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 $50 check for the application fee.
Thank you for your help.
~/Sincerely' ~1~
369 GARDEN STREET
EAST MEADOW, NY 11554
PHONE #516-582 7966
10/13/05 11:27 FAX 516 222
~Kinko's.
KINKOS
Fax Cover Sheet
~]001
FedEx Kinko's of Garden City
Date
Name
Company
Tele. phone
Fax
Telephone: 516.222,9351 Fax:516.222.2938
Number of pages ~ {including cover page)
From:
Name. ~;)~
Company
Telephone
Comments
More than 1,;[00 locations worldwide. For the location nearest you, calf 1.800.ZKINKOS. Visit our website at fedexkinkos.com,
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*************AUTO**3-DiGIT 1 '1 ~
Ramon Barbe
369 Gard~ Street
East Meadow, NY 11554-2906
Ramon Barbe
13.16
Oct. 13,2005 Field
Oct. 13,2005 Field Inspectie
Oct. 13,2005 Field Ins
10/13/05
11:30 FAX 516 222 2~
KINKOS
O04
GARDINER$
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.