HomeMy WebLinkAboutTR-6512A
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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.: 6512A
Date of Receipt of Application: December 15, 2006
Applicant: Vincent Scan dole
SCTM#: 97-7-3
Project Location: 400 Beebe Drive, Cutchogue
Date of Resolution/Issuance: January 24, 2007
Date of Expiration: January 24,2009
Reviewed by: Board of Trustees
Project Description: Install railroad ties 6" x 6", running along both sides of the
property. Level rear yard from side to side with top soil, maintaining the front to rear
slope. Install plantings on both sides of the property for screening, cut Ph rag mites to a
minimum of 12", replace shed on north side of property 50' landward of the wetland line,
and install a 25' buffer zone of natural vegetation approx. 6' landward of MHW to be
planted, and all as depicted on the plan surveyed by John T. Metzger and approved by
the Board of Trustees on 1/22/07.
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 rleterminatio, n from any other agency.
/M'~' ,57 ~
James F. King, President
Board of Trustees
JFK/hkc
.
.
,James F. King, President
Jill M. Doherty, Vice-President
Peg!,')' A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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
TO: V r n C-e.n +S:,w, 01.0 k
Please be advised that your application dated
reviewed by this Board at the regular meeting of
following action was taken:
r~IIS JOb
, I ;;t'f 101
.
has been
and the
(~ Application Approved (see below)
L-) 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: it rO iC~~\ .
11' 'J T I. 'v' \r\5 fC(-,-\,~t0
TOTAL FEES DUE: $ 5D r...
____BY_~l!les F. Kil'lfhl'r:esident
Board of Trustees
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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
1 st day of construction
-:7
Y, constructed
Project complete, compliance inspection.
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Town Hall
53095 Route 2,5
P.O. Box 1179
Southold, New York 11971-0959
James F. King, President
.Jil11L Doherty, Vice. President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Telephone (631) 765.1892
Fax (631) 765.6641
BOARD OF TOWN TRUSTEES
TOVlN OF SOUTHOLD
Southold Town Board of Trustees
Field Inspection/Work session Report
Date/Time:
VINCENT SCAN DOLE requests an Administrative Permit to install railroad
ties running along both sides of the property and rear of property. Level rear
yard from side to side with top soil, maintaining the front to rear slope. Ties
by waterside will be set back 6' from MHW, and 6"X 6" high. Install plantings
on both sides of the property for screening. Located: 400 Beebe Dr.,
Cutchogue. SCTM#97-7-3
Type of area to be impacted:
J Saltwater Wetland Freshwater W etland ~ Sound Front ~ Bay Front
Distance of proposed work to edge of above:
pay( of Town Code proposed work falls under:
~Chapt.275 ~Chapt. 111 ~other
Type of Application: _ Wetland _Coastal Erosion _Amendment "/Administrative
_Emergency _Pre-Submission
Info needed:
flu\,'''dlavi
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Modifications:
Conditions:
Present Were: _J.King _J.Doherty _P.Dickerson_D. Bergen_ B. Ghosio, Jr
_H. Cusack_D. Dzenkowski _Mark Terry other
Mailed/Faxed to:
Date:
:;L~ ' -
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Environmental Technician
Review ?..orn)s0wf"":;J On).. r{<<~+- <oj..f.,\[ IS C.("1,, -to -frM ~
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A-3154
Town 01 Southold
Suffolk County, NY
vz.,
CI~j, STATE
tJ9 ul" ~ /f-J-t
UCENSE OR REGISTRATION NUMBER
STATE
TYPE OF UCENSE
DATE EXPIRES
THE OPeRATOR OR REGISTERED OWNER Of VEHICLE DESCRIBED BELOW
Pl..ATENO.
DATE EXPIRES
STATE PLATE TVPE
ON.V. DN,J. DN,Y ON.J, 0 o PASS o COMM 0
VEHICLE MAKE DODGE
0 BUICK 0 CHEV PONTIAC
, 0 FORD 0 OLOS
0 TOYOTA 0 YOLKS
BODY 0 'DR 0 BUS 0 MCY 0 S.W.
TYFe 0 TlWLER 0 y,,< 0
THE PERSON DESCRIBED ABOVE 18 CHARGED AS FOLLOWS
2100 RENeE
DATE ~ ~NSE
Il./4/D /I
IN VIOLATION OF SECTION SUSD.
OOlHER (SPECIFY)
Ie
o SPEEDING
MPH IN A
PeT
~I ~ISDEMEANOR 0
FACTUAL PART (NOT FOR 1VB)
n."''''';Z~??;;';-;- '"-'"----~::"";:;:hfi7'"
PARKING SCHEDULED FINE CONTACT COURT 0
THE PERSON DESCRIBED ABOVE IS SUMMONED TO APPEAR AT
SOUTHOlD TOWN JUSTICE COURT, 530011 ROUTE 25, SOUTHOLD, NY 11971
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ON
FALSE$TATEMENTS HEREIN ARE PUNISf1Il.SLE /IS A CLASS A MISDEMEANOR PURSUANT TO SECTION 210.45 OF THE P.LN.Y,$.
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o White 0 Black 0 Other 0 HispInlcO -Unk.
o Indian DAlian Dl.Jnk. ONon.tillpank
36. AllaslNlcknameiMaiden Name (Last. First. M:lCidlel
33. R8idenceStatw. 0 Temp. Res.. FOreign Nat.
S ftestdent BTouristOStu~~OttIer
Com,nuter Military 0 . eu Unk
37. Applr~t Condition
o Impaired Drugs 0 Ment.IDis 0 Unk.
o Impaired Aleo 0 InjJ III 0 App Norm
o Home
D Work
44. Race
D White 0 Black 0 Other
o Indian 0 Asian 0 Unk.
52. Glasses
o Yes 0 Contacts
o No
53. Build
o Small 0 large
o Medium
57. MiSc.
59, Vehicle
StatlB
T/\SLFW
60. License Plate No
64. Value
Lit,,!
66. Make
70.Color(5)
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o DMv 0 WantiWarrant
o Crlm. History 0 Stolen' Property
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(-d Open 0 Closed (Jf Closed, chedt box below)
o Arrest DPros.Oedined
DAn st-Juv. OOffenderoeaa
75. NVSPlN Message No
76. Complainant Signature
7810Na
79. Supervisor's Signature (Include Rank)
80. 10 No.
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o Unfounded
o \/Yarrant Advised
o Extract oechn 0 Unknown
82. Status Date
Mn OdY
83. NotlfiedfTOT
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Pages
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DUS.3205 (2/97) 'FALSE STATEMENTS ARE PUNISHABLE AS A CRIME, PURSUANT TO THE NEW YORK STATE PENAL LAW.
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97..7.3 473889 S outhold Active RIS:l SchooL Mallituck School
FIJIan. James Ro1lYea,12006 CwrYr 1 F amilJl FIe. land A\! UOO
400lleebe Dr Land S"e: 0.48 acre. TolaIA\!: 4.500
Owner Total 2 ~ TaKable Value Miscellaneou.
Name: James. AJlan County' 4.500 Book: 12443
Adell Addr: - Mun!: 4.500 Page 5&2
Sheet: 15 Riverside Ave School 4.500 Mortg
PO Box: Bank:
City. MawcBeach. NY Zip 11951. T SchI ofier star: 4.500 Acd No 13
Sale Total 1 Site 1 01 1 land 0010
Book Page Sale Dale Sale Price Owr"" Prpels: 1 FamilJl Aes
12443 5&2 03/15106 &55.1I00Scandole. Vince Nbhd Cd 0
Sewer:
Water:
Utilities:
E Kemption Total: 0 Term Own Building Tolal: 0
Code Amounl Year Pet
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Special District Tolai:4 Value I .~ hnprovement Tolal: 0
Cdde Umls PelJJ/pe MoveT ""_ Type Name Dim1 Dim2 SQFT y, Buill
F002S Culj:~!JII~F[ clIO .00 ,00
PK090Cutch.New S, ;110 .00 .... ... .00y
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Vincent Scandole
400 Beebe Drive
Cutchogue, NY 11935
T. 631 734-5509 F. 631 734-8272
scandole@optonline.net
Addendum to
Permit Application
January 20, 2007
Board of Town Trustees
Town of Southold
P.O. Box 1179
Southold, NY 11971-0959
Tax Map:
097. 07. 003. 000
I ask that the below items that were discussion with Trustees on their onsite
inspection of January 15, 2007 be added to my application.
1. Cut phragm ites to a height of 12 inches.
2. Replace shed on north side of property, set back a minimum of 50 feet from
MHW line.
3. Installing buffer zone of natural vegetation approximately six feet back from
MHW line to prevent erosion as per Trustees request. (see photo). I will check
with Cornell Cooperative to attain name of grass and that will be suitable for
site.
4. Area planting plan (for sides of property) added to survey with attached plant
type list (A), as per Trustee request.
.
.
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
Office Use Only
_Coastal Erosion Permit Application
_Wetland Permit Application V Administrative Permit
Amendment/Transfer/Extension
~eceived Application: IJ./I"S/OJ.
---LReceived Fee:$ ."'0 -
~Completed Application ,.+IISlo,
_Incomplete
_SEQRA Classification:
Type I_Type II_Unlisted_
_ Coordination:( date sent)
LL WRP Consistency Assessment Form 10-\\'6\ Q.,
CAC Referral Sent:
--<<::Date ofInspection:---1..\ ISlO')
_Receipt ofCAC Report:
_Lead Agency Deterrnination:_
Technical Review:
.....-:.Public Hearing Held:--W J-'ll 0')
Resolution:
- luxe ('./
Name of Applicant V It\lCEI\..lI S c4rJdo/E
Address L{.OD (?,Ecbc /),-r,<JE./ Q'-'(JcL.<J?~e,./Y_Y
Phone Number:( ~i() 73 If - s- j i) 7
o EC 1 5
//93S-
Suffolk County Tax Map Number: 1000- 09700 - 07. 00 - co']. 000
Property Location: 400 G L'Y be /) fl, Je, C ",rot, Jf..-" 'LT- 11'9.5 S-
o ,
(: n I
! c? I 'JCcoe rJrz, J e 1- j) E<!vt. f. ,~j ;::>"'10
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
~oard of Trustees APPlica~
GENERAL DATA
Land Area (in square feet): fOr, CI"fff
I
Area Zoning: 8 (\) SfN9 Lc fA ""',U} (2 -s,-rc(,^...Je,=
Previous use of property:
r2~s(dcJ~/I""<-
Intended use of property:
S~"" c
Prior permits/approvals for site improvements:
Agency
Date
L 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:
CD
Project Description (use attachments ifnecessary): If.::, ST/J If all In!1 /2.. ...ItN1
A-L';''''~ aiL . P p..uf'e><.-r-Gf d- rz<E"'>--< . ~ p....."('f:rt.,}. L..-'Vr(,~/
R.!V'"A L.//H.d.. fvt.i>.~ 1: ,,)c 7'-' S ;/JE w, M r-eJr> S i), L (. <-J,t( M"'frVT",~
Pf'?r>MJT...;-v rzt-""'A.... ~LtJlf'3C )11
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. Board of Trustees APPliCeon
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: Q c),J TI<<L 72.,,,, 0/1- I vi ,. Cbtc'"1!J(
w4, L.r M ""',<)1'>""""] ilH '<d'y-.I~ i/ j c' ,yr- () "-'D;(lL"Yl'7
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 X Yes
If yes, how much material will be excavated?
cubic yards
How much material will be filled? I/o tv ~
cubic yards
Y'! fr 1<"",,,
Depth of which material will be removed or deposited: I TV ~ S'))). S
feet
Proposed slope throughout the area of operations: Fru,J, tL' 12""",,, 1 FT - S')/)c' TV S''.IJl;: LCNt-
t>'I<IJU; ~t Ed? d c! S.I/)if I:r-u 3 tr fv. e(~~T'~5f
Manner in which material will be removed or deposited: I) cy> oS.I:;- ,4' '" ~
,
J,""A// fS.' Cfl-T C"- t,'? ./r'>--'.("
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):
(10 ';; /"''''/''':'
/2//1. TlcI scTh"dC r:-,,-.~ W~77-~ C-J,{(
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P,1C'/Cr-Ji ;''^'r R.o,,<>Ff- 'NTV (:JvfG"dK
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PROJECT 10 NUMBER
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
PART 1 - PROJECT INFORMATION
1. APPLICANT I SPONSOR S 2. PROJECT NAME
VlvJCCNI CA,0C(O!e
3 PROJECT LOCATION: !..fod ~d""",,6e: /)Il/de
C2..n-c4.:>,fqe N_,!, //9J,- \) I/'
Municipality Jl O,-'.t" ~o (pI A.J County c...> t4 f-eJ L.k
4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ete _ or provide maD
Lfoo (),C!1...r-be /)/l,,/iE~ C<n-cf.JJv~ /'J_y //j'.J.r Y~(!,~Elj-<.._ -r/)Eif>l.-f-.,T/UK
I J.? h ""'Jr ON fl, 4;- /rT 10 Ltc
5. IS PROPOSED ACTION: 0 New 0 Expansion D Modification I alteration
6. DESCRIBE PROJECT BRIEFLY:
/.IV J'r;>r//n')'
1-z:> p Y<sY,..>,.J') fZu ~ ~-fI-
12~ pc! ON rr.'p.T "" t.c+T eJ r- p"-!"cur7
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e',ff' ~-z:7"t'
7. AMOUNT OF LAND AFFECTED:
Initially ~ Ultimately " ~ acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
":gfves D No If no, describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY
Residential 0 Industrial D Commercial
OF PROJECT? (Choose as many as apply.)
DAgrlculture 0 Park I Forest I Open Space
DOther (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
e>'CY (Federal, State or Local)
~Yes 0 No If yes, list agency name and permit I approval:
SO l-fTt{ 0 (.(? /4u/-r"dl:!-/
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
DYes '13fNO If yes, list agency name and permit I approval:
12. AS A E LT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION?
Oves No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant I Spons Name
Signature
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
.
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PART II. IMPACT ASSESSMENT (To be completed ~ Lead Agency) )
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,bt..cT ~i7.4? -fyes, coordinate the review process and use the FULL EAF.
OVes ONO
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NVCRR, PART 617.6? If No, a negative
declaration may be superseded by another involved agency.
o Ves 0 No
C. COULD ACTION RESULT IN ANV ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, surface or groundwaterquallty or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
rential for erosion, drninage or flooding problems? Explain briefly _. ~. .. I
C2. rsthetiC' agri~Ulturnl' archaeological, historic, or other natural or cultural resources; or community or neighborhood charncter? Explain briefly: '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. rowth' S~bSeqUent development, or related activities likely to be induced by the proposed acti~? Explain briefl.Y.: . . ]]
CG. rng term, short term, cumulative, or other effects not identified in C1'C5? Explain bri;fly:. I
C7. Other impacts (including changes in use of either Quantity or type of energy? Explain briefly:
I .J
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:
Dves ONO I
E. IC=t;:,E, 00 ~~ErE LlKEL V TO BE, CONTROVERSV RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
j
If xes eXP.la.'n
" I
PART 111- 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) durntion; (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.
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 determined, based on the information and analysis above and any supporting documentation, that the proposed actio
WILL NOT result in any significant adverse environmentaUmpacts AND provide, on attachments as necessary, the reasons supporting thi
determination.
Name of Lead Agency
Date
Print 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)
.....
~ Board of Trustees APPli~ion
County of Suffolk
State of New York
V'NCCAJi s'eA~ D DL6 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 HlS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTIIIN 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 ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
J~~~
Signature
SWORN TO BEFORE ME THIS / </
DAY OF DEe.EJ-t6E/:'" ,20~
~jj","&,
ta blic
Nota ~~~CY t FUSCO
ry . ...,e Stale of New lbrfl
"._it.:.882475
CGmm"l:.\~ ..n SIdfiljkCoull\Y 1
-.oJ Jan; 20. 20 a.:
.
.
Board of Trustees Application
County of Suffolk
State of New York
VI Ne eIJI S, e AtJ D C> L~ 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 ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
J~;c' ~
Signature
SWORN TO BEFORE ME THIS I ~
DAY OF bEUH6E;f: ,200t,
J
__j~N~)
ot lJublic
Nota PublNA~CY T. fUSCO
ry . Ie Slate of New York
Qua/7PJfk=)~
llqmriijiSion EXp/iiji JelL 20'0 tL1
.
.
APPLICANT/AGENTIREPRESENTATlVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics orohibits conflicts ofinterest on the Dart cftown officers and emolovees. The Durnase of
this fi is rovide i formation which can the town of ossible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
S' c~rJch Ie
1I''\JQovT
YOUR NAME:
(Last name, first name, J11iddle initial, ~Iess you are 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
Variance
Change of Zone
Approval of plat
Exemption from plat or official map
Other
(If "Other", name the activity.)
Building
Trustee
Coastal Erosion
Mooring
Planning
)(
Do you personally (or through your company, spouse, sibling, paren~ or child) have a relationship with any officer or employee
of the Town of South~ld? "Relationship" includes by blood, marriage, or buslncss 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.
x
YES
NO
If you ansvI"ered "YES", complete the balance of this fonn 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 line A) through D) and/or describe in the space provided.
The town officer or employee or his or herspouse, 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 applicant
(when the applicant is a corporation); .
_B) the legal or .beneficial owner of any interest in a non-corporate entity (when the
applicant is not 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
Town of South old
.
.
L WRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
I. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of South old Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. * Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of South old Town).
3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the L WRP policy standards and conditions contained in the consistency
review law. Thus. each answer must be explained in detail. listinl! both supportinl! and non-
supportinl! facts. If an action cannot be certified as consistent with the L WRP policy standards and
conditions, it shall not be Wldertaken.
A copy of the L WRP is available in the following places: online at the Town of Southold ' s
website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# I:;; C) D
- 09700 - O'?ou -00].0<.J
rJItJtt:NT JMNd;JtO
r r-
L.: ~'
PROJECT NAME
The Application has been submitted to (check appropriate response):
Town Board D Planning Board D Building Dept. D Board of Trustees N
I. Category of Town of Southold agency action (check appropriate response ):
(a)
Action Wldertaken directly by Town agency (e.g. capital
construction, planning activity, agency regulation, land transaction)
D
D
(b) Financial assistance (e.g. grant, loan, subsidy)
(c)
Permit, approval, license, certification:
~
Nature and extent of action:
!rJy77'1.1'/-V{ oj /'2-/ /Z- 77 C /
,
.
Location of action: 4- D C>
.
(l:;,CGb e ;')arJG, 0 (,/7 cftJ)'u'c /0-7- //Pls-
Site acreage: ,Lf Ii
Present land use: /2- ~J'rcC.!,... T ,.-.- L
Present zoning classification: c)r D - Ju~'J f.E F/r/<-1' [7 i? ,:j,c(',,----',-;-+(
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicant: 01/11 CeN J JC4 nlc/:;,0.-
(b) Mailing address: 4-()O f?:, Ls-et; ~ /)/Z,JtE
Q,.rf ci..-i:>.9 "'~ tV!r 119 J ~-
(c) Telephone number: AreaCodet;lI) '7 stf - S-scJ5'
.
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes 0 NoM If yes, which state or federal agency?
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastrncture, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See L WRP Section III - Policies; Page 2 for evaluation
criteria.
DYes 0 NoM Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources
L WRP Section III - Policies Pages 3 through 6 for evaluation criteria
DYes D NO~NotAPPlicable
of the fown of Southold. See
I
I
.
.
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
L WRP Section III - Policies Pages 6 through 7 for evaluation criteria
DYes 0 N~ Not Applicable
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRi>
Section III - Policies Pages 8 through 16 for evaluation criteria
DYes 0 NoB' Not Applicable
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See L WRP Section III
- Policies Pages 16 through 21 for evaluation criteria
o Yes 0 No gNotAPPlicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
through 32 for evaluation criteria.
o oM
Yes
No
Not _Iicable
.
Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies
Pages 32 through 34 for evaluation criteria.
DYes D No'@:::NotApplicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substauces and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria~
DYes D No~ot Applicable
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See L WRP Section III - Policies; Pages 38 through 46 for evaluation
criteria.
o YeD N~ot Applicable
Attach additional sheets if necessary
WORKING COAST POLAs
.
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See L WRP Section 111- Policies; Pages 47 through 56 for evaluation criteria.
DYes 0 No~ot Applicable
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria.
DYes 0 NoRNot Applicable
Attach additional sheets if necessary
Policy 12. Protect agricuIturallands in the Town of Southold. See L WRP Section III _ Policies; Pages
62 through 65 for evaluation criteria.
DYes 0 N~ot Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Policies; Pages 65 through 68 for evaluation criteria.
DYes 0 No g Not Applicable
PREPAREDBY ;!~~-,
TITLE 6 "J-J/,-(
DATE /2~//OC
S.easlde PI~'1ts
Home
Up
Winter Moth
Photo
KENNEDPS
COUNTRY GAlIDENS
~. .....
01/17/2007 04:10 p~
85 Chief Justice Cushing Hwy - Rt. 3A - Scituate, MA 02066 _ 781-545-1266
<,."
'>:,
Seaside Plants ...lilJ (Plants fur SItade'J ~PerelUlials fur S~ ~Plants fur Wet .<\rea$;)
',(fJlo ' mUtt ~; Lawlt Care .....~... 4.,'.
' " Plants fur Dry SOil';" ~..,. COlttro~'6 Grub~'';'' <ii, SIl' ".
Soils
~' HydraJtgea wro)~ ( ~ltady PerelUlials)
Seashore Plants
From our years of experience selling plants on the south shore, we've put
together a list of plants that have shown tolerance to the salty winter winds
of the southern New England Coast Some plants may perform better than
others. Use this list as a guide, please consult a Kennedy's saleperson for
advice based on your specific site conditions.
Shruhs
Buddleia - ~utterfly Bus0
calluna~
.p;//www.kennedyscountrygardens.com/sea.slde_Plants.htm
':il.
'w
If you are
interested in
recelvmg
information
on new
plants &
products,
garden tips,
coupons, and
our events,
lectures,
sales, and
specials click
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contact ill!
page.
Page 1 of 6
Seaside Plar..ts
01/17/200704:10 PM
Caryopteris - Blue Mist
Chaenomeles - Quince
~"~~"--'"'' - "----..'----..
Cornus alba"-,Red Twig Dogwood*)
'--'-_.-:-...;;.;;;r"_^....,_"~.,__".., ,"
Cotinus (Smokebus9.i
(C~t~~e:;;;5
~-
Cytisus - Scotch Broom *
Eleagnus - Autumn Olive
Erica - Heath*
Hamamelis - Witchhazel*
~-~........_-~
Hibiscus -(Rose of Sharar!
-- ",---
(Hy" dr~~;;~. ~.)
---...;; 0,,_,
""-0_.,.-._.<<=---""".
(Ife; gi.~~ra - Ink?~;)
.''"._-._._....-~-
IIex opaca -(An;~;I~~~ H~i~v
Gf;~e~:::~:J(~I~~;!J;;V
'''Juniperus - J~~i;;r1
Ligustrum - Privet
_._._--"--~--'\
Lonicera 7 Honeysucklil
'----....._...._._-_..~
Ornamental Grasses*
Pinus mugo - Mugo Pine*
Pinus nigra" Austrian Pine*
,_..,-~
Pinus thunbergiana ~ack P~~jl*
Myrica pennsylvanica - ,~~~~
Picea pungens -cBj~~~~n;~
~""-~----
Potentilla
Prunus cistena - Sandcherry
~p: Ilwww.kennedyscountrygardens.com/seaside_plants.htm
Page 2 of6
Seaside Plan!s
(P~ln~: - maritima'~.~~:Ch-;;~~)
'., ~ -. '-_'_.:...~,"_~,_", _~..___"..._~~.<w.......,....,.,.,,~, .".' ~;".......,
Pyracantha
01/17/200704:10 PM
Rhamnus - Fernleaf Buckthorn
(ROsa;~g~~~- - Beach R~J
'- (~~~0
Tamarix*
~
~ --
Vaccinium - Bluebeny
<~i~:~l~::)
,~---._...-',,,,,.,,..
Yucca filamentosa - Adams Needle*
Vines
Campsis - Trumpet Vine
Celastrus - Bittersweet
Clematis
Hydrangea
Lonicera - Honeysuckle
Polygonum - Fleece Vine
Wisteria
Trees
Acer platanoides - Norway Maple
Aesculus - Horsechesnut, Buckeye
tp:/lwww.kennedyscountrygardens.com/seaside_plants.htm
Page 3 of 6
Seaside Plants
01/17/200704:10 PM
Crataegus - Hawthorn
Gleditsia triacanthos - Honeylocust
Hibiscus - Rose-of-sharon (Tree form)
~:n~::~~:-~~~;:(;;::~;~;V
_._"-----
Malus - Crabapples
,-"'-'.~"-- . .'. .<.~..,...<_._""_._,._..,.,,., "....,....._,.~~.. ....... ,...~----
.. Pinus nigra - Austrian Pine* )
p:nu~~h~~b;;:gi~~-~B;a~:;1:~
"-------,,.,.,.-...-'"
Platanus acerifolia - London Planetree
Quercus palustris - Pin Oak
Rhus - Sumac
Sophorajaponica - Scholartree
Tilia cordata - Little Leaf Linden
Groundcovers
Arctostaphylos - Bearberry*
(Cij]~-:~ H~~l~
Erica - Heath*
Juniperus - Juniper*
Pachysandra*
~~
( Sedum)
\'. ..-/
(~y'~~;:-~;J:, Periwinkle.;)
Seashore Perennials
tp://www.kennedyscountrygardens.com/seaslde_plants.htm
Page 4 of 6
Seaside Plants
Achillea
Yarrow )
/
Alchemilla - Lady's Mantle
Al1emesla -,Silver Mound, etc.
Aurinia - Basket of Gold
Baptisia - False Indigo
Cerastium - Snow in Summer
Chysanthemum nipponicum, pacificum & superbum Montauk, Shasta & Pacific
\. Daisies "j
-,
Echinops -,Globe Thistl~)
'-- ."'
Eryngium - Sea Holly
Geranium - #ardy Geranium/Crane~~~;i[)
~- ~ .-~--;'--"""-"',-~~
Hemerocallis (DaYIiIJ
----~.-..
,..,,~,...._-~
(11,~s_t~)
Iberis - Candytuft'
.' ...._--~
Lavendula -,"Lavend&
\"'-' /
----..-'"
Limonium 7S';;-L~v~nde~
'.
Nepeta - Catmint
Opuntia - Prickly Pear
............-..---~
Papaver ..c:Oriental Poppy
-_.,.~.,......."_.._."._---......
Perovskia,C:::Russian Sage
Potenti II a
Santolina - Lavender Cotton
'"',-----....~
/Sedum )
',--
StachYs'~ L~
Yucca - Adam's Needle*
:tp:/lwww.kennedyscountrygardens.com/seaslde_plants.htm
011171200704:10 PM
Page 5 016
New Page 2.
Home
Up
Photo
Winter Moth
" ,".
.....~~..l:r":;..:........ .,..i '..i": 1...;
.'o' ,~. '~;"'~'-;I.,'
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.
KENNEDPS
COUNTRY GARDENS
~
'1'
~
V
01/17/200704:12 PM
85 Chief Justice Cushing Hwy - Rt. 3A - Scituate, MA 02066 - 781-545-1266
.' .
- '-.
SeasMe Plants ..$!I l<> Plantsror S1Iade~ 11;'l>erelUlials ror SluuJlj) (rlants rol' Wet .~
,:. PlantS ror Dry Soil~ f;: COlltrollillg Gruhs~ '\',. La\\'lICare .~~,
Soils
Hydrangea ulroi~ (. Sltady PerelUlials~
Woody Plants for Shade
This is a list of shrubs and trees available by Kennedy's that are tolerant to
shady conditions. Deep shade may cause plants to thin out somewhat
because they will naturally stretch for the sunlight.
Acer ginnala - Amur Maple
Amelanchier - Shadblow, Servicebe
~~D1eda polifoliYg Rosema *
---
BllXLL - Boxwoo *
Cercis canadensis - Eastern Redbud
Chamaecyparis obtusa vaT. ~ki Cypr~
Chionanthus virginicus - Fringetree
Clethra alnifolia - Summersweet
tp://www.kennedyscountrygardens.com/plantS%20for%20shade.htm
~
,J
IfYOll are
interested in
recelvmg
information
on new
plants &
products,
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coupons, and
.,
our events,
lectures,
sales, and
specials click
to our
contacl'illi.
page.
Page 1 of 3
N@w Page 2..
Camus ,~::-g-~~d,~:~'~-YellOw twig Dog~~
'------------...
Corylus avellana contorta - Harry Lauder's Walking Stick*
01/17/200704:12 PM
Enkianthus campanulatus - Redvein Enkianthus
(E~~~~~~.~~"~"'~~l:ny;o~'::'~~U~i~
-,,~.
Gaultheria procumbens - Wintergreen*
Hamamelis species*
~..~,"~-",~._.~~-...-...~.......
~~~ra_~~!l2<~~~~i.~)HardY English [vy*
,IfYd;;-;~~~~i~]-;;;i0'Iimbing Hydrangea
~---, ..,",' _.."-....... ..~'._-,--~-,....,~"".-
H drangea quercifoIia - Oakleaf Hydrangea
~: - Holly*,' anese Holly ,~I~kl1~;.~E~l~~;~~~:)
Itea - S weaetspire
Kalmia latifolia - K,lou~~~;~~::~:V
.o.".,.~, ""'''''''',
rLeuothoe* ,./
Ligustrum - Privet
/ ....""""~.=-_..'.'~e"....... "~
L0111cera:"- Honeysuckle
~';.
Magnolia virginiana - Sweetbay Magnolia
Myrica pensylvanica {'B~Yb:;;y,
~---
Pachysandra - Spurge*
Parthenocissus quinquefolia
1P[;;;;~~;dromed~
..--..----..
~j*
SkimmIa*
~----
Taxus'- Yew*
(V;'b;;;~
-"-.."~<-.-~.,,.-'"
tp://www.kennedyscountrygardens.com/plants9620for%20shade.htm
Page 2 of 3
Se.slde Ii'lallts
01/17/200704:10 PM
* denotes evergreen foliage or winter interest
KENNEDY'S Country Gardens
85 Chief Justice Cushing Highway (Rt. 3A)
Scituate, MA 02066
Ph 781-545-1266 ~ Fax 781-545-8210
[Home] [!.l.J2 ]
Last modified: October 311, 2004
tp;//www.kennedyscountrygardens.com/seaslde_plants.htm
Page 60f6
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JAN 2 2 2007
N
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SURVEY OF PROPERTY
AT EAST CUTCHOaUE
TOWN OF SOUTHOLD
SUFFOLK COUNT~ N. 1':
1000-97-07-03
SCALE: 1'=30'
JANUARY 18, 2006
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AREA-19,4n SO. FT.
TO TlE UNES
. =MONUMENT
.
ANY AL TERA nON OR ADDmON TO THIS SURVEY IS A \I1OLA nON
OF SEcnON 72090F THE NEW YORK STATE: EDUCAnON LAW.
EXCEPT AS PER SEcnON 7209-SUBDI\I1S1ON 2. ALL CERnRCA nONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF
SAID MAP OR COPIES BEAR THE fI,IPRESSED SEAL OF THE SURVEYOR
'M{OSE SIGNA TURE APPEARS ~ON.
06-107
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