HomeMy WebLinkAboutTR-3671 AmendFRANK A. KUJAWSKI, JR., President
ALBERT J. KRUPSKI, JR., Vice-President
JOHN M. BREDEMEYER, III
JOHN L. BEDNOSKI, JR.
HENRY P. SMITH
TELEPHONE
(516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
March 9, 1989
John T. Wetzel
4635 Pequash Ave.
Cutchogue, N.Y.
11935
Re: Amendment of permit No. 3671
Dear Mr. Wetzel:
The following action was taken by the Board of Town Trustees
during their regular meeting held on February 28, 1989 regarding your
request to amend the above permit.
RESOLVED that the Town Trustees Approve the request of John T.
Wetzel to amend permit number 3671 to reflect construction of 3' x
16' catwalk, eliminate 3' x 12' float, install 4 pilings to secure
catwalk.
This letter is to notify you that we will amend permit on
payment of fees for work to be done and the amended permit shall take
effect as soon as payment is received. All other terms and
conditions in the original permit granted shall remain.
Fees due: $ 36.00 'Catwalk, (portion below MHWM)
100.0D 4 pilings to support~
Inspection fee
Total fees due
Mooring anchor installation will require a mooring application,
enclosed, and a fee of $25.00.
FAK: jas
Very truly yours,
Frank A._Kujawski, Jr., President
Board of Trustees
THIS PERMIT IS CONDITL D AGAINST THE USE OF TB% I OTHER ORGANO-TIN BOTTOM
PAI~-~£S E~XCEPT WHERE EXPIKESSLY PERMITTED IN WRITING BY THE TOWN TRUSTEES.
John T. Wetzel
-: '!SSUED TO ................................................................................................................................... ; ......
Pursuant fo the provisions of Chapter 6'15 of the Laws of
fha State of New York, 1893; and C.hapfer 404 of fha Laws of fha
State of New 'York 1952; and the Soufhold Town Ordinance en-
flfled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR'OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
-Resolution of The Board adopted afa meeting held on .... .J.~].y....~...z..~....
19.....8...8.'., and in conslderafion of the sum of $..~_0..~...L0...0.. .......... paid by
John T. Wetzel
of Cutchogue
........................................................................................ N. Y. and subject to the
Terms and Condlflons llsfed on the reverse side hereof,
· of Southold Town Trustees authorizes and permits the following:
Construction of a 3' x 12' float with two pilings.
all in accordance with the detailed speciflcafions as presented in
the originating appilcafion.
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 majority of said Board as of this daf, e.
Please tear off and return to the Trustee Office.
r~ .... 3 ,-~,- : .....
¢
TERMS -,nd CONDITIONS
lowing: 1. T~t ~e T~stee Pe~t ~st ~ pro~~y ~sptay~ on ~e pr~ses
eff~ ~y d~g ~e ~i~ of ~rk ~d~ ~e ~t.
1. ~at ~e s~d B~d of T~s ~d ~e Town of ~u~old ~ ~l~ed from ~
a~ damages, or dalm~ for d~ag~, of ~ ~g ~y or ~y ~ a r~t of ~y o~-
..adon ~rfo~d p~t to ~s ~ md ~e ~d Pe~ ~[ at ~ ~ her own ~h
wi~ respect ~ereto, to ~e ~mplete-~dmion of ~e ~d of T~e~ of ~e Town oE ~old
2. That ~ Pe~t ~ v~d for a ~ of ~2 m~. w~ ~ ~d~ to
~ated ~e r~ulred to complete ~e work ~volv~ but ~o~d ~orm~t~c~ w~ r~ ..
"for an e~enSion may be rode to ~e ~d at a later da~.
" 5. ~at ~s Pe~t shoed be ret~ ~def~tely, or as long ~ ~e s~d P~
'-' to ma~ta~ the m~e or pmje~ ~volv~, to provide ~dmce to ~yone ~ncem~ ~ au~- '- ...}.
orhafion w~ ori~mlly obt~
4. That .the work involved will be subject to the inspection and approval of the Board or
--its agents, and non-compliance with the provisions of the originating application, may be ~-se for
revocation' of this Permit'by resolution of the said Board. ' -
5. That there will be no unreasonable interference with navigation as a result_of 'the work
herein authorized.
6. That there shall he no interference with the right of the public to pass and repass along
'the beach between high and low water marks.
.... 7. That if furore operations of the Town of southold require the removal and/or aItecations
m the location of the work herein authorized, or if, in '.the opinion of the Board of Trustee% the
work shall cause unreasonable obstrucuon to free-navigation, the said Permirtee will be required,
upon due notice, to remove or alter this work or projec£ herein stated without expenses to the Town
of Southold.
8. That the said Board will be notified by the Permittee or the completion of the Work suth-
orized.
9. That the Permittee will obtain all other permits and consents ,tl~t may be r~irecl ~p-
plemental to this permit which may be subject to revoke upon failur~ to obtain same.
(See Lear of~ sheet.) '
TOWN OF SOUTHOLD
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
WETLANDS PERMIT
This Wetlands Permit No ..... ~,8..0. .......... has been granted by the Town Trustees according to
62? ' ~il~ by Applicant John T. Wetze] .......
information furnished in Application No ....................... ~u .....................................
........................................ on .?...uJ.T...~.,. ............. 19...8..8. .... A map of the proposed work will be kept
on file in the Trustee Office under the application number given.
Permit granted to do the following work To construct a 3' × 12' float wittz two
Location of property on which work to be done ....&..6..3..5.~.~.e..c~,.a,~.b...~..¥.~.,.,...~.~,t'~;;b,~.~e ......................
Creek, Bay or Harbor fronting property Eugene's Creek
Size of work: Length .............................................................................................................................
3'
Width ..................................................... ~. .......................................................................
Height Above High Water .............................................................................................
Depth Below Low Water .................................................................................................
Yards to be Excavated .....................................................................................................
Yards to be Filled .........................................................................................................
Manner in which material is to be removed or deposited ..........................................................................
Intended use of property ..... .~...e..s~.d..e.F..t.~.~..] ................................................................................................
Conditions if any .....................................................................................................................................
Two years from the date the permit is si~ned.
Expiration Date ...................................................................................................................................
Number of Inspections Required .~.Z~.?~1:~u~.s..t~e.~e~.s~.1:~e~t..~.~b~e~.~t~.e.~d~.~~.9~.~~.~te~
Inspection Fees $10.00 .
-'Liability Policies in the Amount of .........................................................................................................
The validity of this permit is or may be subject to the approval of other governmental or municipal
.authorities. The Town accepts no responsibility in applying for or obtaining such approval. In the
'event that such approval is necessary, the holder of this permit shall not commence operations here-
under until such approval has been obtained in writing. Tl~e failure to obtain such other approval when
required shall subject this permit to immediate revocation by the Trustees upon receipt by the
Trustees- of written notice from such other governmental or municipal authorities of its refusal or
disapproval.
The applicant does by the acceptance of this permit, assume all responsibility for operations under-
taken pursuant to this permit, and shall take all precautions for the prevention of 'njuries to persons
and property resulting from such operation,s. By sucb acceptance, the applicant also agrees to indemnio.
fy and save harmless the Town, and its officers, ageots and employees from any and all claims arising
from operations under this permit and any and all acts or omissions of applicant, his agent and
employees.
The applicant and the owner and occupants of the premises upon which the operations authorized by
.~is. permit are being conducted, do, by the acceptance of this permit, give consent to the Town, and
its officers and employees to enter upon the premises where such operations are being conducted To
make such inspections as the Town may deem necessary to insure that such operations are being con-
ducted in conformity with this permit.
This operation will not substantially: A. Adversely affect the wetlands of the town.
B. Cause damage from erosion, turbidity or siltation.
C. Cause saltwater intrusion into the fresh water resources of the town.
D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife and vege-
tation or the natural habitat thereof.
E.. 'Increase the danger of flood and storm-tide damage.
F. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town.
G. Change the course of any channel or the natural movement or flow of any waters.
H. Weaken or undermine the lateral support of other lands in the vicinity.
!. Otherwise adversely affect the health, safety an, d general welfare of the people of the town.
Signed
Bard of ~outhold ~oWn Trustees
TELEPttONE
~.516) 765-1801
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
To: Southold Town Trustees
From: Southold Town CA.C
Dated: May 20, 1988
The CAC made the following recommendations at their regular meeting
held May 12, 1988:
No. 622 - Dr. Edouard P. Beaugard - Recorn'/nend approval.
No. 623 - Sanford Hanauer - Recommend approval.
No. 624 - Gus Mueiler - Recommend approval.
No. 625 - Clifford Eginton - Tabled
No. 626 - Goldsmith's Boat Shop - Recommend approval.
No. 627 - Joan and John T. Wetzel - Recommend disapproval. There
is not enough space to allow for each homeowner to have
a dock. Suggest the neighbors get together and build one
dock and share it.
If you have any questions, please do not hesitate to contact me.
Linda J. Cooper
Frank A. Kujawski, Jr., Pres.
HENRY P. SMITH
JOHN M. BREDEMEYER,
John Bednoski, Jr.
ALBERT KRUPSKI, JR., Vice-President
TELEPHONE
(516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF $OUTHOLD
Town Hall. 53095 Main Road
P.O. Box 728
Southold, New York 11971
April 27, 1988
Mr. & Mrs. John T. Wetzel
373 Plymouth Street
West Hempstead, New York
11552
Re: Application No. 627
Dear Mr. & Mrs. Wetzel:
The following action was taken by the Board of Town Trustees
during their regular meeting held on April 21 1988 regarding the
above matter. '
RESOLVED that the Southold Town Trustees TABLE the
application of Joan and John Wetzel pending receipt of a map in
scale showing the neighboring structures. The property will have
to be staked for further inspection by the Board.
~ery truly yours,
Frank A. Kuj~wski, Jr., Pres.
Board of Towh Trustees
FAK:ip
cc: Bldg. Dept.
D.E.C., Stony Brook
file
BOARD OF TOWN TRUSTEES
TO;~ OF SO.HOLD
Town Hall, S~09S Main ~oad
P.O. Box 728
Southold, New York 11971
TELEPHONE
(51~) 765-1892
Y
APPLICA~4ON IS HEREBy MADE TO THE TOWN TRUSTEES' OF TH~ TOWN OF
SOUTHOLD, SUFFOLK COUNTY, NEW ¥O'RK FOR THE ISSUANCE OF A P~RMIT
PURSUANT TO TH~ LAWS, ORDINANCES AND REGULATIONS GOVERNING THE
COASTAL AND INTERIOR W~TLANDS, FLOOD PLAINS AND DRAINAG~ AREAS
OF TH~ TOWN OF SOUTHOLD, AND TN~ ISSUANCE OF P~RMITS PURSUANT
TO CHAPT~R~ 32 OF TM~ CODES OF THE TOWN OF SOUTHOLD.
AGENT
PHONE
LOCATION OF PROPERTy FOR ~HICH. PERMIT WANTED
HOME ADDResS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATIO~
DEPTH BELOW LOW WATER
YARDS TO BE EXCAVATED
YARDS TO BE FILLED
WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY
DEPTH AT LOW. TIDE ~
AVERAGE RISE IN TIDE
DISTANCE TO THE NEAREST CHANNEL / FT.
DISTANCE
PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE
THIS
AREA ZONING
MANNER ~N WHICH MATERIAL WILL BE REMOVED OR DEPOSITED
DESCRI BE -ANY KNOWN PRI OR OPERAT IONS CONDUCTED ON THE PI{EMI SE
AND WHETHER ANY PRIOR LICENSE OR PERMITS HAVE BEEN ISSUED TO ERRECT
STRUCTURES OR TO DREDGE OR DEPOSIT FILL ON SA[D PREMISES AND WHETHER
ANY PERMITS OR LICENSES WERE EVER SUSPENDED OR REVOKED BY A GOVERNME!
AGENCY
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
(2/87)-- 7c
617.21
Appendix A SEQ
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 proje(
or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequen
]y, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determin
significance may have little or no formal knowledge of the environment or may be technically e.xDert in environment~
analysis, in addition, many who have knowledge in one particular area may not be aware of the broader concerns affectin
the question of significance.
The fuji EAF is intended to provide a method whereby applicants and agencies can be assured that the determinatio~
process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or actJor
Full EAF Components: The full EAF is comprised of three parts:
Part 1: Provides obiective data and information about a given project and its site. By identifying basic projec
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 project or action. It provide.
guidance as to whether an Impact is likely to be considered small to moderate or whether it is a potentially
large impact. The form also. identifies whether an impact can be mitigated or reduced.
Part 3:im.oactlf any imDaCtis actual(yin Partimportant.2 is identified as potentially-large, then Part 3 is' used to evaluate whether or not th(
DETERMINATION OF SIGNIFICANCE--Type I and Unlisted. Actions
Identify the P°rti°ns °f r-AF c°mpleted f°r this pr°ject: ~, ~ Part l ~~ P~r~ t 2 ' E3Part3
Upon review of the informatio~ recorded on this EAF(Partsl and 2 and3 if appropriate) and any other supporting
information, and considering both the magitude and importance of each impact, it is reasonably determined by the
lead age,~c,a~ 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 prepared.
[] B. Although the project could have a significant effect on the environment, there will not be a significant
effect for this Unlisted Action because the mitigation measures described in PART 3 have been required,
therefore a CONDITIONED negative declaration will be prepared.*
[] C. Th~ proiect may result in one or more large and important impacts that may have a significant impact
on the env'ronment, therefore a positive declaration will be prepared.
* A Conditioned Negative Declaration is only valid for Unlisted Actions
Name of Action
-~--;,:- _~ Name of Leaa A~enc¥,
P/~or ~Type N?m,~ or ~/es~o~slble Of/ccer in[Lead Agency~ ' ' Title of Responsible Officer
Signature of Res~onsib/e Officer m Lead Agency Signature ot Preparer[If different from 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 e
on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be consi(
as part of the application for approval and may be subject to further verification and pubJic review. Provide any addit
information you believe will be needed to complete Parts 2 and 3.
It is expected that completion of the full EAr will be dependent on information currently available and will not in,
new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and sp
each instance. ·
NAME OF ACTION . .
LOCATIOn.OF ACTlO~lnclude Street Address, Mun c pa ity
ADDRESS ~ / /,
and County)
· BUSINESS( 1~/~)~'~,~~TELEPHONEX
NAME OF OWNER (if different)
STATE ZIP CODE
BUSINESS TELEPHONE
(
ADDRESS
CITY/PO
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: I-lUrban I-Ilndustrial []Commercial i-!Residential (suburban)
Fi, Forest i-qAgriculture [--IOther
2. Total acreage of project area: acres.
APPROXIMATE ACREAGE 'PRESENTLY
Meadow or Brushiand (Non-agricultural) .... acres
Forested -- acres
Agricultural (includes orchards, cropland, pasture, etc.) ?~,//~ ,~ gacres
Wetland (Freshwater or tidal as per Articles 24, 25 of ECL).~/
Water Surface Area ~~P'-'~" acres
[~1~ ral (non-fa
AFTER COMPLETIOh
acres
acres
__ acres
..~¢~_.~.?~.x._.~ acres
~ acres
acres
acres
acres
Unvegetated (Rock, earth or fill)
Roads, buildings and other paved surfaces
Other (Indicate type)
3. What is predominant soil type(s) on proiect site?
a. Soil drainage: ~(~elt drained % of site
~Poorlv drained % of site
acres
acres
acres
[Z]Moderately well drained
°,3 of site
b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the
Land Classification System? acres. (See 1 NYCRR 370).
4. Are there bedrock outcroppings on project site? ~Yes
a. What is depth to bedrock? (in fe~J~) _.
2
5. A,,.pproximate ~ercentage of p,oposed project site with slopes: ~0-109, ~/~' % []10-15%
F-[15% or greater
6. Is proiect substantially contiguous to, or contain a building, site, or district, listed on the State or the Natior~
Registers of Historic Places? OYes [~o
7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? 0-lYes
8. What is the depth of the water table? ~ ~ (in feet)
9. Is site located over a primary, principal, or sole source aquifer? E~Yes E~No
10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? [~YYes []No
11 Does project site contain any species of plant or animal life that is identified as threatened or endangered
[]Yes [~o According to
Identify each species
12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations
[Yes g~No Describe
13. Is the project sit~/presently used by the community or neighborhood as an open space or recreation areai
I--lYes L~No If yes, explain
14. Does the present sj, te include scenic views known to be important to the community~ ~Yes 4~No '
15. Streams within or contiguous to proiect area: ~A
a. Name of Stream and name of River to which it is tributary
16.
17.
18.
19.
20.
Lakes, ponds, wetland areas within or contiguous to project area:
a. Name b. Size (In acres)
Is the site served by ~'xisting public utilities? ~Yes ~No
a) If Yes, does sufficient capacity exist to allow connection? I-lYes
b) If Yes, will improvements be necessary to allow connection? ~JYes
Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA,
Section 303 and 304? ~Yes [~No
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 ~2~/es [No
Has the site ever been used for the disposal of solid or hazardous wastes? ~Yes
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
b. Project acreaz4e to be developed: ~
acres initial[y;
c. Project acreage to remain undeveloped ~ acres.
d. Length of project, in miles: ~'~,e_~/ (If appropriate)
e. If the project is an expansion, indicate percent of expansion proposed
f. Number of off-street parking spaces existing .......
g. Maximum vehicular trips generated per hour
h. If residential: Number and type of housing units:
One Family Two Family
Initially b~'/
Ultimately
i. Dimensions (in feet) of largest proposed Structure g~/'~ height; ~
j. Linear feet of frontage along a public thoroughfare project will occupy i~z
acres.
acres ultimately.
· proposed
(upon completion of project)?
Muhiple Family
width;
Condominium
-,3 ~ F length.
ft.
2. How much natural material (i.e., rock, earth, etc.) will be removed from the site?
3. Will disturbed areas be rec[aimed? fi-lYes []No ~/A
a. If yes, for what intend~_~; purpose is the site being rec]aimed?
b. Will topsoil be stockpiled for reclamation? []yes ~No
c. Will upper subsoil be stockpiled for rec[amation? ti-lYes i-INo
4.
tons/cubic ~yards
How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? ;~//z2~,-' acres.
5. Will any maturexforest (over 100 years old) or other locally-important vegetation be removed by this project?
EEYes I~No . .
6. If single phase project: Anticipated period of construction ,~? ~/~z~ months, (including demolition).
If multi-phased:
a. Total number of phases anticipated
b. Anticipated date of commencement phase 1
c. Approximate completion date of final phase
(number).
month year, (including demolition).
month year:
d. Is phase I functionally dependent on subsequent phases? ti-lYes
8. Will blasting occur during construction? [ii-lYes l~o
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.~ 17Yes
· after project is complete
If yes, explain
12. Is surface liquid waste disposal involved? I--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? I-TYes ~'1~o Type
14. Will surface area of an existing water body increase or decrease by proposal?
Explain
15.
16.
~Yes [~1~o
Is project or any portion of project located in a 100 year flood plain?
Will the project generate so[id waste? [Yes ~/o
a. If yes, what is the amount per month tons
b. If yes, will an existing solid waste facility be used? l-lYes []-]No
c. If yes, give name ; location
d.
e.
~'~?o
Wi.II any wastes not go into a sewage disposal system or into a sanitary landfill?
If Yes, explain
[]Yes
F-1No
Will the project involve the disposal of solid waste?
a. If yes, what is the anticipated rate of disposal?
b. If yes, what is the anticipated site life?
Will
17. r-lYes ~o
tons/month.
years.
18. proiect use herbicides or pesticides? ~lYes ~o
10. Will project routinely produce odors (more than one hour per day)? EEYes [~o
20. Will project produce operating noise exceeding the local ambient noise levels? ITYes
21. Will project result in an increase in energy use? [Yes ~"o
If yes, indicate type(s)
[~0
22. If water supply is from wells, indicate pumping capacity ~-~-~
23. Total anticipated water usage per day gallons/day.
24. Does project involve Local, State or Federal fun, ding? l-lYes
If Yes, explain
gallons/minut(~.
go
2~.',~pprovals Required:
City, Town, Village Board []Yes I-[No
City, Town, Village Planning Board []Yes I~No
City, Town Zoning Board E~'es f-INo
City, County Health Department []Yes r-iNo
Other Local Agencies ~'~es i-lNo
Other Regional Agencies [3~i'es []No
State Agencies []Yes I--INo
Federal Agencies [~es []No
C. Zoning and Planning Information
Type
1. Does prcposed action involve a planning or zoning decision? I-IYes
If Yes, indicate decision required:
F-lzoning amendment [-Izoning variance []-]special use permit
rqsubdivision ~site plan
[-]new/revision of master plan []resource management plan F-Iother
2. What is the zoning classification(s)of the site?
3. What is the maximum potential development of the site if developed as permitted by the present zoning?
Submittal
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? []Yes
7 What are the predominant [and use(s) and zomng classifications within a 'A mile radius of proposed action?
8 Is the proposed action compatible with adjoining surrounding land uses within a ~¼ mile? [~-Yes
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 sewer or water districts? [-]Yes
11. Will the proposed action create a demand for any community provided services (recreation, education, polic
fire protection)? ~Yes
a. If yes, is existing capacity sufficient to handle projected demand? il-lYes
12. Will the proposed action result in the generation of traffic significantly above present levels? il-lYes I-IN,
a. If yes, is the existing road network adequate to handle the additional traffic? []Yes l--INo
D. Informational Details
Attach any additional information
impacts associated with your proposal,
avoid them.
as may be needed to clarify your proiect. If there are or m~ay be any adver~
~[ease discuss such impacts and the measures which you propose to mitigate
E. Verification
I certify that the informa:tjon provided above is true to the best of my knowledge.
/ ~ Title
If lke action is in the Coaslal Area, and you are a slate agency, comptele the Coastal Assessment Form before
with ~his assessment.
~rt 2--FROJF_.CT IMPACTS AND . HEIR MAGNITUDF_.
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 b
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 significa:
Any large impact must be evaluated in PART 3 to determine significance Identifying an impact in column 2 sin-
asks that it be looked at further.
· The Examples provided are to assist the reviewer by showing types of, impacts and wherever possibie the thresholc
magnitude that would trigger a response in column 2. The examples are generai[v applicable tl~roughout the State ~
for most situations. But, for any specific project or site other examples and/or ]ewer thresholds may be appropri
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 ~
have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each questi
· 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 ~
imp.act. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but thresh(
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
e. If a potentially large impact checked in column 2 can be mitigated by changels) in the project to a small to moder~
impact, also check the Yes box m column 3. A No response indicates that such a reduction is not possible. Ti
must be explained in Part 3.
IMPACT ON LAND
1. Wilitheproposedactio~ result inaphysica chan~eTot~prolectsite?
~!~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 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 f(~et of existing ground surface.
· Construction that will continue for more than I year or involve more
khan 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 landfi[I.
· Construction in a designated floodway.
· Other impacts
2. Will there be an effect t: .... ~y ur~,que or unusual land forms found on
the site? [i.e., cliffs, dunes, geological formations, etc.)[NO []-lYES
· Specific land forms:
I I 2 3
Small to Potential Can Impact B~
Moderate Large Mitigated By
Impact Impact Project Chang
[] [] ~]Yes [~]No
[] [] [~Yes E~]No
L--J [] [~Yes
[] [] [~]Yes [--]No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
IMPACT ON WATER
3. Will proposed action affect any water body desi'gnated as protected?
(Under Articles 15, 24, 25 of the Environmental Conservation Law~_E/CL)
E3NO ~;~ES
Examp]es 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.
o 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 exist~gZoneW body
of water? I--lYES
E×amples 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:
5. Will Proposed Action affect surface or groundwater
quality or quantity? ~"~O I-lYES
Examples that would appty 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 likelv c~Ju~e Siltation or other discharge into an
existing body of water to tr:e ext'c, nt that there will be an obvious visual
contrast to natural conditions.
· Proposed Action will require the storage of petroleum or chemical
products greater than 1,100 gallons.
· Proposed Action will allow residential uses in areas without water
and/or sewer services.
· Proposed Action locates comr:,ercial and/or industrial uses which may
require new or expansion of existing waste treatment and/or storage
facilities.
· Other impacts:
6. Will proposed action alter drainage fh)w or patte~or surface
water runoff?
E×:mples that would apply to column 2 /j~'"~O ~YES
· Proposed Action would change flood water flows.
1
Small to
Moderate
Impact
2
Potential
Large
Impact
3
Can Impact E
Mitigated B~
Project Chanc.
I--lYes I--]N~
I--lYes r-iN,
I-lYes F-~N(
~Yes i--]N~
[~Yes
[-]Nc
[-]Yes r-]Nc
['-]Yes [~Nc
[~Yes r--iNc
F-TYes [-]Nc
[~Yes F-]Nc
[-]Yes [~]Nc
[~]Yes [--] Nc
[~]Yes [-]Nc
F-~Yes
~--]Yes [--]No
[~]Yes- F-]No
[--]Yes [~]No
E~Yes
~Yes ~--[ No
[~]Yes I'-] 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? ~O []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 1 ton of
refuse per hour.
· Emission rate of total contaminants will exceed .5 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 will allow an increase inthe density of industrial
development witi(in existing industrial areas.
· Other impacts:
IMPACT ON PLANTS AND ANIMALS
;4.. Will Proposed Action affect any threatened or end,snEe/red
species? '~O'- I-lYES
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
nora-endangered species? '~N.~O [YES
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
i0 Will the Proposed Action affect agricultura land r,p~rces?
O [~YES
Exampies that would apply to column 2 %
The proposed action would sever cross or limit access to agricultural
land (includes cropland, hayfields, pasture, vineyard, orchard, etc.)
1
Small to
Moderate
Impact
2
Potential
Large
impact
Can Impact
Mitigated By
Project Chang
[] I-lYes E-]No
[] i--lYes IL-~No
[] E]Yes [--]No
[] - I-lYes [-qNo
,r-]Yes [-']No
I-7[Yes J-]No
F-lYes F-INo
E~Yes [--]No
E]Yes E~No
E]Yes F']No
[~]Yes E~]No
E]Yes I-}No
[--~ Yes .[~No
[--}'Yes F-iNo
¥es rhNo
E~Yes I-]No
[~]Yes [--~ No
8
* Construction activity would excavate or compact the soil profile of
agricultural land.
' The proposed action would irreversibly convert more than 10 acres
of agricultural ia,nd or, if located in an Agricuitutal District, more
than 2.5 acres of agricultural land.
· ]-he 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 RESOURCES, /
11. Will proposed action affect aesthetic resources? .~0 I-lYES
Elf necessary use the Visual EAF Addendum in Section 617.21,
Appendix B.)
E×amples that would apply to column 2
· Proposed land uses, or project 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 .or.historic' pre-
historic or paleontological mportance~ ~"NO fi-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 WiJl~ Proposed Action affect-the quantity or quality of existing or
future open spaces or recreational opportunities~
Examples that would apply to column 2 ' '~/O ~YE$
· The permanent foreclosure of a future recreational opportunity.
· A major reduction of an open space important to the community.
· Other impacts:
9
I 2 3
Small to Potential Can impact Be
Moderate Large Mitigated By
Impact Impact Project Change
[] [] []Yes ~No
[] [] I--IYes [-]No
[] [] l-~ Yes I--i No
[] []. E~Yes [~]No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes. ~No
~ ~ ~Yes ~No
~ ~ .~Yes ~No
~ ~ ~Yes
~ ~ ~Yes ~No ~
~ ~ ~Yes ~No
IMPACT ON TRANSPORTATION
14. Will there be an effect to existing transportation sy.~:~ems?
Examples that would apply to column 2
filYES
· 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 so f fuel or
energy supply? u~(~ I-lYES
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 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 vibration as a result
of the Proposed Action? [~O E-]YES
Examples that would apply 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 exceedin8 the local
ambient noise levels for noise outside of structures.
· Proposed Action will remove natural barriers that would ~ct as a
noise screen.
· Other impacts:
IMPACT ON PUBLIC HEALTH
17. Will Proposed Action affect public health and safe~,~?/~
OYES
Examples that would apply to column 2
· Proposed Action may cause a risk of explosion or release of hazardous
substances (i.e. oil, pesticides, chemicals, radiation, etc.)in the event of
accident or upset conditions, or there may be a chronic Iow level
discharge or emission.
· Proposed Action may result in the burial of "hazardous wastes" in any
form (i.e. toxic, poisonous, highly reactive, .radioactive, irritating,
infectious,' etc.)
· Storage facilities for one million or more gallons of [iquified natural
gas or other flammable liquids.
· Proposed action may result in the excavation or other disturbance
within 2,000 feet of a site used for the disposal of solid or hazardous
waste.
· Other impacts:
10
1
Small to
Moderate
Impact
2
Potential
Large
Impact
Mitigated E
I Projec_t Char:
[--]Yes [~F
F-]Yes F-iF
[-]Yes
~Yes r-lb
J-'lYes Fl[x:
~Yes I'-IN
l-lYes ['-]N
JZ~]Yes
fi]Yes F-IN
F-lYes [~N~
[-]Yes [-]N~
[-]Yes- . [~]Nc
[~Yes [--]Nc
[--]Yes [~Nc
[--]Yes
t-lYes E~No
IMPACT ON GROWTH AND CHARACTER
OF COMMUNITY OR NEIGHBORHOOD
18. Will proposed action affect the character of the exis in~,,community~
E×ampJes that wouid appiy to column 2 ,/~O []YE~
' The permanent population of the city, town or village in which the
proiect is located is !ikeiy [o grow by more than $%.
· 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.
e 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.i
· Proposed Action will set an important precedent for future projects.
' Proposed Action will create or eliminate employment.
· Other impacts:.
Small to
Moderate
Impact
2
Potential
Large
Impact
19.
Is there, or is there likeIy to be, public controv,ersy related to
potential adverse environmental impacts? ~O E]YES
~tion in Part 2 Is Identified as a Potential Large Impact or
~a~P a~ 3--.=VAL- ,,--- ~ ~ -,
--- ~dJ~i] Or ~HE IMPORTANCE OF iMPz~.3TS
3
Can Impact E
Mitigated B)
Project Chart[
~Yes
[~Yes I-]Nc
~Yes ~Nc
[~Yes I~Nc
[~]Yes l']No
[~Yes [--]No
~Yes I-'INo
[~Yes l--lNo
[~Yes F-[No
Responsibility of Lead Agency
Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may b~
mitigated.
Instructions
Discuss the following for each impact identified in Column 2 of Part 2:
1. Briefly describe the impact.
2. D;~scribe (if applicable) how 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 irreversib ty including permanently lost resources of value
· Whether the impact can or will be controlled
· The regional consequence of the impact
· Its potential divergence from local needs and goals
· Whether known objections to the project relate to this impact.
(Continue on attachments)
11
,~ '14-14-11 (2,'87)--9c 617,2 ! SEOR
' , Appendix B
State Environmental Quality Review
V suai EAF Addendum
This form may be used to provide additional information rel~t.ing to Question 1 1 of Part 2 of
the Full FAF.
(To be completed by Lead Agency)
Distance Between
Project and Resource (in Miles)
0-V4 ~A-1/2 1/2-3 3-5 5+
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? [] [] [] [] []
· National Wildlife Refuges and state game refuges? [] [] [] [] []
· National Natural Landmarks and other outstanding [] [] [] [] []
natural features? ·
· National Park Ser~i~e 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?
· Municipal park, or designated open space? [] [] [] [] []
· County road? [] [] [] [] []''
· State? [] [] [] [] []
· Local road? [] [] [] [~]~ []
2. Is the visibility of the project seasonal? (i.e., screened by summer foliage, but visible
seasons)
[] Yes [] No
during other
3. Are any of the resources checked in question ! Used by the public during the time of year
during which the project will be visible?
~___~ Yes ~-~ N o
DI=SCRIPTION OF EXISTING VISUAL ENVIRONMENT
4. From each item checked in question 1, check those which generally describe the
environment.
surrounding
Essentially undeveloped
Forested
Agricultural
Suburban residential
Industrial
Commercial
Urban
River, Lake, Pond
Cliffs, Overlooks
Designated Open Space
Fiat
Hilly
Mountainous
Other
NOTE: add attachments as needed
5. Are there visually similar projects within:
'1/2 mile ~-] Yes [--~, No
*1 miles [~Yes [~]No
*2 miles ~J Yes [--]No
*3 miles [-~ Yes
Within
'1/4 mile * 1 mile
* 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
NOTI~: 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 [] [] [] []
At worksite [] [] [] []
Other [] [~ [~] []
COUNTY OF SUFFOLK )
STATE OF NEW YORK )SS:
BEING DULY SWORN DEPOSE
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, 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
VIRTU~ OF SAID PERMIT, IF GRANTED.
Zn completing this application I hereby authorize the Trustees~
agent 6r representative to enter onto my property to inspect the
premises in conjunction with r~~~ application.
/ ~IGNATUR~ OF APPLICANT
NOTARY PUBLIC
EXAMINED
APPROVED "WETLANDS" PERMIT (CHAPTER 97)
APPROVED "BOAT~DOCKS, WHARVES" PERMIT (CHAPTER 32)
DISAPPROVED "~ETLANDS PERMIT" (CHAPTER 97)
DISAPPROVED "BOATS,DOCKS, WHARVES" PERMIT (CHAPTER $2)
CONDITIONS, IF ANY ~.
EXAMINING BODY
SIGNATURE OF CHAIRMAN
COMPUTATION OF FEES
·
:Z: 0 ra
0
0
/
/
/