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HomeMy WebLinkAboutTR-8031 James F. King, President Bob Ghosio, Jr., Vice-Preaident Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 $outhold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ½ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8031 DATE: DECEMBER 12~ 2012 ISSUED TO: SANDRA CUBBON MAKUCEWICZ PROPERTY ADDRESS: 1900 PARK AVENUE, MATTITUCK SCTM# 123-8-6 AUTHORIZATION Pursuanl 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 December _1_2, 20i2, and in consideration of application fcc in the sum o f W A.[X~ED_as~er Town Board Resolution #2013-189 and subject to the Terms and Conditions as stated in the Resolution. the Soutbold 'Iown Board of Trustees authorizes and permits the I'ollowing: Wetland Permit to relflace the approx. 132' long retaining wall and backfill approx. 15' landward of existing bulkhead; and as depicted on the revised project plan prepared by Sandra Cubbon Makucewicz, received on February 25, 2013 and stamped approved on March 5, 2013. IN WITNESS WHEREOF, the said Board oCYrustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a mgjority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Sandm Cubbon Makucewicz, residing at 1900 Park Avenue, Mattituck, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Pernaittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. ri'hat the work involved will be subject to the inspection and approval of the Board or its agents, and non-colnpliancc with the provisions of the originating application may be cause lbr 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 $outhold. That the said Board will be notified by the Permittee 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 l~redemeyer 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 December 12, 2012 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Sandra Cubbon Makucewicz 1900 Park Avenue Mattituck, NY 11952 RE: SANDRA CUBBON MAKUCEWICZ 1900 PARK AVENUE, MATTITUCK SCTM# 123-8-6 Dear Ms. Makucewicz: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 12, 2012 regarding the above'matter: WHEREAS, SANDRA CUBBON MAKUCEWICZ 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 November 8, 2012, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator 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 December 12, 2012, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that 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 SANDRA CUBBON MAKUCEWlCZ to replace the approx. 132' long retaining wall and backfill approx. 15' landward of existing bulkhead; and as depicted on the revised project plan prepared by Sandra Cubbon Makucewicz, received on February 25, 2013 and stamped approved on March 5, 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 V,~y yours.~ James F. King President, Board of Trustees JFK/amn James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bmdemeyer Michael .L Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, ~ 11971 Telephone (631) 765-1892 Fax (63 l) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ~[[ 4/[ Z , has been reviewed by this Board at the regular meeting of I ~ / I ?~! ! Z~ and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 s~ Day of Construction ($50.00) ½ 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 Southoid. 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 Peter Young, Chairmm~ Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., December 5, 2012 the following recommendation was made: Moved by John Stein, seconded by Audrey Horton, it was RESOLVED to SUPPORT the Wetland Permit application of SANDRA D. CUBBON MAKUCEWlCZ to replace a 132 If. retaining wall and backfill approx. 15' landward of existing bulkhead. Located: 1900 Park Ave., Mattituck. SCTM#123-8-6 Inspected by: Audrey Horton, John Stein, Jack McGreevy The CAC Supports the application with the Condition of a 15' non-turf buffer landward of the retaining wall and removal of the sprinkler head and irrigation line immediately behind the bulkhead. Vote of Council: Ayes: Ail Motion Carried Bob Gbosio..Ir. Vice-President Dave Bergen John Brcdcnlc~¢r Michael J I)omino PO Box 1179 Southold. NY llgTI 'I ¢lcphonc (631 765-1892 Fax (6311 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: SANDRA D. CUBBON MAKUCEWlCZ requests a Wetland Permit to replace the approximately 132' long retaining wall and backfill approximately 15' landward of existing bulkhead. Located: 1900 Park Avenue, Mattituck. SCTM# 123-8-8 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland cc Of Town Code proposed work falls under: hapt.275 Chapt. 111 other Type of Application: __ Wetland __Administrative__Emergency Coastal Erosion Amendment Pre-Submission Violation Info needed: Modifications: Present Were: v"j.,K/jng ~/B. Ghosio ,-'/ D. Bergen, -"51 Bredemeyer.__ Michael Domino D. Dzenkowski Form filled out in the field by Mailed/Faxed to: Date: other 123 °1 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (coo. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: December 10, 2012 Re: Proposed Wetland Permit for SANDRA D. CUBBON MAKUCEWICZ SCTM# 1000-123-8-6 SANDRA D. CUBBON MAKUCEWICZ requests a Wetland Permit to replace the approximately 132' long retaining wall and backfill approximately 15' landward of existing bulkhead. Located: 1900 Park Avenue, Mattituck. SCTM# 123-8-6 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Clarify if the bluff/bank slope will be re-planted with vegetation to prevent further erosion. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King, President Bob Ghosio, Jr, Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Office Use Only Coastal Erosion Permit Application L~Wetland Permit Application __ Administrative Permit AmendmenffTrans~er/Extension ,~O~Rece~vved Application: [ I/o°'/],~ ~Received Fee:$ '~Completed Application~ ___Incomplete / SEQRA Classification: Type I Type 11 Unlisted Coordination:(date sent) ~-LWRP Consistency Assessment Form ~CAC Referral Sent: }l//~/I ~Date o f lnspection:~c~/ff_ .~ Receipt of CAC Report: Lead Agency Determination: ] echnical Review: ~mublic Hearing Held:~o~3~i )x/~/~x Resolution: NOV - 8 2012 Name of Applicant Mailing Address Suffolk County Tax Map Number: Property Location: (provide LILCO Pole #, distance to cross streets, and location) AGENT: (Ifapplicable) Address: Phone: Bo~d of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: ~- L'/~ Previous use of property: /q]~ Intended use of property: /~ tc~f ~ L (~, Covenants and Restrictions on property? __ If"Yes", please provide a copy. Yes /No / Will this project require a Building Permit as per Town Code? Yes x/No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes / No If"Yes", please provide copy o£decision. Will this project require/any demolition as per Town Code or as determined by the Building Dept.? Yes x/No Does the structure (s) on property have a valid Certificate of Occupancy? Yes __No Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? If yes, provide explanation: No ~Yes Project Description (use attachments Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: {~r?~')e~- t%~5 k~ a~o~'t3C~ (gnc~ Area of wetlands on lot: I '3 ~0 square feet Percent coverage of lot: I, ~ % Closesf distance between nearest existing structure and upland edge of wetlands: '70 feet Closest distance between nearest proposed structure and upland edge of wetlands: '7 0 feet Does the project involve excavation or filling? No v// Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: -~ cubic yards cubic yards feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1 APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map SEQR DESCRIBE PROJECT BRIEFLY: ia 7. AMOUNT OF LAND AFFECTED: Initially acres ~/j~ Ultimately acres I/l(j~ 8. WIL ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes [] No If no, describe bdefly: 9 W T IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Re]sidential r~lndustria, [-~Commercial ~[Agriculture [---']ParklForest/OpenSpace ~----]Other (describe) 10. DOESACTIO~NACTIO INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Feder~, State or Local) [~]Yes I ~lNo If yes, list agency name and permit / approval: DOES ANY PECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ---]Yes If yes, list agency name and permit / approval: / RE LT QF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE / Sp sot Nam If the a/ction is a Costa A~rea, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 6t7.47 If yes, coordinate the review process and use the FULL FAF. J~y? J'~J No WILL J, CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaradon may be supemeded by anothe~ involved agency. r-lYes JZ]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be hendw~tten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing lraffic pat[em, solid waste pmductiofl or disposal potential for erosion, drainage or flooding problems? Explain bdefly: C2. Aesthetic, agricultural, archaeological, historic, or other nature or cu rural resources; or community or ne ghbefhood character? Exp ale bna y. C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitals, or threatened or endangered species? Explain briefly: / C4..~ community's existing plans or goal~"~s oft-~ally all'tad, or a change in use or intensity of use of I~'~ or olher natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, sho~l term, cumulative, or other effects not identified in C1 -C57 Explain briefly: C7. Othe~ impacts linciudth~ changes in use of either quantity or ti/pa o energy, xp ain bee ~': - WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICFAI? IIf ~'es, explain brlefi)': [-I171.oI E. IS THERE, OR IS THERE LIKELY TO B~ CO~VERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ),es explain: I--lYes 171NoI PART III - DETERMINATION OF SIGNIFICANCE ('rD be completed by/~ency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substanfdal, large, important or otherwise significant. Each effect should be assessed in connection with its la) setting (i.e. urban or rural); lb) probability of occurring; lc) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sL~fflcleflt detail to show that all relevant adveme 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. Check fids bex if you have Identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUU EAF and/or prepare a posl~,~ declaration. Check this box Ifyou have determined, based on the information end analysis above and any supporting documenfatiofl, that the proposed acti~ WILL NOT result in any significant adverse environmental impacts AND provide, On attachments as necessary, the reasons suppoding thi= determination. Board of Trustees Name of Lead Agency ~ _ Pdnt or Type Name of Responsible Officer in Lead Agency Sj~n-ature of Respor~ible Offide~in Lejb~c[,~q'gency Date President [] Title of Responsible Officer Signalure of Preparer (If different from responsible officer) Town of Sou{IR-0 d Erosion, Sedimentation & storm-water Run-off ASSESSMENT FORM PROPERTY LOCATION: S,C,T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN ~ Dtstrict Secttan BlOck Lot (.1=~ ~ tr~eo BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITI~M # / WORKASSESSMENT I Yes No a. What is the Total Area of the Project Parcels? '1/l (thclude Total Area of all Parcels located within I Will this Project Retain All Storm-Water Run-Oil the Scope of Work for Proposed Construction) ~ A~ Generated by a Two (2') Inch Rainfall on Site? b. What is the Total Area of Land Cleadng {S.F. I Acres) (This item will include all run-off created by site clearing and/or construction ac§vifi6s as well as all and/or Ground Disturbance for the proposed I/i~ ~f~. Site Improvements and the permanent creation of construction actMiy? impervious surfaces.) (s.F.,~r.I 2 Does the Site Plan and/or Survey Show All Proposed /r-'~ PRO'v'~DE Bi~F.F PROJECT DESCE]ivT[ON (provide Add.oriel pa~es as Needed) Drainage Structures Indicating Size & Location? This uu Item shall include all Proposed Grade Changes and ~l~/(.k~0 (IJ~ ~(1(~%,~[ f~q-~k/'~ SlodesC°ntrctlingSurfaceWaterFIow- 'L~x~L~ au:)~)~t,x~aL-~ 1,5-~J- --~"t 3 Does the Site Plan and/or Survey descfibe the erosion r'~ and sediment control practices that will be used to ~/~ ,~ c~-'~ g ~ "~-~Y--I,-~JCt ~ J)~(..~(C~,~.z~ ~ item must be maintained throughout the Entire Construction Pedod. ~C~Lr~ ~ A~ O ~'~ /J ~12~(~5 ¢~'~J~ 4 Will this Project Require any Land Filling, Gradingor //~--~ ~.~.~ Excavation where there is a change to the Natural C~4"~'4~ )(- ~ ~/ l ~ ~ ~r~- '~q 'q~z3` Existing Grade Involving more than 200 Cubic Yards -- of Ma er/al within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? -- 6 Is there a Natural Water Course Running through the ~ Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Recluirements: or within One Hundred (100') feet of a Wetland or Submission o~ a SWPPP is required for all Construction activities involving soil Beach? disturbances of one (1) or mom acres; thcluding disturbances of less than one acre that 7Will there be Site preparation on Existing Grade Slopes / are part of a larger common plan thet will ultimately disturb one or more acres of land; which Exceed Fifteen r-'--1 including Construction activiUes involving soil disturbances el less than one (1) acre where One Hundred (100') of(Horizontal15) feet of VedicalDistance?Rise to J IL~j -- the DEC has determined that a SPDES permit is required for storm water discharges. / forSWPPP'Sstorm WaterShall Dischargesmeet the MinimUmfrom ConstructionRequirementSactivity°f the SPDESpermit Nd.General Pem~it 8 Will Driveways, Parking Areas or other Impervious / / - GP-O-10-O01.) Surfaces be Sloped to Direct Storm-Water Run-Off--L~ 1. T~e SWPPP shall be prepared pbar tu the submiltal of the NOI. The NOI shall be into and/or in the d rec on of a Town right-of-way? -- submitted to/he Department pdor to the commencement of constmcban activity. 2. The SWPPP shall descdpe the erosion aed sediment control pmcliCes and where 9 Will this Project Require the Placement of Material, required, post-construe/ion storm water menagement practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit. In addit fen, the SWPPP shallL~J STATE OF NEW YORK, .e_ C'l~ I,. COUN']~/OF ..~.q...q~.. 3..~.. ...................... SS That I, ............................. !..( ........ being duly sw6rn, deposes and says that he/she is the applicant tbr Permit, And ~hat he/she is the .......... O.(,,Mg.B..~.... ............... Owner, Cc~lmctor, Agent, Corpo~'t;' ~i~:~ ;~ ....................... Owner and/or representative of the Ovmer or Owners, and is duly authorized to perform or have performed the said work ~u]d to make and file this application; that all statements contained m this application are true to the best of his knowledge and belief; and that the work will be perfom~ed in the manner set forth in the application filed here~]Jh. Sworn to before me this; // , ............................ ....... yof. ......... ......... / //,4//,/ · ............... i~l~:;~e V ~7~ ........... :~7];;~/; ...... :'"':: ............ l- ............ FORM - 06/t0 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK fitl'Nb,e-~l)gi~'~-lteci:[C-c- , residing at , being duly sworn, deposes and says that on the day of~, 20 iR,, deponent mailed a tree copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by Sworn to before me this Day of ~ _, 20 i 7.~ Notary Public James F. King, President Bob Ghosio, Jr. , Vice-President Dave Bcrgen John Bredemcyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of SANDRA D. CUBBON MAKUCEWICZ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING 5 ,~Ic~(Z ,~. C_.. ~ lc--{A~Lcolt Z,-residing at/dba I ~ O0 lPtCILIc ~'~-' being duly swom, depose and say: That on the ~°~ay of /~3Lt.¢~ l~-", 20lA, I personally 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 poster has remained in place for eight days prior to the date of the public heating. Date of hearing noted thereon to be held Wednesda¥~ December 12~ 2012. Dated: (signature) Sworn to before me this 3 dayofl~c_ 20/2- Notary Public James F. King, President Bob Ghosio~ Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of SANDRA D. CUBBON MAKUCEWICZ COUNTY OF SUFFOLK) STATE OF NEW YORK) 1, ;'/~/¥~,~'~ [~{L/~ l~u[ ~ Z~- , residing at/dba AFFIDAVIT OF POSTING being duly sworn, depose and say: That on the/[ day of b4-c ~_rrt bill, 201),, I personally 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 poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday~ December 12~ 2012. Dated:r "~(signature) Sworn to before me this day of Notary Public VICKI TOTH Notary Pub!ic~Stat~f~N~w fo~ No O1TOBDJQ6~o Qualified in Suffoik Coun. t.~ ~ ! ~ Commissior~ E×pims lu!v ~ ~! ~ NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Southold, New York, concerning this properly. by the Road, OWNER(S) OF RECORD: SUBJECT OF PUBLIC HEARING: To replace the approximately 132' long retaining wall and backfill approximately 15' landward of existing bulkhead. TIME & DATE OF PUBLIC HEARING: 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 o1:8 a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631)765-1892 Board of Trustees Application County of Suffolk State of New York 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, 1 HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITI~ REVIEW OF THIS APPLICATION. Signature of ~perty Owner ~ SWORN TO BEFORE ME THIS Notary Public APPLICANT/AGENTfREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the anrt of town officers and emoloveas. The ouroose of this form is to omvide information which can alert the town of ~ossiblc conflicts of interest and allow it to take whatever action is n~ to void same. YOUR NAME: ~L~/.A .L~ ~/~ A.) k C~ E-- ~ Od~JJf{l., ~-A)~ ~) bC?V'x (Last name, f'ust name,~iddle initial, unless you am applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ~/ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"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 Sunthold? "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% o f~[~ shares. YES NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agenlfrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): ___A) the owner of greater than 5% of the shares of the corporate stock of the applic0nt (when the applicant is a corporation); ___B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, pm'tner, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 SubmittedthB ~' dayo. f ~-)D~/- 200 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistoncy. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt .minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3; If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- suooortine facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# .- PROJECT NAME The Application has been submitted to (check appropriate response): Town Board [~ Planning Board ~] Building Dept. [] Board of Trustees Category of Town of Sonthold agency action (check appropriate response): (a) (c) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) Financial assistance (e.g. grant, loan, subsidy) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: I / (c) Telephone number: Area Code ( )_ to Yl - ~:¢q~- ~s~O¢% (d) Application number, if any:. Will the action be ¢j2ectly undertaken, require funding, or approval by a state or federal agency? Yes [~ No[7~/I ~l 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 yeia' s ~ No ~-~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - 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/Seetion III - Policies Pages 6 through 7 for evaluation criteria I t/l 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 Sectiol~II - Policies Pages 8 through 16 for evaluation criteria [~/t~l 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 -~ieies P~s 16th~l for evaluation criteria Yes No Not Applicable 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 ~eval~riteria. Yes No Not Appli~ 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 ~aluation 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. I lYes I I No l "'l 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. ~NotA ~ Yes~ No pplicable 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.~NRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~-~ NoI~x//I ~[ 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 wat/e~s. 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 thc Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for eval~tion criteria. ~-] Yes [] Noel ' I Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energ~ and mineral resources. See LWRP Section III - Policies; ~ges 65 through 68 for evaluation criteria. [] Yes ~'] No ~ Not Applicable TITLE 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 Construction, that in the sole discretion of the Board of Trustees, are determined to be related to Superstorm Sandy, until April 1, 2013. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS[ MOVER: Jill Doherty, Scott Russell SECONDER: William Ruland, Councilman AYES: Dinizio Jr, Ruland, Doberty, Talbot, Evaus, Russell 196 ~,X', BULKHEAD /v L: W ?ILHV(~ ~>,~c E FILL APRoX. ~_ooc~ NOV - 8 ~,,,2 N£ V~ SCALE ~,1¢1'-- I' N ~ECE~VE FEB 2 5 2013 £ 7-7A/~ L H£AD Ti.A/G- ~ UL.K NE,A/'2 ?ROPOSED o © ,,'V~-W ,~[TAI NIA/G- WALL APPROVFD ~ OF TRUSTEES TOWN OF o ~°° © T/NC- LA EL)/~/C- o\O I ' I