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Home My WebLink AboutTR-6694A . . 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 SOUTH OLD CERTIFICATE OF COMPLIANCE # 0293C Date: February L 2008 THIS CERTIFIES that the remove/replace existing fence with new stone columns and chain fence. At 40 Town Creek Lane. Southold. New York Suffolk County Tax Map # 64-1-10.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 07/17/07 pursuant to which Trustees Permit # 6694A Dated 08/22/07. Was issued, and conforms to all ofthe requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the,remove/replace existing fence with new stone columns and chain fence The certificate is issued to SOUTHOLD PARK DISTRICT owner of the ;::..~; 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-construction, hay bale line 1 st day of construction Yo constructed ~<OJe" ,omplete, oompl',"," ,",p,,,'o,~Id't If tf~ . 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 1 sl day of construction % constructed ~roject 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.: 6694A Date of Receipt of Application: July 17, 2007 Applicant: Southold Park District SCTM#: 64-1-10.1 Project Location: 40 Town Creek Lane, Southold Date of Resolution/lssuance: August 22, 2007 Date of Expiration: August 22, 2009 Reviewed by: Trustee Dave Bergen Project Description: Replace the existing post and rail fence and chain link fence with new stone columns with chain fence in same place. 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 Creative Environmental Design, dated May 10,2007, and received on July 17, 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 Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. ~o<'~ 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 Han 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 5xJkIJ ~l~ D,'s+r;,c+ Please be advised that your application dated Tu.tJ I? ~ (JO 7 has been reviewed by this Board at the regular meeting of ~us-J--~ cXa:'> 7 and your application has been approved pending the com etion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) ~ Constructed ($50.00) ~ 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: TOTAL FEES DUE: $ 5D Q;i.. BY: James F. King, President Board of Trustees . . James F. King, President Town Han Jil - eSl en Southold, New York 11971-0959 o OSlO, r. -1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: g(ci /D7 0A~ SOUTH OLD PARK DISTRICT requests an Administrative Permit to replace the existing post and rail fence and chain link fence with new stone columns with chain fence in same place. Located: 40 Town Creek Lane, Southold. SCTM#64- 1-10.1 Type of area to be impacted: X Saltwater Wetland Freshwater Wetland - - - Sound ..!.... Bay Distance of proposed work to edge of above: Part of Town Code proposed work falls under: _X_Chapt.275 _Chapt.lll_other Type of Application: _ W etland _Coastal Erosion _Amendment _X_Administrative _Emergency _Pre-Submission _Violation Info needed: Modifications: Conditions: A {( 0 Fe _i-o f' t?,~+- t- r_' I ,;, I}-f do c- C"f (" ~ =~ /( .. J fie::> f<-- ID ~ +:l_--' /46. Present Were: _lK.ing _J.Doherty _P.Dickerson~. Bergen_ B. Ghosio, Jr _H. Cusack_ D. Dzenkowski _Mark Terry_other Form filled out in the field by MailedIFaxed to: Date: Environmental Technician Review r-- ,. ---, '-'>-" ,-"., "-'0-' ,,.,.., ,~-,,-, ,,.,.-, "-"-0 ""-0 01-"-0 --1- . . 1\%\ :: ..~, -~~---~ ---::=---------. ----------=------------ --'------------ --------------- ~'" ".. . . L .,~.".~~ E""",,,,,-,- ~ !...".~"..,~ ~,"-'''''' DI"".~ i' 1211 C1J ""-m ..... ,"..,,"'...., """,-,"', ." .".~ ,., ,,),-,0""0 "",""" "'''''-----'----- ~...------""----- ~?,: :: ::~ --,,'" ..,,,..,,, NeUe (i) COUNTY OF SUFFOLK @ ~fpRedPropertyTaxServiceAgency .D r: OolIl'I&ont... 1Il,...IloD:l,~' mm . '.. ,"""'"""',. '" ~'"' " '" '" "'-""" .' , " lJ';TIlIC1", 064 _~ 12..'"..,''''' ,_,,, ",'M" _,.. '""I",""."-m.","-"",,,, "'I"",n",,,.,,, ''''''''' " 1.. ",,<t, c:JOOo" ",.".s ''''''~''O "1.wl"'H,",,''''_''''' ".c-"""'""'''',..,''''''', 1000 PROPERTYI,lW . , James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, 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 Office Use Only _Coastal Erosion Pennit Applicatioy _Wetland Pennit Application .L Administrative Pennit / _ Amendment/TransD r/E tension ~Received Applicatio: 7 17 07 /Received Fee:$ , cr> ...=-Completed Application _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) _LWRP Consistency Assessment Form CAC Referral Sent: _Date ofInspection:J{jI 'S)OJ _Receipt of CAC Report: _Lead Agency Determination:_ Technical Review: ,.--rublic Hearing He~~J.-1 0') _Resolution: Name of Applicant SOlL.-~~ \6- Po.rlc... (J l~~~ ,G t' Address 40 'lOw f\ (' A'C.LJ<- LG.-IU- I PO. r3i/1f q ~q Jou-%.o Id. N Lf IlC(1\ Phone Number:(l..~\) It.-( - (,.0\9 Suffolk County Tax Map Number: 1000 - roy. - () ( - I 0, I Property Location: r..t If D ~ u..> "-- CA....e...-G~ L.u..r\J...-' / A-KA (fo UJ'\ 't' f%u,(,LL,~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) So u.. '(-ft 0 teL Address: Phone: , ~d of Trustees APPlicatio~ GENERAL DATA Land Area (in square feet): 11-LLQ . 0';- t{1 ((-'tv Area Zoning: Previous use of property: ffiW\ "-'/XLI pOJ" Ie Intended use of property: mUo..l\\Ujlt,( po.rk.- Covenants and Restrictions: Yes If "Yes", please provide copy. / No Prior permits/approvals for site improvements: Agency &'o~..,\~u...,\~ aT l' J Date ~ 6 SL\ \ \ D \ II \ I~ 1- I ~\-L\1:\,g-D?'oll1 -0000 \ l\ \ ID I 01- _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? 1 No_ Yes If yes, provide explanation: Project Description (use attachments ifnecessary): ~\(~f 0 ~lu (\. WI4't-.~ (5 pult-.... l'u.-l \ fUl\co. (.(' <L \\I';;\(.. ~cL l.<l\~ Ae..uJ ..rh~(\e......- . c..u\ \ . r'YI (\ J (JJ 1'\-1-. Q h:u ~ {.U\ rIl. \ "-" J 6.. rot ~ \{i.e.L . 1Ifrd of Trustees APPlicati1lt WETLANDITRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ~\r," OJ f'.lf'I~ +':n5 pD.."'" r<:1-\.\ o..NL (\*'0-1.1' I",~"- bu... WI~ nu-J S h""'"-- CO((,Lj\-.^!;' 6...., A C -hILt '^- ~.... c.J1-- o square feet Area of wetlands on lot: Percent coverage oflot: C> % Closest distance between nearest existing structure and upland __ I edge of wetlands: /5 feet Closest distance between nearest proposed structure and upland /, edge of wetlands: J 5 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 Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: o o Manner in which material will be removed or deposited: ^-II A , Statement of the effect, if any, on the wetlands and tidalwater~ oftl1e town that lIla)' resllltby reason of sudiproposed operations (use attachnlents if appropriate): ~<.rc.., \Al I \, h t.. ('10 Mil to/h_ e... f-f-e-e...t- 0 ('I 'tL.. UJ'e-.-ti ~ (J r t. 6.<J wuteA () ~ ~ --t-oLUn CL/.) 'I-Cu.. j0ro ~C(€A.. ~+,li)iV IJ'Ll-" \f'\-\ul1'\d- 1l-fl\Ct.~t"WAI*" J.\- etfll'h\r-fc.Avo . ,- 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 FECT ID NUMBER PART 1 - PROJECT INFORMATION ,. APPLICANT J SPONSOR Scu.~D\6- PO--{'-\:-- O\J't-r\c....-t- 3PROJECT LOCATION: 2. PROJECT NAME Municipality SDIJ..' ~"-'-' Puric:..... D\~ County f'-..t..+-w\\c 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc. or provide map 40\o\..C." c:..e.A- L.o..N., SO u....%C \cL 1U~ \\4' I 5. IS PROPOSED ACTION: D New D Expansion odification I alteration 6. DESCRIBE PROJECT BRIEFLY: ~0mi)\Ie... eA.i'\~T-\()<n (lulft'"-4 r(A..\\ w-.C ~h(.l..l;'" \'AL ~~ (,iV'~ ~\CLu.. LM 'H- (\c...W & 1-o'N.- c.o\u...iYli\-l: (;.V-<L a..f'\CL\\V fe.() c.JL. \ ~ ~ (.L lY\.L. P \ .-.C.JL,... 7. AMOUNT OF LAND AFFECTED: Initially _ acres Ultimately :, ?:l ~ acres 8.~ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~ Yes D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY o Residential 0 Industrial D Commercial OF PROJECT? (Chaos s many as apply.) DAgriculture Park I Forest I Open Space D Other (describe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F~r~State or Local) DYes ~o If yes, list agency name and permit I approval: -"--n.OOES-- DYes o A J PERMIT OR APPROVAL? If yes, list agency name and permit I approval: 12. AS A RES OF PROPOSED ACTION WILL EXISTING PERMIT J APPROVAL REQUIRE MODIFICATION? Ges No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant I Sponsor Name Date: Signature .- J JlUz<J If the action is a Costal Area, and you are a slate agency, complete the Coastal Assessment Form before proceeding with this assessment . . PART II. IMPACT ASSESSMENT (To be comoleted bv Lead Agencvl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. DVes DNo 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 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 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 C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: 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 energv? Explain briefly: I 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: I DVes DNO 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 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 yes, the G1etermiRatieR of si€lnifk3nce must-elJaluate-thel'>Otentia~ impaetoHhe-preposedaetteneftthe.ef'tVifOftl"flcf\tal characteristic..s oFthe 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 and/or prepare a positive declaration. Che6-kTfils"box"Wyou"havedeteffii-ined", based -on -the hlformation and analysis above and- any supporting documentation, fti-ifthe-proposed acUo- 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 Responsrble Officer In Lead Agency Title of Responsible Officer SIgnature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) .;.;,.... .. Board of Trustees APPlic.n AUTHORIZATION (where the applicant is not the owner) ~ I, Tho (Y\a.J \-\-e i \~ 4t..L- (print G\ffier of property) ~m\'~'\')"'l-t.r residing at PO, i'3.~ 1- 1 (mailing a dress) /ljL JOI:,'I-f\G \~ N.~I \Cr1 \ do hereby authorize I,.. \r'\'d/A.J Bulnt,: J (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. u~~~ (OWftcr's signature) C.0.'--."f\I.rs iO,,~r \~ 8 4Itoard of Trustees APPlica~n County of Suffolk State of New York Ln~~- 0 t3.:..('kn; 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 q~o.~ Signature SWORN TO BEFORE ME THIS '~~.. . DAY OF J~ r ...."Ie....LIICI . NOTARYPU8UC, STATE OF NEW YCF!K NO 52-4624771 QUALIFIED IN SUFFOLK COUNTY fA COMMISSION EXPIRES NOV 30, 20~ ,2007 - d;ntUll({lA/~ -, Notary Pubhc . . APPLICANT/AGENTIREPRESENTATlVE TRANSACTIONAL DISCLOSURE. FORM The Town ofSouthold's Code of Ethics orohibits conflicts ofinterest on the Dart of town officers and emolovees. The Dumose 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: r:J. \ (Last name. first n e, -q1iddle initial, ~less you are applying in the name of someone else or other entity, such as a company. ]f so, indicate thc.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 / V Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee ofthe Tawn .of S.outhald? "Relatianship" includes by blood, marriage, .or business interest "Business interest'~ means a business, including a partnership, in which the tawn officer .or empl.oyee has even a partial .ownership af(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. / YES NO ]fyou 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 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 carporate stack .of the applic~nt (when the applicant is a carporation); ~B) the legal or heneficial own~r .of any interest in a non-corporate entity (when the applicant is nat a c.orparati.on); _C) an .officer, director, partner, or emplayee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th~daY of q....J r-:--200 1 Signature - c_ j{~ . rlT~ Print Name /.:..., ^<!. c-. ..g, ....+<..~ . Form TS I . . 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 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. A Ih"ny, NY 1 ??11 . 518-474-6000 ", . --- SOUTHOLD PARK DISTRICT --- P.O. BOX 959 SOUTHOLD, L.I., N.Y. 631-765-6019 11971 July 13, 2007 ~fE[{;fEDWIE JUI 1 7 7007 ~ Mr. James King, President Southold Town Trustees Town Hall, Main Road Southold, NY 11971 Re: YOUNG'S AVENUE PARK B South hOld Town oard of Trustees Dear Mr. King: The Commissioners have requested that I wr~e to you regarding replacing the existing post and rail fences and chain link fence at the Young's Avenue Park at Town Creek with stone column and chain fences which we have done in two of our other parks. We have enclosed two surveys of the park dated June 19, 2007 by Nathan Taft Corwin Surveyor III and two drawings of the replacement fence areas by Creative Environmental Design dated May 10, 2007. We understand that this project will require an administrative permit. Thank you for your consideration. Sincerely, c;( lAd-<-- ':) - {]<-L~ Linda D. Bertani SecretarylTreasurer