The URL can be used to link to this page

Home My WebLink AboutTR-7905A 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 OFTOWNTRUSTEES TOWN OFSOUTHOLD CERTIFICATE OF COMPLIANCE # 0812C Date: October 10, 2012 THIS CERTIFIES that the 4' wide foot path consisting of gravel from the house through the phragmites to the landward edge of tidal wetlands boundary in order to provide access to the water At 7065 New Suffolk Road, New Suffolk, New York Suffolk County Tax Map # 117-5-30 Conforms to the application for a Trustees Permit heretofore f'fled in this office Dated August 28, 2012 pursuant to which Trustees Administrative Permit #7905A Dated September 19, 2012, was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the 4' wide foot path consisting of gravel from the house through the phragmites to the landward edge of tidal wetlands boundary in order to provide access to the water. The certificate is issued to STEPHEN WALSH owner of the aforesaid property. Authorized Signature Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hail 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 DATE OFINSPECTION: ~// Ch. 275 Ch. 111 INSPECTION SCHEDULE ,/ Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction ~ constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: ~-'~ 7~_ James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Ma'm Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 7654641 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE __ Pre-construction, hay bale line __ Ist day of construction ¼ constructed Project complete, compliance inspection James F. King, President Bob Ohosio, 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 Fsx (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7905A Date of Receipt of Application: August 28, 2012 Applicant: Stephen Walsh SCTM#: 117-5-30 Project Location: 7065 New Suffolk Road, New Suffolk Date of Resolution/Issuance: September 19, 2012 Date of Expiration: September 19, 2014 Reviewed by: John Bredemeyer, Trustee Project Description: To provide a 4' wide foot path consisting of gravel from the house through the phragmites to the landward edge of tidal wetlands boundary in order to provide access to the water. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the project plan prepared by Stephen Walsh, received on August 28, 2012, and stamped approved on September 19, 2012. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. James F. King, President Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated c~/2~/I ~, t has been reviewed by this Board at the regular meetin, g of / ¢~//~/! 2-- and your application has been approved pend,ng the completiod of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above, COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees SCHOOL HOUSE CREEK 202. ~$'47'20" W ~ O.L ~/o/x · 'l - OVEg j ~ J ~ O~ TRUSTEES j ORCHARD STREET 202.68' 4 SURVEY OF PROPERTY SITUATED A~ NEW SUFFOLK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-117-05-30 SCALE 1 "=30' APRIL 3, 2001 AUGUST 14, 2007 LOCATE PILES JUNE 4, 2009 FINAL SURVEY FEBRUARY 28, 2012 SET CORNER MONUMENTS ARIrA = 20,265 sq. ff. 0,465 ac. NO TES: 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM. EXISTING ELEVATIONS ARE SHOWN THUS:~ -3.c, Y-AK ~,&. /ooo- ItT-cE-- 3~ /[ Nathan Taft Corwin III Land Surveyor FflM(E (631)727-2(~0 r~ (~g727-1727 ~/o/x SCHOOL HOUSE I '~ ~/o~ /os~n ru~msm ORCHARD STREET SITE PLAN 202.68' SITE DATA LOCATION MAP TEST HOLE DATA Southho!d Tow,,] Beard of Trustees James F. King, President Bob Ghosio, Jr, Vice-President Dave Bergen John Bredemeyer Michael J. Domino PO. Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report STEPHEN WALSH requests an Administrative Permit to provide a 4' wide foot path consisting of gravel from the house through the phragmites to the landward edge of tidal wetlands boundary in order to provide access to the water. Located: 7065 New Suffolk Road, New Suffolk. SCTM# 117-5-30 Type"of area to be impacted: "Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland ~c. ho~f Town Code proposed work falls under: __Chapt.275 Chapt. 111 other T~AAd Of Application: Wetland Coastal Erosion Amendment ministrative__Emergency --Pre-Submission -- Violation Info needed: Modifications: Conditions: Pre:~h~ Were: J. King B. Ghosio__ J. Bredemeyer Michael Domino Form filled out in,,the,field by Mailed/Faxed to: Date: D. Bergen, D. Dzenkowski other N 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 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 ~ SEP 12 2012 Date: September 17, 2012 Re: Wetland Permit for STEPHEN WALSH SCTM# 117-5-30 STEPHEN WALSH requests an Administrative Permit to provide a 4' wide foot path consisting of gravel from the house through the phragmites to the landward edge of tidal wetlands boundary in order to provide access to the water. Located: 7065 New Suffolk Road, New Suffolk. SCTM# 117-5-30 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. 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 OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application ~ Administrative Permit ~Amandmcnt/Tra~c~nsi°n _~,_Rcceived Application: .~ff/~ J~_Rcccivcd Fec:$~f~)~ Incomplete SEQRA Classification: Type I Iype II Unlisted___ Coordination:(date sent) -~-LWRP Consistency As~,~_ent Form ~/3 CAC Referral Sent: ~' Date of InspectionL Receipt of CAC Repofi: __Lead Agency Determination:__ Technical Review: ~Public Hearing Held: 9// __Resolution: AU0 2'8 2012 Southhsld Town Board of Trustees Name of Applicant Address ~,,~:t~/ ,5o(/~'ol-[q PhoneNumber:(¢$)f ~,6 3 -o '2-i g-'-, ceil: 9o21 Suffolk County Tax Map Number: 1000 - / } 7 - ~'-~ ~ Property Location: (provide LILCO Pole ~, dist~ce to cross s~eets, ~d location) AGENT: (If applicable) Address: Phone: Bol of Trustees Application Land Area (in square feet): Area Zoning: &/~---- Previous use of property: Intended use of property: GENERAL DATA l't-Cs ~ o~ ,v ~t,~ L Covenants and Restrictions: If "Yes", please provide copy. Yes ,/~ No Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Yes ~ No Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes ~ No No Does the structure (s) on property have a valid Certificate of Occupancy .,,~ Yes __ Prior permits/approvals for site improvements: Agency .~ouD.IoZ.,~ Stt~/Pl~,~ %7~"/A Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?. ~ No Yes If yes, provide explanation: Project Description (use attachments if necessary): / Bo of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~ ACC~ ~ S r{4~ c~ Area of wetlands on lot: //j o~, O square feet Percent coverage of lot: :Z..5'- % Closest distance between nearest existing structure and upland edge of wetlands: ~ ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or~ No ~ Yes If yes, how much material will be excavated? A,//~ cubic yards How much material will be filled? --q - ~ cubic yards Depth of which material will be removed or deposited: ..5'- ~ Proposed slope throughout the area of operations: /w I~1 tu,n. I.. Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 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 /:oo 7-- ?A- 3,PROJECT LOCATION: Municipality t~'~_~ ~' SEQR Counb/ j (./j¢::'/¢C; 0 L. K 4. PRECISEHo ~o,~'--LOCATION: A~: ~l,/Street ---c C~J~(Z:~'/-' ~Addess and Roadt~)lntersecti°n..~=~ tv~,/Pr°minent *~ (./i I~.d ma rks O J... ~.~ etc -or provide mae 5. IS PROPOSED ACTION: ~] New [] Expansion [~Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately ,, O~ acres 8 WiLL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? J~Yes [] No If no, describe briefly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) []Residential [] Industrial ~;~l'commercial ['--]Agriculture [] Park/Forest/Open Space [] Other (describe) 10 ' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~'es F'~ No If yes, list agency name and permit / approval: ll. UUE~ ANY ASPE(.;I UP IHE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~]Yes /[~No If yes, list agency name and permit / approval: 12. AS ARE~UULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDEO ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ~-~7~4'~)t'~/~ ~o I/v/d( L,.~'~¥ D to: If the action les Costal Area, snd you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A S_TDRM-WATEI~ GK4/)ING, DILMI~GE AND EROSION CONTROL PLAN DiStrict 5Ktion BIQCK Lot L~B;K[I~'IB:U BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OFWORK - PROPOSED CONSTRUCTION ITEM # / WORKASSESSMENT ] Yes No a. What is the Total Area of the Project Parcals? (include Total Area of all Parcels located within~-"/J~ ~:~ ~ jc I Will this Project Retain Ait Sturm-Wate~ Run-Off the Scope of Work for Proposed Construction) . Generated by a Two (2') Inch Rainfall on Site? b. What is the Tctal Ama of Land Cinating ,A/{ ~t~(~Ac'~s) (This itam will include all run-off created by site ~'~- L,~J~ cleadng end/or construction activities as well as all and/or Ground Disturbance for the proposed :2. ~ o -5 r~- Site Improvements and the permanent creation of construction activity? impervious surfaces.) (s.F.,,~,) 2 Does tha sita Plan andlor Survey Show Att Propesed PROVIDE. BRIEF PROJECT DESCRIPTION ,~ ~ ~. ~ Dndnage Structures Indicating Size & Location? This /~ r~ ~ Item shall include all Proposed Grade Changes and //[/:~ r..~4~/_. L. /.//- ~.~ ~.~l. L,/~/~' Slopes Controlting Surfaca Watar Flow. ~,,,¢--?"- /~,4~77f ?-I-t~ou~/t- ~-~tc 3 DoestheSitePlanand/orSu~eydescdbetheerosion and sediment control practices that will be. used to control site erosion and storm water discharges. 'this t~/'~ A'(~/~. [ ~'~" ~ ~0/'/~. /~. },- ~-/~.. item must be maintained throughout the Entire Construc~on Pedod. 4 WiR this Project Require any Land Filling. Gradingor Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards~ __ of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five ThousandL~ (5,000 S F ) Square Feet of Ground Surface? -- 6 is there a Natural Water Couese Running through the Site? Is this Project within the Trustees jurisdiction Seneral DEC SWPPP Requirements: or within One Hundred (1 g0') fset of a Wetland or~L~ -- Submission of a SWppP is required for all Constmclion activities involving soil Beach? disturbances of one (1) or mom ac. ms; includiog disturbances of less than one acre thai 7Will there be Site preparation on Existing Grade Slopes ~ am part of a lerner common plan that will ultimalely disturb one or more ac*ss of land; which Exceed Fifteen (15) feet of Vertical Rise to I inc~udiog Construction activities Involving soil disturt:!a rices of less than one (1) acre where One Hundred (100') of Horizontal Distance9 L=~J [he DEC has del~rmined thai a SPDES permit is required for storm wa~r discharges. · SWPPP's Shall meet the Minimum Requirements ~ the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious ~ ~r Storm Wator Discharge8 front Construction activity. Permit No. GP-O-tO-00t .} Surfaces be Sloped to Direct Stown-Water Run-Off I. 331e SWPPP shall pe prepared prior to the submittal of the NOL ~he NOI shall be into and/or in the direction of a Town right-of-way? submined to the Department p~or to the commencement of construction activity. 2. The SWPPP shall descdpe the erosion and sediment oantrst p~acSce~ and where 9 Will this Project Require the Placament of Material, required, post-construction sfoml ~ater management pmOlces that will be used and/or Removal of Vegetation and/or the Construction of any ~'~ constructed to reduce the pollulants In storm water discharges end to assure Item Within the Town Right-of-Way or Road Shoulder STATE OF NEW YORK, COUNTY OF .F...o...L...(<.. ................ SS .................... be/.he ']'hat I, And that he/she is the O t~'At ~ ~ .............. (~; Ea;~; '~;'b~;~a't; ~i~;;.';a:j .................... Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; · ............................... No~y Public: .... 0; V~5C~5 i ;'6 I FORM - 06110 Qualified in S. uffolk Coj,ipty Term Expires II~e,~, PART II - IMPACT ASSESSMENT (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coonJinate the review process and use the FULL EAF. B. WILL ~CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTEO ACTIONS IN 6 NYCRR. PART 617.6? If No, a negative declaration may be superseded by another in~sived agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwriffen, If legible) C1. Existing air quality, sudace or gmundwalor q uarK7 or quantity, noise levels, existing traffic pattern, solid waste prnducfion or disposal, potenllal for erosion, drainage or flooding problems? Explain bdetiy: I C2. Aesthetic, agdculturel, archaeolngisal, historic, or other natural or cuiturel resOurces; or community or neighborhood cbsmcter? Expisln briefly: c3. Vegetation or fauna, Ilah, shellfish or w~llife species, significant habitats, or threalans~ or endangered species? Explain briefly: I C4. A community's existing p~ans or goals as off'~afly adopted, or a change in use or intensity of use of land or other natural resources? Explalfl bdetiy: C5. Growth, subsequent develapmenL or related activities likely lo be induced by the proposed action? Explain briefly: I I C6. Long term,'short t--rm, cumulative, ornther effects not identified in C1-C57 EXPlain brietiy: I ! C7. O[her impacts '~indudinf~ chanties in use of either c~uantl~ or type of energy? F_~lain brlefl}/; ' · - · WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVlRONME. NTAL AREA (CEA}? (if yesr explain bdefly: r-I171.oI E. IS THERE, OR IS THERE UKELY TO B~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ~ explain: .... PART III - De: ! e:IdJINATION OF 81GNIFICANCE (To be completed by Agency) IN~TRUG'TION~: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each eftoc~ should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of ocouning; (c) duration; (d) irmveraibBity; (e) geographk~ scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that exl~anetious contain · suffid, eof delall to show that all relevant adverse impacts have been identified end adequately addressed. If question d of part ii was checked yes, the determination of significance must eveluate lhe potential impact of the proposed a~lon eft the · nviru~mentsl charactedstiss of {be CEA Cbeck Ifda bo~ If you have Idsutirmd sue or more poter, ifally la~ge or signlitsant adveme Impac~s which MAY ¢x=cer. Then proceed dimdJy to the FULt EAF and/or prepare a positive desisretiofl. Check this bex If you have daterminad, bssad on the informaflo~ and analysis above aim any supflodlng documsulatisn, thct ~ ac~kx WILL NOT result in any signlflnsnt adverse emaronme~tal Impacts ANO provide, on aifachmenis as necessary, the masons supporting determination. Board of Trustees Name of Lead Agency ~ P~or Type Name of Responsible Officer~ Lead Agency .~/~lgnature of Responsible Officer in Le~,~Ag ency Date President [] Titie of Responsible Officer Signature of Preparer (If different from responsible officer) Boa of Trustees Application County of Suffolk State of New York $7~WAt 6tv D. u,v/4 I.- $t.1 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 H1S/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. SWORN TO BEFORE ME THIS WO~ DAYOF ~F' ,20. jb~ THERESA A. VESPOU Notary Public, State of New York No. 01VF_.5051281 Qualified in ~.uffo[k Cotl~ty APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officers and cmolovces. The ouroose of this form is to orovide information which can alert the town of oossible conflicts of i~tere~t and allow it to take whatever action is necessary to avoid same. YOUR NAME: )(A/~ 5/1/ . ~' r~i~/~ ~L/j O~ (Last name, first nam~,~aiddle initial, tmless you are applying in the nameof sorecone elm 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 (1 f"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 Southgld? "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 .,~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title Or position of that person Describe the relationship between yourself(the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. Thc 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% oftbe shares &the corporate stock of the applicant (when the applicant is a corporation); __B) the legal or'beneficial own~:r of any interest in a non-corporate entity (when the applicant is not a corporation); __C) an officer, director, parmer, or employee oftbe applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this ~_...~..~y of Ao~'o $ ~ 200 1 '7._ Signatur* ~-~,~-.~tg~ u~',,.~-~g~ -- Print Name s'F~,t/~ O. Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for pemfits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which inehides all of Southold Town). 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. Thns~ each answer must be explained in detail~ listing both supporting and non- SUlmortin~ 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 PROJECT NAME The Application has been submitted to (check appropriate response): TownBoard [] Planning Board [~] Building Dept. ~ Board ofTrustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assismce (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of acfion: 7'o~3~'-- ,~,~ ,~tw~'~-oZM.. /~O. mg~ ~f~ot~ Siteacreage: ~t~ P~o~ I~ , ~ Present l~d use: ~ ~ S IB~ k Present zo~ng cl~siflcation: If ~ application for ~e proposed action has been filed ~ ~e Tom of Sou~old agency, ~e folloMng iffomafion shill be provided: (a) N~eofapplic~t: ~T~ D. (b) M~lingad&ess: ~7 ~Fo~L~ 4~ . ~ ~ M.~ II (c) Telephone number: Area Code (o~] I 3 (o 3 '- o 22_ £ .'3-- (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes[~ No[--] If yes, which,state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [] Yes [] No ~Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Poll. s Pages 3 through 6 for evaluation criteria [] Yes ~ No[E~LLi Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No ~Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria [] Yes [] No ~Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Ycs No I V 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 for evaluation criteria. Yes No Not Appl~le 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 ~ot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~ Yes [-~ No ~Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluatiOn criteria. [] Yes~ No ~Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent ases in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [] Yes ['~ No ~Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconie 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 Ill - Policies; Pages 62 through 65 for evaluation criteria. [] Yes ~'~ No ~Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate usc and development of energy and mineral resources. See LWRP Section III - Policies;~ages 65 through 68 for evaluation criteria. [] Yes ~'~ No~1" I Not Applicable PREPAREDBY -5Tt~/~/,/~J,/,0, v~-~L~/,/ TITLE ow/t/~.'0-- DATE g'/J 7//'2- 47 Eatondale Avenue Blue Point, NY 11715 July 23, 2012 Town of Southold Board of Town Trustees Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Dear Ms. Standish/Trustees; Please review this project plan/survey and advise me which permit application I should file for the foot path ending at the wetland boundary as indicated. It appears that I will get the permit from the DEC as long as I do not place grovel seaward of the wetland boundary. Thank you. Sincerely, Stephen D. Walsh 631 921-8598 New York State Department of Environmental Conservation Division of Environmental Permits, Region 1 SUNY @ Stony Brook 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0365 · Fax: (631) 444-0360 Website: www.dec.n¥.qov July 10, 2012 Stephen Walsh 47 Eatondale Ave Blue Point, NY 11715 Re~ Application #1-4738-03190/00002 Walsh Property, New Suffolk Road, New Suffolk Dem' Mr. Walsh: As per our telephone convers0tion of last week, I discussed your request to clear path through the phra.31~t_es~f the tidal wetland boundary with staff in our Marine Habitat Protectioh-unit. It h~ been determined that the phr~a~mites may_be cut to grade to create a path a maximum of four feet in width. No gravel may be placed in this area,-as indicated in our' letter dated June 2~-, 2012, aha no intertidal marsh vegetation (Spartina altemiflora) may be cut. Please revise the project plans as described above and submit 4 copies of revised plans to my attention. Please note the application remains incomplete for two copies of a location map This application will remain incomplete until all the above items are submitted and or adequately addressed. Please do not hesitate to call me at 631-444-0372 if you have any questions. Joe Martens Commissioner cc: File Sincerely, Claim Wemer Environmental Analyst