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HomeMy WebLinkAboutTR-10884A �©� SO Town Town Hall Annex ® Glenn Goldsmith, President 54375 Route 25 V� � p p. Box 1179 A. Nicholas FCrupski, Vice President `® Southold, New York 11971 Eric Sepenoski Telephone (631) 765-1892 Liz Gillaoly CA a® Fax (631) 765-6641 Elizabeth Peeples �41 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU AR E REQUIRED TO CONTACT THE OFFICE OF THE ES RD OF TRUST OFFEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVI BE` INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction '/2 constructed inspection; X When project complete, call for compliance Glenn Goldsmith, President _w`��F S0 Town Hall Annex A.Nicholas Krupski,Vice President ®VV ��® 54375 Route 25 P.O. BOX 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Q Telephone(631) 765-1892 Elizabeth Peeples • a0 Fax(631) 765-6641 100UNTI,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10884A Date of Receipt of Application: November 19, 2025 Applicant: JALC Expeditions LLC SCTM#: 1000-50-1-6 Project Location: 1600 Hyatt Road North, Southold Date of Resolution/Issuance: December 17, 2025 Date of Expiration: December 17, 2035 Reviewed by: Board of Trustees Project Description: Ten-Year Maintenance Permit to hand-cut bamboo to lawn height by hand, as needed. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Anthony Palumbo, last dated November 19, 2025, and stamped approved on December 17, 2025. § 275-5 Permit procedures: (i) Cutting of bamboo to lawn height landward of the wetland boundary. Special Conditions: No trimming on the bluff. No other vegetation is permitted to be cut on the property without further review. Do not disturb any native vegetation during the hand cutting, including but not limited to; Eastern Red Cedar (Juniperus virginiana), Northern Bayberry (Myrica pensylvanica), Marsh Elder (Iva frutescens), and Groundsel Bush (Baccharis halimfolia). Inspections: The approved operations must be commenced within three (3) years from the date of the resolution. The permittee is required to request a Trustee inspection upon completion of the initial cutting. 2 If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees S.C.T.M. NO. DISTRICT: 1000 SECTION:50 BLOCK: 1 LOT(S):5 II COASTAL EROSION LAND N/F OF HAZARD BOUNDARY ` JULIE C4RNEVALE 36E•E FENCE At NO`JIE MO� _ 74�r.O G WIRE FENL EAST XYX X Lis I\ 1 1 I S 64oS0'00"1 1 1\l \ X TIMBER+WAS-_ Lei 1 4 I I 1 I I 1 \ \ \` M 4'S �' '`� GARAGE GEN. snowER za.r ASPHALT DRErvExAT _E -E� (tease GARAGE ��W- -. W W 1�1 ���:.. CDO II I ENE LE n 21.9• W 1 W O - F'/ IN Gi v I I Ip01�O 0.5 ` I I ro a1 N 'I1/ f I INII f I I I I 29.5' 3 I �W 0 I I I I I I 1 I I Pcn ATIO moA 11 m I II la �f nil ,ry I I I I I ra�rn�wlT. Ili 1 11 II I 1 6.0' s.e' r` I I I / W io !! ll!! I to I I , I I rl l l l l I I III 11 I c N ill z DSTY FRAM WELLING i FFL 85.2 o I I r / l 3 ✓', M -' N 24.5 o / N -� CIO s s JIe DRYI 13I.3' /// 5 Z I I f I I I I l i l i l l l ca4loNA O I1 lI _III I1 II I I I Nj NI AII IO fJ II OIII\I�11\I`1�I � HEDGE Go 2.6'N TIMER /AL 0N 371.3944 1 I 1 l I I I I I 1 LAND N/F OF 1 I I I III 1 I I 64eSO'00"W ARTHUR LEUDESDORF UNDERGROUND UTILITY MARKOUT I .O BY PRECISION MARK-OUTS INC. MAY 12. 2027 I S I y y THE WATER SUPPLY, WELD DRYWELLS AND CESSPOOL COASTAL EROSION HAZARD AREA MAP LOCH DONS SHOWN ARE FROMO 07H OBSERVA710NS NYSDEC PHOTO AUG. 5. 198 AND OR DATA 08TAINED FROM OTHERS SHEET 9 OF 49 AUG. 29, 1988 'Sf�` ' AREA:46.251 S.F. or 1.06 ACRES ELEVATION DATUM: NAVD88 V D UNAUTHORIZED ALIMA77ON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY � MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN III ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE RILE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITURON V a 17 LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING LNSTITIFIION,GUARANTEES ARE NOT TRANSFERABLE l THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECInC PURPOSE AND USE THEREFORE THEY ARE NOT IN7ENOED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECRON OF FENCES ADD117ONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS V`+ t \ �_ Ln AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY r T SURVEY OF:DESCRIBED PROPERETY CERTIFIED TO:JALC EXPEDITIONS LLC; O MAP OF: ADVANTAGE TITLE AGENCY, INC.; FILED: STEWART TITLE INSURANCE COMPANY; 1.�1 J`•J SITUATED AT:SOU THOLD WELLS FARGO BANK, N.A.. ISAOA, ATIMA; ^ /� TOWN OR SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC al COUNTY, NEW YORK Professional Lnnd Surveying and Design J Ayr 406>V l P.O. Box 153 Aquebogue, New York 11931 FILE B 221-46 SCALE.1"=30' DATE APRIL 7, 2021 N.Y.S.LISG NO.050882 PHONE(631)298-1588 FAX(031)298-1588 SOU. THO'LD ....TR.USTE.ES No. 1 0 88y h Issued To SAI-c gxq� *.-room& LQ Date la / as ' Address I L o o k,kacv, Roca 1�l0�`�., soL�•0►a THIS. NOTICE MUST BE DISPLAYED. DURING CONSTRUCTION TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.i 765-1892 Glenn Goldsmith,Pre�iurftt ����S�FF01kCOr'ti Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski w ,? P.O.Box 1179 Liz Gillooly 1�y �J Southold,NY 11971 Elizabeth Peeples � fat Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees l Field Inspection Report Date/Time: V'2 12 ZJ Completed in field by: I Palumbo &Associates on behalf of JALC EXPEDITIONS LLC requests a 10-Year Maintenance Permit to cut bamboo on the property to lawn height. Located: 1600 Hyatt Road North, Southold, NY. SCTM# 1000-50-1-6 Typ of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: �hapt. 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/Cond• ions/Etc.: (4- � '_� c' .14 . 0-Cct Zvi 4V Present Were: G. Gg dsmith N. Krupski E. Sepenoski v L. Gillooly E. Peeples S.C.T.M. NO. DISTRICT: 1000 SECTION:50 BLOCK: 1 LOT(S):6 ' COASTAL EROSION LAND NIF OF HAZARD BOUNDARY \\ JULIE CARNEVALE 368.59' E MON.P \I '—_ RE FENCE Al.NG n —�— \ OF V X� S 64°50'00"E 1 \ �` ` —74�uuoERR C vnRE FENCE EAST X sy 1 I I I + 1 I t I I I I I 1\ �� _ X nuBER wAe�- I MON. J 76 J%'S x—� -r_`` GARAGE GEN. INv �\ 1\`\\\\\\\\�\\\\\ I SHOWEzRe1a a o \\ 13.4' � 80 _E GARAGEk ^ I I I I I 1 \ \\ \\\\�N w ENTRANCE ry 21.9 INII INAmmi IN\\\\\\\\\\\\I l Ill III IIIASII I�) �I �8z = W�G� D1 N N I I I I / \ 1 \ J I I I .5' \ 3 N N Ir o.5 W 29 rrO^^ I 11 I I I I 1 1 1 Co ONA�I l l I I I i�OI I I I I II I I / PATIO s.D' \y \ 1 l I 1 CC � C_ z OW FRAME W ` W jJ 1 I N 1 I OwEWNC I I U.P. 1 1600 p o FFlB5.2 0 , I 24 5• c I I ' I I i \ \\ �B �, I I I t ��s \� \�y ` I I / "wE °1 _12I I I IsraFAGE I I I I I / f"E \ . ��v \ \ srEPs 31.e' ��R7.1 '� �o \\ \ \ I se 13b.3' TIMBER)PALL .0'N I HEDGE li I i 1 + m�NN I I I 111,11 11` 13 I \ 0 I \ \` I 1 1 t- , 1 iN A uoN.Co Sl � i � l '\I\I \ 111�11 ��- 11111 I 76'm \ \I I LAND N F OF I j I I II I \ I 1 1 1 I N 64°50100"W 1 ARTHUR LEU ESDORF UNDERGROUND UTILITY MARKOUT BY PRECISION MARK-OUTS INC. MAY 12. 2021 I ,EI Cji LI7 THE WATER SUPPLY, WELLS —WELL.AND CESSPOOL COASTAL EROSION HAZARD AREA MAP - - NO Ir. LOCADONS SHOWN ARE FROM FIELD OBSERVATIONS NYSDEC PHOTO No.56-570-83 `'-"'i C11 c Doi AND OR DATA OBTAINED FROM OTHERS. SHEET 9 OF 49 AUG. 29. 1988 AREA:46.251 S.F. or 1.06 ACRES ELEVA17ON DATUM: NAVD88 C, FE' UNAUTHORIZED ALTERATION OR ADD/BON TO THIS SURVEY lS A wOU RON OF SECRON 7209 OF 7Nf NEW YORK'STAIE EDUCATION CAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE Y.COP GUARANTEES INDICATED HEREON SHALL RUN ONLY TLT THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO ME TIRE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION T �^ = UJ CD LISTED UD?EON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION,GUARANTEES ARE Nor TRANSFERABLE. `; i� O m THE OFFSETS OR DIMENS70NS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE 4-"'-•/; L NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE Nor GUARANTEED UNL£55 PHY9CALLY ENDENT ON THE PREMISES AT M£TIME OF SURVEY I ��'f..11 SURVEY OF:DESCRIBED PROPERETY CERTIFIED TO: JALC EXPEDITIONS LLC; MAP OF: ADVANTAGE TITLE AGENCY, INC.; FILED: STEWART TITLE INSURANCE COMPANY; 11 I SITUATED AT:SOUTH OLD WELLS FARGO BANK N.A., ISAOA, ATIMA; 1 _ TOWN OF:SOUTHOLD SUFFOLK COUNTY, NEW YORK KENNETH M WOYCHUK LAND SURVEYING, PLLC yy Professional Land Surveying and Design #1 l✓� P.O. Box 153 Aquebogue, New York 11931 FILE 1 221-46 SCALED'=30' DATE:APRIL 7, 2021 N.Y.S.LISC.NO. 05C882 PHONE(631)29B-1588 FAX(631)298-1586 4 � ; hot an ht� c; } r B nsw �a a aeo ww aaaa,. ,006 •/'` '+w f r e a .w*w,n.!,.w, •; •L.;'�•� , - i', � ° •.-may + ��:L •i• _ ''„ , ,• '� � � ..ham. i aw t6 �, I� 4, •e•' ao t . _ 5 ♦,ra~O eQre r�r 'a. f ♦�' �'°fy' �f•, "'�• 'O° OA+,� ,y •'y t ,�' ' $$ ff�� ti� b) , •.� ewer. ',Iv`. __{..'a4,: - W• IMIOI ul,! ! • 'fib COUNTY OF SUFFOLK050 K vn..r •• �cee °KIND — —— _ `_ o.u•, u,. _ T..;, _ ... r OFFICE LOCATION: �'0f soUIjyO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) N Telephone: 631 765-1938 Southold,NY 11971 G� • i LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees Cc: Honorable Lori Hulse, Attorney From: Heather Lanza, AICP, Planning Director LWRP Coordinator Date: December 16, 2025 Re: LWRP Coastal Consistency Review JALC EXPEDITIONS LLC, SCTM# 1000-50.-1-6 This application is to cut bamboo on the property to lawn height. 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 proposed action is CONSISTENT with the policies of the LWRP as follows: The plan includes actions that are consistent with the "Administrative Permit" requirements of Chapter§275-2 A of the Wetlands Law of the Town of Southold, including a 10-Year Maintenance Permit to cut bamboo on the property to lawn height which qualifies under§275-3 (k) Minor restoration or alterations of landscaping. 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. Glenn Goldsmith,President ;� Q so UT Town Hall Annex A. Nicholas Krupski,Vice President �� 54375 Route 25 P.O.Box 1179 Eric Sepenoski } Southold,New York 11971 Liz Gillooly ' Telephone(631) 765-1892 Elizabeth Peeples . Fax(631) 765-6641 4en BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application 'B; Wetland Permit Application X Administrative Permit NOV 1 9 2025 Amendment/Transfer/Extensi n B X Received Application: _ 1 k Received Fee: $ S�7. 00 So;r�o 7ur�.n Completed Application: Incomplete: SEQRA Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: _ --Coordination:(date sent): __)�_LWRP Consistency Assessment Form Sent: 1 CAC Referral Sent: k Date of Inspection: 1L (la j S Receipt of CAC Report: _Technical Review: 's,- Public Hearing Held: Resolution: A-LC, e21ZPCdfh0_V\s l c.0 Owner(s) Legal Name of Property (as shown on Deed): .�o5�1i(k1� Mailing Address: �q� 1`ac ' �� 0, _ _ no 112�—L Phone Number: Suffolk County Tax Map Number: 1000 - Property Location: _� Q 4V IC-o\• (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): COl_/ -&Q C) �OL _ AWf Mailing Address: ��-- Phone Number: (0,231 XR-- (O(� Email: [ � Wl U Original Board of Trustees Applica in GENERAL DATA Land Area(in square feet): --qJa,-4z� Area Zoning: I F: Luyx Previous use of property: F G JVI 6 WI ?J4'1 k V YT l Q— I , Intended use of property: _l��U/ lio 1 k+C 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 _[2�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 his project re a y demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? Yes F-1_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? F-1 No ❑ Yes If yes, provide explanation: Project Description(use attachments if necessary): 1W1 1 yGf.S 1 U Ch L- L 41 J ,, Board of Trustees Applica n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Pe L,—Ml*+- l�'(�. U a-VV&0)0 b / cuVL aC dwilcleUWtU Wid P6 t V�WV)66_0 �EWIOWLI I Area of wetlands on lot: _square feet Percent coverage of lot: _ 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?_ _D ____cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations:.` 0_ Manner in which material will be removed or deposited: n TV v 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): In DI�I to 61 Z20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 anSponsor Information ni PCL t&ym Name oflA(ction or Proi t: Project Location(describ and attach a location map): g o o a Z S c ld NN Brief Description of Proposed Action: ►\/1�W V1tV6 in Scwln vtwl o Ua- l Name of Applicants or Sponsor: Telephone: 1 n, 1�-- t U— 6C) E0 E-Mail: Address: I �d V Cit PO: ISta e: Zi C de: 1.Wes 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: ❑ 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? __acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? . �acres 4. Che I land us at occur on,adjoining an ar the prop 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 NIA a. A permitted use under the zoning regulations? 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: � ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO YES ' If the proposed action will exceed requirements,describe design features and technologies: ❑ i O. 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: Ed ❑ 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 ofthe site of the proposed action,or lands adjoining the proposed action,contain NO Y_E 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. ntify the typic bitat types that oc En,or are likely to be found on tf,�-project site. Check all that apply: Shoreline Forest Agricultural/grasslands Early mid-successional Wetland HUrban ESuburban 15.Does the site ofthe proposed action contain any species of animal,or associated habitats, listed NO J YES by the State or Federal government as threatened or endangered? MIFI 16.Is the project site located in the 100 year flood plain? NO YES PL 01 -Selz a 17.Will the proposed action create st rm water discharge,either from point or non-point sources? NO If Yes, a. Will storm water discharges flow to adjacent properties? ❑NO DYES El b. Will storm water discharges be directed to established conveyance systems ff an m drains)? If Yes,briefly describe: ONO ES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids (e.g.retention pond, waste lagoon, dam)? If Yes,explain purpose and size: ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE _ Applicant/sponsor name- I al Ud Date: 16 Signature: Part 2-Impact Assessment. The Lead Agency is responsible forthe 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 regulations? ❑ ❑ 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or,renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a. public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑. ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? El F1 Part3-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, El that the proposed action may result in one or more potentially large or significant adverse impacts and an envirommantal impact statement is required. F1Check 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 Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency T Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of.Trustees .Applioation AFFIDAVIT JCS�%La-V k—Wa,& I' Li b��1 U��Y)Wg4EIN' G DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HISMER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTIS IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTDOLD 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. Siinatu of Property Owner atur Property Owner SWORN TO BEFORE ME THIS // DAY OFWO.�P .. 20 2 S.f Notary Public ELIZABETH WAGNER' NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 WA0001528 Qualified in Kings County Commission Expires February)15,2027 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, J, C—P, U 0- ho- W 001 r L' I I C1. owners of the property identified as SCTM# 1000-. �Ja ! _ LD in the town of . .New York,hereby authorizes to act as mY'ag ent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Propert Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS�T DAY OF �P��P/ , 20 D--5 /-zL Notary Public EL14ABETH WAGNER' NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 WA0001528 Qualified in Kings County Commission Expires February.l5,_2027 APIPLICANT/AGENT/REPRESEN`I'ATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the paruf town officers and employees The nurpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to lake whztever action is necessary to avoid same. t I f ' YOUR NAME: —JOwSb I —A ��L F .Y ..�. L Cri �i XPO(ll J`I'I L L� W . (Last name,first name,diddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other I!` person's or company's name.) I+I f C vv�p&1 i`Y 0- 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 persbnally(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[own officer or employee owns more than 5%of the ares. 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): f1A)the owner of greater than 5%of the shares of the corporate stock of the appliewit n (when the applicant is a corporation); 1�B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); -R-C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted da of 0V-?MWr_ 20 Signature Forth IS I Print Name i ��(,1�1 TQ '" I APPLI CANT/A GENT/REPIR.ES ENTATWE TRANSACTIONAL DISCLOSUPX,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of torn officers and employees The purpose of this form is to provide inforination which can alert the town of possible conflicts of Interest and allow it to take whatever action is necessary to avoid same. YOUR NAME. (Last name,first name,1piddle mitia7,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 �r 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,njarriage,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 sown 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 tliat 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(wh&a 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 th' da of I 40a S Signatur Print Nam ► r\ Form TS 1 � , APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM 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: . VCLtAA rOA-0.6f_�� (Last name,first name,Middle Initial,unless you q0 applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other' name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee. of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or empooyce 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): fjA)the owner of greater than 5%of the shares of the corporate stock of the applicant � (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day f 2 Signature Print Name. Fonn TS 1 Original Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its si ificant 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- supportin 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 tvebsite (soutlioldtown.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# PROJECT NAME ULAJ , The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees i. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance(e.g.grant, loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Location of action: I(0 D V 9-11�N�- Sat �C l� K' \r . Site acreage:_ 1-t ©� Present land use: IGQ- 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: J L-1 i L 7d CvLU-L, L (b) Mailing address: 5 d �- A (c) Telephone number: _� C� - __ is 6 2 - Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No[9 If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form.be returnedJor 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. ❑Yes ❑ No [ZNot 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 10 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 dxot Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize floss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies ?Not s 8 through 16 for evaluation criteria . ❑ Yes ❑ No 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 12 ot Applicable ttac a 1iional 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 ffNot 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[ZNot 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. ffNot Ye.❑ No 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 Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in, Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑Yes 0 No E(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 VNot 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�_" TITLE 1 DATE « `7 0�5 The Law Firm of Palumbo & Associates, P.C. 13200 Main Road, P.O. Box 132 Mattituck,NY 11952 Tel: (631)298-1600 Fax: (631)298-1602 Anthony H.Palumbo,Esq. Tracy K. Palumbo,Esq. November 19, 2025 `-- ------- �n U Board of Trustees Town of Southold NOV 1 9 50375 Route 25 2025 P.O. Box 1179 outhold Town Southold,New York 11971 S Board Of Trustees Re: Administrative Permit application for Bamboo Removal at 1600 Hyatt Road N, Southold,NY 11917 Dear Mr. Goldsmith and members of the Board, Enclosed please find an original and one copy of the application for an administrative wetlands permit to remove the invasive bamboo at the above-referenced property. As you may know, we have been advised that this is the acceptable manner in which to maintain the property. Enclosed please find the following for processing: 1. Original application and one photocopy; 2. Original agent/representative Transactional Disclosure Form; 3. Scanned copies of the owner affidavits, applicant Transactional Disclosure Forms and Agent authorizations (originals to follow in the mail shortly); 4. Two photocopies of the survey (original to follow in the mail shortly); 5. Photocopy of the last deed of record reflecting the ownership of the property; 6. Photocopy of the current tax bill and printout from the Department of State website reflecting Mr. Ho-Walker as the individual representative of the JALC Expetitions LLC, owner of the property (Articles of Organization to follow shortly in the mail); and 7. Check in the amount of$250.00 representing the application fee. As soon as the remaining items are received by our office, they will be promptly submitted to your office for processing. In the meantime, if there are any questions or concerns regarding this application,please feel free to contact the undersigned at the above phone number or by email at trace cr,palumboesq.com. Thank you and I look forward to hearing from you. Very truly y s, Trag'y/Karsch Palumbo Cc w/enclosures: via email h Joshua Ho Walker Lillian Goldsmith