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Home My WebLink AboutFaerber, BrianNew York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) ~.44~0365 · FAX: (631) ~.~.~.-0360 Website: www.dec.state.ny.us Erin M. Crotty Commissioner May 10, 2001 Mr. James Grathwohl 25325 West Main Road Cutchogue, NY 11935 RE: 1-4738-02385/00001 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, Matthew R. Penski EnCon Program Aide MRP/Is Enclosure NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER 1-4738-02385/00001 FACILITY/PROGRAM NUMBER(S) PERMIT Under the Enviror~ntal Conservation Law EFFECTIVE DATE May 10, 2001 EXPIRATION DATE(S) May 10, 2006 TYPE OF PERMIT · New ~ Renewal [] Modification [] Permit to Construct [] Permit to Operate [] [] [] [] [] Article 15, Title 5: Protection of Waters Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island Wells Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality [] Certification [] Article 17, Titles 7, 8: SPDES [] [] Article 19: Air Pollution Control [] [] Article 23, Title 27: MLned Land Reclamation [] [] Article 24: Freshwater Wetlaods [] · Article 25: Tidal Wetlaods Article 27, Title 7; 6NYCRR 360: Solid Waste Manag~nt Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management Article 34: Coasta[ Erosion Manag~nt Article 36: Floodplain Managefl~)nt Artic[es 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO dames Grathwohl ITELEPNONE NUMBER (631) 734-6507 ADDRESS OF PERMITTEE 25325 West Main Road, Cutchogue, NY 11935 CONTACT PERSON FOR PERMITTED WORK EnConsultants, Inc., 1329 North Sea Road, Southan~pton, NY 11960 TELEPHONE NUMBER (631) 283'6360 NAME AND ADDRESS OF PROJECT/FACILITY Grathwohl property, Wi[Lia~b~rg Road, Southold, NY LOCATION OF PROJECT/FACiLITY SCTM #1000-78-5-16 COUNTY Suffolk TOWN Southold DESCRIPTION OF AUTHORIZED ACTIVITY: WATERCOURSE Canal NYTM COORDINATES E:716.4 N:~546.3 Construct single family dwelling, sanitary system, hvo (2) porches, retaining wall, peFvious driveway, landscaped terrace, and decorative wall. All work is to be performed in accordance with the survey stamped NYSDEC approved on 5/9/01. By acceptance of this permit, the permJttee agrees that the permit is contingent upon strict co~liance with the ECL, ail applicable regulations, the Genera[ Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADM i~RATOR: Joh~AOlM'~eLand (MRP) AUT D~SI GNATURE / ~ / // BLdg. #40, ~Z]NY, Stony Brook, NY 11790-2356 May lO, 2001 Page L ,of ~' 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, agents, and assigns for all claims, suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit, Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it ~uthorize the impairment of c, ny rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permtts for State Poiiutant Discharge Eiir'ilinatior, System ~SFDES), Hazardous Waste Management Facilities (HWlVlF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a/ the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found: b) the permit was obtained by m~srepresentation or failure to disclose relevant facts: c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was msued DEC PERMIT NUMBER PAGE 2 OF ~ 1-4738-02385/00001 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 here~n 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 ,-esult 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 undei 6NYCRR Part 608, the NYS Dapsrtment of Environmental Conse~aticn 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 signed and returned, along with photographs of the completed 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: Joseph A. Inqeqno last revised on 2/11/01. DEC PERMIT NUMBER PAGE 3 OF ~ 1-4738-02385/00001 SPECIAL CONDITIONS 1. There shall be no d~sturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 2. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices enter tidal wetlands and or protected buffer areas. 3. 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. 4. All fill shall consist of "clean" sand, gravel, or soil (not asphalt, flyash, broken concrete or demolition debris). 5. The storage of construction equipment and materials shall be confined to w~thin the project work site and or upland areas greater than 50 linear feet from the ;~dal wetland boundary. 6. Sanitary system (bottom of tank and leaching pools) shall be located a minimum of 2' above seasonal h~gh groundwater. 7. To protect the values of the tidal wetlands, a permanent vegetated buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 25 linear feet landward of the tidal wetland boundary. 8. A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer area or 25 linear feet from the tidal wetland boundary, or as per NYSDEC approved plan, at commencement of regulated activities and remain in place until project is completed and all disturbed areas stabilized with vegetation. 9. Roof runoff shall be directed to drywells a minimum of 35 feet landward of the tidal wetland boundary for immediate on-site recharge. 10. All areas of sod disturbance resulting from this project shall be stabilized immediately following project completion or prior to permit expiration, whichever comes first. The approved methodologies are as follows: a. Stabilization of the entire disturbed area with appropriate vegetation (non-fertilizer / non-pesticide dependent grasses, etc.) 11. If seeding is impracticable due to the time of year, a temporary mulch must be applied and final seeding performed at the earliest opportunity when weather conditions favor germination and growth, but not more than six months after project completion. 12. All disturbed areas where soil will be temporarily exposed or stockpiled for longer than one (1) week shall be contained by a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the seaward side between the fill and wetland or protected buffer area. Tarps are authorized to supplement these approved methods. 13. Driveways and parking areas shall be constructed of pervious material. Special Condition 14 is on page 5 of 5. I DEC PERNI~T NUMBER I PAGE 4 OF 5 1-4738-02385/00001 NEW 'fORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 14. The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated tidal wetlands associated with Corey Creek are located at Williamsburg Road, Suffolk County Tax Map Number: District 1000, Section 78, Block 5, Lot 16, otherwise known as the properties of James Grathwohl and his/her/their heirs, assigns, or successors. This property is subject to the provisions of New York State Environmental Conservation Law (ECL) Article 25 or its successor, and the conduct of regulated activities may occur only pursuant to ECL Article 25 if prior approval is given by the New York State Department of Environmental Conservation (NYSDEC) or its successor. Regulated activities include, but are not limited to the erection of any structure(s); excavation; dredging grading and filling; cleanng of vegetation; and application of chemicals." This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this permit. A copy of the covenanted deed or other acceptable proof of record, along with the number assigned to this permit, shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager, Bureau of Habitat, SUNY Building 40, StoRy Brook, New York 11790-2356. DE,2 PERMrT NUMBER ~ PAGE 5 OF 5 1-4738-02385/00001 I PROPOSED SEPTIC SYSTEM AND RETAINING WALL DESIGN Bf FREDERICK S. KE1TH, P.E. OF SAG HARBOR ENGINEERING. SURYEY OF PROPERTY .':'fTUATED AT B:XY~ IE~ 5¢FFOLK COUNTY, NEW YORK TAX Nc. ~000-78-05-16 SCALE 1"=30' FEBRUARY 22, 1999 Land Surveyor /O _~/l~rl~"~~ FREDERICK S. KEITH, P.E. OF ;P'---._ '"~"'~ -/~()A _ ~ ~ ~-~)~-''"'-'"""-'--.",'~d~-- SA~ HARBOR ENGINEERING. ./ ,' ' -...~. ~"--..'~s~' ~ ~,~ ~ ~ ~-.~.. ~ ~°o~o ~ ~ . ~ ~~T" ,".~' ,' , ~, ~ ~-~ '"-": ~ ~' '- ' / /' '.. %. 7 ,'> ~, SURVEY OF PROPERTY SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-78-05-16 SCALE 1"=$0' FEBRUARY 22, 1999 JUNE 29, 1999 ADDED PROPOSED HOUSE PHONE (516)727-2090 Fo~ 516)'22-509~ JAMES GRATHWOL 24' PROPOSED SEPTIC SYSTEM DETAIL PROPOSED CONC. RETAINING WALL DETAIL SURVEY OF PROPERTY $ITUA TEl) A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-78-05-16 SCALE 1 "=50' FEBRUARY 22, 1999 JUNE 29. 1999 ADDED PROPOSED HOUSE CON¢~ Land Surveyor PHONE (515)727-2090 BRIAN FAERBER TEST HOLE DATA 24' FP~]f'i : ENCONSULTANT'-] PHONE NO. : 651 28] 6156 /an. 0~ 2E~02 D~:44Pt.l P-: As I expect that the hearing will need to be noticed and posted, ! will await receipt of the necessary paperwork from your office and ensure that the proposed structures remain staked in the field prior to your next field inspection. Should you require any additional information, please contact me at your earliest convenience. Respect fu'Ily yours,. Robert E. Hel,u,m'm Coastal Management Specialist Enclosures cc: James Orathwohl # SCWA Timc~hy J. Hopkins Ga~eral Coun~e~ Augu~ 8, 20OO ~UFFOLK COUNTY WATER AUTHORITY AdmTnistratlve ~c~: ~060 Sunrise HIg~ay, Oakdale. NY 117~1 (~1) 563~236 F~ (831) IVb. hm~ F. G*ih,~'otd 2532~ West Mai~ Steer Cutclx~e, NY 1193:5 Applic. afim for water zrvke Williamsburg Road, Bayvkw, SCTM # 1000-78-5-16 This leR~r of availabihty is not to I~ cousid~d au adm by ~ Su~ ~ Wat~ A~onw as ~ by ~ N~ York S~c ~z~ ~ ~ A~ ~l~ ~ a ~ ~ ~ pa~ is ~rm,~ ~ ~,il~. Y~ ~ ~s~iblc f~ o~8 ~y ~ pc~ ~ a~m~ thi ~y .... ~~~~~ffC~ *~.~ ..... w.*~ .............. s ,,+~,~ .... "~"" ~ ~ m~red m~r~ This lc'ua' should not b~ deemed a guaramc~ of wa~er amiability at the t~r~ ~ wish to hook-up ami is subj~-'t *o r~iss~. Plea. sc ceetact the SCWA's P-o~ioual Manage* in Westhampton at 631-288-1034 for fees aad conditions of V~y ~ ym~r~, cc: Hmr~ J. Miller, Deputy CEO for OFratic~s Steve Rom:mo, Regional Manager V I F · SURVEY OF PROPERTY SITUATED AT BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-78-05-16 SCALE 1"=$0' FEBRUARY 22, 1999 JUN[ 2B, 1~99 ADDED PROPOS[D HOUSE JULY 28, 1999 REV~[D ~S PER EN-CONSULTN~S AU~'T 5. 1~9 REV1SED ~S PER EN-CONSULTANTS SE~'TEV~ER 8, 1999 RL-~]S,-----------------~ AS PER S.C.D.H.$. J&NUARY 15, 2000 REVlSED S~ PLAN Joseph A. Ingegno Land Surveyor JAWES GRATHWOI. Fox (516)722-509,3 TEST HOLE DATA __ 24" FE'C~F1 : Ef4,]UHSULTAHT~. PHONE NO. : 6-_',1 283 6136 Ian. 02 2002 E~4:43PH P2 EN-CONSULTANTS, INC. 1329 NortU Sea Ro~d Southampton, New York !~96~ 631-283-6360 Fax: 631-283-6136 ENVIRONMENTAL SERVICES January 2, 2002 Albert KrupskJ Board of Trastees Town of Southold 53095 Main Road Southold. NY 11971 Re: Request to Reopen Hearing: James Grathwohl, SCTM N~. 1000-78-5-16 Dear Ntt. Kmpski: On or about 11 August 1999, an application for a wetland permit to improve the captioned parcel with a one-family dwelling was submitted by our office on behalf of Brian and Martina Faerber, then contract vendees. At a public hearing held on 25 August 1999, the Board indicated that it would not render a decision unless and until documentation fi:om the Suffolk County Department of Health Services was provided to indicate that the proposed sanitary system would be approved by that agency, i subsequently informed your office by letter dated 2 December 1999 that the Fae~bers were no longer in contract to purchase the property but that the owner, James Orathwohl, intended to keep the application open in order to develop the property for his owr~ use. After finally receiving a Tidal Wetland Permit from the New York State Department of Environmental Conservation (DEC} dated 10 May 2001 (copy enclosed), I attended the Board's May 2001 work session to discuss yoar request concerning the Suffolk County DepaFtment of Health Services approval. As you no doubt recall, Board members reiterated objections to the idea ora sanitary system being approved less than 100 feet from the wetlands and contemplated how and whether the Board *hould approach the Suffolk County Department of Health Services with its concerns. Although we did not subsequently receive any direct or copied correspondence from yo~ office regarding the matter~ we continued to pursue the application with the Health Department. Due to the need to obtain a variance fi-om the Suffolk County Department of Health Services standards, I attended a public hearing held by the Departmera's Board of Review on 11 October 2001, together with Frederick Keith, P.E., who professionally designed the proposed sanitary system and prepared the engineer's report in support o[ the application (copy enclosed). The Board subsequently rendered a decision in which the requested variances were granted (copy enclosed). Specilically, the Board found that the "approval of a properly installed disposal system will have no significant adverse effect on surface or groundwater quality despite the reduced distance to the shoreline." Because we now have in hand these approvals from the DEC 'and Health Department, in addition to an authon~ttion from the Sufl~olk County Water Authority to connect to public water service Lcopy attached), we must respectfully request that the Board £mally act on the still pending application. Therefore, please reopen the presently adjourned public heaxing at your nex~t regularly scheduled meeting on January 23, 2002. Telephone (5t6) 765-18q~ Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Thursday, August 12, 1999, the following recommendation was made: Moved by Richard Smith, seconded by Abby Cochran, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit Application qf BRIAN & MARTINA FAERBER 78-$-16 to construct a two- story, one-family dwelling and attached garage; two-story deck; and sanitary system to be retained by concrete retaining walls; install drywells, place approx. 350 c.y. of sand fill to achieve required base flood elevation of 8'; connect public water service; all as depicted on the site plan prepared by Joseph A. Ingegno, last revised 3 August 1999. Williamsburg Rd., Southold The CAC recommends Disapproval because of the following reasons: 1. The location is too close to the creek. 2. There are concerns with regards to the proximity of the septic system in relation to the wetlands. 3. The entire structure would have a negative impact on Corey Creek. Vote of Council: Ayes: All Motion Carried Albert J. Krupski. President John Holzapfel, Vice President Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold. New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD office Use Only Coastal Erosion Permit Application ~.~etland Permit Application Grandfather Permit Application _Waiver/Amendment/Changes ~'Received Application:~_~___ ~-Received Fee:$ ;~ ~-- _u~Completed Application~_~___ __Incomplete SEQRA Classification: Type I .Type II unlisted Coordination:(date sent) w~CAC Referral Sent:~_ ~Date of Inspection:~ __Receipt of CAC Report': ' .... Lead Agency Determination:__ __Technical .... Review: ~Public Hearing Held:~~__ Resolution: Name of Applicant Address Brian & blarEina Faerber 250 First Avenue, Apt. 4C New York, NY 10009 Phone Number:(212) 475-6346 Suffolk County Tax~/ Number: 1000 - 78 - 5 - 16 Property Location:~ Q WiliiamsDurg Roao, SouEhold 515' soutl~ o3 ~4ain Road (provide LILCO Pole ~, distance to cross streets, and location) AGENT: En-Consultan~s, Inc. (If applicable) 1329 North Sea Road Address: Southampton, NY 11968 Phone: 516-283-6360 FAX%: 516-293-6136 PROJECT DESCRIPTION BRIAN& MARTINA FAIERBER WILLIAMSBURG ROAD SOUTHOLD, NY SCTM #1000-78-5-16 Construct a two-story, one-family dwelling and attached garage; two-story deck; and sanitary system to be retained by concrete retaining walls; install drywells, place approximately 350 cubic yards of sand fill to achieve required base flood elevation of S'; connect public water service; all as depicted on the site plan prepared by Joseph A. Ingegno, last revised 3 August 1999. ard of Trustees Applicati~ Land Area (in square Area Zoning: Previous use of property: Intended use of property: GENERAL DATA feet): 18,207.32 R-40 Residential No Cl]ange Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~ No__ Yes If yes, provide explanation: Project Description (use attachments if necessary): Construct a two-story, one-family dwelling and attached garage; two-story deck; and sanitary system to be retained Dy concrete retaining walls; install drywells; place approximately 350 cubic yards of sang fill to achieve required base flood elevation of 8', connect public water service; and establish a 20' wide buffer ail as depicted on the site plan prepareu by Joseph A. Ingegno, last revised 3 August 1999. ~ard of Trustees Applicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: One-family dwelling. Area of wetlands on lot: 4,896 square feet Percent coverage of lot: ±27 % closest distance between nearest existing structure and upland edge of wetlands: n/a feet Closest distance between nearest proposed structure and upland edge of wetlands: ~0 feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? How much material will be filled? ±350 As necessary for septic sysLem. cubic yards cubic yards Depth of which material will be removed or deposited: feet Removed to 6' in septic area; filled to base flood elevation = 8' (4' max) Proposed slope throughout the area of operations: min = 1~3 Manner in which material will be removed or deposited: See site plan notes. 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): Throug~l the employment of mitigative measures such as installation of a code-conforming sanitary system; drywells to collect run-off; s~aked haybales & a projecL-11mi~lng fence during construction; and maintenance of a post-construction wetlands Duffer area, the project will have no significant adverse impacts on the adjacent wetlands or Lown waters. I PROJECTI.D. NUMBER 61 7.21 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) 1 . APPLICANT/SPONSOR BRJA.N & IVu~tTINA FAERBER BY I 2. PROJECT NAME ~N-CONSULTANTS, INC. I 3. PROJECT LOCATION: Municipality SOUTHOLD County SUFFOLK SEQR 4. PRECISE LOCATION (Street address and road intersections, p~ominent landmarks, etc., or provide map) WILLIAMSBURG ROAD, SOUTHOLD, SCTM #1000-78-5-16; MAP PROVIDED 5. IS PROPOSED ACTION: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: SEE ATTACHED 7. AMOUNT OF LAND AFFECTED: Initially 0'4'~ acres Ultimately 0.42 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [X] Yes L_J No If No, describe bdefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial [] Agriculture [] Park/Forest/Open space [] Other Describe: tO. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [~ Yes ~ r No if yes, list agency(s) and permit/approvals DEC, SUFFOLK COUNTY HEALTH DEPARTMENT tl. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes ~X]No If yes, list agency r~ame and pemliEapproval t2. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? []Yes []No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Rgt~RT, ~c~~, COASTAL MGMT. SPECIALIST Date: AUGUST 3, 1999 Signature: ~-~~ If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment ~ard of Trusuees Applioau~ AUTHORIZATION (prhnu owner of properUy) residing at ( mailing address do hereby authorize (Agent) to apply for permit(s) from ~he Southold Board of Town Trusuees on my behalf. (Own__ s signauure) ard o£ TrusUees Appl£oau~ AUTHORIZATION (pr£nu owner of proper<y) (mai~ing address Sou=hold Board of Town Trustees on my behalf. Dwner' s Sigh%s/cure ) Board o2 TrUStees Application counuy of Suffolk State of New York / ~,~ ~U~_/Dg~w~oY~~._ BEING DULY SWO~N DEPOSES AhqD AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ~T.T. STAtemENTS CONTALN~u n~EIN ARE TRUE TO THE BEST OF HIS/HER KNOWT.WnGE AND B~nIEF, AND T~AT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOb'&hOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGP~B TO HOLD .l.~k TOWN OF SOUTHOLD AND TWR. TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ~r,r. DAMAGES AND CLAIMS ARISING UNDE~ OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION~ I ~T~j~By AtTf~..ORIZE ~ THUBTEES, Their AGENT ( S ) OR P. F3EESENTATi%~S ( S ), TO ~-V~.L~ ONTO 5~/ PROP52~TY TO INSPECT THE PRF/4ISES IN CONJUNCTION WITH REVIEW OF THIS x Signatu~ SWO~{ TO BEFORE ~E THiS ~/~ DAY OF ~ .,19 Ncuary Public F~ANK E ~OTONDO NOTICE TO ~DJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of Brian & Martina Faerber SCTM~1000- 78-5-16 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request Permit from the Board of Trustees to: SEE ATTTACHED a 2. That the property which is the subject Environmental Review is located adjacent to your property and is described as follows: W~lliamsburg Road, Southol~ 3. That the property which is subject to Environmental Review under Chapters 32,37,or 97 of the Town Code is open to public comment. 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 and dose not reference any other adjacent that might have to review same proposal. OWNERS NAME: MAILING ADDRESS: Brian & Martina FaerDer 250 Firs'a Avenue, Apt. 4C New York, NY 10009 PHONE $: 212-475-6346 Enc.: Copy of sketch or plan showing proposal for your convenience. Name: Jeffrey Green Cheryl Hansen PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: i43 Berry Hill Road Syosset, NY 11791 305 South Windsor Arlington Heights, IL 60004 STATE OF NEW YORK COUNTY OF SUFFOLK doing business En-Consultants, Inc. Robert E. Herrmann , F~ at 1329 Nortl~ Sea Road Southampton, NY , being duly sworn, deposes and says that on the 5tn day of August ,t9 99 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses se~ opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at .southampton , tb were mailed to each of said persons by lcer~if mail. ~_~ ko~t ~. ~ Sworn Co ~fore me this day of ;~a~,, ~ ~ ,19 ,, KlM H. STEPHE,~ ~ C.mmissi=n No, 5015931 at said Notices ~ed) ~~) Albert J. Krupski, President James King, Vice-President Henry Smith Attic Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18~2 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOV~N OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVI~ OF POSTI~CON,q!~[]ANT$ ]NC. ~ 1329 N¢5:]H .g[A RD. I, ~2~ 63, r~s-i-%~-~ ~OlJTH'~M!qOI'i, N.Y, 11058 516-283-6360 being duly sworn, depose and say: That on the [~ day of property known as by placing the Board 6f Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the ~q. (date of hearing noted thereon to be held Dated: Sworn to befQre me this ~L~day of ~6Ld~lA~c_ 199 / Not/ak%y Public ' ~ No~ Public-Sm~ of N~ Y~ ~ Commission No. 5015931 APPLICANT Tile Town of Southold~s. Code of Ethics,prohibits conflicts of interest on the part o£ town officers and employees. purpose of this form,is to provide information which can alert time town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAHEI you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NATURE OF APPLICATIONs (Check all that apply.) Tax grievance Variance Change of zone A~p~oval of plat . Exemption from plat o~ official map Other employ~ of th~ Town oE Southold? 'R~lationship" include. by blood, marriage, or bu.ine~. owflernhip oE (or employment by) a ~orpo~at[on In which the town officer or employee ovn~ more than 5~ of time NO if you anewered ~fES,~ complete t~me balance of this form and date and sign where indicated. r~ame of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant) and the town officer or employee. Either check the appropriate line A) tltrough D) and/or describe in the space provided. The parent, A) town officer or employee or his or her spouse, sibling, or child is (check all that apply)~ the owner of greater than 5% of the shares of the corporate stock of tile applicant (when the applicant is a corporation)x B) the legal or beneficial owner of any interest in a corporation)~ C) an erSt.er, 6!.rector, partner, or employee of fha applicant/ or D) the actual applicant. DESCRIPTION OF RELATIONSHIP APPLXCANT The Town of Southold's Code of Ethics prohibits conflicts of interest on toe part of tqwn officers and employees. The purpose of this form ts to provide information which can alert the town of ps'sidle conflicts of interest and allow it to take whatever action is necessary to avoid same. ~OUR (Last ns/me, first name, middle initial you are applying in the name of someone else or other entity, such aa a company. If es, indicate the other person~s or company's name.) NATURE OF APPLICATIONs (Check all that apply.) Tax grievance Variance cha,gs of zone Approval Of plat , Exemption from pl~ or official map "other," name the activity.) ~ ~-a~ve~ Do Fou peraonallF (or through your ~ompany, epouee, e~blin~, parent, or child) have a relationship with any officer or employee of tire Tows of Soubhold? 'Relationship" includes by blood, marriage, or business Interest. 'Ousineee interest" means a bsetneee, including a partnership, which the town officer or employee has even a partia! ownership of (or employment by) a corporation in which the town officer or employee owns more titan 5% Of the shares. NO If you answered 'YRS,'. complete ~he balance of Chis form and date and sign where lndtoated. Uame sE person employed by the Town sE Southold Title or position of that person Describe the relationship between yourself (~he applicant) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town parent, n) officer or employee or hie or her spouse, sibling, or child is (check all that apply)t the owner of greater than 5% of the shares of the corporate stock of the applic~nt (when the applicant la a corporatton)~ __B) the legal or beneficial o~ner o~ any interest in a corporation)l C) an off~er, d~rector~ partner, ~r ~mp1=yee Of the applicant~ or D} tile actual applicant. DESCRIPTION OF RELATIONSIIIP Submitted this ~ d~o~,199~