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HomeMy WebLinkAboutTR-8746 ®F SO�jP�, Michael J.Domino,President �O� �l® Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders CA Southold, New York 11971 Glenn Goldsmith ® � Telephone(631) 765-1892 A. Nicholas Krupski �`YCOUN11,�c� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES May 17, 2017 TOWN OF SOUTHOLD Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: 355 LAKE DRIVE, LLC 355 LAKE DRIVE, SOUTHOLD SCTM#: 1000-80-3-15 Dear Mr. Patanjo: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, May 17, 2017: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8746 to relocate the dock from the current position slightly over to the east; and as depicted on the site plan prepared by Jeffrey Patanjo, dated April 9, 2017, and stamped approved on May 17, 2017. 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, Michael J. Domino, President Board of Trustees MJ D/dd APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE 11tiq �7r ��7 BOAT BASIN (CONNECTING TO SOUTHOLD BAY) APPROVED DOCK LOCATION LOCATION AFTER PUBLIC HEARINGS AND REVISIONS NEW LOCATION OF DOCK THAT WAS ACTUALLY THE ORIGINAL SUBMITTED LOCATION 57' 57" 5 PROJECTED PROPERTY LINE �Q a ss" 13, 56" PROPOSED 6' WIDE X 20' LONG FLOATING DOCK 5 ' SUPPORTED WiH (2) 10-0 CCA PILES 1p� AND UN—TREATED TIMBER DECKING 6yPROPOSED ALUMINUM HINDGED RAMP�� 9 54 I 12' LONG X 32" WIDE 3 35 35" rc J} 41F, WOMEN BULKHEAD s 79.5s'o3" E 39.59' M.L.W & M.H.W. AT BULKHEADTFE (SURVEY) ' 5 a S 79 " E 40.00 (FILEDI (FILED MAP) N O � � `D 4 rn c0 ^ .— O ^ DISTRICT 1000—SECTION 080.00 m� BLOCK 03.00—TAX LOT 016.000 I N/F ROSARIA FORCHEW 5 DANTON LANE DISTRICT 1000—SECTION 080.00ff LATTINGTOWN, NY 11560 BLOCK 03.00—TAX LOT 014.000 LIBER 11814—PAGE 218 N/F PINKHAM TRUST FILED MAP NO. 1215—LOT 5 7200 3RD AVE, C136 SYKESVILLE, MO 21784 W LIBER 12824—PAGE 713 FILED MAP N0. 1215—LOTS'7 &a Q � I DISTRICT 1000–SECTION 080.00 BLOCK 03.00–TAX LOT 015.000 / N/F 355 LAKE DRIVE LLC I ' LIBER 12559–PAGE 997 FILED MAP NO. 1215–LOT 6 (VACANT LOT) s� �v n 0 ,o c = per` N �APPEO PIPE CIV N 74'00'00" W 80.00' — NiRE FENCE , WRE FENCE LAKE DRIVE (80' WIDE) D ,— �:' 1. L• — U11UTY POLE I—� t I ij 4� 1 —M �' I — � — APR 1 1 `--f 2017 REPRESENTS WATER DEPTH IN INCHES SouthcltlT°wn { 36° BELOW MEAN LOW WATER Bio PROPERTY OWNER: NOTES: 355 LAKE DRIVE LLC 1. ELEVATIONS REFER TO N-.G.V.D. 1929 DATUM 135 WHITEHALL BLVD. PrODOS6C� Ramp & Fl0(L� Permits SCALE: GARDEN CITY, NY 11530 1"=30' 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PREPARED BY: PROPOSED PLAN DATE: 6 HEIDECKER LAND SURVEYING JEFFREY PATANJO 2-18-1s 42 CROWN STREET, KINGSTON, NY 106 HEWITT BOULEVARD 2-18-1 DATE SURVEYED: DECEMBER 24, 2015 9-17 CENTER ITT BOL R 11934 355 LAKE DRIVE 3. ALL DECKING USED SHALL BE UN—TREATED 631-484-9332 SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: JPATANJOOOPTONLINE.NET TAX YAP N0. 1000-80-3-15 1 of 2 . ty ---TN,Parfsh,Dr ' a h. LOCATION _ L 1 fj m NtSayvie lvoz + c. PROJECT LOCATION MAP LAT 41' 02.848' N.T.S. LONG 72° 23.882' PROPOSED 32"' WIDE X 12' LONG ALUMINUM RAMP PROPOSED 10"' CCA PILES (TYPICAL - 2) PROPOSED 6' WIDE X 20' LONG FLOATING DOCK WITH UN-TREATED TIMBER DECKING ------- APPROXIMATE M.H.W. APPROXIMATE M.LW M Z � M NS �/\\�/XX3/j\�/j TYPICAL SECTION — RAMP & FLOAT N.T.S. 13T � f t � `4I E APR 1 1 2017 t I 3 r Southold Torm 4 1 Boar�+'�f Trust E;s PTAX Ramp & Float Permits SCALE: AS NOTED YPICAL SECTION & DATE: LOCATION MAP 1-9-16 355 LAKE DRIVE HOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: MAP NO. 1000-80-3-15 2 of 2 April 9, 2017 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 ' P.O. Box 1179Fill Southold, New York 11971 Ilk APR 1 1 201 �� 7 � RE: 355 LAKE DRIVE -SOUTHOLD SCTM N0. 1000-80-3-15 Southold Town r Hard of Trustees ,_j PROPOSED DOCK RELOCATION Dear Trustees: Attached please find four (4) copies of revised plans for the above referenced project. The floating dock and ramp have been previously approved at a regular Trustee public hearing and were installed in accordance with the approved drawings. If you will recall, a neighbor to the east of the subject property had an issue with the location of the floating dock as originally proposed and we modified our submission to suit the needs of both parties. Upon installation of the dock it was noticed by the neighbor to the west that it interfered with their boating activities and we were asked to relocate the dock slightly to the east. After coordination with both the neighbor to the east and to the west a determination was made to allow the dock position to match the original proposed location. By way of this letter would like to request the approval to relocate the dock slightly to the east as shown on the attached drawings. We have included a copy of letter prepared by council for the property owner to the east allowing the relocation. Please advise us if any additional submissions are required for this work. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, pi� Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 Michael J. Domino, Pre �p511FfOj��4 Town Hall Annex John M. Bredemeyer III,Vice-Presi_e6t 4��® $h G� 54375 Route 25 Charles J. Sanders CAP.O. Box 1179 Glenn Goldsmith Q Southold,NY 11971 A.Nicholas Krupski 4 p! , Telephone(63 1)765-1892 ~ Qla J Fax(631)765-6641 BOARD OF TOWN TRUSTEES ,nom TOWN OF SOUTHOLD Date/Time: ` r`�t �� Completed in field by: all CISI,e-1 tt (c� Jeffrey Patanjo on behalf of 355 LAKE DRIVE, LLC requests an Administrative Amendment to Wetland Permit#8746 to relocate the dock from the current position slightly over to the east. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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: 1 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: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 l Michael J. Domino, Preo�Q 'Y Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Charles J. Sanders N 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 355 LAKE DRIVE, LLC requests an Administrative Amendment to Wetland Permit #8746 to relocate the dock from the current position slightly over to the east. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 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 FORCHELLI, CURTO, DEEGAN, SCHWARTZ, MINEO & TERRANA, LLP COUNSELORS AT LAW THE OMNI 333 EARLE OVINGTON BLVD,SUITE 1010 UNIONDALE,NEW YORK 11553 TELEPHONE (516)248-1700 FACSIMILE.(516)248-1729 WEBSITE:WWW FORCHELLILAW COM JEFFREY D.FORCHELLI MANAGING PARTNER DIRECT DIAL-(5 16)812-6200 DIRECT FACSIMILE (866)522-1239 JFORCHELLI@FORCHELLILAW COM March 16, 2017 Board of Trustees Town of Southold 54375 Route 25 �+ r , ' s ; P.O. Box 1179 l��1 f ---E, Southold, New York 11971 S Att: Michael Domino, President E APR �� Re: 355 Lake Drive LLC by Jeffrey Patanjo So�Jthold ftrrm 355 Lake Drive, Southold Dear Mr. Domino: In connection with the above matter, on behalf of my wife Rosaria Forchelli, I hereby consent to the plan attached hereto dated January 9, 2016, which shows the dock being relocated 10 feet west of and parallel to the northerly extension of the property line which separates the 355 Lake Drive LLC property and the Rosaria Forchelli property. This consent is subject to the following: (a) Rosaria Forchelli does not grant any of her riparian rights to 355 Lake Drive, LLC and 355 Lake Drive, LLC agrees not to claim any. (b) No boat or vessel will be stored on the eastern side of the 355 Lake Drive, LLC dock which encroaches eastward of the extension of the property line that separates the 355 Lake Drive, LLC property and the Rosaria Forchelli property. Yours truly, ROSARIA FOR HEL I By. v E D; FOR HELLI, Attorney in Fact JDF/ka Enclosure cc: Peter Cosola Jeffrey Oak, Ph.D. FORCHELLI, CURTO, DEEGAN, SCHWARTZ, MIMEO & TERRANA, LLP COUNSELORS AT LAW THE OMNI 333 EARLE OVINGTON BLVD,SUITE 1010 UNIONDALE,NEW YORK 11553 TELEPHONE (516)248-1700 FACSIMILE.(516)248-1729 WEBSITE•WWW FORCHELLILAW COM JEFFREY D.FORCHELLI MANAGING PARTNER DIRECT DIAL (516)812-6200 DIRECT FACSIMILE (866)522-1239 JFORCHELLI@FORCHELLILAW COM March 16, 2017 Jeffrey Oak, PhD Senior Vice President, Corporate Responsibility and Development Bon Secours Health System, Inc. 1505 Marriottsville Road Marriottsville, MD 21104 Mr. Peter Cosola 135 Whitehall Boulevard Garden City, New York 11530 Re: Southold Dock Plan Dear Jeff and Peter: Enclosed please find the original letter and plan as per my conversation with Jeff Oak yesterday. Yours truly, IJES D. F RCHELLI JDF/ka Enclosures 1 BOAT ]BASIN (CONNECTING TO SC OW BAY) W . 7 f0 PR0JECTED,PROPERTY UNE ' pftDPOSED,6' YrL •X 20' LONG FLOATING DOCK SUPPORTEQ',YlTT1;2)!1Q'C CCA PILES ;'•, ,. . . �'' (+� AND UN-TREAIEQ'TIMBER DECKING ' Gal 1 3 PROPOSED,ALUMINUM HINDCED RAMP 1 { ' 12' LONG K 32' WIDE ,' till �--- ►z M.LsY1 & M.H.W. AT BULKHEAD f E , (SURVEY) -m a d y 79 " E 40.00 (FILED i (FILED MAP) •�� dslPoCf loo- ot 08000 � OLO[li W0p-rAm Au LAf 016000 p s!/1109A0w roaCIEW � LIES II911.PA05 710 !1190"Ap 110 1vs-L0f s 1 ' I asImcr 1000-wV1011 000.00 _ OL004 0100-rAN LOT OI,AOq LIUIP C,14-PACE te.eA u,n PIC,1215-LOM &9 ,1 el r ' DISTRICT 1000—SECTION 000.00 rte. BLOCK 03,00—TAX LOT' 015,000 " j N/F 355 LAKE ORIVE LLC ,j LIBER 12559—PACE 997 j j FILED MAP 140. 1215—LOT 0 �s (VACANT LOT) I HEREBY CONSENT TO THE ' e� LOCATION OF THE DOCK AS a" SHOWN HEREIN. ROSARIA FO CH L I ��AvaO wa .Y � rt At- Y D.1 FORCHELLI I — - -- - A �t Whey in Fact REPRE5EINTS VIAIEP, DEPTH IN INCHES BELOW•h E&I'LOW 'NATER pp��ii((II�P PITY OWNER: NEU 1'S�LAt DPNE Lt. ROat 1, ELEVATIONS REFEP. TO N.G.U. 1929 DATUM 135 WHITEHALL BUID.30 �'17L�8 1 ��' - •' ��' '�1f""'""-"'1 ~�'I-a�0 2, PORTIOPIS OF Pi-N4 FROM SURVEY PREPARED OY• GARDEN CITY, My I i5 HCIDECI<ER LAPIU SURVEYINGPREPA EO Yf' PRap?�D PLAN' ;I-d9-1h 12 CROVfhI STREET, KiNGSTOPI, NY 1EFFT EY P h1,10 106 I•IEIMTT 60ULEVARD DATE SURVEYED: DECEMBER 24, 2815 CENTER MORICHES. NY 11931kOilrHOLD,CJscGdO fi31—'1.51-9332 TOWN OFFISO UTNOLD 3, ALL DECKING USED SHALL BE UN-TREATED S(JFFOLh COUNTY, MY Iharic>:['I , JPAI'ANJ,000PTONUNEj4EI •Ij1AC,t• 110= . ��j�►43,o�a® j°j 1 OF 2 iRI�unfin:4:� 'aFffi ... w .>✓7>;.sr��cu-t. % ruUr:lnt�u:�lrMsrr.�TC�.. r FORCHELLI, CURTO, DEEGAN, SCHWARTZ, MINEO & TERRANA, LLP COUNSELORS AT LAW THE OMNI 333 EARLE OVINGTON BLVD.,SUITE 1010 } UNIONDALE,NEW YORK 11553 TELEPHONE:(516)248-1700 FACSIMILE:(516)248-1729 WEBSITE:W WW.[:ORCHELLILAW.COM r { JEFFREY D.FORCHELLI MANAGING PARTNER DIRECT DIAL:(516)812-6200 DIRECT FACSIMILE:(866)522-1239 J FORC H ELLICFORCI IELLI LAW.COM r February 23, 2016 Board of Town Trustees j Town of Southold D tur 54375 Route 25 !� P.O. Box 1179 FEB 2LTovvi7 6 ! Southold,New York 11971 Att: John M. Bredemeyer III,President r Southold � Board f TwtleeaI Re: 355 Lake Drive LLC by Jeffrey Patanjo 355 Lake Drive, Southold Dear Mr. Bredemeyer: In connection with the above matter, I enclose herewith a copy of the revised Dock Plan upon which I have executed my wife's consent by me as attorney-in-fact for her as owner. I trust j this will help in your deliberations. Let me take this opportunity to thank you for all the courtesies extended. ! i Yours truly, I *FD. O CHELLI i JDF/ka Enclosure t cc: Jeffrey J. Patanjo (via email—ipatanjo@optonline.net f BOAT BASIN (CONNECTING TO SOUTHOLD BAY) 57 57 fo*` ss PROJECTED PROPERTY LINE PROPOSED 6' WIDE X 20' LONG FLOATING DOCK ss 13. s5' SUPs7 PORTED WTH UN ( UN—TREATED PILES10-0 CCA BER D CKING AND ® ! PROPOSED.ALUMINUM HINDGED RAMP 12' LONG X 32"WIDE 30 3 35 •0 � 1 , woaoDl BtRra+UD S 79'56'03' E 39.59 M.L W & M.H.W. AT BULKHEAD F E (SURVEY) 4 -1 S 79'36'00" E 40.00' ' (FILED MAP) j Q r goy �p sq)' �CO DISTRICT'fOOO-SECnON OSMOO BLOCK 03.00-TAX LOT 018.000 NIF B LJBER ROSARIA FORCHELLI 11814-PACE 218 FILED MAP NO.1215-LOT S DISRtICT 1000-SECTION 080.00 s BLOCK O&OD-TAX LOT 014.000 8 -- - ---- - - ---- -- NP CAROL PINKHAM-CAK--------� - - - - - $ - - - - -- -- --- - - - - - -"- - - -- - _- LIBER 12824-PAGE 713 FILED MAP NO.1215-LOTS 7 h 8 _53• N DISTRICT 1000—SECTION 080.00 BLOCK 03.00—TAX LOT 015.000 N/F 355 LAKE DRIVE LLC LIBER 12559—'PAGE 997 ' ! E 4+ %jIr �, / FILED MAP NO. 1215—LOT 6 (VACANT LOT) ' 34 ® FEB 2 9 2016 o3 N Southold Town o J adofTr t 1 f �� ecu PFs PM' c� N 74'00'00" W rn 80.00' �FrxcF wxe mm LAKE vDRM Z LLl l n _ Lmm P= REPRESENTS WATER DEPTH IN INCHES 36 BELOW MEAN LOW WATER ' PROPERTY OWNER: NOTES: 355 LAKE DRIVE LLC 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 135 WHITEHALL BLVD. Proposed Ra7ri�D & Flodtomits SCALE: GARDEN CITY, NY 11530 1°=30' 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PREPARED BY: PROPOSED PLAN DATE:1-9-16 HEIDECKER LAND SURVEYING JEFFREY PATANJO 42 CROWN STREET, KINGSTON, NY 106 HEWITT BOULEVARD DATE SURVEYED: DECEMBER 24, 2015 CENTER MORICHES, NY 11934 355 LAKE' DRIVE 3. ALL DECKING USED SHALL BE ,UN-TREATED 631-484-9332 SDUY'HOLD, K CO OF SOUTHOLD SUFFOLK COUNTY, .NY SHEET: JPATANJO®OPTONLINE.NET TAX MAP N0. 1000-80-8-15 1 of 2 r John M. Bredemeyer III, President Loma ooG s Town Hall Annex Michael J. Domino, Vice-President4=� 54375 Route 25 Glenn Goldsmith y :.;a ,?" P.O. Box 1179 A. Nicholas Krupski "may' ® ��, Southold, NY, 11971 Charles J. Sanders �: J01 �aoY Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1St day of construction % constructed Y Project complete, compliance inspection :r" � V i't :Y{. .✓" 670 .'a ��,, ,1re��..-.. '.., t d�..S M ? .'t••%- {e••` {e .v' S'�''• �t l�k,: - ! •" 'i{�!1 � � .,1:• f mt••�• at `j'•t4 IIe• `.,§ Mi`9 Ali ! ii' 'di 'r tf = tai �+ t 'bl.• ::., :'. .�' •�=o= Ifji .� _ ;•• � �-iti� .r^..=:=i►lt �tr'�-�}'" �:=r,,,. ,,•'•� ,_ T4s'` •--"'. ul. �f f` %ice`A�t d��,`.l' .� dam"::, .(':`wl. .;, •��: 'G;7:,.�1d ``. 'i ,!'t•,3; i- ?{ '�; �,:s,',•__.P.k�''1L�3�7L',^"av4;��'sn1 ,T":�tK3:�+�6Y-�Ys•'tF,�.`�P¢P�.Ct`7aA�'al!�3,�'".mSCSi! ,.',C'��t.:�:1t;^wry.4' _.__ "x°+,,.%'r,,tc"rKcn�'^-c�^ � ,'s4�z�:•:i,.n?,.n.+,raw»+;,y:1.?Z:tk :n"Z;.�K;:�"7?tY!t,�::,,3^i3:�,�1i�:. ^,� fry -: BOARD OF'SOUTHOLD TOWN TRUSTEES a. SOUTHOLD,NEW YORK f' PERMIT:NO.-8746 DATE: MARCH 23, 2016 t "- ISSUED:TO:,,355;LAKE DRIVEL_ LC' li=t $ t.'�# `yr 93J+":1,'t.i �3'•: ' +.in i'i;:;': t ..,,^-d,.,pi.; .n ' .. � 1• , ��� PROPERTY ADDRESS: 355 LADE DRIVE, SOUTHOLD' 1I }'F SCTIVI#`3000=80=3='15'. .r ,i::ca:+ 1 P". „brs P Cr ,li✓ F4: $ , "-t.f-i, „`, •r '.`zti;,`+. n:;JiYi?` ,.';:`=,s's„+',s:;•t,�. ; .. . 'r`� ,,. _ ,� iz:•,. � }-`�, �AUTH t.� R_ IZATI,ON: ..• Pursuant to the provisions-of Chapter 275'of the-Town'Code_ofthe:Town of•Southold,and in.,,- 3:,." f� ul accordance with'tlie�Resolution'o tHe'Boa ds6t''Tnisteesiadoptedfat'rthe-meeting;held on March 23,2016, and in � �s ? , ? L' consideration of application'fee 4n the sum of 250;00 aid b 355 Lake.Drive•LLC and,subject fo;tlie;Terms 3 ` and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the g following: :_ #"`5,t,�1�' s,7tFv' e'.+ 5t"r;his` nr`<» ,a'ti�c•,, i , +, '� 4 .as. ;a••..^.f:}:,`c`i, 'i 'ate ;;k@,4..�'. to , ,�;'';'? �: :`" y .v{'ti TERMS AND CONDITIONS rive, Sout_hold New_York as of he The Permittee 355 Lake Drive LL e Pe1-�11tdoes ke �understand and prescribe t the fo locating: consideration for the issuance of th 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 pennit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties,and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Pen-nit 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 pen-nit. sols John M.Bredemeyer III,President ®� �®l Town Hall Annex Michael J.Domino,Vice-President ~ O 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G ® p� Telephone(631) 765-1892 Charles J.Sanders ®�/��,oUNT`1Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 23, 2016 - Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: 355 LAKE DRIVE LLC 355 LAKE DRIVE, SOUTHOLD SCTM# 1000-80-3-15 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 23, 2016 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of 355 LAKE DRIVE LLC applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated January 21, 2016, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 17, 2016 and on March 23, 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 355 LAKE DRIVE LLC to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles; and as depicted on the revised site plan prepared by Jeffrey Patanjo, last dated February 18, 2016, and stamped approved on March 23, 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 SOf FD1` John M. Bredemeyer III, President ;:�`O�� KooG Town Hall Annex Michael J. Domino, Vice-President ;"_� r to 54375 Route 25 Glenn Goldsmith uo P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sanders ti'`�h�l , ��°„-{ Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD � , TO: X55 LAKE P"Fl ZLC 4a Please be advised that your application dated Q_A21 201& has been reviewed by this Board at the regular meeting of M4P_ 0� 20/ and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50'.00) 1St Day of Construction ($50.00) / Y Constructed ($50.00) V Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded withr the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES- TOTAL FEES DUE: $ 54 BY: John M. Bredemeyer III, President Board of Trustees John M Bredemeyer III, President o�pSISk o Town Hall Annex Michael J. Domino, Vice-President ,� y 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A. Nicholas Krupski o Pry' Southold, NY 11971 Charles J. Sanders 4fj0 fpr Telephone (631) 765-1892 {' Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 3®�C a� fS P3 Completed in field by: 1ar,,n �'j)jSM%A Jeffrey Patanjo on behalf of 355 LAKE DRIVE LLC requests a Wetland Permit to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 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 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Surveys 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: Tn ©OSS ���/l&v✓ . fl<. $vT� ao f�i�S �or�� o an gCGDTd . Present were: 'V/J. Bredemeyer &// M. Domino —/* G. Goldsmith ✓N. Krupski C. Sanders Other Page 1 of 2 John M. Bredemeyer III, President o�OgOfFO(kcoG t Town Hall Annex Michael J Domino, Vice-President �� yam, 54375 Route 25 Glenn Goldsmith o '`� P O Box 1179 A. Nicholas Krupski o t Southold, NY 11971 Charles J. Sanders '1,jj® p�� Telephone (631) 765-1892 Fax 631 765-6641 BOARD OF TOWN TRUSTEES TOWN OF'SOUTHOLD Date/Time: � \ �"� Completed in Work Session by: � �4 Jeffrey Patanjo on behalf of 355 LAKE DRIVE LLC requests a Wetland Permit to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 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/Calc fation -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: Vf, t r�� Date: Completed By: / Present: ,"J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders / E. Cantrell D. Di Salvo Other Page 2 of 2 John M. Bredemeyer III, Presidents Town Hall Annex Michael J. Domino, Vice-Presidenty-454375'Route 25 Glenn Goldsmith P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sanders �Os ��� � 'Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: _X— b Completed in field by: Jeffrey Patanjo on behalf of 355 LAKE DRIVE LLC requests a Wetland Permit to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles.' Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual/2: 1. Residence: 100 feet 0 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: V®Z,14 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming"pool and related structures: 100 feet + Setback waiver required �'�' /vv! ".0 :,/ Part of Town Code proposed work falls under: S`EQRA Type Ch. 275 Ch. 111 Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation 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: Present were: -J Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 [55 Lake Drive C55 Lake Drive 1000-80-3-15 0/10/16 .R I- T � � � _ ..` — .. ....+ .d �tl► �' "�!. i� ., art 1� i,--t�► y • . �, i� � /� ��a. W 1 1 _ - .. . . _I�`. .__ __ — .�. –_: .1 p �.iQ, �'s-71r.� �• �vl�' `9T� � t � }'_'. :\ `aF 3- t �Oii i � . .. •ntt;i •arl.nn � c{J ll1 6ip`�`St p�1'1 � �''� �t a 1 � � ! ,.I, �t�� i r n .e ... - _ ... ��:i � ,��. ' a�lyp�py11 SCK^}�1t 1� ♦.II{,1, i f .i..,� bl.ri.� J.�t ,. t I,, Y ' ( il ` �y� �i,.�.�1 {' rt .. — *+s ,..: �xw.: - � " "�fr1,. {' „t r� ' '! Cf;'i 1 • {tin r"•1 � Ilt t I i i'i I� ' .�, �� � 1 .. ,..• -C.,i �, �� i l:�'. �. i {•q , '���7 l�� t • !1• 't �. I. iS.���� ��l'tl� + II ` 11' I t � 1 1 I, r � ����'Wx`I•��� �, ,�., � I t kq € ..0, I I', I li r ,_�.,r w. �1 l���+�,�pti i, �.1"•�, �ti' 1 .��i.i�� �p j!� � •� ,1�1 1 1 ��• ,I i {F��;h �� I'i� � � � �� �'1� ��� �., {1�� �� y_ i�� �, � � )1 t,{.1 1t�� {'��I •�, 4'� {.ii.��t �Q 1 ,I �' ( I I . P1 t'1N o� r• ~�' ""Y � '{`�_�, T �i`I!u Lyl��,� �1'1i ,� .fit: t �U ' �p,� �� ,i��`M4� mi K 1 ���wF, i � �' I�' � (,11i' �► �i ` S ��. �!!-.� s`1��It � rN � '�p I k, 1�11.: � :��1 �'�• riz 1 �•le � �,1 � � t , ^"a��I out- MIX I I 1 t 2/ 10/2016 11 : 46 SUffatk` John M. Bredemeyer III, President ,� Town Hall Annex Michael J. Domino, Vice President 54375 Route 25 Glenn Goldsmith y ? P.O. Box 1179 A. Nicholas Krupski �� ® �� Southold, NY 11971 Charles J. Sanders dot ��� 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 355 LAKE DRIVE LLC requests a Wetland Permit to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 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: d. Bredemeyer M. Domino G. Goldsmith N. Krupski ZC. Sandersntrell D. Di Salvo Other Page 2 of 2 I 3 f y I i - f- Photo 2 JAN 2 1 2016 Board of Tmctecs January 17, 2016 NYS Dept. of Environmental Conservation SUNY @ Stony Brook _ 50 Circle Roadtz Stony Brook, New York 11790-2356 Attention: Duty Analyst JAN 2 1 2016 RE: 356 LAME DRIVE -SOU f HOLD. �b---- SCTM No. 1000-80-3-16 rusteei s APPLICATION FOR PERMIT BaoT Dear Sir/Madame: We hereby submit four (4) copies of the proposed plans, applications, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332 or e-mail at jpatanjo@optonline.net. Very truly yours, Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 cc: Town-of Southold Army Corps of Engineers NYSDOS Cllr. Peter Cosola 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 [ek epart- General Services of State Check all permits that apply: Check all permits that apply: Check all permits that his ❑Stream Disturbance ❑Coastal Erosion ❑Section 404 Clean Water Act apply: s: ❑ Excavation and Fill in Management ❑Section 10 Rivers and Harbors ❑State Owned Lands, alNavigable Waters ❑Wild,Scenic and Act Under Water stency❑ Docks,Moorings or Recreational Rivers YNationwide Permit(s)-Identify ❑Utility rrence Platforms ❑Water Withdrawal Number(s): Easement ❑Dams and Impoundment ❑ Long Island Well (pipelines, Structures ❑Aquatic Vegetation Control ,3 conduits, cables,etc.) ❑401 Water Quality 11 Aquatic Insect Control Certification Preconstruction Notification- ❑Docks, ❑Freshwater Wetlands ❑Fish Control §irY / ❑ N Moorings or ❑Incidental Take of Endan- Platforms ❑Tidal Wetlands gered/Threatened Species / ❑ I am sending this IrI am sending L2S I am sending this application application to this this application I am sending this application to this agency. PP to this agency. agency. to this a enc . 5. Name of Applicant(use full name) Applicant must be: 6. Name of Facility or ProperOwner if different than A licant Owner (� E 6 3 55' L a tC L p2►V C- L L G Eloperator �` Mailing Address ❑Lessee Mailing Address t (check all that apply) I [�I JAN 2 1 2016 13S whL+ehe- 6 1v Post Office City Taxpayer ID(If applicantPost Of&e City k is NOT an Individual): Southold Toon CgQPl.�G✓i Zip Codea r State N Zip Cade I � 5—a p state Telephone(daytime) Email Tvn.-rG Telephone(daytime) Email 411.1 -q�l a PC-ter C m5o14.►V%c e- 7. Contact/Agent Name B. Project/Facility Name Proper=beidges n/Block/Lot Number 3..Company Name Project Location-/Provide directions and distances to roads, and bodies of waters: — , 3� La.1LG 0(Llvc-. CV 4G �T) 3,e " Po--rot a lll��� Mailing Address street Address,if applicable Post Office City State Zip Code NY X06 l-�CwL-i'T /�lu� 3S5 Labe 02we j0'-kkot Post Office City Town/Village/City County Cee%+er &4ortcAeS 500 0%of ,5„ „ �� State Zip Code Name of USGS Quadrangle Map Stream/Water Bod Name Telephone(daytime) Location Coordinates:Enter NYTMs in kilometers,OR Latitude/Longitude 631• q g� -�33 Email n NYTM-E NYTM-N Latitude Longitude J1�'�a/1 al 60011�J•11e yl° oa• �Fi`�rb ' 7�° a3 1i INN Ig Hill 70INT APPLICATION FORM 02/13 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed 4PPLICATION FORM-PAGE 2 OF Z Subi_,____;completed page as part of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose.Attach additional page(s)if necessary.Include: description of current site conditions and how the site will be modified by the,proposed project;structures and fill materials to be installed; type and quantity of materials to be used (i.e., square ft-of coverage and cubic yds of fill material and/or structures below ordinary/mean high water)area of excavation or dredging,volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource Impacts;and where applicable,the phasing of activities. ATTACH PLANS ON SEPARATE PAGES. Co.•+Sic r v c-( (9� X a-c9` �l o.. tt n 5 &V CAC- w 3 a" tar �9 l min�s+ •�+" rkiv+r at^,Q 'two 1p LCA Q1Ie Lei !i JAN 2 1 2016 s���t��l�Taxan Board f Trus e Proposed Use: OPrivate ❑ Public ❑Commercial Proposed Estimated 3"� - 6 Start Date: Completion Date: Has Work Begun on Project? ❑Yes ®-No If Yes,explain. L Will Project Occupy Federal,State or Municipal Land? ❑Yes ®'No If Yes,please specify. A ii 10. List Previous Permit/Application Numbers(if any)and Dates: 1-' kA 11. Will this project require additional Federal,State,or Local Permits including zoning changes? RYes ❑No If yes,please list: So- -E!-old At" C00-Pt t4KS60S 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,16 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, ceaIs,or covers up a material fact;or k /nowingly/makes or uses a false,fictitious or fraudulent statement. �)eA- CcSOL� "J-kVPILI- 112-1,1_ SignatuW ant Printed Name Title Date 4'.A s R� C o S n Lam..., 1 ' Signature of Owner Printed Name Title Date _1t{ r LAI 9Ign&Tre of A Ent Printed Name TitleF Date t 30INT APPLICATION FORM 02/13 Application Form Page 2 of 2 New York State Department of Environmental Conservation Imhof PERMISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s)to the Department of Environmental Conservation("DEC"),the signer consents to inspection by DEC staff of the project site or facility for which a permit is sought and,to the extent necessary, areas adjacent to the project site or facility. This consent allows DEC staff to enter upon and pass through such property in order to inspect the project site or facility,without prior notice,between the hours of 7:00 a.m.and 7:00 p.m.,Monday through Friday. If DEC staff should wish to conduct an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate consent for such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s)sought. By signing this consent form,the signer agrees that this consent remains in effect as long as the application is pending, and is effective regardless of whether the signer,applicant or an agent is present at the time of the inspe }�r. b th1e,ei th t the p% ec 9s' or facility is posted with any form of"posted"or"keep out" flee",b&hbe&ift-wltiran-i!loCke ; gate,this permission authorizes DEC staff to disregard such tices or unlocked gates at the;ti of inspection. JAN 2 .1 2016 E The signer further agrees that during an inspection,D C stky,�l�oether-t13in s, take measurements, may analyze physical characteristics of a site includb [,1 limited to soils and vegetation(taking samples for analysis),and may ma a rawings and take photographs. Failure to grant consent for an inspection is grounds for,and may result in, denial of the permits)sought by the application. Permission is granted for inspection of property located at the following address(es): 3$5- GaIt'e pt2 C#I,, By signing this form, I affirm under penalty of perjury that I am authorized to give consent to entry by DEC staff as described above. I understand that false statements made herein are punishable as a Class A misdemeanor pursuantV Section 210.45 of the Penal Law.* r l.cSo" ler— 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 1 S`hoa't 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 f jtr Name of Action or Project: y JAN 2 2016 355 Lave- DRtve- Project Location(describe,and attach a location map): Sa",hod Taxn SBa fTrus ee Brief Description of Proposed Action: PFbP-s--k- b ' wL d•c x 6 ,+IIn�� Q—c��P Gc�"� — tD " ecleS Name of Applicant or Sponsor. Telephone: 9 f-7_q-7 a• - IS -`d °) 355— t e-V e 021 use. L L L- E-Mail: P.,+If 0.5.19..1,jC GVer«on-&)e-4r- Address: 135- City/PO: 35City/PO: State: Zip Code: C a re^ C t+ N K t 15-b 0 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 D 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- 5,9.46%v1& pproval•5,9✓ 6%v1R. z(v5'CC-S I —,-t$ DEG I q inn Gdtl�S 1 1�%-f.S (�pS 3.a.Total acreage of the site of the proposed action? a, .4.1,1 acres b. Total acreage to be physically disturbed? �_acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? D• b 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 ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NOYES N/A a A permitted use under the zoning regulations? El © ❑ b. Consistent with the adopted comprehensive plan? ❑ 12 ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, El ❑ gency: u o county,Date:(-12-99- 8, a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? © ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? _ ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ® ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment- 12. reatment12, 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? ❑ 71 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: (34SonCo.J�rcY�N9 -te Sd.�{-kola �u.0 Tp'rw( krca. 0 �- ISS sf- V 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed LNOYESby the State or Federal government as threatened or endangered?16.Is the project site located in the 100 year flood plain? 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ® ❑ a.Will stone water discharges flow to adjacent properties ❑NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO [-]YES Page 2 of 3 18.Does the proposed action include construbnon or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ® ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: 7 ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: t 2 �Sd�-- Date: Signature: n @tlp& S y PRINT FORA! Page 3 of 3 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; , t' Y. ith, each policy. Following the completion of this written assessment,th, liciuit argen y SIC i E' and submit the documentation required by Section F. i E.CERTIFICATION Pt JAN 2 1 2016 The applicant or agent must certify that the proposed activity is co sister p0-or-th appro. ed _ local waterfront revitalization program, as appropriate. If this certification cannotpk„Qi r chs proposed acti ity' 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." u .� IC Fr Ta n.. Applicant/Agent's Name: � P I - Address: 1 0 geLAJ t-r-r 18l,,4, Cer,-ter AAor t cA crS, Ned 1 l q'3`( Telephone: Area Code(`3� ) y B l ^ 3 3 Applicant/Agent's Signature: Date: I�� L F.SUBMISSION REQUIREMENTS 1. 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 forrn along with his/her application to the federal agency. 3. If there are any questions regarding the submission of this form,contact the 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 10/0411010 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) El 19 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) ❑ d. Reduction of existing or potential public access to or along coastal waters? (19,20) ❑ 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) ❑ Q h. Mining,excavation,or dredging activities,or the placement of dredged or fill material in coastal waters? (15,35) ❑ E L 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) ❑ Q 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) ❑ © f 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) R Q b. Federally designated flood and/or state designated erosion hazard area? (11, 12,17) ER 0- e. c. State designated significant fish and/or wildlife habitat? (7) Q. ❑. d. State designated significant scenic resource or area? (24) El a e. State designated important agricultural lands? (26) ❑ Q f. Beach,dune or barrier island? (12) Q g. Major ports of Albany,Buffalo,Ogdensburg,Oswego or New York? (3) El 1:1 a h. State,county,or local park? (19,20) L 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) © ❑ b. Provision of new public services or infrastructure in undeveloped or sparsely populated sections of the coastal area? (5) ❑ Q c. Construction or reconstruction of a flood or erosion control structure? (13,14,16) ❑ Q d. State water quality permit or certification? (30,38,40) ❑ E e. State air quality permit or certification? (41,43) ❑ Q 4.Will the proposed activity occur within and/or affect an area covered by a State-approved local waterfron0 revitalization program,or State-approved regional coastal management program? (see policies in program document*) ( i t 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 Nov 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: 3SS Lw>Lc j? LLL 2. Address: 135' Whttck—U 81yt , It 5-3o 3. Telephone: Area Code B.PROPOSED ACTIVITY — 1. Brief description of activity: . F L�..,STr VG? le ?� 6 �C•L:TI .-w 5 DJ c.tc . 3 d r k 411 L2 — t O" C Cwt 2. Purpose ofactivity: /D✓t GCC �,s w� oe o+G(Lt e y i2�Gt �•('� G+r i t J�C/�T 1.✓L't L1 S rra-vi 4t, nay, f��n(�trfii tJ 3. Location of activity: $vc-r-oLV— County City,Town,or Village Street or Site Description, 4. Type of federal permit/license required: A6Cnf-J 5. Federal application number,if known: 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: N t� i Di _ L JAN 2 1 So;rScid Tc�!n a Tru e 1 } 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. PRIVACYACT 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. Z?, j oa / n�„►ax- �oL{G�n {'.0�rries -(oti �` 2. Provide the names and addresses of property owners adjacent to your work site (if not shown on the application form or project drawings. 5�w r O/� P `w✓�s (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). TA { `;va — $�•L c2 � w iL + St m 4 i 1i y r°l JAN 2 1 2016 DREDGING PROJECTS g Answer the following if your project involves dredging. Board of Trusbes e 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? 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. 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. 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 if available. For beach nourishment projects, grain size analysis data is required. t 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 modiried. 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 vessel(s) moored thereto from wakes from passing vessels. AJr— 0-iq"leejo . 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. r 1. Indicate the total volume of fill (including backfill behind a structure such as a bulkhead)as well as the volume of rill 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. 2. Indicate the source(s) and type(s) of fill material. 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. Cir C _ r� I JAN 2 1 2016 4 _ sou"hoic T'a"m B ar of Trus ee l J 5 /P The foregoing requests basic information on the most common types of projects requiring Department of the Army permits. It is intended to obviate or reduce the need for requesting additional information;however, additional information may be requested above and beyond what is requested in'this form. Please feel free to add any additional information regarding your project which you believe may facilitate our review. FDr L-1 JAN 2 1 2016 a �Oe � a =06f`Tru i FORCHELLI, CURTO, DEEGAN, SCHWARTZ, MIMEO & TERRANA, LLP c I COUNSELORS AT LAW THE OMNI 333 EARLE OVINGTON BLVD.,SUITE 1010 i UNIONDALE,NEW YORK 11553 TELEPHONE:(516)248-1700 FACSIMILE:(5 16)248-1729 WEBSITE'W W W.FORCHELLILA W.COM r c r JEFFREY D.FORCHELLI MANAGING PARTNER DIRECT DIAL:(516)812-6200 DIRECT FACSIMILE:(866)522-1239 JFORCI-IELLI n FORCIIELLILAW.COM February 23, 2016 f f I Board of Town Trustees Town of Southold D Q V E 54375 Route 25 ' P.O. sox 1179 FEB 2 9 2016 Southold,New York 11971 � a i Att: John M. Bredeme er III�President Y � Sout(ioi�Toarll � hard of Istees Re: 355 Lake Drive LLC by Jeffrey Patanjo 355 Lake Drive, Southold 'Dear Mr. Bredemeyer: I In connection with the above-matter, I enclose herewith a copy of the revised Dock Plan 1 upon which I have executed my wife's consent by me as attorney-in-fact for her as owner. I trust { this will help in your deliberations. i Let me take this opportunity-to thank you for all the courtesies extended. f I Yours truly, II J F D. FO. CHELLI ` JDF/ka � I Enclosure r cc: Jeffrey J. Patanjo (via email—ipatanio@optonline.net) { i 1 r I r I i i i BOAT BASIN (CONNECTING TO SOUTHOLD BAY) ' 57 57 a� ss PROJECTED PROPERTY LINE PROPOSED 6' WIDE X 20',LONG FLOATING DOCK ss SUPPORTED WTH (2) 10.0 CCA PILES 13. 56 57 AND UN—TREATED TIMBER DECKING PROPOSED ALUMINUM HINDGED RAMP 12' LONG X 32" WIDE 63 30 3 J5 F359 8 �w 1YODOFN BUIJafEAD - ti S 79'56'03' E 39.59M.L.W & M.H.W. AT BULKHEAD F E / (SURVEY) � S 79( nMAP).00 � MLED ' 9 cly �o �c 1� c cb -DISTRICT 1000—SECTION 080.00 BLOCK 03.00—TAX LOT 016.000 N/F ROSARIA FORWETII LIBER 11814—PAGE 218 FILED,MAP NO.1215—LOT S DISTRICT 1000—SECTION 080.00 s' BLOCK OAOD—TAX LOT 014.000 N/F CAROL PINKNAM OAK _-- U95f 12824—PAGE 713 TILED MAP N0,1215—LOTS 7&8 DISTRICT 1000—SECTION 080.00 BLOCK 03.00—TAX LOT'015.000 N/F 355 LAKE DRIVE LLC ® r LIBER 12559—PAGE 997E E FILED MAP NO. 1215—LOT 6 (VACANT LOT) I 34 FEB 2 9 2016 o �3 N Sou old Town o adofTr 4 z � �rwvrn PM 'N 74.00'00" W 80.00' VM,FMCE LANE DRM Z LLl t ra 4 umm P= 36" REPRESENTS WATER DEPTH IN INCHES BELOW MEAN LOW WATER PROPERTY OWNER: NOTES: 355 LAKE DRIVE LLC 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 135 WHITEHALL BLVD. Proposed Ra7n,�u & Float rI ALE: GARDEN CITY, NY 11530 "=30' 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: TE: HEIDECKER LAND SURVEYING PREPARED BY: PROPOSED PLAN _9—,6 42 CROWN STREET, KINGSTON,. NY JEFFREY PATANJO —1s-16 DATE SURVEYED: DECEMBER 24, 2015 106 HEWITT BOULEVARD 355 LAKE DRIVE CENTER MORICHES, NY 11934 SOUTHOLD. TOWN OF SOUTHOLD 3. ALL DECKING USED SHALL BE .UN—TREATED 631-484-9332 SUFFOLK COUNTY, NYEET: JPATANJO®.OPTONLINE.NET TAX MAP N0. 1000-80-3-1of 2 VF February 24, 2016 Town of Southold Trustees Town Hall Annex Building - 54375 Rte. 25 P.O. Box 1179 DECEVE I Southold, New York 11971 RE: 355 LAKE DRIVE -SOUTHOLD EEB 2 9 2016 SCTM No. 1000-80-3-15 REVISED PLANS Southold Torn Board of jWsjW Dear Trustees: - Attached please find four (4) copies of revised plans based on comments issued at the February 17, 2016 public hearing. In addition we have included signed plan and letter from neighbor to east confirming their approval of the revised plans. 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 i FORCHELLI, CURTO, DEEGAN, SCHWARTZ, MINEO & TERRANA, LLP COUNSELORS AT LAW THE OMNI 333 EARLE OVINGTON BLVD,SUITE 1010 UNIONDALE,NEW YORK 11553 TELEPHONE (516)248-1700 FACSIMILE:(516)248-1729 WEBSITE:W W W.FORCHELLILA W.COM JEFFREY D.FORCHELLI MANAGING PARTNER DIRECT DIAL:(516)812-6200 DIRECT FACSIMILE:(866)522-1239 JFORCHELLI@FORCHELLILAW COM February 23, 2016 Board of Town Trustees Town of Southold 54375 Route 25 P.O. Box 1179 Southold,New York 11971 Att: John M. Bredemeyer III, President Re: 355 Lake Drive LLC by Jeffrey Patanjo 355 Lake Drive, Southold Dear Mr. Bredemeyer: In connection with the above matter, I enclose herewith a copy of the revised Dock Plan upon which I have executed my wife's consent by me as attorney-in-fact for her as owner. I trust this will help in your deliberations. Let me take this opportunity to thank you for all the courtesies extended. Yours truly, JE Y D. F RCHELLI JDF/ka Enclosure cc: Jeffrey J. Patanjo (via email—jpatanjogoptonline.net) FEB 2 5 2016 .j:ttSst�s .. BOAT BASIN (CONNECTING TO SOUTHOLD BAY) 57 57 `' 55 PROJECTED PROPERTY LINE PROPOSED 6' WIDE X 20' LONG FLOATING DOCK ss SUPPORTED WiH (2) 10'0 CCA PILES 1J• ss s7 AND UN—TREATED TIMBER DECKING © ® ' PROPOSED ALUMINUM HINDGED RAMP 0 12' LONG X 32" WIDE ® 3 35 0 w=04 BUIKKEAD S 79.56'03' E 39.59 M.LW & M.H.W. AT BULKHEAD F E / (SURVEY) -� S 79'36'00" E 40.00' (FILED MAP) n / rn . o V: c 'off oic rn D 0116 DISTRICT 1000-SECTION 080.00 I BLOCK 03.00-TAX LOT 018.000 N/F ROSARIA FORCNELLI LIBER 11814-PAGE 218 FILED MAP NO.1218-LOT 5 DISTRICT 1000-SECTION 080.00 ¢ BLOCK 03.00-TAX LOT 014.000 ---- - --- --' ----- - - ----N/F CAROL PINKHAM OAK - LIBER 12824-PAGE 713 FILED MAP NO.1215-LOTS 7&B I S.3' DISTRICT 1000-SECTION 080.00 BLOCK 03.00-TAX LOT 015.000 N/F 355 LAKE DRIVE LLC If p LIBER 12559-PAGE 997 FILED MAP NO. 1215-LOT 6 (VACANT LOT) FEB 25 2 M� f 016 F �� — �fr1PPm PSE fN s 59i1}hrld i�1^>7 � i � ------------- N 74.00'00" W 80.00' — wmE�ar� WIRE PFMCE LAKED 50, DD ZI Lyl �, - oTIM POLE 3s REPRESENTS WATER DEPTH IN INCHES BELOW MEAN LOW WATER ' PROPERTY OWNER: NOTES: 355 LAKE DRIVE LLC Proposed Rave, & Float rmits SCALE: 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 135 WHITEHALL BLVD. GARDEN CITY, NY 11530 1"=30' 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PREPARED BYPROPOSED PLAN DATE: : HEIDECKER LAND SURVEYING 1-9-16 42 CROWN STREET, KINGSTON, NY JEFFREY PATANJO 2-18_16 DATE SURVEYED: DECEMBER 24, 106 HEWITT BOULEVARD 2015 CENTER MORICHES, NY 11934 3D. TOWN OF SOUTHOLD LAKE DRIVE 3. ALL DECKING USED SHALL BE UN-TREATED 631-484-9332 SOUTHOLD. SUFFOLK COUNTY, NY SHEET: JPATANJO®OPTONLINE.NET TAX YAP N0. 1000-80-8-15 1 of 2 OFFICE LOCATION: ®� S®(/ryQl MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) va Southold,NY 11971 aQ Telephone: 631765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM E To: John Bredemeyer, President Town of Southold Board of Trustees u2016 t FEB 1 0 I From: Mark Terry, Principal Planner LWRP Coordinator Scutnold Town Board Trustees Date: February 9, 2016 - Re: Proposed Local Waterfront Revitalization Program Coastal Consistency Review for Wetland Permit for 355 LAKE DRIVE LLC SCTM# 1000-80-3-15 Jeffrey Patanjo on behalf of 355 LAKE DRIVE LLC requests a Wetland Permit to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. This recommendation is based on the following: 1. The proposed dock is located within a dug boat basin and minor in scale. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Og�FFO(k Peter Young,Chairman co H Town Hall,53095 Main Rd. Lauren Standish,Secretary fi P.O.Box 1179 y ` !� Southold,NY 11971 �lTelephone(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., February 10, 2016 the following recommendation was made: Moved by Peter Meeker, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of 355 LAKE DRIVE LLC to construct a 6'X 20' floating dock, 32"X 12' aluminum ramp and 2-1.0" piles. Located: 355 Lake Dr., Southold. SCTM#80-3-15 Inspected by: Peter Meeker, Keith McCamy Vote of Council: Ayes: All Motion Carried REYDON SHORES PROPERTY OWN ASSOCIATION JAN 2 9 2016 ' P.O. BOX 1693 Toyiii -- SOUTHOLD,NEW YORK 11971 So Board Pf Trustees January 29, 2016 Southold Town Board of Trustees James F.King, President P.O.Box 1179 Southold,NY 11971 Re: Cosola Property, 355 Lake Drive, Reydon Shores, Southold,NY Dear Mr.King: Please be advised that I have been contacted by the Peter Cosola who has advised that he has recently purchased the property known as 355 Lake Drive in Reydon Shores and is in the process of seeking Trustee approval for the installation of a certain ramp and floating dock into the harbor basin area adjacent to his property, situate in Reydon Shores private community, Southold,New York. Mr. Cosola has further advised that the Southold Trustees are seeking consent and/or approval from Reydon Shores Property Owners Association (RSPOA) prior to a determination on the Cosola application for such installation. (Refering to Jan 9, 2016 Proposed Plan prepared by Jeffrey Patanjo) RSPOA has no formal pre-approval process for such requested work and would only expect that all adjacent property owners to the subject property would be notified of this application as apart of the process prior to any approval by the Trustees. Further that in considering the application, the issue of navigability of the harbor basin for all neighboring properties and existing docks should also be considered. Otherwise, RSPOA has no objection to Mr. Cosola's application. Very truly ` rsyours, n, RICHARD W. VANDENBURGH RSPOA President CC: RSPOA Board - S John M.Bredemeyer III,President �Q Town Hall Annex Michael J.Domino,Vice-President aQ 54375 Main Road P.O.Box 1179 James F.King,Trustee *'. Southold,New York 11971-0959 Dave Bergen,Trustee '`, -_- �• Telephone(631)765-1892 Charles J.Sanders,Trustee Fax(631)765-6641 , BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ,� 3 _Coastal Erosion Permit Application Wetland Permit Application Administrative Permit I• �} JAN 2 1 2016 1 _Amendment/Transf r/E epsion Received Application: 1 all / Scutiio;;i Town ceived Fee:$Completed Application_ tItRe Incomplete _ _ _SEQRA Classification: Type I Type Il Unlisted Coordination:(date sent) �LWRP Consistency As essm t orm .& CAC Referral Sent: 1 _Date of Inspection: 6 Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing HeId: 2 Resolution: Name of Applicant 3 55 t a Ke_ Va ive LLG Mailing Address 13 5 l.✓h -I'eh a•I 1 13 L 04 • G t rd c n C' i••1-y , N 115-309 Phone Number:( ) l7- --a a -15-8 9 Suffolk County Tax Map Number: 1000- °'0 0 - '3- t Property Location: 3 5 5 a IL 02 l v e , S o, +k0l A A. C 4,01-�' L-u fl (provide LILCO Pole#,distance to cross streets, and location) AGENT: (If applicable) Address: 106 l4ewLt-r 61Uek • Cee)+er A or ides, f) `( I L a 3z{ Phone: 6 `93 3 a— c� � Board of Trustees Application GENERAL DATA Land Area(in square feet): 11 35 -7 Area Zoning: (Z c S Previous use of property: X c S — U a cin 7 Intended use of property: P-11-OS - vat Covenants and Restrictions on property? Yes IX' No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes V 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 No If"Yes",please provide copy of decision. F k 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 k No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No X Yes If yes,provide explanation: Project Description(use attachments if necessary): e 'k ao -F 'P4+1nq koGIL , 3� K )X 4(�Mrti �.,•� e4 net- 2- - f o" d Pr (e S Boas.. of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: srr 0 cr eQ 9- Area of wetlands on lot: 4171 square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: 4 5"0O feet Closest distance between nearest proposed structure and upland edge of wetlands: -+ Svo feet N _ n Does the project involve excavation or filling? -X- No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? N cubic yards Depth of which material will be removed or deposited: /V),+ feet Proposed slope throughout the area of operations: I - Z ; Manner in which material will be removed or deposited: N I A 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� ert wt11 IVB /..o AJ-.g,41ve tr4c:-cc4- �n w L'- ('1" et S Short Environmental Assessment Form Part 1 -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 infonnation 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: 355 Lmer- D2lVL 5o��-h�1cQ Project Location(describe,and attach a location map): SLG ZcGctT!®� ?t A. Brief Description of Proposed Action: - p`W-, ek- b ' w t d-, x 'a D' 1—`6 rq-i�i►-� r n�.,n Q-c�ntifD ��^� �- - Z o " � cc ,rq �i 1 t S. � Name of Applicant or Sponsor. kE-Mail: elephone: 9 7_q 7 a 355 te-Ve 0Q1LJe. (:LC._ P�ttr�oscQver«oA•�,,�ar Address: City/PO: State: Zip Code: CSA f d e-^ Cv- /V'{ 1 1 $',b 0 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 F1 ❑ 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: ❑ -rev--i vf- 5,9-4kol k -Crv5t'ee1 1 *-4`-t5 D6c I 3.a.Total acreage of the site of the proposed action? o, a6 t acres b. Total acreage to be physically disturbed? �_acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? D• acres 4 Check all land uses that occur on,adjoining and near the proposed action. [:]Urban ❑Rural(non-agriculture) ❑Industrial []Commercial GKesidential(suburban) ❑Forest ❑Agriculture ❑Aquatic E]Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ® ❑ 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? ❑ 12- 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, ❑ ❑ Agency:buttolk County,Date:7-1 TST- ✓ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? © ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 0 ❑ 9,Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: F,-� ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES i 7 If No,describe method for providing wastewater treatment: ❑ i+ 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 agency9 ❑ ✓❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ EE If Yes,identify the wetland or waterbody and extent of alterations in'square feet or acres 6 o P.-C" (3 A S I A G'o,•t,J 0 v{-!n o I a- is wli To 'Cd-( arc- „ �— ISZ- s(- 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline []Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ ✓❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ® EIa.Will storm water discharges flow to adjacent properties? ❑NO ®YES b.Will storm water discharges be directed to established conveyance systemsnznoff and storm drains)? If Yes,briefly describe: LiNo DYES Page 2 of 3 j � 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ® ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: t 2 �Sd Date: Signature: F 6 h 1 PRINT FORM Page 3 of 3 i 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? 1� EL 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: Fl a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e g,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 i No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health9 1:1 El Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail, identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an IYenvironmental 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 environmenttallii pacts. Town of Southold-Board of Trustees '�JI/ V ,II Name of Lead Agency YYY Date Td PJI4 President Print or TypetTX57 le Offi r in Lead Agency Title of Responsible Officer Signature esponsie O ficer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 i February 10, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 355 LAKE DRIVE -SOUTHOLD SCTM No. 1000-80-3-15 MAILINGS Dear Trustees: Attached please find original affidavit's for mailing and posting as required for permit applications. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, i Ji 1 Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 FEB 1 6 2016 "J .J PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name:_ = Address: dm Jh6Vs / .A� h_ 1/i7/ k5oLhh&/d- /47/ -br Joop' dd, //97/ STATE OF NEW YORK `COUNTY OF SUFFOLK v� G� a- - 0 , residing at being duly sworn,deposes and says that on the IdRS day of' 20��, deponent mailed a true copy of the Notice set forth in the Board of TrustdQd 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 person's-as shown on the current assessment r ll of the Town of Southold; that said Notices were mailed at the United States Post Office at Cy ,6lil 22?A6& that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. i Sworn to before me this -p Day of , 20_,�U Notary Public Loriann Patan' Notary Public Statte ofLw York Qualified in Suffolk County sonxpiscommisEe0&07/2pk John M. Bredeme er III, .,sident ��S11fF0(��0 Town Hall Annex y . , � G Michael J. Domino, Vice-President ram y� 54375 Route 25 Glenn Goldsmith y P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sanders ti��l �� fJ 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 355 LAKE DRIVE LLC 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, �,Tr-r�Pv ACt'IL{alOresiding at/dba being duly szhrn, depose and say: That on the 7 day of Q 7�-pntay , 20169, I personally posted the property known as j 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, February 17,2016. Dated: �-- . J (s-gn#ure) Sworn to before me this 7 day of 2AP - Notary Public Loriann Patanl1o� Notary Public State ofTlew York Qualified in Suffolk County Commission ExAp'iirre�07/2p§ o © A m ® r`- M Ln ,a ® ru CIO Ln LOCUST PLLEY� I 1156u F [` <� ( '� i; ;) ' ry m € )" ', 1 (t,,.,- }} 1. Certified Mail Fee c ' fn :. 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G L LrI r' SnUTH_O {y 'y y 11,974 I n1� may, Irl 1-?a P t 's,> jsi t (" -f5 rr- Certified Mad Fee e �- $3.45 S d to Extra Services&Fees(check box,add fee Tpppryggate) ❑Return Receipt(hardcopy) $ �L!■ L,, '� �Retum Receipt(electronic) $�ft��,•1— �� Postmark (� C3 ❑Certified Mail Restricted Delivery $ $�( J tk, ti' e!� r M 3 � En E]Adult Signature Required $ _ `®�31 ❑Adult Signature Restricted Delivery$ O Postage $4.49 , .n $ 4 Total Postage and Fees C3 & $5.34 Ln Sent To Stieet anaApt No.,of PO Boz No ----------------------------------------- r%- Ctty,State,ZIP+4� -------------------------------------------- o o .a 111• '�.¢ "4 - PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: 0 = 31 -- �� („•/ 1 lLJ k STATE OF NEW YORK COUNTY OF SUFFOLK " a. { __i residing at being duly sworn, deposes and says that on the day of , 2C , 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. i Sworn to before me this I Day of , 20 i Notary Public ,NUTILt: UF - 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: 355 LAKE DRIVE LLC SUBJECT OF PUBLIC HEARING : For a Wetland Permit to install a 32"x12' aluminum ramp off bulkhead to a 6'x20' floating dock secured by two (2) 10" diameter piles. Located: 355 Lake Drive, Southold. SCTM# 1000-80-3-15 TIME & DATE OF PUBLIC HEARING : Wednesday, February 17, 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 Ho6-. of Trustees Application County of Suffolk State of New York (2a s c Low 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 a P PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Property Owner SWORN TO BEFORE ME THIS 12 DAY OF "L ,20�(� 9w,frx (� Notary Public Lonann Patan* Notary public State of New York Qualfi:- inSuffolkCounty No:01PA6150861 Commission Expires OB/O��zo� SOL-- of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, CPCA-c-r C v s®l residing at 1'15- Lu In I+e-h—IL (print owner of property) (mailing address) (� vQ Cc tj , �,AH l""3 odo hereby authorize'��r (Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf. i' (Owner's signature) y APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM I� The Town of Southold's Code ofEthics- rohibits conflicts ofinterest on the Farco' w otDicers and cmnlovees.The purpose of I this farm is to provide information which can alert the town of possible conflicts of ititarest andallow�t to takewhatever action is 111 necessary to avoid same. (�4 T 1 YOUR NAME: (2 C, S°[&- ` (Last name,fust name,ipiddle 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 X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other r (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee p of the Town of Southold? "Relationship"includes by blood,rgarriage,or business interest."Ehisiness interest"means a business, including a partnership,in which the town officer or employee has ever,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 ><- If If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th' 4 day of -A A 200 1 k, Signature Print Name QoSoLo- — Form TS 1 a�gU � Town_ ' of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: s.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 01, 1000 X50 3 f STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN T11 s'ccre�e(13655- -Oroo-E c- Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORKASSESSMENT Yes No a. What is the Total Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off (include Total Area of all Parcels located within 113 S 7 l-p.2 L f Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (S.F./acres) This Item will Include all run-off created b site ❑ b. What Is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed O Site Improvements and the permanent creation of construction activity? impervious surfaces.) (S.F.l-Acres) PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages as Needed) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures indifcating Size&Location?This � Item shall include all Proposed Grade Changes and — F] Co.+Sze F(P. Tt Nti iQ o c i-� Slopes Controlling Surface Water Flow. �r 3 Does the Site Plan and/or Survey describe the erosion .3 a"x 1 Z t A l M l n�.�+., P A,^& and sediment control practices that will be used to �! control site erosion and storm water discharges. This El- 4""', 1,0" to G C 14 A Ie S 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 — X a of Material within any Parcel? c rj Will this Application Require Land Disturbing Activities N Encompassing an Area in Excess of Five Thousand )r (5,000 S.F.)Square Feet of Ground Surface? — 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction ® — General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including,disturbances of less then one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to ❑ Including Construction activities Involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? 2L the DEC has determined that a SPDES permit is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious _ for Storm Water Discharges from Construction activity-Permit No.GP-0.10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the NOI.The Not shell be Into and/or In the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or t Removal of Vegetation and/or the Construction of any ❑ — constructed to reduce the pollutants In storm water discharges end to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Item wllt NOT Include the Installation of Driveway Aprons.) Identify potential sources of pollution which may reasonably be expected to effect the quality of storm water discharges. NOTE: If Any Answerto questions One through Nine Is Answered with a Check Mark l 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance Is between 5,000 S.F.&1 Acre in area, component shall be prepared by a qualified Design Professional Licensed In New York a Storm-Water,Grading,Drainage&Erosion Control Plan Is Required by the Town of that Is knowledgeable In the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to issuance of Any Building Permit. (NOTE: A Check Mark(J)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, COUNTY OF...........................................SS That Ik"— .being duly swum,deposes and says that he/she is the applicant for Permit, (Name oI ind{vldual signing Dacdment) And that he/she is the �'�.w�"'� �� M""r 6'�� (Owner,Contractor,Agent,Corporate Offieer,etc.) Owner and/or-representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to I make and file this application;that all statements contained in this application are true to die best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed here 'th. Sworn to before me this; ................1.. ":.......... day of.... -�f ...... .20.1..(P NotaryPublic: ..........................0:� ................. ....................... .......................................... ............................... (Signature of Applicant) FORM - 06/10 Lodann patanlo NotarytPublic State - t w York Oualifitd in Suffolk County NbAlPA6150861 Commission Expires 08/07/20& 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 sib beneficial and adverse effects upon the coastal.areafwhich includes�all of SoutholdTownl. 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. T.hus,,,each:;answer-must,,be "Rlain.W.in_detail, listing both supporting and non- sumporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. r 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# PROJECT NAME 14 e 2 v - S a•� -k(n o l d The Application has been submitted to(check appropriate response): �y Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees lJ 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: +l.✓O P 1 Location of action: 3 5 5 e l Lc_ _O2,o e Site acreage: D g6 I Present land use: J&C&n C.J -, Present zoning classification: ids 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: 3 5`5 Lw V e— 90— v e-- L L C-- (b) Mailing address: 3 S to �1 L-tG 1 4-1 L (3 Ly Car iii Cl- -j X) (c) Telephone number:Area Code (d) Application number,if any: f Will the action be directly undertaken,require funding,or approval by a state or federal agency? ►�K SDEG(A/�M I r.1�-(S'p VS Yes © No❑ If yes,which state or federal agency. `� - C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies;Page 2 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable VC r o,.,j P—i n y f'!'AoO-e i-1'l t,S I I 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 Y Yes ❑ No ❑ Not Applicable r,v ec,-t 9rip tee 4'1 -1 h..� P/vy�cQ ✓N Sv��icr�n? LO r 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 P Yes ❑ No ❑ Not Applicable Q r'v,)ee j PG Gy L S cc,, to 9 'fir b e ei 44� u L l-tLj 6v,,s r f-t G n 7 w c-t•�, -tho t o r r v„n cQ m y P�vn t r•tr cS Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP w Section III—Policies Pages 8 through 16 for evaluation criteria h Yes ❑ No © Not Applicable 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 ElYes ❑ � No '�` Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ LxJ I I l Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No®-Not Applicable s Attach additional sheets if necessary 0 a Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ No © 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!'M—Policies; Pages 38 through 46 for evaluation criteria. 0 Ye❑ No❑ Not Applicable Pr ig (ADV( f e ce eSf -+c, 6 ,,,i4-( ^2 GGICG►- Attach additional sheets if necessary �i 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 L Policies;Pages 47 through 56 for evaluation criteria. 0 Yes ❑ No ❑ Not Applicable ���C"f �e a C•� -�rY M. Gt,/�/►..�- G� � �o.� S� s't"t n T w 't'h 5 ter- rip n !7 rm C r•Fi�_r 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. F] Yes 1:1No 121n/Not Applicable ` x 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 14 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 21 Not Applicable PREPARED BY - Pe�-t-4 I) ► a TITLE q Gn-r DATE January 17, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 r P.O. Box 1179 Southold, New York 11971 1I RE: 355 LAKE DRIVE -SOUTHOLD 2 1 2016 t SCTM No. 1000-80-3-16 APPLICATION FOR PERMIT Tr Dear Trustees: We hereby submit one 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 I 0 :,,,: ►PPROVED BY , D OF TRUSTEES' .sem y �,i'r -OF BOAT BASIN (CONNECTING T0, SOUTHOLD BAY) 57" 57 PROJECTED PROPERTY LINE �a►p PROPOSED 6' WIDE X 20' LONG FLOATING DOCK ss SUPPORTED WTH (2) 10"0 CCA PILES 13 55 s7 AND UN—TREATED TIMBER DECKING �G 9 ® I ° PROPO E X 32MI WIDEHINDGED RAMP a 35 ��. N°ODEN gULJ(NEAD S 79'56'03" E 39.59' M.L.W & M.H.W. AT BULKHEAD F E / (SURVEY) a -1 S 79'36'00" E 40.00' ' Q I O�J� (FILED MAP) rn N � 00 CD `D Qin rn 0 DISTRICT 080.00 BLOCK 03.00—TAX 1000—SECTIO TN 016.000 - N/F ROSARIA FORCHEW ' SLIBER 11814—PAGE 218 FILED MAP NO. 1215—LOT 5 ' DISTRICT 1000—SECTION 080.00 � BLOCK 0300—TAX LOT 014 000 N/—� CAROL PINKHAM-OAK LIBER 12824—PAGE 713 FILED MAP NO.1215—LOTS 7&8 ' DISTRICT 1000—SECTION 080.00 BLOCK 03.00—TAX LOT 015.000 / N/F 355 LAKE DRIVE LLC I LIBER 12559—PAGE 997 FILED MAP NO. 1215—LOT 6 (VACANT LOT) 3 4' � s = p\ q "WPEO PIPE Cl/ N 74'00'00" W 1n 80.00' — NiRE FENS WRE FENCE LAKE DRIVE (50' WIDE) �— — ------- - — unurr POIF' — ` � ��� E B lf 1 ss' REPRESENTS WATER DEPTH IN INCHES FEB 2 9 2016 BELOW MEAN LOW WATER Southold Tovvn B of Tru ee PROPERTY OWNER: NOTES: 355 LAKE DRIVE LLC 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 135 WHITEHALL BLVD. Proposed Ramp & Float Permits SCALE: GARDEN CITY, NY 11530 1"=30' 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: DATE: HEIDECKER LAND SURVEYING PREPARED BY: PROPOSED PLAN 1-9-16 42 CROWN STREET, KINGSTON, NY JEFFREY PATANJO 2-18-16 DATE SURVEYED: DECEMBER 24, 2015 106 HEWITT BOULEVARDCENTER MORICHES, NY 11934 355 LAKE DRIVE SOUTHOLD, TOWN 3. ALL DECKING USED SHALL BE UN—TREATED 631-484-9332 SUFFOLK N SOUTHOLD SUFFOLK COUNTY, NY SHEET: JPATANJO©OPTONLINE.NET TAX MAP N0. 1000-80-3-15 1 of 2 7 LOCATION j � a l (n n 'JL - I 1 N`p�,�viewirRd�=--Ii- J PROJECT LOCATION MAP N.T.S. PROPOSED 32"' WIDE X 12' LONG ALUMINUM RAMP PROPOSED 10'* CCA PILES (TYPICAL — 2) PROPOSED 6' WIDE X 20' LONG FLOATING DOCK WITH UN—TREATED TIMBER DECKING - APPROXIMATE M.H.W. APPROXIMATE M.LW zo by bar 2! TYPICAL SECTION - RAMP & FLOAT N.T.S C E V E 11 FEB 2 9 2016 Southold Town Board Tru ee Proposed Ramp & Float Permits SCALE: AS NOTED TYPICAL SECTION & DATE: LOCATION MAP 1-9-16 355 LAKE DRIVE SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: TAX MAP NO. 1000-80-3-15 2 OF 2 Unauthorized alteration or 0 10 20 30 addition to this survey is a violation of section 7209, METERS subdivision 2, of the New York State Education Law. Copies of FEET this survey map not bearing the HEIDECKER LAND SURVEYING land surveyor's inked or x 0 -6.6 embossed seal shall not be 20 40 60 80 considered to be a valid copy. GRAPHIC SCALE 1" = 20' x-6.2 x -6.2 x -6.4 x -6.4 -6.2 BOAT BASIN -6.2 x -6.4 NOTES x -6.3 x Y 1. FIELD WORK WAS CONDUCTED DECEMBER, o 2015 BY HEIDECKER LAND SURVEYING, PLLC v OC,, 6'� __6 AND ALL MEASUREMENTS WERE TAKEN ON o O 0 THE GROUND. G -5.6 �� - Z pP x -5.7 --"� a 2. PROPERTY LINES, BEARINGS, AND NORTH �„ F� x o ARROW ARE BASED UPON MAP ENTITLED "MAP OF RE-SUBDIVISION OF BLOCK "F" OF S� 6 03 E 39.59 (SURVEY) 5 THE MAP OF "REYDON" SHORES AT BAYVIEW, a L.I., N.Y., PREPARED BY LEWIS N. WATERS, •Z G'O C- -L�O GO '(R LEU MAP) a L.S., DATED SEPTEMBER 2, 1936 AND FILED 736 C OP OF BULKHEAD=2.98' WITH THE SUFFOLK COUNTY CLERK ON WOODEN PILE (TYP.) -4 5 -4.5 -4.5 - OCT08ER 7, 1936 AS MAP NUMBER 1215 / d -4.1 AND DEED FILED WITH THE SUFFOLK COUNTY CLERK IN LIBER 12559-PAGE 997 ON �2� ' WOODE/T�ULKH2 A��� '\ 7/31/2008. / �9� P.K. N IL3. THE THIS PLAT -• BENEFITS PROPERTY ROM RIGHTOSWSETO FORTH IN LIBER / ` FOUND 'bi 1887-PAGE 42. LOW TIDE OBSERVED AT ELEV=-1.6' 4. UNDERGROUND UTILITY LINES IF ANY ARE / ---**,% ON 12/14 @ 8:25AM m Q NOT SHOWN. �. HIGH TIDE OBSERVED AT ELEV=1.2' o / 0 LU J ' �� ON 12/14 ® 2:02PM Of U O REFERENCES / �� ,`" / U rn FILED MAP NUMBER 631 Cp FILED MAP NUMBER 1215 LIBER 1887-PAGE 42 / / ('0 ' 3 3 , \ DISTRICT 1000-SECTION 080.00 BLOCK 03.00-TAX LOT 016.000 N/F ROSARIA FORCHELLI II LIBER 11814-PAGE 218 FILED MAP NO. 1215-LOT 5 v Z 3'- DISTRICT 1000-SECTION 080.00 BLOCK 03.00-TAX LOT 014.000 4'- N/F CAROL PINKHAM OAK LIBER 12824-PAGE 713 / FENCE 1 .0' 3 FILED MAP NO. 1215-LOTS 7 & 8 5 6/E-A-ST- FENCE 1.5' EAST 5.3' j // DISTRICT 1000- ECTIOO 080.00 LOCK 03.00-TAX I OT 015.000 Q \ N/F STEVEN KUBRYK j / 1 LIBER 12559-PAGE 997 FILED MAP NO. 1215-LOT' 0 a ' / (VACANT LOT) w � W I a- ENCE ON LINE (92 CONCRETE MONU ENT o ° POINT +o F FOUND EGINN,I N G i� r N CAPPED PIPE C'V -(NCE 2.0?00 x/74 00'00- - - - - 80_00' EAST - -- - _ /� N1 RE FENCE \ WIRE FENC CERTIFICATION ( I JOHN GERD HEIDECKER, A LICENSED LAKRIVE LAND SURVEYOR IN THE STATE OF NEW ( �l1/I�E) YORK (LICENSE NO. 50719), DOHEREBY q FY THAT THIS MAP WAS PREPARED(IN ACCORDANCE WITH THE J A�'i 2 20106 EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK p STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. THIS CERTIFICATION EXTENDS ONLY TO THE PARTIES NAMED BELOW AND IS NOT TRANSFERABLE. UTILITY POLEy1CGOf I'iil (6n$ 1. 355 LAKE DRIVE LLC OF NE �Q. GSR0 H co C� r �� _ T SURVEY PREPARED FOR: ` 355 LAKE DRIVE LLC t _ PROJ. N0. O ATE: 15HLS113 /JOHN GERD HEIDECKER N.Y. STATE LAND SURVEYOR LIC. # 50719 DATE: TOPOGRAPHIC/BOUNDARY SURVEY SHEET NO. �s . 05 7� 42 CROWN STREET DECEMBER 24, 2015 DISTRICT 1000-SECTION 080.00 1 OF 1 KINGSTON, NEW YORK 12401 DRAWN BY: M.G. BLOCK 03.00-LOT 016.000 'OB # (845)-901-7629 CHK BY: J.H. #355 LAKE DRIVE TOWN OF SOUTHOLD CAD FILE: SCALE: 1"= 20' SUFFOLK COUNTY, NEW YORK 15HLS113FP DWG