HomeMy WebLinkAboutTR- (2) Board Of SOuthOld Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO DATE: ...~/Z9~95 ....
ISSUED TO ..... EILEEN..~ILLA~
Pursuant fo the provisions o{ Chapter 615 o{ fha Laws o{
the State o~ New York, 1893; and ~ap~er 4~ o{ the Laws o{ the
State o{' New Yor~ 1952; and fha Sou+hold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;,' and in accordance with the
Resolution o~ The Board adopfe~ afa meeting held on 6/.~9/~5
19 ~.95, and in consideration o{ the sum o~ $. t,36.5~00 paid by
EILEEN..~I~kNI
o{ ....S.o.uthotd N.Y. and sub~ecf fo the
%rms and Condlflons listed on the reverse side kereo{,
o{ Southold Town Trustees authorizes and perm;ts the {ollowlng:
To ccons~ruct a 3' X 95' c~t~lk, ~ 3' X 15' r~p to ~
Z0~ float as per drawing d~ted ~s received ~ay 19, 1995.
Richmond Creek
a~l ~n accordance wifk fha detailed speci{icaflons as pre~nfed
the orlglnafing appllcaflon.
IN WITNESS WHEREOF, The sai~ Board o{ Trustees ~re-
by causes ifs Corporate Seal fo be a~xed, and these presents
be subscribed by a maiorlfy o{ f~ said Board as o{ this da~e.
......... ........
Albert $. Krupski, President ~%~1~ Town Hail
John Holzapfel, Vice President ~ 53095 Main Road
William G. Albertson ~ e,~ III P:O. Box 1179
Martin H. Garrell ~'~'~ Southold, New York 11971
Peter Wenczel Telephone (516) 765-1892
~ Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
June 29, 1995,
Eileen Villani
189 Old Westbur~ Rd
Old Westbur~, NY 11568
Re: SCTM 986-6-I0
Dear Mrs. Villani,
The following action was taken by the Board of Town Trustees
during its regular meeting held on June 29, 1995 regarding the
above matter:
WHEREAS, EILEEN V!LLANI, applied to the Southold Town
Trustees for a permit under the provisions of the Wetland
Ordinance of the Town of Southold, application dated April 22,
1995, and,
WHEREAS, said application was referred to the Southold Town
Conservation Advisory Council for their findings and
recommendations, and
WR~, a Public gearing was held by the Town Trustees with
respect to said application on June 29, 1995, 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,
W~REAS, the structure complies with the standard set forth in
Chapter 37-18 of the Southold Town Code,
W~EREAS, 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 T~EREFOP~E BE IT,
RESOLVED, that the Board of Trustees approves the application of
EILEEN VILLANI to construct a 3' X 95' dock, a 3' X i5' ramp
to a 6' X 20' float as per drawing dated as received May 18,
1995.
Permit to constr~ct project will expire two years from the date
it is signed. Fees must be paid, if applicable, and permit
issued within six months of the date of this notification.
Two inspections are required and the Trustees are to be notified
upon completion of said project.
FEES: Catwalk: 3' X 80' = 240' X $3 = $720.00
Ramp: 3' X 15' = 45' X $3 = $135.00
Float: 6' X 20' = 120' X $3 = $360.00
TOTAL DUE: $1,215.00 F
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
aJK/djh
cc. CAC
Town Hall. 53095 Main Road
P.O, Box 1179
Telephone Southold, New York 11971
(516) 765-1801
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
TO: Southold Town Board of Trustees
FROM: Southold Town Conservation Advisory Council
DATED: June 22, 1995
RE: Recommendations from Meeting of June 21, 1995
The Southold Town Conservation Advisory Council met Wednesday, June 21,
1995 at ~:30 P.M. at the Southold Town Hall. Present were CAC Chairman
Stephen Angell, and CAC members Bruce Loucka, Robert Kelth, John Hagerty
III, Betty Wells, and Allan Connell. The following applications were discussed
and recommendations given. ~
RECOMMENDATION OF WETLAND APPLICATIONS
No.'1271
Moved by Stephen Angeil, seconded by Robert Keith, it was
RESOLVED to recommend to the Southold Town Board of Trustees PARTIAL
APPROVAL of the Wetland Application of DR. JOHN ALOIA 118-~-9 to rebuild
1~' offshore end of jetty; rebuild 3' x 3' access stairway from existing
platform to bulkhead; install 3~ x 8' access stairs from bulkhead to beach;
rebolt top clamp on bulkhead.
The Council recommends approval to rebuild the 3' x 3f access stairway;
install 3' x 8' access stairs; and rebolt the top clamp on bulkhead.
The Council recommends DISAPPROVAL TO REBUILD 1~' OFFSHORE END
OF JETTY.
The jetty is not currently functioning and is not needed.
The Council also recommends the applicant plant the area behind the
bulkhead with beachgrass to prevent erosion during overwash.
81~5 Nassau Point Road, Cutchogue
Vote of Council: Ayes: All
Motion carried.
No. 1272
Moved by Stephen Angell, seconded by Allan Connell, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL
WITH STIPULATIONS of the Wetland Application of EILEEN VILLANI 86-6-10
June 21, 1995
to construct 95~ x 3~ fixed dock; 15~ x 3~ ramp; 6~ x 20~ float. No dredging
or filling.
The CAC recommends approval of the project but not the scope of the
plans.
The length of the catwalk is an excessive intruslon. The Council recommends
the catwalk be shortened, but, cannot determine the length because there are
no accurate soundings. The CAC suggests the Bay Constable do soundings to
determine a proper length.
The CAC also recommend the width of the catwalk be held to 3~ as shown
on the plans.
Also the Council suggests that a 10' non-turf buffer be installed.
Indian Neck Road, Peconic
Vote of Council: Ayes: All
Motion carried.
No. 1273
Moved by Bruce Loucka, seconded by John Hagerty, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL
WITH STIPULATIONS of the Wetland Application of BORIS CRZIC 50-2-19 to
construct a one family dwelling, decks, sanitary system, bluestone (or similar
pervious) driveway, all landward of crest of bluff. Construct a series of
platforms and Lt' wide stairs above, at and below cFest of bluff for pedestrian
access to beach.
The CAC recommends approval with the following stipulations:
1. Keep all construction, including septic system, over 100' landward of
the Coastal Eroslon Hazard Line. (Stairs excluded)
2. Be sure the stairs end at the toe of the bluff.
3. Elevate stalrs 3~ above the slope of the bluff.
Sound View Avenue, Southold
Vote of Council: Ayes: All
Motion carried.
No. 127~
Moved by S~.ephen AngelJ, seconded by Allan Connell, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL
WITH STIPULATIONS of the Wetland Application of llflLLIAM BEAL OR PAIJL
CACIOPPO 116-3-18 to build a single family dwelling.
The CAC recommends approval with the stipulation that there be NO
DISTURBANCE OF A 50~ BUFFER FROM THE WETLAND LINE and that hay
bales and s~lt fence be used landward of the buffer at the toe of the fill llne
during construction.
New Suffolk Avenue, New Suffolk
Vote of Council: Ayes: All
Motion carried,
No. 1275
Moved by Bruce Loucka, seconded by Allan Connell, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL
of the Wetland Application of MARTIN J. BANCROFT, JR. 27-2-2.3 to
enlarge/enhance existing freshwater pond (only in width) to 300' x 2~,0~ from
A~
Albert J. Krupski, President ~r ,~¥~,~,f~ Town Hail
John Holzapfel, Vice President ~'1~ 53095 Main Road
William G. Albertson ~e~l P.O. Box 1179
Martin H. Garrell ~'~- Southold, New York 11971
Peter Wenczel Telephone (516) 765-1892
Fax (516) 765q823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
S.E.Q.R.A.
NEGATIVE DECLARATION
NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT
APPLICATION NO. 1000-86-6-10 Chapt. 97 - Wetlands
NAME: Eileen Villani Chapt. 37 - Coastal Erosion
DATE: May 26, 1995
RESOLVED that pursuant to Article 8 of the Environmental Conservation
Law, State Environmental Quality Review and 6NYCRR Part 617,
Section 617.10 and Chapter 44 of the Code of the Town of Southold,
notice is hereby given that the Southold Town Trustees, as Lead
Agency for the action described below, has determined that the
project will not have a significant effect on the environment.
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.
TYPE OF ACTION: Type I
DESCRIPTION OF ACTION: Applicant requests a Wetland Permit to
construct a
3' X 95' dock, 3' X 15' ramp to a 6' X 20' float as per drawing dated
as received May 18, 1995
LOCATION: SCTM ~1000-86-6-10
REASONS SUPPORTING THIS DETERMINATION:
1. An on site inspection has been conducted by the Board of
Trustees.
2. An environmental assessment, submitted by the applicant and
reviewed and completed by the Board of Trustees, has indicated that
no significant adverse effects to the environment are likely to occur
should the project be implemented as planned.
cc. CAC
DEC
P~BLIC
NOTI(~
US Army Corps
of Engineers ~lic N0tide N~er: C~-OP-R
Jac~ ~. ~av~s F~r.L ~ Issue Date: 19 A~it 1995
~York, ~.~. 10~-0~ E~iration Date: N/A
To Whom It May Concern:
Enclosed please find a listing of permit'decisions made by
the New York District, Corps of Engineers during the past month.
To facilitate your review, this is an explanation of the
three-letter code denoting the type of permit issued:
FAI -- issued after-the-fact permit
FGP -- issued regional/state program general permit
FLP -- issued letter of permission
FIM -- issued modified permit
FIP -- issued individual permit
FNW-- confirmed applicability of nationwide general permit(s)
For information concerning projects authorized in New Jersey;
New York City, Westchester and Rockland Counties and 9n Long
Island, please contact the Eastern Permits Section at (212) 264-
6731. For information concerning projects authorized in other
areas of New York State, please contact the Western Permits Section
at'(212) 264-0185.
FOR THE DISTRICT ENGINEER:
$
~fF~ F~epn J. eebode U~ /
v ~C~ief, Regulatory Branch
189 Old We -'bury Road
Old Westbu~y;
April 9, 1995
re: application of
Eileen Villahi, Peconic
Southold Town
Board of Trustees
Mr. Albert J. Krupskl Jr
Southold, New York 11971
This letter is in reference to my application to 'construct a
pzer assembly on RiChmond Creek in PecDnic.
In August of 1992, John Geideman as ny representative, applied to
the town of Southold and ali the accompaning Deparnments for
permission to construct a dock on Richmond Creek. Due no an
illn.ess in ny family and a major communication gap regarding my
address, I los~ con,ach with Mr. Gei-demgn and the progress of
my applications~
In August of 1994, as I noticed many new docks on Richmond Creek,
I reconnected with John Geideman and I started corresponding with
si1 the other departments. &bout two weeks ago I received permits
from the Army Corps, Depn. of State and I already had the DEC.(all
cf which I am enclosing ¢opies)~
I am not q'uite sure whan my next step is, however I would
appreciate your reopening my application. It would really be
nice.no proceefl w2th this ne~er ending pro,ject and be able
to use the dock'this summer.
Thank you for all your help. I can be reached by tele~hcne at
516 626-0665~
Yours truly,
Q DEPARTMENT OF THE ARMY
NEW YORK DISTRICT. CORPS OF ENGINEERS
JACOB K_ J^VITS FEDERAL BUILDING
NEW YORK, N.Y. 10278-0090
,~ March 20, 1995
Eastern Permits Section
SUBJECT: Department of the Army Permit No. 94-~9~----
189 Old Westbury Road
Old Westbu , ork 0WN OF uLD
Dear Ms. Villani:
We have completed our review of Application No. 94-07790-L2.
Pursuant to Section 10 of the Rivers and Harbors Act of 1899
(33 USC 403), you are hereby authorized by the Secretary of the
Army:
ACTIVITY: To construct a pier assembly consisting of a 4
foot x 125 foot fixed pier, a 3 foot x 15 foot
hinged ramp, and a 6 foot x 20 foot float to be
secured by 2 pilings. The stated purpose of the
project is to provide a small vessel mooring
facility.
WATERWAY: Richmond Creek, Great Peconic Bay
LOCATION: Village of Peconic, Town of Southold, Suffolk
County, New York
Kindly display ~he enclosed notice of authorization sign at
the project site.
The activity authorized herein must be completed within
three years of the date of this permit. This authorization is
subject to the enclosed conditions. Please find enclosed two
forms to be used to submit to this office, as required, the dates
of commencement and completion for the authorized activity.
The authorized activity must be performed in accordance with
the enclosed plans. If any materfal changes in the location or
plans of the subject work are found necessary, revised plans
should be submitted to the District Engineer. These plans must
receive the approval required by law before work begins.
Notice is hereby given that the permittee should recognize
that a possibility exists that the structures permitted herein
may be subject to wavewash from passing vessels. The issuance of
this permit does not relieve the permittee from taking all proper
steps to insure the integrity of the structures permitted herein
and the safety of boats moored thereto from damage by wavewash
and the permittee shall not hold the United States liable for any
such damage.
If any questions should arise concerning this matter, please
contact Marc Helman, of my staff, at (212) 264-3912.
Sincerely,
C~.l~nel, Corps of Engineers
]~istrict Engineer
Enclosures
STATE OF NEW
DEPARTMENT OF STATE
ALBANY, NY 1225J-0001
ALEXANDER F. TREADWELL
~ECRETARY OF STATE
Eileen Vill~
P.O. Box 2012
Jamesport, NY 11947
Re: F-94-669
U.S. ~my Co~s of En~eers/New York
District Per~t Application ~94-07790-~
EHeen
Tom of Southold, Suffo~ Co~
DEC ~ 1-4738-00108/00002-0
~tter of Permission Issuance
Dear Ms. ViHaffi:
~e Department of State h~ rehewed the i~omafion received on Febma~ 22, 1995
descfib~g the above proposed prQecr.
Based upon ~e ~omation sub~tted, the Depa~ment of State h~ no obje~ion to the
au~ohzation of tbs proposed proje~ by ~tter of Per~ssion. No ~r~er renew is
req~red by the Dep~ment of Stare.
We appreoare your refe~ing tbs i~omation to the Deparrmem cf State for renew.
~e U.S. ~my Co~s of En~neers is berg notffied of this decision by copy of tbs letter.
Sincerely,
Chief. Consisten~ Renew
~d ~ysis Bureau
Diwsion of Coast~ Resources
and Waterfront Rehtalization
~B/~/jtb
cc: COE/New York District - M~c Helman
DEC/Region I - Robert Greene
notice of a,U:thOr,zat,On mUst. be
~1 ""~J: ConspicuouslYdmPlayed. ~ ~ ~ at the s,te of work,
United States Army Corps of Engineers
~rch 20, 1 9 95
A permit to construct a pier, ramo, and float
Ii(: Richmond Creek, Little Peconic Bay
~t: Villaqe of Peconic. Town of $outhold. suffolk County. New York
has been issued to Eileen G. Villani on March 20.1995
189 01d Uestbury Road
Address of PeFmittee 01d Westbur¥, New York 11568
Permit Number Thomas A. York
I I Colonel,. Corps of Enqineers
94-07790 D/strict Commander
ENG FORM 4336, Jul 81 (33 CFR 320-330 EOITION OF JUL 70 MAY BE USED (Proponent: CECW-O)
!995
Q "DEPARTMENT OF THE ARMY
NEW YORK DISTRICT. CORPS OF ENGINEERS
JACOB K. JAVITS FEDERAL BUILDING
NEW YORK. N.Y. 10278-0090
"~ April 7, 1993
Eastern Permits Section
SUBJECT: Application Number 92-12580-L2 by Eileen Villani
To Whom It May Concern:
The New York District, U.S. Army Corps of Engineers, has
received a request for Department of the Army authorization for the
following activity:
ACTIVITY: Construct a 4 foot by 125 foot fixed pier, a 3 foot by
15 foot hinged walk-ramp, and a 6 foot by 20 foot floa~ to be
secured by two pilings.
IN: Richraond Creek, Great Peconic Bay
AT: Peconic, Town of Southold, Suffolk County, New York
APPLICATION BY: Eileen Villani
P.O. Box 2012
Jamesport, NY 11947
As thls is minor in nature, authorization may be by Letter of
Permisslon~ This is in accordanceWith current Pederal Regulations
governin~ work in navigable waters of the United States. To
accomplish the coordination required, prior to the issuance of a
Letter of Permission, your review of the enclosed drawings is
requested.
Pursuant to Section 307 (c) of the Coastal Zone Management Act
of 1972 as amended (16 U.S.C. 1465 (c)), the applicant has
certified that the activity complies with and will be conducted in
a manner that is consistent with the approved state coastal zone
management program.
To allow for the timely processing of the subject application,
your comments are requested withi~ 15 days of the date of this
letter.
Sincerely,
{ J~es W. Haggerty
C~q~e~ Eastern Permits Section
Enclosure
TRUSTEES SUPERVISOR
John M. Bredemeyer, III, President SCOTT L. HARRIS
Albert J. Krupski, Jr., Vice President Town Hall
Henry P. Smith 53095 Main Road
John B. Tuthill ~
William G. Albertson ' ~ RO. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax (5!6) 765-1823 BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
August 27, k992
Mr. John Holzaphel, Chairman
Southold Town Conservation Advisory Council
Southold Town Hall
Main Road
Southold, NY 11971
Dear Mr., Holzaphel:
Transmitted herewith are applications for wetland and/or CEHA for the
following:
Josh London 83-2-3
E. Villan 86-6-10
Donna Schlegal 99-3-15.1
Ernest Gaebel 107-7-7
Thomas Boyle 59-1-7
Please prepare a written report of findings and recommendations with
respect to this application.
Very truly yours,
M. Bredemeyer, Itt
President, Board of Trustees
JMB: jd
J. Kmpski, President Town Hail
Vice President ~ 53095 Main Road
William G. Albertson ~: ~ P.O. Box 1179
Martin H. Garrell "~ Southold, New York 11971
Peter Wenczel ' Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
--~'~tland Permit Application
Grandfather Permit Application
Trustee Lands Permit Application
ceo Waiver .
ceived Application.
erical Review.
mpleted Application
Incomplete
SEQRA Classification:
Type I__.Tlrpe II ~'~nlisted
Coordination:(date sent),
Referral Sent:
e of Inspection:
Receipt of CAC Report:(~ate)'
p Lead Agency Determination:, ~
chnical Review:(date)~/~--~/
blic Hearin~:(date) ~/~/~-' ''F
becision: Approved (Y/N) (~afe)
~Application Fee:$/~. ~ e
Name of Applicant ~g~
Phone Number:( )
Suffolk County Tax Map Number: 1000 -
Property Location: ~-~z.~% ng~D~
(provide LILCO Pole ~, d~stance to cross streets, and location)
Agent:
(If applicable)
Address:
Phone:
TRUSTEES
lotto M. Bredemeyer, III, President SUPERVISOR
Heraj P. Smith, Vice President SCOTT L. HARRIS
Albert J. Krupski, Jr.
John L. Bednoski, Jr. Town Hall
lohn B. Tuthill 53095 Main Road
P.O. Box 1179
Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971
Fax (516) 765-1823 TOWN OF SOUTHOLD
COASTAL EROSION MANAGEMENT PERMIT APPLICATION
TOWN WETLANDS PERMIT APPLICATION
TRUSTEE LANDS PEPJ~IT APPLICATION
Office Use Only:
N~Coastal ErosioD Permit Application
~A4etland Permit Application
~rustee Lands Permit Application
Grandfather
~Completed Apps. Date: ~
~Variance Required,
~ Neighbors nouified Date: ?}{~ 0F S0UTHOLD
~}~~m~. Date Rec. by Office
~nsp. comp. /date : ~-~OConditions
~EQ~ Dete~in./date:
~ublic Hearing/date: '; ~3 ,
Findings: ~ '%~ ~ ~/~ ~ ~ ~ 9~
Permit Vote: (~N): ~ ~'
Special : ~
(also see file) AuDlication Fee:
Application Number; SC2~4 al000- ~
Project Name (If any) 'L&', ~//~/~/ /t~/'-~C,~F--j.¢~',
Date Prepared:
Applicant: J,/~(
Address: ~67~ ~ ~/~. ~. ~/dr?
Phone
Interest: (owner, consultant..lessee,ecc.)
Owner of Property: ~9 ~'//~/
Address ~"~, ~0~' rOUX- J~/~f3'p~F-/ Z.2l
Subject P.ro~perty Locati~/~z~ ~/~¢~C
(Provide LI~CQ 2ole ~, Dista~oe ~o cross Streets ±f no~ on
loc :tion map)
THIS IS NOT A PERMIT
Yds. to be excavated: -~w~_~ Yds. to be filled: ~
Manner in which material will be removed or deposited:
Width of canal, creek or bay fronting property:
Depth at low tide: /if Aver. rise in tide: ~ ~'
Distance to nearest channel: Distanc~ ~roject
extends beyond similar projects in area: 7~i~
Area zoning: /~-~ . Land area in acres:
Is project for private or business use: ~/~4~2~
Intended use of property: ~.~z~c~
Describe known ~rior operations conducted~on premises:
~&s any ~rior lioense or p~rmit bee~ issue~ to ereot stru~t~res~
dredge, or deposit fill on said premises: w
Has any license or permit.~ever been revoked or suspended by a
Governmental Agency:
Project Description
The project description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (i.e., pipeline
and septic system; make additional attackments if necessary).
Authorization (~here th~ applicant is nO~ the owner)
I residing at
(Print-owner of subject property) (Mailing address-phone)
do hereby authorize to apply for
Coastal Erosion permit(s) from the Southold Town Trustees
Signature
THIS IS NOT A PERMIT
County of Suffolk )
State of New York )
J~/~ ~r~Pc~/~g BEING DULY SWORN DEPOSES AND
AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED
PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO
THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE
DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE
'APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT IS), IF GRANTED.
IN COMPLETING THIS APPLICATION, I HEREBY ALVi~HORIZE THE TRUSTEES,
THEIR AGENT ( s ) OR REPRESENTATIVE ( s ), TO ENTER ONTO MY PROPERTY
S ATURE
SWORN TO BEFORE ME THIS /g ~ DAY OF ~-c.c~,~ .,19 ~.-5~_
NOTARY PUBLIC
HELENE O. HORN~=
Notary p~, S~ete of New Yo~
No. ¢95~ 364
Oualifiec~ in Su~otk Count,/ ~ ~
Commission Expkes May 22~ ~9~
Suggested space for location MaP
THIS IS NOT A PERMIT
· ,. Ph~DJECT L0. NuMaER '
· ; Appendix C
State Environmental Quality Review .~
--- SHORT ENVIRONMENTAL ASSESSMENT FORM
~ For UNLISTED ACTIONS Only
PART I--PROJECT INFORMATION (To be completed by AppIicant or Project sponsor) ~
3. ,PROJECT LOCAT ON: ~ ' ' ~ ~ n / ~
8. W~LL PROPOSED ACTJO~ COMPLY WtTH ~X[ST~NG ZONING OR OTH~R EXiSTInG LAND USE ~EST~iCT[ONS?
~ Ne If Ho, descdba briefly
9. WHAT IS PRESENT LAND USE iN VICINITY OF PROJECT?
Res,dentia. [] !~dustrlal [] Corilrnerclg. t [] Agric[~lture [] FeWJForestlOoen s[~ace ~
10. DOES ACTION INVOLVE A PER,~,41T APPROVAL. OR FUNDING..NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTALAGENCY (FEDERAL
STATE OR LOCAL)?
[] Yes ~No If yes, list agency(s) and ~errn=t/approvals
11. DOES ANT ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes '~lo ti ye~. Fist agency name and oerrnlt/aoprovat
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
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
Civil ~ Marine
.::b: JOHN H. GEIDEMAN
j.,~, · Consulting Engineer
· P,O. Box 416
.~.: E. Marion, b. I.
(516} 477-242! New York I ]939
-- To %mom It May Concern,
*John H. Geideman to acc ~s my e~ent in app~Ing fo~ permits
~o oon~t~c~ ~ P~ ~ ~ ~ %/~"
on my property at ~ ~ ~ - ~~ .
Including: N.Y.S Dept. of Envlron~ontel
y U. S Arm~T Corps of ~nglne,~. s
~. Iq.Y.£lott Lic. Lo,~'~ Surw'yor