The URL can be used to link to this page

Home My WebLink AboutTR-7657A 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 CERTIFICATE OF COMPLIANCE # 0697C Date: October 24~ 2011 THIS CERTIFIES that the existing vinyl fence At 1265 Shore Drive~ Greenport~ New York Suffolk County Tax Map # 47-2-26.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated October 5~ 2011 pursuant to which Trustees Administrative Permit #7657A Dated October 19~ 2011 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 vinyl fence. The certificate is issued to JOHN & MARIE SHACK owner of the aforesaid property. Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Brederneyer Town Hail Annex 54376 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.: 7657A Date of Receipt of Application: October 5, 2011 Applicant: John & Marie Shack SCTM#: 47-2-26.1 Project Location: 1265 Shore Drive, Greenport Date of Resolution/Issuance: October 19, 2011 Date of Expiration: October 19, 2013 Reviewed by: Board of Trustees Project Description: For the existing vinyl fence. 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 site plan prepared by John & Marie Shack, received on October 5, 2011 and stamped approved on October 19, 2011. Special Conditions: None. Inspections: 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. ~. Oohert)y, Pr~e ent Board of Trustees JMD:eac VACANT IW. JBLtC WA TER IN STREET SHORE ANY ALTERATION OR ADOITION TO ~ ~JRVEY IS A VIOLATION OF SECTION ?209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-$US~l/I.~ON 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID 1~4P OR COPIES BEAR THE IMPRES~F,D SEAL OF THE SURVEYOR ~OSE E~NA TURE APPEARS HEREOI~, ADDITION4LL Y TO COMPLY ~ITH ~4ID LAW THE TEI~4 'ALTERED BY~ c '~ ~ . MU~T ~ USED 8Y ANY AND ALL SURVEYORS UTILIZIN~ A COPY OF ANOTHER SURVEYOR'S ~1 z? N. 50'3~'30' E. IO0. O0' ~ ' ' ' . ~T-TO~A~' ARE ~T ~ C~ ~ T~ LA~. ~ ..... ~ ' ' E r '.~ ~ EL. ~5.al ~0~ Le~ ~ ,, ~ , r ~ I~ I . I ' J'" , -- ~ ~ ~%~k~ ~ ~ CROSS SECTION I · ' ..... _, ~ k~ / L % % ~ex/~t/~ ~I ~ ~ ~ I,.,., ~ ,,.,' ~~// F I (:~ ~'~I~1' ''~ SURVEY OF ~ I [~>~o ~ ~ LOTS 16, 17 & P/LOT 15 I ' ~1 ~ ' A T GREENPORT ~ "~ ZON: ~'~ ~ ~ TOWN OF SOUTHOLD ' ~ I .,~ .... '~ ~ ~ ~ SUFFOLK COUNTY, N ~ ~ --~ ~ ~ 2147 ~ 0.17 ~ I = ~65 cu./L JAn. EL ~ ¢PR~. A~TJ ~ ...... ~ ' ~ -~- - ~1~ ~ - I~ ~ V~ J~ 5~ ~7 ILOT COVERAll ~ ~ ~ ~. 5~3~0" ~. ~ ~~ - I~ ~ 1137 ~ 0.17. I = 193.3 cu. ll. I /.0~. ~ ....... 114.28' [ ~,~' 193.3122.3 = 8.7 VF ' _~ ~5.1 VF FLOOD ZONES FROM FIRM PI~ ~ ' ES C 36103C0159 5/4/98 0 VE / EXIST/NS ZZ34 s- Il I 869~ Gq. fl. = 1~30 TRAVELER STREET - ,. , ~ ~69~/15746 17~ SOUTHOLD~ N. ~ 11971 AREA = 15,746 sq. ft. to reline · EL. 15.8 _:L _., . ,_. _ SEPTIC SYSTEM ~ --1 9g- 283(2; Jill M Doherly, President Bob Ghosio, Jr. Vice-President James F King Johll Bredemeye~ PO Box 1179 Southold, NY 11971 Telephone(631 765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/VVorksession Report Date/Time: JOHN & MARIE SHACK request an Administrative Permit for the existing vinyl fence. Located: 1265 Shore Dr., Greenport. SCTM#47-2-26.1 wf area to be impacted: ater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland Part of Town Code proposed work fails under: ~hapt.275 Chapt. 111 other Type of Application: '~_/~tland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: "~JiDoherty V/'B. Ghosio L//~J/J King J. Bredemeyer.__ D. Dzenkowski other Form filled out in the field by Bergen, Mailed/Faxed to: Date: Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 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 ' Administrative Permit /~ AmendmenffFransfe/'/Extension ~r Received Application: Jol~hl ~,'~CompletedApplication i 1~1[- Incomplete SEQRA Classification: Type I Type I1 Unlisted Coordination: (date sent) · LWRP Consistency Assessment Form CAC Referral Sent: ~4~r~te oflnspection: [i'~ {i,-~.~ II Receipt ofCAC Repo~:" Lead Agency Determination: Technical Review: ~---~ublic Hearing Held: I ~ [Iq ! Resolution: Name of Applicant Address Phone Number:( )63t- q99-6o-'i Suffolk County Tax Map Number: 1000- ~r]. '~/OC..~._ O~(:>r[ Property Location: I~¢-- QO~O~,'~"\L}K,j ~p'~fl~ ~'~ (provide LILCO Pole ~, dist~ce t~ cross s~et~ ~d lo~fion) AGENT: (If applicable) Address: Phone: Land Area (in square feet): Area Zoning: ~x- Previous use of property: Intended use of property: Covenants and Restrictions: GENERAL DATA 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. Yes No Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? Yx No Yes If yes, provide explanation: Project Description (use attachments if necessary): )ard of Trustees Applicati¢ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~0CC-I'~I.t3~ h0~v~ 't'0~ lq Area ofwetlands on lot: i~o .~ '7~(0 Percent coverage of lot: , oO [ square feet % Closest distance betwqen nearest existing structure and upland edge of wetlands: ~, O feet Closest distance between nearest proposed structure and upland edge of wetlands: [ ~ feet Does the project involve excavation or filling? X 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: cubic yards cubic yards feet _Statement of the effect~ if any, on the weft_ands and.tided wa_ters_ 9t~E town..t_ha_t _m_ay rp§_ult by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 3.P~OJ.ECT LOCATION: Municipality C~ ?'~.~¥~ ~ ~) ~' 4. PRECISE LOCATION: Street Addess and Road Intemections. Prominent landmarks etc -or erovide map IS PROPOSED ACTION: [] New [] Expansion [] Modification / alteration 7. AMOUNT OF LAND AFFECTED: I Initially .OO ~ acres Ultimately .OO i acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? b--I Yes I~ No If no, describe briefly: 9[~HAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential r~lndustdal I~lcommercial r--]Agriculture r~ Park l 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 F~No If yes, list agency name and permit / approval: ~ITDOES-'-ANy A;SPEL:I (JP tHE AcITOT~F HAVE a CURRENTLY VALID PERMIT O-I~' APPROVal? ]Yes '~No If yes. tisl agency name and permit / approval: 12. AS A ULT OF PROPOSED ACTION WILL EXISTING PERMII/ APPROVAL REQUIRE MODIFICATION? Elces t tNo I CERTIFY THAT THE INFORMATION P,ROVI~E~) ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / S,ono/s~r~ 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 Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPEKq'Y LOCATION: $.C.T.Id. ~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER? GRADING? DRAII~AGE AND EROSION CONTROL PLAN c~.~.;,.; :sec~on B~ cot (.KK ~ Ir.:U BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CON~"I'RUfLTION ITI~I # / WORK ASSESSMENT [ Yes No a. What is the Total Area o~ the Project Parcels? (InclndeTotalAmaofatiParcelslocatedwithth [~ ? I~ ~q,~..~. I WillthlsProjectRetalnAiIStcxm-WaterRufl-Off Generated by a Two (2') Inch Rainfall ou Site? the Scope of Work fo~ Propesed Constmc~on) ) (S.F. IAc~ (This item wi, indude a, run-off creatad by site b. What is the Total Area of Land Cleadng cleadng and/o~ construction ac'dvities as well as all and/or Ground Disturbance for the proposed (~ Site Improvements and the pen~.anent creation of constnJcfion acti~ impervious surfaces.) (a.~.,,~,) 2 Does the Site Plan and/or Survey Show All Progosed PROVHM~ BRIF~' PROJECT DES~ON 0~.N*~W0 DrainngeSt~uctures Indicating Size & Location?This Item shall include all Proposed Grade Changes and L~ S~_~(~)~ 0~ ~ ~)~x~ ~(~ StupesConbollingSurtaceWatarFIow. and sediment contro~ practices that will be used to ~ h~.~(J'~lO~ ~.~'~,'~¥'~C.~'~ ~t.~ ~ ' 3 Does the Sito Plan andlor Survey descfibe the ereskm item must ha maintained throughout the Entire Ccnsbuc~on Pedod, ~1,0] ~'rO~y~ (~u, tk~P~0,0[ 4 will this Pmject Require any Land Filling. Gradingor Excavation where there is a change to ~ Natural Existing Grade Involving more than 200 Cubic YardsL=.~J of Material within any Parcer? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand~ (5,000 S.F,) Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction aeneml DEC SWPPP ~e~ulremento: or within One Hundred (100') feet of a Wetland or --~ disturbances of one (I~ more ec~es; [ncfudiog distorbances of less then o~e ac~e that arepertofalanjercommo~planthatwalu~limat~lydlslurboneofmoma(=resof[and; 7 Will there be Site preparafion on Existing Grade SIopes ~ which Exceed Fifteen (15) feet of Vertical Rise to ~ isC~Udi~g Consbucfion acthdt~s involv~ soil d!stolt:a r~es o~ ~ than ooe (11 acm where One Hundred (100') of Horizontal Distance? ~ the DEC has de~wmlned that a SPDES permit is requi~ed for stonn water d~charges. l. The SWPPP shall be pmpaed prior to ~e submlaal of the NOL 'me NOi s~all pe into and/or in the directfon of a Town right-of-way? ~q~ired. pest-constm~ton stown ~ter mar~genleot pmcllce~ that ~a]l be u~ed aod/or Removal of Vegetation and/or the Constmcflou of any D ~ to ~ th~ ~ in ~ ~ ~ ~ ts ~m Rom I/~hln the lown Rl~ht-oLWay o* Road ,~ho~ldor STA~llg OF NEW YORK, C ~" COUNTY OF ... '--',lk.!..!.?.. .,~ SS Jeanne Sweet Bartos ................................... NOTARY PUBLIC, Stat8 M Nitw Yod~ ~ o~ea~ ~r~ ~:,,,~) Qualffiea lit ~UITtilK taoufl~y PP t, And that he/she is thc 0(~) }~ ~ }'" Commission Exits ~St 10, 20.,~"~3 . Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the sa/d 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 ped'ormed in the manner set forth in the application [fled herewith. Sworn to before me this; ..j , ~~ (skj~tom c~ FORM - 06/10 of Trustees Applica~n County of Suffolk State of New York DEPOSES ANEJ AFFIRMS :~HAT I5IE/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 BELI]~F, 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 ' WSign~ture SWORN TO BEFORE ME THIS ~ DAY OF (..3 ~'bo~O e ~ff' _,20. I I Jeanne Sweet Bartos NOTARY PUBLIC, State of New York No. 01BA6210083 Qualified in Suffolk County Commission Expires August 10, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the tort of town officers and emolovees. The ouransc of this form is to on)vide information which can alert the town of oossibl¢ conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name, lust namdmiddle initial, unlc~s you arc applying in the name of someone clsc or other entity, such as a company. If so, indicate thc 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"Other', name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee oftbe Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which thc town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns mom than 5% of the shaves. YES NO X If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by ',he Town of Southold Title or position of that person Describe the relationship between yourself (the applican~JagentYrepresentarive) and the town officer or employee. Either check thc 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 of the applic0nt (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 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 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 detail, listing, both supporting and non- suooortin~, 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, ail local libraries and the Town Clerk's office. scm °r? P OJ CT DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): TownBoard ~-~ Planning Board ~ Building Dept. ~-] BoardofTrustees 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: Location of action: Site acreage:~ Present land use: '¢ ~%,(~D c_~ ) 0Br~ Present zoning classification: ~,~ - Of C) If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: ~(~0Jp~°~ C~ (b) Mailing address: I~(o¢- (~XY~Ot~ (c) Telephone nmnber: Area Code ( ) (9 3 } ~ L~ t) ~) .~ (.0 0 ] ~ (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 Southoid 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 V-~ 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 7] Yes 7] mo [] mot Applicablc 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 [~ Not 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 ICl 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 Ap~able 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 L~ 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 POLICII~ 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 Applicab. le ~ · 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 [] Noir] NotApplical?let 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 TITLE ~ DATE OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Environmental Conservation (DEC) SUNY, Bldg. 40 Stony Brook, NY 11790-2356 (631) 444-0355 Mon., Wed., Fri., 8:00 AM-3:00 PM Suffolk County Dept. of Health Services 360 Yaphank Ave., Suite C Yaphank, NY 11980 852-5700 U.S. Army Corp. of Engineers New York District 26 Federal Plaza New York, NY 10278 917-790-8007 N.Y.S. Dept. of State Coastal Management 99 Washington Ave. Albany, NY 12231 518-474-6000