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HomeMy WebLinkAboutTR-8186 James F. King, President Bob Ghosio, .Ir., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ~ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8186 DATE: MAY 15~ 2013 1SSUED TO: CHARLES RODIN PROPERTY ADDRESS: 70 STROHSON ROAD~ CUTCHOGUE SCTM# 103-10-16 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution oftbe Board of Trustees adopted at the meeting held on May 15, 2013, and in consideration of application fee in the sum of $250.00 paid by Creative Environmental Design 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: Wetland Permit to create a seawater surge barrier berm approximately 325' long, 24' wide, and approximately 4' at highest point throughout the iow-lying areas; and as depicted on the site plan prepared by Creative Environmental Design, last dated April 22, 2013 and stamped approved on May 15, 2013. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee, Charles Rodin, residing at 70 Strohson Road, Cutchogue, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should cimumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location oftbe 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. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. Kin~g, 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 May15,2013 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. David Cichanowicz Creative Environmental Design PO Box 160 Peconic, NY 11958 RE: CHARLES RODIN 70STROHSON ROAD, CUTCHOGUE SCTM#103-10-16 Dear Mr. Cichanowicz: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 15, 2013 regarding the above matter: WHEREAS, Creative Environmental Design on behalf of CHARLES RODIN 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 23, 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 CHARLES RODIN to create a seawater surge barrier berm approximately 325' long, 24' wide, and approximately 4' at highest point throughout the Iow-lying areas; and as depicted on the site plan prepared by Creative Environmental Design, last dated April 22, 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: $50.00 James F. King President, Board of Trustees JFK/amn Jamea F. King, Preaident Bob Ghosio, Ir., Vico-Proaident Dave Bergen John Bredemeyer Michn~l $. Domino Town Hall Annex :54375 Route 25, P.O. Box 1179 Soufl~old, I'I'Y 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD .re~ew~ by this Beam at the ~ular m~fing of ' . ~] J5/]g and ~ur applimtion has been approved pending the completion of ~ fo~owing items ~ecked off below. __ Revised Plans for proposed project Pre-ConStruction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) Constructed ($50.00) Fi,hal Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southoid. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above, COMPUTATION OF PERMIT FEER: dl'n TOTAL FEES DUE: $ 500~) BY: James F. King, President Board of Trustees Southold Town Board 53095 Main Rd P.O. Box 1179 Southold, NY 11971 418 D Street SE Washington, DC 20003 May 14, 2013 RECEIVED MAY 1 5 2013 SoulhoJd T~t~ rl~,,-[ Dear Town Board Members: I am writing with respect to the Permit request of Charles Rodin and Creative Environmental Design, SCTM#1000-103-10-16. My husband and I own the adjacent property at 3600 Little Neck Road. Our property includes marshland and upland directly west and northwest of the proposed berm. The boat ramp at the end of Little Neck Road is within our property line. Mr. Rodin has been a good neighbor and he takes excellent care of his property. We understand that his house was flooded during Hurricane Sandy and the proposed effort to mitigate the risk of future flooding seems sensible. Nonetheless, we do want to convey three concerns about the proposal. First, in the event of surging high tides pushed by winds from the south, across Little Peconic Bay, water would likely be displaced from the berm toward our marshland and the lowest sections of our upland. The marsh on the east side of Little Neck Road floods more frequently than it did twenty years ago. Regular displacement of high storm tides might contribute to the erosion of our marsh. Second, oar house was nearly flooded during Hurricane Sandy; water came to the top of the concrete block foundation at the northwest comer of the house. We may need to build a similar berm in self- defense within a year or two. Will the Board assure us now our permit application would be approved, if this permit application is approved? Third, the dirt and dump tracks required to build a berm would make our property a much less attractive rental during the height of the summer season than it would be otherwise. Following my mom's death last August we have spent the past year, and a fair amount of money, preparing the house to be rented this summer. Will the Board please consider requiring that construction begin next fall, if the permit is granted? My husband, David McMillen, is in Cutchogue now and he will attend the hearing on Wednesday, May 15. Thank you for your kind attention to our concerns. Yours truly, Linda Moeller~ Iloard of Tm~t~ Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 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: CHARLES RODIN to create a sea water surge barrier berm throughout Iow lying areas. Located: 70 Strohson Rd., Cutchogue. SCTM#103-10-16 DO NOT SUPPORT - Plans submitted to CAC lacking in detail and therefore insufficient for review, too many issues: height of berm, DEC approval, deposition of material, Project should be engineered by coastal management specialist due to character of project Proposed by John Stein, seconded by Doug Hardy. All in favor James F. King, President Bob Ghosio, Jr, Vice-President Dave Bergen John Bredemeyer Michael J Domino PO Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: Creative Environmental Design on behalf of CHARLES RODIN requests a Wetland Permit to create a seawater surge barrier berm approximately 325' long, 24' wide, and approximately 4' at highest point throughout the Iow-lying areas. Located: 70 Strohson Road, Cutchogue. SCTM# 103-10-16 ~Sae of area to be impacted: Itwater 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: A,_ Wetland __Coastal Erosion __Administrative__Emergency Pre-Submission ___Amendment Violation Info needed: Modifications: Conditions: ~ o '-- ~ Present Were: -~. King -'B. Ghosio__ -J~-'-~redemeyer -~ Michael Domino Form filled out in the field by Mailed/Faxed to: Date: D. Bergen, D. Dzenkowski other OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (coo. Main Rd. & Youngs Ave.) Southold, NY 11971 M_&I LIN G .aDDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: May 14, 2013 Re: Proposed Wetland Permit for CHARLES RODIN SCTM#1000-103-10-16 Creative Environmental Design on behalf of CHARLES RODIN requests a Wetland Permit to create a seawater surge barrier berm approximately 325' long, 24' wide, and approximately 4' at highest point throughout the Iow-lying areas. Located: 70 Strohson Road, Cutchogue. SCTM# 103-10-16 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 actions are CONSISTENT with the Policy Standards and therefore CONSISTENT with the LWRP. Figure 1 shows that the portions of the property where the berm is proposed are located within the AE flood zone. Figure 1. Subject parcel showing AE flood zones 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, J r., Vice-President Dave Bergen John Bredemeyer Michanl J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office U~ Only dwO aSlal Erosion Permit Application etland Permit Application Administrative Permit AmendmenffTrans f~:r/Ex t~nsion ~ece~-ved Application: 7~..~.~. fl~ Incomplete ___SEQRA Classification: Type l__Type Il Unlisted _ C~:~ordination:(dat~-s~nt ) .... i ] -~LWRP Consistency A~sTssm~:~t Form .~_~_~_~/~ 7CAC Rcr~l sc.t: q [ Z~/I.K - Ca,e orlns~ o.: - · --' .' '! ~-r'-- Recmpt o£ C AC Repo,. _ _. [.cad Agency Delcnn nat on: _~[echnical Review: ~ ~-ZPublic llearing tleld:~' ~ Resolution: !ECE VE APR 2 3 ~0B Soufhold ~own Board of Trustees PhoncNumbcr:( ) g ~--'~5~6 -~q~' I Sutlblk County Tax Map Number: 1000 - [/P~ - I ~9 -I~ Property Location:'TO ~r~'O~,53-th~ .~2-,c~_: (D~t~~ Address: (provide LILCO Pole #, distance to cross streets, and location) (If applicable) Creative Environmental De~fign Peconi¢, NY llgSs Phone: Boal of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: ?x-~ Previous use of property: _._ Intended use of propemy: Covenants and Restrictions: Yes / No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals _ ~_ Yes _ If'Wes", please provide copy of decision. Prior pe~its/approvals tbr site improvements: Agency Dale ~/ No No prior permits/approvals for site improvements. Has any penmt/approval ever been revoked or suspended by a governmental agency'? ~No Yes If yes, provide explanation: Project Description (use attachments if necessar Bo~ of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ?I:L~'~0 ~.vx.Jr /--~r~v~ ~q~G~ Area of wetlands on lot: square feet Percent coverage of lot: ,~'~tg, ~ % Closest distance between nearest existing structure and upland edge of wetlands: _~ 2-z. ...... feet Closest distance between/nearest proposed structure and upland edge of wetlands: /~//~ feet Does the project involve excavation or filling? No ~/ Yes If yes, how much material will bc excavated? 0 cubic yards [low much material will be filled? __.,~r'O~ _ _cubic yards / Depth of which material wilt be removed or deposited: '~_ . _ feet Proposed slope throughout the area of operations: ~ .' ::3 Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): I 617 20 PROJECT iD NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Ordy PART I - PROJECT INFORMATION ( fo be completed by Applicant or Project Sponsor) 1 APPLICANT/SPONSOR 2 PROJECT NAME 3 PRO2ECT LOCATION SEQR iS PROPOSED ACTION [] New [] Expansion i~,~odil~ca~Jon/altera~ion DESCRIBE PROJECT BRIEFLY: ! AMOUN[ OF LAND AFFECIED Initially '~'},~ 7~ at:'r~&~¢..._~2-~~- Ultimately %a~,~ acres 8 WILL PROPOSED ACTION' COMPLY ~TH EXISTING ZONING OR OTHER RESTRICTIONS? ~es ~ NO If no, describe briefly g WH IS PRESENT LAND USE tN VICINITY OF PROJECT? (Choose as many as apply) ~,dential []Industrial E~]Commercial E~]Agriculture []Park/Forest/OpenSpace E~Other (describe) ~0 DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fede~,,State or Local) ]Yes If yes, list a~ency name and permit / approval: 11 DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes [~ If yes, list agency name and permit / approval: 12. AS A ~ESU4ZT E~Ye$ RES OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ga'No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS rRUE TO THE BEST OF MY KNOWLEDGE Applicantsignalure ~£¢'~ ~ Date ~/, t'¢/~/_"~ If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A_ ODES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 6t 7.4? Ii' yes. coordinate the review process and use the FULL EAF. E] [Z].o B. W/ILL/~CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative (~-~=lamtion r~ay be supemeded by another iavol~d a~ency. F~Yes [~]No C. CO~JI..D ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Aeswem may be handwd~en, if legible) C~. Existing air quality, surface or g~'oundwator qualit~ or quantity, noise levels, e~s~i~g Iraf~c pabem, solid weste production or dispesal. ~otenfial for erosion, drainage or tiooding pmb{ems? Explain boelly: I Aes~heti~ a, gnc~J(tural, archaeological, h~storfc, or other natural or cultural resources; or cemmu~ or neighborho~l character? Explain bdetiy: C3. Vegetation or fauna, tish. shol(~ish or wildlife specks, significant habitats o¢ threatened or endangered species? Exp(~i-r~i ' 1 ! O ~/ILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL 1 III - DI:: I I~-.I~IINC, TION OF 81GNIRCANCE (To be completed bY Agency) IN~'I'~tICTIONS: For each adverse effect ideafified above, determine whether if is substaatiaL larg~. Impertant o¢ ofhen~se signlficanL F.~ch effe<~ should ~e assessed in COnr,,ectio~ with its (a} seffir~l ¢.e. urban or rum0; (b) pr0t~ail'~ of oecuning; (c) duratioa; (d) irmvemiblf~. (e) g~3gmphlc scope; aad (0 magnitude. If necessary, add a~tacflments ~r reference suppo~tiag materials. Ensure Ihat explanations cof~tath - soffiofeflt detail te show that all rofevant adveme le,4~acts have been ideofified and adequately add¢~. If questloa d of part Ii was checked the deten'nina~on of s~nlficarme must eveluatelhe pote~tiallmpac~of the preposed ac~on en the en~mnmental (~aracterisflcs of the CEA C~'eck this bex if You ha~fe ~ ~4'"'~d one or more p°tentiatiY large °r significant ad~'~-'cse Impacts whlch MAy occur. Then proceed directJy to the FULl FAF aad/or prepare 8 pool~ve declaration1. Check this box if you have detenalned, based o~ Ihe Information and analysis above and any supposing documeatafion, that [he proposed actio~ WILL NOT result in any slgnil~cant adverse environmental impacts AND provide, on attachments as necessan/, (he masons supportir~g ~i~ Date Pmsidenl I] ]ille of Responsible Ot~cer PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: SI Arl'[~ ()l: NI\V Y( )R tq ('()i/NTY()I SI!I'I*()I ,bcmg duly sworn, deposes and says that on tim i ~'m dayof ~-.~/ ,20~,3,deponcntmailedah-uecopyoftheNotice set foah 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 m'e the address of said persons as shown on the cun'ent assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~Loalq ~k t I 0~ that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Dayof ~,~%~Z~. ,20 Notary Public 113 111~3 (Endorsement Requ[md) Irn $~.11 ~/01/2013 ~{ ~o}~AL USE Postage Cerlifled Fee Retum Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees rn $0.46 $3.10 $2.55 $ $6.il (Endomement Required) Restricted Dellv$~y Fee (Endorsement Required) To~, Po~ a ~ Sent TO I: l c~k~6,i,£~AL USE $0.46 $3.10 $2.~ ~.~ $ $6.11 James F. King. President Bob Ghosio. Jr.. Vice-Presidem Dave Bergen John Bredemeyer Michael J. Domino Town Ilall. 53095 Main Rd. P.O. Box I 179 Southold. NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of CHARLES RODIN COUNTY OF SUFFOLK) STATE OF NEW YORK) ECE VE ~AY 1 4 2013 Southold Town ~ard of Tr,Js?es AFFIDAVIT OF POSTING TO BE COMPLETED/I ETER POSTING REMA 13,~¥ L¥ PLA CE FOR EIGHT DA Y$ being duly sworn, depose and say: That on the {~'ff"day of It'~,~t , ,201~, 1 per~nally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesda% May 15, 2013. Dated: ~ · Sworn to before me this }~q4h day ofC~ 20/~ (signature) CONNIE D. BUNCH Notary Public, State of New York No. 01BUS185050 Quaiified in Suffolk Notary Public 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:~xrJ~s ~~ SUBJECT OF PUBLIC HEARING: To create a seawater surge barrier berm approximately 325' long, 24' wide, and approximately 4' at highest point throughout the Iow-lying areas. TIME & DATE OF' PUBLIC HEARING: .~e~~,lF have /~ 1'~'~ ,~01 ~' o~o~' ~.1o~,.'1' ,~'.' ~ ~ you an interest ir this proiect, you are invited to view the Town file(s) whi.ch are available for inspectionpribr to'the day of the hearing during normal bus~ness days between the hours of'8 a.m and 4 p.m BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 of Trustees Application Count~' of Suffolk State of New York DEPOSES AND AFFIRMS THAT tIE/SHE IS TIlE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE. TRUE TO TttE BEST OF HIS/HER KNOWLEDGE AND BEIAEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY FIE APPROVED BY THE SOUTItOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND AI,E DAMAOES AND CLAIMS ARISING IINDER OR BY VIRTUE OF SAID PERMIT{S), IF GRANTED. IN COMPLETING TtIIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ON¥O MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signnture SWORN TO BEFORE ME THIS Notary P ulJttr~''e~J MICHAEL F. CREED Notary Public, State of New Yo~ O~allfled in New York County NO. 01 CR6,?.54579 M~ O~1'fflliss'~,~ Expi~,~ 01-t7-2016 ~oar& of Trustees Application AUTHORIZATION (v ~cre d~e applicant is not the owner) (print owner of property) (msiling address) 'ql.uaa t4~k, '~ 14 hereby authorize David Cichanowicz, Pres, (Agent) Creative Env ronmenta DesLq r, t,~ apply for permit(s) from the APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM TI~ Town of Southold's Cod~ of P~hk~ txohibits conflicts of interest on the oan of town offico~s and emolovnes. The o~rcose of this form is m ~ovtde inR~nation which can ~ Ibc town of oossible conflicts ofinte~st and allow it to take wlmtev~ nctio~ is (Last name, firs~ n,~ne, ~niddle initial, unluss you are applyin8 tn the r~am~ of someone else or other em/ty, such as a company. If so, indica~ Ibc other person's or company's name.) NAME OF APPLICATION: (Check all ~at apply.) Tax grievance Building Variance Trustee ~ Chang~ of Zone Coastal Erosion Approval of plat Mooring Exemlgion from plat or official map Planning (If "Orbed', name the activity.) Do you personally (or through your company, spou.~, sibling, parent, or child) have a relatiouship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which thc town officer or employee has even a partial ownership of(or employment by) a coq~oratioo in which the town officer or employee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of per~on employed by the Town of Southeld Title or position of that person Describe the relationship between yousseff (the applicant/agent/representative) and ~he town officer or employee. Either check tbe appmpria~ line A) through D) and/or descrihe in u~ space inovided. The Iown of~c~r or employee or his or her spouse, sibling, paint, or child is (~ock all that apply): __A) the owner of groat~r ~ 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); __B) the I~gal or beneficial owner of any interest in a non-coq~omte entity (when the applicant is not a corporation); __C) an officer, director, patter, or empioyce of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I W Town of Erosion, Sedimentation & storm-water Run-off ASSESSMENT FORM SCOPE OF WORK - PROPOSED CONSTRUCTION ~r~l~ ~ / WORK ASSFaSSMENT I Y¢~ NO the Scope of Work fo~ Proposed Coflstmctfofl) Ger~erated by a Two (2') Inch RaklfsJI on Site? c~earing end/or constmctk~ activists as wel as all and/re' Ground DIsturbanc~ for the proposal Site Impmvernenls and the pem~'mnt creation or' consbuctlo~ activity? impen~k~$ surfaces.) 2 Do. ,~ s~to Plan and/or Su~'ey Show,MI Proposed YL~ '~_.~ ~--~4_[-{~,~_~''- ~;~r-~, 3 Does the Slte Plan and/or Survey descgbe the em~3n '~/t~'~'~}CL.'~L' g-~ g~/~ ~ item must be maintained throughoul the Entke 5 Will ~his Application Require Land Disturbing Activities r~ v/// requk~, pmt-comauc~n ~lerm wm~ menagemem p~c~# It~ ..dl be u~d and,~r Rerrmval of Vegetation and/or the ~ o~ any r'~ S']'A'I_~ OF NEW YORK, ,,,..,. C O ,\)~ No. 01'B~J~:I-8,~' ...... COUNTY OF ..,~..~.~ .................... SS Quaiified in Suffolk County Commission ;Expires April 14, That I,. .~.~-.,-.--..~-.-.~.~.J..~.~ ................ being duly sworn, depots and ~ays that he/sbe is the applicant I'or Pemait, And that he/she is the ................ ~:~'~'"'""{'~:~'~'~.'i~i ~-. Owner and/or rcprescn[afiv¢ of the Ore,er or O~¢r~, and is duly authorized to p~rform or have p~rfom~ed thc .said wo~ and to m~k¢ and file dais application; that all statements contained i~ this applicat/on arc wu¢ to the best of hi~ lu~owledg¢ and beli¢£; and that thc work will bt p~{ormcd in the manner set forth in the application filed herewith. uh,c: ........... FORM - 06/10 · Town of Southoid LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Wateff~nt Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listinl~ both suoportina and non- suooorfim, 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--I['~ E0 E ~VEj~$0u~h0td Town scm# io'3 - t - t -- --- / J APR 23 2013 · . [~ The Application has b*en submttt~l to (check appropriate response). Board of towa~oa~a [] Plauning~oa~[--1 Buaaing~ept. [--1 ~oa~oftr~tees 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: Nature and extent of action: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nanaeofapplicant: ff-~.-~'-I~-% ~0xrv~-( g3 Co) Mailing address: ~0 c~O-~Cc:k,-,q~3~C~ I~&, (c) Telephone number: Area Code ( ) oq4 ~- _ ~c-¢~5 ~'~ I (d) Application number, if any: Will the action be directly undertaken, require f~nding, or approval by a state or federal agency? Yes [~ No [~ If yes, which state or federal agency7 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 I. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ~Yes [~ No [-'] Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III- Pollc~ Pages 3 through 6 for evaluation criteria [] Yes ~ NotT3/t3~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWR~/Section III- Policies Pages 6 through 7 for evaluation criteria ~(~ Yes N No [] Not Apphcable" Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4;, Minimize loss of life, structures, and natural resources from Sectio~yllI - Policies Pages 8 through 16 for evaluation criteria flooding and erosion. See LWRP "'' Yes ~ No ~ Not Applicable Attach additional sheets if necessat3t Policy 5. Protect and improve water quality and supply in the Town of Southoid. See LWRP Section HI - Policies. Pages 16 through 21 fo~ evaluation criteria ~/Yes [] No ~NotApphcable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not A Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pag~through 34 for evaluation criteria. ~ Yes [] No [] Not Apphcable At~ach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southoid from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~-] Yes ~ No ~Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~ Yes~ No ~Not Applicable Attach additional sheets if necessary · WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ~ ['-] No [] Not Applicable Attach additional sheets if nece~ary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section HI - Policies; Pages 57 through 62 for evaluation criteria. [--] Yes ~-] No [~ot Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section II1 - Policies; Pages 62 through 65 for evaluation criteria. 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 evalualion criteria. ~-] Yes ~ No ~ot Applicable PREPARED BY -~3a~0'~ ~ DATE N FI_E~/ATION SANDY LOAM FILL ~ TOP901L APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD STRoHsoN FOR PLANTIN¢ EB I I 14'1 WETLANDS WOOD CAT WALK *'-* ' - CONNECTION OF IPOWNSPOUTS "~ -TO NEW Dt~YWELLS ',1/ WETLANI RAMP APR 2 3 2013 sc¢1000-103-10-16 EA9T CtZ. EEK -A.H.W.M, Revision #: Date: 4/22/2013 Scale: 1/16" = 1' Landscape Plan: 1-16-13 Rodin Landscape Design by: David Cichanowicz Creative Environmental Design