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TR-8395
• i John M. Bredemeyer 111, President gf0(,�c Town Hall, 53095 Main Rd. Michael J. Domino,Vice-President ��� �G� P.O. Box 1179 James F.King W Southold,NY 11971 Charles J.Sanders oy 1� Telephone(631)765-1892 Dave Bergen 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 AIL li BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK I PERMIT NO. 8395 DATE: APRIL 23,2014 i ISSUED TO: KATHRYN A. CAMPBELL PROPERTY ADDRESS: 570 HIPPODROME DRIVE, SOUTHOLD SCTM# 66-2-12 AUTHORIZATION .f \ ' Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 23,2014,and in consideration of application fee in the sum of$500.00 paid by Eileen A. Powers,Esq. and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to remove existing platform structure from existing dock, i remove existing wooden decking and replace with open-grating style decking and adding any additional support framing for grating as needed; completely remove I existing catwalk and construct a 2' x+/-43'6" in new location using open-grating style j decking and 4"x4" posts; and attach existing platform onto seaward end of catwalk; i with the condition vessel is not to exceed 14' in length at dock; and as depicted on the site plan prepared by Costello Marine Contracting Corp., last dated April 8,2014, and j stamp approved on Aprif23,2014. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. i o�0gl1FFQ�,f.co , co = Dave Bergen-Absent y�►ol i TERMS AND CONDITIONS The Permittee, Kathryn A Campbell residing at 570 Hippodrome Drive Southold New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title,or interest in real or personal property held or vested in a person not a party to the permit. John M.Bredemeyer III,President �*rjf SD(/jIyo 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 Telephone(631) 765-1892 Charles J.Sanders,Trustee O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 23, 2014 Ms. Eileen A. Powers, Esq. 456 Griffing Avenue Riverhead, NY 11901 RE: KATHRYN A. CAMPBELL 570 HIPPODROME DRIVE, SOUTHOLD SCTM# 66-2-12 Dear Ms. Powers: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 19, 2014 and again on Wednesday, April 23, 2014 regarding the above matter: WHEREAS, Eileen A. Powers, Esq. on behalf of KATHRYN A. CAMPBELL applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated January 24, 2014, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit on structures; the use of open-grate decking on platform and catwalk; newly proposed location will allow structure to be farther away from adjacent property lines; vessel is not to exceed 14' in length at dock; and 2 WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on March 19, 2014 and April 23, 2014, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of KATHRYN A. CAMPBELL to remove existing platform structure from existing dock, remove existing wooden decking and replace with open-grating style decking and adding any additional support framing for grating as needed; completely remove existing catwalk and construct a 2' x +/-43'6" in new location using open-grating style decking and 4"x4" posts; and attach existing platform onto seaward end of catwalk; with the condition vessel is not to exceed 14' in length at dock; and as depicted on the site plan prepared by Costello Marine Contracting Corp., last dated April 8, 2014, and stamp approved on April 23, 2014. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $309.80 Very truly yours, John M. Bredemeyer III President, Board of Trustees JMB/amn 0 9 John M. Bredemeyer III, President gUFFO( Town Hall Annex Michael J. Domino,Vice-Presidents Gam- 54375 Route 25, P.O. Box 1179 James F. King rQia Southold,NY 11971 w Charles J. Sanders �y Telephone(631)765-1892 Dave Bergen Fax(631) 765-6641 - BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Edeen A, ftowcrs4 ti - Please be advised that your application dated 11 2 has been reviewed by this Board at the regular meeting of and your application has been approved pending the completion of the of owing items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) '/ Constructed ($50.00) Final .00 Fee Inspection $50 P ( ) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: Fire ad 1)bck -aeS — 2�x3r��-�Xec� c�Oc k & 0isq K `3bD — �g�• d� Sq , x TOTAL FEES DUE: $ 36L. 'Ri) I BY: John M. Bredemeyer III, President Board of Trustees John Bredemeyer, President �%UFFDJt Town Hall Annex Michael J. Domino, Vice-President °° 54375 Route 25 James F. King P.O. Box 1179 Charles J. Sanders Southold, NY 11971 Dave Bergen y�ol ,� �a40 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Fie)d Inspection/Work Session Report Date/Time: 6 / /q Twin Fork Landscape Contracting, Inc. on behalf of ROY & DAWN WARD requests a Wetland Permit for the as-built 4'x55' fixed dock; a 4'x10' ramp; a 6'x38' float, and a 6'x14' float; for the as-built 18'x50' patio with a 118sq.ft. landing with steps; patio to remain open to the sky and drainage provided to contain run-off; no further construction of any structures/storage buildings between the patio and the bulkhead; and install and subsequently maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. Located: 4075 Stillwater Avenue, Cutchogue. SCTM# 137-1-8.1 REVISED DESCRIPTION AS OF 4/11/2014: For the as-built 4'x55' fixed dock; install a 3'x15' ramp; install a floating dock to be no larger than 120sq.ft. with two (2) proposed 10" diameter float piles; for the three (3) existing piles; add electric and water facilities to the dock; for the as-built 18'x50' patio with a 118sq.ft. landing with steps; patio to remain open to the sky and drainage provided to contain run-off; no further construction of any structures/storage buildings between the patio and the bulkhead; and install and subsequently maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. TT e 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: ' vel-re zee Present Were: Bredemeyer / M. Domino A. King C. Sanders A. Bergen Bay Constable Other Form filled out in the field by ✓ , �/ Mailed/Faxed to: Date: F. B. 1 8 2014 AIP 7W P1 49 Z17- 13=HA) 73U/l N jls - SVD p®s7irJC.s , I7' 61,09-r L'oku-rRL(e')19 A7"/o fQ �4NF N P-�5Re�C-ZlAole a&fl? /v © L-) 73 rco mr- L aCRL .- l� 7W _s'm e z-4 Ao l"Tio) d-f z P) f--�)Iqj- )p R6 ,p JOZ�- 1��2 7- d a/ efir' r -AVC-T"Lt Pc, N -- y_-- oCe.7- Po /,/v � s mss. jai gCL_L , � Ui4s T , =lTiS �Qi ry- 19 Lu t�`I� �- �, Cpm 16r1f John Bredemeyer, President �ogUFF914r Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 James F. King P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: -3 ) ) f C) F 9 Eileen A. Powers, Esq. on behalf of KATHRYN A. CAMPBELL requests a Wetland Permit for the as-built replacement of existing with new 2'x19'2" fixed catwalk to a 5'6"x4'10" fixed dock with 4"x4" posts. Located: 570 Hippodrome Drive, Southold. SCTM# 66-2-12 Type area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code propo d 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: C-'zy�j-, �, ►''�w Present Were: 11. Bredemeyer /_M. Domino J. King C. Sanders Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: �� W4 i w, ,r F ra ' ML jf .- '" — _. ,•' y� .. r ,.. ifs. . .yp ,� a Mill 4t `~'-�. --.......w!— "—.iiNs,-aq,s...,. ►�tl :., ,-Ae:t`.. �rp,'f.'�''!"At��'fte' ►=r }cts .• '•� } 4s¢ • Ift MA y si i + :..- �` ... �A[�'$r.q,�� t' M 'R l SRS., `����� �� •` E '� 9r ',\ g A, ► a - „ �- j ti 'R.�R.;Je �� >k" '�� � � joy 4� ,� •�i r✓Myf �� Gf fay, ( *moii; j► ? �I ��- fir". f�Fg� ,'�� ���.7y Yi;.�.�r Y�• , K �,_ y �h } i�3:��� �!rl ...ql .UJ�.,, i�, VP Of p.y p+ ng jg- _ ,� t �Y Mi�>iI ry r t� , i, r. •, U , Drive"Hippodrome r t 12 i� "^ �/ ♦ r � s`% ,� . ,Southold � w � , *SCTM#66-2-12 S, � . .�le � � .Psi 1• �'> 4�_„�� .��\`, >�����1,'��f'��°ins a�\ '�I'1� 4�� A;�� Vii' rr ''�� '/� !���•� j4 .Ai i�✓�. � ��/ _ A. a John Bredemeyer, President �%UFFnttc Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 James F. King P.O. Box 1179 Charles J. Sanders Southold,���,o� � Telephone (63N) 7651892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: Eileen A. Powers, Esq. on behalf of KATHRYN A. CAMPBELL requests a Wetland Permit for the as-built replacement of existing with new 2'x19'2" fixed catwalk to a 5'6"x4'10" fixed dock with 4"x4" posts. Located: 570 Hippodrome Drive, Southold. SCTM# 66-2-12 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: cz2 �&-Le `ft- PK Present Were: `� J. Bredemeyer ✓" M. Domino J. King ---""'C. Sanders Bay Constable Other Form filled out in the field by Q Mailed/Faxed to: Date: Jarnes F.King,President ��0�SQ(/jO Town Hall Jill M.Doherty,Vice-President h0 y� 53095 Route 25 Peggy A.Dickerson P.O. Box 1179 Dave Bergen Southold,New York 11971-0959 John Holzapfel Telephone(631)766-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE #_ 0149C Date September 6.2006 THIS CERTIFIES that the screened porch At 570 Hippodrome Dr., Southold Suffolk County Tax Map#66_2_12 Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 29, 2005 pursuant to which Trustees Permit#6259 Dated Dec. 21,2005 Was issued,and conforms to all of the requirements and conditions of the applicable provisions of law.The project for which this certificate is being issued is for_ a screened porch The certificate is issued to Kathrvn A. Cam ell owner of the aforesaid property. v'r Authorized Signature • i .j Board Of Southold Town Trustees SOUTHOLD, NEW YORK • 10 . PERMIT NO. .. . ........... DATE: Dec..21.,._.2,pp.5 �.. ISSUED TO YKATHRYN CAMPBELL Pursuant to the provisions of Chapter 615 of the Laws of the.State of New York, 1893; and Chapter 404 of fhe Laws of the State of New York 1952; and the Southold Town Ordinance on filled!REGULATING AND TNE-•PLACING OF OBS.T.RUC NS IN AND ON TOWN WATERS AND PUBLIC LANDS and'-the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS.F$fJM LANDS .UNDER TOWN'WATERS;..'. and in accordance with the Resolution of The Board adopted at a meeting held an ..Dec.. ,21 x 2.0.0.5... and in consideration of the sum of $25Q.00•,_... paid by ........ ... .............Kathryn Campbell•............................................_.......... of ..........Southo•Id...................................................... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following; Wetland Permit to construct a screened porch, and all as de- picted on the plans surveyed by Joseph Ingegno, and last dated November 23, 2005. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board .as of this data. a ��J► ee$ y 3 . , D E C E g y E SURVEY OF DI LOT 9 my DLOCK 4 L xwA MAP OF e,�A'�1e9 BEIXEDON ESTATES f \ - FILE No. 1472 FILED MARCH 16, 1946 SITUATED AT I SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-66-02-12 1 �d6 rf0 SCALE I"=20' d 0 pp\ FEBRUARY 13, 2001 °L yb rp FEPRL ARY by. 27, 200' ADDED 'ROPDSEC PCRCI- S MAY 2. 200' REVSED PROPOSED ADDITION ' \ NOVEBER 3. 2DOE ADDED -ROPOSED PORCH ,. ay NO'✓ MEMBER 23, J005 PROPOSED PROPOSED PORCH cO� r AREA = 10,798.79 sq. ft. (TO-IE LINA 0.248 DO- 101, c.AO rpR+3 ,'S1 r%_, KYfEs I.ELEVATIONS ARE REVERENCED TO N G v,0.1929 DATUM 10 4yF ,y� a ry' EKISnNG EL-eVATId/S ARE SHOWN THUS: \7-� 7,THE LOCATION OF WE_LS AND CESSPCOIS SHOWN HEREON ARE-ROH FIELD b' 9 F7fi I,T �•1+ OBSERVATIONS ANO/OR OAIA OBTAINED FROM OTHERS. 3.FLOOD ZONE INFORMATION'AMEN FROM: FLOOD INSURANCC 1F00..OF t ONE<- ARERATE MAP No.1610300156 G P �',., ly SAA" +�• ZONE A= BASE i— EIFIA'ONS DETFRMINEJ fy y, \ VVV r; N.j / ZAS 500-1EAR A;AS OF iC0-YEAH F_OCJ WTN Av OE 3'� pESO�ARE M�,'4W At �R[f EOTE pVN rti RiiOM�00-rFAR F C OE1-=RMINEO To 3E OITSIDE 5OO- __N I 4 bO S�;Lf Q zA dVINS \roof J . o ,b \ TEST HOLE DATA 32 4, >O `\ (lEs-HOLE o!!c a u=coyA .,Cscrr ucE ON JANUARY 3, zoai) q" \\ _oNlv�—1-NA 1„cawsE sw�s« sTA,- uRKrers AwE0R5DN cA '� e�j0 -- x1nlFCAno-s Anrnm Nocv1 swA AOA rOE°voEg90"'-OR..cM nIE v1A.. '' r` X81�56`7�W a. 5.12 \\ 1 i1S S � TNE C1RS1FNCf K MOR9 OF WAr �` /oe usoMNrs a REpMO,N a O S Axr.NOT allowx A9E NOT w.RANTE6n �r P 40�. g„ MAIN.° Joseph A. Ingegno A Land Surveyor OF N � tilt Su.wys-SuSd.wpr,a- SIe rlarN- EawhucWn!MaN ,NONE(631)727-2090 -aA(631)721-1727 OFTKYS W'OMED AT MAI ADDRESS Uc.NP A966 322 RGAN010 AVE" PO BRA 931 R�IEFNEAO,Nw YP X1301 Ir.11,Nn YaA 11901-0965 - 20-717C a 4 Board Of Southold Town Trustees , x SOUTHOLD, NEW YORK *` DATE: . Set 4 2001 PERMIT NO. ... ...... .... ... :. ISSUED TO KATHRYN CAMPBELL � •- ,�Li#��xt��#tIIlt Pursuadt to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 444 of the laws of the State of New York 1952; and the Southold Town Ordinance en- titled."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL-OR OTHER MATERIALS FROM LANDS UNDER TOWN•WATERS-,"; and in accordance with the Resolution of The Board adopted of a meeting held on AM 29�, 2001I . id b . ....._..._, and m consideration of the sum of =........_200.._._....00......... Pa Y Kathryn Campbell..........-.......,.. .................................-_..... ............................................._. of .... Southold N. Y. and subject to the Terms and Condrflons fisted on the reverse side he , i of Southold Town Trustees authorizes and permits the following: 'J*U-d F---%b Ca Wet a asst now."d.n to tb.a.Uftg aw-.tae'f r..ld.ee' odtb r►tis-.tsf.ddltlon wd wptle o�.t�o 6n—d of 1-1au... dl dW the a.adlNm ttut the dd-aws7 M P=,= at b, oemDw 31n.ad that eh.drt...+r b. put 4 Ysfon sad• Ntructlm starts. A Mw of bq bol s most M plamd down alms tb.watLwd 6ian d-ies emsteastl.a of no mve-q and tb.h.". all in accordance with the detailed specifications as presented in the originating application. t IN WITNESS WHEREOF, The said Board of Trustees her- by causes its Corporate Seal to be affixed, and these presents to to be subscribed by a majority of the said Board as of this date. ab . Trustees _2- .T EWINO WASTE LINE FROM AD.ACENT \\ Y+ (2 / _ EDGE OF BULDWG (WAGE TO BE PE00MECTED L, 8'DA.•S'DEPTH LEACHND POOL I TH I FR.L FLR ELE'✓H.0 GRADE-EL.720 CAST IRON COVER TO pp N G RADE TYPICAL ,b EXPANSION AREA GRADE EL.i30 EXISTING SANITARY SYSTEM D 25• •DIA CLASS 2401 TO BE REMOVED '� Fil�rlrp iir IT SEPTIC UL 2AW PPE ---J `)<x I,E.10.0 TAW , Rt('r•ED Ve"F' LEACFiM:' I F 5 P.• .1 T 95. ( IE 97 1000 GAL IE 92 E S. POOLEL 4.4 J ��+t F (�}' ••� `, Y ' GROU/aWATER EL U__ __ gTp7u0 HEIGHTHEIGHTtETYPP�I v LU y —_— - 8OA.5 DEPTH � — >r SE c I PROFILE LEACHNU POOL w z =_ CLF 9E� s no SCALE CC W `w LANDWARD EDGEOF IOAL WETLANDS AS FLM'$8Y---� 7 EN_COrMATANTS O \ Y4E'Fu a0 \a 1y a� 3"- \••.,n•�'(('"� ( ,I Cc'� r,._I ~7 N 8 \as S C• \ \ t? `"! \ •I o -;1 2'-0' T-0• 2'-0 �/� U = x\\ V/ \ J\+ • � �.. � \,m �._.^ beypp!� 61EACE R¢VE6ATATE�AS AFEAY� ATEpA1a'Ep \ FLAG - I • N GLwR!ADE'E lRISTINy J FMMO JE A14Y TOPSOIL POLE OR vEeErAnoN �O SECTION A C) NO SCALE 6 x r (C\ VrATW x WOOD �0 DOCK z' ` a \ 9 APPROVED BY BOARD OF TRUSTEES C� TOWN OF SOUTHOLD DATE AS P R SECTION T SMEwz .���- W } .G AS PER QSTgN A v N SANDY AOW 1 J ay LLOAM a J (Yrs IT J BROWN LOAMY W n yN�tEY• SAND SM +� q 3(Y 1QeO/ YFee Q FN:TO TD CWIEE sATo sw €L WT� I/1.M QCIW —TERN . '.,L YELLOWISH MOWN RATE.E.wa no TO COAIEf . SANITARY SYSTEM PLAN SAND, As nTEC N o 4 11, f W 1 SCALE 1•.20' TAX MAI NO.1000-66-02-12 `')\''_ _•r.� LOT AREA•0.218 ACRES N f^s10Np vRY LOT INFORMATION TAKEN FROM SLKVEY PREPARED BY TEST HOLE ©CT JOSEPH INSEGNO LS MAY 2.2001 LATLST RE:'VISION NOMcSCIIE U TEST HOLE PEWOR.ED BY DONALO GEOSDENCE I/3/01 (F I SEER ALL MOORINGS STAKES MUST DISPLAY NISIBL, ORING NU ' MBERS ALL DOCKS AND HEADS MUST DISPLAY VISIBYI PERMIT NUMBERS -ffK.. ...71�...,.� • . 1 i ,rYl Y> -.�y 'n.. n^.:'': �• -SAY/ Z 57- Board Of Southold Town Trustees SOUTHOLD, NEW YORK `. ' Mooring # •� K 4 PERM(T NO. ..223.4 ...I.._.......... n 9g :. DATE: ��:�.._.�.I).�.....� 6 . r^ m r ISSUED TO ' '` ='- 'Pursuant to the provisions of Chapter 615 of the Laws.of- r __the State of New York, 1893; and Chapter 404 of the Laws of the< State of New. York 1952 and. the Southold Town Ordinance em- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS } IN AND ON TOWN WATERS AND PUBLIC LANDS and the: � REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM , ` LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held 86 $.... paid by 19 U-, and in consideration of the sum of -._. .. ,. '. .........:.................F?R3ex.. !?-. Roth_..........:._._....... .._........... ......... ._. ......_._... of .. ...Southold....._......._...._......................_ Y. and subject t ... N sbjett he Terms and Conditions listed on the reverse side hereof, ,.,.: of Southold Town Trustees authorizes and permits the following: r s s Approval under the Grandfather Clause to secure :;� ��+;•a<s�gmi�t�, o. �.2_'. i�` ,.catwalk.:and'.8.' 3' dock<in., :: Hippodrome_ Creek. :,,,:. ,,• �.;- :' y all in accordance with the detailed specifications as presented'in the originating application." I IN WITNESS WHEREOF, Thee said Board of Trustees here- by causes its Corporate Seal to be-affixed, and these presents to r: be subscribed by a majority of the said Board as of this date. I +- - .......... el t r •h'.. �. �;•♦ -P i c--`w_ -^.��...rs�•+s•s..s..'w z+-w'v..^.n.w.•v:-....•aw.t.r 4 Mm 1161 -.; Ali, •�.�.;�� �_ ►�.eo7A� A• •,moo►,,r�`� �...•�A��,�,,. ;=. Pi-ease tear off and re ce• AJAP AF�k �� gsr�az' r� f th S't�Slp� ......-MAA y, i �i $r:MEAT i o .. .... ._... __....____ 4''.. _._..._ ......_ _.._ .. ... .......... ..... ... ...._... _pj_ _.OF STORM-- rublv- PINT TD SAIJUARM, A,r-haAV __ . r' . �, �'t• /'BGG/�' .,.,.... ,;,. Name of Creek: rryn� r ...� w Lh t4 (516)7W1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road i P-O. Box 728 Southold, New York 11971 I GRANDFATHER APPLICATION bo I. Name of Applicant: Roger W. Roth " 2. Address of �ea P., of bIiv rode Dr*e 1a� Southold, New York 11971 i' 3. Telephone Number: 765-3792- 4. Year of Construction: 1972/73 5. Sketch of the work including sizes: See attached diagram r. Lot #g OI7. Map �7 Bruce and; Auro Heath t> ( see survey,attached W. Islip, N7 York Lot #10 on Map Charles and Virginia Schmidt { Southold,, New York 765-2501 Lot #11 on Map i Mrs. Nona Seelig Southold, New York 765-3058 6.1 Mark off on the map attached, where your property is located j, using an X. I Signature: ` Please note that there is a $5.00 filing fee, which is a one time " fee, for this application. l - I i+ Mooring Applications- $5.00 Application Fee and a $5.00 annual renewal fee each year. r}�1\Iii lA13 .a! ! •9 �dr\ / r ♦ � ; 1�„►1 �.'� I �!'.! �'J �r* 4J�f .~1y Ff I�(4t}� ".;+' IF al 1= �\ �, � \ ,��'Ri���ir :r l ili Cf �✓, ��`�tiyl�-.�'.. 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POWERS,ESQ. PLLC ATTORNEYAT LAW 456 Griffing Aven ue RIVERHEAD,NEW YORK 11901 (631) 727-8250 (631) 574-8666(fax) June 16, 2014 Southold Board of Trustees Town of Southold _ P.O. Box 1179 D E CE, P Southold,New York 11971 Attn: John Bredemeyer III, President JUN 1 8 2014 1 Re: Our Client: Kathryn A. Campbell Property Location: 570 Hippodrome Drive Southold Dear Mr. Bredemeyer: Enclosed please find a check in the amount of $309.80, which constitutes the amount of the fees due in connection with the approved permit for the dock. Please forward the permit to my attention or call me at 516-695-7660 and I will pick it up from your office. Thank you for your consideration. If you have any questions,please feel free to contact me directly at(516) 695-7660. Very truly yours, EIL N A. PO RS,PLLC Eileen . owers EAP:lw Enclosures FEB-14-2014 15:09 From:LAW OF 6315748666 T017656641 P.1/1 EILEENA.POWERS,F,SQ. PLLC A TTORIVE YAT LAW 456 Cr Wing Avenue FEB 1 $ 2014 RIVERHEAD,NEW YORK 1.1901 (631) 727-8250 (631) 574-8666(fax) J3Utti�6'ia�ii February 14,2014 VIA FAX 631-765-6641 Southold Board ol'Trustees Town of Southold P.O. Box 1179 Southold, New York 11971 Attn: Jim King Re: Public Hearing 2/19114 Our Client: Kathryn A. Campbell Property Location: 570 Hippodrome Drive Southold Dear Mr. King; Please accept this as a request to adjourn the public hearing, currently scheduled for Febnmary 19,2014,to March. 19, 2014. 1 am unavailable February 1. and would like to be present for the hearing. The property has been posted and the Notices have been sent as required to the neighbors. Thank you for your consideration. If you have any questions, or require clarification of'the aNwe,please feel free to contact me directly at(516)695-7660. ve U y yot . EiL E OWF S,PLLC'. Lilcen lowers EAP:lw Enclosures �\%'pF SOUj'yo OFFICE LOCATION: Q �� MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) G Q Southold, NY 11971 O Telephone: 631 765-1938 `,ou ffm Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUMflD , _ _. .. To: John Bredemeyer, President FEB 1 8 2014 Town of Southold Board of Trustees Juiflitl,��sr x- From: Mark Terry, Principal Planner f T LWRP Coordinator Date: February 18, 2014 Re: Local Waterfront Revitalization Program Coastal Consistency Review for KATHRYN A. CAMPBELL SCTM# 1000-66-2-12 Eileen A. Powers, Esq. on behalf of KATHRYN A. CAMPBELL requests a Wetland Permit for the as- built replacement of existing with new 2'x19'2" fixed catwalk to a 5'6"x4'10" fixed dock with 4"x4" posts. Located: 570 Hippodrome Drive, Southold. SCTM#66-2-12 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 determination that the proposed actions are INCONSISTENT with the below listed LWRP policy and therefore are INCONSISTENT with the LWRP: 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. Town records indicate that the structures were constructed without the benefit of review of the Board of Trustees. Aerial analysis shows that the dock structure was constructed after 2004 and before 2006. Due to shallow water depth and limitation of navigable waters in Hippodrome Creek, it is recommended that the Board identify the purpose of the dock and use (vessel type) The dock is located 5'+ from southeast property lines. All docks, including any vessel tied to the dock, shall have a minimum clearance of 15 feet of the seaward extension of any property line from adjacent parcels so as not to interfere with the neighbor's access to waters, unless the Trustees decide otherwise for navigational or other reasons. The applicant has not demonstrated that the following dock standards pursuant to § 275-11. Construction and operation standards have been met. (d) Review and approval of dock applications. Before issuing a permit for a dock structure, the Trustees shall consider whether the dock will have any of the following harmful effects: [2] Whether the dock will unduly interfere with the public use of waterways for swimming, boating, fishing, shellfishing, waterskiing and other water-dependent activities; [5] Whether the dock will cause degradation of surface water quality and natural resources; [6] Whether the dock will cause habitat fragmentation and loss of significant coastal fish and wildlife habitats; [11] Whether the cumulative impacts of a residential and commercial dock will change the waterway or the environment and whether alternate design, construction, and location of the dock will minimize cumulative impacts; and [12] Whether adequate facilities are available to boat owners and/or operators for fueling, discharge of waste and rubbish, electrical service and water service. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed actions. Cc: Lori Hulse, Assistant Town Attorney UFFD�► • S add Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1892 Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., February 12, 2014 the following recommendation was made: Moved by John Stein, seconded by Doug Hardy, it was RESOLVED to SUPPORT the application of KATHRYN A. CAMPBELL to legalize repairs to an existing dock and catwalk made after Superstorm Sandy. Located: 570 Hippodrome Dr., Southold. SCTM#66-2-12 Inspected by: John Stein, Doug Hardy, Keith McCamy The CAC Supports the application with the Condition of a 20' non-disturbance buffer planted with native species and no seasonal pruning or cutting within the buffer area. Vote of Council: Ayes: All Motion Carried James F.King,President � j�qf SON; Town Hall Annex Bob Ghosio,Jr.,Vice-President 54375 Main Road P.O.Boa 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer Michael J.Domino i0 Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only __,,Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/I' nston eceived Application _�meived Fee•$ pleted Application JAN 2 4 2014 Incomplete _SEQRA Classification: .. Type I Type II Unlisted i ordination:(date seat) a"' WRP Consistency am t orm _CAC Referral Sent: ate of Inspection: Receipt of CAC Report: _Lead Agency Determination: cal Review Review:_ Public Hearing Held: Resolution: Name of Applicant Q ,rN n � LLAI j Mailing Address �'�O �,`�� � Pt o�Pa+S �9� 456 KM l to.0 Phone Number:{ ) ► � e Slr�-(c4'S=Xa(t d j Suffolk County Tax Map Number: 1000- 00 - 0��y0 — ga oo O W 1 m Property Location: � tX e e- �.,� -- c" cSS a tt m1b u 2n kA, Qe o Axzr„e. %(L. 'je.., <:�-"` d td 1 i C ' I (provide LILCO Pole#,distance to cross streets,and location) AGENT: r't 12 Yoys Ef S (If applicable) Address: Li 5 'r ktCLG Q Phone 1 . 52n r I rd of Trustees Application GENERAL DATA n (. Land Area(in square feet):_ r."1 qD i- Area Zoning: Previous use of property: 9 t n � GJJW c V q Ca+,,mJ K Intended use of property: S,,nA,,- � v es d-e. 1,x,`''1 Jo-r-,kL A GC f VC, 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 /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 requirey 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 9 mcd of J Y-yl-I—Ms d b 0l0 11 Y�Q w1� e c a i i . No prior permits/approvals for site improvements. � Has any permittapproval ever been revoked or suspended by a governmental agency? No Yes If yes,provide explanation: Project Description(use attachments if necessary): G x `l 0 bck) 19 'd1 X a ' �2rt. O. _ \J� bin, &A o, I m Ok�Q SL�e Fla.,,, 0 Q t Qv\ i *d of Trustees AppliCatiOn 0 WETLANDITRUSTEE LANDS APPLICATION DATA AA Q JQ�C4 -A0 eK f, Purpose of the proposed operations: fe'e0,, _S. awaL, it CQAU.,A\,L Area of wetlands on lot:- _square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland \5,4�t edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes,how much material will be excavated? cubic yards 0 How much material will be filled? cubic yards i. Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations: 0 I Fr Manner in which material will be removed or deposited: a I ef 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): 'JP wyv"ACA dak wk'w-� �^caJ "''V SQ�S esu • 61 Z20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -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 l 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 1 -Project and Sponsor Information Name of Action or Project: A T+ rt 13 aR CA-yvlP k�e I z IL Project Location(describe,and attach a location map): FJ1 U `�� Qa(,'7�6��►'►� Y�il..�rt. �V`�3�.a\Cl �Q� ���Q/ptd u.� ���1-2C Brief Description of Proposed Action:. 9- G�q-r�t wlk S� k �'t x 4-' (o [�5'0 f �S 4 1��C0�To� vS 4-o Lo 1-c- rLS 'IU Qr,C,s 4, cLUc R co,: k \"- QS c�?sLSGn�a2o�� � ��B.J. C �L�i.. �}�"►�A� � / Name of Applicant or Sponsor: Telephone: 5-(6L to q S (a(A O t�•2�a Oc�7,�sQ� E-Mail: OU+e'15.@ 6Q�uk\•-�c •�►�'t Address: City/P State: Zip Code: Ny A070 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? , $ acres b.Total acreage to be physically disturbed? z acres 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. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial esidential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 0 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ P ❑ b.Consistent with the adopted comprehensive plan? ❑ Iff ❑ 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: 9 F-1- 8. 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: ❑ 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 ES 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? ❑ IJ 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: ❑.,SSh-oreline ❑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 I 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, [—]YES Ela.Will storm water discharges flow to adjacent properties? O YES b.Will storm water discharges be directed to established conveyance systems(run and storm drains)? If Yes,briefly describe: NO YES Page 2 of 4 18.Does the proposed action incl=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/sp nsore: (.�,,.� v*S Date: t Signature: r Part 2-Impact Assessment. TC, swering cy i responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the info din Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewthe 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? — 14 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? (�j ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or Elaffect 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? El ❑ ff- El 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, 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 ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? 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. F] 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. Town of Southold-Board of Trustees 1 ,— I J ✓�y ), Name of Lead gency Date /L President Print o ype Name esponsible Officer in Led Agency Title of Responsible Officer ignature of pons ible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 PROOF OF MAILING OF NOTICE, ATTACH CERTIFIED MAIL RECEIPTS Elizabeth Clayton P.O. Box 1403 Vivian Eyre Southold New York 11971 P.O. Box 1055 SCTM#1000-66-2-14 Southold New York 11971 SCTM#1000-66-2-11 Constantine M. Riley P.O. Box 764 Elliot B. Heath, III Southold New York 11971 Ora J. Heath SCTM#1000-66-2-15 P.O. Box 232 Southold New York 11971 SCTM#1000-66-2-13 STATE OF NEW YORK COUNTY OF SUFFOLK residing at Lt,5(, Gy l Avt- � � �a << G d , being duly sworn,deposes and says that on the 1 I day of ' r u , 20�, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment 11 of the Town of Southold; that said Notices were mailed at the United States Post Office at � �head N that said Noti s were 'led to each of said persons by CERTIFIED MAIL/RETURN RECEIPT i Sworn to before me this lam Day of k: , 20� Notary Public � G Postal CERTIFIED MAILW RECEIPT U.S. Postal [�- Only;ail - • 0 CERTIFIED MAILT. o .. Only; .0 SOUTHOLD #�Y 11971 o I,. M SO).1THOLL' ff 11971 MPostage $ $0.49 0+901 m Certified Fee $� � 1` M Postage $ $0.49 0901 �. C3 Postmark Return Receipt Fee Certified Fee $3.30 1,, p (Endorsement Required) ^ Here += $2.70 p p Return Receipt Fee Postmark Restricted Delivery Fee p (Endorsement Required) $2.70 Here C3 (Endorsement Required) $0.00 p nj Restricted Delivery Fee p (Endorsement Required) $40,00 0^ Total Postage&Fees $ $6.49 0/11/?014 ru fU Er Total Postage&Fees $ $6.49 0/11/^014 rU Sent To 11 �^ ru r.R - (--- ru Sent To r- �3&Wji-Ap--t.--N-o--;Apt.No.; a ^ r-q 1�, � V,{ or PO Box No. - V d+ ----- -------- --------------------------- Street,A t No.; City,State,ZIP+4 ------------ ------------/---------�------------- � p' �1 [%- or PO ---------------- City,State,ZIP+4 ----- -------------------------- ------ PS Form 3800,August 2006 See Reverse for Instructi 04 �6 01-ho Ilic, 01 (l9 1 PostalPS Form 3800,August 2006 (DomesticU.S. Postal ServiceT11 CERTIFIED MAIL,,, RECEIPT CERTIFIED MAIL,. RECEIPT r- Only; Provided) co C3 •. Only; u p C3 w SOUTH LD W:11771: c,l, SOUTHOLO NY11971 m Postage $ $0.41 Gt 9 9 si M G: M Postage $ $0.49 0901 Certified Fee a ru $3.30 1 Certified Fee $'i 30 1u O Return Receipt Fee Postmark ru �` Postmark p n $�.70(Endorsement Required) y Here C3 Return Receipt Fee O p (Endorsement Required) $�^, '(} Here Restricted Delivery Fee C3 p (Endorsement Required) $0.00 Restricted Delivery Fee rU i Total Postage&Fees $pr'{� 0�/11.1 (Endorsement Required) $0.00 g $ „ L014 0 nn N Total Postage&Fees $ $6.49 02/11/ 014 Sent To - ru IiA Sent To -3 n(� r-R ------------- ` ------- W"S kL� dl-E. 1` p Street,Apt.No.; r-� -%.- '_} or PO Box No. r-3 Street,Apt.N.' 1 �1 Ciry,State,ZlP+4 �6` \ r` or PO Box No. . 0 . �J� -Ito w v M Q C 1 �/ --------------------------------------------------------------- City,State,ZIP+4 ------------------------- o 00 2006rm ,August 2006 See Reverse for Instructio PS Form 3800,August See Reverse for Instructions . r ZOTO QEET 2000 0262 T ■ Complete items 1,2,and 3.Also compiete -•a••---- item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X resaee so that we can return the card to you. B. Recwved by(Pn Name C. Date Deliv ■ Attach this card to the back of the mailpiece, �Cl�y ' , or on the front if space permits. D. Is delivery address item 1? es 1. Article Addressed to: If YES,enter delivery bei OL G Oa-A-s ��i c, 3. Servicelype ❑Certified Mail ❑Express Mail P U` ilT� ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service isbep Ps Form 3811,February 2004 Domestic Return Receipt 102595-02.M-1540 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SCTM# YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: r-c fal s 4�, s�� �Q cc,+—wa k gas Gote"C"V-16S, CA-TW«tV S' Y q a' (Lvc1�) 14"0`eosfi- 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 15C Jy\n It [Coo--(k- a-t a; 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: �e\o(U a r C d O I You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: Ka�fi�r a ll MAILING ADDRESS: Cto ' O-eP Yo,,4v% Ll 5 tP r1 ,r,1 . t oc( k)V 1(�ol PHONE #: sib -(JR5--)CP (� o AGENT: Eilo A ftme, Eau. PLLC MAILING ADDRESS: �w PHONE 5 Enc: Copy of sketch or plan showing proposal for your convenience. i WA6• ' N t f � NoGIs� A - y1 n V � - vvv`� X- y ✓v V V V a! 2-546 40'400-;f 570 Nr�r�vz�•�Zorr�� �b,czrv� Dov�oLs�,,v,y. /i97/ r�.r..+��b,►: ScTin•boa e-�6-2-ice c�nr.`o +� NO.A~Z484 7;�V.ytlOyi�R4r• z7cT; 34cL 20 �c 4�a-tile! to 4"'Fairs �ic.ta 1 Aril iv w�'r�ajvr� N�.zvy �q,,S•4d�Q� M c W n L .4 N MAW 1 � L-e V.A� r'� �.aTr���ey,.r cater-�a�zL �ovTWocr�, AJ.y, 111771 P.o.B+,c z c�I►rs��a••rs�; A Oct; 30, Za�3 (iil� X79-1Il�j �T John Bredemeyer, President °gOFFOI* Town Hall Annex Michael J. Domino, Vice-President ��° °as 54375 Route 25 James F. King P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of KATHRYN A. CAMPBELL COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS I, C O kc� , residing at/dba 9-14- L0. . yrs l(q L/`{ being duly sworn, depose and say: That on the l I da of bru ar-) , 2011f, I personally posted theroperty known as 77)20 1 Qpo dm-m-p- 'ba - so 6�old tS,4 (1q'-1 by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,February 19, 2014. Dated: a ( 17 I 1 q (signature) Sworn to before me this ITL'day of (Lf Notary Public EILEEN A.POWERS ryPublic.State of Nen,114 No 02P05021242 +`J Qualified in Suffolk 1'1 .Commission Expires March 20_ NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. � OWNER(S) OF RECORD: "ryn g• CO1mP6ell SUBJECT OF PUBLIC HEARING: For the as-built replacement of existing with new 2'x192" foci catwalk to a 5"6"x4'10" fixed dock with 4"x4" posts. TIME & DATE OF PUBLIC HEARING: l�Jednesd�, rrebtaary I9, �n� y - o►�I-orabo�- S'3v� If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours o1� 8 a.m and ,4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 rd of Trustees Appli.cati� cL4 1 esev Ds! y*r •a•see �"� Q Krq-rNRyN fi-• C-4e"P/39J. - BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/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. Signatfire of Property Owner SWORN TO BEFORE ME THIS rte- DAY OF jpuc�rt,2014 �dw+w+ bScoKe✓ ��� Oa.'�s txd of Trustees Application AUTHORIZATION (where the applicant is not the owner) r) C06M* h e residing at 4r° S�.t I kvu PA i Crv►�we.t( � L s ✓�.a�d (print owner of property) (mailing address) do hereby authorize (Agent) EOW A.PPowM Esa, PLLC to apply for permit(s)from the 455 GWn Rini W,N.Y 1 901 Southold pard of Town Trustees on my behalf_ (Owner's signature) ii ATNF APPL �`I PRESENT - TRANSACTIONAL DISCLOSURE FORM s� ,�Q�••'a of>s�"ics u�ohibi,��fli��ofinterest on ffie�t of totva iiffieers atxl�n ..r,, �--•rim to�-z of; +'bW conflicts of bUM and allow it to taTte wha4ever_ation is t neeyto avoid ' ` owe�rs �e 1 YOUR NAME: first You am the rime of t� e � mme w else or other cosily,=Chas a company.If so,Mc*ft o&w persaies or compauy's name.) - i NAME OF APPLICAUM-(heck all that.apply.) BuilTax grievance ding Trustee, -— Variance -- Coastal Erosion , tfianga of Zana j i• PW Mooring monExemptionfromplat or official map Planning Other i (If"Other'",name the activity.) Do you personally(or through your company,spouse,siblhng,parent or child)have a relationship with airy officer or employee �. of the Town of Southold? "Relationship"includes by blood,nomage,or buA"Merest-"Business intcxesf'means a business, including a partnership,in which the town officer or employee has even a partial owmr*p of(or employmart by)a corporation in which the town officer or employee owns more than 594 of shares. `i YES NO - [ete the balance of this form and date and sign where indicated. Myon anstv«ed`CIES",comp - s l Name of person employed by the Town of Southold ; Tltle or position of that person ` Either check - Describe the relationship between yourself(the applieeatlagsatlrePreseotative)and the town officer or employ= the appropriate fine A)Rough 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): r A)the owner of greater than 5%of the shares of the corporate stock of the applicant i (when the applicant is a corporation); ! B)the legal or beneficial owner of any interest in a non-corpomi entity(when the- appficant Is not a corporation); C)an officer,director,partner,or employee of the applicant;or ; D)the actual applim t. ,1 DESCRIPTION OF RELATIONSHIP i1 S • Su6 �, of Gh vk, ' . Signa!ture• ;!. Form TS.1 °i 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.deterniination 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 pro spo ed action will be evaluated. as to its sigpificant 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, listing both supporting and non- 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: o -gf-ou#hold website (southoldtown.northfork.net), the Board of Trustees c Ing De�-` t, all local libraries and the Town Clerk's office. i B. DESCRIPTION OF SITE AND PROPOSED ACTION JAN 2 4 2014 SCTM# 1000 PROJECT NAME The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees L_! 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. < l k c • n� Location of action: Site acreage: OsZ Present land use: <;A - rc Present zoning classification: 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: -0.��1n,_ Ig- (b) Mailing address: pkv 2co,sz.1 (c) Telephone number: Area Code( ) 1 (¢ —Co4 S o (d) Application number,if any: Will the action be direc y 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 M inimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ❑ No ❑ Not Applicable NlA Lt, IN�oakos3 cs a Attach additional sheets if necessary Policy 2. Protect and presery 'storic and archaeological resources of the Town of Southold. See LWRP Section III-Po=plicable ges 3 through 6 for evaluation criteria ❑ Yes 1:1 No 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 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through for evaluation criteria Yes No 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 evaluatio criteria. Yes No Not Applele w 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. F] Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and w;Not s. WRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No 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. �� ❑ Yef] No rNotpplicable Attach additional sheets if necessary WORKING COAST POLICIEO Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations;Not e Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes [:] No 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 1:1 No l�J 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=plicable criteria. ❑ Yes ❑ No Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy gy and mineral resources. 'See LWRP Section III—Policies; Pa 5 through 68 for evaluation criteria. j ❑ Yes ❑ No Not Applicable I i i i I PREPARED BY lsJ tPr TITLED ATE_ � � � 1r S��vS Op , 00 -PRO JeCT JoO ATIoOV GT.�'GlilL ID E C E._ E b APR 1' 4 2014 Burd of Truszpues .:ou±l:c iu%swa o �vooFt-. ,�72o�a e X LST'�d•� r oc�� G a + -/o JQ��vlQV� �X�S.T»`JG. 7iz✓oora�r� �.�cK�r�� ✓8�tz..oNc� � �K�ST��4 carrv.+L� 9:�f ^14W .l+jaTYV.�ttL 9...TNfrR_Y.N C.A.A-fV=,54L=44- S >>97/ t�twcs.r MA'lw�►�r je.v.$.rc zest.elm (ii!) 477-lit? 6,2014 SGT. 3o,2w 'j w 0 +i , O Y Q 1 G�Cr47'lo.�/ L o C:.C1 T/o A.J M.dp J 0 3oot� 4�X03'38",�I �'7�24'.d�Gc"Jul 4 O V/VI...4,•/ r=yR� c o sr4 cE Rpt.ey �3c9 74o•4 Sov oc rte, N y: t/97/ .so vT,v04/=�, , !>971 (� GLtoT J9RLGC,t l •,DTNa[' (� V r V/.4?J z yR0-� T✓ 0.- 3oK 232 SovT. �Z72r�, r�.�! 1197/ ,,,)r' 27d NIPAo.CL40,ht+�.T,s?!Y� 570 =�AZIve soc�TNol-'-3 Y A-�977 of Grp L..�� ver �`✓,XZE , ,U4 { � f-/oc✓�� � Nth �y�d,. � ,�.osa ^` 4► 1J in A t, � � ArrKUVtL) BY rZvrocsC� ✓�W4a-Ge BOARD OF TRUSTEES. ....... 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TAX No. 1000- 66-02- 12 SCALE 1 "=20' FEBRUARY 13, 2001 FEBRUARY 27, 2001 ADDED PROPOSED PORCH MAY 2, 2001 REVISED PROPOSED ADDITION NOVEMBER 3, 2005 ADDED PROPOSED PORCH NOVEMBER 020SURVEY 05PROPOPDATE SOD PORCH AUGUST Q 5S �G NN l9° OGS � "IQ, AREA = 9,940 sq. ft. (TO TIE LINE 0,228 ac. O Go,�� .• a`A�y� � ON 08/07/12) GO G 9s �� G��o .. G°a G���� CERTIFIED TO: �0P�� \o� P9 KATHRYN CAMPBELL C�- �2n 00 2SGi �JFI�Pj e G�\�y? cn� GAF �� HEPD W RAS 2� OG yF <<1 V S y�o� oma• 1 F�� �PNll ��c , ° Ate. `�� o o \�• GP v� 011, CT Q00 7j \ ° t4 �' O� Q-OOr.�,�00Q �Q GGA ti°� ���G�• y.�0 I\ CY ,111, A�• LQ CSS, �c �ZcUX \\\ 00 •�� T� ��� ��5 o �q��F \ Jao �° � J��P•� �oo�G �� tiicy all, 6• �o�o ' ��Ai. �0" 00 00 9.\ d c� �0 ° PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.I.A.L.S. AND APP PTED FOR SUCH USE BY TH OPINe 7E D TITLE ASSOCIATION. �( �'Y�. r7'�� jXFT a\Q ODD WALL � <� A N.Y.S. Lic. No. 50467 Q Nathan Taft Corwin III UNAUTHORIZED ALTERATION OR ADDITION Z� TO THIS SURVEY IS A VIOLATION OF c SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR iygr EMBOSSED SEAL SHALL NOT BE CONSIDERED EQ TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. saksen, Jr. L.S. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 FOX (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. OFFICES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHT OF WAYS 1586 Main Road P.O. Box 16 AND/Oft EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 20-717D