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Home My WebLink AboutTR-5697 ,.- TERMS and CONDI11ONS \,"J ~ The Permittee JOSEPH CHF.R NITSHK A 845 Bay Avenue, East Marion, residiag at N. Y ~ as pan_ of the coosideradoo for the isSo"~ of the Pamit does IIDcIastmd and pcacribe to the fol· lowing: 1. That the said Board of Trustees and the Town of Southold ace celeased from ID1 and all damages, ot claims for cIamages, of suits arisiøg ditecdy ot iadiJ:ecdy as . cau1t of ID1 ope<- adon pecfom>ed pUnuaDt to this peøait. and the aic1 p.. J..... will, at his ot bee own ~ defend ID1 and all such lUllS - iaicI.-I br third paedes, and the aic1 Po· I....... - fuUl.iobIIitr with _peer thereto, to the complete rr"'n<Inn of the Baud of T.- of the Town of SouIJ>nLI 2. That this PemIit is TIIid foe . period of 7d mas. which is (lOA" ,¡f to be the estimated time - cequiced to complete the wod< iø~hoed, butihoaId ~ ......-, ~ for In exteftSÍoo may be made to the Board at a 1atec daœ. 3. That this Petmit should be cetaiøed iødeflDitely, or as long as the said Pecmiuee wishes to maintaÏØ the stIUauce or project iøvolved, to provide evidence to anyone cooœmed that auth- ocizatioo was originally obtained. 4. That the work iøvolved will be subject to the inroo and approva1 of the Board ot Its agents, and oon-axnpliaoce with the ptovisions of the o~ftO'¡"g applicatioa, may be cause lot revocation of this Pamit br IeSOlutioo of the said Board. 5. That there will be no untttsoon.\e intecfeceoœ with navigation as a cau1t of the wotk betein au'tborized. 6. That there shall be DO iøtecfecence with the right of the public to pass and ftPUS aIoog the beach between high and low watee macks. 7. That if futute OpecadODS of the Town of Southold requite the .-.I aDd/or ùtaadoas In the 1oc:ation of the wotk beceiø ..~--i. or if, iø the opiøIoo of the Boød of Tnuœes, the wotk shal1 cause unceasoooI>\e obsttu<ØOl1 to free navigadoa, the said p-I-. will be m¡uired. upoo due notice, to remove or alter this wotk or project beceiø stated wicboac -¡.eo..'" to the Town of Southold. 8. That the said Board will be notified br the Paminee ot the ~ _ of the work auth- orized. 9. That the Petminee will obtain all other permits and conseoll that mar be requited sap- plemental to this petmit which may be subject to revoke upon lailuce to obca1n -- , , . It It , It . It. It It .. . , . . It It.. . . . ...... . . Chemushka - East Marion Project Description: (1-27-03) Applicant proposes to reconstruct and add onto the remains ofan existing catwalk. 3' x 69' of catwalk is proposed over an area of existing 56 linear feet of deteriorated timber catwalk. The catwalk is proposed to be elevated a minimwn of2.5' above the wetlands and is proposed to be supported by (20) 4"x4" CCA timber dock posts. ~ Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda \ Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 29, 2003 Mr. Dan Hall Land Use Ecological Services, Inc. 2676 Sound Avenue Baiting Hollow, NY 11933 RE: SCTM#31-10-15 Joseph Chernushka 845 Bay Avenue East Marion, NY Dear Mr. Hall: The Board of Town Trustees took the following action during a Regular Meeting, held on January 22,2003 regarding the above matter. WHEREAS, Land Use Ecological Services, Inc.. on behalf of Joseph Chernushka applied to the Southold Town Trustees for a pennit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 14,2002 WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on January 22,2003 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code. . 2 . WHEREAS, the Board has detennined that the project as proposed will not affect the health, Safety and general welfare of the people of the town. NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approved the application of Joseph Chernushka for the Wetland Pennit to reconstruct and add onto the remains ofan existing catwalk 3'x82' of catwalk is proposed over an area of existing 56 linear feet of deteriorated timber catwalk - catwalk is proposed to be elevated a minimwn of2-1/2' above the wetlands and is proposed to be supported by (25) 4"x4" CCA timber dock posts with the stipulation that there not be an "L" - new plans submitted January 28,2003 BE IT FURTHER RESOLVED that this detennination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Fee must be paid, if applicable and pennit issued within six months of the date of this notification. If inspections are required, at a fee of$5.00 per inspection (See attached schedule). FEES: $5.00 Very truly yours, au~ J /~ï~z--L Jh Albert J. Krupski, Jr. President, Board of Trustees AJKlcjc cc DEC Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken poliwoda . . Town Hall 63095 Main Road P.O. Box 1179 Southold, New York 11971 / Telephone (616) 765-1892 Fax (616) 766-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Land Use Ecological Services. Inc. on behalf of JOSEPH CHERNUSHKA Please be advised that your application, dated December 14. 2002 has been reviewed by this Board, at the regular meeting of January?7. 7.00, and the following' action was taken: ( X) Application Approved (see below) (-) Application Denied (see below) (-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: One Inspection @$5. 00 TOTAL FEES DUE: $ 5.00 BY: t1Lt&4 ~ ~. ,....1..' 9, PRESIDENT, BOARD OF TRUSTEES ~q.~ ~ , \û'Y ¡y'{ (c~BW~D FEB 1 9 am SIGNED: Soulftold Town Board of Trustees A/QR f LanrlUse . . ',""'·1.,-" -,'" ,., "'.' '. '.'., ¡ C 0 log c a IS, r " C /5, i nc January 28, 2003 Town of Southold Board of Town Trustees P.O. Box 1179 Southold, N.Y. 11971 AlIn: AI Krupski. President Re: Chemushka - East Marion Proposed Dock 845 Bay Ave., East Marion Dear Mr. Krupski: As per the 1-22-03 trustees meeting in regards to the above referenced project, enclosed please find (2) sets of revised plans and project descriptions. These plans now propose a 3'x69' catwalk elevated a minimum of 2.5' above the wetlands. Please do not hesitate to contact this office if there are any questions or if additional information is needed. ~A !%-A/I/- Land Use Ecological Services. Inc. r - li::::I- if'\, rr~ ß',: ~'( '''.', . ,c¡ 'I, . ~ ','l~_o L'û j' DH Enc. ~, !JW8ó~. Souttol~"J\j"rf'w', ;.., -,areoOf TrlJsfeøs . 2576 S'Jund A,;enue . Boiting Hdbi. Nev,. ì,'ork . 11933 631727-2400 . FAY 631-727-2605 Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda ~ . Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Land Use Ecological Services, Inc. on behalf of JOSEPH CHERNUSHKA Please be advised that your application, dated December 14, 2002 has been reviewed by this Board, at the regular meeting of Janl1;:¡ry 7.7. 7.nn~ and the following' action was taken: ( X) Application Approved (see below) (-) Application Denied (see below) (-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: One Inspection @$5,OO TOTAL FEES DUE: $ S. 00 SIGNED: tlt,¿c.-I ~ ~... f'·A..' 9, PRESIDENT, BOARD OF TRUSTEES BY' ~~~~ 4/98 Albert J. Krupski, President James King, Vice-President Artie Foster Ken poliwoda Peggy A. Dickerson . Town Hall . 53095 Route 25 . P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD JOSEPH CHERNUSHKA YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHAlL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 151 day of construction Yz constructed _ xProject complete, compliance inspection. 1/29/03 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD -. YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. C h.e.rV1US/{.<=--- INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction y, constructed ~ Project complete, compliance inspection. Field Inspection 1/20/03 . . \,1. \...-,-..".. ..'~ " ¡t.;.!t.. ,f, .-__..;.,õi. J '- \\, :¡ \,. , I , , I ?/ - t \ R . -. ¥_,-P~~..'" ~._. . , . ;... C '0 ~ nV..6\ì 'nOt . . Telephone (631) 765-1892 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 . SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Wednesday, January 15, 2003, the following recommendation was made: JOSEPH CHERNUSHKA to reconstruct and add onto the remains of an existing catwalk. 4'X 82' of catwalk is proposed over an area of existing 56 linear ft. of deteriorated timber catwalk. The catwalk is proposed to be elevated a min. of 4' above the wetlands and will be supported by (25) 4"X 4" CCA timber dock posts. Located: 845 Bay Ave., East Marion. SCTM#31-10-15 The CAC did not make an inspection, therefore no recommendation was made. . . DEPARTMENT OF THE ARMY .iAI'! ¡ NEW YORK DISTRICT, CDRPS OF ENGINEERS 6 1"",,, JACOB K. JAVITS FEDERAL BUILDING Jd'I.Y-' NEW YORK. N.Y. 10278-0090 January 14, 2003 ---" REPLY TO ATTENTION OF Eastern Permits Section SUBJECT: Application Number 2002-01550-L2 by Joseph Chernushka The New York District, U.S. Army Corps of Engineers, has received a request for Department of the Army authorization for the following activity: APPLICANT: Joseph Chernushka 130 Devonshire Drive New Hyde Park, NY 11040 ACTIVITY: Construct a 4' X 82' pile-supported fixed timber pier elevated a minimum of 4 feet above the grade of wetlands. The purpose of this project is to provide the applicant with waterway access and a mooring facility for recreational vessels. WATERWAY: Marion Lake, Gardiners Bay LOCATION: East Marion, Town of Southold, Suffolk County, NY As this is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing work in navigable waters of the United States. To accomplish the coordination required, prior to the issuance of a Letter of Permission, your review of the enclosed drawings lS requested. Pursuant to Section 307 (c) of the Coastal Zone Management Act of 1972 as amended (16 U.S.C. 1465 (c) (3) (A)), the applicant has certified that the activity complies with and will be conducted in a manner that is consistent with the approved state coastal zone management program. To allow for the timely processing of the subject application, your comments are requested within 20 days of the date of this letter. Sincerely, ,'),~ '"~~ J'1~", «."_ Dr. Marc Helman Acting Chief Eastern Permits Section Enclosure . ~ -< ~ z o ~ ~ -< u o ~ lU ~*.w ~ r\') c.,- o - ¡..... CI::: <; 0 l<. CQ .... CI::: CI::: "'<:: 0 ::r:: 2 o \-{ Q,( <L E I- V) -.::r 0J I c::r .:,¿ :r: \I) '::J 2. PRIVATE / 4 ~I~ 2: \' s¡ ;:) I- o -J 'n\~ , LV ::z: U ... D' r0.... (j)~ -w - , C\I \ , \ . o .~ "0 ~ POINT " ¡ -. .. !! 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Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 I BOARD OF TOWN TRUStEES TOWN OF SOUTHOLD I Office Use Only I I I _ ~inor _Coastal Erosion Permit Applicatiqrl _Wetland Permit Application ~ Major _Waiver/Amendmen C a7ges _Received Application: I t Ö,-" _Received Fee:$ t9.h..... I I _Completed Application J ~ f :J. 'J! 0 Ý _Incomplete _ SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:(date sent CAC Referral Sent: \.- _Date of Inspection: _Receipt ofCAC Report. Lead Agency Determination: Technical Review: _Public Hearing Held I ¡'vvf D ? Resolution: I 1)l\1r L(~ ¡ 4 ,L< Name of Applicant Joseph Chernushka Address 130 Devonshire Drive, New Hyde , p1rk '45-4970 N.Y. 11040 Phone Number:( ) (631 ) Suffolk County Tax Map Number: 1000 - 31 -1 0-1 5 Property Location: 845 Bay Ave East Marion N.Y. 11939 (provide LILCO Pole #, distance to cross streets, and location) AGENT: Dan Hall/Land Use EcologicaL Services, Inc. (If applicable) Address: 2576 Sound Ave. Baiting Hollow NY 1 1 933 Phone: (631) 727-2400 --~- . · BO!d of Trustees APPlica!n . WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: mooring. Lake Access, recreational Area of wetlands on lot: 30,000 square feet Percent coverage of lot: 8+1- % Closest distance between nearest existing structure and upland edge of wetlands: 42+ 1 - feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? N 1 A cubic yards How much material will be filled? N/A . cubic yards Depth of which material will be removed or deposited: N/A N/A feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: N/A Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): The Freshwater wetlands will not be negatively affected by this proposed project. ·. Board of T 1· .. rustees App ~cat~on County of Suffolk State of New York Dan Hall/Land Use Ecological Services, Inc. BErNG DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HERErN ARE TRUE TO THE BEST OF IllS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TIllS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TillS APPLICATION. - IJ~ ~;1-' ~ Signature SWORN TO BEFORE ME TillS IiI< DAY OF MVe.ø!L , ,2002-- . CYNTHIA ALVAREZ NOTARY PUBLIC, STATE OF NEW YORK No.OtAl6080878 OUAlIFIEO IN SUFFOLK COUNTY MY COMMISSION EXPIRES SEPT. 23, 20 C!..fi ·a. of Trustees APplicate . AUTHORIZATION (where the applicant is not the owner) ." I Joseph Chernushka , (print owner of property) residing at 130 Devonshire (mailing address) New Hyde Park, N.Y. 11040 do hereby authorize land Use (Agent) Ecological Services, Inc. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ~~ dcæ { ner's signature) . 8 .. .. Chemushka - East Marion Project Description: Applicant proposes to reconstruct and add onto the remains of an existing catwalk. 4' x 82' of catwalk is proposed over an area of existing 56 linear feet of deteriorated timber catwalk. The catwalk is proposed to be elevated a minimwn of 4' above the wetlands and is proposed to be supported by (25) 4"x4" CCA timber dock posts, ·. Board f 1· t. fila o Trustees App ~ca ~on GENERAL DATA Land Area (in square feet): 377,163 s.f. Area Zoning: Residential Previous use of property: Residential Intended use of property: Residential Prior permits/approvals for site improvements: Agency NYSDEC NJ Letter Southold NJ Letter Date 4 q_n? 12-18-01 . _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? --..lL- No_ Yes If yes, provide explanation: Project Description (use attachments if necessary): Please See Attached Project Description. Ie Board of t I . . 4IIIIÞ Trus ees App 1cat10n County of Suffolk State of New York Dan Hall/Land Use Ecological Services, Inc. BErNG DOL Y SWORN DEPOSES AND AFFIRMS THAT HElSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONT AlNED HERErN ARE TRUE TO THE BEST OF mS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH rN TIDS APPLICATION AND AS MAY BE APPROVED BY THE SOUTH OLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. rN COMPLETING TIllS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENT ATlVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TIDS APPLICATION. - I ~~ ^\ ÆÁ)~_\ ~ Signat~ SWORN TO BEFORE ME TIDS lift DAY OF ;UvtøtL , ,20 02- . CYNTHIA ALVAREZ NOTARY PUBLIC, STATE OF NEW YORK No.0IAL6080B7B OUAlIFlEO IN SUffOLK COUNlY MY COMMISSION EXPIRES SEPT. 23. 20,£ Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda , . Town Hall . 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application (L~ __I of . )fJ~~~------ STATE OF NEW YORK) AFFIDAVIT OF POSTING I,~ (jaL! ' residing at &{ !JIJnU(f'~V ~. _R;d...'lR I t-J,y'. being daly'sworn, depose and say: That on the qTh day of ..:Tc:::v-. ,200~, I personall¡y posted the property known as c..iAP_í(l\J~L-.l",,-. R<-t5 thy ÅJe. Fò..~ (¥\a...rìòV\ by placing the Board of Trusteés official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date O~he ,~~ publi~ ~aring. Date of hearing noted thereon to be held I P,J {f,I.Pv~ 7()~(fM' Dated: ~re)&v!A 1/\ this 2003 . CYNTHIA ALVAREZ NOTARY PUBLIC, STATE OF NEW YORK No. 0 I Al60BOB7B QUALlFIEO IN SUFFOLK COUNlY If!( COMMISSION EXPIRES SEPT 23, 20 D Board. Trustees Application . AUTHORIZATION (where the applicant is not the owner) I Joseph Chernushka , (print owner of property) residing at 130 Devonshire (mailing address) New Hyde Park, N.Y. 11040 do hereby authorize land Use (Agent) Ecological Services, Inc. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. '~ cr¿£?(2 i ner's signature) 8 .' ., · I PROJECT ID NUMBER . . SEQR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM wrUNUSÆDACTIONsOn~ PART 1 - PROJECT INFORMATION ( To be completed by " plican! or Project Sponsor) 1. APPLICANT I SPONSOR 2. PROJECT NAME D HalllLand Use for J. Chemushka Chemushka - East Marion 3.PROJECT LOCATION: East Marion, Southold Suffolk Municipality County 4. PRECISE LOCATION: Street Add... and Road Intersecttons. Prominent landmarks ete - or provide map 845 Bay Ave. East Marion, NY 11939 1000-31-10-15 5. IS PROPOSED ACTION: ø New o Expansion o ModifICation 1...._ 6. DESCRIBE PROJECT BRIEFLY: Please See Attached Project Description. 7. AMOUNT OF LAND AFFECTED: Initially 8.6 .eras Ultimataty 8.6 BCl'e. 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? øy.. ONO If no, desaibe briefty: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose e. many.. .ppIy.) ø Residential Dlndustrial o Commercial DAgricullure 0 Perk I Fore.t I Opan Space o Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR UL TIMATEL Y FROM ANY OTHER GOVERNMENTAL AGENCY {Fed....I, Sial. or Loca~ øYe. ONo If yes. list agency name and permit ¡approval: USACOE, NYSDOS, AND SOUTHOlD TOWN TRUSTEES 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? OY.' øNO If yes, list agency name and pennlt I approval: 1~~ A ~IULT OF PROPOSED ACTION WIll. EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? es tI' No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY. KNOWLEDGE Applicent.L~·or Name ~ Hall" and "y~þ 1~9ical Services, Inc. Date: November 12, 2002 SIonatur. -f .A. d~ / . - If the ac:tion Is a Costal Area, and you are a state agency, complete the Coastal Assessment Fonn before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be comoleted bv Lead Anencvl A. DOES ACTION EXCEED A~ TYPE I THRESHOLD IN 6 NYCRR. PART 617.4? If yes. coordinate the review process and use the FULL EAF. Dyes DNo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 ~CRR. PART 617.6? If No, a negative declaration may be superseded by another IlWOlved agency. D Yes D No C. COULD ACTION RESULT IN fJNf ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten. if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels. existing traffic pattern, solid waste prOOuction or disposal, ¡tential for erosion, drainage or flooding problems? Explain briefly: I C2. Aesthetic, agiaJltl.l'"af. archaeological, historic. or other natural or aJlttnI resources; or COI1Y11urnty or neighborhood character? Explain briefly: I I C3. Vegetation or fa...., fish, shellfish or wikIife species. significant habitalS, or threatened or endangered species? Explain briefly: I I C4. A oommunIty's existing plans or goals as offlcIaIy adopIad. or 8 change In use or intensity of use of land or _ nalural resources? E><IaIn brtefIy: I I cs. GroNth, stbsequent development, or related adivItIes IIIœIy to be Induced by the proposed action? Explain briefly: I I C6. Long term. short term, cunUatiw, or other eIIecIs not identified in C1-C5? ExpIan briefly: I I C7. Other _ includinn In use of either quanlitv or tvDe of enemv? ExplaIn bri I O. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVlROM..4ENT AI.. AREA (CEA)? (If vest explain briefly: I D Yes D No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RÐ.A TED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? if - ;;;;i;,¡n: DYes DNO PART 111- DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each edverse effect identified ebQve, detennine whether if Is substantial, large, important orothelWise significant Each effect should be assessed in connection with lis (a) setting (I.e. urban or ruraij; (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (I) magnitude. If necessary, add ettachments or raference supporting materJals. Ensure that explanetions conlain sufficient delail to show that all relevant adverse Impacts have been Identified and edequately eddrassed. If question d of part Ii was checked yes, thedetermination of significance mustevaluatø the potential impact of the proposed action on the environmental cheracteristics of the CEA. Check this box if you halle Identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed drectly to the FUU EAF and/or prepare a positive _atioo. Check this box if you have determined, based on the informatioo and analysis above and any supporting documentation. IhaIthe proposed acti" WILL NOT result in any stgnlficant adverse environmental impacts AND provide. on attachments as necessary. the reasons supporting thl deternínation. Name of Lead Ñ,enCf Date Print or Type Name of Responsible Qfficer In lead Agency Trtte of Responsible Oftiœr SlgnabJre of ResponSible Officer In lead Agency Signature of Preparer (if dmerent from responsible officer) . . SEQR I PROJECT ID NUMBER 61720 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 . PROJECT INFORMATION ( To be completed by A pplicant or Project Sponsor) 1. APPLICANT I SPONSOR 2. PROJECT NAME D Hall/Land Use for J. Chemushka Chemushka - East Marion 3.PROJECT LOCATION: East Marion, Southold Suffolk Municipality County 4. PRECISE LOCATION: Street Add... and Road Inte_., Prominent landmarks ate - or ørovIde map 845 Bay Ave. East Marion, NY 11939 1000-31-10-15 5. IS PROPOSED ACTION: ø New OExpansloo o Modification I øttøratlon 6. DESCRIBE PROJECT BRIEFLY: Please See Attached Project Description. 7. AMOUNT OF LAND AFFECTED: Initially 8.6 acres Ultimately 8.6 acre. 8. WILL PROPOSED ACTION COMPLY WIlH EXISTING ZONING OR OTHER RESlRICTlONS? øyes o No II no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as eppty.) ~ Resldenliel o Industrial o Commen:iel DAor1cullure 0 Pari< I FOI8St I Open Space o Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAl, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAl AGENCY (Federal, Slata or Locaij øYa. ONO If yes, list agency name and permft ¡approval: USACOE, NYSDOS, AND SOUTHOLD TOWN TRUSTEES 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAliD PERMIT OR APPROVAl? OYa. ~NO tf yes, list agency name and permit I approval: 1fl~S A mULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? Yes II' No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS lRUE TO THE BEST OF MY, KNOWLEDGE Appllcant.L~·or Name D¡ n Hall f\ a~dJ11i\gical Services, Inc. Data: November 12, 2002 Signature I ...A / ,v v I / . - .' If the action Is a Costal Area, and you al'8 a state agency, complete the Coastal Assessment Fonn before proceeding with this assessment PART II - IMPACT ASSESSMENT lTo be comDleted bv Lead Aaencvl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.4? If yes. coordinate the review process and use the FULL EAF. Dyes DNo B. WILL ACTION RECEIVE COORDINATED REVIEW M3 PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No. a negative declaration may be superseded by another involved agency. D Yes 0 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (An"""'r. may be handwritten. ~ legible) C1. Existing air quality, surface or groundwater quality or quantity. noise levels. existing traffic pattern. said waste production or disposal, ¡tential for erosion, drainage or flooding problems? Explain txieIIy: I C2. AesIhetic. agiaJltural. archaeological. historic. or other natural or aJlturaI resources; or canvnunity or neighborhood character? Explain briefly: I I C3. Vegetalioo or fauna, fish, shellfish or wldife species, significant habitats. or threatened or endangered species? Explain briefly: I I C4. A conmunIty's existing plans or goats as oIIicIaIy adopted, or. changO In use or IntenSlly of use of land Or other natural msourœs? Explain briefly: I I CS. Growth, aubse<JJent development. or relaled adiviIies Ulœly to be Induced by the proposed action? Explain txieIIy: I I C6. Long term, short term, cu_. or other effects not Identified In C1-C5? Explain briefly: I I C7. Other ImpacIs I in use of either quantity or MJe 0'''''''''''' ExplaIn brloIIv: I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVlRO~ENTAL AREA (CEA)? (if yes, explain briefly: I Dyes DNo I E. IS THERE. OR IS THERE LIKELY TO BE CONTROVERSY RElJ\ TED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ~ """ e><Dlain: DYes DNO PART III. DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: Foreach adverse -.:t Identified abQve, determine whether Ii Is substantial. large, important orotherwlse significant Each effect should be assessed In connection with lis (a) seWng (i.e. urban or rural); (b) probability of occun1ng; (c) duration; (d) Irreversibility; (e) geographic scope; and (I) magnitude. If necessery, add attachments or reference supporting mater1a1s. Ensure thet explanations contain sufficient detail to show thet all relevant adverse Impacts have been Identified and adequately addressed. If question d of part II was checked yes, the determination of significance mustevatuate the potential impact of the proposed action on the envtronmental characteristics of the CEA. Check this box ~you haw idenlified one or more potentially large or sigrilicantadverse impacts which MAY occur. Then proceed directiyto the FUll EAF and/or prepare a positive declaration. Check this box ~ you have detennined, based on the information and analysis above and any supporting documentation. that the proposed actio< WILL NOT result in any significant adverse envlrormentallmpacts AND provide, on attactments as necessary, the reasons supporting thi determination . Name of Lead IVJer'q Date Pnnt or Type Name of Responsible Officer In Lead Agency Tide of Responsible Qftiœr Signature of Responsible Oftiœr In lead Agency Signahne of Prepðfer (If different 1rom responsible offiCer) I PROJECT ID NUMBER . ,. SEQR 617 20 APPENDIX C STATE ENVIRONMENTAL QUALl1Y REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNUSTED ACTIONS Only PART 1 - PROJECT INFORMATION (To be completed by A plican! or Project Sponsor) 1. APPLICANT I SPONSOR 2. PROJECT NAME D HalVLand Use for J. Chemushka Chemushka - East Marion 3.PROJECT LOCATION: Eas\ Marion, Southold Suffolk Municipality County 4. PRECISE LOCATION: Street Add... and Road Inte!SeCtion.. Prominent Iandmar1ts ete - or provide map 845 Bay Ave. East Marion, NY 11939 1000-31-10-15 5. IS PROPOSED ACTION: ø New o Expansloo o Modlflc8tioo I alteration 6. DESCRIBE PROJECT BRIEFLY: Please See Attached Project Description. 7. AMOUNT OF LAND AFFECTED: Initially 8.6 acres Ultimataty 8.6 acra. 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESlRICTlONS? øyas o No If no, dascriba brially: 9. WHAT IS PRESENT LAND USE IN VICINI1Y OF PROJECT? (Choose as many a. apply.) ø Resldantlal o Industrial Deommercia' DAgricuhura 0 Park I Fora.t' Opan Spaœ o Othar (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM NlY OTHER GOVERNMENTAL AGENCY (FadaraI, Steta or Local) øYa. ONO If yes. list agency name and permit I approval: USACOE, NYSOOS, AND SOUTHOLD TOWN TRUSTEES 11. DOES NIY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? OYas øNO II yes, list agency nama and pennh , approval: 1~ A ~YLT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? es '" No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS lRUE TO THE BEST OF MY)<NOWLEDGE Applicanl_' Sp~sor Na~.A~ Hall \~~d Y1 ~:lïical Services, Inc. Data: November 12, 2002 Signature I ~v / . - .. If the action Is a Costal Area, and you al'8 a state agency, complete the Coastal Assessment Fonn before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed bv Lead Anencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.4? II yes. coordinate the review process and use the FULL EAF. DYes 0 No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617 .6? ~ No. a negative declaration may be superseded by another Involved agency. Dyes ONo C. COULD ACTION RESULT IN AI« ADVERSE EFFECTS ASSOCIATED WITH THE FOlLOWING: (Answers may be handwritten, ~ legible) C1. Existing air quality, swfaœ or groundwater quality or quantity, noise levels. existing traffic pattern. solid waste production or disposal. ¡tential br erosion, d'ainage or tIoodng problems? ExplaIn briefly: I C2. Aesthetic, agriwltural. archaeok:JglcaI, tistoric, or other nabJral or cultural resources; or corrvnœity or neighborhood character? Explain briefly: I I C3"egelatioo or fa..,., fish. shellfish or wldife species, significant habitats. or threatened or endangered species? Explain briefly: I C4. Î COITIII1triy's existing plans Of goals as offidaly adopIed, or a change In use Of inIBnsIty of use of land Of other natural ",,,",roes? E_ briefly: I CS. Growth. SIbsequent developmenL or relaled activities likely to be _ by the proposed action? ExplaIn briefly: I I C6. Loog tenn, short Ie"". curoolative. or other effeds not identified In C1-C5? ExpIah briefly: I I C7. Otherlmoads i In useoleither~or"""'olenemv?ExpIain brieftv: I l D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL õ:'foNEõ~~EA (CEA)? (If yes, explain briefly: I E. IS THERE. OR IS THERE LIKELY TO BE, CONTROVERSY RElATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ~ yes explain: I o Yes 0 No I . PART III- DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: Foreach adverse effect identified abQve, determine whether It is substantial, large, important or otherwise significant Each effect should be assessed In connection with Its (a) seWng (I.e. urban 01' Nral); (b) probability of occurring: (e) duration; (d) Irreversibility; (e) geogn¡phlc scope: and (f) magnitude. If necessary, add attachments 01' reference supporting materials. Ensure thaI explanations contain sutlidenl dataillo show thaI all relevant adverse Impacts have bean idanllfled and edequalely addressed. ~ question d of part Ii was checked yes, the datermlnation of signlflCSnce muslevaluale the polenllallmpactofthe proposed action on the environmental characteristics of the CEA. Check this box~)<JU have identified one or more potentially IargeorsignllicantOOverselmpactswhlch MAY occur. Then proceed directly to the FUU EAF and/or prepare a posltlve_. Check ttis box tf you have determined, based on the Information and anatysis above and any sUPlX»1ing documentation. that the proposed actiOl WILL NOT resutt in any significant adverse environmental impacts AND provide. on attachments as necessary, the reasons st4>f)Ol1ing thi determination. Name of Lead Agency Date Pnnt or Type Name of Respol1SlDle Officer In Lead Agency TrtIe of Responsi~e Officer Signature of Responstble Officer In lead Agency SlgnabJre of Preparer (If different from responsible officer) f Land Use . . , . . '", 'i'V,"'" """,' [ C 0 log :c i IS! ' " ( e sin C December 17, 2002 Town of South old Board of Town Trustees P.O. Box 1179 Southold, N.Y. 11971 Re: Chernushka - East Marion Proposed Dock To whom it may concern: Enclosed please find an application package which includes the following: - (1) original, (2) copies of the completed application form. - (1) original, (2) copies of a Short Environmental Assessment Form - (3) sets of Plans. - Application fee ($200.00). If there are any questions, or if you require additional information please don't hesitate to contact this office. Sincerely, Dan Hall Land Use Ecological Services, Inc. DH Enc. 2576 Sound ,L\venue . Boiling Hollow, New '¡ark. 11933 631127-2400 . FAY. 631-727-2605