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Home My WebLink AboutTR-6710A . 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 _ Yz 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 (6311 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCA \ vcJ-or G(?{&I- ~.u~1t+' TO: Please be advised that your application dated {}l1~1A5f c2'-1 doO 7 has been reviewed by this Board at the regular meeting ,~P-ho~~ /9. ~OO? and your application has been approved pending the completion 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) y" 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 South old 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: $ S-O~ BY: James F. King, President Board of Trustees . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Gbosio, 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.: 6710A Date of Receipt of Application: August 24, 2007 Applicant: Salvator Granfort SCTM#: 70-4.29 Project Location: 575 Hill Road West, Southold Date of Resolution/Issuance: September 19, 2007 Date of Expiration: September 19,2009 Reviewed by: Board of Trustees Project Description: Remove the existing retaining wall, install returns on pathway, and install plantings. 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 survey prepared by Peconic Surveyors, P.C., last revised August 3,1994, and received on August 28,2007. 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. ~G7~ James F. King, President Board of Trustees JFK:eac t rv fD) ~ (C [E ~ W [E ,rm lnlEuL .. 3 2007 ;~ .--.J SOllthold lewn B0ard of Trvstei's . CyCC J( --fj(Btif!j walt::. -k d~ . -.Re9u-=.sf PeY>fI1'~Sloh ./-o/eqvc. C'<I:'+I"'5 U'ol/ Ui't-k'- cut/It: +0 help ;5+ab,liu.. fharqr<:q ."- _ _ _ _:""'~'e!" -"WI'] _ -"' _ _ _ _, f """,,:1<':, c" "' 4/:>ftJ?5 vllal/ +0 6c /?~"'{JV'''- ~PiJJ/lJ FOR WALL RE/WJI//lL FoR 575 HILL ROP/) -5. G RAItJFOICr . - ROUSE . . 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 Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: SALVATOR GRANFORT requests an Administrative Permit to remove the existing retaining wall, install returns on pathway, and install plantings. Located: 575 Hill Rd. West, Southold. SCTM#70-4-29 T~ of area to be impacted: ),(Saltwater Wetland _Freshwater Wetland Sound _Bay Distance of proposed work to edge of above: Pa9'of Town Code proposed work falls under: ~Chapt.275 _Chapt. Ill_other L /" Type of Application: _ Wetland _Coastal Erosion _Amendment --':"Administrative _Emergency _Pre-Submission _Violation _Planning Info needed: Modifications: Conditions: Present Were: _J.King _J.Doherty _P.Dickerson_D. Bergen_ B. Ghosio, Jr _H. Cusack_D. Dzenkowski _Mark Terry_other Form filled out in the field by MailedlFaxed to: Date: Environmental Technician Review '::pl"',,-t c\"+\Ve Spec;<.A _, (\0"; cr"'-...........+~\ ~r~-, ~ ~~ \,{-I<, - PM'" ")(0(55 is {A 'P>J ......-\,"" ~ ~1)...+ h..L..\ct- - .. ~~~k~~~.. ....... .._j~:.~~~4I.Iu.?;;:dnt ..- .. ,~: ~._M_.... ,a,!(.i:'I-.r. ..._!2:,__~_J~.31.~.~ 1... ... _.... .....- .~.- . ..... ....l/.;)....--...-.. .......... ..._...~......_.._.._.... . .......pt!VIJ#;:UU.L~_~~?~!~~>1~ .~ /!J/.:uJ01) ..~&._.m'~~'12!.t7:~/.~.hJ ......Mf-~..tJ.~~.~.. w~fr.f0 ..._.+./U-Pu~~'ttt".L~.~ .~ ~, . ' _._ '_.v'~'_"__'_'..... ""-",,.-..,-,.__.- ,,-_...._-,--. .,_.....~,_. . ....3'~.."'1~t~4.1i.v kW, ~.-U · ... . MrU.V:fL ~ .(.11 .m1~ f'=J" .' ..... . ~<dk . ,_~~M..Ctl/-a1:J/ ;-1l./iiu ~ ~. lit ~ ; .~, ~~ll~ .tt/-~...~..~. WdL ' ~~~ I!:~ .~ tiu ~~~ Ik ~;I' .' .)?~..tItv !~~~ tI.4; .~. &"'~'.'~' f.cti.u~; 3-5 . '~ ~...~.lvtIV /trl~~s . .17/..{ & A" -<.; , .. . ..., /h JJ~/-.-~\\'fs t-Dr~~4W.~ ,,'/~ ~..?0dt .~ ~~ r--V tV "'7' .u .~. "'1~1I/ ...._..........._&,~~...~r ~ .(t"~~~ ..~. .~ ~/ 1;. ~ 1:4.. ~ri, d~' . ~._-'.,~~,..__._,~._-,_.~ -, "-.-," 1~'1t~ ~....fj~.~.;.e~~ tC tivJhiW 1 jC~ ~.c . . . ~J.. ....... .~... ]~5 -,1tj~ . . ~ Ie ow fE ffi) JUl . 3 2007 I~ f . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Lihusio, 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 Coastal Erosion Permit Application Wetland Permit Application ~nistrative Permit Amendment/Transfer/Extension ~eived Application:J'.lri\.(l ~7 ~eceived Fee:$ s.:> ~ ~mpleted Application~) _Incomplete _ SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) _LWRP Consistency Assessment Form CAC Referral Sent: ..l}ate ofInspection:~ \131 ~) _Receipt of CAC Report: _Lead Agency Determination:~ Technical Review: A'Ublic Hearing He~ Resolution: Office Use Only ~[E~[E~WlErm~ ~! I AU G 2 ~ 2C07 t:./ Soutl1old Town Board of Trustees Name of Applicant SA LV ftfO /<.. GR />r 1J {oR-I Address,~Ij~ 1/11 ;&, tJui ?O 'BO,( q IS- ~...d1JD lei , ..u 1 Phone Number:(63i tt,,:91f"5.--' Suffolk County Tax Map Number: 1000 - 7() - Y - d. q Property Location: 5'7'- {.-l \ 1\ 12-& We;-\- (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ~oard of Trustees APPlica~ Land Area (in square feet): GENERAL DATA 'Z.. "3 S- 0 0 r:fJ Area Zoning: ill's)'/) CAfr; It L. Previous use of property: liES 1--.11 [AJ7/ t9 t.-- Intended use of property: R€Sil tF<AfTI1'1 L Covenants and Restrictions: Yes )( No - If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date M Doc~ -(31) of 17UJS/t-ES L..J/jf.t>J/ /77/ Ifu(i :J-I/Jt!'~- t3VLf(/lo.]) '( I1tJltefl Il7/ _ 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): ~(jfJ t R.e1lt /JI AJC ~WI}I,.L O~ CR.-[€"f, i,PO/R..P& oj PIJ17/ u) Ir j) IIIJ.Sr /J- L. L. ) I MS-Tn t..L ?t./ttJ-rnJG!!. A5' Pel J)K/'iI.J.}JlJ6 I PROJECT ID NUMBER 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 PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR SFlLI)A,DR.. G(<P,tJ.Fo ((../ 2. PROJECT NAME 3.PROJECT LOCATION: Municipality ~ t..l County Su F F LJ'" 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ate - or provide map tt/ 5. IS PROPOSED ACTION: D New D Expansion ~ Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: R,C"/OJ/ 1;;- fi?f I SII Ale; ~i'()iJed,'t 11Ilsfa.// tefa,f,J > fer ~u.brIJdle~ JftLW/t1j C-)U&)fFR.,(J~1 vJ fU__L.. fre'/iol.l-S. '1 oN ;<&0/1/; I/lda-I) ~Jt.L1\ -h rJf t<5 7. AMOUNT OF LAND AFFECTED Initially acres Ultimately acres r 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER ~Yes D No rf no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY ~ Residential D Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) DAgriculture 0 Park I Forest J Open Space o Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or local) ~Yes D No If yes, list agency name and permit I approval: :'UOES-ANYJl<Sl'ECT OcTRE' ACTTON'" HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes DNO If yes, list agency name and permit I approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT / APPROVAL REQUIRE MODIFICATION7 []ves DNa I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature / spons~~ ~ Date: Applicant Dl 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 completed by Lead Agency) 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 han~written, 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 - J 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 energy? 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)? (II yes, explain bnefly 1 DYes DNo I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TD PDTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? II yesexelain 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 E.letermiAat-iGA-ef-6lgMlGaAee-fAast-evaluate-th6-fJ€ltential-iml3aet-of-the-j}reposed aetieFt-eflitte-elWiremfl,t:f1tal ,IiBI aeteristics of the-6[A. Check this box if you have identmed 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. Chec"kThlsbox"if you-havedetermTned-,based"on-ftie Tnformation and analysis above and-any supporting documentation, tha"t"the-proposedclctlo" 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 rn Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) . . Board of Trustees Application County of Suffolk State of New York ~ \Vq~..... 6'nt......fo'\'1- 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 1RUSTEES, THEIR AGENT(S) OR REPRESENT A TIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. QM~ SWORN TO BEFORE ME THIS co2 .L/ DAY OF ;:)U(",(.).<;, -r ,20 0 "7 ~f?d~ elIZABETH A STATHIS NOTARY PUBLIC. Slale of New Yorfc No. 01 ST6008173. Suffolk County Tenn Expires June 8. 20te : . . APPLlCANT/AGENTIREPRESEN'tATlVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts ofinterest on the oart of town officers and emolovees. The Durnase 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: ~4. 'va Lv- G.'rQ''',_.'~o~ (Last name, first name, -Ipiddte 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 x 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. 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 Southold 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 applicl,lnt (when the applicant is a corporation); _B) 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, Of employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP ~~:~:~:: t~~~: 200:1 Print Name :S \ ..r ~k.c.:,,,_~ FOnTI TS I . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Han 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 (DEe) 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 ) ??31 518-474-6000 L_ sf '^"') Cl -' o :c l- => o U) u.... o 1 J I "7 ....- ( ~-') , WEST HILL RD. ~/. ~ S. 88.52'40. E. 451.00' s." f"sJ'S, ~ ;j'~9sP.e: RO-4D .z. ~ \n "'?4. ~ ~ ~ cY ~~ CI)~ ~~' J~ 1St *i~ :~ ~ t:; 'It " &<;1 g {;f ~ /.1 G5 "'I> r/"r-O -r/ K z. ~ 10---.<1- _ Y I >{, C'VS~) 0{~~ iok -! t-q ~/; Jt I SS,-~ 1"'5;<- ~ /2 "'~~.~ (I; / eJ'f,,,,, ~ O~' cx/ 4.' "'- ~~,c- " 1, '9~S.~o' 1'lJ,k-~" .~ T-Qo/{ ~ OO.~,' ,,~ '<-<< OC.L- ~ ~ I~, ,"'k, e~ ",.Y{, / Y 'IP o' !>'f' 0, <"-j-- ; -,...~ ") <-r )': .~ ~ ~CJ ~(~ /0", ~_ q I( lrc;J C ."0.... ~~~-r .3<:<>.,3 ,., eJ/. /.,. ..:i.:- ::>:'-./' ./_ ~ _ (" T,r IS JQ.r ;<-.] . tJ... "',. t::;' ~~ G5 ~ ~ ~ "d' ~ ~ G5 4J' ~ 1 .l.':: ~ ~ ~ ~ '.'-4,0- '",~-s-.... "::-" '- '" '\0 Area = 24,826 sq. ft. to tie line SURVEY FOR LUCILLE W GRANFORT ~ AT SOUTHOLD CERTIFIED TO' i-l-' TO WN OF SOUTHOLD LUCILLE W. GRANFOR T lnr. COMMONWEAL TH LAND TITLE INSURANC )'0 SUFFOLK COUNTY, N Y COMPANY go ~ c c;=2: 1000 - 10 - 04 - 29 0: '" c" S '. 1" - 30' ~ ~ , C'iCi1 ca,e.- :; fi: c, I JlJ'J June 30; 1994 % ~LI ,= Aug, 3, 1994 (mons, set) ~ ~ ~ J! =., ..J ~ ; - -. ._~=-:::?) ANY AL TERA TlON OR ADDITION TO THIS SURVEY IS A VIOLA nON OF SECTION 7209 OF THe NeW YORK STA TE EDUCA nON LAW, EXCEPT AS PER SECTION 7209-SUBDlVISION 2. ALL CERTIFICA TlONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF' ONL Y IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNA TURE APPEARS HEREON. ADDlTlONALL Y TO COMPL Y WITH SAJD LAW THE TERN -AL TERED sr MUST BE USED 8Y ANY AND ALL SURVEYORS UrR.IZlNG A COPY OF ANOTHER SURVEYOR.S MAP. TERMS SUCH AS WSPECTED. AND .8ROUGHT~To.-DAT~ ARE NOT IN COMPLIANCE WITH THE LAW. N. Y.S. LlC. NO. 49618 ECONlC VEYORS, P.C. 15161 765 . 5020 P. O. BOX 909 MAIN ROAD SOUTHOLD, N. Y. 1/971 94 - 228