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Home My WebLink AboutTR-4177Board Of $outhold' Town Trustees SOUTHOLD, NEW YORK PERMIT NO... ~_!...7. ~ DATE: .5/2.6/9.3 ....... ISSUED TO ......... ~.0.~ ..~.~;.~5 ............................................................................ Pursuant fo +he provisions of Chapter 615 of +he Laws of +he State of New York, 1893; and Chapter 404 of +he Laws of the State of New York 1952; and the Sou+hold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTION5 IN AND .ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER ivtATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with {'he Resolution of The Board adopted at a meeting held on .... 5.!..;~.(~./.9.:~ .... 19 ...... and in consideration of the sum of $ '150..00 paid by . En:~ G~);a~4!J;an.!;~... J~o~,.. J~..O.. !~ N .. ~.A [~ E.R~ S ........................................................ of ...G~.~hog'~ .................................................. N. Y. and subjec+ fo +he Terms and Conditions lis+ed on +he reverse side hereof, o~ Southold Town Trustees authorizes and permits +he following: 1Kemove & replace (in same location & configuration) 100 1.f. of storm damaged bulkhead. Backfill with 400 c.y. of clean sand brought in over owner's property, l~ebuild existing platform & stairs to allow replacement of bulkhead. Nassau Pt. all in accordance with the de+ailed specifications as presented in +he originating application. IN WITNESS WHEREOF, The said Board of Trustees h,ere- by causes ifs Corporate Seal fo be affixed, and these presents to be subscribed by a maiority of +he said Board as of this daf.e. Albert $. lr~ulmki, Ir., 1ohn L Bednos~, lohu B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Fax (516) 765-1823 TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARi~S Town Hall $~095 Main Road P.O. Box 1179 Southold, New York 11971 COASTAL EROSION MANAGEMENT PERMIT APPLICATION' TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Only: , Coastal Erosion Permit Application Wetland Permit Application --Trustee Lands Permit Application Grandfather "Completed Apps. Date: ' , Variance Required, Neighbors notified Date: SEQRA Type Coord. Review-opt.,mand. Insp. comp./date: .SEQRA Determin./date: _ public Hearing/date: Findings: Permit Vote: (Y/N): Special Conditions: (also see file) TOWN OF SOUTHOLD_ Fee": Application Number; SCTM #t000-104-13-11 Project Name (If any) Date prepared:. ~ May. !3, 199.3 Applicant: EN'CONSULTANTS, INC. Address: 1329 North Sea Road soutnampton, NY ~1968 Phone (516) 283-6360 Interest: (owner, consultant,lessee,etc.) Consultant Owner of Property: JOHN WATERS Address 394 Stewart Avenue, Garden City, NY 11530 Phone ~16 ) 742-8888 (Mrs. Stutzman) Subject Property Location: 3055 Nassau Pt. Road, Cutchogue, NY (ProviUe LILCO Pole ~, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Yds. to be excavated: 0 Yds. to be filled: 400 Manner in which material will be removed or deposited: Trucked in, dumped and graded Width of canal, creek or bay fronting property: One mile Depth at low tide: - Aver. rise in tide: 2'-6" Distance to nearest channel: N/A Distance project extends beyond similar projects in area: 0 Area zoning: R-40 Land area in acres: 1± ac Is project for private or business use: private (no change) Intended use of property: N/A Describe known prior operations conducted on premises: N/A Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises: Unknown Has any license or permit ever been revoked or suspended by~a Governmental Agency: No ~ Project DescriptiOn The project description must alsO include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e., pipeline and septic system; make additional attachments if necessary). SEE ATTACHED THIS IS NOT A PERMIT .Page PROJECT DESCRIPTION Re: JOHN WATERS Remove and replace (in same location and configuration) 100± 1.f. of storm-damagedbulkhead & backfill with 400 cy of clean sand to be brought in over owner's land. tm existing platform and 'stairs will be disassembled to allow replacement of bulkhead then rebuilt. Authorization (Where the applicant is not the owner) (Print-oWner of subject property) (Mai±lng addres~--p~o~e) do hereby authorize En-Consultants, ~nc. to apply for Coastal Erosion permit(s) from the Southold Town Trustees ~e THIS IS NOT A PERMIT Page.3 County of Suffolk ) State of New York ) ~0~ ~. ~Q~g~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(s) OR REPRESENTATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~ !/ S I GNATUR~. ' SWORN TO BEFORE ME THIS NOTARY PUBLIC Suggested space for location Map THIS IS NOT A PERMIT 14-16-4. (2/87)--T§xt 12 J 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) 1. APPLICANT/SPONSOR SEQR JOHN WATERS by En-Consultants 'Il 2. PROJ~-C;i NAME 3. PROJECT LOCATION: Municipality TOWlI of Southold Count~; Suffolk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 3055 Nassau Pt. Road Cutchogu~, NY SCTM: 1000-104-13-11 5. IS PROPOSED ACTION: [~New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: SEE PROJECT DESCRIPTION 7. AMOUNT OF LAND AFFEC¥~D: · 39,044 sq.f~s Ultimately 39,044 sq. f'lTa~=res Initially 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial [] Agriculture Describe: [] Park/Forest/Open space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] No If yes, list agency(s) and permit/approvals COE, DOS, DEC~ 11. DOES ANY ASPF. C¥ OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [~No if yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes ~ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE iS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Signature: ~HN W,~ER~ bv En-Consul~an~.~ Date: If the action is in the COastal Area, and you are a state agency, complete the 5/I3/93 Coastal Assessment Form before proceeding with this assessment OVER 1 PART II--ENVIRONMENTAL ASL ~S ~IT (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. ~:;. 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 [] .o If No, a negative declaration COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) Cl. 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 inducecLby the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in Cl-C57 Explain briefly. C7o Other impacts (including changes in use of either quantity or type of energy)? Explain briefly° Do 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) 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. [] 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 provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer (If different from responsible officer) Date 2 PROJECT DESCRIPTION Re: JOHN WATERS Remove and replace (in same location and configuration) 100± 1.f. of storm-damagedbulkhead & backfill with 400 cy of clean sand to be brought in over owner's land. An existing platform and stairs will be disassembled to allow replacement of bulkhead then rebuilt. EN-CONSULTANTS, INC. 1329 NORYH SEA ROAD, SOUTHAMPTON, NEW YORK 11968 ENVIRONMENTAL SERVICES 516'283-636~ FAX NO. 516-283-613~ TO WHOM IT MAY coNCERN: This letter will authorize Eh-Consultants, Incorporated, to apply for permits on my-behalf. NASSAu ..z~-co~suur,~uT$ SOUTHAMPTON N, Yo 516-2.83-6360 KEY MAP SCALE / -~,joO, LITTLE pEC, ONIG BA._Y $. 10°q3'40. ~. I00.00' ~ ~ ...... -~NlOd Z cIVssVN 7