HomeMy WebLinkAboutTR-6588A
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.
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
South old, N ew 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
_ ronstructed
L Project complete, compliance inspection.
.
.
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.: 6588A
Date of Receipt of Application: April 2, 2007
Applicant: Michael & Teresa Smith
SCTM#: 14-3-2
Project Location: 1405 Terry Lane, Orient
Date of Resolution/Issuance: April 18, 2007
Date of Expiration: April 18, 2009
Reviewed by: Board of Trustees
Project Description: To re-vegetate the bluff by adding American Beach Grass
to the slope and plant a 20-foot non-turf buffer zone along the top of the bluff to
prevent further erosion.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Briarcliff Landscaping, last dated April 16, 2007 and
approved April 18, 2007.
Special Conditions: None
Inspections: Final inspection
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the South old Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
2:::: F,:::Zdent
Board of Trustees
JFK:eac
.
.
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
TO: /fl/cJ,ae.11 ~~ct ~i~
Please be advised that your application dated /Jpn'J 02, .;zoo? has been
reviewed by this Board at the regular meeting of I1tn'l Jl?; ,;z.oo7 and the
following action was taken:
( ~~Plication 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:
- Hno..l -:rt':red-/cr'\ ~
0'-"
TOTAL FEES DUE: $ 5ZJ -------
BY: James F. King, President
Board of Trustees
-.--
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,
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town HaIl
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
Southold Town Board of Trustees
Field InspectionfW orksession Report
Date/Time:~()l
Name of Applicant: /Vl1(~1'&l <-Ie ,(.0., J;-;, ,11.
Name of Agent:
r3>nc,r<-(if-J:
Property Location: SCTM# & Street
1'10 r; Ten,,:> kvu.
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B~efDescIiption of proposed action: TIc -1IL~~1c Ll<.f.{~ J ~.A
-to <;11'6' l\o,~ ("J ,,\~"''"'\ ,'Ik..L- 1~1--~"~~,~ "'<
"-"" '- I CAt"', h. ~ '1 f'" 1ktf? '" I (,:' I [ .
J3/~ < .A <An ~ ;;r<<.l)
L <A.(.(<r
Type of area to be impacted: ./
_Saltwater Wetland _Freshwater Wetland _Sound Front _Bay Front
Distance of proposed work to edge of above:
P'lf! of Town Code proposed work falls under:
~Chapt.97 _Chapt. 37 _other
Type of Application: _ Wetland _ Coastal Erosion_Amendment~Administrative
_Emergency
Info needed:
~~\\J
G"Y)
huu.>~
Modifications:
Conditions: ~ c.f\:,,,\ 5 C 6", ~~ J -to ';2d CIOI-rhr (-. '.
-=- zQt :? nr.('~ L ~r-:::c
ro ~\~Cal\11ur
tl~
Present Were: v(King ~;Doherty "P.Dickerson vD. Bergen
Other: Jb.,. IJ. +btkor c.
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Bob Ghosio, Jr.
MailedIFaxed to:
Date:
Comments of Environmental Technician: DIt.,<-'
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James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Gnosio, Jr.
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, N ew York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
_Coastal Erosion Pennit Application
_Wetland Pennit Application X Administrative Pennit
/ AmendmentITransfilE~tension
J[.Received Application: If 2 0 7
.1CReceived Fee:$ 50 ~' ,
/" Completed Application ~ J-I ~ J
_Incomplete
_SEQRA Classification:
Type I_Type II_Unlisted_
_ Coordination:( date sent)
_LWRP Consistency Assessment Form
---CAC Referral sent:~ /l...
-Bate ofInspection: II II ~7
_Receipt ofCAC Report:
_Lead Agency Detennination:_
Technical Review:
..Public Hearing HeW:]ll 'i/ () )
_Resolution:
Office Use Only
SoutllllGlll
80ard "
Name of Applicant m I tJf rt;;;; " ~I B"f2.F-iJ,A ~ I~
15 ~ c:tWrf:Drwe, 7oAS~?&,IQ;, Ir
Address / " ~~ I..('....,~ LA M-l. V,€, t"',., r AI. y:
} ,
J 11 ~ ~ /17~8'" Phone Number:( )
/'-1- 03 - t);;...
LA-rl-l , {) //;' IV/
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Suffolk County Tax Map Number: 1000-
Property Location:
IlftJ,
7 -l'1"
~
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
..,rd of Trustees APPlicati~
GENERAL DATA
Land Area (in square feet):
~e, ,Q3 . 37
Area Zoning:
2c~1&.erV +t'J
~€SI&.eN+t~
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 pernlit/approval ever been revoked or suspended by a governmental agency?
~No_Yes
If yes, provide explanation:
Project D~~~ripti~~ (u~~ attac~e~ts if~ecess~~€;/~~ bt..A ~-_.._-
~y A-b~~ "-1 b(~~ cRIll. ~ ~fA-~~ (!!-t..y~u. ( a.N4..P1 ('t~i~
~ 'l1,R rlo(le, ?IA""';""j A bu=r -wN<- "jO ;2"SA
^,~O{A ~ 1U1~(4-~~ ~/NRt0S"~ !..JoN1 -f/..-L ~p of b(~p~
~iP".lUII\J7 ~~ .R.('O~~iJ. ~,r=e ~#~ IAN~St/J/ltF
P 14 N Po,r 'P'(41\J'i/ A)~ eJ.,<.:fr:t1(.!. ;lD ql'A-OIM7. 01' Ab.6ITtDA./;t/
~()IL. wltl De rl-O~a fr> 'M.~ -6.f..,FP #-('14 o.e
tOi'T'HIN IDD' oP TOP oP brl./'FJ:.
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lItrd of Trustees APPlicati~
WETLAND/TRUSTEE LANDS APPLICATION DATA
-
Purpose ofthe proposed operations: I 0
~ ~LuEF A6A-1\)i~
Sl~t?l0 ~ -nfFN
rut<rHd<. €RD~ D0
Area of wetlands on lot: ~DO square feetCOl/el' - €STI~~'TO)
Percent coverage of lot: ,~. S~ %
Closest distance between nearest existing structure and upland
edge of wetlands: I Be.{. 32- feet
Closest distance between nearest proposed structure and upland
edge of wetlands:. I ~O feet
Does the project involve excavation or filling?
)(. No Yes
If yes, how much material will be excavated? JJ(A cubic yards
How much material will be filled? 10{ A
cubic yards
Depth of which material will be removed or deposited: tV I A- feet
Proposed slope throughout the area of operations:~
Manner in which material will be removed or deposited:
u~
Statement of the effect, if any, on the wetl<ll1dsand tidal waters ofthe town that may res.!IltiJy
reason of such proposed operations (use attachments if appropriate):
'No ::c LMf..kr ~
b l U~ 'F/'om
vJ i, t( $"T.4- ~ I ~"2-€"
h:tI'THC~ E(2.0r; ON
I
, I PROJECT ID NUMBER
I-
617,20
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
( To be completed by Applicant or Project Sponsor)
.
SEQR
PART 1. PROJECT INFORMATION
1, APPLICANT I SPONSOR .\m :~ 2, PROJECT NAME
MltlA.ACt.-
3PROJECT LOCATION:
Municipality County S '" FFo~ "'-
4, PRECISE LOCATION Street Adde5s and Road Intersections, Prominent landmarks ate - or provide map
l<-t05" ....-:e (\1' I LAr<J(L , DRte~'T / N.y. /1 tt5?-
5, IS PROPOSED ACTION: 0 New D Expansion [g] Modification / alteration
6 DESCRIBE PROJECT BRIEFLY ~fVl2~~~ bJuFi= ~ ~/^4 blu< &.f.(~
{~~5 pJ\A~~ ~ "'f-i.E" S tOptz. ?tANT Ij A- b:J::...1f!1L ':l <>~E" ;-.
Of: ~Uf ;('ID$,A .,.. IY1I~el9-flJ-nfu.$ ~/iUt' S/~ ~ #1€ ~/? t)~
-1JIt ~J,"'F;: 17> f?4GV'nl1r ~d:nIae B2B...r~/'II. Jj d-~
lvf;Vas.C~E 1'1/jN.r ~ f//,t....n;f'l}1. dtmH7~. Ah 7~~/~ t9"1f!...
piJ/T( ;PN>I--( s/)i t. wi '1 b€ /'II OFt> Tb ~ MIIPF t?4~
t91l- /A-J1iJ./-/t0 ID()' I)F n,o /)j;.- A~t.lPP.
7, AMOUNT OF LANO AFFECTED:
Initially acres Ultimately acres
8, WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
~Yes o No If no, describe briefly:
9, WHAT IS PRESENT LANO USE IN VICINITY OF PROJECT? (Choose as many as apply.)
~ Residential o Industrial DcommerCia' DAgriculture 0 Park I Forest J Open Space D Other (describe)
10,' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMA TEL Y FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
DYes [2gNO If yes, list agency name and permit I approval:
II. UVJ::V mTA-sPECT-Or IHI:. ACIION HA\.i'"tA CURR~NrLY VALID PERMIT OR APPROVAL? -
DYes [lg'NO If yes, list agency name and permit I approval:
- - -
12, AS A [ifULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION?
[Jy es No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant I S~ Nlome 0 Q~ 3 7;q lo~
Signature t..."
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 by Lead Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.41 If yes, coordinate the review process and use the FULL EAF.
DYes 0 No
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 0 No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, jf legible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
rtential for erosion, drainage or nooding problems? Explain brieny: . J
C2. (sthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain brieny:,
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
I I
C4'1 community's existiog plans or goals as officially adopted, or a chaoge In use or inteoslty of use of laod or other natural resources? Explain briefly j
C5. rowth' subsequent development, or related activities likely to be induced by the proposed action? Explain briefly' .. il
C6. rng term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: I
C7. rer impacls (including changes In use of either quantity or type of energy? Explain brieny i
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
D'::""'D~~T'~r"~-"'"'" I
, """~.,'" "'''' """ m ". ,~,~,~, ~~"O m M""~ M""" "W'""~,,~ '""^"" ""'_~",
DYes 0 No l _ "j
PART 111- DETERMINATION OF SIGNIFICANCE (To be compleled by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each
effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part Ii was checked
yee:, the determlna!ior-\ of Eignlflcans8 FAble! Gvallffit~teA-tiaH~tfle-j3fef3€lSed-aetieftoFl the efl.iroFlfllcntal thai 8cteristicsofll,6 CCA.
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 andlor prepare a positive declaration.
CheddhlsboXlfyou-havl3"delermTiieif;hasedon "itieJnformation and analysis above and- any supporting" documentation,. thafihe-proposed a-Ciio
WilL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi
determination.
Name of lead Agency
Date
Pnnt or Type Name of ResponSIble Officer In lead Agency
Title of Responsible Officer
Signature of Responsible Officer In lead Agency
Signature of Preparer (If different from responsIble officer)
~oard of Trustees APPlicat~
County of 0 VEEA/S
State of New York
It!te~"',.~ ~ I~ 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 HISIHER 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 ARlSING
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 wr~~IC]ION
Signature
SWORN TO BEFORE ME THIS 3t!J 17-1 DAY OF II Att'{! H
,20~
ROSALIE GORDILLO
Notary Public, State of New York
Registration #01 G061 02502
Qualified In Queens County
My Commission Expires December e, :,.'::,
I~' &cld1o
Notary PubIlc
..rd of Trustees. APPlicatie
AUTHORIZATION
(where the applicant is not the owner)
~
I, A ^ \'( \rid e \ Sf)'\;-00
~br~nt owner of property)
residing at
(mailing address)
15" rVt\ d. 1f><-0 n .
NldSSr\lpeCj\lc:") do hereby
. I r\~ .
L~s.c~ to apply
authorize
(Agent)
-,13n ~r: llff-
for permit(s) from the
Southold Board of Town Trustees on my behalf.
.'1tc~o ~~
(Owner's signature)
8
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APPLICANT/AGENTIREPRESENTATlVE
TRANSACTIONAL DISCLOSURE. FORM
The Town of South old's Code of Ethics nrohibits conflicts of interest on the Dart arroW" officers and emolovees. The Durnase of
this fonn is to orovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is
necessary to avoid same. .
YOUR NAME: t1A (;1#t1f"Z- 1. .J1If,(,", n./
(Last name, first name, J11iddle initial, unless yo'u 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.)
Building
Trustee
Coastal Erosion
Mooring
Planning
x
Tax grievance
Variance
Change oIZone
Approval aIplat
Exemption from plat or official map
Other
(If''Other'', name the 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" 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
x
ffyou 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% of the shares of the corporate stock of the applic<;lnt
(when the applicant is a corporation);
_B) the legal or 'beneficial own~r 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
S~bmitt~-21-doO~~ 2ooif~
Slgnalu - ,(
Prinl Name /,U, I (!,..t~ ( I1.L 1m
Form TS 1
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