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HomeMy WebLinkAboutTR-6331A i James F. King,President *0f SOUJyO Town Hall Jill M. Doherty,Vice-President 53095 Route 25 P.O. Box 1179 Peggy A.Dickerson Southold,New York 11971-0959 Dave Bergen G John Holzapfel �� Telephone(631)765-1892 IyCow '�� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6331A Date of Receipt of Application: April 14, 2006 Applicant: Karen & Roland Grant SCTM#: 86-5-9.1 Project Location: 1775 Indian Neck Lane, Peconic ,Date of Resolution/Issuance: April 19, 2006 Date of Expiration: April 19, 2008 Reviewed by: Trustee Dave Bergen Project Description: To remove dead and/or diseased limbs and branches landward of the top of the bank. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated in the application received on April 14, 2006 Special Conditions: None If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. 00 C 00 ' Ja es F. King, Presi 7ent Board of Trustees \ J' 16-veil 9 c%Pl4/ I �/ sy o-n ° e. �'_ SBo O/ cn lye off' ice: ( X '1 :�(� NN ^ J Polo z�• N.• Tts • 3z1, 1,0 m OrN PAVERS \ �\ i3 12 tire. WETLANDS FLAG BY ROBERT E. HERRMAN F`' 01 f EN = CONSULTANTS, #VC. 1 ON MA Y 7, ►999 �O ♦ SM MR DOCK V . SURVEY., FOR CERTIFIED TO! D /� ROLAND ROL, ND•Y'�: KA4REN GRANT KAREN GRANTT - AT PECONIC SOUTH BAY ABSTRACT INC. • . OF SOUTHOLD •wASHINGl"ON MUTUAL BANK, F.A. TOWN 'SUFFOLK(COUNTY, N. Y. 1000 - 86 , 05 - 91 Scale: 1" = 60' p . Mar. 16, 1995 - APR1L 4, 1995 (re visions) April 6,1995 (revisions) APR 14 2006 May 1,.1995 (revisions) i MAY 4, 1995 (revisions) CATER JAN. 16, 1996 ( s1h hse & barn,.,) hoar. fly 1996 (foundation location) April 3, 1996 ( Additions) Dec. 2071996 (final) MA Y 14, 1999 (.STK FOR DOCK Jane 23,1999(revl:;`) JUNE 7, 2001 ( prop. addillons) July 24, 2001 (oddlllons) NOV. 4, 2002 ( Final ) ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION N.Y.S. LIC. NO. 49618 OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF PECONIC SU, EYORS, P.C. SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR (631) 765 - 5020 FAX (631) 765 - 1797 WHOSE SIGNATURE APPEARS HEREON. P. 0. BOX 909 ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM 'ALTERED BY, 1230 TRA VELER STREET MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY nF Ayop F_R VRVbI'OR'S MAP. TERMS SUCH AS 'INSPECTED AND SOUTHOLD? N.Y. 11971 Albert J.Krupski,President ��of so yo Town Hall James King,Vice-President �0 l0 53095 Route 25 Artie Foster P.O. Box 1179 Ken Poliwoda N Southold,New York 11971-0959 Peggy A. Dickerson � �� Telephone(631)765-1892 COWN Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application _Wetland Permit Application X Administrative Permit —Amendment/Transfer/Extension -effeceived Application: ieceived Fee:$- rjV _Completed Application _Incomplete _SEQRA Classification: Type I Type II Unlisted APR 1 4 2006 Coordination:(date sent) _LWRP Consistency Assessment Form _CAC Referral Sent: _mate of Inspection:J�O49e_ � , _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: _✓Public Hearing Held: Resolution: Name of Applicant YRQC--Q R©Lht\)D U'QW Address P,®. &))( 1 5 1 N®1 kt� �')Wc. k-ma— 9(Cc1'1 kC , kl�q \lq% Phone Number: Suffolk County Tax Map Number: 1000 - %(, _05 ® Q o 1 Property Location: kN ACV, 1 At,�j p ea.©titC 3/i0 vM\Lc- _;OuNu OF Zk ,ta5 . ____—(provide..LILCO Pole.#,_distance_to._cr_oss_str_eets,_and location). AGENT: (If applicable) Address: Phone: Board of Trustees Applic Lon GENERAL DATA Land Area(in square feet): AP P'R®1C, 00(J S Q FT ( a -(n AC QC5 Area Zoning: Rr,—S1VC—NM AL Previous use of property: Intended use of property: Rrc511DC,t, �I AL- Prior permits/approvals for site improvements: Agency Date '5DvTIAOLtD-oWIJ -MOSS f17sJ g (cocr-) P %fo 504f �SOUT"OVD T►b�t� �L PE;V.A1V%M 2-32 `t-Z 1 IzS I iggb ROUsOf 2-1105-2 io/181 tool CS ��i_caom) 2,7 q S3 4- 7- 1 a.I zoo 2 C'Ae3AN A 9L'7$01P-Z V011z51200: (Swi m,nn i+v(= Pao) �� a -'� 11 z�a1 P�A�.►a� 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): Board of Trustees Appl-v -__,ti.on WETLAND/TRUSTEE LANDS APPLICATION DATA. Purpose of the proposed operations: D i seksE o AcNDi og nGJAt7 ume>s RAt,40 :S Area of wetlands on lot:_ square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: wrzo 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? cubic yards How much material will be filled? cubic yards 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: A'u, WO R V- AND G"4 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): vJ p0 pt i (A VU -M -W C WE-1 LPty I S � r� �L1 e T��� PROJECT ID NUMBER 617.20 SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME 3.PROJECT LOCATIOuY7N�:,9 r Municipality So \ o1'1) '�Q�� County fjl�r�Ql.�L 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 1-175 NINN16) "DX_ 5. IS PROPOSED ACTION: C-1-1 New ❑Expansion ❑Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: -fO W-nNE; IN-AID L1m'bs e)zx QQ rRE:s F7- Uo n eX GTk%\�& -ME; DAZE: AUK %-_TtV,%02A7r10K1 0 F T1A15- D(C All %Y1 RI-60 Al. FAAS 12)�O ME A i-R AZ kQJD/ ��� �s � uA�,�L.►may t� Lic�T i� PR��t� ��R�. , 7.AMOUNT OF LAND AFFECTED: Q s ko -mc-Gs NcOsS TO P OF le F1ti%:� ,�� 1 ztMMC0 6 Initially acres Ultimately ' acres woo'D 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? WYes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ©Residential ❑Industrial ❑Commercial ❑Agriculture ❑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 L J 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: 12. AS 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 a�oa� �I�.y om If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT(To be completed 6 Lead Agenc A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 6 7.4? If yes,coordinate the review process and use the FULL EAF. 0 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 involved 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,existing traffic pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: __...._ ...._ .......... ................._.._: C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly:- 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 briefly. C6. Longterm,short term,cumulative,or other effects not identified in C1 C5? Explain briefly: C7. Other im acts(including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA 7 If yes,ex lain briefl : Yes No E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If Xes ex lain: Yes No PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse 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)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 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 actin WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date 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) a i Board of Trustees Application County of Suffolk State of New York 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), 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 � DAY OF 20 006, Notary Public HELENE D.HORNE Notary Public,State of New York No.4951364 Qualified in Suffollt county commission Expires May 22, a 60 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The puMose 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. YOUR NAME: G QA�31/ Kf Qk0 (Last name,first name,-qiiddle 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 K Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"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 partial.ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES 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 Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)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 Submitted this 'M day of M NPIC 200 (o Signature Xa7� A �RCVv.�G Print Name_ V-AQkW `,• ( c�'� ' e Form TS l f (� 1775 Indian Neck Lane P.O.Box 126 Peconic, NY 11958 March 21, 2006 To Whom It May Concern: We would like to attain permission from the Board of Trustees to remove dead limbs from trees located landward of the "top of the bank" (which is a 16'foot elevation). The size and deterioration of this dead material has become a hazard, and is a liability if left as is. We will hire a professional tree company that will only utilize ladders, hand and/or chain saws that they can carry to the site. We will ascertain that they do all possible to minimize disturbing the environment at all. I have attached a copy of the survey, with the area I have mentioned highlighted. 1 can be available at any time, to go over with your representative, on site, what we can be allowed to do. Please contact me at home (631) 734-7388 or by cell (631) 764-3749 so that we may set up a meeting as soon as possible. I thank you in advance for your consideration in this matter. Sincerely, Karen L. Grant MAR 2 1 2006