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TR-9087
Michael J.Domino,President �QF SUFI Town Hall Annex John M. Bredemeyer III,Vice-President hQ� y�lO 54375 Route 25 79 Glenn Goldsmith .1L P.O. ox 11 T Southoldd,,New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams %�` �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 12, 2018 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: RICHARD SACHS 2435 LAUREL LAKE DRIVE, LAUREL SCTM# 1000-121-4-17.1 Dear Ms. Moore: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, December 12, 2018: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#9087 from Carole Rich & Donald Wilder to Richard Sachs, as issued on September 20, 2017. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, —ruj L*-. Michael J. Domino, President Board of Trustees MJD/dd PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold, New York 11971 Tel.(631)765-4330 Fax:(631)765-4643 www.mooreattys.com email: pcmoore_,mooreattys.com Board of Trustees Town of Southold PO Box 1179 Southold NY 11971 hand delivered RE: PERMIT TRANSFER Dear President Domino and Board: Please let this serve as a permit transfer request of permit#9087 (copy enclosed) for property located at 2435 Laurel Lake Drive, Laurel,New York (sctm: 1000-121-4-17.1 ) from Carole Rich &Donald Wilder to Richard Sachs. I am enclosing the Affidavit signed by the owners and their authorization together with my(client's) check is enclosed in the amount of$ 50.00 for said fee. Thank you and please do not hesitate to call should y ave any questions. Ver t ly yours, atricia C. Moore PCM/ss OCT ' 4 2018 ends. OCT i _ .__1 Board of Trustees Applic___on County of Suffolk State of New York RICHARD B. SACHS, BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTI ITH IEW OF THIS APPLICATION. ch Sworn to before me this A8 day of : Wiv& , 2018 C Not4ry P lic MARGARET C. RUTKOWSKI Notary Public, State of New York No. 4982528 Qualified in Suffolk County �O Commission Expires June 3, 9 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) RICHARD B. SACHS,residing at 88 Central Park West#4,New York as owner of premises 2435 Laurel Way a/k/a Laurel Lake Drive, Mattituck,NY (sctm: 1000- 121-4-17.1 do hereby authorize attorney, Patricia C. Moore, to apply for permit(s) and appear before the Southold Board of Town Trustees on my behalf. er's signature) LH B. SA APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Endes prohibits conflicts of interest on the Wrf of town off cus ani emp i•vim, -The so of is&rm Is to ymide Informationwhich can alert thetown of pguhl; i t to tWw whatever Rean r wry to avoid saw. ' YOUR NAME: � C r l (Last name,first name,rpiddle 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,pamn4 or child)have a relationship with any officer or employee of the Town of Southold? "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); 8)the legal ornefiicial owner of any interest in a non-corporate entity(when the applicant is not a coMoratian); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi / Signature Print Nam _ Form TS 1 �lC PA t� C 'A C- ��� SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument DEED Recorded 09/06/2018 Number of Pages 4 At: 04:22:19 PM Receipt Number : 18-0166992 TRANSFER TAX NUMBER: 18-04328 LIBER: D00012977 PAGE: 380 District Section Block: Lot: 1000 121 00 04 00 017.001 EXAMINED AND CHARGED AS FOLLOWS Deed Amount $769,999 00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20 00 NO Handling $20.00 NO COE $5.00 NO NYS SRCHG $15.00 NO EA-CTY $5.00 NO EA-STATE $125.00 NO TP-584 $5.00 NO Notation Cert.Cbpies $0.00 NO RPT $200.00 NO Transfer tax $0.00 NO Comm.Pres $12,399.98 NO Fees Paid $12,794 98 TRANSFER TAX NUMBER: 18-04328 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County FF171❑2 Number of pages '1-,!3 0- 4! !'"-ITH P. E This document will be public CIER.r. IF FOV -CIATY record. Please remove all -0. Social Security Numbers prior to recording. Deed I Mortgage Instrument Deed Mortgage Tax Stamp Recording I Filing Stamps 3 I FEES Amt Page/Filing Fee C7, Mortgage I Basic Tax Handling 00 2. Additional Tax TP-584 Sub Total Spec/ASSit. Notation � or EA-52 17(County) Sub Total Spec.iAdd. EA-5217(State) TOT MTG.TAX R.PT.S.A Daa-—own :fturuy CC) CC He'd to _�rA Contin.of Ed. S. 00 Mansion Tax Affidavit Certified Copy —-- The property coveredby this mortgage is or will be improved by a one or two NYS Surcharge family dwelling only. , 15, 00 Sub Total J YES—or NO Other — — Grand Total If NO,see appropriate tax clause on page# ofs instrument` ih!si 18029929 1000 12100 04CO 017001 017.001 S Community Preservation Fund Real Prol P T S Consideratioe Amount$ j7bq qq PT � Tay.Serv;. �RIPA A 0 � r ,�7P F�Ti.D $ Q-3F1 Agency :"_, 06-SEP-1 Improved Satisfactior,s,fDischaxges/Releases List Property Owners Mailing Address 6 RECORD&RETURN TO: Vacant Land Patricia Moore, Esq. TD 51020 Main Rd. TD Southold, NY 11971 TD Mail to:Judith A.Pascale,Suffolk County Clerk 17 Title Company Information 310 Center Drive, Riverhead,NY 11901 Co.Name Chicago Title insurance Company www.sLj4folkcountyny.gov/clerk Title# 7404—U()I—= 8 Suffolk County Recording & Endorsement Page DEED This page forms part o,"the attached made by (SPECIFY TYPE OF INSTRUMENT) CAROLE RICH AND DONALD E. WILDER The preiniiscs;herein is situated in SUFFOLK COUNTY,NEW YORK. SOUTHOLD TO In the TOWN of —. -- RICHARD B. SACHS In the VILLAGE . MATTITUCK or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILL\G. ns� BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS(INDIVIDUAL OR CORPORATION) STANDARD NYBTU FORM 8007 CAUTION:THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELIL-R AND PURCHASER BEFORE SIGNING. THIS INDENTURE,made the )5 dayof 2018 between CAROLE RICH and DONALD E.WILDER as tenants in common, residing at 2435 Laurel Lake Drive,P.O.Bos 720,Mattituck,NY 11952 parry of the first part,and RICHARD B.SACHS,residing at 88 Central Park West 94 South,New York,NY 10023 party of the second part, W'IT.NESSETIC,that the parry of the first part,in consideration of Ten Dollars and other lawful consideration,lawful money of the United States,paid by the party of the second part,does hereby grant and release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever, ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected, situate,lying and being at Mattituck,Town of Southold,County of Suffolk and State of New York. SEE SCHEDULE`A'ATTACHED HERETO AND MADE A PART HEREOF Being and intended to be the same premises described in a deed made by Donald Rosen and Carole Rich and recorded January 22,1999,in Liber 11941,at page 83 and in a deed made by Donald Rosen and Carole Rich and recorded January 22,1999,in Liber 11941,at page 82. TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appurtenances and all the estate and rights of the party of the first part in acid to said premises, TO HAVE A.ND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part,covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above written. CAROLE RJJCLI DONALD E.WILDER NYSBA Residential Real Estate Fomu m HotDocs"(9100) Copyright Capwite Deveiupment CHICAGO TITLE INSURANCE COMPANY TITLE NO.7404-001151 SCHEDULE A-1 (Description of the Land) Far Tax Map ID(s): 1000-121.00-04,00-017.001 AMENDED 08/02/18 ALL that certain plot,piece or parcel of land,situate,lying and being a;Laurel,in the Town of Southold,County of Suffolk and State of New York,bounded and described as foliows. BEGINNING at a point on the southwesterly side of Laurel Way said point being 2,985.83 feet southerly from the southerly side of Sound Avenue;said point also being where the northerly corner of land(now or formeriy)of Cao intersects the sou;hwestedy side of Laurel Way; RUNNING THENCE South 35 degrees 37 minutes 40 seconds West along land(now or formerly)of Cao 313 48 feet to Laurel Lake, THENCE along Laurel Lake the following 2 courses and distances 1.South 86 degrees 28 minutes GO seconds West,19.39 feet to a point, 2.South 88 degrees 09 minutes 30 seconds West,97.77 feet to a point to land(now or formerly)of Schoenfeld; THENCE North 27 degrees 43 minutes 00 seconds East along said land 361.66 feel to the southwesterly side of Laurel Way, THENCE along the southwesterly side of Laurel Way the following 2 courses and distances. 1.South 65 degrees 39 minutes 00 seconds East,135.03.`eel to a monument; 2.South 57 degrees 39 minutes 00 seconds East,10.00 feet to the point or place of BEGINNING. THE POLICY TO BE ISSUED under this commitment will insure the title to such buildings and improvements on the premises whicn by law constitute real property. FOR CONVEYANCING ONLY: Together with all the right,title and interest of the party of the first part,of in and to the land lying in the street in front of and adjoining said premises. END OF SCHEDULE A ccn,.,,nm,mmruuc-w.�._c r1mm oe.ozne woeau Scneeule n-t_•er.vpai wY-CT-F9vH-01010431074-SPS-1.16140<-pJ1151 STATE OF NEW YORK ) )ss. COUNTY OF SUFFOLK ) On the 15 day of ) ,in the year 2018,before me,the undersigned personally appeared Carole Rich and Donald E.Wilder,personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their capacity,that by their signature on the instrument,the individual,or the person upon behalf of which the individual acted,executed the instrument. rattyPUBL riFOFn Ietrctian trSrA EVYi NOTARY PUBLIC Sat ur +,*SSttrl�%pSuto Ca�atYB¢J a$❑e��n ��2C,21 DEED Tide No.-7 Y101�_ ®t7)t ( Section 121.00 Block 04.00 RICH AND WILDER Lot 017.001 To County or Town SUFFOLK SACHS Return By Mail To: Patricia Moore,Esq. 51020 Main Road Southold,NY 11971 x Reserve This S ace Fur Use Of Recording Office 1 NYSBA Resni nnal Real Estate IF—on tiotDoes^(9/00) Ccpynght Capsofl"Dovelopment -2- Michael J. Domino, Pr, itl�S11FF01 Town Hall Annex John M. Bredemeyer III, Vice-President �' y� 54375 Route 25 Glenn Goldsmith N = P.O. Box 1179 A.Nicholas Krupski "f Southold,NY 11971 Greg Williams ?� �plr Telephone(631)765-1892 T l� Fax(631)765-6641 1171 ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 12/9/1<5 Completed in field by: G . 6a 1 d5r„ J4 Patricia Moore, Esq. on behalf of RICHARD SACHS requests a Transfer of Wetland Permit #9087 from Carole Rich & Donald Wilder to Richard Sachs, as issued on September 20. 2017. Located: 2435 Laurel Lake Drive, Laurel. SCTM# 1000-121-4-17.1 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 V' Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment ✓ Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: OK -Vo 1<-o.yNs �e_� !R&,c' r,^, . Ex �O►ng 066 4 . I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino \//G. Goldsmith N. Krupski G. Williams Other �QF SO Michael J. Domino, President � yQ�o Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 00, Charles J. Sanders Southold,New York 11971 Glenn Goldsmith Q O ® a® Telephone(631) 765-1892 A. Nicholas Krupski lif'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 % constructed Project complete, compliance inspection TERMS AND CONDITIONS The Permittee Carole Rich&Donald Wilder, residing at 2435 Laurel Lake Drive,Laurel, 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. Michael J.Domino, President 0f SO!/Ty0Town Hall Annex John M.Bredemeyer III,Vice-President �� lO 54375 Route 25 P.O. Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith a� Telephone(631) 765-1892 A. Nicholas Krupski Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 20, 2017 Ms. Carole Rich Mr. Donald Wilder P.O. Box 720 Mattituck, NY 11952 RE: 2435 LAUREL LAKE DRIVE, LAUREL SCTM# 1000-121-4-17.1 Dear Ms. Rich and Mr. Wilder: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, September 20, 2017 regarding the above matter: WHEREAS, CAROLE RICH & DONALD WILDER 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 August 7, 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 recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered policies 6.3 & 9.4 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit for the structures; that non-treated lumber is used for any and all repairs to dock; and that any alterations or reconstruction to existing dock will require a new wetland permit from Board of Trustees, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on September 20, 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 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of CAROLE RICH & DONALD WILDER for the existing 80'6" long fixed timber dock consisting of landward steps to ground leading to a ±73'1" long by 4'8" wide fixed dock, and a 12'0" long by 7'5' wide seaward fixed platform in a "T" configuration; with the condition that non-treated lumber is used for any and all repairs to dock; and that any alterations or reconstruction to existing dock will require a new wetland permit from Board of Trustees; and as depicted on the project plan prepared by Donald Wilder, dated August 5, 2017, and stamped approved on September 20, 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, e Michael J. Domino President, Board of Trustees MJD/dd -tea Michael J. Dom ir,U,—President �'S�FFo(k Town Hall Annex John M. Bredemeyer, III, Vice-Presidentt�o�� c�ay 54375 Route 25 Charles J. Sanders o P.O. Box 1179 Glenn Goldsmith ? Southold, NY 11971 A. Nicholas Krupski �+�y ® o� }' Telephone (631) 765-1892 fo Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Please be advised that your application dated 71 Zoll has been reviewed by this Board at the regular meeting of %5 401-7 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) % Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement(complete original form enclosed and submit to Board of Trustees Office) 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: TOTAL FEES DUE: $ Soo f10( BY: Michael J. Domino, President Board of Trustees C� VE AUG - 7 2017 Southold Town ar of Trust P BLL- ®ECf< IJL 2"K6 " 04 -,24 /7 rz —r sr BY `BOARD OF TRUSTEES `T' TOWN OF SOUTHOLD S.c �� > 8® DATE , , zot7 3 x TY PI CR c_. Loh-r 2 o E PTIA 6 04) DDG K /4T ro o8-0 201 -7 51-D E LI'9Ul� L L/iKE DR, N /000-1 21-0 4 - /6 D124(A)k) Z)®a lWZ-0 wl Lo c f�8_-O 5-ZOO 7 c�2®�,� SEG ` 1&40 cd1zzd2 Michael J. Domino, Presk O�Q .00, Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Charles J. Sanders y P.O.Box 1179 Glenn Goldsmith r Southold,NY 11971 A.Nicholas Krupski � p! Telephone(631)765-1892 ��� �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 9/)211`? y; VO Completed infield by: CAROLE RICH & DONALD WILDER request a Wetland Permit for the existing 80'6" long fixed timber dock consisting of landward steps to ground leading to a ±73'1" long by 4'8" wide fixed dock, and a 12'0" long by 7'5' wide seaward fixed platform in a "T" configuration. Located: 2435 Laurel Lake Drive, Laurel. SCTM# 1000-121-4-17.1 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. 275Ch. 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: 14) raLL4 4 %"'A 0- lene& � ± ,20 ) and G 4o q�, c�s1� arc<.�.: Qs Q ��e Gar;S t►ng nan - C-On-Q r0", 1 Q d oc-k 'vb e� 4 MGvh,�hp Irl ar0611; ell/ Present were: J. Bredemeyer AM. Dominoy G. Goldsmith A Krupski 1//C. Sanders Other Page 1 of 2 i �FFQ( ' " Michael J. Domino,Presid O�QS CCG ? Town Hall Annex John M. Bredemeyer III,Vice-President V_ 54375 Route 25 Charles J. Sanders y P.O.Box 1179 Za Glenn Goldsmith ry Southold,NY 11971 A.Nicholas Krupski ?, ® p! Telephone(631)765-1892 �Od �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD bate/Time: Completed in Work Session by: CAROLE RICH & DONALD WILDER request a Wetland Permit for the existing 80'6" long fixed timber dock consisting of landward steps to ground leading to a ±73'1" long by 4'8" wide fixed dock, and a 12'0" long by 7'5' wide seaward fixed platform in a "T" configuration. Located: 2435 Laurel Lake Drive, Laurel. SCTM# 1000-121-4-17.1 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 u x.13.4' m• v 18.a'' 1.7f AUG 2017;' a.a GE s I 1J.D' .IQO' 21,4' 4 j Q;' 9.5. PATIOD' 21.0,, �� QOH l U{{fC°C^ .7. 4,�U:., ' `"'`�.^,�\19 �,• 1A `, nJ 1A_ 12.10 TIE LINE ,7IE LINE SHORE LINE �S 88 09 30 W ' 1"9.39' S 86'28'00' W r LALMLLAM t I rZ b 10x0-121- 04— -7 '_s " 10.00-121— 04-= NO TE: CONTOUR LINES ARE ARE REFERENCED TO THE FIVE EA, STERN ,TOWNS TOPOGRAPHIC MAP N.G.V.D' 0=ME7NUMENT : ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION , OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-SUBDIVISION 2, ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON, i (� E C E � = E PF)jR i AUG ' �VOIVM OF PR OPER T Y AT TTITUCK J Southold To F S 0 UTHOLD Board of COUNTY , N. Y. 1000-121-04-16 & 17 SCALE 1"=30' JAN 9,2001 J 1 S ' i$0 S 1 E' re,po D9p• t " p f0 -110 ^ibbb ?r\OR�J>�.•V�1j11' ,—_4, "01 (gCrGgCJ s� 3Q� f COTTAGE � ♦ I P ��' t 14? r �'� 7 / _ �f6' _•lv 0O / l Ay�1ao 5141 a "i . M S 88'09'30' V - _ 9777' 1939' --- '"" S 86'28'00' V 3 LAUREL LAKE 1000-121-04-16 AREA=20,518 S.F. to tie line 1000-121-04-17 AREA=20,301 S F. to tie line NO TE. CONTOUR LOVES ARE ARE REFERENCED TO THEOt "QtvFGy� FIVE EASTERN TOWNS TOPOGRAPN/C MAP N H V-D frO4 ■=MONUMENT �Jhk,-1,= iIV y 1 T(, Nr 59E1t� ,INS Al 11 RA71FIN IN PULIHI'A-11, IM1_ +URVEI i_ A bIGLAT'GN - pllO �, �, 'g�,Eo FC GT SECT ION :209 CT THE NEW rOFI, _TATE FV0i a'T10N i AW �, i -,r- "e,J,i(' r`AX .6 11 765-1797 E NFFPT Ac PER cI CTFUN 7?179 Ohl"I,:I�W -�,t ,1 F Ilf ILA'IL?N_ HERFGN ARE VAL ID FOR TMS MAP INN L[IF ff 'NE CF I IF IIN 1 11 � O �"LF.a SAID MAP OR LGF7C BEAR -HE IMPRE:Z E, :EAL 9' THE -,,F`"E`OF 1&tL, Ip zTREET WHGSE SIGNATURE APPEARS HEREON 'y;p 17,/0.1 D N 115/1 J I _ fuaR.:'rvr ® JL 7r—pwr ��. ,.a tir .-► �' .=y1!- �"'...•ry ...r'"� ���_ •w4 �,�'r-:yr, ^ms's" � �...y" y. a. j r ;�. r` !. ��`�o ':��`�!1 -. _;p u '' r+A. "F�.r. gyp.. 'T'"' rf, �, �' / ,fC � ✓ - �, " - � i;:r�t 1.a - :+7�° J _ " �r�_Y-. •.+..,_. .._ Y ... �.d�-• ,� r �f-r��r. - - - 1 ♦ f 1 f•' i 1 � _ 1 MATCH --LINE_ LINE ———————z FO PCt-C NO SEE SENO 4 FOR PCL-NO SEE SEC N 110 47 50A 19A w 3 so D E. 43IYI,1 q' 1 AN.) 0 194 45 62A SOA 4A 53A O 10m 43 sl to Im &M '0-- r, m 42 Moa 12 IDA "A 110 TOWN OF SOUTHOLD 17 PECONIC LAND TRUST 7� 81 2 14, &5A(c) 13I SA( 45 32 0"A l) SUFFOLK cou�OF SUFFOLK ,4 1' 'WIN I COUNTY 2 tap NIS- 2 WATER iGA wypUND S.4 AUTHORITY 3 4 9 SA iA(.) &3 7 SA 102 .9 --A 7 112A X COUNTY OF SUFFOLK S.5 91A 'P0 'PO yo COUNTY OF 0 L,NO 0 0yWFFOLK 0 FOR PC SEE SEC.No 122-02� 7 Im 0 N M aA(c) 123 S.4 47A TOM OF SOUTHOLD J/ ?A 7. i w 17 10A 1B 2S2A I122 m l 9 SUFFOLK COUNTY OcoumTy OF SUFFOLK I 15 20 —TERAUTHORTY 'w 21 .0 141 c� 492A 73 1AI.) 1. Z4A 23 TOM OF SOUTHOLD 4) FOR PC No LAUREL LAKE SEE SEC N 125-01-0014c) FOR PCU NO SEE SEC.0 12�14114 d Cy —————— ———————z --------- ----- -———— SEE SEC NO 125 -Z————————— SEE SEC NO 125 LINE MATCH SEE SEC NO 1� SECTION N MATCH K 1 2 s 0 NOTICE E COUNTY OF SUFFOLK Real Property Tax Serv,ce Agen Y L -My-W Ri.d..y—.11 m (21) ZT—= A 15 P G ------- —— 5—,�'� 121 u. oinare,xo 1000 PROPERTY MAP E V (800)*79�6-5233 rvo 6 aw. tI � I OFFICE LOCATION: ®� '®F S®��yOl MAILING ADDRESS: Town Hall Annex '` ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971 ® aQ P LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: September 19, 2017 Re: LWRP Coastal Consistency Review for CAROLE RICH & DONALD WILDER SCTM# 1000-121-4-17.1 CAROLE RICH & DONALD WILDER request a Wetland Permit for the existing 80'6" long fixed timber dock consisting of landward steps to ground leading to a ±73'1" long by 4'8" wide fixed dock, and a 12'0" long by 7'5'wide seaward fixed platform in a "T" configuration. Located: 2435 Laurel Lake Drive, Laurel. SCTM# 1000-121-4-17.1 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 action is INCONSISTENT with the below listed Policy Standards and therefore is INCONSISTENT with LWRP. 6.3 Protect and restore tidal and freshwater wetlands, A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The structure was constructed without a Board of Trustee permit. A Wetlands Permit was not located for the dock structure in this sensitive waterbody. Further the applicant has not demonstrated that the following dock standards pursuant to § 275- 11. Construction and operation standards have been met not meeting policy 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction (d) Review and approval of dock applications. Before issuing a permit for a dock structure, the Trustees shall consider whether the dock will have any of the following harmful effects: [2] Whether the dock will unduly interfere with the public use of waterways for swimming, boating, fishing, shellfishing, waterskiing and other water-dependant activities, The application does not discuss the potential impediments/impacts regarding public access. [5] Whether the dock will cause degradation of surface water quality and natural resources, The application does not discuss the potential impacts to natural resources and water quality. If the dock structure is repaired or rebuilt the use of CCA or other pesticide treated wood should be prohibited. [6] Whether the dock will cause habitat fragmentation and loss of significant coastal fish and wildlife habitats, The application does not discuss the potential impacts to Laurel Lake. [11] Whether the cumulative impacts of a residential and commercial dock will change the waterway or the environment and whether alternate design, construction, and location of the dock will minimize cumulative impacts, and The application does not discuss cumulative impacts to the Laurel Lake. 9.4. Assure public access to public trust lands and navigable waters. E. Provide access to, and reasonable recreational use of, navigable waters and public trust lands under water. 1. Provide for free and unobstructed public use of all navigable waters below the line of mean high water for navigation, recreation, and other public trust purposes, including the incidental rights of public anchoring. Private dock structures extending into public trust waters obstruct public use of waters where the dock is located and does not meet this policy. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. ^ � 1 9g+t}FFO(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., September 13, 2017 the following recommendation was made: Moved by James Abbott, seconded by Caroline Burghardt, it was RESOLVED to SUPPORT the application of CAROLE RICH & DONALD WILDER for the pre-existing docking facility, 80' long with 12'X 7.5' platform. Located: 2435 Laurel Lake Dr., Mattituck. SCTM#121-4-17.1 Inspected by: Peter Young, Caroline Burghardt, Greg Williams, James Abbott Vote of Council: Ayes: All Motion Carried OF Sour Michael J.Domino,President ®� ®l Town Hall Annex JohnM.Bredemeyer III,Vice-President-- ~ ® 54375 Route 25 Charles J.SandersP.O.Box 1179 00 Southold,New York 11971 Tenn Goldsmith ® a� Telephone(631) 765-1892-- A.Nicholas Krupsld l/�'C® Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only DEC 'l E Coastal Erosion Permit Application Wetland Permit Application Administrative Permit AUG " 7 2017 Amendment/Transfer/Extension— Received-Application : �a717 s 3s Received Fee: $25®a00 Completed Application: - 7 Incomplete: SE QRA Classification: Type I_ Type H Unlisted Lead Agency Determination: Coordination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: S`3017 Date of Inspection: q,12,1 Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Legal Name of Property Owner(s): C 4Ro C se_ R i C_t-d DQRJj9 CZ c.01 L0�a;]2 Mailing Address: P & 13" 7'W H4 T ! t Phone Number: &_R 1 -- 7_��- h / i Suffolk County Tax Map Number: 1000 - �` 7 � 4- `f' Property Location: M Z't3 5- &4Q is L t_4K" /j P A09 T%/ i uC'1C /y y (/ YSZ (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: ri 5�1" gl � ioard of Trustees Applicat :n GENERAL DATA Land Area(in square feet): 2c 51 Area Zoning: 9 E251 D e N` Previous use of property: t 9 1L— Intended use of property: �,C S fl#�� T! Pf L Covenants and Restrictions on property? Yes V 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 No If"Yes",please provide copy of decision. Will this project require y demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s)on property have a valid Certificate of Occupancy? V/ 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): /995l6AJ Pf')2-41 T bP- 102E d ST/►1J(-s, ®CtC �� �jM �4 ._ � r� 3oard of Trustees Applica n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: As SI '4 0 ouc Pf>2/9/ / Area of wetlands on lot: ® square feet Percent coverage of lot: ® % Closest distance between nearest existing structure and upland edge of wetlands: C�;, feet Closest distance between nearest proposed structure and upland edge of wetlands: /0 feet Does the project involve excavation or filling? V/ No Yes If yes,how much material will be excavated? N& cubic yards How much material will be filled? `A cubic yards Depth of which material will be removed or deposited: IV Q feet Proposed slope throughout the area of operations: At A Manner in which material will be removed or deposited: AiA 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): 61 Z20 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 1 -Project and Sponsor Information Name of Action or Project: PC-�2,k11-(A-)(- Cr- Project Location(describe,and attach a location map): n Z�3 5 / UuGc_chL �� OiQ /`* -"-7� (/ '76--Z Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: Cglao (Z/ ok)&Gb Camf UbX12 E-Mail: Address: City/PO: tate: Zip Code: /� /(� 15-7_ I.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: Er ❑ 3.a.Total acreage of the site of the proposed action? ®,�� acres b.Total acreage to be physically disturbed? eO acres ® c_Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? rO acres 4. Check all land uses that occur on,adjoining and near the proposed action. ,�,_.�,� E]Urban El Rural(non-agriculture) ❑Industrial ❑Commercial 61residential(suburban) El Forest ❑Agriculture ❑Aquatic Other(specify): ❑Parkland Page I of 4 5. Is the proposed action, NO YES N/ a.A permitted use under the zoning regulations? a ❑ 0 b.Consistent with the adopted comprehensive plan? ❑ ❑ a 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 o 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: 10. Will the proposed action connect to an existing public/private water supply? NO YES ® If No,describe method for providing potable water: ❑ o 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 YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES ® wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ® b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban E]Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES a by the State or Federal government as threatened or endangered? —ff ❑ 16.Is the project site located in the 100 year flood plain? NO YES TT1_ff 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(runo and storm drains)? If Yes,briefly describe: 0, ❑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: ❑ 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? 01 If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑� ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE _- Applicant/sponsor name: �C3 Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning 1:1regulations? [A 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? FA ❑ 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? b.public/private wastewater treatment utilities? ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g_,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. EICheck 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 impts. Town of Southold-Board of Trustees N me of Lead Ager Date rA ('b"„Q :r- V 10 VV" )U President Printor Ty a Nam f Responsi le�iccrinAgency Title of Responsible Officer 11 Signature of Responsib 0 Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Applica, `on AFFIDAVIT 0— 6)-Pe-ro Le- /2/C/41 00 tib- G DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE-APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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. cc Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF 520 /1 Notary Public DE C E � V E DIANE DISALVO ID NOTARY PUBLIC-STATE Of NEW YORK AUG "° 7 2017 No. OID1475593 Auolttled In Suffolk County My Commission Expires April 30, 2011 outhold Town r Trustees APPLICANT/AGlENUREPRFSEN7['ATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the nart of town officers and employees.The purpose of this form is to pMvide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is necess try to avoid same. YOUR NAME �I G GtA-2.0 E� (p( UL-)t,�`boo (Last ridine,first name,middle 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 Twee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) •- Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,igarriage,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 z — 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 20 l Signature Print Name Form TS 1 e IA`• CO I. 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O ❑Adult Signature Required $ - []Adult Signature Restricted Delivery$ C3 Postage �11 $ $11.49 I.r7 Total Postage and Fees M $ $6.59 _a Sent To a __ l u,Eft ter" ��Z-�•._ � C3 Street and Apt.No,or,PO Box No. z c p ®�-' 2 og 1 -�'2-------------------------------------------- City St ,ZIP :ao e eae•e• PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS P 17 A7,e:s7i Name: :f 1 a��'-r 1 " , L LI t cK - r�.ceice:" 7`�e• �� re•SS'-5 OF e. -cx:4��le- ��'►cine - " , � �� �=y ��s 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 MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 I Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: L12fe Vol I SI40 (��7 44 �Z� 2c; (pZ 6QAs'j(�) lJv� .� 15- .S CI-6 O 4- C, t4 E!;s i P-R D t 'zt - 4 KfLLe-2 (-:, p4Dj ' LL- 2eV. A 2r4- S©-1-719/ ►,L :3q-,2 STATE OF NEW YORK COUNTY OF SUFFOLK 000AC-18 C LA)I v Q , residing at Z 3 &UP-G' 'L4V- llq , being duly sworn,deposes and says that on the day of 20 V J_7, 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 p 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 M A�=-F(-2 C,`e-,- that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this a1h Day of , 20_L3 i Notary Public TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2" Michael J.Domino,President �pS�FFD(,�co Town Hall Annex John M. Bredemeyer I11,Vice-President ��� Gym 54375 Route 25 Charles J. Sanders o P.O.Box 1179 Cl.1 2 Glenn Goldsmith ® Southold,NY 11971 A.Nicholas Krupski 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 CAROLE RICH & DONALD WILDER COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, tDe,0AGV) 6' W 1 LOf�i2 , residing at/dba LA-1<-_(T 17 4�9' M I4T7" I . �u X //95-Z being duty sworn, depose and say: That on the Z day of Svq , 2017, 1 personally posted the property known as 3S L ✓1�06�� c,��`f I, r'1 A�`z r 7o cit . 1y � I 1 cc 5 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, September 20,2017. Dated: (signature) Sworn to before me this day of m ?1-7 Ifn/TIPr Notary P lic TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2L3.i8 NUTIL 't: U1 Hk: A1< 1NG 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: CAROLE RICH & DONALD WILDER SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the existing 80'6" long fixed timber dock consisting of landward steps to ground leading to a ±73'1 " long by 4'8" wide fixed dock, and a 12'0" long by 7'5' wide seaward fixed platform in a "T" configuration. Located: 2435 Laurel Lake Drive, Laurel. SCTM# 1000- 121 -4-17.1 TIME & DATE OF PUBLIC HEARING : Wednesday, September 20, 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 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 Water&_ ont Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list,policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated_ as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both 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# 4 o oo G PROJECT NAME /gyp.cJ U9 c_r0 (0.1 L� The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ .construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: F Nature and extent of action: oko COI D 14 Location of action: 2 �3'S L✓�-c�2b L 0019-- (�" f�2 H4-7-—( I ry CK Q y_ f +Ct IS__Z Site acreage: Present land use: Present zoning classification: 12-C S l .D t;'�( 4-'(-- 2. '(- -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: /9 01-14 LQ QJ( Gk (b) Mailing address:-P O. ���Z d , r4-�(��"CJC�(�, C f Z (c) Telephone number:Area Code (9( 8) (d) Application number,if any: /U 4 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LVWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No ❑N t Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic- and archa6ological resources of the Town of Southold. See LWRP Section III=�P,oli/cies Pages 3 through 6 for evaluation criteria ElYes ❑ No [ } Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ' Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES x Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages S through 16 for evaluation criteria ❑ Yes F] No DNot Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold.See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes F] No u 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. ❑ ❑ E r 1 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 n No ✓gNot 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 F] � 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. ❑ YeO No ffNot Applicable Attach additional sheets if necessary 4 5 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 ONot 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 F] No 1Not Applicable ` Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No 0 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 9',Not Applicable PREPARED BY TITLE ©C2),06�_ DATEQ5 077