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Home My WebLink AboutTR-7567A Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen 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.: 7567A Date of Receipt of Application: May 13, 2011 Applicant: Anthony Campo SCTM#: 111-1-26 Project Location: 1165 Fisherman's Beach Rd., Cutchogue Date of Resolution/Issuance: May 18, 2011 Date of Expiration: May 18, 2013 Reviewed by: Board of Trustees Project Description: To remove four (4) dead trees in the right-of-way and two (2) dead trees on Lot #18. 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 May 13, 2011 and site plan stamped approved on May 18, 2011. Conditions: Removal of trees from the Town right-of-way is subject to the approval of the Southold Town Highway Dept. 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 M.~oherty, President [] BoardVof Trustees ~ Office Use Only Coastal Erosion Permit Applicatio~ ~Wetland Permit Application ~'- Administrative Permit ~R Amen d ment/Tr an~s~r ./E/xten sion eceived Application: ~//~[I/ 7Received Fee:$ ~%'~) c~ .~Completed Application &l 1,5111 __Incomplete SEQRA Classification: Type I Type 11 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 He~ Resolution: Name of Applicant ~'/~//~/h//~_ ' ~ Address /7 ~~ ~ Phone Number:(~/) Suffolk Coun, Tax Map Number: 1000- Prope~y Location: /i; ~ ~{¢ (provide LILCO ~ole ~, ~ismnce to cr6ss streets, and Iocmion) //74-5 AGENT: (If applicable) Address: Phone: ~ard of Trustees Application0 Land Area (in square feet):. Area Zoning: ~ - Jr® GENERAL DATA Previous use ofproperty: Intended use ofpropeffy: Covenants and Restrictions: Yes /~No lf"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals If "Yes", please provide copy of decision. es Prior permits/approvals for site improvements: Agency Date ~/No ~No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspende~d~by ~' No If yes, provide explanation: a governmental agency? Yes Project Description (use attachments if necessary): COASTAL EROSION APPLICATION DATA Are wetlands present within 1 O0 feet of the proposed activity? ' No ~Yes Does the project involve excavation or filling? ~No Yes If Yes, how much mmerial will be excavated? (cubic y~ds) How much material will be filled? {cubic yards) M~ner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) // Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ,~ ~]4~9~/~ ~ D~ Area of wetlands on lot: Pement coverage of lot: square feet Closest distance betwee~ nearest existing structure and upland edge of wetlands: 3 ~ 5'-- feet Closest distance between nearest proposed structure and upland edge of wetlands: 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? 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: 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): ~ard of Trustees Application~ County of Suffolk State of New York DEPOSES A~D 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 HlS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WlLL 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. 1N COMPLETING THIS APPLICATION, l HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES 1N CONJUNCTION WITH REVIEW O]? THIS A~PLICATION. SWORN TO BEFORE ME THIS I 34~'x DAY OF :~ ,20 Notary Public CONNIE D. BUNCH Notary Public, State of New York No, 01BU61850SO Qua Ifled in Suffolk County ~,., CommiSSion Expires Apfl 14, 2_~[ ~- County of Suffolk State of New York /~7//O/t~/ 5~, ~/00 BEING DULY SWORN DEPOSES A AFFIRMS THAT E/SHE ~ ~/E/ IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HERE1N 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, 1 HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WIT~HjRF~IE.j}V OF THI/[~ APPLICATION. APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the oart of town Officers and emvlovees. The numose of this form is to vrovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first na~e, ~aiddle initial, unless yo)~am applying in th ame of someone else or other entity such as a comply. If so, indicate 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 (lf"Otber", name the activity.) Do you personatiy (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 a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5°./o o~J~ares. YES NO lfyou 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 thc shares of the corporate stock of the applic0nt (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); __C) an officer, director, partner, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 6t7.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 1 APPLICANT / SPONSOR 3.PROJECT LOCATION)/ Municipality 2. PRgj cZ NAME County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide mad 5, IS PROPOSED ACTION: [---~ew r~ Expansion ~ Modification I alteration g--J SEQR 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL POSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~r~ No If no, describe briefly: 9. W IS PRESENT LAND USE IN VICINITY OF ~dential [] Industrial [~Commercia~ PROJECT? (Choose as many as apply.) ~Agriculture K-~Park/Forest/OpenSpace [--]Other (describe) 10: DOES AGTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, ~tate or Local) [~Yes ~ ~-iqo If yes, list agency name and permit / approval: ~. ~S~,~NY~ASP/ECT OF TRE ,~CT1ON HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [-'-~Yes [~o If yes, list agency name and permit / approval: 12. AS A RESr.~F PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E]Yes 1,1 No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / S me ' - Date: , / Signature x.._../- g,/ - -/ If the action/a Costal Area, and you are a state agency, complete the Coastal'Assessment Form before proceeding with this assessment 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 th/s 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). 3. 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- suvvorting 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 SCTM# /Il / The Application has been submitted to (check appropriate response): Town Board [-~ Planning Bo,rd[~ Builaing Dept. [] Board 1. 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: / I .... Location of action: Site acreage: Present land use: 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: //~f/~7 ~'~. (U) Mailing address: /0 ~-~~"-/g/ ~:]- (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 beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ~Yes ~ No ~N0t 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 ~ No [~oNot 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 ~otApplicable 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 ~ot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. >~ee 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.~_~ ~ ~NotA Ye, , No pplicable Attach additional sheets if necessary WORKING COAST POLICIE~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. Sec LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [-~ Yes ~ No [~NNot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town water. Sec 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 DATE_~ C UTCHOGUE HARBOR ,/ SITE PLAN sc~tEi r'= 2o'-o' ..';/ .,:f