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HomeMy WebLinkAboutTR-5378 John M.Bredemeyer III,President ��oE SoUlyO Town Hall Annex Michael J.Domino,Vice-President �� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G ® Q Telephone(631) 765-1892 Charles J. Sanders �O Fax(631) 765-6641 c4UNTV,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 16, 2016 Maureen and James Levelis 830 Clearview Road Southold, NY 11971 RE: 830 CLEARVIEW ROAD, SOUTHOLD SCTM# 1000-89-3-11.5 Dear Mr. and Mrs. Levelis: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, November 16, 2016: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit #5378 from Jami Friedman to Maureen and James Levelis, as issued on July 25, 2001. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, John M. Bredemeyet III, President Board of Trustees JMB/dd October 4, 2016 Board of Town Trustees , E C E VTown of Southold L� 54375 Main Road PO Box 1179 OCT 276 Southold, NY 11971-0959 01 Southold Tawn To the Board of Town Trustees: We recently purchased a home in Southold at 830 Clearview Road and are requesting to have two permits transferred to our name. The two permits are as follows: C"N)4- cn�tl e� PERMIT NUMBER 6673A:Trim the phragmites that surrounds the elevated timber catwalk Mw #)&hOn 2) PERMIT NUMBER 5378: Catwalk, ramp and floating dock on property Dewed ij/o pr udate+110?0)0 I attached copies of the two permits for your review. We also hereby authorize access to our property for any inspections that may need to be done. Enclosed find our payment of$50. Please do not hesitate to call if you have any questions. I can be reached at(917) 733-3370. Thank you in advance for your help. Regards, . Maureen and Jim Levelis 830 Clearview Road Southold, NY 1197.1 D,Awmce -tom ji. �� 64 V4 John M Bredemeyer III, Pr4ft,, S11FF�C��oGR Town Hall Annex Michael J. Domino, Vice-President r y y 54375 Route 25 Glenn Goldsmith +a P.O. Box 1179 A. Nicholas Krupski o � Southold, NY 11971 Charles J. Sanders �,'y�,�l �oo��' Telephone Fax (63192 ) 765 6648 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: MAUREEN & JAMES LEVELIS request a Transfer of Wetland Permit#5378 from Jami Friedman to Maureen & Jim Levelis, as issued on July 25, 2001. Located: 830 Clearview Road, Southold. SCTM# 1000-89-3-11.5 CH. 275-3 - SETBACKS - WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Present were: J. Bredemeyer Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 John M. Bredemeyer III, Pr �pSu�F���' Town Hall Annex Michael J Domino, Vice-Pres"e t a� Gyp ; 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders y Telephone (631) 765-1892 ?7�T� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: MAUREEN & JAMES LEVELIS request a Transfer of Wetland Permit#5378 from Jami Friedman to Maureen & Jim Levelis, as issued on July 25, 2001. Located: 830 Clearview Road, Southold. SCTM# 1000-89-3-11.5 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: -J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 James F. King, President ��OF soyoTown Hall Jill M. Doherty,Vice-President 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen G Q Bob Ghosio,Jr. �� �O Telephone(631) 765-1892 �yCom N�1 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 22, 2007 Ms. Jami Friedman 830 Clearview Road Southold, NY 11971 RE: 830 CLEARVIEW ROAD, SOUTHOLD SCTM# 89-3-11.5 Dear Ms. Friedman: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, August 22, 2007: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Permit #5378 from Richard & Kim Perry to Jami Freedman, as issued on July 25, 2001. If you have any questions, please contact our office at (631) 765-1892. Sincerely, )xp--.w 0-,5r James F. King President, Board of Trustees JFK:eac Jami D Friedman 830 Clearview Rd. Southold,NY 11971 (631) 786-4255 July 18, 2007 RE: Permit# 5378 Board of Town Trustees Town of Southold 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 To Whom It May Concern: My husband and I purchased our home on 830 Clearview Rd in Southold on March 28, 2007. The prior owners, Richard and Kim Perry, received a Permit(#5378) and Certificate of Compliance for this property. I was recently informed that I needed to transfer this permit to our names(Jami and Joel Friedman). I was instructed to write this letter and send a check for $50.00,which is enclosed. Please contact me if additional information is needed. Thank You. Sincerely, D � � �—Q�r�� G� U L 2 3 2001 LJ Jami D Friedman � Southold Town Board of Trustees James F. King, President ��DF sooTyo Town Hall Jill M. Doherty,Vice-President 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen CA Bob Ghosio,Jr. � Telephone (631)765-1892 1yCOU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0183C Date January 8, 2007 THIS CERTIFIES that the catwalk, ramp & floating dock, and natural path At 830 Clearview Rd., Southold , Suffolk County Tax Map # 89-3-11.5 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 7/3/01 pursuant to which Trustees Permit # 5378 Dated 7/25/01 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a catwalk, ramp & floating dock, and natural path. The certificate is issued to RICHARD &KIM PERRY owner of the aforesaid property. Authorized Signature ar. e Board Of Southold - Town Trustees SOUTHOLD, NEW YORK ' PERMIT NO. ItA '1 DATE: July 25, 2001 f. ISSUED TO .........RICHARD....&....KIM...RER.RY... ..........................._...................... `.{. Aut4arizathitt Pursuant to the provisions of Chapter 615 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 Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;": and in accordance with the Resolution of The Board adopted at a meeting held on .......July....2 1.5, 2001 . and in consideration of the sum of $....O.Q.1.VA........ paid by ....... .R,IGH.A.RD....&....KSA4...PER.RX................._................................................................. of ...Southold.a........................................................... N. Y. and. subject to the Terms and Conditions listed on the reverse side hereof, kip of Southold Town Trustees authorizes and permits the following: Welland Permit to construct a 4'x80'fixed CCA limber catwalk landward from existing catwalk structure-proposed catwalk will be elevated 3'above marsh grade with a 4'x[2'fixed CCA limber ramp at the landward end. Convert existing 2'x36'fixed timber catwalk to 4'x36'fixed , CCA limber catwalk utilizing existing piles. Leave in place existing 4'x8'fixed CCA limber dock 3'xl6'CCA timber ramp and 5'x16'CCA timber floating dock install additional CCA timber piles as required to support proposed 80'catwalk. Calwalk/dock shall be accessed on-site a by a 4'x250'crushed stone pathway,pathway and catwalk lighting is proposed to be installed to the same. Propose extension of existing back yard to 100'from back of house(eastward)grade v and seed as required install in ground sprinkler system in proposed expanded back yard and around the existing developed property. Install 16'x22'CCA timber deck against rear of house approximately 160'from wetlands by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this data. oP' —Trustees . r. TERMS and CONDITIONS Richard & Kim .Perry The Pamkox60 0 MA N aim residing at 830 Clparvin.., Road, SettEiteiri N. Y, as part- of the consideration for the issuance of the Permit daft mulershmd end penQilhe to the fol- lowing: 1. That the said Hoard of Trustees and the Town of Soud+ofd are released from any and oil damages, or claims fat daaosaes, of wits abing dbocdy or indirectly as a result of any oper- ation pforme 1 pursuant to this petmiq end the said Palaeiroee will, at his or her own tatpierse, defend any mrd all such salwIn8lmed by third pacdf,and the said Petmuitree amoom foil OdOV whh respect tLeceta, to the aompkte'esdmson of she Hoard of Trmeeas of the Tows of Som"d 2. That this prank Is*valid fec a pedod of : 24 mos. which it considered to be the estimated thoe'required to complete the work involved, bat-s cold dreadanmcas v►asreat, reverse for an esaendon may be made to the Hoard at a lacer dace. 3. That this permit should be refined indefinitely, or as long as the add Permiaee wishes to maintain the stancture or project lavolved, to provide evidence to anyone concerned that such, cessation was originally obtained. 4. Thu rhe work.involved will be subject to the inspection and approval of the Hoard or Its agents, and non-complisoce with.the provisions of dire originating application,sorry be muse fat revocation of this penult by resolution of the said Hoard. 5. That there will be no unreasonable Interference with navigation as a result of the wadi herein aidhorhxd. 6. Thu there shall be no interference with the right of dire public to pus and repro along the beach between high end low water mortis. 7. That If future operations of the Town of Soutbold r qWm the removal and/or aiteretons In the location of the work hada andodeed, or if# in the opidon of the Hosea of Thsmm% the. work shell aurae unreasonable obstruction to fm navigation, the said Peradem will be required, open doe notice, to remove at alter this work or project basin stated widhou t espema to the Town of Sondold. S. Thu the said Board will be notified by the Pfmiax or the compledogof On work much. orhed. 9. That the Permittee still obtain all other peach and uwmmuis that may be sap- placental to this perait which may be subject to revoke upon faflute to obfia ane. r 0 • � Albert J. Krupski, President SAFFO(/CQ CQ Town Hall James King,Vice-President = � 53095 Route 25 Artie Foster OM - P.O. Box 1179 Ken Poliwoda : Southold, New York 11971-0959 Peggy A. Dickerson y�01 �aQt' Telephone 5-1892 Fax(63 1) 7657/92 366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 21, 2004 Mr. & Mrs. Richard Perry 830 Clearview Rd. Southold, NY 11971 RE: 830 CLEARVIEW RD., SOUTHOLD SCTM#89-3-11.5 Dear Mr. & Mrs. Perry: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., July 21, 2004: RESOLVED that the Southold Town Board of Trustees grants the last One-Year Extension to Permit#5378, as issued on July 25, 2001. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, (� Albert J . -rupso-Jx • President, Board of Trustees AJK:Ims • • Albert J. Krupski,President �►FFO(,�O� C� Town Hall James King,Vice-President 53095 Route 25 Artie Foster p P.O.Box 1179 Ken Poliwoda W Southold, New York 11971-0959 Peggy A. Dickerson Ott Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES June 18, 2003 TOWN OF SOUTHOLD Mr. & Mrs. Richard Perry 830 Clearview Rd. Southold, NY 11971 RE: 830 CLEARVIEW RD.,SOUTHOLD SCTM#89-3-11.5 Dear Mr. &Mrs. Perry: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, June 18, 2003: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#5378. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincereel'y, J d' ' � ' Albert J. Krupski, Jr. President, Board of Trustees AJK:hns 0 0 Albert J. Krupski,President OOFF04 Town Hall James King,Vice-President 0�, Q 53095 Route 25 Henry Smith tiZ' Gy P.O.Box 1179 Artie Foster Z Southold,New York 11971-0959 Go Ken Poliwoda Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 26, 2001 Richard&Kim Perry 830 Clearview Road Southold,NY 11971 Re 830 Clearview Road, Southold,NY SCTM#890-3-11.5 Dear Mr. &Mrs. Perry: The following action was taken by the Board of Town Trustees during a Regular Meeting,held on July 25, 2001,regarding the above matter. WHEREAS, RICHARD & KIM PERRY applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated july 3, 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 July 25, 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. 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. 2 0 RESOLVED, that the Board of Trustee approved the application of RICHARD &KIM PERRY for a Wetland Permit to construct a 4'x80' fixed CCA timber catwalk landward from existing catwalk structure—proposed catwalk will be elevated 3' above marsh grade with a 4'x12' fixed CCA timber ramp at the landward end. Convert.existing 2'x36' fixed timber catwalk to 4'x36' fixed CCA timber catwalk utilizing existing piles. Leave in place existing 4'x8' fixed CCA timber dock 3'x16' CCA timber ramp and 5'x16' CCA timber floating dock, install additional CCA timber piles as required to support proposed 80' catwalk. Catwalk/dock shall be accessed on-site by a 4'x250' crushed stone pathway,pathway and catwalk lighting is proposed to be installed to the same. Propose extension of existing back yard to 100' from back of house (eastward) grade and seed as required install in ground sprinkler system in proposed expanded back yard and around the existing developed property. Install 16'x22' CCA timber deck against rear of house approximately 160' from wetlands BE IT FURTHER RESOLVED that this detemunation 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 from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Fees 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: NONE Very truly yours, p Albert J. Krupskii, Jr. President,Board of Trustees AJK/cjc cc: DEC Building Department Tower Hall. 53095 Main Road P.O. Box 1179 Telephone O + Southold, New Yak 11971 (631) 765-18921 .�lD SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, July 17, 2001, the following recommendation was made: RICHARD & KIM PERRY 893-11.5 for a backyard extension with sprinkler and deck;a crushed-stone path improvement, to widen the existing dock and extend the catwalk landward, and for path and catwalk lighting; dock electric/water supply. 830 Clearview Rd., Southold The CAC did not make an inspection, therefore no recommendation was made. T +r y-pcx cx • ----' CEDAR ` ' � I o � 20 i M ^J Z-1 an.. C .4 out`; •/ I u I L •-^ - _ -- - - — — �^ -- _- •--- — ** w^ _' «. •�^^ ronC[ COUNTY OF SUFFOLK © p a SWiIgLO SEC NO ,-v "e .,.r ,. •�.`_ ,a.�...> Retl PrWertY iax Service AgencY + _ o x ., 089 KIM • r ��-1lM�D £f30 C�4/iMJJ1� �(L L� >� U�/TH ��o SUFFOLK CO HEALTH DEPT APPROVAL . . t`�'' H S NO 3E'S4 'S4 . IT ' 7`4" �Fa , -' ' y ,'.f" '�il'� 'r� LU� r�`wyf�4.i rtt��1 ��fl L.' P� !'!� ��'•:��. i ;.P - _,G^5 iiF_rRt E-A.:% _90 w l J e F r a hP l.:C3. ^' tii:c4V v P dQR POJ :4, AL51 EFL2 7p ;t ME R L.c G NIA,P, i .hA$ 1 P` ( TtT t�G �•�` ^ •t}�( _+•"Tl:pAKti.w err; iw4TATENEMFOF INTENT CLXNtTI �sX THE WATER SUPPLY AND SEWAGE DISPOSA r Y , �rj 3 e r 0' way SYSTVIAS FOR THIS RESIDENCE 'NIL DATE M.S. N0. nb'�' �y i CONFORM TO THE STANDARCS OF TH LAWN BOUNDARY 1�� �w eavoeal ano N supat t.c�Mw wr 1�1� jP'•''-, '` + v t � ( SURF'OLK CO DEPY. OF HEALTH SERVICE! PATH �Qcaticnmarebeen"Umte br so/or Isf 1 D(w and loom (APFn�t/\.) , i APf.;CANT 1 l Y:.;•-- Chtel Wure�r Df Wa •- � >*,� � •- .. � I SUFFOLK COUNTY DEPT OF HEALT Jt '' r PP. TY LINE ;� I SERVICgS FOR APPROVAL O " QQNSTR1.KTKM ONLY TIF UTvE) H. 5. Rt{F. Nd.. % 50. 5B WETLANDS 162 • BOUNDARY - &"r - SUFFOLK CO, TAX MAP DESIGNATION. WETLANDS ° 9¢cs BLOCK PCL PRIVATE TOAD 's < t. VEGETATION �,,,,E,�, ,,,�„ — --- PR ED Yom. I CK SHORELINE �� ,. �=7 �. r DOCK X1P_.C?Ff TJN�A' Il3N _ 0.8 ?k+:`4t r�7 �� � a ��, ILI i • ,l� ^ '.1 4 i -,may. Iii .. y.p. v� p1 •-. r 1 ^ t.r I . WETLAN VEGETATION ORCHARD ROAD PR POSED-CATWALK � v�t:_. L!?•. R �VELOPED . PAT,- i # Y . UAL 44 LAI; ' \f ''IAF A;;7 � - Ah YAiM Y--JFro i ' LiC$HSED LAND Tfa =7E 6a MtE8h1!'ORT own vom _ . aemv..cws w:ar - WETLANDS C . BOUNDARY Sum • W ET LA N D S QED . . . VEGETATION aawNE RS t DOCK CAM Le o. d tar WETLAN4�[ VEGETATION ARD ROAD PR POSE13t4_CATWALK '" R fVELOPED PATqd �.�. -LANA+ `' � �2c5S S��T10 iJ O� PA�3-t LANDSCAPE TIMBER CCA, 3"X5"X8' 48 " LANDSCAPE TIMBER CCA, 3"X5"X8' 2 WIRE+GROUND, CRUSHED STONE, BROWN 10awg UV STABLE 3" DEEP LANDSCAPE FABRIC, ROMEX WIRE, 2X WATER PERMEABLE (PATH LIGHT & DOCK POWER) 1 " WATERLINE, BURIED Ll SPRINKLER TUBING REBAR STAKE, ATTACHED WITH 1 HOLE 1 /2"0 X 18" U CLAMP AS REQ'D 2 PER SECTION [ rmT i4G'. " _ $QFFOfiI OF THE MATER SUPPL LAWN BOUNDARYrowFuu+cot�r SYSTENO FOR Qf�TE s $- The steep dopossi and N su fiptfis !Or Mk f SUFFQLK CQ 0£P •"� .r f a ' kuaw have been rnbpec a w/w •.� ''/�� � s ?. ' ol,efand (SFr...-----,-- 100 `:^ V� • APw_,ran k�SJ' chtd hi qwm M W , �SUFFGLK COUNT At PROP �f } t .r iFlr ' SERratr of A LAWN OP a Y ,.^ t TJF t_=1EJ N. !. ,RSlr. 14o . C� 1 b F ,� WETLANDS I Tire Hd.b'l-+lY at: Avrwov3 BOUNDARY _ SUPFOLK CO. T$ PATI OW. SECT 100 75 (APPROX.) WETLANDS, 4 089 PRIVATE COAD 162 , ' : , y VEGETATION tcwrrFERSAi�+ts#ti PROPOSED DECK +�Myr/(J SHORELINE '" E.� 125- 4r> :, �, r DOCK �- MEAI,V SEA .EVE' SHORELINE kf - c stt' r ' . ORCHARD TOAD WET A M ' { 7 klo VEGETATION £ 1 F%iZ PROPOSED'�CATWALK/ - D€VELOPED PAT SCALE 1 ' =50' LAWN BOUNDARY i" 100 PROPOSED LAWN BOUNDARY WETLANDS BOUNDARY PATH 100 75 ''� (APPROX.) WETLANDS PRIVATE ROAD 162 VEGETATION PROPOSED DECK �. SHORELINE 125 DOCK z ' SHORELINE ORCHARD ROAD WETLANDS' VEGETATION I 1 PROPOSED CATWALK/ r.NL - 3 2001 DEVELOPED PATH SCALE 1 "=50' SUFFOLK CO. HEALTH DEPT.APPROVAL t? N V\�` .. NUT�� H.S. 0.2B�"W-4 P12EM:SES , CLUZDE PAR'I`S F L O �•l `a QTS 38,p t49 e �dpU A� "C 1AF CvE 6EGF�c F)EA>Ff P^0V_ Ftt.EO ,�1N ?{�SUFF Co, S aQ�� , ' 4�"� AEf2!C'S 0 !E-AS V1AP2,LQ 90LCT" NCS SF4v'%�I PUC R FW -��7�t75 ALS QEF EQ 1CS 5�[I-t FfLEG Mes p___— Qa\ . FIUL.E.� 7kcaWn STATEMCKF OF INTENT �'� G�a i` � HITY'OEPg1fMWEt Y OWE[LINC OMIT THE NATER OR T AND.RESIDE E WILL NO A�� s� `'TSTA` FOR THIS RE5IDENCE WILL l CONPQRbN TO THE STANDARDS OF THE c %PGW and wa bcilieaa hw NY SUFFOLK CO. DEPT. Of HEALTH SERVICES., , m. ) been impacts\0' K p and fq1 �. � rit�^ U.. _ APPLICANT. .' �/J� ` '•4;�� k�of — ' SUFFOLK COUNTY OEP'Y, OF HEALTH SERVIC-CS - FOR APPROVAL OF i 4S'.o .Y S' .E .,(S. �` _ .c,. - -.. •. NON ONLY r DATET1N.XT `'- r ` � `` ,�;o.a:, ,,.scat •r1v� . � ��c•>�'".,' y• '. ,tc a+ x�c ��.t'H ." � ..fC_� `(,V :`+ � � C'tn TM.U.1-4 it.S.REF.NO::86•50-54 TSTLB' HQ b7-ilZ"5GC AVPROVEfl: i ie/`� SUFFOLK CO.TAX MAP DES76NATION: j DIST. SECT. BLOCK PCL. ! :�.z � .OIM�NERS'ADORE55: IA Q� HOE' A TOP_OFEOUAIDATfGN �; ,0.3tAE,-vEdip EIEAN SEA LE'%EL. - - - el - � _ UZ PC - 1, t - ,.t.n„. -z+•- £p�.�e� `` o nrt LFi'i• 3' _' - � ;.., mw asaa.�,h,aF MAP Vii= PQOPEj<- j •w.� � -fir.. �,�.�..��.,�p. ��4'CY�✓ 1=:.iG � .� , , � .... LC7�4E. .a+.en.caw=s'wgv.+. «uSCC� C. CC± `�` NowR", .,. - ^T'-'•; gym'\".` L /Al lC�.l�._ll.f.J.L. I`1Av. _hlt=?!!C-C"u-Ff5.3 ,sP5 ;,,,. _ �. - . . _ , ''�,,•� eATyEE"tiV LAIaIeSelil9lYS s ;,T s... ; 7 � l�oy SOU4-tlold ToU-20 'BOald a� Tr�s�ees teciS-e- c}L'-Q c,4 0(.)f C u r f L vi 4-- FQ r m',� #-s3-7t c( r czn c le m r .�vr �S30 G)em4; euJ Ytc�l•� So l„ r1d S �Tiv+ &9-3- It .S, Inane )00, K� AA (z C" q� r Suol�l� NJ 119 -71 -7 6 s- 9YF 6 f �1 p E C E I V E Il3 63 JUN 11 2003 Southold Town Board of Trustees 7/� � � � 9y �to Albert J.Krupski,President • �gUffU(,�c • Town Hall James King, Vice-President 53095 GGy 53095 Route 25 Henry Smith o P.O.Box 1179 Artie Foster co Z Southold, New York 11971-0959 Ken Poliwoda Oy Telephone(631) 765-1892 '>y�l 41 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application ,Wetland Permit Application _Major _Minor —Waiver/Amendment/Changes _Received Application: _Received Fee:$ _Completed Application _Incomplete _SEQRA Classification: Type I_Type II Unlisted _Coordination:(date sent) _CAC Referral Sent: _Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: _Public Hearing Held: Resolution: Name of Applicant F4 ckl AY"7 + 1-1M ?gz=V -y Address Ff30 UL-PcV"%eL-W F -06-V S0014AoLES21N� l911 Phone Number:( ) (03 k- -7(05— q y 9- Suffolk County Tax Map Number: 1000- ef7 - 3 - 1 I , S Property Location: 4� Oak4AA vii (,Pe-11c, f� n 1= <'INf- Cry A-L_ W kVy\)t. W iJ (provide LILCO Pole#, distance to cross streets, and location) AGENT: JUL -" ;i 2001 (If applicable) Address: Phone: Board of Trustees Application GENERAL DATA \ Land Area(in square feet): 5SC700 (A-?Cq-c 1 7 Area Zoning: 1'L�s�Us nIT 1A�1 Previous use of property: VULS 1-D E-"�J 6:1- Intended use of property: Prior permits/approvals for site improvements: Agency Date -Mbrrz s 5 DOG- ?EE�vA- 1T No prior permits/approvals for site improvements. Has any permitlapproval ever been revoked or suspendqd by a governmental agency? No Yes If yes, provide explanation: Project Description(use attachments if necessary): • `$At-K=��� �7�T�r7 s f o.,.l �.J� s �rz l n11�L5�2 . 3 '� �cK I M�if�-0 f�Wlfn)T - C,9,US44 UC> STo rJ 1-; ' W tD�.tJ �OCA- �1i?��zJy7 GP7�L�3 A'llL [_A.►J7y,;PK�1� Ove 3 -Ap r-JA-C�tL L&1-MiJ& -DOC-k- ELi Tl'i�lC/bJ/�-TfA'L SVPR •Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 1M fd,W 'Z- WA-TAA4- PE&L`-531 01l,( Area of wetlands on lot: 1( g 001 square feet Percent coverage of lot: 2 q—_% Closest distance between nearest existing structure and upland edge of wetlands: 1:75- feet Closest distance between nearest proposed structure and upland edge of wetlands: AITA _feet Does the project involve excavation or filling? ✓ No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): Richard & Kim Perry 830 Clearview Road, Southold Wetlands Permit Project Description: Request a Wetlands Permit to construct a 4' x 80' fixed CCA timber catwalk landward from existing catwalk structure. The proposed catwalk will be elevated 3' above marsh grade with a 4' x 12' fixed CCA timber ramp at the landward end. Convert existing 2' x 36' fixed timber catwalk to 4' x 36' fixed CCA timber catwalk utilizing existing piles. Leave in place existing 4' x 8' fixed CCA timber dock, 3' x 16' CCA timber ramp, and 6' x 16' CCA timber floating dock. Install additional CCA timber piles as required to support proposed 80' catwalk. Catwalk/dock shall be accessed on site by a 4' x 250' crushed stone pathway. Pathway and catwalk lighting is proposed to be installed in addition to a dockside lightpost with electrical outlet located on the 4'x 8' $O fixed dock. A 1" fresh water supply is proposed to be installed to the same. Propose extension of existing back yard to 100' from back of house (eastward). Grade and seed as required. Install inground sprinkler system in proposed expanded back yard and around the existing developed property. Install 16' x 22' CCA timber deck against rear of house approximately 160' from wetlands. See attached sketch. P, + C9ic�sS St-076.AJ V/elA,) • 48" NATURAL GRADE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 v 0 0 0 0 0 v 0 0 0 0 0 0 0 v 0 v 0 0 0 0 0 v 0 0 0 0 0 0 0 0 v 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 `CRUSHED STONE, BROWN [LANDSCAPE FABRIC 2 WIRE+GROUND, 3" DEEP WATER PERMEABLE 10owg UV STABLE ROMEX WIRE, 2X (PATH LIGHT & 1" WATERLINE, BURIED DOCK POWER) SPRINKLER TUBING ATTACHED WITH 1 HOLE U CLAMP AS REQ'D LAWN BOUNDARY 100 PROPOSED -� LAWN BOUNDARY WETLANDS BOUNDARY PATH WETLANDS 10075 -� (APPROX.) � - 100 75 �� VEGETATION PRIVATE ROAD - 162 PROPOSED DECK DOCK SHORELINE 125 SHORELINE ORCHARD ROAD WETLANDS' VEGETATION PROPOSED CATWALK DEVELOPED PATH SCALE 1 "=50' PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address : c��STINt LAYI,5zA 5-5- 5r Sq- 3 - 11-y `bvto ! N`f 1120 LAW11>'Dh AS506 . Sky��y 50-1 �i °I r2�Gra-t to�xv� y- 3 - 57. � To ► NAQUy VJi SSs M4tjrJ Bur, 52`] 6-1- 3 — III 1 gOui- -tow .0 Y 119`i 1 AN Mit- L )(3 37 M, Vct-( lAAk� brt. q0 - y - 1 ('0 4VJ�,51100 � Mr1 ozc�90 STATE OF NEW YORK COUNTY OF SUFFOLK KinngSM,c.y I' S_r7.YL`7 , residing at SL30 "Lftywt" (Z;:p being duly sworn, deposes and says that on th ` day of ' 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 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 Town of Southold; that said Notices were mailed at the United States Post Office at that said Notices were mailed to each of said persons by (certified) (registered) mail. � rr � JUL - 9 2001 Sworn to before me this 1 day of TVL�T_,�9 SAR8ARA MMOM Notary Pub c N0t„9Nft,SpUeofRewYak NO.304844W. in sum Albert J.Krupski, President OgUFFO(,(C Town Hall James King,Vice-President .t.�� �(/y .53095 Route 25 Henry Smith o P.O.Box 1179 Artie Foster Southold, New York 11971-0959 Ken Poliwoda 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 ,p of ----- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, L6(wl�� residing at 5130 6LXrA 'LJ14_y) RP being duly sworn, depose and say: That on the 9 qday of5'W'f , 200 ), I personally posted the property known as �3d GcsrauV\Eta t1h� by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of he public earing. Date of hearing noted thereon to be held c oI a►t70A-P. %-k P•y,+ ' Dated: (signature) Sworn to before me this {r ,� day of ,V/Ly 200 � 8• JUL — 9 NotZrky Public BARBARA WUMM L. WPubkStd9efXwTb1k No.01ST4844752 pion Fid dk fftfW 1 14•tE412r®TI—Text t2 � • �, PRQJECT I.D. NUMBER 617.21 SEG 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. PLICANT/SPONSORy 2. PROJECT NAME ;k7 If J. PROJECT LOCATION: Municipality (_) O tL;'> County 5 U F-T— ` a. PRECISE LOCATION(Street address and road intersections, prominent landmarks, etc., or provwe map? �30 UA-Pty"I UA-) V-0 A'> OF-IP O L-�b LPt4�J L� 5. IS PROPOSED ACTION: �• ❑New ❑Expansion Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: . 8ftc� 'fAYZ'P 0xT'�tJ5to�l . tni.lpt:t�l �OC.K/ G�X�iN� LAT'Jlkvk l.A^)Dt.Jf1't'>� 7. AMOUNT OF LAND AFFECTED: Initially V(,Q acres Ultimately acres 3. WILL PROPOSEDACTIONCOMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRIC,IONS? K,Yes 1_:No If No.describe briefly 9. WHAT IS PRESENT LANDD USE IN VICINITY OF PROJECT? 1 Residential ❑•!ndustnal r'Commercial ❑Agriculture LJ Park ForeSVOpen space El Other Describe: 10, DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL. STATE OR LOCAU? .Yes ❑No If yes.list agency(s)and permit/approvals - �f-O- .r . 71. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes Wo If yes, list agency name and permtVapproval 12. .AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE .MODIFICATION? Cl Yes ❑No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Rr� eh-r>('% Date: Signature: •v If the action is in the Coastal Area, and you are a state acency, complete the LCoastal Assessment Form before proceeding with this a.;,;essment OVER PART II—ENVIRWIMENT:\' 'S4MENT ,—o be ':omCletpa Jy aye.nc . A.'CCES ACT;CN EACEEC =Ny • •?E. 7i.RcH0LJ IN i NYC.P, -:RT i'r.:Z7 it 'as. .:cclemate Me Ieview process and -,se ne c---L: _aF ras No E. WILL AC7;CtI AEC EtVE :OCRDINA.CD.REVIEW AS PRCVIDED =:R UNLISTED Av TICNS iN 3 .NYC=R. PORT i;,'37 .1 .No. 3 negarve pec:ar= may De suderseCec cy anomer:nvalved agency. I Lyes Na C. COULD AC71CN RESULT:N ANY ADVERSE =-F==-C-S ASSCC:ASED WITH "-E =JLLCwING; :Answers may -e ianawnrem ,t :eglclal Ci. =xistmq ]Ir quality, suriaca or g,ounowale, eualily or :cannty, aolse :ovals, existing :raffic :ar`,erns, solid .vaste jrecce::dn Jr ilsac potential for erosion. prainage or flooding problems?E.:pldin brrerly: C'a. Aesthetic.agricultural. 3rcpaeological,nlstorlc. Jr Jtner.natural Jr euiturat resources: or community or.ieignbcrneod Cparac:er? Explain zr G. Vegetallon or fauna. '19n. snellnsn or'Nddlife species, signricanr naoitats.or :nrearenea or endangered Species?Exclain orally: C}. A Cpmmunit%s existing plans Or goad as Officially adopted.or a cnange in use or Intensity at use of land or other natural resources?Explain or CS. G(owin, suoseeuent vevemoment, at related dc:rvnies likely to be Inaucea Dy Me proposed ac:Ion? Explain orlefly. CS. Long :arm, anon term, umutative, or outer erfec:s not Identified in C:-057 Explain Dnefly. I• _ I I -T. Cuter:moac:s inc:ac;ng -ranges In use of timer quantity or :ype or energy)? Exolam Dnerly. I 'D. .S THERE CR i5 THERE L:KE_r "a 3E CCrITROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL.itPCCTS? —yes —140 :f yes. explain orierly PART III—OETcaMINATION OF SIGNIFICANCE ITo be completed by Agency) INSTRUCTIONS: For earn adverse effect identified above,determine whether it is substantial,large.Important or otherwise signi tic. Earn effect snould be assessed in connection with Its (a) setting (i.e. urban or rurao; (b).probability Of orca,<yng; (c) duration irreversibility;lef geograonic scope; and (1) magnitude. If necessary, add attachments or reference supporting materials. Ensure explanations contain sufficient detail to snow that all relevant adverse impacts have been identified and adequately addressed. Check this box if you have identified one or more potentially large or significant adverse imoac:s whicn MAY occur. 'hen proceed directly to :he FULL c4F ane/or prepare a positive*declaration. Check :his box if you have determined, based an the information and analysis above and any SUDDOrtinC documentanen. :hat the pr000sea ac:ion WILL NOT result in-zany significant adverse environmental imeactz i AND oravlce on attac:tments as necessary, the reasons supoorting this determination: .nnI JI •C[ +m< Y 4`\gan401e t,.f pC C! .n .CYC �<ep<v rtie Of '(capon Pole llf(icer I :�enJfYr[ JI lCSCCn\,Cie _I:ICCr n :Clp.v1CnCY artn G(YeC J! f'±'JJfC1'. r ,�,(:<'Ln[ :rnT fC5pOn410ie Y(l�C211 ! JIC n Board of Trustees Application County of Suffolk State of New York rPg-CZ-VZZ BEING DULY SWORN DEPOSES AND AFFIRMS THAT SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS41ER 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 THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SigIJ ture SWORN TO BEFORE ME THIS__ DAY OF 20 D/ I Notary Public N0h'y k NO.OIST4844752 eaer,�em in . " n Frnile5 Sept" • • 1AA&A(2/671—Text 12 �--7 PROJECT I.D. NUMBER I 617.21 .SEC Appendix C State Environmental Ouality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) I. APPLICANT/SPONSOR2. PROJECT NAME l RL LApYw + -lm t^'E,Y-,f&Y tti�TL�� s v� v� ►T J. PROJECT LOCATION: I� municipality L) D L—� County 5 U�oL a. PRECISE LOCATION(Street address and road intersections, prominent landmarks. etc.,or provide map) O�V GL..f;�,2U14 {Z-o A'D ) OAF 00-r-� 1.At'jL 5. IS PROPOSED ACTION: El New ❑Expansion Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: - aNC_�_ -Jmy0 "T5,-3c,10 w� sYw>v�svi sok • tri Ayxn v STaNri- ?A1-*LVJ.M/ . „s t n _D o L.K.y 4,y L.A'j'>t JAW`!D wi�k 3 carrwqLX_ LA644'T1WX; -Vor-K s-L-f(Ty"( /L.Jkn ue GI),PPLy 7. AMOUNT OF LAND AFFECTED: ` Initially VI 13 acresUltimately acres 6. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? KYes ❑No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? _ XRestdenbal ❑•!ndustrial ❑Commercial Cl LJAgriculture :'Par1vForesUODen space 0Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL STATE OR LOCAU? 9.Yes ❑No If yes.list agency(s)and permiVapprovals 'r it. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? C3 Yes KNo if yes, list agency name and pennitfapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REOUIRE MODIFICATION? ❑Yes ❑No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Appncanusponsor name: Rf N V-v `? �V�Q� Date: 1�) 7 Signature: A •V If the action is in the Coastal Area, and you are a state acency, complete the Coastal Assessment Form before proceeding with this agsessment OVER PART II—ENVIFONIMENT'. 'SaMENT ,—O be r_omcietea Oy .Agent • 1 A. OOES ACTICN EXCEEC ANY r r?E I TFRES�-.GLO :N i NYG'.R, -cAT i'.7.1:? If yes. cacrelnate me review =rocess aria use me . UL_ =AF. I�Yas I`No B. WILL ACT:CN E :CCROINAr cp REVIEW AS?P,CVIOEO .-,::R UNL'STEO ACT CNS .N S .NYCRR, ?.A;;5:7.57 7 No, a negauve cec:ara may be sueersecec ny ?(tomer Avowed agency. L;Yes `'No C. CCULO ACTICN RESULT IN ANY ADVERSE E?EECTS ASSGC:ATEO WITH T-E?OLLJWING.:Ansxers may tie aanowrmen. .1 :eglclet Cf. Existing air quality, surface or grocnawa[er cuality or :uantity, noise levels. existing :raific :atterns. solie xas;e orcccc::on or alscc potential for erosion, aramage or'loading problems?E%claln ones ly: cz Aesthetic, agricultural, arcaaaolaglcai.nls:onc,or other natural or cultural resources:or community or nelgnpornooa c.^.oration? Exolar➢ J. CZ. Vegetation or .rauna. flsn, snellnin or wildlife soecies, significant haOdais, or:nreatened or encangereo scec:es? Exelaln bneny: CA. A ccmmunity's existing plans or goals as officially scooted.or a change in use or intensity of use of land or other natural resources?Explain c: CS. Glomn. suoseeuerlt ieyelooment or relates=rwhes likely to oe nduaeO py !tie propasea action? Exolaln briefly. C.S. Long [efm, snort :efm.:umuiatrve.or other effects no[ Icentlfiea in G:-05? Explain orlefly. _7. Corer imoacs �inizwcung cnanges In use of a:ther quantity or :vpe or energyi? Explain 0rleny. i I J. .S 7HERE. OR'.S THERE _:KELP 70 BE. CCNTRGVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL..AP4C757 Yes _No ;f Yes. exciain onetty PART III—DETERMINATION OF SIGNIFICANCE (To be Completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large•important or otherwise signi fic Each effect should be assessed in connection with its (a) setting (i.e_ urban or rural)( (D) probability of occooring: (c) duration irreversibility:(el geograonic scope: and(I) magnitude_ If necessary, add attachments or reference supporting materials. Ensure explanations contain sufficient detail to snow that all relevant adverse impacts have been identified and adequately addressec. ChecK this box if you have identified One Or rmore potentially large or significant adverse imoac:s 'which MA' occur. Then proceed directly to :he FULL E.AF and/or prepare a positive'declaraticn. l Che" this box if you have determined, based on the information and analysis above and any succortir, documentation, :hat :he pr000sea ac:ian WILL NOT result in-:any significant adverse environmental imcac: AND provide an attacriment5 as necessary, the reasons supporting this determinalion: V„YrC •ll �a.rY 14CIICY 1 I Irlll 'JI .vOC 4„rfre JI ea`laYrl\r01!\i11rCN .n�a•,10 ♦�a'n<'/ :YI! OI '(a':OOn\r01!UIIiCIf ' )rVnJ1Y1! )1 lISCOf1VOI!'�nrCir.n .11O .axMCY )rl11d IVIG Jr l'•`JJ/!!11! Jrl:f'M( :IOm rltOOritrOr!JII<LII J+Ic