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HomeMy WebLinkAboutTR-7928 Glenn Goldsmith, President ® s®��' Town Hall Annex A. Nicholas Krupski, Vice President �� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone (631) 765-1892 Elizabeth Peeples a® Fax(631) 765-6641 4U�TV,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1922 C Date: June 15, 2022 THIS CERTIFIES that the removal of existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x22' fixed catwalk using flow through decking; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings; for the existing 83' timber retaining wall and the existing 11.2'x3.3' concrete dock access stairs; with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water; At 1695 Mill Creek Drive, Southold; Suffolk County Tax Map #1000-51-6-32 Conforms to the application for a Trustees Permit heretofore riled in this office Dated August 22, 2012 pursuant to which Trustees Wetland Permit#7928 Dated October 17, 2012 was issued and Amended on April 17, 2013 and Amended again on June 15, 2022 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal of existing5'x16' seasonal floating dock 3'4"x16'4" wooden ramp and existing_4'x 16' fixed catwalk; construct new 4'x22' fixed catwalk using,flow through decking; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings; for the existing 83' timber retaining wall and the existing�11.2'x3.3' concrete dock access stairs; with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water. The certificate is issued llis S a ner of a aforesaid property. Authorized Signature br L' 3 MEMO 5" TO: Diane DiSalvo, Clerk Typist FROM: Robert Anderson f. DATE: August 16, 2022 Re: SOUSA Property—Covenants and Restrictions Situate: 1695 Mill Creek Dr. • Southold, NY H. . SCTM#: 1000—51-06-032 MESSAGE: U } Hi Diane, Please see the attached certified recorded covenants and restrictions establishing the proposed buffer at the subject property. Y( 114#yM�VI„YµY.:...'✓t'i Y "*V +” I think this should satisfy everything needed for a Certificate of Compliance to be issued. Let me know if you need anything else on this. 0 Best, Robert f M /1 M � e`1 M �1 s r.e 1n 1 � CC# : C22-30485 =d'f•;.-it COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 08/16/2022 under Liber D00013169 and Page 384 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 08/16/2022 SUFFOLK COUNTY CLERK JUDITH A.PASCALE SEAL IIIVIII IIII VIII VIII VIII VIII VIII iIIII VIII IIII IIII 111111 VIII VIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 08/16/2022 Number of Pages : 12 At: 09:52 : 14 AM Receipt Number : 22-0131044 LIBER: D00013169 PAGE : 384 District: Section: Block: Lot: 1000 051 . 00 06 . 00 032 . 000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $60 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15 . 00 NO TP-584 $0 . 00 NO Notation $0 . 00 NO Cert.Copies $15 . 00 NO RPT •,$200 . 00 NO Fees Paid $315 . 00 THIS PAGE IS A PART OF THE INSTRUMENT-- THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County 515 RECORDED 2022 Aun 16 b9.-52:14 AN Number of pages .JUD*1 T h A. PAS ALE CLERK 0F' SUFFOLK COUNT"? This document will be public L DOOO13169 record. Please remove all F -r Social Security Numbers prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Reco ding/Filing Stamps 3 FEES Page/Filing Fee Mortgage Amt. 1. Basic Tax Handling 20. 00 .2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-52 17 (County) Sub Total Spec./Add. EA-5217 (State) TOT.MTG.TAX R.P.T.S.A. �� y�y Dual Town Dual County — 4A .� � 4A Held for Appointment Comm. of Ed. 5. 00 % Transfer Tax . Mansion Tax Affidavit ���� The property covered by this mortgage is Certif�Cop or will be improved by a one or two NYS Surcharge 15. 00 family dwelling only. Sub Total YES . or NO Other (�' Grand Total If NO,see appropriate tax clause on age# of this ins r met. 4 Dist. 4953869 1000 05100 0600 032000 5 Community Preservation Fund Real Property p T S Illlllllulllllllllllllll�IIIIIIIIIIIIIIIIII Consideration Amount $ Tax Service R RAK A u Agency 12-AUG- CPF Tax Due $ Verification Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO- Vacant Land TD 0.1C3Xpp r1 TD 11q� � TD Mail to: Judith.A. Pascale, Suffolk County Clerk 7 Title Com]2anv Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk.. ' Title# --- -8. Suffolk County Recording & ndorsement Pam This page forms part of the attached L cy,rad 6on, made by: (SPECIFY TYPE OF INSTRUMENT) `'Vallis SCri)53, L W t i)g Rk)ag- The premises herein is situated in SUFFOLKCOL NTY,NEW YORK. TO In the TOWN of Sou In the VILLAGE. or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK OI LY PRIOR TO RECORDING OR FILING. 12-0104..10/08kk (Over) IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MORTGAGE, please,be aware of the following: If a portion of your monthly mortgage payment included your property taxes, *you will now need to contact your local Town Tax Receiver so that you may be billed directly for all future property tax statements. Local property taxes are payable twice a year: on or before January 101 and on or before May 318t Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Tax Receiver with any questions regarding property tax payment. Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes 200 East Sunrise Highway 200 Howell Avenue North Lindenhurst, N.Y. 11757 Riverhead, N.Y. 11901 (631) 957-3004 (631).727-3200 Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes One Independence Hill Shelter Island Town Hall Farmingville, N.Y. 11738 Shelter Island, N.Y. 11964 (631) 451-9009 (631) 749-3338 East Hampton Town Receiver of Taxes Smithtown Town Receiver of Taxes 300 Pantigo Place 99 West Main Street East.Hampton, N.Y. 11937 Smithtown, N.Y. 11787 (631) 324-2770 ' (631) 360-7610 Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes 100 Main Street 116 Hampton Road Huntington, N.Y. 11743 Southampton, N.Y. 11968 (631) 351-3217 (631) 283-6514 Islip Town Receiver of Taxes Southold Town Receiver of Taxes 40 Nassau Avenue 53095 Main Street Islip, N.Y. 11751 Southold, N.Y. 11971 (631) 224-5580 (631) 765-1803 Sincerely, Judith A. Pascale Suffolk County Clerk I J 1 12-0104..06/06kd DECLARATION OF COVENANTS THIS DECLARATION made this 20th day of July, 2022, by Phyllis Sousa, as Trustee of the Phyllis Sousa Living Trust, residing at 4145 Wells Road, Peconic, NY 11958, hereinafter referred to as "DECLARANTS": WITNESSETH: WHEREAS, DECLARANTS are the owners of certain real property located on 1695 Mill Creek Drive, Southold, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 51, Block 6,Lot 32 which is more particularly bounded and described as in Permit#7928 and depicted on the plans prepared by Costello Marine Contracting Corp. last dated July 231-d, 2012 and stamped approved by the Board of Trustees on October 17th, 2012, and filed with the Town of Southold on October 17th, 2012, see Exhibit A Attached; WHEREAS, the property situated on the lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees")pursuant to Chapter 275 of the Town Code of the Town of Southold or it's successor, and various activities conducted upon the property may thus be subject to the regulations and approvals of the Trustees prior to being conducted; WHEREAS, the DECLARANTS therefore made application to the Trustees for a permit pursuant to the Wetland Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a variable width "non-turf buffer" adjacent to and landward of the landward limit of Tidal Wetlands and seaward of the top of the existing bank thereon; and WHEREAS, the DECLARANTS has considered the foregoing and has determined that the same will be for the best interests of the DECLARANTS and subsequent owners of the Property. NOW, THEREFORE, the DECLARANTS does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and perpetually maintained a variable width"non-turf buffer" as defined by Chapter 275 of the Town Code, to wit: "A designated area where turf grass, pesticides and fertilizers are not permitted." And as depicted on the Plans prepared by Costello Marine Contracting, Corp. and dated July 2:3,d, 2012 "Exhibit A" and filed with the Town of Southold on October 171h, 9,012 attached; and 2) These covenants shall run with the land and shall be binding on the DECLARANTS, their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owners have duly executed this instrument this day of_ 20� Phyllis Sousa, as Trustee of the Phyllis Sousa Living Trust STATE OF NEW YORK) COUNTY OF SUFFOLK) ss: -t On theJ_� day of V1 �1 in the year of 20 before me the undersigned, a notary Public in and for the said State,personally appeared Phyllis Sousa, as Trustee of the Phyllis Sousa Living Trust, personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their capacity, and that by their signatures on the instrument, the individual or the persons on behalf of which the individuals acted, executed the instrument. J' e7 Notary Public GZ 11 C.HENLE Notary Public,State of New York No.02HE6016925 ®ualified in Suffolk County Commission Expires November 30,20, EXHIBIT"A" JG�uvt+ .T9wt�� a3oa�wrsa y J N6aNMi� � �AIDE"&" r � _ _7�"Fi*t�7�1�'.ei'�,"`�LA: ,. �'p''ui�ss _'°�f !".�Ti+�. 'r�D1t1Ce'..�. �l�i�`T/►.��i • 7!���°I�°�d1G'�/!�G`� C,:17'WrKJiL. C.'bR���?a/CT . _ ia2-of�•varis c�or��c.�. /eol?z MIA"er maraw_zxn^;emt �..........-. ��. �rwa�cv.�, N.yt 1197! . .SAMT Cm EXHIBIT"A" MEW L oayj 4��1G 41 04 tFs Al o - i G � v r�G�JN�c1..�ie�¢,e yE Fto�?,4L JKRARX, �►•� !/pool 14P Zia M�'Ite- M �E " � �����•�.n�v�� . � kitty,s, �coT,-,�,� . ,oaf/P.9.71 ­77W O.•,!� 14 - -77-slt 144 o�a Oi W.�a C04W,0AOM Zbpm 0404"tO.,f"It 0337 /f&,: �G Mitt CjqdvlAd Wwwft.%r • e�r1.4MijwM� � ��, �:SI. �77� tow I#rj6m" EXHIBIT "A" Aa a 44A �. Q0 I low . vi AlM AV Jk • ti d6'v.,4.6. Roma vea=PWQAe- W-411w%If el- J�AMJir.+e►a'���Tr+vh� As _ �E.�i.•C sNi7"�SGT/VSW / , �ii►o fQ IAA} .AMJO . -r- i s�.R=AJ�'•tu. w+�e�A.1� . tpV40CAd-WM4OAqV)CDO IOC t• &mwA, 1� •40R r�aNcv� SOu SA /d2-o/t®w�ctsCbwr/ssv� �'" rpd,�tasN►�wwsl�!.d+.�5•/1567 gor7Y;/oht/g/V�yt /1�►Y/ �0��=,/� /1R�tA�t / : EXHIBIT"A" Atdy�sa CNO- •d lie.. Til UP IRA 1A a 1 • t!i� ' r d � N•4r+o IL, ,4 a,e SGS' ► J�.7c)L % Wx�i��b�15 ArrKLMU 5T �d,.Ie�ViaR -T OF 7RUME5 TOWN OF MAIRAPOW EXHIBIT"A" ' OT��v 4Tavft JL4-16 37YAO �t�cKatil� 100 AWW 4 1.!�i A"W dP.0 • Sac �i�rycc✓s .�oN� �eroor AUW !Ckftff-AM"G AAffX-0R"AV �.�S+�s stAM. ;pare eeMWlif6 JAy 23. EXHIBIT "A" Ra�aer+cx wrr► ""rdmlmrap- r�►e�t % *Vsrr,1ak 3 N 4.' ' /'ber/•I �•ro�5 PM odi MAW d6o4ft T�,danmsat� .. � MSW,�Q•�• ,r.4•�s�} =a•, . ti a > i G'�cZ4•�a�� `t C XZ OSS SSC 7*/Oti1 ' &VArrAAATi drSr �ir apacie3W*AOfOwl= ® 7�NYdLl3 :3os/:1�1 . rv4l43.COV-W � r���+�.•rt�sr, �.r.y. .,a37 Man-WNW EXHIBIT"A" BOARD OF SOUTHOLD TOWN TRUSTEES h ; SOUTHOLD,NEW YORK l " PERMIT NO.7928 — DATE: OCTOBER 17,2012 ISSUED TO: PHYLLIS SOUSA PROPERTY ADDRESS: 1695 MILL CREEK DR1VE SOUTHOLD SCTM#51-6-32 f 1 AUTHORIZATION i 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 October 17,2012,and in consideration of application fee in the sum of$ 0 . paid by too mado Contracting-CpM.and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and i f permlits the following: Wetland Permit to remove the existing 59x16' seasonal floating dock,314"x1694" wooden ramp and existing 4'x16'fixed catwalk;,construct new 4'x16' fixed catwalk in- place; replace existing decking on wooden ramp with untreated decking;itnst" handrails on ramp and reinstall onto a new 69x20'seasonal floating dock-secured'by two 8"diameter anchor pilings;with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water; and as depicted on the site plan prepared by Costello Marine Contracting Corp.,last dated July 23,2012,and stamped approved on October 17,2012. " 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_ " ---- - - --- ------------- --- -- ----- - ----- -------------- -- - QF** t John Rr i i � EXHIBIT"A" TERMS AND CONDITIONS The Permittee Phyllis Sousa,residing,at 1695 Mill Creel& k as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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 Perrnut 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 for revocation of this Permit by resolution of the said Board. S. 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. 7. 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. The Permittee is required to provide evidence that a copy of this Trustee permit has 1 - --- -- -- recorded with the Suffolk County Clerk's office as a notice covenant and deed restriction to the deed of the subject pai•cel.Such evidence shall be provided within ninety(90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all mayr permits subject b cea o revoke upon consents that may to obtain same• supplemental to this permit, j i f � TITLE NUMBER: 641-S-03573 SCHEDULE "A" DESCRIPTION \� ALL that certain plot, piece or parcel of land, situate, lying and being North of the Un-Incorporated Village of Southold, in the Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the easterly side of West Mill Creek Drive distant 373.86 feet southerly from the corner formed by the intersection of the i southerly side of Meadow Lane with the easterly side of West Mill Creek Drive; THENCE South 46 degrees 02 minutes 10 seconds East along land now or formerly of Willse 264.90 feet to the high water mark of Long Creek; THENCE along the high water mark of Long Creek the following (3) courses and distances: 1) South 54 degrees 11 minutes 53 seconds West, 10.12 feet; 2) South 70 degrees 13 minutes 45 seconds West, 30.99 feet; 3) South 49 degrees 14 minutes 15 seconds West, 37.41 feet to_land now or formerly of Mullen; THENCE along land now or formerly of Mullen, North 46 degrees 02 minutes 10 seconds West, 245.95 feet to the easterly side of West Mill Creek Drive; ; THENCE along the easterly side of West Mill Creek Drive, North 43 degrees 57 minutes 50 seconds East, 75.00 feet to the point or place of BEGINNING. i Glenn Goldsmith,President ��Q� Slit/ Town Hall Annex A. Nicholas Krupski,Vice President ® ®Ie P .O. Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples �® ® & Fax(631) 765-6641 COUNT�,� ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 16, 2022 Robert W. Anderson Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932-2003 RE: PHYLLIS SOUSA 1695 MILL CREEK DRIVE, SOUTHOLD SCTM#: 1000-51-6-32 Dear Mr. Anderson: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, June 15, 2022: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit #7928 for the as-built 83' timber retaining wall and the as-built 11.2'x3.3' concrete dock access stairs; and as depicted on the site plan prepared by Suffolk Environmental Consulting, Inc., dated June 1, 2022, and stamped approved on June 15, 2022. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Glenn Goldsmith President, Board of Trustees GG:dd AERIAL VIEW APPROVED BY BOARD OF r a?USTEES Scale: l" = 40' AERIAL VIEW WEST MILL CREEK DR. Scale: 1" = 10' EXISTING CONC. BLK. TOWN OF SOUTHOI.D r STAIRS to be DATE T ..ti.ti ti ti ti ti.ti tirtirtirtirrr rtir;r�r rtirtirtirLr r ti i 3.3 LEGALIZED & � EXISTING TIMBER RETAINING r / WALL to be LEGALIZED tV 7� M,yyV_ , . 20.5' 78 CROSS VIEW EXISTING WOOD WALK to DOCK Scale: 1" = 5' 15.5" 27.75'.' EXISTING TIMBER RETAINING WALL to be 43 25" LEGALIZED W � . 48++ ----- ..I r cc K � EXISTING CONC. BLK. ELEVATION VIEW STAIRS to be Scale: 1" = 10' LEGALIZED Z TOP of BANK el.9.8' 1� . J J D E C F I V E HEIGHT of WALL: W Q TI IN 0.0'—3.0' J U H 2 M.H.W----------------------- -----------------------------------------------------------------------------_----------- .__. ..... ---� ------ - - - __- _— ------------------ ------------- 2022 M.L.W----------------------------------_------------------- ----__------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------- X EXISTING W Soul►gld Town PERMITTED Board of Trustees DOCK EXISTING TIMBER RETAINING WALL to be LEGALIZED (...See Plan Detail...) V` TOP of BANK PHYLLIS SOUSA LIVING TRUST Property-EXISTING CONCRETE STAIRS & TIMBER RETAINING WALL EXISTING WOOD WALK Situate:1695 Mill Creek Drive-Southold,NY-11971 SCTM#:1000—051—06—032 -'-- M.H.W. EXISTING DOCK Suffolk Environmental Consulting, Inc. Drawn by: RWA Date:_ 6/1/2022 ARSHAMOMAQUE POND P.O.Box 2003 -Bridgehampton,NY-11932 Scale: As Shown 1-� Comments: P-1 1 (631)527—5160 Glem._tldsuuEi�,�President �o�pgUFF01 �Gy ti_ Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 0 Eric Sepenoski ,z P.O.Box 1179 Liz Gillooly �y ® ®�� Southold,NY 11971 Elizabeth Peeples dol �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: 2Z Completed infield by: L- &1166(i Suffolk Environmental Consulting, Inc., on behalf of PHYLLIS SOUSA requests an Administrative Amendment to Wetland Permit#7928 for the as-built 83' timber retaining wall and the as-built 11.2'x3.3' concrete dock access stairs. Located: 1695 Mill Creek Drive, Southold. SCTM#: 1000-51-6-32 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion K Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No ?C Not Applicable Info needed/Modifications/Conditions/Etc.: 1a S) ,M ff,c_j-e\j2 1 22 . ®V- 4b 15S& co+ OL d WA kh a ct e®vl Grp-e+-e. SA-C4'Y_9 Vr4-nivt OP9 I( 0,.S cA­)TrA+f Pn okb-we Present Were: G. Goldsmith N. Krupski E. Sepenoski _k_ L. Gillooly E. Peeples J � Glenn Goldsmith, President ®F S0 Town Hall Annex A.Nicholas Krupski,Vice President ,`®� ®�� 54375 Route 25 P.O. Box 1179 Eric Sepenoskii Southold, New York 11971 Liz Gillooly Elizabeth Peeples � � � Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 2 2Z INSPECTED BY: �� W-® Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1 st day of construction % constructed _ Project complete, compliance inspection COMMENTS: ouccc)L�4- rre-f-e S ��t L CERTIFICATE OF COMPLIANCE: AV1AtkdVWAj— �e� Suffolk Environmental Consulting, Inc. Newman Village Suite E 2310 Main Street • PO Box 2003 • Bridgehampton NY 11932-2003 t 631.537.5160 f 631.537.5291 Bruce Anderson,M.S.,President HAND DELIVERED June 1St, 2022 " CEIVE Attn: Diane DiSalvo Board of Trustees JUN " 2 2W Town of Southold P.O. Box 1179 sawmtaToam Southold, NY QaatdofThMm 11971 RE: PHYLLIS SOUSA LIVING TRUST Property—Requested Amendment Situate: 1695 Mill Creek Drive • Southold, NY • 11971 SCTM#: 1000—051.00—06.00—032.000 Permit#: 7928 Dear Ms. DiSalvo, This Firm represents the Owner of the above referenced property, who wishes to amend the subject permit to include for the existing timber retaining wall (overall length: 83.0') as well as the existing concrete dock access stairs (11.2' x 3.3 ) landward thereof. Attached herewith please find the following; 1. Site Plans prepared by SUFFOLK ENVIRONMENTAL CONSULTING, INC. last dated June 1S1, 2022, depicting both structures with dimensions taken at the site, (four [4] sets); 2. Owner's Authorization, and; 3. Agent's Open Government Disclosure Form. Kindly add this matter to the agenda for the next available Board of Trustees Public Hearing at your earliest opportunity. Thank you for your time and consideration regarding this request. Should you have any questions or concerns pertaining to this matter, please feel free to reach out to this Office at your earliest opportunity. Yours Truly, Robert W. Anderson (enc.) C.c. P. Sousa G. Henle 4 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the 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: Robert W. Anderson—Suffolk Environmental Consulting, Inc. (Last name,first name,middle initial,unless you are applying in the name of someone else of other entity, such as a company.If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,"name the activity.) Do you personally(or through your company,spouse,sibling,parent, or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,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 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 then 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 this y of ';3L)n2 20XZZ Print name Robert W. Anderson .f Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) We, Phyllis Sousa residing at P.O. Box 26 Southold,NY 11971 do hereby authorize Suffolk Environmental Consulting, Inc. To apply for permit(s) from the Southold Board of Town Trustees on our behalf. ,e. James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375Main Road P.O. Box 1179 Southold, NewYork 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 April 17, 2013 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Jane Costello Costello Marine Contracting Corp. PO Box 2124 Greenport, NY 11944 RE: PHYLLIS SOUSA 1695 MILL CREEK DRIVE, SOUTHOLD SCTM# 51-6-32 Dear Ms. Costello: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, April 17, 2013: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Wetland Permit #7928 for a 6' extension to construct a 4'x22' new fixed catwalk using flow-through decking; and as depicted on the revised site plan prepared by Costello Marine Contracting, Corp., last dated February 18, 2013 and stamped approved on April 17, 2013. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK:amn = MAR 2 5 2013 Southold Town Board of Trustees 'I 22' /.4.' James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southnld, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated :~[ 2-G/I~ ~ / has been reviewed by this Board at the regular meeting of L~[17!L'~ 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) __ Ist Day of Construction ($50.00) __ ~ Constructed ($50,00) __ Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) __ 30-Year Maintenance Agreement Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $. "7 ¢, O0 BY: James F. King, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town }tall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (63 I) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 10, 2013 the following recommendation was made: PHYLLIS SOHSA to Amend Wetland Permit #7928 to allow for a 6' extension to the permitted fixed dock to correspond to the dock structure permitted by the NYSDEC. Located: 1695 Mill Creek Dr., Southold. SCTM#51-6-32 The project was not staked, therefore no recommendation was made. S0othdd Town Board o ,lames F King, President Bob Ghosio. ,Ir, Vice-President Dave Bergen John Bredemeyer Michael J. Domino P.O. Box 1179 Southold, NY 11971 Telephone{631 765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: ~7~// o/2,3 Costello Marine Contracting Corp. on behalf of PHYLLIS SOUSA requests an Amendment to Wetland Permit #7928 for a 6' extension to construct a 4'x22' new fixed catwalk. Located: 1695 Mill Creek Drive, Southold. SCTM# 51-6-32 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 ~Administrative__Emergency Coastal Erosion Amendment Pre-Submission __Violation Info needed: Modifications: PrWt Were: ¢/J. King ,/~BB. Ghosio ~'D. Bergen, J. Bredemeyer l/Michael Domino D. Dzenkowski __ Form filled out in the field by Mailed/Faxed to: Date: other New York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 4~.~.-0352 Fax: (631) 444-0360 Website: ~ Joe Martens Commissioner March 18, 2013 Ms. Phyllis Sousa 1§2-01 Powells Cove Blvd. Whitestone, NY 11357 Re: Permit No.: 1-4738-03726/00002 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance dudng the term of the permit. If you are unable to comply with any conditions please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. JRP/Is ,. .... Sincerely, Jacqueline R. Pasquini Envi~nmental Analyst NEW YORK STATE DEPARTMF~F ENVIRONMENTAL CONSERVATIC~ Facility DEC ID 1-4738-03726 PERMIT Under the Environmental Conservation Law (ECL) Permittee and Facility Information Permit Issued To: PHYLLIS SOUSA 162-01 POWELLS COVE BLVD WH1TESTONE, NY 11357 (631) 744-5853 Facility: SOUSA PROPERTY 1695 W MILL CREEK DRISCTM#1000-51-06-32 SOUTHOLD, NY 11971 Facility Application Contact: COSTELLO MARINE CONTRACTING CORP PO BOX 2124 GREENPORT, NY 11944-2124 (631) 477-1199 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Southold Facility Principal Reference Point: NYTM-E: 717.062 NYTM-N: 4551.081 Latitude: 41°04'55.3" Longitude: 72024'57.5" Project Location: 1695 West Mill Creek Drive Authorized Activity: Replace existing catwalk, ramp and float. Install handrails on ramp. All authorized activities must be in strict conformance with the attached plans stamped NYSDEC approved on 3/18/13. (JRP) Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-03726/00002 New Permit Effective Date: 3/18/2013 Expiration Date: 3/18/2018 Excavation & Fill in Navigable Waters - Under Article 15, Title 5 Permit ID 1-4738-03726/00003 New Permit Effective Date: 3/18/2013 Expiration Date: 3/18/2018 Water Quality Certification - Under Section 401 - Clean Water Act Permit ID 1-4738-03726/00004 New Permit Effective Date: 3/18/2013 Expiration Date: 3/18/2018 Page 1 of 6 NEW YORK STATE DEPARTME~F ENVIRONMENTAL CONSERVATIOO Facility DEC ID 1-4738-03726 ~ NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: MARK CARRARA, DepUty Regional Permit Administrator Address: NYSDEC REGION I HEADQUARTERS SUNY ~ STONY BROOK[50 CIRCLE RD STONY BROOK, NY 11790 -3409 Authorized Signature: ~¢~ ~ Date ..~ / l 9 //.~ Distribution List COSTELLO MARINE CONTRACTING CORP Habitat - TW JACQUELINE R PASQUINI Permit Components NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS; EXCAVATION & FILL IN NAVIGABLE WATERS; WATER QUA !.ITY CERTIFICATION 1. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. 2. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Costello Marine Contracting Corp. last revised 2/18/13. 3. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. Page 2 of 6 NEW YORK STATE DEPARTME/~F ENVIRONMENTAL CONSERVATIO~ Facility DEC ID 1-4738-03726 4. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the' Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Depar~ent of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account &any such removal or alteration. s. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 6. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 7. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 8. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 9. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 10. Storage of Equipment, Materials The storage of construction equipment and materials shall be confined within the project work area and/or upland areas greater than 75 linear feet from the tidal wetland boundary. 11. Dock, Catwalk Size Dock or catwalk shall not exceed 4 feet in width and shall be a minimum of four feet above grade (as measured from ground to bottom of dock/catwalk decking) over tidal wetland areas. 12. Use of Treated Wood The use of wood treated with Pentachlorophenol or other wood treatment not specifically approved by the Department for use in wetlands and/or marine waters, is strictly prohibited in the construction of structures that will be in contact with tidal waters. Page 3 of 6 NEW YORK STATE DEPARTMEI'~IF ENVIRONMENTAL CONSERVATIO~ Facility DEC ID 1-4738-03726 13. No Floats, Ramps in Vegetated Tidal Wetlands Floats and ramps may not rest on or be stored in any vegetated tidal wetland. 14. Float Installation The float shall be installed only at the approved location with a minimum water depth of 2½ feet, measured at apparent low tide. is. No Prop Dredging Prop dredging, or the act of utilizing and/or directing the propeller or propulsion system of a motorized vessel and/or the water-borne forces created by said propeller or propulsion system, to excavate or displace existing bottom sediment and benthic habitat for the direct or indirect purpose of establishing or increasing water depth, is a regulated activity and is not authorized by this permit. Prop dredging is strictly prohibited without further written authorization (permit, modification or amendment) from the department. 16. No Permanent Structures on Dock No permanent structures shall be installed on dock/catwalk/float without first obtaining written Department approval (permit, modification, or amendment). 17. Docks at Property Lines Docks/catwalks/floats must not: a. extend laterally beyond property lines, b. interfere with navigation, or c. interfere with other landowners riparian rights. WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS L Water Quality Certification The NYS Depad~nent of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401 (3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. Page 4 of 6 · NEW YORK STATE DEPARTMENIF ENVIRONMENTAL CONSERVAT Facility DEC ID 1-.4738-03726 ~ A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Depa~hnent or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or Transfers The pemfittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOKI50 CIRCLE RD STONY BROOK, NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands, Excavation & Fill in Navigable Waters, Water Quality Certification. 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modificati6n, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. Page 5 of 6 NEW YORK STATE DEPARTMI~OF ENVIRONMENT AL CONSER VA TI(~ Facility DEC ID 1-4738-03726 NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless thc Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee~s Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, eppmvals, lands, casements and rights-of- way that may be required to can'y out thc activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Page 6 of 6 RETURN THIS FORM TO: COMPLIANCE Bureau of Habitat-TVV 50 Circle Road Stony Brook, NY 11790-3409 PERMIT NUMBER: PERMITTEE NAME & PROJECT ADDRESS: NOTICE OF COMMENCEMENT OF CON~TRUCTI N Or Fax to: 631-444-0297 ~ EXPIRATION DATE: CONTRACTOR NAME & ADDRESS: Dear Sir: .TELEPHONE: Pursuant to the special conditions of the referenced permit, you are hereby notified that the authorized activity shall COmmence on · We certify that we have read the referenced permit and approved plans and fully understand the authorized project and all permit conditions. We have inspected the project site and can complete the project as described in the permit and as depicted on the approved plans. We can do so in full COmpliance with all plan notes and permit conditions. The permit, permit sign, and approved plans will be available at the site for inspection in accordance with General Condition No. 1. (Both signatures required) PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS A T LEAST TWO DA YS PRIOR TO COMMENCEMENT OF THE PROJECT AND/OR ANYASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE THE PERMITAND APPROVED PLANS AVAILABLE AT THE WORK SITE FOR THE DURA TION OF THE PROJECT MA Y SUBJECT THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENAL TIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS. Cut alon..~..this line ~< ~= ~ ~ ~= NOTI~ ~ ~ RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-4.~d 0297 Bureau of Habitat- TW 50 Circle Road Stony Brook, NY 11790-3409 PERMIT NUMBER: PERMI'I-I'EE NAME & PROJECT ADDRESS: EXPIRATION DATE: CONTRACTOR NAME & ADDRESS: _TELEPHONE: Pursuant to special conditions of the referenced permit, you are hereby notified that the authorized activity was completed on · We have fully complied with the terms and conditions of the permit and approved plans. (Both signatures required) PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE, WITH PHOTOGRAPHS OF THE COMPLETED WORK AND/OR A COMPLETED SURVEY, AS APPROPRIATE, MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DA YS OF COMPLETION OF THE PROJECT. '1 95-20-1 (11~3)-9d New York State Department of Enwronmental Conservation NOTICE The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further infOrmation regarding the nature and extent of the approved work and any Department conditions applied to the approval, contact the Regional Permit Administrator listed below. Please refer to the permit nUmber shown when contacting the DEC. Permit Number Expiration Date ~0~O3~~,~..Regional Permit Administrator ROGER EVANS NOTE: This notice is NOT a permit COSTELLO MARINE CONTRACTING CORPORATION DOCK BUILDING · JETTIES · BULKHEADING · STEEL & WOOD PILING · FLOATS 423 FIFTH STREET · P.O. BOX 2124 · GREENPORT, NEW YORK 11944 · (631) 477-1199 / 477-1393 / 477-0682 · FAX (631) 477-0005 March 25, 2013 Southold Town Trustees PO Box 1179 Southold, NY 11971 RE: Sousa Property - 1695 Mill Creek Drive, Southold SCTM #1000-51-6-32 Dear Trustees: I am requesting an amendment to permit #7928 issued on 10/17/12 to allow a 6' extension to the permitted fixed dock structure to correspond to the dock structure permitted by the NYSDEC. This will allow the fixed dock portion to extend to the low water mark. I have enclosed the following for your review: Three copies of project plans showing the 6ft reduction · Copy of Town permit #7928 · Copy of DEC permit #1-4738-03726/00002 · Check #10185 in the amount of $50.00 If any additional information is needed, please do not hesitate to contact me. Permit Manager enclosures NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Southold, New York, concerning this property. by the Road, OWNER(S) OF RECORD."'~h~Jli.5 SUBJECT OF PUBLIC HEARING: An Amendment to Wetland Permit #7928 for a 6' extension to construct a 4'x22' new fixed catwalk. TIME & DATE O~F PUBLIC HEARING: If you have an in' ;resf fhis proiecf, you are invited fo view fhe Town file(s) which are available for inspecfion' pribr to'the day of the hearing during normaJ business days befween the hours of'8 a.m and 4 p.m, BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 ~ Sousa PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Charlotte M. Mullen Trust I James P. & Sharon Stack Willse DonaLd G. & Linda S. Price Kelly A. & Scott A. Hilary Address: P.O. Box 1408, Southald, NY 11971 P.O. Box 308, Mendham, NJ 07945 155 Beech Street, Floral Park, NY 11001 1620 Mill Creek Drive, Southald, NY 11971 STATE OF NEW YORK COUNTY OF SUFFOLK Jane P. Costello , residing at Costelio Marine Contracting Corp. PO Box 2124, Greenport, NY 11944 , being duly sworn, deposes and says that on the 9th day of April ,20 13 , 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 Greenport (11944) , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to ~fore me this Day of /"/lOrf/ ,26 (/ Notary Public LYNN E STEVENS No~"y Public- State of New York NO. 01 ST6269424 Qua~i~l in Suffolk County conmssion $1.12 $3.10 08 $2.5 R~r~ $6.77 James P. & Sharon Stack P.O. Box 308 Mendham, NJ 07945 postage Cer[ified Fee Return ReCeipt Fee (Endorsement Required) Res cted Delivery Fee (EndorSement Requ red) $6,31 Kelly A. & Scott A. Hilary ~ I 1620 Mill Creek Drive ~- t Southold, NY 11971 $ ~.66 $3,10 $2.55 $0.00 ...... $6.31 Charlotte M. Mullen Trust I P.O. Box 1408 Southold, NY 11971 0410912013 Postage ~.66 r~ Return Receipt Fee $2.5~ ' i'-1 (Endorsement Required) c~ ~3 Restricted Delivery Fee (Endorsement Required) $0,00 m .... $6.31 m F Donald G. & Linda S. Price I ~ ~ 155 Beech Street ................ t ~L Floral Park, NY 11001 ~ NOTICE TO ADJACENT PROPERTY OWNER BOARD ~)F TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: PHYLLIS SOUSA SCTM# 1000-51-6-32 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from. the Board of Trustees to: Remove exisang 5'x16' seasonal floating dock, 3'4"x!6'4" wooden ramp and existing 4'xl6' fixed catwalk. Construct new 4'x22' fixed catwalk in-place. Replace existing decking on wooden romp with untreated decking. Install handrails on rump and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor piling. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1695 MILL CREEK DRIVE, SOUTHOLD, NY 11971 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 &the Town Code is open to public comment on: April 17, 2013 at 5:30pm. 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. OWNERS NAME: Phyllis Sousa MAILING ADDRESS: 162-01 Powells Cove Blvd. Beechhurst, NY 11357 PHONE #: Enc: Copy of sketch or plan showing proposal for your convenience. (4w) 22' ~L James F. King. Prcsidcnl Bob Ghosio, Jr.. Vice-President Dave Bergen John Bredemeyer Michael J. Domino Iown Hall 53095 Main Rd. P.O. Box I 179 Southo[d, 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 PHYLLIS SOUSA COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER PO,¥TING REMAINS IN PLACE FOR EIGHT DAYS being duly sworn, de~o'~e and s~y: ' That ~ t~e l0 day of ~/~ ~ ,20~, 1 p~rsonally posted the property known as by placing the Board of Trustees of~c~al p~t~rwhere 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 Wednesday~ April 17~ 2013. Dated: Sworn to before me this /~'~tay of/'~ar~ / 20tg LYNN E STEVi~N$ Notary Public- Stat~ of New York NO. 015T6269424 -- Qualifiod in Sul'tblk County Comm~ion ][xpll~., 9 ~ Dq- o~01~ Phyllis SoL, sa Posting 4/10/13 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions' including Building Permits and other ministerial permits' not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", 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. Bo DESCRIPTION OF SITE AND PROPOSED ACTION 51 6 32 SCTM# 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. I ~ 0 E , ~ E ~! scl The Application has been submitted to (check appropriate respo Tow..oard [] Plan.i.g Dept. [3 .nil. lng Dept. MAR 2 9 2013 Southold Town Board of Board of Trustees lei Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Extend previously approved dock structure 6feet to allow the fixed dock to extend to the low water mark. This configuration will correspond to the dock permitted by the NYSDEC. Location of action: 1695 MILL CREEK DRIVE, SOUTHOLD Site acreage: 0.436 ACRES Present land use: SINGLE FAMILY RESIDENCE Present zoning classification: R-40 RESIDENTIAL LOW DENSITY AA 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: PHYLLIS SOUSA (b) Mailing address: 162-01 POWELLS COVE BLVD., BEECHHURST, NY 11357 (c) Telephone number: AreaCode ( )718.747.3717 (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? NYSDEC, NYSDOS, ACOE 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 ora coastal location, and minimizes adverse effects of development. See LWRP Section II1 - Policies; Page 2 for evaluation criteria. [~Yes [~ No [~ Not Applicable The project site had previously had a similar docl~ structure to what we are proposlng. The dock is relatively small and consistent with neighboring docks. Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section lll- Policies Pages 3 through 6 for evaluation criteria [~ Yes I~ No [~1 Not Applicable This property has no significant historic resources. Atiach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~] Yes ~ No ~'] Not Applicable Our proposal will not have any significant effect on the visual quality or scenic resources throughout the Town of Southold. At~ach additional sheets it'necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section 11I - Policies Pages 8 through 16 for evaluation criteria ~ Yes ['~ No ~] Not Applicable Our project will not influence the flooding or erosion in the area. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ~ Yes ~ No ~Not Applicable The proposal will not have any impact on the water quality or supply of the Town of SoutholtL Attach additional sheets il' necessary Policy 6. Protect and restore the quality and function of the Town of Southoid ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. [l~ Yes [~No[~ Not Applicable This proposal will have minimal impact on the Town of Southold's ecosystem during the initial constructiorr Once construction is complete the area with re-establish itself immediately. 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 This proposal will not have any impact on the air quality of the Town of Southold. 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 Ill - Policies; Pages 34 through 38 for evaluation criteria. [-~Yes [~ No ~ Not Applicable This proposal will not degrade the environment with solid waste or hazardous substances. 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 L'vVRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~ Yell No~-'] Not Applicable Our proposal will not limit the public's ability to access coastal waters, public lands or public resources of the TownofSouthobl Theproposedis 6ftlongthanthepreviouslypermittedandpreviouslyconstructed structure. The additional 6fl to ensure that the floating dock will not rest on bottom during low tides. The overall size of the dock is still small and reasonable and consistent with the surrounding area. 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 The previously existing dock structure was in disrepair. The property owner removed the structure not realizing that negates the Grandfather perm& The property owner would like to reconstruct the dock ,structure so that her family can continue to use the property to engage in water-dependent activities such as fishing and swimming. These activities will continue at the site once construction is complete. 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 Ill - Policies; Pages 57 through 62 for evaluation criteria. ~] Yes ~ No ~'] Not Applicable here should be no significant effects on the living marine resources. We will adhere to all Best Management Practices to ensure that the project is not staged, construction materials and equipment will be stored upland and all debris will be contained so ensure it does not enter the waterway. The construction of the dock will take a few days and any underwater lands disturbed during construction will immediately re-establish itself. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section Ill - Policies; Pages 62 through 65 for evaluation criteria. ~l Yes [~ No~'] Not Applicable This proposal will have no impact on the agricultural lands in the Town of Southola~ Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III- Policies; Pages 65 through 68 for evaluation criteria. Yes [~ No [~ Not Applicable This proposal has no influence on the development of energy or mineral resources. Created on 5/25/05 11.'20 AM 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 October 17, 2012 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Jane P. Costello Costello Madne Contracting Corp. PO Box 2124 Greenport, NY 11944 RE: PHYLLIS SOUSA 1695 MILL CREEK DRIVE, SOUTHOLD SCTM# 51-6-32 Dear Ms. Costello: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, October 17, 2012 regarding the above matter: WHEREAS, Costello Madne Contracting Corp. on behalf of PHYLLIS SOUSA 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 August 22, 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 Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: to establish and subsequently maintain a non-turf buffer from top of bank to water; and, WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on October 17, 2012, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 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 PHYLLIS SOUSA to remove the existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in-place; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings; with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water; and as depicted on the site plan prepared by Costello Marine Contracting Corp., last dated July 23, 2012, and stamped approved on October 17, 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: $ 746.00 Very truly yours, ,lames F. Kin§ President, Board of Trustees JFK/amn BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7928 DATE: OCTOBER 17 2012 ISSUED TO: PHYLLIS SOUSA PROPERTY ADDRESS: ,1695 MILL CREEK DRIVE~ SOUTHOLD SCTM# 51-6-32 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 October 17 2012, and in consideration of application fee in the sum of $.500 00 paid by Costello Marine Contractine Corp. 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 remove the existing 5'x16' seasonal floating dock, 3'4'x16'4' wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in- place; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings; with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water; and as depicted on the site plan prepared by Costello Marine Contracting Corp., last dated July 23, 2012, and stamped approved on October 17, 2012. 1N 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. John P, radom~- Ah~mn~. TERMS AND CONDITIONS The Permittee Phyllis Sousa, residing at 1695 Mill Cmelq Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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. 7. 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 Trustecs, 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. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject pm'eel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. James F. King, President Bob Ghosio, Jr., Vic~President Dave Bergen John Brede~ncyer Michael $. Domino BOARD OF TOWN TRUSTEES TOWN OF SOU'FHOLD 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 Ist day of construction __ ~ constructed Project complete, compliance inspection James F. King, President Bob Ghosio, Jr., Vies-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 ,gout, hold, New York 1197141959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Trustee Matters Storm Water Runoff With the recent heavy rainfalls, we are reminded once again of the problems Southold Town has with storm water runoff. With over 100 road ends terminating at creeks, bays, inlets, or Long Island Sound, as well as all of the lawns and homes lining our miles of shoreline, lO0's of thousahds of gallons of storm water runoffenters our wetlands every year. Carrying sediment that prevents sunlight fi.om reaching aquatic plants, nutrients from animal waste and lawn fertilizers that promote algae blooms detrimental to shellfish, and bacteria and other biologicais that in high doses can be harmful to swimmers, storm water runoffis one of the Trustees main public safety concerns. So important, in fact, that Southold has a Storm Water Management Code. Southold Town's Chapter 236 provides an outline for how people need to deal with storm water runoff from their properties. For example, new construction or renovation is required to contain any potential runoffto the wetlands fi.om the construction by installing hay bales and silt fencing. This acts as a barrier and keeps our wetlands clean. Another example in Chapter 236 is that every building must have provisions to collect and disperse, ON-SITE, at least a 2 inch rainfall. This is usually handled by installing gutters, leaders and drywells to the home. The Trustees also have a standing policy of requiring pervious non-turf buffers along bulkheads and at tops of bluffs that help keep run off from entering the wetlands and prevents erosion to bluffs. These are important measures to keep our wetlands safe and clean! Before deciding to renovate or build, the Town Trustees urge you to check our wehsite and the other department's websites to make sure what you are planning to do meet the Town's Codes. These codes have been developed for the good of all citizens. And the wildlife all around us too! ./ /,/2 '4 SOUT'HOLD TRUS Issued To-~/.~~.~~~ Date..~ Address THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF .SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-'1892 Satnes F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredcmeyer Michael J. Domino Town Hall, 53095 M~,n Rd. P.O. Box 1179 $outhold, NY l 1971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line Ist day of construction ~ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7928 DATE: OCTOBER 17~ 2012 ISSUED TO: PHYLLIS SOUSA PROPERTY ADDRESS: 1695 MILL CREEK DRIVE~ SOUTHOLD SCTM# 51-6-32 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 October 17, 2012, and in consideration of application fee in the sum of $500.0Q paid by Costello Marine Contracting Corp. 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 remove the existing 5'x16' seasonal floating dock, 3'4'x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in- place; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings; with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water; and as depicted on the site plan prepared by Costello Marine Contracting Corp., last dated July 23, 2012, and stamped approved on October 17, 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. TERMS AND CONDITIONS The Permittee Phyllis Sousa, residing at 1695 Mill Creek, Southold, 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. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between 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. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the compl~ion of the work authorized. 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. 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 October 17, 2012 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Jane P. Costello Costello Madne Contracting Corp. PO Box 2124 Greenport, NY 11944 RE: PHYLLIS SOUSA 1695 MILL CREEK DRIVE, SOUTHOLD SCTM# 51-6-32 Dear Ms. Costello: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 17, 2012 regarding the above matter: WHEREAS, Costello Marine Contracting Corp. on behalf of PHYLLIS SOUSA 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 August 22, 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 Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: to establish and subsequently maintain a non-turf buffer from top of bank to water; and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 17, 2012, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 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 PHYLLIS SOUSA to remove the existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in-place; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings; with the condition of establishing and subsequently maintaining a non-turf buffer from top of bank to water; and as depicted on the site plan prepared by Costello Marine Contracting Corp., last dated July 23, 2012, and stamped approved on October 17, 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: $ 746.00 .~Very truly yours, James F. King President, Board of Trustees JFK/amn James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated?,/2Z-//2~ , ~ has been · - ~ ~ and reviewed by this Board at the regular meebng ofID 117117.- your application has been approved pending the complefiofi Of [he following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ Ist Day of Construction ($50.00) __ ½ Constructed ($50.00) t/ 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 m-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: ' TOTAL FEES DUE: $ '7. ~.r~ ~q (~ · BY: James F. King, President Board of Trustees Michael .I. Domino PO Box 1179 Southold, NY 1197I Telephone (631 765 - 1892 Fax (63 l) 765-6641 Date/Time: Southold Town Board of Trustees Field Inspection/Worksession Report Costello Marine Contracting Corp. on behalf of PHYLLIS SOUSA requests a Wetland Permit to remove the existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in-place; replace existing decking on wooden ramp win untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings. Located: 1695 Mill Creek Drive, Southold. SCTM# 51-6-32 ¢~salOf area to be impacted: twater Wetland Freshwater Wetland Sound Bay fce of proposed work to edge of wetland Town Code proposed work fa s under' __Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Administrative__Emergency __ Coastal Erosion Pre-Submission __Amendment Violation Info needed: Modifications: Conditions: Pres/e~rtWere: /'/J. Kin /'B Ghosio ~ /J. Bredemeyer 7Michael Domino- D. Bergen, D. Dzenkowski Form filled out in the field by Mailed/Faxed to: Date: other Peter Young, Chairmm~ Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., September 12, 2012 the following recommendation was made: Moved by Doug Hardy, seconded by John Stein, to TABLE the Wetland Permit application of PHYLLIS SOUSA to remove existing 5'X 16' seasonal floating dock, 3'4"X 16'4" wooden ramp and existing 4'X 16' fixed dock; construct new 4'X16' fixed catwalk in- place; replace existing decking on wooden ramp with untreated decking; install handrails on ramp and reinstall onto a new 6'X 30' seasonal floating dock secured by two 8" dia. anchor pilings. Located: 1695 Mill Creek Dr., Southold. SCTM#51-6-32 Inspected by: Peter Young, Doug Hardy, John Stein The CAC Tables the application based on the following observations: Did not appear to be a Notice of Hearing sign posted as of 9/12/12; The dock was not staked; The construction of the dock was started; There is a steep erosion problem in the area of the sensitive grasses and phragmites located along the right side of the dock; and The downspouts should lead into drywells. Vote of Council: Ayes: All Motion Carried James F Krug, President Bob Ghosio, ,Ir. Vice-President Dave Bergen John Bredemeyer Michael J. Domino P O Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: /~//~/I~L Costello Marine Contracting Corp. on behalf of PHYLLIS SOUSA requests a Wetland Permit to remove the existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in-place; replace existing decking on wooden ramp win untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings. Located: 1695 Mill Creek Drive, Southold. SCTM# 51-6-32 ,..T~e of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay © Distance of proposed work to edge of wetland P/ad'of Town Code proposed work falls under:' __Chapt.275 Chap.~, 111 other Type of Application: __ Wetland __Coastal Erosion __Administrative__Emergency Pre-Submission __ Amendment Violation Info needed: Modifications: Conditions: .,f"~_~f ¢/( ~_ ~ oz- /~/ ~ / Present Were: /J.~ng B. Ghosio /J. Bredemeyer/ Michael Domino __ D. Bergen, D. Dzenkowski other Form filled out in. the fi.eld by Mailed/Faxed to: Date: Pl2yIlis $ous~ 7/I6/12 Phyllis Sousa 7/16/12 tl ort athm Pumuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of tho Laws of the State of New York 1952; and the Southo~d Town Ordinance en- titled "REGULATING AND THE PLA~IN~ OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and ~e REMOVAL OF SAND, G~VEL OR'OTHER MATERIA~ FROM ~NDS UNDER TOWN WA~RS;" e~ in ecc~dance wi~ the Resolution of The Board adopted at a meeting held on~Y .~.~.~ ...... 19.~...., end in consideration ~ the sum of ~ ~.~ ...... pald by of ..~ ................ N.Y. ~nd ~ubject to the Terms and Condition~ listed on the reverse side hereof, of Southold Town Trustees eu~orizes end permits the fol~wlng: Please tear off and z~curn to the T~ ',/stee Office. Board Of SoUth°Id'Town Trustees Mooring permit No. ~oor ing No. I, SOUTHOLD, NEW YORK Date: certify that the work as authorized in this permit has been completed and is now ready for your inspection. Also, the number required on this project is clearly visible. I further understand this permit is not valid until this tear off sheet is returned to the Trustee Office. BOARD OF TO~'N TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 GRANDFATHER APPLICATION 1. Name of Applicant: 2. Adarsss of mppli a.t: 3. Telephone Number: Sketch of ~he work ~nelu ng 6. Mark off on the map attached, where your property is located using an X. / Please note that thor is a $5.00 filing fee, which is a one time fee, for this application. Mooring Applications- $5.00 Application Fee and a $§.00 annual renewal fee each year. James F King, President Bob Ghos/o. Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino PO Box 1179 Southold, NY 11971 Telcphone(631 765-1892 Fax (631)76%6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: PHYLLIS SOUSA requests a Transfer of Wetland Permit #2168 from Audrey H. Baker to Phyllis Sousa, as issued on July 31, 1986. Located: 1695 Mill Creek Dr., Southold. SCTM#51-6-32 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland 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 __Administrative__Emergency Info needed: Sound Bay __Coastal Erosion __Amendment Pre-Submission __Violation Modifications: Conditions: Present Were: __J. King __B. Ghosio __ d. Bredemeyer Michael Domino Form filled out in the field by D. Bergen, D. Dzenkowski other Mailed/Faxed to: Date: Board Of $outhold Town Trustees Pu~uant to the prov s OhS of ~hapter 615 of the Slate of New York. 1893; and ~apter ~ of the Laws of the State of New Yor~ 19~2 and ~e Southo~d Town Ordnance rifled "RE~U~TIN~ AND ~E P~CIN~ OF OBSTRUCT ONS IN ~ND ON TOW~ WA~S AND PU~UC L~NDS REMOVAL OF SAND, ~RAVEL OR 'OTHER ~ATERIALS FROM adopted ef · meeting held on Resolution of The Board Terms end Condlfion~ listed on the reverse side hereof, of Sou~old Town Trustees authorizes and permits the following' sub.~tted ~nder the Grandfather CZ~u.e. the orlg;nnfing ,ppllc,t on. IN WITNESS WHEREOF ~e. d Board of Trustees ~re- ~ "bs~by" me'°';~ °f 'h~°eL"~ Please tear off and return to the T~stee Office. Board Of Southold'Town Trustees ~oorlng Permit NO. Mooring No. SOUTHOLD, NEW YORK Date: Z, certify that the work as authorized in this permit has been completed and is now ready for your inspection. Also, the number required on this project is clearly visible. I further understand this permit is not valid until this tear off sheet is returned to the Trustee Office. JUL - 2 2012 Southhold Towa Board of Trustees Name- of Creek: 1. Name of Applicant: 2. Address of Applicant: 3. Telephone Number: 4. Year of Construction: 5. Sketch of the work inclu ng sizes: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road ..o..ox728 Southold, New York 11971 "/ ~ / 6. Mark off on the map attached, where your property is located Signature: ["~/~.~ ~/0~~ .~ Please note thau the~is a $5. 0 filing fee, which is a one time Mooring Applicatious- $5.00 Application Fee and a $5.00 annual renewal fee each year. OFHCE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator OCT 16 2012 Date: September 19, 2012 Re: Proposed Wetland Permit for PHYLLIS SOUSA SCTM#1000-51-6-32 Costello Marine Contracting Corp. on behalf of PHYLLIS SOUSA requests a Wetland Permit to remove the existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk; construct new 4'x16' fixed catwalk in-place; replace existing decking on wooden ramp win untreated decking; install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor pilings. Located: 1695 Mill Creek Drive, Southold. SCTM# 51-6-32 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 denoted following Policy Standards and therefore is INCONSISTENT with the LWRP: 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 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions The structures were under construction without a permit pursuant to Chapter 275 Wetlands and Shorelines of the Southold Town Code. Additionally, if the action is approved and to further Policy 4.2 Protect and restore natural protective features and Policy 6; it is recommended that natural vegetated buffer incorporating existing vegetation landward of the top of bank be required. An example definition follows: NATURAL VEGETATED BUFFER -- a land area of a certain length and width where existing vegetation occurs prior to the commencement of any grading or clearing activity. Vegetation shall be maintained to achieve a minimum percent ground cover of ninety-five (95) percent. To achieve the percent ground cover indigenous, drought tolerant vegetation shall be planted. Survival of planted vegetation shall be (ninety) 90 percent for a period of three (3) years. Maintenance activities within the buffer are limited to removing vegetation which are hazardous to life and property, trimming tree limbs up to a height of fifteen feet (15') to maintain viewsheds, replanting of vegetation and establishing a four foot (4') wide access path constructed of pervious material for access to the water-body. 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 AUG 2 2 20]2 Office Use Only ~Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendmanl/Transt~er/Ex[ension Rece~-ved Applicafi on :~LLT~J/~ Received Fee:$ ~-~) 0 t, __Completed Application __Incomplete __SEQRA Classification: Type I Type I1 Unlisted Coordination:(date sent) ~LWRP Consistency Assessment Form __CAC Referral Sent: __Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~Public Hearing Held: q /]~ ]12_ __Resolution: t Name of Applicant PHYLLIS SOUSA Address 162-01 POWELLS COVE BLVD., BEECHHURST, NY 11357 Phone Number:( ) 718.747.3717 Suffolk County Tax Map Number: 1000 - 51-6-32 Property Location: 1695 MILL CREEK DRIVE. SOUTHOLD (provide LILCO Pole #, distance to cross streets, and location) AGENT: COSTELLO MARINE CONTRACTING CORP. (If applicable) Address: PO BOX 21~.4, GREENPORT, NY 11944 Phone: 631.477.1199 of Trustees Application GENERAL DATA Land Area (in square feet):0'436 R-40 RESIDENTIAL LOW DENSITY AA Area Zoning:. SINGLE FAMILY RESIDENCE Previous use of property: SAME Intended use of property: Covenants and Restrictions: Yes X No lf"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Prior permits/approvals for site improvements: Agency Date Southold Town Trustees #2168 ?/31/86 Yes X No __ 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): Remove existing 5'x16' seaaooal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' lined catwalk. Construct new 4'x16' fixed catwalk in-place. Replace existing docking on wooden ramp with untreated decking. Install handrails on ramp and reinstall onto a new 6'xZ0' seasonal floating dock secured by two 8" diameter anchor piling. of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To reconstruct previously existing dock. Area of wetlands on lot: 0 _square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: 0 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? 0 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 0 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): There are no vegetative wetlands on the project site. All debris will be properly contained to ensure that it does not enter the waterway. 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by A~pllcant or Project Sponsor) 1. APPLICANT/SPONSOR 12. PROJECT NAME PHYLLIS SOUSA ] DOCK RECONSTRUCTION 3. PROJECT LOCATION: Municipal~ SOUTHOLD County SUFFOLK 4. PRECISE LOCATION (Street address and mad Intersections, prominent landmarks, etc., or provide map) 1695 MILL CRI~EK DRIVE, SOUTHOLD, NY 11971 SCTM #1000-51-6-32 LAT/LONG: N:41.087./W:72.416 5. PROPOSED ACTION IS: [] New [] F-xpansio. [] Modmcation/alteratiorl 6. DESCRIBE PROJECT BRIEFLY: Remove existing 5'x16' seasonal floating dock; 3'4"x16'4" wooden ramp and existing 4'x16' fLxed catwalk. Construct new 4'x16' catwalk. Replace existing decking on wooden ramp with untreated decking. Install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor piling. 7. AMOUNTOF LAND AFFECTED: InRialiy 0 acres Ultimately 0 acres 8. VVlLL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No If No, describe brief;y 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Des~3e~:Residential [] IrxJuindal [] Commercial PRIVATE:RESIDENTIAL WATERFRONT [] Agriculture [] Park/Forest/Open Space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOC~d.)? [] Yes [] No If Yes, list agency(s) name and permit/approvals: ARMY CORPS OF ENGINEERS, NYSDOS, NYSDEC, 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 permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMiT/APPROVAL REQUIRE MODIFICATION? [] Yes [] No I Cl::~¥il- y THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE -- Aoplicent/spensor name: . PHYLLIS SOUSA, OWNER Signature: ~ I If the action is in the Coastel Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this =__=_=__~_ment I OVER 1 PART II- iMPACT A$$~_$~M~_NT (T~ be completed by L~d Agent) ~ A. ~ES AC~ON ~CEED ~Y ~E I ~RESHO~ IN 6 NYCRR, P~T 617.47 if ~, ~ ~ ~ ~ a~ ~ ~ FULL ~F. B. ~LL ACTION REC~ C~DI~D R~I~ ~ ~DED FOR U~US~D ACTI~S IN 6 ~CRR, P~T 617.~ If No, a ~afl~ ~Y. ~No C. COULD ~TION RESULT IN ~Y ~RSE EFFECTS ~D ~ THE FO~: (~m ~ ~ ~n, B I~) C1. ~ ~r ~1~, s~ or ~ que~ ~ qua~, n~ ~, ~fi~ ~ pa~, sol~ ~ p~on or ~1, ~1 ~ e~n, drayage ~ flowing pm~? ~aln ~efly: C2. AestheUc, agdcuituml, arcbaeolngicaJ, tdstoric, or o~er natural or cultural resources; or community or neigWondlond c~amcter? Explain briefly: C3. Vegetationorfauna, fish, shellflshorwilclltfespectes slgniflcanthabitats or thmatened or endangered species ,-,-~..,,' ~ C4. A communi~s e~ing plan~ or guels a~ officially a~, or a change in use or intensity of use of ~ or ~ ~ ~? ~n b~Y: C5. Grow~, subsequent development, or related activities likely to b~ induced by ttm proposed action? Explain briefly:. C8. Longterm,$hortte~m, cumulatlve, orothereff~ct~snoticlen0fledinCl-C5? F_~ainbriefly:, C7. Othefin~uec{s (inclnding changesin useofellflorquentityor t~eofene~gy)? F-_.xplain bileS. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? E~yes C~Nc E. IS THERE, OR I$ THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? E]Yes [] No If Yes, explain bdefly: PART III - [~. i m~MINATION OF SIGNIFICANCE (1'o be comph~ed I~ Agency) IN~TRuc'noNs: Fore,oft adveme effect identified above, determinewhelt~r it is substantial, large, important or otherwise significant. Each eff~ should be esse~___~e~_ in connec~on t~4th its (a) setting (i.e. urban o~ rural); (b) pmbabiifiy of occurring; (c) duration; (d) irrevemibility; (e) geographic sco~e; and (fl magnitude. If nec~____~_ry, add attachments or reference supporting mate~als. Ensure that explanations contain sufficient detail to show that all rMevant adverse impa~ have been identified and adequately addresesd. If queatinn D of Part II wes checked yes, the determinatic~ of significance must ev~4~ate fine potential impact of the proposed action on fine enWonmental characteristics of the CEA. EAF and/or prepare a postltve deciaratico. [] Ct~sckthls boxif you nd~ de~miued, based co the infon'naUon and analysis above and any supporting documentation,lbat the prolx~,ed action WIL ' NOT result in any significant acIwfse eflvln~mental Impacts AND provide, on attachments as neuessal'y, the reascos suppolting this determination. Pllnt or Type N~ne ~ Re~ O~cet In Le~d A~ency signature o1 ResP°mll~e Officer in ~ ,~geney Signature of Preparer (If Oilf~ent from mmible otl~a') PART II - IMPACT ASSESSMENT ~o be completed by Lead A~lency) 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. i'-I I?-I No B. WILL ,~CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative d~larafio~ may be euperse(lad by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be haadw~tte~, if legible) C1. F_~s~lg ak quality, surface o~' greundwaler qualif~ or quantity, noise levels, existing traffic pattern, solid waste praduction or disposal, potential for erosion, drainage or itooding problems? Explain b~lefly: I / C2. Ltheito, agricultural, archaeological, h~stoHc, o~' other natural or cultural resources; or ~oremun~ or neighbored ~ara~e~ E.~ain b~ey: C$. Ve§eteiton or fauna, ~h~ ~etl~h or ~ildlif~ ~poctos, siO~ificant belgie, or thmalenod or ~den~*red a~? ~lsin briefly: C4. ! commuolty's existing iflans or goais as officiafl¥ adopted, or a chaoge in use or hl~er~sity (~ use of land or other natural reso~J~'ces? Explain bdeflY: I .. 1 I ................ . I C6. Loag term, short term, c~Jmulaflve, or other effects not identified in C1-C57 Explain briefly: C7. Other impact~ {im:tuding chan~e~ in use et either quantit~ or typo et D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEA~? IIf yesl explain briefly: F_ IS THERE, OR IS THERE LIKELY TO B~I CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If )~es ex,)lain: PART II1 - DI=! IERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadvereee~ectidenti~ed~b~ve~determirtewhetherttissubstenbe~arge~imp~r[ant~r~the~isesignific~nL Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibi[r~y; (e) geographic scope; end (0 magnitude. If necessary, add attachments or referenda supporting materials. Ensure that explanations ~ofltein sufficient detail to show that all relevant adverse impacts have been identified and adequately a~draseed. If question d of par[ ii was checi(ed ~.s. the determination of algnttican~e must evaluate the potential impact of the preposed action ee the environmental characteristics of the CEA. Ghe~ this bex If you ~ve identifiad one or more polefiti~y I~ge o~ eigeiflcent adverse impacts which NIAy occur. The~ proceed dirac~y to the FUL EAF ar~d/ot' prepare a positive declaraticu. Check ~ bex if yeu have deleraflnad, based on the Informaiion and analysis above end any suppor~ docume~tsiion, that the proposed acrid WILL NOT result in any slgni~cant adveme environmental Impacts AND provide, on attachme~s as necessen/, the teaser,s supporting thl determination. Board of Trustees Name of Lead Ager~-~y Print or Type Name of Responsible Office~ in Lead Agency Date President [] Title of Responoible Officer Signature of Preparer (If different from respoRsible officer) .lames F. King, President Bob Ghosio. Jr.. Vice-President [)ave Bergen John Brcdcmeyer Michael J. Domino Town I lalh 53095 Main Rd. P.O. Box 1179 Southold. NY 11971 '1 elephone (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 PHYLLIS SOUSA -) COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING L Jtlll~'~'l'l'~.'-/~.I(~ . residing at /dba doe~l~o being duly swo~, depose an8 say: That on the day of . ,201 , I personally posted the property known as /& q~ Mdl freei5 l)rjVr . ~5tt~.H,t~l,a/; ,~ly I/~71 by placing the B0af-d of Trt~stees"~f'fic-ial poster where it can easily be seen, and that I have checked to be sure the poster has remained in place fbr eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesda% September 19, 2012. Dated: Sworn to before me this No. 01GE6245154 Q~Jsllfled ir',,,Sutfo k County CoffimJssjon Fxprres JuJy 18, ~0 Phyllis Sousa 9/11/12 Name: PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: Charlotte M. Mullen Trust I P.O. Box 1408, Southold, NY 11971 Jalne~ P. & Sharon Stack Willse P.O. Box 308, Mendlmm, NJ 07945 Donald G. & Linda S. Price 155 Beech Street, Floral Park, NY 11001 Kefly A. & Scott A. Hilary 1620 Mill Creek Drive, Southold, NY 11971 STATE OF NEW YORK COUNTY OF SUFFOLK PO Box 2124, Greenport, NY 11944 7th day of September , residing at Costello Marine Contracting Corp. , being duly sworn, deposes and says that on the ,2012 , deponent mailed a true copy of the Notice Day of ' .<~94E~ ~3.e/ , 20 tT-~ Sworn to before me this t'746~ 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 Greenlmrt 01944) ., that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. James P. & Sharon Stack Willse P.O. Box 308 Mendham, NJ 07945 C~AL ~· [ Charlotte M. Mullen Trust I - I t r P.o. ~ox ~4o~ ................. r,- i:...SouthoId, NY 1"197'1 ................. Kelly A. & Scott A. Hilary " 1620 Mill Creek Drive Southold, NY 11.971 Postage Cedified Fee Return Receip Fe Efldorsement Require~ ResMcted Delivel~ Fe (Endorsement Requlre~ Postmark Here Donald G. & Linda S. Price ~ Z55 Beech Street ................. f Floral Park, NY 1:[00! ................. NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: PHYLLIS SOUSA SCTM# 1000-51-6-32 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Remove existing 5'x16' seasonal floating dock, 3'4"x16'4" wooden ramp and existing 4'x16' fixed catwalk. Construct new 4'x16' fixed catwalk in-place. Replace existing deeking on wooden ramp with untreated deeking. Install handrails on ramp and r~lastall onto a new $'x20' seasonal flonting dock setn~nl by two 8" diameter anchor piling. That the property which is the subject of Environmental Review is located adjacent to your properly and is described as follows: 1695 MILL CREEK DRIVE, SOUTHOLD, NY 11971 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: September 19, 2012 at 6p~. 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. OWNERS NAME: Phyllis Sousa MAILING ADDRESS: 162-01 Powells Cove Blvd. Beechhurst, NY 11357 PHONE #: Enc: Copy of sketch or plan showing proposal for your convenience. /C,,," /..,iT.." '4, .1 o£ Trustees Appl~cat~.on County of Suffolk State of New York Jane P. Costello for Costello Marine Contacting Corp. BEING DULY SWORN DEPOSES AND AFFIRMS THAT HF_ffSI-IE 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. y Signature SWORN TO BEFORE ME THIS I ~i4~ DAY OF ~L/t2LI;~ ,20 12- Notar~ Pub~ -- .No. 01GE62451~4 u /18, o(5 COSTELLO MARINE CONTRACTING CORPORATION DOCK BUILDING · JETTIES · BULKHEADING · STEEL & WOOD pILING .- FLOATS 423 FIFTH STREET · RO. BOX2124 · GREENPORT, NEW YORK 11944 · (631) 477-1199/477-1393/477-0682 · FAX (631) 477-0005 AUTHORIZATION FORM ow,er of /~'q~ th;l[ <:C..~.. Pr', '~' (Business/Property Name) located at .~.,v-z.t.~t...~ ~..t(.~/_ , itt, q 'Tt' , do hereby give Costello Marine Contracting Corp. the author/ty to act as agent in my behalf in applying for all the necessary permits for work to be completed at my above referenced property. Town of Southoid Pu INSTRUCTIONS LWRP CONSISTENCY ASSESSMENT FORM AUg 2 2 All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", 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 51 6 32 SCTM# The Application has been submitted to (check appropriate response): Town Board ['--] Planning Dept. [--'] Building Dept. [--] Board of Trustees ~ Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) [---] (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Remove existing 5 'x16' seasonal floating dock, 3 '4 "xl 6 '4" wooden ramp and existing 4 'x16' Fured catwalk. Construct new 4 'x16' fixed catwalk in-place. Replace existing decMng on wooden ramp with untreated decking. Install handrails on ramp and reinstall onto a new 6'x20' seasonal floating dock secured by two 8" diameter anchor piling. Location of action: 1695 MILL CREEK DRIVE, SOUTHOLD Site acreage: 0.436 ACRES Present land use: SINGLE FAMILY RESIDENCE Present zoning classification: R-40 RESIDENTIAL LOW DENSITY AA 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: PHYLLIS SOUSA (b) Mailing address: 162-01 POWELLS COVE BLVD., BEECHHURST, NY 11357 (c) Telephone number: Area Code ( )718.747.3717 (d) Application number, if any: Will the action be directly undertaken, require fi~nding, or approval by a state or federal agency? Yes ['~ No N If yes, which state or federal agency? NYSDEC, NYSDOS, ACnE DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient usc 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 The project site had previously had a similar dock structure to what we are proposing. The dock is reIatively small and consistent with neighboring docks. Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~ Yes ~'] No ~'] Not Applicable This property has no significant historic resources. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. Sec LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [] Yes ~ No [] Not Applicable Our proposal wlll not have any significant effect on the visual quali~y or scenic resources throughout the Town of Southold. 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 Our project will not influence the flooding or erosion in the area, Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ~ Yes [-~ No ~Not Applicable The proposal will not have any impact on the water quailO, or supply of the Town of Southold. 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 Applicable This proposal will not have any impact on the Town of Southold's ecosystem. Ali work will take place landward of the high water line and all construction debris will be contained. 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 This proposal will not have &ny impact on the ~r quali(y of the Town of Southold. Attach additional sheets if necessary Policy 8. Minimi~.e environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section IH - Policies; Pages 34 through 38 for evaluation criteria. [--]Yes [--] No [~ Not Applicable This proposal will not degrade the environment with solid waste or h~urdous substances. 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. ~] Ye~ No~'] Not Applicable Our proposal will not limit the public's abili(y to access coastM waters, public lands or public resources of the Town of Southold. The proposed is similar In size to the previously existing structure. 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 The previously existing dock structure was in disretmir. The property owner removed the structure not realizing that negates the Grandfatherpermit. The property owner wouldlike to reconstruct the dock structure so that her family can continue to use the property to engage in water-dependent activities such as fishing and swimming. These activities will continue at the site once construction is complete. 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 Ill - Policies; Pages 57 through 62 for evaluation criteria. [-'~Yes ["-] No~-] Not Applicable There should be no significant effects on the living marine resources. We will adhere to MI Best Management Practices to ensure that the project is not staged, construction materials and equipment will be stored upland and MI debris will be contained so ensure it does not enter the waterway. The construction of the dock will take a few days and any underwater lands disturbed during construction will immediately re-establish itself. 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 This proposal wtll have no impact on the agHcuitural lands in the Town of Southold. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [] Yes ~ No [~ Not Applicable This proposai has no influence on the development of energy or mineral resources. Created on 5/25/05 ll.'20AM James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P.O. BOx 1179 Southald, New York 11971-0959 Tele' ,hone (631) 765-1892 - 2 2012 ~ Board of Trustees APPLICATION FOR A TRANSFER OF A WETLAND PERMIT DATE ~/~//~)'-, OWER ADDRESS 5'/7 g65' AGENT PHONE PROPERTY LOCATION TAX MAP NO. -~- Signed By: request a Transfer of Permit ~/~r +o ~o~_¥//i Lic~ No. 49668 Joseph A. In§egno Land Surveyor T~tle Su~eys -- Subdivisions Site Plans -- Conslruction Layout PHONE (651)727-2090 Fax (6.31)727-1727 OFFICES LOCATED AT MAIUN~ ~DRESS 322 RO~OKE AVENUE P.O. Box 19.31 \ \ \ \ \ ,.% THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, tF SURVEY OF PROPERTY SlTUA TED A T ARSHAMOMAQUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-51-06-32 SCALE 1"--30' NOVEMBER 2, 2005 AREA : 18,975.95 sq. ff. (TO TIE LINE) 0.436 OC. CERTIFIED TO: PHYLLIS SOUSA BETTY RUGG PECONIC ABSTRACT, INC. FIRST AMERICAN TITLE INSURANCE COMPANY OF J. P. MORGAN CHASE BANK, N. A. NEW Y '4.