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HomeMy WebLinkAbout2018 Airport-Wide Obstruction Evaluation ELIZABETH FIELD AIRPORT (0B8) FISH ERS ISLAN D FY 0 • j Town of = j / • • Fishers I • Ferry District Airport-Wide *of SO Obstruction Evaluation (Survey & Analysis) PREPARED COMPANIES® a FAA y = New York Airports District Office G,�/Nrs AF��o Airport Grant Pre-Application Checklist (COMPLETE ONE CHECKLIST PER GRANn Airport Name: Fishers Island Elizabeth Field Airport Date Prepared: 01/30/2018 SAM CAGE code#: 39TN9 SAM Expiration Date: 09/12/2018 Project Description: Airport-Wide Obstruction Evaluation(Survey&Analysis) ❑ We do not plan on having a project this fiscal year. The FAA is authorized to carry our entitlements Into the next fiscal year. (If checked,sign below,and return to ADO.) Items Required with Preapplication �. • ° Attached, i� 1. Project Schedule(NOTE FAA DUE DATES) oil ❑ ❑ ❑ 2. Standard Form 424, Form 5100-100(parts/I-1V for airport development grants), Form 5100-101 (parts 114V for planning grants) (Includes project cost © ❑ ❑ ❑ breakdown and sketch) 3. Project Narrative and Justification(for Planning or Environmental Projects 0 ❑ ❑ ❑ include Scope of Work) 4. Environmental Documentation (Is the complete environmental documentation matching the potential application project description included?)(Attached or ❑ ❑ 0 ❑ previously submitted to ADO) 5. Construction Safety Phasing Plan/Airspace ❑ ❑ Q ❑ 6. Exhibit A(SOP available)(attached or previously submitted to ADO) 0 I ❑ ❑ ❑ 7. Title Certificate or Long Term Lease Agreement(at the request of ADO) ❑ I ❑ I 0 ❑ Note: If you cannot complete any of the above documents with this submittal, explain in the space provided on page 2 and provide the expected submittal date, but no later than the date specified in the Federal Register. Scott A. Russell Sponsor's Designat Official Representative(Official with authority to sign Grant Agreement) (Type or Print) h Date: a) I A Sponsor's Designated Official Representative(Signature) The purpose of this checklist is to identify some of the requirements and considerations associated with requesting Airport Improvement Program(AIP)funds. Airport Sponsors should read and consider each of the Items carefully. Some of the items can be answered by simply checking the"Yes" and "No" boxes while others require providing additional information as part of the airport's request for AIP funds. Signatures are required,including in required attached forms. Updated October 2016 Electronic submittal using Portable Document Format(PDF)is preferred. Page 1 of 2 Common Key Requirements or Considerations Clear Approaches Per 49 USC § 47107(a)(9). The sponsor must take appropriate action to ensure that terminal airspace required to protect instrument and visual operations to the airport (including operations at established minimum flight altitudes)will be cleared and protected by mitigating existing, and preventing future, airport hazards. (see 5010-Airport Master Record) Bid Protest Procedures. The sponsor requirements for bid protests and appeals is contained in 49 CFR § 18.36(b)(12) Reimbursable Agreement. The cost for reimbursable agreements between the sponsor and a federal agency is allowable if the cost is necessary for the project and the other federal agencies statutes allow this action. For instance, 49 USC § 106(1)(16) allows the FAA to enter into reimbursable agreements in order to carry out the functions of the FAA. An example of this is a reimbursable agreement between a sponsor and the FAA Air Traffic Organization (ATO) for the purpose of having the ATO relocate an FAA-owned navigational aid that is required by an AIP funded project. Non-Fed Coordination. If any type of NAVAID (PAPI, PLASI, VASI, MALS, MALSR, ILS, etc.) is to be installed or relocated as part of the project, the FAA Non-Fed Coordinator must be notified and appropriate airspace studies completed. The airspace studies must be completed before the work can be included in a Federal aid project. These studies can take up to a year to complete. Required Forms (as applicable). Agreement for Transfer of Entitlements (FAA Form 5100-110); NAVAID Forms (PAPls, AWOS, REILs); Modification of Airport Design Standards, Buy American Approval, Certificate of Economic Necessity, SRE Calculation, AIP Revenue-Generating Facility Eligibility Evaluation Form and attachments. Please contact your Program Manager if you cannot find the above forms on the Airports web site. ADDITIONAL INFORMATION: Signatures are required, including in required attached forms. Updated October 2016 Electronic submittal using Portable Document Format(PDF)is preferred. Page 2 of 2 AIRPORT PROJECT SCHEDULE LOCATION: Elizabeth Field Airport- airport-wide o�li Obstruction NoOn Evalua ion RO29y&�Cnal 2018 DATE No. ITEMFAA SponsorCOMMENTS appropriate) (Sent or 1 Submission of Environmental Document 11/30/2017— FAA Prepares-Administrative CATEX 1/1/2018 2 Provide Airspace(For new structures only) N/A 3. Verify Project is on ALP ("Update to ALP) N/A 4. Submission of a Benefit-Cost Analysis N/A 5. Selection of Sponsor's Engineer(within 5 year term 06/01/2017 or project included in associated RFQ) 6. Provide DBE plan and/or revisions to AEA-9 (See DBE and ACDBE Reporting Requirements for N/A Airport Grants) 7. Provide Preapplication Package to ADO 1/31/2018 01/31/2018 8. Provide Final Notice of Intent to Use Funds(via 4/15/2018 04/15/2018 Preapplication Package) 9. Professional Services Agreement 05/18/2018 10. Submit Preliminary Engineers Design Report N/A (Venfy rehabilitation method or pavement section) 11 Request deviations to FAA design standards form N/A with supporting documents 12. Submit project safety phasing plan for FAA N/A approval 13. 90%Complete Plans and Specs(Part 139) N/A (45 days prior to advertising bids) 14. 90%Complete Plans and Specs(Other) N/A (30 days pnor to advertising bids) 15 Submit all transfer agreements to FAA office N/A 16. Obtain wage rates N/A 17. Advertise for bids N/A 18 Bid Opening N/A 19. Bid Tab Submitted N/A 20. Application Submitted(Submit by date required by 6/15/2018 06/15/2018 FAA) 21 Acceptance of Grant Offer 09/17/2018 22. Award of Contract N/A 23. Const. Management Plan N/A 24. Preconstruction Meeting/Notice to Proceed N/A 25 Construction Start N/A 26 Construction Completion N/A 27 NAVAIDS Commissioned N/A 28 Exhibit A revised N/A 29. 5010 updated N/A 30. ALP revised/Construction As-Builts N/A 31. AGIS Updated N/A 32. Project Closeout Report 09/30/2019 Signatures are required, including in required attached forms. Updated October 2016 Electronic submittal using Portable Document Format(PDF)is preferred. OMB Number.4040-0004 Expiration Date*10/31/2019 Application for Federal Assistance SF-424 "1 Type of Submission- '2 Type of Application 'If Revision,select appropriate letter(s) ® Preapplication ®New Application Continuation "Other(Specify) ❑ Changed/Corrected Application Revision 3 Date Received. 4 Applicant Identifier OB8 5a Federal Entity Identifier 5b Federal Award Identifier 3-36-0029- - 2018 State Use Only: 6.Date Received by State- 7 State Application Identifier. 10913._ S.APPLICANT INFORMATION: .a Legal Name' Town of Southold *b.Employer/Taxpayer Identification Number(EIN/TIN). *c Organizational DUNS 11-6003307 1977363870000 d.Address: *Streetl Town of Southold Streetl Town Hall PO Box 1179 *City. Southold County/Parish *State- NY: New York Province 'Country. USA: UNITED STATES *Zip/Postal Code. 11971-000 e.Organizational Unit: Department Name Division Name f.Name and contact information of person to be contacted on matters involving this application: Prefix: Mr.. *First Name Gordon Middle Name *Last Name Murphy Suffix. Title: Manager Organizational Affiliation• Fishers Island Ferry District *Telephone Number. 631-788-7463 Fax Number *Email gmurphy@fiferry.com Application for Federal Assistance SF-424 *9.Type of Applicant 1:Select Applicant Type: D: Special District Government Type of Applicant 2 Select Applicant Type Type of Applicant 3:Select Applicant Type: "Other(specify) *10.Name of Federal Agency: Federal Aviation Adminitration 11.Catalog of Federal Domestic Assistance Number: 20.106 CFDA Title *12.Funding Opportunity Number: 3-36-0029- - 2018 *Title: Airport-Wide Obstruction Evaluation (Survey & Analysis) 13.Competition Identification Number: Title: Airport-Wide Obstruction Evaluation (Survey & Analysis) 14.Areas Affected by Project(Cities,Counties,States,etc.): 4 - obstruction plan.pdf Add Attachment` (.Delete Attachment i, 'View"Attachment . *15.Descriptive Title of Applicant's Project: Airport- Wide Obstruction Evaluation (Survey & Analysis) Attach supporting documents as specified in agency instructions Add:Attachments F DeletdAttach"rrients ; )XeW Attachments=., 1 2 3 4 =TIC I '' . aPaanrA BB w�e m, a P A e ;I // I ]I mwnarlonu aAwAce APP.aActl axvrce C�SdEEg�neers,Inc. 1 .n n ca,rw.—Y 12 puo. nn .I slm ,.n....... r, P.n n vnlbwa u H (� enmsc ec ae..ew Mub.tlen Bunco Aa1en . � Puln, aa.wanwl n.een PmPere L,`i7 nt sec.We'Iep T B.S J.S A Rr>;,c;x ' II�p ddl nB n...11wn nr Jr A _ •%X✓ Harbor fms,wAr nJ w.nwe. taY Be' A S[onr + ... 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P .ma. !y� s<[sseesence.o 21 P mB B BBD mBwT 4 Application for Federal Assistance SF-424 16.Congressional Districts Of: *a.Applicant NY z `b.ProgramlProject NY 2 Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 17.Proposed Project: *a Start Date 09/01/2018 *b.End Date: 03/01/2020 18.Estimated Funding(S): •a.Federal 225,000.00 •b.Applicant 0.00 •c.State 12,500.001 'd.Local 12,500.001 e.Other 0.001 `f. Program Income 0.00 •g.TOTAL 250,000.00 '19.Is Application Subject to Review By State Under Executive Order 12372 Process? ® a.This application was made available to the State under the Executive Order 12372 Process for review on 01/3 0/2018 F] b.Program is subject to E.O.12372 but has not been selected by the State for review. ❑ c.Program is not covered by E.0.12372. *20.Is the Applicant Delinquent On Any Federal Debt? (If"Yes,"provide explanation In attachment.) n Yes ®No If"Yes",provide explanation and attach Add Attachment Delete Attachment. View Attachment• 21.*By signing this application,I certify(1)to the statements contained in the list of certifications"and(2)that the statements herein are true, complete and accurate to the best of my knowledge.,I also provide the requited assurances" and agree to comply with any resulting terms If I accept an award.I am aware that any false,fictitious,or fraudulent statements or claims may subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 218,Section 1001) ®`I AGREE **The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Prefix: Mr. *FlrstName: iscott Middle Name. A. Last Name. lRussell Suffix •Title: ITown Supervisor *Telephone Number: 631-765-1889 Fax Number. 631-765-1823 •Email: acott.russell@town.southold.ny.us •Signature of Authorized Representative, � = 'Date Signed: US Department of Transportation OMB CONTROL NUMBER: 2120-0569 Federal Aviation Administration EXPIRATION DATE: 8/31/2019 Application for Federal Assistance (Planning Projects) Part II — Project Approval Information Section A—Statutory Requirements The term "Sponsor" refers to the applicant name as provided in box 8 of the associated SF-424 form. Item 1 Q Yes ❑No Does Sponsor maintain an active registration in the System for Award Management (www.SAM.gov)? Item 2 0 Yes ❑No ❑N/A Can Sponsor commence the work identified in the application in the fiscal year the grant is made or within six months after the grant is made,whichever is later? Item 3 Are there any foreseeable events that would delay completion of the project?If yes, ❑Yes 0 No ❑N/A provide attachment to this form that lists the events. Item 4 Is the project covered by another Federal assistance program?If yes,please identify other ❑Yes Q No ❑N/A funding sources by the Catalog of Federal Domestic Assistance(CFDA)number. CFDA: Item 5 Will the requested Federal assistance include Sponsor indirect costs as described in 2 CFR ❑Yes 0 No ❑N/A Appendix VII to Part 200,States and Local Government and Indian Tribe Indirect Cost Proposals? If the request for Federal assistance includes a claim for allowable indirect costs, select the applicable indirect cost rate the Sponsor proposes to apply: ❑De Minimis rate of 10% as permitted by 2 CFR§200.414 ❑Negotiated Rate equal to % as approved by (the Cognizant Agency) on (Date) (2 CFR part 200, appendix VII) Note:Refer to the instructions for limitations of application associated with claiming Sponsor indirect costs. FAA Form 5100-101 (4/16)SUPERSEDES PREVIOUS EDITION Page 1 of 4 Section B — Certification Regarding Lobbying The declarations made on this page are under the signature of the authorized representative as identified in box 21 of form SF-424, to which this form is attached. The term "Sponsor" refers to the applicant name provided in box 8 of the associated SF-424 form. The Authorized Representative certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the Sponsor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement,the Authorized Representative shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions (3)The Authorized Representative shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements)and that all subrecipients shall certify and disclose accordingly This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352,title 31, U.S. Code.Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. FAA Form 5100-101 (4/16)SUPERSEDES PREVIOUS EDITION Page 2 of 4 Part III — Budget Information Section A—Budget Summary Federal New or Revised Budget Grant Program Catalog No (a) (b) Federal Non-Federal Total (c) (d) (e) 1.Airport Improvement Program 20-106 $ 225,000 $ 25,000 $ 250,000 2. 3.TOTALS $ $ $ Section B—Budget Categories (All Grant Programs) Airport Improvement Program Other Program (1) (2) 4.Object Class Categories Amount Adjustment Amount Adjustment Total +or(-)Amount +or(-)Amount (Use only for (Use only for revisions) revisions) a.Administrative expense $ $ $ $ $ b.Airport Planning 250,000 c. Environmental Planning d. Noise Compatibility Planning e.Subtotal f. Program Income g.TOTALS (line a minus line f) $ 250,000 $ $ $ $ Section C—Non-Federal Resources Grant Program Applicant State Other Sources Total (a) (b) (c) (d) (e) 5. $ 12,500 $ 12,500 $ $ 25,000 6. 7.TOTALS $ $ $ $ Section D—Forecasted Cash Needs Source of funds Total for Project 1st Year 2"d Year 3'd Year 4th Year 8. Federal $ 225,000 $ $ $ $ 9. Non-Federal 25,000 10.TOTAL $ $250,000 $ $ $ $ Section E—Other Budget Information 11. Other Remarks: (attach sheets if necessary) FAA Form 5100-101 (4/16)SUPERSEDES PREVIOUS EDITION Page 3 of 4 Part IV - Program Narrative (Suggested Format) PROJECT: Airport-Wide Obstruction Evaluation (Survey&Analysis) AIRPORT: Elizabeth Field Airport 1. Objective: This project will include an airfield-wide study of the removal or mitigation of existing obstructions that may be penetrating the Part 77, 20:1 Approach and 7:1 Transitional surfaces,TSS and other applicable TERPS surfaces at all but four Runway ends. Currently there are various vegetative,turf, and man-made obstructions penetrating the 20:1 approach and 7:1 transitional surfaces ranging from 6 inches to 18 feet Work under this phase will include a full AGIS survey in accordance with AC 150/5300-16B through 18B. 2. Benefits Anticipated: Currently the airport is in non-compliance with FAR Part 77 20:1 Approach and 7 to 1 Transitional surfaces. Removal or modification of these obstructions is necessary to meet FAR Part 77 approach and transitional requirements, however a detailed obstruction evaluation has not been performed at 0138, and therefore it is not feasible to determine the extent of the penetrations.The results of the study will be used to identify current and anticipated obstructions and the required extent of removal. Removal or mitigation of the obstructions will increase the overall safety of operations at Elizabeth Field Airport. 3. Approach: (See approved Scope of Work in Final Application) 4. Geographic Location: Elizabeth Field Airport is located on the western side of Fisher's Island Fishers Island is located at the eastern end of Long Island Sound,2 miles off the southeastern coast of Connecticut. 5. If Applicable, Provide Additional Information: 6. Sponsor's Representative: (include address&telephone number) Scott Russell,Telephone: 631-765-1889, Email: scott.russell@town.southold ny.us Address: Town of Southold, PO Box 1179, Southold, New York 11971 FAA Form 5100-101 (4/16)SUPERSEDES PREVIOUS EDITION Page 4 of 4 Project Cost Breakdown Airport: Elizabeth Field Aiport Project Description: Obstruction Evaluation (Survey&Analysis) Construction or Engineering/ Brief Item Description Land Cost Land Incidental Admin. Cost Total Cost Federal Share Non-Federal 90% 10% Airport Wide Obstruction $250,000 $250,000 $225,000 $25,000 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Totals $0 $250,000 $0 $250,0001 $225,000 $25,000 7 2 3 4 CANNELVWT ; I OF --11 imf1,ALAVWP AOMP119TMTN,N RHODE. 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Legend QAirport Property Line Project Areas Runway 12-30 Rehabilitation n� Runway 7-25 Rehabilitation r {_ Obstruction Mitigation 't Airport Entrance Road Improvements 1 Terminal Building Construction Private Hangar Development FSr. E / Private Hangar Development Entrance Improvement E Project Area=3 9 ac Project Area=0.27 ac N N Obstruction Removal - Project Area=0 34 ac V- L250 500 j 115 Terminal Building Construction ProjeclArea=0.39 ac 1 �1!!!!!5iiii@Feet % i a Runway 1 tAr litadon 1 Inch=500 feet Project Area =6.3 8.3 ac Obstruct Removal When pooled at 11"07" Project Area=0 18 ac Date 9/15/2016 5 Obstruction Removal yy/ W Project Area=089 ac Q Runway 7.25 Rehabilitation Q Project Area=2 5 ac COMPANIES E r a s Elizabeth Field Airport Town of Southold = Fishers Island, New York 0 Alf ernative 2 Preferred Alternative z Figure 1-3