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Home My WebLink AboutTR-6673A . . 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 15t day of construction _/ constructed ~ 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.: 6673A Date of Receipt of Application: July 3,2007 Applicant: Jami D. Friedman SCTM#: 89-3-11.5 Project Location: 830 Clearview Road, South old Date of Resolutionllssuance: July 24, 2007 Date of Expiration: July 24,2009 Reviewed by: Board of Trustees Project Description: Trim the phragmites that surrounds the elevated timber catwalk to 12" high on an as needed basis. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the South old Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the plans prepared by Jami D. Friedman, received on July 3,2007. Special Conditions: The trimming is limited to two (2) feet in width on either side of the catwalk. 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. 1::;; K: ~ent 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 (6311 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD TO: TOJV\ fj). F( ,'edrnCM Please be advised that your application dated Y c.J'1 3, o:Joo1 has been reviewed by this Board at the regular meeting of .:::Ji..d~o?4,dCo7 and your application has been approved pending the com pie on of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 151 Day of Construction ($50.00) y, Constructed ($50.00) 0inallnspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: .1('7) Ci () TOTAL FEES DUE: $ JIJ - BY: James F. King, President Board of Trustees . . ~~ loW SO{j~ l{.~ ~~ TOVl1l Hall 53095 ROute 25 P.O. Box l179 Southold, Nevl York 11971-n~JS;~' James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Telephone ':6~n) Fax (631) 76.5-664-= BOARD OF TOI'V"N TRUSTEES TOViN OF SOUTHOLD Southold Town Board of Trustees Field LTlspection/W orksession Repor1 Date/Time 7 (II 107 Name of Applicant: ~ <.) Y'I CitrJ Name of ~A...genL Property Location: SCTM# & Street BriefDescnption of proposed actior;:~ fhJ ~ of area to be impacted: _Salrwater 'Wetland _Freshwater \Vetland Distance of proposed work to edge of abo-/e: SOllnd Front Bav From - ~ ~ of Town Code proposed work falls under: Chapt.W Chapt. ~ other - .;nS- )))- J TyPe of Application: Wetland Coastal Erosion Amendment Administrative - - - - _Emergency ~ e,14 ~_A no 1h'l ~l'~ ~ Cd\-f we:( l~ I). _ t ~ '("\ ~~ hQ(c"".......'r Modifications: Conditions: Present Were: L1"King <Doherty ~ickerson~. Bergen Other: .--/ Bob GhC.1sic, ,Jr. Mailecl!Faxed to Date Comments of Environmental Teclmician: .,.";,,,, ;-- "~"" > ~,.. '-<_.',,_>Om ~ ~__F'2C~C~.>~ ~"C " ::-,;, ,0.> ..'''0' T~"~~'~/' I I, , ClD~1l el~C~ ". ,,2' ,...",' ."", I t--- t~~~~ "",', ,.:" "", \~ ! ,'" I: I' , 0 "', '~'::.:~:::" /~~ ! '10 .~:-;\ 2 7.c7>C~ . I ,~~~7"~. -. ,C.: II; '-, \ I ~ I / V--""'" . ' I I / ' , '" '- "', I ''0"''' / / ". J. ____.,"_~..._---_, J _'<;,/ '", ~~:::C~: ) ! ! -----.:. "j " '" ;--\. ~,"" ~. .''':' "'" ----, / ~"'o, \.:V Ii .::," ! ) / ,,_s ,.,,,,, :"";._. .;" I:': " '._-,,- :,':':,_,,'" "d> O' 12." -_... 12."'0' ....".. ,X""~';:~,"~;, 'FU ~ COUNTY OF SUFFOLK CD ~ R:~;'?~i;: },~;~:;;e ,~~~;Cj "' " _. A , ...,-"..,-,.. ~~.."..". '-::i"" .,::~." ..,"'"",., '~.'."'" ,~ ';';",'~;'\; ."'L. ''''..'''M ........... .........,,- ul""'~:::':'::' '-:'0"'''''' "",,;-i'-- .t;J ".." SOlJTHOLO ~ , 1"""""'1000" --""'"'''' -N- . . $EC1l0~ NO 089 oo~o,~w..,o- . ~ r r .( .;:-- . - ~ .~-~~- =-I~ tr ( d rl\ ",..J .- ~. .:r-: - ~'.. - - -. ~ ., . ".....;.. - . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Gnusio, Jr. . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only IIB1 FE C IE 6 WI FE 7m '/f)]! JUl - 3 aJo7 {/)); _Coastal Erosion Permit Application / _Wetland Permit Application ~ Administrative Permit ./ Amendment/Tran1r/Axtension ~eceived Application: 7. 1 0 7 LReceivedFee:$ ')lJo.:;' , _Completed Application _Incomplete SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) _ L WRP Consistency Assessment Form CAC Referral Sent: /'Date ofInspection: 7/1 I ICf) _Receipt of CAC Report: _Lead Agency Deterrnination:_ Technical Review: ~blic Hearing Held: 1/J~~ Resolution: , SOUlllhold Tow Board of Trus~ Name of APPlicant5G.M', J) fRle.dlY\An Address 15?D C1. ""'\\lIe l.U Rcl 3&J,.~\d ~A.L~ Ii Q 11 Phone Number:(~30 18(.,- 4.::159 Suffolk County Tax Map Number: 1000 - gq - ~'3- II.....1=) Property Location: ('k.- A'"'=' hoJ ~j,,,vc.-t) (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ~d of Trustees APPlicatio~ GENERAL DATA LandArea(insquarefeet): gllhat(!..+ J...e+ f)2, c..'8'2. ~7F+ Area Zoning: l2.tSl \ r\JUY\-hoJ) Previous use of property: ~ ( (><0'''1 d..9..J'I\~cJ) Intended use of property: 5A-mL (Q. "..1 ~ r'(\~ Covenants and Restrictions:_ Yes If "Yes", please provide copy. ./ No 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 -- If yes, provide explanation: AI/A Project Description (use attachments if necessary): I~ /J \C)J. Q~ UII - to ~ iru. phCd3(Y\\\es -tl-a..-+ \'5u.J\f\~ \...1'i\~0\.lJL .d 0 \ In.. ~~a V" (I A<+ Ll n. Q l\--.=I-o 12IM.h.. CJJJ\fl9...IY\.lr I Y --=tho ~~~ ~ ~('~ ~ ~ l.J.:Jo.s..'(...~ ~' WIll e\l"'<!n+u.naht mo....\'u 1+ 11J'f\~~. JouJ...~ ~ -\0 ~ OV\ ClJi\ OJ;) JT\.U.....~d ~.. tlJrd of Trustees APPlicati~ WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:---LJ E" lA.J('5U.. \~ .Q.t-JIuto -h-vvn ~ P ~y~qN\vk.D -:mod. S~ 6lJJ\ .cle.v<dJLcl -hm~v ('a+u.Yl ~K. fa 12\n~ f~~~\~~~~~~ ~ ~~~ t,tpcYl -tt\.L~ u.blK 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 Yes If yes, how much material will be excavated? ,.lIp,. cubic yards How much material will be filled? NIP, cubic yards Depth of which material will be removed or deposited: rJ /p. feet Proposed slope throughout the area of operations: N/'" Manner in which material will be removed or deposited: Nift . Statement oft.he effect, if any, on the wetlands and tidal waters ofthe town thatlllay result by reason of such proposed operations (use attachments if appropriate): 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) 2, PROJECT NAME . SEQR 'I PROJECT 10 NUMBER PART 1. PROJECT INFORMATION ~ D rR.1 ~3o ~~o.l"\l\e..u...I ~ 1, APPLICANT I SPONSOR CXro\ 3.PROJECT LOCATION: Municipality 5~ \ County Co 4. PRECISE LOCATION: Street Addess and Road Inters~clions, Promin,nt landmarks et~ or tee (!.ko.J\vleuJ ~ S:IlAtnc(<i AJ'i wn I (~5lN\\le~ J provide map 5. IS PROPOSED ACTION: D New D Expansion Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: We ~ ~~<c ~~~(o 01.>v\ ~ ~K.. -to -i-t::l~Y\ +N~ 121"~, 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~s 0 No If no, describe briefly: '!.:Y'!IAT IS PRESENT LAND USE IN VICINITY ~ Residential 0 Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) DAgriculture D Park I Forest J Open Space D Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F~, State or Local) o Yes ~ No If yes, list agency name and permil I approval: 1:-mJES~ry'ECTOFTRFACTT0Nt1AVc A CORRENTIY VALID PERMIT OR DYes ~o If yes, list agency name and permit I approval: APPROVAL? 12. AS A ~LT OF Ges MNo I CERTIFY PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature f-",--- Date: I ~J (17 Applicant 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 ITa be comnleted bv Lead Aaencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? It 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 hanQwritten, 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 briefiy: I m I C6. Long term, short term, cumulative, or other effects not identified in C1.C5? Explain briefly: I .. . .. .. I C7. Other impacts (including changes in use of either quantity or type of enemy? Explain briefly: I I D WILL THE PROJECT HAVE AN IMPACT ON THE ENViRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEA)? (If yes, explain briefly I DYes D No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ye,explaln DYes DNO I I 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 -.---.---.. yes,the-detem:liAaooR-Gf-signifIGaRse-must-evaluate-thepoten-tia-l-iffii*let--ef-tt:le-I3FepOSed aetionoo--the-eflvirenme.ntal cl'lsracterist1es-of,the-6CA. 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. Ched<.Tfifsboxnj(you-have determTned', based'on-ftie hlformation and analysis above and any supporting documentation, fti-iitthe-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 Pnnt or rype Name of Responsible Officer In Lead Agency Tille of Responsible Officer Signature of Responsible Officer 10 Lead Agency Signature of Pre parer (If different from responsible officer) . Board of Trustees . Application County of Suffolk State of New York ~ j~\ \) rR.\("~~ 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 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. r1 P____d t7 - Signature SWORN TO BEFORE ME THIS B. 01'- DAY OFJu n-e, ,20~O I SUSAN E. JAEDICKE HAUSER Notary Public. State 01 New York No. 4962497 Qualified In Suffolk CoUO!Y Com 8t..un._~'110 PU..d '"~ ........ h..,L e__ftl~ mission Explree '2-( '"201 Ii) ..,ard of TrusteesAPplicat~ AUTHORIZATION (where the applicant is not l'\"'~ So.rt\\ t> ~~~ rR\c..~esiding (print own r of property) t- the owner) I, at '?30 e..~Q"\\Jiew e.eL (mailing address) ~*'o \d. , N-f 113:]1 do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ~ r~A (Owner signature) 8 . . APPLlCANT/AGENTIREPRESENTATlVE TRANSACTIONAL DISCLOSURE FORM The Town of South old's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emolovees. The Durnose of this fonn is to orovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is necessarY to avoid same, YOUR NAME: :\0.11\\ 1)t>.S\If1\e fQ.IrAr-M~ (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.) 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 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. ./ NO YES If you answered "YES", complete the balance of this form and date and sign where indicated. Name ofpcrson employed by the Town of South old 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, ot 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); _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 Submitted this day of 200 Signature +-e.~ Print Name , h fQ",J.l'fIIW'I Form TS 1 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) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Enviromnental Conservation (DEC) SUNY, Bldg. 40 Stony Brook, NY 11790-2356 (631) 444-0355 Mon., Wed., Fri., 8:00 AM-3:00 PM Suffolk County Dept. of Health Services County Center Riverhead, NY 11901 852-2100 U.S. Army Corp. of Engineers New York District 26 Federal Plaza New York, NY 10278 212-264-3912 N.Y.S. Dept. of State Coastal Management 162 Washington Ave. Alh,ny, ~ 17711 518-474-6000