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Home My WebLink AboutTR-6714AJamea F. King, President ~~pF SOpr~~ Jill M. Doherty, Vice-President Q ~ Peggy A. Dickerson Dave Bergen y ,~ Bob Ghosio, Jr. '~ ~ ~O ~~OOUNfY,~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 766-1892 Fax (631) 765-6641 CERTIFICATE OF COMPLIANCE # 0347C Date August 8, 2008 THIS CERTIFIES that the placement of mulch along atn h to pond removal of dead/dving trees, and nrunm~ of lower branches on healthv trees At 7619 Soundview Ave. Southold Suffolk County Tax Map #59-6-9 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 9/7/07 pursuant to which Trustees Wetland Permit #6714A Dated 9/19/07 was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the placement of mulch alone oath to pond removal of dead/dying trees and runing of lower branches on healthv trees The certificate is issued to PAMELA MAINO & RICHARD JOHNSON owners of the aforesaid property. J Authorized Signature . 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-constructionSife ;(\Sfec.h'on 1 st day of construction Yo constructed 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.: 6714A Date of Receipt of Application: September 7,2007 Applicant: Pamela Maino & Richard Johnson SCTM#: 59.6.9 Project Location: 7619 Soundview Avenue, South old Date of Resolution/Issuance: September 19, 2007 Date of Expiration: September 19, 2009 Reviewed by: Board of Trustees Project Description: Place down mulch along path to pond, remove trees that are dead/dying and saplings, and prune lower branches on healthy trees. 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 plans prepared by Pamela Maino & Richard Johnson, and received on September 19, 2007. Special Conditions: A pre-construction site inspection must be performed by a Trustee prior to any activity beginning. 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. ~G7~ James F. King, President 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: Pcvne1a. (Y)~((\O ~ 'Klchvd ;]QhnS:Jn 7. ~CO Please be advised that your application dated been reviewed by this Board at the regular meetin of and your application has been approved pending the co following items checked off below. has .;;bo7 pletion of the Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) y, Constructed ($50.00) 7 Final Inspection 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: . 0 TOTAL FEES DUE: $ 5o~ BY: James F. King, President Board of Trustees c::- '" If) c:. ~ p; ,-" T'"'' ,-"., ,.,,-. ,.,,-, '-00" ,.,,-, " (}'I."" 00-'1'01 ",."." '-:>-0 ,."., '-"'0 '-00-' '-'0" ,. . + / " fl. # If, " /' / ( I, . ,'\ ! <l I '.~ I _.. t -~ I", 11 U 31.'''01 ";ZoI) (O~~.) . ~~" 'ORPQ......- ,..UC..... .....,....., -.;m;;----+----- U'Ul:.rG.... l l L ___...,_ E _ ~ _.~... N"'-'.... ,_. .....,,, ""... ""'......IL .., .~- "" ."",."'" ~".~., -----::::---"..., ....- ..","",. (i) COLtHr OF SUFFOLK @ RedPropertyroxServlceA~y . . ~tonl~E.~NTIDIJI ~ . - - -----" SOUTHOlD SECTION NO Ff.. ::. ~.""'., o _........R --.".-..,-- .~...T1"''''''''''''' "',..."...",,,...."",,,11: ",,,,,,,1>><"''''''$_'' ~,,..,, ''''It. PI"""""" 'II: "'''-'''''''"'',,, "'''''''''''. 12U + 059 1000 PROI'ERTYWN' . _~ 12.,."....1>"" '_'R 1>"&1<' ,-,.. ~ I,~_~~~-,,-<_.o__~---=='-_- ~-, ----;:;.~~- "J-.J 6'6' '''0, ..... ---, ~ ;.;2..1 6- .z. '0 "'",.., ~ '?t. o y , 0,..... "" 0,' ,z; ..... ." '1,.;;> ij ~. 'v 0," " '" " E N 78'35'1~ 53.99 S 78'25'12" 32.38 [ ~-O'o<% , <V<"'<"'<V~"'YO' cO / //~ n<t:J. '-b ,... \ ." (' 0", <'0 "'" ~~l::l ~o- ---_ .",.Q._ -4 I -~ --- ----. ----. ('-~ ""'0. ~//. '/<1:. 0>.'0, (' eM S 78'25'12" 35.42 [ 1{p/7 Sbre1 'I;6J ;/'iC r., -rf, 12)' ,'r! "-fl!~ 1 t :in is,. \...JUv.. \J '" . ~ OJ "'", "6-t> c;}.o -"- .., '<v "'.". J' NOTES: 1. ELEVATIONS ARE REFER.ENC! b.. EXISTING EL~YA:rl<!I\IS.A.f ~ EXISTlN.C ~/'lm~liR!JN[ 'l'f-l F.FL. - G.Fl. - '}t. T... _ (f' 8.fl. - '--' T.w. - /' .w. _ c,a.. '" 2. :rHESE PROPER:rIES ARE IN ~..' y- FLOOD INSURANCE RA:rE Mft '7 Q,.( 0.;) ZONE AE: BASE FLOOD ELE oJ 'V\. " \ ' ..( ~~ ---5 ,0 ~ ~ APPRO';;: ~\~ \~ lolf~~)tJARD 01, l.t;,,; i L: .~ t ~ t~ ~,,~ TOWN OF SOUTHOlD \l~ 1f DATE ...;)5r07 ~\~) \'\"" ~~ t~,,} '\) 'C' ~ J 'V'v" x\ ~~V?~ " ))(1;) ~~<JV~ ,-r- ~lft 'i.; ;x/ ..I (?< i)\()Y v9 V\() \ \ ~ ""'0. / /.. Jo <1:. . 0.. ~ , , " I . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob lihOsio., Jr. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 ~ Coastal Erosion Permit Applicati~ Wetland Permit Application .L Administrative Permit / AmendmentffranSfr//itension ~eceived APPlication:~ 7 07 LReceived Fee:$ ;-0 ~ Completed Application ~lncomplete ~SEQRA Classification: Type I~ Type II~ Unlisted_ ~ Coordination:( date sent) ~ L WRP Consistency Assessment Form CAC Referral Sent: ..-Date ofInspection:g \ \3/0' } ~Receipt ofCAC Report: ~ Lead Agency Determination:_ Technical Review: flublic Hearing Held:~llqllj} _Resolution: MA, I, ~ '. ~ ))V~ Co....,+ fi"",, I ''!) V I 11.(' A.J 'r I()~ c,S! C:.95! <-(62'6 .:J L ,~,A Jo~"~ A "'-Z ~() ~W=() \ <L- <611 00;;5 Office Use Only Name of APPlicantJ) ('-i iA'\ ~ \ (j }.,\ 0 , 'I 0 1 ~L3 SOlA "'') V, eW Phone Number:~J \ Address 1fD) ~ ~ ~ n Wi ~ ,[f)) Ill], SEP - 7 7fJIf1 ~ Southhold Town Board of Trustees ~ c. ." -:f1 Suffolk County Tax Map Number: 1000 - <; I - L "".- II - Property Location: \J\J i> c,1- 0 r ~.p.1 V\ P'l <: ~. O(l. r~ 0.-... (jr{! CLI- ')(o\~ ~CN-~d~UJo.~ (provide LILCO Pole #. di tance to cross streets, and location) ~W AGENT: (If applicable) QII'\ Address: Phone: (",,"31 833 S,S I J "'rd of Trustees APPlicati~ GENERAL DATA Land Area (in square feet): Area Zoning: --- '<-,f,'S 1 Ci ~ I'JT \ 1\-'-- Previous use of property: K t~ I ~ '2:-N 'II <At. . Intended use ofproperty:----=:Ku I 0<;: tV 1\ {-\/L Covenants and Restrictions: If"Yes", please provide copy. Yes /' No Prior permits/approvals for site improvements: Agency Date V/ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspe~ by a governmental agency? No Yes -- If yes, provide explanation: ~ ~ard of Trustees APPlicati~ WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: &~(~s.e.. II>L~ rJ. Vh c.h~ ~ ) S"t\-llcft I ~otA- I.tettl~ ~ Y~I~O _t-t"''-f~ 4" ~t ~ Area of wetlands on lot: square feet Percent coverage oflot: % Closest distance between nearest existing structure and upland edge of wetlands: (, I feet Closest distance between nearest proposed structure and upland edge of wetlands: \1 A: feet Does the project involve excavation or filling? ~ No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards 0-8- Depth of which material will be removed or deposited: 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 waters ofthe town that may result by reason of sudiproposed operations (use attachr!lents i{appropriate): ..u.... ~~ J1lD.) ~ poc"l8 ( G L L ~/J L- l q 11- T ~'1?IT PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by A plicant or Project Sponsor) 2. PROJECT NAME M.(.(, "'0 . SEQR PART 1 . PROJECT INFORMATION 1. APPLICANT I SPO~ IV\.Q.,.... ~,oh".s"l)l') 3.PROJECT LOCATION: Municipality 1.6 'I Sou.c)Y'i1 uJ -Ave.. County Sob v + l;"O/ J AJy Sv 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks ate - or provide map '71,,1"1 SO"~d","'.v AV'-f., "3oJ+t.-.o Id tJy 5. IS PROPOSED ACTION: D New o Expansion odification I alteration 6.0ESCRIBE PROJECT BRIEFLY: r~o,,-e.. clJ~\~e.a<i +-ree~ ) s.0:J~ 1 (ylaC-L- W\..\A.. \ ~ H ~.",-l ~r) 1NVl\.....+~c_~.-\ C\~~ "-15 . 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WlTH EXISTING ZONING OR OTHER RESTRICTIONS? ~ D No If no, describe briefly: ~ IS PRESENT LAND USE IN VICINITY l!::1 Residential D Industrial o Commercial OF PROJECT? (Choose as many as apply.) DAgriCulture D Park I forest I Open Space D Other (describe) 10.. DOES ACTI AGENCY (Fede DYes No INVOLVE A PERMIT APPROVAL, OR FUNDING, State or Local) If yes, list agency name and permit I approval: NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL CTUOFIRl::. ACIIUN -RAVtA CUKKl::.NILY VALID PERMIT OR APPROVAL? If yes, list agency name and permit I approval: PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? ROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant Date: Signature ~ q I D If the action Is a Costal Area, and you are a state agency, ete the Coastal Assessment Form before proceeding with this assessment . . PART II - IMPACT ASSESSMENT (To be eomaleted bv Lead Aaenev) 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 ONo 8. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIOEO FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.61 If No, a negative declaration may be superseded by another involved agency. DYes ONo c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be han~written, ~ legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pallern, 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 C6. Long term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: I I Cl. Other impacts (including changes in use of either quantity or type of energy? Explain briefly: I l D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If tes, explain briefly: 1 DYes D No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yesexplain 1 DYes DNo L 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 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 )'es,tRe-GetefminJtion of &i@niRBaflGe-must-evaluatethe-potential impact of the--j3f6posed Betiof! OR the-elWironmentfll cfiaracteristics of II te-eEA-:-"-- 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. CheddhlsboXlf you-havedefermTried-, basecron-ttie Tn-formation and analysis above and- any supporting-documentation, fhaithe-proposed iictio WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi detemination. Name of Lead Agency Date Pnnt or rype 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 APPlica~n County of Suffolk State of New York r (JfJ-7"lGf C /4 ~ 12_ uJ /~ BEING Dill- Y 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 illS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TillS 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 TillS APPLICATION. ~ TY SWORN TO BEFORE ME THIS -, DAYOF ~. ,20 tf) 7 ~~~ otary Publ ic ......... I'RTRIClA CORWIN -'No Public. State Of New .... ~OIC05017852 m Suffol~ ~ Stpt 13. ~/ ~. '.... .. 4Ifard of Trustees APPlicattIJ AUTHORIZATION (where the applicant is not I, YCl'VV\.i\C\ M 0'" \)J~I'lS~:1iding (print owner of property) ~ the owner) at ( mailing C;ou" address) V I ~-AJ ft v"-C do hereby authorize IL v--J \2-e- \ \r\j CJ C {" (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. \~~ ( , 8 . . APPLlCANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofSouthold's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emolovees. The DUroose 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: ~ tt VY\ -e \ a f'v\ a. I Y) () (Last name, first name. .tpiddle initial. unless yo'u are applying in the name of someone else or other entity. such as a company. Ifso, 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 pial or official map Other (If''Other'', name the activity.) Building Trustee Coastal Erosion Mooring Planning vj Do you personally (or through your company. spouse, sibling, parent:. Of child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or bus.iness 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 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 descri.be 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 applic~nt (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 Signature PrintNam + 200 J. .... Fonn TS I Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO NY.S. Dept. of Environmental 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. Alhany, NY ] ??31 518-474-6000