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HomeMy WebLinkAboutTR-5453Albert 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 OFSOUTHOLD August 4, 2003 Mr. James Sleckman 105 Astor Avenue St. James, NY 11780 RE: SCTM#77-2-5 150 Oak Avenue . $outhold, NY Dear Mr. Sleckman: The Southold Town Board of Trustees at their Regular Meeting held on Wednesday, July 23, 2003 took the following action. RESOLVED, that the Southokt Town Board of Trustees Approve an Amendment to Permit #5453 to reduce the size of the dock to 4 feet by 60 feet with a ladder at end of dock to access boat as per plans prepared by Susan E. Long Permits dated October 4, 2001 and revised July 28, 2003. If you have any questions, please call our office at 765-1892. Albert J. Krupski, Jr. President, Board of Trustees cc: DEC AJK:cjc Prepared for: ~'am~ Slec~ Pr~pe~ed b~ Susaa E. Long Permits P.O. Box ¢6 East Marion, NY l 1939-0046 (63l) 477-3455 ~ e-c- E-5-~ 8nAT lames Sleckmaa 150 Oak Street Southold, NY 11971 SCTM #1000-77-2-3 Ma'{ ,~ o, atoo.3 October 4, 2001 Sheet I of 2 '1 AUG - 4 2003 $outhold Town Beard of Trustees AUG - 4 2002 Su.~n E. Long Permit~ P.O Box 46 East Ma~on, NY 11939-0046 (631 ) 477-3455 Prc~cl: Iz~t~l 4' x~;O' -- ~xeddocb~ ~Na. LAP,~R ACCE_~ 8a~'r October 4, 2001 Sh~ 1 of 2 r-l Jarne~ Sl~claman 150 Oak S~-~et Sou[hold, NY 11971 SCTM #1000-77-2-5 Frome JJ~J~i AUG - 4 2003 Southold Town ~ B, oard of Trustees ~m t~ IllilAUG -4 ~003 J Soutl~old Town L Board of Trustees P~epa~l for:,~ ! SO C:~k S~k~~1 Su~a~ R. Lo~ pem~t~ (63l) 477-3455 Pm~: ~x~'mll 4' O~obcr 4, 2001 Sheet I of 2 Jam~s Sleck:m~n 1 SO Oak Street ~ouflwld. ~ ) 1971 SCUM #1000-77-2-5 Iiil AU~ - 4 2003 Southold Town ~oard of Trustees (63~) 765-1892 Town Hall. 5309.5 Ma/a Road P.O. Box 1179 ~outhold, Ne~ Y<xk 11971 SOUTHOLD TO~VN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, July 15, 2003, the following recommendation was made: Moved by Donald Wilder, seconded by Thomas Schlichter, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A STIPULATION of the Amendment application of JAMES SLECKMAN to Amend Permit #5453 to reduce the size of the dock to 4'X 60' in order to meet the requirements of the NYSDEC. Located: 150 Oak Ave., Southold. SCTM#77-2-5 The CAC recommends Approval of the application with the Stipulation that there is no change to the shoreline. V_ote of Council: Ayes: All Motion Carried Memo TO: SOUTH HOLD BOARD OF TOWN TRU~T~Eg FROM: Jim Sleckman DATE: 7-15-03 ATFN: CHARLOTTE RE: PERMIT # 5453 Dear Charlotte, Enclosed are my "notices to adjacent property owners", along with proof of mailing receipts, notarized copies of affidavit of posting and proof of msillngs. Enclosed is also a copy of my permit from the New York state DEC. If you have any questions, please feel free to call me. Regards, Jim Sleckman ®P~el · N~ rk State Department of Ehvironmental Div,=~r,, of Environmental Permits Building 40 - SUNY. Stony Brook, NY 11790-2356 Telephone (631) 444-0365 Facsimile (631) 444-0360 / Conservation Erin M. Crotty Commissioner July 9, 2003 Mr. James Sleckman 105 Astor Avenue St. James, NY 11780 RE: 1-4738-02975/00001 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. Sincerely, Carol A. Farkas Fnvlrcmrnemtnl Analyst CAF/ls NEVV YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSER'v~N PER ,T. MBER I 1-4738-02975/00001 ~ UMBE- (S) '"PERMIT Und;~tnh~ Ej~nL~ewnra [ EFFECTIVE DATE Jul), 7, 2003 EXPIRATION DATE(S) July 7, 2013 TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] Article 15, Title 5: Protection of Waters [] Article 15, Title 15: Water Supp]y [] Article 15, Title 15: Water Transport Q Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certifica- tion [] Article 171 Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: '13dal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste ManacJement [3 Article 27,'Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER James Sleckman (631) 862-6311 ADDRESS OF PERMITTEE 105 Astor Avenue, St. James, NY 11780 CONTACT PERSON FOR PERMITTED WORK Susan E. Long Permits, P.O. Box 46, East Marion, NY 11939-0046 NAME AND ADDRESS OF PROJECT/FACILITY ITELEPHONE NUMBER (631) 477-3455 Sleckman p. roperty, 150 Oak Street, Southold Suffolk Southold Goose Creek DES~I PTI .O,N 0F'A,~THORIZED ACTIVITY: Const'tucL.a 4'x 60' ca~walk with ladder at seaward end. Ail work must be done in accordance with the / attach~d'-ptampref~fed by Susan E. Long Permits on 6/25/03 and stamped NYSDEC approved on July 7, 2003. p;. .................................................... applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: I ADDRESS Roger Evans (CAF) I Region 1 Headquarters, Bldg. ¢f-40, SUNY, Stony Brook, NY 11790-2356 SPECIAL CONDITIONS 1. 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. 2. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the tidal wetland boundary. 3. Dock or timber catwalk shall not exceed 4 feet in width and shall be a minimum of 3% feet above grade* over tidal wetland areas (* as measured from ground to bottom of dock sheathing). 4. The use of wood treated with pentachlorophenol in the construction of structures that will be in contact with tidal waters is strictly prohibited. 5. Dock reconstruction or replacement or seasonal installation shall not involve expansion or substantial modification of existing structures or facilities. 6. No dredging, excavating or other alteration of shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 7. Docks/catwalks/floats may not (a) extend laterally beyond property lines, (b) be placed so that docked boats extend over adjacent property line, (c) interfere with navigation, (d) interfere with other landowners riparian rights. 8. Permittee may remove catwalk on a seasonal basis due to adverse weather conditions or ice. DEC PERMIT NUMBER 1-4738-02975/00001 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. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 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. 6. 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. 9. 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 ~i~neH_ ~nd rc~h irn~H, ~lnn_n with photographs of the comoleted work and, if required, a survey. 10. 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 Susan E, Lonq Permits 6/25/03. DEC PERMIT NUMBER PAGE 3 OF 4 1-4738-02975/00001 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 o. peration 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 speciat 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: Facilit7 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 wdtten 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 (SPD ES), 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 P_eg!or,?l Permit Adrnini~tr~fnr. R~o_ion 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 matedal 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 1-4738-02975/00001 l:"repared fo~': Jame~ Sleckraa.n. '150 Oak Street ~outhold, i'TY 11971 $CTM #1000-77-2-5. $~,,~n E. Long ~2er'atits P,O. Box 46 ~.ast Madon, 1-TY 11939-0046 (631) 47%3455 A..N~) co?4Lt['l IONS OF PIgRMIT NO. DATE ',:3 ~'am~ Sleclanan 150 Oak Street Southold, lqY 11971 $ CI'Ivl #1000-}7-2.$ t ~tory prom~ Goncrat~ PoUo Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERI',41T NO. 5~l(~m~'~ DATE: Nov. 2.0.r .;~001 ISSUED TO ........... J.A~g.$ ..~C~g~.AN .................................................... Pursuant to the provisions of Chapter 6lEi of the L~ws of the State of New York, 1893; end Ghepter 404 of the L~ws of the State of New York 1952; and the Southold Town Ordinance en- titled ."REGULATINC= AND THE PLACINCo OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, CoRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;~. and in accordance with the Resolution of The Board adopted at a meeting held on ..hlmz..... 20~h, ,, 30.0.1...., and in consideration of the sum of $...200.,.00 .... paid by · ..Growlelz---Coz~st~u~-tion.. on .beh~i£-..of James"'S~liiii'ifii' ":': ....... o{ ...... ~.a~.t...Marion,. ........................................ N. Y. and subiect to the Terms and Conditions listed on the reverse ride hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit for a 4'x42' dock; 4'x16' ramp, 6'x20' float and recess stairs from beach onto dock. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by ~auses its Corporate Seal to be affixed, and these ~.resenfs to be subscribed by a 'majority of the sa,d Board as of tb~s dat~. TERMS ~nd CONDmONS James Sleckman pan. of the coasicle~8o~ for the ~ of ~he P,..,~dt do~ tmclersmmi ~ pa~oqbe to the ~ol- L That d~e sa/d Board of Trust, ecs 9nd rise Town of Soughofd az~ ~leased l't,.-u any ~ sdl d.,~.~s, oc ,4,t,~ fo~ d..-%oes, of suits arising dimxly ac indirectly as a result of any opes- with ~p~ct ~er~o, to the tmnplete ,-~4udon of the Board of Tn~s of d~e T~ ~ ~ Z. That rigs Penait Is ~slid f~ a .peiiod of ~4 mos. ~4gch ts com~esed to be the estimated time'tequffed to comlgem the wodc invol~,ed, ~ d~uM ~,,~ wsrram, request for an extension may b~ ~ to the Boetrd at a la~ex ~ 3. Tl~t this .Permit should be t~"tained indefinitely, or as long as the said P_~ffx'ee wishes to mah,r-!q the stmcmze or project involved, to pmvlde evidence to anyone concesaed that orizs, tlon was o~igtn~lly obtained. 4. That d~e wo~ involved will be subject to the inspectio~ and spptovsl of the Bo~d ot ~ ~ ~d ~1 } ~ ~ ~ l ~{ provisions of dm ori~n~t~ng applications may be arose fo~ t~m:stion of this Permit by resolution of the said Board. 5. That the~e will be no unxeasomble intexfe~ence with navigation as · ~ of the woei het~n adtborbed. 7, Th,st if fum~ ol~t, ations o~ the Town of Southold t~ClUite the t~mval nad/or alms~ttoas in the location of the wo~ bemtu sutlsottzed, or lt~ In lhe opin~ of d~e Bo~i of Tmstee~ ~e ~otk ~ came unt~-~cson~le obstmaion to free navig~tlon~ t~e said Pennlttee will be teq~Ited, upon due notice, to remove or alter ~ work o~ project herein stated without eq~mses to the Town 8. That the said Board will be notified by the Petmitxee ot ibc _comple~ of t~e ,~k ~ 9. That the Petmittee will obtain aH other permit_ and consents d~t may be tequized plemental to this permit which may be subject to revoke upon failure to ~ same. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK ~SSUED TO ........... ~.:A M ~.~ ...~.~.A~ ..... DATE: Nov, .2.Os ·2.001 Aut'l orizatiau Pursuant to the provisions of Chapter 6IS of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952~ and the Southold Town Ordlnar~e titled ."REGULATING AND THE PLACING OF OBSTRUGTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN'WATERS[~. end in accordance with the Resolution of The B6ard adopted at a meeting held on ..No.~... 20:h, -,:20.0.1...., and in consideration of the sum of $..200.,.00 ..... paid by · ..Cr.owle. Ty:...~Const~uotion..en behat£--oi:.~ames.-.$[e-el<~.fi.~/.---: ......... of ...... l~.a~.t...Marion,. .............................. N, Y. and subject to the Terms and Conditions listed on the reverse slde hereof, of Southold Town Trustees authorizes end permits the following: Wetland Permit for a 4'x42' docki 4'x16' ramp, 6'x20' float and recess stairs £rom beach onto dock. all in accordance with the detailed specifications as presented in · the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by ~euses its Corporate Seal to be affixed, and these presenh to be subscribed by a majority of the said Board as of this dat~. Albert J. Krupski, President James King, Vice-President Henry Smith Attic Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 November 27, 2001 Crowley Construction c/o Susan E. Long Permit PO Box 46 East Marion, NY 11939-0046 RE: James Sleckman 150 Oak Street Southold, NY. SCTM#77-2-5 Dear Mr. Crowley: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on November 20, 2001, regarding the above matter. WHEREAS, Crowley Construction. on behalf of James Sleckman. applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated October 4, 2001 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 November 20, 2001 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code. 2 WHEREAS, the Board has 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 approved the application of James Sleckman for a Wetland Permit for a 4'x42' fixed dock, 3'x16' ramp 6'x20' float and recess stairs fi.om beach onto dock. BE 1T FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Permit to construct project will expire two years fi.om the date it is signed. Fees must be paid, if applicable and permit issued within six months of the date of the notification. Fee must be paid, if applicable and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified when project is started and on completion of said project. FEES: $1,008.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJm/cjc cc: DEC Army Corp. Dept. of State Albert J. Krupski, President James ~e-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53O95 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD . November 27, 2001 ..~~-- · 0: Crowle¥ Con~ Please be advi.~ed has been reviewed ~ ( X ) Application., behalf of tober 4, gO01 ~eeting of taken: (__) Application D (__) Application T, If your application iu now due. Make check o Trustees. The fee is of rates as set forth fee is ,u~'Southold Town ........ =uuordlng to the schedule ..~.l~Struction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. , COMPUTATION 9F PERMIT FEES: 4'x42'" Dock 168 feet x $3.00 $504.00 3'x16' Ramp 48 feet x $3.00 $144.00 6'x20' Float 120 feet x $3,00 $360.00 $1,008.00 TOTAL FEES DUE: $ !-008-00 SIGNED: BY: 105 Astor Ave St. James, NY 11780 June 2, 2003 Southold Town Trustees POBox 1179 Southold, NY 11971-0959 Attn: Lauren Dear Lauren, As per our recent telephone conversation, enclosed is my check for $720.00 payable to the Southold Town Trustees. This check is for a new four foot by 60 foot dock on my property at 150 Oak Avenue in Southold. The approved design for the dock, with a cover letter by Susan Long explaining the situation, will be arriving at your office this week. If you have any questions, concerning this matter, please feel free to contact me at home at 631 862 6311 or work at 516 458 1729. Thank you for your cooperation. Sincerely, nes Sleckman Telephone (631) 765-1892 To~t I/~1, ~095 Ma~n R.o~d P.O. Box 11'/9 · ~uthokl. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Monday, October 15, 2001, the following recommendation was made: Moved by Bill McDermott, seconded by Scott Hilary, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit Application of JAMES SLECKMAN to install a 4'X 50 f'xed dock, 3'X 16' ramp, 6'X 20' float and access stairs from beach on to dock. Located: 150 Oak Street, Southold. SCTM#77-2-5 The CAC recommends Disapproval of the application because of the poor water quality. As a result, the area is closed to shellfishing. An added structure would contribute to this problem. The CAC recommends an onshore/offshore stake. Vote of Council: Ayes: All Motion Carried DEPARTMENT OF THE ARM'1 NEW YORK DISTRtCT, CORPS OF ENGINE~R~ JACOB K. JAVAS ~L N~ YORK, N.Y. I~B ~.astern Per~lit$ Section Pe~ruary ?, 2002 SUBJECT: Application No, 2002-00075-L1 by James Sleckman 'The New York' District, U.S.'Army Corps of Engineers, has received a request for Department o~ the Army authorization for -the .following activity: ......... APPLICANT: James Sleckl~an 105 Astor Avenue Saint James,' N~ 11780 ACcliVITY; ..... ' ~n;tall a"pie~ a's~embly cons'~;~i~w of a'~' by 50' fixe~ timber pier, a 3' ~y 16' ramp, and a ~' by 20' float secured by two (2) 2-Dile dolphins. The puz~ose of t~is project is to provide recrsat~onal access to Goose Creek. WATERWAY: Goose Creek, Shelter Island Sound LOC~TION: Town of Southold, Suffolk county, New York As this is minor in na=u~e~'-autho~$zation may be by Letter of Permission~ This is in .accordaac9 'w~th current Federal Regulaui=ns governing wor~ in navi~able waters of th~ United States. To accomplish the coordination re~ire~, prior to issuance o~ a Letter of Permission, yovaT revis~ of ~ha enclosed drawings is requested. Pursuant =o Section 30? (c) of the Coastal Zone Management Act of 1972 as amended (16 U.S.C, 1465 (.c) (3) (A)), ~he applicant has certified that ~he activity complies with and will be conducted in a manner that'is consistent ~ith the approved state coastal zone ~anagement program. .. ........ To"mliow for'the timely p~ocesstng o~ the subject ................ applicauion, your 'comments are requested within 15 days of the ~ete of this letter, Enclosures Sincerely, Eastern Permits Section ~003 0~oh~'4~2001 St~! 0£2 Albert J. Krupski, President James King, Vice-President Artie Fester 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 APPLICATION FOR AN AMENDMENT TO A PERMIT AGENT PHONE ADDRESS ~ PROPERTYLOCATION_ ]~-?') Olrlrl~ ]"~Ol~I ~..~O~TlJOt~t) /k,J~ TAXMAPNO. ,"OOo Xec-4~o,o '77,~ ~/oc.(q .~, t-or ~-- ID~ 'JO'~S S "/'e. r'e.~.ucc {-kc_ Size Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O, Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose and say: That on the ID day of 5 ~ I. ~, , 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 pl~ for eight days prior to the date of)he public __hearing. Date ofhearing noted thereon to be helrl,~ ~ ~t ~ ~ ~,~5~-~,~ Dated: ~[gnature) Sworn to before me this DIANE ERDEM PROOF OF MAILING OF NOTICE ATTACH.CERTIFIED MAIL RECEIPTS Name: Address: I. -7 S T STATE OF NEW YORK COUNTY OF SUFFOLK , being duly sworn, deposes and says that on the ~., ~- day of O'ct ~C ,20~_~.~ deponent mailed a tree copy of the Notice set forth in the Board of Trnstees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the To. wn of Southold; that said Notices were mailed at the United States Post Office at ~ O(~ e~-~ ~o~ , that said Notices were mailed to each of said persons by (certified) (registered) mail. NMi/y Publlo, State of Hee/Ymt 4998618 Eq~ir# Me/ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, .TOWN 'OF' sOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to ~ a Permit from the Board of Trustees to: 2. That the property which is the subject of Enviro~mental ~eview is located adjacent to your property~nd is described as follows: 3. That the project which is subject to Environmental Review -ander Chapters 32, 3~, or 97 of %he Town Code is open to public co%ment on: ~ !'k 5i o2 You ~ay contact the Trustees Office at. 76~-1892 or in s~iting. The above referanced proposal .is under review of the Board of T~astees of the Town Of Sout~old and does not reference any other agen~f that might have to review same proposal. Enc.: Copy of sketch or plan showing proposal for your convenience. ~ Sledanan '1 Ken Po h'.'. uda BOARD OF TOWN TRUSTEES TOV,,qq OF SOUTHOLD Office Use Only Coastal Erosion Permit Application ~"~Vetland Permit Application f Major 9,'awer'Amend ment,'Chanees ~_~.4~ec~e~x ed Apphcation ~ecewed Fee $ ~ ~ompleted Application~L~ _ lncomplete~_ _ SEQR~ Class~ficatton lvpe I Type II~Unlisted_~ Coordinat~on.(date sent~ -~-XC Referral Sent -~ae of Inspection_ I~/01 .. ReceiN oFCAC Repo~ L. en~ Agent5 Determination _ Technical Re', ~ex~ ~ubhc Hearing Held Kesolur Minor 'xame ot'Apphcant ...-~/I~_~ _~L'~...C.~' lq &lq -'.,d& es s IO.5' 5,3095 Route 75 P O Box 1179 Southold, New York i 197 Telephone ~651, %5- Fax ,631., 765- ORIGINAL 1011-3 F.T. Phone Number t ) ~J~~_~ll -- - County Ta× Slap Nt, mber 1000 - f77'- ~- ~' , pr,.:,', ~,le L[LCO Pole ~, distance to cross streets, and Iocatton) ~LE~ C Obi 5T~-..DeT~ 0 N[ , it' .q?hcable ~ Phone Boated of Trustees A~plication Land Area (in square feet): Area Zoning: ~_~ Previous use of property: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen/ded by a governmental agency? ~ No Yes If yes, provide explanation: Project Description (use attachments if necessary): F)M TO 6CK · Boar~of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: I Area of wetlands on lot: square feet Percent coverageoflot: -- 0 - % Closest distance between nearest existing structure and upland edge of wetlands: qO ' feet Closest distance between nearest proposed structure and upland edge of wetlands: - {~ feet Does the project involve excavation or filling? v/// No Yes If yes, how much material will be excavated? tq[A cubic yards How much material will be filled7 ~/[ A cubic yards 'lI Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: t~ [fit Manner in which material will be removed or deposited: feet 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): · . Boar~f Trustees ApDlication County of Suffolk State of New York 3U5~ ~. M~N~ BEING DULY SWORN DEPOSES AI~D AFFIRMS THAT HE/SHE IS THE A~PLICANT FOR THE ABOVE DESCRIBED pERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEPdEIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD ~ TOWN OF SOU~OLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM A~ AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID. PERMIT(S), IF GRAlqTED. IN COMPLETING THIS APPLICATION, I HEI~EBY AU~ORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ON~ 59f PROPERTY TO INSPECT THE PPd~MISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. - Signature Notary Public Qualified in Suffolk 7 AUTHOKIZAT[0N FORM I, ,~,Om~..~ ~le~l(t~.~ ownerof /6~o Of~< /'OOE (name) (street address.~ locatedat ~O~{I-o}ll P°C-( do hereby giveJ-.-'lO.~ f~.lCOc,.,~.tLr (town & stgte) (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 descn~bed above, Signature NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: ~ ~ ~C~ SCTM#1000- 7~- ~ YOU ARE HEREBY GIVEN 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: ;0o~q-~\ You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold ~nd does not reference any other agency that might have to review same proposal. OWNERS NAME: MAILING ADDRESS: ~f$ Enc.: Copy of sketch or plan showing proposal for your convenience. I~O. BOX 618 GREENPORT, NY 11944 CROWLEY MARINE CONSTRUCTION BULKHEADING ° DECKS ° DOCKS * BEACH STAIRS TEL./FAX (651) 477-1772 CELL (651) 831-1740 IO0~ S'ul'~unoo:~V u.l*o,I, Plollgnos 9991 ~:91 9Ig XV.-I gO:['I ~llLI. IO/t'O/OI Albert J. Krupski, President James King, Vice-President Hem'y Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765.1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ............ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, '1"-~ ~6~IL~ , residing at ~ being duly sworn, ~pose and say: That on the ~%ay of0~6~ 200 [, I personally posted the property known as 1.~ ~A~ ~F~ ~a,~L~ by placing the Board-of TrUstees 'of~ic£a~ pos£e~'~he~e 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 public hearino. Date of hearing noted thereon to be held Dated: I0 - Sworn to before me this z~gDday of Oc%0~E~,_ 200 Notary Public SUSAN IL LONG Notary Public, State of N~ Yolk No. 01L04958343 Qualified in Suffolk County Commission Expire~ November 6,~,1~ · 14-16-2 (9/95)--7c 617.20 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEQR Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent. ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not be technically expert in environmental analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full E^F is intended to provide a method whereby applicants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet flexible enough to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focuses on Identifying the range of possible impac~ts that may occur from ~ project or action. It provides ' guidance as to whether an impact is likely to be considered sm·Il to moderate or whether it is a potentially- large impact. The form ·lsD identifies whether an impact can be mitigated or reduced. Part 3: If any imp·ct in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify the Portions of EAF comp)eted for this project: CI Par~ 1 r'l Part 2 [~Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magnitude and importance of each impact, it is reasonably determined by the lead agency that: A. The project will not result In any large and important impact(s) and,·therefore, Is one which wiil not have a significant impact on the environment, therefore a negative declaration will be prepared, B. Although the project could have a significant effect on the environment, there will not be a s'lgnlflcant effect for this Unlisted Action because ~e mitigation measures described in PART 3 have been required, therefore a CONDITIONED negat|~e declaration v41! be prepared.* [] C. The project may result in ohe '0r'm'o~. I~rge add Important Impacts that ma~ have a s!gntficant impact on the environment, therefore · positive declaration will be prepared. ° A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Hame of Lead Agency Print or Typ~ Hame of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Date , · PART 1--PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the enviro'~ment. Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify each instance. NAME OF ACTION LOCATION OF A~ION ~nclude Slt~[ Addresl, Munl~plllty and NAME OF APPUCANTffi~NSOR NA~E OF ~NER 0( differed ADORE. S~ . I BUSIHESS TELEPHONE ^TE I · BUMNE~e TELEPHONE · ~TATE ~, ] Z/P CODE Please Complete Each Que~lion-Indicate N.A. If .or applicable A. Site Desoriptlon Physical setting of overall project, bo~ developed ~rnd undeveloped areas. 1. Present land use: f'"lOrban Olndustrlal [:]Commercial [:]Forest . O,~riculture ~Other :2. Total acreage of project area: acres. APPROXIMATE ACREAGE Meadow or 8rushland (Non-agricultural) Forested Agricultural (Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) Water Surface Area Unvegetated (Rock, earth or fill) Roads, buildings and other paved surfaces Other (Indicate typel 3. What is predominant soil type(s) on project slte~ a. Soil drainage: '~Well drained % of site OPoorly drained % of site ~Resldentlai (suburban) I-IRural (non-farm) PRESENTLY AFTER COMPLETION --~>~ acres -- 0 ~ acres ~- acres ~O ~ acres -- acres -0 ~ acres acres , / 0 acres -- acres ~ ~' acres ~ acres ~ ~ acres ~ acres -~ ~ acres ~ acres . ~ acres I-IModerately well drained .__ % of site b. If any agricultural land ls involve, how many acres of soll are classified within soil group I through 4 of the NYS Land Classification Systeml' MIA acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project slte~' C]Yes IgNo a. What is depth to bedrockS' N lA (In feet) 2 5. Approximate percentage of pro'poised project site with slopes: I~0-10% % O10-15% % O15% or greater % 6. Is proiect substantially contiguous, tot,or contain a building, site, or district, listed on the State or the National Registers of Historic Places? OYe~ [~No 7. is project substantially contiguous to a site listed on the Register of National Natural Landmarks~ C]Yes C~No 8. What is the depth of the Water table? AlIA (in feet). 9. Is site located over a priniary, principal, or sole source aquiferS' I-lYes I~No 10. Do hunti'ng, fishing or shell fishing opportunities presently exist in the proje'Et area? I~,Yes L-"JNo 11. Does project site contain any species of plant or=anifnal life that is identified as threatened or endangered1 ~lYes ~No According to .'~IJ,.SAN IF_. Lo, NC, Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations] I-lYes ~No Describe 13. Is the project site presently used by the community or neighborhood as an open space'or recreation area? I-lYes ~No . If yes, explain 14. Does the present site include scenic views known to be important to the community? I-lyes ~No ' '~ ' 15. Streams within or contiguous to projec~ a'fea: ,V/A a. Name of Stream and name of River to which It is tributary AI/A ~..- 16. Lakes, ponds, wetland areas wlthir~ (~e'contiguous to project area: a. Name (~ Dh 5 E~ ("i1~. F.-F'_~ b. Size (In acres) 17. is the site served by existing p~b!tc utilities? ~Yes a) If Yes, does sufficient capacity exist to allow Connection? I-lYes r-INo ~'/A b) If Yes, will improvements be necessary to allow connection? [3Yes I'-INo 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304i' OYes lilNo 19. I~ the site located In or substantially contiguous to a Critical E~'iro, nmental Area deslgnated pursuant t6'Article 8 of the ECl., and 6 NYCRR 617i' OYes etNo ' ' 20. Has the site ever been used for the .c[Isposal of solid or hazardous wastes. ~ I-lYes r'lNo B. Project Description 1. Physical dlmenslons and s. cale of prolect (fill In dimensions as appropriate) a. Total contiguous acreage owned or controlled' by pr. oJ:ect,~,ponsor ' ~ acres. b. Project acreage to be developed: - ~ ~ acres Initially,.;., .. - 0 ~ acres ultimately. c. Project acreage to remain undeveloped - Q -- acres. d. Length of project, in miles: -(~ ~ (If appropriate~[' e. 'If the project is an expansion, Indicate percent of expansion proposed f. Number of off-stre'~t parking spaces existing -- O - ; proposed g. ~axlmum vehicular trips generated per hour -- C~ ~ · (upon'completion of project)? h. If residentlah Number and type of housing units: One Family Two Fa. rally Mu~Uple Family Condominium Initially ~ ~ " Ultimately ~ . i. Dimensions (in feet) of largest proposed structure height; width; ~ length. J. Linear feet of frontage along a public thoroughfare project will occ, upy..' bi' fL 3 · 2. How much natural material (i.e., rock, earth, etc.) will be removed from the sitei' , -~ - 3. Will disturbed areas be reclaimed? C]Yes C]No I~N/A a. if yes, for what intended purpose is the site being reclaimed~ /vi,A, b. Will topsoil be stockpiled for reclamation? nYes I-'lNo c. Will upper subsoil be stockpiled for reclamationS' OYes (~No 4. How many acres of vegetation (trees. shrubs, ground covers) will be removed.{rom site? --~" acres· $. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? [~Yes I~No 6. If single phase project: Anticipated period of construction oN.E. months, (including demolition), 7. If multi-phased: a. Total number of phases anticipated ~3NF-.. (number). b. Anticipated date of commencement phase I ~I6U month c. Approximate completion date of final phase month d. Is phase I functionally dependent.on subsequent phases? I-lYes nNo 8. Will blasting occur during construction? OYes ~No 9. Number of jobs generated: during construction . ill ; after project is complete, . 10. Number of jobs eliminated by this project .., -O- , '11. Will project require relocation of any projects or facilities? I-lyes ~No If yes. explain ,,_ 12. Is surface liquid waste disposal involved? C]Yes ~No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged /v ~A 13. Is subsurface liquid waste disposal involved? CIYes I"lNo Type 14. Will surface area of an existl,n~',water body increase or decrease by proposal? 0-1yes eaNo Explain 15. Is pro~ect or any portion of project located in a 100 year flood plain? I-lyes ~'lNo 16. Will the prolect generate solid waste~' ' r'lYes a. If yes, what is the amount per month N'!.A tons b. If yes, will an existing ·solid waste facility be used? nyes fLl'No c. If yes. give name . ~/~ ; location Nih d. Will any wastes not go into a sewage dispos.al system or into a sanitary landfill? OYes e. If Yes, explain ,NIA tons/cubic yards year, (including demolition). year. 17. Will the project involve the disposal of solid waste~ a, If yes, what is the anticipated rate of dlsposal[' b. If yes, what is the anticipated site Itfe~ /~. ~A 18. Will project use herbicides or pesticides? OYes OYes ~No I .~ tons/month. years. I~No 19. Will project routinely produce odors (more than one hour per day)? nYes ~No 20. Will project produce operating noise exceeding the local ambient noise levels? nyes 21. Will project result in an increase in energy use~' 0'lYes ~No yes , indicate tyl~(s) . 22. If water supply Is from wells, Indicate pumping capacity .N.!A gallons/minute. ' anticipated water usase per day ,~.]A gallonslday. 23. Total 24. Does project involve Local, State or Federal fundlng[' 0-1yes ~No If Yes, explain t E1No 25. Approvals Required: Submitlal Type Date City. Town, Village Board [~Yes r-INo City. Town, Village Planning Board /'-lYes ONo City, Town Zoning Board OYes ONo City, County Health Department OYes DNo Other Local Agencies ~Yes I-INo Other Regional Agencies.' OYes C1No State Agencies ~¥es I-INo Federal Agencies ~Yes nNo C. Zoning and Planning Information 1. Does proposed action !nvolve a planning or zoning decision? C]Yes ~No ' If Yes, indicate decision required: Dzoning amendment r'tzoning variance I-}special use permit Dsubdivislon Dsite plan C~new/revision of master plan Dresourc'e management plan [~oth~r N/~ 2. What is the zoning classiflcation(s:)of the site? ~LL~ i _~_ktT! AL ~_~Rq'~'P,.FR',~HT' 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 4. What is the proposed zoning of the site? /~//,.'{ 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? ~lYes OHo 7. What are the predominant rand use(s) and zoning classifications within a ~ mile radius of proposed action? 8. Is the proposed action compatible with adjolnlng/surroundine land uses within a 1/~ mile? I~Yes [-tNo 9. If the proposed action is the subdivision of land~ how many lots are proposed? a~ What Is the minimum lot size proposed~ /~ 1,4 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? I:lYes ~No 11. Will the proposed acUon create a demand for any community provided services (recreation, education, police, fire protection)? DYes liaNo a. If yes, is existing capacity sufficient to handle projected demand? DYes I-INo 12. Will the proposed action result In the generation of traffic significantly above present levels? OYes' J~No a. If yes, is the existing road network adequate to handle the additional traffic? OYes [:3No D. Informational Details ^ttach any additional information as ma? be needed to clarify ~,our project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. F_ Verification ~~ I certify that the information provided above is true to the best of my knowledge. ApplicantJSpopsor Name ....~D.~A~[ I=', L.~I,4.~ '~F-,-~,.I'4 I~'.~ Date' Signature-t~qLl~/,42. ~ ~ Title '~ol~(J.AJ/J'~- ~, -- If the action Is in the Coaslal Area, and you are a state agency, complete the Coastal Asse~ment Form before proceeding with this assessment. ,, 5 Part 2--PROJECT IMPACTS AND THEIR MAGNITUDE Responsibility of Lead Agency General Information (Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations been reasonable! The reviewer is not expected to be an expert environmental analyst. · The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples andlor lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative and have been offered as guidance. They do not constitute an exhaustive list of impact~ and thresholds to answer each question. · The number of examples per question does not indicate the importance of each question. · In identifying impacts, c9nsider long term. short term and cumlative effects. Instructions (Read carelully) a. Answer each of the 20 questions In PART 2. Answer Yes I! ther~ will be any impact. b. Maybe answers should be considered as Yes answers. c, If answering Yes to a question then chock the appropriate box (column 1 or 2) to Indicate the potential size of the Impact. If Impact threshold equals or exceeds any example provided, check column 2. If Impact will occur but threshold Is lower than axample,'.~;.heck o. olum~ 1~ . ' d. Iden(Ifylng that an Impact will be potentially large (column 2) does nbt mean that It Is also necessarily significant. Any large Impact must be evaluated In PART 3 to determine significance. Identifying an Impact In column 2 simply asks that It be looked at further. e. If reviewer has doubt about size of the Impact then consider the Impact as potentially large arid proceed to PART 3. f. If a potentially large Impact checked In column 2 can be mltlgateCby change(s) In the project to a small to moderate Impact, also check the Yes box In column 3. A No response Indicates that such a reduoUon Is not possible. This must be explained In Part 3. I 2 3 Small to Potential .Can Impact Be Mc?derate Large Mitigated By Impact ImPact PrbJect C,.hange O I-I l-qYes ONo O O OYes ONo 0 0 OYes ONo CO [] O~es 0 0 OYes ONo 0 0 OYes ONo 0 0 OYes ONo 0 0 Oyes 0 0 OYes 0 ~ OYes ONo IMPACT ON LAND 't. Will the proposed action result in a physical change t.o the project site~' [:]NO OYES Examples that would apply to column 2 · Any construction on slopes of 1S% or greater, (15 f6ot rise per 100 foot of length), or where the general slopes in the pro~ect area exceed 10%. · Construction on land where the depth to the water table is less than `3 feel · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally'within ,3 feet of existing ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons cf natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway, · Other impacts 2. Will there be an effect to any unique or unusual land forms found on the site[ (i.e., cliffs, dunes, geological formations, etc.)r3NO nYES · Specific land forms:. 6 IMPACT ON WATER 3 Will proposed action affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) ONO [:]YES Examples that would apply to column 2 · Developable area o( site contains a protected water body. · Dredging more than 100 cubic yards of material from channel of a protected stream. · Extension of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water? I-1NO E3YES Examples' that would apply to column 2' · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction of a body o! water that exceeds 10 acres of surface area. · Other impact~: 5. Will Proposed Action affect surface or groundwater quality or quantity;' [3NO I-lyES Examples that would apply to column 2 · Proposed Action will require a discharge permit. · Proposed Action requires use of a source of water that does not have approval to serve proposed (project) action. · Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed off the site to facilities which presently do not exist or have inadequate capacity. · Proposed Action would use water in excess of 20,000 gallons per day. · Proposed Action will likely cause siltation or other discharge into an existing body of water to the extent that there will be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroleum or chemical products greater than 1,100 gallons. · Proposed Action will allow residential uses In areas without water and/or sewer services. · Proposed Action locates commercial and/or Industrial uses which may require new or expansion of existing waste treatment and/or s. torage facilities. · Other impacts: 6. Will proposed action alter drainage flow or patterns, or surface water runoff? C]NO DYES Examples that would apply to column 2 · Proposed Action would change flocx:l water flows. 7 ; 1 2 3 Small to Potential Can Impact Be Moderate Large M~tlgated By Impact Impact Project Change ~ [] (-~Yes E~No [] [] F-lYes E]No [] [] ~]tes [~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes Proposed Action may cause substantial erosion. Proposed Action is incompatible with existing drainage patterns. Proposed Action will allow development in a designated floodway. Other impacts: IMPACT ON AIR . Will proposed action affect air quality;t I-1NO E]YE$ Examples that would ~pply to column 2 Proposed Action will induce 1,000 or more vehicle trips in any given hour. Proposed Action will result in the incineration of more than 1 ton of tel:use per hour. [mission rate of total contaminants will exceed S lbs. per hour or a heat source producing more than 10 million BTU's per hour. Proposed action will allow an Increase in the amount of land committed to industrial use. Proposed action will allow an increase in the density of industrial development within existing industrial areas. Other impacts: IMPACT ON PLANTS AND ANIMALS · Will Proposed ^ctior{ affect any threatened or endangered species~' n/co OYES Examples that would apply to column 2 Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. Removal of any portion of a critical or significant wildlife habltaL ^pplica(ion of pesticide or herbicide more than twice a year, other than for agricultural purposes. O(her impact4: '. Will Proposed Action substantially affect non-threatened or non-endangered species~ ~]NO I-lyES Examples that would apply to column 2 Proposed Action would substantially Interfere with any resident or migratory fish, shellfish or wildlife species. Proposed Action requires the removal of more than 10 acres of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 0. Will [he Proposed Action affect agricultural land resources~' E]NO OYES Examples that would apply to column 2 The proposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture; vineyard, orchard, etc.) I Z' ' 3~ Small to Potential Can Impact be Moderate Large Mitigated By Impact Impact Project Change [] [] ~]Yes [~]No El [] []Yes []No [] ~ ~Yes ~No 0 ~' ~Yes ONo O ~ ~Yes O ~ ~Yes ONo ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes 8 · Construc:ion activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District. more than 2.5 acres of agricultural land, · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g.. subsurface drain lines, outlet ditches. strip cropping); or create a need for such measures (e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources~ ONO I-lYES (If necessary, use the Visual E^F ^ddendum in Section 617.20, Appendix B.) Examples that would apply to column 2 · Proposed land uses, or project components obviously different from or in sharp contrasi to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? nNO r'lYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur In an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13, Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that would apply to column 2 BNO OYES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space Important to the community. · Other Impacts: 1 2 3 Small to Potential Can Impacl Moderate Large Mitigatea Impact Impact Project Cha O O []Yes [] O O OYe~ [] O O F]Yes [] 0 O OYes [] [] [] OYes C [] 0 OYes F 0 [] OYes [] O O OYes O 0 OYes 0 0 OYes F [] 0 Oyes 0 O OYes O O []yes 0 0 OYes E E B) IMPACT ON CRITICAL ENVIRONMENTAL AREAS Will Proposed Action impact the exceptional or unique character- ~st~cs of a critical environmental area {CEA) established pursuant to subdw~s~on 6 NYCRR 617 14(8) ? ONO OYES List the environmental characteristics that caused the designation ol the CE.A, Examples that would apply to column 2 Proposed Achon to locate within the CEA? Proposed Action will result in a reduction in the quantity of the resource? Proposed Action will result in a reduction in the quality of the resource? Proposed Action will impact the use. function or enjoyment of the resource~ Other impacts. IMPACT ON TRANSPORTATION 5 Will there be an effect to existing transportation systems? · [~NO [~YES Examples that would apply to column 2 Alteration of present patterns of movement of people and/or goods. Proposed Action will result in major traffic problems. Other impacts: IMPACT ON ENERGY 16 wd[ proposed action affect the community's sources of fuel or energy supply? J~]NO [3YES Ezamples that would apply to column 2 ' Proposed Action will caus_e a greater than 5% increase in th~ use of any form of energy in the-municipality. ' Proposed Action will require the creation or extension of an energy transmission or supply system to serve more than 50 single or two family residences or to serve a major commercial or industrial use. · Other impacts' 10 I 2 3 ~ Small to Poten'tial Can Impact B Moderate Large Mitigated By Impact Impact Project Chanc~ [] [] []','es []Nc [] [] OYes •No [] [] []Yes I-IN• [] [3 I-lYes []No [] [] []Yes •No [] [~ •Yes •No [] [] •Yes •No [] [] [~1 Yes J~No [] [] []Yes [~No [] [] []Yes E3No [] [] []Yes [3~o NOISE AND ODOR IMPACTS 17 W,II there be objectionable odors, noise, or vibration as a result of the Proposed Action[ ~NO [~YES Examples that would apply to column 2 · Blasting within 1,500 feet of a hospital, school or other sensitive lacility. · Odors will occur routinely (more than one hour per day). · Proposed Action will produce operating noise exceeding the local ambient noise levels for noise outside of structures. · Proposed Action will remove natural barriers that would act as a noise screen. · Other impacts: IMPACT ON PUBLIC HEALTH 18. Will Proposed Action affect public health and safety~ . [3NO (~YES Examples that would apply to column 2 · Proposed Action may cause a risk of explosion or release of hazardous substances (I.e. oil, pesticides, chemicals, radiation, etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. · Proposed Action may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) · Storage facilities for one million or more gallons of liquified natural gas or other flammable liquids. · Proposed action may result in the excavation or other disturbance within 2,000 feet of a site used for the disposal of solid o~ hazardous waste. · Other impact~: IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 19. Will proposed action affect the character of the existing communRy~ [:]NO [3YES £xample~ that would apply to column 2 · The permanent population of the city, town ct village in which the project is located b likely to grow by more than $%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for futura'projects. · Proposed Action wtll create or eliminate employment. · Other Impacts: 1 2 3 -- Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change ~ [] ©Yes [] [] OYes ~INo [] [] ' []Yes D ~ ~Yes ~NO ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~Ho ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~Yes 20. Is there, or is there likely to be, public controversy related to potential adverse environmental Impact~' [:)NO [::]YES If an), actJo~ In Pitt 2 Is I<Jentlfled al a potential ~arge Impact o~ If you camlot delenmlna the magnitude o! Impaol, proceed to pa~l 3 11 Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead AgencT 'art 3 mus( be prepared if one or more impact(si is considered to be poteniially large, even if the impact(s) may nitigated. nstructions )iscus$ the following for each impact identified in Column 2 of Part 2: · Briefly describe the impact. '.. Describe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change(s). Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: The probability of the impact occurring The duration of the impact Its irreversibility, including permanently lost resources of value Whether the impact can or will be controlled The regional consequence of the impact Its potential divergence from local needs and Whether· known objections to·the proje~:t relate to this impact. (Continue on attachment5 (5 ! 7.20 SEQR Appendix B State Environmental Quality Review Visual EAF Addendum This form .may be used to provide additional information relating to Question 11 of Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between Visibility 1. Would the project be visible from: · A parcel of land which ts dedicated to and available to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public observatlo, n, enjoyment and appreciation of natural or man-made scenic qualities? · A site or structure listed on the Hational or State Reglsters of Historic Pieces? · State Parks? · The State Forest Preserve? · i"lational Wildlife Refuges and state game refuges? · Hatlonal Hatural Landniarks and other outstanding natural features? · Hational Park Service lands? · Rivers designated as Hatlonal or State Wild, Scenic or Recreational? · Any transportation corridor of high exposure, such as part of the Interstate System, or.Amtrak? · A governmentally established or designated Interstate or inter-county foot trail, or one formally proposed for establishment or designation? · ^ site, area, lake, reservoir or highway designated es scenic? · Municipal park, or designated open space? · County road? · State? · Local road? Project and Resource (in bliles) 0-~A V4.V2 V2.3 3-5 5+ [] [] [] [] [] 0 [] [] 0 [] [] [] [] [] [] [] O [] O' [] 0 [] [] [] [] [] [] [] [] [] O [] [] 0 [] [] O [] [] [] [] [] [] [] [] [] O O [] [] [] [] [] O [] 0 O [] O [] Is the visibility of the project seasonal? (i.e., screened b~/summer foliage, but visible during other seasons) []Yes OHo Are any of the resources checked In question I used by the public during the time of year during which the project will be visible? []~'es OHo 1 DESCRIPTIOH OF EXIST[HQ VISUAL Ei~IVIROHMEHT 4. From each item checked in question I, check those which generally describe the surrounding environment. Within "~A mile '1 mile Essentially undeveloped [] [] Forested [] [] Agricultural [] [] Suburban residential [] [] Industrial [] [] Commercial [] [] drban [] [] River, Lake, Pond [] [] Cliffs, Overlooks [] [] Designated Open Sp~ce [] [] Fiat [] [] Hilly [] [] Mountainous [] [] Other [] [] MOTE: add attachments as ne,ded Are there visually similar projects within: ol/z mile ["]Yes OHo "1 miles E]Yes OHo '2 miles r-lYes OHo '3 miles r'lyes OHo °Dlstance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSORE 6, The annual number of viewers likely to observe the proposed project Is HATE: When user data Is unavailable or unknown, use best estimate. COHTEXT 7. The situation or activity In which the viewers are engaged while viewing the proposed action is · FREQUEHCY Holidays/ Activity Dally Weekly Weekends Seasonally Travel to and from work [] [] [-] [] involved In recreational activities [] [] [] [] Routine travel by residents [] [] [] [] At a residence [] [] [] [] At worksite [] [] [] [] Other [] [] [] []