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Home My WebLink AboutMoeller, JacquelineAlbert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 8. 2002 Catherine Mesiano, Inc. 12 Mill Pond Lane East Moriches, NY 11940 Jacqueline Bittner 4305 Soundview Avenue Southold, NY SCTM#68-1-17.1 Dear Ms. Mesiano: The following action was taken at the Southold Town Board of Trustee Regular Meeting on September 25, 2002. RESOLVED, that the Southold Town Board of Trustees Approved JACQUELINE BITTNER for Emergency Permit to repair 72 bulkhead washed out and along with 1000 cubic yards of material from behind the bulkhead. Additional 24 feet of bulkhead raised/damaged minor damage 20 feet bulkhead at the seaxvard end easterly return wash out occurring behind the westerly end of 55 lbot section of bulkhead. Bulkhead located approximately 64 feet seaward (north) of existing dwelling, which distance reduced to approximately 17 feet as a result of the erosion of the bluffdue to the damage to the bulkhead. Propose to install a +/- 110 wall of fitted concrete rubble and/or natural rock a top filter stop filter fabric approximately 300 cubic yards of clean fill along the inside radius of the deteriorating bluff proposed xvall will be 5-6' above the existing grade and 2-3' below the existing grade. Subject to a full application to be submitted under Chapter 97 and Chapter 37 as soon as the application form is formally adopted by the Town. If you have any questions, please do not hesitate to contact this office. Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK:cjc Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson September 20, 2002 BOARD OF TOWN T~USTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, NewYork 11971-0959 Telephone(63D765-1892 Fax(63D 765-1366 Catherine Mesiano, Inc. 12 Mill Pond Lane East Moriches, NY 11971 RE: Jacqueline Bittner 4305 Soundview Avenue Southold, NY SCTM#68-1-17.1 Dear Ms. Mesiano: Attached please find the Approved Plan dated September 20, 2002 for the above noted premises for emergency repairs for damage done to the bulkhead. Subject to a full application to be submitted under Chapter 97 and Chapter 37 as soon as the application form is formally adopted by the Town. If you have any questions, please do not hesitate to contact this office. Very truly yours. Albert J. Krupski, Jr. President, Board of Trustees AJK:cjc Enclosure: FROM :(_ M~SIAND INC. ~ FA× NO. :651-878-8951 ~p. 19 ~00~ Oi:~PM p~ i~n Latham G3 r.$- [B88 p. I TRUSTEE KRUPSKi: Honestly a letter fi',.m the appli,.,~a£ would be fine. A letter is fine as ',:~g as you work it out. I need a motion to go off the pubfic nearing. tRUSTEE SMITH: I will make a motion to ~o offthe pubtic hearing and go back to our regular meeting. tRUSTEE KING: 3econaed. TRUSTEE K~LrpsK~'' Al! ~v ~"~vor. ALL AYES V. RESOLUTIONS: Sasan L. Long Permits on behalf of JACQUELINE MOEY.LE~. reque~[s a Gr~dfather and Coastal 7.,,..~on to replace 55' timber bulkhead in-kind/in-place backfill with approx. 30 c.y. clean fill from approved ,.t?land source. Locater:: 4305 Soundview .;..'enue, Southold SCTM#68-; - 17.1 TRUSTEE SMITH moved to .\pp~ove the application ~vith the stipulation that the reconstruction of 2 low profile ','est :e,.:y wtli :-'e 45' iengW, same as ii is tiow. 'llae east jetty taking t l:e line out fi.om 45' and taken the straight end o f that other bulkhead go out za'..other 45' whatever that measurement is that is how far the west jetty. Parallel to meet the same difference fi.om the fi.ont of the bulkhead as the west jetty, 3-1/2 feet down fi.om top of the bulkhead. TRUSTEE POLIWODA seconded. ALL AYES TRUSTEE KRUPSKi abstained. VI. MOORINGS: GREGORY YAK,~.BOSKI requests a mooring iv. Cedar Beach for a 24' boat. ACCESS: Private. TRUSTEE FOSTER mowd to table the application because of wait:ng hst. TRUSTEE POLIWODA S¢c,~nde& 2, PETER L. TREXLER requests a Duck Blind in West Creek. ACCESS: Public. TRU,<3TEE 3~2~,L~S:._.'' n~a'.'e~ to ::e::v ~,pplica~/cv.. TRUSTEE FOSTER Seconded. :'C~L AYES MEETING ADJOUNED AT: 11:00 pm Respectfully submitted by: Charlotte Cunningham, Cl6rk Board of Trustees New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Website: www.dec.state.ny.us FEB 2 0' John P Cahifl Commissioner Februar'J 14 2001 Jacqueline Moeller PO Box 269 Pecomc, N.Y. t I958 Re. Shoreline Consrructibn Work at 4305 Sound',Sew Avenue Town of Sour. hold Permit =~ t-4738-02788 ,' 00001 On or about December 22, 2000, you were issued a Tidal Wetlands perrmt by the Departmem of Envtronmenrai Conservation authorizing the reconstruction of approximately 55 linear feet of existing t~mb~r b~i~:c:.~.i,:_~ ~n ~hc r~£erenced property.. Tius pertmt authorizes the following acri;Sties only: 'kind, 'n-slxc_~ :econstraction of the existing bulld~eading, placement of up to 30 cuhic yards of backfill tbr the reconsm~cted bullch_ead and planting of the backfill area with beach grass. it has come to our attention that the existing 40 foot and 125 foot long groins or jetties at this site have been removed, and that you may be planning to reconstruct these structures. P!ea~e he advised that any construction activi~ associated with the removal or reconstruction of these ~oins is regulated under the Tidal Wetlands Land Use Regulations (6 NYCRR Part 661) and requires Department approval before any work is started. As your current perrmt authorizes the bnll~head recor, struction and related activities only, you have no current authorization fi.om this ag,~acy ro make any modifications to the groins. If ,,ny '~ork is planned or now underway to reconstruct the grams, I recommend that it be baited immediateiy and not restarted until a valid permit or other approval is issued by this agency. Recunstruction of the groins withou: first obtaining the proper Tidal Wetlands permit is a violauon of the Environmental Conservation Law which includes penalties such as significant fines and requirements tbr removal. Please contact me at (631) ,14,1.037L if you have any. questions or need to discuss this situation. Thank you for your attention in this matter. Sincerely, George W. Hammarth Deput7 Regional Permit Admmis~rator MAR-21-2001 10:34 COASTAL RESOURCES S18 4?3 2464 P.01 NEW YORK STATE DEPARTMENT OF STATE DIVISION OF COASTAL RESOURCES AND WA TERFRONT RE VITALIZATION 41 STATE STREET ALBANY, NEW YORK 12231 USA Phone: (51g) 474-6000 Fax: (518) 473-2464 FAX MESSAGE To: Tovfa of Southold Trustees From: Barry Pendergrass o~'~ Date: March 21, 2001 I~R2 I Re: Permits for groin construction Message: The Depa~htient of S~ate has been advised that the Southold Trustees may be considering local permits for conslxuction of groins in waters of Long Island Sound. The Trustees should be awa~e that such cons~xuction would require permitz ~om the US Army Corps of Englnec~s and thc New York State Department of Environmental Conservation. The Trustees should provide the project applicant with this information so that they are fully informed as well. Please feel free to contact me directly at the phone number below if you have any questions on these matters. Number of sheets (including this cover sheet): 1 If there is a question or problem, call: Barry Pendergress at (518) 486-3277 TOTAL P.O1 Telephone (631) 765-1892 Town H',tll. 53095 Main Road P.O. Box 1179 So.hold, New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Monday, March 19, 2001, the following recommendation was made: JACQUELINE MOELLER 68-1-17.1 to repiace washed away 45' jetty with 45' Iow- profiie (2.5' high)jetty. Replace washed away 125' jetty With 75' Iow-profile (2.5' high) jetty. 4305 Soundview Ave., Southold The CAC did not make an inspection, therefore no recommendation was made. Albert J. Krupski, President James King, Vice-President Henry Smith Artie Fester Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD COASTAL EROSION MANAGEMENT PERMIT Permit Number: 5254 Date: December 6, 2000 Name of Applicant/Agent: Susan L. Long Permits. Name of Permittee: JACQUELINE MOELLER Address of Permittee:Maple Lane Southold, NY Property Location: 4305 Soundview Avenue Southold, NY Description of Activity: to replace 55' timber bulkhead in kind/in place backfill with approx. 30 c.y. clean fill from approved up land source. Reco,L~tLuc~ion of 2 ivw profile j'~ttieo 45' l=,~th, 3-1/2 feet dc%;n frAm to~ e¢ h,,]u~ Date of Permit Issuance: November 21. 2000 This permit is valid for a period of two years from the dates of issuance. SPECIAL CONDITIONS: ...... Bluff restoration through a re-vegetation agreement is a necessary special condition of this permit. A relocation agreement is attached hereto and is a necessary special condition to this permit. A maintenance agreement as attached with application and is a necessary special condition of this permit. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 5~'''~'~ DATE: ..~.o~..2.1, _2.000 ISSUED TO .......~:~gQ.U. EL~./~.. ~Q.ELLER ............................................ Pursuant to the provisions of Chapter 615 of the I~ws of the State of New York, 1893; and Chapter ~ of the L~ws of the State of New Yore 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERStt and in accordance with the Resolution of The Board adopted at a meeting held on ~PX.~....2]? .... 2000 ..... and in consideration of the sum of $ .. ]~sQ.:.~) ..... paid by Susan L.....Lon.g .Pe.rmits on behalf of Ja¢.ct.uetine.-.Moelter ...... of .....~?~.~?.!~.'. ............................. N. Y. and subject to the Terms ~nd Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes end permits the following: Grandfather Permit to replace. SS' timber bulkhead in kind/ in place backfill with approx. 30 c.y. clean fill from approved up land source. P, ccc, nctruc/"-~,r, cf 2 lc':; pref~!e all in accordance with the detailed specifications'as presented in the originating appficatlon. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs 'Corporate Seal robe affixed, and these presents :to be subscribed .by a 'rmajority of the said Board as of this darn. - ' Tr, v, slecs TERMS end CONDITIONS The Permlt~e Jacqueline MoeHer residing at 430,5 Soundview Ave .... . $o,_'_the!d, N. Y~ ts pazt of the consideration for the issuance of zhe Permit does understand and prescr~ to the fol- l~ng: 1. That the said Board of Trustees and the Town o~ Southold axe reletsed from any and all &magas, or O,~'~ for damages, of sulu trtsing directly m indim:fly as · result of any ope~- orion performed puz3oaflt to this permit, and the said Penn/eeee will, at bls or be~ own expmse, &fend any and all such mits'initiated by thkd parties, and the said Peflnittee -~--~_ full llaHlity with respect thereto, to the c~mplcte exclusion of the Boa~ of Trustees of the To~ of StmtlKfld 2. That ~ Permit h valid for · period of 24. mos. wh~% i5 consklered to be the estimated time required to complete the work involved, but should circm,~:.,flces war, m. request for tn ~t~sioa may be trade to the Bo~xl at a later da~e. 3. That this Permit should be retained indeirmitely, or as long as the said peemietee wishes to maintain the structure or project involved, to provide evidence to aayone concerned that anth- orlzation was otlgloally obtained. 4. That the work involved will be subject to the .inspection and approval of the its agents, and non-compliance with the provisions of the otlglmdng appllcation~ may be _~,,~ revocation of this Petmlt by resointion of the said Board. 5. That there will be no unteasooahie interference with ntvigation as a result of the work herein authorized. 6. Th~tt there shall be no interference with the tight of the public to ~ and repass along the beach between high and low water marks. 7. Tha~ ff future ope~ions of the Town of Southold require the removal and/or altecedom in the location of the work herein mthodz~ or if, in the opinion of the Bontd of Trogee~ t~. work ,h~1! ceme unreasonable obstruction to free navigation, the said Pennlttee ~ be teq~ upon due notice, to remove or alter d~s work or project herein stxted without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee et ~he completion of the work attth- orlzed. " 9. That the Permittee will obtain aH other petmlts and consents chat may be required sup- plemental to this permit which may be ~x~ject to revoke upon failure to obtain Telephone (631) 765-1892 Tower H~dl. ,~3095 M~in ~ P.O. Bo:: II"FJ · m~hold. New. ¥o~k 11971. SO~HOLD TOWN CONSERVATION ADVISORY COUNCIL At .the meeting of the Southold Town Conservation Advisory Council held Wednesday, November 15, 2000, the following recommendation was made: · ,~.,,L.,.E.,,R~6$-I-17.1 to replace 55' timber bulkhead inkind/inplace, backfill ~~~'~PlSroved ~pland source. ' 4.,0~ Soundv~ew Ave., Southold therefore no recommendation was made. FROM ~C MESIANO INC. FAX NO. :$51-878-8951 Mapion La,ham Sep. 19 2002 01:24PM P2 631-7~S-[958 p.! Prep~red for: Jacqtmline Moeller Maple Lane, Southold, NY 11971 SC]~ #L000-6~1-17.1 Prepared S.E. Lon~ Perr~ts P,O. Box 46 ....... U MESIANO INC. September 19, 2002 AJ Krupski, President Town of Southold Board of Trustees Box 1179 Southold, NY 11971 FAX NO. ;631-878-8951 CA'rH u.[/ Li~nsed R~ Real Estate Consultant Sep. 19 ~00~ 01:23p~ Jacqueline Bittner 4305 Soundview Ave, Southold SCTM # 1000- 68-1-17.1 Dear Mr. Krupski: I am the agent for Jacqueline Bittner, owner of the above referenced property. We are requesting a Permit for emerge,n, cy repairs for damage done to the bulkhead dudng a recent .storm. Approxim.ately 72 of functional bu . approximately 1000 cubic yards of mateda, from ~:~ndd~ha~:.a,s_~hed .out along wl,~, of the bulkhead was raised/damaged. Minor damage was sustained by 20' of bulkhead ..... uu,~.neao. An additional 24' at the seaward end of the easterly return and . end of the 55' section of bulkhead T wash. out ~s occurring behind the w ' he bulkhead was Io~-'--' - . esterly seaward (north) of the existing dwelling, which distance has been reduced to ,-~L,~u approximately 64' approximately 17' as a result of the erosion of the bluff due to the damage to the bulkhead. We are seeking an emergency Permit for a temporary repair to avoid further degradation .of the bluff and loss or substantial damage to the dwelling. We proposed to install a _+11 O' wall of fitted concrete rubble and/or natural rock atop filter fabric and approximately 300 cubic yards of clean fi I · · - bluff. The proposed wall will .~, .~...__a.l.ong t~e Inside radius of th · · be 5,~ ,=~,uv~ [ne exlstino ar~,,t~ ~,,~ -~ ,~, e~ deteriorating existing grade..As previously stated, this a temporary measure we believe to be necessary to avoid further - .-.- ..... ,., ~-,o oelow the substantial loss. Attached hereto is sketch of the proposed activity provided by John Hocker of Latham Sand & Gravel, Ms. Bittner's contractor. ! believe this description aCCUrately reflects the recommendations discussed at the site inspection 'on.September 18, 2002. Should you require any additional information, please contact me. Your immediate attention to this matter is greatly appreciated. //~atrerire M~s'a~ , residen~O. I~r~ Encl. Cc: John Hocker 12 Mill Pond La~ . East Moriches, New York 11940 · 631.$?K$951 P1 BO..kRD OF TOWN TRUSTEES TO~3,%' OF SOUTHOLD F,~t n H,dl 53095 R=ute 25 P O. B~;x l17t, Southold. Nt'~ York 1197 [ Telephone , Fax ,631, ORIGINAL Office Use Onb Coastal Erosion Permit Applica. fi,¢ -~-VVetland Permit Application t/ Major ___Min°r ~k ar, er AmendmeatEha~es Receixed .Application ~14~--O Recei,ed Fee'S M~, Completed Application _ h'tcomplete SEQRA Classification I)pe I Tspe Il .... Unlisted Coordmanon Mate sentL~~ C.XC Referral Sent ~~ Dat¢ ol'lnspe~tion ~/~ Receipt ofC.4C Repo~ ' Lead Agent> Determinauon Techntcal Rex iex~ I>u~hc Hearing Held ~esolul Name of Z, PPhcant .,~'~C. ~U ELI NE M~O E. L L r~ I~ ;. 'P. F. aoN mq,..t4,,./ I iq $ 8' -. Phone Nurnber County Tax MapNulnber In00- ~. l- 1'7,] Pr:pen,, Lc, cation. ~30..5' ~OO N ^ _ ~_~%f. ro', ~de LILCO Pole ,, disiance% cross streets, and location} ............. Pho,e ~31 of Trustees Apg WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~R E~J ~-N T' ~SUt-I~ ~ gP, D Area of wetlands on lot: square feet Percent coverage of lot: N I A Closest distance between nearest existing structure and upland edgeofwetlands: O feet :~ETr,{ Ar'r~,c~tEb 'to au~EAb Closest distance between nearest proposed structure and upland edge of wetlands: O feet Does the project invo ve excavation or filling? No v/~ Yes If yes, how much material will be excavated? -o - cubic yards How much material will be filled? b~v~ ~05 0a cubic yards Depth of which material will be removed or deposited: -- 2. feet Proposed slope throughout the area of operations: hit ~ t ~£ - Manner in which material will be ~ or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): of Trustees Land Area (in square feet): Area Zoning: ,5~ N~t ~ Previous use of property.: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: Agency Date I '1 __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend?ed by a governmental agency? ~' No Yes If yes, provide explanation: b]/~ Project Description (use attachments if necessary): NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: 3AC~U~LL~ ~a~ SCTM#1000-~-[- YOU ARE HEREBY G~VEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: 2. That the property which is the subject of Environmental Review~s located adjacent to your property and is described as follows: 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on: ~lAllol You may contact the Trustees Office at 765-1892 or ih ~riting. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: ~AO_~i~! ILING ADDRESS: ~,TNAM PHONE ~: P'O. 50g Eric.: Copy of sketch or plan showing proposal for your convenience. Hat 2! O1 02:26p Susan E. Lon~ 516-477-3455 p.2 ;.lbert J K.rupskL Premdent Henry Smith Telephone16311 765-1S~Z Fax {631., 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES; TOWN OF SOUTHOLD .I.n the Matter of the Application STATE OF NEW YORK) AFFIDAVIT OF POSTING I, _-~O~M ~0C~-- , residing at being duly sworn, deposeand' say: Thai on the l k~h day of ~ARCH, 200~, I personally posted the property known as HJD.C ~O~/~VI~\~J A\/E / ~lT ~( ~ Dy 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~e hearing. Date of hearing noted thereon to be held~_~ ~o Sworn to before me this SUSAN E. LONG Notary Public, Stat~: nI New York No, 01 :.04956343 Qualified ,n Su[191k County Commission Expires Navamoer 6, 31 Mar 21 O! O2:26p Susan E. Lonc 516-477-345S p.1 SUSAN E. LONG PERMITS I~.O', Box 4a FAX TRANSMITTAL Number of pages, including cover AUTI-IORIZATION FORM Date: (name) (street address) locatedat .5'o,.ckbold, M.5). Ilrt~{ do hereby give /-'*~'h~,~ (town & state) (contractor) and Susan E. Long the authority to act as agent on my behalf in applying for all necessary permits for work to be done on my property described above. Scale: I" = ~0' Ail m,~efial ~re~ed I~' . OUND AV ._ · Replace 4~' ~y ~d re~lace 'J 25' jetty with ~a ?$' j~y (low profile) Prepared for: Jacqueline Moeller Maple Lane, Southold, NY 11971 SCTM ~1000-68-1-17. 1 Prepared by: S.E. Long Permits P.O. Box 46 East Marion, NY 11939-0046 She~ l of.l. Orl$1NaL · -,: ,':'-, %h.h-i. ~,: BOAi{D OF TO~A!N' TRUSTEES TOWN O}' SOU I'MuLi) Office Use Only ___Coassal Erosion Permit Applica5ion de5land Permi% Application ___lran,ifathez Permi5 Applicauicn ____',','2tver ,~eniment ,Changes ~=""'' '~ A~licasi3n: _ z E ~ ~..:. 2-AssLftca2iCIi: 2r2Lilnation:!dase sens) "AC Pc'ferra~ SenE: ' ' in i .... i i~ =,i_~,~ ~,21.3 =, di~kdRco E,z.'cr.:3s~ -i =lc>._2caEle~ ard of Trustees Applicati GENERAL DATA Land Area (in square feet): ;~%~p~K Area Zoning: 1~_~ b~'r!~ %~) ~T Previous use of property:, ~b~7; Intended use ~of property: N~ ~k;C~__ Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permft/approval ever been revoked or suspended by a governmental agency? ~No Yes If yes, provide explanation: (use attachments if necessary): Project Description ( ~rd of Trustees Applicati~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: .~_~j~ ,~~ ,0~)%~ Are wetlands present within 75 feet of the proposed activity? No w/ Yes Does the project involve excavation or filling? No ~ Yes If Yes, how much material will be excavated? -O- .(cubic yards) How much material will be filled? ,~ e.~ · (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably ar~ticipated resulting from implementation of the project as proposed. (Use attachments if necessary) l 4 617.2.1 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) .~. APPLICANT ISPO~j,~R I 2. PROJECT NAME SEC :ThC e. HEb[N F-- ~0 3. PROJECT LOCATION; - -- 5. iS PROPOSED ACTION: . ) ~'--~ New [~ Exean$ton [--1Modlflca tlon/ait er orlon 't~ ~ P-- O/~$ T/~-t) CT'I 0 I,~ 6. OESCRI6E PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED; ~. WILL ~ROP,'~SED ACTION COMPLY WiTH EXISTING ZONING OR OTHER E.XJSTING LAND USE RESTRICTIONS? "~Yes L~No If No, describe Dnefly 1~. DOES ANY ASPECT OE THE ACT[O~ HAVE A CURRENTC~ VAUD PERMIT OR APPROVAl? ~2. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MOO P CATION? If the action is in the Co~slal Area, and 7ou are a stale a~ency, complete Coastal Assessment Form before proceeding with this a~essment OVER 1 PART I]--£NVIRONMENTAL A?¢ESSMENT ftc be comoleted Dy Agenc'/) C. COULD ACTION RESULT iN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING. IAnswers may ~e nanawr,[Jen. 3. IS tHERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL ~MPACTS? ~ Yes [] NO If Yes, explain briefly PART III--0ETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect idenfifled above, determine wnetBer rt is suBstantiaL large, ~mponam or otherwise Each etfecf should be assessed in connection with its (al setting (i.e. urban or rural); (b) probability of occ~-~ng; ~rrevers~dHity; (el geograpBic scape; and (t~ rnagqitude. If necesea~, add attacBments or reference supporting materialS. Ensure exolanafions contain sufficient detail Io show that all relevant adverse impacts have been idemlfled and adequately adcressea. ~ Check this box if you have identified one or more potentially large or sfgnifican~ adverse impacts wh~c~ occur. Then proceed directly to the FULL EAF and/or prepare a positive' declaration. --I, Check this box if you have determined, based on the information and analysis above and any documenlat~on, that ~he proposed action WILL NOT result in_~3,ny significant adverse enwronmental rmcac~s AND prowde on attaci~ments as necessary, the reasons supporting this determination: DJ[l: 2 . . ~rd of Trustees Applicati~ County of Suffolk State of New York ~S~ ~~ ~ ~ BEING DULY SWORI~ DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMElgTS CONTAINED HEP~EIN Ai{E TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL HORK WILL BE DONE IN THE M~NNER SET FORTH IN THIS APPLICATION D AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. E APPLICANT AGREES TO HOLD THE TOWN OF SOLVEHOLD AND THE ~DWN USTEES HARMLESS AR-D FREE FROM A~[Y_ AND ALL DA~iAGES AND CLAIMS ARISING UNDER OR BY VIRT~3E OF SAID PERMIT(S), IF GR3~NTED. IN COMPLETING THIS APPLICATION, I HEREBY AtFEHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATI¥-ES(S), TO ENTER ON"iX) M~ PROPER~ TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS Notary Public CLAIRE L. GLEW Notary Public, State of New York No. 01 GL4879505 Qualified in Suffolk County._.. \ Commission Expires Dec. 8. ~ 7 Scale: l*'= ,0' a~g~ ~de 6'-7' ,SOUND VIF_.W AVf. Rel9 -,.,., ..~i~ .....55' 6 -',her b,,rk'~,,,.,ad in-l.~, in-place% backfill ~ mpproxiax~t, ely 30 ~ ~ clem~ fill from approve~i uphmd ~ Prepared for .lacqueline Moeller Maple Lane, Southold, NY 11971 SCTM ~_1.000-68-1 - 17.1 Sheet 1 of 1 S.E. Lon~ Permits P.O. Box 46 Ea~t I~ion, NY 119390046 November 2. 2000 Albert J. FLr~pski, Presid~nt James King, Vice-President Henry. Smith Artie Foster Ken Poliwoda To~vn Hall 53095Main Road P.O. Box 1179 Southold, New York 11971 Telephone(516) 765-tS~2 Fax(516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the MatteJ. of the Application AFFIDAVIT OF POSTING I .. T' _~]~_az~% resid~.ng at ~~ .... Being duly ,,worn, oepose and say: That on ~he I~d. ay of~O~,~, _~ pecseI~al%? posted the by p!ac~.ng th(~ Board of Trustees off_icidi pose. er where it can easily De seen~ and that I have checked to be sure the poster b~s remalned in place for seven days prior to the date of tthe~ public hearing. (date of hearing noted thereon Dated: (signature) · - Sw~o~ to before me this day of ~ '~(9~) SUSAN E. LONG Notary Public, State of New York No. 01LO4,,~)SL343 Qualified in Suffolk County Commissiofl F-xi~es November AUTHORIZATION FORM Date: (name) (street address) locatedat .5'o,x-[l~o{~l~ Ni,~. Ilct-tI do hereby give Ln~ch~ ~o.t~d~r~:, (town & state) (contractor) and Susan E. Long the authority to act as agent on my behalf in applying for all necessary permits for work to be done on my property described above. ~OV I 4 ~ Sca~: l'= .0' All ~ tr,~,~l lamh~ . ~d ~b,~i?~d E, udware avatage t~d~ 6'~7' SOUND VIEW AVE. Proposed: Re~-,'-*xislia~ 55' timber b.lld,esa ia-x-i~, ia-place. ~ with =pproxin~tety 30 cu. ~ dean fill from approved upland source Prepared for: Ja~lu~lin~ Moeller Maple Lane, Southold, NY 11971 SC-TM Iii 000-68- I-17.1 ghe~ 1 of I S.IK Long Permits P.O. Box 46 East Marion, NY 11939-0046 N~vember 2, 2000 AUTHORIZATION FORM · ,,'. (name) '- (s~reet address) locatedat "Soo,'~b~'ld, M,h~i: IIq'/} do hereby give ~m4hn,~ ~q~0.n~g=-,<, (town & state) (contractor) and Susan E. Long the authority to act as agent on my behalf in applying for all necessary permits for work to be done on my property described above.