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HomeMy WebLinkAboutTR-6333A . 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.: 6333A Date of Receipt of Application: April 13, 2006 Applicant: Ronald and Eileen Breuer SCTM#: 116-4-3.1 Project Location: 100 Dean Drive, Cutchogue Date of Resolution/Issuance: April 19, 2006 Date of Expiration: April 19, 2008 Reviewed by: Board of Trustees Project Description: Re-vegetate the buffer area 50' x 36' in accordance with the planting plan submitted, with the addition of high marsh wetland grasses (Spikegrass: Distichlis spicata and Salt marsh hay: Spartina patens) planted landward of the existing wetland vegetation, install shed 24' from the buffer area, a parking area 28' from the buffer and all as depicted on the survey prepared by Joseph Ingegno and received April 13, 2006 by the Board of Trustees. 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. r&<~ James F. King, Vice-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 BOARD 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 15t day of construction -7 y, constructed ~ Project complete, compliance inspection. . . 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 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ~J.J f;)leV\~ Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: 1..(//3101, '-Illq/Ob , has been and the L-~ Application Approved (see below) L-) Application Denied (see below) L-) 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. l.>iJ0 r h~)"U-'~ ~ ?-y(v ~ COMPUTATION OF PERMIT FEES: ~ -h "" ( TOTAL FEES DUE: $ )D r., BY: James F. 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NO. ,";q S~A7E ~ -:->, 14 '" D,x I _' 17;//.< ;/-/'-/,/ A./y UCENSE OR REGISTRATION NUMBER OPERATOR OWNS VEHICLE DYES DNO DATE EXPIRES PLATE NO STATE PLATE TYPE ON,V DN,J o N,Y DN,J 0 DPASS o COMM 0 VEHICLE MAKE 0 D BUICK 0 eN'" 0 CADILLAC 0 0 FOOD 0 OLD' 0 PLYM D TOYOTA D VOLKS D 600Y D ,,~ 0 'O~ D '" D Mn mE 0 TRUCK C TRAILER D ,^N D VINNUMBER DODGE PONTIAC o s.w THE PERSON DESCRIBED ABOVE IS CHARGED AS FOLLOWS PLAC:.~F ?,?CURRENCEj '-J ../,_/ \_' /..J t. q -pA~FOF~NSE AM :5' ~';J(._ 0 VlOLAllON OF SECTION sueD .A?T~PECIFY) . / C o SPEEDING MPHINA t I.)-~_ TIME PM D ) ,~ .Jq, .-<- '."l.,.'__' A/v OTHER OFFENSE MISDEMEANOR 0 FACiUAL PART (NOT FOR TYS) THE ABOVE NAMED OEFENDANT DID ON THE STATED DATE, TlME AND PLACE ~.....~rl P/:;C-<cY:/ /',:/./ ~ -:;L- ~Lt!" (.A..;<.,+lq __'_d u..-, ~J .:, 7/ V'''' ,r<_ c '.> /~r",L,;'" c/o:;:. c: /~ ~/ -it-, .'v, 1-17 L\ -'- i C< The Foregoing IS based on (pe"'Or>a1 knowladge) andlor (inIormation 8. beliefj,lhe"""",e t>eingthQaltaC hed.womdeposition(.)oI dated PARKING SCHEDULED FINE $ CONTACT COURT 0 THE PERSON DESCRIBED ABOVE IS SUMMONED TO APPEAR AT !.; ~~) ", SOUTHOLD TOWN JUsnce COURT, $309S ROUTE jlS, SOUTHOLD, NY 11971 ClATEOF~flANCE(I>IOTFOAT\I8J ON "~ }' j ^". i .J. r:; /-1 .,z 7:7 (" ^' FAlSE STATEMENTS HEREIN ARE PUNlSKolSLEAS A CIJISS A MISDEMEANOR PURSUANT TO SECTION2tO.45 OF THE PL,N,V,$ I OA~) / BADGE" /:/' COMPlAINANT , / ,/ ;' "'''Tmtn "'T"\T"\T:I"'.....,..."I'",..-:t LJ9q - r;Lj 0t . ~ ~. ? . , ~ -0 l' ? ., A ~ -. ,rr ~ f~", , -0 ~ ,F . ~s rees . Town of Southold Suffolk County, NY A - 3281 The People ot the State of New York .s. lAST ~ (DEFeNOANl) FIRST NAME <I ~ _Vel' Ro~ I. Sl ~OR"SC.t!.."..dk ...,<""~ f?~-tl.... CIlY ~ STATE DI')< -:11$ ..v Y- UCENSE OR REGIS'n'lATlON NUMBER '7J.. STATE MIDDLE INmAL APT. NO. .P Iny~ , PLATE NO. DATE EXPIRES STATE Pl.ATETYPE o N.Y. o N.J. o N.Y. ON.J. 0 OPASS o COMM 0 VEHICLE MAKE 0 BUICK 0 OHEV 0 CADIllAC 0 FORO 0 OI.OS 0 PCYM 0 TOYOTA 0 VOU<S 0 ,ooy 0 'OR 0 'OR 0 'us 0 MCV TYPE 0 T''''01< 0 _LE' 0 VAN 0 V1N NUMBER o DODGE o POtIT1AC o s.w. MISDEMEANOR 0 FACTUAL PART (NOT FOR 1'VB) STATED DATE. TlME AND PLACE ,'It u,. , , TheFONogoingis~on(P&r.Ol'\!llknowll<lg.)and/Or(InIo~.>M&.bel~l).h.ourcebelngthl&ttachlcllWOmo.pc*ilion(l)01 ...... PARKING SCttEOULED FINE $ CONTACT COURT 0 THE PERSON DESCRIBED ABOVE IS SUMMONED TO APPEAR AT ~ 1I...Ie( SOUTHOLD TOWN JU9TlCE COURT, uoee ROUTE 215, SOOTHOLD, NY 11171 00 tI'7 I ..n"..""".:-"o<rn"'. I l"'. 7 ON Ar~..1 Ul;;..~" AT f"9- FALSE STATEMENTS HEREIN AI'tE PUNISHABLE AS A CLASS A MISDEMEANOR PURSUANT TO SECTION210.4S OF THE P~N,Y,S. DATE 3 If. 0"- SADGE r(- _ ....,...,.....r ~,"/P'''iC'' '~ 1. Agency !tI New York $t~te. . . .. 3.0RI 14 l(7Orig b.~:~N~~O 16. Incident No. e -,,>,,+i... ?;;"LV . INCIDENT AEPoRT 1 NY 0 <"'-S- DSupp 7. Report Day 1~~t'l /~ lot:.I';qq~' ~Gbc~l1'~" L 10. Day 1111. Date 12. Time o~~rred~..ls~~Y l~jDatellY 10(.. ~~~~ (.,4+ OR/From, Ii I 'f Il' -01'70 .., '.-l 0 ~ I 0" .. 16. Incident Type 17. Business Name 18. Weapon(s) A Ii 70""",,- <:.o.L u :..I...i: D"'- 19. Incident Address (Street No., Street Name, Bldg. No., Apt. No.) 1~20. City, State, Zip (0 CUT DV) 12~;a;5e B. /00 ~ C_,J,t,Ju, 7w..... .1 ~"OMjN<; "UB' L/el. DEll 'AU "'1 ;<:.:: Nl"'~:q~ OFFeNsE . .. .CISI 23. No. of Victims C 1 rc:: 91~ ~O - !.vo I~..._.'l- I 2 24. No. 01 Suspects D. 3 I...n. ~5; PerSij~:ryp~; ~~_~#~~~t: PJ';iO-<?t~~-: ~t;='~'!:$biJJhtei\'~~' ':PR ~ Fel'S~,fleportti't9:'- WI~i(n~~-_ ';Nfj;llot, tn!e,;Y;ewed VI'",Victlm:',126. Victim also complainant DY ON E I 'iYPt1 ~O JIA~Ir{~~; FIRst,t.lltibl~, TIT!-~! '., ,,, . ~f$l# No:,'$T~ ~Me;'a~(Nq.; ~PT: NO., CiTY, '!TATt. ZIP,' .' ':~ilieP/1df1$;~q.; .. ., ',' 1'.~-. F. :, i /"0 7O'-U~ r;~'SIcc.'1 Ad ~.4,,4. 1./ ',., ..... 1 l"1o..~ . IlAI'II':" G. ;~;O'f IR...... v<<r R4..... 1./ y~~ C..Ji. Ion..! ~.II.. /).~ 1.1,.//< uy. .IC' ...... l ........... H. . ....... I''''... L ;. .j ;t~'; I"".,." 27. Data of Birth 128. Age 29. Sex 130. Race 131. Ethnic 132. Handicap 33. Residence Status o Temp Rss. - Foreign Net. J. I,':' I I OM OF []Whila o Btack o Other 0 Hispanic 0 Unk. DYes o Residenl o Tourisl o Student o Other DU [] Indian o Asisn DUnk. 0 Non-Hispanic DNo o Commuter o Military o Homefess DUnk. 34:'i~,:/(~O'135. Name (Last, First, Middle) 36. Alias/Nickname/Maiden Name (Last. First, Middle) 137. Apparent Condition K, o Impaired Drugs 0 Mental Dis. 0 Unk. o Impaired Alec Olnj/UI 0 App Norm 38. Address (Street No., Street Name, Bldg. No., Apt. No.. City, State, Zip) j39. Phone No 40. Social Security No. L. o Home o Work 41. Date of Birth 142. Age 43. Sex 144. Race 145. Ethnic 146. Skin 147.occupationL!',,: M. /.1:' I OM OF []While o Black o Other 0 Hispanic 0 Unk. OUght 0 Dark 0 Unk. o U [] Indian o Asian DUnk. [] Non-Hispanic o Medium [] Other 48. Height 49. Weight 1 ~O\.:~i') I ~'N~'r"1 52. Glasses I ia. Build 154. Employer/School [ 55. Address N. I. [] Yes 0 Contacts [] Small [] Large , o No [] Medium I!lliIIri 56. Scars/Marks/Tattoos (Describe) 57. Misc. 1 -~ """ 2 IAl3i l S A:,:rl iAF\! i- il 'ABU..: 3 :::::0 4 59. Vehicle 60. license Plate No. 161 Slate 62. Exp. Yr, I 63. Plate Type 164. Value lC. = Status FunD .. .. Partial 0 5 65. Veh. Yr, 66. Make 167. Model 168. Style 169. VIN. = 6 r \, 70. Color(s) 171 Towed By: 172. Vehicle Notes 7 ., To: = 73, B . I', /?~ /./ ./!?...... ,- ../...,~./ D_c/ ./""'/. ../ <"// ....t ./-C... 9 .4'''<>,,-<- .:rA. ,-.J~..-I .r:......J' okla. .' ~.... it... t/ cw--- ,,;: ...L. .'s F== .'../. /Z.. - /- ./ I~c ,.. /. ,.L t.... 10 1\ :2 ...... ,.t:'; &t I. !cc" /0., .-c tL o.c ""f~ ~ (/L ./ 11 S''-_.-.,:,o,....~ ,. . ~_~J "c;, "..-- 12 \ '/;'''''k~..L :#FA 7?....1 G; . . Ie'.. ; 13 : "'. ..) I' .; "W' 74. Inquiries (Check all that apply) 75. NYSPIN Message No. i 76. Complainant Signature a:' .. ! DDMV o Want/Warrant o Scofflaw DCrim. History o Stolen Property o Other use -cover ll!' sheet 77.2ffice'c"r'ICCI"d;jCk) 17";;_ 79, Supervisor's Signature (Include Rank) 180. ID No. 84/ .. ;1< III 5 z , Page ~ 81. Statils 'lI0per;~J Closed (If Closed, check box below) 1-1 Unfounded ~;St"~; 1.01:: 183. Notiti,dTDT / 01 'J VICI. Refused to Coop.J Arrest ' Pros, Declined I J Warrant Advised ~ DCBI i:J Juv. - No Custody CJ Arrest- Juv L Offender Dead DExtrad. Declin o Unknown Pages DCJS-320S (10/03) "FALSE STATEMENTS ARE PUNISHABLE AS A CRIME, PURSUANT TO THE NEW YORK STATE PENAL LAW. < "' . New York State Depal,ent of Environmental cons!ation Division of Fish, Wildlife & Marine Resources, Region One Marine Habitat Protection Buildin9 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0295 FAX: (631) 444-0297 3/21/2006 Notice of Violation Ronald Breuer 100 Dean Drive Cutchogue, NY 11935-2505 Date of Violation: On or before 3/1412006 Location of Violation: 100 Dean Drive, Cutchogue Tax Map ID # Permit # (if applicable): Dear Sir/Madam: Records of this Department indicate that you are in violation of the Environmental Conservation Law (ECL): D D D D D tJ Article 15, Protection of Navigable Waters Section 15-0505.1 6NYCRR Part 608 Article 15, Wild, Scenic and Recreational Rivers Act Section 15-2709.2 6NYCRR Part 666 Article 13, Protection of Marine Waters Section 13-0345.2 Article 17, Prohibition Against Pollution of Marine Waters Section 17-0503.2 Article 24, Freshwater Wetlands Act Section 24-0701.1 6NYCRR Part 662 Article 25, Tidal Wetlands Act Section 25-0401.1 6NYCRR Part 661 ~ -... ~ Denise Sheehan Commissioner Page 1. . ... In that you caused, or permitted _e caused: Clearing of vegetation an!cement of fill in an area of IOO'x50' and a 30'xI5' parking area in adjacent area to tidal wetland without permit to do so. Placement of fill in a high marsh area of 25'x48' and placement soild waste in high marsh area of lO'xIO' in a New York State Regulted Tidal Wetland without the benefit of a permit to do so. Contravention of this/these Article(s) of the ECL is a violation and/or a misdemeanor punishable by a fine of no more than $10,000 per violation. Penalties may be assessed for each day that the violation continues. Please be further advised that violations of the ECL which are not resolved may be the subject of an administrative hearing pursuant to Title 6 of the Official Compilation of Codes, Rules & Regulations of the State of New York (6NYCRR, Part 622). You are hereby advised to cease your operation at the referenced location immediately. Please contact the following office within thirty (30) days of receipt of this letter, so that we may attempt to resolve this matter. Failure to contact this office within this time period will result in this matter being referred to the Department's Regional Attorney for further enforcement action. To schedule an appointment for a compliance conference in this matter, please contact The Compliance Unit at (631) 444-0295. Compliance conferences will be held with the Regional Manager of Marine Habitat Protection. Very truly yours, ~ ~-r- Charles T. Hamilton Regional Supervisor of Natural Resources Stony Brook cc: Jimmy King - Town of Southold Trustees Certified Mail # 7005 182000029464 1603 NOV# 06CTH94 Page 2. m~rch 15,2006 Field Inspeln . - .-:....---r-. \ ~ '. .' '.;.~- - " ..06' ....:,.. .. . . .-' ... ..,.~. ~'. ,"", - ., .' -' . . . . .... . . .. - ,,", '. :-- ~';'::::"~... -Ji.? -. ,.,-....... h 15 2006 Field Inspe1l' n marc , . r..., ,- ;...~..#"."r'.'_._ r"" . .. -. - ~ ,. - - --- -~ .. :;.. '.. -. ..~....- ..,:.. .~...~.~; -. -'';"- - ---,.i#.;i.~ ..... . . ";~~ - ,., p.., ..:0....;.-:..- if;.-....i.."""' .. · -'~'.;~ !'zWI .' ~ ~....... -~ -. - . . . ..., .- ..;.; -' -~... 't.""" -. ~. ,.. "'.. march 15,2006 Field lnspew -~ " ... - .-" , -, ; ~ . ..,.. .~ , .. of -<..~ "'\ ....,.......7... -. ,..; ... ,- .;...~ .......- ..~......~ - .. ;.~...~ - - -..... , ......~~. ..... ';:~~.;':' ..;", J.-;:<:-:. . -< .. . .:.'""-:~ ", .'.,' ~._-t~ . """"':....~ :.:~~~::. ~ -, ..w. ~ -t,_ Ill;"; -" ." :... ''':.10\, .... '.' - ~ ~. h 15 2006 Field Inspew marc , . . 4..'1 )' I '. -~ .. , .,.-- " - ,~,,- .... . ~ ~~. L t:- .. .._ .~. 4 ::$;, - . i......... . to..... .... '~ :.:..t~~!~, . . ~..~-~..~~ .,....~.~. .....~..:;.~~,.~~. . .... ." ...~.. .. ".. '.~ I..~ "t;;.. " ~ ;"'.-. t;-.~ '7.. .' :. '.... ......-'('.-:- .,:. :~~~ ~~~~L. '. ....... march 15,2006 Field InSpew . '- '.;; . - - ~ ~-'"::\....J... -.c=.. ~~ -'- .'--... ., ~ - -'- ,;- ~"" ---..= I ("..~.~ .:"'.. ...-""" }, ,..:t::- u--- ~ (f> / " r'.i march 15,2006 Field Inspec_ . -- f~~" Project Description (with attachments survey plan, Exhibits A &'8) We will replenish the buffer area 50' x 36' with 120 bush blueberry plants (Vacciunum angustifolium) staggered at 4 ft intervals (OC). Sow wild flower seeds between bushes to also assist in reducing soil erosion, A mulch path 6 ft wide 6" in height would run the length with two bird feeders on the side 25 ft apart (OC). (see survey map plan & exhibit A). The edge of the 50 ft buffer zone for 150 ft in back of the house. would plant 6 Eastern Red cedar trees (Juniperus virginianus) 4' high with (30) Northern Bayberry plants (Myrica pensylvanica) in-between the trees. A mulch buffer zone 4 ft wide and 8" high would run at the base of the these plantings, For wild life 3 bird feeders would be installed approximately 40' apart. Here too wild flower seeds would be sowed behind the bushes to also assist in reducing soil erosion. After the 50 ft buffer zone zoysia seed ( 25 Ibs) would be planted to retain the soil. To insure growth, 30 yards of high quality screened top soil would be.used in this area. A tool shed (exhibit B) would be placed in the upper wood land, 24 feet from the buffer zone, 39 ft from driveway and 46 ft from curb. A parking space for the RV would be established adjacent to the curb, 28 feet from the buffer zone. Red cedar (Juniperus virginianus) 14 would placed 10 ft apart (OC) on three sides of this space (see survey map plan ), All dead branches piled on ground would be chipped and used for mulch. Only organic fertilizer will be used on vegetation. An irrigation system will be used to support the growth of the plantings. rX~,b,-r A pfCt"t/lr,j ChOlrt APB 1 J \(--- ......- I \T~:~'_iJ I ), l' 71 2): i . ~:-..J i *' *" 2' , 36' I '1 '1 1 2 )'-~'1 " ;I, ";j-.,oj, lI'- .,. * T 7f >>-' J/f ~ 2/ , )(.-, 2 ' k '':/< ~ :k- ~ ~,~ x_c. i , i * ~- * }>/:< .. J I 1"" ~ -J!<-. ;t )t. t (tJf~ ~ *" l_~.__. ~. ---.. j ~ ~ . * .*- ;j.: -s: u -- )/(:.*' )f *' )I .X'--- ;r * *- 150' x. ;s; 1::' )(- '---' x -*. :*- -*. ..*-... ..* iff * -;/(. -., ' ~ ' ~ * ~ ~ ~ L~-*'~- , :* ~ ~ '* ~'*- }>/( ;f . ,'"* '* ~ "* *- i'* ~ ~ , ^ .s .3 ~. x x . .0{, - , flZl~ * * >> ~ ~ * ~ f i t~. ~ · * . * ,.~. \~* ...~ , ' " . ' , . ..,L,!-. I j .,L--'''--IL..-".... r --'-"r--r---t~ ~ So { 36" ;:::.. / g 00 ~(()o+h C-r 50:::; /:; 0 0 'YV { I 2- 0 p4n7:;; fx hi bit A pfc.n+''''3 ChOirt 1(- . 361 7/ !( . 2 ' . "- ",. --r- 1 , ? 1 ) .=., * ~-'Jf ~ T ~ -*. ~ ~ *" *" jf i ~ ~: 7# ~ i \ ._ h- G':""'-1 J I )1 2.' 21 1 l j'.---r ' '. 2~ : *' *: ~ *- 21 ' )t' i * ~- * )#< , ~;vJ 1_ )}.<. t ftJ(~ * .~ i )t. -* .~ -* *- .)(C._.' )(. *- ~;~ ~,* -*}I<;r * -.s; -..:: - Jk .)/c-* ~ '* Jk; ~ *' .:;; ~ '--- :7f-. % ~ * * *' '* ~ 501 x- ).<.. :y , . A.. :3#- -*-*" * ~ * -)r -S- ~ ~.J!( * ~ * ~ ,.,,~'...'.'.* ,-* . >. 1$ .3 x , ),:...... :* ~ ~ '* ~* '* ;f . X ~..,* '* ~ ."* ~ i ~ ~ ~ >< HZl-* * * >> ~ ;;ff;- * * l i ~'\l..- . ,..I....,J~ ...~..,.. "*. . ~ . * .,~ iJ# ?f"\ .~ , I " '___ L i . . i'; ; ': , -.1-,..-..-...+-.,._.,1...." ... T """"'.T._.l-~ ;li\ I' .. So { "36" ;:::.. / is ()U ~(n~H t:~ s<0::: /:; 0 0 ":1 ( I 20 ~~ Albert tJ. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . . (j~ ~rrP'~ ~~ ~r SOUlf;a?c-.~ ~.~' + + en :>c ~.. ~ Town Hall 53095 Route 25 P.O. Box 1179 Southold, Now York 11971-0959 .. Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicat~ ___Wetland Permit Application Administrative PCl'lnit Amendment/Transfer/Extension 3eceived Application: IfIG/tic ,,-Received Fee:$ ;: Completed Application r. :l,7l51,;; ~Incomplete _SEQRA Classification: Type I______Type 1I____Unlisted._ __Coordillation:(date sent)~~_~ LWRP Consistency Assessment Porm =CAC Referral Sent:__~_ ------ ~Date of Inspcction:______ ____Receipt ofCAC Report:______ _Lead Agency Determination:___~,~_ Technical Review: <;Public Hearing Held:~1J!flJ., -- _Resolutioll:~.__.___~..._ ,-- APR 1 '1 1")'1,....."..... ~ L';_'O Name of Applicant 'Ro."",\cl -I Z, lee'" ~'relA(('v Address IOeJ 1)V\1'\. PI{' \~~ C.l.dc"'<l~1 ,flY //935 Phone Numbcr:(()~~ _} S 4 -1_$ J 5, tYJ !c-3 /) if 9 'J - 7 '-I (g j/b- ()~-'-LI /DD DR!;"- "b.....''''..... C:r,.:tch"'SlAIJAJ'f 1/'155 Suffolk County Tax Map Number: 1 000 - Property Location: 7/A .. . 'lI::t(proYide LILCOPo!e #,_distancetocross streets, and location) . AGENT: A / If ^i ________ (If applicable) Address: Phone: te S C <A L -- <3 (VVV' ,u.J P,5-1--<..1,\., 5r'-""~ (Srllc,~1 ~ ~rd of Trustees APPli~io'" GENERAL DATA Land Area (in square feet) J,e; ,fJ~ Area Zoning: "-K' 'l. S' Ide YI f,ll I Previous use of properly: -""K e ~ " de", 1- -, 'i J Intended use of property: K.R s: ,~ll~fl '1 L Prior permits/approvals for site improvements: Agency Date ;11 / fJ . L No prior permits/approvals lor site improvements, Has any permit/approval ever been revoked or suspen}led by a governmental agency'! V No Yes -- If yes, provide explanation:,. 1/ /I!' Project Description (use attachments ifnecessary): ~e-e. Nfl.J(~ P"'S-<- (In''' p/".s AffClch"J .. .. Project Description (with attachments survey plan, Exhibits A & B) We will replenish the buffer area 50' x 36' with 120 bush blueberry plants (Vacciunum angustifolium) staggered at 4 ft intervals (DC). Sow wild flower seeds between bushes to also assist in reducing soil erosion. A mulch path 6 ft wide 6" in height would run the length with two bird feeders on the side 25 ft apart (DC). (see survey map plan & exhibit A). The edge of the 50 ft buffer zone for 150 ft in back of the house, would plant 6 Eastern Red cedar trees (Juniperus virginianus) 4' high with (30) Northern Bayberry plants (Myrica pensylvanica) in-between the trees. A mulch buffer zone 4 ft wide and 8" high would run at the base of the these plantings. For wild life 3 bird feeders would be installed approximately 40' apart. Here too wild flower seeds would be sowed behind the bushes to also assist in reducing soil erosion. After the 50 ft buffer zone zoysia seed ( 25 Ibs) would be planted to retain the soil. To insure growth, 30 yards of high quality screened top soil would be used in this area. A tool shed (exhibit B) would be placed in the upper wood land, 24 feet from the buffer zone, 39 ft from driveway and 46 ft from curb. A parking space for the RV would be established adjacent to the curb, 28 feet from the buffer zone. Red cedar (Juniperus virginianus) 14 would placed 10ft apart (DC) on three sides of this space (see survey map plan). All dead branches piled on ground would be chipped and used for mulch. Only organic fertilizer will be used on vegetation. An irrigation system will be used to support the growth of the plantings. 4It ~rd of Trustees APPli4llio~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:3 l> h. h e"'-_ w~t!!, ~<I 6& f~ lr o..yH, {.Y VQ').e1..f'Oh _~~~~~ltJ );.:E~:_,~_reS_~'IU( C< "c/ }'vi" I Y> t" 'n'" v e (\ . Area of wetlands on lot: 1/'1 A C \r e square feet Perccnt coverage oflot: 25 % Closest distance between nearest existing structure and upland edge of wetlands: I ().) feet Closest distance between nearest proposed structure and upland edge ofwetlands:~___feet Does the project involve excavation or filling? No v Yes !fyes, how much material will be excavated? ,vI A cubic yards How much material will be filled? 3D cubic yards "" Depth of which material will be removed or deposited: Z .fCet Proposed slope throughout the area of operations: ~ '... A I ,.u~__~ l,.-:; " Manner in which material will be removed or deposited: . -- r v (,t c Ie. dr..ys <\ \0') So h" H I -t'f , '.> 0' I I whul L\'y\u~ D v..... r y (". k~ Statement of the effect, ifany, on thewetl<I1ldsand tidalwater13 oftlle town that may result by reason of such proposed operations (use attachments if appropriate): E."h"hC"- -€~,->i,,,~ Y~~.tt"t,dn c."t~J reclL,c-<. \; ~ I J -t \r ~) S I ~ 1') ~ (> t c V' cl ~ . l\ e \-I \) " y <:>" '" . "" \ C. k J (, c t I V ~ To (,'(1t".1 1Ai11~( IJe .....<, pJ."t~"",rJi"lt .. .. J .. . . . , PROJECT 10 NUMBER PART 1. PROJECT INFORMATION 1. APPLICANT I SPONSOR 1("""ld IC 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 2. PROJECT NAME 3.PROJECT LOCATION: \..- S' C1 -(fa / k' Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ate M Of orovide Il\ap .. \. ,f.. \ I () 0 i) ~"l.. 0 y- i 11.(, cJ~ I ~.M 01 f)!-'VI-, (';".A/v-l. (1..J1-cVt .4.~.<<Jl/ . evnl n e.w 'At,e/YU(.G .4o-t-V<< /,,,V.J; 5. IS PROPOSED ACTION: D Nnw 0 Expansion G:d Modification I 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? o Yes 0 No If no, describe briefly: ~T is PRESENT LAND USE IN VICINITY L.:1 Residential D Industrial D Commercial OF PROJECT? (Choose as many as apply.) DAgricu"ure D Park I Forest I Open Space D Other (describe) 10. OOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or local) DYes ~o If yes, list agency name and permit I approval: 11. DOES DYes A~A}PECT OF THE ACTION HAVE A CURRENTlY VALID PERMIT OR LJ1NO If yes, tist agency name and permit I approval: APPROVAL? 12. AS A ~uy OF Yes l.Y1fo I CERTIFY PROPOSED ACTION Will EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? Applicant THAT THE iNFORMATION 7 ( PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature Date: '/, j 2 ja L' If the action Is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment '. .. .. . - PART \I - IMPACT ASSESSMENT (To be comDleted b(l.;;;d Age~) A. DDES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. DYes DNa 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 DNa c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be l1an~wrjlten, if legible) C1. Existing air quality, surlace 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 neighborhood character? Explain briefly: L . ... ... ... ........ ... I C3. Vegetation or fauna, fish, shellfish 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 term, short term, cumulative, or other effects not identified in C1.C5? Explain briefly: I I C7. Other impacts (incJudin changes in use of either auantitv or type of energy? Explain brieflv: I I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEAF (If yes, explainbriefly I DYes 0 Na t E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain i DYes DNa I J 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 (Le. 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 H 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 10 the FULL EAF and/or prepare a positive declaration. Check ihisl,ox" ff you"'lave--delerm-ineif, baseir6idhe -Information andallalysisabove anct" any sUpportillg documentatlon,- thaiiheproposed ~ictio. WILL NOT result in any significant adverse environmentallmpacts AND provide. on attachments as necessary, the reasons supporting thl determinalion. Name of lead Agency Date Print or rype Name of Responsible Officer In lead Agency Title of Responsible Officer SIgnature of Responsible Officer in lead Agency Signature of Pre parer (If different from responsible officer) .. .. Board of Trustees Application County of Suffolk State of New York ~r,,, (c( Je 51-(' U E'\r~BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS TI-IE APPLICANT FOR THE ABOVE DESCRIBEDPERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELlEF, AND THAT ALL WORK WILL BE DONE IN TIm MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY TIm SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES I-IARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING tJNDER OR BY VIRTUE OF SAID PERMlT(S), IF GRANTED. IN COMPLETING TI-ns APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY '1'0 INSPECT THE PREMISES IN CONJUNCTION WITHR 7 F ,[-I1S APPLICATION Signature SWORN TO BEFORE ME THIS _/1-!7t~DA Y OF_~1____,20M ~~ lid' Notary Public .IanlC'~ Nist Notary Pttbh' \,fNew Jersey No. 2,;:,..<,).')'"' >~~!,:,1~on County Commiss.... ""e"-C3 October 7, 2008 . . .. APPLICANT/AGENT/REPRESENtATIVE TRANSACTIONAL DISCLOSURE FORM YOUR NAME: The Town of SOUl hold's Code of Elhics nrohibits conflicts of interest on the Dart of town officers and emnlovces. The Dumase of this form is to nrovide information which can alert the town of ODS sible conflicts of interest and allow it to take wl1utever action is nee ssa to avoid same. ' } 0'1'\ 0\ I cI K. 6re (AI!. \r (Last name, first name, _Q1iddle initial. upless you arc applying in the name of someone else or other entity, such as a company. Ifso, indicatctheothcr person's or company's name.) , NAME OF APPLICATION: (Check all that apply.) Tax grievance Vuriance Change of Zone Approvalorplat Exemption from plat or official map Other (If "Other", name the activity.) __~ Building Trustee Coastal Erosion Mooring . Planning Do YOIl personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee ofllle Town of South old? "Relationship" includes by blood, ITjarriage, or bus.iness iilterest. "Business interest'! means a business, including a partnership, in which the lawn 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% ofthe shures. YES NO ,/" Ifyoll answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the TaWil of Southold __. Title or position oftllat person ~_~__~_ Describe the relationship between yourself (the applicant/agent/representative) and Ule town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The lown officer or employee or his or her spouse, sibling, pnrent, o'r child is (check all that apply): A) tllO owner of greater than 5% of the shares of the corporate stock oflhe aPl)lic~l1t -- (wheil the applicant is Il corporation); ~_ll) the legal 01' 'beneficial own~r OfllllY interest in a non-corporate entity (when the applicant is nol a corporation); - __ C) an officer, director, partner, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this ___day of Signature Print Name 200 Form TS I