HomeMy WebLinkAboutTR-6865A Jill M. Doherty, President
Bob Ghosio, Jr., Vice-President
James F. King
Dave Bergen
John Bredemeyer
Town Hall Annex
54375 Main Road
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
# 0624C
Date March 22~ 2011
THIS CERTIFIES that the replacement of the existing stockade fence with picket fence and
chain-link fence landward of the bulkhead
At 12500 Main Rd.~ East Marion
Suffolk County Tax Map #31-14-7
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 4/29/08 pursuant to which Trustees Wetland Permit #6865A dated 5/21/08 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 replacement of the existing stockade fence with picket fence and chain-link fance landward
of the bulkhead.
The certificate is issued to SOPHIA ANTONIADIS & MARIA XEFOS owners of the
aforesaid property.
~t~or~e 'd S~i~at~u
Jill M. Doherty, President
Bob Ghosio, Jr., Vice-President
James F. King
Dave Bergen
John Bredemeyer
Town Hall, 53095 Main Rd.
P.O. Box I 179
Southold, NY II971
Telephone (63 I) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION:
~Ch. 275
Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1st day of construction
½ constructed
V/'/Project complete, compliance inspection.
INSPECTED BY:
COMMENTS:
CERTIFICATE OF COMPLIANCE:
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.: 6865A
Date of Receipt of Application: April 29, 2008
Applicant: Sophia Antoniadis
SCTM#: 31-14-7
Project Location: 12500 Main Road, East Marion
Date of Resolution/Issuance: May 21, 2008
Date of Expiration: May 21, 2010
Reviewed by: Board of Trustees
Project Description: Replace existing stockade fence with new aluminum style
%" pickets on 4" centers in similar height, beginning at the bulkhead at 48" height
for 30' and 72" height for the 70 linear feet landward.
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
survey prepared by Nathan Taft Corwin III, last dated October 18, 2007, and
received on April 29, 2008.
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
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
1st day of construction
½ constructed
Project complete, compliance inspection.
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
Please be advised that your application dated /¢~(,'] o,1(~, ~Tf___,Ooc~' h,,as
been reviewed by this Board at the regular meetin'g of /Y')~u ¢1],, c¢-OO~"
and your application has been approved pending the comp~fion 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)
,/~ 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 PERMrT FEES:
TOTAL FEES DUE: $ ~--'(--) ~
BY: James F. King, President
Board of Trustees
Sofia Antoniadis
12500 Main Road PO Box413
East Madon, New York 11939
April 30, 2008
Southold
Board of Town Trustees
Town Hall Annex Building
54375 Route 25
P.O. Box 1179
Southold, New York 11971
MAY - 5 2OO8
Re:
12500 Main Road
East Marion, New York 11939
Dist: 1000, Sect: 031.00 Block: 14.00, Lot: 007.000
Greetings:
Kindly attach the enclosed photos to the permit application sent in earlier in the week.
Thank you for your assistance.
Sincerely,
Sofia Antoniadis
'~,s~ Ieee)
L~/'
!~.00 ~ oo'7,oo0
May 23,2008
Sofia Antoniadis
12500 Main Road PO Box413
East Marion, New York 11939
Southold
Board of Town Trustees
Town Hall Annex Building
54375 Route 25
P.O. Box 1179
Southold, New York 11971
Re~
12500 Main Road
East Marion, New York 11939
Dist: 1000, Sect: 031.00 Block: 14.00, Lot: 007.000
Greetings:
Enclosed find a check for $50 as the final inspection fee for the fence permit granted.
Kindly mail permit to the above address. Should you have any questions or need
additional information please do not hesitate to contact me by cell phone
(646) 201-3560. Thank you for your assistance-
Sincerely,
James F. King, President
Jill M. Doherty, Vice~President
Peggy A. Dickerson
Dave Bergen
Bob ~nosio, Jr.
Town Hall
53095 Route 25
P.O. Box 1179
Southo]d, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Omce Use Only
Coastal Erosion Permit Applicatiofl~-
Wetland perrmt Application ~ Administrative Permit
~ Amendment/Trans fer/Ex~ension
Iz .Rece~ved Application:
l~R. eceived ree:$ ~'~ O5~, ,
~'~ompleted Application
__Incomplete t -
__SEQRA Classification:
Type I Type II Unlisted
__Coordination:(date sent)
__LWRP Consistency Assessment Form
~_CAC Referral Sent:
__9~Date of Inspection:
__Receipt of CAC Report:
__Lead Agency Determination:
__Technical Review:
__~-Public Hearing Held: ._gfT, _,~.t
__Resolution:
Name of Applicant Sofia Antoniadis
PO Box 413 East Marion, New York 11939
Address
Phone Number:646) 201-3560
Suffolk County Tax Map Number: 1000 - Section 031.00 Block 14.00
12500 Main Road East Marion, New Y6rk 11939
Property Location:
Lot 007.000
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
of Trustees Applicati
GENERAL DATA
75,248 sq feet
Land Area (in square feet):
Area Zoning: 1000 Residential
Previous use of property:. Residential
Residential
Intended use of propemy:
Covenants and Restrictions: Yes xx 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?
xx No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):_ To replace existing stockade fence and
replace with new aluminum style 3/4" pickets on 4" centers in similar height tothe
old. The new fence will start at the bulkhead at 48" height for~0 ft and 72" height
for the~0 linear feet landward.
of Trustees Applicat~
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose ofthe proposed operations: Replace exisitng rotted wooden fence with new
for security and prpoerty border. Old fence is falling down.
Area of wetlands on lot: 0 square feet
Percent coverage of lot: 0 %
Closest distance between nearest existing structure and upland
edge of wetlands: 100 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 20 feet
Does the project involve excavation or filling?
xx No Yes
If yes, how much material will be excavated?
How much material will be filled?
Depth of which material will be removed or deposited:
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
cubic yards
cubic yards
feet
Statemen~ o~the effect, if any, on the wetlands and tidal waters of the town that maX result by
reason of sU~fi proposed' ;~;ati~n~ ~us~ ~t~hmeri~s i~ h~-4p~ihte~i .............
No effect on wetland or tidal water from the proposed operat±ons
IPRoJECT ID NUMBER
PART 1 - PROJECT INFORMATION
SEQR
1.APPLICANT/SPONSOR
Sofia Antoniadis
617.20
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
( To be completed by Applicant or Project Sponsor)
2. PROJECT NAME
Antoniadis Fence Replacement
3.PROJECT LOCATION:
East Marion, Southold I County Suffolk
Municipality
4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc ~ or provide map
12500 Main Road, East Mar±on, New York 1]_939
DJ-st ]-000, Sect 03]-.00 Block t4.00 Lot 007.000
5. IS PROPOSED ACTION: [~ New [~ Expansion r---1Modification / alteration
6. DESCRIBE PROJECT BRIEFLY:
Replace exisiting old wooden fence with new aluminum
3/4" pickets on 4" center fence in same place as exisiting
7. AMOUNT OF LAND AFFECTED: NO ettect on land
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 VICINI~/ OF PROJECT? (Choose as many as apply.)
~] Residential E~ Industrial E~ Commercial [~Agriculture E~ Park / Forest / Open Space
E~ Other (descdbe)
10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING,
AGENCY (Federal, State or Local)
E~Yes r~No If list name and /
yes,
permit
NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
]lUUb5 ANN~HECI UP IHb AUIION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
[]Yes o If yes, list agency name and
pe~it / approval:
Non ~ur±st±ctional £or ~he DEC ....
12. AS A ~I~,ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
E~Yes __No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
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.
r-~ Yes ["-I No
B. WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 6f7.67 If No, a negative
declaration may be superseded by another involved agency.
I-lYes E~No
c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwdffen, if legible)
C1. Existing air qualib/, 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 character? Explain briefly:
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
I
c y xls lng p a r goas a a y adap e r a chang se or m ty use o and or o her natura resources Explain briefly
C5 Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
C6. Long term, short term, cumulative, or other effects not idenfiged in C1-C57 Explain briefly:
C7 Other impacts (including changes in use of ~i!her quantity or type of energy'~ ~(~bin briefly:
WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA CEAt? (if ~_es, explain
E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSy RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:
:'ART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, ~arge, 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) [rreversibility; (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
7es, the determ!nat!cn of s!gn!.r.'ca~ c~ must ~'a~a~u crc thc pctc~ia~mpaet~fthepr6po .~ cd aege f~oe ~heenv:,r on me~ai chF. r~ ~erisfic~of the CFA.
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.
C-hack t~is bo~ify~'l~-~/~ ~Jeterm~'d', b~sed-on th~ ~'f~J~:r~ation and analysis above andany supporting documentation, that'~h~l~op~edacfi~);
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi:
determinafion.
Name of Lead Agency
Date
Title of Responsible Officer
Signature of Preparer (If different from responsible officer)
Print or Type Name of Responsible Officer ir, Lesd Agency
Signature of Responsible Officer in Lead Agency
Board of Trustees Application
County of Suffolk
State of New York
Sofia Ant oniadis
BEING DULY SWORN
DEPOSES AND AFFIKMS THAT HE/SH~ IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HISfltER KNOWLEDGE AND BELI]~F, 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.
- /Signature
SWORN TO BEFORE ME THIS 28 DAY OF April
,20 08
"Notary Public
IGOR GUREVICH
NOTARY PUBLIC, State of New York
No. 01GU5015~64
Qualified in Kings County tOG
Commission Expires July 26, 20__
oard of Trustees
ApplicatO
AUTHORIZATION
(where the applicant is not the owner)
(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/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officers and emolovees. The ouroose of
thi~ form is to provide information which can alert the town of ~ossible conflicts of intere?t and allow it to take whatever action is
necessary to avoid same.
YOURNAME:
Anion] adq ~ _. .qo f'l a
(Last name, first name, ~niddle 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 Trastee
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
Of"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 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
XX
lfyou 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 applic0.nt
(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, parmer, or employee of the applicant; or
__D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
Form TS 1
Submitted this ~ o~_ i
Signature ~ I-~ .k~-.~,~.. ~
PrintName~ So~a Antoniadis
Albert J. Krupski, President
James I~Jng, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OFSOUTHOLD
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.
Alhany, NI~F 19931
518-474-6000
Sofia Antoniadis
12500 Main Road PO Box413
East Madon, New York 11939
Apd128,2008
Southold
Board of Town Trustees
Town Hall Annex Building
54375 Route 25
P.O. Box 1179
Southold, New York 11971
Re:
12500Main Road
East Madon, New York11939
D~t:lO00, Sect:031.00 Block:14.00, Lot:O07.000
Greetings:
I respectfully request an permit for the replacement of the exisitng fence on the east
side of the property. The exisitng fence is old and falling down. I would like to install an
aluminum picket fence, (photo enclosed_). The proposed fence will start at the bulkhead
at a 48" height, go north landward forgO linear feet and continue at a 72" height for the
remaining~O linear feet. The fence will not have effect on the wetlands.
Additionally, the alteration to the fence is nonjudsdictional to the DEC since the existing
bulkhead was pdor to 1977. I am in the process of obtaining a formal letter of non-
judstiction from the Stony Brook office.
Enclosed please find a check in the amount of $50 and two full scale copies of the
property survey. Should you have any questions or need additional information please
do not hesitate to contact me by cell phone (646) 201-3560.
Sincere/y,
'40" E
79.7%'
NOTES:
SURVEY OF PROPERTY
SJ~TUA TE
EAST MARION
TOWN OF SOUTHOID
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-31-14-07
SCALE 1"=20'
OCTOBER 18, 2007
AREA = 75,248 sq. ff.
(TO lIE LINE) 1.727 aC.
ELEVATIONS ARE REFERENCED
EXISTING ELEVATIONS ARE
EXISTING CONTOUR LINES
TO N.G.V.D. 1929 DATUM
SHOWN THUS:~
ARE SHOWN THUS:
APPROVED BY
BOARD OF TRUSTEES
TOWN OF $OUTHOLD
DATE
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N.Y.S. Lic. No. 50467
Nathan Taft Corwin III
Land Surveyor
PHONE (631)727-2090 Fex (631)727-1727
THE RXIRTENCE OF RIGHT OF WAYS
AND/OREASEMENF$ OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.