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TR-8048
John M.Bredemeyer III,President ��'oF SOU�yQ� Town Hall Annex Michael J. Domino,Vice-President �� O 54375 Route 25 P.O.Box 1179 � _ Glenn Goldsmith � � Southold,New-York 11971 A.Nicholas Krupski � • aQ Telephone(631) 765-1892 Charles J. Sanders ���(soU�,ry�� Fax(631) 765-6641 , . BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE ` � # 1239C Date: June 21, 2016 THIS CERTIFIES that the renair and/or replacement of existin�failed bulkhead sheathin�with vinvl sheathing• repair and/or replace topcaps timberpilin�s(12"diameter x 20') timber wale"rs stringers tie rods and deadmen•repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairwav due to Hurricane Sandy dama�e; � ' At 3925 &3995 Nassau Point Road, Cutcho�ue - . � Suffolk County Tax Map#1000-111-9-5.1 &5.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated Janua ,ry 29,2013 pursuant to which Trustees Wetland Permit#8048 - � '. - � Dated Februarv 20, 2013,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 renair and/or r�lacement of existin�failed bulkhead sheathin�with vinvl sheathin��air andlor replace top caps timber pilin�s (12"diameter x 20') timber � walers stringers tie rods and deadmen• repair andlor replace existing 3' wide staircase and platforms �3'x4')• and replace seasonal aluminum 3'x15' stairwa�due to Hurricane Sandv dama�e. The certificate is issued to ANDREA PARKS owner of the aforesaid property. � �� - Authorized Signature %� � ' . . ' � 4 F a, 1 ��f _ l r ��iE�T.'I-�i+i: John M. Bredeme er III President ;y��-oSu�FO(��o�t:, Town Hall Annex Y , o G s, Michael J. Domino, Vice-President �a y1'=�, 54375 Route 25 Glenn Goldsmith �� •' ?" P.O. Box 1179 A. Nicholas Kru pski ''u� � �'� Southold, NY 11971 Charles J. Sanders ��y�o! �,a��� Telephone (631) 765-1892 �'J=�u��} Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD `'- ��o�i� DA�E OF INSPECTI�N: �C275 C 11 h. h. 1 . INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction � '/z constructed � Project complete, compliance inspection. INSPECTED BY: N��f�Qs�''`' COMMENTS:,S��S ��� Gvrte�j' .pd��f��e /�,,, ��. CERTIFICATE OF COMPLIANCE: James F.King,President �O+11gtlfFi?( cOri Town Hall,53095 Main Rd Bob Ghosio;Jr.,Vice-President a y� _ P.O.Box 1179 Dave Bergen w Southold,NY 11971 John Bredemeyer �,y ♦ �� Telephone(631)765-1892 Michael J.Domino �4j ' `a� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO. SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line Is' day of construction / % constructed Project complete, compliance inspection e°°04°4 P4/°/rrpa,-'� ,.'d•a°¢q°4°4°.e°1r/eopo�-:;.. "� a o\;._ ..., iae 0.rs °°a.rrr's' ,-h.,aa �....: Ch a°r• >qq@y'_ 1is 0\ a OIV a\qe i/!� `�0004 1i11�' ,, Q�41N /1110°y a0i01if f10/�a `1�149 O1'j0o� �.�"�� -- ,.G,"-�'.�—.-..... W,`�r ,.'.�„"' f .�✓""uw+�,�wu�>t„"",,�,,[s/, ._ ..Y'u"t�'��u.ww,4"WW .�w,.''."� �""wuW....�.u�'"",yy. ''� ::L.:tu•�. e .x n .w.aa -.U.a ir :a�,: 1-- x t 0 BOARD OF SOUTHOLD TOWN TRUSTEES. SOUTHOLD,NEW YORK PERMIT NO. 8048 DATE: FEBRUARY 20, 2013 yl°4 ISSUED TO: ANDREA PARKS PROPERTY ADDRESS: 3925 & 3995 NASSAU POINT ROAD, CUTCHOGUE 69deae SCTM# 111-9-5.1 & 5.2 odno'4°4 e'pia,r AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 20,2013,and in consideration of application fee in the sum of WAIVED as per Town Board Resolution#2013-60 and 2. subject to the Terns and Conditions as stated in the Resolution,the Southold Town Board of Trustees a�g014 Il/r� j authorizes and permits the following: `r Wetland Permit to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide � ssso+ staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage; and as depicted on the project plan prepared by Andrea Parks, last dated on January 29, 2013 and stamped approved on February 20, 2013. �4te1�+ 1 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 this date. _ 1\� NIA� frla W x o r l� c `�ryY°Rik 1f11rc Ei B r 4R.. axle F 3 4 Z� -' '. -'y pt 1OEM% 9� A ��t �^ �� /\ C � '.. .�' '] \ i�._.. +`'•. !\v k °0lQe' -.;': �r S�."e��6 90pa�� _;: ^i���, 0�@��i9.^..:.: ..' :ragi/0 41@e�o ..xgae'� d1Nyi? :' =?es114 01@00a -�•°o�9�f 1��'.•e qe ` eeatb �_-.., t,,see asa aae eaa ��w,_s�fr� /.. ,,,,. \f%r�, _. .:: - r. �� .. :_�: �./,g:. ,:,. "-•!::o°°•. � ,.�`\s ea :\ �e� eae .a! �. t- TERMS AND CONDITIONS The Permittee Andrea Parks residing at 3925 &3995 Nassau Point Road,Cutchogue,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 Pennittee 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 Pennittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. Y ATION VIEW Scale: i.o" - ga.®' PARKS JA N 2 9 2013 1 1—J PK=5 3925-3995 NASSAU POINT RO CUTCH A old Town Board hf Trustees OGUE BLUFF STA.TR'1A%AY TOP of BLUFF APPROVED BY j . `BOAR , 0 OF SOUTNOLD - nan sUd ',TP -t.SHEATIT-ING(i8'D) S D, 2 2� h a o R�1PRst2 o�,( f o r � (l�C vi�T1f � a ,TcP CAP(2 x 1 s^)P' PROPOSED PLATFORM(8'x 4') Cy 4 to xi z --- O .z +_ 0D 140 0,_ 10.n n PROPOSED^S'T--URA A (&x 15') peppv 9(DOWN Positionj PPG*= =B TLndBEP=PILJNGS (12"gyp) ��` 'N1 o ti � �orvv�o-i14iBER`•-'_S,� `" n '', � fYT - c*,A /c)y P-eAkFt - ----- __ 200 t.0' d =K'M(along, �Z. F t - j•` . E STING- E PROPOSED TOP CAP (2" x 18") PROPOSED PLATFORM (3.0' x 4.0') klog vw-, - of ROD OpOSED TIE_ pp Q s p O e U) © O ® o rn Q o� d ply O a p pO STAIRWAY (3.0' x 15.0') co o O O obi- 9 O ' aoo� 0 d 5 u rvey of Lot 22 - "Map of Nassau Point Glub Properties, Section All Filed on October 14, lalci 05 Map # -145 5G NT# 1000-III-1-5.2 � E C� CDti� E WE Surveyed: 08-10-04 i Situate: Nassau Point I S Town: Southold Ij JAN 2 9 2013 Suffolk County, NY li SCALE I"= 40' Ij Southold Town �i Board of Trustees GertlPfed to: ,�,{ � Jonathan Parks Tenn15 Court �I - 1 I� lI ---35' +/- Andrea Parks ®�guy x 1 ` li PeconGitimo cage Inc. 41C 1 4 l) Peconic Abstract Inc. 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GertlHcO- uMol PIo41noS tOM o e rot arsf arable addlllanl Nstl Lort PREPARED BY: C107 6 7 NVP SEA LEVEL MAPPING a THIS PLOT WAS DEVELOPED I t A 3 0 FROM SURVEYS OF 08-10-04 P.O.BOX�538 ��� LOT AREA (to tie Iines)� ROBERT H. FOX,NYS Llc#50191 RIVERHEAD,M'11901 PH 631--122-9430 Sheet I Of 1 Lot #23 = 41,IG5 SF 5/16/2004 2:44:05PM G:%E—in 04- 04-slm\porkso815o.pro TE -AT10N VIEW PARKS 3925-3995 NASSAU POINT ROAD CUTCHOGUE D L C� C 0 �1 C JAN 2 9 20i3 BLUFF S`I`AjR1,x%AY / Southold Town M1 _ Board of Trus ees TOP of BLUFF 0 PROPOSED VPi Yj-SHEA ITILNG(18'D) N*', a ��c o 'd • as PROPOSED TOP CAS(2"x 18") o� a' PROPOSED PLnT'FORIbI(3'X 4� C 60 0'+ ------------ 140 0, ., r 1 PROPOSED STAIRWAY(.3'x 15') ----J 4(D05[•'N Position) PROPOSED T'L!TBEP.PTLIIVGS(12" 1 PROPOSED fiUMBER'-:'ACERB -- ---200w,± fi0 STAII2lTdAY:140'±fro E uo=ez ,xom an.uomex STING PROPOSED TOP CAP (2" x 18")�' TIN a PROPOSED PLATFORM (3.0 x 4.0,) ofBLUFF _es_ zk ED TIE_RpID pROPps O �p e Q pYOp C7 Q O O s LOG�� 1+ o n p 8 j PROPOSED STAIRWAY (3.0' x 15.01 . co ; co N �e b OCR K . Vtq qJJ r� ti N t7' ",LE A IOVIEW s 'SE �'d ITp ONS Scale: 1.®" _ 20.0' ± PARKS 3925-3995 NASSAU POINT ROAD CUTCHOGUE BLUFF STAIRWAY �a TOP of BLUFF o 0 0° PROPOSED VhNY'L SHEAT't3ING(18'D) a ��c aoe b ( 1 PROPOSED'TOP CAP(2" PROPOSED PLATFORM3'x 4 a � � W e '0 O 64 0'± 10 140 0'_ �tJ .c 1 410A'± PROPOSED STAIRW-j4Y(:3'x 151) 9(DO`�:'N Position) PROPOSED TLMBER PILINGS(12" PROPOSED'TINIBER t S(7°x 8") 't t .200 t � - — ` EUSTING VZ PROPOSED TOP OAP (2" 18") PROPOSED PLATFORM (3.0' x 4.0') BOOM ofBT�FI � ED TIE-ROD �l0 O© ©o ' FROPOS a. Q Iwo 191 6 CA g U� Q g® g BOG 11 �+ PROPOSED STAIRWAY (3.0' x 15.0') co o 0% O g c S: .e1 ✓ p � ` � r N OG' � O d c - C7cn m N UNDRA,,: cS� EJ U f Veil of Lot 23 N "Map of Nassau Point Glub Properties, Section A" w.+-Z-1 .E Filed on October 14, KIM as Map # -145 SGT# 1000- '-ci-5.1 S Surveyed. Ob-10-04 Situate: Nassau Point Town: Southold Suffolk County, NY U 't `11 SCALE I"= 40' 't �• t Gertlfled to: Mon o' Il tt Andrea Parks Gitimortage Inc. Peconic Abstract Inc. ° Fidelity National Title Insurance Company of NY ° -a (� #FNP01032 ------ ' Q0 ' :"" ---------- 0' ° Z 413• 1 o = Gone°Pr..... N _....... °fa orth 10.0 t. pC�" y 1 NCO CI = 036 50 ' 1 , u 1 y 1 rn 1 — p �.It � G' ° step 1 9 �, FI , O eod wires ul; N PotiO O `n 5tr p ° o co =+ NoUye o fl ° Ihloll 3qt +�� -i 1p -6 O - t ! v'°�°a O Z o0 Lot LID b si _ 0 65 011 �\ v O - y„o,tnorizetl olterotkn a Daemon to wvey mop oorkg o—re to a torveyor•t sem't o [ion tbn o k;iot.E lslon 7.OF t - Nen Yak Stote EoYcotion La.+.' -only caplet from"orig—of this survey morkea 1 a,w-Igrol of me W D surveyor i zI-PWI tool shall be ontlOeretl LO lTe vOlitl true caplet' "Lot ° L 'LertlFkot:ons—1.—tl hereon skf':ify—Wt �`� survey- 1 1-te0[+oecore 51 V the ex- M C' Z by[N Fl york Slate A o bb of ProF—b i C Lo,tl S:Fveyors. rJO�tl certlf kaLbns y1011 nm only [,Y[l Ord On.0 Ue 1 F[o t B MW COmpo�'y.gOvepa�eC Q, tol agency one levrg zu on l,tea ro reon,o d th.�zeroi Uo'sf-l'�G beet-Ol Ottlw ro O Gu PREPARED BY: m SEA- LEVEL I MAPPING THIS PLOT WAS DEVELOPED RIVERHEAD,NY 11901 P.o.Box 53b LOT AREA (to tie lines): FROM SURVEYS OF 08-10-04 ' PH 631--122-993o ROBERT H. FOX,NY5 Llc#50191 Sheet I Of I Lot #23 = 41,IcI5 SF 8/16/2004 2:44:ObPM G:\6Emoin 04-IQ-04-5lm\porYs0815a.pro James F. King, President �OF SO!/T Town Hall Annex O Bob Ghosio,Jr.,Vice-President �� l0 54375 Main RoadP.O. Box 1179 Dave Bergen Southold, New York 11971-0959 John Bredemeyer G p@ Telephone(631) 765-1892 Michael J. Domino ��UNT`1,�y Fax(631) 765-6641�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 20, 2013 Ms. Andrea Parks 3995 Nassau Point Road Cutchogue, NY 11935 RE: ANDREA PARKS 3925 & 3995 NASSAU POINT ROAD, CUTCHOGUE SCTM# 111-9-5.1 & 5.2 Dear Ms. Parks: The Board of Town Trustees took the following action during its regular meeting held on . Wednesday, February 20, 2013 regarding the above matter: WHEREAS, ANDREA PARKS 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 January 29, 2013, 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 February 20, 2013, 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 ANDREA PARKS to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage; and as depicted on the project plan prepared by Andrea Parks, last dated on January 29, 2013 and stamped approved on February 20, 2013. 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, C ' James F. King President, Board of Trustees JFK/amn James F.King,President too Town Ball Annex Bob Ghosio,Jr.,Vice-President w, 54375 Route 25,P.O.Box 1179 Dave Bergen Q.f + Southold,NY 11971 John Bredemeyer ' Q aQ 1 Telephone(631)765-1892 Michael J. Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: AV) oe-0, Par s Please be advised that your application dated113 has been reviewed by this Board at the regular meeting of Z b S . and n o your application has been approved pending the completio the ollowing items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 t Day of Construction ($50.00) '/2 Constructed ($50.00) Final Inspection Fee ($50.00). Dock Fees.($3.00 per sq. ft.) 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: $ S BY: James F. King, President Board of Trustees Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 �J Telephone(631)765-1892 Q1 y` Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Tues., February 12, 2013 the following recommendation was made: Moved by John Stein, seconded by William McDermott, it was RESOLVED to SUPPORT the Wetland Permit application of ANDREA PARKS to repair or replace existing bulkhead using vinyl sheathing; repair or replace staircase, platforms and seasonal aluminum stairway. Located: 3925-3995 Nassau Point Rd., Cutchogue. SCTM#111-9-5.1.& 111-9-5.2 Inspected by: John Stein, William McDermott The CAC Supports the application and recommends a bluff stabilization plan. Vote of Council: Ayes: All Motion Carried r n D E C , FEB 1 5 2013 I L Southold _Board of Trusicrs OSUF FQ(,�. James F.King,President P.O.Box 1179 Bob Ghosio,Jr.,Vice-President Southold,NY 11971 Dave Bergen ' - Telephone(631 765-1892 John Bredemeyer Fax(631)765-6641 Michael J.Domino Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: 7 ;�a / - ANDREA PARKS requests a Wetland Permit to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage. Located: 3925 & 3995 Nassau Point Road, Cutchogue. SCTM# 111-9-5.1 & 5.2 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound �y Distance of proposed work to edge of wetland . Part of Town Code proposed work falls under: ✓Chapt.275 Chapt. 111 other Type of Application: y Wetland _Coastal Erosion _Amendment Administrative_Emergency . Pre-Submission Violation Info needed: Modifications: aAl el Conditions: Present Were: J. Kin �8. Ghosio '�D. Bergen, yJ. Bredemeyer Kin Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: RESOLUTION 2013-60 ADOPTED DOC ID: 8430 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2013-60 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JANUARY 2, 2013: RESOLVED that the Town Board of the Town of Southold hereby waives Trustees' permits fees for any repairs or construction, that in the sole discretion of the Board of Trustees, are determined to be related to Superstorm Sandy,until February 1, 2013. Elizabeth A.Neville Southold Town Clerk' RESULT: ADOPTED [UNANIMOUS] MOVER: William Ruland, Councilman SECONDER:Albert Krupski Jr., Councilman AYES: Ruland,Talbot, Doherty, Krupski Jr., Evans,Russell t�i / 1 ills 10 r.tar. _ 0 f t.. 4106* ', %b# ��+ � 'N, �• � ` '"IR"' � ,.^" i � AIR !� ,1. ss NMI ,�, .... ,fir A. �` ,may � ^.. � _�/► • � $ ^ W s � w ,E ro 7, • .. aF 7 F. S .t s, w i. a' �r A � H � � v f 3 4W." as r; Opp wY" � 7" + i !� � * q,.4& t Idol X t but � _ ,i try► ,'�" 8 i r � „ r 'w_" _ .• r► fir,= IF \ iM;b11. • +i► __ �.- ,fir '�,! '�► '�-. 1 '+� fg .. i�- �.:t� "ter s1F .. J•.it � t►y. 4, IW iell • i IMP 40 Z_ Ma" y ��.•�� �!y'1 �; •� • .,ice .• . v - / i I � a 4 w *%OPP CAM'.. NA 10 R� yy �y w.. sr- 0._. w'e1 Owl Ih� All • wTM - n .�- ' . w to .r tA40 jk Lk, } i r ,erg • �ti_ - �` � � �+, GOP, M ._ �%. R 1; to r%Fw A-'. 10 i R '• ' " .. it N low •4, ► �s �bS Y 4 h r ; t a, �� �xr � ►x w • ....-•-M�'." 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Box 11779 SS: Town Hall Annex 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) y Telephone: 631 765-1938 Southold, NY 11971 O �O Fax: 631 765-3136 UNTI,�� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM ttcc To: Jim King, President , E C E V E Town of Southold Board of Trustees, ! r, From: Mark Terry, Principal Planner FEB 15 2013 LWRP Coordinator Southold Town Date: February 13, 2013 -Board of Trustees Re: Proposed Wetland Permit for ANDREA PARKS SCTM#1000-111-9-5.1 & 5.2 ANDREA PARKS requests a Wetland Permit to repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sandy damage. Located: 3925 & 3995 Nassau Point Road, Cutchogue. SCTM# 111-9-5.1 & 5.2 The proposed actions have 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 above actions are CONSISTENT with the LWRP. Note that the Board issued a permit for the stair in 1993. A permit was not found for the bulkhead and seasonal ramp and they should be considered new construction. a�� R i Board Of Southold Town Trustees' -' SOOT OLD, NEW YORK PERMIT N0—,AA4? ,,£ — DATER ..:J6Dat!94:.._.._ MUED TO EAnt4artzativit � Pursuant to the presfir iw" a€ of Chapivr 6.I.5 of the saws of a Act Stake.of Now York. 18?3,am Chapkr of the Lava*f fie ` SWu # N I'�t Southall Town Ong'aa e f 4ted "REGULATING AND THE PLACING OF OBSTRUCTIONS 1 s' IN AND ON -TOWN WATt S AND ,PUBLIC 'X.&NDS AMJ6 }. REMOVAL SANI�, �'�I. OP. O 1 R MATERIALS FROM k t LANDS UNDER TOWN WATER$:" anJ in ac rd 'With true w - Ras Finn of The IIl mtaf'ndop foj at a ft*ght! t, . i <M �', ,�94 ° + I9....9 " and 'M C085 d0"dian of#hq sum of jid by - o iNIi"I tT , N. Y. arod suwkf ta�the 'berms and candiita es Ifsted an f e revom side hates" + �� of Southard Town Trustees authorize and permth t ° owimsp_ Gran+i£4t t` St,*ra t to rat,nmvtruut stairs (59r X 361) :r :iurvey. xa*saga Point.. r }I all 16 aecvrdenice with the clrA%&� specifimations as prosmde4 ire IN 1+ JTNM WHEREOF, 'fhe sa;i and of'Trud"s late. 1:�Y Cagle& ih car ra+e SOA fo bo,aff d, fhosa �� fo be suhsaribed bar at mtaMy of the setd Lam as, of i s +� t .. �L.(� ,��. t�es.,cxx' >,.vse.�rm �°w>.awe.t'�W..s..u..._.._a....... M�•i Pk��. .. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F.King, President of SU(/T� Town Hall Annex �0� ®�0 Bob Ghosio,Jr.,Vice-President 54375 Main RoadP.O.Box 1179 Dave Bergen -' ' Southold, New York 11971-0959 John Bredemeyer • Crz Telephone(631) 765-1892 Michael J.Domino O Fax(631) 765-6641 �yC4UNT`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Woastal Erosion Permit Application etland Permit Application Administrative Permit / Amendment/Transfer/ tension , (i (� 2 p ✓Received Application. E l� l5 v ,Received Fee:$ WANE e SA Lxrh' h#ZD),3-�� Completed Application _Incomplete JAN 29 2013 _SEQRA Classification: Type I Type II Unlisted Co Town ordination:(date sent) Southolduste �LWRP Consistency Ass ss ent Form 2 3 ar f Tru tees ZCAC Referral Sent: Date of Inspection: _ "u Receipt of CAC Report: _Lead Agency Determination: Technical Review: _Public Hearing Held: Resolution: Name of Applicant �S� �O l Mailing Address ��� � I l � �� If) Phone Number:( ) �" Qq 5 Suffolk County Tax Map Number: 1000 - C'' CO 1 l ( —`� Property Location: hQ,3SQW V(3 I n 7E7 QOO\A ,n " a3r-e)I rnile— (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: , i Boa-rd of Trustees Application GENERAL DATA Land re feet): 6-At oo ea(i s a PqQk Area Zoning: Previous use of property: 9QG16-0-,n o.l Intended use of property: f&r�bcam. I. I Covenants and Restrictions on property? Yes No j If"Yes", please provide a copy. i 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. I Does this project require a variance from the Zoning Board Appeals? Yes No If"Yes",please provide copy of decision. Will this project require any demolition as per Nertificate Code a, determined by the Building Dept.? Yes NoDoes the structure (s) on property have a valid of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior pe its/approvals for site improvements. Has any pe t/approval ever been revoked or suspended by a governmental agency? No Yes If yes, ovide explanation: I Project Description(use attachments if necessary):Pl QS F ( Gr a 1_� v) COAP5 � 3\r' �7'/Y Vl1 d��C�l'S 5 nq �(C r-0 Js dl e rror c�►� dr.�Q/oy- Bo ; 1 of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA e Purpose of the proposed operations: `-20-t � bo jo_�)r�k�9 inn eick/1Ij 2� 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. cu 'c yards l How much material will be filled? ubic yards Depth of which material will be removed or de osited: feet Proposed slope throughout the area of ope tions: Manner in which material will be re ved or deposited: Statem/oftect, if any, on the wetlands and tidal waters of the town that may result by reasonosed operations (use attachments if appropriate): it 617.20 SEQR PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY :W SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME (�'��c' r, SWT K S 3.PROJECT LOCATION: Municipality rQ c County 4.PR ISE LO ATION: Stree Addess and Road Intersections, Prominent landmarks etc -or p ovide ma 39 - 9�5 `H�s poll ( t . (' . \(P �Ta� f i 5.IS PROPOSED ACTION: ❑ New ❑Expansion ❑Modification/alterations r' ` 1 (,���epf� Vlp a i 9 I i 6�QESCRIBE�'P f J�CTF "�I� � -" '�� '`�-�i le� �U�1k 5' `'Un 1i llJ�r�j �yt, (Ul I f (tom` 1 t 1 st��`�-1�,�� ; Q��-1� c�r+�joY re:Pl cA e�F�� cr�,��, �-i��n 1�e� �i� ,►�s C I2' �0 20'� i -b r .lva1 exs,n1cSe2 a�' 011 V-N V1Sfco�n �1e.Vcl,��o� t2�� ,"`^ `1 r►v���ne Sc�np� R 7.AMOUNT OF LAND AFF TED Initially goo ^aeres Ultimately pZd0 aasr SQsk 8.WILL ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes ❑ No If no,describe briefly: I I I residential AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ❑Industrial ❑Commercial —]Agriculture ❑Park/Forest/Open Space ❑Other (describe) 1 1WEI ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL Federal, State or Local) No If yes, list agency name and permit / approval: 11.DOES ANY A CT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes o If yes, list agency name and permit / approval: 12. AS A RESULT PR POSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ❑Yes ❑No I I CE FI T AT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE i Applicant / Spons e ' rate: Signature If the action is a Costal Area, and you are a state agenc , omplete the Coastal Assessment Form before proceeding with this assessment i ' i PART If- IMPACT ASSESSMENT o be com feted by Lead Agency). A.DOES ACTION EXCEED ANY TYPE(THRESHOLD IN 6 NYCRR,PART 61TA? If yes,coordinate the review process and'use the FULL EAF. ❑Yes Q No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another involved agency. El Yes a No. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,If legible) C1. Existing air quality.,surface or groundwater quality or quantity,noise levels,existing traffic pattem;solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetio,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly. C3. Vegetation or fauna,,fish,shellfish'or wildlife species,significant habitats,or threatened or endangered sp'edes?Explain briefly: C4. A community's existing plans or goals as officially adopted,or a•change in use or intensity of use of land or other natural resources?Explain briefly- CS. _...... ..__ _....... ...... _. _.. ......__._....._ _ _ C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: Long term,short-term,cumulative,or other effects not identified'in Cl-05? Explain briefly: -- •• C7.•Other impacts(including than es in use of either quantity or type of energy?D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF"A CRITICAL ENVIRONMENTAL AREA CEA? If .es,ex lain bnefly: ElYes 0 No E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es explain: ❑ Yes a No . PART III-DETERMINATION OF SIGNIFICANCE(To.be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whetherit is substantial,large,important or otherwise significant Each effect should be assessed in connection with its(a)setting(i.e.urban or ruraq;(b)probability of occurring;(c)duration;(d)irreversibility;(e) geographic scope;and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain- sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part fr was checked yes,thedeteanination ofsignificance mustevaluate the potential lmpactofthe proposed action onthe emilronmentalcharacteristiks of the CEA. Check this box if you have Identified one ormore potentially large orsignificantadverse impacts which MAY occur.Then proceed directly to the FULI EAF and/or prepare a positive declaration. Check this box Ifyowhave determined,based on the information and analysis above and any supporting documentation,that the proposed actio WILL NOT result in any significant adverse environmental Impacts AND provide, on'attachments determination. as necessary,the reasons supporting thi i Board of Trustees Name of lead Agency President Print or Type Name of Responsible Officer In Lead Agency Title of Responsible Officer of Responsible Officer in*L,, — gfgna(urency Signature of Preparer(If different from responsible officer) James F. King, President Town }-tall.53095 Main Rd. Bob Ghosio,Jr. .Vice-President } ,}. , P.O. Box 1 179 Dave Bergen ! Southold.NY 11971 John Bredemeyer W d� Telephone(631)765-1892 Michael J.Domino �� �`� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD D EC IVE BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- F E B 2 0 2013 In the Matter of the Application of Southold Town ANDREA PARKS f Tr COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING i� I,A?'1CfQa � �K-� , residing at/dba 39z,5- - SggS N(zk 1�l,� �'� being duly OvJrn, depose and say: ThqAon the S d y o rL r01 I Personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight dayscrriuo to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, Fa 20 2013. Dated: (sig t Sworn to before me this ?day of e u690 13 ELIZABETH A. FARNAM Notary Public, State of New York No. 01FA6162855 Qualified in Suffolk County otary ublic Commission Expires March 19, 2015 NOTICE- OF H, EARINGI NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD. n rec�. i0orks SUBJECT OF PUBLIC HEARING: To repair and/or replace existing failed bulkhead sheathing with vinyl sheathing; repair and/or replace top caps, timber pilings (12" diameter x 20'), timber walers, stringers, tie rods, and deadmen; repair and/or replace existing 3' wide staircase and platforms (3'x4'); and replace seasonal aluminum 3'x15' stairway due to Hurricane Sand damage. TIME &. DATE PUBLIC HEARING- Wexkn"t, Fe647'-V!Mr1,,20,, 2013V0A or a�� 6 If you have an interest in this project, you are invited to view the Town file(s) which are available for ins ection rior to the day of the hearing during normal business days between the ours o 8 a.m and 4. p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 PROOF OF MAILING OF NOTICE F E B 2 0 2013 ATTACH CERTIFIED MAIL RECEIPTS Southold Town BoardTrustees Name: Address: 03fjj�, Nil � I �agS��rno nn N�C�Q cco-nt7 KO a4 F(a r Y-) o a,) STATE OF NEW YORK COUNTY OF SUFFOLK b , residing at 6j- @ q 04 being duly sworn, deposes and says that on the 18 ay of , 201�, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said rsons as shown on the current assessment roll of the Town of Southold; that said Notic ere mailed at the United States Post Office at�nee- — , that said Notices r mailed to each of said persons by CERTIFIED MA /RETURN RECEIPT. Sworn to before me this Day of T: ,b rua M , 20 13 ELIZABETH A. FARNAM Notary. Public, State of New Y� 55 l 01 Suffolk Co Qualified in Suffolk Count~, Nota Public Commissian'�Expires March 19, �6�1�SUIFQ/r�a Town of Sou-mold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN District Seci'wn — o- -K— Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. I I SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels locaied within �� Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (S.F. Acres) (This item will include all run-off created by site / b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed ®� , Site Improvements and the permanent creation of construction activity? (S.F. Acres) impervious surfaces.) / 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages as Needed) Drainage Structures Indicating Size&Location?This t Y d/� c ) Item shall include all Proposed Grade Changes and I Slopes Controlling Surface Water Flow. / t�� p / Does the Site Plan and/or Survey describe the erosion 4-r-��7�c� � and sediment control practices that will be used to VVV_ control site erosion and storm water discharges. This 1^h}�2✓ W�f.��s 1n h4s , 612� Yo�S Item must be maintained throughout the Entire "� -((�� Construction Period. CARacky"Cky) LgP-_t"t( 6"d JOY reP1 Clce 4 Will this Project Require any Land Filling,Grading or / _ Excavation where there is a change to the Natural 1J/ L?C f S 3t f l r0� Existing Grade Involving more than 200 Cubic Yards — f' of Material within any Parcel? C2_)cL0 9 S2Q.9v� �I�°�^ �� ``3 tx 16� 5 Will this Application Require Land Disturbing Activities Sl T Encompassing an Area in Excess of Five Thousand ❑ — e� W� (5,000 S.F.)Square Feet of Ground Surface? eta Lin cj�� !-_� 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction — General DEC SWPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to — including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the NOI.The Not shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, l required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder —compliance with the terms and conditions of this permit.In addition,the SWPPP shall identify potential sources of pollution which may reasonably be expected to affect the Area?(This Item will NOT Include the Installation of Driveway Aprons.) fY P P Y Y P !. quality of storm water discharges. NOTE: If Any Answer to questions One through Nine is Answered with a Check Mark I 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.&1 Acre in area, component shall be prepared by a qualified Design Professional Licensed In New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. (NOTE: A Check Mark(4) and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, I COUNTY OF..... !..�.SS i' ��} r .........being duly sworn,deposes and says that lie/she is the applicant for Permit, That I,.......Y..�!...�.1�...-........... :�...�.�. . (Name of individual s!gning Document) Andthat he/she is the d "I-./........................................................................................................ (Owner,Contractor,Agent,Corporate Officer,etc") Owner and/or representative of the Owner or_Owners;and is duly authorized to perform lave performed the said work and to make and file this application;that all statements contained in this application are true t e est of his knowledge and belief;and that the work will be performed in the manner set forth to the application filed herewj Sworn to before me this; .30 yot✓c'1 (3 I r ................:..............................day ,20..... i ic: ....0 G .........Notary Publ 1l. ;I ......... .................... ............................ (Signature of Applicant) Notary Public 1� New York FORM - 06110 No.OILY06190696 Qualified in Suffolk County Commission Expires July 28, Boa of Trustees Application County of Suffolk State of New York i i 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 TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE T TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S),TO ENTER ON Y PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH R I OF THIS AP P ICATION. Si n u of Property Owner SWORN TO BEFORE ME THIS DAY OF JAdU I 2013 ae Notary ubli NMMy=L Z��WE FJN York No.01A 634"05 Qualified in Suffolk Count Cmn ission Expires May 31, I`� I j. 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 puraose of this form is to provide information which can alert the town of possib16 conflicts of interest and allow it to take whatever action is necessary to avoid same^.,� YOURNAME: F- t-5) A(�N "�'�� KE—-� (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 ' person's or company's name.) NAME OF APPLICATION: (Check all that.apply.) 'Tax grievance Building Variance Trustee Change of Zone Coastal Erosion I Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) I Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship.with any officer or employee of the Town of Southold? "Relationship"includes by blood,Marriage,or business interest."Business interest"means a business, including a partnership,in-which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO f If,you answered"YES",complete the balance of this form and date and sign where indicated. I' Name of person employed by the Town of Southold i 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): I!, I A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); I 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. I �I DESCRIPTION OF RELATIONSHIP ,1 is i Submitted this"dayof0Q � Signature Print Name Form TS I } i I I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form.should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 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 consist ❑ ds and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: o i at tlhe Xon oRMScuth website (southoldtown.northfork.net), the Board of Truste Of ice, the Planning ep rtm nt, all local libraries and the Town Clerk's office. Southold Town B. DESCRIPTION OF SITE AND PROPOSED ACTION —Board f stee SCTM# f oop 9 9 -6_2 PROJECT NAME eu r J. 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: QLce Q3C� -�,�Je Na e and extent of action:tug She-e��4.r C31 0V-4: � v►„ in U M -z�j a V V,) P Location of action: Site acreage: Pre x Present land use: ��of Present zoning classification: A e5 *"J1 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: ecv (b) Mailing address: �\ � led V� (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No El// 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 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. ❑Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III=Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No FV1 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No Not Applicable i I Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes No L18Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the* quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages.22 through 32 for evaluation criteria. ❑ ❑ [A Yes No Not Applii__ _e Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable - Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.. ❑ Yes ❑ No Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the.Town of Southold. See LWRP Section III=Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye�] No 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 [" Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No 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 LA Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY An Awjj- Q3yyz TITLE 003 ��� DATE 1 13