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Home My WebLink AboutTR-6903A . . 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 V 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 SOUTH OLD Permit No.: 6903A Date of Receipt of Application: June 10, 2008 Applicant: Joint Industry Board of Electrical Industries SCTM#: 83-2-1 Project Location: 3800 Duck Pond Road, Cutchogue Date of Resolution/Issuance: June 18, 2008 Date of Expiration: June 18, 2010 Reviewed by: Board of Trustees Project Description: Trim the phragmites to l' by hand, as needed. 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 John C. Ehlers Land Surveyor, last dated February 25, 2008, and received on June 12, 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 South old Town Code, a Wetland Permit will be required. This is not a determination from any other agency. r~~ 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: OO;n+ :;::-".dUc"ifry~d. C)..p elecf--rtea..f ::r;,duc~r:es Please be advised that your application dated .:::Gt\€.. 101 c900~ has been reviewed by this Board at the regular meeting of -:TOoe.. ( <5;..7Od Yr 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) Yo Constructed ($50.00) 7 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: $ 50--- BY: James F. King, President Board of Trustees """,.... ~.-"., ",."., t.~;:: .,,,.. ..".. ,.,;.. ,,-os., "..... ,."., ..,,-, ,.".. ,."., '.".0 0,", ..,,-, "." + ~ 1 I 1 +,. ~=.:.::.. --z- c_...,.. ~ ,....',..,. 0-- ~ ',,,,,,,,,,,,,,,,,,-....- I ~~U~t~" "',... I ~~ ,Et"c.'"'.." ..."" ------z'- OJ '"~~ + ~ , ! . . S()l.lND '" "... ." '" /, o -N- ~ I , I , ,,~~, " . 1 1 l , , " I , , 1 I I, i ," SfCTIONNQ 083 PROPERTY ~N' ".1 ".'''e> "..P(:I...... """".'"'. ...-01.....3 'ORPQ...... """C..... .os-..-", """"-..... $[E$[c..... _""001.3 ---z ,!- --i'- r-~ ----r ," ----7'- --i!- 'HSI'c.~.'OS ""SEC........ =::..~ 12lJ -....".. '....u.... ....n"'''. '......".. --".. -.."..,,, ~~' "'~t" !~'~'~~~;~ '-""" ..."" ...... ,.""".. --, COUNTY OF SUFF~lK <D (i)R a Property Tax Service Agency . ~11""'ter RIYortIood,Nll1!l11 : '... ,"""~'i!l;_ _ ...... ..".,"~ ~'-"","".. .._~..,~.,.. ~:m, N(:TICt ....".....,..""'.,,......"',,",.. ~',:!::, ~:::': :":""" ~!~:~,,:;'='""'" !H" y ,oJ '.. , , ~ '" ... ... o -.. SOUTHOLD :-=- lZ"""'l~.~~]1A_"" lIIDlt;103 1000 """""""'",--'".,,,. . . James F. King, President Jill M. Doherty, Vice-President Peggy A Dickerson Dave Bergen Bob t;nosio, 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 Office Use Only _Coastal Erosion Permit APPlicaX' _Wetland Permit Application Administrative Permit it Amendmentffransfe< X!9nsion Received Application: 10 OY ReceivedFee:$ 5D' /CompletedApplication~ _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:(date sent) _ L WRP Consistency Assessment Form _ CAC Referral Sent: _Date of Inspection: _Receipt ofCAC Report: _Lead Agency Determination:_ Technical Review: ..A'Ublic HeariogHe~ _Resolution: Address Name of Applicant Phone Number:( ) AddJ;ess: t')\4, ,/~ : Suffolk County Tax Map Number: 1000 - 8-=3 - 2 -I Property Location: ~ Du::i: yen::} ~ ~~ N'-f "q~? (provide LILCO Pole #, distance to cross streets, and location) ~~k:JtJ\\\,-o.yYl 3 ~/TWlfV~~ ~ (If applicable) I ~ Phone: (i~I-7~ ....~3 5 ~,O. ~y. '-IJiD ~ ~\~=35' B~ of Trustees APPlication~ GENERAL DATA Land Area (in square feet): N/Pr- Area Zoning: t\Jf A. Previous use ofproperty:~ Intended use of property: €d~/)nttl t:U l~n;tI ~ <pe\V A-I't: Covenants and Restrictions:_ Yes If "Yes", please provide copy. )a No Prior pennits/approvals for site improvements: Agency f. ~VS~? *& _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? 1No Yes If yes, provide explanation: Project Description (use attaclunents ifnecessary): ~ ~mrteb Ob ~ ~ ~ ffi l~. ~ 'to-=-the f\ ,-(i1+T V\) hm 4.L11.L- pull ,'r\ +r1.e dyNe. w~ .... I StlJd of Trustees APPlicatio~ WETLANDrrRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: B, (X')rY\ f?(A&11W~ leG- Nl%1>W"Bt1 V\M~ -to 1ft-- ~ Area of wetlands on lot: 7f), r515D square feet Percent coverage Oflot:~% Closest distance between nearest existing structure and upland edge ofwetlands:-.-N J A- feet I Closest distance between Jej!Jst proposed structure and upland edge ofwetlands:~ n feet . Does the project involve excavation or filling? X1 No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ~ from ~ 4 Cttt" fdy hard . .~tatement of.!!tl: l:!T~~iLanx,<>.n. tI1ewl:~I~(jg_an(Ltid~wl!l~pftl1c:!()\V!lJJ~a! may ~lli. reason of such proposed operations (use attachments if appropriate): Nlk I PROJECT 10 NUMBER j_ 617.20 APPENDIX C STATE ENVIRONMENTAl QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNUSTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) - SEaR PART 1 - PROJECT INFORMATION I~'b 3.PRDJECT LOCATION: '3 'D ()~ Municipalily ~E' NL( Counly 4. PRECISE lOCATION~ Street Addess and Road Intersections. Prominent pri O(L 2. PROJECT NAME Ckr1(JN C I.-~ So~ landmarks ate. or Drovtde map SkN-r/{f2-i N f Wt>-re-L 5. IS PROPOSED ACTION: D New o Expansion D Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: G:r{JOm ~\'Tl:.S FvY hA~ ~ ne~ -40 1++. 7. AMOUNT OF LAND AFFECTED: Initially 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 ~ Residenlial D Industrial Dcommercia' OF PROJECT? (Choose as many as apply.) DAgriculture 0 Park I Forest J Open Space DOlh~r (describe) 10..DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY O~ER GOVERNMENTAL AGENCY (Federal, State or Local) DYes ~ No If yes, list agency name and permit I approval: ~Yes APPROVAL? f DNa W yes, list _ncy name and pennlil approval: , _._~l}t71lJl)\'~_~md:~- ~BqD1Ll Jfl\(.Jos . Applicant )A Si olure PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY ~NOWLEDGE D'ate: tofl6f~ If the action Is a Costal Araa, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment ~ard of Trustees ApPlicatflt County of Suffolk State of New York 'NiU;arn J. ~ ,WI,I ~ La~t'>P /L ^ 1-. __L~ r.... LCtm~1 BEING DULY SWORN DEPOSES AND AFFIRMS THAT HElSHE 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 TIm TRUSTEES, TImIR AGENT(S) OR REPRESENT ATIVES(S), TO ENTER ONTO MY PROPER TO INSPECT THE PREMISES IN CONJUNCTION WITH ,,, F PLICATION. DJJ L SWORN TO BEFORE ME THIS \0 DAY OF ~'"'-~ ,20 0'0 C"""\....... __ \.;>~ Notary Public ALI'r::e'rIllW'tlldL NalIIJ~!W~~o~nty Quartfied 1ft .....~. Q CommiSsion Utlues Sept. 25. 3e..=> -- ^ . . ~ at ..- ."'1",,",'" '-1 H 11.- ,.... _ .,.,1t.Dt la _ cIIe _> . ! t4&~"If-:{. 1-, u ~CtJ &.tk {JJ .. ( '14..__ ~.t t"nkrF AI.! ....., .-e~ U,M1.J!IJI",.f FAtl. ~ k J,. C'-") 1- u~ r".~ to ....- ~_ ~r.c.) Ccaa _ ..~ __at _1'.l4ll I . _III' _u. 1;~.fbil U JO~H DOCE"-,' ; '7'8- 6'11-2000>,1123 I I I I I I - _.-- -" .-.....-. __ __ _u_._ . ...__......_____ ~ , SI-7JI.{- '3-'Y . . APPLICANT/AGENTIREPRESEN1'ATIVE TRANSAcrIONAL DISCLOSURE FORM 1l1c Town ofSouthold~s Code of Ethics orohibits conflicts ofinterest on the Dart oftoWu officers and elDolovees. The nurnose of this Conn is to nrovide inforination which can alert the town of nossiblc conflicts of interest and allow it to IBke whatever action is :~:::~iW7i\i ().t'Y\ ~ . ~ ~ lW,-n ~La~~...h-.&t--t (Last name, fIlS! name, ",iddle initial, unless you are applying in the name of c.p'u., ~ . N SOlOCone else or other entity, such as acompany.lfso, indicate the other & person's or company's name.)' NAME OF APPLICATION: (Check aU that apply.) Tax: grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (I f"Other", name the activity.) Building Truslee Coastal Erosion Mooring Planning x . Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship .with any officer or employee of the Town of South~ld? "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 corpomtion in which the town officer or employee owns more than 5% of the shares. . YES NO )0 . If you answered "YES", complete the balance of this form and date and sign where indicated. Narne 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) andlor 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 S% of the shares of the corporate stock of the llfll>licant - (wben the applicant is a corporation); . B) the legal or beneficial owner of any interest in a non-corporate entity (wbcn the - applicant is nota corporation); . . _ C) an officer, director, partnci-, or employee of the applicant; or _D) the actual applicant DESCRIPTION OF RELATIONSHIP SUbmltted~ Signature . Print Name 1m. 200 .!> Fonn TS I