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HomeMy WebLinkAboutTR-4002'Board Of $outhold Town Tru ees ~' ~' SOUTHOLD, NEW YORK PERMIT NO...Z!0.0.F .................... ~. DATE: .... ~ch...~Z,... 1992 ISSUED TO Maria Tru~ia Pursuant fo the provisions of Chapter 615 of the Laws of the State o~ New York, 1893; and Chapter 404 of fha Laws of the State of New York 1952; and the Southold Town Ordinance eh- Htled "RESULATIN® AND THE PLACIN$ OF: OBSTRUCTIONS IN AND .ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" end in ~ccordance wi~h ~he Resolution of The Board adopted a~ a meeting he~d on Marc.h 26.,.. 19...9.2.., and Jn consideraHon o~ ~he sum of $ ~.,.0~ pMd by ...... La~d....~ G~ ...... .o.~. b~hMf ~f...M.~.ia...T.~.p~ ............................... of N.Y. and sab~ec~ fo fha Terms and gond[f[ons JJsfed on the reverse side hereof, of Soufhold Town Trustees authorizes and permits fha foJJow~nm to construct a one family' dwelling 75~ ~rom tidal wetlanBs as delineated by the Town Trustees and as per revised survey dated January 31, 1992. all in accordance with the detaijed speciflcaflons as Presented in the origlnafing application. IN WITNESS WHEREOF, The said Board o~ Trustees dilate- by causes ifs Corporate SeaJ ~o be a~Jxed, and ~hese presents ~o be subscribed by a majority o{ smd Board as o{ f~Js daf, e. Trustees TRUSTEES John M. Bredemeyer, III, President Henry P. Sm/th, Vice President Albert I. Krupski, Jr Jolm L. Bednoski, Jr. lohn B. Tuthilt Telephone (~16) 765- ! 892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPER VISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 April 2, 1992 Land Use Company 2576 Sound Avenue Baiting Hollow, ~/ 1'1933 Re: Maria Trupia SCTb! #1000-78-1-10.16 Dear Mr. Bowman: The following action was taken by the Board of Town Trustees during its regular meeting held on March 26, 1992 regarding the above matter: ~{EREAS, LA~D USE CO. ON BEHALF OF ~ARZA TRUPIA applied to the Southold Town Trustees for a permit under the ~rovisions of the Wetland Ordinance of the Town of Southold, application dated December 13~ 1991 and, W~EREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS~ a public hearing was held by the Town Trustees with respect to said application on March 26, 1992 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in ~destion and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, ~HEREAS, the Board has determined that the project as proposed will not affec~:¥the health safety and general welfare of the people of the town, ' NOW, THEREFORE BE ZT RESOLVED THaT LAND USE COMPANY ON BEHALF OF MARIA TRUPiA BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDIN~gCE TO: construct a one family dwelling 76' from tidal wetlands line as delineated by the Town Trustees and as per revisedsurvey dated January 31~ 1992. This permit will expire two years from the date it is signed. Fees must be paid, if~licabie[ and permit issued.within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Permit will be issued upon payment of the following fees for work to be done below Mean H~gh Water Mark: no fees Very truly yours, Bredemeyer, III President, Board of Trustee JMB:jt cc: Bldg. Dept. Conservation Advisory Council file Telephone (516) 765-1801 Town Hall, 53095 Main Road P.O. Box 1179 8outhold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL TO; From: Dated: Re: $outhold Town Board of Trustees Southold Town CAC March 23, 1992 Recommendation of Wetland Applications The following recommendations were adopted by the Southold Town Con- servation Advisory Council at its meeting held Thursday, March 19, 1992. On a motion by John Holzapfel, seconded by Bruce Loucka, it was RESOVLED to recommend to the Southold Town Trustees approval of Wetland Application No. 78-1-10.16 of Maria Trupia to construct a dwelling, deck and pool. Sleepy Hollow Lane, Southold. Vote of Council: Ayes: All Motion carried. On a motion by Stephen Angeil, seconded by John McCormick, it was, RESOLVED to recommend to the Southold Town Trustees disapproval of Wetland Application No. 113-6-8 of Jo¥ce Beckstein Laskin to add a second 6' x 20' float plus one 8" diameter pile to existing dock to reach deep water. The CAC recommends disapproval because additional length will create navigational problems and the soundings the applicant submitted appear adequate. 670 Holbrook Lane, Mattituck Vote of Council: Ayes: All Motion carried. On a motion by Stephen Angell, seconded by John Holzapfei, it was RESOLVED to recommend to the Southoid Town Trustees approval with stipulations of Wetland Application No. 111-14-12 of Dan Kohn to remove and replace pilings in existing bulkhead; resheath inside of 182 I.f. of existing bulkheads and backfill with 225+ c.y. of clean sand; remove and replace all decking and framing, all of which is located landward of bulkheads. The CAC recommends approval provided the applicant: (1) Plants a 20' natural, native vegetation buffer by bulkhead as per the Zoning Code. (2) Remove gas tank. (3) Contain runoff (hay bales, drywells, etc) on property to avoid future problems with the bulkhead. Little Peconic Bay ROad, Cutchogue Vote of Council: Ayes: All Motion carried. TRUSTEES John M. Bredemeyer, HI, President Henry P. Smith, Vice President Albert J. Kmpski, Jr. John L. Bednoski, Jr. lohn B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCorr L. aAmUS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 August 8, 1991 Tanya Lachenmeyer Land Use Company 2576 Sound Avenue Baiting Hollow, NY 11933 RE: Waiver request for Maria Trupia SCTM%1000-78-1-10.16 Dear Ms. Lachenmeyer: The following action was taken by the Board of Town Trustees during its regular meeting held on August 1, 1991: RESOLVED that the Town Trustees DENY the request for a waiver to construct a single family dwelling, sanitary system, detached garage, decking and swimming pool and submit a full permit application. Enclosed please find a application form and notes on flagging done by John 'Bredemeyer on August 2, 1991 to be incooporated on the survey° If you have any questions, please do not hesitate to contact this office. ruly yours, John M. Bredemeyer, III President, Board of Town Trustees JMB: jt cc: Bldg. Dept. enc. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE [516) 765-1892 7OWN OF' S. OUTHOLD APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, 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 SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO, APPLICANT'S NAME: MAILING ADDRESS: ~")'~"~ J-- ~/O J~, [/JO DATE 12/10/91 Maria Trupia TEL. NO. P.O. Box 871, 68-60 108th St., 3H, New York, N.Y. 11375 AGENT: Tanya Lachenmeyer/Land Use Company TEL NO. 516-727-2400 AGENT ADDRESS: 2576 Sound Avenue Baiting Hollow, N.Y. 11933 PERMIT REQUESTED TO: Please see attached project description LOCATION OF PROPERTY FOR REQUESTED PERMIT:. Sleepy Hollow Lane, Southold, N.Y. 11971 HAMLET: .- Southo!d Goose Creek TAX MAP NO: 1000- 078-I-p/o 10.16 CREEK, BAY OR HARBOR FRONTING PROPERTY- SIZE OF PROPOSED WORK: LENGTH: 53' WIDTH: 36' Page 2. YDS. TO BE EXCAVATED: 0 YDS. TO BE FILLED: 0 MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: n/a WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: 2500' DEPTH AT LOW TIDE: AVER. RISE IN TIDE: n/a DISTANCE TO NEAREST CHANNEL: 3500' DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN AREA: AREA ZONING: residential IS PROJECT FOR PRIVATE OR BUS. USE: INTENDED USE OF PROPERTY: single family residence DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: none private HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, no OR DEPOSIT FILL ON SAID PREMISES: HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED .BY A GOVERNMENTAL AGENCY: no DESCRIBE FULLY THE REHABILITATION OF PROPERTY: Applicant acjrees to maintain a 50' undisturbed buffer area DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: Property will be improved with a single family residence and attached decking ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: no WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: enclosed 1.¢-!6.4 [2/87)--Text 12 ' PR~)JECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) FORM SEQR 1. APPLICANT/SPONSOR Tanya Lachenmeyer/Land UseI 2. PROJECT NAME 7nmpRny Cnr M~ri ~ Trm3i~ J private residence 3. PROJECT LOCATION: Municipality Southold County S'Llf folk PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) Sleey Hollow Lane, Southold (map enclosed) S.C.T.M. No. 1000-078-1- P/O 10.16 5. IS R~POSED ACTION: .~New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Please see attached project description 7. AMOUNT OF LAND AFFECTED: Initially ~.'~ _ '7F)~ c -~ acres Ultimately z'J'~, 700 ~ -F, acres 8. ~ILL PROPOSE~CTION COMPLY WiTH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes ~No If No, describe briefly Applicant is proposingconstruction of a ~welling 55' from the TWL line which requires a 20~' variance 9, V~t~T IS PRESENT LAND USE IN VICINITY OF PROJECT? .~Residential [] !ndustrial [] 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~E~ R LOCAL)? /~Yes [] No If yes, list agency(s) and permit/approvals N.Y.S.D.E.C. 11. DOES ANY ~CoT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes If yes, list agency name and permit/approval 12. AS A RESULT (~F~43ROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes ~No CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n.~a~ Tanya Lache_nmeyer/Land Use Co. for Maria Trupia Signature: Date: 12/10/91 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 ASSESS ~'~'NT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 if yes, coordinate the review process and use the FULL E~F. [] Yes [] No B. 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 C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WiTH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic 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 officiatly 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. C6. Long term, short term, cumulative, or other effects not identified in Cl-C57 Explain briefly. C7. Other impacts (incl~Jd ng 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 IIi--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Chock 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 ady significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name Of Lead ^g~2rJCy Print or lype N,lrne ol Responsible Officer in Lead Agency Signature o! Responsible Officer ;n Lead Agency I'itle of Responsible Officer signature of Preparer (if differenl, trom responsible officer) Date COUNTY OF SUFFOLK ) STATE OF NEW YORK ) Tanya Lachenmeyer/Land U~e Company for Maria Trupia BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT 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. IN COMPLETING THIS APPLICATION· I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~ignature %D~ Applicant SWORN TO BEFOR~H~ THIS 10th ~ ~' t/~TARY PUBLIC DAY OF December CHARLES W.- BOWMAN NOTARY PU~L!C, State of Naw York No. 4668958, Suf,~otk County EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 MIA CONSULTING AND DESIGN, INC. MAY 6, 1991 TO ALL REGULATORY AGENCIES: IL HEREBY AUTHORIZE LAND USE COMPANY TO APPLY FOR ALL APPROVALS NECESSARY TO COMPLETE MY PROJECT. SIGNATUR ''''~' '" ' .... (718) 793-4785 MARIA TRUPIA P.O. BOX 871 68-60 108 STREET, 3-H FOREST HILLS. N.Y. 11375 PART 1--PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining wh~ther the action proposed may have a significant effect on the environment. Please complete the enbre 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 anv 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. NAME OF ACTION .OCATION OF ACTION (include Street Address, Munici3ality and ~unty; Sleepy Hollow gane, Southold, New York, Su££olk Coung~ NAMEOFAPPLICANT/SPONSOR Maria ~rup~a Tanya Lachenme~er/ Land Use Compan~ for BUSINESS ~ELEPHONE (516 727-2400 ADDRESS 2576 Sound Avenue CiTY/PO f STATE 1 ZiPCODE Baiting Hollow N.Y. 11933 NAME OF OWNER (If different) BUSINESS TELEPHONE Maria Trupia ADDRESS CITY/PO Box871, 68-60 108th Street, 3H Forest Hills DESCRIPTION OF ACTION STATE I ZIP CODE N.Y. - 11375 A~plican% proposes to construct a single family dwelling, sanitary system, detached garage, decking & swimming pool. All improvements ~..Eilbe a minimum of 76' from the landward limits of TWL Please Complete Each Question-Irmticate N.A. if .ot applicable A. Site Description Physical setting of overall project, bc;th developed and undeveloped areas 1 Present land use: ~0rban ~lndustriat [-]Commercial [-]Forest I-1Agriculture ~Other 2 Total acreage of project area: 1.O 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) /~Residential (suburban) E3Rural (non-farm) PRESENTLY AFTER COMPLETION · 7 acres .5 acres acres acres acres acres .3 acres .3 acres acres acres acres acres acres .2 acres acres acres 3. What is predo~ninant soil tvpe(s) on project site? CPA Carver & Plymouth Sands a. Soil drainage: ,~WeH drained 7(3 % of site [~Moderately well drained % of site 'Poorly drained 30 % of site b. if any agricultural land is involved how many acres of soil are classified within soil grou:) 1 through 4 of the NYS Land Classification Svstem? acres (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? [~Yes ~No a What is depth to bedrock? 600'',~ + (in feet) 2 5. Approximate percentage of proposed prt,,ct site with slopes: jg~'0-10% 1 ~qO % D10-15% % · ,~. 15% or greater % 6. Is proiect substantially contiguous to, or xc~ontain a building, site. or district, listed on the State or the National Registers of Historic Places? ~Yes ~[;~No 7. Is proiect substantially contiguous to a site listed on the Register of National Natural Landmarks? DYes /~No 8. What is the depth of the water table? ~ (in feet) 9 Is site located over a primary, principal or sole source aquifer? OYes /~No q0 Do hunting, fishing or shell fishing opportunities presently exist in the project area? []Yes [~o 13. Does project site contain any species of plant or animal life that is identified as threatened or endangered? According to Field Investigagion OYes /~No Identify each species 12. Are there any uniqu, e or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) E3Yes ~No Describe 13. ls the project site ,presently used by the community or neighborhood as an open space or recreation area? --}Yes ~[No If yes, explain Does the presenl;,~te include scenic views known to be important to the community? 0-lYes /~No Goose Creek !5. Streams within or contiguous to project area: a. Name of Stream and name of River to which it is tributary Great, Peconic Bay 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name b. Size (irt acres) 17. Is the site served by existing public utilities? ~Yes F-No a) If Yes, does sufficient capacity exist to allow connection? XYes [-INo. b) If Yes, will improvements be necessary to allow connection? D-lYes ~No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? fiYes /[~No ~ 19. Is the site located in or substantialf.~contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 ~;,Yes F-1No 20. Has the site ~ver been used for the disposal of solid or hazardous wastes? fi]Yes XNo B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor 1 , C~ ... b. Project acreage to be developed: .2 acres initially; .2 c. Project acreage to remain undeveloped .8 acres. d. Length of project, in miles: n/a (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed f. Number of off-street parking spaces ~xisting 0 ..: proposed 2 g..Maximum vehicular trips generated per hour 2 h. If residential: Number and type of housing units: One Family Two Family Multiple Family Initially Ultimately 1 i. Dimensions [in feet) of largest proposed structure * height; j. Linear feet of frontage along a public thoroughfare project will occupy is? 80' · less ~han 35' acres. acres ultimately. 0 %; (upon completion of project)? Condomimum 50' width; t t O~ length. ft. ~ 0 ~ z © D oo Z~ ~.~ 0~ ~ L L,~ 2 How much natural material (i.e., to, earth, etc.) will be removed from the sit,_. 3. Will disturbed areas be reclaimed? []Yes [~No /b~'N/A a [f yes for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for rec amation? FqYes' c. Will upper subsoil be stockpiled for rec amation? I-lYes F1No 4. How many acres of vegetation (trees, shrubs, ground covers) Will be removed fr, om site? 0 acres. 5. Will any matu~j(~c~rest (over 100 years old) or other locally-important vegetation be removed by this project? F~Yes 6. If single phase project: Anticipated period of construction .. 7. If multi-phased: n/a a. Tc~tal number of phases anticipated b Anticipated date of commencement phase 1 c. Approximate completion date of final phase d. Is phase 1 functionally dependent on subsequent phases? 8. Will blasting occur during construction? (l-lYes /J~No 9. Number of iobs generated: during construction 6 ~10. Number of jobs eliminated by this project 0 ~11. Will project require relocation of any projects or facilities? (number). tons/cubic yards months, (including demolition). month year, (including demolition). month year. I~Yes F-1No ; after project is complete 0 []Yes I~/o If yes, explain 12. Is surface liquid waste disposal involved? (l-lYes 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? [~Yes (No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain []Yes [-INo 15. 36. 17. 18. 19 20. 21. Is project or any portion of project located in a 100 year flood plain? /J~Yes Will the project generate solid waste? '~Yes []No a. If yes, what is the amount per ,month .01 tons b. If yes, will an exis.ting solid waste facility be used? ,~Yes []-]No c. If yes, 'give name Southold To~n Land Fill ' ; iocationSOUthold d. Will any wastes not go into a sewage disposal system or into a sanitar~ landfill? e. If Yes, expiain [-INo [Yes Will the project involve the disposal of solid waste? F-iYes a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? years. Will project use herbicides or pesticides? F3Yes /~o tons/month. Will project routinely produce odors (more than one hour per day)? (l-lYes E~o Will project produce operating noise exceeding the local ambient noise levels? F3Yes Will project result in an increase in energy use? ~'Yes (No If yes . indicate type(s) Electricity, Home ~eating Oil o 22. If water supply is from wells, indicate pumping capacity 10 23. Total anticipated water usage per day . 300 gallons/day, 24. Does project involve Local, State or FederaJ funding? F~Yes If Yes, explain gallons/minute. o Part 2--PROJECT IMPACTS AND THEIR MAGNITUDE Responsibilily o/ Lead Agency Gencral h]formation (Read Carefully) · In ('o;nph,~in~ lhe form ~he reviewer ~hould be guided by the question: Have my respons~'~ and determinations been ~easnnable~ lhe reviewer is not expected to lm an expm'[ environmental analyst. · identifying that an impact will be potentially large (column 2) does not mean that it is also nece~sar s' sigqificant. Any large impa¢t must be evaluated in PAR i' 3 to determine significance. Identifying an impact in -{)iumn 2 simply asks that it.be looked at further. · 1'he [xamples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2.1he examples are generally applicable through~ut the State and for most situations. But, for anv specific project or site other examples and/or tower thresholds may be appropriate for a Potential I. arge Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will varV. Therefore, the examples are illustrative and 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. Instn~diOns (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 1 or 2) to indicate the potential size of the iml)act. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshold is tower 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 indicates that such a reduction is not possible_ This impact, also check the Yes box in column 3. A No response must be explained in Part 3. IMPACT ON LAND I. Will the proposed action result in a physical change t~the project site? ,,~O ~YES Fxamples 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 project 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. · 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 sanitar~ landfill. · Construction in a designated [Ioodwav. · Other impacts an effect to any unique or unusual land forms found on cliffs, dunes, geological formations, etc~J~NO F1YES forms: 2. Will there be the site? (i.e.. · Specific land I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] E~JYes E~]No [] [] J--lYes []No [] [] E]Yes [-}No [] [] [--]Yes [--]No [] [] E~]Yes []No ~ ~ ~Yes ~No ~ ~ . ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No 25. Approvals Required: Type Submittal Date City. Town Vill,~.-P,c, ard I_gYes City, Town, Village t'lamfing Board ~lYes L]No Cit`/, Town Zumn~ Board ~Yes ~No City, County ~te,,'.lh Department ~Yes ~No Othe~ Local Agench,s [TJYes Other Regional Agencies ~ ~Yes ~No State Agencies x'~Yes ~No ~No Federal Agencies ~' e~,~ C. Zoning and Planning Information'~ 1 Does proposed action involve a planning or z~ing decision? If Yes. indicate decision required: L~]zoning amendment ~zoning variance ~,,.. [~]special use. permit [~]new, revis~on o1' master plan E]resource m~gagement plan 2. What is the zomng classification(s)of the site? ~Yes ~No E~subdivision ~site plan [~other What is tl~e maximum potential development of the sit(~'~ff developed as permitted by the present zoning? 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 recon~'mended uses in adopted local land use plans? I-lYes 7. What are the predominant land use(s) and zoning classifications within a ~/~ mile radius of proposed action? E3No 8 Is the proposed action compatible with/~djoining/surrounding land uses within a ~,~ mile? I-lYes I-INo 9 If the proposed action is the subdivision of land, how many lots are prOposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewe~ or water districts? [~]Yes E~]No 11. Will the proposed action create a demand for any community provided se,rvices (recreation. education, police, fire protection)? ~Yes [-JNo a. If yes, is existing capacity sufticient to handle projected demand? U]Yes U]No 12. Will the proposed action result in the generation of traffic significantly above pri~sent levels? IX]Yes [_3No a If yes, is the existing road network adequate to handle the additional traff~c? E]Yes i-lNo D. Informational Details · Attach any additional information as may be needed to clarify your project. If there'are or may be any adverse impacts associated with ,/our proposal, please discuss such impacts and the measures which ~ou propose to mitigate or avoid them. -~ E. Verification I certify that the information provided above is true to the best of my knowledge. Applicaut/Sponsor Name Date Signature Title if the action is in the Coastal Area, and you are a stale agency, complete Ihe Coastal Assessment Form before proceeding wilh this assessment. IMPACT ON WATER Will proposed action affect any water bodv designated as protected? {Under Articles 15 24,2.5of the Environmental Conservation Law, ECL) [ZJNO ~YES Examples that would apply to cohJmn 2 [)evelopable area of site contains a protected water body. Dredging more than 100 cubic yards of material from channel of a protected stream I:xtension of utility distribution facilities through a protected water body. Construction in a designated freshwater or t~dal wetland, z Z~ Will proposed action ~ffect any non-protected existi~ or new body of waler~ ~0 ~YES E~amples tt~at would apply ~o 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: 5 Will Proposed Action affect surface or groundwater quality or quantity? E3NO 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 likely cause siltation or other discharge into an existing body of water to the extent that there will be an obvious visual contrast to natural conditions · Proposed Action will require the storage of pgtroleum or chemical products greater than 1,100 gallons. · Proposed Action will allow residential uses in areas without water andtor sewer serwces. · Proposed Action locates commercial ahd/or industrial uses which may require new or expansion of existing waste treatment and/or storage facilities · Other i,llpacts: 6 Will proposed action alter drainage flow or patt~ms, or surface water runoff? ~NO E3YES Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [~] E~Yes E~JNo [] ~ []Yes []No [] L-~ [~Yes []No [] [] EJYes []No ~ ~ ~Yes ~No ~ ~ ~Yes ~No g [] gYes ~No g g ~Yes ~No ~ g ~Yes ~No ~ Q BYes ~No] ~ Q ~Ves ~No~ ~ ~ ~Yes ~Nol ~ ~ ~Yes ~No ~ ~ ~Ves UNo ~ ~ ~Yes ~No .... ~ ~ []Yes * 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~YES 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 5 tbs. per hour or a heat source producing more than 10 million BIU's per hour. * Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will 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 end~n..g~ered species? ,~?NO I-WES 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 non-threa~n_~ed or non-endangered species? , 2g~NO I-lYES 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 a~e) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10. Will the Proposed Action affect agricultural land r, es~Jrces? _.'?~. NO E]YES Examples that wo'uld apply to column 2 · The proposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, wneyard, orchard, etc.) 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes E~]No [] [] []Yes [~No [] [] []Yes [~]No [] [] []Yes []No [] [] []Yes E~]No [] [] []Yes [~No [] '~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes UNo ~ ~ ~Yes' ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes UNo ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No · Construction activity would excavate or compact the soil profile of agricultural and · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural 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 field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCE~,~. 11 Will proposed action affect aesthetic resources? q;3~NO [~YES (If necessary, use the Visual EAF Addendum in Section 617.21, Ap~')endix Examples that would applv to column 2 · Proposed land uses, or project components obviously different from or m 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 enlovment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scemc 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~istoric, pre~ historic or paleontological importance? ,d2~lO I-lYES 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 of existing or future open spaces or recreational opportunities?~, Examples that would apply to column 2 ~t-~NO i-lYES · The permanent foreclosure of a future recreational opportunity. · A maior reduction of an open space important to tile community. · Other impacts: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] i [~]Yes []No [] [] [~Yes []No [] [] [~Yes []No [] [] []Yes' []NO [] [] []Yes []No [] [] []Yes []No [] [] []Yes I'-INo [] ~ UYes ~No ~ ~ ~Yes ~No ~ ~ UYes ~No ~ ~ ~Yes ~N0 ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ OYes ~No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation~s_~ms? ,2~NO e~¥es Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods. · Proposed Action will result in major traffic problems. · Other impa~ts: IMPACT ON ENERGY 15. Will proposed action affect the community's sou.~ of fuel or energy supply? ~UNO E-lYES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increas'e 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 {b serve more than 50 single or two family residences or to serve a major commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, noise, or vibratio_~as a result of the Proposed Action? ~NO I~YES Examples that would a~ply to column 2 · Blasting 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 HEALTI! 17 Will Proposed Action affect public health and safe'v? ~ Examples lhat would apply to cohJmn 2 E]YES Proposed Action may cause a risk of explosion or release of hazardous substances (i.e oil, pesticides, chemicals, radiation, etc.) in the event of acciden! or upset conditions, or there may be a chronic Iow level discharge or emission. Proposed Action may result in tile burial of "hazardoOs wastes" in any form (i.e. toxic, poisonous, highly re.active, radioactive, irritating, infectious, etc ) Storage facilities for one million or more gallons of liquified natural gas or other flammable liquids. Proposed action rna¥ result in tile excavation or other disturbance within 2,000 feet of a site used for the disposal of solid or hazardous waste. · Other impacts: 10 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] ~Yes ~No [] [] ~Yes ~No [] [] []Yes []No [] [] E]¥es []No [] [] []Yes [~No [] [] []Yes []No [] [] Uves []No [] [] []Yes I--INo ~ ~ ~Ves ~No ~ ~ ~Ves. ~No ~ ~ ~Yes ~No ~ ~ ~Ves ~No ~ '~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~N0 ~ ~ ~Yes ~No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the exk~n~ommun,ty? ~-~JNO []YES 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 ~:apital 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 wi I 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. mportant precedent for future projects. · Proposed Action will create or eliminate employment. · Other impacts: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] r'[Yes [--[No [] [] [--]Yes []No [] [] []Yes I-]No [] [] []Yes []No [] [] []Yes []No [] [] []Yes i-qNo [] [] []Yes []No, [] [] []Yes []No [] [] [~Ves []No 19 Is there, or is there like ¥ to be. public contrqxver_~sy related to potential adverse environmental impacts? ~dNO E3YES 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--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact[s) is considered to be potentially large, even if the impad(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: , 1. Briefly describe the impact../~S~ ~//~ ~ff'~ -~/' 6~ 2. Describe (if applicable)~ &'h°w~&~-the i~ pact~cqgld~/~4~,~b~ mitigated or reduced to a small to moderate impact by p ro'ectl change[s). 3. Based on the informahon available,-dYdde 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 ~~ .... lts ~rrevers,b,I,W, including permanentl~ lost resources of value Whether the impact can or ~ill be controlled 7~~ ~/~ The regional consequence of the mpact ~ ~ ~/~w Its potent,at divergence from local needs and goals ~ ~'~ m~ Whether known oblect ons to the project relate to th~s ~mpact. [Continue on attachments) 11 PART 1--PROJECT INFORMATION Prepared by Proied Sponsor NOTICE' Tbisdocument is designed to assist in determining wt~ett~er the action proposed may have a significant effect 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 inforn~ation requiring such additional work is unavailable, so indicate and specify each instance. NAME OF ACTION LOCATION OF ACTION {Include Street Address, Municipality and County) NAME OF APPLICANT/SPONSOR ADDRESS CITY/PO BUSINESS TELEPHONE ( ) STATE I ZIP CODE BUSINESS TELEPHONE ( ) 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: E3Orban E31ndustrial [Z]Commercial F-]Residential (suburban) ~Rural (non-farm) ~Forest E3Agriculture ~Other 2. Total acreage of project area: acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) acres acres Forested acres acres Agricultural (Includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) acres acres Roads buildings and other paved surfaces acres acres Oti~er (indicate type), acres acres 3. What is predominant soil tyl~e(s) on prolect site? a. Soil drainage: I~Well drained % of site E]Moderately well drained % of site [,~]Poorly drained % of site b. If any agricultural land is involved, bow many acres of soil are classified within soil group I through 4 of the NYS l.and Classific,ation System? acres. (See 1 NYCRR 370}. 4 Are there bedrock outcroppings on prolect site? ~Yes I-]No a. What is depth to bedrock? (in feet) 2 14-16-2 [2/87)-- 7c 617.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEQR Purpose: l'he full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant 'lhe question of whether an action mav 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 litlle or no formal knowledge of the environment or may be technically expert 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 1he 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 and 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a prolect or action. It provides guidance as to wh~'ther an impact is likely 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 inmortant. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify lhe Portions of E^F completed for this projecl: [] Part I [] Part 2 []Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both tile magitude and importance of each impact, it is reasonably determined by the lead agency that: [] A. The project will not result in any large and important impact[s) and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prt~ared. [] 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 CONDITIONF-D 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 Pri~l ~r ~e N~me ~ Respa~sible OiJic~r i~ Le~d Ase~c? Title ~J ~e~n~ible re at Respa~siJ~le Officer i~ L~d Ase~c~ ~ ~iB~ur~ ~ Pr~rer (1~ diff~ren~ Jra~ res~ibl~ ~ffi~r) 1 l Revisions bY: Land Use 0o. ." Date~% 5/10/91,