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Home My WebLink AboutBolter, Eugene �..}��.,. n.-;�e a.,.r. ,4 . .. �-.. ..'_ •,�,ta:r:?:h;Cv" 01 t+` IIIfF TOWN OF SOUTHOLD TOWN CLERK'S OFFICE, SOUTHOLD, NEW YORK WETLANDS PERMIT This Wetlands Permit No. ...46............ has been granted by the Southold Town Board according to information furnished in Application No. ......60 filed by Applicant ....EU eD.Q.. 3.Q2.t.eX......... ........................................ on J.anuary. . ...2.9..... 19..81.... A map of the proposed work will be kept .. .... ...... .. . .. on file in the Town Clerk's Office under the application number given. Permit granted to do the following work .. construct :a timber dock consisting of...... a 60 ft: by 4 ft : fixed catwalk.,....12 ft: by. hine . rami= ..and :. ..... .... ..... ......... 16 ft, by 6 ft , float plus associated pilings, ................................................................................................................................................................. Location of property on which work to be done ..Broadwaters Road, ,Nassau Point ................. ........�.. ... .......Cac,?�og �.....NQW..YQXX........................................................................................................... ; .................................................................................................................................................................. Creek, Bay or Harbor fronting property .....Broadw,�tsrs„Cov.......... .............;, , 1II, ..,.......j. . .. ....................................................... ........................ .............................. k ........................ ` � � ... Size of work: Length ....... gJI............................ .:............:................:........\:..,, :�.f...... ' Width .............Xt................................ .................... ...................:..:.:..........:....: .... Height Above High Water .... ........................................................ Depth Below Low Water ........ ' Yardsto be Excavated ...........AQP.e.........:..................:...............................,.................... Yardsto be Filled ...........?.QnQ............................................:........................................ Manner in which material is to be removed or deposited ...... .................................................................................................................................................................. Intended use of property ..Residential.............................................................................................. ..........................................................................................................................................:....................... 1 Th 14 : b 14 deck shall be eliminated entirel Conditions if any ......,..........Q...............r...... '.......... t...................................................................At... y• 2: The catwalk shall be not less than 3 ,feet' above ground level . ....................................................................................................................................................... ExpirationDate ........................................................................................................................................ Number of Inspections Required .....-.-- ................................................................................................. Inspection Fees . .. LiabilityPolicies in the Amount of........ :.-...................................................................................... ..... The validity of this permit is or may be subject to the approval-of other governmental or municipal authorities. The Town accepts no responsibility in applying for or,obtaining such approval. 'I n the event that such approval is necessary, the holder of this permit shall not commence operations here- under until such approval has been obtained in writing. The failure to obtain such other approval when required shall subject this permit to immediate revocation by the Town Clerk upon receipt by the, Town Clerk of written notice from such other governmental or municipal authorities of its refusal or, disapproval. tti�tri The applicant does by the acceptance of this permit, assume all responsibility for operations under- taken pursuant to*this permit, and shall take all precautions for-the prevention of injuries to persons and property'resulting from such operations. By such acceptance, the applicant also agrees to indemni- fy and save harmless the Town, and its officers, agents and employees from any and all claims arising from operations under this permit and any and all acts or omissions of applicant, his agent and employees. The applicant and the owner and occupants of the premises upon which the operations authorized by this permit are being conducted, do, by the acceptance of this permit, give consent to the Town, and its officers and employees to enter upon the premises where such operations are being conducted to make such inspections as the Town may deem necessary to insure that such operations are being con- ducted in conformity with this permit. This operation will not substantially: A. Adversely affect the wetlands of the town. B. Cause damage from erosion, turbidity or siltation. C. Cause saltwater intrusion into the fresh water resources of the town. D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife and vege- tation or the natural habitat thereof. E. Increase the danger of flood and storm-tide damage. F. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town. G. Change the course of any channel or the natural movement or flow of any waters. H. Weaken or undermine the lateral support of other lands in the vicinity. I. Otherwise adversely affect the health, safety and general welfare of the people of the town. / Signed �....! ...,..�. , ....... Town Clerk Town of Southo! L �• .1 wr Date......AA.ril....,....I.M1.................................... V, V G . J ' MINUTES OF PUBLIC HEARING -- HELD MARCH 24, 1981 WETLAND' APPLICATION OR EUGENE BOLTER A public hearing was held by the Southold Town Board at the Southold Town Hall, Main Road, Southold, New York on Tuesday, March 24, 1981 at 3: 45 o' clock p.m. in the matter of the applica- tion of Eugene Bolter for a permit under the provisions of the Wetland Ordinance of the Town of Southold. Present were: Supervisor William R. Pell, III Councilman Henry W. Drum Councilman John J. Nickles Councilman Lawrence Murdock, Jr . Councilman Francis J. Murphy Town Clerk Judith T. Terry Town Attorney Robert W. Tasker Absent was: Justice Francis T. Doyen SUPERVISOR PELL opened the hearing at 3: 45 o ' clock. COUNCILMAN NICKLES read the legal notice of hearing, as follows: . .NOTICE IS HEREBY GIVEN THAT a public hearing will be held by the Town Board of the Town of Southold at the Southold Town Hall, Main Road, Southold, New York, at 3:45 P .M. , Tuesday, March 24, 1981, in the matter of the application of Eugene Bolter for a permit under the provisions of the Wetland Ordinance of the Town of Southold for permission to construct a timber dock consisting of a deck, fixed catwalk, hinged ramp, foat and associated pilings at the north side of Broadwaters Road on Broadwaters Cove, Nassau Point, Cutchogue, New York. . . . . .All persons interested in said matter shall appear at-the time and place above specified and will be given an opportunity to be heard. Dated: March 10, 1981 JUDITH T. TERRY SOUTHOLD TOWN CLERK. . . COUNCILMAN NICKLES: I have a Negative Declaration notice and letter from the Board of Town Trustees' stating the following action was taken: Ms. Judith T. Terry Southold Town Clerk Town Hall Southold, New York 11971 Page 2 Public Hearing - Eugene Bolter March 24, 1981 Dear Ms. Terry: The following action was taken by the Board of Town Trusttes at a regular meeting held March 4, 1981: RESOLVED to recommend to the Southold Town Board approval of the wetland application of En-consultants, Inc. for Eugene Bolter subject to the following: 1. Elimination of the 14' x 14' deck because it would be over wetlands according to the Town Law which specifies spatina patens as one of the grasses. 2. Catwalk be a maximum width of three feet and three feet above ground level . Your st;ltrtly,- s/ Anna T. Hataier, President Board of Town Trustees Letter from the Conservation Advisory Council: Ms. Judith T. Terry, Town Clerk Town Hall Southold, New York 11971 Dear Ms. Terry: We are in receipt of your letter (undated) in regard to the wetland application of Enconsultants, Inc. for Eugene Bolter. The Conservation Advisory Council has inspected the property and recommends that the Town Board approve the application subject to the catwalk being 18 inches over the grass. Yours truly, s/ Frank Cichanowicz III, Chairman Conservation Advisory Council COUNCILMAN NICKLES: I also have- Proof of Publication from David H. Walker of the Suffolk Times and Patricia Wood of The Long Island Traveler-Watchman and Judith Terry, Town Clerk that it was posted on the Town Clerk'=s Bulletin Board. SUPERVISOR PELL: You have heard the reading of the notice, does anybody wish to speak in favor of the application of Eugene Bolter? (No response. ) Does anybody wish to speak in opposition to the application? ('No response. ) ' Does anybody wish to be heard on the application? MRS . RUTH OLIVA, North Fork Environmental Council: We would just yr3 Page 3 Public Hearing - Eugene Bolter March 24, 1981 like to say that we have no objection to this application as long as the recommendations of the Trustees are approved. SUPERVISOR PELL: Thank you. Anybody else wish to be heard on the application.' (No response. ) If not, I will declare the hearing closed at this time. COUNTY OF SUFFOLK ss: STATE OF NEW YORK Patricia Wood, being duly sworn, says that she is the ,Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, _ __ _____ a public newspaper printed at Southold, in, Suffolk County; LEGAL NOTICE NOTICEOF-HEARINGand that the notice of which the annexed is a printed copy, ° has been published in said Long Island Traveler-Watch- NOTICE ' IS HEREBY l GIVEN THAT a public hearing man once each week for ........................................weeks will be held by the Town Board a of the Town of Southold at the successively, commencing on the .................................... Southold Town Hall, Main Road, Southold, New York, at day of ................... 19., 3:45 P.M., Tuesday, March 24, 1981 in the matter of the ........................................................................ application of Eugene Bolter for a permit- under the pro- visions of the Wetland Ordih- ance of the Town of Southold for permission to construct a timber dock consisting of a deck, fixed catwalk, hinged, . Sworn to before me this ................................ day of ramp, float and associated a pilings,at the north side of ........................ 19. �. Broadwaters Road on Broad- -waters Cove, Nassau Point, Cutchogue, New York. All persons interested in said matter shall appear at"the time and place above specified and will be given 'an•oppor- tunity ppor tunity to be heard. ` CLEMENT d °�OP�J�OR9 DATED: March 10, 1981. �� Pi�9L9 JUDITH T.TERRY ' 4 e of i�®va Vora C',52-932172.5 SOUTHOLD TOWN CLERK` Co�� is In olgg CNgg 1' 1T,3/12/81(41) em march 30, LEGAL NOTICE Bi___.eaters Cove, Nassau NOTICE OFHEARING Point Cutcho New York. NOTICE IS" -;HEREBY All,persons interested in GIVEN THAT a°public hear- said matter shall appear at ing will,be held by'the Town place above the time and pla Board.of the Town of Southold specified and will la given an at the Southold-,Town Hall, opportunity to be heard. - Main ,Road, Southold, New DATED: March 10,heard. York, at 3:45 P.M.; Tuesday, JUDITH TTERRY DF SUFFOLK, 1 1981. March 24,19881 in the matter of T. � the application of-Eugene Bol- SOUTHOLD TOWN CLERK NEW YORK. ss: ter for a permit under the 1TM12-3640 I J provisions of the Wetland IH Walker. Ordinance of the Town of �"® `:. .! . . . . . . . . . . , . being duly Sworn. Southold for permission to construct a timber dock con- says that . .ha . . , is Printer and Publisher of the SUFFOLK sisting of-a deck, fixed cat- walk, hinged ramp, float and WEEKLY TIMES, a newspaper published at Greenport. in said associated pilings at the north n` f Broadwaters Road on county; and that the notice, of which the annexed is fa printed �� copy. has been published in the said Suffolk Weekly Times once in each week, for . . . . one. . . . . . . . . . . . . . . . . . . weeks successively commencing on the .1?t l. . . . . . . . . . . . . . . . . . . . day of . . . . . . .Max 9.81 GV a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sworn to before me this 12th . . . . day of . . . . . . . 19. $1. j . . . . . . . . . . . . . . :� ,1�,-, , ��iU/. - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HELEN K DE VOE NOTARY PUBLIC,State of New York No 4707878,Suffolk County Term Expires March 30, 19Z3 STATE OF NEW YORK: SS: COUNTY OF SUFFOLK: JUDITH T. TERRY, Town Clerk of' the Town of Southold, New York, being duly sworn, says that she is over the age of twenty-one years; that• on' the .6th day of march 19 81 she affixed a notice of which the annexed printed notice is a true copy, in a proper and substantial manner, in a most public place in the Town of Southold, Suffolk County, New Fork, to wit: - Town Clerk Bulletin Board, Town Clerk Office, Main Road, , Southold, New York 11971 Notice of public hearing on wetland application of Eugene Bolter - 3:45 P. M. , March 24, 1981. I Judith T. Terry Southold Town Clerk Sworn to before me this 6th day of March` 19'81 /A iG,3L(J►../ 0� 1.� � Notary Public I ELIZABETH ANN NEVILLE NOTARY PUBLIC, state of New York No. 52-8125850, Suffolk Coun Term Expires March 30, 19g.._ !I f! LEGAL NOTICE NOTICE OF HEARING NOTICE IS HEREBY GIVEN THAT a public hearing' will' be held by the Town Board of the Town of Southold at the Southold Town Hall, slain Road, Southold, New ,York, at 3: 45 P.M. , Tuesday, March '24), 1981 in the matter of the application of Eugene Bolter for a permit 'under, the provisions of the Wetland Ordinance of the Town of Southold for permission to construct a timber dock consisting of a deck, , fixed catwalk, , hinged ramp, float and associated pilings at the north side of Broadwaters Road on Broadwaters Cove," Nassau Point, Cutchogue, New York. . All persons interested in said matter slial-1 appear at the time and place above specified and will be given an op' portunity to be heard. , DATED: March 10, 1981. JUDITH T. TERRY SOUTHOLD TOWN. CLERK PLEASE PUBLISH ONCE, MARCH 12, 1981' AND FORWARD ONE AFFIDAVIT OF PUBLICATION TO JUDITH T, TERRY, -SOUTHOLD_ TOWN CLERK, TOWN HALL, MAIN ROAD, . SOTJTHOLD. , NE?9 YORK • 119 71 N Copies to_ the following: The_ SuffoYk,, Times The- Long Island Traveler-Watchman Town Board Members Town Clerk Bulletin 'Board ,.O oU JUDITH T.TERRY TELEPHONE TOWN CLERK OF (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT Dated: March 10, 1981 Pursuant to Article 8 of the Environmental Conservation Law State Environmental Quality Review and 6 NYCRR Part 617, Section 617. 10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Board, as lead agency for the action described below, has determined that the project , which is unlisted, will not have a significant effect on the environment . DESCRIPTION OF ACTION Application of Enconsultants, Inc. for Eugene Bolter for a wetland permit . Permission is requested to construct a timber dock consisting of a 141x141 deck, 601x4' fixed catwalk, 121x4 ' hinged ramp, and 16 ''x6 ' float plus associated pilings at north side of Broadwaters Road on Broadwaters Cove, Nassau Point, Cutchogue,N.Y. The project has been determined not to .have a significant effect on the environment for the following reasons : An environmental assessment has been submitted which indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as planned. Because there has been no response in the allotted time from the New York State Department of Environmental Conservation, it is assumed that there is no objection nor comments by that agency. Further information can be obtained by contacting Mrs. Judith T. Terry, Town Clerk, Town of Southold, Town Hall, Main Road, Southold, New York 11971. Copies to : Commissioner Flacke D. DeRidder, Stony Brook Enconsultants, Inc. Building Department , Southold Town Clerk Bulletin Board � 3 RECEIVED BOAR 9 STEES MAR � 1��1 . OUT , Tom Clerk Southold FO COU Telephone �® O 516-765-1938 Southo . 11971 March 6 , 1981 Ms . Judith T. Terry Southold Town Clerk Town Hall Southold, New York 11971 Dear Ms . Terry: The following action was taken by the Board of Town Trustees at a regular meeting held March 4, 1981 . RESOLVED to recommend to the Southold Town Board approval of the wetland application of En-consultants, Inc. for Eugene Bolter subject to the following: 1 . Elimination of the 14 ' x 14 ' deck because it would be over wetlands according to the Town Law which specifies spatina patens as one of the grasses . 2 . Catwalk be a maximum width of three feet and three feet above ground level . Yours truly, ANNA T. HATAIER, PRESIDENT BOARD OF TOWN TRUSTEES By Muriel Tolman, Clerk I -r ct , SOUTHOLD TOWN . CONSERVATION ADVISORY COUNCIL _ Southold, N. Y. ��'� �® F€B z 5 1991 TOVIC[q, ClW 9010014 February 25, 1981 Ms . Judith T. Terry, Town Clerk Town Hall Southold, New York 11971 Dear Ms. Terry: We are in receipt of your letter (undated) in regard to the wetland application of Enconsultants, Inc. for Eugene Bolter. The Conservation Advisory Council has inspected the property and recommends that the Town Board approve the application subject to the catwalk being 18 inches over the grass. Yours truly, FRANK CICHANOWICZ III, CHAIRMAN CONSERVATION ADVISORY COUNCIL By Muriel Tolman, Secretary OFEIGiOF OWN: C`L'ERK T,oN,1V':_O SOiJ T O JUDITH T.TERRY UFFOLR=CQ171T TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 February 10, 1981 Mr. David DeRidder Environmental Analysis Unit N.Y.S . Dept . of Environmental Conservation Building 40, SUNY - Room 219 Stony Brook, New York 11794 Dear Mr. DeRidder: Enclosed is application of Encpnsultants, Inc, for Eugene Bolter for a wetland pexm,it and short Environmental Assessment Form pertaining to the same. This project is unlisted and our initial determination of non-significance has been made and we wish to coordinate this action to conform our initial determination in our role as lead agency. - May we have your views on this matter. Written comments on this project will be received at this office until March 2, 1981. We shall interpret your lack of response to mean there is no objection by your agency. Very truly yours, Judith T. Terry Town Clerk Enclosures cc: Commissioner Flacke Southold Town Building Department Enconsultants , Inc. OF�k'ICEpp�Ok-Z _ E.:TO'11�N CLERK TO OF SOUTHOIDY JUDITH T.TERRY • SUFFO_ LK-COL7NTI' TELEPHONE T o1VN CLERK " ,-„`w;.a ;,~; R4 (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 February 2, 1981 To Whom It May Concern : Attached hereto is Environmental Assessment Form completed by Enconsultants, Inc. for Eugene Bolter in connection with his wetland application no. 60 for a wetland permit. Permission is requested to construct a timber dock consisting of a 14' x14' deck, 601x4' fixed catwalk, 12 'x4' hinged ramp, and 161x6 ' float plus associated pilings at north side of Broadwaters Road on Broadwaters Covp, Nassau Ppint Cutchogue, New York. ��rJudith T. Terry Town Clerk Posted on Town Clerk' s Bulletin Board on 2/2/81 ' K� ^'„J'.a .i'd�'�,,;Vin'•”rt~'L,4',C'Y;ari,x2.'S:;;i,'fSr'ii'`Z'^:r'+ ",:.'w u'1+:�ya F.t""{ 'c"-,�. -es,+is:�c 've�;.a-• •.x. _ d �' ,. '',rte �, ice. ., t. ,_ .,..._. „ n;r•+_. . ,.�.-,r.-�r,�',%_ - �';�; '..a€.±�; �:��:� 3J�;Y� .�c� ,'�"�;�%�:'��"µ�M`»,^ .-t;,... �'., c•;...''t�,�,, "°x""ro `'f' Ltj+ tt'!°:- . OFF¢iCE'OE 04VN;m.0 L FORK OW,N OF SOUTHbED JUDITH T.TERRY IJRF6LICO11N 'Y TELEPHONE TOWN CLERK ' x (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 . Southold Town Board Southold Town Hall Southold, New York 11971 Gentlemen: Transmitted herewith is application no. 60 for a wetland permit submitted by Enconsultants, Inc. for Eugene Bolter. Copies of this application have been forwarded to the Board of Town Trustees and Conservation Advisory Council on this date for their report of findings and recommendations. Very truly yours, Judith T. Terry Town Clerk JTT/bn Enclosures F RAI o ICF�.UF;y`�'0117N C 1� RK O, F, OU -1 L JUDITH T.TERRY SL7FF.OrK` OIJN TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 Mr. Frank Cichanowicz III , Chairman Conservation Advisory Council Southold Town Hall Southold, New York 11971 Dear Mr. Cichanowicz: Transmitted herewith is application no. 60 for a wetland permit submitted by Enconsultants, Inc. for Eugene Bolter. Please prepare a written report of findings and recommendations with respect to this application and submit said report to me within 20 days of receipt of this letter. t } Very truly yours, Judith T. Terry Town Clerk JTT Enc.losures 1C) OF, 0 Cv RK r9 =ate. — :firms '; �W `O OLTT H r . JUDITH T.TERRY SFEO i C ._•LAN TELEPHONE TowN CLERK � (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 Mrs. Anna Hataier, President Board of Southold Town Trustees Southold Town Hall Southold, New York 11971 Dear Mrs. Hataier: Transmitted herewith is application no. 60 for a wetland permit submitted by Enconsultants, Inc. for Eugene Bolter. Please prepare a written report of findings and recommendations with respect to this application and submit said report to me within 20 days of receipt of this letter. Very truly yours, Judith T. Terry Town Clerk JTT Enclosures Town Of Southold Town Clerk's Office Southold, N. Y. APPLICATION FOR WETLANDS PERMIT Application No. ................................ Date of Application ..............1.1.29./Al............ .... Identity of Applicant ....... -.consultants, Inc.....................for...Eugene...Bolter..,............... ... . .... ..... ............ 64 N. Main st. Broadwaters Road Southampton, N.Y. 11968 Cutchogue Addressof Applicant ............................................................................................................................. INSTRUCTIONS FOR PERMIT A. This application is to be completely filled in by typewriter or ink and submitted to the Town Clerk in quadruplicate, accompanied by writter permission from the owner of the property if not the some as the applicant. B. Pilot Plan must be drawn to scale on the reverse side of this application showing the location of property, the names and locations of owners of adjoining properties, and a detailed description of proposed project. (Note: Copies of the Pilot Plan may be made by a copy machine and attached to the Permit Application:) C. No operation shall be initiated by the applicant until all permits that are required are issued. D. A detailed statement of the rehabilitation and proposed condition of the premises after the work is completed must be given, including a survey if required. E. If permit is being sought for a more sizeable excavation than the construction of a private single dock or jetty, then this application must be accompanied by a survey and topographical map certified by a registered land survey or Professional Engineer. The horizontal control of survey shall be based upon an approval local coordinate system. The vertical control for elevation and sound- ings shall be based upon United States Coast and Geodetic Survey and/or United States Geological Survey datum. F. A statement must accompany the application describing any known prior operations conducted on the premises in question and whether any prior licenses or permits have been issued to erect structures or to dredge or deposit fill on said premises and whether any such permits or licenses were ever revoked or suspended by a governmental agency. G. A filing fee of $25.00 shall accompany the application. This filing fee includes one inspection, there is a $5.00 fee for each additional inspection. H. The Town Board upon requestt�� applicant for a permit, may waive in whole or in part, the provisions of Article 11, Section ,'subdivisions 6) and (where it finds that nature of the proposed operations are such. that 'the requirements of such provisions are not necessary for a proper consideration of a permit application. I. Upon approval of this application the Town Clerk will issue a permit to the applicant. Such permit shall be available for inspection at any time, upon request. Examined ................................. ................ 19....... Approved ............................................................... Disapproved ........................................................... Conditions, if any ................................................................................................................................. .................................................................................................................................................................. ................................................................................,................................................................................ ExaminingBody ....................................................,................................................................................ Signatureof Chairman ................................................................................................................ ..... APPLICATION IS HEREBY MADE to the Town Board of the Town of Southold, Suffolk County, New York, for the issuance of a permit pursuant to the Laws, Ordinances and Regulations govern- ing the Coastal and Interior Wetlands, Flood Plains and Drainage Areas of the Town of Southold: ;constt•uct-a timber dock consisting of a 14'x14' deck, 60'x4' Permit requested to ................................................................................................................................. fixed catwalk, 12'x4' hinged ramp, and 16'x6' float plus associated pilings. ................................................................................................................................................................. Location of property for which permit wanted...,Broadwaters Rad,..oad, Nassau Point, Cutchogue .................................................... ................................................................................................................................................................. Home address of permit applicant if different from aforesaid location ..�1.X..gQxxtYSggdg ,ce„to„ En-consultants, Inc. ................................................................................................................................................................. Creek, Bay or Harbor fronting property .......Bro .....adwate, rCo.......... s.. ....ve.......................................................... ................................................................................................................................................................. Size of proposed work: Length ......... see description above................,................................................................................ Width ..................................................................................................................................................... HeightAbove High Water ........X......................................................................................................... DepthBelow Low Water ........................................................................................................................ Yardsto be Excavated .......................................................................................................................... Yardsto be Filled ......................0........................................................................................................... Width of canal creek or bay fronting roe 1500'+ Depth at Low Tide ..3............... Average Rise in Tide .. .. .9�� ................................................................................................................ o� • Is this for private-'or business use? .........................Private ................................................................. Area Zoning ........residential.. .................. ................................................................................................................. Manner in which material will be removed or deposited ........n/.a.................................................... . .................................................................................................................................................................. Intended use of property ......resident.i.a.l.,..no....,change ...... . . . . .... ................................................................................ ...........................................................•................................................................................................. Written consent of owner of property, if not the same as the applicanti X enclosed ........................................ .................................................................................................................................................................. .........4................................................................................4....................................................................... COUNTY OF SUFFOLK ) SS: STATE OF NEW YORK ) ......... ................................I ...Roy L. Haje being duly sworn deposes and says that he is the applicant for the above described permit, and that all statements contained herein are true to the best of his knowledge and belief; that the work will be done in the manner set forth in this application and as may be approved by the Town Board of the Town of 'Southold. The applicant agrees to hold the Town of Southold and the Town Board harmless and free from any and all damages and claims arising under or, by virtu of said permit, if granted. 0 Signatu e Applicant Sworn to efore me this ... �. ...- .......... day of ... . ... ...... .... ......... ..., 19-1V ... .:.� .... ... ......... ..... . Notary Pubic BARBARA A. KELLY Nelary Public,State&N.Y' To�nNMNitabWe,so.198./... 14-16-3 (12/78) APPENDIX B SHORT ENVIRONMENTAL ASSESSMENT FORM INSTRUCTIONS: (a) In order to answer the questions in this short EAF is is assumed that the preparer will use currently available information concerning the project and the likely impacts of the action. It is not expected that additional studiee, research or other investigations will be undertaken. (b) If•any question ,has been answered Yes the project may be significant and a completed Environmental Assessment Form is necessary. (c) If all questions have been answered No it is likely that this project is not significant. (d) Environmental Assessment 1. Will project result in a large physical change to the project site or physically alter more than 10 acres of land? . . . . . . • • • . . . Yes No 2. Will there be a major change to any unique or unusual land form found on the site? . . . . . Yes No 3• Will project alter or have a large effect on an-existing body of water? . . . . . . . . • • Yes No 4. Will project have a potentially large impact, on groundwater quality? • . . Yes No 5• Will project significantly effect drainage flow on adjacent sites? . . . . . . . . • . • • Yes No 6. Will project affect any threatened or endangered plant or animal species? . . • . • . . • • . • Yes No 7• Will project result in a major adverse effect on I air quality? • • Yes No 8. Will project have a major effect on visual char- acter of the community or scenic views or vistas known to be important to the community? • . Yes No 9• Will project adversely impact any site or struct- ure of historic, pre-historic, or paleontological importance or any site designated as a critical environmental area by a local agency? . • . Yes No 10. Will project have a major effect on existing or I future recreational opportunities? s Yes i No 11. Will project result in major traffic problems or cause a major effect to existing transportation systems? • s • • • • • • • • • • Yes No 12. Will project regularly cause objectionable odors, noise, glare, vibration, or electrical disturb- ance as a result of the project's operation? . Yes No 13• Will project have any impact on public health or safety? . • . . • . • • M_ Yes No 14. Will project affect the existing community by directly causing a growth in permanent popula- tion of more than 5 percent over a one-year period or have a major negative effect on the character of the community or neighborhood? . Yes No 15• Is there pubCa, ' co ersy concerning the projec Yes No PREPARER'S SIGNATURE: �( i TITLE: 1L'� V REPRESENTING: l DATE: 9/1/78 '"tlrt y,i-•,i' ,'�!� !,'�'P'''�;t'''1i,n'r`sto:.b't" wy,,t;tx�I�a�ut',.`�'";i,:;" ',{, ,i� vl - •. � ' a !• ;i :', i'�;r•'y 't ,ry. 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