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TR-9371
Glenn Goldsmith,President �Q�SO(/jy Town Hall Annex Michael J.Domino,Vice-President ,`O� O p 54375 Route 25 P.O. Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski G Q Telephone (631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 eoUNi`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 17.23C Date: July 13, 2020 TBIMCERTIFIES that the removal and replacement of 10 linear feet of bulkhead in-place .using vihyi slieathirig:'and to establish and perpetually maintain,a 10' wide non-tur`f bufferalorig the landward edge of the neW43u1khead; _ At 1580 Hobart Road,'Southold = Suffolk County Tax Map#1000=64-3-2.2 Conforms fo.the-application-fora Trustees Permit,heretofore filed in this office Dated October`l 1,2018 pursuant to which Trustees Wetland Permit#9371 Dated December 12, 2018,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal and replacement of 104inear feet of bulkhead in-place using vinyl sheathing-, and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the new bulkhead. The certificate is issued to Andrew Semons owner of the aforesaid property. Authorized Signature July 29, 2021 Town of Southold Trustees E C - V Town Hall Annex Building L� 54375 Rte. 25 . P.O. Box 1179 ��" AUG _ 2 2021 i Southold, New York 11971 RE: 1580 HOBART ROAD-SOUTHOLD Souc sid?uam SCTM No. 1000-64-3-2.2 Board of?rustees FILED CVENANTS Dear Trustees: Attached please find filed covenants for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, .� a��- Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 CC# : C21-12214 COUNTY CLERK'S OFFICE _ J� STATE OF NEW YORK `' AUG — 2 2021 COUNTY OF SUFFOLK Sjuth—oid Tcwn Board of Trustee I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that 1 have compared the annexed with the original DECLARATION recorded in my office on 05/26/2021 under Liber D00013106 and Page 053 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 05/26/2021 SUFFOLK COUNTY CLERK JUDITH A.PASCALE SEAL ti J 11111111111111 IN I IIIIII VIII VIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 05/26/2021 Number of Pages : 5 At: 11 : 03 : 31 AM Receipt Number : 21-0100407 LIBER: D00013106 PAGE : 053 District: Section: Block: Lot: 1000 064 . 00 03 . 00 002 . 002 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $25 . 00 NO Handling $20 .00 NO COE $5 . 00 NO NYS SRCHG $15 . 00 NO TP-584 $0 .00 NO Notation $0 . 00 NO Cert.Copies $6 .25 NO RPT $200 . 00 NO Fees Paid $271 .25 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County AUG - 2 2021 Board Of Ti lsteos b T� L a .r Number of pages 5 RECORDED 2021 Mau 26 11:0,3:31 Ali JUDITH A. PASCALE This document will be public CLEW OF record. Please remove all SUFFOLK COUNTY Social Security Numbers L DQOO131e6 F 053 prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/ Filing Stamps 3 FEES Page/Filing Fee Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Tota I Notation Spec./Assit. or EA-52 17 (County) Sub Total �� e Spec./Add. EA-5217(State) TOT. MTG.TAX Dual Town Dual County R.P.T.S.A. Held forAppointment Comm. of Ed. 5. 00 b ; Transfer Tax ; Mansion Tax Affidavit The property covered by this mortgage is &ertified Copy, � or will be improved by a one or two 5 NYS Surcharge 15. 00 `2 family dwelling only. Sub Total a` YES or NO Other �'j Grand Total J I If NO, see appropriate tax clause on page# of this instrument. 4 Dish 4501357 1000 06400 0300 002002 l 5 Community Preservation Fund Real Propi P T S � Consideration Amount$ Tax Servic R CFE } IIWII��lllul�llllllllll�llll�l� Agency 14-MAY-2 CPF Tax Due $ Verificatil J Improved Satisfactions/Discharges Releases List Property Owners Mailing Address 6 RECORD&RETURN TO: I `-Va ant Land Jeffrey Patanjo ; ;i I� T� P.O. Box 582 , Bohemia, NY 11716 _ AUG - 2 2021 TD TD soudloid Town A-18-1dof Trustees Mail to: Judith A. Pascale, Suffolk County Clerk Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# $ Suffolk County Recording & Endorsement Page This page forms part of the attached Declaration made by: ___'(SPECIFYTYPE OFINSTRUMENT) Andrew Semons The premises herein is situated in 1580 Hobart Road SUFFOLK COUNTY, NEW YORK. TO In the TOWN of Southold In the VILLAGE or HAMLET of Laurel BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MOR TGAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property taxes, *you will now need to contact your local Town T ax Receiver so that you may be billed directly for all future property tax statements. Local property taxes are payable twice a year: on or before January 101h and on or before May 31�,. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Tax Receiver with any questions regarding property tax payment. Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes 200 East Sunrise Highway 200 Howell Avenue North Lindenhurst,N.Y. 11757 Riverhead,N.Y. 11901 (631)957-3004 (631)727-3200 Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes One Independence Hill Shelter Island Town Hall Farmingville, N.Y. 11738 Shelter Island, N.Y. 11964 (631)451-9009 (631)749-3338 East Hampton Town Receiver of Taxes Smithtown Town Receiver of Taxes 300 Pantigo Place 99 West Main Street East Hampton,N.Y. 11937 Smithtown,N.Y. 11787 (631)324-2770 (631)360-7610 Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes 100 Main Street 116 Hampton Road Huntington,N.Y. 11743 Southampton,N.Y. 11968 (631)351-3217 (631)702-2470 Islip Town Receiver of Taxes Southold Town Receiver of Taxes 40 Nassau Avenue 53095 Main Street Islip, N.Y. 11751 Southold, N.Y. 11971 (631)224-5580 (631)765-1803 Sincerely, Judith A. Pascale Suffolk County Clerk dw 2/99 12-0104 06/06kd r J DECLARATION OF COVENANTS THIS DECLARATION made thisday of , 2021, by Andrew Semons, residing at 1580 Hobart Road, Southold, NY 11971 hereinafter referred to as "DECLARANT(S) ": W I T N E S S E T H: WHEREAS, DECLARANT(S) is/are the owner(s) of certain real property located on 1580 Hobart Road, Southold, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 64, Block 3, Lot 2.2 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor,_ and various activities conducted upon the ' property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT(S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required establishment and perpetual maintenance of a 10' wide non-turf buffer along the landward edge of the new bulkhead; AUG - 2 2021 Souilrold Town Board or Trustees NOW, THEREFORE, the DECLARANTS) do/does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be an established and subsequently maintained 10, wide non-turf buffer as defined by Chapter 275 of the Town Code; and as depicted on survey/site plan prepared by Jeffrey Patanjo, dated September 26, 2018 and stamped approved on October December 12, 2018, see Exhibit ?!. attached; and 2) These covenants shall run with the land and shall be binding on the DECLARANT(S) , his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN J� WITNESS WHEREOFA the owner(s) has have duly ie ecuted this instrument this ez? day of ,2021. Andrew Semons STATE OF GG ss( COUNTY OF J On the day of Aahtl� in the year 20siz, before me the undersigned, a No ary P41id in and for said State, personally appeared pPeiy) , personally known to me or pr ved 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, and that by his/her/their signature(s) on the instrument, the individual or the persons on behalf of which the individual(s) acted, executed the instrument. Ck No ary Public �l �� C1 O M N U N CN Flo;tin � �U S—IATF- dl ASG — 2 2021 # 6 i:�0 Lo 1 3 50 2 File No'. RH00300039 SCHEDULE A-DESCRIPTION -vr Ak AMENDED 02/11/08 ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, County of Suffolk and State of New York, being more particularly bounded and described as follows: BEGINNING at a point on the southwesterly side of Hobart Road at the northeast corner of the herein described premises where the same is distant 20.08 feet southeasterly as measured along the southwesterly side of Hobart Road from the southeasterly side of land now or formerly of H. Smith; RUNNING THENCE from said point or place of beginning along the southwesterly side of Hobart Road South 26 degrees 25 minutes 00 seconds East, 155.92 feet; THENCE South 58 degrees 35 minutes 00 seconds West, 254.69 feet to the approximate high water mark of Town Creek; THENCE along the approximate high water mark of Town Creek along a tie line North 59 degrees 52 minutes 08 seconds West, 85.68 feet; THENCE North 58 degrees 35 minutes 00 seconds East, 184.10 feet; THENCE North 31 degrees 25 minutes 00 seconds West, 80.00 feet; and THENCE North 58 degrees 35 minutes 00 seconds East, 125.00 feet to the southwesterly side of Hobart Road at the point or place of BEGINNING. D, AUG ® 2 2021 Ll,'s Board af_i, PROPOSED FIR TIMBER TOP CAP - --r—a_—�T--- OMIEDY 10'MM e'0.c + 'EXHIBIT_AI PROPCSED V)M*REAR WALE / NOTE: f1woVE EXISTING BULKHEAD STRUCTURE N ITS ENTIRETY °� wAOE RSP A94 ND IE�EXACT SAME POS17M Psp�Pj/ PROPOSED 6•d CCA 0 70P d 607TDH WALE i o $ n A'Piio70WE TdH�.B.z t / 9�s \ O ILL *EL 011k- P STONE PATO PROPOSED r TIP=A LAY-LOG RIE ITS QI7i0=fC ` \ N i \ \ LD47K D a'4P CCA RLE.6•nC a' ��•\ \ DAL�vARran��eo Yip xn"/'• p �sLn A71D \ PROPMM le LONG I.CIA.MV.TIE ` L —1 RW,6•Dc \ --`—`- 1 STORY \ � T1 SAND RESIDENCE \ PROPOSED'if LONG coo aP00 M YL sIEE7Ixe p o �- •p CcliV o I O a TYPICAL BULKHEAD SECTION I C"i \\ N.T.S. '� y op ;n o Lill, 11,00, APPROb BY '1 LINE OF 10'WIDE NON-TURF BUFFER 36 Obi BOARP*0F TRUSTEES TOWN OF SOUTHOLD EXITING BM WALL TO RMN LOCATION MAP BU J.PATANJOVEGUAO DAUGUST12,20118 Fl� !� ATE 9t�,e i'� ZCl� N.T.S � �� ` EXISTING WOOD BULKHEAD TO REMAIN / PROPOSED 10 LF VINYLEMO KH IN-KIND AND IN-RACE OFF EXISTfNG ;t � "• � _1�( �-eu-C , EXISTING JETTY TO REMAIN PROPERTY OWNER: PREPARED BY: ANDREW SEMONS JEFFREY PATANJO . 1580 HOBART RD. P.O. BOX 582 �.,`9sa• �•� SHED SOUTHOLD, NY 11971 BOHEMIA, NY 11716 y / tS3d 631-484-9332 �� 5 JJPATANJOQGMAIL.COM 00 Proposed Bulkhead Permit Plans SCALE: NOTES: �� DETAILS AND DATE: 1.-LOT-AREA: 30,691 S.F. / 0.70 ACRES PROPOSED PLAN,LOCATION MAP 9-zB-,a EXISTING WOOD DOCK TO REMAIN 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: 1580 HOBART ROAD DAVID H. FOX L.S. P.C. -' SOUTHOLD, TOWN OF SOUTHOLD 64 SUNSET AVE. WESTHAMPTON BCN NY 11978 SUFFOLK COUNTY, NY SHEET: SURVEY LATEST DATED FEBRUARY 2, 2008 TAX MAP NO. 1000-64-03-2.2 1 of 1 Glenn Goldsmith, President �QF SOUTy Town Hall Annex Michael J. Domino,Vice-President ,`O� ��� 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III 1 [ Southold, New York 11971 A. Nicholas Krupski G Telephone (631) 765-1892 Greg Williams Fax(631) 765-6641 UNrI,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /20,v INSPECTED BY:` Ch. 275 "' Ch. 111 INSPECTION SCHEDULE Pre-cortstruction; haybale line/silt 4boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection COMMENTS: 44-13 7 CERTIFICATE OF COMPLIANCE: aTa-z-ZZ:1, r^'SUFFo1K�—_ Michael J. Domino, President � o�o co�� Town Hall Annex John M. Bredemeyer, III, Vice-President 54375 Route 25 Glenn Goldsmith ;y P.O. Box 1179 A Nicholas Krupski �y • �` Southold, NY 11971 Greg Williams �o! , ��� � 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 1St day of construction Y2 constructed When project complete, call for compliance inspection; c BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 9371 DATE: DECEMBER 12, 2018 i ISSUED TO: ANDREW SEMONS PROPERTY ADDRESS: 1580 HOBART ROAD, SOUTHOLD I SCTM# 1000-64-3-2.2 AUTHORIZATION i j 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 December 12. 2018, t and in consideration of application fee in the sum of$250.00 paid by Andrew Semons and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to remove and replace 10 linear feet of bulkhead in-place using vinyl sheathing; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the new bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, dated September 26,2018,and stamped approved on December 12,2018. I IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of the 12''day of December,2018. OgpfFOj�. : H %85 i I r I .e i . I i i :ill aR4tiAMYiti4•:ai"ua:G'itn`tGs.(li(uvix+i.M:firublL:tSa�/llSt?u.4]i2iutidM:if%isw}is3C4b:v:[Gtii.GWdSY!]x1b,r'Yi'$AIYn"u'a�iXJY4'4liSS3uid17.171Cet1xN19.�M�a�??YtS41 17sY.GvSr]k V.Gl.(1J5.WRu15'lL8%�-iiNdL l=r, 1 - TERMS AND CONDITIC The Permittee Andrew Semons, residing at 1580 Hobart Road, Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this 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. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. 11. 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. Survey for: r I �. ANDRE W SEMONS At Southold o< Town a / Town of 1 1 1(\0 Suffolk o Southold • cp 'Is[ / y Suffolk County, New York S.C.T.M.: 1000-064.00-03.00-002.002 �Q a SCALE:1"=40' I NOTES: 1. AREA = 30,691 S.F. yon ` r:. \ O 2• ■ = MONUMENT FOUND, 1 = STAKE FOUND. *' 1 3. REFERENCE DEED: L. 11896 P. 627 91S A r y . vl ZV�; lop 1 do. r riot c, of Fz Q 41-1\Gr � ,� ` GATE: FEB. 02, 2008 JOB NO:2008-026 �C)Att 40 , . CERTIFIED TO: � ANDREW SEMONS LANDAMERICA TITLE INSURANCE COMPANY j tel, e1 �s r� NS`9. `1ydy� o F?G <° E toy" oO Ot l 0 11*b ,7s?fie; (\OV�\O!b ( DAVID H. FOX, L.S. P.C. N.Y.S.L.S. #50234 FOX LAND SURVEYING tw k 64 SUNSET AVENUE 'y 68• r WESTHAMPTON BEACH, N.Y. 11978 (631) 288-0022 r'qA RCf�£ „NA °L fir. -OM1 Cr H gY - rY '14f JI t1c, 1,1. ti'%��\ ::E.• � ._{l t.'A °t"> r 5f't r.l,.'='. :.l s. •,,.Y __._ DWG: 2008-026 PROPOSED FIR TINBEw TOP CAP OD� PROPOSED Ir LONG 10•BUTT PROPOSED J•%e•REAR IYME OCA TREATED 1eBElt PILL 5'0.a NOTE: REMOVE EKISIING BULKHEAD ooetwc GRADE �y1Py STRUCTURE IN TTS ENTIRETY (ILS AND INSTALL NEW BULKHEAD ( IN THE EXACT SAME POSITION PROPOSED e•!•CCA P�/ O TOP s BOT1ou wuE 10 lcl� E OVA " 5$55 s `Noy __:::: APPRODMWE r,R.r.n.as: N"wom kLLW IL am* DOS"IIN0 axxNEAD PROPOSED e•DP CCA uv-LOC PRE TOIA DE REMOVED ENTIRETY. STONE PATIO 9� PROPOSED e'tw CG P'LF,e'A�3/4- j G06LVA.BOLTED m LAV-LOO OALVAH. 7RRUO LAY- OSED 10'LO ��e'0.0 G PATIO SLATE 91 rROPOSE.D 1�LANC ax woo MNYL �s EETINc ` 1 STORY TYPICAL BULKHEAD SECTION FRANDRSIIDENCE GARAGE N.T.S. o 9A�/0 / ! 11 ' � �I S80 Hobert Road r ' 9 // 00�5p 6 APPR®VESB / LINE OF 10' WIDE NON-TURF BUFFER OO'' E BOARD OF 'l jZb TEES s y$g5 /// TOWN OUTHOLD EXISTING BRICK WALL TO REMAIN LOCATION MAP B EXISTING TANJOVEGETAONDAUUGlSTD2�0 8E"T'Fl� DATjF/ p iuP�i� ,ZT Zoog N.T.S. y EXISTING WOOD BULKHEAD TO REMAIN PROPOSED 10 LF VINYL BULKH IN-KIND AND IN-PLACE OF EXISTING \ \ / EXISTING JETTY TO REMAIN cnzEr3o / PROPERTY OWNER: PREPARED BY: \4, ANDREW SEMONS JEFFREY PATANJO �# 'L's9. y � / 1580 HOBART RD. P.O. BOX 582 S2• y W SHED E SOUTHOLD, NY 11971 BOHEMIA, NY 11716 Q ` W.► ° �� 631-484-9332 y 5g'g5 JJPATANJO®GMAIL.COM 4- Proposed Bulkhead Permit Plans SCALE. 1"=30' NOTES: PROPOSED PLAN, DETAILS AND DATE: 1. LOT AREA: 30,691 S.F. / 0.70 ACRES LOCATION MAP 9-26-18 EXISTING WOOD DOCK TO REMAIN 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: 1580 HOBART ROAD DAVID H. FOX L.S. P.C. SOUTHOLD, TOWN OF SOUTHOLD 64 SUNSET AVE. WESTHAMPTON BEACH NY 11978 SUFFOLK COUNTY, NY SHEET: SURVEY LATEST DATED FEBRUARY 2, 2008 TAX MAP N0. 1000-64-03-2.2 1 of 1 Michael J.Domino,President �QF S0 Town Hall Annex John M.Bredemeyer III,Vice-President ,`O� y�1 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 COUNTI,� ` BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 12, 2018 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: ANDREW SEMONS 1580 HOBART ROAD, SOUTHOLD SCTM# 1000-64-3-2.2 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 12, 2018 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of ANDREW SEMONS, 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 October 11, 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 December 12, 2018, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVE the application of ANDREW SEMONS to remove and replace 10 linear feet of bulkhead in-place using vinyl sheathing; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the new bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, dated September 26, 2018, and stamped approved on December 12, 2018. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd Michael J Domino, President Town Hall Annex John M. Bredemeyer, III, Vice-President o ` i 54375 Route 25 Glenn Goldsmith o ti P.O. Box 1179 A Nicholas Krupski Southold, NY 11971 Greg Williams Telephone (631) 765-1892 Z:2 u Fax (631) 765-6641 BOARD OF TOWN TRUSTEES I2,Z0 4 TOWN OF SOUTHOLD TO: ANDREW SEMONS c/o JEFFREY PATANJO Please be advised that your application dated October 11, 2018 has been reviewed by this Board at the regular meeting of December 12, 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) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30- Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) xx The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code The following fee must be paid within 90 days or re-application fees will be necessary You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES. TOTAL FEES DUE' $ 50.00 ' " BY- Michael J Domino, President Board of Trustees Michael J. Domino,P ;ntSUFFU(,� `�0 C� Town Hall Annex John M. Bredemeyer III, Vice-rresident b��� Gym` 54375 Route 25 Glenn Goldsmith y = P.O. Box 1179 A.Nicholas Krupski 0 ry Southold,NY 11971 Greg Williamsy p� Y Telephone(631)765-1892 y �_l Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: � J =i3 Completed infield by: - 0 Jeffrey Patanjo on behalf of ANDREW SEMONS requests a Wetland Permit to remove and replace 10 linear feet of bulkhead in-place using vinyl sheathing; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the new bulkhead. Located: 1580 Hobart Road, Southold. SCTM# 1000-64-3-2.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application- Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 49111�2' I ha r d & acknowledged the foregoing Trustees comments: Agent/Owner: / ` Present were: y J. Bredemeyer M. Dominoy. Goldsmith v N. Krupski VIG. Williams Other w r Photo 1 i16 r -.mac_,.,� ...y .• t T� �� ., F� i y w r c A , t Photo 2 \♦ .'�' ♦. 'i6 . .. ., ice. i •la V}-.. .... '� . Y R „r R4 W wWtiLT'�EWeo°°pNofTrE jti �� Al W V1 " 7 Ntl.= �' yMy ....t,... �.AE#P4t%`RWtYTk,8F09Cf40EtMY ,:t .. � � yy x1000 maavw _'. ow, �k?r a^k �_a t i.,vs,� i ph.,P •' -.n.'.may,�'� �$21: 'd.�:. :.S°Y i i�: n`9 ewi W y •PT '�O� M1 y�.'aF F � ♦O \O \ ,M1�♦ . F � pP 1 ' o to p 'P lb O M1 ♦ F .P P F 5 O a C 14A 1 9 • f tF ^I 5 IAA(c) Fp yL F s .M1 14.7 12 1.71 F O � r '� \•4 9 t' •\ 1 TAI=>I g � ,z j W+ — —_ -- -- ®wvda COUNTY OF SUFFOLK © E SOUTHOLD \SECTION NO (21) - Q " � —_� NOTICE �' Real Pro pertyTax SernceAgency Y aeo t rx _ ___ __ CouMyG°YtRNN,M4,NT11401 M 064 �u. M-a __- R�,�+Maly ate° u• —_— mu, --r-- mu.--ww-- cu movcrtry nx s[enc[narxcr. ��� P 1000 PROPERTY MAP OFFICE LOCATION: rjv soyoMAILING ADDRESS: Town Hall Annex �O lQ P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 • �Q Telephone: 631 765-1938 Irou 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: December 6, 2018 Re: LWRP Coastal Consistency Review for ANDREW SEMONS SCTM# 1000-64-3-2.2 Jeffrey Patanjo on behalf of ANDREW SEMONS requests a Wetland Permit to remove and replace 10 linear feet of bulkhead in-place using vinyl sheathing; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the new bulkhead. Located: 1580 Hobart Road, Southold. SCTM# 1000-64-3-2.2 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 that: 1. The Board require the installation of a 20' wide non-turf buffer landward of the retaining wall as required in Wetland Permit(4387). This action proposes a 10' wide non-turf buffer. 2. Existing vegetation is preserved. 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 yF�OE�.r�G Peter Young,Chairman 4 Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 �► '� Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., December 5, 2018 the following recommendation was made: Moved by John Stein, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of ANDREW SEMONS to remove and replace 10 If. of bulkhead in same location as existing with new vinyl. Provide 10' wide non-turf buffer landward of proposed bulkhead. Located: 1580 Hobart Rd., Southold. SCTM#64-3-2.2 Inspected by: Peter Meeker, John Stein Vote of Council: Ayes: All Motion Carried ��0f $U!/jy0 Town Hall Annex Michael J.Domino,President ti0 l , John M.Bredemeyer III,Vice-President P.O. Route 25 ,�, P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith �� • Telephone(631) 765-1892 A.Nicholas Krupski 0��,co : Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application L Wetland Permit Application Administrative Permit (� �Amendment/Transfer/Extension p 1 OCT 2��� Rcceived Application: I D<<I d Received Fee: $ 2-5D,00 -�`�� Completed Application: !1 1�— SozrKd Town Incomplete: SEQRA Classification: Type I_ Type II_J Unlisted Lead Agency Determination: Coordination:(date sent):_ _ LWRP Consistency Assessment Form Sent: AC Referral Sent: 1 q� g Date of Inspection: 125% Receipt of CAC Report: Technical Review: _ Public Hearing Held: Resolution: Legal Name of Property Owner(s): A 014 S t.n o^ s Mailing Address: 1 5-80 4. 10a rt Phone Number: q1 -7 - S19 -) 339 Suffolk County Tax Map Number: 1000 - a- Property Location: /58c' 11e64 rt 17 L Som-{ G► sem. I W-,C- l*" 'v"k,° (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: P c0 (� o X 583— B-o 17,-m(1 N`1 2 ! - ! / Phone Number: 6 3 �' g y '9 3 3 d— �p j�� Board of Trustees Applic ion GENERAL DATA Land Area(in square feet): d9• 7 Area Zoning: tC S Previous use of property: &S' Intended use of property: Ile'S- Covenants and Restrictions on property? Yes No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes '� No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ✓1`Io Does the structure(s) on property have a valid Certificate of Occupancy? ✓Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? �No Yes If yes,provide explanation: Project Description(use attachments if necessary): R.Oyrave 4 o R �4� /� Lf e 1- L L �l�D✓c� I o' wl�l h ova— '�. /� �� �/ lin�wt,L� a� �f�j�� - Board of Trustees Applic ion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: n,,_c s 2cl�l4cc �o �� e sfi Ry 1q,,L(4 Lie,40 [ 14 54/YLL 10C 4+t-,^ •c S e-*�l Y*-141 a.. �-d. ti.Gc,, •4(— H ( . P(oPa$C� ZJ✓ L.IL�fG.IJ� Area of wetlands on lot: -7 S o square feet Percent coverage of lot: 2.3 % Closest distance between nearest existing structure and upland edge of wetlands: _ feet Closest distance between nearest proposed structure and upland edge of wetlands: . feet Does the project involve excavation or filling? `� No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? (4—cubic yards Depth of which material will be removed or deposited: " (A feet Proposed slope throughout the area of operations: ° - 2- Manner Manner in which material will be removed or deposited: -JA 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): eee Pf- •c-f OfAdQ ►is t 0e-4--t 4W k 2 s� o F- -�'� 11 1► i,.a�-rit Grnt AI(_C.t�c w�l� Ta�4K -t'4 �voi�1 cPs� -flv,� vLkW flu�_�� h'k� ,,,ric.lL �ir{�•necaQ �arerwt/� of Sa.rce . Short Environmental Assessment Form Part I -Project Information Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 1580 Hobart Rd-Southold Project Location(describe,and attach a location map): See location map Brief Description of Proposed Action: Remove and replace existing bulkhead Name of Applicant or Sponsor: Telephone: 917-319-1339 Andrew Semons E-Mail: asemons@optonline.net Address: 1580 Hobart Road City/PO: State: Zip Code: Southold NY 11971 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑✓ ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ NYSDEC/NYSDOS/Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.71 acres b.Total acreage to be physically disturbed? 0 01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 71 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial m Residential(suburban) E3 Forest DAgriculture ❑Aquatic []Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES I N/A a.A permitted use under the zoning regulations? ❑ 71 ❑ b. Consistent with the adopted comprehensive plan? ❑ ❑✓ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, Agency:buffolk ouna e: - 1:1 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES IT El b.Are public transportation service(s)available at or near the site of the proposed action? ❑✓ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑✓ ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑✓ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑✓ ❑ b.Is the proposed action located in an archeological sensitive area? ❑ ✓ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑✓ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑✓ ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional m 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? Common Tem,Piping Plover,. ❑ 16.Is the project site located in the 100 year flood plain? NO YES TT IVI 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO YES ❑✓ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ❑YES Page 2 of 3 18 Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: W] ❑ 19 Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: __ ❑ Exact location unknown-this is a residential neighborhood I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spon na rew emo s Date: Signature- a PRINT FORM Page 3 of 3 F responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? u� 2. Will the proposed action result in a change in the use or intensity of use of land? (✓ [ a 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 a affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9 Will the proposed action result in an'adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may _ occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined, based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees _ Y141 Name of Lead Agency Date 111pe9 ��I on. ,�,9 m i President Print or ame�o� �es�onsib icer Mer ea Agency Title of Responsible Officer I Signature of Respon ble Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) L PRINT Page 4 of 4 EAF Mapper Sumn f Report Wednesday, August 01, 2018 7:29 PM _ Disclaimer: The EAF Mapper is a screening tool intended to assist " 5400:100-25400 6415';-2L}0-10C'06'40G-200-.350p'164ftC';5COi-1 g00tu project sponsors and reviewing agencies in preparing an environmental 6400-100-2 0000assessment form(EAF).Not all questions asked in the EAF are 1. �1 j- 6400-100-30002 6400-200-22!'00 64!10-500-1600(; answered by the EAF Mapper Additional information on any EAF 6400-100-21'0006400-100-271100 l 64i;n-200-70!''0 �+ question can be obtained by consulting the EAF Workbooks. Although { 6400-"2170-39000 (}� the EAF Mapper provides the most up-to-date digital data available to 6400 '10!-22000 "'� 6400-200-196r-,0 P DEC,you may also need to contact local or other data sources in order G400-100;14006 6440 1`?C` 30001 >,3Cr© 3�'C'"1 Cpl i }� to obtain data not provided by the Mapper Digital data is not a 1), 0-10o-29000 640' -2 00-9fj U0 6 3t q?UO 41(100 substitute fora enc determinations. 64001-200-430+:+1 agency a° 640 -200=1.3000 y, 1 400-100-14007 6440 100 310006400 :30 1 c In � 060 _ i40t-2 0--1 5 otltaoa .Montreal 400-100-10001"..--4 -'6400-300-2001 ;3[! 0026400-2!0-14000 d'b. .:, 6400-400,5000 . SOut�tp� 0-400 -40-I6 64+' 0-400-6001 00=700-2'7000' ' "'r 640'-44.0 i 6r (3400-400-6001- Totonto 6100-'7 00-2 9 001 z+I. R ch,rd•ar 7000-600-34000 f`+,n 1' r� Atbarry 300-7C0'39(1o" " 7r�Gf300t�9 64017 307 .4�7Q0 f '�rolt Bacton �i300=700-31 C1016300,=7pG-33000 6400;300-5000 fr ?rmldenc:e ---' f`ft_ Sorrcea Esri,HERE.GarmiR;-USGS.' Clrrda,d -��` 6300-700-11,4 t% INCRE1,AENT P,NRC ; G 7000 6360-700-19'0006300-700-20011 R' ` I NN 630'1%-r'00 200017 6300=7 00d1UPPMETI,EsriChins IHcng-K g;�E r~iplr SourCes;�seii, .E,Garmin, 6300-700=2300"r,Esri'T�!eVon4 NGCC Columbus 'Pittsburgh USGI$111ata31rn�lF, ItiCREh,IEtJT 634,0-70C'-22000-Fi3!3p-700'-25t7G ttr; t a� ntributCr, ptfi f 00pp f' „ F,NOCan, Esri.iapan,tAETI, 33Q0,-700-24'C'063C'0-7C0-260r,! er crnmun,t clonal, ,f{�� tr, a ?. wad„ ina;Hang Kcng),Esri Part 1 /Question 7 [Critical Environmental Yes Area] Part 1 /Question 7[Critical Environmental Name:Peconic Bay and Environs, Reason:Protect public health,water, Area- Identify] vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 Part 1 /Question 12a [National Register of No Historic Places] Part 1 /Question 12b [Archeological Sites] Yes Part 1 /Question 13a [Wetlands or Other Yes-Digital mapping information on local and federal wetlands and Regulated Waterbodies] waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15[Threatened or Yes Endangered Animal] Part 1 /Question 15[Threatened or Common Tern, Piping Plover, Least Tern Endangered Animal- Name] Part 1 /Question 16 [100 Year Flood Plain] Yes Part 1 /Question 20 [Remediation Site] Yes Short Environmental Assessment Form - EAF Mapper Summary Report 1 Board of 'trustees Application. AFFIDAVIT 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 PERIVIIT(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. 4L Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS r DAY OF 201'b at. d. �i). otary Public 0 TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO 01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2OAe1 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We A ,? Sten an s owners of the property identified as SCTM# 1000- in the town of New York, hereby authorizes �CA- �V2 t _ 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 th' r perty. roperty Owner's ignature Property Owner's Signature SWORN TO BEFORE ME THIS—_ I DAY OF 0_c47)AJC.r , 20_1,g otary Public TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO 01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,202�X APPLIC T/AGE N'T/REPRESENTATI-�rE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics WAlibits conflicts of interest on the part of town officers and ernplovees.The pub. rpose.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 necessar to avoid same, YOUR NAME: �/�' n S. A nA r e-`) (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 Southold? "Relationship"includes by blood,marriage,or business interest."I3usincss interest"means a business, including a partnership,in which the town officer or employee has even a partial owncrship of(or employment by)a corporation in which the town officer or employee owns more than 501,.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 applicantlagenUrepresentative)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) pply):__ A)the owner ofgreater than 50%of the shares of the corporate stock of the applicant (when the applicant is a corporation); ___13)the legal or beneficial owner of any interest m a non-Wrporate cntrty(when the applicant is not a corporation); C)an ollicer,director,partner,or employee of the applicant,or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this daLN 20Signature____ " � pPrint Name `� Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold'c Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The pumose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. T YOUR NAME: (Last name,first nalbe,Middle initial,unless yo are applying to the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map _. Planning Other (if"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,njarriagc,or business interest.`Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than S%of the shares of the corporate stock of the applicont (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 ofrecr,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this fit: y of Sep* 20 Signature Print Name Form TS 1 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: SCTM#1000-64-3-2.1 SCTM#1000-64-3-3.1 Rich,James H III & Rich, Leslie E Hobart Road LLC SCTM #1 , Mario -2-11 RivelliMari c/o Joseph Battaglia 2 Colby Road PO Bo806 1435 Hobart Road Box Port Washington, NY 11050 Southold, x 811971 Southold, NY 11971 SCTM#1000-64-2-12 SCTM #1000-64-2-13 Terp,Alfred J Pietrodangelo, Diane PO Box 64 158 Watson Avenue Southold, NY 11971 West Orange, NJ 07052 STATE OF NEW YORK COUNTY OF SUFFOLK Jeffrey Patanjo ,residing at P.O. Box 582, Bohemia,NY 11716 being duly sworn,deposes and says that on the 3 day of December , 20_18,deponent mailed a•true copy of the Notice set forth in the Board of Trustees Application,directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at 'u�o�,�M . x_ , that said Notices were mail each of said persons by CERTIFIED MAIL/RETURN RECEIPT. i Sworn to before me this 3 Day of December , 20 18 Z:1 MARILYN S. HICKSUV)AOLA I Q.A A- i NQTARYPUBLIC.STATE NEW YORK o Public Registration,,%.% ,365488 Qualified in Suffolk County Commission Expires October 10,2021 Postal • Postal ILi CERTIFIED 0 ■ ■ CERTIFIED . ■ a Domestic Mail Only 0r r%- rUDomestic Mail Only fUFor delivery ir,,j�%nation,visit our r` spa a website;4information,rU For delivery ul Certified Mail Fee -11 -1 Certified Mail Fee Ln $ C Extra Services&Fees(check bon,add tee ppropnet.) Ln $ Q ❑Return Receipt(hardcopy) $ Extra Services&Fees(checkbox,add fee as appropriate) Q ❑Return Receipt(electronic) $ Postmark r3 ❑Return Receipt(hardcoW $ Q ❑Return Receipt(electroaio) $ Postmark Q ❑Certified Mali Restricted Deilvery $ Here Q ❑Certified Mail Restricted iDdh rt' ,$ Here Q ❑Adult Signature Required $ Q ❑Adult Signature Required $ Q ElAdult Signature Restricted Delivery$ ❑Adult Slg estrlcted Delty"$ 43 Postage coPostage i .A $ Q Total Postage ant SCTM#1000-64-3-3.1 p Total P3iiiVp ar / � $ ent To Hobart Road LLC Co $ ent To \//nom, SCTM#1000-64-2-11 Q c/o Joseph Battaglia o ' S Rivelli, Mario r, SrieeisndapEai � SiiaBieitaapti n 1435 Hobart Road �rry Ste'te;ziP+a PO Box 806 :.. Southold, NY 11971 A'TIP: Southold, NY 11971 Postal CERTIFIED MAIL" RECEIPT M CERTIFIED MAILP RECEIPT LnDomestic Mail Only Q Domestic Only rU For delivery information,visit our website at www.usps.com". IL 0 ° v, " Certified Mail Fee. Ln Certtfied Mail Fee \ S $ f Ln $ Extra Services&Fees(check boy add propdate) Ln Extra Services&Fees(check box,add fee as appropriate) Q C]Return Receipt(hardcopy) $ r C-3 E]Return Receipt(hardcopy) $ Q ❑Return Receipt(electronic) $ I Postmark Q E]Return Recelpt(electronic) $ Postmark Q ❑Certifled Mail Restricted Delk-ery $ Here Q ❑Certified Mall Restricted Delivery $ Here Q []Adult Signature Required Q []Adult Signature Required $ ❑Adult Signature Restricted DON"$ ❑Adult Signature Restricted Delivery$ Q Postage Q Postage do ED $ Q Total Postage and Total Postage and $ SCTM#1000-64-2-13 $ SCTM#1000-64-3-2.1 � senrro Pietrodangelo, Diane 03 Sent To ra Rich James H III & Rich, Leslie E CC3 SiieeiandAWfVo 158 Watson Avenue Q Siieetand'Apf.7�lo. 2 Colby Road �`- y crit'-side W;41 West Orange, NJ 07052 crit'siaie;zi�+4� port Washington, NY 11050 Postal CERTIFIED oRECEIPT _0 M Domestic Mail Only r` ru For delivery informaticn.visit our website at www.usps.com". ,sem . IrLn Certified Mail Fee ul $ 4 Extra Services&Fees(check bcv;add ptmptlate) Q ❑Return Receipt(hardcopy) $ Q ❑Return Receipt(electronic) $ Postmark Q []Certified Mall Restricted Qei*y $ Here Q ❑Adult Signature Required `)IF S ❑Adult Signature Restricted Delivery$ Q Postage co r0 $ Q Total Postage an, Co $ SCTM#1000-64-2-12 r-q Sent To Tarp,Alfred J C3 SiieeiandAji£Ni p0 Box 64 crit'sraie;ziP+4 Southold, NY 11971 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS 14 r � Name: 6q-3 — 2 e & q- 3 STATE OF NEW YORK COUNTY OF SUFFOLK , residing at being duly sworn, deposes and says that on the day of , 20 , deponent mailed a.true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 Notary Public December 6, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 1580 HOBART ROAD-SOUTHOLD SCTM No. 1000-64-3-2.2 AFFIDAVIT TRANSMITTAL Dear Trustees: Attached please find proof of mailing and posting affidavits for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 Michael J.Domino,President O�Q I OG Town Hall Annex John M.Bredemeyer III,Vice-President �� � 54375 Route 25 Glenn Goldsmith ti z P.O.Box 1179 A.Nicholas Krupski 15 fry Southold,NY 11971 Greg Williams y p� Telephone(631)765-1892 ��l �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of ANDREW SEMONS COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, Jeffrey Patanjo ,residing at/dba P.O. Box 582,Bohemia,NY 11716 being duly sworn, depose and say: That on the-L day of December , 2018 , I personally posted the property known as 1580 Hobart Road, Southold. SCTM# 1000-64-3-2.2 by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,December 12,2018. Dated: z'3- 18 4- ArAture) Sworn to before me this 3 day of Dec. 2018 MARILYN S. HICKS NOTARY PUBLIC,STATE OF NEW YORK Rpi"ion No.01 H16365489 Notary Pu lic OusliRad in Suffolk County Commission Expires October 10,2021 NUTILt: Uim -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: ANREW SEMONS SUBJECT OF PUBLIC HEARING : For a Wetland Permit to remove and replace 10 linear feet of bulkhead in-place using vinyl sheathing ; and to establish and perpetually maintain a 10' wide non- turf buffer along the landward edge of the new bulkhead. Located : 1580 Hobart Road, Southold. SCTM# 1000-64-3-2.2 TIME & DATE OF PUBLIC HEARING : Wednesday, December 12, 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 Tovni). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# l 4 - 3 - -�--;k- PROJECT NAME l S"g o �)o&-t rc9 The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit, approval, license,certification: ❑-- Nature and extent of action: Gvw o,..4 .&VjA (i�t'4cc 10 Lf- o F -AIX i Sit n y S,-LK h its oQ i n S a i1M t LOCA-(zo,�, wf� new ..�.�41L - PlovccQQ !o` ti,(cQc non-��/� Location of action:. So Site acreage: d•-1 o Present land use: R9 $ Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: n X(.eL4,, S lm on S (b) Mailing address: �D /)a R,t.Q t2-d - 5-0114A o(d N-t 111 -7 / (c) Telephone number: Area Code( } q 17 - 3 114 3� (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? t-'Is A fG- 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. EI/Yes ❑ No ❑ Not Applicable Qr,r1evE providAs ! Ae-4j �y—c-4ts,..c. t �C IL�eic 9 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 2 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 Q Yes ❑ No ❑ Not Applicable ee.4- PfrcAeG {v t, a ,,,tlip/i'tlr•tiy h.-LK(e.,X 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 PrYes ❑ No ❑ Not Applicable �r•I- + Pro-be e--!') .Ec 4,r tf- Cass YteR eke elle-1 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 P—Yes ❑ No ❑Not Applicable Projez,4 Pr frets a-(—s,cs by r d-eegP a r.k#A " 5*<A1j,"en 4,troj Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes ❑ No❑�t 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 ElNo U Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. �,�� Ye'o No u Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ❑' Tot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No []--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 ❑ NoNot Applicable PREPARED BY J ' 1 �'a�► o TITLE_41-en f DATE g- 2-4-/7 October 8, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 E C E I V E nD P.O. Box 1179 Southold, New York 11971 OCT 1 1 2018 RE: 1580 HOBART ROAD-SOUTHOLD SCTM No. 1000-64-3-2.2 Southold Town APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, t, o J rey n'o .O. Box 582 Bohemia, NY 11716