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HomeMy WebLinkAboutTR-8487 John M. Bredemeyer Ill, President g�yF�O( -co Town Hall,53095 Main Rd_ Michael J. Domino, Vice-PresidentaV Gym P.O. Box 1 179 James F. King N Southold,NY 11971 Charles J. Sanders 41- �� 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 '/2 constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8487 DATE: AUGUST 20,2014 I ISSUED TO: CHANNING REAL ESTATE,LLC C/O DOUGLAS CHAN PROPERTY ADDRESS: 455 MACDONALDS CROSSING, LAUREL i SCTM# 145-4-17 i i AUTHORIZATION f I ` 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 August 20,2014,and in consideration of application fee in the sum of$250.00 paid by Channing Real Estate, LLC and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits i the following: i Wetland Permit to remove and replace 78 linear feet of storm damaged timber f bulkhead and 35 linear foot return with new vinyl bulkhead and return in-place; add 100 cubic yards of clean sand fill; and install a 10' wide non-turf buffer along the landward edge of the bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated June 18,2014 and stamped approved on August 20,2014. 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 i - I i .yr :?D a Berggu i L . -- } r'f 0 9 TERMS AND CONDITIONS The Permittee Channing Real Estate LLC c/o Douglas Chan, residing at 455 MacDonald's Crossing, Laurel,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: I. 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. The Pennittee is required to provide evidence that a copy of this 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. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. 11. 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. • 0 John M.Bredemeyer III, President �*rjf SjyO Town Hall Annex Michael J. Domino,Vice-President 'tom 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 % A. Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 20, 2014 Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: CHANNING REAL ESTATE, LLC C/O DOUGLAS CHAN 455 MACDONALD CROSSING, LAUREL SCTM# 145-4-17 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 20, 2014 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of CHANNING REAL ESTATE, LLC C/O DOUGLAS CHAN 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 July 22, 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 issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy.standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on August 20, 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, 2 10 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 the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of CHANNING REAL ESTATE, LLC C/O DOUGLAS CHAN to remove and replace 78 linear feet of storm damaged timber bulkhead and 35 linear foot return with new vinyl bulkhead and return in-place; add 100 cubic yards of clean sand fill; and install a 10' wide non-turf buffer along the landward edge of the bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated June 18, 2014 and stamped approved on August 20, 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: $50.00 Very truly yours, ?_ +^ &0 .= John M. Bredemeyer III President, Board of Trustees JMB/amn John M. Bredemeyer 111, President I FQ( - Town Hall Annex Michael J. Domino,Vice-PresidentGy 54375 Route 25, P.O. Box 1179 James F. King ca Southold, NY 11971 Charles J. Sanders � Telephone(631)765-1892 Dave Bergen O Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD - TO: ��e_ Wan D r- C� n n ( n Lr� LLC- Please be advised that your application dated has been reviewed by this Board at the regular meeting of I ` Zb and your application has been approved pending the completion oft e f (lowing 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 Inspection Fee ($50.00) 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: TOTAL FEES DUE: $ 5(),W BY: John M. Bredemeyer III, President Board of Trustees e. E ,PA •,��„ •„fit rte ��.R,� �'„�.��j `e •':,s� i' � 'il .ars 'f�► ,� a. ,� � � -, ��•�'".��47t� .Yah �°�'��'� ..:,`. a ` aY 1 . � Y M` . : ♦. t [ ' moi• r ` r x t �a ` ,'"-Channing Real Estate, LLC c/o Douglas Chan 455 MacDonald Crossing, Laurel SCTM#145-4-17 8/13/14 i 0 0 John Bredemeyer, President \p%UFFot,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 ��ol ,� �a°� Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field InspectionMork Session Report Date/Time: /,>x/11 / 3 / y Jeffrey Patanjo on behalf of CHANNING REAL ESTATE, LLC, c/o DOUGLAS CHAN requests a Wetland Permit to remove and replace 78 linear feet of storm damaged timber bulkhead and 35 linear foot return with new vinyl bulkhead and return in-place; add 100 cubic yards of clean sand fill; and install a 10' wide non-turf buffer along the landward edge of the bulkhead. Located: 455 MacDonald Crossing, Laurel. SCTM# 145-4-17 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: i Conditions: Present Were: J. Bredemeyer M. Domino J. King -CSanders Bergen Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: �5 �1 z - � a F s-. 4 ie. r Photo 1 ECl-,_ ..-:._- .� JUL 2 2 2014 =q �r i q yR. Photo 2 t, a a6 r4 ply, Photo 3 i r� At, 1 �iY'• July 20, 2014 NYS Dept. of Environmental Conservation SUNY @ Stony Brook a{ , 50 Circle Road E C_. _ a Stony Brook, New York 11790-2356 JUL 2 2 2014 Attention: Duty Analyst RE: 455 MACDOMD CRS,LAUREL,NY .` SCTM N0. 1000-145-04-17 Board ..'L'_ APPLICATION FOR PERM Dear Sir/Madame: We hereby submit four(4) copies of the proposed plans, applications, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631484-9332 or e-mail at jpatanjod%Optonline.net. Very truly yours, Je y Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 cc: Town of Southold Douglas Chan, Channing Real Estate, LLC • 30INT APPLICATION FORM • For Permits/Determinations to undertake activities affecting streams,waterways, En waterbodies,wetlands,coastal areas and sources of water withdrawal. US Army Corps of New York You must separately apply for and obtain separate Permits/Determinations from Engineers(USACE) State each involved agency prior to proceeding with work.Please read all instructions. APPLICATIONS TO 1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart- General Services Ment of State Check all permits that apply: Check all permits that apply: ❑Stream Disturbance ❑Coastal Erosion 11 Section 404 Clean Water Act Check all permits that Check this apply: applies: ❑ Excavation and Fill in Management ❑Section 10 Rivers and HarborsState Owned Lands ❑Coastal ❑ p, ❑ Navigable Waters Wild,Scenic and ,u'/' Under Water Consistency ❑Docks,Moorings or Recreational Rivers Nationwide Permit(s)-Identify ❑Utility Concurrence Platforms ❑ Water Withdrawal I Number(s): Easement ❑Dams and Impoundment ❑ Long Island Well (pipelines, Structures ❑Aquatic Vegetation Control ,% conduits, 13401 Water Quality ❑Aquatic Insect Control cables,etc.) Certification Preconstruction Notification- ❑Docks ❑ Freshwater Wetlands ❑ Fish Control ❑ Y / BN Moorings or ,..,/ ❑Incidental Take of Endan- Platforms L7 Tidal Wetlands gered/Threatened Species ,_,/ ❑ I am sending this application ❑ I am sending this ❑ lam sending L`s I am sending this application to this agency. to this agency. application to this this application -agency. to this agency. S. Name of Applicant(use full name) Applicant must be: 6. Name of Facility or Property Owner(if different than 'DD✓�Iws C- � L�lOwner APPlicant) Chatinto; ❑Operator Mailing Address ❑Lessee Mailing Address (check all that apply) 131 wtsT 3s � sT 6FL Post Office City Taxpayer ID(If applicant Post Office City Is NOT an individual): AJG.N -.�o(LIL State N Zip Code State Zip Code I DOG) Telephone(daytime) Email Telephone(daytime) Email 51fo• -7-76. 093$ rr Property Tax Map Section/Block Lot Number 7. Contact/Agent Name 8. Project/Facility Name Sr �V�AG�ONri.LfJ�- efiifwN� COO- �ys� Cy-) I Company Name Project Location-Provide directions and/distances to roads,bridges and bodies of waters: � �5S �iaG�orw.l.�- CfotS�w�b, .. SCG Locs.'J•/ed I✓r� 7t 6F -e Lf eA+.► a Mailing Address Street Address,if applicable Post Office City State Zip Code NY / p6, dewl-rT �Lv� . Ns'S' ni�.c�o.�wtd• Lrolt'"'d LoiVre, 44 4& Post Office City Town/Village/City County ('ea+`f M oris ies sow•th'14 5,.J=1co State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name N4 /193 M.%-tt1+,,c.tL I PIC C&AILC- Telephone(daytime) �.9 33� Location Coordinates: Enter NY]Ms in kilometers,OR Latitude/Longitude Email NYTM-E NYTM-N Latitude Longitude J P�-IYar�' SOP♦on���e.� yo'S�'s3.9y" 7a'3a's��b NMI 30INT APPLICATION FORM 02/13 This is a 2 Page Application Application Form Page i of 2 Both Pages Must be Completed SSeiNT APPLICATION FORM—PAGE 2 OF 2 • t this completed page as part of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and Its purpose.Attach additional page(s)if necessary.Include: description of current site conditions and how the site will be modified by the proposed project;structures and fill materials to be Installed; type and quantity of materials to be used (i.e., square ft of coverage and cubic yds of fill material and/or structures below ordinary/mean high water)area of excavation or dredging,volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource impacts; and where applicable,the phasing of activities. ATTACH PLANS ON SEPARATE PAGES fLcnwivG ani¢ 7b Cf pF c�aMs' 't��r►4eA- b.+c,ILl. ctidt is K.X12. 3 r .L�r •F r�+�. t� -r��.•,l�c N �'�'✓�•+ w t# �•,e w %J Owl(� ro�s�QQ lop G ly e G �N,L�6a d1- �.V �N/v{G �.®Cw"�t�...> �i,5 -�lC�a�t'�^'� • Will CIll A $4 AA F,,t La�dlw.�R o� b✓ ��k �• +''�I" ill "vs'T 6lvrf�� 4 t'.r'n Pro osed Use: Private ❑ Public ❑Commercial Proposed O t i Estimated lm.,t Y-JY p Start Date: r '( Com letion Date: Has Work Begun on Project? ❑Yes IQ No If Yes,explain. Will Project Occupy Federal,State or Municipal Land? ❑Yes Glo If Yes,please specify. 10. List Previous Permit/Application Numbers(if any)and Dates: r•► IA 11. Will this project require additional Federal,State,or Local Permits Including zoning changes? Yes ❑No If yes,please list: �['✓,,..n+ e F Soy.f'k�ll2 TevSK's�S 12. Signatures.If applicant Is not the owner,both must sign the application. I hereby affirm that information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further,the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature,and by whomever suffered, arising out of the p jest described herein and agrees to indemnify and save harmless the State from suits,actions,damages and costs o very n e and description resulting from said project.In addition,Federal Law,18 U.S.C.,Section 1001 provides fora fine of not ore $10,000 or imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conte ,or vers up aterial fact;or knowingly makes or uses alse,fictitious or fraudulent statement. G' f1 uJK?i( Signature of ant Printed Name Title Date Signature of of Own Printed Name Title Date MngMr'e ofAgent Printed NaTne— Date 30INT APPLICATION FORM 02/13 Application Form Page 2 of 2 New York State Department of Environmental Conservation Ak PERMISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s)to the Department of Environmental Conservation("DEC"),the signer consents to inspection by DEC staff of the project site or facility for which a permit is sought and,to the extent necessary, areas adjacent to the project site or facility. This consent allows DEC staff to enter upon and pass through such property in order to inspect the project site or facility,without prior notice, between the hours of 7:00 a.m.and 7:00 p.m.,Monday through Friday. If DEC staff should wish to conduct an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate consent for such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s)sought. By signing this consent form,the signer agrees that this consent remains in effect as long as the application is pending, and is effective regardless of whether the signer,applicant or an agent is present at the time ofthe inspection. In the event that the project site or facility is posted with any form of"posted"or"keep out"notices, or fenced in with an unlocked gate,this permission authorizes DEC staff to disregard such notices or unlocked gates at the time of inspection. The signer further agrees that during an inspection,DEC staff may,among other things, take measurements, may analyze physical characteristics of the site including, but not limited to, soils and vegetation(taking samples for analysis),and may make drawings and take photographs. Failure to grant consent for an inspection is grounds for,and may result in, denial of the permit(s)sought by the application. Permission is granted for inspection of property located at the following address(es): q6 AA.. VONT.CA ('no ss1/4!7 r V ^-✓fx, By signing this form, I affirm under penalty of perjury that I am authorized to give consent to entry by DEC staff as described above. I understand that false statements made herein are punishable as a Class A misdemeanor pursuant to Se tion 2 .45 of the Penal Law.* l�a�s GW N-20l� Print Name and Title gnature Date *The signer of this form must be an individual or authorized representative of a legal entity that: • owns fee title and is in possession of the property identified above; • maintains possessory interest in the property through a lease,rental agreement or other legally binding agreement;or • is provided permission to act on behalf of an individual or legal entity possessing fee title or other possessory interest in the property for the purpose of consenting to inspection of such property. Permission to Inspect Property Application supplement 12/08 617.20 • Appendix B Short Environmental Assessment Form Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name offJ Action or-P oject: 7s� /lfleaG l)a�"'�Lt7� CIOdS'(✓ Project Location(describe,and attach na location map): Apilf Brief Description of Proposed Action: R4.0wavvG un.0 re/Odstc -7Z •` 4"41'G90 ft M heti 41eje' s&A aaw(A 35- t.f o,f d2(a�+aw�G� -t-a�Iv�t'L 44vfA> w t.Fk .vcw vc—y L b✓c.IGk I N fOMG ltiGai �-(•� baS "Q'x<t�"I.ry . jnnrOv0slt lop e-q o f d ft S�wtQ- l✓all GaYAP�w4>ra� ,,aL bvGkht..tr� �", R..cPlrir.� �sf d,.rttiy Sado/AL . Name of Applicant or Sponsor: Telephone: S�6 ,77 b . S d 3 C Aa4(1t fZq a LLG Div Ott CE-Mail: Address: rat wtsf 35- City/PO: State: Zip Code: t-StM. *(.X-IL I �_- I 000/ 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: ❑ 12, Tivv,v .f sovrholot -tcvSt'stb 1 ►-"%.IS 0lec- 3.a.Total acreage of the site of the proposed action? v. 9.'Y7 acres b.Total acreage to be physically disturbed? R.+ acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? e• 3» acres 4. Check all land uses that occur on,adjoining and near the proposed action. � [:]Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial SI esidential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ 0" ❑ b.Consistent with the adopted comprehensive plan? a 17 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: [a ❑ 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? nj ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? �12r ❑ 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: a ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO 1 YES Places? b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: [2rShoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑Wetland ❑Urban OSuburban 15.Does the site of the proposed action contain any species of animal,or associated babitats,listed NO YES by the State or Federal government as threatened or endangered? Z❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? ❑NO []YES b.Will storm water discharges be directed to established conveyance systems(runoffr' and st❑orM srains)? If Yes,briefly describe: LI x Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoun ment 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 J0FMY KNOWLEDGE D / Applicant/sponsorn Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 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?" Fk No,or Moderate small to large s 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? ❑ ❑ 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 ❑ ❑ 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? ❑ ❑ 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 w_ No,or Moderate small to large _ impact impact may may 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 healtb? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 r a� / O / a ♦ 4" 4 M1/ O f D8 12 F �v / M1 1 F 3 d, e P ♦ / M1. / ♦ AMq r f j / e / dlp� / c ip e� e,P / O a G y�F gyp 1` E� N-1 COUNTVOFSUFFOLK © E 80UTNOLo secnoN No Ge,W— --- "-- o —� w _ _ Real Pnaperty Tau Service Agencyr -- o..W -- �1 �....a.. ......,,.., M 145 Y .inxo 1000 more—MAP OFFICE LOCATION: O��OF SOUjyOIO MAIL P.ONGBoADDRESS: Town Hall Annex 54375 State Route 25 l Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) G Q Telephone: 631 765-1938 Southold, NY 11971 Fax: 631 765-3136 0Urm,��' LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM E C fl, AUG 1 9 2014 To: John Bredemeyer, President Town of Southold Board of Trustees , } From: Mark Terry, Principal Planner LWRP Coordinator Date: August 19, 2014 Re: Proposed Wetland Permit for CHANNING REAL ESTATE, LLC, c/o DOUGLAS CHAN SCTM# 1000-145-4-17 A Grandfather Permit (3986) for a 90' bulkhead and returns was issued on February 28, 1992. Jeffrey Patanjo on behalf of CHANNING REAL ESTATE, LLC, c/o DOUGLAS CHAN requests a Wetland Permit to remove and replace 78 linear feet of storm damaged timber bulkhead and 35 linear foot return with new vinyl bulkhead and return in-place; add 100 cubic yards of clean sand fill; and install a 10' wide non-turf buffer along the landward edge of the bulkhead. Located: 455 MacDonald Crossing, Laurel. SCTM# 145-4-17 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 yFFO� 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., August 13, 2014 the following recommendation was made: Moved by Peter Young, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of CHANNING REAL ESTATE, LLC to remove and replace 76 If. of storm damaged timber bulkhead and 35 If. bulkhead return with new vinyl bulkhead in same location as existing. Provide 100 cy. of clean sand fill to replace lost during storm. Located: 455 MacDonald Crossing, Laurel. SCTM#145-4-17 Inspected by: Peter Young The CAC Supports the application, however, there is a concern with the potential impact the bulkhead will have on the adjacent property to the west and the road end. Vote of Council: Ayes: All Motion Carried ` nO � t AUG 1 4 2014 1` G x James F.King,President �OF SO!, Town Hall Annex 0�► 0 54375 Main Road Bob Ghosio,Jr.,Vice-President h P.O.Box 1179 i Dave Bergen # Southold,New York 11971-0959 John Bredemeyer cat Telephone(631)765-1892 Michael J.Domino Fax(631)765-6641 I' i- BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD , i Office Use Only j I --,Coastal Erosion Permit Application j Wetland Permit Application Administrative Permit Amendmentaransfiqr/rExte#sion V1 Veceececeived Application: rvedFee:$ io✓ mleed Application 2 _Incomplete � � i ID _SEQRA Classification: J U L 2 2 2014 1 Type I Type H Unlisted Coordination:(date sent) 7LWRP Consistency Ass men Form �C C Referral Sent: �te of Inspection: Receipt of CAC Report: Lead Agency Determination: , finical Review: blic Hearing Held.—91* Resolution: V Vvj lot S Name of Property Owners) ti n n w �a t es t'..4c (Z C. Ckwn Address 1 31 west 35"*3 S'r b FC. N�� q•iekA)I _ PPO t Phone Number:( ) S/b • 77 i — 6 a 36 Suffolk County Tax Map Number: 1000- I Ys- 04-17 Property Location: y S s- M X r-D•A1^W rv1 S 9 - 4.4 -,re- I 1 (provide LILCO Pole#, distance to cross streets, and location) AGENT: 1'e frr- re Para n 1 (If applicable) Address: 106 14,ew l-t-t 61".d f Ce,4 -reom �o�e�ticS �w ii 1 Phone: ` 3 I 4 Y•9 3-7-A- 1 Ard of Trustees Application • I GENERAL DATA Land Area(in square feet): . 3 S• 17 Area Zoning: y2 c S i. Previous use of property: R C so a*"+)..C Intended use of property: 5 cn*�« (-- 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 i. and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ✓ No If"Yes",please provide copy of decision. , Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Does the structure(s)on property have a valid Certificate of Occupancy? ✓Yes No Prior permits/approvals for site improvements: is Agency Date i i' I . f ' No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ''No Yes If yes,provide explanation: Project Description(use attachments if necessary): R e,ry u-+G -*n,a &4044 ee 7,0 t F o4: $'Tort oew.*W a'ej -6--w6eA, boCA hen& 4,7,P- '8571e 19,c4he-vot Aft,4 In h•rth ✓t.�•y 1, b.,t h e440 t.y +7o,,.o 44 -Oft • P/ovr sPt !oo c if o F c lt'O'n 5,6"A F,11 4-- losr dvt-i v4 -5:7orin , l i Bc& of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Z va- a •cam r f14CG T fi iC of- '4'M m"100 b,�,wkt ,A-e b✓ClGNt I.�S4rxc 1 L p�yt - //` I . G It •r!f clew-) S��►�sc�. I'f "�o /1/��G �Sl f �v(tNq S'lolM Area of wetlands on lot: square feet Percent coverage of lot:Y % Closest distance between nearest existing structure and upland edge of wetlands: 2oy feet Closest distance between nearest proposed structure and upland edge of wetlands: 2•o feet Does the project involve excavation or filling? No ✓ Yes 1 If yes,how much material will be excavated? _cubic yards How much material will be filled? t VP cubic yards , Depth of which material will be removed or deposited: 3 feet Proposed slope throughout the area of operations: /- Manner in which material will be removed or deposited: 4'cgQ _P�La✓al'e R Z SKid2 51re-eX 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): 'rel ere w,11 IPL NO &,e4,0-rive- G, 4ce,,r bN we-f-t rad T/16�L W(l be got1-h to G e I • • 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 Project: y ST Mote, Dr—to e r..cst.- Project Location(describe,and attach a location map): Brief Description of Proposed Action: Qs m v vG a a&o re,44Ct `7'G 1-f- . ♦f d"n W fAegQ +'M elf- 410C k 4kA Qi wA s f A,"&o QL-l✓i.,�/�w ifk .v cw vc.�.y l- b✓UGk k.� I grov`OG 100 4q 5a�a� ��ll Gk,.a2waraP +� �b✓GkSta� ,,, A.�P�rct l,.st d✓rtyy 5to/� . Name of Applicant or Sponsor: ,; Telephone: 5-4 ,7-r` . SJ 3b C {+�4A� �.� �t�k a LLc Div Itt Cl,►�h E-Mail: Address: 131 we 61- 35,4A 5T FL City/PO: State: Zip Code: 1000/ 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 Er 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: ❑ TIt/✓N of S+v'r�+lat 'CcvSt'et5 1 ►-+`1 S c�F.c_ 3.a.Total acreage of the site of the proposed action? o. 3 27 acres b.Total acreage to be physically disturbed? d•V 4 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? e• 3*)7 acres 4. Check all land uses that occur on,adjoining and near the proposed action. �,� ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ERIGsidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 0 0 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ 0 ❑ 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: ❑ 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 YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? 0 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? Erl ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: z 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ['Shoreline ❑Forest ❑Agricultuml/grasslands ❑Early mid-successional ❑ Wetland El Urban OSuburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, 1:1a.Will storm water discharges flow to adjacent properties? []NO [:]YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ❑YES _ Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? ❑ If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE D Applicant/sponsor 4n Date: 7 b/-2ply Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" 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 u ❑ regulations? 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? ® ❑ 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 ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: © 1 ❑ 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 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage (� problems? �J 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. ECheck 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. b I'A4 U 7_01W-1. 6 o ar; // f� ,Name ofLea 4ALye ncy Dat J 5/ Orn/",ILoV. Print or Type Name of Respo sible icer in Lead Agency TV6 of Responsible Officer Signature of Respopfible 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 Name: Address: MCDDM1Cb tbge e P4 PD 313 La el , 1 I Q+,�s Gannen VD bcx 1b2, l�q5 z Cbxej (off Q-cSe ,qvc STATE OF NEW YORK COUNTY OF SUFFOLK J4�a�Gi>1 d ,residingat bein&duly sworn,deposes and says that on the day of 20deponent mailed a true copy of the Notice set forth in the Board o rustees 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 roll of the Town of Southold; that said Notices were mailed at the United States Post Office atothat said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before nle this g Day of 20J_4 i Notary Public Qj Loran Paten- Notary Public�tew York Qualified in CommisNsoty ionOlP 1508t�1 nea OM7/1018 John Bredemeyer, President gufFO(� Town Hall Annex Michael J. Domino, Vice-President ��°�° c°ay 54375 Route 25 James F. King y P.O. Box 1179 Dave Bergen o • Southold, NY 11971 Charles J. Sanders y�'ai , , �a°! 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 CHANNING_REAL ESTATE, LLC, c/o DOUGLAS CHAN COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS , residing at/dba 10(p 144 A-M Vd C. n-cr Ac-n-en m\q l L being duly sworn, depose and say: That on the 10 day of Au,-3u5+ , 20141 personally posted the property known as 45 MacDcnak-j Grt�sInO Lour l NY 11q46 by placing the Board of Trustees official p ster 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, August 20,2014. Dated: (sipKatW Sworn to before me this ,O day of A'5 201Lf Notary Public Lodann Patanlo Notary PubNc Sta of New York Qualified ink County No:01 P 150861 Commission E 0n7t20le 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. Ch"ni T*oJ Es"o OWNERS OF RECORD: o as man SUBJECT OF PUBLIC HEARING: Remove and replace 78 linear feet of storm damaged timber bulkhead and 35 linear foot return with new vinyl bulkhead and return in-place; add 100 cubic yards of clean sand fill; and install a 10' wide non-turf buffer along the landward edge of the bulkhead. TIME & DATE OF PUBLIC HEARING: &JfAfleaJ�,' Pm&�,po, c;IoIL� 40robo4x+5,b* 30W If you have an interest in this project, you are invited to view the Town file(s) which are available for insection rior to the day of the hearing during normal business days between the ours o 8 a.m and ,4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 BA of Trustees Application I County of Suffolk w State of New York i Di )� y C 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 1.. 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 IS AP ICATION. Signature roperty Owner I SWORN TO BEFORE ME THIS ` DAY OF ,20 I ` r,QaiN "U',lK Notary Public - State of N w York ' N0. 01fU6184229 Notary Public Qualified in N!-,v York cunty my commission Frpires_ —��b i e�& of Trustees Application • i AUTHORIZATION (where the applicant is not the owner) I, '00•.,21•►s e g a n residing at 131 wcsT S S7 y 5T 6,FL (print owner of property) (mailing address) t✓cw �Ox , /0Y I o©vl do hereby authorize �__ _�_ (Agent) to apply for permit(s)from the Southold Boar of To Trustees on my behalf. (Owner ignature) f 1 i • li i �C APPLICANUAGENTBEPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM 1� no Town of L ;his form is to provide information which can alert the town of i—nama sono I cts of irate al w it to take whatever action�S TIMN to avoid same. / YOUR NAME: _ C N♦0., h lk S (Last name,fust name,.gtid a initial,unless you are applying to the name of I someone else or other entity,such as a company.If so,indicate,the other person's or company's name.) i j NAME OF APPLICATION: (Check all that apply.) Taxevance Building � Tivstee Variance Change of Zone Coastal Erosion Approval of plat Mooring 1 I Exemption from plat or official map Planning Other (if"Other",name the activity.) u personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee Do y° or business interest"Business interesP'means a business, of the Town of Southold? "Relationship"includes by blood,marriage, 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°r6 of s ares. YES NO � Ifyou answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold I Title or position of that person Describe the relationship between yourself(the applicantlapa/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"hild 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); I 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 j D)the actual applicant. I DESCRIPTION OF RELATIONSHIP .I j : Submitte4this -Signature Print Nam Form TS 1 k i Town of Southold _Erosion, Sedimentation AStorm-Wa#er Run-off ASSESSMENT FORM [- PROPERTY LOCATION: S.C.T.AA.S. i' _ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A /y r OY 17 0A—TER,GRADING,DRAINAGE AND EROSION CO L!PLAN '61a<ir1M mon -105'e ck- Tot^- C1111111TIFIND BY A DESIGN 11111111101IFESSIONAL IN THE STATE OF NEW VOW& i� SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? 1 Will this Project Retain All Stam-Water Run-Off (Include Total Area of all Parcels located within 1 yJ.T d.X77 Generated by a Two(2')Inch Rainfall on Site? the Scope of Work for Proposed Construction) (This item will include all run-off created by site ❑ 1 (S ./Arras) b. What is the Total Area of Land Gearing clearing and/or construction activities as well as all i and/or Ground Disturbance for the proposed -goG- �3 Site Improvements and the permanent creation of construction activity? impervious surfaces.) ( F.f Apse) PROVIDE BRIEF PROJECT DFSCREMON (m&$Aditmd cos as N.ad.d) 2 Does the StPlan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location?-This — Item shall include all Proposed Grade Changes and Aew9ytk •ri.R 4-d lam.G e -7 Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion / �!✓(, /t a `s�� 3 s C - ♦ ( and sediment control practices that will be used to _/ F-1 control site erosion and storm water discharges. ThisI W1.0% New ✓diver L by 4A4(,,0 , Item must be maintained throughout the Entire f Construction Period. '�GP�rIr Gt l®D dN Gftee.�+ S�r� 4 Will this Project Require any Land Filling,Grading or • ` Excavation where there Is a change to the Natural ❑ z!�� �S� [� �'ly�iA1• Existing Grade Involving more than 200 Cubic Yardsul of Material within any Parcel? § Will this Application Require Land Disturbing Activities Encompassing an Area In Excess of Five Thousand ❑ ' (5,000 S.F.)Square Feet of Ground Surface? r 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP itaauiraments: or within One Hundred(100')feet of a Wetland or I Submission of a SWPPP is required for all Construction activities involving sod Beach? disturbances of one(1)or more acres;including disturbances of bas than one acre that7 Witi there be Site preparation on Existing Grade Slopes ❑ are pais of a larger common pen that witfimately d rd �ltub one or more saes offend; which Exceed Fitteen(15)feet of Vertical Rise to Including Consbuclfon wNtles Involving sod disturbances of less then one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit Is required for storm water discharges. (SWPPP's Shall meet the IBmimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction sativity-Pennk Na OP-040401.) Surfaces be Sloped to Direct Storm-Water Rurt-Oif F-11.The SWPPP shell be prepared prior to the submittal of the NOI.The NOI shad be into and/or in the direction of a Town right-of-way? submitted to the Deperknent prior to the commencement of construction activigr, 2.The SWPPP shat describe the erosion and sediment control practices and where S 1MII this Project Require the Placement of Material, required,post-construction$turn water management practices thet will be used and/or Removal of Vegetation and/or the Consh ictiott of any constructed b reduce the pollutants to storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit.In addition.the SWPPP shat Area?irrNe mem vole Nor induct.as euan.sen a udw„ey Aprons i identity potential sources discharges.pollutn vthiolb may reasonably be ebpeeted b affect the NOTE: R Any Answer to Questions One tMo h tans is Ansv.end with a Check Mark Ih 3.AD r W atone water quire, M a Box and the constructlon sift disturbances is between St0 W.A 7 Asn in 1 S.m SWPPPa that require,the post-constructionDesi storm water management practice Y s Storm-water,Grading,Drelnaee a Erosion Control Plea Is rad woe, of ' component ledge abprepared dr a quaand Design Professional Licensed in New York Southold and Must be Submtted for Review Prior to Issuance of Building Town that is knowledgeable in the pdne les and practices of Storm Water Management (NOTE: A!Yuck Matic(%N)amlfor Anftw for each Queseon is Required for as Compete Application) : STATE OF NEW YORK, �'/�/� CAAOUNTY OF........(................................SS 771st I,.........v ?.C ...............................being duly swum,deposes and says that he/she is the applicant for Permit, (Name of indvidual signing Document) And that he/she is the . ! .............................. (Owner,Contractor,Agent ......................................................................................... Corpareta Officer,ala) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be performed in the manner set forth in the application filed herewith. sworn to before elme this; II ...............................................djiy of. �J��............................. ,20... Notary Public: ................... ........ if+3 .E1 G ; ............ ............................................. ...... .. tic 5t�, C Of IvCw York atureofApplicant) FORM - 06/10 No. CIFU60118422U �) Oualified in Ns�'.'YorkCcun?Yb My s Commission Expire ;�,� Town of Southold i LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS I. 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 si ' cant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). j.. 1 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 ealained in detail, listing both sanuorting and non- _ suauortina facts. If an action cannot be certified as consistent with the LWRP policy standards and { conditions,it shall not be undertaken. . i. 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 lanning Department- all local libraries and the Town Clerk's office. D E CFI a t� B. DESCRIPTION OF SITE AND PROPOSED ACTION ' JUL 2 2 2014 SCTM# 1 y f - `� 1 -7 ' PROJECT NAME 5 5 /1/�aG D��«C.lz ��o1SlN l��vl L _... I The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees L"S 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: Ae~va dwQ &014cs. -10 L(' ala.aa2cd2 b-r-X"4-.tQ C.1960 3SCF v 6&, ee,,cP ewyc v•, L bw L& �ts.vn nv S.finc Lv�w'T�a� .�rivrdc !ro yyIf- CIMA fanIO 41/! 1&^ghw.,.r412 of- b0(-kAto4,P 7t• 941:1*61e L�sT a2�r�Nf Strom+ I ' Location of action: (1�-r 4Aa c D!:',va LaQ Site acreage: d•3? 7 Present land use: l2e S!cV 6^-t�w(. 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: i (a) Name of applicant: fee. CGkb (b) Mailing address: / 3 t w,c yr 3S- d+ L 0 A.-se 'J H IJN_ f ( von( (c) Telephone number:Area Code( ) 5-1& 013 8 ! (d) Application number,if any: 14 Will the action be directly undertaken,require funding,or approval by a state or federal agency? i, Yes 0 No❑ If yes,which state or federal agency? r-''1 QQCc— I 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 f P n��G'f ty�hw n t t s tom....»v A•-(-� C�+.+,raG'�•GI�- a.� .Pl�vc.�..vg I. ✓t L v«.`1,,, rt�/,'/� �. 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 F] Yes ❑ U No Not Applicable I i i. 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 j i 2Yes ❑ No ❑ Not Applicable Pry i t c k r O v��Q r� �ir.C. a ti/c r��!lT„_a D--r�`'�t-`"'�'w�► b✓�tG/�•�d , Attach additional sheets if necessary I. NATURAL COAST POLICIES Policy 4. Minimize loss of fife, structures, and natural resources from flooding and erosion. See LWRP j Section III—Policies Pages 8 through 16 for evaluation criteria Yes ❑ No ❑ Not Applicable ProjirG4' -the- G.ft eye Lws►� I��+.+Q crpet of ��-Ftvv Z.r,.1 w- fit- ✓P�n� ,..�{-L . 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 Pr'owe,+ Prof a. "rrieA- 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. ❑ ❑ I rJ ! ! L Yes No Not Applicable I . i 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 evaluatioxt criteria. ❑Yes ❑ No U Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the.Town of Southold. See LWRP Section III=Policies; Pages 38 through 46 for evaluation criteria. ��� 1:1Ye� NoET Not Applicable Attach additional sheets if necessary I 0 i WORKING COAST POLICIES i 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 Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic j Estuary and Tom[waters.See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No U 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 1:1No� Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No L� Not Applicable PREPARED BY TITLE A le n tet' DATE 7- I• I I. July 20, 2014 Town of Southold Trustees FRE Town Hall Annex Building54375 Rte. 25 ' ') P.O. Box 1179 ,UL 2 2 2014 Southold, New York 11971 { RE: 455 MACDONALD CROSSING, LAUREL, NY - SCTM No. 1000-145-04-17 APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 ti S 0S�o� v� C E 6a ;J �p v� J U L 2 2 2014 i o e ar R=15. 0 L=24.39 N p. �1 d- 44 i . lIX o; p w a 66 y 0 PROJECT LOCATION MAP O r� cs� MM cmc.100 Cf OF ru Lasr N.T.S.oo y ouac soar �. o� /n;'F CONNU m SSW NaaSOFM BULK" x , a PROJECT ti , APPROVED BY o x ,. �,�,,,'A LF WK�,,,��, LOCATION / BOARD OF i RUSTEES PROF=uE OF 10'IM-nff 9%M J a6 TOWN OF SOUTHC DATE 2� l NOTES: PROPERTY OWNER: SCALE: 1. ELEVATIONS REFER TO M.L.W. CHANNING REAL ESTATE LLC BULKHEAD PERMIT PLANS 1"=30' 2. LOT AREA =14235.17 SQ.FT. (0.327 ACRE(S)) 131 WEST 35TH STREET 6 FL 3. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: NEW YORK, NY 10001 PROPOSED PLAN DATE: 6-18-14 MICHAEL K. WICKS LAND SURVEYORS PREPARED BY: CENTER MORICHES, NY 11934 JEFFREY PATANJO 106 HEWBL455 MacDonald CROSSING ITT BLVD. DATE SURVEYED: JUNE 5, 2014 CENTER ITT D. NY 11934 LAUREL, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: 631-484-9332 TAX MAP N0. 1000-145-04-17 1 OF 2 PROPOSED TIMBER TOP CAP NOTE: REMOVE EXISTING REMAINING STRUCTURE IN ITS ENTIRETY PROPOSED 3"X6" PROPOSED 1' LONG 10" BUTT AND INSTALL NEW BULKHEAD REAR WALE CCA TREATED TIMBER PILE, 6' IN THE EXACT SAME POSITION O.C. AS STORM DAMAGED BULKHEAD RE—PLENISH 100 CY RAISE TOP ELEV. APPROX. 1 FT. SAND LOST DURING STORM - - - -- APPROXIMATE M.H.W. REMOVE REMAINING \ \\ \\ DAMAGED BULKHEAD PROPOSED 8" TIP CCA TIMBERS \ \ \ \ \ \ LAY—LOG PILE APPROXIMATE M.L.W \ ,�\ \ PROPOSED 8" TIP CCA PILE, 6' PROPOSED 6x6 CCA O.C. 8' LENGTH. BOLTED TO TOP & BOTTOM WALE LAY—LOG WITH 3/4" PROPOSED 10' LONG ESP 8.5 GALVANIZED THRU—BOLTS. VINYL SHEETING PROPOSED 16' LONG 1 " DIA. GALV. TIE ROD, 6' O.C. TYPICAL SECTION N.T.S. PROPERTY OWNER: CHANNING REAL ESTATE LLC BULKHEAD PERMIT PLANS SCALE: 131 WEST 35TH STREET 6 FL As Noted NEW YORK, NY 10001 PREPARED BY: PROPOSED SECTION DATE: JEFFREY PATANJO 6-18-14 106 HEWITT BLVD. CENTER MORICHES, NY 11934 455 MacDonald CROSSING 631-484-9332 LAUREL, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: TAX YAP NO. 1000-145-04-1 2 OF 2 V , JUL 2 2 2014 7 7�-7——i ro `rw. 1 � xy �j. A R=15. 0 ?�G 0�6S,� ;r 4, 4, �Qio� ��� x /439 •� tl x� o0 �5 x� �i O O �y AS N� Y ✓ r D V O d 4 N M C N 0 O N O J N W } LY to 9 J W SURVEYOF PRa L i-i s U FRTY Z LOT 10 & WESTERLY HALF OF LOT 9 0 j MAP OF V1 EDGEMERE PARK z COPIES OF THIS SURVEY MAP NOT BEARING THE LANG- YOR'S INKED o FILED:7—2-1931 — MAP #:742 OR EMBOSSED SEAL SHALL NOT BE..CONSIDF. _O COPY. SITUATE Q�ti�CL K. y0 LAUREL \v� TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. k SURVEYED: JUNE 5, 2014 0503�3p NOTES: STANDARD NOTES: 1. PROPERTY KNOWN AS TAX MAP# 1000-145-04-017 2. LOT AREA =14235.17 SQ.FT. (0.327 ACRE(S)) d 1. COPYRIGHT 2012 MICHAEL K. WICKS LAND SURVEYING 3. THIS SURVEY WAS PREPARED USING A TRIMBLE 2. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY MAP BEARING A S3 ROBOTIC TOTAL STATION. MICHAEL K, WICKS, P.L.S. #50390 'E LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209, Sue-DmSION 2, of NEW YORK STATE EDUCATION LAW. 4. PROPERTY CORNER MONUMENTS WERE NOT SET AS h 3. ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL PART OF THIS SURVEY. ARE Gf:NUINF.. 1'RUF. AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK AND OPINION. 5. VERTICAL DATUM: MEAN LOW WATER = 0.00' MICHAEL K WICKS W CERTIFICATIONS ON THISORD BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP LAND SURVEYING Y WAS PREPARED IN ACCORDANCE WRFI THE CURRENT EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE 6 ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, INC. THE CERTIFICATION IS •C LIMITED 'TO PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS PREPARED, 200 BELLE VIEW AVENUE TO THE TITLE COMPANY, TO THE GOVERNMENTAL AGENCY, AND TO THE , LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP. CENTER MORICHES, NEW YORK 11934 N , THE CERTIFICATIONS HEREIN ARE NOT TRANSFERApI.E. VOICE: 631.874.0156 - FAX: 631.909.3845 6. THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE m NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED. IF ANY UNDERGROUND o IMPROVEMENTS OR ENCROACHMENTS EXIST OR ARE SHOWN, THE RECORDS OF RICHARD C. DRAKE a IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY]'HIS SURVEY. O '7. THE, OFFSET (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES 70 SCALE: SURVEYED BY: DRAWN BY: THE. PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE' ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS, 1"=3O' M.W./B.W. A.C. 1 OF 1 POOLS, PATIOS PLANTING AREAS, ADDITIONS TO BUILDINGS, AND ANY OTHER 'TYPE OF CONSTRUCTION. / - - U