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TR-8734
Michael J.Domino,President so Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski aQ Telephone(631) 765-1892 Greg Williams ���eoU ,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1518C Date: October 3, 2018 THIS CERTIFIES that the removal and replacement of 37 linear feet of existing bulkhead in- place using vinyl sheathing and raise the height an additional 12"• install a 21 linear foot bulkhead extension installed in more of a straight line;re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs and re-vegetate area with beach grass and other wetland plantings; dredge approximately 65 cubic yards of material which is to be utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off-site location; At 840 Old Harbor Road,New Suffolk Suffolk County Tax Map#1000-117-5-51.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated December 11,2015, pursuant to which Trustees Wetland Permit#8734 Dated January 20,2016,was issued and Amended on January 17,2018 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal and replacement of 37 linear feet of existing bulkhead in- place using vigil sheathing and raise the height an additional 12"• install a 21 linear foot bulkhead_ extension installed in more of a straight line-,re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs and re-vegetate area with beach grass and other wetland plantings; dredge approximately 65 cubic yards of material which is to be utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off-site location. The certificate is issued to Frederic Endemann owner of the aforesaid property. JL9Y�t) Authorized Signature Cantrell, Elizabeth From: Fred Endemann <fendemann@gmail.com> Sent: Wednesday, September 19, 2018 9:41 AM To: Cantrell, Elizabeth Subject: Permit Number 8734 SCTM No. 1000-117-05-51.1 Dear Trustees, Our work at Old Harbor Road in New Suffolk is complete. The new bulkhead is in place. The dredging has been done. Two types of grasses are growing on the slope above the old low-sill bulkhead. Please let me know if and when a final inspection is due and if there is any cost involved. Sincerely, Fred Endemann 631-680-5948 1 Michael J.Domino,President ``*zf SUyO Town Hall Annex John M. Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �cOUNT O Y Fax(631) 765-6641 � I,N� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 101316 y Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed V/Project complete, compliance inspection. INSPECTED BY: NKi,,,pA COMMENTS: j�p�,, —/ N°(( ego "'. CERTIFICATE OF COMPLIANCE: ar Michael J.Domino,President ��Q� soTown Hall Annex O � 54375 Routg 25 John M.Bredemeyer III,Vice-President '` P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas KrupskiO �hc Telephone(631) 765-1892 Greg Williams coUFax(631) 765-6641 NT`I�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 17, 2018 Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: FREDERIC ENDEMANN 840 OLD HARBOR ROAD, NEW SUFFOLK SCTM#: 1000-117-5-51.1 Dear Mr. Patanjo: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, January 17, 2018: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8734 to modify the original bulkhead replacement to be a 37 linear foot replacement with a 21 linear foot bulkhead extension installed in more of a straight line in lieu of the angled version of a 40 linear foot replacement and 20 linear foot of new bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, dated November 28, 2017, and stamped approved on January 17, 2018. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, L*ge A�4� Michael J. Domino, President Board of Trustees MJD/dd - _zs December 4, 2017 Town of Southold Trustees E C E I V E Town Hall Annex Building �- 54375 Rte. 25 D EC - 7 2017 P.O. Box 1179 Southold, New York 11971 Southold Town RE: 840 OLD HARBOR LANE, NEW SUFFOLK Board of Trustees SCTM No. 1000-117-05-51.1 TRUSTEE PERMIT No.: 8734 APPLICATION FOR PERMIT Dear Trustees; Attached please find three (3) copies of revised plans for the above referenced project. We hereby request an amendment to the approved permit (#8734). The proposed plan has been modified to revise the original bulkhead replacement in a straight line in-lieu of the angled version as shown on the original plans. The original approved plan includes 40 LF of remove and replace and 20 LF of new bulkhead. The revised plan includes 37 LF of remove and replace and 21 LF of new bulkhead as shown on the attached plans. In addition to the attached plans we have included a check in the amount of$50 and color photographs of the subject area for your use. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, J rey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 Cc: Mr. Frederick Endemann PROJECT LOCATION � RE-SHAPE BO LF OF EXISTING ERODED BANK. INSTALL TWO TIERS OF COIR LOG STABILIZATION O AND PLANT WITH CAPE AMERICA BEACH GRASS l -' �.:: .{:. //\// // // PROPOSED]DOUBLE ROW OF 9 DIA. \ \ \ COIR LOG STAKED 2'O.C. \\/\\/\\/\\/\\ PROPOSED DOUBLE ROW OF 9•DIA. s '\ \ \ \ \ CDIR TOG 0 `L = i / / / / / \ STAKED 2 O.C. p 1 -�',:,., n: �•�'r -:,,-:.. r"=r,� �/\/\/\/\ PROPOSED 4'WIDE NIIERIIDAL MARSH AREA �' 7 1 a PLANT w/2•sPARnru ALTERNIFtoRA PLUGS 0 12 O.C. RPRO)UMATE M.H.w. EL.2.st � - REMOVE AND REPLACE 37 LF OF EXISTING BULKHEAD WITH NEW VINYL I N LANDWARD EXISTING G•� D AS ;:, ` ,' ,�.�•`,_<< 4';.+`�_: \ \ \\ \ APPRoxnaATE M.Lw a. is .. � . .. -' x-•.: ..n.•. .f ,...: \ \ \ \ 123 43 9 °.....i:R ': :`;._,-.:-y; sm BoTm St G y 7_=:'r{;:'•', n5,if 4,,`,=J' "'2* �\\\\jam\'\N\1 N�\��\��\�/ \\ \\ \\ \\ \\ \\ \\/\\\ — \ REMOVE EXISTING BULKHEAD AND FILL p::. N SEAWARD OF PROPOSED EXISTING LOW—SILL BULKHEAD BULKHEAD }•• ::��( ;'1.; _:.,s r,. TO REMAIN UNDISTURBED Z A PROPOSED 21 LF OF NEW VINYL BULKHEAD EXTENSION lir,•'ev'Suf[cL!<r:Ln,...,,..�., .,r..r......._,_.:•� .,. : ;_;,y'+;y:(.y�y.: P RE-SHAPE 60 LF OF EXISTING o ` +.� + + ERODED BANK. INSTALL TWO ,- .i.< .'•til •.5:=... 0 + + + TIERS OF COIR LOG ti + + + STABILIZATION AND PLANT WITH / TYPICAL SECTION — BANK STABILIZATION ` ,� + + � P CAPE AMERICA BEACH GRASS PROJECT LOCATION MAP N.T.S. ' �. N.T.S. + PROPOSED TOP OF BANK LINE A s PROPOSED 4' WIDE INTERTIDAL MARSH AREA / PROPOSE AREAS OF DREDGING TO 13' PLANT W/ 2" SPARTINA ALTERNIFLORA PLUGS DEPTH OF -5.0' BELOW MLW ELEVATION. 0 12" O.C. TOTAL FO0 RINT OF 2,200 SF AND 6a DREDGE SP IL QUANTITY OF 65 CY TO BE DISTRIB ED BEHIND EXISTING ` � UTI L APPROXIMATELY CY LOW-SILL B KHEAD AND REMAINDER �► s, $ EGD -NO H FILL NOTE: STRUCTURE EXISTING BULKHEAD BROUGHT TO PPROVED LANDFILL FOR S �g, AND AL EXISTING LOW- L BULKHEAD / STRUCTURE IN ITS ENTIRETY DISPOSAL L URAL AND INSTALL NEW BUL KHEAID p LANDWARD OF EXISTING PROPOSED FIR TIMBER TOP CAP ,X WITH RAISED ELEVATION OF RE-VEGETATION. 1' HEIGHT ABOVE EXIST. TOPCAP PROPOSED 3 + + + +"X6" PROPOSED 22' LONG 10" BUTT + + + PROVIDE 1 OCY CLEAN REAR WALE CCA TREATED TIMBER PILE, 6' `O.C. �, SAND FILL BACKFILL , BEHIND BULKHEAD W r p+ 1 / APPROVED B � O� L s N6 + 3 p++ ) o BOARD OF TRUSTEES PROPOSED 6"x6" CCA TOWN OF SOUTHOLD F `rll TOP do BOTTOM WALE �' ��� �O� � 4-� L=, i /`',' ��oQ tK «< III APPROXILUITE M.H.W. EL 2.5t • " 1 DATE -TAvvA?-xl 1-7zoig5 N 87'55'00" W 1 D�i) 2Ti7DEC EXISTING BULKHEAD I i---'_-- Scuthaid lewn LAY—LOG PILE ar f r t PROPOSED E TIP CCA TO BE REMOVED IN '' APPROXIMATE M.LW EL.O.O± LAY—LOITS ENTIRETY. PROPOSED 8" TIP CCA PILE, 6' I I I O.C. 8' LENGTH. BOLTED TO LAY—LOG WITH 3/4" GALVANIZED THRu-BOLTS. \/\\ /��//�//��//�\//�\�/�,��/�\77:77' �,� REPRESENTS WATER DEPTH IN FEET \� \ -5z BELOW MEAN LOW WATER PROPOSED 16' LONG 1 DLA. GALV. TIE ROD, 6' O.C. PROPERTY OWNER 11-28-17 REVISED BULKHEAD REPLACEMENT ALIGNMENT FREDERIC ENDEMANN DATE REVISION Ww PROPOSED 9000 VINYLI6' LONG SHEETINGSTAURT, FL 34996 CL� NOTES: NE PLANTATION ROAD APT 4706 PERMIT PLANS SCALE: STA 1. SITE PLAN PREPARED FROM SURVEY PREPARED BY: 1„-30'PREPARED BY: NATHIN TAFT CORWIN III DATE: TYPICAL SECTION — BULKHEAD 1586 MAIN ROAD JAMESPORT, NY 11947 JEFFREY PATANJO PROPOSED PLAN & SECTION 11-7-15 N.T.S. DATE SURVEYED: JUNE 22, 2009 106 HEWITT BLVD. CENTER MORICHES, NY 11934 840 OLD HARBOR LANE 2. LOT AREA = 1.145 ACRES 631-484-9332 NEW SUFFOLK, TOWN OF SOUTHOLD J PATANJO@OPTON LINE.NET SUFFOLK COUNTY, NY SHEET: TAX MAP NO. 1000-117-05-51.1 1 OF 1 FFO(K Michael J.Domino,Presic g� O�Q CSG Town Hall Annex John M. Bredemeyer III,Vice-Pr6siuent �� �� 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith 0 Southold,NY 11971 A.Nicholas Krupski ��1 �a0! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: k-j Jeffrey Patanjo on behalf of FREDERIC ENDEMANN requests an Administrative Amendment to Wetland Permit#8734 to modify the original bulkhead replacement to be a 37 linear foot replacement with a 21 linear foot bulkhead extension installed in more of a straight line in lieu of the angled version of a 40 linear foot replacement and 20 linear foot of new bulkhead. Located: 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 J Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 uFFQc Michael J.Domino,Presic o�OS KCOG Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski � p'r Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Jeffrey Patanjo on behalf of FREDERIC ENDEMANN requests an Administrative Amendment to Wetland Permit#8734 to modify'the original bulkhead replacement to be a 37 linear foot replacement with a 21 linear foot bulkhead extension installed in more of a straight line in lieu of the angled version of a 40 linear foot replacement and 20 linear foot of new bulkhead. Located: 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9'- ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 r • Photo 1 J •�'#`�''a`�Y HSI`(". 7y y!` ,�t !.y � j,." •�'F 'i4' •.tf�? �!+•' .- ;w.A" r, ,+,�.�, �` 'ate "- ,4ftl '�r< r �•-!'t p ti '�.Sr"r•6 „�^++.ISP, � 1 9 YK �" � ray �• .�' Photo 2 n j V E L nFC - 7 2017 Southold Town B a;' Tru 't t so A Alt DEC - 7 2017 1 11 ardoffrustoes 1 e book a Is„.4' f 71 .4 4, .. K . , q• 711 7 11 A � A Michael J.Domino,President OF Soy0 Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O. Box 1179 Charles J.Sanders jW Southold,New York 11971 Glenn Goldsmith ® Q Telephone(631) 765-1892 A.Nicholas KrupskiO Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 18, 2017 Frederic Endemann P.O. Box 745 Cutchogue, NY 11935 RE: 840 OLD HARBOR ROAD, NEW SUFFOLK SCTM# 1000-117-5-51.1 Dear Mr. Endemann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 18, 2017: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#8734, as issued on January 20, 2016. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, 0 Michael J. Domino President, Board of Trustees MJD:dd l Tc)�)A / S , S , 26(7 RF_ ckHifigi 6'Arc, Rfz 6Lp OAA J5gR �U)- PC.) $0x 7LfS C t�(Cti/a�VT2 NY /� ( 3s E C E a V ED] SEP — 5 2017 Southold Town Board TTustoes— Michael J. Domino, Presi% ��S�FFO(,�CO 1, j Town Hall Annex John M. Brederrieyer I11, Vice-Pe-s dent ��� GyJ, 54375 Route 25 Charles J. Sanders � z P.O.Box 1179 Glenn Goldsmith 0 Southold,NY 11971 A.Nicholas Krupski ��l 41 p! Telephone(631)765-1892�a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed infield by: 1� FREDERIC ENDEMANN requests a One-Year Extension to Wetland Permit #8734, as issued on January 20, 2016. Located: 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C..E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 6\ IrA e Present were: -'-J. Bredemeyer &4 Domino - G. Goldsmith's N. Krupski C. Sanders Other Page 1 of 2 Michael J. Domino, Presi, i �Qg11FF0(,��0 Town Hall Annex John M. Bredemeyer III,Vice-President ��� Gym 54375 Route 25 Charles J. Sanders o =G P.O.Box 1179 Ze Glenn Goldsmith ' Southold,NY 11971 A.Nicholas Krupski A,ho® �apl� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: FREDERIC ENDEMANN requests a One-Year Extension to Wetland Permit #8734, as issued on January 20, 2016. Located: 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. 525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 Town fall, 53095 Main Rd John M Brederneyer (t(, President o��S�PfDCKco G PO Box 1 179 Michael J Domino, Vice-President o ��.a rry l 1971 James F King �' z Sort u, l V y 0, �� Telephone(631) 765-1892 Charles J Sanders O Dave Bergen ��l Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSP=ECTION SCHEDULE Pre-construction, silt fence 1st day of construction % constructed 713roject complete, compliance inspection I i I BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK `t PERMIT NO. 8734 DATE: JANUARY 20, 2016 ISSUED TO: FREDERIC ENDEMANN I I I PROPERTY ADDRESS: 840 OLD HARBOR ROAD, NEW SUFFOLK I � j SCTM# 1000-117-5-51.1 I AUTHORIZATION i Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on January 20,2016,and in consideration of application fee in the sum of$250.00 paid by Frederic Endemann and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to for the removal and replacement of 40 linear feet of existing i bulkhead in-place using vinyl sheathing, and raise the height an additional 12"; install a 20 linear foot bulkhead extension; re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs, and re-vegetate area with beach grass and other I wetland plantings; dredge approximately 65 cubic yards of material which is to be i utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off- site location; and as depicted on the site plan prepared by Jeffrey Patanjo,dated November 7,2015, and stamped approved on January 20, 2016. I i IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. I j 40 tro r M I r ---- - -- -- - - - --- -- - ----- TERMS AND CONDITIONS The Permittee Frederic Endemann residing at 840 Old Harbor Road,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. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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. 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 *QF SQ�/lyQl Town Hall Annex Michael J. Domino,Vice-President h 54375 Route 25 l L lig P.O.Box 1179 Glenn Goldsmith Southold, New York 11971 A. Nicholas KrupskiG p � � Telephone(631) 765-1892 Charles J. Sanders �< CjAUNN Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 20, 2016 Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: FREDERIC ENDEMANN 840 OLD HARBOR ROAD, NEW SUFFOLK SCTM# 1000-117-5-51.1 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, January 20, 2016 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of FREDERIC ENDEMANN 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 December 11, 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 January 20, 2016, 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 approve the application of FREDERIC ENDEMANN for the removal and replacement of 40 linear feet of existing bulkhead in- place using vinyl sheathing, and raise the height an additional 12"; install a 20 linear foot bulkhead extension; re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs, and re-vegetate area with beach grass and other wetland plantings; dredge approximately 65 cubic yards of material which is to be utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off-site location; and as depicted on the site plan prepared by Jeffrey Patanjo, dated November 7, 2015, and stamped approved on January 20, 2016. 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/dd John M. Bredemeyer 111, President gUEFO(,t-C Town Hall Annex Michael J. Domino, Vice-President ,��� �Gy 54375 Route 25, P.O Box 1 179 James F. King Southold,NY 11971 Charles J. Sanders y • �� Telephone(631)765-1892 Dave Bergen '* �aO Fax(63 I) 765-6641 BOARD OF TOWN TRUSTEES j TOWN OF SOUTHOLD TO: FREXkic F-NDEAIA AI 0 4 q o4myza Please be advised that your application dated DECEi I I i 20(, has been reviewed by this Board at the regular meeting of TAMIL" 1-0,2G! 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) 1 st Day of Construction ($50.00) Y2 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: sot TOTAL FEES DUE: $ BY: John M. Bredemeyer III, President Board of Trustees . ... . . . . - .:,^. r . . . . . . ., .. , . .i: . .... ... / .,. -' .. .. PROJECT . . . LOCAT ION .. O .. . . , RE-SHAPE 60 LF OF EXISTING ERODED BANK.' . . . . . . . 0 . TWO TIERS OF COIR LOG STABILIZATI N INSTALL S. „ . AM ERICA BEACH'GRAS _. WITH CAPE . ,.- . AND PLANT ., t�.' v-S. .�. ... .. r. .1 , a. , .. "' r „ ,r.'... ., .. , 7 -. ,: , i, ,.. a.,,. -- r. a-r f' r.. .. .� / / —�� — ..,. x LE ROW OF>F DIA x. ..,... \ \ \ PROPOSED DOUB t- ,- / // // // IR LOG STAKED 2'O.C. s `� i,. n / 00 %}' \ \ \ \ sp f j\/\/\/\/\ sED DoueLE Row of s' Dla �' .. :, ,-, // // // // PROPO . . \\ \\\\\\\\\\\ \ COIR LOG STAKED 2 0 C \ \ �� s• x r /\//\\//\\//\\/\ \ PROPOSED 4' WIDE INTERRDAL MARSH AREA . . . ll\ / / / / i , , .-1/j\/j\ Puwr w/7 sPARnHA aTERrnfLORA PLUGs / i 'F` /� „:: \ \ \ \ \ of 4 o a2• oc. r, / / O'" , ._,.;.:,..., .,,.:... M.H.W. EL 2.5i , F ,:•.,.".'. _ .,- . APPROXIMATE ::'._,,:,t :.,'. ,..,::,.,.f_-,. \ \ \ \ \ \\ \ EMOVE -AND REPLACE 40 LF OF �' ,..r....:. : : \ \ \ \ i a< �,\\ \\ \\ \\ \\ \\ I at EXISTING BULKHEAD WITH NEW VINY _ i / / / / . . ti.,; .;':: . / / / 0 S EXISTWG ;- -.s,�,,N-111„'•,,, ,.,,,.k..,. :,' ,. _ / / / IN SAME LOCATI N A / . . . N .::..:....::.: ,,,.,::::..,::::.a,.r,:,. _,,, \\ \\\\ \\ \\ \\ - , / / / / / / -r. '. ".:Fr.: / / / / / / APPROXIMATE M L 43 „,. . . , - '.,' ; :.', r.. . . \ \ \ \ \ . . 1 .. . . .. / / / / /\ \ \ \ \ C� \ \ \ '\ t SAND BOTTOM \ '\ \� \ \ \ \ \ \ \ \/ / / h? Q / / / / / / / / / /���7 T 7 _ - p' . .. \ / / /\/\ \ \ \ \ \ \ \ \ .. _. .. . / / \/\.. 7 ,.. . NEW _. ,,..,ti�,�.,..,z:.;,,...;,.<::,t:..,...�:-_,, �: PROPOSED 20 LF=;OF _ ;,.>;,s�_,l :.-,%. ,:,,a>. ;,.,.... EXISTING LOW-SILL BULKHEAD , .f,.,•. .. To REMAw UNDISTURBED VINYL BULKHEAD EXTENSION ,, ,,.' _,.. ....,.,!_„r ., -s .. .. mss.. _ � ., -r,� 3 . - ;, ;i; ;r;; ;1 .. . ; ,; - . . O . . >�k:•• P �, J a:A;, a. `�:f Y G . t:'�t;° S N '' ' 6 F 'OF EXI TI , — : "SHAPE 0 L . . 0 RE ��b y - /�,o' ..,, '�, _. �� 2 ERODED, BANK:' INSTALL TWO . ,.- - N + f.�A.;, k y�:`w"Scaffnia' !.::,.. , ;M,m;a;i,;-,_:'_`S_: "'F'k; . . p + + + nn V' .. ,& . r h,.V OG . ,. . . + + TIERS OF COIR "L / . +` ¢ .. . o� w :4�, ; ;; .:.:..:. ,., + + . . . � .. . . . STABILIZATION 'AND PLANT WITH .:.. '.r ! s :,�'•i,sy,r:, :, ,: ... . - . SS . .. �� P -CAPE AMERICA BEACH:--::GRA TYPIC`AI SECTION BANK STABILIZATION . . '. .. . . N.T.S. . PROJE CT LOCATION MA P . N LINE . <„ : N.T.S. . / . -. \ Y' . " s 1p so D 4' WID . `` LA W 2" SP ,, . RNIFLORA PLU . . . PROPOSE AREAS OF DREDGING TO \ 13' POS / A GS �Py PRO E INTERTIDAL MARSH AR P N RTINA ALTE —5.0' BE I s s ��, 0 12" O.C. " . o�\� DEPTH 'OF LOW MLW ELEVAT ON 1 . . . . . TOTAL;FOO .RINT OF 2,200 SF AND �P „ . G . . : DR . . . . . . EDGE SP IL. QUANTITY OF 65 CY TO BE DISTRIB ED BEHIND EXISTWG . .. .. . . — , :LOW„ SILL B LKHEAD AND REMAINDER UTIL APPROXIMATELY CY - — EGD ;"NOU H FILL , _: \o BE EXISTING :LOW— L BULKHEAD / . . . PRO ILL FOR . . 9 BR OUGHT TO AP VED LANDF . NOTE: REMOVE EXISTING BULKHEAD P AND ;ALL URAL . STRUCTURE, IN ITS ENTIRETY . . - . — 10 DIS OSAL• . AND INSTALL.NEW BULKHEAD . . z .. , . .. . . 1x IN THE EXACT SAME POSITION PROPOSED FIR TIMBER TOP CAP + + r . RE VEGETAT N . . . WffH RAISED ELEVATION OF .. . . OVE EXIST. TOPCAP . HEIGHT AB + + + " .. s 22' LONG 10' BUTT ": - r P + p PROPOSED 3"X6" PROPOSED / , . REAR WALE REATED TIMBER PILE, 6' . CCA T ` 1 PROVIDE-20CY CLEAN O.C. , - SAND FILL BACKFILL BEHIND BULKHEAD s� P + + 4 i� _ ,: APPROVE[ �EY . . . . . / S .. /+� N ,s � + �P��- ,'�o � yT;��4ARD'Of TRUSTEE D 6"x6" CCA ' j oQi� of .SOUTHQIJ�; " _. ..... .. TOPP& BOTTOM WALE / % :_ , . . - , �., . . . APPROXIMATE M.H.W. EL 2.5� N 87'55 00 W , J, .. I " I 145.00' �U. -2G 2G/&' ��: "J . . . I ,., 1 1 a - -------- - • ----- ---------------- ---- . ' � . . �'' �..�r� DEG .2015 . . . EXISTING BULKHEAD" , . APPROXIMATE M.LW EL O.Ot : . 1 i -_ ,.: -,. _r__- i :.:: PRbPOSED �' TIP CCA TO BE REMOVED IN , tt LAY-LOG PILE ITS ENTIRETY. I . . ,' , , - tom_ , - ,._ A - . . : . .. . . . . " . . .. . .. PROPOSED 8" TIP CCA PILE, 6' , . . O.C. 8' LENGTH:'•BOLTED TO . 1 //\��j/\fj/�/�\\ \ REPRESENTS WATER DEPTH IN FEET . LAY-LOG WITH.3/a". . . I ,// //\/\I� l , \//�\/ �/\//\%\ -5.2 . . u—eoLTs. .. .. ;, ,// /�.//,\,\,� ... 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Lic: No.' 50467 � � o *, o "° . N 000. : o�� .. UNAUTHORIZED ALTERATION OR ADDITION . .. . .. . O�' SCT ON 720 OFSTAE�NEWTYORKO STATE " . . . . EDU J�° � �� CATION LAW �Gp� Nathan Taft Corv�rin III . COPIES OF THIS SURVEY MAP'NOT BEARING . . ., . o ) )) FOUND CONC. . . .' . . .'.:.THE LAND SURVEYOR'S INKED SEAL OR . . .:;. . . . / .: : N 87 55 00 W . MON DSS E ONSI ER D . . .. . . , 45 O TOBBESADALIDLTRUELCOPY. .B Lan r - '. C D E O �� unu " CERTIFICATIONS INDICATED HEREON SHALL ,RUN ' ury yo . POLE .. ONLY TO R HDE A RSO N FOR WH OM THE SH RVEY E I '' ' T17 E COMPANY, GOVOERNMENBAL AGENOCYTAND`: _ ' : .. - - - . - LENDING INSTITUTION LISTED HEREON, AND le urveys — ivisions — S�e lan uc Layout I " ." .. . . . . CHAEL RA �`c . . . .. . _ .. - .. N/0/F rt s Subd' ' ' f P s Cons. tion MI TO THE ASSIGNEES OF THE LENDING INSTI . YNOR .�� \ TUT10N. CERTIFICATIONS ARE NOT TRANSFERABLE: PHONE'(631)727-2090 FOX (631)727-1727"' . - . . . . . . , .. . . THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT _ MAILING'ADDRESS . . , . . . " AND/OR EASEMENTS OF RECORD, IF 1586 Main"'Road P.O. Box 1931 . . .. , ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Riverhead, New York -1 1901-0965 . - . . . : . . - .. . . .. — ,• ! .: . . .. HYDROGRAPHIC MAP N "Old Harbor Docks" �o�0c��� Surveyed: 02-22-11 0�,0�&,����' w E SCT# 1000-117-5-51.1 Town: Southold Suffolk County, NY / / Datum: M LW r V 300' / Timber will 1 q 60 ay t9 i / Ma Na �.�• � >�111 ` �X11 tp >�10 ON A 0 / Fir �ri p � � s is > iP % ' DEC 1 2015 o s boko� oN � bb �p \N% % �,���,,� /,,' % � �� �•oma_ _,— �'9 V yrs M'� � o � 9 > > u \ Q pow or formerly \ \ Co 1< MI NpPt \ rte- SEA n� .a LEVEL O MAPPING Oi Box#366 's y Aquebogue co OG \ �� NY 11931 ROBERT H.FOX NYS PLS#50197 John Bredemeyer, President �OFF94q Town Hall Annex Michael J. Domino, Vice-President ��° °mss 54375 Route 25 Glenn Goldsmith ; P.O. Box 1179 A. Nicholas Krupski y • '� Southold, NY 11971 Charles J. Sanders �O1 ,p �a° Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: I/!y 11(a Jeffrey Patanjo on behalf of FREDERIC ENDEMANN requests a Wetland Permit for the removal and replacement of 40 linear feet of existing bulkhead in-place using vinyl sheathing, and raise the height an additional 12"; install a 20 linear foot bulkhead extension; re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs, and re-vegetate area with beach grass and other wetland plantings; dredge approximately 65 cubic yards of material which is to be utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off-site location. Located: 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 Typ of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: \/ Chapt.275 Chapt. 111 other Type of Application: ✓ Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: V Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: ,�'- v ff t-. M ,vUM.rs,� 61� C�v41 i'11�(a,G Iis✓ti .1.1.�.1.;,, <1\ — ��r�� 1n1..(:4h C�1u+ i V �'Ana+ iln) '; ��J (,lt.� ^�7w✓ Present Were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. 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P 2 9 0 x+e 1] 19.1 211.2 C 28m1 °e1' nl^° ST - NI = 183 188 1 X19.3 m Z _ mJ+ K1NC. !. 6m 11 a18 •a 2] 1A T2„v 1 w• �i m O M 21 m . a� 66W suv w ' 142`n � 't — _, m+m _ w �p yOgoLPs1�-� 13 � • 8J m w \ ST. ;85 322 ']2.1 m 142 t84 1A a 22 x23 24 28.5€26p� `°° yANN •� 2a _261 A_]0 0� 5oymiaxD 1 15 NEW 511FFIXx AVE T 12 -1] TIT 21 -2A "P >w / 2, 9 a sAd 2bnlcl .0 16 i9 26 i31 1 f IC) 4.1 y,- -zo =zs r;,• -- O �- _i2 .LICKSON -10 y 2V. Tl 1 1m23 ffl t8, 162 .w mO laLoy v\ �4d 3 A,., tic 35 41 i2a '/ tat '6. 209 16 •r � 2.1A(c) 1.8A(c) 12A w m 90 m - t23 8 { 122 a 42 z BAY PECONIC r� a " GREAT r•..,...,.. __ _ _ _ __ __ NOTICE dwv'� COUNTY OF SUFFOLK © K °. SOUTHOLD SECTION N 121 2 _a.,,_ — -- n.��.. --"-- E >. M —O — _ —�—_—_ r Real Property Tax Serv)ce Agency v 11>• L,^ °F 117 K CountyCmin RNerMC,NY 11901 _w,f Nala.z�4) •^' -- Y.. —v-- ���.�--"-- vwarcvw a rvr n x v wr A si8iCr 90 _____ .x sLw cc rs 9��e- P 2000 PROPERTY MAP OFFICE LOCATION: �O�*Of SO . OlO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) cn �c Southold, NY 11971 �p� Telephone: 631 765-1938 olyc4U ,� 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 January 14, 2016 Re: Local Waterfront Coastal Consistency Review FREDERIC ENDEMANN SCTM# 1000-117-5-51.1 Jeffrey Patanjo on behalf of FREDERIC ENDEMANN requests a Wetland Permit for the removal and replacement of 40 linear feet of existing bulkhead in-place using vinyl sheathing, and raise the height an additional 12"; install a 20 linear foot bulkhead extension; re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs, and re-vegetate area with beach grass and other wetland plantings; dredge approximately 65 cubic yards of material which is to be utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off-site location Located. 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 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 Policy Standards and therefore is CONSISTENT with the LWRP. 1. It is recommended that the area re-nourished behind the low sill bulkhead be planted with spartina alterniflora. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. �����gpFFO(,hcoG Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P O Box 1179 • Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., January 13, 2016 the following recommendation was made: Moved by Peter Young, seconded by John Stein, it was RESOLVED to SUPPORT the application of FREDERIC ENDEMANN to remove and replace 40 If. of existing bulkhead with new vinyl bulkhead in same location and 12" raised height; installation of 20 If. of proposed vinyl bulkhead extension; re-shaping of 60 If. of eroded bank along with installation of two tiers of coir logs and planting with beach grass and wetland plantings; dredging of approx. 65 cy. material to be utilized as nourishment behind low-sill bulkhead or disposed of off-site. Located: 840 Old Harbor Lane, New Suffolk. SCTM#117-5-51.1 Inspected by: Peter Young Vote of Council: Ayes: Peter Young, Peter Meeker, John Stein, Jack McGreevy, Keith McCamy Nay: Doug Hardy John M.Bredemeyer III,President �Q ,S.(/�� . Town Hall Annex Michael J.Domino,Vice-President tib` 64376 Main Road P.O.Box 1179 James F.King,Trustee ' ' Southold,New York 11971-0959 Dave Bergen,Trustee G .- Charles J.Sanders,TrusteeTelephone(631)766-1892d. Fax(631)766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Xoastal Erosion Permit Application Wetland Permit Application Administrative Permit / Amendment/Transfer/Extension ✓ Receiv_ed Application: 12111-I5' Received Fee:$ ZSR,M m r w R V V f• y i _Completed Application 12j5-15* _Incomplete �-- SEQRA Classificat' n: Type[__Type 11 V Unlisted ' DEC 1 1 2015 " Coordination:(date sent) / g!� yrLWRP Consistency Assessment Form CAC Referral Sent: 12.23.16 1 — —� Date of Inspection: Il14./to _Receipt of CAC Report: _Lead Agency Determination: Technical Review: /'Public Hearing Held: 1,�/lo Resolution: Name of Applicant fc ccter« ell A e M a n n Mailing Address S` q Nt: P14nt4,41o0 aok& APfi q-706 S{o ar-' ,f7 L 34 1916 Phone Number:( ) 631 - Goo -59 q b Suffolk County Tax Map Number: 1000- 1 1-1- o s - 5 Property Location: S y o o l k +1 a r Ivor li n c, O ctA.) so�o Oc ,5e.-- Lo��-t-�o�, e,-1 4-P (provide LILCO Pole#,distance to cross streets,and location) AGENT: (If applicable) Address: 10 6 14«1-t--r o cP , Ce n-t-e r A-A or i c k c S , .n)� 11 9 3 y Phone: 6 31. 10 Y-1 33a- L � 1 Lrd of Trustees Applicatio: GENERAL DATA Land Area(in square feet): y 9 I $ S o Area Zoning: 2 c s.J e n+,,,, L Previous use of property: V a e k o%+ —AA u ri n w Intended use of property: , a r i et h- 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 V" 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 ?e No Does the structure(s)on property have a valid Certificate of Occupancy? Yes X No Prior permits/approvals for site improvements: Agency Date 5oy,-VkP1& T�"S+Ces 3-5- 10 61.w s-il a„1J1he4A N`1 S DEc. 3 - 10 (tom 5.1c daucheglj No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?-y—No Yes If yes,provide explanation: Project Description(use attachments if necessary): S-ec A+4&--h,-6C 840 OLD HARBOR LANE, NEW SUFFOLK SCTM No. 1000-117-05-51.1 PROJECT DESCRIPTION The proposed project includes removal and replacement of 40 LF of existing bulkhead with new vinyl in same location & 12" raised height, installation of 20 LF of proposed vinyl bulkhead extension, re-shaping of 60 LF of eroded bank along with installation of two tiers of coir logs and planting with beach grass and wetland plantings, dredging of approximately 65 CY of material to be utilized as nourishment behind low-sill bulkhead or disposed of off site. B1 I of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 5-ec Area of wetlands on lot: go square feet Percent coverage of lot: o % Closest distance between nearest existing structure and upland edge of wetlands: ,-11A feet Closest distance between nearest proposed structure and upland edge of wetlands: 10 feet Does the project involve excavation or filling? No >C Yes If yes,how much material will be excavated? 6 s cubic yards How much material will be filled? 2 o cubic yards Depth of which material will be removed or deposited: aL-+ feet Proposed slope throughout the area of operations: 0 50 Manner in which material will be removed or deposited: J r,J-).e �o be !L/Y�ovt� h.7 C�4M LhGI( b✓LILcT, F, il �•�tt/t.�F,.(.._ L.naQw 1.rCQ ,,� h,, l htkcQ �, be- 401tceo wtfh ec-theme elm shed bac-Ke-r ..2 eA-c4,,,&+oA 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): T Ae erpler-4 ,,✓c C..c�! s we-} lti�� q ruSs�S, AnLf o(lims. c�L �f"o ` ( T-7 q (•n1SeS br- tej9Aired Short Environmental Assessment Form Part I -Project Information 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: / 4o otd- Na���r LS.�G NGW S✓1-t'�liC Project Location(describe,and attach a location map): $ec Loct-t P., /v-,4-10 Brief Description of Proposed Action: �,/ AAk J2g01tce ¢o L� op h✓��hta�� i...sr~[( ?opt= ,�.��,✓ r��.Clch�td?� Dre1fe � Sc l d F �ian� RC-.S�4PG li0 L� rG �GnlL 4rtt9 i..+1fa�� !'oir 1&6 S i'o. 6, 2z 4*[e,q pnr9 P�tnr,.✓�1 Namee of Applicant or Sponsor: Telephone: +' rte E-Mail: FCniPtma.nn�s ma.�C .Co.., Address: 5q4 12J . 4,0-t- q-706 City/PO: State: Zip Code: 54L,&r-r rL- 3`11 lb 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 F] 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: f S ►-+"1 59£GI�IM�� Co/Lft)/ ✓K00S1 5C."44.14 r"s-rt- F]3.a.Total acreage of the site of the proposed action? I. I`I S acres b.Total acreage to be physically disturbed? o•t o acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? I'�y S acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial [Residential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 3 5. is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ 7 D b.Consistent with the adopted comprehensive plan? D © ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? D ❑ 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:Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, gency: u oCounty,Date:7-12-813 ❑ ❑✓ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO j YES b.Are public transportation service(s)available at or near the site of the proposed action? a ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: D ❑ 10. Will the proposed action connect to an existing public/private water supply'? NO YES If No,describe method for providing potable water: a ❑ 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: R ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 0 ❑ b.Is the proposed action located in an archeological sensitive area? ❑ I ✓ 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ 131 If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 'Drtd9C 2,20. Sj' 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline ❑Forest ❑Agricultural/grasslands El Early mid-successional [�a Wetland ❑Urban E'Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? ❑ RI 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, � ❑ a.Will storm water discharges flow to adjacent properties? D NO 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 3 18.Does the proposed action include _truction or other activities that result in the irr_r ___dment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: © ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: © ❑ 20. Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: F ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: FF-,E(a ,G r< l C FND r n4",n/ Date: Signature: PRINT FORM Page 3 of 3 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)9 If Yes,explain purpose and size 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? [P 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 El available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage 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. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, at the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees /�- / :- ,/L/, Name of Lead Agency Date ue / President Print or Tyame of Re onsible Officer in LeaA Xgency Title of Responsible Officer - �2 A Ja*,,� at re of Res i fficer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 o1. 0 Town of Southold Erosion, Sedimentation $ Storrir-Water Run-off ASSESSMENT FORM AN PROPERTY LOCATION: S.C.T.M.fl THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A b0D I t 7 '05- Sl•/ STORM-WATER.GRADINO,DRAINAGE AND EROSION CONTROL PLAN e$mon -RbT �t ' CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within J Will this Project Retain All chStDRainfall o Site? the Scope of Work for Proposed Construction) `�9$�S/1•i`I� Generated by a Two{2")Inch Rainfall on Site? (S.F./awes) (This Item will include all run-off created by site ❑ b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposeda sow >".f Site Improvements and the permanent creation of construction activity? I0. impervious surfaces.) (S.F./Acres) PROVIDE BRIEF PROJECT DESCRIPTION gide Admdanal Papas as Needed) Drainage Does the Site Plan and/or Survey Show All Proposed ❑ Drainage Structures Indicating Size&Location?This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion ❑ S Cc A 44,4 11ke A and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards F-1 of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand ZC (5,000 S.F.)Square Feet of Ground Surface? jp Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC.SWPPP Reaulremants or within One Hundred(100')feet of a Wetland or Submission of a SWPPP Is required for all Construction actMties involving soil Beach? disturbances of one(1)or more sores; including disturbances of lase then one acre that 7 Nil there be Site preparation on Existing Grade Slopes ❑ are part of a larger common plan that wig ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to x Including Construction activities involving soil disturbances of less then one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES pemdt Is required for storm water discharges. (SWPPP's Shan most 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.GP-0.10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off X 1.The SWPPP shag be prepared prior to the submittal of the NOi.The NOI shag be Into and/or In the direction of a Town fight-of-way? El submitted to the Department prior to the commencement of construction acuv ty. 2 The SWPPP shsl describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction skim water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants In storm water discharges and to assure Item Within the Town Right-ofWay or Road Shoulder — — compliance with the lamas and conditions of this permit.In addition,the SWPPP shall Area?(Tea Item■ter NOT Incruda aw Instillation of Driveway Aprom.) Identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answeto Questions Ons through Nine Is Answered with a Check Mark 3.All SWPPPs that require the post-conshuction storm water management practice In a Box and the conshwtbn site disturbance Is between 1,000 S.F.S 1 Acre In area, component shag be prepared by a gcag0ed Design Professional Licensed In New York a Storm-Water,Grading.Drainage&Erosion Control Plan to Required by the Town of that Is knowledgeable In the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to issuance of Any aullding PemdL (NOTE: A Check Matic(4)and/or Answer for each Question is Reituired for a Complete Application) STATE OF NEW YORK, COUNTY OF...........................................SS That .......being duly swum,deposes and says that he/she is the applicant for Pemtit, (Name of Individual signing Dowmarl� Andthat he/she is the ...... . ............... .......... ..... .... .. .............................................................. (Owner,Contractor,Agent,Corporate Officer,sic.) 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 ui 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 heremth. Sworn to before me this; r ..............��.......................day of Notary Public: ..........ef ... ... ...................... : .... � .. ............ (Signature of"cant) FORM - 06110 WOreIS2a 8 January 13, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 840 OLD HARBOR LANE, NEW SUFFOLK SCTM No. 1000-117-05-51.1 CERTIFIED MAILING & POSTING Dear Trustees. Attached please find original affidavit's for Certified mailing and posting as requested. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 John M. Bredemeyer III, President �o�o coG- Town Hall Annex Michael J. Domino, Vice-President �� y� 54375 Route 25 Glenn Goldsmith 1 y x P.O Box 1179 A. Nicholas Krupski ",o • �;" Southold, NY 11971 Charles J. Sanders ``y��1 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 FREDERIC ENDEMANN COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR NOT LESS THAN SEVEN DAYS I, _ QiL1 f)a+an I D , residing at/dba (p 41m):6L BI yr/ ml IIg34 being duly sworn, depose and say: That on the q day of J C-Yt-Q , 201(0, l rrsonally posted the property known as �4D o i d {�-qbo r i2d . 2w Su�ft ty_ 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, January 20, 2016. Dated: (si a re) Sworn to before me this q day ofJW 20 1L Notary Public Notary public Pao m York Quo. in in County No:01 150861 Commissar ams 567120Lis PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: � Z� Y� -i F, m y ISI -i Itt,-n D I'bbY LCt • I'I�II� I -c4v CIL I Iq5 2- YS po x r;-4 He lac r 14 , Fal v STATE OF NEW YORK COUNTY OF SUFFOLK J>°-(� ep rj✓ O , residing at lO C0 He w I � gl GY)'1 ► being duly sworn, deposes and says that on the /1:23 _day of Q (,� , 201_(p, deponent mailed a true copy of the Notice set forth in the Board of Truste6s 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 assessme='v f the Town of Southold; that said Notices were mailed at the United States Post Office at at wC"S , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. i Sworn to before me this 13 Day ofQAnUbGL, 20L(2— Notary Public Pu Nc pataIN York Wed in County No:01P 150881 Commission Expires 08107/20.& PostalPostalV CERTIFIED, , • • r' Domestic I Domestic Er n uLnJ 111 rq Certified Mail Fee �r O'(�1 r-1 Certified Mail Fee� 3.45 - 0934 nj $ '�4. $ �,,14 iU Extra Services&Fees(check box,add fee aleOormfate) C� i ❑Return Receipt(hardcopy) $ i V V V Extra Services&Fees(check box,add/ee e!aDpre) a f° ` 6 „_, ❑Return Receipt(hardcoPY) $--7 V ❑Return Receipt(electronic) $ • U iV•VL' tt,,���+ Postma ik lD ❑Return Receipt(electronic) $ V ❑Certified Mail Restricted Delivery $ er 0 7 Here Q Adult Signature Required $ , — ,� C3 ❑Certified Mall Restricted Delivery $ if tri Q ❑Adult Signature Required $ []Adult Signature Restricted Delivery$ �\ / V []Adult Signature Restricted Delivery$ V t ti Postage $U.49 S o Postage $0.49 rij Total Postage and F ff.74 - i 6 rr q Total Postage and flees.74 A S eOO W. � . rel Sent To `/ $ Q r \ /l Sent To _ h. i/ ---------------------------- i-- -- $treetand Apt IVo.,of Box No -- -- --- "---"-------------------------------- O Street and Apt.No.,or P x No. --------------------------------------------------------------- (� City,State,ZIP+4• C -efe, ---e------------ ----- S[ ZIP+4 """" :. r r r rrr•r• r r r r r rrr•r• Postal CERTIFIED MAIV RECEIPT ru CO Domestic Mail OnlyN LrMAT4 TjUV 07,10':1,t°9'S3 r- Certified Mail Fee $3.4` ��CK6 `68314 rU Extra Services&Fees(check box,add tee Ig py:rp Q ❑Return Receipt(hardcopy) $ 7 V l J E-3 ❑Return Receipt(electronic) $ E:3 ❑Certified Mall Restricted Delivery $ AN 1 3 a �O, C3 ❑Adult Signature Required $ t-V f ❑Adult Signature Restricted Delivery$ C3 Postage $4.49 ru � Total Postage and F s 201 � a f�.74 r-a Sent To C3 kD�- nStt nd AtNoor o. City,State,ZIP+4 -------------------------------------------------- ------- r r r r r rrr•r• PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: " Si @4}:i'�-.�'.�v, i Kh�.i�."v6; r•"!i�Y • ' ti ... 'Y�'g.nf��',f,.t"tl(.:. � 5 u''@tb v.'l+�°e':x '.:,•.. STATE OF NEW YORK COUNTY OF SUFFOLK , residing at being duly sworn,deposes and says that on the day of , 20____, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIUR.ETURN RECEIPT. i Sworn to before me this Day of , 20 i Notary Public PostalPostal CERTIFIED MAIL@ RECEIPTCERTIFIED o RECEIPT Domestic Mail . �- Domestic ru r ,rl For delivery information,visit our website at www.usps.com,. Ln For delivery information,visit our website at www.usps.com b S Ln rq Certified Mail Fee ;3.45 e Certified Mail Fee �' ��` $ $3.45 �� /C' 934 ru $ ti�GH '� Lr) 14 Extra Services&Fees(check box,add tee�p ppprApgere) O`` ft Extra Services&Fees(check box,add fee ) ((1 O ❑Return Receipt(hardcopy) $ 7 V•V V q A r` ❑Return Receipt(hardcopy) $ l/t � ❑Return Receipt(electronlc) $ i C`a Postmark ❑Return Receipt(electronic) $ Post Lt _ � ❑Certified Mall Restricted Delivery $��_ � Here ❑Certified Mail Restricted Delivery $ �r.� H ig,. 6 ry 00 y Y J`N Q ❑Adult Signature Required E�V'r�7C�- I W N 201 � ❑Adult Signature Requlred $ V ❑Adult Signature Restricted Delivery$ A -A ❑Adult Signature Restricted Delivery$ �, O Postage w O Postage {�4�?. ru $0.49 0lei `�3 S $0.49 $ $ rq Total Postage and s IO Total Postage and Fess 74 01/13/2016 $ •74 Ln Sent To �O ` ' � Sent To 111 a _ �ll o �rt_1Jl _______________ StreetandA%it.IVdyQrPC)BoxlVo.- p Stieet and A t No.,or Pb Box No. r� - ----------------------------------------------------------- Ciry,State,2IP+46-- -- - --- -- -------- ------------------------------------------ Ciry State,ZIP+4e--------- 102-000 9047 See Reverse for Instructions PS Form 3800,April 2015I I 111 9047 U.S. Postal Service" U.S. Postal Service" CERTIFIED a J RECEIPT cc CERTIFIED MAIV RECEIPT Domestic �n Domestic Mail Only Ln Only nj ru Ln Ln For delivery information,visit our website at I 1W S AVE r1 x . 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City,State,ZlP+4e City State,Z%P+4 e PS Form :11 1 11 11 •I 01 April 201511 9047 See Reverse for Instructions PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: ` 1 � 0-3 - 7 I � ! sem, �,`• 117 y p . STATE OF NEW YORK "`{" ": f• `' COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20___, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 Notary Public NUTILt: Uim HLAKING 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: FREDERIC ENDEMANN SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the removal and replacement of 40 linear feet of existing bulkhead in-place using vinyl sheathing, and raise the height an additional 12"; install a 20 linear foot bulkhead extension; re-shape 60 linear feet of eroded bank along with the installation of two tiers of coir logs, and re-vegetate area with beach grass and other wetland plantings; dredge approximately 65 cubic yards of material which is to be utilized as nourishment behind the existing low-sill bulkhead or disposed of at an off-site location. Located: 840 Old Harbor Road, New Suffolk. SCTM# 1000-117-5-51.1 TIME & DATE OF PUBLIC HEARING : Wednesday, January 20, 2016 — 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 B d of Trustees Application County of Suffolk State of New York ,rccl ect L fir►of c M4 n n 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. `7iz'd" Signature of Property Owner 'r SWORN TO BEFORE ME THIS 64 DAY OF �jo Ve&kV(— ,29 /5- Notary"Public Noy � P�7�w Yak Commission � 09J07/20� H4 i of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, V-,(e&erLL residingat 544 r.►IE Plknfat�oh " (print owner of property) (mailing address) A p T y 1 oe S'l",a r f ,Fc„ 3 y9 9 6 do hereby authorize —,Se-Ff LL- (Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature) i APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM l The Town of Southold's Code of Ethics pgghiblts conflicts ofintcrest on the part of town officers and employees.The owse of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever.aetion is neceg=to avoid same. YOUR NAME: �- (Last name,first name,iriddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _ Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other Of"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,ntarriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership or(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO L__�— If you answered"YES",complete the balance of this form and date and sign where indicated. r i Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicanttagent/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 14-1 day of Itio V t m)magw,20 f S Signature - - . Print Name Ffze-p ryzi�- END rt MhNN Form TS 1 r 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 sunnorting 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# 11 -7 - 05 _ 51. I PROJECT NAME 814 o o t,L P&I 6'/L 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: 5-ex Location of action: 1?`l 0 r I& H u r 6 o r 4:-4 u� Site acreage: 1. 145- present 4SPresent land use: ✓&e&^t - A.Aa« Present zoning classification: (Ze-s 1-Q ^'VI 1�C- 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: �Fr e d e--t c, E n w n (b) Mailing address: 154q tiE P1 k A+rr -h e—n A O r y-7 Oto Si-�,,-,r+ , F-t_ 34q 14 (c) Telephone number:Area Code( ) y 31- 6 o - 5 g 4 23 (d) Application number,if any: Ih Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes © No❑ If yes,which state or federal agency?_t-1 so Ee- ��P s]N�,s r�'os 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. R Yes ❑ No ❑ Not Applicable Ar0)ee.A coAS1S4'en-r w��f'k S.,rrProp«'I"les 4n d- a^ cc5se-r'r -tv hoaficRs . Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 10 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 Q Yes ❑ No ❑ Not Applicable Proarc4 Pr-eserves 4hr- em& aeq914ces eee rre't•r-t4edt 6.,c.1e-4r4e0 a n& a roof c tf1 ti t w S t-r�c r. reS e—i to 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 ❑ Not Applicable Pf'►Jrcf (Greven-ts a yA I n S7 J*SS e6 ZVe?d 01,1.k Stdt �, t•,-r�-r�e dl b 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 R Yes ❑ No ❑Not Applicable errod.ee4 Prow irs G/oSton x14 ProvtZe's t,,.c"r�4n� ten t7nys 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. Zr ❑ ❑ Yes No Not Applicable PriItcE a1eWt*.,,a,(_ 1.'ct-4.a - /uh+ �► 1 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. F] Yes [:] No LTJ'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. ❑YesEl No [S�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. ❑ YeO No El 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 ❑ Not Applicable PfOvtJeS Lor'rrnVSt n y 444 zt--tics 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 allot Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No 9 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 I a TITLE 2 qcn r DATE ►l-(q- 1 s December 2, 2015 NYS Dept. of Environmental Conservation SUNY @ Stony Brook 50 Circle Road Stony Brook, New York 11790-2356 Attention. Duty Analyst RE: 840 ULD HARBOR LANE, NEW SUFFOLK, NY SCTM No. 1000-117-05-51.1 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, P Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 cc: Town of Southold Mr. Frederick Endemann Army Corps of Engineers NYSDOS i 1 DEC > > 2015 l JOINT APPLICATION FORM , 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 ment of State Check all permits that apply: Check all permits that apply: [3 Stream Disturbance ❑Coastal Erosion 13 Section 404 Clean Water Act Check all permits that Check this ref Management apply appllies. ICs.Excavation and Fill in ❑Section i0 Rivers and Harbors ❑State Owned Lands IRCoastal Navigable Waters ❑Wild,Scenic and Act Under Water Consistency ❑Docks,Moorings or Recreational Rivers ®Nationwide Permits)-Identify ❑Utility Concurrence Platforms ❑Water Withdrawal Numbell Easement ❑Dams and Impoundment ❑Long Island Well (pipelines, Structures ❑Aquatic Vegetation Control 3 conduits, ❑401 Water Quality ❑Aquatic Insect Control cables,etc.) Certification Preconstrudion Notification- ❑Docks ❑Freshwater Wetlands ❑ Fish Control I3'Y / ❑ N Moorings or 13 Incidental Take of Endan- Platforms Tidal Wetlands gered/Threatened Species Ei'I am sending this application ❑ I am sending this I am sending I am sending this application to this agency. to this agency. application to this this application agency. to this a enc . S. Name of Applicant(use full name) Applicant must be: 6. Name of Facility or Property Owner(if different than 19Owner Applicant) f7reAeriCIC. 6..,ACA4„n ❑Operator Mailing Address ❑Lessee Mailing Address (check all that apply) 54'l jU. A?1'096 Post Office City Taxpayer ID(If applicant Post Office City is NOT an individual): 5 -k✓.i r+ State F L zip code 3'1496 State Zip Code Telephone(daytime) Email Telephone(daytime) Email 631. 680 - 517'1$ Fe�I der"4""� �'gic.Piw+ 7. Contact/Agent Name B. Project/Facility Name Property Tax Map Section/Block/Lot Number I DOO - 117- fls- S/•/ Company Name Project Location- Provide directions and distances to roads,bridges and bodies of waters: Sre- L PC&+1n„ /0410 Je Fire �a-i'a h a Mailing Address Street Address,if applicable Post Office City State Zip Code NY ldb Hewitt 614 S`>'O Old lqal LGr►e AJe Post Office City Town/Village/City County 0eA+er N(bric-hes Snvtho1aQ SU E�oL1L State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name A) //13'1 5A "4rbor School 011 Crcev— Telephone(daytime) Location Coordinates: Enter NYTMs in kilometers,OR Latitude/Longitude 63/ Email NYTM-E NYTM-N Latitude Longitude J P'-t..,f D Q oP-tbnl,.,e.A)ct' qt)°59.72-6 -7 A'VI-9W JOINT APPLICATION FORM 02/13 This is a 2 Page Application Application Form Page i of 2 Both Pages Must be Completed APPLICATION FORM-PAGE 2 OF 2 Sub his completed page as part of your Application. 40 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—P&GES. e0MOVC 'QA� r-epitee 4{aL F of e'XL S �y aQtTe�I tecp 4e4 e9 ,H S4n�e L-0C--hroyi wL 2a�Seca heflA t ol= !�". -,,Sr,i( i✓lw ao LF eF �w� L I., _7 . {1c -S t, L14 a �k tstlNtf h anlL f,2 Ge tf� and1 ST�bll/�� wifih ii Ley f ancA P/kn-t, ays Deedfc 1, 5- F -54 a anrR to <<cee beli /OloPoSel A2 le-4e--cSL o2 /La.�►�ove mG� -S�f �E o ,�P �Y ..u2- L o e k-�r' v.� Proposed Use: 19 Private ❑ Public ❑Commercial Proposed ! Estimated Start Date: Z-/ Completion Date: Has Work Begun on Project? ❑Yes WNo If Yes,explain. Will Project Occupy Federal,State or Municipal Land? ❑Yes M No 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? ayes ❑No If yes,please list: -T11 w,-, •f- 5*L,- k .I A -rry c-rtc5 1 0 Lt S I7 o S/ A,-,--I ,-,- .7 Co/LPS 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. SAM F_ Signature of Applicant Printed Name Title Date ED 15Rlc �Nb1✓/4,vN Ci w:yi(L / '2 - !S Signature of Own r Printed Name Title Date -.�t rG Qe.Tan�a '4 IeA+ _ lf-lo-lam n ture of A ent Printed me b Title Date JOINT APPLICATION FORM 02/13 Application Form Page 2 of 2 New York State Department of Environmental Conservation _ MUM MW 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 staffto 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. [a 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): $ 4o a l& 0artoor L,--e , t-Je--> S,, F�oCIL By signing this form, I affirm under penalty of perjury that 1 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, Prredeete; 0nAea•4r+n, pwnek Zzyu Print Name and Title 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 Short Lnvironmental Assessment Form Part I -Project Information 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: S-f o 014 14,,A.,- L,, -,G ) n+cw $✓(-fie llL Project Location(describe,and attach a location map): Sec Cou-h P., M*_P Brief Description of Proposed Action: 2tnti,v„L Z,Q (Zeptee o L� of b✓c� e,,Or r—STt It 2 o LF it,u . C e-4eq. � of,ed91 k 5-c`1 d F raanea , I c-s4., t ISD C.G of, b4AiC_ ledcP t..+JrAh11 loorr le{ S ?a. 5r(iza-f'ce,7 A410 P1t1n_f11VJ1 Name of Applicant or Sponsor: Telephone: •F'-eeL E-Mail: ftnQtmcsnnr!i? mc,�C .co,,, Address: Sys} r-+E 12J • ,40pt y7od City/PO: State: Zip Code: 54L,&r•-t Fi 3Y996 1. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. if no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes, list agency(s)name and pen-nit or approval: ❑ «-+.tI 494 4rt-.7 Go/GPI' ✓KS�oSI T.�..,.+ uG So,, �(�olaQ ti..St�c 3.a. Total acreage of the site of the proposed action? I. I`I S acres b.Total acreage to be physically disturbed? P. o acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor'? I'iy t acres 4. Check all land uses that occur on,adioining and near the proposed action. ❑Urban []Rural(non-agriculture) [:]Industrial ❑Commercial Wesidential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ F�l ❑ 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? ❑ X❑ 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:Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, Elgency: u o oun a e: - - 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? a ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply`? NO YES If No,describe method for providing potable water: M ❑ 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: r-1 A F(] ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places'? ❑ b. Is the proposed action located in an archeological sensitive area? ❑ 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 9r�dac 2,200 sF 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline [1 Forest ❑Agricultural/grasslands ❑Early mid-successional CR Wetland ❑Urban 'Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ 21 16.Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO ❑YES 2 ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ONO AYES Page 2 of 3 18.Does the proposed action include ruction or other activities that result in the iml hent 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: © F 20. Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: FTZE(a ,r/z i c Date: // —1 1-/ _J5- Signature: /SSignature: PRINT FORM Page 3 of 3 NEW YORK STATE DEPARTMENT OF STATE COASTAL MANAGEMENT PROGRAM Federal Consistency Assessment Form An applicant,seeking a permit,license,waiver,certification or similar type of approval from a federal agency which is subject to the New York State Coastal Management Program(CMP),shall complete this assessment form for any proposed activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent with Nev York State's CMP as required by U.S. Department of Commerce regulations(15 CFR 930.57). It should be completed at the time when the federal application is prepared. The Department of State will use the completed form and accompanying information in its review of the applicant's certification of consistency. A.APPLICANT (please print) 1. Name: ('rtdtrit._ E,+alt.nahh 2. Address: 544 n,E AA. Apr 4704 :5r.Ar-t, GL 34944 3. Telephone: Area Code B.PROPOSED ACTIVITY 1. Brief description of activity: R-'---e. RncQ y0 LF b-tx e&d, t-5rwlt 'i0 �E r,[w hr�lGkt Q, 2¢-Sl�uPt loo LL bAnl[. ung Q�Y�q-!'-i,�.iS� l�fsdSc !►5 cy sF St...ce . 2. Purpose of activity: Cwt s-r,*.. 4 tat/lAe*X 3. Location of activity: S"(f.LA - evy }(atbor t.-i--- County City,Town,or Village Street or Site Description 4. Type of federal permittlicense required: ArMj 0-cyCP S 5. Federal application number,if known: v-'J A 6. If a state permit/license was issued or is required for the proposed activity,identify the state agency and provide the application or permit number,if known: tJ 4 SD4EL C.COASTAL ASSESSMENT Check either"YES"or"NO"for each of these questions. The numbers following each question refer to the policies described in the CMP document(see footnote on page 2)which may be affected by the proposed activity. 1.Will the proposed activity result in any of the following: YES/NO a. Large physical change to a site within the coastal area which will require the preparation of an environmental impact statement? (11,22,25,32,37,38,41,43) b. Physical alteration of more than two acres of land along the shoreline, land ❑ under water or coastal waters? (2, 11,12,20,28,35,44) c. Revitalization/redevelopment of a deteriorated or underutilized waterfront site? (1) ❑ Q d. Reduction of existing or potential public access to or along coastal waters? (19,20) 0 e. Adverse effect upon the commercial or recreational use of coastal fish resources? (9,10) f. Siting of a facility essential to the exploration,development and production of energy resources in coastal waters or on the Outer Continental Shelf? (29) ❑ g. Siting of a facility essential to the generation or transmission of energy? (27) ❑ 151 h. Mining,excavation,or dredging activities,or the placement of dredged or fill material in coastal waters? (15,35) ® ❑ i. Discharge of toxics,hazardous substances or other pollutants into coastal waters? (8,15,35) ❑ ® _ j. Draining of stormwater runoff or sewer overflows into coastal waters? (33) ❑ k. Transport,storage,treatment,or disposal of solid wastes or hazardous materials? (36,39) ❑ 1. Adverse effect upon land or water uses within the State's small harbors? (4) ❑ �[ 2.Will the proposed activity affect or be located in,on,or adjacent to any of the following: YES/NO a. State designated freshwater or tidal wetland? (44) Ea 0- b. b. Federally designated flood and/or state designated erosion hazard area? (11, 12, 17) Q Q c. State designated significant fish and/or wildlife habitat? (7) [ a d. State designated significant scenic resource or area? (24) ❑ Q. e. State designated important agricultural lands? (26) a f. Beach,dune or barrier island? (12) g. Major ports of Albany,Buffalo,Ogdensburg,Oswego or New York? (3) h. State,county,or local park? (19,20) Q i. Historic resource listed on the National or State Register of Historic Places? (23) a 3.Will the proposed activity require any of the following: YES/NO a. Waterfront site? (2,21,22) ❑ a b. Provision of new public services or infrastructure in undeveloped or sparsely populated sections ofthe coastal area? (5) ❑ m c. Construction or reconstruction of a flood or erosion control structure? (13,14, 16) ❑ 9 d. State water quality permit or certification? (30,38,40) ❑ ER e. State air quality permit or certification? (41,43) ❑ 19 4.Will the proposed activity occur within and/or affect an area covered by a State-approved local waterfron❑_ revitalization program,or State-approved regional coastal management program? (see policies in program document*) D.ADDITIONAL STEPS 1. If all of the questions in Section C are answered"NO",then the applicant or agency shall complete Section E and submit the documentation required by Section F. 2. If any of the questions in Section C are answered "YES",then the applicant or agent is advised to consult the CMP, or where appropriate, the local waterfront revitalization program document*. The proposed activity must be analyzed in more detail with respect to the applicable state or local coastal policies. On a separate page(s),the applicant or agent shall: (a)identify,by their policy numbers,which coastal policies are affected by the activity,(b)briefly assess the effects of the activity upon the policy; and,(c)state how the activity is consistent with each policy. Following the completion of this written assessment,the applicant or agency shall complete Section E and submit the documentation required by Section F. E.CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program, as appropriate. If this certification cannot be made,the proposed activity shall not be undertaken. If this certification can be made,complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program, or with the applicable approved local waterfront revitalization program,and will be conducted in a manner consistent with such program." Applicant/Agent's Name: —J—eFkc!j P&'-a n)0 1 4 jent Address: I D b M ew,fit Cto e'er- A 0 r I e- e 51 t J y I q3`/ Telephone: Area Code(1 ) ) �- Applicant/Agent's Signature: Date: ►1' i N'1 F.SUBMISSION REQUIREMENTS I. The applicant or agent shall submit the following documents to the New York State Department of State, Office of Coastal, Local Government and Community Sustainability, Attn: Consistency Review Unit, One Commerce Plaza-Suite 1010,99 Washington Avenue,Albany,New York 12231. a. Copy of original signed form. b. Copy of the completed federal agency application. C. Other available information which would support the certification of consistency. 2. The applicant or agent shall also submit a copy of this completed form along with his/her application to the federal agency. 3. If there are any questions regarding the submission of this form,contactthe Department of State at (518)474-6000. *These state and local documents are available for inspection at the offices of many federal agencies, Department of environmental Conservation and Department of State regional offices,and the appropriate regional and county planning agencies. Local program documents are also available for inspection at the offices of the appropriate local government.Revised 10/04/1010 ENVIRONMENTAL QUESTIONNAIRE This is intended to supplement ENG Form 4345, Application for Department of the Army Permit, or the Joint Application for Permit used in the State of New York. Please provide complete answers to all questions below which are relevant to your project. Any answers may be continued on separate sheet(s)of paper to be attached to this form. PRIVACY ACT STATEMENT The purpose of this form is to provide the Corps of Engineers with basic information regarding your project. This information will be used to facilitate evaluation of your permit application and for public dissemination as required by regulation. Failure to provide complete information may result in your application being declared incomplete for processing, thereby delaying processing of your application. GENERAL—APPLICABLE TO ALL PROJECTS 1. Explain the need for, and purpose of, the proposed work. 6x( sT,,,y b eL1G h-e"- - is c�Teflb�uTCc2 �xstr.,�9 hl�(-� hHs CoN f"1.+.�c..(_ 4V-'PS1oV1 AnaQ n1�� 5 STk �tlafi �n, Pn[�StI�••J hon- (o�, S//1 er-f fu-- n ecdL d r c O' /n y +,> l u,.> ,2 -.'w t L 'ov,-+ 4,ce c SS 2. Provide the names and addresses of property owners adjacent to your work site (if not shown on the application form or project drawings. S 6L-' n o/1 Sv(Lvec1 ftVOt&Oed (Please note that depending upon the nature and extent of your project,you may be requested to provide the names and addresses of additional property owners proximate to your project site to ensure proper coordination.) 3. Photographs of the project site should be submitted. For projects in tidal areas, photographs of the waterway vicinity should betaken at low tide. Using a separate copy of your plan view, indicate the location and direction of each photograph as well as the date and time at which the photograph was taken. Provide a sufficient number of photographs so as to provide a clear understanding of conditions on and proximate to your project site. 4. Provide a copy of any environmental impact statement, or any other environmental report which was prepared for your project. 5. Provide a thorough discussion of alternatives to your proposal. This discussion should include, but not necessarily be limited to, the "no action" alternative and alternative(s)resulting in less disturbance to waters of the United States. For filling projects in waters of the United States, including wetlands, your alternatives discussion should demonstrate that there are no practicable alternatives to your proposed filling and that your project meets with current mitigation policy (i.e. avoidance, minimization and compensation). T6c ``nJo- �..tldt, W.O"A& - alt"-, ��� 4�GQifrD. l e,r`vS�o9, of banlL , ,vo �ccrsS -�2 Su�C �oa-t-s u � R a �QI�A DREDGING PROJECTS Answer the following if your project involves dredging. 1. Indicate the estimated volume of material to be dredged and the depth (below mean low water) to which dredging would occur. Would there be overdepth dredging? wo0l& he -to -51 h_,tmw n�A . L. w The 2. You can apply for a ten-year permit for maintenance dredging. If you wish to apply for a ten-year permit,please provide the number of additional dredging events during the ten-year life of the permit and the amount of material to be removed during future events. -T�.ere L,.,00 �� +hf2� lidZrk4-c��a,l cQre��� tt��.nts l (- A- i CP e- 1'.e(Z/Mr4" I S iSSvGGQ 3. Indicate of your drawings the dewatering area(if applicable)and disposal site for the dredged material (except landfill sites). Submit a sufficient number of photographs of the dewatering and disposal sites as applicable so as to provide a clear indication of existing conditions. For ten-year maintenance dredging permits, indicate the dewatering/disposal sites for future dredging events, if known. 4. Describe the method of dredging(i.e. clamshell, dragline, etc.) and the expected duration of dredging. CJli Slcl( h- n c rw� 5.Indicate the physical nature of the material to be dredged(i.e. sand,silt, clay, etc.) and provide estimated percentages of the various constituents N available. For beach nourishment projects, grain size analysis data is required. Dr,e4 ye 15 5, LtLt - S4 N A n!fl ✓SCGQ be k ' Q grq'7-sex S C'Ickec..b 04- "e(,,Ad 4-✓P(,,Ad 6. Describe the method of dredged material containment (i.e. hay bales, embankment; bulkhead, etc.)and whether return flow from the dewatering/disposal site would reenter any waterway. Also indicate if there would be any barge overflow. Dred4lc Spot- w111 �c 4,Tain �cbe_�L ICQ PC® d1 P,,Se l MOORING FACILITIES Answer the following if your project includes the construction or rehabilitation of recreational mooring facilities. 1.It is generally recommended that any fixed piers and walk ramps be limited to four feet in width,and that floats be limited to eight feet in width and rest at least two feet above the waterway bottom at mean low water. Terminal floats at private, non- commercial facilities should be limited to 20 feet in length. If you do not believe your proposal can meet with these recommendations,please provide the reason(s). 2. Using your plan view, show to scale the location($), position(s) and size(s) (including length,beam and draft)of vessel(s) to be moored at the proposed facility, including those of transient vessel(s)if known. 3.For commercial mooring sites such as marinas,indicate the capacity of the facility and indicate on the plan view the locations) of any proposed fueling and/or sewage pumpout facilities. If pumpout facilities are not planned,please discuss the rationale below and indicate the distance to the nearest available pumpout station. 4. Indicate on your plan view the distance to adjacent marine structures, if any are proximate and show the locations and dimensions of such structures. 5. Discuss the need for wave protection at the proposed facility. Please be advised that if a permit is issued,you would be required to recognize that the mooring facility may be subject to wave action from wakes of passing vessels, whose operations would not be required to be modified Issuance of a permit would not relieve you of ensuring the integrity of the authorized structure(s)and the United States would not be held responsible for damages to the structure(s) and vessels) moored thereto from wakes from passing vessels. BULKHEADING/BANK STABILIZATION/FILLING ACTIVITIES Answer the following if your project includes construction of bulkheading (also retaining walls and seawalls) with backfill, filling of waters/wetlands, or any other bank stabilization fills such as riprap, revetments, gabions, etc. 1. Indicate the total volume of fill (including backfill behind a structure such as a bulkhead)as well as the volume of fill to be placed into waters of the United States. The amount of fill in waters of the United States can be determined by calculating the amount of fill to be placed below the plane of spring high tide in tidal areas and below ordinary high water in non-tidal areas. ) n -T �e r (,,It( ;G Nv -r" 1 l P�4CC 2. Indicate the source(s) and type(s) of fill material. All . ,11 will Coir �ror1 dry f� c SA� L 3. Indicate the method of fill placement(i.e. by hand, bulldozer, crane, etc.). Would any temporary fills be required in waterways or wetlands to provide access for construction equipment? If so, please indicate the area of such waters and/or wetlands to be filled, and show on the plan and sectional views. December 2, 2015 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 840 OLD HARBOR LANE, NEW SUFFOLK LA' DEC 1 1 2015 SCTM No. 1000-117-05-51.1 APPLICATION FOR PERMIT c�;hGi�Tcvdn Dear Sir/Madam: We hereby submit one (1) original and three (3) copies of the proposed plans, application, 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. Very truly yours, effrey Patanjo 106 Hewitt Blvd Center Moriches, NY 11934 Cc: Mr. Frederick Endemann