{Isf* Yt Rt(c-_ STATEY,DepartmentofEnvlronmsntalConservation

OfflceofGenerdServlcar

IleDartmentof late

Received

sEP 1 1 20n

lvySDOSll$ArnyCoOrol Englmcrr r

Jolrur AppucnrtoN FoRMFor Permrts for activities activities affecting streams, waterways, waterbodies, wetlands, coastal areas, sources of water,and endangered and threatened specres.

You must separately apply for and obtain Permits from each involved agency before starting work. Please readall instructions.

1. Applications To:>NYS Department of Environmental Conservation Y] Check here to confirm you sent this form to NYSDEC.

p rioatwetlands fl Water WithdrawalCheck all permits that apply:

[l Stream Disturbance

[Z Excavation and Fill inNavigable Waters

[Z Doct<s, Moorings orPlatforms

[lOams and lmpound-ment Structures

@+ot Water QualityCertification

[l Freshwater Wetlands

f] Wild, Scenic and I t-ong lsland Well

. :::::l'::;:,:^'"" tr m""illll"Tf""- Management Threatened Species

>US Army Corps of Engineers lZ Cne* here to confirm you sent this form to USACE.

Check all permits that apply' [Z Section 404 Clean Water Act [Z Section 10 Rivers and Harbors Act

ls the project Federally funded? [- yes 7 ruo

lf yes, name of Federal Agency:

General Permit Type(s), if known:

Preconstruction Notification : T* Yes NoI

M Cfrecf here to confirm you sent this form to NYSOGS.

conduits, cables, etc.) [Z Ooct<s, Moorings or Platforms

>NYS Office of General Services

Check all permrts that apply.

I State Owned Lands Under WaterI utit,ty Easement (pipelines,

>NYS Department of State f Cfrect< here to confirm you sent this form to NYSDOS.

Check if this applies. [7 Coastal Consistency Concurrence

is NOT an individual

Mailinq Address Pos!_Qfftgql !Iy_ State ZipE''''* --ltrf" -lTelephone

Applicant

917 217-5766 Email ibortolis

Must be (check allthat apply): [7 O*ne, [l operato, f] Lessee

3. Name of Property Owner (if different than Applicant)

Post Office / Citv State Zio

Telephone

Jotrur Appltcartou FoRru 08/16 Page I of4

t,Jorrur Appt-lcATtoN Fonm - Continued. Submit this completed page as part of your Application.

State Zio

trr;--lTetephone @ Email

Prooertv Tax Mao Section / Block / Lot Number:

lr"r"t I tr, I tq I

Post Office / Citv State ZioNY E--l

Proiect Location Coordinates: Enter Latitude and Lonortude in deqrees, minutes, seconds:ratituoe Eo--]. l;t--l E- I' Lonsitro" lri--]. l;;--___l E;-___-l

Provide directions and distances to roads, intersectons,t.9 miles south of Sunrise Highway (27) and r.3 miles west of the Wantagh State Parkway

6. Project Description: Provide the following information about your project. Contnue each response and provideany addrtronal information on other pages. Aftach plans on separate paqes.

a. Pu of theRepair/Development of the waterfront at a residential home to (a) restore/maintain shoreline storm resiliency to erosion, (b) providesafe access for water-dependent recreational activities (boating, fishing and swimming) and (c) provide safe berthing conditionsmitigating the risk of damage to recreational boats and flood protection structures (bulkhead) during storm events.

b. Description of current site conditions:The project site originally comprised the residential structure, a bulkhead, over-water platform, pier,over-water platform, pier, floating dock and boat lift were constructed in i976, repaired/modified in

and/or destroyed during Hurricane Sandy.

floating dock and boat lift. The

t998 and significantly damaged

c. Proposed site chanqes:Reconstruct/update the original waterfront infrastructure.

d. Type of structures and fill materials to be rnstalled, and quantity of materials to be used (e.9., square feet ofcoveraqe, cubic Vards of fill material, structures below ordinary/mean hiqh water, etc.):

Structures with components extending below the ordinary high water include: (a) 83 t-F bulkhead constructed of vinyl sheet pile andtimberframing;(b)lS.6x8.oFT(605SF)fixedplatformbuiltoftimberpiles,framinganddeck;(c)ll.ox 5.oFT(t855F)fixedL-shaped pier constructed of timber piles, framing and deck; (d) z8o SF of floating dock(s) that are accessible via gangway (to SF);

and (e) 19.o x 1o FT ( t9o SF) elevated boat lift.

e. Area of excavation or dredqrnq, volume of material to be removed, location of dredqed material placement:

No dredging is proposed. Excavation associated with the removal of the bulkhead will be limited to the adiacent upland area. lt isipated the area to be excavated will be approximately t6-ft behind the existing bulkhead. All material excavated will be be

temporary staged on site and replaced in the original location.

f. ls tree cutting or clearing proposed? l--- Y", lf Y below.Timing of the proposed cutting or clearing (month/year):

Number of trees to be cut: Acreage of trees to be cleared:n/a n/a

Jorrur ApplrcAnoN FoRM 08/16 Page 2 of 4

*lrrJotNT APPLtcATtoN Fonru - Continued. Submit this completed page as part of your Application.

q. Work methods and tvpe of eouipment to be used:construction and material storage will be staged from upland area or a work barge temporarily moored on-site. Excavation,

al of the existing bulkhead and installation will be performed by an small excavator and/or crane. All material excavated will notthe site and may be temporarily staged upland within the site. Proper erosion control methods will be used.

h. Describe the planned sequence of activities:control measures will be set up at the site. Temporary excavation will be performed to facilitate removal of the existingand pier. lnstallation of the new bulkhead will occur first. Installation of the new fixed and floating docks and demolition of

existing residential structure will follow. Construction of a new residential structure will be completed last.

i. Pollution control methods and other actions to environmentalAll material removed will be properly staged and removed to an appropriate disposal facility. Use of vinyl or fiberglass sheets havebeen selected to minimize the leaching of chemicals into the waterway. Diesel equipment will use ULSD and use diesel particulatefilters (DPF) whenever available. The contractor shall take care to minimize idling of machinery on site.

). Erosion and silt control methods that will be used to prevent water qualitv impacts:All sediment control methods will be established prior to starting construction and maintained for the duration of all construction onthe site.

k. Alternatives considered to avoid regulated areas. lf no feasible alternatives exist, explain how the project willmrnimize lmpacts:

No feasible alternative exists. The bulkhead must be maintained to prevent erosion and maintain the viability of the residential upland.The project has been designed to match the existing conditions while providing a durable and and long term solution.

l. Proposed use [Z Prrvate [--]puulic I lCommercial

m. Proposed Start Date Spring zor8 Estimated Completion Date: Fall uorS

' Yes lfY

p. List any previous ermit / Apphq

Town of Hempstead Permit No. 776 - Dated t976 to David SchwartzNYS DEC Application lD 1-2829-01179/ooot Dated t7 March t998 by David SchwartzUSACE Application lD 98-o365o-13 Dated 6-April 1998 to David SchwartzTown of Hempstead Permit No. 776 t4-April1998 to David Schwartz

Willthis project require additional Federal, State, or Local authorizations, including zoning changes?f:*' - Yes lf Yes, list below.

Jotur Appr-tcATtoN FoRM 08/16 Page 3 of4

JoINT APPLIcATIoN Fonru - Continued. Submit t'his completed page as part of your Application.

Signatures.Applicant and Owner (lf different) must srgn the application.Append additional pages of this Signature section if there are multiple Applicants, Owners or ContacVAgents.

I hereby affirm that informatton provided on this form and all attachments submrtted herewith is true to the best ofmy knowledge and belief.

Permtsston to lnspect - I hereby consent to Agency inspection of the project site and adjacent property areas.Agency staff may enter the property without notice between 7:00 am and 7:00 pm, Monday - Friday. lnspectionmay occur without the owner, applicant or agent present. lf the property is posted with "keep out" signs or fencedwith an unlocked gate, Agency staff may still enter the property. Agency staff may take measurements, analyzesite physical characteristics, take sorl and vegetation samples, sketch and photograph the site. I understand thatfailure to give this consent may result in denial of the permit(s) sought by this application.

False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the NYSPenal Law. Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature,and by whomever suffered, aristng out of the project described herein and agrees to indemnify and save harmlessthe State from suits, actions, damages and costs of every name and description resulting from said project. lnaddition, Federal Law, 18 U.S.C., Section 1001 provides for a fine of not more than $10,000 or rmprisonment fornot more than 5 years, or both where an applicant knowingly and willingly falsifies, conceals, or covers up amatenal fact, or knowrngly makes or uses a false, fictitious or fraudulent statement.

Date

3o August 2017

Printed Name

Mr. John Bortolis

of Owner different than

Adon Austin

Title

Owner

Date

3o August 2017

Principal Director

Date

Printed Name Title

EolAoencv Use Onlv DETERMINATION OF NO PERMIT REQUIRED

Agency Application Number

(Agency Name) has detenninod that No Permit isrequired from this Agency forthe project described in this application.

PrintedName

Signature

Title

Date

Jorur AppLrclrrou Fonu 08/16 Page 4 of4

+

t

LAT: +40.6395LONG: -73.5539EAST BAY

BULKHEAD REPLACEMENT

34OO HEWLETT AVENUEMERRICK, NY 11.566

30 AUGUST 2OT7

PROJECT INFORMATIONLOCATIONPRIVATE RESIDENCE OF MR. JOHN BORTOLIS, 34OOHEWLETT AVENUE, IN THE TOW\ OF HEMPSTEAD, NASSAUCOUNTY, NEW YORK ALONG EAST BAY.

PROJECT NOTIFICATIONNONCE TO PROCEED IS PROVIDED BY RISING TIDEWATERFRONT SOLUNONS ON BEHALF OF THE PROPERTYOWNER, MR. JOHN BORTOLIS.

GENERAL CONTACT INFORMATIONRISING TIDE WATERFRONT SOLUTIONS, PLLC466 SUNRISE HIGHWAY, SUIIE 102ROCKVILLE CENTRE, NY 11570PHONE: 516-595-3483EMAIL: CONTACTCTRT-WS.COM

DEFrN rTrON(S)AU]HORITY MR. JOHN BORTOLIS

ENGINEER: RISING TIDE WATERFRONT SOLUTIONS, PLLC

CONTRACTOR: TO BE DETERMINED

SKETCH INDEX

VICINIW MAP

SK-1 T]TLE SHEET

SK-2 FACILITY PLAN

SK-3 BULKHEAD PLAN & ELEVATION

SK-4 BULKHEAD SECTION & DETAILS

sK-5 P|ER/PLATFORM FRAMINC PLAN

SK-6 PIER/PLATFORMDETAILSFOR RTGULATORY PERMITNOT FOR CONSTRUCTION

PROJECT DESCRIPTION

THE SCOPE OF WORK HEREIN COMPRISES ALL LABOR, MATERIALS AND EQUIPMENT TO REPLACE THE EXISTING BULKHEAD IN POSITION AND ELEVA]ED PER

DETATL "A" (SK-4) ("|N-PLACE" AND 18 TNCHES HTGHER tN ELEVAION) WTH THE TLLUSTRATED NAVY-STYLE BULKHEAD. THE PROJECT INCLUDES, BUT lSNOT LIMIIED TO:1. REMOVAL AND DISPOSAL OF THE EXISTING EULKHEAD CONSTRUCTED OF SHEET PILE(S), NMBER PILE(S), AND TIMBER WALE(S). ALSO INCLUDED IS

THE REMOVAL AND DISPOSAL OF THE EXISTING FOUNDATION SYSTEM.2. DECONSTRUCTION, TEMPORARY STORAGE, AND REINSTALLATION OF ALL ADJACENT OBJECTS AS DIRECTED BY THE HOMEOWNER.

3. THE RECONSTRUCTION OF A RESTRAINED NAVY-STYLE BULKHEAD, FIXED OVER WATER PLATFORM, FIXED PIER, VESSEL LIFT, AND FLOATING DOCK(S).4. NO DREDGING PROPOSED.

PR.JE.T No' P17o731.oo

scALE N. T. s.

DATE 30 AUGUST 2o1rSKETCH

SK_1 OF 6REV|S|ON NO.

oDRAWN BY

JWKCHECKED BY

AMA

LOCATION PLAN

BULKHEAD RTPLACEMENT (VrnRrCK)MR. JOHN BORTOLIS

STATT: NEW YORK EAST BAY COUNTY: NASSAU

PROJECT DESCRIPTION

lHE SCOPE OF WORK HEREIN COMPRISES ALL LABOR, MATERIALS AND EQUIPMENT TO REPLACE THE EXISTING BULKHEAD IN POSITION AND ELEVATED PER

DETATL "A" (SK-4) ("|N-PLACE" AND 18 TNCHES HTGHER rN ELEVAnON) WTH THE TLLUSTRATED NAVY-STYLE BULKHEAD. IHE PROJECT TNCLUDES, BUT rSNOT LIMITED TO:

1. REMOVAL AND DISPOSAL OF THE EXISTING BULKHEAD CONSTRUCTED OF SHEET PILE(S), NMBER PILE(S), AND TIMBER WALE(S). ALSO INCLUDED IS THEREMOVAL AND DISPOSAL OF ]HE EXISTING FOUNDATION SYSTEM.

2. DECONSTRUCTION, TEMPORARY STORAGE, AND REINSTALLATION OF ALL ADJACENT OBJECTS AS DIRECTED BY THE HOMEOWNER.

3. IHE RECONSTRUCTION OF A RES]RAINED NAVY'_STYLE BULKHEAD, FIXED OVER WATER PLATFORM, FIXED PIER, VESSEL LIFT AND FLOATING DOCK(S).4. NO DREDGING PROPOSED.

HEWLETT AVENUE

10'-o"PROJECTBOUNDARY

EASEMENT

TIAL

7(

TABTE 1 - TIDAL AREA CUT/Ftu.

ITEM QUANTITY

PROJECT FILL 0.00 cY

PRO]ECT CUT O,OO CY

NET CUT/FILL 0.00 cY

F- REPUTED PRoPERTY oFWETTE ZUBLI

6REPUTED PROPERTY OF ---

ERIC HOROWITZ

EXIST. RESIDENSTRUCTURE

EXIST. POOL(NoIE 1)

EXIST. VINYL FENCE(NorE 1)

ttF)(n

\iof,

FLANK PILE(rYP. BolH S|DES)

FLANK WALL(TYP. BOrH S|DES)

)A- ADJ. PROPERTY

I wATERFRoNT ASSETS)r-TIMBER PILE

(rYP. 14 PLA.)

FIXED O\ER WATER PLATFORM(75'-8" x 8'-0"=605 SF)

VINYL SHEET PILE

TIDAL BOUNDARY(AHW I ALW - SEE PARNAL ELEV.)

FLOAT'ING DOCK(4'-0" x 20'-0"=80 SF)

IILttFIXED "1" PIER(5'-0" x 37'-0":18s SF)

FLOATING DOCK(2O'-O" x 1O'-0":12OO SF)

a

/ L_ADJ. PRoPERTY/ wanRFRoNT ASSETS

(/ EAST BAY' 1wro.=rs,rzs'-0") .tdF

RECREATIONAL \ESSEL LIFT --(19'-0" x 10'-0"=t190 SF)

. C.\- ExtST. MOORTNG ptLEv (NoTEr-TYP.5PLA.)

NorE(s):1. REMOVE,/REINSTALL AS DIREC"IED BY HOMEOW\ER.2, NO DREDGING PROPOSED.

L79'_11" PROPERTY BOUNDARY

T83,-3" BULKHEAD LENGTH

'Z>oE=Lr-l r ro_5.oa5,E

=3Hsoa tL

tr9

PROJECT No' Pr 7o731.oo

scALE 1: 30

DATE 30 AUGUST 2017

SKETCH

SK_2 OF 6REVIS|ON NO.

0DRAWN BY

JWKCHECKED BY

AMA

FACILITY PLAN

BULKHEAD REPLACEMENT (H,{rnnrC<)MR. JOHN BORTOLIS

STATE: NEW YORK EAST BAY COUNTY: NASSAU

rf

IF+

HDG. HELICALANCHOR PILE(NorE 3)

VINYL SHEET PILE

TIMEER PILEsPA. AT 6'-0" O.C.

TIMBER CLAMP(TREAIUENT TYPE 3)

TIMBER TOP WALE(IREAIUENT TYPE 5)

II

. L SCARF JT. AT 18'-0" O.C./ TYP. AT TOP WALE

PARTIAL PLANBULKHEAD

TIMBER TOP WALE

T,/BULKHEADEL. +7.82

TIMBER MID WALE(TREATUENT TY"E 2)

v AHW EL. +1.32=

VALW EL. -2.31=

t",NoTE(S)

PARTIAL ELEVATIONBULKHEAD

HDG. NE ROD(TYP. AT PILES)

TIMBER BOTTOM WALE(IREATUENT TYPE 2)

1: APPURIENANCE(S) TO BE REMO\EDAEINSTALLED ASDIRECIED BY HOMEOWNER. NOT SHOITN FOR CLARITY.

2: FIXED O\ER WATER PLATFORM NOT SHOW\ FOR CLARITY.3: PROVIDE HEUCAL ANCHOR AT LOCATION OF POOL.

| -t-1",!.,

TIMBER LAY LOG(TREAruENT TYPE

FUU'LLo

UFaacizL

oI

-rO

ll2ttlJ

,z>ou-a'3>E8'e

=s?o<;eMo

LM,NoYlL'

PRoJEcr No' P17o7J1.oosc^LE

N. T. s.

DATE Jo AUGUST 2017

SKETCH

SK_3 OF 6 0REV|STON NO.

ORAIVN BY

JWKCHECKED BY

AMA

PARTIAL PLAN AND ELEVATION

BULKHEAD RTPLACEMENT (VrnRtCK)MR. JOHN BORTOLIS

STATE: NEW YORK EAST BAY COUNTY: NASSAU

EXIST. NMBER PLANKING(RE-FAcrNG)

DETAILT/BULKHEAD DEFINITION

oI

io

TERFRONT STR.

OVER WATER PLA]FORM DISTANCE TO STRUCTURE

FND. SYSTEM OFFSET

PARTIAL

TIMBER CAP

TIMBER CLAMP(TREAII,IENT TYPE 1)I

x OETAIL ,,A"

TIMBER DECK

@

th"o HDc. TrE ROD(LEN.= 18'-0")

Q IMBER LAY Loc(TREAT}/ENT TYPE 3)

ADJACENT GRADE

TIMBER PILE(TREAIUENT TYPE 5)(ALT.: HDG. ANCHOR PILE

o--r

i

@I

no

I

aUJ;<Y

O:NU(D

tr(Jl,-

TIMBER PILE CAP @L

@

.t

flJLrJ

Ue.

@

FI(JtrIoUI:zJlcl

i

TIMBER WALE(TYP. 5 PLA.)

T]MBER DIAGONALERACING

I

VINYL SHEET PILE/TIMBER PILE(TREATUENT TYPE

1- r,u,roF ExcAVAroN

ORIG. BULKHEAD

TIMBER PILE(TREAllr,lENT TYPE 1)

TYP. SECTIONN.r.s.

NOTE 1: APPURTENANCE(S) TO BE REMO\EDfEINSTALLED ASDIRECTED BY HOMEOWNER. NOT SHOWN FOR CLARITY.

TABTE 2. FITI. DESIGNATIONS

PLACED FILL REQ'D FOR 18" ELEVATION

REPLACED ERODED/LOsT FILL

RECLAIMED/ORIGINAL FILL OR DREDGE 5POIL5

DREDGED MATERIAL

L'z>oE=a'3.E

5e

=83sEtL

5iCCA TREATED PER AWPA-P5

CCA TREATED PER LATEST AWPA STANDARDS,COMMODIIY SPECIFICAIION A,P 3.0

PR.JE.T No' Pl7o7J1.ooscALE

N. T. s.

DATE Jo AUGUST 2017

SKETCH

SK_4 OF 6REV|SION N0.

oDRAWN BY

JWKCHECKED BY

AMA

SECTI ON

BULKHEAD REPLACIMENT (UrnnrCK)MR. JOHN BORTOLIS

STATE: NtW YORK EAST BAY COUNTY: NASSAU

FOR REGULATORY PERMITNOT FOR CONSTRUCTION

(FIXED PIER OVERALL LENCIH)

a EQ. SPA.=27'-3"

v-v-v-v-U-V-V'

EAST BAY(wlD.=t3,175'-0")

PLAN

=oJLV'

V- PIER/PLATFORM FRAMING sCALE;1:10

v-

PRoJEcr No' P17o73l.ooscat'

N. T. s.

DATE 30 AUGUST zoflSKETCH

SK_5 OF 6REVISION NO.

0DRAWN BY

JWKCHECKED BY

AMA

PrER/ernrronr\/l FRAMTNG PLAN

BULKHEAD REPLACEMENT (rrlrnntCX)MR- JOHN BORTOLIS

STATE: NEW YORK EAST BAY COUNTY: NASSAU

a--l

--lPzrn

=onx

?m ^c_>!la)-1z-EO ul>o<n--lor-

a

ooCZ.--l5z_

aaC

wCT_i\fr-u> rrlONn-orTI T_n>r --l> -rlC)otf|nTrlZ.O-1 rrl

vAHW EL.+1.32E

VALW EL. -2.31=

ELEVATIONFIXED PIER scALE: 1:10

NOTE: FIXED OVER WATER PLAITORM AND BULKHEAD NOT SHOWI| FOR CLAR|TY

6'-3" 66'-0" J-5

?? ?? ?? ?? ?

ELEVATIONFIXED OVER WATER PLATFORMNOTE: FIXED PIER AND BULKHEAD NOT SHOWN FOR CLAR|TY.

4dnACiTAY

8!GZi<3H-1 no<z-,

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a*xg'Ol-

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Photc 1 - Tal<en 30 ;\ugust 2017

{l

Photo 2 - Taken 30 August 201-7

486 Sunrise Highway, Suite 102

Rockville Centre, NY L1570(516) 595-3483 | www.rt-ws.com

Page | 1 of3

Piroto 3 - Tal<en 30 August 2017

tllrt1tt,d..L

iifl . *{.:' ,' .,

J- \.?r,.:r r {

##1 \

"-- I__.*"__

-d.,1i**'.:{

"-*-_.d#{,

t\\

\[It

486 Sunrise Highway, Suite 102

frockville Centre, NY 11570

{516i 595-3483 I www.rt-ws.com

Photo 4 - Taken 30 August 2017

Page | 2 of3

Photc 5 * Taken 30 August 2017

Photo 6 - Tal<en 30 August 2017

486 Sunrise Highway, Suite 102

Rockville Centre, NY 11570(516) 595-3483 | www,rt-ws.com

Fage I 3 of3

7

Short Environmental Assessment FormPart 1 - Project Information

Received

sEP 1 1 20t7

Instructions for Comnletins

Part I - Project Information. The applicant or project sponsor is responsible for the completion of Part l. Responses

become parl of the application for approval or funding, are subject to public review, and may be subject to further verification.Complete Part I based on infonnation currently available. If additional research or irrvestigation would be needed to fullyrespond to any item. please answer as thoroughly as possible based on current infbrmation.

Complete all items in Part L You may also provide any additional information which you believe will be needed by or usefulto the lead agency; attach additional pages as necessary to supplement any item.

Ptunnr.sY;??"sf opment

Part t - Project and Sponsor Information

Name of Action or Project:

Bortolis (Merrick) Waterfront Reconstruction

Project Location (describe, and attach a location map):34oo Hewlett Avenue in Merrick (New York) along the north shore of South Oyster Bay approximately 1.9 miles south of Sunrise Highway (27) and 1.3

west of the Wantagh State Parkway.

Brief Description of Proposed Action:The Applicant is seeking to permit the repair and replacement of waterfront infrastructure, which include: (a) 83 LF bulkhead will be constructed ofvinyl sheetpileandtimberframing; (b)75.Ax8.oFT(605SF)fixedplatformbuiltoftimberpiles,framinganddeck; (c)37.ox 5.oFT(185SF)fixedL-shaped pier constructed of timber piles, framing and deck; (d) z8o SF of floating dock(s) that are accessible via gangway (to SF); and (e) t9.o x to FT

(r9o SF) elevated boat lift.

Name of Applicant or Sponsor:

Mr. John Bortolis

Telephone: 9.t7 217_5766

E-Mail : ibortolis@puminc.com

Address:

J4oo Hewlett Avenue

City/PO:

Merrick

State:

NY

Zip Code:

11566

L Does the proposed action only involve the legislative adoption of a plan. local law. ordinance,administrative rule, or regulation?

IfYes, attach a narrative description ofthe intent ofthe proposed action and the environmental resources thatmay be affected in the municipaliry and proceed to Paft 2. If no, continue to question 2.

NO YES

V tr2. Does the proposed action require a permit, approval or funding from any other govemmental Agency?If Yes, list agency(s) name and permit or approval:USACE Permit, NYS DEC Permit(s); NYS OCS Permit(s); NYS DOS Permit(s); Local Town Permit(s).

NO YES

T a3.a. Total acreage of the site of the proposed action?

b. Total acreage to be physically disturbed?c. Total acreage (project site and any contiguous properties) owned

or controlled by the applicant or project sponsor?

0.27 acresAcreage indicated includesover-water area whereconstruction is proposed. TheTotal Land Area is o.t9 Acres.

0.09 acres

0.27 acres

4. Check all land uses that occur on, adjoining and near the proposed action.

I Urban E Rural (non-agriculture) [ Industrial ! Commercial fl Residential (suburban)

EForest ElAgriculture

EParkland

Z Aquatic EOther (specify);

Page I of3

5. Is the proposed action.a. A permitted use under the zoning regulations?

b. Consistent with the adopted comprehensive plan?

NO YES N/A

tr a utr tr a

6. Is the proposed action consistent with the predom inant character of the existing built or natural

landscape?

NO YES

u a7. Is the site ofIf Yes, identifo:

the proposed action located irr. or does it adjoin. a state listed Critical Envirorrmental Area? NO YES

a tr8. a. Will the proposed action result in a substantial increase in traffic above present levels?

b. Are public transportation service(s) available at or near the site of the proposed action?

c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action?

NO YES

V trZ trV f

9. Does the proposed action meet or exceed the state energy code requirements?If the proposed action will exceed requirements, describe design fearures and technologies:

NO YES

a tr10. Will the proposed action connect to an existing public/private water supply?

lf No. describe method for providing potable water:

NO YES

tr aI l. Will the proposed action connect to existing wastewater utilities?

If No. describe method for providing waste'"\'ater treatment:

NO YES

tr a12. a.DoesthesitecontainastructurethatislistedoneithertheStateorNational RegisterofHistoric

Places?

b. Is the proposed action located in an archeological sensitive area?

NO YES

V trn V

13. a. Does any portion of the site of the proposed action. or lands adjoining the proposed action, containwetlands or other waterbodies regulated by a federal, state or local agency?

b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody?If Yes, identifo the wetland or waterbody and extent of alterations in square feet or acres:

Prooosed action encroaches into South Ovster Bav to reoair or reconstruct (a) 83.2 LF navv-stvle bulkhead; (b) 6oS SF fixedplatform built of timber piles, framing and deck; (c) rr5 SF fixed pier constructed of timber piles, framing and deck; (d) u+8 SF

NO YES

tr atr V

14. Identifu the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:

0 Shoreline E Forest E Agricultural/grasslands

I Suburban

I Early m id-successional

Z Wetland Eurban15. Does the site of the proposed action contain any species of animal, or associated habitats, listed

by the State or Federal govemmellt as threatened or errdangered?

NO YES

a trI 6. Is the project site located in the I 00 year flood plain? NO YES

l,/l17. Will the proposed action create storm water discharge, either from point or non-point sources?

If Yes.a. Will storm water discharges flow to adjacent properties? flNo lvesb. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)?

If Yes. briefly describe: ENO lveS

NO YES

a tr

Page 2 of3

18. Does the proposed action include construction or other activities that result in the impoundment ofwater or other liquids (e.g. retention pond, waste lagoon, dam)?

If Yes. explain purpose and size:

NO YES

V trI 9. Has the site ofthe proposed action or an adjoining propeffy been the location ofan active or closed

solid waste management facility?If Yes. describe:

NO YES

V T20. Has the site ofthe proposed action or an adjoining propeffy been the subject ofrernediation (ongoing or

completed) for hazardous waste?If Yes. describe:

NO YES

a trI AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MYKNOWLEDGE

Applicant/sponsor name: tu]f. John Bortolis Date: lo August zorT

Signature: t

PRINT FORM Page 3 of3

EAF Mapper Summary Report Tuesday, August 29,2017 12:04PM

I '--l' ' 63 -327-14', 63.-3t7-t S

Disclaimer: The EAF Mapper ts a screentng tool tntended to assistproject sponsors and revlewrng agencres rn prepanng an envrronmentalassessment lorm (EAF) Not all questrons asked in the EAF areanswered by the EAF Mapper Addrlronal rnformation on any EAFquestron can be obtarned by consultrng the EAF Workbooks Althoughthe EAF Mapper provrdes the most upto-date drgrtal data avarlable toDEC, you may also need to contact local or other data sources rn orderto obtarn data not provrded by the Mapper Drgrtal data rs not asubstrtute for agency determrnatrons

3.-32I-53F'"''"".-,""'4-Ji"Qdl-orrne."L]SGSr-auer$"' 8lri32r -r'3

JspEn, hrtgTl, Esri &hing Ifi6.8. EstirTtsih$dl-

. s*SHE,lE$f P t*RCEn" Esril, Esrili"ifte {r{or!g.

Parl l I Question 7 [Critical Environmental NoAreal

Parl l I Question 12a [National Register of NoHistoric Placesl

Partl lQuestion 12b [Archeological Sites] Yes

Part 1 I Question 13a [Wetlands or Other Yes - Digital mapping information on local and federal wetlands andRegulated Waterbodiesl waterbodies is known to be incomplete. Refer to EAF Workbook.

Pan 1 I Questron 15 [Threatened or NoEndangered Animall

Part 1 I Question 16 [100 Year Flood Plain] Yes

Parl l I Question 20 [Remediation Site] No

Short Environmental Assessment Form - EAF Mapper Summary Report

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NEW YORK STATE DEPARTMENT OF STATE

COASTAL MANAGEMENT PROGRAM

Federal Consistenc)' Assessment Form

nefteiyffi

$EP r r afi?N{BDtiE

Plannryl e Devehpment

An applicant. seeking a pennit, license, waiver, certification or similar type of approval fronr a federal agency which

is subject to the New York State Coastal Management Progranr (CMP), shall complete this assessment form for any

proposed activity' that will occur within and/or directly affect the State's Coastal Area. This form is intended to

assist an applicant in certifuing 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 conrpleted form and acconrpanying information in its

review of the applicant's certification of consistency.

A. APPLICANT (please print)

L Name: Mr. John Bortolis

2. Address: 34oo HewlettAvenue, Merrick, NYtt566

3. Telephone: Area Code ( ) 917 217-5766

B. PROPOSED ACTIVITY:

I . Brief description of activity:

Repair/Reconstruct waterfront structures including: (a) 83.2 LF bulkhead will be constructed of vinyl sheet pile and timber framing; (b)

75.6 x 8.o FT (6o5 SF) fixed platform built of timber piles, framing and deck; (c) 37.o x 5.o FT (t 85 SF) fixed pier constructed of timberpiles, framing and deck; (d) z8o SF of floating dock(s) that are accessible via gangway (ro SF); and (e) t9.o x ro FT (r9o SF) elevated boatlift.

2. Purpose of activiry:

Repair/Development of the waterfront at a residential home to (a) restore/maintain shoreline storm resiliency to erosion, (b) providesafe access for water-dependent recreational activities (boating, fishing and swimming) and (c) provide safe berthing conditionsmitigating the risk of damage to recreational boats and flood protection structures (bulkhead) during storm events.

3. Location of activity:

Nassau Merrick 34oo Hewlett Avenue

Counly City, Town, or Village Street or Site Description

4. Type of federal permit/license required: USACE Permit

5. Federal application number, if known: Unknown

6. If a state pennit/license was issued or is required for the proposed activity, identify the state agency and

provide the application or pemrit number, if known:

NYSDOS, NYSDEC, NYSOGS - Unknown

C. COASTAL ASSESSMENT Check either "YES" or "NO" for each of these questions. The numbers followingeach question refer to the policies described in the CMP document (see footnote on page 2) which may be affected

by the proposed activiry.

l. Will the proposed activity'result in any of the following: YESNO

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) Etrb. Physical alteration of more than two acres of land along the shoreline, land under water or

coastal waters? (2, I I , 12.20,28.35, ,l-l)

c. Revitalization/redevelopment of a deteriorated or underutilized waterfront site? ( I )d. Reduction ofexisting orpotential public access to or alongcoastal waters? (19, 20)

e. Adverseeffectuponthecommercial orrecreational useofcoastal fishresources? (9, l0)f. Siting of a facility essential to the exploration, development and production of energy

resources in coastal waters or on the Outer Continental Shelfl (29)g. Siting of a faciliry essential to the generation or transmission of energy? (27)

h. Mining, excavation. or dredging activities, or the placement of dredged or fill material in

coastal waters? (15. 35)

i. Dischargeoftoxics.hazardoussubstancesorotherpollutantsintocoastal waters? (8, 15,35)j Draining of stormwater moff or sewer overflows into coastal waters? (33)

k. Transport, storage, treatment. or disposal of solid wastes or hazardous materials? (36. 39)

l. 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:

a. State designated freshwater or tidal wetland? (44)

b. Federally designated flood and/or state designated erosion hazard area? (l l. 12, l7)c. State designated significant fish and/or wildlife habitat? (7)

d. State designated significant scenic resource or area? (24\e. State designated irnportant agricultural lands? (26)

f. Beach, dune or Barrier Island? ( l2)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 require any of the following:

EEEtrEEEE

YESNO

EEEtrEEEEDEEEEtr

a. Waterfront site? (2, 2l ,22)b. Provision ofnew public services or infrastructure in undeveloped or sparsely populated

sections ofthe coastal area? (5)

c. Construction or reconstruction ofa flood or erosion control structure? (13, 14. l6)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. or State-approved regional coastal management program?

(see policies in program document*)

trtrYESNO

-EEEE-EEBEEtr

tlE

D. ADDITIONAL STEPS

l. If all of the questions in Sectiorr C are answered "NO", then the applicant or agency shall complete Section E and

submit the docurnentation required by Section F.

2. lf 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) identifu, by their policy numbers, which coastal policies are affected by the activity, (b)

briefly assess the effects of the activiry 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 docurnentation required by Section F.

E. CERTIFICATION

The applicant or agent must certifl/ that the proposed activity is consistent witlr the State's CMP or the approved

local waterfront revitalization program, as appropriate. If this certification cannot be made, the proposed activiry

shall not be undertaken. If this certification can be made, complete this Section.

"Tlre 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 rnanner consistent with such

program."

Appl icant/Agent's Name: Mr. John Bortolis

Address: 34oo Hewlett Avenue, Merrick, NY 11566

Telephone: Area Code (

Appl icant/Agent's Signature:

) e1l]17'5769

/(,,

F. SUBMISSION REOUIREMENTS

l. The applicant or agent shall submit the following documents

Office of Planning and Development, Attn: Consistency Review99 Washington Avenue, Albany, New York 12231.

Date. Jo-Aug 2017

to the New York State Department of State,

Unit, One Commerce Plaza-Suite 1010,

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. Ifthereareanyquestionsregardingthesubmissionofthisfbrm,contacttheDepartmentofStateat(5 r 8) 474-6000.

+'fhese state and local documents are available for inspectron at the otfices of nrany t'ederal agenctes, Departntent ofenvironrnental Consen'ation and Department ofState regional ottlces. and the appropriate regional and count)'planning agencies.

[,ocal prograrn docurnents are also al'arlable fbr inspection at the offlces ofthe appropriate local governn]ent.

l{E!flYORKSTATEOFOPPORTUNITY

Department ofEnvironmentalConservation

APPLICATION FOR PERMITFOR THE CONSTRUCTION, RECONSTRUCTION OR EXPANSION OF

DOCKING AND MOORING FACILITIES(lncluding Platforms and Breakwaters)

Supplement D-2

Please read all rnstructrons on the followng pageTYPE OR PRINT CLEARLY IN INKAttach addrtronal rnformaton as needed

FOR AGENCY USE ONLY

DEC APPLICATION NUMBER

U.S ARMY CORPS OF ENGINEERSAPPLICATION NUMBER

pROJECT CONSTRUCTION DESCRIpTION; The repair and replacement of waterfront infrastructure, which include: (a) navy-style bulkhead; (b) fixed overwater platform; (c) fixed pier; floating dock(s) that are accessible via gangways; and (e) an elevated boat lift.

1 TYPE OF ACTIVITY

n *u* Facrhty Constructon lfl suostantrat Reconstructron ! .rrrn",on ! chrns",n ur"

2 CAPACIry OF DOCKING FACILITY OR MOORING AREA

Maxrmum number of boats to be docked

Maxrmum number of boats to be moored

Boat type and srze ranges to be served

)

o

(1) 40 ft Recreational Powered Watercraft and (z) Personal Watercraft

Total surface area of faolrty penmeter 8,2oo square feet

square feet proposed over-water coverage.1,26o

3 IDENTIFY STRUCTURE WPES AND THE USE OF SUCH STRUCTURES, INCLUDE SIZE, TYPE OF CONSTRUCTION AND MATERIALS TO BE USED, IF

SUBSTANTIAL RECONSTRUCTION IS REQUIRED, EXPLAIN EXTENT OF ACTIVITY INCLUDING PERCENTAGE OF THE TOTAL STRUCTURE SIZEAFFECTEDProposed Activity includes a bulkhead, two (z) over-water structures, two (z) floating docks and an boat lift to be used as a docking facility or as access tothe docking facility.

sTR. 1-'Navy-Style'bulkheadconstructedofvinyl sheetpilewithtimberpiles&framing. Bulkheadis33LFanddoesnotresultinoverwatercoverage.

STR. z - Timber pile supported fixed over-water platform. Proposed platform is 75.6 ft long and 8.o ft wide resulting in 605 SF of over water coverage.

STR.3-Timberpilesupportedfixedpier. Theproposedpieris3T.oftlongand5.oftwideresultingint85SFof overwatercoverage.

STR. 4 - Two (z) Timber w/ Foam Floating Docks measuring 2o.o ft x 1o.o ft and 2o.o ft x 4.o ft resulting in a total over water coverage of z8o SF.

STR.5-ElevatedBoatLift. Proposedfour(4)timberpileliftistg.oftxto.oftandresultsintgoSFofoverwatercoverage.(contrnue on attached sheet rf necessary)

4 FOR NEW FACILITY, EXPANSION OF EXISTING FACILITY OR CHANGE IN USE, CHECK APPROPRIATE ITEMS AND DESCRIBE THE SERVICES TO BE

Potable water supply extended to dock pedestal for boat wash.

PROVIDED

E water suppty

E ,"*rn" Drsposat

E Electrrcat Suppty Underground supply to dock pedestal for shore power.

E eas suppty

E easotrnelorl Supply

E o,n"..

(contrnue on attached sheet rf necessary)

/(5 SIGNATURE DATE Jo-Aug 2oi7/.

(rev. 3/16)

APPLICABILITY

1 . The construction, reconstruction or expansion of docking or mooring facilities on, in or above state-ownedlands under water requires authorization from the New York State Office of General Services. Forapplication requirements contact: New York State Office of General Services, Divisron of Real PropertyPlanning, Bureau of Land Management, Empire State Plaza, Corning Tower, 26th Floor, Albany, NY12242. A permit pursuant to Article 15, Title 5 of the Environmental Conservation Law may not berequired from the Department of Environmental Conservation in these circumstances.

2. The determination that no permit is required from the New York State Depaftment of EnvironmentalConservation does not necessarily mean that no permit is required from the Unites States Army Corpsof Engineers. All parties considering constructing projects wrthin the navigable waters of the State shouldconsult directly with the United States Army Corps of Engineers to accurately determine whatrequirements apply.

INSTRUCTIONS

1. Application shall rnclude four (4) copies of thrs form, a map showing the facility location, scaled plans,cross-sections and specifications depicting all major structures and the delineated facility perimeters thatinclude a reference point tied to a permanent structure or signrficant natural features.

2. This application must be accompanied by a New York State Department of Environmental ConservationJOTNT APPLTCATTON FOR PERMtT (95-19-3).

3. Applications shall be submitted to the Regional Permrt Admrnistrator at the appropriate office of theDepartment, as indicated on the JOINT APPLICATION FOR PERMIT.

4. Construction, reconstrucilon or installatron of docking and mooring structures shall NOT be started untila permrt authorizing such activity has been issued by the New York State Department of EnvironmentalConservation.

5. The following definitions as listed in 6 NYCRR Part 608.1 apply.

Docking Facility means any marine, boat basin, marine terminal, and any other areas on navigablewaters containing a single structure or a collection of related structures, such as docks, piers,platforms, bulkheads, breakwaters, and pilings, used for the reception, securing, and protection ofboats, ships, barges or other water craft.

Mooring means a float, buoy, chain, cable, rope, pile, spar, dolphin or any other device orcombrnation of devices that are anchored or fixed in navrgable waters of the state to which a vesselcan be made fast.

Mooring Area means a collection of individual moorings located within a definable area of navigablewaters of the state and under single private ownership or control.

Perimeter means a boundary of a docking facility or mooring area consrsting of a series ofconnected imaginary lines on a plan or map, encompassing all related structures such as docks,bulkheads, breakwaters, pilings, piers, platforms or moorings and the travel lanes and berthingareas that function together to create a facility or area at which vessels may be docked or moored.

Platform means a generally honzontal, flat surface located in, on or over a waterbody, on whichstructures can be constructed or any activitres can be conducted.

Substantial reconstruction of structures means restoration or rebuilding, involving fifty percent(50%) or more of an existing fixed structure's surface area.

Google Earth Imagery from 3/6/2012 of the area around 3400 Hewlett Avenue, Merrick, NY 11566. Obtained January 25, 2018