The URL can be used to link to this page

Home My WebLink AboutTR-6438INSPECTION ROUGH PLBG. INSULATION FINAL [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRERESISTANTPENETIM~}: !- REMARKS: ~ 0CT -,~ ?~¢ DATE /~)-~'~ '~ ~) ~/ INSPECTOR -~ ~~-.-- Town of SouthoM PC/Codebook for Windows Encumbrances to public roads. [Added 8-8-2006 by L.L. No. 12-2006] (1) No person shall intentionally discharge or cause to be discharged any water of any kind onto a public highway, roadway, right-of-way or sidewalk causing a public nuisance, hazardous condition, or resulting in flooding or pooling in or around the public area, including neighboring properties. NaSSau Point - Old Manhaden Road Extension scale ~,,= 6o~ 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 EMERGENCY WETLANDS PERMIT Permit No.: 6438E Date of Receipt of Application: September 20, 2006 Applicant: Nassau Point Property Owners Assoc. SCTM#: 111-9-(2&3) Project Location: Old Menhaden Rd., Cutchogue Date of Resolution/issuance: September 20, 2006 Date of Expiration: N/A' Reviewed by: Board of Trustees (Trustee Dave Bergen-Recused) Project Description: To repair and replace the existing drainage basins due to storm damage. Findings: The project meets all the requirements for issuance of an Emergency Wetlands Permit as determined by the Board of Trustees. The issuance of the Emergency Wetlands Permit allows for the operations as indicated on the application received on September 20, 2006. Special Conditions: None. This is not a determination from any other agency. J ea~s F. King, Pre '~ent Board of Trustees Z TEST BOR~VG ~ ~ !-~URI/EY OF M,4P OF NA~.,~WiU POINT C~U~ PROPERTIE$ '.~ A T~IA SSA U POINT TOI/I~I OF SOUTHOLD AREA = to tie lines .1. 0935 Acres CONTOUR LINES AND ELEVATIONS. ARE ): JFERENCED N. G, V. To D.,.~ SUF~DLK COUNT, Y, N Y. ~,~7. e,. ~5 and or /rom dale ob/mined from olher$. ?II- 09- 02 I" = 50' 5, ~995 (Health Dept. Info 11, 1997 1N.. ~,HW~ ~ 30, ~998 r con~o~, x~e.~ / CERTIFIED TO' PHiLiP J. BACON SU~4N J. BACON COMMONWEAL TH LAND TITLE iNSURANCE COMPANY RHR 97 0855 / ~n for~li~r w/Ih /he STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOS~L SYSTEi~9 FOR SINGLE FAMJL Y RESIDENCES end wix ~ide ~y the c~o~tlon$ sel forth /herein ~nd on the permll lo CoAslrucL P. o. It~o r~ V~LE~rREE r SOUTHOLD, N.Y. 11971 49618 LOT (~ AREA = .l 0935 Acres to tie lines LOT ~ · :.,~RVEYOF MAP OF NA _,~A__~U PO~Fr CLUB ~ED ~P "A" A ~ASSAUPOINT TO~ OF SOUTHOLD ARE ~_?ERENCEO TO N.~' V. 0o,,~ K COUNT, Y, N . i"_- 50' o ':.~y 5, 1995 ~ ~. 8,. ~95 (Ho~th Dept. Info ) ~ 30, ~ ~ co.~o¢ ~ ~ ' on~ or from Erin o~td~ed from olher~. CERTIFIED TO, PHIL~° J, BACON SUSAN J. BACON COMMONWEAL TH LAND TITLE INSURANCE COMPANY RHR 97 0855 I ~rn fond#or wJfl~ /he STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE DISPOSZE. SY$TE~ FOR S~LE FAM~ Y and ~ abMe b~ fhe c~f~ Sel /~l~ /herein perm# lo coeslrucl. P.O. 1~30 TIaA V~LEt~STREET SOUTHOL~ N.Y, 1192"1 NO. 496~8 Architects * Engineers ~, Construction Managemem 32645 Main Road Cutchogue. N.Y. 11935 www.blvdplan.com Phone: 631 734.2011 Fax: 63 1,734.2276 STO~ DAMAGE TO OLD MENHADEN ROAD ~dbert J. Krupski, Pres~x ent James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD __Coastal Erosion Permit Application __Wetland Permit Application __AmendmentJTrans f~r/Extension ~..~Received App lic a tio n :~[~s~,)J~fi ~eceived Fee:$ ~" _~---Completed Applica tion2~c,~_ __Incomplete __SEQRA Classification: Type I Type II Unlisted Coordinafion:(date sent) LWRP Consistency Assessment Form CAC Referral Sent: __Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination: __Technical Review: ~'P~ublic Hearing~H~ld: ~---"R~solution:_ ~_ [~[~,~ Office Use Only __ Admimsu'ative Permfit SEP 2 O ""c" Name of Applicant Address Phone Number:( ) Suffolk County Tax Map Number: 1000- I [.[.~ q 10~_.~.~ Property Location: ~7/~ /t'~ e,,,t ~. a~/t,} __ ~_rovid~LILCO.P_ole ~, distance to cross streets, and location) . -. ........... AGENT: (If applicable) Phone: Board of Trustees Appl~tion Land Area (in square feet): Area Zoning:. GENERAL DATA Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency Date .~ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ,)( No Yes If yes, provide explanation: Project Description (use attachments ifnecessary):~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: //I.,/t/~ 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 /)(' Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: cubic yards cubic yards feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by 15 te t PROJECT ID NUMBER PART '1 - PROJECT INFORMATION APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Appricant or Project Sponsor) 2. PROJECT NAME cou. 4 ¥1.1k PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map SEQR 5.1S PROPOSED ACTION: [] New r-]Expansion ,~Mod[ficatJon/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? [~Yes [] No If no, descdbe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Residential []Industrial r~commercial ~'~Agriculture E~]ParklForestlOpenSpace ~]Other (describe) 10/DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDtNG, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~']Yes [~No If yes, list agency name and permit / approval: 11. L)tJE~5 ANY A;SP'EC.I L)I- IHE Ag;TION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? r-lYes r~No If yes, list agency name and permit / approval: 12. AS A T 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 / Sponso~ 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 I THRESHOLD IN 6 NYCRR, PART 6t 7.4? If yes, coordinate the review process and use the FULL EAF. [--"~ Yes J'--J No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS iN 6 NYCRR, PART 617.67 Jf No, a negative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be han~lwrJtien, if legible) C1. Existing air quality, sudace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for eros[on, drainage or flooding problems? Explain boefiy: C2. Aesthetic, agriougural, archaeolo0ical, historic, or other natural or cultural resources; or community or neighborhood chamctoO Explain briafly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or andan§emd spacies? Explain briefly: C4. ^ community o e×~$tm0 plans or goals as officially adopted or a change In use or intensity et use et land or other natural resources? Explain brmlly C5~ Growth, subsequent development, or related activities likely Id be induced tiy the proposed action? Explain briery: C~. Long term, short term, cumulative, or other effects nol identified in C1-C57 Explain btiefl¥: C7. Other impacts (including changes in use of either quantit~ or type of energy? Explain bri*tiy: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEAI? Ill yes, explain bdefi¥! E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ~/es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve'determinewhetheritissubst~ntia~arge~imp~r~3nt~r~therwisesigni~cant~ 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 (0 roagntiude. 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 :.,es, the determ!n=fion of ~[gn!fioc ncc muct cvcluate Lhc pctc;','Jc~ !m~'.cct cf th c p re. p~..;cd ccticn an thc c ~ ¥:,~c,n m c ~,.'&', char& c~c~',~',co of ~ha C~. Check Ihis box if you have identified one or more potentially large or significant adverse impacts which MAy occur. Then proceed directly to the FULl FAF and/or prepare a positive declaration. ~'e 6E'i'~' b~ if ~u- i{ ~ ~ ~i~ r~T~'c~: 6 ~s ~ ~ o~ {~ ir~f~)~n~ati0n a~ ~aly~is above a~d' ~y ~upp0~J~ docu~n~i~[~ tt~¥i~ro~)~ ~(~ WILL NOT result in any significant adverse environmental impacts AND provide, on attschmenls as necessary, the reasons supporting thi~ determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Board of Trustees Ap~ation AT~i~ORI ZA~ION (where the applicant is not the owner) ~--..F$ ~*~D..5~P'~'i,'f~.~'~ residing .at ~. ~ ~4~ (print owner of prdper{y) (mailing address) do hereby authorize ~' (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. JOH~ F STU~PF ~ 8 Board of Trustees Application County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT ~o~s ~o ~o~ ~,OWN o~ so~,~o~ ~ ~ ~ow ~,~ ,~- ~ Sig~h,~t ~ re SWORN TO BEFORE ME THIS [~ DAYOF ~__.~ ,20OG9 Notary Public aO~ £ STUIIPF I~o. 48Se.1~. ~ualillecl in N~ ~ ~ lr~ Exaires j~ ~,~t~·- APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics vrohibJts conflicts of interest on the tort of town Officers and emolovees. The oumose of this form is to arovide information which can alert the town of~ossthle conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name, middle initial, unle~you a~applying in the name 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 Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name thc 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" ncludce by blood, marriage, or business interest. "Business interest'~ means a business, including a pannership, 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 X NO If you answered "YES", complete the balance o£this form and date and sign where indicated. Name ofperson employed by the Town ofSoud~old ~I~I~R/ Title 0r position o f that person "7'~V~ }t ~' ~- Describe the relationship between yourself(the applicant/agentJrepmsentative) and the town officer or employee. Either check thc appropriate line 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 shams of the corporate stock of the applic0nt (when the applicant is a corporation); __.B) the legal or beneficial owner of any interest in a non-corporate entity (wheo the applicant is not a corporation); C) an officer, diroetor, pa~nei', or employee of the applicant; Or __.D) the actual applicant. Form TS 1 Submitted tUs/ L ay of.fi.t' , 200 Signature ~, ~,,-~.~,.jr . -- No. 4 . ~i~ in Na~u ~unW