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TR-8065
Michael J.Domino,President O��QF SOUj' Town Hall Annex John M.Bredemeyer III,Vice-President O 54375 Route 25 Charles J.SandersJi P.O.Box 1179 Southold,New York 11971 Glenn Goldsmith Q Telephone(631) 765-1892 A.Nicholas Kru ski Fax(631) 765-6641 p 1y�00NT`I � BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 20, 2017 Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: BRENDAN & KRISTINA TULLY 220 WEST SHORE DRIVE, SOUTHOLD SCTM# 1000-80-5-4.1 Dear Mr. Patanjo: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, September 20, 2017: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#8065 from NSHE Williamston, LLC to Brendan & Kristina Tully, as issued on February 20, 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 contact our office at (631) 765-1892. Sincerely, X" Michael J. Domino, President Board of Trustees MJ D/dd July 21, 2017 Town of Southold Trustees Town Hall Annex Building R, 54375 Rte. 25 �` F- =-----,f, P.O. Box.1179 Southold, New York 11971 ; JUL 2 6 2017 RE: 220 WEST SHORE DRIVE, SOUTHOLD, NY Suufihuld Town SCTM No. 1000-80-05-4.1 tT OWNERSHIP TRANSFER REQUEST Dear Trustees: On behalf of Brendan & Kristina Tully we hereby request all permits be transferred from previous ownership into the new owner of record. As part of the wetland permit application all required documents are attached and the fee is included in the provided check. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332 or e-mail at ipatanio optonline.net. Very truly yours, PJeffreyyatanjo 106 Hewitt Blvd. Center Moriches, NY 11934 Michael J.Domino,Pres; i S�fF04 m `yO�Q COG Town Hall Annex John M. Bredeeyer II1,Vice , ` yJ, 54375 Route 25 Charles J. Sanders o P.O.Box 1179 Glenn Goldsmith 0 Southold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Y7 P Date/Time: I t) JW `5 Completed in field by: Jeffrey Patanjo on-behalf of BRENDAN & KRISTINA TULLY request a Transfer of Wetland Permit #8065 from NSHE Williamston, LLC to Brendan & Kristina Tully, as issued on February 20, 2013. Located: 220 West Shore Drive, Southold. SCTM# 1000-80-5-4.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/cons' Itant/application completeness/comments/sWdardap: i Present were: /Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 i Michael J. Domino,Pres F04 4119, Town Hall Annex John M. Bredemeyer III,Vice-President y_ 54375 Route 25 Charles J. Sanders N = P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski y ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Jeffrey Patanjo on behalf of BRENDAN & KRISTINA TULLY request a Transfer of Wetland Permit #8065 from NSHE Williamston, LLC to Brendan & Kristina Tully, as issued on February 20, 2013. Located: 220 West Shore Drive, Southold. SCTM# 1000-80-5-4.1 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* . A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. 525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: , LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 James F. King, President oF sooryo Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen T Southold, New York 11971-0959 John Bredemeyer co Q • ~O Telephone (631) 765-1892 Michael J. Domino I~enulm, Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0941C Date: December 11, 2013 THIS CERTIFIES that the removal and replacement of 881f of deteriorated bulkhead with new vinyl in same location, construction of 15' return on east side, stabilization of bank with Cane American Beach Grass, removal and replacement of existing 6.4'x3.2' stairway and 8'x4' platform At 220 West Shore Drive, Southold, New York Suffolk County Tax Map # 80-5-4.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated January 2, 2013 pursuant to which Trustees Wetland Permit #8065 Dated February 20, 2013, was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal and replacement of 881f. of deteriorated bulkhead with new vinyl in same location: construction of 15' return on east side, stabilization of bank with Cane American Beach Grass: removal and replacement of existing 6.4'x3.2' stairway and 8'x4' platform. The certificate is issued to NSHE WILLIAMSTON LLC owner of the aforesaid property. o~ Authorized Signature James F. King, President O~sAfFO(,rCO Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President ~y ((y P.O. Box 1179 Dave Bergen Southold, NY 11971 John Bredemeyer Telephone(631)765-1892 Michael J. Domino Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /-Lr, Jam. /3 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale linetsilt boom/silt curtain 1s' day of construction /'/z constructed V Project complete, compliance inspection. INSPECTED BY: 211, COM NTS: D.K . CERTIFICATE OF COMPLIANCE: 1 • • CHRIS MOHR LAWNCARE & LANDSCAPING, INC. PO BOX 48 CUTCHOGUE, NY 11935 631-765-4617/ 631-765-9026 Fax n ~ C ~ ~ V ~ D u^u( JUN 2 6 2013 To Whom It May Concern: out ald Town Re: Regina Melly r e 220 West Shore Drive Southold, NY Please be advised that a tree on the bay side of the property known as 220 West Shore Drive, Southold is dead and in need of removal. I am writing this letter to request that I be allowed to remove the dead tree and remove all wood chips to the dumps. Sincerely yours, C ris Mohr President i( N~O~T ~ .~~1 r ~ J i r ~y ~ t. , i ~ _ ~ li ` _ f K 1 . 1 . _lt. rl / / J v ~y t i / .i Y Y t ° . ,v, , M c+r f s, ;'3; y ,1 ~i k 3 . r' - „ r i i~ 4 _ 'Y ~ ` ~ ~ ~ i j.~ ~ . r ~ , ' 1 ? ~ - . _ * y - / r ~ ~ ~ V( ~F 1 1 i ) f i i ~ ~ 4 1 ~ ~ ~ , n ~ - ~t J J . I Y - r r ~ h ~ ~ a . ~ as ; a~:`~ _ n v.m - ~ . -r: ~ i<x ~ - r ~ tax v f Y^ ~ ~ , ~ ~ ~~s~ '"`,s+: Vi ?d'~1~ 5 k~. 4 6~ ~ 4 u2 ~6 3 f h 1`~~k... , , aye 2, ~$'m _ ' ~i: & . L $uFFttt~- James F. King, President ~p~ COG Town Hall, 53095 Main Rd. Bob Ghosio; Jr., Vice-President ~ y~ P.O. Box 1179 Dave Bergen ~ ~t Southold, NY L 197 k John Bredemeyer ~ • ~ Telephone (631)765-1892 Michael J. Domino y~Oj ~ ~pr 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 APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 15~ day of construction %2 constructed ? Project complete, compliance inspection - - - - BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT N0.8065 DATE: FEBRUARY 20.2013 ISSUED TO: NSHE WILLIAMSTON LLC PROPERTY ADDRESS: 220 WEST SHORE DRIVE. SOUTHOLD SCTM# 80-5-4.1 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 20, 2013, and in consideration of application fee in the sum of WAIVED as oer Town Board Resolution #2013-189 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 and replace 88 linear feet of deteriorated bulkhead with new vinyl bulkhead in same location; construct 15' return on east side; stabilize bank with Cape American Beach Grass; remove and replace existing 6.4'x3.2' stairway and 8.0'x4.0' platform as required to construct bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated on February 22, 2013 and stamped approved on March 15, 2013. IN WCCNESS 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. n o~~gUFFtI(,~co r a l~ _ N ~ W y ~o a~ .t TERMS AND CONDITIONS The Permittee NSHE Williamston LLC residine at 220 West Shore Drive, 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 Pernittee assumes full liability with respect thereto, to [he 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 Pennittee 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 [he 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 iC future operations of [he Town of Southold require [he 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 umeasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permit[ee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which tnay be subject to revoke upon failure [o obtain same. James F. King, President ~o~~OF SOUjyolo Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen # # Southold, New York 11971-0959 John Bredemeyer G Q Michael J. Domino ~ Telephone (631) 765-1892 ~~~~OU~,~~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD February 20, 2013 Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: NSHE WILLIAMSTON LLC 220 WEST SHORE DRIVE, SOUTHOLD SCTM# 80-5-4.1 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 20, 2013 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of NSHE WILLIAMSTON LLC 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 January 2, 2013, 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 LW RP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 20, 2013, 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, z ~ • 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 the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of NSHE WILLIAMSTON LLC to remove and replace 88 linear feet of deteriorated bulkhead with new vinyl bulkhead in same location; construct 15' return on east side; stabilize bank with Cape American Beach Grass; remove and replace existing 6.4'x3.2' stairway and 8.0'x4.0' platform as required to construct bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated on February 22, 2013 and stamped approved on March 15, 2013. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, James F. King President, Board of Trustees JFK/amn ~~o~osuFFO~~-LPG James F. King, President y ~ Town Hall Annex Bob Ghosio, Jc, Vice-President u. ~ 54375 Route 25, P.O. Box I l79 ' Dave Bergen ~.y ~ Southold, NY l 1971 John Bredemeyer ~Oj ~ ,~.DC Telephone (63l) 765-1892 Michael J. Domino Fax (63l) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ~J ~'-F-1'F~~l ~(2 -~C~ VI I ( rf7~~ / ys N ~ x.131 ~ ~ I Q M~~n .L.L Please be advised that your application dated 2 3 has been reviewed by this Board at the regular meeting of Z 2D 3 and your application has been approved pending the completion oft a following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 15` Day of Construction ($50.00) Y2 Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed. below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon. completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ ~b 3 ~~3 .1~ ~G35 ~I BY: James F. King, President Board of Trustees • ~Q~gyFFD(,rc Peter Young, Chairman ~ ~ Town Hall, 53095 Main Rd. Lauren Standish, Secretary ~ ~ P.O. Box 1179 'F Southold, NY 11971 y'~ a 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 Tues., February 12, 2013 the following recommendation was made: Moved by John Stein, seconded by William McDermott, it was RESOLVED to SUPPORT the Wetland Permit application of NSHE WILLIAMSTOWN to remove and replace existing 6.4'X 3.2' stairway and 8'X 4' platform as required to construct bulkhead. Located: 220 West Shore Dr., Southold. SCTM#80-5-4.1 Inspected by: John Stein, William McDermott Vote of Council: Ayes: All Motion Carried X19 15 r i ~ r„ 2013 I-= ~'i i' s~mn~,~, ~~:rt- Ooard of ros'.ces L- - I ~ f ~4 _ - w~ ~ k n..~ u i:r I ~ h ~ ~ ~ ~ a w . P .:v :d•. fps j "'t, ~t'~. ~ ~ ~ / ,gyp` ; ~ ~ ~ ~r'.. ~~+d~,~ ~ j~~~~ t~ • I T ~'2 ~ r ~ r i , 4r ~ y r ' ' "suFFO~k James F_ King. Presidrnt p~ Cp P.O. Box 1179 bob Ghosio, Jr., Vice-President ~jZ d2~i Southold, NY 11971 Dave Rergen pp o ~ Telephone (631 765-1892 John Bredemeyer A 0 M ~ Fax (631) 765-6647 Michael ,L Domino 'F y~ol f ~ao~. Southold Town Board of Trustees Field InspectionNVorksession Report Date/Time: ~~f / 3 ~ Jeffrey Patanjo on behalf of NSHE WILLIAMSTON LLC requests a Wetland Permit to remove and replace 88 linear feet of deteriorated bulkhead with new vinyl bulkhead in same location; stabilize bank with Cape American Beach Grass; remove and replace existing 6.4'x3.2' stairway and 8.0'x4.0' platform as required to construct bulkhead. Located: 220 West Shore Drive, Southold. SCTM# 80-5-4.1 Type of area to be impacted: -Saltwater Wetland -Freshwater Wetland -Sound -Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 -other Type of Application: Wetland -Coastal Erosion -Amendment _Administrative_Emergency Pre-Submission Violation Info needed: Modifications: Conditions:.(,~i" '~il~vO~~~ Preseere: ~ J. Kin ? B. Ghosio ? D. Bergen, -~J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by ~ 2 ~ Mailed/Faxed to: Date: g~fFD(,p ti~~~ Peer Young, Chairman Q Town Hall, 53095 Main Rd. Lauren Standish, Secretary O T P.O. Box 1179 • Southold, NY 11971 y1/pf ~~0~" Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., January 16, 2013 the following recommendation was made: Moved by Derek Bossen, seconded by William McDermott, it was RESOLVED to SUPPORT the Wetland Permit application of NSHE WILLIAMSTOWN LLC to remove and replace 88 If. of deteriorated bulkhead with new vinyl bulkhead in same location and stabilize the bank with beachgrass. Located: 220 West Shore Dr., Southold. SCTM#80-5-4.1 Inspected by: Derek Bossen, Peter Young The CAC Supports the application with the Condition of a 10' non-turf buffer planted with native vegetation and the slope is re-vegetated. Vote of Council: Ayes: All Motion Carried n ~~~D~~~~r~~';I lun~~j JAN ~ g 2013 ~~~-1~~ ~ I I I Scutfmltl lo~~n f2~~rJ of .,_fa_,_ ._...n. r 4.~ ~ ~F'w= a P ° 1 i r7 y „ .+-.--.r N 7 sue' t+ + K ~ - ;.c._-.."_'.mm~ m.. - _ Y'~r;: _ i ~ i »a, w~~<_ Q r~ .fit. T~ ~.t. . Photo 1 -Looking East ~ z5~ i ~ 2,2fl13 y t 6 _ _ _..~....~~"~..a i ~7~ ~~n" PCL XL error Subsystem: xlparse Error: Input Stream EOF Operator: Parser Position: 145620 • IOINT APPLICATION FORM • For Permits/Determinations to undertake activities affecting streams, waterways, ~ ~ waterbodies, wetlands, coastal areas and sources of water supply. New York You must separately apply for and obtain separate Pormits/Determinations from Engleers (USAGE) State each involved agency prior to proceeding with work. Please read all instruetlons. APPLICATIONS TO 1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart- General Services ment of State Check all permits that apply: Check all permits that apply: ? Stream Disturbance ? Coastal Erosion ? Section 404 Clean Water Act Check all permits that Check if this Mena ement apply: applies: ? Excavation and FlII in 9 ? Section 10 Rivers and Harbors ? State Owned Lands Coastal Navigable Waters ? Wiid, Scenic and Act Under Water Consistency ? Docks, Moorings or Rea~eational Rivers Nationwide Permit(s) -Identify ? Utility Concurrence Platforms ? Water Supply Number(s): Easement ? Dams and Impoundment ? Long Island Well 3 (pipelines, Structures conduits, ? Aquatic Vegetation Control cables, etc.) ? 401 Water Quality ? Aquatic Insect Control Certification PreconstruLtion Notification - ? Docks, ? Freshwater Wetlands ? Rsh Control ? Y / ? N Moorings or ? Incidental Take of Endan- Platforms ? Tidal Wetlands gered/Threatened Species I am sending this application ? I am sentling this I am sending I am sending this application to this agency. to this agency. application to this this application a enc to this a en 5. Name of Appliwnt (use full name) Applicant must be: 6. Name of Facility or Property Owner (If different than NSHE WILLIAMSTOWN LLC Owner Applicant) SAME ? Operator Mailing Address ? Lessee Mailing Address ~ 2 G ~P~YI/JOG~ ,F'DfJ~ (check all that apply) Post Office City Taxpayer ID (If applicant Post Office City 5 C~.Q r J is NOT an individual): State Ny Zip Colde 0 r State Zlp Code Telephone (daytime) Email) Telephone (daytime) Email 845-598442 REGINAMELLY~YAHOO.COM 7. Contact/Agent Name 8. Project /Facility Name Property Tax Map Section /Block /Lot Number JEFFREY PATANJO 220 WEST SHORE DRIVE 1000$0-054.1 Company Name Project Location -Provide directions and distances to roads, bridges and bodies of waters: 220 WEST SHORE DRIVE -SEE LOCATION MAP Mailing Address Street Address, if applicable Pos[ Office City Stale Zlp Code 106 HEWITT BLVD. NY 11977 220 WEST SHORE DRIVE SOUTHOLD Post Offce City CENTER MORICHES Town /Village /City County SOUTHOLD SUFFOLK State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name NY 11934 SOUTHOLD SOl1THOLD BAY Telephone (daytime) Location Coordinates: Enter NYTMS In kilometers, OR Latitude/Longitude 631484-9332 Email NYTM-E I N1TM-N Latitude Longitude JPATANJO~OPTONLSJE.NET 47° G2' S6" 7"e° 23' S6" For Aaencv Use Only DEC Application Number: USAGE Number: JOINT APPLICATION FORM 09/10 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed ~NT APPLICATION FORM -PAGE 2 OF 2 • Submit this completed Dage as part of your Application. 9. Project Description and Purpose: Provide a complete narrative desttiption of the proposed work and its purpose. Attach addtional page(s) if necessary. Include: description of current site conditions and how the site will be modified by the proposed project; structures and fill materials to be installed; type and quantity of materials to be used (I.e., square R of coverage and cubic yds of fiU material and/or structures below ordinary/mean high water) area of excavation or dredging, volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitlgation activities proposed to compensate for resource impaUS; and where applicable, the phasing of activities. ATTACH PLANS ON SEPARATE PAGES. REMOVE AND REPLACE EXISTING DETERIORATED TIMBER BULKHEAD WITH NEW VINYL BULKHEAD IN EXACT LOCATION AS EXISTING. REMOVE AND RE-INSTALL EXISTING STAIRWAY AS REOUIRED TO CONSTRUCT BULKHEAD. STABILIZE BLUFF WRH AMERICAN CAPE BEACH GRASS UPON COMPLETION OF BULKHEAD. Pro sed Use: Private ? Public ?Commercial Proposed Estimated po Start Date: 1/0212013 Com letion Date: 1/16/2013 Has Work Begun on Project? ? Yes No If Yes, explain. Will Project Occupy Federal, Slate or Municipal Land? ? Yes ~ No If Yes, please specify. 10. List Previous PermR /Application Numbers (if any) and Dates: WA 11. Will this project require additional Federal, State, or Local Permtts Including zoning changes? Yes ? No If yes, please list: TOWN OF SOUIHOLD TRUSTEES 12. Signatures. If applicant is not the owner, both must sign the application. I hereby affirm that information provided on this form and alt attachments submitted herewith Is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further, the applicant accepts full responsibility for all damage, direct or Indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the State from wits, aUlons, damages and costs of every name and description resulting from said project. in addition, Federal Law, 18 U.S.C., Section 1001 provides for a fine of not more than $10,000 or imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conceals, or cov rs u material fact; ork/n~owingly makes or~us%s a f Ise, fictitious or fraudulent statement. _K [vl r% Bw,vcR lappllcrn 7 i s ~ l a Slgna[ of Applicant Printed N~ a Title Da Signature of Owner Printed Name Title Date ZC(-~ru„ ~A}an~c A~rnf »~3~ 1L Si at re of en Printe- d N~ Title Date For Aaenev Uae Oniv DETERMINATION OF NO PERMIT REQUIRED Agency Project Number has determined that No Permit is required from th!s Agency for the project described ir. (Agency Name) this application. Agency Representative: Name (printed) Title Signature Dale 70INT APPLICATION FORM 09/10 Application Form Page 2 of 2 New York State Department of Environmental Conservation _ v PERNIISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s) to the Depaztment of Environmental Conservation ("DEC"), the signer consents to inspection by DEC staff of the project site or facility for which a permit is sought and, to the extent necessary, azeas adjacent to the project site or faciliTy. This consent allows DEC staffto enter upon and pass through such property in order to inspect the project site or facility, without prior notice, between the hours of 7:00 a.m. and 7:00 p.m., Monday through Friday. If DEC staff should wish to conduct an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate consent for such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s) sought. By signing this consent form, the signer agrees that this consent remains in effect as long as the application is pending, and is effective regazdless of whether the signer, applicant or an agent is present at the time of the inspection. In the event that the project site or facility is posted with any form of "posted" or "keep out" notices, or fenced in with an anlocked gate, this permission authorizes DEC staff to disregazd such notices or unlocked gates at the time of inspection. The signer further agrees that during an inspection, DEC staffmay, among other things, take measurements, may analyze physical characteristics of the site including, but not limited to, soils and vegetation (taking samples for analysis), and may make drawings and take photographs. Failure to grant consent for an inspection is grounds for, and may result in, denial of the permit(s) sought by the application. Permission is granted for inspection of property located at the following address(es): 220 WEST SHORE DRIVE, SOUTHOLD, IdY 11971 By signing this form, I affirm under penalty of perjury that I am authorized to give consent to entry by DEC staff as described above. I understand that false statements made herein are punishable as a Class A misdemeanor pursuant to Section 2]0.45 of the Penal Law. Print Name and Ti le Signature Date *The signer of this form must be an individual or authorized representative of a legal entity that: • owns fee title and is in possession of the property identified above; • uraintaias possessory interest in the property through a lease, rental agreement or other legally binding agreement; or • is provided permission to act on behalf of an individual or legal entity possessiug fee title or other possessory interest in the property for We purpose of consenting [o inspection of such property. Permission to Iuapect Properly Apptigtlon Supplement 12/08 ENVIRONMENTAL QUESTIONNAIRE This is intended to supplement ENG Fonn 4345, Application for Department of the Army Permit, or the Joint Application for Permit used in the State of New York. Please provide complete answers to all questions below which are relevant to your project. Any answers may be continued on separate sheet(s) of paper to be attached to this farm. PRIVACYACT STATEMENT The purpose of this form is to provide the Corps of Engineers with basic information regarding your project This information will be used to facilitate evaluation of your permit application and for public dissemination as required by regulation. Failure to provide complete information may result in your application being declared incomplete for processing, thereby delaying processing of your application. r~Fe?F?aAL..eav? ?r•ABLE TO ALL PROJECTS 1. Explain the need for, and purpose of, the proposed work. THH HXISTING BULKHHAD IS DHTERIORATHD AND IN NHHD OF REPLACHMENT TO PROTHLT AGAINST LOSS OP LAND. 2. Provide the names and addresses of property owners adjacent to your work site (if not shown on the application form or project drawings). SEE PLAN. (Please note that depending upon the nature and extent of your project, you maybe requested to provide the names and addresses of additional property owners proximate to your project site to ensure proper coo?dination.) 3. Photographs of the project site should be submitted. For projects in tidal areas, photographs of the waterway vicinity should be taken at low tide. Using a separate copy of your plan view, indicate the location and direction of each photograph as well as the date and time at which the photograph was taken. Provide a sutbcient number of photographs so as to provide a clear understanding of conditions on and proximate to your project site. 4. Provide a copy of any environmental impact statement, or any other environmental report which was prepared for your project. 5. Provide a thorough discussion of akematives to your proposal. This discussion should include, but not necessarily be limited to, the "no action" alternative and attemative(s) resulting in less disturbance to waters of the United States. For filling projects in waters of the United States, including wetlands, your alternatives discussion should demonstrate that there are no practicable alternatives to your proposed filling and that your project meets with current mitigation policy (i.e. avoidance, minimization and compensation). TEE NO-BUILD ALTERNATIVE WOULD RESULT IN LOSS OF LAND AND PROPERTY. DREDGING PROJECTS Answer the following if your project involves dredging. 1. Indicate the estimated volume of material to be dredged and the depth (below mean low water) to which dredging would occur. Would there be ove?depth dredging? 2. You can apply for aten-year permit for maintenance dredging. If you wish to applyfor aten-year permit, please provide the numberof additional dredging events during the ten-year life of the pem?it and the amount of material to be removed during future events. 3. Indicate of your drawings the dewatering area (rt applicable) and disposal site for the dredged material (except landfill sites). Submit a sufficient number of photographs of the dewatering and disposal sites as applicable so as to provide a clear indication of existing conditions. For ten-year maintenance dredging pem?its, Indicate the dewate?ing/disposal sites for future dredging events, if known. 4. Describe the method of dredging (i.e. clamshell, dregline, etc.) and the expected duration of dredging. 5. Indicate the physical nature of the material to be dredged ~.e. sand, silt, clay, etc.) and provide estimated percentages of the various constituents if available. For beach nourishment projects, grain size analysis data is required. 6. Describe the method of dredged material containment (i.e. hay bales, embankment, bulkhead, etc.) and whether return flow from the dewatering/disposal site would reenter any waterway. Also indicate if there would be any barge overflow. MOORING FACILITIES Answer the following if your project includes the construction or rehabilitation of recreational mooring facilities. 1. It is generally recommended that any fixed piers and walk ramps be limited to four feet in width, and that floats be limited to eight feet in width and rest at least two feet above the waterway bottom at mean low water. Terminal floats at private, non- commercial facilities should be limited to 20 feet in length. fl you do not believe your proposal can meet with these recommendations, please provide the reason(s). 2. Using your plan view, show to scale the location(s), position(s) and size(s) including length, beam and draft) of vessel(s) to be moored at the proposed facility, including those of trensient vessel(s) if known. 3. For commercial mooring sites such as marinas, indicate the capacity of the facility and indicate on the plan view the location(s) of any proposed fueling and/orsewage pumpout facilltes. Hpumpout facilities are not planned, please discuss the rationale below and indicate the distance to the nearest available pumpout station. 4. Indicate on your plan view the distance to adjacent marine structures, if any are proximate and show the locations and dimensions of such structures. 5. Discuss the need for wave protection at the proposed facility. Please be advised that if a pem?it is issued, you would be required to recognize that the mooring facility may be subject to wave action from wakes of passing vessels, whose operations would not be required to 6e modified. Issuance of a permit would not relieve you of ensuring the integrity of the authorized structure(s) and the United States would not be held responsible for damages to the structure(s) and vessel(s) moored thereto from wakes from passing vessels. BULKIIEADING/BANK STABILIZATION/FILL/NG ACTIVITIES Answer the following if your project includes construction of bulkheading (also retaining walls and seawalls) with backfi~ll, filling of waters/wetlands, or any other bank stabilization fills such as riprep, revetments, gabions, etc. 1. Indicate the total volume of fill (including backf~ll behind a structure such as a bulkhead) as well as the volume of till to 6e placed into waters of the United States. The amount of fill in waters of the United States can be determined by calculating the amount of fill to 6e placed below the plane of spring high tide in tidal areas and below ordinary high water in non-tidal areas. NO PILL WILL BE IMPORTED FOR CONSTRUCTION. 2. Indicate the source(s) and type(s) of till material. N/A 3. Indicate the method of fill placement (i.e. by hand, bulldozer, crane, etc.). Would any temporary fills be required in waterways or wetlands to provide access for construction equipment? If so, please indicate the area of such waters and/or wetlands to be filled, and show on the plan and sectional views. ALL WORK TO HE ACCOMPLISHED SY LAND WITH RUBBER TRACKED EXCAVATOR. The foregoing requests basic information on the most common types of projects requiring Department of the Army permits. It is intended to obviate or reduce the need for requesting additional infom?ation; however, additional information maybe requested above and beyond what is requested in this form. Please feel free to add any additional information regarding your project which you believe may facilitate our review. NEW YORK STATE DEPARTMENT OF STATE COASTAL MANAGEMENT PROGRAM Federal Consistencv Assessment Form An applicant, seeking a permit, license, waiver, certification or similar type of approval from a federal agency which is subject to the Newyork State Coastal ManagementProgram(CMP), shall complete this assessment form for anyproposed activity that will occur within and/or dvectly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent witFt New York State's CMP as required by U.S. Department of Commerce regulations (15 CFR 930.57). It should be completed at the time when the federal applicatlon is prepared. The Department of State will use the completed form and accompanying inforrnafion in its review of the applicant's certification of consistency. A. APPLICANT (please print) NSHE WILLIAMSTOWN LLC 1. Name: nn J C 2. Address: d~ G~IP/~I't'J~~~®'t°' /~'PSV'~/~~~ fUS`~3 3. Telephone: Area Code ( )845-598-6442 B. PROPOSED ACTIVITY I. Brief description of activity: REMOVE AND REPLACE 88 LF OF DETERIORATED BULKHEAD IN ITS ORIGINAL LOCATION. 2. Propose of activi EXISTING BULKHEAD IS DETERIORATED AND IN NEED OF REPLACEMENT. 3. Location of activity: SUFFOLK SOUTHOLD 220 WEST SHORE DRIVE County City, Town, or Village Street or Site Descripfion ARMY CORPS OF ENGINEERS 4. Type of federal permiUlicense required: N/A 5. Federal application number, if known: 6. If a state pemriUlicense was issued or is required for the proposed activity, identify the state agency and provide the application or permit number, if lmown: NYSDEC C. COASTAL ASSESSMENT Check either "YES" or'NO" for each of these questions. The numbers following each question refer W the policies described in the CMP document (see footnote on page 2) which maybe affected by the proposed activity. 1. Will the proposed activity result in any of the following: YES / NO a. Lazge physical change to a site within the coastal area which will require the preparation of an environmental impact statement? (11,22,25,32,37,38,41,43) b. Physical altem[ion of more than lwo acres of land along the shoreline, land under water or coastal waters? (2,11,12,20,28,35, 44) c. Revitalization/redevelopmen[ of adeteriorated or underutilized waterfront site? (1) Q ~f d. Reduction of existing or potential public access to or along coastal waters? (19, 20) e. Adverse effect upon the commercial or recreational use of coastal fish resources? (9,10) ~x f Siting of a facility essential to the exploration, development and production of energy resources in coastal waters or on the Outer Continental Shelf? (29) Q g. Siting of a facility essential to the generation or transmission of energy? (27) h. Mining, excavation, or dredging activities, or the placement of dredged or fill material in coastal waters? (15,35) Q i. Dischazge of Wxics, hazardous substances or other pollutants into coastal waters? (8, I5, 35) Q j. Draining of stormwatet runoff or sewer overflows into coastal waters? (33) Q JSc] k. Transport, storage, heatment, or disposal of solid wastes of hazardous materials? (36, 39) . Q D I. Adverse effect upon land or water uses within the State's small harbors? (4) 2. Will the proposed activity affect or be located in, on, or adjacent to any of the following: YES / NO a. State designated freshwater or tidal wetland? (44) b. Federally desigoated flood and/or state designated erosion hazard area? (11, I2, 17,) Q a State designated significant fish and/or wildlife habitat? (7) d. State designated significant scenic resource or area? (24) _ X e. State designated important agricultural Inds? (26) Q f. Beach, dune orbamerisland? (12) Q g. Major ports of Albany, Buffalo, Ogdensburg, Oswego or New York? (3) Q h. State, county, or local park? (19,20) Q i. Historic resource listed on the National or State Register of Historic Places? (23) Q 3. Will the proposed activity require any of the following: YES / NO a. Waterfront site? (2, 21, 22) b. Provision of new public services or infrastructure in undeveloped or sparsely populated sections of the coastal area? (5) c. Construction or reconstruction of a flood or erosion control structure? (13, 14, 16) Q d. State water quality permit or certification? (30, 38, 40) Q e. State air uali ermit or certification? 41, 43 X q tYP ( ) - - 4. Will the proposed activity occur within and/or affect an area covered by a State approved local waterfront revitalization program? (sec pclicies is local program document) Q D. ADDITIONAL STEPS 1. If all of the questions in Section C aze answered 'NO", then the applicant or agency shall complete Section E and submit the documentation requved by Section F. 2. If any of the questions in Section C are answered "YES", then the applicant or agent is advised to consul[ [be CMP, or where appropriate, thelocalwater&ontrevitaliTationprogramdocumentf. Theproposedactivirymustbeanalyzedin[Wore detail with respect to the applicable state or local coastal policies. On a separate page(s), Ote applicant or agent shall: (a) identify, by their policy numbers, which coastal policies are affected by the activity, (b) briefly assess We effects of [he activity upon [he policy; and, (c) state how the activity is consistent with each policy. Following the completion of this written assessment, Ote applicant or agency shall complete Section E and submit the documentation requved by Section F. E. CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program, as appropriate. If Otis certification cannot be made, the proposed activity shall not be undertaken. If this certification can be made, complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program, or with the applicable approved local waterfront revitalization program, and will be conducted in a manner consistent widt such program." JEFFREY PATANJO ApplicanUAgent's Name: Address:106 HEWITT BLVD., CENTER MORICHES, NY 11934 Telephone: Area Code ( )631-484-9332 ApplicanUAgent's Signature: Date: 11 3 t t y F. SUBMISSION REQUIItEMENTS 1. The applicant or agent shall submit the following documents to the New York State Department of State, Office of Coastay Locsl Government and Community Sustsinab0ity, Attn: Consistency Review Unit, l Commerce Plaza, 99 Washington Avenue -Suite 1010, Albany, New York 12231. a. Copy of original signed form. b. Copy of the completed federal agency application. c. Other available information which would support the certification of consistency. 2. The applicant or agent shall also submit a copy of this completed form along witkhis/her application to the federal agency. 3. If there are any questions regazding Ote submission of this form, contact the Deparhnent of State at (518) 474-6000. '"These state and local documents are available for inspection at the offices of many federal agencies, Department of enduonmental Conservation and Department of State regional offices, anti the appropriate regional and conty planing agencies. Local progmm documents are also available for inspection at the offices of the appropriate local govemmeut. e e a..._a. - ~ _ _ ro ti~~ N »o rn „ , y~ r ~ \ @1Y Ar; ~ W ~ a! r ~ ~ x „ - \ +u c, w e ~ - / /q~ ` r ~ f ~ry8 / ] ' Vyy / 8 ay I_--T_ i o x a; _ n w r.r __.o __-a_ O d. 3 -r _ f .i u .n _ o _ - 'c IFI, & ~n ro _ rr _ ~n.r m w rai m n b- I z ~ - _ _ _ M+. w.r r _ _ ~ z w m.r x. n ___n f n n i o, . m _ > __rf w i i _ _ n___ w i i ~ ~ ~ .m i .__._e_ _ ar _f ------r,..- ~ ~ a r _ 0,.. ~ - RROVe co - „_r ~~m~. F~ ~i y~ e a 9 Y g - a ~ xmee COUMV OF SUFFOLK © a sarxwn •rox --2-- Iml __O ~ v Reel R~iweM Taz Sem¢~Ogenry r a o = ~~~.~w,.~~v. s..~ a ~,.m e.. m.r...r..cwua. v r~ r. aeo Bwrv Rxa OFFICE IACATION: o~~OF SO(/jyOl MAILING ADDRESS: Town Hall Annex ~ O P.O. Box 1179 54375 State Route 25 J} # Southold, NY 11971 (cot. Main Rd. & Youngs Ave.) ~ Q Telephone: 631 765-1938 Southold, NY 11971 • Fax: 631 765-3136 o~yCOU~,~~ LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees 2 ~ ~ ~ ~p 2 From: Mark Terry, Principal Planner ~ LS WI IS r1~~ LWRP Coordinator L FEB 1 5 2013 Date: February 15, 2013 Southold Town Re: Proposed Wetland Permit for NSHE WILLIAMSTON LLC oar f trustees SCTM#1000-80-5-4.1 Note: Permits for the aroposed structures were not found. They were reviewed as new construction. Jeffrey Patanjo on behalf of NSHE WILLIAMSTON LLC requests a Wetland Permit to remove and replace 88 linear feet of deteriorated bulkhead with new vinyl bulkhead in same location; stabilize bank with Cape American Beach Grass; remove and replace existing 6.4'x3.2' stairway and 8.0'x4.0' platform as required to construct bulkhead. Located: 220 West Shore Drive, Southold. SCTM# 80-5- 4.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that the applicant gains permission of property owner to conduct action. 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 January 28, 2013 Town of Southold Trustees Town Hall Annex Building (1 ~ C ~ ~ V ~ D 54375 Rte. 25 ail'=',I( D P.O. Box 1179 U U Southold, New York 11971 JAN 19 pp13 RE: 220 WEST SHORE DRNE, SOUTHOLD, NY thod own SCTM No. 1000-80-05-4.1 REVISED PLANS Dear Elizabeth: As discussed in your office, attached are the revised plans for the above referenced property. I have added the dimensions of the platforms to the plan as requested. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, ffre Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 To. .lamas F. King Pagn 2 012 20'13-0'1 -'IB 03'.55'.'12 (OMT) 30'144000 From. R~cnv.tl Vvntlanbu • REYDON SHORES PROPERTY OWNERS ASSOCIATION ~ ~ Ci ~ O ~ P.O. BOX 1693 SOUTHOLD, NEW YORK 11971 Southold Town Boarcl of Trustees Januazy 17, 2013 _~pN T $ James F. King, President P.O.Box 1179 d Southold, NY 11971 Re: NSIIE Williamston LLC (Regina Melly) Property, 220 west Shore Drive, Reydon Shores, Southold, NY 11971 Dear Mr. King: Please be advised that I have been contacted by Regina Melly who has advised that they are in the process of seeking Trustee approval for certain repairs to the bulkhead located on the hay side of her property in Reydon Shores private community, Southold, New York. Mrs. Melly, who is the principal of the applicant, has further advised that the ...Southold Trustees aze seeking consent and approval from Reydon Shores Property Owners Association (RSPOA) prior to approving the NSHE Williamston LLC application to proceed with those repairs to that portion of the bulkhead in front of their property that appeaz to be at or above the mean high water mazk and lying north of the property line of applicant's property. (Referring to May 3, 2007. Survey performed by Reddan.Stuveying) Mrs. Melly has assured me that in addifion to any necessary permits required, .they will be supplying the necessary proof of insurance frm their licensed contractor performing the work that will. list RSPOA, Inc. as an additional insured while having the work performed. Therefore, please allow this letter to confirm that RSPOA has no objection to the NSHE Williamston LLC application which seeks to repair and replace those necessary portions of the aforesaid bulkhead that aze located directly in front of the applicant's property, and further consents to allow access of the applicant's equipment upon .adjoining RSPOA properly to effect those repairs, provided the bulkhead is not enlarged or moved from its prior location. To be clear, any deviation from the prior location and size of this bulkhead .would require ore formal approval from the entire RSPOA membership. sruly s, CHARD W.VANDENBU H POA President _ - Te. Jamas F. King Pv9v '1 of 3 20'13-0'I -'IB 03:55.'12 (GMT) t6t 440D0 Frem. RICM1Vrtl VvntlanburgM1 ~3 FAX COVER SHEET TO James F. iGng COMPANY Southold Town Trustees FAX NUMBER 16317656641 FROM Richard Vandenburgh DATE 2013-01-18 03:58:19 GMT RE NSHE Williamston LLC Application, 220 West Shore Drive, Reydon Shores, Southold COVER MESSAGE Please refer this to the Trustees regarding the above referenced pending application. Thank you. o~~~~~~~ 2013 dAN 1 8 ~moa owa T W WW.E FAX.COM Office Use Only oastal Erosion Permit Application Wetland Permit Application _ Administrative Permit _AmendmendTran fer/~xtension ? eceived Application: Z I l 3 V ReceivedFee:$ WQiVe - Tg. ~CSOIu~~oY~#2913-1$'~ ~Comple[ed Application Incomplete _SEQRA Classification: - " an ~ i ~C~I Type IType IIUnlisted_ oordination:(date sent) ~ ~ - WRP Consistency Ass.~~ss~~en--t Fo (I I ~ i~3o/13 ~ • CAC Referral Sent: 1/~0/ I~j Date of Inspection: -Receipt of CAC Report: -Lead Agency Determination: Technical Review: Public Hearing Held: Z3 Resolufion: Name Of Applicant NSHE WILLIAMSTOWN LLC ~ / ~y~ Address _ ~ ~ G ~i`H 1`?CID`" ^ AA Phone Number:( ) e4s-s9e-6442 Sl~'~S~n/~ /OS Suffolk County Tax Map Number: 1000 - so-os-4.1 Property Location: zzo WEST SHORE DRIVE, SOUTHOLD, NY 272.92' EAST OF OAK DRIVE (provide LILCO Pole distance to cross streets, and location) AGENT: JEFFREY PATANJO (If applicable) Address: 106 HEWITT BLVD., CENTER MORICHES, NY 11934 Phone: 631-484-9332 ~~d~'~' I~~~/~3 ~ • Board of Truat~es llpplication GENERAL DATA Land Area in Ics~T.zo ( square feet): _ Area Zoning:,__..---- Ras. Previous use of ro RaaxasNTIAL P P~Y~ REEIDatrrlAI, intetlded use of propery:__._ _ Covenants and Restrictions:_Yes x No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals _Yes x No If "Y'es", Please provide copy oYdecision. Will this project require any demolition as per Town Cade or as determined by the Building Dept. Yes x __No Does the structure (s) on property have a valid Certificate of'Occupancy x Yes No Prior penniWapprovals for site improvements: Agency Date No prig pemtits/approvals for site improvements. Has any permitlapproval ever been. revoked or suspended by a governmental agency? x No Yes If yes, provide explanation: Project Description (use attachments if necessary): RaMOVa ANn RaP4ACE sa L8 OP DETERIORATED BULxaEAII NTTH NEN VINYL BULRHRAD IN 9AMfi LOCATION. STABILIZB HANK NITB AMERICAN CAPS BHACH 6RA83. Q~n.o vt ~n~1. /'(~~r Ge au,S-fw 6.'t'X 3.Z~ s'~•,~way wnsL S.P'X y(J' P~t~rn A S r't+ vtYS~ ~fU 6~.t-t'r ~..er b.. t,..~.he.,.tl . JAN 1 4 2013 outhold Town and to Trus~ees Bo~ of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To PROTECT LOSS OF LAND AND PROPERTY. Area of wetlands on lot: ° square feet Percent coverage of lot: N/A Closest distance between neazest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Dces the project involve excavation or filling? No X Yes If yes, how much material will be excavated? 6 ° cubic yards How much material will be filled? 6° cubic yards Depth of which material will be removed or deposited: ' feet Proposed slope throughout the area of operations: z° ~ Manner in which material will be removed or deposited: REMOVE AND RE- INSTALL EXISTING MATERIAL IN SAME LOCATION BY MEANS OF RUBBER TRACKED EXCAVATOR Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): THERE WILL BE NO EFFECT TO WETLANDS AND TIDAL WATERS BY THIS PROJECT. , Hoard oP Truateea Application COASTAL RROSION APPLICATION DATA tLen.vLt [rnJ- rrplece i$ LF .v r?e-t'.fL~rar•Q b«e.2Ghe~.c@. Purposesof'proposedactivity:_._ i"'"th ~vcw vt,..~t, y+~~tllcr~rR t.~ Sr,mc L+ca~ra..., ~?..brL;c, ~x„ty i,,,~{H AMertc..n eapt (,fcrbi•!~ ~rkXS. JZeMr•µe-anrR reps+ee .t.~e~rsrwa. t.4f'v~ 3. $jw,rl?a.~ R2~~.f.D"k4.U'fit 't`FrfM ws rya«rroe¢ to ~+.--s7r~sR f3r,G,i:6w+bQ Are wetlands present within 1.00 feet of the proposed activity? X No Yes Doez the project involve excavation or filling? No x Yes ~~I! [f Yes, how much material will be excavated't_6o {cubic yards) How much material will be filled? ao {cubic yards} Manner in which material will be removed ~ deposited: ~~v~ ~D PLACED IN SANS LOCATION WITH RUSHER TRAI„XED EXCAVATOR. 17eseribe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from impk~ttation of ffie project as proposed, inchxling erosion increase or adverse effects on natural protective features. (Use attachments if necessary} THE&8 ARS NO NEOATIVA IMPACTS TO TH8 SNVZROlatH[i1' DUS TO THS CON6TRDCTION. BY ZN5rALLATION OF A NEM HDLSHEAD BRO6ION WILL SE REbHC60 AND LARD PRE- SERVED. ~ ~~~9V~ ~ D D .....JAN #-4 20f3 Southold Tawn T • 617.20 • Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -PROJECT INFORMATION To be coin leted b A licant or Pro ect S onsor 1. APPLICANi/SPONSOR 2. PROJECT NAME NSHE WII.LIAMSTOWN LLC PROPOSED BULKHEAD 3. PROJECT LOCATION: Munidpaltty SOUTHOLD Counq, SUFFOLK 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provitle map) 220 WEST SHORE DRIVE, SOUTHOLD SEE LOCATION MAP. 5. PROPOSED ACTION IS: New ~ Expansion ~ ModificafioNalteration 6. DESCRIBE PROJECT BRIEFLY: REMOVE EXISTING DETERIORATED BULKHEAD AND REPLACE WITH NEW VINYL IN SAME LOCATION. 7. AMOUNT OF LAND AFFECTED: Initially .01 aces Ultimately AI acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Q Yes ~ No If No, describe bdefiy 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ~ IndusVial ~ Commerdal ~ Agrfcutture ~ PadVForesVOpen Space ~ Other Describe: RESIDENTIAL HOME 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? Yes ~ No If Yes, list agency(s) name and pennitlapprovals: NYSDEC, ARMY CORPS OF ENGINEERS, NYSDOS, 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 permitlapprovals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? Yes ~ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicantlsponsorname: REGINAMELLY-NSHEWQ,LiAMSTOWNLLC Date: Signature: If the action is in the Coastal Area, and you area state aggency, complete the Coastal Assessment Form before proceeding with tflis assessment OVER 1 Reset PART II - IMPACT ASSESSMENT o be tom feted b lead A enc 0. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coocd'mate the review process and use the FULt EAF. Yes Q No 8. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a tlegatlve dedaratlon may be superseded by anotller involved agency. Yes a No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLONANG: (Answers may be handwritten, illegible) C1. Existing air quafity, surface or groundwater quality or quantity, noise levels, existing traffic pattern, slid waste production or disposal, potentlal for erosion, drainage or flooding problems? Explain briefly: C2. Aeslhego, agriwltural, ardaeobgical, historic, or other natural or cultural resburces; or cemmunlty or neighbofiood charade(! E~IaiFl briefly: C3. Vegetalron or fauna, fish, sheflfish a wildlife-spades, signficenf habitats, or Ihreaterred or endangered spedas7 ErylaM briefly: C4. A community's exisang plans ar goals as offidafly adopted, or a drange ur uu a intensity of use of land or dher natural resource57 F~WWin briefly: C5. Growth. subsequent development, or related activities likely Io be induced by the proposed action? Explain briefly: C6. Long term, shon~term, cumulative, or other effects not identified in C7-C5? Explain briefly: ~ C7.~ Qther impacts rndudi than es in use of ashen uanbt or t of ever ? E lain brrefl ; - - - - O. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTALCHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CFA ? If , e lain briefl Yes a No E IS THERE, OR IS THERE LIKELY TO 8E CONTROVERSY RElATEO TO P07ENTItU. ADVERSE F1JVgtONMF-M'AL IMPACTS? If lain: Yes Q No AART III - DETERAAINATIINJ OF SIGNIFICANCE (To be twmpieted by Agency) KISTRUCTIONS: Foreachadvelseeffedidettbfiedatxrve,deteaninewhether#issllbstaolial,large, anportarltorolherwPsasigMflcant Eadl should t>0 assessed in connection witlt its (a) seltlrg (i.e. urban or rureQ; (b) probability d oxurting; (c) duration: (d) imevetsbihly; (e) geegrapltk scope; std (Q magnitude. N necessary, sfld attachments a reference supporting materials. Ensure that explanations contain - - - Sufllctent delatl toshow that agrelevant adverse impacts have been identified and adequately atldaessed. Ifgttestitxr d of part g was ctledted yes, lMe detemtltlation of signlNr:ance must evaluatetlle potential impadof the P atfilon on Ilia ettuironmetdad oharacterlstilcs of the CEA (alectctlYa boxifyou have ldentlfied ona ormore potendatly Wtge orsignificant adverse knpadswMch MAYOlxltr. Thenprocead dbectlyto the FAF and/or prepare a positlve dedarafiort. Check tlas box Nyou~have delemdned, based on pte bnfonnrtatlon and analysis above and arty suppodkg doaanentatlan, lhaR the proposed Mvn.l NOT result in any signgficant adverse environmental impacts AND provMe, on~ attachmerus as necessary, the reasons supporWg lhi detemtinaflon. Board of Trustees c! ! E~ s ~O/3 ~1 Name/of Lead A/ge-ncy ~ Dale J/7 {1/l C> ! . ~~l Al President p Print or Type Name of Responsible Officer in lead Agency title o(Responsible Officer Q,r.7~rrrca ~ / Si~ rafum or Responsible ORcer in Lead ncy Sgnature of Preparer (If different from responsible officer) n ~ ~ ~ ~ ~ ~ PROOF OF MAILING OF NOTICE lunUl D ATTACH CERTIFIED MAIL RECEIPTS FEB 1 9 2013 Southold Town B srd of Tru tees Name: Address: S' n i I „I h~ 5 ~t Jrr~., ~u~?el Kllc,Y(X~S 13a ~r~bver~cP. ~ ~{C 9 V~nc~~N- Ihan2~lti ~ i ~ (~7 ~ ~ay~~d ~ ~~3~f ~eien Le vor 2~5 ~ ~ ,~~I- ~~E Ny ~y loia~ STATE OF NEW YORK C~OU/N[T~Y OF SUFFOLK SIC-F'I Q~V~. ,residing at ~-~(,U i~ ~ I V~ . QYl-ICY ~ 1 P ~ ,being duly sworn, deposes and says that on the I a day of yt, , 203 ,deponent mailed a true wpy of the Notice set forth in the Board of Trus s 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 assessmennt roll of the Town of Southold; that said Notices were mailed at the United States Post Office at 1~~ C{rk~ ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn t ~~ef~o~re~m~e~ this ~ 3 Da of`~}'-"`==~' 203 Notazy Public n Patan'o N ~ ~ N ~No:O1P 1 kC'unYork Commission Expiroa OOI07/20J~ ~o~vsu''n rG James P. King Pre9idem r4 To~cn I lall, 13095 Main Rd. Bub Ghosio. Jr.. Vice-President ~ W ~ ~ P.O. Boy 1179 Uavc Bergen ~ ~ ~ ~ Southold NY 11971 John Brcdemeycr 7/~ Telephone (631) 765-I R92 Michael 1. Domino 1 # Paa (631) 765-6641 BOARD OF TOWN TRUSTEES 2 TOWN OF SOUTHOLD n LS `rte Q ~S ~IjnuS F E B 1 9 2013 BOARD OF TRUSTEES: TOWN OF SOUTHOLD SoutholtlTown In the Matter of the Application of ar fir to NSHE WILLIAMSTON LLC COUNTY OF SUFFOLK) STATE OF NEW YORK) '~J AFFIDAVIT OF POSTING 1, ~-F~~11 1"Cf~ ~ 1(~ ,residing at /dba ~O ~u1 ~ t~- ~~~(d. ~e~ ~ ~ ,U1~Y,ch~~ I Ig3~l being duly sworn, depose and say: That on the 13 day of~~~~~ ~,J 201-~, I perso all posted the property known as a2-o w.~ ~nr~ ~r 1 ve ~vl •~~~~d by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, February 20, 2013. Dated: ~3•~3 - s~ ature) Sworn to be re me this i3 day of20~3 . otary Public Not~ry Publiac S P~New Yak Qualified in Sk CouMy No: 01PA6150861 Commission Expires OBl07I20~ NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: /USH'~ Gc~~ Il~o~r?a~'tx~~n LLC.. SUBJECT OF PUBLIC HEARING: To remove and replace 88 linear feet of deteriorated bulkhead with new vinyl bulkhead in same location; stabilize bank with Cape American Beach Grass; remove and replace existing 6.4'x3.2' stairway and 8.0'x4.0' platform as required to construct bulkhead. TIME & DATE OF PUBLIC HEARING: GJed~esdb~~. deb ~a~y :Zo, ao ~ 3 • on or abo~- 6: ~I ~'1 If you have an interest in this protect, you are invited to view the Town file(s) which are available for inspection rior to the day of the hearing during normal business days between the hours o~8 a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 i Bo~ of Trustees Application County of Suffolk State of New York NSHE WILLIAMSTOWN LLC C/O REGINA MELLY BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/I~R 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. Signature SWORN TO BEFORE ME THIS Y~ y T~ DAY OF ~ c"~ ~ ,20 ~ Z Notary Public Frauds P. McNy Notary payer, State of N.Y. Terre MExpiros914~a ~ t~" 8~ of Trustees Application • AUTHORIZATION (where the applicant is not the owner) -7 / ' / ~ I, REGINA MELLY reSidlrtg at ec.~ (~~P~~~04~ .C G~~ (print owner of property) (mailing address) Sr:3~Ps~~'A/~ .riy/~'s33 do hereby authorize JEFFREY (Agent) PATANJO to apply for permit(s) from the Southold Boazd of Town Trustees on my behalf. l~ (Owner's ~gnature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on thepart of town officers and emolovees The ouroose of this form is to provide information which can alert the town of possible conflicts of interest and allow i[ to take whatever action is necessary to avoid same. YOUR NAME: NSHB WILLIAMSTOWN LLC C/O RBGINA MELLY (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Cheok all Wat apply.) Tax grievance Building Variance Trustee % 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, martiage, or business interest. "Business interest" means a business, including a partnershiq 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 % 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/represen[ative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in anon-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 l/ day of ~P ~ J~~ 2up Si~tature Print Name ~ :t'/ j} l' Form TS 1 Town of Southold ~s Erosion, St~dlmentation 8 Storm-Water Run-off ASSESSMENT FORM ~ iF' PkOPERTY LOCATgN: B.GT.M. k THE FOLLOwIMB ACrpNS MAY REOYIRE TF~ SUBMISSION OF A ~t ydP' tP.F ~o s q,) s w T ruH 3G6ET gae~ ~ -Td- C~1 ED BY A DE810N PROF ~ STAT! OF NEFY YOIDC SCOPE OF WORK -PROPOSED CONSTRUCTION TI'EM N / WORKASSESSMINP Yes No a. What b Dte Total Alen d Me Prtljad Parceb? ~ ~ WII fNS Project Retain M Storm-Water Run-OIF (Include ToWI Area d ell Parcels located wbtM 16 , 571.2 / 0.4 0 Generated by a Two (2') Inch ReidaO m SNB? the Srape d Work for Proposed CansUlwtlon) (Dkg item vrill include ell rtrnoD cre9led b1r site X ? b. What b the Total Area d lath Clearing (sF. rte) deartr0 anNor eoruintclton aWviDes ere we0 as ell and/or Ground WhaberKe the proposed 2,000/0.05 Site MlprovemeMS and the permanent aratbnd construdbn adivity7 impervious surfaces.) te.F.l Avu) PROVIDE BRIEF PRO,)E(.T DFSCRIPCION tRwW M1bM V+araNaeree) 2 DoBa the SiM Plan andor Survey Show M Proposed Drainage StntcNres IMicedng 91ze & Locatlon? Thb X Nam ahaa Include all Proposed Grade Changesand REMOVE AND REPLACE HXISTING BULIOtEAD IN ITS Sopes Caaokktg Surface Weir Fbty. 3 Dees Dre sDe lkan arldlor survey describe Dre eresion - Q CURRENT LOCATION. and eeaimem controlprectlcea that vaN be used l0 X control ske. erosbn and atom water dlardmrges. Thb IMm must be maintained throughout the Elltre Coretrucaan Pedod. 4, WAI thb Project Require arty Land Fiirlg, Gredlrg or Fxcevatlon where there b a drrtge ro the Natural Fxisting(xade lnvolvin9 more than 200 Cubic Yards R. d Materiel avian enY Parcel? - 5 wal rob AppNraDOn Requke Lana txSlUrb1llg Actlvises Encompassing an Area M Excess d Ftve liroueartd _ X (5,000 S.F.)Square FeetdGround Surface? 6 b Deere a Nahsal Welar Cotuse RumNq tlnough the Ste? b 1Ns Prrject wNMn Die TnrasBes htasmcnon a Dafarar nEC BVYPpp aeaNr.or~: a within One Hurdred (700') feat d a Wldbnd or suembWOn a a swPPP b Isgrwad br v Conalmdon adhwec irlecbbg eel Reedn abbdrnne der (i) a more atlas: IndudFS dbbrerloea d bss Fan olr eae rlwt 7 NAI there be Site preparetbn on Fxbtlrq Grade Slopes are pnde brger common qan tltN wi daarblY dlaba aMamtn aoasdbnd; which Exceed FlReen (75)featdVetlkal Rbeto ? X inQxela COnaimdlon adNNas lmroNYlq ad~dbbtMmrsabw Fan ale (t)act rArle One Hundred (100')of Fbrh~IDlydance? me DEC has debmrnatl that a SPDES Dalldtb mquted far atom wale dbtlrgee ( ewPPPS ffiNI nrN tlla Mnkrwm Rw,Nramalr dNe SPD~ taafrnl Pom1k jg WiN Driveways, Parking Areas a other Impervious fw alorm Wtlx Dbehwgsa free CanWuctlan u:tlvly • Pxmk Nw OPa•10iet.) Surfaces bB Sbped to Direct SMrmt•Waler RurfOR ? X i. The SWPPP sIIW bB pmpered trot b tra &arlYlbl d iM NOI. The Np aheN Da Inm andfar In the diraeDOn d a Tam rightaLway! ' eubmbdbtlr DBpenmant pdab Femmrnoamamdoomeudlon acttdb. a.lhe SYrPPP shat Msalho the wwim em aadYrom mad PracOcws and wfrra ,q WIII iMe Pro(ed Require Die Plecerrrerk d Matead, rquhad, gr[aombudlan sbml water mrrrsamsnt Padkea the eft ee used aMror Rertaval d Vegebtlon and/or Ure CenatNCtlon d arty ? X mrwaeabmamr tlv DOlubmb hMOnnwabr dbdlrpas andmeasae Nam WNhkt the Town Right-of-Way err Road Shoulder mrlpaFlea wM tlla bm®BM mldkeM dmb DBrmN.N BddH611, Fe aWPPP amY ~?irN~lbm MII NDTasWdrtl-MYYb,dWlwrr M,aM.) Itlanlsy pdentlY snws d pdFltlsnMlkh may nwwnahy be aryemetl b eaed tlla quaNly dstarm wMa dhcharyea. NOTE: MAny Anawrto Qreetlolr One ibotghNb NAllaaredwMaQrdtAMk 3.MSYVPPPa art rplMe are txrtcrosbuctbn teem rrbr managelme Pacaca b•3ax andfir mmirudlen alb dMWMnesbbalwasll4oaD 8F.a1Aa Merae, mrlpomkahal De Diapered DYequeRlletl tbaprl PrefeaBienBl Lbwrad In New Yak •SbrmdeaW, eratlllq dahraea Erwbn eenaol Plenblbeuhedby Uw iownN Eleibknowledseehb hale Pindpba end Predkasdatam Warr MSnapwnant 9WFdd sect MestWBuDrelaed ter ReNwe Pllerb lN,YIIMdAiq, ttdtlMB Perndt prore: nOledraballl eMbrNrwarbesm oaveambNaeredaxaeonarb~ppsrtm) STATE OF NEW YORK, COUNTY OF SS N ~l 17rat I . . 1.....L.L._.....................~....... being duly sworn, deposes and saYS thaz he/she is the applicant for Pemat, (~of YlllNddrl seNy oonarrll) , . /~(D~ Andthat he/she is[[[t~~~he - .'lornwr, cwaedor, gvam, txrpaeta ONoer, Owner and/or tepresentaRve of the Owner or Omtras, and is duly authorized m perform a have performed the said wodc and m make and file this application; thaz all statements contained iu this application are true to the best of his Itrowlydge and belief; and that the work wi0 be performed in the manner set Forth in the application filed herewith. Swom to befo me ibis; 7'(`I .......day of . < 20..~ 2- y n Notary Public: _---..~~':.r~...`.~.^........f.Y..._f..~................ .......~lyt.~.:.~........_ L~ (slsllaaa.d FORM - 06/10 No~ry PHbYc 8~te ~ N Y 02ME-f~1425 Term lEl~kes 4/29120 /~I,r Town of Southold LWRP CONSISTENCY A55EtS.SMENT FORM A. INSTRUCTIONS 1. All applicatds for permits' ittctuding Town of Southold ag~cies, stroll eamplete this CCAF for proposed actions that are subjxt to the Town of Southold Waterfimu Consistency Review Law. This a.4sessment is inteauled to suppleanent other information used by a Town of Southold agency in making a detem»nation of consistency. 'Except mirror exempt arxionr including Buildtrig Peronits and other ministerial permits trot located within the Coastal Erosion HazaPd Area. 2. Before answering the questions in SeLKion C, the preparer of this fin should review dre exempt minor action lid, policies and explanations of eac}t policy contained in tlx Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluat~l as to its ~gnificant beneficial and adverse effects upon the coastal area (which itN;krdes all of Southold Towv). 3. if any que~ion in Sectiar C on this forth is answered "yes", then tho proposed action may a1~t N>e achievemetrt of the LWRP policy standards and conditions contained to the ooosistency review law. Thus, the action should be analyzed in more detail sod, if necessary, modified prior to making a determination that it is consistent in dte maximum extent practicable with ilte LWRP poltcy standards and conditions. If an arfion cannot be certified as c~sistant with the LV?RP policy starxlards and conditions, it shall not be undertaken. A ~y of the LWRP is available in the following plus: online at the s 2 ' website {southoldtown.nothfark.net), the Board of Trmstarrs Office, L local libraries and tlne Town Clerk's office. B. DE;SCRIPI'ION OF 5TCE AND PROPOSED ACTION JAN 1 4 2013 # so os a.i (hold sown The Application 6ss been submitted to (check apprc~rriate response}: Towo Board © Planning Dept. ~ Building Dept. © Board otTrustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, plarnring activity, agency regulation, land transaction} (b} Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of acticm: RENbVH AND laiPLACH a9 LF OF DHTHRIORATHD BULHIIHAD WITH NHW VINYL BULIUiHAD. STABILI2B BLOFF WTTH AMERICAN CAPH BEACH GRA93. fC [iY.swC A+~ !`CPl.C( tnc~s^f,ry t.y ~J~ 3.~ ` 5'r.a~yt7 ~Ln.R $.a'k 4-e' ~t'o rtin a z rC/~ w~ht' -fo Go.s~'rz~~r 6.,uGh~•~c2 , Location of action: zzo WEST SHORE DRIVE, SOUTHOLD Site acreage: 0.40 PfeSentland USe: RESIDENTIAL Present zoning classification: RES . 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: NSHE WILLIAMBTOWN LLC C/O REGINA MELLY (b) Mailingaddress:_ - ~~,~w~~o~.~~~ sl%rs~ /~ti Y i~~s~3 (c) Telephone number: Area Code ( ) 845-598-6442 (d) Application mnnber, 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 - ARNY coxes of ENCrNEERs DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Towu of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. 0 Yes ~ No ? Not Applicable PROJECT ENHANCES COMMUNITY CHARACTER BY WAY OF PROVIDING A VISUALLY APPEALING AND FUNCTIONAL BULKHEAD. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III -Policies Pages 3 through 6 for evaluation criteria ? Yes ? No x? Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III -Policies Pages 6 through 7 for evaluation criteria © Yes 0 No Q Not Applicable PROJECT ENHANCES VISUAL QUALITY BY PROVIDING A VISUALLY APPEALING BULKHEAD. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimi~r Toss 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 PROJECT PROTECTS THE LOSS OF LAND RAND EROSION DUE TO TIDAL CURRENTS AND UPLAND RUNOFF. 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 0 Not Applicable PROJECT PROTECTS WATER BY WAY OF PROVIDING A BARRIER FOR SEDIMENT EROSION. Attach additional sheets if necessary Policy 6. Protect and restore the quality and funMion 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 ACTION HAS NO EFFECT ON ECOSYSTEMS. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III -Policies Pages 32 through 34 for evaluation criteria. ? Yes ? No © Not Applicable ACTION HAS NO EFFECT ON AIR QUALITY. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III -Policies; Pages 34 through 38 for evaluation criteria. ? Yes ? No ©Not Applicable ACTION HAS NO EFFECT CAUSED SY SOLID AND HAZARDOUS WASTE. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III -Policies; Pages 38 through 46 for evaluafion criteria. ? Ye~ No ®Not Applicable ACTION IS LOCATED ON PRIVATE PROPERTY. At[ach 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 ACTION IS LOCATED ON SINGLE FAMILY RESIDENCE AND UTILIZED TO ACCESS BEACH AND WATER. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III -Policies; Pages 57 through 62 for evaluation criteria. ? Yes ? No ©Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III -Policies; Pages 62 through 65 for evaluation criteria. ? Yes ? No © Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III -Policies; Pages 65 through 68 for evaluation criteria. ? Yes ? No © Not Applicable Created on 5/25/05 11:20 AM 7a n ~ ~j 2 0~3 December 31, 2012 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 220 WEST SHORE DRNE, SOUTHOLD, NY SCTM No. 1000-80-05-4.1 APPLICATION FOR PERMIT Dear Sir/Madam: We hereby submit one original and three (3) copies of the proposed plans, application, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, e rey Patanjo Hewitt Blvd. Center Moriches, NY 11934 RESOLUTION 2013-189 >®R * ADOPTED DOC ID: 8608 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION N0.20I3-189 WAS. ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON FEBRUARY 26, 2013: RESOLVED that the Town Board of the Town of Southold hereby waives Trustees' permit fees for any repairs or construction, that in the sole discretion of the Board of Trustees, are determined to be related to Superstorm Sandy, until April 1, 2013. l~~Q Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [ONANIMOUSJ MOVER: Jill Doherty, Scott Russell SECONllER: William Ruland, Councilman AYES: Dinizio Jr, Ruland, Doherty, Talbot, Evans, Russell s ~ „cz~"s z ti ~~s~s ~`c tic ~ P k ,.a 2 - ~ 1 ~ITiD[{pen these Bank.NA. F~ +9.cwn \ / U SOUTHOLD BAY - - -'~EAN LOW WATER EMOVE AND REPUCE E105T. WALKWAY g STAIRS AS REQUIRED TO CONSTRUCT BULKHEAD HW AT TOE OF BULKHEAD ROPOSED NNYL BULKHEAD (IN SAME ALIGNMENT AS EXIST) PROTECT NEIGHBORING BULKHEAD - (TYPICAL EAST AND WEST) _ _ ED 15' BULKHEAD RETURN <o_-- - - - --~,I: . - ___-45 4'x8.5' PUTFORM I ~ 3.5':8.25' PLATFORM ~ I i~ ~ 3.5'x3.5' PIATFORM I O MR OF DISRkjPTION AND (y i GROUND DISTURBANCE O I ~ i O , ~ n n i i i I . I i i ~ ~ i I ~ i I; ~ ~ v ~ ~ ~ I ~ i ~ i I I / / I 1, I L III i I CONC. PAIq I I i i ~ WD. DECK I EXISTING I SCTM 1000-80-05-3.1 I R I N SCTM 1000-80-OS-5.1 AUkIEI KARPAS I LAURA & VINCENT B. MANETTI 132. ANDOVER ROAD 215-15 67TH AVE. ROSLYN HEIGHTS, NY 11577 \ BAYSIDE, NY 11364 wD. oEa I I GARAGE I I w l w l ~ I ~ ~ I 1 -`r' A ~ 13 ~ ~~C~~~ I N ~ ZI -a"', fE8252013 O _ ~ N ODIhD~ti T~1YD ar of;cl_'~:~ APPR D R=z ~ s ss~ , I N 80ARD OF TRUSTEES ~ I TOWN OF SOUTHOLD ~,S,T x;90 04, DATE 3 , s ,.3 S'HORE' DR ~ ~ I VE ~ , 2/22/13 TRUSTEE COMMENTS 1/27/13 ADDED STAIR PLATFORM DIMENSIONS 1/15/13 PER NYSDEC COMMENTS 1/7/13 PROPERTY OWNER: DATE REVISION NSHE WILLIAMSTOWN LLC. fJOTES: SCARSDAWEO,ONYR~O5D83 BULKHEAD PERMIT PLANS SCALE: 1. ELEVATIONS REFER TO ASSUMED DATUM ~ =zD LOT AREA: 16,57'.2 S.F. / 0.40 ACRES PREPARED BY: PROPOSED PLAN DATE: 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: JEFFREY PATANJO 1z 1 1z REDDAN SURVEYING INC. 106 HEWITT BOULEVARD zzo NEST SHORE DRIVE 962 MONTAUK HWY. BAYPORT, NY 11705 CENTER MORICHES, NY 11934 SOUTHOLD, TOWN OF SOUTHOLD SURVEY LATEST DATED JANUARY 4, 2010 631-484-9332 suFFOLx couNTr, n7 SHEET: TAX XAP N0. 1000-80-OS-4.1 1 of z PROJECT "P~"~' LOCATION ©crP~~ G~' ~x'm„tn x a w ~ a oReydo hones a S" ,s Q "~Y~~eWRcedE'xl NBa~,i,;ovRd x 0. s a G d~~ 3e, cedar Beach Rd PROJECT LOCATION MAP N.T.S. PROPOSED ALUMINUM OR CCA EXISTING BLUFF TO BE TIMBER TOP CAP RESTORED WITH AMERICAN CAPE BEACH CRASS OR EQUAL PROPOSED 16' LONG 10"0 CCA TREATED TIMBER PILE. 6' O.C. PROPOSED 3"Xfi" REAR WALE NOTE: REMOVE EXISTING BULKHEAD STRUCTURE IN ITS ENTIRETY AND INSTALL NEW BULKHEAD I IN THE EXACT SAME POSITION AS EXISTING I I N H PROPOSED 6"x6" CCA it TOP dt BOTTOM WALE PROPOSED 8" TIP CCA EXISTING BULKHEAD LAY-LOG PILE TO BE REMOVED IN ITS ENTIRETY. ~I IPPRO%WTE Y.H.W. B. 1.54 PROPOSED 8" TIP CCA PILE, 6' O.C. 8' LENGTH. BOLTED TO j \ LAY-LOC WITH 3/4" ~ ~ \ APPI10%WTE M.LW Fl. 0.04 GALVANIZED THRU-BCILTS. / PC~ROPOTIEDROD. 6oNO.C~.. DIA. ~//\\//i\~/\\~/\\~/\\\//\\~/~~/\\~/\\\///\\~/\\\//\\ \\~i~\~ //i.//i./G PROPOSED 14' LONG C-LOC 9900 VINri SHEETING ~ .•-0• ~ TYPICAL SECTION A-A N.T.S. ~ a•-o• a-o' REMOVE AND REPLACE IXISTING WNDRAILS b'4 REMOVE AND REPUICE IXISTNG SLRINGD75 TOP OF PROPOSED 9UDCMEAD PflOPOSEU a%a CG SUPPORTS S'S PROPOS D BUU<HEAD SYSTEM IXISTING SAND BOTTOM / I NG SAND BOROM ~V~~~~%V~//~~/~~V~ IuNDRNLS D AEPUCE IXISTING 3/a' OKVANRED HARDWARE ~~~i~~~i%i%~~~ REMOVE AND REPLACE IXISIING STflINGERS TYPICAL SECTION -LANDING N.r.s. TYPW`11 SECTION -STAIRS N.t.S. 1/15/13 PER NYSDEC COMMENTS 1/7/13 PROPERTY OWNER: DATE REVISION NSHE WILLIAMSTOWN LLC. NOTES: 22 GLENWOOD ROAD BULKHEAD PERMIT PLANS SCALE: SCARSDALE, NY 10583 1 ••=Z0• 1. ELEVATIONS REFER TO ASSUMED DATUM 2. LOT AREA: 16,571.2 S.F. / 0.40 ACRES PREPARED BY: PROPOSED SECTION DATE: 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: JEFFREY PATANJO 8c LOCATION MAP 12-,-,2 REDDAN SURVEYING INC. 106 HEWITT BOULEVARD zzo NEST SHORE DRIVE 982 MONTAUK HWY. BAYPORT, NY 11705 CENTER MORICHES, NY 11934 SOUTHOLD, TOWN OF SOUTHOLD SURVEY LATEST DATED JANUARY 4, 2010 631-484-9332 suFFOLrr coUNTr, NY SHEEP: TAX YAP N0. 1000-80-OS-4.f z of z fir, r.::~~ SOUTHHOLD ti._------"_ _ ti• ~ J/~N 1 ~ 2010 E 88.19' S 53°09'29,, I wua .+.:L,mn LOr ~ un aA~AD ~ _ BOTTpA NERD BULK ~ OF t~r SURVEY OF P/0 LOT 12 AND 13,14,15 ON MAP OF w REYDON SHORES, Rw FILED: JULY 1ST, 1931 i.n~Nw MAP#631 SITUATED AT FEN ' ~ Q SOUTHOLD °'e TOWN OF SOUTHOLD Lor Q gT +i 'r "/o` ~ SUFFOLK COUNTY, N,Y C~ ~ I~ SCTM:1000-080.00-05.00-4.1 ~ ~ Y Q LOT AREA:16571.2 SQ. FT. ~ ~ ~ N 0.4 ACRES ~ EUEVAlIp15 IAE ASAIYEO DAn1Y a.N ? 50' ON RRST BOOR wm 2ND STORY ? ~ OEtlf m SeJ, L ~ PROPOSED LINE OF 4'-®' L ' ARROR NTAE OR SIMWA Ir ~ ~ I ~ i ~ wooD REEK . ~OOp ~tE ~ + ~ j I;~..,I, , ' ~ I930' wN°e°o B.30' j til Z~ ~D~ 3 ~ ~ . n. ~ 25.09' Vl 12.49' ~ ~ +9.20' 'i ~ N +as' a 6.29' RETAIN NG c ...r I , f x ~ TWO STORY ~ I---- n 5.00' WALL W FRAMED +.as, V RESIDENCE O ' A O AswMEO nRSr FLOM2 ~g r RC', ELEVAnaN saaD 8 0 PROPOSED ~ 1400' PO Y EQUIP. WIDOOR $HONFF ~ 23.OD' ~ , e. A~ b 1 PROPOSED LEA o1NSERVICE ~+T ~ ~ AtC q.N SWIMMING POOL .13' oWAN~Mtc ~ 2.00' 14.'W' r W TWO CAR GRAVEL RIVE O ° GARAGE x, t ' ,A ~ EIEV FLODR A .,m ~ 23.15,---- zs.as' L(~ O MI N O~ ~ L(~ w ier Lor "T LP Lyr lP Cn > z ~ o ~ , a. ° Y (1 O 272.92 PIPO.L 1.0 NE A SUS ~ ~'mG~RROVEfd ~Y ~ 216, 6 ~ ~'p/~RD OF TRUST~~S RID ao`asE r,f'IT% ~~13-,~0 F(~ ~4r A copy o4 thle eoeument without ° /q ~ ^ ~ 't(7/`:.`-_""°'" propper application of the eurveyo~ e l VQ' ~ 0" smboued Beal should be assumes to , ` REVISIONS De an unauthorized copy. OF) /w~P D 11 ~~11 1y/ ~ ADD SALT WATER POOL 8E SHRUBS 1-4-2010 Frank C. Wataon P ADD PROP. POOL & AMENITIES 10-28-2009 q VEnI AMENDED 08/24/2009 REDDAN SURVEYING INC. 982 MONTAUK HIGHWAY BAYPORT, NEW YORK 11705 NSHE WILLIAMSTOWN LLC. Phone 631-654-3845 Fox 631-289-1978 mallbox®reddansurvn .com UNAUTHORIZED AITERATON OR ADDITION TO THIS SURVEY IS A NOLATON OF SEC110N 7208-2 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. LOCATIONS AND DIMENSIONS SHOWN HEREON ARE FOR INFORMATIONAL PURPOSES ONLY AND ARE NOT 70 BE USED TO LOCALE ANY NEW CONSTRUCTION (FENCES, SNEDS, ~„s N,y rxc Licensed Land urveyor ADDITIONS, POOLS, ETC...). THIS SURVEYOR WILL NOT BE gESPON5IBLE FOR ANY 07-125 05/03/2007 1 20~ NYS License No. 049556 CONSTRUCTION LOCATED BY THIS METHOD.