Loading...
HomeMy WebLinkAboutTR-5201 Docko, Inc.  P.O. Box 42'm, MysU¢, OT 00855 (860) $72-8959 F~: (800) 572-750g, e-ma)l: docko@snet, net January 18, 2005 Mr. Albert Krupski, President Southold Board of Trustees P.O. Box 1179 Southold, NY 11971 Re: Rolla Campbell Property Boat Life Variance Dear Mr. Krupski: Last summer the Board of Trustees approved the removal of a floating dock and ramp and extension of the fixed pier including an "L" shaped end pier for Rolla and Kim Campbell's property in East Harbor on Fishers Island. Part of their original application was the installation of a boat lift as well. We would like to know if the Board of Trustees would be agreeable to reconsidering the boat liit since it was not approved as part of the dock modification application. We understand that the dock ordinance prohibits the installation of boat lifts. I feel however that there are mitigating circumstances in East Harbor that are beyond the considerations emphasized when the ordinance was adopted. The water in East Harbor is usually wavy and can be rough when there is a west or especially northwesterly, wind. The waves build with significant fetch in Fishers Island Sound and as the water depths become shallow in East Harbor, especially at low fide, the waves build toward the breaking point in the vicinity of the Campbell's dock. This is a tough environment to put a boat in the 20' to 35' range and during such conditions the vessel will stress and wear the fie-off lines significantly and even damage the cleats or guides on the vessel. This was the justification behind the boat lift installed at the Balcom's property next door in the 90's. We feel that this is an urgent consideration for the Campbell's for boating to be realistic and for the safety of the Campbell's and the equipment to be maximized. Conditions in the Sound can change quickly; smooth water at departure does not guarantee smooth water upon returning It would be greatly appreciated if you would reconsider this; we would be agreeable to making a presentation or visiting with you at the site at your convenience to observe these particular conditions. Again, we feel that the prohibition against boat lilts is a viable consideration in small creeks and protected areas, but this is not one of those areas: If you could let me know the consensus of the Board, we will pursue this further as appropriate. CC: Dr. & Mrs. Rolla Campbell File: 03-03-1409 CAMPBELL ltofully submitted, B. Neilsoi~ P.E. Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 21, 2004 Mr. Keith Neilson, PE Docko, Inc. P.O. Box 421 Mystic, CT 06355 RE: ROLLA CAMPBELL PRIVATE RD., FISHERS ISLAND SCTM#4-4-16 Dear Mr. Neilson: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, April 21,2004: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5201 to add 24 If. of 4' wide fixed wood pile and timber pier extension and a 20 If. X 4' wide "L" including associated braced support piling. A new braced tie-off piling and relocate three existing braced tie-off pilings, and all as depicted on the plan prepared by Keith B. Neilson, PE dated July 11,2003. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms Docko, Inc. RO. Box 421, Mystic, CT 06355 (860 Fax: (860) 572-756! d~H 2 3 2004 ~il: docko@snet.net Mr. Robert H. Goldie, Esq. Satterlee Stephens Burke & Burke LLP 230 Park Avenue New York, NY 10169-0079 Re: Application No. 2003-01296 L2 Rolla Campbell Dear Mr. Goldie: We are in receipt of your letters dated December 5a' and 15th to the U. S. Army Corps of Engineers regarding the modification of the dock system at the home of Rolla B. and Klm Campbell on Fishers Island. I have discussed with Dr. Campbell your proposed modifications to the dock which would relieve your current objections. I explained that the purpose of the tie-off piles being at 17 feet is to afford protection of a berthed boat even if storm surge tides are encountered and the Campbell's are unable to move the boat in advance of such tides. These tie-off piles could be lowered five feet to an elevation of 12 and still provide a reasonable level of protection for up to 10-year storms. On that basis, Dr. Campbell is agreeable to lowering the tie-off piles. I have also explained to Dr. Campbell that with his current 27-foot Osprey motorboat, a berthing pier of 25 feet would accommodate almost all of their needs without blocking the lift slip. It does not provide such desirable access for the southwesterly slip. Dr. Campbell has agreed that in the interest of maintaining neighborly relations, he will direct us to shorten the "L" by 10 feet. We will submit revised drawings to the Corps of Engineers in response to your letters so that this permit process may be completed and drawings to the other agencies who have already issued permits. We trust that you will find this all to your satisfaction. Yours truly, DOCKO INC . Keith B. Neilson, P.E. KBN:jm CC: Dr. Rolla Campbell NYS DEC: Westerlind US ACOE: Roth TOS: Krupski File: 03 -03 - 1409 CAIVlPBELL Telephone (631) 765-1~92 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, January 13, 2004, the following recommendation was made: ROLLA CAMPBELL to Amend Permit #5201 to add 24 (+/-) if. of 4' wide fixed wood pile and timber pier extension and a 30 (+/-) If. X 4' wide wood fixed "L", a boat-lift ~ncluding associated braced support piling and relocate three braced tie-off pilings all waterward of the apparent high water line. · Located: Private Rd., Fishers Island. SCTM#4-4-16 The CAC did not make an inspection, therefore no recommendation was made. ROLLA CAMPBELL PHOTOGRAPHS ABOVE: THIS PHOTOGRAPH SHOWS THE EXISTING PIER LOOKING FROM THE BALCOM PROPERTY TO THE EAST. THE REASON FOR THE PIER'S LENGTH IS CLEARLY EVIDENT IN THIS AND THE NEXT PHOTO SHOWING SHALLOW SUB-TIDAL WATERS AND AN EXTENSIVE INTER-TIDAL SHELF NEAR SHORE, STREWN WITH BOULDERS. BEC $oothofd Town Board of ~ustee$ 27 LOCATION MAP PROJECT: WATERWAY: LOCATION: APPLICANT: DATE: "DOCK MODIFICATIONS" EAST HARBOR FISHERS ISLAND, TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ROLLA CAMPBELL JULY ! 1, 2003 46 TAX ASSESSOR'S MAP 004, SECTION 4, LOT 16 PROJECT: WATERWAS~': LOCATION: APPLICANT: DATE: "DOCK MODIFICATIONS' EAST HARBOR FISHERS ISLAND, TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ROLLA CAMPBELL JULY 11, 2003 I [ (~) COUNTY OF SUFFOLK ~, ..... SOUTH~OLD ~- ~ ~Real Prol0ertv Tax Service AgencyI ........ 004 PROPERTY MAI Docko, Inc. RO. Box 421, Mystic, CT 06355 (860) 572-8939 Fax: (860) 572-7569, e-mail: docko@snet.net October 30, 2003 NYS DEC Environmental Permits BuiMing 40, SUNY Stony Brook, NY 11790-2356 Re: Rolla Campbell Dock Modifications To Whom It May Concern: On behalf of Dr. Rolla Campbelll we request a Tidal Wetlands Permit including Water Quality Certifications, as necessary, for dock modifications on Fishers Island, New York. ~te enclose the following in support of this permit application: Four prints each of plans titled: Project: Waterway: Location: Applicant: Date: "Dock Modifications" East Harbor Fishers Island, Town of l Suffolk County, New Yol Rolla Campbell July 11, 2003 Four copies of the NYS DEC Joint Application, including the Short Environmental Assessment Form, Tax Assessor's Map, Photographs and Location Map. I trust that you will find this application package complete and acceptable; please let me know if the need for further information arises. Very truly yours, DOCKO, INC. Keith B. Neilson, P.E. KBN.'jm Enclosures CC: Rolla Campbell US File: 03-03-1409 CAMPBELL . t I FOR PERMIT United States Army Corps of Engineers NYS DepLof EnvironmentalConservaflon ROLLA CAMPBELLI (631) 788-7803 PRIVATE ROAD (Constructor Place) FISHERS ISLAND, NY 06390 [] CeasLal Erosion Con,roi [] Owner [] Operator [] Lessee [] Municipafity I Governmental Agency [] 401 Water Quality Certification Owner or AgentJContact Person [] Owner [] Agent/Contact Person Telephone Number (daytime) [] Potable Water Supply KEITH B. NEILSON, P.E., DOCKO, INC. (860) 572-8939 [] AguaUcVegetalJon Control P.O. BOX 421 Post Office I S~te I ZJu Code [] Aquatic insect Control MYSTIC CT 06355 (State Owned Lands Under Water) SUFFOLK F.I.,TOWN OF SOUTHOLD 1000-004-4-16 utdlty Easement (pipehnes, conduits. PRIVATE ROAD (631) 788-7803 [] Docks. MoodngsorP[atforms FISHERS ISLAND CT 06390 EAST HARBOR [] FreshwaterWeUands Permit NEW LONDON, CT-RI-NY ADD 24 (+/-) LF OF 4-FT. WIDE FIXED WOOD PILE AND TIMBER PIER [] [:~.ks (cor~,~ct or Place) EXTENSION AND A 30 (+/-) LF X 4' WIDE FIXED "L". A BOAT LIFT INCLUDING [] Mooflngs (Establish} ASSOCIATED BRACED SUPPORT PILING, AND RELOCATE THREE BRACED TIE-OFF PILINGS ALL WATERWARD OF THE APPARENT HIGH WATER LINE. [] [] [] Y., No T.B.D. e,planat~nof why work was started withou, perm,~)Y~es N~O _L~rlS~_O,~-.iO-1//O001 ~U~.'~ J,,~..O(20 16, Will t~Js Project Require Additional [] [] II Yes. U.S.ACOE, TOWN OF SOUTHOLD Date ~_°¼ '~'~ ~' Signature IN ~.~t.~,~ I (- Titie RESET ~ROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR ROLLA CAMPBELL 3.PROJECT LOCATION: FISHERS ISLAND, TOWN OF SOUTHOLD Municipality J 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed b~, Applican[ or Project Sponsor) 2. PROJECT NAME DOCK MODIFICATIONS I SUFFOLK I Count/ SEQR 4. PRECISE LOCATION: Slreet Addess and Road Intersections. Prominent landmarks etc -or provide map PRIVATE ROAD 5. IS PROPOSED ACTION: ~ New r-'] Expansion ~Mod~fication/alteration 6. DESCRIBE PROJECT BRIEFLY: ADD 24 (+/-) LF OF 4-FOOT WIDE FIXED WOOD PILE AND TIMBER PIER EXTENSION AND A 30 (+/-) LFX 4-FOOT WIDE FUXED "L", A BOAT LIFT INCLUDING ASSOCIATED BRACED SUPPORT PILING AND RELOCATE THREE BRACED TIE-OFF PILINGS ALL WATERWARD OF THE APPARENT HIGH WATER LINE. 7. AMOUNT OF LAND AFFECTED: Initially 100 +/- acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes [] No It no, describe bdefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~Residential []Industrial E~commercia, ~Agriculture [~ParklEorestlOpenSpace ~]Other (describe) 10 DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [-~--~Yes ['-'~No If yes, list name and permit / agency US ARMY CORPS OF ENGINEERS, TOWN OF SOUTHOLD 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [--~Yes j-~No II yes, list agency name and permit / I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ROLLACAMPBELL Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc},) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD N 6 NYCRR, PART 617 4'~ If yes, coordinate the review process and use the FULL EAF. [~Yes ["~ No B W~LLA~Tl~NRECElVEc~~RD~NATEDREV~EWA~PR~V~DEDF~RUNL~STEDACT~~NS~N6NYCRR~PART617~6? IfNo, anegative declaration may be superseded by another involved agency. I---IVes I--'l No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if Jegible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding probJems? Explain briefly: C2. Aesthetic. agflcufiuml, archaeological historic, or other natural or cultural resources: or community or n~ighberhood character? E×plain briefly: I C3. Ve~j.tdGun or fauna, fish, shelltish or wildlife spec[es, significant habitats, or threatened or endangered species? Explain briefly: I C4. A community's existing plans or goals as officially adopted, or a change in use or intensi~y of use of land or other natural resoumes? Explain briefly: I C5. Growth, subsequenl development, or related activities likely to be nduced by the proposed action? Explain bdefly: I C6. Longterm, shortterm cumulative, or other effects not dentifledinCl-C5? Explain briefly: I C7. Other h D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? IIf }'es, explain bdefl¥: r--~ Yes E-~No E. IS THERE. OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENV RONMENTAL IMPACTS'~ if }'es explain: PART III - 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) irreversibifity; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that air reJevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CF_~ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then prcceed 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 actiol WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi; determination. Name of Lead Agency Date Title of Respensible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsibh~ officer) Docko, Inc. RO. Box 421, Mystic, CT 06355 (860) 572-8939 Fax: (860) 572-7569, e-mail: docko@snet.net October 30, 2003 NYS DOS Department of Coastal Resources 41 State Street, 8th Floor Albany, NY 12231 Re: Rolla Campbell, Fishers Island Dock Modifications To Whom It May Concern: On behalf of our client, we submit the attached Federal Consistency Assessment Form for dock modifications on Fishers Island, New York. We enclose herewith the following in support of this permit application: Two prints each of plans titled: Project: Waterway: Location: Applicant: Date: "Dock Modifications" East Harbor Fishers Island, Town of Suffolk County, New Y~ Rolla Campbell July l 1, 2003 Two copies of Corps of Engineers, NYS DEC and Town of Southold Application forms, Location Map, Tax Assessor's Map and NYS DOS Coastal Management Federal Consistency Assessment Forms. I trust that you will find this application package complete and acceptable: please let me know if the need for further information arises. Very truly yours, DOCKO, 1NC. Keith B. Neilson, P.E. KBN.'jm Enclosures CC: Rolla Campbell File: 03-03-1409 CAMPBELL Federal Consistency Assessment Form An appli,cent, seeking a permit, license, waiver, certification or similar type of approval from a federal agency which is subject to · the New York State Coastal Management Program (CMP, shall complete this assessment form for any proposed activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent with New York State's CMP as required by U S. Department of Commerce regulations (15 CFR 930.57(. It should be comp01eted at the time when the federal application is prepared. The Department of State will use the completed form and accompanying information in its review ct the applicant's cerbfication of consistency. A. APPLICANT 1. Name: ROLLA CAMPBELL 2. Address: PRIVATE ROAD, FISHERS ISLAND, NY 06390 3. Telephone: Area Code (631) 788-7803 B PROPOSED ACTIVITY 1. Brief description of activity: ADD 24 (+/-) LF OF 4-FT. WIDE FIXED WOOD PILE AND TIMBER PIER EXTENSION AND A 30 (+/-) LF X 4-FOOT WIDE FIXED "L*, A BOAT LIFT iNCLUDING ASSOCIATED BRACED SUPPORT PILING AND RELOCATE THREE BRACED TIE-OFF PILINGS ALL WATERWARD OF THE APPARENT HIGH WATER LINE. 2. Purpose of activity: THIS IS A PRIVATE DOCK FOR RECREATIONAL BOATING. 3. Location of activity: SUFFOLK FISHERS ISLAND, TOWN OF SOUTHOLD PRIVATE ROAD County City, Town or Village Street or Site Description 4. Type of federal permit / license required: US ARMY CORPS OF ENGINEERS 5. Federal application number, if known: NOT YET KNOWN 6. If a state permit / license was ~ssued or is required for the proposed activity, identify the state agency and provide the application or permit number, if known: COASTAL ASSESSMENT Check either "YES" or "NO" for each of the following questions. The numbers following each question refer to the policies described in the CMP document (see footnote on page 2) which may be affected by the proposed activity. YES N~O 1. Will the proposed activity result in any of the following: a. Large physical change to a site within the coastal area which will require the preparation of an environmental impact statement? (11, 22, 25, 32, 37, 38, 41, 43) .................... b. Physical alteration of more than two acres of land along the shoreline, land under water or coastal waters? (2, 11, 12, 20, 28, 35, 44) ...................................... c. RewtalJzat~on / redevelopment of a deteriorated or underutilized waterfront site? (1) ....... d Reduction of existing or potential public access to or along coastal waters? (19, 20) e Adverse effect upon the commercial or recreational use of coastal fish resources? (9,10)... f. Siting of a facility essential to the exploration, development and production of energy resources in coastal waters or on the Outer Continental Shelf? (29) ................. g. Siting ct a facility essential to the generabon or transmission of energy? (27) ........... h. Mining, excavation, or dredging activities, or the placement of dredged or fill material in coastal waters? (15, 35) ................................................. Discharge of toxics, hazardous substances or other pofiutants into coastal waters?(8,15,35) j. Draining of stormwater runoff or sewer overflows into coastal waters? (33) ........... k. Transport, storage, treatment, or d~sposal of solid wastes or hazardous materials? (36, 39). I. Adverse effect upon land or water uses w~thin the State's small harbors? (4) ........... 2 Will the proposed activity affect or be located in, on. or adjacent to any of the following: a. State designated freshwater or tidal wetland? (44) ............................. X b. Federally designated flood and / or state designated erosion hazard area? (11, 12, 17) .... X c. State designated significant fish and / or wildlife habitat? (7) ...................... d. State designated significant scemc resource or area? (26) .......................... e. State designated important agriculturallands? (26) ............................. £ Beach, dune or barrier island? (12) ........................................... g. Ma)or ports of Albany, Buffalo, Ogdensburg, Oswego or New York? (3) .............. h. State, count~/, or local park? (19, 20) ...................................... i. Historic resource hsted on the National or State Register of Historic Places? (23) .......... X X X X X X x X X X X X X X X. 3. Will the proposed activity ~ any of the following. a Waterfronl site? (2, 21, 22) .............................................. X b Provision of new public services or infrastructure in undeveloped or sparsely populated sections of the coastal area? (5) ........................................... c Construction or reconstrucflon of a flood or erosion control structure? (13. 14, 16) ...... d. State water quality permit or certilication? {30. 38, 40) ........................... e. State air quality permit or cediflcation? (4t, 43) ............................ 4. Will the proposed activity occur within and / or affect an area covered by a State approved Local water~ront revitalization program? (see policies in local program document) ......... D. ADDITIONAL STEPS X X X X 1. If all of the questions in Section C are answered 'NO", then the applicant or agency shall complete Section E and Sub the documentatron required by Section F. 2. If any of the questions in Section are answered "YES", then the applicant or agent is advised to consult the CMP, or where appropriate, the local waterfront revitalization program document. The proposed activity must be analyzed in more detail with respect to the applicable state or local coastal policies. In the space provided below or on a separate page (s), the applicant or agent shall: (a) identify, by their policy numbers, which coastal policies are affected by the activity. (b) briefly assess the effects of the activity upon the policy; and (c) state how the activity is consistent with each policy. Following the completion of this written assessment, the applicant or agency shall complete Section E and submit the documentation required by Section F. E. CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program, as appropriate. If this cert~flcaflon cannot be made, the proposed activity shah not be undertaken. If this certification can be made, complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program, or with the applicable approved focal waterfront revitalizaflon program, and will be conducted in a manner consistent with such program." Applicant/Agents Name: ROLLA CAMPBELL Address: PRIVATE ROAD, FISHERS I.~,~ND, NY 06 90 Telephone'Area Code ~631) 788-7803 ~ ,,t ~ ~ &).,ob.v=J ~, '- ' Applicant/Agent's SJg.ature: ,(./~.,~._ ~,.~ -, I ',-~ \.~ F. SUBMISSION REQUIREMENTS 1. The applicant or agent shall submk the following documents to the New York State Department of State, Division of Coastal Resources and Waterfront Revitalizabon, 162 Washington Avenue, Albany, NY 12231. a Originalsigned form. b. Copy of the completed federal agency application c. Other available information which would support the cedification of consistency. 2. The applicant or agent shall also submit a copy of [his completed form along with his / her application to the federal agency. 3. If there are any questions regarding the submission of this form, contact the Depadment of State at (518) 4744~000. 'These state and local documents are available for inspection at the offices of many federal agencies, Department of Environmental Conservation and Department of State regional offices, and the appropriate regional and county planning agencies. Local program documents are also available for inspection at the offices of the appropriate local government. '. Docko, Inc. RO. Box 421, Mystic, CT 06355 (860) 572-8939 Fax: (860) 572-7569, e-mail: docko@snet.net October 30, 2003 Mr. Michael Vissichelli U.S. Army Corps of Engineers Jacob Javits Federal Center, Room 1937 New York, New York 10278-0090 Re: Rolla Campbell Dock Modifications Dear Mr. Vissichelli: On behalf of Dr. Rolla Campbell we request a Department of the Army Permit for dock modifications on Fishers Island, New York. We enclose herewith the following in support of this permit application: Two prints each of plans titled: Project: Waterway: Location: Applicant: Date: "Dock Modifications" East Harbor Fishers Island, Town of Suffolk County, New Yo Rolla Campbell July 11, 2003 Two copies of Corps of Engineers and NYS DEC Application Forms, Location Map, Tax Assessor's Map, photographs and NYS DOS Federal Consistency Assessment Form. I trust that you will find this application package complete and acceptable; please let me know if the need for further information arises. Very truly yours, DOCKO, INC. KBN.'jm Enclosures CC: Rolla Campbell ~frmlts File: 03-03-1409 CAMPBELL ·" APPLICATION FOR DI~I, RTMENT OF THE ARMY PERMIT OMB APPROVAL NO. 0710-003 · ~'(33 CFR 325) Public repoainl~ burde0 tar this collection of information is estimated to average 5 hours per response, including the thne for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.. Send comments regarding this burden estimate of any other aspect of this collection ofinformation, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Service Directorate of of Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1'504. Arlington, VA 222024.302; and to the Office of Management and Budget. Paperwork Reduction Project (0710-0003). Washington, DC 20503. Hease DO NOT RETURN your farm to either of those addresses. Completed applications must be submitted to the District Engineer having jurisdiction over the location of the proposed activi[y. PRIVACY ACT STATEMENT AuthoriB,': 33 USC 401, Section 10; 14[3,Section 404. Principal Purpose: These laws require permits aulhorizing activities in, navigable waters ofthe United States the discharge of dredged or fiIl material into waters of the United States, and the transportation of dredged material for the purpose of dumping it into ocean waters. Routine Uses: Information provided on this form will be used in evaluating this application for a permit. Disclosure: Disclosure of requested information is is voluntary. If information is not provided, however, the permit application cannot be processed nor can a permit be issued. One set of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this application (see sample drawings and instructions) and be submitted to the District Engineer having jurisdiction ofthe proposed activity. An application that is not completed in flail wdl be returned. 1. APPLICATION NO. 5. APPLICANT'S NAME ROLLA CAMPBELL 6. APPLICANT'S ADDRESS PRIVATE ROAD FISHERS ISLAND, NY 06390 7. APPLICANT'S PHONE NO'S W/AREA CODE a. Residence (631) 788-7803 (ITEMS 1 THRU 4 TO BE FILLED BY THE CORPS) 2. FIELD OFFICE CODE 3. DATE RECEIVED ITEMS BELOW l'0 BE FILLED BY APPLICANT 8. AUTHORIZED AGENT'S NAME & TITLE DOCKO, INC. THOMAS C. LAW 9. AGENT'S ADDRESS P. O. BOX 421 MYSTIC, CT 06355 lO. AGENT'S PHONE NO'S W/AREA CODE a. Residence b. Business b. Business 1 I. STATEMENT OF AUTHORIZATION I hereby authorize, DOCKO, INC. to act in my behalf as my agent in the processing of this application and to furnish, upon request. supplemental information i9 Oupport of tilts permit application. APPLICANT'S SIGN,affURE DATE ROLLA CAMPBELL NAME, LOCATION AND DESCRIPTION OF PROJECT OR ACTIVITY 4.DATE .~op. COMPLETED (860) 572-8939 12. PROJECT NAME OR TITLE (See ~nstmctions) DOCK MODIFICATIONS 13. NAME OF WATERBODY, IF KNOW 0f applicable) EAST HARBOR 14. PROJECT STREET ADDRESS (if applicable) PRIVATE ROAD 15. LOCATION OF PROJECT SUFFOLK NY COUNTY STATE 16 OTHER kOCATION DESCRIPTIONS, IFKNO%~. tSeeinstructions) LAT. 41°IT'00"N, LONG. 71°56'38"W OLD COAST GUARD STATION AT EAST HARBOR, FISHERS ISLAND, NY 17. DIRECTIONS TO THE SITE TAKE FERRY TO FISHERS ISLAND, TAKE EAST END ROAD TO THE LAST LEFT, (DRIVEWAY) PRIOR TO FISHERS ISLAND COUNTRY CLUB GOLF COURSE. TURN RIGHT WHERE DRIVEWAY SPLITS. ENG FORM 4345, Feb. EDITION OF SEP 91 IS OBSOLETE. (Proponent:CECW-OR 18. Nature of ~ctivit~' (Description of project, include all features) ADD 24 (+/-) LF OF 4-FT. WIDE FIXED WOOD PILE AND TIMBER PIER EXTENSION AND A 30 (+/-) LF X 4-FT. WIDE FIXED "L", A BOAT LIFT INCLUDING ASSOCIATED BRACED ~UPPORT PILING AND RELOCATE THREE BRACED TIE-OFF PILINGS ALL WATERWARD OF THE APPARENT HIGH WATER LINE. 19. Project Purpose (Describe hc reason or purpose of the project, see instructions) THIS IS A PRIVATE DOCK FOR RECREATIONAL BOATING. 20. Reason (s) for Dischm'ge N/A USE BLOCKS 20-22 |E DREDGED AND/OR FILL MATERIAL IS TO BE DISCHARGED 21. Type is) of Material Being Discharged and the Amount of Each Type in Cubic Yards N/A 22. Surlhce Pa'ea in Acres of Wetlands or Other Waters Filled (see instructions) N/A 23. Is Any Portion oflhe Work Already Complete? Yes No X IF YES, DESCRIBE THE COMPLETED WORK 24. Addresses of Adjoining Properly Owners, Lessees, Ftc., Whose Property Adjoins the Waterbody (if more than can be entered here, please attach a supplemental list) NORTH: ROBERT GOLDIE, TRUSTEE, LUCILLE BALCOM TRUST, 230 PARK AVE.,SUITE 1130, NEW YORK, NY 10169 SOUTH: FISHERS ISLAND COUNTRY CLUB, FISHERS ISLAND, NY 06390 25. List of Other Certifications or Approvals/Denials Rece red lyon other Federal, State or Local Agencies for Work Described in This Application AGENCY TYPE APPROVAL* IDENT. NUMBER DATE APPLIED DATE APPROVED NYS DEC PENDING PENDING TOWN OF SOUTHOLD PENDING PENDING DATE DEN[ED )Would include bus no restricted to zoning, budding and flood plain permits. 26. Application is hereby made for a permit or permits to authorize the work described in this application. I qertifyI~at the i~formation in this application is complete anll accurate. I thnher certify that 1 possess the authorily to undertake the work described hereill~q,'/a~a a~litlff/ll~ theldulv IFu~hodzed agnntofthe/applicant. SIGNATU~'E OF AP'PLICAN'F}J~ ' d D DATE -- t:~,'r /' /- ,~ · oil~/v~k- f'~ [~l~ SIGNATURE OF A ..... ~JATE ROLLA CAMPBELL ]'he application must be signed by the person ~ho desires to undertake the proposed activity (applicant) or it may be signed by a duly authorized agent if the statement in block 11 has been filled out and signed. 18 U.S.C. Section 1001 provides that: Whoever, in any manner within thejurisdiction of any department or agency of the United States knowingly and willfully falsifies, conceals, or covers up any trick, scheme, or discuises a material fact or makes any false, fictitious or fi-audu]ent statements or representations or makes or uses any false writing or document knowing same to contain an3.' false, fictitious or fraudulent statements or entry, shall be fined not more than $10,000 or imprisoned not more than five ),ears or both *U.S.GPO: 1994-520478/82018 Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 September 20, 2001 Mr. Glenn Just JMO Consulting Services PO Box 447 Quogue, NY 11959-0447 ReL Kim K. Campbell Private Road, Fisher's Island, New YorK SCTM#4-4-16 Dear Mr. Just: The follo~ving action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday. September 19, 2001. RESOLVED, that the Southold Town Board of Trustees grant an Amendment to Permit # 5201 to construct a 3-1/2'x22' ramp in lieu of the proposed 4'x12' ramp for the approved docking facility.. However, this permit does not constitute any other permits fi.om other agencies. If you have any questions, please call our office at 765-1892. Albert J. Krupski, Jr. President, Board of Trustees AJK]cjc CC: DEC Army Corp. Dept. of State Telephone (631) 765-1892 Tovat Ha~. 53095 Ma/n Road P.O. Box 1179 ~outhold. ~Ie~ York Ilg?l SOUTffOLD TOWN CONSERVATION ADVISORY COffl~lCll', At the meeting of the Southold Town Conservation Advisory Council held Tuesday, September 11,2001, the following recommendation was made: KlM K. CAMPBELL to Amend Permit #52.01 to construct a 3 ¼'X 22'. ramp in lieu of'the approved 4'X 12' ramp for the approved docking facility. Private Road, Fishers Island. SCTM~4-4-16 The CAC did not make an inspection, therefore no recommendation was made. FPO~ : ~Tm8 CONSOLTIhlG PHONE NO. : 6S~ 8687 A~9- 14 2800 88:~8RM P82 J,M.O,. Environmental Consulting Services August ] 4, 2000 Southold Town Trustees P.O. Box 1179 Southold, N.Y. 11971-1179 RE: Application for Klm Campbell-dock S.C.T.M.No. 1000-004.4-16 Dear Sirs: AUG / Enclosed for your review and files please find a copy of the N.Y.SD.E.C. Permit recently issued for this project. arb Phone (631 ) 653-0607 · Fax (631 ) 653-3348 121 Jessup Ave., 2nd Floor · P.O. Box 447 Quogue, New York 11959-0447 FPO~ : ImO CON'BIJLTIN~] PHONE NO, : ~5~ 060? Aug, i4 2000 OP~:~SAfd PO~ New York State Department of Environmental Conservation Division of Environmental Permits, Region One Br~[Idlng 40 - SUN'(, Stony Brook, New York 11790-2356 Phone; (631) 444-0365 · FAX: (631} 444-0360 Web$1te: www.dec,state,ny.us John P, Cshlll Kim K. Campbell 895S Southeast Bridge Road, Suite 2002 Hobs Sound, FL 33455 August 1, 2000 RE:1-4738-02707/00001 Dear Per~ittee: In conformance with the requir ants of the State Uniform Procedure~ Act (Article 70, ECL) and its implementing regulatlons (~NYCRR, Part 621) we are enclosing your permit. Please read all conditions care- fully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the Weather. Very truly yours, enclosure Environmehtal Analyst I FROM : 3mO CONSULTING PHONE NO. : 653 060? STATE DEPARTMENT OF ENVIRONMENTAL EONRERVATIO~ PERMIT Under the Envlror~nental Cc~Bervatlon Leu Aug. 14 2000 08:39AM PO4 EFFECTIVE DATE , Au)ust 11 ZOO0 Auguat $1, 2003 F I TYPE OF PERMIT J New 0 Renewal D Modification [] Permit to Construct D Permit to Operate PERMIT ISSUED TO I TELEPHOgE NUMBER _Klm K.Cempbetl {631) 788-5550 ,] NAME ARD'ADDRESS OF PROJECT/FACiLITY Campbel ! Property Private Read - off East End Road LOCA110N OF PRO,IECT/FACILI?¥ F~shers la[end NY 06390 D~-~CRIPTTON OF AUTHORTZm. D A~TTVIT~ ITELEPNDNE NU14BER (651) 653-0607 By acceptance of thle permit, the parmlttee agrees that the permit ts contingent upon strict comptlance w~th the ECL, ail applicable regulations, the General Conditions specified ieee page 2 & 3) and any Speclat Condftlo~e l~clUded as part of thte permit. PERNIT ADMINIGTRATORz Roger Ewne HEP AUTIIORIZED SIGNATURE Page I of 4 FPO~q : ~Tml--I CONSLILTING JO PHONE NO. : 6,53 0607 Aug, 14 2000 08:39Ar'1 PI~5 N ~ STA'rE OEPARTMENT OF ENVIRONMENT^L CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permlttea Accepts Legal Responsibility and Agrees to Indemnification The permlttee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, Its representatives, employees, agents, and assigns for all claims, suits, actions, damages, and costs of every name and descrlplion, arising out of or resulting from the permittee's undertaking of ectlvlt(es or operation and malnten, ance of the facility or facilities authorized by the permit In compliance or non-compliance with Iht terms and conditions of ~he permit. Item B: Perrnlttee's Contractors to Comply with Permit The permlttee Is responsible for informing Its Independent contractors, employees, agents and assigns of Ihelr responsibility to comply with this permit, Including all special condlllons while acting as the perml[tee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environments Conservation Law as those prescribed for the permlttea. Item C: ' Permltllea Responsible for Obtaining Other Required Permits The permlttee is responsible for obtaining any olher permits, approvals, lands, easements end rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permlttae any right to Irespass upon the lands or Interfere with the riparian rights of others In order Io perform the permitled wo~k nor does ti authorize the impairment of any rights, title, or interest In real or personal property held or vested In e person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, Including relevant records, is subject to inspection at reasonable hours and Intervals by an authorized representative of the Department of Environmental Conservation (Ihe Department) to determine whelher the permittee is complying with this permit and the ECL. Such representative may order the Work suspended pursuant to ECL 71-0301 and SAPA 401(3}. The permlttee shall provide a person to accompe~y the Deparlmant's representative during an Inspection to the permil area when requested by the Department. A copy of this permit, Including ell referenced maps, drawings and special conditions, must be available for inspection by the Department et ell times at the project silo or faclllly. Failure to produce a copy of the permit upon requesl by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department. issuance of this permit does not modify, supersede or rescind any order or determlnallon previously Issued by the Deparlment or any of [he terms, oondltlons or reclulraments conlatned In such order or determlnallon. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit, a separate written application to the Department for renewal, modification or transfer of this permit. Such application must Include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be In writing. The perml/tee must submit a renewal application at least: a) 180 days before expiration of permlis for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Faclfltles (SWMF): and b) 30 days before expiration of all olher permit types, Submission of applications for permit renewal or modlf/callon ere to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook, NY 11790-2356 General Condition 4: Perml(~ Modifications, Suspensions and Revocations by the Department The Deparlment reserves the right to modify, suspend or revoke this permit. The grounds for modlllcetion, suspension or revocallon include: a) the scope of the permit[od activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit wes obtained by misrepresentation or failure to disclose relevant facts; c) new material Informalion is discovered; or d) environmental condillons, relevant lechnology, or applicable law or regulation have melerieIly changed sfnce the permit was issued. 1-4738-02707/00001 PAGE 2 OF..~. FPOM : ~TrnO CONSULTING PHONE NO. : 65~ 0F~07 Auc~. 14 2000 08:40AM P06 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAl. CONSERVATION PEr~MIT.IW ~¢1, rev ~g ADDITIONAL GENERAL CONDITIONS FOR ARTICLE8 15 (TITL£ $), 24. 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) 1. If future operations by the State of New York require an alteration In the position of the structure or work herein authorized, or if, In the opinion of the Department of Environmental Conservation It shell cause obslrucllon to Ihs free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or des(ruction of the natural resources of the State. Ihs owner may be ordered by Ihs Deperlment Io remove or el(er the structural work, obstructions, or hazards caused thereby without expense {o the State, and it, upon (he expiration or ravoca[Ion of this permll, (he structure, fill. excavallon, or other modification of Ihe watercourse hereby authorized shall not be compleled, the owners, shall, without expense to the State, and Io such ex(ant and rn such time and manner as (he Department or Environmental Conservation may require, remove all ~r any portion of the uncompleted struclure or fill and restore lo Its former condition Ihe navigable end flood capacity of the walercourse. No claim shall be made against the Slate of New York on account of any such removal or alteration. 2, The State of New York shall In no case be liable for any damage or inJury to the struc(ure or work herein authorized which may be caused by or result from future ope(aliens undertaken by the State I'or the conservallon or Improvement of navigation, or for other purposes, and no claim or right 1o compensation shall accrue from any such damage. 3. Granting of this permit does nol relieve Ihs applicant of the responsibility of obtaining any olher permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard. New York State Office et General Services or local government which may be required. 4, All necessary precautions shall be taken to preclude col]lamination of any wetland or wale(way by suspended solids, sediments, fuels, solvents, lubricenls, epoxy Coatings, paints, concrete, leachers oreny other envlronmenlally deleterious male(leis associated with the project. 5. Any material dredged In {he conduct of Ihs work herein permitted shall be removed evenly, wtlhou( leaving large refuse plies, ridges across (he bed oF a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shell be no unreasonable interference with navigation by Ihs work herein authorized. 7. If upon the expiration or revocation of this permll, /he project hereby authorized has not been completed, the applicant shall, wllhout expense Io the State, and Io such exlent and In such time and manner as the Deperlmen( of Envlronmenlal Conservallon may require, remove all or any portion of the uncompleted structure or fill and res(ore Ihs site to I(s former condition. No claim shall be made againsl the Slate of New York on account of any such removal or alteration. If granlod under 6NYCRR Per RISR fh,~ ~v.~ no~,,- ,',,ertl o~ Cn',,Ironmo ',lei CUl Io~1 ~'d[FJfl ! ereoy cer[irtes that (he subJectproJectwJ notcon(ravenaeffluentlimlta onsorotherllmi at°nsorstandardsunderSections301,302,303, 306 and 30? of tho Clean Water Ac.t nf 1 ~77 (~1 O~;_~ ~ 7) pr~,,*,lao~ Ih¢~t oil or 1.1~o t.u~ll(Iu~l~ Iluteo herein are met, g. At least 48 hours prior (o commencement of the project, the pa(milles and contractor shall Sign and return the top portion of the enclosed notification form cart ~'ing that they are t'ully aware of and unders and all terms and conditions of this perm t. Within 30 days of cornplellon of projec, the bottom portion of fl~e form must also be signed and returned, along with photographs of the completed work and, tf required, a survey. 10. All actlvllles authorized by this pa(mil must be in strict conformance with the approved plans submitted by Ihs applicant or his agent as part of the permit application. Such approved plans were prepared by a_Qj'~r. Palm@r & Kln~l on 5/'10/o0 DEC PERMIT NUMBER 1-4738-02707/00001 P~'~.~30F.~._ FROM ~mO CONSULTING PHONE NO. : 653 0607 Au9. 14 2000 08:41AM PO? NEW YORKSTA?EOEPARTM~NTOFENVIRONMENTALCONSERVA?iON SPECIAL CONDITIONS 1. Dock or limber catwalk shall not exceed 4 feet In wldlh and shall be a minimum of 3% feet above grade* over Ildal wetland areas (' as measured from ground to bottom of dock sheathing). 2. Floats and ramps may not rest on ar be stored In any vegetated tidal wetland. 3. No dredging, excavating or other alteration of shoreline ar underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities In the future. No permanent structures may be Installed on dock/catwalk/float without first obtaining written Department approval (permit, modification, or amendment). Pilings may not: (a) extend beyond property lines, (b) be pieced so that docked boats extend over property lines, (c) Interfere with navigation, (d) interfere with ether landowners riparian rights. No struclures are 1o be constructed on pilings without further authorization of the Deparlment. 1-4738-02707/00001 PAGE 4.~ of 4 FLOA'D~O DOC~ Vi/ ,+' RA~P W/ RAIUNO5 KEY MAP SCALF~ 1'=2000' S'".T~/};~ 4~/'../~ ~ PR~ F~ '~~.~7~ ,.,., ,. ~_.~..~,, ~ ~5 O 50 ~. ~FFDLK CDUNTY TAX MAP REF. ~IC SC~E IN ~ET ~L~ ~ .~ ~ ~ DIST. lo00 SEC. o0~ ~LDCK 4 LDT ~G ~Y ~,2~ ~~ ~.~_~ § 1 J MAY 10, 2000 PROPOSED 20' LONG X 6' WlDE FLOAllNG DO(~ PLAN OF PROPOSED DOCK PREPARED FOR KlM K. CAMPBELL FISHERS ISLAND, NEW YORK -~D£ v~lrw* -~.'~o . '":;: T6p.~ls PI.AN OF PROPOSED DOCK ui,.,'::,~,:..< o~' PR~ FOR F~SHERS iSLAND, NEW YORK New York 'State Department of Environmental Conservation NOTICE The D. epartment of Environmen,-- ,", ........... . · ,., ~.,~-~rva[ion (DEC) h.a.s Issued permft(s) p.ursuant to the Environmental Conserv for_w_o.rk b.emg 'conducted at this site. For . ah.on_.L, aw regarding lhe natur-, .,.-,-, ------ - - , further mformahon .~ ,,,,u uxJen[ or WOrK a roved ~D_e. pa. rtmental cond~hons on i ~_~,,,,~,,,...__P~P . and any ~am~mstrator hsted ~,--.-,-. ,',,- . . eg~onal Permft .,.,~,uw. r-mase refer to the ermi shown when contacting the DEC.P t number Permit Number /-FTJ2~ Expiration Date '_',--~ Regional Permit Administrator JOHN W. PAVACIC NOTE: This notice is NOT a permit Dear Sirs: Mrs. Lucille Balcom The Boat House Fisher's Island, NY 06390 August 17, 2301 I am writing to object to the fact that my neighbors,l~r, and Mrs. Rolla& Kim Campbell of Fisher's Island, New York have been given permission to build a 140 foot dock in front of their property in East Harbor, Fisher's Island. I sent two previous letters regarding my objections to this dock, heard nothing back. I have learned recently from my neice, who spoke to The Army Corps of Engineers and the Dept. of Environmental Conservation that neither of my letters were receivedby these organizations. Although the dock is going to be built beginning in Sept.2001, I would like to register with all of you my concerns. East Harbor is a lovely, quiet,small,open harbor. Nothing has marred this harbor for over fifty years, and small and larger boats have enjoyed this harbor all summer long because of its beauty, swimming, f~shing and good water. Many boats anchor along the shore to enjoy these pleasures. I feel it would certainly limit some public'usage to have such a hugh dock in this harbor, which has been so beautifully preserved for so long. Lobster catching is done in this harbor, too, and this dock would limit space for this. I see the dock limiting public use in an area they have always enjoyed. East Harbor is one of the few protected,open harbors left along the NY and Connecticut shores and the preservation of its natural beauty,wild life and public use should be protected and the waters should be left as open as possible. I realize that personal issues do not come into play in decisions you make regarding requests for docks, but I think it is important for you to know that the couple who are building this dock are doing it for Mrs. Campbell's adult son who visits the island for approximately 10 days to two weeks a year and would like to,perhaps,get a boat some~ay. ~Oir. and ~,~,s. Ca~,~pbell are good friends, but I just do not think this harbor should oe disturbed for such a reason. Furthermore, I am 89 years of age, the dock is only 90 feet from my deck over the water, and the noise involved with pile driving will be terrible in September,while I am in residence until the end of October. I would appreciate hearing your thoughts in regard to this letter, which I am sending to Southol~) the Dept. of Engineers and the DEC. cc: Dept of Coastal Resources Yours sincerely, Luci 11 e., i B~I ~onl .... Board Of $outhold Town Trustees SOU,THOLD, NEW YORK PERMIT NO. ,,~O~,OI ... DATE: ~-g.~. ?.~....2.g..O0 KlM K. CAMPBELL ISSUED TO .............................................................................................................................. Pursuant to the 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 OrdJnanca 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 Jn accordance with the Resolution of The Board adopted at a meetlncj held on ~..u..~........~.~.~. ..... I~g.g....., and in consideration of the sum of $....~.~.0.......0..Q ...... paid by ....... K~.~.....K.:.....q am,~.~.~J=! ......................................................... : .................... of ........ ~.~-~.~:,~...~.~.~ ......................................... N. Y. a.d subiect to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the followlncj: Wetland Permit to construct a 4'Xi 120' fixed dock elevated 4' above grade, 4'X 12' ramp, 6'X 20' float and (4) out Files all in accordance with the detaiJed spec;ficatlons as presented in the odcjinatlncj application. IN WITNESS WHEREOF, The sald Board of Trustees here- by causes its Corporate Seal to be af~.~xed, and these p.resents to be subscribed by a'majorlty of the sa,d Board as of th~s dat~. - · TERMS and CONDmONS The permi~ Kim K. Campbell 8965 South East Bridge Rd., Ftobe Sound, FL residing at N. ¥~ a~ pa~t of the consideration for the ismance of Rte permi~ do~ understand and pt~,cri~e to the fol- lowing: 1. That the said Bo~trd of Trustees ~ the Town of So~thogd rte released fz~n ~ny all damages, or ~t.;.,,. for damages, of mits tdsing directly or lndlm~y ts a ~ of ~my ope~- atloa pedonned puz~u~t to this p-~a% and the =/d P-,~,~*~ee w/Il, at ~ ot 1~ own with respect thereto, to the complete exdudon of the Boa~ of Tnute~ o/the Town o/ · 2. Tl~t ~ P~m~t is' v'.dld fo~. pezlod of 2 4 mo~ which ....... zor aa e~teaston may oe maae to the Boa_ed at z l._te_t date. 3. That thh Permit shou/d be zetalned indefinitely, or as long as the mid P~tzee ~d.shes to malmain the structure or project involved, to p~ovide evidence to anyone concerned ~h~t ~mth- odzadon was originally obta/necL 4. That :he wo& iavolved will be subject to the inspection sad approval of Cbc Board agents, a~ci noa-complla~ce with the provisions o~ ~ae ori~g application, may be ,~,,~ revocation of this Petmlt by te~olutlon of the said Boa~L 5. That ~ere will be no mu'ea.~,~-~e interference with tmvigation as a result of the wodt he.in ~u'thodzed. 6. Tha~ there shall ~e no interfet-ence with the tight of the public ~o ~ and t~-pass along the beach between high and low water m~rks. 7. That if future operations of the Town of Southold ~ the ~emoval and/or nlte. mdons in the location of the v~- he. In mthotized, or ifs in ~he opinlo~ of the Bo~d of T~ the. work ~h.l! cause unreasonable obsttucnon to free navig~d_,~ t~e said Petmittee will be teclatte~ upo~ due notice, to remove or ~lter this wot~ or project herein stated without e~emes to the Town of Soathold. 8. That the said Boazd will be notified by the Petmittee ot the ¢om~le~on'of the work lath. o~L 9. That the Permittee will obtain all other pezmits sad con.se~ts dmt n~7 be :ec/ulzed sup. plement~ to this permit which n~7 be subject to revoke upon fn;l,,~ to ob~n same. Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 29, 2000 Mr. Glenn E. Just J.M.O. Environmental Consulting P.O. Box 447 Quogue, NY 11959-0447 Re: KIM K. CAMPBELL SCTM#4-4-16 Dear Mr. Just: The following action was taken by the Board of Town Trustees during its regular meeting held on August 23, 2000 regarding the above matter: WHEREAS, J.M.O. Environmental Consulting on behalf of KIM K. CAMPBELL applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated July 17, 2000, 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 August 23, 2000 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 structure complies with the standard set forth in Chapter 97 of the Southold Town Code, 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 the Board of Trustees approve the application of KIM K. CAMPBELL to construct a 4'X 120' fixed dock elevated 4' above grade, 4'X 12' ramp, 6'X 20' float and (4) out piles. BE IT FURTHER RESOLVED that this determination 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. Permit to construct and complete 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: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms cc: DEC ACE Dept. of State SITE KEY MAP SCALE: 1"=2000' PROPOSED DOCK x -4.36 PROPOSED 20' LONG X 6' WIDE FLOATING DOCK W/ ~' WIDE P.N~P w/ ~UNGS PROPOSED PIUNGS x -3.25 PROPOSED FIXED DOCK 120' LONG X 4' WIDE -~' 70'55'00' W 6... "~-~ 195.31,~. ~ RONN.mD BALCOM m ROCK .---- BOARD OF TRUSTEES · ~ ~[ P~OS[D DOCK D[ST lO00 SEC. 004 BLACK 4 LDT 1G MAY 10,2000 HINGED RAMP W~ RAI[JNGS PROPOSED 20' LONG X 6' WIDE FLOATING DOCK PROPOSED FIXED DOCK ~X-- M.L.W. EXISTING GRADE 5 2.5 0 VERTICAL SCALE 5 20 10 0 HORIZONTAL SCALE PO MAY 10, 2O00 PLAN OF PROPOSED DOCK PREPARED FOR KlM K. CAMPBELL FISHERS ISLAND, NEW YORK JUL I MAY 10, 2000 PLAN OF PROPOSED DOCK PREPARED FOR KlM K. CAMPBELL FISHERS ISLAND, NEW YORK Telephone (516) 765-18q~ Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 $OUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, August 15, 2000, the following recommendation was made: KIM K. CAMPBELL 4-4-16 to construct a 4'X 120' fixed dock elevated 4' above grade, 4'X 12' ramp, 6'X 20' float and (4) out piles. Private Rd., Fishers Island The CAC did not make an inspection, therefore no recommendation was made. REPLY TO ATTEN~qON OF Eastern Permits Section DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAVITS FEDERAL BUILDING NEW YORK, N.Y. 10278-0090 August 2, 2000 SUBJECT: Application Number 2000-00898-L2 by Kim K. Campbell To Whom It May Concern: The New York District, U.S. Army Corps of Engineers, has received a request for Department of the Army a~thor~zation for the following activity: APPLICANT: ACTIVITY: WATERWAY: LOCATION: Kim K. Campbell Suite 2002 ~U~ 8965 Southeast Bridge Road Hobe Sound, FL 33455 Construct a 4-foot by 120-foot ~i~er leading to a 4-foot by 12-foot ramp connected to a 6-foot by 20-foot float secured to three pilings with four mooring piles, one off each corner of the float.' The purpose of this project is to provide a safe mooring facility for the applicant's boat. East Harbor, Long Island Sound Fishers Island, Town of Southold, Suffolk County, New York As this is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing 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) (3) (A)), 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 within 15 days date of this letter. of the Enclosures Sincerely, ~ee~f~asH~e~rgnerpt}ermits Section 49 50 FISHERS I S L A N D .. S O U N D · '"~ G A R D I N E R S LIONHEAD' 0 ROCK PROPOSED KEY MAP SCALE: 1"=2000' N/F RONALD BALCOM /~'--NEIGHBORING DOCK PROPOSED PILINGS--% ~M_M'LW'__-'~ bI.H.W EXISTING m ROCK SLOPE PROPOSED 20' LONG X 6' WIDE FLOATING DOCK W/ 4' WIDE RAMp W/ RAIUNGS PROPOSED FIXED DOCK 120' LONG X 4' WIDE FORMER GARAGE LOCATION 70'55'00' W 195.31 '~- \\ 57'67'00' W 66.55' S 42'29'00" 250.00' \ l, PILINGS TD BE DRIVEN B5' MIN. DR TI] REF 2, SUFFOLK Cl]UNTY TAX MAP REF, DIST. lO00 SEC, 004 BLOCK 4 LOT 16 50 25 0 EXISTING RESIDENCE PLAN OF PROPOSED DOCK PREPARED FOR KlM K. CAMPBELL GRAPHIC SCALE IN FEET MAY 10, 2000 FISHERS ISLAND, NEW YORK 50 PROPOSED FIXED DOCK 5 2.5 0 I~m m VERTICAL SCALE 20 JO 0 "' ---- HDEIZDNTAL SCALE MAY 10, 2000 HINGED RAMP W/ RAIUNGS PROPOSED 20' LONG X 6' WIDE FLOATING DOCK M.H.W. f ---EXISTING GRADE PLAN OF PROPOSED DOCK PREPARED FOR KlM K. CAMPBELL FISHERS ISLAND, NEW YORK F=~D ViE_~ D!DE VIEW NOT TO SCALE NOT TO SCALE PLAN OF PROPOSED DOCK PREPARED FOR KlM K. CAMPBELL FISHERS ISLAND, NEW YORK MAY 10, 2000 SHEET 3 OF 3 Docko, Inc. RO. Box 421, Mystic, CT 06355 (860) 572-8939 Fax: (860) 572-7569, e-mail: docko@snet.net Mr. Chuck Hamilton NYS DEC Building 40, SUNY Stony Brook, NY 11790-2356 February 18, 2004 Re: Dock Modifications, Fishers Island Rolla Campbell Dear Mr. Hamilton: We are pleased to submit herewith the revised permit application and drawings for Rolla and Kim Campbell at East Harbor on Fishers Island. These drawings reflect terms of our most recent discussion which was to remove the boat lift and add a tie-off pile in the no/thwest quadrant of the berthing area for boat security during high wind and higher than normal waves. In addition, we had received correspondence from Mrs. Balcom which indicated a strong preference to reduce the height of the tie-off piles fi-oral7 feet and reduce the size of the "L" shaped pier by 10 feet. Both of those modifications have been done as well in the interest of neighborly relations. All of these changes have been coordinated with the New York State, Department of State in Albany and I believe that we have satisfied all concerns. We are awaiting modifications to the Town's permit application process. Evidently, the proposed modifications were considered an expansion of and therefore subject to the moratorium. Nonetheless, we would request issuance of the DEC permit at the earliest opportunity so that these issues can be resolved. Your assistance has been greatly appreciated, as always. Please let me know if the need for further discussion arises. Yours truly, DOCKO, INC. Keith B. Neilson, P.E. Enclosures CC: Dr. & Mrs. Rolla Campbell NYS DOS: Pollay Town: Krupski ACOE: Russell Smith File: 03-03-1409 CAMPBELL OF B,,,N..GOt"I T~U~T L ::: '. : · . ~ p~ /. ... ~OdEGZ' "' -' · '"" ' :~'~J ~ ' POCK ~OOFICATION5 L.OCATION , .: ' - '.:.. :.: '/ '~ . .. __ · · .. · , ~ ~ ~ :: t : '. ' ". · '" ~- --'~'~ ~/F P~OPE~ ' ' '' '" '" 'J~ / OF N~: ' ..: ' ,? /. ! ~COUNT~CLUB ... · :.. ' ,~[ ~ ~ ~ % ~/~, · ' ' .' ' ' . . -~" ~/ ~ '%r : , '; ' and ~TONINeTON '"--"- '..'. '" '.. '.''. ':. ; ' ' "]..,, / ..~.'..~ ~i:.].':"i..'.t ~D~FOF~DEF~DW~DmlLE.~D~BER ' . - · '. - : /, - -~ . .~" · "' - PlE~EN~ION~OA~O~LFX~'kMDEF~D'L', ' . ~TE ~¢,, ', ~. ~- ' .: .'.',' ":. ' .' INCLUDIN~ '.. ' ~O~ LINE (~. ', I -.. ':' :...: '.. · · - -' }~ ::- B~EO ~E~FF ~ILLN~ ~O ~A~ ~E ~I~NG : , : ' . . · ·. · · ..'.' ': [ · :.. · ~ .' ' :~_Z -: :~-~ -~ B~EO~E~FFPlLIN~WA~OF~ ~O~TN~. 5. T~E~E AC~LICATION ~I2.A'CCN~ 124EP~2.E~SENT A COI'flRLAI~ON OF ¢LII;L~,/'~-Y¢ FOR P~RhllT PURPOSES. THEY ~ NOT CONSTRUCT]ON CONT..ACT DOCur'dENTS. 6. ADJOINING FI~HE~-.~ ISLAND COUNT~r' CLU6 Fi~HE~-..~ ISLAND SOuTHOLD, NY NO~FH: ~BBI~F ~OLDIE, J~. ~[ LUCIELE IBALCO~ Nb-NV YOP4(, NY 101~ I:::'l~,O J ECT: ~0Ct4 I~IOOI[=ICATION~ LOCATION: 5UN:OLK COUN'Pr', NEW YO~F. JULY 11, 200..3 DQCKQ, INC. FISHEP.~ ISLAND, TO',.VN OF ~OUTHOLD EXISq~NG 6' × 20' I q .... f-- FLOAT EXSTING BA~ ~i2-~ID / /;24~STla-.AINT PILINGS TIE-OFF PiLE (TYP) ~ . /TO BE 12JEh'IOVEO ~OOTI::~INT OF ...... ~ '-'~' . . LOCA"fqON: FISHE~2.~ I~LANO, TO'vVN OF ~UF'I=OLK. COUNTY', N~NM YO~.K NE'vV TIE-OFF PlLIN-~' ~'T -55 FIXEi2 'L" ~UPPOI~T PiLE (TYP) NEW -:::~ ~ 3.9 -2 I0 -35 N -11 'B o:' -2.9 5.0 x -5.o I~,ELOGA TED TIE-OFF PlLIN~ I-2.6 or TOWN OF: DATI~ /o v .... > -4.2 FOO13:~NT '<-5.5 ;" -5.4 NEW FIXEI~ ~IE~ EN~ EL Q [DEC E~AT L~FT FJXED 'b' [DIM. [:::~d~J ~C T: DOC~ i'ffODIFICATION_5 LOCATION: ~I~HEI~ I~L,AND, TOWN OF 5,OUTHOLD ~U~FOLK COUNTY, N~,,V YORK ~,\(ATEIL:¥VAY: ~T HAI~IBOI~ ~ DA~: JULY 11, 2OO~ ~ ~) ~DCN: ~0~ C~ELL ;.. ~G O~1~9 Ill NEW NEVV ~UPPO~'T 20 PI~OJECT: RE'v'iSEID 2-13-0,~ D~C DONATION: RER LENGTH ~ENT: ~HEET -~ OF ,4- M~c~s, CT 06555 560 572 8-~59 F~< ~60 572 7569 5M/~L; docKo@snet.net Albert J. Krupski, President James King, Vice President Henry Smith Artie Foster Ken Poliwoda /Received Application: f Received Fee: ~ ' f Completed Application Incomplete SEQRA Classification: Type I X Type II Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Office Use Only Unlisted X Coordination: (date sent) /CAC Referral Sent: I~:~,J~ /Date of Inspection: 'l!iq!O Receipt of CAC Report: Lead Agency Determination: Technical Review: ~Public Hearing Held: Resolution: - 2003 S0uth01d Town Board of Trustees Name of Applicant ROLLA CAMPBELL Address P. O. DRAWER, FISHERS ISLAND, NY 06390 Phone Number: (631) 788-7803\~ Suffolk County Tax Map Number: 1000 - 004-4-16 Property Location: PRIVATE ROAD, FISHERS ISLAND (provide LILCO Pole ~, distance to cross streets, and location) AGENT: DOCKO, INC. (If applicable) Address: 'P. O. BOX 421, MYSTIC, CT 06355 Phone: (860) 572-8939 Fax: (860) 572-7569 ! Board of Trustees Application Land Area (in square Area Zoning: feet) GENERAL DATA : 4.3 acres Previous use of property: Residential-Former Coast Guard Station Intended use of property: Residential Prior permits / approvals for site improvements: Agency Date Town of Southold #5201, August 29, 2000 New York State DEC 1-4738-02707/00001, Aug. 31, 2000 X__ No prior permits / approvals for site improvements. Has any permit / approval ever been revoked or suspended by governmental agency? X No Yes a If yes, provide explanation: Project Description (use attachments if necessary) : ADD 24 (+/-) LF OF 4-FT WIDE FIXED WOOD PILE AND TIMBER PIER EXTENSION AND A 30 (+/-) LF X 4' FOOT WIDE FIXED "~', A BOAT LIFT INCLUDING ASSOCIATED BPACED SUPPORT PILING AND RELOCATE THREE BRACED TIE- OFF PILINGS ALL WATERWARD OF THE APPARENT HIGH WATER LINE. Board of Trustees Application WETLAND / TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: NOT APPLICABLE Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and edge of wetlands: feet Closest distance between nearest proposed structure edge of wetlands: feet Does the project involve excavation or filling: X No Yes If yes, how much material will be excavated? How much material will be filled? N/A Depth of which material will be feet upland and upland N/A cubic yards cubic yards removed or deposited: Proposed slope throughout the area of opera~ions: Manner in which material will be removed or deposited: Statement of the of the town that (use attachments effect, if any, on the wetlands and tidal waters may result by reason of such proposed operations if appropriate): 3 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES .. TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application STATE OF NEW YORK) AFFIDAVIT OF POSTING Bosrd ot,lmstee$ being duly sworn, depose and say: That on the ~ day of~c~ ~/ , 200t/, I perst~nally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place/~r eight days prior to the cl~te of the publi% hearing. Date of hearing noted thereon to be held [~q__ ~Z/. )//SetI ~//1~ ~ Dated: (signat~e) Sworn to before me this day o f'~flYv/200~ ~/btotary Public /~ ~ ~/~/~ ~X~/~Z~: NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: ROLLA CAMPBELL SCTM#1000-004-4-16 YOU ARE HEREBY GIVEN NOTICE: That it is the intention of the undersigned to request a Permit from the Board of Trustees to: ADD 24 (+/-) LF OF 4- FOOT WIDE FIXED WOOD PILE AND TIMBER PIER EXTENSION AND A 30 (+/-) LF X 4'FOOT WIDE FIXED "L", A BOAT LIFT INCLUDING ASSOCIATED BRACED SUPPORT PILING AND RELOCATE THREE BRACED TIE-OFF PILINGS ALL WATERWARD OF THE APPARENT HIGH WATER LINE. o That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: PRIVATE ROAD, FISHERS ISLAND 3. That the property which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment. You may con~act the Trustees Office at 765- 1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: ROLLA CAMPBELL MAILING ADDRESS: P.O. DRAWER FISHERS ISLAND, NY 06390 PHONE #: (631) 788-7803 Enc.: Copy of sketch or plan showing proposal for your convenience. 5 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS U.S. Postal Se~wce CERTIFIED MAIL RECEIPT fDomeslic Mall Only: No Insurance Cove,age Prowded) Y m m U.S. Postal Service CERTIFIED MAIL RECEIPT Certified Fee Return Receipt Fee STATE OF CONNECTICUT COUNTY OF NEW LONDON DOCKO, INC. , residing at 14 HOLMES STREET, MYSTIC, CT , being duly sworn, deposes and says that on the ,gt~ day of ~-~¢CW~f-, 200~, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite ~here respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at MYSTIC, CT , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me nhis ~ffa Day of b~Cj~~ , 200~ Notary Public ~ 6 Board of Trustees Application County of Suffolk State of New York ROLLA CAMPBELL 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 ALL 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 TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVE(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. OO SWORN TO BEFORE ME THIS DAY OF VERONICA HAMILTON NOTARY PUBLIC STATE OF NEW YORK NO. 01 HA6067785 QUALIFIED IN SUFFOLK COUNTY T RM EXP,B S... I,P-/17/O 7 Board of Trustees Application (where the ROLLA CAMPBELL AUTHORIZATION applicant is not the owner) (print owner of property) FISHERS ISLAND MYSTIC, CT residing at PRIVATE ROAD (mailing address) do hereby authorize DOCKO, INC. to apply for permit(s) Town Trustees on my behalf. ~)(Owner's signature) (Agent) from the Southold Board of ~001 To~ Hail {53096 M~Lu Ruad P.O. Box {.179 8outho{d, N~.w York 11971 Telel~hone (5].6) 765-1892 (616) 766-1823 BOARD OF ToWN TRUSTRE8 .... TOWN OF 8OUTHOLD LETTER OF REOUEST FOR AN AMENDMENT ~ DATE 8/28/01 OWNER Ki~n'K. Campb'ell PHON~C/O788=55'50 ....... ADDRESS 8965 Sodth East Bridge Rd, Hobe ~.und .... FL ~l~nn.E, J'u~t o~ JMO AOENTConsu±tlng ~erv~ces PHONE 653-0607 Al)DP, Egg P.O'. Box 447, Quogue, NY 11959-0447 PROPBRTYLOCATiON Private road, Fishers Island TAX M~{dmNO.... .1000±4-4-16 //W~ JMO.'C0nsulting r~que~anAiR¢,d~¢,iioP~lmii~5201 to construct a 3½'x 22' ramp in lieu of the approve 4. x. 12' ramp· for the approved docling :facility. (copy of Permit· ¢~5201 enclosed) Signed By: · G1 n E. t as agent Sap 25 O1 AJbert d. Krupski, president James Vdng, Vice. President Henry Sm[th .~r tie Foster Ken Pollwoda oonsultlng 63~53 3348 Town H~ll .63095 Route 26 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1566 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application ......... STATE OF NEW YORK) , /'~ AFFIDAVIT OF POSTING I,~[~ U~ residing a~ . ~eing duly sw~n, depose and s~y: - ' property known as by placing the ~ard of Trustees official poster where it can easily be seen, and that I have checked to be sure the pos%er has remained in place for eight days prior to the ~te of public he, ring. Date of hearing noted e this Nolle/R~blle State of New York No. 48015559 Ouallfleo in Suffolk Co_u[~ty Term Expirea 12,31~ Sep 05 O1 09=16a jMo consultin~ Albert J. I~xupski, presi e~nt James ~ng, Vi~-P~dent He~ Smith ~ie Foster Ken · ~ SSS 348 ' Town Hall 53095 Route 25 P D. Box llq9 Southold, New York 11971-0959 Telephone ($31) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWI~ OF SOUTHOLD In the Matter of the Application COUNTY OF SUFFOLK~ STATE OF NEW YORK) ~etng duly -sworn, depose~a~d ~ ~ -- ' onall sted the That on the~ day o~].,~209[,~pers y.pO property known as ~ ~ 9n~ !| .~' %~__~ ~V~ . . by placing the Board of ~6~ees 'official poster,where ~r can easily be seen, and that I have checked to be sure the pos%er has remained in place for eight days prior to the date of ~he. ~ public h~aring. Date of hearing ed thereon to be hel~/~, ~ Dated: o be~ this YHOMAII ~, OOHE~'I'Y JR, Notmry ~ubH= 8te~e of New No, Oua;;fieo Ln Suffolk Co_u,~ty Term Expires 1 Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO.. ,,~?O~,0 1 ... DATE: .A..u...g..~ ...2..c~.~....:~.l~.00 KIM K. CAMPBELL ISSUED TO .............................................................................. : ....................................................... · Pursuant to the'provhlons of C;hapter 615. o.f the Law, s.,of the State of New York, 1893j end Chapter 404 of the ,L~.ws .ct me -.State Of New York~19$2~ and the Southold To~n.urmnanoe en- titled ."REGULATING AND THE PLAC:ING OF OBSTRUOTIONS IN AND ON TOWN WATERS AND PUBLIC: LANDS and the REMOVAL OF SAND, GRAVEL' OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERSj~: and in accordance with the Resolution of The Board adopted at a meeting held on .A....U..l~..'.....~.:~.,. ..... I~g...'.., and In consideration of the sum of $....~.~.9~.....0...0. ........ pald by ......... ~.!.?.....K..i.....g.~.~ ........................................................................... .~ ..................... of ........ [~.~.L..z.~.l.~."..d.. ......................................... N. Y. and. sublect to the Terms and Conditions listed on the reverse .side hereof, 'of Southold Town* Trustees authorizes and permits {hd following'. Wetland Permit to construct a 4'X: lZO' fixed dock elevated 4~ above grade, 4~X 12~ ramp, 6~X 20~ float and (4) out piles all' in accordance with the detailed speclflca.flons es presented in · the originating application. '- ',~ IN WITNESS WHEREOF, The said Board of Trustees here- by causes lis Corporate Seal fo Joe affixed, and th~se presents fo be subscribed by 'a'majorlfy of fha said Board as of this darn. TERMS and CONDITIONS' Klm K. Campbell te~Idlng at, 8965 South East Bridge Rd., Hobe Sound, FL . p~rt of the comiderattoa for the ~ of ~e P~t d~ ~d~ ~ p~ to ~e fei- nH ~mag~ 0t d~ f~ ~ of ~ a~ ~y ~ ~y ~ a ~t of ~ o~- 2. ~nt ~ Pe~ ~'~d f~ n ~ of 24 ~ W~ h ~ to ~ ~ for ~ ~inn may ~ ~de ~ ~e ~d at a la~ ~ ot~n~on w~ oti~ly ~t~ 4. That the work Involved will be mb}eot to the hts,.cries and approval of the Bot~ et lt~ agents, and non-compUance wh~ the pier, fens of ~e o~--~ IppH~do~ ~y ~ ~ f~ ~fion of th~ Pe~t ~ ~olufl~ of the said B~& ' : 5. That there will be no unreasonable Interference w~th mtv~gadon as It result of the week '. herein su'thothed. .. 6. That there shall be no interference with the tight of the public to pass and repass alee~ the beach between high and low water m,~k~. · 7. Tbet if future opetagotu of the Town of Southold teclulte work shah ~ u~ble ~s~ to f~e u~n due no~ ~ ~ve or alter ~ ~ or pro~ berrie of ~o1~ . e. That the said Board will be nodfled by the Pemdttee et the c~ai'ledon ~f the work anth. ia, m m:s pemut wmcu amy ee subject to revobe upon fa/lute to obtal~ same. aert J. Krupskl, President Jnmes I{i.g, Vice-President IIent3, Smith Attic Foster Ken Poliwoda Town Hal! 53095 Route 25 P.O. Box 1179 $outhold, New York 11971-0959 Teiephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 29, 2000 Hr. Glenn E. Just J.M.O. Environmental C~nsulting P.O. Box 447 Quogue, NY 11959-0447 Re: KIM K. CAMPBELL SCTM#4-4-16 Dear Mr. Just: The following action was taken by the Board of Town Trustees during its regular meeting held on August 23, 2000 regarding the above matter: WHEREAS, J.M.O. Environmental Consulting on behalf of KIM K. CAMPBELL applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated July 17, 2000, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Publl'c Hearing was held by the Town Trugtees with respect to 6aid application on August 23, 2000 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, WREREAS, the structure complies with the standard set forth in Chapter 97 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 TBEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of KIM K. CAMPBELL to construct a 4'X 120' fixed dock elevated 4' above grade, 4'X 12' ramp, 6'X 20' float and (4) out piles. BE IT FURTHER RESOLVED that this determination 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. Permit to construct and complete 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: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms cc: DEC ACE Dept. of State Alberl J. Krupski, President ,tnme~ King. Vice-President [l*-nry Smith A,'¢ie Foster Kon Poliwoda Town Hall 53095 Main Road P.O. Box 1179 ,qoutimld. New York 11971 T~'lcphone (5191 765-18 ~2 Fax (5161 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTItOLD Office Use Only Coastal Erosion Permit Application 7Wetland Permit Application Grandfather Permit Application . Waiver/Amendment/C~ang~ ~ec--6ived Applic~q!/OllqO eived Fee:$ flSD-J ' ,leted Appli~cL~n ~lqJO~ Incomplete __~EQRA Classification: Type I Type II Unlisted Coordination:(date sent) /CAC Referral Sent: of Inspection~2~~ __Receipt of CAC Repot ..~ Lead Agency Determination: __Technical Review: ~,~Public Hearing Held:~_~ Resolution: Name of Applicant Kim K. Campbell Address 8965 South East Bridge Road, Suite 2002, Hobe Sound FL 33455 Phone Number:(C/O)631-788-5550 Suffolk County Tax Map Number: 1000 - 004-4-16 Property Location: Private road no # ~O~v ~(~C (provide LILCO Pole #, distance to cross streets, and location) AGENT: Glenn E. Just/ J.M.0. Environmental Consulting (If applicable) Address:P.O. Box 447, Quogue, N.Y. 11959-0447 Phone: 653-0607 FAX#: 653-3348 Board of Trustees Application Land Area (in sguare Area Zoning: R-120 GENERAL DATA feet): > 1 acre Previous use of property: Existing single family dwelling Intended use of property: same Prior permits/approvals for site improvements: Agency Date X No prior permits/approval~ for site improvements. }{as any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: unknown Project Description (use attachments if necessary): Applicant proposes to construct a 4'x120'fixed dock elevated above grade, 4'x 12' ramp, 6'x 20' float and (4) out piles as per enclosed plans prepared by Chandler, Palmer and King dated 5/10/00. Boated of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Private recreational docking Area of wetlands on lot: n/a square feet Percent coverage of lot: n/a % Closest distance between nearest existing structure and upland edge of wetlands: n/a feet Closest distance betwee~/~earest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? How much material will be filled? n/a Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: n/a Manner in which material will be removed or deposited: n/a cubic yards cubic yards n/a Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): As proposed, project should have no negative impacts upon the waters or wetlands of the Town of Southold. s~T.2o SEQR APPENDIX C STATE ENVIRONMENTAL QUAL~Y REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Proiect Sponsor) 1. APPLICANT/SPONSOR / 2. PROJECT NAME Klm K. Campbell Proposed dock 3. PROJECT LOCATION: ' ~cou.ty Suffolk Mu.icipa,~ Fishers Island Private road no # Location map and survey enclosed 6. DvES~IBE PROJECT BRIEFLY: Applicant proposes to construct a 4'x 120' fixed dock elevated 4'above grade, 4'x 12' ramp, 6'x 20' float and (4) out piles as per enclosed plans prepared by Chandler, Palmer and King last dated 5/10/00. 7. AMOUNT OF LAND AFFECTED: Initiefly . J~ Bores Ultimal.iy "~ seres 6. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER .~XISTING LAND USE ~":~l .t~,TiONS? [] Yel E] ND If no, describe briefly 9. T IS FRt:se:NT LAND USE iN VICINITY OF PROJECT? Single family dwelling and count~?y club 10. D~L~.??ACTION INVOLVE A PERMFF AFFRuVAI. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal State or Southold Town Trustees, [i.Y.S.D.E.C., N.Y.S.D.O.S. & U.S.D.O.A. 11. DOES ANY P CT OF THE ACTION HAVE A CURRENTLy VAUD PERMIT OR APPROVAL? 12. AS A RESUL F PROPOSED ACTION WILL EXISTING P",~,;-'.:T/APPROVAL REQUIRE MODIFICATION? I CERTIFY AT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE . / ~ // .~. .') o,ta .¥ I[~-I(./(J , 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 F~'Cpl · JmO J.M.O. Environme.tal Censultin Ser'vico To whom d! may c4)nceu1; through your ag~lCy eild utllers fIl~olved with lhi~ pro,eot..I M () C',,,~ulh,g S .rv~cem relnin~ to coordinate ~11 ~pplov~l~ ,e~r). {hrough ~t,u, ~,d oil,el imolv(Td a~e~les, a~ i~11 a~ mint areltilect, engmeer a,d ~ntroctot~. We reque~ dmf all Ibc om~ otJ.M.o. ~nvironme,~l Co,,ultin~ Sctvice~ Phono (631 ) 6.~3 060/ · {'ox r6i't ) 653-,R3/IB 121 ,IOr,~uI., Avn · 21'K{ l:k)O~ · I.'.O. BOX 447 30 3E,b'd S,,]30,¢':"H 6t"~S:3:;.&TEgT Z3: T¢ PHONE DEPOSES AND 'AFFIRMS THAT~E/~H~' IS '~E A~P~T FO~ DESCRI~ PE~T(S) ~ T~T ALL STAT~S TRUE TO ~E BEST OF HIS/~ ~O~EDGE wO~ w~ BE ~E IN ~ ~ SET FO~ IN ~D AS ~Y BE ~PROVED BY ~E SO~O~ ~ BO~ OF TRU~T~ES. TH~ APPLIC~ A~ES TO ~O~ ~ ~ OF SO~ ~D ~E TO~ TRUST~ES M~LES~ ~ F~E ~OM ~ ~ ALL D~S ~ CLAIMS ~ISIN~ ~ OR BY ~R~ OF SAID PE~IT(~), IF ~. CO~5ETIN~ ~I~ ~LICATION, I NERVY A~ORI~ ~E TRUSTEES, ~ IN~P~ ~E ~IS~S ~N CONJ~CT=ON AgPLICATION. $~OR~ TO BEFOR~ M~ THIS~~ , ,]913e]..,H 6Pgc<38.~ l: -41 Z2:[0 080E/'90 ,'/_0 Name: Lucille PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Balcolm U.S. Posta~ Serwce CERTIFIED MAIL RECEIPT Address: c/o Fiduciary Trust Co, 2 Center, N.Y.N.Y. 10048 World Trade Sworn to before me this /~ [3- · -- Re[urn Rece,pt Fee i~[~ ~'~.w..!,% ~d~ ~ ~,, ~r~:~:~;-~-~:-------; ................................ .---;-~-~ / COUNTY OF S '~:~'~'--"~""~"~ ~ ........................... UZ ~~ .~S~ . , residing at - u /~%~~, ~ein~ duly sworn, deposes and says that on the /~ day of ~c~ ,~0 , deponent mailed a true copy of the ~tice set forth In the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposlte the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that s~ Notices were mailed at the United States Post Office at ~3D~, that said Notices were mailed to each of said~ersons by (certified) (registered) mall. Not ~ - ~f-"%-----CAROLYN C. HOGAN Qualified in Suffolk County Commission Expires February 20, PROOF OF HAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Fishers Island Development Co Address: Draw E, Fishers Island, N.Y. 06390 U.S. Postal Service CERTIFIED MAIL RECEIPT (Domestic I~lall O~ly: No h~surance Coverage Provided~ ru [ ........................................... COUNTY OF SUFFOLK u /~O~f-~, beinq duly sworn, deposes and says that on the /~ day of' 2~I.~L[ ,~0 , deponent mailed a true copy of the N6tice set forth l~the Board of Trustees Application, dlrected to each of the above named persons at the addrosses set opposite there respective names; that tho addr~o~ ~t oppo~lt~ the namo~ of the addr~s~ of *~td por~ons a~ shown on roll of th~ ~own of Southold~ that ~a~ the United States Post Office at ~D t?~l ~_ , that said Notices were mailed to each of satd~ersons .... (ro~lsterod) mall. rttfled) Sworn to before me this day of / .. , , ~... .... i., St -- ~ '---' No. 4962579 ~mi~ion ~ires Februa~ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD , In the matter of applicant: SCTM#1000- 004-4-16 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Applicant proposes to construct a fixed dock 4'x 120' elevated 4' above grade, 4'x 12' ramp, 6'x 20'float and (4) out piles. 2. That the property which is the subject of Environmental Review~s located adjacent to your property and is described as follows: Private road no #, Fishers Island 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on: - ~You the Trustees Office at contact may 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNER~ NAME: Kim K Campbell MAILING ADDRESS: c/o J.M.0. P.O. Box 447, Qu08ue, N.Y. PHONE #: 631-653-0607 Environmental ConsultinR 11959-0447 Eric.: Copy of sketch or plan showing proposal for your convenience.