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Home My WebLink AboutTR-5969AAlbert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hail 53095 Route 25 P.O. Box 1179 Southold, NewYork 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Permit No.: 5969a Date of Receipt of Application: 8/18/04 Applicant: Mark Baisch SCTM#: 35-4-11 Project Location: 1425 Gull Pond Lane, Greenport Date of Resolution/Issuance: August 18, 2004 Date of Expiration: August 18, 2006 Reviewed by: Board of Town Trustees Project Description: Install 6x6 whaler with 2x6 trex cap to top of existing bulkhead entire property width. Remove (1) pine (2) beech (2) birch trees from bank on south portion of bulkhead area. Temporarily remove natural vegetation adjacent to bulkhead and replace when regrading is complete. Install landscape border minimum 5' behind bulkhead- fill area with gravel. Grade behind landscape border to contour of neighbor to the south. Area north on bulkhead to remain natural with vegetation Remove frame steps to landing for dock-replace with path to house at grade. Install gutters on north and south roof fascia and install drywells to contain runoff as shown on diagram Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. The issuance of the Administrative Permit allows for the operations as indicated on the attached plans submitted to the Trustee office August 23, 2004. Special Conditions: Place hay bale line along bulkhead while working near water. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Albert J. Krupski, Jr., President Board of Trustees /_ lbf JUL 2 7 2O04 Soothold Town Bnsrd of Trustees Pro,lect Description 1425 Gull Pond Lane Greenport, New York r-I Install g~'g,.~" whaler to top of existing bulk_head entire property width. r-I Remove (1) pine (2) beech (2) birch trees fi.om bank on south portion o£bulkhead area. [] Temporarily remove natural vegetation adjacent to bulkhead and replace when regrading is complete. [] Install landscape border minimum 5' behind bulkhead-fill area with gravel. [] Grade behind landscape border to contour of neighbor to the south, [] Area north on bulkhead to remain natural with vegetation. [] Remove frame steps to landing for dock-replace with path to house at grade. [] Install gutters on north and south roof fascia and install drywells to contain run off as shown on diagram. BOard of Trustees LOT 14 29 LOT ~6 ~ ~ ~ u.P. EA~ENTS OF N~Uu~u O 'OR ~/NOT SHO~ ARE NOT GUARANTEED. uNAUTHORIZED ALTERATION OR ADDITION TO THIS SURt4EY IS A VIOLA ?7ON OF SECTION 7209 OF THE NEW YORK 5TA YE EDUCATION LA~ COPIES QF THIS SURVEY MAP NOT BEARINg THE LAND SURVEYOR'S INKED SEAL OR EMBOSSEO SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDIOATE¢ HEREON SHALL RuN ONLY TO THE PERSON FOR WHOM THE SURPEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GovERNMENTAL AGENCY AND LENDING INSflTUTION LISTED HEREON, AND TO THE ASSIGNEES OF mE LENDING INSTI- TUTION, GUARANTEES ARE NOT TRANSFERABLE. ,RVEY OF: P/q LOT No. 15 MAP OF FORDHAM ACRES, sECT. FILED MAR. 07, 1962 FILE No. 5519 GREENPOR T SITUATED iN: TOWlq OF: SOUTHOLD SUFFOLK COUNTY, DATE: 04/15/04 DIST. Lc.T.M. NO. 1000 ONE NEW YORK JOB NO. B04-~211 SCALE: 1" - 50' SEC. BLK. LOT 055 04 11 KENNETH H. BECK~ Surveying and Land Planmng 1814 Middle Country Road Suite D Ridge, N.Y. 11961 (831) FAX (631) 345-9429 :RM. FRAhAE FLO/kllNG DOCK FNC. BH 0.3S 0.5S 0.2W WALK OL NS ~.F. '~FNC. O.3S 0.7S WALK 2.1 LANI FNI 0.6 1 FRAME LANDINGS ' FRAME D La ' ~ STEPs ~ .5 ~ ~ s~o~¥ ~ 12.~ ., DWELL/No Z Il .5' FRAME STEPS 12.4' FRAME LANDING Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(63D 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Perrmt Application a~"Wetland Permit Application Major Waiver/Amendment/Cl:tanges ~--~Rece~ved Application:~[_ ~ceived Fee:$~ ~"~ompleted Applic ation~t~_ __Incomplete __SEQIL~ Classification: Type [ Type II Unlisted __Coordination:(date sent). CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Lead Agency Deterrmnation: Technical Review: ,,~Public Hearing Held:~ __Resolution: AUG ] o 2e,94 Board of Trustees Name of Applicant ~ tar I~ 5a ;SCL, Address ~~V Phone Number:( ) ~0~ / Suffolk Count.,,, Tax Map Number: 1000 - Property Location: .%4 (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicabl~ / Address: ~ 200 dO ~:~ ..4.-'/.~T7.. ,'Te. te~-_, ,t/. '~/ Phone: t / Board of Trustees Application Land Area (in square feet): Area Zoning: GENERAL DATA Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed op~/tions: _~~ ~ ~'~ square feet upland Area of wetlands on lot: Percent coverage of lot: (~ Closest distance between nearest existing structure and upland edge of wetlands: 0~. 020 ' feet Closest distance between .nearest proposed structure and edge of wetlands: /(.f//flf- feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: cubic yards cubic yards feet 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): PROJECT ID NUMBER 617.20 SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. APPLICANT / SPONSOR 2. PROJECT NAME 3.PROJECT LOCATION: County Municipality 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or r)rovide mar) IS PROPOSED ACTION: [] New []Expansion ~]Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ['~Yes No If no, descdbe bde~ly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) E~Residential []Industrial [~]Commercial J'~Agriculture E~]ParklForestlOpenSpace [~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ---]Yes []No If yes, list agency name and permit / approval: lt. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? E~]Yes [~No If yes, list agency name and permit / approval: 12 AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ~Yes E]No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Date: Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc~/I A. DOES ACTION EXCEED ANY TYpE THRESHOLDIN6NYCRR PART617.4? rfyes, ccordinate the review process and use the FULL EAF. r~Yes []No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 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: / I C2 !esthetic, agricultural, archaeological, historiC,' or other natural or cultural resources; or com'~ity or neighborhood character? Explain ~rie,y: C3. Vegetation Or faunal fish, ;~leilfi~h or~wiidii~.e Specio~: ;ignificani'habitats, or t~'~a{ened or';nd~ng;red Species? E~pl~in C4. Acornmunlysexs ngpan~o~g(~a'sasoffica yad~)~)~,'orach'ange museorih ensity~fuseo and or (~ther natur~l resources? Explain ~riegy: C5. Growth, sutisequent development, or related activities likel~ to be induced by th'e proposed action? Explain briefly: C6. Long term, short term, cumula6vo, or other e~ect~ not ido~'ii~l in Ca-CS? Explain briefiy: C7. Other impacts (includin~ chan~es n~use~of eith'~r"~]'fi'ahti~ or tTpe of energy? EXpiain bdefl¥i ' D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA [] Yes [] No J (If)'es, explain brie~},: I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? if '(es explain: 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); (bi 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. The n proceed directly to the FULl EAr 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 actior WILL NOT result in any significant adverse environmental impacts AND provide, on afiachments as necessary, the reasons supporbng thi~ determinabon. Name o[ Lead Agency Title of Responsible Officer Print er Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer IIf different from responsible officer) Board of Trustees Application County of Suffolk State of New York s ,'c BE NGDU YSWO 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 IOWN 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. ~tgnature 0 ' Notary ME1.ANIE DOROSk'l #OTARY PUBLIC, State of New ~ No. 01DO4634870 Oualified in Suffolk County ,.~ of Trustees Applicati~ AD'£~ORI ZATION (where the applicant is not the owner) (print owner ~f' property) (mailing address ) ( Agent ) apply for permit(s) from the Southold Board of Town Trustees on my behalf. / ' (Ow-ne~'s signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officers and emolovees. The ouranse of this form is to omvide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is necossarv to avoid same. · (LaSt name, fu~t name, 8aiddle initial, unless yoo are applying in lhe name of someone else or other entity, such as a company. I f so, indicate the other persoo's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooting 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 parmership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative) and the town officer or employee. Either cheek 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 applic~.nt (when the applicant is a corporation); __B) the legal or beneficial owner of any interest in a non-corporste 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 Form TS I Signature Print Name FNC. 0.3S :RM. WALK OL NS 4~ ~u~w/~''f° ~ RAMP FRAME FLOADNG DOCK ~'¢I IA''l /'l u~ ,. _,~ .- I ti O~ WALK 2.1 BH 0.5S (~ 0.2W FRAME LANDINGS F~ · FNC. O.SS 0.7S LANI 5' rf~A~~ ~' '¢2.7' 12.9' OW£LLiNG ~ ~ FRAME FRAME I,z.I ~ STEPS ~ LANDING 11.4' FNI 0.t~