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TR-8163
CC# : C16-18186 • 4A':1'p'A R g'"C4rT COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 04/26/2016 under Liber D00012862 and Page 085 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 04/26/2016 . SUFFOLK COUNTY CLERK ��al-LY-X- JUDITH A.PASCALE I SEAL- ' ' . _ 11111111 iiia 11111111111111111111111111111111111 ilii 111E1111111 III I iiia 1111 SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 04/26/2016 Number of Pages : 4 At: 02 :27 : 42 PM Receipt Number : 16-0064524 LIBER: D00012862 PAGE : 085 District: Section: Block: Lot: 1000 077 . 00 01 . 00 009. 000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15 . 00 NO TP-584 $5 . 00 NO Notation $0 . 00 NO Cert.Copies $0 . 00 NO RPT $200 . 00 NO Fees Paid $265 .00 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County- n ® • RECORDED Number of pages Lf 20/6 Apr 26 02:27:42 PM JUDITH A. PASCALE CLERK OF SUFFOLK COUNTY This document will be public " L D00012862 record. Please remove all P 085, Social Security Numbers prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Page/Filing Fee r Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. p��., or EA-52 17 (County) Sub Total 1O Spec./Add. EA-5217 (State) TOT.MTG.TAX R.P.T.S.A. OZ�IT� ::;�*cUU,�;' �. Dual Town Dual County *' , � e,,, Held for Appointment Comm. of Ed. 5. 00 �a; .. r Transfer Tax Affidavit,,,,,,,"' ,J MMansion Tax The property covered by this mortgage is Certified Copy . or will be improved by a one or two NYS Surcharge 15. 00a5 family dwelling only. Sub Total., YES or NO Other Grand Total If NO,see appropriate tax'clause on �' page It °fin rrinct. 1 1 1 4 j Dist. 3142932 1000 07700 0100 009000 5 Community Preservation Fund Real Property PTS 11111111111111111111111111 Consideration Amount $ Tax Service R DHO A Agency 26-APR-1 CPF Tax Due , f$, r ffication — ' Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address 7, ✓� RECORD & RETURN TO: _" Vacant Land 'ti tsz-4 F ( h, TE; vi. rhk,-ct,i-t(*e-vet TD 443 x411.�`V' / A)kf ) f 7`7- TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# (-; y Suffolk County Recording & Endorsement Page This page forms part of the attached 0-e__CA Y "� 0Y1 made by: , (SPECIFY TYPE OF INSTRUMENT) 1 .P. 7 ` iy•k=6.A.) The premises herein is situated in (1,3. rQ AL -M i p J SUFFOLK COUNTY,NEW YORK. TO In the TOWN of SO uC\\0 \(;\ In the VILLAGE or HAMLET of - BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104..10/08kk (over) DECLARATION OF COVENANTS THIS DECLARATION made this oat day of Apr; ( , 20 14 by _Robert J. and Bonita M. Schwan, residing at _52 Summerwood Rd. Holbrook, NY , hereinafter referred to as "DECLARANT (S) ": WITNESSETH : WHEREAS, DECLARANT (S) is/are the owner (s) of certain real property located on 1200 Oak Ave._, Southold, NY , Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 077. 00 , Block 01. 00 , Lot 009.000 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT (S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that approximately 114.5' of concrete bulkhead be replaced utilizing vinyl sheathing and to backfill structure with approximately 10 cubic yards of clean sand to establish"a 10' wide "non-turf buffer" adjacent to and landward of the bulkhead; NOW, THEREFORE, the DECLARANT (S) do/does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained a 10' wide "non-turf buffer" as defined by Chapter 275 of the Town Code; and as depicted on the approved Board of Trustees application; and 2) These covenants shall run with the land and shall be binding on the DECLARANT (S) , his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner(s) has/have duly executed this instrument this day ofreyled -r 20,1j; 4A,`� . - �//�� ' O ER' SIGNATURE 7 -,0 k i v , G(yL.) J h3 - OWNER'S IGNATURE / ail) r 5c NL, -� 0ob<iw STATE OF j' , . ss: COUNTY OF Ste ) O? //- On the a day of r , in the year 20 /6., before me the gunders ' d, a1plotary Pu lic in and for said State, personally appeared e.-4/46 4( ( U4J personally known to me or proved to me_ on the basis of satisf ctory /evidence to be the individual (s) whose name (s) is,/are subscribed to the within instrument and acknowledged to me that he/she/they executed• the same in his/her/their capacity, and that by his/her/their signature (s) on the; `instrument, r the individual or the persons on behalf of w ' ch the individual (s) acted;' executed the instrument. / 40 Notar Public dt16%, MARYANN R BARBIS Notary Public,State of New York Qualified ein Suffolk County 9298 - Commission Expires May 19,20Zif °161148S7 .”6% 2 n,' , t q/ .i ' r M� NTITLE & ABSTRACT ACT 1 INTERNATIONAL BLVD.STE.1203,MAHWAH,NJ,07495 5 (201)529-1710 Telephone:(201)529-1492-Fax: • TITLE NUMBER: 111002- NY061642 • SCHEDULE ALL THAT , CERTAIN PLOT,PIECE OR PARCEL OF LAND,WITH THE BUILDINGS AND IMPROVEMENTS THEREON ERECTED, SITUATE,LYING AND BEING IN THE TOWN SOUTHOLD,LONG ISLAND,NEW YORK,MORE PARTT KNOWN-AND " DESIGNATED AS AND BY THE LOTS N0.3088,,30909 AND 310,ON A CERTAIN MAP ENTITLED MAP GOOSE BAY ADE LEWIS IN THE TOWN OF SOUTHOLD,SUFFOLK COUNTY,NEWORK 12A 934ID APABEING'GM IN THE OFFICE N. THE CLERK OF THE OYSTER BAY,LONG ON NEW 13 YORK DATED SEP NO.1176 COUNTY OF SUFFOLK ON THE 13TH DAY OF NOVEMBER,PARCEL ARE BOUNDED AND DAS AND BY THEES R BED AS FOLLOWS:(ABSTRACT NO.1197) WHICH LOTS WHEN TAKEN TOGETHER AS ONE - BEGINNING AT A POINT ON THE NORTHWESTERLY SIDE OF OAK AVENUE AT THE DIVISION LINE BETWEEN LOTS NUMBERED 307 AND 308 AS LAID DOWN ON RUNNING THENCE SOUTH 45 DEGREES 24 MINUTES 40 4Y SECONDS NEST WEST•RALONG THE NORTHWESTERLY SIDE OF OAK AVENUE 46.48 FEET TO THE LAND NOW OR FROMERLY NORTH 52 DEGREES 07 MINUTES 30 SECONDS WEST ALONG THE LAST MENTIONED DIVISION LINED 1ETIN 2 FEET;OTS THE THENCE NORTHO45 ND 308;DEGREES 24 MINUTES 40 SECONDS EAST 65.00 FEET TO SAIDLINE 140.00 FEET TO THE • NUMBERS 3 THENCE SOUTH 44 SIDE OF OAK AVENUE AT THE POINT ORREES 35 MINUTES 20 SECONDS SPLACENOF BEGINNING. THAT PORTION . NORTHWESTERLY SAID PLOTS ABOVE-MENTIONED TO THE CENTER LINE THEREOF, EREOHE F,SUBJECT TO TOGETHER WILL ALL THE RIGHT,TITLE AND INTEREST OF THE PARTY OF THE FIRST PART OF IN AND TO TOFHE THE ROAD OR ER S TOADJACENT THE RIGHT OF OTHER OWNERS OF PLOTS•ON�SAID MAP TO TO PASS OVER AND USE THE SAME. TOGETHERE PAR IE5,0 THE FIRST PART OF IN AND TO THAT PORTION BIGHT,TITLE AND"INTEREST pp TH OF LAND LYING NG IN ALL THE FRONT OFFDL ADJACENT TO:S,AID�PLOTS'f0 THE MEAN HIGH WATER LINE OF GOOSE CREEK, SUBJECT TO THE,RIGHT OF OTHER�OW,.NERS 0F RLOTSON SAID MAP _ -INCLUSIVE,-'' p -LOTS 277 TO 310 INCLUSIVE,{ SAIDRIGHTTODL TxTHE_rRIGHT_'TO.USE-FOR ALL;REASONABLE PURPOSES ALL THAT PORTION OF LAND LYING IN FRONT OF PL�pGEF�t-ILII BE NS NOS.53 TO OTHER 1 PLOT 1Vt=PERS ON SAID MAP, Arm RESPECTR ATHE THEREODAS MAY BE IN COMMON WITH OTHER PLOT OWNERS O LE_S AND RI=GI 1lATIONS?�WHO MAY HCTO THE A REA,PNp til E Hl.- _ - ` � O1J�p OWNER USE OWNERS OF PLOTS SAID MIM SUBJECT TE RU-iN �; EI GfUN,ERSTOOD TH`�'A'Jf SH` " �; 5AI ;OV1� ER OR OWNERS MAY DO SO PROVIDING FROMTTIGOOS TIME'EK DESIRE EFS C1`; JTI4y,t K '.e, -� ;4 0 r`a.;,., F," Qx .- M ' SAID DOCK GOOSE CREEK DESIENTO=°E ER OWN RS N?LOCA OVISIONS�A SSING OVER WITH AND THE CONSENT THE SAID DOES NOT PREVENT OTHER-01NNEFiSpER�QTSOIVSAI,D;M'�4RR)1551N'G AND REASONABLE USE OF LAND HEREIN REFERRED TO'AND�PROVIDINGP.R , ,._ .. �- _-� THE OLIVER BROS.BUILDING AND CONSTRUCTION CORP.I8 SECIYRED. . Page2of9 Prepared by:VALTECH RESEARCH, INC. ,k)12 James F.King,President I�010 SOu4s, Town Hall Annex Bob Ghosio,Jr.,Vice-President ���,4O • !O 54375Main Road . P..O.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer •G Q �� • 4 . �O �� Telephone(631) 765-1892 Michael J.Domino O(4,COU '�� Fax(631) 765-6641 ��' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0922C Date: October 16, 2013 THIS CERTIFIES that the reconstruction of a±114.5' bulkhead using vinyl sheathing in-place; backfill of clean sand; removal of all concrete debris; 4' wide path to dock and a 10' wide non-turf buffer landward of bulkhead At 1200 Oak Avenue, Southold,New York Suffolk County Tax Map # 77-1-9 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 15, 2013 pursuant to which Trustees Wetland Permit#8163 Dated May 15, 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 reconstruction of a±114.5' bulkhead using vinyl sheathing in-place; backfill of clean sand; removal of all concrete debris; 4' wide path to dock and a 10' wide non-turf buffer landward of bulkhead. The certificate is issued to ROBERT J. &BONITA M. SCHWAN owners of the aforesaid property. 1 / Af thorized Signat e 1 James F.King,President ,40' stIffk Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President t,��yg �Ot P.O. Box 1179 Dave Bergen y at ; Southold,NY 11971 John Bredemeyer ! 1'$ Telephone(631)765-1892 Michael J. Domino Fax 4 -0,0. Fax(631)765-6641 , BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE F INSPECTION: 0 `r , •-‘----e) ,��a" Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction %2 constructed Project complete, compliance inspection. INSPECTED BY: 1 f / i,', &4 COMM TS/� 'r7 ","-A-- itfredV"."7 Ager.,..e--te-e--1.ti_ V 7 a--® k3 CERTIFICATE OF COMPLIANCE: • • James F.King,President ,''' CO O . Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President ? .4- Dave Bergen � P.O.Box 1179 N John Bredeme p 4Southold IdY 11971 �� Telephone(631)765-1892 Michael J.Domino '•��O O =. 1 ,14 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 1'1 day of construction IA constructed / Project complete, compliance inspection rte, . - .% r - BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK / PERMIT NO. 8163 DATE: MAY 15,2013 • ISSUED TO: ROBERT J. & BONITA M. SCHWAN .I " PROPERTY ADDRESS: 1200 OAK AVENUE, SOUTHOLD i 1 SCTM# 77-1-9 - AUTHORIZATION Y Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of ,� i' Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on May J 15,2013,and in consideration of application fee in the sum of$250.00 paid by Bonita M.& Robert J. Schwan or authorized waiver of Town Board and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Cr Wetland Permit to reconstruct in-place approximately 114.5' of concrete a�a ,/ bulkhead utilizing vinyl sheathing and to backfill structure with approximately 10 a�� , ( II cubic yards of clean sand to be trucked in from an upland source; with the conditions -- to to establish and subsequently maintain a 10' wide non-turf buffer landward of bulkhead and a 4' wide path to dock; and all concrete debris to be removed off site; and as depicted on the site plan prepared by J.M.O. Environmental Consulting, last ,,\ ��� dated March 28,2013 and stamped approved on May 15,2013. I 1 IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, 1 : { and these presents to be subscribed by a majority of the said Board as of this date. -- OfFQ(,. 921:41-e—Sallsa II 4;tor ea"41..). fl 4 \ n • (3 „is�� o/,, ,el-le M e yes- 4' j T` ���fOZ :f:�-� ��� efN-a;Qf 1A F4 '1 -_,-pr s , - )� l.. V iYV V�� V j V A l 1 1 , ---- V� �/ • • TERMS AND CONDITIONS The Permittee Robert J. & Bonita M. Schwan,residing at 1200 Oak Avenue, Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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. 2. 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. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. 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. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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 �, 3�.Of SOUIyo , Town Hall Annex Bob Ghosio,Jr.,Vice-President �� ' 4 0 54375 Main Road * *% P.O. Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer G .2 �� '4 Telephone(631) 765-1892 Michael J. Domino O ���s Fax(631) 765-6641 courm, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 15, 2013 Mr. Glenn E. Just J.M.O. Environmental Consulting PO Box 447 Quogue, NY 11959-0447 RE: ROBERT J. & BONITA M. SCHWAN 1200 OAK AVENUE, SOUTHOLD SCTM# 77-1-9 Dear Mr. Just: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 15, 2013 regarding the above matter: WHEREAS, J.M.O. Environmental Consulting on behalf of ROBERT J. & BONITA M. • SCHWAN 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 April 8, 2013, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 15, 2013, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 • • 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 ROBERT J. & BONITA M. SCHWAN to reconstruct in-place approximately 114.5' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with approximately 10 cubic yards of clean sand to be trucked in from an upland source; with the conditions to establish and subsequently maintain a 10' wide non-turf buffer landward of bulkhead and a 4' wide path to dock; and all concrete debris to be removed off site; and as depicted on the site plan prepared by J.M.O. Environmental Consulting, last dated March 28, 2013 and stamped approved on May 15, 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: $0.00 Very ruly yours, James F. King President, Board of Trustees JFK/amn r ��O��gpFFQ(�e Peter Young,Chairman ' Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O. Box 1179 VtO � Southold,NY 11971 \4o �'riTelephone(631)765-1892 4 /to/ Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., May 8, 2013 the following recommendation was made: ROBERT J. & BONITA M. SCHWAN to reconstruct in place approx. 114.5' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with approx. 10 cy. of clean sand to be trucked in from an upland source. Located: 1200 Oak Ave., Southold. SCTM#77-1-9 SUPPORT — Bulkhead should be aligned with abutting bulkheads, also applicant should provide disposition plan for concrete. Proposed by Doug Hardy, seconded by John Stein —All in favor Illr 110 %UFFOu( James F. King.President r0G C P.O.Box 1179 Bob Ghosio.Jr.,Vice-President >'S Southold,NY 11971 Dave Bergen Telephone(631 765-1892 John Bredemever ,y Fax(631)765-6641 Michael 1. Domino 'T`r1 y1 #aOp re • Southold Town Board of Trustees Field Inspection/Work Session Report d1/43 3S Date/Time: J.M.O. Environmental Consulting on behalf of ROBERT J. & BONITA M. SCHWAN request a Wetland Permit to reconstruct in-place approximately 114.5' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with approximately 10 cubic yards of clean sand to be trucked in from an upland source. Located: 1200 Oak Avenue, Southold. SCTM# 77-1-9 The 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 _Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Info needed: Modifications: Conditions: ✓ O � /win" "I � e7 /1Q�ge_ ( - / ; 0 Presen ere: J. KJ B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. 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S. ,..-. :_•.•.. , .314 1..:•,, - •,,, • • N.w._,.,..1.,.... , ... ,. . , - 1 , 1 1 . . i - - , fittb.... i ); , , ,i .:1 li ,1,Iv-, ,I.cimf::. <E-'44......,,k -,...:Eliiv, •-:--,::- ,..,,,,......7.:;,. ..:41 ' ' • , i,'.•,, f :. 0./Iiii ...1 1 , . - A „ -.. ,.• ." • i i , ) , .,1;1 :. z.._.— '' -.). 4''; .A.4* .k i t , i - i•- • ' .. . /va.,- „..T.- . „; / • , A "4, ,,..4, 1..i..!* •• 1 - so,CkCr• ....V ••••• • ,.... .11('• If..0" ., -' ' ',t'? *i';'',5 1. . I. 14 . •..., -. •- ' 1' qi ill '' i . ; • __ . :.:4es • 113USTEES ilett John M.Bredemeyer,ID,President 3 . ; SUPERVISOR H 1 P.Smith,Vice President ` BSE, 11 �xr SCOTT L HARRIS Albert 7.Krups1d,Jr. 6 ` '�..- 4`1 _ John L Beduoski,Jr. `= 1 . s4 / Town 53095 Main Rid JohnB.Tuthill P.O.Box 1179 Telephone(516)765-1892 BOARD OF TOWN TRUSTEES Southold,New Yodc 11971 Fax(516)765-1823 TOWNOFSOUTHOLD October 2, 1991 Schriefer Construction 1130 6th Street breenport, NY 11944 12E: Helen Schwan SCTM #1000-77-1-9 bear Mr. Schriefer The following action•was taken by the Southold Town Board of Trustees at the special meeting on Thursday, September 26, 1991; &SOLVED that the Southold Town Board of. Trustees grants dermission to replace in-kind/in-place the retaining wall amaged by the hurricane at the above referenced property. rf you have any questions, please do not hesitate to contact this office. IVery truly yours, )44- 701Agerrelt 4ohn M. Bredemeyer, III resident, Board of Trustees CMB:jmt Cc: Bldg. Dept. --- ALL MOORINGS AND STAKES MUST DISPLAY VISIBLE MOORING NUMBERS ALL.DOCKS AND BULKHEADS MUST DISPLAY VISIB4E PERMIT NUMBERS �a Board Of Southold Town Trustees 7r-- '` SOUTHOLD, NEW YORK / tc Mooring R N/A L/ _S r, • PERMIT NO. 2000DATE:44gust 2,-.1985 i t" ISSUED TO HelenSchwan _._.. .... ._ -.. _-- _ <:, •j . e - -tv Authorization • , ,Pursuant to the provisions of Chapter 615' of the Laws of T j -- (� the State of New York, 1893;and Chapter 404 of the Laws of the , t � x ,S I.' State of New York 1952; and the Southold Town Ordinance en- 7,' I " " :Jr titled "REGULATING AND THE PLACING OF OBSTRUCTIONS ' ti it .IN AND OPf�V! TOWN WATERS AND PUBLIC LANDS and. the x(- r' _,i REMOVAL OF SAND, GRAVEL OR.OTHER,MATERIALS FROM 1 k LANDS UNDER TOWN WATERS;" and in accordance with the °;1$'‘..4 Ja r ipli Resolution of The Board adopted at a meeting held on August..1., .r . t I9.. ;., and in consideration of the sum of $ 0..Q _paid by i, '({ P Helen Schwan . _ c. `!1 F '.� of Southold_-____ ..._ _ N. Y. and subject to the me, k '". Terms and Conditions listed on the ;rave se side hereof, *"Lc.:_e\./.( A % -4' of Southold Town Trustees authorizes and permits the following: y ,,,.,i `( ,. , ., Application approved under the'Grandfather Clause , !' - .aal=jt t to secure a permit for a, Bulkhead ., in Southoldall in accordance with the t c ` o- 1 application submitted. " IA " all in accordance with the detailed specifications as presented in l'll ft - the originating application. " ( F"-I IN WITNESS WHEREOF, The said Board of Trustges here- i`� . • $ by causes its Corporate Seal to be affixed rid these presents to F Y#: r be subscribed by a majority of the / oard;as of this te. t (r^ c ' t i�Q 7iL% �, d �. Ill h � , tnz. 17/ , 411:71. 444. cskaiSeJ-7;fkt .+; \ T 1 r ,, I'rrate j -rk#4c*1 k I it, )1J / }Gig xo:., r, , m,.air "n ' 3 q�: o t ,.. , ,,r itis.... , Please tear off and return to the Trustees • Board Of Southold Town Trustees SOUTHOLD, NEW YORK MOORING NO. PERMIT NO. DATE: ISSUED TO .. . I. , certify that the work as authorized in this permit has been completed and is now ready fcr your inspec- tion. Also, the number required on this project is clearly visible. Z further understand this permit is not valid until this tear sheet is returned to the Trustees. STREET ADDRESS: 1200 OAK AVENUE LOT NUMBERS REFER TO 'MAP OF GOOSE SURVEY OF PROPERTY BAY ESTATES' FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON NOV. 13, 1934 AT SOUTHOLD AS MAP NO 1176. 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AA rt s 4 NzdR O Y ,r Cx y o Very 9.1 Pme O Z �3 1 3 G.n.0 la O• w r'r( Q it 1� 3v,`$-'.1,C,Kx t x a 9 C j x a C Clemnew Fu= ai < m o }G i K N Parish Or Be'iE o O Normfi€09'6 41 Sieeelist pp �, 3,s e,E\. knehor to C• a coG p O 5v ; S a _e�, Cgose 3 Jt Greek a g 1 di o' o a o a 2 14,4/ y SrkneA1 a r� d „j ye 0' Maar Ba Cl K N eay�new Rd Ext r YN it 1 o a NBuye,ew RJ i QD T C q (3 ' V Y U, U v r' S G gii y V 'C3 0 .S6. 1 y 4/aro B hh. a rRry AR,y ha ? VS qn m tl `Z Watrm 5( ('Cr ey Cre4k .-= - s Q e, ; f y 33 02013 Google- http://maps.google.com/maps?f=q&source=s_q&h1=en&geocode=&q=Oak+Avenue+11971... 4/1/2013 oraroo N c,...• I;al /*St 4 Mee A mgp d /Apo/ ,j` Mei al *4 4 ,,----___ „A ®n , 4w,4„cr) ....,„ ,1011; , all' _.. NPFIEE COUNTY OF SUFFOLK © om. swmm SECT NNo E `.. --F— . ori _0 -- Ass Unto..., R_.&P�eKYT Service YprcY r _ — a rm.eP...a.PP.a... �0 g n A .. m.cr6 ... mo „ SUl�y0 OFFICE LOCATION: ��� �� - MAILING ADDRESS: Town Hall Annex � ,�O 4 . P.O. Box 1179 54375 State Route 25 , Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Tele hone: 631 765-1938 Southold, NY 11971 �; �O,,,� Fax: 631 765-3136 - Q �1 �ycOUNTV ,;1.,', , LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM � � C � I V To: Jim King, President MAY 1 3 2013 Town of Southold Board of Trustees Southold Town From: Mark Terry, Principal Planner Board of Trustees LWRP Coordinator Date: May 10, 2013 Re: Proposed Wetland Permit for ROBERT J. & BONITA M. SCHWAN SCTM#1000-77-1-9 J.M.O. Environmental Consulting on behalf of ROBERT J. & BONITA M. SCHWAN request a Wetland Permit to reconstruct in-place approximately 114.5' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with approximately 10 cubic yards of clean sand to be trucked in from an upland source. Located: 1200 Oak Avenue, Southold. SCTM# 77-1-9 • 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 provided that that the Board considers the following additional best management practices: To further Policy 5: Protect and Improve Water Quality in the Town of Southold and Policy 6; Protect and Restore the Quality and Function of the Town of Southold Ecosystem. 1 If the action is approved, it is recommended that: a. Verify if trees landward of the bulkhead could be retained. b. Require a non-turf buffer planted with indigenous vegetation landward of the bulkhead. 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 • +l James F.King,President ts"rig SOOjj Town Hall Annex Bob Ghosio,Jr.,Vice-President It 4 6`% 64375 Main Road P.O.Box 1179 Dave Bergen A+ * Southold,New York 11971-0959 John Bredemeyer �' i 4b rP Telephone(631)7654892 Michael J.Domino Fax(631)765-6641 _ �, COUri frill� F. BOARD OF TOWN TRUSTEES _ TOWN OFSOUTHOLD RECE V E M Office Use Only Coastal Erosion Permit Application APR - 8 2013 y Wetland Permit Application Administrative Permit AmendmenvTransfer«mon Southsl own ei ved Application: 11141-; 8oartl of 7r state Completed Application y/$//_3 _Incomplete iii SEQRA Classification: Type I Type II_Unlisted_ Coordination:(date sent) LWRP Consistency As ssm t Form L//oa0/L 3 cAC Referral Sent- y /'_ Date of Inspection: Receipt of CAC R _—Lead Agency Determination: Technical Review Y Public Hearing Held: ,51 151/3 _Resohuion: Name of Applicant Robert J. & Bonita M. Schwan Mailing Address 52 Summerwood Road Holbrook, NY 11741 phone Number:( ) 631 -472-2919 Suffolk County Tax Map Number: 1000- 77-01 -09 Property Location: 1200 Oak Avenue Southold (provide LILCO Pole#,distance to cross streets, and location) AGENT: Glenn E. Just-JMO Environmental Consulting (If applicable) Address: P.O. Rox 447 Ouogue,NY 11959-0447 653-0607 Phone: •ard of Trustees Applicatiol GENERAL DATA Land Area(in square feet): 7,8 0 5 Area Zoning: Previous use of property: Single family dwelling Intended use of property: Single family dwelling Covenants and Restrictions on property? Yes x No If"Yes",please provide a copy. 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 x No If"Yes",please provide copy of 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? x Yes No Prior pennits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. �.. Has any pennit/approval ever been revoked or suspended by a governmental agency? , No Yes If yes,provide explanation: Project Description(use attachments if necessary): Applicant proposes to reconstruct in place approximately 114 .5 ' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with approximately 10 c.y. of clean sand to be trucked in from an upland source •rd of Trustees Application. WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Rulkhead reconstruction Area of wetlands on lot: 650 square feet na Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No x Yes If yes,how much material will be excavated? 10 cubic yards How much material will be filled? 10 cubic yards Depth of which material will be removed or deposited: 4 feet Proposed slope throughout the area of operations: 1 :1 Manner in which material will be removed or deposited: Backhoe 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): As proposed, the project should have no negative impacts upon the waters or wetlands of the Town • • 817.20 • Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -PROJECT INFORMATION(To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME Robert J.&Bonita M. Schwan Bulkhead reconstruction 3. PROJECT LOCATION: Municipality Southold County Suffolk 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) 1200 Oak Drive Location map&survey enclosed 5. PROPOSED ACTION IS: ❑✓ New Expansion Li Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Applicant proposes to reconstruct in place approximately 114.5'of concrete bulkhead utilizing vinyl sheathing and to backfill the structure with approximately 10 c.y.of clean sand to be trucked in from an upland source 7. AMOUNT OF LAND AFFECTED: Initially 0 acres Ultimately 0 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ❑✓ Yes El No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? 0 Residential ❑ Industrial [3 Commercial 0 Agriculture ❑ Park/Forest/Open Space El Other Describe: Single family dwellings 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 permit/approvals: Southold town trustees,N.Y.S.D.E.C.,N.Y.S.D.O.S.&U.S.D.O.A. 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes 2 N If Yes,list agency(s)name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? 0 Yes z No I CERTI THA E INFORMATIO PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDG Applicant/sponsor name: .//ust as ant Date: 3403 Signature: If the action is in the Coa tal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 Reset i • PART II - IMPACT ASSESSMENT(To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAF. El Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another involved agency. Yes 0 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible) Cl. Existing air quality,surface or groundwater quality or quantity,noise levels,existing traffic pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: C4. A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural resources?Explain briefly: C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: C6. Long term,short term,cumulative,or other effects not identified in C1-05? Explain briefly: C7. Other impacts(including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA)? (If yes,explain briefly: ❑ Yes a No E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: ^ l l Yes DNo PART HI-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its(a)setting(i.e.urban or rural);(b)probability of occurring;(c)duration;(d)irreversibility;(e) geographic scope;and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have Identified one or more potentially large or significant adverse Impacts which 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 supporting documentation,that the proposed actlor WILL NOT result in any significant adverse environmental Impacts AND provide, on attachments as necessary, the reasons supporting thh determination. Board of Trustees a ,5-/7/i3 Name of Lead Agency — Date `�//4 1/145 F //1/0Z•1President a Print or Type Name of Responsible Officer in ead Agency Title of Responsible Officer r ature of Responsible Officer in Lead cy Signature of Preparer(If different from responsible officer) • I09' FFO(kCO-. , °S. e 4 ; James F. King.('resident I ti - j Town Hall. 53095 Main ltd. Bob Ghosio,Jr. . Vice-President ,* P P.O. Box 1179 Dave Bergen t IL... ISouthold.NY 11971 John Bredemever Telephone(631)765-1892 Michael J. Domino '1 + �r a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ROBERT J. & BONITA M. SCHWAN COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED A FTER POSTING REMAINS IN PLACE FOR EIGHT DAYS I, Glenn E. Just , residing at /dba 121 Jessup Avenue, Ouogue, N.Y. being duly sworn, depose and say: That on the 6t141ay of May , 2013, I personally posted the property known as 1200 Oak Avenue, Southold 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 Wednesda Ma 15 Al 13. Dated: /, Af (si_ lir, S orn to before me this I c ay of litui 20 (5 t4 'tck Notary Si ANGELI A. REESE E.:_ .:.v State of New York nu hug Ir. tlThttlk County Comm savor, Expires December 30, NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. • OWNER(S) OF RECORD: --Robed- °n' '` Schwan SUBJECT OF PUBLIC HEARING: To reconstruct in-place approximately 114.5' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with approximately 10 cubic yards of clean sand to be trucked in from an upland source. TIME & DATE OF PUBLIC HEARING: • GJectne3doty, May 15; ao 13 - of-or oboe SSOPM If you have an interest in this project, you are invited to view the Town file(s) which are available for inspectionrior to the day of the hearing during normal business days between the hours of a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 • • PROOF OF MAILING OF NOTICE • ATTACH CERTIFIED MAIL RECEIPTS Name: Address: Patricia Melchoine 107 Shady Brook Circle, Unit 100 St. Simons Island, GA 31522 Peter Ortner, 8765 SW 120th ST, Miami, FL 33176 Harold Reese, Jr. & ors 74 Whitehall Road, uockville,Centre, nNy 11790 STATE OF NEW YORK COUNTY OF SUFFOLK Glenn R. JUST , residing at f g!flJessuo Avenue n„nn„ v , being duly sworn, deposes and says that on the day of Apt--;'t , 20(3 , deponent mailed a true 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 • ailed at the United States Post Office at �e� , that said Notices W. e ' . -d to each of said persons by CERTIFIED M /R TURN RECEIPT. ,/ Sworn to before me this I Day of UGH , 2013 CeSi'Lq6„(11( Th Public ANGELL R. REESE Pul:."ic, State of New York .:C O:..._.ATOF'J4 in Sufioik ':'::!Linty ,�rl Commierior, Expires December 30,"=� Ord of Trustees Application • county of Suffolk $Mte of New York '0)&7 \Au3cun BEING DULY SWORN DEPOSES AND AFFIRM THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE (' TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN.THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION. I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. 14,11:a. - of Property Owner n' SWORN TO BEFORE ME THIS (9c DAY OF �(„(6i9 ,20 LAURAN MARGARET D'AGOSTINO �/1 Notary No.Public,State of New01DA6057653 York / / {i Qualified in Suffolk Count I Pi Commission Expires April 30 L I.. Notary Public • I • . • S J .M•1J. Environmental Consulting Services To whom it may concern: Please be advised that we have authorized the firm of J.M.O. Environmental Consulting Services to act as our agent on our behalf in applying for certain approvals through your agency and others involved with this project. M.O. Consulting Services has been retained to coordinate all approvals necessary through your and other involved agencies, as well as our architect, engineer and contractors. We request that all communications, correspondences, notices, approvals and calls be addressed directly to the offices of J.M.O. Environmental Consulting Services. Signature (EfiZ-1-2--- Dated O 812C/ 2"- fl Phone (631) 653-0607 • Fax (631) 653-3348 121 Jessup Ave • 2nd Floor • P.O. Box 447 Quogue, New York 11959-0447 Srd of Trustee Applioatioa• AUTHORIZATION (where the applicant is not the owner) I, f�c5Oz- T 7c.t4USA w/ residtgat oe k_a. 1/7 `{ (print owner of property) (mailing address) do hereby authorize (Agent) Glenn E. Just JMO Environmental Consult�iawyfor peamit(s) from the Southold Board of Town Trustees on my behalf. (Own )'signature) • • • APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM • The Town of Southold's Code of Ethics aobibits conflicts of interest on the woof town officers mid employees.The impose Qf this form is to provide lnfamationwhich can slat the town of Downie conflicts of west and allow it to$n whatever action is • necessary to avoid same. p YOUR NAME: �\ c_,-ht WJ' ,-hi tr , 9eoQEIET V. - . (Last name,first name,ipiddle initial,tmless yet am applying hi the nsme of someone else orother eerily,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 Cwstal Erosion Change of Zane - . Approval of plat Mooring Exemption nom plat or official map Planning Other Of"Other",here the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with ray officer or employee of the Town of Southold? "Relationship"includes by blood,rgarriage,or business listerest"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 /( - Ifyou answered"YES",complete the balance of this form and date and sign where indicated. • . iI Name of tenon employed by the Town of Southold • Title or position of dud person i 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. The town officer or employee or his or her spouse,sibling,parent,or child is(checki all that apply): i. A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); - B)the legal orbeneficial owner of any interest in a non-corporate entity(when the - applicant is nota corporation); - _C)an officer,director,puma,or employee of the applicant or ! • D)the actual applicant. DESCRIPTION OF RELATIONSHIP - !i: j Submitted this� day of DrUctkCN 200 • Signature r,(34' - ,( Print Name r'N'154r-ez v`. ScvetAsf • Form TS 1 •• illi . I I APPLICANT/AGENT/REPRESENTATIVE I TRANSACTIONAL DISCLOSURE FORM I The Town of Southold's Code of Ethics mohibits conflicts of interest on the cart of town officers andeaolovees.The ouroose of this form is to urovide information which can alert the town of possible conflicts of interest and allow it to take whatever action i8 lycesaary to avoid same. YOUR NAME: Just, Glenn F (Last name,fust name,middle initial.unless you are applying in the name of I someone else or other entity,such as a company.If so,indicate theother person's or company's name.) II NAME OF APPLICATION: (Check all that.apply.) Tax grievance Building ariance Trustee I C Change ofZone Coastal Erosion i' Approval of plat Mooring I Exemption from plat or official map Planning - i' Other - i - (lf"Other",name the activity.) I, Do you personally(or through your company,spouse,sibling,parent or child)have a relationship with any officer or employee I of the Town of Southold? "Relationship"includes by blood,marriage,or business interest"Business interest"means a business, i 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. 1I' YES NO X 1! 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 - �r,�,; 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(cheek ail that apply): . Ir A)the owner of greater than 5%ofthe stales of the corporate stock of the applicant II I (when the applicant is a corporation); - i B)the legal or beneficial owner of any interest in a non-corporate entity(when the ' applicant is not a corporation); _C)an officer,director,partner,or employee of the applicant;or _D)the actual applicant. DESCRIPTION OF RELATIONSHIP - I • Ii. Submitted this i day o; ------ Signature Print Name G1 en F J'tst ' Form TS l 1! i i 1 I • • ;; *` Town of Southold Erosion, Sedimentation & Stonn-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: seen.it THU rou.oWINa ACTIONS MAY REQUIRE THU SUBMISSION OP A •tt'S 1 0 0 0-7 7-01 -0 9 STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN •••, -Dior .ethn sloth –La-- CERT/PIED BY A DESIGN PROFESSIONAL IN THE STATE OP NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT YesNo a. What is the Total Alae of the Project Parcels? I Will this Project Retain AN Stonn-Water Run-Off (Include Total Area of all Parcels located within 7,AOS Generated by a Two(T)Inch Rainfall on Sae? the Scope d Work for Proposed Construction) —/-8 c sou) (The item willun Include all roff created by site — h is the e Total Area of Land Clearing Jeering and/or construction activities as well as all and/or Ground Disturbance for the proposed 650 Site Improvements and the permanent creation of construction actNity? impervious surfaces.) 2 Does Site Plan Surw AN Proposed BRIEF PROJECT DESORPTION (Rage Anthem.Pape neffiedna Drainage samaras inarathig Size&LOn This i Item shall Includeall Proposed Grads Changes and — II Applicant proposes to Slopes Controlling sauce caeca Flow. 3 Does the Site Plan and/or Survey describe the erosion reconstruct in place approximately a 1ldsedknadwntrol Practices that"I be used t° control site erosion end storm waterdiacherges. This 114 .5 ' of concrete bulkhead item must l»maintained throughout the Entire Construction Period. utilizing vinyl sheathing and to di Noll this Project Require any Land Filling,Grading or backfill the structure with Excavation where there is a change to the Natural x Erdsti g Grade Involving more than 200 Cubic Yards of Material within any Parcel? apprnximal-a$y 1f) r• y of C1 ®nn 5 WBgib Application Require Land Disturbing ActiNges I sand to be trucked in from an Encompassing anArea inExcess ofFive Thousand _ V (5,000 S.F.)Square Feet of Ground Surface? • • upland snurra 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction © 4 General DEC SWPPP Rsgorawnb: or within One Hundred(100')feet of a Wetland or 9ubnesbn eta SWPPP Is required for al Corbvctbn media Mvdvhg rata Beat? dlabsbacoes of one(1)a ave east Including disturbances of lees dim one acre that 7 Will there be Site preparation on Existing Grade Slopes am pert of a Mgcommon plan that wit Genet*disturb one or more saes drag which Exceed Fifteen(15)feet of Verbose Rise to ❑ X indudag Consbaeflon activities Iiwdvbg soil disturbances of ten than one(1)acre when one Hundred(100')of Horizontal Distance? the DEC has detemard that a SPDES permit Is required for storm waerdbahergea (SY/PPP%Shall meet the Minimus Requirements of the SPIES General Permit 8 Will Driveways,Parking Areas or oma impervious for Stone Water Discharges from Conshueybn wintry•Permit No.GPs-10m1.) Surfaces be Sloped to Direct Stam-Water Run-Off ❑ X 1.The SWPPP shag be prepared prior to the submittal of the NOt.The NOt shag be into and/or In the direction of a Town -of- I submitted to the Dpma ard prior to the commencement of construction aedvgy. W9)R . 2 The SWPPP shod describe the erosion and sediment cod practices and where 9 Wig this Project Require the Placement of Material, • Vi . required.poetcmeauodon slays water management practices Met vii be used eras Removal of Vegetation and/or the Construction of any X constructed lo reduce the pceubnb in Menu weer disderges and to assure Item Within the Town Right-of-Way or Road Shoulder oonpiwt a with the tern end conditions of fhb pent In addMun,the SWPPP shag — : Idrdfy pewee straws of pagufbn St,may reasonably be expected to affect the Arae?irte.wes re MOT teerbtlw bbeaaemarorweewp`Aamowl welly of storm water dIschinges. NOTE: If My A,wn to Clusetion 0mi through an.I.Anseeed wih•Cheek Nei 3.Al SWPPP that require to poMeoahudim storm weer management practicefn a Box and the wabueew sae disturbance Is between 5,000 es.\t Asn In area component anal be prepared bye gabled Dusan PmkNlws ucoeed la New you a sevum -wat r,Grading,Drainage a Erosion Control Plan te Required by UM Tem of that bimwiedga.W title prMdges and practices of Siam Water Menseement eaMdd end Most eubnabd for Review Odor le Pent .'.. (Nora AQM M.A(-1)gnd/r Pater for rrA queson le Remind be Coupon Awa de) �I STATE OF NEW YORK, COUNTYOFSuffOlk 111at L G 1 cnn F A„„hT.}}S.t being duly sworn,deposes and says that he/she is the applicant for Permit, (Nems of ki&d l l Spring Document And that he/she is the Agent (owner,Comrade,AgentCorporate actor,ail) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have pert. ed the said work and to make and file this application;that all statements contained in this application are true to e best of ' owledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. / Sworn to before me this; ,, � p Notary Public; ..../.d;:! „_.(k�a ✓ 20.1.3 .. .. Ii •• (Goma*or ) FORM - 06/10 GINA A.LOCKS No.01 L06057960 • Notary Pubic.State of New York Quailed In Suffolk OU' D.S My Commission Expires • • Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. 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 consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this formshould 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 evaluatedas 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 `oro", 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- supporting 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# 1 000 77 _ 01 -09 PROJECT NAME Bulkhead reconstruction 1. The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees R it 1. 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 assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: x❑ Nature and extent of action: Applicant proposes to rernnctrnrt apprnximata1y 11d c ' of concrete bulkhead utilizing vinyl sheathing and to backfill the structure with approximately 10 c.y. of clean sand to be trucked in from an upland site • • • Locaionofaction: 1200 Oak Drive, Southold Site acreage: 7 ,805 s . f. present land use: Single family dwelling Present zoning classification: R 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name ofapplicant: Robert J. & Ronita M. Schwan 52 Summerwood Road (b) Mailing address: Holbrook, NY 11741 -5612 (c) Telephone number: Area Code( ) 631 -472-2919 (d) Application number,if any: Unknown Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes No—1 If yes,which state or federal agency?N.Y.S.D.F.C. ,N.Y.S.D.O.S. U.S.D.O.A. 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. n Yes ❑ No n Not Applicable The propnsed project Anec not in"Ol"e "delrelnpment`d ane chni,l ri have no impart upon open spare, the charas-ter—e5 the community, etc Tt is felt that- Chic prninrt is consistent with this policy 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 Fl Yes ❑ No ❑ Not Applicable The project will haeme no impacts upon any hislic or arrhaenl ngi ral rocnnrreq Tt i s felt that this project is consistent with this policy Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section HI—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable The prnjert will have nn imparts upon any scenic resourres or impart any visual qualities of the Town Tt is felt that this project is consistent with this policy 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 11 Yes ❑ No ❑ Not Applicable The reconstructed bulkhead should protect the existing dwell-LnJ from stmrm damage and flooaing and shn„lfl not with this policy Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold.See LWRP Section HI —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ❑Not Applicable The prnjeCt shall have nn impart upon the quality or quantity of potable water. It is felt that this project is consistent with this policy 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. O 0 0 • • Yes No Not Applicable The project shall have no negative impacts upon the quality of or the function of any wetlands, ecosystems or areas of cirri f1 can* rea-stai T'] sh nor-1_10U ril_i fe unt i tats rf is falt that this prnjart is rnnsistant with this pnliry Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable The project shall have no impact upon air quality. It is falt that this prnjart is rnnsistant with this policy 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 The project does not involve the use of or the disposal of hazardous substances or wastes. The remains of the removed co concrete bulkhead shall be disposed of properly. It is felt that this project is consistent with this policy 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. ❑ Yet❑ No❑ Not Applicable The project will have no impact upon public access to, and the recreational use of coastal waters, public lands or the public resources of the Town. It is felt that this project is_nncistcnt with this .pnliry F. Attach additional sheets if necessary • - • i . WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in - suitable locations. See LWRP Section III-Policies;Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable The project will have no impact upon Southold ' s water-dependent uses or the siting of new water-dependent LISPS in suitable loratmons Tt is felt that this project is consistent with this pn1iry Attach additional sheets ifnecessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable The proiect will have no imparts upon the suhstainahle use of living marine resources Tt is felt that this project is consistent with this policy Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III-Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable The project does not involva agric»1t»ra1 1aa5lc._It is felt that this. pnliry is not applirahle to this project Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III-Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable The project does not involve the use of nr the development of energy or mineral resources. It is felt that this policy is not applicable to this project PREPARED BY Glenn E. Just TITLE Agent DATE 0 Applicant: Robert J. & Bonita M. Schwan Location: 1200 Oak Avenue Applicant proposes to reconstruct in Purpose: Bulkhead reconstruction place approximately 114.5' of concrete J Datum: Apparent Low Water bulkhead utilizing vinyl sheathing U Locus: 41.048382 -72.40053 and to backfill structure with u S C T M Nn 1000-77-01-09 Approximately 10 c.y. of clean sand Lu 6 APPROVED BY to be trucked in from an upland source. E BOARD OF TRUSTEES At Goose Creek, Southold. Town of v, TOWN OF SOUTHOLD Southold, Suffolk Count), New York c ci DATE 1153 /13 as o /j�m (T l I -, w > o l U 3 0 ti bp Is" 0 0 m 5 p Zcf NJ ^ = cf �' g u 'm '> 0' n , ct �r c cwi>ON -> w D d O U co N_ ,n _ I z O QLJi In O w Il J I Q C` -� cr n L__-- EX DOCK' �` [0 — a� s ,, w �/ J 1� ____ fz 2 /----Rt 32,1 ---> NSP 0CIT N ER I ' PROPOSED SCALE I = 20' Applicant proposes to reconstruct in place approximately114.5' of concrete c' d oY bulkhead utilizing vinyl sheathing Ho Eo y b and to backfill structure with ii - • �? tv ' y Approximately 10 c.y. of clean sand Z • b to T to be trucked in from an upland source. 2 oAo c o 0 At Goose Creek, Southold, Town of o o a C o CD Southold, Suffolk County, New York o N r a. O r o oN ,0 < Ro 6 m oo � w =;` D . A sv C4 i y 0 SFD e----3 2' -- •32' EX • PR** ; _ DE LIM' r OF i / D(STURI3ANCE 07 u i FILL -'�'- ,AHWt2 N. 1,8 —A LW 0 PROP /1`—, i DEAOMEN // E`XGRADE PROP t10 CY OF CLEAN WALES w SAND FRjM AN uu T UPLAND SOURCE 'n j FOR 13ACKF1 L1. I - a z rt > o s Ll- 9ECEIVEQ APR - 82013 Southold Town Board of Trustees r �_� .1-C9 r>W1 > S FET 2 OF 3 U J.M.O. Environmental Consulting Services Quogue, New York I . EXISTING SCALE Applicant: Robert J. & Bonita M. Schwan Location: 1200 Oak Avenue Purpose: Bulkhead reconstruction Datum: Apparent Low Water Locus: 41.048382 -72.40053 S.C.T.M.No. 1000-77-01-09 SFD > EX GRADE AH4Y'�� 13 -->ALW GRADE Li rl v T S w Applicant proposes to reconstruct in place approximately 114.5' of concrete bulkhead utilizing vinyl sheathing and to backfill structure with Approximately 10 c.y. of clean sand IECEiVED to be trucked in from an upland source. At Goose Creek, Southold, Town of APR - 8 2013 Southold, Suffolk County, New York Southold Town :Tarn .fTr to 'i?Nr�� � SHEET .3 OF3 J.M.O. Environmental Consulting Services Quogue, New York STREET ADDRESS: 1200 OAK AVENUE LOT NUMBERS REFER TO 'MAP OF GOOSE SURVEY OF PROPERTY BAY ESTATES' FILED IN THE SUFFOLK COUNTY CLERK'S AT SOUTHOLD AS MAP NO, 1176. OFFICE ON NOV. 13, 1934 TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1000-77-01-09 SCALE: 1'= 20' FEBRUARY 5, 2013 GOOSE -= GREEK � � C � Iv � D APR - 8 2013 itho.Town UNNAMED STREET Board°`T"S�$ v 4NAk PIUNG O PILING A O ' r/ N4524'40""E -------65.00'IIT `/ TDP WALL COP WAu` EL0' - I CONCRETE WALL TDP WALL 0.7.W. ,.7 0/L (� - EL3.e' AM /\ L 4--) gWOOD WALL T-- 9 m L cri O a a. • Z d WALL "H F u vtri 0 r D/I + Ni. 0 -1 • O O r R1 --I m Ate- 0 0 Ov C-� co —•1 W ' 55 WOOD O A I DECK RN ' ATTACHED ��TT SHEDS vV J2.4' I2.4y Z 1 STORY FRAME rU v HOUSE 0° / P' (fin.flr.el.=5.5') 1 M N m l ' 25.0' m O a 7.5' ATTACHED n 7.0' I SHED I 9 4,, Du PAVERS PATIO rn QO ni N$ J - -- I L\`: