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HomeMy WebLinkAboutRamon, BarbeOctober 14, 2005 Re: Pre-submission Inspection Arm: Lauren Standish I am requesting a Pre-submission Inspection to be conducted on my property, 480 Rabbit Lane, East Marion, tax map number, 473889 31. -18-9. As discussed, this inspection is to occur on November 9~, 2005. I am interested in determining whether this property is "build able" or the Trustees "jurisdiction" of this property. Enclosed is a $50 check for the application fee. Thank you for your help. ~/Sincerely' ~1~ 369 GARDEN STREET EAST MEADOW, NY 11554 PHONE #516-582 7966 10/13/05 11:27 FAX 516 222 ~Kinko's. KINKOS Fax Cover Sheet ~]001 FedEx Kinko's of Garden City Date Name Company Tele. phone Fax Telephone: 516.222,9351 Fax:516.222.2938 Number of pages ~ {including cover page) From: Name. ~;)~ Company Telephone Comments More than 1,;[00 locations worldwide. For the location nearest you, calf 1.800.ZKINKOS. Visit our website at fedexkinkos.com, 10/1~/0~ 11:27 FAX ~1~ 22 18 KINKOS ~002 ........ 10/13/05 11:28 F~AX 516=__ 2~0~S --S~m' TO'VVN OF' OUTHOL,.D. '~f~'ICE~TION: ' IDATED ~L PROPER~ ~AX :~ ~.73889 31.-~8-9 [~003 3642 400 RABBIT LA 313 I,,,Ih,.Ihl,h,l,l,,I.h,hll,h,ll,..Ih,,ll.,I,h,,,I.II *************AUTO**3-DiGIT 1 '1 ~ Ramon Barbe 369 Gard~ Street East Meadow, NY 11554-2906 Ramon Barbe 13.16 Oct. 13,2005 Field Oct. 13,2005 Field Inspectie Oct. 13,2005 Field Ins 10/13/05 11:30 FAX 516 222 2~ KINKOS O04 GARDINER$ SURVE¥ OF PR OPER T Y AT EAST MARION TOWN OF $OUTHOLD SUFFOLK COUNTY, N.Y. I000 - ;9I o 17 - {I Scale I" = 30' June 23, I988 10/13/05 11:30 F~[ 516 222 KINKOS l~005 ,( '1 , ~ ~1~ ~lfll. / ---.~.,i.,,:,-.~=,?~_~- ..... ! · Albert J. Krupski, President James King, Vice-President Attic 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 Office Use Only Coastal Erosion Permit Application __Wetland Permit Application Amendment/Transfer/Extension Received Application: Rec, eived Fe~e,~ ~lSlicatio~, Type I__Type II Unlisted __Coordination:(date sent) ___LWRP Consistency Assessment Form CAC Referral Sent: __Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Administrative Permit Name of Applicant ~'~\-~ ~. 0,,~X~ Address '9_~q ~.~ ~.~ ~ Phone Suffolk County Tax Map Number: 1000- Dir~a~:l' :~[.'-~'-~. Property Location: ~12~ ~-~2t~¥3'\\ ~t_L~... (provide LILCO Pole #, distance to'ross ~treets, }md location) AGENT: ...~rff '~3\'~Dcz~ihlce. (If applicable) ' ~ Address: Phone: Board of Trustees Application GENERAL DATA Land Area (in square feet): .~)['7) ~Cht Area Zoning: ~.~ ~\~9~'X~ ~_,_~ Previous use of property: ~C~\q Intended use of property: Prior permits/approvals for site improvements: Agenqy__ D~te __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen3led by a governmental agency? ~/ No Yes If yes, provide explanation: Project Description (use attachments if necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: .?x3OfX~f-~Q ~D~O ! (~Ca2_ Area of wetlands on lot: '-~ square feet Percent coverage of lot: \t~lq % Closest distance between nearest existing structure and upland edge of wetlands: N I.{5~ feet Closest distance between~n, garest proposed structure and upland edge of wetlands: ~ feet Does the project involve excavation or filling? V/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): Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No ~/r Yes Does the project involve excavation or filling? V/No Yes If Yes, how much material will be excavated? _(cubic yards) How much material will be filled? .(cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) IPRoJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only SEQR PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. APPLICANT / SPO~J.SOR 12, PROJECT NAME )~("~ County Municipality PRECISE LOCATION: Street Ad'ess and Road Intersections, Orprominent ~andmarks etc - provide 5, IS PROPOSED ACTION: [~ New [] Expansion [] Modification / alteration 6, DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED' Initially acres 8. PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes [] No If no, describe bdefly: 9. W AT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as manyas apply.) ~Residential E~lndustdal E~c°mmercial ~]Agriculture [] Park / Forest / Open Space E~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, A[~NCY (Federal, State or Local) Yes E~No If yes, list agency name and permit / approval: NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL 11. DO S ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Y~s E~No If yes, list agency name and permit / approval: 12. AS A R~NLT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? MY KNOWLEDG ~ CERTIFY THAT THE ~NFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF Date: / Sponsor Name 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 Af)ency) A. DOES ACTION E ED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. B. WiLLACTiON RECEiVECOORDiNATEDREVIEWASPROV~DEDFORUNLISTEDACTIONSIN6NYCRR. PART617'67 IfNo, anegative declaration may be superseded by another involved agency. C. COULD ACTION RESULT'IN~Y ADV~E~SE ~:FI~ECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwdttsn, 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; . / C2..~e~'~hefic, agricultural, archaeological, historic, or other natural or cultural resources; 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 communiiy's existing pians or goals a~ officially ad0Pied, o~ a change in use or intensity of use of land or other natu a · p Y: C5. Growth, subsequent development, or related activities iiJ~ly to be induced by the proposed action. Explai y: C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: CZ. a use of either c WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA/CEAI? Ill ~'es, explain briefly: E IS THERE, OR I~ THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If }/es explain: PART Ill - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: Foreachadveraeeffectidenti~edab~ve~determinewhetheritissubstantia~arge~imp~rtan~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 (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that a~l relevant adverse impacts have been identified and adequately addressed. If question d of par ii was checked yes, the determination of significance must evaluate the potential i m pact of the proposed action on the environmental characteristics of the CEA. LI Check this box if you have identified one or more poten iai y large or slgnlticant adverse impacts wh ch MAY occur. Then proceed directly to the FU 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 acrid WILL NOT result in any signiflcent adveme environmental impacts AND provide, on attachments as necessary, the reasons suppoding thi.< determination. Name of Lead Agency 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) NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: YOU ~ HE.BY G~EN NOTICE: 1. That it is the intention of the undersized to request a Pe~it from ~e Bo~d of Trustees 2. That the properly which is the subject of Environmental Review is located adjacent to your property and is described as follows: ~O12c2L~ '~ ~-~O~t ~O~TL~ 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. MAILING ADDRESS: PHONE #: Enc: Copy of sketch or plan showing proposal for your convenience. SUR V£Y OF PR OPER T Y A T EAST MARION ]'OWN OF $OUTHOLD SUFFOLK COUNTY, N.Y. 1000 - 3I- 17- Scale ~" = 30' Juno 23, 1988 GA RDINERS BAY PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: STATE OF NE'.,V YORK COUNTY OF SU]:FOLK '--~'x. ,--~.-. ~.C,_k'Y~k~X'~ , residing at ~.~ ~~ ~., ~- --_ ~x, ~.. -. ~ ~x kk~ bmng duly sworn, deposes and sazs mat on me. p~V k~ I~' >~.~x ~ ,{~ ~ , ~ ...... * ~=ilod a tree cony of the Not~ce ~et ~h in n=:d persons at the addresses set opposite there respective names; that the addresses set opposite the names o f said persons ~e the ad.ess of said persons as sho~ on the cu~ent assessment roll of the 1o,~ of Southold; that said potic~s w~.p,t~a ~t ?~tya ~tZ ~t Office at ~- ~c~ ~ , that said Nonces were maneO to each or sam Per'un Sworn to beJ~ore me this a~~'¢~ Day of J)~:6/J~ P;~ ,2~/.~--- ~N~otary Public ~ei~h A~dm~rian Nolary Public NY ~30 4704103 N~ssau CIy Cmnrmssion [~P 3 30 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 uny question in Section C on this form is unswered "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- suo~ortin~ facts. If un 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 SCTM# PROJECT NAME The Application has been submitted to (check appropriate response): TownBoard [~ 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: Nature and extent of action: 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: .-~ ~(-~. o (b) Mailing address: ~o(4 ~,c~?x~'t)Jq (c) Telephone number: Area Code (gg) (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? C. Evaluate the project to the following policies 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 be.__nefici~ n~o ,~f ~ coastal !ocation, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [~Yes ~] No [~ 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 [] Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~/Yes [-~ No ~ Not Applicable Attach additional sheets if necessao' 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 Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southoid. Sec LWRP Section III - 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 Not Applicable AtXach 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 ~/Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous S~ynCes and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. es [~ 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. ~ Ye~ No ~-~/Not Applicable ARach additional sheets if necessary ~VORKING 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 [] Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation 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 At~ach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP S~sIII - Policies; Pages 65 through 68 for evaluation criteria. ~-] No ~ Not Applicable Board of Trustees Application County of Suffolk State of New York ~ ~ .~,~. BE~O D~Y swo~ DEPOSE~'--AND AFFIRMS THAT HE/SHE IS T~ ~PLIC~T FOR T~ ~O~ ~s~ ~,~(s)~ ~.~ ~ s~~s co~ ~ ~ BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSSES. T~ ~PLIC~T AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSTEES H~ESS ~ F~E FROM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY V~T~ OF S~ PE~IT(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 MY PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~TH ~W OF T~S ~PLICATION. SWORN TO BEFORE ME THIS ~ DAY OF Keith A~dourian Notary Public NY #30 4704103 Nassau Cry Commission Exp 3-30-,J~J'-2~..4)~7 ,'~e~em t3~ o-- ,20ao~c APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the nan of town officers and emi>levees. The numose of this form is to emvide information which can alert the town of ~ossthle confficts of ultc~¢?t and allow ~t to take whatever actton ~s (Last name, first naml~,~niddl'~-ihi~ial, u~lass you are applying in the n,uuc o~ someone else or other entity, such as a company. If so, indicate, tl~ other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat on from plat or official map (If"Otl~r", name the activity.) Building Trustee Coastal Erosion Mooring Planning 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 ~. pa~ial ownership of(or employruent 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/agent/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% of ibc shares of the corporate stock of the applic~mt (when the applicant is a corporation); B) the legal or beneficial ownqr of any interest in a non-corporate entity (when the applicant is not a corporation); __.12) an officer, director, partner, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted ~day(~~200 __~ Signature ~_~',~-~ ~.q2~,~l~ PdntNam( '~C~cx~ ~IYlO~. Albert J. Krupski, President James King, ¥ice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hail 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Environmental Conservation (DEC) SUNY, Bldg. 40 Stony Brook, NY 11790-2356 (631) 444-0355 Mon., Wed., Fri., 8:00 AM-3:00 PM Suffolk County Dept. of Health Services County Center Riverhead, NY 11901 852-2100 U.S. Army Corp. of Engineers New York District 26 Federal Plaza New York, NY 10278 212-264~3912 N.Y.S. Dept. of State Coastal Management 162 Washington Ave. Albany, NY 12231 518-474-6000 Board of Trustees Application AUTHORIZATION ' (where the applicant is not the owner) (print owner of property) residing at (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) § 58-1 NOTICE OF pUBLIC HEAl, lNG Chapter 58 § 68-1 NOTICE OF PUBLIC · § 58-1. Providing notice of pul)lie hearings. [HISTORY: Adopted by the Town Board of tho Town of Southold 12-27-1995 az I~L. No. 25-I99~$. &meu&ments noted where applicable.] § 58-1. Providing notice of public he,wings. Whenever the Code calls for a public hearing, this section shall apply· Upon determining that an application is complete, · the board or commission reviewing the same shall fix a time 0md place for a public hearing thereon, The bard or commlssbn reviewing an application shall provide for the giving or notice: A. By causing a notice giving the time, date, piece and nature of the hearing to be published in the official newspaper within the period prescribed by law. B. By requiring the sppllcant to erect the sign provided by the town, which shall be prominently displayed on the premises facing each public or privats street which the property involved in the application abuts, giving notice of the application, the nature of the approval sought thereby and the time and place of the public hearing thereon. The sign shall be set back not more. than tan (10) feet from the property line. The sign shsJl be displayed rot a period of not less than seven (7) days immediately p~eceding the date of the public beoxing. The applicant or his/her agent shall file an affidavit that s/he has complied with this provision. C. By requiring the applicant to send notice, to the owners of record of every pcoperty which abuts and every property which is across from any public or private street § 58-1 souTHOLD COD~; § 68-1 from the property included in the application. Such notice shall be made by certified mail, r~urn receipt at least seven (7') days prior to the date raquested, po~ted ' ' of the initial pubiis hearing on the application and addressed to the owners at the addre~sca listed for them on the local ac~essment roll. The applica~-t or agent sh~l file an affidavit that s/he has complied with this provision.