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HomeMy WebLinkAboutTR-7060A • � bti����FIZ�,��0 . James F. King,President Town Hall,53095 Main Rd. Jill M. Doherty,Vice-President. P.O.Box 1179 Peggy A. Dickerson , Southold,NY 11971 Dave Bergen �Jf� ��' Telephone(631)765-1892 Bob Ghosio,Jr. 1 Fax(631)765-6641 BOARD OF TOWN TRUSTEES. TOWN OF SOUTHOLD DATE_OF INSPECTION: -t'�Ch. 275 Ch. 111 �. INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction '/2 constructed Project complete, compliance inspection. cbt-e-M ' INSPECTED BY: COMMENTS: l � 'CERTIFICATE OF COMPLIANCE: r l , .James F. King,President �Of SO(/r�O Town Hall Annex Jill M. Doherty,Vice=President h� �� 54375 Main Road Peggy A. Dickerson. P.O.Box 1179 Southold,New York 11971-0959 Dave.Bergen G Q Bob Ghosio,.Jr. Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7060A P ater of Receipt of Application: March 18, 2009 Applicant: Deborah Doty SCTM#: 103-13-5.3 Project.Location: 670 West Creek Ave., Cutchogue Date of Resolution/Issuance;April 22,•2009 Date of:Expiratlon: April 22, 2011 Reviewed by: Trustee Dave Bergen Project Description: To remove a diseased tree adjacent to the wetlands, with the stump cut to:grade. 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 March 18, 2009. 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. Jame F. King, Presid t Board of Trustees osu�Foc,r James F.King,President P.O.Box 1179 Jill M.Doherty,Vice-President Gyp Southold,NY 11971 Peggy A.Dickerson too Telephone(631)765-1892 Dave Bergen ,y Fax(631)765-6641 Bob Ghosio,Jr. y vial � ,�ao Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: H G Po DEBORAH DOTY requests an Administrative Permit to remove a diseased tree adjacent to the wetlands, with the stump cut to grade. Located: 670 West Creek Ave., Cutchogue. SCTM#103-13-5.3 Ap e of area to be impacted: altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland 10 Part of Town Code proposed work falls under: YCChapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion _Amendment —Administrative—Emergency Pre-Submission Violation Info needed: Modifications: Conditions: 11c CD 7 �� oce Present Were: _J.King _J.Doherty_P.Dickerson ,X D. Bergen_ B.Ghosio, D. Dzenkowski Mark Terry_other Form filled out i the field by Mailed/Faxed to: Date: Environmental Technician Review- View N � osed: Dock W E s c� plicant: Deborah Doty Q9 urrppose: Private Mooring s 6 SGt# 1000-105-15-5.3 h Situate: Cutchogue , o�a ��0 Town: Southold Suffolk Count , NY \0V O , Teid Rancc�e: 2'+/- 0,u�,S, dl� Datum: Al H. N 'v-g�,v ��a �o �y of Q� SGALE 1'= 40' Cj o F\o J C9m T�. � 0 I off` 0.4, T ID p' 1.9 1.6 f2 0-9 `.`.,61& •`y4, d �/, 1a IA18 11.4 12 050.4 ` C IA IB 1.4 �(3�n'eOnJ• 13 i3 `liA:�. K [•� 7l •S, ` J�� "J 1 r- 2D � I.6 Id � \. 2.2 1.9 19 .IB I1 O5 l� . f'\`16 2.0 2.2 JA l.9 15 0.4 ` _ 13 2A I n p r 22� 22 2.2 19 IA 1.1 'Ab _ V •` �� 1�/JdI ��/�� .�/���J 2.2 A 1.9 2.0 2A . .\�(gy ' OS 2 22 20 �P,t�Q9��Dc 1.4 09 22 �22 2.0 22. 2-2 2D2D 2.0 ��t��-Y l'1 .4 13 o.9 1V .Y S `G/ / 2.2 ., 22 22 a'0`.1 1.1 1.0 t APPROVIND AS PER TERMS 22 ,C1.�A 22 V IB !b IA 22 22 z.1 1.9 Ib AN1? CONDITTONIS OF iy�U �1 O��r��y 0�22 2.2 2-2 22 22 22 22 I.9 1B Ib 12 �= ' iYd: V���+ IJ000) 22 22 IA 22 22 1-9 13 �y LQ 23� 2-3 �2.3 2.2 I.9 i3 �(6-,,1 E 1-5 23 2-3 EOM 23 2.2 22 222.2 1.9 15 L4 ' \ /S � 23 22 I< 23 222.0 rr 22; 2-5 22 19 12 V f V V o V e Vti O I t _ Proposed Fixed Walk Scale: I"=20' .,1! Fiberglass Grid Material Limit of Tidal Notiands caritalevered 2 square openings as delineated by P. Fox MAR 1 8 2009 kayak slide 4'x 50'(min.1.5'abv.gr.) oa-on-os 500'+ to copo5ite 2-4" pvc pipes --- - I yam- - - - �: _ :._: _�_ '. M.y-:I ---- --s .. L'� " ----- - ---- - Il 5 M ; II 1 ii �i I✓+� h '1 2 �; ' ii .. Fiberglass bttm. Grid Panel V"O-ne 4" x 4" a Forte 4 x14 1 12' o.c. 57 Ps _ Amendeid FF�EPAPUED BY: The applicant requests permission to modify the ramp by re-using material used 112 4 SEQ LMLfor construction of the ramp and creating 3 steps to grade. No change to the ol- MA\�1NG overall length or width is proposed. _ o¢ l- 5 F.o- #sss -- ---- - -... TH15 FLOT HAS DEVELOPED FROM 5URv=Y5 OF OG-06-03 Sheet II Of II IL R05ERT H.FOX, NY5 Lfc#5014"i 4/24/2005 9:51:21AM rA5LK\dcNo429o5ar[ �_ � •�i�r�t •fir � '1, � � � �� ��� 1 1 .1i• � d� , i FORM AL -ems-.ram =-- _ � .i�► �"��.�•- A. j tow, 4� Ali i C „ �a III s .. .a1., James F..King,President 'Of SUUTyo Town Hall Jill M.Doherty,Vice-President ,`O l0 53095 Route 25 P.O. Box 1179 Peggy A.Dickerson Southold,New York 11971-0959 Dave Bergen Bob Unusio, Jr. �� Telephone(631)765-1892 �yeDU Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application _Wetland Permit Application Administrative Permit Amendment/Transfer/Extension "Received Application: -3 M ­ffeceived Fee:$ M mpleted Application 3)fW101 _SEQRA.Classification: L� Type I Type II Unlisted s Coordination:(date sent) _LWRP Consistency Assessment ent Form �,`• '" MAR 1 8 2009 i _CAC Referral Sent: F'1 _Date of Inspection U Atb%e �. _Receipt of CAC Report: l::----- - - - _Lead Agency Determination: h.p?rt, e;T� Technical Review: ._-_....__..-- �blic Hearing Held: Resolution: Name of Applican i o-Q h Address 6 70 lc Pd G3 A� I l ge C�.�celiac�•-�. `� 11.4 3 S Phone Number: A) 7 3,q --G�`�{ 9-- Suffolk.County Tax Map Number: 1000 - �(63-1?LS. 3 Property Location: 7e) i (provide LILCO Pole#, distance to cross streets, and location) i , AGENT: (If applicable) Address: Phone: Board of Trustees ApplL ion GENERAL DATA Land Area(in square feet): 3 2 c� / Area Zoning: J2 - y D Previous use of property: Intended use of property: S�� Covenants and Restrictions: Yes X No If"Yes",please provide copy. Prior permits/approvals for site improvements: .�. Agency Date 1 1 I y!� �r i �rSiPi�! p '✓�/i2��C�� �G,J i/J[,�9_ f J rn 1q No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? .k No Yes If yes,provide explanation: Project Description(use attachments if necessary): Board of Trustees Appli ,ion WETLAND/TRUSTEE LANDS APPLICATION DAjfA. Purpose of the proposed operations: Area of wetlands on lot: square feet 5� _ s .✓ �✓r_Mj 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? D� 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: N A7 feet Proposed slope throughout the area of operations: �Q-- 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 b y - — y -"- reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER 617.2- SEAR 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 �bard3.— 3.PROJECT LOCATION: Municipality CLl�Cito •__ County v 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landm rks etc -or provide map AU >� 5YIS PROPOSED ACTION: © New l❑Expansion ❑Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: 7.AMOUNT OF LAND AFFECTED: rv\, Initially acres Ultimately acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ZLYes ❑ 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 ❑No If yes, list agency name and permit / approval: VALID PERMIT OR APPROVAL? ❑Yes 1-1No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ❑Yes 0 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 Board of Trustees App.Lication County of Suffolk State of New York r �o cz, 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 .T WILL BE DONE INHE 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. ignature SWORN TO BEFORE ME THIS /7 DAY OF ,200,9 qotarypubblic LORRAINE KLOPFER Notary Pub ia,Stme of New York ldo.4.228373 QualifiFd in Suffolk County 9 Commission Expires Nov.30, o940 APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose 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: (Last name,first name,giiddle initial, ss 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 (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 •X1 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_ day of Signs - Print Name Form TS I