The URL can be used to link to this page

Home My WebLink AboutTR-7119A James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosf. o, 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 V/' 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.: 7119A Date of Receipt of Application: May 29, 2009 Applicant: Henry Kaminer SCTM#: 90-1-9 Project Location: 250 Midway Road, Southold Date of Resolution/Issuance: June 24, 2009 Date of Expiration: June 24, 2011 Reviewed by: Trustee Peggy Dickerson Project Description: To trim the phragmites to 12" 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 site plan prepared by Henry Kaminer, and received on May 29, 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. F. King, l~'resident 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 /?~-¢,~¢), ~ ~ has been reviewed by this Board at the regular meeting of 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) ~ Constructed ($50.00) Final nspection 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 James F. King, President Jill M, Doherty. Vice-President Peggy A. Dickerson Dave Beqgen Bob Ghosio. Jr. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~///~///5 q HENRY KAMINER requests an Administrative Permit to trim the phragmites to 12" by hand, as needed. Located: 250 Midway Rd., Southold. SCTM#90- 1-9 ,Typ~of area to be impacted: ~./Saltwater Wetland Freshwater Wetland Sound Bay Distance. of proposed work to edge of wetland. Pad/of-fi'own Code proposed work falls under: XJS'hapt.275 Chapt. 111 other Type of Application: c~Wetland __Coastal Erosion ._Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: J.King J Doherty ~P.Dickerson __ D. Dzenkowski Scott Hilary__other Form filled out in the field by D. Bergen__ B.Ghosio, Mailed/Faxed to: Date: 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 Application Wetland Permit Application W/' Administrative Permit Amendment/Transfer/Extension ~ece~ved Application: u/Received Fee:$ ~0" ~Completed Application ~1 Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent). LWRP Consistency Assessment Form CAC Referral Sent: ....-Date of Inspection: ~ [ I Receipt of CAC Report: Lead Agency Determination: Technical Review: ...~ublic Hearing Held: Resolution: Name of Applicant ->d,z ~cSL~ 32/ PhoneNmnber:~/) 7dff Suffolk County Tax Map Number: 1000- ~ 7' ~g~e[ _ Property Location: a,~ rx&~,,,¥ /~o,a~; ,fa Wexgc~',~/ i~*^~- Ar 3,~xt~-"~o~.¢ ~,¢ (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: 3oard of Trustees Applica~ Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: GENERAL DATA Covenants and Restrictions: If "Yes", please provide copy. Yes No ; Prior permits/apProvals for site improvements: Agency Date __ 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 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: '~-~c/ ~:~/]<~_. fo/f~-//97~:' Area of wetlands on lot: square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project~volve excavation or filling? If yes, how much material will be excavated? ~]//~ cubic yards Howmuchmaterialwillbefilled? ' fi"J//~ cubicyard~// Depth of which material will be removed or deposited: }~J ~ Proposed slope throughout the area of operations: ~ ~4 Manner in which material will he removed or deposited: feet Statement oft~? e_f~ec_t, if ~'0n the w~t_!_a~n~ds and_tid~! w~ters olde. town tha_t.¢ay resu!t_~7 _ reason of such proposed operations (use attachments if appropriate): ./ PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR, 3.PROJECT LOCATION: Municipality 4. PRECISE LOCATION: Street Addes~ and Road Intersections, Prominent landmarks etc- or orovide ma~ 617.20 APPENDIX STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 2. PROJECT NAME County ~1~ ~ l/ 5. IS PROPOSED ACTION: [] New []Expansion r~Modification/afleration 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. I~/ILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes L~ No tf no. describe briefly: .~_'HAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential []industrial r~commercia, [~]Agriculture [] 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) [~]Yes r~No If yes, list name and permit / agency approval: 11.UUE5 AN'( A;SP'E. CI OF IHE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? "--]Yes r~No If yes, list name and permit / agency approval: ~2. As ^ RESULT OF PROPOSED ACT,ON W,LL ~X,ST~.G PERM,T! APPROVAL REQU,RE MOD,F,CAT,O.? I~es I--INo I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponso~ 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 FUI~L EAF. [~] Yes 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 involved agency. F-'] Yes ~No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be hanawritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: I_ C2. Aesthetic, agricultural, amhaeological, historic, or other natural or cultura~ resources; or community or neighborhood character? Explain bhefiy: C3. Vegetation or fauna, fish, shelffish or wildlife species, significant habitais, or threatened or endangered species? Explain briefly: I C4. A community's existing plans or goals as officially adopted, or a change in ~e oi *int~i*ty of use of land or other na ufa resources? Explain' bnefl~* ".' C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Longterm, shortterm, cumulative, or other effects not idengfied in C1-C5? ExplainbHefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAl ENVIRONMENTAL AREA (CEAI? ~lf ~es, explain bdeti¥: E. tS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? f yes ex~lain: 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) probabilibj 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 detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked ye-~, the d e!erm!~_-.5on efc!gn!ficcnca must cva~uctc th c 7.ctc~,~cl ~mpcct cf thc, prcFcc,cd c,ct~o n on thc, cfiv[ronmanta', c,~sra,.;~, ;o;;,~ of fha C~.A. 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 FULi EAF and/or prepare a positive declaration. (~;~ec)~ this b~i~'y~-I~ave cl~'~(JI based'o-n'{fi~ ~orm:~tion and ~nalysis above and any suppo~tin~ documentation, that th~-I~rop~ WILL NOT result in any signif'mant adverse environmental impacts AND provide, on attachments as necessary, the reesons supporting 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 Applilion County of ShlTulk ~o Yo'~7.~ State of New York ~ ENR~ ~4 ~ ,~ t-~ BEENGDULY SWORN DEPOSES ~ ~F~S THAT ~/S~ IS T~ ~PLIC~T FOR T~ ~O~ DESC~ED PE~T(S) ~ T~T ~L STATE~NTS CONT~D ~ ~ TR~ TO T~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ T~T ~L WO~ ~L BE DO~ ~ T~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOU~OLD TO~ BO~ OF TRUSTEES. T~ ~PLIC~ AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSTEES ~ESS ~ F~E FROM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~RT~ OF S~ PE~T(S), ~ G~TED. ~ CO~LET~G ~S ~PLICATION, i ~BY AUTHO~E T~ ~US~ES, T~ AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~TH ~W OF ~S ~PLICATION. Signature Not~ Public .I APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE. FORM Thc Town of Southold's Code of Ethics orohibits conflicts of interest on thc oart of toWn Officers and emolovees. The ~umose of this form is to nmvide information which can alert the town ofoossible eonfficts of interest and allow it to take whatever antion is necossarv to avoid same, (Last name, first name,~niddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indieat~ 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 If you answered "YES", complete the balance of thls form and date and sign where indicated. Name of person employed by the Town of Soutbeld Title br position of that person Describe the relationship between yourself(tbe applieanffagent/representative) 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): A) the owner of greater than 5% oftbe 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 entit~ (when the applicant is not a corporation); C) an officer, director, parmei', or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this ~Taayof t~ta)~ 200 _~ Signature - ~b/.~---~ ~ Print Name .14 ~'~ I~)t I~/I ~ t A/ t~/~_ / / APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE