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Home My WebLink AboutTR-6604A 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 CERTIFICATE OF COMPLIANCE # 0263C Date October 3, 2007 THIS CERTIFIES that the sand path to beach At the end of Sunset Lane, Southold Suffolk County Tax Map # 88-6-13.6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 5/1/07 pursuant to which Trustees Permit #6604A Dated 5/16/07 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 sand path to the beach. The certificate is issued to ANGEL SHORES HOMEOWNERS ASSOC., INC. owner of the aforesaid property. ;.- 0< ~ 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 151 day of construction _/ constructed L Project complete, compliance inspection. /0 I:l.l 01 ()~ ~ . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Gnosio, 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 Application _ Wetland Permit Application =::2"Administrative Permit _ AmendmentITransfer/Extension _Received Application: ~ived Fee:$ ~,.. .1/1107 \;. ,-" . ~ (f~- ~ ........completed Application ...:->71/67 I, ~ll ~~ :.~ If: Incomplete ' J \ =SEQRA Classification: I 1\11 MAY - 1 2007 TypeI_TypeII_Unlisted_ ~' U: _Coordination:(date sent) L _LWRP Consistency Assessment Form .' '.__'_'" CAC Referral Sent: Southold lown --Pate of Inspection: 6l9/(l} ,Beard of Trustees _Receipt of CAC Report: _Lead Agency Determination:_ Technical Review: _Public Hearing Held: 511f)l(rJ _Resolution: , ......1 (J \1 I~ l ---, n. , . ! I' , , 'I i I , 1../ 0- . NameofApplicantA..A/&-f~ .('//tJ/lfS #H.R'd~#F/lJ ,.,(~.cdP.e:fP 7~c. / Address R 0, l3 OX 1';:f/) SOf/ T/fIJL/) I AI Y 1/~'7 / Phone Number: ( ) ~3/' ')66, tbS-6.:7 Suffolk County Tax Map Number: 1000 - S~C : () fig. tJO BiDc,/(: 06. ()O t (J r;' / 3 - / I . Property Location: fJAYj/le~ FA/I) ,,~SvA/5",I;T.4'~J ()tC/h$.,,~~p~/'c. PAY ~, 7, ~. -# 3 E~LJ 6/: J'v/f/f'e/ "L"v: (provide LILCO Pole #, distance to cross streets, and location) AGENT: \ -g/~ /I. P./-Ao~ (If applicable) v ' Address: Phone: 4It Board of Trustees APPli~ion GENERAL DATA Land Area (in square feet): (/, .J? Area Zoning: ;f~f/~c'~OA~. Previous use of property: Sv-v ~ /'7 h/~ ? Intended use of property: J ~ / ~ ;? /,;'" ~ ~e~c~ 18eAl-ch Covenants and Restrictions: Yes - If "Yes", please provide copy. ~No Prior permits/approvals for site improvements: Agency Date _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or SUSP~d by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments ifnecessary): fe/1././lce ,,/6ov/ 30/A/l';- of SA~/ tJ.A- ?~/,{ h /:l~/lc./ /v~c~ Pt//1S t7/f/;.?/lCe/ t y /!/o/p le/lS'~/p tI~ ~//I' L /S- ZdO,? / r . Board of Trustees APPliWion WETLANDIfRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ;ff;O/dc~ 4C'/l-cl" ~7lo-$/m Area of wetlands on lot: ~4 square feet Percent coverage of lot: I % Closest distance between nearest existing structure and upland edge of wetlands: 0/'.4- feet Closest distance between nearest proposed structure and upland edge of wetlands: # ftJ feet Does the project involve excavation or filling? No V Yes If yes, how much material will be excavated? 0 cubic yards How much material will be filled? ':3 () cubic yards Depth of which material will be removed or deposited: 2- feet " . Proposed slope throughout the area of operations: /'1/ p/ h,# L . Manner in which material will be removed or deposited: /Vliet' L 8/1/l/1~L H~tatement o(!?e ~_ff~~~!tallY,~~!!J.~__~~t13!l~~ _all~L tid~\V_~!~~ ~ft:l!e. ~9~_~.11~~}J!~Y~e.S!l!t~y reason of such proposed operations (use attachments if appropriate): ,., /f/ IJ A/ I: . 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1. PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT I SPONSOR :::7i:'I"" . rc~-?f('/? 2. PROJECT NAME /1t't/tv~I'A ~ /!s'5c. ~c:# /f~~7)P Svrrt7L// . I PROJECT 10 NUMBER SEQR See j?AP 5. IS PROPOSED ACTION: D New D Expansion D Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: 1fT.' /L/f"C ~ /l6t:?v7- S /I~ ~ ~# I?t-T~ ;0 30 )//!"n/Js 86?4C4 t o..~ 7. AMOUNT OF LAND AFFECTED: Initially acres tJ. tJ 6" Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~s D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Residential D Industrial D Commercial DAgriCUItUre D Park I Forest I Open Space DOther (describe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) DYes ~o If yes, list agency name and permit I approval: 12. AS A ~T OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? Des [RfNo I CERTIFY THAT IS TRUE TO THE BEST OF MY KNOWLEDGE Date:Y~7 Applicant Signature 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 ACTIO!:!.-~EED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. DYes LMNo 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. o Yes ~ 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, ["'W'mQ'"'~~'"'~.'~" Ex,,,,",,,,, _. . ..~ ~ .. n, :. ~ I C2. r""" 'grio"p~""'''''' h'.lori,. ,,""'" ",.",, "'001'"" reoo""..", '"mmoo"y ~' ""h~""'<>d oh,_" Ex"',. 'riofly, , C3. r~~"' f,"""~~ " wild.,. ~cl~. "'".'~"' h:~". "~,~I'"<>d "'"d."'~red .poc'~? E''''.". '","y. : = 1 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 P' {/ "'. :. I c51~:"=~'~~~: ,~,,,~,y~b' .d,,,dby 100 ,m"..d ''''00' Ex",," """:_=. ' .. .1 C6. T' I~. .hort te:::;;;:~" ,ff""" "'" .,"""" '" C1-<OS? Ex".," .",,,, .: I C7. Other impacts (including changes in use of either quantity or type of energy? Explain briefly: I /,p p / . ..m ....... m. I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL D'~~:M~EA(C:I' :If~':~~"'" .rio: . T U.I E. 'Cj"~:;' ~E UKEL Y TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENV'RONMENT AL 'MP ACTS? . ~. ",~'.,", . [ " :: . ... "', , u., .. . j 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 (Le. 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 il was checked yes, the determination of significance must evaluate the potential iR'lf*ict of tho proposed BotiOR on the environmental characteristics 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 FUll EAF and/or prepare a positive declaration. CheckThTsbox ifyouhavedelermiiled;baseif'on-fhe Information and lmalysisabove and' any supporting documentation; tliiHhepropos6CiaCtlor 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 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 Application County of Suffolk State of New York J2; /~ rf /2r~77/f BEING DULY SWORN . DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRlBEDPERMIT(S) AND THAT ALL STATE.MENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF illS/HERKNOWLEDGE 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 TillS 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 TillS APPLICATION. ~ig1.d~ SWORN TO BEFORE ME THIS \ DA Y OF ('\'Clv\ ,20 \:S1 \ CONSTANCE SZYMCZAK NoIaIy Public. Slate Of" ~ No.C;'SZ6125618 Qualified In Suffoll CouMv. ._. Clmmiasion Exolres AprI1..~~ .:.-;. '- . . Board of Trustees, APp.tion AUTHORIZATION (where the applicant is not the owner) J; 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/AGENTnREPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emplovees. The pur:pose of this form is to provide information which can alert the town of possible conflicts ofintercst and allow it to take whatever action is ~:::;~id0-tJ ~~ A. h~ ~ . (Last name, first name, J,lliddle initial, unless you are applying hi 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 ,.,-' 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 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, of child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applic(lnt (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 .'..__....___. _no. Submitted this Signature Print Name Form TS 1 . . 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.: 6604A Date of Receipt of Application: May 1, 2007 Applicant: Angel Shores Homeowners Association, Inc. SeTM#: 88-6-13.6 Project Location: End of Sunset Lane, Southold Date of Resolution/Issuance: May 16, 2007 Date of Expiration: May 16,2009 Reviewed by: Board of Trustees Project Description: Replace approximately 30 cubic yards of sand on path to beach. 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 plan received on May 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 South old Town Code, a Wetland Permit will be required. This is not a determination from any other agency. /:::; K~ ~ent 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: ~j Shores ~re13 AosoC,'<<--HOfl/ kc. Please be advised that your application dated 1Yb...J4,' tOO? has been reviewed by this Board at the regularmeeting of m; Ie" ~co? and the following action was taken: ' ( ~IiCation Approved (see below) L-) Application Denied (see below) L-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: - 0(10..-1 -;:;::;'-5fee-H on Fee TOTAL FEES DUE: $ ~ ~ BY: James F. King, President Board of Trustees '3~ 9.~ ~~ ~, ~ 1 .. i:- -..:: IC~ ~ ~, ,,0 .. - ~ ~, tl ~ .~ ~...'- ....~ ,...",0.1 ~ ~ .-\ ~ , ;fr?~ /to ps~~/? ~3/-;?~J' ~s--~'3 If ..~ " . '!' ,'>- '~'.'; -'. . q. ..' . l' 1('9 .;', !:.~ . 0 . ". j!." . ./ '.:s' -;.. .. . ; ~'. ~. '.: .; /.."\1,; .:.,~:: ; \ .... \ \ .., \ f ,: I' ; 111 ~ ; L.;} '" '\ '" ",. "'. '\ ,,- ..... ... ... R J ~~ Ii :m fJ~~ . "'~ It ~ . , 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 117.9 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/W orksession Report 5"-~-OI Date/Time: NameOfApPlicant:~~ S~ ~~ Ao,l(~ Name of Agent: Property Location: SCTM# & Street Brief Description of proposed action:-EJGitC<" SO\(\.cA In Lo\( CY\ (a1'h~ ~Gk Type of area to be impacted: V _Saltwater Wetland _Freshwater Wetland _Sound Front _Bal Front Distance of proposed work to edge of above: Part of Town Code proposed work falls under: _ Chapt.~ _ Chapt. ~ _other 077~ 11) Type of Application: Wetland Coastal Erosion Amendment Administrative - - - - _Emergency Info needed: r ~_ L... t a. 1\ - rt:,.,,~ Modifications: .. Conditions: Present Were: _<-:rting _J:Doherty _PTIIckerson _"--rr"Bergen Other: ~ob Ghosio, Jr. MailedIFaxed to: Date: Comments of Environmental Teclmician: .- /I/v ?t'~ .)'h/p?S /~'/-?~ c:?~'//~~~..r $~A~~ C?<< or- SC/'/z-J~r .L//~-e cP./'- /f?Ce7/V/C 8y .~.. )-.. '>4:;~- J},. .~-ltc .JJ" 1, t"lJ~.' · -~.". .. .', . ~;, . "f \; ii, " "'\' . '" \, e AnyJ r'--: ~, ~1i' 'j.' i ~~ . '/'I 4! , '.. '~~.-1' ';'j' "', .. " ,J> t (, \' . , ~" ~ ~O('&O \ I It I I , "~",~ ," }.J ,," .n.1 . J I 'iJ f" -~:.<; tl , , ' . . \ ~. l ;1 ;1" .~ ,l,'~ ... , Ut\~,;,<",. ,,'\.,... , . <-, /: ) , r 1.'.. !;.:~ II , {:f;: .. ~~:'.. '1_",~..~. ... I, ~14-~1 .-1. ., ~.... ~1."'':.~'~'' :e:.~ '. I ' '), ,-t, r "'~....,'" .'~; . .' ~~~; ~ p:.. ~. . ,~~ .., \1t ."- ", ",. ~ . (.~.~.; ~; '"' .,.~. f" ~~- ,~ Ai t< -, .i.-t ) ,i, :, ~ _;: II ;.~.; /;; "~-I Ill':>" t " _ .' lIoo. 1\';' ;(1, '.'1 (I; ,. v..~:'... -", _.\ t,'" . { . ~ . , i~ . , " If . r' -:. , , .' , , 'st';' " r " :, :.;,..,.; .' 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