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HomeMy WebLinkAboutTR-6832An L~ James F. King, President ~OF SQUly ~ Jill M. Doherty, Vice-President .`0 Ol0 Peggy A. Dickerson #f l~ Dave Bergen Bob Ghosio, Jr. ~ ~ ~~~~ ~~~~I/NTy,~..0'' BOARD OF TOWN TRUSTEES Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 766-1892 Fax (631)765-6641 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 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 '/z constructed Project complete, compliance inspection. u James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. ,~~OF SOUTyo~ 'F ~ ~~~~ ~y000NT1,~;~'` BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6832A Date of Receipt of Application: March 10, 2008 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631)765-6641 Applicant: Adrian Sapollnik SCTM#: 90-3-11 Project Location: 225 Lakeside Drive, South, Southold Date of Resolution/Issuance: March 19, 2008 Date of Expiration: March 19, 2010 Reviewed by: Board of Trustees Project Description: Trim/Remove trees and brush from within the wetland buffer area. Trim the phragmites on an as needed basis by hand to 12" in height. 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 site plan prepared by DBV Partners, received on March 10, 2008. Special Conditions: A 15' non-turf buffer to be installed. Tree removal not to include stump removal. 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, Wetland Permit will be required. This is not a determination from any other agency. James F. King~President Board of Trustees JFK:eac W C~ James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. TO: ,~!'~,OF SOUryO~ ~~ ~ ~ ~~p~ ~~y00UNTV ,a~,9'" n ~J 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 Please be advised that your application dated ~C~n 10 d2(cU~ h^a~ been reviewed by this Board at the regular meeting of ~ 9 ~1S 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) ~' z 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: cv TOTAL FEES DUE: $ ~ O ' BY: James F. King, President Board of Trustees N ~._ _ „P~. .. ., p .... .. ss .. ..d ~ -~ ... ux ~ om[o [mlv PnengjNY 119% u.~ ` v s ~~ pp[~ OO~ .m.a, .~,. -_ _.. .u,. .... .. P .° °` g~,o Loop P ° ~ ~ _ .. .. '-i !J ~...4~ ~a~ ,. ~~ - ~' - ~ ~, ~ a j er ~ J ctoaa 4 c ^ q2 ,. cgyr ~ M. ~....,,. = v ~ vi ..usu "' b ,. ., / r t ~ ., y .. .~. .~ s ~ ; s cx ~ ~ av,a _ 'x. • ~ .a / iz „~.. ~ .. _ y/ u ~ ~ Ol ~ "'~ .. .~ o y CFpIR _i Ppyll - a / ..n.,uu x e - 3 m .. ~~ " _ _ / " /~ " Win'.. '4 ' ~ X rse g a s . 1 " 7 s ~ X 1 1 lME Y ~ I ~ ~ ~A9 .y ~ 0 ° 9 a ~ < u 1 - p ~ w~ i . ~ e " m . a 1 F . i-~-_ ' ,, ~ .. x .~ i.n. Q2 R ., ..rc^... ..a e., i np, .,. a ,~ 6 e .. v .. : r. _ - j o y _ '4 - i i I u.~ .. .~ .. ~e { i ~ n. I u u i n. ' :. ~ _ _ ~ . .,. .. ~ I i I ,., I i i a sv....~-__...-~ .-_~ NECK BN Eu r _~_ ~ "'" 1211 '" O ^ - °""'" - _~-_ - - __-_ """'" --'-- n. .:. N011[E COUNi7 OF SUFFOLK © Ped P t i k i a A r' a SOUiHOLO ~ SECiIOH Np E ..._. --- fl v .v.. '--~-.- .. .. .. -- - _ -.__ _ __ -„ -_ __ _ _ roper y rv px ce gency ~anry pnlr Al~slw{XI IWI ~ ~ l ),,, / v a 090 p n n ,. _ a,... ~,. _ ~,"mr.e, ..-..-_ ... ..vrt..rtr p ° lppe PPOPEfliY YM CI~fJ-P~~Ne ST~LLWgTER LAKE FLOAUNG DOCK (W000) r m w DZ. w w 0 0 0 ' ~ + I '^ C~~ /~ DREDGED ~j c ~ 1,~ FILE ~ I,L l ~ 1 /) ~`~ ~_.._.._ _ _ MAP_. _ UNE IIJJf~ )) LJC ~/ A _..._.._ _ _._ ~ n ~ Y~ GL's ~'~~ ~i U / ~{'~~/ 523 ~?' 1 ~Qf ~Y ~~~~%/~ E ~ ~ ~ 5 1: ~ /s~ Nauffb N WOOD DECK ti ~ N D O 4. J' W000 STEPS A WO ^~00 ~ O m ~ 0 P' V 6.3' <~ O ~ X A ..pp ~ O O W000 DECK THIS AREA ~ ~w = o 1J.9' O m zi.e' ~' ro W00 ECK e.J•-- / WOOD FRAME I m m m W ~ RESIDENCE ~~ ~ ~ W N I Z ~ ~ 1 4 ~ ~ O ~ ~ m z ]1.6' > ], 1' ~0 D.9~ n C A < j BLUEGiONE WALXWAY n o u - ~ m ~ z STEP pp o N A < LO F K F ~ f (H Ou n CONC MON DR. E. ~}1,34 POINT CEDAR LAKESIDE DRIVE PRIVATE ROAD GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PR£PAREO, AND ON Hl5 BEHAdf 70 THE PRE COMPANY, GOVERNMENTAL AGENCY, (ENDING INSTI R/TION IF LISTED HEREON AND o ~~.~~~ ~ [~ C ~ o of ~, APPROVF~~~ v FCCIIVr'N OF SOUTHOl.: I.r~~1 { 6 fJPa 7 8 o'g o~~ W IN (SOUTII) TO THE ASSIGNEES OF IHE LENDING INSTITUTION CUARAN TEES ARE NOT TRANSFERABLE TO LOT r 62 SURVEYED: 17 SEPTEMBER 2007 ADDIPONAL INSTIIU AON$ OR SUBSfOUENT OWNERS ~N scALE ,,= so' UNAUPiORQEO ALTERATION QR ADO( TION TO THIS SURVEY /5 A KOLA RON OF SECTION 7209 OF 7HE NEW YOR T SUBDIVISION MAP AREA = 19,951 $. F. K S ATE EDUCATION LAW. OF CEDAR BEACH PARK 0 4 SRACRES COPIES OF THIS SURVEY MAP NOT BEARING . THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID AtUf SITUATE `°PY BAYVIEW, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED BY FMy 9o SURVEYED FOR: SHEENA ACHARYA STANLEY J. ISAKSEN, JR. DATE FILED DEC 20, 1927 ADRIAN SAPOLLINIK P.O. BOX 294 NEW SUF~FOLK. N.Y. 11956 TM/f loon-oso-o3-011 631-7,~4-5835 //1~ .J GUARANTEED 70: _ _ _ _~' sHEENA AcHARrA LI SED D SU YOR ADRAIN SAPOLLINIK YS Lic. o. 49273 07R1 COMMONWEALTH LAND 71TLE INS. CO. ~~ ~~n c~ D n ~~~ ~~~ ~ Ccc, SJ~ '~ ~ ~- ~~ ~'°~ ~~ ~ ~~~~ t~.~ ~C~~~T ~3' ~~ r /1 ot~.~-~~"(-~ i ~; ~- ~~~,~~~~ ~ `J James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen BoU ~nusio, Jr. ~o~~pF SOUryo~ #' l#o~ • ~,0,~ ~~y00UNT1,~~'' n L~ Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only -Coastal Erosion Permit Application -Wetland Permit Application ~Adminis[rative Permit AmendmendTrans fer/Extension ~ceived Application: Received Fee:$~ ~CompletedApplication 3 la O -Incomplete _SEQRA Classification: Type IType IIUnlisted Coordination:(date sent) LWRP Consistency Assessment Form CAC Referral Sent: Date of Inspection: 3 ~ O -Receipt of CAC Report: -Lead Agency Determination: Technical Review: public Hearing Held: l) ., ,... Name of Applicant / } 1 q,U~pc Lt, ./SK Address-h,ti-~tKFSr1~= ~;2 ~'evri~ ~ J;7~>Na~1~--~~'t%7~ Phone Number:( ) In `f ~ - ~~Z- QO ~~ Suffolk County Tax Map Number: 1000 - Property Location: (provide LILCO Pole #, di cr , AGENT: DAVID VERITY (If applicable) P.O, BOX 151 SOUTHOLD, NY 11971 5 - 4980 Phone: ~ard of Trustees Applicat~ Land Area (in square Area Zoning: Previous use of property: Intended use of property: GENERAL DATA 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 pennit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide Project Description (use attachments if necessary): ~oard of Trustees Applical~ WETLAND/TRUSTEE LANDS APPLICATION DATA. Purpose of the proposedoperatiaons: _~~F-P /IJL}j/~~~j/O~J~ ~n.l~ V2~:1 i/ivy J/~r.~ t2G$i~,,~J T G~ S'H% 2 Area ofwetlands on lot: Percent coverage of ]ot: ~~~ feet Closest distance between nearest existing structure and upland edge ofwetlands: feet Closest distance between nearest proposed structure and upland edge ofwetlands: feet Does the project involve excavation or filling? ~-~/No Yes If yes, how much material will be excavated? How much material will be filled? cubic yards cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: feet Manner in which material will be removed or deposited: LtJ L~ ~d b-~ lf.~~ ~ ~ ~-r ©~ i 7- _ ooh. ; ~ . Rt~~-~~1 ~-- vv-~ S .Zc ~~ ~ cv~/( ~.P~y1_/~. KJ Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by rea of such proposed operations (use attachments if appropriate): /x.90 C~S ~~1! ~ o ~J ~~ ~~L.z.P . PROJECT ID NUMBER 61720 • SEAR 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 ((~ AS vf}r'GLL rt/i 3.PROJECT LOCATION: Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc - or provide map 2zs ~~+K~s~~~ ~~. st~~ T~ 5. IS PROPOSED ACTION ^ New ^ Expansion ^ Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: (~~ Tit- ~-r~/tic ~~ ~a-~ ~-lS~ ~ 5'~.~-~-e. C~~ ~- w~ ~ (~-~ ~-2 ~2~~ >r ~-f . c~ ~ CQ ; ~~ I Rr~~~~' (~,,a-~ wc~~~l~. 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ^ Yes ^ No If no, describe briefly: 9. WHAT 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 (Fetleral, Stale or Local) ^Yes ^No If yes, list agency name and permit /approval: -l t: DOES-ANY ASPECT OF-THE ACTfOf~-HAV~A~UFFRBN TLY VALID PERMIT OR APPROVAL? ^Ves ^No If yes, list agency name and permit /approval: 1II2~~,A,''S A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? IJres ^No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /Sponsor Name Date: ~ Signature - `~ ~d ~~ 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? If yes, coordinate the review process and use the FULL FAF. Yes ~ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART fi17.6? If No, a negative declaration may be superseded by another involved agency. 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 traffc 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 characteR Explain brie/ly C6. V egetation or fauna, fsh, shellfsh or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: 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: C5. G rowth subsequent tlevelopment, or related activities likely to be induced by the proposed action? Explain brieFly C6. L ong term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: C7. O ther impacts (including changes in use of either quantity or type of energy? Explain brieFly: D. WILL THE PROJECT E AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTA EA CEA ? If es, ex lain brieFl : Yes No E. IS THERE, OR IS TH LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTALIMPACTS? If es ex lain: Yes o -. -...- -... -_- - _-_.. PART III -DETERMINATION OF SIGNIFICANCE (TO be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whetherit 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 --- --yeslhedeterulinaNOnofsignifieanseinus[evaluatethepotentialimpaetofthe prepeser}eetianontheenvireharaetcristiesoftheCEAr Check this box if you have identigetl one or more potentially large or significantadverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box rf you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WILL NO7 result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons suppoding this determination. Name of Lead Agency Print or Type ame o Responsib a Icer In Lead Agency Ignalure of esponsible Offcer in Lead Agency Title of Responsible Officer Signature of Preparer (If different from responsi le officer) Board of Trustees Application County of Su#Te~k ~~ ~~k- State of New York ~~~ ~9- S~I7L~ illy 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 REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ignature SWORN TO BEFORE ME THIS ~ ~ DAY OF .x ~!'UlL/t -- -~--- / , ; ~--~ 1 ,G Plota. ~ Pub is AUDREY YULFO DE LOS SANf08 NoLry Publics State of Nwv Yak 20 0 Y~~~~O / O ~oard of Trustees Applica~n AUTHORIZATION ' (where the applicant is not the owner) <<~ I, JJr~SAd/ J~}~e~wVSk residing at ~~ L~«Sy,~E ~j ~~cvrF.F (print owner of property) (mailing address) ~~~~f"~D~-.~ ~yY 11 ~ 11 do hereby autho (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. {Owner's s~ 8 APPLICANT/AGENT/REPRESENTATI VE TRANSACTIONAL DISCLOSURE FORM a. , ., ~ .,, .. ,.. necessary to avoid same. ~^y YOUR NAME: ` Last na t ~"•~6 e~~ ~ u5iflal, utlt~5 otfat4 fi (someone ~PEI~i'eAn~,~~1faffiacorttpany. It`so, person's or compafg3ap).>765 - 4980 NAME OF APPLICATION: (Check all that apply.) the )VERITY Box 151 SOUTHOLD, NY 11971 (631) 765 - 4980 Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other / (If"Other", namethc activity.)__ ~ ~2~ ~~-'~~' ~rar"'i /~'!r^~ Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any oC~cer or employee of the Town of Southold? "Relationship" includes by blood, rttarriage, 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 otTi or employee owns more than 5%of the shares. YES NO If you answered "YES", complete the balance of this form and dntc and sign w+he>re indicated. Name of person employed by the Town of Southold M / ~ -~ _ v ~ 2 I T/ Title or position of that pcrson ~ l ~ i N ~ ~.e ,77+.1 Describe the relationship between yourself (the applicant/agendrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town off icer 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 [he 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 corpomtion); C') an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OP RELATION SnHIP ) G~- tJv C l7 ~L L~/ GC/ Submitted this ~Qay~of 200 _ Signature (.'~1y~i'`-z-~-~--- Print Name (~~/7 ~ l/R /t lTy Form TS 1 CREDI~UISS~ • ~~U~~ Q ~~ h~' ~ ~ ~~~ ~r~~s ~c~~ ~c c~~~., ~~ Y~°~ also eww~e ~~ ~w q~~ q~,pco~r~~ ~° ,~~a~ l- 3 {~`e~ ~K ~l/A ~ V~`nQ( W~Qs"~' We CQ3LVS>~ ~.t~ ~,:~ ~~se . "uv! ~S, Adrian Sapollnik Director Media and Telecommunications Group CREDIT SUISSE SECURITIES (USA) LLC Direct 1 212 325 2024 Desk Fax 0373 Mobile X242 6807 ~