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HomeMy WebLinkAboutTR-7461E Jill M. Doherty, President Bob Ghosio Jr, Vice-President James F. King Dave Bergen .John Bredemeyer Town Halk 53095 Main Rd. P O Box [ 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD EMERGENCY WETLANDS PERMIT Permit No.: 7461E Date of Receipt of Application: January 19, 2011 Applicant: Michael Mutsakis SCTM#: 51-4-16.1 Project Location: 20985 Soundview Ave., Southold Date of Issuance: January 19, 2011 Date of Expiration: 90 days from date of issuance Reviewed by: Board of Trustees Project Description: To install boulders along the landward side of the destroyed bulkhead and backfill with approx. 1,000 cy. fill. 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 January 19, 2011. Special Conditions: A full Wetland Permit must be applied for within 90 days from the date of this permit in order to conduct any further activity. This is not a determination from any other agency. Jill .l~O'Doherty, ~resi~d t Board of Trustees Jill M. Doberty, President Jame~ F. King, Vic~-Pre~ident Dave B~gen Bob Gho~io, Jr. John Bvedem~y~r 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 ~mergency P~rmit Application .__.Coastal Erosion Permit Application Wetland Permit Application ' Adminiat~afiv~ Permit AmendmenttTrans f~r/Extem~ion ~/'Received Applicatio_n:~.j.~ ,..'"Rec,~iv~d Fee:$ <0[7 ._~5omplct~d Application .__Incomplete __SEQRA Clarification: TYi~ I Type II Unlisted _._Coordination:{datc s~n0 · · __LWRP Consistmacy Assessment Form .__CAC Referral S~nt: __Date of Inspection: .__R~ceipt of CAC Report: __Lead Agency Determinalion: ___T~hnicat Rcwiew: 4.~pUblic Hearing Held: ___Re. solution: Name of Applicant ° Phone Suffolk ~unty T~ Map Nmber: 1000 - mpmy Loca~on: R09 ~ ~o~d¢ LILCO Pole ~, dist~ce to ~ss a~, md Io~fion) AGENT: (If applicable) Address: Phone: Board of Trustees Appl&oa~n GENERAL DATA Land Area (in square fe~t): Previous use of property: ~---~/~J~ '~/~! ! hltended use ofproperty: R~I ~."~' / Covenants and Restrictions: Yes J 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 j No No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agonc~. ~/' No Yes If yes, provide explanation: Board of Trustees Appllc~ WETLAND/TRUSTEE LANDS APPLICATION DATA. Purpose of the proposed operations: ~]][c.~.[ ~ ~ ~}o~ ~-~[~,o..~ .~,~ ~ ofw*fl~ on lot: ~qum f~ f~ Percent 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: feet Does the project involve excavation or filling? No V Yes If yes, how much material w/Il be excavated? cubic yards How much material will be filled? ,(. ~ cubic yards 'Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: [/l ~t 7~ Statement of the effect, if any, on the wetlands and tidal waters of~e town that may result by. Board of Trustees Application COASTAL EROSION APPLICATION DATA _~ No Yes Does the project involve excavation or filling? No JYes If Yes, how much matedal will bc cxcavated? ~cnbic yards) How much material will be filled? Manner in which material will be removcd or dcposit~l: (cubic yards) Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. ('Usc attachments if necessary) IPROJECT ID NUMBER PART '1 · PROJECT INFORMATION APPLICANT I SPONSOR 3.PROJECT LOCATION: I 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completsd by A ,licant or Project Sponsor) · PROJECT NAME Municipality County 4. PRECISE LOCATION: Street Addes$ and Road intersections, Prominent landmarks etc -o~ provide mae IS PROPOSED ACTION: [] New ~--~Expanslon E~]Modifica§onlaiferation SEQR Initially acms Ultimate!y acres ~es ~ NO If no, describe b~e~: 9. WHAT tS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) I~Residentia, r-"ilndustfia, ~lcommercia, E~ric.ifure E]Park/Forest/OpenSpace [~] Other (describe) 10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIfvtATELy FROM ANY OTHER GOVERNMENTAL AGENCY (Fed~ Slate or Local) , F-lYes L~No If yes, list agency name and permit I approval: 11. uOl::~i 'ANY_.~.~FEUI CF IHE A(.;II[JN HAVE A CURRENTLY VALID pERMIT OR APPROVAL? F--~Yes L~No if yes, list agency name and permit I approval: i OF PROPOSED ACT,O. WI.L PER.., APP.OV^. RE:.,.. DI.,CAT,ON? I CER~ ~T THE INFUSION PROVIDED ~O~ IS TRUE TO ~E BEST OF MY KNO~EDGE ~g~tur~ If the action is a Cos~l A~a, and you am a s~te agency, co~lete ~e Coas~l ~se~ment Fo~ before p~eedlng with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenC~ * ~;~5'~ ~ .............. '. . C6. Leflglemt, shqftterm, cumu!alJve, erothere~,,~-,notldenljliedlnCl.CS? Explainbrie~. 07. O{hef, aT-~.~--j[inCludtng c.%,.~, kl useofeltherquanfitym, t,~3e ofene~g~ i:,.T~._~..bde~' · I-° .... O. WIlL mE PROJECT HAVE AN IMPACT ON mE ENVIRONMENTAL CHARA~ISTICS THAT CAUSED THE EST~J~LISHMENT OF A C_,RI'rlCA F-.NVlRONMENTAL AREA (CEA)? . I E. I~ 'l~r ~.,~-. OR I~ 'R4ERE UKELY 'ro BE~ CONTROvERsY RELATED 'ro'POTENTU~. AOVERSE ENWRC;:,'.'~%~'AL ~MPAC'rS? ff yea iI~I~l'RUCllON8: F~rea~h~dver~ee~fec~iden~e~:~ve~debq1~ne~tissubstantia~'~arge~r~Aem~es~gn~ Each efl~ should' be m~,m=sed I~ ~onnec6on v~h ~ (a) se~ng (i.e. urban o~ ~); (b) prdo;bl~ of occu~ng; (C) ~; (~ ~ (e) · ufl~detall, to show ~at all relevant adverse Impacts have been id~ and a~ ~. If question d of part Il was ,d,,mcked detemtlm=~on. . .'"' -. ........ ,m.,,,~.~.,m m~a~ ,-mu prm'me, ~1 am=ciA/lents as eecessap/. Ihe rm=s~ls suppo~flg f~ Beard of Trustees Name of Lead Agency Data Jill M. Doherb/ ' President Print or Type Name of RespOnsible Officer in Lead Agency Title of Responsible Officer "S/gnature °f Resp°nslble Office~ In Lead Agency Slgna[ure of preparer (If different from responsible officer) Board of Trustees Application County of Suffolk State of New York ,,,~]~',,~'~.. ,~)~,jjr'~,~/ $ BEmGD~y SWO~ DEPOSES ~ ~F~S T~T ~S~ IS ~ ~PLIC~ FOR T~ ~0~ DESC~ PE~T(S) ~ T~T ~L STA~S CO~ ~m ~ TR~ TO T~ BEST OF ~S~ ~O~,RDGE ~ Bm.mF, ~ T~T ~ Wo~ WmL BE DO~ ~ T~ ~R SET FOR~.m ~S ~PLICATION ~ AS ~Y BE ~PRO~ BY T~ SOU~O~ TO~ BO~ OF ~UST~S. ~ ~PLIC~ AGeS TO HOLD T~ TO~ OF SO~O~ ~ ~ TO~ TRUSTS ~ESS ~ F~E ~OM ~ ~ ALL D~S ~ CL~S ~S~G ~ OR BY ~ OF S~ P~T(S), ~ G~. ~ CO~LET~G ~S ~PLICATION, I ~BY A~HORIZ~ ~ ~US~S, T~ AGE~(S) Oa ~P~SE~A~S(S), TO EN~R O~O ~ PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~ ~W OF ~S ~PLICATION Si~ature SWORN TO BEFORE ME THIS. DAY OF -,..~Or) ,- 20 / f lx~far~ Public ' LAUREN M. STANDISH Nora,5' ~u~.'l{c, ..State of New Yor~ [':, © :~T$!64008 Q(',~: ..,; i~, $!Jffoi! Co iltv TRANSACTIONAL DISCLOSURE FORM Th~ Town of Southold's Code of Ethics oroh~its conflict~ of integer on ~e n~t of town bffieom and emolovee~. The ~ of this form is to orovido infodnation which c~n ~ort th~ town of oossibl~ conflicts ofhter~ and allow it to mite whatevor action is nece.~nrv to avoid same. .- (l.~zt name, fw~t name., rplddl~ initial, u~le.~ you am applying'~ Re nam~ of someone el~ or o~er entity, anch ~ a company. If so, iodica~ ~ha.other perzoa'z or company's name.) NAME OF APPLICATION: (Check all ~ al~ly.) Tax ~ev~nc~ Building Varh~ Tm.st~ Change of~ ~ E~on A~mval of plat Mooring Ex~ption fwm plat or official m~ Piing Do you personally (or through your company, spou~ .~bling, parent, or child) have a r~lafion~hip.with any officer or employeo w f t d Rea ~ mdud b bl~ oftheTo nq .~u hg[ ? I tio~'p ' ~ y '~ '~, . ~ n B~iq~' ~t ~a~s'nes~ including a ~h/p~ in which ~e town o~r or ~plo~ h~ even a ~al ow~hlp of (o~ employment by) a ~tion in whi~ ~e to~ o~ or employ~ owns mo~ th~ 5% of ~e ~s. YES NO ~ .., If you ~swe~ "YES~' complete the ~lan~ of N~ of ~on ~ployed by ~e Tm~ of Sou~ld Title br ~si~on of that pc~n ~ri~ the ~latiov~ip betw~n you~ff(~ ~pli~ff~n~p~nt~ive} ~d ~ ~ ~ffi~r or ~ployee. Eider ~k the a~mprh~ llne A) ~rough D) an~or de~ in ~e ~ pm~t&~ ~e m~ offi~r or e~loyee or h~ or her ~u~ ~iblin~ p~ ~ ~hild is (~k all ~ ~ly}: A} ~ o~r of~eat~ th~ 5% of the sha~s of ~e ~e s~ of~ a~li~n~ (wh~ the ~plic~t is a co~m6on); ~B) ~e leg~ or ~neficlal owner of ~ inte~st in a ~n~o~m~ ~ti~ (w~ ~e n~H~t Is ~t a ~n}; · ' - ~C) ~ offi~r, di~tor, ~, or ~ploy~ of ~e appli~ Or DESCRIPTION OF RELATIONSHIP Form TS 1 h41CHAEL t,4UTDAKID I-'VEL.¥N t,4. CAPAOGAW. ID NOTE~: · DENOTE~ MONUMENT FOUND ~ ~ENOTtE~ PIPE POUND ..... DENOTE~ ~OO~ FENCE GRAPHIC SCALE ]"= 30' 0 30 50 90 i i ¢ ,.>y...,r ....... , ......................... ,,~¥~ A ~[~.,.~ N.Y.S. ,~c. NO. S020~ JOHN]6/.;, EHLERS EAND SURVEYOR 6 E^SI'.-I~AIh~: SlREEI RIVERNEAB. N. Y. 369-8288 Fax 369-8287 REFERENCE # 97-0072 ge 13 (P4~_ ,