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Home My WebLink AboutTR-7018A James F. ICing, 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 ¼ constructed i//""Project complete, compliance inspection. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 Permit No.: 7018A Date of Receipt of Application: December 5, 2008 Applicant: R. Polly Leider SCTM#: 94-1-9 Project Location: 1055 Sound View Avenue, Mattituck Date of Resolution/Issuance: January 21, 2009 Date of Expiration: January 21, 2011 Reviewed by: Trustee James F. King, President Project Description: To install a split-rail fence on the property with chicken- wire along the bottom. 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 Ken Robbins, and received on January 20, 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. Board of Trustees JFK:eac James F. King, President Jill M. Doherty, Vice-President Pegg~ 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: J Please be advised that your application dated~' --/-~ffc~OC(~., ~CC)~ has been reviewed by this Board at the regular meeting of -..~--o,~,c,to. rq o~z(, ~ and your application has been approved pending the completio~of th~ 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) __ ¼ Constructed ($50.00) '~/ 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: TOTAL FEES DUE: $.~() O-'~ BY: James F. King, President Board of Trustees 05/24/07 ll:27AM Ken Robins Custom Renova%ions 631 734 2650 p.02 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 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 Applicatio~ _--~Wetland Pennit Application l~ Administrative Permit Amendmentfrranst~r/Extension ece~ved Application: ompleted Application __.Incomplete __SEQRA Classification: Type I .... Type II__Unlisted ..... Coordination:(date sent). LWRP Consistency Assessment Form {;7AC Referral Sent: ~D_ ate of Inspection:ff_'~ P, eceiptofCACRe{;~ri?-' w ...... ___Lead Agency Determination: Technical Review: -l~iblic [Clearing I-le~i-_~t...~_ ~~ ~ Resolation: Name of Applicant Address / O Phone Number:( Suffolk County Tax Map Number: 1000 - Property Location: / (57 ~ ~ ?ffcgt) ,q~ q ~.a:x_7 _ (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: 5. 05/24/07 ll:27AM Ken Robins Custom Renovations of Trustees App 631 734 2650 p.04 Land Area (in square feet):__ Area Zoning: GENERAL DATA / Previous use of property: .... Intended use of property: Covenants and Restrictions: Yes "X No If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date ....... No prior pemfits/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): ' ti ll:27AM Ken Robins Custom Renovations 631 734 2650 of Trustees Applicat: p.03 WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: square feet Percent coverage of lot: o~ C~ % Closest distance between nearest existing structnre and upland edge o f wetlands:__~,._2~ Closest distance between nearest proposed structure and upland edge of wetlands: ............. feet Does the project involve excavation or filling? _._ x~/____ No ............ Yes If yes, how much material will be excavated? }.][o%v Ill[ich material will be lilled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in xvhich 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 operaticms (use htt~hmen~s if' app;c~prihtesi 06/24/07 Ii:27AM Ken Robins Custom Renovations 631 734 2650 of Trust~es Applicat p.05 AU~'HORI ZA~ION (where the applicant is not the owner) (print owrfer of property) (mailing ad~ress ) do hereby authorize.. ~ Agent to apply for permit(s) from the Southold Board of Town Trustees on my behalf ( Own-er' s -~gnature ) KATHLEEN E. ]{ICKHY ['<:) 0iH16055598 , Qt~:.hr:~ed in Bronx County ~[{ C,~mafi';sion Expires February 26, 05124/07 11:27AM Ken Robins Custom Renovations 631 734 2650 p.06 Board of Trustees Application County o f S u ffed4c--~ 6-~0 Z/C~ State of New York ~;"~ec~--~_~Z2 ~ ~ ~5 e')'~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERIMIT(S) AND THAT ALL STATEIv[ENTS 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 ViR_TLrE 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 TI-~i PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ' ' Sig i / S/DAY KATHLEEN E. HICKEY Notary Public, State of New York No. 0]H16055598 Qualified in Bronx County.~e,. Commission Expires February 26, .~/It 0S/24/07 11:27A~ ~n ~obins Custom R~nova~ions 631 734 26S0 p.07 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) 2. PROJECT NAME County 4 PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks elc -or provide map SEQR S IS PROPOSEB ACTION: [] New [] Expansioi~ []Modil~ca6on / alteration 6 DESCRIBE t:'ROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: 8 V~ILL PROPOSED ACTION COMPLY WITFt EXISTING ZONING OR OTHER RESTRICTIONS? L~Yes [~ No if no. describe briefly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~,~... Reside,,tial []Industrial F~Commercia, E~Agricui,ure []Park/Fores,/OpenSpace []O,her (describe) tO DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTNER GOVERNMENTAL AGENCY (Federal, State or Local) ]Yes E~?o yes, agency name and permit / approval; r~: DOES: AN'V~AsPECr-OF"TRE'-ACTION' ~VE A~'(~OR~AEID'-P~Ri~iT"O~ APPR~'~,L~ E~Yes ~o If yes, list agency name and permit / approvaL: 12 AS A RESULT OF PROPOSED ACTION WILL EXISTING PERivlIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED A~E IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / ~ Date: If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment 51TUATE-' HATFIT1JC, K TOi*IN, 5~T=OLK C, OUNT'f', 1'~ .',',',',',',',','~ R V E ¥ E P O5-10-O2 SUFFOLK bOUNTY TAX # IO00-q4-I-q N , ,&