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HomeMy WebLinkAboutTR-8326A James F. King, President o~@e~ffO~ rCO Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President P.O. Box 1179 Dave Bergen Southold, NY 11971 W John Bredemeyer oy~o Telephone (631) 765-1892 Michael J. Domino 1 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction _ %2 constructed Project complete, compliance inspection James F. King, President OF SO(/Ty0 Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen Southold, New York 11971-0959 John Bredemeyer G Q ~O Telephone (631) 765-1892 Michael J. Domino O OOUNTY Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8326A Date of Receipt of Application: October 28, 2013 Applicant: Mattituck Park District SCTM#: 126-6-17 & 18 Project Location: 11020 & 11280 Great Peconic Bay Blvd., Mattituck Date of Resolution/Issuance: November 13, 2013 Date of Expiration: November 13, 2015 Reviewed by: Board of Trustees Project Description: To repair three (3) landward drainage assemblies in the existing asphalt parking lot by removing the surrounding asphalt, excavating the soil surrounding the drywells, and repairing or replacing the damaged drywells; crushed rock will then be filled in around the drywells, and a maximum of 1,850 square feet of new asphalt will be installed on top. 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 Joseph Fischetti, Jr., P.E., received on October 28, 2013, and stamped approved on November 13, 2013, and as also indicated on the survey prepared by John C. Ehlers, Land Surveyor, last dated June 28, 2013 and stamp approved on November 13, 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 snFra~~ James F. King. President P.O_ Box 1179 Bob Ghosio, Jr., Vice-President 'tF Southold, NY 11971 Dave Bergen ? Telephone (631 765-1892 John Bredemeyer ,r Fax (631) 765-6641 Michael J. Domino Gy Z' 'yol ,~aor Southold Town Board of Trustees 1nFiield Inspection/Work Session Report Date/Time: 'v-Y 6, 2- 11 Suffolk Environmental Consulting on behalf of MATTITUCK PARK DISTRICT requests an Administrative Permit to repair three (3) landward drainage assemblies in the existing asphalt parking lot by removing the surrounding asphalt, excavating the soil surrounding the drywells, and repairing or replacing the damaged drywells; crushed rock will then be filled in around the drywells, and a maximum of 1,850 square feet of new asphalt will be installed on top. Located: 11020 & 11280 Great Peconic Bay Boulevard, Mattituck. SCTM# 126-6-17&18 Type of area to be impacted: -Saltwater Wetland -Freshwater Wetland -Sound -Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 _Chapt. 111 -other Type of Application: _ Wetland -Coastal Erosion -Amendment -Administrative-Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Preset Were: A~-J. Kin$ /Ghosio VID. Bergen, 4J. Bredemeyer M Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: • Drainage Leaching Basin Repair Specifications (2) Leaching basins as directed by the Park District 1. Saw cut and remove the asphalt at basins as required. 2. Remove all impervious material from the sides and bottom of the leaching basins and remove material from site or as directed by the Park District 3. Wrap leaching basins with filter mesh 4. Backfill the sides to 3 feet with stone 5. Backfill the bottom with 3 feet of stone 6. Reinstall the cast iron grate to grade as required 7. Backfill the top of the concrete cover with compacted RCA to grade NEi • E88ty~ D OCT 2 8 ,;',3 T - D OCT 2 8 soautuiu icwri8' Diameter j ~ ' MIN. 3' MIN. • FILTER MESH aIF ar 3/4' steno 7-0" to groundwater LEACHING BASIN DETAIL WEHry~ 9 .05 46~C MAYFITUCK PARK DIS RICI' I'roperty Situate: 11280 Peconic Ray Boulevard, Mattituck, NY SCI'M#: 1000- 126-6- 17K 18 F 'POW Y t s r r ~ oy ^ "zr,•~ ~ ~ s~~` "s~ lX~~'~~U ~ fi ~ fir.' I t "t kn- ~ .r sY °•+P'-c a r-' ...7 P.~; .r i ~ .~a<` S~'~ I~,w so tc , A~ N-1 f A ,~'2. ~e.~.r~ r~Y - ..t! s r +C. si' ~ rR s-` y f' f 44 -'s-r~i c.~~ i F~'`i~ Sri' rx~f ` ' FS' CCT 2 8 I Board-uf Trustees Photograph shoving one of the three damaged drainage assemblies to be replaced. Photograph taken from the center of the subject parking lot facing northeast MA1"1'I1'1'C'K PARK DISTRICCI' Property Situate: 11280 Pec•onic Bay Boulevard, Maltituck, NY SCI :M#: 1000 - 126- 6 - 17 K 18 Y ItWW.C.9-NJC lit. WANkAk ......us. :i',... ! 14ir OCT 2 8 So~thau icw8 ar of Tr Photograph of the parking area. Photograph taken from the bulkhead on the subject property facing north. AdIk MA11'I1't iCK PARK DIS'FRIC T I'roperty Situate: 11280 Pee•cmic Bi tv Botiicx•ard, Mattitiick, NI' SC"1'M#: 1000 - 126 - 6 - 17 K 18 n Blow MMIfY: L t:j - - e'L7??W OCT 2 8 Photograph of the parking area. Photograph taken from the edge of the suhject parking lot facing east. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I A y J I . ~ m ? ,f to 1 9 J / ~ J / ~ V V V N`m~ , 9 b / e it .J V ¢VJ •f j ~ / zwe I• ~ ~ t i gym;.: s / «w / a s / s s / iry ~ ' i • ~ sesxn .m / A / 4- N ~ COUNTY OF SUFFOLK © ° cnwm R.1PPmperty Samm AW . w u ~Z6 OFFICE LOCATION: o~~OF SO(/lyOl MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 * l~ Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) d+ *c Southold, NY 11971 Q Telephone: 631 765-1938 Fax: 631765-3136 ~y00UNV,~ LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President NOV - 7 2013 Town of Southold Board of Trustees From: Mark Terry, Principal Planner outl""" LWRP Coordinator I- Board ' s v ' Date: November 7, 2013 Re: LWRP Coastal Consistency Review for MATTITUCK PARK DISTRICT SCTM# 1000-126-6-17&18 Suffolk Environmental Consulting on behalf of MATTITUCK PARK DISTRICT requests an Administrative Permit to repair three (3) landward drainage assemblies in the existing asphalt parking lot by removing the surrounding asphalt, excavating the soil surrounding the drywells, and repairing or replacing the damaged drywells; crushed rock will then be filled in around the drywells, and a maximum of 1,850 square feet of new asphalt will be installed on top. Located: 11020 & 11280 Great Peconic Bay Boulevard, Mattituck. SCTM# 126-6-17&18 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 EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "B" which states: B. Replacement, rehabilitation or reconstruction of a structure or facility, in kind, on the same site (inplace), including upgrading buildings to meet building or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures may not be replaced, rehabilitated or reconstructed without a permit and shoreline erosion control structures (including, but not limited to, groins, jetties, bulkheads, filled piers) located within Great Peconic Bay, Cutchogue Harbor, Little Peconic Bay, Hog Neck Bay, Noyack Bay, Southold Bay, Shelter Island Sound, Pipes Cove, Orient Harbor, Gardiners Bay, Long Island Sound, Fishers Island Sound and Block Island Sound (excluding all creeks); 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 Coastal Erosion Permit Application Wetland Permit Application X Administrative Permit Amendment/Transfer/Extension Received Application: 11.18113 ReceivedFee:$ 004~2 - Completed Application: 1 18 D I, - _ {I ~w Incomplete: .m K, D SEQRA Classification: Type I -Type II Unlisted- OCT 2 Coordination(date sent) Y_LWRP Consistency Assessment Form: I I-3 `l Date of Inspection: (1 f(1l othoiti ;awn Receipt of CAC Report: Tr Lead Agency Determination Technical Review: )Public Hearing Held: /11)-;,/13 Resolution: Name of Applicant MATTITUCK PARK DISTRICT Address P.O Box 1413, Mattituck, NY, 11952 Phone Number: (631) 537 - 5160 Suffolk County Tax Map Number: 1000-126-06-17&18 Property Location: 11280 Peconic Bay Boulevard. Mattituck, NY (provide LILCO Pole distance to cross streets, and location) AGENT: fames F Laird 0 Suffolk Environmental Consulting, Inc. (If applicable) Address: P.O. Box 2003; Bridgehampton, NY 11932 Phone: (631) 537 - 5160 Board of Trustees Application GENERAL DATA Land Area (in square feet): 280,490 square feet ± Area Zoning: R - 40 Previous use of property: Park (Veteran's Memorial Park) Intended use of property: Park (Veteran's Memorial Park) Covenants and Restrictions: Yes X No If "Yes", please provide a copy. Does this project require a variance from the Zoning Board of Appeals Yes X No If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes X No Prior permits/approvals for site improvements: Agency Date Board of Trustees Permit No. 4507 1995 Board of Trustees Permit No. 6541 2007 Board of Trustees Permit No. 7125 2009 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): Applicant proposes to repair the three [31 landward drainage assemblies in the existing asphalt parking lot This will consist of removing the surrounding asphalt, excavating the soil surrounding the drywells, and repairing the damaged drywells. Crushed rock will then be filled in around the drywells, and a maximum of 1850 square feet of new asphalt will be installed on top. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purposes of proposed activity: Ap lid cant proposes to repair the three [31 landward drainage assemblies in the existing asphalt parking lot. This will consist of removing the surrounding asphalt, excavatine the soil surrounding the dryEells and repairing the damaged drMells. Crushed rock will then be filled in around the drywells, and a maximum of 1550 square feet of new asphalt will be installed on top. Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structures and upland edge of wetlands: 0.0'+ feet (exrsdng Bulkheading) Closest distance between nearest proposed structures and upland edge of wetlands: 120 feet (proposed drainage assembly) Does the project involve excavation or filling? No X Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): No impact to the tidal wetlands is anticipated in that the work being performed is landward of an existing bulkhead. Board of Trustees Application N/A COASTAL EROSION APPLICATION DATA Purposes of proposed activity: 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? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 - Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part I - Project and Sponsor Information Name of Action or Project: MATTITUCK PARK DISTRICT Property Project Location (describe, and attach a location map): 11280 Peconic Bay Boulevard, Mattituck, NY SCTM#: 1000 - 126 - 06 - 17&18 Brief Description of Proposed Action: Applicant proposes to repair the three [3] landward drainage assemblies in the existing asphalt parking lot. This will consist of removing the surrounding asphalt, excavating the soil surrounding the drywells, and repairing the damaged drywells. Crushed rock will then be filled in around the drywells, and approximately 615 square feet of asphalt will be installed on top of each drainage assembly, 1850 square feet in total. Name of Applicant or Sponsor: Telephone: 631 - 537 - 5160 James F. Laird - Suffolk Environmental Consulting, Inc E-Mail: James.F.Laird@gmail.com Address: P.O. Box 2003 City/PO: State: Zip Code: Bridgehampton New York 11932 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no, continue to question 2. 2. Does the proposed action require a permit, approval or funding from any other governmental Agency? NO YES If Yes, list agency(s) name and permit or approval: ? 3.a. Total acreage of the site of the proposed action? 6.4 acres b. Total acreage to be physically disturbed? <0.1 acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? _ 6.4 acres 4. Check all land uses that occur on, adjoining and near the proposed action. ? Urban ? Rural (non-agriculture) ? Industrial ? Commercial 0Residential (suburban) ?Forest ?Agriculture mAquatic ?Other(specify): ZParkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ? ? b. Consistent with the adopted comprehensive plan? ? ? ? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ? 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO YES If Yes, identify: Peconic Bay ? 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES ? b. Are public transportation service(s) available at or near the site of the proposed action? ? c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ? 9. Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements, describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No, describe method for providing potable water: _ ? Project is to repair drainage assemblies. As such no potable water is required. 11. Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: ? Project is to repair drainage assemblies. As such no wastewater capacity is required. 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ? b. Is the proposed action located in an archeological sensitive area? ? 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain NO YES wetlands or other waterbodies regulated by a federal, state or local agency? b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody? ? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: 0Shoreline ?Forest ?Agricultural/grasslands ?Earlymid-successional ? Wetland ?Urban 0Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? ? 16. Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge, either from point or non-point sources? NO YES If Yes, ? a. Will storm water discharges flow to adjacent properties? ? NO ?YES b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: ?NO []YES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: ? ? 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes, describe: 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or NO YES completed) for hazardous waste? If Yes, describe: W1 ? I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor ame: ame . Laird - Suffolk Environmental Consulting, Inc. Date: Signature: Part 2 - Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept "Have my responses been reasonable considering the scale and context of the proposed action?" No, or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ? regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? nit 3. Will the proposed action impair the character or quality of the existing community? U2 4. Will the proposed action have an impact on the environmental characteristics that caused the ? establishment of a Critical Environmental Area (CEA)7 5. Will the proposed action result in an adverse change in the existing level of traffic or ? affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate I ? reasonably available energy conservation or renewable energy opportunities? L-1 7. Will the proposed action impact existing: a. public / private water supplies? b. public/ private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic, archaeological, ? architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, I ? waterbodies, groundwater, air quality, flora and fauna)? u Page 3 of 4 No, or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? 1 1:1 11. Will the proposed action create a hazard to environmental resources or human health? H 1:1 Part 3 - Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered "moderate to large impact may occur", or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. ~ R)]J dr Tg(.)5 ~f ado() / 13 Name of Lead Agency Date \ fito r_5 F Izl 6- d0965 PZAl1- Print or pe Name of Responsible Office in Lead Agency Title of Responsible Officer Sign re of Responsible Officer in Le Agency Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 i i Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) Wei UERRY GOEHMNGM PARK COMMISSIONER residing at 11280 Peconic (print owner of property) (mailing address) Bay Boulevard; Mattituck NY do hereby authorize Suffolk Environmental (Agent) Consulting„ Inc. _ to apply for permit(s) from the Southold Board of Town Trustees on our behalf. (Owner's signature) a- County of Suffolk State of New York GERRY G_OEHRINGER PARK COMMISSIONER -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 HISMER 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 HARMELESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY BIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(SO, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signat re SWORN TO BEFORE ME THIS a DAY OF 20 ~ Ac- Notary Public VICKITOTH NotaryNPublica0I of Now York Q~aT innires Suffolulu 28. lk C 8 g& Comm ission Ez i i APPLICANT TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the town officers and employees. The purpose of this form is to provide information which can alert the town of Possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: GOEHRINGER, GERRY (PARK COMMISSIONER) Last name, first name, middle mit , un ess you are applying in the name o someone else of other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of zone Approval of plat Exemption from plat or official map Other (If "Other," name the activity.) x Wetlands Permit 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 y NO If you answered "YES," complete the balance of this form and date annd~~ sign where indicated. Name of person employed by the Town of Southold Title or position of that person _'2 / Describe the relationship between yourself (the applicant) and the town officer or employee. Either check to 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 then 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 noncorporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or --PM) the actual applicant. DESCRIPTION OF RELATIONSHIP / l On/ S" l~ l/i?L /tG~~ /~J U G~ ' d J ~ ai Submitted this ! day of "1 1 ' H 20 Signature Prin ame ~ Town of $ou ho#c Erosion, Sedimentation & Stornj- Afar RVpn o 1~SSE SMENT FORM PrtoPEaiv LOCATgN: 5.c.7x r. 1 ,e" ` MAIIWISSON GFA 1000 - 126 - 06 - 17&18 '6F6G.i' 'ltiaon -MeT 'TnT- NTA SCOPE OF WORK - PROPOSED CONSTRUCTION rrEM # / WORK ASSESSMENT Yea No a. What Is the Total Area of the Project Parcels? (Include Total Area of ail Paces located within 6.4 acres ± GeWsnerated Protect Retain AN StoR*M Site? Se Q the Scope of Work for Proposed Construction) (s.F. /Aaro) G(This enerated micro[ will by Include al Inch licrea A o on by tike b. What Is the ToW Area of Land Clearing dm *V anNaInclude entW[rctlort ail ion al'ttiNtiee a a ks wok as all and/or Ground Disturbance for the proposed < 0.1 acres ± Site Improvements and the pemmnent creation of cernetrULtiOtt adivky! (S.F. //ua.r) 2 Dees thaw and/or Survey Show m Proposed PROVIDE BRIEF PROJECT DESCRIPTION tAww..merr Pro. a oration Dralnege thft res Indicating Size E Location? This ? Item AM Include all Proposed Grade Changes and Applicant proposes to repair the three f31 landward Slopes Controlling Surface Water Flow. drainage assemblies in the existing asphalt parking 3 Does the Sue Plan adlorSurvey describe the emsion ? lot. This will consist of removing the surrounding and sediment control prectices that will be used to control site erosion and storm water discharges. This asphalt, excavating the soil surrounding the drvwells. Rem must bemaiitainedttwaghxdtheEntire and repairing the damaged drvwells. Crushed rock C°"stmctlonPertoe• will then be filled in around the drvwells, and a 4 WIN this Project Require any Land Fltiang,Grading or maximum of 1850 square feet of new asphalt will be EXCWSaonwhere there Is achange rotheNature] [existing Grade Involvnp more than 200 Cubic Yards _ installed on top. of Material within any Parcel? 5 Will titb Application Require Land Disturbing Activities Encompassing an Area In Excess of Five Thousand ? (5,1100 S.F.) Square Feel of Ground Surface? 6 Is Ohre a Natural Water Course Ruxvnkg tixough the Site? Is #6 Project within the Trustees jurisdiction DaraW DEC 61" Roauke naas: or within One Hundred (100') feet of a Wetland or suanMbn of a PWPP is mogL*ed br as CamtnKOm adMbes invohkq sa Ream? draxbrres eons (t) a moo tines; indudalp dia+onms a ra aan ere sae Thu 7 Will there be Site. preparation on Existing Grade Slopes an pat a e tugaoarwen plan aul wa manlydraeb as ormae aao a Iend; which Exceed Fifteen (15) feat of Vertical Rise to bWdrg Wmeuarn aarbee swoMkg sa disMbance. a nee than we (1) sae whm One Hundred (10(y) of Horizontal Distance? - the DEC bas dalnmaad apt a SPDW perm is mwAW for asrm warn disdargee. (swPpre sho mot the ftw.mm Requimmuo oar srDEa [rennet Mrma 8 WN Driveways, Per" Areas or cow impervious for sons water DtsdmW kern construction WINIty. Persil Ra OPa.faaw.) Surfaces be Sloped to Direct Storm-Water Run-Off 1. Te aWPPP Nom be paps sd pMr loaa.vawlw a me wol. Te tfa one be Into and/or In time direction of a Town dgtaof-ways - submMrdlotheDepeMmMPrWbteraXMW ffWM of waftotlonsanV 2. The SWPPP shall 0"abe one wodan and sediment cwJM pradlon sit when 9 will this Project Require me Placement of Material, ropied, lms(oonssueamm abnrtraM nmweara* pmdion sr w¦ ere nod aroma Remove! of Vegetation ad/or the ConeWdfon of any =wabcYd 1a M* #4R0ailarm in siouriwNaardam,as vnd ins axe tom Within Ore Town ROW-Way or Road Shoulder - wefillrlwfiisodmndapmnabr. pwmM.bsddMion, the BWPPP tlpI Area? lmstr+ wsaoresbaftk ww.n rwtwwrM«+J Id~ypalar/Y sbrrM aparAbewfmkh m+Y me>ronadY he stpedW o Nod tin k atrsilyasmrmaalerdrdurgn. Inas RAti oo rbOwrseu+Dns MM 10erMpwv bckN S.Aa$QVPPPa anM msn'1la aia poseeaWmuctlon sbrmwarr nrnaparwxa.dk. tasasaM errfte,tion- aea sioaaa.b.ve.r MbNw+sin 4.400 Z.F. F. & IAaabsna, cwrgxxdAdbapi p.rsaeyagarrdDesign Pm1eeernwt.kensedrwwYork +ab~.waw, y gmaro.&erca ocamotPrnrR.aram 'byewr~ar IMYknvNstlgabrhMpamncOrs era predkesa StamwNar AloeOemeru. aoullmta.nCf6.taan"M "Mview fhfo:to manna army auks"p- axni•= nttawra sews Nl esdr«amm~r/areadr onwamkPeawas fer.tknakns MWasm) ~ SI'A17EOFNEWYORY, SUFFOLK COUN1eOF.... @SUFFOGC - SS 11ra[1 . ENVIRONMENTAL CONSULTING, INC. being drily swum, deposes and says that he/she is the applicant for Pen-nit, [Rase areMdmw aerie Doaxnaa) And that he/she is the AGENT (owner. Cerweclor, PaaM. papaw otpc«..Ir:i 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 love to the best of his knowledge and belief, and that the work will be performed in the manner set forth in the application Fded herewith. Sworn to before me this; / NICHOLE L MARKO Kl .........A. day, of . O.nrL`!Y1oa . 2013 / f~uillNd 1, Scapa of Yak .1,~ nt3ld1o1t my Notary Public. ^AW~J! No:O1MA82e0712 (sgnswed~~xplnwMay ,201; FORM - 06110 0 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 Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 126 - 06 - 017 & 018 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: Applicant proposes to repair the three 131 landward drainage assemblies in the existing asphalt parking lot. This will consist of removing the surrounding asphalt, excavating the soil surrounding the drywells, and repairing the damaged drvwells. Crushed rock will then be filled in around the drywells, and a maximum of 1850 square feet of new asphalt will be installed on top. 0 Location of action: 11280 Peconic Bay Boulevard; Town of Southold. New York Site acreage: 6.4 acre ± Present land use: Park Present zoning classification: R-40 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: Mattituck Park District (b) Mailing address: P.O. Box 1413; Mattituck, New York 11952 (c) Telephone number: Area Code ( 631 ) 872 - 5211 (d) Application number, if any: N/A Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ? No N If yes, which state or federal agency? NYSDEC 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 Subject proposal is consistent with this policy in that it attempts to expand access to Veteran's Park by improving the functionality of the existing parking lot through proper drainage, thereby increasing the efficiency of infrastructure and easing the use of the parking lot. 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 ® Not Applicable Policy 2 is not applicable in that subiect lot and the surrounding neighborhood cannot be deemed a substantial historic and/or archaeological resources. 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 5 through 7 for evaluation criteria ® Yes ? No ? Not Applicable Subject proposal will not adversely impact the visual quality of the surrounding area in that the proposal is to simply replace damaged drainage assemblies already in place in the parking lot. 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 Subject proposal will fully comply with Policy 4 in that the proposed repair of existing drainage structures will better handle large amounts of rainfall than the currently existing drainage assemblies. 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 ® Not Applicable Subject proposal is not applicable to this policy in that it will have no effect to the water quality/supply within the surrounding area. 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 Applicable Subject proposal will maintain the quality of the surrounding ecosystem in that the proposal is to simply repair the existing drainage assemblies that are already in place. Accordingly, this g_roiect will comply with Policy 6 Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria ? Yes ? No ® Not Applicable Subject proposal is not applicable to this policy. Attach additional sheets if necessary 0 0 Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ? Yes ? No ® Not Applicable Subiect proposal is not applicable to this policy. Attach additional sheets if necessary PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria ® Yes ? No ? Not Applicable Subject proposal is to maintain and preserve the public use of this waterfront park. Consequently, this proposal complies with this Policy. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria ? Yes ? No ® Not Applicable Subject proposal is not applicable to this policy. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town Waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria ? Yes ? No ® Not Applicable Subiect proposal is not applicable to this policy. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ? Yes ? No ® Not Applicable Subject proposal is not applicable to this policx Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ? Yes ? No ® Not Applicable Subiect proposal is not applicable to this policy. Attach additional sheets if necessary Created on 11612006 @ 1:00pm Suffolk Environmental Consulting, Inc. Newman Village, Suite E, 2322 Main Street. P.O. Box 2003. Bridgehampton, New York 1 1 93 2-2003 (631) 537-5160 Fax: 37-5291 Bruce Anderson, M.S., President P' ~ii @ n October 23, 2013 OCT D 2 8 Mr. Jim King, Chairman 4-i,. i~ is Southold Board of Trustees P.O. Box 1179 Southold, NY 11971 Re: MATTITUCK PARK DISTRICT Property Situate: 11280 Peconic Bay Boulevard; Mattituck Southold; New York SCTM#: 1000 -126-6-17 & 18 Dear Mr. King, As you know, this Firm represents the Mattituck Park District in their efforts to renovate Veteran's Park. In order to further improve on the conditions at the park, the Mattituck Park District is proposing to repair the three seaward leaching basins in the parking lot at Veteran's Park. Accordingly, I have attached the following: • Three [3] copies of the Administrative Wetlands Permit Application including signed authorizations from the applicant. • Three [3] copies of the Survey of the subject property, showing the existing conditions thereon prepared by John Ehlers LS last dated June 28, 2013. • Three [3] copies of the Project Specifications certified by Joseph Fischetti, P.E. • Three [3] copies of Photographs showing the current condition of the subject parking lot • A Check for the requisite application fee, made payable to the Southold Town Trustees ~91jw enc. cc: Mattituck Park District Drainage Leaching Basin Repair Specifications (2) Leaching basins as directed by the Park District 1. Saw cut and remove the asphalt at basins as required. 2. Remove all impervious material from the sides and bottom of the leaching basins and remove material from site or as directed by the Park District 3. Wrap leaching basins with filter mesh 4. Backfill the sides to 3 feet with stone 5. Backfill the bottom with 3 feet of stone 6. Reinstall the cast iron grate to grade as required 7. Backfill the top of the concrete cover with compacted RCA to grade N M ~EB: APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE L ( /3 /3 B?' Diameter 3' MIN. 3• MIN. FILTER MESH 4.O" j 1 314' stone 7-0" to groundwater LEACHING BASIN DETAIL pF NEI' e •V ~ 9 ,*O. OSY~~ SURVEY OF PROPERTY N SITUATE: MATITrUCK APPROVED BY W E *T T ~ BOARD OF TRUSTEES TOW1V : SOU HOLD TOWN OF SOUTHOLD S SUFFOLK COUNTY, NEW YORK DATE 13 SUFFOLK GOUNTY TAX WS 1000- 126-6-I1 1000-126-6-18 n [ Q} D SURVEYED: JUNE 23,2006 lunuf SEPTIC ADDED JULY 18, 2006 8 2013 SEPT. 6, 2006, MARCH 24, 200-7 T ~2 APRIL 17, 2001, DEG. 12, 2004 UPDATED JAN 21, 2013, FEB. 12, 2013, [CC PROPOSED ACTIONS MARGH E5,2013 - _ _ REVISION MARGH 24, 2013, JUNE 28, 2013 I s _ 10 C RTEMM 7th: s ~wp06 f 1 I I r a vt~- 11 111, 1 I 1 I ! \ 1 q~ 65 Y o t 9d APP \ O 1 1 \ i P \ } 6 01 / PSp\ I (RD p X Jib ` 8i 3 9P •v o+ i / q \i 4 ~y\\od \ k. k~ a`~ ~c ` \I\ . \I 1. yea. a _ _ \ Y \ I \ f~ \ \ \ 1` 1` \ 5t m ~1 is ~l 9 ~Q I V\50 y tF ° \ \`I •4 \ W\\dew9 ~ ~~f mHt e 6` \ ~ \ 1 \ f T _ G\oP ~ o 10 .06 .01 6,54w S~~1%.94? h . a , i i X14 LLII l 0$ l l i'o~eti / / sg9 ~ fep~, Notes: 10 of At ¦ MONUMENT FOUND (PROPOSED CONTOUR) yQ,,o ~G.J FEMA FLOOD ZONES AS ANNOTATED FROM FIRM MAP NO. 36103G0452 H DATED SEPTEMBER 25,200q ELEVATIONS REF NAVD TO DATUM 10 FOOT NON-TURF BUFFER LANDWARD OF THE NEW BULKHEAD 6RAPHIG SCALE I"=50' 020 tAND TO BE PLANTED WITH BEACH GRA55 I FOOT ON CENTER AREA = 280,4-10 5F or 6.4382 Acres 0 50 100 150 JOHN C. EHL.ERS ?HLERS LAND SURVEYOR p6 ~E{A~pSpT[ ]MpA.~~INSTREET MT N.Y.S. LIC NO. 50202 R VERHEAD, N.Y.11901 11901 369-8288 Fax 369-8287 REF.CAUwn\ToLa\Drop60x\06\06\0 iDmpbox106106V06-203 sandy update.pro