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Home My WebLink AboutSTRUPP, DAVID TRUSTEES Jolm Mt Bredemeyer, Iii, President ?IenD~ P. Smith, Vice Pr~ident Albert J. Kmps~, Jr. Jo~m L. B~nosh~ 30~ B. Tuth~ll Telephone (515) 765-1892 Fax (51t5) 765-i823 BOARD OF TOWN TRUSTZES TOWN OF SOUTiIOLD SUPERVISOR SCOTT L. HARR/S Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 1 t971 April l, 1992 Glenn E~ Just c/o J.MoD. Consulting P.O. Box 447 Quogue, NJ 11959 David Strupp SCTM~ i000-3-18-5 Dear Mr. Just: The following action was taken by the Board of Trustees at their regular meeting of March 26, i992: Resolved that the Southoid Town Board of Trustees grant a waiver to remove paving, curbing, island, railroad tie p!anter~ fencing and shed.; construct stone driveway~ tennis & croquet courts and guest house & sanitary system. ' If you have any questions, please give us a call.. Very truly yours, Presi~ent~ Board of Trustees J[~B/djh TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski. Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTT.L. HARRIS S~apervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (5~6) 765-1823 Telephone (516) 765-1800 May 22, 1990 Glenn Just J.M.O. Consulting P.O. Box 447 Quogue, NY 11959 RE: Strupp Property, Fishers Island SCTM ~1000-3-18-5 Dear Mr. Just: The Trustees reviewed your application submitted by J.M.O. Consulting on behalf of David Strupp. After an on site inspection, it was determined that this project is out of Trustees jurisdiction. Ail other approvals that may be applicable should be secured prior to the commencement of the project. V~ruly yours, John M. Bredemeyer, III President, Board of Trustees - JMB: jb cc: CAC Bldg. Dept. File DEC APPlICAtION NUMBER ~.~ NEW YORK Slate DEPARTMENT DE ENVIRONMENTAL CONSERVATION ~__~ JOINT APPLIOATION FOH PEH~iT u.s.~.~ COR~S o~ ~NC~N~RS ~m~C~.ON NO. Please read ALL inslrt ctJons on hack before completing this application. Please lype or pdnl clearly in inL Attach addilional information as needed. ~ARTICEE 9, TITLE 1, ARTICLE 43 6NYCRR 646 (LAKE .GEORGE RECREATION ZONE) ~ARHC[E 15, TIHE 3 (AQUATIC PESTICIDE5 CONTROL) ~6NYCRR 327 (AQUATIC VEGETATION) ~6NYCRR 328 (FISH} ~6NYCRR 32~INSECTS} ~ARTICLE ~5, H~tE 5 6NYCRR 608 (PROTECTION OF WAIERS) ~For the construction, reconslructlon, or repair of a DAM or other impoundment structure. ~For the disturbance of a STREA~ DED OR BANES or excavation in or fill of NAVIGABLE WATERS. ~401 WATER QUALITY CERTIFICA11ON ~ARTICLE 15, TIlEE 15 ~6NYCRR 601 (WATER SUPPLY) ~6NYCRR 602 (LONG ISLAND WELL) RTICtE 15, TITLE 27 6NYCRR 666 (WILD, SCENIC AND RECREATIONAL RIVERS) ' ~RHCEE 24 6NYCRR 662, 663 (FRESHWAIER WETLANDS} * ~TlCtE 25 6NYCRR 661 (TIDAL WETLANDS) ~ARHCtE ~4 6NYCRR 505 (COASTAL EROSION) ' ~SECTION 10 (RIVER AND ItAR~OR ACT OF 1899) for structures and work in navigable waters of the U.S. ~COASTAL CONSISTENCY CERTIFICATION ~SECHON 404 (CLEAN WATER ACT OF 1977) for disposal of dredged or fill material in waters of the U.S. ~SECTION 103 (MARINE PEO[ECTION, RESEARCH AND 5ANCIUARIES AC1) for ~he transportation of dredged ma[erlals for dumping inlo ocean waters. 1. LIST PREVIOUS PER~IT/APPLICAHON NUMBERS AND DALES (If any) None 2. APPLICANt IS A/AN ~Owner [~Operator [-~Lessee []Municipality/Governmqntal Agency (Check as many as apply) 3. NAME OF APPLICANT (Use Full Name) J.M,O. Consulting for MAILING ADDRESS J TELEPHONE (Where can be reached during day) ~55 East 86th Street .. ~203) 889-3397 POST OFFICE' j stATE j ZmcODE :,iew York N.Y. 10028 4. NAME OF _ [~]Owner ]~gent/Cogtacj Person ~lenn E. dust/ J.M.O: Consulting ' MAILING ADDRESS (Check one} TELEPHONE (Where can be reached during day) P O. Box 447 .'" ( 51~ 653-O607 POST OFFICE luogue STATE J z,, CODE N.Y. ~1959 PROJECT/FACILITY LOCATION (Mark location on map, see Number la on reverse side) Cou,ty Suffolk J tow, or c~ty Southold J Village Fishers Island. STREET ADDRESS {If different from applicant) private Road pOsT OFFICE ~ishers Island i STATE I ZIP CODE N.Y. J 06390 6. NAME OF STREAM or BODY or WATER Un-named Freshwater Wetlands 7. HAS WORK BEGUN ON PROJECT/' If YES, attach explauation on starting work without permit, includedates, j 8. WILL PROJECT UTILIZE STATE LAND~ I~]Yes ~/o Show work on map and/or drawings. J I~]Yes 9' PROPOSED USE: ~Priv~te 10. PROPOSED STARTING DATE: I 11, APPROXIMATE COMPLETiON DATE: J 12. FEE OF (NYS Pe,mit Only) ~ ~.u~ ~ Co~m~,d~ ASAp ASAP ~:PROI[CT DESCRIPIION: (e g quantity and t~pe of material ~o be excawted, dredged or used for fill or rip rnp. Ioc~llon o~ disposal sRes; type of structure to be tnstMled; hei~h~ of dnm; sJxe of impounden~; c~pncltles of proposed wn~er sources; exten[ of distribution system; etc.) Flease See Attached" 14. WILL tills ProJect requ,re ADDITIONAL FEDERAL. stATE AND/OR LOCAL PErM.sT ~'uffolk County Department of Health Services Southold Town Building Dept. j~s. cErt,E,cAT,ON: ~L,.Yes [] No If yes, please list: I hereby affirm Ihat under penalily of perjnry that informal/on provided on this form and all attachments submitted herewilh is true to the best of my knowledge "' and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Seclion 210.4S of the Penal Law. : ' Further. the applicant accepts full responsibilily for all damage, direct or indirect, of whalever nature, and by whomever suffered, arising out of the project described herein and agrees lo indemnify and save harmless the Slate from suits, actions, damages and costs of every name and description resulting from said project In addition. Federal Law, 18 U.S.C. Section 1OO1 provides for a fine of not more Ihan $10.O00 or imprisonment for not more than five years, or both, · ~ where an applicant knowingly and willh, lly falsifies, conceais,~ covers tip a materi$ facl; or knowingly makes or uses a false, ficlilous'o} fraudulent statemenL ~' ~lherebvauth°rizetheagentnamedinNumber~'°submitt~app~tti~ybehalf'~~. 1~0 ~ / ~ ~ . / ~._ ' OAT[ ~ ...... ~~_~~ Pres,, J.M.6.TiTLE Consulting PLEASE READ ALL INSTRUCTIO~ON REVERSE SIDE 7~cant proposes to remove paving, curbing, island, railroad tie planter, ~enc~ng, shed and to construct a new stone driveway with turn around, tennis court, croquet court and guest house with associated sanitary as per enclosed survey. Kindly note that only minor regrading is involved and that a continuous line of staked bay bales shall be install and, shall remain and be maintained during edallonphasestOp OfoferosiOnconstruction.COntrol blanketsA permenant 75 undisturbed natural buffer area shall remain between the freshwater wetlands area and i/ne of hay bales." 617.21 Appendix A Slate EnvironmentaI-Qualily Review SEQR FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full E,AF is designed to help applicants and agencies determine, in an orderly manner, whether a project ,)r action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ~y, there are aspects of a project tt]at are subjective or unmeasureable. [t is also understood that those who determine ];ignificance may have little or no formal knowledge of the euvironment or may be technically expert in environmental . nalysis. In addilion, many who have know/edge in one particular area may not be aware of the broader concerns affecting~ Ihe question of significance. ~he full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination ;,rocess has been orderly, comprehehsive in nature, yet flexible to allow introduction Of information to fit a project or action. ?':dl tM: Components: The full EAF is comprised of three parts: Parl 1: Provides objective data and information about a given project and its site. By identifyin~ basic project. data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Parl 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides ~uidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially- large impact. The form also identifies wire[her an impact can be mitigated or reduced. Par! 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is acluaJly important. DETERMINATION OF SIGNIFICANCE_ Type I and Unlisled Actions Identify lhe Portions of EAF completed for this project: [] Part 1 [] Part 2 ' ~Part 3 Upo'n review of the information recorded on this EAF (Parts I and 2 and 3 if appropriate) and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: ' [] A. Tile project will not result in any large and important impacfl'~) and, therefore, is one which Wl]l nol have a ~ignificant impact on the environment, therefore a negative declaration will be prepared. ~ B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required therefore a CONDITIONED negalive declaration will be prepared.* [] C. The project may result in one or more large at~d important impacts that may have a significant impact on the environment, therefore a positive declarallon will be prepared. * A Conditioned Negative Declaration is only va/id for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of R~'~p,:msil.~lu ()ffi(er in I.~'ad Agency title of Responsible Officer Sign,l~ure ~ I.~r~,par~:r [1i different from responsible officer) J.) ~11 e 1 PART 1--PROJECT INFORMATION " Prepared by Projec! Sponsor ,~OTICE: This document is designed to assist in determining whether the action proposed may have a significant effec't on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent~ on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify each instance. . ~e Slreet Address, Municipality and Counly) ~~ltin for David BUS,NESS TELEPHONE ~.= ......... ~_~ .ue STATE ZIP CODE ~ David Str~ BUSINESS TELEPHONE ~ 950 Pa~k Ave~e '"' DESCRIPTION ~ ~ STATE ZIP CODE i "Please see attached" Please Complete Each Question-Indicate N.A. if nol applicable A. Site Description Fhysical setting of overall project, both developed and undeveloped areas. 1. Present land use: [~Urban E31ndustrial ~|Commercial UResidential (suburban) [~Forest I~Agriculture r~Other 2. Total acreage of project area: -- ~ _ acres. APPROXIMATE ACREAGE -- Meadow or Brushland (Non-agricultural) Forested Agricultural (Includes orchards, cropland, pasture, etc,) Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) Water Surface Area Unvegetated (Rock, earth or fill) Roads, buildings and other paved surfaces Other (Indicate type)__ I~Rural (non-farm) PRESENTLY AFTER COMPLETION ---2~_7~2 _ acres ~ acres' - -~L - acres ~ ~ _ acres acres _ ~ _ acres _ 0o67____0 ~ acres ~ acres 0_____.20_~ _ acres _ ~ _ acres ~ ~ acres ~~q ,_ acres' _ acres 3. What is predominant soil type(s) on project site? Sand -Pleas~ ~e:,,~ ¼~~.. __ a. Soil drainage: ~Well drained]_DD__ -- % of site E3Moderately well drained __ % of site L-qPoorly drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? ~ acres. (See I NYCRR 370). 4. Are there bedrock outcroppings on project s te~ ~Yes li~No ~ a. What is depth to bedrock? ~ (in feet) crcenlage of proposed project site with slopes: [30-10% 80 ' % E]10-15% ~ % EllS% or greater 15 % project subslantially contiguous to, or contain a building, si~e; or district, listed on the State or the National Registers of Historic Places? [:]Yes ~No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks~ E]Yes 8.What is the depth of the water tablei ~ (in feet) ' 9. is site located over a primary, principal, or sole source aquifer? []Yes E]No 10, Do hunting, fishing or shell fishing opportunities presently exist in the project area? E]Yes E]No 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? ~Yes UNo According to ~ Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) E]Yes I~No Describe ' 13.'1s the project site presently used by the community or neighborhood as an open space or recreation areat' If yes, explain 14 Does the present site include scenic views known to be important to the community? EJYes ~No 15 Streams within or co~tiguous to project area: a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to proiect area: a. Name ~ b. Size {in acres) ~ ~7. Is the site served by existing public utilities? i~Yes E]No a) If Yes, does sufficient capacity exist to allow connection? DYes ~No b) If Yes, will improvements be necessary to allow connection? ~Yes E]No lq. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article Section 303 and 304? E]Yes ~No . Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article of the ECL, and 6 NYCRR 6177 I~Yes I, Has the site ever been used for the disposal of solid or hazardous wastesl - [:]Yes ~]No Project Description Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor ~~ acres. b, Project acreage to be developed: ~ acres initially; 0~___ _-. acres ultimately, c. Project acreage to remain undeveloped 6.031 ' acres. d. Length of project, in miles: ~ (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed ~ f. Number of off-street parking spaces existing -~L_; proposed -~L~. %; g. Maximum vehicular trips generated per hour ~ ('upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Initially ~ Condominium Ultimately i. Dimensions (in feet) of largest proposed structure ~ height; ~ width; ~4.~ ,_ length. !j. Linear feet of frontage along a public thoroughfare project will occupy is? ~~ ft. 9. Number of jobs generated: during construction 10. Number of lobs eliminated by this project 11. ..uch r:altlral material fie, rock, earth, etc.) will be removed from the site? .,. will disturbed areas be reclaimed? {~Yes [~lNo L~IN/A a. If yes. for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? ~Yes E]No c. Will upper subsoil be stockpiled for reclamation? g}Yes E}No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0.!71 acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? EJYes ~No 6. If single phase project: Anticipated period of construction '{ months, (including demolition). 7. If multi-phased: N/A a. Total number of phases anticipated (number). b. Anticipated date of commencement phase I __ month c. Approximate completion date of final phase month d. Is phase I functionally dependent on subsequent phases? r-lyes [:]No Will blasting occur during construction? [~Yes ~No 10 ; after project is complete Will project require relocation of any projects or facilities? I-lYes UNo tons/cubic yards .. year, (including demolition). year, If yes, explain 12. Is surface liquid waste disposal involved? I-lYes [~No a. If yes, indicate type of waste (sewage. industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is snbsnrfacr' liquirl waste disposal involved? [~Yes I-INo Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain DYes J~No 15. 16. Is project or any portion of project located in a 100 year flood plain? I-lYes ~]No Will the project generate solid waste? ~Yes I~No a. If yes, what is the amount per month 0.35 tons b. If yes, will an existing solid waste facility be used? ~Yes f-INo c. If yes, give name Fishers Island Landfill ; location .' Fi~her~ !~l~nd d. Will any wastes nol go into a sewage disposal system or into a sanitary landfill? E3Yes e. If Yes, explain i-INo 17. Will the project involve the disposal o( solid waste? ~Yes DNo a. If yes, what is the anticipated rate of disposal? 0.35 tons/month. b. If yes, what is the anticipated site life? KI./A years. 18. Will project use herbicides or pesticides? ~]Yes (~No 19. Will project routinely produce odors (more than one hour per day)? [:]Yes [~No 20. Will project produce operating noise exceeding the local ambient noise levels? [~]Yes 21. Will protect result in an increase in energy use? [)~}Yes [:]No If yes , indicate type(s) IZl~r-~r{¢nl_ ~ I4'~rn~ IJ~t-~rl~ f'l~l 22. If water s.pply is from wells, indicate pumping capacity N/A gallons/minute. · 23 Total anticipated water usage per day N/A gallons/day. 24. Does project involve Local, 5tare or Federal funding? ~lYes ~No If Yes, explain ~]No 4. Town, Village Board Trustees ~Yes ~No , City, Town, Village Planning Board OYes ~No City, Town Zoning Board OYes ~No City, County HeMth Department []Yes E]No Olher Local Agencies ~Ye~ Other Regional Agencies ~Yes State Agencies N.g.S.D.~.C. ~Yes ~No Federal Agencies ~Yes Type Wetlands Single family Article 24 Submittal Dale 3/90 3/90 C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision;~ OYes [~No If Yes. indicate decision required: E]zoning amendment E}zoning variance E]special use permit ~subdivision Osite plan E]new/revision of master plan E]resource management plan Oother 2. What is the zoning classification(s)of the site? R-IZ0 3. What is the maximum, potential development of the site if developed as permitted by the present zoning? _ ()ne single family dwelling 4. What is the proposed zoning of the site? 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? []Yes 7. What are the predominant land use(s) and zoning classifications within a ',~ mile radius of proposed action? R-I20 UNo Is the proposed action compatible with adjoining/surrounding land uses within a % mile/ [~Yes ~No If the proposed action is the subdivision of land, how many lots are proposed? . . ~/A a. What is the minimum lot size proposed~ Will proposed action require any authorization(s} for the formation of sewer or water districts? E)Yes ~No 11. Will the proposed action create a demand for any community provided services (recreation. education, police. fire protection)~ E]Yes a. If yes, is existing capacity sufficient to handle projected demand? OYes E]No 12. Will the proposed action result in the generation of traffic significantly above present levels? E}Yes ~No a. If yes. is the existing road network adequate to handle the additional traffic~ E]Yes ONo , Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse mpacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or voi~ them· .. Verification I certify that the information provided above is true to the best of my knowledge. pplicant/$ponsor Name Glenn E. Just fo~ David Strupp Date March 31, 1990 nature Title Pres.r J.M.O. Consulting' the aclion is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proeeedin~ th this assessment. 5 'J-M:O, Congulting for David Stg~lpp ' Private Roafl,. fishers Island !% or co~t'..:n n strue;ule ~' nrehneo~.og~eoi alt~. lister' In Tho ::~Zlster t.. ;l$~tor:a ]'!flees1' . , yeg :X · Survey et~lllcstlv, J/or your eou,tyJ, I;-'~ tl~e ::."-.~ ~lth!, !lin i,r~po~ed pto,~eet ~.~.xeavsted, m!,e~, .~r. tldsen?et'~ filled, ';"!ltles '" Ily ~ ~to ~ ._ - yes, bric ~Jeribe each, Please no~¢ encl'osedos, u, rveY P. el~.ster of ,l!stetle.r-',,~es ~!thhl or eOJn~.,"~t, lo. the i,ropo~ed I,ro.~ert alee! e.'~y hu'~,,;,,,.,'.,,.,et,~,~s__......~.~ ....-. .__ built I, rlor to Ig4O re)d/or listed o, the Stero If~fcri,t~V-- for er. ell bul:dl,g/s:ruetu:o (use {cE. hotue~ outbulldh,g, bh~n, bridget d&m tutmel)e RECORD OF APPEARANCE ~ss Inslrucllons el Ihs bollom before complellng Ihla form. ;; r. NAM~ ADDRESS AND OnOANI~TIOH OF PENSOH MAKING AH APPEA~NCE: Glenn E. Just/ J.H.O. Consulting ~.0. Box 361 .~adtng Rlver,~.¥. 11792 2. CATE OF APPEARANCE: SUBJECT OF APPEARANCE: 4. NAME AND ADDRESS OF CLIENT: David Strupp [930 Park Avenue New York, N.Y. 10028 ~. ACTING IN CAPACITY OF: [] Lobbyist [] Attorney [] Agent [] Othe~ (del~c~ibe) E. tlAS OR WILL A FEE gE PAID FOR APPEARANCE? ] ~a. le OVER S2,000/VEAR INCURRED. EXPENDEO OR RECEIVED FOR [] Ye~ [] Ne I LOBBYiN~ EFFORYS? ' []'flee [] No ?. EIGNATURE OF PERSON IF APPEARING IN PERSON,* E, DEC STAFF REPRESENrAT~VF' E. DEC ORGANIZATIONAL UNIT: DATE: Inelruollone for Complellng tho Record of Appearance I. Complellon of Ibis form Is required when one o! Ihs following lakes place: e. TItleD PARTY--SecIIon 166 ol Ihs Execullve Law requires Ihs New York Slate Deparlmenl or Envlronmenlal Con- servation lo maintain for ptJbllc Inspection a record ct who appears before It for a lea as · third party--an attorney, egenl, or representative--on behalf of a parson or organization subJecl lo the regulelory (urlsdlcllon ot Ibis De- parlmenL Tbls usually occms when Ihs third party's client Is Involved In an enlorcemenl mailer or fmmal permit application mailer. (Nolo: This does ROI apply to non-entorcemenl or casual conferences or Inquiries simply seeking' Informallon or advice from Ihs Deparlmenl.) b. LOBBYIST--When a person or ori;enlzallon (Giber Ihen e New York Slala governmenl employee or e New York Slale governmenl organlzallon acting In an official capacity) appears--whether at the Department's request or on their. own Inlllallve--for Ihs purpose of Inlluenclng Ihs edopllon or reJecllon of leglslalfon (before II Is given a number by Ihs leglslalure), rules or regulellone, reis making or budgel flame. AR "appearance" ce~ be · telephone call, personal vfsll, loller, conversation el a meeting, or any olher type Gl conlact. (Note: This Iorm does not have to be Iflled GUI . for the person's or organlzellon's appearances el public hearings On a proposed regulallon. Their appearance(s) will be recorded es ~arl of Ihs hearing record.) · This form should be filled out (excepl for Items elghl and nine) by Ihs appearing person and given to Ihs DEC slefl person before whom he/she Is appearing. The DEC slaff person Involved should complele Ihs form by filling In Items elghl and nine. in cases where Ihs appearing parson does not fill out the Iozm, the DEC stair person Involved should'fill II out for them, excepl Items slx (unless Ihls Informallon Is supplied) and seven· Th~n complele Ihs form by IIIl~ng In llama elghl end . nine, The I~EC slalf person must torwsrd all originals of compleled forms et Ihs end of Ihs month I ~ -, Planning, Inlerolflce Mailing Code 2751 at ti- , C · c J.M.O. Consulting P.O. Box 467 Quogue, N.Y. 11959 516-653-O607 and to secure Dated: To whom it may concern: Please be advised that I have autl~orized Glenn E. Just, President of J.M.O. Consulting to act as the agent on my behalf to apply for the necesssry permits through your agency. j.m.o, consulting p.o. box 447 quogue, n.y. 11959 (516) 653-0607 ~¥15 LqO0 APPLICATION CRECKbIST I of 2 pages NOTE:' APPLICATION MUST INCLUDE: STANDARD FORMS - Appropriate Applicatiom for Permit. Short Environmental Assessment Form, Structural Assessment Form· NOTE: For all projects requiring.Wild, Scenic & Recreational Rivers Permits aud for commercial, iudustrial or multi-residential pro- jects, submit a long Environmental Assessment Form· X 2. APPLICATION FEE: Refer to enclosed fee schedule $10.00 minimum, Check or Money Order payable to NYS DEC. You will be notified of additional fees, if any. X 3. A~thorlzation letter from the owner where the applicant is not the ow;ret. 4. Staking and labeli~tg of the seaward/wetland side of the proposed structure or fill area. X 5. Photographs of the staked project area mounted on a separate and labeled page. X 6. County Tax.Map Numbers: Photo of Tax Bill will suffice. Suffolk: Dist. 1000Sect.003 Blk. 18 Lot 5 Nassau: Sect· Blk. Subblock Lot X Project Pla~,s Ifour copies) - Plans must clearly slow tile pro- posed project aud include all approprlate dimensions, elevations and must be at a s~ale of 1" to 100' or larger· X 8. Address of project locatiou (i~ vacant land; telephone pole ! or other idelltifyillg landmark). MINIMUM PLAN REQUIREMENTS (FOUR COPIES REQUIRED) PROJECT: Alterations and/or Extensions New House Construction l, 3, 5, 6, 7, & 8 j.m.o, consulting p.o. box 447 quoguE, n.y. 11959 (516) 653-0607 New York State Department of Environmental Conservation Region I Headquarters SUNY, Building 40, Stony Brook, NY 11790-2356 Date: Thomas C. Jorllng Commissioner To: Ouoc, ue. Representing: ,/~ 1'/)/.. / ¢ 4/-,o.0 I - 4 738'- OOlR, F/oooo/-o Dear: M~ d~4~ , In response to your request for a freshwater wetlands determination for the property identified below, the New York State Department of Environ- mental Conservation has determined that the proposed project is more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24 of the New York State Environmental Conservation Law). Proposed action: ~k~0(~ ~A~IIHG. i ~.~/flht} 19b~/tb; ~dLRD~ ~ ~L~.i ~(_1~61 ~NQ Surveyed by: ~T~V~N , J, ~AH~b Date: 9 Iz~f% Tax Map N~er: 1000 - 5 - 5 . ~C *0 Please be advised that this letter does not relieve you of the responsi- bility of obtaining any necessary permits or approvals from other agencies. Very truly yours, · ' Christine J. Cost~oulos W( Deputy Regional P~mit A~inistrator L7 C3 100 50 0 ~00 200 300 ~ 4 I SCALE ~N FEET CURVE LINE 2S