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HomeMy WebLinkAboutFritz, Peter & JoanMark Terry Planning Department Southold Town Box 1179 Southold, NY 11971 January23,2013 ECE VE JAN 2 4 201 ~l~rd of Tmste~ Dear Mr. Terry, Thank you for taking the time to speak with me today in regards to Wetlands Permit TM#71-1-8 (Fritz property N. Parish Dr.) It is my understanding from our conversation that the reason that you found the application consistent with the LWRP, is only because of the pre-existing permit approved by the Trustees in 2011. In 2011, you found their permit application INCONSISTENT with the LWRP. Because the Trustees approved a variation of the 2011 permit, it now makes the project consistent with the Local Waterfront Revitalization Plan? This makes the 2013permit consistent with the 2011 permit. It does not make the project consistent with the LWRP. Thank you for your time and consideration. I appreciate that your depadment is quite busy. Sincerely, Maggie Merrill 700 N. Parish Dr. Southold, NY 11971 Cc: Town Trustees Conservation Advisory Council My name is loan Fritz. My husband, Peter and I have owned the proper 75~,AIl North Parish Drive since 1998 when we purchased it from my mother, ho alongS0ut~01d Town with my father owned it since 1958. My family has been paying taxes ~ ~ t|~s ~0arO 0JTrustc0S property for close to 6 decades. Members of my family have been residents of Southold town for almost nine decades. My father, maternal grandmother, great aunts, great uncles, aunts and uncles are all buried here, as will my mother, my husband and I, and our children. We are before you tonight because of environmental and climatological changes that began before members of my family took up permanent residence in Southold. My husband is an insurance broker who over the years has specialized in insuring the worldwide offshore oil and gas exploration and production operations of some of the worlds largest and geographically diverse integrated oil companies. They operate in some of the world's most environmentally sensitive areas. Governments across the globe, the oil companies themselves and the insurance industry realize that what 20 years ago was called the "hundred year storm" is now the norm. Katrina and Rita devastated the Gulf of Mexico coast as well as the offshore energy industry; recent storms across the North Sea and Europe have caused billions of dollars of damage. As a result, governments, in order to protect the environment and lives, are exercising stricter control and requiring more robust design of all newly constructed offshore facilities. The insurance industry has responded by either only insuring those facilities designed to today's standards or for those underwriters willing to write older units in storm prone areas like the Gulf of Mexico their premium has risen up to 2,000% making it unaffordable for smaller companies. You may ask what this has to do with our request for a full bulk heading? We say it has everything to do with it. Storms like Sandy have become the norm and we argue that communities in storm prone areas need to be proactive in protecting the lives and property of their citizens while not damaging the environment. My husband and I are not scientists but it seems logical to us that when property is eroded the run off into the bays not only damages property but also harms the environment and causes contamination. If we look at our particular situation in 2011, while we had originally applied for full bulk heading the Trustees and DEC approved the installation of approximately 50' of bulk heading and 50' of rock revetment. As the Trustees saw, Sandy did no structural damage to the bulk heading but a large portion of the rock revetment was destroyed with substantial erosion going directly into Southold Bay. We would liken the difference in the effectiveness of the bulk heading vs. the rock revetment to the difference between the strength of an offshore platform designed in 1980 and one designed today. While we are relieved we didn't suffer more damage and loss of property from Sandy, we also feel that had we been allowed a full bulk heading in 2011we would not be standing in front of the Trustees today again asking them to do what is right for both us as tax payers as well as the environment. As we said earlier, the community has an obligation to protect the property of all its citizens. We understand our neighbor has expressed a concern that by allowing us to extend our bulk heading it could increase the potential for erosion to her property from future storms. We take this concern seriously and have hired Mr. Joseph Fischetti PE who is here with me tonight. He assures us the extension of the bulk heading should not exacerbate any erosion to our neighbor's property from future storms. We thank you for the opportunity to come before you tonight and encourage you to take the bold step of approving our plans which will best protect both our property and the environment of the entire town of Southold and it's bays. JAN 2 3 20k~ Jan. 15,2013 Southold Town Boa~ of Trustees Southold Town Annex Box1179 Southold NY 11971 Re: SCTM # 1000-71-1-8 Peter & Joan Fritz 755 North Parish Drive 82 foot new bulkhead ,ECEOVE JAN I 5 2013 $outhold Town Boar~ of Dear Trustees, In regards to the above referenced permit request, we would like you to know of our concern as owners of the adjacent properties (Croasdale 695 North Parish Drive, Merrill 700 North Parish Drive). We would like to register our objection to the proposed 55 feet of new bulkhead and 32 feet of new return bulkhead. Such a structure is against town code and we believe would cause substantial erosion to our property. We would respectfully like to ask the Fritz's to explore a less harmful alternative. As property owners, we empathize with the Fritz's desire to stem the erosion to their property, but do not want to see it happen at the expense of our property. Margaret Merrill 700 North Parish Margaret Merrill POA for Margaret Croasdale 695 North Parish Drive Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-I 892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., January 16, 2013 the following recommendation was made: Moved by Derek Bossen, seconded by Doug Hardy, it was RESOLVED to NOT SUPPORT the Wetland Permit application of PETER & JOAN FRITZ to remove rock revetment and extend bulkhead to protect waterfront. Located: 755 North Parish Dr., Southold. SCTM#71-1-8 Inspected by: Derek Bossen, Peter Young The CAC does Not Support the application and recommends leaving the rock revetment in place and to enhance the rip-rap with native plantings, remove all irrigation, exterior lighting, and non-native vegetation from the buffer, and to extend the buffer an additional 5'. Vote of Council: Ayes: Ail Motion Carried ,lanlcs F King. President Ghosio, .ir, Vice-Presidem John Bredemeycr Michael J I)omino PO Box i lTg SOtllhoJd. NY 1197l Telephone (631 765-1892 Fax (63 I) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: Natural Images Landscaping on behalf of PETER AND JOAN FRITZ request a Wetland Permit to remove the existing rock revetment and extend existing bulkhead to protect waterfront. Located: 755 North Parish Road, Southold. SCTM# 71-1-8 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 Info needed: Modifications: Conditions: Present Were: ~'J'~J. King 6B~Ghosio L J. Bredemey~ ~ Michael Domino Form filled out in the field by /~3 __ D. Bergen, D. Dzenkowski Mailed/Faxed to: Date: other 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: January 17, 2013 Re: Proposed Wetland Permit for PETER AND JOAN FRITZ SCTM#1000-71-1-8 Natural Images Landscaping on behalf of PETER AND JOAN FRITZ requests a Wetland Permit to remove the existing rock revetment and extend existing bulkhead to protect waterfront. Located: 755 North Parish Road, Southold. SCTM# 71-1-8 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney 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 Office Use Only ~7.CwOaStal Erosion Permit Application ctland Permit Application Administrative Permit , Amendment/Transfer/Extension '-/ Received Application:~L[~_'~ ~,eceived Fee:$ ~--~ t ~£'] I ~/Completed Application II ! 7~q !1 7~- __Incomplete SEQRA Classification: Type I Type II Unlisted NOV 2 9 2012 Coordination:(date sent) 7~LWRP Consistency Assqssnlent Form -~CAC Refe~al Sent: Date of Inspection: Receipt of CAC Report: Lead Agency Determination: _fechnical Review: '~Public Hearing Held: I 1'~3,] !.-~ Resolution: ' ~ Name of Applicant Azr££ + f, etr2- MailingAddress 91 ~HnP~, ~o~ ~n~U~s~'~ ~/ //o~o Phone Number:( ) $ ~7 - RWo -7 Suflblk County Tax Map Number: 1000 - 7/' / - ~ Prope~yLocation: 75~- do~ ~'SR ~oa% ~o~o~o.,~ /19v/ (provide LILCO Pole ~, distance to cross streets, ~d location) AGENT: ~TO~A~ /~-~.~ i ~cAA/~~- I~ (If applicable) ad: 87a- qoqq B~d of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: x0g3i ~,~ 7~,,~ ~. Covenants and Restrictions on property? __Yes If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? __ J No //Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. / Does this project require a variance from the Zoning Board of Appeals? __ Yes -/ 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 v' No Does the structure (s) on property have a valid Certificate of Occupancy? fi/ Yes __ No Prior permits/approvals for site improvements: Agency , , Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? If yes, provide explanation: ,//No Yes Project Description (use attachments if necessary): ;ormo ua Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~/'e~o,.~ g,,Os 7'/~ ~3 o<.~'~4~,n,O Area of wetlands on lot: ~ S~ square feet Percent coverage of lot: ] % Closest distance between nearest existing structure and upland edge of wetlands: b g feet Closest distance between nearest proposed structure and upland edge of wetlands: O feet Does the project involve excavation or filling? No ~/ Yes If yes, how much material will be excavated? cubic yards How much material will be filled? ~0 cubic yards Depth of which material will be removed or deposited: ~ ~' ~ feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 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): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME county ~.gOFFOc~ SEQR 3.PROJECT LOCATION: Municipality ',~'OC,'7'W ~ ~-,0 4. PRECISE LOCATION:~7,~..~/g~ ,Sffeet /~'~,~-/~;~/Addess and ~adD,~l~lntersect~ons.~ou7'''~ ~)~-~3Pmminent ~'/y[andmarks//<~-7 jetc -or provide mai) 5. IS PROPOSED ACTION: [] New ~'~xpansion [~ModificatJon/alteration 6. DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: ri , Initially acres Ultimately '/? acres 8 WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~'Yes [] No If no, describe bde~y: ResT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) idential E~lndustdal []Commercial ~---~Agriculture []Park/Forest/OpenSpace []Other(describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, AGEN Y (Federal, State or Local) ~es F~ No If yes, list agency name and permit / approval: NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~'Yes - If yes, llst name and permit / approval: []No agency 12. ~ A RESULT OF PROPOSED ACTION WILL EXISTING P/ERMIT/ APPROVAL REQUIRE MODIFICATION? [~fes ?cN~RTiFY T ? THE ,NFOR ~ PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor NaF~i~~ Date: If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT Mo be completed by Lead A~lenc~/) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PANT 617.47 If yes. coordinale the review process and use the FULL EAF. F-Iv.., 171.o S. WILL ~CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. FART 617.67 If No, a negative declaration may be superaeded by another involved agency. C. COULD AC3'ION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOU_OWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quanffiy, noise levels, existing baffic pattern, solid waste production or disposal, po{ential for erosion, drainage or I]o<xliog problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or c~ltural resoumes; or community or neighbedmnd character? Explain bdel~y: C3. Vegetation or faurm, fish, shelffish or wildlife species, significant habitats, or threatened or endangered species? Expiain briefly: I C4. A community's existing plans or goals as off. ally adopted, or a change in use or i~tensity of use of land or other natural resources? Explain bdefly: I C6. Long term. short lerm, cumulative, or other effects not identified in C1 -C57 Explain briefly: C7. o. the~ impacts t;inclndin~l chan~es in use of either ~uanfit / 1 O. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? Ill yes, explain briefly: E. IS THERE, OR IS THERE LIKELy TO BE~t CONTROVERSy RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ~es e~teffi: PART I# - DETERMINATION OF SIGNIFICANCE (To be completed by INSTRUCTIONS: Foreachadvemeeffectidefltifledabove, determinewhetheritissubstaofial large importantorotherwisesigniflaanL Each effect sh~ate be assessed in con~n with its (a) setting (i.e. urban or rural); (b) probabiF~'y of o~curdng; ((;) duration; (d) irreversibillty; (e) geographic scepe; and (f) magnitude. If necessary, add altachrnents or reference supporting materials. Ensure that explanations c~llate sufffetent detail to show lhat all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potenttallmpac~ of the preposed action on the environmental charaofe~'tics of the CEA. Check thle box if yco have idenfified one or more pctenflally laege or slgnfiicant adverno impesfe which MAY occur. Then p(~l directly fe the FUU EAF and/or prepare a positive dedarafion. Check this box If you have determined, based on the inf<xma~n and analysis above and any suppodlng documentallon, that the proposed acllm WILL NOT result th any slgni~cent ndveme environmental impacts AND provide, on attachments as necessa[y, the masons supporfing thi.~ de~ennffiation. Board of Trustees Name of Lead Agency Pdn~ or T~ Name of Responsible Offi~ Lead Age~ S~ alure o Responsible ~rin Le~gen~ Dale President [] Title of Responsible Officer Signature of Preparer (if different from responsible officer) Town of Sou- old Erosion, Sedimentation & Storm-water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATEI~ GRADING, DRAINAGE AND EROSION CONTROL PLAN ~ District Section Block Lot (~:K I II'll:D BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUuIION l'll]t~# / WOKKASSESSMENT [ Yes No a. What is tb,~ Total Area of the Project Parce s? (Inctude Total Area of all Parcels located within 1 Will this Project Retafo Ail Siorm-Watar Run-Off the Scope of Work for Proposed Construction) /?~/~ Generated by a Two (2") Inch Rainfall on Site? b. What is the Total Ama of Land Clearing W(S.F. / Acres) (This item will include alt run-off created by stie clearing and/or construction activiges as well as all and/or Ground Disturbance for the proposed Site improvements and the permanent creation of construction activffy? impervious surfaces.) (S.F. / Acres) PROVIDE BRIEF PROJECT DESCRIPTION (~o~ ~d~ P~ ..~, 2Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and .V-- ~3 __ Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion zr and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Peded. 4 Will Ibis Project R~luire any Land Filling, Gradiog or Excavation where there is a change to the Natural Existing Grade involving more than 200 Cubic Yards~L~ --V of Matedal within any Parcel? 5 Will this ApplicaUon Require Land Disturbing Activities / Encompassing an Area in Excess of Five ThousandL~ V (5,000 S.F.) Square Feet of Ground Surface? -- 6 is there a Natural Water Course Running through the Site? is this Project within the Trustees jurisdiction General DEC awPPP Requirements: or within One Hundred (100') feet of a Wetland or Submission of a SWPPP is requked for all Construction aclivifies involving soft Beach? disiuebances of one (1) or ~r~re ac~es; including disbJrbances of less than one acre thai 7Will there be Site prepara0on on Existing Grade Slopes ~ / are part of a larger common plan thai will ullima Idly disturb one or more acres of land; whic. h Exceed Fift.e, en (15) feet of Vertical Rise to iocJuding Conslruction activities involving soil dislurhences of less ~han one (1) acre where On. ~Hundred (100) of Horizontal Distance? L.-J -- the DEC has determined that a SPDES permit is required tor storm water discharges. SWPPP', Shall meet ,he Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other impervious for Storm Water Discharges from Cm~stmctton activity - Permit No. GP-O-10-O0t.) Surfaces be Sloped to Direct Storm-Water Run-Off 1. The SWPPP shall be prepared pdor to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town Hght-of-way? required, ges[-conslxuction storm weler management p~acUces that will he used and/or Removal of Vegetation and/or the Construction of any STATE OF NEW YORK, O f'/~- ,/./ covm'Y OF ss q'ha[ I ........ ,..~....~....:2...v..,.....)....].....~.,.k,.~tName of individual skjning Document, .... ................ being duly swbm, deposes and says that he/she is the applicant tbr Pem~it, he/ ae ...... (Owner, Cmbaclor. ,~9'~i: ~)'~o~i~ Officer, e~c.) .............................................................. Owner and/or representative of the Ovmer or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained iii this application are true to the.~,best of his lmo. g~ge and belief; and that the work will be performed in the manner set forth in the application filed herewith. / ] / ] Sworn to before me this; ///~ / .......................... · --~......../':~... ....... day of ......... ...~.....~:...~... ................ 20..[.. '~- P/~ ~ Notary Public: ......... ~lq..~.,~.:...~ .~....:....: .................................. l.d../~...t ...................... ....~ .................. ......... .... .......... ,, FORM-06/10 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ECE VE ,lAN 1 5 2013 SoutholdTown PETER & JOAN FRITZ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING l, 5co47~ ~ ~--+~/~ , residing at /dba being duly sworn, depose and say: That on the } Ko day of .Sm~,.~m v- q ,201~ I personally posted the property known, as 75'S ~,,'-~ '¢,"',~h'° ~0. .%.~-~¼o\~ w~. hqw I 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 Wednesda% January 23~ 2013. ated: // (sl-gnature) ~ Sworn to before me this /~ dayofda~ 20/3 }tar 4 N PENNY .I~EDELL Not~y Public, State of New York MAILING OF NOTICE ~RTIFIED MAIL RECEIPTS EOE VE JAN 1 5 2013 Southold Town Board of Trustees STATE OF NEW YORK COUNTY OF SUFFOLK ~u~o ~ ~ ~.Y. I 1 ~ ~ [ o being d~y swo~ d~ ~ ~ ~t on ~e //~h dayof_J~no~q ,20~,d~nmt~a~e~yof~eNofi~ s~ ~ in ~e Bo~d of T~t~Appli~fion, d~ ~ ~ch of~e a~ve ~ ~m m ~e Mdr~ ~ o~site ~ r~ve ~; ~ ~e ~ ~ op~ ~ ~ of ~d ~ ~ ~e ~ of~d ~ ~ ~ on ~e c~t ~mt roll of~e To~ of Sou~old; ~at ~d Nofi~ w~ ~ at ~e U~ S~t~ Post Offi~ at ~Cco~ I ~ , ~t ~d Nofl~ w~ m~l~ ~ ~h of~d ~ by ~RT~D ~~ ~CE~. Day of ~Jd e~ ~ff~ ~, 20 ' PENNY ~EDELL Notary Pub/ic.State of New York ~ua//Nfo. 018E6099317 . . 'fled in Suffolk NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be hel.d by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Ma~n Road, Southold, New York, concerning this property. OWNER(S) OF RECORD:"P~¢ 3'-o~n Fr~f~- SUBJECT OF PUBLIC HEARING: To remove the existing rock revetment and extend existing bulkhead to protect waterfront. TIME & DATE OF PUBLIC HEARING: If you have an interest in project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1 892 Bo~of Trustees Application County of Suffolk State of New York ~qr'q %~ 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 HISBrtER 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 1NSPECT THE PREMISES IN CONJUNCTION WITH REVIE~ OF THIS AP~CATION. Signature of Di'operty Owner SWORN TO BEFORE ME THIS <xgC~ DAY OF P~ O x/ ,20 i ~ Notary Public ~ard of Trustees Applicatio~ AUTHORIZATION (where the applicant is not the owner) I, g6~ ~/~"~,~ 7~'~/'7/Z. residingat 7/ (print owner of property) (mailing address) t~ a/q ~ ~_ /%t/ //6).,,70 do hereby authorize (Agent) ~';/-~ ( C4 c.{ ('-9- f~oo ('~ to apply for permit(s) from the Sou3 Boar~wn Trustees on my behalf. (Owner's signa'h~) ~ / (~ JAN 2 3 2013 ~ld Town . . Bo~ of Trustees Application AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at ?/~/wq?r,~ ADo/~ a (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Bgard of Town T/~tees on my behalf. (0 ne s signature) _D APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics Dmhibits conflicts of interest on the east of town officcm and emolovees. The ouroose of this form is to omvide info~ation which can alert the town of ~ossiblc conflicts of intem~t and allow it to take whatever action is necessary ~o avoid same. (Last name, first name, ~iddlc initial, unless you am 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 (If "OtheF, name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, 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 coq~oration in which the town officer or employee owns more than 5% of the sh~res. YES NO J Ify0u 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) thc oyvner of greater than 5% of the shams of the corporate stock oftbe applic0nt (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, parmer, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfxont 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). 3~ If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- suooorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. B. DESCRIPTION OF SITE AND PROPOSED ACTION 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. Plalmiagl)epartment, all local libraries and the Town Clerk's office. ~i [~ ~ ~- SCTM# .] O0O ~71 - O I - o ~ ! Thc Application has been snbmitted to (check appropriate response): Town Board [] Planning Board ~ Building Dept. [] Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) Co) Financial assistance (e.g. grant, loan, subsidy) (c) Nature and extent of action: Permit, approval, license, certification: Location of action: Site acreage:. Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailingaddress: 71 ~'II/gP6I-. (c) Telephone number: AreaCode~/~ - ~,~9'7- ~?-707 (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes[~ No~] If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ~ Yes ~ No ~Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Po)fcies Pages 3 through 6 for evaluation criteria [-] Yes ~ NoF-~i I 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 [--q/Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes [] No [-] Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southoid. See LWRP Section III - PoliCies Pages 16 throu~ 21 for evaluation criteria [] Yes [-~ No[~1 VlNotApplicable 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 Applic~ 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 At, ach 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. ~N [] Yes~ No otApplicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. ~-~ Yes [] No ~/Not Applicable At-tach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LV~RP Section III - Policies; Pages 57 through 62 for evaluation criteria. At, ach 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 - Polic~ges 65 through 68 for evaluation criteria. ~ Yes ~ No~1 I~ Not Applicable" DATE M ,VW NATURAL BANK iMAGES 9 t'~, 2 9 20~2 '~', 2 9 2012 NATURAL IMAGES 20!2