The URL can be used to link to this page

Home My WebLink AboutTR-8505A • • John M. Bredemeyer Ili, President glSEFq( .co Town Hall,53095 Main Rd. Michael J. Domino, Vice-Presidents Gym P.O. Box 1179 James F. King ti x Southold,NY 11971 631 hone Charles J. Sanders y �` �� Telephone( ) 765-1892 Dave Bergen �l dao Fax(631)765-664 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1St day of construction '/ constructed Project complete, compliance inspection 0 SOF SO(/j John M. Bredemeyer III, President ��► yQl Town Hall Annex Michael J. Domino,Vice-President O 54375 Main Road P.O.Box 1179 James F. King,Trustee CA INC Southold, New York 11971-0959 Dave Bergen,Trustee �p Charles J.Sanders,Trustee O Telephone(631) 765-1892 ��'CoUNT`I,�c� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8505A Date of Receipt of Application: September 12, 2014 Applicant: James A. Cope SCTM#: 37-5-22 Project Location: 1390 Bayview Drive, East Marion Date of Resolution/Issuance: October 22, 2014 Date of Expiration: October 22, 2016 Reviewed by: Board of Trustees Project Description: To remove an existing silted-in drywell and overflow drain pipe; install an approximately 6' wide by 96' long pervious area with a 6" to 12" varying depth pervious sand base, and cover with a flat bluestone surface. 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 James A. Cope, received on September 12, 2014, and stamped approved on October 22, 2014. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. John M. Bredemeyer III President, Board of Trustees John Bredemeyer, President o�oSUFF91t 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 �� ,� �a°� Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: JAMES A. COPE requests an Administrative Permit to remove an existing silted-in drywell and overflow drain pipe; install an approximately 6' wide by 96' long pervious area with a 6" to 12" varying depth pervious sand base, and cover with a flat bluestone surface. Located: 1390 Bayview Drive, East Marion. SCTM# 37-5-22 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 '-Te �Y Mailed/Faxed to: Date: SE low fLO .v r ,F• .tit y,V��°'�.1�l� a I.�'��- 'Y" �•% r, r i-Ir'IV pfi � � p r\�1 w • g � w ' t \ e a• i op r 4F Ar VP Am w •lam � � `�f a":. ems► � s'��, �+' xj+'p_ f��z�„ s�� / _- � ,au a Av JW r i v c .ten t aft} �� tf=i a e�ly �'_� 1 ,+ "r`� ✓.fr r *� ': - y go i a , �i- -'' � r • �« - � fir��, �•�a =� , 1 � c� c : Not Nov �. e��t-.=mac• ,� _�_lfj� �.. Rho1 Aw y e !t + p+M 'l • or .y'e SAN ` Y..� •Jr i • �"' i alb:: ��e� - • P 34, zi 4� 440 L r * �P pi �.. �. y�!!;�,+y;�y"��a +*,+ •.. wr,� . � �� yet � ��r —.._.� a::�'�' 7'.s r - t , X3'•,3 a e - 40P4p„ , rt r. i i y +i,� r�� is �.. � 1 �• AW MAP ?r I :ir ir M'�� •a� J Z �� 5 ate, ,r/ r _IL A" J4.�..yw., E., t ' r�• 9' ,.�y,,^ /4- F7 (!?WS� �Ef'►�DV�—D- WELLVED WE1-z- ��(CAv4 7Z7-6 .4N o 6 0 John Bredemeyer, President sUFF014c 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 'oi , , �a°! Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: J D / T //'—'o-i' JAMES COPE requests a Pre-Submission Inspection for the elimination of an unauthorized drywell and overflow pipe which discharges into the Spring Pond canal; and repair and an upgrade of a footpath leading to a bulkhead on the property to assist with the runoff from Bayview Drive to Spring Pond canal. Located: 1390 Bayview Drive, East Marion. SCTM# 37-5-22 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: 6dIT 4q , --I 4) y- - J Modifications: Conditions: Present Were: J.Bredemeyerzm. Domino J. King C. Sander D. Bergen Bay Constable Other Form filled out in the field by Z ��^`' �-, Mailed/Faxed to: Date: a. f'. - - .. -. �»' '�,.•t ��/°" til �►.� "�*' '• a 'i• #. ,� r t,.T nf'S� J , • w. r - Ff1 „ J j .$ s , James Cope 1390 Bayview Drive, East Marion b.. SCTM#37-5-22 br 9/10/14 PF f .lop, it IL 4. . a _ . • � say 4 „ - , tom* � ,� � ,,e�!" � �• ��, � „� � ,� � fYr � 1r V � - y a d- a a � 4 �+ •4*` et r -1!'i".-. ' h' . �y�.. t �- .. - _ t „PJM,, �.,on, S2 e f P ems! p d d f f ' �^'` � A un,. rN.l M '"�, �� 1*♦ � a'er �� J � + I � OREM ��i ♦ e d r, r w .vv � Pe.r tB r m, � I� .w,wn as d ' t ' -----_ COUNTY OF SUFFOLK mm .ww wx..exxcc�...w x.uu somxorn sEcnoN cT� Real Property Tax Service Agency i .,twt vmn o r. n.M�.au rr — ,� w,rn.mwn..uwvw wnn Gwn 4„w wmnre x M m K -- wrwr �� wnannxmwwruvnw a s ,m m b o-.mcr xa ,Me �37 1 . . BA YVIEW DRIVE r: mom N. 89'4470" E. _ _ __ 152.87' T \ 4 — — — Q SURVEY OF LOT 15 SE'CTON OW "GARMWrS BA Y ESTA TES SECTION TWO" 4 IS•�L � v_ S FOLK COMTY FZE NO. 275 01 s A T EAST MAR/ON y 3 TOWN OF SOUTHOLD r prow hs� • _ -- =° '► -Zo � Z SUFFOLK COUNTY, N. Y. 3*' wo - 37- OS - 22 �p qo m Scale: 1"= 20' pp - -_ 5,,.. i 5,, ,\ s \ April 12,1994 \ woo —- - , / l god s� R 07-y. cza .4. \ SA ��oIN 3TC �� o zo r T. Prepared in accordance with the minimumFEMA ZONES A 7 EL, 9 � , N.Y.S. LIC NO. 496/8 standards for title surveys as established A 7 EL. 8 by the L.I.A.L.S. and approved and adopted PECONIC SURVEYORS, P.C. for such use by The New York State L and AREA = 11623 sQ.f t. B (5/6) 765 - 5020 Title Association. P. 0. BOX 909 t0 fie kos ELEVA TIONS AAV CONTOUR LIDS ARE REFERENCED MAIN ROAD TO N.G.V.DA TUAL SOUTHOLD, N.Y. l/97I 94-147 0 OFFICE LOCATION: O��OF SO!/Tyol MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) rn G Q Telephone: 631765-1938 Southold, NY 11971 • �O P OUNT`I LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM FTo: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner OCT ': f 2014 ` LWRP Coordinator Date: October 16, 2014Tr Re: Proposed Wetland Permit for JAMES A. COPE SCTM# 1000-37-5-22 JAMES A. COPE requests an Administrative Permit to remove an existing silted-in drywell and overflow drain pipe; install an approximately 6' wide by 96' long pervious area with a 6"to 12" varying depth pervious sand base, and cover with a flat bluestone surface. Located: 1390 Bayview Drive, East Marion. SCTM# 37-5-22 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 John M.Bredemeyer III,President �*rjf S�(/Tiyo Town Hall Annex Michael J. Domino,Vice-President ,`O lO 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 `,oU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicatio s--&t*W _Wetland Permit Application V Administrative Permit _Amendment/Transf r/Ex ension7111 � >aeceived Application:eived Fee:$ a SD pa, �mpleted Application SEP 22014 �'�4 _SEQRA Classification: Type I Type II Unlisted ; _Coordination:(date sent) -• : ;: ..: _ flq- �LWRP Consistency Assessment Form b d AC Referral Sent: _Date of Inspection: S _Receipt of CAC Report: _Lead Agency Determination: Yechnical Review: Public Hearing Held: Z Resolution: Name of Applicant x)o 8c)x (og 39 Mailing Address /,3 90 i3AV V/,e 1W Die/VE C, ��,AKiDN � /�Y 9 6,31) L/-77 -o7v6o Phone Number:( Suffolk County Tax Map Number: 1000 - *7.3 ,FF -3-7• -,5- - 12- Property Location: /3 9D 1-3,4 V V/EW 6,12i VG- 1"A/z/OA/ n/�/ 939 R,4YV/�'7v b)01VL=_ (provide LILCO Pole#, distance to cross streets, and location) AGENT: A11,4 (If applicable) Address: Phone: rd of Trustees ApplicatioO GENERAL DATA Land Area(in square feet): O.3 A art E-r sp r=T Area Zoning: R�/a L-7XI77,4 L Previous use of property: UNZJIEVL__Z-DPZ D Intended use of property: / 7'/4 L Covenants and Restrictions on property? Yes _ C�No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes X 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 X _No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? ___Yes -7 X_No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date _X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?_X_No Yes If yes, provide explanation: Project Description (use attachments if necessary): R/nom /"TO T'H-E 51-2/K/G nbA/b OAA144- Vol L- 61=- Tumor- 14RCA6;) A&jAe&7rT' m �e e7VO LI)FT/4�E S/� & PD✓JD C��7vvf}L c3611_kl/C�}D AND &pO/T/NU�NG ( 'C�e�NTICx/DUS, 'rC� �3r4/✓/��W a�IV E2a57oNtirz2aL �EP�li2� 0774 7-/Z (See- 0-4ac k ed) }�2VEN T f1 V,Y Guff _— 4s Z- 1 oto iiV T' T 7-/29 ,�Of} -L-I tiE- - — --_- PIAN A .C.4NAL N T 2/ N Pi 'TGN 42!�„ 7- o l-7T 4,E7A/6 7',4-/ /S 'l " 6 /F T� . a:aZ ID r/,5r X'/S T 6/-jG! / &A L.) IAJ 7-0 A Z=1- 4T Bo d of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: c=S s To D an/vc �D/Z LfFVNLH/NG O� /YI(�TD�[ SSS LUfL7ElZ�'/ZAFT yA/GS, C?,41UOE5� T(/ 2r"'/-l2kFA NLF r 7'7 ,RUL/KNf Aa flab 5l9AF� E�oS)10AJ dONT2O�, Area of wetlands on lot: 119 square feet Percent coverage of lot: O % Closest distance between nearest existing structure and upland edge of wetlands: -2-1 feet Closest distance between nearest proposed structure and upland edge of wetlands: O feet Does the project involve excavation or filling? No Yes If yes,how much material will be excavated? 3 O cubic yards How much material will be filled? 3 D cubic yards Depth of which material will be removed or deposited: l feet Proposed slope throughout the area of operations: kul-rN A•PPAZzlW. 6"' bRol- 1:7�20M FAyV/C-Mi/ D/.L TD CAVAL_ 90r-T 1 Manner in which material will be removed or deposited: N AN b Du c, ,�n/n F=ILL Lz 2U.V 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): 2L--bue 192 EL/M/N/47L /eOAD 4-N7) 1V172A-7iF= p61-07/0� 0,Al `70SPQ/Cs A?tIA 6 C/$- 4-1— L/m/Nf�T S VL`7ZL �72bg%Dft/ T-2py'/ l�vA7�-7z 2vn1 d�� • • 617.20 Appendix B Short Environmental Assessment Form Instructions for Comnletinp, Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 l -Project and Sponsor Information Name of Action or Project: 2tm��lA7iUnJ OF P/-37/ 1w AY RL J V14L_ O/= UN/aUT/-!02/ZA. Project Location(describe,and attach a location map): 1390 /3, 1VIEW b2 , ZE , MAOroAr MVV //939 Brief Description of Proposed Action: RL-7noV E t)rzA/a/ 4-r I2oA p Ac,14 H,4 S . /J n )='z-ow /5'1 Pe C-'0,42_1 ,4�?L)Al pF71= /AJ 70 SC/2r"ACE jZU�v Off/= 1=2D ROAD Jr, '4yv/�Zu D,e� /n/ Tb SPtz/►V C R� 1) I'Y) T/Czrt 7E G2Ot>A/Z S DS/D,v wHiC�4 _7ni 77/L� I.Aj iv S,r�/rvC /-bA/ TH 7Z3 /30L/4E,tFD . Name of Applicant or Sponsor: Telephone: 63/ 4/ 77 — ,2O ( o ✓f�/YI�� V00, D /4- Co�E E-Mail: // 1 41 Address: 1,390 R,,4VVi L---w b>z City/PO: State: Zip Code: 2' 'en4fz/vkv N �' 1 1193 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3.a.Total acreage of the site of the proposed action? lL acres b.Total acreage to be physically disturbed? (p'�( S� 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 Residential(suburban) E3 Forest ❑Agriculture ❑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? ❑ [91 ❑ 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: E,;o ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES I F1 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: n 1.21 El 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? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: JZ 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 ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ® ❑ 16.is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? I O YES If Yes, a.Will storm water discharges flow,to adjacent properties? NO YES ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO YES PLRV/UUS S/JRFAOF S7bAi e Yl l4+�/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: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO I 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/sponsorname: �—/i97 /LfS 14 C?DPY� Date: Signature: TJ Part 2-Impact Assessment. The Lead Agency is responsible for the comp) qn-d 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 F] ❑ 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? ❑ F1 4. Will the proposed action have an impact on the environmental characteristics that caused the El El of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ F]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, El a architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. 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. F] 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 Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Town of Southold Erosion, Sedimentation A Storm-Water Run-off ASSESSMENT FORM PROPERTY LocarloN: s.c.T.M.Ir: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 04 y► STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN -BM&-r melon -MrmF- -M— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within SF Site?Will this Project Retain All Storm-WaterSRun-Off the Scope of Work for Proposed Constriction) �i Generated by a Two(2")Inch Rainfall on Site. (S.F./Acres) (This item will include all runoff created by site ❑ b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Jr-� S� Site Improvements and the permanent creation of construction activity? (S.F./Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages as Ned) Drainage Structures Indicating Size 8 Location?This � F OF VA(AU7-"0Z17zt� D/ZA/n/AGC (tem shall include all Proposed Grade Changes and R/PE nMG Po/v/�� Fi<L VA/Av7"Nt-�2/Z 4 D Slopes Controlling Surface Water Flow. �Rytutl_[- 3 Does the Site Plan and/or Survey describe the erosion M and sediment control practices that will be.used to Z 1 t�-m D v.4 L- o F= ru/z)- /4REA to S f= control site erosion and storm water discharges. This —"°'- /�J� rD F71/D of.5PRI/ u6 Ponyn. Ty item must be maintained throughout the Entire ,gAyv/�w be/VE• Construction Period. �) Z�--Po5/DN Oonl r.--DL- IPG 24 D F 4 Will this Project Require any Land Filling,Grading or 41) PO t uTib rt! 41�7n/7lZOL F/zo M ROAD tui y 5 Excavation where there is a change to the Natural r7� y Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Fi Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction }� General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or y — Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; Including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to including Construction activities involving sold disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? F-1 the DEC has determined that a SPDES permit is required for stone water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious F-1for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shah be prepared prior to the submittal of the NOI.The NOI shall be Into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shah describe the erosion and sediment controrpractices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any ❑ constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the tents and conditions of this permit.In addition,the SWPPP shall Area?(This ram will NOT Include the fra allaaon of Driveway aprons.) identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark 3.AN SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.81 Acre in ares, component shall be prepared by a qualified Design Professional Licensed in New York a Storm Water,Grading,Drainage 3 Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit (NOTE: A Chedr Mark(4)and/or Answer for each Question is Required for a Complete Application) SPATE OF NEW YORK, COUNTY OF--5-0..........°..�... ..........SS That I..................................... ..........................................being duly swom,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) Andthat he/she is the /' !.................................................................................................................................... Owner Contractor,Agent,Corporate Officer,etc.) 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 mgthis; 'r- ..............................` e .. ............ ay of .... . .....................,20 `x' Notary Public: ....... Q Ot f lYDitt............. . ........... .......... ......................... .... .. ....... Jr (Signature of Applicahi nt) FORM - 06/10 NO.OIHY6189695 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 06/30/20 (0 Bled of Trustees Application County of Suffolk State of New York `✓ �OP BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/UW KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN.THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF sem _ ,20 l�F Notary Public CAROL HYDELL NOTARY PUBLIC-STATE OF NEW YORK NO.01HY6189695 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 06/30120 APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The puroose 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 neceg=to avoid same. YOUR NAME: (Last name,first name,ip ddle 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 dl . Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial.ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO Ifyou answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi � day of SL-P 2044f- Signature Print Name J/1 i►1 Form TS l f Town of Southold • • LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" 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: onli website (southoldtown.northfork.net), the Board of Trustees O =e rnrit 1 local libraries and the Town Clerk's office. z B. DESCRIPTION OF SITE AND PROPOSED ACTION SEP 1 2 2014 ^r PROJECT NAME PP/Vf1-FZE� P20PE2-ry u)f{ 7Z -/Z f0l`/ OFF /0 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: ,4 s"Lare-ZVAY 95-"Z-0,V& 6"/,V/D E w TI-I A b coP O F � � ALo/V 6 C-NTl 1ZC L�-WG7T-! r-Ro/✓i /-/-/GH Polxi-' 4i /3,4yVlL--w P2 TD L.bu> Pol"7--kms//, Di= RU//11-1CAb 5Pg11j& ponlD 6,01-rH 9 UND0/-4"T1NG P/7S- AL-o.t/G -r-4C- 951 AA/-D �L'J✓c7zED LUl7H"/�LIJC S72)Al GUh'/C/-f wl-L ,B6 L'on/-rf+iiv&FD W177+/N A !o'[ulDt GfJ/ J Y !Z86E7)LC/oJrl, Td/- 5U/Zi r10E LtJ/LL 1346E- S1WOD714. eivY/l2E /�NGTH aurLL- 6E /�,:t�2VloUS. Location of action: i'3 /.3A Y✓/�--W 0 2/ v�� L—' /YJ loll /,/ 9 3 9 Site acreage: D, 3 A f e c s Present land use: /zed//D'w C[= 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: 4 001' r�o 3'�!x 6's-' (b) Mailing address: 3 °I / '7 7 2_o�p (c) Telephone number: Area Code( ) (d) Application number,if any: /Vo/UG— Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No�Z 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 /Nil M-!'02 CL � � �IZD 72L /�'► F,4Y V/�l�V /5,2/✓F �!A/,U O�/-�� NL�12.C3�/ inn �n c 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 1� 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 0 Yes ❑ No ❑ Not Applicable LL/M/ IU,4 &!�--ROS/O n/ /AJ 70 SP/zinoC; poAJA BY �Z�/✓ A.1'4 77,06 6vA-T2'Pc_ /ZUA/ dF-,c" I //'»P20VE WA7&7Z OUA-Li —7V /N Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural re$ources from flooding and erosion. See LWRP Section III—Policies Pages S through 16 for evaluation criteria ® Yes ❑ No ❑ Not Applicable ,4!5 A13e>yL (,,ff-3 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 I Yes ❑ No ❑Not Applicable A15 tl r3oy 3 ) 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. ❑ ❑ ❑ 2:-000 001,1T�4r0/Av1+n/7-5 I^f SPZ/n16 P,�qN/6 8y /25y.4b Rvn/or=1-::;7 Yes No Not Aplable 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 N 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. MX Yes ❑ No ❑ Not Applicable Li��Nf}7� A/4-%C�2 2UA/ FPZo'w 191V0 Sy220UN11/i(1� 1'00A-b S /N 7'0PON/b 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. ❑ YeO No�9 Not Applicable Attach additional sheets if necessary WORKING COAST POLICIFe 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. FX], Yes ❑ No ❑ Not Applicable EL/InII FJ T alATe� RU&I dFiL FROM /Z04,}- S /N 7a 5P2/NG AOVb 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. 0 Yes ❑ No ❑ Not Applicable /f�ZP L--Zl/ii/yA-iE//Q - ()LIE z�.FUL �NEy�/CAS S, in/f�TE I2��UCE 2—�US/bnl /IV'70 2/N67 P6kl-b 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—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No [C] Not Applicable PREPARED EY -e lam' TITLE DATE TO: Southold Town Trustees FROM:James Cope 1390 Bayview Drive E. Marion NY 11939 631«477�2060 DATE: Sept., 8, 2014 1 respectfully request a pre project inspection at my property, located at 1390 Bayview Drive, E. Marion, NY at your earliest convience. The proposed project is the elimination of an unauthorized dry well and overflow pipe which discharged into the Spring Pond canal and the repair and an upgrade of a footpath leading to a bulkhead on the property. Also the repair and upgrade to a surface runoff path from Bayview Drive to the Spring Pond canal. Thank you, cr:p 8 N1,4 .. .... �SBS.,.,.., - S -T IF SLA to Pel° G LANDSC.477ER S -.(0 t 9 Df 6.4YVIEW g -- - -- 3 11��- -- -- - • D.r 'SAND• 1 _ S ��/ .its-L� ,� '.._ •.S/}u D'•'• ..,. �;. ��, ��ND • SA%1 a-� c.... .� PoNo �1„ �D G�n�G ttl/'TN �'Bs-uESTo�v� �3U�1Gf 4 � NdfE t A;-V 9 DEQ S�ONS W 11�L $E Ff LL Eb TO T14 �f'OP OF i ea- w I?H �f" 8tUE57U"� 3TO Q w(TM 2" BLV��'►b�E APPROVED BY BOARD OF RUSTEES TOWN OF SOUTHOLD DATE C-1 1.3 qo z3,4y v/c D,�Z/V t 4 7 7 —.-2e)66 E, /",4,&--/OA/ N �I I d I IMIS f ,s. �I . 4; .4 BA YV/EW DRIVE ; .. S . T G �o _ N. 8904470' E. 152.87' T ILAz_ SURVEY OF N c LOT 15 so_ _ -- -_-- _ _ ,g• �, w SECnM OW "C14RMMrS BAY ES TA TES SECTION TWO" 'y AFFOUCCOMM ENO. 275 - ti° y '— _ s� A T EAST MAR/ON ' e k''� 00, prop h s 6- a - _9 , , TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 3*'& MW - 37- 05-22 v0 q , \ Scale: 1"= 20' April 12,1994 rgo. � t k, a•a J SOT FF , • � o�) (b i h ` 1i i UP - g K C3* ck 40 �e OfR2�4 /N 4145SI AI ov �Hk1NYOQ'� Prepared in accordance with the minimum FEMA ZONES A 7 EL, 9 �' N.Y.S. LIC. NO. 496/8 standards for lil/e surveys as established b the L.I.A.L.S and roved and adopted A7 EL. 8 y �P P PECONIC SURVEYORS, P.C. for such use by The w York Stole Land _ AREA = 11623 3 ft. B (5/6) 765 - 5020 Title Association, r q'• P. 0. BOX 909 to tie /n@S ELEVA TIONS AND CONTOUR L/NES ARE REFERENCED MANN ROAD TO N.G.V.DA TUM. SOUTHOLD, N.Y. /1971 94-147