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Home My WebLink AboutTR-8238A James F.King,President �o��g11FF0�,�co Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President G� P.O.Box 1179 Dave Bergen y Southold,NY 11971 John Bredemeyer �A� �� Telephone(631)765-1892 Michael J.Domino 1 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 Project complete, compliance inspection James F.King,President *0f SQU�y Town Hall Annex Bob Ghosio,Jr.,Vice-President �� Ol 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer N � Michael J.Domino • �OQ Telephone(631) 765-1892 O�yCOUNTY,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8238A Date of Receipt of Application: July 11, 2013 Applicant: Anne & Robert Piscioneri SCTM#: 135-1-10 Project Location: 21925 Soundview Avenue, Southold Date of Resolution/Issuance: July 17,.2013 Date of Expiration: July 17, 2015 Reviewed by: Board of Trustees Project Description: To add an overflow cesspool landward of existing cesspool. 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 project plan prepared by Morris Cesspool, received on July 11, 2013, and stamped approved on July 17, 2013. 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. v� James F. King, President Board of Trustees STREET ADDRESS: 21925 SOUNDVIEW AVENUE N SURVEY OF PROPERTY SOUND AT SOUTHOLD LONG �r TOWN OF SO UTHOLD SUFFOLK COUNTY, N. Y. — -- - ---- -- ---- . __ ---- _ SCALE.- 1'--20' tiw N o DUNE A 2013 vg E � �¢ �g� c� ? BMW OF- - RAW _^ �� O smic --�,,412 - VW _ ww. Z JUL 1 1 2013 Z m Southold Town Board of Trustees ILA s H� APPROVED .BY FLOOD ZONE �5:o FF. e3, 1 2:5' 1 1`�ySE :BOARD.OF TRU.�iTE$ UNE 3.9 6 4 a+ C�lf, Tf W OF.SOVT IOIQ J N ZpNE X , _- u oaf. : 7 17 13 cA a' ,tee j 56-1 15S S W o, 11 ELEVATIONS REFERENCED TO N.A.V.D. 1988 ,pna+s FLOOD ZONE FROM FIRM RATE MAP NUMBER 36103CO158H SEPTEMBER 25, 2009 VIEWCOASTAL EROSION HAZARD LINE FROM �� HAZARD AREA M COASTAL EROSION �,OFr NE�,1- No. 55-581-83 o lkclANY AL 7ERA 77ON OR ADDI7701V TO THIS SURVEY IS A VIOLATION - • N.Y.S. LIC. NO. 49618 AREA-4,609 SO. FT. OF SECAON 72090E THE NEW YORK STATE EDUCAAON LAW. � g ONIC SU EYORS, P.C. TO TIE LINE EXCEPT AS PER sECnoN 7209—SUBDI VISION 2. ALL CER77F7CA nDNS 31) 765-5020 FAX ( 1) 765-1797 HEREON ARE VAUD FOR 7NIS MAP AND COPIES 7HEREOF ONL Y:IF 1-4ND P.0. BOX 909 f SAID MAP OR COPIES BEAR :THE IMPRESSED SEAL OF THE SURVEYORp WHOSE S/GNA LURE APPEARS HEREON. SOUTHOLDN.TRAVELER STREET 13-1[JO James F.King,President �v pSUFFO(,�Cp P.O.Box 1179 Bob Ghosio,Jr.,Vice-President Gyp Southold,NY 11971 Dave Bergen y Telephone(631 765-1892 John Bredemeyer ,+. Fax(631)765-6641 Michael J.Domino Southold Town Board of Trustees Field InspectionMlork Session Report Date/Time: Morris Cesspool Service on behalf of ANNE & ROBERT PISCIONERI requests an Administrative Permit to add an overflow cesspool landward of existing cesspool. Located: 21925 Soundview Avenue, Southold. SCTM# 135-1-10 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 —Administrative—Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: J. King B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: 4 qa fY �F p P � a r { e w 7' ;lrl d . a Go �' earth metees 200 0600 lo SOUND ISLAND ONO P-0 m f-D-1111 S, 21 "D"iii-K SEO7 Oxi w Inul) Y. 46 Lao ftw DR. Op ax at j 44 L COUNTY OF SUFFOLK G Real Property Tex Service Agency Y 135 A in- -PER- f James F.King,President SU(/r Town Hall Annex Bob Ghosio,Jr.,Vice-President ,`O� �� 54 Main Road P..O.O.Box 1179 Dave Bergen t Southold,New York 11971-0959 John Bredemeyer laic Michael J.Domino �Q Telephone(631) 765-1892 O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only V. _Coastal Erosion Permit Application _Wetland Permit Application -Administrative Permit JUL Amendment/Transfer/E tension # 2Q�3 Received Application: I I 13 _Received Fee:$ — Southold Towq _Completed Application !/ 3 _Incomplete _SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) LWRP Consistency Assessment Form i✓ 19or-l:7-eary 2111113 _CAC Referral Sent: W Date.of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: XPublic Hearing Held: 7 Resolution: Name of Applicant 6 �yS o T S Mailing Address S o t� 36 Phone Number:( ) 7/y 3 s 7 2O& Suffolk County Tax Map Number: 1000 - Property Location: (provide LILCO Pole#, distance to cross streets, and location) AGENT: ,4YID r2,+Zr f (fF fmobl Jd lz 4t, (If applicable) ( Address: .0 �(p lI Y i✓/!/� o Phone: (l � 3rd of Trustees Applicati� i GENERAL DATA Land Area(in square feet): d / s r 7- Area Zoning:_ — p i Previous use of property: Intended use of property: 9 rt s ; I Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes V No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. / Does this project require a variance from the Zoning Board of Appeals? Yes f/ No If"Yes",please provide copy of decision. Will this project requir any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? V Yes No 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): C�.ss DQbI B4 d of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: r) 10 L.� C 52 r i Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: 2 6 feet i Closest distance between nearest proposed structure and upland edge of wetlands: v� 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? C� cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: n Manner in which material will be removed or deposited: K 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 CCU s (ft-7-9s a 3 I 3.PROJECT LOCATION: Municipality 51b(A-t County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landm r s etc -or provide map YOJU& 5.IS PROPOSED ACTION: ❑ New 19 Expansion ❑Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: Flow C 6 TYPO&I S'rf A d r'ek 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 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.) 121 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 I./ I No If yes, list agency name and permit / approval: VALID PERMIT OR APPROVAL? ❑Yes No If yes, list agency name and permit / approval: 12. AS A RE LT 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 / Sp gorame ate: Signature / If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment RJP architec 13,July 2013 To; Board of Trustees Southold N.Y. Enclosed is the original, notarized copy of the application E-Mailed to you on 12, July 2013. Also enclosed is the authorization for D. Morris to act on our behalf for This application. Vegy truly yours, Robert J. Piscioneri D E C E I W E J U L 17 2013 Southold Town T e ROBERT,J. PISCIONERI, Architect 50-52 194 Street — Flushing, NY 11365 - Phone (718) 357-2014— Fax(718) 357-2014 0 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 PERMITS)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. ature of Property Owner SWORN TO BEFORE ME THIS ' DAY OF Notary Public KI BANG Notary Public,State o1 New York No.01BA6218038 -- Qualifie in Nassau County COMMISSION EXPIRES 02/22/2014 s�^--rd of Trustees Applicatic�,-- AUTHORIZATION (where the applicant is not the owner) I, .Ri ! iding at 56-52 JR4 5T. (print owner of property) (mailing address) WeW MEADMI W11165do hereby authorize (Agent) OMC19 to apply for permit(s)from the So thold Board of Town Trustees on my behalf. er s signature) Board of Trustees Application County of Suffolk State of New York J. 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 KNOAILEDGEAND 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), [F GRANTED. IN COMPLE-ri'NG-imis APPLICATION, I HEREBY AU111ORIZE TI-1E TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WIT14 REVIEW OF THIS APPLICATION. X Si; wtureorpropelly owner SWORN TO BEFORE ME THIS DAY OF Notary Public K! BANG Notary Pdblk,State of New York No,018A621GS 0oalified in Nassau County COMMISSION EXPIRES 02/22/2014 ..........................................................__................ ............................. Hoard of Trustae8 Apsi�&L�.•: AUTHORIZATION (where the applicant is not the owner) jS siding at ro(5- x 1, _ (mailing address) (print owner of property) Y,jdo hereby authorize_ (Agent) �C .Ra9 to apply for permit(s) from the So hold B and of Town Trustees ou my behalf. er s signature) �— Board of Truatt;eea Application AUTHORIZATION (where tl)e applicant is not the owner) ��,� Cif residing at 5n- �• (mailing address) (print owner of property) -• t YT..k It%% hereby authorise • (Agent) ,� to apply for pen-nit(s)from the Southold Board of J'own Trustees on my behalf. (Owner's signalurc) 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 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. YOURNAME: M b Q�15 DOL bfl'S 1 (Last name,first name,.riddle initial,unless you are applying to 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 ofZone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other // (If"Other",name the activity.) Dtl a 4 rk...y 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 interests 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%o e 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 / day of -sue 20011 Signature. Print Name P 5 Form TS l 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- supportink 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 SITE AND PROPOSED ACTION SCTM# pr PROJECT NAME, ,/l �5-cICJA/Z s/' The Application has been submitted to (check appropriate response): �y Town Board El Planning Board❑ Building Dept. El Boardof Trustees En 1. Category of Town of Southold agency action(check appropriateresponse): (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: �r Location of action: ��S r ou.rz��J� �w /�v ��'y d/1/ N 1��Q 7� Site acreage: Present land use: Present zoning classification: - �a 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: ate fo'c(on Ya f (b) Mailing address: �y -S�� 2 Y S% r-feE 34 r�aLO )U y 11AS- (c) Telephone number: Area Code Zd�y (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? 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 allot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes 0 No U 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 ❑ 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 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 [allot 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. ❑ ❑ [�f Yes No Not Ap ible 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 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 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. ❑ L"—I YeO No Not Applicable Attach additional sheets if necessary WORKING COAST POLICII Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No u 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 ❑ No 12r 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 ❑ No [dNot Applicable PREPARED BY TITLE DATE I 1 OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Environmental Conservation (DEC) SUNY, Bldg. 40 Stony Brook, NY 11790-2356 (6.31) 444-0355 Mon., Wed., Fri., 8:00 AM-3:00 PM Suffolk County Dept. of Health Services 360 Yaphank Ave., Suite.0 Yaphank, NY 11980 852-5700 U.S. Army Corp. of Engineers New York District 26 Federal Plaza New York, NY 10278 917-790-8007 N.Y.S. Dept. of State Coastal Management 99 Washington Ave. Albany, NY 12231 518-474-6000