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Home My WebLink AboutTR-7453E NYS DEPARTMENT OF ENVIRONMENTAl. CONSERVATION EMERGENCY AUTHOHIZATION Pumuant .to' Erwimnmental Conaer,4~Jon .Law A~tlcle 70 (6 NYCRR Part 621) EFFEGTI~ DATE: 01/~/~ · Name & Addr~. of Permitlle/AI)pllomlt: Dabble Gdllo~ 2316 Bumett St Bl~x~l~/fl, NY 11229 Tel~h(me It: (917) 659-2739 ID~.. C. # 1.4738434015/000011 Name & Addr~. of Contnct/Agent: MelI~M Butler 206 Lincoln St RJvemead, .NY t 1901 FTOJI0t LOCMIon: ' 55705 ~ound VkWv Ave (Routa 48), ~outhold. NY ~'"TTM'# t000-44-1:14. X ArIJGla 2~ of tl~ EGL, ONY'GRR Part NI: Tidal W~tMnd~ Article 34 of the ECL, 6NYC;RR.Part 606: Coastal Eroak~n Ha:aM Amae A~lde 15, Title 5 of Ih~ ECL, eNYCRR Pa~t 608: Pro~ction of Watem Artide 15, Title 5 of the ECL, 6NYCRR Part 608: Water Qimllty C,~tiltcation Article 24, Tltto 6 of ~e ECL, 6NYCRR Prat 663: Freshwater Wetland~ Article 15, Title 27 of rrm ECL; ONYCRR Part OOO: Wild. $c~qi¢ &. Recreational Rivers Instal! 1 - 3 ton stone seaward of the ex,ting house fOund~tiofl. Place 30 cubic'yards of clean sand rfli landward of the stone. Inltall 6' x 6' pasta to suppoff, the exbtlng porct~. The'project .~11 be ar~ordance with plans pta;areal by Jeffrey T. Butler, P.E.. P.C. oft 17J27110 and stamped NYSDEC approved 01/06/11. Baaed on Ihe Department's review of the iituation an( tho information provided by the T°w~ of Southold Board.of Trustees and'having consulted with the Debertment't Bureau .of Habltat. Tklal Wet, nde. the Department has debermined that thi~ Nlualion met the definition of ~t cringerS, "~ evank W~ mmmmtto mt ~ tlwemt to life. henlth, m,omrtv, or fta~W~l ~Ul'~Clk' es defined in the Uniform Pmoed~ regulation-, 8action e21.1(j)'. There wa. ar) immedlate'threM to' public safety, propertyl tranapona~n infrastructure end natural re.mines. · .. TO ~)~d S~NOHZ ~3ning ~£O8Z~LT~9 9b:~T TTO~/ZO/TO ~B - 7 2011 FAG[ 63/93 'PA®E: ~0 3D~d SVI,,O*-I£ aBa±n8 £EOGZgLTC9 9~:~T ~TO~/LO/TO Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Brederneyer 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 EMERGENCY WETLANDS PERMIT Permit No.: 7453E Date of Receipt of Application: December 29, 2010 Applicant: Debbie Grillos SCTM#: 44-1-14 Project Location: 55705 County Road 48, Southold Date of Issuance: December 30, 2010 Date of Expiration: NIA Reviewed by: Board of Trustees Project Description: Due to recent storm damage, temporarily place one-to-three ton stones in front of existing foundation, including 30 yards clean fill; install 6"x6" post from existing foundation to support porch. Findings: The project meets all the requirements for issuance of an Emergency Wetlands Permit as determined by the Board of Trustees. The issuance of the Emergency Wetlands Permit allows for the operations as indicated in the application received on December 29, 2010. Special Conditions: A full Wetland Permit and Coastal Erosion Permit must be obtained in order to conduct any further activity. This is not a determination from any other agency. /J~ M. Doherty, Preside~J /vBoard of Trustees ~' L~ oF -I'4 044 Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD - - ~,Office Use Only Coastal Erosion Permit Application Wetland Permit Application __ Administrative Permit Amendment/Trans fer/Extcasion ~eceived Application.~_t~) 3~Received Fee:$ ~ -- __Completed Application ~Incomplete __SEQRA Classification: 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: Name of Applicant Address Z B I b Phone Number:(~g) Suffolk County Tax Map Number: 1000- /~ :~°~1 ~h/,-/-/~-/ Propmv~ocatio..' ¥~OS- ~-+ ~ S~O+~/d, (provide LILCO Pole #, distance to cross streets, and location) AGENT: ~C.~ ~0 ~-[e4-- (If applicable) Address: ~ O, ' ox 2GI Phone: Wrd of Trustees Applicatio~ GENERAL DATA Land Area (in square feet): 'u,5] l~ 0 Area Zoning: Ce ~ i ~ ~ ~ / Previous use of property: Intended use of property: Covenants and Restrictions: Yes X 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 ,X No X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project DescriPtion (use attachments if necessary): "~/%~.~ O~;E-~ 7-0- of Trustees ApplicatioO WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: '~ .J~ec ~ c ~ /~O A ;~ ¢ Area of wetlands on lot: .square feet Pement 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: /o 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? ~qD~ cubic yards Depth of which material will be removed or deposited: ~7~ Proposed slope throughout the area of operations: _~ ~ o Manner in which material will be removed or deposited: 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): 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 County G O-:'~l "~0 { ~ 5. IS PROPOSED ACTION: [~ New [] Expansion 4. PRECISE LOCATION: Street Addess and Road Intersec§ons. Prominent landmarks etc -or erovide mad [] Modification / alteration ~ 6. DESCRIBE PROJECT BRIEFLY: SEQR 7. AMOUNT OF LAND AFFECTED: Initialiy ~), I ~. 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 r-~lndustrial []Commercial OAgriculture []Park/Forest/OpenSpace E--]Other(describe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~Yes r~ No If yes, list agency name and permit / approval: ll. UUl:~5 ANY A~PP_¢[ Ol- IHE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? E--]Yes ~'~'"~No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [Ze:ONe I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Signature / If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment ~ard of Trustees Applica~n County of Suffolk State of New York o ~ BEING DULY SWORN 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 o~ ~ DAY OF /.01~ ~_~ ,20 tO LAUREN I~1. STANDISH ~ry Public, State of New York · N0 01ST6164008 uua fled in Suffo k ~untv (;omm~i~n ~xpires Apr ~ p ard of Trustees Applicat~ AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at 2~ ~uc~+% S+ (mailing address) do hereby authorize ( Agent ) ~?~ ~d~)~ Of- to apply for per. it(.) from the Southold Board of Town Trustees on my behalf. (Owner's signature) 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Thc Town of Southold's Code of Ethics nrohibits conflicts of interest on the oart of town officers and emnlovccs. The nuroose of this form is to orovide information which can alert the town ofvossible conflicts of interest and allow it to ~ke whatever action is ne- ; .i :_void: (Last name, fu~t name, ~niddlc initial, tmless you are applying in the name of someone cig or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tox 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 the Town of Southold? "Relationship" includes by blood, ma~iage, or business 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. YES NO ~ l£you answered ~YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Soothold Title or position of that person Describe the relationship between yourself(the applicant/agenffrepresentative) 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 the corporate stock o£the applic~.nt (when the applicant is a corporation); __B) the legal or beneficial own~:r of any interest in a non. corporate entity {when the applicant is not a corporation); C) an officer, director, par~er, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1