Loading...
HomeMy WebLinkAboutTR-8406A John M. Bredemeyer 111, President ��gUEFl1(,r'OvaTown Hall,53095 Main Rd. G Michael J. Domino,Vice-President P.O. Box 1179�� y� James F. King W Southold,NY 11971 Charles J. Sanders �y �� Telephone(631)765-1892 Dave Bergen Ol �� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1St day of construction % constructed Project complete, compliance inspection John M. Bredemeyer III,President ��rjf SU(/ljy0 Town Hall Annex Michael J.Domino,Vice-President '`� l0 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G Q Charles J.Sanders,Trustee O • Telephone(631)765-1892 IyCOU '� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8406A Date of Receipt of Application: March 26, 2014 Applicant: North Fork Country Club SCTM#: 109-4-8.3 Project Location: 26342 Route 25, Cutchogue Date of Resolution/Issuance: April 23, 2014 Date of Expiration: April 23, 2016 Reviewed by: Board of Trustees Project Description: To renovate the existing waste bunkers at the 15th hole by constructing a new 10'-20' varying width, 520' long waste bunker; excavate approximately 5,000 cubic feet and replacing it with 5,000 cubic feet of new sand; four (4) gravel pits will be installed, each 4' high by 3' wide and spaced approximately 100' apart; and remove the existing non-functional drainage pipes. 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 Briarcliff Landscape, last dated March 20, 2014, and stamped approved on April 23, 2014. 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. John M. Bredemeyer III, President Board of Trustees John Bredemeyer, President �%UfF014r Town Hall Annex Michael J. Domino, Vice-President °° 54375 Route 25 James F. King : P.O. Box 1179 Charles J. SandersSouthold, NY 11971 Dave Bergen y�o! ,p �a°! Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field InspectionMork Session Report Date/Time: q —P.— I,-/ Briarcliff Landscape on behalf of NORTH FORK COUNTRY CLUB reuests an Administrative Permit to renovate the existing waste bunkers at the 15 h hole by constructing a new 10'-20' varying width, 520' long waste bunker; excavate approximately 5,000 cubic feet and replacing it with 5,000 cubic feet of new sand; four (4) gravel pits will be installed, each 4' high by 3' wide and spaced approximately 100' apart; and remove the existing non-functional drainage pipes. Located: 26342 Route 25, Cutchogue. SCTM# 109-4-8. 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 Notice of Hearing card posted on property: Yes No Not Applicable Info needed: Modifications: Conditions: � �" �t 1�r�✓��'✓t�--, ��-��� Present Were: .AM. Domino J. King C. Sander D. Bergen Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: John Bredemeyer, President �SUFF014� Town Hall Annex Michael J. Domino, Vice-President ��� 54375 Route 25 James F. King -,� P.O. Box 1179 Charles J. Sanders o a Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: Wlfg ioz / V Briarcliff Landscaping on behalf of NORTH FORK COUNTRY CLUB requests a re- Submission Inspection for the proposed reconstruction and expansion of the existing storm destroyed 15th hole waste bunkers overlooking West Creek. Located: 26342 Route 25, Cutchogue. SCTM# 109-4-8.3 Typeof-wea to be impacted: ✓Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland " ems 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 Notice of Hearing card posted on property: Yes No Not Applicable Info needed: Modifications: eot(zp 5- el 6-G-('S7'r- 7*-, I- A ,J PD A.)D Conditions: ` Present Were: '1J. Bredemeyer '� M. Domino t-`J. King C. Sanders rx G-F ry Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: n« ,taaw yt � a o.to« aJE aEc.o.wz xa.. p, • 1 rur_---�---- ------ ------ .um. —�— — 'h s ,:a zN ,x-xxm it oxkFJoar nom 2 O 0.3 LM +xa.« t vap N ° I. a tus � ro S „•a wa � $ Eicpcu..m..w 1.,Nq t a.x n aN cu uwmsnww« 4 •r ytpl of �araanwn M' I� I t • I %s. _ � X13 s a o- t La t�ql uaa �( n we \ oJNq i u �\ x1. 1L 'p U J Ltt KtlOD Y0' 0..1 / 1N Wg I 1N LY. • � :p �. w.n 1:Wq _ ,..a F t.iJ«p ©'I II 17 Lt} 1M )aka 1.N _1 N t.N.» 1JNq p I Qy ;sO :N 9 3 nNW I ae aa?A ro lS N,Nq LN �• N.,) vu u.te H x0.N(q J.o.Jfurtpptpx•t.sraaa:,nc}. j j ...\r� p IIA aEE afC.0.0. s ,temmx.. } n — eKE ars.Karo aaE aea.a w E n...• — �• ,� ^I � — —_ ...� __` � __:—_ _ a1011LE COUNTY OF SUFFOLK © K o pypgy t:S7ECTIONO Red aaotyTausSorwimA M w wTCN _____ EK aB.MQ 10• tart !!AIC._ LfNE „ I I 9EE SEC.NO. ,x# I oaa.aoaa 612# IJNQ , ].a alt EB2yc) ,EW � NM +N4 / � ,SCF aCVT„QD SGNp95� g I roRNOP saulNo�o � u .L._-.� f NO� � sae I ay � PeroNlc uxo lRusr .Wd i ' , //5G na. , NaN6„wnutEAtefM1 '1 / mea a. % axAk, I / x12 1 aWd I 4 2Wd aCUr1,ClD aid / I "MAW n I I a+ aEN4 ,� .�.. xwd ' .%/ " aE'N•I ...lJ. . • 3 E a » 3 � © a 5. 1.aA ' /CurCtga,t!- ,.ird :/2]'Nq \._( aa''Vd1 1,,APd ,1'Z 1.xArd 1>» tMN7 LUNI ' �t M�Jtlt W T • � � uiEtl '. --' �.. LiNc +• t1Ak1 \ a 1 EA,d • � PECOMC ( of _ winter° /•„rY q e `slur •• ,�," p`b_rs' f :'z .c� 4F.0.28 LD..4+ a ` x+, ,. Q,� Pgo E.ENcI .aN`\ `a6V41 R g 4p i"M/ NOTICE COUNTY OF SUFFOLK © x w SOUTNOLD SECTION NO G r —�— a+l ,. O --•-- ,A,uNNNtAua Real Properly Tax Service Agency r M 116 N r '� __ • r�r--.tom-- A p U...•� n .� n� a ---- P� +•� PROPERTY IMP 0 0 1 *oF sorry OFFICE LOCATION: ��� �lG MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971G�►Ol • COQ Telephone: 631 765-1938 Fax: 631 765-3136 y�4UNT`I,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President APR 1 8 2014 Town of Southold Board of Trustees From: Mark Terry, Principal Planner ""Xl.. LWRP Coordinator Boardt Tr.,. Date: April 16, 2014 Re: Proposed Wetland Permit for NORTH FORK COUNTRY CLUB SCTM# 1000-109-4-8.3 Briarcliff Landscape on behalf of NORTH FORK COUNTRY CLUB requests an Administrative Permit to renovate the existing waste bunkers at the 15th hole by constructing a new 10'-20' varying width, 520' long waste bunker; excavate approximately 5,000 cubic feet and replacing it with 5,000 cubic feet of new sand; four (4) gravel pits will be installed, each 4' high by 3' wide and spaced approximately 100' apart; and remove the existing non-functional drainage pipes. Located: 26342 Route 25, Cutchogue. SCTM# 109-4-8.3 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. 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 O���F s0UrhO/_ _ Annex Hall 54875 Main Road Bob Ghosio,Jr.,Vice-President �o P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer Telephone(681)765-1892 Michael J.Domino yCFax(631)766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Applicatio Wetland Permit Application Administrative Permit _Amendment/Transf /Ex i n MAA 2 6 2014 feceivedFee:$ eceived Application: to 1 bompleted Application �� 5oriwId `uI;Board of Trusten '. Incomplete _SEQRA Classification: Type I Type 11—Unlisted _Coordination:(date sent) LWRP Consistency Assessment Form _CAC Referral Sent: - ' tq Date.of Inspection: Receipt of CAC Report:' Lead Agency Determination: Technical Review: Public Hearing Held: 3 Resolution: Name of Applicant 1Jo -+ irk Dov 'U���b Mailing Address TO . Phone Numben((31) 3q— 3 Suffolk County Tax Map Number: 1000- (Q Q "' q Property Location: IJOr'�h+a�Kv Club a 6 4a Main tZoac� C�,t+chorjv'e- , N Y IQ3 S (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) {� Address: `�j,D f0V k— FO V Phone: I j q S r �rd of Trustees Applicati� i GENERAL DATA Land Area(in square feet): '?9 FeS Area Zoning: 0 0 0 I O q —' y 7. 1 Previous use of property: Golf Course Intended use ofro l� P P�'S'� Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes 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?_ K—No Yes If yes,provide explanation: Project Description(use attachments if necessary): 1Re q,4a escis-}ins wash bin kers of Ur. h +dol-c. . y a C'O', A01 10-J �rr s �°p0 �f Qr s�-(-.- ,�y� � v� w�►I f�� insfal�e�� e�c1� q, H x ��►•1�� afar#-, ALC O wi i BqW of Truateea Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: reno V �K i k- i )o nkp6 a- 154:h kote. Area of wetlands on lot: D _ square feet Percent coverage of lot:�mA- Closest distance between nearest existing structure and upland edge of wetlands: 75 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: K& ---- feet Does the project involve excavation or filling? No X Yes If yes,how much material will be excavated? gy o o O cubic How much-material will be filled? 5-, 000 cubic Depth of which material will be removed or deposited: ` feet Proposed slope throughout the area of operations: N A- Manner in which material will be removed or deposited: x ca-v ak►can 1Xj ex La aid 13!4 hartcl W 1 A sb b rel ?A W�eel b4, - 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): mo 517.20 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 1 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 I. 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 1-Project and Sponsor Information Name of Action or Project. NoOh 'Fork. Cour!' Club 15tH Nolo W:a61c 3vnKeo Re=V Project Location(describe,and attach a location map): 1514 W Lf, : W40 rOR.K CC)U JTRY C"6, ROOM-If, C-UTCH06U E,NY Brief Description of Proposed Action: Renov a}ie:n of IS?H We: wasrle 6mke-�S, W6tk were 4aw,7� b y Numbane S2-,-Ay avid, row are rwrt-funeA-i oral, We. rlan 1v exc,3ve �e- appooxum41e1� .5000 G..�bic��'► WfhcirS wi4% 50po culo►c {-eel of Sang. Q J`►4�e1 pits W;U a15o jx IAslallul, tack vncSsoant) y 'fed+high .md .3 feet wi4r--- snci st� &pfrvxrma4e4 y too fecf- aPafi.AVo w;,( remve mis-lir 5 non-furc.+iz>nal dr ns• Name of Applicant or Sponsor:: Telephone: 734—"7 13 Nnr �rlc Com Cl vb E-Mail: Address: co 34a KarfA Q0 a-d W BOX 7 QS- City/P0: State: zip Cod. C ktCkc) ue— N t l5'3s' 1.Does the proposed action only involve the legislative adoption ofa 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? _ �f 9 acres b.Total acreage to be physically disturbed?. 30�ooQ s�.H-e�ws c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. r3 Urban ®Rural(non-agriculture) ❑Industrial U]Commercial W Residential(suburban) P orest ❑Agriculture ®Aquatic WOther(specify): GCtf ❑Parkland Page 1 of 4 0 • 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ ❑ b.Consistent with the adopted comprehensive pian? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ a 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: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES a ❑ 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? J( 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: NA �1 ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 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? a . F]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: R1 Shoreline W Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland []Urban ❑Suburban 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 TXT 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 Hage 2 of 4 0 0 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: © .❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name:_ �-C ��r't d 6-" ' C Date: 3 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 1 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 targe impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? El 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ 3. Will the.proposed action impair the character or quality of the existing community? a 4. Will the proposed action have an impact on the environmental characteristics that caused the © F]establishment of a Critical Environmental Area(CEA)? 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 © ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ® ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? a ❑ S. Will the proposed action impair the character or quality of important historic,archaeological, (;, r`El1 architectural or aesthetic.resources? R 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, a F]waterbodies,groundwater,air quality,flora and fauna). 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 RI El problems? IL Will the proposed action create a hazard to environmental resources or human health? 5 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. FJCheck 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. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 • Town of Southold Erosion, Sedimentation $ Storm-Water Run-off ASSESSMENT FORM 3 PROPEItTY LOCATION: S.C.T.AL S: THE FOUATAWIHA ACTIONS MAY�fifI6QW RE THE SLI MBION OF A STOdM 3 et cin -NliM- -'M— C OF IMWVM- SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? Wig this Proms Retain All Storm Water Run-OAF (Include a of Area of allposeParcels beefed within .=' 7,,K5 Generated by a Two(2)Inch Rai M on Site? the Scope of Work for Proposed Construction) &F�.IM) (This hem will include all run-off created by site X Q b. What is the Total Area of land Clearing clearing and/or oonstuction activities as well as all -- and/or Ground Disturbance for the proposed30)tD00 •f f• Site Improvements and the permanent creation of construction activity? (S.F.IAcres) Impervious surfaces.) PROVIDE BE PROJWr DESCRIPnON wmwe Aa waw Pees na retried) 2 Does the Site Plan and/or Survey Shaw All Proposed Drainage Structures Indicating Size&Location?This Y Q Item shall include all Proposed Grade Changes and Ll__ w2evt�v a an 04- ISri, hd e wase bun kr�r3 Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion ❑ (PrjciS�,'r ' t,uh��ti Were dama y by NtWCane and sediment control practices that will be,used b control site erosion and storm water discharges. This SarJ(daft ),C now nodfunc:kon a 1, k)P o I&A-Is< Item must be maintained throughout the Entire i— Construction Period. v--Aca-i& e —.—9—$TMi Mai-rl N.S—b00—Sc.ft-44 la ;n.�i ! Will this Prct Require any land Filling,Grading or Excavation where there is a change to the Natural w 1 1h S,000 610 S*4. Fo,.Y,9eftj Pk f�a b< Existing Grade Involving more then 200 Cubic Yards _ of Material within any Parcel? jnststW, each rnZ�suri rw y'h19H b� 3' Wid-f' 5 Will this Application Require Land Disturbing Activities aAA,c!M GCj I O O'a'pa,r.it,.,.,I"j50 "ll .be r't5ry)ONi t Encompassing an Area in Excess of Five Thousand — (5,000 S.F.)Square Feet of Ground Surface? e-Kisti4A.cj, 4ns . 6 Is there a Natural Water Course Running through the Site? Is ibis Project within the Trustees Jurisdiction General DEC SWPPP Regul(grnernte: or within One Hundred(100)That of a Wetland or x Submbelon of a SWPPP is required for all Consbrrcdon adivldes kinmrhg sal Beach? disturbances of one(1)or mora apes; Including dMurbances of lees than one acre thatWill there be Ste are part d a larger common pan that wit W&mteyr dbturb one or moos saes d land; 7 preparation on Existing Grade Slopes v including Conslnuctbn aaftles rove Ang sol dbtuftnees of lass then one(1)acre where which Exceed Fifteen(15)feet of Vertical Rise to T the DEC has determined that a SPMS peradt Is required for storm water diadmW. One Hundred(I W)of Horiaonttel Distance? (SWPPft Shall meet the Minimum Regrdrernarfs of tine SPDES General Permit 8 Will Driveways.Parking Areas or other Impervious ❑ for Stam Wager Discharges from Construction weft-Permit Na GP41.1"01.) Surfaces be Sloped to Direct Storm-Water Run-Off1.The SWPPP shag be prepared prbr to the s0mftel of tine NOL The NOI shat be into and/or in the direction of a Town right-of-wa�ItNA submtled loft Deparbnent prior to tine commencement or oonsbuclbn aceft. 2.The SWPPP shag desafbe the erosion and sedirrrent control pnsclbes and where 6 Will this Project Require the Placement of Material, required,past-con.bucdon sbrm water management practices that will be used ancUor Removal of Vegetation and/or the Construction of any F—T&am �ae etrucled to mduce the po4in slam water dbdharga and to seem [tem of Within the Town Right- -Way or Road Shoulder wendry nca with the tents and oondigons of this penNt,in addition,the SwPPP t Shag Area?(nds Item win wr uvlude We inrum o w adwww spromj klentify polangsl Sources of pokidon which may reasonably be epected to affect the quagly of slam weler dlicimiles. NOTE: If Any Answer to questions one through Nine Is Answered win a cbwk mak 3:At MNPPPs drat require the post-ooratnadion storm water mgmegamem prectioe in a Boat and the cormbuetlon SVS distrrrfya3,000 S E 81 Ase In a coent shag be prepared by by a qualgkd Deslpn Professional hloensed in Now York a Storm Wabr.Grading, ag Draine&P.rwbe�>pp the Townnti mponof that Is laww1 dgeabb in the principles and precbes or Sioma Weter Managernent Southold and Must be SubmiaS >) I BWktgg Pu POW. Aahw*MedcN)ondlaraawsrfor Sldall"d in >;uffolk SMTE OF NEW YORK, � � M County COUNTY OF. .. .. ...........SS Y Cnmml»Non inplfai May for 2014 .............................being duly swom,deposes and says that he/she is the applicant for Permit, (Name d>n d soft Doamhera) cc \ Andthat he/she is the ........................................ T: .. s.rV . a.. .:Y............................. (owner,Conbador,Apra,corporate OBicer etc.) Owner and/or representative of the Owner or Owners,and is duty authorized to perform or have performed the said work and to make and file this application;that all statements contained in tbis_application are true to the best of his knowledge and belies,and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ^� M ....n.t.(1cl...��............................day of....1.:.! .....h....................,201.7 Notary Public: ...... 1.�..�.�.'��.1- ....... �............................. .... .. ...... .: . `�{Slgnafise d Ap�cant FORM - 06110 B(1 0f Trustees Application• I County of Suffolk State of New York A k- "RQ- Yk 0 5 BEING DULY SWORN DEPOSES AND AF IRMS 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. Signature of Property Owner SWORN TO BEFORE ME THIS D� DAY OF ,20 VA LEEANN R. MARINO NOTARY PUBLIC-STATE OF NEW YORK Qua No. 01 MA6147275 My Com tfl"to Suttoik County #xpW*i May 30-2014 Notary Public BcW of Trustees Application. I AUTHORIZATION (where the applicant is not the owner) NORTH FORK COUNTRY CLUB I, O residing at P0 oda (print ,:;"a of pro ) (mailing address) do hereby authorize (Agent) —TYJL)�Lt6 apply for permit(s) from the Southold Board of Town Trustees on my behalf. Y� (hex's signator ) APPLICANT/AGENT/REPRESEN ATWE TRANSACTIONAL DISCLOSURZ,FORM lhg Tnwe of+outhold's Code of Elwsgproh%bits conflicts of interAon the_W of bffictrs and employ &The MMse of this form is to.n.avide information which catt_alp the mm of pQmft conflicts of inum and allow ft Lo take whatever action is gyp+to avoid same. YOUR NAME: t —f, G t'1�0 (Last dame,first name,middle initial,unless you are 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 X Variance 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 this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check 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 -24 day ofA4tDLrA _200 • Signature. Print Name Form TS I Town of Southold • • LNM 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 Towel 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- listing both supporting and d nou- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION E �tr. _V E SCTM# O o 0 4 — 7. 1 MAR- 2 6 2014 PROJECT NAME 15TH Hole, WU4e_ Rinker ReAoaa-;on 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: Genova--lion. of P�cisfi � nEx�-fun.c�-ic�nal wa��b�nkcrs TW �c f-{ x 3� w;cl ��- i nil P�e�-►�►-c_,�3-svr-i n� �' K 3 W t • Location of action: l"J&k-CooAu du�, Rook�5�4,�kh e.N� y :l5V Ho Site acreage: ui- _ xWs Present land use: ,W-Vu j oh and Gnlf Co'dcs-e Present zoning classification: L'pmG`i 3 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: No A Toi'k dou ub (b) Mailing address: M:;Piti ZW Fb Box :7, (c) Telephone number:Area Code(i,3�) V I :Z 1,3g (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. 0 Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 2. Par*ct and, preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ Nom Not Applicable 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 © 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 S. 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 �-N 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 ApAle 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[LJ 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 LNVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes F] No lelaNot 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 LMW Section III-Policies; Pages 38 through 46 for evaluation criteria. nn ❑ Ye�] No LTJ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIEO Policy 14. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No © Not Applicable 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 0 Not Applicable 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 M 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 ® Not Applicable PREPARED BY ..� TITLE LWCDATE _Z T� at LANDSCAPE www.briarcIlfflondscap*.com February 25,2014 fico '-a MAR - 5 2013 Su Dear Southold Town Trustee Department, rd of T i st . We would like to meet with The Southold Town Trustees on site at The North Fork Country Club in Cutchogue to have a field inspection of the two waste bunkers that we plan on restoring. The two waste bunkers are on the 15''hole overlooking West Creek. Thank you, Don Wilcenski Neal Cichanowicz Joyce Grigonis Odea.(631)765-1220 PO box 222,9aconk,NY 11950 Pax:(631)7"-0015 1.1635 Rau#*25 i I Ad of Trustees Application 1 County of Suffolk State of New York ��re BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE 3 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 F HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS I APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATTVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. I r ! e of PropeAy Owner SWORN TO BEFORE ME THIS 1 S� DAY OF ,20 `I LEEANN R. MARINO NOTARY PUBLIC-STATE OF NEW YORK No. 01 MA6147275 c CUO"fied in Suffolk County My CommbrNon Expires May 30, 2014 Notary Public J . B& of Trusteed Application i' l AUTHORIZATION (where the applicant is not the owner) u6 r, g en eliding at O 3o� — !' (print owder of pro ) (mailing address) qcZ �v 075– do hereby authorize (Agent) ��.a� �r -Loc• c� to apply for permit(s) from the Southold Board of Town Trustees on my behalf. f ere {Own s i a e) 10,000 60UAIZE fool \VA6TF E5U N 4F- z 0 ?-0' VIpr- 15 Fool o DL4Mr.TrJZ GRAVEL PIT g �z. ... r 520' LONG DMUM .,,.. ��.. 4uAvLL PIT APPROVED BY BOARD OF TRUSTEES 3 FOOT TOWN OF SOUTHOLD �Q•\J�'� <V.Avt.L Prr oDATE -3// ;;pVETLM Pt) 3Four z DIAMGTGfZ ` 41 AVLL PIT /01 ''/D Boar f Tr ae 2" DEEP SAN C) TOP PRLbbI NG .......... ... ............................... NO'T TO SALE ` . . , � . �� 12" DEEP 3/8" AM Joe� N L. PEA ( ,IZIT NfCC 15Tfl .HOLE VA6TL E5U N 4LR.S -- t LOCATION: UTnjo(;U�,: NY P �y&' E ,��,-." EXISTINIt ?� ��y �, , - , - � , - � , - , - , - ALE 5141, PEA R.I a14F20 yy" � DATA: 12-2x3 12-3N3 ART IN SECTION Vi E��/ o f GZAVEL PITS 3-20-I4 •ANDSCAPE • 36" \\/IDE o 60UAIZL ooT MA.STL. E5U N V LZ Mtn .;r.: O 3ri. Foal DIAMUck PIT5 FOOT 52o LoN G DIAMGT� -RAVI MT APPROVED BY O BOARD OF TRUSTEES 3 FOOT o1olo- pI,,,ML= TOWN OF SOUTHOLD 4u.Avc.l_Prr 30 DATE Z AVL Rtt ^ T LAN D6 rs -•�- t DIAMGTGR <V-AVLLPff i01 t Board of Trustees LIZ " me p SAN[) Top Pu bbi N(; ............................... NoT To SCALr 12" DLLp 3/80 Joe) NAML: PL4 GZIT Nf CC IsTLWJ flOLF \VAbTL E5U N 4F- R.6 % a, , LOCATION: cuTcflxu1,: NY " fi �W � ' � Y� tet, SCALA 314 O i PEA (;PIT VN y� 11 — 20 �,�• ��, �-t, moi,� Wit,�• �a 12-2 0-13 NO ART IN J F dcC1 ! l .5ECTION \/I LA/ OFGZ4\/LL PIT-5 3-20-I • • LANDSCAPE 36" \VI DF-