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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 '-... °°od II II i S EOT~Obi A- A ~CAL£-i"~- o°* ,~ £ C TI O/',I F ¢.4 , 3a~uarT 2S~ 2004 Rev's~ b~oy 2 ~ 2004 0 Hydroorap¼ic Survey Pre~>erect {:or; p,iillo~ F:'oint. Associotion Soukhold, Ne~ YorR Tide ~onge: Potum: ~eon Lo~ ~ater USGS 5ench "5 528 Reset" pond ®~APHIC SCALE I": 40' N MAPPING Sheet I Of I I \\ I0 P-¢ez.' ¢%oFn, ~'~'~ n~l ~,d DOl $ PofiD JA~ 1 9 2006 zq 2oo¢ ¢ ~,.,, Sl, =oo~' 5 ECT/ON A- A $ 6A,L E':I-r': ~' WI /.]. OW POINT,A.:' ~cOLtT/-/OZ. 1)