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Home My WebLink AboutIavarone, Joseph 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 August19,2009 Ms. Carol Baumann 325 Wood Lane Peconic, NY 11958 Re' JOSEPH IAVARONE 405 WOOD LANE, PECONIC SCTMft86-6-4 Dear Ms. Baumann: Enclosed is your refund check in the amount of $50.00, which is represents the application fee Paid on behalf of Joseph lavarone for an Administrative Permit. The application has been withdrawn, as per your request. Sincerely, Lauren M. Standish, Secretarial Assistant Board of Trustees TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES P.O. BOX 1179 SOUTHOLD. NY 11971 Carol Baumann August 19, 2009 50-666-214 Fifty dollars and 00/100 ........................................... ~O~ Re fund-Iavarone ,~.~ ~7 cTT)~ "'OOl, 08;h[' 'I02~hO&g~?': OSOOO~S?Oh,' James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob ~nosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office UseOnly __Coastal Erosion Permit Application Wetland Permit Application ' __ . )~ Administrative Permit / Amendmentfrransfer/l~xtens~on ~Rece~-vved Application: ~ I q]Oc/ t/Received Fee:$ ,~ c~' ~. ~./Completed Application ~/q~O q Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent). LWRP Consistency Assessment Form CAC Referral Sent: ~'Date of Inspection: q !q lOCI Receipt of CAC Report: __Lead Agency Determination:__ Technical Review: ~45~blic Hearing Held: q I.d~[OR __Resolution: Name of Applicant Address Phone Number:( ) .'516, - 6, g) '4 - OG,'?[¢ Suffolk County Tax Map Number: 1000 - Property Location: /qO~" io,5c>oct (provide LILCO Pole #, distance to cross streets, and location) AGENT: O_gM'LoC--' (If applicable) Address: ~-qS- t_~oo Phone: of Trustees Applicat] GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: Covenants and Restrictions: Yes ~ No If "Yes", please provide copy. 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 Has any permit/approval ever been revoked or suspended by a governmental agency?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: ~oject Descoption (use attachments if necessary): ~ard of Trustees Applicat' WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ~O ~c~ c~.3 O~op~c~ Area of wetlands on lot: b3~ Mo~ 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 involve excavation or filling? X 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 d~osited: cubic yards cubic yards feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by_ ~as0n of ~Uc~fi~prop~d- ~p'~i-ati~n-s- ~t~s~~ ~it~el~S ii~ ~ppiz0p~i~it~}~- PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT ~ 3.PROJECT LOCATION: Municipality 6'17.20 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 4. PRECISE LOCATION: Street Addess and Road InterseclJons, Prominent landmarks etc -or provide mad SEQR ' 5. is PROPOSED ACTION: [] New [] Expansion DESCRIBE PROJECT BRIEFLY: r-]Modification / alteration 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~Residential [~lndustrial [---]Commercial E~Agriculture E~] 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 [--~No If yes, list agency name and permit / approval: 11. L)Ut::5 ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes ~"]No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~Yes ~7]No CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE /~ponsor ~~rea, Date{~.. ~?~ 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 617.4? If yes, coordinate the review process and use the FULL EAF. [-'"~ Yes ~No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative dectarabon may be supemeded by another involved agency. I--IVes i 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 b'affic pattem, solid 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 or intensity of use et land or other natural resources? Explain briefly: C§. Growth, subsequent development, or related activities likely lo be induced by the proposed action? Explain briefly: C6. Longtenn, shortta~m, cumulative, or other effects nct identified in Cl-C5? Explainbrietiy: C7. Other impacts (including changes in use of either ~uant!~ or type et eaergy? Explain briefly: D. WiLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTALAREA CEA ? I[f es explain bpefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~detorminewhetheritissubstantia~~~arge~imp~rtant~r~therwisesignificant~ Each effect should be assessed in connection with its (al setting (i.e. urban or rural); (bi probability of occurring; (c) duration; (d) [rreversibility; (el geographic scope; and (f~ magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that ail relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked ~,'-~., th-~ det-~rm!~-~!!c~ cf =!g~!.r.'c3~ nc o-re, ,u¢t cvc,~uctc th c pctcet~cl ~mpcct cf thc, prapcc,cd c,cficn cn thc c~,v~rc~,m~nt~', Check this box if you have identified one or more potentiallylarge or significant adverse impacts which MAY occur. Then proceed direct~ to the FULl EAF and/or prepare a positive declaration. (~h e ~..~'~h~ box if yo~have ~ ei~l~-~ ~[se~he i~for~ation an~l ~aiysis above an(~ an~; ~u~po~Jn~' do(~u~ent~tion, t~¥ ~'{e-~;'dp~ ~'~o~ WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi= determination. Name of Lead Agency Date Title of Responsible Officer Signature of Preparer (If different from responsible officer) Pdnt or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Board of Trustees pp ication County of Suffolk State of New York ,,.To rr/J ~Z-~-~. ~ BEING Dray m, os~.s ~ ~FnmS THAT HE/Sm IS Tm APPLIC~T FOR THE ~OVE D~.SCmEI~ PEmT(S) ~ T~T ALL STATEmNTS CONT~.r~r~D 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 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. ~- ,20o~ SWORN TO BEFORE ME THIS M~ BALarY ublic Notary Public, State of NY No. 01D06144136 Qualified in Nassau County Commission exp,ms ~',~cil 24, 2010 ~oard of Trustees Applica~ AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at %~-o ~6~h=~C~c~+ (mailing address) do hereby authorize to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (~er s signature) 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the cast of town bfficors and emnlovees. The ourooso of this form is to rmv de information which can alert the town of oussible conflicts of intere~ and allow it to rake whatever action is ss to void same, VOURNAME: OOa . Co c o t... , (Last name, first name, middle'initial, unless you are applying in the 0amc of someone e s~ or other entity such as a company. If an, indicate thc other person's or company's name.) NAME OF APPLICATION: (Cheek 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 thc Town of Southold? "Relationship" includes by blood, marriage, or business interest "Business interost~' means a business, including a partocrshlp, in which the town officer or employee has even a partial ownership of(or employment by) a coq)oration in which the town officer or employee owns more than 5% of the shares. YES NO ~/ · ' If you acswered "YES", complete the balance of this form and date and sign where indlc~ted. Name of person employed by the Towu of Soothold Title Or position of that person Describe the relationship between yourself (the applican~/agcnt/represe ntative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in thc space provided. The town officer or employee or his or her spouse, sibling, parent, o~' child is (check all that apply): A) tho owner of greater than 5% of the shares of thc corporate stock ofthe applicont (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (wh~t~ thc 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 I Submitted thi.~. ~ day of_ t[3~cq~ ~- $'~'- 200 ~ Signature (._~_~. /~e.,,.. PrintName ~.P¥O..o~.~ ~6~_,*.~,.1~ James F. King, President Jill M. Doherty. Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio. Jr. P.O. Box I 179 Southold, NY 11971 Telephone (63 l) 765-1892 Fax (63 I) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: JOSEPH IAVARONE requests an Administrative Permit to install a gate on the south side of the dwelling; install a 5' high wire fence on the north side from the corner of the dwelling to the dock; and create an impervious walkway from the corner of the front porch to side yard to rear porch. Located: 405 Wood Lane, Peconic. SCTM#86-6-4 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: __J.King __J.Doherty __P.Dickerson __ D. Dzenkowski other Form filled out in the field by D. Bergen__ B.Ghosio, Mailed/Faxed to: Date: DUP-.VE¥' NO. 7~ I i i 4 feet aeep TAX LOT 29 LEN1-ZEP,.E5 HOUDE C. ONNECT~D TO PUBLIC WA'TEA TAX LOT ,3 I .~IMON FA~dlL¥ HOU~P CONNI~CTED TO FUDLIC WATI~R '---- I='ROVIDE I0' NON-TURI= BUff-ER ALONG IDULKI"fffAD '. ~;:XJ~D FLOOD ~E ~Vl~ UNE I PATIO __ ~ TO DE / TAX LOT O I.ANG F~'II L¥ t'tOUS, E CONNECTED TO PUBUC WAT[P., NEW HOME I~UILT CONNEL..icu/TO pU~,IJC WATER cO~ McDONALD C.-~:~JCIENCE TOPOGRAPHIC 5UP-.VL~' Of PROPEKTY PECONIC TOWN Of 50UTHOLD 5UPffOLK- COUNTY, N.Y. HAYNES LAND SURVEYORS