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HomeMy WebLinkAboutYOUNG, JAMES JFRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 November 29, 1988 James J. Young 150 Hampton Road Garden City, N.Y. 11530 Re: Waiver fee for property located at Minnehaha Blvd., Southold, N.Yo Dear Mr. Young: Pursuant to your request for a waiver for construction of a garage at above mentioned location~ the Board of Trustees have inspected property. Payment of $25.00 waiver fee is due and payable to this office so that we may process same. FAK:jas Very truly yours, Frank A Kujawski, Jr. President Board of Trustees Southold Town Trustees Town Hall 53095 Main Road Southold~ NY 11971 To Whom it may concern: I do hereby authorize Gerry Horton to act in my behalf in securing a waiver from the Board of Town Trustees for my project located at my home on Minnehaha Blvd. in Southo!d, and in no way hold him responsible for the outcome of such action. James Young October 3, 1988 Board of Town Trustees Town Hall Southold, NY 11971 Dear Sirs: I hereby request a waiver of permit for construction of a garage at my home on Minnehaha Blvd. Southold. The , garage will be further back from the water than the house and behind an existing bulkhead. Thank you in advance for your cooperation. Gerry L. Horton 'for James Young ,3 - BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southotd, New York 11971 TELEPHO1VE (516) 765-1892 APPLICATION IS H~R£BY MADE TO THE TOWN TRUSTEES OF THE TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF THE TOWN OF SOUTHOLD, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODES OF THE TOWN OF SOUTHOLD. APPLICATION NO. DATE OF APPLICATION PHONE NO . LOCATION OF PROPERTY FOR WHICH PER~IT WANTED HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION WIDTH HEIGHT ABOVE HIGH WATER DEPTH BELOW LOW WATER YARDS TO BE EXCAVATED YARDS TO BE FILLED WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY DEPTH AT LOW. TIDE 'C9 AVERAGE RISE IN TIDE 0 DISTANCE TO THE NEAREST CHANNEL FT. DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE AREA IS THIS FOR PRIVATE OR BUSINESS AREA ZONING MANNER ! N WH 1 CH MATERI AL W ! LL BE REMOVED OR DEPOS I TED INTENDED USE OF PROPERTY DESCRIBE ANy KNOWN PRIOR ON THE PREMISE FT. AND WHETHER ANY PRIOR LICENSE OR PERMITS HAVE BEEN ISSUED TO ERRECT STRUCTURES OR TO DREDGE OR DEPOSIT FILL ON SAID PREMISES AND WHETHER ANY PERMITS OR f~I/~NSES WERE EVER SUSPENDED OR REVOKED BY A GOVERNMENTAL 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 APPL I CANT. ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD PROHIBIT THIS PROJECT? 14-;~6~4 f21873--Text 12 .. ' [~R~JECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) APPLICANT /SPONSOR ~ 2. PROJECT 3. PROJE~CT LOCATI(~t~, . SEQR FORM 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or prowde map} 5. IS PROfeSSED ACTION: [~New [] Exeansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: lnitial~ , , ~ O~ acres Ultimately · 0 [ acres 8. W~L~ROP©SED ACTION COMPLY WITH EXISTING ZONhNG OR OTHER EXISTING LAND USE RESTRICTIONS? 1.5.J Yes [] No f No, describe briefly 9. W~IS PRESENT LAND USE iN VICINITY OF PROJECT? ~ Residential [] !nduatrial [] Commercial [] Agriculture [] Park/Forest/Open soace [] Other Describe: 10. DOES ACT[ON INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATEr~ LOCAL)? - I"1 Yes [] No If yes, list agency(s) and permit/approvals 11. DOES ANY ASPr~T OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes L:_J No If yes, list agency name and permit/approval 12. AS A RESULT qFr~ROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MOD F CATION') [] Yes E~,No ' CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE -- / Date: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II--ENVIRONMENTAL AS~-~SMENT (To be completed by Agency) A. DOES[] YesACTION EXCEED[] No ANY TYPE ~ ~RESHOLD IN 6 NYCRR, PART 617.127 If yes, cobrainate the review process Emd use the F~-~ B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 if No, a negative declaration may be superseded by another involved agency. [] Yes [] No C. 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 commun ty or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in Cl-C57 Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) 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 aqlverse environm~.~qtal impacts AND provide on attachments as necessary, the reasons supporting this determination: ~l~rlalul'e Ul J~esponslbie OJficer in Lead A[ency Lead A ~L'I'*C y Ddte J JtJe ot t~.t.'~pollstbje L)l[icer 14:'~6;.2 (2/87)-- 7c 617.21 SEQR Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of~ a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may be technically e.xpert in environmental analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured.that the determination process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides obiective data and information about a given proiect and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 an~[ 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides 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: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. '. DETERMINATION OF SIGNIFICANCE--TyPe I and Unlisted Actions Identify the Portions of EAF completed for this project: [] Part I [] Part 2 [-]Part 3 Upon review of the informatio~ recorded on this EAF (Parts I and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: [] A. The project will not result in any large and important impact(s) and, therefore, is one which Will not have a significant impact on the environment, therefore a negative declaration will be prepared. [] B. Although the project could have a significant effect on the environment, there will ~ot be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration Will be prepared.* C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Yype Name of Re~.ponsible Officer in Lead Agency Signature of ~'~:espons~ble Officer in Lead Agency Title of ['responsible O~'ficer Signature of Preparer (If different from responsible officer) Date 1 PART 1--PROJECT INFORMATION . Prepared by Project Sponsor NOTICE: This document is desi§ned to assist in determinin8 whether the action proposed may have a si§nificant effe on the environment. Please complete the entire form,. Parts A through E. Answers to these questions will be consider( as part of the application for approval and may be subject to further verification and public review. Provide any addition 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 invol~ new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and speci: each instance. NAME OF ACTION LOCATION OF ACTION (Include Street Address, Municipality and County) NAME OF APPLICANT/SPONSOR ADDRESS CITY/PO BUSINESS_TELEPHONE (. ) NAME OF OWNER (If different) I STATE I ZiP CODE BUSINESS TELEPHONE ( ) ADDRESS CITY/PO STATE ZIP CODE DESCRIPTION OF ACTION 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-iUrban i-Ilndustria] F-ICommercial- I-1Forest E3Agricuiture I-lOther 2. Total acreage of proiect area: acres. APPROXIMATE ACREAGE Meadow or Brushfand (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? a. Soil drainage: i-?Well drained 9/0 of site ~Poorly drained % of site F-lResidential (suburban) l-lRural (non-farm PRESENTLY AFTER COMPLETION acres acres acres acres acres acres acres acres acres acres acres acres acres acres acres acres I--[Moderately well drained % of site b. If any agricultural land is invo ved, how many acres of soil are classified within soil group I through 4 of the NYS Land Classification System? acres. (See 1 NYC~RR 370). 4. Are there bedrock outcroppings on project site? l--lYes ~No '~' a. What is depth to bedrock? [in feet) '~pproximate percentage of proposed project site with slopes: r-],0-10% °' FI10-15% % [-]15% or greater % Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of Historic Places? F-lYes I-tNo 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? I-lYes I-INo 8. What is the depth of the water table? (in feet) 9. Is site located over a primary, principal, or sole source aquifer? [-]Yes I-1No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? I~Yes []No -- 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? i-lYes I--INo 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 by the community or neighborhood as an open space or recreation area? F-lYes []-]No If yes, explain ' 14. Does the present site include scenic views known to be important to the community? [--Wes f-iNo ' 15. Streams within or contiguous to proiect 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: a. Name b. Size (In acres) 17. Is the site served by ~xisting public utilities? I-lYes L-']No a) If Yes, does sufficient capacity exist to allow connection? I-lYes F-iNo b) If Yes, will improvements be necessary to allow connection? [-IYes [-INo 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Aftic[e 25-AA Section 303 and 304? r~Yes I~.,No , 19 Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617.~ [-IYes 20. Has the site ever been used for the disposal of solid or hazardou~ wastes? l-lYes E-]No B. Project Description 1. Physicai dimensmns and scale of project (fiji in dimensions as appropriate) a. Total conti~,uous acreage owned or controlled by project sponsor b Project acreage to be developed: acres initially; c. Project acreage to remain undeve!oped acres. d. Length of project, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed f. Number of off-street parking spaces existing ; proposed g. Maximum vehicular trips ~enerated per hour Iupon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Initially Ultimately i. Dimensions (in feet) of largest proposed structure height; width; j. Linear feet of frontage along a public thoroughfare project will occupy i~? acres. acres ultimately. length. ft. Condominium 2. How much natural materk, d.e., rock, earth, etc.) will be removed from the site? tonslcu'bfc ~Vards 3. Will disturbed areas be reclaimed? l-lYes [-INo [-IN/A a. If yes, for what intend:_Z purpose is the site being r:eclaimed~ b. Will topsoil be stockpiled for reclamation? I-lYes E-1No c. Will upper subsoil be stockpiled for reclamation? K-]Yes []No How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? acres. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? i']Yes I'-lNo If single phase project: Anticipated period of construction If multi-phased: a. Total number of phases anticipated (number). b. Anticipated date of commencement phase I month c. Approximate completion date of final phase d. Is phase 1 functionally dependent on subsequent phases? Will blasting occur during construction? i-lYes I-tNo months, (including demolition). month l-lYes I-1 No-' year, (including demolition). yeah 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? ; after project is complete I-IYes F"]No If yes, explain 12. Is surface liquid waste disposal involved? I-lYes [-1No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? [-]Yes []No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain I-qYes l-lNo 15. 16. Is project or any portion of project located in a 100 year flood plain? Will the project generate solid waste? I--IYes [-INo a. If yes, what is the amoup, l~ per month tons b. If yes, will an existing solid waste facility be used? [Yes I-]No c. If yes, give name ; location d. i-lYes []No Will any wastes not go into a sewage disposal system or into a sanitary landfill? If Yes, explain []--[Yes 17. 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? 18. Will 19. Will 20. Will 21. Will project result in an increase in energy use? If yes , indicate type/s) I-lYes F]No tons/month. years. project use herbicides or pesticides? [Yes [-]No project routinely produce odors (more than one hour per day)? f--lYes project produce operating noise exceeding the local ambient noise levels? [Yes []No 22. 23. 24. Does project involve local, State or Federal funding? If Yes, explain F-lYes F'INo If water supply is from wells, indicate pumping capacity Total anticipated water usage per day gallons/day. ~Yes '~ ~allons/minute. l-lNo F-INo · 2:~:'~.Approvals Required: City, Town, Village Board I-IYes I-1No City, Town, Village Planning Board I-lYes I'-INo City, Town Zoning [3oard [-']Yes E3No City, County Health Department I--lYes [-'lNo Other Local Agencies l-lYes E]No Other Regional Agencies l-lYes I-[No State Agencies I-IYes i-]No Federal Agencies I-lYes i-INo Submittal Type Date C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? I-lYes I-INo If Yes, indicate decision required: I-Izoning amendment I-]zoning variance l-lspecial use permit I-lsubdivision ["lsite plan I-']new/revision of master plan I-Iresource management plan i-]other 2. What is the zoning classification(s)of the site? 3. What is the maximum potential development of the site if dev,eloped 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? I-lYes E3No 7. What are the predominant land use(s) and zoning classifications within a 1/~ mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a '/~ mile? I-lYes [-INo 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water di'stricts? I-IYes [--]No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? i-lYes I-]No a. If yes, is existing capacity sufficient to handle projected demand? [-]Yes I-]No 12. Will the proposed action result in the generation of traffic significantly above present levels? I-lYes E']No a. If yes, is the existing road network adequate to handle the additional traffic? i-]Yes [-]No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or m~y be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the information provided above is true to the best of r~;,:~knowledge. Applicant/Sponsor Name Date Signature Title If the a£tion is in lhe Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. Pa¢"~--PROJECT IMPACTS AND Tr ,::R g/IAGNITUD'E 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 beer reasonable? The reviewer is not expected to be an ~xpert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simpl~ asks that it be looked at further. · The Examples provided are to assist the reviewer by showing type; of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable'tl~roughout the ~tate and for most situations. But, for any specific project or site other'examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative 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. 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 potentiaJ size of the impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshold is lower than example, check column 1. d. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3. e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the project to a small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. This must be explained in Part 3. IMPACT ON LAND . Will the proposed action result in a physical change to the project site? f~NO E3YES Examples that would apply to column 2 Any construction on slopes of 15% or greater, (i5 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. Construction on land where the depth to the water table is less than 3 feet. ' Construction of paved parking area for 1,000 or more vehicles. ' Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than I year or involve more than one phase or stage. · Excavation for mining purpose, s that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2 Will there be an effect t: .... ,y umque or unusual land forms found on the site? (i.e., cliffs, dunes, geologica formations, etc.)~NO ~YES · Specific land forms: 6 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [~Yes [--]No [] [] []Yes i'[No L--J [] [-~ Yes i-]No [] [] [~]Yes ~-']No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? (Under Articles 15, 24, 2.5 of the Environmental Conservation Law, ECL) []NO [YES Examples that would apply to column 2 · Developable area of site contains a protected water body. · Dredging more than 100 cubic yards of material from channel of a protected stream. · Extension of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water.~ i-]NO l]--lYES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. · Other impacts: 5. Will Proposed Action affect surface or groundwater quality or quantity? I-[NO []-]YES Examples that would apply to column 2 · Proposed Action will_require a discharge permit. · Proposed Action requires use of a source of water that does not have approval to serve proposed (project) action. · Proposed Action reouires 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 presefltly do not exist or have inadequate capacity. · Proposed Action would use water in excess, of 20.000 gallons per day. · Proposed Action will likely c~u~;e si[ration or other discharge into an existing body of water to tr;e extent that there wilt be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroieum or chemical products greater than 1,100 gallons. · Proposed Action will allow residential uses in areas without water and/or sewer services. · Proposed Action locates commercial 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 flow or patterns, or surface water, runoffS. ~NO ~-'~ES~ ' Examples that would apply to column 2 · Proposed Action would change flood water flows. ' 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] I--lYes [-'[No [] [] [--]Yes I--INo [] [] [-IYes i-]No [] i--[_ I-lYes l-]No [] [] I--lYes I--]No [] [] [-'~Yes: [-1No [] [] ['-]Yes []No [] [] [-']Yes []No [] [] []Yes []No [] [] []Yes []No [] [] [--]Yes []No [] [] []Yes []No [] [] []Yes [-[No [] [] []Yes .[]No [] [] []Yes []No [] [] I-lYes []No, [] [] /-1Yes. []No [] [] [--]Yes [--]No [] [] l-lYes []No [] [] ~Yes []No '[] [] [--],Yes [--]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: 1 2 3',i - Small to Potentia Can Impact Be Moderate Large Mitigated By Impact Impact Project Change IMPACT ON AIR 7. Will proposed action affect air quality? i-]NO [~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 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 []YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal [] list, using the site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. [] · Application of pesticide or herbicide more than twice a year, other [] than for agricultural purposes. · Other impacts:... [] 9 Will Proposed Action substantially affect non-threatened or non-endangered species? [-qNO l-lYES Examples that would apply to column 2 · Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. · Proposed Action requires the removal of more than 10 acres of mature forest (over 100 years of age) or other locally important vm4etation. IMPACT ON AGRICULTURAL LAND RESOURCES 10 Will the Proposed Action affect agricultural land resources? I--/NO E]YES Examples that would apply to column 2 · The proposed actton would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, cYtc.) :? 8 []Yes []No []Yes []No []Yes []No []Yes ' [--]No []Yes []No []Yes IZ-]No []Yes []No []Yes []No fi]Yes l-]No []Yes [--]No []Yes i-]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 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? [-INO l-lYES (if necessary, use the Visual EAF Addendum in Section 617.21, Appendix Examples that would apply to column 2 · Proposed land uses, or project components obviously different from or n sharp contrast to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pr~- historic or paleontological importance? [-]NO I-IYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that would apply to column 2 t~NO C]YES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the comniunity. · Other impacts: 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] I~]Yes I-'] No [] [] E:]Yes [-]No [] [] i-'lYes r-]No [] ['-I. I~Yes r-lNo [] [] E]Yes [~]No [] [] [~Yes ['--] No [] [] ' i-lYes I--[No [] [] E3Yes r-INo [] [] i--]Yes [-']No [] [] ~Yes. []No [] [] [~Yes [--]No [] [] E~Yes [--]No [] [] E3Yes i-lNo [] [] l-lYes E~No [] [] ['-]Yes [~No IMPACT ON TRANSPORTATION 14. ¥¥ill there be an effect to existing transportation systems~ FqNO E~YES 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? ~ I-1NO [Z]YES 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? l-[NO I-/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 exceeding the local ambient noise levels for ~oise 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? E]NO E3YES 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 w~thin 2,000 feet of a site used for the disposal of solid or hazardous waste. Other impacts: 1 Small to Moderate Impact 2 Potential Large Impact Can Impact B~ Mitigated By Project Chang l--IYes EJNc [~]Yes l~No [-]yeS'- [~No [--]Yes E]No /-'lYes ~]No I'-IYes [-']No i-lYes ["-~ No I-lYes ['-]No [--]Yes I-]No .~. [~Yes [--]No I--lYes [-']No ~Yes- . [~No [~Yes [~]No [-"lYes i-]No [-]Yes i']N0 [--]Yes I-]No 10 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes Z-]No [] [] ' []Yes' ' r--INo [] '[--~, r~Ves I-'1 No [] [] [~Yes []No [] [] []Yes . E]No [] -.[]' []Yes l--INo [] [] []Yes 1:3No [] [] E3Yes E3No [] [] []Yes rqNo IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the ex]sting community? []NO F~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%. o The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. Development will create a demand for additional community services (e.g. schools, police and fire, etc.) Proposed Action will set an important precedent for future projects. Proposed Action will create or eliminate employment. Other impacts:.. 19. Is there, or is there likely to be, puglic controversy related to potential adverse environmental impacts? I--[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--F--VALUAT!ON OF THE I~3PORTANCF_ OF iI¥]PA.3TS 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 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 irreversibility, 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) 's~' 11 · 14-14.! 1 {2:871--9c SEQR £ 617.21 Appendix R State Environmental Quality Review Visua] EAF Addendum This form may be' used to provide additional information relating to Question 11 of Part 2 of the Full EAF. . (To be completed by Lead Agency) Visibility 1. Would the project be visible from: · A parcel of land which is dedicated to and available to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public observation, enjoyment and appreciation of natural or man-made scenic qualities? · A site or structure listed on the National or State Registers of Historic Places? · State Parks? · The State Forest Preserve? · National Wildlife Refuges and state game refuges? · National Natural Landmarks and other outstanding natural features? Distance Between ' -, Project and Resource (in Miles) 0-].4 ~,4-V~ I/2.3 ',, 3'5 5+ · National Park Ser~zice 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. [s the visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other seasons) ' []Yes []No 3. Are any of the resources checked in question 1 used by the public during the time of year during which the project will be visible? ~Yes L-~' No DESCRIPTION OF EXISTING VISUAL ENVIRONMENT ,, 4. From each item checked in queStion ! check those which generally describe the surrounding environment. ' Within '1/4 mile * 1 mile Essentially undeveloped Forested [] [] Agricultural " [] [] Suburban residential [] [] Industrial [] [] Commercial [] ~- [] Urban [] [] River, Lake, Pond [] [] Cliffs, Overlooks [] [] Designated Open Space Hilly [] [] Mountainous [] [] Other [] [] NOTE: add attachments as needed " [] [] 5. Are there visually similar projects within: '!/2 mile []Yes []No *1 miles I--lYes []No .. *2 miles 'I--lYes []No *3 miles [--}Yes * Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number of viewers likely to observe the proposed project is __ NOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Holidays/ Activity Daily Weekly Weekends SeasonalI~ 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: Gerry L. Horton BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, 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 $OUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. in completing this application I hereby authorize the Trustees, agent or representative to enter~onto my property to inspect the premises in conjunction with re of th's p lica 'on. SIGNATUR~F APPLICANT SWORN TO BEFORE ME: THIS DAY OF 0~_L~.~ NOTARY PUBLIC HELEN l'L DE VOE NOTARY ~gLIC. Sta~e ~f New York Ne. 4707~78, Su~olk ~u~ T~ ~r~ ~rch ~, 1~/ EXAMINED APPROVED "WETLANDS" PERMIT (CHAPTER 97) APPROVED "BOAT,DOCKS, WHARVES" PERMIT (CHAPTER 32) DISAPPROVED "WETLANDS PERMIT" (CHAPTER 97) DISAPPROVED "BOATS,DOCKS, WHARVES" PERMIT (CHAPTER.32) ~ CONDITIONS, IF ANY EXAMINING BODY SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85