Loading...
HomeMy WebLinkAboutTR-7892John M. Bredemeyer III, President �oF S0 Michael J. Domino, Vice -President James F. King, Trustee Bergen, Trustee i�iDave • a0 liYCOU Charles J. Sanders, Trustee BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 CERTIFICATE OF COMPLIANCE Telephone (631) 765-1892 Fax (631) 765-6641 # 1062C Date: October 21, 2014 THIS CERTIFIES that the construction of a 4'xl 15' fixed dock, 3'x15' hinged ramp and 6'x20' floating dock with the use of open -grate decking At 700 Broadwaters Road, Cutchogue, New York Suffolk County Tax Map # 104-10-2.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated July 18, 2012 pursuant to which Trustees Wetland Permit #7892 Dated August 24 2012, 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 construction of a 4'x115' fixed dock, 3'x15' hinged ramp and 6'x20' floating dock with the use of open -grate decking. The certificate is issued to JOSEPH ZALNER owner of the aforesaid property. ?_ 'vn &W&� -a-, Authorized Signature John M. Bredemeyer 111, President Michael J_ Domino, Vice -President James F. King Dave Bergen Charles J. Sanders �o�ogUFFD��-�o 0 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE F INSPECTION: Ch. 275 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: Qa�e CERTIFICATE OF COMPLIANCE: &M Town Hall, 53095 Main Rd- P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 • John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee July 23, 2014 Joseph & Judith Zalner 68-39 Manse St. Forest Hills, NY 11375 • BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: JOSEPH ZALNER 700 BROADWATERS ROAD, CUTCHOGUE SCTM# 104-10-2.1 Dear Mr. Zalner: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, July 23, 2014: RESOLVED that the Southold Town Board of Trustees grants a One -Year Extension to Wetland Permit #7892, as issued on August 22, 2012. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Michael J. Domino Vice -President, Board of Trustees MJD/amn John Bredemeyer, President $uFFot Michael J. Domino, Vice -President ���CIO, James F. King - Charles J. Sanders o Dave Bergen Date/Time: • Town Hall Annex 54375 Route 25 P.O. Box 117.9 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field InspectionMork Session Report JOSEPH ZALNER requests a One Year Extension to Wetland Permit #7892, as issued on August 22, 2012. Located: 700 Broadwaters Road, Cutchogue. SCTM# 104-10-2.1 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre -Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: Present Were: J. Bredemeyer M. Domino Bay Constable Form filled out in the field by Mailed/Faxed to: Date: J. King C. Sanders D. Bergen Other 77e &.:ca� w 4i t' --- - --Vxema�-- ---- c�10 2c2l-Y V, 2 f2 11,779 nD -E C FF —iffl-- --_-' t- -- —2-1011-Ar _ - - a. 'P7ft c�-- - ---- -- b N(6c� !9�;Anr�"dsl Ur2 IOSLAL-r -- _- __ ---la QOLA • G \„ Zo-lyle-r J u-)-L+� Z!>JV ev_ P 3q rise-��- James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino 0 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 0 Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone(631)765-1892 Fax (631)765-6641 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. 7892 DATE: Au¢ust 22, 2012 ISSUED TO: JOSEPH ZALNER PROPERTY ADDRESS: 700 BROADWATERS ROAD, CUTCHOGUE SCTM# 104-10-2.1 AUTHORIZATION Pursuant to the provisions of Chapter 275 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 Aueust 22, 2012, and in consideration of application fee in the sum of $250.00 paid by Loriann Patanio and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a 4' x 115' fixed dock, 3' x 15' hinged ramp and 6' x 20' floating dock; with the conditions of the usage of open -grate decking on the dock over vegetated wetlands; the usage of non -treated lumber on the decking of the fixed dock, ramp and float; and the proposed structure will not impede navigation, and as depicted on the site plan prepared by Jeffrey Patanjo, last dated July 11, 2012, and stamped approved on August 22, 2012. 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. ,c,�►FFO(,r", oy ��� 0 0 TERMS AND CONDITIONS The Permittee Joseph Zalner residing at 700 Broadwaters Road Cutchoeue, New York 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. 2. 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. 3. 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. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11 James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino August 22, 2012 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: JOSEPH ZALNER 700 BROADWATERS SCTM# 104-10-2.1 Dear Mr. Patanjo: ROAD, CUTCHOGUE • Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971.0959 Telephone (631) 765-1892 Fax (631) 765-6641 The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 22, 2012 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of JOSEPH ZALNER applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 18, 2012, 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 recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policies 6, 6.3, 9.3 & 9.4 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the use of open -grate decking on the dock over vegetated wetlands; the use of non -treated lumber on the decking of the fixed dock, ramp and float; the proposed structure will not impede navigation, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on August 22, 2012, at which time all interested persons were given an opportunity to be heard, and, 0 11 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of JOSEPH ZALNER to construct a 4'x 115' fixed dock, 3'x 15' hinged ramp and 6'x 20' floating dock; with the conditions of the usage of open -grate decking on the dock over vegetated wetlands; the usage of non -treated lumber on the decking of the fixed dock, ramp and float; and the proposed structure will not impede navigation, and as depicted on the site plan prepared by Jeffrey Patanjo, last dated July 11, 2012, and stamped approved on August 22, 2012. 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: $ 1,625.00 Very truly yours, o� aures F. King President, Board of Trustees JFK/amn 0 James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Please be advised that your application dated�T 2 has been reviewed by this Board at the regular meeting of o Z 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) Constructed ($50.00) VI/ Final Inspection Fee ($50.00) V/_ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: Final Tnspcc_-{-ioh —$ 50, oo -1, ',xtd Doc►C'fjy,V 3&OSC X-8fty sq.-(' z: 411D8p Hinjtd camp '31X/51 45 5'L4x !;3 Pe f- sq -0 =$ 135 Floa-i- = 120 TOTAL FEES DUE: $ I LC Xt R d I,SZS BY: James F. King, President Board of Trustees Joseph Zalner 700 Broadwaters Rd., Cutchogue SCTM# 104-10-2.1 8/1512012 Peter Young, Chairman Lauren Standish, Secretary 0 �o�pggFFD(,fCo Conservation Advisory Council Town of Southold E Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631)765-6641 At the meeting of the Southold Town Conservation Advisory Council held Wed., August 15, 2012 the following recommendation was made: Moved by Doug Hardy, seconded by Audrey Horton, it was RESOLVED to SUPPORT the Wetland Permit application of JOSEPH ZALNER to construct a 4'X 115' fixed dock, TX 15' ramp and 6'X 20' floating dock. Located: 700 Broadwaters Rd., Cutchogue. SCTM#104-10-2 Inspected by: Audrey Horton, Doug Hardy Vote of Council: Ayes: All Motion Carried James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Do Lino Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: (1, I 1 Z 2. P.O. Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax(631)765-6641 JOSEPH ZALNER requests a Wetland Permit to construct a 4'X 115' fixed dock, XX 15' ramp and 6'X 20' floating dock. Located: 700 Broadwaters Rd., Cutchogue. SCTM#104-10-2.1 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound _Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: 4!,Chapt.275 Chapt. 111 _other Type of Application:. Wetland _Coastal Erosion _Amendment —Administrative—Emergency Pre -Submission Violation Info needed: Modifi Condition Present Were: =J. King -B. Ghosio —/� D. Bergen, — N. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field IX, I- Mailed/Faxed to: 0 • Photo 1 - Looking East Photo 2 - Looking West Photo 3 - Looking West Photo 4 - Looking North E July 15, 2012 NYS Dept. of Environmental Conservation SUNY @ Stony Brook 50 Circle Road Stony Brook, New York 11790-2356 Attention: Duty Analyst RE: 700 BROADWATERS ROAD, CUTCHODUE, NY SCTM No. 1000-104-10-2.1 APPLICATION FOR PERMIT Dear Sir/Madame: 0 We hereby submit four (4) copies of the proposed plans, application, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, ffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 cc: Army Corps of Engineers NYSDOS New York State Department of Environmental Conservation _ dhow NW PERMISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s) to the Department of Environmental Conservation ("DEC"), the signer consents to inspection by DEC staff of the project site or facility for which a permit is sought and, to the extent necessary, areas adjacent to the project site or facility. This consent allows DEC staff to enter upon and pass through such property in order to inspect the project site or facility, without prior notice, between the hours of 7:00 a.m. and 7:00 p.m., Monday through Friday. If DEC staff should wish to conduct an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate consent for such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s) sought. By signing this consent form, the signer agrees that this consent remains in effect as long as the application is pending, and is effective regardless of whether the signer, applicant or an agent is present at the time of the inspection. In the event that the project site or facility is posted with any form of "posted" or "keep out" notices, or fenced in with an unlocked gate, this permission authorizes DEC staff to disregard such notices or unlocked gates at the time of inspection. The signer further agrees that during an inspection, DEC staff may, among other things, take measurements, may analyze physical characteristics of the site including, but not limited to, soils and vegetation (taking samples for analysis), and may make drawings and take photographs. Failure to grant consent for an inspection is grounds for, and may result in, denial of the permit(s) sought by the application. Permission is granted for inspection of property located at the following address(es): 700 BROADWATERS ROAD, CUTCHOGUE, NY 11935 By signing this form, I affirm under penalty of perjury that I am authorized to give consent to entry by DEC staff as described above. 1 understand that false statements made herein are punishable as a Class A misdeme or pursuant to Section 210.45 of the Penal Law. * JOSEPH ZALNER / OWNER t %' IS-- t L Print Name and Title Signature Date *The signer of this form must be an individual or authorized representative of a legal entity that: • owns fee title and is in possession of the property identified above; • maintains possessory interest in the property through a lease, rental agreement or other legally binding agreement or • is provided permission to act on behalf of an individual or legal entity possessing fee title or other possessory interest in the property for the purpose of consenting to inspection of such property. Permission to Inspect Property Application Supplement 12/08 • JOINT APPLICATION FORM • For Permits/Determinations to undertake activities affecting streams, waterways, waterbodies, wetlands, coastal areas and sources of water supply. New York You must separately apply for and obtain separate Permits/Determinations from State each involved agency prior to proceeding with work. Please read all instructions. US Army Corps of Engineers(USACE) APPLICATIONS TO Applicant must be: JOSEPH ZALNER Owner 1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart - (check all that apply) Post Office City FORREST HILLS General Services ment of State Check all permits that apply: Check all permits that apply: Telephone (daytime) Email ❑ Stream Disturbance ❑ Coastal Erosion ❑ Section 404 Clean Water Act Check all permits that Check if this ❑ Excavation and Fill in Management ❑ Section 10 Rivers and Harbors apply: ❑State applies: 0 Navigable Waters ❑ Wild, Scenic and Act Owned Lands Coastal '❑ s or Recreational Rivers Docks, Moorings � Nationwide Permit(s) -Identify Under Water Utility Consistency Concurrence Platforms ❑Water SuDDIY Number(s): Easement ❑ Dams and Impoundment ❑ Long Island Well (pipelines, Structures ❑ Aquatic Vegetation Control conduits, ❑ 401 Water Qualitycables, ❑ etc.) Aquatic Insect Control Certification ❑ Fish Control Precons[ruction Notification - ❑Docks, ❑ Freshwater Wetlands ElY / ElN Moorings or ❑ Incidental Take of Endan- El Tidal Wetlands Platforms gered/Threatened Species El I am sending this application 13I am sending this EDI am sending [ am sending this application to this agency. application to this this application to this agency. a enc . to this a enc . 5. Name of Applicant (use full name) Applicant must be: JOSEPH ZALNER Owner Post Office City CUTCHOGUE ❑ Operator ❑ Lessee Mailing Address 6839 MANSE STREET (check all that apply) Post Office City FORREST HILLS Taxpayer ID (If applicant County is NOT an individual): State NY Zip Code 11375 Telephone (daytime) Email 631-734-2705 BROADWATERS COVE 7. Contact/Agent Name JEFFREY PATANJO Company Name Mailing Address 106 HEWITT BLVD. Post Office City CENTER MORICHES State Zip Code NY 11934 Telephone (daytime) 631-484-9332 Email J PATANJO@OPTON LINE. N ET 6. Name of Facility or Property Owner (if different than Applicant) JOSEPH ZALNER Mailing Address 700 BROADWATERS ROAD Post Office City CUTCHOGUE State NY Zip Code 11935 Telephone (daytime) Email 631-734-2705 CUTCHOGUE NY 11935 8. Project / Facility Name Property Tax Map Section / Block/ Lot Number ZALNER PROPERTY 1000-104-10-2.1 Project Location - Provide directions and distances to roads, bridges and bodies of waters: SEE ATTACHED MAP Street Address, if applicable Post Office City State Zip Code 700 BROADWATERS ROAD CUTCHOGUE NY 11935 Town / Village / City County SOUTHOLD SUFFOLK Name of USGS Quadrangle Map Stream/Water Body Name SAG HARBOR BROADWATERS COVE Location Coordinates: Enter NYTMs in kilometers, OR Latitude/Longitude NYTM-E NYiM-N Latitude Longitude 41° 00'42.15" N 72° 27'01.12" W JOINT APPLICATION FORM 09/10 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed • N APPLICATION FORM - PAGE 2 OF 2 • Su mit this completed page as part of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose. Attach additional page(s) if necessary. Include: description of current site conditions and how the site will be modified by the proposed project; structures and fill materials to be installed; type and quantity of materials to be used (i.e., square ft of coverage and cubic yds of fill material and/or structures below ordinary/mean high water) area of excavation or dredging, volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource impacts; and where applicable, the phasing of activities. ATTACH PLANS ON SEPARATE PAGES, CONSTRUCT 115' LONG X 4' WIDE FIXED PIER, 15' LONG X T WIDE RAMP AND 29 LONG X 8' WIDE FLOATING DOCK. Proposed Use: El Private ❑Public ❑Commercial Proposed Start Date: 11/1/2012 Estimated Completion Date: 11/15/2012 Has Work Begun on Project? ❑ Yes El No If Yes, explain. Will Project Occupy Federal, State or Municipal Land? ❑ Yes 11 No If Yes, please specify. 10. List Previous Permit / Application Numbers (if any) and Dates: N/A 11. Will this project require additional Federal, State, or Local Permits including zoning changes? 2 Yes ❑ No If yes, please list: ARMY CORPS OF ENGINEERS, NYSDOS, TOWN OF SOUTHOLD TRUSTEES 12. Signatures. If applicant is not the owner, both must sign the application. I hereby affirm that Information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said project. In addition, Federal Law, 18 U.S.C., Section 1001 provides for a fine of not more than $10,000 or imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conceals, or covers up a material fact; or knowingly makes or uses a false, fictitious or fraudulent statement. -rr ScP4 -Zaj7e& ptJNE2 17•IS•IL Sig,TrEV A llcantq Printed Name Title Date 1'' ToSLp� �a1nL�(.. OWNER -7. 1S • iL Si er Printed Name Title Date �i FG/LN 1'A }wn f o k �LQ-r • l 4 I L Si ur f Agent Print + TI a Dale JOINT APPLICATION FORM 09/10 0 • NEW YORK STATE DEPARTMENT OF STATE COASTAL MANAGEMENT PROGRAM Federal Consistency Assessment Form An applicant, seeking a permit, license, waiver, certification or similar type of approval from a federal agency which is subject to the New York State Coastal Management Program (CMP), shall complete this assessment form for anyproposed activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent with New York State's CMP as required by U.S. Department of Commerce regulations (15 CFR 930.57). It should be completed at the time when the federal application is prepared. The Department of State will use the completed form and accompanying information in its review of the applicant's certification of consistency. A. APPLICANT (please print) JOSEPH ZALNER 1. Name: 700 BROADWATERS ROAD, CUTCHOGUE, NY 11935 2. 3. Telephone: Area Code (64) 734-2705 B. PROPOSED ACTIVITY 1. Brief description of activity: CONSTRUCT 115' LONG X 4' WIDE FIXED PIER, 15' LONG X 3' WIDE RAMP AND 20' LONG X 6' WIDE FLOATING DOCK. 2. 3. Location of activity: SUFFOLK County 4. Type of federal permittlicense 5. Federal application number, [1fflr0P.[iZel1l City, Town, or Village ARMY CORPS OF ENGINEERS N/A ►LtItl-3:�ilsl� r��tla\I�:by:Fi7_l�7 Street or Site Description 6. If a state permit/license was issued or is required for the proposed activity, identify the state agency and provide the application or permit number, if known: NYSDEC 0 0 C. COASTAL ASSESSMENT Check either "YES" or "NO" for each of these questions. The numbers following each question refer to the policies described in the CMP document (see footnote on page 2) which may be affected by the proposed activity. 1. Will the proposed activity result in any of the following: YES / NO a. Large physical change to a site within the coastal area which will require the preparation 13 of an environmental impact statement? (11, 22, 25, 32, 37, 38, 41, 43) ............... . b. Physical alteration of more than two acres of land along the shoreline, land ❑ under water or coastal waters? (2, 11, 12, 20, 28, 35, 44) .......................... c. Revitalization/redevelopment of a deteriorated or underutilized waterfront site? (1) ...... EL R d. Reduction of existing or potential public access to or along coastal waters? (19, 20) ...... EL ,s e. Adverse effect upon the commercial or recreational use of coastal fish resources? (9, 10) ... [a -a f. Siting of a facility essential to the exploration, development and production of energy resources in coastal waters or on the Outer Continental Shelf? (29) ................... E1 im g. Siting of a facility essential to the generation or transmission of energy? (27) ........... a b. Provision of new public services or infrastructure in undeveloped or sparsely populated h. Mining, excavation, or dredging activities, or the placement of dredged or fill material in sections of the coastal area?(5).............................................. coastal waters?(15,35).................................................... Q n i. Discharge of toxics, hazardous substances or other pollutants into coastal waters? (8, 15, 35) E1 JE j. Draining of stormwater runoff or sewer overflows into coastal waters? (33) ............ E1 ix k. Transport, storage, treatment, or disposal of solid wastes or hazardous materials? (36, 39) . EZ im 1. Adverse effect upon land or water uses within the State's small harbors? (4) ............ 11 I 2. Will the proposed activity affect or be located in, on, or adjacent to any of the following: YES /NO a. State designated freshwater or tidal wetland? (44) ................................ [93 0 b. Federally designated flood and/or state designated erosion hazard area? (11, 12, 17,) ..... Q b. Provision of new public services or infrastructure in undeveloped or sparsely populated c. State designated significant fish and/or wildlife habitat? (7) ........................ sections of the coastal area?(5).............................................. d. State designated significant scenic resource or area? (24) .......................... Q c. Construction or reconstruction of a flood or erosion control stmcture? (13, 14, 16) ....... e. State designated important agricultural lands? (26) ............................... CL 0 f. Beach, dune or barrier island? (12) ........................................... El e. State air quality permit or certification? 41, 43 g. Major ports of Albany, Buffalo, Ogdensburg, Oswego or New York? (3) ............... Q h. State, county, or local park? (19, 20) .......................................... EI i. Historic resource listed on the National or State Register of Historic Places? (23) ........ Q 3. Will the proposed activity require any of the following: YES / NO a. Waterfront site? (2, 21, 22) 0 b. Provision of new public services or infrastructure in undeveloped or sparsely populated sections of the coastal area?(5).............................................. Q x c. Construction or reconstruction of a flood or erosion control stmcture? (13, 14, 16) ....... d. State water quality permit or certification? (30, 38, 40) ............................ e. State air quality permit or certification? 41, 43 X 4. Will the proposed activity occur within and/or affect an area covered by a State approved local waterfront revitalization program? (see policies in local program document) .............. Q 0 0 D. ADDITIONAL STEPS 1. If all of the questions in Section C are answered "NO", then the applicant or agency shall complete Section E and submit the documentation required by Section F. 2. If any of the questions in Section C are answered "YES", then the applicant or agent is advised to consult the CMP, or where appropriate, the local waterfront revitalization program document*. The proposed activity must be analyzed in more detail with respect to the applicable state or local coastal policies. On a separate page(s), the applicant or agent shall: (a) identify, by their policy numbers, which coastal policies are affected by the activity, (b) briefly assess the effects of the activity upon the policy; and, (c) state how the activity is consistent with each policy. Following the completion of this written assessment, the applicant or agency shall complete Section E and submit the documentation required by Section F. E. CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program, as appropriate. If this certification cannot be made, the proposed activity shall not be undertaken. If this certification can be made, complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program, or with the applicable approved local waterfront revitalization program, and will be conducted in a manner consistent with such program." JEFFREY PATANJO Applicant/Agent's 106 HfWITT BLVD., CENTER MORICHES, NY 11934 Telephone: Area Code (631 ) 484-9332 Applicant/Agent's F. SUBMISSION REQUIREMENTS Date: "' 11 4 r L I. The applicant or agent shall submit the following documents to the New York State Department of State, Office of Coastal, Local Government and Community Sustainability, Attn: Consistency Review Unit,1 Commerce Plaza, 99 Washington Avenue - Suite 1010, Albany, New York 12231. a. Copy of original signed form. b. Copy of the completed federal agency application. c. Other available information which would support the certification of consistency. 2. The applicant or agent shall also submit a copy of this completed form along with his/her application to the federal agency. 3. If there are any questions regarding the submission of this form, contact the Department of State at (518) 474-6000. *These state and local documents are available for inspection at the offices of many federal agencies, Department of environmental Conservation and Department of State regional offices, and the appropriate regional and county planning agencies. Local program documents are also available for inspection at the offices of the appropriate local government. 0 Policy 44 0 There will be no negative effect to the vegetated tidal wetlands or wildlife and fish habitats by this proposed action. a RRC40"TI s COV£ P '° P J swiX �Wn C S A ✓ sue , S � 9 i QD s .. l ®� iMYWR1ER COVE __ s� t y ° ♦ 1 ! ♦iu w. .9 gym' \. n OFSUFFOLK © e re s ilY�q r c 104 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765.1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: August 15, 2012 Re: Proposed Wetland Permit for JOSEPH ZALNER SCTM#1000-104-10-2.1 ,i 2 G1 2 C - The proposed action is located within a New York State Department of State Significant Fish and Wildlife Habitat Area, a New York State Critical Environmental Area and a Peconic Estuary Critical Natural Resource Area. Jeffrey Patanjo on behalf of JOSEPH ZALNER requests a Wetland Permit to construct a 4'x115' fixed dock, 3'x15' hinged ramp and 6'x20' floating dock. Located: 700 Broadwaters Road, Cutchogue. SCTM# 104-10-2.1 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 INCONSISTENT with the LWRP and listed policy standards provided below. The property has access to Broadwaters Cove via the waterfront location and opportunity for a mooring. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 0 0 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions The applicant fails to prove that the action meets the following requirements § 275-11 Construction and operation standards C. 2 (d) of the Southold Town Code: (d) Review and approval of dock applications. Before issuing a permit for a dock structure, the Trustees shall consider whether the dock will have any of the following harmful effects: [2] Whether the dock will unduly interfere with the public use of waterways for swimming, boating, fishing, shellfishing, waterskiing and other water -dependant activities; The 115' dock will impede and hinder the use of the public waters for recreational activities including boating, fishing, shell -fishing and other water dependent activities. [3] Whether the dock will unduly interfere with transit by the public along the public beaches or foreshore; (6] Whether the dock will cause habitat fragmentation and loss of significant coastal fish and wildlife habitats; i ne proposea action is located within a New York State Critical Environmental Area At the discretion of the Board of Trustees, any operations proposed in critical environmental areas (§ 275-2) may be subject to more stringent requirements than detailed in this section. Such requirements may include, but are not limited to, denial of certain operations, shortening or 9.3 9.4 0 0 reducing the size of structures, and increasing the width of non -disturbance buffers. The proposed dock structure will result in the fragmentation of marine environments. (7] Whether the dock will result in the destruction of or prevent the growth of vegetated wetlands, seagrasses including eelgrass (Zostera marina) and widgeon grass (Ruppia maritima) or shellfish; This question has not been addressed [11] Whether the cumulative impacts of a residential and commercial dock will change the waterway or the environment and whether alternate design, construction, and location of the dock will minimize cumulative impacts; and The continued construction of dock structures within a Significant Fish and Wildlife Habitat/Critical Environmental Area will affect the public use of the area, and degrade the ecological quality of the area through introduction of contaminants, disruption of marine life habits etc.... Correspondingly, physical and functional loss to wildlife has been found to occur through the loss and/or impairment of habitat, disruption of habits and migration patterns (structure and activity) and introduction of harmful contaminants. The most common contaminant associated with docks is wood preservatives impregnated into the wood used to prolong the life of a dock. Three trace metals; arsenic, chromium and copper are the most common. These three metals have the greatest potential to increase in estuarine environments from docks (Sanger and Holland 2002). boom that will retain all suspended sediments within the immediate project area. (12] Whether adequate facilities are available to boat owners and/or operators for fueling, discharge of waste and rubbish, electrical service and water service. No such facilities are proposed or discussed. Preserve the public interest in and use of lands and waters held in public trust by the state and the Town of Southold. A. Limit grants, leases, easements, permits or lesser interest in lands underwater in accordance with an assessment of potential adverse impacts of the proposed use, structure, or facility on public interest in public lands under water. The dock structure will result in a net decrease in public access to/on public underwater lands. Assure public access to public trust lands and navigable waters. A. Provide free and substantially unobstructed passage along public trust shorelands. E. Provide access to, and reasonable recreational use of, navigable waters and public trust lands under water. 2. Permit limited obstruction of public use, including navigation, in navigable waters: Mooring of a vessel in public waters provide temporary private use of the public waters. 3. Obstruction of navigable waters and underwater lands is limited: 0 0 b. to the minimum necessary for access to navigable waters. The minimum is determined by evaluating the following factors: (ii) the range of tidal water level fluctuation, The water depth within the proposed location of the dock terminus is shown as 2.5 feet which is limiting for many types and sizes of vessels. Due to limited water depth, a seasonal mooring is recommended ina more appropriate location. whether or not alternative means to gain access are available. environmental sensitivity of the area, the seasonal mooring of vessels are more appropriate in this area. In the event that the action is approved require that a non -disturbance buffer. minimum 15' in width, be established from the wetland line landward. The existing vegetation should be incorporated within the buffer. 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 0 • Office Use Only Coastal Erosion Permit Application _L,.�6etland Permit Application Administrative Permit —Amendment/Transfer/Extension ✓1Feceived Applicatio , y 11 _Received Fee:$ - n S\2kvp Completed Applica ly _SEQRA Classification: Type IType II Unlisted �oordination:(date sent) W RP Consistency Assessment Form .3 0 a CAC Referral Sent:v �n: Date of Inspectio Receipt of CAC Report: _Lead Agency Determination: Technical Review: --P-ublic Hearing Held: 2 - Resolution: Name of Applicant 6839 MANSE ST., FORREST HILLS, NY 11375 Phone Number:(631) 734-2705 Suffolk County Tax Map Number: 1000- Property 000- Property Location: 700 BROADWATERS ROAD, CUTCHOGUE, NY 11935 (provide LILCO Pole #, distance to cross streets, and location) AGENT: JEFFREY PATANJO (If applicable) Address: 106 HEWITT BLVD., CENTER MORICHES, NY 11934 Phone: 631-484-9332 Land Area (in square feet): Area Zoning: SFR Ad of Trustees Application • GENERAL DATA Previous use of property: RESIDENTIAL Intended use of property: RESIDENTIAL Covenants and Restrictions: Yes x No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes x No If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes x No Does the structure (s) on property have a valid Certificate of Occupancy >< Yes No Prior permits/approvals for site improvements Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No Yes If yes, provide explanation: Project Description (use attachments if necessary): CONSTRUCT FIXED DOCK. SEE ATTACHED Ad of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: CONSTRUCT FIXED DOCK TO GAIN ACCESS TO WATER DEPENDENT USES. Area of wetlands on lot: 4, 900± square feet Percent coverage of lot: 6 Closest distance between nearest existing structure and upland edge of wetlands: 64 feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? o cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: Ia-4% Manner in which material will be removed or deposited: N/A 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): THERE WILL BE NO NEGATIVE EFFECT ON TIDAL WETLANDS DUE TO THE PROPOSED PROJECT. Bd0d of Trustees Application • COASTAL EROSION APPLICATION DATA Purposes of proposed activity: CONSTRUCT FIXED DOCK TO GAIN ACCESS TO WATER DEPENDENT Are wetlands present within 100 feet of the proposed activity? No x Yes Does the project involve excavation or filling? x No Yes If Yes, how much material will be excavated? o (cubic yards) How much material will be filled? o (cubic yards) Manner in which material will be removed or deposited: N/A Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) THERE WILL BE NO ENVIRONMENTAL IMPACTS DUE TO THE CONSTRUCTION. • 677.20 ` Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1 . PROJECT INFORMATION (To be connoleted by Aoolicant or Proiect Soonsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME JOSEPH ZALNER ZALNER PROPERTY FIXED DOCK 3. PROJECT LOCATION: Municipality CUTCHOGUE County SUFFOLK 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 700 BROADWATERS ROAD, CUTCHOGUE, NY 5. PROPOSED ACTION IS: ❑✓ New ❑ Expansion Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: CONSTRUCT 115' LONG X 4' WIDE FIXED PIER, 15' LONG X 3' WIDE RAMP AND 20' LONG X 6' WIDE FLOATING DOCK. 7. AMOUNT OF LAND AFFECTED: initially .01 acres Ultimately Al acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? R✓ Yes ElNo If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Z✓ Residential 1:1 Industrial Commercial Agriculture ❑ Park/Foresvopen Space ❑ Other Describe: RESIDENTIAL BOAT DOCKING 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? Z✓ Yes ❑ No If Yes, list agency(s) name and permit/approvals: NYSDOS, NYSDEC, ARMY CORPS OF ENGINEERS, TOWN OF SOUTHOLD 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes ❑✓ No If Yes, list agency(s) name and permivapprovals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? Yes R✓ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponame: TpSe/h $aloe/( Date: -1 • 15• YZ Signature: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 7 0 PART II _ IMPACT ASSESSMENT ITo he cornnleted 6v Lead ADencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. 11 Yes Q✓ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. E] Yes ❑✓ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattem, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in Cl -05? Explain briefly: C7. F. Other impacts(including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? If yes, explain briefly: ❑ Yes E✓ No R IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex Iain: ❑✓ No Ir PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial,large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part if was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed ai WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting determination. Board of Trustees p Name of Lead Agency J wt T S F. lei /J G, Print or Type Name of Responsible Officer in Lead Agency /%dL•� / O Zn/Z Date President o Title of Responsible Officer Signature of Preparer (If different from responsible officer) 0 • �bo k Town of Southold Erosion, Sedimentation & Storm -Water Run-off ASSESSMENT FORM �y� �g PROPERTY LOCATION: S.C.T.N. C. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM•WATER, GRADING, AGE AND EROSION S 7 1000 104 10 2.1 CONTROL PLAN '6isG, 'gam —oeF— —r= CERTIFIED BY A MSION PROFESSIONAL IN THE STATE OF NEW YORK SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Panels? I Will this Project Retain All Storm -Water Run -Off (Include Totalof all Parcels located within81,578.39/1.873 the Scope of Workoris for Proposed Construction)n)(s Generated by a Two (2") Inch Rainfall on Site? F inose) (This item will include all run-off created by site X ❑ b. What is the Total Area of Land Cleating clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 0 Site Improvements and the permanent creation of construction activity? Ryt impervious surfaces.) (S.F. Acres) 2 Does the Site Plan and/or Survey Show ca Proposed PROVIDE- BRIEF PROJECT' DESCRIPTION IP,ewBSAedsshul Faroese wua,ol Drainage Structures Indicating Size 8 Location? This X Item shall Include all Proposed Grade Changes and Slopes Controlling Surface Water now. CONSTRUCT 115' LONG X 4' WIDE FIXED PIER, 3 Does the Site Plan and/or Survey describe the erosion 15' LONG X 3- WIDE RAMP AND end sediment Control praCdCe3 drat will be used to X control site erosion and storm Water discharges. This — ❑ 20' LONG X 6' WIDE FLOATING DOCK. dem must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filing, Grading or Excavation where there Is a change to the Natural Existing Grade Involving more than 200 Cuble Yards — X of Material within any Parcel? 5 Will this Application Require Land Disturbing Acdvides Encompassing an Area in Excess of Five Thousand a X (5,000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction X orwithln One Hundred (100')feetofa Wedandor General DEC SWPPP Re In nts: Submbaion of a SWPPP is mulred for all Constantin adlrlties Involving sad Beach? disturbances of one (1) or Aare saes; Including disturbances of lase men one acre met 7 Will there be Site preparation on Existing Grade Slopes am pad of a larger common pian that will ultimately disturb one or more acres of land: which Exceed Fifteen (15) feet of Vertical Rise t0 including Construction acdvl0es ImoWig soil disturbances of lean men one (1) acre where X One Hundred (100') of Horizontal Distance? — the DEC has deternlned that a SPDES Penne b required for storm water discharges. ( SWPPP's Shall steel the Minimum Raqulremants of the SPOES Gann/ Permit 8 Will Driveways, Parking Areas or other Impervious for Slorm Water Discharges from Construction aeOviQf • Pwred No. GP -0.10-001.) Surfaces be Sloped t0 Direct Ston -Water Run -Off ❑ 1. The SWPPP shall be re rad r to the suEnsRel of the NOT. The NO] shell be P Da Dria —X— Into and/or m the direction of a Tawn right-~. submitted to the Department prior to ore cmnnhancenant o/ construction activity. 9 Will this Project Require the Placement Material, 2. The SWPPP shall dwaibe the erosion and sediment control practices and wham required, postconstmelion storm water management practices that will be aced andlor of Removal of Vegetation and/or the Construction of any constructed to reduce me pollutants in storm water discharges and to assum Item Within the Town Right -of -Way or Road Shoulder — X compliance with the terms and conditions of this pemat. in addition, the SWPPP shat Areal frkb item wad NOT Ir,dna dr hwalMan arodv.wy AphoryJ identify potential Sources of Pollution which may reasonably be expected m oiled the quality of storm wane, discharges. NOTE: NA,ry AnawartoGwlbns Orw tlnough Nles uAnawerad vdmaCherk Nark 3. AN SWPPPs that require the post -construction storm water management practice In a Box and the construction site disturbance Is batwsan 5,000 S.F. 81 Asn in ares, eanponem shall be prepared by a qualified Design Professional Licensed In New York a Slmrrb41fMar, coding, Drainage S Erasion Control Plan la Requited by the Twit of Southold and Mustbs Su' ' d for Review Prorto Neesnes NAny Building Permit. that is knowledgeable in me pdncples and practices of storm Water Management. (NOTE: ACherA Mer(J)ena/or Aremerfa eadrQwnbnb Pequkrr loreCmgba APPleaaon) STATE OF NEW YORK, COUNTY OF ........................................... SS .. That I, ....._JOSEPH ZALNER .......... beim d swom, deposes and says that 6 �S' Po Y he/she is the applicant for Permit, Individual sign.......... mens.......... (Nems of Irc9vldal siperg Downanq And that he/she is the ...........................................OWNER .......... .................................................. ................. ......................... ....... . (owner, Contractor, Agant. Comorale Once, etc) Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contaitred in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ...........1.5 ...............................day �ul`�.,... 20.1„2,_ Notary Public: ta&A.r.......... .........0 .................. .. (Signsturec FORM - 06/10 PaPaIaI1C�Y 0 PA8�1501i OFN Commission* 08/07/20]1+ 0 August 13, 2012 Southold Town Board of Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971-0959 RE: 700 BROADWATERS ROAD, CUTCHOGUE, NY SCTM No. 1000-104-10-2.1 PROOF OF MAILING & AFFIDAVIT OF POSTING Dear Sir/Madame: Attached, please find Affidavit of Posting and Proof of Mailing Notice along with Certified Mail receipts for the above referenced application. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. � r , AUG 15 2012 Very truly )Pffev-PP: ._. I- 106 Hewitt Blvd. Center Moriches, NY 11934 • �o�gpFFO(,�co • James F. King, President Town Hall, 53095 Main Rd. it Bob Ghosio, Jr. , Vice -President T P.O. Box 1179 Dave Bergen Southold, NY 11971 John Bredemeyer "y4yp1 ��a Telepho e (631) 765-1892 Michael J. Domino Fax_ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD �I D)F In the Matter of the Application of J U L, AUG 1 5 JOSEPH ZALNER COUNTY OF SUFFOLK) STATE OF NEW YORK) —,� n AFFIDAVIT OF POSTING I egf-r-u `, +"^)D residingat/dba l06 Newrrr �L�c� C,r-iC,L /ylgelvtic5., N4 being duly sworn, depose and say: That on the � day of Avg- ' 201? I personally posted the property known as —7mo gri..�w ttf-t C,�t'cl+o9•.c by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed., August 22, 2012. Dated: Sworn to b fore me this ?i'" day of7 20 Notary Public MANCINE P. BURKE no" 182te of NwrYpk Qwlftd In & MA County Commission Egwn Much 30,1014 04 #� � e L�l (si re) Name: MAry 4 ✓lSw pec 66 - CA r P I me $CArPIme 2,)eni (LS 126heh/II h., 0 0 PROOF OF MAILING OF NOTICE v AUG 1 5 2012 ATTACH CERTIFIED MAIL RECEIPTS Address: �v3v 61'P" W. T';t'f t Cn rcho7'c-1 ✓v'1 f[!3f STATE OF NEW YORK COUNTY OF SUFFOLK G.O. Qi SI 1013 Gu.'�Lzofua� N 7 Ira 35— 11�� t/oL i1Vc. Opt fie' 4 S g (n�.r.Pw kTcrcJ Xe . ,vti , A-)7._ /002 t �1 0�—, . , ^'y res3r— Jt(�rc�,/ PA 4w n ) a ,residing at IOb fftw, rt AWl+Q. Ccn-re/t- p ri ci ee N"( 119 b y , being duly swom, deposes and says that on the / day of Avf-sl 20L, 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 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 roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Cen ft R M o r ' ctict that said Notices were mailed to each of said persons by (certified) (registered) main. Sworn to before me this Fl Day of _� 20 J1-2 12 Notary Public MANOWE P. 9t1NRE ON" pwic, mw or NawN1A No. •6270.!7 OWM*d M BoBolt Cou Cwwdssion E*kos YuN 30.2614 NOTICE TO ADJACENT PROPERTY OWNER BOARD Of TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: JoSep�1 �o�nc/L YOU ARE HEREBY GIVEN NOTICE: AUC 15 2C12 Fes' �i husrc�� SCTM# lov, loq- lo -d.) 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: C,0 -i 4- 4` � 11S' FNV-* - do�IL, 3 XIJ (ya,v��Cl a.+cQ. < 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1 00 $roA�Qw�tCfS IQoa.tQ -t-CA 3. 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: You may contact the Trustees Office at 765-1892 or in writing. The above -referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal PROPERTY OWNERS NAME: Tm se t o 4 e l n MAILING ADDRESS: 6S39 manse T PHONE#: isi- -73y a-1or AGENT: -Je-A4 rt,1 VA -t^ my MAILING ADDRESS: > v 6 14ew Tt BLvd - (yen-kex 11,1 o r IC -hes, PHONE M &3/• y bq_ey3 a.. Enc: Copy of sketch or plan showing proposal for your convenience. 375 - :.. ,� , 3OM D9XW F 7MLS, ILLS IM IISiS Im xFwn e3R[wRo CLIIFW mOCIFS Sf 115}� MI <. 1. ELR/.1RW5 Rf[N IU RGVD. 1939 Mlul :. LJl MFA 81.5ma U. / 1273 /OSS 3 Pm1tlR5 O F FRW SIgLY RRLF RV: x0%m A RVS LVD 9RaC 1310 RD111R1i MFVUf. RVERf1D. w s ung m.FFR m 22.m !. M VDm MD SIL1Ll RF WI -RUED Im O K.mgR15 q1W l w R s R4 " W qvR xL County of Suffolk State of New York JOSEPH ZALNER Ad of Trustees Application • BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS I-� Notary Public Lorinnn W�� Commission OBIOf/201 N. Signature DAY OF c3U� 12 ad of Trustees Application • JOSEPH ZALNER (print owner of property) FORREST HILLS, NY 11375 AUTHORIZATION (where the applicant is not the owner) residing at 6839 MANSE ST. (mailing address) do hereby authorize JEFFREY (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (y, . ( wner's ' nature) E Ll APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: JOSEPH ZALNER (Last name, first name, middle initial, 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 Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee X Coastal Erosion Mooring Planning 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 ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO X If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner 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 Submitted t' t6 day of -S. I 20IY r 2— Signature Signature Print Name nl Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS I. 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. 2. 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). 3. If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 104 - 10 - 2.1 The Application has been submitted to (check appropriate response): Town Board [11 Planning Dept. 0 Building Dept. E Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Frl Nature and extent of action: CONSTRUCT 115' LONG X 4' WIDE FIXED PIER, 15' LONG X 3' WIDE RAMP AND 20' LONG X 6' WIDE FLOATING DOCK. Location of action: 700 BROADWATERS ROAD, CUTCHOGUE Site acreage: 1.973 ACRES Present land use: RESIDENTIAL Present zoning SFR 0 2. 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: JOSEPH zALNER (b) Mailing address: 6939 MANSE ST., FORREST HILLS, NY 11375 (c) Telephone number: Area Code ( ) 631 734-2705 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [i] No ❑ If yes, which state or federal agency? ARMY CORPS OF ENGINEERS 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. ❑ Yesx❑ No ❑ Not Applicable ACTION MEETS POLICY REQUIREMENTS. 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 171 Yes ❑ No [i] Not Applicable 0 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 F� Not Applicable ACTION IS CONSISTENT WITH SURROUNDING PROPERTIES. 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 D 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 0 Yes 0 No ® Not Applicable ACTION HAS NO EFFECT ON WATER QUALITY. 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. 0 Yes []No © Not Applicable ACTION HAS NO EFFECT ON ECOSYSTEMS. 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 ACTION HAS NO EFFECT ON AIR QUALITY. 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 ACTION HAS NO EFFECT CAUSED BY SOLID AND HAZARDOUS WASTE. 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. ❑ YeLl No © Not Applicable ACTION IS LOCATED ON PRIVATE PROPERTY. 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 ACTION IS LOCATED ON SINGLE FAMILY RESIDENCE AND UTILIZED FOR RECREATIONAL BOATING ACTIVITIES. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III — Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No © Not Applicable ACTION WILL PROMOTE RECREATIONAL RESOURCE FOR LANDOWNER BY WAY OF BOATING ACTIVITIES. 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. E Yes ❑ No ® Not Applicable Created on 512510511:20 AM 0 July 15, 2012 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 700 BROADWATERS ROAD, CUTCHOGUE, NY SCTM No. 1000-104-10-2.1 APPLICATION FOR PERMIT Dear Sir/Madame: 0 _.112 We hereby submit one original and three (3) copies of the proposed plans, application, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 1 �I `PROPOSED 20' LONG X 6' WIDE FLOATING DOCK SUPPORTED 'MH (2) 8"0 PILES I"-' PROPOSED HINDGED RAMP 15' LONG X 3' WIDE PROPERTY OWNER: JOSEPH & JUDITH ZALNER 6839 MANSE STREET FORREST HILLS, NY 11375 PREPARED BY JEFFREY PATANJO 106 HEWITT BOULEVARD CENTER MORICHES, NY 11934 NOTES 1 ELEVATIONS REFER TO N G V.D 1929 DATUM 2 LOT AREA. 81,578,39 SF / 1.873 ACRES 3 PORTIONS OF PLAN FROM SURVEY PREPARED BY JOSEPH A INOEGNO LAND SURVEYOR 1380 ROANOKE AVENUE, RIVERHEAD, NY SURVEY LATEST DATED OCTOBER 22, 2000 4. ALL WOOD USED SHALL BE UN -TREATED c°vt FLAG (TYPICAL) INC 2000 \ J \ 25. 'H 112 f A Rr4. GARAGE yr ry N GRA'/f( DRr l F� DOCKAGE / n / EPPROVED BY / RD FF TRUSTEES / N OF SOUTHOLD DATE � I Z 2 12 REPRESENTS WATER DEPTH IN INCHES BELOW MEAN LOW WATER / .,Lu hpr l j 5239 JUL 1 D 2012 °°\ Eoou[! dTnnq 4�, H Proposed Dock & Float PROPOSED PLAN 700 DROADWATERS ROAD CUTCHOGUH TOWN OF SOUTHOLD SUFFOLK COUNTY, NY AX MAP NO. 1000-104-10-2.1 1"-30' 1 OF 2 L— PROPOSED FIXED ELEVATED PIER 115' LONG X 4' WIDE SUPPORTED WITH 6"0 PILES 0 8' OC. (TYPICAL BOTH SIDES) PROPOSED OPEN -GRATE DECKNG TO BE FLOW-THRU INTERLOCKING PANELS OR EQUAL \ 32 ,. \ SS \ J3,MEAN HIGH WATER 30, 2012 \JUNE LOW WATER \`-MEAN JUNE 30, 2012 \DOSZ \ \ S 2 PROPERTY OWNER: JOSEPH & JUDITH ZALNER 6839 MANSE STREET FORREST HILLS, NY 11375 PREPARED BY JEFFREY PATANJO 106 HEWITT BOULEVARD CENTER MORICHES, NY 11934 NOTES 1 ELEVATIONS REFER TO N G V.D 1929 DATUM 2 LOT AREA. 81,578,39 SF / 1.873 ACRES 3 PORTIONS OF PLAN FROM SURVEY PREPARED BY JOSEPH A INOEGNO LAND SURVEYOR 1380 ROANOKE AVENUE, RIVERHEAD, NY SURVEY LATEST DATED OCTOBER 22, 2000 4. ALL WOOD USED SHALL BE UN -TREATED c°vt FLAG (TYPICAL) INC 2000 \ J \ 25. 'H 112 f A Rr4. GARAGE yr ry N GRA'/f( DRr l F� DOCKAGE / n / EPPROVED BY / RD FF TRUSTEES / N OF SOUTHOLD DATE � I Z 2 12 REPRESENTS WATER DEPTH IN INCHES BELOW MEAN LOW WATER / .,Lu hpr l j 5239 JUL 1 D 2012 °°\ Eoou[! dTnnq 4�, H Proposed Dock & Float PROPOSED PLAN 700 DROADWATERS ROAD CUTCHOGUH TOWN OF SOUTHOLD SUFFOLK COUNTY, NY AX MAP NO. 1000-104-10-2.1 1"-30' 1 OF 2