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TR-7927
r g11fFQ(�- James F.King,President �q� cOG Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President o �� P.O.Box 1179 Dave Bergen 64 w Southold,NY 11971 John Bredemeyer.. • Telephone(631)765-1892 Michael J.Domino Oj �`aoe 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 1st day of construction. % constructed Project complete, compliance inspection b 1 c, -��V'♦�, �i ♦r.`� poi r4.,-'_:....e „�h.'s'r,, "-yN.�1lY - - .i .�iri - .eP��•!•', •li �� 'i �Q % 1`I It .. �t 1� 111/,'gg 6, , '�'°, ' 18'k` ''TM-' ''<'' 4�S:E�'.`'' °S'�1 £...' '.> >..... .^... ;SL:' ..'. '''-. '•4S1!'. "�'' ''''3"x° °''1°�.' '?N"°1."�43?•°�'n'!;P''„1'' &f"'.2'k'."' BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK Y - ..�, PERMIT NO. 7927 DATE: OCTOBER 17,2012OWN ISSUED TO: JUDITH HOCKEMEYER ' ., OF PROPERTY ADDRESS: 285 BAYVIEW AVENUE, SOUTHOLD SCTM# 52:5-27 i AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of-Southold and in v accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 17,2012,and in consideration of application fee in the sum of$250.00 paid by Loriann Patamo and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the ,r. „- a�Its following: Wetland Permit to remove existing timber bulkhead and replace with 49 linear feet of new vinyl bulkhead and raise it V above existing with a+/-32' return and a 15' K e. return; and provide 30 cubic yards of clean fill; with the condition of establishing and ._'+r'� subsequeptly,.maintaining a 10' wide nowturf buffer.along.rptprps,and a 15' wide non turf buffer along landward side of bulkhead; and as de irted,on.the�site lan;, re pared � g �.. P�. P P P by Jeffrey Patanjo, last dated October 19, 2012 and stamped approved on October 31, s� 2012. J Alt 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. 17 - ( •YII+ � �� - coo M �gUFO ,�c John Bredeme - i� 4 K � � �/J'�".:•�`-�0fEs3-�'u�ai+`�f:u'Y�:�'7�5'G+A.'a��?':[`uaX.�.:�i°'a'"k'�nivasitiinsxY3sS��ik9":tF:+"Zr`tu`�'�an�'�;U:�""�ii°'r.�,?d�3i'�5'aid;%'u'i�a".�'i'et".Yii�. r. e�' BFis�a - :: ,lF'i2G t� �`•�{. :���4��1�1�1..,✓r.; �...AAiI,�/�ti�.r .: _ �,���Ii1��1+1.L _.,,� �`�,i'/�� _..,.,// +1�L. .��,1 0 Ise �-' - ^e�l� 1 1� • _ .._ .. �`a-� acs✓��. _«-, s.:.�. -� -- .:•. ' -,. c..Ns!a .•.. - �_....�:.0�,..- s.� ...:�>�:4 _ �� .:::L', _�- TERMS AND CONDITIONS The Permittee Judith Hockemeyer,residing at 285 Bayyiew Avenue 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. James F.King,President Qf S0 Town Hall Annex 54375 Main Road Bob Ghosio,Jr.,Vice-President P.O.Box 1179 Dave Bergen [ C $outhold,New York 11971-0959 John Bredemeyer N ,e G pQ Telephone(631) 765-1892 Michael J. Domino '�Q�yC � � Fax(631) 765-6641 COU , BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 17, 2012 Mr. Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: JUDITH HOCKEMEYER 245 BAYVIEW AVENUE, SOUTHOLD SCTM# 52-5-27 Dear Mr. Patanjo: - The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 17, 2012 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of JUDITH HOCKEMEYER 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 September 13, 2012, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the.Town Trustees with respect to said application.on October 17, 2012, 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 JUDITH HOCKEMEYER to remove existing timber bulkhead and replace with 49 linear feet of new vinyl bulkhead and raise it 1' above existing with a +/-32' return and a 15' return; and provide 30 cubic yards of clean fill; with the condition of establishing and subsequently maintaining a 10' wide non-turf buffer along returns and a 15' wide non- turf buffer along landward side of bulkhead; and as depicted on the site plan prepared by Jeffrey Patanjo, last dated October 19, 2012 and stamped approved on October 31, 2012. 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 Ve truly yours, D James F. King President, Board of Trustees JFK/amn James F.King,President y Town Hall Annex Bob Ghosio,Jr.,Vice-President Q 54375 Route 25,P.O.Box 1179 Dave Bergen y �'� Southold,NY 11971 John Bredemeyer �4j �,'bQ Telephone(631)765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: '� O� C. Please be advised that your application dated 3 h2- has been reviewed by this Board at the regular meeting of 1 !b 7 2 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) 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: P( al Tnseec-hOti -Pee LSD.N) TOTAL FEES DUE: $ S© ©D BY: James F. King, President Board.of Trustees Peter Young,Chairman Q Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1892 ax(63`1;)J65-6641 1..!! �� C I111�� jjjJ(JJJJj Conservation Advisory Council OCT 1 2 20 j + i 12 Town of Southold ��:•, >s B��.r��u�7ruslees j At the meeting of the Southold Town Conservation Advisory Council held Wed., October 12, 2012 the following recommendation was made: Moved by Doug Hardy, seconded by John Stein, it was RESOLVED to NOT SUPPORT the Wetland Permit application of JUDITH HOCKEMEYER to remove existing timber bulkhead and replace with 49 If. of new vinyl bulkhead with 25'X 15' returns, raise elevation 1' above existing and provide 30 cy. of clean fill. Located: 245 Bayview Ave., Southold. SCTM#52-5-27 Inspected by: John Stein, Doug Hardy, William McDermott, Audrey Horton, Peter Young The CAC cannot Support raising a bulkhead by 1' and questions how high and how far out to sea can a bulkhead project? The application is absent of compelling evidence to show the need to raise the bulkhead. Furthermore, the bulkhead has eliminated the marsh grass and there should be a non-turf buffer Vote of Council: Ayes: All Motion Carried Judith Hockemeyer 215 Bayview Ave..Southold SCTW 52-5-27 101012 r i � 4 t � r ; " "r R r # a i "3• ?45 Bayvie-vN Ave.. Southold 101012 r - Judith Hockenievei yy - i.. :J► � :dY4"4'v�. _mow, � �. t s; 1 PROJECT , LOCATION \ r _ 0L.1 L J. . ... ... zoo>\ cg 5 o 00, 0. �1000ron ft PROJECT LOCATION MAP N.T.S. / N \ �� ✓ KfPPROYE BY \ p�,�Gbs /0 BOARD Of TRUSTEES0° � TOWN OF S4UT1 �.D \ �y es _10loe DATE 10 3, '� \ \�o019 l ri \ 0 NOTES. ro� � 1p 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM °'*0�`� ° �° � \ 2. LOT AREA: 7,905 S.F. / 0.181 ACRES >lp � \����" /off 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: Q �+ p ° � . i / �O PECONIC SURVEYORS, PC 1230 TRAVELER STREET, SOUTHOLD, NY 11971 SURVEY LATEST DATED AUGUST 9, 2005 0pll PROPERTY OWNER: PeA ° J. HOCKEMEYER �'+ ,�O Wyly 10/19/12 SOUTHOLD TRUSTEE COMMENTS (BUFFER & RETURN LEN. 166-26 POWELLS COVE BLVD. 9A �� DATE REVISION BEECHHURST, NY 11357-2050 S`' -� BULKHEAD PERMIT PLANS SCALE: LC 1"=20' PREPARED BY: PROPOSED PLAN & DATE JEFFREY PATANJO 106 HEWITT BOULEVARD OCT 2 5 2012 I'4' � LOCATION MAP s-1-12 CENTER MORICHES, NY 11934 } ________ SOUTHOLD, TOWN OF SOUTHOLD T"`''' SUFFOLK COUNTY, NY SHEET: TAX MAP NO. 1000-52-05-27 1 of 2 PROPOSED ALUMINUM OR CCA — TIMBER TOP CAP PROPOSED 12' LONG CCA TREATED TIMBER PILE, 6' O.C. PROPOSED 30CY CLEAN FILL FROM UPLAND SOURCE PLACED PROPOSED 3"X6" BEHIND BULKHEAD REAR WALE NOTE: REMOVE EXISTING BULKHEAD STRUCTURE IN ITS ENTIRETY AND. INSTALL NEW BULKHEAD IN THE EXACT SAME POSITION :::::. ::. :.: :..::::. :. ::. ::. ::.: . :::::.. .. .. . .. . WITH RAISED ELEVATION OF 1' HEIGHT ABOVE EXIST. TOPCAP APPROXIMATE M.H.W. EL 2.51 n PROPOSED 12' LONG CCA --------------------- ----— — -- — — TREATED TIMBER PILE, 6 O.C. n In �� __PROPOSED 6"x6" CCA PROPOSED 6"x6" CCA WALE TYPICAL OF 2 TOP & BOTTOM WALE PROPOSED 10' LONG SHOREGUARD 225 VINYL SHEETING PROPOSED 8" TIP CCA ! APPROXIMATE M.LW EL O.Ot PROPOSED 3"X6" LAY—LOG PILE REAR WALE EXISTING BULKHEAD ` EXISTING SAND BOTTOM PROPOSED 8" TIP CCA PILE, 6' TO BE REMOVED IN ITS ENTIRETY. LAY—LOGLWITHH3�4 BOLTED TO VINYL SHEETING DETAIL GALVANIZED THRU—BOLTS. PROPOSED 20' LONG 1" DIA. GALV. TIE ROD, 6' O.C. PROPERTY OWNER: J. HOCKEMEYER 166-26 POWELLS COVE BLVD. 9A BEECHHURST, NY 11357-2050 11"PROPOSED 10' LONG SHOREGUARD 225 VINYL SHEETING PREPARED BY: TYPICAL SECTION A-A JEFFREY PATANJO 106 HEWITT BOULEVARD N.T.S. CENTER MORICHES, NY 11934 NOTES: 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 2. LOT AREA: 7,905 S.F. / 0.181 ACRES 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PECONIC SURVEYORS, PC 1230 TRAVELER STREET, SOUTHOLD, NY 11971 SURVEY LATEST DATED AUGUST 9, 2005 ?—�=-=� a BULKHEAD PERMIT PLANS SCALE: 0 1 ': AS NOTED OCT 2 � `? PROPOSED SECTION DATE: ---J SOUTHOLD, TOWN OF SOUTHOLD ? °t' € SUFFOLK COUNTY, NY SHEET: BrT;J c i`_fees 2 OF 2 TAX MAP NO. 1000-52-05-27 James F.King,President pgUf FO(,(04 P.O.Box 1179 Bob Ghosio,Jr.,Vice-President Gyi Southold,NY 11971 Dave Bergen y Telephone(631 765-1892 John Bredemeyer ,,. „x, Fax(631)765-6641 Michael J.Domino t�- Southold Town Board of Trustees Field InspectionMorksession Report Date/Time: Jeffrey Patanjo on behalf of JUDITH HOCKEMEYER requests a Wetland Permit to remove existing timber bulkhead and replace with 49 linear feet of new vinyl bulkhead and raise it 1' above existing with a 25' return and a 15' return; and provide 30 cubic yards of clean fill. Located: 245 Bayview Avenue, Southold. SCTM# 52-5-27 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion _Amendment Administrative_Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: �- J. Kin, B. Ghosio e— D. Bergen, J. Bredemeyer "/ Michael Domino D. Dzenkowski other Form filled out in the field by cad ,o Mailed/Faxed to: Date: October 4, 2012 C y Town of Southold Trustees Town Hall Annex Building OCT - g 2012 J 1 54375 Rte. 25 P.O. Box 1179 S001111old Tow» Southold, New York 11971 Board of Trustees Attention: Elizabeth Cantrell RE: 245 BAYVIEW AVE., SOUTHOLD, NY SCTM No. 1000-52-05-27 DEC PERMIT 1,�ti� Dear Ms. C rell: Attached please find DEC Permit for the above reference project for your use. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Je re Patanjo 6 Hewitt Blvd. Center Moriches, NY 11934 New York State Department of Environmental Conservation Division, of Environmental Permits, Region One AIM SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 401111111110 Phone: (631-)444-0404 Fax: (631)444-0360 _ Website:www.dec.ny.gov Joe Martens Commissioner September 14; 2012 D Ms. Judith Hockemeyer ! ;; x 'f 166-26 Powells Cove Blvd. 9Ai f OCT _ l� NY 11357 2 Whitestone, 9 201 �., Re: Permit No.: 1-4738-04136/00001 soutnno!� roY� $o°rrt of Trustees Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article.70, ECL) and its implementing regulations (6NYCRR, Part 621)we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance.during the term of the permit. If you.are unable to comply with any conditions please contact us.at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely, , Gene R. Zamojcin Environmental Analyst GRZ/Is NEW YORK STATE DEPARTMEN' ENVIRONMENTAL CONSERVATION 110 Facility DEC ID 1-4738-04136 PERMIT Under the Environmental Conservation Law CL Permittee and Facility Information Permit Issued To: Facility: JUDITH HOCKEMEYER HOCKEMEYER PROPERTY 166-26 POWELLS COVE BLVD 9A 245 BAYVIEW AVEISCTM 1000-52-05-27 WHITESTONE,NY 11357 SOUTHOLD,NY 11917 (347) 368-6160 - Facility Application Contact: lit) JEFFREY PATANJO u OCT - 9 , 106 HEWITT BLVD �012 CENTER MORICHES,NY 11934 Southholj iOWn (631)484-9332 $0.-=-r °t T�ust°°s Facility Location: in SOUTHOLD in SUFFOLK,COUNTY Village: Southold Facility Principal Reference Point: NYTM-E: 718.3 NYTM-N: 4551.42 Latitude: 41°05'05.1" Longitude: 72°24'04.0" Project Location: 245 Bayview Avenue-Watercourse-Arshamomaque Pond Authorized Activity: In-place replacement of 74 linear feet of existing functional bulkheading and backfill. Replacement of existing or the construction of new bulkhead returns. Reconstruct existing,or construct new parallel capping boardwalk landward of bulkhead. All authorized activities shall be done in strict conformance with the attached plans stamped."NYSDEC Approved" on 9/14/2012. (GRZ) SAP# 1-08-010 Permit Authorizations Tidal Wetlands-Under Article 25 Permit ID 1-4738-04136/00001 New Permit Effective Date: 9/14/2012 Expiration Date: 9/13/2017 Water Quality Certification-Under Section 401 - Clean Water Act Permit ID 1-4738-04136/00002 New Permit. Effective Date: 9/14/2012 Expiration Date: 9/13/2017 Excavation & Fill in Navigable Waters-Under Article 15,Title 5 Permit ID 1-4738-04136/00003 New Permit Effective Date: 9/14/2012 Expiration Date: 9/13/2017 Page 1 of 7 lAft NEW YORK STATE DEPARTMEN" ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04136 NYSDEC Approval By acceptance of this permit,the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: SUSAN ACKERMAN, Deputy Regional Permit Administrator Address: NYSDEC REGION 1 HEADQUARTERS S.UNY @ STONY BR00KI50 CIRCLE RD STONY BR OK, 11790'-3409 . Authorized Signature: Date Gam 't, Distribution List JEFFREY PATANJO Habitat-TWA EUGENE R ZAMOJCIN Permit Components NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS,APPLY TO ALL AUTHORIZED PERMITS' NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS; WATER QUALITY•CERTIFICATION; EXCAVATION & FILL IN NAVIGABLE WATERS 1. Regulated Activities Authorized By This Permit This permit ONLY authorizes those regulated activities/structures identified under the section titled "SAP Authorized Activity". The Department does not issue after-the-fact or as-built permits. This permit does not authorize activities, or legitimize the existence of structures,which would have required a permit but for which no permit or other authorization has been granted by the Department. 2. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Jeffrey Patanjo,dated 8/1/2012 . Page 2 of 7 Aft NEW YORK STATE DEPARTMEN. ;T ENVIRONMENTAL CONSERVATION `! Facility DEC ID 1-4738-04136 3. Notice of Commencement At least 48 hours prior to commencement of the project,the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30-days of completion of project,the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 4. Excavation for Bulkhead/Structure Prior to any construction or removal of bulkheads and other shoreline stabilization structures all backfill shall be excavated landward of the structure and retained so- as not to enter the waterway,tidal wetland or protected buffer area. 5. Replacement Bulkhead Maximum Height ,The top elevation of the replacement bulkhead shall be no more than 18 inches higher than the existing bulkhead. 6. No Seaward Extension of Bulkhead The new bulkhead shall be constructed in place of the existing bulkhead with no seaward extension of the outermost bulkhead face. 7. Jet-in Bulkhead Bulkheads constructed directly adjacent to vegetated tidal wetlands shall be hand driven or jetted in with no disturbance to the tidal wetland. Trenching is strictly prohibited. 8. Backfilling The installation of the approved replacement bulkhead shall be completed prior to the placement of any fill material behind the structure. 9. Clean Fill Only All fill shall consist of clean sand, gravel, or soil(not asphalt, slag, flyash,broken concrete or demolition debris). 10. No Beach Excavation For Fill No excavation of the beach is authorized for the purpose of obtaining fill or stone materials. 11. No Dredging or Excavation No dredging, excavating or other-alteration of shoreline or underwater areas is authorized by this permit,nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 12. No Runoff Over or Through Bulkhead.or into Wetland Upon completion of the bulkhead replacement authorized herein,there shall be no discharge of runoff or other effluent over or through the structure or into any tidal wetland or protected buffer area. 13. Use of Treated Wood The use of wood treated with creosote,pentachlorophenol or other wood treatment not specifically approved by the department for use in wetlands and/or marine waters,is strictly prohibited in the construction of structures that will be in contact with tidal waters. 14. Parallel Capping Boardwalk The width of the parallel capping boardwalk shall not exceed six(6) feet. No portion of the boardwalk shall extend seaward of the most seaward face of the bulkhead sheathing. 15. No Structures on Reconstructed Bulkhead or Pilings No structures, other than structures specifically authorized by this permit, shall be constructed on the reconstructed bulkhead or pilings without further authorization from the Department(new permit,modified permit). 16. Storage of Equipment,Materials The storage of construction equipment and materials shall be confined to the upland area landward of the bulkhead or on a barge. Page 3 of 7 NEW YORK STATE DEPARTMEN 'ENVIRONMENTAL CONSERVATION, Facility DEC ID 1-4738-04136 .17. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 18. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland) and removed to an approved upland.area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 19. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation (grasses, etc.) immediately following project completion or prior to permit expiration,whichever comes first. If the project site remains inactive for more than 48 hours or planting is impractical due,to the season,then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor gennination. 20.,Temporary Mulch,Final Seeding If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed at the earliest opportunity when weather conditions favor germination and growth but not more than six months after project completion. 21. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. 22. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure.or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 23. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized,or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free.navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State,or cause loss or destruction of the natural resources of the State,the'owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if,upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall,without expense to.the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require,remove all or any portion of the uncompleted,structure or fill and restore to its former condition the navigable.and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 24. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings,paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 25. State May Require Site Restoration, If upon the expiration or revocation of this permit,the project hereby authorized has not been completed,the applicant shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require,remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. Page 4 of 7 AM NEW YORK STATE DEPARTMEN, P ENVIRONMENTAL CONSERVATION, Facility DEC ID 1-4738-04136 s _ WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS 1. Water Quality Certification The NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977(PL 95-217)providedthat all of the conditions listed herein are met. GENERAL CONDITIONS -Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records,is. subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department)to determine whether the permittee is complying with this permit.and the ECL Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions,must be available for inspection by the Department at all times at the project site or facility. Failure to produce.a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals,Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal,modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal,modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal,modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK,NY11790-3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands,Water Quality Certification, Excavation&Fill in Navigable Waters. Page 5 of 7 AM NEW YORK STATE DEPARTMEN` ENVIRONMENTAL CONSERVATION Facility DEC ID 14738-0413� 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the-right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental;conditions,relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute,regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims,suits, actions,and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of,the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil_Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assign's of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals,lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Page 6 of 7 NEW YORK STATE DEPARTMEN',_ ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04136 Item D: 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 propertyheld or vested in a person not a party to the permit. Page 7 of 7 NOTICE OF COMMENCEMENT OF-CONSTRUCTION RETURN THIS FORM TO:COMPLIANCE _ Or Fax to: 631-444-0297 AM- Bureau of Habitat-TW 50 Circle Road _ Stony Brook, NY 11790-3409 PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Dear Sir: Pursuant to the special conditions of the referenced permit,you are hereby notified that the authorized activity shall commence on . We certify that we have read the referenced permit and approved plans and fully understand the authorized project and all permit conditions.We have inspected the project site and can complete the project as described in the permit and as depicted on the approved plans. We can do so in full compliance with all plan notes and permit conditions.The permit,permit sign,and approved plans will be available at the site for inspection in accordance with General Condition No. 1. (Both signatures required) PERMITEE: DATE CONTRACTOR: " DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS AT LEAST TWO DAYS PRIOR TO COMMENCEMENT OF THE PROJECT AND/OR ANYASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE THE PERMIT AND APPROVED PLANS AVAILABLE AT THE WORK SITE FOR THE DURATION OF THE PROJECT MAY SUBJECT THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS. Cut along this line NOTICE OF COMPLETION OF CONSTRUCTION RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0297 _ Bureau of Habitat-TW 50 Circle Road v Stony Brook, NY 11790-3409 - PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Pursuant to special conditions of the referenced permit,you are hereby notified that the authorized activity was completed on We have fully complied with the terms and conditions of the permit and approved plans.(Both signatures required) PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE, WITH PHOTOGRAPHS OF THE COMPLETED WORK AND/OR A COMPLETED SURVEY,AS APPROPRIATE, MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COMPLETION OF THE PROJECT. 95.20-1 (8/87)-9d ` New .York State Department of. Environmentaf Conservation : .AOL ISWO ' NOTIC The Department of Environmental Conservation (DEC) has issued permit(s). pursuant to . the- Environmental Conservation Law for work - being conducted at this site:. For" further information regarding the nature and - extent of work approved .and . any Departmental conditions on it, contact the Regional Permit Administrator listed below.. Please .refer to the permit numb-er.. shown when contacting the .DEC.. . Regional Permit Administrator -Number .. FOC�ER E Permit2d � � CCE WE .Expiration Date 111 .21 `1 i f NOTE: This notice is. NOT a permit' OCT . �`:� � -'92012 $ r Ilea To sieV _ Board* of Trusfees New York State Department of;Environmental Conservation Division of Environmental Permits, Region One _ 9, SUNY @Stony Brook, 50 Circle Road,.Stony Brook, NY 11790-3409 r Phone: (631-)444-0404 Fax: (631)444-0360 _ Website:www.dec.ny.aov Joe Martens Commissioner September 14, 2012 Ms. Judith Hockemeyer ? 166-26 Powells Cove Blvd. 9A ' SEP Whitestone,-NY 11357 70L2 Re: Permit No.: 1-4738-04136/00001 Southhord Town 'Ord of Trustees Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621)we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained-in the permit to ensure compliance.during the term of the permit. If you.are unable to comply with any conditions please contact us,at the above address. Also enclosed is a permit sign which is to be conspicuously posted.at the project site and protected from the weather. Sincerely, , Gene R. Zamojcin Environmental Analyst GRZ/Is Aft NE'W YORK STATE DEPARTME, _ `)F ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04136 PERMIT Under the Environmental Conservation Law CL Permittee and Facility Information Permit Issued To: Facility: JUDITH HOCKEMEYER HOCKEMEYER PROPERTY 166-26 POWELLS COVE BLVD 9A 245 BAYVIEW AVEISCTM 1000-52-05-27 WHITESTONE,NY 11357 SOUTHOLD,,NY 11917 (347)368-6160 Facility Application Contact: JEFFREY PATANJO 106 HEWITT BLVD CENTER MORICHES,NY 11934 (631)484-9332 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Southold Facility Principal Reference Point: NYTM-E: 718.3 NYTM-N: 4551.42 Latitude: 41°05'05.1" Longitude: 72°24'04.0" Project Location: 245 Bayview Avenue-Watercourse-Arshamomaque Pond Authorized Activity: In-place replacement of 74 linear feet of existing functional bulkheading and backfill. Replacement of existing or the construction of new bulkhead returns. Reconstruct existing,or construct-new parallel capping boardwalk landward of bulkhead. All authorized activities shall.be done in strict conformance with the attached plans stamped."NYSDEC Approved" on 9/14/2012. (GRZ) SAP# 1-08-010 Permit Authorizations Tidal Wetlands-Under Article 25 - Permit ID 1-4738-04136/00001 New Permit Effective Date: 9/14/2012 Expiration Date: 9/13/2017 Water Quality Certification-Under Section 401 - Clean Water Act Permit ID 1-4738-04136/00002 New Permit. Effective Date: 9/14/2012 Expiration Date: 9/13/2017 Excavation & Fill in Navigable Waters-Under Article 15,Title 5 Permit ID 1-4738-04136/00003 New Permit Effective Date: 9/14/2012 Expiration Date: 9/13/2017 Page 1 of 7 1' NEW YORK STATE DEPARTME'. ,)F ENVIRONMENTAL CONSERVATIO° Facility DEC ID 1-4738-04136 NYSDEC Approval By acceptance of this permit,the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: SUSAN ACKERMAN,Deputy Regional Permit Administrator Address: NYSDEC REGION HEADQUARTERS S.UNY @ STONY BROOK150 CIRCLE RD STONY BR OK, 11790'-3409 . Authorized Signature: Date Gam/ 1�/Z�bit Distribution List JEFFREY PATANJO Habitat-TW EUGENE R ZAMOJCIN Permit Components NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS,APPLY TO ALL AUTHORIZED PERMITS' NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS -Apply to the Following Permits: TIDAL WETLANDS; WATER QUALITY CERTIFICATION; EXCAVATION & FILL IN NAVIGABLE WATERS 1. Regulated Activities Authorized By This Permit This permit ONLY authorizes those regulated activities/structures identified under the section titled "SAP Authorized Activity". The Department does not issue after-the-fact or as-built permits. This permit does not authorize activities, or legitimize the existence of structures,which would have required a permit but for which no permit or other authorization has been granted by the Department. 2. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Jeffrey Patanjo, dated 8/l/2012 . Page 2 of 7 Aft NEW YORK STATE DEPARTM]W.___-�DF ENVIRONMENTAL CONSERVATIC_. Facility DEC ID 1-4738-04136 3. Notice of Commencement At least 48 hours prior to commencement of the project,the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30-days of completion of project,the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 4. Excavation for Bulkhead/Structure Prior to any construction or removal of bulkheads and other shoreline stabilization structures all backfill shall be excavated landward of the structure and retained so as not to enter the waterway,tidal wetland or protected buffer area. 5. Replacement Bulkhead Maximum Height The top elevation of the replacement bulkhead shall be no more than 18 inches higher than the existing bulkhead. 6. No Seaward Extension of Bulkhead The new bulkhead shall be constructed in place of the existing bulkhead with no seaward extension of the outermost bulkhead face. 7. Jet-in Bulkhead Bulkheads constructed directly adjacent to vegetated tidal wetlands shall be hand driven or jetted in with no disturbance to the tidal wetland. Trenching is strictly prohibited. 8. Backfilling The installation of the approved replacement bulkhead shall be completed prior to the placement of any fill material behind the structure. 9. Clean Fill Only All fill shall consist of clean sand, gravel, or soil(not asphalt, slag, flyash,broken concrete or demolition debris). 10. No Beach Excavation For Fill No excavation of the beach is authorized for the purpose of obtaining fill or stone materials. 11. No Dredging or Excavation No dredging, excavating or other-alteration of shoreline or underwater areas is authorized by this permit,nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 12. No Runoff Over or Through Bulkhead.or into Wetland Upon completion of the bulkhead replacement authorized herein,there shall be no discharge of runoff or other effluent over or through the structure or into any tidal wetland or protected buffer area. 13. Use of Treated Wood The use of wood treated with creosote,pentachlorophenol or other wood treatment not specifically approved by the department for use in wetlands and/or marine waters,is strictly prohibited in the construction of structures that will be in contact with tidal waters. 14. Parallel Capping Boardwalk The width of the parallel capping boardwalk shall not exceed six(6) feet. No'portion of the boardwalk shall extend seaward of the most seaward face of the bulkhead sheathing. 15. No Structures on Reconstructed Bulkhead or Pilings No structures, other than structures specifically authorized by this permit, shall be constructed on the reconstructed bulkhead or pilings without further authorization from the Department(new permit,modified permit). 16. Storage of Equipment,Materials The storage of construction equipment and materials shall be confined to the upland area landward of the bulkhead or on a barge. Page 3 of 7 Aft- NEW YORK STATE DEPARTM],- OF ENVIRONMENTAL CONSERVATIC z Facility DEC ID 1-4738-04136 .17. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 18. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 19. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation(grasses, etc.) immediately following project completion or prior to permit expiration,whichever comes first. If the project site remains inactive for.more than 48 hours or planting is impractical due to the season, then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor germination. 20.-Temporary Mulch,Final Seeding If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed at the earliest opportunity when weather conditions favor germination and growth but not more than six months after project completion. 21. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. 22. State Not Liable for Damage The State of New York shall in no case be liable for any damage or .injury to the structure.or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 23. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized,.or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free.navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State,the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if,upon the expiration or revocation of this permit,the structure, fill, excavation, or other modification'of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require,remove all or any portion of the uncompleted.structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 24. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings,paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 25. State May Require Site Restoration, If upon the expiration or revocation of this permit,the project hereby authorized has not been completed,the applicant shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require,remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. Page 4 of 7 Aft- NEW YORK STATE DEPARTMI_- , OF ENVIRONMENTAL CONSERVATICmow Facility DEC ID 1-4738-04136 WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS 1. Water Quality Certification The NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977(PL 95-217)provided that all of the conditions listed herein are met. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records,is. subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department) to determine whether the permittee is complying with this permit.and the ECL..Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions,must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals,Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal,modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal,modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal,modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK,NY11790-3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands, Water Quality Certification, Excavation&Fill in Navigable Waters. Page 5 of 7 r AM NEW YORK STATE DEPARTMI __-%)F ENVIRONMENTAL CONSERVATIa . _ Facility DEC ID 14738-0413a 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental:conditions,relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute,regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Pesponsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages,to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of,the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit,including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Page 6 of 7 AM NEW YORK STATE DEPARTME`L:._- )F ENVIRONMENTAL CONSERVATIOi. 00 Facility DEC ID 1-4738-04136 ' Item D: 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. Page 7 of 7 -,-n 7:!E OF COMMENCEMENT OF CONSTRUCT _ RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0297 Bureau of Habitat-TW 50 Circle Road Stony Brook, NY 11790-3409 PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Dear Sir: Pursuant to the special conditions of the referenced permit,you are hereby notified that the authorized activity shall commence on . We certify that we have read the referenced permit and approved plans and fully understand the authorized project and all permit conditions.We have inspected the project site and can complete the project as described in the permit and as depicted on the approved plans. We can do so in full compliance with all plan notes and permit conditions.The permit,permit sign,and approved plans will be available at the site for inspection in accordance with General Condition No. 1. (Both signatures required) PERMITEE: DATE CONTRACTOR: ' DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS AT LEAST TWO DAYS PRIOR TO COMMENCEMENT OF THE PROJECT AND/OR ANY ASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE THE PERMIT AND APPROVED PLANS AVAILABLE AT THE WORK SITE FOR THE DURATION OF THE PROJECT MAY SUBJECT THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS. Cut along this line NOTICE OF COMPLETION OF CONSTRUCTION RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0297 _ Bureau of Habitat-TW 50 Circle Road Stony Brook, NY 11790-3409 - PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Pursuant to special conditions of the referenced permit,you are hereby notified that the authorized activity was completed on We have fully complied with the terms and conditions of the permit and approved plans.(Both signatures required) PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE, WITH PHOTOGRAPHS OF THE COMPLETED WORK AND/OR A COMPLETED SURVEY,AS APPROPRIATE, MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COMPLETION OF THE PROJECT. 95.20-1 (8187)-9d , New York State Department of. Environmen-tAl Conservation Now . N. O. TICE The Department of Environmental Conservation (DEC) hasissued permit(s). pursuant to the, Environmental Conservation Law for work - being conducted at this site.. For further information regarding the nature and . extent of work approved .and any Departmental conditions on it, contact the Regional Permit Administrator listed below.. Please .refer to the permit number . shown when contacting the .DEC.. . Regional Permit Administrator -N mber AI3?--0' q ) ROGER c Permit u VAN. ,Expiration Date 11 .71 NOTE: This notice is. NOT a permit Ae� PROJECT LOCATION \ 0 ., f, sira�lwt�uck �Y %p I� 51 p f sp ti(. �� 'p RN!" / PROJECT LOCATION MAP ro� N.T.S. o� \ G00o0\0G0/0 lowOo G�O�? . N YS D E C APPROVO AS PER TERMS AND CONOI110NS OF . \ QOOQos� GEP��,°� \ o ���°� DAIE 4 dos PEAMRNO. V' 4v NOTES: 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM , 2. LOT AREA: 7,905 S.F. / 0.181 ACRES ti° 42 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: 01 PECONIC SURVEYORS, PC PROPERTY OWNER: �� W Q0 ,�� 1230 TRAVELER STREET, SOUTHOLD, NY 11971 J. HOCKEMEYER \O , �y� SURVEY LATEST DATED AUGUST 9, 2005 166-26 POWELLS COVE BLVD. 9A BEECHHURST, NY 11357-2050 ch`' ti E c BULKHEAD PERMIT PLANS SCALE: G� e 1"=20' PREPARED BY: O SAP PROPOSED PLAN & DATE: JEFFREY PATANJO i 'Ll 106 HEWITT BOULEVARD LOCATION MAP 8-1-12 CENTER MORICHES, NY 11934 SOuthllo!d Town SOUTHOLD, TOWN OF SOUTHOLD Board of Trustees SUFFOLK COUNTY, NY SHEET: TAX MAP NO. 1000-52-05-27 1 OF 2 PROPOSED ALUMINUM OR CCA TIMBER TOP CAP PROPOSED 12' LONG CCA TREATED TIMBER PILE, 6' O.C. PROPOSED 30CY CLEAN FILL FROM UPLAND SOURCE PLACED PROPOSED 3"X6" BEHIND BULKHEAD REAR WALE NOTE: REMOVE EXISTING BULKHEAD STRUCTURE IN ITS ENTIRETY AND INSTALL NEW BULKHEAD :::::: ::::::: :::::: IN THE EXACT SAME POSITION ........ ...................................... WITH RAISED ELEVATION OF :::::::::::::::. :::. ::::::.:::: :::::::.::: ::. :::::. : 1' HEIGHT ABOVE EXIST. TOPCAP ' APPROXIMATE M.H.W. EL 2.5i �� PROPOSED 12' LONG CCA ------— ------- II TREATED TIMBER PILE, 6' O.C. ; �PROPOSED 6"x6" CCA ! PROPOSED 6'x6" CCA WALE TYPICAL OF 2 TOP & BOTTOM WALE PROPOSED 10' LONG SHOREGUARD 225 VINYL SHEETING PROPOSED 8" TIP CCA i APPROXIMATE M.LW EL 0.0i PROPOSED 3"X6" LAY—LOG PILE REAR WALE EXISTING BULKHEAD \ EXISTING-SAND,BOTTOM PROPOSED 8" TIP CCA PILE, 6' TO BE REMOVED IN O.C. 8' LENGTH. BOLTED TO ITS ENTIRETY. I j\\�\\j\\j\\�\\j\\�\\�\\j\\\ LAY—LOG WITH 3/4" \//\\//\\//\\//\\//\\//\\/�\\/ �/ VINYL SHEETING DETAIL GALVANIZED THRU—BOLTS. PROPOSED 20' LONG 1" DIA. GALV. TIE ROD, 6' O.C. PROPERTY OWNER: J. HOCKEMEYER 166-26 POWELLS COVE BLVD. 9A BEECHHURST, NY 11357-2050 PROPOSED 10' LONG SHOREGUARD 225 VINYL SHEETING PREPARED BY: TYPICAL SECTION A-A JEFFREY PATANJO N.T.S. 106 HEWITT BOULEVARD CENTER MORICHES, NY 11934 NOTES: 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 2. LOT AREA: 7,905 S.F. / 0.181 ACRES 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PECONIC SURVEYORS, PC 1230 TRAVELER STREET, SOUTHOLD, NY 11971 SURVEY LATEST DATED AUGUST 9, 2005 D E C E W E- PTAX HEAD PERMIT PLANS SCALE: I y i � �� AS NOTED SEP $ 5 2012 ROPOSED SECTION DATE: T3-,—12 SCLthhol, Town Bour of it sees THOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: MAP NO. 1000-52-05-27 2 OF 2 S E P 13 2012 Southhold Town Board of Trustees Photo 1 - Looking South Photo 2 - Looking West n Photo 3 - Looking West Photo 4 - Looking Southwest August 21, 2012 NYS Dept. of Environmental Conservation �1 4n SUNY @Stony Brook ►�y° � 50 Circle Road � Stony Brook, New York 11790-2356 ; SEP 1 3 2012 !1 LL-�� Attention: Duty Analyst Southho!d Town Board of Trustees RE: 246 BAYVIEW AVENUE, SOUTHOLD, NY SCTM No. 1000-52-05-27 APPLICATION FOR PERMIT Dear Sir/Madame: We hereby submit four(4) copies of the proposed plans, applications, check, photographs and required data 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, J rAPatanjo 106 Hewitt Blvd. Center Moriches, NY 11934 cc: Army Corps of Engineers NYSDOS Town_of--Southold'-Trustees Judith Hockemeyer JOINT APPLICATION FORM For Permits/Determinations to undertake activities affecting streams,waterways, FMI x waterbodies,wetlands,coastal areas and sources of water supply. New York You must separately apply for and obtain separate Permits/Determinations from US Army Corps of State each involved agency prior to proceeding with work.Please read all instructions. Engineers(USAGE) APPLICATIONS TO 1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart- General Services ment of State Check all permits that apply: Check all permits that apply: ❑ Stream Disturbance ❑ Coastal Erosion ❑ Section 404 Clean Water Act Check all permits that Check if this ❑ Management apply: applies:Excavation and Fill in ❑ Section 10 Rivers and Harbors ,, Navigable Waters ❑ Wild,Scenic and Act ❑ State Owned Lands ❑ Coastal Recreational Rivers Under Water Consistency R ❑ Docks, Moorings or ❑ Nationwide Permit(s)-Identify ❑Utility Concurrence Platforms ❑ Water Supply Number(s): Easement ❑ Dams and Impoundment ❑ Long Island Well (pipelines, Structures ❑ Aquatic Vegetation Control conduits, ❑ 401 Water Quality cables,etc.) ❑Aquatic Insect Control ❑Docks, Certification Preconstruction Notification- ❑ Freshwater Wetlands ❑ Fish Control 0 Y / ❑ N Moorings or El Tidal Wetlands ❑ Incidental Take of Endan- Platforms gered/Threatened Species El I am sending this application ❑ I am sending this El I am sending ID I am sending this application to this agency, L7application to this this application to this agency. a enc . to this agency. 5. Name of Applicant(use full name) Applicant must be: 6. Name of Facility or Property Owner(if different than JUDITH HOCKEMEYER El Owner Applicant) SAME ❑Operator Mailing Address ❑ Lessee Mailing Address 166-26 POWELLS COVE BLVD,9A (check all that apply) Post Office City BEECHHURST Taxpayer ID(If applicant Post Office City is NOT an individual): State NY Zip Code 11357-2050 State Zip Code Telephone(daytime) Email Telephone(daytime) Email 347-368-6160 7. Contact/Agent Name 8. Project/ Facility Name Property Tax Map Section/Block/Lot Number JEFFREY PATANJO BAYVIEW AVE.BULKHEAD 1000-52-05-27 Company Name Project Location-Provide directions and distances to roads,bridges and bodies of waters: SOUTH END BAYVIEW AVENUE-SOUTHOLD,NY 11917 Mailing Address 106 HEWITT BLVD. Street Address,if applicable Post Office City State Zip Code 245 BAYVIEW AVENUE SOUTHOLD NY 11917 Post Office City CENTER MORICHES Town/Village/City County SOUTHOLD SUFFOLK State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name NY 11934 SOUTHOLD ARSHAMOMAQUE POND Telephone(daytime) Location Coordinates: Enter NYfMs in kilometers,OR Latitude/Longitude 631-484-9332 Email NYTM-E NYTM-N Latitude Longitude JPATANJO@OPTONLINE.NET 41°05.083' 72°24.068" ForsAaencv Use Only :DEG AppUcatian Number USAGE Number y JOINT APPLICATION FORM 09/10 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed JOINT APPLICATION FORM— PAGE 2 OF 2 Submit this completed page as part of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose. Attach additional page(s) if necessary. Include: description of current site conditions and how the site will be modified by the proposed project;structures and fill materials to be installed; type and quantity of materials to be used (i.e., square ft of coverage and cubic yds of fill material and/or structures below ordinary/mean high water) area of excavation or dredging, volumes of material to tie removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource impacts; and where applicable,the phasing of activities. ATTACH PLANS ON SEPARATE PAGES. REPLACE EXISTING DETERIORATED TIMBER BULKHEAD WITH NEW VINYL BULKHEAD IN SAME LOCATION AS EXISTING. CONSTRUCT 15' LONG RETURN AND 74'OF BULKHEAD. RAISE BULKHEAD ELEVATION 1'IN HEIGHT.IMPORT 30 CUBIC YARDS OF CLEAN FILL TO BE PLACED BEHIND BULKHEAD ON LANDWARD SIDE. Proposed Use: 0 Private ❑ Public [ Commercial Proposed 12/1/2012 Estimated 12/14/2012 Start Date: Completion Date: Has Work Begun on Project? ❑Yes El No If Yes,explain. Will Project Occupy Federal,State or Municipal Land? ❑Yes El No If Yes,please specify. 10. List Previous Permit/Application Numbers(if any)and Dates: N/A/ 11. Will this project require additional Federal,State,or Local Permits including zoning changes? 0 Yes ❑ No If yes,please list: NYSDOS,TOWN OF SOUTHOLD TRUSTEES 12. Signatures.If applicant is not the owner, both must sign the application. I hereby affirm that information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said project.In addition, Federal Law, 18 U.S.C.,Section 1001 provides for a fine of not m re than $10,000 or imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conceal , covers up a material fact; or knowingly makes or uses a false,fictitious or fraudulent statement. ignatur of Appl' t Printe Nam�OCLAA4eeZ- t Date .i l 0 Lk)ism ?-Ofinature of Owner Printed Name 11 Title Date �C 1-rf� �w T•^t � 41 G✓6'f °b i nbture of/Agent Printed Name J Title Date ;.For Aggl}cv Use Only DEfEitMIIINATTOrI OF NO PERMIT REQI�TRED 5 T f f a ', t Agency Pr6jeCt Number has deterrhIhed that No P ermit is required frorp this Agency for the project described�n (Agency Narpe) this application x 4 5 Agency Representative Name(panted} Tfle SiiiiinhirP6 at, Fx d 3, i h JOINT APPLICATION FORM 09/10 Application Form Page 2 of 2 ENVIRONMENTAL QUESTIONNAIRE This is intended to supplement ENG Form 4345,Application for Department of the Army Permit, or the Joint Application for Permit used in the State of New York. Please provide complete answers to all questions below which are relevant to your project. Any answers may be continued on separate sheet(s)of paper to be attached to this form. PRIVACY ACT STATEMENT The purpose of this form is to provide the Corps of Engineers with basic information regarding your project This,information will be used to facilitate evaluation of your permit application and for public dissemination as required by regulation. Failure to provide complete information may result in your application being declared incomplete for processing,,thereby delaying processing of your application. GENERAL—APPLICABLE TO ALL PROJECTS 1. Explain the need for, and purpose of, the proposed work. �(opo5t� b�c ti�u6z as e"a b�c-��s� �x�st,Ny try be FJ � k� /5 �.Z�" (lo gw�2- r.v �v��� v IL �(��klC.a►e n"�. 2. Provide the names and addresses of property owners adjacent to your work site (if not shown on the application form or project drawings). ,J,(G �I k✓1 (Please note that depending upon the nature and extent of your project, you may be requested to provide the names and addresses of additional property owners proximate to your project site to ensure proper coordination.) 3. Photographs of the project site should be submitted. For projects in tidal areas, photographs of the waterway vicinity should be taken at low tide. Using a separate copy of your plan view, indicate the location and direction of each photograph as well as the date and time at which the photograph was taken. Provide a sufficient number of photographs so as to provide a clear understanding of conditions on and proximate to your project site. A +"a G�e i- fn A er l i c,4+10„1 4. Provide a copy of any environmental impact statement, or any other environmental report which was prepared for your project. 5. Provide a thorough discussion of alternatives to your proposal. This discussion should include, but not necessarily be limited to, the "no action" alternative and alternative(s)resulting in less disturbance to waters of the United States. For filling projects in waters of the United States, including wetlands, your alternatives discussion should demonstrate that there are no practicable alternatives to your proposed filling and that your project meets with current mitigation policy (i.e. avoidance, minimization and compensation). A F3v61,9 aG-b u rL✓uG-� LGn�,Q SGkitnenta-fvo,J of— 4,e- !,✓u7itiwF� �osS o � pe l S o,,,&l f f-v f t 47 a�tk +ti - etoN c A s t>S c- e k DREDGING PROJECTS Answer the following if your project involves dredging. 1. Indicate the estimated volume of material to be dredged and the depth (below mean low water) to which dredging would occur. Would there be overdepth dredging? 2. You can apply for a tern--year permit for maintenance dredging. If you wish to apply fora ten year permit,please.provide the number of addition►dredging events during the ten-year life of the permit and the amount of material to be removed during future events. N /} 3. Indicate of your drawings the dewatering area(if applicable)and disposal site for the dredged material (except landfill sites). Submit a sufficient number of photographs of the dewatering and disposal sites as applicable so as to provide a clear indication of existing conditions. For ten-year maintenance dredging permits, indicate the dewatering(disposal sites for future dredging events, if known. W lA 4. Describe the method of dredging(i.e. clamshell, dragline, etc.)and the expected duration of dredging. PIAr 5.Indicate the physical nature of the material to be dredged(i.e.sand, silt; clay, etc.) and provide estimated percentages of the various constituents if available. For beach nourishment projects, grain size analysis data is required. 1✓{A- ' 6. Describe the method of dredged material containment (i.e. hay bales, embankmen4 bulkhead, etc.)and whether return flow from the dewatering/disposal site would reenter any waterway. Also indicate if there would be any barge overflow. N Iq MOORING FACILITIES Answer the following if your project includes the construction or rehabilitation of recreational mooring facilities. 1.It is generally recommended that any fixed piers and walk ramps be limited to four feet in width, and that floats be limited to eight feet in width and rest at least two feet above the waterway bottom at mean low water. Terminal floats at private, non- commercial facilities should be limited to 20 feet in length. If you do not believe your proposal can meet with these recommendations,please provide the reason(s). N JA, 2. Using your plan view, show to scale the location(s), position(s) and size(s) (including length, beam and draft)of vessel(s)to be moored at the proposed facility, including those of transient vessels) if known, l N 4 3.For commercial mooring sites such as marinas,indicate the capacity of the facility and indicate on the plan view the location(s)of any proposed fueling and/or sewage pumpout facilities. If pumpout facilities are not planned,please discuss the rationale below and indicate the distance to the nearest available pumpout station. N JA- 4. Indicate on your plan view the distance to adjacent marine structures, if any are proximate and show the locations and dimensions of such structures. tj IA- 5. Discuss the need for wave protection at the proposed facility. Please be advised that if a permit is issued,you would be required to recognize that the mooring facility may be subject to wave action from wakes of passing vessels, whose operations would not be required to be modified. Issuance of a permit would not relieve you of ensuring the integrity of the authorized structures)and the United States would not be held responsible for damages to the structures)and vessels)moored thereto from wakes from passing vessels. BULKHEADING/BANK STABILIZATION/FILLING ACTIVITIES Answer the following if your project includes construction of bulkheading (also retaining walls and seawalls) with backfrll, filling of watersAvetlands, or any other bank stabilization fills such as riprap, revetments, gabions, etc. 1. Indicate the total volume of fill(including backfrll behind a structure such as a bulkhead)as well as the volume of fill to be placed into waters of the United States. The amount of fill in waters of the United States can be determined by calculating the amount of fill to be placed below the plane of spring high tide in tidal areas and below ordinary high water in non-tidal areas. 4 -r. -r,.l 3 a c.y ., ( c (<�H �it l will �L P le,c ea S e h,n ct +6 f 7✓c.�G�C o.tQ C Le.m d W a Ilia) d e- to P2a I !.v�_ o c „� ce � hT 2. Indicate the sources)and type(s)of fill material / mo h C �e n Sk is A l5 (.t.c.( -firD.k "P(6c n a- Sa vrcc 3. Indicate the method of fill placement(i.e. by hand, bulldozer, crane, etc.). Would any temporary fills be required in waterways or wetlands to provide access for construction equipment? If so, please indicate the area of such waters and/or wetlands to be filled, and show on the plan and sectional views. . 7, I( Wilt w 1-r L1 516 l dZ ar-eels /LrQ a - rr pr ,, s`c9L b�L1LtiCw � . t, /L G✓Ge The foregoing requests basic information on the most common types of projects requiring Department of the Army permits. It is intended to obviate or reduce the need for requesting additional information;however, additional information may be requested above and beyond what is requested in this form. Please feel free to add any additional information regarding your project which you believe may facilitate our review. PROJECT dj LOCATION \\ +Y 6 Pay! ��i 0. / PROJECT LOCATION MAP 3 N.T.S. 000 \ a���/ ,sue 1 �� y`��► @T Wl \ / �� NOTES: 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 2. LOT AREA: 7,905 S.F. / 0.161 ACRES 3. PORTIONS OF PLAN FROM SURV41REPARE BY- PROPERTY SURVEYORS, PC PROPERTY OWNER: f, 1230 TRAVELER STREET, SOUIH71 J. HOCKEMEYER `� emu`. .�0,� SURVEY LATEST DATED AUGUST 166-26 POWELLS COVE BLVD. 9A ,'1 ,h Ak BEECHHURST, NY 11357-2050 yh �O y BULKHEAD PERMIT PLANLE:PREPARED BY: Q T"m20�JEFFREY PATANJO j PROPOSED PLAN &106 HEWITT BOULEVARD te'CENTER MORICHES, NY 11934 LOCATION MAP -+zSOUTHOLD, TOWN OF SOUTHOLDSUPTOLK COUNTY. NY TAX MAP N0. f000-Sz-OS-Z of 2 PROPOSED ALUMINUM OR CCA TIMBER TOP CAP PROPOSED Ue LONG CCA PROPOSED 30CY CLEAN FILL TREATED TIMBER PILE,S'D.C. FROM UPLAND SOURCE PLACED PROPOSED S'XG' BEHIND BULKHEAD REAR WALE NOTE:REMOVE EXISTING BULKHEAD STRUCTURE IN ITS ENTIRETY AND INSTALL NEW BULKHEAD ...........:::::::::::r:•:ii•:i:•ii: IN THE EXACT SAME POS IMN ............................................ ..........::::::::::..:::.:......:.....�::.�.:�:::::::::.�•• WITH PRISED ELEVATION OF q 1'HEIGHT ABOVE OAST.70PG1P MM4XM9[MH.t.EL.7,! E PROPOSED 12'LONG CO 152 L TREATED TIMBER PILE,6'O.C. __PROPOSED 854'CCA PROPOSED BIB'OrA WALE TYPICAL OF 2 .. TOP d:BOTTOM WALE PROPOSED 10'LONG SHOREGUARD PROPOSED 8'71P CCA 223 VINYL SHEETING LAY-LOG PILE Af4Rmum MUE D.OD! PROPOSED 3W EXSTING BULIMM EXISTING SANK BOTTOM REAR WALE ., PROPOSED 8'RP CIA PILE,6' TO BE REMOVED IN / d O.C.8'LENGTH.BOLTED TO ITS ENTIRETY.LAY-LOG WITH 3/4' \ VINYf SHF,xE71NG DETAIL GALVANIZED THRU-BOLTS. / \ PROPOSED 20'LONG 1'DI A. TIE ROD,6'O.C. PROPERTY OWNER: J. HOCKEMEYER 166-26 POWELLS COVE BLVD. 9A 0\&PROPOSED 10'IANO BEECHHURST, NY 11357-2050 SH�GU L ARD 225 VINY PREPARED BY: TYPICAL SECTION A-A JEFFREY PATANJO NX.S. 106 HEWITT BOULEVARD CENTER MORICHES, NY 11934 NOTES: 1. ELEVATIONS REFER TO N.G.V.D. 1929 DATUM 2. LOT AREA: 7,905 S.F. / 0.181 ACRES 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PECONIC SURVEYORS, PC 1230 TRAVELER STREET, SOUTHOLD, NY 11971 SURVEY LATEST DATED AUGUST 9, 2005 BULKHEAD PERMIT PLANS CALE: AS NOTED PROPOSED SECTION SATE: 12 SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY HE TAX MAP NO. 1000-52-05-27 2 OF 2 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -PROJECT INFORMATION To be completed by A licant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME JUDITH HOCKEMEYER BAYVIEW AVENUE BULKHEAD 3. PROJECT LOCATION: Municipality SOUTHOLD County SUFFOLK 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) 245 BAYVIEW AVENUE,SOUTHOLD-SEE ATTACHED LOCATION MAP 5. PROPOSED ACTION IS: New Expansion Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: RECONSTRUCT EXISTING TIMBER BULKHEAD WITH NEW VINYL IN SAME EXISTING LOCATION 7. AMOUNT OF LAND AFFECTED: Initially .01 acres Ultimately .01 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? �✓ Yes No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? �✓ Residential ❑ Industrial Commercial Agriculture 11 Park/Forest/Open Space Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,STATE OR LOCAL)? ZYes ❑ No If Yes,list agency(s)name and permittapprovals: NYSDEC,NYSDOS,ARMY CORPS OF ENGINEERS,TOWN OF SOUTHOLD TRUSTEES 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes ❑ No If Yes,list agency(s)name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? Yes Z No I CERTIFY THAT THE FORM TION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant1sponsorname: Date: Signature: If t action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER Reset q PART II - IMPACT ASSESSMENT To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAF. ❑Yes ❑ 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. Yes 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 pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,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 species?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: C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: C6. Long term,short term,cumulative,or other effects not identified in CI-05? Explain briefly: C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA)? ❑Yes ❑ No If Yes,explain briefly: E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes No If Yes,explain briefly: PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its(a)setting(i.e. urban or rural); (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 II was checked yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. 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 AND provide,on attachments as necessary,the reasons supporting this determination Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(If different from responsible officer) LVYReset New York State Department of Environmental Conservation _ oboe NW PERMISSION TO INSPECT PROPERTY By signing this permission form for submission with an application for a permit(s)to the Department of Environmental Conservation("DEC"),the signer consents to inspection by DEC staff of the project site or facility for which a permit is sought and,to the extent necessary, areas adjacent to the project site or facility. This consent allows DEC staff to enter upon and pass through such property in order to inspect the project site or facility,without prior notice,between the hours of 7:00 a.m.and 7:00 p.m.,Monday through Friday. If DEC staff should wish to conduct an inspection at any other times, DEC staff will so notify the applicant and will obtain a separate consent for such an inspection. Inspections may take place as part of the application review prior to a decision to grant or deny the permit(s)sought. By signing this consent form,the signer agrees that this consent remains in effect as long as the application is pending, and is effective regardless of whether the signer,applicant or an agent is present at the time of the inspection. In the event that the project site or facility is posted with any form of"posted" or"keep out"notices,or fenced in with an unlocked gate,this permission authorizes DEC staff to disregard such notices or unlocked gates at the time of inspection. The signer further agrees that during an inspection, DEC staff may,among other things, take measurements, may analyze physical characteristics of the site including, but not limited to, soils and vegetation(taking samples for analysis),and may make drawings and take photographs. Failure to grant consent for an inspection is grounds for, and may result in, denial of the permit(s) sought by the application. Permission is granted for inspection of property located at the following address(es): 245 BAYVIEW AVENUE, SOUTHOLD, NY 11917 By signing this form, I affirm under penalty of perjury y that I am authorized to give consent to entry by DEC staff as described above. I understand that false statements made herein are punishable as a Class A misdemeanor pursuant toLSet' n 210.45 of the Penal Law.* (I I A c�+ �w rint lKame an Title Signature Date *The signer of this form must be an individual or authorized representative of a legal entity that: • owns fee title and is in possession of the property identified above; • maintains possessory interest in the property through a lease,rental agreement or other legally binding agreement;or • is provided permission to act on behalf of an individual or legal entity possessing fee title or other possessory interest in the property for the purpose of consenting to inspection of such property. Permission to Inspect Property Application Supplement 12/08 NEW YORK STATE DEPARTMENT OF STATE COASTAL MANAGEMENT PROGRAM Federal Consistency Assessment Form An applicant,seeking a permit,license,waiver,certification or similar type of approval from a federal agency which is subject to the New York State Coastal Management Program(CMP),shall complete this assessment form for anyproposed activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent with New York State's CMP as required by U.S. Department of Commerce regulations(15 CFR 930.57).It should be completed at the time when the federal application is prepared. The Department of State will use the completed form and accompanying information in its review of the applicant's certification of consistency. A.APPLICANT (please print) JUDITH HOCKEMEYER 1.Name: 2.Address:166-26 POWELLS COVE BLVD, 9A, BEECHHURST, NY 11357-2050 3.Telephone: Area Code(3zg)368-6160 B.PROPOSED ACTIVITY 1.Brief description of activity: REMOVE EXISTING TIMBER BULKHEAD AND REPLACE WITH NEW VINYL BULKHEAD IN SAME EXACT LOCATION. 2.Purpose of activity: EXISTING BIJEKHEAE) IS E)ETERieRATEE) 3.Location of activity: SUFFOLK SOUTHOLD 245 BAYVIEW AVENUE County City,Town,or Village Street or Site Description ARMY CORPS OF ENGINEERS 4.Type of federal permit/license required: N/A 5.Federal application number,if known: 6. If a state permit/license was issued or is required for the proposed activity,identify the state agency and provide the application or permit number,if known: NYSDEC C.COASTAL ASSESSMENT Check either"YES"or"NO"for each of these questions. The numbers following each question refer to the policies described in the CMP document(see footnote on page 2)which may be affected by the proposed activity. 1.Will the proposed activity result in any of the following: YES/NO a.Large physical change to a site within the coastal area which will require the preparation of an environmental impact statement? 11 22 25 32 37 38 41 43 b.Physical alteration of more than two acres of land along the shoreline,land under water or coastal waters? (2, 11, 12,20,28,35,44). . . . . . . . . .. . . . .. . . . . . . .. . . c.Revitalization/redevelopment of a deteriorated or underutilized waterfront site? (1) .... . . d.Reduction of existing or potential public access to or along coastal waters? (19,20). . .. . . rII RI e.Adverse effect upon the commercial or recreational use of coastal fish resources? (9,10)... f. Siting of a facility essential to the exploration,development and production of energy resources in coastal waters or on the Outer Continental Shelf? (29). . .. . . . .. ... . ... . . . g. Siting of a facility essential to the generation or transmission of energy? (27).. . . . .. . . . . EL .1 h.Mining,excavation,or dredging activities,or the placement of dredged or fill material in coastal waters? (15,35). . .... . . . . . . .. . . .. . . .. . . . . . . . . . . . . . .. . . ... .. . . .. .. .. i.Discharge of toxics,hazardous substances or other pollutants into coastal waters? (8, 15,35) j.Draining of stormwater runoff or sewer overflows into coastal waters? (33).. . . .. . . .. .. k.Transport,storage,treatment,or disposal of solid wastes or hazardous materials? (36,39). EL 1.Adverse effect upon land or water uses within the State's small harbors? (4). . .. .. .. . . . . 2.Will the proposed activity affect or be located in,on,or adjacent to any of the following: YES/NO a.State designated freshwater or tidal wetland? (44). . .. . .. . . . . . .. ... . . . . . . . .. . . . .. . b.Federally designated flood and/or state designated erosion hazard area? (11, 12, 175). .. . . _ c.State designated significant fish and/or wildlife habitat? (7). .. . . .. .. . . .. . . . . . . . . . . . d.State designated significant scenic resource or area? (24). . . . . . . .. .. . . .. . . .. . . . . . . . e.State designated important agricultural lands? (26). .. . . .. . . . . .... . ... . . . . . . .. . . .. f.Beach,dune or barrier island? (12). . . . . .. .. .. . . .. . . . . .. . . . .. . .. .. .. .. .. .. . . . . g.Major ports of Albany,Buffalo,Ogdensburg,Oswego or New York? (3). . . . . . .. . .. .. .. h. State,county,or local park? (19,20). .. . . . . . . .. . . .. . . . . .. . . .. . . .. . . . . . . . . . . . . . i.Historic resource listed on the National or State Register of Historic Places? (23). . . . .. . . 3.Will the proposed activity re Hire any of the following: YES/NO a.Waterfront site? (2,21,22). . . .. .. . . . . . . . . . . .. . . . . . . . . .. . .. . ... . . . .. .. .. . . .. b.Provision of new public services or infrastructure in undeveloped or sparsely populated sections of the coastal area? (5) . . .. . . . . .. . . . . . . . . . . . . .. . .. . . .. c.Construction or reconstruction of a flood or erosion control structure? (13, 145 16). . .. .. . d. State water quality permit or certification? (30,38,40). . . . . . . . .. . ... . . .. .. .. .. . . . . e.State air quality permit or certification? 41,43 4. Will the proposed activity occur within and/or affect an area covered by a State approved local waterfront revitalization program? (see policies in local program document). .. .. . . . .. .. . . D.ADDITIONAL STEPS 1.If all of the questions in Section C are answered"NO",then the applicant or agency shall complete Section E and submit the documentation required by Section F. 2.If any of the questions in Section C are answered"YES",then the applicant or agent is advised to consult the CMP,or where appropriate,the local waterfront revitalization program document*.The proposed activity must be analyzed in more detail with respect to the applicable state or local coastal policies. On a separate page(s),the applicant or agent shall: (a) identify,by their policy numbers,which coastal policies are affected by the activity,(b)briefly assess the effects of the activity upon the policy; and,(c)state how.the activity is consistent with each policy. Following the completion of this written assessment,the applicant or agency shall complete Section E and submit the documentation required by Section F. E.CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program,as appropriate. If this certification cannot be made,the proposed activity shall not be undertaken. If this certification can be made,complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program,or with the applicable approved local waterfront revitalization program,and will be conducted in a manner consistent with such program." JEFFREY PATANJO Applicant/Agent's Name: Address:106 HEWITT BLVD., CENTER MORICHES, NY 11934 Telephone: Area Code(631 )484-9332 Applicant/Agent's Signature: Date: F. SUBMISSION REQUIREMENTS 1.The applicant or agent shall submit the following documents to the New York State Department of State,Office of Coastal,Local Government and Community Sustainability,Attn:Consistency Review Unit,1 Commerce Plaza,99 Washington Avenue-Suite 1010,Albany,New York 12231. a.Copy of original signed form. b.Copy of the completed federal agency application. c.Other available information which would support the certification of consistency. 2.The applicant or agent shall also submit a copy of this completed form along with his/her application to the federal agency. 3.If there are any questions regarding the submission of this form,contact the Department of State at (518) 474-6000. *These state and local documents are available for inspection at the offices of many federal agencies,Department of environmental Conservation and Department of State regional offices,and the appropriate regional and county planning agencies. Local program documents are also available for inspection at the offices of the appropriate local government. Policy 44 There will be no negative effect to the vegetated tidal wetlands by this proposed action. All wetlands will be protected during construction. Policy 7 There will be no negative effect to the wildlife and fish habitats by this proposed action. The bulkhead will be removed in a manner to prevent major sedimentation of the waterway. p� of� P` •` t? FORPC.NO. � � m2aW H'� jai' • £ '9 • tt 2 ap�0 C - J�a K• '9 s fit,, i,NO s �. 7 M1 M1 R M1� —147 fO,P NO. �9 2 9 '° E a E SEC NO. Rt b b A mP , ANOEPUY"•'EOOR`wmA,ni"I` •e.sn(cl tz.TAly ��,• .,✓' � � '..tee� �'�8�� ea � zeta u � ENI vuq \\•, b Q �\ F * CIA(l) N9ERTSON a I 15A1�1 ,v ` ♦ t \s v. ssz,�£.' '" st •�l 'ate' 1� ° ,4° a . \ TONtI OF SOOiNOLD \\ •\,a :'''p,t'. „` ,e'�, Pe•FaovmravNra 13 xs. 1 PECONILIANO—V I �� T 7 �' •O\ a �g rc m P 9 FORP NM �I O °1/' 1.Yt ✓ ^a.p \ SEE YC.N0. � ®a,mt0 SFESEG NO. --��� b `� u E _-•,m,.0 ossotay.0 E \ A £ NP �, ',.SA _ � _______ �___ _ �Z_____l1NE �IMTOH— �-----l1NE >n nb�F ; NQOM SEE 6E0 NO.OiB SEE SEC N0.6Y s NOTICE COUNTYOFSUFFOLK © K swTitrnn SECTION NO - E��� —iz— IZt) O2 """ — -- -- Real Property Tax Service Agency y ® a '$Z C'ar�uu ______ Nr.r ••.•• ytN<Iv P va 10°a PROPERTY MAP O...r a r _____ o_ _ October 22, 2012 Town of Southold Trustees I E C Town Hall Annex Building F 54375 Rte. 25 OCT 2 5 2012 E f P.O. Box 1179 l Southold, New York 11971 -_n r..a..... ....... .:.._ �_�v Attention: Elizabeth Cantrell ` " "' ' Ty"" f RE: 245 BAYVIEw AVE., SOUTHOLD, NY SCTM No. 1000-52-05-27 REVISED PLANS Dear Ms. Cantrell: Attached please find four (4) copies of revised plans based on comments addressed during the meeting of October 17, 2012. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, eff ey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 7 OFFICE LOCATION: �� So MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold,NY 11971 G • � Telephone: 631 765-1938 Fax: 631 765-3136 olyCOU LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM _ ECE WF ` To: Jim King, President F[Iii OCT 12 2012 �� s Town of Southold Board of Trustees Southold Town From: Mark Terry, Principal Planner Beard+ of Tr;. 'ms LWRP Coordinator Date: October 12, 2012 Re: Proposed Wetland Permit for JUDITH C. HOCKEMEYER SCTM#1000-52-5-27 Jeffrey Patanjo on behalf of JUDITH HOCKEMEYER requests a Wetland Permit to remove existing timber bulkhead and replace with 49 linear feet of new vinyl bulkhead and raise it 1' above existing with a 25' return and a 15' return; and provide 30 cubic yards of clean fill. Located: 245 Bayview Avenue, Southold. SCTM# 52-5-27 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 Policy Standards and therefore is CONSISTENT with the LWRP. It is recommended that the proposed 15' wide Landscaped Buffer landward of the bulkhead (excluding returns) be established to reduce turf area and improve water quality of Arshamomaque Pond. 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 Office Use Only ' ";... w _Coastal Erosion Permit Application PP Wetland Permit Application Administrative Permit Amendment/Transfer xtension %# SEP I.S Received Application: I3 Ja Received Fee:$ Completed Application 13 lA Southhold Town _Incomplete Board of Trustees _SEQRA Classification: Type I Type II Unlisted —Coordination:(date sent) LWRP Consistency Assessment Form / CAC Referral Sent: g 29 hZ, Y Date of Inspection: a _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: �(Public Hearing Held: Resolution: Name of Applicant JUDITH HOCKEMEYER Address 166-26 POWELLS COVE BLVD, 9A, BEECHHURST, NY 11357-2050 Phone Number:(347) 368-6160 Suffolk County Tax Map Number: 1000 - 52-05-27 Property Location: 245 BAYVIEW AVENUE, SOUTHOLD, NY 11917 (provide LILCO Pole#, distance to cross streets, and location) AGENT: JEFFREY PATANJO (If applicable) Address: 106 HEWITT BLVD, CENTER MORICHES, NY 11934 Phone: 631-484-9332 Can` hoard of Trustees Application GENERAL DATA Land Area(in square feet): 7,905 SF Area Zoning: SFR Previous use of property: RESIDENTIAL Intended use of property: RESIDENTIAL Covenants and Restrictions: Yes x No If"Yes",please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes x No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes x No Does the structure (s) on property have a valid Certificate of Occupancy x Yes No Prior permits/approvals for site improvements: Agency Date x No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No Yes If yes,provide explanation: Project Description(use attachments if necessary): REMOVE EXISTING TIMBER BULKHEAD AND REPLACE WITH 49 LF OF NEW VINYL BULKHEAD WITH 25' & 15' RETURNS. RAISE ELEVATION 1' ABOVE EXISTING AND PROVIDE 30 CUBIC YARDS OF CLEAN FILL. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: EXISTING BULKHEAD IS DETERIORATED AND IN NEED OF REPLACEMENT. Area of wetlands on lot: o square feet Percent coverage of lot: N/A Closest distance between nearest existing structure and upland edge of wetlands: 2 feet Closest distance between nearest proposed structure and upland edge of wetlands: 2 feet Does the project involve excavation or filling? No X Yes If yes,how much material will be excavated? o cubic yards How much material will be filled? 30 cubic yards Depth of which material will be removed or deposited: 1 feet Proposed slope throughout the area of operations: z Manner in which material will be removed or deposited: SKID STEER PLACED LANDWARD OF PROPOSED BULKHEAD. 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): THERE WILL BE NO EFFECT ON WETLANDS DUE TO LOCATION AND SEPARATION DISTANCE REQUIRED FOR NEW BULKHEAD INSTALLATION. Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: EXISTING BULKHEAD IS DETERIORATED AND IN NEED OF REPLACEMENT. Are wetlands present within 100 feet of the proposed activity? No x Yes Does the project involve excavation or filling? No x Yes If Yes, how much material will be excavated? 0 (cubic yards) How much material will be filled? 30 (cubic yards) Manner in which material will be removed or deposited: SKID STEER PLACED LANDWARD OF PROPOSED BULKHEAD. Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) THERE ARE NO KNOWN ENVIRONMENTAL IMPACTS FROM THE REPLACEMENT OPERATIONS DUE TO CONSTRUCTION METHODS UTILIZED. 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -PROJECT INFORMATION To be completed by A licant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME JUDITH HOCKEMEYER BAYVIEW AVENUE BULKHEAD 3. PROJECT LOCATION: Municipality SOUTHOLD County SUFFOLK 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) 245 BAYVIEW AVENUE,SOUTHOLD-SEE ATTACHED LOCATION MAP 5. PROPOSED ACTION IS: New Expansion ✓❑Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: RECONSTRUCT EXISTING TIMBER BULKHEAD WITH NEW VINYL IN SAME EXISTING LOCATION 7. AMOUNT OF LAND AFFECTED: Initially .01 acres Ultimately •01 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? �✓ Yes ❑ No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ❑� Residential Industrial Commercial Agriculture Park/Forest/Open Space Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,STATE OR LOCAL)? Z Yes ❑ No If Yes,list agency(s)name and permit/approvals: NYSDEC,NYSDOS,ARMY CORPS OF ENGINEERS,TOWN OF SOUTHOLD TRUSTEES 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes ❑� No If Yes,list agency(s)name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? Yes ❑✓ No I CERTIFY THAT THE FORM TION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: J '�- .� iA4 QUev Date: Signature: If t action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 RSDW PART II- IMPACT ASSESSMENT To be completed by Lead Agency). A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAR Yes a 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. 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 pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,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 species?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: C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: ... .................. ... .....__.. ................... .............. C6. Long,term,short term,cumulative,or other effects not identified in CI-05? Explain briefly: C7:Other impacts includin than es in use of either quantity or type of ever ? lain briefl :'" -" D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA? If .es,explain briefly: aYes a No E. IS THERE,OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ves explain: aYes Q No PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its(a)setting(i.e.urban or rural);(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 ii was checked yes,the determination of significance mustevaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large orsignificant adverse impacts which MAY occur.Then proceed directly to the FU EAF andfor prepare a positive declaration. Check this box Ifyou have determined,based on the information and analysis above and any supporting documentation,that the{iroposed acio WILL NOT result in any significant adverse environmental impacts AND provide,on attachments as necessary,the reasons supporting thi determination. Board of Trustees p QC7- Name of Lead Agency Date r-> I All 6- President p Print or Type Name ofResponsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible r in Lead Agency Signature of Preparer(If different from responsible officer) i October 8, 2012 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 Attention: Elizabeth Cantrell t l OCT 1 0 2w RE: 245 BAYVIEw AVE. SOUTHOLD NY '� southhold Town SCTM No. 1000-52-05-27 Board of Trustees AFFIDAVIT OF POSTING& MAILING Dear Ms. Cantrell: Attached, please find Affidavit of Posting and Proof of Mailing Notice (including Certified Mail Receipts)for the above referenced application. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, ffr y Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 Q�t$U.fFQr? -�O Sv James F.King,President - Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President CIO P.O.Box 1179 Dave Bergen 4 • Southold,NY 11971 John Dave Bergen a ��! Telephone(631)765-1892 Michael J.Domino �� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD _ - - ` -! �h L L"! OCT 10 2012 ii BOARD OF TRUSTEES: TOWN OF SOUTHOLD i --------------------------------------------------------------- �� -___ SOUti1110? Town In the Matter of the Application of Board of Trustees JUDITH HOCKEMEYER COUNTY OF SUFFOLK) STATE OF NEW YORK) Te, AFFIDAVIT OF POSTING I ��/ ��T A n b ,residing at/dba 1.°b 14 e"- C"t4— Allot_>!cAe-sy being duly sworn, depose and say: That on the 7 day of D c-f o bet& , 201 ZI personally posted the property known as 2 q s, Q 4.,v,s, Av¢. 9.,vA-614 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, October 17, 2012. Dated: Sworn to before me this 8 day of OC--1-. 20 12- U otary Public . nn Patanto Notary P k fNew York Quaff i Au61�5fOk861unty Commission Expires 08/07/20L`� iL PROOF OF MAILING OF NOTICE r L,, OCT 10 2012 ! � ATTACH CERTIFIED MAIL RECEIPTS �� southho!d Town Board of Trustees Name: Address: I , I C� �1oh�, �. �a.�-�ac,�oo c�. �3�� �-v�en�1 �a. ��-� L.0 0, & .mm Gu) �-. > �1 � ;�le4S My 1174 E . anJ h- I 1(4 A 'A. WiWre'� Po /q- STATE OF NEW YORK COUNTY OF SUFFOLK a ,residing at l vb &fed- ./Lti c`us, til .�(a 3 i ,being duly sworn, deposes and says that on the day of jam, 20JZ 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 812ft MbIrl(, (-5 ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before l� me this Day of_D��Ic> , 20 �- Notary Public L nn Paten o Notary Public State of�Vew York Quali6edin Suffolk County No:01 PA6150861 Commission Expires 06/07/2o-1 ' NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: -JUlt+h ,y oc-1K emege2 SCTM# { 000 - 54- 05-2--7 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: �A64,r_ kupp( C4,ear _ a',1GQ. re/0t*La NLw VIN.�C- h✓ULIlR4roQ. 4�- {�-LfC �t a�+t.- �' l5'�'tN� frl � ,� /tttvi_. A.,.& , JS- � 12Fi?e.�.o. P�04Ll,GE �a Gti( vG 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 2N pva7v[�c.� A✓�.t..c l S•✓-{-�.�� _ 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: W CA-n`s.0 ©e+..be2 ( -7. 201 R5.,cr 6 =oa 9,4A . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: ���kb 1-�ot,dG��►,a.?c�t� MAILING ADDRESS: 66- y6 QGveg. !14 &e4,fzi' ,v% 113� PHONE * 317- 76-s- d 160 AGENT: MAILING ADDRESS: 1 oG Ntwrr-t fvl.vcQ- Olalf5-.L iU""ales, A& 1[_1 b y PHONE #: 611- t1 Jq f 37�- 1 Enc., Copy of sketch or plan showing proposal for your convenie i4e, !� f f ` OCT 10 2012 ter, { Scut hh Doardo'Trustees PROJECT Rya• LOCATION lGxfhamarwck • PROJECT LOCATION MAP Po - CD -c-3, oeo e> 0 777 _i o� Ito i{ O N Iv yiPj` �, NOTES: 1ELEVATIONS REFER TO N.G.V.D. 1929 DATUM ----�-• 2. LOT AREA: 7,905 S.F. / 0.181 ACRES 3. PORTIONPECONICS OF PLAN FROM SURVEYORSPC SURVEY PREPARED BY: P �,9 ,,y1 1230 TRAVELER STREET, SOUTHOLD, NY 11971 J. HOCK EYER J. .�0 SURVEY LATEST GATED AUGUST 9, 2005 166-26 POWELLS COVE BLVD. 9A BEECHHURST, NY 11357-2050 yy 4 DU =0 PaRIQf, PZW cALE: JEFFR PATANJO Orf j� PAWMSBD PLAN& 106 HEWITT BOULEVARD 1"101v me CENTER MORICHES, NY 11934 SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY !�Z YIP JR lM_W_06•!J t aF 2 PROPOSED ALUNNUI OR CCA RNTNR TOP CAP PROPOSED 12'LONG CCA PFIDPOSEO 30CY CLEAN FILL TREATED TIMM PILL.6'O.C. FROM UPLAND SOURCE PLACED PROPOSED 8•X6' LLEHINO suuq EAD REAR WALE NOTE,REMOVE E716tIN0 BULKNEAO STRUCTURE IN RS ENRREIY AND INSTALL NEW BULKHEAD . .......... N THE DUCT SAME POSITION ............................................................ WITH RAISED ELEVATION OF 1'HEXLIIT A8011E EXIST.TOPCIAP -- — — _� AFIN=WE ALM IL a.SE fl PROPOSED IT LONG CCA X ---_�--- _ TREATED TN M PILE,6'O.C. - d PROPOSED 6•x6'CCA - PROPOSED 6W CCA �� WALE TYPICAL OF 2 TOP h BOTTgd WALEF `pROpOS£O IW LONG SHOREOIW D • 21S VINYL SHEETING PROPOSED 6'TIP OGL MAX uL.v O.aas PROPOSED 3'X6' LAY—.00 PILE DWINO SULXWAD a. L s D REAA WALE PROPOSED 6' CCA PILE.G' TO BE REMOVED IN O.C.6'LENOTN.BOLTED TO A ENTIRETY. LAY—LOD wmI S/4- C.VAHOEO TFfLU—Tf0I1s. PROPOSED 20'LOW I'MA. GALV.RE ROD,6'O.C. . PROPERTY OWNER: J. HOCKEMEYER 166-26 POWELLS COVE BLVD. 9A RGPOSED 10'LONG BEECHHURST, NY 11357-2050 SHOREGUMRD 225 VINYL SHEETING PR PAR �`�-- JEWN P ANJO N.ts, 106 HEWITT BOULEVARD CENTER MORICHES, NY 11934 [-C a) NQTES: I. ELEVATIONS REFER TO N.O.V.D. 1929 DATUM o J 2. LOT AREA: 7,905 S.F. / 0.181 ACRES zL 3. PORTIONS OF PLAN FROM SURVEY PREPARED BY: PECONIC SURVEYORS, PC m t Tv 1230 TRAVELER STREET, SOUTHOLD, NY 11971 ! p SURVEY LATEST DATED AUGUST 9, 2005 T"D 7:SDUrNOLD; WAD PEP" AM CAL.E: �_ AS NOTED E-TOWN OF SOUTNOLD SUFOLK COUNTY, NYlYIP ANR f000-61-0��7 z GF 2 Board of Trustees Application County of Suffolk State of New York JUDITH HOCKEMEYER BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. QA Signature SWORN TO BEFORE ME THIS ( � DAY OF 20 1 2- Notary Public FERALDINE MAAlA CURATOD G otary NO!01CU623741ic-state ot 4eW Qualified in Queens Co ntCommission Expires Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I� JUDITH HOCKEMEYER residing at 166-26 POWELLS COVE BLVD, 9A (print owner of property) (mailing address) BEECH HURST, NY 11357-2050 do hereby authorize JEFFREY (Agent) PATANJO to apply for permit(s) from the Southold Board of Town Trustees on my behalf. `(Owner's signature) V 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: JUDITH HOCKEMEYER (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 X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted ois day of 200 Signature \,"& 4" Print Nam -A �ud .c Form TS I �dos� k Town of Southold Erosion, Sedimentation t& Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.th THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 1000 52. OS 27 STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN :)s r c- SeNton -F3 0c Tt CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within Will this Project Retain All Storm-Water Run-Off the Scope of Work for Proposed Construction) 7.9 0 5/0.181 Generated by a Two(2)inch Rainfall on Site? (S.F./Awes) (This item will include all run-off created by site X 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 10 0 0/0.02 3 Site Improvements and the permanent creation of construction activity?. (S.F.!Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show Proposed — PROVIDERI BEF PROJECT DESCRIPTION (Provide AddidonalPages asNeeded) Drainage Structures Indicating Size 8 Location? tion?This X Item shall include all Proposed Grade Changes and F-1 REMOVE EXISTING TIMBER BULKHEAD AND Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion — a REPLACE WITH NEW VINYL BULKHEAD IN SAME and sediment control practices that will be used to X control site.erosion and storm water discharges. This LOCATION. item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or Excavation where there Is a change to the Natural Existing Grade Involving more than 200 Cubic Yards _ X of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities El Encompassing an Area in Excess of Five Thousand X (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction X General DEC SWPPP 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 vAll ultimately disturb one or more acres of land: vv1i1ch 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? El % 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-OffEl 1.The SWPPP shall be prepared prior to the submittal of the NOI.The NO)shall be Into and/or in the direction of a Town right-of-way? X 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, ❑ required,post-construction storm water management practices that will be used andlor 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 X compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Item will NOT Include the Installation of Driveway Aprona.) Identify potential sources of pellut(on which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark 3.AN 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 shell be prepared by a qualified Design Professional Licensed in New York a Storm Water,Grading,Drainage&Erosion Control Plan to Required hythe Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prlorto issuance ofAny Building Permit (NOTE: A Check Marc(J)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, �� COUNTY OF.. ....................SS '17iat I,...... ITH HOCKEMEYER ....being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) Andthat he/she is the ............................................OWNER . ... ... ... . .... ....................................---....................... (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ...............t�. day of.. .. v�— .............. ...2206� NotaryPublic: A.L�......�................................ . ........................... ........ (Signature of Applicant) FORM - 06/10 GERALDINE MARIA CURATOLO Notary Public-State of New York NO.O1CU6237414 Qualified in Queens CEM 1 !� y Commission Expires + 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",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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# 52 _ 05 - 27 The Application has been submitted to(check appropriate response): Town Board Planning Dept. 0. Building Dept. E Board of Trustees El 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital Q 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: REMOVE EXISTING TIMBER BULKHEAD AND REPLACE WITH 49 LF OF NEW VINYL BULKHEAD WITH 25' & 15' RETURNS. RAISE ELEVATION 1' ABOVE EXISTING AND PROVIDE 30 CUBIC YARDS OF CLEAN FILL. Location of action: 7245 BAYVIEW AVENUE, SOUTHOLD, NY 11917 Site acreage: 0.181 ACRES Present land use: RESIDENTIAL Present zoning classification: SFR 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: JUDITH HOCKEMEYER (b) Mailing address: 166-26 POWELLS COVE BLVD., 9A, BEECHHURST, NY 11357-2050 (c) Telephone number:Area Code( ) 347-368-6160 (d) Application number, if any: N/A Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes 0 No❑ If yes,which state or federal agency? ARMY CORPS OF ENGINEERS, NYSDEC, NYSDOS 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. 0 Yes ❑ No ❑ Not Applicable PROJECT ENHANCES COMMUNITY CHARACTER BY WAY OF PROVIDING A VISUALLY APPEALING AND FUNCTIONAL BULKHEAD. 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 0 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 F] Yes 0 No F� Not Applicable PROJECT ENHANCES VISUAL QUALITY BY PROVIDING A VISUALLY APPEALING BULKHEAD. 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 0 Yes 0 No 0 Not Applicable PROJECT PROTECTS LOSS OF LAND AND EROSION DUE TO TIDAL CURRENTS AND UPLAND RUNOFF. 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 0 No []Not Applicable PROJECT PROTECTS WATER QUALITY BY WAY OF PROVIDING A BARRIER FOR SEDIMENT EROSION. 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 [1] No[;] Not Applicable ACTION HAS NO EFFECT ON ECOSYSTEMS. 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 ACTION HAS NO EFFECT ON AIR QUALITY. 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 ACTION HAS NO EFFECT CAUSED BY SOLID AND HAZARDOUS WASTE. 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. ❑ YeEEI No® Not Applicable ACTION IS LOCATED ON PRIVATE PROPERTY. 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 ACTION IS LOCATED ON SINGLE FAMILY RESIDENCE AND UTILIZED FOR RECREATIONAL BOATING ACTIVITIES. 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 ACTION WILL PROMOTE RECREATIONAL RESOURCE FOR LANDOWNER BY WAY OF BOATING ACTIVITIES. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. Yes ❑ No © Not Applicable Created on 5125105 11:20 AM August 21, 2012 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 C `'J _11`j�— r; :.::41 Southold, New York 11971 RE: 245 BAyv[Ew AVENUE, SOUTHOLD, NY 3 2012 SCTM No. 1000-52-05-27 APPLICATION FOR PERMIT Town Dear Sir/Madame: We hereby submit one original and three (3) copies of the proposed plans, application, check, photographs and required data 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, J rey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 Cc: Judith Hockemeyer September 12, 2012 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 1 i r 6 Southold, New York 11971 ! t ' SEP 17 2012 RE: 245 BAYVIEW'AVENUE, SOUTHOLD, NY southhoid Town ----� SCTM No. 1000-52-05-27 -- @„Board of TrLs,. REVISED APPLICATION SHEETS Dear Elizabeth: Attached, please find four (4) copies of revised sheets from application with new project descriptions. In addition, I have included four (4) copies of the SEAF for your use. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. . Very truly yours, JePrbPanjo 106 Hewitt Blvd. Center Moriches, NY 11934