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HomeMy WebLinkAboutTR-8246 James F. King, President ~~guffOt,rc Town Hall, 53095 Main Rd. P.O. Box 1179 Bob Ghosio, Jr., Vice-President aO ~ Dave Bergen ~ ~ Southold, NY 11971 John Bredemeyer may.- Telephone (631) 765-1892 Michael J. Domino 1 ~ Fax (63l) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 721i0URS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR APRE-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 ~ day of constnJCtion _ %z constructed Project complete, compliance inspection - BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK I~; PERMIT N0.8246 DATE: JULY 17, 2013 ISSUED TO: ALBERT & BARBARA REIBLING PROPERTY ADDRESS: 75 ISLAND VIEW LANE, GREENPORT ~ SCTM# 57-2-32 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on July 17.2013, and in consideration of application fee in the sum of $250.00 paid by leffrev & Loriann Patanjo and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: I j Wetland Permit to remove and replace 151 linear feet of existing bulkhead with new vinyl bulkhead; replace 30 cubic yards of clean till; replace existing 27'x9' deck and 4'x8' stairs to beach; establish and subsequently maintain a 10' wide non-turf buffer on landward side of bulkhead; with the condition stairs to beach are retractable; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated May 11, 2013 and stamped approved on July 17, 2013. IN WITNESS WHEREOF, the said Boazd of Trustees hereby causes i[s Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. ~o~gUFFO(,~c - o yr I TERMS AND CONDITIONS The Permittee Albert & Barbara Reibling residing at 75 Island View lane Greenport New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: I . 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 OF S~(/T Town Hall Annex H 54375 Main Road Bob Ghosio, Jr., Vice-President 0/- ~ ~o P.O. Box 1179 Dave Bergen * Southold, New York 11971-0959 John Bredemeyer T Michael J. Domino ~ ~ p Telephone (631) 765-1892 ~ Fax (631) 765-6641 a~~co~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 17, 2013 Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: ALBERT & BARBARA REIBLING 75 ISLAND VIEW LANE, GREENPORT SCTM# 57-2-32 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, July 17, 2013 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of ALBERT & BARBARA REIBLING 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 June 20, 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 July 17, 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 ALBERT 8~ BARBARA REIBLING to remove and replace 151 linear feet of existing bulkhead with new vinyl bulkhead; replace 30 cubic yards of clean fill; replace existing 27'x9' deck and 4'x8' stairs to beach; establish and subsequently maintain a 10' wide non-turf buffer on landward side of bulkhead; with the condition stairs to beach are retractable; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated May 11, 2013 and stamped approved on July 17, 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 Very truly yours, James F. King President, Board of Trustees JFK/amn James F. Icing, President H ~ Town Hal( Annex Bob.Ghosio, Jr., Vico-President w 54375 Route 25, R.O. Box 1179 Dave ar ~'y ~ t~ Southold, NY 11971 John B~ eyer ~1 ~ ~0~ Telephone (63l) 765-1892 Michael J. Domino Fax (63 765-6641 BOARD OF TO WN TRUSTEES TOWN OFSOUTHOLD To: 1 e-~-1-eU Pa-~n~o ~-1 b.er-(' -r P,~r~ara ~e i~611~ Please be advised that your application dated Zb 3 has been reviewed by this Board at the regular meeting of ,and your application has,been approved pehding the completion of a foNowing Items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 151 Day of Construction ($50.00) '/z Constructed ($50.00) Final InspecFron Fee ($50.00). Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable. to Town of Southold. The fee is computed. below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The inliomrirlg fee must be paid within 90 days or re~applicatlon fees will be necessary. You will receive your permit upon completion of the ai~ove. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ SO • ~ O BY: James F. King, President Board of Trustees • ~~gyFFO(,~O • ~O O~~ Peter Young, Chairman ~ Town Ball, 53095 Main Rd. Lauren Standish, Secretary ~ ~ P.O. Dox 1179 Southold. NY 11971 y~0~ * ~~0~' ~re~ePnunc(63~)76>-ia9z Pax (631) 765-6647 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., July 10, 2013 the following recommendation was made: Moved by John Stein, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the application of ALBERT & BARBARA REIBLING to remove and replace 151 If. of storm damaged bulkhead with new vinyl bulkhead. Replace 30 cy. of clean fill lost during storm. Replace 27'X 9' deck and 4'X 8' stairs to beach lost during storm. Located: 75 Island View Lane, Greenport. SCTM#57-2-32 Inspected by: John Stein The CAC Supports the application with the Condition the beach stairs are retractable. Vote of Council: Ayes: All Motion Carried ~ a o ,r'f` ~t j 4,4 C zr ~~tl ~~~yqq;~ '~Yr a ~l ~~~P4-!~"'K'f ~ ~ ' s~ ~ ems„ i ; 4Z, n'~Y t ~ ~~5'~:#' men ~ ~ N .rr L C ~ o ~ y~- Y:. s T ar ~ ~~1 ~ Y ~ ms's- y~i _ y`.^ ~ , : ~~2 ~~q+~'fi9 T~ ~ {r tl a '"r _ 'k~ P 114, f B. 5~ 'e ~ ~1, ~-r ~p~ ' a ''"N I~ T 0! y '3 1 L t~ r _ A~~ • V? , . as r , F r - i3F o~ ~ - I Y' - l q t ~ ~ ~ ~ *~';tea ~ , I' ,y f f.'v:~ r ~ - ~ 8rr';tf'' ~ . ~x~ ~~a+~a,~`t t~ %i fF` `v°;~E ~ t "At i ~ V+ ~ .y ~ Ta 'y I i `r~s~ ~ JL. t: ! _ 1 ~ [ r • ~ 1 y ',1 i A~ f' ~F rT, T ;1y- w ' i~~ al.•~,~ ~ r 1 f 1 ~ ~ ay a ~ `T ~ i s~ 7 ~ 5Y . r ~ a ~ SFr ,,~.1 ~'y+yy ~ ~ ~ .-~~f ?~c k~ r~ +`''1~~~~y F? ? r, t ~ t 1.1 , ~ 1 , 4 1 r ~ . y[ ror. 1 r ~ ~ ~ ~ ~71 Y4 C{ ~f ` ~ ' ~ " ~~1 :,i~P fit„; i ggfFO(,~ .lames F. King President ~p~ CpG P.O. Box I ll9 Bob Ghosio. h., Vice-President ~ Z~ Southold, NY 11971 Dave Bergen ~ Telephone (631 765-1892 .lobo Bredemeyer ,y ~ Fax (631)765-6641 Michael .I. Domino ~ ~ yyo1 ~ ~aa. Southold Town Board of Trustees Field Inspection/Work Session Report Jeffrey Patanjo on behalf of ALBERT 8~ BARBARA REIBLING requests a Wetland Permit to remove and replace 151 linear feet of existing bulkhead with new vinyl bulkhead; replace 30 cubic yards of clean fill; replace existing 27'x9' deck and 4'x8' stairs to beach. Located: 75 Island View Lane, Greenport. SCTM# 57-2-32 Type of area to be impacted: -Saltwater Wetland -Freshwater Wetland -Sound ?Bay Distance of proposed work to edge of wetland ParJ.of Town Code proposed work falls under: _Chapt.275 _Chapt/111 -other Type of Application: f Wetland -Coastal Erosion -Amendment _Administrative_Emergency -Pre-Submission Violation Info needed: Modifications: 7 % ~xr7 `F' -fn P o f` ~UL 1~ h',r ff .b~ D/' Tn /3 r ~ Conditions: Present Were: '~J. King _B. Ghosio `~D. Bergen, `~J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by J i= ~,v~ Mailed/Faxed to: Date: • 11 LS J!1~! ? 0 ?n,3 t: ~ ~ ~s(:~-- ate. ~ 6 k ~ ~ i ~ ..Y t _ e^-" ~...°."w": , sL. I 4y 1 _ . '.:,R ~`,G ~ f' 1 y, w r Yy ~ Y ~ ~ . ~ ' - Photo 1 . a'R* : l~.F. rf ,y ~ p' ~ ~ ~ ~ qy .~!a i~. ~ ,t.,. - N _ ~ £ r O ?c r _ O a is ~ ~1; 5p~ , '_~s r '4~ ~ ~yy~~ N 4y~ r f } ; e y~ k `'w k~ _ _ C f i ~+Y'~?{x:4/)'7 ~,~t `E'~. ~4 ,~Y~~,:' ',~•..r s~ a a.E'- - + =F spaa ~ X ,c+f ~ t it ~ 4 ~ 1q ~4~ ~ ~a y~Y~ f 7 F `fir i. j ~ }~;r ~ 1 .D r~. d` ,5 - a ^ d ~I ~ , t;~ • 4 _ _ C7 '!'1 ,rY - • kI ~ ,ys~y. MJ~a~1 y/ fY ~ !e ~ 1 .H. ~ 1 "~y>rq+Fl.~}~y4„~:...:NPnr ~..1. n i i1 iCy y ~.~x~1. 7/ ~ ~ - o<.`' r ~ •a ~,,~y u~Y~y( f,~? 3 r .wc fa ~ ~ t t;, ffi M ,r.4: rc. ~ Photo 4 June 17, 2013 NYS Dept. of Environmental Conservation 50 Circle Rtoad Brook ~ ~ ~ ~ ~ ~ r~,~ Stony Brook, New York 11790-2356 JuLnlul JUN 2 0 7013 J` Attention: Duty Analyst RE: 7518LAND VIEW LANE, GREENPORT, NY Southold b~rvn SCTM N0.1000-07-02-32 nar ~ ens APPLICATION FOR PERNNT Dear Sir/Madame: We hereby submit four (4) copies of the proposed plans, applications, check, photographs and required data for permit approval for the above referenced project. ff you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332 ore-mail at jpatanjo~optonline.net. Very truly yours, c Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 x: Albert & Barbara Reibling • 70INT APPLICATION FORM • V For Permits/Determinations to undertake activities affecting streams, waterways, ~ ~ waterbodies, wetlands, coastal areas and sources of water supply. US Army Corps of New York You must separately apply for and obtain separate Permits/Determinations from Engineers (USAGE) - State each involved agency prior to proceeding with work. Please read all instructions. APPLICATIONS TO 1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart- Generai Services ment of State Check all permits that apply: Check all permits that apply: ? Coastal Erosion ? Section 404 Clean Water Act Check all permits that Check if this ? Stream Disturbance apply: applies: ? Excavation and Fill in Management ? Section 10 Rivers and Harbors ? State Owned Lands ? Coastal Navigable Waters ? Wild, Scenic and Acb Under Water Consistency ? Docks, Moorings or Recreational Rivers Nationwide Permit(s) -Identify ? Utility Concurrence Platforms ? Water Supply Number(s): Easement ? Dams and Impoundment ? Long Island Well 3 (pipelines, Structures ? Aquatic Vegetation Control conduits, ? 401 Water Quality cables, etc.) ? Aquatic Insect Control ? Docks, Certification Preconstruction NotiFlcation - F eshwater Wetlands ? Fish Control Moorings or ? Y / ? N Platforms D7 Tdal Wetlands ? Incidental Take of Endan- gered/Threatened Species ? I am sending this ? I am sending ? I am sending this application a lication to this this a lication 1~ I am sending this application to this agency. to this agency. pp pp a enc . to this a en 5. Name of Applicant (use full name) Applicant must be: 6. Name of Facility or Property Owner (if different than ? Owner Applicant) Albert ~~++bArc~ Qetbltn/ ?operator Mailing Address ? Lessee Mailing Address (check all that apply) °~9a 5 /t7 Ca cPew GrcST '~2 Post Offce City Taxpayer ID (If applicant Post Office City is NOT an individual): t~o+1L-~vw~ ~el tiffs State n.! y Zip Code / D S9 $ State Zip Code Telephone (daytime) Email Telephone (daytime) Email e1y• 24S• 2613 6a+br1C+?crlton~.,vol- 7. Contact/Agent Name 8. Project /Facility Name Property Tax Map Section /Block /lot Number JC~'~ P -f5 =S(wnB ?tlw ~~nt (so0 -57~~~-31 re a'ra n o Company Name Project Location -Provide directions and distances to roads, bridges and bodies of waters: $c G Lo C4 ~c..•+ ~K~ Mailing Address Street Address, if applicable Post Office City State Zlp Code NY 106 f/ewt-t-t (•~l,?cQ- ~S Zs~tntP Vlcu/ IANC ~«eaP°/~' 9Yy Post Office City ~A( Town /Village /City County eCn-~'G'(' Nso.('IG~IeS Sow-th°IcQ S,~F¢o(.1c.. State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name t193y 5~.~'t'ko~c~ Pcto/1~C ~r^ Telephone (daytime) d 31 • $y' 9 332 Location Coordinates: Enter NYTMs in kilometers, OR Latitude/Longitude Email NYTM-E NYTM-N Latitude Longitude JPu-~-an,J~@~P~nr.)~er. q~'oy.B®au 7d °.aa.s~Bt,.J For-Aaencv Use Only DEC. Application Number: bSACE Number: JOINT APPLICATION FORM 09/10 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed • T APPLICATION FORM -PAGE 2 OF 2 • Submit this completed page as part of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose. Attach additional page(s) if necessary. Include: description of current site conditions and how the site will be modiFled 6y the proposed project; structures and fill materials to be installed; type and quantity of materials to 6e used (i.e., square ft of coverage and cubic yds of fill material and/or structures below ordinary/mean high water) area of excavation or dredging, volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource impacts; and where applicable, the phasing of activities. ATTACH PLANS ON SEPARATE PAGES Qt.n o?c un~ .ICS/AU /.f/ c~F °F St~ttrM <f!a.-s, ...g. ~t S.~CI000~,e4.~ t.~!{'li NLw v[n..~L rN Srt niG G~~RT~~N GrS G1r[5-F/NJ. ~/4 Ge 3 o F E l F• Gos t t~~rr.~-~ S ~.~.,.f . /25r°%` c ~ 17 a- 9' l1 c o ra n GC CCI~ Rn~ y~X~r S'r<rr rS Lv Sf Ge~rr...~ $f,~/'rr . Pro osed Use: Private ? Public ?Commercial Proposed 9, f~ / 3 Estimated q _ ,y _ / 3 p Start Date: Cam letlon Date: Has Work Begun on Project? ? Yes No If Yes, explain. Will Project Occupy Federal, State or Municipal Land? ? Yes o If Yes, please specify. 10. List Previous Permit /Application Numbers (if any) and Dates: r.--' ' p 11. Will this project require additional Federal, State, or Local Permits including zoning changes? Yes ? No If yes, please list: r-~..,.,~ F 5...-~L..ld Tr,.stc~r. 12. Signatures. If applicant is not the owner, both must sign the application. I hereby affirm that Information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said project. In addition, Federal Law, 18 U.S.C., Section 1001 provides for a floe of not more than $10,000 or imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conceals, o.~ers up a material fact; or knowingly makes or uses a false, fictitious or fraudulent statement. LUI~ ~'~(,C..ft.~rs R~~t~ 1~~'lCi~f,~~ Otc~rlC~r ~-3f7--/_. J naturg-,of Applica Printed Name Title Date ,~~e~,L~' .C.~-~-.~-`-e f-I~tZT l~crlic, C7cv/~l~(~ s-3e,.,_/.3 Sign re of Owner Printed Name Title Date B" na re of A ent Printed Na e P Tie Date -Foie-AaencvUSe Only _ DETERMINATIONS-OF NO PERMIT REQUIRED Agency Project Number has determined that Np PermR is required from Ehis Agency for tha proiecEdestfibed in (Agency Name) ' this application. Agency Representative: Name (printed) Title Signature Date JOINT APPLICATION FORM 09/10 ~ Application Form Page 2 of 2 New York State _ Department of Environmental Conservation PERMISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s) to the Department of Environmental Conservation ("DEC"), the signer consents to inspection by DEC staff of the project site or faciliTy for which a permit is sought and, to the extent necessary, areas adjacent to the project site or facility. This consent allows DEC staff to enter upon and pass through such property in order to inspect the project site or facility, without prior notice, between the hours of 7:00 a.m. and 7:00 p.m., Monday through Friday. If DEC staff should wish to conduct an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate consent for such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s) sought. By signing this consent form, the signer agrees that this consent remains in effect as long as the application is pending, and is effective regardless of whether the signer, applicant or an agent is present at the time of the inspection. In the event that the project site or facility is posted with any Form of "posted" or "keep out" notices, or fenced in with an unlocked gate, this permission authorizes DEC staff to disregard such notices or unlocked gates at the time of inspection. The signer further agrees that during an inspection, DEC staff may, among other things, take measurements, may analyze physical characteristics of the site including, but not limited to, soils and vegetation (taking samples for analysis), and may make drawings and take photographs. Failure to grant consent for an inspection is grounds for, and may result in, denial of the permit(s) sought by the application. Permission is granted for inspection of property located at the following address(es): ~s Zs/an~ VI~cJ L~i~c Cztcn~or~-. 1-"'J By signing this form, I affirm under penalty of perjury that I am authorized to give consent to entry by DEC staff as described above. I understand that false statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Print Name and Title Signature Date *The signer of this form must be an individual or authorized representative of a legal entity that: • ovens fee title and is in possession of the property identified above; • maintains possessory interest in the property through a lease, rental agreement or other legally binding agreement; or • is provided permission to act on behalf of an individual or legal entity possessing fee title or other possessory interest in the property for the purpose of consenting to inspection of such property. Permission to Inspect Property Application Supplement 12/08 • s~~.zo . Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -PROJECT INFORMATION To be com leted b A licant or Pro'ect S onsor 1. APPLICANT/SPONSOR 2. PROJECT NAME Al6tt~' ~ ~al~Cra. Qct(~l.n ~S Ss14.+r9 ?t<w Lar~~ 3. PROJECT LOCATIO//N: Municipality U fG<q ~ Couniy 5~ LK' 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 5. PROPOSED ACTION IS: New ~ Expansion ModificatioNalteration 6. DESCRIBE PROJECT BRIEFLY: `4 GG~ /T ! C ~ ~ F $ 2`o !/v,. o~t<<h <.5 e<¢ !Jr (.lG /i<ocQ - 7. AMOUNT OF LAND AFFECTED: Initially of acres Ultimately ° ~ acres 8. WILL PR OSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes ~ Na If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? t~esidential ~ Industdal ~ Commercial ~ Agriculture ~ Park/ForesVOpen Space ~ Olher Describe: ~StlX ln'I'lb~~. YLU 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 permiVapprovals: 11. DOES ANY ASPECTI--OIF ~THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes I~1°~ If Yes, list agency(s) name and permiVapprovals: 12. AS A RESULT OF PROP D ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicanVsponsornome: Date: 7 ' 3 O / 3 Signature: ~ If the action is in the Coastal Area, d you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 Reset` PART II -IMPACT ASSESSMENT To~ om leted b Lead A enc A. DOES ACTION F~CEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. Yes ~ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 677.6? If No, a negative declaration may be superseded by another involved agency. Yes ~ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may tie handwritten, if legible) Ct. 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: G2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood charade(? 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 offcially adopted, or a change in use or intensity of use of land or other natural resources? Explain hrie9y: C6. Grow[h, 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-C6? 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)? Yes ~ No If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? Yes ~ No If Yes, explain brieFly: PART III -DETERMINATION OF SIGNIFICANCE (To kie completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determinewhetheritissubstantial,large,importantorotherwisesignificant. 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 identifed 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 ormore potentially largeorsignificant adverseimpacts which MAY occur Then proceed directly to the FUL EAF and/or prepare a positive declaration. Check this box ifyou have determined, based onthe information and analysis above and anysupportingdocumenlation, thatthe proposed action WlL NOT result in any signifcant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination Name of Leatl Agency - Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible OfFcer Signature of Responsible Officer in Leatl Agency Signature of Preparer (I different from responsible ofFCer) Reset _ .,,a o,,>m € ro~ x' A N z44. E- - - ~ ~ SP.9 u e 54 ~ +vo ~ ) aya ~1 • ~ .u 1 r ^d ` ` ~ i I a a. i r ~ I O \ ~ i / ~ ~ ~ i i mwo ~ ~ ° ii A./~ n i P ~r i i• ~ s SOUMU ISUNU ~E~~R :I - i ~:e'°.~ GOUNII'OF SUFFOLK e ~ r. P+I O r .M .~`..ernw..us gplPgplyT 8wrta Apwq ~ OFFICE LOCATION: ~~OF SO(/ryO MAILING ADDRESS: Town Hall Annex ,`0 l~ P.O. Box 1179 54375 State Route 25 .If, .If, Southold, NY 11971 (cor. Main Rd. & Youngs AveJ T T Southold, NY 11971 G~ ~ Telephone: 631 765-1938 ~ Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM jLJ{ ~ L u V ~ ~ J ll L 1 1 2013 Saulhcld Tcvan To: Jim King, President o r rTr e s Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 9, 2013 Re: LWRP Coastal Consistency Review for ALBERT & BARBARA REIBLING SCTM#1000-57-2-32 A permit (6517) for the actions was issued by the Board in 2007. Jeffrey Patanjo on behalf of ALBERT & BARBARA REIBLING requests a Wetland Permit to remove and replace 151 linear feet of existing bulkhead with new vinyl bulkhead; replace 30 cubic yards of clean fill; replace existing 27'x9' deck and 4'x8' stairs to beach. Located: 75 Island View Lane, Greenport. SCTM# 57-2-32 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 LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Office Use Only oastal Erosion Permit Application Wetland Permit Application _ Administrative Permit D ~ ~ ~ p Amendment/Transf /Ext nsion ~ D Received Application:~~~~3 D /Received Fee:$ SO ~ompletedApplication 3 JUN 2 0 2013 Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ Sou;ho!tl sown ~oordination:(datesent) 3 Bar f'ructees _LWRP Consistency Asses ment Form VAC Referral Sent: ate of Inspection: D Receipt of CAC Repo Lead Agency Determination: ~echnical Review:~--~; Yublic Heazing Held..~~;~ Resolution: Name of Applicant A16<r-~ ~ (3a~b.+i.~ ~~ibl%.+~ 6 Address ~qa8 /~«'duwcr-e5T D/'• ~Ivrk•lowN l~C)~1, -j,s y l 0 59 9 Phone Number:( ) q l ~I - 2 4 5- 2 6 13 Suffolk County Tax Map Number: 1000 - 5 7 - e - 3 .Z Property Location: ~5 Zsl.r,d ?~~w LuNe , ~rtt.,Pm~-F (provide LILCO Pole distance to cross streets, and location) AGENT: ~Ffre~ ~a-} ^Jo (If applicable) Address: lob f/~..~~-t -I F3lvice, C~^-Fer n/lonc,hes ,may 1193 `f Phone: 6 3/~ SI S y• 9 3 3 7- ~~T • Board of Trustees Application GENERAL DATA Land Area (in square feet): q, I I q Area Zoning: A t S Previous use of property: R~5 Intended use of property: R~5 Covenants and Restrictions: Yes ? No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes ? 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 ? No Does the structure (s) on property have a valid Certificate of Occupancy Yes No Prior permits/approvals for site improvements: Agency Date ? No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ? No Yes If yes, provide explanation: Project Description (use attachments if necessary): Rrmo~e GncQ. rep/ace lsl t~- ®F S-I'.IM ~Qyma~s~ b,rc,lc{~eu.t2 wttl~ NC«.~ v~.~/yL 6~.C1GL,sr„d. /LcP/wrc 70 of Chan G. II Grp? r~..l~,~.c~ S1eri.•+. ftc?ltcc .Z 7'k4~ N~k'~5~ JTRI~.S -I. ~7ta.li~ te51" GPI/wq 57~ii"~ • Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 2lmnvc .w.R rcpl.ccc isi sr c~` damw~'esQ b~uCken.d~ c.ttkh .vt.,.~ vt..~.?L h~clGhtw~P. ~LeP/tc~ 3°ey of coca F' II c®St sP~iw y 5~"~fm /Leo c~ a ~ ~ x 9 ~ d «K 4^ `Q ' -tom ba,..G G. Sr cB..r~.~.~ S4'.~Nr c, ~ $Tw~~S Area of wetlands on lot: d square feet Percent coverage of lot: ~ Closest distance between nearest existing structure and upland edge of wetlands: /mom 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 be excavated? ~ cubic yards How much material will be filled? 3 o cubic yards Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the area of operations: / ~ Manner in which material will be removed or deposited: P.x~a v u -~'o 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): ~A~t« w~l~ be ,vfl <E~cc+ o.~ wc-r1a~~S A?C ~o '~NS~"rvC'1"fo.J Board of Trustees Application COASTAL EROSION APPLICATION DATA /1 ~(c/no VL arn~ rcPl'~L~ /S/ ci si Sr cin ~arnt9 ct~ Purposes of proposed activity: b~uChL+~Lt tvcth ,vcw ?c.~~(, hvl.L'l.cs..~• ~(c~l4c~ $c cy vG G~tn ~/1 Gr57 dV/tN 5?"m /.rr 2c Pl. ce 2~ `u 9 ~~c-~~- ~e.n.R 4`x~i~ 51ai/S bL4L~^ f!uS'T V/7Ny $T !M Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? ~ (cubic yards) How much material will be filled? s° (cubic yards) Manner in which material will be removed or deposited: Earc a v +o r Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) "~~.!!C t,,,l/ Ix ,yo ,~.cLy.. d-,rc// fit p•. c'p's -TIrG prc~LC~F ~lm~tcQG rv1! w- f~..~G"/ler4,L- bv~L~ Ltd ene~ {-tc•~i-.~ •F ~lwPL/+y sr.za • Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -PROJECT INFORMATION To be com leted b A Iicant ar Pro'ect S onsor 1. APPLICANT/SPONSOR 2. PROJECT NAME AGbto~' cT ~or~xcr~. Qct~f7l•>z -~S =slanr9 ?t<w Gant 3. PROJECT LOCATIO//N: Municipality r+ rl t7 ~ + County 5~ l.K- 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) ~S Z slw,lm yr<w L<cnc C~c cri pa~-l J,-s"( $tc la ci.-f !ea M4P 5. PROPOSED ACTION IS: New ~ Expansion Modifcaticn/alteration 6. DESCRIBE PROJECT BRIEFLY: ~F $2"v o~li ii.n ell 4.~GlG /rCCCQ /Lc!'lace !sr Cf S fLt <r• ° ?e 7. AMOUNT OF LAND AFFECTED: Initially . Ol acres Ultimately ° ~ acres 8. WILL PR OSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes ~ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? 'Residential ~ Industrial ~ Commercial ~ Agriculture ~ Park/Forest/Open Space ~ Other Describe: ~St/X C.,'~'IF.~L {'fie /r'r~ 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 permiVapprovals: 1 t. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes to If Yes, list agency(s) name and permiUapprovals: 12. AS A RESULT OF PROP D ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicanUsponsor name: Date: ? ~-,~p- /3 Signature: ' -r-L- If the action is in the Coastal Area, d you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 Reset.: PART II -IMPACT ASSESSMENT To be com leted b Lead A enc 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. Yes ~ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. Yes ~ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. 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, fsh, shelifsh 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 C7-CS? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? F~plain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? Yes ~ No If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? Yes ~ No If Yes, explain bdefly: PART III -DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverseeffedidentifiedabove,determinewhetheritissubstantial,large,importantorotherwisesignificant. 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 identifed and adequately addressed. If question D of Part II was checked yes, the determination of signif cance must evaluate the potential impact of the proposed action on the environmental characteristics of the CFA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL EAF andlor prepare a positive declaration. Check this box ifyou have determined, based on the information and analysis above and anysuppoding documentation,thatthe proposed action WlL NOT result in any signifcant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination So v7r~(nGdA~l~ 7`Q~stF.FS ~~L z~i3 Name o Lead Agency - Date ~,ywl ES ~ /~iW G- Print or Type Name of Responsible O icer in Lead Agency Title of Responsible Officer ignature of Responsible Officer ead Agency Signature of Preparer (If different from responsible officer) Reset PROOF OF MAILING OF NOTICE - ATTACH CERTIFIED MAIL RECEIPTS Name: Address: ~ru.2~ E~osemaY,~~~ ~I CId Field ~d . ~a-t~-~-teld C~-o~say r ~ a.~.err ~ ~~c. Ny ? twice t~DIUJY~YI LP Cq~rD " X551 c 1 n I 1 p m rJ ~o ~ ~l(;l.Yli~ ~W LVL "''I ~O ~ ~IId Jo ~0~ `~l ~ l0 STATE OF NEW YORK COUNTY OF SUFFOLK residing at ~ r7(p ~IPW I{~ . ~ ( I ,being duly sworn, deposes and says that on the day of J U`~ , 20~, deponent mailed a true copy of the Notice set forth in the Boazd of~~rustees Application, directed to each of the above named _ persons at the addresses set opposite there respective names; that the addresses set Y opposite the names of said persons aze the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~I Cyi D S .that said -ces were mail each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Swom to before me this Day of U~T, 20 Notary Public Loriann P Notary Public Stat~~~odc Qualified in Su No:01PAti1 ~ coelon oero~ao,~ • ~t OgU>rF0(,~ • M~~O~ CpGd James F. King. President ~ w ~ Town Hall. 53095 Main kd. 13ob Ghosio. Jr. ,Vice-President ~ P.O. Bos 1179 Dave Bergen ~ ~ ~ Southold, NY 11971 John 6redemeyer 7/~ ~~0~ Telephone (631) 765-1892 Michael J. Domino 1 ~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ALBERT & BARBARA REIBLING COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING ~~yy±± TO BE COMPLETED AFTER POST/NG RFMA/NS IN PLACE FOR E/CHT DAYS 1, V~'t'fl'P~/ pa+G.n io ,residing at /dba ~Q~Q E-{ew Rj~ Ud being duly sworn, depose and say: That on the ~ day of Ju 2013, I personally posted the property known as ~15 l Sh rv~ V I-C,tnl L1,t < men a~~- by placing the Board of Trustees official poster where it an easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, July 17, 2013. Dated: (si at ) Sworn to before me this 7da~y pof~~f U~y2013 U (.(1,U1 N~ otary Public P1 Yak No:01P 150880 Commission Expires OB/01/20/~ 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. ~ ~ I berl- ~ ~j~r-b~ra OWNER(S) OF RECORD: fie; bl;n 9 SUBJECT OF PUBLIC HEARING: Remove and replace 151 linear feet of existing bulkhead with new vinyl bulkhead; replace 30 cubic yards of clean fill; replace existing 27'x9' deck and 4'x8' stairs to beach. TIME & DATE OF PUBLIC HEARING: • (~c~ny, S`~lY 17, ~0?3 - o~-or o~xx~-~5:'3~c~ ~ If you have an interest In this protect, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours o} 8 a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Board of Trustees Application County df Suffolk State of New York ~Lbc~f Re~bl~~~S BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/I~R 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. P Signature SWORN TO BEFORE ME THIS~DAY OF IL ~~~,20 V 1~~ 1 Notary Public Loriann Patanl'o Notary Public State oft ew York Qualified m Suffolk County No: 01PA6150861 Commission Expires Ot1/07R0 Board o£ Trustees Application AUTHORIZATION (where the applicant is not the owner) I, A(t7er+ Qe~hl%~~ residing at 998 Nleado~cresT D2. (print owner of property) (mailing address) yorK~o~...~ }~a~yb~5~ *+9 Io598 do hereby authorize T ~Frcy F (Agent) ~ Qa -I"a n~ o to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the Dart of town officers and employees The nuroose of this form is to provide information which can alert the town of possible conflicts of interest and allow i[ to take whatever achon ~s necessary to avoid same. YOUR NAME: Rp1 }'(`~`J . ACb~r-I' (Last name, first name, middle initial, unless you aze applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other", name the activity) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO If you answered "YES", complete the balance of [his 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/agentlrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in anon-corporate entity (when [he applicant is not a corporation); C) an officer, director, partner, or employee of [he applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted t 's 3 ~ day of y ~ 200 ~:3 Signature Print Name - f Ei d Li Form TS 1 . ,oK Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LocATION: s.c.T.M. a: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBNISSION OF A Y° foaG $ 7 p) 31 STORM•WATERr ORADI DRAINAO! AND EROSION CONTROL PLAN s r e 3ac~on -S1-eTr - CERTIFIED BY A DESIGN PROF SWNAL IN THE~STATE OF NEW YORK. SCOPE OF WORK -PROPOSED CONSTRUCTION ITEM # / WORKASSESSMENT Yes No a. What is the Total Area of the Project Paroels? ' ~ Will Phis Project Retain All Storm-Water Run-Off (Indude Total Area of all Parcels located wDtln 9 f t I 0.7e 9 Generated by a Two (2") Inch RainfaN on SIM7 ~ ? the Scope of Work for Proposed Consfrudion) (s f Aga) (This item will include aN ron-off created bysite b. Whet is the Tofai Area d Land Cleadng clearing andlor corrshuc5on acgviNes as we0 as all andlorGround Disturbance forthe proposed .?sOO O.o6s Slte lmprovemems and the permanem creation of constmctron acgvlly7 Impervious surfaces.) (a../AOSS) Q Does the Site Plan andlor Survey Show All Proposed ? PROVIDE~B1tTEF PROJECT' DESCRIPITON wro~nseadaloiwl Paaeeas Nasomi Drainage StnieWres indicating SzeRLoeation?This Item shall Indude all Proposed Grade Changes and ~4 c c / J"! C F a F Slopes Contrelling Surface Water Flow. (Lent .~c ge rS' f e~ 3 Does the Site Plan andlor Survey describe the erosion / a f3 ~C K/t c ,p r...~ Avc,,,~ yt„i r~ - and sedimentconhol procdces that will be used to control s@eeroslon and slam water discharges. This y l.eGe ~'f rh 9 r f~e GlL e+r'i ~ Item must be maintained throughout Me Entire ~/o~ ConsWction Period. C/r X r 5-CR r CS x..57 6lr 4, WiN fhfs ProJed Require any Land Flllirtg, Greding a n-n Exravadon where there Is a. change to the Naturel 5 ' "'c 1A cc 3 O !c f r LC Existing Grade Involving mole than 200 Cuhlc Yards /1 of Material wNhin arty Paroef7 G an ~r j ~ ~ S? r~ u / /ti5 $'telM ' ~ WNI this Appllcaffon Require Lend Disturbing AdlviNes , / Encompassing an Area in Excess of Five Thousand ? (5,W0 S.F.) Square Feet of Ground Surfaoa2 s Is there a Nalurel Water Course Running throlph the Site? Is this PmJectwithln the Trusteesjudsdlctlon Gemnl Dec SWPPP Reaulrerrrenls: orwithln One Hundred (100') feet of a Wegand or Beach? Submtsaion of a 5WPPP is required for atl ConsWIXion acltvltles invdving sdl disturbances of ease (1) or more acres; indutlln9 disurbances of less man one acre mar ~ Will there be Site preparation on F~dstlng Gmde Slopes ? are part of a lamer common plan met wR uttbnalety disturb one err mme aces attend; yvhich Exceed Fifteen (15) feat of Vertical Rise to ? IndudingtkmsWWOn acWiNes lnvoNhg soil dishubancesofless man ease (1)acre wham One Hundred (100')of FbdzoMal DlsOnce7 me DEC has detemYnad mat a SPDES pertnlt is requiredPor storm water discharges. (SWPPP's Shall meal tM Minimum Requirement of me SPDES Gansnl Permit $ Will Ddveways, Perklrg Areas Of other ImpervlOUs for Storm Wafer Obcharges from Consbucaon aetwfry - Pannit No. GP-0.70-001.) Surfaces be Sloped to Direct Slant-Wafer Run-off ? i. The 9WPPP shall be Prepared error b the subMttel M me NOT. The NOI shell be into andlor in the tliredl0n of a Town I~ght-Of-Wat/~ submitted to the Depedmant pdorb me commancemenlof mass Wctiml acWfly. yyN this Pro 0Ct R Uife tlla Placement of Metedal, 2. The SWPPP Shafldescdbe the erosion aM Sediment controlpredkes and where 9 l ~ ? - requlred, postcorrsWCNon storm water management prectlees met vAll be used andlor Removal of Vegetation andlor the ConstrucNOn of any wrewated m reduce me pollulenls n stmmweter mscharges and to assure Item Within tie Town Right-oT-Way or Road Shoulder compllenCa win the terms end conditions of this pertnL In addition, me SWPPP Shah Afea? ttlae lien rill NOT lnelude 16e ImNlhtlon Madwwry Apmm) Identlty po~ntlal sources of poNuNon wh(eh may reasonably h9 expacletlmaffectme NOTE: If Arty Anewerto Quesaona One mrough Nina is Answendwllh aChmk Mark quality Mstorm vrdtar discharges. in a Box end me mlxWellon sIN dkWrbarlea Is between 6,000 S.F. a d Aare In area, 3. AO SWPPPs mat requlreme post-construcgon storm water management practlrs a8brm-Weler.ending, orelnageB Erosbn Cool Plan to Required bymoTwm of eomporlent shall ba Prepared by equeliflad Design PrefessPonelLkensed (n New York 9oumold and MUatba SUbmitletl for Review Pdorm Issuance ofArryeutltling Permit mat fs knowledgeable'yr the principles antl practices ofsmrm water Management. 0y~: AChedi MaAt~l ardlor Aneweriormeh Oueslbnb Requretl fora Compete AppllraltanJ STATE OF NEW YORK, A iC~O/~UQNI~T~}Y-O(Fn(...y...`...L,.~ SS That I,..rL`..f.C`~1...4..---.1`1....5.IL/Y`:1.•\~~-~-•••.••°••••"being duly sworn, deposes andsays that he/she is the appGcantfor Permit, (Name of Indlvldral signing Downmen[ ,Jas p And that he/she is the kL.~~.r11...W'~ •(Owner, COnlmclon l~gant,Caparete Officer. alo.) Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contabted in dtiv application are taste to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the apphcaton filed herewith. Sworn to before me this; a day of ..,.~~............~.....,20~..J Nottty Public:........ L~7.:.:' ...,Q~k~~rr•"••"°."'......................... `J (Sgnalwa MApPliwni) FORM - 06110 Loriann Paten o Notary Public S~e ofNew York Qualified In SWfdk County No:O1PA6150861 Commission Expires 00J07I20L~ 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 form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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 Boazd of Trustees Office, the Planning Department, all local librazies and the Town Clerk's office. B. DESCRIPTION OF STTE AND PROPOSED ACTION SCTM# S 7 - O _ 3 d- The Application has been submitted to (check appropriate response): Town Board © Planning Dept. ~ Building Dept. ~ Board of Trustees 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: Nature and extent of action: Rim ~c and rcP(acc /s! CF ai 51=rm GQ4Ma~c~ 1:t.l.Kttec..cQ o..r-r~ NG..? V[N~jL b.. ~lcbcc.. cP. ~~t cc 3o oy ~p c%4.-~ F.tl G.St d,~/w~ 5'f-r.a. /lip ~+ct ~ ~ ~~~LG KMJt H~k h ~ 5'rRirS -f. t~tu~G, lti5"f cer.~~r'7 S~°r"" Location of action: S Z 51~ ~ t/i c.,.. ~ 4 h < C~ rrc., pe. } Site acreage: ~ • 8 ° Present land use: ~ S ` ~ to ""L Present zoning classification: 2t S - 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 of applicant: Ql ~cr+ ~ Qec b"fK- ~•tt `y (b) Mailing address: a9a`i5 /?1taGQ°wclcsfi fa P. 1fo~~l+o.,.,~ E/t~h+s~ N ~l ~os9'b (c) Telephone number: Area Code ( ) 9 t y - a 4S' "a ~ t 3 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ No ? If yes, which state or Federal agency? ~ 4 5 ~ i; ~ DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. Yes ? No ? Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LW12P Section III -Policies Pages 3 through 6 for evaluation criteria ? Yes ? No ~NOt Applicable Attach additional shits if necessary Poliky 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III -Policies Pages 6 through 7 for evaluation criteria © Yes ©No Q Not Applicable ACTION PROVIDHS POR IMPROVED VISW~I, COMPONffiiTS. 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 ® Yea ©No ©Not Applicable RECONSTRDCTION OF HDL~AD WILL PROTECT LOSS OF PROPSRTY DOS TO EROSION. Attach additional sheets if necessary Policy 5. Protect and improve water quality and.snpply is the Town of Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria © Yes ~ No ©Not Applicable A I NO B F CT ON 1rA Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecwsyatems including Significant Coastal Fish and Wildlife Habitats snd wdlands. See LWRP Section III -Policies; Pages 22 through 32 for evaluation criteria. Q Yes Q No © Not Applicable ACTION HAS NO EFFECT ON ECOSYSTEMS. 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 Q No © Not Applicable ACTION HA8 NO SFFBCf ON AIR ITY. Attach additional sheets if necessary policy 8. Minimise environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See Lw1tP Section III -Policies; Pages 34 through 38 for evaluation criteria. © Yes ? No ~ Not Applicable ACTION FiAS NO BPFSCI CAIISSD BY SOLID AND NAZARDOII3 NASTS. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreattoaal a~ of, coastal waters, public hmds, and public resources of the Town of Southold. See LWRP Section III -Policies; Pages 38 through 46 for evaluation criteria. nn © Ye~-1 No ©Not Applicable ACTION I9 IACATSD ON PRIVATE PROPERTY. Attach additional sheets ifnecessary wox>s~vc coASr PoLlctESs Policy 10. Protect Soathold'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 ACTION I8 LOCATSD ON SINOLS PANILY RBBIDSNCB AND DTILIZBD POR RBCRBATIONAL nOATINO ACTIVITIBB. Attach additional sheets if necessary Pottcy 11. Promote sustainable uae of llvtng marine resources in Long Island Sound, the Pecouic Eatusry and Town waters. See LWRP Section III -Policies; Pagea S7 through 62 for evaluation criteria. © Yes ? No ~ Not Applicable ACTION STILL BRONOTR RBCRBATIONAL RSSODRCS POR LANDOWNBR SY WAY OP ROATINO ACTIVITIBS. Attach additional sheets if accessary Policy 12. Protect agltcultm'al lands in the Town of Southold. See LWRP Section III -Policies; Pages 62 throag6 6S for evaluation criteria. © Yes ? No ©Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral reaoarces. See LWRP Sectiou III -Policies; Pages 6S through 68 for evaluation criteria. © Yes ? No © Not Applicable Created on 5/25/0511:20 AM June 17, 2013 Town of Southold Trustees Town Hall Mnex Building n ~ ~ ~ Q n 54375 Rte. 25uv,I( - -I, J~ P.O. Box 1179 ll Southold, New York 11971 JUN 2 0 2013 RE: 7518LAND VIE~v LANE, VREENPORT, NY Southall town .-11 SCTM No. 1000-57-02-32 r~ APPLICATION FOR PERMNT Dear SirlMadam: We hereby submit one original and four (4) copies of the proposed plans, application, diedc, photographs and required data for permit approval for the above referenced project. ff you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. V truly yours, effrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 r ,1.4.5 ISLAND VIEW ~ NE °y ~ -Pf~CS Ctve~ U ~ .1 F ~ - - _ d.4.7 S 85'40'00" E I PROPOSED 32 lF V1Nri BULKHEAD } (IN SAME AllGNMENi AS EXIST.) n?U T¢?+y` , {r t. e5-;;v~, 107.52' ~ ~ ' - _z; ~ ~ ,r CH. LNK. FENCE ~ ~ mad c 4~.. WOOD ~ rc gn~s'm' ~ '>n, BULK = °~"i O ~ ~ Li ~ VU ~ ~ o O I ~ ~~,a o v r+ 1 = ~ ,1 ~ ~ ~ ~ x° p~ e P[~ ~ ~ A ~ ~ ~ Saga BFy R 1 6 ~ ~z ~ ~ ~ 1 1 ~ ~ E'st 4< 1 ~ 1 m O r ~ O m~~ a v v 1 1 ~ y t f f \ H 1~~ tip f~ fTi ~ "~O e1.4.3 d.4.5 r '1 f \ ^ r~+`"~ a"' o-~, g, a' PROPOSED 77 LF NNri BULKHEAD l 1 g'~° ,~.~~,tt r ~O \ (IN SAME ALIGNMENT AS EXIST.) 4 ~ V PROPOSEDVUNE OF 10' NON-TURF BUFFER ~ " D N/F DF CAFPRO c°~~ 1 . 9' REPLENISH'(~PpROX. 30 CY OF FlLL LOST ~ Y ~ - ~ WDDp DECK \ ~ DURING STORM PROJECT LOCATION MAP 2 STORY FRAME ~ oo m ~ RESIDENCE Y WOOD WAIX \ rn \ R@12AtT~~~~ m F.FL=10.0 1 N.T.S. J REP E WOOD DECK (27'X9') AND STAIRS f ~ ~ ~ ~ ° '1 (4'X8') OST DURING STORM ~ ij~ cJ°r+ 6.5~ - - - WOOD JEftY ~ ~ IIiV 7 0 2~)3 I r ' PROJECT o ° ~ ~ LOCATION W BUUtHFAD ~ ' ' ~ L-_ v. ~ ' , n FENCE d.3.9 CN' LNK ~ D' ~ PROPOSEO 42 LF VINN. BULKHEAD p 94.2 (IN SAME PLIGNMENi AS EXIST.) APPROVED BY MEAN HIGH WATER . ~ - - o S Tg'32'2Dp w i BOARD OF TRUSTEES TOWN OF SOUTHOLD ENO N/F OF REIDY .DATE f7 l3 NOTES: PROPERTY OWNER: scALE: 1. ELEVATIONS REFER TO NGVD 1929 ALBERT REIBLING BULKEIEAD PERMIT PLANS ,•~=20~ 2. LOT AREA: 9,111 S.F. / 0.209 ACRES 2928 MEADOWCREST DR. 3. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: YORKTOWN HEIGHTS, NY 10598 PROPOSED PLAN DATE: PECONIC SURVEYORS PREPARED BY: e-tt-t3 1230 TRAVELER STREET, SOUTHOLD, NY JEFFREY PATANJO 106 HEWITT BLVD. 75 ISLAND VIEW LANE DATE SURVEYED: APRIL 29, 2004 CENTER MORICHES, NY 11934 CREENPORT, TOWN OF SOUTHOLD SUFFOLK COUNTY. NY SHEET: 631-484-9332 TAX YAP N0. 1000-b7-02-32 t of 2 PROPOSED TIMBER TOP CAP NOTE: REMOVE EXISTING REMAINING STRUCTURE IN ITS ENTIRETY PROPOSED 3"X6" PROPOSED 14' LONG 10" BUTT AND INSTALL NEW BULKHEAD REAR WALE CCA TREATED TIMBER PILE, 6' IN THE EXACT SAME POSITION O.C. AS STORM DAMAGED BULKHEAD RE-PLENISH SAND RAISE TOP ELEV. APPROX. 1 FT. LOST DURING STORM in '-'.r ~ I APPROXIMATE M.H.W. REMOVE REMAINING PROPOSED 8" TIP CCA D FMB RS BULKHEAD j\\\~\~/~\j/\\//\%\\//\ / LAY-LOG PILE \ APPROXIMATE M.L.W PROPOSED 8" TIP CCA PILE, 6' PROPOSED 6"x6" CCA TOP & BOTTOM WALE O.C. 8' LENGTH. BOLTED TO LAY-LOG WITH 3/4" PROPOSED 12' LONG CLOC GALVANIZED THRU-BOLTS. 9000 VINYL SHEETING PROPOSED 16' LONG 1 " DIA. GALV. TIE ROD, 6' O.C. TYPICAL SECTION N.T.S. PROPERTY owNER: BULKHEAD PERMIT PLANS SCAAs~ Noted ALBERT REIBLING 2928 MEADOWCREST DR. YORKTOWN HEIGHTS, NY 10598 PROPOSED SECTION DATE: PREPARED BY: 5-11-is JEFFREY PATANJO 75 ISLAND VIEW LANE 106 HEWITT BLVD. CREENPORT, TOWN OF SOUTHOLD CENTER MORICHES, NY 11934 SUFFOLK COUNTY, NY SHEET: 631-484-9332 TAX lfAP N0. 1000-b7-02-32 2 of 2