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HomeMy WebLinkAboutTR-6740A FILE NOTES (For Office Use Only) DATE & INITIALS Q -- (o I a 1 ) 1 -ko �Q i dQCIA r 'IcfQ oL+ i, : az , ---- - e7tj - �� 17 O1C C r! i +i 1. ��-�rP�s���/r �� __ �m��,tecL ark- ('��a,�e �3eaeh _- — ._ _ ___ .505 `7'/z� _ ����c C,�.�Ctc� - �Sf'---�aR�an_ __ .�. _ - X31 � `� ? � a 3 �2 �3� � .' � y,1�h t�.''µ't�+``����.fRs,'4� �t:,,'"",�a"//�'iai� .M�'"�•., bb e4 y 1 •'_ J �"1l'�rit,„1 h`_`w:aF e *; ;.X 4'r CL ;. , ,.; t►z � 09110/2008 10 ' 03 4��J4$,���i�,- a� I�� 1. S•'•s�"��L.�. r.+. � 7 , 40 ot -Aw ay ♦ r. 4, - w• � v ./ ' 0.9 0'0 8, 1}0 40 4 a, m * v r. ,� p�� �✓ ` Zvi i� , ,,�� i';"� �� � ) , • D� ' M � i"'moi'.' �r;'� ♦`te ' �� In � b r y�t r R - • .,�, 16 } �y r �� x � r ' R •' .. 1n� aA 40 r1 1 if r 1. w ki .� '-1 a` a A, y[\^fit `' �• 4f « R . Q2 ��� 'fit `s.. ''��t,� t ►�' l�.�� �' .i, .,. s, Aya�k •t'�s;, t }I'.I � � �i � � „„ Ott• 'r N L SSS y1v0'/•20 0 8 10 . 0 2 .od5r ��9s'F-�X?,� f l _ f 1 , ` l • ' "i'4.�.-.rte i .��'!�+ - i +,- � `��, - J 09/ 10/2008 10 ' 02 L ' ;�'r:•?y.. •�r V• it 11 .w%` A 10S 44 � ; James F. King,President ��OF SQUTyO Town Hall Jill M. Doherty,Vice-President 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen G Bob Ghosio, Jr. '�` �� Telephone(631) 765-1892 COUNTY,�cFax(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 / '/2 constructed V Project complete, compliance inspection. James F. King, President -``�q soaTyoTown Hall Jill M. Doherty,Vice-President 53095 Route 25 P.O. Box Peggy A. Dickerson 1 Southold,New York 111971-0959 Dave Bergen CA Bob Ghosio,Jr. �0 Telephone(631) 765-1892 �y 00UNiV, Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6740A Date of Receipt of Application: October 2, 2007 Applicant: Pebble Beach Lot Owners Association SCTM#: 21-5-10 Project Location: 5065 The Long Way, East Marion Date of Resolution/issuance: October 17, 2007 Date of Expiration: October 17, 2009 Reviewed by: Board of Trustees Project Description: Install a fence with two gates, one for members to access private beach and second gate to allow emergency vehicles to access 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 application prepared by Anthony Vivona, and received on October 2, 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 ��Of soyoTown Hall Jill M. Doherty,Vice-President ,�O �� 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson l [ Southold,New York 11971-0959 Dave Bergen G Q Bob Ghosio,Jr. O Telephone (631) 765-1892 Comm,N�' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES n TOWN OF SOUTHOLD TO: Pebble 69ac Gcr)-DCJn&ls Ai oc Please be advised that your application dated t'ATobe(_ O?, has been reviewed by this Board at the regular meeting of_Oc4-ai_er/ 7 acr7 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) /%2 Constructed ($50.00) V 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: p� Il�14��7 TOTAL FEES DUE: $ SU BY: James F. King, President Board of Trustees kv 3••r� ` fir '' ' "� r '' r a^ A ,i , t VR2'b L sfY \C r .1 a r — s t - , t 00097T7 41S V L Y �N ^ / O �- D�� �o �J• �u y�u4 g •.0 I J`° ro/ c Ov p /� p`' b� •µ• Ji ' � R.• iWn �e 0 44 uoncc CgWT7 OF SUFFOLK © v SOUTHOLD SEciox W i -- - izi� _O —_ •—_-_ •` �. Fed PrWKtr Tm Service R9WEY a 021 C �,•,y, panty dins 9�,s sgMY 11PT Y {��/(/�()jT\�+�� uwa Daae � James F. King,President ��q so yo Town Hall Jill M. Doherty,Vice-President 53095 Route 25 Peggy A. Dickerson # P.O. Box 1179 Southold,New York 11971-0959 Dave Bergen 9z Bob uttusio, Jr. �� Telephone(631)765-1892 eouff ,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES RDE C E 9 V TOWN OF SOUTHOLD D Office Use Only OCT - 2 2001 _Coastal Erosion Permit Applicatioy southhohl Town _Wetland Permit Application ✓ Administrative Permit Board of Trustees _Amendment/Transfer Extension Received Application: �� O ,,,,'Received Fee:$ _Completed Application _Incomplete Type Classification: Type I Type IIUnlisted _Coordination:(date sent) _LWRP Consistency Assessment Form _CAC Referral Sent: 'ate of Inspection: I Q1 I 07 _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: /Public Hearing Held: 10 1 Resolution: Name of Applicant PZ by &14 C ©T ato0 F k K /7 Address/ -f{8 4�7_Pll? _1 osJ 1U t Y l I q,? 9 Phone Numbene&I ' 1-/'? 0 2 9 a i;:� Suffolk County Tax Map Number: �1/000 - aq ( — 57-7 /U Property Location: S� //7'� " 625 mel 'y n (provide LIILLCO Pole#, distance to cross streets, and location)) AGENT: &N / .PO1U T/ V l V o " A (If applicable) Ce tI Address: Phone: Ord of Trustees Applicatico GENERAL DATA Land Area(in square feet): Area Zoning: Previous use of property:aF j{ C d { Intended use of property: Covenants and Restrictions:—z/Yes No If"Yes",please provide copy. Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): rrlcE Lu17- To '6A7£S ., 6r2T /9< cSS PRIUAtz 19F Cd{ . .5Sa„Nd G"-19 To ,at/oc,jf ko Ar-cfAS H rd of Trustees Applicati� WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:Te " , �PHc�� ,C arl am C1 . Area of wetlands on lot: _ square feet Percent coverage of lot: % 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? 0 cubic yards Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): A) F PROJECT ID NUMBER • 617.20 • SEQR 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/SPONSOR 2.PROJECT NAME 3.PROJECT LOCATION: Municipality County 4. PRECISE LOCATION: StrrY,�tdess and Road Intersecromin�ent landmarks etc -or provideP.f ma e - 5. IS PROPOSED ACTION: New ❑Expansion ❑Modification/alteration d` 6.DESCRIBE PROJECT BRIEFLY: ��^" o� � .�� �- l t.c.,v� �G.0-Er o ��•a/J Q C9�+-.i�' e&TI ctyt— 64n 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres &WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? KYes ❑ No If no,describe briefly: 09. AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/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) ❑Yes No If yes, list agency name and permit / approval: lA`I �EA � PERMIT ORAPPROVAL? ❑Yes No If yes, list agency name and permit / approval: 12. ASA E ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? as No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor me Date: 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 ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? It yes,coordinate the review process and use the FULL EAF. E]Yes ❑ 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. El Yes ❑ No 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: C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood cha;;ct r?Explain briefly: NI C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats or threatened or endangered species?Explain briefly: �O 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: ) /f) C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: 1A16 C6. Long term,short term,cumulative,or other effects not identified in Cl-05? Explain briefly: /v C7. Other /impacts(including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA 7 If yes,ex Iain briefl : Yes OQ No I = E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex Iain: Yes X1No _. _... 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 (I) 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 steva4uate4hepotent;aI impact tthe-proposed en the environmental charscteri„ics oft].8 BEA. 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 d you have determined,based on the information and analysis above and any supporting documentation,that-the—proposed actio WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting lhi determination. Name of Lead Agency Date Print or Type Name of Responsible Officer in-Lead Agency Title of Responsible Officer gnalure o esponsib e Officer in Lead Agency Signature of Preparer(If different from respond leo cer) �rd of Trustees Applicat AUTHORIZATION Y17- 33.2 - $$ 33 ce(I or Q o0''an (where the applicant is not theowner) y77 a�S- L' ExOc � ,A-fe)agAo residing atpoR 38'7 L—YL7J/ /,0A/ (print owner f property) mailing address) %/l 2 Gto Gcn_ A—. hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf . &�L L - (Owner' signature) I c—, 8 *Board of Trustees Application County of Suffolk State of New York V GtJU" BEING DULY SWORN DEPOSES AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBE PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/IIDR 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 REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THI/SAPPLICATION. nature SWORN TO BEFORE ME THIS M DAY OF Oc-1 1200-) LAUREN M.STA DISH ('YQt l t t it Notary Public,StatSegopfpNow lbrk ` apalMad inSiSu fclk t piny tary Public Commission Expires April 9,2p APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold s Code of Ethics prohibits conflicts of interest on the Part of town officers and emolovees The purpose of this form is to provide information which can alert the town of p9ssible conflrcts of interest and allow it to take whatever action is necessary to avoids same. n �j YOUR NAME: VIVO A/ (Last name,first name,middle initial,unless 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 Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"OtheC',name 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,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 50N f 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,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (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 Submitted thi _ day of O 2002 Signature Print Name V e fE Form TS 1 + Albert J. Krupski, President O�sVFF�(�CO Town Hall James King,Vice-President ti'Z` Gy 53095 Route 25 Artie Foster P.O.Box 1179 Ken Poliwoda v, Southold, New York 11971-0959 Peggy A. Dickerson iv.f%O Telephone(631) 765-1892 1 `1 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]hany NY 12231_.--- 518-474-6000 143 142 0 71 70 69 68 67 66 65 64 2 OPEN 1 7 1 `.' U 141 T SPACE I Fu I z 6] 6t] J.59M 57 56 55 n,5453T519 48 47 46 5 74 -Pine� c Q e 1` 0 D L -� D v EA 75 , AY ]2 11 � � TH m L N • lJ k E ONG 76 43 r 13 10 —AZa 1 ti 77 42 Q 14 9 a 2 Fb 1 78 41 - 150` 8 a 3 <O�'C 79 40 0 16 7 x 4 9 OPEN 39 U 17 OPENBPACE ' 6 5 1 ti SPACE 38 18 U 1� ti 81 C 36 F- 19 0 ' APPRO ED BY 82 35 20 VILLAGE OF BOARD di TRUSTEES 83 ESCE!vT GREENPORT I 84 PROPERTY i TOWN OF SOUTHOLD--C97 85 a 29 0 27 625 22 21 LATE l t �y4 86 0 1y 87 88 31 1Z� 89 32 GOLF AND COUNTRY CLUB D ECEIYE 90 98 D ��9 91 94 95 OCT - 22007 �1,�6 993 HE G��Ern�i At r ,g LONG ISLAMewd sf Ilo SOUSOUND em ons 01-159 09 05 0 OYU-01rvi 227-0 5-21.0 ne loo"' 1 e-m-0 oe m o ]-02 05 ,` 17-05 5 p / Z J 9 x T 19.1• LJ61[1 10 11 5.1 6 12 11 11 15 I6 i 1•• S 21 § x 6VA Xw puu 6• :so9 \\\1•SMG x��.,X �~ , �'�' ,§ S 5 6 "s ]0 S��I jZ«J�, ' p $P 6 � S�SIGI y1• xa ", 1 8.• IMP JJ e i S N � 5 1�•lc Vy �I Cl Omlx �S lm' y6 Sl SRAlWm 1G t V1 1,1• 3J� 99 x 1, A O y']•' SM Y � 116 15 avo- Jo 20 SS 1 M 12 72 1 x 6,6•.c1 S t iJ L4 � 12 SSA % 1 C" 1.16 ct N LL S .A avcx v,a 11 A. S 6 O m iEx Q f 96 •:A ry 13A�� , q wnaeTr a �- - - 16 LO6 � i 156 n 9 rw ra.w. 6 6 So D b 119 15 ' l7 LS 21 6 M. 16 S' O.ME SC. i06 PQ.IP. s Lob N U % / 21 n-01-0012 6EE YC.N0. a Sx D '�r c '�1 �' .� / n . 6 wa• 19 A-%-OlJ S s ,` - — Z OCT - 2 2007 MATU LJ* 1C U � 1T-, + ME Me..WON �J ! � ^s / 1 � Southlrold Tmhl eosro et Trosteq IN Jx4 E ». ,.,� m.�a, �, —_— a.m D.xx 9,ME6.YX. .L, �. NOTICE COUNTY OF SUFFOLK © E MN SOUTHOLD SECTION NO E o..w u.Xo mx. —�— MemxM�.,M,A . 1211 1m4 O X, AlO.I: ,x. —_E-- Mlr mnMew --X-- xE xnxw J� w.oxwe olslree.s: . 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