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HomeMy WebLinkAboutTR-9323 Glenn Goldsmith, President s®(/�� Town Hall Annex A. Nicholas Krupski,Vice President ,�®� ®�® 54375 Route 25 P.O. Box 1179 Eric SepenoskiSouthold,New York 11971 Liz Gillooly G Telephone (631) 765-1892 Elizabeth Peeples ® ��® Fax(631) 765-6641 C®UTI,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 18, 2022 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: NICOLE MARTORANA & DAVID ALWORTH 3400 DEEP HOLE DRIVE, MATTITUCK SCTM# 1000-115-17-11 Dear Mr. Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, August 17, 2022: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#9323 from Frank Martorana, Mindy Martorana & Bryan Martorana to Nicole Martorana & David Alworth, as issued on October 17, 2018. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Glenn Goldsmith, President Board of Trustees Glenn.Goldsmith,President o�g�FFl1(h COGy Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 ca Eric Sepenoski Wgo P.O.Box 1179 Liz Gillooly �y • 0�� Southold,NY 11971 Elizabeth Peeples � Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Completed in field by: �'. � ��Sr�, En-Consultants on behalf of NICOLE MARTORANA & DAVID ALWORTH requests a Transfer of Wetland Permit#9323 from Frank Martorana, Mindy Martorana & Bryan Martorana to Nicole Martorana & David Alworth, as issued on October 17, 2018. Located: 3400 Deep Hole Drive, Mattituck. SCTM#: 1000-115-17-11 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative 'Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: or, Qia�,s�Ec. Present Were: . ✓ G. Goldsmith N. Krupski E.,Sepenoski L. Gillooly E. Peeples Michael J.Domino,President * /��v SO Town Hall Annex Sf O �f 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 11 Glenn Goldsmith 7�L Southold,New York 11971 A.Nicholas Krupski G .� Telephone(631)765-1892 Greg Williams O Y Fax (631) 765-6641 OUNT`4, R_� �w I V E BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD AUG ­ 5 2022 APPLICATION FOR A TRANSFER OF A WETLA and COASTAL EROSION MANAGEMENT PERMIT DATE August 2, 2022 OWNER Nicole Martorana & David Alworth PHONE 516-527-0054 MAILING ADDRESS 3400 Deep Hole Drive, Mattituck, NY 11952 AGENT En-Consultants PHONE 631-283-6360 ADDRESS 1319 North Sea Road, Southampton, NY 11968 PROPERTY LOCATION 3400 Deep Hole Drive, Mattituck TAX MAP NO. 1000-115-17-11 I/We En-Consultants for Nicole Martorana & David Alworth request a Transfer of Permit#9323 from Frank Martorana, Mindy Martorana & Bryan Martorana Signed By: Robert E. Herrmann, oastal Management Specialist Board of Trustees App- ' ration AUTHORIZATION (Where the applicant is not the owner) I/We, Nicole Martorana owners of the property identified as SCTM# 1000- 115-17-11 in the town of Southold .New York, hereby authorizes En-Consultants 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 f r this property. N N/A Prope ;Owner's Sign l ture Property Owner's Signature Nicole M 'rtorana l SWORN TO BEFORE ME THIS I �' DAY OF A�4 , 20Z Notary Public 7PUBLIC. M.Grier NOTARTATE OP NEW YOWLRo.01GR6399126Suffolk CountyCommis October 15,20,Al Board of Trustees Ap] ' 'cation AUT'TIOPJZA'TION (Where the applicant is not the owner) I/We, David Alworth owners of the property identified as SCTM# 1000- 115-17-11 in the town of Southold New York, hereby authorizes En-Consultants 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. N/A Prope er's Signature Property Owner's Signature David Alworth SWORN TO BEFORE ME THIS h DAY OF , 20 Notary Public Jacob Ni. Grier NOTARY PUBLIC,STATE OF NEW YORK Registration No.01GR6399126 Qualified in Suffolk County Commission Expires October 15,20a Board of Trustees App,-'-Pation AFFIDAVIT Nicole Martorana 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. N/A i e of Pr perty Owner Signature of Property Owner Nico a naturMartorana SWORN TO BEFORE ME THIS l DAY OF � L 20 Notary Public Jacob M.LOFNEW NOTARY PUBLIC,STATYORKRoils moon No.06"tbdIn SuHC,m"I"Aon Expires 20 Board of Trustees Apj� `cation AFFIDAVIT David Alworth BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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. N/A Sign f roperty Owner Signature of Property Owner David Alworth SWORN TO BEFORE ME THIS / DAY OF 20y?; &77� Notary Public Jacob M.Grier NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 GR6399126 Qualified in Suffolk County Commission Expires October 15,2023 APPLICANT/AGENT/REPRESENTATfW TRANSACTIONAL DISCLOSURE FORM The To%tim of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The aurMse 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. YOURNAME: Martorana, Nicole (Last name,fust name,Middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X 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 or(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicantlagent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applic4nt (when the applicant is a corporation); I3)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' 1� y of 2011— Signature Print Name Nicole M rtorana Form TS 1 r 4 APPLICANT/AGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Toy%m of Southold's Code of Ethics rohibits conflicts of interest on the art of town officers and emnloyecs.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: David Alworth (Last name,first name,ipiddle 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 X 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 of;•iccr 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 employce has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 90M f the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applic@int (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this / y of / 20 Signature Print Name D (worth Form TSI Michael J. Domino, President o�psafo(K�oG4� Town Hall Annex John M. Bredemeyer, III, Vice-President �o� :X. 54375 Route 25 14 Glenn Goldsmith P.O. Box 1179 A Nicholas Krupski ' Southold, NY 11971 Greg Williams ~y�ol , „ �`��l Telephone (631) 765-1892 � r 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 1s' day of construction % constructed When project complete, call for compliance inspection; Att 2L BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 9323 DATE: OCTOBER 17, 2018 a ISSUED TO: FRANK MARTORANA, MINDY MARTORANA & BRYAN per: J MARTORANA PROPERTY ADDRESS: 3400 DEEP HOLE DRIVE, MATTITUCK SCTM# 1000-115-17-11 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 17, 2018, and in consideration of application fee in the sum of$250.00 paid by Frank,Mindy&Bryan Martorana and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a fixed timber"T" shaped dock(elevated 4' above grade of marsh and constructed with open-grate decking), consisting of 41x5l steps at landward end; a 4'x391 catwalk; and a 41x10' fixed seaward platform; and as depicted on the site plan prepared by En-Consultants,dated July 16,2018, and stamped approved on October 17,2018. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of as of the 17th day of October,2018. C2 COO.) %;50 1 VI-WN, TERMS AND CONDITIONS The Permittee Frank Mindy&Bryan Martorana, residing at 3400 Deep Hole Drive, Mattituck, 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. O` �jyol Michael J.Domino,President V� soTown Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski Yp� Telephone(631) 765-1892 Greg Williams `,OM, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 17, 2018 Robert E. Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: FRANK MARTORANA, MINDY MARTORANA& BRYAN MARTORANA 3400 DEEP HOLE DRIVE, MATTITUCK SCTM# 1000-115-17-11 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 17, 2018 regarding the above matter: WHEREAS, En-Consultants on behalf of FRANK MARTORANA, MINDY MARTORANA& BRYAN MARTORANA, applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated August 31, 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 October 17, 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, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 � , 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 FRANK MARTORANA, MINDY MARTORANA& BRYAN MARTORANA to construct a fixed timber"T" shaped dock (elevated 4' above grade of marsh and constructed with open-grate decking), consisting of 4'x5' steps at landward end; a 4'x3g' catwalk; and a 4'x10'fixed seaward platform; and as depicted on the site plan prepared by En-Consultants, dated July 16, 2018, and stamped approved on October 17, 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: $300.00 Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd APPROVED BY Ionil oo z o ®AR®. OF TRUSTEES 0 QF' m TOWN-OF -SOUTHOLD DATE � pa Qst oa - O /� /J,�( oy -R, k 1 7 go l g s BUN6Ak0 Mattltuck sT Cr r m/ Airport CENTER Marratooka Pt Pew o Paa O" _ 51T�(ACC�55 VIA 50,11�cT PROMMI ) HOLE DRIVE CAOLAE EXT GREAT PE( i BAY d , 5uffolk County Nagstrom Map 4 2000' D fA Z CONC WALK D Y m a Notes: \ I, To provide sutgle point of safe,elevated structural rn \ access to water over vegetated tidal marsh;private dockage of small noncommercial watercraft 2-S < 2. l7atum;MLLW- 0' -0" FRAME HOUSE3, Water depths and elevations tran5cri6ed from C - R. hydrocfaphic survey prepared 6y John C,Ehlers ❑ N k Land Surveyor,last dated Auoiust I,2018 DEC& J 4 I, k 4. hock to consist of treated lumber;untreated open-cirate :T decking;and hot-dipped galvanized steel hardware 5. flan and erossview diaq-ams of proposed dock are " — 30' schematic and intended only to establish project location, 1+ scope,and basic construction details for permlttinq purposes N and are not intended to serve as or substitute for engineering or construction plans for purposes of construction EDGE OF LAWN 4' 6, Property location:5400 Peep Note Prive, 5' Mattituck;5CTM#1000-115-17-II _ 9 ��� raTWL3j @L,' � MM - - - - - i t i--..--.___ V- s r I DD � _ 1 V- V. -DR' AUG 3 1 2018 m REMAINS n EXISTING Dp PREVIOUSLY o I+� - -0.5, __ _CK STRUCTURE r i Sauthald Tom �- 10, 41 O, h Board of Trttstce,5 PROPOSED CONSISTING OF4'x APED FIXED DOCK E N - CONSULTANTS r CATWALK, AND 4'x 1 p OPS' 4'X 39' DE'E'P 1 H®L� CREAK LATE°RM 1319 NORTH SEA RD, - — _ SOUTHAMPTON, NY 11965 ML`W — — — — — — 631-253-6360 a FPOF05W FIX�P 'T 5HMt L? POCK FOp FHV, I LC ON teff HO[,� Cf? M MAfflTUCK, NY SH��f I OF 2 1-16-18 5�CVON TWU PPOPO5�P FIXrP 11MP3 F, POCK 5c&L : 1'' - 10' LPI;OP05EP PIM?TIMMP,"T"-5HAPW POCK / +26' 7 STEPS PIX�P � 11Mf3�p CATWALK y, — OMN-Gr?AT>✓PACKING POM HANPM(TV.) � WOOP NANPt?nAIL(M) 4' PI9P"T" PLATPOf?M a 6" CAPS&STpINGEpS X MHW- 2'-8" NM MLLW- O'-O" IM— �X,G1ZAP� Ll u V- u u 6" PU5(6' -8' O,C,,T'PJ n f=- o c c o W m E N - CONSULTANTS ppOP05�P F109 'T 5I-IAM2 POCK FOP\ FNV, I LC ON P��P 1319 NORTH SEA RD. N01.� Cf?M, MA1'l1TUCK, NY SOUTMV APIPT-CN, W 11965 5H��f 2 OF 2 1-I6-18 631-253-6360 . s — Michael J. Domino President ti oCG Town Hall Annex John M. Bredemeyer, III, Vice-President �� '�A ; 54375 Route 25 Glenn Goldsmith y z; P.O. Box 1179 A Nicholas Krupski oy o���' Southold, NY 11971 Greg WilliamsTelephone (631) 765-1892 Zr Fax (631) 765-6641 1a,2�1� TO: MARTORANA c/o EN-CONSULTANTS Please be advised that your application dated August 31, 2018 has been reviewed by this Board at the regular meeting of October 17, 2018 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) PAID Final Inspection Fee ($50.00) xx Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: 4'x15' catwalk = 60 sq. ft.x $3.00 = $ 180.00 4'x10' platform = 40 sq. ft.x $3.00 = 120.00 TOTAL FEES DUE: $ 300.00 BY: Michael J. Domino, President �I�2'a Board of Trustees , r a r ` ..._ ,1 'Ta. o�� Uryol Michael J.Domino,President ®F SOTown Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith hc c Southold,New York 11971 A.Nicholas Krupski �Q Telephone (631) 765-1892 Greg WilliamsFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 18, 2018 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11971 RE: ENVIRONMENTAL DECLARATION OF SIGNIFICANCE PURSUANT TO NEW YORK STATE ENVIRONMENTAL QUALITY REVIEW ACT NYCCR PART 617 FHV, LLC 3400 DEEP HOLE DRIVE, MATTITUCK SCTM# 1000-115-17-11 Dear Mr. Herrmann: The Southold Town Board of Trustees adopted the following Resolution at a meeting held on Wednesday, October 17, 2018: DESCRIPTION OF ACTION: En-Consultants on behalf of FHV, LLC; c/o GARY SALICE requests a Wetland Permit to construct a fixed timber "T" shaped dock (elevated 4' above grade of marsh and constructed with open-grate decking), consisting of 4'x5' steps at landward end; a 4'x39' catwalk; and a 4'x10' fixed seaward platform. Located: 3400 Deep Hole Drive, Mattituck. SCTM# 1000-115-17-11 S.E.Q.R.A. NEGATIVE DECLARATION OF ENVIRONMENTAL SIGNIFICANCE: WHEREAS, on October 15, 2018 the Southold Town Board of Trustees found the application of FHV, LLC; c/o GARY SALICE to be classified as an Unlisted Action Negative Decision pursuant to SEQRA Rules and Regulations. A Short Environmental Assessment Form and a field inspection have been completed by the Board of Trustees and it is hereby determined that it will not have a significant effect on the environment, and; WHEREAS, the Southold Town Board of Trustees are familiar with this project having visited the site on October 10, 2018, and having considered En-Consultants plans for this project dated July 16, 2018, showing the proposed dock and water depths, and John C. Ehlers survey dated September 18, 2017, last revised August 1, 2018, and; i WHEREAS, in reviewing project plans dated July 16, 2018 and water depths, it has been determined by the Board of Trustees that all potentially significant environmental concerns have been addressed as noted herein: • Navigation: The proposed catwalk meets standards and does not extend beyond 1/3 across the water body. Depths for the dock terminus are within Town Trustees, New York State Department of Environmental Conservation and United States Army Corps. of Engineers guidelines and there is no recognized Federal/New York State/Town navigation channel in the immediate vicinity of the proposed structure. • Scope: The proposed catwalk is comparable to docks on neighboring properties in an area where docks historically are used for commercial and recreational purposes. • Scope in relation to the riparian rights of shellfishers: The plan allows a standard elevated design that will not impede access for those seeking shellfish and crustacea in season. • Scope in relation to view sheds: The seaward end of the proposed dock will not extend appreciably beyond neighboring docks and as such the perspective will not be discernibly different from the existing view. • Environmental upkeep: The dock design projects a usual lifespan of 30 years with limited pile replacement so as to minimize disturbance of the bottom. THEREFORE, according to the foregoing, the Southold Town Board of Trustees Approve and Authorize the preparation of a Notice of Negative Declaration pursuant to SEQRA for the aforementioned project. If you have any questions regarding the above, please contact this office. Very truly yours, Michael J. Domino, President Board of Trustees DEPARTMENT OF THE AF i! —'I —fes U.S.ARMY CORPS OF ENGINEERS,NEW YORK DISTRICT D E IJ �?i7 I JACOB K.JAVITS FEDERAL BUILDING 26 FEDERAL PLAZA � NEW YORK NEW YORK 10278-0090 SEP 2 4 2018 S P 1 outhold Town Regulatory Branch e SUBJECT: Permit Application Number NAN-2018-01228-EME by FHV, LLC The New York District, U.S. Army Corps of Engineers, has received a request for Department of the Army authorization for the following activity: APPLICANT: FHV, LLC ACTIVITY: The project would install a new catwalk, four-feet wide by 39-feet long; and fixed dock structure, four-feet wide by 10-feet long, in a "T" configuration. The structure would be supported by 8 (8) 6-inch diameter wood float anchor piles seaward of Mean High Water. The water depth at the terminus of the structure would be approximately 12 to 18-inches below mean lower low water. Inter-tidal wetlands exist in the project area. The catwalk would be elevated a minimum of four-feet above the grade of the wetland as measured from the bottom of the stringers, and have an open grate deck. The structure would extend approximately eight feet seaward from the plane of the mean low water into Deep Hole Creek. The channel is approximately 47-feet wide in the project location. The,purpose of this project is to allow water access and mooring for small watercraft. WATERWAY: Deep Hole Creek, tributary of Great Peconic Bay LOCATION: The project is located at 3400 Deep Hole Drive, in the Town of Southold, Suffolk County, New York As this is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing work in navigable waters of the United States. To accomplish the coordination required, prior to the issuance of a Letter of Permission, your review of the enclosed drawings is requested. Pursuant to Section 307 (c) of the Coastal Zone Management Act of 1972 as amended (16 U.S.C. 1456 (c)(3)(A)), the applicant has certified that the activity complies with and will be conducted in a manner that is consistent with the approved state coastal zone management program. SUBJECT: Permit Application Number NAN-2018-01228-EME by FHV, LLC - 2 - SEP 17 2018 In order for us to better serve you, please complete our Customer Service Survey located at http://www.nan.usace.army.miI/Missions/Regulatory/CustomerSurvey.aspx. To allow for the timely processing of the subject application, your comments are requested within 20 days of the date of this letter. If you have any questions, please contact Ms. Lisa Grudzinski, of my staff, at (917)790-8428 or lisa.a.grudzinski(a�_usace.army.mil. Sincerely, Ronald R. Pinzon Chief, Eastern Permits Section Enclosures FBI ECEI %fE ESEP2L42018] Southold Town a � /yJ USACE 'ILC: NAN-2018-01228-EME J420 `$ i, a r �P G GOLD SP o9m� /r�- ' � 0 SoO�° OREGON m Bidwell �r meyard stelfe di Borghe ® P4^ rds 8 ry cM fa ShePruoadHcuse tea, -�• YS `NOP000p 9"2 Vineyards a•cw ons k N s EAST ATTITUCK 84 CUT H UE sy lL yQJQ' �� FII (_ z Q 48 \ LI u� UQq rya TRH s 25 GallucfoFamly 2 °�o e° .=, Winery oul 25 o Y Pellegnni a l MSG A myl Vineyards S g! Op oil a R� Po 'vy a eo Jif s pus r E �O Matotuck G °° AZAEFA Co.Agi .* + tG- � RD Pk 90a b-ill `' g� ty •\0� ti O $� 5 3 y Fsr yy 1 La>Y °� o y oR m m 4 r. •O an� p � r�� o° LL Tan ® y tYln•ralookn 6`�- n2 o Q\' ' O 3 "`•'�. amu-c� O y< 4"2m 9� oPtoN 4 e01 EW o � a- -Pvc L(l ON POINT NO F'Q� � �Od °�'•I -�.-�ar 48 OR \�0 AOR S 0 .-:J•t7 3 LD jacr -a e° m $ Mattit'uek Crce- 5 °\5 Airport ' cEl En 6z G Marratooka Pt _ PO F LEGION V�9 KRAUS R13Vfia �� (ACC�55 VIA ` � ?i `� 51J6JEC7 t'pOt' M) a mr O PMI FOIA GRE rl� 0X rr77rr �^• hagm �` Park 4S E•E'rT l71'lE _ 0l`IC 4-za O,P my 9 t 4 BAY PAGE 1 OF 3 Suffolk County Hagstrotn Map 45 Gm � Ao 1 t, - +2000' DO" ii" •, i� 'B3'',('' .C3'' ='a-i azao'gs'.aF•' 1• ` . .. ,f`'I•('. . -'�:�'I:'' - - 't 1+Y'r,�;r� i,,,• it ..� 7 inlnnka 3 SUFFO USACE FILE:NAN-2018-01228-EME 3 and S c coq �'o y s �Q0 m M7 009 ' K 0 o s 0 Q ,on Qg'l R s «F' m / O,P s su cam - Manituck sT Crre�- AlrpDrt CENSEP 1 Marratooka Pt pV 519(ACa55 VIA DE �� 51JIUCf FFWFp FTY) EP HOLE' DRIVE' CAMP MI EOIA � G R EA T P '( E T t BAY. Suffolk County Nagstrom Map-45 1" _ -t-2000' (1) Z = CONC WALT o m Notes; \ I, fo provide sinoje point of safe,elevated structural access to water over vegetated tidal marsh;private D \ dockage of small noncommercial watercraft 2-STORY < 2, Datum;MLLW- O' -0" FRAME fIO1SE 5, Water depths and elevations transcribed from hydroq"aphlc survey prepared by John C,Ehlers D ti Land 5urvegor,last dated Augtst I,2018 DECK 14 1, 'f, Dock to consist of treated lum6er;untreated open-crate deckinq;and hot-dipped galvanized steel hardware 0 5. Plan and crossview diaq-arns of proposed dock are 1 1) — 30J schematic and Intended only to establish project location, Nscope,and basic construction details for permlttinq purposes and are not intended to serve as or%6stl;atte for EDGE OF LA engiwurinq or construction plans for purposes of construction WN 4' 6, Property location 3400 Deep We Drive, 5' Mattiuck;5CfM#1000-115-17-11 V- Ic. -. TWO 39' PDrL (�% ��p L m MI1W v_ U. V- " x V- w �fM m � w rn�o � REMAINS ! SEP 2 4 2018 - _ -EXISTING ppFCK STRUC 0, o C� _ '-o sl .. - __ ruRE o L-�-G--Id—fownIO 4 1 0 ar o Tru�tgcs PROPOSED 7 (�y CONSULTANTS � E i } p�` 1� CONSISTING pF4' 5 D FIXED DOCK I"d " S S� �I�i�'� pi ] DEEP e J CATWALK;AND 4 x 1 STEPS' 4'X 39' DE ` HOLE' CREE,.K LATFORM 1,319N(C) TH SEA RD. 9 - _ SOUTHAMPTON, NY 11968 MLLW - --_ _ _ _ 631-283-6360 o PFIOF05�12 F102 "1''I-SNA W nOCK FRENV, I LC ON MV PAGE 2 OF 3 HO1, CQTK, W11TUCK, NY 5H�ff I OF 2 1-16-16 USACE FILE:NAN-2018-01228-EME .;a-: o C"i 5�CION THPU FPZOPO5�P FIX�P 11MP3 P, POCK UM N o 0 scala; i" = to' o 0- CD) w am PWPO5E17 ME?TIMMR"T"-5WW KIOCK / — 5TEP5 PI9f7 +39' 'flA/M CATWALK 5' — 0MN-6P.ATE MCKING POPE NAN17M(TW.) MW"P'PLATPOF.M WOOn HANl7l?AIL(TT.) 6"CAP5&5TMNalZ5 x'. MHW-T-61 1 NM MLLW G O'"O" -V 6"PILE5(6' -8' O,C„TYF,) N ,f°`�'�S ►3°p ax NI"S a" :��FL1:o;Y z ' 1311- NORTH SSEEA RD, ppOPO5�n F109 If,1_5H*�P Sol ITA? .I1�; 'ION, NY 119168 POCK FOP, FNV, [,I C ON PW PAGE 3 OF 3 6 g m283-63" HO1. Ck��K, MA'']TUCK, NY 5H[�f 2 OF 2 7-16-18 I 5 U RV EY Of P ISO P E RTY NEWN 51TUATE : MATTITUCK- _ FOLK ,q o V Ell U E TOWN : 50UTHOLD �, 5U FFOLK COUNTY, NY L 1+1 SURVEYED 10- 18-201 7 UPDATED OG- 1 9-2018 1q: LAND NOW p REVI5ED 07-03-2018 FINK R OR,MWLY 0F. DOCK REVISED 08-01 -2018 MILADY MARTp"NA SUFFOLK COUNTY TAX # I 1000 - 115 - 17 - II I CERTIFIED TO: ASPHALT DRIVEWAY II FHV,LLC LU QOM I r CROWN TITLE CORPORATION FIRST AMERICAN TITLE INS. CO. Y 24 3, � � I I Z D cB U W FRgME I' ' 5 O STOOP �V O U a0 tet- O �- _ _ I�r (VI I I i 09 LL f (pLLI ���I o J J LLJ 1 Q� r a.2 g �► it g o J ; I p pl I; Q LL, 1 1� 1� I o of of I I w AUG 3 1 2018 jI zl l I I L �I ill I I Board of Trsstns.___ ELECJ METER ❑ I f I I� IZ RO AN E � � I I MON UNDER NOTES ® MONUMENT FOUND I I I —X X—X— WIRE FENCE ELEVATIONS REF. MLLW= 0.00' ) Q r DO cK / Area = I I,108 Scl. Ft. LAND NOW OR Fp DRgI� Ole i 1i I I GRAPHIC SCALE Acres55 i — 20 NENRYS NVC�RLrpP, pUTL�PIPE I I WETLAND FLAGS SHOWN THUS 1� F.E.M.A. FLOOD ZONE X FROM F.I.R.M. PANEL 3G 103CO482H / v "Unauthorized alteration or addition to a survey ` O� mop bearing a licensed land surveyors seal is a JOHN C. E H LE f�5 LAND 5 U f�VEYO 'y �j violation of section 72or sub—division Education io of the ����G.4N New York State Education Law "Only copies from the original of'his survey marked with an original of the land surveyor's (n�� stomped seal shall be considered to be valid true copies" G EAST MAIN STREET N.Y.S. LIC. NO. 50202 7k f "Certifications Indicated hereon signify that this ' t( survey was prepared in accordance with the ex— RIVERt1EAD, N.Y. 1190 I 369-8288 Fax 3G9-8287 77 'sling Code of Practice for Land Surveys adopted #X TIDAL WETLANDS BOUNDARY AS DELINEATED BY EN-CONSULTANTS 4-27-18 �i� O� by the New York Stale Association of Professional esurve o tonhne.net Land Surveyors Said certifications survey y is run only —, to the person for whom the survey's prepared, Y@ p tis S020 and on his behalf to the title company, gavernmen— F tat agency and lending institution listed hereon, and 17-184 LANDS to the assignees of the lending institution Certifica— tions are not transferable to add'Lonal nsl'tulions Michael J. Domino,Pr_' it o�pgOFFt7(,i-coG Town Hall Annex John M. Bredemeyer III,Vice=President may` y� 54375 Route 25 Glenn Goldsmith yP.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams � p! Telephone(631)765-1892 �Ol �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 1 �j0l) %IS Completed in field by: En-Consultants on behalf of FHV, LLC; c/o GARY SALICE requests a Wetland Permit to construct a fixed timber "T" shaped dock (elevated 4' above grade of marsh and constructed with open-grate decking), consisting of 4'x5' steps at landward end; a 4'x39' catwalk; and a 4'x10' fixed seaward platform. Located: 3400 Deep Hole Drive, Mattituck. SCTM# 1000-115-17-11 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 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: W✓ J. Bredemeyer ,/ M. Domino ✓ G. Goldsmithy/ N. Krupski G. Williams Other rnV,LLC,3400 DEEP HOLE DRIVE,IWAMTUCK NI M Ar �Y„moi:.- 3R .,•�-M Google Y Figure 1. Aerial view of subject property and surrounding docks to north,south,and east(across creek)in October 2017. Aerial image by Google Earth. J ke lA"jIL 4 may. r• P k jr�• r i f �. Figure 2. Aerial view of subject property and previously existing dock structure present in October 2006. Aerial image by Google Earth. r 5Ga r ''� e'F. °� 'j��g'Saf,�,A1,•In A' `Wit. ^ r !�. r t �ahF2.'r .v 17 T\• 'ti•f+ Rt! ��II i uk�� et3,e, tr4u 4't � / f �'`dpivZ,./R � c - [ ` j�;,�j�� � Irl� '�i.Q� '�'''a '•c, d's �;.l �8, �`�� �'iii'�. — ,A ' i'•'1'�I� �'l�t`p�/�h�` Y�b�111 { `y � -- :/ exp.: � •� ���jur��I/S��t ✓ � I� �s }h ' � ',y�e may` _V,LLC.3400 DEEP HOLE DRIO N.A.TITUCK a Y I to s: Lid - w n 5 r a v i f •�, �-r� "�, -amu 4��a•' n ��a,�,��il ,. '��! .�r+. /r 3Y _•e+`s9y'i.J t_�f��:�-,f� �'����h���1s' t��� 1 • ,' lii�' � w � Figure S. Looking east over location of proposed fixed"V-shaped dock and at existing fixed"T"-shaped dock located to the east across Deep Hole Creek. - s • e`er-J'�' ��fs 'R;-. 'I , � ,'�r4'� - I •Y��'!t'1 � .�f�A iia. . ...- i,.b ,`;,,:�'".�` ��'0...ip�, safy--'.• �i=".t. - a}�..-�cs5� ;�- s� ` . '---..ate f.•r �-. �_ . . P � -. _. � -k... ' r Figure 6. Looking west from Deep Hole Creek in location of proposed fixed "V-shaped dock toward subject dwelling and remains of previously existing dock structure. e .0m) _ Ja o SEE SEC.xo.w .mw ruTCN -7--_—_ _ — -- --_ -- —43�— wlol la \RONM\s°Eorstenr>• GR 'PORT _ my EE 6 Bz tsalcl a - ,+Y N 1 ,I 115AIc) 2t.aVc) 2a ,1 11 RFK � "' O O Se Yeo_ 2.4 2 3 •� 3 'an(,:I Hess-wrHfsovrwn op R 25 a1� a 1B • \t © 1 5 t 239ryc) I e t e $ q �YOtK ^ a • � � ' f le .` e N 10 +"' � ^' ♦ " M O 3 tb]Alc) 3 - -•1 QQ J O O 3 to a 13 i 'C p tp LgA(q G ® za 3 •. tOxxa sM„°`° ♦ m to a _ "n sti. 25 — z+ 5 - \/"°epl6flx^ 13 311 26 --- MART MolcA ' us §s +e � Baegc) ^ SUFFOLK x+a � ,t�'^ ^nzr ^ a 33.5 ea a - /eA a' 28A 1AAlc1 31 \0 N a m za 22.7A1c1 lalY•dci 92 .xnl 1 2 t Za i 75 1 15^ ^ M" z\ +Y'1� O� \, ) a• a-Pv 1t IB u{ � • Sal a= "a 9 > 3a^ 25 JI � ^ So.1 31 t n ze a iwAv OF a� r 1TAIc) SUFFOLK n� 1I " �` ^ ^ N w •,i° $ ai^ i4o 1 15.1A1,) d O1.]10 p aamnn a SOYyc) 1 " 1aILc 2 11AI / - 10 l a 3Ma'° t ^ M 2+ • a xr 1\ 2T " N 9 p •" 82 11 9 1° 1 2 1 ~ ° i r t3 ° N a+° a ^•r 11 10 M -B? r ^ a OH 13Nc1 1 x SEE SEC.NO. a 3 11 t1 1\ { a ^ t a^ ^ate ♦? m _e2fa1 ,1 ^ $ ,`^ •^m a - x +t ^t\y a j I za Ic tn1 i •�- tt1 \y\ ^' 13 ^ ^ \\ A b10 1.3ALc1 * \B + OZ �F r 1a 15 18 H to e.18,7A-4.)It Oar hs wr � .y P 4R M1 � 12 M't\Z � M ION PARSEE SEC.NO. 13 CEL NO. M1A1 'P dL. MI T m 'S 1 ♦ $ - F /OR PCL.NO. i 11 n FOR PCL NO. ,6 n SEE SEG NO. tnOt-0021 2\uc) SEE SEC.NO. 5 8 a � tzzasooa B e �i 1z3osme ,d �y 1 ----- ----- LINE m SEF 58c.xO.ta S —z- y YATCH •♦ I 1 , �P ----- — 11NE - lea * MATCH SEE SEG NO.123 b +a 1s 1a 13 12 �1K1 f�2y HO E K 101 to + ®fes sotmooLp SECTNJN NO L m.�. ua _x-- NOTICE Service OF SUFFOLK © E ��� _�_ ,.tea a O �_� --�— ��--rt-- - Real Property Tax SeceAgenCy E (21) v He .xLA�oY 115 0"uMY Gntn RHHx,re,xYttigl AI t tt E P^o u. e.ru. --c-- oru.--♦-- ` A wrtwn No IND PROPERTY AMP t12 tt! tia U .,e,., a w. tztAxt�+zu _____ mx+smiw>EAgm aN zt A1c1 -- -- OFFICE LOCATION: �0�*0f SU(/�yOlO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) • COQ Telephone: 631765-1938 Southold,NY 11971 ® Fax: 631 765-3136 W4UfVTY,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To:' Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator Date: October 16, 2018 Re: Local Waterfront Coastal Consistency Review for FHV, LLC; c/o GARY SALICE SCTM# 1000-115-17-11 En-Consultants on behalf of FHV, LLC; c/o GARY SALICE requests a Wetland Permit to construct a fixed timber"T" shaped dock (elevated 4' above grade of marsh and constructed with open-grate decking),-consisting of 4'x5' steps at landward end; a 4'x39' catwalk; and a. 4'x10' fixed seaward platform. Located: 3400 Deep Hole Drive, Mattituck. SCTM# 1000-115- 17-11 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 the dock standards are met to further Policies 6 and 9. Note that the creek is very narrow and shallow in this location. This recommendation was made in consideration of a previously issued permit for a similar dock structure in the same location. 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 r og+�FFQxk Peter Young,Chairmanti 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 Mon., October 15, 2018 the following recommendation was made: Moved by Peter Meeker, seconded by John Stein, it was RESOLVED to SUPPORT the application of FHV, LLC to construct a fixed timber 'T" shaped dock consisting of 4'X 5' steps; a 4'X 39' catwalk; and a 4'X 10' seaward platform. Located: 3400 Deep Hole Drive, Mattituck. SCTM#115-17-11 Inspected by: John Stein, Peter Meeker The CAC Supports the application with the Condition the docking facility does not exceed 1/3 across the width of the creek. Vote of Council: Ayes: All Motion Carried J l , Cantrell, Elizabeth From: Robert Herrmann <rherrmann@enconsultants.com> Sent: Monday, October 15, 2018 3:28 PM To: Hagan, Damon Cc: Cantrell, Elizabeth; DiSalvo, Diane Subject: FHV, LLC, 3400 Deep Hole Drive, Mattituck Attachments: 3400 DHD deed.pdf Damon, as we discussed earlier today,title to this property was transferred on Friday from FHV, LLC,to new owners, Frank and Mindy Martorana. Therefore,we would like to make note for the public record on Wednesday that the name of the applicant should be modified accordingly. As evidence of the property sale, I am attaching herewith an unrecorded copy of the deed. I also expect to be able to forward to Liz and Diane (copied here) all of the Trustees' application authorization forms signed by the new owners prior to Wednesday's hearing. Thanks for your guidance and for your offer to discuss with the Trustees this evening. Best, Rob Robert E.Herrmann,MEM Coastal Management Specialist En-Consultants 1319 North Sea Road Southampton,NY 11968 Phone: 631-283-6360 Fax:631-283-6136 Email:rherrmann@enconsultants.com www.enconsultants.com 1 r - _ TO WHOM IT MAY CONCERN: r%%ilI aaaihoriz6 Et1- at�uLCai1ts to arc y proFty for tl� purpose�E nis temic alr�ati�e�an€1�'�P al lln t�rr�ey 4V atlands andother envi onmcntal l+waur"imntB making L a i�t1 tairi � � � behalf a .+ r c�acting 23"'Y�t � ,C r thy: Maa sof : - '4 r+ l�ttaa a1 I�r �als and mlated' UM- _ u41'r d Print Name D131ed - j _....�.�..� I?,11?N;nLFi U4,RU3Ch EN-CONSULTANTS G"IEIV D October 29, 2018 NOV M 2 201 Southold town Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold,New York 11971 Attn.: Elizabeth Cantrell Re: Bryan Martorana 3400 Deep Hole Drive,Mattituck SCTM#1000-115-17-11 Dear Ms. Cantrell: Enclosed are the original Board of Trustees Application Authorizations and Disclosure Forms for Bryan Martorana. Should any additional information be required,please contact our office. Sincerely, Kim ephe s Enc. 1319 North Sea Road Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com environmental consulting 3 � Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) - 9 I/We, (N owners of the property identified as SCTM# 1000- 1�' 1`l `� .in the town of .,New York,hereby authorizes, d -_..__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: Pro w 's Signature Property Owner's Signature SWORN TO BEFORE ME THIS -- �(�, - DAY OF QC ;20�� �)NoQy ublic JACQUELYN STEWART ECEJVE Notary Public,State of New York,Suffolk County No.01 ST4673379 ( Commission Expires July 31,gyp NOV " 2 201$ Southold sown Board of Tiustees Board of Trustees Application County of Suffolk State of New York .3 r\1��, -BEING DULY SWORN DEPOSES AND A FIRMS THAT HE/SHE IS,THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature - - SWORN TO BEFORE ME THIS :DAY OF N PIUNis i - i, dAC®UELYN STEWART, ypary Public,State of New York,Suffolk County No.01 ST4673379 commission Expires July 31, IF DD NOV - 2 2018 Southold Town Board of Trus mos APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM and emnloveet:-11'enumoseof this'MrMJ9h V6vi&infh6ii&i6n4Wh- e: can Wift ih�own lbl YOUR NAME an -(Last name, first-name,middle initial,unless you are-ijolyifigiiiike-7name 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 594 o shares. YES NO _ - 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. 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); Q an officer,director,partner,or employee of the applicant;or `D)the actual applicant. NOV 2 2018 DESCRIPTION OFRELATIONSHIP es Submitted tkS' V b-zr 2041 gU('\jvLA 'fvl&f-to MI Form TS 1 X Print Name, Board of Trustees ;6Iicatton AUT,lj[ RIZATI ► "cre the applicant is coot the caw tisr) - �/-_- - .� m the���� ' MC of the pMpy identified as SUM100o,115 � � - i �%;47V Ncw Yom hcrcbv, auftfizO- W,rct as Tny agent and Zi to all tk ctnr�o9+a ed a,the,applicad'osn prcr s fix ,MAS) the South,614 Tom ncc , Bow-d of Truz(o cs for this prop FO 0 - � � .lot JACQUELYN STEWART Notary Public,State of New York,Suffolk County No.01 ST4673379 CM missiocn Expires July 31, ?j?V B.=d of T *sx "CaLtion county ofSuff6lk S(atr,ofNcwYcTkL , 14ING DLqy SWORN HEABOVE EASES A►ND FIRMS T I I - IS 1 �PLr9 } t 'I'F� � ARE : ��► IT(s) AND THAT ALL S"I`,�i rEME 'S C0t4 `- ,gESC,Tonm BEST OF T��'i�9NVLM)GsE AND BELM ,4ND THAT ALL LL WORK TRLTAND AS MAY W�'IL L RE DONE fi14E N "NER SES "RTI I IN"SIS APPLICATION T APPLICANT BE ' �' By M-sb . HOLD 'OWN I�o,�,_E � rRUSIME S.AGR EE TOWN TRUSTEES E a T 1kI X�I 'I E 114 +1 =7JI IMS RISING HAR I.8 AND FRET-FROM ANY AND ALL T i)]F,R oR.Ry V IR BOF S�►ID PE T ' C 'C OR S AppLICATIO ,I HF. RY A4 f I ?1 E T 'THE. REPRESENT .TIS SN TO EATER ONS PROPERTY INSPECT PREMISES,ZIN C NJUN ON WITH IS�P�'�XC,�"�`I�}�: S � SWORN TO B { F OREll 0 Wric JACQUELYN STEWART Notary Public,State of New York,Suffolk County No.01 ST4673379 commission Expires July 31. )Da-0 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Oka iloficem and keingloy-ees.' ;pqMosed" .this•fo�pl„'is`to nrrivide infomiation'wliioli'_oan_alert thetowri of possible conflicts of interest and atlow'it to'1a1cewhateder action"is' YOURNAME- (Ast name,first-name,middle initial,tin-less-you are applying indie 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%oftheshares. 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): the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); 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 Submitte d -2 -SU rnt� Prin ane, Form TS I Board of Trueteeo Application i AUTHORIZATION (Where the applicant is not the owner) s Me,-12) r n(x 4 owners of the property identified as SCTM#1000. 1 ���� in the town of New York,hereby authorizes ----- to�`'�`tA to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board'ofTrustees for this property. E Pr, w 's Signature Property Owner's Signature i SWORN TO BEFORE ME THIS�f --,DAY OF C , _ ,20_ C `No' y Public JACQUELYN STEWART Notary Public,State of New York,Suffolk County No.01 ST4673379 Commission Expires July 31,Zp�� t -Board of Trustees Application County of Suffolk State of New York 3 a(A cxr�v rfAn ck BEING DULY SWORN DEPOSES AND AFFIRMS THAT HEISHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS)HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD-THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF'GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TOENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. f Signature t r SWORN TO BEFORE ME THIS, DAY OF i I N is JACQUELVttf STEWART $dotary Public,State of New � York,Suffom Cojnly No.Oi ST4673379 tamissfon Expires July 31, } AP'PLICANT/AGENTIREIPR ESENTA TIVE TRANSACTIONAL DISCLOSURE FORM The IQ=of 5 ' of Ibis r6rmvi w ' w—it io tnke whatever glign IS neck to avoid same. �,f� YOUR NAME ,r la{} 1`�+!`�kt rano, F (Last name,firs;name,middle initial,unless you are applying in the name of someone else motherr entity,such ass 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 front plat or official map Planning Other (If"Otter",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%o a shares. t YES NO Ifyou answered"YES",complete the balance ofthis form and date and sign where indicated. ((( Name of person employed by the Town of Southold 4i Title or position of that person Describe the relationship between yourself(the applicant/agentfrepresentative)and the town officer or employee.Either check the appropriate line Al through 0)andlor describe in the space provided. 1 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. t DESCRIPTION OF.RELATIONSHIP f Submitted t } b_r 204 Signature Print NameC--,,/ . �1-10 P'1(A Form TS 1 Standard N Y B T U Form F argain and Sale Deed,with Covenant against Grantor's Acts Form 3290 —UnifrmoAcknowledgment CONSULT YOUR LAWYER 13EFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE,made the 12th day of October,2018 BETWEEN FHV, LLC,a New York limited liability company with offices at 2315 Pine Tree Road, P.O. Box 1295, Cutchogue, New York 11935, party of the first part;and FRANK MARTORANA AND MINDY MARTORANA,husband and wife, residing at 172 Baylawn Avenue, Copiague, New York 11726, as to an undivided 95%interest, and BRYAN MARTORANA, residing at 172 Baylawn Avenue, Copiague, New York 11726, as to an undivided 5%interest, as tenants In common, Party of the second part, WITNESSETH,that the party of the first part,in consideration of Ten and 00/100--($10.00)--Dollars,and other good and valuable consideration paid by the party of the second part,does hereby grant and release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever, All that certain plot, piece or parcel of land, situate, lying and being at Mattituck, Town of Southold, Suffolk County,New York, bounded and described as follows: BEGINNING at a concrete monument on the easterly side of Deep Hole Drive, said monument being 1475,30 feet southerly from the intersection of New Suffolk Avenue with the easterly line of Deep Hole Drive, RUNNING THENCE from said monument South 79 degrees 00 minutes 00 seconds East along the land now or formerly of Frank and Mindy Martorana and through a concrete monument, a distance of 118.74 feet to a tie line along the ordinary high water mark of a dredged canal; THENCE along a Tie Line along the ordinary high water mark of said dredged canal South 13 degrees 38 minutes 10 seconds West, a,dlstance of 100,11 feet to the land now or formerly of Henry S.Huecker, THENCE along said land North 79 degrees 00 minutes 00 seconds West, to a concrete monument, a distance-of 103.41 feet'to the easterly line of Deep Hole Drive; THENCE along the easterly line of Deep Hole Drive North 04 degrees 52 minutes.50'seconds East, a distance of 100.58'feet;to the aforesaid.concrete monument at the point of BEGINNING. Being and Intended to be the same premises described in a deed made by Bank of America, N.A. and recorded March 20;2018, in Liber 12954,at page 453. TOGETHER with all right,title and interest,if any,of the party of the first part'in and to,any streets and roads abutting the above described premises to the center lines thereof,TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises. TO HAVE AND TO HOLD the premises herein granted'unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever, except as aforesaid. AND the"party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose.The word"party"shall be construed as if it read sense of this indenture so requires. "parties"whenever the IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day ander rst above written IN PRESENCE OF- FHV, LLC B : 11deeditmadorana2018 arses V. Salice, an hg Member E. 'D ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN ivew fork STATE State of Newyork,County of Suffolk,as- State of New York,County of Suffolk,as On the l� day of October,in the year 2018 before me,the undersigned,personally appeared On the day of in the year CHARLES V. SALICE before me,the undersigned,personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be theproved t individual(s)whose name(s)is personally known to me or proved to me on the basis of (are)subscribed to the within instrument and acknowledged to satisfactory evidence to it the individual(s)whose name(s) o me that he/she/they executed the same in his/her/their (are)subscribed it the within instrument and acknowledged to capacity(ies), and that by his/her/their Signature(s) on the me that he/she/they executed the same in his/her/their instr nt,the individual(s),or the person upon behalf of which capacity(ies), and that by his/her/their signature(s) on the e indivi ual(s)acted,exe u e the instrument, instrument,the individual(s),or the person upon behalf of which the individual(s)acted,executed the instrument V . ion ure nd office of individual taking acknowledgment) Notary P lic (signature and office of individual laking acknowledgment) MfCEY.Gll" Notary Public W 011D148 2248 3uwft Cauuny CWJW i Sept 30,2021 TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State(or District of Columbia,Territory,or Foreign Country)of On the day of in the year County of ss ,before me,the undersigned,personally appeared personally known to me or proved to me,on the basis of-satisfactory,,evidence to be the individual(s)whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies),and that by his/her/their signatures)on the instrument,the individual(s),or the person upon behalf of which the individual($)acted, executed the instrument,and that such individual made such appearance before the undersigned in the (msert the City or other pohtical subdivision) n (and insert the Slate or Country or other place the acknowledgment was taken) (signature and office of individual taking acknowledgement) Notary,Public BARGAIN AND SALE DEED WITH COVENANT AGAINST.GRANTOR'SACTS SECTION 115.00 Title No. BLOCK 17.00 FHV,LLC LOT 011:00 TO FRANK MARTORANA AND MINDY DISTRICT 1000 MARTQRANA, husband&Wife,as to an undivided 95%interest and BRYAN MARTORANA,as to an undivided 5%interest STANDARD'FORM OF NEW YORK BOARD OF TITLE,UNDERWRITERS" 1 A W U LL' 0 Z `o K 0 U W 1' W W fn a ,o LL W U 6 a to y x i- w w N W C FOR COUNTY USE ONLY _ 1 INSTRUCTIONS(RP-5217-PDF-INS)-vrvrn orps state ny us l Ct.sWtS Code ) New York,State Department of Taxation and Finance C2,Date Deed Recorded Once of Rea(Property Tax Services C3.Book at C4.Page L , RP-5217-PDF PROPERTY INFORMATION —• Real Property Transfer Report(8110) 1.Property 3400 Location 'EiREET N,JMRER Deep Hole Drive Southold -STREET NAME •nrYoa Toni MattituCK 2.Buyer Martorana °16'cE 11952 Name Frank 'zIP caaE UST NAME'COMPMrY Marto Tana FIRST NAME USi NPMFlCOMPANy Mindy S Tax Martorana FIRET NgME Billing Indicate where future Tax Bilis are to be sent Bryan Address if other than buyer address(al bottom of form) lASTN^ME/CouPaNY FRST NgrAE - aTgEET tNA1eER hrya NAME CRy OR TONfI 4.1ndfeate the n umber of Assessment sT^TE z°covc Rog parcels transferred on the dead 1 b of Parcels OR D Pan d a Parcei (Only If Part of a Parcel)Chock as they apply. S.Deed 4A,Planning Board with Sub(Iwisian Authority Exists Property •FRornF— FEET —X OR 0.33 Size 'DEPTH 'ACRES 48,Subdivision Approval was Required for Transfer 4C.Parcei Approved for Subdivision with Map Provided ❑ FHV, LLC 6.Seller El Name IAST NgMrICOMPpryY FiRsi NAME UST NAhtE/Cah!PNJY 7.Select the description which most accurately describes the FwsT NAME use of the property at the time of sale. Check the boxes below as h Ownthe apply; . ersl Y 71 One Family Residential BP Type is Condominium 9.New Construction on a Vacant Land I tOA.Properly Located wthin an Agricultural District 0 10B.Buyor received a disclosure notice Indicating that The property Is In an SALE INFORMATION Agnculturai District 15.Check ono or more of these conditions as applicable to transfer•' 11.Sale Contract Data 09/12/2018 A Sale Between Relatives or Former Relatives B,Sale between Retailed Companies or Partners in Business, 12.Date of saleiTmnsfer 10/12/2018 C•Ono of the Buyers is also a Seller D Buyer or Seger is Government Agency or Lending Institution E Deed Type not Warignty or Bargain and Sale(SpeCify Below) •11.Full Sale Pnco 650,000,00 F Sale of Fractional or Less than Fee lnteres (Full Sale Price is the total amount paid for the o G.Significant Change In Pro e t(spe$t Below} Tills payment may be m the farm of cash,other Properly ioraudln P do Sale Taxable Status and Sale Dates g personal progeny H.Sale of Unusual F is ors Affecting Sale Pace mortgages of other obligations)Please round to the nearest whole doloods or tarassumption of 1.Other Unusual Factors Alfegmg sato Price(Specify Below} amounf J None 14,Indicate the value,of persona(_ Damment(s)on Condibon; Property Included In No safe 00 ASSESSMENT INFORMATION-Data should refft t ti a t_,__.- -•- Lest anal Assessment Rol and Tax B II 16.Year of Assessment Roll from which information taken (YY) 18 •tZTotal Assessed Value '9,900 Property class 210 '20.TaxMa - '19.School District Name 473812 Mattltuck-C Map Identifier(s)IRoll Identinor(s)(ifmoro than four,ahach shoot with additional Identiner(s)) Utchogue 1000-115,00-17,00-011,.000 CERTIFICATION I Certify that all of the items Off. r an tared false statement of material( � othis form argjrue and correct(to the best of my knowledge and button and I understand that R erefn/subject me to tf he dr this arrnai law relative to No making and filing of false instruments, the making of any willful NAS @S E C T C INFORMATION b ` enliylhalrsn°t nrfatlm.oll Me IT ;ronlorfidumarySUen aname nn confect infomlaho Oran-lock CaY r� Ranywho can answerqueseoas regard n8 ua vansrermust pe entered T R e loins-lock comparry•,asrale air SELLER SGNA}URE n RRM1siof. GATE YPa or dnt claady) Martorana Frank ir� le�.c1� usTw.n;E FIRST NgME SIL `l�ti �15ti 8MERsi Na - ,,w�-- - GATE •TEL""—rr-OCk JE.99999991 erREEi NLMEER •STREET NM IE 1 t•r I 1�_•� JL G lT f I i ' BUYER'S E 'STATE 'z.P eooE Ross 1 1 Daniel VC. ( -ST NAME FIRST-- (631) _ 298-1200' AREACODE TELEPHONE NUMECR f&5999999) Schedule C Part--Explanation pf Exemption Claimed m Part 1,Lne 1(check any boxes that apply) (c(continued) — The conveyance of real property is exempt from the real estate transfer tax for the following reason, a.Conveyance is to the United Nations,the United States of America,the state of New York or any of their instrumentalities, agencies or political subdivisions (or any public corporation, including a public corporation created pursuant to agreement or compact with another state or Canada) b..Conveyance is to secure a debt or other obligation ❑ c Conveyance is without additional,consideration to confirm,correct,modify or supplement a prior conveyance d.Conveyance of real property is without consideration and not in connection with a sale,including conveyances conveying realty as bona fide gifts e.Conveyance is given in'connection with a tax sale ❑ f.Conveyance is mere change of identity or form of ownership or organization where there is no change in beneficial ownership, ❑ (This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property comprising the cooperative dwelling or dwellings.) g.Conveyance consists of deed of partition ❑ h Conveyance is given pursuant to the federal bankruptcy act ❑ i Conveyance consists of the execution of a contract to'sell real property without the use or occupancy of such prope ❑ granting of an option to purchase real property without the use or occupancy of such property rty or the J Conveyance or real property which Is subject to restrictions which prohibit the use of the entire property for,any purposes ❑ except agnculture, recreation or conservation, pursuant to Section 1449-ee (2) 'Q) or (k} of Article 31-D of the Tax Law. (See,required Town approval,below} k.Conveyance of real property for open space,parks,or historic preservation purposes to any not-far-profit tax exempt ❑ corporation operated for conservation,environmental,or historic preservation purposes. 1.Other list explanations in space below(Grandfather/Contract) in.Conveyance of real property as a primary residence where the grantee is a first-time'homebuyer (attached approvedapplication)' n.Conveyance of real property to a tax exempt,not-for-profit corporation for the purpose of providing affordable housing. �❑ L f o.The conveyance approved for an exemption from the Community Preservation Transfer7ax,under Section 1449-ee of Article 31-D of the Tax law:(See j in Schedule C) Town Attorney orotber designated afficial Penalties and Interest Penalties Interest Any grantor or grantee failing to file a return or to pay any tax within Daily compounded interest will be charged on the amount-of the the time required shalt be subject to a penalty of 10%of the amount tax due not paid within the time required. of tax due plus an interest penalty of 2%of such amount of -each, month of delay or OaCtion thereof after the expiration of the first month after such return was required to be riled or the'tax became due. However, the interest penalty shall,not exceed 25% in the aggregate. Signature th t The uncle is ne erti the grantor(s) and grantee(s) must mg any certification sign). FHV, Low e ne—returncli t or art limen, is co the best of his/her B Chart Grantor Salice, Managing Me ber a Grante ana Grantor n y G a ee art:oranay �- ryan ar orana )`°5 ncEr0i I y�l ETownships. I� East Hampton p Peco is Bay Region l Riverhead 0 and 0 C® Unity Preservation Fund 111 Southam Shelter I pton 0 Proceeds of this transfer tax are disbursed to the Southold I Townships in which the transaction takes place for its acquisition of land,development rights,and other interests in property for conservation purposes. Please print or type. Schedule A Information Relating to Conveyance Grantor Name(individual,last,tlrst,middle initial) ❑Individual FHV, LLC Social Security Number ❑Corporation Mailing address ❑Partnership P.O.Box 1295 Social Security Number 9 Other Qty state Cutchogue ZIP code Federal employer ident raniee Name(individual;last,first,middle initial) 11935 Individual Frank Martorana,Mind M Socjgl Secuntv Numhor __ Y artorana and Bryan Martorana 0 Corporation Matting address ❑Partnership 172 Ba fawn Avenue 5 cial5ecuriIvNumber Other City State Copiague NY 11726ZIP e ��• _ 11726 Location and d escription of properiyconveyed �_— Tax map designation Dist Address Section I Block Lot village Town 3400 Deep Hole Drive 1000 115.00MI altltuck 17,00 o11,00o' Southold I ' I Type of property conveyed(check applicable box) Date Ofcanveyance �Improved - Dual To'vrns• p Vacant land 10/12/20.18 month dor ysar —•�—"'— —�--��� Condition of conveyance(clWck all Ilrn/apply) a- Conveyance of fee interest b.,Acquisition of a f. -Conveyance whfch consists of a mere controlling interest(state k-Contract assignment Percentage acquired •change of identity or form of ownership or I. -Option assignment or surrender c--Transfer of a controlling Interest(state—%) organization g.-Conveyahce for which credit or tax Le-Leasehold assignment'orsurrender n.- ancet'Percentage transferred y,) ( Leasehold grant d-Conveyance to cooperative housing previously paid will be claimed o. - Conveyance of an easement p. - corporattOn h,-Conveyance of cooperative apartment(s)I. Conveyance for which exemption is e-Conveyance pursuant to or in lieu of ',Syndication claimed(complete Schedule B.Part II) foreclosure or enforcement of security J. -Conveyance of air rights or development rights q•-Conveyance•af property partly within and interest partly without the state Schedule B - Community Preservation Fund r• other(describe) Part I-Computation of Tax Due 1,Enter amount of consideration for the conveyance(front line 1 TP584 Schedule B) 2.-Allowance(see below) 1 650,000.00 3.Taxable consideration(subtract line 2 from tine I) 2 150,000.00 4 2%Community Preservation Fund(of line 3)'make certified check payable to SUFFOLK COUNTt CLERK --- 5.Property not subject to CPF Tax(See Schedule C) 3 500,000.00 4 10,000.0 s El For recording officer's use Amountreceived Date received � Transaction number i Allowance East Hampton $250,000 00 Improved $100,000.00 Vacant Land(Unimproved) Shelter Island $250,000.0oimprove d $1001000.00 Vacant Land(Unimproved) Southampton $250,000.00improved $100,000.00 Vacant Land(Unimproved) Riverhead $150,000.0011"Inproved $`75,000.00VaCant Land(Unimproved) Southold $150,000.00lmproved $75,000.00 Vacant Land(Unimproved) 1£0£:3 C9/Ciel) rage 4 of d TP-584(4113) 1 Schedule 0-Certification of exemption from the payment of estimated personal income tax(lax Law,Article 22, SW=663) Complete the following only if a fee simple interest or a cooperative unit is being transferred by an individual or estate or trust. If the property is being conveyed by a referee pursuant to a foreclosure proceeding,proceed to Part 11,and check the second box under Exemptions for nonresident transferor(s)/sei/er(s)and sign at bottom. Part I-New York State residents If you are a New York State resident transferors)/seller(s)listed in Scnedule A of Form TP-584(or an attachment to Form TP-584),you must sign the certification below.If one or more transferors/sellers of the real property or cooperative unit Is a resident of New York State,each redden:transferor/seller must sign in the space provided.If more space is needed,please photocopy this Schedule 0 and submit as many schedules as necessary to accommodate all resident transferors/sellers. Certification of resident transferor(s)/seiler(s) This is to certify trial at the time of the sal transfer of the real property or cooperative unit,the transferor(s)/seller(s)as signed below was a resident of Neer Stata,and th ore is not required to pay estimated personal income tax under Tax Law,section 663(aj upon the sale or tra rfg of" t fl pe or cooperative 't Signatur /' Print full name Charles V Salice,Managing Member Date n 10 lL at -1`6 Pnnl full name Date Signature, Print full name " Oate , Signature Pant f.ll name Date Note.,A resident of New}brk State may still be required to pay estimated tax under Tax Law,section 685(c),but not as a condition of recording a deed. Part 1I-Nanresidenis of New York State !l you area.nonresident of New York State listed as a transferor/seller in Schedule A of Form TP-584(or an attachment to Farm TP-584) but are not required to pay estimated personal income tax because one of the exemptions below applies under Tax Law,section 663(c), check the box of the appropriate exemption below.If any one of the exemptions below applies to the transnder(T/s Law,ssecti'that transferor(s)/selier(s)is not required to pay estimated personal income tax'to New York State under Tax Law,section 663.Each nonresident transferor/seller who qualifies under one of the exemptions below must sign in the space provided.Til more space is needed ch nonresident photocopy this Schedule D and submit as many schedules as necessary to accommodate all nonresident transferors/sellers. If none of-these exemption statements apply,you must complete Form IT-2663,Nonresident Real Property Estfmated'lncdale Tax Payment Form,.or Form IT-2664,Nonresident Cooperative Unit Estimated Income Tax Payment Form For more Information,see Payment of estimated personal income tax,on page 1 of Form TP-584=I: Exemption for nonresident transferors)/seller(., This is to certify'that at the time of the sale or transfer of the real property or cooperative unit,the transferors)/sefler(s)(grantor)of this real Property Or cooperative unit was a nonresident of New York State,but is not re uired,to a estimated ersonal ircome,tax under Tax L section 663 due to one of the following-exemptions' q pay p aw; The real property or cooperative unit being sold or transferred qualifies in total as the transferor's/seller's principal residence (within the meaning of Internal Revenue Code,section 121)from Date to-- Date no additional consideration, gagee (see lnstruchons), The transferor/seller is a mortgagor conveying the mortgaged property to a mo in foreclosure,or in lieu of foreclosure with ❑The transferor or transferee is an agency or authority of the United States of America,an•agency or authority of the state of New,Ycrk,this Federal National Mortgage Association,the Federal Home Loan,Mortgage Corporation,the Government National Mortgage Association,or a private mortgage insurance company. Signature ' Print full nam_e DaiP Signature _ Print full name nate - Signature Print full name Date Signature Pnrl full name Ozte - Page 3 of 4 TP-584(4113) Schedule C—Credit Line Mortgage Certificate(Tax Law,Article 11) Complete the following only if the interest being transferred is a fee simple interest. I(we)certify trial:(check the appropriate box) 1.OXXJ The real property being sold or transferred is not subject to an outstanding credit line mortgage 2. ❑ The real property being sold or transferred is subject to an outstanding credit line mortgage.However,an exemption from the tax is claimed for the following reason ❑The transfer of real property is a transfer of a fee simple interest to a!person or persons wno held a fee simple interest in-the real property(whether as a joint tenant,a tenant in common or otherwise)immediately before the transfer, ❑The transfer of real property is(A)to a person or persons related by blood,marriage or adoption to the original obligor or to one or more of the original obligors or(B)to a person or entity where 50%or more of the beneficial interest in such real Property after the transfer is held by the transferor or such related person or persons(as in the case of a transfer to a trustee for the benefit of a minor or the transfer to a trust for the benefit of the transferor). II I The transfer of real property is a transfer to a trustee in bankruptcy,a receiver,assignee,or other officer of a court. ❑The maximum principal amount secured by the credit line mortgage is$3,000,000 or more,and the real property being sold or transferred is not principally improved nor will it be improved by a one-to six-family owner-occupied residence or dwelling. Please note:for purposes of determining-whether the maximum principal_amount secured is$3,000,000 or more as described above,,the amounts secured by two or more credit line mortgages may be aggregated under certain circumstances.See TSB-M-96(6)-R for more information regarding these aggregation requirements. ❑Other(attach detailed explanation). 3 ❑ The real property,being transferred is presently subject to an outstanding credit line mortgage However,no,tax is due for the reason: following ❑A certificate of discharge of the credit line mortgage is being offered at the time of recording the deed.. ❑A check has been-drawn payable for transmission to the credit line mortgagee or his agent for the balance due,and a satisfaction of'such mortgage will be recorded as soon as it is available. 4 ❑ The real property being transferred is subject to an outstanding credit fine mortgage recorded in (insert liber and page or reel or other identification of the mortgage).The maximum principal amount of debt or obligation secured by the mortgage is .No exemption from tax is claimed and the tax-of is being paid herewith.(Make check payable to county clerk where deed will be recorded or,if the recording is to take place in New.York City but not in Richmond County,make check payable to the•NYC Department of Finance,) Signature(both the grantor(s)and grantee(s)must sign) The undersigned certify that t e above infar 8tion contained to schedules A,B, attachment,is to the b i ren knoewl ge,true and complete,and a it ize the Pers I n subm reing such certification,ion their behalf to receive a copy for recordI h eed or other instrument of ing the convey FHV, LLC By,, ing Memb e r es Grantor signature Sa ice Tale Gran ee sigq r ar O na77-`--- t� ar orana ( ' Grantor signature Tit--1e---__ t1�dl r t�., B an antee signature Mar orana Tie -hY Reminder:Did you complete>a!I of the required information in Schedules A,B,and C?Are you required to complete Schedule D?if you checked e,'f,or g in Schedule A,did you complete Form TP-584:1?Have you attactled your check(s)made Payable-to the county clerk where recording will take place or,if the recording is in the New York City boroughs of Manhattan,Bronx,Brooklyn,or Queens,to the NYC Department of Finance?If no recording is required,sena your check(s),made payable to t directly to the NYS Tax Department,REIT Return he Department of Tazation and Finance, Processing,PO Box 5045,Albany-NY 12205-5045 TP-684(4113) t 3 State Department of T"iron and Finance combined Real Estate rfecordfng office time stamp �— Transfer Tax Return, Credit Line Mortgage Certificate, and Certification of Exemption from the Payment of Estimated Personal Income Tax See Form TP-584-1,Instructions for Form TP-584,before completing this form Print or type Schedule A—lnforrnation relating to conveyance Grantor/Transferor Name(rtmd,vidual,last,6:stmrodlemrtraVE]cneckrtmorethanonegrantor) ❑Individual FHV,LLC I Social security number ❑Corporation Madmg address ❑Partnership P.O.Box 1295 Social security number ❑Estate/Trust City State EDNY' Single member LLC Cutchogue ZIP code Federal EIN 0 Other Single member s name if grantor is a single member LLC iwe mstruchons) 11935 Single member EIN or SSN Grantee/Transferee Name(rind wdual last lir,middle rmfia�(❑check amore Than one grantee) ❑x Individual Frank Martorana,Mtnd y Martorana&Bryan Martoiana Iia ❑Corporation 11 Mailing address ❑Partnership 172 Baylawn Ave. o is secu ity number ❑Estate/Trust City --`' State ZIP code ❑Single member LLC Copiague NY =uerarcnv—'—' ❑Other Single member's name if grantee u a single member LLC(see,nstructrors 11726 Single member EIN cr SSN Location and description of property conveyed Tax m (incluap designaddress ation'- SWIS code Street addr Sectideodashes)n,block&lot (six'digits) City,town,or village County dots and ----T 115.00-17.00-011.000 3400 Deep Hole Drive 473889 Mattituck Suffolk Type of property conveyed(check applicable box) 1 O One-to three-family house 5 ❑CommerciaOndustrial Date of conveyance 2 Residential cooperative 6 ❑Apartment building y Percentage of real.property 3 ❑Residential condominium 7 ❑Office building 10 12 2018 conveyed which 188asidential 4 Vacant yeas land 8 ❑Other— — maem day real property U0 (see instructions) Condition of conveyance(check all that apply) f„E)Conveyance which consists of a' a., Conveyance of fee interest mere change of identity or'form of I'❑Option,assignment or surrender ownership or organization(attach b.❑Acquisition of a controlling interest(state Farm TP-584 7,Schedule r7 m❑Leasehold assigns ent or surrender Percentage acquired %) g.0 Conveyance for-which credit for tax n.❑Leasehold grant previously paid will be claimed(attach C. ❑Transfer of a controlling interest(state Form TP-584.r,Schedule G) percentage transferred %) In.❑Conveyance of cooperative apartments)” o D Conveyance of an easement d.Cl Conveyance to cooperative housingP.❑Conveyance for which exemption corporation i.❑Syndication, from transfer tax claimed(complete Schedule B,Part 111) e. ❑Conveyance pursuant to or in lieu of J.❑Conveyance of air fights or, q.❑Conveyance of property partly within developmentg and partly outside the state foreclosure or enforcement of security. k.❑Contract`assignment interest(attach Form TP-5841,Schedule E) G t]Conveyance pursuant to divorce of separation For recording officer's use Amount receivedDate received S•El Other(describe) Transaction number Schedule F3.Part I $" Schedule B,Part it s il— Town Hall Annex Michael J. Domino,President � John M.Bredemeyer III,Vice-President �� �4 54375 Route 25 P.O. Box 11 Glenn Goldsmith S Southold, New York 11971 A.Nicholas Krupski O Telephone(631) 765-1892 Gre Williams ® Fax,(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only �Wetland CoastalErosion Permit Application Permit Application Administrative Permit Amendment/Transfer/Exten ion Received Application: Wt 31119 Received Fee: $ ZSIA 00 Completed Application: •1N Incomplete: SEQRA Classification: Type I Type II Unlisted V/ Negative Dec. Positive Dec. Lead Agency Determination Date: �Coordination:(date sent): q• +Fr, rE, C, E E LWRP Consistency Asses�nnent Form Sent: �`- `9 fib• ;; >> CAC Referral Sent: Date of Inspection: D l0 �'j AUG 3 1 2018 Receipt of CAC Report: Technical Review: t--- __/_ g Public Hearin Held: 1 �— Southold Towin Resolution: Board of Trustees I Name of Applicant FHV,LLC c/o Gary Salice Address P.O.Box 1295, Cutchogue,NY 11935 Phone Number: 323 333-3404 Suffolk County Tax Map Number: 1000 - 115-17-11 Property Location: 3400 Deep Hole Drive,Mattituck 4 (property is located on east side of Deep Hole Drive,+/-1,475'south of New Suffolk Avenue) (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road, Southampton,NY 11968 Phone:631-283-6360 5ef+`r IV Board of Trustees Ap :�atiorn GENERAL DATA Land Area(in square feet): 11,108 Area Zoning: R-40 Previous use of property: Residential,one-family dwelling Intended use of property: Same,with fixed dock Covenants and Restrictions: Yes No If"Yes", please provide copy. Will this project require a Building Permit as per Town Code? Yes X No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by Building Dept. Yes X No Does the structure(s) on property have a valid Certificate of Occupancy Yes No Prior permits/approvals for site improvements: Agency Date Southold Trustees Wetlands Permit#9279 July 18,2018 Southold Trustees Wetlands Permit#1741 October 27, 1988 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description(use attachments if necessary): Construct a fixed timber"T"-shaped dock(elevated 4'above grade of marsh and constructed with open-grate decking),consisting of 4'x 5'steps;a 4'x 39'catwalk;and a 4'x 10'seaward platform,all as depicted on the project plan prepared by En-Consultants,dated August 20,2018. Board of Trustees Applic ion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To provide single point of safe,elevated structural access to water over vegetated marsh;private dockage of small noncommercial watercraft. Area of wetlands on lot: +/-890 square feet Percent coverage of lot: +/-8 Closest distance between nearest existing structure and upland edge of wetlands: +/-45 feet deck Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet dock Does the project involve excavation or filling? X N o Yes If yes, how much material will be excavated? N/A cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A 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): See attached addendum. WETLANDS ADDENDUM FOR FHV,LLC 3400 DEEP HOLE DRIVE MATTITUCK,NY SCTM#1000-115-17-11 Statement of Effect The proposed dock is intended to provide a fixed point of safe,elevated structural access over the existing vegetated marsh to allow for access to the water and private dockage of small watercraft in Deep Hole Creek. The property was historically improved with a fixed dock structure in the same location as the proposed dock,which was permitted by the Board of Trustees pursuant to Permit No. 1741 in 1983,but readily available aerial photography indicates that the prior structure has not been present in more than 10 years. However,similarly configured fixed "T"-shaped docks have more recently been permitted by the Board on the surrounding properties,including the adjoining northerly property(Permit No.7718,issued in 2012)and the property located to the southeast across Deep Hole Creek(Permit No. 7671,issued in 2011). The subject dock would thus be constructed amongst these surrounding docks,consistent both with their specifically approved configurations and the general"construction and operation standards"for docks set forth by Section 275-11(C)(2). Specifically,the structure would extend 8 feet seaward of mean lower low water,approximately half of the allowable one-third extension into the approximately 47'wide waterway at MLLW;and would be situated more than 15 feet from the side property lines. To minimize and mitigate any potential impact of the project on the adjacent vegetated tidal marsh and surface water quality,the proposed catwalk has been designed with the minimal scope necessary;and would be elevated a minimum of 4 feet above the grade of marsh and constructed with open-grate decking. Therefore,the dock would have no adverse impact on navigation or other public and recreational use of Deep Hole Creek;would not cause a"fragmentation of ecological communities;" and would not result in the physical loss,degradation,or functional loss of ecological components or otherwise significantly adversely impact the adjacent vegetated tidal wetlands or surface waters of Deep Hole Creek. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I-Project Information.The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available.If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: FHV,LLC Dock Project Location(describe, and attach a location map): 3400 Deep Hole Drive,Mattituck,Town of Southold, Suffolk County,NY,SCTM#1000-115-17-11;property located on east side of Deep Hole Drive,+/-1,475 south of New Suffolk Avenue,location map provided. Brief Description of Proposed Action: Construct a fixed timber"T"-shaped dock(elevated 4'above grade of marsh and constructed with open-grate decking), consisting of 4'x 5'steps;a 4'x 39'catwalk;and a 4'x 10'seaward platform,all as depicted on the project plan prepared by En-Consultants,dated August 20,2018. Name of Applicant or Sponsor: Telephone: FHV,LL( 323-333-3404 c/o Gary Salice E-Mail. gam,@nfay.com Address: P.O.Box 1295 City/PO: State. Zip Code: Cutchogue NY 11935 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. X 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: NYS DEC,USA COE,NYS DOS X 3.a.Total acreage of the site of the proposed action? 11,108 sf -- b Total acreage to be physically disturbed? < 1,000 sf c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 11,108 sf 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural (non-agriculture) ❑Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®Aquatic ❑ Other(specify): ❑ Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 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.Deep Hole Creek,Pecomc Bay&Environs,Reason.Significant coastal fish&wildlife habitat; Protect public health,water,vegetation&sceme beauty,Agency Southold Town;Suffolk County,Date:3-9-90,7-12-88 X 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9. Does the proposed action meet or exceed the state energy code requirements9 NO YES If the proposed action will exceed requirements,describe design features and technologies: N/A 10.Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: N/A 11. Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: N/A 12.a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X b. Is the proposed action located in an archeological sensitive area? X 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? X 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: Approximately— 100 100 sf of proposed dock will encroach over Deep Hole Creek below NMW. 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply. ® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ® 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? X 16.Is the project site located in the 100 year flood plain? NO YES X 17.Will the proposed action create storm water discharge,either from point or non-point sources9 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❑YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g. retention pond,waste lagoon,dam)? If Yes,explain purpose and size: X 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: X 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: X I AFFIRM THAT THE INFO ATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Rob Hann, Coastal Management Specialist Date: August 23,2018 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 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 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 regulations9 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(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 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? 11.Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance.The Lead Agency is responsible for the completion of Part 3.For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part I 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 impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 P /• .s' c� hyo �-`..' 6gvi O I O ia4 '� °Ol0 PPF• P s s0000 OREGON qo °OC m ° Nps Bidwell p $y neyards stelaodi dsorgh Vl & ery m . 0000�eN Sherwood House Y S opo a� Vineyards ons rea s EAST ,ATTITUCK =.4 N�oLE ly CUT H UE G v vL .,AYs,. CgUlt eo ��.n N Ca �a z 48 P TRK s � V a o 25 0�� Galluclo Family i o0 � VVnery pv \ SMpp�E Pellegrini PFS Vineyards o � O a\rd THE Pic ��A APs Ofl Oq Gp o�S Op` -� G%\ o < P !y s m 99 P� � � ro yL 9 P �SQQ z CLUB Ofl r5 aPo 8A �Q `O �Ya g i ya e�o� P Matotuck HS `n 3 o AIALEA no moi z �L Po s °tO yqt�, Tan4 0o useu ® 15S F " �E0 02 a y� F 3 z•- }' l0llrl �a s Ny jON $ta �! i:3: NE �,t,,• = .,:P9� <UPTO F° mPS�s F9p Oq`�,� /'mow.,° Po NOP P� Cem• � � ., oo H POINT o V 9 0 � t _/ - "_/ �,,.� eco . 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S ` t I Board of Trustees Appli.aetion r S y ALUTHORIZA.TIO (Where the applicant is not the owner) F; 4 �r .cam -I/We, —Cftftb- flee,Member„FHV,LLC r owners of the property identified`as SGTM#1000- 115-17-11 in the town.of k Mattituck a New York hereby authorizes En-Consultants to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Tows ' Board of Trustees for this property. j j y 1 NZA Pro Owner's Signature Property Owner's Signature ;{ ChAesAallee,Member FW LLC / , SWORN TO BEFORE ME THIS q- D Y"OF Y-CYK otary Public =PUBLIC. -SCHWAMBORN STATE OF NEW YORK o.OiGA6274028 Suffolk Countypires Dec.24,ARL t - Board of Trustees Application, I ' County of Suffolk j State of New York . cb�res-sure,Vember,FfiV pec BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT`FOO THE,ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE,AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY 4 BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR.BY VIRTUE OF SAID PERMIT(S),IF GRANTED- IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIRAGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THI PLIC ON. gignature,chsrb7S"M,,Member FliV,nLLG ,7/ri' l. 6R ry SWORN TO BEFORE ME THIS q. �DAY OF _f Q(CK—____ ,20 E t a No u lie E GATZ-SCHWA�MBORN UBLIC.STATE OF NEW YORK ration No.OIGA6274028 lified in Suffolk County sion Expires Dec.24,20� P t ,o APPLICANT/AGE NUREPRESENTA I TRANSACTIONAL DISCLOSURE FORM i The,Down of ou ftoCd' de of Athfcy ill"s Famefinterrost on tho garrottow%officers and ertn c+ cem The a o—Sw. thisr fnrmls to provide`n# at` 000 alert hefownof ossffifeconflictsoifnte, tandatto info. esufi reveraet'o is y necessary to avoid same,. -eKaftfs Salice,Member YOURNAME: FHV LLC (Last name,first name,middle initial,unless you are applying im the name of someone efs&orotherentity,such as acompany.Ifsa,indicatethe other s person-'&orcompany's name.) f NAME OF APPLICATION: (Check all.that apply.) Tax grievance Building Variance Trustee X Change ofZone Coastal Erosion, 4 Approval ofplat - Mooring Exemption from platoroffiefal map Planning Other (If"Others;name the activity.) Do you personally(or through your company,spouse,siblfng,parent,or child)have arefationship with any officerorempioyee of the Town.of9outhold7 "Relationshfpss includes by blood,marriage,or business interest."Business interest's means a business, including a partnership,in which the town officer or employee has even a partial ownership of(oremploymentby)a corporatioa in which the town officer or employee owns more than 5%ofthe shares. YES NO ✓ 9 tf you answered"YES",complete the balance ofthfs form and date and sign where indicated" r blame ofpersonemployed by the Town ofSouthold Title or position ofthat person Describe the relationship between yourself(the applicantlagentfrepresentative),and the town.ofliceroremployee,Either check w the appropriate line A)through D)and/or describe in the space provided. Y The town officer or employee or his or her spouse,sibling,parent;or child is(check all that:apply): ____A)the owner ofgreater than 5e/a of the shares of the corporate stock of the applicant (when the applicant is a corporatutn)F B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,directors partner,or employee of the applicant;or D)the actual applicant. DESCPJPTION OF RELATIONSHIP Submitted this ! dayQ P gignatura Print Fame es a ice Form TS I FHV LLC APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORINT The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same YOUR NAME: Herrmann YRnharr F (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION. (Check all that apply.) Tax grievance Building __ Variance 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 Southold9 "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 X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi day of August 2018 Signature Print Name Obert E. Herrmarm Form TS I i Michael J.Domino,President4�Q CO ,�l Town Hall Annex John M.Bredemeyer III,Vice-President ���, 54375 Route 25 Glenn Goldsmith cm P.O.Box 1179 A.Nicholas Krupski 1_� Southold,NY 11971 Greg Williams � 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 FHV,LLC; c/o GARY SALICE COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, Robert;,-E.-I Herrmann , residing at/dba En-Consultants 1319 North^Sea Road, Southampton, NY 11%8 being duly sworn, depose.and say: That on the 9th day of October , 2018, I personally posted the property known as 3400 Deep Hole Drive, Mattituck, Town of Southold; SC1M #100o-115-17-11 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 WednesdM October 17 2018. Dated: 4- (signature) worn to before me this (7 da of Q( 20 KIM H . STEPHENS NOTARY PUBLIC Kotar'y Public STATE OF NEW YORK COMMISSION NO 5015931 QUALIFIED IN SUFFOLK COU TY EXPIRES AUGUST 2 , 2f1�� NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: FHV,LLC SCTM#1000-115-17-11 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: 0 Construct a fixed timber"T"-shaped dock(elevated 4'above grade of marsh and constructed with open-grate decking),consisting of 4'x 5'steps;a 4'x 39'catwalk;and a 4'x 10'seaward platform,all as depicted on the project plan prepared by En-Consultants,dated August 20,2018. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 3400 Deep Hole Drive,Mattituck 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: Wednesday, Ccf6ber 17, 2018,@ 5:30 p.m. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. FHV,LLC c/o Gary Salice PROPERTY OWNERS NAME: P.O.Box 1295 MAILING ADDRESS: Cutchogue,NY 11935 PHONE #: 323-333-3404 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road,Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. 0 PROOF OF MAILING OF __NICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 1000-123-3-28 P.O.Box 1179 Town of Southold Southold,NY 11971 1000-115-17-10.1 172 Bay Law Avenue Frank&Mindy Martorana Copiague,NY 11726 1000-115-17-12 P.O.Box 1427 HS Huecker Irrevocable Trust Mattituck,NY 11952 1000-115-16-16 3215 Deep Hole Drive Scott&Kim Czujko Mattituck,NY 11952 STATE OF NEW YORK COUNTY OF SUFFOLK Robert E.Herrmann doing business at En-Consultants 1319 North Sea Road Southampton,NY 11968 , being duly sworn, deposes and says that on the 9th day of October ,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 their 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 Southampton , that said Notices were Mailed to each of said persons by (certified)( *3buvoc� mail. Robert E.He nn Coastal Managment Specialist Sworn to before me this 9th KIM H . STEPHEN S day of October 2018 NOTARY PUBLIC STATE OF NEW YORK COMMISSION NO . 5015931 Nota blic IFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 , 20� J. TM Postal • Postal © ■ ■ N Io / CERTIFIED MAI I Er .D Domestic 11jail Only R-]190 14 1 lYgVK in Er I� . Y t r rl Certlfled Ma l Fee L i• xx e � 1 z3 k' a j Certified Mall Fee liy O $ R � $ Extra Seryices$FeeS(check box,add fee da-ppmpiiate),,,', . I F i �- 'M ExtraSBrv, as&Fees(checkbox,add!eeasappropdat) �� 7� Retum Receipt(hardcopy) $ � M Retum Recelpt(hardcopy) $" ❑Retum Receipt(e'ectrontc) $ Postmark ❑Retum Receipt(electron'.) $ PostQ ❑Certlfled Mail Restdcted Delivery $ t 1/ Hero 0 ❑Certlfled Mafl Restricted Delivery $ /❑Adult Signature Regwred ry$ „�,l! _w �7� ❑Aduit S'gnature RegwredAdult Signature Restncted DeliveIt WT y 1 $ -" o C3 Postage / O ❑Adult Signature Restricted Delivery$ tjl C3 Postage `\ Ir� � total Post TOC - �I ,� 1 $ Town of Southold 958-�5 i ru 119�g' Sent To I I $ Frank&Mindy Martorana 1 C3 P.O.Box 1179 1 rq Sei 172 Bay-lawn Avenue city,sr re' Southold,NY 11971 i- M1 sips' Copiague,NY 11726 -------- I TM P• ■ • — — - i :CERTIFIED, O ■ ■ ■ k p ■ ■ st'ic Mail On ly r%- Ln Donie Ir rq For delivery information,visit our�we6site at wimusps.torh". r3 Certified Mad Fee 1-1 Certified Mail Fee U1 8 rq Extra Services&Fees(check box,add fee as appropaate) ;�./ r-3 $ ❑ Return Receipt(hardcopy) $ '�`• )�, Extra Services&Fees check b pp pnate) ( box,add fee as a ro 0 \' 0 ❑Retum Receipt(hardcopy) $ ❑Retum Receipt(electronic) $ K-�-1�7 Postmark ,\ ❑Retum Receipt(electronic) $� ❑Certified Marl Restricted Delivery $ Here �i Certified Mail Restricted Delivery $ Postmark []Adult Signature Required $ I�r�i _ o ! E3 ❑ $ �Adult Signature Required CY9C3 j []Adult Signature Restricted Delivery$ j` �� ❑gduh Signature Restr.ted Delivery$ , t (O Postage— __ ___-- -- p l i Jl Postage \ ; \ Q y\ \ 4 n Total' HS Huecker Irrevocable Trus at'195b-1 n Total Pos a sent? P.O.Box 1427 $ Scott&Kim Czujko 1 Sent To ! i o Street Mattituck,NY 11952 I C3 ________' 3215 Deep Hole Drive I Sveetan Mattituck, 11952 city s ------ - f SENDER • • COMPLETE ■ Complete items 1,2,and 3. t V ■ Complete Items 1,2,and 3. A. Sig re ■ Print your name and address on the reverse ❑ ■ Print your name and address on the reverse en so that we can return the card to you. ti� gerit�. ■ Attach this card to the back of the mail lece (P ed Name C. Date o ■ Attach this card to the back of the mailpiece, X C.cD od rive e P Received ) A so that we can return the card to < e�e�ue� y r e � �e rY or on the front if space permits. A"� �� or on the front if space permits.- p 'vFp5�i1 1. Article Addressed to: 7 �r D. Is Ner�address different from item 1,) ❑V 1. Article Addressed to: D. Is delivery address different fr it rQ 1? 11Ye r. If YES~¢,b�er delive address below: ❑tvl, If YES,enter delivery address low: o� f�D : IIt�T; :O. �'o:, _�;: ; � �S� � g°` .�;'T�l✓1��of.So;;titoid - _ ' Tviatt:ruck,!,P1' 1 i952 �cn P.O. Box 1179 ® Southold,NY 11971 Ott 3. du t I Wat r 2 El Priority Mail E f 3. Service Type ❑Priority Mad Express@ S� ❑Adu t nature ❑Registered Mail _ . III Mal �' i It Signature Tm ��I a nature Restricted Delivery ❑Registered Ma ❑ uIt Signature Restricted Delivery 9590 9402 4373 8190 1105 46 ertifAAad@ Delivery ❑Registered Mad Restricted l7 Certified Mad Restricted Delivery ❑Return Receipj �a� �`i UC 43 r 3 8 I yU 1 I U�LL Certified Mad@ Delivery _❑_Collect on Delivery Merchandise ❑Certified Mail Restricted Delivery ❑Return Receipt for Delivery Restricted Delivery 11 Signature Conf ❑Collect on Delivery Merchandise 7 017 2400 0 0 0 0 0114 1954 iii 13Signature Conf 2. Article Number(Transfer from servira r�r.en - - )elivery Restricted Delivery ❑Signature ConfirmationTM 1 ❑Signature Confirmation _ w Restricted Delivery Restricted Delii 7 017 2 4 0 0 0 0 0 0 0114 1978 Restricted Delivery Restricted Delivery (over$500) _ (over$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt D • • • ON ON DELIVERY Mai • • ■ Complete items 1,2,and 3. A. Sig ature ■ Complete items 1,2,and 3. 1 A.Nnattpre . 1 ■ Print your name and address on the reverse ■ Print your name and address on the reverse . 11 Agent so that we can return the card to you ( ❑Addressee so that we can return the card to you. ■ Attach this card to the back of the mailpiece, B eived by( inted me) Date o Deli ■ Attach this card to the back of the mailpiece, B eceive Print e) C. or on the front if space permits. tX t f��( or on the front if space permits. /�!� ! 1. Article Addressed to: D. Is delivery address differen om item 19 ❑Yes 1. Article Addressed to: Is delivery ress different from item 1? If YES,enter delivery address below: ❑No - . J If YES er delivery address below: J J Scott&Kim Czujlco Flank&Mind 1 3215 Deep Hole Drive Mindy Martorana J I 172 Baylawn/ VC%le oplaglle, NY P.�attituck 11952 11I 3. Service Type Priority Mail Express@ ? J l - 3. Service Type ❑Adu ignature El Registered MadTM ❑Adult Signature ❑Priority M ❑ It Signature Restricted Delivery ❑Registered Mail Restricted _ It Signature Restricted Delivery ❑Registered erhfied Mad@ Delivery I g ry ❑Registere' 9590 94IJz 4313 til yU l l U5 o3 - ❑Certified Mad Restricted Delivery ❑Return Receipt for I ertified Mad@ Delivery i ❑Collect on Delivery Merchandise Certified Mad Restricted Delivery ❑Retu—r-- — -dlect on Delivery Restricted Delivery 11 Signature ConfirmationT" I _ ❑Collect on Delivery SMarcign 7 017 2 4 0 0 0 0 0 0 ❑114 19 4 7 g _ 7 017 2 4 0 0=-- �r°"•}"n Delivery Restricted Delivery ❑Sign cured Mall ❑Signature Confirmation v 0 0 0 0114 19 61 Rail ❑Sign _ lured Mad Restricted Delivery Restricted Delivery i ------ Aa _ eAad Restricted Delivery Restricted over$500) � Domestic Return Receipt PS Formt38111,July 2015 PSN 7530-02-000-9053 J 4 �� Domestic Return Receipt - ,NUTILt: Ulm HtAKING 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: FHV, LLC; c/o GARY SALICE SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a fixed timber "T" shaped dock, (elevated 4' above grade of marsh and constructed with open-grate decking), consisting of 4'x5' steps at landward end; a 4'x39' catwalk; and a 4'x10' fixed seaward platform . Located : 3400 Deep Hole Drive, Mattituck. SCTM# 1000- - 115-17-11 TIME & DATE OF PUBLIC HEARING : Wednesday, October 17, 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 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 significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 115 - 17 11 PROJECT NAME Fxv,LLC The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 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) El (c) Permit, approval, license, certification: Nature and extent of action: Construct a fixed timber"T"-shaped dock(elevated 4'above grade of marsh and constructed with open-grate decking),consisting of 4'x 5'steps;a 4'x 39'catwalk;and a 4'x 10'seaward platform,all as depicted on the project plan prepared by En-Consultants,dated August 20,2018. Location of action: 3400 Deep Hole Drive,Mattituck Site acreage: 11,108 sf Present land use: Single family residential Present zoning classification:R-40 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: FHV,LLC (b) Mailing address: c/o Gary Salice P.O.Box 1295,Cutchogue,NY 11935 (c) Telephone number: Area Code 323-333-3404 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ® No❑ If yes, which state or federal agency? NYSDEC,USAGE,NYSDOS C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. F]Yes 1:1No ® Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III- 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 ❑ Not Applicable The proposed dock would be located in the same location as a previously existing,Trustee-permitted dock(Permit No. 1741,issued in 1983)and amongst numerous other similarly configured dock structures,including the Trustee-permitted dock structures located on the adjoining northerly property(Permit No.7718,issued in 2012)and the property located to the southeast across Deep Hole Creek(Permit No.7671,issued in 2011). Therefore,consistent with Policy 3,the proposed dock would be in harmony with the visual quality of the surrounding developed shorelines of Deep Hole Creek. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ❑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 ❑ Not Applicable To the extent that it is applicable,the project is consistent with Policy 5 because the dock will be constructed with untreated decking. 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 1 LWRP CONSISTENCY ASSESSMENT FORM ADDENDUM FOR FHV,LLC 3400 DEEP HOLE DRIVE MATTITUCK,NY SCTM#1000-115-17-11 Policy 6 The proposed dock is intended to provide a fixed point of safe,elevated structural access over the existing vegetated marsh to allow for access to the water and private dockage of small watercraft in Deep Hole Creek. The property was historically improved with a fixed dock structure in the same location as the proposed dock,which was permitted by the Board of Trustees pursuant to Permit No. 1741 in 1983,but readily available aerial photography indicates that the prior structure has not been present in more than 10 years. However,similarly configured fixed "T"-shaped docks have more recently been permitted by the Board on the surrounding properties,including the adjoining northerly property(Permit No. 7718,issued in 2012)and the property located to the southeast across Deep Hole Creek(Permit No. 7671,issued in 2011). The subject dock would thus be constructed amongst these surrounding docks,consistent both with their specifically approved configurations and the general"construction and operation standards" for docks set forth by Section 275-11(C)(2). Specifically,the structure would extend 8 feet seaward of mean lower low water,approximately half of the allowable one-third extension into the approximately 47'wide waterway at MLLW;and would be situated more than 15 feet from the side property lines. To minimize and mitigate any potential impact of the project on the adjacent vegetated tidal marsh and surface water quality,the proposed catwalk has been designed with the minimal scope necessary;and would be elevated a minimum of 4 feet above the grade of marsh and constructed with open-grate decking. Therefore,consistent with Policy 6,the dock would not cause a"fragmentation of ecological communities;"result in the physical loss,degradation,or functional loss of ecological components; or otherwise significantly adversely impact the adjacent vegetated tidal wetlands or surface waters of Deep Hole Creek. o —SEE ATTACHED NARRATIVE— Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No® 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 ® 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. ® Yes ❑ No❑ Not Applicable Due to its proposed position well within the seaward intrusion limits set for docks both by the Southold Trustees and the U.S.Army Corps of Engineers,the proposed dock would have no adverse impacts on navigation or otherwise affect the public's access to or use of the surrounding waterway. And due to the heavily vegetated shoreline and fine,mucky soils,the surrounding conditions do not allow for public pedestrian pass and repass along the shoreline. The project is therefore consistent with Policy 9. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southol.. water-dependent uses and promo« siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy It. 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 ® 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 ® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PREPARED BY TITLECoastal Management Specialist DATE 8/23/18 Robert E. er nn Amended on 811105 i I _ t I ti EN-CONSULTANTS EardV E DDAugust 23,2018 Town of Southold own t Board of Trustees _ 54375 Main Road Post Office Box 1179 Southold,New York 11971 Re: FHV,LLC 3400 Deep Hole Drive,Mattituck SCTM#1000-115-17-11 Dear Board of Trustees: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Short Environmental Assessment Form, b) Authorization&Disclosure Forms, c) Operating Agreement for FHV,LLC, d) Consent and Authorization of the Members of FHV,LLC, e) Project plan prepared by En-Consultants, last dated July 16,2018,, f) Survey prepared by John C.Ehlers Land Surveyor, last dated August,2018, and g) LWRP Consistency Assessment Forms. 2. One(1)set of site photographs. 3. Application fee of$250.00. I trust this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. 'Since rely, Robert E.Herrmann Coastal Management Specialist /khs Enc. 1319 North Sea Road Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com environmental consulting