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Home My WebLink AboutTR-6712A . 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 Y, 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.: 6712A Date of Receipt of Application: August 6,2007 Applicant: Robert Boger SCTM#: 87-4-5 Project Location: 723 Main Bayview Road, Southold Date of Resolution/Issuance: September 19, 2007 Date of Expiration: September 19, 2009 Reviewed by: Board of Trustees Project Description: Placement of 36 cubic yards of fill along the north and east sides of the property, which was recently placed to prevent flooding. 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 application prepared by Robert Boger, received on August 6, 2007. Special Conditions: No more fill is to be placed on property and the drainage pipe is to be removed. 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. ,t: F :;2;,eOI 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 'led (f''^ ~/toJo7 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ~6ber-t- R:,o~ef Please be advised that your application dated JL..f,j u. ~+ 6 I ~O 7 has been reviewed by this Board at the regular meeting <W 5io ..Q~b&- /~. Oloo? 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) ~Finallnspection 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: $ ~'5V~ 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: ROBERT BOGER requests an Administrative Permit to fill in land on north and east sides of property to prevent flooding. Located: 723 Main Bayview Rd., Southold. SCTM#87-4-5 q/13- 01 Tte of area to be impacted: V Saltwater Wetland Freshwater Wetland Sound _Bay ~ CA.w.- Distance of proposed work to edge of above: P<pi of To:wn Code proposed work falls under: ~Chap!.275 _Chap!. Ill_other Type of Application: _ W etland _Coastal Erosion _Amendment V Administrative _Emergency _Pre-Submission _Violation _Planning . Info needed: tb) -eLe v-rl M / f 6 (", -t.^'" I .I- c, ~J\-\.d r fiJ ( ,f- ~ {:/( ~ Modifications:-----!?e, /"Y" Conditions: ~ --' ~ . P~ent 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 Mailed/Faxed to: Date: Environmental Technician I " I . D 7 Review l~ wi' I ~\\ ~ -fn,,,,"! \tel> .,JIll IT I:k ~'"' . Lvc& (). ('\o,.,+vr~ fl~~), 1V1f~ 91/~ - fT. .s~tt-e u..A..~.-s. ~()\,\Il<S,On r WO(l( lA.-O-'" O--VeClO-.Llc:t~......~ o~~b\.J...\\t\ . .. ... ,..1 .'-"-01 ".<0.. '-0'-0 ".17-0' ".".., ,.,,-, ,-;;. ,.,.-. ." '-"-0 ""'.""SW'""" -N- . (3) Hl.2a _~.D.~~ ~"",- "". ".. . R' ----~~ '- _/ --,J / ~'~:~ . ';, r- ,--:"<J '\ \ ': '\,,-,~ -'--~ .~ -~~ -, .:."---- --- I, t ~ r;;', \ '~.?9 ~ '0 .." "'" IIECK 'M -~--------;;;-~-- I 1 I, ~} ~-- . -- ~ ----------=::- :::-- '" I." .....".. /1;' / ~ ~j ~j ~ L _~_M"" E__..... ~ .....M'~.n N.......'- ,-- -+- [21! (1) _....,,~--"-- -........ ~..-- "'~"''''N_.''__ ""'.0'''''.'''. ... ... ""... '... "'L'O'''''' ""''''''' "''''''_-----'----- n. 'or , "',.,,", ..'''-------''-----''''. ::"..,,-"--- ':.~:.~ NO~n (i) COl.tHY OF SUFFOlK @ \ib Rea Property lOX. Service Agency ...11 tolr1tyCootor- 1Ii\I..~~1111ll1 .. """."" .. . * .. 'I ::~. ~ , '" SOUTHOlO SECTION NO _~~ "'-,,,<lor l>." '_'H """"'-,"-""""",,",",,, ["""""''''''''"'''''1.."". """'-' '''-''I'W.''< "",.,,,,,. ~1""; """a..."',,,,,,,,- ". ......"""",,,,,.""[.0["'. 087 ,..'-<1., 1000 pF!Op[Rnl,lN' ~ 69/27/2667 16:27 7656641 PAGE 62 .... ~ .Ii CD I I.. <.!> 11 :::> 11&1 '< 0 . , , K SURVEY OF PROPERTY AT BAIT/Err TO"N OF SOUTHOLD SUFFOLK COUNTY, N.Y. ,ooo-n-D4-fItf SCALI: ,"-ItO' DEC. ~', '999 __10,llt7...n. ...u._ . . '~,. . '. r ;~f';,"" -. , .~~">"':'~, '. ~ . . 'r-~' >?(p -Jd'::> of;.- C" ." d I c9 \1) we..'> ~t'<€P- \,J~,H' . afec.. "'." ~,s, \,0"..:/,., w"'- ~0-.61 ::>(,)o:t-~ ' x APPROVED BY BOARD OF TRU TEES TOWN OF SOUT OLD DATE9~1.y~ 07 _......____IV_~..-..- tlI.,.,Ull'tfIT.......__. ..... tl'tf?''''fIfI.~____ ____ 1IfII(.:1,..._-_...ra.b..,.,., "y~ =r-,....:=n~:=-... ...~ . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob lfnosio't 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 Pemrit Applicatioy" _Wetland Pemrit Application L Administrative Permit / _Amendment/Trans er! xtension V Received Application: 0 ~ ZReceived Fee:$ /00 It; sh -LCompletedAPPliCatiOn~i\5~\JlI~ ~ _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) _LWRP Consistency Assessment Form CAC Referral Sent: ~ate ofInspection:~/.:LIO ') _Receipt ofCAC Repo : _Lead Agency Deterntination:_ Technical Review: ....Public HearingHe~ Resolution: Office Use Only Name of Applicant ~Qbe<i-- ~~ Address 'I'd.:?:' !y\a.,V,\ ~v'\6-) <2-6 (fn.vCik ~~I;).-W,,~ fJ ~) Phone Number:~3'D '-I s \- \Q \ I., Suffolk County Tax Map Number: 1000- ~':;~i~CI !1ln Jlocation: ~ t:l ~1-{)'--\- DS" \~l (,,- S{. , S,Mt' "-"t>le , ~ '3~ll\o (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ~d of Trustees APPlicati~ GENERAL DATA Land Area (in square feet): Area Zoning:--J'Z. - YO (0, Sn 5_-1-' Previous use of property: f2-Q5i~f)h( \ Intended use of property: ~ :5l.A..(Y)(Y).er Go .J+,,--< .L 6 Covenants and Restrictions: Yes If"Yes", please provide copy. No Prior permits/approvals for site improvements: Agency j(;~",l? ~\d r(~,.\.-""s D~~ ~ oC+ ~ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or susPt1 by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments ifnecessary): .,h"\\ ;", pl~ \~ ""- 1'\-cM ~1cM- S;J", -k rre",-,o",~.c \DO<9: ~~ or:: tlrrd of Trustees APPlicati~ WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~ \ \ '" ~& Qo~~ s\ clP of p\O~A1 +u \~ 0"- ,,-oc{L I2revE'.J- +=\"""L",-" ~ Area of wetlands on lot: square feet Percent coverage oflot: ,-r::D % 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? ~ cubic yards How much material will be filled? 'SI,., cubic yards Depth of which material will be removed or deposited: '-1-(" .oct...., feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: d,^""",p k-v..eJ... Statement of the effect, if any, on the wetlands and tidal waters of the town thatlIla)'restiltby reason of such proposed operations (use attachments if appropriate): sk"",-\c\ h.~ rw ~..w~ ""- +k LJ..I'-~\o"..ls or ~Jd wOIUrs 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 I SPONSOR ~ be.,4- 2. PROJECT NAME 3.PROJECT LOCATION: Municipality ~J County \tc 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ete - or provide map '7:l~ ~ OJ \ <"".,,( R.J. fl" v&t '(24 ""'-\2 -W< ^' R\-.~ S::,~ \~, fj I 5. IS PROPOSED ACTION: D New D Expansion ~ Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: ~\\ ,I' \~ fr~~ 0"'- >"va"*", ~ .,Q,c-,<I- S: d. J 0 ~ rD;'''''''~ ,(2.{",,,, ~ "- ~ 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY ~ReSidenljal Dlndustrial Dcommercia' OF PROJECT? (Choose as many as apply.) DAgricu,ture D 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 (Federal, State or Local) DYes D No If yes. list agency name and permit I approval: lrOOES DYes A~SFECr Ur IHt A<.;IIUN HAV~AmCORRENrI:TV7\lJD PERMIT OR APPROVAL? t...pJ. No If yes, list agency name and permit I approval: 12. AS A R []yes ULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? o CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature ~ (.. S/ Applicant 6v'---- Date: lithe 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 comoleted by Lead Agency) 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. DYes ~No 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. o Yes 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~ il 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 1 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 Cl-C5? Explain briefly: I I C7. Other impacts (including changes in use of either quantity or type of energy? Explain briefly: [ ~ ,,,- '" - - - ..-' 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 o Yes ~No I E. IS THERE, OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: 1 o Yes ~NO I PART III . 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 determiRa-tien of si€lnifIGaAG€Hil\l-s-t-evaluate--the-veteAtial~ml*let-ef-tIlef)ffi!36se6-aetieft-e-Fttfteellvfreftmental eharacte:ristics of the 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. Checklhlsui)ox-if yi)u'have determined, base<ron -thekiformation and analysis above and- any supporting documentatf()r1, fhaithe-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 Dale Print 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 Application County of Suffolk State of New York ~/~ 0LVt...'-- BEING DULY SWORN DEPOS)tS AND AFFIRMS HAT 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 SOUTH OLD 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. ~~~ / Signature SWORN TO BEFORE ME THIS lih-. DAYOF ~J- ,20 0 '1 ~Pfd~.. Ikfr:U1.{ pvb /,'( ; :."": eard of Trustees APPlicate AUTHORIZATION (where the applicant is not the owner) ~ I, (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) 8 : . . APPLICANT/AGENTIREPRESENt ATIVE TRANSACTIONAL DISCLOSURE FORM The Town of South old'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 necessarv to avoid same. YOUR NAME: Si.k~Of\ 30~~OA (Last name, first name, J1liddte initial. Wlless you 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 4 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 [ann 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, or child is (check all that apply): ~A) the owner of greater than 5% of the shares of the corporate stock of the applici,lnt (when the applicant is a corporation); _B) the legal or beneficial ownt?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 Signature Print Nam 200! LLSevr-- o "'- O~'" Fonn 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 SOUTH OLD 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 1190l 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. A1bany~2231 518-474-6000