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HomeMy WebLinkAboutDavid, Mildred TOWN OF SOUTHOLD TOWN .CLERK' S OFFICE ' SOUTHOLD, N.Y. WETLANDS PERMIT This Wetlands Permit # 29 has been granted by the Southold Town Board according to information furnished in Application # 42 filed by Applicant Kurt A. Koehler, a/c Arthur -and Mildred David on October 15 1979 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 place a 36 ft. by 3 ft. wooden - catwalk over a grass area at private property atEugene Creek, Cutchogue. Location of property on which work to be done Stillwater Avenue, Cutchogue, New York. Creek, Bay or Harbor fronting property Eugene Creek Size of work: Length 36 ft Width 3 ft. Height Above High Water 1 in. Depth Below Low Water 0 Yards to be Excavated none * Yards to be Filled none Manner in which material is to be removed or deposited --- intended use of property residential, private recreational use of owners. Pa Conditions if an Expiration Date ---- Number of Inspections Required Inspection Fees ---- Liability Policies 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. In the event that such approval is necessary, the holder of this permit shall not commence operations hereunder 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 The applicant does by the acceptance of this permit, assume all responsibility for operations undertaken 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 indemnify and save harm- less 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 opera- tions are being conducted to make such inspections as the Town may deem necessary to insure that such operations are being conducted in conformity with this permit_ Thisoperation 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 vegetation 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. O'Lherwise adversely affect the health, safety and general welfare of the people of the town. S`E ; E A L" Signed Town Clerk, Town of4Vouthold Date January 22 , 1980 1 PUBLIC HEARING ON APPLICATION FOR MR. & MRS . ARTHUR DAVID FOR A WETLAND PERMIT A public hearing was held by the Southold Town Board at the Southold Town Hall, Main Road, Southold, New York 11971, at 3 : 08 P.M. on the 8th day of January, 1980 in the matter of the appli- cation of Kurt A. Koehler on behalf of Mr. and Mrs. Arthur David for a permit under the provisions of the Wetland Ordinance of the Town of Southold for permission to place a 36 ft. by 3 ft. wooden catwalk over a grass area at private property at Eugene Creek, Cutchogue, New York. PRESENT were : Supervisor William R. Pell III Justice Frederick J. Tedeschi Councilman John J. Nickles Councilman Henry W. Drum Councilman Lawrence Murdock, Jr. Town Clerk Judith T. Terry Town Attorney Robert W. Tasker ABSENT was : Justice Francis T. Doyen SUPERVISOR PELL opened the hearing at 3 : 08 P.M. COUNCILMAN DRUM read the legal notice of hearing, as follows: "NOTICE OF HEARING. Notice is hereby given that a public hearing will be held by the Town Board of the Town of Southold, New York on January 8 , 1980 at 3 : 00 o 'clock P.M. in the matter of the application of Kurt A. Koehler on behalf of Mr. and Mrs. Arthur David for a permit under the provisions of the Wetland Ordinance of the Town of Southold for permission to place a 36 ft. by 3 ft. wooden catwalk over a grass area at private property at Eugene Creek, 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: December 4 , 1979 . BY ORDER OF THE SOUTHOLD TOWN BOARD By JUDITH T. TERRY TOWN CLERK COUNCILMAN DRUM (continued) : I have an affidavit that this has been published in the Long Island Traveler-Watchman. I have an affidavit that this has been published in the Suffolk Weekly Times, and also has been published on the Town Clerk' s Bulletin Board, Town Clerk ' s Office, Main Road, Southold. I have a letter s a Public Hearing held l/ , 0 Application for Mr. & Mrs . Arthur David Page 2 from the Southold Town Conservation Advisory Council to the Southold Town Board: "Gentlemen: The following action was taken by the Southold Town Conser- vation Advisory Council at a regular meeting held October 23, 1979 . Resolved to recommend to the Southold Town Board approval of Wetland Application #42 submitted by Kurt A. Koehler on behalf of Mr. and Mrs. Arthur- David. The application is for permission to place a 36 ' x 3 ' wooden catwalk over a grass area at private property at Eugene Creek, Cutchogue. Yours truly, Frank A. Kujawski, Jr. , Chairman Southold Town Conservation Advisory Council" I have a letter from the Board of Town, Trustees to the Town Board: "Gentlemen: The following action was taken by the Southold Town Trustees at a regular meeting held November 5, 1979. Resolved to recommend to the Southold Town Board approval of Wetland Application #42 of Arthur David for permission to place catwalk over grass area at private property of the ap- plicant at Eugene Creek. Yours truly, Muriel Tolman, Clerk I have a Negative Declaration, Notice of No Significant Effect on the Environment. I guess that ' s about it. SUPERVISOR PELL: All right, you have heard the reading. Does anybody wish to speak for the applicant? (There was no response.-Y, Does anybody wish to speak against the applicant? (There was no response. ) To that, does anybody wish to be heard on the subject? Any comments from anybody? (There was no response. ) If not, I ' ll call the meeting closed. The hearing was declared closed at 3 :10 P.M. Respectfully submitted, �6r4s2&�).�61 eftzt(_��- I M . L.F. Kowalski, Secretary LEGAL NOTICE NOTICE OF HEARING COUNTY OF SUFFOLK NOTICE IS- HEREBY STATE OF NEW YORK ss. GIVEN that a public hearing will be held by.the Town Board of the Town of Southold°at the Southold Town Ha11;.,Main Patricia Wood, being duly sworn, says that she is the Road, Southold,'198U at 3:00 o'clock New York on Januar 8�198Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, P.M. in the matter_of the , I o public newspaper printed at Southold, in Suffolk County; application of Kurt A. Koehler on behalf of Mr. and Mrs., and that the notice of which the annexed is a printed copy, Arthur David for a permit ' has been published in said Long I land Traveler-Watch- under the provisions of the Wetland Ordinance of the man once each week for ........................................ weeks Town of Southold for permis- -sion to place a 36 ft. by 3 ft. successively, commencing on the .....dl............................. wooden catwalk over a grass area at private property at day of .. �............. 19.1. .. Eugene Creek, 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 to be heard. DATED: December 4, 1979 BY ORDER OF THE Sworn to before me this .................... .. clay or SOUTHOLD TOWN BOARD JUDITH T.TERRY, J........., 19../..G�. Town Clerk 1T,12/27/79(1071) Notary Public ANTOINETTE SERKOSKI NOTARY Pll,WC, Sta'e of N,vv York Resid-•i; in Surtalk County No 52-4300796 'or.,,iission Expires March 30, 19f2l LEGAL NOTICE NOTICE OF HEARING NOTICE` IS ;- HEREBY' f GIVEN that�a-public hearing .� COUNTY OF SUFFOLK1 will be held by the Town ,Board'- s3, of the'Town of Southold'at the. STATE OF NEW YORK, J Southold Town _Hall,,-MainY, t Road, Southold, Nevi York on" JOAN GZTS TAVS ON r January 8,1980;at 3:00,dclock_ • „ • • • • being duly Sworn, P.M. in the matter, of. the. i application of Kurt A.Koehler says that . . . . . , is Printer and Publisher of the SUFFOLK on behalf of Mr.&Mrs.Arthur f David for a permit under the • WEEKLY TIMES, a newspaper published at Greenport, in said -provisions of the Wetland Ord- inane of the Town of Southold county; and that the notice. of which the annexed is a printed for:permission to place a 36 ft. by_;ft.-wooden catwalk over a grass area at private property copy. has been published in the said Suffolk Weekly Times at Eugene Creek, Cutchogue;" New York. once in each week. for ONE • • • • , , , weeks said matr shalla dt appear at- successively commencing on the . ,twenty®s even tb. • • • • . the, time and place above De c emb specified and will be given an' day of . . . . . . . . . .e r.. . . . 19 7 9 i opportunity to be heard: • • • • . . :"" 7 DATED:, - . . . . . . . . . . . , . December 4,,1979 BY ORDER,OF Sworn to bgfore me this . . .,�2 . . . . . ... i THE SOUTHOLD ` c� TOWNBOARD J day of !{ .,���P� r�.l. 19.7. !. J r JUDI TERRY ��� r rf• • . . . . ' TOWN CLERK .�. . . . . .` . . . . . . . �1TD27-3354 - ' ' ' . . , . . • • . MARGARET A. YOUNG NOTARY PUBLIC, State of New York Suffolk County - No. 52-9776395 Term expires March 30, 198J { , f STATE OF NEW YORK: SS : , COUNTY OF SUFFOLK: !I I JUDITH T. TERRY, Town Clerk of the Town of l Southold, New York, being duly sworn, says that she is over. the Wage of twenty-one years ; that on the 5th day of December 119 79 she affixed a notice of which the annexed printed notice is a true copy, in a proper and substantial manner, in a I{ �imost public place in the Town of Southold, Suffolk County, New I I iYork, to wit:- Town Clerk Bulletin Board, Town Clerk Office Main Road, Southold, N.Y. 11971 j f� l ii I, Notice of hearing upon application of Kurt A. Koehler, a/c 4,!!Mr. & Mrs. Arthur David for a wetland permit - 3: 00 P._M. , January { 8, 1980 i I' Judith T. Terry, ToA Clerk I I R� jiSworn to before me this 5th day of December , I _ i' 19 79 i. - �I r� J Notary Publi j ELIZABETH ANN NEVILLP NOTARY PUBLIC, State of New York No. 52-8125850, Suffolk CouppS.ty Term Expires March 30, 19?�4 I i E i' t { �i I I LEGAL NOTICE NOTICE OF HEARING NOTICE IS HEREBY GIVEN—that a public 'hearing wi'll ,be held by the Town Board of the Town of Southold at the Southold Town Hall, Main Road, Southold, New York on January 8, 1980 at' 3 : 00 o' clock P.M. in the matter of the application 'of Kurt A.' Koehler on behalf of Mr. & Mrs. Arthur David for a permit under the provisions' of the wetland Ordinance of the Town of Southold for permission to place at 36 ft. 'by 3 ft. wooden catwalk over a grass area, at private property at Eugene Creek, 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: December 4, 1979 BY ORDER OF THE SOUTHOLD TOWN BOARD JUDITH, T. TERRY TOWN CLERK PLEASE PUBLISH ONCE, DECFMBER 27, 1979 , AND FORWARD ONE AFFIDAVIT OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK, MAIN ROAD, TOWN HALL, SOUTHOLD, NEW YORK 11971. Copies to the following on December 5, 1979 : The Suffolk Times The Long Island Traveler-Watchman Town Clerk Bulletin Board Mr. Kurt A. Koehler SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL Southold, N. Y. November 28, 1979 Southold Town Board Main Road Southold, New York 11971 Gentlemen: The following action was taken by the Southold Town Conservation Advisory Council at a regular meeting held October 23, 1979. Resolved to recommend to the Southold Town Board approval of Wetland Application #42 submitted by Mr. Kurt A. Koehler on behalf of Mr. and Mrs. Arthur David. The application is for permission to place a 36' x 3' wooden catwalk over a grass area at private property at Eugene Creek, Cutchogue. Yours truly, FRANK A. KUJAWSKI, JR. , CHAIRMAN SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL By Muriel Tolman, Secretary BOAR STEES OUT FO CO_ U Telephone e� Q 516-765-19381 Southo . 11971 November 27, 1979 Southold Town Board Town Hall Southold, New York 11971 Gentlemen: The following action was taken by the Southold Town Trustees at a regular meeting held November 5, 1979. RESOLVED to recommend to the Southold Town Board approval of Wetland Application #42 of Arthur David for permission to place catwalk over grass area at private property of the applicant at Eugene Creek. Yours truly, Muri�man, Clerk FEfJt, 'C�.WN�`C K JUDITH T.TERRY �S:• OEfk' C TELEPHONE TOWN CLERKS REGISTRAR OF VITAL STATISTICS a , (516) 765-1801 Southold, L. I., N. Y. 11971 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENS1'IRONMENT Dated: November 23, 1979 Pursuant to Article 8 of the Environmental Conservation Law State 'Environmental Quality Review and 6NYCRR Part 617, Section 617. 10 and. Chapter 44 of the Code of. the Town of Southold, notice is hereby given that the Southold Town Board, as lead agency for the action described below, has determined that the project will not have a significant effect on the environment. DESCRIPTON OF ACTION Application of Kurt A. Koehler, a/c Mr. & Mrs. Arthur David for a wetland permit. Permission is requested to construct a stationary 36 ft. by 3 ft. wooden catwalk over grass area at Stillwater• Avenue on Eugene Creek, Cutchogue, New York. The project has been determined not to have a significant effect on the environment for the following reason; 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. Further information can be obtained by contacting Mrs. Judith T. Terry, Town Clerk, Town of Southold, Main Road, Town Hall, Southold, New York 11971. Copies to: Kurt A. Koehler, a/c Mr. & Mrs. Arthur David Commissioner Robert F. Flacke, DEC, Albany Roy L. Haje, DEC, Stony Brook Suffolk County Department of Planning Building Department Town of Southold Town Clerk Bulletin Board RECEIVED New York State Department of Environmental Conservation NOV � 11979 Am Regulatory Affairs Bldg. 40, SUNY - Room 219 Stony Brook, NY 11794 Town Clerk Southold (516)- 751-7900 Ro_bert-;,F.•-F1acke Comm i s s loner November 19, 1979 Office of Town Clerk Town of Southold Southold, NY 11971 Dear Ms. Terry: Re: Kurt Koehler Wetland Appl. #42 (catwalk)_ This project is located within State jurisdiction, so will need New York State Dept. of Env. Conservation approval as well. Forms have been sent. Re: John C. & Frank J. Diller Minor Subdivision Since the subdivision of land is further than 300' from tidal wetlands this proposal is beyond state jurisdiction. Re: Wim. L. & Muriel A. Murray Minor Subdivision Since this is further than 300' from the nearest tidal wetland and further than 100' from the nearest freshwater wetland over 12.4 acres it is- beyond NYS DEC jurisdiction. Re: Geo. L. Penny IV Minor Subdivision Since Lily Pond and its associated wetlands total less than 12.4 acres, this proposal does not come under NYS DEC jurisdiction. Re: Roger H. & Richard J. Praetorius Minor Subdivision This proposed action does not conform to tidal wetland development restrictions which require a minimum of 40,000 sq. ft. on propose lots in unsewered areas. NYS DEC approval is required of all new subdivisions--,of land extending into tidal wetlands and areas adjacent to them. No application has been received. Forms will be sent. Very truly yours, Robert Thurber W/cr Environmental Analyst OFI E OF.�Y'Oti CORK TOWN;.OR SO HOLD JUDITH T.TERRY 'SUFFOLK`COUNT TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS r _rr%7if Southold, L. I., N. Y. 11971 November 1, 1979 Mr. Roy Haje Environmental Analysis Unit Building 40, SUNY - Room 219 Stony Brook, New York 11794 Dear Mr. Haje: Enclosed find application of Kurt A. Koehler, a/c Mr. & Mrs. Arthur David for a wetland permit and short Environmental Assessment Form. This project is unlisted; other agencies may be involved but the optional coordinated procedures for designating lead agency and determining signif- icance will not be followed. The Southold Town Board wishes lead agency status. (SEQRA) May we have your views on this matter. Written comments on this project will be received at this office until November 20th. We shall interpret lack of response to mean- there is no objection by your agency. Very truly yours, d. Judith T. Terry Town Clerk Enclosure ; "a O �FICE_.OF T61ti- Utt tRK TO�W,N`"OF SOLJT OL JUDITH T.TERRY tSIJFFOLK:COL�]VTY TELEPHONE TowN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 October 15 , 1979 Supervisor James Homan Southold Town Board Members Southold Town Hall Southold, New York 11971 Gentlemen: Transmitted herewith is application no. 42 for a wetlandpermit submitted by Kurt A. Koehler, a/c Mr. & Mrs. Arthur David. Copies of this application and environmental assess- ment form have been forwarded to the Board of Town Trustees and Conservation Advisory Council on this date for their report of findings and recommendations. Environmental Assessment Form has also been posted on the Town Clerk' s Bulletin Board. Very truly yours, Judith T. Terry Town Clerk K U C w �'" Y� OEF1�C'I :O TOOti N- CV RK �OW;N9 OFA SOUTHOLD -ate. JUDITH T.TERRY SUFE0LK,v'GQ "NT. TELEPHONE TOWN CLERK „; (516) 765-1801 REGISTRAR OF VITAL STATISTICS �` < Southold, L. I., N. Y. 11971 October 15, 1979 Mr. Frank Kujawski, Jr. , Chairman Conservation Advisory Council Marratooka Road Mattituck, New York 11952 Dear Mr. Kujawski : Transmitted herewith is application no. 42 for a wetland permit submitted by. Mr. Kurt A. Koehler, a/c Mr. & Mrs. Arthur David. 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 r •. OU,ILE QF J RK OW1V.O `SOUT O.]✓D JUDITH T.TERRY SUFF.OL I COL`, T TELEPHONE TOWN CLERK . �, � (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 October 15, 1979 Mr. Philip Horton, President Southold Town Trustees Town Hall, Main Road Southold, New York 11971 Dear Mr. Horton: Transmitted herewith is application no. 42 for a wetland permit submitted by Mr. Kurt A. Koehler, a/c Mr. & Mrs. Arthur David. 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 r JUDITH T.TERRY �EV OK TELEPHONE TowN CLERK ' ►• (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 October 15, 1979 To Whom It May Concern: Attached hereto is Environmental Assessment Form completed by Kurt A. Koehler in connection with his application no. 42 for a Wetland Permit. Mr. Koehler representing Mr. & Mrs. Arthur Da vid requests permission- to construct a walkway over grass area at Eugene Creek. Judith T. Terry Town Clerk Posted on Town Clerk, Bulletin Board 10/15/79 r - Town Of Southold Town Clerk's Office Southold,N. Y. APPLICATION FOR WETLANDS PERMIT Application No. ......T..� .................. '/Date of Application .....�.D..�..�.�.....1.�.�.. ............ Identityof Applicant .... ....................................................... /Address of A licant .. 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 written'permission from the owner of the property if not the same as the applicant. B. Pilot Plan must be•drown 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 elevatipi% d 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 reques ,pf f�e applicant for a permit, may waive in whole or in part, the provisions of Article ll, Sectio , subdivisions (1J and (0-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. f 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: Permit requested to .. �.� ..1�.t...�.�.Q..a.4�ff.p.................................................................... Location of property for which permit wanted...°-�.. S�T�L L ��A TEA u E tJ�,r... ...... ............................ .................. .........................................../..........��.Yb l�fc'►.................................................................................. Home address of permit applicant if different from aforesaid location .............................................. 1 .d. 'Rx....:n ....................�............�......Ott.�:�................................................................... Creek, Bay or Harbor fronting property �Tv'. �ti�.: K .. ...... ......... .... ......... .............................................. .................................................................................................................................................................. Size of proposed work: Length .......:� 6 ( ................................................................................................................................ Width ...................................................................................................................................................... HeightAbove High Water ......1..".......................................................................................................... DepthBelow Low Water ..........��.............................................................................................................. Yardsto be Excavated .........!.."....c)A .................................................................................. Yardsto be Filled ............... .®. 9................................................................................................. Width of canal, creek or bay fronting roe Qa��T� c�A( „rER,,,®,C;,,,!;4„ I.L.E........ Depthat Low Tide ...... .r .................................................................................................................... i AverageRise in Tide ... ....................................................................................................................... Isthis for private or business use? .... `cA.V.&-r� ;........................................................................... AreaZoning ......1� L:................................................................................................ Manner -in which material will be removed or deposited .................................................................. . .............................................................................................................................................I.................... 0 9 e Intended use of property . .. y.. .............. .. ... ... ...57 ."..................... ..........................................................................................,....................................................................... Written consent of owner of property, if not the same as the applicant ..� ".'. � +K •� ............................ ...... �� .. ,.. .. .. n ,r COUNTY OF SUFFOLK ) STATE OF NEW YORK ) SS: ....................................... . .. ................. �a� .......... 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 virtue o said p rmit, ilf rant ................................................................................. Signature of Applicant Sworn to before me this ..../..:5....................... dayof ........................ . .aa Nota Public JUDITH T. TERRY NoOry Public, State of New York No, 02rW44963 Suffolk county, CommIa©lon Expires March TOWN OF SOUTHOLD SHORT ENVIRONMENTAL ASSESSMENT FORM INSTRUCTIONS : a In order to 'answer the questions in this short EAF it 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 studies, 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 existing body of water? . . . . Yes t,/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 VNo 6 . Will project affect any threatened or endangered plant or animal species? . . . . . . . . . . . Yes No 7. Will project result in a major adverse effect on air quality? . . . . . . . . . . . . . Yes \,//No 8 . Will project have a major effect on visual character of the community or scenic views or vistas known to be important to the community? Yes VINo 9 . Will project adversely impact any site or structure of historic, prehistoric or paleontological importance or any site / designated as a critical environmental area �// by a local agency? -• . • - -- - . . . - Yes No 10 . Will project have amajoreffect on or future recreational opportunities? . . . . . . . . . Yes ✓ No 11 . Will project result in major traffic problems or cause a major effect to existing / transportation systems? . . . . . . . . . . . . . . . . . Yes t/ No 12 . Will project regularly cause objectionable odors, noise, glare, vibration, or electrical disturbance as a result of the project ' s / operation? Yes I/ No 13 . Will project have any .impact •on .public •health. I" or safety? . . . . . . Yes VNo 14. Will project affect the existing community by directly causing a growth in permanent population 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 Nf� 15 . Is there public controversy concerning the / project? . . . . . . . . . . . . . . Yes i/ No PREPARER S SIGNATURE REPRESENTING 1` �EL.�s�\ DATE C t PtOeO5F- D 57'H7"IeNAR h � 3� c� rjDCni G TVuIaLE�' CEJVE(Z G1�A S5 cy _ oil KNOW- in no ddh �C F? LE . /its — cfr r ors Pa�pQs' p i`f}TtU Iv JURY 3 fcr 7C ?�� taJ iOPL=N OV-Fp G-RAss f�Rr"A . J FIVE (6) FAMS or- POLtSP0 LES To ()--tt t'i A eCAN 1 1E C90 t=i=ffT 14 PART' L.ENCTIW wi st / FFt,^t� Otn1 � Ani L NE i N cue- ��frR� y-six (3) /5 CH pr PL A C 6,0 x r= E r= r A P,*r R`r i N vi r r H . FtAsr PAtR 01= PILES 'T� aE PLAGFA ON LAND }_ r MIATY ONE RNA 0N /JALF �� 1 jli, ►'- 1` EP $ HORE L11,ia - p/ Fl,"=TH p 4 LES -c e, Pttac U , na v�r4rEa, , . FcuR (3NA .0N NRLF � Lt ''j�.) rC-E: - " Ro '� 5Nc�RE_ L rN/ � , oso{� i9 ote ilk 32305 - t �0 100 .,2g ofyep �. 0 Of 0*1 10 ° {°srd�h210 ,y0' ;o «o i9, {oerd 56005 10 16 '*z'.a:- '':.'-, ;•'Rs y.•t;-i. - ,•�A;�' .- .. .,,y�' "`��' ik', h'a+;�� --z�i...�i:r'�t'-itt.,.., '�r,'"- ,d, :;.' `'.'` l�a.r. - Q r°O/!° SURVEY FOR ARTHUR DAVID 8 M/LDRED PA V/D 5U80/VISION MAPF/LED/N THE OFF/CE LOT NOS, 17 18 , "NAP OF PROPERTY OF M S. HAND )FTHECLERKOFSUFFOLK COUNTY ON -EPT. /8,/930 ASF/LEVO. 730. AT CUTCHOGUE DATE SEPT TOWN OF SOUTHOLD SCALE; / SUFFOLK COUNTY, NEW YORK NO. 78- 5 UNAUTHORIZED ALTERATION OR ADDITION TO ,THIS -'-GUARANTgEO To ' SURVEY IS A VIOLATION OF SECTION 7208 OF THE VSL/FE T/TL /NSURANCECOMPs NEW YORK STATE EDUCATION LAW. NEW YORK ' *COPIES OF THIS SURVEY NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL,SHALL NA'W/LTONFEOERAL SAV,/1VGS 81 NOT BE CONSIDERED TO BE A VALID TRUE COPY, *GUARANTEES INDICATED HEREON SHALL RUN ONLYTO"THE FOR y ' - IS PRPARED AND ONRSON H S BEHALF OTO,THE TITL.ETHEECOMPANY GOVERN= ' " IIF OF 11/�►� MENTAL AGENCY AND LENDING INSTITUTION LISTEDHEREN,AND TO THE ASSIGNEES LENDING NSTITUT ON.GUARANTEES ARE NOTTHE RANSIFERAALE, TO ADDITIONAL INSTITUTIONS OR SUBSEQU$NT "' ® ' t' 'r �►' OWNERS. r *DISTANCES-SHOWN HEREON FROM PROPERTY LINES TO E?SISTING,S,TRUCTURES ARE FOR A.SPECIFIC PURi?05F AN'W'ARE,NOT TO'BE-USED TO f STABL:iSH- `, *":p�:r , j ,QE F 58 6 A) t 7 iii /� / 1 rL 7 -17 --1Y (aQ.3.�Ln JL. 0—r-401 tip-r, ,c,,•i;,V;,'. :�'f`.'A°.� . 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