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HomeMy WebLinkAboutTR-8048 John M.Bredemeyer III,President ��'oF SOU�yQ� Town Hall Annex Michael J. Domino,Vice-President �� O 54375 Route 25 P.O.Box 1179 � _ Glenn Goldsmith � � Southold,New-York 11971 A.Nicholas Krupski � • aQ Telephone(631) 765-1892 Charles J. Sanders ���(soU�,ry�� Fax(631) 765-6641 , . BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE ` � # 1239C Date: June 21, 2016 THIS CERTIFIES that the renair and/or replacement of existin�failed bulkhead sheathin�with vinvl sheathing• repair and/or replace topcaps timberpilin�s(12"diameter x 20') timber wale"rs stringers tie rods and deadmen•repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairwav due to Hurricane Sandy dama�e; � ' At 3925 &3995 Nassau Point Road, Cutcho�ue - . � Suffolk County Tax Map#1000-111-9-5.1 &5.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated Janua ,ry 29,2013 pursuant to which Trustees Wetland Permit#8048 - � '. - � Dated Februarv 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 renair and/or r�lacement of existin�failed bulkhead sheathin�with vinvl sheathin��air andlor replace top caps timber pilin�s (12"diameter x 20') timber � walers stringers tie rods and deadmen• repair andlor replace existing 3' wide staircase and platforms �3'x4')• and replace seasonal aluminum 3'x15' stairwa�due to Hurricane Sandv dama�e. The certificate is issued to ANDREA PARKS owner of the aforesaid property. � �� - Authorized Signature %� � ' . . ' � 4 F a, 1 ��f _ l r ��iE�T.'I-�i+i: John M. Bredeme er III President ;y��-oSu�FO(��o�t:, Town Hall Annex Y , o G s, Michael J. Domino, Vice-President �a y1'=�, 54375 Route 25 Glenn Goldsmith �� •' ?" P.O. Box 1179 A. Nicholas Kru pski ''u� � �'� Southold, NY 11971 Charles J. Sanders ��y�o! �,a��� Telephone (631) 765-1892 �'J=�u��} Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD `'- ��o�i� DA�E OF INSPECTI�N: �C275 C 11 h. h. 1 . INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction � '/z constructed � Project complete, compliance inspection. INSPECTED BY: N��f�Qs�''`' COMMENTS:,S��S ��� Gvrte�j' .pd��f��e /�,,, ��. CERTIFICATE OF COMPLIANCE: � � gUfFp(,� James F.King,Pre.fiident ��4� COG� Town Hall,53095 Main Rd Bob Ghosio;Jr.,Vice-President � P.O.Box I l79 b Dave Bergen W � Southold,NY I1971 - John Bredemeyer �� ♦ �� Telephone(631)765-1892 Michael J.Domino �Ol � �� Fax(63l)965-6641 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 _ 15� day of construction YZ constructed V Project complete, compliance inspection ��11+�� � � � , � . ,.... �� �. 5 1 � ' � Q�\ �� . � � -� ` �f4n� • Yp'Y. Yf 1 96iMr✓rtCWLRMA4`Yd^�HYYdtl:GUSAT.yq�Ow�RN�kYkCYk"'�+YMYM9WACSnv#M'CR' I)Y^�MY'���F4 nrrR^4-Y'a w�uM+nu� . \ � �' � j BOARD OF SOUTHOLD TOWN TRUSTEES 4 SOUTHOLD, NEW YORK � PERMIT NO. 8048 DATE: FEBRUARY 20, 2013 ISSUED TO: ANDREA PARKS (l PROPERTY ADDRESS: 3925 & 3995 NASSAU POINT ROAD, CUTCHOGUE � ; SCTM# 111-9-5.1 & 5.2 � � AUTHORIZATION � � �` , � ��;, � Pursuant to tlte pru�isions of Chapter 275 of the Town Code of the Town of Southold and in °�� ec�ordancc wrih the Re�olut�on of the E3oard of Trustees adopted at d�e meeting held on Februarv 20,2013, and � � in�ons�deraunn nf application fec in the sum of W ANED as per Town Board Resolution kf 2013-60 and �� � subjcct to lhe�I�erms and Condihons as staled in thc Resolution, the Southold Town Board of Tms�ees � � � audiorizcs and permits Ihc tollowmg. /. � 's'.�.; . ; i '_, � • :I WeUand Ycrmit to repair and/or replacc cxisting failed bulkhead sheathing with �� ` l � vinyl shcathing; repair and/or replace tup caps, timber pilings (12" diameter x 20'), � � timber walers, stringers, tic rods, and deadmen; repair and/or replacc existing 3' wide � � staircasc and platforms (3'z4'); and replace seasonal aluminum 3'z15' stairwa,y due to �^` � Hurricane Sandy damage; and as depicted on the project plan prepared by Andrea � � � � , � Parks, last dated on January 29, 2013 and stamped approved on February 20, 2013 � � ��� ' ��. IN W IINESS WIiEREOF,tl�e said Board of��rustees hereby causes its Co�porate Seal to be aftixed � -� and these prea�nts to be tiubscribed by a ivajority of the said k3oard as of th�s date. � ( � _ _ ��gUFfO(,�� -� � '� ; ��O OGy , — �-��c� - _ - , y � �` �' 1 �..� -— -cw.,�:.�-�. • � � y'�rp` � ,�.ap! ___ -- ---- — - --- � ��, � � � � : �'::. ,.. ,i � `�� �3. ;,s;,o,,- ��+�y�.,� �� �'�-��''�:�� � ��t' r�'-������'�' "��G�t .�.�.��.,�'�s � `�����" s ''� �,��-�����``. � v �'�°i�ili�,���,�!�r✓?:,' LG'�y,�4,'._��� ����!�e W+ ��6�4'.��:��`� �i '°�+���iiy ,�_��y��.• "�.:i�b � "�--�`" i;,,.�,4�_����H,i;�°�'�Y'.�`^� �SS� rd������� ��.. .-. � � �.•.. ���� � � ' � ' �. � � TERMS AND CONDITIONS The Pennittee Andrea Parks residina at 3925 & 3995 Nassau Point Road.Cutchoeue.New York as part of the consideration for the issuance of the Permit does understand and prescribe ta the following: 1. That the said Board of Tnistees and the Town of Southold are released from any and all damages, or claims for dama�es, of suits arising directly or indirectly as a result of any operation perfonned pursuant to this pennit, and the said Pennittee will, at his or her own expense, defend any and all such suits ini[iated by third parties, and the said Perniittee assumes Cull Iiability with respect thereto, to the complete exclusion of the Board of 'I'rustees oC the"I'own of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be[he estimated time requirul to complete the work involvecl, but should circumstances warrant, request for an cxtension may he madc to the Board at a later datc. 3. I'hal this Penni� shouid bc retained indefinitely, or as long as lhe said Pemiittee wishes to maimain the structure or project involved, to provide evidencc to anyone conccmeci that auU�orizatirn� was originally obtained. 4. 1'hal the work involvul will be sul�ject lo the inspeclion and approval of the Board or its agenls, and non-compliancc with Ihc provisions of Nie originaling applica�ioi� may be cause for rcvocalion ot this Pcrmit by resolulion of lhc said [3oard. 5. I�hat lherc� will bc no unreasunablc inte�ference with navigation as a result of the work hcrcin aulhorizcd. 6. Chat thcre shall be no interference with the right of thc public to pass and repass along the beach between high and low water marks. 7. I�hat if fuWrc operations of the'I"own of Southold require lhe removal and/or alterations in thc location uCthe work herein au[horized, or if, in the opinion of tlie Board of Trustees, the work shall cause wireasonable obstruetion to free navigation, die said Pe�nittee will be required, upon duc notice, to remove or alter this work project herein stated without � expenses to the Town oC Southold. 8. That Oic said [3oard will be notified by the Permittee of the completion of the work audiorized. 9. That the Pennittee will obtain all other permits and consents Uiat may be required supplcmental to this pennit, which may be subject to revoke upon failure to obtain same. � � James F. King, President ��F S�(/ly Town Hall Annex Bob Ghosio,Jr., Vice-President �O� ��� 54375 Main Road P.O. Box 1179 Dave Bergen 1�( 1�f Southold, New York 11971-0959 . John Bredemeyer G Q Michael J. Domino '� � �� Telephone(631) 765-1892 O��COU�� Fax(631) 765•6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 20, 2013 Ms. Andrea Parks 3995 Nassau Point Road Cutchogue, NY 11935 RE: ANDREA PARKS 3925 & 3995 NASSAU POINT ROAO, CUTCHOGUE SCTM# 111-9-5.1 & 5.2 Dear Ms. Parks: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 20, 2013 regarding the above matter: WHEREAS, ANDREA PARKS 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 29, 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 LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on 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 ANDREA PARKS to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage; and as depicted on the project plan prepared by Andrea Parks, last dated on January 29, 2013 and stamped approved on February 20, 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, v �� James F. King President, Board of Trustees JFK/amn � � ��o��guFFp��-cPG f James F. King,Ptesident o en � Town Hall Annex Bob G6osio,Jr., Vice-President Q 54375 Route 25,P.O. Box 1179 ' Dave Ber en .y,y`� �, Southold,NY 1197 L JoluiBredemeyer 'K!1 � `a� Telephone(63l)765-I892 Michael J. Domino Ea�c(63l)765-6641 BOARD OF TOWN TRUSTEES TOWIV OF SOUTHOLD ro: �-�n r��ea Parks Please be advised that your application dated 3 has been reviewed by this Board at the regular meeting of_ 2 L b 3 and your application has been approved pending the completion o the ollowing items checked off below. _ Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 151 Day of Construction ($50.00) Yz 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 foilowing fee must be paid within 90 days or re-application fees will be �ecessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMfT FEES: TOTAL FEES DUE: $ s� � pn BY: James F. King, President Board of Trustees • �o�suFFa��.�, � ti � Peter Young,Chairman � � Town Hall,53095 Main Rd. Lauren Standish, Secretary � rn P.O. Box 1 U9 'F Southold,NY t 1971 �7/ � Telephone(631)765-1892 �! # �� FaX�6s p�bs-bba� 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 ANDREA PARKS to repair or replace existing bulkhead using vinyl sheathing; repair or replace staircase, platforms and seasonal aluminum stairway. Located: 3925-3995 Nassau Point Rd., Cutchogue. SCTM#111-9-5.1 & 111-9-5.2 Inspected by: John Stein, William McDermott The CAC Supports the application and recommends a bluff stabilization plan. Vote of Council: Ayes: All Motion Carried � -, - - ��.,, , � ,-; - - , :---- i - ' " � ���,. ; __ _ ____; � , � �------_, � � SUFFO(,� lamcs F.Kine,President ���� CQ� P.Q Box I 179 HobGhosio.lr.�Vice-Pmsidenl � d Southold,NY II971 Dave[3ergen oy ? Telephone(631 765-1892 ,bhn Rredemeycr �y T Fax(631)76�-6641 MichaG 1 Domino � 'T` y�of � �aor � Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ��`� / 7 Zo /�- ANDREA PARKS requests a Wetland Permit to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage. Located: 3925 & 3995 Nassau Point Road, Cutchogue. SCTM# 111-9-5.1 & 5.2 Type of area to be impacted: - _Saltwater Wetland _Freshwater Wetland _Sound �ay 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: ;�fs �' � r� l,� 6 -_ � ?!C''% =s d�/ i'� v /f Conditions: Present Were: ' J. Kin ✓B. Ghosio '�D. Bergen, �J. Bredemeyer �Michael Domino D. Dzenkowski other Form filled out in the field by � JC I �� Mailed/Faxed to: Date: __ _ _ — __� _ ��''""�� � RESOLUTION 2013-60 + `��� ADOPTED DOC ID: 8a3o THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2013-60 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JANUARY 2, 2013: RESOLVED that the Town Board of the Town of Southold hereby waives Trustees' permits fees for any repairs or construction, that in the sole discretion of the Boazd of Trustees, are determined to be related to Superstorm Sandy, until February l, 2013. �'��',a�Q�"'_"_— Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED (UNANIMOUSJ MOVER: William Ruland, Councilman SECONDER:Albert Krupski Jr., Councilman AYES: Ruland, Talbot, Doherty, Krupski Jr., Evans, Russell � / '" n�:�,-::f -�� y ' ~ .k.. ��t"- � - �� _. k . .. ._ � . ` i '..} ' � � _ �,. . ..1. 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Box 1179 54375 State Route 25 .If. ,1f. Southold, NY 11971 (cor. Main Rd. &Youngs AveJ T Southold, NY 11971 v' '� Telephone: 631 765-1938 � • �O Fas: 631765-3136 ��'`�OUNi'1 Nc� LOCAL WATERFRONT REVITALIZATION PROGFLAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President D � � � � � '� I� i —�„ :i Town of Southotd Board of Trustees ;!� ��_% From: Mark Terry, Principal Planner FEB 1 5 2013 ! LWRP Coordinator � outhold Tawn Date: February 13, 2013 �r irru� �s Re: Proposed Wetland Permit for ANDREA PARKS SCTM#1000-111-9-5.1 & 5.2 ANDREA PARKS requests a Wetland Permit to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage. Located: 3925 & 3995 Nassau Point Road, Cutchogue. SCTM# 111-9-5.1 & 5.2 The proposed actions have 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 LW RP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that above actions are CONSISTENT with the LWRP. Note that the Board issued a permit for the stair in 1993. A permit was not found for the bulkhead and seasonal ramp and they should be considered new construction. H • � � � � ....,. _ . . � � ., w �,.._ , .�..� __ _., ,___._. � � . , � . .. . . . 5 .f-. . .. . �ar� C�f So��d Tow� Truste�� SCWTHOtD� NEW YQRK �9. : 'k34t _ .,. R*TE: _ .6130144 _ , ISSt,�G► Tti ..,.�?A,4'I��..G�7[GkI�S .. . _ . . _ _,. _.,., '' .r�r��I1�t��[f�tltl Pwiraa# to iMr prov6i�ens af Cl�twr 615 af thr iarri oF r !M SfaFe of hkw Ycrr4. 1&4+3,and Clwpf�r#{of tlro tanMs r� ihr Stata af iYrw Ya�i� 145�: �and lh�r Sar�hdd fi�wm �m tiflad "BE6ULAT�+lG M!D Tf� PL,ACiP� t3F OS51RUC1'IC1PL5 ; �+1 A�1 ClPA TOW�i WATEIkS Ai�ID �'U� �.ANCS rrd tbi RER�bYA�. 4P SANb, +�il�4Y� GR CITt�R b�1�TERiA�.# FR►�lul UNDS tNYDE� TC14Vh1 XnlAT�4:" and in �ooard� +� 1� ` Resolulian t�T1�a 8osrd ndapdad ai i m�ola�q t�r3 on 4139l9!i_. � 19 4�. �e! i�e sansadaryifiwn a# Ft+o w+n of � AQ9,40, pa�d hy : a _ ..���.�.�n�+�.+��t�...._. _.. .._. . .. _._ ._.. _.._._.... _.,....... Y t �y'� y���_. b...,. �.Y +v �i� � � P! _,...hlFiaRdi3....i.M14A}�r . r'ri3TtCuv,bWd....... IA. 1. � iil�K# }5 IiI! f�nn� dad C`.andiYieei Gsled an �r revMA► �bdp I�qtlOf, 9f Swtlwld Towrr Truuteaa a a� psrm[t��1�wr faiiowk� Gr�aelf�tbaat- �rwnt ta rsacm�#suct aiaire f 59" % 36') ae� �pir '� ew'xey: Namaas� Pttitai. aN � tscotd�wac� wii� tha detai�d speci44citian� a pr�wrtFad in �N '1�h► i(Y�iA�. .. � W171VES5 Wi�iE��C3F, 'tka �abd'Meaed af Tru�ta�s 1rn- by carr�a i1s Cixpe*� 5M1 ia bs alfiowrd, and l�4se Fo be wi»cr,'Ir�d iW a mejari�y aP Has sstd 8aard af of � . ��. �.s.�.�.� _ .. � � � �. „� . � ,� `�.���- . . _. _: T;�� u: w� t � {� 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 � F S� • Town Hall Annex ' James F. King, President �� Uljy 0� 0� 54375 Main Aoad Bob Ghosio,Jr.,Vice-President h O p,0. Box 1179 Dave Bergen � � Southold, New York 11971-0959 John Bredemeyer G Q Michael J. Domino '�O � �� Te1Fas(6316 76676841892 �y�OUNTi�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only �oas[al Erosion Permit Application edand Permit Applica[ion AdminisVa[ive Permi[ / AmendmenUTrans edE tens�on � �5 2 � � � �/ Received Application: � �� �6 ' �ReceivedFee:$ U;QiVE� Sb�u�IlaY��ZD�3-lo� �n� Completed Applica[ion �� �� � Incomplete -----��� JAN 2 9 2013 SEQRA Classification: Type 1_Type II__ Unlisted Coordination:(date sent)_ outhoid Town �LWRP Consistency Ass ss ent Form_ 2�_�_ __ � CAC Referral Senl: _� 1 Date of Inspection: Receipt of CAC ReporC Lead Agency Dctermination: _ Teclmical Review: �Public Hearing Hel�� Resolution: �� Name of Applicant � ��C� �C�`J-�(�S Mailing Address �j��� � J I I � 1 VQsv��` �Qi ✓1 � ^"'"''-' �?�.�'l��� Phone Number.( ) ��� �J T � ��� � Suffolk County Tax Map Number: 1000 - �) � - �-J. I dhC� �OC� '- I I 1 -9 - ,`�•� Property Location: 1 �1�gSC'AA.1. 1 OI ✓�'� ���� , ��c�c�tJ�� -�}f��rn -� . � �,��e, a�d �ri e.�`��� e 6 m���. be, V� ��, � 1 �� � (provide L1LC0 Pole #, distance to cross streets, and locafon) AGENT: (If applicable) Address: Phone: � � C�`�a��'. Bo�d of Trusteas Application . GENERAL DATA ��- aCp �'�� L��ea�(ip sc�are feet : � �q,�� rF U-�� _S9� � . �t��-e ��eL� 1 a�t� Area Zoning: �Si�Qi'� �I Previous use of property: �-�lv�1�a I Intended use of property: �i C�L-�L i cy.y Covenants and Restrictions on property? Yes No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board Appeais? Yes No If"Yes", please provide copy of decision. Will this project require any demolition as per w Code a determined by the Building Dept.? Yes No r Does the structure (s) on property have a valid ertificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior pe its/approvals for site improvements. Has any pe t/approval ever been revoked or suspended by a govemmental agency? No Yes If yes, ovide explanation: Project Deseription(use attachments if necessary):�2.Pc� Y c�/ov �'2�a�� sL?c��5�'r�q u p��, �\e_�, �bc�.1k-1�sza� sh���� � wr-�, vt� � h a�;�,� ; �r o�-����' ���` ao �� � �sY.,�✓ i�r ' �m�Y vUd� s�nv� e�s� tie ra�� �z�d�- c,.r, re,��a.�r �D��v ,�e� c�2 e�,c�°s�'���,3�t u,`-a���'� ��1wt�rw,s �3�Pcw��� x 4ft� a� - s �r Jvcr �, ca1J��o� � �ei�n� ��y �loo.�r� �e���s �am �le��c s�o. �ev�� �(v`^.� }�nY ri c a l✓� __�,,n C �, . Bo�d of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: K Q,�a l►� �Q��� CT� �u�`������ c�v,o� 5��,�ca � c� ��� � �. ���a�.�,e� Sc�.rndc� �l Area of wetlands on lot: squaze feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated. cu �c yards t. How much material will be filled? ubic yards Depth of which material will be removed or de sited: feet Proposed slope throughout the area of ope tions: Manner in which material will be re ved or deposited: Statement of effect, if any, on the wetlands and tidal waters of the town that may result by reason of su proposed operations (use attachments if appropriate): PROJECT ID NUMBER 617�20 SEQR • APPENDIX C STATE ENVIRONMENTAL QUALITY �W SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT!SPONSOR 2.PROJECT NAME (��� �� S T / S �, f�PR..�� '�'('�-K-�-S Fs'r0lZ�� Q 3.PROJECT LOCATION: L-� — I Municipaliry 'S� �.n� l_�/ ��Q w . County �7(J.��l�F-- . 4c.�PR ISE LOCpATIO�3Nr� Stree Aqdd.�ess apn,d� �Road Interse ons. P/��r m,�inent landmayr�-k1s��etc�-/or P ovide m�ay p!�,�}� '�� J 1�� �"J� lJ �I`—Z7I l�.l �0��� `�V� � ��( VV . V���J�aN � a.�'�J��C'� �-� �. � �Ck4o C,'�l�_ S. IS PROPOSED ACTION: � New �Expansion ❑Modifcation/alteration� O_ `� � —1�y ��� � f3�. C�\!.1� 1 6 ESCRIBE PROJ CT Fl-- -- ����� , I �� qi���� ce�lo.e� ��v2, �c� ��\�d �ulk�c�d s ' w;� r`^� s►-,oa��v� P�e�-��( c,�/o�. r�f��cnc� {�� �cx(�, t-rml�r �r �hgs C �2� x2o') �-�� Wc3.�ers; �5�.-5 �s, L,� rad,� , dec�,c�,v�,�.rr, � ne-('°�� � d-cl�vV re,�i�.c2 �ac�sti � s�;r a �3'wr�� , ' �la:�w�s C3 `x4-' d-,d sti��l � d\N,m��,u+� �3'X i5' } st�r�.,a� �.a.�.�s� ��y ��t�-�r��� by �FI a`hh� e.��;s �v�„ �I�va.�ed �ecy, te�� �o� `i'�-`1_rv�'cane. Sc�, � 7.AMOUNT OF LAND AFF TED Initially O� acres Uttimately��� .asres - 8.WILL ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes ❑ No If no,tlescribe briefly: 9.W T IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) �, Residential �Industrial �Commercial �AgriculWre �Park/Forest/Open Space �Other (describe) '�� 10. DOE ACTION INVOIVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL '� AGEN (Federal, State or Locaq � es �No If yes, list agency name antl permit / appmval: D� �- 11.DOES ANY A CT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ' ❑Yes o It yes, lisl agency name and permit / approval: ' 1�2. A"S A RE�T PR POSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I vies ❑No � � � . � � I CE �FW T T THE WFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE . � ,� I Applicant / Spons ��N e ' ate: � : ' ' � �q I�. SignaNre � . I If the action is a Costal Area,and you are a state agenc , omplete the Coastal Assessment Form before proceeding with this assessment � � PART II- IMPACT ASSESSMENT o be com leted b Lead A enc A OOES ACl10N EXCEED ANY 7YPE I THRESHOID IN 6 NYCRR,PART 61T.4? I(yes,coordiaate Ihe review process afxf-use lhe FULL EAF. � Yes a No B. 4NLL AC710N RECEIVE CAOROINqTFD REVIEW AS PROVIDEO FOR UNUSTED ACTIONS IN 6 NTCRR,PART 617.67 It No,a negaUve dedaradon may be s�arseded by aaolher involved agenq. � � Yes a No C. COUTA ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIA7E0 WITH THE FOLIOVNNG(Mswers may be handwdtte�.H legible) C1. EqsUtg air quafity,surtace or grounCwater quaFty or quanlity,nolse levels,ezistirg traK�c pattem,sWid waste proGuction or disposal, pole�tial for erosion,drainage or flaotling problems? Ezplam briefly: C2. Aesihed0.agricultural,archaeobgical,histoiic,or oqier�atural or wltural�esources;or commwdty a neighbofioad chafadeR E�lain briefly: C3. Vegefation or fauna,fish,shellflsh�or w�ldGfe-species,sig�ificanf habitffis,or threateneQ or eMaigen.W speciesT 6cpWM Ixiefly C4. A mmrtwnity•s ezisting plans or goais as officially atlopteA,or a�chaoge�ia use w intensity ot use of land or dher natural resources9 Fxplaln briefly: C5 Growth,gubsequent developmenL or relatetl adivities hkely fo be induced by Ihe proposed action?Fxplain briefly: � �� C6. Long term,shoA lerm,cumulafive,or o(her effects not ideotifietl in C7-CS? Ezplain briefly: -� " � � C7.-OtfceY im ads indudin chaa es in use of ei(her uao6t or! e of eae ? E Iain briefl ;-- - �� � �� �--�� -�----- "� D. WILL TNE PROJECT HAVE AN IMPACT pN 7HE ENVIRONMENTAL CHARACTERISiICS THAT CAUSED THE ESTABUSHMENT OF A CRITICAL - � ENVIRONMENTAL AREA CEA? If es, lain briefl : - � � Yes a No � . E IS THERE,OR IS iHERE IIKELY T4 6� CqNTROVERSY REIhTED TO P07ENTULL SE F1�MRONMENTql.IMPACTS7 If es Iain: QYes a No PART III-DETERMINAT1pN OF S�IGIiIFICANCE(To be completed bY/1gen�Y) " . MISTRUC710NS: ForeachadverseeffectiCentiryedabove.detertninewhetheritiswbstaaBal,large.importarrtorotlienWsesignificant Each effed alaWd be assessed in oonnedion wilh ds(a)selting p.e.urban w ruraq:(b)P��dY af occuning�(c)durado�:(d)imeversd�� 9ea9rephk SooPe:e�d(�me9Ntude. If neoessary�add attachments w reference supporting matarials. Ensure that explanetians contaen. sufflcient defa8 Qo show Wat aU relevant adveFse impads have been idenGfied and adequatelY addeessed. IfquesHon d of part d was d�qdced yes.the da�fna6bn of signlficeme murt evaluatelha potendal Mipactof the Prop�ed acUon on Uie enNrontneMa� af�ataC6e�istics of Uie CEA EAF�boxifyouhav.eWe�UGedoneormorepoteMiallylaigeorsigMfic:a�ri.adverseknpadswhld�lAAYocax.ThanpromeGdiredtytotlie PrePeR e P�dedarafian. � ��box NYou-have detertnk�eG�baaed on pie MfotmaUo�a�d analysis above and aaY supPaAing documentaUo�.diat tlte proposed a WILL NOT result in airy significant adverse environmental impads AMD provide.on�attachmenls as neoeSsa�Y.tlie reaso�s suppqtirg Nii detertninafion. N Board of Tnistees [� yf� 8 J�/3 Name of Lead Ageacy Date �����f / - �y/� � President � PnM or ype Name of Responsible Officer in Lead Agency Tille of Respons7ble ORcer o�- / gnaWre of Respo�s�ble Officer m Lea gency Sgnature of Preparer(If different hom responsible officer) � ���oSUF�Q k � lumes P. I�in�. Presideni ��� ���� ��o�rn I lall. 53095 Main Rd- Bob Ghosio. Ir. . V ice-President � ,��. rn � P.O. Bu� I 179 Dave L3rrgcn µ � ♦ '�"'� Southold.NY I 1971 .IohnBredemeyer 'f/ 0� "Celephone(631)765-1892 Michael.I. Domino �1 � �'� Fax(631)765-6641 BOARll OF TOWN TKUSTEES TOWN OF SOUTHOLD n � � � 0 � � BOARD OF TRUSTEES: TOWN OF SOUT'HOLD ll LI � ------------------------------------------------------------- - F E B 2 0 2013 In the Matter of the Application of Southold iown ANDREAPARKS T COUNTY OF SUFFOL,K) STATF, OF NEW YORK) �1FFIDAVIT OF POSTiNG I, �C�,�� �Q'���� , residing at/dba 3��� ' �qqJ �d�`�C.'l.� T � � � _ — _ -- ____ being duly s rn, depose and say: Th��h� d�yilo�lC� 01��sonally posted the properry known as ! by placi��g the Board of Trustees official p ster where it can asily be see�, and that 1 have checked to be sure the poster has remained in place for eight days rioi to the clate of tl�e public hearing. Date of hearing noted thereon to be helcl Wednesda F ru '' 20 2013. Dated: ����� }� / (sig t Swom to before me this ��day of��-0 13 ELIZABETH A. FARNAM �—_ Notary Public, State of New York No. 01 FA6162855 �.,�� � Qualifled in Suffolk County otary ublic � Commission Expires March 19, 2015 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: gnc�r�� P� � , SUBJECT OF PUBLIC HEARING: To repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'); timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminu Ti��aE a&e tDATE an�dF a�U B LI C H EARI NG: G�aec�►�esdo�/, Fcbr�ary2v, 20�3 - o�n o� ��#- 6 :vd � � If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours ot 8 a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 — _ � � � , , . - ' � � � EC � 019 � D PROOF OF MAILING OF NOTICE D _ ATTACH CERTIFIED MAIL RECEIPTS F E B 2 0 2013 outiwld own Name: Address: c�J�Y'n�� ��`(1�0.Q� ��`T� I VG� ��1 � �U v ��,� S���r 4-� .t'�-.�;y I.�.�� , ���, N�l ► 1 � � �(re.i�e, MQ�}+mu �,tsl-,a�u�� , � �� Nas-��.F �o�n� �o a� Md.�t�'� � ��)��s `lov� ��vi� �l(� �Ja ��.� ��r v�`t �o a.s� - STATE OF NEW YORK COUNTY OF SUFFOLK �(�.�1A P Y�y kg > residing at c3`���' ���� N����,� �o�r� fc� C�,A �Q o�—, being duly sworn, deposes and says that on the �� ay of , 20�, deponent mailed a true copy of the Notice set forth in the Boazd 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 sons as shown on the current assessment roll of the Town of Southold; that said Noti ere mailed at the United States Post Office at�f een[�jr-�— , that said Notices mailed to each of said persons by CERTIFIED MA L/RETURN RECEIPT. Swom to before me this � � Day of F�. r , 20 l3 ELIIABETH A. FARNAM Notary f�ublic State of New Y� a A �� � � No.Q'�FA6162855 K� QuaHfled in Suffolk Counh �— Nota Public Commission Expires March 19 d�w�� Town of Sou old � �OgErosion, Sedimentation 8� Storm-Water Run-off ASSESSMENT FORM vROPEH7Y LOCAiION: S.C.7.M.»: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A �l �� STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN s�ict 3�ution BToc� ' o� CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONS'IRUCT'ION ITF.M# / WORK ASSFSSMF.NT Yes No a. What is the TOWI Area of the ProjecJ Parcels7 � Will this Project Retain All Storm-Water Run-Off iii Qnclude Total Area of all Parcels bcated within � �� Generated by a Two(2")Inch Rainhall on Site? / the Scope of Work for Proposed Construction) ' (This item will include all run-oH created by sile V ❑ (S.F./Acres b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all andlor Grountl Disturtance forthe proposed -H ^O� , Site Improvements and the pertnanent creatlon of construction activily? �X impervious surfaces.) � (S.F./Aves) Q Does ihe Site Plan andlor Survey Show All Proposed �❑ PROVIDE BRIEF PROJF:CI' DFSCRIpt'ION t���aiu�Mi r.��.,.H«nm� Drainage SWctures Indicating Size&Location?This .. 1Y �, �,/C �,.�^ �,��,�,� ,�N ' Item shall Include all Proposed Grade Changes and � i -����� "r��� L Slopes Conholling SuAace water Flow. / �/t �q.� Iv�o • LQA �✓ Does the Site Plan andlor Survey desuibe 1he erosion , / � 7 I �� and sediment control practices that will be used to V L � 1 control site erosion and stortn water discharges. This 'U1^n�✓ VJ�1.12.YS y S��i t�4�YS , FS2-. YOGS item must be maintained throughout the Entire �J ��--1 � 1 Cons[ruchon Period. �'�L1"!�"l�a�'1 "'. �`Q,P�l."1� O�T'OY Y�,[�l C`.lC�"' 4 Will this Pmject Require any Land Filling,Grading or / � \ y,(� Ezcavation where there is a chan e to the Natural � �1C1�S`�Uld 5iL1.1 YCLR��. �-3� W f�) � �+l rOV Ezisting Grade Involving more th n 200 Cubic Yards � �� � of Matenal within any Parcel? C 3�(�� � SQ G.)p✓1�� 0.'�M j n uw1 ��3 7C�S� 5 Will this Applicalion Require Land Disturbing Activities � — / `__ Encompassing an Area in Excess of Five Thousand S � �` � (5,000 S.F.)Square Feet of Ground Surface? QjQ,�1{\ .S' yr+ �p),/a .�,�,j� s Is[here a Natural Water Course Running through Ihe ❑ — - Site? Is Ihis Project within the Trustees jurisdiction General DEC SwPP Reuuiremenb: or within One Hundred(100')feel of a Wetland or Submission o!a SWPPP is required for all Consbuclion aclivities involving soil Beach? d'sWrGences of one(7)or nwre acres; induding d'SNrbances ot less ihan one acre thal 7 Wii1 there be Site preparation on Ezisting Grade Slopes ❑ / are patl ot a la�gar common plan Ihat will uftimately disturb one or more acrcs of land; `i which Exceed Fikeen(15)feel of Vertical Rise to inGuding Construction acNvilies invoNing soi�dislurDances o(less than one(7)acre where One Hundred(100')oF Honzonlal Distance? Ihe DEC has determined Mat a SP�ES permit is required for slortn water tlischaryes. (SWPPP's Shall meet Mre Minimum Requirements of the SPDES General Permil $ Will Dfiveways,Parking Areas O�othef ImpeNioUs ❑ � for Storm Water Diacharges hom Conzlruetion aetiviry-Permit No.GP-0-10-001.) SurfaCes be Sloped�o Difect S[oRn-Wa�er RUn-Off 1.Tha SWPPP shall be Orepered pnor lo ihe subminal of 1he NOI.The NOI shall be in[0 and/of in Ihe direc�ion of a Town nght-of-Way? submilte0 to ihe Depenment pbr b tha commencament of construclion activiry. 2.Tha SWPPP shell descri0e the emsion and sedimanl conlrol practices ana where 9 Will this Project Require ihe Placement of Material, ❑ — I required.poslconStmGion storm waler management practices Ihat will be used an0/or Removal of Vegetation and/or the Construction of any conslructed to reduce Ihe pollulants in slorm water discharges and to assure I[ym Within the Town Right-of-Way or Road Shouldef compllance wilh the terms aeW cond'Rions of ihis permil.In a0tldion,the SWPPP shall qrea?�rn�.u.m win xo*mowa:en�i�miwo�a�om.w.ynaooa.� identify polential sources ol polution which may reasonaWy Ee expecled to aHect the quality of storm water discharges. NOTE: I(Any Answer to Questiona One through Nine la Answeretl wIN e Chxk Mark , 3.All SWPPPs I�a�require the posttonsiruction slormwater managemenl praciice �n a Box and�he cons4uction site tlisturbanee b between S,OOO S.F.81 Acre in area, ' component shall�e prepared by a qualifieA Design Professional licensetl in New Vork a Srorm-Water,Grading,Drainage 8 Erosion Controi Plan ia Requiretl Oy the Town ol Ihat is knavAedgeable in Ihe pn^ciples and p2ctices of Seortn Water ManagemenL Southold antl Musl be Sabmitted for Review Ptlar to iesuantt o/Any Building PermiL �. (NOTE'. A C�etk MaM(�) antllm Mswer fn eac��ueslion is Required kt a CanpW�e AppliwGon) S1'ATE OF NEW YORK, .L� I�� i /� COUM'Y OF..... .........�.. ....................SS ' 1'hat I,:f...l..l..�>�%!...'C..�...........�:.�I�...`..�..........bein dul swinn,de�oses and sa s d�at he she is the a licant tor Permfy �... (NamaolinGivitlualsigni�gDocument) � Y' 4 Y � pV I Md that he/she is the .............................................�....�.�J. � �-� I� ....................................................................................................... (Owner,Conlraclor,Agenl.Gxporata Olficer.elc) 'I Owner and/or representauve of the Owner or Owners,and is duly authorized to perform ave performed the said work and tn � make and file this application;that all statements contained in this application aze trve t e est of his luiowledge and belief;and i tha[the work will be pedormed in the manner set forth in Ihe application filed herewid � Swom to before me this; r� i � -3� � - y �J 0.-0� � � [� .....................................,...�.,...�}...da �......\....�../.�.............................. ,20..... ....... . Notary Publir. ....��,.�L�.l..........T�'..T..�C`:.��..............._......... �. .. ....................................................... . (Si9naWre M AppfipM) FORM - 06/10 �'� 1 1 96 QuaNlbd in Suffdk Cou�y Commission�icpires luly 28,ZO�� Bo� of Trustees Application • County of Suffolk State of New York �a2.� p�a�ic s BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE T TRUSTEES, THEIR AGENT(S) OR REPRESENTATNES(S), TO ENTER ON Y PROPERTY TO INSPECT THE PREMISES IN CONJLTNCTION WITH R I OF THIS APP ICATION. , i K � Si tu of Property Owner SWORN TO BEFORE ME THIS �� DAY OF -���`�''^� ,ZD �3 ,e � _ Notary ubli � 0 � 375�b� anMrwon�M�r 3Ci',"2U �� � � APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold s Code of E[hics orohibits conflicts of interes!on the part of town ofFcers and emolovees The ouroose of ��, this fortn is to nrovide information which can alert the town ofpossible contticts of�ntefest and allow rt to take whatever actwn�s li nece �rv to avoid same. ��^ """ n � � '�, YOUR NAME: �I'TK��� �• "� A � . '��, (Last name,first name,�iddle initial,unless you are applymg m the name of : someone else or other entity,such as a company.If so,indicate the other persods or company's nameJ �''� NAME OF APPLICATION: (Check all ihat apply.) . . - . ; Building . ;� � Tax grievance � .. . Variance Trustee � � � Change of Zone Coastai Erosion � Approvai of plat Mooring �. Exemption from plat or official map Planning _ � � O[her (lf"Other�,name[he ac[ivity.) � Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any office�or employee of[he Town of Southold? "Relationship"includes by blood,marriage,or business interesl"Business interesP'means a business, including a partnership,in which the[own officer or employee has even a partial owncrship of(or employmen[by)a corporation in which the town officer or employee owns more than 5%of the shares. . YES N� � If you answered"YES",comple[e 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 applicanUagenUrepresentative)and the town officer or employee.Ei[her check ���, Ihe 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 appiicant . � (when the applicant is a corporafion); B)the legal or beneficial owner of any inrerest in a non-corporate entity(when the applicant is not a corporation); _C)an officer,director,partner,or employee of the applicant;or D)tbe actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of�ZOQ' �3 Signature ���� _ Print Name S — I Form T'S I Town of Southold • • LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for pernuts* including Town of Southold agencies, shall complete this CCAF for proposed acUons that aze 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 rncluding Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A pronosed action will be evaluated as to its siQnificant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standazds and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listine both supportin¢ and non- supportine facts. If an action cannot be certified as consist ds and conditions, it shall not be undertaken. • A copy of the LWRP is available in the following places: i at t���'o�o��@uth website (southoldtown.northfork.net), the Board of Truste O ice, the Planrung'��ep rtm nt, all local libraries and the Town Clerk's office. outhold own B. DESCRIPTION OF SITE AND PROPOSED ACTION e SCTM# 10Op - �11 - `� 'S. � d�c�. �000 — III- V -J-2 PROJECT NAME D\?.1� C}i,C�A S`�.,�Y C�-S� �q�C�,l:l lr The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ conshuction,plazming activity, agency regulation,land transaction) ❑ (b) Financial assistance (e.g. grant,loan,subsidy) (c) Pemrit,approval,license,certification: ` � ` Q�c�i/ o,.��ov I�e�cx�e �ic i slA��a �.i I� bv �'I:l-.�0..c� �6.0 0� . �, w i f�"� i n � Na e and extent of a�tion: i�-,he,V � �� � � �t Z'�"� �p� st,�h'�.,r , r �d ov r lace �-�� �ox,�s ; � P ,,`j . �ov re.��ace e-`�'�stil�, S Ycd�S2 �3` �r e c.�01� �o.'�.��tv�� �'3 x� � Seo,soh o. �r�, iv,um cs �� °^ �✓� L?� �o a,k�� d�.a.b r�'"s �,r, e le�c�, _ �a m� I�ur*-i e �� � • � G • . /'� ' � Location of action: ��� � �9 / 5 ��c��Ji.l.� � � �L,(J������-� Site acreage: `� 2�� �� Present land use: ��-S I�CI��1��Gl I Present zoning classification: l�e��� (.l a 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: 1 I V (�'�� 1��S _��� (b) Mailing address: �_ r � � 4,�� 9� I VC����� p' G �UJ _ <'.u�r �d� (c) Telephone number: Area Code ( ) /,, r� I / �� — u d�J z (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No� If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III–Policies; Page 2 for evaluation criteria. �Yes � No � Not Applicable Attach addition2l sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Po(icies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No � Not Applicable � � Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No� Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria � Yes � No � Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria � Yes � No �ot Applicable Attach addiNonal 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 Appli�e � Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. � Yes � No� Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III— Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No �Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. � Ye�1 No�ot Applicable 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 evaluatiou criteria. ❑ Yes ❑ No � Not Applicable 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�P,1 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 PREPARED BY �1G�� ��� TITLE �U� �� DATE + �'13 5 u rvey of Lat 23 N "Map of Nassau Point Uub Propertivs, Section A" �v� \ E Filed on October 14, IG19 as Map # l45 SGT� 1000-.lN-9-5.1 S Surveyed: 08-10-04 Situate: Nassau Polnt Town: Southold Suffolk Gounty, NY �� '; � SGALE I"= 40' ' ��I!i Gertlfled to: � �� �, 6� ��il � Mdrea Parls Mon- _ � �, �i I� il �It ii `', r � Utlmorta e Inc. F"d� �1 0 � Peconlc tract Inc. �, � � 3 �NP0 032�onal Tltle M o , � �� ' � ' . � ° � Ineurance Gompany oP NY � � ��Q�' �� � � Q� � __ -_--_-' o � # --- r i, "3�, +/- '� -n � ' ' `� ' - Z ',, 413•0 °i 1� � ',,Q o ' i� 1 � LOnL. 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