The URL can be used to link to this page

Home My WebLink AboutTR-6334AJill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD CERTIFICATE OF COMPLIANCE # 0602C Date November 8, 2010 THIS CERTIFIES that the removal/pruning of vegetation to provide for planting of smaller plants to secure bluff from erosion and regarding of turf area to direct mn-off away from bluff edge At 1230 Ruch Lane, Southold Suffolk County Tax Map #52-2-36 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 3/28/06 pursuant to which Trustees Wetland Permit #6334A dated 4/19/06 was issued and conforms to all of the requirements and Conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal/pruning of vegetation to provide for planting of smaller plants to secure bluff from erosion and re-grading of turf area to direct mn-off away fi.om bluff edge. The certificate is issued to DAVID HOFFMAN owner of the resaid property., Authorized Signature Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 $outhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE INSPECTED BY: COMMENTS: __ Pro-construction, hay bale line/silt boom/silt curtain __ 1st day of construction ~ constructed Project complete, compliance inspection. CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6334A Date of Receipt of Application: March 28, 2006 Applicant: David Hoffman SCTM#: 52-2-36 Project Location: Ruch Lane, Southold Date of Resolution/Issuance: April 19, 2006 Date of Expiration: April 19, 2008 Reviewed by: Board of Trustees Project Description: Removal/pruning of existing vegetation to provide for planting of smaller plants to secure bluff from erosion and regrading of turf area to direct run-off away from bluff edge and all as per the plans prepared by Creative Environmental Design revised 4/06 by Derek Bossen. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth by the Board of Trustees. Special Conditions: Final inspection If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth by the Board of Trustees, a Wetland Permit will be required. This is not a determination from any other agency. Board of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ,~/ reviewed by this Board at the regular meeting of following action was taken: has been and the ( X/(Application Approved (see below) (__.) Application Denied (see below) ( )Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in Chapter.97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOA]RI) 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 ¼ constructed Project complete, compliance inspection. T James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John I~olzapfel Town Hall 53095 Route 25 P.O. Box 1179 Sou~hold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTI~ES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: /~ -{ ~,-Of° Name of Applicant: ,~4~Ji J ~o3(=( Name of Agent: C.,Aj~-i'x ct~ ~u?- Property Location: SCTM# & Street Brief Description of proposed action: ~qe of area to be impacted: . Saltwater Wetland Freshwater Wetland Distance of proposed work to edge of above: P~C of Town Code proposed work falls under: hapt.97 Chapt. 37 other Type of Application: Wetland __Coastal Erosion __Emergency Info needed: Sound Front Bay Front Amendment Administrative Modifications: Conditions: Present Were:~/J.King J.Doherty "' P.Dickerson X/D. Bergen~J.Holzapfel __Other: -~, ~ -- -- ' Mailed/Faxed to:' Date: I .// I1\ /. ! ! L~,~ 7. 8 2Q06 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 (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application __Wetland Permit Application --~minist~ative Permit __Amendment/Transfer/Extension ,~R~eceived Application:.~xJJ~ ,.."Received Fee:$ ~ ~mpleted Applic~ation. ,.~ ~,.,'~ _~ __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent) ~,.~"LWRP Consistency Assessment Form Ix!O~ __CAC Referral Sent: ~-~l~ate of Inspection: q! ~ ~_\~10 Receipt of' CAC Report: - Lead Agency Determination: Technical Review: --~Public Hearing Held: q!lq!~t, _ __Resolution: £ubO Name of Applicant ba,~& Phone Number:(9q) ~5~- ~D Suffo~ Co~ty Tax Map Number: 1000 - ~ - ~ - ~ ~ Prope~y~cation: Las~ hoaS~ fierce bead E~c~ c~ ~(cA lane ~royMe LILCO~le ~,distance to cros~ s~eets, ~d location) (If applicable) Address: 3ri/& O Po ~o~, 160 ~oard of Trustees ApplicOn Land Area (in square feet):. AreaZoning: ~-.eSt~ elqlLtO._ GENERAL DATA cre s Previous use of property: /~e 5,den Cia [ Intended use of property:. ~¢ gl ~t'1 h~ / 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? "A No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~toard of Trustees ApplicaOn WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 19 Area of wetlands on lot: 0 Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: / % feet - c_~,~c~ Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No x~ Yes If yes, how much material will be excavated? 5 ~ [ 0 cubic yards How much material will be filled? ._~ ~ ~ !~ cubic yards Depth of which material will be removed or deposited: o ~ feet Proposed slope throughout the area of operations: cn Mariner in which material will be removed or deposited:.~ fflO I[ square feet-we+land Iora&d sea ard ~'e Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (UsC a~¢hmehts ff apPrOPriate): PROJECT ID NUMBER PART '1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: 2. PROJECT NAME PRECISE LOCATION: Street Addess and Road Intersec'ons, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [] New [] Expansion []Modification / alteration 6~ DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially ~ O~, acres Ultimately ~ O~-~.~ acres 6. 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.) ~F~Residential E~lndustdal ~--~Commercial ~---~Agriculture []Park/Forest/OpenSpace E~]Other (describe} 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) F-~Yes ~No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes E~No If yes, list agency name and permit / approval: l[~es. AS a RESULT[~No OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? 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 Agency) A. DOES ACTION EXCEED ANY TYpE THRESHOLD N6NYCRR PART617.4? Ifyes, coordinate the review process and use the FULL EAF. r-]Yes [~No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS ~N 6 NYCRR, PART 617 6? If No, a negative declaration may be superseded by another involved agency. r-]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 bdefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources er community or ne ghborhood characterq 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 0t use of land or other na ura 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 C1-C57 Explain briefly: C7. Other impacts (includin~ changes in use of either ~uantit,,/ or t~fpe of ener ? Explain briefi)/: D. WILL THE PROJECT HAVE AN ~MPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEAI? Ill yes, explain briefly,: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ff ~,es explain: PART III - Dc ~ ~:I,tMINATION 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 C hack this box if you have identified one or more potentially la rye or significa nt adverse impacts which MAY occur. The n proceed directly to the FULl EAF and/or prepare a positive declaration. ~heck ihis bo~ i~yo0 h~v~ de{eFrnin~d, b~sed On th~ i~formation and ~nalysis above and any ~upporting documentation, that ~h~ ~roposed WILL NOT result in any significant adverse environmental impacts AND provide, on attachmen s as necessary the reasons supporting thi: determination. Name of Lead Agency Date Title of Responsible Officer Pdnt or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) (where the appl£c~Lu~ is no~ the owno:) .., 8 Board of Trustees Application County of Suffolk State of New York ~os~s ~ m~s ~ ~/s~ is ~ ~ucm~ ~oa ~ ~o~ ~sc~ ~;s~ ~ ~ ~ s~a~s co~ · a~ ~o ~ ~s~ o~ ~s~ ~o~o~ ~ ~m~, ~ ~ ~ wo~ W~L BE DO~ ~ T~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSSES. ~ ~PLIC~ AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUST. S ~ESS ~ F~E FROM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~T~ OF S~ PE~T(S), ~ G~ED. ~ CO~LET~G T~S ~PLICATION, I ~BY AUTHO~E T~ ~US~ES, T~ AGENT(S) OR ~P~SE~ATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~~ON, Signature SWORN TO BEFORE ME THIS c~ ~ DAY OF ~ ,20 CO ~, Board of Trustees Application County of Suffolk State of New York BErG D~Y SWO~ DEPOSES ~ ~F~S THAT ~/S~ IS ~ ~PLIC~T FOR T~ ~O~ DESC~ED PE~T(S) ~ T~T ~L STATE~NTS CONT~D ~ ~ ~ TO T~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ ~T ~L WO~ W~L BE DO~ ~ T~ M~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSSES. ~ ~PLIC~T AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ ~USTEES ~ESS ~ F~E FROM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~ OF S~ PE~T(S), ~ G~TED. ~ CO~LET~G ~S ~PLICATION, I ~BY A~HO~E T~ ~US~ES, T~ AGE~(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~TH ~W OF T~S ~PLICATION. ~ignatu~ swo ro ,20 Notary Public2 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town Officem and emolovees. The ouroose of Ibis form is to nrovide information which can alert the town of~ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: (Last name, first name, ~niddle initial, unless you are applying in the nm'ne 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 Trastee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"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 ]fyun 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 tine 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 applic0nt (when the applicant is a corporation); __.B) the legal or beneficial own~ of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, per~ner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this Signature Print Name day of 200 9003 6L ~dV ~, I G' o.c