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Home My WebLink AboutTR-6194AAlbert J. Krupski, President James King, 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) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6194A Date of Receipt of Application: Aug.5, 2005 Applicant: Samuel and Anne DeLuca SCTM#: 78-2-31 Project Location: 1350 Glenn Road, Southold Date of Resolution/Issuance: August 24, 2005 Date of Expiration: August 24, 2007 Reviewed by: Board of Trustees Project Description: Administrative Permit to replant bluff area with native vegetation, handcut Phragmites to 1' as needed, trim boat ramp area with no cuffing of Spartina alterniflora, as per plans surveyed by Peconic Surveyors approved August 24, 2005. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. Special Conditions: None. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Albert J. Krupski, Jr., President Board of Trustees Albert & I<rupski, President James King, 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) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Offiee UseOnly Coastal Erosion Permit Application __Wetland Permit Application ~'"'Administrative Permit Amendment/Transfer/Extension ,,"~k~c ~ d Application:~_ "~eceived Fee:St~ ~-----tgompleted Application~.,~_ ~Incomplete __SEQRA Classification: Type I Type I! Unlisted -~LCwRprdination:(date sent) Consistency Assessment Form ~ [ ~1~ _,~_CAC Referral Sent: ~ate of Inspection:~~_ Receipt of CAC Report: Lead Agency Determination: ~_Technical Review: ~"l~'~lic Hearing He~ __Resolution: Name of Applicant Address Suffolk County Tax Map Number: 1000 ~ Property Location: ~O O '[ ~ 0 t~ f~ PhoneNumber:{~.~g ~- 7~.~- ~.~q 0 7~'- o~- g / (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: >ard of Trustees Applica~ GENERAL DATA Land Area (in square feet>:, t>9'~,t q q9 g~>, Previous use of property: ~ ~'$ I I~ ~ ~J "'FI 'tar L Intended use of property: Prior permits/approvals for site improvements: Agency $o o'r~4ot, t) __ 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):. ~ard of Trustees Applicat, WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: /)~ t'~ ~'g'~,~-t4~- ~ ~ I= Area of wetlands on lot:~l~OX.~gr~ square feet Percent coverage oflot:_~f,~,~./0 % Closest distance between nearest existing structure and upland edge of wetlands: ~'7 feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? */ 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 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): PROJECT ID NUMBER SEQR PART t - PROJECT INFORMATION 1. APPLICANT / SPONSOR 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 County ~* ~/F ~"O L f~, 3.PROJECT LOCATION: Municipality 4. PRECISE LOCATION: Street Addess and Read IntersecUons, Prominent landmarks etc -or provide mad 6.1S PROPOSED ACTION: [~New [~Expansion [--]Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: ~l~Jl~~ ~ Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? L--JYes [__J No If no, descdbe briefly: 9. WHAT iS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose asmanyasappiy.) [~Residential r~ Industrial ~-'-] Commercial [~Agriculture r'~ Park / Forest / Open Space [~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) r-'-~Yes ~'1~o if list name and permit / approvak yes, agency 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? r'~Yes E~o if list name and permit / approval: yes, agency 12~ AS A RES[,~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E es 'No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE iS TRUE TO THE BEST OF MY KNOWLEDGE Applicant ' Sp~sor Name ~ ~.~ . Date: 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 A~lenc~/) 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 [---]Yes [--'1 No 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. r-]Yes r~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 traffic pa[tern, sctid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, amhaeological, historic, or other natural or cultural resoumes; 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: C4. A community's existing plans or goals as officially adopted, or a change in use o~ intensity o~ use of land or other naiural 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 identified in Cl-C57 Explain bdefiy: C7. Other impacts fincludin~ chan~es in ~se o[ ~!!be[ Cl~?~!it~ o~ [~/~ ~!.¢n~-~/~ ~xp ~ ~ ~ri~fiy _ t D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ~? l!~ ~/e~, ~xP!ai~ bd~fi~: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If },es explain: E~TM E~]No - ' PART III · DETERMINATION OF SIGNIFICANCE (To be comptated by Agency) INSTRUCTIONS: F~reachadversee~ectident~~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesigni~cant~ 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 (t) 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 yes, the determination of significance must evaluate th e potential i m pact of th e proposed action on th e environmental chara cteristics of the C EA. 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 documentation, that the proposed actio 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 Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Board of Trustees Application County of Suffolk State of New York ~ ~ IF/,, O 6 L.- be ~.,{J~ ~ '~ ~ &'gd~ ~)g L F~,~E1NG 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 FIlS/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 WIT~ VIEW OF T .APP~ION. - Signature SWORN TO BEFORE ME THIS ]WD DAYOF ~ ,20~90"' JoANN JAHNCKE Nota~/Public, State of New No. - 01JA5030898 Oualifled in Nassau Counly Commission Expires July 25, · APPLICANT/AGENT/REpRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the van of town officers and emnlovees. The nurcose of this form is to nrovide information which can alert the town of ~ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. ¥OURN E: be&ve (Last name, first dame, ~niddle initial, unless you are applying in the ngune 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 Trustee ~ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning 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 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 t~' If you 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 applicantIagent/reprosentative) 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): __:~) 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, partner, or employee oftbe applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submittedthis t.~ dayof_ ~j¥.~t/%r 200 .~ PrintName~-~ ~L~ ~ Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town ofSouthold Waterfi'ont Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on tiffs form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, tnodified prior to making a detemtination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website :al (soutboldtown.nonhfork.net), the Board of Trustees Officef~ libraries and the Town Clerk's office. DESCRIPTION OF SITE AND PROPOSED ACTION AUG -5 S0uth01d Town Board of Trustees [~ Planning Dept. [-~ Building Dept. [--] BoardofTrustees [~ SCT # q D :4 Si The Application has been submitted to (check appropriate response): Town Board Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, plalming activity, agency regulation, land transaction) (b) Financial assistance (e.g. grantl loan, subsidy) (c) Petanit, approval, license, certification: Nature and extent of action: Location of action: Site acreage:~ff Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: ) (c) Telephone number: Area Code ~$ t '- 7~ -%~ -- ~ q 0 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ No ~ If yes, which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. Yes [-~ No [---~ot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Sonthold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~ Yes ~-~ No ~'/Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria Yes No [~Not Applicable A~ach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section Ill -Policies Pages 16 through 21 for evaluation criteria Yes [~ No [~Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes ~ No V~ot Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~-] Yes ~ No ~ot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [-~ Yes ~ No [~Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes [~ No ~N~Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [--] Yes [-] No ~ot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Pecouic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 forevaluatmn' criteria.' ' [] Yes ~ No ~Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ~-] Yes [~] No ~'~Not Applicable Attach additional sheets if oecessary Policy'13. Promote appropriate use and develop~nent of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~ Yes ~ No ~Not Applicable Created on 5/25/05 11:20 AM IV DATE H S. R~F. NO. tw.,.~, n~-~-. -I~ ,.,wi /7/ shown hereon are from field observations and or from data obtained from others. ~..0~ ~ 05 ~ ~ ~ .~ q/s~ ~ /.~ ,~ I ( VACANT LOT 15 MAP OF "WES T CREEK ES TA TES" FI~ED AUGUST 19, .1963 FILE NQ 3848 A T SOUTHOLD TOWN OF SOUTHOLD ,SUFFOLK COUNTY, N Y. 1000 78 02 '31 -- -- March1, 1991 APRIL ~ 1991 AREA = 22,999 Aug. ~91 /~- f''~ /"'~'~ No~. ~I (found) A~i120,1994 (fin~) . ;ONIC ~RVEYORS, P.C. ') 785 - 5020 ). BOX 909 N ROAD JTHOLD. N Y. 11971 49618 Prepared in accordance with the minimum The water supply ~nd sewage disposal standarde for title eurveys ae 'establiehed systems for this residence will conform by the L.I.A.L.S. and al~oroved and adopted,to the standards of The Suffolk County for euch use b~y Th~ New York State Lane Department of Health Services. Title Aeeocietion. TIE L/NE ALON( ORDINARY HIGH WATERMARK cREEK AS PER FILED MAP wEST BEV!SE2) ~TIC SYSTE~ 9-/I-~/