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HomeMy WebLinkAboutTR-7209A Jill M.Doherty,President ��0f SjyO Town Hall Annex Bob Ghosio,Jr.,Vice-President ,`O l0 54375 Main Road James F.King J [ P.O.Box 1179 Southold,New York 11971-0959 Dave Bergen G cr John Bredemeyer a� Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 20, 2011 Mr.•Michael Wilson 590 Tarpon Dr. P.O. Box-870 Southold, NY 11971 RE: 590 TARPON DR., SOUTHOI�D SCTM#57-1-6 Dear Mr. Wilson: In response to your request dated December 16, 2011, the proposed burial of a proposed tank within an existing established yard area is an Exempt action in accordance with Chapter 275-4 (9) Wetlands and Shoreline of the Southold Town Code. Therefore, no further action is required by this Board. Very truly yours, Jill . Doherty, Presid t Board of Trustees JMD:Ims ivtICHAEL R. WILSON 590 Tarpon Drive PO Box 870 Southold,NY 11971-0870 Home: (631)477-4174 Cell: (214)213 0296 December 16, 2011 Jill Doherty,President Board of Town Trustees Town Hall Annex Building DEC 1 9 2011 54375 Route 25 P.O. Box 1179 Southold NY 11971 Dear Ms Doherty: Re: Town code 274-4, Section A,paragraph 9,burial of a propane tank within 100 feet of wetlands I would like you to confirm that I do not need a Town of Southold permit for installing a 500 gallon propane tank for my home. We want to add a built-in electric generator to make sure we have electricity during future storms. Attached is a statement from C. F. Van Duzer Gas Service Inc. that the only suitable location for a buried tank is behind the house. The tank will be in the area more than 50 feet from the canal,but less than 100 feet. I have attached a copy of our lot layout. Currently we have a 50 gallon tank above ground behind our house(also within the 100 feet line) for cooking,but it would be much safer if we buried a 500 gallon tank: The installation would be done in accordance with all other Town and State requirements. Thanks in advance. If it is OK to install the tank, feel free to sign and return this letter. Sincerely, 1hoposal Page No. Of Pages C. F® VAN DOZER GAS SERVICE, INC. 46155 Route 48 Box 1497 SOUTHOLD, NEW YORK 11971 (631) 65-3882 FAX (631) 765.8 5-3452 04 PRqWSAL SUBMITTED PHONE DATE/,/� � � 7T�6 .b8 NAME Z7Z/A122i:2- zy. CRY,STATE and ZIP CODE5P7/ JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for. Of Cd G Of VM110511! ,hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: dollars($ ). Payment to be made as follows: All materiel is guaranteed to be as specified.All work to be completed In a workmanlike r manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature cliarge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control.Owner to carry fire,tornado and other necessary Insurance. Note:This proposal may be Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. Arreptart of proposal —The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. Date of Acxeptance: Signature 1 J ' PSI - -Cao /VA 4-- 11 ON"el --1e - -- .kl NY - 0 SITE PLAN T,d / Ov DA 'V45 49=1'" 0 r Ifo -socvrHocP sAbRks- -s17"- rGO 4 TARJ;4iAA40,14d 4/4E DAM T - ILS _ -1- .�.�..� TAR'' POWORIVE -TQWN .S THOLD F-0 F , ouNT,, ,Y. e y C14OFM9UOCIATES o6ciesiv James F.King,President ``�OF S0U�yO Town Hall Annex Jill M.Doherty,Vice-President l0 54375 Main Road P.O.Box 1179 Peggy A.Dickerson Southold,New York 11971-0959 Dave Bergen G �� Telephone(631) 765-1892 Bob Ghosio,Jr. Telephone Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7209A Date of Receipt of Application: October 29, 2009 Applicant: Michael Wilson SCTM#: 57-1-6 Project Location: 590 Tarpon Drive, Southold Date of Resolution/Issuance: November 18, 2009 Date of Expiration: November 18, 2011 Reviewed by: Board of Trustees Project Description: To transplant selected taller plants to both north and south of areas and replace with native lower growing plants. 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 site plan prepared by Creative Environmental Design, received on October 29, 2009. Special Conditions: None. 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. James F. King,' resident Board of Trustees JFK:eac James F.King,President OOF S0Ujy� Town Hall Jill M.Doherty,Vice President l0 53095 Route 25 Peggy A.Dickerson P.O.Box 1179 Southold,New York 11971-0959 Dave Bergen Bob Ghosio, Jr. �l �Q 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 1st day of construction / % constructed V Project complete, compliance inspection. James F. King,President *OF SOUT�o Town Hall Jill M.Doherty,Vice-President ,`O l0 53095 Route 25 Peggy A.Dickerson J�f P.O. Box 1179 Southold,New York 11971-0959 Dave Bergen G Q Bob Ghosio,Jr. �� Telephone(631)765-1892 ol�•��UNT�,� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Please be advised that your application dated _OG4-06 d% c^CUa has been reviewed by this Board at the regular meeting of A )lye v6ac f Z CRCO 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) 1 st Day of Construction ($50.00) % Constructed ($50.00) 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: � J 9 Z1 I TOTAL FEES DUE: $ �O ` BY: James F. King, President Board of Trustees � t 4 r .. �ii► �.A a� � � �t h Ir -Nl� It 4.1 I � � Dead Invasive Spreading Tall Unsightly Dead Invasive Dead Clethera Grasses Weed killed Weeds Bayberry Grasses Clethera Grasses and Bushes t R S . r tr t,.,� �' •a°°'dew. � y a.+ a, -; pro.1 � ,•ems♦ e7 �A� . .w ' M Dead Invasive Spreading Tall Unsightly Dead Invasive Dead Clethera Grasses Weed killed Weeds Bayberry Grasses Clethera Grasses and Bushes osuFFot,� James F.King,President Off' CQ P.O.Box 1179 Jill M.Doherty,Vice-President CS� Southold,NY 11971 Peggy A.Dickerson QD Telephone(631)765-1892 Dave Bergen Fax(631)765-6641 Bob Ghosio,Jr. Southold Town Board of Trustees Field InspectionMorksession Report Date/Time: Creative Environmental Design on behalf of MICHAEL WILSON requests an Administrative Permit to transplant selected taller plants to both north and south of areas and replace with native lower growing plants. Located: 590 Tarpon Dr., Southold. SCTM#57-1-6 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion Amendment —Ad ministrative_E merge ncy Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: _J.King _J.Doherty_P.Dickerson D. Bergen_ B.Ghosio, D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: xv -4 AA WA om O M� .a ,s lei- � a •fir,;.-. .� ,,�.� �►I.�Y AIV +!' +4�L".I lly� o 6 � � 0 4. "V ♦pp"f^ f Air F..yyS.`�.�r►.��ll�'+�+ ii�► vi �.,.. 4�..I �' �R i r `4 .1 r \ rt �r James F.King,President Off'ogu�FoL CQ P.O.Box 1179 Jill M.Doherty,Vice-President Gyp Southold,NY 11971 Peggy A.Dickerson ti Telephone(631)765-1892 Dave Bergen ,y Fax(631)765-6641 Bob Ghosio,Jr. y !� Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: /4�7��77 Creative Environmental Design on behalf of MICHAEL WILSON requests a pre-submission inspection to discuss the possible options of re- arrangement of the existing plant material in the non-turf buffer. Located: 590 Tarpon Dr., Southold. SCTM#57-1-6 Typ f area to be impacted: ,Zoaltwater Wetland Freshwater Wetland Sound Bay . Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ZChapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion _Amendment �Administrative_Emergency Pre-Submission Violation Info needed: Modifications: Conditions: jVj,11f1)7-Xi A) �579 /�yj65;CK-9 %'�� G�✓ ` �Y r , Present Were: ''�J.King Doherty_►iP.Dickerson / Bergen_ B.Ghosio, D. Dzenkowski other Form filled out in the field by /yJ Mailed/Faxed to: Date: Board Of Southold Town Trustees :_} f r. SOUTHOLD, NEW YORK u•- J 70 DATE:October 26, 2001 t . PERMIT NO. . .... .............. GILLIAN & MICHAEL WILSON............11..................... ` ISSUED TO .................... .. .... . Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- .a titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS + IN AND ON TOWN WATERS AND PUBLIC LANDS and the 1 REMOVAL OF SAND, GRAVEL-OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the October 24, • Resolution of The Board adopted at a meeting held on ......................_.... -• 2001 200 00 ........ and in consideration of the sum of #.........�............. ... paid by En-Consultants. Inc. Jor,Giilia •...8r...lyiiel el._VlTilson.......... ... of .........Southampton ................. --.... N. Ye end, subject to the t Terms and Conditions listed on 4he reverse side hereof, wing: of Southold Town Trustees authorizes and aerrnits }hfa fe11e t Wetland permit to remove and replace f inplacel apprea. II5 1lnear ft. of sales. timber ,t a Z bulkhead with C-Luc plastic bulkhead and dredge aroa 00' tang up to l0'oft bulkhead , r) to a maximum depth of -i' ALN to rerovcr lost upland 11Ut use approa. 6D cy• spoil for backltll. Construct nf[nee•bulkhead +timber dock. cbnelstlng of a 5'1 5'canlile., ;redg9 L platforrs: 1'Kla'hinged ramps and 4'% LO' floes tc br eecuted by (L1 t. diameter R . 2. 0 ionstruct a rnw fg,ul, dwelling HteF attached deck:dtd•emnv and sadist+-system; aed connect w public rater aervlce.and Zh the condittoa o[a 50' ...-disturbance buffer: •hayba�c• placed down at ehr HO- non-dlstutbanee fine and p.,.d s to. a s■nv von[ in all m a�run o[I. and a 4'wide path through said bu[[er to the proposed dock. sLL as dnptct�d on ed r.",ed plan dated 10130101. t R the originating appncanon. r The said Board of Trustees Mere- ' J IN WITNESS WHEREOF, 1 by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. M.iCV Trmsees y-r *•�asr tar • . SURVEY OF LOT 40 MAP OF SOUTHOLD SHORES Q 2 s gJ, FILE N..3LLS3 FILED AUGUST 29, 1993 4 1� sZ SITUATED AT ARSHAMOMAQUE N OF SUFFOLKCOUNTYY, NEW D ORK S.C. TAX No. 1000-57-01-06 SCALE 1'-30' �• ::'.°•v.•+����••' �AI JA1999 1 998 ADDED COW"LINES Eg, I jj� MARCH oC�R 2.2001 ADDED NOTES Y OCTOBER 29, 2001 REVISED S PLAN RE 6 -0 e SE CCN28 q OU16 FINAL Nr1 LSURVE.Y N Frl�4rf ,: f MAY 19.2003 ADOEO REPLANTING PLAN q \ / •' AREA - 19.89B.D2 sq. if. '•' / 0�. (TO BULKHEAD)0.457 ac. 1"r Zna Sf'/ y l,��Q '• 1.atrAioa Aa omcm m Ka m.1Wutw�r CMW oQKM p At OM INWNni@ S- -10- - .. /•p •'ttE� � z now I roe now�pE WA Mw lrtalL91!e /may (Q{�p AAIA!O �M Is r 1CD-Yn11 R® .YOLi[ efml u �:• ~A,'l�V '" l / qm • � >aC�' 0 nyM,/OOf a1�IIM alY.1t</IO6 1G1 TIWI W •�•i:'� b\�, 0 Q`' rOaL1�A:lm rlpl tao-lfM neee 0� .11n'Ia � :;,:Yc�., h `�� f, �P�,3 oQ�..�•: me A PI V r q�;,�,Q 2HOV8f-0RY A�� m �� S• .o me A yG r MOW 11// p• �ryc�G! N t� � P ®♦Mfw[wQiM pJ+o wL BE---k� a nu o6 ESOy *000 /06. 1P y r.901Ewtw�i a lv ro�. •�l+c,n nrmm �Ppy '�.4.• Ka r Alo.-+w w R.uo OUT :.' c g•J� .tip=• y� �-%t r 1v. ar� 1cD 1 awa•0 ,( M 2alS a(-a10�.al u"OIY�4 al 1\Ma,aMIRS Irk>aC6,C QL nM0 �. , • SR9.'OrV R9}L 1 V.al Leal 4 A) e Is LET r /� � •.. .m /� •o I / Q•.!• PECONIC ABSTRACT, Inc. 4p ° n•f y`�, !r .y •Jp •� FlDELITY NATIONAL TITLE INSURANCE COMPANY OF N YORK (-ON O MICHAEL WILSON �nl+mrw n 6a GILLIAN WILSON ,,.,a AID A11AAp!ND 1e01ra e b �1r (1 O`•�ti 1S M 1K IL.1as Sal[1/•O ti,Q44P 0 l)® �:t. W ,. �'''`• ` ':.'.: .°: istal is a ns l�'ii p1ia:ma w �-79W '''..E••:. . N o^ a.aoo:u.. J aeprl A. Ingegno �, aer0 or *w,er Land Surveyor g6 M ti eI2D L1L O• C � , of eon q l Ewp y m.wn..po,m em,w.,.`•4.0 3 �S "� .�'�. .�•c nn.s.�r.-sme.++o:-- sb na. w)w �`•w mM M o.m- Fa.(631)727-1727 441.�(0 \ � n,lto..mn.rnm rc w trerwar. Flat¢(ail)727-2990 //y�,,,�� �I�K tJwlr K■A17 OF"GrS LWIM AT WANG AWRW -'Tk r t.160 RMBaKE AWIE Pa.Bw 1111 An.Nm nr6nN AR rear aVYAKRIO)- 1aNLnrtAu•Nn raw 11YOt pwuhooa.1M.role t1W1-ovao O_psi O Town Hall Albert J.Krupski,President Z Gy 53095 Route 25 James King,Vice-President J.Z P.O.Box 1179 Artie Foster y Southold,New York 11971-0959 Ken Poliwoda 0 Peggy A.Dickerson Telephone(631)765-1892 Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 27, 2003 Patricia C. Moore, Esq, 51020 Main Road Southold,NY 11971 Re: Gillian&Michael Wilson 590 Tarpon Drive,Southold,NY SCTM#57-1-6 Dear Ms. Moore: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held May 21,2003. RESOLVED,that the Southold Town Board of Trustees Approve an Amendment to Permit# 5438 to construct 115' of 4' high retaining wall 6' landward of the existing bulkhead. Plant 6' area between bulkhead and retaining wall with beach grass on 18"centers revegetate 50 foot buffer as per approved plans dated May 19th,2003 This is not a determination from any other agency. If you have any questions, please call our office at 765-1892. Albert J. Krupsski, Jr. f/ President,Board of Trustees AJK:cjc ..14. nM FF•a1: ray. T6a New York State Department of Environmental Conservation Division of Fish, Wildlife & Marine Resources, Region One Marine Habitat Protection Building 40- SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0295 FAX: (6311 444-0297 Erin M.Ciaay Commissioner Amendment to Permit August 1,2002 Michael&Gillian Wilson � 4107 Rainsong Drive � � � 0 � � • Dallas,TX 75287-6645 D Re:UPA# 1-4738-02161100003 MAY 2 Q z(1�3 Project location: 590 Tarpon Drive Southold, NY F-- Southold Tm Dear Pennittee: Board of Trustee= N/A Your recent request to extend the above permit has been reviewed pursuant to 6NYCRR,Part 621, The expiration date is extended to: ,X Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR,Part 621. It has determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions.Therefore,the permit is amended to authorize: Construct 115 feet of 4 foot high retaining wall 6 feet landward of the existing bulkhead.Plant 6 foot area between bulkhead and retaining wall with beach grass on 18 inch centers. All work shall be done in accordance to plans prepared by James H.Rambo,Inc.dated 7112/02 and stamped NYSDEC approved 8/1/02. This letter is an amendment to the original permit and as such,shall be available at the job site whenever authorized work is in progress. All other terms and conditions remain as written in the original permit. Very Truly Yours, V. Deputy Regional Permit Administrator CC: MHP New York State Department of Environmental Conservation Division of Fish, Wildlife & Marine Resources, Region One Marine Habitat Protection Building 40 - SUNY, Stony Brook, New York 1 1790-2356 Phone: (631) 444-0295 FAX: (631) 444-0297 Erin M.Crotty Commissioner Amendment to Permit June 6,2002 Gillian&Michael Wilson 4107 Rainsong Drive Dallas,TX 75287-6645 Re: UPA# 1-4738-02161/00003 Project Location; 590 Tarpon Drive, Southold Dear Permittee: N/A Your recent request to extend the above permit has been reviewed pursuant to 6NYCRR, Part 621, The expiration date is extended to: —X_ Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR,Part 621. It has determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore, the permit is amended to authorize: Increase area of disturbance to 30' maximum for the purpose of storing excavated material resulting from the bulkhead replacement. Restoration of buffer area shall be done in accordance to plans prepared by Plantings by The Sea, Inc. dated 6/5/02 and stamped NYSDEC approved 6/6102. This letter is an amendment to the original permit and as such,shall be available at the jab site whenever authorized work is in progress. All other terms and conditions remain as written in the original permit. Very Truly Yours, Deputy Regional Permit Administrator CC: MHP I 1 1J AM FF•:rt4: Fe:: Tv: !E: ':{J •it JG1 - Rt✓P�r�tTrNf, Gxt�ra`ll� �v�f�Q P rq �-a2csT�� a�►r�k.�n� K 41 fil H. -• l�� book /7�•I�,pUw�p %�7n�t6 ra2��?d�S NYS DEC .�.�Q U��t.�Q-n.� APPROVED AS PBit TERMS AND CONDITIONS R PERIET NO 3t-Od 6 ®6,0 3 71 z.416 Z DACE i 7- C P AY 2 0 c.uuJ Southold Town - •. ._. Pr-rd 0{Trustees w A44 FS N YS DEC APPROVED AS PER TERMS AND CONDITIQNS O PBRMIT NO M-0 9/6/44o p:3 / w DATE xl 4. 'F ✓Sa'iC� y /'"�� :-1•�r�• Se•/E EY/slr,✓Cr oi.✓F Tol�f�..w:�/ � �—� Gr4awvpsEL � TR�W.t 'cANY,EO �t�S,S TiE AP.�S / �� �asHHawFrsuct-.cam `� ; Bvyy No.VEYSuC+tCE STCpaS G?Ass i1= AJ►A�G4 - _ 7CO Z Y E.P4Y e,- .1,.o� —� r s.1 s-o 1 r 1 „BR• �s qq3 1 c--�' — —� —� a s y s z•zsr�, ', r Iu ra raw. '�" 3 m1 n ra srestc.w. w,mt t w a s � r3ar �� ��C Ir.3I.k1 k SEE SEL w. o• "`�„ Wrn. s Iom � � as>_os-oizs �,�. 1eYn.'. . b r,r s '• Is.s s ... . �i. xc''e Io �Y wi a a V M as a c Is /� '}' •BLUE M1I � 'i9 s r It3 . ... /t0.111c1 �v SOUND ISLAND SHELTER .ees a NOTICE COUNTY OF SUFFOLK © x ,w.a SOUTHOLD SECTION NO E W" ZEE r Red Property Tax Service.Agency _ C GrAY ant Povrlmg N T.]3901 �� _.' '•- �_ _�' ... ,�_.� --.,.,...;•_..._`�-.x' ._. �e "_:-..us._��, .•Rb�f.L�T.v..`�s+rry-..�:e2tih... _ _ a > . N �sstNo. uxc T. LIS may, �m Lt/kN:. ~,!♦0 ♦ �� ,..'�- �� � W �� u�N � 6 7' o A B�CpRE qq ,V ,� ,c J � ]♦... >_sva t2 z• � p♦ '- N0 ® O K" J SOUND ISLAND SHELTER i s w -- NOTI COUNTY CE Real Pro a ty Tax ServlceKAge� r '� SEC noN f211 _O ': ��v urt F Conty CpmM W aclna4 N T 11901 N 0 5 7N0 _ ouTu 77 OFFICE LOCATION: _ ��rjf S0!/r�o MAILING ADDRESS: Town Hall Annex �� lQ P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 � Q Telephone: 631 765-1938 �� Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANG 4r" To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: November 13, 2009 1 V -- Re: Proposed Wetland Permit for MICHAEL WILSOI, j SCTM#1000-57.-1-6 ---- Creative Environmental Design on behalf of MICHAEL WILSON requests an Administrative Permit to transplant selected taller plants to both north and south of areas and replace with native lower growing plants. Located: 590 Tarpon Dr., Southold. SCTM#57-1-6 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 LWRP Program. 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 Vv*ov SOUTyO Town Hall Jill M. Doherty, Vice-President ,`O �� 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold, New York 11971-0959 Dave Bergen G Q Bob unosio, Jr. Telephone(631)765-1892 C,oU ,� Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD (�l Office Use Only l� _Coastal Erosion Permit APP licatio � _Wetland Permit Application i�Administrative Permit OCT 2 9 2009 _AmendmendTransf r/Ext nsion eceived Application: O 9' y Received Fee:$ Southhold Tow p Board of Trustees .Completed Application I off- �-) _Incomplete _SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) _ ✓LWRP Consistency Assessment Form l j c)-Q _CAC Referral Sent:_ Date of Inspection: 1 1 _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: public Hearing Hel�-�� Resolution: Name of Applicant -„N-1a.p-A Nits)��� 6z�' Address � 's..�>n'-) e, Phone Number:( Suffolk County Tax Map Number: 1000 - � Property Location: (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: �(Z-4- '1 a3 B( 3 of Trustees Application GENERAL DATA Land Area (in square feet): ),,(zz2 , 5q FfE - Area Zoning: Previous use of property: rr�,2 s Intended use of property: Covenants and Restrictions: Yes No If"Yes", please provide copy. 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): �1 �lSpt a•s't i�l(� p= 1-0 i�l c� i E 4 t 0 V- �-izr�eb� . Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: '126 LOC-AMON tJ i Nil tl'r �t tb 9�t vvt ►N1�t"� 1FU�i fz�& O(CvN +c.c� / tJ-&U�I A)J Area of wetlands on lot: square feet Percent coverage of lot: C9 % Closest distance between nearest existing structure and upland edge of wetlands: I0 feet Closest distance between ne rest 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: 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 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 LOCATION: ---r' y���` Municipality ate` County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: ❑ New ❑Expansion n Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: t�l n45 L,ti lb►Y � t �v� (mow�Yc- Vet lei o F- P_A�,j J-S wA P LAGC- eDe . 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 0 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.) 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 F\-7No If yes, list agency name and permit / approval: _ __1��E-S-ANY-ASPEN-OF"THE-ACTION-TRUE—A CURRENTLY-VALT 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 [N No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE T-O/THE BEST OF MY KNOWLEDGE Applica nsor Name CgE i)i/6 C—AA111?0-,V�eV7M (DC—$IC��Y Date: Signatur t If he acti n is a Costal Area, and you are a state agency, complete the oastal Assessment Form before proceeding with this assessment 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 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 N 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: NO C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: ' 'V C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: N 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. O C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: /V O C6. Longterm,short term,cumulative,or other effects not identified in C1-05? Explain briefly: F—t4o C7. Other impacts(including changes in use of either quantity or type of energy? Explain briefly: (V ) D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA 7 If es,ex lain briefly: Yes I %A No E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: 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(Le. 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 --- yg�the determinationofsignificance-rnusfevaluatethepotential-impaet-oftheprepesedaetiefrefrthe-envifonfnentaFcharacterfsticsof-theEEA --- 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) 3oard of Trustees Applica - n County of Suffolk State of New York rll e,a G t I 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 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. Signa re SWORN TO BEFORE ME THIS oZq DAY OF "o(,t0bv� ,20 LAUREN M.STAA%SW Notary Public,State ew York Qualified in Suffolk County Notary Public Commission Expires April 9,2 11_ i I A of Trustees AppLicatio Jk AUTHORIZATION (where the applicant is not the owner) I. 1'� �f o 1�►J \ 1�c� residing. .at T U (print owner of property) (mailing address) do hereby authorize (Agent) �rc!SA-vk�v— y. 't. to apply for permit(s) from the Southold Board of Town Trustees on, my behalf. (Owner' s signature) l , 8 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 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: �1�Q' w �(�� ���okiet� (Last name,first name,Middle 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 (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 V 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 Submitte �r�j, of 6�T 2009 Signature Print Name Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. 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. 2. 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). 3. 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 detail, listing both supporting and non- supporting 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 SITEAND PROPOSED ACTION SCTM# I bOC) - - I - - U PROJECT NAME The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. 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) ❑ (b) Financial assistance(e.g. grant, loan, subsidy) (c) Permit, approval, license,certification: Nature and extent of action:. - E19P00JA-L- -Ta 2E—Lc>—' Q i C ND I Ti o tiAL Ra.A,v Location of action: J� U l/ C' p AJ 'lDi7i1 V 6 d Site acreage: S Present land use: ��5�i76�u i 74L Present zoning classification: Pes . -z-- 2. 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: CRC- --17(/6 &&l 100A/IMA-11 Oil r (b) Mailing address: P� �(�� 1�v C�o��L �`�''�1. fi9s (c) Telephone number: Area Code f '73 V— ?�7i (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 1Xr 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 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LV R" Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No y 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 P 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 Z 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 W 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 Apl ble Attach 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 ❑ No L 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 5� 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. ❑ YeZ] No$ Not 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' KINot 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�z 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 ❑ NoA 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 ❑ NoM Not Applicable PREPARED BY �1 c/ CrC fhkd/D��G Z TITLE 1 C5. DATE /O a f CREATIVE 39160 Route 25 ry Post Office Box 160 ENVIRONMENTAL e Peconic,NY 11958 DESIGN 631-734-7923 631-734-7924 fax Division of Indian Neck Corporation September 29, 2009 Southold Town Trustees Pre Application site visit Request Creative Environmental Design has been authorized to Represent Mike Wilson of 690 Tarpon Drive, Southold, NY. The purpose of the visit is to discuss the possible options Of re arrangement of existing plaint material in the non turf buffer approved by the trustees permit in 2002. Enclosed is a $ 60.00 c k for th visi David Cichano Pre Creative Environmental Design 1 1 SEP 3 0 20094 -rd of Trustees 'Applicatic: ,- AUTHORIZATION ' (where the applicant is not the owner) 9 residing- at T U (print owner of property) (mailing address) do hereby authorize (Agent) -t to apply for permit(s) from the Southold Board of Town Trustees on _my behalf. (owner' s signature) 8 t loard of Trustees Applica' .., n County of Suffolk State of New York 76?-a AG b_j)LSD/V BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERM[IT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/BER 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 g T� DAY OF EFT ,20 ota Public MARGARET C. RUTKOWS10 Notary Public, State of New York No. 4982528 Qualified in Suffolk County r Commission Expires June 3, •r ,y � 4 tied tr • � T y i1�:e i j s t l s s i i i i 1 r � r f # r G Al. ,,.'t`., \Jf-- C1 \o lam+ —P L..L t� a ; D4..rt-1- cat". -----� �--�- r� OCT 2 9 2009 ' APT -OVE V'OA RD OF TRU"S h EES Southhotd Tolva Bo lyd of Trustees TOWN OF SOUTV:r-,,!:D d