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Home My WebLink AboutTR-7842A James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen lohn Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ¢OIC oe Please be advised that your application dated (0[~[10- has been reviewed by this Board at the regular meeting of r7 Il ~! 0,, 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: $ ~'-~9, (~ BY: James F. King, President Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 lelephone (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 __ Ist day of construction ¼ 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.: 7842A Date of Receipt of Application: June 22, 2012 Applicant: Nick Pologeorgis SCTM#: 135-1-26 Project Location: 22655 Soundview Ave., Southold Date of Resolution/Issuance: July 18, 2012 Date of Expiration: July 18, 2014 Reviewed by: Board of Trustees Project Description: To install a 3' high picket fence along the retaining wall and side yards and a flagpole with associated lighting. 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 22, 2012 and project plan 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 .lames F King. President Bob Ghosio. Jt, Vice-President 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: NICK POLOGEORGIS requests an Administrative Permit to install a 3' high picket fence along the retaining wall and side yards. Located: 22655 Soundview Ave., Southold. SCTM#135-1-26 T/ype of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Town Code proposed work falls under: pt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Pr..~R~ ~Were: ~ King ~B. Gh)OmSiiOn /~_ D.~,ergen, J. Bredemeyer_ Michael Do ' o / D. Dzenkowski Form filled out in ~he field by Mailed/Faxed to: Date: other OFFICE LOCAT/ON: 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 Fox: 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 17, 2012 JUL 1 7 2012 P0ard of Trustees Re: Proposed Wetland Permit for NICK POLOGEORGIS SCTM#1000.135_1_26 NICK POLOGEORGIS requests an Administrative Permit to install a 3' high picket fence along the retaining wall and side yards, and a flagpole with associated lighting. Located: 22655 Soundview Ave., Southold. SCTM#135-1-26 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 Office Use Only __Coastal Erosion Permit Applicatio~ __Wetland permit Application ~ Adminislxative Permit ~__~Ree&eAmen~en~s f~xtens3n e~-ved Application: ed Fee:$ ~O ~-: ' ted Appli~ation(~! ~3~.~!' ~' · __Incomplete __SEQRA Classification: Type I Type II Unlisted__ _C/oordinafion:(date sent) ~-./I~WRP Consistency Assessment Form CAC Referral Sent: ~43ate of Inspection: ~Receipt of CAC Repo/t:' __Lead Agency Determination: nical Review: c Hearing Held: __Resolution: Name of Applicant Address (-~2 su~o~ ¢ou~ ~ax ~a~ Sumbe~: 1000- Property Location: 2012 (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: Board of Trustees Application GENERAL DATA Area Zoning: ~_g.~ 0... ~. ~"~~, Previous use of property: ~.} . ~ Intended use of property: ~[ ~' Covenants and Restrictions: Yes x-// No If "Yes", please provide copy. Does this project require a variance fi.om the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Yes ~/No Will this project require any d~t]aolition as per Town Code or as determined by the Building Dept. Yes X,,/ No / Does the structure (s) on proPerty have a valid Certificate of Occupancy ¢ Yes __ No Prior permits/approvals for site improvements: Agency __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen~d~d~y a governmental agency? V No Yes If yes, provide explanation: Project Description (use attachments if necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: "~/~O ~Qd,/~- C~ ~) ~] ~ Area of wetlands on lot: -~i ~ .square feet Percent coverage of lot: o % Closest distance between nearest existing structure and upland edgeofwetlands: ~(9. ~S' feet Closest distance between ~.arest proposed structure and upland edge of wetlands: .~ feet Does the project involve excavation or filling? L/ 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 fee 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): Bogd of Trustees Application County of Suffolk State of New York 'I1[ . .er") '~} BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/g~rIE 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 1N 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 1N CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS "'~ [ S ,~ DAY OF ~-~ 20 /tO QUALIFIED IN KINGS COUNrl'¥ REG. #01 FA6225990 MY COMM. EXP. 08/02/2014 617~0 PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 · P~OJECT INFORMATION ( To be completed by Ap01icenl or Project Sponsor) 3.PROJECT LOCATiON: 4. PRECISE LOCATION: Slmel Addesa and Ro~d Intemec~ons. Prominenl ~andman~6 etc SEQR 6. DESCRIBE PROJECT BRIEFLY: InRl~lly i~! Ulm~ly acm WILL OPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as app4y.) E]O~her (dasutbe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGE ¥ (Federal. ~eor L~Cal) Ye~~ E~NO Ifyas. Ilet agency name and perr~i{I aplxovel: 11, DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLy VALIO PERMIT OR APPROVAL? ~]Yes ~ if yes, list agency name and permit ! approval: ~z. ^s ^ RESU'T OF .RO.OSE= ACT~O. ~"" ~X,ST~.~ .ENMrr~ ^.PROVA~ REQU~.~ ~O=~F,C^~ON? i c~.~,~ THA. ~E ,.FO.~T.~. PROVIOEO A.OVE ,S ~.UE If the action Is a Costal Area, ami you are ~ state agency, complete the Coaxial A~sessment Form before I~oceedlng with thl~ PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.4? If yes, coordinate the review process and use the FULL EAF. ~]Yes [71No 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 C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED W~TH THE FOLLOWING: (Answers may be handwritten, if legible) C1.Existing air quality, sudace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or farina, fish, she fish or wildlife species, sigmficant habitats, or hrea ened or endangered specJes. Exp a n bnefly I C4. ! community's existing pl~n~ or goals as officially adopt~d, ora chan§~ ~ use o'~ intensity of use o~"iand o oth'~'~"natu'ra resO~m'es? ~:xp aln briefly: ~ C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I C6. Long term, shor~ term, cumulative, or other effects not identified in Cl-C57 Explain briefly: C7. Other impacts linciudin~l chanties in use of either ~uardit~, or t)'pe o e ~1~'. Explain briefl~': ). WILL THE PROJECT HAVE AN iMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? Itl }'es, explain briefl~': E. IS THERE, OR IS THERE LIKELY TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: r--lYes rT-1 NoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adveme effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irmversibility; (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 significanca must evaluate the potential impact of the proposed action on the envirenmental characteristics of the C EA. 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 EAF 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) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the mart of town officers and emnlovecs. The numose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last dame, ~'irst t~e, middle initigl, unless you are applying in t~e name ol 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", name 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? "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 pa~ial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southotd Title or position of that person Describe the relationship between yourself (the applicant/agenffreprasantative) 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 applicant (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", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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 The Application has been submitted to (check appropriate response): TownBoard [] Planning Dept. [-~ 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) Co) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: e--~- ~3 c~ ,9 ~c "'Jq 0,~ {~) ~]' ~--~ Location of action: Site acreage: D~,(~. Si~.O. Mt Present l~d 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) Name of applicant: ~N~ (b) Mailing address: (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? 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 ~ot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southoid. See LWRP Section III - Policigs 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 ~"-~ot 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 L--~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 ~otApphcable" 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 ~ot Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southoid. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. [] Yes [] No ~ Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and ba,ardous substances and wastes.~-See LWRP Section HI - 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. [] Ye~[~ No ~ot Applicable Attach additional sheets if necessary WORKING COAST POLICIES 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 necessa:y Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evalu~n criteria. ~-~ Yes ~ No L_~Not Applicable Attach additional sheets ifneeessaty Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies 65 through 68 for evaluation criteria. [] Yes [] Not--1/l_~ Not Applicable Created on 5/25/05 11:20 AM LONG ISLAND ,~W, )ur;~ PPRC ..... BOAMYC TOWN '~PROX: 105 L.F. Of PROPOSE~. +2 IN FORMER LOCATION UNDERMINED IN THE DECEMBi~ · .. ,v ~tm--4~A-c~.~.~ss .. .. -t-49' 2 STY DVF.-J-LING PROPOSED ±100' VINYL RETAINING WALL IN PLACE Of EX. 'TEMPORARY CONCRETE BLOCK WALL TOBE REMOVED A?ROVED AS PER Tx_¢L~ / w I, RO AD E N- CONSULTANTS INC 1319 NORTH SEA RD, SOUTHAMPTON, NY 11968 631-283-6360 ?ROPO~P I~fAININ6 WAl. l., 5fONt~, I~NOLIRISHMP. Nf. ~ PI. ANflN~5 POR NICK POUO~OP. Lil5 ON I. ON615t. ANP 50UNP. 50LI1~tOI. P, 5UPPOgK CO,, NY 5I~P.Y I OF 2 7/22/I0, 4/I~/II