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HomeMy WebLinkAboutChamberlain, Kathy (3) gUfFO(,~ Albert J. Krupski, President CQG - Town Hall James King, Vice-President 'f~ ~ - 53095 Route 25 Artie Foster y - P.O. Box 1179 x Southold, New York 11971-0959 Ken Poliwoda Peggy A. Dickerson ~ ~ 'yif~Q aQ`' Telephone (631) 765-1892 1 ~ Fax (631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 12, 2004 Kathy Chamberlain P.O. Box 406 Peconic, New York 11958 Dear Ms. Chamberlain, Thank you for your letters of August 6 and August 9, and for communicating with your neighbor and lawn service. The area where the Phragmites was cleazed and cut must be left to grow back and keep that buffer area between the pond and any mowed area. Sincerely, Heather Tetrault Environmental Technician Kathy Chamber[ain P. O. Box 406 445 Huntington Blvd. Peconic, New York 11958 August 9, 2004 Albert J. Krupski, Jr. Board of Town Trustees Town Hall P. O Box 1179 Southold, New York 11971-0959 Dear Mr. Krupski: I just wanted to let you know-to follow up my letter to you of August 6`h-that yesterday I bought additional blue reflector lights at the hardwaze store and re-fenced off the area in question on my property, measuring according to the specifications in your letter to me of July 29"'. I have also communicated with both sets of neighbors across the dirt road and put the instructions to the lawn service I use in writing. I trust there will be no further problems. Sincerely, ~ Kathy Chamberlain AUG 1 0 2004 D SouthoM Town Board of TNSteea • 0 \N Kathy Chamberlain 9 P. O. Bos 406 445 Huntington Blvd g ~ Peconic, New York 11958 Aygust 6, 2004 Albert J. Krupski, Jr. President, Board of Trustees Town Hall 53095 Route 25 P. O. Box 1179 Southold, New York 11971-0959 Dear Mr. Krupski, I received your letter of July 29`h saying that the Board of Town Trustees had visited my property and found that someone had mowed in the area in question. I have rented my house and been away on vacation, and was not aware that anyone had mowed there. In response to our discussion when I met with the Board in June, I went to Hart's hardware stare and bought blue reflector lights and brown rivine and used these to rope off the area that was not to be mowed. I informed my neighbor that she was not to touch it, and she agreed that she would not. As a further precaution, in case there was any confusion, I also spoke to the person who cuts my grass and told him to be sure not to mow behind that line (though he had not previously mowed there). He came after I spoke to him and did leave that area alone so I felt sure he had understood me. To make things crystal cleaz, I have again today-let both my neighbor and the lawn service I use know what the situation is-that they are not to do any mowing or cutting whatsoever in that area. I have also asked my summer renter to keep her eye on things and to let me know if there is a problem. I will go out as soon as I can and check that the area roped off meets with the dimensions you specified in your letter. I wish to take care of the area properly and to cooperate with you in this matter. Sincerely, Kathy Chamberlain BOARD OF TORN TRUSTEES • TOWN OF SOUTHOLD • (631)765-1892 i Fax(63l)765-6641 To: Zen kow5 K~ Fax: ~(o~j ' 15 From: ~2ct~l,ef T2"~.A(} Date: ~E~. 02OU`} Re: C?Y~rnl~(r (urn-/~n~l., L,~=I~a_ges: 11~ n~1 CC: ~d'UI.Jne Jo~+nS~(l /~t'~ flit lac - /vISLI'te ~..sw ? Urgent ? For Review ? Please CommerN ? Please Reply ? Please Recycle times ff M ( 1_p S-4 c ~ ~e~ o~ A -+-0 ~ -(y,Q rTn.rs +~2e o~~,~e 'ly,a+ 'llts ~ k.ea w H ~ t1 ~ e p lace .C „-.0„-k -n w ~q~ tic.e (c 6y 1 n-rl4eei wa /VGIw a,~e a I,, I ct~ W"{~ ^ueS 1 W UL ?lecn-~ rn slle~ ~r+.~ "h.R '~~e(.Ise ~ook t~ ~;S 1'vtc~l"~._ Gncl -~o be ~yso i,.Se~I an~ Quefh~r.-i Tetrault, Heather From: Tetrault, Heather Sent: Tuesday, July 27, 2004 1:12 PM To: Dzenkowski, Don Cc: 'ebj-eati@vbb.net' Subject: Chamberlain Don Peggy, Artie, and I visited this site and put a rope with blue reflector stakes marking the area which is not to be moved; this is the area which was not moved before and was all phragmites. The area is10' off the telephone pole towards the lake; The area is N-S 24' deep; W-E 31 31' wide This is the area not to be mowed. Thanks. Heather 1 ~gpFFO(,~ Albert J. Krupski, President CQ Town Hall James King, Vice-President Gy~ 53095 Route 25 Artie Foster y - P.O. Box 1179 Ken Poliwoda Z Southold, Neav York 11971-0959 Peggy A. Dickerson ~ ~ '1if~0 ~Qt' Telephone 1631] 765-1892 1 # Fax i631J 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 29, 2004 Ms. Kathy Chamberlain P.O. Box 406 Peconic, NY 11958 Deaz Ms. Chamberlain: The Board of Town Trustees has visited your property at 445 Huntington Bh'd, Peconic in order to clarify the area which is to be allowed to grow back. There is now a rope with blue reflector stakes marking the area which is not to be mowed. This is the area, which was cut, and Phragmites removed for which the Notice of Violation of April 25, 2004 was issued. The no-nlo~v area is 10' off the telephone pole towards the lake; The area is North-South 24' deep and West to East 31' wide. There has been mowing in this azea since you and Mr. Zweig met with the Board of Town Trustees on June 24, 2004, when [hey explained to you to not mow that area. Please clarify this with anyone who you hire or allow to cut in your yard. A new violation will be issued if the mowing continues. Very Truly Yours, Albertski, Jr./k ~ ' AJK/hct ~~P~ ~ ~ pernLt~ ~p ~~~nk , fit m ~ ht a~ -b , a" 2C~ h . P.O.Box 406 Peconic, NY 11958 Apri130, 2004 Southold Town Board of Trustees P.O.Box 1179 Southold, NY 11971 Dear Town Trustees: I azn writing on behalf of my wife Kathy Chamberlain to report that she is undergoing major abdominal surgery today in New York City and will be hospitalized for a number of days before going home for aseveral-week period of recuperation. Under the circumstances, she is unable to consider the permit application called for in connection with a reported violation of wetlands code on her property on Huntington Blvd. in Peconic but would like to apply for a hearing before the Board of Trustees to discuss the matter. Kathy has asked me to tell you that she will attend to this matter as soon as she is able and asks that you allow her without penalty to consider the matter and appeaz before you in a hearing when she is able. If everything goes well, she should be ready by the first of June. In the meantime, no further work will be done in the area under review. Thank you for your consideration. Sincerely, Michael Zweig p ~u~l~ YAY - 3 2004 D Southold Town hard of Trustees L • NOTICE OF VIOLATION • t - Date: To: 1~i4~Tti /aW C~ArritQdt G4i /V (Owner or authorized agent of ownner) Address: ~D 1J'ui..JTi~+r 7~D+-~ B/v ~ ~o,vic ( ress of owner or authorized agent of owner) Please ake notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article I, Section 97-20 a premises hereinafter described in that C/~o,~,~,~ ~,~ysl~,.i /oo ~ of .4 f~QtSb a..sff... wtTGorl .6~9f 'T.4,t.... ~i4C.C wi N You are therefore directed and ordered to comply with the following: S`f'o P ~ l 1 w o el ~ ~ Nd A- PP I .r..e ~a-1... G~ sa-,r.~l c F 'T7z.a. s-~l-~.~.s X04 r.F T a,... ~ + Fb,~ o ~ A- l a.~.w-~L eorr.n I e.+Q,d I on or before the Z7~ day of tgQ~ , 20~~. The premises to which this No~ti7ce of Violatio(n'~)refers are situated at: w7c• ~.eJ R l J d T~e-L n G I Town of Southold, Suffolk County, NY (Suffolk County Tax Map Designation: Dist. 1000 Section: (0~7 Block: 3 Lot: Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisonment or both. N TI E: You have the right to apply for a hearing before the Board of Trustees of the Town of Southold, provided that you file a written request with the Clerk of the Trustees within 10 days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola- tion should be modified or rescinded. ~l Bay Const ,Town of Southold, NY I. 4gencY mnmrmnn ' New York State 3 oql a.e orig s case NO 6 modem No o INCIDENTREPORT Nv C / ? wpp y_ js gepor[Day B Dare 9 Repwr Gme Occurred 10 Dey II Oa[e 12 rime DCORred I) Gay la Dare t5 rime TO:J~' mo IoZf IoY Sic - ino ~l o y ~leV -s!~= ~.o Y Zr ov Weft 16.IMiden[ type q Bus~nets Name 18. Weapon(Q 0 V 19 mcedent Address (street NO.,SUee[Name, Bldg No.Apt Not 2D Gty, Stare. Lip(QC ? r ? VI Zt Locanon Code B Z _ ~ +a,. I P 2Z Off NB.':.` .[AY1f - - ? _ ;A .11NME Of OFFENSE - CTS 23 No o(mttims ~ a uo f...zr FT 2 2a. No.Oy Suspects 3 (}f 25.Plrson Type:CO ~COmplainentOT.OtlserM-ePetiun interviewed PRaPerson RepOrgng yyl.yWyllx Nl.NOt lntmlewcd Vl .Vktlm 26 Vicum also complainant QYQN E ryy TYPEMO NAME(LAST, FIRSi,MIDDLE, TITLE) Date of STREET NO., STREET NAME, BLDG. NO., APT.NO., CRY, STATE. Zip Telephone No 2 Birth O 6S i L F. a~ 2 - Ala I tom` 4 t 0 z ~ B 7z - ~ Bo yo C9~dr t:~,,,/~ 6 -i~o y G L TL c ~ .3ds H. a I. Z). Date of Binh 28 Age 29. Sex 30. Race 31. Ethnic m„ ? M ? f ? White ? Black ? Other Ni 32 Handrcap 1J Repdence Status Qiemp Res.-Foreign Nat. I ? span¢ ?unk ? Yes ? gepdent ? rounst ? student fl Other I U ? tgean ? Adan ?Unk. ? NOnalitpanec ? No ? Cpnmuter ? Meli[ary Q Nome ea ?Unk 3a.TypHNO 3S. Name(LasC Firrt, Meddle) 36. AIiasMickname/Maitkn Name(Last. First Middle) 3I. 4pparmtCOndition k = Impaered Dr G ? ugs ? Mental Dis Qunk. N Q empaired 4l<o ? Inj/ III Q App Norm 6 to )B.Address (Sheet NO., Streec Name, Bldg No. Apt No, Ciry, Slate. Zip) 39 Phone NO a0 Sopal Se<uriry NO Q Home L, ~yOj ? WOr4 a~p n.Date Of Berth 92 age 93 Sex aa. Race aS. Ethnic a6.S4in a). Occupation M N~ Q M Q i Q WhRe ? Black Q Other Q Hispanit Q Unk. Q Light QDdfk Q Una J¢ ? U ? rndmn ? 4Van ?Unk. QNon-Hispanic ?Medum ? Other NQ ~ aB. Heeght a9 weeght 50 nau 51 Eyes 52 Glasses 53 Build 5A Employe•bchool 55 Addreu Z Q Yes ? [omaas QSmall Qta•ge N N ? No ? Medium N 56. SCaN Masks /tattoos (Dexnhel 5] Misc ? 1 SB.'VICtImIX Property Property QvantRyl Maklar ? S[atut T T Model Serial NO. DesaipUOn Value 2 T ? F d `:e S9 Statvse 60. License Plate NO FullQ 61. Aatn 62 Exp Yr 63 Plate Type 6a Value ~ k~~ ~ PartmlQ g LL ~ 65 Veh Yr. 66 Make 6] Model 68 SIYIe 69 mN a )O. Color(s) ll towed By. R Ven¢le Notes ) y .f TO ~a T`a I'o C i /J TZ to > h N w k= a a z ~ ~ Iz N c c, t S ma3 ~ w 1/ R rF T a 13 dtt l~v rvr~p ~itJ 2 ~ Re s m )d. Irpuirles (Check a at apply) )S NYSPIN Message NO )6 Comdainam Agnam•e - ? DMV ? WanVWarrant ? Scofflaw F ?CFIm. History Q SIdM P•pperty Q Other fleGlT f rt' ff' e(mdude k) ]B eD NO )9 Supermsor's Signature (Ind We Rank) BB ID NO ~ m-1 Z a~~ 81. Status pen QOOSed Df ?rnM.check bo. below) QUnfoVrgM ~ R2 Status Date 83 NonbM.40i p( Q ? Via. Refused to Coop ? Arrest Q pros OMmed Q War•ant Adveud ' ?CBI Q]uv -NO CusmOY ?Arrest iu. ?Otteader Dead QE.vad Decl.n QUnknpwn ~ ~ vages DJS-3205 j7197~ `FALSE 57AiE MENTS ARE PUNISHABLE AS 4CRIME. PURSUANT TO THE NEW YORK STATE PENAL LAW • n of Southold Police Department A'CIDENT NUhfRER • CONTI TION/SUPPLEMENTARY REP d y-3f-a DATE-TIME OF REPORT DATE-TRt OF INC EN7 T F~ O 2 0 2 //o .Page of / awcR NO. ~ If. L ~'T / !/E~ LEr/~!/~ 0~ d-~fiz 9~7~Gi3-~~~~ ~ C N G I /N /00~ O F ~,q. ~ AKM I r RE~ TOINN.OeFF~ER NA~SN~ COMMAND ~ REPORTRJ "y SUPERVISOR REVIEWING ~/I DATE/TIM • NOTICE • Police Dept. -Bay Constable Town of Southold Peconic, New York 11958 NOTICE OF VIOLATION y / Date: fcy TO: T~ t~ / J! I~c ~c'., i /:~i`J. ' ' y9l.~i C 1-l ~ /:i (Owner or authorized agent of owner) Address: o ~ ~ E ;%v r''-<- (AddFess of owner or authorized agen[ of owner) Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article II, Section 97-20 a premises hereinafter described in that , in. _ - _ You are therefore directed and ordered to comply with the following: , v=1 ~ , r=,._.. ~7.., i _ , ~ ~ d on or before the _ day of ~ , 20 _ The premises to which this Notice of Violation refers are situated at: ~ Town of Southold, Suffolk County, NY (Suffolk County Tax Map Designation: Dist. 1000 Section: ~ Block: Lot: ) Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisonment or both. NOTICE: You have the right to apply for a hearing before the Board of Trustees of the Town of Southold, provided that you file a written request with the Clerk of the Trustees within 10 days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola- tion should be modified or rescinded. Bay Consta.bke, Town of Southold, NY Town of Southold A~ 2 9 3 6 Suffolk County, NY The People of Me State of New York vs. LAST SE (OESE! q1 -FlR,%NAME MIOOUE INNIPL 5111E 0 ~ `~R APT. NO. a srgTE nP ucENSE afl flE TflgnoN NuMBm STALE TYPE OF LICENSE DATE EMTflE9 EX DAIS OF BIRTH OPEMTOP OHMS VEHICM: ?YES ?NO THE OPEMTOfl OA flEGISTEflED OMIEP aF VEHICLE DESLflIBED BElON I RAZE NO. PATE FYJARES STATE RATE TYPE ? N.Y. ? N.J. ? N.Y. ? N.J. ? ? PASS ? CpAM ? VEHICLE MAKE ? OODGE ? BUICK O CHEV ? CADILLAL ? PONTMC ? FOND ? IXDS ? PLYM M ? TOYOTq ? VOU(5 ? • 1 ' BODY ? 3 DN ? A DN ? BU6 ? MCY ? S W. TYPE ? TRUCK ? TPNIEfl ? VAN ? wN NUMBEfl THE PEASON DEBgiIBppEO ABOVE M CHMOED A8 FIX10W8 ~/~f' N/p~itV 6 lJ~~ ~'9~AN/G Pcr S'/-~/os/ ~d0 PM C~LY~..~i •J6E~ 9lfiQIC WUMYNv wOUnON OF 8ECnON SUED. OTNE?VEHICIE AND iRMFlL UIW DF THE %ATE DF NEW Y011N ?oCcIM A ? o.s. O caM wu ? Hnz 7 ~ 7 D6 VEN MAT BPEEgND OTH~ER tOFFENSE MPN INA MPH ZONE /V~ [Qir~~lrlr MISDEMEANOR ? FACNAL PMT (NOT FOP TVS) NAMED DEffliD/JJT I ON TILE BTATEp MTE.n EANp RACE_~~y~/~ ~ t b l~4~ly7y~~ LJ~/7}~Iy .t~ ~ O S R/~/JJ~{~ LEJ!// ' n. Fen9DHO• fgnor.IxrowMEal.^ae. (Mgm.Rna MwA V. wuo uYM V. wc~~lw~~^(^(YY^^'~~'bpo~bNi)d tlabE ~~U PMKMNS SCNEDIRED FlNEE 1 CONfACTCOURL? THE PERSON DESCRIBED ABOVE q SUMMONED N APPEM AT 80UTXgD TOWN JUSnCE CWRT, 6EOEE ROUTE L, BOUINOID, NY f 1%1 IM ON x V AT p~ uMM FNBEBTgTEMENi9 XERBNME 0.N81M&E g9ACW$AMI9[EMFANGi PUfl9WNITD~9 /ECIIW RIU.KCi Tf P.LX.Y.9. COMPWNgM DAne . ~ BADOEY~ P COURT COPY A- 2 9 3 7 Town of Southold Suffolk County, NY LET The Peepk of the SGtale~ofyNew York vs. iala~ /lA/lP/~I J MIDDIF PY141 ADM ~Ow1~Sw.s-7f1~. ~/t J APr.NO. STATE ~mx~c NY //y'~ CENSEM EGISTMPON NUMBfP STATE LYPE DF LICENSE DATE E%gBES E% DALE OF BIBTN OPEWTM OWNS VENIIXE THE OPEMTMMBEGISiEBED bWNEq aF OYES OHO PUTE NO. YEIIIgE OESCNBED BELOW DALE EXFl~ STATE ?N.Y. ?NJ. ?N.Y. ?NJ. PUTE TYPf ? PASS ? CCMM ? YE1bCIE SIAXE ? BUKM ? C,~ ? DOME ? F~ ? GdluC ? PONIMO ? IXDS ? PLYM ' ? TOYOTA ? w%It5 BODY ? 2M TYPE ? TNUpt ? ATNNIEq ? BUS ? MCY ? S. W. ' ? VN! ? WNINMIBEH THE PERSON DESCRIBED ABOYE IS CHARGED AS FOLLOWS PIAC MOCC RRENCE T ~/I/f PCT TE FO NA TIME PM OIY. ~j'yM~ / / Z 7 O d ~ ? ~IL~2~QO~ SurFauccolmrcxr I gATgN OFSECDON $UBD. MTNE? ?ODER PECIFY) OEIMOIE ANp TRAFFL UwMMESTATE OFNEW Y011K . / I O~V g ? D.S. ? COA1 ? BUS ? NAS ? SPEEDING DEF VBI wT MPH INA MpN ZOrIE OTHER OlPENSE Ai sss FACTUAL PMTINpTFgi TVB) ~~l// TIIE AB YE NAMED DEPENWNTgO pI THE STATED pA TE. TIME AIm p1ACE /00~ O~ C/.'D k/ ~ ~~'lli rtlj( 11M FpRyq •pMpM (OMVIUYwIpp~)~Yr~L04 - T_'...~"°.~wTv Ipp npla SpW PARKING SCNEDVIEp Fl! S COIfTACf CgIRT ? THE PEgBON DESCNIBEp ABOYE IB SiN1YDNFD TO ADPEAR 4T SOUTNOip TOWN.BISLICE COURT. []DS{BOUTE iS. SOII}IpIp. NY 110>t MIEOF WgAp4I.E1Wi WRT9 M ~~~/~o AT F49EBTATB.EN181piBNMEgM51M&EA9AQA98A~yp..~~~~~.~~ ~AN~Fl>gIMNf TDBKIpI21 p.tl DF 11E P1NY8. M 0 BADGE _ COURT COPY W ~ • do a~ z s o ;a ~I Ho rAAa K ,.F,E~Uyt or~ ~'p t ~ t ^ ~ a i ~ 1 ~ ~ t is ct Z i ! ~ ~ ~ ~ 2 \ a ~ 1 ~O1.4~~! ~ PN 1 d1_ 7 Y cL ~ 2 ~ v, C~ d ~6 ~ Cl O Q t5 t V~ O m _'~„t ' t2 ~ ~ a d 2f~ WN~T~ 1 Z us B d yEW N~ ~ y ~,a ~ $ ~ ~ 33 O N ~ ~ P ~5i 5EL tab e ~P~ ~ - ~ ~v. Mgt. ..-r AUT-JtMN LAk~ ~t wa. ,~.a..m yucc~D `as uta eta , r . ~ ~ ~s ~ ~ 7- !'tA'~tN6 '~i. 91 iR STRg59E.`t Ql ~G. _A ~e~+xi~ 56~ a t ' 1 P ~~~t Z ro5 L~rK~ v ~ EsF. P~ 5 L,~'vJtTZER 13 ~ 4pEq. a•~ "2;5A. { ~ U ~ F+-p^GK , Q - • 'fi N N Yt~ t R ~R~i>- p '10 U E ~~r a 4~R„~gs ~ 4 ti,Q ~ T~ ~ . ~ ~ a 1- P_ to S3 a a - - - ~ ~ ~ •ti W m ~ o ~Y ~i~~ t ~ 5. A ~ Y- / i0 63 6a a VMt' `SQ'L ` . - 2 ~ s- Albert J. Krupski, President ~ o~oSUFFi)(,~~o James King, Vice-President ~`Z` Gy Town Hall Artie Foster ~ ~ 53095 Route 25 y P.O. Box 1179 Ken Poliwoda ~y ~ Southold, New York 11971-0959 Peggy A. Dickerson ~ • '~0 ~aO~ Telephone (631) 765-1892 ~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES July 13, 2004 TOE of souTxoLD Ms. Kathy Chamberlain P.O. Box 406 Peconic, NY 11958 RE: 445 Huntington Blvd., Peconic SCTM#67-3-5,6&7 Dear Ms. Chamberlain: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Thursday, June 24, 2004: RESOLVED, that the Southold Town Board of Trustees DENY the Wetland Permit application of KATHY CHAMBERLAIN to cut phragmites down to 1' along the edge of Autumn Lake. The entire area previously disturbed, as indicated in the violation, must be left undisturbed in order to allow for natural revegetation. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albertski, Jr.~~ ~ - President, Board of Trustees AJK:Ims ~ ~ ~ `4 F ~ ~ t~ \ ~ ~ 'Cr ~ c O _ _ - ~ v~ a ~ m z i Q N ~J ~ ~ ~ V o i ~ ~ ~O a i o O o r Q ~ F}- ~ ~ Q~ ~ b W ? ~ m ~ ~ ~ ~ ~ x ~ a n F" + S ~ \ ~ ~ w d 3 ~ Q 3 ° O g ~ s~ m ti o 0 ~y ~ V ~n 9. 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Krupski, President ~~0 C~ Town Hall James King, Vice-President ti~ Gy 53095 Route 25 Artie Foster O ~ P.O. Box 1179 h Z Southold, New York 11971-0959 Ken Poliwoda Peggy A. Dickerson ~.f. ~ Telephone (631) 765-1892 ~~j .It, ~a Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application ~ /G~etland Pemait Application Major Minor ~Q~ /ALL !1 . I 11.C..~ Waiver/Amendment/~)'~n es iReceived Application: II e/Received Fee:$ p(~ .2ompleted Application ~ D ~ ~ ~ ~ U Incomplete _ _SEQRA Classification: I Type IType IIUtilisted JUN - 2 2GJ4 Coordination:(da[e sent) CAC Referral Sent: /Date of Inspection: Southold Town Receipt of CAC Report: Board o1 Trustees Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Name ofApplicant /~a/~ y ~ h am h er /a n Address Hy5 Hu?lNv~~,~p~~ 6/vc~ ~ i'ecv~~~'c~ ~'V ~l. 1 / 95 8 Phone Number:(;;sl) 5 o h/ Suffolk County Tax Map Ntunber~: 1000 - ~ 7 - 3 - 5 ~ ~ ~ 7 j ~-li ~ / / •F Lt.K Y'Y i 3~ Property Location: - u,epr-~, x i r, r~ a al j ~ F s ; ti n r /g de . l..a_e.L C{ttaClv~c~ t-aX map (provide LII,CO Pole distance to cross streets, and location) AGENT: via (If applicable) Address: Phone: i ~ • • Board of Trustees Application GENERAL DATA Land Area (in square feet): 3 2 5 / . ~ s y rC.e.c~1- Area Zoning: •~~s ~ rah" ~ l Previous use of property: ~v- ~ ~ u rN ~ „vr H Intended use ofproperty:_~ r~ c.~ ' v ~r~f~ Prior permits approvals for site improvements: Agency ryl~ Date 7~wn o-/ Snu/Yt oleP .Q~[rYcQ,'nq Jc°p l', y~[5,/87 Con v.cn fs cF ~/el, hcuvz. fc driulXr~o No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? y No Yes If yes, provide explanation: Project Description (use attachments if necessary): - ~ u r- p h ra 9 ~~-,r h ~ s ~Qown fv a ~o~t u/dnc~ -[~d'c~~ oi' hGCfucr~rl ~a.~e ~i/ /tarc~l OG7 - 3._ (o a~t~ cwt cecPiplv]rnq y-eiz`"' Sera// /~ai~ 06 3 -5 ~.e.c.L talc cNO~~ affacL'~~) . - i~iP a-cJea LVi'~~Irv) i7~,~GUr~z contr~,u~rrsr~c~w:n9 /a~~? a 5 C 'v,z ~.Qo~~~ ~!P last 23 c;~aiS (5~'/~cP ~ bv«9t~! r'"Lu `~~~~iEr•fyJ y L • • Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~ U ~ to ~ / ~ ~ ~ ~ 9 m• rE s ~/1cr`~ucb~~~~vlf ~.axR- ~.~i~,~i~•,~ct c~/Ntc~i'ph~vv~ Area of wetlands on lot: 2 ° ° square feet CE s t, ~ r~~ f~ Percent coverage of lot: 7 % s ~ a ~ Closest distance between nearest existing structure and upland edge of wetlands: apP~-ox . ~5 feet Closest distance between neazest proposed structure and upland edge of wetlands: ;v j ~a feet ~ y,~; s~. ~ r Prcc c 1-u Does the project involve excavation or filling? No Yes v/ A If yes, how much material will be excavated? cubic yazds ,i, ~.4 How much material will be filled? cubic yards . a 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): - no ~c !'7~ cr G /csoli Gc~ uF s1?.2o SEAR PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART t -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1 APPLICANT/SPONSOR 2. PROJECT NAME O.PROJECT LOCATION: Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION : ? New ? Expansion ? Modfication !alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY MATH 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.) ? Resitlenlial ? Industrial ? Commercial ?Agricul[uro ? 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 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 agency name and permit /approval: 112. lA"S A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ?Yes ? No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /Sponsor Name Date: Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment .r ~ ~ • PART II -IMPACT ASSESSMENT o be tom leted b Lead A enc A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process antl use the FULL EAF. Yes ~ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative Declaration may be superseded by another involvetl agency. Yes ~ No C. 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, existng traffic pattern, solitl waste production or tlisposal, potential for erosion, drainage or flooding problems? Explain bdefiy: C2. Aesthetic, agricultural, arohaeologiwl, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, sign cant habitats, or threatened or endangered species? Explain bdeFly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain brieFly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain bdeFly: CG. Long tens, short term, cumulative, or other effects not identified in Ci-C57 Explain bdeFly: C7. Other im acts inUudin than es in use of either uanti or a of ene ? Ez lain bdefi D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? If es, ex lain bdefi Yes ~ No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain: Yes ~ No PART III -DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identfied above, determine whether it is sutufantial.large,important or otherwise signifcant.Each effect should be assessed in connection with its (a) setting (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 ofthe CEA. Check mis box if you have identified one or more potentially large or significant atlverse impacts which MAY occur. Then proceed directly to the FUL 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 acfio WILL NOT result in any significant atlverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Pnn[ or ype Name o esponsi a icer in Lea gency Title of Responsible Officer Signature of Responsible Officer in Leatl Agency Signature of Preparer (I different om responsible officer) Board of Trustees Application County of olk Ncw ~~o~~ State of New York ~"at;7~Fef7 CL1avrl~Fr/a~.l 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/I-IER 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, 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 I5~ DAY OF ~oAO ,20 off W6TAR~ N~RfiMA r /Notary Public ~ ~ JONATHAN '!_MASI 'GtOTARY PUBLIC. 'SFc'kd~fvew y~ No. O1 CAM+81, l5 If QuaLfi •d Ir a.o..a Canty O6 ~AmmissionF.n~x' e~ Scpt .d, LJ i • Kathy Chamberlain P. O. Box 406 Peconic, New York 11958 June 1, 2004 p ~~~od~ Board of Town Trustees D Town Hall 53095 Route 25 JUN - 2 2004 P. O. Box 1179 Southold, New York 11971-1892 Southold Town Board of Trustees Dear Boazd of Trustees: Enclosed is my application for a permit, following our conversation at your work session on Wednesday, May 26`h. You indicated then that the permit application does not (at this time at least) need notices to adjacent property owners, and you suggested that in place of a survey I submit Town of Southold Property Record Cazds along with a tax map of the area, which I have done. I am also enclosing a check for $500. You indicated that a site review would take place on Wednesday June 16`h. If you could let me know approximately what time, I would appreciate it. My phone # is 765- 1604. Sincerely yours, Kathy Chamberlain