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TR-9024
1 Michael J.Domino,President SO Town Hall Annex John M.Bredemeyer III,Vice-President ~ 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �� Telephone (631) 765-1892 Greg Williams ��ycoUNT`I,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 15, 2018 Michael Kimack P.O. Box 1047 Southold, NY 11971 RE: KATHY HALBREICH 5100 SKUNK LANE, CUTCHOGUE SCTM# 1000-138-2-12 Dear Mr. Kimack: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, August 15, 2018: WHEREAS, Michael Kimack, on behalf of KATHY HALBREICH applied to the Southold Town Trustees for an Amendment to Wetland Permit #9024 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated June 21, 2018, 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 to be Consistent with the Local Waterfront Revitalization Program policy standards, 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, 2 RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit#9024 to modify the proposed dock to be the following: remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 4'0"x5'6" walkway to a 4'0"x12'0" fixed dock with eight (8) 4"x4" pilings (walkway 22sq.ft. and fixed dock 48sq.ft.); decking shall be Thru-Flow for both walkway and fixed dock; and structure to be installed one (1) foot further seaward than originally approved; and as depicted on the site plan prepared by M.A. Kimack, dated May 24, 2018, and stamped approved on August 15, 2018. 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 This is not a determination from any other agency. Sincerely,. f1 Michael J. Domino, President Board of Trustees MJD/dd Michael J. Domino, Pref o�QSVFFf1C�'�,o0 Town Hall Annex John M. Bredemeyer II1,Vice-r--es"ident �� �� 54375 Route 25 Glenn Goldsmith CD y z P.O.Box 1179 A.Nicholas Krupski 0 Southold,NY 11971 Greg Williams 4,1 p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:--A/-) Ll"b Completed in field by: Michael Kimack on behalf of KATHY HALBREICH requests an Amendment to Wetland Permit#9024 to modify the proposed dock to be the following: remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 4'0"x5'6" walkway to a 4'0"x12'0" fixed dock with eight (8) 4"x4" pilings (walkway 22sq.ft. and fixed dock 48sq.ft.); decking shall be Thru-Flow for both walkway and fixed dock; and structure to be installed one (1) foot further seaward than originally approved. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 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 Noticeof Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Jac,/-J- L'?f�"'j4 G' I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: v/ ,J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other yawiy�Fsmtrrf/uty j i CV L' JUN z 1 2018 Southold Town Board of Truster .1 _ 'KATKY HALBREICH :^�-- — – 4ess Skunk Lane, CLtchogue, N.Y. 1193 : '` r � :.:� °,� � ' `� -;•�� Baa-iG'�� - =�' - PROPOSED DECK AND WALKWAY I "WOVE EXISTING DECK AND PIUNGS ANY 91 C, ` �`� � - 1A0 .-_ - �N• ARRC3VEDAS�PER+TERMS Represented by Michael A. Kimack AND CONDITIONS OF �y J i Date: October 27,2017 APPR0_, ER:�Y I E IMIT NO CERTIFICATION =tUS_T �E Hereby-certify that this is a true copy of a portion _� 4 TOWN-OF, ti 1 1�7 L.td Of this property by Kohn C.Ehlers,Land Surveyor _ - 1. `-.+.%..,_.. ... .�`i----_ f :t _, ,• i "� Z" ` , -- -,"'{/",... a 1• R Dated May 6,2016.No details or features which DATE.. •`'~ r. _ .t` ; 7- _ Would bear upon this application have been Omitted. a ; �: y: .�►: 1'= r� _ + r`c SEs' .� - _ ' 4V�) _ -.:.:,�__ �_ - _ - - •>,�_ :�^,f, i ,�`,- . . , - -��`. •1• .,11i��.. -��,�-. �I1,�R�'!S - Aae�A.ffi'aW4ack,Agent,Oen.27,2$17 " ;. �• �'+;,! - xT�4.'4 N. _- � r .x+. -, � -mac.^lrri'-' + ` = _ .- ._ � - �- f ' ;- .'�' Kik. �a '.�ii:'+«:-•_ SY ,�, — - - Chl 110 •;t'r'i`.r=�?.yY�' _7 Ire: _„,:, ClS77NG aw AA -TSO 4 '* - . f' - _ • 0. j70,41 W�[AND Glv,E / I/ 41-0 � I II � n �� i ;L Irv! 3a 5CAc#: ! 3�r. ( � JUN 21 2018 I S,,,u,,hoId To,,-;n Board of Tfn:tees y NYSDEC APPROVED AS PER TERMS AND CONDITIONS OF3 PERMIT NO. f✓ 3 �� DAT 136 r- ret! W� &Z Sr ,FILSC�ws le) Cel 77C, • _--�s�n v� OEC.�l1l�C� TZAI CAL 2,59K/jdeAL kWA y I i N 5 U RVEY Of LOT 1035* P/O LOT5 1045 105 A5 5HOWN ON A CERTAIN 5UBDIV15ION MAP ENTITLED"MAP OF NA55AU FARM5 FILED IN THE OFFICE OF THE CLERK OF THE COUNTY OF SUFFOLK ON MARCH 28, 1935 A5 MAP NO. 1 179 51TUATF : CUTCHOGUE e W E TOWN : 5O UTH O LD � 5UFFOLK COUNTY, NY ' 5URVEYED 05-09-2016 TREE ROAD S 5UFFOLK COUNTY TAX # PIE awialt roadway 1000 — 138 - 2 — 3.6 P>E otJTIL. DRIVEW_AY " . .. . . .. ....... - IL. EOG CERTIFIED T0: ' 250.00'` N805814011E ru , KATHY HALBREICH •. ABSTRACTS. INCORPORATED ' `r'X12.4' !-..._. FIRST AMERICAN TITLE INSURANCE COMPANY i (0 - CITIBANK N.A. 0 �k.� HEDGE 24FRAME N I" N GARAGE O o m O ti� 36.3' ----------------- I i AC -- -- 9 ------------ ` 26.5❑ ------- N 1pL ILI I p ry2AME JUN 1 201$ FRAM JUN DECK LOT 103 — — — p 32-C I - - s Cot,c. 12.3' — — -- — 0 LOT 104 _ Q I- - - --- _ -- - - 6 P/ O r� + I� 6 _ 1 O W m f CEDAR TR.EE5 / HED 0 ._- 180.0 � / 58058140"W o�- - ' O P/O PLOT 124 �j P/O LOT 104 P/O LOT 104 O P/0 LOT 105 0 _ 0 p 0 _ 0 b a iL ,./ LL CV . Z � 58GO5814011E 717 G5 .00 D LOT 106 PARCEL 2 0�/ C1�� ' SUFFOLK COUNTY TAX# (n�i 7C 1000 - 138 - 2 - 12 ry LAN N�oo Ef fI pNp yptOD yn51yo°uA1 X zZrn Z TOWN Ot N82°�SOW° 0uf 7743'41"Ei � 3' ° o O ° z o `Tory3C o� 2°00, `o,a 000 0' 30,,4(;' OO8 rCIoNND xpiON30.4G — �MNIrnCrn _70 I rOI w ynLUAM 7 AREA=822 5q. Ft. AREA=631 5q. Ft. ARI!A=0.018 Acres AREA=0.014 Acres I FLOOD ZONE ANNOTATED FROM FEMA F.I.R.M MAP NO. 36 1 0300 1 6411 "Unauthorized alteration or addition to o survey i map bearing a licensed land surveyors seal is o NOTED: violation of section 7209, sub—division 2, of the PIPE FOUND JOHN C. E H LE R5 LAND 5 U RV EYO R 0� �� New'York State Education law." a--.,3_ 5TOCKADE FENCE �� C � � "Only copies from the origind of this survey A marked with an original of the land surveyor's SPLIT RAIL FENCE �s O�N N�,p stamped seal shall be considered to be valid true N copies" 6 EA5T MAIN 5TREET N.Y.5. LIC. NO. 50202 'Certifications indicated hereon signify that this survey was prepared in accordance with the',ex— isting Code of Practice for Land Surveys adopted Area = 33,900 5q. Ft. RIVERHEAD, N.Y. 1 1901 369-8288 Fax 369-8287 - Q by the New York State Association of Professional i '� �� �� Land Surveyors. Said certifications shall run only Area = 0.7782 AereS 2sF 5�2� �� to the person for whom the survey is prepared, GRAPHIC SCALE 1 s= 30' ��ANQ s and on his behalf to the title company, hereon,tal agency and lending institution listed hereon, and to the assignees of the lending institution. Certifica— tions are not transferable to additional institutions 16-147 i i I 1 - r PSI Kathy HalbTeich SCTM#: 1000-138-2-12 1/7/18 _ _ - � - � �= _•�!`-•ice� ' v ��,.��� ..r�� 0 � _ • — I 1 11% J•i w - '�� of �� v'. ,'. ^ \.-1 �.D 11 _' /`� r� !: ,/ .--rr "� `�. � r �'���\',�w�7b �s ��� {�•:��.t,�/e�'.� J. �,-iiV� F y '�f •t ��� ��t��� � r� - 1`2, `��- 1 _ YiX�,F%Y p% \i ,4 . .! �y y fr• �lf�x a���1��,�✓/ llFe� .�` �.' C 'i/ r6 ':T E. �� �.*r J1 .,+�/ !., � r �� r,� !I^ \s',�' 1,�-� �� , ',� •1I ,� r:w,� i. �l8 / 7 /2 0+18 �/ ' 'S 'i 9 .,-- , r -- Kathy Halbreich 5 100 Skunk Lane,Cutchogue ♦ 111 -138-2-12 r _ R r 7 � rr _ � �` I ��/ 7� � /', I, f / , s y �>�l ,l 1r'� � i• ��. r �f; .�.P'�k��. A i�1�i I t �' �,�ll x !r! r���ti'� �� ' j �,1�, r �� �� �, 1 i;' �,X 5,� �+`'.' ♦•. n a !'. � f� _ lyJ fifi .amu ,. - � ., �►�� ?�� :� �L a � / `!,,` �.x �Ti� � °'vn''�`y� � i :, jo V. ,. .� � � - - � ',1 T f"� 1,/ `R� �IM�,t' �t kr � 7� 4•��:�+ a ~i�.'' f �� 1 ,s: � i! i/ �+" I � nt, i`�/J � rSl, I �I� 91 ��It y ti�- :,•/�. t� _ -.>, - Y W�,. T " - Aw 46 —1000 .O�"lejr,�r�.C4�=y�..,� at3p.. ipO�, /\ •.,, , sem;` ' _ - .. �_ - �// �., 4V,"�:., ` '' i {. Lei�!��'� ,"�,{sy, � - sem• �< �'_�" ` �-- - ''f• - r �•-r!rwt'.At .tFY�,�'_'�.=.i- lipw (3)Halbreich dock Taken March 27,2017 looking NNW f , � 1 1 FFEt f i / k � � •�; _ yam`' (4)Halbreich dock s Taken March 27,2017 Looking North Ask NEW YORK STATE DEPX• -TENT OF ENVIRONMENTAL CONSER'. 'ION Facility DEC ID 1-4738-04531 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: Facility: KATHY HALBREICH HALBREICH PROPERTY 28 E 4TH ST 4995 SKUNK LNISCTM 1000-138,-2-3.6 & 12 NEW YORK,NY 10003 CUTCHOGUE,NY 11935 Facility Application Contact: MICHAEL A KIMACK PO BOX 1047 SOUTHOLD,NY 11971-1047 (516) 658-6807 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 713.522 NYTM-N: 4543.693 Latitude: 41°00'59.3" Longitude: 72°27'38.3" Authorized Activity: Remove existing 5' 5" x 6' fixed deck platform and two outer pilings. Insta114' x 12' fixed open grate dock and Tx 5' 6" fixed open grate ramp (in "L" formation) and eight pilings. All authorized activities must be in`strict conformance with the attached plans stamped NYSDEC_ approved on 6/5/18. Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-04531/00001 New Permit Effective Date: 6/5/2018 Expiration Date: 6/4/2023 Water Quality Certification -Under Section 401 - Clean Water Act Permit ID 1-4738-04531/00002 New Permit Effective Date: 6/5/2018 Expiration Date: 6/4/2023 Page 1 of 7 NEW YORK STATE DEPA' _ _'[ENT OF ENVIRONMENTAL CONSER`- ION � Facility DEC ID 1-4738-04531 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator:LAURA J SCOVAZZO, Deputy Regional Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,N 1790 -340 Authorized Signature: Date Distribution List ' MICHAEL A KIMACK Marine Habitat Protection LAURA J SCOVAZZO Permit Components " NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to�the Following Permits: TIDAL WETLANDS; WATER QUALITY CERTIFICATION 1. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 2. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and retum,the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 3. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. Page 2 of 7 Imbue NEW YORK STATE DEPAI. dENT OF ENVIRONMENTAL CONSER1.,__ TON Facility DEC ID 1-4738-04531 4. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 5. Storage of Equipment, Materials The storage of construction equipment and materials shall be confined within the project work area and/or upland areas greater than 75 linear feet from the tidal wetland boundary. 6. Dock, Catwalk Size Dock or catwalk shall-not exceed 4 feet in width and shall be a minimum of 4 feet above grade (as measured from.ground to bottom of dock/catwalk decking) over tidal wetland areas. 7. Wood Preservatives a. Pressure treated wood used for construction of in-water structures must have undergone a treatment process approved (stamped or otherwise marked as certified) by the American Wood Preservative Association. b. Wood treated with Pentachlorophenol (PCP) must not be used in marine or brackish waters. Wood treated with PCP must be aged in the open air for at least three months prior to in-water use., c. The use of creosote treated wood is prohibited both in the water and upland areas. d. Chromated Copper Arsenate (CCA)pressure treated wood must be clean and free of CCA surface deposits. Wood with surface deposits must be washed for at least 5 minutes under running water prior to use. The washing must occur greater than 100,feet landward of any regulated wetland and/or water body. (Note "E."-below for handling wash water.) e. Any wood debris such as sawdust or wash water must not enter any water body, including wetlands or protected buffer areas. ; 8. Catwalk Decking The decking of the catwalk shall be constructed of NYSDEC-approved fiberglass grating to reduce shading impacts from the approved structure. 9. No Floats This permit does not authorize the installation of floats. 10. Use of Structure The authorized structure is provided for access to the waterway and is not intended for the mooring or launching of vessels. Prop dredging, resulting from motorized vessels intentionally powering in shallow waters, is a regulated activity and is not authorized by this permit. 11. No Dredging or Excavation No dredging, excavating or other alteration of shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 12. No Permanent Structures on Dock No permanent structures shall be installed on dock/catwalk/float without first obtaining written Department approval (permit, modification, or amendment). Page 3 of 7 v NEW YORK STATE DEPAb.__,'[ENT OF ENVIRONMENTAL CONSERI,__ ;ION Facility DEC ID 1-4738-04531 13. Docks at Property Lines Docks/catwalks/floats must not: a. extend laterally beyond property lines, b. interfere with navigation, or c. interfere with other landowners riparian rights. 14. Pilings at Property Lines Pilings shall not: a. extend laterally beyond property lines, b. interfere with navigation, or c. interfere with other landowners riparian rights. 15. No Structures on Pilings No structures, other than structures specifically authorized by thin permit, shall be constructed on pilings without further authorization from the department(permit, modification or amendment). 16. Install,Maintain Erosion Controls Necessary erosion control measures, i.e., straw bales, silt fencing, etc., are to'be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and-is to be maintained in,good'and functional condition until thick vegetative cover is established. 17. Maintain Erosion Controls All erosion control devices shall be maintained in good and functional condition until the project has been completed and the area has been stabilized. 18. Responsibility It is the responsibility of the permittee to remedy any incidental disturbances resulting in damage to or removal of the-wetland vegetation. 19. Disturbed Areas Upon completion of construction activities, any disturbed areas shall be planted with the appropriate intertidal marsh vegetation. Any questions regarding appropriate plantings should be directed to the Bureau of Marine Habitat Protection at 631-444-Q295. 20. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered•by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. Page 4 of 7 NEW YORK STATE DEPA. TIENT OF ENVIRONMENTAL CONSER 'ION Facility DEC ID 1-4738-04531 21. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed,the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 22. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 23. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Michael A. Kimack, last revised 5/24/18, stamped NYSDEC approved 6/5/18 . 24. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS 1. Water Quality Certification The authorized project, as conditioned pursuant to the Certificate, complies with Section 301, 302, 303, 306, and 307 of the Federal Water Pollution Control Act, as amended and as implemented by the limitations, standards, and criteria'of state statutory and regulatory requirements set forth in 6 NYCRR Section 608.9(a). The authorized project, as conditioned, will also comply with applicable New York State water quality standards, including but not limited to effluent limitations, best usages and thermal discharge criteria, as applicable, as set forth in 6 NYCRR Parts 701, 702, 703, and 704. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. Page 5 of 7 Aft NEW YORK STATE DEPA_, -TIENT OF ENVIRONMENTAL CONSER 1 'ION om Facility DEC ID 1-4738-04531 A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands, Water Quality Certification. 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of'the'project as described'in the permit'application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the,commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. Page 6 of 7 v NEW YORK STATE DEPA'_• TIENT OF ENVIRONMENTAL CONSER', ,TON low Facility DEC ID 1-4738-04531 NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the,State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking,of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits,.actions, or'damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision. under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit._ Item D: No Right to Trespass or Interfere with Riparian Rights This'permit does not convey to the permittee any right to trespass upon the lands or interfere with the, riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Page 7 of 7 From: Aspell,Jennifer L(DEC) <Jennifer.Aspell@dec.ny.gov> Sent: Friday, May 4, 2018 10:42 AM To: mkimack2@verizon.net Cc: Scovazzo, Laura (DEC) <laura.scovazzo@dec.ny.gov> Subject: RE: 1-4738-04531/00001 : Halbreich Property Hello Mike, For these plans I would have a couple of comments: 1. What is the justification for the dock in this configuration?Typically we do not permit docks to go parallel to the bulkhead because it does not provide justification for a water dependent use. It seems to be more of a "deck" in this configuration. My original comments proposed a structure that would go out perpendicular to the bulkhead and that would allow for water access only. 2. We would need to see a cross view of the plans to ensure that the dock is raised 4' above grade because there is IM in this area. 3. Are you proposing open grate decking?That is something we would also need to see over an area of IM. A 4' wide dock that goes straight out perpendicular to the bulkhead for water access, has open grate decking over IM and is 4' above grade is something that we typically permit. Any other questions feel free to ask. Thank you! Jen From: mkimack2@verizon.net [mailto:mkimack2@verizon.net] Sent: Wednesday, April 04, 2018 6:35 PM To:Aspell,Jennifer L(DEC)<Jennifer.Aspell@dec.ny.gov> Cc: kathy halbreich@moma.org Subject: RE: 1-4738-04531/00001 : Halbreich Property _">�A�'7'i~NTtOf�lr.�7"t�;,sEetrit�il°`Ctrr`r"i�fr��trr at? .sct�r'�aI source�C3t�°raft f�N/�n cr��..'y/.�d'Chtnen�s'ur,.�aticic:t�n°.links'raitt�i;in »:(�wn?'(���ers�i�t'a .,;: �a� 3�•=. - .Y•y�� .,�� .�� ��.' .� +Cx g '3a'..:�,e g.q�xa °1 ,.3 W" Z '3e•��' ..�ty; ..'Y• ,`p ��xq , Y �- a>_ „' �8c ru=.g'. �°';�.: �fix,- ws,�hi i` ,.�:°'?,"'�...° �.. ° a.°° .� �� °�. .x4 e�.��a�¢•4E 0�° a���x r °x�=` �>.a�. .;x:x° ;;°;��'. _ qs i�, - 1?LX C,�'�'E� Ll'}�5. �:. � -�•a �. �y'��«.-' aa,.�. Hi Jennifer: Attached find a revised site plan for a dock, rather than a deck. The top of the proposed dock would be even with the top of the existing wood bulkhead.There would be no stairs and the width would not exceed 4 feet. I went back to the site to visually determine where the land begins to slope toward the bulkhead.There is little or no vegetation as the ground has begun to pitch downward. The design idea is to remove a top board of the wood bulkhead to allow the proposed dock to horizontally project landward the 18" +/-to have the deck line up with the existing grade. This 18" distance would allow the placing of two 4"x 4" pilings at or near the top of the slope and with sufficient distance to be set at a stabilizing depth.This scheme removes 6.5 ft. of the proposed walkway That would have been within the intertidal marsh.The staring point of the proposed dock would not impact the vegetation and allows the minimum access point to the dock from the landward side of the bulkhead. Let me know if this revised scheme would meet your review standards. If so, I will then prepare the detail sheet and submit three sets of each to Laura. Thank you for your response to this matter From: Aspell,Jennifer L(DEC) <Jennifer.Aspell@dec.ny.gov> Sent:Tuesday,April 3, 2018 11:28 AM 2 mkimack2@verizon.net From: Aspell,Jennifer L (DEC) <Jennifer.Aspell@dec.ny.gov> Sent: Wednesday, May 23, 2018 9:08 AM To: mkimack2@verizon.net Cc: Scovazzo, Laura (DEC) Subject: RE: 1-4738-04531/00001 : Halbreich Property Attachments: DSCN0041.JPG; Scan2.TIF Hello Mike, Sorry for the delay in getting back to you, I was out of the office last week. I stopped by the site again to check the vegetation and confirm that there is still IM In the area.The attached photo shows some of the IM that is of concern to US. I spoke with my supervisor and we can approve the latest design that you emailed where the dock turns parallel to the bulkhead. However, we will need it to be approximately 4' off of the "bulkhead" to protect that patch of IM. So where you are currently proposing 18" off the bulkhead for the stretch that is parallel to the bulkhead that space will have to be increased to avoid disturbing that area. Your current design (attached) modified to be 4' seaward from the bulkhead with open grate decking would be something we can permit. Thanks, Jen Aspell From: mkimack2@verizon.net [mailto:ml<imack2@verizon.net] Sent: Friday, May 04, 2018 2:22 PM To: Aspell,Jennifer L(DEC) <Jennifer.Aspell@dec.ny.gov> Subject: RE: 1-4738-04531/00001 : Halbreich Property 4'. fE IT3C/1i fijs ernaij catrte frorii;air' xternr�l svures. # o Writ°op�e atta firrrents or:cttek finks frra a i rkriot �?aserjde,s'O �r: ?� d.s �;e• ,. zr �i_ „„,;UCi81�7LaL'�G�(.�•Lf7'lpl�S.•°.,�ro;� .� ��z �° - .'��v�'' �,,:. ' I Jennifer: I remember our conversation. if the structure was wider than 4 feet, it is defined as a deck, which is not permitted. I changed to a 4 ft.wide structure to qualify as a dock.The configuration would allow a person to launch a kayak with even depth To make ease of entry and also back onto the dock. There is no IM on the water side of the wood bulkhead where the proposed dock is to go. I kept the top of the dock the same as the existing deck. The short ramp (18") would not interfere with the IM because it would simply come even with the top of an eroded inclination to Allow access to the dock. Yes, we would be proposing open grating regards 1 To: mkimack2@verizon.net Cc:Scovazzo, Laura (DEC) <laura.scovazzo@dec.nv.gov> Subject: 1-4738-04531/00001 : Halbreich Property Hello Mike, I received your message about the Halbreich property.Just to clear up any confusion, I am sending you some photos that we took on site to better show the situation.The structure is located in an area of intertidal marsh so we require that the decking on the structure be open grate and 4' above grade as to not impact the vegetation and allow light penetration. In the photos attached you can see that the decking on the structure to the north is also elevated at least 3' above grade.The design may need to be altered to achieve these standards, a ramp up to the pier or steps possibly?We are also not opposed to the having the pier extend further landward if that helps in designing a structure that meets these standards. If you have any other questions feel free to ask me or for further permitting questions you can contact Laura. Thank you, Jennifer Aspell Marine Biologist, Marine Habitat Protection New York State Department of Environmental Conservation 50 Circle Rd, Stony Brook, NY 11790 P: (631) 444-0296 1 jennifer.aspell @dec.n ..qov 3 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY @ Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www dec.ny,gov March 16, 2018 Mr. Michael Kimack PO Box 1047 Southold, NY 11971-1047 Re: U PA#1-4738-04531/00001 Owner— Kathy Halbreich Facility—4995 Skunk Lane SCTM#1000-138-2-3.6 & 12 Cutchogue (Baldwin's Creek) Dear Mr. Kimack: Department technical staff completed their initial review of the referenced proposal and had the following comments. Expansion of the existing overwater deck/platform to 6' x 8' cannot be approved. In the alternative, however, replacement at the existing 5.5' x 6' dimension of open-grate design with the addition of the 3' x 8' open-grate walk to the platform would be approvable but the walk must also be modified to be four feet above grade (since it's located in high marsh). Technical questions regarding the above should be directed to Jennifer Aspell at 631-444-0296 Upon receipt of five copies each of revised project plans depicting the modifications specified above, processing will resume. Sincerely, Laura J. Scovazzo Environmental Analyst II cc: K. Halbreich- J. Aspell/BMHP, File ZNEORKDepartment of ORTUNITY Environmental Conservation i NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY @ Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www dec.ny.gov June 6, 2018 Ms. Kathy Halbreich 28 East Fourth Street New York, NY 10003 RE: Permit No.: 1-4738-04531/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing"regulations (6NYCRR, Part 621) we are enclosing your permit for the referenced activity. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather and a Notice of Commencement/Completion of Construction. Please note, the permit sign and Notice of Commencement/Completion of Construction form are sent to either the permittee or the facility application contact, not both. Sin rely, Laura J. Scovazzo Permit Administrator LJS/Is EWYORK Department of al OPPORTUNITY Environmental Conservation s OFFICE LOCATION: so MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) �r Southold,NY 11971 �pQ Telephone: 631 765-1938 Fax: 631 765-3136 �y�oUNTI LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: August 2, 2018 Re: LWRP Coastal Consistency Review for KATHY HALBREICH SCTM# 1000-138-2-12 Michael Kimack on behalf of KATHY HALBREICH requests a Wetland Permit to remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 3'x8' (24sq.ft.) walkway using thru- flow decking leading to a two (2) step wood staircase to a proposed 6'0"x8'0" wood frame fixed dock using thru-flow decking and four(4) 6" diameter pilings to secure the dock. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP provided the following is determined: 1. The low water depths at 1.25' MHW are concerning. 2. The vessel has not been identified. What is the draft? 3. It,has not been proven that the action meets the 1/3 rule with a vessel in this narrow area of the creek. Can boats pass at low tide. Note the dock is entirely located on a parcel owned by the applicant. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing written determination regarding the consistency of the proposed action. �g+tkfFQC�. Peter Young,Chairmanh Town Hall,53095 Main Rd. Lauren Standish,Secretary e P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 l Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Thurs., August 9, 2018 the following recommendation was made: Moved by Peter Meeker, seconded by Peter Young, it was RESOLVED to SUPPORT the application of KATHY HALBREICH to Amend Wetland Permit #9024 to conform to the NYSDEC permit requirements. Remove existing 5.5'X 6' wood dock and two (2) 4"X 6" wood pilings. Construct 4'X 5'6" walkway to a 4'X12' fixed dock Weight (8) pilings. Walkway 22 sf. and fixed dock 48 sf. decking shall be thru-flow for both walkway and fixed dock 1' further seaward than previously approved. Located: 4955 Skunk Lane, Cutchogue. SCTM#138-2-3.6 Inspected by: Peter Young The CAC Supports the application using Thru-flow decking on the walkway. Vote of Counci: Ayes: All Motion Carried t *� Ott Town Halt Annex Michael J.Domino,President 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Charles J.Sanders Southold New York 11971 Glenn Goldsmith z � r Telephone(631) 765-1892 A. Nicholas Krupski ._*rlfJjp � _ ` Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extensio eceived Application: r _Received Fee: $,_ ! Completed Application:--7JUN 2 Incomplete: 2018 SEORA Classification: Type I_ Type I1_ Unlisted ( i Lead Agency Detennination: Southold Town ! �Coordination:(date sent):___.a I.��`l Lair of Trustees_ ---__.__�_�� LWRP Consistency Assessment Form Sent. _ CAC Referral Sent: Date of Inspection: Receipt of CAC Report: - Technical Review:._ -.-..a Public Hearing Held: _. L ����~ Resolution: Legal Name of Property Owner(s): Mailing Address: 1d' 5 4"� Y7.- AR& 1Z_t_l -�Ny /0 00 Phone Number: _ 9/7 ZZ,1-- Suffolk Suffolk County Tax Map Number: 1000- 3 Z- 7I 6100 Property Location: .� U .....5'C?urg or BA►1� __ (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): _._ �eC ,_._� / � ._.. -. . Mailing Address: _ aF„X /04-7 Phone Number: ___ _._ �►. 1Q( d�.__ __ _-_ CO\���� Board of Trustees Application GENERAL DATA Land Area(in square feet): , , F®0 Area Zoning: 40 Previous use of property: tlp L Intended use of property: RZfl Q5W Z,.f 4 Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes DC No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? ( No Does the structure(s)on property have a valid Certificate of Occupancy?_ Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes,provide explanation: Project Description(use attachments if necessary): /`1/ 7721VST.��� I! 7— � 17 0!7 o CoAp � oe� vv�� CO OX/ftl-N& ,�`5-4XC 6 /0 * W 00,0 ®G cle a-k�Cv 0 l 'xd r ,W d.U� //),0'--0 Or Y4641"fly'-QFA IMRP 76VAIV !',e,!510/Cd/Sl-y APPROver ' Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: AMID 15eo W2a5 -AAAE 4 Cj76.9 Area of wetlands on lot:� e-1 n R square feet Percent coverage of lot: _ _ _0„_____% Closest distance between nearest existing structure and upland edge of wetlands: 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? A11,4 cubic yards How much material will be filled? tid/� cubic yards Depth of which material will be removed or deposited: IV feet Proposed slope throughout the area of operations: _rLQe5� - 70 Manner in which material will be removed or deposited: A11,4 _. 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): lrrt 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification, Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 17-Project and Sponsor Information Name of Action or Project: Project Location(describe,and attach a location rnap): Brief Description of Proposed Action: ��yy p,('�y TD JWC P�,PMlT'�P�`�U/,�h�yT.��rE,�DSC��/y/T�/YD �®�RE�s�'p®ti1�ENc�•��'� J �Mav� �/J'TlNG ,S'.3���X��t6'�G�aap Dvcic .SND�Z!/O�l�9 xd G�JGan �/C,//►iGS. COA07A4/e/'x .5"' V,4e JeOAY ro '0'/®"x ti a/'Xlrop POC/C 40 �G P1VN6s1�4 -VJ u�WZ&1V�V 2Z_V'#NDiv(�J' BE RT'/ l OUJ AelcellvG Oz Alma&V4z14 f/r� 1OW'*F1AOPPocic Name of App leant or Sponsoi: Telephone: -_6Q7 Address: State. I rip Code 7_/'/040 -_-__ ._-._ _._. ._...._ X9'70-_-- 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. Uno,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: 3.a.Total acreage of the site of ttre proposed action? Q, acres b.Total acreage to be physically disturbed? O Z—acres C.'l'otal acreage(project site and any contiguous properties)owned b or controlled by the applicant or project sponsor? �, Vlo Z acres 4. Check all land uses that occur on,adjoining"and near the proposed action. E]Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ,Residential(suburban) El Forest ❑Agriculture ❑Aquatic ❑Other(specify): _ ...._. .�. ❑Parkland Page t of'4 5. Is the proposed action, NO_ YES N/A a. A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? lEl u�I ll�1 6. Is the proposed action consistent with the predominant character of the existing built or natural -NO--- YE S landscape? n INA LSI 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:,_____ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO Y--E1S 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: � -- — l-I ---- ----------- --- - ------------- ----- --------- -- - ----�� - 10. Will the proposed action connect to an existing public/private water supply'? NO YES If' No,describe method fbr providing potable water: /(!,/,# 9 Ll ------ 11.Will the proposed action connect to existing wastewater utilities? - - - - - — -- --- NO YES If No,describe method for providing wastewater treatment:__,,, , ,V A .Q.w 12. a.Docs 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,lhe proposed action,contain NO YEST wetlands or other waterbodies regulated by a federal,state or local agency? El XK b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland S-or waterbody and extent of alterations in square feet or acres: 9 .,_.-.�... ._.r... .... .....�..__..,�_._... 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 rnid-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, - a.Will storm 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: ❑NCS QYE,S ff Page 2 of 4 18, Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.� retention pond,waste lagoon,dam)? If Yes,explain purpose and size, 19 1 fas 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: AFFIRM THAT THEA.INFORMA'T'ION PROVIDED ABOVE IS TRUE AND ACCURATE TO'I'llE 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 niater ials submitted by the project sponsor or otherwise available to the reviewer, When answering the questions the reviewer should be guided by the concept``Have illy responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur• I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land's 3. Will the proposed action impair the character or quality of the existing communityv 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ t❑��� establishment of a Critical Environmental Area(C13A)? 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. Wil I the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy co_nscrvation 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, (� I�1 waterbodies,groundwater,air quality, flora and fiturna)? 1 J EI Page 3 of 4 No,or moderate small to large impact impact 3 may may occur occur 10. Will the proposed action result in an increase in the potential far erosion,flooding or drainage (-1 problems? u 11, Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lend 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. C;heck this box if you have determined,based on the information and analysis above,and any supporting documentation, L _f that the proposed action may i esult in one or more potentially large or significant adverse impacts and an environmental impact statement is required, Check this box if you have determined,based on the information and analysis above,and any supporting d0CUrnelltatiO11, that the proposed action will not result in any significant advcise environmental impacts. Torn of Southold-Board of Trustees __.._.... . Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if'different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Appli :ion AFFIDAVrT ` _ BEING DULY SWORN DEPOSES AN13 AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) 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 SOUTHLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN-OF SOUTHOLD AND THE BOARD OF 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, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND O.R.COASTAL EROSION PERMIT ISSUED BY THE BOARD_ OF TRUSTEES DURING THE TERM OF THE PERMIT, a Signature of Property Owner -SWORN TO BEFORE ME THIS , _ 4� DAY OF 2917 Notary Public Board of Trustees Appli ,tion AUTHORIZATION (where the applicant is not the owner) I, 4o, b ZZ'` lam! residing at (print=4 of owner of property) (mailing address) do hereby authorize (Agent) to'apply for permit(s) from the Southold Board of Town Trustees on my behalf. O ner's signature) I APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town,of t o 's C dir —Wilbio conflicts of into e t n t e nart oftoWil 6ffigwvmA e. LSlot+e4 s,gjje ut17. tl is r tap vide fora r�tlmn�vhieh oa��aicrt the town of uossible conflicts cxF intrresk and alln�v it tnLAc whatever action is J neeeaM to avoid same. YOUR NAME: 1 (Last name,first namolApiddle Initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance — Building �- Variance _ Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or t{trough your company,spouse,si6ting,parent,or child)have a relationship with any officer or employee of the TAwn of Southgld? "Relationship"includes by blood,alarriag%or business interest."Business interest"-means a business, including a partnership,in which the towrcoMcer or employee lips oven a partial ownership of(or'employment by)a corporation in which the town officer or onq)Joyee ovens more than 5%of the shares. YES ,— NO V - If you answered"YES",complete the balance of this form and slate and sign where indicated. Name of person employed by the Town of Southold Title br 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 ofgreater than 5%ofthe shares of the corPOrate nock oftlie applicant (Nvhen the applicant Is a corporation); B)the.legal or bencfielal'owner of any interest in a non-corporate entity(when,the, applicant is not a corporation); C)an officer,director,partner,or employee of tile,aplalican4 or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 7 day of 20YL-�7 Signature PrintName C AXZ k Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM 'lire'Tovs�nofSautholii'sCddeoFihicst�t�al�itiitsecmtl(ctsofittttestontl%eirarto•ftawn'affcersAnd_emt�� a rt-fili _ u o f its f to; vide' fo ` nfio wftii h camale 'the f _ tb1 r fli f fere al o o akc.wbatLerac on s n_ecessary to avoid same. YOUR NAME: (Last name,first name,.rpiddle initial,antes you are applying rn the name of someone else or other entity,such as a company.If so,indicated the'other person's or company's name.) NAME OF APPLICATION: (Check all that apply.)- Tax grievance Building _ Variance _ Trustee Change of Zone T Coastal Erosion _ Approval of plat _ Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you psi sa rily,:(i? t(iO�lt�y4�C !t!?an ,s1?Quse.sibill�g;phronfi;; r child)have a relationship With any officer or employee of the Taivit-ofSputitol¢Z2elaiitSnskrtp'nihltl8cs by(itoki, criagc,�,or;business interest.`Business interest"means a business, including -}SarCner'sfip,,iri wiiioii° ie'tt}i�vtt o#C?�ci� rvtt1laYe t?ps vYen a partial ownership of(or employment by)a corporation in whidlr t1iG°Citesn't:fict;br etztplrt�'ee:t�vntrx more'iait;5°lo shares. YES _— NO - If you answered"YES",complete the balance of this form and bate 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 townofficer or employee.Either check the appropriate line A)through I:?)and/or desc4be".in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): f►yth :o �r of,gs04W than 3�Jfl of he slut :of itie araCe stoct£gf the Ap Eti�attt (when the aiaCilieiitye agntaiaotir}, l�iliel�giit or=lsenei�cial Q«;ne�-ofany"�ntcre�t irr:si;noir=ca�poc�te.entit�•(v►'11�ittli� •appiicuni3snot;-acorparatio�); - G).an ciflicer,-diicctiSr,.pitrinei�_or•cmployce of'tiru:•apptican'ti;trr D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted jd�a f � 2( Signature Print Name _ r- Form TS 1 PROOF OF MAILING OF NOTICE ATTACK CERTIFIED MAIL RECEIPTS Name: Address: IM-2-4 GLo�'/,fit o•v 3-/ 95" J�IUN& ZAN,e. cvrc�aG 9 5157,-fkllNe 44AI4 cvrce-�a6�li 2A C751 }? Q� 14Vo NY i ,7q10 STATE OF NEW YORK COUNTY OF SUFFOLK A ,L2�Coe , residing at po. g�X ltjQ7 JNEMeee2.VY/197,1 , being duly sworn, deposes and says that on the 7AA9 day of Aw.-,"67- , 20/8, 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 PW_M,060 ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this �J ) Day of T , 2_0 _/T_ ,i( i Notary P blic DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. 01D1475593 Qualified in Suffolk County My Commission Expires April 30, 201 1 �--` c,1�FFU(,�- Michael J.Domino,President4�Q COG Town Hall Annex John M.Bredemeyer III,Vice-President ,ice �-,4 54375 Route 25 Glenn Goldsmith y ,' P.O.Box 1179 ZZ A.Nicholas Krupski Southold,NY 11971 Greg Williams ?/�0! p� 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 KATHY HALBREICH 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,XCiS?�L ,Q delh4lVe , residing at/dba P A ,eDX //V7 S'D4924 K MY being duly sworn, depose and say: That on theZ�day of,46*6W7— , 201$, I personally posted the property known as 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,August 15,2018. Dated: (sig ature) Sworn to before me this 130, day ofq 20(g, r /�1 DIANE DISAWO NOTARY PUBLIC-STATE OF NEW YORK Notary Public o. O1 D1475593 Qualified in Suffolk County My Commission Expires April 30, 20_�Z_ idio6al,i uinjoU o!3sewo(3 I 1 £9061000-Z -0139L NSd 9 l,oe Ainq L90,wj (009$19AO) 010 a 0 fi 9 11 5.11 /jaiulecl palopiseB IwIN painsuliEi 1 1 1 .ry wn AJ9AJI90 P910111SOU 61 92 fi:g' "I 9 Irevi pamsul Ei J o1jeuuuuoo einjeuBis o ki[a8A1I9C1'U0 1091100 0 -7 uoIjeLuuguo0 ainjuu5is[I fJOA118C]P sa _3 V I jo;ld419AIJB(I UO 1081100 El E XC leoeH uineslpueqojaVq joU[j fJ9A1IaCj 119131.11sed 11UN 139911jeo 0 -D 0 0 AJGA1190 ollevq P9911180 0 86 0 LVZ 90S9 ZLVZ ZOV6 0696 a. 'luakilea polop1seli einjauft jInpV 0 peloijisqu IWVq Paiels,15911 e1-1 Willelm PWOIS168H 0 injuuBiS jInpV IDS @sseidxa 118114 14POUd El edAL eouuaS Z A T r C C Apt r C c) ON❑0 :molaq sssuppe Ajaiulep Jejue sqA[:] L I.U.1941 U-104 IuGJG.4!P s' S9JPP73 AJBA]19P SI :01 passeippV-9131W -sl!wjad acieds J!juOjj 91.41 Uo Jo o 110 A -4 47 dav W 6 g.,t; 40 204- .0 leoeidipw 9LIj jo Nouci aql 01 P.1130 slql 1-101134V 0 M '6 fJ@Al]eC[10 9113(3 UUd)Aq P9AIS09bi -E3 44 R (GWRN P01 :5 %a -nof,of piuci et4l uinjai ueo am;Bqj os LL S a 1E asAqAqj qL11 uo ssaippu puL,euueu jnOA lu!Ad N U! 'A ZU95V r-3 2 9 8 21 '8. Pus'Z'l,swell ejeldWoo m .9— UBIS -V E Ek X 0 4J. m u1 mm m cc a: G�O Noll 110"o L 9606 92fig TOGO Ofi90 —15TE 0 L i,41ENDEN:1�(jdkEtk T141S It,1 a-conniter COMPLETE, HIS _T SECTION ON DELIVERY- %0 �!6W it�iW'��2;and 3. • A. Signature 4.5 01 C�4 E Print your name and address on the reverse CV X ❑ ❑Agent -4 11 Addressee C14 so that we can return the card to you. B.'Received by(Printed Name) C. Date of Delivery (D 00 ■ Attach this card to the back of the mailpiece, r or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1? E3 Yes 1O M OM A//>60 A If YES,enter delivery address below: 0 No r194- fWA& • CUPW - NY // -v .j -4. -6 3. Service'rype 0 Priority MiVi Express@) IN 0 dulls U Registered MadTm % %lBog II I SII III EJ Adult Signature Restricted Delivery 0 Registered Mail Restricted U.S 9590 9402 2472 6306 2410 81 rt fled Mad® Delivery �4z' (1) 1 1-. i �n. I *QCP.rt;fied Mail Restricted Delivery FidietrurhraRecelpt for .6s . M q ID CX Merchandise ndise 0 Collect on Delivery S2 5.0 M 11 Signature ConfirmatlonT ? E E 0 Collect on Delivery RestdIcted Delivery LLI '0 0 11 In4ured I_]Signature Confirmation (L Mail W . I . � � , - 0 0001 5428 9095 L) < < 5 064 0 Insured Mail Restricted Delivery Restricted Delivery ODD o (over$500) (1_ I - . 3811,,July 2015. . . .7530'02'-000-91]53'PSN b Form . . . . . Domestic Return Receipt WTT 6 92fig TOGO Oh9O STO�- . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said person's as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of 20 Notary Public ,NUTILI:---Ul�; 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: KATHY HALBREICH SUBJECT OF PUBLIC HEARING : For an Amendment to Wetland Permit #9024 to modify the proposed dock to be the following: remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 4'0"x5'6" walkway to a 4'0"x12'0" fixed dock with eight (8) 4"x4" pilings (walkway 22sq.ft. and fixed dock 48sq.ft.); decking shall be Thru-Flow for both walkway and fixed dock; and structure to be installed one (1) foot further seaward than originally approved. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 TIME & DATE OF PUBLIC HEARING : Wednesday, August 15, 2018 — at or about 5 :3013. 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 Town of Southold VA-rRP 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 sig uficant beneficial grid adverse effects upon the coastal area which includes all of Southold`Town 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. 'Thus, each answer must be explained in detail, listing both supporting and non- supporting filets. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shalt 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 ANIS PROPOSED ACTION SCTM# PROJECT NAME &442&425,J C}� /JZ�G��2�1/,tJ G�Ji9L1LGU�9,� The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. D< Board of Trustees 1. Category of Town of Southold agency action(check appropriate•response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation, land transaction) ❑ (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit,approval, license,certification: Nature and extent of action:SWAIP 74M5 TRUrOSS"&Ap,'Ot!/T 11=40 'VX y 7-b comawRM �o We PwP'a-M./'.rte 0�C f i�rer�p r®R�,�s'f�v�'x6 r v o a,0P UA1&Y, C 6A/,MRtv t?6k&1.•¢Y 7V If to u� � . �r`1e1A!G J,fY OU 0,5 7 eV Al-4.2) ,cQeP BGTiZ1 GV-4410004� i A Location of action: Site acteeag .. - Com_ :77d" 2 Present land use: VA L_. Present zoning classification: 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: /2�AZZOEZ � (b) Mailing address:, �4 J',�: 4t'7. 7 4 Al-Y IV 10 006- 1025 (c) Telephone number:Area Code (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes'n No 21 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 POLI Policy 1. Foster_a pattern of development in the Town of Southold that enhances.eommunity 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. n Yes F] No Not Applicable of Y2 ZAA5 ACcs Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVV"Section III—Policies Pages 3 through 6 for evaluation criteria Yes'E] No 9 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section IH—Policies Pages 6 through 7 for evaluation criteria ❑ Yes No ❑ Not Applicable 120 D aWIZ -1V6 Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria C1 Yes No 1:1 Not Applicable Yme� PorlZ ujQ C ,f e c U D 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 11 Yes ❑, No F27N Not Applicable !2a � W 0v L SE: Oy - 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 evalu--a-tion criteria. FUI 1J t I � Yes No Not Applicable f'nD 'G?Iw f'l2 P—1,4E cr JJQUt}qq�� n! - / o Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LVVRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes F] No V Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and w(Mttes. See LVVRP Section III—Policies; Pages 34 through 39 for evaluation criteria. Q Yes 0 No U Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and -recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. 1_1 YeF] NoR—J NotApplicable 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 ❑ NojZ 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 1:1 No rX`-1 Not Applicable O Attach additional sheets if necessary Policy 12. Protect agricultural lands in the 'Town of Southold. See LWRP Section III --Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No 9 Not Applicable Attach additional sheets if necessary _ Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED 11Y__LO// .E���G TITLE &?5/117--__'� DATE14�0/!y Maim Diane From: Mike Kimack <mkimack2@verizon.net> Sent: Friday, October 13, 2017 1:07 PM To: DiSalvo, Diane Subject: RE: Halbreich Attachments: documents0011.PDF Hi Diane: . Attached please find the Notice of Incomplete Application from the DEC When I talked with Laura,she said their tidal wetlands map showed the line appearing to Be located landward of the bulkhead. I looked at the map. It shows the existing dock, but no discernable bulkhead. The is of a large scale generally following the tidal wetlands.The photo did noy delineatew the bulkhead as a physical Boundary to the tidal wetland line along the 20 ft.of property . I believe DEC just needs a letter from the Trustees saying That said bulkhead represents the tidal wetland boundary which would then modify their general map as to the boundary Thanks From: DiSalvo, Diane [mailto:diane.disalvo(�i)town.southold.ny.us] Sent: Friday, October 13, 2017 11:13 AM To: 'mkimack2@verizon.net' Subject: Halbreich Can you please send us a copy of the DEC letter you spoke about in your pre-submission inspect request. Diane D%SCILVO Southold Town Trustees Town Hall Annex/First Floor 54375 Route 25 P.O. Box 1179 Southold,NY 11971-0959 (631) 765-1892 Fax: (631) 765-6641 i 1 `1 New York State Department of Environmental Conservation Notice of Incomplete Application - This is NOT a Permit Application ID: 1-4738-04531/00001 13atch Number: 809710 Facility: HALBREICH PROPERTY 4995 SKUNK LNISCTM 1000-138-2-3.6 & 12 CUTCHOGUE,NY 11935 Contact: MICHAEL A KIMACK Owner ID: 1634985 110 BOX 1047 SOUTHOLD,NY 11971-1047 Permit(s)Applied for: l - Section 401 -Clean Water Act Water Quality Certification 1 -Article 25 Tidal Wetlands Pmject Location: in SOUTHOLD in SUFFOLK COUNT' Your application for Permit is incomplete. The following items are required: 1) Project plans. Submit 5 copies Additional Information: Although your recent resubmissiom added MH'Oi and MLW to the cross-section plan as requested,they did not add them to the project plan and did not depict the intertidal marsh vegetation on either the project plan or the cross-section. Please submit five copies each of revised project plans and cross-section plans which depict apparent high water, apparent low water and intertidal marsh vegetation/tidal wetland boundary. *Please note that the boundary must be delineated by a qualified person and the plans must indicate the name of the individual delineating the boundary and the date of delineation. Upon receipt of all of the above, processing will resume. cc:M. Kimack Please submit requested information by_, No further action can be taken rintil all of tlzese materials are received. Contact Person. Signature _ LAURA J SCOVAZZO NYSDEC Date: April 19, 2017 SUNY @ Stony BrookJ50 Circle Rd Stony Brook; NY 11790 Telephone Number: (63 1)444-0368 - i p ECEIVE iD! OCT 13 2017 Southold Town Board of Trustees i New York State Department of Environmental Conservation Notice of Incomplete Application - This is NOT a Permit Application ID: 1-4738-04531/00001 /3atch Number: 809710 Facility: HALBREICH PROPERTY 4995 SKUNK LNISCTM 1000-138-2-3.6 & 12 CUTCHOGUE,NY 11935 Contact: MICHAEL A KIMACK Owner IU: 1634985 110 BOX 1047 SOUTHOI,D,NY 11971-1047 Permits)Applied for: 1 - Section 401 -Clean Water Act Water Quality Certification 1 -Article 25 Tidal Wetlands Project Location: in SOUTHOLD in SUFFOLK COUNT" Your application for Permit is incomplete. The following items are required: 1) Project plans. Submit 5 copies Additional Information: Although your recent resubmission added MHW and MLW to the cross-section plan as requested, they did not add them to the project plan and did not depict the intertidal marsh vegetation on either the project plan or the cross-section. Please submit five copies each of revised project plans and cross-section plans which depict apparent high water, apparent low water and intertidal marsh vegetation/tidal wetland boundary. *Please note that the boundary must be delineated by a qualified person and the plans must indicate the name of the individual delineating the boundary and the date of delineation. Upon receipt of all of the above,processing will resume. cc;:M. Kimack Please submit requested information by_ No further action can be taken until all of these materials are received. Contact Person. Signature _ LAURA J SCOVAZZO NYSDEC Date: April 19, 2017 SUNY @ Stony BrookJ50 Circle Rd Stony Brook;NY 11790 Telephone Number: (63 1)444-0368 ECEIVE OCT 13 2017 Southold Town Cantrell, Elizabeth From: Mike Kimack <mkimack2@verizon.net> Sent: Thursday, October 12, 2017 8:28 AM To: Cantrell, Elizabeth Subject: Halbreich Hi Liz: would like to request a site visit by the Trustees for Kathy Halbreich,4995 Skunk Lane, Cutchogue Thhe Trustees have already issued a permit to replace her existing dock.The DEC is requiring that we Have a qualified person designate the Tidal Wetlands line. I assume that would be the bulkhead. If that is what the Trustees determine,then I would need a letter so stating to send to DEC. If another line is established, I would request they flag for our surveyor to layout on a survey. I will drop the$50.00 fee off today Best PDE .1 I� u 'dI E r-- OCT 1 2 2017 Southold Town Board oTrse 1 Michael J. Domino, Presi O�Q$UFFU(�COG Town Hall Annex John M. Bredemeyer I11,Vice-Fresiaent � 54375 Route 25 Charles J. SandersN = P.O.Box 1179 Glenn Goldsmith X ^1 Southold,NY 11971 A.Nicholas Krupski ?� • p!� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 11 NO Completed in field by: Michael Kimack on behalf of KATHY HALBREIGH requests a Site Inspection to determine/delineate the Tidal Wetlands line on the property, as requested by the NYSDEC. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 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 V Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application co/m' pleteness/comments/standards: Present were: U J. Bredemeyer M. Domino ZG. Goldsmith N. Krupski /C. Sanders Other Page 1 of 2 Michael J. Domino,Presic SUFFO(K O�Q CCGI Town Hall Annex John M. Bredemeyer III,Vice-Pr siaent �� �,,, 54375 Route 25 Charles J. Sandersy $ P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Michael Kimack on behalf of KATHY HALBREIGH requests a Site Inspection to determine/delineate the Tidal Wetlands line on the property, as requested by the NYSDEC. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 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 4r ' Kathy : / 1 00 Skunk Lanc, 11• 1000-138-2-12 M� Ilk- IF • y — _>c_-�,.r..r•'"r.a-'sem ..r _ _ ���`' = � ., --�1 A �t r�Ir! r - / ' ,� '.0 •_ i i �- s � tom' *OF SO Michael J. Domino, President � Ol0 Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. SandersCOO Southold, New York 11971 Glenn Goldsmith �l Telephone(631) 765-1892 A. Nicholas Krupski �'C®U 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/silt boom/silt curtain 1 st day of construction Y2 constructed complete,lete liance inspection J p com p p FW0.5,MV, R r, BOARD Or"SOU"MOI D TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 9024 DATE: MAY 17, 2017 ISSUED TO: KATHY HALBREICH f PROPERTY ADDRESS: 5100 SKUNK LANE, CUTCHOGUE SCTM# 1000-138-2-12 0 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on May 17, 2017, and in consideration of application fee in the sum of$250.00 paid by Kathy Halbreich and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to remove existing 5'5"x6'0"wood dock and two(2)4"x6"wood pilings; construct a 3'x8' (24sq.ft.)walkway using thru-flow decking leading to a two(2) step wood -flow decking and four(4) o a proposed 6'01lx8'0" staircase tro wood frame fixed dock using thru 4" diameter pilings to secure the dock; and as depicted on the site plan prepared by M.A. Kimack,dated on April 6,2017,and stamped approved on May 17,2017. . ..... Oil IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. qdsaf Fat 0 TERMS AND CONDITIONS The Permittee Kathy Halbreich, residing at 5100 Skunk Lane, Cutchoguue, New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the-Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. v 1 *pF SO Michael J.Domino,President ��� yolO 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 _® �Q Telephone(631) 765-1892 _ A.Nicholas Krupski liyC � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 17, 2017 Michael A. Kimack P.O. Box 1047 Southold, NY 11971 RE: KATHY HALBREICH 5100 SKUNK LANE, CUTCHOGUE SCTM# 1000-138-2-12 Dear Mr. Kimack: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 17, 2017 regarding the above matter: WHEREAS, Michael Kimack on behalf of KATHY HALBREICH 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 March 29, 2017, 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 17, 2017, 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 f 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 KATHY HALBREICH to remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 3'x8' (24sq.ft.) walkway using thru-flow decking leading to a two (2) step wood staircase to a proposed 6'0"x8'0" wood frame fixed dock using thru-flow decking and four(4) 4" diameter pilings to secure the dock; and as depicted on the site plan prepared by M.A. Kimack, dated on April 6, 2017, and stamped approved on May 17, 2017. 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, Michael J. Domino President, Board of Trustees MJD/dd _ 1,.�_N_.FJs_gF r"4_�V_N_OE St�CJTf�GY.D -BYAPPR®iEST�� OF i R ' EE & - TOV N,bF SOUTHOLD A W30 - f�I_vD_�O_Ul�t4)_�D/9 ro a O /_ • 3 2 SQ• � ,�, �' FT• !: 4; s� u a w oocm/4*(/2 APR 1 0 2017 Q N 6 Southold tOWn r a B r�i_ot;rz sts �� 1 _ _ __ _SKUNK.t._.ANF, - - ro _ _ PRo�sEo oEC�c� wAL,�cwA y . 3x_46 _ _rWO, 7)0 Ti 7P4'X6�0PI�. WO:5' SG4G�=!- ---,� _ T----- ley" E Np�Q,p�'�,1. t .9-0 7-Airy-.41,6117 S3 a131 1 12D u;,AQ:plstjliios I "77 - - ---- - --- -- - - --- -- -- - - ---- - �4dM1.� S=r, 7 �s _ LIOZ p ddb °0� , t,� off'- -- - -- - - -- - - - --- ---- � - I ,47 v 9 x;;its OM /M /M i �h .� ,all 1fJ�iC 7 f ly ! i i i . ►.. r _. t?' r'�7 �Pfl7Ssd/d;,S3;,Z' _ + e��j 37tY3s05-- -- 9OF ( � Sia'/S hrl9fl„Z�7i�g 'o' ' � Ia � Zlx„t�2� _ - Nl�'7 ;a 0 7/b'ZYCo,L tYO'f70. ,9 X#d/s / (WIR 9i'Df „ r 00 Town J. Domino, President F �O CCS Town Hall Annex John M.Bredemeyer III, Vice-President j � G��t, 54375 Route 25 y Charles J. Sanders z 4 P.O.Box 1179 Glenn Goldsmith vp ^(J Southold,NY 11971 A.Nicholas Krupski .yf1 ® �p�}^ Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: kA-TAS( H*--096-tcl'- Clo Mic&Ae L KL&ACK” Please be advised that your application dated filApcht_ `!qc 217 has been reviewed by this Board at the regular meeting of 1z 1f 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) �� a g % Constructed ($50.00) 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 with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 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: b al a TOTAL FEES DUE: $ BY: Michael J. Domino, President Board of Trustees Michael J. Domino, Presir � " �O C' Town Hall Annex t John M. Bredemeyer III,Vice-President ���' ®G2 < 54375 Route 25 Charles J. Sanders P.O.Box 1179 Cn Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski �O Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD i Date/Time:_ �� 1;� 3C Completed in field by: ,A) Michael Kimack on behalf of KATHY HALBREICH requests a Wetland Permit to remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 3'x8' (24sq.ft.) walkway using thru- flow decking leading to a two (2) step wood staircase to a proposed 6'0"x8'0" wood frame fixed dock using thru-flow decking and four (4) 6" diameter pilings to secure the dock. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 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 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/sta nda rds: mus vqy teo6ejd6t f, Present were: r J. Bredemeyer M. Domino `� G. Goldsmith '� N. Krupski C. Sanders Other Page 1 of 2 Michael J. Domino;Presito�QSiSfF01 �oG Town Hall Annex John M. Bredemeyer III,Vice-President �� yam,, J 54375 Route 25 Charles J. Sanders � P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski jb�,ol p!• Telephone (631) 765-6641-192 Fax BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Michael Kimack on behalf of KATHY HALBREICH requests a Wetland Permit to remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 3'x8' (24sq.ft.) walkway using thru- flow decking leading to a two (2) step wood staircase to a proposed 6'0"x8'0" wood frame fixed dock using thru-flow decking and four (4) 6" diameter pilings to secure the dock. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 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 W, :.o 17.—WA4 , ' f � Kathy / F. 00 Skunk11' 1000-138-2-12 5/9/17 1 r.r 105 �} arm .r .✓' 1 �, `3 ' ''f l p.. '��$..n J �'. _'', d /� 1 i', pQ'�: �•^r o 1"i�- IY r i' � l� � +JJ}4 � A .,r } � _ i� iSn.s<.! r � '+��' .•Y'.�l- _ - - 'F 1 1 d 1 � L .?' � ,� r i •�.1f,4'#f�yY'tt V� t:;��, r y - i �;a/ ( �; i�`�`yj:•�' -�y,{r;' -�1v i .��J�'ta�,1 t �i+�:-" a� ��� .` � _. �$• /.v( r' ¢ : t r !/ a t 1#0 r>: Irl• t: �✓ '„� = ti !r r'tV ' lNrM�,rr{J= ` _ :.�►� - r r x �� e... 7JiJ.� \ l� ��.r?c,,�;1�y;"4 i� � �.�4�•�1� -°-•�sj i� � .•y:a+j �� �r �/. �„y�.r� ��°``� 7; �� r Ir.. \v Y7t^''�e i� •4_ 1� - ti f ` �"� . _ _! as vAL.• +S+' ,�j ' /'� •. �- tom R' /a • 1� H $t ` �y"1,, •S .t. �, • �7 s, - • !� / ,-1/1 x i:tY �� 'f��r k 'r�� / �� � ,x�4 i ?' �• R � a ,I - 7v- 0 v- 1 �' PARCEL 2 ' SUFFOLK COUNTY TAX# (V ` 1000 - 138 - 2 - 12 � �pND NOW OR fORMERIY OF: / 0 Y QF foRm TOWN OF 50UT�O� / SU 03 LAND ONS OOF g0gmOVD i (� Z / 11L1 l `J3 FRAME /; �j N N avucnFa.D � O"E77°43+4 "E o m80I 0N 73` o °� o o1� rZl0 Crn - �$ t5 O O � Gtrn 82°oOt'O't � m - 0 ' 82°00' 10 30.713 46' 3O•Q'�I ND NOW OR FORM�Y JON N Nay [�� ND NOWON VIA NIXON AREA=822 5q. Ft. AREA=G31 Sq. Ft. AREA=0.018 Acres AREA=0.014 Acres t 1 FLOOD ZONE ANNOTATED FROM FEMA F.I.R.M MAP NO. 3G 103CO I G4H NOTES: I – PIPE FOUND 13 o— STOCKADE FENCE JOHN C. E M LE R5 LAND 5 U RV EYO R � — --- - - SPLIT RAIL FENCE D _J G EAST MAIN STREET ' N.Y.5. LIC. NO. 5020 n G Area = 33,900 51. Ft. RIVERHEAD, N.Y. 1 1901 3G9-8288 Fax 3G9-5,257 `bLa'' Area = 0.7782 Acres 1 GRAPHIC SCALE I°= 30' longlslandlandsurveyor. om -147 1 I 5URVEY Of LOT 1039* P/O LOT5 1045 105 A5 SHOWN ON A CERTAIN 5UBDIV151ON MAP ENTITLED"MAP OF NA55AU ffARM5" FILED IN THE OFFICE Of THE CLERK Of THE COUNTY Of SUFFOLK ON MARCH 25, 1935 A5 MAP NO. 1 179 51TUATE : CUTCHOGUE + TOWN : SIOUTHOLD W or E 5UffOLK COUNTY, NY SURVEYED 05-09-2016 INE SUFFOLK COUNTY TAX # TRF E RDA S asphalt roadway 1000 - 138 - 2 3.G UTIL. nEDG 7 CERTIFIED TOPOLE : 0 UT'L- 250-00 GUY \Mszf KATHY HALBREICH NbG;058'40"'�: ABSTRACTS, INCORPORATEDeD FIRST AMERICAN TITLE INSURANCE COMPANY E.j 12.4' CITIBANK N.A. HEDGE 24.9 FRAME M GARAGE (y AC ---- ) ---- ------- - 62 ---------------- 2 93 V- LU 2 STORY FRAME DECK FRAME H605F �' HAR 2 9 2017 LU LOT 103 0� 0 320 CONC. 0- p/ Uj . 12.3' O O LT 10 A.T K71 0 GVKD. rDT00r 13� (y) 0 tiEDG. GEI)AR TFf F5 0 180-00, 58GO58140Wh/1' f14 pO LOT 10p/O PLOT 124 1 / II / 0— N p/O LOT 104 /0 LOT 105 00� QO In o Oa, LJO 0 - 0 0 LL (V 00 ----------- 5805814011E 77 G5 .00 03 0 LOT 106 PARCEL 2 5Uf fOLK COUNTY TAX# 1000 - 138 - 2 - 12 0 Now 0?, LANG Of 5OUT,0LDOPS -n Of; �7 f Y LAND NOW OF,fo? TOWt4 of 5011MIN =D o 0 000, 1 out 577°43'41 E 0 Q rn 10 0i 0 Ul 0 N 0 0 61 0 - b rn 0 O'S 00 T� 0 3 0 "0"''0_ "I " 02070 C C 9 It 000 tio 4, b Q 0 000% 1 82 rn G 000% to V 09 0', XON 13 MRD rogmc?LY 7 FJC, MNI VALUA NoON NIXON 7", ARfA=822 5q. ft. AREA=G3 15q. ft. AP,EA=0.0 18 Acrer, AREA=0.0 14 Acres IFLOOD ZONE ANNOTATED FROM FEMA f.I.R.M MAP NO. 3G 103Cq(g4=f1 "Unauthorized alteration or addition to a survey NOTE5: map bearing a licensed land surveyor's seal is a violation of section 7209, sub-division 2, of the PIPE FOUND New"York State Education Low.' -------- 5TOCKADEfENCE JOHN C . EHLER5 LAND 5URVEYOR "Only copies from the original of this survey ------- 5PLIT RAIL PENCE marked with an original of the land surveyor's stomped seal shelf be considered to be valid true copies" G EAST MAIN STREET N.Y.S. LIC. NO. 50202 * "Certifications indicated hereon signify that this survey was prepared in accordance with the ex- Area = 33,900 5q. ft. RIVERHEAD, N.Y. 1 1901 369-8288 fax 369-8287 c 0. fisting Code of Practice for Land Surveys adopted by the New York State Association of Professional Land Surveyors. Said certifications shall run only Area = 0.7782 Acres 6020 t the person for whom the survey is prepared, GRAPHIC SCALE I It= 30' lonc LAND to, n his behalf to the title company, governmen- jl5landland5urveyor.com and on agency and lending institution listed hereon, and Bei to the assignees of the lending institution. Certifica- I G-147tions are not transferable to additional institutions , -q F f�Se� IV { a (1)Halbreich dock Taken March 27,2017 Looking WSW ;yam a py pm _ 4 i e (2)Halbreich dock Taken March 27,2017 Looking South r �Yt -- �S: �� R�,A �'`l I ��!� t' _ray,-_- �' � �._... '- - "�_� �• 11l Om*F7 Vff • v (3)Halbreich dock - - _ Taken March 27,2017 looking NNW IA r t y�,C,,t�✓ � � wig 1 �`''.� t Y� t - � (4)Halbreich dock Taken March 27,2017 Looking North R � >s $m--4----_B_ - ra a 7 d 141 / ID $ Q1NEtf� 1 ( \ \ rte, "",,"•_""'" \\ 32 ' � 6 7 ^ 3 to A 5 rp 1s m^ a� 6 ry O � 2 7 Yy im b 0 A ✓ >< a m "" .a � z 1 � 21 $ p0 2 25 hp wumv O � 27 ^2 � m 92y !s 30 a �rr � a1 xx 8 NOamgyY COUNTY OF SUFFOLK © E SOO7NotD SECTION NO ,o`"•M;„ ;,;�'-'- _ — M. - - - - -- —` --' -- '�^°^�°^��^ Real PropertyTaaxServiceAgency Y co m CeMei RNeiMaO NY11NN ^^ry 138 M ,Y u ^icr N^ ". .a-' "a. t - __ - .J ....'vJ.1C+u ':. ,i_• _ - - _ _ ETICE ~ .� _ P PROPERTY MAP r8 OFFICE LOCATION: ®�*®f S® y®� MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) crs Southold, NY 11971 ® �� Telephone: 631765-1938 C®U�TY,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: May 16, 2017 Re: LWRP Coastal Consistency Review for KATHY HALBREICH SCTM# 1000-138-2-12 Michael Kimack on behalf of KATHY HALBREICH requests a Wetland Permit to remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 3'x8' (24sq.ft.) walkway using thru- flow decking leading to a two (2) step wood staircase to a proposed 6'0"x8'0" wood frame fixed dock using thru-flow decking and four (4) 6" diameter pilings to secure the dock. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 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. %pFFO�►k�� Peter Young,ChairmanH -� Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., May 10, 2017 the following recommendation was made: Moved by Greg Williams, seconded by James Abbott, it was RESOLVED to SUPPORT the application of KATHY HALBREICH to remove existing 5'5"X 6' wood dock and two (2) pilings. Construct 3'X 8' walkway with Thru-Flow decking. Construct a two (2) step wood staircase to proposed 6'X8' wood frame dock with Thru- Flow decking and four (4) 6" dia. pilings. Dock is 48 sf. and staircase is 6 sf. Located: 5100 Skunk Lane, Cutchogue. SCTM#138-2-12 Inspected by: James Abbott, Peter Young, Greg Williams The CAC Supports the application but recommends the tire is removed from the shoreline. It was also noted that the existing slope is at risk due to erosion. Vote of Council: Ayes: All Motion Carried � q Soar ;'° John M. Bredemeyer III,President '� �1 Town Hall Annex Michael J.Domino,Vice-Prident �'Y � 3 �$ 54375 Main Road es P.O.Box 1179 James F.King, Trustee c SoLlthold New York 11J71-09�r �9 cam. c:,• b .,;��>��." Dave Bergen, Trustee �' .� Telephone(631) 765-1892 Charles J. Sanders, Trustee ' t .l(#i Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only oastal Erosion Permit Application Wetland Permit Application D Administrative Permit / Amendment/Transfer/ xtension V/Received Applicat n: _ �'2 � 17 MAR 2 9 2017 / Received Fee: Completed Application: _Incomplete: _ m Southold Town _SEQRA Classification: r Type I Type II Unlisted ..,Coordination:(date sent): 5 7 V LWRP Consistency Assessment Form: CAC Referral Sent: �� 17 VDate of Inspection: _Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Name of Applicant: _ �/ L eA�_1 C9 Edi Mailing Address: 2P , .4 xr. xPT �� , M. Y �Y. /a a 03 Phone Number: P/ 7- Suffolk County Tax Map Number: 1000 - ' Pro Property Location: f'&.(J/1// - ...__L M—le 0 U rely Q 6 64 E, (provide LILCO Pole#, distance to cross streets, and location) AGENT: __ �(7Al2!gL... (If applicable) Address: . .aX Phoned c ,��� Board of Trustees Applics on GENERAL DATA Land Area (in square feet): 9 ,0 0 Area Zoning: Previous use of property: Intended use of property: l'/AneN 721A)L Covenants and Restrictions on property? Yes X No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? - _Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X _N o Does the structure(s)on property have a valid Certificate of Occupancy? X Yes----No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation: Project Description(use attachments if necessary): I 01/ jC/J�Jjt'(, �'S6iX 6 W 00,0 �o Ck 4AIl-) rW 00 4-'IX 6 W601-9 IZI-V&ST C 0,V fi-;eVC7" 9/x'd /124 yo,rd --. l �44V/3Y W �TRP( Loly.DL1�lG - C QN�J'//ZU C 9' A ._....�L,/& y /. /tel. p k ml(>S . Board of Trustees Appli.c4 on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: D Area of wetlands on lot: --(j - square feet Percent coverage of lot: --p- % Closest distance between nearest existing structure and upland edge of wetlands: --0- feet Closest distance between nearest proposed structure and upland edge of wetlands: —0— feet Does the project involve excavation or filling? >e No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? _0 cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Zoyj 5 ,o Manner in which material will be removed or deposited: AM 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): v jo I o&(1 Pull I jlPd M -(Xj!-,)ods) ioq)()E] oijunbV❑ ojnjjnoij2Vr-j Isojol E] (ut,q,tiiqns)jpijuopps,,)�% It101OUILUODM jtl.ljSlIPUjr-j M wilon,posodwd-,)ql ipou pu'e'(7UlUlOfpu'uoiri000 iptil sosn ptiel Ile s 3 10 U 4.iosuods pol'old jo luuoildde oqj Xq POIJO.IILIOD.10 poumo(sopiodoid silon'Biluoo Sue puB aI(s mroid)D!3-miou jujol-o SQAOU 6pQq.mjsi p X1 luoisXqd;)q of o2ewov Iviol,-q 01!S QLJJJO jVJGJ,'IR-C :113Ao.iddu jo 1!uuod pue mou(s)XotioSe Isil IsoAjj -§—:]A zhuo2v julumu.10A02.1otpo Cue LUO.11�uipunj.to IPAoidde'I!Ltjjod v winboi uoijou psodo.id oLp$Qocl -Z Z uoljsQnb of onull U 03'OUJI -Z lied of p o ao o.i d p u e X i ud ioi unw atp ui pa=k1ye 3q kew F1INN juqj soomosw [IRIUQLUUO.IIAUO OLIJ PUB Llopoe psodoid aLlijo wolm oyljo uoildjjc)s;Dp OMILI.IJULI U gOelie'S),kjl Zuoijujngoj io'olni OAljV.IjSlUiLUPU s3A ON 'DOLIBUIplo Imul 1vool luuld ujo uo(idope QATIBIS1201 QLJJ QAJOAUI XJUO LIOIJO13 POSOdo.ld 0111 Soo(] - x'N. :opo,,)dvZ :Od/Sl!:) xo :ssoippv "21J z-p,-/Y �q ')/—�-":ouoLjdojoL :josuodS.lo jueoijddV.jo omupq -,W 01� ovy Vly X 0 7-YI7214a 11717 17.rod PWd (2-6 --7-r&,?cYIW.,r OrV 0 M afy ova ey�7 14 0 7 4f>(,,a 9 L -�Y7IYM -202Wly 9.7 '421YIA10761 172 0 7-:A-7 alla A" lWe" 6Z4-r (W J vs Ael e;K1 'g; -IJ t*)Wdw 0 3 9NI471W (room X.,./AV (2) 0 ew aviv In,0"g x c2vvIl-.-(j -;? 9 wAUy:uoijoV posodOJdJO uoijdijosa(].jDpjg 3?Y(7;7 71M,;rJ :(dew uoilpool v Llovile puv laqposop)uoiluoorl 100fOld :IDQCOJd JO uOPOVJO OLuBK uotletwopposuodS Puy,WCO-ld- I ;.cud -Luol! Sue jugwolddns of Slessoom se softd Isuoij!ppp tjo-ent, Xouo2u poloqj of ltIlasn jo Xq pDpoou oq jj!m;DAQijaq nog,qojqM UOI)13WIOJUI IVU0111PPLI Sue QP!Aojd oslu Aw no,, -I iced ui swol! Ile,oizidwoo -uoilutuiqlut luojino tio posuq aIq!ssod se XlqSiio.ioql sis.jomsue asuald'woj! Suv of puodsoi Xjjnj of popoou-,)q pinom UOljU21jSaAUI 30 qOJIMPI 113UOII!pp*e,ll ".)jqPj!PAP X11wonno uotimijojui tio poseq I IJVd Q19ldwO,-) .uOIjI?OU(J'3A ioqljnj of lookins oq XMI PUL"MOW-m-)ilqnd of jo,.)fqns we"SUIPUnj.10 JUAoiddu jqj tjoiluoilddt oqljo 1judatiloo�pq sasuodso)i -[ pt,,4jo uotialdum)aqjioj ajq!suodsai st.tostiods p;)fojdio)uu;)!jddo atil wilimmojul laofold- I I.Jud Bijilaiduioa ioj suoijanalsul IUJOJ JUOWSSd.VSVjV;U9lllUOJIAU3 IJOI/E U xymaddy ot Y 19 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ElD b.Consistent with the adoptee{comprehensive plan? L®�_I_ 6. is the proposed action consistent with the predominant character of the existing built of natural NO Y-ES landscape? 7. Is the site of the proposed action located in,or does it adjoin,a state listed Ci itical Environmental Area? NO YES If Yes,identify: vaj ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO (Y�E�S Imo! b.Are public transportation service(s)available at or near tile L—.1e site of the proposed action? �j( l— '1 c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? —9 1:1 9. foes the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and tech no logics: ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES !f No,describe method for providing potable water: �/% _ (Vl [] 1.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewatet treatment: / jy( 12 a. Does the site contain a structure that is listed on either the State or National Register of I listoric NO YES_ Places? X n` b.Is the proposed action located in an archeological sensitive area? EL 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO� YES wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? rg If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres; 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional 9 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? 9 ll 16.Is the project site located in the 100 year flood plain? —NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a. Will storm water discharges flow to adjacent properties? �NO YES b.Will storm water discharges he directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: No QYP.S Page 2 of 4 18 Does the proposed action include construction or other activities that result in the impoundment of NO YES_ water or other liquids(e.g. retention pond,waste lagoon,darn)? 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:_..-.-._.. .. ._– _w. ful 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: W _ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGEl Applicant/sponsor name: _! !� G ``I R,4.C`G Date; _ (�/-�617 Signature: �. _ _ ,LYi�� Part 2-Impact Assessment. The Lead Agency is responsible for the coin pletion of Part 2. Answer all of the•fbllowing questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"l lave 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? ff 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CFA)? 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: ❑m-- a. public/private water supplies? b.public/private wastewater treatment utilities? L 8.. Will the proposed action impair the character or quality of important historic,archaeological, �/1 ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natrn•al resources(e.g., wetlands, —❑ m waterbodics,groundwater,air quality, flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may May 10. W i I I the propose(] action result in an increase in the potential foi-erosion,flood ing or drainage Fv� El problems? El 11. Will the proposed action create a hazard to environmental resources or hUrnan health? Part 3'Determination ofsignificance. The Lead Agency is responsible for the completion ofPart 3. For every question in Part 2that was answered"moderate to large impact m«yocour",orifthmr ixoneed ouexplain wily uparticular element ofthe proposed action may orwill not result inusignificant adverse environmental impact, please complete Part 3. Part 3Should, inauffioiuntdetail, identify the impact, including any measures or design elements that have been included by the pnqjuot sponsor to ovoid or reduce impacts. Part 3 Should also explain ho`*the|oud agency determined that the impact may orwill not hosignificant. Each potential impact Should hnassessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude, Also consider the potential for uhort-turm` long-term and cumulative impacts. Check this box if you have determined, based oil the information and analysis above,and any supporting documentation, that the proposed action may jesult in one or more potentially large or significant adverse impacts and an environmental impact staternent 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 environment,I i Town of Southold-Board of Trustees N aof Lead Agency u4e President - ---T__� b,)_M ,;�4 .- —___ - __ - 1— WlinFoffype Name of Responsi c Officer in Lead Agency Title of'Resporisible Officer | 8i&ilatoruo[Roupo/x�b|oOfficer in [.eud A&uuoy Signature ofPnupu/or(if different hnm Responsible Officer) | PRINT Page 4 ot'4 Board of Trustees Applici 'on AFFIDAVIT BEING DULY SWORN DEPOSES AN13AFFIRMS 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 S'OUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF 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, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MYRROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. 11 ,--gh4ibLW (VA ) Q—JSign'ature of Property Owner SWORN TO BEFORE ME THIS . q DAY OF 2017 ....__.. Notary Public Board, of Trustees Applsce Da AUTHORIZATION (where the applicant is not the owner) I, K4+�o v __ —W b `�'` lam/ residing at .29, 45f_4% Wt__) MY10W-3, (print nam of owner of property) (mailing address) do hereby authorize (Agent) Ise i ►�� cam. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. O ner's signature) API'LICANT/AG ENT/RE-PRESE NTATIVF TRANSACTIONAL,DISCLOSURE FORM The'town of Sautint, 'S CtYtIL'Of Etl,'1CS.p�1)i,l l5 conf_l�cts O interest nn the n)r o sw! Ef!S:t.rs and c,pio recs 'i E)e purpose cif titinsr(21:&(s to provldc j�,torn,rtitic,),w},ich can alert the town of tLo.s�,il�le,cot i7ie s f�crest and alloy it to take Wltalcver notion necessary to avoid same, m YOUR NAME: 0 _/2-CAL,4- -- (Last name,first name,jniddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate,the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance - Building �- Variance Trustee Change of 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,shouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interesC'means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employce owns more than 5111a of the shares. YES NO y If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the'rown of Southold__,_ _ Title br 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 applie,�111( (when the applicant is a corporation); I3)the legal or bencficial owner of any interest in a non-corporate entity(When tha 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 7 day of ./`I20�� Signature PrintName � _�_ / hNz Form TS 1 APPLICANT/AGENT/REPRE,SENTATIVE TRANSACTIONAL IDISCLOSURE FORM ]'he To of Southo d's Code of :thi hib's conflicts of intere on the part of own dricerspid emnlovees.The 1p�rpose of this fnrm is to nroyide information which Call Alert the town of nosslble Conflicts of lnterCSk and al1nW It t0 fillCC Whatever aGtlOrl IS necessary to avoid same. YOUR NAME: (Last name,first name,diddle 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 X Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map T Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling;parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business intoresC'means a business, including a partnership,in.which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns snore than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either aleck 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 oarporate stock of the applicjlnt (when the applicant is a corporation); [3)(lie legal or beneficial owner of any interest ina non-co"rpbrate entity(wlteti isle applicant is not a corporation); C)an officer,director,partner,or•employce of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted n da f 20f/rl Signature _ PrintNameJt Form TS 1 N Cr °1 WE S I E A7fI6 s ) •!;" CO tiw l� to ra fU Certified Mall Fee $3I3c 0971 fu Certified Mail Fee $ 13c «. ..=w j(C�71 °' $ 77 Er I $ r,,77 r9 EXtfa Servioes&Fees(check box,add fee P ) \ r-I EXtra Services&Fees(check box,add lee `�pp mate) ' rt� ❑Return Receipt(hardcopy) -$ ° t\ ❑Return Receipt(hardcopy) $ a✓ r- ❑Return Receipt(electronic) $ YI d ® P tura C3 ❑Return Receipt(electronic) $ d f a P e fk O ❑Certified Mall Restdcted Delivery $ X11 H re ❑Certified Mail Restricted Delivery, $ (1) ) C-3C3 ❑Adult Signature Required - $ []Adult []AdultAdult Signature Required $ - - O ' B Adult Signature Restricted Delivery$ �✓ f-1 Adult Signature Restricted Delivery$ rt� .t I tee, C3 Postage $I_i 149 I Ln Ln Postage, $1(I 49 Ln $ � la/ Ali 7 r- $ ' I Total Postage and Fees C3 Total Postage and Fs C $ 6I59 -0 Sent To � � � _-____ /,,/ /�� `,f I ' ,0 S tTo t r r/� O Sf�ee ain P No.,or P ox ,/ O Street andA o. 1`4-O ox qlo.. _ - L f ---------- rO - - ----------- City,Sta Z' +4 / r' L - �Iry Sta /LL /V r Y 7�'� � I :ae r ,r err•r _ i PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20___, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at that said Notices were mailed to each of said persons by CERTIFIED MAI URETURN RECEIPT. i Sworn to before me this Day of , 20 i i s Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: �r Address: j;Z ,0XIA 46 NY 11?V /adz- 2"/.4/40i Z" Q cord,06 cog STATE OF NEW YORK COUNTY OF SUFFOLK --Ml i- /f � rliL , residing at being duly sworn,deposes and says that on the day of - y _, 20� deponent mailed a true copy of the Notice set forth in the Board of Trustees Application,directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at (/VL1_-> , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20J_7 ;.- Notary Public QONNIE D.Notary Public,Stae of tNew York No.01 aU6185050 QuaffCommissio'nn Exp pHi 1cou4� 2Qa--(� Michael J. Domino, j..,.ident ��Q�Q �Co�h - Town Hall Annex John M. Bredemeyer III,Vice-President , y� 54375 Route 25 Charles J. Sanders P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ®! ai 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 KATHY HALBREICH 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 /CAiq, -1 A92 a , residing at/dba PD UrNDtn At y. &.?7> being duly sworn, depose and say: That on the 4 day of IYAP )/ , 2017, I personally posted the property known as 49CF eyilk eAUW , tcrr�c�csr.�y,� AIX by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,May 17,2017. Dated: (signature) Sworn to before me this 15'4�) day of(TV�20 1'7 Notary Public CONNIE D.BUNCH Notary Public,State of Now York No.01 BU6186060 Qualified In Suffolk County �O Commission Expires April 14,2_� ,NUTILt: Ui HtARING 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: KATHY HALBREICH SUBJECT OF PUBLIC HEARING : For a wetland Permit to remove existing 5'5"x6'0" wood dock and two (2) 4"x6" wood pilings; construct a 3'x8' (24sq.ft.) walkway using thru-flow decking leading to a two (2) step wood staircase to a proposed 6'0"x8'0" wood frame fixed dock using thru-flow decking and four (4) 6" diameter pilings to secure the dock. Located: 5100 Skunk Lane, Cutchogue. SCTM# 1000-138-2-12 TIME & DATE OF PUBLIC HEARING : Wednesday, May 17, 2017 — 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 Town of Southold LWRP CONSISTENCY ASSESSMENT FORINT 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 sitnnnficant beneficial and adverse effects upon,the coastal area.(which includes all of Southold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explsainM in detail, listing both supporting and anon- supRorting 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 ANIS PROPOSED ACTION SCTM#Z.:?� - PROJECT NAME_, � G ,Q C'/� 42 a CA-- r�l►�/� GlJi�L/C r�~� The Application has been submitted to (check appropriate response): Town Board ❑ Planning]Board❑ Building Dept. Z Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation, land transaction) ❑ (b) Financial assistance(e.g. grant, loan,subsidy) (c) Permit, approval, license,certification: iP�/JDYI` 6 % �U0 IJV O CG .tZ�l//� Nature and extent of action: G �2) �rX6✓1 W 00,0 PI41AI&S' C',0A1JV-RVCT.?X4P`1 Z�-f'�fir, J rA l 'CA XI o �12a�OSL�,d 6 6 `rx ?Lo Gwj Gds / G ZV/ P Location of action: ��^� 1'/LU/V>C 1'4AJ-C_U�_C�/���1,� Site acreage: 0�_ —7 d>2 Present land use: Present zoning classification: —Qac 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: VV Y AtR I C�� (b) Mailing address: 7L"�J-7; APT 7.6 _ A/ }! V— (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken,require fining, 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 LNVRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No g Not Applicable v s' cc Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVVRP Section III—Policies Pages 3 through 6 for evaluation criteria F] Yes 1:1 No 1Z Not Applicable Attach additional sheets if necessary Policy 3. Enhanice visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes Z No ❑ Not Applicable 120 D.1' L IV 6 r W Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRjP Section III--Policies Pages g through 16 for evaluation criteria ❑ Yes 9 No ❑ Not Applicable Y� OX O "('l_ L ,0LcL0 , �/S��a � CU-,N1C1V -PXk4U4PD 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 54Not Applicable 6VOv _ !2� L 22 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 LWR.P 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. Yes ❑ No 0 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 It'] Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. �(—� ElYes1 ] NoR Not Applicable 25 12o _ OW ARZ VA � 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 0 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 S Not Applicable ` 2026' wed /.fjYi�� 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 Z Not Applicable N0 Zjy o.4 rT OIL) A-&Iy rt,,'Zr Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWR.P Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY� TITLE ,eq(7 , DATE��7