HomeMy WebLinkAboutTR-6283A
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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
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
15t day of construction
Yo constructed
~Project complete, compliance inspection.
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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
Permit No.: 6283A
Date of Receipt of Application: December 1, 2005
Applicant: Janet Carrus
SCTM#: 86-6-26.1
Project Location: 7055 Indian Neck Lane, Peconic
Date of Resolution/Issuance: January 18, 2006
Date of Expiration: January 18, 2008
Reviewed by: Board of Trustees
Project Description: To selectively remove non-native plants and re-vegetate
bluff with native species.
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
plan prepared by Trimble's Nursery dated August 11,2007.
Conditions: None
Inspections: See attached schedule.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
}:::fY{4
James F. King, ;es~nt
Board of Trustees
14 2005 Field InSP.'on
Dec, ,
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· ~'I> TRIMBLE!
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'J if Corcbaug NURSERY
UnU5ua( Annua~, PerennialS, SGruGs &' Trees' Innovative Landscape Design & Insta((ation for Private ani Commercia(pro)'erties
Anne E. Trimble
Pro}rfctor, Director'!!
LandScayeDes(q/l
anlrnsta((ation
Nancy Leskody
Proyrietor, Manager qf
Green6ouseanaN"PtANT LIST/JANET CARRUS BLUFF .
7055 INDIAN NECK LANE, PECONIC
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ARTEMISIA STELLERANA (Beach wormwood)
LATHYRUS JAPONICUS (Beach Pea)
SOLIDAGO SEMPERVIRENS (Seaside goldenrod)
AMELANCHIER CANADENSIS (Shadbush)
MYRICA PENSYLVANICA(Bilyberry)
PRUNUS MARITIMA (Beach Plum)
ARCTOSTAPHYLOS UVA-URSI (Bearberry)
ANDROPOGONSCOPARlUM(UmeBrue~em)
.AMMOPHILA BREVILIGULATA 'CAPE'(CAPE
AMERICAN BEACHGRASS) ,
ANDROPOGON VIRGINICUS(BROOM SEDGE) .
BACCHARIS HALIMIFOLIUM(GROUNDSEL
BUSH) , .
CHASMANTHlUM LATIFOLIUM (NORTHERN
SEAOATS) .
CHYSOPISIS MARIANA (GOLDASTER)
IVA FRUTESCENS( H ~LDER)
PANICUM VIGATU . H GRASS)
ROSA VIRGINIANA ROSE)
imagination "
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OPTUNIA HUMIFUSA(PRICKLY PEAR)
SPARTINA PECTINATA (FRESHWATER
CORDGRASS)
JUNIPERUS VIRGINIANA (RED CEDAR)
VACCINIUM CORYMBOSUM(HIGHBUSH
BLUBERRY)
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II O>oper\IIive ExIemion
Page 1 of6
Seashore Plantings
The misty and enchanting atmosphere of coastal landscape attract more and more people to build their homes by the
seashores. New homeowners often desire a luxuriant vegetation surrounding their dwellings for protection and privacy.
However, the non-tempered winds and ocean spray present an enormous challenge to plant life to be able to stabilize in
unsettled sand. It is cruciai to select suitable plants which endure the harsh environment for a successful seashore
landscaping.
Plants that are able to survive in the rugged coastal environment must withstand the prevailing winds, tolerate the salt spray
and be capable to set their roots into dry and porous sand. The use of native plants has become more acceptable by many
contemporary gardeners and been boosted by the awareness of ecological and energy issues in coastal environment. It is a
logical approach, because, native plants are the survivors that are tolerant and adapted to the specific conditions of
seashores. However, some introduced species which can do well in seashore conditions should also be induded for
increasing the stabilization of sand dunes and the aesthetic values along the shorelines.
An understanding of coastal ecosystem is essential to be able to position proper plants at the proper places. Seashore
p1antings serve an important function as a natural erosion stabilization for dunes and bluffs along the coastiine. There are four
major coastal ecosystems could be identified on Long Island shores with distinct ecological characteristics.
Belt I - A. Seashore Conditions
fi..,,,,1.billllsltafiOll of Brit I
Areas consist of relatively flat beach and beach dune that
predominate the south shore of Long Island. The beach dunes
immediately flanking beaches are known as primary dunes. The most
common primary fore-dune plants are herbaceous perennial plants
that die to the ground in the fall of each year and send up new shoots
from their roots in the spring. These primary fore-dune plants act as
dune stabilizers. They slow the wind at the dune surface, causing
deposition of wind borne sand. During storms their root systems help
hold sand in place, thereby slowing the rate of dune erosion.
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Beltl-
B. Coastal Sound Bluff Ecosystem
Narrow beaches backed by eroding sandy bluffs characterize
much of the north shore of Long Island, induding parts of the
north shore of the South Fork. The beach bluffs flanking the
narrow beaches on Long Island's north shore are over one
hundred feet high in some areas. There are many good plants
including grasses, vines, low shrubs, and minor trees that can be
used for bluff-stabilization projects.
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CtJtlStI1/ S"und Sluff EctlSysttl.
Belt II Coastal Plain Ecosystem
Areas sit behind the sand dune or the bluff.
Plants usually are more protected from the
dunes, bluffs, screens, or artificial structures.
/hit III
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Coastal Plain Ecosystem
file://C:\DOCUME-l \SCOTTC-l\LOCALS-l\Temp\PKN3FB8Xhtm
4/26/2004
Belt III Barrier Beach Ecos_m
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Page 2 of 6
On barrier beaches, the secondary dunes lead to a protected bay. The back of the primary dune and the protected areas of
secondary dunes are Characteristically vegetated in a zoned mosaic pattern. This means that micro-environmental conditions
aver the dominance of various plants in relatively close proximity making generalizations about this area very difficult.
Two limiting factors seem to playa key role here though: height above sea level and exposure to salt laden sea breezes. The
lower the elevation the closer the plant communities are to the water table. The dry dune areas (at higher elevations) behind
the beach are very similar in many respects to a desert environment for the stationary plants found growing there. It is very
hot with sand surface temperatures of 1200 F. not uncommon. It is also very dry. Rainwater percolates very rapidly through
sand and so plants must have very deep root systems to reach the water table below.
Landscape Plants for the Coastal Environment
This list is broken down into belts of exposure depending on the ecosystem of the Long Island coastal environment. The
maximum water support is drip irrigation. Plants in the list with an asterisk are for the Barrier Beach Ecosystem. This, being
the harshest environment, needs special attention.
Belt I-A. Seashore Conditions
"Ammophila breviligul I American beachgrass
. Artemisia stel/arana / Beach wormwood
"Lathyrus japon/cus V Beach pea
.Solidago sempervirens V Seaside goldenrod
(Virtually no woody plants could survive in this harsh environment)
Belt I-B. Coastal Sound Bluff Ecosystem
Trees:
"'Pinus thunbergii Japanese black pine
Prunus serafina Choke cherry
Shrubs:
'" Arne/anchier canadensis V Shadbush
'" Elaeagnus angustifolia Russian olive
"Elaeagnus umbel/ata Autumn olive
"Ugustrum ovalifolium California privet
*Myrica pensylvanica ./ Bayberry
"'Prunus maritima V Beach plum
"Rhus spp. Sumac
... Rosa nitida
Grasses, Ground Covers and Herbaceous Perennials:
"Arctostaphylos uva-urSJ VII Bearberry I
I II I
file:l/C\DOCUME-l \SCOTTC-l \LOCALS-l \Temp\PKN3FB8X.htm
4/26/2004
I Chrysanthemum nipponicum I Montauk daisy
I Cotoneaster horizontalis I Rockspray cotoneaster I
*Lonicerajaponica 'Hallinana' I Hall's honeysuckle
* Juniperus conferta Shore juniper
I *Opuntia humifusa I Prickly pear
I "Sadum spp. I
Belt II - Coastal Plain Ecosystem
Trees:
Acer pseudoplatanus Sycamore maple
Arne/anchiar canadensis Serviceberry
Caltis occidentalis Hackberry
Crataegus crus-galli Cocks pur hawthorne
Crataagus phaanopyrum Washington hawthorne
Gleditsia triacanthos Honeylocust
"'Juniperus virginiana Red cedar
Photinia villosa
Populus alba 'Bolleana'
Ulmus parvifolia Chinese elm
I Shrubs: I
I Aronia arbutifolia I Chokeberry
Amnia melanocarpa Black chokeberry
Clethra alnifolia Sweet pepper bush
*Comptonia peregrina Sweet fern
Cotoneaster spp.
"Hydrangea macrophylla French hydrangea
"lIex glabra Inkberry
IIlax verticillata I IMnterberry
"'Juniperus chinensis
.,. Juniperus horizontalis Creeping juniper
I Lonicera tatarica I Honeysuckle
*Pinus mugo
Salix purpuraa Purple osier
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Page 3 of 6
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file://C:\DOCUME-l \SCOTTC-l\LOCALS-l\Temp\PKN3FBSX.htm
4/26/2004
Syringa vulgaris Common lilac
Tamarix spp. Tamarisk
Viburnum dentatum Arrowwood
Viburnum opulus Cranberry bush
Viburnum prunifolium Black haw
Vaccinium corymbosum Highbush blueberry
I I
Grasses, Ground Covers, Herbaceous Perennials:
* Artemisia spp.
*Elymus arenarius Blue Iyme grass
Euonymus fortunei
*Festuca ovina 'Glauca' Blue fescue
Hadera helix
*Hemerocaffis spp. & cvs.
*Hibiscus moscheutos Marsh mallow
Hypericum calycinum Creeping 51. John's wort
*Lavandula angustifolia English lavender
Lonicera heckrottii
* Rosa wichuraiana Memorial rose
'Santolina spp.
* Spartina pectinata Freshwater cord grass
*Yucca spp.
Belt III - Barrier Beach Ecosystem
Trees:
Abies concolor WhiteFIf
Acer platanoides Norway Maple
Acer rub rum Red Maple
Betula pendula European White Birch
Cedrus at/antica Atlas Cedar
Cryptomeria japonica Japanese Cedar
Fagus sylvatica European Beech
Fraxinus americana White Ash
FraxmuspennsyWanka Green or Red Ash
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Page 4 of 6
file//C\DOCUME-l \SCOTTC-l \LOCALS-l \Temp\PKN3FB8X.htm
4/26/2004
.lIex opaca I American holly I
Malus spp. & cvs. I Crabapple I
Nyssa sylvatica I Pepperidge; Black Gum I
Picaa abies Norway Spruce
I' Pinus Sylvestris I Scots Pine
I pyrus spp. I Pear
I Sophora japonica I Japanese Pagoda Tree
I Syringa reticu/ata I Japanese Tree Lilac
I Tifia spp. I Basswood; Linden
I Shrubs: I
.Berberis spp. Barberry
Chamaecyparis spp. False Cypress
*Cytisus scoparius Scotch Broom
'Euonymus japonica Euonymus
Forsythia spp. Forsythia
. Juniperus spp. Juniper
*Kolwitzia amabilis Beaulybush
'Potentilla spp. Shrub Cinquefoil
Spiraea spp. Spirea
'Rosa spp. Rose
Taxus spp.
Thuja spp.
Viburnum spp.
I Weigela spp. I
I Glasses: I
I Erianthus ravennae I Ravena Grass
I Helictotrichon sempervirens I Ornamental Oats
Miscanthus spp. Eulalia Grass
Panicums spp. Switch CJrass
Pennisetum spp. Fountain Grass
Pha/aris arundinacea picta Ribbon Grass
I II
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Page 5 of6
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file://C:\DOCUME-l \SCOTTC-l\LOCALS-l\Temp\PKN3FB8X.htm
4/26/2004
Ground Covers: I I
Gal/una spp. Heather
I Erica spp. I Heath
I Uriope II Uriope I
I Pachysandra terminalls II Pachysandra I
I Vinca minor II Myrtle I
I I
Herbaceous Perennials
Armenia maritima Sea Pink
Asclepias tuberosa "eed
Hosta spp. Plantain Lily
Narcissus spp. Daffodil
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Page 6 of 6
"
About this plant list: Michael Graham of Deerfield Frankenbach Nursery of Water Mill contributed all information on woody
ornamental plants and some herbaceous perennials. Jim Gross of Environmentals in Cutchogue and Professor Robert Mower
of Cornell University reviewed the list. Lois Davis, an avid gardener and Master Gardener of Remsenburg who designs and
maintains many herbaceous perennial gardens in the Hamptons contributed information and her expertise. Sketches were
drawn by Jeanne Daniele, a Master Gardener and landscape designer of Northport. Most plant species produced on Long
Island will do well in protected borders other than the barrier beach ecosystems, or similar sites.
For more information contact: Tom Kowalsick, Extension Educator - Horticulture, CCE - Suffolk County
Horticulture Leaflets Online
4/03
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L~TTERlof NON-J~C"!Qti
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Bob Day ,
. 88wyekoff Street
BroOJ(Jyn, N~t1201
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Dear Mr. Day:. I, , :
. BaSed.on the infonnation you have SUbmitteL, the New York State Department of Environmentat
Conservation has detennlned that:. . 'r ' ;
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The' property landward of the 14 foot e/evatiQn contour line at the western property line and
continuing in's northeasteny. d ir.acti. '.on a.Io..n..gth. e. .....1...4.~.... t. eJev atl.... 0... n...co. n. to., urU ne and be./owthe ;
existing ~n~k patio, where the JUnSdlqtJQnaflm. . 'KIirY ,tto,~m~>the16 foot elev~tion c:ontour
line continuln to the northem ProP'Ell1YlIile.lb~c ,tIll~jurisdIctiOn:of.Artlcle 25 (T!dal .
Wetlands). ~e elavatlon contour I/n8S are' hownqrLthe..aiJrvsy Prepared by Peconlc Sur..eYQrs.
P.C. last revised on 4/5/01. '.
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Therefore. In !iccordance with the. currem Ti. 81.. W etlil!lds. Land.. . U.. lie. '. ReQu.... fa. tions (6NYCRR Pa,1 ,
661) no p'ermit is .requi~ under ~e Tlda!W .'. '-'~lis&be'adVlse9, however, ~hat no '
constructi?n! s~lrnentatlon. or dlsturb~", .lta . .... ~:"f!!t~ilIli9&"!iward of the tl~a.l. .
wetlands Junsdlctional boundal)', sa incf1 . ' . '. ". "..Oi.it:ali8lmlt, . It Is your reSPDfls1bJlity to
e. n.. s ~re that all necessary precautions ar'$ta. '.. ", .:p.' ~jem,.y. i~.lJrJema. tIOn ,?r ~ther ~Itemtiofl .
,orj~hsturbance to the grol.lnd surfacecr\'__ . .WIt~'1i1 TldaJiW""!'IdsJurlsdlctlon which maJt .
,resultfrom your p'roje~. Such p~utjonJl . ., 'fod~_.Tl1afntlllnlna;ad$ll~!Ite work am<! betvv"e~
. the tidal. wetland JU 1sdlctional tioundary a~l'ld: !H'.,PrCtject(l.e. s' t5't()~0' 'wide constru;:.'tion area},
or erecting a temporary fence, barrier, or hay b$le barm. .
P1llase be furthE!r advised that this letter d. .' 09t relieve you of the res.ponsibility of obtaining aro/ '
necessary permits or approvals from other a. . neles. ' >
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SUGGESTED PLANTINGS/CARRUS
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SHRUBS/ORNAMENTALS
AMELANCHIA CANADENSIS
CERCIS CANADENSIS
MYRICA PENNSYL V ANICA
V ACCINIUM CORYMBOSUM
JUNIPERUS VIRGINIANA
ILEX GLABRA
ILEX VERTICILATA
CLETHRA ALNIFOLIA
PRUNUS MARITIMA
ROSA RUGOSA
ARONIA
ROSA CAROLIANAlVIRGINIANA
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PERENNIALS
SEADIDE GOLDENROD
ASCLEPIAS(BUTTERYFL Y WEED)
ARTEMESIA
SCHIZACHYNIUM SCOP ARIUM(LITTLE
BLUESTEM)
EL YMUS ARENARIUS(BLUE LYME GRASS)
LA THYRUS JAPONICUS(BEACH PEA)
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Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_Coastal Erosion Pennit Application
_Wetland Pennit Application V'Adrninistrative Pennit
AmendmentITransfer/Extension
-1tOceived Application: /;:)}, /O~
_~eived Fee:$ )) )-'
_ eiimpleted Application If).. /, /O'S
_Incomplete
_SEQRA Classification:
Type I_Type "_Unlisted_
_ Coordination:( date sent)
_ L WRP Consistency Assessment Form
CAC Referral Sent:
~te ofInspection: }'fJ./I4/Oi
_Receipt ofCAC Report:
_Lead Agency Detennination:_
Technical Review:
:;:;::'f.;blic Hearing Held: 1d-/~IJor
,
_Resolution:
--:-~-' ----.
DEe - 1 2005
Name of Applicant
.J1\~fT U\R-e<<S
loSS :nJhlhJ NFct ~
~lt
Address
Phone Number:(4 tI1 t5.q t - U?O
B6 - 0'- -l(P. I
PropertyLocation:~D~:J)Jbt~ Nfdt: /8IAe
Suffolk County Tax Map Number: 1000-
-{provide BLeD Pole #, distance to cross streets; and location)
AGENT: A-nl\G f .1'\({MelB ~M~5 at- Co~ JJUR4~
(If applicable) ~. I
Address: m B? MAW 'RJ/tD
CU.T{;HolfJ'F fJY /11-37 Phone: 1#~/~7?'ft'l'1'1
4Itoard of Trustees APPlica4llb
GENERAL DATA
Land Area (in square feet):
t5()O ~qf;". !PrPPetX.)
Area Zoning:
Previous use of property: ftup.p::.
Intended use of property: 17LuPF - ~kt$JLiZA17{)J.J l7zo1e:r
Prior permits/approvals for site improvements:
Agency
Date
_ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
~No_ Yes Lf./v( fOM\/ r.N~WU\>~ ')
If yes, provide explanation:
Project Description (use attachments if necessary):
. . JGtEc:nUELj ~EMa! NON- IJlftltf PltW1$[iflli#l'?/ti~/itrI ~/;'t6(j,c;w0
'Rf-VffttTl1TE f';&fF tfJlTII 1J!t7111E MiIJiiJ fftZ/e? flAvr 5ElEcrw
fr;:!Z J):{ !I/fI(tfEf) fill/.$. AfIA tlJl/fR flI/IuJ /5 5~PI: ARIA
lAity! I/tJ/IIlui /VIti- et 1PtJtlfED WI/ERE rIlE /SAtz/;/I/ZI51-
'/fJR17l11. BmIiJ5l<<JIt?~ jtJfT t/qW-tJ; t?F J>ENI~ ~tI1 5TtK'# 5t1R4t:-"5.. ,
!JF HEA ! 1/ Uflu7f/M RftBft5 m~l4'tJlr> Ir plt't/IIJ gc API/!.fft/?/E" 7lJ %tILT
HttE ?pAtm#A rPA/ 1]~/?fB(.
~oard of Trustees APPlica4lln
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
;lE5!lJ,l;471eAl t?,c 8t/,tr,c
.
Area of wetlands on lot:
square feet
Percent coverage oflol:
%
Closest distance between nearest existing structure and upland
edge of wetlands: feet
Closest distance between nearest proposed structure and upland
edge of wetlands: If NA feet
Does the project involve excavation or filling? lfh.'tIe; ~~/E.s
~ eE/lfl.t/1rl &F ?CtfIE Itfft/t 1. 7Z~,ff5YS7EZf.5
No t/ es
If yes, how much material will be excavated? 6
cubic yards (,IT /fm )
How much material will be filled?
b
cubic yards
Depth of which material will be removed or deposited: ~iihllitff5feet
(
Proposed slope throughout the area of operations: ( ?) tj 5"0 (No C:lt'Mt7E IN I:XI5T1.t1.r
~IG)
Manner in which material will be removed or deposited:
fll/7i4ftt '/ -cy /lAAI!>
. u__Statement ofthe.effect,ifan.y,nnthewetlands and tidal waters of the town that may resulL~----
reason of such proposed operations (use attachments if appropriate):
11zrxJlJ;r fl#/;L/J NtJT If Aft If))( tiFft;:;f
4Itoard of Trustees APplica~
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
ec -()6'Ir/?rAIb {Vim 4!A71t'l'E 'f?m76
Are wetlands present within 100 feet of the proposed activity?
No V Yes
Does the project involve excavation or filling?
No / Yes
If Yes, how much material will be excavated?
b
fa
(cubic yards)
How much material will be filled?
(cubic yards)
Manner in which material will be removed or deposited:
8y #4:A/D
,
Describe the nature and extent ofthe envirorunental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
N6J) f ~ M Y IWtllJt/ME
,
Itfrlfl~! ff5l1M77PN 'P 111fT/IE 1iMn/J1rS
1?MJrF / 'JIM, ~rlfr/JoJ
.
.
CARRUS
52 Ardsley Avenue West
Irvington, New York 10533
November 23, 2005
Southold Town Trustees
Town Hall
53095 Route 25
P.O. Box 1179
Southold, NY 11971
DEe - 1 2005
To Whom It May Concern:
Re: Trimble's ofCorchaug Nursery
& 7055 Indian Neck Lane, Peconic, New York
I authorize Trimble's of Corchaug Nursery, 20985 Main Road, Cutchogue, New York
11935 to selectively clear, prune and access the non indigenous plant material on the
bluff of my property at 7055 Indian Neck Lane, Peconic, NY and re-vegetate it with
indigenous DEC and Trustee approved plant material. Anne Trimble from Trimble's
Nursery will provide you with a list and a plan,
Sincerely,
c~
JC:cr
.
I PROJECT 10 NUMBER
.
I
.
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)
SEQR
1. APPLICANT I SPONSOR 2. PROJECT NAME
3.PROJECT LOCATION:
Municipality County
4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ate - or orovide mao
5. IS PROPOSED ACTION: D New D Expansion o Modification I 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 DNa If no, describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
~ReSidential D Industrial DCommerciaJ DAgriculture D Park / Forest J Open Space D Other (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
DYes DNa If yes, list agency name and permit I approval:
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
DYes DNa If yes, list agency name and permit I approval:
-------....-- - ------ ------- ...
12. AS A ~ULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION?
[]yes Na
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant I Sponsor 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 eomoleted bv Lead Aaenevl
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF.
DYes DNo
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 DNo
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 I
C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
I I
CG. Long term, short term, cumulative, or other effects not identified in C1-C5? Explain brietly:
I I
C7. Otherim acts (including channes in use of either nuantitv or tvne of enernv? Exnlain brietlv:
r I
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: 1
DYes ONo I
E. IS THERE, OR IS THERE liKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain
DYes ONO I 1
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 othelWise significant. Each
effect should be assessed in connection with its (a) setting (Le. urban or rural); (b) probability of occurring; (c) duratic;m; (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 environmental impacts 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)
Town of South old
.
.
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
I. All applicants for pennits* 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
Watemont 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. )istin!!: both supportin!!: and non-
suppomn!!: facts. If an action cannot be certified as consistent with the L WRP policy standards and
conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: online at the Town of South old 's
website (southoldtown.nortbfork.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#
PROJECT NAME
The Application has been submitted to (check appropriate response):
Town Board 0 PlanningBoardD BuildingDept.D Board of Trustees 0
I. Category of Town of South old agency action (check appropriate response):
(a)
Action undertaken directly by Town agency (e.g. capital
construction, planning activity, agency regulation, land transaction)
o
o
-- - (b)
Financial assistanre (e.g. grant,loan,-subsid~-
(c)
Permit, approval, license, certification:
o
Nature and extent of action:
.
.
Location of action:
Site acreage:
Present land use:
Present zoning classification:
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:
(b) Mailing address:
(c) Telephone nwnber: Area Code ( )
(d) Application nwnber, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes D NoD
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 infrastructure, 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 D No D Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
L WRP Section III - Policies Pages 3 through 6 for evaluation criteria
DYes D No D Not Applicable
.
.
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 D No D 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 LWRP
Section III - Policies Pages 8 through 16 for evaluation criteria
DYes D No D Not Applicable
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
- Policies Pages 16 through 21 for evaluation criteria
DYes D No DNotAPPlicable
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.
D
D
D
Yes
No
Not Alicable
.
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 D Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
DYes D No D Not 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.
DYeD N()_D Not Applicable
Attach additional sheets if necessary
WORKING COAST POLlCt
.
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 D No D Not 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 D No D Not Applicable
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages
62 through 65 for evaluation criteria.
DYes D No D Not 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 D No D Not Applicable
PREPARED BY
TITLE
DATE
. .
Board of Trustees Application
County of Suffolk
State of New York
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.
Signature
SWORN TO BEFORE ME THIS
DAY OF
,20_
Notary Public
. ..-
eaoard of Trustees APPlica&n
AUTHORIZATION
(where the applicant is not the owner)
....
I,
(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)
8
.
.
APPLICANT/AGENTIREPRESENTATlVE
TRANSACTIONAL DISCLOSURE FORM
The Town ofSouthold~s Code of Ethics orohibits conflicts ofinterest on the Dart of town officers and emDlovees The nuroose of
this Conn is to ~~vide i~forination which can alert the town of DOssible conflicts of interest and allow it to take whatever action is
necessarY to avoid same. .
YOUR NAME:
<"(l2.fM 131C, k(U!,
(Last name, first name, -l1liddle initial, unless 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 APPLICA nON: (Check all that apply.)
Building
Trustee
Coastal Erosion
Mooring
Planning
Tax grievance
Varianee
Change of Zone
Approval of plat
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 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% of the shares.
YES
NO
><
If you answered "YES", complete the balance of this fonn 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 applicantlag~ntlrepresentalive) and the town officer or employee. Either check
the appropriate line A) through D) and/or describe in the spac~ provided.
The lown officer or employee or his or her spouse, sibling, parent, Or child is (check allthal apply):
~) the owner of greater than 5% ofthe 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 1