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Home My WebLink AboutTR-7845A James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 # 0788C Date: August 21, 2012 THIS CERTIFIES that the installation of a 4" Palisade 6' X 8' panel fence along the west side of the property At 4625 Aldrich Lane Ext, Mattituck, New York Suffolk County Tax Map # 112-1-14 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 29, 2012 pursuant to which Trustees Administrative Permit #7845A Dated July 18, 2012, 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 installation ora 4" Palisade 6' X 8' panel fence along the west side of the property. The certificate is issued to WARREN & SUSAN CANNON owners of the aforesaid property. Auth~ Jame~ F. King, President Bob Ghosio, Jr., Vice~President Dave Bergen John Bredemcyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box I 179 Sou~hold, NY 11971 Telephone (63 I) 765-I 892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 /~'L~' /7 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain __ 1st day of construction ¼ constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: James F. King, President Bob Ghosio, Jr., Vice-Pr~ident Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (63 l) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated (~ [&q il;3- has been reviewed by this Board at the regular meeting of r) I I ~113- and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) v''/ Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ ~'-0,~ BY: James F. King, President Board of Trustees James F. King, President Bob Ghnsio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 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 Pre-construction, hay bale line I st day of construction ~ constructed Project complete, compliance inspection James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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.: 7845A Date of Receipt of Application: June 29, 2012 Applicant: Warren & Susan Cannon SCTM#: 112-1-14 Project Location: 4625 Aldrich Lane Ext., Mattituck Date of Resolution/Issuance: July 18, 2012 Date of Expiration: July 18, 2014 Reviewed by: Trustee John Bredemeyer Project Description: To install a 4" Palisade 6'X 8' panel fence along the west side of the property. 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 June 29, 2012 and survey stamped approved on July 18, 2012. Inspections: 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. Board of Trustees James F King, President Bob Ghosio, Jr, Vice-President Dave Belgen John Bredemcyer Michael J. Domino P.O Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ) ~'~ WARREN & SUSAN CANNON request an Administrative Permit to install a 4" Palisade 6'X 8' panel fence along the west side of the property. Located: 4625 Aldrich Lane Ext., Mattituck. SCTM#112-1-14 Type of area to be impacted: __Saltwater Wetland __Freshwater Wetland Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ~'~Chapt.275 Chapt. 111 other "'/SSound __Bay Type of Application: __ Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: //'J. King__B. Ghosio __J. Bredemeyer___ Michael Domino Form filled out in the field by j, /(///,.)~ Mailed/Faxed to: Date: D. Bergen, D. Dzenkowski other COUNTY OFSUFFOLK (~ 112 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 13, 2012 Re: Proposed Wetland Permit for WARREN & SUSAN CANNON SCTM#1000-112-1-14 JUL 16 2012 Soulhho!d Town [~0ar~ 0f Trustees WARREN & SUSAN CANNON request an Administrative Permit to install a 4" Palisade 6'X 8' panel fence along the west side of the property. Located: 4625 Aldrich Lane Ext., Mattituck. SCTM#112-1-14 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 office use Only Coastal Erosion Permit Application Wetland Permit Application ~;~Administrative Permit AmendmenqTrans let/Extension ~ece~vved Application: ~9~ ~Q [[ ~' JReceived Fee:$ t~'~_~ ' - ~Ob~mpleted Application __Incomplete __SEQRA Classification: Type I Type II Unlisted__ Coordinatioo:(date sent) ~EWRP Consistency Assessment Form CAC Refelral Sent: of Inspection: ~ Receipt of CAC Report: Lead Agency Determination:__ Technical Review: ~_._2~i'filic Hearing Held: ,r) Resolution: Name of Applicant ~i~,, ~ Address ~]~ ~b&~ ~ ~~ Phone Number:(~t ' Suffolk CountyTax MapNumber: lO00- Prope~y Location: ~ ~ ~ (provide LILCO Pole ~, di~ance to cross AGENT: (If applicable) Address: Phone: Board of Trustees Application Land Area (in square feet): Area Zoning: ~ ~' ~' 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 Yes ~ No If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes }g No Does the structure (s) on property have a valid Certificate of Occupancy ~ 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? ¥~ No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~'t ~ ~&~' ~1~'~ ~ a,, Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: square feet 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 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 wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART I - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) APPLICANT/SPONSOR SEQR 3.PROJECT LOCATION: F PRECISE LOCATION: Street Addess and Road Intersections, Prominent ~andrnarks etc -or 0rovide map PROPOSE° ACTION: New E:] p.nsio. E3Mod"'cation,al ratio. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially 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.) [~esidential []Industrial [~Commercia, E~Agriculture E]Park/Forest/OpenSpace [~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 yes, list agency name and permit / approval: 11. UUt:_5 ANY A~PbC]-OF THE ACTION HAVE A CURRENTLY VALID ~SERMIT OR APPROVAL? E~Yes ~i~No If yes, list agency name and permit / approval: 12. AS A RF.~ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E~es I CERTIFY THAT IHE INFORMATION PROVIDED ASOVE IS TRDE 10 THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART I! - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD iN 6 NYCRR, PART 617.47 tf yes, coordinate the review process and use the FULL EAF. [--~ Yes [~]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. [~Yes [~]No G. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattem, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, histonc, or other natural or cultural resources; or community or neighborhood character? Explain bne y. C3, Vegetation or ~auna, fish, she fish or w~ d rio species, s~gn ficant hah tats, or tbreate or endangered spedes? Explain briefly: I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I ............................. I C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: I t C7. Other impacts Iincludin~l chanties in use of either quantit;/or type of ener~;/? Explain bfiefl;/: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA fCEAt? Ill yes, explain briefly': [-I Yes rTINo [ E. IS THERE, OR IS THERE LIKELY TO BE1 CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: r-lyesI PART III - DETERMINATION OF SIGNIFICANCE (To be comp[eted by Agency) INSTRUCTIONS: F~reachadversee~ectidentifiedab~ve~determinewhetheritissubstantia~~iarge~imp~rtant~r~therwisesigni~cant. Each effect should be assessed in connection with its (a) seffing (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient 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 the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULl FAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio~ WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. Board of Trustees [] Name of Lead Agency Date President [] Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Board of Trustees Application County of Suftblk State of New York ~1~(1( f.~ ~t ~_/~t~gt3~ 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), 1F 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 DAY OF ,20 / Notary Public LAUREN M. Not~w Public, Stak'~ of No. 01ST616490~~: Qualified in Suffo!i Commission ~pims APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE. FORM The Town of Southold's Code &Ethics t>rohibits conflicts of interest on the tort of town officem and emnlovees. The nuroose of this form is to nrovide information which can alert the town ofoussible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name, ~niddle initial, unless yOU are applying in the name of someone else 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.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other", nan]e 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? "Relatioaship" 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% of the shares. YES NO ~1~ If you 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 applicantJagentdrepresentative) 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 of the applicont (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. DESCR1FFION OF RELATIONSHIP Form TS I ' "d"h' ~ t~ da' of ~/$1~1~' 200 t ~ Print Name . ~ ~ 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 Towh 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 dctail~ 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, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION PROJECT NAME ]0.~ ~1~~1~'~ ~' ~~ t $ ~'$*~ The Application has been submitted to (check appropriate response): Town Board P,anning Board W1 Building Dept. I--1 Board ofT stees Category of Town of S outhold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Site acreage: SI~. SS t ~ Present use: · · Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: /~l~,~l~ ~ II; ~&/~'sO~ ~ ~d$/~ (c) Telephone number: Area Code ( ~ ~' (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 ~otApplicable 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 Southoid. 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 ~ 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 ~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 App~ble At, ach 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 ~ Nob 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 ~r~ot 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 POLICIE 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 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 P~PA~DBY i~0u jO