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HomeMy WebLinkAboutTR-6013 James F. King, President -``~~F SDUjyO ~ Town Hall Jill M. Doherty, Vice-President hOVV l~ 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson * Southold, New York 11971-0959 Dave Bergen ~ O Telephone (631)765-1892 Bob Ghosio, Jr. Q ~ Fax (631) 766-6641 ~'`~OUNTi,~c~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 17, 2007 Mr. Vincent Flaherty 10 West St., Apt. 23G New York, NY 10004 RE: 1775 INLET WAY, SOUTHOLD SCTM#92-1-8 Dear Mr. Flaherty: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., October 17, 2007: RESOLVED that the Southold Town Board of Trustees grants the last One-Year Extension to Permit #6013, as issued on October 20, 2004. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, o'r,~~ Jam s F. King President, Board of Trustees JFK:Ims James F. King, President ~~OF SDU~yO Town Hall Jill M. Doherty, Vice-President l~ 53095 Route 25 Peggy A. Dickerson P.O. Box 1179 Southold, New York 11971-0959 Dave Bergen G Q John Holzapfel ~ i~ Telephone (631) 765-1592 I~COU~'~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 23, 2006 Mr. Vincent Flaherty 10 West Street New York, NY 1004 RE: 1775 INLET WAY, SOUTHOLD SCTM# 92-1-8 Dear Mr. Flaherty: The following action was taken at the Southold Town Board. of Trustees regular meeting held on Wednesday, August 23, 2006: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Permit #6013 from Ted Dowd to Vincent Flaherty, as issued on October 20, 2004, and grants aOne-Year Extension to Permit# 6013, as issued on October 20, 2004. This is not an approval from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincere(~y James F. King President, Board of Trustees JFK: hkc v',~~~N ~ J. aH~ R7y /o L' 7 ~ 7,~~ ~ ~ ~ ~ i . :~73 G- 7'0 8 ~ ~ o2c-o ~o9Q,~ of o~v-? 1l~us~tfs.. o ~N ~~z~ D .13~ y s 7c OC7 - 9 2001 ~S ~,c ~i 7 9 so„mn,y u TNo t~ lU~ I l 9 7~ ~o.A1 M w N o~~l ~ i /7! H~ ~~un~~.~ H 5 / S j t ~ut'S i~ti ~di£,uyi~ti' - /op/,j ~ # ~ Fc lNC Qf~Giti~G OY y~,/ !,5 ~`J`7,~ ~b~l,r"'" l~V ~RcOt~,P i / ~~J)~Fs S ~Fe, ~ ~S `~c~ / Pd ~~1~°~ .r ~ A c COSTELLO MARINE CONTRACTING CORPORATION DOCK BUILDING • JETTIES • BULKHEADING • STEEL & WOOD PILING • FLOATS 423 FIFTH STREET • P.O. BOX 2124 GREENPORT, NEW YORK 11944 (631) 477-1199 /477-1393 /477-0682 FAX (631) 477-0005 May 31, 2007 Southold Town Trustees ^ p PO Box 1179 ~ Southold, NY 11971 bn BI~-3~~'~c ~ . RE: Flaherty Property - 177 Inlet Way, Southold C Dear Sirs: I am requesting a name transfer on permit #6013 issued to Ted Dowd on October 20, 2004 and permit maintenance dredging of the entrance of Fairhaven Inlet. Vincent and Eileen Flaherty are now the property owners. I have enclosed a copy of permit #6013, a Letter of Request for an Amendment and $50.00 transfer fee. If any additional information is needed to process this request, please do not hesitate to contact me. Sincerely, ne P. Costello ~ ~ ~ ~ ~~~1 Permit Manager LI I---- ~ , ; I ; . Enclosures JUi~i [007 I____ ~~~~„n~~;~,,o~~~, ~ • O~O$uFF~(~CO • Town Hell Albert J. Krupaki, President ~.j. l/y 53096 Main Road James King, Vice-President ~ ~ P.O. Box 1179 Henry Smith as x Southold, New York 11971 Artie Foster - "py • ~'tC Ken Poliwoda Telephone (616) 786-1892 ~01 ~ ~~O Fax (516)765-1823 i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD LETTER OF REQUEST FOR AN AMENDMENT DATE OWNER ~/111CP,Yl.~' r ICL~~1~R( PHONE ,~lo~' 7~~Q ADDx~ss to WeS~ S~,re~~--~nT3~C~. , Nei ~r k~. Nr~Y 1600' AGENT (~Q I ~Q Y~ PHONE X031 ~ ~ l 7 ADDRESS PROPERTY LOCATION -I TAX MAP NO. I OOb ~ `i I/We l 1~1('.~ l~ I`~ V1YIY~l? ~lTr(L(~/114~ydest an Amendment to Permit # (00 I~ -~L~,~ICIYIC~e ~'1P Yl(lapP ~rnnn~Pl~ (1~Itil'f l~1YIPV~~ Y1Q VtVi Yl~ ~~llG~~~(.(.~___ Signed By: n ~ ~ Q ~ C rn~ JUN ~ 2007 I~ U, .___~I sa~,moib~roW~, BoarA of Tnutees G~ - U a~~ AUG - 2 2006 U _ _ ~ / o / ~ 6 /S P ,iJt.2~ ~ /~2. 7?CJi'l'J~<--Y' ~ . CO ~ ~ ~ ~ / ~ ~ ~ ~ ~ ~ .R . ,~,~s •..a. ^ ..r.. w ;t _ _ , Board Of Southold -Town Trustees SOUTHOLD, NEW YORK Uct 20 2004 ~ PERMIT NO.. v.0r DATE:.........' ~ ~ TED DUWD -f' ISSUED TO ~ ,2~U~~p~`t~~tftplt s Pursuant 4o the provisions of Chapter 615 of the Lewz of the State of New York, 1893; and Chapter 404 of the Laws of the t State of New York 1952; and the Southold Town Ordinance en- #itled "REGULATING-AND THE PLACING-OF -OBSTRUCILpN$. IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS.F$OM LANDS .UNDER TOWN WATERS;". end in accordance with the ' Resolution of The Board adopted at a meeting held on Uct. 20 2004 ,and in consideration of the sum of ji .250 paid by Ted Dowd ~ of ..............Sau,tha Ed_............. N. Y. and. subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: WetQ.and pvunit .to mai.nte~iance dne.dge the ev~tiuxnee ov ' Fa.urhaven In2e~t with a. 10 yeah ma~.ntenanee dhedgtng peJcm.it, a~id a,P,2 as dep~.c~ed on the pLa~i phepcuced by Ted Dawd dated Sept.. 23, 1994. all in accordance with the detailed specifications as presented in the originating eppGeation. X IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs Corporate Seal to be affixed, and these presents to be sukiscribed by a majority of the said Board .es of this data. ~ ;/aKen Pae.iivod ' sn ~ AhtCe Foa.ten. Iabaent) O ~ F' .x Trosrc ,..,I ~nNnrT~nMc Ted Dowd TLe Permittee residing at Southa2d N, y,~ as ~acr of the eonsidetatioa for the Itsuance of the Permit does updectand and presaffie ro the fol- 8' i. Thu the said Board of Trustees sad the Taws of Southold as released team any sad _ all damages, « tiaims for damages, of stria arising, directly « indirectly as a molt of nay opa- -adoa .{~erfocmed .pmmat~~his .pmait, sad 3ha ~.e wL~ u W_s or 6a tnva eipmse, defend any tad all sudt wits'laidated 'by third ~atdes, and the said Peranttsee assntnes btii Babllity widt respect thereto, io ehe:oomplete ezdttsion of the Board of Trustees of the Town of Southold 2. That this Peahdt is wdid for a period of 24 mos. whirfr >s tJtlmidabd ro be the estimated time required ro complete the work involved, but rhonld tirdttnstances warrant, cegaest for as e:xnsioa .may be ande to the Board u a hua date 3. That this Permit should be retained fadefiaitefy, or as long as the said Pemdttee wishes m atainaia the sttuttute or project involved, to provide evideaae m anyone ooaaraed ehu aath- odzttdoa wu odgioaBy obtained 4. That the wodciavolved will be abJeat to the and appcaval of the Hoard « Its agents, and noaaompliaoa with the prorisiom of the odgiaadog applicadoq may be case for tevoca6oa of this Permit by resoludoa of the aid Baud. 5. Thu there will be ao uareasoaable iaterfermoe with mvigadoa as a mutt of the vteek herein authonfttd. - G. Thu there shall 6e no iatetfereaae with the right of the public to pass and tepaa along the beams belwKen big6 and low water marks. 7. Thu if future operation of the Town of SouthgW require the. removal aod/« alseradam in the lontlon of the wedc herein aumodned, or B. is the ophdon of the Boars of Tmsoea, the . wtadc shall cruse aarasoaable obstructroa to free mvigadan, the said Peomittee will be requited, aeon titre aotioe, to retowe or alter this work « project 6ueia stared without to the Town • of Southold 6. Thu die aid Baud wlll be nodited by the Permiuee « the eoaopktian of the work atah- ontaed. - g. That the 'Pemdtsee w111 abtaia all other permia and eoosmt: tdsat mq 6e required «P' phymm~l m this permit whidr maybe subjaa to rewire tywa faiYrca to obuia aatoe. ~gpFFO(,~c Albert J. Krupski, President Q Town Hall James King, Vice-President = G'y~ 53095 Route 25 Artie Foster Oy - P.O. Box 1179 Ken Poliwoda ~ ~ Southold, New York 119 71-0959 Peggy A. Dickerson ~ '1'.f~0 ~Q`' Telephone 1631) 765-1892 1 ~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 20, 2004 Ted Dowd 1775 Inlet Way Southold, NY 11971 RE: CEDAR BEACH, 1775 INLET WAY SOUTHOLD SCTM# 92-01-08 Dear Mr. Dowd: The Board of Town Trustees took the following action during its regular meeting held on Wednesday October 20, 2004, regarding the above matter: WHEREAS, TED DOWD applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 24, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 20, 2004, 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, 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 97 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, RESOLVED, that the Board of Trustees approve the application TED DOWD to maintenance dredge the entrance of Fairhaven Inlet, with a 10 year maintenance dredging permit, as depicted on the plan prepared by Ted Dowd dated September 23, 1999. 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.) This is not a determination from any other agency. Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/hct o~~gOfFO(,~co °s Telephone p ~ Town Hall (63l) 765-1892 ~ = 53095 Route 25 Q ' .F P.O. Box I I79 y~ol ~ ~aO~ Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Monday, October 18, 2004, the following recommendation was made: Moved by Don Wilder, seconded by Jack McGreevy, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit application of TED DOWD to dredge the entrance of Fairhaven Inlet - Ten-Year Maintenance Permit. Located: Cedar Beach - 1775 Inlet Way, Southold. SCTM#91-1-8 Vote of Council: Ayes: All Motion Carried 1 a 71- q N f i 5 ~I goo ~e eyfQQ pq 45q`i rn ~ S'1 .F j. y if4~; C Y Y ~ ~=I- r i. ~ ~ . t N~i~ e ~ K o o .E V e'1 i 'si iia Qu °m ~ i Ifr. Ifi i ~1 ~ Bi - 't )I{ I ~~I II .E' f if 8h5a3 f e 3Z ia3a? °6 3 sa:~~ iltPi iiiii 1` ~ \ IIII' /r ~ , ~t its? I ' ~ / a ~IEa'a Cfly ~ z ! c _J m ep e~ ~ ~ itf13 ox r TWO a° r.l v II'4I E. _ gat ~ e i ~ - ~ f~itt 10/13/04 Field Inspection ~ • .y,, , ~ _ jP. r ,K~, r , ...:y,,.,._ . • _ ~",;"Y'. 'i"y't i~ i fA~1 I~~Y X13 _ _ 11 t - _ i~~'~~~~ 4wa P,~,~ _ j t _ 6n . 7. :.cri" ~ f ~ ...his . !~ti ly¢ `.``i . ~ u . " ~ S i i~ k~! II{ ~1{' ~ ~ ~,k t', f r s~ ~ i I 10/13/04 Field Inspection • • i _ , r v+ I 10/13/04 Field Inspection • . - ~ 3 . ~ - r~i/~~ w~ V ~ ' tFT • ~ ~4y~, y. HKM ~i. A._. M'~MI~•..~1~~~9~. La.~..~J 5.~4.-.~+~'j ~~,a~, yS,vPxA„t~Yy`~y ~~h 3 '-r~1 5 ` r ^~F4"- yl ~ r J {r c '~~y~r°?ti+~°~,,~'~'~-.~S.~t 7ycl~,e ~ 't`~ A M, hi i4 3:Y t +y ~ - .~1. ~ f~l_1 y Y"-'~ ry, L i__; M1 _ ~ h ~ may, ai ~yy~",~,T~.j~ i `+i`} fY~yi~~r. T~.°~' _ ~1 ~a.y ~rH~y *-F.~y _hi COUNTY OF SUFFOLK c ~ - „ [ ~ ; ~ p ;~MAy ~ 5 _ , STEVE LEVY _____f SUFFO LK COUNTY EXECUTIVE - ~ ~ " g~-~,t :1 Tfc1~°S DEPARTMENT OF PUBLIC WORKS CHARLES J. BARTHA, P.E. RICHARD J. LAVALLE, P.E. COMMISSIONER LESLIE A. MITCHEL CHIEF DEPUTY COMMISSIONER DEPUTY COMMISSIONER April 26, 2005 Hon. Albett L Krnpski, Jr. Southold Town Tnutee Southold Town Hall PO Box 1179 Southold, NY 11971 RE: Proposed Maintenance Dredging of Cedar Beach Harbor Inlet-Spur (Fairhaven Inlet) Town of Southold Dear Mr. Krupski: The County is making preparations to present the subject waterway to the Dredging Project Screening Committee for approval. We acknowledge receipt of Heather Te[raulPs March 22, 2005 letter transmitting a copy of a Town pemvt to Ted Dowd for dredging of the entrance of Fairhaven Inlet. However, the Town must submit the following additional information for this proposed project no later than May 27, 2005: 1. The water depth above the shoaled area at low tide, on a map or drawing of the waterway; 2. The desired channel depth. 3. The use of the Fairlaven Inlet waterway- For example, the number ofhouses/docks sensed by the waterway (See enclosed Dredging Project Screening Committee criteria for approval). If you have any questions or require additional information concerning this matter, please contact myself or William Hillman, Chief Engineer of Highways, Stmctures and Waterways at 631-852-4002. Very trnly yours, Charles J. , P.E. Commissioner CJB:DL:sc Enc. Cc: Kevin Law, Chief Deputy Counry Executive/General Counsel SUFFOLK COUNTY [S AN EQUAL OPPORTUNITY /AFFIRMATIVE ACTION EMPLOYER 335 YAPHANK AVENUE ¦ YAPHANK, N.Y. 11980 ¦ (631) 852-4010 FAX (631) 852-0I65 § A8.5. Criteria for County dredging projects. (Derived from Res. No. 242-1979; amended 12-23-86 bt L.L. No. 6-1987) A. No proposed County dredging project shall be approved by the Dredging Project Screening Committee nor by the County Legislature unless such project shall be in the public interest. B. A dredging project shall be deemed to be in the public interest if it supports, advance or enhances the following types of uses, activities and/or facilities. (1) Publicly owned, leased and/or operated marine facilities, including but not limited to mooring aeeas, boat basins, marinas, docks and boat ramps. Boat ramps need not consist solely of paved asphalt but may be composed of concrete, treated lumber, gravel or crushed stone extending to the mean low water mazk. The parking areas associated with such a facility must accommodate at least six (6) cars with trailers and may be composed of smooth grassed azea, crushed stone, pavement or concrete. A Public mooring azea within an enclosed embayment must have within its proximity a publicly owned pazcel of ]and fronting on the embayment permitting public access in order to qualify as a public purpose. (2) Marine cormercial uses, including but not limited to boatyazds, ship repair facilities, commercial fishery docks and product transfer sites. (3) Industrial, transportation and utility uses, including but not limited to petroleum project transfer facilities, feny terminals and power plants. (4) Institutional uses such as education and public safety facilities. (5) Recreational uses, including but not limited to boat livery stations, party boats, marinas and yacht clubs open to used by the general public. (6) Reduction of the risk of public health problems based upon a certification by the Suffolk County Department of Health Services that the public health will be protected by dredging for the particular year the channel is proposed to be dredged. (7) Open water shoals outside of navigation channels to improve general navigation. (8) Obtaining fill from navigation channels for the purpose of beach nourishment and shoreline construction. (9) Mitigating damage or shoaling caused by the County of Suffolk. (10) Reduction of a navigational hazard caused by shoaling at bay -canal interfaces. ~SUFFO(~-~, Albert J. Krupski, President Q~ Q Town Hall James King, Vice-President G'f~ 53095 Route 25 Artie Foster y - P.O. Box 1179 Southold, New York 11971-0959 Ken Poliwoda ~ • Peggy A. Dickerson y~0 Telephone 1631) 765-1892 1 ~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 22, 2005 h1r. Dean Leonardi Suffolk County Department of Public Works 335 Yaphank Ave. Yaphank, NY Re: Dredging at Cedar Beach, Southold Dear Mr. Leonardi: The Trustees request that you review with the dredge screening committee the "spur" area beyond the entrance to Cedar Beach Creek. Enclosed is a copy of the permit that was issued to the property owner along that area of the creek, with a map showing the proposed dredging area. Please inform this office after you have evaluated the area if it meets the public benefit criteria and if the County will be dredging it. Please contact this office with any questions. Si erely, ~ Heather Tetrault Em~ironmental Technician ~pgQ~~~PLS? Pl 'ar 1:{ 16H MARSH • • , ~p7~RT"IA4L n aRS tt ~ , IN'TERTIDA ~ K MPR3H M R5 N 1D EDG IN6 FIRER~6y ~'~w sw~x~~ TiON ' oA~ ~~AA ~ VeG~"fA pP/A0X JO'Y JS/ L aN JJ o (6~AGK~ , c y( Ai,~SSJ _ ~ , • T1rav w+~: r 14oo-qs' 3 . ~ ~ a' ~ 015 Po~iA '9'~ FN c SITE \ _ MIGH MpASN ~~x 12R~ , ~ ~ - y CyLnc~ 1 ~ ~ . - " FR\ _ a <<" a, ~.y ~ ~ 1 ~ 6 iel?c \ R SAND I ~ r~a~\ s TR 1 SHROVE ~(r~eeo 1 OF TRUaT E~ ~ \ 1 1 H~,G T ~ WN OF SOUT OLD 177s rwF* w~ jc ~o ~4 i SEccur.~}p y DI~POSAS_ pR6p n ~s-~~ u ! ~ - P1~~1t4D it fIN9 foil: TGD pOwO I..JlT1,i ~ECbNIC piny 1775 IN:RyiIIIY I~eQarssr 6agc 68i ~~7i ~eisT wit - Se,r*~o ~ uv u~7r CIItNO~O, NY 7AS 3u JlR snVli ?1a. ~~2 9/2397 iO - NYS DEC APPROVED AS PFR TER11i$ 1 ~ ' AND CONDITIONS OF ~ilJ~ ~ Z ~~J PERMIT NO, ~'y~38-ao6ag/000/S '7 OI DATE / ,b'l Oo ~J/Qp J/~Llcr ~ OT' o~ Albert J. Krupski, President o~~S~FFO(~-co/~ Town Hall James King, Vice-President ~'i` zy 53095 Route 25 Artie Foster O ~ P.O. Box 1179 Ken Poliwoda W ~ Southold, New York 11971-0959 Peggy A. Dickerson ~.jr ~ Ott Telephone (631) 765-1892 ~Oj ~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only -Coastal Erosion Permit Application ?V~etland Permit Application /PQajor Minor _Waiver.%AmendmentlChan es /ReceivedApplica[ion: ~/~/t~+I -F~eceived Fee:$ completed Application ~ D ~ ' M 12 -Incomplete 1~! 6 _SEQRA Classification: Type I_Type II_Unlisted~ _Coordination:(date sent) SEP 2 4 2004 SAC Referral Sent: ate of Inspection: _3 -Receipt of CAC Report:- ~b -Lead Agency De[ermirtation: Technical Review: /Public Hearing Held: ' -Resolution: 7d7 _ ~ Scr.y4S f-~~t nr Name of Applicant o/ G/ raf/errLc j'C, 33~1~ Address / 775 _l til ~ ri S ~ t~~/~ ~ A/, 9 7 / Phone Number:(~h 7 ~ ~ 3 2Z~ Suffolk County Tax Map Number: 1000 - 9~- o/ - b,q PropertyLoeation: (,~~~r- Ue~c-~ /~7 .S' ~/etYU2~ ~LrU ~~n ti (provide LILCO Pole ,distance to cross streets, and location) AGENT: L~~/e sS (If applicable) / Address: ~,x i.2 3 .~o v ~~o ~d ti~5~ /1 j T~ , ~p~ a Phone: 76 $ 2 3 S • • Board of Trustees Application GENERAL DATA Land Area (in square feet): ~ . 2 Ac ra .S Area Zoning: ~es, ~ e~ ~ r Previous use of property: l~ e s . d e ~ Intended use of property: ~ ~ s . ~ c ~ / i Prior permits/approvals for site improvements: Agency Date ti'v o~L ~~;L~~ ~u. ~fs o/ F u~.~r e-r, 3 .3 /~20D n -T i ~z~t ~/oo clLL~, r 2/ ~f2 ocJ So~r~~~fl ~~SL~r~ /D /2S//9 9D„ y/J'-a~r.l cf'/C~~;,1. ~T ~ 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 Descriptioon (use attachments if necessary): ~o ,yc z~ e~ z`~-,~, o y C~' r ~zin L cam. i.~ ~•i'J GG G :O G /J /n ..r ~h r i~YJ ~i-t~ r ~ f_ C i~~ ~ ~ /.yam ~ ~ o w in ~b~ ih L~ • Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Pur/~pose of the proposed operations: _ S z ~s~ ~ ~ i° -E~--~- ~EG r7ih t1~PGr~ Area of wetlands on lot: square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No I~ Yes r If yes, how much material will be excavated? f ~0'~ cubic yards \ 3 0' X ~ s') -'l ~ r`1 c. N" How much material will be filled?_~_,cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Mann~elr in which material will/be removed or deposited/: t '!'2 a~ ~l na G~~m 4~J II ~~'G!(Gt Or f,~Y ¢ (`L (,/~r ~i 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): 1 / / /"ZIr ~1?C~ ~/J/CG p~C 1.fiC !J ~-Grl /~O ~/~i'»3~ C. Y2 ~J5 4- ~;sh will re~~-. is se, • gUFFOI~ • Albert J. Krupski, President ~0 C~ Town Hall James King, Vice-President Gy 53095 Route 25 Artie Foster q ~ P.O. Box 1179 Ken Poliwoda W ~ Southold, New York 11971-0959 Peggy A. Dickerson Gy ~ Telephone (631) 765-1892 ~'Oj ~ .1,`D~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of Ted--D°---'-='-~-------------------------------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, D ~L~S ~ i ,residing at / 7 D O ~ Ma-`-~ ~ ~ N being duly sworn, depose and say: That on the day of , 200 I personally osted the roperty known as 1 77 i~Y~~T Grl~-U ~T~`D ~O~U1z s~ ~Db2~rs_~ff by placing the Boazd of Trustees tcial poster where it can easily be seen, and that I h~ ave checked to be sure the poster has remained in place for eight days prior [o the date of the public hearing. Date of hearing noted thereon to be held ~Qf . - ()C'~Q(' o1'J, a1Q~`l " Dated: /Q - (signature) Sworn to before me this Ci'~ dayofCC~ 200{ NprAR'!~ 0 N1t N . y PROJECT ID NUMBER 617.20 SEAR 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~.,rPROJECT/~NAME//O r(3' L°~~e.,Z~p .yy a -G ~ M2~et i//ed in /dr ~i/'9a a T~>~G~ 3.PROJECT LOCATION. Municipality .S ~~n'~ / County .S~ ' 3. PRECISE LOCATION Stree~ 9dtless arJd Roaq ,lotersgctlon .Prominent Jandmarks etc -or prov~7Qe mao - /JZSZ4-_Le-t _/Y~1/rSoCr_Z=e /d~~~-l ~cl,ti~~,~_~kLG.~~z?- - zo Ganc.a-/ GUS-ynC rnn, eP/.9/rCT~.i~inr'aCc a~ ~e~c~ ~o~a~Y roc ~c J e „ 7-,- .t ~iC. ,Lc F'Z` ~J/ri ~a [/e;_ ~°n - /^pZ ' 5. IS PROPOSED ACTION : ? New ? Expansion ®Modification /alteration 6. DESCRIBE PROJECT BRIE.FLLY: ~y- B x 'fp i. j , o ~ Fo ~ ~ ~n o zn ~ ,r~rg a~ rq ~eo~~2~c2 c,0 G2i r92r/t~ L~~c ~ 6VLlIC~/ C~o ,.{'G-,3 5 /o r~r-~~ O d, /re ~'o d~e,A9 r o ~ b~y Su fl n llf Co~~tY v~ Ce far f.3ei~6 r.,/~ ~re d / ~ /Yli tc o d G vSe ~ o h iJ~/~ /.~i„ is 6 e zc-/-:e,!' Y t ~/i/ t 7. AMOUNT OF LAND AFFECTED: Initially / ~q acres Ultimately y acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ®Yes ? No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ® Residential ~ IntlusUial ~Gommercial ?Agriculture ~ Park /Forest /Open Space Other (tlescdbe) s i n q~ L l- i ,n ~ J m~ L . S 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 pennR /approval: 11. DOES LANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ?Ves i~NO If yes, list agency name antl permit /approval: 12. AS A RELS.29LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? es No ~£EIFTIFY THAT T~I~E~HJ/EQRMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Appli t /Sponsor Name / ~e_ d ~ Date: q~l 2/o G~ Si n lure If the action is a postal Area, a ou are a state agency, complete the Coastal Assessment Form be re proceeding with thls assessment PART II -IMPACT ASSESSMENT To be tom leted b Lead A enc 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, illegible) C1. Ezis[ing air quality, surtace 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 resouroes; or community or neighborhood charecter7 Ezplain briefly: C3. Vegetation or fauna, fish, shellfish or wiltllife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopletl, or a change in use or intensity of use of lantl or other natural resources? Explain briefy' C5. Growth, subsequent development, or related activities likely tc be intluced by the proposed action? Explain bdeFly: C6. Long term, short term, cumulative, or other eNects not ident~ed in C1-C6? Explain briefy: _ _ C7. Other im acts inclutlin than es In use of either uanti or of ener 7 Ex lain bdeFl D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA 7 If es, ex lain bdeFl Yes ~ No E. IS THERE, OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ez lain: Yes ~ No PART III • DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effectident~ed above determine whether it is substantial,large,importantor 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 sign~cance must evaluate the potential impact of the proposed action on the environmental characteristics ofthe CEA. Check this boz if you have identifetl one or more potentially large or signFlicant atlverse impacts which MAY occur. Then proceed directly to the FUL EAF and/or prepare a positive declaration. Check this box if you have tlelerminetl, based on the information antl analysts above and any supporting documentation, that the proposed actin WILL NOT result in any signfipn[ adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting lhi determination. Name of Leatl Agency Date not or ype erne o esponsi a icer in ea gency Title of Responsible Officer ignature o esponsi a cer in Lea Agency ignature o reparer d Brent m responsible o ter) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Nam~ej: / / Address: ' / f~ 1 ~e yr//~ t ~ 4- /~Z ~~~~a. /9"n.r 2s / /'vs~eeS a2~ ~z~/cs /CO,f~~,.h S~2~eS l~os/yn~ ~i/y //sue STATE OF NEW YORK CO_U~NTY OF SUFFOLK ~ L/a w ~ ,residing at / 77 S ~ /e t {'V ~ Y f , y ,being duly sworn, deposes and says that on the 2~ day of ,,~'c„ ~ , 20p 5, deponent mailed a true copy of the Notice set forth in the Boazd 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 aze 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 S~ro , , ~ r~ . /I/ U, that said N ~ were mate ch of said persons by (certified) (registered) mail. Sworn to be re me this 3`~ d Day of 20~~ Notary Public Claire L. Glew Notary Public. State of N!W Yolk No. 01 GL4879605 Qualified in Suffolk County Commission Expires Dec. 8, OOk, Board of Trustees Application County of Suffolk State of New York ~ G~ C c~ d BEING DULY SWORN DEPOS SAND 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/I-IER 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 COb~IPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER O SPECT THE PREMISES IN CONJiJNCTION REVIEW OF THIS APPLICAT ~ i Signat ~ SWORN TO BEFORE ME THIS ~ 3 DAY OF ~_r~o ,20~ ~L~ Notary Public Clalre L. Glew Notary Public, State of New York No.O1GL4879505 qualified in Suflolk Count Commission Ezpirea Dec. 5, ~oard of Trustees Applica~n AUTHORIZATION (where the applicant is not the owner) I , T w residing at / 77.5 Z/ f GZ (print owner of property) (mailing address) 7 r3 ,,T; 93 y S~ ~ t~,~ 1~ //y7 / do hereby authorize /~i~ y~ ~/,,F (Agent) c~~~ to apply for permit(s) from the Southol r o Trustees on my behalf. r s signat 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the Dart of town officers and employees The puroose of thi f to provide information which can alert the town of possible conflicts of interest and allow i[ to take whatever action is necessary to avoid same. / YOUR NAME: ~ ~o w [Y (Las[ name, fast name, r!tiddle initial, unless you are applying in the name of someone else or other entity, such az a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coaztal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other', name the activit}~.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any otlicer 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 [own 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 [he balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of [hat person Describe the relationship between yourseff (the applicant/agenUrepresentative)and the town otl:icer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town otlicer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5•h of the shares of the corporate stock of the applicant . (when the applicant is a corporation); B) the legal or beneficial owtter of any interest in anon-corporate entity (when the applicant is not a corporation); C) an officer, director, partney or employee of [he applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted t(u's__ cy ati~e~200 Signature Print Name ~-cam/"7 Form TS 1