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Home My WebLink AboutTR-7782 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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 ¼ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PER.MIT NO. 7782 DATE: MARCH 21, 2012 ISSUED TO: EDWARD J~URZIr. NIA PROPERTY ADDRESS: 50 SHORE RD, GREENPORT SCTMt~47-2-1 AUTHORIZATION Pumuant to the provisi~*ns of Chapter 275 and 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 21 consideration of application fee in the sum of $250.00 paid by Edward Jurzenia and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and Wetland Permit to install a storm water run-off drainage area; well draining soils are encountered; fill excavated area with sand and gravel and to remove trees as needed for site recess; and removal of all dead trees, and as depicted 0m the site plan dated February 17, 2012 stamped by Joseph Fischettii, Jr. Licensed Professional Engineer received on May 8, 2012 and stamped approved on May 8, 2012. This approval is conditioned upon the following; the site shall be dewatered with the recommendation of the Town Engineering office dated March ~. a~ drawn on the submitted plan~shaH!b~utilized during construction; andthe applicant may ~mo~0 only th~ ~rees roq~ivod~or site aecess and along Siivermere~Roa~ ~rior to eonstr~cti~n o~t site, the remairdng~t~ees on site may be remOVed two months a~'ter the comple~ton of ~e permtfted?~'~givities if (liere are no indicators of growth/life ~h the remaining trees, as per Trustee site inspection. IN WITNESS WHEREOF, thc said Board of Trustees hereby causes its Corporate Seai to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. ( T~RMS AND CONDITIONS The Permittee, F~wa_r_d Jm'geilia~ 1400 Silvennerp Rd., Greenp0rt, NY as part of the consideration for the issuance of the Per[nit dogs understand and prescribe to the following: That the said Board offlr~4ustces 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 perfom~ed pa{st~fini ti> this permit, and the said Permittee will, at his or her expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete ekclusion 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, requost for an extension may be made to the Board al a later date. That this Permit should be relained 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 pernfit by resolution of the said Board. That there will be no um'ehsonable interference with navigation as a result of the work 'herein authorized. ' : That there shall be no inlerference 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 Soathold require the removal and/or alterations in tah~do0~t[on ofit~woO, hemi!a auth~iz~d, or. if, inthe opinion the work shall cnus¢~masonabl~ obstruction to free na-eigation~ the said Pennittee~will be .required, upon?~ue noli~e~ to:[groove 9r altgr lhis work proj~t herein stat,od without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required s~ppieff~ental.to this pernfit, which may be subject to revoke upon failure to obtain same. 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 March 21, 2012 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Mr. Edward Jurzenia 70930 Silvermere Rd. P.O. Box 285 Greenport, NY 11944 RE: 50 SHORE RD., GREENPORT SCTM~47-2-1 Dear Mr. Jurzenia: The Board of Town Trustees took the following action during its regular meeting held on Wed., March 21,2012 regarding the above matter: WHEREAS, EDWARD JURZENIA 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, completed application dated December 15, 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 January 18, 2012, 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, 2 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 EDWARD JURZENIA to install a storm water run-off drainage area; excavate shaft until well draining soils are encountered; fill excavated area with sand and gravel and to remove trees as needed for site access; and removal of all dead trees, and as depicted on the site plan dated February 17, 2012 stamped by Joseph Fischettii, Jr. Licensed Professional Engineer received on May 8, 2012 and stamped approved on May 8, 2012. This approval is conditioned upon the following: the site shall be dewatered in accordance with the recommendation of the Town Engineering office dated March 5, 2012; hay bales, as drawn on the submitted plan, shall be utilized during construction; and the applicant may remove only the trees required for site access and along Silvermere Road prior to construction on site, the remaining trees on site may be removed two months after the completion of the permitted activities if there are no indicators of growth/life on the remaining trees, as per Trustee site inspection. 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:$100.O0 Very truly yours, ~King, President Board of Trustees JFK/Ims Ed Jurzenia 1400 Silvermere Road Greenport, NY 11944 (631)477-0011 February 23, 2012 VIA HAND DELIVERY Jim King, President Town of Southold Trustees Town Hall Annex Building 54375 Route 25 P.O. Box 1179 Southold, NY 119671 Re: 50 Shore Road, Greenport NY SCTM# 1000-47-2-1 Dear President and Mcanbers of the Board of Trustees: As requested, attached hereto please find an updated plan of proposed work at the subject property illustrating a cross section of the drywell/drainage feature. If you require any additional information, please let me know. tfully~bmitted, Ed Jurzenia~/ I\ Existing Lift Station -- VACANT UPLAND WOODED AREA~ APPROXIMATE LINE OF EXISITNG WETLANDS. SCTM #: 1000-45-06-08 $ & SILT FENCING AS NEEDED OR REQUIRED. GRADE PROVIDE CLEAN SAND & GRAVEL FILL TO REPLACE EXCAVATED CLAY MATERIAL CONTRACTOR MAY USE CONCRETE 12" DIAMETER CU~RNG RINGS -- AS NEEDED TO ACCOMMODATE TOWN Right-of-Way SILVERMERE ROAD SCTM #: 1000-47-02-01 VACANT LOT 20'X 20' WITH 12' DIAMETER DRAINAGE SHAFT AT CENTER. EXCAVATE TO A DEPTH AS NEEDED TO REACH WELL DRAINING SOIL AS APPROVED BY THE ENGINEER. BACKFILL WITH CLEAN SAND & GRAVEL. 20' PAD FOR EQUIPMENTACCESS. ALL FILL TO BE CLEAN, NATURAL, STONE OR PACKING DIRT MATERIALS. CO.TRACTORS.ALL PROTECT ALL ADJACENT PROPERTIES AS NEEDED FROM DAMAGE ASSOCIATED WITH CONSTRUCTION ACTIVITY. SCTM #: 1000-47-02-02 EXISTING CO'I-rAGE SCTM #: 1000-47-02-03 EXISTING COTTAGE TOWN Right-0f-Wa~/ TO EXISTING PRIVATE ROAD AS NEEDED OR REQUIRED. NOTES: 1. ALL EXCAVATED MATERIAL MAY BE LEFT ON SITE. 2. ALLTREES ON PROJECTSITE MAY BE REMOVED AS NEEDED TO ACCOMMODATE SITE ACCESS. SCTM #: 1000-47-02-07 EXISTING COTTAGE SCTM #: 1000-47-02-06 EXISTING COTTAGE SCHEMATIC SITE PLAN SCALE: 1" = 40.0' CROSS EXCAVATION SECTION PROFILE SCALE: 1# = 10.0' 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 March 21,2012 Mr. Edward Jurzenia 70930 Silvermere Rd. P.O. Box 285 Greenport, NY 11944 RE: 50 SHORE RD., GREENPORT SCTM#47-2-1 Dear Mr. Jurzenia: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., March 21, 2012: RESOLVED, that the Board of Trustees APPROVES the application of EDWARD JURZENIA to install a storm water run-off drainage area; excavate shaft until well draining soils are encountered; fill excavated area with sand and gravel and to remove trees as needed for site access; and removal of all dead trees. This approval is conditioned upon the following: i) the applicant shall submit a plan stamped by a licensed professional engineer; ii) the site shall be dewatered in accordance with the recommendation of the Town Engineering office dated March 5, 2012; iii) hay bales, as drawn on the submitted plan, shall be utilized during construction; and iv) the applicant may remove only the trees required for site access and along Silvermere Road pdor to construction on site, the remaining trees on site may be removed two months after the completion of the permitted activities if there are no indicators of growth/life on the remaining trees, as per Trustee site inspection. Very truly yours, King, President rustees JFK:lms Ed Jurzenia 1400 Silvermere Road Greenport, NY 11944 (631) 477-0011 Via Hand Delivery Jill Doherty, Chairperson Town Hall Annex Building 54375 Route 25 P.O. Box 1179 Southold, NY 119671 Re~ 50 Shore Road, Greenport NY SCTM# 100-47-2-1 Dear Chairperson Doherty and the Board of Trustees: As requested, attached hereto please find an updated survey of the subject property indicating where the proposed drywell/drainage feature will be located. Please let me know when the Trustees will be placing this matter back on an agenda for further consideration and if you require any additional information. fully~bmitted, Ed Jurze~// Z 85'31'40" W SILVER LANE 90.84' NEAR SURVEY OF PROPERTY $ITUATE THE VILLAGE OF GREENPORT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-47-02-01 SCALE 1 "=50' DECEMBER 11, 2011 AREA = 16,065 sq. ff. 0.369 oc. EDWARD P. JURZENIA Nathan Taft Corwin III Land Surveyor PHONE (650727-2090 F~x (631)727-1727 VACANT UPLAND WOODED AREA SILVERMERE ROAD 20' X 20' WITH 12' DIAMETER DRAINAGE SHAFT AT CENTER+ EXCAVATE SCTM #: TO A DEPTH AS NEEDED TO REAC 1000~7-02~J1WELLDRAININGSOIL. BACKFILL VACANT WITH CLEAN SAND & GRAVEL. LOT SCTM #: 1000-47-02~)2 EXISTING COTTAGE - APPROXIMATE LINE OF EXISITNG WETLANDS. SCTM #: 1000-45-06-08 PAD FOR EQUIPMENT ACCESS+ ALL FILL TO BE CLEAN, NATURAL, STONE OR PACKING DIRT MATERIALS NOTE: CONTRACTORS.ALL PROTECT ALL ADJACENT PROPERTIES AS NEEDED FROM DAMAGE ASSOCIATED WITH CONSTRUCTION ACTIVITY. EXISTING I COTTAGE -- HAY BALES & SILT FENCING AS NEEDED OR REQUIRED TOWN Right-of-Way TOWN Rig ht -0 f-Way~ REPAIR ALL DAMAGE TO EXISTING PRIVATE ROAD AS NEEDED OR REQUIRED, NOTES: 1. ALL EXCAVATED MATERIAL MAY BE LEFT ON SITE 2. ALL TREES ON PROJECT SITE MAY BE REMOVED AS NEEDED TO ACCOMMODATE SITE ACCESS SCTM #: 1000-47-02~)7 EXISTING COTTAGE SCTM #t '{000-47-02-06 STORMWATER DRAIANGE PROJECT SCHEMATIC SITE PLAN SCALE: ~" = 50.0' Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 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., January 11,2012 the following recommendation was made: Moved by Doug Hardy, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit application of EDWARD JURZENIA to install a storm water run-off drainage area; excavate shaft until well draining soils are encountered; fill excavated area with sand and gravel; remove trees as needed for site access; and removal of all dead trees. Located: 50 Shore Rd., Greenport. SCTM#47-2-1 Inspected by: Derek Bossen, Doug Hardy, William McDermott Vote of Council: Ayes: All Motion Carried MCDONALD (~EO$CIENCE Box 1000 SOUTHOLD NEW YORK 11971 631-765-3677 JAN 11 DEAR SIRS: YOUR BORING IS DONE. BEFORE THE DATA CAN BE RELEASED WE REQUIRE PAYMENT OF THE FOLLOWING AMOUNT; TEST HOLE BORiNG....$ ~:~ ~C) , ~.~ MARK S. MCDONALD 2012 BORING DONE AT THE REQUEST OF.' SCTM [CcO -~-'/- z.-I ADDRESS TOTAL FOOTAGE DRILLED: Z8075819 7~t81~5 MAIN RD., GREENPORT, NY 119t4-~8~3 J~ i 1 '12 149-02 GREENPORT Ol/ll/2012 MARK MCDONALDmmmmmmmmm~*mmm*mmmmmmmmmmmmmmmm~mmmmmmmmmmmmmmm $940. OO OO2245 and OOCENTSm ~ CASHIER'S CHECK ii, OO 2 ~hS,m ~Nq 0000 0,1" Jill M Dohe~ty, President Bob Ghosio, Jr. Vice-President James F King Dave Berge~l John Bredemeyer P.O. Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax ( 631 ) 765 -6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ,'//~' ~/~ EDWARD JURZENIA requests a Wetland Permit to install a storm water run-off drainage area; excavate shaft until well draining soils are encountered; fill excavated area with sand and gravel; remove trees as needed for site access; and removal of all dead trees. Located: 50 Shore Rd., Greenport. SCTM#47-2-1 Type of area to be impact.,gd: __Saltwater Wetland "Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland ¢) / P~?f Town Code proposed work falls under: v __Chapt.275 Chapt. ~11 other Type of ApplicZn: ''~ Wetland __Coastal Erosion ~Amendment ~Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Pres~j. t Were: ~. King B. Ghosio Bredemey~r. ¢/ D:-B-zemk'ow~ki _ Form filled out in the field by ~/'D. Bergen, ~,,"'-ot he r Mailed/Faxed to: Date: Jill M. Doherty. President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John B~edemeyer PO Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~'-t9F', (.{ EDWARD JURZENIA requests a Wetland Permit to install a stormwater run-off drainage area; excavate shaft until well draining soils are encountered; fill excavated area with sand and gravel; remove trees as needed for site access and removal all dead trees. Located: 50 Shore Rd., Greenport. SCTM#47-2-1 Type of area to be impacted: __Saltwater Wetland //¢reshwater Wetland Dist~qce of proposed work to edge of wetland Pa/~ of Town Code proposed work falls under: ,/Chapt.275 Chapt. 111 other Sound __Bay Type of Application: , /Wetland Coastal Erosion Amendment ~Ad m~mstrabve__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Presze~t Were: ~J. Doherty . Ghosio . ing D. Bergen, ~t/J. Bredemo-~r D. Dzenkowski other -- Form filled out in the field by Mailed/Faxed to: Date: Page 1 of 1 Standish, Lauren From: Patrick Bencivenga [pbencivenga@mac.com] Sent: Monday, June 13, 2011 2:18 PM To: Standish, Lauren Subject: Silermere Drive, silver Sands Motel waste sight I am a home owner at 935 Shore Drive, adjacent to Silvermere Drive and behind the Silver Sands Motel. I am aware of the non drainage condition at this location am not available to attend this hearing. The area in question poses a problem and most importantly is a health risk to the neighboring and surrounding communities. A stagnant body of water such as this is a breading ground for mosquitos. In addition, this problem which I have been advised was caused by the lack of drainage has killed the many trees which at one time were alive and well. They are now dead and pose a potential liability and risk in the event a tree falls into the road, thus blocking access. There are people of older age living on this block and there is certainly a potential need for emergency access. The area in question is a obvious problem that if not corrected will have negative effects on for the local community. Thank you. Patrick Bencivenga 935 Shore Drive Greenport, NY 11944 On May 31,2011, at 10:12 AM, Standish, Lauren wrote: Secretarial Assistant Board of Trustees (631) 765-1892 6/13/2011 Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 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., June 15, 2011, the following recommendation was made: Moved by Meaghan Burke, seconcded by Jack McGreevy, it was RESOLVED to NOT SUPPORT the Wetland Permit application of EDWARD JURZENIA to install a stormwater run-off drainage area; excavate shaft until well draining soils are encountered; fill excavated area with sand and gravel; remove trees as needed for site access and removal of all dead trees. Located: 50 Shore Rd., Greenport. SCTM#47-2-1 Inspected by: Meaghan Burke, Peter Young The CAC does Not Support the application because the application is incomplete. The CAC recommends the Trustees require a detailed site plan to include test borings to determine if they can reach adequate depths of well draining soils. Vote of Council: Ayes: All Motion Carried ? SCOTT A. RUSSELL SUPERVISOR TOWN HALL - 53095 MAIN ROAD Fax. (631)-765-9015 JAMES A. RICHTER, R.A. ENGINEER TOWN OF SOUTHOLD, NEW YORK 11971 Tel. (63I)-765 - 1560 JAMIE.RICHTER~TOWN.SOUTHO LD.NY .US OFFICE OF THE ENGINEER TOWN OF $OUTHOLD James King - President Southold Town Board of Trustees 53095 Main Road Southold, New York 11971 Dear Mr. King: Re: Janua~ 17,2012 Test Hole Data Sheet SCTM #: 1000-47-02<)1 As per your request, I have reviewed the Test Hole data for the above referenced residential lot located on Silvermere Road in Greenport. This report is dated 12/14/11 and has been prepared by the office of McDonald Geoscience. Your question, as I understand it, was weather or not a gravel shaft could be expected to provide adequate drainage for this residential building lot. This type of drainage shaft would not be considered an uncommon drainage practice where clayed soils are found to exist. In addition, the Suffolk County Health Department requires a similar method of construction for new septic systems that are designed in areas where poor drainage soils are encountered. By excavating a shaft through the bad soils and backfilling with clean sand & gravel, you provide a filtered conduit through witch water can recharge back into the ground water system. In this case, the intent would be to construct a stormwater BMP that would allow surface water to recharge back into the water table and reduce the flooding on this residential lot. My only concern would be the stability of the site during construction. The applicant should be required to install Hay Bales & Silt Fencing around the perimeter of the construction activity to control silt and prevent debris from entering the road system and adjacentwetlands on the other side ofthe town roadway. In an effort to assure the success of this type of BMP at this location, I would recommend that it be excavated to a average width of eight (8') feet in diameter and extend a minimum of five (5') feet below the bottom of the clay layers or forty six (46') feet in depth. If you have any questions concerning this matter, please contact my office. cc: Peter Harris, Superintendent of Highways Jim McMahon, DPW SCOTT A. RUSSELL SUPERVISOR TOWN HALL - 53095 MAIN ROAD Fax. (631)- 765 - 9015 JAMES A. RICHTER, R.A. ENGINEER TOWN OF SOUTHOLD, NEW YORK 11971 TeL (631) - 765 - 1560 J AM IE. RiCHTER~TOWN.SOUTHOLD.NY.US OFFICE OF THE ENGINEER TOWN OF $OUTHOLD James King - President Southold Town Board of Trustees 53095 Main Road Southold, New York 11971 Dear Mr. King: Re: Janua~ 17,2012 Test Hole Data Sheet SCTM #: 1000-47-02-01 As per your request, I have reviewed the Test Hole data for the above referenced residential lot located on Silvermere Road in Greenport. This report is dated 12/14/11 and has been prepared by the office of McDonald Geoscience. Your question, as I understand it, was weather or not a gravel shaft could be expected to provide adequate drainage for this residential building lot. This type of drainage shaft would not be considered an uncommon drainage practice where clayed soils are found to exist, in addition, the Suffolk County Health Department requires a similar method of construction for new septic systems that are designed in areas where poor drainage soils are encountered. By excavating a shaft through the bad soils and backfilling with clean sand & gravel, you provide a filtered conduit through witch water can recharge back into the ground water system. In this case, the intent would be to construct a stormwater BMP that would allow surface water to recharge back into the water table and reduce the flooding on this residential lot. My only concern would be the stability of the site during construction. The applicant should be required to install Hay Bales & Silt Fencing around the perimeter of the construction activity to control silt and prevent debris from entering the road system and adjacent wetlands on the other side of the town roadway. In an effort to assure the success of this type of BMP at this location, I would recommend that it be excavated to a average width of eight (8') feet in diameter and extend a minimum of five (5') feet below the bottom of the clay layers or forty six (46') feet in depth. If you have any questions concerning this matter, please contact my office. Sincerely, James A. Richter, R.A. cc: Peter Hards, Superintendent of Highways Jim McMahon, DPW McDONz4g D GEOSCIE NCE Box 1000 * Southold, New York 11971 · (631) 765-3677 TEST HOLE DATA SHEET Name: Jurzenia Surveyor: NC Location: Tax Map Number: Greenort 1000-47-2-1 Project Description: Lot Date: 12/14/11 Dark Drown loaal OL Crown clay CH 37' 41' 53' Water in Drown clay CH Water in brown clayey sand SC Water in pale brown fine sand SP Comments: Water encountered 7.2' below surface. Compare elevation to water level. Water level readings in extensive clays can be unreliable~ ~est hole ooring...$940.O0 /-- ~D~ ~/-'~-~ Name: Surveyor: Location: Tax Map Number: Project Description: Date: McDON 4 I ]) GEOSC NCE Box 1000. Southold, New York 11971 · (631) 765-3677 Jurzenia NC Greenort 1000-47-2-~ Lot 12/14/11 7.2' TEST HOLE DATA SHEET Dark Drown loam OL Brown clay CH Water in Drown clay CH 37' 41' Water in brown clayey sand SC Water in pale brown fine sand SP 53' Comments: Water encountered 7.2' below surface. Compare elevation to water level. Water level readings in extensive clays can be unreliable~ ~est hole ooring..,.$940.O0 J-- ~ ~'~ SCOTT A. RUSSELL SUPERVISOR TOWN HALL - 53095 MAIN ROAD Fax. (631)-765-9015 JAMES A. RICHTER, R.A. ENGINEER TOWN OF SOUTHOLD, NEW YORK 11971 Tel. (631) -765 - 1560 JAMIE.RICHTER~TOWN.SOUTHOLD.NY.US OFFICE OF THE ENGINEER TOWN OF SOUTHOLD James King - President Southold Town Board of Trustees 53095 Main Road Southold, New York 11971 Re: 50 Shore Road, Greenport SCTM #: 1000-47-02-01 March 5, 2012 Dear Mr. King: As per your request, I have reviewed your letter dated 3/2/12 an offer the following: Your first question, as I understand it, was whether or not the site would need to be drained prior to excavation of the shaft. While it is possible to excavate the shaft without dewatering the site, it is not recommended. Without dewatedng, the site may be difficult to maintain and could become a silt problem for the adjacent Town Road. Various locations could be used to dissipate the standing water. A potential location for dissipation of stormwater would be to the north by pumping into an existing drainage system that currently runs along the railroad tracks. Your second question related to how much material will be excavated and how will it affect the final grade of the site. Exacting Topography of the site has not been taken. However, it would appear that it would take well over 1,000 Cubic Yards of matedal to fill in the lot. The proposed excavation would generate about 100 Cubic Yards of material. While there would be a change in grade, it would not be considered significant. If you have any questions concerning this matter, please contact my office. CC: Lori Hulse, Asst. Town Attorney Jim McMahon, DPW Page 1 of 1 Standish, Lauren From: Terry, Mark Sent: Wednesday, February 22, 2012 3:33 PM To: Standish, Lauren Cc: Hulse, Lori Subject: SCTM#1000-47.-2-1 Lauren, Please forward this to the Board. I have reviewed the proposed action on SCTM# 1000-47-2-1. It is my understanding that the action is being proposed as a flood control project, in that respect the action is CONSISTENT with Policy 4 of the LWRP which states: "Minimize loss of life, structures and natural resources from flooding and erosion." However, it is unclear if the drainage control structure would continue to benefit the adjacent property owners or be limited to the subject parcel. Could the Board clarify this? Also I am not qualified to determine if the proposal will succeed in providing flood control, for that determination an engineer should be consulted. Mark Terry Principal Planner LWRP Coordinator Town of Southold Planning Department P.O. Box 1179 53095 Main Road Southold, New York 11971 (631) 765-1938 Mark '[e[ry@town,southold.ny, us 2/23/2012 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: FROM: DATE: RE: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Jamie Richter, R.A. Office of the Engineer James F. King, Presider~ ~-- Board of Trustees March 2, 2012 Edward Jurzenia 50 Shore Rd., Greenport SCTM#47-2-1 As you know this Board is considering an application to install a private drainage feature at the above referenced site. During the January 18, 2012 public headng the issue whether the site would require dewatedng pdor to commencing the proposed work was raised. Please advise this Board if, in your opinion, the site would require dewatedng and the appropriate method of dewatering. Additionally, the applicant has represented that all materials from the site that are excavated to complete the installation of the drainage feature will be left on site. Please advise if you believe that this will result in a change of grade on the property. We would appreciate your prompt attention to this matter as to avoid further delay in this application. 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 TO: FROM: DATE: RE: James A. Richter, R.A. Office of the Engineer James F. King, Presiden~ Board of Trustees January 24, 2012 PROPOSED STORMWATER DRAINAGE PROJECT 505 SHORE RD.~ GREENPORT SCTM#-47-2-1 A public hearing concerning the above-referenced application was held on Wed., January 18, 2012. Our Board closed the hearing and reserved decision until a thorough review of alt recently submitted documentation and testimony from the hearing has been completed. In order to move forward with a decision and ensure this project will not have an adverse affect on the adjacent properties, the Code requires the project plans to be stamped by a registered professional engineer. We would appreciate your prompt attention to this matter as to avoid further delay on this application. 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 June 20,2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert Schmeder 1100 Manhasset Ave. Greenport, NY 11944 RE: ED JURZENIA 505 SHORE RD., GREENPORT SCTM~47-2-1 Dear Mr. Schroeder: The Board of Trustees reviewed the request to waive certain application requirements. After inspecting the property on June 15, 2011, the Board finds that in order to conduct a thorough review of your proposed drainage project, the requirement of a survey created no more than one year to the date of application, and certified by a registered land surveyor or registered professional engineer is an important component of your application. In addition, we are asking that you also include test borings with the actual depth needed to reach well-draining soils. Please be advised that your application for the above-referenced property remains incomplete and therefore the hearing scheduled for June 22, 2011 has been postponed until further notice. Your application will be considered for a hearing upon receipt of this requirement. V~ry truly yours, ~loarO of lrustees Cc: Ed Jurzenia May 6, 2011 HAND DELIVERED Jill Doherty, President Southold Board of Trustees 54375 Route 25 (Main Road) P.O. Box 1179 Southold, NY 11971 Re: Application of Ed Jurzenia Dear Ms. Doherty, In response to your letter dated May 6, 2011, enclosed please find a check in the amount of $250.00, a copy ora portion of a map drawn by Van Tuyl, from the 19~0s and a completed Erosion, Sedimentation and Storm Water Run-off Assessment Form. Additionally, please consider this letter a formal request to have the following application requirements waived: 1. Application fee 2. Survey dated no more than one year prior to the date of the application 3. Dated and stamped plans certified by an Engineer. The reason for the requested waiver stems from the history of the flooded condition of this property, which I believe was the result of certain work performed by the Town in the area and is the direct cause of the necessity of making this application to the Trustees. Further, the proposed work will benefit the Town and my neighborhood, since it will provide much needed drainage for the entire area and will prevent stormwater runoff into the Bay. I believe it is unfair to have to pay a fee for the application, for an updated survey and engineered plans in light of these circumstances. Finally, as an alternative to certified Engineering plans, I have provided a detailed drawing which fully illustrates the work to be performed on site. The nature of the work on site is vey simple and should not require a full set of engineered plans. I have also submitted a copy of a portion of a map from the 1950s to assist the Board. //~ect fully ~e/~t . .." Edward Jurzeniay Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54376 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 May 6, 2011 Mr. Robert Schroeder 1100 Manhasset Ave. Greenport, NY 11944 RE: ED JURZENIA 505 SHORE ROAD, GREENPORT SCTM~47-2-1 Dear Mr. Schroeder: Please be advised that your application for the above-referenced property submitted on May 4, 2011 is incomplete pending the following items: application fee in the amount of $250.00 made payable to the Town of Southold; completion of the Storm-water Run-off Assessment Form (copy attached); and survey created no more than one year prior to the date of application, and certified by a registered land surveyor or registered professional engineer. Your application will be processed upon receipt of these items. ~11 M. Doherty, Presider~ ~loard of Trustees JMD:lms Cc: Ed Jurzenia Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD etStal Erosion Permit Application land Permit Application AmendmentjTrans fer/Extension ~eceiv~d Applic~ ~eceived Fee:$ (,Q~ ~,~:~mple,ted ___mcomplete ~_ __SEQRA Classification: Type I Type I1 Unlisted Coordination:(date sent). ~,'LWRP Consistency Assessment Form ~.~'CAC Referral Sent: ~[ ~! [ ~.elgrate of Inspection: /~ l lX~ ] Il __Receipt of CAC Repo~rt:I' __Lead Agency Determination: Technical Review: ~blic Hearing Held: (~ ],~.! I[ __Resolution: Office Use Only Administrative Permit Name of Applicant Address ~('~4'/L/pcl t'7-'t~k]~/} I fT~/Phone Number:( ff 7 Suffolk County Tax Map Number: 1000 - Property Location: (provide LILCO Pole #, distance to cross streets, and location) AGENT: /~ ~/°.2 ~T C' (If applicable) Address: //0~ ~~d%~~[~~F~/~//~tff~ ~rd of Trustees Applicatio~ GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: Coven~ts ~d Restrictions: Yes ~ No If"Yes", please provide copy. Does this project require a vmance from the Zoning Board of Appeals If"Yes", please provide copy of decision. Prior pe~its/approvals for site impmvments: Agency~ Date Yes ~,, No ~ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): of Trustees Applicatio~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~'~',--~ ,/k'~,~? ~-- ~"0~'''~ Area of wetlands on lot: (~ .square feet Percent coverage of lot: f-) % Closest distance between nearest existing structure and upland edge of wetlands: iA-'//~-'' feet Closest distance between pearest proposed structure and upland edge of wetlands: ~-.~/,~--- feet / Does the project involve excavation or filling? No )fi/__ Yes If yes, how much material will be excavated.~~(~ ~ubic yards How much material will be filled? ~'~,--~ ~//~ cubic yards Depth of which material will be removed or deposited:/J/t/~"k~ e~et Proposed slope throughout the area of operations: 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): B~rd of Trustees Applicatio~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 1 O0 feet of the proposed activity? Yes Does the No Yes ¸g? If Yes, how ' (cubic yards) How much _(cubic yards) Manner in which or deposited: Describe the nature and extent of the impacts reasonably anticipated resulting from implementation of the (Use attachments if necessary) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: --. - 3 20E STATE OF NEW YORK COUNTY OF S FO K ~. 1('/5::4::;/N'P"°'[~(/ //~/y,'"/' , bein,~.duly sworn, deposes and says mat on the ~'~ daY of C,]/I)~/g ,20~, deponent mailed a tree copy of the Notice set forthin 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 mi1 of_the Tnwn oLSouthold; that said Notices were mailed at the United States Post Office at ~'~t~//l~]~ , that said No~s were mai~ to, ach of said persons by (certified) (registered) mail· Sworn to before me this ~ ,d Day of ~7-~.,~a ~, ,20 Notary Public Commisdon [xplril Mirth Jill M. Dohe~ly, President Bob Ghosio. Jr., Vice-Prcsident James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765 1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of EDWARD JURZENIA COUNTY OF SUFFOLK) STATE OF NEW YORK) ~]~t ~ ,,residing at/dba _ 3 2012 POSTING being duly sworn, depose and say: That on the ~ day of J~/l~0 "'"~20'~'~ers~°~ly~pTted the propeay known as by placing thc Board of Trustees official poster where it can easily be seen, and that 1 have checked to be sure the poster has remained in place tbr eight days prior to the date of the public heating. Date of heating noted thereon to be held Wed~ January 18, 2012 on or about 6:00 PM. Dated: ~nature) Sworn to before me this ,~ ~tay ofX~,~'320 ~ 2, Notary Public Town of Southold Erosion, Sedimentation & Storm.Water Run-off ASSESSMENT FORM PROPERTY LOCAT)ObI: $.C.'TJ.~ THE FOLLOWING ACTIONS MAy REQUIRE THE SUBMISSION OF A ( ~ (,.I ~ ~_ [ STORM'WATER, GRADINGt DRAINAGE AND ERGSK)N CONTROL PLAN SCOPE OF WORK ~ PROPOSED CONS')~x-I{~JC~['ION ]TF_,.I~# / WORKA~SF~SI~ENT [ Yes No conmmction activ~y? imper~ious surfacas.) PROVIDi~ BRIEF PROJECT DESCRIFIION Excavatt°n where the~e is a change t° ~e Natural [~ 6 Is ~ere a Natuml Water Coume Running ~ro~gh the D ~/ ~islurl~n~es of o~e (1) or mom acres; 8WPPP'. Shall meat the Minimum Requlrement~ of required, p~t-consb',~o~ sram v, ater management practices mai ~1 be ,sad end/~ Removal of Vegetaaon andlor Gle Ca',.strucfion of any STATE OF NEW YORK, COUNTY OF ..~.L~.~.:....~ ................... SS And uMt he/she is the ~)9,.~ ~ Y"' - Owner md/or representalive of the Owner or Owners, and is duly authorized to perform or have pefforme!i/the said work and to make and fde this application; that all statements coni~ined in fl~is applica6on are frae ~he best of hill}tug'edge and belief; ,'Lad that the work will be performed in thc n~nner set £otth in the applicmion filed herev~a~ / / / Sworn to before me ~is; // om~ Public: ..~. ~~ ................................................... FORM - 06/1 NOTARY PUBLIC, State of New York No. 02AN6098246 Qualified in Suffolk County Commission Expires January 12, 20~d- PROJECT ID NUMBER SEQR PART 1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NA, ME APPLICANT / SPONSOR 3.PROJECT LOCATION: Mun,cipa/ity 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5 IS PROPOSED ACTION: ~ New r--1 Expansion ~Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT ~F L.~ND AFFECTED: ,~"'- acres Initially ...~,.~/ acres Ultimately 8.F~L PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~es [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROdECT? (Choose as many as apply.) ~Residential []Industrial E~]Commercial ['-~Agriculture e--~ Park / Forest / Open Space r'"~Other(describe) Z //h:AhT- 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) F'--~Yes [~o if yes, list agency name and permit / approval: 11 DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes r-..~'~o if yes, List agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? CERTIFY THAT TI-~I-NFORMATION I~/II~D ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Sponsor Name $/' Signature ~ ~ ' " ~a ~--.~s a Costal~.__, 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 617.4? if yes. coordinate the review procss~ and use the FULL EAF. r-]Yes [~No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. [~Yes ~"l No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surfaco or groundwater quality or quantity, noise levels, existing traffic pattsm, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly; C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborbood character? Explain briefly: I 1 C3. Vegetation or f~'~na, flshl shelffia~l or wildlife species, significant habitats, or threate~'or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or ether'natural resources? Explain briefly: I I C5. Growth, subsequent development, or mlateq activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1 -C57 Explain briefly: I C7. Other impacts linclodin9 chanties in use of'~i~'~r ({uantii~"or t~'~e ~i energia/? ExPlain bhefi~': D. WILL THE PROJECT HAVE AN iMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? IIf )'es, explain briefl~': I--lYes 1-71 NoI .............. E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If )'es explain: r-lYes 17iNoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contsin sufficient detail to show that all relevant adverse impacts have been identified and adequately addrassed. If question d of part ti was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the C EA. Check this box if you have identified one or more potenUally large or significant adverse Impacts which MAY occur. Then proceed direct~ to the FULL FAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Board of Trustees Name of Lead Agency Date Jill M. Doherty President Pdnt or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different trom respoqsible officer) 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 (63 I) 765-1892 Fax (631) 765~6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of EDWARD JURZENIA COUNTY OF SUFFOLK) STATE OF NEW YORK) t AFFIDAVIT OF POSTING I, '~/~g///~//4 residing at/dba/~ ~/~7~C~-'- being duly sworn, depose and say: That on the~fl day by placing the Bo~d of Trustees official poster where it c~ easily be seen, ~d that I have checked to be sure ~e poster has rm~ned in place for ei~t days prior to the date of the public he~ng. Date of he~ng noted ther~n to be held Wed, June 2~011 ~ ~ ab~ 6:00 PM. Dated: ~-~- Il (silage) / ' / Sworn to before me this ~ ~ day of ~20 ~ I Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK ~ , being duly s-worn, deposes ~d ~ day of ,20 , d~onent roiled a ~e copy of ~e Notice set fo~ in the Bo~d of Trustees Application, directed to e~h of~e above n~ed pe~ons at ~e ad&esses set opposite ~ere resp~tive n~es; ~at ~e ad&esses set opposite ~e n~es ofs~d persons ~e ~e ad&~s of said p~ons ~ sho~ on ~e e~t ~sessment roll of ~e To~ of Southold; ~at s~d Noti~s were m~Ied at the U~t~ S~tes Post ~;~) (registered)mail. ,that smd Noti~were mall~o e~h of said pe~ns by Sworn to before me ~s ~/~ Day of_~ ,20 ~/ I Not~-y Pubhc of Trustees Applicati~ AUT~ORI ZATION (where the applicant is not the owner) (print owner of property) (mailing address) (Agent) to apply for permit(s) from the 8 of Trustees ApplicatiO County of Suffolk State of New York DEPOSES ~ ~F~ ~T ~?S~ IS T~ ~PLIC~T FOR T~ ~O~ DESC~ED PE~IT(S) ~ T~T ~L STATE~NTS CONT~D ~ ~ TR~ TO ~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ T~T ~L WO~ ~LL 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 SOU~OLD ~ T~ TO~ TRUSTEES H~ESS ~ F~E ~OM ~ ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~T~ OF S~ PE~T(S), ~ G~TED. ~ CO~LET~G TinS ~PLICATION, I ~BY AUTHO~E ~ ~US~ES, t~m AGENT(S) OR ~P~SENTATI~S(S), TO EN~R O~ MY PROP~T~TO ~SPECT t~ P~MISES ~ CON~CTION ~~W OF ~ ~PLICATION. Signature ~ SWORN TO BEFORE ME THIS DAY OF ~ JENNIFER ANDALORO NOTARY PUBLIC, State of New York No. 02AN6098246 Qualified in Suffo k County ,., Commission Expires January 12, 20J._a.a.a.a.a.a.a.a~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics umhibits conflicts of interest on the uart of town officers and emalovees. The ~uroose of this form is to orovide information which can alert the town of eossible conflicts of interest and allow it to take whatever action is necessorv to avoid same. YOUR NAME: ,~Yc,~,,~4~/-3~ :-~'f-g~ff/~"J~,~ (Last name, fn'st name, roiddle initi~, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ' ~ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (1 f "Other", name the activiiy.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest'? means a business, including a partnership, in which the town officer or employee has even a partial ownemhip of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shams. YES ~ NO lfyou answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold ~ r~,/L.~ ~t4'fi~ff/ Title Or position of that person ~ ./'/,~ .. ,o<-.~.4 ~ 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 all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applic0nt (when the applicant is a corporation); ___B) the legal or beneficial own~:r 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 I Submitted thi~ay o1~ g/~j~//~/~. /200__ Print Name ~. =.~ ~ ~/~. ~.~ 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. Thns~ each answer must be explained in detail~ listing both supporting and non- snooortin~ 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 PlanninKDepartment all local libraries and the Town Clerk's office, l,!)~'i - 4 2~ii B. DESCRIPTION OF SITE AND PROPOSED ACTION scm# - / The Application has been submitted to (check appropriate response): TownBoard [] Planning Board ~ BuildingOept. ~ BoardofTrustees 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: 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: ~r.~a~//~ Jc4t,/L~//n//q-- /lqqq (c) Telephone number: Area Code ( ) (~-~//) q'77 - cpo / / (d) Application number, if any: Will the action be directly tmdertaken, 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 IH - Policies; Page 2 for evaluation criteria. f-~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 Southold. 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 ApI~ble Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. [~ Yes ~] No ~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section 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 POLICIEO 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 Peconie Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Yes V-~ 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 DATE ~~ ~ ~ APPROXIMATE LINE OF MAY 2012 · / ~ q EXlSITNG WETLANDS. ~ ~ · ~ ~;---~F~_~ ~.~ ~ ~ SCTM #: ~ooo-4s~6~8 , : GRADE ~ ~VACANT ~ ~'~' ~ ~ " WOODED AR~ ~ ~/~) ~ '. ......... ~ ' ' % ~ CONT~CTOR MAY USE CONCR~ ~ ~ ~ ~ ~ ~ ~ HAY BALES & SILT AS NEEDED TO ACCOMMODA~ ' '~ ~ ' ~ ~ ~' FEHClNGAS NEEDED '..1~ ~ ~ ~ ~ ~_ ~ / I THE~CAVA~ONOFC~YMATERI~ · . . ~. ~ ~ m ~ ~ LmSt=~on ~ ~ ~ ~ I ~" ~ ~ ~ -' ~' ~ ~ ..... ~ ,,~ht~ I '.'. TOWN Righ'~-~I'" ''. ,' I .................... ~ '' :' ~E ~ o E I : .'. .-. '1 .. ~ ~ ~ ~ /~ ~a ,-- ~~ ~ I~l / TO~IS~NGPmVATERO~ I : ~ X ~~ I i I I IBI / AS NEEDED OR REQUIRED. ~ E..L A, :''' ~ ~ ~ ~ ~ q~ ~ LOT ~ t Iil ~ MAYBE~MOVED~NEEDEO ~ O, ~ '- ~ ' ~~ TO ACCOMMODATE S~ ACCESS. scm ~. " EXISTING '. . .~ ~ ~ ~"' ,,, STORMWATER D~NGE PROJECT ~"::~ . SCHE TIC SITE X ~ : X X " EXISTING . SILVER LANE SURVEY OF PROPERTY SITUATE SILVERMERE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-47-02-01 SCALE 1'=$0' DECEblBER 10, 2011 AREA = 16,063 sq. ff. 0..%69 CERTIFIED TO: EDWARD P. JURZENIA Land Surveyor P~IONE (631)727-20g0 Fax (631)727-1727