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Home My WebLink AboutTR-7265AJill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 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 ~A constructed Project complete, compliance inspection. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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.: 7265A Date of Receipt of Application: April 20, 2010 Applicant: Todd & Elizabeth Cantrell SCTM#: 117-2-14 Project Location: 2070 Grathwohl Road, New Suffolk Date of Resolution/Issuance: April 21, 2010 Date of Expiration: April 21, 2012 Reviewed by: Board of Trustees Project DescriptiOn: To replace the existing driveway. 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 in the application prepared by Elizabeth Cantrell, and stamped approved on April 21, 2010. 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. Board of Trustees JMD:eac Jill M. Doh~rty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application ,,/Administrative Permit Amendme ntfFrans fer/Extansion ~_Rece~vved Applica~.L[~a~ I ~(} ~Received Fee:$ ~ ' ~Completed Application ~&Ol[(~ Incomplete SEQKA Classification: Type 1 Type II Unlisted Coordination:(date sen0 LWRP Consistency Assessment Form CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Lead Agency Determination: LlmicalReview: lic Hearing Held: q .~.~.~) Resolution: Name of Applicant Address 7o Phone Number:( ) Suffolk County Tax Map Number: Property Location: (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: of Trustees Applicatio0 GENERAL DATA Land Area(in square £eet): / 0. /(~5-~ ~f_-, Area Zoning: "~ Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes /No Prior permits/approvals for site improvements: __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen, ded by a governmental agency? 0 No Yes If yes, provide explanation: Project Description (use attachments if necessary): · Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Area of wetlands on lot: square feet Percent coverage of lot: (~3 % Closest distance between nearest existing structure and upland edge of wetlands: /OO~-~%, feet Closest distance between nearest proposed structure and upland edge of wetlands: ~- ~3CJ~. feet Does the project involve excavation or filling? No / Yes If yes, how much material will be excavated? ~ cubic yards How much material will be filled?O43Ofogo (2~) cubic yards w'l . Depth of which material ~ I be removed or depos~ted:~l~ Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ~atemen~ 0~_the e_ff_ec_t, if any, on ~!~9. wetlands and tid~l_.w.a__ters of~e town_that _m. ay~ res_ul_t_b_7 . reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality 617.20 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 SEQR 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or erovide mad o7o I 6. IS PROPOSED ACTION: [] New [~ Expansion [] Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT ~.t: LAND AFFECTED: Initially~) acres Ultimately acres 8. WiLL PROPOSED ACTION COMPLY WITH EX]STING 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 []Industrial [----ICommercial [~Agriculture ~l Park / Forest / Open Space r~olher (describe) 10.'DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) E~Yes 'l~No If yes, list agency name and permit / approval: 11. UL)ES 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 R~ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I~e, ~.O I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant , ~._~.~ ~______~j,~ Date: ~/'~'~ Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART Il - IMPACT ASSESSMENT (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF. E~Yes r~No B. WILLACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involvtd agency. I-1 E No L COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be han~lwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste producbon or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agficuflural, 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 community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: C7. Otherimpacts (including changes in use of either quanti or tye of ener ') Ex lain briefl- D. WiLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTALAREA CEA ? If es ex lain bdefl · [~Yes r---~NoI ( ) ¥' P ~': ............... I E. IS THERE OR IS THERE L KELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain' PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesi~ni~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 all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked ~,.-"-~, th_" d-"t-"rm!.-.at!e,-, of s!g.".!.¢.'~c= must =vc!uctc thc pctcntlcl !,mf)a ct of thc ~rcp~..;¢~ c,~c,n e.n thc cnvlr~n,T,c~,~,I characteristics c, fth6 C ~.~,. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL FAF and/or prepare a positive declaration. Ch et-k- ~ 'b~-~ I~;;~/~"~n~d. based onthe information and analysis above a~d any ~u p po~ling' d ocume nt~ ti(~n,' t-I~-at'~l~ro p0s ed a ctio~ WILL NOT result th 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 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) of Trustees Applica~ County of Suffolk State of New York swo 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 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. Signature - SWORN TO BEFORE ME THIS ex)0~ DAY OF ~ ,20/1) 1Notary Public LAUREN M. STANDISH Notary Public, State of New York No. 01ST6164008 Qualified in Suffolk County Commission Expires April 9, 2D 1__~/ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the vart of town Officers and emolovees. The ouroose of thi~ form is to ~rovide information which can alert the town of oossible confers of interest and allow it to take whatever action is neeessarv to avoid same. (Last name, first name, middle initial, unless you am applying in the name of someone else or other entity, aneh as a company. If so, indicat~.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 Mooting Exemption t?om plat or official map Planning Other (It"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 buginess 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. If you answered "YES", complete the balance of thls form and date and sign where indicated. Nameofpersonemployedhy Title 0r position o[that person Describe the relationship between yourself (the applicant/agcnffrepresentative) 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 the shares of thc corporate stock of thc applic0nt (when the applicant is a corporation); __.B) the legal or beneficial ownvr of any interest in a non--corporate entity (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 t~da~f ~200 J_O Signature [~,~/,--~4/pM;ZYt t'~'?~ _ ~, 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 Waterfxont 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- suooorting 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 Offide, the Planning Department, all local libraries and the Town Clerk's office. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# //7 & The Application has been submitted to (check appropriate response): TownBoard ~ Planaing Board [] Building Dept. [-~ Board ofTrustees~ 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 ofaction:~p.~0/oc_f,.~ G~ [~7Lf/fO Site acreage: · 3903. Present land use: Present zoning cl~sification: ~ ~O If ~ application for ~e proposed action h~ been filed ~ ~e To~ of Sou~old agency, ~e follo~ng ~o~ation shill be prodded: ¢) M~lingad~ess: ~ ~ Will ~e action be directly ~de~e~ req~re ~g, or approv~ by a state or feder~ agency? Yes No I~l if yes, whch state or federfl 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 beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section IH - 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 Southoid. 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 A~ pplicable 3 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 I.~1 Not Applicable 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 through 21 for evaluation criteria Yes [] No [ NotApplicahlc 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 Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes []No~ Not Applicable I 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. Yes [-~ 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 HI ' Policies; Pages 38 through 46 for evaluation criteria. Yes~ No ~ Not Applicable Attach additional sheets if necessary WORKING COAST POLICII~ 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 I 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 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 DATEr, S_ TM# 1000-1~7-02-0~4 GUARANTEED TO: TODD CANTRELL ELIZAI~ETH CANTRELL / / GEORCE ROAD APPROVED BOARD OF TRLJ3~ TOWN OF SOUTHOLDNEI~ DATE , ~/~.~ N/F' MCINTYR£ SURVEY OF DESCRIBED PROPERTY SITUAT£ SUFFOLK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: TODD CANTR£LL ELIZABETH CANTRELL SURVEYED: t3 DECEMBER 2003 SCALE I"= 30' .aREA = 17,105,66 S.F. OR 0.392 ACRES SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW SUF/~-OLK. N.Y. 11956 5- '-