HomeMy WebLinkAboutTR-6621E
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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
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.: 6621E
Date of Receipt of Application: May 30, 2007
Applicant: Ralph Panella
SCTM#: 1000-87-6-9
Project Location: 540 Takaposha Road, Southold
Date of Resolution/Issuance: June 1, 2007
Date of Expiration: N/A
Reviewed by: James F. King, Trustee President
Project Description: A temporary repair of the westerly bulkhead with non-
treated plywood, replace fill washed out behind bulkhead and top with 20-50Ib.
rock from edge of bulkhead to about 20+/- feet landward.
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 May 30,2007.
Special Conditions: A full Wetland Permit must be obtained in order to conduct
any further activity on the shoreline structures.
This is not a determination from any other agency.
;..- 5< ~
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 Gnusio, 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
Office Use Only
Coastal Erosion Pennit Application/ t' ~
= Wetland Pennit Application --\,L Administrative Permit [/'merqen
AmendmentlTr~tension \J
~eceived Application: () 7
L Received Fee:$ 5(j>.2-
_Completed Application
_Incomplete
_SEQRA Classification:
Type I~Type II~UnIisted_
_ Coordioation:( date sent)
_ L WRP Consistency Assessment Form
CAC Referral Sent:
_Date ofInspection:
_Receipt ofCAC Report:
_Lead Agency Detennination:_
Technical Review:
_Public Hearing Held:
Resolution:
A:r.t-
c-y .
11'11
g IECIEIVIE D
MAY 3 0 'lf1J1
SeatIIIIoIlI TGwI
IloInIII TIISlIII
Name of Applicant Kll\9 \-., Y.<l"-I~ LLA-
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Address S 110 7.()\(l<Ip{.9~"A- )2"ot'J)lM~\1 ,.<j.,1d!?P.i'1- p,(),f],pxIIoLIJ,-~rfllllb
.s,,/1vtho Ii> I "'Y II q')J Phone Number:(lt?! 7 b.s- - I)~
Suffolk County Tax Map Number: 1000 - '113J'.fQ ?7. - 6- 9
Property Location: sVo '7A;; IJ P, 5), It- 'j)rt A 1\, >C .t/'ft, IJ liJ I }.I Y 11 ~ 7/
(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):
Area Zoning:
~~
Previous use of property: K q... ,~ If' I\J-.j "q I
Intended use of property: 'ke 7\ \::, l:'Ni I A I
Covenants and Restrictions:
If "Yes", please provide copy.
Prior permits/approvals for site improvements: N /-Ilr
Yes
/
../ No
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 if necessary): RePJ40f:" TILL 4I4fheb
v'vt bQh,,,,~ bvll<.hH"b iN I)ilj:>d 1:9.1 NoR-l-h FM7f>r<4ll.t
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I' ~p w 111\ -20 .-/" So ~vv(\l11 K'CK-
-\f'OV'-...coN~~ ~ bvll<l,!,yj.~ ~l::>"v"" ;Jpi:... -CC?Q1' [1'1"'\ Vv'~~~
1rf'.fiJr/R1\,,-\yt<~j)If./~ ~'",\\ 'f ~o)-b-'/.(;"" -1-17 ?~qV~N7" -Fvyj~~_ ~roSIM').
~
tlrrd of Trustees APPlicat~
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: ---JFM. Pp'j> '1\ II '1 ('MU'q ~.::>t. '1
""R.".,^ I "- ~h'] 1< I.,,,,,. ~ ~~\MQ ':P,n- LvA.S.h~ f) v'f- irv
APQ,L ''t}.7 NI!~fh EA>T$g'-\~~'N~ bvl~ h4 AI\ ~ -J.9'IJ wr,."" did-ooll
?ov/'-'~ ~7'll,.,.e;.. ~:"'>HV\ edlf' .9"f. bv'l"h~~b 2i9+PQ7 I t-;9Nt; wJ'12h '-
RJ/
Area of wetlands on lot:
square feet
Percent coverage of lot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: 67,.:t 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? Cs( cubic yards
(? How much material will be filled? .d fl tl:t ~? cubic yards
, iL '"'t-
Depth of which material will be removed or deposited: ~ ~
Proposed slope throughout the area of operations: IV I A-
Manner in which material will be removed or deposited: JP.. \J~)( e-~ II'J C I fA,.!
feet
f ,\.."--- ~ >-JD'" t= ---+.~ je1>1',," r,
Statement of the effect, if any, on the wetl<lllds and tidal waters of the town that 1l1ay resultiJy
reason of such proposed operations (use attachments if appropriate):
/'10 N t:
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617.20
PROJECT ID NUMBER APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART 1 . PROJECT INFORMATION (To be completed by Applicant or Project Sponsor)
1. APPLICANT I SPONSOR 2. PROJECT NAME
El'V1n6e/J~
SEQR
3.PROJECT LOCATION:
Municipality go \.I -+ ~" I County
4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent
S/..fo -rAJ::APHIt f'1 ROA"b) SIV'Iht>}i',)
(VlA!N Bt4!'v/ e-'W
IN
~vI?1"1)
landmarks ate. or provide map
).\ 'J .JJq71 I IN7.pr.fprT/lJN
5. IS PROPOSED ACTION' D New
o Expansion ~ ModificatIon I alteration
6.DESCRIBE PROJECT BRIEFLY JlepJ4~Q. 'Dlf.tt-'-lf '.W' :},(;"I-J-o ~P:#IL. l;f7
N '". ot'tb 8 J2-1'Yl -.be"INP \vIKku]:) ""-"nf {,\Jl~"
Ik-M 41-JTflri"- .~-:-!::~~ "",L'TT~".:t 1 -f~~1 ~ ",M bv/I<I\Q.{h )..rlN~W>1-J!.~
/lQ f-o 5'<7 ,-UV"'u ,"J'~..~ .', .
7. AMOUNT OF LAND AFFECTED:
Initially acres Ultimately acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
~Yes D No If no, describe briefly:
g. WHAT IS PRESENT LAND USE IN VICINITY
0ReSidential D Industrial 0 Commercial
OF PROJECT? (Choose as many as apply.)
DAgriCUllUre D Park I Forest I Open Space
DOther (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
l}(]Yes D No If yes, list agency name and permit I approval:
A~ASPt:.1..: I Ur I HI::. AI..: IIUN HAVE"A- CDKKl:.N Il Y VALID PERMIT OR-~APPROVAL?
~NO If yes, list agency name and permit I approval:
S A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT / APPROVAL REQUIRE MODIFICATION'
es DNa
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant
Signature ."
~.d-
Date:
~,p 17
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 ITo be comDleted bv Lead Aaencv)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NVCRR, PART 617.4? If yes, 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.
DVes oNO
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, surface 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:
I 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 II
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 [meacts including changes in use of either uantltv 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)?(lfyes, explain briefly 1
DVes DNa I
E. IS THERE, OR IS THERE L1KEL V TO BE, CONTROVERSV RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:
DVes DNo I j
PART III- 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) 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:, t~g dgtgrminatign of E:igniHGaRse-must-evalI:late-tRe-f}oteA-tial-irRfX3et of the I3reposea aetiOR OR the ef\tiFeflmeftta-l cl9aracteltstiCS'Oftlie aCA.
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.
cheEkffili box-W you' ha,'-Ei-deiermTried-; basea-on-ihe kiformation and analYSIS above and-any supporting documentation, tha-t the-proposed acfio.
WILL NOT result in any significant adverse environmental impacts AND provide. on attachments as necessary, the reasons supporting thi
detennination.
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)
\,..
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.(....-
~Board of Trustees ApPliCa~n
County of Suffolk
State of New York
{l'"
K ~ ~ VA)'\f LL fl BEING DULY SWORN
DEPOSES 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 A TIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
&~dw.th-
,
Signature
SWORN TO BEFORE ME THIS
/! '#--
jD DAYOF /tAO/
_,20 QJ
-'
~()
(J1.~ ~.
Notary P'ublic
"
.
----
: '....:
.ard of Trustees APplica.
AUTHORIZATION
(where the applicant is not the owner)
l-
I,
(print owner of property)
do hereby authorize
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner's signature)
;\/
'"
1'-
8
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APPLlCANT/AGENTIREPRESENTATlVE
TRANSACTIONAL DISCLOSURE FORM
The Town of South old's Code of Ethics orohibits conflicts ofinterest on the Dart allOw" officers and emolovees. The Durnose of
this (ann is to nrovide information which can alert the town ofoossible conflict<; of interest and allow it to take whatever action is
necessarY to avoid same.
YOUR NAME: P A ~ Ii: L'-fIIl< {>. \ \? '" L,
(Last name, first name! -Ipiddte initial, unless you are applying in the name of
someone else or other entity, such as a company. Ifsa, indicate the other
person's or company's name.)'
NAME OF APPLICA nON: (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, parent, or child) have a relationship with any officer or employee
of the Town of South old? '''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% ot:.the shares.
./
YES
NO
1 f you answered "'YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of South old
Title or position of that person
Describe the relationship between yourself(the applicanVagentJrepresentative) 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, of child is (check all that apply):
~A) the owner of greater than 5% of the shares of the corporate stock of the appliqmt
(when the applicant is a corporation);
_8) 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~bmitted ~~ M-1L
Signature tf; ~ ~
Print Name A. LLA
200 7
Form TS I