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Home My WebLink AboutTR-6118Board Of $outhold Town Trustees SOUTHOLD, NEW YORK SCTM~88-6- 18.5 PERMIT NO... ~. J..J.~ ........ DATE:..~.~.i! ~.t ...~005 MICHAEL ZEVITS ISSUED TO ...................................................................................................................... Pursuant to the provisions of Chapter 615 of the Laws of the Stale of New YorL 1893, and Chapter 404 of the ,L~. ws of the Stale of New York 1952= and the Southold ToWn Ordinance titled ."REGULATING AND THE PLACING OF OBSTRUC]'IQNS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, C, RAVEL' OR OTHER k4ATERIALS-F~OM LANDS UNDER TOWN WATERS;'..!. and in accordance with the Resolution of The Board adopted at a meeting held on ....... ~g0~, and in consideration of the sum of $ ..~?.L? .. paid by Michael Zevits of New Jersey .. .-T~->¥~. and subject to the Terms and C~ondlflons fisled on the reversesidle hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to construct a single-family dwelling,attached rear porch/deck,pervious dr~iveway~and sanitary system,with the condition drywells are installed to contain the roof run-off,a line of. hay bales is placed down prior to const.,and a 25' non- all in .a .ccor.daece with .the detailed specifications as presented in the o.glnatm~ ~ppJJ~tlo.. turf buffer landward of the bulkhead~ and all as de~ic~e~ on the survey prepared by John T. MetzRer last dated /. /. ~T~LIESS WHEREOF. The se,d Boara ~,f Trustees by causes |ts Corporate Seal to be at?xed, and these presents be subse, n'bed by a 'majorliy of the sa~d Board .as of this date. TERIvlS end CONDmONS Michael Zevit s' ~t 33 Bear Mountain Rd., New Jer.se~ . .. .,., YJ~Y[~ ,e ' ~f: ~he coition to~ the i.~mmmce of ~¢ Pem~¢ do~ ~md~nd and prescribe to thc roi- 4. That the work involved will be subject to the inspection its ab, eats, and no~-oompUatxce with the ptovi~ons of tbe ed~,~.g ~c~o~ amy be ~_~ foe ~'oottion of ~ Peanlt br tcsoludoa of the ~id $. ~ ~ ~ be no umreasoaable interference with mvi~¢b~__ as · reault of the wodt Is~da ~thottzed. " upon d~e nottce, to remove or dtet dais wodc or project hetdn stated ~Mlout ez~as~ to the/o~m~ Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TO~,VN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ½ constructed ¢'"~Project complete, compliance inspection. .~bert J. Krupski, President James King, Vice-President Attic Foster Ken Poliwoda Peggy' A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone1631) 765-1892 Fax(631~765-6641 April 20, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Matt D. Ivans Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bddgehampton, NY 11932-2003 RE: MICHAEL ZEVITS 1450 WEST LANE, SOUTHOLD SCTM#88-6-18.5 Dear Mr. Ivans: The Board of Town Trustees took the following action during its regular meeting held on Wed., April 20, 2005 regarding the above matter: WHEREAS, Suffolk Environmental Consulting, Inc. on behalf of MICHAEL ZEVlTS applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 22, 2005 and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 20, 2005, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of MICHAEL ZEVITS to construct a single-family dwelling, attached rear porch/deck, pervious driveway, and sanitary system, with the condition drywells are installed to contain the roof run-off, a line of hay bales is placed down before the project begins, and a 25' non-turf buffer landward of the bulkhead, and all as depicted on the survey prepared by John T. Metzger last dated May 26, 2005. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Albert J. Krupski, Jr., President Board of Trustees AJK/Ims Albert J. l{xupski, President James KJ. ng, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone ~63l) 765-1892 Fax 1631) 765-½3~,5 (~}.~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ~.~j~lO~' reviewed by this Board at the regular meeting of fl~ !e)Z~!O .'~- following action was taken: has been and the f)Application Approved (see below) )Application Denied (see below) ) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: - -¢ S'O,O0-- TOTAL FEES DUE: $ ~CO,O'0 SIGNED: PRESIDENT, BOARD OF TRUSTEES Telephone ~63 l'~ 765-1892 Town Hall 53095 Route 25 P.O. B6x 1179'' Soudmld. New York 1197 [-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tues., March 15, 2005, the following recommendation was made: Moved by Doris McGreevy, seconded by Jennifer Mannino, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of MICHAEL ZEVlTS to construct a single-family dwelling, attached rear porch/deck, fence, driveway, and sanitary system. Located: 1450 West Lane, Southold. SCTM#88-6-18.5 The CAC recommends Approval of the application with the Condition of a 50' non-tuff buffer and a split-rail fence. The CAC recommends the applicant save as many trees as possible. Vote of Council: Ayes: All Motion Carried ~Photo Photo indicating the staked locations of the wester,~ost corners of the ,ProPOSed .d~elling and attached porch/deck within the central se~°n of subject proPer~y. Phot° taken from the central section of subject prope~, f'ad~g e~st. hoto mdlcatm~ b.oth the~pparent hlgh.w..ater ~ark (wetlands hne) on the day of the s~e ~nspec~i~n and the ~xisting t~mber bulkh~d along the so~thern edge of subjec~ p~pe~y. Phot~ ~ken from the southwe~ern c~ner of sUbj~ ~roP~rty~ facing east. (Photo taken in NY Photo indicating the approximate location of the proposed improvements within the central section of. subj~t p~oper~y. Photo taken .from the sout~estern corner of subject property, along the shoreline of Hog NeCk Bay, facing northeast. Situate: c/o Little Pecouic Bay Road & R.O.W.; Bayview; Town of Southold, NY Proposed Construction Access Route SITE HOG NECK BAY HAGSTROM StreetAtlas SCTM #: 1000 - 088 - 06 - 018.5 Suffolk Environmental Consulting, Inc. Newman Village. Main Street. P.O. Box 2003, Bridgehampton, New York 11932-2003 ~6311 537-5160 Bruce Anderson. MS.. President June 14, 2005 Mr. Albert J. Krupski, Pres~ent Town Hall P.O. Box 1179 Somhold. NY 11971 gel Situate: SCTM #: Fax:t6311537-5198 ZEVITS Application c/o Private Road & Little Peconic Bay Road Town of Southold, NY 1000 - 088 - 06 - 018.5 Dear Mr. Krupski. As per your last request for additional information concerning the above referenced application, please 17md enclosed: (1) Revised Survey of subject property, prepared by PECONIC SURVEYORS, P.C.. last dated May 26. 2005. indicating the requested information, including: II Proposed Drywell within the northwestern section of subject property; and 2) Proposed Bt~ffer (25' width) situated along the landward side of the existing bulkhead. By way of this correspondence, and on behalf of Mr. Zevits, kindly issue the requested permit at your earliest opportunity. Should you have any questions regarding this matter, or require additional intbrmatiom please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely, Matt D. lvans enc. cc: M. Zevits P / ,/~ I ~/ ,"d ~ ,, , 1~ ,'~ , ~,, ~' ~ I! Suffolk Environmental Consulting, Inc. New, man Village. Main Street, P.O. Box 2003. Bridgehampton, Ncx~ York 11932-2003 1631l 5~,7-516 I F:.t\: 167,1 } 537 51tis Bruce .{nderson. M.S.. Prcqdcnt May26, 2005 Mr. Albert J. KrupskL President Town Hall P.O. Box I 179 Southold, NY 11971 Re: Situate: SCTM #: ZEVITS Property c/o Private Road & Little Peconic Bay Road Town of Southold, NY 1000 - 088 - 06 - 018.5 Dear Mr. Krupski. As per request concerning the above referenced application, please find enclosed: Check made payable to the Town of Southold in the amount of $ 50.00 to cover the additional requisite application fee. By way of this correspondence, and on behalf of Mr. Zevits, I request that you finalize the review of subject application and issue the requested permit at your earliest opportunity. Should you have any questions regarding this matter, or require additional information, please feel flee to contact this office at any time. Thank you in advance for your cooperatk~n. Sincerely, Ma~ D. Ivans eric. cc: M. Zevits Suffolk Environmental Consulting, Inc. Newman Village. Main Street, P.O. Box 2003. Brtd~ehampton, Nex~ York II 16311 537-5160 Fax: 1631 ~ 537 5198 Bruce Anderson. M.S., President 'Cia Facsimile and Regular Mailing March 21, 2005 Mr. Albert J. Krupski, President Town Hall 53095 Main Road ?.O. Box 1170 Southold, NY 11971 Re: Situate: SCTM #: ZEVITS Application c/o Private Road & Little Peconic Bay Road Town of Southold, NY 1000 - 088 - 06 - 018.5 Dear Mr. Krupski, As you know, this Firm represents Mr. Michael Zevits, owner oftbe property referenced above, who is pending review fi.om your office for improvements thereon. This proposal is scheduled to be heard before your Board on Wednesday evening, March 23, 2005, however, due to scheduling conflicts, this office cannot be present to represent Mr. Zevits. Accordingly, by wa), of this correspondence, kindly adjourn this matter for the next available Southold Board of Trustees meeting. This office additionally requests for public re-notification of this project. Should you have any questions and/or commems, kindly contact this office at any time. Thank you as always for your attention and consideration. Sincerely, Matt D. lvans cc: M. Zevits Albert J. Krupski, President John Holzapfel, Vice President Jim King Martin H. Garrell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P. O. Box 1179 Southold, New York 11971 Telephone (631) 765-1892 Fax (631) 765-1823 Office Use only X Coastal Erosion Permit Application Wetland Permit Application Grandfather Permit Application Waiver/Amendment/Changes / Received Application: o~l~QL~l- ~Received Fee: $ ~O- --~Completed Application. ~11QI5%~ Incomplete S EQPJt Classification: Type I Type II Unlisted Coordination: %date sent) -~CAC Referral Sent: gll~l~[ ---Date of Inspection:~llul~ __ Receipt of CAC Report: Lead Agency Determination: Technical Review: ~Public Hearing Held: ~[~lD%/o~ Resolution: Name of Applicant MICF~kEL ZEVITS Address 33 Bear Mountain Road; Rin~woodt NJ 07456 Phone Number( 973 ) 962 - 1286 Suffolk County Tax Map Number: 1000 - 088 - 06 - 018.5 1c~'~ Property Location: ~/o Private Road & Little Peoonic Ba~ Road (provide LILCO Pole fi, distance to cross streets, and location) AGENT: Suffolk Environmental Consulting, Inc. Address: P.O. Box 2003 Bridgehampton, NY 11932 Phone Nuraber: (631) 537-5160 Fax: ~(631) 537-5198 of Trustees Application GENERAL DATA LanG Area ( in square feet) Area Zoning: Previous use of property: Intended use of property: 18r 097 sc~u&re feet Vacant lot improved with bulkhead Residential Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval governmental agency? ever been revoked or suspended by a X No Yes If yes, provide explanation: Project Description (use attachments if necessary) : Applicantproposestoconstru~thefollowingimprovements within subje~ property: (1) Single family dwelling (two-story) containing 1,260 square feet "footprint'); (2) Attached rear porch/deck containing 640 square feet; (3) Fence measuring 150.0' + along the easterly property boundary; (4) Pervious (gravel) driveway containing 1,000 square feet; and (5) Sanitary System. 2 of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: A~DlicantDmposes to con~ucta priva~ sin~le-~mi~ dwellin~(two~todes);rear attached po~deck;~nce;driveway;andsanitswsystsmwi~insu~ectproperty. Area of wetlands on lot: 0.0 square feet Percent coverage of lot: 0.0 % Closest distance between edge of wetlands: 0.0 Closest distance between edge of wetlands: Does the project X No If yes, nearest existing structure and upland feet (Existing Bulkhead) nearest proposed structure and upland 90.0 ± feet (Proposed SE corner of porch/deck) involve excavation or filling: Yes how much material will be excavated? N/A cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: N/A Manner in which material will be N/A removed or deposited: N/A 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): No negative impacts are anticipated due to the location of the proposed improvements being the maximum attainable without resulting in zoning non-conformity. In addition, the neighborhood consists of improved lots similar in design and scope with respect to the distance from wetlands/surface wetsrs which have not resulted in any negative impacts to the surrounding environment. Purpose of Board of Trustees Application COASTAL EROSION APPLICATIOM DATA N/A Proposed Activity: Are wetlands No If Yes, how much material will be excavated? How much material will be filled? present within 75 feet of the proposed activity? Yes (cubic yards) (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from the implementation of the project as proposed. (Use attachments if necessary) Albert J. I~'upski, President James King, Vice-President Artie Foster Ken Poliwoda Pegg? A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 1 [971-0959 Telephone t631) 765-1892 Fax t631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTE1ES: TOWN OF SOUTHOLD h~ the IV~latter of the Application COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING ;e;°~:t~;~710057I personally posted/the property knowtl as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight~days prior to the date of the public hearing. Date of hearing noted thereon to be held ~ ~Doj~tC ~_O, ~'OO~-" . Sworn to before me this ~O'~ day NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: Michael Zevits SCTM # 1000 - 088 - 06 - 018.5 YOU ARE HEREBY GIVEN NOTICE: 1. That is the intention of the undersigned to request a Permit from the Board of Trustess to: Applicant proposes to construct a private sin;lie-family dwelling (two-stories); rear attached porch/deck; fence; driveway; and sanitary system within subiect property. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: c/o Private Road & Little Peconic B&~ Road; B&~view; Southold~ N~ 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. 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 does not reference any other agency that might have to review same proposal. OWNERS NAME: Michael Zevits MAILING ADDRESS: 33 Bear Mountain Road; Rin~woodr NJ 07456 PHONE # (973) 962 - 1286 Enc.: Copy of sketch or plan showing proposal for your convenience. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: JOSEPH ZEVITS: 97 Baylor Avenue; Hillsdale, NJ 07642 SCTM fl: 1000 - 088 - 06 - 018.4 JOSEPH & ORS ZEVITS: 97 Baylor Avenue; Hillsdale, NJ 07642 SCTM fl: 1000 - 088 - 06 - 018.6 JOHN L. & JOAN FRANCO: 21 Carman Lane; St. James, NY 11780 SCTM fl: 1000 - 090 - 01 - 025 CLYDE G. MILDRED: 417 Bogie Street; Palmdele, CA 93551 SCTM fl: 1000 - 090 - 01 - 018 STATE OF NEW YORK COUNTY OF NEW YORK Diane K. Wassick- Suffolk Environmental Consultin~t Inc. , residing at Newman Village; Main Street, Bridgehampton, NY , being duly sworn deposes and says that on the day of , 2004, 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 their 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 Bridgehampton, that said Notices were mailed to each of said persons by (certified) (registered) mail. DIANE K. WASSICK Sworn to before me this day of , 2004 Notary Public Board of Trustees Application County of Suffolk ) State of New York ) I~ATT D. I~S , BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN 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 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 REPRESENTATIVE(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~Signature SWORN BEFORE ME THIS \~otary Publ %~ _ /-? GINA U. 96ANGA IIOTARY PUBLIC, STATE OF NEWYORK GUAUFIED IN SUFFOLK COUNTY NO.O*ISG6047652 / '/. *~ COMU SS ON EXPIRES SEPT. 05, 20,~ !_( 7 Board of Trustees Application AUTHORIF2%TION (where applicant is no~ the owner) I, MICHAEL ZESTS, residing at Mountain Road;Rin~wood! New Jersey authorize Suffolk Environmental Consulting, (Agent) to apply for permit(s) from the SouEhold of Trustees on my behalf. 33 Bear do hereby Inc. Board ' '/ Ow~signature/ 14-164 (9/95)-Text 12 617.20 ' PROJECT I.D. NUMBER ~ Appendix C I ] State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNliSTED ACTIONS Only SEQR PART 1- PROJECT INFORMATION (To be completed by Applicant o{ Project sponsor) I. APPLICANT/SPONSOR I 2. PROJECT NAME Suffolk Environmental Consulting, Inc. [ ZEVITS 3. PROJECT LOCATION: Municipality Town of Southold County Suffolk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc. or provide map) c/o Little Peconic Bay Road & R.O.W.; Bayview; Town of Southold, NY 5. IS PROPOSED ACTION: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Applicant proposes to construct the following improvements within subject property: (1) Single family dwelling (two- story) containing I, 260 square feet ("footprint"); (2) Attached rear porch/deck containing 640 square feet; (3) Pervious (gravel) driveway containinl~ I, 000 square feet; and (4) Sanitary System. 7. AMOUNT OF LAND EFFECTED: Initially < 0.2 acres Ultimately < 0.2 acres 8. WILL PROPOSED ACTION 'COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No If No, describe briefly g. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? []Residenbal [~]lndustdai F-ICommemial []Agriculture ~]Park/Forest/Open space ]-~Other Describe: Private single family residences with related appurtenances, all of similar size. I0. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENT AGENCY {FEDERAL, STATE OR LOCAL)? [] Yes [~No If yes, list agencyls) and permit/approvals Suffolk County Dept. of Health Services approval: New York State Dept. of Environmental Conservation approval I I. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] No if yes, list agency(s) and permit/approvals 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? [] Yes [] No I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n nme: Matt ~ lvalls - Suffolk Environmental Consulting, lnc_. Date: Signature: /~ '/~---- // Monday,~December 13, 2004 If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART g- ENVIRONMENTAL ASSESSMENT (To be com~)leted by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD tN 6 NYCRR, PART 617.12? use the FULL EAF. [] Yes [] No if yes. coordinate the review process and B. WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS iN 6 NYCRR, PART 617.67 If No, a negative declarahon may be superseded by another involved agency. D Yes 0 No COULD ACTION RESULT tN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if tegible) C1. Existing air quality, surface or groundwete~ quality, noise levels, existing traffic patterns, solid waste production or disposal. pctantial for erosion, drainage er flooding problems? Explain bdefly: C2. Aesthetic, agricultural, archeologicel, historical or other natural or cuflural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitat, or tflreataned or endangered species? Explain bdefly: C4. A community's existing plans or goals as officially adopted, or change in use or intensity of use of land or natufat resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term. cumulative, or other effects not ~lentitied in C1-C57 Explain briefly: C7. Other impacts (including changes in use of either quantity er type of energy)? Explain briefly: D. WILL THE PRO JECT HAVE AN IMPACT ON THI~ ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? []Yes [qNo D. IS THERE, OR iS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? I~ yes [] No If yes. explain briefly PART III - DETERMINATION OF SIGNIFICANCE (To be complMed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, impodaof, or otherwise significant. Each effect shcukl be assessed in coonec~on with [ts (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duretion; (d) ~reversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that e.xplaneflor~s contain sufficient detail to show that all relevant adverse impacts have been identified end adequately addressed, if ques§an O of Prat II wes chanl~ed yp~, the doferminetion and S~gnificance must evaluate the potential impact of the proposed action on the an~ronraantal characteristics of the CEA. [] Check this box if you have identified one or more potentially large or significant adverse impacts whicfl MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaraUon. [] Check this box If you have determined, based on the information end analysis above and any supporting documentation, that the proposed action WILL NOT resug in any significant adverse environmental impacts AND provide on attachments es necessary, the reasons supporting this determination: Name of Lead Agency Print or Type Name of Responsible Officer Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer (if different From responsible officer) Suffolk Environmental Consulting, Inc. Ne~ man %Jlage. Mare Street, P.(). Bo'~ _00.~. Bridgchampron. New '~,rk I 1~'32-2003 Bruce Anderson, M.S.. President February I1, 2005 Mr. Albe~ J. Krupski, President Town Hall P.O. Box 1179 Southold, NY 11971 Re,' Situate: SCTM #: ZEVITS Property e/o Private Road & Little Peeonic Bay Road Town of Sonthold, NY 1000 - 088 - 06 - 018.5 Dear Mr. Krupski, This Firm represents Mr. Zevits, owner of the above referenced property, who is seeking all required regulatory permits to improve thereon. In order to do so, approval fi.om your Board is required. Enclosed herewith please find a completed Wetland Permit Application. Application contents are as follows: Town of Southold Trustees Wetlands Permit Application; (2) Short Environmental Assessment Form; (3) Photographs of subject property, indicating the location of all proposed structures thereon (two [2] sets); (4) Location Map for easy reference (two [2] copies); (5) Survey of subject property, prepared by PECONIC SURVEYORS, P.C., indicating all proposed structures thereon, last dated February 3, 2005 (two [2] copies); and (6) Check made payable to the Town of Southold in the amount of $250.00 covering the requisite application fee. By way of this correspondence, and on behalf of Mr. Zevits, I request that you conunence review of this application and schedule for the next available Board of Trustees meeting for permit issuance. Should you have any questions regarding this matter, or require additional information, please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely. Matt D. Ivans attachment cc: M. Zevits