HomeMy WebLinkAboutTR-5963WILLOW POINT ASSOCIATION
Southold, N. Y.
SCM# 56-5-28
June 19, 2006
Board of Town Trustees
Town of Southold
Re: Permit No. 5963
The above referenced maintenance dredging pemdt is expiring on
July 21, 2006. The Willow Point Association would like to extend
this permit for additional time period allowable under the Town of
Southold Code.
Sincerely,
/Andrew Nikolich
JUN ]cj 2006
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
June 21, 2006
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Mr. Andrew Nikolich
850 Budd's Pond Rd.
Southold, NY 11971
RE:
WILLOW POINT ASSOC.
WILLOW POINT RD., SOUTHOLD
SCTM#56-5-28
Dear Mr. Nikolich:
The following action was taken by the Southoid Town Board of Trustees at their Regular
Meeting held on Wednesday, June 21,2006:
RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to
Permit #5963, as issued on July 21,2004.
This is not an approval from any other agency.
If you have any questions, please do not hesitate to contact this office.
Sincerely,
President, Board of Trustees
JFK:lms
GULL
lo0
110
POND
MANHAgSET
march 15, 2006 Field Inspection
march 15, 2006 Field Inspection
march 15, 2006 Field Inspection
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Southold Town Board of Trustees
Fi¢ld InspectiorJWorkscssion Report
Property Location: SCTM# & Street
Brief Description of proposed action:
Type of area to be impactfid:
Saltwater Wetland '~ Freshwater Wetland
Distance of proposed work to edge of above:
Part of Town Code proposed work falls under:
__Chapt.97 Chapt. 37 other
Type of Application: Wetland __Coastal Erosion __Amendment __Administrative
__Emergency
Info needed: ixA~L[_
Sound Front ~Bay Front
Modifications:
Conditions:
Present Were: ~.King __J.Doherty ~.Dickerson
Other: ~1 ~,~qh-~
D. Bergen~JU~.Holzapfel
Mailed/Faxed to:
Date:
FEB-22-2006 15:£~ SHH STOr,,~¥ ~OOK 1631 444 02~i P.01/01
New York State Department of Environmental Conservation
Division of Solid & Hazardous Materials, Region One
Building 40 - SUNY, Stony Brook, New YOr~ 11790-2356
Phone: (631) 4~-4-0375 · FAX: (631) 444-0231
Website; www.dec, state.ny.u$
Denise M, Sheeh~q
Commissioner
February 16, 2006
Andrew Nikolich
Willow Point ,M~ociation, Inc.
185 Willow Point Road
Soulhold, NY 11971
Re:
Dredging of Canal off Budds Pond
Permit # 14738-03327/00001
Dear Mr. Nikolich:
The New York State Department of Environmental Coraervaion (Department) has
reviewed the February 1, 2006 x~por~ oft. he chemical analysis performed on a sample of thc
material to be da'edged. Based on those results, the Departmem has de. tennined that the malerial
may be harlflled upland without restriction, Should you have additional questions regarding ~is
matter, do not hesitate to contact me.
Sincerely,
Mark Carfare. DEP
TOTRL P,~i
New York State Department of Environmental Conservation
Division of Environmental Permits
Building 40 - SUNY, Stony Brook, NY 11790-2356
Telephone (631) 444-0372
Facsimile (631) 444-0360
Denise M. Sheehan
Acting Commissioner
July 19, 2005
Willow Point Association Inc.
185 Willow Point Road
Southold, NY 11971
2006
1-4738-03327/00001
Dear Permittee:
In conformance with the requirements of the State Uniform Procedures Act (Article
70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your
permit. Please read all conditions carefully. If you are unable to comply with any
conditions, please contact us at the above address.
Also enclosed is a permit sign which is to be conspicuously posted at the project site
and protected from the weather.
CKW/ls
Enclosure
Sincerely,
Claire K. Werner
Environmental Analyst
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC PERMIT NUMBER I EFFECTIVE DATE
1-4738o03327/00001
July 19, 2005
FACILITY/PROGRAM NUMBER(S) PERM IT EXPIRATION DATE(S)
Under the Environmental July 19, 2010
Conservation Law
TYPE OF PERMIT · New [] Renewal [] Modification · Permit to Construct [] Permit to Operate
· Adicle 15, Title 5: Protection of Waters
[] Adicle 15, Title 15: Water Supply
[] Article tS, Title 15: Water Transport
[] Article 15, Title 15: Long Island Wells
[] Article 15, Title 27: Wild, Scenic and
Recreational Rivers
· 6NYCRR 608: Water Quality Cediflca-
tion
[] Adide 17, Titles 7, 8: SPDES
[] Adicle 19: Air Pollution Control
[] Article 23, Title 27: Mined Land
Reclamation
[] Adicre 24: Freshwater Wetlands
· Article 25: Tidal Wetlands
[] Adicle 27, Title 7; 6NYCRR 360:
Solid Waste Management
[3 Article 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
[3 Article 34: Coastal Erosion
Management
[] Article 36: Floodplain Management
[] Articles 1, 3, 17, 19, 27r 37; 6NYCRR
380: Radiation Control
PERMIT ISSUED TO TELEPHONE NUMBER
Willow Point Association Inc, (631) 765-6015
ADDRESS OF PERMITTEE
185 Willow Point Road, Southold, NY 11971
CONTACT PERSON FOR PERMITTED WORK
Andrew Nicolich, 850 Budd's Pond Road, Southold, NY 11971
TELEPHONE NUMBER
(631) 765-6015
NAME AND ADDRESS OF PROJECT/FACILITY
Willow Point Association Inc. property, Willow Point Road SCTM # 1000-56-5-28
COUNTY TOWN WATERCOURSE
Suffolk Southold Budd's Pond
NYTM COORDINATES
DESCRIPTION OF AUTHORIZED ACTIVITY:
Maintenance dredge 800' of canal and channel to Budd's Pond to a depth of -5' below mean Iow water, place a total of
900 cubic yards dredge material (in 100 cubic yard batches) in temporary transfer area on upland, for ultimate off-site
disposal at an approved upland location. All work must be done in accordance with the attached plans stamped
NYSDEC approved on 7/18/05,
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all
applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of
this permit.
PERMIT ADMINISTRATOR:
Mark Carrara (CKW)
AUTHORIZED SIGNATURE
ADDRESS
Region 1 Headquarters,
Bldg.#40, SUNY, Stony Brook, NY 11790-2356
DATE
Page 1 of 4
July18,2005
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
SPECIAL CONDITIONS
1. The proposed project is within 500 feet of a documented piping plover and least tern nesting area. For the duration
of the permit, no work shall be conducted from April 1'~ through August 31" of any year.
2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area
(upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected
buffer areas.
3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted
activity.
4. During the dredging operation, the permittee and his contractor shall prevent spillage of sediment during excavation
and haulage. Dredging shall be accomplished with a clam shell or other closed "bucket" equipment.
5. No dredging shall occur within 10 linear feet of the seaward edge of the marsh.
6. Dredging is prohibited from June 1- September 30 ofeach year to protect spawning shellfish and/or spawning finfish.
7. All side slopes of the dredged channel shall have a maximum of 1:3 slope.
8. Material approved to remain on-site and/or within the Department's Tidal Wetland jurisdiction must be retained so
as not to re-enter any water body, tidaJ wetlands or protected buffer area. Off-site, upland disposal of dredge material
beyond the Department's Tidal Wetland jurisdiction requires the approval of the Division of Solid and Hazardous
Materials (631) 444-0375 and is not covered by this permit.
DEC PERMIT NUMBER
1-4738-03327/00001
PAGE 2 of 4
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608
( TIDAL WETLANDS)
If future operations by the State of New York require an alteration in the position of the structure or work herein
authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable
obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people
of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the
Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the
State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of
the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to
such extent and in such time and manner as the Department of Environmental Conservation may require, remove
all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood
capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal
or alteration.
The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized
which may be caused by or result from future operations undertaken by the State for the conservation or
improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such
damage.
All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids,
sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally
deleterious materials associated with the project.
Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large
refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause
damage to navigable channels or to the banks of a waterway.
There shall be no unreasonable interference with navigation by the work herein authorized.
If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the
applicant shall, without expense to the State, and to such extent and in such time and manner as the Department
of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore
the site to its former condition. No claim shall be made against the State of New York on account of any such
removal or alteration.
If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the
subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303,
306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met.
At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top
portion of the enclosed notification form certifying that they are fully aware of and understand all terms and
conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be
signed and returned, along with photographs of the completed work and, if required, a survey.
All activities authorized by this permit must be in strict conformance with the approved plans submitted by the
applicant or his agent as part of the permit application.
Such approved plans were prepared by A. Nikolich stamped NYSDEC approved on 7/18/05.
DEC PERMIT NUMBER
1-4738-03327/00001
PAGE 3 of 4
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification
The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the
State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the
extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in
connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance
or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits
actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims,
suits, or actions naming the DEC and arising under article 78 of the New York Civil Practice Laws and Rules or any citizen
suit or civil rights provision under federal or state laws.
Item B: Permittee's Contractors to Comply with Permit
The permittee is responsible for informing its independent contractors, employees, agents and assigns of their
responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect
to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental
Conservation Law as those prescribed for the permittee.
Item C: Permittee Responsible for Obtaining Other Required Permits
The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may
be required to carry out the activities that are authorized by this permit.
Item D: No Right to Trespass or Interfere with Riparian Rights
This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of
others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or
personal property held or vested in a person not a party to the permit.
GENERAL CONDITIONS
General Condition 1: Facility Inspection by the Department
The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an
authorized representative of the Department of Environmental Conservation (the Department) to determine whether the
permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL
71-0301 and SAPA 401(3).
The permittee shall provide a person to accompany the Department's representative during an inspection to the permit
area when requested by the Department.
A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection
by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a
Department representative is a violation of this permit.
General Condition 2: Relationship of this Permit to Other Department Orders and Determinations
Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any
order or determination previously issued by the Department or any of the terms, conditions or requirements contained in
such order or determination.
General Condition 3: Applications for Permit Renewals or Modifications
The permittee must submit a separate written application to the Department for renewal, modification or transfer of this
permit. Such application must include any forms or supplemental information the Department requires. Any renewal,
modification or transfer granted by the Department must be in writing.
The permittee must submit a renewal application at least:
a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous
Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management
Facilities (SWMF); and
b) 30 days before expiration of all other permit types.
Submission of applications for permit renewal or modification are to be submitted to:
NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook NY 11790-2356
General Condition 4: Permit Modifications, Suspensions and Revocations by the Department
The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds
for modification, suspension or revocation include:
a) materially false or inaccurate statements in the permit application or supporting papers;
b) failure by the permittee to comply with any terms or conditions of the permit;
c) exceeding the scope of the project as described in the permit application;
d) newly discovered material information or a material change in environmental conditions, relevant technology or applicable
law or regulations since the issuance of the existing permit;
e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental
Conservation Law or regulations of the Department related to the permitted activity.
DEC PERMIT NUMBER PAGE 4 OF 4
1-4738-03327/00001
NYSDOH 11418
NJDEP NY050
CTDOH PH-0205
PADEP 68-00573
Wednesday, February01, 2006
Andrew Nikolich
Willow Point Association, Inc.
185 Willow Point Road
Southold, New York 11971
TEL: (631) 765-6015
FAX (631) 765-6015
RE: Buds Pond Canal & Channel Southold, N.Y.
Dear Andrew Nikolich:
Order No.: 0601245
American Analytical Laboratories, LLC. received 1 sample(s) on 1/20/2006 for the analyses
presented in the following report.
Samples were analyzed in accordance with the test procedures documented on the chain of
custody and detailed throughout the text of this report.
The limits provided in the data package are analytical reporting limits and not Federal or
Local mandated values to which the sample results should be compared.
There were no problems with the analyses and all data for associated QC met laboratory
specifications.
If you have any questions regarding these tests results, please do not hesitate to call
(631) 454-6100 or email me directly at lbeyer~american-analytical.com.
Sincerely,
Lab Director
56 TOLEDO STREET · FARMINGDALE, NEW YORK 11735
American Analytical Laboratories, LLC.
Date: O1-Feb-06
CLIENT:
Project:
Lab Order:
Willow Point Association, Inc.
Buds Pond Canal & Channel Southold, N.Y.
0601245
Lab Sample ID Client Sample ID Tag Number
0601245-01A Composite of Dredging Area 8432
Work Order Sample Summary
Collection Date Date Received
1/19/2006 1/20/2006
Page 1 of I
~E
S
56 TOLEDO STREET · FARM INGDALE, NEW YORK '1'173,5
(631) 454-6100 · FAX (631) 454-8027
NYSDOH 11418
TAG #/COC 084 3 2 CTDOH P"-020~.
NJDEP NY050
PADEP 68-573
CHAIN OF CUSTODY / REQUEST FOR ANALYSIS DOCUMENT
CLIENT NAME/ADDRESS CONTACT:
PROJECT LOCATION:
LABORATORY SAMPL1NG
ID # DATE/
TIME
SAMPLE # - LOCATION
SAMPLE(S)
SEALED YES / NO
CORRECT
CONTAINER(S) YES / NO
FOR
METHANOLPRESERVED
SAMPLES
[VOLATILE VIAL #1
MATRIX S=SOIL; L=LIQUID; SL=SLUDGE; A-AIR; W=WIPE; p=PAINT CHIPS; B=BULK MATERIAL
TYPE G=GRAB; C--COMPOSITE, SS=SPLIT SPOON
RELINQUISHED BY (SIGNATURE) DAT~/,~, SPRINTED NAME
~ ~1,~o
'RELINQUISHED BY (SIGNATURE) DATE PRINTED NAME
TIME
TURNAROUND REQUIRED:
NORMAL ~ STAT [~ BY
I~ECE)V~,~f'BY LAB (SIGNATURE)
COOLER TEMPERATURE:
COMMENTS / INSTRUCTIONS
DATE J~y 4~PRINTED NAME
/ /
DATE PRINTED NAME
TIME
WHITE-OFFICE / CANARY-LAB / PINK-SAMPLE CUSTODIAN / GOLDENROD-CLiENT
American Analytical Laboratories, LLC.
56 Toledo Street
Farmingdale, NY 11735-
TEL: 6314546100 FAX: 6314548027
CHAIN-OF-CUSTODY RECOBD
Page I of I
Subcontractor:
EcoTest Laboratories, Inc.
377 Sheffield Avenue
North Babylon, NY 11703
Sample ID Matrix
TEL: (631) 422-5777
FAX: (631) 422-5770
Acct #:
Collection Date
Bottle Type
SW9060
Requested Tests
23-Jan-06
r 0~01245-01A Sediment
1/19/2006
MISC
Comments:
Relinquished by:
Relinquished by:
Analyze for TOC.
Results by 1/30/06, Thanks.
Date/Time
Received by:
Received by:
AMERICAN ANALYTICAL LABORATORIES, LLC
56 TOLEDO STREET
FARMINGDALE, NEW YORK 11735
TELEPHONE: (651) 454-6100 FAX: (631) 454-8027
DA TA REPORTING QUALIFIERS
For reporting results, the following "Results Qualifiers" are used:
Value
U
J
B
E
D
P
N
H
If the result is greater than or equal to the detection limit,
report the value
Indicates the compound was analyzed for but was not detected. Report
the minimum detection limit for the sample with the U, i.e. "10U". This is
not necessarily the instrument detection limit attainable for this particular
sample based on any concentration or dilution that may have been
required.
Indicates an estimated value. The flag is used:
(1) When estimating a concentration fer a tentatively identified
compound (library search hits, where a 1:1 response is
assumed.)
(2) When the mass spectral data indicated the identification,
however the result was less than the specified detection limit
greater than zero. If the detection limit was 10ug/L and a
concentration of 3ug/L was calculated report as 3J. This flag
is used when similar situations arise on any organic
parameter i.e. Pesticide, PCBs and others.
Indicates the analyte was found in the blank as well as the
sample report "1 OB".
Indicates the analytes concentration exceeds the calibrated
range of the instrument for that specific analysis.
This flag identifies all compounds identified in an analysis at
a secondary dilution factor.
This flag is used for Pesticide / PCB targe~ analyte when
there is >25% difference for detected concentrations
between the two GC Columns. The higher oLtb~values
is reported on Form I and flagged with a "P".
This flag indicates presumptive evidence of a compound.
This is only used for tentatively identified compounds (TICs),
where the identification is based on a mass spectral library
search. It applies to all TIC results. For generic
characterization of a TIC, such as chlorinated hydrocarbon,
the flag is not used.
Indicates sample was received and/or analyzed outside of
The method allowable holding time
American Analytical Laboratories, LLC.
Date: O1-Feb-06
CLIENT:
Lab Order:
Project:
Lab ID:
Willow Point Association, Inc.
0601245
Buds Pond Canal & Channel Southold, N.Y.
0601245-01A Date Received: 1/20/2006
Client Sample ID:
Tag Number:
Collection Date:
Matrix:
Composite of Dredging Area
8432
1/19/2006
SEDIMENT
Analyses
MERCURY SW-846 7471
Mercury
Result Limit Qual Units
8W7471 B
U 0.0159 mg/Kg-dry
PCB'S AS AROCLORS SW-846 8082
Aroclor 1016
Aroclor 1221
Aroclor 1232
Aroclor 1242
Aroclor 1248
Aroclor 1254
Aroclor 1260
U
U
U
U
U
U
U
PESTICIDES SW-846 8081
4,4'-DDD
4,4'-DDE
4,4'-DDT
Aldrin
alpha-BHC
beta-BHC
Chlordane
Chlorobenzilate
DBCP
delta-BHC
Dieldrin
Endosulfan I
Endosulfan II
Endosulfan sulfate
Endrin
Endrin aldehyde
Enddn ketone
gamma-BHC
Heptachlor
Heptachlor epoxide
Hexachlorobenzene
Hexachlorocycropent adien e
Methoxychlor
Toxaphene
3.6
3.9
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
U
PERCENT MOISTURE
Qualifiers:
* Value exceeds Maximum Contaminant Levcl
E Value above quantitation range
J Analyle detected below quantitation limits
S Spike Recove~ outside accepted recovery limits
DF Date Analyzed
Analyst: BK
1/31/2006
SW8082A (SW3550) Analyst: NP
130 pg/Kg-dry 3 1/27/2006 6:16:00 AM
130 pg/Kg-dry 3 1/27/2006 6:16:00 AM
130 pg/Kg~ r? 3 1/27/2006 6:16:00 AM
130 pg/Kg~lry 3 1/27/2006 6:16:00 AM
130 pg/Kg-dry 3 1/27/2006 6:16:00 AM
130 pg/Kg-dry 3 1/27/2006 6:16:00 AM
130 pg/Kg-dry 3 1/27/2006 6:16:00 AM
SW8081 B (SW3550) Analyst: KB
7.9 J pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 J IJg/Kg<lry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-clry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-dP/ 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-dry 3 1/25/2006 7:05:00 AM
24 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-d~y 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~lry 3 1/25/2008 7:05:00 AM
7.9 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~iry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~lr? 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~ry 3 112512006 7:05:00 AM
7.9 pg/Kg<lry 3 1/25/2006 7:05:00 AM
79 pg/Kg<lry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~ry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~lry 3 1/25/2006 7:05:00 AM
79 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg-dry 3 1/25/2006 7:05:00 AM
7.9 pg/Kg~ry 3 1/25/2006 7:05:00 AM
76 pg/Kg~by 3 1/25/2006 7:05:00 AM
D2216 Analyst: PA
B Anal.xle detected in lhe associated Method Blank
H Holding times for preparation or analysis exceeded
ND Not Detected at the Reporling Limit
U Indicates the compound was analyzed for but not detecle
Page 1 of 2
American Analytical Laboratories, LLC.
Date: O1-Feb-06
CLIENT:
Lab Order:
Project:
Lab ID:
Willow Point Association, Inc.
0601245
Buds Pond Canal & Channel Southold, N.Y.
0601245-01A Date Received: 1/20/2006
Client Sample ID: Composite of Dredging Area
Tag Number: 8432
Collection Date: 1/19/2006
Matrix: SEDIMENT
Analyses Result
Percent Moisture 37.0
TOTAL METALS
Arsenic 5.06
Cadmium U
Chromium 28.6
Copper 24.9
Lead 13.4
Nickel 18.9
Zinc 75.1
SEMIVOLATILES SW-846 8270(PAH)
Acenaphthene U
Acenaphthylene U
Anthracene U
Benzo(a)anthracene U
Benzo(a)pyrene U
Benzo(b)fluoranthene U
Benzo(g,h,i)perylene U
Benzo(k)fluoranthene U
Chrysene U
Dibenzo(a,h)anthracene U
Fluoranthene U
Fiuorene U
Indeno(1,2,3-c,d)pyrene U
Naphthalene U
Phenanthrene U
Pyrene 290
Limit Qual Units DF Date Analyzed
0 wt% 1 1/26/2006
SW6010B (SW3050A) Analyst: JP
0.732 mg/Kg~ry 1 1/30/2006 12:52:47 PM
0.293 mg/Kg-dry 1 1/30/2006 12:52:47 PM
0.586 mg/Kg-dry 1 1/30/2006 12:52:47 PM
0.586 mg/Kg~/ 1 1/30/2006 12:52:47 PM
0.439 mg/Kg~/ 1 1/30/2006 12:52:47 PM
0.586 rog/Kg-dry 1 1/30/2006 12:52:47 PM
0.586 mg/Kg~iry 1 1/30/2006 12:52:47 PM
SW8270D Analyst: PT
19o pg/Kg-dry 3 1/24/2006 3:10:00 PM
190 pg/Kg~nj 3 1/24/2006 3:10:00 PM
190 pg/Kg~ry 3 1/24/2006 3:10:00 PM
190 pg/Kg-dnj 3 1/24/2006 3:10:00 PM
190 pg/Kg~nj 3 1/24/2006 3:10:00 PM
190 pg/Kg~lnj 3 1 ~24~2006 3:10:00 P M
190 pg/Kg-d nj 3 1/24/2006 3:10:00 PM
190 IJg/Kg-d nj 3 1/24/2006 3:10:00 PM
190 pg/Kg<lnj 3 1/24/2006 3:10:00 PM
190 pg/Kg~lnj 3 1/24/2006 3:10:00 PM
190 pg/Kg-dw 3 1/24/2006 3:10:00 PM
190 pg/Kg-dnj 3 1/24/2006 3:10:00 PM
190 p g/Kg~lry 3 1/24/2006 3:10:00 PM
190 p g/Kg-d~y 3 1/24/2006 3:10:00 PM
190 pg/Kg-dw 3 1/24/2006 3:10:00 PM
190 pg/Kg-dry 3 1/24/2006 3:10:00 PM
Qualifiers:
Value exceeds Maximum Contaminant Level
E Value above quantitation range
J Analsete detected below quantitation limits
S Spike Recovery outside accepted recovery limits
B Anable detected in the associated Method Blank
H Ho]ding times for preparation or analysis exceeded
ND Not Detected at the Reporting Limit
U Indicates the compound was analyzed for but not detecte
Page 2 of 2
0~/30/2006
13:47
6314225778 ECOTEST LABORATORIES PAGE 82/82
~-c o's'es t Laboratories Inc 377 Sheffield Ave
North Babylon. NY llW03
631 422--5777
LAB N0.260251.00
SOURCE OF SAMPLE:
SOURCE OF SAMPLE:
COLLECTED BY:
MATRIX:.Solid
01/30/06
American Analytical Laboratories
56 Toledo Street
Farmingdale, NY 11735
Lori Beyer
PO#:
AAL 80601245-01A
Client
SAMPLE:
DATE COL'D:0f/19/06 RECEIVED:01/24/06
ANALYTICAL PARAMETERS
Tot Organi~ Carbon
UNITS RESULT
mg/Kg 16000
DATE OF
FLAG ANALYSIS LRL
01/27/06 3000
ANALYTICAL
METHOD
EPA41S.1
REMARKS:
rn = 1762
LRL=laboratory Reporting Limit
Results reported on dry weight basis.
NYSDOH ID # 10320
DIRECTOR~of
INFORMATION ON TESTING OF DREDGE MATERIAL
To obtain a representative sample, several grab samples must be taken in different locations in
the area to be dredged and throughout the depth of the material to be removed, then composited
into one. The composite sample must be analyzed by an ELAP certified laboratory.
Arsenic
Cadmium
Chromium
Copper
Lead
Mercury
Nickel
Zinc
Anthracene
Benzene
Benzo(a) anthracene
Chrysene
Benzo(a)pyrene
Benzo(b)fluoranthene
Benzo(k) fluoranthene
Dibenzo(a,h) anthracene
Total PAHs
Sum of DDT+DDD+DDE
Chlordane
Dieldrin
PCB's (sum of aroclors)
Total Organic Carbon
Lab Methods: EPA 8081A for pesticides, EPA 8082 for PCBs, EPA 8260B for VOCs, EPA
8270C for SVOCs, EPA 6010B for metals.
For a list of ELAP certified labs, please visit the web site
http://www.wadsworth.org/labcert/elap/comm.html and scroll down to Suffolk, then select labs
that are certified to analyze solid and hazardous waste.
Town of Soulhold
' ~- 5 2 9 3 Suffolk County, NY
Town of Southold
~A- 5 2 9 2 Suffolk County, NY
__ The People of the State o! Ne-~ork vs
The People of the State of New York vs.
L~'~T~E,,$J~'~...~) · J FIRSTNAME
UCENSE OR R EGISTRA3~ ON NUMBER
IIIItllllllllllllllllllll
~NNUMBER
THE PERSON DESCRIBED ABOVE iS CHARGED AS FOLLOWS
A'5294
Town of Southold
Suffolk County, NY
The People of the,State o! New Ym'k vs.
COURT COPY
Board Of $outhold 'Town Trustees
SOUTHOLD, NEW YORK
WILLOW POINT ASSOCIATION
ISSUED TO ...................................................................................................................................
Pursuant to the provisions of Chapter 615 of the Laws of
the Stute of New York, 1893; and Chapter 404 of the ,L;9. ws of the
State of New York 1952: and the Soufheld Tovm Ordmance en-
titled ."REGULATING AND THE PLAC:ING OF OBSTRUO~IC)blS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALSJ~!LOM
LANDS .UNDER TOWN WATERS?. and in accordance with the
Resolution of The Board adopted afa meeting held on ......~a].¥
· 2.~.Q.6.'.., and in ¢onslderatlon of the sum of $....~.~.g..'..g.g ...... paid by
.... ~!!~.w.....~at.. A~aoc3~tioa ................................................................. , ........... : .........
of Sout~9~....¥.; ..................................... N. Y. and subject to the
Ter~;"'"';;;;] ~nd,t,ons listed on the reverse dale hereof,
of Southeld Town Trudees authorizes and permits the following:
Wetland Permit to maintenance dredge: SEE ATTACHED
ADDENDUM
~ll' in accordance with the deta~d specifications as presented in
· the originating application.
IN WITNESS WHEREOF, The said Board Of Trustees ~re-
by ~uses ifs Corporate. ~al fo. be a~xed, and these..~senh fo
be subsc, rlbed by a'malorfly of the satd Board .as of ~h daf, e.
/
TERMS ,nd CONDmONS
Willow Point Association
st Willow Point Road, Southold , .., .- N, ¥~ 'ss
the comlde~oa ~o~ d~e ls~mnce of d~e P,'~* does unck~cl and ~ to the roi-
L That t~ sald ~! o~ Trust. s and the Town o[ 8oudgdd axe released from any ~
sit dauag~ o~ ,4.~... ~m dama6~ oE mits raisin& dim~ et ~,u,,~tty as I mult of say ope~-
24 '
m ...i~-.i. th~ gp _.c~.~.~. o~ lzo~ect involved, to pmvlde evidence m anyone
4. That the work involved will be mbject to tt~ lm~km and approval o[ the ~ et
its agen~ and ~l~.~,,~, '~,tth the ptxrvi~om of tl~ o~a~aflng application, may be cau~ for
[dm~e~t~l m dgs pennit ~d~/ad~ may 'he mbJeet to tt~o~ npaa ~dln~ m '~d" san~
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Sout hold, New York 11971-0959
Telephone (631j 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OFSOUTHOLD
ADDENDUM TO PERMIT #5963
WILLOW POINT ASSOCIATION
WILLOW POINT ROAD
SOUTHOLD, NEW YORK
Wetland Permit to maintenance dredge approximately 900 feet of an existing
Budd's Pond channel and canal to a width of 50' and depth of 5'feet. The
dredging is to be performed by utilizing crane and clamshell bucket. A dredge
spoil site will be chosen in coordination with the New York State Department of
Environmental Conservation. Dredging to be done in accordance with plan
prepared by Andrew Nikolich last dated May 25, 2004 for dredging activity only
and a revised plan depicting a Trustee approval spoil site will be required for final
approval.
The dredge spoil site on the plans submitted to the Trustees was denied due to
the presence of upland wetland species in that area. A new site will be chosen.
Elevation of the association property will stay the same. The existing roadway will
be restored and regraveled after the work is complete, with no disturbance to the
vegetation bordering the road.
Albert J. Krupski, President
James King, Vice-President
.~t ie 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
July 21,2004
Andrew Nikolich
850 Budd's Pond Road
Southold, N.Y. 11971
RE: Willow Point Association
Willow Point Rd.
Southold, NY
SCTM # 56-5-28
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday July 21,2004 regarding the above matter:
WHEREAS, Andrew Nikolich on behalf of Willow Point Association 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 June 28,
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 July 21,2004, 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,
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 WILLOW POINT
ASSOCIATION to maintenance dredge approximately 900 feet of an existing Budd's
Pond channel and canal to a width of 50' and depth of 5'feet. The dredging is to be
performed by utilizing crane and clamshell bucket. A dredge spoil site will be chosen in
coordination with the New York State Department of Environmental Conservation.
Dredging to be done in accordance with plan prepared by Andrew Nikolich last dated
May 25, 2004 for dredging activity only and a revised plan depicting a Trustee approval
spoil site will be required for final approval.
The dredge spoil site on the plans submitted to the Trustees was denied due to the
presence of upland wetland species in that area. A new site will be chosen.
Elevation of the association property will stay the same. The existing roadway will be
restored and regraveled after the work is complete, with no disturbance to the
vegetation bordering the road.
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 $50.00 per inspection. (See attached schedule.)
Fees: NONg
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/hct
AJbert J. Krupski, President
James I~ing, Vice-Presi({eff~'
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
Claire K. Wemer
Department of Environmental Conservation
Tidal Wetlands
SUNY Bldg. 40, RM 219
Stony Brook, NY 11790-2356
August 3, 2004
Re: Willow Point Association
Willow Poim Road
Southold, NY
SCTM# 1000-56-5-28
Dear Ms. Wemer:
The Board of Town Trustees has approved the application of Andrew Nikolich on behalf
of Willow Point Association for a Wetland Permit to maintenance dredge approx. 900fi.
of an existing Budd's Pond Channel and canal to a width of 50 fi. and depth of 5 fi.
Dredging will be performed by utilizing crane and clamshell bucket but denied the
disposal site proposed by the applicant.
The disposal site for the approx. 900 CY. of dredged material will be determined by the
Nexv York State Department of Environmental Conservation, coordinated with the
Southold Town Board of Trustees.
The original disposal site proposed by the Association on the Association property on
either side of the association road has been denied due to the existence of upland wetland
species on those sites on either side of the gravel/beach stone road.
Please contact this office to coordinate a decision on the disposal site for the dredge spoil.
Very Truly Yours,
Albert J. Krupskl, Jr..
August 3, 2004
Re: Willow Point Association
Willow Point Road
Southold, NY
SCTM# 1000-56-5~28
The Board of Toxvn Trustees has approved the application of Andrew Nikolich on behalf
of Willow Point Association for a Wetland Permit to maintenance dredge approx. 900ft.
of an existing Budd's Pond Channel and canal to a width of 50 fi. and depth of 5 fl.
Dredging will be performed by utilizing crane and clamshell bucket.
The disposal site for the approx. 900 CY. of dredged material will be determined by the
New York State Department of Environmental Conservation, coordinated with the
Southold Town Board of Trustees.
Telephone
(631) 765-1892
To~ Hall
53095 Route 25
P.O. Box 1179
Sou~old, Ne~v York 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Tuesday, July
13, 2004, the following recommendation was made:
Moved by Don Wilder, seconded by Doris McGreevy, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the
Wetland Permit application of WILLOW POINT ASSOCIATION to maintenance dredge
approx. 900 ft. of an existing Budd's Pond channel and canal to an original width of 50
ft. and depth of 5 ft. Dredging will be performed by utilizing crane and clamshell bucket.
Approx. 900 cy. of dredged material will be disposed on Willow Point Assoc. property.
Located: Willow Point Rd., Southold. SCTM#56-5-28
Vote of Council: Ayes: All
Motion Carried
2004
Willow Point Asso~iation F~bruary 3, 2004
B~y ~e ~
~old, N.Y. 11971
Now Yotit ~ ~z,ent Of Enviroltme~tal Conservation
Dt¥islon of Envlronmmlal Permits
Building 40-SUNY, 8tony [~ook, N.Y. 11790-2356
Attl~h~d is applto~lton for a permit to mninte~mnoe dredge~ an ~ia~8 ~nel I~n~ ~om Budd'~ P~d
to ~o WIII~ P~nt Ass~iatlm C~nI.
~e Wlfl~ P~t As~U~ Cmal ~s ~ilt ~ l~, ~d at ~e ~e time ~n~ to ~e Bu~'s Prod.
al~[ ~e ~ of B~'s P~d ap~oxi~tely 50 ~ wi~ ~ 4.5 f~t d~p m f~ili~te nav~a~ f~ Se
~iati~ ~ ~ At ~e t~e no DEC ~it was r~uk~ f~ ~e ~g.
In 19~ a D~C P~it ~ 10-~44 ~d ~t of the A~y P~mit
50 ~ ~ ~0 ~ ~ ~dd's ~d Ch~el wh~e ~e ~atnage pi~ insml[~ by the T~ of ~u~old
~ ~u~tim of ~d ~t ~ ~fo naviBatim.
S~ ~e ~1 ~im of fflc ~ol ~e till c~ts ~d st~s sl~ly ~okflll~ ~e c~ol
~th ~d ~t ~vi~im is no lms~ ~k m~iat~ in Iow tides.
We ~u ~ ~w~ ~d r~u~ d~uments for a ~opos~
It's 50 ~ ~ts~l wd~ ~d 4 ~ d~ at ~W.
We ha~ ~i~ ~. ~ N~oli~, ~ ~iation m~r, ~d ~ldmt of Will~ Point
C~m~l~ to file ~ ~ A~i~'s ~al[
Veo' Truly Yours, ~
~id~d Kublak M.D.
February 3, 2004
Willow Point Association February 3, 2004
Bay Home Road
Southold, N.Y. 11971
New York DeparUncnt Of knvirorunental Conservation
Division of Environmmtal Permits
f3uilding 40-SUNY, Stony Brook, N.Y. 11790-2356
Dear
Attached is application for a permit to maintenance dredges an existing channel leading fi.om Budd's Pond
to the Willow Point Association Canal.
The Willow Point Association Canal was built in 1966, and at the same time connected to the Budd's Pond.
During this construction the Budd's Pond Channel was dredged 20 to 25 feet seaward ot'inter6dal marsh
along the shore of Budd's Pond approximately 50 tbet wide and 4.5 feet deep to thcilitate navigation for the
association boat owners. At that thne no DEC pa'mit was required for the dredging.
In 1984 a DEC Permit # 10-84-0944 and Departraent of the Array Permit # 13404 were obtained to dredge
50 t~e~ by 50 ti:et of Budd's Pond Channel where the drainage pipe installed by the Town of Southold
caused accumulation of sand that impaired safe navigation.
Since the original construction of the channel the tidal currents and storms slowly backfilled the channel
with sand that navigation is no long~ sari: especially in low fides.
We are presenting drawings a,~d required docmnents tbr a proposed maintenance dredging of the channel to
Ws 50 feet original width and 4 feet depth at MLW.
We have designaled Mr. Andrew Nikolich, an association member, and resident of Willow Point
Community to file in the Association's behalf
Vet) Truly Your~,/~-'~
R/chard Kubiak M.D.
~'esident
)mdre ~,, N~kohgh
Willow Point Association
850 Budds Pond Road
Southold. NY 11971
STATE OF NEW YOR~,
DEPARTMENT OF' STATE
4 [ STATE STREET
ALBANY. NY I 2~3 I-OOO I
July 1:, ,-004
Re: F-2004-057l
U.S. Ama)' Corps of Engineers:Ney. York Dtstnct Permit
Apphcanon - Andre'.,.' Ntkoligh - Maintenance dredge
approxmmtely 900 cubic yards sand from 50' x 800' area to a
depth orS' belov.' MLW
Budd's Pond, To,tn of Southold, Suffolk Count,,,
General Concurrence
Dear Mr. Ntkohgh:
The Department of State recewed your Federal Consistency Assessment Form and consistency cemficatton and
supporting reformation tbr thts proposal on June 21, 2004.
The Department of State has determined that this proposal meets the Department's general consistency
concurrence cnterm. Therefore, further re,aew of the proposed activin/by the Department of State, and the
Department's concurrence ,.v~th an mdivMual consistency cemfication, are not reqmred.
When commumcatmg w~th us regarding th~s matter, please contact Vance A. Ban- at (518) 402-3399 and refer to
our rite ~F-2004-0571.
Smcerety,
Sam Messma
Deputy D~rector
sm
cc:
COE.,New York District - Michael Vtss~chelh
NYS DEC Region 1- John Pavactc
.lune 1, 2004
8aslllo Esposlto
1045 Budd's Pond Road
SouthoId, N.Y. 11971
Willow Point Association
850 Budd's Pond Road
Southold N. Y. 11971
RE: Dredging of Budd's Pond Canal
I have reviewed plans and drawings for the dredging of Budd's Pond Canal and I have no
The proposed dredging of the canal shall be kept to at least 10 feet away from my bulkhead with
a slope down of 45 degrees to a maximum depth of 4 I~ feet, measured from the surface at
Mean Low Water.
Very Truly Yours,
Basllio Esposlto
June i, 2004
Judy Teeven and Paula Dldonat~o
325 Willow point Road
Southold, N.Y. 11971
Willow POint Assoc'letJon
850 Budd's Pond Road
Southold N. Y. 11971
RE: Dredging of Budd's Pond Canal
We have reviewed plans and drawings for the dredging of Budd's POnd Canal and we have no
objection to the pro~ project.
The proposed dredging of the canal shall be kept to at least 10 feet away from our bulkhead with
a slope down of 45 degrees to a maximum depth of 4 1/2 feet, measured from the surface at
IVlean Low Water.
Very Truly Yours,
Paula Dldonato
To whom it may concern:
03/15/04
I am the owner of property located at sec 56, block 05, lot 27, Willow Point Road,
Southold, N.Y.. I am aware oftbe dredging project to be done adjacent to my property
and I am in agreement with the scope of this work,,/~ff
Robert Boger
Albert J. Krupski, President
James King, Vice-President
Al'tie Foster
Ken Poliwoda
Peggy A. Dickerson
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
etlastal Erosion Permit Application
and Permit Application ,.,~l~Iajor __ Minor
,R~L'Eive d Fee:$
L~.~'bmplcted Application
__Incora~lete
__SEQRA Classification:
Type I Type II Unlisted
Coordination:(date sent)
~LffAC Referral Sent:~
~,el~te o f Inspection: ~1~..1'~'1
__Receipt of CAC Report:_ '
__Lead Agency Determination:
Technical Review:
~il~lic Hearing Held:~L0_l~
Resolution:
JUN 2 $ 2~J4
Sou~old Town
Board of Trustees
Town Hall
53095 Route 25
P.O. Box 1179
Ssuthold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
Name of Applicant
Address
Phone Number:(~0 76.5'" ' 60/.5'
Suffolk County Tax Map Number: 1000 - ~5-'~'~ ~5"- 2- ~
Property Location: VV'/~ L o w' /°0/,~' r /qgo...~
(provide LILCO Polo #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
,.~OuZlqo~-D Ad.x/. ILO7/ Phone: 7~'.3'- 6o15-
Board of Trustees Application
GENERAL DATA
Land Ama (in square feet): / 3; 0 0 3
Area Zoning: /ec$~ t>c~ T//tt- /w,4~/.~,,,t ~
Previous use of property:
Intended use of property:
Prior permits/approvals for site improvements:
Agency Date
2 No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency7
V/ No__ Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
Board of Trustees Application
WETLANDfrRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: 7-o ~,,',~ffe~,/~ ~/~o,~c/
Area of wetlands on lot: //~oo square feet
Percent coverage of lot: /0 %
Closest distance between nearest existing structure and upland
edge of wetlands: ~/~ feet
Closest distance between nearest proposed structure and upland
edge of wetlands: A//~ feet
Does the project involve excavation or filling?
If yes, how much material will be excavated?_~oO cubic yards
How much material will be filled? ~ Oo cubic yards
Depth of which material will be removed or deposited: .3'- feet
Proposed slope throughout the area of operations: 2~-
Manner in which material will be removed or deposited:
Statement of the effe~t, if any, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
PROJECT ID NUMBER
~ART '1 - PROJECT INFORMATION
1. APPLICANT / SPONSOR
617.20 SEQR
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
( To be completed by Applicant or Project Sponsor)
2. PROJECT NAME
County .~/..,'
3.PROJECT LOCATION: ~V//~.~.OV~
Muni~pali~ ~ ~ ~Z O ~'~ '
4. PRECISE LOCATION: S~eet Adde~ a~ R~d Intem~aons, Prominent landmass etc - or provide mad
/
5.1SPROPOSED ACTION: ~New ~pans~n ~M~caaon/a~flon
6. DESCRIBE PROJECT .BRIEFLY;
?.00
7. AMOUNT OF LAND AFFECTED:
Inil~ally ~. ~' acres Ultimately ~. ~ acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
/~Yes [] No if no, desc~be bedify:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
~Residential [~lndustrial r-~commetc~al r~Agticulture [~Park/Forest/OpenSpace []Other{describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
~]Yes r~No If yes, list agency name and permit I appmvak
'Z-
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes ~No If yes, list agency name and permit / approval:
12. AS A RESULT OF PROPOSED ACTION WiLL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Date:
·
Signature
/
If the action Is a Costal Ama, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥)
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.
E~Yes ,[~No
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative
declaration may be superseded by another involved agency.
[~Yes E~]No
C, COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, sun"ace or gmundwatur quality or quantity, noise levels, existing traffic pahem, solid waste production or disposal.
potential for erosion, drainage or flooding problems? Explain bdefly:
I
C2. Aestheti~i ag,,~ult~ral, archaeological, histodc, or other natural er cultural resources; or community er neighborhood character? Explain bne~ly.
C3. Vegetati°~ ~'~-~una, fish, sl~elifish or wildlife species, significant habitats, er threatened or endangered species? Explain briefly:
C5. Growth, ~ubsnduent development, or related activities likely to be induce, d by tbe pro~ed action? E×plain briefly:
Cti. Longterm, shortterm cumulative erect ~ff~:ts notidentifind
c?. Other i~pa~ts linc~riih~ ~h~h~es id h;~ ;~$ither quahii~ or t~ o~ ~ne~ Expiai~ baefi¥: ..........
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA ICEAI? IIf ~'es, explain briefly:
E. IS THERE, OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If),es explain:
r-lYes FINe
:'ART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each 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) pmbsbility of occurring; (c) duration; (d) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked
yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
Check this pox if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULI
EAF and/or prepare a positive declaration.
Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actiol
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
Title of Responsible Oificer
Print or Type Name of Responsible Officer in Lead Agency
Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer)
Albert J. Krupski, President
James King, Vice-President
Attic 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
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application of
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I, /~vO,eCvv' {:v/tgo~'O% residing at gSO
being duly sworn, depose and say:
That on the G day of J~/¥ ,200'~ I personally posted the property known as
by placing the Board of Trustees 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 of the public
heating. Date of hearing noted thereon to be held
Dated:
Sworn to before me this
~ dayo,~<[c1 200~
Notary Public L_
NIARYIIETH PASCALE SCISCENT£
Notary Pubtic, State of New Yo~k
No. 02SC5043553
Oualified in Nassau ~
~l~mi~'a Ex, ir# MayS,
Board of Trustees Application
AU-£uORI ZATION
(where the applicant is not the owner)
(print owner of property)
residing at ~3-O ~uW~ /~D
(mailing address)
do hereby authorize
Age nt )
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
Board of Trustees Application
County of Suffolk
State of New York
~.'t) ~e e- v~ Pg~ ~ o z / ~ ~t BErG D~Y SWO~
DEPOSES ~ ~F~S ~T ~/S~ IS ~ ~PLIC~T FOR ~ ~O~
DESC~ED PE~T(S) ~ ~T ~L STA~S CO~D ~ ~
~ TO ~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ ~T ~L WO~
~L BE ~ ~ ~ ~R SET FOR~ ~ ~S ~PLICATION ~ AS MAY
BE ~PRO~D BY ~ SO--OLD TO~ BO~ OF ~US~ES. ~ ~PLIC~
AG~ES TO HOLD ~ TO~ OF SOU~OLD ~ ~ TO~ ~US~S
~ESS ~ ~E ~OM ~ ~ ~L D~AGES ~ CL~S ~S~G
~ER OR BY ~ OF S~ PE~T(S), ~ G~D. ~ CO~LET~G ~S
~PLICATION, I ~BY A~O~ ~ ~US~ES, ~ AGE~(S) OR
~P~SE~ATI~S(S), TO E~R O~O ~ PROPER~ TO ~SPECT ~
P~SES ~ CON~CTION ~ ~W O~ ~S ~PLICATION.
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
Thc Town of Southold's Code of Ethics orohibits conflicts of interest on the oa~ of town officers and emniovees. The ournesc of
this form is to orovide infOrmation which can alert the town of oussible conflicts of ~-~:~;. and allow it to teke whatever action is
necessary to avoid same.
(Last name, first anme, ~iddle initial, unless you are applying in the ~m,,,c of
someone else or other enlity, such as a company. If so, indlcate.~ other
person's or company's nmne.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee
Change of Zoue Coastal Erosion
Approval of plat Mooring
ExemF4ion from plat or official map Planning
Other
(If"Other-, name thc activity.) Iff,~r£~l~k~C~-
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? "Rclatiouship" includes by blood, marriagn, or business intoresc "Business interest~ means a business,
including a partnership, in which the town officer or employee has even a pmiial ownership of (or employment by) a corporation
in which the tow offi~r or cmvloyce ow~ more than
YES NO
if you answered "YES", complete the balance of this form and date and sign where indicated.
Name of person employed by thc Town of Southoid
Title or position of that person
l)cscrihe the relationship between yourself 0he appiicani/agcnt/represc nt ativc) and the town officer or employee. Either check
the appropriate line A) through D) and/or describe in the space provided.
Thc town officer or cmployce or his or her spouse, sibling, parent, or child is (cl~ck all that apply):
___A) the owner of greater than 5% of the shares oftl~ corporate stock of the applicant
(when thc applicant is a corporation):
B) the legal or b~neficial owno' of any interest in a non-cerporate entity (when thc
applicant is not a corporation);
C) an officer, director, partner, or employee of the applicant; or
__.D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
Form TS 1
Submitted this day of 200 O
Signature
Ltl
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