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Home My WebLink AboutHuecker, HenryTelephone (631) 765-1892 'lbwn Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971~)959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Monday, November 17, 2003, the following recommendation was made: HENRY HUECKER to expand existing cesspool system landward of existing system. Addition of pool to receive existing system. Located: 3300 Deep Hole Dr., Mattituck. SCTM#115-17-12 The CAC did not make an inspection, therefore no recommendation was made. I I I I II I I I i Albert J. Krupski, President James King, Vice-President Attic Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southeld, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Office Use Only Coastal Erosion Permit Application ~.,~-~Wetland Permit Application ___ Majo~ Waiver/'AmendmenVChan~.es ~dk'~ece~ved Application: ~'R"eceived Fee:$ ~.~"~ ---- · ,-~'mpleted Apl~lic~tion __Incomplete __S£QIL~t Classification: Type I Type Il U~flisted Coordination:(date se~)0~tl~ ~_...,E~C Referral Sent: ,.~__----.-~ate of Inspection: ~~ Receipt of CAC Report: ___Lead Agency Detemanation: __ Technical Review: ~'ublic Hearing Held: //]~.~ Resolution: f Minor OCT 7 (' Board Name of Applicant Address 3~ 0 L) Suffolk County Tax Map Number: 1000- Property Location: 37t) o ~-W-~(r~3, (provide LILCO Pole #, distance to cross streets, and location) Phone Number:(6,tO AGENT: (If applicable) Address: Phone: Board of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: 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 Has any permit/approval ever been revoked or suspended by a governmental agency?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 operations: Area of wetlands on lot: ,g*Ffl~'~c Percent coverage of lot: ~/~ ~ % Closest distance between nearest existing structure edgeofwetlands: ~ ~.~' feet square feet and upland Closest distance between nearest proposed structure and upland edge of wetlands: q~ ~ ~ feet Does the project involve excavation or filling? No X Yes lfyes, how much material will be excavated? How much material will be filled? cubic yards cubic yards Depth of which material will be removed or deposited: S '/~ feet Proposed slope throughout the area of operations: t.~ ~ Manner in which material will be removed or deposited: '~ ~_~]~ '~"~-~- 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): Appendix C State Environmental Cuality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION ¢'o be completed by Applicant or Project sponsor) SEQ 3, PROJECT LOCATI(~N: ~ cf l I .~ 5. iS PROPOSED ACTION: ~ New ~'Expansron [] MooifJcallonlalteradon 5. DESCRIBE PRO~ECT BRIEFLY: ~ qes,denI,al I~,!nau sinai ~¢~ C~,mmercla~ FEDERAL, T1. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALle PERMIT OR APPROVAL? [] Yes [] No If ',/es, JJs! agency name and permrtlapproval If the action is in the Coastal ,Area. and you are a state 3c~ency, complete the j Coastal A~aessm.r]. Form before proceeding with [his as_s, essmen~ OVER PA,qT li--E~ £~,1ENT-~ ]e .-.~cqc,e{e.a C'/ Igenc /' ~ART II{--OETE.=,MINATICN OF SiGNIF[CANC::- ~To ~e comole(ecI my Agency) Albert J. Krupski, President James King, Vice-President Arkie 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 (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application ~ of __ ................... iECEI E Bosrd of Trusteel AFFIDAVIT OF POSTING being duly sworn, depose ~d say: ~at on the day of ~ ¢ V , 200 ~ I per~nally posted by placing the Bo~d of Trustees official poster where it c~ e~ily be seen, ~d that I have check~ to be s~e the poster h~ remained in pla~ for ei~t days prior to the date of the public he~ng. Date of berg noted thereon to be held~~c Dated: .--' ~si~a~e~ S~gom to before me '3 ~y o~.~ .200 the property known as t~',~ct~ Iv"--/ Notary PublT~ Board of Trustees Application County of Suffolk State of New York DEruosz~ ~dmJ AVlqRMS 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 NIY PROPERTY TO ~NSPECT THE PREMISE S IN CONJUNCTION ?~VIE~//~S OF T,~[/~, P/~ATION',/'g igna re~~ SWORN TO BEFORE ME TmS DAYOF dTt_d- ,20 Notary Public NEW SUFFOLK AVENUE OCT 3 0 2003 Southold Town Boa[d of Trustees NTg °Oo,oo,,~ SUR',/E'r' OF P~OPER'T"r" SITUATE: MATTITUC, K TOY~N OF SOUTHOL~ SUFFOLK COUNT'C, NEY',I YORK NOT~: ~~~ERS LAND SUq',E'~0R 6 EAST MAIN STREET 36g-B2B8 Fa~ 369-8287 l~ , S LIC r~,_-, 50202