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HomeMy WebLinkAboutTR-6489A James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Ir. 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 Date of Receipt of Application: October 24, 200~ Applicant: Al~b.~rt Leutwyler and Diana DeLucia SCTM#: 107-4 5 Project Location: 4573 Wickham Ave,. Mathtuck Date of Resolution/Issuance: November 15, 2006 Date of Expiration: November 15, 2008 Reviewed by: Jim King Project Description: Hand trim Phragmites to 12", as per survey prepared by Smith Jung and Gillis received by the Board of Trustees Oct. 24, 2006; This permit is for the cuffing of Phragmites ONLY in the designated shoreline area and no cutting of any other wetland vegetation or native vegetation. 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~mi~.n.~.from any other agency. James F. King, President 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 Permit No.: 6489A Date of Receipt of Application: October 24, 2006 Applicant: Albert Leutwyler and Diana DeLucia SCTM#: 107-4-5 Project Location: 4573 Wickham Ave,. Mattituck Date of Resolution/Issuance: November 15, 2006 Date of Expiration: November 15, 2008 Reviewed by: Jim King Project Description: Hand trim Phragmites to 12", as per survey prepared by Smith Jung and Gillis received by the Board of Trustees Oct. 24, 2006; This permit is for the cutting of Phragmites ONLY in the designated shoreline area and no cutting of any other wetland vegetation or native vegetation. 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~etermination from any other agency. James F. King, President Board of Trustees James F. King, President Jill M. Doherty, Vice-President Pegg~ 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.: 6489A Date of Receipt of Application: October 24, 2006 Applicant: Albert Leutwyler and Diana DeLucia SCTM#: 107-4-5 Project Location: 4573 Wickham Ave,. Mattituck Date of Resolution/Issuance: November 15, 2006 Date of Expiration: November 15, 2008 Reviewed by: Jim King Project Description: Hand trim Phragmites to 12", as per survey prepared by Smith Jung and Gillis received by the Board of Trustees Oct. 24, 2006; This permit is for the cutting of Phragmites ONLY in the designated shoreline area and no cutting of any other wetland vegetation or native vegetation. 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~,min2n'~fr°m any other agency. James F. King, President Board of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Town Hall 53095Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: //h~/~ c' ! '/ Name of Applicant: Name of Agent: Property Location: SCTM# & Street Brief Description of proposed action: Sound Front Bay Front Type of area to be impacted: Saltwater Wetland Freshwater Wetland Distance o£proposed work to edge of above: Part of Town Code proposed work falls under: __Chapt.97 Chapt. 37 other Type of Application: __ Wetland __Coastal Erosion __Amendment __Administrative __Emergency Info needed: Modifications: Conditions: Present Were: __J.King __J.Doherty ~P.Dickerson D. Bergen Other: Maiied/Faxed to: Comments of Environmental Technician: Date: James F. King, President Jill M. Doherty, Vice-President Pegg~ 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 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated [O/~Z ¥/© ~ has been reviewed by this Board at the regular meeting of f( [ ( f' [~ ~ and the following action was taken: ( V~)Application Approved (see below) ( ) Application Denied (see below) ( )Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: ~' 0 7~7~/{ I~ &fdoJcSYJ TOTAL FEES DUE: BY: _ James F~ King, 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 __ 1stdayof construction ½ constructed __ Project complete, compliance inspection. · Map for: 4573 Wickham Ave Mattituck, NY 11952-2355 Ddving Directions: To Here - From Here SO~TNOLO James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Jolm 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 Perm/t Applicationj ZWetland Permit Application ~.~ Adminis~:afive Permit Amendment/Transfer/Extension ~[[eceivved Application: --,'"Received Fee:$ %~oTnp 1 eted Application __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordmation:(date sent) __LWRP Consistency Assessment Form CAC Referral Sent: __Date of Inspection: Receipt of CAC Report:__ __Lead Agency Determination:__ Technical Review: ~Public Hearing Held: Resolution: Name of Applicant A ~ ~rv [.e. Otw ~ tear ,- O ~exncx D~Cu~ ~, Address t4.q'73 VX/i¢lc,14o. v-v~ Ave- Phone Number:( Suffotk County Tax Map Number: 1000- 107~ 00/0~ Property Location: L~t.. ~ ~ 500~.t ~O,r~ (provide LILCO Pol~, distance to cross streets, ~d location) AGENT: (If applicable) Address: Phone: oBoard of Trustees ApplicOn Land Area (in square feet): Area Zoning: Previous use of property:_ Intended use of property: GENERAL DATA ^crc. Prior permits/approvals for site improvements: Agency Date ~x 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 if necessary): ,J ~oard of Trustees Applic~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 'q--g-, z~, ~q~O~v¥~ ( (.~ 5 Area of wetlands on lot: 70 0 square feet Percent coverage of lot: cy o/o % Closest distance between nearest existing structure and upland edge of wetlands: ~-U) 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? ~' cubic yards Ho~v much material will be filled? f cubic yards Depth of which material will be removed or deposited: J feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal wa_ters of the town that may [es_u!t bY reason of such proposed operations (use attachments if appropriate): pROJECT ID NUMBER PART '1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT. NAME SEQR 1 APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality 4 PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: ~ New ~ Expansion ~ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: Initially acres I/~.C, ¢~-C,"'~ Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes [] No If no, describe briefly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) F~Residential E~lndustrial E~commercial E~Agriculture E~Park/Forest/OpenSpace ~lOther (describe} 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, AGENCY (Federal, State or Local) r-~Yes F':/~No if yes, list agency name and permit / approval: NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL -- -- ll'TUOES ANY A~PECl PI- fHE ACFION HAVE A CURRENTLY ~¢;~[~r~5~llT OR APPROVAL? E~]Yes r~-~No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ~ CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Date: If the action is a Costal Area, and you are a stats agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD tN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. WILL ACTION RECEIVE COORDINATED REVIEWAS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If 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 handwri6en, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potenfiat for erosion, drainage or flooding problems? Explain briefly: C2, Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shelffish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C5. Growth, subsequent developmen, or related ac v es ikely o be nduced by he proposed action? Explain briefly: C6~ Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: C? ither impacts (including changes in use of either quanfib/or type of energy? Explain briefly: WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENITAL AREA (CEAI? /If yes, explain bdefl~: E]¥es pqNoI E tS THERE, OR IS THERE L!K~LY 1-O BE! ~Ol~ll-ROV~R~Y R~LA~D TO POTENTIAl_ ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) IN STRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or olherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (bi probability of occurring; (c) duration; (d) irrevemibility; (e) geographic scape; and (0 magnitude. If necessa~, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impact have been identified and adequa[ety addressed. If question d of part ii was checked yes, the determinat!o~ of ~!gnifiecnce must cvs!ustc thc potemiaFimpsct ~.~f th~ prcpcacd c,c fic.~, on thc cnvlronm¢.ntal ch&r~',ctar~st[cs ofth~ 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[ FAF and/or prepare a positive declaration. C-hecl~ ~i~ tJ~'~ yo~ i~ave determined~ based on the ~nformation and analysis above and any supporting documentationl that thep~op~sed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thfi determination. Name of Lead Agency Date Title of Responsible Officer Signature of Preparer (If different from responsible officer) Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Board of Trustees Appli ~n County of Suffolk State of New York x-Vv DC-> ,act ,q BE O swoP DEPOSES AND ~F~S THAT ~/S~ IS T~ ~PLIC~T FOR T~ ~0~ DESC~ED PE~IT(S) ~ T~T ~L STATE~NTS CONT~D ~ ~ TR~ TO T~ BEST OF ~S~R KNOWLEDGE ~ BEL~F, ~ THAT ~L WO~ W~L BE DO~ ~ T~ M~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSTEES. T~ APPLICANT AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TOWN TRUSTEES ~ESS A~ F~E FROM ~Y ~ ~L D~AGES ~ CLA~S ~ISING ~DER OR BY VIRT~ OF SAD PE~IT(S), ~ G~TED. ~ COMPLETING T~S ~PLICATION, I HEREBY AUTHO~E T~ ~US~ES, T~IR AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~MISES ~ CONJ~CTION ~TH RE~W OF T~S ~PLICATION. Signature SWORN TO BEFORE ME THIS ~ ~ DAY OF G c a~ / ,e--.- ,20 o <7 Notary Public Board of Trustees. AppliCon AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at (mailing address) do hereby authorize (Agent to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the oart of town officers and emolovees. The nuroose of ~[his form is to orovide information which can alert the town of tmssible conflicts of thtemst and allow it to take whatever action is necessary to avoid same, YOUR NAME: D tOt~Ot ~ b{-) ~('~ (Last name, first name, ~niddle initial, unless you are applying in the narnc 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 the activity.) /k~6klA&[,/~¥1F6~ V'~ ~51/'X*/~)C Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~'~ 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 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 her spouse, sibling, parent, or child is (check all that apply): ___A) the owner of greater than 5% o f the shares of the corporate stock of the applicant (when the applicant is a corporation); ___B) the legal or beneficial own~' of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 REF ONLY: 1000-107-04-005 SEC, SHD JOB 11218 M^P OF WOLFPiT PONO ESTATES (TO HWL) S 84~35'00" E 146,5' FND N 84o$5'00" W , ~(TO HWL) /(/' SURVEY OF PROPERTY SKuated at MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY NEW YORK Soo/e: 1"- 30' Survey Certified To: ALBERT LEUTWYLER DIANA DELUCIA F~DELITY NATIONAL ~11LE iNS, CO ~10~- 7404-6~TS7-SUFF NOF~TH FORK SANK Dates JULY 31, 2006 Sur~yed Smith, Jung & Glllts f20 Meg~ A~ue ~one, 831 ~75 3192 LEU TWYLER-DELUCIA