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HomeMy WebLinkAboutGazza, Diane OF SOUTHOLD TOWN,CLERK'S OFFICE tOUTHOLD,-NEW YORK VETLANDS PERMIT This Wetlands Permit No. ........... has been granted by the Southold Town Board according to information furnished in Application No, ....... 'January 20 1,9AQ..... A m ap of the proposed work will be kept on f ile.in the Town Clerk's Off ice under the application nu mber given. and catwalk over Dryads Basin Creek, Bay or Harbor fronting property ........... ^^ ^^^^`^^^^^^~~^^^`^~~^~^^^~`^^~~~~^^^^^^^~~'~~~^^^'^^~`^~^^^~^~^^^^^^~^ ~~.'~..~.'.~'.~~..--~..~~~-�-'...^..'.,'�����'~-.' ' - ' 82 ft. .' .' S�mofxvork: ~'....~~...'-'~'.~.'..-__,,_^,____~,~_,_~_._,_~~,,,___~,�_,__~__,~,_~~,__,,~_,,,,.,_,,_,_. 4 ft �^ - - � Width ~''...-�.'���.�..,--..'.'.^_....___,,,,,,,__,_,^,,,,,~,_,,_~,~~,__,__~,,___,,~~,,^~,,_~,,,,,~~,,, . ^ . . 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The valid '� of this permitpermitisor may be subject to the approval of other governmental ormunicipalmunicipal 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 here- under mnti\ suchapprmVolhmmboenobteinedinxvriting. Thmfoi|uretombtoinsuohotherupproVolxxben required shall subject this permit to immediate revocation by the Town Clerk upon receipt by the Town Clark of written notice from such other governmental or municipal authorities mfits nafuoo| or � disapproval. sl' -Ir p, 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 inspeciion's 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. 30 Signed ....... .. . . ... . ............. Town Clerk, Town of Southard -S E;A, L 1980 Date. 1..8................................................. �'Y s't PUBLIC HEARING ON APPLICATION OF DIANE GAZZA -FOR A, WETLAND ,PERMIT " A public hearing was- held by the Southold Town Board at the Southold Town Hall, Main Road, Southold, New York 119711 at • 4 : 00 o 'clock P.M. on the 25th day of March, , 1980 regarding the application of Diane Gazza for a permit under the provi- sions of the' Wetland Ordinance of the Town, of Southold for permission to construct a floating dock and catwalk over the wetlands at her property at 2710 Cedar Beach Road, on ,Dryads- Basin, Southold, New York., Present were: Supervisor William R. Pell III Councilman Lawrence Murdock, Jr. Councilman Henry Wo Drum Councilman John J. Nickles Councilman George R. Sullivan Town Clerk Judith Ti Terry Town Attorney Robert W. Tasker Absent was: Justice Francis T. Doyen SUPERVISOR PELL• opened the. hearing at 4 : 00 P.M. and asked Councilman Murdock to- read the legal notice of hearing and' related documents. COUNCILMAN MURDOCK: 'T: ;have:=.a copy of the legal notice dated March 13 , 1980 . Also, I have notice's from the Suffolk Times and Long Island Mattituck Traveler Watchman that it was published March 13 , 1980. The legal notice reads 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 4 : 00 P .M. o 'clock on the 25th day of March, 1980 in, the matter of the application of Diane Gazza for a permit under the provisions of the Wetland Ordinance of the Town of Southold for permission to construct a floating dock and catwalk over 'the wetlands at her property at 2710 Cedar Beach Road, on 'Dryads Basin, Southold, 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: February 26 , 1980 BY ORDER OF THE SOUTHOLD TOWN BOARD JUDITH T. TERRY, TOWN CLERK. . . . I A - Page 2 Public Hearing held March 25, 1980 Application of Diane Gazza COUNCILMAN MURDOCK (continued) : I have a notice that it was posted on the Town Clerk' s Bulletin Board. We have a letter from the Conservation Council dated -February 25, 1980 . . .Mrs. Judith T. Terry, Town Clerk Town Hall Southold, NY 11971 Dear Ms. Terry: The following action was taken by the Southold Town Conservation Advisory Council at a regular meet- ing held February 2, 1980: RESOLVED to recommend to the Southold Town Board approval of Wetland Application #45 submitted by Diane Gazza to install a floating dock and catwalk overrv:wetlands. . . . Yours truly, Frank Cichanowicz III, Chairman, Counservation Advisory Council Another one addressed to Ms,. Judith T. Terry, Town Clerk': The following action was taken by the Southold Town Trustees at a regular meeting held February 6, 1980: RESOLVED to recommend to the Southold Town Board approval of the wetlands application #45 of Diane Gazza to install a floating dock and catwalk over wetlands at property located at Cedar Beach, Southold, with the con- dition that the width of the catwalk be decreased from five feet to three feet. . . . Yours truly, Anna T. Hataier, President Board of Town Trustees SUPERVISOR PELL: Thank you very much. You have heard the reading of the proposed wetlands application. Does anybody wish to speak against the application? (There was no response. ) There isn't anyone to speak against it? Does anyone wish to speak for the applicant? Does anyone wish to speak on the application? (There was no response. ) If not, I will declare the hearing closed and we will go back into the Town Board regular meeting. Page 3 Public Hearing held March 25, 1980 Application of Diane Gazza The hearing was declared closed at 4: 04 P.M. Respectfully submitted, Linda F. Kowalski LEGAL NOTICE -F COUt4TY OF SUFFOLK NOTICE OF HEARING STATE OF I',dEW YORK NOTICE IS HEREBY { GIVEN THAT a public hearing will be held by the Town Board of the Town of Southold at the Patricia Wood, being duly sworn, says that she is the I Southold'Town Hall, Main Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, Road, Southold, New•York, at 4:00'P.M. o'clock•on the 25th o public newspaper printed at Southold, in Suffolk County; day of Miirch, 1980 in the and that the notice of which the annexed is a printed copy, matter of the application of Diane Gazza for a permit has been published in said Long Island Traveler-Watch- under the-.provisions of the man once each week for ..................... weeks Wetland Ordinance of the """"" """"// Town of Southold for permis- successively, commencing on the .....a sion to construct >a floating dock and 'catwalk.-over, the C� I day of ../? .................. 19 wetlands at her property at6U.... { 2710 Cedar Beach Road, on Dryads Basin, Southold, New York. ...... .................. ......... !........... . All persons interested in said matter shall'appear at the time and place above specified and will b„ given an oppor- tunity,to be heard. Sworn to before me this /.. ............. ... day or DATED: February,26, 1980 BY ORDER OF THE SOUTHOLD TOWN BOARD d% Cr .............. 19..�v.. JUDITH T.TERRY, I Town Clerk 1T,3/13/80(129) UA ................. .... ... .. �� ...... . Notary Public CLEMENT j.THC)MpSON NOTARY PUBLIC,state of Nov,Yorh Na.52-9321725 Residing in Suffolk County Commission EX*63 A.srch 30,fl LEGAL NOTICE NOTICE OF HEARING NOTICE IS HEREBY COUNTY OF SUFFOLK, 1 GIVEN THAT a public hear- t ing will be held by the'Town STATE OF NEW YORK, r ss d Board of the Town of Southold at the Southold Town Hall, JO �N GUS TAVS ON �Main Road, Southold, New . . . . . . being duly Sworn. York, at 4:00 P.M. o'clock on SHE the 25th day of March, 1980 in says that . . . . . . . . is Printer and Publisher of the SUFFOLK the matter of the application of Diane Gazza for a permit I WEEKLY TIMES, a newspaper published at Greenport. in said under the provisions of the 1 Wetland Ordinance of the county; and that the notice. of which the annexed is a printed Town of Southold for permis- ; sion to construct a• floating copy, has been published in NE said Suffolk Weekly Times dock and catwalk over the wetlands at her property at once in each week, for . . . . . . . . . . . . . . . . . . . . . . . . . . . weeks 2710 Cedar Beach Road, on Dryads Basin, Southold, New successively commencing on the th i r t e en th York. . . . . . . . . . . . . . . .. . . . . . . . . . + All persons interested in da of MARCH 19 80 said matter shall appear I y i the time and place above ' p j specified and will be given an j ' ' ' ' ' ' ' ' ' ' ' ' opportunity to be heard. I . . DATED: February 26,1980 Sworn to before //me this . . . . . ..,, BY ORDER OF day of . . /. I��. . . 19 UV. J THE SOUTHOLD TOWNBOARD " " JUDITH ' TOWN CLERK . . . .� ;�(r� lTM13-3401 ANCY R. DOUGLA •NOTARY PUBLIC,State of New York -Residing in Suffollc County Cl'cs. Ido. 52-6086685 Commission Expires March 30,1&2) ��UN tO��S,OUTTt�'L JUDITH T.TERRY S ;Fs ,LTC �I Y TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT Dated: February 26, 1980 \ 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. DESCRIPTION OF ACTION Application of Diane Gazza for a wetland permit. Permission is requested to construct a floating dock and catwalk over the wetlands at her property at 2710 Cedar Beach Road, Southold, 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, Southold, New York ,119 71. Copies to: Diane Gazza Commissioner Robert F. Flacke, DEC, Albany Roy L. Haje, DEC, Stony Brook Building Department, Town of Southold Town Clerk Bulletin Board I i I � I` ! i! i ' STATE OF NEW YORK: SS : Ii COUNTY OF SUFFOLK: ii ;i I( JUDITH T. TERRY, Town Clerk of the Town of II . !! Southold, New York, being duly sworn, says that she is over - the I t; age of twenty-one years; that on the 28th day of FPbriiary li i 19 80 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 II York, to wit:- Town Clerk Bulletin Board, Town Clerk Office i; ! Main Road, Southold, N.Y. 11971 ; I II i, - iLEGAL NOTICE, NOTICE OF HEARING - APPLICATION FOR A WETLAND PEM1IT OF DIANE GAZZA, PUBLIC HEARING - 4: 00 P.M. , MARCH 25, 1950 . f1 Judith T. Terry, Tp4m Clerk II II Sworn to before me this f i 28th day of February i� 1 19 80 t Notary Public ELVABETH ANN NEVILLS l NOTARY FUBLIC, State of New YoPR No 52.8125850, Suffolk CouAS1*�l Tprm Fxolres March 80, 19-- 1 i i I 1, f I. i' 1 .1 f i 1 _ , 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, Main Road, Southold, ,New York, at 4: 00 n.M. -o' clock. on the 25th day_ of March, 1980 in the matter of the ar)-olication of Plane, Gazza for a permit under the provisions of the Wetland Ordinance of the Town of Southold, for permission to construct a floating clock and catwalk over the wetlands at her Property at 2.710 Cedar Beach Road, on Dryads Basin, Southold, 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: February 26, 1980 BY ORDER OF THE SOUTHOLD TOWN BOARD JUDITH T. TERRY TOWN CLERK PLEASE PUBLISH ONCE, M3ARCH 13, 1980 , AND FORWARD ONE AFFIDAVIT OF' PUBLICATION TO JUDITH T. TERRY, TOWN CLERK, MAIN ROAAn, TOWN HALL, SOUTHOLD, NZEW YORE.. Copies to the following on February 28, 19,80 : The, Long Island Traveler-Watchman The Suffolk Times Diane Gazza Town Clerk Bulletin Board SOUTHOLD TOWN •' RECEIVED CONSERVATION ADVISORY COUNCIL VE® Southold, N. Y. FEB 2 5 1980 To�jr, Clerk SQUfhold February 25, 1980 Ms. Judith T. Terry, Town Clerk Town Hall Southold, New York 11971 Dear Ms. Terry: The following action was taken by the Southold Town Conservation Advisory Council at a regular meeting held February 2, 1980. RESOLVED to recommend to the Southold Town Board approval of Wetland Application #45 submitted by Diane Gazza to install a floating dock and catwalk over wetlands. Yours truly, FRANK CICHANOWICZ III, CHAIRMAN CONSERVATION ADVISORY COUNCIL By Muriel Tolman, Secretary RECEIVED BOAR STEES SEB 2 5 1980 OUT RO_ ' COU _ Town Clerk Southold Telephone 516-765-1938 Southo . 11971 February 25, 1980 Ms. Judith Terry, Town Clerk Town Hall Southold, New York 11971 Dear Ms. Terry: The following action was taken by the Southold Town Trustees at_-.a regular meeting held February 6, 1980. RESOLVED to recommend to the Southold Town Board approval of the wetlands application x#45 of Diane Gazza to install a floating dock and catwalk over wetlands at property located at Cedar Beach, Southold, with the condition that the width of the catwalk be decreased from five feet to three feet. Yours truly, ANNA T. HATAIER, PRESIDENT BOARD OF TOWN TRUSTEES By Muriel Tolman, Clerk IM'.AU)AML STATE DEPARTMENT OF EP .._ RATA4 COYSERVATIO;� Bldg. 40, ,SUNY, Stony Brook, NY 31794 .`' NOTICE OF INCMLETE APPLICATION February 11, 1980 , Diane L. Gazza 2850 Cedar Beach Road Southold, NewYork 11971 Tidal Wetlands ;.. " Stream Protection Permit.Applied for:_T,1 , Location Dryads B- s l �G dz a = Leach Harbor 7 Hog Neck/Southold . ' -Application Number: TW 15276-0337 (Pi-ease refer -to this number in aLL your correspondence.) Yom APPL.Ii,�UION FOR THIS,PER'+93'l' IS INCOMPLETE. x You failed to incl-ude with your application the full amount of the re- quired fee. Please submit a check or money order in the amount of $_25.00 _ payable to the Department of Envirccmental Conservation. x ' Please submit the following data: a four ft. wide catwalk("pier) and ramps three ft. over marsh would be pre- ferable to allow continued growth below. Is this acceptable? Different plans show different numbers of floats. Are there two or three? When re- vised consistent plans received this application will be sent to Environ- mental Notice Bulletin for publication and comment period It appeals that other DEC permits maybe required in connection with your proposed-project. In order for a.-comprehensive review of all DEC permits for this project to be rade, it is necessary for you to submit applicatior('a) 'for -the following permit(s) . If- you have reason to request -that all permits not be processed sinmul.ta- , neously please notify the permit agent below to discuss-,the matter. -. It has been determined that your project is subject to Article 8 of- the —" Envixcrmental Conservation Law, the State Environmental Quality Review _,' , Act (SEgR) Your application will be considered complete when y For further information, -contact -thisoffice. ae -N.-�h ber Telephone Number �, �,-__�00 If you-wish to withdraw your application rather than complete it', please f notify the permit agent for refund of application fee. 14-12-5 j10/-77) `;'7:p A�;.• R.�;i"Y._,{+ `i,j�Y'i•w=�•yt-7 r r e- - Y ``{'''u`;k' of>;Southold.Town er Clks '_�,i;,.:,;,',L',a;G,,i�'!t:*., ••cc:'.,Town � ',r•,`: _ r _ - I _. �•;�• ;;, ':�#r�'}�'�ri(},. 1) 't�,y�.� ;��:+v--d�t^ �`,�`S,t;. .i.�, ,,rrr^• - ' - "t .,'�ry 'r.%'r',,t '�„-;. ': '�yl,p,.t ytrG�'Y,te�"RM�� +M•'' =f�M$.n. ,y ,r -F, ;�`, t�'' 4�','� = -- y '.3,Y `>if'tii�}t•n.'1�"' :�-S -p vb�%5'' ?'. :4:,+r,'pJ _ �11'r• `4 '7.n`'- _ :bY'+J .fit �'li,�'•``. - �c'' i�f;v' ''air t'�'' •i"'-i 'n'., .�d%",•„ •i;: .� rr:ylya'r, � 1�.r'a, "'.t, fir- ,z,. ' _,y' :,. .. t r;�.: ;� `•ti',:' J`.t a .�-r� '� y,,' �* '' ..�b :,'vn: ��' i• t ''ix^,m'Y"Sr L 'r. F`-,�,�rr^k •, rte'+ •,,r _ „r:�. •'-i n.f•.Y.� t�..-,.�., k,/'�K`+ a''Y .r'n-,;=rc't. '�,t';4=_• ;-a - '"t.`'♦F - .. ...,.,.4';.. ,r ,,d.e : .' , ,• .i 4,x•rtM1 n e •r yr •,.y,pya tpa,,,", a.,r. ' ;tr�}+�.v�;«?xr.:u*.'�v6•��.a�ecx4�.-ru Srtl:,Ma-.:; -,:,,,fSi tiv?, ,..• `, , -�.'4:: - , r•15`r..C.,r'r.:�a'.'=.r;aq;g+a..:C�r2.•�,F:.. .. ., - , � -t�A�l i...4wride., _-n aQF K QL JUDITH T.TERRYTELEPHONE Town CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 February 5, 1980 Mr. Roy Haje Environmental Analysis Unit Building 40, SUNY - Room 219 .Stony Brook, New York 11794 Dear Mr. Haje: Enclosed find application of Diane Gazza 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 significance 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 February 25, 1980 . We shall interpret lack of response to mean there- is no objection by your agency. Very truly yours, Judith T. Terry Town Clerk Enclosures cc: Building Department OFFICE OFi 'C�tiN IlERK ' OWN§bFa SOUTHOI D JUDITH T.TERRY SUFFYOLK�-'O NT( TELEPHONE --ad•4' YJ •r.3 '' jh 1 ToNvN CLERK ." (516) 765-1801 REGISTRAR OF VITAL STATISTICS ' Southold, L. I., N. Y. 11971 January 28, 1980 To Whom It May Concern: Attached hereto is Environmental Assessment Form completed by Diane Gazza in connection with her application no. 45 for a wetland permit. Ms. Gazza is requesting permission to install a floating dock and catwalk over wetlands, property located at 2710 Cedar Beach Road, Southold, New York. Judith T. Terry 61/� JTT/bn - Town Clerk cc:file Posted on Town Clerk Bulletin Board on 1/28/80 � f s Sl- OF,Vt t� ft Pour O FSQ.IIT OL JUDITH T.TERRY SFF,O�LK=`COUIY TELEPHONE TOWN CLERK ,`fPo3 r`: .� � (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 January 28, 1980 Supervisor William R. Pell III Southold Town Board Members Southold Town Hall Southold, New York 11971 Gentlemen: Transmitted herewith is application no. 45 for a wetland permit submitted by Diane Gazza. Copies of this application and environmental assessment 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 JTT/bn cc:file Enc./ OFFICE OFT,TO C`L �tK TQVUN OFA,SOU_T` 02 JUDITH JUDITH T.TERRYSUFEOI UIV �' TELEPHONE TowN CLERK ..� ,�,� 1� x3 (516) 765-1801 REGISTRAR OF VITAL STATISTICS r Southold, L. I., N. Y. 11971 January 28 , 1980 Frank Cichanowicz III, Chairman Conservation Advisory Council Lupin Drive Cutchogue, New York 11935 Dear Mr. Cichanowicz: Transmitted herwith is application no. 45 for a wetland permit submitted by Diane Gazza. 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/bn cc:file Enc./ 11 f e{ ami Y' � � OF>r 1,:oF `�o N' E K T6 N=,,O SOUT 0115 JUDITH T.TERRY �S;U'FF K_=COU;l -yl TELEPHONE b-•''r'r J i � YV TOWN CLERK °�`. � ° (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 January 28, 1980 Mrs. Anna Hataier, President Southold Town Trustees Town Hall, Main Road Southold, New york 11971 Dear Mrs. Hataier: Transmitted herewith is application no. 45 for a wetland permit submitted by Diane Gazza. 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/bn cc:file Enc./ 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 ufdo 2 . Will there be a major change to any unique or -unusual land form found on the site? . . . . . . . . . . Yes eINo 3 . Will project alter or have a large effect on existing body of water? . . . . . . . . . . . . . . . . . . . . . . Yes /' No 4. Will project have a potentially large impact on groundwater quality? . . . . . . . . . . Yes V�o 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 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 No 9 . Will project adversely impact any site or structure of historic, prehistoric or paleontological importance or any site / designated as a critical environmental area g// bya local agency? • . . . . . . . ... . . . •:� . : . : . . . . - Yes No 10 . Will project have amajor effect on existing g// or future recreational opportunities? . . . . . . . . . Yes No 11 . Will project result in major traffic problems /` or cause a major effect to existing // transportation systems? . . . . . . . . . . . . Yes " No 12 . Will project regularly cause objectionable odors, noise, glare, vibration, or electrical disturbance as a result of the project ' s operation? . . . . . . . Yes No 13 . Will project haveanyimpactonpublichealth or . safety? . . . . . � . . Yes �/No 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 ,J neighborhood? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 15 . Is there public controversy concerning the project? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YesZNO PREPARER ' S SIGNATURE /� ` - k;:?� REPRESENTING DATE / r• x Town Of Southold i n hl Z 1980 Town Clerk's Office Southold, N. Y. l - APPLICATION FOR WETLANDS PERMIT Application No. ... ..................... Date of Application ................................................ Identityof Applicant .................�.llvc............ . �v!:4........................................................ Address of Applicant ,-2gSo 31�� D S�c?UTtfo ���, ................................................. ....7..... ............... ........ INSTRUCTIONS FOR PERMIT A. This application is to be completely filled in by typewriter or ink and submitted to the Town Cleric 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 reques�ryry�f applicant for a permit, may waive in whole or in part, the provisions of Article Il, Sectiorf a, subdivisions (b) and 611-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 InterioJr�,JWetlands, Flood Plains and Drainage Areas of the Town of Southold: Permit requested to .............!... ............L-0/.;/.(!!.G....ba•G/C;.........6 ........................ GA.�/ /�.....(2��)......©.v ....... L 7.L. :N��.5........................................ Location of property for which permit wanted....2.76 ...... r .. . . .... j.......... CJ 17h L,9 A ......................................................... .................................................................................................... Home address of permit applicant if different from aforesaid location` �C::?�'8 ...... ................ �jL 1 �2I 5,*077o44 J9 ................................................................................................................................................................... Creek, Bay or Harbor fronting property .........P.��-�.. ........... .................................................................................................................................................................. Size of proposed work: Length ................................................ ...Y/......................................................................................... WidthS ..................................................................................................................................................... HeightAbove High Water .....................3... ........................................................................................ DepthBelow Low Water ......................................................................................................................... Yardsto be Excavated ........................................................................................................................... Yards to be Filled O ................................................................................................................................... Width of canal creek or bay fronting property yoU .. /................................................... Depthat Low Tide .................................................2.l/v............................................................... J.... /�v -iAverage Rise in Tide ............................................ .......I.. ............................................................. • � n Isthis for private or business use? .............................. .. ..�r..................................................... Area Zoning ............................9�',?7/pw' nei"� ............................................................................... ................ Manner in which material will be removed or deposited ..............A)6............................................. . ....................................................................................I................................................................................ Intended use of property ...........d� L'7i/zC?��7DI✓................................................................................ .................................................................................................................................................................. Written consent of owner of property, if not the some as the applicant ........................................ .................................................................................................................................................................. ........................................................................................................................................................ COUNTY OF SUFFOLK ) SS: STATE OF NEW YORK Y .............. .r..fl/.tC ............. ..................................... 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 ��vi��rtue of said permit, if granted. ....... jit- � Q ............... .. . .................Signature of AW Sworn to before me this ....... .. ..T:.!.,...... day of ......�.4N.1114.R ..................., 19.�f�. ....L . - ).0 Notary Public ELIZABH ANN LB NOTARYPUBLIC, State of New York No. 52.8125850, Suffolk Cou t �� Term Expires March 30, 19141) iv ed L AVl -pt r4l? IS f.4 iF 4 Glt 11 D-r. c c 6- 17 41IJ C, "ic ;.Ofjl '4 P PJ' f-irrl. r 13,W), Alp 4. :';�,n�,;» •_i t'+• , ,, , . , '.a'✓:-":c, '.;t.. 'r '.��'L ,�?liyi' _ ^ -.,; •' "t _ +"� •.�. 'Rr ,,,_, `=s Y w,�,l?S�'°,;.'✓ ,. 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