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HomeMy WebLinkAboutTR-9205 Michael J. Domino, President �o� ooGy Town Hall Annex John M. Bredemeyer, III, Vice-Presidento 54375 Route 25 Glenn Goldsmith H = P.O. Box 1179 A Nicholas Krupski 1�iy • �� Southold, NY 11971 Greg Williams '�'ol „ �a� Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection; .�, ("i �''` "k L %'- `� ss« .fie L IJ!- \ +�w °(^ � !/ - 1. .;``; '•.� (� �' i .6' �$i.. ;��\ � in.. ` f.f�� i. TIM `��,�5` S'?'�3K�%'Nk70�'+7S�dY.6WY �S'PMlri''.11'd,6" ',�;.SPY.VJ�E7'+,�,1Y'•�S�'�. .S�RGv ?39T' °.Ur''hC6�713�5'D"�SZ$u7&dnd� ST�'&°aiQ17 �i' r BOARD OF SOUTHOLD TOWN TRUSTEES r ` SOUTHOLD,NEW YORK ' PERMIT NO. 9205 DATE: APRIL 18,2018 ISSUED TO: ADAM & SANDRA SHEBITZ '- PROPERTY ADDRESS: 630 RUCH LANE, SOUTHOLD ;¢if SCTM# 1000-52-2-26 .y $ M ;F 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 April 18, 2018, and in ,�. consideration of application fee in the sum of$250.00 paid by Adam & Sandra Shebitz and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits Y`r , the following: Wetland Permit to install two tiers of coir logs for a length of 51 linear feet along the toe of the existing % s% bank; provide 25 cubic yards of clean sand fill from an upland source for bank re-nourishment and v install native plantings on re-established bank; all work to be completed landward of the mean high water line and any existing wetlands; and as depicted on the site plan prepared by Jeffrey Patanjo,dated j March 10,2018,and stamped approved on April 18,2018. i; IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, J and these presents to be subscribed by a majority of the said Board as of this. a 0 zl y %T �x�,'S�➢➢w.�x'i%3��'.33AL" AZuSY+.U'ite'CLYe`Tai29t6'aL05�ui^vt�91�:nL`YuiTYPnSi1[Y.Sa �+RS�+YS:Gi�ft� .SU�XC5 I �., •� f '•�St�i ..-�- ai 1. s.:+ «��,�r. .• t« � �� — ' ..:q vA� a �,�: •.e «��i. TERMS AND CONDITIONS The Permittee Adam& Sandra Shebitz residing at 630 Ruch Lane, 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. Michael J.Domino,President rjf SU�Tjyo Town Hall Annex John M.Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Telephone (631) 765-1892 Greg Williams O Fax(631) 765-6641 cou BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 18, 2018 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: ADAM & SANDRA SHEBITZ 630 RUCH LANE, SOUTHOLD SCTM# 1000-52-2-26 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 18, 2018 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of ADAM & SANDRA SHEBITZ, applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 16, 2018, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program_ Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found 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 April 18, 2018, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ADAM & SANDRA SHEBITZ to install two tiers of coir logs for a length of 51 linear feet along the toe of the existing bank; provide 25 cubic yards of clean sand fill from an upland source for bank re-nourishment and install native plantings on re-established bank; all work to be completed landward of the mean high water line and any existing wetlands; and as depicted on the site plan prepared by Jeffrey Patanjo, dated March 10, 2018, and stamped approved,on April 18, 2018. 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 r - 5URVEY OF PROPERTY 51TUATEs AR514AMOMAQU `. TOM SOUTHOLP ' - ;- � • N 5,.g9=OLK COUNTY, lel' j 5URVEYED 05-21-03 _ PPOP05ED ADDITION 10-22-03, 11=224-03, 12-18-03 REVI5ED ADDITION 10-13-2004 5UFFOLK COUNTY TAX # i S 1000-52-2-26 CEk TO: Sandra L.Schpoont Steven D.Axelrod � Commonwealth Land Title Insurance Company -00, ,x eq�`9scv Q'e O p ^^ cy 0 , �0 pAll , 10 CP-6q 401) 'Lsi�� 0 04 =0�00� 'rOJ °e � J , ca 4` 19cicl• a 0� foa Op-NJ of LI'Cts reqs (J• 0 4f 020 Z2�'�R SAO Ol►� O•C` F Z e�?• S�opa,� ZLa'° A �+rE� NOTES: 0 MONUMENT FOUND T `:�A y � •IMavll•or..:ee E-�.{ ,'. �. - y mop bearhia Iak.eeenoeroen dOaw / 0 PIPE FOUND babyar eeLNlebbm neeozo,mla,le Mo ' y New York stoke ed—U.I.m. .— a ti �; — -�•I � �, $ .%,i•�`•r ' f •ony Loplea tram tM ongvwl m ws eu+vay ,-. N�...Y..-- e?.... E f^•, j„t ...q, t+ Pi morkad wiN m orlylnl of the fad a Itd-t b 1yy k y f .wt,'�' s{amped Beal shell be eamNered tv be vats tnn WELL LOCATION PROVIDED 13Y OTHERS : r^ - _"'- wrtlrkouom roLeted tnreon nywg ttoe lhN 1't propred k�accordance wIN d ek- f „� elNg wee w croLllLe for Lantl sways mepeae ELEVATION5 REFERENCE NGVD'2q �? 1 "° ”�' °'nth ' MAR 1 6 2018 ;`-�" � to the person tar whom the/rvey 4 prepaed, �`q> avd m hls Mhall W tM!4b Lom,my /rnnen- ZONED R-40 , Ne�eig eed.a �.NtuVan lbtee °^ �aNel� t (lora er/ro!trea/vcble!e oddebrol babtutksa AREA = '1,G83 sf or 0.18 acres e n: ' n "3 JOHN C. EHLERS LAND SURVEYOR , 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHIC 56ALE 1"= 20' RIVERHEAD,N.Y. 11901 _— 369-8288 Fax 369-8287 REFA\Hp serverUPROM03-238,pro go s � o, �T100 o,� \ / EXISTING PLATFORM AND STAIRS TO ,A " \ REMAIN UNDISTURBED ,,---PROPOSED PLANTINGS A MIX OF CAPE AMERICA BEACH GRASS rOAND ARCTOSTAOHYLOS uva—ursi MASSACHUSSETTS — BEARBERRY FOR 12' WIDE DISRUPTION AREA ALONG BANK WIDTH PROVIDE 25 CUBIC YARDS OF CLEAN SAND FROM UPLAND SOURCES TO RE—NOURISH MATERIAL LOST FROM ERODED BANK \ , V. ^ PROPOSED 51 LF OF COIR LOG TERRACES (TYPICAL OF 2 ROWS SEPERATED N, C5 \ V. o h BY 6') STARTING AT TOE OF BANK AND FOLLOWING EXISTING LINE OF EROSION S9� \ \ V, 9 10000 V_ Gj EXISTING REMAINS OF TIMBER WALL TO REMAIN A �� EXISTING VEGETATED TIDAL WETLANDS AS IDENTIFIED SO BY J. PATANJO ON FEBRUARY 24, 2018 •� � V, �V_ APPROVED By � � �BOARDOF T�USTEES AO ViIN=`bF�S_OUTHOLD DATE MAR 1 6 2018 ! PROPERTY OWNER: L—Dow 'r"'+' 5 __.._1 ADAM SHEBITZ SANDRA SHEBITZ PROSED PERMIT PLANS SCALE: O' 440 KENT AVE — PH1A BROOKLYN, NY 11249 NOTES: PREPARED BY: PLAN DATE: 1. ELEVATIONS REFER TO N.A.V.D. 1988 DATUM JEFFREY PATANJO 3-10-18 P.O. BOX 582 2. SITE PLAN PREPARED FROM SURVEY PREPARED BY: BOHEMIA, NY 11716 630 RUCH LANE JOHN C.' EHLERS LAND SURVEYOR BOHEMIA, NY 1 HOLD, TOWN OF SOUTHOLD DATED: 8-21-03 631-484— mail.comSUFFOLK COUNTY, NY SHEET: JJPatanjo@9 MAP N0. 1000-52-2-26 1 of 2 r -IDA_ N Shorecrest Bed 0`14� aF R �J&Breakfast yay'- 3' i rYyyaf. Town°Beach r:r yds fr f< 630 Ruch Lane r,. t _ r /F Southold Beach I !r - f / 'Google LOCATION MAP N.T.S. PROPOSED PLANTINGS A MIX OF CAPE AMERICA BEACH GRASS N, EXISTING GRADE AND ARCTOSTAOHYLOS uva—ursi MASSACHUSSETTS — BEARBERRY FOR 12 WIDE DISRUPTION AREA ALONG BANK WIDTH PROPOSED 8" COIR LOGS STAKED 2' O.C. AS SHOWN ON PROPOSED PLAN PROPOSED 25CY OF CLEAN SAND FILL FROM UPLAND SOURCES TO RE—PLENISH MATERIAL LOST DUE TO EROSION PROPOSED 8" COIR LOGS STAKED 2' O.C. +I AS SHOWN ON PROPOSED PLAN 00 APPROXIMATE M.H.W. EL. 2.0± APPROXIMATE M.L.W EL. 0.0± APPROX 18' FROM M.H.W. TYPICAL SECTION N.T.S. r= r t t, , MAR 1 6 2018 PROSED PERMIT PLANS ASNOTED ION & LOCATION MAP DATE: 3-10-18 630 RUCH LANE HOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: MAP N0. 1000-52-2-26 2 OF 2 �oF soar Michael J.Domino, President � yQIO Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Charles J.Sanders P.O.Box 1179� Glenn Goldsmith Southold,New York 11971 G Q 'o a0 Telephone(631) 765-1892 A.Nicholas Krupski Telephone N Fax(631) 765-6641 BOARD OF TOWN TRUSTEES 11Zb610 TOWN OF SOUTHOLD TO: ® FMAWDJ Please be advised that your application dated M412C* 412019 has been reviewed by this Board at the regular meeting of AMC tS, Yet 9 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) 1 st 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. $ 510,E BY: . Michael J. Domino, President Board of Trustees Michael J.Domino, Pre. yt �SUFFO(,r�, !P Town Hall Annex John M. Bredemeyer III,Vice-President �yJ, 4 L 54375 Route 25 Glenn Goldsmith cz y P.O.Box 1179 A.Nicholas Krupski 1�_ Southold,NY 11971 Greg Williams � p! Telephone(631)765-1892 dol �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time. Completed in field by: Jeffrey Patanjo on behalf of ADAM & SANDRA SHEBITZ request a Wetland Permit to install two tiers of coir logs for a length of 51 linear feet along the toe of the existing bank; provide 25 cubic yards of clean sand fill from an upland source for bank re-nourishment and install native plantings on re- established bank; all work to be completed landward of the mean high water line and any existing wetlands. Located: 630 Ruch Lane, Southold. SCTM# 1000-52-2-26 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary,Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 / Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Surveys 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: d'i­ I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer ✓M. Domino G. lGoldsmith Krupski G. Williams Other Page 1 of 2 Michael J. Domino,Pre; psVFFQ(Ale, Town Hall Annex John M. Bredemeyer III,Vice-r`resident ��o� ®��J, 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Jeffrey Patanjo on behalf of ADAM & SANDRA SHEBITZ request a Wetland Permit to install two tiers of coir logs for a length of 51 linear feet along the toe of the existing bank; provide 25 cubic yards of clean sand fill from an upland source for bank re-nourishment and install native plantings on re- established bank; all work to be completed landward of the mean high water line and any existing wetlands. Located: 630 Ruch Lane, Southold. SCTM# 1000-52-2-26 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 G. Williams E. Cantrell D. Di Salvo Other Page 2 of 2 dam.&Sandra Shebitz 30 Ruch Lane,Southold CTM#: 1000-52-2-26 1 � 1 .. i.�-A„�*Z.iCyaw..w,•.�n a- � � �...� 'y� J f��� �. �� .��17+1'�, � �s*S > y�,. ,.t0 -. A '.�`''••. 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W',Ori'1I .r:a a"a4�p`2 r.k,r -��`l� '?� ray •:�. err-.•- � w� � $11 s v'�\� �:.11 1 K� L r� �i�.e _ .a,�� +'S.• _ 6_...'�.:f � I- /F,(i�1—v�..ri 1\ �� {- �. a �{'aa t - •.1 .- S a`•{v' y'' bw a, ki i Photo 1 (2/24/18) r� r S ! 4 4 r„ Photo 2 (2/24/18) Photo e Photo 4 (2/24/18) el 10, .iA A(c) 2.Mc) eq,7 O51-.5-m- 13 (ZERVFO FOR PARK 4w) PLAYGMMD) 4 2xA(0 _2 Lk A�SERTSON 0 ED 7 1 7 A ISA 58 We =0 MONO 13M TOM OFsovni= IVO 511. swc) U7 7 alAlw MODNICIANOMUST -10\ jr 32A m 8 Im FOR PCL FOR R PCL NO SEE SEC.NO SEE SEC NO 05SO1411 14 rEF N0. 056444)24 ——————————— ——————--F-————— — ——————-z———— YNE UNE -- SEESEC NO SEE SEC NO m L — G ————- E x. (21) NOME COUNTY OF SUFFOLK K SOMOLD NO ------- — Real Property Tax Service Agency y ...Jw a w.e�2tM0.,zu u� —__� o.eu. --v-- uwu.--w.-- vrtxartw+rtfExvFlOnssoxoHfm °1 A 062 'D A P OFFICE LOCATION: h®��®� S®���0� MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) sia � ® �Q Telephone: 631 765-1938 Southold, NY 11971 ® Fax: 631 765-3136 lyComm,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: April 17, 2018 Re: Local Waterfront Coastal Consistency Review for ADAM & SANDRA SHEBITZ SCTM# 1000-52-2-26 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 actions are CONSISTENT with the Policy Standards and therefore are CONSISTENT with the LWRP provided the following. 1. Verify if a 10'wide non-turf buffer required by Wetland Permit 7724 has been installed. The top of bluff is shown landward of the platform at the 20' elevation. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Peter Young,Chairman q 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., April 11, 2018 the following recommendation was made: Moved by Peter Meeker, seconded by James Abbott, it was RESOLVED to SUPPORT the application of ADAM & SANDRA SHEBITZ for the installation of two tiers of coir logs for a length of 51 If. along toe of existing bank, provide 25 cy. of clean sand fill from upland sources for bank re-nourishment and install native plantings on re-established bank. All work to be completed landward of the mean high water line and any existing wetlands. Located: 630 Ruch Lane, Southold. SCTM#52-2-26 Inspected by: Peter Meeker, John Stein The CAC Supports the application with a 10' vegetated buffer. Vote of Council: Ayes: All Motion Carried UTH, � __ ' Michael J.Domino,President ®� SOTown Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 41 P.O.Box 1179 Charles J.Sanders �, ti Southold,New York 11971 Glenn Goldsmith -mac® ® y Telephone(631) 765-1392 A.Nicholas Krupski life®U��1�, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit t' Received Amendment/Transfer/Extension Application: _ 3ilL•jg ; Received Fee: $ 25D.00 �_- , i? _� _ Completed Application: Incomplete: / jr SEQRA Classification: Type I_ Type II Unlisted MAR 1 6 2018 Lead Agency Determination: Coordination:(date sent): 31301 lg m - LWRP Consistency Assessment Form Sent: S" ' '' ^-'q CAC Referral Sent: 314-19 -1U_____1 Date of Inspection: <«<1 Receipt of CAC Report: Technical Review: _ Public Hearing Held: �� t Resolution: Legal Name of Property Owner(s): A c.a Mailing Address: (4 L4 0 JL&n f A v C ' P H 1 a ,B r o 01L��,o f nl y ►! a 4 g Phone Number: oil 7- y 9 M'16 6 3 Suffolk County Tax Map Number: 1000- Property Location: 1v:30 S-ee CoG�-1'r�n n'uP (If necessary,provide LILCOO^Pole#, distance to cross streets, and location) AGENT(If applicable): �1'�•FFf G�f Qac -�a�r�� c Mailing Address: P. O . 130>< ex I pi 1171� Phone Number: 6 3 ' `� B y 'g 3 3 a- ®�� ,, J"' C�- a��� Board of Trustees Applica,_ y-In GENERAL DATA Land Area(in square feet): Area Zoning: !Zc S Previous use of property: �c S Intended use of property: J2.S Covenants and Restrictions on property? Yes ✓ No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes ^"*' No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ✓No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ./ No / Does the structure(s)on property have a valid Certificate of Occupancy? ✓_Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ve"No Yes If yes,provide explanation: Project Description(use attachments if necessary): S,ce- 9-++e-c�eg - l - Adam &Sandra Shebitz 630 Ruch Lane Southold, NY 11971 SCTM No.: 1000-52-2-26 PROJECT DESCRIPTION: The project includes the installation of two tiers of coir logs for a length of 51 LF along toe of existing bank, provide 25 CY of clean sand fill from upland sources for bank re-nourishment and install native plantings on re-established bank.All work to be completed landward of the mean high water line and any existing wetlands. r Hoard of Trustees Applica', m WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: S'e'e— &-++-C.' (.�- Area of wetlands on lot: S'/G square feet Percent coverage of lot: L•y % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: . feet Does the project involve excavation or filling? No `� Yes If yes,how much material will be excavated? cubic yards How much material will be filled? 195- cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: 6 Manner in which material will be removed or deposited: Al( w aAK- -te b-c 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): Them will 04 6 I;Pe o f®4t4'jvc eWee--f o, u HoAS of,,e .-(o .e b M erm s to A An .0 New r lG 14-t a l s. Short Environmental Assessment Form Part I -Project Information Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation 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: Proposed shoreline stabilization at 630 Ruch Lane-Southold Project Location(describe,and attach a location map): See location map Brief Description of Proposed Action: Install proposed coir log bank stabilization along toe of bank for 51 If total length in two rows.Provide 25 cy of clean sand fill from upland sources for re-nounshment and plan disturbed area with vegetation listed on plans. Name of Applicant or Sponsor: Telephone: 917-494-1663 Adam&Sandra Shebitz E-Mail: adam.shebitz@gmad com Address: 440 Kent Ave -PH1A City/PO: State: Zip Code: Brooklyn NY 11249 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑✓ ❑ may be affected in the municipality and proceed to Part 2. 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: F-1 P1NYSDEC/NYSDOS/Army Corps/Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.18 acres b.Total acreage to be physically disturbed? 0.01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.18 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industnal []Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 3 1 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ EI- b. b.Consistent with the adopted comprehensive plan? ❑ 171 ❑ 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:Name.Mill Creek,Name:Peconic Bay and Environs,Reason:Significant coastal fish&wildlife habitat, Eleason. ro ec public health,wa er, io vege a n, scenic beauty, gency. ou o own o, ruffalk ennift Ca.. 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES F71 0- 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: ❑✓ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Fv_(� ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? F71 ❑ b.Is the proposed action located in an archeological sensitive area? F ❑ 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: m Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional m Wetland ❑Urban m 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? Piping Plover ❑ ❑✓ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO YES ❑✓ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES Page 2 of 3 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 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: Z ❑ 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: FV71 ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Adam Shebitz Date: jA-1 j Signature: PRINT FORM Page 3 of 3 18 Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the F-1establishment 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? F1 Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 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 in/pacts Town of Southold-Board of Trustees t1�Na e of Lead Agency Date o President Print or Type Name f Responsi leficer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 EAF Mapper Summa( P eport "unday, March 11, 2018 1:44 PM Disclaimer: The EAF Mapper is a screening tool intended to assist 140;-G(50052OU:100-3000 'r` �,Q 300-230005200'-300-27000.:1--`^ Protect sponsors and reviewing agencies in preparing an environmental ""' v ti_' 5200c-300-22000,-1: r- assessment form(EAF).Not all questions asked in the EAF are 4.30!JO_;I'©0=.9 60r1,�, •�C.�y�"%!� r 52©s0-3'00'-2000 0 , ":-t--,^-•, �; ,,;� •1,,,: answered by the EAF Mapper.Additional information on any EAF _52;00-Tr6d 20005200-100-400© rrl '� 'r:�. 5_200-3.00-28000 520010073000 5204 3dOr2'1000 52100-3 Q532009 he EAF Mapuestion can per bovidestained the most die EAF gital data available to f ` ,.- v� ' 5200-300=30000 PP P p g DEC,you may also need to contact local or other data sources in order 5200=100 1'0 ;,)5,200 340-10©Q ~ ` 52,00-o0=31 o000Or300=4003 to obtain data not provided by the Mapper.Digital al data is not a 5200-30-2000©f.74--4 ~X52 0©-'366 33000 substitute for agency determinations. 5200.5;200;200t33 5200-300=h8�00 ��'^ 51 00500�-/900db;� , ' 001 .�r'5k2003-00-1700- 200Q-5200- 016030j� X5200 , -`552f130 i rrn ,220-300060©,45 '� 59 100: 370002®0200=13002 -200-Qa ',. , „ 2001-300-1000(2O 52 -52.00-20 280OV' -P00-200 1300,1 = -520;0',300-4-001' Tor” onto05200=200-330ff15200-300"1,3000'00!200=120; ti til tror 5l :�1a7 ; �: r X200 2 00=36009 �'FJs r�ullr*a r ' 2Q0-200=80.Q0 52;00 2©0 3200 ; „ �,-- 52 0,'200s35®045200500c1000`'�., tt;; �+ . f� Qt_ 1, ;tiBo�ton 200:200;7003, �• fit y "5200'500=2000 , 5200:200=700 , 50 - ri HERE,Garmin,USCS,,I'_ Clev4i{iod rr 55,Q!,7(3,Oi7®0(t 52'00 a`` ` t;ftt r{�Cg"0 4{100 a r `''`. •-Ir���;rt���-R�yREf�IEdJT'P ti 1'00=$00�4i300' - ' ,- .1� " r - '�ti•` ."� ° M'µ�:r,r:.y:,4.vala>" �.' "' �,:. J_a sn,,METI,EsniGfiina{Hcng-Kgb9)i.J0�60'0.0 r Ctl"to i'�P9t kiiu{ylt ;S®urc ]Esri, y E.Garmm, 13500=300 2000j tCcrc-s„Esr,i;{;T}iailend}„N�CG;,? - Columbus!'<-_'n"' -USGIZSthrrt INCREMENT 3500;304JO,Os CnStetFota 1�=�' i " t., ,F. pntii rutcr�',andth GIS ` 4 ,”i_.- -u: __,� :1?ltfGsn, Esri Japan„7sAETlti, ' ti Use��Qmmunsti clnna9l st ` 1 500'-309-1,000pi '- �' �' _' s 1i(',i3t_' W1Nm sf� ulna{Hcng,Kc?1gp,E=ri,, Part 1 /Question 7 [Critical Environmental Yes Area] Part 1 /Question 7[Critical Environmental Name:Mill Creek, Name:Peconic Bay and Environs, Reason:Significant coastal Area- Identify] fish &wildlife habitat, Reason:Protect public health,water, vegetation, &scenic beauty,Agency:Southold, Town of, Agency:Suffolk County, Date:3-9-90, Date_:7-12-8.8_ Part 1 /Question 12a [National Register of No Historic Places] Part 1 /Question 12b [Archeological Sites] No Part 11 Question 13a [Wetlands or Other Yes-Digital mapping information on local and federal wetlands and Regulated Waterbodies] waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15[Threatened or Yes Endangered Animal] Part 1 /Question 15 [Threatened or Piping Plover Endangered Animal -Name] Part 1 /Question 16 [100 Year Flood Plain] Yes Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 1 Board of Trustees Application AFFIDAVIT A4nl 5etjdee, 5hcbate.— 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 LEST OF HIS/HEIS KNOWLEDGE AND BELIEF,AND THAT ALL WORD WILL. BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLID TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD `DEIN+ TOWN OF SOUTHOL.ID AND THE BOARD OF TRUSTEES HARMLESS AND FLEE 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 TETT OF THE PERMIT. Signature of Property O, 110r Signature of Property Owner SWORN TO BEFORE ME THIS _ / � �� DAYOF 11 )ak Ch , 20 l� Notary Public CAROL LOPEZ NOTARY PUBLIC-STATE OF NEW YORK N Q.Q'I L06370575 Qu,alified,in,6r�nx,,Connty'' My CommissioExpires 02-05-2022 4 I•. Board of Trustees Applieatioxa AUTHORIZATION (Where the applicant is not the owner) AA owners of the property identified as SCTM# 1000. in the town of New Fork,hereby authorizes ��"� �►l� 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,Ownees Signatyy Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF /04i"Gh , 20 � Notary Public CAROL LOPEZ NOTARY PUBLIC-STATE OF NEW YORK No.01L06370575 Qualified in,Bronx County My Comma�sloh Expices02-05-2022 _ J r APPLICANT/AGENT/RE'PRESENTATIVE, TRANSACTIONAL DISCLOSURE'RE' ]EOMI The Town of Southold'§Code of Ethics prohibits conflicts of interest on the part of town officers and employees.Tlic Duose of this form is to_provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,first name,jpidd a initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning _ Other (If"Other",name the activity.) Do you personally(or through your company,spouse.,sibling,parent,or child)have a telationship 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 tie town officer oh employee has even a partial ownership of(or employment by)a copporation in which the town officer or employee owns more than 5%ofdhe 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 clic shares of the corporate stock ofthe applic§nt (when the applicant is a corporation); 13)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 L d y of f-N[-r 20i Signature Print Name— O, t Form TS 1 r APPLIiCAN'S'/AGENT/RE' IDRESENTA' EVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The ou ose of this form is to provide information which can alert the town of Possible confliels of interest and allow it to talce whatever action is necessary to avoid same, l YOUR NAME: S F e4 nek fcR— (Last name,first name,jpiddle 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 Do you personally(or through your company,spouse,sibling,parent,or child)haven ielationship with any officer or employee of the Town of Southold? "Relationship"includes by bloocl,marriage,or business interest."Business interest"means a busincss, including a partnership,in which the town officer oremployee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%oftIbe 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 ilie share:;of the corporate stock ofthe applicpnt (when the applicant is a corporation); B)the legal or beneficial owner of any interest in anon-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 !^t-r 20,1 Signature L �r Print Name=5WVb,§4��Sfl i7 _ Form TS 1 AFPLIiCANT/AGIENT/R EPRESENTATWE TRANSACTIONAL IDISCLOSURE FORM I The Town of Southold Code of Ethics prohibits conflicts of interest on the part of town officers and employees The pumose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same, f YOUR NAME: (Last name,first name,iiiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of 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 ✓ i If you answered"YES",complete the balance of this form and date and sign where indicated. I 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. i 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 th' )I da of l� 20 1 d Sianature •- Print Nam ' a ,, Form TS 1 r April 12, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 { '" APR , 1 2018 `~ Southold, New York 11971 Su<<` oo`d Torn RE: 630 RUCH LANE-SOUTHOLD SCTM No. 1000-52-2-26 -,-- AFFIDAVITS Dear Trustees: Attached please find Affidavits of Posting and Mailing as required for hearing. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, 1 1 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 • e •o - oEIPT CE�RTIFIEDMARECCERTIFIED o RECEIPT r,o -only estic Wil Only m LnQ Er asou ISTi � IF LII L p, Certified Mall Fee 1 %/' ? ✓%- Er Certified Mad Fee $3.45 1_ �] l� $ r $ 7 A D Extra Services&Fees(check bar,add tee ��mnrlate) to Er Extra Services&Fees(check bar,add tee p a e) ❑Return Receipt(hardcopy) $ $�1 _ p I i,SIU Postmawr'rk ❑Return Receipt(hardcopy) $ —► ❑Return Receipt(electronic) $ Z O ❑Return Receipt(electronic) $ - PIPS�rttark 0 ❑certified Mall Restricted Delivery $ - H O ❑Certified Mail Restricted Delivery $ I •(I I-I n ❑Adult Signature Required $ 00 , . 0 E]Adult Signature Required $ $.�I•5f�,I AS ❑Adult Signature Restricted Delivery$ ❑Adult Signature Restricted Delivery$ J (3 Postage $0.50 50 IM Postage $CI.StI Ln $ tl4/11/?Ii1 L $ 1.14/11/2�li = Total Postage and 56.70---- = Total Postage and r ri $5`7f_i $ent To SCTM# 1000-52-2-25 r` sent To SCTM#1000-52-3-5 Daggett, Katie& Bennett, Daniel ri r C3 5'----1andApt No.; gg O'Brien,John A � SfieeiandApLNo., j r`' 560 Ruch Lane - �` 1802 21St Street Southold, NY 11971 Astoria, NY 11105 TM Postal Service p RECEIPT /q S , Er NEW(cc 11 Er Certified Mail Fee $3.45 Ali 1 b 5 1)65z�Extra Services&Fees(checkbaxadd tee ps,�o�mcNate) U) urs❑Return Receipt(hardcopy) $ q'lr rlrf❑Return Receipt(electronic) $ II i `�Pos�o ❑Certified Mad Restricted Delivery $ $000mark 3 ❑Adult Signature Required $ [:]Adult Signature Restricted Delivery$ O PostageLn $0.50 ° = $ 114/11/2018 Total Postage and Pegs $ �ne7al � Sent To SCTM#1000-52-2-28.1 0 N,5etandApCNo.; Sharp, Colleen & Keating,Andrew City Stste,ZIP+4® 43 Great Jones Street New York, NY 10012 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: <<. f • x:.3:5 STS' � � �.m ., -'.t. `� } ,y STATE OF NEW Yof, COUNTY OF 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. k i k Sworn to before me this Day of , 20 I Notary Public 0 5 PROOF OF MAILING OF NOTICE ATTACK CERTIFIED MAIL RECEIPTS Name: Address: SCTM# 1000-52-2-25 Daggett,Katie &Bennett,Daniel 560 Ruch Lane, Southold,NY 11971 SCTM# 1000-52-2-28.1 Sharp, Colleen&Keating,Andrew 43 Great Jones Street,New York,NY 10012 SCTM# 1000-52-3-5 O'Brien,John A 1802 21st Street,Astoria,NY 11105 STATE OF NEW YORK COUNTY OF SUFFOLK Teffrey Patanjo ,residing at P.O.Box 582,Bohemia,NY 11716 being duly sworn, deposes and says that on the /I day of April , 20 18 , 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 1304 ice,�.� , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of April 2018 ' MARILYN S.HICKS ' NOTARY PUBLIC,STATE OF NEW YORK i i I Registration No.011-1163654N Not Public �4— Qualified in Suffolk CountY Commission Expires October 10,2021 Michael J. Domino,President ��$11FF0(,�co Town Hall Annex John M.Bredemeyer I11,Vice-President ���� GyJ, 54375 Route 25 Glenn Goldsmith ti z P.O.Box 1179 A.Nicholas Krupski ® Southold;NY 11.971 Greg Williams Telephone(631)765-1892. Fax(631)765-664.1 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD -------------------------=------------------------------------- In the Matter of the Application of. ADAM & SANDRA SHEBITZ COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT.OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLA.CE FORAT LEAST SEVEN_ DAYS.PRIOR,TO THE PUBLIC HEARING DATE: 1, Jeffrey Patanjo residing at/dba P.O. Box 582,Bohemia,NY 11716 being duly,sworn, depose and say: That on the // day of April , 2018, I personally posted the property known as 630 Ruch Lane,Southold,NY 11971 SCTM# 1000-52-2-26 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,April 18,2018. Dated: April 11,2018 ign ture) Sworn to before me this day of April 2018 MARILYN S.HICKS [NOTARY PUBIJC,STATE OF NEW YORK Aqtarylic Registration No.01HIS366489 t]uamed in Suffolk County Commission Expires October 10,2021 NUTILL Ulm H ;tA , N 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: ADAM & SANDRA SHEBITZ SUBJECT OF PUBLIC HEARING : For a Wetland Permit to install two tiers of coir logs for a length of 51 linear feet along the toe of the existing bank; provide 25 cubic yards of clean sand fill from an upland source for bank re-nourishment and install native plantings on re-established bank; all work to be completed landward of the mean high water line and any existing wetlands. Located: 630 Ruch Lane, Southold. SCTM# 1000-52-2-26 TIME & DATE OF PUBLIC HEARING : Wednesday, April 18, 2018 — 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 I 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 icant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. I£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- suonorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# S off- - a - a a? PROJECTNAME 13an 1G AA- 63t:' le e-Lt The Application haus been submitted to (check appropriate response): �—�/ Town Board El Planning Bozird❑ Building Dept. ❑ Board of Tirustees E I 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: t P Location of action: 30 2..& Lu •e Svc +4 a l s� Site acreage: a - 15 Present land use: R S Present zoning classification: Qe S 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:_ Ad Ain '54n +-Z (b) Mailing address: q q O K c n+ gy e - GryalLlyn , N4 !I '-y9 (c) Telephone number: Area Code( ) '11 -7 g `f l 6 6 3 (d) Application number,if any: 144 Will the action be directly undertaken,require fimding,or approval by a state or federal agency? Yes FNo❑ If yes,which state or federal agency? t- -t SD'cc-I t44 SDOSJ RaaN CA-PS C. ]Evaluate the project to the following policies by analyzing how the propect 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 I. Poster 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 LWRF Section III-Policies-, Page 2 for evaluation criteria. RrYes ❑ No ❑ Not Applicable Proiec4 Pf oi'ee-rs •1— li S+1n e&e. cue Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-P,oliiccies Pages 3 through 6 for evaluation criteria 1:1Yes ❑ �; No I-1 Not Applicable ( A Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout-the Town of Southold. See LWRJ? Section KIR—Policies Pages 6 through 9 for evaluation criteria W Yes ❑ No ❑ Not Applicable Prci,et,i elovtkeS & wa+,r&,t 5k-preIiae Oma cujcvsts -oroJite, Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWR j? Section III—Policies Pages S through 16 for evaluation criteria ErYes ❑ No ❑ Not Applicable roiee4 Pro-teef's et4eomst eiroSloA 4ndl er-0%-1tcOcS Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See ILWRP Section Ell —Policies Pages 16 through 21 for evaluation criteria Yes ❑ No ❑Not Applicable r.vle&A raves -c4 4✓4,��&.� l'Jw fedwc&pip! Cro,lr•ou ted► aLOtcry +(%oe Plwn-H#lys 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 LVVRtP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ Yes leo Not Applicable Pr,,je e¢ Pr,tee- l e- -OW vi ion^c&--t doer wcf -G�®S[o.. aa� stcd �� Pl�v�tsnys 45 i°'eSTi •^y areR 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 ❑ leo U 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 ILWR P Section III—Policies; Pages 34 through 38 for evaluation criteria. 1:1 Yes 1:1as No I—J 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 lLWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yeo No u Not Applicable Attach additional sheets if necessary 3 WORDUNG COAST POLICIES Policy I®. Protect Southold's water-dependent eases and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ Ido ❑✓ '-Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in ]Long Island Sound, the Peconte Estuary and Towne waters. P atSee LWRP Section HHI—Policies; Pages 57 through 62 for evaluation critea°ia. F] Yes 1:1 No ITNot Applicable Attach additional sheets if necessary Policy Ila Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; ]Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No LJ'INot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section HE—IPolicies; Pa s 65 through 68 for evaluation criteria. F] Yes F] No ppDlicabk PREPARED BY �7�-r�-,,, �� TITLE E A� e•►1' IIATE 3 LI18 J February 14, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 630 RUCH LANE-SOUTHOLD SCTM No. 1000-52-2-26 APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Ve truly yours, ffrey Patanjo P.O. Box 582 Bohemia, NY 11716 if F �t MAR j 6 2018