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Home My WebLink AboutTR-6757A . . 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 y" constructed ~roject complete, compliance inspection. . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Han 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.: 6757A Date of Receipt of Application: September 14, 2007 Applicant: William & Marie Myers SCTM#: 114-12-13.1 Project Location: 400 Ole Jule Lane, Mattituck Date of Resolution/Issuance: November 14, 2007 Date of Expiration: November 14, 2009 Reviewed by: Board of Trustees Project Description: Remove the four (4) trees near the dwelling and construct a 40' x 120' garden, all landward of the 50' non-disturbance area. 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 prepared by William & Marie Myers, received on September 14, 2007. Special Conditions: No activity is to occur within the 50' non-disturbance buffer. 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. Foo~'f}:at;oo tmm '"y othe, ageo,>,. 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: LJ,\hoJV\ ~ (()O-.f;e. t1I~tJ3 Please be ad;ised that your application dated ~t6~ dl.C07 has been reviewed by this Board at the regular meefui9 of ). 'In llP;"ber N,. daJ 7 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) Y2 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: 00 TOTAL FEES DUE: $ So ~ ~Z1)01 BY: James F. King, President Board of Trustees ~ ~ ~ ~ . t> ~ JJ ~ "'- . . 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 InspectionIWork session Report Date/Time: It at/07 WILLIAM & MARIE MYERS request an Administrative Permit to remove trees near dwelling and plant garden. Located: 400 Ole Jule Lane, Mattituck. SCTM#114-12-13.1 Type of area to be impacted: YSaltwater Wetland _Freshwater Wetland Sound _Bay Distance of proposed work to edge of above: ~ of Town Code proposed work falls under: _ Chapt.275 _ Chapt. 111 _other Type of Application: _ Wetland _Coastal Erosion _Amendment IAdministrative _Emergency _Pre-Submission _Violation _Planning Info needed: ~ Q;w. of. &:-t~ lfnr o~" f\ 0+ \' '^ ~ <ti-rM~~ diU Modifications: Conditions: Present Were: v:('King 0Doherty ~ickerson_D. BergenUGhosio, Ir _H. Cusack_ D. Dzenkowski _Mark Terry_other Form filled out in the field by MailedIFaxed to: Date: Environmental Technician Review Ij U~ jjI ~ .1 I. i i Ii " II Ii iil ii i ) . ~ . . $lt"""m'" I -<>-Z I ~/ . "..~ .n......... . . ~ -r- H:l"'" .,,- '""" '""" .l , ~~i ~ ;,. r u' ~. , ';~ " , ,!l I. ~ ~ ~ ~ . I t ~~ """-i l ,;.1 "'t ;1. n~ , I f\~ ej_ ~ ~ 5~- ~~t 15-~~ >-~.~ ~~- . ~&:; u;!!~ o !;I~i :(~"i~ \j ~i ~ j i ::; ffi i:'-I!' ~ z ; ~:o ~: I!!; I un: !: I. [j ~~~h~~ ;;jmJ ;,!.!!l ii ii i i jj Ii p~q I II lr ijjij) i i i ii i ! ~ ! ! ~ ! Illi i I IdUl ie!!! I Iii l : l'I' II I I' ! ~ !;! j i }J I - h !;;; H ~ ~ . I 'I l I III d 1III ~ I, I::t III I Ii d! "Jq hili ) . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Gnusio, Jr. . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD _Coastal Erosion Permit Applicati<1ll _Wetland Permit Application ~ Administrative Permit _ Amendment/Trans er/l',x..!>..nsion ....-p:.,ceived Application: III \0 I L Received Fee:$ . n .-eompleted Application \ l _Incomplete _SEQRA Classification: Type I_Type Il_Unlisted_ _ Coordination:( date sent) _LWRP Consistency Assessment Form CAC Referral Sent: /Date ofInspection:~ _Receipt ofCAC Report: _Lead Agency Determination:_ Technical Review: 1>ublic Hearing HelcCID1.IIIID Resolution: Office Use Only Q/141(Y) \5)1~ ~ .~- ~.D [[ .J; 1\f'U~_~ 4. "01, SGl:t,/W] k','.I' Rr_~~:~~~;':."~_~'~ _ . Name of Applicant /)JILLtJHtll ~ MM/~ At Ye:072J Address 400 OUE: ;JulA UlA.e. I'1M1T17VCt;, v..Pf, !1"1.r'2. , PhoneNurnber:(v~ 3f:,7-737,f" Suffolk County Tax Map Number: 1000.:::eL Ll4.Do - e,1OCJ.:. /2-.00 - Ulf' 13.00/ Property Location: 400 OLe JV~ LAve; v1Nt-fTlT1.lc(C I N -'1 (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: 4Itaoard of Trustees APplica~n GENERAL DATA Land Area (in square feet): I ,7Q3 AcW Area Zoning: Previous use of property: ((t.3 fOe/JTlkl Intended use of property: 5th'1.te- Covenants and Restrictions:_ Yes If "Yes", please provide copy. t/No Prior permits/approvals for site improvements: Agency Date ~ prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend~ by a govermnental agency? VNo Yes -- If yes, provide explanation: Project Description (use attachments if necessary): !<Er1(()vE nees fb/l 5/ffi'N N€M. fic;.AUE tttvtJ flf./t>./f GMoe/l. ~Board of Trustees APPlic",on : WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: S/TCC7Y /HJt} ~ Area of wetlands on lot: I '3r3 /U€5 square feet Percent coverage of lot: "I; % Closest distance between nearest existing structure and upland edge of wetlands: .r5' feet Closest distance between ~earest proposed structure and upland edge of wetlands: M'A feet Does the project involve excavation or filling? VNo Yes If yes, how much material will be excavated? J..//A cubic yards How much material will be filled? II/A . cubic yards Depth of which material will be removed or deposited: II I A feet Proposed slope throughout the area of operations: ;.!! If Manner in which material will be removed or deposited: Statement of tile effect, if any, on the wetllll1<lsand tidal waters of the town thatlllfll' r(lSlllt~l' reason of such proposed operations (use attachments if appropriate): . 617.20 . PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION (To be completed by Applicanl or Projecl Sponsor) SEQR 1. APPLICANT I SPONSOR 2. PROJECT NAME VJI/..U AM ~ M!rRA~ fI4It~ 3.PROJECT LOCATION: 400 0 I.C J"Ul-e I..{we.. v\lIArrrNCt" / (/0'1 5c.JFftJt.Je Municipality I tq$t.. County 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks ate - or provide map SMt"" 5. IS PROPOSED ACTION: ~New D Expansion D Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: ~~(Iti()tJe Tflrrs !of/. S!rfery IWtJ G4Az/\ - 7. AMOUNT OF LAND AFFECTED: Initially 1/,0 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 OF PROJECT? (Choose as many as apply.) ~ Residential D Industrial o Commercial DAgriculture D Park I Forest I Open Space OOther (describe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMA TEL Y FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) DYes ~o If yes, list agency name and permit I approval: ". UVt~ "'" _M~tc.' vr onto ACIION HAVE A CURRtoNILY VALlDt'rnMIT OR APPROVAL? - DYes 5(tNO If yes, list agency name and permit I approval: -- -- - -- 1~: A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? es ~No I CERTI FY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant I &t'U1.!1~. tJaHlt:l Date: Signature U-....L. Ifthe 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 Aaencv) A. DOES ACTIO~CEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. o Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration ~e superseded by another involved agency. c=J Yes No 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: htlA - I C2. Aesthetic, agricultural, archaeological, historic. or other natural or cultural resources; or community or neighborhood character? Explain briefly: W/A: I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I Hilt .... - 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~(A- I C5. Growth, subsequent development, or related activities likely 10 be induced by the proposed action? Explain briefly: I MfA - . ..^- I C6. Long term, short term, cumulative, or other effects not identified in C1~C5? Explain briefly: I {.itA- I C7 Other impacts (including changes in use of either quantity or type of energv? Explain briefly: I 6i lit J 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: II D Yes ~ No I E. IS THERE. OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: I DYes ~NOI . .... ... . ... .... n .. ... PART 111- DETERMINATION OF SIGNIFICANCE (To be compieted 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. tl:l8 9gtmmination efsigffific3nse mlJst eVol1J3te the l'loteRtia~6t cftMe f3r6f36se€l aetioR 6R tAB e:.l9vireRfficFltal cl'laractGristiGS oftl,e-€[A. 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 andlor prepare a positive declaration. Chec-kthf:idJox if you have-delerrriTnEMf,- based-on-ftieiiiformation and ^analysisabove and- any supporting documentatlon;- fha"t"the-proposed actio. 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 Pnnt 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 1M *R 1l2' O. fIMI res 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 TRUSTEES, THEIR AGENT(S) OR REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS ~;'Sig5'f""-1 ' Jtjrft-. DAYO~t. ,2001 G;t(!l/JJ'7 fYI- ~~ olary Public LAUREN M. STANDISH Notary Public, State of New York No.OlST6164008 eomQyalified in Suffolk County mission ExpIres April 9. 20..JL . . APPLlCANT/AGENTIREPRESENTATlVE TRANSACTIONAL DISCLOSURE. FORM The Town of South old's Code of Ethics orohibits conflicts of interest on the Dart allow" officers and emolovees. The Duroose of this ronn is to orovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is necessarY to avoid same. ' YOUR NAME: WILl-/ AM f fiMt{€ /1\ 'IdS (Last name, first name, 'IIiddle initial, unless you are applying in the name of someone else or other entity, such as a company. Ifso, indicate. the other person's or company's name.)' NAME OF APPLICATION: (Check all that apply.) Tax grievance BUilding;,r' Variance Trustee_ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other", name the activity.) ---A-DM IllItST/lJt1l~ Do you personally (or through your company, spouse. sibling, parent, Of child) have a relationship with any officer or employee of the Town of South old? "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 t./" 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, or 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 own~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 dayof ~ 200 _ Si~nature ~a./Z:/L/ ~.h.q, Prmt Name Form TS I ! t?A./, >' r. I rl'Zlf'~.5 "I'IEf-!; I" IC TlI -tip- It{' GM().Vr:;~. . k', "!11<~; S. ?~3:>'AO ~,. .. (f{1 !ilSj-\)!lj ~!ij"'~"'1> ..~.aE.~"""'.'''' .~~i~ ~~... .~. .~~. .~ii;!J). ~ ;lj:O:::f ill~ ~~~Ii ~.~i~ ~~~;;l !<j . .~~ t!l~~~'" "'il'i~nt$ ~"'!'>\!l~ ~m~~?;; Iljr-~~ ~~~~~ "'~,",h S'(~"':::! ~'il" ~ 5:i ~ :ij ~ OJ (lo9 r, \j .9 /.s_ ~ "0..... .~ -../0 .... ~ :t ~ ,.. \Ja :i"'r- ). "1..... i'i"':!' ~ 'I "'Nj ['j ~.". ~;;iOj 1>: "60 ..~'" r-;:: OJ Rl - At) a", :-- ~ II ~~ ~ Cl)a "'~ toJll~ ~ ~:-O::l g] If' -A l\J ..., . .... I;) .. A~ ;;.. " .... ,:$ .... lb $;:I ~ If If . '. -1- ''b ~~.. oo~ ~ [' Cii-~ I' I "'., " ~ I~ ;.i1, ~ "li IJ~ "" (\> ::::! II~ '^ f) . -J i 11 ~~" i ~ liiri~ I' --~ I h ." ,'" ,,,Q ~ I~ " / ~ 'Q '0. ~ -=:::::---- " ill ~~~~i~ ~~~~ ~ q N. 0'3710' ~ \ '(11 112.68' :. \ \ \ ~ I .~. PPROVED BY OARD OF TRUSTEES OWN OF SOUTHOLD E >~(./~ 7 i7'. /" .r, '4Ct '4' ~ 'b ,;: o,)i ~ , 0 ~.~ i " ~ ~Y" 6T 0' \\ 0 /A.i;/ \ ~ \ /. ".,::; N.O'3"1~30. -dl!;l ei'~ ~.\~ \ / ~ SI'UT:= "P · ty\ ~ /~ ~ f h l' . ~ d ,~..././: 'I ~ ~ v"" \ '\ _ // qr ~ A. 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