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Home My WebLink AboutWICKHAM, J PARKER CASE AC~ER CASE DESCRIPTION CLASS CODE ] CASE TYPE INCIDENT REPORT Southold Town Police Department Route 25 Peconic, New York i 1958 516-765-2600 ~RIMINALCASE ID NON CRIMINAL HOW RECEIVED [] ~ FOR SERVICE ,~FFICER INITIATED PAGE / OF / [] COUNTER REPORT oL INCIDENT LO~ATION A NBR STREET NAME m [] BLOCK ID COMMERCfALBLDG. [] PUBLIC BLDG. I [] INTERSECTION D INDUSTRIAL BLDG. [] PUBLIC PARK 0 [] PRIVATE HOME [] MULTI DWELLING [] PARKING LOT N PEI~SON INVOLVEMEN~ CODES; C- COMPLAINANT F - FINDER M - MISSING PERSON D - DRIVER I - INJURED/AIDED 0 - OWNER E - EMPLOYEE J - JUVENILE P . POLICE OFFICER P REPORTED DATE , -/~ -,~ ~ OCCURRED FROM Y~' Y/-~-- ,~ ~--- TO /-/~- ?~- DESK OFFICER PATRO F[,,..~ER [] SCHOOL [] COUNTRY CLUB/GROUNDS [] BANK D OTHER [] CHURCH R-REPORTING PERSON V-VICTIM S-SUSPECT W-WITNESS U-UNKNOWN Z-OTHER //2-0 ~RS IPERSON i LAST NAME HOME PHONE SUSINESS PHONE I OCCUPATION RACE CODES A- AStANYORIENTAL B - BLACK H - HISPANIC I-AMERICAN INDIAN 0- OTHER W- WHITE COMPLEXION PERSON LAST NAME FIRST Mo..~7_./~.~y~_J ADDRESS CODE HOME PHONE I BUSINESS PHONE I OCCUPATION PERSON L~.ST NAME FIRST MI I ~DRESS ~DE HOME PHONE ) BUSINE~ PHONE ~ ~UPATION Na,-ra~ve: (Print or Type Only) PDT~-I A Board Of Southo[d Trustees SOUTHOLD, NEW YORK PERMIT NO. DATE: , iSSUED TO ....... p..a,.~:Jf;m~f';._,?~,c,.,~?,'.n,.~ ....................................................................... Purs~a~ff ~o ~he pro~Mons of Cflap~er ~i5 of fhe Laws of fffbd REG~LA~N<~ AND THE PLAC[N~ OF OBSTRUCTIONS ~OWN WATERS AND PUBUC LANDS ~N AND ON REMOVAL OF SAND, ~RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and b ac~orda~oe Resok~'bn ~f The Board a~opfed et a mee~b~ held on ..... May. 28.,... Jg..?.~..~ ~nd b ¢ons~deraf~on of fhe sum of $ ZS0.,.00. pald by ............ 7 ...'L ? Parker Terrn~ a~d Condff~o~s ~s'~ed on fhe reverse s~de hereof, o{ Soufho~d Towr~ Trusfees ~ufhorkes and perm]rs fhe ~o ~egzade th.e bank and seed aa per pIan~ of ~he 5o$1 and Water Conservation. District fhe or]gip,~'H.,9 appJkafbm IN WITNESS WHEREOF, The said Board of Tmsfees kere- by causes frs Corporate Seal fo be aff]×ed, a~d fhese pre~eMa fo be subscribed by a ma[Drily of fhe ~[d Board as of fh]s daf, e, / 'Trttstees / TRUSTFZES John M. Bredemeyer, Hi, Presiden~ Albea J. Krupski; Jr. Vice President Fte~ g SmirCh John B. Wfl.lNm G. Aibemqon Telcp~:mne (516) 765-1892 Fax (51~) 765q823 ~ BOAPd) OF ~'~'~WN..~, l, TRUSTEES TOV~2q OF SOLU'HOLD SUPERVi. SOR %wn Hall 53095 MaN Road EO. Box '!i79 SouthoI& New ~ork 11971 199~ July 8, ~ o Parker Wickh~ Airway Drive P.O~ Box 1312 ~attituck~ h~Y 11952 Re: Parker Wickh~ '~ 1~ ~-~9-6 ~ SC%~ %__000-'q. i Dear Mr~ Wickh~:~- The '~ ~ ~ '~ -' ~=o.=lowxng action was taken by the Board of Town ~'~rustees during its regular meeting hel~ on~,~,~av,, 2g~. 1992 rega~ing the above matter: ~ ~ ~ ~ ~ Wickha~m appiied~ to the Southo!d W~F~$ ~ ~ a.r~ce~ ~o~ Trustees for a Ordln~n~.~= of the Town of permit un,er the provisions of the Wetland Southo=~ application dated~ April 21. 1992 and~ b~ER}gAS said application was referred, to the Southold Town Conservation Advisory Council for their fittings and reco~endations~ and ~ ~EREAS~ a p~b!ic hearing was held by the To~ Trustees with res~ct to said application on t4ay 28. !992 at which time ali interested persons were given an opportunity to be heard~ and~ %~HER~EAS~ the Board men, ers have personally viewed and are familiar with the premises in question and the surrounding area~ and. WHE~ the Board has considered all the testimony and docm~aentation appL~catmon ~ and~ s~mitted concerning this ~ ~ - W~.AS~ the Board has determined that the project as proposed ~iil not affect the heatth~ safety and general welfare of the people of the town ~ NOW, ~HER,zFORZ RESOLVED that the Board of Trustees approves the application of Parkez Wickh~n to regrade the bank and seed as per plans of the Soil an~ Water Conservation '-: This permit will empire two years from the date it is signed~ Fees if a } z~cable and permit issued within six months must be paid~ ' ' of the date of this notification~ ~o inspections are re~ired and the Trustees are to be ~.~otmfled~ upon completion of said project. Permit will be issued upon pa~ent of the following ~= for work to be done below Mean High Water Mark: No fees Very truly yours~ John ~. Bredemeyer~ President~ Board of JMB: jt 4/28./-92 Recommendations n a motion by Stephen Angell, seconded by John McCormick, it was RESOLVED to recommend to-the Southold Town Trustees a_p__proval of the application of Parker Wickham 115-9-6.1 & 7 to comply with violation. The CAC recommends approval C~f the application as long as apPlican~ follows the soil plan which was submitted, Airway Drive, Mattituck Vote of C0uncil: Ayes: All t~otion carried. Page 2 JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall. 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 January 29, 1992 To: From: Re' Valerie Scopaz, Senior Planner Judith Terry, Town Clerk~~ Parker Wickham - Wetland Violation In response to your memorandum of January 27, 1992 alleging a violation on the Mattituck Airbase property for which a change of zone petition has been submitted, I am attaching a copy of the map which accompanied the petition, and ask you to delineate on the change of zone parcel exactly where the violation has occurred. Thank you. cc: Town Board Town Attorneys PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham. Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall. 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 MEMORANDUM: TO: FROM: RE: Date: Judith T. Terry, Town Clerk £ Valerie Scopaz, Town Planner Parker Wickham - Violation %92-0242 Chapter 97-20 SCTM~ 1000-115-9-6.1 & 123-1-1 January 27, 1992 This violation appears to be on Mattituck Airbase property for which a change of zone petition was made by Parker Wickham. How will this violation affect the Town Board's handling of the application and the environmental review in particular. Also, this probably should be brought to the attention of Cramer, Voorhis & Associates for their information. cc: Harvey Arnoff, Town Attorney TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 January 23, 1992 Parker J. Wickham Airway Drive P.O. Box 1312 Mattituck, NY 11952 RE: Parker Wickham - Violation 992-0242- Chapter 97-20 SCTM~1000-115-9-6.1 & 123-1-1 Dear Mr. Wickham: After further consultation with the Town Bay Constable and a site inspection by Trustee(s) it is the position of this office that, in addition to the requirement of your filing for a permit, you must immediately remediate the site against potential siltation of the adjacent wetland by placing a staked row of haybales at the top of the embankment. Since the ground is hard frozen you will have to auger in the bales and secure them with re-bar or snowfence stakes etc. A minimum of 2 stakes per bale is required and several haybales are to be staked as landward returns to prevent run-off from short circuiting around the barrier. No additional work is to be done in the disturbed area or within 75' of any wetlands onsite until the entire Board of Trustees has had an opportunity to contemplate your permit application and visit the site. Based on the information to date, you should expect the requirement of a substantial remediation, including possible total removal of all materials placed in this wetland. If this office can be of further assistance, please do not hesitate to contact this office. Very truly yours, M. Bredemeyer, III President, Board of Trustees cc: Town Attorney, Town Planning, Bay Constable TRUSTEES John M. Bredemeyer, 1II, President Henry P. Smith, Vice President Albert J. Krupski, Ir. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARR/S Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11:971 January 23, 1992 Parker J. Wickham Airway Drive P.O. Box 1312 Mattituck, NY 11952 RE: Parker Wickham - Violation ~92-0242- Chapter 97-20 SCTM]1000-115-9-6.1 & 123-1-1 Dear Mr. Wickham: After further consultation with the Town Bay Constable and a site inspection by Trustee(s) it is the position of this office that, in addition to the requirement of your filing for a permit, you must immediately remediate the site against potential siltation of the adjacent wetland by placing a staked row of haybales at the top of the embankment. Since the ground is hard frozen you will have to auger in the bales and secure them with re-bar or snowfence stakes etc. A minimum of 2 stakes per bale is required and several haybales are to be staked as landward returns to prevent run-off from short circuiting around the barrier. No additional work is to be done in the disturbed area or within 75' of any wetlands onsite until, the entire Board of Trustees has had an opportunity to contemplate your permit application and visit the site. Based on the information to date, you should expect the requirement of a substantial remediation, including possible total removal of all materials, placed in this wetland. If this office can be of further assistance, please do not hesitate to contact this office. Very truly yours, M. Bredemeyer, III President, Board of Trustees cc: Town Attorney, Town Planning, Bay Constable TRUSTEES John M. Bredemeyer, III, President Hemy P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednosld, Ir. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-I823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTr L. HARRIS Town Hall 53095 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: ~oastal Erosion Permit Application wrWetland Permit Application rustee Lands Permit Application randfather 7Completed Apps. Date: ~[~[f Variance Required, Neighbors notified Dat~e: £A~ 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) Application Fee: Application Number; SCTM 91000- Project Name (If any) .- - Date Prepared: J~ ~-- / -- ~ 7--- Applicant: ~/ ~ /~)/~/?/~f~ ~/~/ C/~ /-/~d ~ Phone Interest: (owner, consultant,lessee,etc.) Owner of Property: ~-/~ _/~~7J~_ Address .~ r ~ ~ ~..~. ~ ~.~/~ Phone (~/~) Subject Property Location: ~1~ ~ ~. (Provide LILCO Pole 9, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Yds. to be excavated: ~O~ ~ Yds. ~c_.bc fillc~: Manner in which material will be removed or-~=~~: Width of canal, creek or bay fronting prope~i/~_-- ~- . Depth at low ti~----- Aver. rise in risc: Distance to nearest chan~ Distance prcjcct - extends beyond similar projects in_area: ~ Area zoning: Land area in acres: Is project for private or business use: ~/~¢~ . ~ Intended use of property:~s~/~C~ ~_o~ ~c~_ ~(~ .o~T ~~D~ Describe known prior'operations conducted on premises: Has any prior, license or permit been issued.to~ect structures, dredge, or-deposit fill on said Premises: Has any license or permit ever been revoked or'suspended by a Governmental Agency: ~JO Project Description The project desqription must al~o include plans for reclamation of land disturb~~_c~3~uction of the principle and accessory structure~rground structures.(i.e., pipeline and septic syst~~e addi~l attachments if necessary). I.. ~ r~ing at. (Print-owner o~t property)- ---TMa-~in--~--~ress-phone~ ~o hereby authori~ ~ to apply for Coastal Ero~ermit(s) fro~ Southold Town Trustees Signat~ure · THIS IS NOT A PERMIT County of Suffolk ) State of New york ) ~j il {' <,~.~., ? ~ i"- i~;~] iC,,,~..~O~¥¥'b BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/S~E 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 APPLI CATION. SWORN TO BEFORE ME THIS P~.~ DAY OF 7LL[,...LA/~.~..,~. Suggested space for location Map THIS IS NOT A PERMIT 14-16-2 (2/87)-- 7c 617.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT OR~ Purpose: The full EAr is designed to t~eip applicants and agencies determine, in a,~!.~'_~J.~½l~.~7~.whether a project or action may be significant ll~e question of whether art action may be significant is not always easy to answer. Frequent- Iv, there are aspects of a project that are subjective or unmeasureable. 1[ is also understood that those who determine significance may have little or no formal knowledge of the environment or may be technically expert in environmental analysis. In addition, many who [lave knowledge in one [)articular area may not be aware of the broader concerns affecting the question of significance. 1 he full [;Al: is intended to provide a method whereby applicants and agencies can be assured that the determination process [las been orderly', com~)rehensive in nature yet flexible to allow introduction of information to fit a project or action. Full EAF Componenls: 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 prolect data, it assists a reviewer in tile analysis that takes place in Parts 2 and 3. Pad 2: Focuses on identifying the range of possible impacts that may occur frorn a project 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 Parl 3: If any~mpact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not tile impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify lhe Portions of EAF completed for this project: ~ Part 1 ~ Part 2 l~iPart 3 Upon review of the information recorded on this FAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: A. The project will not result in any large and important impact(s) and, therefore, is o~e which will have a ~ignificant impact on the environment, therefore a negative declatalion will be prt,~red. [] B. Although the project could have a'~i~gnificant 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. The proiect may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency /_ Print or TypefName of Responsible Officer in Lead Agency Title of Responsible Officer $igna u~e of Responsibl~Officer in L~.a~./~Agen.c¥ Signature of ?reparer (If different from responsible officer) Date 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 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 information requiring such additional work is unavailable, s° indicate and specify each instance. NAME OF ACTION LOCATION OF ACTION (Include Street Address, Municipality and County) NAME OF APPLICANT/SPONSOR ~.~q/~--~-~ ._2, /O,q~,~_/</-:~o_ ,~k. BUSINESS TELEPHONE ADDRESS I STATE ZIP CODE ,,u .:24. BUSINESS TELEPHONE ( ) CITY/PO NAME OF OWNER (If different) ADDRESS CITY/PO STATE ZIP CODE DESCRIPTION OF ACTION Please Complete Each Question-Indicate N.A. if nol applicable A. $it~ D~oription Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: FlOrban E31ndustrial ~Commercial E3Residential (suburban) E3Forest I-1Agriculture I-1Other 2. fotal acreage of project area: ~ acres. APPROXIMATE ACREAGE Meadow or Brushland (Non-agricultural) Forested Agricultural (Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) Water Surface Area Unvegetated (Rock. earth or fill) Roads. buildings and other paved surfaces Other (Indicate type) 3 What is predominant soil type(s) on project site? E3Rural (non-farm) PRESENTLY AFTER COMPLETION acres acres acres %~ acres acres ,,_~;~ acres acres ~ , ,~,3~' acres acreS~./2~ ~.~,~ acres acres ~.~/ ~i~x: acres acres acres acres '~¢~/ acres a Soil drainage: J~Well drained ~5'"~ % of site E]Moderately well drained % of site [.TJPoorly drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS t_and C assific,ation System? acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on prolect site? EJYes ]~No a What is depth to bedrock? (in feet) 5. Approximate percentage of proposed project site with slopes: [~0-10% % E310-15% ~15% or greater % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of Historic Places? ~Yes ~No 7. Is project substantially contiguous to a site listed on tile Register of National Natural Landmarks? F-lYes ~'No 8. What is the de~oth of the water table? ./,9~'~ (in feet) 9. Is site located over a primary, principal, or sole source aquifer? [Z]Yes 10 Do hunting, fishing or shell fishing opportunities presently exist in tile project area? ~Yes 11 Does prolect site contain any species of plant or animal life that is identified as threatened or endangered? [~]Yes ~No 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) L-lYes ]~No Describe 13. Is the project site presently used bv the community or neighborhood as an open space or recreation area? ~Yes ~?No If' yes, explain 14. Does the present site include scenic wows known to be important to the community? F~Yes ~]~No 15. Streams within or contiguous to project area: a. Name of Stream and name of River to which it is tributary 16 Lakes, ponds, wetland areas within or contiguous to project area: 17. 18. 19. a. Name Is the site served by existing public utilities? I~Yes E3No a) If Yes, does sufficient capacity exist to allow.connection? b) If Yes, will improvements be necessary to allow connection? b. Size (In acres) [Z]Yes [Z]No E3Yes ~No Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? [Z]Yes [Z]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 F_3Yes ~]No 20. Has the site ever been used for the disposal of solid or hazardous wastes? E3Yes '~o 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 acreage to be developed: acres initially; c. Project acreage to remain undeveloped acres. d. Length of prolect, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expans.ion proposed f. Number of off-street parking spaces existing ; proposed g. Maximum vehicular trips generated per hour h If residential: Number. and type of housing units: One Family -two Family acres. acres ultimately. (upon completion of project)? Multiple Family Condominium Initially Ultimately i. Dimensions (in feet) of largest proposed structure height; i- Linear feet of frontage along a public thoroughfare project will occupy is? width; length. ft. 2. How much natural material (i.e., rock, ~,~rth, etc.) will be removed from the site? 3. Will disturbed areas be reclaimed? l-lYes []No L-JN/A a. If yes, for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? L~Yes UNo c. Will upper subsoil be stockpiled for reclamation? UYes J-lNo 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? kgYes []No 6. If single phase project: Anticipated period of construction 7. If multi-phased: a. Total numher of phases anticipated (number). 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 g]No 9. Number of jobs generated:"during construction 10. Number of jobs eliminated by this project 11. Will project require relocation of any projects or facilities? months, (including demolition). tons/cubic yards month year, (including demolition). month year. UIYes E3No ; after project is complete ~Yes' I-1No If yes, explain 12. Is surface liquid waste disposal involved? DYes DNo 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 i-1No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain I-lYes I-1No 15. Is project or any portion of project located in a 100 year flood plain? gYes 16. Will the project generate solid waste? E3Yes I~No a. If yes, what is the amount per month tons b. If yes, will an exis-ting solid waste facility be used? I-lYes UINo c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain E3No U1Yes i-lNo 17. Will the project involve the disposal of solid waste? DYes r-lNo a. If yes, what is the anticipated rate of disposal? tons/month b. If yes, what is the anticipated site life? years. 18. Will project use herbicides or pesticides? ilL_)Yes E]No 19. Will project routinely produce odors (more than one hour per day)? E]Yes g3No 20. Will project produce operating noise exceeding the local ambient noise levels? U]Yes 21. Will project result in an increase in energy use? E3Yes ~No If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity gallons/minute. 23. Total anticipat.ed water usage per day gallons/day. 24. Does project involve Local, State or Federal funding? U]Yes UiNo If Yes, explain DNo 25. Approvals Required: City. Town, Villas, r:~ard L-lYes [-_]No Cily, Town. Village I:hmning Board [~Yes ~]No City, Town Zunln$~ Board ~Yes ~No City, County lie,:'.lh Department ~Yes ~No Other Local Agencies F]Yes ['~No Other Regional Agencms ~Yes E~No State Agencies ~Yes ~No Federal Agencies ~Yes ~No Type Submittal Date C. Zoning and Planning Information I Does proposed action involve a planning or zonmg decision? [~Yes ~No If Yes. indicate decision required: L]zoning amendment f~zoning variance [-Ispecial use permit ~stlbdivision ~site plan [~lnew, revision of master plan E3resource management plan [-_Jother 2 What is the zoning classification(s)of the site? 3 What is tl~e maximum potential development of the site if 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 recommended uses in adopted local land use plans? l-lYes f-INo 7 What are the predominanl land use(s) and zoning classifications within a V~ mile radius of proposed action./ 8 Is the proposed action compatible with adjoining/surrounding land uses within a ~,4 mile? OYes U]No 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? I-lYes (2]No 11 Will the proposed action create a demand for any community provided servmes (recreation, education, police, fire protection)? UYes FJNo a. If yes, rs existing capacity sufficient to handle projected demand? E3Yes E3No 12. Will the proposed action result in the generation of traffic significantly above present levels? F1Yes ~No a. If yes, is the existing road network adeqL, mte to handle the additional traffic? l-lYes r-lNo D. Informational Details Attach any a(Iditional information as may be needed to clarify your prolect. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid thenl. E. Verification I certify that the information provided above is true to the best of my knowledge. Applicant/Sponsor Name Date Signature Title if the action is in the Coastal Area, and you are a stale agency, complete the Coastal Assessment Form before proceeding with this assessment. 5 Part 2--PROJECT IMPACTS AND THEIR MAGNITUDE Responsihilily of I_ead Agency Gencral Information (Read C~refully) · In ('Omlfleting the form the reviewer should be guided by the question: Have my response~ and determinations been reasnnahle? [he reviewer is not expecW.(J to Jm an experl environmental analyst. · identif~ing tt~at an impact will be potenti,llv large (column 2) does not mean that it is also necessarily significant. Any large impa~ t must be evaluated in I)qR i 3 to determine significance. Identifying an impact in ' c~iurtln 2 simply asks that it,he looked at further · The Examples provided are to assist the reviewer hy showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Potential I.arge Impact response, thus requiring evaluation in Part 3. · The impacls of each project, on each site, in each locality, will vary. 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. InsttucJions (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 impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but tl~reshold 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 3L e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the project to a small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. This must be explained in Part 3. foot of length), or where the general slopes in the project area exceed 10%. ,, Construction on land wl~ere tile depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Conshuction 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 nqaterial (i.e.. rock or soil} per year · Construction or expansion of a sanitar~ landfill. · Construction in a designated floodway. · Other mapacts I 2 3 Small to Potential Can impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [~]Yes i--/No [] [] []Yes []No [] [] F-lYes []No [] [] ~Yes F-]No [] [] E~]Ves []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes I-1No [] [] []Yes []No IMPACT ON LAND I. Will the proposed action result in a physical change to the project site? ~]NO I-lYES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 2 Will there be an effect to any tmique or unusual land forms found on the .site? (ie.. cliffs, dunes, geological formations, etc.)~NO I~YES · Specific land forms: IMPACT ON WATER 3 Will proposed action affect any water body designated as protected? (Under Articles IF,, 24 25 of the Environmental Conservation Law. ECL) E3NO []YES Examples thal would apply to column 2 · Developable area o[ 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 tidal wetland. · Other m~pacts: 4 Wil proposed action affect any non-protected existing or new body of water? E}NO E3YES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction o[ a body of water II,at exceeds 10 acres of surface area. Other impacts: 5 Will Proposed Action affect surface or groundwater quality or quantity? E3NO E]YES Examples that would apply to column 2 · Proposecl 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 petroleum or chemical products greater than 1,100 gallons. · Proposed Action will allow residential uses in areas without water andlor sewer services. · Proposed Action locates commercial ahdlor industrial uses which may require new or expansion of existing waste treatment and/or storage facilities. · Other impacts: 6 Will proposed action alter drainage flow or patterns, or surface water runoff? E3NO 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 [] [_~ []Yes []No [] ,F-J []Yes []No [] [] []Yes l-~No [] [] ~]Yes []No [] [] []Yes []No [] [] []Yes []No ~ [] ~-_] []Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No · Proposed Ac[ion 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 [~YES Examples that would apply to coh,mn 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 lbs. per hour or a heat source producing more than 10 million B~[U'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 endangered species? [_']NO I~YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list, using the site. over or near site or found on the site. ·Rernoval 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-threatened or non-endangered species? ~NO ~]YES Examples that would apply to column 2 · Proposed Action would substantially interfere with any resident or rn grator¥ fish, shellfish or wildlife species. · Proposed Actio~ 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 resources? ~NO E]YES Examples that wo'uld apply to column 2 · '[he nroposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, etc.) I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [--[Yes []No [] [] []Yes UNo [] [] ~]Yes [~No [] [] [~Yes []No [] [] [~Yes []No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Y~s ~No ~ ~. ~Yes' ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District, more than 2.5 acres of agricultural land. · The proposed action would disrupt o~' 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? DNO [:]YES (If necessary, use the Visual EAF Addendum in Section 617.21, Apr)endix B.) Examples 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 of historic, pre- historic or paleontological importance? I:]NO E]YES 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 tile 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 E3NO [:]YES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community· · Other impacts: 9 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] ~[]Yes []No [] [] [~Yes i-]No [] [] []Yes []No [] [] []Yes E-]No [] [] []Yes []No [] [] [~Yes []No [] [] E~]Yes · ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No' ~ ~ ~Yes ~N0 ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? [-ZNO E3YES 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 impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? UNO E~]YE S 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 t~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 vibration as a result of the Proposed Action? ~NO U-lYES Examples that would apply to columu 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 HEALTH 17. Will Proposed Action affect public health and safety? [Z]NO [Z]YES 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 tile burial of "hazardoOs wastes" in any form (i.e. toxic, poisonous, highly rea. ctive, radioactive, irritating, infectious, et(:.) · Storage facilities for one million or more gallons of liquified 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 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [~Yes []No [] [] I-lYes []No [] [] [--I Yes [~No [] [] [:]Yes ~No [] [] [~Yes /--INo [] [] []Yes ~--~No ~ ~ UYes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes. ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~NO ~ ~ ~Yes ~No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing community? []NO []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 will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an. important precedent for future projects. · Proposed Action will create or eliminate employment. · Other impacts: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [~Yes []No [] [] []Yes 'i--[No [] [] I-lYes []No [] [] f-lYes []No [] [] l--lYes []No [] [] []Yes []No [] [] I-lYes []No. [] [] l-lYes I-]No [] [] []Yes []No 19 Is there, or is there likely to be. public controversy related to potential adverse environmental impacts? [~NO ~]YES 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 impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2~ Describe (if applicablel 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 irreversibility, including permanently lost resources of value · Whether the impact can or ~vill 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 ~® P