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HomeMy WebLinkAboutTRAENDLY, HENRY JFRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITtt BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 February 2, 1989 TELEPHONE (516) 765-1892 Mr. Lee Shadbolt 356 New York Avenue Huntington, New York 11743 Re: Lee Shadbolt for Henry H. Traendly, to construct an addition to the single family residence, property located at 13220 Main Road, East Marion., N. Y., Tax map number 1000-31-14-12. Dear Mr. Shadbolt, Please be advised that the Board of Trustees inspected the above referenced property and it was determined that the project proposed is out of our jurisdiction. This determination is only a determination rendered by this Board. Any other approvals that may be applicable are required prior to the commencement of the project. Enclosed is a check in the amount of $125.00, which is a refund on your application fee for a Wetland Permit ($150.00). The fee for an inspection is $25.00. Thank you for your courtesy and cooperation in this matter~ Very truly yours, ~rrea~ikdeAntKUj awski, Jr Board of Town Trustees FAK: jmr cc: Bldg. Dep't. Board of Appeals D.E.C., Stony Book BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES OF THE TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS~ ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF THE TOWN OF SOUTHOLD, AND THE ISSUANCE' OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODES OF THE TOWN OF SOUTHOLD. APPLICATION NO. DATE OF APPLICATION . IDENTITY OF APPLICANT .... HONE NO .... _5_S- ' ------ ADDRESSOF APPLICANT ...... ____ ~ TAX MAP NO. AGENT PHONE NO . %~-~.~0~ --' PERM, T REQUESTED __~_~ _,, ..... ~_ ,__~_~ ...._-~, LOCATION OF PROPERTy FOR WHICH PERMIT WANTED_]~_2~'~:_~L~_~_~~ HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION ...... .. ' ~-~._2~____ HEIGHT ABOVE WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY ....... --~- DEPTH AT LOW- TIDE AVERAGE RISE IN TIDE DISTANCE TO THE NEAREST CHANNEL___O FT. DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE AREA O FT. IS THIS FOR PRIVATE OR BUSINESS USE?__~, __ ......................... MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED ..... _~_____ INTENDED USE OF PROPERTy DESCRIBE ANY KNOWN PRIOR OPERATIONS CONDUCTED ON THE PREMISE AND WHETHER ANY PRIOR LICENSE OR PERMITS HAVE BEEN ISSUED TO ERRECT STRUCTURES OR TO DREDGE OR DEPOSIT FILL ON SAID PREMISEB AND WHETHER ANY PERMJTS OR LICENSES WERE EVER SUSPENDED OR REVOKED BY A~GO~,V~E_RNMENTAL DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE PREMISES AFTER THE WORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF THE PROJECT SITE IF NECESSARY WRITTEN CONSENT OF THE OWNER OF THE PROPERTY, I F NOT THE SAME AS THE ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD PROHIBIT THIS PROJECT? 14-16-,~ f2/8?)--Text 12 PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 3. PROJECT LOCATION: County ~F~ 4, PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc. or provide maD) SEQR 5. IS PROPOSED ACTION: [] New ~ Expansion [] M edification/alteration 6. DESCRIBE PROJECT BRIEFLY: DW/ELLIMGr~ 7. AMOUNT4}F LAND AFFECTED: Initially [.~-~:~'~ ,?'~Z. acres Ultimately S~F--- acres 8, WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] No If No, describe briefly WHAT tS PRESENT LAND USE IN VICINITY OF PROJECT? '~Residential [] Industrial [] Commercial Describe: [] Agriculture [] Park/Forest/Open space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STA~TE~.O R LOCAL)? ,~Yes [] No If yes, list agency(s) and permit/approvals 11. DOES ANY .,~.t~.,JECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes )Z~No If yes, list agency name and permit/approval 12. AS A RESULT. OF PROPOSED ACTION WILL EXISTING PERM!T/APPROVAL REQUIRE MODIFICATION? [] Yes ~No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/spons~r name'. ~b~J~ :~)~[~ A~--~[T~ ~ - ¢'~ t Date: Signature: ~, ~ .~~..~.~'t~,~ If the action is in the CoaStal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II--ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 [] Yes [] No If yes, coordinate the review process and use the FULL EAF. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 may be superseded by another involved agency. .[]yes~' '[]No If No, a negative declaration 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 patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: 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 C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes ~ No If Yes, explain briefly PART Ill--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 (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibitity; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that ail relevant adverse impacts have been identified and adequately addressed, [] 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 action WiLL NOT result in any significant adverse environmental impacts AND p_r'ovide on attachments as necessary, the reasons supporting this determination: Print or 1ype Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Name of Lead Agency Title of Responsible Officer Signature of Preparer (if different from responsible officer) [~-.te -' 1.4, "~ 6-,.Z (2187) -- 7c 617.21 Appendix A SEQR State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may be technically e.xpert in environmental analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured.that the determination process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: " Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 an~[ 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a proiect or action. It provides guidance as to whether an impact is likelv to be considered small to moderate or whether it is a potentially- large impact. The form also identifies whether an impact can be mitigated or reduced. Part 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 actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify the Portions of EAF completed for this project: [] Part 1 [] Part2 [~Part 3 Upon review of the informatio~ 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 ~ead agency that: , [] A. The project will not result in any large and important impact(s) and, therefore, is one ~Vhic'h Will not have a significant impact on the environment, therefore a negative declaration will be prepared. [] 13. Although the project could have a significant effect on the environment, there will ~ot be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration Will be prepared.* [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or rype Name o~: Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Otiicer Signature of Preparer (If different trom responsible officer) Date 1 PART 1--PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant eff~ on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be consider as part of the application for approval and may be subject to further verification and public review. Provide any additior 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 invol new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and spec each instance. NAME OF ACTION LOCATION OF ACTION (Include Slreet Address, Municipality and County) NAME OF APPLICANT/SPONSOR tBUSINESS, TELEPHONE ADDRESS ( ) CITY/PO NAME OF OWNER (If different) ADDRESS CiTY/PO DESCRIPTION OF ACTION STATE ZiP CODE Please Complete Each Question-Indicate N.A. if not applicable A. Site DescriptiOn .. Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: r-lUrban f-]Industrial I-]Commercial' []Residential (sub. urban) [Rural (non-farn- I~Forest Il.Agriculture ~Other 2. Total acreage of project area: acres. APPROXIMATE ACREAGE Meadow or 13rushiand (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). 3. What is predominant soil Wpe(s) on project s re? a. Soil drainage: [-tWeJl drained _ _ 95 of sJte PRESENTLY AFTER COMPLETION acres acres acres acres acres · - acres acres acres &CrO5 acres acres acres ~3. C res acres acres acres [Moderately well drained ~ 98 of site ~Poorly drained _ ~ % of site b. If any agricultural land is involw.~d, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? ~ acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project s te~ ~Yes iTNo .~- a. What is depth to bedrock? __ (in feet) 2 · "5%'~ppr,oximate percentage oftproposed prOject site with slopes: []0'10 % ,o 1-110-15 °/0 [-]15% or greater 6. Is project substantially contiguous to, or contain a building, Site, or district, listed on the State or the National Registers of Historic Places? l-lYes r-lNo 7. Is project substantially contiguous to a site listed on t'he Register of National Natural Landmarks? F-lYes [-INo 8. What is the depth of the water table? _ {in feet) 9. Is site located over a primary, principal, or sole source aquifer? f-lYes i-]No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? I-:lYes ~No 11. Does project site contain any species of plant or an'imal life that is identified as threatened or endangered~ I-lYes [-]No According to ' Identify each species __ 12. Are there any unique or unusual [and forms on the project site? (i.e., cliffs, dunes, other geological f0rrnations) 0-1Yes F-INo Describe 13. Is the project site presently used by the community or neighborhood as an open space or r~creation areal I-lYes F"]No If yes, explain - 14. Does the present site include scenic views known to be important to the community? I-lYes [-]No · 15. Streams within or contiguous to project area: a. Name of Stream and name of R]ver to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name b. Size (In acres) 17. Is the site served by Texisting public utilities? i-lYes []No a) If Yes, does sufficient cap-acity exist to allow connection? r-lYes [~No b) If Yes, will improvements be necessary to allow connection? E3Yes I-1No 18; Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, A~ticle 25-AA, Section 303 and 304? Q--]Yes eno 19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 r-'lYes [~No 20. Has the site ever been used for the disposal of solid or hazardous wastes? l-lYes i-]No B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled b.y project sponsor b. Project acreage to be developed: acres initially; c. Project acreage to remain undeveloped 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 ; proposed g. Maximum vehicular trips generated per hour (upon completion of project)? h. If residenua[: Number and type of housing units: One Family Two Family Multiple Family InitialJv Ultimately i. Dimensions (in feet) o1: lar~4est proposed structure _ j. acres. acres ultimateIy. Condominium _ height; . _ width; length. Linear feet of frontage along a public thoroughfare proiect will occupy i~? ft. 3 2. How much natural mate?iai (i.e., rock, earth, etc.) will be removed from the site~ · tons/c,~blc ~a ~d~s 3. Will disturbed areas be reclaimed? l-lYes [-lNo I~N/A . · a. If yes, for what intend,_,~ purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? FqYes I-1No c. Will upper subsoil be stockpiled for reclamation? I-lYes I-1No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? l-lYes I-1No 6. If single phase project: Anticipated period of construction 7. If multi-phased: a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 month c. Approximate completion date of final phase d. Is phase I functionally dependent on subsequent phases? 8. Will blasting occur during construction? ~Yes I"lNo 9. Number of jobs generated: during construction 10. Number of jobs eliminated by this project 11. Will project require relocation of any p~'ojects or facilities? months, (including demolition). month F'IYes I-lNo" year, I:inc.luding demolition). year.. ' after project is complete l-lYes i-]No If yes, explain 12. Is surface liquid waste disposal involved? l-lYes I-INo 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 subsurface liquid waste disposal involved? I-lYes l~No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain 15. Is project or any portion of project located in a 100 year flood plain? i-lYes l-lYes I-1No E~No 16. Will the project generate solid waste? I-IYes E~No a. If yes, what is the amounl~ per month tons b. If yes, will an existing solid waste facility be used? [Z]Yes I-INo' c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain E3Yes r-INo 1.7. Will the project involve the disposal of solid waste? l-lYes a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? years. 18. Will project use herbicides or pesticides? ['-lYes I-lNo l-lNo tons/month. 19. Will project routinely produce odors (more than one hour per day)? l-lYes [-1No 20. Will project produce operating noise exceeding the local ambient noise levels? ~]Yes 21. Will proleCt result in an increase in energy use? i-'lYes F-INo If yes , indicate type(s) 22. I~ water supply is from wells, indicate pumping capacity 'L ~4aJlons/minute. 23. Total anticipated water usage per day gallons/day· 24. Does proiect involve Local, State or Federal funding? l~Yes F-1No If Y'es, explain I~No 4 . ' ' ..2~;',,Approvals Required: City, Town, Village Board l-lYes I-INo City, Town, Village Planning Board I-lYes l-]No City, Town Zoning Board E]Yes I'-!No City, County Health Department E~]Yes E3No Other Local Agencies E]Yes I-INo Other Regional Agencies E-]Yes I-]No State Agencies l-lYes l-INo Federal Agencies l-lYes I-tNo C. Zoning and Planning Information Type 1. Does proposed action involve a planning or zoning decision? E]Yes I-]No If Yes, indicate decision required: - I'"]zoning amendment I-Izoning variance [-]special use permit I-]subdivision l-]site plan i-]new/revision of master plan i--Iresource management plan [-lother 2. What is the zoning classification(s)of the site? 3. What is the maximum potential development of the site if der,eloped as permitted by the present zoning? Submiltai Date 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? F3Yes 7. What are the predominant land use{s) and zoning classifications within a ~¼ mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a lA mile? i-]Yes l-]No 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is ~he minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? r-]Yes r-]No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? [-']Yes f-lNo a. If yes, is existing capacity sufficient to handle projected demand? r-lYes F-INo ' 1'2. Will the proposed action result in the generation of traffic significantly above present levels? F-Wes []No a. If yes, is the existing road network adequate to handle the additional traffic? i-lYes I-INo D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or m,4y be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the informat~0n provided above is true to the best of m~;,.~knowledge. Applicant/Sponsor Name Date Signature T~tle If the a.c..tion is in /he Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with thi's assessment. 5 Part 2--PROJECT IMPACTS AND THEIR MAGNITUD Responsibility of Lead Agency '.' General Information (Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations bee: reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simpi. asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold o magnitude that would trigger a response in column 2. The examples are generally applicable'tl~roughout the ~tate ant for most situations. But, for any specific project or site other'examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part :3. · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative anc have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each question. · The number of examples per question does not indicate the importance of each question. · In identifying impacts, consider long term, short term and cumlative effects. Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column I or 2) to indicate the potential size of the impact, if impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshold is lower than example, check column 1. ,. d. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3. e. If a potentially large impact checked in column 2 can be mitigated by change(.s) in the project to a small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. This must be explained in Part 3. ' Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material ('i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts IMPACT ON LAND 1. WiII the proposed action result in a physical change to the project site? ~NO ~YES Examples that would apply to column 2 Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the pt:oject area exceed 10%. Construction on land where the depth to the water table is less than 3 feet. Construction of paved parking area for 1,000 or more vehicles. 2 Will there be an effect t: .... ,y u;,que or unusual land forms found on the site? (i e., cliffs, dunes, geological formations, etc.)~NO [~YES · Specific land forms: 1 2 3 Smallto Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [~Yes [--]No [] [] []Yes []No L--] [] [~Ves []No [] [] []Yes ~No [] [] []Yes []No [] [] '~¥es []No ~ ~ ~Ves ~No ~ ~ ~Ves 6 IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? [Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) EE]NO []YES Examples that would apply to column 2 · Developable area of site contains a protected water body. · Dredging more than 100 cubic yards of material from channel of a protected stream. · Extension of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water? I-INO I-IYES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. · Other impacts: $. Will Proposed Action affect surface or groundwater quality or quantity? l-]NO I-lYES Examples that would apply to column 2 · Proposed Action will_require a discharge permIt. · Proposed Action requires use of a source of water that does not have approval to serve proposed (project) action. · Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed off the site to facilities which presently do not exist or have inadequate capacity. · Proposed Action would use water in excess of 20,000 gallons per day. · Proposed Action will like['., c;~use siltation or other discharge into an .. existing body of water to tr;e extc. nt that there will be an obvious visual contrast to nature] conditions. Proposed Action will require the storage of petroieum or chemical products greater than 1,100 gallons. Proposed Action will allow residential uses in areas without water and/or sewer services. ~ Proposed Action Iocates comrr.ercial and/or industrial uses which may reqmre new or expansion, of ex,stin~; waste t~eatment and/or storage facilities. Other impacts:_ 6. Will proposed action alter drainage fMw or patterns, or surface water runoif~ ~NO ~ ' ' ~.'~ ES Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 1 Small to Moderate Impact 2 Potential Large Impact 3 Can Impact Be Mitigated By Project Change [--]Yes ['-] No [--[Yes 1--JNo ["']Yes E]No l']Yes I-]No I--lYes E]No l-lYes,: I-'I N o I-'lYes [--[No i--lYes l'-~No I-lYes [--]No F-lYes E]No ~Yes ~No E~Yes EJNo E]yes [-7~ No [-[Yes E-[No I-lYes l-'-JNo E]Yes ENo, E]Yes- . ['-']No E]Yes Il-]No F-IYes l']No FTYes EJNo [?Yes E~NO · Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns, · Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7. Will proposed action affect air quality? [NO I-lYES Examples that would apply to column 2 · Proposed Action will induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of more than I ton of refuse per hour. · Emission rate of total contaminants will exceed $ lbs. per hour or a heat source producing more than 10 million BTU's per hour. · Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action v~ill allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect-any threatened or endangered species? E3NO []YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. · Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. · Other impacts: 9 Will Proposed Action substantially affect nonIthreatened or 'non-endangered species? I-/NO []Y£S Examples that would apply to column 2 · Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. · Proposed Action requires the removal of more than 10 acres of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10 Wdl the Proposed Action affect agricultural land resources? ~NO f~YES £xamples that would apply to column 2 · The proposed action would sever, cross or limit access to agricultural land (includes cropland, hayf elds pasture, vineyard, orchard, e'tc.) 8 1 Small to Moderate Impact Potential Can Impac'~ Be Large Mitigated By Impact Project Change [] [-]Yes [~]No [] ~--] yes E~]No [] ~-'}Yes [~No [] - ~Yes' ' ~No ['"]Yes ]-']No Yes I No [-/Yes []No []Yes ['-]No [~]Yes [--/No []Yes [--/No [~Yes []No [~Yes []No [~]Yes .E-]No [~JYes I-]No []Yes Lr:-INo ~','es [ZINc [] []Yes [-]No · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultutal District, more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g., subsurface drain lines, outlet ditches, strip cropping); or create a need for such measures (e.g. cause a farm fieid to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources? [-]NO []YES {If necessary, use the Visual EAF Addendum in Section 617.21, Appendix 13.) Examples that wouId apply to column 2 · · Proposed land uses, or proiect components obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pr~- historic or paleontological importance? E~NO E3YES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect the quantity or quality oi; existin~ or i:uture open spaces or recre,~[ional opportumdes? Examples that would apply to colurnn 2 ffqNO [~]YES · The permanent foreclosure of a future recreational opportunity. · A maior reduction of an open space important to the comntunity. · Other impacts: 1 Small to Moderate Impact 2 Potential Large Impact 3 Can Imoact Be Mitigated By Project Change [~Yes I]No E]Yes i'-lNo I--lYes I']No E]Yes r-lNo E]Yes [--]No L--'] Yes Ir[No I--lYes E]No [~Yes [--]No [~Yes [-]No [~Yes.., I-1No l-lYes ['-1No E]Yos [--]No [~Yes Jr]No ['-lYes [~]No [~]Yes I-]No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? Examples that would apply to column 2 E-]NO I-IYES · Alteration of present patterns of movement of people and/or goods. · Proposed Action will result in major traffic problems. · Other impacts: IMPACT ON ENERGY - 15. Will proposed action affect the community's sources of fuel or energy supply? , [-qNO F1YES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of any form of energy in the municipality. · Proposed Action will require the creation or extension of an energy transmission or supply system to serve more than 50 sin§lo or two family residences or to serve a major commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16. Will there be obiectionable odors, noise, or vibration as a result of the Proposed Action? l-]NO [-]YES Examples that would apply to column 2 ' DIasting within 1,500 feet of a hospital school or other sensitive facility. ' · Odors will occur routinely (more than one hour per day). · Proposed Action will produce operating noise exceeding the local ambient noise levels for noise outside of structures. · Proposed Action will remove natural barriers that would act as a noise screen. · Other impacts: IMPACT ON PUBLIC HEALTH 17. ~ViJl Proposed Action affect public health and safety? []NO I-qYES Examples that would apply to column 2 · Proposed Action may cause a risk of explosion or release of haza~rdous substances (i.e. oil, pesticides, chemicals, rad at on etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. · Proposed Act/on may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, .radioactive, irritating infectious, etc.] · · Storage facilities ior one m/ilion or more gallons of l[quified natural gas or other flammable liquids. · Proposed action may result in the excavation or other disturbance w~thm 2,000 feet of a s~te used for the disposal of solid or hazardous waste. · Other impacts: 1 Small to Moderate Impact 2 Potentia Large Impact Can Impact Mitigated B~ Project Chan.c ~]Yes [~N~ i'[Yes [~Yes '- /--]Yes [~No fi-~Yes [-]No [~/Yes I]-'/No [~Yes r-]No [~Yes [-JNo /-]Yes [-]No ..~ [~Yes [--]No [~]Yes [~]No ~Yes.. l-]No E]Yes [~]No [~/Yes ['-]No [-]Yes Jr']No [~]Yes i-]No 10 IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing commun tV? F~NO [-IYES Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for additional community services {e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future projects. · Proposed Action will create or eliminate employment.. · Other impacts: 19. I 2 - 3 Small to Potential Can Impact Moderate Large Mitigated By Impact Impact Project Chang~ [] [] ~¥es []No [] [] ' []Yes ' [],'~o [] []. []Yes []No [] [] r-]Yes []No [] [] [--]Yes . []No [] --[]' []Yes []No [] [] i--lYes []No Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? I-iNO F3YES if Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 Part 3--EVALUAT!ON OF THE ]~'J~PORTANCF_. OF Responsibility ot: Lead Agency Part 3 must I)e prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may be mitigated. Inslructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 21' Describe (if applicable) [iow the impact could be mitigated or reduced to a small to moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibiJity, including permammtly lost resources of value · Whether the impact can or will be controlled · The req~onal consequence of tile impact · Its potenual diw~rgence from local needs and goals · Whether kno~¥n object~ons to the proj~ct rei,lte to this m~pact. (Continue on attachm~rnts) '~. 11 14.14.11 617.21 Appendix B Slate Environmental Quality Review V sua EAF Addendum SEQR This form may be' used to provide additional information relating to Question 1 1 of Part 2 of the Full EAF. ' . (To be completed by Lead Agency) Visibility 1. Would the project be visible from: · A parcel of land which is dedicated to and available to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public observation, enjoyment and appreciation of natural or man-made scenic qualities? · A site or structure listed on the National or State Registers of Historic Places? · State Parks? · The State Forest Preserve? · · Natiofial Wildlife Refuges and state game refuges? · National Natural Landmarks and other outstanding natural features? . · National Park Serq, ice lands? · Rivers designated as National or State Wild, Scenic or Recreational? · Any transportation corridor of high exposure, such as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate. or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as scenic? Distance Between ' -. ProJect and Resource (in Miles) 0'~A ~,~-V~ 1/2-3 '-.. 3-5 5+ · Municipal park, or designated open space? [] [] [] [] [] · County road? [] [] [] [] [] . · State? [] [] [] [] [] · Local road'~ 2. Is the visibility of the project seasonalO (i.e., screened by summer foliage, but visible during other seasons) ' . . f-lYes l~JNo 3. Are any of the resources checked in question during which the project will be v s ble; ,.'Yes ~No used by the public during the time of year DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1 check those which generally describe the surrounding environment. ' Essentially undeveloped Forested Agricultural Suburban residential Industrial Commercial Urban River, Lake, Pond Cliffs, Overlooks Designated Open Space Flat Hilly Mountainous Other " NOTE: add attachments as needed Within '1/4 mile * ! mile 5. Are there visually similar projects within: *Vz mile f-~ Yes [-']No *1 miles J--IYes E~No *2 miles '[-] Yes [~No *3 miles ['-[Yes J-[No * Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is 'FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work [] [] [] [] Involved in recreational activities [] [] [] [] Routine travel by residents [] [] [~ [] At a residence [] [] [] [] ^t worksite [] [] [] Other [] [] [] [] 2 COUNTY OF SUFFOLK ) STATE OF NEW YORK )SS: BEING DULY SWORN DEPOSES AND SAYS THAT HE 15 THE APPLICANT FOR THE ABOVE DESCRI'BED PERMITS, AND.THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, THAT THE WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND' AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. 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, IF GRANTED. Zn comDleting this application I hereby authorize the Trusteesj agent 6r representative to enter onto my property to inspect the premises in conjunction with re~,[ew Qf t2%is~-a,~lication. ~iGNATuI~E~ OF,.A~LiCANT SWORN TO EFORE ME THIS DAY OF UAME$ J. GERAGHT¥ ~DTARY PUBLIC, State of No~ ~938055 'Commssun Exs '~s ~', -~XAMINED APPROVED "WETLANDS" PERMIT (CHAPTER 97) APPROVED "BOAT,DOCKS, WHARVES" PERMIT (CHAPTER 32) DISAPPROVED "WETLANDS PERMIT" (CHAPTER 97) DISAPPROVED "BOATS,DOCKS, WHARVES" PERMIT (CHAPTER 32) CONDITIONS, IF ANY EXAMINING BODY SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 55 John Street, New York, NY 10038 (212) 786-8282 October 20, 1'988 Board of Trustess Town of Southold Town Hail 53095 Main Road P, O, 8ox Southold, NY 11971 Deor Sirs: This is to inform Bou that ~ om giving my full authorizotion to Loo, R, Sh~dbott, ~rchit®ot, ~o ~ct ~s tho ~pplio~nt on my boh~lf in ordor to obtain To~n p~rmits for ~ho proposod HHT/sh CC: L~® R. Shadbolt/ J'