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Home My WebLink AboutTR-7396AJill 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 CERTIFICATE OF COMPLIANCE # 0587C Date September 22, 2010 THIS CERTIFIES that the existing 8'X 12' shed At 2150 Jockey Creek Dr., Southold Suffolk County Tax Map #70-5-21.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 8/31/10 pursuant to which Trustees Wetland Permit #7396A dated 9/22/10 was issued and conforms to all of the requirements and Conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing 8'X 12' shed. The certificate is issued to RALPH JEFFREY RUSSELL owner of the aforesaid property. ~t~orize~A~ S~i~a~r 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 F~x (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7396A Date of Receipt of Application: August 31, 2010 Applicant: Ralph Jeffrey Russell SCTM#: 70-5-21.1 Project Location: 2150 Jockey Creek Dr., Southold Date of Resolution/Issuance: September 22, 2010 Date of Expiration: September 22, 2012 Reviewed by: Trustee Bob Ghosio Project Description: Existing 8'X 12' shed. 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 application received on 8/31/10 and stamped approved on 9/22/10. Conditions: None 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. Jill I~..}Doherty, Presider~f Board of Trustees Jill M Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/VVorksession Report Date/Time: RALPH JEFFREY RUSSELL requests an Administrative Permit for the existing 8'X 12' shed. Located: 2150 Jockey Creek Dr., Southold. SCTM#70- 5-21.1 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland 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 ._Administrative__Emergency Pre-Submission __ Info needed: Sound Bay __Amendment Violation Modifications: Conditions: Present Were: __&King __J.Doherty __J. Bredemeyer B.Ghosio, D. Dzenkowski other Form filled out in the field by ~ D. Bergen__ Mailed/Faxed to: Date: COUNTY OF SUFFOLK (~ SOUTHOLO ~ed Property Tox Se~vlce A~ency 0 7 0 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, N-Y 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: From: Date: Re: Jill Ooherty, President Town of Southold Board of Trustees Mark Terry, Principal Planner LWRP Coordinator September 16, 2010 Proposed Wetland Permit for RALPH JEFFREY RUSSELL SCTM# 1000-70-5-21. RALPH JEFFREY RUSSELL requests an Administrative Permit for the existing 8'X 12' shed. Located: 2150 Jockey Creek Dr., Southold. SCTM#70-5-21.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the denoted following Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Jill M. Dohe~3', President James F. King, Vice-President Dave Bergen Bob Ghosio, Jn John Bred~meyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 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 ~"~Adminlstrative Permit R ~_.~endmentfrrag~fer0~xtension eceived Applicatio~ eceivext Fee:$ 5'~) ~--I-{q"~t~°~s~; IJ~ ff"-e~ 7Completed Application'<~ !~"'~} I [i3 __Incomplete __SEQIL~ Classification: Type I Type II Unlisted ~Coordination:(date sent) ~WRP Consistency Assessment Form ~ I~-II~ · ~AC Referral Sent: 1~\ ~ ~--'Dat e of Inspection: ~ 'k'~ [ ( ,X~ (A~) ~Receipt of CAC Report: __Lead Agency Determination: Technical Review: --t~ublic Hearing Held: C~ [ ~-~-['[ il3 __Resolution: Address .~{~ ~-~ (..A_J. Ak .IB~er Suffolk County Tax Map Numbs: 1000- 90 ~ ~[, I Prop~yLocation:~O ~0~ ~~, ~o~[~/~ (p~vide LILCO ~le g, dist~e to ~oss s~eets, ~d locmion) ~ AGENT: (If applicable) Address: Phone: of Trustees Applicati¢ Land Area (in square feet): % 'l1 7~"~' Previous use of property: Intended use of property: GENERAL DATA Covenants and Restrictions: Yes ~(~_ No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Prior permits/approvals for site improvements: Agency Date Yes No K 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 pard of Trustees Applicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ~-°--~x.,~ ~0xf ~-~C~x~ Area of wetlands on lot: 0 .square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: I 1~O' feet · Closest distance between nearest proposed structure and upland edge of wetlands: Jh 1, ~' feet Does the project involve excavation or filling? ~ 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: or cubic yards cubic yards feet . Statement of. fie ~ff_ect, !f.~ny~ 9~ fi!e wgt_!_an__d9 ap4_tid~ ~yat_e.rs_ Pf~e._tpwn.~ha_t ~ay re_sult_b_y reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALtTY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 1. ARPLICANT / SPONSO, Rf~ 2. PF~JECT NAME ^ I Municipality~ ~ ~,~ Coun~ 4. PRECISE LOCATION: S~ Addess and Road Intemec~ons. Prominent landmass etc -or provide mad ~U / J 5. IS PROPOSED ACTION: ~ New ~ ~pansion ~Modi~ca~on/alleration , 7. AMOUNT OF LAND AFFECTED:initiali~ ** '~ ~ ?~4~' 8. ~LL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRI~IONS?~ ~Yes ~ Ne If no, describe briefly: RHAT iS PRESENT ~ND USE IN VICINI~ OF PROJECT? (Ch~se as many as apply.) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Lo~l) ~Yes ~No If yes, list agency name and permit / approval: 11. UUE~ ANY A~P~CI O~ IHE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~No If yes, list agency name and pe~it / approval: I CERTIFY THAT THE INFORMA~ PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant Date: Signature ~ I ~ction is a Costal Area, and you are a s~te agency, COrn ~ Coastal Assessment Form before aroceedino with this a;se~m~nt S) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCA'RON: S.C.T.M. ~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATERI GRADING~ DRAINAGE AND EROSION CONTRO~ PLAN D~Ct Sm:BO. Sleek cot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION iTEM# / WORK ASSESSMENT [ Yes No (InciudeTotalAmaofallParoalsfacatedwithin ' . I WillthlsProJectRetathNIStorm-Wate~Run-Off the Scope of Work for Proposed Construction) ~ ~j' Generated by a Two (2') Inch Rainfall on Site? ' (S.F. / ~:~[) (Tiffs item will include all mn-off created by site b. What the Total Area of Land Cleadng cleadng and/or construction activities as well as all '\ and/or Ground Disturbance for the proposed ~ '~;~ ~ Site Improvements and the permanent creation of construction act~(/S.F.~s~ '' impervicus surfaces.) 2Does the Site Plan and/or Survey Show Att Proposed PROVIDE BRIEF I~ROJECT DT~C]~t'rtON ~ ~ P~--~Ne,m~ Drainage Structures Indicating Size & Location? This ~ r~ item shall include all propes~l Grade Changes and~\. aep[~ ~f~ '(/i/~ ~4~'~-~ ~r-,~ ~/~..~ Slopes Controtling Surface Water Flow. [~ 0 ~/~. - 0~_~..~ , ~_~ ~ ~,~ ~f~f~x 3 Does the Site Plan and/or Survey descn-be the erosion and sediment control practices that witl be used to ~/~0~7~"'1C-C~. ~'d~A,~(,,~ ,J~'~ control site eroslon and ste~'m water discharges. This item must be maintained throughout the Entire Construction Peded. (~ -/~l~(/~/] ~ ~i /~1 ~ 4 Will this Project Require any Land Filling, Gradingor ~r~ ~ ~ ~/~ l~' Excavation whera there is a change to the Nateral ~"~ Existing Grade Involving more than 200 Cubic Yards of Matedal within any Pamel? 5 Will this Application Require Land Dis~rbing Activities Encompassing an Area in Excess of Five Thousand~ (5,000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Water Couree Running through the site? Is this Project within the Trustees jurisdiction _.~ I~eneral DEC SWPPP Refluiremente: or within One Hundred (100') feel of a Wetland or Submissia~ of a SWPPP is required f~r all ConsttucUon activities i~voNing so~l Beach? distud~es of one (1) o~ mom acres; including disturbances of less than one ac~e that 7Will there be Site preparation on Existing Grade Slopes am l;ert of a larger common plan that will ultimately disturt~ one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to Inctudthg C°nstmcti°n activi6es inv°iv~ng s°il disturt'~ances of less than °ne (1) acre where One Hondred (100') of Horizontal Distance?I--I the DEC has determthnd that a SPDES permit is required for stem1 water discharges. ; SWPPP'. Shall meet the Miatm.m Requireme.te of the SPDES General Pemllt 8 Wiil Driveways, Parking Areas or other Impervious ~or Stom~ Water Discharges from Construction activity - permit No. Gp-0-tO-001.) Surfaces be Sloped to Direct Storm-Water RumOff~ 1. The SWPPP shall be p~ ~ th the submittal of the NOL The NOI shall be into and/or in the direction of a Town dght~f-way? submiffed to the Department prio~ to the commencement of o~nstmction activity. 2. The SWPPP shall describe the erosion and sedlmeat control pmclice~ and where : 9 Will this Project Require the Placement of,Matedal, ~.quired, i~st-constmatJen stem water management practices that will ha used end/or Removal of Vegetation and/or the Consbuction of any constructed to red. ce the pciluta~ts in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder--L~ compliance with the te~ns and c~ditlons of this perm~ In addition, the $WIPPP shell Area? (Thl. Itea Will NOT Inelu4~ flee I~llatieat el' ~ ideofify p~en~at sources of Pellatlon whlc~ may reasonably be expected to affect the qualiLy of storm water discharges. NOTE: If Any Answer to Q~e~#o~. One through Nine I~ ~.~red wtth a Cbe~k Mark 3. All SWPPPs ~t require the Peat-¢onat ruction storm water management practice in a Box end I~e ~onatn~tlon .Ire dimurbence ia batsmen ~,O00 $.F. & ~ ~ th ama, component shall be prepared by a qualifiad Design Prof*-~slonel Licensed in New York a Stenn-Wofer, Grading. D~atnage & Erosion Coofml Plan I~ Reqatmd by tha T~'~m of that is knoMedgeable ;n the principles and practices of Stem1 Water Management. Southatd and Must be Su~itted ~or Re~iaw Prior to I~suan~e of ~ Bulling Pe~atL (NOTE: A C~ed~ Mark (.~) and/m* .NY~v~ ~' ead~ Queteml b Requlmd fro- e C~ Appllcat~n) COUbrl'Y OF ......~.....£ .E .~.1.~ .~ ......... SS ~laat I ~.....~.~.~....~...~..AI~..~L/.. ............... being duly sworn deposes and says that he/sbe is the applicant for Permit, And that he/she is the .... t~J..~..~.........}~.. ............................................................................................................................. Owner and/or r&presentafive of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to be~e me this; .~ ~ ............ ........ · ................. ......... ..................................... FORM - 06110 NOTARY PUBLIC, State of New York No. 01 D04634870 Qualified in Suffolk County ommission Expires Septemb~ 30, z..~ Qoard of Trustees Applica~n County of Suffolk State of New York EP~14S AND AFFI~S~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), 117 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 WI REVIEW OF APPLICATION. SWORN TO BEFORE ME THIS $1 - DA¥OF MELANIE DOROSKI NOTARY PUBLIC, State of New York No. 01 D04634870 Qualified in Suffolk County .3 ,, Commission Expires September 30~ ~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE. FORM The Town of Southold's Code of Ethics urohibits conflicts ofinterast on the oart of town officem and emolovees. The ouroose of ibis form is to nrovide information which can alet~ the town of nossible conflicts of intem~t and allow it to hake whatever action is necessary to avoid same. ( L~[s~ r~amc, re'st ~amc, ~aidd]e imtial, unless you arc applying in the name of someone else or other cnfityl such as a company If so, indicatc~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"OtheW, 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, nlarriage, or bUSiness interest. "Business interest" means a business, including a par~nershlp, 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 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 applicanffagenffrepresentative) 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 ~hild is (check all that apply): ___A) the owner of greater than 5% of the shares of the corporate stock of the applic0n~ (when the applicant is a corporation); __B) the legal or'beneficial owner 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 , 200 __ Signature Town of Southuld LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that arc 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 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 detafl~ listing both supporting and non- suooorfin~ 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 Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check approt~riate response): Town Board ~ 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: Natureande~[entofaet~o¥:~¥B,4~ bC~ ~t-A~]v~P-./~ / Location of action: Site acreage: ~ Present land use: ~ 94~[ Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: ~3/q ~'l?~x.~ (b) Mailing address: ~] b-D ~{A ~C ~1~ &~-e.. (c) Telephone number: Area Code ~'?{ ~te~'~ ~OIt ~ (~"l'~) (o'q"]~:~7 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ NOPSI. Ifyes, which smte or federalagency? C. Evaluate the project to thc 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 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 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 71 No Not Applicable A~ach 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 ~, 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 Apl~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 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 III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes~] No [~ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE~I~ 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 Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. Sec LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~ Yes ~ No [] Not Applicable ~oef('. Of ~ru$ !'6S 'l. AUG 31 2010 Bo~rcI Of Trustees