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HomeMy WebLinkAboutTR-3823Board Of $outh, ld Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 3823 DATE: . .April 26, 1990 ISSUED TO .... Erika Swimmer ................. Authorizatioa 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 . April 25, 19 90 , and in consideration of the sum of $ paid by of ................. N. Y. and subject to the Terms and Conditions "listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: To construct a single £amily dwelling, sanitary system with retaining wall, well and bluestone (or similar) driveway. Approx. 800 c.y. of fill to be trucked into raise grade. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF., The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this dat,e. TER~S end CONDITIONS The Perm/m Erika Swlmmew r~siding at Orchard Lane. Southold. N. Y~ ss part of the consideration for the issmmce of ~he p. rml~. does understnnd and preatribe to the f~- 1. That the said Board of Trustees and the Tm of Southold axe released from any ~=d all damages, or d~im* for d~m~g~, of suits arising dir~dy or indicectly as a reault of any ~ atlon pefforme~ pu~unnt to this ~.tmit, ~ the ~ PermiKee will, at his or her own expem~ defend any and all tach suits initiated by third par~, and the said Permltten assumes ~ ~ with respect thereto, to the complete e~dusion of the Bo~d of Tmsreas of the Town of 5nathoM 2. That this Permit is valid for a period of 2'} mos. which is comfdm4 to be fl~ astimated time required to complete the work involved, but should eiro,,~c~$ ~ ~ for an extension may be made to the Board at a later dat~ 3. That this Perm/t should be retained indefinitely, or as long as the ~ P.,,M~'ee ~ tO maintain the structure or project involved, to provide evidence to anyone concerned that ansh- orizaton was originally obtained. 4. That .the work involved will be subject to the inspection and approval of the Board m its agents, and non-compliance with the provisiom of the originatag application, may be ,'~-~ fne revocation of this Permit by tesointion of she said Bo~d. 5. That there will be no unreasonable interference with navigation as a result of the wodt herein authorized. 6. That there shall be no interference with the right of the public to pass and mpa.ss along the beach between high and Iow water marks. 7. That if future operations of the Town of Sonthold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, work shali cause unreasonable obstrucaon to free navigation, the said Permlttee will be requimd~ upon due notice, to remove or alter this work or project herein stated without expenses to she of Southold. s. That the said Board will be notified by the Permi~ee ot ~he c~pletio~ of the work 9. That the Permittee will obtain aH other permits and consan~ dmt may be requh'ed sup- plemental m this permit which may be subject to revoke upon failure to obtain same. TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, .Ir. John B. Tuthill Telephone (516)'765-1892 Fax (516) 765-1823 · BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SLrpERVISOR sco'I-r L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 April 1, 1992 Roy Haje En-Consultants 1329 North Sea Road Southampton, NY 11968 RE: Erika Swimmer SCTM #1000-90-4-12 Dear Mr. Haje: The following action was taken by the Southold Town Board of Trustees on Thursday, March 26, 1992: RESOLVED that the Southold Town Board of Trustees grants anextension on the above referenced permit to construct a one family dwelling to expire on April 25, 1993. If you have any questions, please do not hesitate to contact this office. John M. Bredemeyer, III President, Board of Trustees JMB:jmt COUt,~Tf OF SUFFOLK Octobcc 1. 1991 Mr. Roy Li ~la~, President En-Consultmqta. Lqc. 1329 North .Sea Road Dear Mr. Haje: £nciosed ~s s c.l.,y oi d,c i:ioa~d o. Pc, ;,('~'~' .ietcm~;.!(i,.,n concem./",g the tub)et.? ~*.'p!ica~ion Ba.~ed ~-:n r~ m.ior;z,,~a,n .%ubm.,~cd, the Boa d gra{,ted r...% requeo for v~m~mc~ Very u'uly yom, Dcnn~ Moran, P.E. Chaim~aa Boa.rd of Revtew DM/h' Ellclo(~uf¢ cc: Mr. Wahcr G. Lmdlcy Ms. Susan D. Windeshelm Mt~ :~nka Swim. me; 3/~. [~'~.~ 52nd ctre-rl, New Yo~ 10022 Board o£ Trustees Town of $outhold %309e Main Road $outhold, New York Mr. John M. Bredame¥~:r, III Pt'e:;]der:t, Board of Trustees Re: £rika Swimmer Permit #3823 Dear Mr. Bredemeyer: ca]l me, very truly yours, //~,,[., ,' '."/, Marcia Z. Heftcr MZH/mlk Da,,.'d }i.~'fi$, M.D. M P.H. Applie~_,r,t: ~.~- Roy :. Haje. P_.<'o:~:d:a.ts. Inc., 1~9 N~r~h Se~ Road ,Sou~ .a'lpt~ Is, Nc~ Yo~ 11968 ait¢ p~'am well. }. ~'e ~i~ i~ ~ ~6,~ ,?::~;,- ~, ~ ~ :er. si: ~'~ 3. ~blic ' **: ~at~, a not av~able. David HarrLn, M.D.. M.P.H. Pa~e Two DM:Ir Dc:role Moran, P.~__., Chairmatt WILLIAM W, E$SEKS ESSEKS, HEFTER & ANGEL March 13, 1992 MONTAU K HIGHWAY P. O. Box 570 Board of Town Trustees Town of Southold 53095 Main Road P. O. Box 728 Southold, NY 11971 Re: Permit ~3823 Date of Issuance 4/26/90 Owner of Property: Erika Swimmer Dear Board Members: I am writing to request a one (1) year extension on the captioned permit as it is due to expire on April 25, 1992. Construction has not begun on the captioned property due to the time spent obtaining various permits and approvals from the NYS Department of Conservation, Suffolk County Department of Health, and the Town of Southold. In order we were required the following: to obtain the permits from the various agencies, to preform many tasks, some of which included 1. The preparation of a survey for the property by a surveyor; 2. The preparation of application forms; 3. A test hole and well were drilled, and the well water analyzed; A title search was prepared by an abstract company and filed with the Health Deparment; ESSEK$, HEFTeR & ANGEL COUNSELORS AT LAW The Health Department required us to make offers to surrounding neighbors to relocate their wells; 6. We attended hearings before the DEC and the Health Department; and 7. We prepared and filed covenants and restrictions on the property. As well, Mrs. Swimmer lives in Germany and the transmitting of documents and information back and forth required additional time. This process has taken the last two years to complete. We have now received the permits necessary to obtain a Building Permit and begin construction. Obviously, this will not be finalized before the Trustees permit expires. We would appreciate, therefore, receiving an extension on the Trustees permit for one (1) year, until April 25, 1993. Thank you for your attention to this request. Very truly yours, Marcia Z. R~fter MZH/mlk cc: Mrs. Erika Swimmer Mr. Erik Swimmer TRUSTEES John M. Bredemeyer, III. President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone ( 516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTt L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 April 30, 1990 Roy L. Haje En-Consultants, Inc. 1329 North Sea Road Southampton, NY 11968 Re: App. No. 1-3-90-90-4-12. Erika Swimmer Dear Mr. Ha/~ The following action was taken by the Board of Town Trustees during its regular meeting held on April 25, 1990 regarding the above matter: WHEREAS, En-Consultants IN BEHALF OF Erika Swimmer applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 27, 1989 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 25, 1990 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 Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, WHEREAS, the Board accepted the revised plan of April 9, 1990, NOW, THEREFORE BE IT RESOLVED THAT EN-CONSULTANTS IN BEHALF OF ERIKA SWIMMER BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: construct a single family dwelling, sanitary system with retaining wall, well and bluestone (or similar) driveway. Approximately 800 c.y. of fill to be trucked into raise grade. This permit will expire two years from the date it is signed if work has not commenced by said date. Fees must be paid, if apDlicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Permit will be issued upon payment of the following fees for work to be done below Mean High Water Mark: /~o ~ ~ ~~ ~//~) Very truly yours, Bredemeyer, III President, Board of Trustees JMB: jb cc: Bldg. Dept. Conservation Advisory Council file EN-CONSULTANTS, INC. 1329 NORTH SEA ROAD, SOUTHAMPTON, NEW YORK 11968 ENVIRONMENTAL SERVICES 516-283-6360 FAX NO. 516-283-6136 April 16, 1990 Board of Trustees Town of Southold Town Hall, 53095 Main Road Post Office Box 728 Southold, New York 11971 Re: Erika Swimmer Orchard Lane, Southold Application No. 1-3-90-90-4-12 Dear Sirs: Attached please find a slightly revised site plan for the project referenced above. Fill needed to accomplish this plan will be approxi- mately 800 cubic yards. Please substitute this plan for the one presently in your files in order that all reviewing agencies may approve the identical plan. RLH:khs Enc. cc: Marcia Hefter, Esq. truly, President 617.21 SEC~ Appendix A , State Environmental Quality Review '- FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a proie( or action may be significant· The question of whether an action may be significant is not always easy to answer· Frec~uen Iy, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determin signdicance may have little or no formal knowledge of the environment or may be technically e.xpert in environment: analys~s. In addibon, many who have knowledge in one particular area may not be aware of the broader concerns affectin the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determinatio process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or actior Full EAF Components: The full FAF is comprised of three parts: Part 1: Provides obiective data and information about a given project and its site· By identifying basic projec data. it assists a reviewer in the analysis that takes place in Parts 2 an8 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a proiect or action. It provide- guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially large impact· The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used ~/o evaluate whether or not th( impact is actually important· DETERMINATION OF SIGNIFICANCE--Type 1 and Unlisted Actions Identity Ihe Portions o[ EAF completed [or this project: ~ Part 1 x~ Part 2 ' I-]Part 3 Upon review of the informatio~ recorded on this EAF (Farts 1 and 2 Z'nd 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: ~ A. The proiect will not result in any large and important impact{s} and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prepared. i-J B. Although the proiect could have a significant effect on the environment, there will ~ot be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* C. The project may result in one or more large and important impacts that may have a significant impact on the environment· therefore a posilive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Lead Agency ~ Responsible Oiflcer m Lead A~ncy , Signature 1 Pi~t 2--PROJ~.CT Ii~IPACTS .AND Responsibility of Lead Agency General Information (Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significa Any large ~mpact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 sin asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types o[ impacts and wherever, possible the thresbol~ magmtude that would trigger a response in column 2. The examples are generally applicable t~roughout the State for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropr, for a Potential Large Impact response, thus requiring evaluation in Part 3, · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each quest~ · The number of examples per question does not indicate the importance of each question. · In identifying impacts, consider long term, short term and cumlative effects. -- ~- Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column I or 2) to indicate the potential size of t impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but thresh~ is lower than example, check column 1. d. If rewewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the proiect to a small to render. impact, also check the Yes box in column ,1. A No response indicates that such a reduction is not possible. must be explained in Part 3. IMPACT ON LAND 1. Will the proposed action result in a physical change to the project s~te? ',,~ NO []YES Examples that would apply to column 2 · Any construction On slopes of 1.5% or greater, [15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is }ess than ] feet. · Construction of paved parking area for 1,00D or more vehicles. · Construction on land where bedrock is exposed or generally within ] f~et of ex~sting ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation ~or mining purposes that would remove more than 1,000 tons of natural material (i.e.. rock or soil] per year. · Construction or expansion nj; a sanitary landfall. · Construchon in a designated floodway. 2 \Viii there be an effect t: ..~Vu~:,que°runusuaJland forms tound on the site/(i e.. cliffs, dunes, geological formatrons, etc.)[,",~O ~YES · Specd~c land forms: I 2 3 Small to Potential r Can Impact ~ Moderate Large Mitigated By Impact Impact iPr°ject Chang [] [] ~¥es i-]No [] [] ]]]Yes ["]No [] [] EYes ~No [] [] ~Yes ~No [] [] EVes F'INo [] [] []]','es []No [] ~ EVes ~,'~o [] [] EYes []No [] [] E]¥es []~o ?. [] , [] ~]Ves i-]No IMPACT ON WATER .t. Will proposed action affect any water body designated as protected? (Under Articles 15, ')4, 25 of the Environmental Conservation Law, ECL) ~NO ~]YES Ex,moles that would apply to column 2 · Oevelopable area of site contains a protected water body. · Dredging more than 100 cubic yards of material from channel of a protected stream. · Extension of utility distribution facilities through a protected water hod' · Construction in a designated freshwater or tidal wedand. · Other impacts: 4. will proposed action affect an,/non-protected exist~g~,or new hod of water? ,~NO []YES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. · Other impacts: S. Will Proposed Action affect surface or groundsvate~ / quality or quantity? }~:]NO [YES Examples that would apply to column 2 · Proposed Acbon wdlzequ~re a dischar~]e permit. · Proposed Action requires use of a source of water that does have approval to serve proposed (prolect) action. · Proposed ,~,ct~on requires water supply from wells w~th greater than gallons per minute pumping capacity. · Construction or operation c~'.uslng any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed off the site to facilities ~h~ch presently do not exist or have inadequate capaci:y. · Proposed Action would use water in excess of 20,000 gallons day. · Proposed Action vvdl likeb/ cau,,e sfftation or other discharge into existing body of water to tn-z, ext'._.nt that there wdl be an obvious vis~ contrast to natural conditions. · Proposed Action will require the storage of peuoleum or chem~ products greater than 1,100 ~allons. · Proposed Action wdl allow residenuaJ uses m areas w~thout water and/or sewer services. 6 £x:mples that would apply to column 'Z · Proposed Action svouJd ch]nge flood w,~ter llows. 7 · I 2 3 Small to Potential Can Impact: Moderate Large Mitigated I? Impact Impact J Project Chart L) 5 [] [] ~]Yes y. [] [] []Yes ly a. ~ g gYes ~S al ~ ~Yes S · Construction activity would excavate or compact the soil profile of al~ricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultutal District. more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems (e.§., subsurface drain lines, outlet ditches. strip cropping); or create a need for such measures (e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources.;' '~E~NO E3YFS {If necessary, use the Visual FAF Addendum in~'ection 617.21, Appendix Examples that would applv to column 2 · Proposed land uses. or prolect component~ obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural· · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or significantly reduce their enloyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? ~,~NO OYES I:xamples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantiall'F contiguous to any facility or s~te hsted on the State or National Register of historic places. · An,/ impact to an archaeological site or fossil bed located witt3in die prolect site. t Proposed ^croon will occur in an area designated as sensKive i:or a~chaeolog~cal sKes on the NYS Site InventorV. · Other impacts: iMPACT ON OPEN SPAC,": AND RECREATION 13 Wdl Proposed Action aftect the quanhtv or quality ot ex~stmq or /uture open spaces or recre,ltlonal opportunrtles~ ~ Examples that would apply to coJumn 2~O ~]YFS · 1'he permanent foreclosure or a future recreational opportun.tv. · .'\ malor reduction oi an open space nnportant to the COmmumty. · Other ~mpact$ 9 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] I-~Yes I-]No [] [] []Yes []No I'~ [] [:]Yes [~No [] ID. []Yes []No [] [] F~yes []No ~ ~ ~Yes ~ ~ ~Yes ~No D D DYes DNo ~ ~ DYes 0 0 OYes ~NO IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the exiting community? ~NO [DYES Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future proiects. · Proposed Action will create or eliminate employment. · Other impacts: I 2 3 Small to Potential Can Impact Bt Moderate Large Mitigated By Impact Impact Project Chang, [] [] ["]Yes I--iNo [] [] ' [-'l Yes []No [] [] I~Yes I--INo [] [] I:]Yes []No [] [] []Yes []No [] [] l-lYes [-'~No [] [] []Yes []No [] [] I-ryes []No [] [] I--tYes []No 19. Is there, or is there likely to be, public contro¥~sy related to potential adverse environmental impacts? ~O DYES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 Part 3--EVALUATION OF THE I~IPORTANCE OF h~iP:q,;TS Responsibility of Lead Agency Part 3 must be prepared if one or more imPact(s) is considered to be potentially large, even if the impact(s) may b mitigated. Instructions Discuss the following for each impact ~dentffied m Column 2 of Part 2: Briefly describe the ~mpact. 2. Dbscr~be (if applicable) how the impact could be mmgated or reduced to a small to moderate impact by prolect change(s 3. [3ased on the informabon available, decide ff it ~s reasonable to conclude that this impact is imporl~nl. To answer the question of importance, consider: · The probability of the rmpact occurring · The durauon of the ~mpact · Wh~ther the impact can or w,ll be controlled 11 TRUSTEES John M. Bredemeyer, 11I, President Henry P. Smith. Vice President Albert J. Krupski. Jr. .lohn L. Bednoski, John B. Tuthill Telephone (516) 765- ! 892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOFF L. HARRIS Supervisor Town Hall, 530~5 Main Road P.O. Box 1179 Southold, New York ! 1971 Fax (516) 765-1823 Telephone (516} 765-I800 S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. NAME: Erika Swimmer DATE: March 22, 1990 RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as Lead Agency for the action described below, has determined that the project will not have a significant effect on the environment. Please take further notice that this declaration 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. TYPE OF ACTION: Unlisted in CEA DESCRIPTION OF ACTION: Construct a single family dwelling, sanitary system with revised location, as requested by NYSDEC, well and bluestone (or similar) driveway. LOCATION: Orchard Lane, Southold, NY. Tax map No. 1000-90-4-12 REASONS SUPPORTING THIS DETERMINATION: 1. An on site inspection has been conducted by the Board o Trustees. 2. An environmental assessment, submitted by the applican~ reviewed and completed by the Board of Trustees, has indicated ti no significant adverse effects to the environment are likely to should the project be implemented as planned. Please complete, and return this form processing. Involved Agency: ~,-~ . Project Name: ~--~ ~. ~ Location: o~/~~' Z-~.'~''~'~'~ SCTM: Iw~,~, ~9~''~-~ We at ~ D~C AGENCY Trustees ass~ing Lead Agency. Comments/Reasons: lexpedite (Have~ objection to ~.~~ ~4AR 01 1990 Signature of Authoriz.~d Representative EN-CONSULTANTS, INC. 1329 NORTH SEA ROAD, SOUTHAMPTON, NEW YORK 11968 ENVIRONMENTAL SERVICES 516-283-6360 FAX NO. 516-283-6136 March 2, 1990 Board of Trustees Town of Southold Town Hall, 53095 Main Road Post Office Box 728 Southold, New York 11971 Re: Erika Swimmer SCTM #1000-90-04-12 Dear Sirs: I am in receipt of a February 8, 1990 letter to me signed by Albert J. Krupski, Jr. Upon reading the letter, however, it sounds as if it was intended to be addressed to the Suffolk County De- partment of Health Services. As it asks for "... input from your office in regard to septic system placement..." Disregarding any confusion in whom the letter was mailed to, I would like to point out that it is my opinion that the location of the sanitary system is not within the Phragmites area. I have attached a revised site plan done at the request of the New York State DEC. I also enclose a copy of their Notice of Incomplete Appli- cation which indicates that, if these modifications were made we would satisfy the 75' setback from wetlands to house. In addition, the revised location of the sanitary system is in accordance with their recommenda- tion. Based upon this, the project may now be largely or totally beyond the jurisdiction of the Trustees. Please review these matters RLH:khs Eric. cc: Marcia Hefter, Esq. and advise of your opinion. You~tr ~, NEW Y TAT. DEPART.ENT OF ENV,RONMENTAL OONS T,O2: , Region / NOTICE OF INCOMPLETE APPLICATION THIS IS NOT A PERMIT APPLICATION NUMBER OWNER ID NUMBER PERMIT TYPE(S) APPLICANT FACILITY/PROJECT ADDRESS / CITY '~ STATE ] ZiP CODE LOCATION ~ Completed application form (enclosed). ~ Other DEC permits appear necessary. Submit appli- ~Completed Pa~ I of the Long/Sho~ Environmental cations (enclosed) for the following permits: Assessment Form (enclosed). ~ Completed Pa~ I of the Structural-Archaeological If you have reason to believe that all permits should not be processed simultaneously, please notify the Assessment Form (enclosed). ~ contact person below, clearly stating your reasons. ~ Project location map (USGS or eauivalent~ which clearly ~ The project ~s being rev[ewe~ pursuant to the ~tate shows the project location with respect to identifiable Environmental Quality Review Act (SEQR). A desig- roads and other notable features (~ copies)· nation of Lead Agency and determination of signifi- ~ Project plans/Engineering repo~ (~ copies), cance will be made before your application can be ~ Su~ey map showing the Freshwater~ldal Wetland considered complete. boundary at the project location (_~ copies). the Lead Agency, bas determined that the project may ~ Signed letter from landowner giving you permission to have a significant effect on the environment. A draft apply for a permit on his/her property, environmental impact statement must be prepared or ~ List of other agencies having jurisdiction over project, accepted by the Lead Agency· ~ Representative color photographs of the project area ~ The correct fee was not submitted. Please submit a and surroundings. Please label each with a description check or money order payable to the New York State and date taken (~ copies). $ ~ List of previous DEC permits for owner/facility. ~ See attached checklist(s). ~ You may be contacted for additional information. ~ Additional requirements: Please submit requested Information by No luther action can be taken until all ol materials are m~lved. If you wish to withdraw your application, pl~se notify the contact person below. Thank you. ~ A conference Is recommended to discuss this application. Please contact the person ~low to arrange a meeting. Return the WHITE COPY of this form to DEC with Requested Information. CC: Retain thff YELLOW COPY for yourself. New York State Department of Environmental Conservation Bui ding 40--SUNY, Stony Brook, New York 11794 Thomas C. Jorlin Commissioner TRUSTEES John M. Bredemeyer. IIL President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 February 27, 1990 The following action was taken by the Board of Town Trustees at its regular meeting held on February 22, 1990: RESOLVED that the Southold Town Board of Trustees assumed Lead Agency on the application of Erika Swimmer. 1-3-90-90-4-12. This was unanimously approved by the Board. TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD sco'i-r L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone ( 516) 765-1800 LEAD AGENCY COORDINATION REQUEST Enclosed is a permit application and a completed part I of the Environmental Assessment Form. Southold Town Trustees are interested in your ageny's comments in acting as SEQRA Lead Agency for: NAME: ~' ~T3~ LOCATION: O~c ~c%~ ~ TAX MAP: I~' DESCRP~: PE~IT REQUIRED: ~ TO~ WETL~D ( ) OTHER SEQ~ CLASSIFICATION: ( ) ~e I ( ) ~ ~LISTED ( } Type II CEA Please contact Albert J. Krupski, Jr., Trustee _, with~_~30 days and be advised that the Southold Town Trustees~/(-D~~- ~(D-~) to assume lead agency. - / SENT TO: DOS ( ) DEC (~ DOM (~ PB (u~ ZBA ( ) BAD ('~ Please complete, processing. Involved Agency: Project Name: Location: SCTM: We at AGENCY Trustees assuming Lead Agency. detach and return this form to expedite (Have/No) objection to Southold Town Comments/Reasons: Signature of Authorized Representative TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTT L. HARRIS Sups, rvisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 LEAD AGENCY COORDINATION REQUEST TO: '~.~ ~o~k\ DATE: Enclosed is a permit application and a completed part I of-the Environmental Assessment Form. Southold Town Trustees are interested in your ageny's comments in acting as SEQRA Lead Agency for: NAME: E~ ~ ~3'.oqf~C LOCATION: ~ci-.c~ ~- Lc~c~ , ~oo4~. PE~IT REQUIRED: (~ TO~ WETL~D ( ) O~ER SEQ~ CLASSIFICATION: ( ) ~e I ( ) ~e II (~ ~LISTED ( ) CEA Please contact John M. Bredemeyer, III, President, w~h~30 days and be advised that the Southold Town Trustees ~T~/(~ ~T) to ass~e lead agency. S~T TO: DOS ( ) DEC (~ DOH (~' PB (~ZBA ( ) BLD (~ Please complete, processing. Involved Agency: Project Name: Location: SCTM: We at AGENCY Trustees assuming Lead Agency. detach and return this form to .expedite (Have/No) objection to Southold Town Comments/Reasons: Signature of Authorized Representative Telephone (516) 765-1801 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 To: From: Dated: Re: SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL'I! FEB 2 0 Southold Town Board of Trustees T~. ~:. ~.~- Southold Town Conservation Advisory Council February 20, 1990 Recommendation of Applications The following recommendations were made by the CAC at its last meeting of February 16, 1990: RESOLVED to recommend to the $outhold Town Trustees APPROVAL of Wetland Application No. 478 submitted by Costello Marine on behalf of JOHN VASSIL to amend Wetland Permit no. 478 to extend existing 6' x 24' float dock ~-~ for a total of 6' x 34'. Salt Lake Lane, Mattituck Vote of Council: Ayes: All Motion carried. RESOLVED to recommend to the $outhold Town Trustees APPROVAL AND DIS APPROVAL of Wetland Application No. 1-4-90-81-1-16.1 submitted by En-Consultants on behalf of Edward Deutsch. The Council approves the construction of a 4' x 16' hinged ramp secured to drest of bank by two 4" posts; and a 6' x 20' float secured by two 8" diameter pilings. The CAC disapproves the construction of 215 I.f. of timber retaining wall at or above the line of MHW. The Council feels this is actually bulkheading and suggest the applicant plant native vegetation to stabilize the beach and bluff. Regarding the construction of the single family dwelling with garage, deck, drive- way, well and sanitary system the CAC feels the applicant move the house back so there will be no disturbance within 75', i.e. trucks clearing the area for work. All work should be at least 75' away. Briar Lane, Southold Vote of Council: Ayes: All Motion carried. RESOLVED to recommend to the Southold Town Trustees APPROVAL of Wetland Application No. 1-6-90-103-3-7 submitted by En-Consultants on behalf of Dr. David Winkler to construct a tiber dock consisting of a 4' x 130' fixed elevated (4~ above grade of marsh) walk; 4~ x 12' rampl 6' x 20' float secured by town 8" diameter pilings. Beebe Drive, Cutchogue Vote of Council: Ayes: All Motion carried. RESOLVED to recommend to the Southold Town Trustees DISAPPROVAL of Wetland Application No. 1-3-90-90-4-12 submitted by Eh-Consultants on behalf of~l~ · ~[~1~1~1~.-.~ construct a one family dwelling, sanitary system with retaining wall, well and bulestone driveway, all as shown on submitted site plan. Approximately ~l Page 2 300 c.y. plan. The CAC of clean fill to be truckend in to raise grades to those shown on submitted 5. 6. Orchard Lane, Southold Vote of Council: Ayes: Motion carried. disapproves the application, which is within jurisdiction, because: The CAC does not agree with the wetland line The construction envelope is within 75' The Cesspool is too close to the marsh There is concern as to where the well will be located There is concern as to where the cesspool effulent is going to go The drainage ditch is not shown on survey All RESOLVED to recommend to the Southold Town Trustees DISAPPROVAL of Wetland Application No. 1-5-90-145-4-15 submitted by Eh-Consultants on behalf of Richard Zeidler to construct a 49' bulkhead plus 6' return on north side. Bulkhead to extend from end of exisitng bulkhead north generally along mean high water to met existing rip-rap. Dredge an area up to 15' off bulkhead to maximum depth of 4' below MLW. The CAC suggests rip-rap instead of bulkhead to fit in with neighbors. There is no necessity for the dredging. Unnamed road off McDonald Road, Laurel Vote of Council: Ayes: All Motion carried. RESOLVED to recommend to the Southold Town Trustees APPROVAL WITH REVISIONS of Wetland Application No. 1-2-90-78-5-12 submitted by Proper-T Services for Constantinos Markotsis to replace 90 I.f. of bulkhead with new bulkhead 18" seaward of old bulkhead,; extend bulkhead 20-+'; relocate walk~ey, ramp and foating dock at new bulkhead; dredge area around floating dock to approximately 3' at Iow water. The CAC approves if bulkhead is replaced in kind, in place and not the 18' as submitted, allows addition on same level with current bulkhead and truck way excess fill from site. Williamsburg Road, Southold Vote of Council: Ayes: All Motion carried. RESOLVED to recommend to the Southold Town Trustees APPROVAL of WEtland Application No. 1-10-90-52-8-2 of Vincent and Barbara Claps to construct a two-story single family dwelling with garage beneath, swimming pool, deck, porch, driveway, and septic system. Lot #I, Long Pond Estated, Southold Vote of Council: Ayes: All Motion carried. RESOLVED to recommend to the Southold Town Trustees APPROVAL of Wetland Application No. 1-10-90-110-7-26 submitted by Proper-T Services of S¥ Stahl to repalce an existing bulkhead (132'); add 15' return at each end and fill behind new bulkhead. 1435 West Road, Cutchogue Vote of Council: Ayes: All Motion carried. TRUSTEES John M. Bredemeyer, III, President - -Henry P. Smith, Vice President Albert J. Krupski. Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 February 8, 1990 Roy L. Hage, President 1329 North Sea Road Southampton, NY 11968 RE: Erika Swimmer Dear Mr. Hage: The Southold Town Trustee would like the Suffolk County Health Department to issue a permit for well and septic system prior to our review of the application for Erika Swimmer. The problem on this property is that their proposed septic system is adjacent to and possibly part of a phragmites bed with some spartina and groundsel bush which communicates directly with Sandpiper basin by means of a vector control ditch. It was the Board's opinion upon inspection that this could result in contamination of not only the adjacent wetlands but also the surface waters. Therefore, before we review this application we would appreciate if not a permit, at least input from your office in regard to septic system placement that would cause no contamination to adjacent protected areas. Even without your permit, only suggestions for re-locating the proposed system, could we comfortably act on this application, and then pass it on to your department. Looking forward to your response. Sincerely, Albert J. Krupski, Jr. Member, Board of Trustees AJK:jmt cc: Health Department New York State Department of Environmental Conservation 50 Wolf Road, Albany, New Yom 12233 Thomas C. Jodlng Commissioner ..., RE: LEAD AGENCY COORDINATION REQUEST The purpose of this request is to determine under Article 8 (State Environ- mental Quality Review - SEQR) of the Environmental Conservation Law and 6 NYCRR Part 617 the following: ~..!.~ Your agency's interest in acting as lead agency; 2. Your agency's jurisdiction in the action described below; and 3. Issues of concern which your agency believes should be evaluated. Enclosed is a copy of the permit application and a completed Part 1 of the Environmental Assessment Form to assist you in responding. Project Name: .S-~.y,,~"'~m.'~c. ~ I~F'op6fr-'J-y Project Location: DEC Project Number: /_~7/7j~_00~_/~/~00/~0 SEQR Classification: [9/] Type I DEC Contact Person: ~)c~uiO ~. DEC Position: [ ] Unlisted no objection to your agency or another agency assuming lead agency DEC has status for this action, but reserves the right to comment on this action if a positive determination of significance is made. -2- [] DEC has no objection to your,'~gency or another agency .assuming lead agency status for this action, but we have the following concerns regarding this. project (see "comments" below). £] DEC wishes to assume lead agency status for this action. The proposed action has been identified by DEC as occurring wholly or partially within or substantially contiguous to a critical environmental area (CEA) that was designated by _~-~/~ c~o. ~c-~,c ~ ~ It is t~e position of this Department that your agency, if it has a juris- diction over the action, should assume the lead agency role based on the existence of the CEA and the fact that the' anticipated impacts are primarily of local significance. [ ] Other. (See comments below) Comments (Optional): Response: Please respond to this request within 30 days of the date of this letter. If no response is received within 30 days, we will assume that you have no objection to DEC or another agency assuming the role of lead agency, and have no comments to offer regarding the proposed action at this time. If neither your agency nor any other involved agency, including DEC, has indicated a will- ingness to serve as lead agency within 30 days of this letter: [ ] We will petition the Commissioner of DEC to designa~.tead agency for this action. [ ] We will petition the Commissioner O~]~)E~ to designate your agency as lead, presuming you have jumis~di~tion. Please feel free to contact this office for further information or discussion. Sincerely, Enclosures cc: (see distribution list) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPLICATION NUMBER ~ APPLICATION FOR PERMIT Read In~ttuctiom on back be[om completing this application. Please type or print clearly in ink. Use separate addenda and e~hibit~ to provide all data and expianations for v/nich Space on this form is inadequate. [] ARTICLE 15, TITLE 3 (CONTROL OF AQUATIC INSECTS. WEEDS.. OR UNDESIRABLE FISH) [] ARTICLE 1S, TITL~ S (PROTECTION OF WATERS) [] For the disturbance of a STREAM BED or excavation in or fill of navigable waters [] ARTICLE 15, TITLE 1S [] WATER SUPPLY [] LONG ISLAND WELL [] ARTICLE 24 [FRESHWATER WETLANDSI [] Permit [] Letter of Permission [] ARTICLE 25 (TIDAL WETLANDS) I NAME OF APPLICANT. Erika Swimmer b~ En-Consultants, Inc. 2 APPUCANT IS A/AN [] Individual [] Partnership [] Associat,on ~]~ Corporation [] Municipabt'/ [] Governmenta] Agency 3. NAME AND TITLE OF OFFICIAL SIGNING APPLICATION PHONE Roy L. Haje, President 516-283-6360 1329 North Sea Road Southampton N.Y. 11968 Erika Swimmer 212-753-2239 c/o 340 East 52nd Street New York N.Y. 10022 Southold Item 5bl LAND~ ~thold Sandpiper Basin [] Yes [] [] Publ,c [] Commerc,a] ASAP One Year s 10 Enclosed PROIECT DESCRIPTION Feet ct r,p-rap new channel: cub,c yards o f material to be removed, draining, dredging, filling, and Iocat,on of d,sposa~ s,tes: st tu to I~ ,n~tall~l~ he~i~ht SEE ATTACHED ' ~['7~'=".~ ' [] Dam [] Excavation/Fill [] Stream Disturbance [] SPDES/NPDES [] Water Supply [] L I. Wells [] Freshwater Wetland Long Island Traveler Watchman, Traveler Street, Southold, New York 11971 14. IS ANY PORTION OF THE ACTIVITY FOR WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETED1 here,n and agrees to ,ndemmfy and save harmless the State from suil[s..~l~tJons.~h~a.~/Tnd cost~ of every name and description resulting from said prolect November 15, 1989 ~ Roy L. H~e, l~res~den~GNATuRE --SEE REVERSE SIDE-- INSTRUCTIONS 1. Prepare and submit four (4) copies of this application. Use typewriter or print clearly in ink. 2. Submit with the application three copies of a drawing showing location and extent of work to be done. .3. Applications by counties, cities, towns and villages shall be signed by the chief executive officer thereof or the head of the department or agency undertaking the project. 4. The applicant may be required to publish a "Notice of Application" as provided by the Regional Permit Administrator. $. If other than owner makes application, written consent of the owner must accompany application. 6. Acceptance of a permit subjects permittee to restrictions, regulations or obligations stated in application and/or permit. 7. If a public hearing is necessary, the applicant ma,/be required to furnish the names and addresses of aU adjacent landowners and all known claimants to water rights. 8. Applications for the construction, reconstruction or repair of a dam or other impoundment structure must be accompanied by Supplement [3-1. 9. Applications for a water supply permit must be accompanied by Supplement W-l, special instructions on which SUPERCEDE certain of the above instructions. See "Water Supply" handbook '[0 Applications for a permit to apply a chemical to control or eliminate aquatic vegetation must be accompanied by Supplement A-1. A-2, or A-3 11. Question No. 12 pertains to projects involving two or more applicants. One typical example is a new subdivision, requiring a Wetlands Permit for the developer, the project to be within a water district extension, requiring a Water Supply Permit for the town. 12. Be sure to enclose proper application fee, noted accordingly ~n item 10; see Part 621, Uniform Procedures Rules. Rule 621 4. (If in doubt, discuss w~th Regional Office before submitting application). 13 INCOMPLETE OR INACCURATE INFORMATION MAY DELAY PROCESSING! INFORMATION Application for permit to the New York State Department of Environmental Conservation ~s authorized by Environmen- tal Conservation Law ~rtic[e 15 (Title 3~ontro[ of Aquatic Insects, Weeds, or Undesirable Fish; Title 5-Stream Protection; Title 15-Water Suppl¥,L and Article 24 (Freshwater Wetlands). NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION REGIONS Region I Region 2 Region 3 Bldg 40-Room 219 2 Wodd Trade Center 21 South Putt Corners Road SUNY at ~tonv Brook 61st Floor New Paltz, N.Y. 12561 Stony Brook. N Y. 11790 New York. N Y 10047 Attn: Regional Permit Administrator Attn Regional Permit Adm~mstrator Attn' Re$~onal Permit Administrator (914) 255-5453 (516) 751-7900 [212) 488-2756 Region 4 2176 Gudderland Ave. Schenectady. N Y 32306 133 o1~a I ~1~ i t Admrmstrator 68O Region 4 (Sub-Office) Route 10, Stamford N.Y. 12167 Attn Alternate Regional Permtt Admimstrator (607) 652-7364 ReRion 7 P.O Box 5170. Fisher Avenue Cortland, N.Y. 13045 Attn: Regional Permit Admlmstrator (607) 753-3095 or Re~ion 7 7481 Hen~/Clay Blvd. Liverpool. N Y t3088 Attn: Alternate Regional Permit Administrator (315) 42B~497 Region 5 Rt 86 Ray Brook, NY. 12977 &ttn. Regional Permit Admlmstrator (518) B91-1370 Region S (Sub-Office) Hudson Street. Warrensburg. N.~ 12885 AU.n: Alternate Regional Permit Administrator (518) 623-3671 ReRion 8 6274 E. Avon-Lima Road Avon, N.Y. 14414 Attn: Regional Permit Admln,strator (716) 226-2466 Region 6 (Sub-Office) State Office Bm[drag 207 Genessee Street. Utica. N.Y. 13501 Attn' Alternate Regional Permit Administrator (315) 793-2555 Region 9 600 Delaware Avenue Buffalo, N.Y. 14202 Attn: Regional Permit Administrator (716) B47~4551 PROJECT DESCRIPTION Construct a one-family dwelling, sanitary system with retaining wall, well and bluestone lar pervious) driveway, all as site plan of Peconic Surveyors. cubic yards of clean fill will raise grades to those shown. (or simi- shown on attached Approximately 300 be trucked in to To find: Dirt road immediately south of General Wayne Inn. SOUTHO-~ n ,:,1 PLANI'IING gOn',:3 . 14'.1b-~2 [2;87]--7c 61'7.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEQR Purpose: The'full E^F is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may be technically expert in environmental analys~s. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full E,~,F is intended to provide a method whereby applicants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet flexible to aUow introduction of information to fit a project or action. Full EAF Components: The full E^F is comprised of three parts: Part 1: Provides objective data and information about a given proiect and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a proiect or action. It provides guidance as to whether an impact is lik~J'f to be cousidered small to moderate or whether it is a potentially- large impact. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify Ihe Portions of EAF completed for this projecl: i-'l Part 1 [] Part 2 ' []Part 3 Upon review of the informatiok recorded on this EAF {Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: [] A. The project will not result in any large and important impact{si and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prepared. [] 8. Although the project could have a significant efJ'ect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negalive declaration will be prepared.' [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a posilive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of z~.ctlon Name of Lead Agency Print or l'ype Name of Responsible Officer ~n Lead Agency Title ot Re,l~Onslble Otricer Signature ot Responsible Officer ~n Lead Agency Signatureot Propater(IfddferenttromresponssbJeoff~cer) PART 1--PROJECT INF ATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have ~ significant elf on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be conside as part of the application for approval and may be subject to further verification and public review. Provide.any add[tic information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not [nyc new studies, research or investigation. [f information requiring such additional work is unavailable, so indicate and spec each instance. _ NAME OF ACTION LOCATION OF ACTION (Include Street Address, Municipahly and County) NAME OF APPLICANT/SPONSOR I SUSINESS TELEPHONE En-Consultants, Inc. I (516) 283-6360 ADDRESS - 1329 North Sea Road CITY/PO I STATE I ZJP CODE I Southampton I NY 11968 HAME OF OWNER (If ditferen0 Erika Swimmer IBUSINESS TELEPHONE (212) 753--2239 ADDRESS c/o 340 East 52nd Street CITY/PO I STATE I ZJP CODE New Yozk NY ~0022 0E$CRIPTION OF ACTION SEE ATTACHED Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall proiect, both developed and undeveloped areas. 1. Present land use: [:]Urban [:]Industrial I-ICommercia) rqForest I-I^griculture t~'lOther 2. Total acreage of project area: · 85 acres. APPROXIMATE ACREAGE Meadow or Brushland (Non-agricultural} Forested Agricultural (Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24. 25 of ECLJ Water Surface Area Unvegetated (Rock. earth or fill} Roads. buildings and other paved surfaces Other (Indicate typo) Landscaped 3. %,Vhat is predominant soil type(s) on prelect site~' a. Soil drainage: Sand ~Well dra,ned 40 % of site ~'Poorly drained 50 % of s~te ~Residential (suburban) Vacant 2-~ J c~nt- i ,-~ 1 ~]Rural (non-far' PRESENTLY AFTER COMPLETIO.N · 49 acres . 49 acres .24 .09 acres acres .12 acres .12 acre~ · 10 ~,%toderately well drained 10 · ' ~li'~' l:''~ site b. If any agricultural land is revolved, how many acres oi soil are classdied w,thin sod group 1 through 4 of the N'~ Land Classdicatlon System~ - acres. (See I NYCRR 370). 4. Are there bedrock outcroppings on prelect site( ~Yes l~No a. What ,s depth to bedrock? 500 (in feet) .. 2 $.",~pproximate percentage o~oposed proiect site with slopes: 10 0 ?$ D10-1 · . . r .. ~]15°.% or greater _ '6. Is project substanually contiguous to, or contain a building, site, or district, listed on the State or the Nationa Registers of Historic Places? D-lYes [~No 7. Is proiect substantially contiguous to a site listed on the Register of National Natural Landmarks? I~,Yes IL"INc 8. What is the depth of the water table? 6.9 ' (in feet)at test ho'le.. 9. Is site located over a primary, principal, or sole source aquifer? ~]Ye$ f-INo 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? EYes 11. Does project site contain any species of plant or animal life that is identified as threatened or endangerea~ I~Yes [~No According to Roy T.. ltaje Identify each species 12. Are there any unique or unusual [and forms on the project site? (i.e., cliffs, dunes, other geological formations i--lYes /~No Describe 13. Is the project site presently used by the community or neighborhood as an open space or recreation area; [~Yes E~No If yes, explain 14. Does the present site include scenic views known to be important to the community? [:]Yes rXNo 15. Streams within or contiguous to proiect area: n/a a. Name of Stream and name of River to which it is tributary 16. Lakes. ponds, wetland areas within or contiguous to project area: a. Name Sandpiper Basin 17. Is Jhe s,te served by ~xisting public utilities? ~Yes a) If Yes. does sufficient cap'acity exist to allow connection? b) If Yes. will improvements be necessary to allow connection? b. Size (In acres) [~Yes ImNo i~,Yes ~'No 19 20 Has the site ever been used for the disposal of solid or hazardous wastes? 100+ Is the s,te located in an agricultural district certified pursuant to Agriculture and ,Markets La~v. Article 25-AA Section 303 and 304? DYes ~No Is the s~te located in or substant,ally contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL. and 6 NYCRR 6177 ~]Yes t-]No ~Yes ~No Project Description Physical d~mens,ons and scale of project (fill in dimensions as appropaate) a. Total conhguous acreage owned or controlled by project sponsor , °,85 b. Prolect acreaae to be developed: .15 acres initially; .15 c. ProJect acreage to remain undeve!oped · ~ acres. d. Length of prolect' ,n re,les: n/a (If appropriate) e. If the prolect is an expansion, indicate percent of expansion proposed n/a acres. acres ultimately. I. Number of o~f-street parkmt~ spaces existing 0 h. If residential: Number and type of hou~,nL~ un,ts' One Famdy Two Family Imtpallv ] Ultm~,~tulv ~ i. gim~.ns~ons (~n [~et) of I8~est proposed structure ; proposed 2 [upon completion of prolectJ? Multiple, J:anllly Condomm,um :~-~ he.4ht: 20 w,dth: 45 length j. Linear feet of frontage along a public thoroughfare project w,II Occupy ~? ~ ft. 3 )(i.e.. rock, earth, etc.) will be removedem the site? 7. How much natural mat 3. Will disturbed areas be reclaimed? []Yes I-1No I~IN/A a. If yes, for ~vhat intend...: purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? F'IYes ,r-lNo c. Will upper subsoil be stockpiled for reclamation? l-lYes r]No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? o 15 acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? i-lYes J~No ' ' 6. If single phase proiect: Anticipated period of construction 12 7. If multi-phased: a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 c. Approximate completion date of final phase d. Is phase 1 functionally dependent on subsequent phases? 8. Will blasting occur during construction? I-lYes [~No 9. Number of jobs generated: during construction 10. Number of jobs eliminated by this project 0 11. Will project require relocation of any projects or facilities? 0 . tons/cubic yards months, (including demolitionl. month year, (including demolition). month year, E]Yes I-INo" 0 after project is complete C3Yes I~INo If yes, explain 12. Is surface liquid waste disposal involved? I-lYes J~No' a. If yes, indicate type of waste (sewage. industrial, etc.) and amount ' b. Name of water body into which effluent will be discharged '13. is subsurface liquid waste disposal involved? ~Yes (No Type Sewaqe 14 %Viii surface area of an existing water body increase or decrease by proposal? I-lYes Explain {~No 15. Is prelect or any portion of project located in a 100 year flood plain? 16 Will the proiect generate solid waste? ~"lYes f-lNo a. If yes, what is the amount per month .1 tons b. If yes, will an existing solid waste facility be used? []]Yes []No Southold Landfill ' location c. If yes, give name d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain [~Yes ~lNo Cutchogue ~]Yes ~No 17. Will the prelect involve the disposal of solid waste? a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? lg. Will prelect use herbicides or pesticides? J~Yes ~Yes Ii]No tons/month· years, l~No 19 Will prelect routinely produce odors (more than one hour per day)? ~]Yes J~No 20. Will prelect produce operating noise exceeding the local ambient noise levels? l-lYes 21. Wdl prelect result in an increase in energy use? J~Yes r-lNo If yes , indicate type(s) Oil & Electricity 22. If water supply is from wells, nd cate pump,ng capacity 2 gallons/minute. 23. Total anticipated water usalge per day 300 gal ons/day 24 Does project ~nvolve Local, State or Federal funding? J~Yes L~NO If Yes. explain J~No 4 '25.' Approvals Required: Type Submittal Da~e - City,' Town. Village 8Bard i-lYes I-aND City, Town. Village Planning 8Bard DYes I-INa City. Town Zoning 8Bard DYes I~No City. County Health Department [~Yes tNB Other Local Agencies ~-Yes f-INa Other Regional Agencies DYes I-INa State Agencies []['Yes I-1No Federal ^gencies i-lYes I'"]No SCDH-San.s~s. & well Trustees DECt TW 11/89 11/89 11/89 C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? IDYes IXlNo _ If Yes, indicate decision required: I-Izoning amendment I-Izoning variance ["'lspecial use permit C]subdivision ["]site plan ~new/revision of master plan Dresource management plan f-lather 2. What is the zoning classification(s)of the site? R-40 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 1 one-family dwelling 4. What is the proposed zoning of the site? 1~,-~ · S.. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 1 one-family dwelling 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? []Yes 7. What are the predominant land use(s) and zoning classdications within a ¼ mile radius of proposed action? private residences 8. Is the proposed action compatible with adjoining/surrounding land uses ~vithin a 'A mile? I~Yes [~,~ 9. If the proposed action is the subdivision of land, how many lots are proposed? n/a a. What is the mimmum lot size proposed? 10. %¥ill proposed action require any authorization(s) for the formation of sewer or water districts? f-lYes 11. Will the proposed action create a demand for a~y community provided services (recreation. education, police fire protection)? r-lYes [~No a. If yes, is existing capacity sufficient to handle projected demand? I-lYes 12. Will the proposed action result in the generation of traffic significantly above present levels? I-lYes a. If yes, is the existing road network adequate to handle the additional traffic? []Yes I-INa D. Informational Details Attach any additional information as may he needed to clarify your project. If there are or m'ay be any advers, impacts associated w~th your proposal please discuss such impacts and the measures which you propose to mitigate o avoid them· E. Verification I certify that the/ntorma~on~provided above is true to the best of my knowledge. · Appl cant Sponsor N~e~ F~7 / {Swimmer by..En-Consultants, ThC. ...... ~..~ 11/15/89 Signature., ~,~. ~ .~ "~ ~tg~ Title President-- 11 the act,on .~X~n-Ylh~U~o,~'~all,~rea, a~l you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. 5 ALBERT J. KRUPSKI. JR..~-~3~ JOHN M. BREDEMEYER. III , President JOHN L. BEDNOSKI. JR. HENRY P. SMITH, Vice President John B. Tuthill BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Mare Road P.O. Box 728 Southold. New York 11971 FEI.~I'HONE January 12, 1990 Mr. John Holzapfel, Chairman Southold Town Conservation Advisory Council Southold Town Hall Main Road $outhold, New York 11971 Dear Mr. Hol~apfel: Transmitted herewith is application No. 1-3-90-90-4-12 for a Wetland Permit submitted by En-Consultants. Please prepare a written report of findings and recommendations with respect to this application. Very truly yours, John M. Bredemeyer, III President Board of Town Trustees JMB:jmt TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. I -~-C[C'-~- ~t-t~- DATE November 15, 1989 APPLICANT'S NAME: Erika Swimmer by En-Consultants~ TEL. NO. 212-753-2239 Inc. MAILING ADDRESS: c/o 340 East 52nd Street~ New York~ New York 10022 AGENT: En-Consultants, Inc. TEL NO. 516-283-6360 AGENT ADDRESS: 1329 North Sea Road, Southampton~ New York 11968 PERMIT REQUESTED TO: SEE ATTACHED LOCATION OF PROPERTY FOR REQUESTED PERMIT: Orchard Lane, Southold HAMLET:- Southold TAX MAP NO: 1000- 090-4-12 CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE OF PROPOSED WORK: LENGTH: see attached Sandpiper Basin WIDTH: see attached PROJECT DESCRIPTION Construct a one-family dwelling, sanitary system with retaining wall, well and bluestone (or simi- lar pervious) driveway, all as shown on attached site plan of Peconic Surveyors. Approximately 300 cubic yards of clean fill will be trucked in to raise grades to those shown. To find: Dirt road immediately south of General Wayne Inn. Only determination that house is beyon~ jurisdiction is requested. If within, please process application. Page 2. YDS. TO BE EXCAVATED: YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: dumped and greaded. Trucked in, WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: 120±' DEPTH AT LOW TIDE: 3' AVER. RISE IN TIDE: 2'6" DISTANCE TO NEAREST CHANNEL: n/a DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN AREA: n/a AREA ZONING: Residential IS PROJECT FOR PRIVATE OR BUS. USE: private INTENDED USE OF PROPERTY: Residential DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: None known HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: None known HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: None known DESCRIBE FULLY THE REHABILITATION OF PROPERTY: Upon completion of construction, parcel will be ~raded & landscaped. DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: landscaped. ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: None known WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: SEE ATTACHED WHOM IT MAY CONCEP~N: au~norlze Eh-Consultants, Inc. to apply for permiZs be.half. '. PROJECT i.D. NUMBER 617.21 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 Erika Swimmer by En-Consultants, In~ .2. PROJECT NAME SEQR 3. PROJECT LOCATION: Orchard Lane Municipality Southold County Suffolk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) Orchard Lane, Southold To find: Dirt road immediately south of General Wayne Inn. 5. IS PROPOSED ACTION: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: SEE ATTACHED ?. AMOUNT OF LAND AFFBCTED: Initially · 8 4 8 7 acres Ultimately . 8 4 8 7 acres 8. WrLL PROPOSED ACTION COMPLY WITH EXISTrNG ZONrNG OR OTHER EXISTrNG LAND USE RESTRICTIONS? [] Yes [] NO If No, describe briefly g. V.tHAT IS PRESENT LAt;D USE IN VICINITY OF PROJECT? [] Res,dentlal [] !ndustnal [] Commercial [] Agriculture [] Park/Forest/Open space [] Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDBRAL, STATE OR LOCAL)? r~ Yes [] No If yes, list agency(s) and permit/approvals DEC SCDH 11. DOES ANY ASPECT OF THE ACTIOr,I HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] ['lo If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPRQVAL REQUIRE MODIFICATION? [] Yes [] No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Erika Swimmer by En-Consultants, Inc. Dale: 11/15/89 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 1 PART II--ENVIRONMENTAL ASS' qMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 II yes, coordina~'e the review process and use the FULL'DAF. [] Yes [] NO B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative d~clar~tion may be superseded by another involved agency. [] Yes [] .o C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Exisling air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aestf~etic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly C3. Vegetation or fauna, fish, shellfish or wddlife species, significant t~abitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain brielly. C6. Long term, snort term, cumulative, or other effects not identified in C1-C57 I~xplain briefly. C7. Other impacts (including changes in use of eHher quantity or type pi energy)? Explain briefly. D. ~S THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each etfect should be assessed in connection with its (a) selling (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessai'7, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show 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 impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determfnation: 2 PROJECT DESCRIPTION Construct a one-family dwelling, sanitary system with retaining wall, well and bluestone (or simi- lar pervious) driveway, all as shown on attached site plan of Peconic Surveyors. Approximately 300 cubic yards of clean fill will be trucked in to raise grades to those shown. To find: Dirt road immediately south of General Wayne Inn. Only determination that house is beyond jurisdiction is requested. If within, please process application. COUNTY OF SUFFOLK ) STATE OF NEW YORK ) En-Consultants, Inc. for Erika Swimmer BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. 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, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. swoRN To BEFORE DAY OF EXAMINED BY KAY M. DOUGHERTY NOTARY PUBLIC, State of New Yo~ No 0~D0,~901601, Suffolk County Term £xp,,~ July 20,/o/FI APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 ·. 14'.1 d-,2 (2,'87]--7c 617.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEQR Purpese: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly. there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or mav be technically e~(pert in environmental analys~s. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potenually- large impact. The form also identifies whether an impact can be m~t~gated or reduced. Part 3: If any impact in Part 2 is id~nufied as potent=ally-large, then Part 3 is used to evaluate whether or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify the Portions of EAF completed for this project: [] Part I [] Part 2 ' []Part 3 Upon review of the information recorded on this EAF (Parts I and 2 and 3 if appropriate), and any other supporting informauon, and considering both the mag~tude and importance of each impact, ~t is reasonabl,/determined by the lead agency that: [] A. The project wd[ not result in any large and important impact(s) and. therefore, is one which will not have a sigmf~cant ~mpact on the environment, therefore a negative declaration will be prepared. [] B. Although the project could have a significant efiect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negalive declaration will be prepared.' [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declarahon is only valid for Unlisted Actions Name oi Actton Name o~ U_,ad ,\gency Print or type Name oi Responsible Officer m Lead Agency Title or [.:e,pons~ble Orucer Srgnatute ot Responsible Of ricer ~n Lead Agency ~iguatureot Prt,parer(Ifddferent lromresponslbleorficet] Date PROJECT DESCRIPTION Construct a one-family dwelling, sanitary system with retaining wall, well and bluestone (or simi- lar pervious) driveway, all as shown on attached site plan of Peconic Surveyors. Approximately 300 cubic yards of clean fill will be trucked in to raise grades to those shown. To find: Dirt road immediately south of General Wayne Inn. 0nly detePmination that house is beyond jurisdiction is requested. If wlthin~ please process application. 5.' Approximate percentage of I prelect site with slopes: 100 % ~10-1596 0~ [~1578 or greater *,6 6. Is orolect substanua[b,' contiguous to. or contain a building, site, or district, listed on the State or the Nation,-, Registers or H~storic Places? F"IYes I~No 7. Is prelect substanoall¥ contiguous to a site listed on the Register of National Natural Landmarks? EYes I~.Nc 8. What is the depth of the water tab[e? 6._9' (in feet)at test hole.. 9. Is site located over a primary, principal, or sole source aquifer? [~Yes [~No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? EYes I~No 11. Does project site contain any species of plant or animal life that is identified as threatened or endangereo; EYes [~No According to Roy L. Hale Identify each species 12. Are there any umque or unusual land forms on the project site? (i.e.. cliffs, dunes, other geological formations [~]Yes ~2~No Describe 13. Is the proiect site presently used by the community or neighborhood as an open space or recreation area; ~]Yes f~No If yes. explain 14. Does the present site include scenic views known to be important to the commumtv? ~Yes ~No 15. Streams within or contiguous to proiect area: a. Name of Stream and name of River to which it is tributary 16. Lakes. ponds, wetland areas within or contiguous to prelect area: a. Name Sandpiper Basin 17 Is the s,te ser;'ed bvTex,sung pubhc uuht~es? fqYes F2]No a) If Yes. does sufficient capaot¥ exist to allow connecUon? b) If Yes. wdl ~mprovements be necessary to allow connection? b. Size (in acresl ~Yes [-'No ~Yes _~No 100+ 18 Is the s~te located in an agrrcuJtura] d,str~ct certified pursuant to Agriculture and ."-tarkets Law. Article 25-AA Section 303 and 304~ ~Yes ~'No 19 I~ the sge located in or substant~alh/ contiguous to a Critical Environmental Area designated pursuant to Article oi the ECL, and 6 NYCRR 6177 ~]Yes [~]No 20. Has the site ever been used for the disposal of solid or hazardous wastes? ~]Yes ~No B. Project Description 1. Physical dimensions and scale of prelect (fiji in dimensions as appropriate] a. Total cont,~uous acreage owned or controlled by project sponsor .85 b. Project acreaqe to be developed: .15 acres imtiall,,,; .3_5 c. Project acreage to remain undeveloped .7 acres. d. Length o1: prelect' in mdes: ~/a (If appropriate) e. If the .orolect is an expansion, red,cate percent of expansion proposed f. Number of o~f-street park,m4 spaces existing 0 · proposed 2 5 h. If res,dL, nt~a[ Number anti type o~ hous,nq umts' One Faro,Iv Two }-amdy Imt,allv Uh.n.~telv ,. D~m~'ns,ons im teetJof larqest proposed structure 35 height; 20 w~dth; j. Linear ieet o~ frontage along a public thorough/are prelect ~,ll occupy acres ultimately. n/a h, tultqfle Farad,; 45 . length. . ft. 3 2. How much natural mater. (i.e.. rock, earth, etc.) will be removed fru~ the site? 0 tons/cubic,,/ards 3. Will disturbed areas be reclaimed? [~Yes [No K'IN/A a. If yes, for what intend__ purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? l-lYes []No c. Will upper subsoil be stockpiled for reclamation? ~]Yes ~]No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? .15 acres. 5. Will any mature forest (over 100 years old) or other locally.important vegetation be removed by this project? I-lYes [~No - - 6. If single phase project: Anticipated period of construction 12 . . months, (including demolition). 7. If multi-phased: n/a a. Total number of phases anticipated . (number). b. Anticipated date of commencement phase I . month ¢. Approximate completion date of final phase . month d. Is phase 1 functionally dependent on subsequent phases? DYes I-1Nc~' 8. Will blasting occur during construct on? [~Yes [~No 0 9. Number of jobs generated: during construction ; after project is complete 10. Number of jobs eliminated by this project 0 11. Will project require relocation of any projects or facdities,~ [~Yes []]No If yes, explain year, (including demolition). year. 12. Is surface liquid waste disposal involved? I-iYes f~No a. If yes, indicate type of waste (sewage. industrial, etc.] and amount b. Name of water body into which effluent wdl be discharged 13. Is subsurface liquid waste disposal involved? OYes DNo Type Sewaqe 14 '.viii surface area of an existing water body increase or decrease by proposal? [-]Yes Explain ~No 15 Is prolect or any port~on of project located m a 100 year flood plain? 16 Will the project generate solid waste? ]~]Yes DNo a. If yes, what is the amount per month · ]- tons b. If yes, will an existing solid waste facility be used? [~:Yes [-1No Southold La~dfill location c. If yes, give name d. W,II any wastes not ~o into a sewage disposal system or into a sanitary landfill? e. If Yes, explain E~Yes I~No Cutchogue E~Yes [~No 17. Will the project involve the disposal of solid waste? a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? _ 1~ Will prolect use herbicides or pesticides? DYes E3Yes ~No tons/month· years. 19 Will project routinely produce odors (more than one hour per day)? ~lYes [~ENo 20 Will project produce operating noise exceedm[~ the local ambient noise levels? r-lYes 21 ~,V~II prolect result in an increase in energy use? [~Yes [~No If yes . indicate type(s) Oil E Electricity 22 If water supply is from wells, indicate pumpm~ capacity 2 gaJJons/mlnute. 23. Total anttc~pated water usage per day 300 gallons/day 24 Does project ,nvolve Local. State or Federal funding? ~Yes [~No If Yes. explain [~No 4 · ,- 2~.'.Approvals Required: Type Submittal Date City.· Town. Village Board [~Yes ~lNo City, Town, Village Planning Board ~]Yes f~No City. Town Zoning Board ~]Yes I-~No City, County Health Department ~Yes Other Local Agenczes [~Yes Othe.~ Regional Agencies [~Yes ~]No State Agencies [~:Yes I~No Federal Agencies I'-[Yes ~]No SCDH-San.sys. & well Trustees DEC~ TW 11/89 11/89 11/89 C. Zoning and Planning Information 1. Does proposed action involve a planning or zomng decision? I-lYes []No _ If Yes, indicate decision required: . ~]zoning amendment f-lzoning variance I~speciaJ use permit [~subdivision I~site plan []new/revision of master plan f~resource management plan I-iother 2. What is the zoning classification{s)of the site? R-40 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 1 one-family dwelling 4. What is the proposed zoning of the site? no c~hange · 5.· What is the maximum potential development of the site if developed as permitted bY the proposed zoning? 1 one-family dwelling 6 Is the proposed actton consistent w,th the recommended uses in adopted local land use plans? []Yes [~,~. 7. What are the predominant land use(s) and zomnq classifications w~thin a ~ rode radius of proposed action? private residences 8. Is the proposed action compatible w,th adjoining/surrounding land uses within a ',~ mile? [~Yes 9. If the proposed action is the subdivision of land. how many lots are proposed? n/a a. What is the mimmum lot size proposed? 10 Will proposed action require any authorization(s) for the formation of sewer or water districts? I-~Yes 11. Will the proposed action create a demand for apy community provided services (recreation, education, pallet fire protectton)? f-~Yes I~No a. If yes, is existing capacity sufficient to handle projected demand? ~]Yes f-lNo 12. Will the proposed acbon result in the generation of traffic sigmficantlv above present levels? I-lYes a. If yes, is the existing road network adequate to handle the additional traffic~ ~]Yes [~]No D. Informational Details Attach any additional information as may be needed to clardv your prelect. If there are or m~ay be any advers, impacts associated w~th your proposal, please discuss such :mpacts and the measures which you propose to m:tigate o avotd them. E. Verification I certHy that the mform.)~t,on pray,dud above. ,s rue to the best of my knowledge Appbcanr$-on*or Name ~ika ~.~]~ner by En-Consultants, Inc. ' ~ 11/15/89 S,%'nature J/~k (~x ~:,q/~,',,o ~'i" President I!th Roy L. Haqe,~ e action is in Ihe Coastal' A~.L and you age a state agency, complete the Coastal Assessment Form before proceeding ~,ilb Ihls assessment. Pa 2--PROJ.'=CT IMPACTS AND T, ~IR MAGNITUDr= Responsibility of Lead Agency General Information [Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations be reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significan~ Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simF asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of. impacts and wherever: possible the threshold magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State ar for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropria for a Potential Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative ar have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each questio · The number of examples per question does not indicate the importance of each question.. · In identifying impacts, consider long term, short term and cumlative effects. Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential size of t~- impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshoi is lower than example, check column 1. d. If reviewer has doubt about size of the impact then consider the impact as potenuaily large and proceed to PART e. If a potentially large impact checked in column 2 can be mitigated by changels) in the project to a small to moderat impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. Th~ fnust be explained in Part IMPACT ON LAND 1. Will the proposed action result in a physical change to the project site? E]NO [~Y£S [,amples that would apply to column 2 · An,/ construction on slopes of 15% or greater. (15 foot rise per 100 foot of length}, or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the ware( table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generaib' within 3 f~et of existing ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfall. · Construction m a designated iJoodway. · Other ~rnpacts 2 Will there be an effect t,....,y u=;.que or unusual land forms round on the site) (i e., chffs, dunes, geological forma[rons, etc.}~NO [~YES · Spec~frc land forms: 6 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [~]Yes r-]No [] [] []Yes I--]No ~ [] ~Yes E3No' [] [] []Yes E3No , I [] [] [~','es []No[ ~ ~ ~Yes ~No ~ ~ ~Yes ~No (VACANT) --~. PHR A D MITES Z (VACANT) · ?OWN OF SOUTHCLD AREA = 36,969 eq. ft. or 0.8487 acres (to t/el~ne) SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE OF REF, NO. APPROVED SURVEY OF PROPERTY AT BAYVIE W TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 090 04 SCALE I'= $0' OCR 25,1989 Non ~ 1989 { revise ) 12 .Y.S. LIC.NO 49668 ~YORS P.C. (5~6) 7'65 - 5020 E O. BOX 909 MAIN ROAD SOUTHOLD, N, Y, U971, LOTNUMBERS REFER TO " MAP OF '* CEDAR BEACH PARK " FILE~DEC. 20 ,1927 IN THE OFFICE OF THE DUFFOLK COUNTY 89 - 388 VACANT) E~ Z z S. LIC,NO.49668 R 0 BOX 90~J'~ _~J N_~ o_AP. AREA = 36,969 sq. fL or 0.8487 acres (to tie //ne ) (VA CANT/ SUFFOLK COUNTY DEPARTMENT OF HEALTH SER. VI~ES FOR APPROVAL OF CONSTRUCTION ONLY SATE OF REF. NO. APPROVED SURVEY OF PROPERTY AT BAYVIE W TOWN OF SOUTHOLD SUFFOLK I000 090 SCALE I"= 30' COUNTY, N.Y. 04 12 OCT, 25, 1988 Nov. 9, 1989 (revise) LOT NUMBERS REFER TO " MAP OF " CEDAR BEACH PARK " FILED DEC. 20 . 1927 IN THE OFFICE OF THE SUFFOLK COUNTY CLERK AS MAP NO. 90 ELEVATIONS ARE REFERENCED TO N.O.V.D. 89 388 LIL 'm ~ ~ Z o 15' (DWELLING) SUFFOLK COUNTY DEPARTMENT OF HEALTH SER. VI~..3 FOR APPROVAL OF CONSTRUCTION ONLY DATE OF REF. NO. (VACANT) APPROVED SURVEY OF PROPERTY AT BAYVIE W TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 ' 090 04 12 SCALE I": 30' OCT. 25, 1989 Nov. 9, 1989 (revise) , ..; ~S. LIC.NO.4966~ , . R O. BOX 909 MAIN ROAD SO~HOLD , N. Y. li971, TOWN OF LOT~UMBERS REFER TO "MAP OF "CEDAR BEACH PAR~" FJLEDDBC. 20 ,t927 IN THE OFFICE OF THE SUFFOLK COUNT CLERK AB MAP NO. 90 ELEVATIO~IS ARE REFERENCED TO 89 - 388. 60 , IROH VACANT) (VACAN?) SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE OF REF. flO. APPROVED SURVEY OF PROPERTY AT BAYVIE W TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 090 04 12 SCALE I"= 30' OCT. 25, 1989 Nov. 9, 1989 (revise) LOT NUMBERS REFER TO "MAP OF "CEDAR BEACH PARK" _ ~.~ - FJLEi:i DEC. 20 , 1927 IN THE OFFICE OF THE SUFFOLK COUN~,~'~ CLERK AE MAP NO, 90 ~[*~1 ~L ~¥ ~ , ' ELSVATION$ ARE REFER~CED TO N.G,V.D. · ~ tf/~ . ~,~ D 89 - 388 VACANT) 4 %..J_. AREA = 36,969 sq. ft. or 0.84~7 acres (to tie line ) SURVEY OF PROPERT~ ~ TOWN OF SOUTHOLD SUFFOLK COUNTY, I000 090 - 04 SCALE I"= 30' OC~ 25, 1989 Nov. 9, 1989 (revise) ARE REFER~CED TO N.6mV.D. UU~~"JJ~'~_ 89 - 388