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Home My WebLink AboutTR-7660A Jill M. Doherty, President Rob Ghosio, Jr., Vice~President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. ROx 1179 Southold, New York I1971-0959 Telephone (631) 765-1892 Fax (631) 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 Pro-construction, hay bale line 1st day of construction ~ constructed _.~ Project complete, compliance inspection Jill M. Doherty, President Bob Gho~io, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Ma/n 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.: 7660A Date of Receipt of Application: October 14, 2011 Applicant: Phillip Stanton SCTMft: 64-1-14.7 Project Location: 522 Town Creek Lane, Southold Date of Resolution/Issuance: October 19, 2011 Date of Expiration: October 19, 2013 Reviewed by: Board of Trustees Project Description: To remove an oak tree in danger of falling into Town Creek. 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 En-Consultants, received on October 14, 2011 and stamped approved on October 19, 2011. Special Conditions: None. inspections: Photograph(s) of area where tree was removed as 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. Oi~M'. Doherty~nt Board of Trustees JMD:eac Philip Stanton 522 Town Creek Lane Southold, NY SCTM #1000-64-1-14.7 [? Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Brederneyer 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 Applicationj __Wetland Permit Application I/ Administrative Permit Amendment;Transfer/Extension ~/'Rece-~ved Application:~ ~Received Feel ~'~ .~ . __.~.~ompleted Application l( ] {L~ I{ Incomplete SEQRA Classification: Type I Type II Unlisted __Coordination: (date sent) LWRP Consistency Assessment Form D~atC Referral Sent: · e of Inspection: ~-{ [ 1¥~ [tL(~ ~ Receipt of CAC Report: Lead Agency Determination: Technical Review: ~,"Public Hearing Held: ![7)[ [ el II I Resolution: Name of Applicant PHILIP STANTON Address 198 ORCHARD STREET, APT. 5, NEW YORK, NY 10002 Phone Number: (212) 941-9069 Suffolk County Tax Map Number: 1000 - 64-I-14.7 Property Location: 522 TOWN CREEK LANE, SOUTHOLD (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 Board of Trustees Applica~n GENERAL DATA Land Area (in square feet): 39,456 SQ. FT. Area Zoning: R-40 Previous use of property: DEVELOPED RESIDENTIAL, SINGLE-FAMILY DWELLING Intended use of property: NO CHANGE Covenants and Restrictions: If "Yes", please provide copy. Yes X No 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 DEC NJ #1-4738-03199/00001 7/23/03 DEC ARTICLE 25 #1-4738-03199/00003 3/21/05 Date Yes X No SOUTHOLD WETLANDS #5809 9/24/03 SOUTHOLD WETLANDS #5974 8/18/04 COE #2004~00700-L2 4/15/08 DOS #F-2004-0593 8/06/04 __ 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: Proiect Description (use attachments if necessary): To remove an oak tree in danger of falling into Town Creek. of Trustees Appli WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To prevent tree from falling into creek. Area of wetlands on lot: N/A .square feet Percent coverage of lot: N/a % Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? N/^ cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A 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): The project entails the removal ora tree to prevent it from falling and disturbing tidal wetlands. Therefore, the project will not have any significant adverse impacts on the adjacent tidal wetlands or waters of the Town. ' PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR PHILLIP STANTON BY MN-CONSULTANTS 3. PROJECT LOCATION: Munidpality SOUTHOLD 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by >licant or Project Sponsor) 2. PROJECT NAME County SUFFOLK 4. PRECISE LOCATION: Street Address and Road Intersections. Prominent landmarks etc - or provide map 522 TOWN CREEK LANE, TOWN OF SOUTHOLD, SCTM #1000-64-0-14.7 5.1SPROPOSEDACTION: [] New []Expansi~m ~ivlxtfficafion/alterafion 6. DESCRIBE PROJECT BRIEFLY: SEQR To remove an oak tree in danger of falling into Town Creek 7. AMOUNT OF LAND AFFECTED: Initially 1.3 acres Ultimately 1.3 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? []Yes [] No If no, describe briefly: 9. WHAT 1S PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~ ResidenEa, [] Industrial [] Conm, ercial [~]Agficulture [] Park/Forest/Open Space [~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~Yes [] No If list name and permit / approval: yes, agency 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes [~No If yes, list agency name and permit / approval: I~.~S A R~.~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? II Yes.No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / SpOor Name ROBERT E. HERRMANN, COASTAL MGMT. SPECIALIST Date' OCT. I 1 2011 If the action is a Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment · PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by A ~licant or Project Sponsor) 1. APPLICANT / SPONSOR 2. PROJECT NAME ~HILIP STANTON BY MN-CONSULTANTS 3. PROJECT LOCATION: Munk~pality SOUTHOLD Counly SUFFOLK 4. PRECISE LOCATION: Street Address and Road Intersections. Prominent landmarks etc - or provide map 522 TOWN CREEK LANE, TOWN OF SOUTHOLD, SCTM #1000-64-0-14.7 5.1SPROPOSEDACTION: ~ New ~]Ex-pansion ~Moc~fication/alteration 6. DESCRIBE PROJECT BRIEFLY: SEQR To remove an oak tree in danger of falling into Town Creek 7. AMOUNT OF LAND AFFECTED: hi,ally 1.3 acres Ultiimtely 1.3 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.) [5~Resident~al [~lndusltial ['~Conmlercial [~Agricult~re [~ Park / Forest / Open Space MOther(describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~Yes [5~No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes [~No If yes, list name and permit / approval: agency I~.~S A R~.~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? J I Yes L~No I CERTIF~//THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Spons~.~e ROBERT E. HERRMANN, COASTAL MGMT. SPECIALIST Date: OCT. l 1,2011 Signature ,~ -- If the action is a Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use I~e FULL FAF. E]Yes j~'l NO B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, a negative declaration may be superseded by another involved agency. I-1Y IZ]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answem may be handwritten, if idgibte) Ct. Existing air quality, suHace or groundwater quality or quantity, outse levels, existing traffic paffem, solid waste prnducSon er dispona(, pofenfial [or emslou, drainage or tiouding problems? Explain briefly: I C2. Aesthetic, ngdcultural, archaeotsglc~l, historic, or other natural or cultural resources; or community or neighb<m~md charaCter? Explaid briefly: [, C3. egetat!on or fauna, tish, shellfish or w~ ire species, significant habitats, or Ihraatennd or endangered species? Exptsib briefly: C4. A c,:~munity's existing plans or goals as officially adopted, o~ a change in use or Intensity of use of land er other natund resources? F_x~ln briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short tern% cumulative, or olher e~'fects not identi~ed in Cl-C57 Explain bhally: I C7..(~r Impacts (including ~,,iues in use of either cluantit}/or ~ of energy? Ex~olain briefly: / I I 0. VVILL THE PROJECT NAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? tlf ~'es, explain bdefl¥: ~'--~ Yes ~"~ NoI E. IS THERE, OR I$ THERE LIKELY TO BEl CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) . INSTRUCTIONS: For eadn adverse effect identified above, determine whether it is substantial, large, imperfant or ofheneise significant. Each effect should be assessed in co~nection with its (a) setting (i.e. urban or rural); (b) probability of occunthg; (c) duration; (d) Irreversibirdy; (e) geographic scope; and (0 magnitude. If necessary, add attachments or rufemnce supporting materials. Ensure that e~anatlees contain suffictant detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate Ihe potentialimpact of the proposed ac0ofl on the environmental characteristics of the CEA EAF and/or prepare a positive ded~rallon. Check this box if you have determined, based on the Infa~natkm and analysis above and any supporting documentetlen, ltmt the proposed acrid, WILL NOT result in any significant adverse environmental impacts AND provide, en atiachmenfa as necessary, the masons supporting IN= determination. Board of Trustees Name of Lead Agency Date Jill M. Doherty President Pdrd or Type Name of Responsible Officer in Lead Agency Title of Responsible Offmer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Board of Trustees Applicati A U'£'~ORI ZATION (where the applicant is not the owner) (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the southold Board of Town Trustees on my behalf. 8 Board of Trustees Ap~ County of Suffolk State of New York ~f* t t_ t ? ~'r-~'V~5~' 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 FIlS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TI-IlS 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 AR/SING UNDER OR BY VIRTUE OF SAID PERMIT(S), EF GRANTED, IN COM?LETING 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 Tills APPLICATION. SWORN TO BEFORE ME THIS ~'" DAYOF ?'fg{~P~'~' ,20g~ Notary Public THOMAS E. KOZAK Notary Public-State of New York No. 02KO6151038 Qualified in Kings County My Commission Expires Aug, 7, 2010 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSUKE FORlVl Thc TqwD of Southold'$ Code of Bthiqs ~rohibits conflicts ofinter~t on tho nm't of town o~ce~ ~d emglovee~, ~e ~umose of lhi~ fo~ is to Qrovid¢ info.arian which c~ ~]¢~ thc to~ ofgo~ib]~ conflicts ofintcr~t ~d allow it to t~ whatever ~ction is ~ccss~ ~o ~void same. . .. ,. (~t n~; ~t n~e, ~ddle ini~al, ~ you ~ appl~ng m m~ n~ ox ~o~ne alte or o~ en~, tush ~ a comps7. If to, ~dfcat~ ~e other perton't or ~omp~y'~ n~.) NAME OF APPLICATION: (Chock all that apply.) Vari~mca Chm~go of Zono Approval of plat Bxemption from plat or official n~p. Other (If "Other", name the activity,) Do you personally (or through your company, spouse, sibling, p~rent, or child) have a relationship w/th any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interem, "Business interest" moans a business, including a partnership, in which the town officer or employee ha~ avon a pm'rial ownership of (or employment by) a corporation in which the town officor or employee owns more than 5% of tho shatos, NO I£you answered "YE", compIoto the balance of this form and dat~ and sign where indicated. Name of person employed by the Town of Southo, ld Title or position of that person Describe the relationship bom~/ccn yourself (tho applican~/agent/roprcsontafive) and the town officer or employee, Either check the appropriate line A) through D) and/or describe in thc spa¢o provided. The town officer or employee or his or her spouse, sibling, pazent, or child is (check ali that apply): A) the owner of greater than $% of thc shares of the corporate stock of the applicant (when tho applicant is a corporation); B) thc legal or beneficial owner of any intezest im a non-co.orate entity (when the applicant is not a corporation); C) an o~cor, director, pamer, or employee of thc ap?licant; or , ,.D) the actual applicant, DESCRIPTION OF RBLATIONSHIP Pxint Name "F"h, I~ 1-5. -x-~c,.~ ._ EN-CONSULTANTS 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www.enconsultants.com ENVIRONMENTAL CONSULTING October l 1,2011 REOUEST FOR AN ADMINISTRATIVE WETLANDS PERMIT Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Re: Philip Stanton 522 Town Creek Lane, Southold SCTM #1000-64-1-14.7 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including a) Short Environmental Assessment Form; b) Authorization & Disclosure Forms. One (1) set of site photographs. Application fee of $50.00 wetlands. I trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Sincerely, Robert E. Herrmann Coastal Management Specialist /kBs Eric. I.SURVL='¢ OF LOT .5 AS SHOHN ON MAP OF LAND SHOHIN® PROPOSEO SUB, PI'VISION MADE FOR HELEN Pi. LATSON APPROVE~ BY SOUTHOLO TOHN PLANNIN® SITUATE: 50UTHOLD TOHN: SOUTHOLD SUFFOLK COUNTY, N'r' 5IJRvE'r'EO 0q-25-02 APIIENI2~ID 04-0i-04 5E, T:~ i000-64-1-14.~ BOARD, MAT I:~, Iq"/I N 'e... x \ JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\LHp server\dLPROS\02-290b.pro