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HomeMy WebLinkAboutTR-5877Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda PeggT 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 OFSOUTHOLD CERTIFICATE OF COMPLIANCE # 0034C Date April 20, 20C5 At THIS CERTIFIES that the bulkhead 2535 Cedar Lane, East blat±on Suffolk County Tax Map # 37-4-10 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 2/23/04 pursuant to which Trustees Permit # 5877 Dated 3/24/04 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is to remove/replace existing bulkhead The certificate is issued to aforesaid property. Kenneth L. Stein osvner of the Authorized Signature Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ~'~t~t7 DATE: .~!~rch 24., 2004 ISSUED TO ............ CE. NI?E.T.~ ..I~.:....~.TEIN' ......... Autl arizatiau Pursuant fo the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the I.~ws of the State of New York 1952; end the Soufhold Town Ordinance en- titled "REGULATINCo AND THE PLACINmo OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the REMOVAL OF SAND, C~RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and Jn accordance wlfh the Resolution of The Board adopted at a meeting held on .M.e:'Ccl~ 2.4~. 200.¢ , and in consideration of fha sum of $ 200.(~0 . paid by Kenneth L. Stein of ....East ........... Marion N.Y. and subject to the Terms and Gonditions listed on the reverse side hereof, of Soufhold Town Trustees aufhorlzes and permlfs the following: Wetland Permit to remove 107' linear ft. of deteriorated bulkhead and reconstruct in the same. location with vinyl sheathing, and as depicted on the plan prepared by David Corwin dated February 10, 2004. all in accordance with the detailed specifications es presented in ~ne originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal fo be affixed, and these presents to be subscribed by e mejorlfy of fha seld Board as of this date. Artie Foster (absent) "' Trustees TERMS and co~mc~s The Perm~ee Kenneth Stein ~idlngat 2535 Cedar Lane~ East Mai'iq>Fl N.Y. as para of the comidemdoa for the lsmaa~ of the Permit does uade~tand and pn~albe to the fol- lowing: 1. That the said Board of Trustees and the Town of 5o~thold rte released f£,~ say and all damages, or ~.i,~. for ao,,..ges, of suits as/siag d/tectly ot /ndlm:dy as · _v~_*k of say o1~' with respect thereto, to the t~mplete exclusion of the Board of Ttmtees of the Town of 5outbold 2. That this Permit h valld for a period of 24' m~__ wblth is conskle~d to be the estimated time requited to complete the work invol~l, but should d_rcumstances warrant, teclne~t for an ext,~ion may be made to the Board at a later date. 3. That this Permit should be te~ined indefinitely, or as long as the said Petmlttee *d.daes maintain the structure or project involved, to provide evidence to tnyone coacemed that anth- orlzatlon was ori~r,.lly obtained. 4. That the work involved will be subject to the inspection and approval of the Board ot its agents, and non-complLance with the provisions of the ~ appHcat~n, may be cause foe revocation of this Permit by tesohtion of the said Board. 5. That there will be no ~le interference with navigation as a result of the work he~n au'thodzed. 6. That there ;hall be no interference with the tight o~ the l~hlh' to ~ am[ ~ aloog the b~....ch l~twcea hi.oh and low water marks. 7. That i~ futt~re operations of the Town of So~thold zequire the removal and/or alterations inthe location of the ~tk heze/n tuthodzed, or if, in the opinion c~ the Boa~d o/Tmstee~ the ~ *h~ll t~u.~ tm_,-e~soc~le obe~ to free navlgado~ the said Petndttee will be Veq~eds upon due notice, to remove ot alter this work ot pwject herein stated without ~ to the To~n 8. That the said Board will be notified by the Petmittee ot dae ,,~?~eflon of the wed~ mth- ot-b~L 9. That the Pennlttee will obodn all other l~'nn~ and coments that may be vequlted p[emental to chis permit which may be subject to revoke upon f~lh,~, to Ol:~In same. 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. S+-e~ V\ INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction % constructed V Project complete, compliance inspection. . . 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 i 631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 24, 2004 Mr. David Corwin 639 Main St. Greenport, NY 11944 RE: KENNETH L. STEIN 2535 CEDAR LANE, EAST MARION SCTM#37-4-10 Dear Mr. Corwin: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 24, 2004 regarding the above matter: WHEREAS, David Corwin on behalf of KENNETH L. STEIN applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated February 23, 2004 and, 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 March 24, 2004, 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, 2 . . WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined 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 approve the application of KENNETH L. STEIN to remove 107' linear ft. of deteriorated bulkhead and reconstruct in the same location with vinyl sheathing, and as depicted on the plan prepared by David Corwin dated February 10, 2004. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $5/.100 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, £t¿.-i 9- ~.tj., Albert J. Krupski, Jr. President, Board of Trustees AJKllms . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: U (I n 1'\ t r-h þ(. ~ R L f~ Please be advised that your application dated .:2..\.;;13 \ 0</ has been reviewed by this Board at the regular meeting of ~_ and the following action was taken: L.J.¿j' Application Approved (see below) L-) Application Denied (see below) L-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fee COMPUTATION OF PERMIT FEES: .$ :s0.00 (M~C L.cè.ù þ£- necessary. '" TOTAL FEES DUE: $ 50,00 i -:tt 'J:)~ ~ û---t..C"C ' \\''C ' I.t ¡ Iltl f}J // ( / ---------- SIGNED: d'~-¥ Il ~'9»0 PRESIDENT, BOARD OF TRUSTEES . . Telephone (631) 765·1892 TO\vn Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERV AnON ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Monday, March 22, 2004, the following recommendation was made: Moved by Tom Schlichter, seconded by Doris McGreevy, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of KENNETH L. STEIN to remove 107 linear ft. of deteriorated bulkhead and reconstruct in the same location with vinyl sheathing. Located: 2535 Cedar Lane, East Marion. SCTM#37-4-10 The CAC recommends Approval of the application with the Condition the current non- turf buffer be maintained. Vote of Council: Ayes: All Motion Carried . . GAR DINERS BAY ESTATES HOME OWNER ASSOCIATION, INC. P.O. Box 4, East Marion, New York 11939-0004 February 19.2i)04 Mr. & Mrs. Kenneth Stein Fi\'e "\roods Witch Lane Chappaqua. New York 10514 Dear Mr. & Mrs. Stein: This letter ackno\vledges the Gardiner's Bay Estates HOIneo\\.:ners Association approval of:our bulkhead replacement on your waterfront property line as shown on your survey map. Should you ha\ e an) questions or request additional information, please do not hesitate to contact us. Sincere "00 e ge Peter. President IS r; ltt~) ~~"re' MA~ - C,," ..J S''''~I¡thbll 'Town """r8oârU ~ . . I!!!!!".. .,;<:f"'J'..>." .':-,_"_-_- _ . ?ì'~{.-. -..~.~.~~~.~::.;~¿--: ~, --j l ;1 l + ~ 1'- ~ ~ n i G 0 ~ a e5 ! ~ § § < ~ . . . . I I I , 1 --> ... 9g I' ~-~ :1 ~~ c·!:::!>- ~.;" ~sI-' ~- ! ~iia I . 13", - I U"l1~ ! = CD , '" "I' .;1'1 / j~.." , ~ i!~i~ "'I , ~ ªi" , .. - "~iI; ...J ~. \ Un! ' 'I ~ I 'I" I .,1 !~ ~ .I .! I I"::' till!!! i",~ ~;@J ',1;-, , '.~ ~ ' : I 11I1!!i f-- , , -<:>- Z I ---~ :- ¡ , ,,, ' IIII i ~ ~ i ~ t II1I' , , ' , 1 i 1111 I'· , I!! Iii f , , ~.. .. III i i i i jÌ ii i hili) ie!!! I I,' ,I ¡ '!; + ~ , ~ ~ I I I í II - 3' 'E;.,¡¡;;¡ . !" , " ¡llId ¡W. I ! ~ JI, ~ J ~ ¡ ntH .........O....zO PROPERTY OWNERS SCTM 1000-37-4-9 BARBARA ANN PAGANO 2435 CEOAR LAN E PO BOX 555 EAST MARION, NY 11939 SCTM 1000-37-4-10 (APPLICANT) NANCY & KENNETH STEIN 5 WOODS WITCH LANE CHAPPAQUA, NY 10514 SCTM 1000-37-4-9 NANCY STEIN 5 WOODS WITCH LANE CHAPPAQUA, NY 10514 SCTM 1000-37-4-17 GARDINERS BAY ESTATE CLUB INC. PO BOX 4 EAST MARION, NY 11939 oK LOT 9 () '" o » '" LOT 10 APPLICANT <¡; z '" LOCATION MAP I I I 50 100 150 200 SCALE '·.100' ~. : I,; EAST MARION ~ ~ k' I.t};;';' \, -- I~ ,¿.{I 11-.....,... _., l'.,' k. Vi 'f>:~--:~~::: ¡o--: \, c / ;;:\.,. \\ ':¡ ",' ~4\, 'iè..' ..., I ,. \ ~ ./;.-- "" \'9Jt;)! )~\/ ) \..;;/.r )1' \.. ~~~;; ~~ (", i'V .:'~''S'<-~1'' -"'~:.' I f~\ ~::',~::'" ,~~. ~.- ~ , ':ii~. ''-~\\ '\t,'" -~ .0 ~ .~'" "'{C', ,...~'otc \.. ~""'\ \ ·c, \"Koo\ ' LOCUS I \i~\ ~ ... \'.,~:\ .~ \. I '~ifif¡:¡'" ¡ .... ',xi., :Ji} M'': " \\''''- Ì'>¡~t. <."#, ORIENT HARBOR VICINITY MAP HAGSTROMS MAP OF SUFFOLK COUNTY MAP 26 GRID E-45 APPROX. SCALE 1'=3,000' '. ,. :to'. SPRING POND VICINITY MAP SPRING POND LOT 17 UNDERWATER LANO ~[E [~ IE ~ ~iJ ~, L ~ C'lltrl,"ld 10\";11 FWHd út T¡II~t -'~c, I:'~ BULKHEAD REPLACEMENT SPRING POND EAST MARION TOWN OF SOUTHOLD APPLICANT: KENNETH STEIN SHEET 1 OF 3 FEBRUARY 10, 2004 DRAWN BY: D. CORWIN ---- - FLOOD EBB- SPRING POND \, EXISTING BULKHEAD REPLACE IN KIND \ EXISTING FLOAT At> BUU<HE'AO UNEJ t!:S IDi iDI llZll IDI . IZII 60' EXISTING WOO EXISTING ." PVC r OVERFLOW ALW, AHW & BL'LKHEAD LINE CCNTIGUOUS 38' '" '" '-' 2Ò; NÕ TURF BUFFER ., ~v. DRAJNAGE BASIN INLET WOOD DECK ~ ~ 1 STORY FRAME HOUSE 2535 CEDAR LANE GARAGE PURPOSE, REPAIR DETERIORATED BULKHEAD ." PVC OVERFLOW AS PER SOUTHOLD TOWN TRUSTEES PERMIT NO. 5262, 12-27-2000 lli]) WATER DEPTH 10 20 30 SCALE '--3D' BULKHEAD REPLACEMENT SPRING POND EAST MARION TOWN OF SOUTHOLO APPLICANT: KENNETH l. STEIN SHEET 2 OF 3 FEBRUARY 10, 2004 DRAWN BY: D. CORWIN 99' I: ©©© ROAD RUNOFF DRAINAGE BASINS CEDAR LANE PLAN VIEW REPLACE 107 L.F. Of EXISTING BULKHEAD IN SAME LOCATION DATUM: ALW -------. GRADE~ FRONT VIEW 6 5' , ; I I AHW ALW MUD LINE 10' &12' VINYl ":ìHEATHING 6" )( 6" C':;A WALE L~1D" x 12' CCA PILES 6' O.C. . _ -- - 5.0 TOP OF BULKHEAD 3/'- x 12' GALV. TIE ROD"--J ~ 1 O· x 8' CCA ANCHOR PILES 6' O.C. CROSSVIEW DIAGRAM 0' I 5' 2' 2.4 APPARENT HIGH WATER 6" )( 6n CREOSOTE WALE 0.0 APPARENT LOW WATER -1.2 MUD LINE BULKHEAD REPLACEMENT SPRING POND EAST MARION TOWN OF SOUTH OLD APPLICANT: KENNETH L. STEIN DRAWN BY: D. CORWIN FEBRUARY 10, 2004 SHEET 3 OF 3 . . 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 SOUTH OLD Office Use Only Coastal Erosion Permit Application ~land Pennit Application ~ajor Waiver/Amendment/Ch ge ~eived Application: ð ~ceived Fee:$ ..-cõmpleted Application ~Incomplete _SEQR'I. Classification: Type I_Type Il_Unlisted_ _Coordination:(date sent) ...cAC Referral Sent:~ ~ate ofInspection:~ _Receipt of CAC Report: _Lead Agency Determination:_ Technical Review: ""I'úblic Hearing He~ Resolution: Minor '~ l!: F~ ' Ii r--,ì \.1 I:" i . -, ,~--_. SOl\~nold ¡own BOj'ct at TlUstees Name of Applicant { 'E MN E:T H L ST/=.JN Address C) WMt¡S WITc..~ LN,) CHAPPA~UIT) NY 105 I 4 Phone Number:() 2. )"2.. - ~ \8 - (H (] 0 Suffolk County Tax Map Number: 1000 - :<.l - 4 -} Ü Property Location: "2..5'35" <:.,E:DAK LN.' EA~T MAR.ICÞ/ ¡NY $y~¡NG- p(}l\1i) (provide LILCO Pole #, distance to cross streets, and location) r1 7J~~\~ AGENT: DA'IJ I f) CO K VV I N (If applicable) Address: ~ ~ q \"\ A 11'\\ S í 1)'\4tt-l~~\ & Kt: E.-N Po 1<, N Y J Phone: ç, .3 \ -If /7 - 0> I e If . . Board of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: /ZE5IÐENT'¿¡ L. Previous use of property: Intended use of property: - Prior permits/approvals for site improvements: UNKN ð4JN Agency Date ~ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): R1::M~"F 107 L..INEAR, FEET OF DE.TER.IORATED RUUZJ.tEA,b) REC-CI\I.$.T"R,L.)c.r IN THE SA-¡\,,\e. Ct>(.,A'ï\~N NEW ßL.)UZ\-\'EJIt> WJíJ../ V/AI'}I.... -SrtEt.\':' 2- ~ . . Board of Trustees Application WETLANDffRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: R£..C.dN STI(.UGI DéTE/UO;eßTF/) ð'u'L..t< HEA D Area of wetlands on lot: ~ square feet Percent coverage oflot: '- % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland --- edge of wetlands: feet Does the project involve excavation or filling? No .....---- Yes ¡fyes, how much material will be excavated? 'id cubic yards How much material will be filled? £.10 cubic yards Depth of which material will be removed or deposited: - feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ßACJ<.FJt..L ee/l/AiD 8(JU(HM() l.J) LL- ßP t=J-.CAV/}T¡;:./) "TH~/\I R..£fJ/fC,£L> 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): NO EF¡=ECT /YIIT/CI Þ/'IíEl> J . . Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: % Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated?__(cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) Lj . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Polìwoda 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------------------~---------------- In the Matter of the Application of __~(lJrl{l~~~-~..-~1J2.il)c-.----------------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) I J:::>A-UJ () c::A. W I IV , AFFIDAVIT OF POSTING M.4I/¡/ Sí Ç..<!.~.EJl/NA./. III Y being duly sworn, depóse and say: 0¡'-1 . That on the/ day ofA-f4éÇ /j , 20oy. I personally posted the property known as J<";::;Á//V£.n; ,:: T£/II./, c...~ 04¿<!lÞ. G4; í A1A4Jr! N by placing the Board of Trustees official poster where it c~ easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be heldlLJa#. .~ ~~~ _ Ot"\ ðr- ab ~+ "',00 10. Dated: 3/«;2./0'+ , residing at r;; 3cr /11lJ t.¡ ff04f¿ j .a~ (signature) Sworn to before me this ~¿;¡, day of~OO i ~.~.~ . tary Public JANET E. STAPlES Nota~ Public Stale of New YartI No. 4831949, Suffolk Countr ^ '" Commission EJepim July 31. 20 ~ . . Board of Trustees Application ,..... 'f...c...c;. County of SI1fi"ðlk State of New York lC4..JrJl!nt J... 'S~,../ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF IllS/HER KNOWLEDGE AND BELŒF, 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 TIllS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TIllS APPLICATION. · ~¿fs SWORN TO BEFORE ME THIS BOTWINICK PUBLIC, State 01 New Yor~ No. G34B3l241 Qualified In Broil' County r Commission Expires "7-) L 0 '\ ~-rl.. DAY OF J~. ,20~ t.;" . 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only . SEQR I PROJECT 10 NUMBER PART 1 . PROJECT INFORMATION ( To be completed by A plicant or Project Sponsor) 1. APPLICANT I SPONSOR 2. PROJECT NAME Kenneth l. Stein Stein Bulkhead Replacement 3.PROJECT LOCATION: Town of Southold Suffolk Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc - or provide map 2535 Cedar Lane, East Marion, NY, spring Pond 5. IS PROPOSED ACTION: 0 New o Expansion ø Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: Remove 107l.F. of deteriorated bulkhead, reconstruct in the same location new bulkhead with vinyl sheets 7. AMOUNT OF LAND AFFECTED: Initially - acres Ultimat~y - acres B. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? 0ves o Na If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ø Residential D Industrial D Commercial DAgriCU,ture D Park I Forest I Open Space [J Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMA TEL Y FROM ¡\NY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [2 Yes ONa If yes, I;st agency name and permit I approval: NYSDEC, US Army Corps of Engineers, Southold Town Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes [2 NO If yes, list agency name and permit I approval: 1f'"-t: A ~,UL T 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 Applicant I S~sor Name - Date: . , .. Sinnature .t....;;;;.} i "-A::~I .. ::) (I ,;<'" , ~~ -. If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Fonn before proceeding with this assessment PART II - IMPACT ASSESSMENT ITo be comaleted 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 DNa B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. Dyes DNa c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, ij legible) C1. Existing air quality, sulface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: I I C2. Aesthetic, agricultural, archaeoiogical. historic, or other nab.lral or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or fauna, fish. shellfish or wildlffe species, significant habitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as offIdally adopted, or a change in use or Intensity of use of land or other natural resources? Explain briefly: I I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I I Ga. Long term, short tenn, cumulative, or other effects not identified in C1-GS? Explain briefty: I I C7. Fcts {includina ch""""" in use of either auantilv or Ivne af enemv? ExDlain briefly: I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If yes, exDlain briefly: ] D Yes D No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: I D Yes D No I PART 111- DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: Foreach adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (1) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all r~evant adverse impacts have been identified and adequat~y addressed. If question d of part ii was checked yes, the determination of signifrcance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAYoccur. Then proceed directly to the FUU EAF and/or prepare a positive declaration. Check. this box if you have detennined, based on the information and analysis above and any supponing documentation, that the proposed actiOf WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Pnnt or Type Name of Responsible Officer 10 Lead Agency Title of Responsible Officer Signature of ResponSIble Officer in Lead Agency Signature of Preparer (If different from responsible officer) . . Nancy C. Stein 5 Woods Witch Lane Chappaqua, New York 10514 (914) 241-0515 January 24, 2004 TO WHOM IT MAY CONCERN: I am the owner of the premises located at 2665 Cedar Lane:, East Marion, New York. J understand that the replacement of the deteriorated bulkhead at the adjoining premises to the north, 2535 Cedar Lane, East Marion, New York will encroach on my property at least 6 feet. J have no objection to the proposed replacement or encroachment. Very truly yours, 'ì L~/L-'\ t~ C V~ Nancy C. Steiri ~11'F~B ~ ~ ïH ~ Soulho!d Town BO':Hd of Trustees . . APPLlCANT/AGENTIREPRESENT ATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold~s C..odc of F.thiC!. nrohibits confljcts ofintcrest on the Dart of town officers and CII1nlovees. The ournase of this form is to orovide information which can 81m the town ofoossih1e conflicts of interest and allow it to take whatever action is necessarv to avoid samc. YOUR NAME: Sf"{IJ úJ,J (1' "' \... . (Last name. (1I'St name, J¡liddle initial, unless you are applying in the name (of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPL/CATlON: (Check a/l that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "'Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning ......... Do you personally (or through your company, spouse, sibling. parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood. marriage, or business interest. "Business interest'" means a business, including a partnership, in which the town officer or employee has even a partial ow.nership of (or employment by) a corporation in which the town officer or employee owns more than 5% o~ shares. YES ___ NO ./ If you answered ··YES". complete the balance or this fonn and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check tbe appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling. parent, or child is (check alJ that apply): _A) the owner or greater than S% of the shares of the cotpOrale stock or the applicant (when the applicant is a corporation); _B) the legal or beneficial ow~ of any interest in a oon...corporate entity (when the applicant is not a corporation); _C) an officer, director, partner, or employee or the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi Signature Print Name v~ _200 i- Form TS I '4E iJ,Jænt L S(C¡.[ . . --//11 .~) 7 /:": , . APPLICANT/AGENTIREPRESENT A TIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the Dart artoW" officers and emolovees. The Dumose of this Conn is to DTovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is necessar\' to avoid same. YOUR NAME: í)A ¡"¡ I' '.~C"¿ VI tV /.Je-5{J ì (Last name, first name, middle initial, unless you are applyin.g in the name of someone else or other entity. such as a company. Ifso, indicate the other person's or company's name.) NAME OF APPLlCA nON: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other «(["Otherh, name the activity.) Building Trustee Coastal Erosion Mooring Planning >-- Do you personally (or through Jour company, spouse, sibling, parent, or child) have a relationship with IIDY officer or employee of the Town of Southold? "Relationship" includes by blood. marriage, or business interest "Business interest" means a business, including a partnership. in 'Which the to\-",n officer or employee has even a partial ownership of (or empl(Jyment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ----~- If you ans\\ered ··YES··. complete the balance of this form and date and sign where indicated. Name of person employed b) the TO\\!n of South old Title or position of that person Describe the relationship between )'ourself(the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); _B) the legal or beneficial own~r of any interest in a non-corporate entity (when the applicant is not a corporation); _C) an officer. director, partner. or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELA TIONSHlP Submitted th~day of /'1~-V¿clj Signature ' G ~ "-- \.... \ Print Name bAt/IV ,-(',.¿¿<-AI 200~ ~' Form TS I - . 631-477-0184 David S Corwin 639 Main Street Greenport. NY 11944-1431 . wrwm@optonhne net February 16, 2004 Board of Town Trustees Town of Southold P. O. Box 1179 Southold, NY 11971-0959 Subject: Stein Bulkhead Replacement, Spring Pond, East Marion Dear Trustees: Enclosed please find a permit application for replacement in kind of an existing bulkhead for Mr. Kenneth Stein, 2535 Cedar Lane, East Marion, NY. The application includes: · One original plus 2 copies of the application form · Short Environmental Assessment Form · Survey - 3 copies · Project Drawing - 3 copies · $200 Application Fee · Neighbor's letter of permission Sûutho\d Túwn BC3r,j c,f Trl:')t~.:'S If you require any additional information or have any questions please contact me directly. Very truly yours, " fir i ~ . ::t:-,.v,;jc ,-' ujJ' "'--'j David S. Corwin ' U) ¡:;,:¡ ~" :,¿ <e: ~ 0::0 .~ ~ 2 ~I U),,; o~.... ....0 ¡:.:¡ '" Z...J30 o~ o~¡.,o~wr!. p-'r.,:>-<~~~"""'I-zr<)" 0 >< c<e:~~ ~:::> I~g ~~I'\ p:¡~~¡;¡<e:~~g.II'" :> -. ~ ¡.,;:::;: I-O';..Ò p::; :::;:¡ ,,.., ¡.; 8 :": lL. Z ~ - >---, L() "",'V-' '-' ...J :::; :::> "-' ...... _ r,q ¡;: ¡.,~ 00 ,--'--, UJC'J ~tJ¡",;;:U) ü~<}õ2 ..--i ¡:.:¡ "v, <e: Z V") a. 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