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Home My WebLink AboutLepeter, Mary TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, NEW YORK WETLANDS PERMIT This Wetlands Permit No. ...35............. has been granted by the Southold Town Board according to information furnished in Application No. .....49......... filed by Applicant ...nary.LePeter ..... ......................................... on .....MP-Y..8............ 19.N.... 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 CCA treated timber dock consisting ................................................................................... of a 31x8' fixed catwalk, 3' xl2 ' hinged ramp, and a 6'xl2' float secured ...6K.1"p"il" ng"at...nudly..'blyd':""'Dock"to"be" 5r"'s67fftTf"6f"iiort'IierZy"p"roperty , line. No dredging or other alteration to be done. ................................................................................................................................................................. Location of property on which work to be done ...3800 Deep Hole Drive, Mattituck .................................................................................. ................................................................................................................................................................. ..............................................................................................................................:.i..................:......:....... "ft i canal off Deep Hole Cree" ' "�� Creek, Bay or Harbor fronting property �........................:. .............. ....................................... ............................................................. �...,. . , ......... . .}., . ... as described above Sizeof work: Length ...................................................................................... ... r;rPI /� ......... Width ....as described above...................................... '�.. tif,rt ........... ..................... Height Above High Water ,,,2 ft: DepthBelow Low Water ................................................................................................. Yards to be Excavated ...,.,none ..................................................................................... Yards to-be Filled ..........none ............................................................................................ Manner in which material is to be removed or deposited ......................................................................... ................................................................................................................................................................. Residential Intendeduse of property ......................................................................................................................... ................................................................................................................................................................. Conditionsif any ..................................................................................................................................... ................................................................................................................................................................. ExpirationDate ..................................................................................................................................... Number of Inspections Required ............................................................................................................. InspectionFees ........TR. ..r.................................................................................................................. 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 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. 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 ind'emni- 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 saltw"ater 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 navigatiori 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 . ... ............:-1�:.�s.� .... ......... i Town Clerk, Town of Southol S�E A�L " •)' Date........JN!Y. .................................. AIN'OTES-0t'kPUt IC_*REAI21=� r HELD JULY 22, 1980 APPLICATION OF MARY ,LePETER A public hearing was held by the Southold Town Board at the Southold Town Hall, Main Road, Southold, New York at 3 : 44 o'clock p.m. in the matter of the application of Mary LePeter for a permit under the provisions of the Wetland Ordinance of the Town of • Southold for permission to construct a dock, catwalk, ramp', and float at 3800 Deep Hole Drive, on a canal off Deep Hole Creek, Mattituck, New York. Present were: Supervisor William R. Pell, III Councilman Henry W. Drum Councilman John J. Nickles Councilman Lawrence Murdock, Jr. Councilman George R. Sullivan Justice Francis T. Doyen Town Clerk Judith T. Terry Town Attorney Robert W. Tasker SUPERVISOR PELL opened the hearing at 3 : 44 o'clock p.m. and asked Councilman Murdock to read the legal notice of hearing. COUNCILMAN MURDOCK 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 : 40 o'clock p.m. on Tuesday, July 22, 1980 in the matter of the application of Mary LePeter for a permit under the provisions of the Wetland Ordinance of the Town of Southold for permission to construct a dock, catwalk, ramp, and float at 3800 Deep Hole Drive, on a canal off Deep Hole Creek, Mattituck, 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: June 26, 1980. JUDITH T. TERRY TOWN CLERK . . . . COUNCILMAN MURDOCK: We have a notice of publication from Patricia Wood, of the Long Island Traveler-Watchman, and a notice of publication from the Suffolk Weekly Times. We also have a notice from the Town Clerk that it was posted on the Town Clerk Bulletin Board. And we have here a Negative Declara- tion, which is a notice of no significant effect on the environ- ment by the Office of the Town, pursuant to Article 8, Environ- s P- Page 2 Public Hearing - 7/22/80 mental Conservation Law. We have a notice from the Town Trustees: . . .The following action was taken by the Board of Southold Town Trustees at a regular meeting held June 4, 1980, RESOLVED, that the Southold Town Trustees find there will be no detriment to the - environment regarding Wetland Application No. 47 of Mary LePeter. . . . Signed by Anna Hataier, President Board of Town Trustees We also have another notice from the Conservation Advisory Council of the Town of Southold: . . .The following action was taken by the Southold Town Conservation Advisory Council at a regular meeting held May 27, , 1980, RESOLVED, to recommend to the Southold Town Board approval of Wetland Application No. 47 of Mary LePeter as submitted. . . . Signed by Frank Cichanowicz Chairman Conservation Advisory Council SUPERVISOR PELL: Thank you. You have heard the reading. Does anybody wish to be heard in opposition to the proposed hearing of Mary LePeter? (There was no response.) Nobody wishes to be heard in opposition? Does anybody wish to speak in favor of the application? (There was no response. ) Does anybody wish to be ,heard at all on the application? (There was no response. ) All right, if not, I will declare the hearing closed of Mary LePeter. The hearing was declared closed at approximately 3 :48 p.m. Respectfully submitted, Linda F. Kowalski C04,INTY Of SUFFOLK STATE OF NEW YORK LEGAL NOTICE `Nbtice of Hearing 140TICE IS HEREBY Patricia Wood, being duly sworn, says that she is the GIVEN that a public hearing Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, will be held by the Town Board'_ 1 of the Town of Southold at the a public newspaper printed at Southold, in Suffolk County; r Southold Town Hall, Main Road, Southold, New York, at and that the notice of which the annexed is a printed copy, 3:40 o'clock P-M. on Tuesday, ' hos been published in said Long Island Traveler-Watch- July 22, 1980 in the matter of , application of Mary Le- I man once each week for 0.... weeks the app .... .......... ...... , Peter for a permit under the s provisions of the Wetland i successively, commend g on the ....!................................................ Town of Ordinance of, the l Southold for permission t, { i construct a dock, catwalk, and float at 3800 DeepHol . ramp on a canal off DeeDrive, � ,, Deep Hole Creek, Mattituck, I ..... ........ ................;............... ............. New/York. All` persons interested in said matter shall appear at the, time and place above specified and will be given an oppot- Sworn to before me this ...1.................. da of tunity to be heard, pATED• Jne 26,JUDITH 8 TERRY ........ . . .. ................ 19.( ... Town Clerk 1T,7/10/80(81) 1 .............. . .. .Pu .. ....... ............ blic . , CGEM iqT J.THrjMpS®,V PIOT4l1N PUBLIC,Slate of pkvr Nora eswi g ir�2su fell 9321725 PUBLIC, ►n Co� er,FX&M march P COUNTY OF SUFFOLK, 1 LEGAL NOTICE STATE OF NEW YORK, ss: NOTICE OF HEARING NOTICE IS HEREBYi AA.��U . . . . . . , • being duly GIVEN that a public hearing • • • JQN. GTJSTY Sworn, will be held by the Town Board, of the Town of Southold at they says that . SHE. . , is Printer and Publisher of the SUFFOLK Southold Town Hall, Main Road,Southold, New York, ate WEEKLY TIMES, a newspaper published at Greenport, in said 3:40 o'clock P.M. on Tuesday,i July 22, 1980 in the matter of County; and that the notice, of which the annexed is a painted the application of Mary LePe ter for a permit under the; copy, has been published in the said Suffolk Weekly Times provisions of the Wetland Or- dinance of the Town of South- once in each week, for . . . . . . �U. . . . . . . . . . . . . . . . . weeks old for permission to construct ! a dock, catwalk, ramp andssuccessively commencing on the . . te?a: ?. . . . . . . . . . . . . . . . . float at 3800 Deep Hole Drive, on a canal off Deep Hole i day of July. . Creek, Mattituck, New York. All persons interested in, .Ly . . U./. r"1st. . . . . . . . . . said matter shall appear'at the time and place above Sworn to before me this specified and will be given an opportunity to be heard. ! day of . . . . . . . . . . . . . 19 . . .. J DATED: June 26, 1980 ��_ JUDITH T.TERRY . . . . . . . TOWN�CLERK� 1TJy10-3477—_� ---- - . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . HELEN K.DE VOE NOTARY PUBLIC,State of New York No.4707878,Suffolk County Term Expires March 30, 1991 i`! I; f` STATE OF NEW YORK: i; SS : ('i COUNTY OF SUFFOLK: i. II JUDITH T. TERRY, Town Clerk of the Town of ,I 1,1Southold, New York, being duly sworn, says that she is over- the j� age of twenty-one years; that on the 30th day of June 1980 she affixed a notice of which the annexed printed Ii ! notice is a true copy, in a proper and substantial manner, in a 'I ; most public place in the Town of Southold, Suffolk County, New j1 York, to wit:- • Town Clerk Bulletin Board, Town Clerk Office 1; Main Road, Southold, N.Y. 11971 ` Notice of Hearing - Wetland application of Mary LePeter ! !I 3:40 P .M. , Tuesday, July 22, 1980. 1 Judith T. Terry, Tofn Clerk 11Sworn to before me this i ,I �! 30th day of June ' i 1980 • f 'otary Public ELIZABETH ANN NEVILL2 i NOTARY PUBLIC, State of New Yelp , No. 52.8125850, Suffolk Cou Term Expires March 30, 19, ., i i 1 f� I' s if 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 3:40 ! clock P. M. on Tuesday, July 22, 1980 in the matter of the application of Mary LePeter for a permit under the provisions of the Wetland Ordinanc of the Town of Southold for permission to construct a dock, catwalk, ramp and float at 3800 Deep Hole Drive, on a canal', off Deep Hole Creek, Mattituck, 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: June 26, 1980 JUDITH T. TERRY TOWN CLERK PLEASE PUBLISH ONCE, JULY 10, 1980, AND FORWARD ONE AFFIDAVIT OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK, MAIN ROAD, SDUTHOLD, NEW YORK 11971. Copies to the following on June 30, 1980: The Long Island Traveler-Watchman Inc. The Suffolk Times En-consultants, Inc. , a/c Mary LePeter Town Board Members Town Clerk Bulletin Board OFF�CEvOFI,- 'Q�VN�,a1C 'RK iY tip.%•,'%_.;> S:', ,=z A^„`,;1 a t 1,0WN:`OF\+S0UTHO-LD JUDITH T.TERRY 4�iFFOLK COL1T TELEPHONE TOWN CLERK �' t" (516) 765-1801 REGISTRAR OF VITAL STATISTICS 'LZL� Southold, L. I., N. Y. 11971 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT Dated: June 11, 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 Enconsultants, Inc. for Mary LePeter for a wetland permit. Permission is requested to construct a dock, catwalk, ramp and float at 3800 Deep Hole Drive on a canal off Deep Hole Creek, Mattituck, 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',effect 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: Enconsultants, Inc. a/c Mary LePeter Commissioner Robert F. Flacke, DEC, Albany David DeRidder, DEC, Stony Brook Building Department, Town of Southold Town Clerk Bulletin Board ®BOAR RECEIVED STEES J A 121900 FOC4U Telephone : : x n Town Clerk Southold' 516-765-1938 Southo . 11971 June 11, 1980 Southold Town Board Town Hall Southold, New York 11971 Gentlemen: The following action was taken by the Board of Southold Town Trustees at a regular meeting held June 4, 1980. RESOLVED that the Southold Town Trustees find there will be no detriment to the environment regarding Wetland Application #47 of Mary LePeter. Yours truly, ANNA T. HATAIER, PRESIDENT BOARD OF TOWN TRUSTEES By Muriel Tolman, Clerk RECEIVED SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL JON 51980 Southold, N. Y. TAM ORR Sautti I June 5, 1980 Southold Town Board Town Hall Southold, New York 11971 Gentlemen: The following action was taken by the Southold Town Conservation Advisory Council at a regular meeting held May 27, 1980. RESOLVED to recommend to the Southold TownBBoard approval of Wetland Application #47 of Mary LePeter as submitted. Yours truly, FRANK CICHANOWICZ III, CHAIRMAN CONSERVATION ADVISORY COUNCIL By Muriel Tolman, Secretary 0 KgL*OF',Jd'IC CERK TOWN?QiF, SOU, THOL 7 JUDITH T.TERRY 'SUFF.,O1LKjCOLTTY TELEPHONE TOma CLERK � (516) 765-1801 REGISTRAR OF VITAL STATISTICS � YLZL" Southold, L. I., N. Y. 11971 May 13, 1980 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 Enconsultants, Inc. for Mary LePeter for a wetland permit 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 May 30, 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: Commissioner Flacke Southold Town Building Department ® E10EsO Y; OIYN 'GLEV K 1CSUN'OF UT70 JUDITH T.TERRY St3 FOI K C U TELEPHONE TowN CLERK V+rysw. r (516) 765-1801 RL:GISTRAR OF VITAL STATISTICS �.•t Southold, L. 1., N. Y. 11971 May 13, 1980 To Whom It May Concern: Attached hereto is Environmental Assessment Form completed by Enconsultants , Inc. for Mary LePeter in connection with her applica- tion no. 49 for a wetland permit . Permission is requested to construct a dock, catwalk, ramp and float at 3800 Deep Hole Drive on,- a canal off Deep Hole Creek, Mattituck, New York. Judith T. Terry.'-/ Town Clerk Posted on Town Clerk' s Bulletin Board - 5/13/80 oft TOWN`OF}SOTJTH() JUDITH T.TERRY_ SUFFOLK=COUNTY TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 1-lay 13, 1980 Southold Town Board Town Hall Southold, New York 11971 Gentlemen: Transmitted herewith is application no. 49 for a wetland permit submitted by Enconsultants, Inc, for Mary LePeter. 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, Aee-�- Judith T. Terry Town Clerk Enclosure ';��,o RC"- I'O WN*�C�;ERK TQ��IVrt OF�iS,'OLTT,HO�, JUDITH T.TERRY SUFF,OLK-=COLIlt TELEPHONE TOWN CLERKS �° a� rq (516) 765-1801 REGISTRAR OF VITAL STATISTICSts Southold, L. I., N. Y. 11971 May 13, 1980 Mr. Frank Cich_anowicz, Chairman Conservation Advisory Council Southold Town Hall Southold, Never York 11971 Dear Mr. Cichanowicz: Transmitted herewith is application no. 47 for a wetland permit submitted by Enconsultants•, Inc, for Mary LePeter. Please prepare a written report of findings and recommendations * th 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 Enclosure OFFCCErOF�T0.4VN';�CL•ERK O yN-OF SbiJTHOP I ITh;-°�.--^� JUDITH T.TERRY 'SUFF_0L-`K-c,6mOUY TELEPHONE TOWN CLERKr'�•J`K?l (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 May 13, 1.980 Mrs . Anna Hataier, President Board of Southold Town Trustees Southold Town Hall - Southold, New York 11971 Dear Mrs . Hataier: Transmitted herewith is application no. 49, for a wetland permit submitted by Enconsultants, Inc, for &Lary LePeter. 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 Enclosure f ' Town Of Southold Town Clerk's Office Southold, N. Y. APPLICATION FOR WETLANDS PERMT Application No. ...... �.................... Date of Application .......51... �� ................................ Identity of Applicant Mary LePeter by En-consultants,Inc. ............................................................................................................................. Address of Applicant .RR1,Box 90 #3800 Deep Hole Drive, Mattituck, N.Y. 11952 ................................................................................................................. -' (64 North Main St. , Southampton, N.Y. 11968) 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 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 request t e applicant fgr a permit, may waive in whole or in part, the provisions of Aericle 11, Section subdivisions 9) and Uff 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 ................................................................................................................................. .................................................................................................................................................................. ................................................................................................................................................................. Examining Body ....................................................,................................................................................ 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 „construct a.CCA;° treated timber dock..consisting.,of..a 3.'x8:..fixed catwalk, 3'x12' hinged ramp, and a 6'x12' float secured. b; one piling at each end. Dock will be 25' south of northerly property line. No dredging or other alteration will be done. ................................................................................................................................................................. Location of property for which permit wanted....,....3800..Deep..Hole..Drive..Matt.Lt l.c ............... ................................................................................................................................................................. Home address of permit applicant if different from aforesaid location .......................... .................................................................................................................................................................. Creek, Bay or Harbor fronting property ..........eanal...af£..IAeep..Hale..Creek.................................... .................................................................................................................................................................. Size of proposed work: Lengthsee, spets...above............................................................................................................ Width ..................................................................................................................................................... HeightAbove High Water ........2.'.......................................................................................................... DepthBelow Low Water ....................................................I.................................................................... 0 Yardsto be Excavated ........................................................................................................................... Yardsto be Filled ................................................................................................................................... Width of canal, creek or bay fronting roe 40' Depthat Low Tide ..............................4................,................................................................................ AverageRise in Tide ............................................................................................................................ • Is this for private private...................................................................... v e or business use? . Area Zoning residential ............................................................................................................................................. Manner in which material will be removed or deposited ....n/a................................. ...................... . .................................................................................................................................................................. Intended use of property ........xe.S1.dexLt.:L4LL.......................................................................................... .... ....4................................................................................i........................................•............................... Written consent of owner of property, if not the some as the applicant ........................................ ........................................................................................................................................................ .........4................................................................................n....................................................................... COUNTY OF SUFFOLK SS: STATE OF NEW YORK Roy, L, HaJ e......................................... 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 virtW of s 'd ermit, if granted. ......... . .. ....... ......... ........................................... Signot rh�of Applica Sworn to before me this ..�`�........................... day of ... . :;l......... ...., 19. .�`�... r_ a Publi RICHARD J. MICALLEP Notary Public, State of New York No. 52-7924970, Suffolk County Commission Expires March 30, 19TC— 38 . 79000,00"". /49.0 II ;i O io i Q ;:` *Lovs Pro Pose << KMom (LJ s/o'r 3'X Ja,I RAMP J !-oT• 3'xV CATWAI Co. H4Isfrom S C4 I G I =.2 000 W41 I477" o ® $ A 44cLcen f` 'ProP-?-1/49 O A. , F,c. k 2Z4 les r+ 8. Tol►n FQbC. moa-t-,N S�,terd Data►,, = M LO v,,� Pr,v4tc use br owncrP119M 79000 !!/ 88,'OWry R'�' P�,q it Sec.tion 0- Floaf' PROPOSED DOCK S- QQ r 7 i?,- dk canl4 d o f f � V -- -- 12�---� I DG�pp1 Nolc Crctk D: Note Dr;v G Qa . FL OAT MGt+,+uckI r- of Sou+Aal� Scc�ion o,� Ca� �✓u(1C t1vljLj ' k Co-I N• Y M Le- P c�e r a fc b ,E N_ CONSUULTAAIMTS Fx,5 t,n Som'f-h 4'M(1 1 O h do+ o►„ S heed' lo� I I SSS/So 9;dc_V, ew"o- Doc k AUTHORIZATION This shall authorize EN-CONSULTANTS, INC. to apply for the necessary permits for the project described on the attached application. I certify that I am the (owner) (contract vendee) (an officer of the corporation which owns or operates) the subject parcel. 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 . Will project result in a large physical change ' - to the project site or physically alter more than 10 acres of land? . . . . . . . . . . . . . . . . . . . . Yes XNo 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 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 re,sult 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 bya local agency? . . . . . . . . . . . .. . . . . - . . .: . . . . . - Yes No 10. Will project have a major effect on existing 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 have any impact on public health ,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 neighborhood? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 15 . Is there public controversy concerning the project? . . . . . . . . . . . Yes No PREPARER ' S SIGNATURE — A. - -4Fe REPRESENTING DATE S