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Home My WebLink AboutTR-8281AJohn M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee June 17, 2015 Nancy S. Talcott Elaine N. Abelson 2545 Arrowhead Lane Peconic, NY 11958 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: NANCY S. TALCOTT & ELAINE N. ABELSON 2335 & 2545 ARROWHEAD LANE, PECONIC SCTM# 98-2-24 & 25 Dear Ms.Talcott & Ms. Abelson: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, June 17, 2015: RESOLVED that the Southold Town Board of Trustees grants a One -Year Extension to Administrative Permit #8281A, as issued on August 21, 2013. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, John M. Bredmeyer III President, Board of Trustees JMB:eac John Bredemeyer, President gofW4, Michael J. Domino, Vice -President James F. King y z Charles J. Sanders • Dave Bergen Town Hall Annex 54375 Route 25 P.O. 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: NANCY S. TALCOTT & ELAINE N. ABELSON requests a One -Year Extension to Administrative Permit #8281A, as issued on August 21, 2013. Located: 2335 & 2545 Arrowhead Lane, Peconic. SCTM# 98-2-24 & 25 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Type of Application: Wetland Coastal Erosion Administrative Emergency Pre -Submission Notice of Hearing card posted on property: Yes Storm Water Management Review: Yes No Info needed: Chapt.111 other Amendment Violation No Not Applicable Not Applicable Modifications: Conditions: 0/ Present Were: ,d-Bredemeyer -M. Domino J. King C. Sanders D. Bergen Bay Constable Other Form filled out in the field byy ef�e eICA1016t1 Com' Mailed/Faxed to: Date: Nancy K c Talcott and Elaine Noyeg Abelson 2545 Arrowhead Lane Peconic, NY 11958 TO: The Southold Board of Town Trustees .�.,n, Regarding Permit # 8281A Dear Sirs tl MAY 12 2015 Our original permit expires on August 21, 2015. We have not done any of the work entailed in the permit due to storms, snow, etc and other repairs that were more pressing on our home. We would like to apply to extend our permit until August 2016 for the sole purpose of rebuild our path to be its 4' allotment from our home to the beach so no one gets ticks as they walk down. There are very few stumps but there are dead or dying tree limbs and a lot of small branches that were marked by the surveyors. . Please do not hesitate to call us if you have any questions or concerns. Sincerely, f Tc�C� Nancy Knox T Ic tt Elaine Noyes A elson mai) �b A0 86X L73 peC vn I- c( N' M-51 James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone(631)765-1892 Fax(631)765-6641 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 0 W ' elf BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone(631)765-1892 Fax(631)765-6641 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 0 James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8281A Date of Receipt of Application: June 3, 2013 Applicant: Nancy S. Talcott & Elaine N. Abelson Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 SCTM#: 98-2-24 & 25 Project Location: 2335 & 2545 Arrowhead Lane, Peconic Date of ResolutionlIssuance: August 21, 2013 Date of Expiration: August 21, 2015 Reviewed by: Board of Trustees Telephone (631) 765-1892 Fax(631)765-6641 Project Description: To rebuild a 4' wide and approximately 270' long path to the beach with sand; remove stumps, fallen trees and dead or dying limbs & branches throughout the properties. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Michael A. Kimack, last dated May 29, 2013, and stamped approved on August 21, 2013. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. James F. King, President Board of Trustees w.r At a y max e AL i Sv?e r ... .:_ � ._ .d�..�� '�, �. � s.'. � �!-S4e�l' '�� :rWY�d .9 �. I!�T LL .'YJ. ��r ii • ', v: A 'A� _� Yt/ + R cott& Ela mo ,qe rA- 21 paw �, I S/►�_ _ +,+SII J� '` �., r; ..�- _ `�� Tic �, t 1 'S. � '� . • � y . ♦ \ jy 0 0 James I=. Ding. Presidentrp� COG P_O. Box 1179 Bob (ihosio. Jr_ Vice -President �� Z� Southold, NY 11971 Dave Bergen o Telephone(631 765-1892 John Bredemoyer M Fax (63 1) 765-6641 Michael l Domino Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 4416� IV 20/ 3 j3 ; �o Michael Kimack on behalf of NANCY S. TALCOTT & ELAINE N. ABELSON requests an Administrative Permit to rebuild a 4' wide and approximately 270' long path to the beach with sand, remove stumps, fallen trees and dead or dying limbs & branches throughout the properties. Located: 2335 & 2545 Arrowhead Lane, Peconic. SCTM# 98-2-24&25 Type of area to be impacted: altwater Wetland _Freshwater Wetland _Sound ay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt111 _other Type of Application:/Wetland _Coastal Erosion _Amendment ,�Administrative_Emergency Pre -Submission Violation Info needed: - - L✓%TG/il✓A V10L0)r/d A:D Modifications: Conditions: AlelAII IA, /*e7_/ 11,4raynIc-y j 1��Gt� / ° �� of A�•¢o �lou 117^1 f� Present Were: J King B. Ghosio D. Bergen, �J. Bredemeyer v Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: 0 James F. king, President �Y(x� ' CpG P.O. Box 1179 Bob Ghosio, Jr.. Vice -Presidents Z Southold, NY 11971 Dave Bergen ? Telephone (631 765-1892 John Bredeme)er ,y T Fax(631)765-6641 Michael J. Domino y�Ypl * ,baa. Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: J J L /O 7p/-? / Z - 1� Michael Kimack on behalf of NANCY S. TALCOTT & ELAINE N. ABELSON requests an Administrative Permit to rebuild a 4' wide and approximately 270' long path to the beach with sand; remove stumps, fallen trees and dead or dying limbs & branches throughout the properties. Located: 2335 & 2545 Arrowhead Lane, Peconic. SCTM# 98-2-24&25 Type of area to be impacted: I,--- -Saltwater /_Saltwater Wetland _Freshwater Wetland _Sound _Bay Distance of proposed work to edge of wetland Pad of Town Code proposed work falls under: _Chapt.275 _Chapt. 111 _other Type of Application: _ Wetland _Coastal Erosion _Amendment ✓Administrative_Emergency _Pre -Submission Violation Info needed: Modifications: i d /V1/1 �-' ry+G✓'R D Conditions:r'��~ Present Were: ✓J. King B. Ghosio ✓J. Bredemeyer Michael Domino Form filled out in the field by J, p VP Mailed/Faxed to: Date: D. Bergen, D. Dzenkowski other V R°s eta ✓ ��r � -�-'. _ , -.'_ \/ +1iX �y[��y�wf <c� Wagt S�i��R��S.•. 'moi l� _. ,.^�l a •-f! � �Y' '. e• y 1 y rn^ �wk AT RN Re . . . . . . . . . . Vii!' R, 1. . . . . . . . . I . W I all WiT 404 .a.. - s r �. • _ yOf 25 ' --UL .01 I � _ l w � u Oe zy �� .• " `.� CD4 �b4�e��e� .Q�iC nL z W 6 e mmonr L • � � �,� ``� ® O � a a � s •� i <P S s r I s ; V4\ % _ 0 — _ —_—_—_ —•• --� — � - ReYo�lgally Ta B�NmASxry e LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM JUL 1 1 2013 To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 17, 2013 Re: LWRP Coastal Consistency Review for NANCY S. TALCOTT & ELAINE N. ABELSON SCTM#1000-98-2-24&25 Michael Kimack on behalf of NANCY S. TALCOTT & ELAINE N. ABELSON requests an Administrative Permit to rebuild a 4' wide and approximately 270' long path to the beach with sand; remove stumps, fallen trees and dead or dying limbs & branches throughout the properties. Located: 2335 & 2545 Arrowhead Lane, Peconic. SCTM# 98-2-24&25 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 to remove stumps, remove fallen trees and dead or dying limbs & branches (landward of the top of bank) are CONSISTENT. Further, it is my recommendation that the proposed actions to clear the hatched areas (seaward of the top of bank) are INCONSISTENT with LWRP Policies 4.1 and 4.2 (below) and therefore, INCONSISTENT with the LWRP. 4.1 Minimize losses of human life and structures from flooding and erosion hazards. B. Use vegetative non-structural measures to manage flooding and erosion hazards. • SOUj�o MAILING ADDRESS: OFFICE LOCATION: o��q Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 y @ Telephone: 631 765-1938 i� ��y00UN% Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM JUL 1 1 2013 To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 17, 2013 Re: LWRP Coastal Consistency Review for NANCY S. TALCOTT & ELAINE N. ABELSON SCTM#1000-98-2-24&25 Michael Kimack on behalf of NANCY S. TALCOTT & ELAINE N. ABELSON requests an Administrative Permit to rebuild a 4' wide and approximately 270' long path to the beach with sand; remove stumps, fallen trees and dead or dying limbs & branches throughout the properties. Located: 2335 & 2545 Arrowhead Lane, Peconic. SCTM# 98-2-24&25 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 to remove stumps, remove fallen trees and dead or dying limbs & branches (landward of the top of bank) are CONSISTENT. Further, it is my recommendation that the proposed actions to clear the hatched areas (seaward of the top of bank) are INCONSISTENT with LWRP Policies 4.1 and 4.2 (below) and therefore, INCONSISTENT with the LWRP. 4.1 Minimize losses of human life and structures from flooding and erosion hazards. B. Use vegetative non-structural measures to manage flooding and erosion hazards. 0 2. Use vegetative measures to increase protective capabilities of natural protective features. 4.2 Protect and restore natural protective features. Natural protective geologic features provide valuable protection and should be protected, restored and enhanced. Destruction or degradation of these features should be discouraged or prohibited. B. Maximize the protective capabilities of natural protective features by: avoiding alteration or interference with shorelines in a natural condition The proposed clearing of the Atlantic red cedar and other coastal species within the beach/coastal plain (hatched area seaward of the top -of bank) does not support the above policies. Many Atlantic red cedars' leaves were "burned" in the area by the effects of Tropical Storm Sandy and are now re- generating. Note that several stumps and areas of "topped" vegetation is visible in the photos supplied, indicating that the vegetation was previously cleared. Figure 1. Subject parcel. Source: Bing. 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 0 James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino hO��Of SOC49 Nc pryo�yy T ��yCnuuty �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application _Wetland Permit Application Administrative Permit Amendment/Transf / tension �eceived Application: �ceivedc- ompleted Application 13 _Incomplete u _SEQRA Classification: Type IType II_Unlisted _Coordination:(date sent) �.WRP Consistency Assessment Form J7 CAC Referral Sent _ ate of Inspection: Receipt of CAC Report: Lead Agency Determination: --,Technical Review: ✓ Public Hearing Held: Resolution: L Town Hall Annex 5437'5 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 JUN - 3 2013 SoutWd Town ,oWNCY 7W1%1 Tlq4C'O7-7- Name of Applicant AZ/2441,E 4-0-YAES AAg : O Mailing Address 5-4 AAV- 9/ rT JX <%pP.'4 Al Y. Al Y. l DD Z 8 Phone Number:( ) 2/ i - jzz — 'J 5�4 98- Z -24 Suffolk County Tax Map Number: 1000 - fB - Z_ 4C Property Location: z4m5 (provide P ,j�:-jCDN/ Ca Al. Pole #, distance to cross streets, and AGENT: (If applicable) Address:-- RIVAO IPE5 RR. CIyf.P�V I/V-Y // qQl Phone: AH/ 127--2100 Ord of Trustees Applicatico GENERAL DATA Zor' 26-f 60� 984 Land Area (in square feet): LOQ Z4 (y17f7JF1 Area Zoning: a251y11 0Vr111VL, Previous use of property: 7742 -- Intended use of property:R�//1£y►/%—/i¢ L Covenants and Restrictions on property? Yes No If "Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes XNo If "Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes __�< 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 is No Does the structure (s) on property have a valid Certificate of Occupancy? —>C—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): BCO of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: %/) A156byZD Z oOZ4 66P Area of wetlands on lot: 62 S2Q t square feet I Percent coverage of lot: ,5�0 t % Closest distance between nearest existing structure and upland edge of wetlands: A4 feet Closest distance between nearest proposed structure and upland edge of wetlands: Ail,4 feet Does the project involve excavation or filling? _X_ No Yes If yes, how much material will be excavated?cubic yards How much material will be filled? 1410AIZ 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: N1ir% 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): Al il 4eF_ PROJECT ID NUMBER 0 617.20 • SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT / SPONSOR 2. PROJECT NAME eW&14* Py��Gl AW C �L ,� Ag716;�� Pzr P� T/►�JYy 3.PROJECT LOCATION: Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map NA*Z Jb 'r'V'6 ii/ O/= ~C'W/1�d7 zAA-01E OVV Az*ow#'EdW eoVZ O' OV iC a rt« /�50CWi e ,B.Vy 5. IS PROPOSED ACTION: ❑ New ❑ Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: q�0'a6x. 27�FT of �.S�T�N�.gY7'� B��1cy G 9 �r IN woo w1 p;LAip, �1i vv� J7VI iP 5 , �c6✓✓ JAS, r Dib a2 by/NG Clr�es p' �/�ANCI�Es Nv D�,J&A)47;5V ,g& X OM J7t;E- pIAg V 7. AMOUNT OF LAND AFFECTED: Initially I.R6 acres Ultimately 2.H6 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? I JV Yes ❑ No If no, describe briefly: WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) c9.. IY i Residential ❑ Industrial 1:1 Commercial Agriculture ❑ Park / Forest/ Open Space ❑ Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ElYes XNo If yes, list agency name and permit / approval: vv .�.�I ION HAVE A CURRhN I LY VALID PERMIT OR APPROVAL? ❑Yes 0 If yes, list agency name and permit / approval: 12. ASA E ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? es No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name M�(,yr/T A &1^0ve Date: Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment 0 0 PART 11- IMPACT ASSESSMENT fTo hp rmmntofarl by I ^art ennn t .A. D�-O--E-(S ACYION EXCEED ANY TYPE t 7WRESHOfD IN 6 NYCRR, PART 617.47 If yes, word -male the review process and use the FULL EAR l._J Yes Q No S. WILL ACTION RECEIVE COORDINATED RENEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 WCRR, PART 617.67 If No, a negative may be superseded by another involved agency. - 5Y [✓ He C. C0(1LD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten , N legible) . C1. Edsft air Quality, surface or groundwater quality or quantity, noise levels. existing traffic patem, solid waste production ar tfisposal, . pier" 6111F eroslen. drainage of Ibodi g problems? Explain bdaay: C2 Aeslheft agrlaAtural: arobaeaogtual, trktorl4 or otter nahral or Wirral resbuees: or or charsder? Explain bltegy: C3. Vegetation or fauna, fat4 shellfis ' speGes. sigtgflcanl tilt; s, or gu"teriendangered species? FiTtlatn bdefly. C4. A comaku tty's existing plans or goals ---Q adopted, or a change -in use or intensity of use of land or other natural resotnce57 Explain Mieffy. C5. Growth, gubseguent development, or related activities likely to be induced by the proposed adion? Explain briefly: - __.. C6. Long term, short-term, amulalive, "other effects not idenlZa in C1-05? Explain briefly. C7: Other impacts ndtM cha es in use of etttter ..ni .or�nf O. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL ARTA 7 QYes Q No E. IS THERE, OR IS 7HERE UKELY TO CONTROVERSY RELATED TO POTENTIAL AL wAP if . 0 Yrs (D Noexotairt PAPE W _ FIFMZDAAHJAiV W rte —••—•-•—_.. .. 110110107MMf Foreachadveme feo(jQanU wabomdoWnlllewh aBect shoWd be assebmif In conneclan v tl Its (a1 se#kV (La. urban or gecg(aphk saps and (4 RuWkude. If naoessa fy, add aftachum s or JO-1_1I_t�YV 1-...IL�_� _•__ th"WIN S)QW41111L Each Iftx (di (aleveraw, (e) .. (hat exQ11811atm corm it - . -. EAFatuVorpmpartapo&VvededaagwL ..-._'- ..._..,_.„„-,.a,,.,,,,e.aa,,. uwamwnmwATO=ir.ThMpraaeeddWcdytoUte FU MILL p result in haveas detem**c, based a lire iMomlegoti and analysis above and any supWft docivilaftgon, that the proposed act delenninatiat. Y I&NgoW adverse environmental impacts AND provide, on agadanenis as necessary, the reasons supporting t Board of Trustees Name of lead Agency President Pnnt or Type Name orResponsible Officer m Lead Agency Tiffe of Responsible ORcer ci .,<r.—.nrc...,.:_._-.------ e0�kTown of Southold Erosion, Sedimentation & Storm -Water Run-off ASSESSMENT FORM PPRppp�E�Ty L W .C -TA THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A " D "2 STORM -WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN Q toIffBCERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM il / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? 12437-8.4 Will this Project Retain Al Storm -Water Run -Off (Include Total Area of all Parcels located within p� the Scope of Work for Proposed Construction) Generated by a Two (2') Inch Rainfall on Site? (Ibis Item will include all runoff created by she X (S.F. r AaesI b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all — ❑ anrd/or Ground Disturbance for the proposedO Site Improvements and the permanent creation of construction activity? impervious surfaces.) (S.F.I Apes) 2 Does the Site Plan and/or Survey Slaw All Proposed BRIEF PROJECT PROVIDE DESCRIPTION (Pra,nds AtldNwW PaOaa on Na,u,El Drainage Structures Indicating Size &Location? This — ❑ Item shall include all Proposed Grade Changes andR ZFff1;&P AdMX. 7-70 cr, Or Slopes Controlling Surface Water Flow. $ Does the Site Plan and/or Survey describe the erosion >r/�qY �� gEgt^/,1 W/fApN/� and sediment control practices that will be used to ❑ control site erosion and storm water discharges. This — 4//AI IA/AQ;rR, RFJ J DVF_ J]''jiN.VSitem must be maintained throughout the Entire Construction Period. � t ✓,,v' r r� CiI,1E[ F/✓ 7 d DWAR offl&& 4 Will this Project Require any Land Filling, Grading or Excavation where there is a charge to the Natural ❑ — Existing Grade Involving more than 200 Cubic Yards / of Material within any Parcel? ��r art �r p , r I-! / ,V 5 Will this Application Require Land Disturbing Acd I' Encompassing an Area in Excess of Five Thousard �( ❑ (5,000 S.F.) Square Feet of Ground Surface? — 6 Is there a Natural Water Course Running through the ❑ Site? Is this Project within the Trustees jurisdiction 1/ or within One Hundred (100') feet of a Wetland or L1 — General DEC SWPPP Requirements: Submission of a SWPPP Is required for ell Construction activities involving sol Beach? diswrtances of one (1) or more saes; including disturbances of less than one sore that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common pan that will uMmetely disturb we or more acres of land; which Exceed Fifteen (15) feet M VBNcaI Rise a X Including Construction activities Involving sol disturbances turbances of leas than one (1) acre where One Hundred (100') of Horizontal Distance? the DEC has determined that a SPDPS permit b storm writer for stowater discharges. (SWPPWs Shall inset the Minimum Re"Imanords or the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious far Stenn Water Discharges from Conshuctlon activity -FamnN No. GP -0.10-001.) Surfaces be Sloped to Direct Storm -Water Run -Off x ❑ 1. The SWPPP shat be prepared prior so the submittal a the Not. The Not shad be into and/or In the direction of a Town rightof-way? — 9ubn*W to tlha Department prior to the mnanxaemem of construction activity. 2. The SWPPP Wal desalt the erosion and sediment control practices and where required. pcetcwwtrhrctbrh slam water management praoloes that we be used andla 9 Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any constructed to reduce tiro polulanls In storm water discharges and to ensure Item Within the Town Rightof-Way or Road Shoulder — — hwnplenc , with the to and conditions of this permit. In notation, the SWPPP shell Identify potentW sources of pollution which may nationality be effected to affect the Area? pant mw wa NOT brand, the heiseNNn a mkh APreeel quality of skxm wadardi chergas. NOTE: N Any Answar W Questions ors through Nine Is Answered with a Check Mark 3. AN SWPPPa that require time post -construction Nam water management practice in a Box and the construction she dbterbanse N betvnan 3,000 S.F. S 1 Arae In arra, conponend shell be prepared by a quelled Design Professional Licensed in New York a SbrmiWbr, Greding, Draknpe a Erosion Central Plan Is Rmuhd bytMYeast of that Is knowledgeable N time principles and practices of Slam Water Menagernent Southold and Must be Submitted for Review Prior Issuance of Any Buldanng PbhNt. (NOTE: Actions Miss (4) ouaWmN R"AW for. cm4NUM0drNm) STA17E OF NEW YORK, CC0U,NT`Y�OFy...J.'U.F.F.Q�I.�........... SS That I, ........ F.:R.I .7Xrr.F...f.`t'...I.L{./...Y..7H..�.... being duly swom, deposes and says that he/she is the applicant for Permit, (Norm o (Name I leddduea soft Doaar r Andthat he/she is the.....................................................%FN:�.......................................................................... (owner. . Agent, Corr points, 0Nov. .) Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewidAWWNY GEORGE SORBERA JR. Sworn to before me this; fiOlMy Public, State of New York ()Upjftd in Suffolk I o. 0o1SO6230 93 County N 3 ..................................�... y ........ .. ............... ,10/. a par 1- - 014 Notary Public: ........... ......... .... .......................... �.�� ...... ........... ...... ....... ...... (Signature N Applicant) FORM - 06/10 County of Suffolk State of New York Bod of Trustees Applicatio* A1DYjrnf' 196�5Z--570 L/ 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/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS Notary Public MICHAEL A. MMACK Notary Public, State of New York No. 09',1605-7^_3 Qualificd Li t:_3°_J County Tears Expi:s Larch 11'r200B i *d of Trustees Applicatiove AUTHORIZATION (where the applicant is not the owner) EL,q�iy� NGY�S' /?,BEG1bN I ,SWCy ./py11,v / yf, W7T residing at Y4 £ 9Jf JrT aer 3 (print owner of property) (mailing address) N Y Al Y f Q0 -Z9 do hereby authorize (Agent) W (i,QE,1 Al lL1,414 'L,K to apply for permit(s) from the Southold Board of Town Trustees on my behalf. • 0 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM YOUR NAME: /%Cl7iglrL Q LeI/y19PCx (Last name, first name, Middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate theother 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.) r ,&Vz 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 this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicantlagentlrepresentative) 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 a non -corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this _0 day of 20J5 Signature Print Name L Form TS 1 Town of Southold • • 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. 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" 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, listine both supportine and non- supportine facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. I n A copy of the LWRP is available in the following places: online Town of S website (southoldtown.northfork.net), the Board of Trustees O e Plgpging local libraries and the Town Clerk's office. JJUUNN B. DESCRIPTION OF SITE AND PROPOSED ACTION I uthotd ewn 91P Z 24 aero of rn�_ tt r� SCTM# �� - Z -_ Z�' PROJECT NAME 'Q�LAtAGF.l7 P, �Dr" t%GUi9Y,�DY,L I P71/`9�5. The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board ❑ 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: w1 jw)vl> E 4'<N W/D7;v KRt'PYP— . WIPSl Location of action: Z: 4S ,499 WWW LANAy,E�W C, A-$ X t ,?-58 Site acreage: Z 606 A Present land use: AV— UP- Nr1AL Present zoning classification:_je.�VEA1%%19L 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: N,qA✓ CY .17-ANTAA1 Y�W- W7 - (a) Name of applicant: /.5L0 rs (b) Mailing address: r"4 alp' �/��, 4 _3 NSW yCVZ-, IVY. lDb ZB (c) Telephone number: Area Code ( ) 2/2 7 ZZ — :f,7` ,34 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No ® If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III — Policies; Page 2 for evaluation criteria. ❑ Yes ❑ No ;0 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 — Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No W Not Applicable 0 Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III — Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No X Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III — Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No �` Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III — Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No V Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III — Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Appable 0 Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes [:]No N Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III — Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ElNo� 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. ❑ 4] No ® Not Applicable Attach additional sheets if necessary WORKING COAST POLICIP Policy 10. Protect Southold's water -dependent uses and promote siting of new water -dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No X Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Townwaters.aters. See LWRP Section III — Policies; Pages 57 through 62 for evaluation criteria. 1:1 Yes 1:1 No �J Not Applicable additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No X Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III — Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable PREPARED BY 1Z TITLE A&ENT DATE �/30�/3 - til �O Z ".S'o "Is• X4 0 .100 it A4 - J N 3 2013 34a?. 3 7 y -- _�� D vIBL JAY Q uw own +,�y/ W�`,RNp m w�DtN D `�, egg �� _q= • .gX�D= g$"z-1Rr1 'TUBS o t 14z APPROVED BY BOARD OF TRU frl low N, Y. 7PRl3vns�p Rlt-AF cDAV6l�PA7N i 1 4rj 1�JBEAl3�/, TrUMp e,&W 6N 7RE,� r• - .,• ._.. - "" -- " til . 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