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HomeMy WebLinkAboutTR-9102 Michael J.Dommo,President *Qf SO Town Town Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President ,`O l0 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski N G � Telephone(631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 COW N BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 16, 2019 Matthew 011en Goose Neck Property Owners Association 94 Floral Pkwy. Floral Park, NY 11001 RE: THOMAS O'NEILL PRIVATE CANAL IN GOOSE CREEK & 1600 SMITH DRIVES., SOUTHOLD SCTM# 1000-78-1-41 & 76-3-3 Dear Mr. 011en: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 16, 2019: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#9102, as issued on October 18, 2017. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Michael J. Domino President, Board of Trustees MJD:dd Michael J. Domino, Presides,` OFF 14- Town Hall Annex John M. Bredemeyer III,Vice-Pm-=u nt �� 54375 Route 25 Glenn Goldsmith ti x P.O.Box 1179 A.Nicholas Krupski r Southold,NY 11971 Greg Williams 4,- �ap� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD - Date/Time: '� 1 If, y �Completed in field b :rlya�A� Matthew 011en, Goose Neck Property Owners Association President, on behalf of THOMAS O'NEILL requests a One-Year Extension to Wetland Permit#9102, as issued on October 18, 2017. Located: Private Canal in Goose Creek & 1600 Smith Drive South, Southold. SCTM#: 1000-78-1-41&76-3-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and 'related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 / Ch. 111 SEQRA Type: 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: Bredemeyer < M. Domino G. Goldsmith N. Krupski Williams Other l Maim Diane From: matto@nybeacon.com Sent: Friday, September 27, 2019 1:45 PM To: DiSalvo, Diane Cc: 'Greg Tyrer'; 'Monson General Contracting Co.Inc.'; 'Carol Brown'; 'Martin Gitlin'; billirene@verizon.net; diabeticdave@optonline.net; 'Denis Rousseau' Subject: Permit Extension 9102 Hi Diane: Thanks for taking the time to speak with me. Per our conversation, I hereby request that permit#9102, set to expire 10/18/19, be extended for one year. I am putting a check in the mail for$50 for the extension. My mailing address is 94 Floral Pkwy, Floral Park, NY 11001 My best phone contact is 212 495-9499 Please call or email if there is anything you need from me on the issue. Thanks very much Matt 011en President, GNPOA ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. ! li L'� _ t• i _ SPP 2 7 2019 Baartl„f lru:!r� _� 1 .t I %p� SO 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 �y� Telephone(631) 765-1892 A. Nicholas Krupski CoUff" 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 1St day of construction % constructed Project complete, compliance inspection WAL--4"" A BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 9102 DATE: OCTOBER 18,2017 j /1l,: ISSUED TO: THOMAS O'NEILL PROPERTY ADDRESS: PRIVATE CANAL IN GOOSE CREEK& zl 1600 SMITH DRIVE SOUTH, SOUTHOLD fi SCTM# 1000-78-1-41 & 76-3-3 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 18, 2017, and in consideration of application fee in the sum of$250.00 paid by Thomas O'Neill and subject to the Terms and ''11x1 i Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the a fi' E following: Wetland Permit for a one time only maintenance dredge of approximately 300 cubic yards of spoil within os a±25 foot wide by 1157 foot long area of channel bottom along the entrance of a private canal to a depth A of-3.5' mean low low water with 1:3 slopes; dredge spoils to be placed on association property within an enclosed area using staked hay bales and silt fencing to dry; once dried the dredge spoils are to be spread out on site; and as depicted on the site plan prepared by Robert H.Fox,dated November 22,2016 and stamped approved on October 18,2017. 1 IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Sea]to be affixed, I and these presents to be subscribed by a majority of the said Board as of this date. S%3f F01 CIO 41- TERMS AND CONDITIONS The Permittee Thomas O'Neill, residing at 1600 Smith Drive South, Southold, 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. 3 • Goose Site Map Neck �'o _ �c� ° Lfn l Dreddh its r SSS D 1 � t0 E C E d V E Applicant: GNPOA � Ter O�gdge i 100. I'D Safe Navigation r S � I'D Surve ed: 11-22-16 SEP 15 2017\k\ 1 o , .ti' Situate:Goose Creek \, o 00 �h Town: Southold Southold Town l� `', ` ' Suffolk,,� Suffolk County, NY oar of Trusteep' Datum: M L L VV 30 nlgph� , !; 00 j 00 /�� h p� CC Cf 03 -I+75-_-- --_---------�---- - -- to A,-?qq 1 ��,Ib 1+50Vol I j ' 'ham , 1 / '27 - --- b Ate'/Ib �� -------- - -- - - - -=------- Q > ^o 71/`c�� ' /,{ �� 1+25 Ifo ® B Y _ --- h p `V o ° , 1Ib Qj T U A L DATE AZ Ig Z01-7-- Ib ry JI s0i _- - ---- � /, /`� %• ° 0+50-- ------------- -- ------- �,d'"// ^� <0 f ;/ox QST 14, .f �V, I\ RLK kzg ..• .. x c -0+2 --------------� -------- '�' , ti /f �' Sheet 1 VIP � ® ; ROBERT H. FOX Dig 25'wide with 1:3 slopesp NYS PLS#50197 `� �` x P 0 Box#366 -3.5 MLLW approx. 300 CYs o Aquebogue, NY 11931 q/15/2011 2 Iq 45PM G\5L"oose,2016 pro - i Spoil Placement Typical Spoil Section Applicant: GNPOA NTS Purpose: Safe Navigation i Surveyed: 11-22-16 j pinned place 270 CYs sof material pinned Situate: Goose Creek 1 haybales &- max. 1.5 high haybales & Town: Southold silt fence spread on site after dried silt fence Suffolk County, NY until dry _ ___until dry Datum: M L L W 5.1 i 30' p ECEH , , , SEP 15 2017 - `� l� 0 Southold Town 4.,z 't 1 0 Opard of Trusteea---------JN ti CD CD 4.6 CD 5GT# 1000--16-3-3 t Land of: Goose Neck Place approx. 270 4. Property Owners Assoc. 5 9 Cys of material y � 1.5' max. hi h with pinned haybales CP dried material to be spread on site CDS 54 - Sheet 2 ROBERT H. FOX NYS PLS# 50197 P O Box#366 Aquebogue, NY 11931 Q/13/201'7 2JcI,55PM 0A5L"oose20I&pro Michael J.Domino,President ®f SO(/j�o Town Hall Annex John M.Bredemeyer III,Vice-President ,`O l® 54375 Route 25 P.O.Box 11 Charles J.Sanders l Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski ® Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 18, 2017 Matthew 011en, President Goose Neck POA 94 Floral Pkwy. Floral Park, NY 11001 RE: THOMAS O'NEILL PRIVATE CANAL IN GOOSE CREEK & 1600 SMITH DRIVE SOUTH, SOUTHOLD SCTM# 1000-78-1-41 & 1000-76-3-3 Dear Mr. 011en: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 18, 2017 regarding the above matter: WHEREAS, Matthew 011en, Goose Neck Property Owners Association President on behalf of THOMAS O'NEILL 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 September 15, 2017, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 18, 2017, at which time all interested persons were given an opportunity to be heard, and, 1 --w 2 r 1 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of THOMAS O'NEILL fora one time only maintenance dredge of approximately 300 cubic yards of spoil within a ±25 foot wide by ±157 foot long area of channel bottom along the entrance of a private canal to a depth of-3.5' mean low low water with 1:3 slopes; dredge spoils to be placed on association property within an enclosed area using staked hay bales and silt fencing to dry; once dried the dredge spoils are to be spread out on site; and as depicted on the site plan prepared by Robert H. Fox, dated November 22, 2016 and stamped approved on October 18, 2017. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd Michael J. Domino( esident r���o ig 4`�o "-�' Town Hall Annex John M. Bredemeyer, III, Vice-President ti,�oeq�i , oy 54375 Route 25 Charles J. Sanders <}u P.O. Box 1179 Glenn Goldsmith y Southold, NY 11971 A. Nicholas Krupski �y Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: -rom/+G ama.q0 IN4106U) ata( Please be advised that your application dated- '%f7- 15-, 201 has been reviewed by this Board at the regular meeting of OCT- I8, 0017 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) '/z 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: $ '9`0 0 ID �I I � I1� BY: Michael J. Domino, President Board of Trustees Michael J. Domino Presk gUFFO(,� Town Hall Annex John M.Bredemeyer III,Vice-President ��� Gym 54375 Route 25 Charles J. Sanders cz y z P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski 4t Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 10 �� Completed in field by: Matthew 011en, Goose Neck Property Owners Association President on behalf of THOMAS O'NEILL requests a Wetland Permit to maintenance dredge approximately 300 cubic yards of spoil within a ±25 foot wide by ±157 foot long area of channel bottom along the entrance of a private canal to a depth of-3.5' mean low low water with 1:3 slopes; dredge spoils to be placed on association property within an enclosed area using staked hay bales and silt fencing to dry; once dried the dredge spoils are to be spread out on site. Located: Private Canal in Goose Creek, Southold & 1600 Smith Drive South, Southold. SCTM# 1000-78-1-41 & 1000-76-3-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet - 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 d 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: Present were: J. Bredemeyer M. Domino Goldsmith - ✓N. Krupski C. Sanders Other Page 1 of 2 Michael J. Domino, Presii' S11fF0(� 0 C'OG �_- Town Hall Annex John M. Bredemeyer III, Vice-President �� yJ, 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith "? Southold,NY 11971 A.Nicholas Krupski y 0!� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Matthew 011en, Goose Neck Property Owners Association President on behalf of THOMAS O'NEILL requests a Wetland Permit to maintenance dredge approximately 300 cubic yards of spoil within a ±25 foot wide by ±157 foot long area of channel bottom along the entrance of a private canal to a depth of-3.5' mean low low water with 1:3 slopes; dredge spoils to be placed on association property within an enclosed area using staked hay bales and silt fencing to dry; once dried the dredge spoils are to be spread out on site. Located: Private Canal in Goose Creek, Southold & 1600 Smith Drive South, Southold. SCTM# 1000-78-1-41 & 1000-76-3-3 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 Thomas O'Neill ~ ' Private Canal in Goose Greek& 1600 Smith Drive South,Southold SCTM#: 1000-78-1-41&1000-76-3-3 10-10-17 .lr s t' i { 4 r . �Z _ _ � _ F o , FE C R SEP 1 5 2011 Southold Town Copy of NYS DEC Application Y E-uplemer-; io App!icatlo- STRUCI-UR,4',L ARCHAEOLOGICAL ASSES,-',IVENT FORM (CAAF) PART 1 APPUCANT COMPLETES T 1 tF-0R,' I A S C) A .tip PIRQjF—C'T NF—QR IN4ATI!—DN P c)i e c'4'1 a c i N'3, m 0- E! j5- OF PV2 W*rF Y Y, 100 C) 9 .. ........- pro,cs-�d ad;`a,,;erit to, or does Qonta'� F"�Yes n aies bu!jdjI-,g or .-d in :he 8raTeicr NationaRszgls�e., i-Ustorin, Places? 50- v=ars old or M Yes Are tinere any buNd"ings or -qt:,,,,,cures i; adiacent to or vjr1h;n the proposed proiect area? L 'r,e . 'W r I Ve--5, T provide f 11 the an�,*vver to 4qu slion V'-- aindl'or 0 d 511-rUr,;4ure truse attachments a. Name of struGtuf'e SEP 5 2017 1 Southold Town A.rfi of TIw�ir z5- v utbuild"ing. �arn� dslruc�Lire X. house, 0 -JI mins; d, Appromr-nate ag,,-� or date; of const, F !Yes ct 'physina',,-�tisual' posec project nave any IM Pa � 1� - � 7. Wight the pro SNC? upon any buildings or Struc,�,Lures listed in the State of v 'years old or eis- of Historic pipoes or 15 Nationa! c) r R � Le older? ii if Yes, describe briefly (�jse atftachrileMS ;f naceSsaFY)' art -Apt PART I — APPLICANT COMPLETES M,;ng �!-)d sUucture ihaa,, ma,; 8. Provide Photograaph,�_, of eviery bu t - L '-Iit '=,4 by 'n's L P S�t S* described in number 7, on the oi-, o i e Qfthispage reCOMMended, 0 I'Viininnuim photogmphs 10. Photoga'phs rrust be 3.5" X 5` in siZe o.- i;F,,gel 0 Photos rriv-s" be clear and focused Dir"itai Pnolkog-a-hs must be prini-ed on pholp, r te wodluce,� . 1-1,f , -,, - 1 , - 'U S e fft i n g o a ,min,t,�,j— o rl.,e. Is I s b e� P d, s —a, Plan, i`f possible Photo 1: Zbo­l 4h ar-,d sirde of the stru shor - e e�,)We t. ; - I � 'L. , rC7 as - , L k 11jily ticc�eed dose t ro t h e b -diM,g a s p D s s j'Od!e. B e th a s t FUM t Uf' p a rtl a!:y o c bY treesQr W�ii­ P ho4c 2: .S, how af bui:d.-g or slrul�--ure to road%wav or stirroi.,rii , Has the land witl,'M the P:-oposed projeo-L area beer, F1 Yes previously distQrbed o?, alt-_-,ed (eXcavate,1-A; landscaQed. will-t}es installe-4)? Ifyes, descri'De br;c-fr,, deo��t,, C,-'dist' -bance (Lis- attachiments if necessaryk W proXiMaLe Ap L �E+V.IjEEt E with sk)oes: A % SEP 1 5 20717 §6 it P Approximate p rcePtag, Ojec Site With the V,,'ell drained following dranagecharacteristics: Moder.ateiy well drained Poorly dralined r � HfES SEP F_ r o ec re lu IV fib_� 16 f� epared By �Pnnt or �L/Pe nature}: PIlg — Date: -nature: ................ . cc � 'tE4.it - J71e•e•- , pS^-•- .r •??if: ��r,._ SAM- r 4` DEPARTMENT OF ENV[RONRAENTA 1. CONSERVATION EC) COMPLETES APPLICAN �. Applicant Na- { ectl amao x 2 rOi Facility Nannie 66 of VA-If c,9l 3. JA D2C Number 4. 111€Chi, the prQpvsel'"]. prciEct have Or:�` ir,'��'a(i tib.::ij'slt:�i;�� M.. ! SGS i upon any buBdings or sIs"ugu = ! v« ri�"d :i�tv� r� 'lnte •`JtGt4� o� l('' 'rational Regisre,, cf , lss:Oris w aces or 5 --'-------- a �Pears 0"dc� ^:�er. y la ye,sy D CC rr1us:i CC'SUi? ;v1ir) : �� 03C!ce ;f Pats, RecmG,on and His,, i� ve-s-a a;,;cn ✓� z I i �„R, P). request a e:e-r�;.latic;� o e ��-;; c � -�: : y€''''?l.•z tt��++�� fes�++•; �� i'?Usi :." t ? S i��IJiiit :'v �"�C �..7ia i' R �L.�SS"'_ {Tiaces rrt i i•�fur y i rT7.'er comments rerCe"Ging project irilpaCt'. Include in -.-ra*,Jwn sU pij C Ly e appWant i response q t: t; .e ( { n lei} �,e::CC«iui�J � ("'..� and Z5 lli Pat t 1 of :y.7 �.`�ii t•� �{ ARCr•tAEO'...00,IU'iL SITE S i tjovs t's"?e pr C Qsedr C'i;evi area CCi;lviCl vr`t".h a u?>'Cip. square . Ej Yes or stippled area on OJPRHP:SSt CeJ'oe teCxseo ^yCa No n ento Map? "{ jl S.' Is :i ae ;3,oposedf p o,-.'e.: area outside of a c we or square, tout �Yes ;l me for hicli info,rtmatio^ ;?as teen provided ,ex: 4 `o ! t�l.ocurt�entea reports is ci knL'1�°.?t'n s:-es; tha: sugt 1,y { ! archaeologically sensitive? t� 9 N f y if yes, what- the nature and source of i; nor s i1 , ? I1 Uj is SEP 1 5 7 - Southold�Tqw4n*" 7, Is the proaosed proieo: area apparently undi Curbed? ar otTr esor t 6. ill the proposed ac. on inc?ude a physical disturbance of the Yes i� protect area? 1 i : 0. Is the Slope in the area characteristically less than 15% uY;,s �i 41,4(unless on jimestcner'flint escarpments)? El No t it 10, is the proposed project area characteristicaily rooderatelyv 0Yes j P /� ` d' ca ! drained? No N ) " five,)' or well drained• tL If the ansa;tors to 5, -10 are yes, an archeological survey should be performed by the applicant. Provide the applicant with a copy of or the linkto the State Nrs=onc Preservation i l; l Office, Phase I Archaeological Report CvrmaE FRequirements (08/05). '` ' _ yes DEC must consul t�{,rit , OPRNr be`cr si Flee answer t�o 5 Is no, btu, on,we.s.to �- i� are ' -gerfog, "U . own TVPI'11'1 1-11; -.:<< � �p _.�1,• � � cess� i •r r., PARS' 2ENT �_ —� T O ENVIPONMEN T AL C O' NSERVA#ION (DEC) COMPLETES C3i.7i',d!lsgS airuCtur= ar^, �^ ^' .- ,. location. S QE U Lii_.�ulL�s^a S! cc lt�entiiieu al ase mject 4 Q SI PA- Buildings, v Cures r t1 n is it uc n, arL Ge0?uglcab sides identified. bu- .1^ ! 3, Cc i=." no s`.ir�.�ir red i ! fur-,hert t m�: ;s r i; € rea. No cultural, res-ources review rL;t::red. 11 1 g mer s:�rt{a by DE" 4. �.ii 41� .i," PR P i 1e'�{:. �rel,�. v . ��.Lrul.::,i''es Archaec ogics! suRtey `equked IL PrS�GaLerd by: !i /0312009 - Technical detaills updated If_ ,� SEP 1 5 2011 Soutiiairl Town ar of Trus ees P".oJect fivoi'mation, Instructi:ans for 2rt I 'project �ZCC"I e !S res45for 1 J1 e Coj.j n of p�.6rj I `azl Of fC�- lee, p �=�700, 1 �--,, !e a"a:! n'svar cr resDomd t�- � * COMP!ezo a!: ;Zem'� it, V'a-t You-,a,, also p-c-%ide addl-.i nal infam-:_'lo''=Yh)c.-: YC VY 1 d E0 i , -% • t�ac ager�cy-ane�h a,, n�-Cessar'--C'sur ��I-n" Project apd 'Ajeol- pf26'194f27-y 6-n Name o-. "TojecC Location rdeszcfte, aT,,d a location map 0 o f D e--�Cri 51 i 0 n�-f P r 5�()s CCT., OW, CANAA- 6) :5 001 t's —r o �5 Iry Nam e Of'_kVnIlCan Or&l.a:- .Sor, Telephone% Z' L4 q S tj q I A;4-,Tprt�w 0�' pg'Klii LC 0 e? C;tyfM t 140 4 ri in ti ado. Y ' Volve Qoes the prc)DO-5'' a0zlor Oar or re'gv ion' VN9'47"s�Ia� e te7, t Qf prcposed action?-11d Yes,pttaqh a n4mat , .5criotion ofth 'e tO q11 t1on 4- Part 2. if rm, "n e4 ;,i the municiPe!ity and pr YES &V�C affect - — I t NO 'a"iy QM"a emT'!em2A EV- C '? 'ropoSed Cti .1 1 2. Does the p Oval. Ir yes, list F'gtnoyl "name and perm or app, "acres 2. opT 'jvv 07^��-Je 3. Top, a r ed? Total us pmp-'r-ies" To, '-a-p tol�- phys'Ca"i),dls11t. 'J%'C()-, 'ec�'site.and 2 Total acre:acre(Pro� 7 1,;c;:m or C, t or tro-,I'd by th a Pp - pr 03 dpin""-g and rn o a, 'i C, r'in' d-u'sHal oCom m '10 9' 0 1caln,!re V, E D E1. SEP 1 5 2017 of3 Southold Town p aro Trust oes 1� a(s,."a�'...,,,,,ls`i. .3 ",`r.. `'£',�, �A 4 6 rV,S�s:''�i'�,•'i"',� a at:T to tC:�:SGu.7,++rJ��,. t Ll,�i! uGk.a .�.._"_ji.�........•---..,..._- ..._____-..--......,.... ".,..., �-^.�i, _ 4�:. � .. Y �-wi'11"..fit Vi,.,C4y.',i.. 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Does z`':'S J)r`a ~a 3:.w. ._ Tha: iS 1 '� ct-�"c "a:v C-le _, ar cna e �r rt,: No_& z F.LiCS: ?-k u. ✓ ,--•_•1 LI' t �� i,c C,�•' .o - _ c`2 r ,an.6-s a ^a�.+rte' vim, - 1\0 k;£C � ...yv _VV'v.. ..'r:_e.4.�v. 4.S �Y C�'4::,...Y l..t.r N. _,,7,'.G G4..�::, v.S`'.l.r. � t _ � 7 i �` •.,,.`.. r 'Y_(..__._�-....._,��„sem, C. ts.�i�l� ay, � � LS;G^c`tt; ?�i�:, Qf 2,CiU3�% 5:'l`t0.r.}''•�`BXISi:r�1'a�}:2:^:G'.�.:-U:c:;i�0u:%� 1 v..n�: .:x.tv:]::?.rc�..f�yv:G°.':�.'`%.�.'E b4�•x,• . 1C'.:��"���" c _ _-__• 1• •4 .h ; <S je '�1`a�.i r"f yr Lt1w VCCUe Cit i�a;,- $,ely to ti?°e FGt+-6 an tE]�P ijvtii S? 3!1 t t�ii f <. G�ic. �4 zzC 1ffCtypicalryc. )} s rte; W edand 0 Urb ,z _-'¢ :1 e 0_O ose fYon cc:lta a. 's? c ' -a?-: . �v -d 1 U ,f.I:as _ (�� �./�'.''w� G � .�I1G' z .....`-w..+.....,-,—•..--...-._ ! i+--/.-�; I r-•.•--•-'•._._��`r�� � v ` 1 ! it :1'+l I� .Jv SEP 1 5 2017 ' 4 ' --^_^ I *Y` -+,11^ {,':r4i-���5[;: �:i�.:: ........... t"_ •n.�-a°-••. S.i.3 ra .-,�F,15L Southold Town ` r et. Bard of Trustees t ----� j, !WJ”) i.., W 4 u zl� LC` K,7 +:'•-=.+t t •Lli t S;(: <:e:7:"j4i '1.G�L'ti.»u Fie,,.°" - M„ �;• pw oes '!o] t w, I,O P OW t �.t ••4�ry..� "v lrt G�"r lL:• js.a.�th -...,.:+..»... .-......—......�,."_." —• v. T � 14er qui '1d�S `p v r :OTi � 0; c 17 �rS, CXJIl � `4 a =y 2Fi n ?. �'wST° fcw ri HE; be she &te POPQ,d achon or rulase and Z C l C: an 20, Has h- Si:e' r _ a i t?! Ali' t?QVSC-t wwC' 'r4--,_.a: - `� ia'1f; si:i1 . O: tF .. .�iiCsT:•C:]YCi:":g 4P No �S�S.0 COMPlf'Yc-st describe: T AFFIRM THAT T MA INFORMATION ,':RC)OWED WOVE IS TRUE -kND A.Ct:..v:A,r E,TO THE E BEST OF W, KNOWLEDGE AP v an or,soT najn e,him At, ale s%i~_fa�``,-6: V�i� � f SEP 1 5 2017 Southo d Vill Bparj of Trus oe IM =.77 F, Ticilij! d d. S cert & 'c: ild FCi ' n d a,,v n e S,Ca i -,z F-, Tcsn 'c da,; e a 2--- naue 2 3r S S 2 SCS; rCDU",Te,--' o" a Serrate Site ^1J .,"GS M- -ess-- a,-, --- s-,1e ;gar. Ta d a r cs i -Gild, r Z: qlap S1�1.0,1,,'r,, C'C' s., c -ODS- ;ecl ved and pr�l mar--,iNmetry access c:eadv 2 —'J ag--i'll v,,'�len appik�ati0r, io-m :s epi ,c-na-d de's �;l -c- s,aned ty 'r- �and-vinei abe`--c' n,-S S; ,pOSGd g,a- L t- avidence Jt S a'K e c a,I jc-1 s. i,- haav;�y clea-inp. area�s� and prcvide plal7l aPd DhL Zj 7ro r-, o d a 1 w e 11 a t-o jr,c 'Z:2�d a�eas. C-4 �y LqLd 2' weidn p a f, S S, atee CjC-�)O de!-T'ci--sArai:.--)n D;=C rqay Fequire a surve� w v,W,.e,- depth--- 0 I slrucwres, SUCK as docks, j:-j--,s & floats. Seu, pg' 0, llclrdielaied exp`a, 'cr . WETLANDS APPLICATIONS ONLY- of gradj,'19, ciearinq5 and ground, dist.urbance," {Ire rri''S' N� S'M'V- L S -- wetiand bounda,�,- t;-je freshw�lter AL Rj�ERS APPUCAT_tQLNS�ONILY'� WfLl). SCpi�ItC & RECREATION L n'lV 1 ForrF, EF �f E ]D e n I a L S, 'ppi rn., Gay SEP 1 5 2017 Man7 soutjj(� la Town BoarI of Trustees ;z y •...type% Site Plans: ,ter all P}•c;e,;, � - •^%its: t; ,�. _ ��+ �.. Drop tc�k r c _ � `ll^")(s4r`'a r:.: .:ls.;r.`;i.,• � '3 t.rs� o1 • T �'4�evr ..rjr^i r.-.�(� GIV, �ri�.�. r..j i"'1...: t/•^ � Y� F - ••"mac:l;:ui wC`^ '^i ri � .., .Gi i'"4: (T�t/e^ ^}, ,„ . .. L t�Gt.-ty� 5:'�?` 4,.-Yt ��` 4`( C^':4� r�l••_ �_� ,.. � 'i'""JJjj li C"7ciC �.'_ ta:.I:. �,'trt1V y'ryt^'P-1u!' ..l��v�; r`CIt'r ,. T vtri,• , 7J '"tt•.�s,Y I :�.1:i vt::!(C;a. V /:•x.•15, �� r 4'.C�iIG�Iyiti uf74"''"' ^ or cj or � 't is vXC n i'�S7`:}"?,�'jf..`^ i-.� 'lr"f .,a. ..�l'i si vtl� ;i �f...`7'3 t�� `.r r%� .�i�•^!G'"�` ;�' .a;S �''�'� • v �!r :..rf�u '�vs i r"a;r' '"1�^r ' Lair i.:rt'C'�'ii,': J�qr R. 9' ',N:Gj u.�i.!(��•' -P Ca 0- _ O UrrllCi�:i S `sYC ' _... f L.• vCni i rT�i J' i,.. �'`}� 6J.w.C.:r�.14'-', I `�� �• f` M'r1 4 (plot Plans) nct�to.scall- y' sc"'nc,C. t 1 s i a iE' ;7 GC i` �7 a iw. S1.3rve,ts 21f, red O ?1ei Zn t iG seC£n4 aLtV ' r ?CY1(f� .± s t... r� a-re. not acceptan:v. I C-l'oss ''§fiew: BASIC 1"t tri€lu it��'i£'Ci on sil GCC7sS SvcIC3 Cistil}i x .�••••��qt^j C "hr zs ;iwvvt,�'... :✓: G'.✓..i � por..-h s:; tt,..t.o1` ,,C e c�6 3t r� Iv �; r 4 IS otCynF .?ri ?IS G4!t S1 Ci'0SS MµCi! �7 ;i1C\` io a c.r �' ca:-Tle Lf prepre'r and prepared depth- at ptldfi. G^pC•erj7 high' lvYuaTv 1'Itv H r; ` ,) } wa4 r Iy t u�;!S:i90 ?,9C Crr-���s�C: swruo itre; a n a grade 1 dirge �-o,iS of ail ," ate— gals 4 �G u CCS or affec-,ed areas irl i:1C: es C' fez--, d1S7G=ruau belh',een Structures and Comut}r?ents i.e. d'stance �t?';eIl :Ic'.r` S 'r- Tfl`",u ar d Gi!' S"°4aT: MC], C?sir^nce from bu kha-ad to. house) v i j ;i at-er Ialf s' proposed r i°4v t E; SPECIFIC DEETA#LS LISTED ASOV1✓ AND i1`v'' "ADDITIONAL PLAN DETAILS" FOP. YOUR PRO) IECT TYPE ON PAGES 3 AND , MUST BE 1',1 PLANS. Additional Guidance can be obtained from exampies of die�irams giver; on the Du website- Vii. ' {5'lJ k�',rg�CrSt�.__� •?i�`.l,v✓�',`�'L51$t' �_J— �� D � 0, V "- �'� SEP 1 5 2017 southold Town Board-of Trus oe J-4 ADDITIONAL PLAtN D I_K1 :. fC r SpaCliiC D ;s Cants. and Piers � t WaTs cr ' Y�-`z C: ,+ µ•ms-' . Ln ..�'f.�a w. Doan [nes it Mean Lciver WA Prl?tUca( fear deter�i�?i�ca �°r`�t�r L�...���h,s, nt, POTendi� ; _ fe_ 3 z ?, �:o :ims shoui {{tee P �.,kJ�G: iv - � r t3 C, `?,.rVoti(^r• [-{v otf)er t:{1^ T'U ; O :,� is SI1CUld 'L,16 garter' yiii ?;� _ .lC :! a - �5'( War t. '� tY�hG t+ L.} ..�.: tom.,�'L:S .tJ �•� ?��'? � �,, � `'. a� a ri'eas:.;rcp i '� ;.t'" swX �` e.t.:11 �-, !:� lr;:S w`=�+^ =i.� ! i be v� a v Elis: eaddi. acLa cit 9:?t a(g Innes >;+,'t i} "s�;nd; d^cCt:l ��^, ^In Cr1 C Jr +,, h �y"�: sc si 3C' e `� �+ {�v,U d ;aesr `t e comers c€ as oam ��t me fano vY nj -_ any uam O' „at 2, ?; The eK?Siirty C[ ndnk ns sine,: :Mae rle i Of a' ICaJle) and, mus_ bea, µtgy Y.�'tG !EgranN i^vw e', , :. ra?c^, any se. re'GrU1C8 :c ? U O5Gal:1i`; Gate Ilri=• eq:ip: en; ;cr; aiC:bencnmat j. ' dal) used to determine • �; ei r,;ir.� sJ4 e wie,eG:•., u. depthsAH pa.t e... ..,, c;e 1 i!elCd :.tr C. �.Y}fs,�. i�'�.`�-* Land' CCe thy . �i:: Ja,„', of�•v r'1' �; v r, thy Y c irlc s'JNe % C;iC�t`"ocs and sha`, be de' ed 4 wt Ge:aivl..L. r} �,'v.`�e�,� seaic;z 5lti'tfiti. ,eiere,,?ced to the t;%LB-V Vc";°;,al as defined by Nt:JAA, �ierkic'Tur�13Lr'ailCr:ri Oceanog raphK Products C2G:t ��R liCwa. iriOA.=i iviC('C?=: i ! t iei 't '^� dwt� n res , ce"t:.e can by found a�.: :,nt"i ruin{e\.o Ss.t"rt Measuireme i:i tai\Or S1° ifC-., a S'r~Ur1dng pole or Surds,' i4Li s:jcz!€ q a Wsc (I :;iameite.,) on --he bo".1 m.to preven, any peneuai;o"; irl.4 ;t S'uts-uae DQOK 1309 Plan Viov.': i dep:ns i:} ai3f.c-Ing area(s) at 10' intervals as explained above J�vk Gross Viev<r: Dp k ; ;races of b.aita t and acioinkng Sl Ofe PGSght Q Gicz iiClt G duClCfng over grade SEP 1 5 2017 House &1c�r e?:$enst`a4`�iu'tidifi�?t�s, Southold Town plr4 1�iYV; Bard of Trustees Sire s b�fiiC�ifT� to be. on pilings t E St iff' 4 s ^ r e S ,n and P"C+ OSed d rivevvay a ?0 JC i�aC�,4l1G uTc v r ' r"Ecr3_it rP( O{ sUrfCi..E' Oa XE tt l r� } pavBd or UnpaVeG�i r the arca coven ed G tot 11 f .l tl C1✓/1� )ea �total f �1(e� G twG^ (non'\'v, llae �4sf t surflac eS c0IMQaRec3 iQ iota` UF7• deck. i 0-Ve j aIeaS .. ,° toStrJCWP� HoC J 0' � X1(2 ; '?i;11 't C St_11 Elio, JA -- rs• 'n' ?a_-fi �.. x` •,zas`"'z; s r a -`r ,t.s• ,;;z ' TOT hve ir' n .. ..re i 707,-1 • F a.`.�;..i^�..:u..•.,'1 r� �:�, .,� ..';2�>`..:ems.r, ° °.� .",✓'~i..i,:,y ... r _ ,. •< j'.."<.."„'^"•i,«�.i•.-.......�,,..�I�t +�.rG�g�Sa C�� �t t �.w�i''c,)(Y !} x r^•.. 2 p'I"v ti. 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""'•�Y' %SS+'�ia�:•;.i'•'-"w't}`'['.vvo'^di Wi+w+A f ..+. +�.:' _ Y as'al:t':'st «''�4'�y."fi•'•y�''•�' yy7'. >�..,.�..,...cr:.axr.>_::.J..0'y,�",..i. �S' r.%f et'•^7,•'z-'-1:= 'SF',,.'"I..:•'.r•,"'..,a_„'"5.':•Ca`sts.'1•w'�......o..-,-.3ar.:. ,v�.q-•!; 'R/.. '^ r. >* _ ."*."'s�•Jir'st"{.`4,C .� '+T''"},d..^i-AlS1.?k.:-A..is .7:•:.". ,.�.� v,•R. �:,.qa.s,[:,C"°✓•;'r"-+-'i"^..'..�Sr••...-,--...-`[+" .' ''F`"c'` 'i"1 �' Yea-:.'..fzrr.,jS.aS'.a`,'�::.sR.__...�I:Z � .'t P i ,oma, J,,F'�.s, .....f C:•�i3.'G r'"�' -".,moi'.s:l!J+'�! a ti0(1 Orr �Gj'4.� 0 ��a .+e;. .`F r<,',{ y .' .�. S`i'd%• .�: ��<L:•-`•�. '.' r;��t Ce1 .QINT it PLICAT'ION FORM, 0 9J -- , I scr'r U,e > C 6� Poll L, IIQr rn .lies "es oPi:�kc' coy I Lai 'I�ge er'c pu"'-s re.- ft 'S OF air 4s T'r,- A(SES' !tie'-P. -redg_ 'J�L PL 4L L 47- Tb 014 r—q tv Use: PAZ Lj PUb,,'c &ec: in e-S n Corn,::Ie Larld? ye� if yes,pleas' Js 'C' pf'Ca" Ap t; uni anY; ani s project OF F70 44W F M�'S o a. PevL i r �4- S;VnatUres. if aopj',Car?L- jS e ov.rner�, otdq mus`,si= n�Oe a7p�7ff ,—=. I hereby aflirm that informazion' providii�d or. this form-and all attachments submit ed ecewith is true to best of my know.pdge �qcl beflef. false statemepLsOrnade.harAjn re punishable,as aG ass Am.-Isdemeanor p&sulani,to Sec—"o;1 21005 of t1he Penal',-Ta arn, -ard age'dlr�--t`*-Ineir,ect"of ti4hazpve. Pawre,7-rd by whomeve- Ouffereco,' Fuither, the ap Ircant cce j�'&' ,': ,6- arising cut of the-projectt described herein,and aareeS to llldemnl'i and save harm'1e5sthc State from suits, actions,dam.ages arid costs oil eve,-y name and descriptlon resLgtjng frorn spid Project.in Fiderei Late, va U.S.C.,Section 1001-prvides fyr B fim=- I -it'Knowingly and of not more than S10,000 01" irnprisonrient for no,,more than 5 y'ea's, or both.whera an applica, ateria f fact; or knowi,"91Y Ma!<es or uses a false,rict,,tious or frauou'16nt statement conceals, or Covers UP 8 ril .17 Ap 6 lwlk.�A 3J 13 It Printed fame 01411 Date —----------- pripted Narle n a t--,re Of A c e r ees. fit --11— 7. :nc.vXfse:Qn vr i�'CL- "d 47%n C f 0 u, a,.p j : ,� I 4 W-1-rV I •as, 5s 9, 141 � X ''kSt Ite Depart raent 'By"I-* To INSPP-C-T PRC ?PI-ning this PERT, Of F . Y -nvlrorlxr Ion form - staff,of the 1 101 submissio, ental Corse n�,,ith an appl;catio, adjacent to Project sit, nbervafi., 14 n for a P.P r fl, ("DEC,,) rinit(s?to the facility the signer consents to th -a project it,of for which a permit is -l'Ough such facility. Tb- Sc)uAt and,to he ex ti 0 1).by UEC te- scansent nt allows DEC sialf to enter upon the'llours of 7;40 a• in older to ilisl)ect the areas :00 a.M an at ally .and 7.-00 p.m., t Site or facjlit� and pass )th. iqlout prior nol� ay dITO'U 9'1 ri day, T en i. H DEC staff should ranee, I t for such an ItIlle8,DEC staff�V,, id wish to con .11 so 110ti (1).,Ct �i Inspection's SPection. �Y the applicant and will oblain a separate Tnaytake Place as par-,of the application review deny the perr t(,S) Sought. By signing this c prior to a de or -t3 gran remains in effect as lo,_ng 2, '-"sent form,the Signer 3.1:1,reeS I�Iat the 3ppljcat.0this consent 1ri is pending, and IS effeQ 0 Ve �C�--,Iydless of ;vhelher the 8ignor,aPplicant or an a'eylt is Present at the time of titic irispec or facilif t.' - ev nt that the project site .Y is postedvvit �ion. In the h any f0r'M of"Posted" or"K, gate, this eeP QUV notices.,or fenced in with an .,ed t h' permission authorizes DEC staff to disregard such notices or unlocked gates at the time of inspection. The signer fardlier agrees that dunng an inspection,DEC staff ni ay,among other things, take rneaSurclnents, may analyze physicetl characteristics of the site including,but riot limited to, soils and vegetation (taking samples for analysis),and may make drawings and take photographs. Failure to grant consent for an inspection is grounds for, and may result in,denial of the permit(s) sought by the application. permission is granted for inspection of property located at the following,address(es); 0 000 !?)idei-petialt�lofperjlir'y�'llat lant authorizedloglue cOl-se"t By S ign I L to en tr Cswff as described abovo. I widerstand thatfulse s'ateme,"13 imade lierein are y by DE C 4 demeanor pursuaiif t(i Section 210.45 of tile PeMl[Lp� 0 ,!ass A In is & Signature D E Print �ra?lt� anti Title` rCPr�>5CnJJfiVC Of 2 legal V1 ihdiv"dual Or authorized -411ust be?it *Thc signer of thi5 10 $Ion or-J�e prOPP-M ide 0AUrl, I in 0a,.,ns fee titre .slid is in p05-1?s n the lease,rano 0,.01hZT00S!CSS0'Y. e propertY through a �5sing cssor,v I POSS maintains P055 Vc(an behalf of 2*,lindividutJ ot 43',cn*y Southold Town jlspe�-tjon Of SUGF1 's pmidcd p8cmssion to ns-,ntinglo the PMPC* "ne purpl)sr-or co supl*',fit Iv, fV 41 C— v U SEP I 5 2017 l �.Pl sout FIRT�,vn _(Lard of L sLeeq______j �,s:- r n " r� �.��'ti y��.d -.'iC��'1y"k i+� � ,�,�. 1 i�� "g,i '�„ '�, � <� � • �11 9R"'�� � !4" z ,a 4k f JL all, ,� R I g ♦*.,�.R,k . �. � t �" a 'fit ♦�.. � � , y R x t a ,.y;' .. .fir._ � >.�: _,,� �. •� "r � '�� ��:� pr VA 10 A AO 4 OF ,A e n r' .a r 1 2017 ` - o�..:he'd Town t� 7- now k i rk 4.r " ,r, f .• , r ,� . ti Er 40 Jp r IW 44 YA W. fat jai sou AMW ;».. 9 its olm15 r I mill -0. 1 e s 1 x E t���Y }}✓�4i t�a�� SEP : Ml ' r 6° x f a II - U► d lw Aw, o . t i.Lm �- �„ 1� � �p � W►N ►'T too, *06 SEP 1 5 2017 so,mc,"frown R. F i x' �U R ... JL . e ,-t++ ,:y, , ;: a 0 ," ION • ,` a Y Py �a 44 4 i xMO" 4v $4 x —777- --Now r#rr '. n+► - Xaa r -. .� «. �'" �" ~" ,.. x a 00*1 R M <�• "" ,, a< x _�yallY w - e yam, a 'kM. qtr r n �y a� a wk m f' r: zR"4•' 77— t 106 iom 17311 lo. TO"OF a 1P i020 nn SOL"NOw 1 I 799N.) 32 33 m>4 2 SEESEC.NO Dn 22 I IA(,) COON WFFOLX 41 152 V. Ar SEE SEC.No We ,4> ID 14 7A4,) 0 162 3 5 Is, ms 9 4%) i L) "A(c) SEE SEC NO — ------ NOTICE COUNTY OF SUFFOLK EK SOUTHOLD SECPONNO IE —Z— (21) 01, Real Property Tax Service Agency y G 078 M E IN A D URPI P PROPERTY MAP OFFICE LOCATION: �O ® �® MAILING ADDRESS: Town Hall Annex �® " �® P.O. Box 1179 54375 State Route 25 ,M Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971 '" #' ` a® P COW ri LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: October 16, 2017 Re: LWRP Coastal Consistency Review for THOMAS O'NEILL SCTM# 1000-76-3-3 Matthew 011en, Goose Neck Property Owners Association President on behalf of THOMAS O'NEILL requests a Wetland Permit to maintenance dredge approximately 300 cubic yards of spoil within a ±25 foot wide by ±157 foot long area of channel bottom along the entrance of a private canal to a depth of-3.5' mean low low water with-1:3 slopes; dredge spoils to be placed on association property within an enclosed area using staked hay bales and silt fencing to dry; once dried the dredge spoils are to,be spread out on site. Located: Private Canal in Goose Creek, Southold & 1600 Smith Drive South, Southold. SCTM# 1000-78-1- 41 & 1000-76-3-3 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 CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided: 1. In water turbidity controls are require during dredging operations. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairmany 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., October 11, 2017 the following recommendation was made: Moved by Keith McCamy, seconded by John Stein, it was RESOLVED to SUPPORT the application of THOMAS O'NEILL to dredge bottom of private canal at 78-1-41 to open mouth of canal to allow navigation. Spoils will be transferred to adjacent HOA property 76-3-3. Located: Off Main Bayview Rd., Southold. SCTM#78-1-41 Inspected by: Keith McCamy, Peter Meeker, John Stein Vote of Council: Ayes: All Motion Carried Michael J.Domino,President Ay ,``, Town Hall Annex `� iia "' y 54375 Route 25 John M.Bredemeyer III,Vice-President ; ' .- i P.U.Box 1179 Charles J.Sanders a - N Southold,New York 11971 t1z Glenn Goldsmith65-1892 Telephone(631) 7 • � .� ._..���� ix" 6641 A.Nicholas Krupski ' x•_' Ivf` iw `��`i," Fax(631) 765- ]BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application I:n Wetland Permit Application Administrative Permit Amendment/Transfer/Extensyy�n/— `Received Application: 7Received Fee: $ 25^01ApCompleted Application: - Incomplete: SEQRA Classification: Type I_ Type Il Unlisted _Lead Agency Determination: Coordination:(date sent):_,__._ 7 ELWRP Consistency Asssme t Form Sent: Jb.l�l CAC Referral Sent: '27`1 Date of Inspection: 7011011 Receipt of CAC Report: oe Technical Review: Public Hearing Held:__ _v 1 Resolution: Legal Name of Property Owner(s): Tt�0 04✓�-S ® �'j Mailing Address: SVt7 r14- � �� �� Ho L0 / Phone Number: ___•__�(13 I -7 -3-7 S sa Suffolk County Tax Map Number: 1000 - Property Location: a1(/A-Fe- G��-lt ,4 //� Cc o o S E G/u`��C Z � (,ID P Y (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): __ !Al o , �6-vJ 0',`�-=- P�fS�,>Lv�rl Qy,,, 01y- /� Mailing Address: LL �� r / L/ ����4-f, � Z/� 4/6 0/ Phone Number: 21 T 17 g � Board of Trustees Application GENERAL,DATA, Land Area(in square feet): �� 0200 &�, ic-f- Area Zoning: 07T" R(xA-A-- VA-Gv+1 V 7' �-,4yV D Previous use of property: N A V 16�+-M 0 A) Intended use of property: PJ4 41 6&T 1 0/J Covenants and Restrictions on property? Yes ✓ No If"Yes",please provide a copy. Will this project require a Building Pennit 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 detennined by the Building Dept.? Yes No!!� No Does the structure(s)on property have a valid Certificate of Occupancy? Yes�No Prior permits/approvals for site improvements: AgencyDate _D&C P DeA)4 l zo)of 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): DREDGE (3v7fnwi of P2tvA-�' eA4fv,+(- p4T- scT- o o o - 7:6�-gl , W4 Mt-F(Lorq T 140n4e3 ,4 s W AS 140•4 f"tF,"13&rt.s 1 L b1 P B o A--TS a nt i Aw ll o Ik c ,�-c-, 7 c�MIA� r 5 F�L��vl, W JY4 s.41Pvr� #Fr i r s A4014 7vfV' lPV r&r1T or rd is P(24 1-e c,7- lS 7-D. ®e9l�-A) HW 14fOce 1-f� o F -rHeF c-ofl/A-L 7-0 772-0"5�c&--*42 6-0 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 'Tp I YK _1-0 _t+C4,01A) L -+�Plqv Area of wetlands on lot: Zoo square feet Percent coverage of lot: 5- % Closest distance between nearest existing structure and upland edge of wetlands: Jeet Closest distance between nearest proposed structure and upland edge of wetlands:---_N-JA— feet Does the project involve excavation or filling? No ✓ y es CE Y C#4'11+T1 D A AD ff 6-0 6 270 If yes, how much material will be excavated? cubic yards How much material will be filled? 1A cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: _, AN b F"vK tA-"A4, F---vT1V44 WIX 06 W&Pffoo&D UJ,714 1114- W!",l3, W 004-1 1� 4 F"M ADJ A4-4-W-r L"'012 19[Za,09,z-r1LrV 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 Assessfnent Fot•m Instructions for Completinp, 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,ate 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 I. 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 -Pro"cct and Sponsor Information Y%A = ou 1 p26-s1� T G'ocs� n1 Pi���ry �wnl�Ks �9 foct 0^� Name of Action or Project: _p_R,e D 6 E 801tvm ® p jO2t UAB'- &4AJ M_ /n► 6aoS& (f 2& 1.--' Project Location(describe,and attach a location map): sa r, o o o - -7 8 Brief Description of Proposed Action: � �p&646 �O_ae> t of tVjUW4-t� c -N� �' AT SC -/o o- 7 /W 0 Lt t'-1• 6F CA4V 114. 15 /1j iL G L rN/ s v1r.UO N><4'A� T I&UpACWN6 W4v16r4V01V. seelt;s Ta J 400+ 4ssoelpiLt7004� Name ofApplicantorSponsoi: r Telephone: 21^-Z ga1S-C7 (1ggW� - MATNI� OtisH,RE51®�Tr Goose E-Mail: Y17A,at -&DP--1Vhecfra^ e0 fli Address: qV"'OR& Pr4161 City/PO: State; Zip Code: I.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. 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, Ln3.a."Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? LESS TNY4��l acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? S acres d. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban Eil'Rural(non-agriculture) ❑Industrial ❑Commercial ❑Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES :NIA a. A permitted use under the zoning regulations? ❑ F] b.Consistent with the adopted comprehensive plan? 0 ❑ El 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:, E`} t_l. 8. a.Will the proposed action result in a substantial increase in traffic above present levels? f �NO- YES L- 0 b.Are public transportation service(s)available at or near the site of the proposed action? (—`I c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? © 0 I1 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: a El 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water:. F,/] F] 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: O 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'? El 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: El R i-ess _.rl f d i ftp Apoir� �c�ru►6-��u _Z�--__z-Tv-c��f.s -to d 14. Identify the typical habitat types that occur on,or are likely to be t'ound on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early in id-successional [Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or federal government as threatened or endangered? o 16.Is the project site located in the 100 year flood plain? NO `YYEES'` 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, � ❑ a.Will storm water discharges flow to adjacent properties? - ®NO YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: [i }'NO DYES 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: Z El 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 subje'ct of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: Fv1 0 I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO T H E BEST OF MY KNOWLEDGEo Py 17 Ve o c &c 0- PA,o R 6--2-'y ,0 YJ 1 4'0 Applicant/sponso"anie- Date: d% (JV�_I 1� Signature: -711 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 I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action9" "No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? EJ 2. Will the proposed action result in a change in the use or intensity or use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or 5X 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 El reasonably available energy conservation or renewable energy opport Lill ities? 7. Will the proposed action impact existing: a.public/private water supplies? b public/private wastewater treatment utilities? Fl- El 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 1:1problems? 11. Will the proposed action create a hazard to environmental resources or human health? 1'a rt 3-Determination of significance. The Head Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, F1 that the proposed action may result in one or more potentially large or significant adverse impacts and an _ environmental impact statement is required. !J 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 it pac . Town of Southold-Board of Trustees to 7 ameL — Agency \ Date A eX6e( . .� 0 `WW1 jVU President —A Print*ignature Nar e of Responsib Officer in Lead Agency Title of Responsible Officer of Respon i le fficer in Lead Agency Signature of Preparer (if different from Responsible Officer) PRINT Page 4 o f'4 it Board of Trustees Application AFFIDAVIT — MAS_-�">�( t„' BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE 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 of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS 3 DAY OF_ �° ,20 1 C _ Not y Public GILDA L. GATELY Notary Public-State of New York No.01 GA6215635 Oualified in Nassau County My Commission Expires January 4,20� Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) owners of the property identified as SCTM# 1000-_ 776in the town of - r�, 1{om s©Le Lz) New York,hereby authorizes P,2oP ©wvd 6-t'LS /44 0GOA fiv�Mtw ®L- �r2�51 Gooses to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORD' TO BEFORE ME THIS V3 DAY OF S��'T , 20 1 _ _ Notairy Public GILDA L. GATELY Notary Public-State of New York No.01 GA6215635 Qualified in Nassau County My Commission Expires January 4,20_L%__ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORINT Tate�_n�im of Southol<Cs C acic raf i;tlrics nrnhilaitti ean(]iels of inlcrr%l nn fliuwt OI U7"11 Off Icer%and Cm11IoVe+:s.'l he pnrposr;of this forrr7 is to arrrticic intarrrnitIoit N_vliirli c;1n sticrlti( town of rxrssibIc c{7tfIicl.,of il�tcres '�r?d:si ativ it ter L<:l:c 'Ik;sl�, cr fiction is YOUR NAME: ®L L SIA Tri' .PR�S 11l cv T �OoSE N�GK PROPS (Last name,first name,.gr►' rddle initial,unless you are applying in the name of D'W Pj£R5 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 pal sona]ly(or through your company,spouse,sibling,parent,or child)have a ruiauonshga with any ofArcar or eniployee of they Town or Southold? "Relzitinnship"includes by blood,marriage,or business interest_"Business inkrst"uierrns a business, including a partnership,in cilia,the toc.n ot'ficervi employee has even n partial owslership of(or cniploytnen(by)a corprarat'son in which the town off icer or crnployec Owns more titan 5%of the shares. YES AT NO V . If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Sppthold Title or position of that person /#A_ — Describc(lie relationship between yourself(the al)plicant/agenUrepresentative)and the town officer or employee.Either check the appropriate line A)through D)and/or descriNo in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)(lie owner of greater than S%of the shares of the corporate stock of the applic*nt (when the opptican(is a corporation); B)the lel al orbeneftcial owner of tory interest in a non-corporate entity(when the _1 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 S day f 2 ( N Signature Print NameWv§ Form TS 1 m,4 TrH ew o L,,L 04,W'l AZ_L '' P2t4i 1)IwT14009E Pio t A_T y ��� �� s �� t rs �I oma► { APPLICANT/AGENT/RE PSENTATIVE i TRANSACTIONAL DISCLOSURE FORM Thcwn of Stlicicl'sCoda orC,thics piahihitr•conflicts of interest ori thc_part stftown officers ancl'em tIc eey s• I"lie��urpose of j this fqt nr is toamvide inforination which can alert the'town of nos%ible conflicLs of interest and allow it to I:rice Ntihalever action is necessary to avoid_ sante. YOUR NA_ME: t1 1 LIL ' (Last name,first name,piiddle 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.) I)o you personally(or llirough your company.spouse,sibling,parent,or child)have,a relationship with any offiecr of employee o!•the'fmvn,of Southold? "Relationship ,includes by blood,ntairiage,or husiticss interest "ftitsiness interest"means it business, including a partnership,in which the town officer or cnrployee has even a partiil ownership of(or employment by)a corporation to which fltc town oft icer or employce owns more thin 5%of the shares. ILYES NO v i 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/agcnt/representative)and the town officer or employee.Either check the apptopria(c line A)through D)andlor 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 S%of the shares of the'eorporat4 stock of the applicant (when the applicant is a corporation); B)the legal or benulicial owner of any interest in it 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. DESCRIP T ION OF RELATIONSHIP Submitted this �aslay of �2, 0 Signature_ Print Name q_ ("I J+14 f 4_E l%t_ Form TS 1 Postal 1 SI . Postal-Service C. o � I CERTIFIED . ERTIFIE® KILo ■ EQIEI ■ .a Somestic OU, HOL) t 1 . i_ S0U1 iDL •1, , .0 Certified Mail Fee � ' t �t t ,•-p $3.35 �j 7 J V � Certified Mall Fee M $ $8.35 (1234�, Extra Services&Fees(check box add fee s pp pate) 1 7 I m Extra Services&Fees(check box,add-fee a - 1 7 Q ❑Retum Receipt(hardcopy) $ .r ❑Retum Receipt(hardcopy) $ $partSgaate) Q 13 Return Receipt(electronic) $ (} �JU Postmark C3 1 ❑Return Receipt(ate ironic) $ cell ��I'U� i Q ❑Certified Mall Restricted Delivery $ d f r fn i Postmark Q ❑Adult Signature Required -' Here ❑Certified Mall Restricted Delivery $ sk i i fii r g q $ Q ❑Adult signature Required __.�,,� — Here' ❑Adult Signature Restricted Delivery$ ❑Adult Sign Q ature Restricted Delivery$ 'r Postage M $0.70 Q Postage Ln $ M $ $0.49 in Total Postage and$5.511 1►_1/11 I�1117 Q $ g 1 till 1/2117 c Total Pasta a and Fees 7 1 L $5•2 � Sent To �,M iL. •L'�H_-) - Iti-' Sento Sheet a /-�No.. --------- TCO IUo11 tf J�7( o Q Stye t--- PQtL No:,or PO BoNp. """ ! M1 --1-M���o ��/(�/r LSC j "te;Z%P+4 r t4 / rrr.r 1 � �T - - - B/57j e Postal, r „r C3 CERTIFIED MAIV:RECEIPT, CERTIFIED MA10 RECEIPT Q., /e , � rQ � SOU HOU 71 rgUt QU •STH01_ s 7- A 1,97,kl� . 33 pp �l] Certified Mail Fee � � �p Certified Mail Fee -0 $ $3.35 Ij734 $3.35 1-1234 M Extra Services&Fees(checkbox,add fee $ 1 7 `� ITl $ 17 Q ❑Return Receipt(hardcopy) $ ip r9f ate) I Extra Services&Fees(checkbox,add tee �Pp r te) 'F Q ❑Return Receipt(hardcopy) $ 1 0 Q Return Receipt(electronic) $h—( I jj�}_ pOxtmark Q ❑Return Receipt(electronic) $ Postmark Q ❑Certified Mail Restrictetl Delivery $ $f 4 fes_ Here I Q ❑Certlfled Mail Restricted Delivery $ rte,�,ftir_ Hare Q ❑Adult Signature Required $ Q ❑Adult Signature Required $ ,t.: -- ❑Adult Signature Restricted Dellvery$ ❑Adult Signature Restricted Delivery$��— Q Postage m Q Postage Ln $ $13.49 m $0.49 Q Total Postage and Fees 1(1/11/2(11 7 ut Total Postage and Fees 11 x/11/ 017 $ $5.29 - Q $ $5.29 Sent [� Sent T L �� t �}�IC� / --------- ��-�v P i r 9 � tiSYreat"n PE? ox — © �------—�m Q s �a o "i:ti�,o PO Box L— LL------- -------- -------------------------------- ------- e Q�- 7 J11H Q p -- ----- -------A---- V F NCS�-} Crfy,--------------- P"�- -------- Cdy,State:ZIP+4��-- - ---------- -b ---- -p -b L Aly /1'9-11 1 Postal r r rr,•, J CERTIPIED 'MLAILIP ■ ■ M ca so • SDUiHtlUD B 11 li R 43 Certified Mall Fee �c rQ $ $3.35 0234 M 1 Extra Services&Fees check 6 17 1 ( ox add fee s ate) Q El Return Receipt(hardcopy)' $ Lr Q ❑Return Receipt(electronic) $ $11.00 Postmark Q ❑Certified Mall Restricted Delivery $ $M1 I Here Q [I Adult Signature Required $ ❑Adult Signature Restricted Delivery$ Postage M $ $0.49 Q Total Postage and Fees 111/11/1117 $ $5.29 0 Sent T� j I L ` h_y 8�-AT L. �SC*CPiog StreetGG pt. o or POB " o N p t � � � ary,s , tP+ - r�FtOL7� 1 7 J Michael J. Domino,President O�Q �'�G Town Hall Annex John_ M.Bredemeyer III,Vice-President �� yam, 54375 Route 25 Charles J. Sanders y z P.O. Box 1179 Glenn Goldsmith 0 7 Southold,NY 11971 A.Nicholas-Krupski 'l� ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of THOMAS O'NEILL COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE residing at/dba 9q FC-044-C /�A' 44 *l being duly sworn, depose and say: That on the 10 day of 19CM&—IL , 2011-, 1 personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, October 18, 2017. Dated: / /1�11 . aueuw &Z"'i (signature) Sworn to before me this 19 ''day of( 1vW0)7 N tary Public GILDA L. 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Ln Total Postage and F e5 1101/11/2017 u'1 Total Postage and Fees 10/11/2017 $J.29 $ T $ $5.29 Sent To m t,4 F- LLL rSent To �- r74' I ------------------------------- ra / /L �`" ------ �(/ �// Q Street and �tyNQ rPp.o�(�fo. Q S"meet-n-d--"Apt.No.,or P�B xx No. I `C� FFG J�'1 �� 1 _ c! ®'^ n �� City Sfat�IP ---- D - ) `T c7 ty, ate,Z,��FL��D nJ l/q-71 - :l e 1 e e eee•e + :11 1 11 111•e ® ® y © No ■ ® oLn e ■ �QCO /. N /. • SO1lTF(OL=# � tY 1 �,D - + -� 971 r5 � r- is ' 1> t7 �. L `'•• §`' Certified Malt Fee ep Certified Mall Fee $3.35 01238 ,� $3.35 1-1238 $ 17 frl $ - 17 frl Extra Services&Fees(checkbox,add lee s pp r�dare) Extra SeNlCes&Fees(checkbox add(ee p 1poate) Q ❑Return Receipt(hardcopy)_ $ ❑Return Receipt(hardcopy) $ °1j�F•! ❑Return Receipt(electronic) $ $0.00 Postmark 0 ❑Return Receipt(electronic) $ $0.00 Postmark � Q ❑Certified Mall Restricted Delivery $ $0.00 ,Here ❑Certified Mall Restricted Delivery ivery $ $9.09 Here Q ❑Adult Signature Required Q ❑Adult Signature Required $ ❑Adutt Signature Restricted Delivery$ []Adult Signature Restricted Delivery$ _ Q Postage , Q Postage l fT1 $0.49 M $ $11.49 1 C1/1112�117 1 o Total Postage and Fes 10/11/2017 Total Postage and Fees $ $ ,`yt� Q $c.2� $ r- Sent To QZ4Li Z—" ® o / O' Street an AptVic-ITNo.,or Ply Bo No: Q Street nd Apt.No.,or PO Box Nt--------------------------------- I ti ��f� � "• (/C N City,State,ZiP+4� - r it --�------T /J l�-----S-O®G--� ------------------ ®y City State,2!)5;;j8 /i / d 7 fV f! :ee I ee eee•e - :el 1 11 e1 •I• - - PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS 76 a1 i,�eW',�.��'�J=,r.�•+i v..e.dn w$ l + 4 ..:':..,. F ,� [�. �,'S, STATE OF NEW YC COUNTY OF SUFF ;fie day of ` i" =2 4tice set forth in the Boardd persons at the address opposite the names o :. M assessment roll o n •cv� ;,', a current `!''?C �µ .. -ted States t s Post Office at >.` d persons by CERTIFIED !{1c. °"ts�f`S. ' Sworn to before me this v Day of , 20 i t Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 600W .vim Pwocc-lfr y ow0ic`A C/a ar b4 J/V r 5W 1W 4ut"),-- C-—4w- so, `io 7' &A IreW W 6117-*✓ /-��•¢/1/1 PGH2 //go '!�;0"44V 9//td." e5o rhe 'y v Ilk 60 A-/ i/yr/ /rffca �c /a_yv s.�o�z� ��2�r� sa ��// �eLc/`l C //�-7'/ 1Z�1•,a[9-�j ®/rvC-1CL tYzrJ `1���� �d/G,��- S�-�!'� �,.�1�e� !uy td��l �d / TY,�G—�t, ✓i�>��cc�,t /yg0 y er ��rl��� �''a` ��`�v�cL�, �,�w/�i�-7 iI &It2Utti/ . 64-le /5^S/oryp ,,Afr, p�E c�� /(/7-6 S moi` dt 5 c / f cL/'� /11Cgr�e�/yf � >i/,u�- n,�lv /c! �/ ✓T l �9411,''3��rfGLa2`��//Z�nj�j "/70a 5rvri/7f �/1Gt/l 5;aw-1 S6K` /6tJI Gl/� J STATE OF NEW YORK COUNTY OF SUFFOLK residing at 1142/1-L P/Z- -p ,4p- 191i-rLx /V being duly sworn, deposes and says that on the - day of Oc-rvXliC 2 , 201'--, 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- ' AA�t P,+I?r /Lj� , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this \ -4-h Day of OCObQL( , 20 - C i Notaryublic GILDA L. GATELY Notary Public-State of New York No.01 GA6215635 Qualified in Nassau County My commission Expires January 4,20 I0 NUTILt: Ui --- HtAt( 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 : THOMAS O' NEILL SUBJECT OF PUBLIC HEARING : To maintenance dredge approximately 300 cubic yards of spoil within a ±25 foot wide by ±157 foot long area of channel bottom along the entrance of a private canal to a depth of -3.5' mean low low water with 1 :3 slopes; dredge spoils to be placed on association property within an enclosed area using staked hay bales and silt fencing to dry; once dried the dredge spoils are to be spread out on site. Located: Private Canal in Goose Creek, Southold & 1600 Smith Drive South, Southold. SCTM# 1000-73-1 -41 & 1000-76-3-3 TIME & DATE OF PUBLIC HEARING : Wednesday, October 18, 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 Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its si fgm icant 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 inust be explainW 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# 77 - - PROJECT NAME 2� 4 c" m4 � ir i co o sE c't2&-c- Kc 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: DfL-&-iX F 1-!;10W-a 1k► © F 1921 0--T-,Y- C,4-IVA- - FOP- I-7W Pt t2Po 5 6- O P N AN t &N--7-1 D/4. '&-�66-N 2 S fi 2-16 Gia. Ll J s slq-ru 0 vJ r b u--m &-o A-N 6 12 45 rt--aa Tp t+o,+ pay 6-fL Lz1 ry D a v P Location of action:^ CA- A-t- 50 T6 M SCT- /00® -7 Site acreage: C-t s S 7_140-N ( 40-& Present land use: y°''t'j 14 L rj A" A-r7 ea Present zoning classification: y`-(-I s 2 /L v ,Q G�-ruT L/,1-N/� 5 2. if an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: PJ&CIZ- logo , (a) Name of applicant: ,MA--( F46-W &"&-rJ COO-C& 446-e44_' )45 S o e I "'J.'7 ark (b) Mailing address: `( 4�7k-o fL A`- i/6' vi y f=�_O eL✓-L p r4 ✓L!c /,jy j l b b / (c) Telephone number: Area Code( ) 2/a Ct C, - Cl Y_ r ci (d) Application number,if any: N l/1-- Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No a 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 Pest Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Poster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, snakes beneficial use of a coastal location, and minimizes adverse effects of development. See LNV P Section III-Policies; Page 2 for evaluation criteria. [—]Yes ❑ No [allotApplicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWI2P Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ 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 2 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 Secretion III—Policies Pages S through 16 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ffNot 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 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 ❑Ilio[H Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No I 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© Not Applicable Attach additional sheets if necessary Y i WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑,Yes ❑ No 2 Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III— Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No 2 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LUMP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No a Not Applicable PRE PAREDBY�M� i � � �`'" �LLpwn��-n-�5 TITLE DATE �i 3//I