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Home My WebLink AboutTR-7999A BOARD TOWN OF SOUTHO~ DATE j TEST HOLE DATA P SURVEY OF PROPERTY $ITUA TED A T LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-145-02-1.2 SCALE 1"=40' NOVEMBER 2, 2005 JANUARY 15, 2005 ADDED PROPOSED HOUSE AUGUST 7, 2006 REVISED PROPOSED HOUSE MAY 26, 2011 STAKE SOUTHERLY PORTION OF WEST PROPERTf LINE NOVEMOER 1, 2012 REVISED PROPOSED HOUSE DECEMBER 7, 2012 REVISED NOTES AREA = 21,275.42 sq. ff. Oo eUL~.~D) 0.488 ac. 1. ELEVATIONS ARE REFERENCED TO N.A.V,D, 1988 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:~ EXISTING CONTOUR LINES ARE SHOWN THUS: -5 F.C[. - RRST FLOOR 2012 0467 Nathan Taft Corwin III Land Surveyor PHONE (631)727-2090 Fax (631)727-1727 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 CERTIFICATE OF COMPLIANCE # 0837C Date: February 11, 2013 THIS CERTIFIES that the existing bulkhead and retaining wall structures At 60 Great Peconic Bay Blvd., Laurel, New York Suffolk County Tax Map # 145-2-1.2 Conforms to the application for a Trustees Permit heretofore f'ded in this office Dated December 27, 2012 pursuant to which Trustees Administrative Permit #7999A Dated January 23,2013, was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing bulkhead and retaining wall structures. The certificate is issued to JOHN C. DILLER owner of the aforesaid property. ~uthorize~ SignatUre -- Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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 DATE/~ INSPECTION: ~/~'4',~J' /(" / Ch. 275 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain __ Ist day of construction /~ constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: 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 Permit No.: 7999A Date of Receipt of Application: December 27, 2012 Applicant: John C. Diller SCTM#: 145-2-1.2 Project Location: 60 Great Peconic Bay Blvd., Laurel Date of Resolution/Issuance: January 23, 2013 Date of Expiration: January 23, 2015 Reviewed by: Board of Trustees Project Description: For the existing bulkhead and retaining wall structures previously approved by the Trustees in 2006; the previous approval of these structures was included as part of a permit issued for these and for similar structures on this and three additional properties. 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 survey prepared by Nathan Taft Corwin III, Land Surveyor, last dated on December 7, 2012, and stamped approved on January 23, 2013. 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 P.O. Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ,)/~'~ / 4,, 7, ~,' '~- Proper-T-Permit Services on behalf of JOHN C. DILLER requests an Administrative Permit for the existing bulkhead and retaining wall structures previously approved by the Trustees in 2006; the previous approval of these structures was included as part of a permit issued for these and for similar structures on this and three additional properties. Located: 60 Great Peconic Bay Boulevard, Laurel. SCTM# 145-2-1.2 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound '"'"Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ~Chapt.275 __Chapt. 111 other Type of Application: __ Wetland ~Administrative__Emergency __ Coastal Erosion Amendment Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: ~'"'J. King 4,~B. Ghosio__'~D. Bergen, ~ J. Bredemeyer ~'"Michael Domino D. Dzenkowski Form filled out in the field by other Mailed/Faxed to: Date: TRUSTIfl~S John 1VI. Bredemcyer, Ilk President Albert L Krupski, ~r., Vice President Henry P. Smith John B. Tuthill William G. Albermon Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L HARRIS Town Hall 53095 Main Road P.O. Box I179 Soutfiold, New York 11971 December 22, 1993 Larry Tuthill 1215 Inlet Lane Greenport, NY 11944 RE: John Diller sCTM ~1000-145-2-1.1-1.6 Dear Mr. Tuthill: The following action was taken by the Southold Town Board of Trustees on December 21, 1993: RESOLVED that the Southotd Town Board of Trustees grants an amendment to the above referenced permit to ad~ a secom~lar~ bulkhead landward of existing one as drawn on survey received December 13, 1993. If you have any questions, please do not hesitate to contact this office. President, Board of Trustees Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 145-2-1.1, 1.2, 1.3, 1.4DATE:.....311!19~ ..... 1~$' & 1.6 ISSUED'TO ....,T,.Q~._c~ ..~I~.R.. .............................. Pursua~ to the provisions of Chapter 615 of Se Laws of the State of New York, 1893: and C~apter 404 of fha L.~ws of State of New York 1952: and the Seuthold Town Ordinance eh- tilled "RE~ULATING AND TIlE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBUC LANDS and REMOVAl- OF SAND, GRAVEL OR OTHER MATERIALS FROId LANDS UNDER TOWN WATERS;" and in accordance wffh the Resolution of The Board ad.pled at a meeting held on 19 ..9~, end Jn consideration of the sum of $ paid by of ....................................................................... N. Y. and ,ub. ied to Se Terms and Conditions listed on ~he reverse s~de hereof, of Soufhold Town Trustees authorizes and permlfs fha following: l~epair existing bulkhead. Located Peconic Bay Blvd. Mattituck ~ithin 18" all in accordance with the defai~ed specifications as presented in Se originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs Corporate Seal to be affixed, and these present~ to be subscribed by a majority of, ~le~id Board~as of this dat~. ............ · · Y: State Lic, Land Surveyor, . Date l/z~-Iq~ PHOTO A: Looking NNE. Subject bulkhead begins at the double pile and extends 57'~-~ to the right in 1he photo, (12.24.12 at 1329 hrs) PHOTO B: Looking WSWi Stfbject bulkhead begins 12'& left ik¥om the stairs in the right fore- ground and e~xtends left in the photo. (12/24/12 at 1328 hrs) PROJECT SITE PHOTOS Application regarding the property of John C. Diller, SCTM #1000-145--2d.2 Represented b~ PROPER-T PERMIT SERVICES P~O. Box 6/7, Cutchogue. NY 11935 James E Fitzgerald, Jr. 5 I6~734-5800 December 25, 20 t 2 PHOTO C: Looking N. Approximate intersection of property lines and butktvead are indicated by pink-flagged stakes, circled (12/25/12 m 1556 hrs) PROJECT SITE PHOTOS Application regarding the properly of John C. Diller, SCTM # 1000-145-2- t .2 Represe~ted by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue NY 11935 James E. Fitxgerald, Jr. 516~734-5800 December 25, 20 t 2 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 $outhold, 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 $outhoid Town __ Board of Date: January 18, 2013 Re: Proposed Wetland Permit for JOHN C. DILLER SCTM# 1000-145-2-1.2 Proper-T-Permit Services on behalf of JOHN C. DILLER requests an Administrative Permit for the existing bulkhead and retaining wall structures previously approved by the Trustees in 2006; the previous approval of these structures was included as part of a permit issued for these and for similar structures on this and three additional properties. Located: 60 Great Peconic Bay Boulevard, Laurel. SCTM# 145-2-1.2 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 54376 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 Uas Oaly Coastal E~mion Permit Applicatio~ Wetland Peamit Application ~/Adminislrative Permit Ameadment/rraasfur/Ext~tsion ~:~eceivcd Applicatio~:~~.- 7Completed Applicatio. { 7. { Z7 / { ~ Incomplete t SEQRA Classification: Type I Type I[ Unli,~ ,Coordinatioa:(dat~ sea~) v/ LWRP Consisteacy Asscasmeat Form ~.~i~AC l~f~'al Seat: /0~ ~ ate of Inspection: ' Receipt of CAC Report: ' t - Lead Agency Detcvrmieafion: --'4'Teclmical R~view:' ~/ Public Hearing Held: · Rasolufion: Name Of Applicant Mailing Address Phone Number:( Suffolk County Tax Map Number: 1000- . Property Location: ~0 ~C~(~O ~4 I-C f, avr [ (provide LILCO Pole #, distance to eross streets, and location) (If applicable) Address: Phone: ~rd of Trustees Applicatio~ GENERAL DATA Land Area (in square fee0: Area Zoning: Previous use of property: Intended use of property: Covenants and Rastrictions on property?. __ If"Yes", please provide a copy. Yes /No Will this project require a Building Permit as per Town Code? Yes v/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. Doe. s this project require a variance from the Zoning Board ofAppeals? __Yes V// No If "Yes", please provide copy of decision. Will this project require.~ny demolition as per Town Cede or as determined by the Building Dept.? Yes ~ No Does the structure (s) on property have a valid Certificate of Occupancy? Yes ~No Prior permits/approvals for site improvements: ....._Agency __ No la/or permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?. I/No If yes, provide explanation: Yes Project Description (use attachments if necessary): PROJECT DESCRIPTION: The purpose of the project is to provide a separate and distinct record, with a unique permit number, applying to existing bulkhead and retaining wall struc- tures previously approved by the Trustees in 2006. The previous approval of these structures was included as part of a permit issued for these and for similar structures on this and three additional properties. WETLAND/TRUSTeE LANDS APPLICATION DATA Purpose'of thc proposed operations: Area of wetlands on lot: -" ~) '~ square feet Percent coverage of lot: -- 0 -- % Closest distance between nearest existing structure and upland edge of wetlands: -- 0 -- fe~t Closest distamce between nearest proposed structure and upland edge of wetlands: -- 0 --' feet Does the project involve ~cavafion or ffllingt ~" No Yes If yes, how much material will be excavated? ~/A cubic yards How much material will be filled? ~/A cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the m~a of operations: ~//~ Manner in which mat~ial will be removed or deposited: /~//~. 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): It is expected that the oroject will have no significant effect u~on the wetlands and tidal waters of the Town. 6'17.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by A~3pllcant or Project Sponsor) 1. APPLICANT/SPONSOR 12. PROJECT NAME James E. Fitzgerald, Jr. - Proper-T Permit Services I Diller bulkhead re-permitting 3. PROJECT LOCATION: Municipality Laurel County Suffolk 4. PRECISE LOCATION (Street address and mad intersections, prominent landmarks, etc., Or provide map) 60 Peconic Bay Boulevard, Laurel, NY 11948 5. PROPOSED ACTION IS: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: The purpose of the project is to provide a separate and distinct record, with a unique permit number, applying to existing bulkhead and retaining wall structures previously approved by the Trustees in 1993. The previous approval of these structures was included as part oft permit issued for these and for similar structures on this and three additional properties. 7. AMOUNT OF LAND AFFECTED: Initially NMT 0.l ac~s acres Ultimately N/A ac~es 8, WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes ~[~ No If No, describe bdefiy 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial [] Agticulture [] ParldForesl/Open Space Small- to medium-size waterfi'ont single-family private dwellings BOther 10, DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes ~ No If Yes, list agency(s) name and pen~Jit/appmvals: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] No If Yes, list agency(s) name and permilJappmvals: Southold Town Trustees; unnumbered permit dated 3/11/93 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [~] Yes []No I C;~.T.~ FY THAT T[~}NI~R~TION PROVI~.D~ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor na(ne: IJaffies E.~e~- /~ Date: 12/25/12 If the ~(~ion is in the Cgoastal Area, and you are a state agency, complete the Cbastal Assessment Form before proceeding with this assessment OVER I Reset PART II - IMPACT ASSESSMENT ~,e completed by Leed Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordi~ate the review process and use the FULL EAF. ~--] Yes DNo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, a negative declaration may be superseded by another invelved agency. r'-~Yes ["-~ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surtace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, histedc, or other natural or cultural resources; or community or neighborhood character? Explain bdefly: C3. Vegetation or fauna, fish, shellfish or wildlife spedes, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as oificially adopted, or a change in usa or inte~ity of use of land or other natural resources? Explain b~iefly: C5. Growth, subsequent development, or related activffies likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in CI-C57 Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? Expiain bhefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? [] Yes ~l No If Yes, explain bdefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain bdefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtent~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibifity; (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 adveree 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 this box if you have identified one or more potentially large or significant adverse impactswhich MAY occur. Then proceed directly to the FULl. EAF and/or prepare a positive declaration. [] Check this box if you have determined, based on the information and analysis above and any supportieg documentation, that the proposed action WiLl. NOT result in any significant adverse environmental impacts AND provide, on aflachments as necessary, the reasons supporting this determination Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Date T~tie of Responsible Officer Signature of Preparer (If different from responsible officer) Reset PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc)') A. DOES AC'TION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, cea(dinate the review process and use the FULL EAF. I--I [Z].° WILL ~CTION RECEIVE COORENNATED REVIEW AS PROVIDED FOR UNMSTED ACTIONS IN 6 NY'CRR, PART 617.67 If No, a negative 171.o C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED W1TH THE FOLLOWING: (Answers may be handwritten, If legible) Cl. Existing air qua[~, sun~ce or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for eros~en, drainage ~ flooding problems? Exp~ale bde#y: I C2. Aesthe~3. agricultural, archaeo4ngicst, hletodc, or other natural or cultural re.sources; or ~enlmunlty o~ neighborhood charac~efq F._~xplaln briery: I I C3. Vegetation ~r fauna, fish, sheltiish or wildlife species, signlrmant habitats, o~ ~, matened or endangered species? Explain ts~fly: I I C4. A community's e~isting plans or goals as officially adopted, or a change in use or mtens ty of use o(land of o~er natsra resources? Explain briefly: C5. Growth, ~ubsequent development, or relat'~l actlvities lil~;ly't7 f~e-ih~uced by t~l~e pro~se~ a~io~'~in ~fly: I 1 C6. Long term shod tom1 cumulative, of other effects not ideotified in C1~C5? Explain briefly: -- C7. (~ther impacts {indudin~ chanties in use of either- ClU'~lflt), or type of ener~';?'~XPlain briefly: ...... / D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEA~? E~] Yes [Z]N° I Ill ~s' explain brieti¥: .... ,,, ,: , ,,,, E. IS THERE, OR IS THERE UKELY TO BI~i CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ~: I PART III - Dr: ~ualINATION OF SIGNIFICANCE (To be completed bY Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether It is substaQItat, large, impodant or olherwtse significanL Each effe~ slmuld be assessed in connection with its (a) se(ting (i.e. urban or rural); (b) probability of occuning; (c) duration; (d) itTevmsibia~, (e) geographic scope;, and (t) magnltucla. If fleeeSSary, add attachments or ref~ence suppo~ng matertala. Ensure that exptana~ons contain .. sufl'mlant detait to show that all relevant adve~e Impacts have been kleatified and adequately addressed. If qnestlea d of part Ii was checked yes, the ~.~--,~lnmion of significance must evaluate the potential impa~of~e p~ action on the environmental eharacledstics of the CFA EAF and/qr pmpore a posl~e dedarafisn. WILL NOT reauif Iff any s~u3atlt adverse eflvlroflme~al Impa(/s AND provide, off atlachme~s as necessaly, the reasons suppo~dg determination. Board of Trustees I"I . ~Y~:~'~ / ~ ~"~/.~ Name of Lead Agency Dale S~ ature o ResponSible Officer in Lea.~,A~ncy Signature of Preparer (If different from responsible officer) Town of $outhold - Chapter 236 - SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENI~AL INI~ORMATION: (All Reclue~ed Information is R~l,~fircd for a Complete Appli~ti_on) ancot pe~ ~ M~ ? Y~ No ................................................ ~ln~t and SW~PA~ ~r R~ ~ ~ by ~ Te~ of ~old ? Y~ CO~ O~ ....... ~...~ ........... S~m ~ bdorc mc ~; /~ ~2 / / ~WPPP Assessment FORM: O:3-12 No Qualified r, nmmission Expires August 31, 20~'~. Board o~ Trustees Application County of Suffolk State of New York DEPOSES AND AFFIRMS 3~I-IAT HFJSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED I-IR. REIN AKE 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 RE isEs IN oo o, io swo~TOBEPOX~U~V~nS '~3~ D^¥o~?~tCt~ ,2ol_f_ Norm7 Public BONNIE W. MAZZAFERRO Notary P'ablic, State of New York No. 01MA4667612 Qualified m Suffolk County _[ Commission Expires August 31, 20 I~"~ 162 Charleston Park Nashville, TN 37205 President Board of Town Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Dear Sir: Please be advised that I hereby designate and authorize James E. Fitzgerald, Jr. of Proper-T Permit Services to act in my behalf as my agent in the submission and processing of a permit application for an as-built bulkhead and an as-built retaining wall on my property located at 60 Peconic Bay Boulevard, Laurel, and designated by Suffolk County Tax Map No. 1000- 145-2-1.2, and to furnish, upon request, supplemental information in support of the applica- tion. olin I~tller APPLICANT/AGENT/REPRF_~ENTATIVE TRANSACTIONAL DISCLOSURE FORM Th~ Town of Southold's Code of Ethlas tin.bits conflicts of intcrnst on the tort of to'va 6ffleers and enmlowns. The uaroose of ~q th~m is to omvide Infi~rinatinn whic~ ami simt the town of~%slbl6 conilicts ofllatmm~ and allow it to ~ what~''vc~ action is nacossacv to avoid sacns. ...i. ,~I .. . (Last name, first name, ~niddle Inl~, .~l~ss you am applying hi t~. ~ame of somcona als~ or oth~r entity, such as et company. If an, indic~¥hC.other person's or company's name.) - NAMB OF APPLICATION: (Che~k ali that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal F. rosion Approval of plat Mooring Exemption from plat or official map Planning Other Of'Other',, name the activity.) Do you pe~onally (or through your company, sponsc, sibling, parent, or child) have a relationship ~ith any officer or employee of thc Town qf~Southold? "Relationship" includes by bio,d, marriage, or bus, ness i~terest. ~Busines~. intere~n means a bnsinnss. including a pactne~hip, n which thc town officer or cmploy~ has cvco ~ pastiat ownership o f (~ employment by) a corporation in whic~ the town officer or employee owns moro than 5% of the shams, YES NO if you answered'YES", completa the balanc~ of this form and date and sign wh~m iadica~L Name of persgn employed by th~ Town of Southold Title br ix)silion e f that pe~son DascHb~ the rolafloa~hip b~tw~n your~if (th~ applicant/ag~Vmpms~n tative) and ll~ towa officer or eroployce. Either clmck the appmp~-iat~ linc A) through D) and/or dcsc~..b~ la the spa~ ProVid'-A- . . T~ t~wn officer or employce or his or her spouse, sibling, paropt, Or child is (clvzok ~ that apply): x) t~ owner o~r than s% o~t~ ~h~ oethe ~o~r~o ~to~kof~.~li~ (wheh the applicant is a corporation.); . · :: .. B) th~ legal 0r]0eneticial own?r of any interest m a non-~.rporat~ coti? applicant is not a corporatkm); C) an officer, director, parto~, o~ employee of tho applicant; or D} tho actual applicant. DES{~RH~TION OF RELATIONSHIP '-- Form TS I APPLICANT/AGENT/REPRESENTATIVE TRAIq'SACTIONAL DISCLOSURE FORM ~ Town of Southald'e Code of £thles prohibits confllots ofinterast on the hart oftolvn l~ffieera and enmlovees. The numos~ of this form Lq to orovida info,nation which can clmt the town of~ossthl6 confficts oflnte~, and allow it to loire whatever action is necessnr~ to avoid same. : . · (Loot name, first name, .gflddle ialfial, .upleas yob am applying ia thp ~amc of someone ela~ or other entity, auoh as a company. If so, indicale~.fle.' .other person's or company's aame.) · - NAME OF APPLICATION: (Cheek all that apply.) ' ' · ": '...: Variance Change of Zone Appravnl of plat Exemption from plat or official map Other (1 f"Other', name the activity.) Building Tmsl'~ Coaslal Ero~ioo Mooring Planning Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship:with any officer or employee of the Town ~t~outhold? "Relationship*' includes by blo~d, man'iagn, or bu.~inezs illlerast"Bash?~ iaterest~ means a business, including a partnership, in which thc town officer or amployee has even it portia[ owneishlp o f (o.t employmant by) a corporation in which the town officer or employee owns moro than 5% of tho shares. YES NO ~(~ ' '- lfyou answemd"YES", completo the helanc~ of this form and dat~ end sign where lndicg!r d, Name of p~r~n employed by the Town of $outhold Title br position of that person D~sorlhe the relationship between yourseif (the applicant/ng~nt/reprasan tatlve) and ti~ town officer or employee. Either check the appropriate llne A) through D) and/or deact!be in the space provided. The town officer or employee or his or her spouse, sibling, parent, ar child is (check all'~at apply): A) the owner of greater than 5% of tho shmes of the corporate stock of the aPPlicant ' (wheh the applicant is a corporation); B) the legator benefialal owner, of any inle~est in a non-~rpotat? entity (whe~ app icant is eot a corporatmn) .... C) an officer, director, partner, o{ employee of the applicant; or .. D) the actual applicant. DB$C. R. IPTION OF RELATIONSHIP '.- Form TS 1 .Pd ~ ~rw ..~ t . LWRP CONSISTENCY ASSESSMENT FORM sc~ tcc~-tq~-z- hZ P~OJ~CT~.m~ ""g' tlev-q~tkhe,ad2 ~_"Pe,~d'b ~t~ The Application has been submitted to (check appropriate response): TownBoard ~] PLannlng Board ['-] Building Dept. [~ Board ofTrustees Category of Town of Southold agency action (check appropriatg'response): (a) (c) Nature aud extent of action: Action undertaken directly by Town agency (e.g. capital -' [] construction, planning activity, agency regulation, land Financial assistance (e.g. grant, loan, ~subsidy) * ' DEC 27201Z Permit, approval, license, certification: ~... i Location of action: Site acreage:. ?resentzo .gc as ca. on: :- If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: ,~1~ (b) Mailing address: (c) Telephone number: Area Code ( ). (d) Application number, if any: Will the action be ~rectly undertaken, require funding, or approval by a state or federal agency? Yes ~ NolV~t Ifyes, which state or federal agency? December 25, 2012 APPLICANT: JOHN C. DILLER SCTM #: 1000-145-2-12 LWRP CONSISTENCY ASSESSMENT FORM Policy 1 [] YES Foster a pattern of development in the Town of Southoid that enhances com- munity character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. [~O [] NOT APPLICABLE The continued existence of these existing, functional, previously permitted by the Trustees, shoreline structures is not inconsistent with the character of the water- fi'ont community, and because of the relatively small footprint of the existing struc- tures it is felt that there is no adverse impact on the desired preservation of open space. Infrastructure use is not a factor since the project is accessory to and ac- cessed from private property. The maintenance of the erosion control purpose of the structures is certainly a beneficial use of the coastal location, and there is no in- cremental increase in development in the area since the structures already exist, and have existed for many years. Policy 2 [] YEs Preserve historic resources of the Town of Southold. [~/NO [] NOT APPLICABLE There is no evidence to indicate that the immediate area of the structures includes, now or in the past, historic features, and it is to be expected that the mainly inter- tidal nature of the project area is unlikely to have been the site of recoverable arti- facts of past civilizations. Policy 3 [] YES Enhance visual quality and protect scenic resources throughout the Town of Southold. [] NOT APPLICABLE The continued existence of the structures will result in no apparent change in the project site. The existing structures, which will retain their present forms, are com- patible with other existing shoreline structures in the area, and will not adversely affect dynamic landscape elements (tidal fluctuations, seasonal vegetation changes; seasonal/diurnal changes in ambient light) which might contribute to ephemeral visual qualities. Policy 4 [] YEs Minimize. loss of life, structures, and natural resources from flooding and ero- sion. ~NO [] NOT APPLICABLE It is intuitively obvious that the likelihood of the structures contributing to in- creased hazards which could result in the loss of life fxom flooding or erosion is probably non-existent. There is no new construction proposed. The existing struc- tures have adequately provided protection from flooding and erosion. Policy 5 [] Protect and improve water quality and supply in the Town of Southold. [~0 [] NOT APPLICABLE The project will not have any effect, either positive or negative, upon water quality and supply in the Town of Southold. Policy 6 [-3 Y~S Policy 7 [] YES Protect and restore the quality and function of the Town of Southold's ecosys- tem. [] NOT APPLICABLE The structures will successfully continue their functions in this regard; their con- tinued existence will have no direct effect upon the Town's ecosystem, however that may he defined. The project will have no new effect upon existing tidal pat- terns and there will be no degradation of water quality. All statutory and regulatory requirements, at all levels of government, will be strictly complied with. No dredging, excavating, or filling in wetlands is included in the project. Protect and improve air quality in the Town of Southold. [~NO [] NOT APPLICABLE The project involves no physical activities, and thus will not result in any new air pollution, nor will the existence of the structures upon completion of the project.. Policy 8 [] YEs Policy 9 [] YEs Policy 10 [] YES Policy 11 [] YES Policy 12 [] YES Policy 13 [] YES Minimize environmental degradation in the Town of Southold from solid waste and hazardous substances and wastes. [~NO ~ NOT APrLICABLE The project will not result in the generation of any additional solid waste. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. [] NO [~NOT APPLICABLE This policy is not applicable to thc proposed project. Protect Southoid's water-dependent uses and promote siting of new water- dependent uses in suitable locations. [] NO [~OT APPLICABLE This policy is not applicable to the proposed project. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. []No GOT APPLICABLE This policy is not applicable to the proposed project. Protect agricultural lands in the Town of Southold. [] NO [~NOT APPLICABLE This policy is not applicable to thc proposed project. Promote appropriate use and development of energy and mineral resources [] NO [~/NOT APPLICABLE This policy is not applicable to the proposed project. Proper- T Permit Services POST OFF/CE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 President Southold Board of Town Trustees Post Office Box 1179 Southold, New York 11971 December 26; 20! 2 (631) 734-5800 BEC 2 7 ~_ Re: Application for Permit on Behalf of John C. Diller; SCTM #10~JIT-T45"z2r~ ? Dear Sir: Attached are documents which have been prepared in response to the Trustees' request for docu- mentation supporting the desired re-permitting of the shoreline structures on the Diller property, and the subsequent issuance of a Certificate of Compliance. A Trustee permit, issued on 3/11/93 and amended on 12/21/93, allowed the repair of an existing bulkhead and the new addition of a "secondary bulkhead" landward of the existing bulkhead. The permit covered the project on six contiguous lots, 1.1 through 1.6. Presently, Mr. Diller, as owner of lot 1.2, has requested a Certificate of Compliance for the portions of the two shoreline struc- tures on his property. In order to have the process conform more nearly to present administrative standards, the Trustees have requested that this application be submitted to, in effect, establish lot 1.2 as a distinct entity and to respond to our request on that basis. Proper-T Permit Services represents Mr. Diller in this matter, and a letter of authorization is part of this submission. If there are any questions, or if additional information is needed, please call me. Sincerely, Enclosures: ~/ Application Fee (Administrative Permit) ($50) Final Inspection Fee ($50) Application Form (2 copies) Letter of Authorization (2 copies) Notarized Statement (2 copies) Transactional Disclosure Form (2 copies) LWRP Consistency Assessment Form (2 copies) Short EAF (2 copies) Stormwater Assessment Form (2 copies) Project Plan (2 copies) Project Site Photos (2 copies) Survey of Property (2 copies) a subsidiary of THE PECONIC EASTERN CORPORATION Proper- T Permit Services POST OFF/CE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 DFC 1 3 2012 ~, December 12, 2012 (631) 734-5800 President Southold Board of Town Trustees Post Office Box 1179 Southold, New York 11971 Re: Request for Certificate of Compliance; Permit No. "145-2-1.1, 1.2, 1.3, 1.4, 1.5 & 1.6" Dear Sir: A contract vendee has requested a copy of a Certificate of Compliance for the project authorized by the Trustees' referenced permit. Please provide the document. If, because of the possibility that the Town Code in effect in 1993 did not require such a document, and it is the Trustees' decision that it would not be meaningful to issue such a document at this time, may we have a written statement to that effect? A copy of the permit, dated 3/11/93, is attached Si~erely, /~ [~ /am e'~ . g a subsidiary of THE PECONIC EASTERN CORPORATION