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Home My WebLink AboutTR-9030A Michael J.Domino,President � y�lO Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O. Box 1179 Charles J. Sanders N Southold,New York 11971 Glenn Goldsmith � ® �� Telephone(631) 765-1892 A.Nicholas Krupski �lif'`+oU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: -7/7/17 V✓ Ch. 275- Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction Y2 constructed V Project complete, compliance inspection. INSPECTED BY: d, COMMENTS: Wo1� Ides ��=te Don ar ,p4- -cQ, 5CU5sws CERTIFICATE OF COMPLIANCE: Michael J.Domino,President *Of SOUjy�lO Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 Charles J. SandersP.O.Box 1179 N Southold,New York 11971 Glenn Goldsmith '01 • �Q Telephone (631) 765-1892 A. Nicholas Krupski , coum� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1365C Date: July 18, 2017 THIS CERTIFIES that the installation of park benches picnic tables and a kayak rack onto the property, At 75 Nassau Point Road, CutchoQue Suffolk County Tax Map #1000-104-8-8.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 24, 2017 pursuant to which Trustees Administrative Permit#9030A Dated June 21, 2017, was issued and:conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the installation of park benches,picnic tables and a kayak rack onto the property. The certificate is issued to Nassau Point Property Owners Association owner of the aforesaid property. a Authorized Signature �pF SO(/j Michael J.Domino, President � yplo Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O. Box 1179 Charles J.Sanders Southold, New York 11971 Glenn Goldsmith O ® y0 Telephone(631) 765-1892 A. Nicholas Krupski yCoU 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 V Project complete, compliance inspection Michael J.Domino,President ��0f SOUjyOI Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith ® COQ Telephone (631) 765-1892 A. Nicholas Krupski COUNTY, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9030A Date of Receipt of Application: April 24, 2017 Applicant: Nassau Point Property Owners Association SCTM#: 1000-104-8-8.1 Project Location: 75 Nassau Point Road, Cutchogue Date of Resolution/Issuance: June 21, 2017 Date of Expiration: June 21, 2019 Reviewed by: Board of Trustees Project Description: To install park benches, picnic tables and a kayak rack onto the property. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the project plan prepared by Donna Mayne, received on April 24, 2017, and stamped approved on June 21, 2017. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. n `JtRq+ f� Michael J. Domino, President Board of Trustees 1 i ria ,ar 1 _• r r t T y E f BOARD OF 'I�ZUSTEES A • • �PWN OF SOUTHOLD D TVNE Ili 20CI i r - • a • y Nassau Point Beach April 2017 Picnic Tables Park Benches 7'-,5" 1 n 21-01 ',1 21-5 151" 3111 41 W / 31-011 7-8 rAPR 2 4 2017 i ......... r T Michael J. Domino,Presid z I S�FfO(k�O�i y Town Hall Annex John M. Bredemeyer III,Vice-Prestaent ,Z �� 54375 Route 25 Charles J. Sanders z P.O.Box 1179 Cn Glenn Goldsmith 1 Southold,NY 11971 A.Nicholas Krupski yob p � Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: ?J 1� Completed in field by: NASSAU POINT PROPERTY OWNERS ASSOCIATION requests an Administrative Permit to install park benches, picnic tables and a kayak rack onto the property. Located: 75 Nassau Point Road, Cutchogue. SCTM# 1000-104-8-8.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: a (2— Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Seders Other Page 1 of 2 Michael J. Domino,Presid. � O�QSUFFO(� i Town Hall Annex John M. Bredemeyer III,Vice-President y,,, 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski *n p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: NASSAU POINT PROPERTY OWNERS ASSOCIATION requests an Administrative Permit to install park benches, picnic tables and a kayak rack onto the property. Located: 75 Nassau Point Road, Cutchogue. SCTM# 1000-104-8-8.1 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 VI "s-z in C Supply Exceptional Comfort Malibu benches are the perfect choice for environments where looks are just as important as rugged durability. VVdh the contoured seat and seat-back these benches supply exceptional comfort. Their unique design also prevents any potential snagging of clothing and irlury as a result of sharp comers or exposed hardware. The combination of environmentally friendly, recycled plastic construction with stainless steel wordes whether the climate is hardware means no sun, sea or both. As an additional feature, armrests are available for WI the added comfort appeal or to help meet ADA guidelines- V Length In-ground fftunt Cedar Bench I Black Logs Re, ycAeld Plasliko Ste- ""v N n a We Elegant @`Green" Picnic Table This s"over Picnic table has the appearance of the traditional wood Picnic table but is constructed with 100%recycled plastic for a more environment friendly touch. Recycled plastic is weather resistant, easy to clean, and won't splinter. Slats are available in the wide variety of colors shown. Heavy-Duty Vx Sw legs provide the kind of durability needed in any recreational setting. Tables are available in either 6 or V lengths. Tabletop and seats come with either 2" x 1(r or T x IV width planks depending on the length table ;a r'XR you select. VVheelchatr accessible tables are also available, and are identified"Universal Access" by a blue end cap. Table is secured YAth all stainless Model RPOS steel fasteners. Cedar Top and Seats I Brown Frame a _ � f l( � w. , r } c 1 ti �ll .� mks 1Y t k t •� .; •111 : yav r , , r -�,.�£� +x,.:iYN�� ii�.a�°� �� ,� :� A�� ` ..,d ,•, .._. .... N�«owa, „a��. ,u , `ate „r. , I r 1 M x ;r u E M , r i y €I �1'� a r r :r a p � t � WWII 41 oz t, r�« y.. ar.t a° Y."n .. •zip''. u _ $' ,' Y stn• .. 4� rr^ � wnt�.".0 ,, r .. � # .. �a H ms7 is ;X *` ^iM .►, °tY i q�r s ''u,r 9shit.... - «}.� ` +.. r..F.r r° 'Y'�YIF' t, hl^•• •:;nt a �' d w It —�—• + o: e.G `.� • - . «.... .. .._ .. a..� y� �' `'m�" � ,r �- �� er ._., Jr i «.�r,rdl � '+a S:e' .,(a �-` n � A)Ay t f } r r _.xsr-t�: ert a - •wuww s:xra ` � i 1 s Fill':C:fl17:ew-3Y.jpi' SIT P&-.-,1 --RATION 'LOOK DIMENSIONS TABLE T These di -ions are ideal to use for your 1t is most impormm to have a solid,fiat and level foundation for yow gazebo. foumdatioat,tvlzeflmT you l e a gazebo door ornot. Indicate the lotmtiou of your gazebo foutudation by doing the following. size C 1 Cut 8 hoards at a 22.5'angle Each should be the length of dimension`C' 8 ft. 1413'7/s (W 39 74" at their longest point. 10 ft, 129'/x' 120" 49 rr/16" 2. Place the boards around the perimeter of the A $"�ft. 155 7/81' I44"° 59:51i site to be prepared for pour-gazebo. �r 14 ft 181 7&' .168" 69"/r4" Verify that the boardss are pwsitianed in an a 16 ft_ 207 192'" 791,67 octagonal shape by using dimensions'r1 and'S'. p t3 " " '� 181t_ ��3 /� 216 89,12- 3. Spray paimt along the outside of the boards to V20 ft 239 0&' 240" 99-'/Y6" indicate the precise perimeter ofyour gazer llturr E._rLmW gazems shoWd be installed on a and then remove the b . concrete pad made to these dimemons. *Note:if you choose the concrete pad o.Vion,refer to the instructions s in dh-bottom right caner 24 ft_ 316" 292 1211�/►E of this page. 28 ft. 37011,- 342" 141 1'/1 ' 30 396 t/$" 3W 151 s/R" Carefully consider the recommendations listed blow prior to choosing the ideal foundation for your gazebo. CRUSHED STONE CONCRETE PYLONS S��071N�CRE�TEPA�]D � I. Dig out 3"-G of ground. 1.Dig 12"diameter holes at each octagonal I.Dig out 47-5"of ground so it is 2_ Plant-concrete blocks at each octagonal point and in the renter(9 holes torsi)- level all throughout its lowest point_ point and in the center(9 blocks total). ?Begirtnkp at the ground's highest point, 2.Temporarily plant wood foams 3. The top of the blocks will be the plant a 12"diameter Quick:-Faro tube. around the perimeter of your highestpoint of your foundation.All 3_Secun:ty plant the remainder of the tubes gazebo foundation area. blocks trust be level%ith each other mabng sure the top of each is le-ml with 3.Dig a 12'xl2"continuous footing 4. Place 3"-4"of crashed stone around the top of the first tube that you planted wound the perimeter of the pain. the blocks and throughout the in the ground. 4.Use rebar as needed. foundation.Make sure none of the crushed 4.Use tebar as needed :5.Pour cancree througltom ttte base, stone are higher than the blocks. 5.Frill each tube%vA concrete and allow it making sure all points of the top to me before placing your gaze de& are le%,l_ b.Tose metal L brackets to secure the gazebo dem to tate pylons. r-,� 134nning ';bad I eck 4 ma-DI �. 1 I� Note-The top dt3 L'1DIIE tY3�CtE pad should be I"abote g'd& V concych, d I C 1 27 x 12'cerrniti¢tstrs foauzng I7s�rh armies Haag upon 3'tsr fi depth wail cond2ftans 612"-l 7"cement blocks 2"thick 12,.deter concrete tabes hen you cut the form boards ® fur;your concrete pad,make sure lire short points of each board are Stretch a string around the Such a string around dila cut to the"C"dimension.This perimeter according to the chart per. 'eta accudi€g to the chart cvdfl erasure that your concrete above.Place the blocks against above.place the concrete pylons pad is made precisely to the the string. against the string. dimensions shown above. \\ Amish Country Cffzebos is not responsible for site paeparatims.The property owner is Visible for permits if ars are teed.Enginecred drawer wre avmiIabk- J �ys� 9TH µ��} x 'r1'liY• i ro mr ,r-.01 / pa 5 c / `4•'r'S,.why We � .•f z'��t3w; Z4 f5ir„ #SSS, %ty IS -" Michael J.Domino,Presid ~' �Q Ca Town Hall Annex John M. Bredemeyer III,Vice-President G��, 54375 Route 25 Charles J. Sanders P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski '1',�O �p� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD J° Date/TimetIO Completed in field by: N- Nassau Point P.O.A. on behalf of NASSAU POINT CAUSEWAY ASSOC. requests a Pre- Submission Inspection to propose trucking in a sufficient amount of sand to cover the badly eroded beach; and for a proposed gazebo, benches and picnic tables which would be located on the other side of the parking lot, away from the beach. Located: 75 Nassau Point Road, Cutchogue. SCTM# 1000-104-8-8.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice'of Hearing Card Posted: Y / N Ch. 275 Ch.-111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application comm pleteness/comments/standards: — Cg'iMe elf-I-I�c� Present were: J. Bredemeyer '_�M. Domino G. Goldsmith N. Krupski L t,b C. Sanders Other Page 1 of 2 Michael J. Domino, Presid, (�A Town Hall Annex John M. Bredemeyer III,Vice-President � 54375 Route 25 Charles J. Sanders P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Nassau Point P.O.A. on behalf of NASSAU POINT CAUSEWAY ASSOC. requests a Pre- Submission Inspection to propose trucking in a sufficient amount of sand to cover the badly eroded beach; and for a proposed gazebo, benches and picnic tables which would be located on the other side of the parking lot, away from the beach. Located: 75 Nassau Point Road, Cutchogue. SCTM# 1000-104-8-8.1 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 a k .', 44iH w A 14,41i"ol�llol y WAIL 3 � / r. d r 3: feet 500 meters 100 N314= LIME CREEK LD 44 15 21 0 fil C) G) 9A( el 4 rxw 2. 13 6A(c) o- BROADWATERS COVE o, TOWN OF SOUTHOLD tic) 12 4N, 110(c) 18A(.) 12 s 4 6 9 Q9 HAYWATER COVE -7' :OUNTY,OF,SUFF9LSECTION NO I IX OFFICE LOCATION: � *®f S®�dyOl® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) cn Southold, NY 11971 ® �Q Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Mike Domino, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: June 13, 2017 Re: Local Waterfront Revitalization Program Coastal Consistency Review for NASSAU POINT PROPERTY OWNERS ASSOCIATION SCTM# 1000-104.-8-8.1 NASSAU POINT PROPERTY OWNERS ASSOCIATION requests an Administrative Permit to install park benches, picnic tables and a kayak rack onto the property. Located: 75 Nassau Point Road, Cutchogue. SCTM# 1000-104-8-8.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the 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. \\QF S®(/ly Michael J.Domino,President Town Hall Annex h®� ��O John M. Bredemeyer III,Vice-President 54375 Route 25 jW P.O.Box 1179 Charles J.Sanders N Southold,New York 11971 Glenn Goldsmith �Q Telephone(631) 765-1892 A.Nicholas Krupski lif'COUN1 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/Extensi n Received Application: '�Zµ1 7 Received Fee: $ 1"Q,00 Completed Application: r; DF , Incomplete: SEQRA Classification: Type I_ Type R Unlisted Lead Agency Determination: r ' APR z 4 2011 Coordination:(date sent): LWRP Consistency Assessment Form Sent: �' q` l' -y�—CAC Referral Sent: Southold;a,80 V Date of Inspection: 13,17 Roardof T, rustp'g J Receipt of CAC Report: Technical Review: Public Hearing Held: zt,17 Resolution: Legal Name of Property Owner(s): ZZ4_0_A Mailing Address: �Pd 13n,< ---? V,6 (f_ c-e-fc-g-C o Q u AJ Y //J3 S— Phone Number: f- 7!? U- to--,J 4 ^ 1�'A'IIUA '�— Suffolk County Tax Map Number: 1000-- 9 Property Location: (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Board of Trustees Applic;; ion GENERAL DATA Land Area(in square feet): � 9/,/, Area Zoning: d," Previous use of property: Ar "'V A f tf 12'e13L C-K— Intended use of property: Covenants and Restrictions on property? _______Yes__ 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 >< 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.? YesNo Does the structure(s) on property have a valid Certificate of Occupancy? Yes )4- No AJIA Prior permits/approvals for site improvements: Agency Date X110 N e�- No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? )1, No Yes If yes, provide explanation: Project Description (use attachments if necessary): Ag rk 11�P tiaeS Board of Trustees App11e4- on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: he6 s9 r"eA -C-a� r res e a--r— -1-1-z—, col"M LC"1'4- Area -Area of wetlands on lot: A 1 ,4 e- square feet -Z) 7 . �51 Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: /O U 4/4�'l feet Closest distance between nearest proposed structure and upland edge of wetlands: /o d feet Does the project involve excavation or filling? 41 No Yes If yes,how much material will be excavated? /� /� cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: A,/ 9- feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 'hz Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: //'.�o /' d>4 - Project Location(describe,and attach a location map): Brief Description of Proposed Action: e-C/ Name of Applicant or Sponsor: Telephone: E-Mail: Address: �d /3oX 6 City/PO: State: Zip Code: C` t two I /1/ y /193_5'_ 1.Does the proposed action o ly involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3.a.Total acreage of the site of the proposed action? , acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial esidential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 4 5. is the proposed action, NO YES A a.A permitted use under the zoning regulations? ❑ ET ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 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 YES b.Are public transportation service(s)available at or near the site of the proposed action? ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: f,� ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO S Places? ❑ b.Is the proposed action located in an archeological sensitive area? ❑ ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ PT b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Idet}tify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline El Forest ❑Agri cultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO ES 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 YXS If Yes, ❑ a.Will storm water discharges flow to adjacent properties? ❑NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ❑YES 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,dam)? If Yes,explain purpose and size: ❑ Er 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO Y completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spon name: �OV�FSs/}GG d'diAl� Dater Signature: lt_ _4—e— i Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning 1:1regulations? Fr 2. Will the proposed action result in a change in the use or intensity of use of land? F] 3. Will the proposed action impair the character or quality of the existing community? I-1 ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate (�� ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? EO/ El b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage la", [:1problems? 11. Will the proposed action create a hazard to environmental resources or human health? LLA Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by ------the-project-sponsor--to-avoid-or-reduee-impacts—Part3-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. F] Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees (JI /t I Name of Lead Agency Date oyiq Ib President Print or Type N e of Res on ' le Officer in Lead Agency Title of Responsible Officer Signature of Resp Bible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT I Page 4 of 4 J 'Board of Trustees Applica�__<:)n AFFIDAVIT A PDI BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN -- -ARE-T-RUES'O-THE--BE-S-T-OF-HISIHE-R-KNOWL-EDGE-AND-RELIE�ANH--T-RA-T---------- ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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 OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature o roperty Owner SWORN TO BEFORE ME THIS DAY OF L , 20 17 Aliw� A(A4- Notary Public DIANE DISAWO NOTARY PUBLIC-STATE OF NEW YORK No. OID1475593 Qualified In Suffolk County My Commission Expires April 30, 20IT APPLICANT/AGENT/REPRESENTATWE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,first name,griddle 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 through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of&uthold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of /�` 0�/ 4,200-17 Signature mac_ t Print Name Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt ..._____.___.._.__minor-action_listpolicies..and_.explanations_of_each_policy_.contained_in_the To_wn_o£Southold-Local__.__ .._ Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# - - PROJECT NAME The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity, agency regulation,land transaction) ❑ (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit, approval, license,certification: ❑ Nature and extent of action: �i--- Location of action: o7''iy�ss�9cef. �e� Site acreage: Present land use: 6x— 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: /?/'/'O P P�/7 -- --------- ---- — - -------------------------------- (b) Mailing address: �� aoX 2 SSG Cu (c) Telephone number: Area Code 01-7,7 (d) Application number,if any: Will the action be dir y undertaken,require funding, or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Polici 'Pages 3 through 6 for evaluation criteria 1:1 Yes 1:1 No Not Applicable f Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pa 8 through 16 for evaluation criteria F] Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 throu 21 for evaluation criteria 1:1Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No Not' .,plicable 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 uluation criteria. --_--�_-_❑ Yes--D No 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. El Yes 1:1No E1 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. �� 1:1Ye� No U Not Applicable i f Attach additional sheets if necessary WORKING COAST POLL_31S Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See WRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes [:] No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Tow7NotApplicable rs. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes 1:1 No ` Attach additional sheets if necessary Policy 12. ProtectENot ltural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for eon criteria. ❑ Yes ❑ No Applicable Attach additional sheets if necessary Policy 13. PromoteENot priate use and development of energy and mineral resources. See LWRP Section III—Policies; 65 through 68 for evaluation criteria. ❑ Yes ❑ No pplicable PREPARED BY_,��p st�,AVA- ,�/��y�� TITLE DATE Proposed Pian for the NPIOA Section of Nassau point Beach At the last Board meeting held in October,a discussion ensued concerning the possibility of beautifying the underutilized Nassau Point section of the causeway beach.The primary objective was to come up with a plan to make our area a more appealing and usable place for our members to enjoy their time while at the beach. A committee was formed and over the winter months and they formulated a plan,or you might say a dream,to enhance the area by establishing a park like setting close to the beach. Utilizing the grounds between the parking area and road,a shade focused oasis from the hot sun of the beach will be provided. The first phase of the plan will begin with the creation of a relaxing gathering place to meet up with friends and family.This would be achieved, with the addition of several picnic tables(2)and park benches(4) interspersed between the trees.The pian will also incorporate two free standing Kayak racks,to be placed at the far right area near the existing railing,allowing members to lock and leave their kayaks behind if they choose,avoiding the need to drag them back and forth every time they want to use them. The second phase of the plan will be the addition of a beautiful and yet very functional 12'x14'Gazebo,which will certainly become the centerpiece of our community beach.It will be the perfect spot for enjoying a sunset or an early morning sunrise with maximum views of both Peconic Bay and Broadwaters Cove. We feel strongly that these improvements will enhance the quality of life in our community while making better use of the beach area that we own. Nassau Point Property Owners Association P.O. Box 346 Cutchogue,NY 11935 Town of Southold Board of Trustees Southold Town Hall Annex_ 54375 Main-Rd,.- ,P.O,. ain Rd:P.O. Box 1179 Southold,NY 1197-1, February,23, 2017 Dear Trustees; The,Nassau Point Property Owners Association is considering some improvements to our Causeway Beach located at the entrance'of Nassau Point on Nassau Point Road,next to the_ Town of Southold beach. -Before proceeding, we would like to request a"pre-submission inspection"of our proposed project. It-is our understanding that.the trustees will be,visiting various-locations on March 14. I-will be available to join the trustees to explain the project along with-Donna Mayne (cell 9 809-3902),and Jack;DiPaola(cell 516-650-2230). We ate all members-of.the NPPOA.boarc By means of this letter we.grant the trustees the necessary permission tot go on the property, question, the Causeway Beach. Also enclosed is_a check for,$50 payable to the Town of Southold to cover the cost of the,inspection.; For your information,_the board is looking to-increase the amount of sand atthe,beach byeii dredging or-trucking in a sufficient amount of sand to.cover the badly eroded beach. Additionally,we would like to site a gazebo,benches and piciuc tables on the property on tI other-side of the parking lot, away from-the beach.=This project is•still in its early stages but would appreciate the views and inputbefore proceeding.` If you'should have any,questions,please do not hesitate to contact me at,202-744-1467•or b; email.. - _. .. _ _-_ _-. _ _. Sincerely, Alfonso Martinez-Fonts,-Jr. Recording.Secretary. Du FEB 2 4 2017 4 Southold ToWn _1 �(�fl�01 Tr�cipn� J