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HomeMy WebLinkAboutTR-3760Board Of Southold TOwn Trustees SOUTHOLD, NEW YORK PERMIT NO ...... :~.2,6.,9 ................. DATE: ,....M.~¥....g 6.,....!988 ISSUED TO ......... ~.(~.S.,~.P.~.. ~EVITS .................... Authorization Pursuant to +h.e provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "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 at a meeting held on ~.a..¥....~.5.~..._~.988 19 ............ , and in consideration of the sum of $ ............................ paid by of .......................................................................................... N. Y. and subject to the Terms and Conditions llsfed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: To co9nstruct 4' x 8' walkway, 4' x 10' ramp, 4' x 15'float, install pilings as plan submitted. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs Corporate Seal to be affixed, and these presents to be subscribed by a majority of th.e..~aid Board as of this dat,~ TERMS and CONDITIONS The Permittee JOSEPH ZEVITS residing at Little Peconic Bay Lane~ Southold~ N.Y. N.Y., as part of the consideration for the issuance of ,the Permit does understand and pt~ribe to the fol- lowing: The Southold Town Trustees Permit must be prominently dislolayed on.p..rem, ise. s_effected, d,,uri~ng pe, riood_,o,f.work.' 1. That the said lrioard ot Trustees ann me xown or ~oumoia are reteasea from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 24 2. That this Permit is valid for a period of mos. which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permi~tee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that auth- orization was originally obtained. 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 cause 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 be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstructton to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee ot the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents ,that may be required sup- plemental ro this permit which may be subject to revoke upon failure to obtain same. 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold~ New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 February 2, 1990 Walter Lindley Suffolk County Department of Health Services Wastewater Management Division County Center Riverhead, NY 11901 RE: Joseph Zevits, Wetlands permit for one family dwelling. Dear Mr. Lindley: The Southold Town Board of Trustees does not have any jurisdiction over a well and cesspool or any project located more than 75' from wetland fringe. Therefore, the Board would encourage the Suffolk County Department of Health Services to complete its review process. If this is too complicated, then please send us a copy of the placement of well and septic system showing your approval of the site and it's location to the~ wetlands. This Board will then review the application with respect to the house placement and protection of the wetland fringe on the property. Should you have any questions, please do not hesitate to contact this office. Very. truly yours, Albert Jo Krupski, Jr. Vice-President, Board of Trustees AJK:jmt cc: Roy Reynolds Joseph Zevits FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. ttENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 ~ay 26, 1988 TELEPH ONE (516) 765-1892 Mr. Joseph Zevits 2470 Rossett St. Fort Lee, New Jersey 07024 Re: Application No. 610 - 1000-090-1-13 Dear Mr. Zevits: The following action was taken by the Board of Town Trustees during their regular meeting held on May 25, 1988 as follows: WHEREAS, Joyce and Joseph Zevits applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated January 29, 1988, and WHEREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a public hearing was held by the Town Trustees with respect to said application on May 25, 1988 at which time all interested persons were given an opportunity to be heard, and WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general Welfare of the people of the town, NOW, THEREFORE, BE IT RESOLVED that Joyce and Joseph Zevits BE AND HEREBY IS GRANTED PERMISSION UNDER THE PROVISIONS OF THE WETLAND O~CE OF THE TOW~!~QUTHOLD TO: As amended: to construct~.~4./_.xl8_~tationary walkway,(4' x 1]6']kramp with a 4' x 15' float secured byFtw~'~. This permit is~ with the provision that the catwalk i~ende~d landward of the wetland line and a 25 ft. vegetated buffer zone is to be maintained landward of the mhw. Property is located on Lot No. 31, Little Peconic Bay Lane, Southold. This permit will expire two years from the date it is signed if work has Joyce and Joseph Zevits - Page 2. not commenced by said date. There are two inspections required and the Trustees are to be notified upon the completion of the work. Prior to the issuance of said permit by the Clerk, the applicant shall file with the Clerk a certificate that he has public liability insurance policies insuring against any liability which may arise in the performance of the operations pursuant to such permit in such amount as shall be fixed by the Trustees, which said policies shall name the Town as a name insured. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. Please return to the Building Dept. for a determination on the need of any other permits that may be required for this project. T~e following fees are now due and payable: 10' x 4' walkway~ZX~ 40 sq. ft. @ $1.00 per sq. ft. = 4: x 15~ float 60 sq. ft. @ " " " ,, = ~[~pilings @ $25.00 ea. Wetland Inspection fees / Total due: Very truly yours, $40.00 60.00 10 .'00 / President Board of Town Trustees FAK: ip cc: Commissioner Thomas C. Jorling, D.E.C., Albany ~'~~ Robert A. Greene, D.E.C., Stony Brook ~-~-h Stephen Mars, Army Corps of Engineers '~~ Thomas Hart, Coastal Management J°hn H°lzapfel' Ghairman' S°uth°ld T°wn C'A'C~,. ~/?~fC~ Victor Lessard, Admin., Building Dept. · Board of Appeals file March 24, 1988 - Pa9, On a:motion made by John Holzapfel, seconded by John Tuthill it was RESOLVED to recommend to the Southold Town Trustees that Wetland Application No. 610 of Joseph and Joyce Zevits be tabled pending clarification of the ~ocation of the wells and cesspool system~. Little Peconic Bay Lane, Southoid. Vote of Council: Ayes: All Motion carried. On a motion by John Holzapfel, seconded by JOhn Tuthill, it was RESOLVED to recommend to the Southold Town Trustees approval of the Wetland Application No. 611 of Edward Deutsch to construct a fixed elevated walkway, hinged ramp, two floats with pilings. The CAC approves with the stipulation that there will be no off road parkin§~ which would result in harm to the marsh. Cedar Beach Road, Southold Vote of Council: Ayes:- All Motion carried. On a motion by Heather Tetrault, seconded by Margaret Feeney, it was RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 612 of Arnold Blair to add to an existing dock a ramp and float. Vanston & Sunset Road, Cutchogue Vote of Council: Ayes: All' Motion carried. DISTRIBUTION OF NEW APPLICATIONS NO. 614 - Oyster Farm Associates by Neted of America, Ltd. by Henry E. Rayno~ to dredge, enlarge bulkhead existing marina basin. East side of Shipyard Lane, East Marion Group Inspection No. 615 - Bernard and Carole Kiernan by Garrett A. Strang to'construct catwa~ dock and floating dock. _ North Parish Drive, Southold Daniel Kujawski inspection No. 616 - John C. Vassil for Costello Marine Contracting Corp'. to replace existing bulkhead, in kind, in place. Salt Lake Lane and James Creek, Mattituck. Margaret Feeney inspection No. 617 - Janet Swanson by En-Consultants, Inc. tocconstruct 100' of' timber retaining wall with two 15' angled returns. Wall to be approximat£ 4' north of toe of bluff and landward of MHW. Wall will be armored with approximately 40 c~y. of I000 to 1000 lb. stone. Ryder Farm Lane, Orient Group inspection No. 618 - Wilhelm Frankeh~oy j. H. Geideman to dredge approximately 300± c.y. Maintenance dredge, fill to upland site by contractor. 965 Osprey Nest Road, Greenport. John Tuthill inspection q~'a--~~O.4. RD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road :b~ff~ P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 APPLICATION IS HEREBY 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 //-~_~__/~ I DENT I TY OF APPL I CANT__00SED_~__g[_~i_T__S_ada~ j0~_~__Z~¢LT.$__~_2_0_I_)_~[&4_-908C~PH°NE NO___ ADDRESS OF APPL I CANT__2470_[~lSSp_.t.t._.SZ~Ip_p~ _._Fn.nt. I ee.,_~_nz.o_~ ..... TAX MAP No..~j~0_]_k_C0.~ Tax Map AGENT PHONE NO. LOCAT ION OF PROPERTY FOR WHI CH PERMIt WANTED__L.0_~_~131,_Li_ttle._P_P_C_0ni_C __Ba~t I_arm+_S2tL~o_Ld, h[Y_ nn_k4~s_L./ak_e HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION CREEK, BAY OR HARBOR FRONTING PROPERTY_~_.t. SIZE OF PROPOSED WORK_appY'nx_imate]~_13_0._Xatla_~e. ft. LENGTH app_r.o x ima_t, eAy_.._4_5_ 'F .t. HEIGHT ABOVE HIGH WATER D£PTH BELOW LOW WATER 0 YARDS TO BE EXCAVATED_ a~proximate~ 175 cu. sds. YARDS TO BE FILLED none WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY DEPTH AT LOW. TIDE 0 103 ft. AVERAGE RISE IN TiDE___a_p_~_roximatel y_ 2½ ft. DISTANCE TO THE NEAREST CHANNELB__~_~_r_0x. 500 FT. DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE AREA IS THIS FOR PRIVATE OR BUSINESS usE?__aD,¥'.ivate AREA ZONING Residential FT. MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED Bulldozer INTENDED USE OF eROeERT¥____~rivate residence DESCRIBE ANY KNOWN PRIOR OPERATIONS CONDUCTED ON THE PREMISE L i m i t e d L_a_n_d_cl e_a_r_i_n~. 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 LICENSES WERE EVER SUSPENDED OR REVOKED BY A GOVERNMENTAL AGENCY DEC Permit ~JQ:~-_O~9_8_]~_ DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE PREMISES AFTER THE WORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF THE PROJECT SITE IF WRITTEN CONSENT OF THE OWNER OF 'THE PROPERTY, IF NOT THE SAME AS THE APPLICANT.__._~ ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD PROHIBIT THIS PROJECT? None 14q6-~,2. , (2/87)--7c 617.21 SEQ R 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 objective data and information about a given project and its site~ By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 anal' 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a project or ~ction. It provides guidance as to whether an impact is likely to be consid~'red 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 id(~ntified as potential[y-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 1 [] Part 2 FqPart 3 Upon review of the informatio~ recorded on this EAF (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 one which Will not have a significant impact on the environment, therefore a negative declaration will be prepared. F-I- 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. 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 va[id for Unlisted Actions Application f6r Permit to construct a residential boat dockage. Name of Action home & small catwalk & float for JOSEPH ZEVITS / JOYCE ZEVITS Name of Lead Agency ~ (Same as above) (Sa. me as above) Print or Type Na~e of Resp~onsible Officer in Lead Agency Title of Responsible Officer /IS' at~of Respo~ble ~f~er ;n~ Lead Agency S,gnature of Preparer(If different from responsible officer) 'Date ~' - -- _: 1 PART 1--PROJECT INFOt~MATION ' ~,, . Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effe¢ on the environment. Please complete the entire form, Parts A throu§h E. Answers to these questions will be considere 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 EAF will be dependent on information currently available and will not involv new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specif each instance. NAME OF ACTION Construction of a residential home and small catwalk and float for boa't dockage LOCATION OF ACTION (Include Street Address, Municipality and County) Little Peconic Bay Lane~ $outhol~;, NY NAME OF APPLICANT/SPONSOR BUSINESS TELEPHONE JuSEi~H Z~.VIiS / ,J0YbE ZLVIIS ( I ADDRESS ,~,70 ~ossett Street CITY/PO ~- ISTATE Fort, Lee, NJ INJ ZIP CODE NAME OF OWNER (If different) (Same as above) ADDRESS (Same as above) BUSINESS TELEPHONE (201) 944-9080 CITY/PO STATE I ZIP CODE DESCRIPTION OF ACTION Construct a rest-dent[al home and small catwalk and float for boat dockaqe Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting .o.f overall project, both developed and undeveloped areas. I Present land use: r-lurban [-]Industrial l-lCommercial []Forest Il,Agriculture FqOther 2 Total acreage of project area: less than I acres. APPROXIMATE ACREAGE Meadow or Brushland (Non-agricultural) non~ Forested none Agricultural (Includes orchards, cropland, pasture, etc.) none Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) none Water Surface Area none Unvegetated (Rock. earth or fill) Roads, buildings and other paved surfaces Other (Indicate type]. -0- [~Residential (suburban) I-IRural (non-farm PRESENTLY AFTER COMPLETION acres acres acres acres acres acres acres acres acres acres less than Z acres 'less than 1 acres none acres acres acres acres 3. What is predominant soil type(s) on project site? t0psoi'l and sand a. Soil drain.age: ~Well draine(~ 100 % of site ~Moderately well drained % of site ~Poorly drained % of site b. If anyagricultura] and is involved, how many acres of soil are classified within soilgrouD1 through 4 of the Land Classification System? N/A acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? I-],Yes El(No a. What is depth-to bedrock? N/A (in feet) 5. 'Approximate percentage of pro~,,sed project site with slopes: []0-10% % E310-15% % " E315% 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? I-lYes ~No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? f-lYes )~[No 8. What is the depth of the water table? 10 ft., (in feet) 9. Is site located over a primary, principal, or sole source aquifer? E3Yes ~No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? F3Yes DJ]No 11. Does project 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) F-lYes E~No Describe ,13. Is the project site presently used by the community or neighborhood as an open space or 'recreation area? I-lYes E~No If yes, explain " 14. Does the present site include scenic views known to be important to the community? []Yes D(1No 15. Streams within or contiguous to project area: N/A 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. a. Name WP_st I'ake Is the site served by-existing public utilities? E-]Yes []No a) If Yes, does sufficient capacity exist to allow connection? b) If Yes, will improvements be necessary to allow connection? b. Size (In acres) F-lYes E~No I-TYes [-INo Un kn0;,:n 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, A~ticle 25-AA, Section 303 and 304? E3Yes [2~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 6177 I-lYes I-XNo 20. Has the site ever been used for the disposal of solid or hazardous wastes? f-lYes [~No 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 ]esg b. Project acreage to be developed:less than ½acres initially; ]ess c. Project acreage to remain undeve!oped ] ess than ~acres. d Length of project, in miles: N/A (I.f appropriate) e. f the project is an expansion, indicate percent of expansion proposed than 1acres. than ½ acres ultimately. N/A %; N/A Condominium N/A N/A appr0x 30 ' length. ft. f, ',lumber of off-street parking-spaces existing N/A rio ne g. Maximum vehicular trips generated per hour h. If residential: Number and type of housing un~ts: One Family Two Family Multiple Family Initiallv ], , N/A N/A Ultimately i N/A N/A i. Dimensions: (in feet)of largest proposed structure c~P~OX'height; approx./lO ~ width; j. Linear feet of frontage along a public thoroughfare project will occupy is? N/A. 3 ; proposed (upon completion of project)? 2. How much natural material (i.e., rock, earth, etc.) will be removed from the site? none 3. Will disturbed areas be reclaimed? i-lYes I-1No IXiN/A a. If yes, for what intendc ' purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? [~Yes ENo c. Will upper subsoil be stockpiled for reclamation? [~Yes []]No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? -0-acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? I-IYes I~No apo~0X, 6. If single phase project: Anticipated period of construction ' !~ months, (including demolition). 7. If multi-phased: N/A a. Total number of phases anticipated (number). tons/cubic ~vards b. Anticipated date of commencement phase 1 c. Approximate completion date of final phase d. Is phase I functionally dependent on subsequent phases? 8. Will blasting occur during construction? I-lYes F~No 9. Number of jobs generated: during construction approx. 20 10. Number of jobs eliminated by this project 0 11. Will project require relocation of any projects or facilities? month year, (including demolition). month year; I-lYes l~No~ ; after project is complete 0 []Yes ~No If yes, explain 12. Is surface liquid waste disposal involved? f-lYes [~No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent wil] be discharged 13. Is subsurface liquid waste ~isposal involved? E~Yes (]No Type Sewage 14. Will surface area of an existing water body increase or decrease by proposal? l-lYes Explain FXtNo 15 Is prcject or any portion of project located in a 100 year flood plain? 16. Will the project generate solid waste? ~[~Yes a. If yes, what is the amount per month 0 tons b. If yes, will an existing solid waste facility be used? E-lYes ~No c. If yes, give name ; location d. []Yes ~No Will any wastes not go into a sewage disposal system or into a sanitary landfill? If Yes, explain []Yes ~No 17. Will the project involve the ~]isposal of solid waste? i~Yes a. If yes, what is the anticipated rate of disposal? 0 b. If yes, what is the anticipated site life? uflkrl0wn years. 18. Will project use herbicides or pesticides? ~]Yes [~No l-lNo tons/month. 19. Will project routinely produce odors (more than one hour per day)? (-lYes 20. Will project produce operating noise exceeding the local ambient noise levels? 21. Will project result in an increase in energy use? [l-lYes ~No If yes , indicate type(s) [~No [l-lYes ~No 22. If water supply is from wells, indicate pumping capacity approx. 23. Total anticipated water usage per day approx. 45 gallons/day. 24. Does project'involve Local, State or Federal funding? E]Yes If Yes, explain ]~0 gallons/minute. [~No 25.' ~pprovais Required: City, Town, Village Board I-lYes ~No City, Town, Village Planning Board l-lYes r~No City, Town Zoning Board [~Yes I-INo City, County Health Department ~Yes I-qNo Other Local Agencies I~Yes F-INo Other Regional Agencies I-lYes ~No State Agencies I~Yes [-INo Federal Agencies r-lYes I~No Type Bldq. Permit ASAP Water & Sewage ASAP Southol d Trus tees ASAP Submittal Date DEC dppruvud _ 7./g7 C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? i-lYes []No If Yes, indicate decision required: i-lzoning amendment I-]zoning variance I-]special use permit r-lsubdivision r-lsite plan r-lnew/revision of master plan I-lresource management plan [-]other 2. What is the zoning cJassification(s)of the site? R~¢iden't~a] 3. What is the maximum potential development of the site if developed as permitted by the present zoning? Residential Home 4. What is the proposed zonidg of the site? R~y`id~ntial 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? (%am~ ay, above) 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? [~Yes 7. What are the predominant land use(s) and zoning classifications within a ~/~ mile radius of proposed action? Residential [-1No 8. Is the proposed action compatible with adjoining/surrounding land uses within a ~A mile? EgYes I--INo 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water di'stricts? I-IYes )l~No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? l-lYes I~No a. If yes, is existing capacity sufficient to handle projected demand? l-lYes l-[No 12. Will the proposed action result in the generation of traffic significantly above present levels? i-lYes IXlNo a. If yes, is the existing road network adequate to handle the additional traffic? []Yes []No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which y~u propose· to mitigate or avoid them. ' .... E. Verification I certify that-the information provided above is true to knowledge. If the actio~ is!n th/~oastal Arekan~~ a state agency, complete the Coastal Assessment Form before proceeding with this a~essmen~. · 5 Ps 2--PROJECT IMPACTS AND Ti .JR MAGNITUDE 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 expert 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 types 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 State an6 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~wiH be any mpa. ct. 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 'mpact. 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 I. Will the proposed action result in a physical change to the prolect site? ~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 feet of existing ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1 000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. o Construction ~n 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 Il. YES · Specific land fbrms: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change , ~ [] IT]Yes E~No [] [] [--]Yes r-]No [] [] r-lYes [~No [] [] [--]Yes ~-lNo [] [] []Yes I-[No [] [] fi]Yes i-[No [] [] '" []Yes [--]No [] [] [~]Ves- []No [] [] []Yes []No [] [] [--]Yes []No IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? (Under Articles 1.5, 24, 25 of the Environmental Conservation Law, ECL) [~NO E]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: Nrmp_ 4. Will proposed action affect any non-protected existir~g or new body of water? I~INO I-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? ~.C~IO I-lYES 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. · ProposeC Action reauires 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 ir~' 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 natura] 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 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 drai'nage flow or pattern, s, or surface water runoff? ~('NO EYES Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 I 2 3 Small to Potential Can Impact Be Moderate large Mitigated By Impact Impact Project Change [] [] [-]Yes [--INo [] [] i-]Yes [~No [] [] ['-[Yes []No [] [] []Yes I-]No [] [] 'l--IVes [--INo [] [] []Yes [--]No [] [] [--]Yes [-]No [] [] ~]Ves ['-]No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~ ~Yes ~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: IMPACT ON AIR 7. Will proposed action affect air quality? t-XiNO F-lYES 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 m 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 mpacts: IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species? E~NO [::]YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list. usin8 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? ~NO i-lYES Examples that would apply to column 2 ~ .· Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. · Proposed Action requires the remova[ of more than 10 acres of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10. Will the Proposed Action affect agricultural land resources? " E~NO I~YES Examples that would apply to column 2 · The proposed action would sever, cross or limit access to agricultural land (inciudes cropland, hayfields, pasture, vineyard, orchard, etc.) 8 Small to Potential Can Impact'E~e Moderate Large Mitigated By Impact Impact Project Change = [] [] i--lYes []No '[--I [] []Yes i-]No [] [] []Yes J-'JNo [] ~] - : []Yes [-']No [] [] I-lYes []No [] [] []Yes E3No [] [] E~Yes i--I No [] [] ~Yes F-INo [] [] []Yes []No [] [] ['-]Yes []No [] [] []Yes []No [] [] [--]Yes []No [] [] [~Yes ~[]No [] [] []Yes ~]No [] [] E3Y'es EbNo [] [] E~Yes E3No [] [] E3Yes []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 Agricultutal 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? r~NO I-lYES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix 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 FIYES 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 Regi. ster 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 Folumn 2 ~NO E3YES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Other impacts: 1 2 3 - Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact i Project Change [] [] I--lYes i--1No [] [] [~]Yes I-1No [] [] [-lYes [-]No [] [~]. ~]Yes i--1No [] [] [~Yes i--1No [] [] [~]Yes [--[No [] [] [~Yes [-INo [] [] I--lYes E~]No [] [] E~]Yes [-1No [] [] ,r-[~Yes... I--]No [] [] i-lYes [-1No [] [] ~]Yes [-']No [] [] I--lYes l~No [] [] F-lYes i~No [] [] I--lYes l']No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? L-)(1NO l-lYES 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? []NO i-lYE 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 to serve more than 50 single or two family residences or to serve a ma.lot 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 []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 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? E~NO []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 the burial of "hazardous wastes" in anv form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) · 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 ~mpacts: 1 Small to Moderate Impact 2 Potentia Large Impact Can Impact Be Mitigated By Project Chang( l-lYes [--[No I--lYes l-]No I-lYes [--[Nc~ []Yes r-]No [-]Yes [--]No ~Yes F-INo I--lYes []No i-lYes [--JNo El-lYes El--]No I--lYes i--INo l--lYes ['1No E~Yes- . [~]No []Yes I--[No I--lYes []--] No []Yes i--iN0 i--lYes [-']No 10 IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing community? E~NO E~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 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: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [-'[Yes [--[No [] [] ' [--]Yes []No [] [] I-lYes i--I No [] [] I--lYes []No [] [] []Yes [-1No [] -~, [-~' []Yes []No [] [] r-lYes []No [] [] l--lYes []No [] [] E3Yes ~No 19. Is there, or is there likely to be, public controversy related to potential adverse environmental mpacts~ ~NO E-]YES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the iVlagnitude of Impact, Proceed to Part 3 Part ,g--EVALUATION OF THE [~IPORTANCE OF [MP,~,~,TS'~ '~, 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 Iii applicable) how the impact could be mitigated or reduced to a small to moderate impact by project c. hange(s). 3. Based on the information ava able, decide if it is reasonable to conclude that this impact is important. ' To answer the question of importance, consider: · The probabilitv 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) 14-14-1'i (2/87)--9c '-~ 617.21 ~r. SEQR Appendix B State Environmental Quality Review V sual EAF Addendum This form may be-used to provide additional information relat, ing to Question 1 1 of Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between Project and Resource (in Miles) 0-1/4 1/4 - 1/2 '/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? o State Parks? [] F~ [] [] [] · The State Forest Preserve? [] ~ [] [] [] · National Wildlife Refuges and state game refuges? [] F~ [] [] [] · National Natural Landmarks and other outstanding [] F- [] [] [] natural features? - · National Park Ser{zfce 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 F [] [] [] [] 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. ls 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 during which the project will be visible? ~Yes l--J~ No 1 used by the public during the time of year DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check.those which generally describe the surrounding environment. Within · 1/,~ mile * 1 mile Essentially undeveloped [] [] Forested [] [] Agricultural [] [] Suburban residential [] [] Industrial [] [] Commercial [] [] Urban [] E~]' River, Lake, Pond [] [] Cliffs, Overlooks [] [] Designated Open Space [] []- Flat .... [] [] 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 -[]Yes []No *3 .miles []Yes []No * 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 approx. 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 Activity Travel to and from wOrk Involved in recreational activities Routine travel by residents At a residence At worksite Other FREQUENCY Holidays/ Daily Weekly Weekends Seasonally COUNTY OF SUFFOLK ) STATE OF NEW YORK )SS: Oj~ B£ING DULY SWORN DEPOS£S A SAYS HE IS THE R 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 A~D AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF $OUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANT£D. in completing this application I hereby authorize the Trustees~ agent'or representative to enter onto ~y property to inspect the rem ses DAY OF , ! 9 ~ ~ ~OTARY PUB-lC \ EXAM [ NED APPROVED ~'WETLANDS" PERMIT (CHAPTER 97) APPROVED "BOAT, DOCKS, WHARVES" PERMIT (CHAPTER 32) DISAPPROVED "~ETLANDS PERMIT" (CHAPTER 97) DISAPPROVED "BOATS,DOCKS, WHARVES" PERMIT (CHAPTER 32) CONDITIONS, 1F ANY EXAMINING BODY SIGNATURE OF CHAIRMAN COMPUTATION OF FEES' Approved 2/27/85 800 ~doe,~ood Lane por-~ Lee... ~,~-~ Jersey January 25, i988 Mr= Henry P= Smith~ President Board of Town Trustees To~n of Southold 53095 Main Road Southoid~ Ne~ York 11971 Re~ House construction & dock construction Dear Mr ~~°~-a~. th: With reference ~o.~ ,,o:~-~ ~.. i~ta-=:-~ ~ dated January 1~ ~oo, requestin~ ~urther information ~_~ my. mpplicatin~.~ enrlosed_ is the follo~ing: a copy of a~m surve~ deoict~ng the location ~f my house the ~vc-~,~.~ and ~loazin~ oncE. ~u~.~.~u ~.~ .... a ...... ~--~ an the sur~,ey~ please find a detailed descriotion~.-~ the dock construction. T~-~ino that this information is in accordance with ~,our requirements ~ remain~ 3!VO C.