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HomeMy WebLinkAboutTR-6843A James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. ,~ OF SOplyo~ • ~O 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 PRIDR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR APRE-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 Sc 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. ,y,~/~; ~ OF SOl/ryo~ T ~~ • ~O Ol~COU~,~~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6843A Date of Receipt of Application: April 1, 2008 Applicant: William Kenney SCTM#: 79-4-5 Project Location: 1515 Anchor Lane, Southold Date of Resolutionllssuance: April 16, 2008 Date of Expiration: April 16, 2010 Reviewed by: Board of Trustees Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631)765-6641 Project Description: To install a permeable stone patio off the existing deck. 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 plans prepared by Creative Environmental Design dated March 2008 and received on April 1, 2008. Conditions: None 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. Jame .King, Preside Board of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. ~o~~pF SOUT~O~ • ~~0,~ ~~y00UNT1 ~.,~' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631)765-6641 To:~JtUa~tim I/~nnoli Please be advised that your application dated ~(~ I ~~ Q has been reviewed by this Board at the regular meeting of ~/I{n./U t? 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) 15~ Day of Construction ($50.00) Y~ 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: $ SZ~. Uy BY: James F. 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In~eataC hat9en [11ta : ~n 1 ~ ~ `. ~ ~ ^ ~ nnlY b tl1: (•~_•tOn IOf Yltgft dt• 34P.+Jt' .- a~ e ~ is c'roered. anc on his 3ahaM to Ms i . ~ 4 ~ ! ~.~..~ 3-,- tiY• comfenY. pewrrrlertrel ksneY ^_ni 1 ~ !arrjnC inrtitWian IUtC911af lOn and e ~ to me -sapr+ez d t5s landirp itaU• ~(.Q~ TQ ~r -J- ` t: I~Etj Y., ~ ro N`.>.^. a~'nivntucimaM w4quwrt ~ ~~ '~- AUr. 6 ° -~ - r ~. ~ ~~'SF ~ -, rou a;..` ~ ~ r_ • •, ' ; ?:7(..v HE~CTH 9'~1V16FS ~o.~ - ~ I ~ I !•y ~ ~~ . .~, ll c cl .~-~ -~ `I r- r a ~ i ~ zn 5 _ I _ ~ J1''n ~' ~~ v~ ~.--^'§' Bled ~. ~ _ __ _ ,., ~- ~ u ~__ ~ ~ SUFFOLK•COUNTY HEALT dgIEjJT . e '~ 3 d C ,~ ~, ° ~ ,~~nzcN SINGLE FP.tdILv C'':~ -CLING ON~ d a- \ ° j ., ~ ~ -._-J ~ ' H.D. REF. NO. ~e2~ II < 3tEV~e ~ =N I •' 4 1 ~ ~! w z `\ ° z`.. N r: _T. N "''' ,(d ' DATE _ _ , i ~CT 2 9 ,~s~ `~ • (~~+/ li I ~ ~~ CONC. WA(•y,. THE SEWAGE DISPOSAL AND YJ, TER UPPIY FACI~AIES FOR THIS (~ O I ~ ~f ~_~ ,g~" ~ LOCATION HAVE BEEN INSPECTED Y THIS DERR~RiMENT AND , ~ ~,r" t ~ ~ FOUND TO BE S~TISF CTORY. ~~ z uG:E O to ! ^ / /~ ~ / -•~._. SS. ANY '.(7 - < ~ ~ - -saw, ~ _ ys Ch1ef of, astewater M Bement Setstion _, W (y C) NIil LTf' HEECH vD' a i~ O ~ _ 4v.K,. ~_ w J , - ~ ~' 13 1' Iii C. iq ~ ~ Z ~D a. _ S~o~c ' G•` v. ,N JI d I r. i 3CG TD . Q S. 25.5¢ x' ~'.</ - ~,.'}o. J w~. ~,NINDJAMMERCf2t1iE ~ ~ lSJ U La ~ ~ - n'" `{-~1~ --~~'' II -.o i IC.LAhIC SU2vEY025 - Gr2E~'NPCCLTFN•Y. 3.E_y . "$ ~~ TQ McAN SEA t~/EL _ _-- dL-'Ir ~. 7i- _: ~IL`~ r ~ _.. ~_, _ , ~~ I 4~<.tA °^...,0(~~F~ ~L1JE' , ('`,nli ~ ;~JSE "'+ i•.i~G~~l~ ..~ t .I~ •f• ,~E_ _c~IC `=~ ~_.. Cpl' J~ r 't ! - I , Southhold Town ~'. ~.r '-'`.1-~~: z ./ .~ ~-~f~'. ~ ~ ' C I/ i t i ~ a: . - Board of trustees ~ ~ - ~` ^~t,'E r °AYVIESn/~ : i-~=!.O'S.2EFE2 v~P_'AF'~:.F=4lic9('i'C_:~:N-S EST'S.-.LAT. t:~FIIEG !J THE SUFR.v.7, -- - j MAP AMENDED.-LrlAQ2$Ig86 __ .. T:%`,~/N OF'_.SOC)THOLC NY :` E~"G'S :FFICtE ~ NL4P hfG~62, 'I L Jume< F- King. President Jill AI. Uuhert}', lice-President Pcggc a. Dickerson lla~-e Bergen Bob ~-nusio, Jr. „~~OF SOUryo~ ~~ ~ ~~ ~~'~~OUNTI ,~~„~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD O((ice Use Only _ Coastal Erosion Pem~it Application ': zdand Permit 4pplication ~dminish~ative Permit .AmzndmenNTransft~!Cxtension R«zi~~zd Apph~anon: L'(~I U ~Rc~eived Fe< S S~ _~ /Completed application __`~~I ~0 Incomplzte_ SGQE2A Classification: T}pz I "C}pe II_ _ linlisred __ Coordination:(date sent) i1.~1'RP Consistency Assessment Porm ~~ ~':AC Rzfzrral Sznt n ~aiz of [nspze[ion:~~~(~- _ Kzczip~ of CAC Rzporc _ ~- Lzad .Aecncv Dc~erminaiion: Tzchnical Rzciew. LF'[iblic I Izaring Held. ~~( _ Kzsolution: Name of App ~P. ,~, Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (6311 765-1892 Fax (6311765-6641 [~ ~' (~ ~ ;v1 -, yadress lSiS q-,ye~orL ~~E ~vu.n-~a~-r~~e4 ~ N~.Q . __~ Phone~Number:(63~ 'I~i S - ~-~o (.~ SufFolk County Tax Map1Number: 1000 - ~q - ~ _ S Property Location:- Jys-/~F a 5 A~dyi (pro~~ide LILCO Pole ii, d/~is~1tance to cross streets, anOOd location) ~ ~,~,~ " n~ aGF\'T: ~rG~ (../G/~y.i/~wic2, f/~S. C.RizA7/vC ~.V~ild~J~i~1Ltiu~~~ OAS/~'" tlt applicable) ~~hh~ess: 3y/6o - ~'~c zs - P.r ~X /60 N~%GON~L , ~/~ /19 ~ Phone ~ 3 / 73 ~ 792 3 y~f ~8~~ ~rd of Trustees Applicati• GENERAL DATA Land Area (in square feet): 20, 7700 S[1 ~ ' Area Zoning: 1tE5j~FiVTi ~'~ Previous use of property: Intended use of property: N/~ Covenants and Restrictions: 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 suspended-by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): /n',S~fY1LA-~/0 ~ d~ !~ Qr~rnts>~tr roiv~ P.g-ro ~a Co./~y~t o~ ~ard of Trustees Applicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA. Purpose of the proposed operations: ~vyE t n~~tzoa uhrocy,~-~ Area of wetlands on lot. O square feet Percent coverage of lot: (']' Closest distance beriveen nearest existing structure and upland edge of wetlands: 6"S"' feet Closest distance between nearest proposed structure and upland edge of wetlands: ~35 feet Does the project involve excavation or filling? No / Yes If yes, how much material will be excavated? 5~ cubic yards How much material will be filled? ~~ cubic yards Depth of which material will be removed or deposited: ~2 feet Proposed slope tltroughout the area ofoperations: - S 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): 9/on/~ PROJECT ID NUMBER 61720 • SEAR APPENDIX C STATE ENVIRONMENTAL pUALITY 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 / ! 6}rJ~ C- /G~9~Vow / L Z '/ ~(/i ~~/A~i-i F r-Nr~E 3.PROJECT LOCATION. ~--'"_--- ~ M n V u ~,.~Na~~,y County 4. PRECISE LOCATION. Street Addess and Road Intersections. Prominent Landmarks etc -or provide map /S/S ~niG ~/o r2 Ga-.i~ /~'o~oJcp, ,~J_ y. 5. IS PROPOSED ACTION : ^ New rjt'Expansion ^ Modification /alteration L~JI 6. DESCRIBE PROJECT BRIEFLY. ~ ~ y+.e ///.5: ~4u-Afi7dN e~ Ar PE.e Mgt c b7arYe ~-i'-~~ >f A~ifd~C - / / ~ / 90 54FT- ~v linnx.c~T Ya ~i5 f~N~ ~j F~~ .o 7.AMOUNT OF LAND AFFECTED. Initially acres Ultimately acres •~I x~-~=5, 8. HILL OPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes ^ No If no, describe briefly: 5 VVH T IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ^ Industrial ^ Commercial ^Agriculture ^ Park /Forest /Open Space ^ Other (describe) IO.DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGEPJCY (F deral e State or Local) , ~ / ^Yes ~O II yes, list agency name antl permit /approval 11. DOES-ANY ASPECT OF THE--ACTF6N-HAVE-A CURRENTLY-VALIDPERbI17OR APPROVAL?- - -- ^Yes ~~ If yes, list agency name and permit /approval: L 1 3 1f2~A'S A RE T OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? res N LJ o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Nar~(Jg -^ ~/ Date: ~ ( r• Signature A~ ~ ~ ~'G ( ~ ' 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 ITe he nomnlntod by t o~R e A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? V If yes, coordinate the review process and use the FULL E4F. Ves ~lo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 677.6? If No, a negative declaration maybe perseded by another involved agency. Yes ~ Jo G COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwdtten, if legible) Ct. Existing air quality, sudace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: n/v C2. Aest he tic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood charactef7 Explain briefly: ~ / YY 0 C3. V ege ta tion or fauna, fsh, shellfish or wildlife species, significant habitats, or threatened or endangeretl species? Explain briefly: + / /V ~ 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: N~ C5. Grow th , subsequent tlevelopment, or related activities likely to be induced by the proposed action? Explain briefly: M / /Y C". L ong term, shon term, cumulative, or other effects not identified in Ci-C6? Explain briefly: ~v C7. O ther impacts (including changes in use of either quantity or type of energ ?Explain briefly: ~O D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONME N T A L AREA CEA ? If l i es, ex a n briefl ,,- -- ,, ff Yes hiI No E. IS THERE. OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain: Yes ~ No • ^• R,x,miar wrv yr m~ntrlcANCe (I o be completetl by Agency) INSTRUCTIONS: For each adverse effect iden[ifed above, determine whetherit is subslantial,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 --- -~yesthedetermiaatioaoCSignifisaneemusfevaluate thepotentiakimpaefofthe~preposedae[ionorrfheertvira~eMaEohereet 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. Check this box if you have determined, based on the information and analysis above and any supporting documentaUOn, that the proposed a. WILL NOT result in any significant adverse environmental impacts AND provide, on atlachme s as ne essary, the reasons suppoding //~~ determination. (.,RHSrifir' &NVbecWmErtls7.1~ c~f3/!.*~ / 08 Name of Lead Agency ~'''j/ pp `~~ ate ~fwfor ~,LN7~y~rry~GZ ' ~'t%-~. p~5„~c,~T or l ype PJuae,o Re slicer in ead A-C gency - Tdle of Responsible Officer Signature o Preparer (If diKerenl from responsible o cer) ~oard of Trustees Applicat• County of Suffolk State of New York ~~ t ~-l,a-nJ a~,1Ji c; _ 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/FIER 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 CONJiJNCTION WITH REVIEW OF TIIT4 APPLICATION. rSr SWORN TO BEFORE ME THIS_DAY OF G~L1,L,( ,2p(7S' LAUREN M.STANDISH Notary Public, State of New York No.O1ST6164008 y ~ ~ ~~`~~ Commualic~n ExPSeffA;~rC~ n?0~ otary Public ~ard of Trustees Applicat~ '. ~ / (where the applicant is not the owner) I, W ~ I~Il~yln ~~~1),.1~~-/) residing at ~$/i A.vc-Lio,c° LAKK,- (print owner of pr perty) (mailing address) ~'~~`~~~ ~ do hereUv authori ~P ' LI~U~~ CtLI-{P~~1~1n.%IGZ- P~FS (Agent) (2~~tTiUt~ ~n.~`'~(kWW/f~liX}( ~-~~~ apply for permit(s) from the Southold Board of Town Trustees on my behalf. 8 ~. APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics prohibits conflicts of interest onthe Dart of town officers and emplovees The oumose of rh• r '° to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is ne ssa to,voidsame. ~ /(/~~ e / YOURNAME• i~L'!1'11/t ~NVI,~IJ/l~/hC/~ ~/JL<V//Gry, IJ~ILf C/L/77nVaWIL7i Last name, first name, rpiddle 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 Variance Change ofZone Approval of plat Exemption from plat or official map Other (If"Other", 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 employce has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5%o(the shares. YES NO If you answered "YES", complete the balance of this fornt and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship behveen yourself (the applicanVagent/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 anon-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 Submit day of A / ~ 200 8 Signature , Print Name Form TS 1 ~ t GZ Building Trustee ~ G Coastal Erosion Mooring Planning