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Home My WebLink AboutTR-8626 FFQt� John M. Bredemeyer III, President i'p�0 ooG Town Hall Annex Michael J. Domino, Vice-President `+�� y< 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A. Nicholas Krupski y oy.,. Southold, NY 11971 Charles J. Sanders Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 21 71.014 V Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS- dr CERTIFICATE OF COMPLIANCE- John M. Bredemeyer III, President so yoll Town Hall Annex Michael J. Domino,Vice-President 54375 Route 25 P.O. Box 1179 Glenn GoldsmithCAO Southold, New York 11971 A. Nicholas Krupski �p� Telephone(631) 765-1892 Charles J. Sanders 0<ol UNTY, Fax(631) 765-6641 �D � BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1243C Date: July 7, 2016 THIS CERTIFIES that the repair of the existing 4'x25' bluff stairs; existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk; and install a proposed mooring pile 16.7' off seaward end of catwalk; with the condition of the use of thru-flow decking on the catwalk; At 700 Ruch Lane, Southold Suffolk County Tax Map #1000-52-2-28.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 27, 2015 pursuant to which Trustees Wetland Permit#8626 Dated June 17, 2015, was issued and conform to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the repair of the existing 4'x25' bluff stairs-, existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk-, and install a proposed mooring pile 16.7' off seaward end of catwalk; with the condition of the use of thru-flow decking on the catwalk. The certificate is issued to ANDREW KEATING owner of the aforesaid property. Authorized Signature John M. Bredemeyer 111, President Michael J. Domino, Vice -President James F. King Charles J. Sanders Dave Bergen �p®�pgUFFO(,Y�oG c CIO �� • ':,fi BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 1) 765-1892 Fax (631) 765-6641 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, silt fence 1St day of construction '/ constructed 4 Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YOLK PERMIT NO. 8626 DATE: JUNE 17, 2015 I� ISSUED TO: ANDREW KEATING ( PROPERTY ADDRESS: 700 RUCH LANE, SOUTHOLD SCTM# 52-2-28.1 AUTHORIZATION Pursuant to the provisions of Chapter 275.of the Town Code of the Town of Southold and in _ accordarice with the Resolution of the`Board of Trustees'adopted at the meeting held on June 17, 2015, and in consideration of application'fee in the sum of $250.00 paid by Andrew KeatiriQ and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Boaid of Trustees authorizes and permits the .j following: N MW Wetland Pe'r`mit to repaii1he"exis'ting 4'x25' Bluff stairs; existing catwalk sections to be reconstructed as needed forta 4'06' catwalk;'aiid install woroposed mooring pile 16.7' ; {_ off seaward end of catwalk; with the condition of the use of thru-flow decking on the catwalk; and as depicted' on the survey prepared by John"C. Ehlers, last dated August , 10, 2013, and stamped approved on July 17, 2015. !_ . IN WITNESS WHEREOF, the said Board of Trustees,hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. tiFF01 co .d�7 TERMS AND CONDITIONS The Permittee Andrew Keating residing at 700 Ruch Lane, Southold, New York as part of the consideration for the issuance of the Pertmt does understand and prescribe to the following: 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 pennit, 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. 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. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Pernlittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee June 17, 2015 Nancy Dwyer PO Box 632 Southold, NY 11971 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: ANDREW KEATING 700 RUCH LANE, SOUTHOLD SCTM# 52-2-28.1 Dear Ms. Dwyer: Town Hall Annex 54375 Main Road P_O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 17, 2015 regarding the above matter: WHEREAS, Nancy Dwyer on behalf of ANDREW KEATING 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 April 27, 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 June 17, 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, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ANDREW KEATING to repair the existing 4'x25' bluff stairs; existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk; and install a proposed mooring pile 16.7' off seaward end of catwalk; with the condition of the use of thru-flow decking on the catwalk; and as depicted on the survey prepared by John C. Ehlers, last dated August 10, 2013, and stamped approved on July 17, 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, John M. Bredemeyer III President, Board of Trustees JMB/eac OI sIw- •1119: I•» IA-, WM a L• John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King Charles J. Sanders Dave Bergen TO: i -T n 1 ' Town Hall Annex 54375 Route 25, P_O. Box 1179 Southold, NY 11971 Telephone (63 1) 765-1892 Fax (631) 765-6641 Please be advised that your application dated Apr1 10 "� c�C) 15 has been reviewed by this, Board at the regular meeting of,._) LAn t— j '), V'5_ and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre -Construction Silt Fence Inspection Fee ($50.00) 1st Day of Construction ($50.00) '/ Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: 1� _7nso, F&c - -'�'S-0 TOTAL FEES DUE: $, > U ® C0% BY: John M. Bredemeyer III, President Board of Trustees John Bredemeyer, PresidentguFF01 Michael J. Domino, Vice -President ��°�y� James F. King ti Charles J. Sanders • Dave Bergen Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: /' a b /1ir Nancy Dwyer on behalf of ANDREW KEATING requests a Wetland Permit to repair the existing 4'x25' bluff stairs; existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk; and install a proposed mooring pile 16.7' off seaward end of catwalk. Located: 700 Ruch Lane, Southold. SCTM# 52-2-28.1 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 Type of Application: Wetland Coastal Erosion Administrative Emergency Pre -Submission Notice of Hearing card posted on property: Yes Storm Water Management Review: Yes Info needed: Modifications: Chapt.111 other Amendment Violation No Not Applicable No Not Applicable Present Were: __�/__J. Bredemeyer VM. Domino /JKing ,G. Sanders V16. Bergen Bay Constable Form filled out in the field by ?� - Mailed/Faxed to: Date: Other �� / - d'r � rcz�4 t//- ", �4 - . 1, .; t_ j„� / i . _ ' � ✓\ � i}2015 -9'y 54` irE.y�,��, �t�'" � , )''� � �. i l+ r . , b ! • i... � �/�1M' ,Ai .1R= �S � •� � � iM �. �.r Y s �!� =Yi ��,5 fi%�it� --1 `�_r • )1..�. •j!•>X..,~ ....,� .� . Y.:H' ' V ��'. lis • \ • & "J:M _.t ""^n.rl.r••" John Bredemeyer, President �ogUFFtI4� Michael J. Domino, Vice -President James F. King y z Charles J Sanders o Dave Bergen Town Hall Annex 54375 Route 25 P O Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: r 3 Nancy Dwyer on bed If of ANDREW KEATING requests a Wetland Permit to repair the existing 4'x25' bluff stairs; existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk; and install a proposed mooring pile 16.7' off seaward end of catwalk. Located: 700 Ruch Lane, Southold. SCTM# 52-2-28.1 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Soundy/Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ./Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre -Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: i (e- X /a 1�ad — Present Were Bay Constable J. Bredemeyer V M. Domino _J. King Sanders Form filled out in the field by Mailed/Faxed to: Date: Other . Bergen _'Andrew Keating 00 Ruch Lane, Southold w •r'Q _i� ,'� • _ SCTM# 52-2-28.1 NOV- �.. � .,,�j i .i .A C. r! � vim% i:'' � ..�I�`.:. .��'a _ �.. r P,r- • ��'�-�`°``'�'�" --.ate:. ��-_ _ - -� _. --... _ -- ---•ti,;-. � - - �i�- -�-"- -"t!1� i °! ,' � ( �• moi' r _ S' t rt x-. � `'l �"'� :`,8 'Lg`. � .. r �,� �_� New York State Department of Environmental Conservation Division of Environmental Permits, Region One. SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 4.44-0372 Fax: (631) 444-0360 Website: www.dec.nv.gov August 1, 2014 Mr. Andrew Keating 43 Great Jones St. #5 New York, NY 10012 Re: Permit No.: 1-4738-04228/00001 Dear Permittee: APR 2 7 2015 Joe bfartens Commissioner In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. C KW/Is H Sincerely, Claire K. Werner Environmental Analyst .f. _— NE`V YORK STATE DEPARTM OF ENVIRONMENTAL CONSERVATII � Fncility DEC ID 1-4738-04228 PER -MIT Under the Environmental Conservation Law (ECL) Perinittee and Facility Information Permit Issued To: ANDREW KEATING 43 GREAT TONES ST 45 NEW YORK, NY 10012 (347) 232-5816 Facility: KEATING PROPERTY 700 RUCH IN SOUTHOLD, NY -11971 Facility Location: in SOUTHOLD in SUFFOLK COUNTY 'Village: Southold Facility Principal Reference Point: NYTM-E: 717.574 NYTM-N: 4551.836 Latitude: 41°05'19.3" Longitude: 72°24'34.6" Project Location: 700 Ruch Lane - Watercourse - Arsharrrornoque Pond Authorized Activity: Repair existing stairs in place, remove remains of storm damaged catwalk, replace with 4'x 36' catwalk and install one mooring pile. (CKW) ARNO-DEP Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-04228/00001 New Permit Effective Date: 8/1/2014 Water Quality Certification - Under Section 401- Clean Permit ID 1-4738-04228/00002 New Permit Effective Date: 8/1/2014 Expiration Date: 8/1/2019 Water Act N YSDEC Approval Expiration Date: 8/1/2019 By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with tine ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: MARK CARRARA, Deputy Regional Permit Administrator Address: NYSDEC REGION 1 HEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK, NY 11790 -3409 Authorized Signature: Date -L/ � /mol - Page 1 of 6 f� NEW YORK STATE DEPARTMENT OF ENVIRONNIENTAL CONSERVATION � Facility DEC Ill 1-4733-04223 Habitat - TW CLAIRE K WERNER Distribution List Permit Components NATURAL RESOURCE PERMIT CONDITIONS NATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS; WATER QUALITY CERTIFICATION i. Notice of Commencement At least 48 hours prior to commencement of (lie project, the permittee and contractor shall sign and return the top portion of the enclosed notification .form certif},ing that the), are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 2. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 3. No Construction Debi -is in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in wetlaiids and/or protected buffer areas. 4. No Disturbance to Vegetated Tidal Wethands There shall be.no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. s. Storage of Equipment, Materials The storage of construction equipment and materials shall be confined to the upland area landward of the top of bank or on a barge. G. Wood Preservatives a. Pressure treated wood used for construction of in -water structues must have undergone a treatment process approved (stamped or otherwise marked as certified) by the American Wood Preservative Association. b. Wood treated with Pentachloroplienol (PCP) must not be used in wetlands or surface waters. c. The rise of creosote treated wood is prohibited both in the water and upland areas. Page 2 of 6 NEW PORK STATE DEPARTIM ENT OF P NVIRONMENTAL CONSERVATION Facility DEC ID 1-4733-04223 d. Chroinated Copper Arsenate (CCA) pressure treated wood must be clean and free of CCA surface deposits. Wood with surface deposits must be washed for at least 5 minutes under running water prior to use. The washing must occur greater than 100 feet landward of any regulated wetland and/or water body. (Note "E." below for handling wash water.) e. Any wood debris such as sawdust or wash water must not enter any water body, including wetlands or protected buffer areas. 7. Cahvalk Size and Decking Dock or catwalk shall not exceed four feet in width. Catwalk decking shall be constructed with NYSDEC approved fiberglass grating to reduce shading impacts from the approved structure. S. No Floats This permit does not authorize the installation of floats. 9. No Prop Dredging Prop dredging, or the act of utilizing and/or directing the propeller or propulsion system of a motorized vessel and/or the water -borne forces created by said propeller or propulsion system, to excavate or displace existing bottom sediment and benthic habitat for tine direct or indirect purpose of establishing or increasing water depth, is a regulated activity and is not authorized by this permit. Prop dredging is strictly prohibited without further written authorization (permit, modification or amendment) from the department. 10. No Dredging or Excavation No dredging, excavating or other alteration of shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the finture. 11. No Permanent Structures on Dock No permanent structures shall be installed on dock/catwalk/float without first obtaining written Department approval (permit, modification, or amendment). 12. Docks at Property Lines Docks/catwalks/floats must not: a. extend laterally beyond property lines, b. interfere with navigation, or c. interfere with other landowners riparian rights. 13. Pilings at Property Lines Pilings shall not: a. extend laterally beyond property lines, b. interfere with navigation, or c. interfere with other landowners riparian rights. 14. No Structures on Pilings No structures, other than structures specifically authorized by this permit, shall be constructed on pilings without further authorization from the department (permit, modification or amcndnncnt). Page 3 of 6 NEW YORK STATE DEPARTMENT Or ENVIRONMENTAL CONSERVATION Facility DEC ID 1-1733-04223 15. Conformance With Plans All activities authorized by this permit must be in strict cotllornlance with the approve(] plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Matthew Benjamin Sherman dated 4/16/14, stamped NYSDEC approved on 7/31/14. 16, State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from filture operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 17. State May Order Removal or Alteration of Worlc If future operations by the State of New York require an alteration in the position of the structure or work lierein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. Is. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 19. Precautions Against Contamination of 'Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other envirornmentally deleterious materials associated with the project. WATER QUALI'T'Y CERTIFICATION SPECIFIC CONDITIONS 1. Nater Quality Certification The NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Nater Act of 1977 (PL 95-217) provided that all of the conclitions listed herein are met. Page 4 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION � Facility DEC ID 1-4738-04228 GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other- Department Orders and Determinations .Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or° Transfers The permittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: . Regional Permit Administrator NYSDEC REGION 1 IIEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK, NY11790 -3409 ,1. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands, Water Quality Certification. 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; Page 5 of 6 NEW YORK STATE DEPARTIVI ENT Or ENVI_RONIMENTAL CONSERVATION Facilily DEC ID 1-4735-04223 d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable lav or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit 'Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility said Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification (toes not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other- Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, casements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights 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. Page 6 of 6 I ;E OF (:OrtlMEKC;:IJ -M 1 UF (A), N I I<Uc: IH - f URN -TURN THIS FORM TO COMPLIANCE Bureau of Habitat -1 W 50 Circle Road Stony Brook, NY 11790-3409 ,TRNIT NUMBER: ?LRP/IITTEE NAME & PROJECT ADDRESS. t.;ON'l RACTOR NAME & ADDRESS: TE! EPf-;C71�1E Sir ,{ ,manl to the special conditions of the referenced perrnil, you n'3l+ii j !( al t',e authorized activity Sf1cN{ Cillllm;P,r CS en -_ We certify that we have read the referenced perm; and approved pans and fully understand the authonzed project and all .""III t conditions We have inspected the project site and can cowq� !M(t tsi0;;!-.t as doscntsed in the permit and as depleted on the ipproved plans We can do so in full compliance with all plan nc,.leS a id pr -i; 'd r7 ncM :-s. Thi., permit, permit sign, and approved plans will 3 available at the site for inspection in accordance with General Conri:tivn ion ' iE?c:.h s4,iatmes required) PERMITEE. !)ATF CONTRACTOR: I V H= I1 -IIS NO OCE MUST BE SENT TO THE AF30lir_ ADORLSS AT LEA,' i' ;"4'trt I D.4 YS 121OR TO COMMENCENIEMT OF' THE PROJECT ANOIORAIVYASSOCIATE0ACTIVITIES. FAILURE TOI,rE-1'0114 fi " I,'.; +i¢;<;,:'t `>7 Tull: PERMIT SIGN. OItI-.'AVETHE PERMITAND `,11PR0VE1) PLANS AVAILABLE A7' THE WORK S1 TF FOR 1 -HL L,IJI ti i A i1- (;l- Ii -P- -'1;OJL-CT 1VIA`/ SUBJECT T f'IE P;-RMITTEE ,UVI iOR CONTRACTOR TO APPLICABLE SANCTIOIS AND PENAL. IIL,37R NOP's GOPIP! LANCE W17H PER:U,I r CONDITIONS. t along this line N \ N ` NOTICE OF COMPLETION 0LE - CON TRUC1';+:7AI ---+ :+ rURN THIS FORM TO.COMPLIANCE : jr €`ax u: 1: _` r• i, 7 b Bureau of Habilat- TW 50 Circle Road Stony Brook, NY 11790-340t, ;v wA1T NUMBER. i ''i 3 -di. 'c F HIM l 1 EE NAME & PROJECT ADDRESS :ONTRACTOR NAME_ & ADDRESS 1 EL.I-i'f=UN�. simnt to special conditions of the referenced permit, yuu ar r; ;1'•• alulh.w ped activity was camplet .d on ---- 11Ve 11,3ve fully complied v::ln the terns ;,1110r;, t r:3•r,;.0 :.r. „l;p;avc:c dams (Bou, sulnah.r;;S required) PE:RMOITEF >i - CO ITRACTOR DA I :;rS N0710E, 1J✓ITH P1-IOTOGRAPHS 01- I'HF C0IIPLE7EC i1:0 - i% r R r I: r; " SURVEY, ✓,S A WPPO`'RIATE, MUST BE ;ENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COfw`-r cI ' p.p ' 'ZCT waEnttiuecm £"Oi^'cr 's;�>r"s` �� P // IPROPE ut /I� mo_.•-_. 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X �I F yr ] "°'" w •.n cm' . q 3 1 Hc) ��• v O'a'r' � A\ � ,c lit.P l• � .� A f 55 I 'Q'o\\ � \�A sA�,,, �P'Py `r 0sac) I •r � \ --' '1 P 1 •Rd i G "� I3 D 1341, b �i \ 1, O \ 1 ✓i _ s�hoas o � I r: 23 \ 3 iegq t / 1F 1 �O\ve PEcontc LAADTRIJST TI Ssntc^ a P/ � vd, r. ry P@12A w ;P FORSEPCL NO, j`"c ` \ FOR PCL -NO �e •' Y ` " t rant FEEEL NO \ 5653040x00 ,• f zEESEG o y `Op c mza�an i5 300,A,114 \ 79E.C�No — — — — ----------- --------- ------ i i�------- — — -----IL NE 1 "A OAC 114 \\L� MATCN - SEE SEL NO 050 EEEEEC NO 050 L E a _ '�"` y "") `^' — —' mow^ — -- m NOTICE 9:rn';.�� COUNTY OF SUFFOLK C A �o souTnow sEcrlou No G - (xt OO -- —_ --_ _—_ryP• Real Property Taz Service Agency v ^ .o, A 'm w Trv6 ,Dox 52 't'F.isN P m m PROPERtt hNP Cantrell, Elizabeth From: Nancy Dwyer <nancydwyerdesign@aol.com> Sent: Wednesday, July 22, 2015 10:03 AM To: Cantrell, Elizabeth Subject: Keating Hi Elizabeth, Regarding Andrew Keating on Ruch Road. He has asked that all Trustee correspondence and approvals be sent directly to him since he is anxious to get started on the construction If there is any info you need from me, let me know and I'll get it to you asap Thanks! Nancy Nancy Dwyer Design Consulting, Inc. PO Box 632 Southold, NY 11971 c. 631-739-4617 1_0 13 o (LD A' J ® LK cat- 7 �► -e t` l y Ov l tyj V\AA1(1� � �cSS • clv I I� I ON, v A �l3 � �-��fi To p t5 NevO '-/ukKj NY I p 0 1 � Cantrell, Elizabeth From: Nancy Dwyer <nancydwyerdesign@aol.com> Sent: Tuesday, May 05, 2015 9:15 AM To: Cantrell, Elizabeth Subject: Re: Andrew Keating Application Hi Elizabeth, The proposed Keating mooring is to be 8 inch diameter Let me know if there is anything additional needed. Thanks! Nancy Nancy Dwyer Design Consulting, Inc. PO Box 632 Southold, NY 11971 c. 631-739-4617 -----Original Message ----- From: Cantrell, Elizabeth <elizabethc(aD_town.southold.ny.us> To: 'Nancy Dwyer' <nancydwyerdesignna.aol.com> Sent: Wed, Apr 29, 2015 12.02 pm Subject: RE. Andrew Keating Application Great! Thank You! From: Nancy Dwyer[mailto:nancydwyerdesign@aol.com] Sent: Wednesday, April 29, 2015 11:56 AM To: Cantrell, Elizabeth Subject: Re: Andrew Keating Application Hi Elizabeth, Attached is the DEC permit. I'll find out the info on the moring and get back to you asap! Thanks! Nancy Nancy Dwyer Design Consulting, Inc. PO Box 632 Southold, NY 11971 c. 631-739-4617 -----Original Message ----- From Cantrell, Elizabeth <elizabethc(d,)town.southold.ny.us> To 'nancydwyerdesign(c)aol.com' <nancydwyerdesign(cDaol.com> Sent: Wed, Apr 29, 2015 11 43 am Subject: Andrew Keating Application Hi Nancy, Could the Trustees please have a copy of the entire DEC permit? We only have page 1 of 6 and the DEC approved plan You could email it or fax it at 765-6641 Thank you very much OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: May 18, 2015 A r�i MAY 1 8 2015 B ' Re: Local Waterfront Coastal Consistency Review for ANDREW KEATING SCTM# 1000-52-2-28.1 Nancy Dwyer on behalf of ANDREW KEATING requests a Wetland Permit to repair the existing 4'x25' bluff stairs; existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk; and install a proposed mooring pile 16.7' off seaward end of catwalk. Located: 700 Ruch Lane, Southold. SCTM# 52-2-28.1 The proposed actions have 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. The following is recommended to further the policies: 1. Flo through decking for the dock structure. 2. The elimination or minimization of pesticide treated lumber. 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 ti Lauren Standish, Secretary J Conservation Advisory Council Town of Southold Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1889 Fax(631)765-1823 At the meeting of the Southold Town Conservation Advisory Council held Wed., May 13, 2015 the following recommendation was made: Moved by Keith McCamy, seconded by Doug Hardy, it was RESOLVED to SUPPORT the application of ANDREW KEATING to conduct repairs to existing bluff stairs w/piles and stringers to remain. New treads, handrails in all locations. Repair/replace stringers, if needed. Reconstruct catwalk sections, as needed. Proposed mooring pile seaward of catwalk. Located: 700 Ruch Lane, Southold. SCTM#52-2-28.1 Inspected by: Keith McCamy, Doug Hardy The CAC Supports the application, however, the project was not staked and the property was not posted. The CAC recommends the materials are based on best management practices. Vote of Council: Ayes: All Motion Carried 1, M AY 1 5 2015 I Nunemaker, Amanda From: Nancy Dwyer <nancydwyerdesign@aol.com> Sent: Monday, April 27, 2015 4:31 PM To: Nunemaker, Amanda Hi Amanda, The contact info for the builder is as follows: Chris Fokine Fokine Construction Services 59 B North Midway Rd PO Box 477 Shelter Island, NY 11964 Phone: (631) 749-2130 Fax: (631) 749-3510 Let me know if there is anything else needed for the application. Thanks again for letting me hand it in today!! Nancy Nancy Dwyer Design Consulting, Inc. PO Box 632 Southold, NY 11971 c. 631-739-4617 John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only oastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transf r/Ext nsion Aceived Application: /5 Received Fee:$ Completed Application / 5 _Incomplete _SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) RCIAC WRP Consistency Assess ent onJr-n 1 Referral Sent: 4 0 _ ate of Inspection: j 5 _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: S S Resolution: Name of Applicant T) V a j fe tj -1 z &'1 n Mailing Address 4,5 (Ktaj JQAe Phone Number:( ) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 APR 272015 -9-6 0y,�jY )0012 - Suffolk County Tax Map Number: 1000 - 6'a — 9 - g v • I Property Location: ) D tzuclk L16u kl e2 5�00` 6q4 -s -a-' 5� 6� .za (provide LILCO Pole #, distance to cross streets, and location) AGENT: oott)c�/i` t ( (If applicable) V Address: Fo 130 * � -5 0-1 &L t-1 Phone: `%%�� a90!5 yard of Trustees Applicata GENERAL DATA Land Area (in square feet): &!56q . Area Zoning: 9 ^ �o Previous use of property: 5111110 aM(L4111 Intended use of property: 55,44 0 -- Covenants and Restrictions on property? Yes _X _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 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 No Does the structure (s) on property have a valid Certificate of Occupancy? VYes 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? No Yes If yes, provide explanation: Project Description (use attachments if necessary): Y415 a4 e (5 -tt7 JL>Cd Sb l G T rd of Trustees Applicatic- WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: �p 9��Q r J 9 l a Iia cl Vo r ( 160- Pue-, Area of wetlands on lot: 00 square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: 36 feet Closest distance between nearest proposed structure and upland edge of wetlands: —° feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: 0 Manner in which material will be removed or deposited: 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): 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 - Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 - Project and Sponsor Information Name of Action or Project: f1 Qep- -�I AA (4 e- Project Location (describe, and attach a location map): pp 0 0 12 1/Ck LA n e �? V Brief Description of Proposed Action: �epvt(rs 4v zK4S-hYl e. 4A Name of Applicant or Sponsor: Telephone: o kia yl ,Q,IT E -Mail: (m 6 dw e r 49� dl �9 Address: 1 1 City/PO: fd avx 630, SOL) lno lod State: kJ V Zip Code: 11171 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 andel permit or approval: ❑ p e, Fee -441+ 3.a. Total acreage of the site of the proposed action?e / ,� o� acres 4p_5-69 _-;6. i. b. Total acreage to be physically disturbed? acres Sego S �. 0 c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? acres 6p S_ 6 �7 4. Check all land uses that occur on, adjoining and near the proposed action. A ❑ Urban ❑ Rural (non -agriculture) ❑ Industrial ❑ Commercial L sidentjal (suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page I of 4 /.,c d4A 5 Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ❑ P".1711 FY_ �rj ❑ ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: NO YES �A ❑ 8. a. Will the proposed action result in a substantial increase in traffic above present levels? 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? NO YES EL 1K ❑ ❑ 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: t-ilIq NO YES �9 ❑ 10. Will the proposed action connect to an existing public/private water supply? gg If No, describe method for providing potable water: NO YES jam{ ❑ 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: 01A NO YES ❑ ❑ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic 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 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? Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: NO YES ❑ OR ❑ YES Jil ❑ ElIf Il 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: horeline El Forest ❑Agricultural/grasslands El Early mid -successional �PNetland ❑ Urban ❑ Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES ❑ 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? If Yes, a. Will storm water discharges flow to adjacent properties? ONO OYES b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: ONO OYES NO YE ❑ Palge 2 of 4 18 Does the proposed action include construction or other activities that result in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: NO YES 1 ❑ to large impact impact may 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: NO YES occur I . Will the proposed action create a material conflict with an adopted land use plan or zoning rte/ 1:1regulations? ❑ 2. Will the proposed action result in a change in the use or intensity of use of land? 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES ❑ ❑ Pf 0 of a Critical Environmental Area (CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spon or na e. 0 V1 FDLU Q r' Date: Signature: LWA 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?" Page 3 of 4 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 rte/ 1:1regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the Pf 1:1establishment of a Critical Environmental Area (CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a. public / private water supplies? I I b. public / private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic, archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, ❑ waterbodies, groundwater, air quality, flora and fauna)? Page 3 of 4 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. EICheck 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. [ZCheck 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 i paycts. S� 5 Town of Southold - Board of Trustees � /✓ - Name of ad Agency Date Print or Ty e me espon ible Office/in-Lead Agency ignature of -Responsible Officer in Lead Agency President Title of Responsible Officer Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 No, or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage 1:1problems? 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. EICheck 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. [ZCheck 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 i paycts. S� 5 Town of Southold - Board of Trustees � /✓ - Name of ad Agency Date Print or Ty e me espon ible Office/in-Lead Agency ignature of -Responsible Officer in Lead Agency President Title of Responsible Officer Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 Name: STATE OF NEW YORK COUNTY OF SUFFOLK PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: i MAY 2 2 2015 Prd/ , residing at 3 +S MA, i n D 0 0� , being duly sworn, deposes and says that on the 1,-2z day of� 20�, deponent mailed a- true copy of the Notice set forth in the Board of T supplication, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at 50 L)+1,L j 0 , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this 2a 2 Day of ��t20.15_ Notary Pubdc TRACEY L. DWYER NOTARY PUBLIC, STATE OF NEW YORK NO. 01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2p& IP.STForm 3800iAuaust 2006 See Reverse for Instructions • r�7f1` � i m , Li Ir co Ln *TE "CT%0i's c^ N Postage $ $0.49 0971 —0 9 r-9Certified Fee $3.30 ® Return Receipt Fee stm O (Endorsement Required) $2� NN re C3 Restricted Delivery Fee, �u`: (Endorsement Required) $0. ®� 7,` 0 C3 y fu Total Postage & Fees $ $6.4 �� 5/1J r -•i Sent To i t ------- ---- Street, Apt. No. j� � ------ r'- or PO Box No. I'� W W \� OUTPS Form 3800, August 2006 See Reverse for Instructions UA Ip rl ,1 r� . r—a BO Lo 5h� Y �n .Y. ,•-y�i.-� ('Y}�7T7 � ryL 1 KI i�ti,y � ru Er ° Er °ry/trty�J IFiyi �1l65C� � i L Uf 8" rq r SW Iy'7\ NlG-11hC7 L U Ljj Restricted Delivery Fee r- 1:1) $ $0,49 0971 W Total Postage & Fees r� Postage $ $0,49 1 Return Receipt Fee Certified Fee ostma $3 Q(Endorsement C3 ReturnReceipt Fee - dbs ark �y e C3 (Endorsement Required) 0 $2. G Restricted Delivery Fee ru t� ��A I3 (Endorsement Required) ®��! $0. Al z M rU Total Postage & Fees ® r— �s Sfi u - Sent To OV C3 Street, Apt. No.; r�t�� or PO Box No. P� � v T eo f IP.STForm 3800iAuaust 2006 See Reverse for Instructions • r�7f1` � i m , Li Ir co Ln *TE "CT%0i's c^ N Postage $ $0.49 0971 —0 9 r-9Certified Fee $3.30 ® Return Receipt Fee stm O (Endorsement Required) $2� NN re C3 Restricted Delivery Fee, �u`: (Endorsement Required) $0. ®� 7,` 0 C3 y fu Total Postage & Fees $ $6.4 �� 5/1J r -•i Sent To i t ------- ---- Street, Apt. No. j� � ------ r'- or PO Box No. I'� W W \� OUTPS Form 3800, August 2006 See Reverse for Instructions �, �r► f1� � Form 3800. August 2006 cee oe.. Ir u rl ,1 r� . r—a BO Lo Ln Y �n .Y. ,•-y�i.-� ('Y}�7T7 � ryL 1 KI i�ti,y � _ . `• v� Er ° IFiyi �1l65C� � i L Uf 8" 17 (Endorsement Required) M Restricted Delivery Fee r- Postage $ $0,49 0971 W Total Postage & Fees Certified Fee $3.30 Sent To O Return Receipt Fee ostma Q(Endorsement Required) $2.70 Restricted Delivery Fee (Endorsement Required) $0.00 a � 0 ru t� Total Postage & Fees $ $be49 1 15 ®��! Sent To Of r -3v ® r— ------------------------------------------------ Street Apt. No.; 11 or PO Box No. 1 So 91 Sfi �, �r► f1� � Form 3800. August 2006 cee oe.. Ir u rl ,1 r� . r—a BO Lo Ln r� Postage Certified Fee C3 Return Receipt Fee 17 (Endorsement Required) M Restricted Delivery Fee 0 (Endorsement Required) M W Total Postage & Fees a Sent To ® r* -— Street, or PO Box No. John Bredemeyer, President Michael J. Domino, Vice -President James F. King Dave Bergen Charles J. Sanders osuFFock a�O� COGy o � C/' x BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Route 25 P O Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 BOARD OF TRUSTEES: TOWN OF SOUTHOLD lL.: --------------------------------------------------------------- I] In the Matter of the Application of M AY 2 2 2015 ANDREW KEATING COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS residing at /dba �J�J `P 5 Mot I � being duly sworn, depose and say: That on the 12 -day of �4 , 201..x, I personally posted the property known as ?o by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, May 20, 2015. Dated: (signature) Sworn to before me this adna day of May 20 ) 5 Notary iblic TRACEY L. DWYER NOTARY PUBLIC, STATE OF NEW YORK NO. 01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30, 20L� ilUTILI: Uim HLARIllu E-1 I NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board o Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER( E TI N SUBJECT OFHEARING : To repair the existing 4'x25' bluff stairs; existing catwalk sections to be reconstructed as needed for a 4'x36' catwalk; and install a proposed mooring pile 16.7' Off seaward end of catwalk. TIME & DATE OF PUBLIC HEARING : Wednesday, MMay 20, 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 B a.m. and 4 p.m. BOARD F TRUSTEES * TOWN OF SOUTHOLD (where the al it is not the owner) residing at J3 .( (print name of owner of'property) (mailing address) do hereby authorize -V/ +Jvj� --- qv�ck jee (Agul,A) gpo.cy Duo Inz d#'NSUL'fln�plyti)rpermit(s)from the Southold Board of'rown Truster.~ on my behalf. 0, (Owner's signature) Board of Try s Application AFFIDAVIT kEf+-J1A)q BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE ISTHE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE REST OF I-HS/HER KNOWLEDGE AND BFIAEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLDTOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO I-IOLDTHE TOWN OF SOUTHOLD AND THE BOARD OFTRUSTLES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED, IN COMPLETINGTHIS APPLICA'T'ION, I HEREBY AUTHORIZE THE 'TRUST'EES THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT, 61ature of Property Owtier SWORN TO BEFORE ME THIS DAY 01'—..(,# .20/s z... .. .... notary Pu "Ob. iy 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 information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessarto avoid same. YOUR NAME: DW q te" , (Last name, first n e, piddle initial, un ess you are applying m the name of someone else or other entity, such as a company. If so, indicate the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other', name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town 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 this4 y of 1 s 0 200. Signature Form TS I y Print Name �& J'► W r APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL, DISCLOSURE FORM YOUR NAMEf _.. ./.TN�I��'w fl11E�.rli4G)___—._._...._____...._._ (Last name, ffrst name, gliddlc Initial, unless you am applying fa the namo of wineoae else or other entity, such as a wmpsny. if so, indicate tie other person's or company's alto:.) NAME OF APPLICATION' (Check all that apply.) Toe grievance Building _, .,....._ VariancC _ .._,_ Trustee _!�... Change ol'Zone _ Coastal Erosion Approval Of Plitt........ Mooring Exemption from plat or offcial rnap ! Planning —_ Other (II"Other", name theactivitY-) Do you pcpr eufally (or through your company, spouse. sihliniy parrm, or child) have a relationship with any officer or employee W rpannolship,in whiell usiness iI111C*townlonicer orrempioyeelitas even a p.rnlal Ownrrsill(1h(Or e1100y(Wrll by)," CO(PufaUan in whii:h file tolwt officer or kniplayee uveas note than 5".0 of IIx shares. YES r NO X If you answered "YES", complete the balance of this Corm and dale and sign where indicalcil. Name of person employed by the 'rown of Soal)Iold ._._ ..._ _. Title of position of that person _ Descrik the relationship b:tween yourscif (the aMlitxurt/agenVrepresentativc) and tie town officer or employee. Either check the appropriate line A) through I)) anrllor describe in tlx: space: provided. The town Officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): _ A) the owner orgretaer flimi 5% of the shdue;i of the Cotpnratc Mock of rhe npplieanl (svflcu the applicant is a colpotilllon). B} Ilic legal or Nwf icial owner of nay intcresl in a Imo-wrpomte entity (when the applicant is not it cnrixualinal: ^ C) an of icer, director, partner, or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP y aA O/ Submitted Ntis � r day of _�rr � Z� 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). 1 If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non - supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# - oZf PROJECT NAME Kaa.4 1-m Y2.e APR 2 7 2015 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 exte t of action: p Kea 1 (S `i�7 P�Ca S4►rtA bA v She (' .� T Location of action: ' V -y Yevc'h L-tc A--"- '--V u 1q-4 Site acreage: ®p 5 Present land use: f e— 51 Present zoning classification: — �D 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: PnJVe sy (b) Mailing address: 14,22 6r'xA4 JayL e..5 A P J 160 9 (c) Telephone number: Area Code ( (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes N No ❑ If yes, which state or federal agency? pg�� 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 ❑ Noni Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWR.P Section III — Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section IH — Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III — Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No of Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section IH — Policies Pages 16 through 21 for evaluation criteria Yes El No of Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III — Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Apl.__-.�ble 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 MNot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III — Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No-Ef�ot 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. ❑ Ye� No Lr Not Applicable 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. ❑ Yes ❑ No fplNot 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 1)kNot Applicable ' 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 ❑ NoTot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. 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