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HomeMy WebLinkAboutTR-7005A 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.: 7005A Date of Receipt of Application: October 17, 2008 Applicant: Jane Sweeney SCTM#: 104-7-1.3 Project Location: 150 Mason Dr., Cutchogue Date of Resolution/Issuance: November 19, 2008 Date of Expiration: November 19, 2010 Reviewed by: Board of Trustees Project Description: To trim and remove two (2) dead trees, and to maintenance trim four (4) trees. 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 Roderick VanTuyl P.C. received on October 17, 2008. Conditions: The area 100' off the seaward end of the deck to the landward edge of the wetlands must remain as a "no-mow" zone. (See attached survey.) 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. Jam F.~King, Pr~sid~ Board of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: l [- (t~ © ~:~ JANE SWEENEY requests an Administrative Permit to trim and remove two (2) dead trees, and to maintenance trim four (4) trees. Located: 150 Mason Dr., Cutchogue. SCTM#104-7-1.3 .Typ~area to be impacted: /_.~,,~altwater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland .Pa~j::~-R~wn Code proposed work falls under: ' '--Chapt.275 Chapt. 111 other / Type of Application: L..~etland __Coastal Erosion ~Administrative__Emergency Pre-Submission __ Amendment Violation Info needed: Modifications: Condition .~)g~I-~ (~ Pre~D.Wl~zr~ ~i2~g,.~° hetty ~P Dicke rs° n V D. '--' ·~_' --~tl~er -- Form filled out in the field by D.Bergen ~.B.Ghosio, Mailed/Faxed to: Date: Environmental Technician Review- 104 L 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 Penrdt Application Wetland Permit Application t/~Administrative Permit AmendmenffTr ans fer/Ext en~on ~'Received Apptic at ion :~)/~_~/ _~_~C:~mplet e d Application Incomplete SEQKA Classification: Type I Type 11 Unlisted Coordmation:(date sent) LWRP Consistency Assessment Form ~ CAC Referral Sent: ~' ~Date oflnspection: I I] tlt OY Receipt of CAC Report: Lead Agency Determination: Technical Review: lh~c Hearing Held: Resolution: Name of Applicant ~.? ~,~ Address I 5 0 /V~ a S e_, Phone Suffolk County Tax Map Number: 1000 - UropertyLocation: [/,~Sq- eh// o/r /Vla3o~ / ~+~ce~: (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: of Trustees App Land Area (in square feet): Area Zoning: GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes ~- No Prior permits/approvals for site improvements: Agency No prior pemfits/approvals for site improvements. Has any permit/approval ever been revoked or suspen.ded by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~--~'~'~', ~,-,,,4 £¢..-~v¢ ~-- Ooard of Trustees Applicat WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: /~}~,,,~4¢~,~.,o._ o(~ ~,o,¢,¢ Area of wetlands on lot: Percent coverage of lot: feet Closest distance between nearest existing stmcture and upland edge of wetlands: [ 0 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ o feet Does the project involve excavation or filling? "/' No Yes If yes, how nlnch material ;viii be excavated? How much material will be filled? cubic yards cubic yards Depth of which material will be removed or deposited: feet Proposed slope ttn:oughout the area of operations: (~ Mmmer in which material will be removed or deposited: Statement of[he effect, if any, on the we!lpds and tida! w~_ter5 pftl}e toxvn that may result_by reason of such proposed operations (use attachments if appropriate): pROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1 APPLICANT/SPONSOR 3.PROJECT LOCATION: Municipality ~ 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks elc -or provide map SEQR DESCRIBE PROJECT BRIEFLY: Initially acres [ . .~ Ultimately acres ' 8 WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~JYes [] No If no, describe briefly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) []Residential J~lndustrial J~Cornmercial [~]Agr[culture E]ParklForest/OpenSpace J~ Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, AGENCY (Federal, State or Local) ~JYes J~No yes, agency name permit approval: list and NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL 11~¥DOb~5 ANY~E~3T OF TRE ACTION RA~-'C13RRENTLY VALID PERMIT OR APPROVAL? J~JYes j'~No If yes, list agency name and permit / approval: 12 AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE '~f/"~ ~ ~''~" ~ Date: Applicantsignature l S~am~.~:~....~~/~ ~.~,--~t~--~.-~,~r ¢ ~/' 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 617.47 If yes, coordinate the review process and use the FULL EAF. B WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be han~wriflen, if ~egible) C1. Existing air quality, sudace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, polential 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 o~ fauna, fish, shellfish or wildiife species, significant habitats, or threatened or endangered species? E×piath briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensi~y at use o~ land or other natural resources? ~xplaia C5 GraPh, subsequent dovelop~enl~ or related actNifies likely to ge inducnd ~y ~he p[oposed action? Ex01ain Briefly: C6. Long term, shod term, cumulative, or other effects not identified in C1-C57 Explain briefty: C70~her impacts (inclndlng changes in use at either quantity or typo of energy? Explain briefly: D WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AR~A !~PAI? E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMEN~.A.L. IMPACTS? If yes explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed 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 sc~pe; and (0 magnitude. If necessary, add attachments or reference supportin9 materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed, tf question d of part ii was checked yes~he deter m!n~tion ef e!g nifi6e, nco m~m.t evalea,%qheoe!e~tie~im4~ct of th o p reposed ~,cfio a e~-th c c F, vir on~~i~ of [~EA' Check this box if you have identified one or more potentially la rge or significant adverse impacts which MAY occur. Then proceed directly to the FULl. EAF and/or prepare a positive declaration. Check fhis box if youhav~ (~etermin~d, based on the information and analysis above and any suppoding documeniationl thai ~he proposed action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons suppoding thi.~ determination. Name of Lead Agency Date Title of Responsible Officer Signature of Preparer (If different from responsible officer) Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Board of Trustees Application County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS T__JsIE 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 TOYVN 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. SWORN TO BEFORE ME THI 'S /~"~ DAYOF ,2odPF Notary Public APPLICANT/AGENT]REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics t~rohibits conflicts of interest on the part of town officers and employees. The nuroose of this form is to nrovide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name, first nam¢,~aiddl¢ inltial, unless you are applying in t~e name of someone else or other entity, such as a company, lfso. indicate the other p~rson's or company's name.t NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Coastal Erosion Change of Zone __ Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other", name the activity.)_ Do you personally (or through 3,our company, spouse, s bling, paren~ 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 pa/lnership, in which ~he 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 ~ If you answered '~YES", complele the balance of this form and date and sign where indicated. N amc of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicanUagenffrepresentative) and the lown 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 alt 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 a non-corporate entity {when the applicant is not a corporation); C) an officer, director, par~er, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submittechthis ! q day of ~. C) c~ 200 ~;r Sign at u r e ~ g~.----~ie¥~-- ~ zo~ ~ / N ~T CuT-c_HOd~uE G yv' ~ '/" E ~ S ~-~ p/s~. I000, 5¢c4:. lOq, B/~.T, P~r¢~l 1.3 ,~rnended t~at?. 24, 19~/ Land 5urv~or~ ~ Me~ york