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Home My WebLink AboutTR-6685A James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 August 19, 2009 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Anne Sowinski 18 Snedecor Avenue Lindenhurst, NY 11757 RE: 825WEST LAKE DRIVE, SOUTHOLD SCTM# 90-1-26.1 Dear Ms. Sowinski: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, August 19, 2009: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #6685A, as issued on August 22, 2007. This is not an approval from any other agency· If you have any questions, please do not hesitate to contact this office. Sincerely, · King President, Board of Trustees JFK:eac 18 Snedecor Avenue Lindenhurst, NY 11757 July 23, 2009 Mir. James F. King President Board of Town Trustees Town of Southold Town Hall 53095 Route 25 Southold, NY 11971 The undersigned respectfully requests a one-year extension for Permit #6685A. This permit was issued on August 22, 2007 and expires on August 22, 2009. (Please see attached.) The project description for this permit is to abandon the existing cesspool and install a new septic tank and leaching pools on the landward side of the existing dwelling. This dwelling is locat~l at 825 West [ake Drive, Southold, SCTM#: 90-1-26.1. Thank-you very much for your consideration. JUL 2 8 2009 Southold To ~', ~/ Yours truly, Anne Sowinski 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 __ 1st 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.: 6685A Date of Receipt of Application: August 1, 2007 Applicant: Anne Sowinski SCTM#: 90-1-26.1 Project Location: 825 West Lake Drive, Southold Date of Resolution/Issuance: August 22, 2007 Date of Expiration: August 22, 2009 Reviewed by: Trustee David Bergen Project Description: Abandon the existing cesspool and install a new septic tank and leaching pools on the landward side of the existing dwelling. 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 dated July 12, 2007 and received on August 1,2007. 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. 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: Please be advised that your application dated f:~, ,x,5~t /,, o~,o') has been reviewed by this Board at the regular meeting~f and your application has been approved pending the c~m~etion of t~e 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) ½ Constructed ($50.00) ~Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: ANNE SOWlNSKI requests an Administrative Permit to abandon the existing cesspool and install a new septic tank and leaching pools on the landward side of the existing dwelling. Located: 825 West Lake Dr., Southold. SCTM#90-1-26.1 Type of area to be impacted: X Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of above: Part of Town Code proposed work falls under: X Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment X Administrative __Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: __J.King __J.Doherty __P.Dickerson -/~'~. Bergen__ B. Ghosio, Jr H. Cusack D. Dzenkowski Mark Terry~other Form filled out in the field by Mailed/Faxed to: Date: James F. King, President Jill M. Doherty, Vice~President Peggy A. Dickerson Dave Bergen Bob ~nosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Applicatio~/ Wetland Permit Application .~r Adminis~:ative Permit Amendment/Transfer/Extension eceived Applicatio~n~ ;~] I ]07 eceived Fee:$ ~) '~' ' ' ~%mpleted Application ~ltl6) __Incomplete __SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~-4z'WRP Consistency Assessment Form __--GAC Referral Sent: ~v~ ~ of Inspection:~]_. ll[ ~? __Receipt of CAC Report: __Lead Agency Determination:__ Technical Review: ~p~folic Hearing Held~ [t-~oh [ Ih ~) Resolution: Suffolk County Tax Map Number: 1000- ~ O ~- O ( -- Property Location: ~-2~C ~,J~Sk~ ¢~,c--e q~t' rovioe LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: B~ 2d of Trustees Applicatioz. Land Area (in square feet): Area Zoning: /~z,~ ~ ~. ~'~t Previous use of property: 0-e'5,~e~ 0¢ Intended use of property: (2-,,3 '~e.~c~ GENERAL DATA Covenants and Restrictions: Yes v~ No If "Yes", please provide copy. Prior permits/approvals for site improvements: t-) o c'& Agency Date v/No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspende~dJoy a governmental agency? ~ No Yes If yes, provide explanation: Project Description (use attachments i f necessary): ~ ~rd of Trustees Applicatic WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: _square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: r)o feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ ~ feet Does the project involve excavation or filling? No t~ Yes If yes, how much material will be excavated? ? cubic yards How much material ~vill be filled? ' ? cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: feet Statement of[he effect, if any, on the wetlands and tidal w~!ters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER 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) 2. PROJECT NAME SEQR 3.PROJECT LOCATION: 4. PRECISE LOCATION: S~reet Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [~w r-]Expansion [] Modification / 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? ~Y~s [] No If no, describe briefly: 9 WH IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~entia, []Industrial E~]Commercial [~]Agriculture ~l Park / Fores, / Open Space [-'~Other (describe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~es ~No If yes, list agency name and permit / approval: 11 U~Jtz5 ,ANY A~,L-'t;I (JI- THE AUTION HAVE~ A C~JR~NTLY VALID PERMIT OR APPROVAL? ]Yes [~o If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT~,~HE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /~onsor Name Il / /,Date: com~p retel;hteh~;aoCat~;; i;saseC~)sStj~nAtr~oa; amnbd, fY;rUe a;reo~eSet~ti;;g~hctY~,, assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A!]enc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 6t7.47 If yes, coordinate the review process and use the FULL EAF. E~Yes r~No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. C COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1 Existing air quality, sur[ace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic. agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity et use of land or other natural resources? Explain briefly: C5 Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, shor~ term, cumulative, or other effects not identified in Ct-CS? Explain bdegy: C7 Other impacts {including changes in use of either quantity or type of energT? Explaia briefly: O WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE, OR IS TJ~ERE LIKELY TO [~Yes BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENT~I~IMpACTS? If yes explain: 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) irreversibiiity; (e) geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting materials. Ensure lhat 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 determ!R=t!e.q of eig~.fi~ance muot cvcluale~hc potcntialimpac~ o~th c. praGc.3cd c. ctlon on thc cnvironmc,~atcharactedstics of the GEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur Then proceed directly to the FULl EAF and/or prepare a positive declaration. Check this box if youhavedeterminedl based on the information and analysis above and any supporting documentation, that ~he proposed actioi WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the masons suppoding thi~ determination. Name of Lead Agency Tifie of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency 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 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 BELlEF, 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 REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS ,2o ard of Trustees Applicati~ AUTHOP~I ZATION (where the applicant is not the owner) (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) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts ofinterast on the part of town officers and emolovees. The oumose of thi~ form is to oruvide information which can alert the town of ~ossible conflicts ofintem~t and allow it to take whatever action is necessary to avoid same. (Last name, first name, ~niddle initial, unless you ave applying in name of someone else or other entity, such as a company. If so. indlcate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (1 f"Other", anme 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 Southold? "Relationship" includes by blood, rqarriage, 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 / lfyou answered "YES", complete the balance oftbis 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 applicantJagen~/reprasentative) and the town officer or employee. Either check the appropriate llne 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 corporate stock of the applicont (when the applicant is a corporation); B) the legal or beneficlal 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 Form TS 1 Submitted this i day o{ /J(t~c~t,. 200 Signature ~ (~_ /_ ../~>~,-~ ~',-,, ~ PrntName 4::~-,~ t~ ~_~'c~c~o~,~-.~ k~ I I.(,ONI(, ASSOCI,iTTF. S, lite. MARITIME & ENVIRONMENTAL CONSULTANTS July 25, 2007 Southold Town Trustees PO Box 1179 Southold, New York 11971 ~IJUL 2 5 2007 Southhokl Tewn Board of Trustees Letter of Non-Jurisdiction Enclosed is a copy of an application to replace an existing caving ~n cesspool at 825 West Lake Drive.(1000-90-01-26.1) Because of the distance of the new sanitary system from the wet lands, over 100 ft., and that it is also upland ora previously installed bulkhead, a non-jurisdiction letter is requested. Peconic Associates Inc. PO BOX 672 · GREENPORT, NY 11944 · TEL: 631-477-0030 · FAX: 631-477-0198 E-MAIL: peconica@optonline.net I l;( )ffiC ASSOCIA'I'I-'S, MARITIME & ENVIRONMENTAL CONSULTANTS July 25, 2007 Suffolk County Depastment of Health Services Office of Wastewater Management 360 Yaphank Avenue, Suite 2C Yaphank, NY11980 JUL 2 5 2007 Southhold Town Board of Trustees Enclosed is form WWM-057 and supporting documents for the replacement of an existing cesspool with a septic tank and leaching pools. Because of the distance from the wetlands a non-jurisdiction letter has been requested from the Southold Town Trustees. There is a safety concem regarding the existing cesspool which has started to cave in and is covered with a sheet of plywood. As soon as the new sanitary system is installed the existing cesspool will be filled in. Peconic Associates Inc. Merlon E. Wiggin PO BOX 672 - GREENPORT, NY 11944 . TEL: 631-477-0030 · FAX: 631-477-0198 E-MAIL: peconica@ optonline.net SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FC R OFF Z CE U S E C N~[ Y OFFICE OF WASTEWATER MANAGEMENT 360 YAPHANK AVENUE,(631)SUITE852-57002C' YAPHANK, NY 11980 Health Department Ref. No. APPLICATION FOR SEWAGE DISPOSAL AND WATER SUPPLY FACILITIES FOR ADDITIONS~ REMODELING, CONVERSION OR SANI~E OF SINGLE-FAMILY DWELLINGS OR ADDITIONAL STRUC~I~U~'J~ Name of Applicant: ~ Mailing Address: , Name of Agent (if not applicant): . Mailing A~ss: Name of Prope~ O~er (if not applicant): Marling Ad.ess: ITelephone No. Telephone No. (~%~) t-tqq -00 ~0 Telephone No. ( ..-4 J Dist. I Sect. Tax Map No. I ID O O q O Existing/Proposed Water Supply: (check one) [W~'Public Water Supply [ ] Private Well Block I Lot Existing/Proposed Sewage Disposal: (check one) [Mn-Site Sewage Disposal [ . ] Public Sewer Is a Town or Village Zoning Variance Required? Yes [ ] No [~3'~lf yes, include copy of approval Is a NYSDEC or Town Wetland Permit Required? Yes [ ] Number of Bedrooms: Existing New proposed No [ v:Jfff yes, include copy of permit & plan Total ,~ Are you proposing to use existing sanitary system? Yes [ ] Briefly describe the proposed work and use No r,/f Application is hereby made for a permit to construct in accordance with this application, surveys and plans submitted. I hereby certify that I have examined this complete application and the statements therein are true and correct, and that all work shall be done In accordance with all apphcable Town, County, State and Federal Laws. "Any false statement made herein is punishable as a misdemeanor pursuant to S210.45 of New York State Penal Law." Print Name of Applicant Date Title WWM-057 (Rev. 12/06) Page 1 of 2 I/M)276p. Ol/ff7 F.,D BY ~ WI~GI~ ~ OP/NER ADDRESS' 825 P/EST LAKE DR. A T BA YVIEP/ SOUTHOLD, N.Y. 11971 SEPTIC SYSTEM DESIGN..;; 8Y MERL P/IGGIN, ENGINEER LOT NUMBERS REFER TO "SUBDIVISION MAP CEDAR BEACH PARK" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON DECEMBER 20, 1927 AS FILE NO. 90. SURVEY 0~' PROPERTY AT BA YVIE~ TO~N O_Y' SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-90-01-R6.1 SCALE: 1~$0' FEBRUARY 20, 2007 MARCH 15, 2007 {REBARS SET,) MARCH 27, 2007 {BULKHEAD LOC.,) MAY 21',. 2007. I .TEST HOLE) JUL Y 12, 2007(r=v;~J~') ~ "'- .~ APPROVED BY c~i BOARD OF TRUSTEES TOWN OF SOUTHOLD ,z ~.,~. DATE ~/,~y / o '7 7 SEPTIC SYSTEM ~- Iooo ~1, ~EPTIE 5 LF_.4CH~POOL$ TEST HOLE DATA McflONALfl GEOSClE~ICE 5/16107 I om fomflior with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ond will ob/de by the conditions set forth therein and on the permit to construct. The Iocotion of wells ond cesspools shown hereon ore from field observoUons and or from doto obto/ned from others. Devotions referenced to N.G. VD. ANY ALTERA170N OR ADDI170N TO THIS SURVEY IS A 140LATION OF SECTION 7209 OF THE NEW YORK STATE EDUCAITON LAW, EXCEPT AS PER SEC/TON 7209-SUBDIVISION 2. ALL CER17FICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COP/ES BEAR THE IMPRESSED SEAL OF THE SURI~YOR WHOSE SIGNATURE APPEARS HEREON. FLOOD ZONE FROM FIRM 36103C0169 G MA Y 4, 1998 AREA-25,320 80. FT. (631) P.O. BOX 909 1230 TRAVELER $OUTHOLD, N.Y. 11971