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TR-8809
Michael J. Domino,President ��0f MUTyO Town Hall Annex John M.Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O.Box 11 Charles J.Sanders [ l�[ Southold,New York 11971 Glenn Goldsmith G ® O@ Telephone(631) 765-1892 A. Nicholas KrupskiO J Fax(631) 765-6641 ly�0UNT1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1410C Date:November 8,2017 THIS CERTIFIES that the removal and replacement in-place of 63 linear feet of deteriorated bulkhead with new vinyl bulkhead a 26 linear foot return and a 33 linear foot return; and to raise the height an additional 12" from existing top cap elevation; with the condition that height is no more than 18" in order to match the current neighbor to the north; At 2625 Bay Shore Road,Greenport Suffolk County Tax Map#1000-53-4-21 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 18, 2016 pursuant to which Trustees Wetland Permit#8809 Dated May 18,2016,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal and replacement in-place of 63 linear feet of deteriorated bulkhead with new vinyl bulkhead a 26 linear foot return, and a 33 linear foot return;and to raise the height an additional 12"from existing top cap elevation; with the condition that hei htg is no more than 18" in order to match the current neighbor to the north. The certificate is issued to DWYER/BARTH REVOCABLE FAMILY TRUST c/o LAUREL PHELAN owner of the aforesaid property. j Authorized Signature SOF SO(/yy Michael J.Domino,President � O' Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. Sanders v, Southold, New York 11971 Glenn Goldsmith � ® y0 Telephone (631) 765-1892 A. Nicholas Krupski O��C�U��� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 11,16'1)1 —4Z'Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: -\7 �ie� Ve" COMMENTS: CERTIFICATE OF COMPLIANCE: `'� �� w UFEnt John M. Bredemeyer III, President _y��O Town Hall Annex Michael J. Domino, Vice-President C'Z eg a. ��' 54375 Route 25 Glenn Goldsmith ti o 1 z r P.O. Box 1179 A. Nicholas Krupski l',", . - 3J Southold, NY 11971 Charles J. Sanders 't',._--40./ , , -k, Telephone (631) 765-1892 `�==.-_<:�==w2 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 1/2 constructed / Project complete, compliance inspection John M.Bredemeyer III,President ,.'I®�A :soupz,- Town Hall Annex Michael J.Domino,Vice-President �� ~ • 4" ® ` 54375 Route 25 P.O.Box 1179 Glenn Goldsmith ; Southold,New York 11971 A.Nicholas Krupski ® '• 9n. a0Qz. Telephone(631) 765-1892 Charles J.Sanders Fax(631) 765-6641 �OOUNTV � �•�.. t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD • May 18, 2016 Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: DWYER/BARTH REVOCABLE FAMILY TRUST do LAUREL PHELAN 2625 BAY SHORE ROAD, GREENPORT SCTM# 1000-53-4-21 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 18, 2016 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of DWYER/BARTH REVOCABLE FAMILY TRUST do LAUREL PHELAN applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated April 18, 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 May 18, 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 DWYER/BARTH REVOCABLE FAMILY TRUST do LAUREL PHELAN to remove and replace in-place 63 linear feet of deteriorated bulkhead with new vinyl bulkhead, a 26 linear foot return, and a 33 linear foot return; and to raise the height an additional 12" from existing top cap elevation; with the condition that height is no more than 18" in order to match the current neighbor to the north; and as depicted on the site plan prepared by Jeffrey Patanjo, dated April 10, 2016, and stamped approved on May 18, 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: None Very truly yours, drit— 40%.‘, fetta#0769 John M. Bredemeyer III President, Board of Trustees JMB/dd .!tl.c.,...:.;..;::„, f{ a. , 14.1 i 41_,,_, \, ...0,.....17,„ ,, `111 alas ,...„..•:. 4`141 tlff T_tom• ``1141 rlyjy`� tt /e� Vr ° 11 Lf° °� ,-;,---t-----,4-0.4' -; `4-0.4'u 4'-�. t.s -;--'m`"yW r. e r _" 1 1 el""--',4'u'�..."41 r° 1\ "1 i�\+~ lit ` r 4/ VF t P. ..✓' � J, Y 7:•••t i $ i y `. 4 `" N l.ti- l 2'j=, � ,c---, ,,..) --.1� '.rr'. Ag, -„, i," „ �,-,. '. -- Flu ,14.,; �,, ' , a�',2,4--,--A :,-„..2 ..=, LOn ti..-,,,`,,,,,,,!`2" ,.5...,./.,..7,,,,.....5•,.. 7 m ,,,,!+✓�"L.. .,,.1" '<: .!:.,,,,, '^:14 .,T.«..,,,„ra r ri•,t 'gym ,Y.:d r_PJ'a:<:,•;u ....tu1.,1 ,/,..7_, .e J, ' � `` BOARD OF SOUTHOLD TOWN TRUSTEES 'IA ,�-�k SOUTHOLD, NEW YORK lik.:// .' r�;y;: / t 5'. Mme' • E. f1;;m,r, PERMIT NO. DATE: MAY 18, 2016 k 1;,?, ,/..-... ..; ,.f,. '121;7▪ 4-'t. €7 ISSUED TO: DWYER/BARTH REVOCABLE FAMILY TRUST do LAUREL PHELAN 1, , �; �� PROPERTY ADDRESS: 2625 BAY SHORE ROAD, GREENPORT-- .:4..."E: h c - SCTM# 1000-53-4-21it ,`I AUTHORIZATION 1'„y>`_., Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in P 1t accordance with the Resolution of the Board of Trustees adopted at the meeting held on May 18, 2016, and in pr n; consideration of application fee in the 'sum of$250.00 paid by Dwyer/Barth Revocable Family Trust and —, • .;aa a 4 041 • P;'p subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees ,=,` Y^,, fEc�' authorizes and permits the following: ) 4 ' (.,:'- ` Wetland Permit to remove and`replace in-place 63 linear feet of deteriorated bulkhead uj/p • - with new vinyl bulkhead, a 261inear foot return, and a 33 linear'foot return; and to J raise the height an additional 12” from existing top,cap elevation; with the condition m a �, that height is no more than 18" in order to match the current neighbor to the north; 1...�, and as depicted on the site plan prepared by Jeffrey Patanjo, dated April 10, 2016, and , 11-• : stamped approved on May 18,2016.. `l R ,�' '} IN WITNESS WHEREOF,the said Board.of;Trustees hereby causes its Corporate Seal to be affixed, �•'. and these presents to be subscribed by.a majority of the said Boars as of this dat-. Aire % , 1�r '� �k0 � G� „..:4, / l dl if: .l',:‘,,- el: 1...c",'14e6 . i. ,. 4$. o Ail 1 ‘,i..)' _ / r r vi. f. \ Y/It. =,...-,.4 I .jai yip t �1 €:„ i yiJ .. \'r ..esst, r;..u='oos.m•,u sa'.a. zaai,<wucB w3.tor, ,a.r2':.c,47ze,1-4,, ,a m„,s...as--afu„s aw.tt,. ..:::,,,.4.Q.7,77-y,',.4=,—,,51,,T=z .:^:. ” ,z+....,,z w 6, ,,,.L.,x --„ ,a.;$,/ .. i`v -' �•:JJ. J., �-J'J 'i 1:4-.”`.t-'1 ` y L .',-4., -. •g.Q `-.i-'r. -'''-‘,. .4 $ '^`•<' '': t .r i y It (/<?�'t'l , WAWAJ ,, �vj7 �„ „ t 1 f Ir{, a% 0 . \ 1 4 ,..• ��/1#•.:1 `J'Ir 1 W- -° �j ` !y`�. t fi i'^-^:- *,ar rr jt °•tiz'w }ri t;it�J „r.. n t i .42r < S:irrr• 4°1triii •S _• <4 r1 J'- ;- ••1 ,Irl f1% e Ttg; .. 1r,1`” a d .• ,0 `J y. TERMS AND CONDITIONS The Permittee Dwyer/Barth Revocable Family Trust c/o Laurel Phelan, residing at 2625 Bay Shore Road, Greenport, New York,as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. 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 pennit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. + - + SURVEY OF: PROPERTY LOCATED AT ARSHAMONAOUE - LOT 45 AS SHOWN ON AMENDED MAP "A" OF PECONIC BAY ESTATES _ FILED: MAY 19, 1933: FILE No, 1124 _ - TOWN OF SOUTH'OLD - SUFFOLK COUNTY, NEW YORK - S.C.T.M. # 1000-53-4-21 • . AREA = 8,617.5 SF. ± HIGH WATER -MARK , SCALE: 1"=30' - NOTE: THE EXISTENCE OF- RIGHT OF WAYS, - ` \ b WETLANDS AND/DR EASEMENTS OF RECORD IF ANY. NDT SHOWN ARE NOT GUARANTEED. . - - vt so ttt BULKHEAD �" L , - 21.4'/S CR 0 - , LOT 44 i" 1, �� �� 0 � . o � 'aa 1 STORY q" // S FR. RES fEN \ . �A . V� p� 0yl MON' hadl'eE�r 01 , ''‘g • N Epo . . 5 06,5$• 1 re RES1116 _, f F ��NCF v���' �GI 't I t.i N €, (1 OAF O'AO `3 . - - . op e. POLE . _ APR 18 2016 `-' UNAUTHORIZED ALTERATION OR ADDITION TD TM9 SIJtVEY•IS A VIOLATION SURVEYED B Y: - OF SECTION MO OF THE NEW YORK STATE EDUCATION LAM. - COPES Or THIS SURVEY MAP NOT SEARING THE-LAND SURVEYORS DIKED PAULB A R Y L S K I LAND S U R V E Y I N G OR mosso SHALL NOT BE CONSIDERED TO OE A VALE TRUE COPY. . GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO P A T C H O G U E NY 11772 THE PERSON FOR WON THE SURVEY IS PREPARED.AND ON HOS BEHALF TO - TLISSTEnDTH EREN.A COMPANY. O THEA NTAL YTHC LENOPDING I D I INSTITUTIONTITUTI0N. i PHONE 631-294-6985 GUARANTEES�C OUENTT TRANSFERABLE TO ADDmoNAL OWNERS. i FAX 6-31-627-3186 PAULBARYLSKIoYAHOO,COM • - i APRIL 6, 2015 2030 , + _ - + / ......i. / C �°n;/ - NOTE REMOVE EXISTING BULKHEAD PROPOSED FIR TIMBER TOP CAP STRUCTURE IN ITS ENTIRETY i�O AND INSTALL NEW BULKHEAD PROPOSED 14' LONG 10' BUTT ',/,,,, IN THE EXACT SAME POSITION PROPOSED 3'X6 TREATEDCCA TIMBER PILE, 6' / RAISED ELEVATION OF /PROPOSED �Q «a yHEIGHT ABOVE EXIST. TOPCAP REAR W 7_, ___K V- John M. Bredemeyer Ill, Presidentf7 OFFO(tC Town Hall Annex Michael J Domino, Vice-President � b � ' �Gy 54375 Route 25 Glenn Goldsmith o ` P O. Box 1179 A. Nichoras KrupskiSouthold, NY 11971 Charles J. Sanders �4 o�1.7 Telephone (631) 765-1892 v� � ,;,. Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: IA V4 k 1D tiaif -- Completed in field by: k/Z5 JS Jeffrey Patanjo on behalf of DWYER/BARTH REVOCABLE FAMILY TRUST, c/o LAUREL PHELAN request a Wetland Permit to remove and replace in-place 63 linear feet of deteriorated bulkhead with new vinyl bulkhead, a 26 linear foot return, and a 33 linear foot return; and to raise the height an additional 18" from existing top cap elevation. Located: 2625 Bay Shore Road, Greenport. SCTM# 1000-53-4-21 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=V 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 Nil Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment VWetland Coastal Erosion Emergency Violation Non-Jurisdiction Surv<ey5 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: V. t v'1 etkec vo ski -(7 �-�1✓e 00dive4A), \ J .11-4C gt4 2 Present were: \Z-J. \'Domino 1A. Goldsmith N. Krupski VC. Sanders Other Page 1 of'2 John M. Bredemeyer Ill, President og�FFOtkCo Town Hall Annex Michael J. Domino, Vice-President �o k Gy g 54375 Route 25 Glenn Goldsmith o u P.O. Box 1179 A. Nicholas Krupski o • 1. � Southold, NY 11971 Charles J. Sanders 4/ x� Telephone (631) 765-1892 • Fax fs‘).^;61vFax (631) 765-6641 1�: Erb BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Jeffrey Patanjo on behalf of DWYER/BARTH REVOCABLE FAMILY TRUST, c/o LAUREL PHELAN request a Wetland Permit to remove and replace in-place 63 linear feet of deteriorated bulkhead with new vinyl bulkhead, a 26 linear foot return, and a 33 linear foot return; and to raise the height an additional 18" from existing top cap elevation. Located: 2625 Bay Shore Road, Greenport. SCTM# 1000-53-4-21 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. S25% 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 Dwyer/Barth Revocable Fam Trust c/o Phelan 2625 Bay Shore Road,Greenport SCTM#: 1000-53-4-21 5/11/16 _ .. '1111°°"111116 4s At_ '''--: . .. ,.. .. .0 .' _., . .4... N , .., ,,,,.. _......... . I111 . _ _ - _ _ _ ...... , I 1 : ._-__-711'' ,F. .., dellik 111 Id r ,,,,,r • — .., 0-•-rm.. A t-.•-• _ -..."4".Q•ke...< ___-, -- • __ ..... _ _ Pill MI 4 4 ., . 4-...... P111.1111111 .- .- i.. . , , 11 -1 * . ..... . ..... , .... 1.. . ..... ----,- - . - _ •"4, - "... _. -vr,,,,! - . 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Box 1179 54375 State Route 25 % Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) A Telephone: 631 765-1938 Southold, NY 11971 ® e P COUNIOV,`•efi "d'9 i LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD • MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees re From: Mark Terry, Principal Planner LWRP Coordinator Date: May 12, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for DWYER/BARTH REVOCABLE FAMILY TRUST, do LAUREL PHELAN SCTM# 1000-53-4-21 Jeffrey Patanjo on behalf of DWYER/BARTH REVOCABLE FAMILY TRUST, do LAUREL PHELAN request a Wetland Permit to remove and replace in-place 63 linear feet of deteriorated bulkhead with new vinyl bulkhead, a 26 linear foot return, and a 33 linear foot return; and to raise the height an additional 18" from existing top cap elevation. Located: 2625 Bay Shore Road, Greenport. SCTM# 1000-53-4-21 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. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairman ti - Town Hall,53095 Main Rd. Lauren Standish,Secretaryv. rrr P.O.Box 1179 o `F y1� Southold,NY 11971 �b / Telephone(631)765-1889 ",�' Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., May 11, 2016 the following recommendation was made: Moved by Peter Meeker, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of DWYER/BARTH REVOCABLE FAMILY TRUST to remove and replace 63 If. of deteriorated bulkhead with new vinyl bulkhead and 26 If. return and 33 If. return in same location as existing and 18" raised height from existing top cap elevation. Located: 2625 Bay Shore Rd., Greenport. SCTM#53-4-21 Inspected by: Peter Meeker, Keith McCamy The CAC Supports the application with the Condition the non-turf buffer is increased to a minimum of 10'. The CAC questions the need for raising the elevation of the bulkhead 18". Vote of Council: Ayes: All Motion Carried re' S d6,'•S©U 1, Town Hall Annex John M.Bredemeyer III,President ;X 4 - _:-- 4;` c!r 54375 Main Road Michael J.Domino,Vice-President 1' - t-' [. � P.O.Box 1179 ' James F.King,Trustee k u Al, �1 ; ' Southold,New York 11971-0959 ' Dave Bergen,Trustee + -* ._,:: 4 % Telephone(631)765-1892 Charles J.Sanders,Trustee o*r` `---?"• Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit _ uAmendment/Transfer/Extesion Received Application: I r!ci! _ , - Received Fee:$ 250,OV I --;'•,--___________-___-__!...—.-_-.....7a . ,, ,t-z-: .,r ` , ., v7--Completed Application attic/t it, '.1 _.1 ° k, i _Incomplete-_ ;t 'a _SEQRA Classificati n: I 1 8 2016 H i.--- / . ,,____ Type I Type 11 Unlisted QPR Coordination:(date sent) ` �LWRP Consistency As$essme t Form `5'�`�� S��•tl�;;r Torn S 1_ ICAC Referral Sent: r 27.1 i 3. ;;a{,-. a_� s if Date of Inspection: .ie//(/ I' _Receipt of CAC Report: _Lead Agency Determination: - i Technical Review: - Public Hearing Held: 5,/8‘,/ Resolution: Name of Applicant 2) e2 / 8*rf-h Qa.,oe..abi, .E.,„, rr.si % tavrel -PIe(4i Mailing Address Il 14.e . tone- kiwa-hilto„r Ny 117'13 , Phone Number:( ) `3/' 10.5- -' 3a'" Suffolk County Tax Map Number: 1000 - 53 H -a I Property Location: a b .S {3a,..1 S hart. R-A - 6.aers.poa--1- See 1-5 € 1..moa41•.7 i✓+ (provide LILCO Pole#, distance to cross streets, and location) , AGENT: 3-eF•rr c,/ R -ea nj a (If applicable) Address: l °6 liewi-t'f (11,cQ . f ah l e r orta4-c 5, ,J9 t I?34/ Phone: 631 4 $1.4339- ,,,r 0‘, ,,Toilif, A,1 r- Bodru of Trustees Application GENERAL DATA Land Area(in square feet): 45,b 21 Area Zoning:' 1'Le 5 Previous use of property: 2.c sed eA+1.-C Intended use of property: -2e schen+,w l Covenants and Restrictions on property? Yes xl No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _ Yes >e No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals'? Yes X No L G- If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes x No Does the structure(s)on property have a valid Certificate of Occupancy? >r Yes No - Prior permits/approvals for site improvements: Agency Date 5( No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? Y No Yes , If yes,provide explanation: Project Description(use attachments if necessary): gem o ve art rc O(ft c '6.3 f- ® - dee ft.(4-1712 t-ew vL it <4.6Q. cui d 26 L4 i 4,.,vt, a eta 3 3 2.F re.r z,,A0 1N $.cmc. IDcal/O4S " $ 4frxesiv.7 Q4a /g '` /lq is<442 he ,Irt- frillmac/ST/d/ 1-4, 4#4, e(e -1/4'07 • u1 I I Boar_. Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Peirv®ue toihte c0 ae i3 e f rF de-eerevr§+.4 6„cicti ow wt-j-h ,VCA.' vc� ,L 00(Zite4,02, Arl Z6 L# 44-44-ret 4P 33L4- re-tur,,, 'IA Somme L.0'44'1044 ' S eXeS71 riy 46042 104' ra )�� ?leiyh+ F/sit .e Lr/ar --1-6/eaI° eleudefied, Area of wetlands on lot: square feet Percent coverage of lot: k Closest distance between nearest existing structure and upland edge of wetlands: - x.14, feet Closest distance between nearest proposed structure and upland edge of wetlands: ,v (r feet 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? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect,if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): -7-Acre. c..c 11 ye no roe,4-41 G c 4- 4,4 z..c 1-4 a e04 due -Co Pr^O,eCA . P'si hVe eoCv4- r5 red,-ci n7 Selel watr 1 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 information currently available If additional research or investigation woula be needed to fully respond to any item,please answer as thoroughly as possible based on current.informationv Complete all items in Part 1. You may also provide any additional information winch 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: 2 6 2 f 66.-k S h o n e 12-oL 6,C.tGt, Project Location(describe,and attach a location map): See t.e4 4Gm7 64) Brief Description of Proposed Action: 2emo,x Gnd2 fcplue.e to LP /PP 4-ii& ' c. re 44 k 33 t^f- re4‘,to I n Sant- lee4-t!ioS a$ its-rin7 ‘..ti C— A0.02 rettscd2 1, ecyhf oe- /$ ,r lave P-.xcsfin9 Name of Applicant or Sponsor: / Telephone: G l _1 3 v r)w1o.ClB�r¢� dwee dole ,44,111 7447 % Lavtey ���kn Eillad. imr•®ill d hoTmA,!•�+,,, Address 1 7 -Theh... LAne City/PO 1 State Zip Code. rlv,i-F7n7'vn 1 // y 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? _f _ If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ✓ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2 Does the proposed action require a permit,approval or funding from any other governmental Agency° NO YES If Yes,list agency(s)name and permit or approval' Er T9;,, m $ h4,1 dl- s-t t-eS I 3 a Total acreage of the site of the proposed action° D. I e 7 acres b. Total acreage to be physically disturbed° p, 0 3i, acres c Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor' 0.117 acres =' Check all land uses that occur on,adjoining and near the proposed action [Urban ❑Rural (non-agriculture) [Industrial ❑CommercialRestdentia:(suburban) EForest DAgncult'ire ❑Aguatic ❑Other ispectfv-) ❑Park'a id Page 1 of 3 5. Is the proposed action, NO YES I NIA 1 a A pemlitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? n , E _. 6 Is the proposed action consistent with the predominant character of the existing built or natural I NO YES landscape? n ✓� 7 Is the site of the proposed action located in,or does it adjoin,a state listed Cntical Enyi:onmental Area9 NO YES If Yes,identify Name Peconic Bay and Environs.Reason Protect public hearth water vegetation.&scenic beauty. (� Agency.Sunotic County,Date (-12-88 I ; ® 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? r i ❑ Imo. c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? E 2 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. C C 10 Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water C El 11 Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: C 12. a.Does the site contain a structure that is listed on either the State or NationalRegister of Historic NO YES Places? - El El 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') n El b. Would the proposed action physically alter,or encroach into,any existing wetland of waterbody? Er- 0 If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: i- 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 DEarly mid-successional ❑ Wetland ❑Urban 0 Suburban 15 Does the site of the proposed action contain any species of animal,or associated habitats,listed NO I YES by the State or Federal government as threatened or endangered? a ! C 16.Is the project site located in the 100 year flood plain? NO`� YES I l ✓ 17 Will the proposed action create storm water discharge,either from point or nor.-point sources? NO YES If Yes; ✓ E a Will stoma water discharges flow to adjacentpropenies? ❑NU EYF,S 1 I b Will stonTr water discharge,'be directed to establisned con eyance systems li toff and storm drains)? if'1'es, briefly describe. ENO EYES I Page 2 of 3 I IS lioes the proposed action include construction or other activities that result in the impoundment of NO i YES i ; ;:Q;a or other hnttids(e 7 retention pone waste lagoon, on:)? ; I If Yes,explain purpose and size. , _._.. 19 1las 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: BI 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: 11-71 am L__ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor ijar:e: L AI..(CI_ 11 elan Dale 0/3' /, ' "Fr aSi azure' :ter -e,.., 7-'ice.-cam. • PRINT FORM Page 3 of 3 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: I9. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the L 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: 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 No,or Moderate small to large impact impact may may occur occur 10 Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. i7(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 environment impacts. Town of Southold-Board of Trustees :;'7 J6 . N9me of Lead Ag ncy Date .._)/..9)1 J (6, � � �,P /` President Print or Ty,,re Name of Res nsibl Officer in Lead Agency Title of Responsible Officer . ure of Res o si le fficer i Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 .‘- U.S. Postal ServiceTM U.S. Postal ServiceTM I I CERTIFIED MAID® RECEIPT , ( CERTIFIEDMAI�° RECEIPT ,a Domestic Mail Only I w Domestic Mail Only ,a For delivery information,visit our website,at www uses.corne rl For delivery information,visit our website at www:usps.corn® E 0 T 'NY '1}J4; :\. `t�'-r (' LnDi MASH"t Nr. 13� :\ ' [19c,..-,, `E l 'i t rs 1'"' t' '�J •f 934 Certified Mail Fee 0934 Ill Certified Mail Fee r t{13.30 Er $3.3�� �+ Ir $ p" $ `�`' c 6 O Extra Services&Fees(check box,add fee $p ate)w - - 06 im Extra Services&Fees(check box,addfee a 7 q W Rrj 0 Return Receipt(hardcopy) $ � '• V� `.,T� Return Receipt(hardcopy) $ �lpk 0 cl ❑Return Receipt(electronic) -- $ i I I ,`® POsi ark ; I ❑Return Receipt(electronic) - $ `,1 1 oytmark i f] ❑Certified Mail Restricted Delivery $ ,I t I.1 :-re I C ❑Certified Mall Restncted Delivery $ I '1 1 - !'Hp)e y �Y `_ ;t7 0 Adult Signature Required $ ; •re t I= 0Adult Signature Required $ ■ ` _J r '� I O 0 Adult Signature Restricted Delivery$ -i A- I ❑Adult Signature Restricted Delivery$ 'i �(r`' Postage '`e,' �� I Postage $0.47 �� LAI C7 $4.47 $ Fees 0 /i 0/201 d Total Postage and X3.77 Vc 05/10/1016 rp Total Postage and$3.77 ra $ I Sent To i Sent To (MCO a ..r in ci Street and Apt No,orPO I 1 I, Street and Apt No r OBoXfilo' r',Di 17 CD5d N - i r- Ci ,ZIP+4�jt y 1 i n City,State,ZI13+4® --e fl(l/ ff City,State /f[ 'PI /V - '3800,A•ri120 , - N. r-r .r•r-•r" S••R-v- -f• I t r t PS Form 31300,April 2015 PSN�sso.oz'000-goal See Reverse for Instructions _ I PS F. 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City, ��530-oz-000-soar See Reverse for Instructions' J PS�Form'38OO April Li., sao 02 WO ' See Reverse'for Instructions } PS Form 3800.4111 2015 -- -- I PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: VU -61A5 T* 1-7729 ¶rt Low , b MIS 20 I �U�od -Jh 2-575 13951rmyt Pd . G-.eerio-A-5t/usevizA 6/I )7 lord L, niaTei Ivy 1 (378 -room off'jiyAhcAd Cxa) 5boc 5 po 80x I(7Oi Sida' Ji97) 7015 1660 0000 0995 0188 7015 1660 0000 0995 0171 7015 1660 0000 0995 0164 i ' 7015 1660 0000 0995 0201 STATE OF NEW YORK COUNTY OF SUFFOLK g J P wl 0 , residing at INP(9 AeW i 2 VIvcf . rim IN 1 1 1N , being duly sworn, deposes and says that on the 10 day of Mel,(/ , 20/(1), 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 (-coy-IY)DY1( Pj , that said Not -s we e mailed to ch of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this ID Day of 20 _ Loriann Patanlo • Notary Public State of New York Qualified in Suffolk County +� a No:01 PA6150861 u�t, �0 No: Expires 08/07/20 Notary Public SUfFO/� Town Hall Annex John M. Bredemeyer Ill, President �o�a wµ Coi"� Michael J. Domino, Vice-President �� yam' , 54375 Route 25 Glenn Goldsmith ti P.O. Box 1179 A Nicholas Krupski o Southold, NY 11971 Charles J. Sanders 1,7/iv 44/ 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 DWYER/BARTH REVOCABLE FAMILY TRUST, c/o LAUREL PHELAN COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, cirffreild Pa17/01:50,residing at/dba DIP t1GW Can it ch4 being duly sworn, depose and say: That on the '1 day of W.Q , 20l(P, I personally posted the property known as t 2504.4 G111--PA• by placing the Board of official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,May 18, 2016. Dated: 2 -''6(A-7 (sig ture) Sworn to before me this 1 Loriann Patanjp day of 20 l(D Notary.Public State of New York Qualified in Suffolk County No:01PA6150861 URQ -U Commission Expires 08/07/20 to Notary Public May 11, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 2625 BAY SHORE RD. -GREENPORT SCTM No. 1000-53-4-21 AFFIDAVITS Dear Trustees: Attached please find original affidavits 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, r Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 NUTILL th- HLARING 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: DWYER/BARTH REVOCABLE FAMILY TRUST, c/o LAUREL PHELAN SUBJECT OF PUBLIC HEARING : For a Wetland Permit to remove and replace in-place 63 linear feet of deteriorated bulkhead with new vinyl bulkhead, a 26 linear foot return, and a 33 linear foot return; and to raise the height an additional 18" from existing top cap elevation. Located: 2625 Bay Shore Road, Greenport. SCTM# 1000-53-4-21 TIME & DATE OF PUBLIC HEARING : Wednesday, May 18, 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 Boar if -Trustees, Application County of Suffolk State of New York P(7,eleip1 '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 F' . PREMISES IN CONJUNCTION WITH-REVIEW OF THIS APPLICATION. F Signature oTProperty Owner SWORN TO BEFORE ME THIS J Lesdayl3DAY OF -)c \ ` ,201 k Ns�PUbiee�)vt.tS aV N W"York Pio.,®ipAstsao2t ly lnittistau County �C`or�nris© E�rpftss March 19,2,0 Notary Public Boar e E Trustees Appiicition , AUTHORIZATION (where the applicant is.notsthe,owner) 1, 4 vee 1- P64 14in residing at r 1 (print owner of property) (mailing address) /44 740,1/ AIL( ti 3 do hereby authOrize 0;Cie-ei (Agent) to apply for permit(s)from,the Southold Board of Town Trustees on my behalf. ,11# signate) 5, 5, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM he Town of Sou mid'sC•deofEthic trehibiscoaflicts• iner•st'i th--- ,'•nftoiv ;flico a •e '10 ees.The u ,die of this form is to provide-inforirintion which can a1crt.-the town o'fpossible confiiets of interest and allow•itto takewhatever action is ,this to avoid same, - YOUR NAME: P`telaoa , hei.o.re.C- - . , ' (Last name,first name,ipiddle initial,unless you are applying in ihe name of someone else or other entity,such as a company.If so,indicate_thcother person's or company's name.) j NAME OF APPLICATION: (Check all that apply.) Tax grievance Building- , Variance Trustee - ?' _ ' Change of Zone Coastal Erosion Approval of plat Mooring ! Exemption from plat or official map - Planning - • ' • Other ; (If"Other",name the activity.) ' • ' Do you personally(or through your company,spouse,"sibling,parent,or child)have a relationship.with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,,or business ihtcrest."•13us'mcss interest"means's business, t including a partnership,in which the town officer or employee has even a partlel"ownctsl�ip of(or•emoloyment by)a corporation g= ." in which the town officer or employee owns more than 5%of the shares: ' - -- • • .' YES NO ; If you answered"YES",complete the balance of this form and date and sign where indicated, . Name of person employed by the Town of Southold z Title or position of that person ,,r • Describe the relationship between,yourself(thaapplicant/agent/repiesentative)and the town officer or employee.Either check • the appropriate line A)through D)and/or describe in the space prodided. The town officer or employee or his or her spouse,sibling,parent,or"child is(check all that apply): i A)the owner of greater than 5%of the shares of the corporate stock of the applicant , (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the • • applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 4.5 day of ;J,�� 200 o� „„. Signature w ..,,,c,,,,,,,..„,......'.......-MES. -' " Print lame 6atvo�C P6�1 -(A y Form TS 1 SUfPq • ‘.1'Ddu Tów !.' 4j''f, .cstkh.�1d1 Erosion, ;;eldicrtventatiO $',St „ on arrt�=V{late�`Ru ®o'f�f�►SSESSIUI�NT FORM � __,��.. ,, PROPERTY LOCATION: s.arlN.#:" , , THE,FOLLOWING,ACTIONS-MAY REQUIRE THE SUBINISSION OF A 0�„'?%17,-1,° /vct9 S3 Li , 2I . ,'STORM•WATER;GRADING,DRAINAGE AND EROSION.CONTROL PLAN 7151EMT oc on crck7 'Tor—=- CERTIFIED BY A:DESIGN PROFESSIONAL IN THE STATE OF NEW YORK, SCOPE OF WORK - PROPOSED CONSTRUCTION I I'I'I`#,/'WOltIC ASSESSMENT- 1 Yes No , a. What is the Total Area of the Project Parcels? ” (Include Total Area of all Parcels located within '�-„Will this Project,Retain All Storm-Water Run-Off , the Scope of Work for Proposed Construction) V.1, ®'19 Generated bye Two,(2')Inch Rainfall on Site? b. What Is the Total Area of Land Clearing (S, ,Acres)` -'(Thls Item1will include all run-off created by site clearing and/orcenstrucdon activities aswell as all - and/or Ground DistUrbance for the proposed • construction activity? Jb®al'1�,;,off(? Site Improvements and the permanent creation of (3.1;7Adr;)- - impervieu`s'surfaces.) PROVIDE BRIEF PROJECT DESCRIPTION (ProvldaAdd(donelPagosesNeaded)' 2 .Does'the:Site-P)an'and/or Survey Show All Proposed ;- Dralnage_Structures'Indicating Size&Location?This ,Item shall'inctudeall Proposed Grade Changes and •L -- a-P+wnt use .4a r2 1 iia i`ee€ to 3 LC €0,GSlopes Controliing'Surface Water Flow, 3 boas the,Site'Plan and/or Survey describe the erosion '5dn, h ems,01-' a n 62 2 Co L f f 7 3`F, , and sedi'nient'Control praslices that viIll be used to K control site erosion and'storm water discharges, This ./24-41.1,1, .1-F 54,44.a t mt.:.0• .e®did item must be maintained throughout the Entire Construction Period . . A S /S ti#7 rA I$ " Im 1.5.e4-Will this Project Require any Land Filling,Grading or • A eel hf �� Gt Excavation,where there is a change to the Natural . i Existing Grade;lndolving more than 200 Cubic Yards ' • - of Material.with•in any Parcel? x a ' Will this Application Require Land Disturbing Activities i v': Encompassing an Area in Excess of Rim Thousand 74 i -' (5,000 S;F.)Square Feet of Ground Surface? • • 6 is there-a Natural Water Course Running through the - Site?`'Mills Project within the Trustees jurisdiction General DEC SWPPP Requtrements: arwithIn.One 1-tundred(100')feet of a Welland or fl - Submission of a SWPPP Is required for all Construction activities involving soil . Beach? r' disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land;` ' including Construction activities involving soil disturbances of less then one(1)acre where, which onExdr ed 10 ')Fifteen(1 o}feel of Vertical Rise to the DEC has determined that a SPDES permit is required forstor m water discharges. One Hundred'(100')of Horizontal Distance? 0_ .,t_ ._,,, (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking'Areas or other impervious far Storm Water Discharges from Construction aolivity-Permit No.GP-0.10.001) Surfaces be Sloped to Direct Storm-Water Run-Off ® X' i 1.The SWPPP shell be prepared prior to the submittal of the NOI.The NOI shell be submitted to the Department prior to the commencement of construction activity, Into and/or in that direction of a Town right-of-way? 2.The SWPPP shell describe the erosion and sediment control practices and where 9 Wiitthis Project Require the Placement of Material, required,post-construction storm water management practices that wilt be used and/or - Removal of Vegetation and/or the Construction of any ),( constructed to reduce the pollutants in storm water discharges and to assure - Item-Within the Tenn Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit.In addition,the SWPPP shall Identify potential sources of pollution which may reasonably be expected to affect the Area??This Item will HOT Include the Installation of Driveway Aprons.) quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3.All SWPPPs that require the posl-construcllon storm water management practice to a Bou and the construction site disturbance is between 6,0003.p.&I Awe Mares, 1 component shell be prepared bye qualified Design Professional Licensed In New York a 3lonmweter,•Greding,Submitted 8 Erosion Control Plan le Required by tho Town that is knowledgeable In the principles and practices of Storm Water Management. (NOTE: Southold and Must be)and/ofor Review Prior to Issuance of Any Buildingto Permit. (NOTE:' ACheckMark,(d)and/or Answer for each Question is Required for rlCOmpleleApplication) STATE OF NEW YORK. ' NICOt:'D.:A 'b E ,,. COUNTY OF, S ra CA-� SSi 'Wiry Pybiic,-5tnttd of New YeAry - ' - No,01 PA6163021 That I, L di w re-(, Ph-eI n Quefiff d rn> as a ons (Name of individual signing Document} being duly sworn l S�i ( �� apOjicant for' Permit, And that he/she is the ®e69av Cf (Owner,Contractor,'Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is.duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are tete to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application ftled herewith. Sworn to before me this; + , ./c.0 day of.., ., r// ,20,/40' ' � ~ _ Notary Public: ,. ....a �,... � fr , ... - tr dti v e (Signature of Appllpnl) a FORM - 06/10 r NieOt:E D-PAf DES, • Notary Pubtta,State of N.&York No.,O1 RA6163021 -Qualified-inhNUesau County Commission Expires March19,20 =11 r Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its significant beneficial and adverse effects upon the coastal.area(which'includes all Of Southold Town). 3: If any question in Section C on this form is answered "yes"or"no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each:answer must t,be.explained in_detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# S 3 - - 2./ PROJECT NAME -2 "a taA-1 Sl+ore rR — evrie4e 'fl The Application has been submitted to(check appropriate response): Town_Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Es-- 1. 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: (2i, c,u€ ani rePl4ce (,3 t,.F f eft4ceiorated2 �„LlG1e��¢ wlfh ncru ait,vti(, ✓L ie4,.& An62- 6,Lf. ret'rvt 4KB 3) t F re,4%,I Yn $g.o <. LOe44104 $ 0. 5 -roe si- ny '►✓!i ISt`2vJse‘e Ae►'h r ,Fromex6 S17n/ Location of action: 2 6 2 5 01....1S 1►.r c . - 6 r-e e n p a r'f Site acreage: ® . 117 Present land use: R cs idt eA-6 at.C Present zoning classification: 12 e s;d e,,+ I. 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: Ow yet1 Iawrtf+ (14,AAvedalt 44,1 y % 14„t cL P (b) Mailing address: 17 1-6<a. l-ne- ,LL,, f��t fi®, m dv'? 11 7y4 (c) Telephone number:Area Code( ) 31.30--9 3° • (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? - Yes No❑ If yes,which state or federal agency? /'' 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 n No ❑ Not Applicable Pr,je .Cn hmekGts Lo,nm..n.f,? C 144«ae+-s/ b� w o f- Pro via 1 a p.c4,4,1 a .srrc.12, I .j headZ .ra2 4.4j41e-rtf Pr®fier . Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Fe' Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria rx Yes ❑ No ❑ Not Applicable er l ee4 Peyua de s sea •-• eQ c®a 5!5-fe41-f «.t-tit -eke- t-.,cam.-t 49414,ven-ey • • Attach additional sheets if necessary NATURAL COAST POLICIES F Policy 4. Minimize ioss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable . E .Prcjec¢ Prvtec-tS 4,5 til n s-e t . Pr et- due -o erresc") • 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 Yes ❑ No ❑Not Applicable Prejac-f Prottee&s 4.3 ad lSt- jeaPim -I.4.tc e . • Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ Yes No Not 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. n Yes n No k Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ No KNot Applicable J PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ YeI No[Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies;Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No [E Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No Not Applicable • /- Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ Nol-q Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No C Not Applicable PREPARED BY J . Pe '1—�.�J a TITLE Ai t'a-r DATE it•I i•i' April 15, 2016 Town of Southold Trustees r,; Town Hall Annex Building x-- 54375 Rte. 25 P.O. Box 1179 APR 1 8 2016 `` r Southold, New York 11971 i j E � RE: 2625 BAY SHORE RD. -GREENPORT Sct,thcld Town SCTM No. 1000-53-4-21 APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934