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HomeMy WebLinkAboutTR-8438A Michael J.Domino,President \of soyo Town Hall Annex John M.Bredemeyer III,Vice-President O l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 CA A. Nicholas Krupskiet • Q Telephone(631) 765-1892 Greg Williams es��� � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COMPLIANCE - -- - # 1479C Date: June 18, 2018 THIS CERTIFIES that the installation of a+/- 3.6' high architectural picket"village style" fence along north property line-, install a 4' wide dual purpose French drain/access path along northeast corner and north side of dwelling; install a+/-12' long kayak rack along south property line with seasonal cantilever kayak slide over bulkhead; 'At 2660 Village Lane, Orient Suffolk County Tax Map #1000-26-1-18 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 7, 2014 pursuant to which Trustees Administrative Permit#8438A Dated June 18, 2014,was issued and Amended on September 17, 2014 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 the installation of a+/ 3.6' high architectural picket"village style" fence along north property line; install a 4' wide dual purpose French drain/access path along northeast corner and north side of dwelling; install a+/-12' long_kayak rack alongs_outh property line with seasonal cantilever kayak slide over bulkhead. The certificate is issued to John M Bredemeyer, Jr & Jeanne R Bredemeyer Family Trust c/o John Bredemeyer owner of the aforesaid property. Authorized Signature Michael J.Domino,President OF SU!/T�o Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith, Southold,New York 11971 A.Nicholas Krupski • Q Telephone (631) 765-1892 Greg William,sUNTI, O Fax(631) 765-6641 � �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /7 er7� �Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction / '/2 constructed Vom complete, compliance inspection. Project c p p p INSPECTED BY: CO MENT : CERTIFICATE OF COMPLIANCE: �� U�y Michael J. Domino,President \pf SO ®� ®�® Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 0 1 P.O.Box 1179 Charles J.Sanders G P . .`' Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski l�c®UNTV Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 17, 2017 John M. Bredemeyer III, Co-Trustee P.O. Box 245 Orient, NY 11957 RE: JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST c/o JOHN BREDEMEYER 2660 VILLAGE LANE, ORIENT SCTM# 1000-26-1-18 Dear Mr. Bredemeyer: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, May 17, 2017: RESOLVED that the Southold Town Board of Trustees grants the Last One-Year Extension to Administrative Permit#8438A, as issued on June 18, 2014, and Amended on September 17, 2014. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Michael J. Domino, Vice-President Board of Trustees MJD:dd To: Southold Town Trustees From: John M.Bredemeyer o-Trustee,J&J Bredemeyer Family Trust Re: Request Permit Extension for Administrative Permit Number 8438A Date: May 8,2017 Dear Trustee President,Domino, Please consider this request for a permit extension for the above referenced permit for the May 2017 Trustee Meeting as the current permit extension will expire before the June meeting and we have not finished the dual-purpose french drain/walkway. Thank you for your assistance in this matter, Sincerely, i John M.Bredemeyer III,J&J Bredemeyer Family Trust, Co-Trustee CC: Eric R. Bredemeyer, Co-Trustee p E C E I V E MAY - 9 2017 Southold Town John M.Bredemeyer III,President O�®F S®Uj/y®1 Town Hall Annex Michael J. Domino,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski ® aOc Telephone (631) 765-1892 Charles J.Sanders Fax(631) 765-6641 Fax BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 18, 2016 John M. Bredemeyer III, Co-Trustee P.O. Box 245 Orient, NY 11957 RE: JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST c/o JOHN BREDEMEYER 2660 VILLAGE LANE, ORIENT SCTM# 1000-26-1-18 Dear Mr. Bredemeyer: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, May 18, 2016: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Administrative Permit#8438A, as issued on June 18, 2014, and Amended on September 17, 2014. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, ' Michael J. Domino, Vice-President Board of Trustees MJD:dd a John M Bredemeyer III, President 04 ,0"", (�o l Town Hall Annex Michael J. Domino, Vice-Presidentp54375 Route 25 Glenn Goldsmith `; P.O. Box 1179 A Nicholas Krupski Southold, NY 11971 Charles J Sanders � Telephone (631) 765-1892 Fax 631 765-6641 h{ X ( ) BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: MO OVA Completed infield by: JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST, c/o JOHN BREDEMEYER requests a One-Year Extension to Administrative Permit#8438A, as issued on June 18, 2014, and Amended on September 17, 2014. Located: 2660 Village Lane, Orient. SCTM# 1000- 26-1-18 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 L✓ofCh. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission 'V Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N _Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: An 0o _ "Mj .f Present were: J. Bredemeyer t M. Domino L, G. Goldsmith- __IZNI. Krupski --iz—A. Sanders Other IAo%jJ Q Page 1 of 2 John M. Bredemeyer III, President ° �pS�FFU(,tco i Town Hall Annex Michael J. Domino, Vice-President ��o Gym 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders 4, p��0 Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN�OF SOUTHOLD Date/Time: Completed in Work Session by: JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST, c/o JOHN BREDEMEYER requests a One-Year Extension to Administrative Permit #8438A, as'issued on June 18, 2014, and Amended on September 17, 2014. Located: 2660 Village Lane, Orient. SCTM# 1000- 26-1-18 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town:- B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable'and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: I Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 ���F S�Ur Town Hall Annex John M. Bredemeyer III,President y� ,`O l0 Michael J.Domino,Vice-President 54375 Main RoadP.O.Box 1179 James F. King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee OCOQ Telephone(631) 765-1892 Charles J.Sanders,Trustee Fax(631) 765-6641 'YC4UMy,N BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 17, 2014 Mr. John Bredemeyer, Trustee PO Box 245 Orient, NY 11957 RE: JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST C/O JOHN BREDEMEYER 2660 VILLAGE LANE, ORIENT SCTM# 26-1-18 Dear Mr. Bredemeyer: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, September 17, 2014: RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Administrative Permit#8438A to withdraw the expansion of the non-turf buffer area on north side of dwelling from the permit; and as depicted on the revised project plan prepared by John Bredemeyer, received on September 8, 2014 and stamped approved on September 17, 2014. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Michael J. Domino Vice-President, Board of Trustees MJD:amn APPROVED BY BOARD OF 'i RUSTUS p i a � TOWN OF SOUTHOyLD Q --- ! SEP - 8 2014 DATE. \x � O Jo. 1r / 11W.i st ip ' . __ - p aoll Key �3- j ii O jr _ CAN .: ... fer t _ I<A YA o, to z m 0 0 John Bredemeyer, President �%%IfFOl,tc 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�o! ,p �a°! Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: John Bredemeyer on behalf of JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST, c/o JOHN BREDEMEYER requests an Administrative Amendment to Administrative Permit#8438A to withdraw the expansion of the non-turf buffer area on north side of dwelling from the permit. Located: 2660 Village Lane, Orient. SCTM# 26-1-18 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: Present Were: J. Bredemeyer M. Domino J. King C. Sanders D. Bergen Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: • 0 John M. Bredemeyer III,President *OF S Town Hall Hall Annex Michael J. Domino,Vice-President 'lam �p 54375 Main Road James.F.King,Trustee P.O.Box 1179 Dave Bergen,Trustee y Southold,New York 11971-0959 Charles J.Sanders,Trustee Telephone(631)765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SEP - 8 2014 Southold Town'- APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT DATE -heMkr O WNER J•'J . t0*M PHONE MAILING ADDRESS /'► 0. ieh i f 7 AGENT ZdAj, V-4r e Q- 2i fjW PHONE_G 3 /- 3 ?u �f" ADDRESS Zf1-S gj o PROPERTY LOCATION :Z 66 0 f/� Oki ek, 1 TAX MAP NO. 2-6- /- / Tahh #V.,eAP",4,-ia, I/We r 'T+ � nI_'Ujrrequest an Amendment to Permit#JP 96�f to—_����ic�l'AM./QimC�l►eI " GJ,��tihcr /10•��rF 6w6�2✓' q/'�ct e� �Ua�-,rlr d� V� ��/r `� 77(P S� �rcU!/rte N� ��ir✓1/ Tf�19 A- AvIrd �a v1r, ), co -141$ fiir►�. ,„ e.�, ���la��,�, ��' � .��f✓re red ,,�� � m�se ��orel�a�f,��� ��v+�(T ,�..�/sir✓c ,�,�, �.,,,,,� urh4 f �d� 9�e �hs�i�y ef-f 4"k. Signed BY: '�'` Tvvs- ¢. ?A*rl • 0 ar John M. Bredemeyer III, President ��QF soTown 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,TrusteeFax(631) 765-6641 l'Y�UUNTY,�c� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD John M. Bredemeyer,Jr., &Jeanne R. Bredemeyer Family Trust July 10, 2014 c/o John Bredemeyer P.O. Box 416 Orient, NY 11957 RE: Administrative Permit No. 8438A Dear Mr. Bredemeyer, as Trustee, In response to your letter dated June 24, 2014, please be advised that the Board has reviewed your request regarding the non-turf buffer area. Please note the attached permit includes conditions that the permittee provide proof that the covenant and deed restriction be filed with the Office of the Suffolk County Clerk within 90 days of the issuance of the permit, as per Town Code § 275-10 (J). Thank you for your anticipated compliance. Sincerely, Michael J. Domino Vice-President To: Southold Trustees From: John Bredemeyer, Trustee, J & J Bredemeyer Family Trust Re: Non-Turf Buffer C&R June 24, 2014 This request concerns the recent administrative wetland permit approved to construct a fence, kayak rack and provide a small expansion to the existing non-turf buffer. I have been informed by the Trustee Clerk that the small irregular 10'x20' expanded non-turf buffer approved by the Board should be recorded as C & R's. As this proposed non-turf area was "volunteered by the applicant" as an independent, environmental improvement and not conditioned by the Trustees in association with the proposed fence or kayak rack, on behalf of the J & J Bredemeyer Family Trust, I would respectfully request that any filing of C & R's for the property be held in abeyance until major repairs to the retaining wall along the property's waterfront are applied for. This would enable the Trustees to establish a "Board approved" C & R buffer for the entire parcel and not start a dis-connected piece-meal approach for the small area in question, where frequent over-topping of the sea-wall by storm surge renders the area permanently incapable of maintaining a managed turf area. God's saltwater already provides an immutable and permanent C & R for the entire site. Thank you for your consideration in this matter. omeyer, Trustee J & J Bredemeyer Family Trust. JUN 242014 John M. Bredemeyer Ill, President �OgQFFO(,r� Town Hall,53095 Main Rd. �G Michael J. Domino,Vice-President P.O. Box 1179�� ¢� James F. King H ae Southold,NY 11971 Telephone 631 765-1892 Charles J.Sanders y � !� P ( ) Dave Bergen �Ol O 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 V/ Project complete, compliance inspection FSO John M. Bredemeyer III,President o��� UljyOl Town Hall Annex Michael J. Domino,Vice-President 54 Main Road P..O.O.Box 1179 James F. King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee ;4*3 • �O� Telephone(631) 765-1892 Charles J. Sanders,TrusteeNT`1, Fax(631) 765-6641 �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8438A Date of Receipt of Application: May 7, 2014 Applicant: John M. Bredemeyer, Jr. & Jeanne R. Bredemeyer Family Trust c/o John Bredemeyer SCTM#: 26-1-18 Project Location: 2660 Village Lane, Orient Date of Resolution/Issuance: June 18, 2014 Date of Expiration: June 18, 2016 Reviewed by: Trustee Michael J. Domino Project Description: To expand the non-turf buffer area on north of dwelling; install a +/-3.6' high architectural picket "village style" fence along north property line; install a 4' wide dual purpose French drain/access path along northeast corner and north side of dwelling; install a +/-12' long kayak rack along south property line with seasonal cantilever kayak slide over bulkhead. . 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 project plan prepared by John M. Bredemeyer, Jr. & Jeanne R. Bredemeyer Family Trust, received on May 7, 2014, and stamped approved on June 18, 2014. Special Conditions: Permittee is required to provide evidence that the non-turf buffer of the Trustee permit has been. recorded with the Suffolk.County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit 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. Michael J. Domino, Vice-President Board of Trustees John M. Bredemeyer,Jr. &Jeanne R. Bredemeyer Family Trust c/o John Bredemeyer 2660 Village Lane,Orient SCTM#26-1-18 5/14/14 1 r7n 1 Y h .i� John Bredemeyer, President °��%UFFDIt Town Hall Annex Michael J. Domino, Vice-President �° o 54375 Route 25 James F. King P.O. Box 1179 Charles J. Sanders o Southold, NY 11971 Dave Bergen ��i ,F �a°� Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 12-,, --o %� John Bredemeyer on behalf of JOHN M. BREDEMEYER, JR. & JEANNE R. BREDEMEYER FAMILY TRUST, c/o JOHN BREDEMEYER requests an Administrative Permit to expand the non-turf buffer area on north of dwelling; install a +/- 3.6' high architectural picket "village style" fence along north property line; install a 4' wide dual purpose French drain/access path along northeast corner and north side of dwelling; install a +/-12' long kayak rack along south property line with seasonal cantilever kayak slide over bulkhead. Located: 2660 Village Lane, Orient. SCTM# 26- 1-18 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound / Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed: Modifications: Conditions: d - Present Were: J. Bredemeyer Vll. Domino J. King C. Sanders D. Bergen Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: 82.88.88 IUiCN - - -- 0]-t000 Y EEE LISEC.NO. ,630.°0 5 • _ 0}2t-Ot W xssa wx n � S „. B LME w.iCN NE ,OR PCL.NO. 9EE SE1'NO 1 M in ' M 111 ^' 023M c..�o. o N iu 4 � �,�A • �Y x, rzz $S. 12.1 NPJ'� zs Q1 _ 21 24 (w.w'uM1 \� P 43,4 n ; 28.18 •\ \ w \ °� ..a•� 1.u1c1 4 nu \0 �.OI(ch O p.B ..12 a\ \�j Y p w p , , e' r 23 In Jy \ I \ m F Ie 211 �\♦ 33Nc1 1 t0 Ea..��o� —�— "" ,. (21) '^ �.,,u." --'O'-- P,.wa,,, __.__ M NO>•ICE COUNTY OF SUFFOLK © K or sou]NOLn SECigN No EI -M---- _ _� — v..�--�-- Reality Tax NServios Agerwy M 26 �� P..w. , o..�r . ,o p P inciro IMe PROPERTY IU mr+.wortr�ax� p . pF SOUryo OFFICE LOCATION: O l0 MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 NC (cor. Main Rd. &Youngs Ave.) G • OQ Telephone: 631765-1938 Southold, NY 11971 � � o�'.�OUNT Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM VFM AY 1 9 2014 To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: May 19, 2014 Re: Proposed Wetland Permit for JOHN M. BREDEMEYER, JR. &JEANNE R. BREDEMEYER FAMILY TRUST, c/o JOHN BREDEMEYER SCTM# 1000-26-1-18 John Bredemeyer on behalf of JOHN M. BREDEMEYER, JR. &JEANNE R. BREDEMEYER FAMILY TRUST, c/o JOHN BREDEMEYER requests an Administrative Permit to expand the non- turf buffer area on north of dwelling; install a +/-3.6' high architectural picket "village style" fence along north property line; install a 4' wide dual purpose French drain/access path along northeast corner and north side of dwelling; install a +/-12' long kayak rack along south property line with seasonal cantilever kayak slide over bulkhead. Located: 2660 Village Lane, Orient. SCTM# 26-1- 18 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed actions are CONSISTENT with the Policy Standards and therefore are 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 M M John M.Bredemeyer III,President �*qf Slf� Town Hall Annex Michael J.Domino,Vice-President �O lQ 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,TrusteeOI�COU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicatioy _Wetland Permit Application V Administrative Permit _Amendment/Transf r/ t nsion ✓Received Application:!._ 7 M AY - 7 2014 Received Fee:$/O _Completed Application S _Incomplete T 111a :ut i1 _SEQRA Classification: Board of es Type I Type II Unlisted Coordination:(date sent) _7LWRP Consistency Assessment Form CAC Referral Sent: VeDate of Inspection: _Receipt of CAC Repo t: _Lead Agency Determination: Technical Review: r7Public Hearing Held: Resolution: PP cQeyCv �iz� irg4 ce fo✓ �nT �i� �,CylVr�m►`'7 Tr�l� Name of Applicant Sah me K e Mailing Address Phone Number:( Suffolk County Tax Map Number: 1000 - z Property Location: �2, 6 6 O (provide LILCO Pole#, distance to cross streets, and location) AGENT: /1/ll�%) E (If applicable) Address: Phone: and of Trustees Applic 4W GENERAL DATA Land Area(in square feet): /-u j 6'z1-1 QreQ C �;1D D Area Zoning: /Z e.7i 't, � l Previous use of property: Intended use of property: 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 require y 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 er;o r "Oey.r4f fv 6")14— IF e-7 Mu f- ec h� eMer�en1,7 �c�„► �l �-- No prior permits/approvals for site improvements. / Has any permit/approval ever been revoked or suspended by a governmental agency? y No Yes If yes, provide explanation: Project Description (use attachments if necessary): e-�/°Qr�d hod- 7wrf Fence o71 l/-,-4- /oeyl� Z/NE, ��, f,���/ ,IDE d�� r ,�"'?0`U + II., C 4 I/pe vvlel i;lftl �^�GYak rock. /%/�EeVL� bf�i/N /PcGLe.fl A /��ti ON /�//El �/�(24Spe r � �hGa�f On Sovdk �r�per�� �;NEy w (Ih Se'aroma 1 Cwrfc'IUe/pad rd of Trustees Applicat' WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ,e.� D "74) 41ea �od c e /&wn re circ &9L.o-,ko edy d��►�ar�; �m� bk ✓i�f k�%l1 K ���K- Area of wetlands on lot: �� square feet Percent coverage of lot: c4ji k If_ % Closest distance between nearest existing structure and upland edge of wetlands: /J-) feet Closest distance between nearest proposed structure and upland edge of wetlands: 15' feet Does the project involve excavation or filling? No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: A� Manner in which material will be removed or deposited: N 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): 07r 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 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 Pro ect: .l 4J_ [7�/C� QYYI@�6- )"/y �,s f -z rh ram G'hieh�l Project Location(describe,and attach a location map): -:2- 660 Vi Va_ c L � Brief Description of Proposed Action: arc E rcT ���J�Qv-F� � E pt;rve-C car.1SIS�C,Jf LA,,ik V, 11 ,QrcA, Qch "C lue l s/24I N �I D I)j9 e Q GC 6-9 To ,9E� /QAe-K w eft~ ,f"E Flf c l)a 1 C"4(21eu&, o u ev 6u Gnt�l. ie,4yR k �r,,c l/ iS dAs Name of Applicant or Sponsor: }— �l Telephone: 33. IT"' 7 13r� d C�ell(✓ �—Gfiv+2� /w3 T E-Mail: Address: /0" a, City/PO: CJ/ l elks I /- 4 1 Zip Code: 7 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: ❑ F1 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? a acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 3 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial EfResidential(suburban) ❑1~orest ❑Agriculture F-1 Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YE N/A a. A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑/ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: �'�''"y C F 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES F;71 Li 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: ❑ EJ 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? rj] ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Ideptify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline El Forest ❑Agricultural/grasslands ❑Early mid-successional Wetland ❑Urban Ef 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? p`l ❑ 16.Is the project site located in the 100 year flood plain? LLNO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, m a.Will storm water discharges flow to adjacent properties? A14 NO AYES LJ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and sto drains)? If Yes,briefly describe: E]NO [ S S-' ���a n� 1-0 - dra,noma- 14 C-Y1 iJ'i e Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: F71 ❑ 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/spon name:T'`7 6Ve,0e*ey&- j47,/tf V f-j Date: S—7- N 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 large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ® ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? �f ❑ 3. Will the proposed action impair the character or quality of the existing community? 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 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 fes( ❑ reasonably available energy conservation or renewable energy opportunities? l__I 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, © ❑ 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 1:1problems? Ef 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. F1Check 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 12J o2 0 /q- Name of Lead Agency Date At tka e T. Pts;den Print or ype Name of Responsible Officer Lead Agency Title of Responsible Officer Signature of Respon ' le Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 rd of Trustees Applicat4W County of Suffolk State of New York BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)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. V, , Aa h' Signature erty Owner 14 SWORN TO BEFORE ME THIS l DAY OF ,20 1 v � Notary Public CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 puaNfted in Suffolk County Commission Expires April 14,2 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the vart of town officers and emnloyees.The vumose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: 141b h ki /k_ tare d ew e PY 91c y e✓ j�,��1y �wf (Last name,first name,Middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate.the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) -- Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship.with any officer or employee of the Town ofSouthold? "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.an Name of person employed by the Town of Southold v e A74 Title or position of that person 7b`^' I tz2a 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 ZD)the actual applicant. DESCRIPTION OF RELATIONSHIP CDG av` vTT i/r/lc`a�� Submitted ft day o 2004 Signature Print Name �tiH k Form TS 1 } Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant icant 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: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# PROJECT NAME^ f �rQ�C� �-J J�✓»�l l`� J� ���vv�C ar f f 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: arCg� e�,a G/�e L� 7Prx;/h re&,e o-N N Pro per 4 g ZI,Vf Jv✓ ar � � � l S>L ee j� ✓� /lam Location of action: 2 6w Site acreage: Present land use: 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: b A I F�G J* (b) Mailing address: P6, , (c) Telephone number: Area Code( ) 3� 3 - - 7a (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 1� If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation criteria. Yes ❑ No ❑ Not Applicable fir- -�-ut2r- areq i1y C- cls, Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Not Applicable 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 ie / / lEr) T ZTZ CA 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 Pa es 8 through 16 for evaluation criteria 1:1 Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes ❑ No ❑Not Applicable D��Ilry A 0-C i�'rj�ya✓��"�►- t � iN�rr�r»i 2iry G 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 cab 4 Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No Eallot 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. 10, Yej--] No❑ Not Applicable kA k'ZI�� c ,h fv' �G G rP /014 /l�� C /C' �✓'G'b ¢i CLlli� Attach additional sheets if necessary WORKING COAST POLI Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ZrNot 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. 1:1 Yes 1:1LTJ No 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 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Polic=pplicable 65 through 68 for evaluation criteria. ❑ Yes El No PREPARED BY ✓ �h cry e�e �f TITLE �re � r'�7 DATES 7��y T } '0 cry- MAY 7 2014 0 - �r APPROVED BY � s►otno�a;grin x BOARD OF TRUSTEES � 6 TOWN OF SOUTHOLD 1Z DATE Q ig 0 ti sop Sit fl. _ -:✓�- � _ � 6 P Stn 0 �--� DR41AI kA YA ;o cn z ;GAS(_ m 5U -TY OF PROPERTY �I 51 TUATE: ORIENT TOWN: 5OUTHOLD W E SUFFOLK COUNTY NY S SURVEYED JUNE 20 2012 CERT. ADDED: JAN 3, 2013 SUFFOLK COUNTY TAX # Now or Fog, l�e irus't L°nd Revoc°b - I - 18 John B•µenry 1000 — 26 oah erly Kno b I Form C 3RTIFEED TO: N a1 ., 9 JOHN M.ER1®Et�YIER. c Jr.ps. � JEANNE R.)B� FAMILY TRUST � � FIDELITY NATIONAL TITLE INSURANCE r ��" NB2,32 2oelolve. COAFANY OF NEW YORK a4 a l n ' \ \ al 1 1 1 �I N NE XTEN510 � a, `'9._. - .:. ,�' \ � al 13•x`.. toot II — � g N 1 MAY — 7 2014 B fT si I' fl w �q 1 , 1 l0 N 1 1 W w, kw � I a S ISI u � � 0 I N, N, pd) 9 cue u^°ok O 6 d1•w r �,�.n� � p1 N,�1212-IN 1„ N, q, NI NOTES: erl of orm y ■ MONUMENT FOUND Land NO�Q°fQ y4eil oN -It—e'd y �Ey D FROM FIRM MAP �iy g FEMA FLOOD ZONE LINE ANNOTATE ,� la 6b H DATED 5EPTEMBER 25, 200a d°° No. 36103 GOO sh,r� _r��� �� G.E.H.L. AS ANNOTATED FROM COASTAL EROSION HAZARD AREA MAP 2 g s o Jn TOWN OF SOUTHOLD PHOTO No. 5Q-52q-83 DTD AUGUST 2q, IG88 �o o Al- ......- .. ia. o 1 e mac. go r 50 a�e�d ,9 ELEVATIONS REFERENCE LOW LOWER WATER AS 0.0' SAN <SFO JOHN C. EHLERS Lt Nm SURVEYOR Area _ 6, 82 SGFT Area = 0.16 ACRES 6 EAST MAIN STREET N.Y.S.LIC.N0.50202 GRAPHIC SCALE I"=30' RIVERHEAD,N.Y. 11901 12\12-138.pro 369-8288 Fax 369-8287 REF.Q\UsersVohnVhopbox\