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Home My WebLink AboutTR-7107A 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 ,~ st day of construction ¼ constructed Project complete, compliance inspection. SURVEY FOR PETER E~ DOROTHY MIGCICHE gt FRANKLIN E. ~t DOROTHY R. TOMPKINS AT B/IY VIEW TOWI~ OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE: I"'- eUAttANTEED TO: CHICAGO TITLE INSURANCE CO;~fPANY PETER E~ DOROTHYMICCICNE ~ FRANKLIN E. ~ lOVED OF Tkd,; 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.: 7107A Date of Receipt of Application: May 1, 2009 Applicant: Peter Micciche SCTM#: 78-6-4.1 Project Location: 270 Private Road #12, Southold · Date of Resolution/Issuance: May 20, 2009 Date of Expiration: May 20, 2011 Reviewed by: Trustee Peggy Dickerson Project Description: To replace collapsing cement block leaching pool with a new pool landward of the existing. 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 application prepared by Peter Micciche, and received on May 1, 2009. 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. · 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 Please be advised that your application' dated /'~v'//., ~ ~' has been reviewed by this Board at the regular meeting of /~,-~O., ~Q andyour application has been approved pending the comple~ion 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 PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 1197l Telephone: 631 765-1938 Fax: 631 765-3136 Jim King, President Town of Southold Board of Trustees From: Mark Terl3/, LWRP Coordinator Scott A. Hilary, LWRP Coordinator Date: May 6, 2009 Chapter 268, WATERFRONT CONSISTENCY REVIEW Administrative permit for PETER MICCICHE SCTM#78-6-4.1 PETER MICCICHE requests an Administrative Permit to install (further landward) 1-4 x 8' leaching pool to replace collapsing block leaching pool. Located: 270 Windy Point Lane, Southold. SCTM#78-6-4.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to us, it is our recommendation the proposed action is CONSISTENT with LWRP policy standards and therefore is CONSISTENT with the LWRP. In the event that the proposed action is approved, the following (BMP's) Best Management Practices are recommended: 1) Locate the new leaching pool as far back from the wetland boundary (bulkhead) as practicable. 2) Install a line of hay bales seaward of the proposed action as an erOsion control measure to retain runoff sediments during excavation and installation. 3) Require hay bale line to remain until the disturbed lawn (ground area) area is reestablished. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob ~no~io, 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 Application,, Wetland Permit Application v~ Administrative Permit Amendment/Transfer/Extension _v/_~Re ceive d Application: // Received Fee:$ .5~)~5' ' ' Completed Application Incomplete SEQRA Classification: Type I Type H Unlisted__ Coordination:(date sent) 4~LWRP Consistency Assessment Form~-/(/ CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Property Location: (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: of Trustees Applicatio~ Land Area (in square f~t): Area Zoning: ~ ¢ ,~R Previous use of property: Intended use of property: GENERAL DATA Covenants and Restrictions: Yes ~ No If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date __ No pr/or permits/approvals for site improvements. Has any permiffapproval ever been revoked or suspended by a governmental agency? X, No Yes If yes, provide explanation: Project Description (use attachments if necessary): rd of Trustees Applicatio~ WETLAND]TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: /"-~//~ c -~ ///~ c/( Area of wetlands on lot: '~- square feet Percent coverage of lot: -'~-~ % Closest distance between nearest existing structure and'upland edge of wetlands: -7 ~'- feet Closest distance between ne.~.~gst proposed structure and upland edge of wetlands: 7,~ feet Does the project involve excavation or filling? No 'X Yes If yes, how much material will be excavated? / ~2_ cubic yards How much material will be filled? ' ~/ cubic yards 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: feet fitatement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such prop~d-~p~rati~n-s ~use- PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART '1 - PROJECT INFORMATION ( To be completed by Al: ~licant or Project Sponsor) 1. AP~PIz~(NT / S PONS(~R 2. PROJECT NAME 3,PROJECT LOCATION: 4. PRECISE LOCATION: Sffeet Addess and Road Intemecaons, Prominent landmass etc -or provide mad ~. ~s PROPOSE9 ACTION: ~ ~.w ~ ~p~n~ion ~Modi,ca,o./~,~t~on SEQR 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? r~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Residential []Industrial E~]Commercial [~Agdculture [I]Park/Forest/OpenSpace E~Other (describe) 10.'DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) E~Yes ~JNo If yes, list name and / agency permit approval: ll.U[JE;5 ANY A~FE(;r UP IHE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? i-~Yes ~]No If yes, list agency name and permit I approval: I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor N/~. :~..~ ': 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 ~o 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 EAF. ['-'lYes E~ 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 inv01ved agency. F-~ Yes E~No c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be han~,writtsn, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for emsioo, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, amh'~"~eological, hisioric, or other n"~~turat or C3. Vegetation or fauna, fish, shelh'ish or wildlife species, significant habitat~, or threatened or endangered *pecies? Explath b~efly: C4. A community's exisling plans or goals as officially adopted, or a change in use or intensity of use 6f land or other natural resources? Explain briefly: 1 C5. Su equent devslepment, or related acbwbes hkely to he ~nducod by the proposed ac§on? Explain br~e~y C6. Long term, short term, cumulative, or other effects not identified in CI-C57 Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF ENVIRONP E~Yes E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? E~Yes E~NO PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantiaI~~arge~imp~rtant~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (La. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detsil to show that all relevant adverae impacts have been identified and adequately addressed. If question d of part ii was checked ~,,ee, the d _~t~_rm!.-.at!c.-, cf s!?,.".!.r.'e= ~ ce muct cvcJu3tc 5hc pctc~ie~i mpcct cf thc pre. Fcc. cd ¢. cUc ~, cP, thc cr'r4rc~,~,,c.~,~: ch~racteF;~c.~ ,.,f Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directiy to the FULL FAF and/or prepare a positive declaration. '- ~;~ ~h~s box if ~Eh~v~6~6~Tned; ~sea~)h the ]~f~r~ti0n and ~r~aly~is ~b0ve a~ a~ WILL NOT resuE in any significant adverse environmental impacts AND provide, on attachments as necessa~/, the reasons suppeding thi~ determination. Name of Lead Agency Date Title of Responsible Officer Pdnt or Type Name of Responsible Offmer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) of Trustees Applicat~n County of Suffolk State of New York "~e'~-~ cc M I c ~ t ~¼ e. BEING D~Y 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 HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE 1N 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), I1· 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 I~'- DAYOF /'~Q~z/ ,2oOq 0tlota~y Public ~ard of Trustees Applicat~ AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at 9q ~4~UD~ (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 prohibits conflicts of interest on the oart of town officem and employees. The nurooso of this form is to erovide information which can alert the town of vossible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name,r~iddle 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 Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (1 f"otber', name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee oftbe Town of Southgld? "Relationship" includes by blood, man'iage, or buginass 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 ~ 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 applicant~ngent/representative) and the t~wn officer or employee. Either check the appropr ate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, o~' child is (check all that apply): __:A) th~ owner of greater than 5% of the shares of the corporate stock of the applicsnt (when the applicant is a corporation); B) tlc legal or 'beanfieial owner of any interest in a non-corporate entiW (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted thj,~9~__~y of ,~ ,,~r~ 200 ~ Si~ature ~ ~ff/C~f~ Print N~e ~" ~t ~ I ~ ~ 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 of Southold Waterfront 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 this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suooortin~ facts. 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 (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION scm# -:,g - / The Application has been submitted to (check appropriate response): Town Board [] Planning Board ~ Building Dept. ~-~ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Location of action: Site acreage: Present land use: Present zoning classification: (b) Mailing address: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name ofapplicant: ~ff.~/r~ (c) Telephone number: Area Code ( ) /~o..~/ 2~ S / (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes F-] No [-~ If yes, which state or federal agency? C. Evaluate the project to the following polici6s by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. 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. Sec LWRP Section III - Policies; Page 2 for evaluation criteria. Yes F~ No J~Not 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 Yes No'or Applicable 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 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.--~ f ~ Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 th.r~,ugh 21 for evaluation criteria 7] Yes ?3 No~X~ot 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 Not Ap~ble Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southoid. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes [] No'or 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 ~¥es ~ ~,o [] ~,ot Applicable/~r,~/I, ~ 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. Attach additional sheets if necessary WORKING COAST POLICIEO 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 ~,xNot Applicable Attach additional sheets fnecessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconie Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~ Yes ~'~ N~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~ot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~'] Yes ~ No [~Not Applicable TITLE