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Home My WebLink AboutTR-5968A . . 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) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 5968A Date of Receipt of Application: August 2, 2004 Applicant: Nicolo DiBartolo SCTM#: 127-3-6.1 Project Location: 475 Condor Court, Laurel Date of Resolutionllssuance: August 18, 2004 Date of Expiration: August 18, 2006 Reviewed by: Board of Trustees Project Description: To install water service approx. 12' under the wetlands to the residence. 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 plan prepared by Gregor Well Drilling, Inc. dated June 2, 2004. Special Conditions: None 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. ~,~ 9- ~~79~-l'~. Albert J. Krupski, Jr., President Board of Trustees c;J .-.~::, ~.v '- ..J > 8j ~ ~ <5 ~> !;~. ~J!I! >-~.a ~l~ - ~"'~ U:l! 0 , . "/'! l' , ~ Ilill ..! _ ~ is ~ ,j! . "II: " nn! Hili! II l!ll ! i;j11jl M'1I1 ",. , 1II1I r I r i! .,Iil 11111 I'" .. o!! I!! ".., , 1IIII1 .,11.1 Ijllll 1111' I Ie!!! I Iii ! ,'I! I I I" - " 9 E . I ~ ~ . I i ~ II!!:! + IW, III d, ~p i III ii I I Ld I: -+-;:~--==e.m ~ ~ ~ G![7-r----'"" !~ ~ i ~ 1 m i i i I ~i ~ ,! m. ~r--lQ.lIlI.- .....,.. ,.......,! 8j~ ~i: ~J!I! ~t.l ~ ~~ g~~ o ;;I:~ sl!m .iiln !ijlllJ ,hhll ,;jiW 1lI,"I ii i i i lnq ,,' il 11111 1 ' .. .. o!!!! 1 i i ii i i ",11" I III! I " III le"1 I Iii I ,. '," I 1 II - h If;' I ~3 . I ,\ ' , II I II, III Iti!' + d, "1'1 iJ Iii ......u...Z"l . ,. , . . 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) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~ Coastal Erosion Permit Application ~etland Permit Application _ Major - Minor Waiver/Amen~s Aeceived Application: ~ ~EA~G ~ ~ \Yl ~ .... ~ceivedFee:$~ Q ~ompleted Application _Incomplete - _SEQRA Classification: 2004 Type I_Type II_Unlisted_ _Coordination:(date sent) CAC Referral Sent: SouUtoI Town - -Date ofInspection:~~ Board of ",stees __Receipt ofCAC Report: .... _Lead Agency Deterroination:_ Technical Review: "...public Hearing He~'8JoL -- Resolution: Name of Applicant /7//[,00 J) rl3A-R-roLo Address 1f.7 5 (nnJ!JtJl{ rrr:- j4C(;t~L Nt, Iljlf G ? (-Sl., ~ 0 J-?. 'f (hlOILrL)phone Number:( ) h;; I-:;Z '18 - /) J t I ( f>I'&"t 6) Suffolk County Tax Map Number: 1000 - / ~ 7- - 0"3 ~ b. / Property Location: fL JZ., t"t?Nt!OP( c r. Lri-Urf-GL /'V-}" /f9c/t C ~'7 sr! lV/!rTE 6/Mic f}/L ~O() ( (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ~oard of Trustees ApPlica~n GENERAL DATA Land Area (in square feet): ?OOI@Q/ , Ir/C 11-/ c , _ "5/11'1& ~ 126 J r!}12 /l./(;~ ( Area Zoning: Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency Date Y-/z ~/tJO ~~/;M&t I I 5Cl~ Tf(t{jJ7??f tL~S()7 ( Ly:rO D f. c....# !-Lf1J5'-()/() 7{)! ty(J(/O S- f d-. No prior permits/approvals for site improvements Has any permit/approval ever been revoked or suspend~ by a governmental agency? V No Yes -- If yes, provide explanation: Project Description (use attachments if necessary): ! IV 5774LL Wtf-r6~ S&X YICG V II PIPit 1/(/1/IL) ~/lO: /I'IJT'fN /,J' ~"'I!P{ i"'rj"t,v;:7~ () 6- J {tJ ~cc- (( U tZ-tlElV r L( /If 111/ 6- )~ L[ j;a~ 4Itoard of Trustees ApPliCa~n WETLANDrrRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: :7J<J4 Area of wetlands on lot: ,;2tlc7,.(}Cj1J I square feet Percent coverage oflot: .,t:5""% Closest distance between nearest existing structure and upland edge of wetlands: 51?U feet Closest distance between nearest proposed structure and upland edge of wetlands: Sf) 0 feet Does the project involve excavation or filling? No /' Yes If yes, how much material will be excavated? b cubic yards CII/trl...'f Y- E-I. IT i+uU5 R fi-S rrJ~JJ IV trH- SA-f1412 1'11/-r6-It14t How much material will be filled? () cubic yards Depth of which material will be removed or deposited: 4-_ feet Proposed slope throughout the area of operations: III IA-- (s Ii.- Ii d) Ilikll (fV c.j Manner in which material will be removed or deposited: (Ill tJ L /fea:::. Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): -AJowP - D UUi-C r I o/llf-f-L BotG5.- Iv (!( ~) ET)tf-1U;) ~ rrur5 14/ t' ( tJ . . - Board of Trustees Applicat10n COASTAL EROSION APPLICATION DATA Purposes of proposed activity: kJUtiK >Pttr/(c!E- ,//11/ t:- By D rlLfi.CT/(}rJtJ{ B orlE fA t1/~&(L h..JI;...TUtf/IJ5 Are wetlands present within 100 feet of the proposed activity? No /Yes Does the project involve excavation or filling? No / Yes If Yes, how much material will be excavated? ~ (cubic yards) o (cubic yards) How much material will be filled? Manner in which material will be removed or deposited: (N jJ L!).e 6- [;/1/ rR-l( -I-- t>- fir f{; IJ IhS -;-tJ ,,~ ILc: S 1t) /LV 4J I T If- 7f}Mc- VOf~ Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) /IJ 0 ;U C - D IlL 6- Cr7dl(/ f1.--l 13 0 tUf- 1J-!;1;& )( (t11If~ L-- 'f /J I k ;'VI/3t( W I3--Tlf1-1f/ Ii S Foil 2 II h ty //,1/'(( I-(A/€ Ir/III . ( I ;40/ jJ (,pJ/l/1l1--c r IV 17/f lv fi---r tl'1--1vl j' STATE 617.20 APPENDIX C ENVIRONMENTAL QUALITY . SEQR PROJECT ID NUMBER REVIEW 1. APPLICANT I SPONSOR AI ( CIJ Co SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by Applicant or Project Sponsor) 2. PROJECT NAME PART 1 - PROJECT INFORMATION .0 1/;,4-P- Jt) Lo . " .2 3.PROJECT LOCATION: Municipality L,4u r26-l. County 5 Cf F ~ t-tL.. 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ate - or orovide maD C'r, 11Jc< ~ 111, ~lb twllM- 5. IS PROPOSED ACTION: D{] !/frff' New D Expansion o Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: , , / {!OIVt/(3:t'/ /0131((. t1/rl-~tl V (14 "D I (l.6 c r / d IV f4. ( f tJ Hit I JJ 1/2jj.CI1 P 11/,4 ( J3 t9 U Jl;1 ;J!l 0 11m r1- /4- t 7 /;< /I 11/6- T 1#,v/l.5 Ft2t71'1 f<7wloll If 13 "t2- t<E er 7ZJ t2651f)~ W fi.4-1/hv1J5/ !f/f/t/U 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~ Yes D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY ~ Residential D Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) ~Agriculture 0 Park I Forest I Open Space D Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~Yes D No If yes, list agency name and permit f approval: :S tJ C( 71ft; L Jl) W IV' 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes ~NO If yes, list agency name and pennit f approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? []ves No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant 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 ITa be completed bv lead Aaencvl 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. DYes DNo 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. DYes DNO 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 I C2. Aesthetic, agricultural, archaeological. historic, or other natural or cultural resources; or community or neighbortlood character? Explain briefly: I I C3. Vegetation or fauna, fish, sheltfish or wildlife species, significant habitats. or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: I I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I I C6. Long tenn, short term, cumulative, or other effects not identified in C1-GS? Explain briefly: I I C7. Other imoacts (including channes in use of either nuantitv or type of enernv? Ex lain brieflv: I I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If yes, explain briefly: I DYes D No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain I DYes DNo I PART 11I- 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); (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 jj 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. Then proceed directly to the FUL EAF and/or prepare a positive declaration. Check this box if you have detennined, based on the information and analysis above and any supporting documentation, that the proposed actio WILL NOT result in any significant adverse environmental impacts AND provide, on attadlments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Pnnt or Type Name of Responsible Officer In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 4IIoard of Trustees ApPlicatlln County of Suffolk State of New York /1/( C{J 10 ..0/ B~~ roL-o BEING DULY SWORN 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 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 REPRESENT A TIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. cf1~l!~ SWORN TO BEFORE ME THIS 3 tJ fit DAY OF Jl( L '/ I ,20~ ~~~~-? Notary Public L.Af*y P->. ~CA..4' c..<J:.. NO,A"'I "'A''!.{..{C/"Se..-n: oF.A.JY /Jo. O( Ku'4'1 \<c, "'6'5<;.., { :5t..<EFoL/::" COUNTY TeC2<M c,J(p( t2 e:;, Dee€>>< DCI2 2' S :? 06 ~ , . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The T wn f uth Id' C f thi hib' c nlli 0 inte st on e thi ti nIl' to vide inforinati n which can alert town of sib confli neces..'W'V to avoid same. of wn of' tere leers d e 10 se f d all w it to take wha ver action is YOUR NAME: Nt C- 0[0 J} I !3;J-fi.. rol-o (Last name, first name, J11iddle initial, unless you are applying in the name of someone else or other entity, such as a company. Ifso, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat Of official map Otber (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning -r- 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. orhus'iness 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 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 tbe relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or ber spouse, sibling, paren~ or child is (check all that apply): _A) the owner of greater than 5% oflbe shares nfthe corporate stock of the applicant (when the applicant is a corporation); _B) the legal or beneficial owner of any interest in a non-rorporate entity (wben the applicant is not a corporation); _ C) an officer, director, partner, or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP FormTS I ~A/~.?-a~ '"......~'" .r"t-~ ~~:ta~:e t ~~ 13 ! LARP-<{ <7. G.:::~t-(<::.~ (-Jcrro,-'\!-.'1 (JlA-fnltc I ~An::-l!:)i=(0l.f t-.:>c. O\Kc.<.",a,\(o"'';;0 "Su.H=D(J1C... Cot:..< vrt../' ---ao.eA?~///Ze'? /~ce.Z5), .-?<poS- . . Trustees Town of South old July 30, 2004 Gentlemen: Re: Water Service Administrative Permit Attached is completed application for a tidal wetland permit to install a water service line from the end of Suffolk County Water Authority's main on Condor Ct. to my residence by the use of "directional bore." The method will avoid contact with the wetland and secure me safe, potable water from a secure water supply. Your processing of this application for an administrative permit will be appreciated. Yours truly, c2UBa ~~A~ ~?I;~,~ ~ Southold Town Board of Trusfees ," " Q M. o J3 + + *1 Cr\'1t....,..."" e.nJa'cQc\Cot. \ en"" "I Qa '\J E~...-'" ......Ji:!.: JJ>. .~ - - ~ . ..-- i.\..... ... lo-'l. --'II" - Ex,<,t;,,"l '":>c....... F\ MG.;;" "':.(.o.\t..: \-\'0(" ',,\O'"'"to. \ "~("H 1:.0. \ PREPARED: JuNE 2.2004 GREGOR WELL DRILLING, INC. 228 EAsT MONfAUK HIGHWAY HAMPrON BAYS, NY 11946 ~o \ ~o ~) ~ + ~ '\'\ ... ... + ... }./ 1GB M A rzSI-4 hlJTE V E G E "'A"-~ E.\~"a.-'{ioC\ Oo..-t",,~\c, A ......u..C'<" eo ~ Q06~ 6 E\,,-,,~"'! \0("\ f\....""'''''.. ~ c,"'","o'W WOo"<~< c.ee.. ..... c,,,,...\\o,,,, Wo.-"'-' c.ru.\'\,. ....... E""'! Ru.c\.. ~ f\_~, -. ~. #.t t~~.:~~,nC) ." ~wo.."'~( c:.e,..."c.tt.. '.....1 .... ... r ., I ~/~ E'..'! - I~c 10 , ''-\ ,.. ,'Z..~1f III_\, _---- - Co e.'\J. - "Z,..~-<.. ______________ -~-E\...., -"\1.'-\" ) . -YROJE c.. T P lA~1 'Wo.;":"C SQC-! ic.t.. WI {TN C R C>5S V / c,^1 . 0,01 ~~\ :::1\ ~'''-Q. Ru~s \'1 \JI \V IV ------- Ii..... 1 E.\t,..,..'t,.,'.",. :...:::...:;:. -__ ".,'-\\" -- --- E..h.""'. -1.ctsl-c;" --I" ---- E\~". :-1V:-~-;:-- ---, \O'..z" ,"" 40 ,"<. ~O ~(oX'o.,,, 0 -z.... \-\ O(>E. '?("O~i\e. 'JievJ ytC-TV\.(2../E. R E... ~ 4i I W jt-T1f:rL MI'/-w 7Cw/J. .j,j,. 7- CfVr-rZ y H-oL c:.. 1--0 oIL (III{/.- f5.If? 'J '*- 3 T \ 0 4 L {}l (;..:, {.rl-IV ~ /... IJ of( /"\/ Ir- rJ FlU M ?;{L I PG4., -#- 4+-5' F(2....()vVT OF ;1-o<1~E- WfTH- f3 Le- ~~ :G~-::~ ~ PROPOSED NEW WATER SERVICE FOR NICHOLAS DEBARTOLLO 475 CONDOR COURT LAUREL, NY 11948 southold lown Board ot lrustees +- '\'\ +- +- ~a ~M._ ~ ~ + + ~.. \ + ~o ~) "\ + ~ J.I IGH M A rzs ~ !JNTf. VEGETA"'~ E.\to'llo..~ioC\ Oo.-\-u<,<,\'" A <;<"u.t"nt,. ~ ()C"\"It."""~ E.n-\CQ(\c.It. E.x''''"'' ;...."l \ Q l;.\~"o."\' \0<"'\ ":>c.'Wf\ en"t,") p.....u.l'<'..~ M...,('\ Qa '" I ~. It , '1/ ooch. 0.0) a:: h p.(~Q. -- E\c...-.... ,,' ..:::JI R....<\o;. ~z.'-\t..._IO:::-..:-:-~:.. \'1 1M \V IV ------- 11:-,," 1 E,\t."..'l..".". ~ ___ 14.'-\'- ----- E.\.", -"L'I'-o;" ~ ------- E\.... _ .".=-;-;:-- "":. c.o. \Ct.; \-\OC '",,\0"'"""\"0.. \ "toe"'r \ (.Co. \ (.. 40 ,"... ~o' Dw'-\\\ t\ G) Act,Q. ''t' ii.. \n"\o new '" Wo..~t.( See'"", ;'c.~ l't"-I",."" "---- I'Z.'-~" I,,"" _ - _.-::::...~ E:\..... _ "L~..<O.. E.,.... -I~c~' -- -v ______________ -~-Eh..., -~1.I-\.. . ) . ~Ro:rEc..T PlA~1 \=>CODOc:,e.O "l,... \-I.D~t. v.Jo..-'I;e.< S~('OJic.. Ii',/ H C (] V c: " ' .... v/JIT "",055 /L\A/ c,"'Ill.\\OW ""....'ct< c.rt.. \A. R.....~.. R.....<\.. .~,\ '="'" d:f L/-- ~ 5 -t\- ~\ 1W 'V("O~i\e. "iev.l PREPARED: JuNE 2. 2004- GREGOR WELL DRILLING, INc. 228 EAsT MONTAUK HIGHWAY HAMnON BAYS, NY 11946 r (C- Tt< tZ-L f2-G:..- #- ( W r+-1?Yt( ;YJ Itl/V S {wll4 -II- 2- .6 /V 771..'1 Jh, (c ~tVJ(r1V I- 6#?r If-- 3 T( r},4-{ hi IYTtl1-N /J J.. OiJ/(wo' /1/, ;C;Z-IJl1 8;(lI:J6c tJ;-l.{- d ~ P/1.JJI'<// D;::' f/t;d€. WI/If 6-)ClrlIoLtf { (5)~(C~~\Yl~ If\l AUG - 2 2004 PROPOSED NEW WATER SERVICE FOR NICHOLAS DEBARTOLLO 5 CONDOR COURT UREL, NY 11948 Southold Town Board of Trustees