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HomeMy WebLinkAboutTR-8069 James F. King, President Bob Ghosio~ Ir., Vien-preside~ · Dave Bergen ' John Bredemeyer Michael I. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Maia Rd. · . P.O. Box 1 t79 Telephone (631) 765-1892 Fax (63 !) 765-6641 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE ,/ Pre-construction, hay bale line 1st day of construction __ ¼ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8069 DATE: FEBRUARY 20~ 2013 ISSUED TO: JOHN W. BELLANDO PROPERTY ADDRESS: 1370 JACKSON STREETn NEW SUFFOLK SCTM# 117-10-10 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 per 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 100 linear feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic yards of clean sand fill behind bulkhead; plant disturbed bluff with beach grass; replace existing deck and stairs; with the condition that the upper deck is no more than 100 sq. ft.; and to establish and subsequently maintain a 10' wide non-turf buffer at top of the bluff; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated February 22, 2013, and stamped approved on March 22, 2013. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee John W. Bellando, residing at 1370 Jackson Street, New Suffolk, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third pmties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board Will be notified by the Permittec of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King. President Bob Ghosio, Jr. Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 February 20, 2013 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: JOHN W. BELLANDO 1370 JACKSON STREET, NEW SUFFOLK SCTM# 117-10-10 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 JOHN W. BELLANDO 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 22, 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 to remove and replace 100 linear feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic yards of clean sand fill behind bulkhead; plant disturbed bluff with beach grass be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, the LWRP Coordinator recommended that the proposed application to replace existing deck and stairs to pre-hurricane location and dimensions be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered the Local Waterfront Revitalization Program policy 6.3 to the greatest extent possible through the imposition of the following Best Management Practice requirements: the upper deck to be no more than 100 sq. ft.; to establish and subsequently maintain a 10' wide non-turf buffer along the top of bluff; 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, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees APPROVES the application of JOHN W. BELLANDO to remove and replace 100 linear feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic yards of clean sand fill behind bulkhead; plant disturbed bluff with beach grass; replace existing deck and stairs; with the condition that the upper deck is no more than 100 sq. ft.; and to establish and subsequently maintain a 10' wide non-turf buffer at top of the bluff; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated February 22, 2013, and stamped approved on Mamh 22, 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 James F. King, President Bob Ghosio, Ir., Viee.-President Dave Bergen John Bredemeyer Michael I. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, ~ 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated , ! Z_7~/L~/ / has been reviewed by this Board at the regular meeting of ?_b '--q and your application has been approved pending the completion oltthe {'~)llowing items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day (~f. Construction ($50.00) ½ Constructed ($50.00) v/// 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: BY: James F. King, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Tues., February 12, 2013 the following recommendation was made: Moved by John Stein, seconded by Doug Hardy, it was RESOLVED to SUPPORT the Wetland Permit application of JOHN BELLANDO to remove and replace 100 If. of existing bulkhead with vinyl bulkhead and to NOT SUPPORT the application to raise bulkhead top cap elevation 4' above existing, import 130 cy. clean sand fill behind bulkhead; and planted disturbed bluff with beach grass. Located: 1370 Jackson St., New Suffolk. SCTM#117-10-10 Inspected by: John Stein, William McDermott The CAC Supports the application to replace the bulkhead, however, does Not Support the raising of the bulkhead to 4' in height. The CAC further recommends the run-off from the top of bluff is addressed and the installation of a 20' non-turf buffer. Vote of Council: Ayes: All Motion Carried 2013 ' PO Box 1179 Southold. NY 11971 [elcphone (631 765~1892 Fax (631 ) 765-6641 Date/Time: Southold Town Board of Trustees Field Inspection/Worksession Report Jeffrey Patanjo on behalf of JOHN W. BELLANDO requests a Wetland Permit to remove and replace 100 linear feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic yards of clean sand fill behind bulkhead; plant disturbed bluff with beach grass; replace existing deck and stairs to pre-hurricane location and dimensions. Located: 1370 Jackson Street, New Suffolk. SCTM# 117-10-10 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: ~G'hapt.275 Chapt. 111 other Type of Application: ~etland __Coastal Erosion ~Ad ministrative__Emergency __Pre-Submission __Amendment Violation Info needed: Modifications: Conditions: Present Were: J. King ~B. Ghosio __ D. Bergen, t,/~. Bredemeyer ,-"'Wlichael Domino D. Dzenkowski Form filled out in the field by .I,,~ Mailed/Faxed to: Date: other Photo 1 Photo 2 Photo 3 January 18, 2013 NYS Dept. of Environmental Conservation SUNY ~ Stony Brook 50 Circle Road Stony Brook, New York 11790-2356 Attention: Duty Analyst 1370 JACKSO. STREET, NEW ~UFFOLK, NY SCTM NO. 1000-117-10-10 APPLICATION FOR PERMIT Dear Sir/Madame: We hereby submit four (4) copies of the proposed plans, applications, check, photographs and required data for permit approval for the above ~ project. ff you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Center Modches, NY 11934 cc: Army Corps of Engineers NYSDOS John Bellando ECE VE JAN 2 2 20t3 New York State .~OZNT APPLZCATZON FORM For Permits/Determinations to undertake activities affecting streams, waterways, waterbodies, wetlands, coastal areas and sources of water supply. You must separately apply for and obtain separate Permits/Determinations from each involved agency prior to proceeding with work. Please read all instructions. US Army Corps of Engineers (USACE) APPLICATIONS TO 1. NYS Department of Environmental Conservation Check all permits that apply: [] Stream Disturbance [] Coastal Erosion [] Excavation and Fill in Hanagement Navigable Waters [] Wild, Scenic and [] Cocks, Moorings or Recreational Rivers Platforms [] Water Supply [] Dams and Impoundment [] Long Island Well Structures [] Aquatic Vegetation Control [] 401 Water Quality [] Aquatic Insect Control Certification [] Freshwater Wetlands [] Fish Control [] Tidal Wetlands [] Incidental Take of Endan- gered/Threatened Species [] I am sending this application to this agency. 2. US Army Corps of Engineers Check all permits that apply: [] Section 404 Clean Water Act [] Section 10 Rivers and Harbors Act [] Nationwide Permit{s) - Tdentify Number{s): $ Proconstruction Notification - E~] Y / [~ N [] I am sending this application to this agency. 5, Name of Applicant (use full name) Applicant must be: JOHN W, BELLANDO [] Owner [] Operator Mailing Address [] Lessee 25 WELLESLEY ROAD (check ail that apply) Post Office City ROCKVlLLE CENTRE Taxpayer ID (If applicant is NOT an individual): State NY Zip Code 11570 Telephone {daytime) Email 212-286-2474 JOHN_BELLANDO~CONDENAST.COM 3. NYS Office of General Services Check all permits that apply: [] State Owned Lands Under Water [] Utility Easement (pipelines, conduits, cables, etc.) [] Docks~ Moorings or Platforms [] I am sending this application to this a~ency. 4. NYS Depart- ment of State Check if this applies: [] Coastal Consistency Concurrence [] T am sending this application to this a~lenc¥. 6. Name of Facility or Property Owner (if different than Applicant) Nailing Address Post Office City State Zip Code Telephone (daytime) Email 7, Contact/Agent Name JEFFREY PATANJO Company Name Mailing Address 106 HEWrrf BLVD. Post Office City CENTER MORICHES State Zip Code NY 11934 Telephone {daytime) 631-484-9332 8. Project / Facility Name 1370 JACKSON STREET Property Tax Nap Section / Block / Lot Number 1000-117-10-10 Project Location - Provide directions and distances to roads, bridges and bodies of waters: SEE LOCATION MAP Street Address, if applicable Post Office City State Zip Code 1370 JACKSON STREET NEW SUFFOLK NY 11956 Town / Village / City County SOUTHOLD SUFFOLK Name of USGS Quadrangle Map Stream/Water Body Name SAG HARBOR GREAT PECONIC BAY Location Coordinates~ Enter NYTM~ in k ometers, OR tatitlJde/Longitude NYTM-E NYTM-N Latitude Longitude 40° 59' 21.13" 72° 28' 35.50" 3OZNT APpLTCATZON FORM 09/10 This is a 2 Page Application Application Form Page I of 2 Both Pages Must be Completed JOINT APPLICATION FORM - PAGE 2 OF 2 Submit this completed page as parc of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose. Attach additional page(s) if necessary. Include: description of current site conditions and how the site will be modified by the proposed project; structures and fill materials to be installed; type and quantity of materials to be used (i.e., square ft of coverage and cubic yds of fill material and/or structures below ordinary/mean high water) area of excavation or dredging, volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource impacts; and where applicable, the phasing of activities. ATTACH PLANS ON SEPARATE PAGES. REMOVE AND REPLACE 100 LF OF EXISTING BULKHEAD WITH VINYL BULKHEAD. RAISE BULKHEAD TOP CAP 4' ABOVE EXISTING. IMPORT 130 CY OF CLEAN SAND FILL BEHIND BULKHEAD. PLANT DISTURBED BLUFF WITH BEACH GRASS. Proposed Use: [] Private [] Public []Commercial IPr°p°sed IEstimated Start Date: 4-1-13 I Completion Date: 4-15-13 Has Work Begun on Project? [] Yes [] No [f Yes, explain. Will Project Occupy Federal, State or Municipal Land? [] Yes [] No [f Yes, please spedfy. 10. List Previous Permit / Application Numbers {if any) and Dates: N/A 11. Will this project require additional Federal, State, or Local Permits including zoning changes? [] Yes NYSDOS - SOUTHOLD BOARD OF TRUSTEES [] No If yes, please list: t2. Signatures. If applicant is not the owner, both must sign the application. T hereby affirm that information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 2[0.45 of the Penal Law. Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the State from suits, ections, damages and costs of evew name and description resulting from said project. In addition, Federal Law, [8 U.S.C., Section 100[ provides for a fine than 5 years, or both where an applicant knowingly and willingly falsifies, or knowingly makes or uses a faJse, fictitious or fraudulent statement. Printed Name Title Date Printed Name Title Date Printed Nam~ Date JOINT APPLICATION FORM 09/10 Application Form Page 2 of 2 New York State Department of Environmental Conservation PERMISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s) to the Department of Environmental Conservation ("DEC"), the signer consents to inspection by DEC staffofthe project site or facility for which a permit is sought and, to the extent necessary, areas adjacent to the project site or facility. This consent allows DEC 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 ~'or such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s) sought. By signing this consent form, the signer agrees that this consent remains in effect as long as the application is pending, and is effective regardless of whether the signer, applicant or an agent is present at the time of the inspection. In the event that the project site or facility is posted with any form of "posted" or "keep out" notices, or fenced in with an unlocked gate, this permission authorizes DEC staff to disregard such notices or unlocked gates at the time of inspection. The signer further agrees that during an inspection, DEC 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): 1370 JACKSON ST., NEW SUFFOLK NY 11956 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 210.45 of the Penal Law.* Print Name and Title Date *The signer of this form must be an individual or authorized representative o~la legal entity that: · owns fee title and is in possession of the property identified above; maintains possessory interest in the property through a lease, rental agreement or other legally binding agreement; or is provided permission to act on behalf of an individual or legal entiiy possessing fee title or other possessory interest in the proper~.y for the purpose of consenting to inspection of such property. Permission to Inspect Property Application Supplement 12/08 NEW YORK STATE DEPARTMENT OF STATE COASTAL MANAGEMENT PROGRAM Federal Consistency Assessment Form An applicant, seeking a permit, license, waiver, certification or similar type of approval from a federal agency which is subject to the New York State Coastal Management Program (CMP), shall complete this assessment form for any proposed activity that will occur within end/or directly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent with New York State's CMP as required by U.S. Deparanent of Commerce regulations ( 15 CFR 930.57). It should be completed at the time when the federal application is prepared. The Deparm~ent of State will use the completed form and accompanying information in its review of the applicant's certification of consistency. A. APPLICANT (please print) JOHN W. BELLANDO 1. Name: 25 WELLESLEY ROAD, ROCKVILLE CENTRE NY 11570 2. Address: 3. Telephone: Area Code ( ) 212-286-2474 B. PROPOSED ACTIVITY 1. Brief description of activity: REMOVE AND REPLACE 100 kF OF EXISTING BULKHEAD WITH VINYL BULKHEAD. RAIRF Rill KNEAD TC~P CAP 4' AROVE F×IRTIN~ IMPORT 13fl CY C)F CI FAN RAND FILL BEHIND BULKHEAD. PLANT DISTURBED BLUFF WITH BEACH GRASS. 2. Purpose of activity: EXISTING BULKHEAD INSUFFICIENT HEIGHT DURING STORMS. 3. Location of activity: SUFFOLK NEW SUFFOLK 1370 JACKSON STREET County City, Town, or Village Street or Site Description ARMY CORPS OF ENGINEERS 4. Type of federal permit/license required: N/A 5. Federal application number, if known: 6. If a state permit/license was issued or is required for tbe proposed achvity, identify the state agency and provide the application or permit number, if known: NYSDEC C. COASTAL ASSESSMENT Check either "YES" or "NO" for each of these questions. The numbers following each question refer to the policies described in the CMP document (see footnote on page 2) which may be affected by the proposed activity. 1. Will the proposed activity result in any of the following: YES/NO a. Large physical change to a site within the coastal area which will require the preparation of an environmental impact statement? (11, 22, 25, 32, 37, 38, 41, 43) ................ b. Physical alteration of more than two acres of land along the shoreline, land under water or coastal waters? (2, 11, 12, 20, 28, 35, 44) ................. ......... c. Revitalization/redevelopment of a deteriorated or underutilized waterfront site? ( 1 ) ...... 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) f. Siting of a facility essential to the exploration, development and production of energy resources in coastal waters or on the Outer Continental Shelf7 (29) ................... []_ I~] 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 coastalwaters? (15,35) .................................................... I~ ~ i. Discharge of toxics, hazardous substances or other pollutants into coastal waters? (8, 15, 35) [] .~ j. Draining of stormwater runoff or sewer overflows into coastal waters? (33) ............ I~ ~ k. Transport, storage, ~'eatment, or disposal of solid wastes or hazardous materials? (36, 39). [~...~ 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 designated flood and/or state designated erosion hazard area? (11, 12, 17,) ..... c. State designated significant fish and/or wildlife habitat? (7) ........................ d. State designated significant scenic resource or area? (24) .......................... e. State designated important agricultural lands? (26) ............................... __ f. Beach, dune or barrier island? (12) ........................................... []..~] g. Major ports of Albany, Buffalo, Ogdensburg, Oswego or New York? (3) ............... ~..~1 h. State, county, or local park? (19, 20) .......................................... ~..[] i. Historic msoume listed on the National or State Register of Historic Places? (23) ........ ~..~] 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) ....... ~' "~ d. State water quality permit or certification? (30, 38, 40) ............................ ~- ~] e. State air quality permit or certification? (41, 43) ................................. ~]' ~] 4. Will the proposed activity occur within and/or affect an area covered by a State approved local waterfront revitalization program? (see policies in local program document) .............. ~]_ ~ D. ADDITIONAL STEPS I. If all of the questions in Section C are answered "NO", then the applicant or agency shall complete Section E and submit the documentation required by Section F. 2. If any of the questions in Section C are answered "YES", then the applicant or agent is advised to consult the CMP, or where appropriate, the local waterfront revitalization program document*. The proposed activity must be analyzed in more detail with respect to the applicable state or local coastal policies. On a separate page(s), the applicant or agent shall: (a) identify, by their policy numbers, which coastal policies are affected by the activity, (b) briefly assess the effects of the activity upon the policy; and, (c) state how the activity is consistent with each policy. Following the completion of this written assessment, the applicant or agency shall complete Section E and submit the documentation required by Section F. E. CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program, as appropriate. If this certification cannot be made, the proposed activity shall not be undertaken. If this certification can be made, complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program, or with the applicable approved local waterfront revitalization program, and will be conducted in a manner consistent with such program." A , , JEFFREY PATANJO ppticanffAgent s Name: Address: 106 HEWlTT BLVD., CENTER MORICHES NY 11934 Telephone: Area Code ( ) 631-484-9332 Applicant~Agent's Signature: /~}~/~4 ~ F. SUBMISSION REQUIREMENTS Date: 1. The applicant or agent shall submit the following documents to the New York State Department of State, Office of Coastal, Local Government and Community Sustainabllity, Attn: Consistency Review Unit, 1 Commerce Plaza, 99 Washington Avenue - Suite 1010, Albany, New York 12231. a. Copy of original signed form. b. Copy of the completed federal agency application. c. Other available information which would support the certification of consistency. 2. The applicant or agent shall also submit a copy of this completed form along with his/her application to the federal agency. 3. If there are any questions regarding the submission of this form, contact the Department of State at (518) 474-6000. *These s~ate and local documents are available for ~nspection at the offices of many federal agencies, Department of environmental Conservation and Depar~nent of State regional offices, and the appropriate regional and county planning agencies. Local program documents are also available for inspection at the offices of the appropriate local government. ENVIRONMENTAL QUESTIONNAIRE This is intended to supplement ENG Form 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 form. PRIVACY ACT 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. GENERAL--APPLICABLE TO ALL PROJECTS Explain the need for, and purpose of, the proposed work. EXISTING BULKHEAD IS IN NEED OF REPLACEMENT AND NEEDS TO BE RAISED DUE TO STORMS WASHING OVER IT AND ERODING EXISTING BLUFF. 2. Provide the names and addresses of property owners adjacent to your work site (if not shown on the application form or project drawings). ON PLAN. (Please note that depending upon the nature and extent of your project, you may be requested to provide the names and addresses of additional property owners proximate to your project site to ensure proper coordination.) 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 sufficient 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 alternatives to your proposaL This discussion should include, but not necessarily be limited to, the "no action" alternative and alternative(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). THE 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 Iow water) to which dredging would occur. Would there be overdepth dredging? 2. You can apply for a ten-year permit for maintenance dredging. If you wish to apply for a ten-year permit, please provide the number of additional dredging events during the ten-year life of the permit and the amount of material to be removed during future events. 3. Indicate of your drawings the dewatering area (if 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 permits, indicate the dewatering/disposal sites for future dredging events, if known. 4. Describe the method of dredging (i.e. clamshell, dragline, etc.) and the expected duration of dredging. 5. Indicate the physical nature of the material to be dredged (i.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 Iow water. Terminal floats at private, non. commercial facilities should be limited to 20 feet in length. If 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 transient 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/or sewage pumpout facilities. If pumpout 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 permit 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 be 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. BULKHEADING/BANK STABILIZATION~FILLING ACTIVITIES Answer the following if your project includes construction of bulkheading (also retaining walls and seawalls) with backfill, filling of waters/wetlands, or any other bank stabilization fills such as riprep, revetments, gabions, etc. 1. Indicate the total volume of fill (including backfill behind a structure such as a bulkhead) as well as the volume of fill to be 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 be placed below the plane of spring high tide in tidal areas and below ordinary high water in non-tidal areas. NO FILL WILL BE IMPORTED FOR CONSTRUCTION. 2. Indicate the source(s) and type(s) of fill 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 BE ACCOMPLISHED BY 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 information; however, additional information may be 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. 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by Applicant or Pro~ect Sponsor) 1. APPLICANT/SPONSOR /2.PROJECT NAME JOHN W. BELLANDO /BELLANDO - NEW SUFFOLK 3. PROJECT LOCATION: Municipality NEW SUFFOLK County SUFFOLK 4 PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 1370 JACKSON STREET, NEW SUFFOLK 5. PROPOSED ACTION iS: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: REMOVE AND REPLACE 100 LF OF EXISTING BULKHEAD WITH VINYL BULKHEAD. RAISE BULKHEAD TOP CAP 4' ABOVE EXISTING. IMPORT 130 CY OF CLEAN SAND FILL BEHIND BULKHEAD. PLANT DISTURBED BLUFF WITH BEACH GRASS. 7. AMOUNT OF LAND AFFECTED: Initially .0] acres Ultimately .0] acres 8 WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes ~[~ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial Descdbe: RESIDENTIAL HOME [] Agriculture [] Park/ForestJOpen Space [] Other 10 DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes U No If Yes, list agency(s) name and permit/approvals: NYSDEC / ARMY CORPS 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] No if Yes, list agency(s) name and permit/approvals: 12, AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMiT/APPROVAL REQUIRE MODIFICATION? []Yes []No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicantJsponsor n~e: ,~ ~,~, ~- y r~,~ t~ ~ Date: ~ If t~e action is in the Coastal Area and you are a s~ta agency, complete the ~ Coastal Assessment Form before proceeding w th thru assessment OVER i PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? if yes, coordinate the review process and use the FULL EAF. E~] Yes UNo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART617.6? If No, a negative declaration may be superseded by another involved agency. r~Yes DNo c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: C2. Aesthetic, agricultural, archaeologicai, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3 Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of Jand or other natural resources? Explain bdefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? [] Yes [] NO If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ] Checkthisb~xify~uhaveidenti~ed~ne~rm~rep~tentia~~yIarge~rsigni~cantadverseimpactswhichMAY~ccur- TbenprocseddirectlytotheFUL[ EAF and/or prepare a positive declaration. [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILl NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination Name of Lead Agency Date Print or Type Nanqe of Responsible Officer in Lead Agency Titls of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) BAY 117 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 To: From: Date: Re: LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM Jim King, President Town of Southold Board of Trustees Mark Terry~ Principal Planner LWRP Coordinator FEB 1 5 2013 Southold fown February 15, 2013 Proposed Wetland Permit for JOHN W. BELLANDO SCTM#1000-117-10-10 Jeffrey Patanjo on behalf of JOHN W. BELLANDO requests a Wetland Permit to remove and replace 100 linear feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic yards of clean sand fill behind bulkhead; plant disturbed bluff with beach grass; replace existing deck and stairs to pre-hurricane location and dimensions. Located: 1370 Jackson Street, New Suffolk. SCTM# 117-10-10 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, to remove and replace 100 linear feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic yards of clean sand fill behind bulkhead; plant disturbed bluff with beach grass; is CONSISTENT with the LWRP. Further, it is my recommendation that proposal to replace the existing deck is INCONSISTENT with the below listed LWRP policy. A permit was issued by the Board for the stairs and decks in 2009 (below). However, a condition requires code compliance if the 11' x 15' deck is replaced 6.3 Protect and restore tidal and freshwater wetlands. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The 252 square foot deck is not a permissible action pursuant to 275-11 Construction and operation standards, A (6). 275-11 Construction and operation standards. A. General. The following standards are required for all operations within the jurisdiction of the Trustees: (6) Decks and platforms. No decks or platforms shall be permitted on or near bluffs. Platforms associated with stairs may not be larger than 32 square feet. [Amended 10-11-2005 by L.L. No. 17-2005] BOA.RD OF SO~.rf'tlOLD TOWN TRtIS'I?.ES SOtrfllOt~ N~W YORK AI.f'I~TION 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 Office Use Only ~wOaStal Erosion Permit Application etland Permit Application Administrative Permit Am en dment/Transt*effEx/ension l~,Rece~vved Application: ~/Received Fee:$ 'l - - I'. ~'Completed Application Incomplete SEQRA Classification: Type 1 Type Il Unlisted C C°°rdinati°n:(date sent) //~ WRP Consistency Ass~ssmen, t F--oorm AC Referral Sent: __Date of Inspection: '[ / ' __Receipt of CAC Report: __Lead Agency Determination: ~pueChnical Review: 1 blic Hearing Held:~JL..~ Resolution: ' ' JAN 2 2 2;13 Name of Applicant JOHN W. 8ELLANDO Address 2S WELLESLEY ROAD, ROCKVILLE CENTRE NY 11570 Phone Number:( ) 212-286-2474 117-10-10 Suffolk County Tax Map Number: 1000 - Property Location: 1370 JACKSON STREET, NEW SUFFOLK NY 11956 (provide LILCO Pole #, distance to cross streets, and location) AGENT: JEFFREY PATANJO (If applicable) Address: 106 HEWlTT BLVD., CENTER MORICHES NY 11934 Phone: 631-484-9332 Boa~'d DE Trustees PAGE 06/09 GENERAL DATA Land Area (in square foeO: 46,32 Area Zoning: Previous use of property: Intended use of property: Covenants ~d R~stri~ions: If "Yes", please provide copy. RES RESIDENTIAL RESIDENTIAL Yes x No c v Southold Town 8oard of Trustees Does this project require a variance fi~om the Zoning Board of Appeals __ If"Yes", please provide copy of de~ision. Yes x No Will this project require any demolition as per Town Code or as determin~ by the Building Dept. ,Yes x No Does the structure (s) on property have a valid Certificate of Oooupa~cy x Yes __No Prior permits/approvals for site improvement~: Agency Date x No prior permits/approvals for site improvements, Has any permi'dapproval ever hewn revoked or suspended by a governmental agency? x No Yes If ye~, provide explanation: Project Description (us~ attachments if necessary):. REMOVE AND REPLACE 100 LF OF EXISTING I~ULKHEAD WITH VINYL BULKHEAD, ~^ISS BULKHEAD TOP CAP ELEVATION 4' ABOVE E)~STING, IMPORT 130 CY OF CLEAN SAND FILL BEHIND BULKHEAD, pLANT OIBTURBED BLUFF WITH BEACH GRA~. ~ cjeL~t~. ~'~t ~,~.;~ ~'E.~.. 02/0~013 0~12A~ Board of Trustees Applioation I I "?" ! ~ ~ ~ PAGE 07/0~ WETLAND/TRUSTee LANDS A~pLICATION DATA Purpose of the proposal operations: R£MOVE AND REPLACE 100 LF OF F..YJSTINQ BULKHEAD WITH VINYL BULKHF~,D, RAISE BUL*HEAD TOI=' CAP ELEVATION 4' ABOVE EXISTING, IMPORT i30 CY OF CLEAN SAND FILL BEHIND BULKHEAD. PLANT DISTURBED BLUFF W~TH BEACH GR,~,,S,~. ~ [,~ ~ Area of wetlands on lot: o square feet Percent coverage of;lot: 0 % Closest distance between nearest erdsting smaeture and upland edge of wetlands: N/A feet Closest distance between n~mst proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? No x Yes If yes, how much material will be excavated? o cubic yards How much material will be filled? ~3o cubic yards Depth of which material will be removed or deposited: 4 feet Proposed slope throughout the area of operations: 2% Manner in which material will be removed or deposited: ~XCAVAmR Statement of the effect, if any, on the wetlands and tidal waters of tho town that may result by reason of such proposed operations (use almchments if appropriate): THERE WiLL BE NO EI~FECT ON WETLANDS OR TIDAL WATERS DUE TO THE BULKHEAD CONSTRUCTION. Appendix C Stat~ Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be co~.-p!-~-~-d by A,ppllcant or Project $1~nsor) ~ APPUCANT/SPONSOR 2, PROJECT NAME $OI-IN W, ~LLA~DO [ B~LLAI',I)0 ' NEW SU'~0LK 3, PROJECT LOCATION: ~,.i,i~,,~y NEW SUI;FOLK Couray SU~FOLIC 4. PRECISE LOCATION (Site~ agdress sn~ mad intern e cftc r~,. orormnent landmatk~, etc., or provide mep) 1370 ~'ACKSON STREET, NEW SI-TI=FOLK PAGE - 4 20 88/09 5. pflOPOt~ED ACTION IS: [] New [] Eq~r..~lon [] Mocrntealion/si~a~on 6, DE~GR[BE pROJECiTBRIEFLY; R.~MOVE AND R.1/pLACE 100 LF OF EXISTIlqG BULEHEAD WITH VINYL BULKHEAD. RAISE BULKI-II/AD TOP CAP 4' ABOVE EXISTING. IMPORT 130 Cf' OF CLF. AN SAND FILL BEHIND BULKI-IF. AD, PLANT DISTURBED BLUI~ WITH BEACH GRASS. ~ ~'~t~''''~ ~.~t.~4.~ S-~-.,,$ -~-- .~¢-~"f¢¢~<-,"~ ~"¢~'~f~'" 7. AMOUNT OF LAND AFFECt=D: Inithllly ,0l ac~s UitimMe~y .0l e~e~ WILL PROPOSED ACIION COMPLY WITH EXISTING ZONING OR OTHI~E EXISTING LAND ~ RES~ICTIONS? [] Yes [] No If No, tJ~cl'itm bri~ WI-~T IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residerfgal [] Indusflia[ [] Commercial RtiSIDENTIAL HoM~ 10. nOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENT,N. AGENCY (FEDERAL, STATE OR LOCAL)? [] y~ [] No If Yes, i'~t agency(s) r'klme ami perrdt/al:~mval$: NYSDEC / ARMY COP.PS 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? [] Yes [] NO If Yes, ~sl agency(s) name an6 pem~il/approvals: 12. A-~ A RESULT OF PROPOSED ACTION WILL [~( STINQ PERMrT/APPR~I~'AI. REQUIRE MOOIFICATION? CERTIFY ~HAT THE INFORMATION PROVIDED A~OVE IS TRUE TO THE BEST OF MY KNOV~_EDGE Bign~ure: action is in the Coast= and you are a state a.g.enoy, aompleta the proceeding with this assessment OVER PART II - IMPACT ASSESSMENT I['1'o be completed by Lead A~lenc)') A. OOES AC'TION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRFL PART 6t ?~47 If yes. coordinate the revfaw process and ese the FULL EAF. ia. IAM_L Ac'noN RECEIVE COORDINATED REVIEW AS PROVIOED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. I---lYes [~No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED W1TH THE FOLLOWING: (Aeswem may be handwritten, ff legible) C1. Existing air quarA'y, surface or groundwater quali~y or quantity, noise leve:s, existing traffic pafiem; solid waste pro(luc~ion or dispesol. po(eh[iai fef erosion drainage or Ilondthg pmblems'~ Explain b~efly: C2. Aesl~etib, agricultural archaeoingical, h~stonc, or other natural or cultural resources; of comn~olty or neighborhood c~.,~a~r? ~ .~q~!~ bdefly: C3, Ve.a~i~iiun or fauna, fish. sh~elti~sh or wild fe species '[ C5. Growth, ~ubsequer~t devolopment, or related activities likely to be induced by the proposed action? FY, plain brie~ly~ C6. Long term. shod term, cumulative, or olher effects nol identified in Ct-C57 Explain br ENVIRONMENTAL AREA (CEA~? (If yes: explain briefly: THERE. OR 18 THERE LIKELy TO BE. CO~VERSy RELATED 'TO gTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ] Yes [] No PART III - DETERMINATION OF SIGNIFICANCE (1'0 be completed bY Agency) ' ~ INSTRUCTIONS: F~read1adversee~fectide~tifiedab~ve~determinewhether~tissubeta~tia~lerge~impedant~tJ1enelees~gni~canL Each effect should be ~ in co~ with its (a) setting (Le. mban or rural); (b) probabirdy of (x~curdflg; (c) dgraflon; (d) k'mve~sibEf~, (e) geographic scope; and (t) magnitude. If fle~essafy, add attachments o~ reference ~flg materials. Ensure that explanations cofltain. sufflderd de'ail to show that all relevant adverse impacts have been klentified and adequalely eddmssed If queslkm d of pa;t ii was checked YeS, the de~eimlnation of significance must evaluatethe pcqemhd impactofthe pmpo~daclkm on ~ ;~aii~[~ ~ ~ ~ ~ ~ EAF and/~' prepare a posi6ve deolaration. -=' ~'~ "q'a~-~ w[w~n wt'~T oes~r. 11left preseed dire~ to the FULl Check this box/fyou have determined, based on the Infonnatibn and aflafysis above and any suppo(ling documenfaUO~l, that the proposed ac~ WILL NOT result in any slgnhlcant adverse envhonmental impacts AND provide, on attachments as necessaiy, the reasons supporting fbi: determination. Board of Trustees Name of Lead Agency Pdn~ or Type Name of Responsible Of~cer in Lead Agency President Dale Title of Responsible Officer Signalure of Preparer (if different from responsible officer) lm~n Ilall. 53095 Main P,d. F'.() Bo× 1179 SoulhoId, NY 11971 Telephone (631 ) 765-1892 }:ax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of JOHN W. BELLANDO COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING , residing at/dba JO being dnly sworn, depose and say: That on the"3 day of,~ ~gKt./O }bo . 201~5, I pers,onally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the postcr has remaincd in place lbr eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesda¥~ February 20, 2013. Dated: ~,. ~%. ~'~ (~i~n~ure) ~ 0 Sworn to before me this 13day of ~D. 2013 kl~q otary Public U No~/..P.u .b~. 8~tal~-~'New York u u a Lm_ecl~i~.?La~_ _C_q u n ty No: u1fh~8150861 ., Commission Expires-O~lO?/2OI. L~ NOTICE OF HEARING 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: SUBJECT OF PUBLIC HEARING: To remove and replace 100 lir~ar feet of existing bulkhead with vinyl bulkhead; raise bulkhead top cap elevation 4' above existing; import 130 cubic ya~s of clean sand fill behind bulkhead; plant disturbed bluffwith beach grass; replace existing deck and stairs to pre-hurricane location and dimensions. 1-1ME & DATE OF PUBLIC HEARING:: If you have an interest in this project, you are invited to view the Town file(s) whi.ch are available for inspection~rior to the day of the hearing during normal bus~ness days belween the hours of'8 a.m and 4 p.m BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: STATE OF NEW YORK COIYNTY OF SUFFOLK Cr'n r ~ .~ day of , residing at I(}~ (~g_~)l~C'{5 ~_~. · being duly sworn, deposes and says that on the ,20 {~.{~_, deponent mailed a tree copy of the Notice set forth in the Board of Tmst~es Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~l~J4~}~ .~0{1~ kld~. , that said Notices were mailed to each of said persons by CERTIFIED MAIL'RETURN RECEIPT. / '6/ - ~ Sworn to before me this Dayof ,20 Notary Public~ Lmiann Patanio No~I/Pub#c State ofNew Yo~ QEa,I)~. in Suffolk County No: 01PA6150861 Commission Expires 08/07/20J._~ Board of Trustees Application County of Suffolk State of New York JOHN W. BELLANDO BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.  7 Signature ,/ SWORN TO BEFORE ME THIS / ~ ~'- DAY O ~l~'~O../~JO./~ ,20l -o~ of Trustees Application AUTHORIZATION (where the applicant is not the owner) [, JOHN W. BELLANDO (print owner of property) residing at 25 WELLESLEY ROAD (mailing address) ROCKVILLE CENTRE, NY 11570 PATANJO do hereby authorize JEFFREY (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ( APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The ]own of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees. The purpose of this form is to orovide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: BELLANDO, JOHN W. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) fax 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, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO X If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicanffagentJrepresentative) and the town officer or employee. Either check the appropriate line A) through D) ancffor describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __~D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Print Nam~-h~,~-,~ f~./q, ddad o o 200 Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M. H THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 1000 117 10 10 STOI?~-WATER, GRADINIi~ DRAINAGE AND EROSION CONIROL PI. AN SCOPE OF WORK - PROPOSED CONSTRUCTION IT. EM # / WORKASSESSMENT ] Yes No STATE o~ N~.~ ~). 'c. b~bN55'-b~ ..7.~/......o~..4....~.. ............... ss And that heAhe sthe~t~..~U...~ '6'~;kco. t~,~, '"co.~"t~"'"'ofr,~U"~) ............................. Owner and/or representative of the Owner or Ownmrs, and Js duly authorized to perform or have performed the said work and to make and file tiffs application; that ali statements contahied in this application me true to the best ot'his knowledge and belieF; md that the work wl]] be performed in the m~turler set [olth in the application filed herewitlL ...... , ~o~ ~,br .F_~~~.<.).~ ................................... FORM - 06/t0 Town of Southold LWR~ CONSISTENCY ASS~gsMENT FORM INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, ~all complete this CCAF for proposed aafions that are subject to thc Town of Southold Waterfront Consistency Roview Law. This assessment is inmn&d m supplement otber information used by a Town of Southold making a dgterminsfion of consistency. *Except minor ~empt actionz in~ludin8 Building permits and other rainisterial t~rmits not located within the Coastal Erosion Hazard Area. 2. Before answering tbe questions in Section C, thc prepa~r of this form should review the ~mpt minor action list, policies and explanations of each policy contained in ~he Town of Southold Local Waterfront R~vi~ization Program. A proposed action will b~ evaluatrd as to ~ si/nl/icant beneficial and adverse effects upon thc coastal are~ (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", then the proposed action may affevt the achievement of the LWRP polivy standards and conditions contained in the consismncy review law. Thus, th~ action should be analyzed in more detail and, if necessary, modifi~i prior to making a detuminafion lh~t it is consistent to thc maximum extent pra~icabl¢ w/th the LWRP policy standar& and conditions. If an action carmot be certified as comis~ent with the LWRP policy stand~rcls and conditions, fi8 - Southold Town .l?oa .d of ~tees A copy of tt~ LWRP is available in the following places: onlire at tl website (soutt~old~vn.norlhfork.ncO, the Board of Trnstees Office local libraries and tt~ Town Clerk's office. DESCRIPTION OFSITEANDPROPOSEDACTION sCTM#, 117 10 10 _ The Appliemfion has been submitted to (ch~ck appropria~ response): I. Category of Town of Southold agency a~tion (che~k appropriste response): (a) Action undertaken directly by Town agency (e.g. capital conslru~tion, planning activity, agency regulation, land u-ansaction) (b) Financial assistance (e.g. grant, loan subsidy) (e) Permit, approval, license, certification: Nature a~d extent of a~on: R~MOVE AND REPLACE 100 LF OF EXISTING BULKHEAD WITH VINYL BULKHEAD. RAISE BULKHEAD TOP CAP 4' ABOVE EXISTING, IMPORT 130 CY OF CLEAN SAND FILL BEHIND I~ULKHEAD, PLANT DISTURBED Location of action: 1370 JACKSON STREET, NEW SUFFOLK NY 11956 Site acreage:. 1.07 RESIDENTIAL. Present land use: Present zoning classification: RES 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: JOHN W. BELLANDO (b) Mailing address: 25 WELLESLEY ROAD ROCKVILLE CENTRE, NY 11570 (c) Telephone number: Area Code ( ) 212-286-2474 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~] No[--] lfyes, which state or federal agency? NYSDEC/ARMYCORPS/NYSDOS 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 PROJECT ENHANCES COMMUNITY CHARACTER BY WAY OF A VISUALLY APPEALING AND FUNCTIONAL BULKHEAD. Attach additiottal 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 [] 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 PROJECT ENHANCES VISUAL QUALITY BY PROVIDING A VISUALLY APPEALING BULKHEAD 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 II1 - Policies Pages 8 through 16 for evaluation criteria ~ Yes [-~ No [] Not Applicable PROJECT PROTECTS THE LOSS OF LAND AND 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 [~ 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 function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. ~-~ Yes [] No [] Not Applicable ACTION HAS NO EFFECT ON ECOSYSTEM. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. [] Yes ~-~ No [] Not Applicable ACTION HAS NO EFFECT ON AIR QUALITY. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [] Yes [] No ~ Not Applicable ACTION HAS NO EFFECT CAUSED BY SOLID AND HAZARDOUS WASTE. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes~ No [] Not Applicable ACTION iS LOCATED ON PRIVATE PROPERTY. 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 1II - Policies; Pages 47 through 56 for evaluation criteria. [~ Yes [--~ No [] Not Applicable ACTION IS LOCATED ON A 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 December 31, 2012 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 1600 JACKSO. STREET, NL=W SUFFOLK, NY sc'rM No. 1000-117-10-12.3 .a~,uc~ FO~ I~.marr JAN 2 ?- Z,~12 I Dear Sir/Madam: We hereby submit one original and three (3) copies of the proposed plans, application, check, pho{ographs and required data for permit approval for the above referenced ff you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Center Moriches, NY 11934 RESOLUTION 2013-189 ADOPTED DOC ID: 8608 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO~ 2013-189 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 ~onstmction, that in the sole discretion of the Board of Trustees, are determined to be related to Superstorm Sandy, until April I, 2013. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUSI MOVER: Jill Dohezty, Scott Russell SECONDER: William Ruland, Councihnan AYES: Dinizio Jr, Ruland, Doherty, Talbot, Evans, Russell c bank' Citigold® // JACKSON STREET S 84'00'00" APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD Y FEB 2 ~ 2013 100,00' GREAT PECONIc BAY NOTES: 1. ELEVATIONS REFER TO N.A.V.D. 2. LOT AREA: 46,552 S.F. / 1.07 ACRES 13. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: JACK ALLISON HALL 995 SUNRISE HIGHWAY, BABYLON, NY 11704 DATE SURVEYED: OCT. 2, 2009 2/22/13 PER TRUSTEES MEETING DATE REVISION BULKHEAD PEPJ~IT PLANS SCALE: 1 "=40' PROPOSED PLAN :DATE: 1-8-1,3 1370 JACK~ON STREET NSF/ SUFFOLK, TO~'N OF $OUTI'[OLD SUFFOLK COUNTY, NY ~HEET: TAX MAP NO. 1000-117-10-I0 1 OF 2 PROPERTY OWNER: JOHN W. & ELLEN BELLANDO 25 WELLESLEY ROAD ROCKVlLLE CENTER, NY 11570 PREPARED BY: JEFFREY PATANJO 106 HEWlTT BOULEVARD CENTER MORIOHES, NY 11954 631-484-9352 PROJECT LOCATION N.T.S. MAP PROJECT LOCATION PROPOSED 8" TiP CCA .~/ ~ LAY-LOG PILE ~ / PROPOSED 14' LONG 1' OLA, (~J-V. TIE ROD, 6' O.C,- BLUFF TO BE RESTORED WITH AMERICAN CAPE BEACH GP~S OR EQUAL --PROVIDE 150 CY OF CLEAN ~',10 FILL BEHIND BULKHEAD FROM UPLAND SOURCES VIA EXCAVATOR PROPOSED 3"X6' REAR WALE EXISTING BULKHEAD TO BE REMOVED IN ITS TIMBER TOP CAP 14' LONG lO"e CCA TREATED TIMBER PILE, 6' O,C. NOTE: REMOVE EXISTING BULKHEAD STRUCTURE IN ITS ENTIRETY AND INSTALL NEW BULKHEAD IN THE EXACT SAME POSITION TO 4' ABOVE EXISTING TOP CAP. 6"x6" CCA TOP, MID & BOTTOM WALE TYPICAL SECTION N.T.S. PROPOSED 12' LONG C-LOC 9000 ~NYL SHEETING NOTES: 1. ELEVATIONS REFER TO N.A.V.D. 2. LOT AREA: 46,532 S.F. / 1.07 ACRES 3. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: JACK ALLISON HALL 995 SUNRISE HIGHWAY, BABYLON, NY 11704 DATE SURVEYED: OCT. 2, 2009 DATE RE¥ISION BULKHEAD PERMIT PLANS SCALE: N.T,S, PROPOSED SECTION DATE: & LOCATION MAP 1-8-1,3 ,~?o J~cKsoN s?~ZZT NEW SUFFOLK, TOWN OF SOUTHOLD SUFFOLK COUNTY, ~ SHE~: TAX MAP NO. ~000-~-~0-t0 2 OF 2 PROPERLY OWNER: JOHN W. & ELLEN BELLANDO 25 WELLESLEY ROAD ROCKVILLE CENTER, NY 11570 PREPARED B~ JEFFREY PATANJO 106 HEWITT BOULEVARD CENTER MORICHES, NY 11934 631-484-9552