of the Southold Town Code. Please note that a copy of this document or, in the alternative, a sworn statement attesting to the filing is to be presented to the Office of the Board of Trustees within 90 days of issuance of the permit. Regards, Assistant Town Attorney Cc: Board of Trustees~ Suffolk Environmental Consulting, Inc. Newman Village, Suite E, 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003 (631) 537-5160 Fax: (631 ) 537-5291 Bruce Anderson, M.S., President December 13, 2011 Via Hand Submission Ms. Jill Doherty, Chairperson Board of Trustees Town Hall P.O. Box 1179 Southold, NY 11971 Re: Kram Property Situate: 2 Sunset Drive; Town of Southold SCTMti: 1000- 88-6-12 Dear Ms. Doherty, As you know this Firm represents the owner of the property referenced above who has obtained approval to improve thereon. As per the requirements of the Southold Board of Trustees I enclose herewith a Certified Copy of the Declaration of Covenants and Restrictions recorded in the offices of the Clerk of Suffolk County in Liber 12678 page 975. Should you have any questions concerning this matter, please feel free to contact this office at any time. Thank you in advance for your attention and consideration. cc: Mr. Kram CC#: C11-45963 COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on'12/09120'11 under Liber D00012678 and Page 975 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 1210912011 SUFFOLK COUNTY CLERK JUDITH A. PASCALE SEAL SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Number of Pages: 4 Receipt Number : 11-0134405 District: Section: Block: 1000 088.00 06.00 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Page/Filing $20.00 NO Handling COE $5.00 NO NYS SRCHG TP-584 $0.00 NO Notation Cert. Copies $5.20 NO RPT Fees Paid Recorded: At: 12/09/2011 10:30:28 AM LIBER: PAGE: Lot: 012. 000 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL $20.00 $15.00 $0.00 $3o.00 $95.20 D00012678 975 Exempt NO NO NO NO JUDITH A. PASC~T.~ County Clerk, Suffolk County Number of pages ' L.~ This document will be public record. Please remove all Social Security Numbers prior to recording. 1 Deed / Mortgage Instrument 2: Deed / Mortgage Tax Stamp FEES Page / Filing Fee Handling 20. 00 TP-584 Notation EA-S2 17 (County) EA-5217 (State) R.P.T.S.A. Corem. of Ed. 5. O0 Affidavit .._ (C'.~rtified Cop.)/ NYS Surcharge 15. 00 Other SubTotal SubTotal Grand Total 4 I Dis' Real Pro[ Tax Servi Agenq Verificati ZOO0 08800 0600 OZ2000 012.000 8 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932 Mail to: Judith A. Pascale, Suffolk County Clerk 310 Center Drive, Riverhead, NY 11901 www.suffolkcountyny.gov/clerk Tit e # Recording / Filing Stamps Mortgage Amt. 1. Basic Tax 2. Additional Tax Sub Total Spec./Assit. or Spec./Add. TOT. MTG. TAX Dual Town __ Dual County __ Held for Appointment Transfer Tax Mansion Tax The property covered by this mortgage is or will be improved by a one or two family dwelling only. YES or NO If NO, see appropriate tax clause on page # __ of this instru[nent., Community Preservation Fund Consideration Amount $ CPF Tax Due $ Improved VacantLand TD TD ¸TD Title Company Information Suffolk County Recording & Endorsement Page This page forms part of the attached by: STEVEN H. KRAM Declaration of Covenants and Restrictions (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY, NEW YORK. made TO In theTOWN of SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES In the VILLAGE or HAMLET of SOUTHOLD BOXES 6 THRU 8 MUST gE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property taxes, *you will now need to contact your local Town T ax Receiver so that you ma)/be billed directl¥ for all future property tax statements. Local property taxes are payable twice a year: on or before January lO,h and on or before May 31,,. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Tax Receiver with any questions regarding property tax payment. Babylon Town Receiver of Taxes 200 East Sunrise Highway North Lindenhurst, N.Y. 11757 (631) 957-3004 Riverhead Town Receiver of Taxes 200 Howell Avenue Riverhead, N.Y. 11901 (631) 727-3200 Brookhaven Town Receiver of Taxes One Independence Hill Farmingville, N.Y. 11738 (631) 451-9009 Shelter Island Town Receiver of Taxes Shelter Island Town Hall Shelter Island, N.Y. 11964 (631 ) 749-3338 East Hampton Town Receiver of Taxes 300 Pantigo Place East Hampton, N.Y. 11937 (63 I) 324-2770 Smithtown Town Receiver of Taxes 99 West Main Street Smithtown, N.Y. 11787 (631) 360-7610 Huntington Town Receiver of Taxes 100 Main Street Huntington, N.Y. 11743 (631) 351-3217 Southampton Town Receiver of Taxes 116 Hampton Road Southampton, N.Y. 11968 (631 ) 283 -6514 IslipTown Receiver of Taxes 40 Nassau Avenue Islip, N.Y. 11751 (631) 224-5580 Southold Town Receiver of Taxes 53095 Main Street Southold, N.Y. 11971 (631) 765-1803 dw 2/99 Sincerely, Judith A. Pascale Suffolk County Clerk DECLARATION OF COVENANTS THIS DECLARATION made this ,~0 'fl' day of ~/P//~¢4/~', 2011, by STEVEN H. KRAM, residing at 2 Sunset Lane, Southold, New York 11971, hereinafter referred to as "DECLARANT": W1TNESSETH: WHEREAS, the DECLARANT is the owner of a certain real property located on 2 Sunset Lane, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 88, Block 6, Lotl2, which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT therefore has made application to the Trustees for a permit pursuant to the Wetlm~ds Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a 10 foot non-turf buffer along the landward side of the bulkhead; and NOW, THEREFORE, the DECLARANT does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained adjacent to the bulkhead a 10 foot "non-turf buffer' as defined by Chapter 275 of the Town Code; and 2) These covenants shall run with the land and shall be binding on the DECLARANT(S), his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN ye[,TNESS WltE~REOF, the owner(s) has/have duly executed this instrument this STEVEN H. KRAM GALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles SS. On 11/30/2011 DATE before me, Anette Mullem, Notary Public Name, Title of Officer (eg, "Jane Doe, Notary Public") personally appeared Steven H. Kram NAME(S) OF SIGNER(S) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Of Notary Public OPTIONAL ANETTE V. MULLEM ' [ CommissiOn # 1~193 · Nota~ Public - CM~o~a ~ n ~ Los Angeles Cou ~ C~mm. E~ires Jul 17,2013 ~ Though the data is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. DESCRIPTION OF ATTACHED DOCUMENT Title or Type of Document: Declaration of Covenants Document Date: 11/30/2011 Number of Pages: 1 Signer(s) Other Than Named Above: CAPACITY(lES) CLAIMED BY SIGNER Signer's Name: Steven H. Kram [] Individual [] Corporate Officer- Title(s): [] Partnership - [] Limited [] General [] Attorney in Fact [] Trustee [] Guardian or Conservator [] Other: Declarant Signer Is Representing: Self Top of thumb here ID 03148E (Rev 01/2008) (098P) Page I of 1 Schedule A ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being at Bayview, near Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the Southwesterly line of a certain 60 foot private road, which point is: NORTH 67° 35' 20" West a distance of 151.24 feet from the intersection of the Southerly line of said 50 foot private road with the Southeasterly line of a certain 50 foot private road extending from Bayview Road Southerly to Little Peconic Bay, said intersection being 1813.95 feet Southwesterly along said Southwesterly line of said 50 foot private road from its intersection with the Southwesterly line of Bayview Road; RUNNING THENCE South 35° 02' 40" West a distance of 166.00 feet to ordinary high water mark of Little Peconic Bay; RUNNING THENCE in a Northwesterly direction along said ordinary high water mark of Little Peconic Bay North 67° 35' 20" West a distance of 100 feet to the other land now or formerly of Edward Mills and Amelia C. Mills, his wife, and Edith Mills and Olsson 8ooth; RUNNING THENCE North 35° 02' 40' East a distance of 166.00 feet to the Southwesterly line of the first mentioned 50 foot private road; RUNN lNG THENCE along the Southwesterly line of said 50 foot private road South 67° 35' 20" East a distance of 100 feet to the point or place of BEGINNING. Jill M. Doherty, President Bob Gho$io, Jr., Vice~President James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 DATE OF INSPECTION: Ch. 275 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ch. 111 INSPECTION SCHEDULE Pre~construction, hay bale line/silt boom/silt curtain 1st day of construction __ ~ constructed ~/Project complete, compliance inspection. INSPECTED BY: COMMENTS: f ~ 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 1 st day of construction % constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7648 DATE: SEPTEMBER 2L 2011 ISSUED TO: STEVEN H. KRAM PROPERTY ADDRESS: 2 SUNSET LANE~ SOUTHOLD SCTM#88-6-12 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold an~ with the Resolution of the Board of Trustees adopted at the meeting 2011 of application fee in the sum of $250.00 paid by Steven H. Kram and subject to the Terms and Conditions ns in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to excavate and remove entire bulkhead and install new bulkhead in- place utilizing vinyl sheathing; remove and replace timber platform and stairs to be serviced seasonally; in-place replacement of return on east side termination to be armored with 10 yards core stone; proposed 26' replacement in-place return termination to be armored with 10 yards core stone; fill void areas with 60 yds. clean sand; and install a 10' non-turf buffer along the landward side of the bulkhead, with the Condition of permission from the adjacent property owners for the off-site location of the core stone, and as depicted on the site plan 2011 and stamped approved on September 21, 2011. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Jill M. Doherty - ABSENT TERMS AND CONDITIONS The Pcrmittee, StevenH. Kram, residing at 2 Sunset Lane, Southold, NY as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the previsions 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 nigh 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 fr~e navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of tnis Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion 6fthe work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to tnis 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 September 21,2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Bruce Anderson Suffolk Environmental Consulting, Inc P.O. Box 2003 Bridgehampton, NY 11932 RE: STEVEN H. KRAM 2SUNSETLANE, SOUTHOLD SCTM#88-6-12 Dear Mr. Anderson: The Board of Town Trustees took the following action during its regular meeting held on Wed., September 21,2011 regarding the above matter: WHEREAS, Suffolk Environmental Consulting, Inc. on behalf of STEVEN H. KRAM applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance, application dated August 31,2011, 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 September 21,2011, 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 of the Southold Town Code, and, 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, and, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees has found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVES the application of STEVEN H. KRAM to excavate and remove entire bulkhead and install new bulkhead in-place utilizing vinyl sheathing; remove and replace timber platform and stairs to be serviced seasonally; in-place replacement of return on east side termination to be armored with 10 yards core stone; proposed 26' replacement in-place return termination to be armored with 10 yards core stone; fill void areas with 60 yds. clean sand; and install a 10' non-turf buffer along the landward side of the bulkhead, with the Condition of written permission from the adjacent property owners for the off-site location of the core stone, and as depicted on the site plan dated August 30, 2011 and stamped approved on September 21,2011. 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, Bob Ghosio, Jr., Vice-President Board of Trustees BG/Ims PROPOSED BLrLKHEAD IIECONSTRUGTION PLANS PLAN SITE ,-._ Perm ss onl place rof;k armor, as-sh°wn ab°Ye, °n AIlgel Sh°res Heine°whets Ass°ciati°n pr°perry granted: 110/20/11 .~ ~ /----7~ ~ ~ , PresidentL Angel Shores Homeowners Association 10/20/11. 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 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Steven H. Kram Please be advised that your application dated 8/31/11 has been reviewed by this Board at the regular meeting of 9/21/11 and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ¼ Constructed ($50.00) XX Final Inspection Fee ($50.00) ~)c~ -\~,\~\\\ __ Dock Fees ($3.00 per sq. ft.) XX Other- letters of permission from the adjacent property owners allowing for the off-site location of the core stone. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be ' necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 50.00 BY: Jill M. Doherty, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., September 14, 2011, the following recommendation was made: Moved by Derek Bossen, seconded by Audrey Horton, it was RESOLVED to NOT SUPPORT the Wetland Permit application of STEVEN H. KRAM to excavate and remove entire bulkhead and install new bulkhead in-place utilizing vinyl sheathing; remove and replace timber platform and stairs to be serviced seasonally; in- place replacement of return on east side termination to be armored with 10 yards core stone; proposed 26' replacement in-place return termination to be armored with 10 yards core stone; fill void areas with 60 yds. clean sand; and install a 10' non-turf buffer along the landward side of the bulkhead. Located: 2 Sunset Lane, Southold. SCTM#88-6-12 Inspected by: Derek Bossen, Doug Hardy The CAC does Not Support the application because the practice of permitting returning bulkheads causes the property to become a peninsula. The CAC recommends the entire bulkhead is moved landward approx. 20' to AMHW with minimal returns. The CAC questions how far the Trustees are willing to allow a property to extend into the Bay? Vote of Council: Ayes: All Motion Carried Jill M Dohctly. President Bob Ghosio. Jr. Vice-President James F. King Dave Bergen JOhll Bredemeye~ PO Box l I TO Southold. NY [ lq71 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: Suffolk Environmental Consulting, Inc. on behalf of STEVEN H. KRAM requests a Wetland Permit to excavate and remove entire bulkhead and install new bulkhead in-place utilizing vinyl sheathing; remove and replace timber platform and stairs to be serviced seasonally; in-place replacement of return on east side termination to be armored with 10 yards core stone; proposed 26' replacement in-place return termination to be armored with 10 yards core stone; fill void areas with 60 yds. clean sand; and install a 10' non.turf buffer along the landward side of the bulkhead. Located: 2 Sunset Lane, Southold. SCTM#88-6-12 rea to be impacted: ter Wetland Freshwater Wetland __Sound Bay Distance of proposed work to edge of wetland Part of,,..T~own Code proposed work falls under: ~,h~pt.275 Chapt. 111 other Type of Application: U/Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: P_re/se~nt Were: ~J. Doherty ~_~B. Ghosio ~J. King r../ J. Bredem~yer_ D. Dzenkowski other -- Form filled out in the field by Mailed/Faxed to: Date: A Bergen, 51TUATE, BAYVIt~H 'i'Ol,~l, ~::~11-10~ ..~UFT-OLK r__Z:UI, I'I~, N'r' JOHN C. EHLERS LAND SURVEYOR 6 FAST MAIN STR~T NY.S LIC NO 50202 ~ew York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (516) 444-0365 FAX: (516) ~.~.~. 0360 Erin M, Crott7 LETTER OF NON JURISDICTION-TIDAL WETLANDR commissioner March 28, 2003 Steven Kram 11499 Bellagio Road: Los Angeles, California 90049 Dear Mr Kram, RE: SCTM 1000-88-6-12 2 Sunset Lane Southold New York Based on the information you have submitted ~ ,_,~!'-~ _-:cc: ',---,.,~..,=,~; ~ ;.;.= ~^;..t;,,g fam=tio~aL~ bulkhea~ ~~ of Part 661( Tidal Wetland Regulations). ( Survey J C Ehlem dated 3/28103) Therefore, in accordance with the current Tidal Wetlands Regulations (6NYCRR Part 661) no permit is required for regulated activities landward of the functional timber bulkhead. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result fi'om your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hale bay berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, , Chades T Hamilton Permit Administrator BMHP file COUNT~~ OF SUFFOLK it' Suf k Environmental t onsu rog, nc. Newman Village, Suite E, 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003 (631) 537-5160 Fax: (63 I) 537-5291 Bruce Anderson, M.S., President October 13, 2011 Ms. Lauren Standish Board of Trustees Town Hall P.O. Box 1179 Southold NY 11971 Re: Kram Property Situate: 2 Sunset Drive; Town of Southold SCTM #: t000 - 88-6-12 Dear Ms. Doherty, As you know this Firm represents the owner of the property referenced above who is seeking to improve thereon. As per the requirements of the Southold Board of Trustees I enclose herewith a check made payable to your order to cover the requisite final inspection fee. Should you have any questions concerning this matter, please feel free to contact this office at any time. Thank you in advance for your attention and consideration. Sincerely, Diane K. Wassick enc. cc: Mr. Kram 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 TO: Steven H. Kram Please be advised that your application dated 8/31/11 has been reviewed by this Board at the regular meeting of 9/21/11 and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) XX Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) XX Other- letters of permission from the adjacent property owners allowing for the off-site location of the core stone. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be ~ necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 50.00 BY: Jill M. Doherty, President Board of Trustees 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 To: From: MEMORANDUM Jill Doherty, President Town of Southold Board of Trustees Mark Terry, Principal Planner LWRP Coordinator LJ ' SEP 2! 0!i IL'" ' Sc:thh0: ~i:;' n Date: September 21, 2011 Re: Proposed Wetland Permit for STEVEN H. KRAM SCTM#88-6-12 Note that the plans lack elevations of the the bulkhead. It is recommended that the Board require such elevations. Suffolk Environmental Consulting, Inc. on behalf of STEVEN H. KRAM requests a Wetland Permit to excavate and remove entire bulkhead and install new bulkhead in-place utilizing vinyl sheathing; remove and replace timber platform and stairs to be serviced seasonally; in-place replacement of return on east side termination to be armored with 10 yards core stone; proposed 26' replacement in-place return termination to be armored with 10 yards core stone; fill void areas with 60 yds. clean sand; and install a 10' non-turf buffer along the landward side of the bulkhead. Located: 2 Sunset Lane, Southold. SCTM#88-6-12 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided the following best management practice is required pursuant to: § 275-11. Construction and operation standards. A, General. The following standards are required for all operations within the jurisdiction of the Trustees: (2) Erosion control. Installation of an erosion control structure is necessary during any building, grading, landscaping or site work activity within Trustee jurisdiction. This structure may include, but is not limited to, installation of a silt fence, hay bales, wood chip berm and silt booms. The placement of the erosion control structure(s) shall be determined by the Trustees or their designee. All intertidal construction and excavation requires the installation of a silt boom that will retain all suspended sediments within the immediate proiect area. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Jill M. Doberty, President James F. King, Vice-President Dave Bergen Bob Gho~io, Jr. John Brcx:lemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765 - I $92 F~x (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Emergency Permit Application Coastal Erosion Permit Application -~-Wetland Permit Application __ Administrative Permit .~n .~Amendmenffl'rans fer/Extension Received Application:_~l~[~ ~- _Recelved Fee:$~ --.,A2-omplet ed Application ~eomplete __SEQRA Classification: Type I__Type II Unlisted __Coordination:(date sont) ~L~WRP Consistency Assessment Form ----~AC Referral Sent: C~ \311 ~l _,,,15rite or Inspection:~ __Receipt of CAC Report: __Lead Agency Determination: Technical Review: '~,,,P~blic l-lcarins Held:~J~_~. ~Rosolution: . Name of Applicant -~ ~"~'M ~r- Address ~. ~ql,{5~"ff Lqdg ffe,J-rh%~-~ ! Phone Number:( Suffolk County Tax Map Number: 1000- Property Location: (provide LILCO Pole #, distance to cross streets, and location) (If applicable) Address: ?hone: GENERAL DATA Land Area (in square feet): /~D ~( /~$ Area Zoning: ~g J ~_--4t~,~t~ Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes X No Does this project require a variance from the Zoning Board of Appeals __ If"Yes", please provide copy of decision. Ycs Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?. ~t No Yes If yes, provide explanation: Project Description (use attachraents if necessary): rd of Trustees Applicatio~ WETLANDfl~RUSTEE LANDS APPLICATION DATA. Purpose of thc proposed operations: Area of wetlands on lot: ~) .square feet Percent cove'rage of lot: ~& % Closest distance between n~arest existiag structure and upland edge of wetlands: ~ ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ feet Does the project involve excavation or filling? No )< Yes If yes, how much mater/al will be excavated? /'/0 cubic yards How much material will be filled?_~_ ..~.... g?/~) cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: '(~) Manner in which material will be removed or deposited: ._s_mtemen~ 0~_9~. eff_e?_~ if any, on the wetlands and tidal waters of the town that m_az result by ~jTm/7-~ mason of such propo~f ~-pYa[ib-ri~'(use atta6~e~S ~app~:d~i~.t~'}] .......................................... Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present with'm I00 feet of the proposed activity?. No ~ Yes Does thc project involve excavation or filling? No ~ Yes If Yes, how much material will be excavated7 t~ (cabic yards) How much material will be filled? 40 (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 6t7.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 1.APPLICANT/SPONSOR I / 12. PROJECT NAME 3.PROJECT LOCATION: 4. PRECISE LOCATION: Sffeet Addes$ and Road Intersections, Prom}nent landmarks etc -or provide map 6. DESCRIE~E PROJECT BRIEFLY: 7. A,MOUNT OF LAND AFFECTED: 8. WILL. PROPPED A~ION COMPLY ~TH EXISTING ZONING OR om~ RESTRICTIONS? Yes ~ No ]f ~,des~b~iefly: ~Res~fial ~lndus~al ~C~mer~al ~u.um ~Park/Fomst/Op~Space ~O~er(des~be) ~Ye~ ~No ff y~, ~t age~ n~e and ~rm~ I appm~l: ~Yes ~ ~ ~s, list a~ncy na~ a~d p~m~ / approval: 12. AS A OF PROPOSED ACTION Will EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E~JYes No Appl[car~t / Sponsor Name Signnn~re I CERTIP( THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO ~J~iE BEST OF MY KNOWLEDGE If the action is a Costal Area, and you ere 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 617.4? If yes, cooedinate the review process and usu the FULL FAF. i-lYes ['~"1 No WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration reay be superseded by another involved agency. I~Yes r~lNo C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing sir quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain b~iefty: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain bdetiy: I C3. Vegetation or fauna, fish, Shelifish or wildlife species, significant habitats, or threatonad or endangered species? Explain bdefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other nedJral ~soorces? Explain briefly: C§. Growth, ~baequant development, or relat~ a~ies likoly to he indtw..~l by tho propo~d a~on? E~lain C6. Long term, short term, cumulative, or other effents not identified in Cl-C57 Explain brietiy: I C7. Other impacts ~includin~] chanties in use of either c~uantit~ or t~pe of ener~lT? Explain bdelly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE, OR IS THERE LIKELY TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) ~ INSTRUCTIONS: For each adverse effect identified above, detarmine whether it is substantial, lerge, impedant or othenvise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of oncun'ing; (c) duration; (d) irmvereibitity; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting mate~tals. Ensure that explanations contain sufrmient detail to show that all mtavant adverse impacts have been identified and adequately addressed. If question d of part ii was chect(ed yes, the determination of significance reust evaluate the potential impact of the proposed action on the environreental characte~stics of the CEA. Cbe~ this box If you have Idena~ad one or mom potsndally large or significant adverse Impacts which MAY occur. Then proceed directiy to the FULL EAF ond/or pmpara a positive declaration. Check this box ff you have petennleed, based on the Information and analysis above and any supporting documentation, that the Ixoposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments aa necessary, the reaSons suppofling this determination. Board of Trustees Name of Lead Agermy Jill M. Dohert¥ :F~fot..? Type Name of Responsib e, lgfticer in Lead Agency "' b"lg nature of Respb~=lt~fole Officer ~(~ad Agency President Title of Responsible Officer Signature of Preparer (If different from responsible officer) Town of Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T~M. ~. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING~ DRAINAGE AND EROSION CONTROL PLAN District Section Btock Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION I'I'/CM # / WORK ASSESSMENT ] Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels iocated within ~.0 ~ I~ '~ I Wil}thisProjectRetainAIIStorm-WaterRumOff the Scope of Work for Proposed Construction) Generated by a Two (2") Inch Rainfall on Site? (S.F. I Acres) (This item will include all mn-off created by site V~ ii b. What is the Total Area Land Cleadng cleadng and/or construction activities as wall as all -- and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? impervious surfaces.) (s.F.,~.~ 2 Does the Site Plan and/or Survey Show AIl Proposed PROVIDE BRIEF PROJECT DESCRIPTION ~e t,~ ~.. ~ Drainage Structures Indicating Size & Location? This V/ item shall include all Proposed Grade Changes and and sediment control pracaces that will be used to ~ control site ~rosion and storm water discharges. This -- ~ (*~)b ~J ~,..4~txl~,~ item must be maintained throughout the Entire Construction Period. ~"~>' ~'"~ ~J_~'~z~,.,~,7 ~.l{ 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural ~' ~ ~ Existing Grade Involving more than 200 Cubic YardsL~U -- j.~) ~..~,% ~\ of Matefial within any ParceJ? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand v (5,000 S.F.) Square Feet of Ground Surface? -- 6 ,s there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or -- Subm~.sion of a SWPPP is required for all Constmclion activities involving soil 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 pair of a larger cornmon plan that will ultimately disturb one or more acres of lar, fl; which Exceed Fifteen (15) feet of Vertical Rise to r'~ including Conslmction aclivilies involving soil disturbances of less than one (1) acre where One Hundred (100') of Hodzontul Distance? -- the DEC has determined thai a SPDES permit is required tor stoml water discha~es. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious for Storm Wager Discharges from Construction activity - Permit No. GP-0-10-001 .) Surfaces be Sloped to Direct Storm-Water Ru r'e-Off 1. The SWPPP shall be prepared prior to the submiaal of the NOI. Tl~e NOI shall be into and/or in the direction of a Town right-of-way?~L~ v 2. The SWPpp shal[ describe the erosion and ssdirm~t control practices and where 9 Will this Project Require the Placement of Material, coastructadr~quired' post..constnJclion sthlm wefor rner~gement practice~ that will be used andlOrto r~luce the pollctanis in storm water discharges and to assure Removal of Vegetation and/or the Construction of any O STATE OF NEW YORK, COUNTY OF ........................................... SS That I ................................................................................. being duly swbm, deposes and says that he/she is the applicant for Permit, And that he/she is the Owner and/or representative of the Ova)er or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained iu this application are ~rue to the best of his klmwledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; FORM 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 STEVEN H. KRAM COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I,~/~)gn,2 ff. {<..J4~'q!t_~.- , residing at/dba, t<~./.i~/~t..~_ ~.~/O~.t~.~F~JT¢14~ O.&,d~t~'Ya~-,,,~. in~ duly sworn, depose and say~. .... ~" That on the 9¢~ay of,~¢~ 201~, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed~ September 21~ 2011 on or about 6:00 PM. Dated: '(s~gnature) Sworn to before me this day of 20 No, Cr 'ublic Matthew O. Ivens Notary Pub!it ol N?w Yorl( No. 011v6053559 Oualif,ed in St, ftc;ik County Commissiort Expires January 22, PROPOSED BULKHEAD RECONSTRUCTION P~S ~ KRAMProperty SITE PLAN SUFFOLK ENVIRONMENTAL CONSULTING, INC. Permission:Lo place rock armor, as. shown above, on Angel Shores Homeowners Association property granted: 10/20/11 ~ ~ ~c ~ , President, Angel Shores Homeowners Association 10/20/11. Suffolk Environmental Consulting, Inc. Newman Village, Suite E, 2322 Main Street, P.O. Box 2003. Bridgehampton, Ne'a, York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson. M.S., President September 13, 2011 Ms. Lauren Standish Board of Trustees Town Hall P.O. Box 1179 Southold, NY 11971 Re: Situate: SCTM #: KI?A M Property Sunset Drive; Town of Southold, NY 1000 -- 88-6-12 Dear Ms. Standish, As you know this Firm represents the owner of the property referenced above who is seeking to improve thereon. As per the hearing requirements of the Southold Board of Trustees I enclose herewith: Affidavits of Mailing dated September 9, 2011, with certified receipts attached to all abutting property owners. Please be advised that we will forward to you the green receipts cards as we receive them. Should you have any questions concerning this matter, please feel free to contact this office at any time. Thank you in advance for your attention and consideration. Sincerely, Diane K. Wassick enc. cc: Mr. Kram Name: PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: John Fallon 1000-88-6-13.44 1000-88-6-13.43 Angel Shores Homeowners Association 1000-88-6-13.57 1000-88-6-13.60 P.O. Box 116K; Mattituck, NY 11952 P.O. Box 428; Southold, NY 11971 STATE OF NEW YORK COUNTY OF NEW YORK States Post Office at were mailed to each of mail. Diane K. Wassick c/o Suffolk Environmental Consultingt Inc., residing at 2322 Main St.; Newman Village Suite E; P.O. Box 2003; Bridgehampto~ NY 11932 ,being duly sworn deposes and says that on the ~ day of~~._~ 20 [~ , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United Brid~eham~ton , that said Notices said persons by (certified) (registered) Sworn to before me this 2011 of Trustees Application AU'ruOILIZATION (where the applicant is not the owner) (print owner of property) residing at ~ ~o~ (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner' s signature) 8 of Trustees Applicatio~ AUTHORI ZAP/ON (where the applicant is not the owner) (print oWner of Droperty) (mailing add~es$) ~d~ ~-~'A~'~! ~ ~ do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. "s signature) 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold'e Code of Ethics orohbits eonflias ofintemst on the vart of to~n~ Officers and emolovees. The ournoS~ of ibis form is to m'ovid~ in fofination which can alert lh~ town of oo~ible conffiets of ~tet~t and allow it to tel~e whelm, er aodonS~ nneessurv to avoid same. YOUR NAME: · (Last name, first name, olJddle initial, uplosa you are applying in the name of sumcone else or oth~' entity, such aa a company. If so, indicate, the.otter par$otl's or compally'$ name.) NAME OF APPLICATION: (Chack all that apply.) Tax grievance Building Varianc~ Trustee Change of Zone Coastal Ems{an Approval of pint 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 ~Sourhpld? "Relationship" includes by blo~d, rrl~rdage, or business internal "Busi~ interest'~ means a business, ineludlng a partnership, in whleh the town o fficxr or employee has even a partial ownership of (or empinyment by) a corporation in which the town officer or employee owns more than 5% of the sha~s. YES NO ~ , If you answered '~YES~, complete the balance of this form and date and sign where indicated. Name of per,on employed by thc Town of Southold Title br pa~ition o f lhat per~n __ : Describe thc r~lationahip between your~eif (the appliuant/agent/represe n(ativ¢) and the town o.ffie~r or employee. Eilher 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 ia (check all that apply): __3.) the owner 0f greater than 5% of the shares of the corporate stock oftha ap{~licatll (when the applicant is a coq:~ratlon); __B) the legal 0r~enefi¢ial own~ of any intel'est in a non-corporate entity (when the applicant is not a corporation); __C) aa officer, director, parme?, or empinyaa of the applioant; or __ D)the actual applicant. DESCRIPTION OFRELATIONSHIP 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 Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listin~ both supporting and non- suooortin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# //~d). ~:~ ~:~ ] PROJECT NAME ~--~,~r 'hi I~g.,A-o-,x 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) ~-~ Co) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Board of Trustees Application County of Suffolk State of New York BEING DULY SWORN ~.POSES ~v ~mMS ~n^T ~m/sIm ts tlm ~Puc~d~rr ~oa T~ ~O~ DESC~ PE~T(S) ~ ~T ~L STA~mNTS CO~D ~ ~ m~ TO Tm ~EST OF mS~ ~O~EVOE ~ U~[~, ~ TroT ~ WO~ ~L BE DO~ ~ Tm ~R SET FORm.m ~S ~PLICATION ~ AS MAY BE ~PRO~ BY ~ SOU~OLD TO~ BO~ OF TRUSTEES. T~ ~PLIC~T AG~ES mo HOLD m~ TO~ OF SOU~OLD ~ ~ TO~ ~UST~S ~ESS ~ F~E ~OM ~ ~ ~ D~GES AND CL~S ~S~G ~ER OR BY ~RT~ OF S~ P~T(S), ~ G~ED. ~ CO~LET~G T~S rePLICATION, I ~REBY AU~OM~ ~ ~US~ES, T~ AGE~(S) OR ~PRESENTA~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT m~ P~SES ~ CON~CTION ~ ~W OF T~S ~PLICATION Si~ature SWORN TO BEFORE ME THIS ~_?-h Notary Public 0UAUFIED IN SUFFOLK COUNT~ COMMISSION EXPIRE8 Location of action: Site acreage:. Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code ( ) '3 { D ~ ~'~ - ForDeD O (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? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - 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 [--] Yes ~ No [~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria - Yes [] No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southoid. See LWRP Section III - 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 Appli~e Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. No ~ Not Applicable Yes 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 POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~ No [] Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island ,Sound, the Peeonic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~ Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [] Yes [] No [~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. Yes ~] No ~] Not Applicable PREPARED BY ~"~,~,d ~ TITLE Dt6~L- DATE u ¥ 0 o /'7-