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TR-8567
410 000 John M. Bredeme er 111, President `''������.... Y � Town Hall,53095 Main [td.' Michael J. Domino, Vice President P.O. Box 1 179 James F. King N x Southold,NY 11971 Charles J. Sanders ; y,� �� Telephone(631)765-1892 Dave Bergen ' Fax Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD i 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 ' • • t • ... ....... r„. F •,-.: ',.'..., '...."1 ... . ::•• ;' . -. ! . JAN 2 3 2015 ' , ., . 1 0 , -,,-..:- -, ..:..., .. ...,,,,,...,.,. . r. „:I ''' -, r r"',-.1. • • v: r4. ft:; .:;.1'.'`.!- ,- ,..-.1 t\l.5.2., (...) . 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PROPERTY OWNER: ^ —NEYOYE MD REPIfCE 57 LF OF BULKHEAD �l {b/ \ W DIRECTLY IANDY4WD of EXISIMiG O GARY MANGOS c xzocYofFULosr 121 STERLING PLACE e�� DURING STORY W W • MEW ITCH WATER&CRO Bnmea FACE BROOKLYN, NY 11217 /1Asa � moi,, �.� ":".. .....e........................w T'ROPOSED TlE of To'ran-TING euFFm PREPARED BY: ® �.• / I. °osn'D` EA1W E""'os AS TD°"FED By ,� JEFFREY PATANJO J.PATANJO CM ram 1'zo„ 106 HEWITT BLVD. 4-/ . • CENTER MORICHES, NY 11934 . . RUMEN/RETURN Z (W ` W i NC �S9LFOF 631-484-9332 W / DIRECTLY INEWARD OF EOM O BULKHEAD PERMIT PLANS SCALE: 1"=30' NOTES: 1. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: PROPOSED PLAN DATE: RODERICK VAN TUYL, P.C. 11-11-14 GREENPORT, NY DATE SURVEYED: SEPT. 20, 1995 1295 ISLAND VIEW LANE GREENPORT, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: TAX MAP NO. 1000-57-02-16 1 OF 2 PROPOSED FIR TIMBER TOP CAP PROPOSED 3"X6" PROPOSED 8' LONG 10" BUTT REAR WALE CCA TREATED TIMBER PILE, 6' O.C. PROVIDE MAXIMUM 20CY CLEAN SAND PROPOSED 6"x6" CCA NOTE: INSTALL NEW BULKHEAD SHEETING FILL TOP WALE DIRECTLY LANDWARD OF EXISTING BULKHEAD SHEETING AND REMOVE 'YA OLD BULKHEAD SHEETING. RAISE A A\ ELEVATION OF PROPOSED BULKHEAD P -H 1' HEIGHT ABOVE EXIST. TOPCAP M APPROXIMATE M.H.W. EL. 2.5± AM. VA — -- — -- WV I y :ND BOTTOM EL EL. 1.0± 0. B APPROXIMATE M.LW EL. 0.0± , \ : \ EXISTING BULKHEAD \ \ \\\\ \\ \\ \ PROPOSED 8" TIP CCA TO BAEL REMOVED IN LAY—LOG PILE ITS OF NEW /\\///\//\/ /\ // //\/\\\j// A PROPOSED 8" TIP CCA PILE, 6' BULKHEAD /\\/\\>\/ PROPOSED O.C. 8' LENGTH. BOLTED TO POSITION FACE OF •�O PROPOSED 8' LONG CLOC 9000 LAY-LOG WITH 3/4" PROPOSED BULKHEAD GALVANIZED THRU-BOLTS. VINYL SHEETING DIRECTLY LANDWARD OF EXISTING BULKHEAD TO PROPOSED 16' LONG 1" DIA. BE REMOVED GALV. TIE ROD, 6' O.C. TYPICAL SECTION N.T.S. PROPERTY OWNER: SCALE: GARY MANGUS BULKHEAD PERMIT PLANS As Noted 121 STERLING PLACE BROOKLYN, NY 11217 PROPOSED SECTION DATE: PREPARED BY: 11-11-14 JEFFREY PATANJO 106 HEWITT BLVD. 1295 ISLAND VIEW LANE CENTER MORICHES, NY 11934 GREENPORT, TOWN OF SOUTHOLD , 631-484-9332 SUFFOLK COUNTY, NY SHEET: TAX MAP NO. 1000-57-02-16 2 OF 2 C 'Jl!;- * + y 3, 4* • `V:,"7,s t ii� '' •',t#•Z :7'11tN1� .jt.�y" y:11.j% . ",\- / `. I BOARD OF SOUTHOLD TOWN TRUSTEES � , :__.,\'!,, SOUTHOLD, NEW YORK , , ,`` 1:: 1 PERMIT NO. 8567 DATE: FEBRUARY 18,2015 . E ISSUED TO: GARY MANGUS °„•`` .� r-,'; PROPERTY ADDRESS: 1295 ISLAND VIEW LANE, GREENPORT , � , i I SCTM# 57-2-16 AUTHORIZATION , tN, Y ice' /„6r 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 February 18,2015,and , _. ,' in consideration of application fee in the sum of$250.00 paid by Gary K.Mangus,Architect and subject to the , Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits 1 the following: /4-1 Wetland Permit to remove and replace existing bulkhead with 57 linear feet of � -� ' ''' new vinyl bulkhead directly landward of existing; remove and replace directly i' landward of existing a 39 linear foot return on south side, and a 15 linear foot return on '' north side using vinyl sheathing; replenish area with 20 cubic yards of clean sand fill ' behind bulkhead; restore 30 sq.ft. of area to natural vegetated state upon/\\,,,,:; " reconstruction; and to install and subsequently maintain a 10' wide non-turf buffer �{- I along the landward edge of the bulkhead; and as depicted on the site plan prepared by 1 \// Jeffre Patanjo, last dated November 11,2014 and stamped approved on February Y JP PP 18, 2015. 1,,,, IN WITNESS WHEREOF the said Board of Trustees hereby causes its Corporate Seal to be affixed, c, ''''' Lfand these presents to be subscribed by majority a ma'ori of the said Board asof this date. 1) ---- .. \,.. rA,:.,;,,, , aii. ,,-aguFFoc�=- - . y Co- 1 ` 'l t ._..ice_ i i� _.,./ r l'k 00 AT i; r - i � i'��Jj� ��`���1 Charles J. Sand s-Absent • i ...1 ,„‘-„("' s.,,,,,!t\\ ..., , ;;.: ,, ,.,� � - ma w '1 t, w • • TERMS AND CONDITIONS The Permittee Gary Mangus, residing at 1295 Island View Lane,Greenport,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages,of suits arising directly or indirectly as a result of any operation performed pursuant to this permit,and the said Permittee will,at his or her own expense,defend any and all such suits initiated by third parties,and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if,in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee 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. • ��, ��. • -�'�,oF soar John M. Bredemeyer III, President ��I° 04 �� ; Town Hall Annex Michael J. Domino,Vice-President i O 54375 Main Road 41 41 P.O. Box 1179 James F. King,Trustee Southold, New York 11971-0959 Dave Bergen,Trustee �� Charles J. Sanders, Trustee = y�'QUi*`;it° Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 18, 2015 Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: GARY MANGUS 1295 ISLAND VIEW LANE, GREENPORT SCTM# 57-2-16 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 18, 2015 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of GARY MANGUS applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated January 23, 2015, 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 February 18, 2015, 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 • 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 approves the application of GARY MANGUS to remove and replace existing bulkhead with 57 linear feet of new vinyl bulkhead directly landward of existing; remove and replace directly landward of existing a 39 linear foot return on south side, and a 15 linear foot return on north side using vinyl sheathing; replenish area with 20 cubic yards of clean sand fill behind bulkhead; restore 30 sq.ft. of area to natural vegetated state upon reconstruction; and to install and subsequently maintain 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 November 11, 2014 and stamped approved on February 18, 2015. 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, dot-- 6,4,10107,41¢- John M. Bredemeyer III President, Board of Trustees JMB/amn • • ,,, John M. Bredemeyer 111, President �,.�`��UFFQ Town Hall Annex OS j'�c`- Michael J. Domino, Vice-President /, o�y: 54375 Route 25, P.O.Box 1 179 James F. King Southold,NY 11971 ; c4 � ; �' Telephone 631 765-1892 Charles J. Sanders , y�O a0�'��, P ( ) Dave Bergen =- 1 ' '�, Fax Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: J- e 19a.-1-01/4n o &- Cary Mar II-5 Please be advised that your.application dated } 2.3/js- has been reviewed by this Board at the regular meeting of 2f 1 k IS and your application has been approved pending the completion of a following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction.($50.00) 1/z Constructed ($50.00) • V 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: 16,1 TOTAL FEES DUE: $ 5O.ODaD 9a A, • BY: John M. Bredemeyer III, President Board of Trustees -- i ary Mangus -, 1295 Island View Lane,Greenport ., _ ., ,„..,,,:„..„: „... . _ ,.• , • M#57-2-16 11/15 „,„..,.. ,,,, ..,.... ,, „.,.... ... .. .„....., :„. ..,.., • , ., ..... , , . ,, „ . . ..,. ..„`' • , '• ,\ '.ti' 't '. ' '-`.-. : - ' _. ,... ..' . , . -I. . • . , , \' : •‘ 1 I i '- L I ,. . ', if '',\ ., ,..,. .lefk.: 4 ' -•, 1 '•4.•',(1.\ 1: ‘,1 -.1.,,' i- ,..4” '• ‘ 1411 lii1/4N 4t;',p tylo - -.:;1' - - '.'.', • il‘Nie,iO4 'I'M t ,t,•' -0 k , `• '\ .01.V•h,..', ,,, • 1 v4 0 • ,i,: !•1-,1 ilf.//1. 44 ” ; -4411P, , • ,, A ,,,k.-1110:•, v,i1:- ‘, • ,o. gio ifi, , . •O'fill' t-., ,• i , /.. la ftl,N,t •Nk,,, _ -,N.,. 1- I if x NI, It4V' ‘ isith‘ • ° . - il 1 ifil : I , ilk _..,.,•,;,,,,, • ,i, I .„, ik ) Vi lii 11/4 ) t.iii.,ApV , A:\Ikvs7 \ '11 .,V.. sh 400c-7.) .‘ \1 011itt` 0,,,#111,,,A3t$4 /411 v ' rfr "V 01/400r ---- ,, 41)k‘ 1 N A t\li -"pi. Op s ,k .. . .. . . . • ' - , . ,11.1 ilia i..Y - .p.0,, • . .., , , . :, .,* . .,, ' • 1 -:i';'l . .,, , ,. 1' / / '. ' ' '! \:,4„, -4,•,,.,. . •' ':':..._ , • '; I/ i \'''.'.-_'_„,„ - •Ili ,. ...relr'!; -41117"t'''''''''''''4, .....,.,. .• , i''' ..' ..,-,,,:- •'- ' ., . 4 • ,,,,,,,_ John rF�� Michael J. Domino, Vice-President ;' � c 54375 Route 25 James F. King i i 1 P.O. Box 1179 pit Charles J. Sanders 'o �i Southold, NY 11971 Dave Bergen `'-IN ,� ya°'�' Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: It 17- F j 1 S q",5 O Jeffrey Patanjo on behalf of GARY MANGUS requests a Wetland Permit to remove and replace existing bulkhead with 57 linear feet of new vinyl bulkhead directly landward of existing; remove and replace directly landward of existing a 39 linear foot return on south side, and a 15 linear foot return on north side using vinyl sheathing; replenish area with 20 cubic yards of clean sand fill behind bulkhead; restore 30 sq.ft. of area to natural vegetated state upon reconstruction; and to install and maintain a 10' wide non- turf buffer along the landward edge of the bulkhead. Located: 1295 Island View Lane, Greenport. SCTM# 57-2-16 Typ of area to be impacted: Saltwater Wetland Freshwater Wetland Sound ay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: v 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: kJ. Bredemeyer XVI. Domino kJ. King CYC. Sanders D. Bergen Bay Constable Other Form filled out in the field by Mailed/Faxed to: Date: • 1 + JAN 232015 ~ i? Photo 1 r • • • P1111111111111111°11°P.W „7"1" VIIIIPPF . 41-‘,/ - .• • • • . ,a 1.. . ,. 'it ia‘r--• ' to.,4;ijii001 1 "411411041 1 k . r- • ''' " ,q194%11V-e. ' ' -,...• . - . . .4 ,1„ - ..,„ -1,- • -- , - •.. • -No ,- -4 , • .„),. , <., %,), : .. . & ''......1,4,-- - •:.% , ... 4 , .. ' . le - / .„, ..... 40* .. • 4 ' , • . . v J, r. iik • . .4 ,... . ., / '11. 1 it . ...rth ....- ‘... • Photo 2 f • > . . . «:> . o» ?>� • . . . . . : w <�:a: wr • : r>:, � �® . . • Photo 3 • • t ... -1 ;6' ,,,, N4- ,. „ 1 h. , Mr //Aft i P . t,> 'f / kW ".:14:""�`�}. rfi iF1 4 _ r .f'f-^{� ks V �e w a y 4 , et Photo 4 • • January 22, 2015 NYS Dept. of Environmental Conservation ; 4 ] SUNY @ Stony Brook 50 Circle Road JA N ? ^ ,,,- Stony Brook, New York 11790-2356 Attention: Duty Analyst RE: 1295 ISLAND VIEW LANE GREENPORT, NY SCTM No. 1000-57-02-16 APPLICATION FOR PERMIT 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 631-484-9332 or e-mail at jpatanjo@optonline.net. Very truly yours, Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 cc: Town of Southold Mr. Gary Mangus ;1 : •* JOINT APPLICATION FORM • .A., For Permits/Determinations to undertake activities affecting streams,waterways, 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 meat of State Check all permits that apply: Check all permits that apply: Check all permits that Check if this ❑Stream Disturbance 0 Coastal Erosion ❑Section 404 Clean Water Act apply:• applies: ❑ Excavation and Fill in Management 0 Section 10 Rivers and Harbors ❑State Owned Lands 0 Coastal Navigable Waters 0 Wild,Scenic and Af Under Water Consistency El Docks, Moorings or Recreational Rivers L7 Nationwide Permit(s)-IdentifyConcurrence 0 Utility Platforms 0 Water Withdrawal Number(s): Easement ❑Dams and Impoundment 0 Long Island Well (pipelines, Structures ❑Aquatic Vegetation Control 3 conduits, ❑401 Water Qualitycables,etc.) ❑Aquatic Insect Control Certification Preconstruction Notification- El Docks, ❑ Fish Control Moorings or 0 Incidental Take of Endan- ❑0FFreshwater Wetlands ❑ Y / EN Platforms L7 Tidal Wetlands gered/Threatened Species �,/ ❑ I am sending this application 0 I am sending this 0 I am sending CII am sending this application to this agency. to this agency. application to this this application agency. to this agency. i 5. Name of Applicant(use full name) Applicant must be: 6. Name of Facility or Property Owner(if different than IB Owner Applicant) is 4 r y intim rvv5 ❑Operator Mailing Mdress 0 Lessee Mailing Address (check all that apply) I?! Slid)n j eiACe sre '46 Post Office City Taxpayer ID(If applicant Post Office City is NOT an individual): ervok.lyn State.. Zip Code !!1.17 State Zip Code Telephone(daytime) Email Telephone(daytime) Email 417. b1o• 1f78 84(II.r►owl„_t 6)80241,L.441 7. Contact/Agent Name 8. Project/Facility Name Property Tax Map Section/Block/Lot Number Tt4{rcti PA-edge) !els" is/..titer, /vev - S7-oa-ii. Company Name Project Location- Provide directions and distances to roads,bridges and bodies of waters: Ssc to e4 4.0A, (V/419 Mailing Address Street Address,if applicable Post Office City State Zip Code NY I Pb 14e w t-rt aLtAt . • ib.9 S 1.614 nd. t/!kw Little Greene9(4.. /MN Post Office City Town/Village/City County Cen-f-ei 4/1ectC/( e5 5,9041%o1A 5v>FFpCiL State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name f•s4 1031/ So,' 4-k•111. doNiaini Pant- CrteK- Telephone(daytime) b3,• .gist't1 .7332- Location Coordinates: Enter NYTMs in kilometers,OR Lati de/Longitude Email lf NYTM-E NYTM-N Latitude Longitude J fa'he►njv a off o,tlire.mit y!'t>y' '3.ys" 7 ' d''/o4a•" 1," J 'I a -.,,:,f,',244.-,5°! i r-9 ��A s r ',.`ij nrf 0114 h,:.'44-,';,:f.'4 ly+,-�g. f] t JOINT APPLICATION FORM 02/13 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed atINT APPLICATION FORM-PAGE 2 OF 2 • it 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. Qemot.e AAA re/bee ? tF to•F bd.citht Asaw t t. L O✓GIcheea• Rr.►�.vc An& (1q'/' a 3•1 tF 4 4Ser b'44che ) re-Iw s .1 titw i.c C . 17--41st T•j edrf heifk t 11" 4442 vG cle4n sav f i( k•44-4 F e ! 4.4.Gheuict9_ Cris( 3e sr o-F we4l*v,eQ Ore 44C _ leelnovat v �l.Aci?,raj `j✓t./ l,twedb✓t,16ti�,a2 ti•e 1. a2 Ls' v$t4llh4nIPweeret .v f rex4f,•vy 4,'lce rev?" ‘44-#e4--- to Si- # 4_oSi- 11*1sO.4 w` NGW eveniPlc; • Proposed Use: L7 Private 0 Public ❑Commercial Proposed " -1 Estimated s,,A , ,.., Start Date: Completion Date: Has Work Begun on Project? 0 Yes 1211. If Yes,explain. Will Project Occupy Federal,State or Municipal Land? 0 Yes I i If Yes,please specify. 10. List Previous Permit/Application Numbers(If any)and Dates: 11. Will this project require additional Federal,State,or Local Permits including zoning changes? Ll Yes 0 No If yes,please list: T,rw,v .. F .So✓4- i.Z . l ry t 1-4.e 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 project described herein and agrees to indemnify and save harmless the State from suits,actions,damages and costs of every name and description resulting from said project.In addition, Federal Law,18 U.S.C.,Section 1001 provides for a fine of not more than$10,000 or imprisonment for not more than 5 years,or both where an applicant knowingly and willingly falsifies, conceals,or covers up a material fact; or knowingly makes or uses a false,fictitious or fraudulent statement. C t,tz r/V A<ri ee.,6-S p w ex-A...1 ANI L t vvw(- I-2D-)5- gnatur of A piic Printed Name Title Date Aca--C AAI-2.D• I5 ignature Own Printed Name Title Date n re of Ag nt Printed Nathe Title Date ,rr'� h.'t YxsF+ `'s,p ,� .a s JOINT APPLICATION FORM 02/13 Application Form Page 2 of 2 New York State 4111 • Department of Environmental Conservation _ w 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 of the 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): 245 Zsl..,a vtew Isac , 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 Section 210.45 of the Penal Law.* NIa /y S f dWNe/Z- l J? 11 Print Name and Title v Signature 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 41110 • 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: 12 4S =s i' d2 vlrw £4•P a✓GKh«-ek Project Location(describe,and attach a location map): Coe. rt c444 Goemt<o.✓ Brief Description of Proposed Action: a7.,.p a 40412 reelutr 67 1.-f. •A' 44.••Latdei «.a w 01,44.0 1,4~ro deo"lie 31 .L.F t r t-f t1G-1 vr.rs . 8.v50.41 20 14.-K.Qwor.Q at I.,iixl+e.#4 . G/ticr,-U 3® Sfr s. e44'rc2S 4✓'t4. . Name of Applicant or Sponsor: Telephone: .b t -`t$7$ t��arLt /1/LKrvvS E-Mail: 0Rr�rasneys el lur�t +'l.Co Address: v tat STerliny Plate c.ie. 46 City/PO: State: Zip Code: gSCiolLl7h A/"t 11117 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 E. 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: 0 Er r I S b e L - Tit in► m F 50v 4I.bi 3.a.Total acreage of the site of the proposed action? tfr PSN acres b.Total acreage to be physically disturbed? P.01 L acres c.Total acreage(project site and any contiguous properties)owned y or controlled by the applicant or project sponsor? 0' 31 acres 4. Check all land uses that occur on,adjoining and near the proposed action. El Urban 0 Rural(non-agriculture) ID Industrial ❑Commercial [v]Kesidential(suburban) ❑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? ❑ IEt ❑ 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? ❑ r]. 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 Et ❑ b.Are public transportation service(s)available at or near the site of the proposed action? 2 ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ©' 0 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: 2 ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES if No,describe method for providing wastewater treatment: El ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 2- b.Is the proposed action located in an archeological sensitive area? Er ❑ 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? ❑ E b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? 2 ❑ 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: Br Shoreline 0 Forest 0 Agricultural/grasslands ❑Early mid-successional Wetland 0 Urban Pluburban 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? E ❑ 16.Is the project site located in the 100 year flood plain? NO YES T vr 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? ENO DYES a 0 b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ONO DYES 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: ri 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: C ❑ 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: D I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponso ame: 4'r1 fnw.n 7 v S ,s w N c/1 Date: I -20 '"J 5 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?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning 111regulations? 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? El 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: LI a.public/private water supplies? b.public/private wastewater treatment utilities? 111 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, n ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 • No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? E 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. ElCheck 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 NYSDEC SUNY @ Stony Brook 50 Circle Road Stony Brook, NYT 11790 I hereby give Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 permission to submit all applications and address any comments required on my behalf for the following property: 1295 Island View Lane, Greenport, NY 11944 Gary Mangus 121 Sterling Place, Ste. 4B Brooklyn, NY 11217 x Nerices >6� 111 03 30 55 t 05 24 05 SEE SEC.NO.053 0308 02 N 0)nn, Cn _ _ LINE MATCH _ UNE C c n .r.0, "�*1811114 302 ��rvp „:- • 7.4c1 ELRi SEOE�0II N.. ♦ e����� `''.AaGv70 .4 csa��li- , 'N /moo f.w .a' �N• !� 4 N lips,40. .0e, • aE( NIV .i rmNOpu ® \ Y3 .WE 1111111 Ai' 'Pii ao uuN o op �-i �` _ d 2i) — '��j I r/ J SENO is '. si.,„. Ill 26, »>m II E �� ��"' � - -- *-.."0 �^ — -- --"-- Nance ^ COUNTY OF SUFFOLK © K �.* soul".. SECTION NO EG. '�' N21 0... ' 0 '� _ Real Property Tax ServNce Agency v >._._ - ... w... -- ... o...1 'e>as ' fowMCwM it War IIM, M 57 vre lerNv> .vaN, Nn s a ;.� ae m v ase >ewa m � ,A " ° as amnc,w SaM IOTA J PROPERTY Mw > �I { � ... ..y ^'3 v T- .'t .o. E ., ..• -.�. ..... ti k x1�.Lwt'�'"8 $'� �"a 33c a� �..a • ,,i .. • OFFICE LOCATION: ��� 0 •14 � MAILING ADDRESS: Town Hall Annex � ` ' \ P.O. Box 1179 54375 State Route 25 4 % Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) N �r G Q �� P Southold, NY 11971 Telephone: 631 765-1938 O 1 .__ 0'1 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees If ' ' FEB 1 0 2015 From: Mark Terry, Principal Planner LWRP Coordinator Date: February 10, 2015 Re: Proposed Wetland Permit for GARY MANGUS SCTM# 1000-57-2-16 Jeffrey Patanjo on behalf of GARY MANGUS requests a Wetland Permit to remove and replace existing bulkhead with 57 linear feet of new vinyl bulkhead directly landward of existing; remove and replace directly landward of existing a 39 linear foot return on south side, and a 15 linear foot return on north side using vinyl sheathing; replenish area with 20 cubic yards of clean sand fill behind bulkhead; restore 30 sq.ft. of area to natural vegetated state upon reconstruction; and to install and maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. Located: 1295 Island View Lane, Greenport. SCTM# 1000-57-2-16 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP provided that: 1. Construction of the bulkhead is implemented to minimize the removal/death of the spartina alterniflora seaward of the existing bulkhead. 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 • ,,, • Peter Young,Chairman ; - Town Hall,53095 Main Rd. Lauren Standish,Secretary �. P.O.Box 1179 el) twit Southold,NY 11971 `-, :# Telephone(631)765-1889 Ol # Ilt" Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., February 11, 2015 the following recommendation was made: Moved by Peter Meeker, seconded by John Stein, it was RESOLVED to SUPPORT the application of GARY MANGUS to remove and replace existing bulkhead with 57 If. of vinyl bulkhead and 39 If. return on south side and 15 If. return on north side. Replenish 20 cy. of clean sand fill behind bulkhead, restore 30 sf. of area to natural vegetated state upon relocation of bulkhead. Located: 1295 Island View Lane, Greenport. SCTM#57-2-16 Inspected by: John Stein, Peter Meeker The CAC Supports the application with the Condition of a 10' non-turf buffer along the landward side of the bulkhead and the 30' vegetated area is maintained with native species. Vote of Council: Ayes: All Motion Carried L FEB 1 3 2015 John M.Bredemeyer III,President ;a'• �O `Sot ',eIi,' 4,�'=` Town Hall Annex Michael J.Domino,Vice-President ,' '` G►Y.�, 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee H Rse` Charles J.Sanders,Trustee � Tel (631)76b-1892 eCni V, Fax(631)766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _goastal Erosion Permit Application AL wetland Permit Application Administrative Permit _Amendment/Trans r/E tension ✓,Received Application: I '2 (S _.. .. .. ✓yeceived FeerI I (�' 1/Completed Application h "1/S IS • _Incomplete SEQRA Classification: Type I Type II Unlisted JAN 2 3 2015 oordination:(date sent) LWRP Consistency As ess nt Form 1 136/1-5 7AC Referral Sent: J Date of Inspection: II 15 (5 l—•--- _Receipt of CAC Report: _Lead Agency Determination: _Ifechnical Review: Public Hearing Held: 15 Resolution: Name of Applicant Gael n/)a a 0 v s Mailing Address /? 1 S 4'r l i ri . Pl'' Ce- 51'c 116 e r"m k i,,t /J1 11'17 Phone Number:( ) 111• 690 - 4 715 Suffolk County Tax Map Number: 1000- s 7 - o a -11 Property Location: /3415- "c l"^ V i e C,r r4n roo2a- Sec- I s e.t-b eon /I)ID (provide LILCO Pole#, distance to cross streets,and location) AGENT: `Tehfre y Pe Ta eu (If applicable) Address: lob H QGv Cer) -1-e{ ,o r t c ,a 5, Ail it ?3y Phone: (93/• Veit 33a- I l a1°P Gard of Trustees Applicatio> GENERAL DATA Land Area(in square feet): /D /77. 0g s f Area Zoning: 2 e St dee,ti r.L_ Previous use of property: g is Lien fi w( Intended use of property: Re cider-rik. Covenants and Restrictions on property? Yes V/ No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes ✓ No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes '7 No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Does the structure(s)on property have a valid Certificate of Occupancy? ✓Yes No Prior permits/approvals for site improvements: Agency Date ✓ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? 1/No Yes If yes,provide explanation: Project Description(use attachments if necessary): Re"pve mut fcfliee ;eisitN' b,.Uche4e& werit 4-7 LP �� tires(. bvW I ead ism 31 LG P4Arvrnr eN Soo h Sid kid JrIF //rLir.Q P.) A.,/t."141 sae, % /04lah 80 t? eF e%h SAno2 c.<< be ii412 kstjarea eSzotc 3o Sf ♦L arm ,V,yrv/ v erria, sTK�G of (1440.- iv-s) .L bicuAa"l . ( 01 non u-r.0 bu-et-/ rd of Trustees Application 0 WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Qarno...€ 44(Q (cpl..ce 41/4,5ti.. th,ut z .Q w di ti 7 c of h.LK.he.2 a &Ato ) 04)s044, ceeh. of)1,12 istf (4vAs•v.4'AAP f+h s• • ( lerns4 Cy iF clan smote. .411 'hincD b4G)'haI• gGS 'r+e- 305 F •F 4 felt,+.' ,t—'l''rv(.- 11C7 c zee-rex_ s r e-l .cot 4-c o../ m& h✓Lizl e,LCt Area of wetlands on lot: /5" square feet Percent coverage of lot: to•1'i Closest distance between nearest existing structure and upland edge of wetlands: 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet Does the project involve excavation or filling? No ✓ Yes If yes,how much material will be excavated? cubic yards How much material will be filled? Pe cubic yards Depth of which material will be removed or deposited: / feet Proposed slope throughout the area of operations: /A Manner in which material will be removed or deposited: 1 uC- xwov7odZ -vx- 'h'r 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): Wip.seect b.,wha.,42 be- 1.-51-Ada J6.4( F 4.-Atsr.ide, b.,clGh 2 t+ Avacdc. AS rvQ uNr-rIA w as . a/ec bile hem /t re.- -ova_ it e- 4h e144)+l.A.ht ?D sf c✓c4141 gas c{4*.-1 Q • • 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 I. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 12 or =c l°.►d2 wet,. (.*pc I✓GKh<o-ol- Project Location(describe,and attach_ a location map): SLG A 444e4esk 1.044447e.' ,,l4?o Brief Description of Proposed Action: RinZotx 411.12 reelftr 6-7 Lf. •L ht.c*40t4Q 0,/its agse 11 't.E /YC.f . 10 cA1 •f elan ra f4.414:42 4*0dwvv.r.e 4G I.,ii, 4� 4,6Q . Ld . Ct 1 d tf. vF t s€-K°-•x .S a✓Gs. . • Name of Applicant or Sponsor: Telephone: q i ,6 e m-161g a,4 - /VtsryovS E-Mail. 041-NA►4,104 ecrt.t. Address: la s-renr eltate sTe. 416 City/PO: State: Zip Code: (afrolLlgh MI //2/7 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? ❑ If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that Et 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: ❑ a rv`IS AOC. — Town/ ei 500$414. Zroc eeS 3.a.Total acreage of the site of the proposed action? o. as y acres b.Total acreage to be physically disturbed? 0• °t n acres c.Total acreage(project site and any contiguous properties)owned yy or controlled by the applicant or project sponsor? �'2a_l acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban 0 Rural(non-agriculture) El Industrial 0 Commercial 12<esidential(suburban) ❑Forest ❑Agriculture 0 Aquatic ❑Other(specify): - ['Parkland❑Parkland Page 1 of 4 • • 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? D 1 .❑. 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 2 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: P ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES 2 ❑ b.Are public transportation service(s)available at or near the site of the proposed action? l ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? f ❑ 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: 2 ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Er D 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? rI- ❑ 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? ❑ 2 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: [Shoreline 0 Forest 0 Agricultural/grasslands ❑Early mid-successional Wetland 0 Urban [r]'guburban 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? Lam- LI 16.Is the project site located in the 100 year flood plain? NO YES Vt. 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, 1E7 [11a.Will storm water discharges flow to adjacent properties? DNO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: DNO DYES Page 2 of 4 w • 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: El ❑ 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: e' I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponso ame: 4 C '1)dviv7 v S , efi Date: I —20 1 5 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?' No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning Elregulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? a 4. Will the proposed action have an impact on the environmental characteristics that caused the �/ establishment of a Critical Environmental Area(CEA)? LL 5. Will the proposed action result in an adverse change in the existing level of traffic or (—X 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? Q 8. Will the proposed action impair the character or quality of important historic,archaeological, I I 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 0 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? I J► 1 I. 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. IIICheck 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 iinvironmental 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.„ mpacts. ,y Town of Southold-Board of Trustees 1__30 //JP Nanwf Le Agency Date 5o , he lA co` C( President Print or Ty ' ame of Responsible Officer in Lead Agency Title of Responsible Officer ordire of Respon -officer in Lea Agency Signature of Preparer(if different from Responsible Officer) I PRINT I Page 4 of 4 • PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: ?1A-e JontS cio Donna Y1 o 401 Zn Ave. AO- 24,6. 01 0`1 ►10 v YGIvIK�A�9el�na succiCoyott I5`1-4,5 2q 74 e. 10 � -e s�rmc�� ��3�� A u IA,-K1311 �D b)( Win &Per 4 l q 4y a7 ev ire. 4 tom a 8tY l,a.. E ,0 13°- l(73 a � . ul holla+�� L� TY '12p5 I sl ah d u iew La . 6yeet pmt Jom STATE OF NEW YORK COUNTY OF SUFFOLK Pa nj b , residing at I c I-I'w i D\VCl Cm fl'1 11.1311- , being duly sworn,deposes and says that on the 10 day of evruary , 2015, deponent mailed a true copy of the Notice set forth in the Board of Trustioes 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 assessmen roll of the Town of Southold; that said Notices were mailed at the United States Post Office at (no' mor l thfs , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this 1 v Day of F kJrt,ta1'y , 20 I`j • A61,t cum, Qtfaiiiv Notary Public Lonann Patanio Notary Public - of New York Qualified in '17- No: No:01P .150W Commission Expires 013107120/8 • • John Bredemeyer, President ''guFFot�: Town Hall Annex Michael J. Domino, Vice-President ';r°�� c°o': 54375 Route 25 James F. KingP.O. Box 1179 Southold, NY 11971 Dave Bergen o Charles J. Sanders , ya 0 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 GARY MANGUS COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS 1, ,TK-Frey 3 ?Manic) , residing at/dba I O ro E U YL - B'l v d Cenier fyIo n l es ni i 1.6151+ being duly sworn, depose and say: That on the day of February , 2015, I personally posted the property known as 12'15 1510 nci V ri Lanes 6-reenpb►4- by placing the Board of Trustees official poster where it tan easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,February 18,2015. Dated: 2 • %O . (si:na,(re) Sworn to before me this sodayof Feb 2015 ou.aww -Fatn. v Notary Public • York •'t , in 'f►', County * 11P x-,150861 Commission Expires 08/07/20 Iv NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: GARY MANGUS SUBJECT OF PUBLIC HEARING : A Wetland Permit to remove and replace existing bulkhead with 57 linear feet of new vinyl bulkhead directly landward of existing; remove and replace directly landward of existing a 39 linear foot return on south side, and a 15 linear foot return on north side using vinyl sheathing; replenish area with 20 cubic yards of clean sand fill behind bulkhead; restore 30 sq.ft. of area to natural vegetated state upon reconstruction; and to install and maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. TIME & DATE OF PUBLIC HEARING : Wednesday, February 18, 2015 — at or about 5:30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 ! 0 ,_: -- Town of Southold i8 ( Erosion, Sedimentation & StarM-Water Run-off ASSESSMENT FORM Or ;' PROPERTY LOCATION: S.C.T.M.5: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 1I ? //io 37 9 U. STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN -.,0 3fikict s8 e0on ' ock Tot— 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? 1 Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within /p,(T•l7A.?3Y 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 ✓❑ b. What is the Total Area of Land Clearing (s. ) clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed soa,/®.B i Site Improvements and the permanent creation of construction activity? impervious surfaces.) (S.F./Aden) PROVIDE BRIEF PROJECT DESCRIPTION (Provide Addtlonv Pape,es Needed) 2 Does the Site Plae Indicating SurSi Show Alla Proposed /� Drainage Structures Size&Location?This �/ Item shall Include all Proposed Grade Changes and j4Inot a aadL (996 CB 67 Lf, of Slopes Controlling Surface Water Flow. �" , 3 Does the Site Plan and/or Survey describe the erosion / ❑ Il4B ay btu 4 .1 SCF rrin+S . T• 41'..ti and sediment control practices that will be used to control site erosion and storm water discharges. This _ 20 e.' i f C(uses s 4,1A 61 I bd.110 item must be maintained throughout the Entire CConstruction Period. 2264,k 4l ALAI. t:( 4120 ST •F 4 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural We—flank• Existing Grade involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities 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 �y Site? Is this Project within the Trustees jurisdiction u/� General DEC SWPPP: Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP Is required for all Constmct on 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 pert of a larger corrdnon plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to ❑ V Including Construction activities Involving soli 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 Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other impervious �✓/ for Storm Water Discharges from Construction activity-Permit No.OP-o-le-Oe1.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the NOt.The ROI 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 shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that win 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 terms and conditions of this permit.In addition,the SWPPP shall Area?(ml.Item wul NOT Include the Installation 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 I 3.All SWPPPs that require the post-construction storm water management practice Inc Box and the construction site disturbance k between 5,000 S.F.31 Acre In area, component ahem be prepared by a qualified Design Professional Licensed M New York a Storm-Water,Grading,Drainage&Erosion Control Plan b Required by the Town of that is knowledgeable M the principles and practices of Storm Water Management. Southold end Must be Submitted for Review Prior to Issuance of Any Building Permit (NOTE: A Check Multi.)ardlor Answer for each Question is Required fora Complete Application) STATE OF NEW YORK, �f`/��... .� COUNTY OF... r"C�'�-I, SS That I,...Garr . .5 being duly sworn,deposes and says that he/she is the applicant for Permit, (tier of Individual signing 0 end) And that he/she is the ...... .. • (Owner,Contractor,Agent,Corporate Gillian,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/� me this; ( I of O o�� day of�!1 . 0 2015 Notary Public: ..�W,..d.li.�ll1. k}Ij✓4suP/'e IF ,41 ,..r .Ignahre of Applicant) FORM - 06/10 L' , Pate*Notaew York Nfied in ,s,_'1 County No:01P r.150861 Commission Expires 08/07/20 t Ord of Trustees Application • County of Suffolk State of New York 64 4A4nrs BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ignature of Property Owner SWORN TO BEFORE ME THIS g0 DAY OF darL.cGirl.( ,2011/45 #1 ! LJ • S Notary Public p Loriann Patanlo NoCNYial6edblip Siete in Suffolk Cew York ounty Commission IExppiires X07/20/8 ad of Trustees Application • AUTHORIZATION (where the applicant is not the owner) I, 401 01 AAA.1.704 residing at /Zt S 72s� P1'.ee Y8 (print owner of property) (mailing address) $rem l ym ,'9 11217 do hereby authorize -1764r&.1 (Agent) l c20,4•41.0 to apply for permit(s)from the Southold Board of Town Trustees on my behalf. Owner's sign • • APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide•inforinatien which can alert the town of possible•conflicts of interest and allow it to takewhatever•action is necessary to avoid same. A YOUR NAME: A/1 i,1 vS, 6itell (Last name,first name,middle ihitial,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 / l Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO •//. if you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP • • Submitted this • 0 da of cja Vfl9 -' Signature Print Na 404.1 MA- c_s5 Form TS 1 y • • 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: online at the Town of Southold's website(southoldtown.northfork.net),the Board of Trustee W cice,,thePlanning Dep- all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION JAN 2 3 2015 SCTM# S 7 - a - 1!. !!r PROJECT NAME 12 9 S 2 c1•r,..ck vow G c Fa✓L,11 k` _ 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: R e. tt *442 t- .,QI4ee .a4ciSikv7 byLLk€4.6 4..#14-h 1...F 1...F of vr. t. 6✓LkbesQ et't'F 0e04VM1 BN s.%.44 ¢.4,c itn& /SGF •F {s-tve,J •N ,✓,/s44 slcee1 /(016n/Sb 7c el aF Tan S4ne2 f•/c h.b4n8 bvl.IGhood, PeS'Cote_ 3a64- •F 4(.0(4, -6 �•��'�/4 '.'c.11n n.0R s-r4te v9o.) rclooce-ti,„) F bw ciGkt«0 • • • Location of action: /.? 'r z S 1.44_ t.« LwK 4 r. p 04.4. `1 •l'J 1{K Site acreage: d •21Y Present land use: /2 biti+tma-- Present zoning classification: ie S 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: 6 kat Ma n(�S (b) Mailing address: 1 i i 5-ref l I n7 to/4e c 5>d •Y 8 .i3 rpdeli/ei tv`1 // 2 1 7 (c) Telephone number:Area Code( ) 717 " G 90 -T S 1g (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes Er No❑ If yes,which state or federal agency? '-'" s Do-c- 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 lame )'s *On 04'4 Tr ItA0141,41 erdigerhiS Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III--olPolicies Pages 3 through 6 for evaluation criteria [21 Yes ❑ No E 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 Er Yes ❑ No ❑ Not Applicable Ae•ri.N 4.41 ha,4ee5 y ei I irt7 4 .Q.. Qne 4ee. ".$ Lrt$ ri L..r.eQ , Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Pr Yes ❑ No ❑ Not Applicable Pr•jec4- Qr,'r€c+s Ars inS 2•sf •f /ror-47 ,. ..a j.o e...d�a1!•.t�..-� e N c.,✓ (fit ti 0...aC b✓(„that, 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 g Yes ❑ No ❑Not Applicable 19(Pa ee-+ Pm. roveS is•Ti�C- s)v Lttiy 'bit ,1.•..-1 rf 1 eaeon-i�►� 2"""r.0 e.,e- •b e/t,slo✓1 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. n ❑ R' • S Yes No Not Applicable • 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 El No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes El No 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. Yell]nn No Zot Applicable ec,JIC4- is { .' -ta Pr,u Attach additional sheets if necessary • • WORKING COAST POLICIES 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. n Yes ❑ No IKNot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III–Policies;Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No 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 evaluationuacriteria. ❑ 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 ["Not Applicable PREPARED BY —T ^ Pti 4-e-in a TITLE Ai e')-1- DATE I.1 1.1 S I • January 22, 2015 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 - ---� P.O. Box 1179 l� �' Southold, New York 11971 If L JAN 232015 RE: 1295 ISLAND VIEW LANE GREENPORT, NY SCTM No. 1000-57-02-16 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, y Patanjo 9reo 106 Hewitt Blvd. Center Moriches, NY 11934