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Home My WebLink AboutTR-5998Albert J. I~upski, President James Kin~, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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 ~ constructed Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO...~ ... DATE: ...S..~'~'....~.~.~.....2.004 ISSUED TO ROBERT KELLER Pursuant to the provlsion~ 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 To~n Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUC]IONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL. OR OTHER MATERIALS.EJLOM LANDS UNDER TOWN WATERS:?. and in accordance with the Resolution of The Board adopted at a meeting held on ~.~:~..,~.~ .... ~0.~?......, and in consideration of the sum of $.. ~.~.~.,..g.~ ...... paid by Ro bcJtt K~l~r Terms and Conditions listed on the reverse side hereof, of Sc~uthold Town Trustees authorizes and permits the faJlowJna~ Wetland Permit to construct ~n mt~hed g~mge/~ddition with porch ~nd decking, oonstr~¢t ~n ~tt~ched second-stow ~dditJon to the existing dwelling, 8nd to remove/tapioca ~he existing gr~vel driveway, with the condition drywells Bnd guttem ~re Jnet3fled to ~on~in the roof run-cfi Bnd 3 line of hey b~les is placed down before the project begins, 8nd ell 85 depicted on the survey p~ep~red by Joseph A. Ingegno lest d~ted Msrch 24.2005. ali in accordance with the detai~ed specifications es presented in · the originating application. IN WITNESS WHEREOF, The ~ald Board Of Trustees here- by causes its Corporate Seal to be affixed, and t~ese.~.resenh; to be subserlbed by a 'majority of the said Board as of this darn. .lames K±ng TERIdS and CONDITIONS ~ ~c 380. Knoll Circle, East Marion ...... N. ¥~ ~ ~u~- of the con~deratlon fo~ the /s~uance of d~e p,.~m~< do~ undecstancl a~l p~ ~o the roi- 1. ~ the ~ .~tt'd o~ Tt'u.~e~ smd the Town ~ ,%ud~old ate relea.~d from any and all dam~e~ o~ .4.~ f~ dam~ of s~ ~ d~cdy ~ indite~y a~ ,, ~ of any ope~- ~ respect ~eteto, to-~e~c~ p~e~e ,~,'lmlon of ~e ~ of T ~r~.__~e~._ of the T°wn of ~ Z. That this ~ l~'valld for n 1,,~I,.,4 of .24 mo~ ~l~k b c~ m I~ ~ · '~,-.ted ~ne'vezluked to complete the ~ tnwlved, lint dmald tlrcumstances wat~m', tec~est ~or an ~.,~,-~tlon .may be made to tt~e ~ at a ~,~'? dltte. B. That this Permit should be retained indefinitely, or ts long ns f~e sam Petmlttee wishes to' m~;,',ta.ln tb~ stmct~e or project involved, to provide evidence to znyone concerned chat ttud~- 4. That the work/nvolved will be subject to t~e ~ md approval of dm Bo~d its agent~, and nm~-compfl-,,,',- with d~e provisions of d~e orlgi,~,~g application, nay be cause tevocatlon of tbls Permit by resolution of the mid ~ 5. Thtt there will be no untes~on~le interference with nav~iotx ts · remlt of the w~k up0n due notk~ to mnove or alter d~ wink or project Im-~ s~,t.d ~Mmut etl~n~ to the Town Ii. ThatthesaldBoatdwtllbenotlfiedbythePem~tteeot~O~Metioa~fthewc~au~. pkmentat to _d,i_, permit ~4flc~ may he subject to revoke upon f..-~ to ohttin san~ Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 September 22, 2004 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Bruce Anderson Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932 RE: ROBERT KELLER 380 KNOLL CIRCLE, EAST MARION SCTM#37-5-11 Dear Mr. Anderson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, September 22, 2004 regarding the above matter: WHEREAS, Suffolk Environmental Consulting, Inc. on behalf of ROBERT KELLER 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 August 6, 2004, 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 September 22, 2004, 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, 2 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 ROBERT KELLER to construct an attached garage/addition with porch and decking, construct an attached second-story addition to the existing dwelling, and to remove/replace the existing gravel driveway, with the condition drywells and gutters are installed to contain the roof run-off and a line of hay bales is placed down before the project begins, and all as depicted on the survey prepared by Joseph A. Ingegno last dated March 24, 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:S100.00 Very truly yours, Albert J. Krupski, Jr., President Board of Trustees AJK/Ims Albert d. 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 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated reviewed by this Board at the regular meeting of q following action was taken: has been and the ( '~')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: TOTAL FEES DUE: $ ~,L~ SIGNED: PRESIDENT, BOARD OF TRUSTEES /-7,/T)¢.,/./o ~' ]/,'y Pa; ~ ~ l R ~/le~ A~'ra 1¢ ,~5 o Telephone (631) 765-1892 To v,~n Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, September 14, 2004, the following recommendation was made: Moved by William Cook, seconded by Don Wilder it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit application of ROBERT KELLER to construct an attached garage/addition with porch and decking, construct an attached second-story addition to the existing dwelling, and to remove/replace the existing gravel driveway. Located: 380 Knoll Circle, East Marion. SCTM#37-5-11 Vote of Council: Ayes: All Motion Carried SURVEY OF l,O'F$ 25 &' 26 M'AP OF CARD NI:,R _. BAY £( 7,03, TP/O FILE No. 275 FILED SEPTEMBER 23, t927 ~ ITL A T£'D A T E..\.~ ~I MAR[ON TOWN OF' SOUTHOLD SUFFOLK COUNTY. NEW YORK S.C. TAX No. 1000-37-05_ SCALE 1"=20' DECEMBER 31, 1998 AREA = 11,574.20 sq. ft. NOI'_~S: ,'o r~£ uN[. 0.266 ac. 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 EXISTING ELEVATIONS ARE SHOWN THUS:L- EXISTING CONTOUR LINES ARE SHOWN THUS: DATUM ~.0¢'05t~ lO DIA. x &' ~;~t~' ~_ CONNECT ~WIN~ TO I:~¥~_LL APPROVED BY BOARD OF TRUSTEES TOWN OF $OUTHOLD DATE 'RT/FIED TO: Joseph A Ingegno OF NEW YORK ROBERT KELLER .... BARBARA KELLER PREPARED IN ACCOROANCE WITH THE MINIMU~ STANDARDS FOR TffL~ SURVEYS A~ ESTABLISHED ~Y TH[ L.I.A.L.S. AND APPROVED AND ADC~T~D FOR SUCH USE BY T~[ NEW Y Land Surveyor ONE (631)727-2090 Fax (631)v2v-172v '\ 6 Albert J. Krupski, President James King, Vice-President Peggy A. Dickerson Artie Foster Ken Poliwoda 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/Amen~d~.ent/~hanges /Received Application.glbl ~,,'keceived Fee:~ /Completed Application~ - Incomplete SEQRA Classification: Type I Type II Unlisted Coordination: (dat~ ~CAC Referral Sent: w--Date of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: ~-- Public Hearing Held: Resolution: Name of Applicant Robert Keller Address 11 Moffitt Boulevard; ILm~ Shore~ NX 11706. Phone Number(631) 666.- 9200 Suffolk County Tax Map Number: 1000 - 037 - 05 - 011 Property Location: 380 Knoll Circle; East M arion~ NX (provide LILCO Pole #, distance to cross AGENT: Suffolk Env£ronment~l Consultingt Address: P.O. RoX 2003 Brid~eh~tont Phone Number: (631) 537-5160 Fax:(631) streets, and location) Inc. N~ 11932 537-5198 Boa~rd of Trustees Application GENERAL DATA Land Area ( in square feet) : 11~ 574.20 s~are feet Area Zoning: Previous use of property: Private single famil~ dwellin~ Intended use of property: Private single fl--~lx dwelling ac~d/t£onal a~uztenmnces. Prior permits/approvals for site improvements: Agency Town of SoutholdB~ard of Trustees Wetlands (No. 4994) Date Max 26f 1999 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary) Applicant proposes to construct the following: (1) Attached Garage/Addition (w/porch & decking) situated off the northern side of the existing dwelling, measuring 855.0 square feet * ("/ootpr/n;"); (2) Attaehed 2nd Story Addition situated off the northwestern side of the existing dwelling, measuring 72.0 square feet ±; (3) Removal of the exJotJn9 graYel drfvowa¥ situated within the northeastern seetion ofsubjeet property; and (4) Installation of a roplacomeflt gravol driveway situated within the northern section of subject driveway. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Construct various additions existing dwelling thereon; Area of wetlands on lot: Percent coverage of lot: (including porches & deck) to the replace the existing gravel driveway. 250.0 ± square feet 2.16 -+ % Closest distance between nearest existing structure and upland edge of wetlands: 15.5' ± (wood planter); 22.0' ± (house) Closest distance between nearest proposed structure and upland edge of wetlands: 32.0' ± feet Does the project involve excavation or filling: X No Yes If 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: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be 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): Due to the location of the proposed improvements landward of the existing structures thereon, no negative impact to the environmental condition of the wetlands are anticipated due to_ the existing structures not resulting in any impact to said wetlands. Board of Trustees Application COASTAL EROSION APPLICATION DATA N/A Purpose of Proposed Activity: Are wetlands present within No Yes If Yes, how much material will be excavated? How much material will be filled? 75 feet of the proposed activity? (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) 4 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095Route 25 P.O. Box 1179 '" Southold, New York 11971-0959 Telephone~,631) 765-1892 Fax!631 765-1366 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD Da the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, Diane K. Wassick , residing at Newman Village; Bridgehampton, New York 11932 Main Street, Ste E; Bridgeha~ being duly sxvom, depose and say: That on the 10 day of Sept. ,2004, I personally posted the property known as 380 Knoll Circle; East Marion/ SCTM~ 1000-0J7-05-011 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 {~l~d.,,~Ot. ~,~. i~ ° . Dated: (sig aS5r e) .... Sworn to b~efore me this Z?day200;/ Matthew O. Ivans Notary Public oi New Yorl[ No. 011V6053859 OualiheO in Suftolk Coonty Commission Expires January 22, 20~7 Name: Barton C. Johnson: Gardiner~ Bay Estates: Joan Egan: OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: 29 Oscaleta Road; P.O. Box 175; South Salem, NY 10590-0175 SCTM #: 1000 - 037 - 05 - 010 P.O. Box4; East Marion, NY 11939 SCTM #: 1000 - 037 - 05 - 019 & 1000 - 03l - 06 - 009) P.O. Box 777; East Marion, NY 11939 SCTM #: 1000 - 037 - 05 - 012 STATE OF NEW YORK COUNTY OF NEW YORK Diane K. Wassick- Suffolk Environmental Consulting~ Inc.,residing at Newman Village; Main Street; Bri~geha~?ton~ NY , being duly sworn deposes and says that on the 10th day of September, 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 ~6~7~- , 2004 ~otary Public Matthew O. Ivans ~lotery Put~[[c o! New YoI~ No. 011V6053859 Quatilied in Su!!o~k County ~,ommission Expires January 22, NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SCTM # 1000 - 037 - 05 - 011 YOU ARE HEREBY GIVEN NOTICE: 1. That is the intention of the undersigned to request a Permit from the Board of Trustees to: Applicant proposes to construct the following: (I) A~ched Garage/Addition (w/porch & decking) situated off the northern side of the existing dwelling, measuring 855.0 square feet + (~footprint'); (2)Attached 2no Stor~ Addition situated off the northwestern side of the existing dwelling, measuring 72.0 square feet ±; (3) Removal of the existing gravel driveway situated within the northeastern seetion of subjeet property; and (4) Installation of a replacmsmnt gravel driveway situated within the northern seetion of subjeet driveway. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 380 Knoll Circle; East Marion; Town of 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: MAILING ADDRESS: PHONE # : Robert Keller 11 Moffitt Boulevard; Ba~ Shore~ NX 11706 Enc.: Copy of sketch or plan showing proposal for your convenience. 5 Name: Barton C. Johnson: Gardiners Bay Estates: Joan Egan: PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: 29 Oscaleta Road; P.O. Box 175; South Salem, NY I0590-0175 SCTM #: 1000 - 037 - 05 - 010 P.O. Box 4; East Marion, NY 11939 SCTM #: 1000 - 037 - 05 - 019 & 1000 - 031 - 06 - 009) P.O. Box 777; East Marion, NY 11939 SCTM #: 1000-037-05 - 012 STATE OF NEW YORK COUNTY OF NEW YORK Matt D. Ivans - Suffolk Envirormaental Consultin~ Inc.,residing at Newman Village; Main Street; Brid~eba-~ton~ ~ , 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 , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this day of , 2004 Notary Public Board of Trustees Application County of Suffolk ) State of New York ) ROBERT KELLER 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, l 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. SWORN BEFORE ME THIS ] Nancy Maggio I Notary Publlo, State of New Yo~ I Registration ~PO1MA6037227 I Qualified In Suffolk County [ My'Commission Expires Feb. 14, Signature - DAY 0F3- {_2004 Board of Trustees Application AUTHORIZATION (where applicant is not the owner) I, ROBERT KELLER residing at 11 MOFFITT BOULEVARDi BAY SHORE, NEW YORK, do hereby authorize Suffolk Environmental Consulting, I~. to apply for (Agent) permit(s) bom the Southold Board of Trustees on my behalf. ~(~Owner s signature) 14-16~t (9/95)-Text 12 PROJECT i.D. NUMBER 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only SEQR PART 1- PROJECT INFORMATION (To be completed by Applicant or ProJect sponsor) I. APPLICANT/SPONSOR 2, PROJECT NAME Suffolk Environmental Consultin[~, Inc. KELLER 3. PROJECT LOCATION: Municipality Southold County Suffolk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc. or provide map) 380 Knoll Circle, East Marion, New York 5. IS PROPOSED ACTION: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Please refer to the attached Project Description. 7, AMOUNT OF LAND EFFECTED: Initially 0.0tS acres UI0mately 0.018 acres WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [~Residential []Industrial []Commercial []Agriculture []Park/Forest/Open space r~other Describe: Single family dwellings. 10. 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 agency(s) and permit/approvals New York State Department of Environmental Conservation Tidal Wetlands 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 PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes [] No I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Bruce A. Anderson, Suffolk Environmental Consulting, Inc. Date: Signature: ~ / J~- -- 8/4/2004 If the ac'don is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART it- ENVIRONMENTAL ASSESSMENT (To be completed by A~]ency) DOES ACTION EXCEED ANY TYPE ~ THRESHOLD IN 6 NYCRR, PART 617.127 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 declaration may be superseded by another involved agency. [] Yes [] No (~. COULD ACTION RESULT tN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quatity, surface or groundwater quality, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? E~plain briefly: C2. Aesthetic, agricultural, archeological, historical or other naturai or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitat, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or change in use or intensity of use of land or natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, sho~t term, cumulative, or other effects not identified in C1-C57 Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN ~MPACT ON THE ENVIRONMENTAL CHARACTERiSTiCS THAT CAUSED THE ESTABLISHMENT OF A CEA? []Yes []No D. IS THERE, OR iS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] NO If yes, explain briefly PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect idenl~f~ed above, det~mine whether it is substantial, large, important, or otherwise significant. Each effect should be assessed in connec§on with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irroversibility; (e) geographic scope; and (f) magnitude. If necessa~, add attachments or reference supporting materials. Ensure that explonatioos contain sufficient detail to show that all relevant adverse impacts have bean identif~l and adequately addressed, if question D of Part II was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. [] Check this box if yon have identified one or more pctenfielly large er significant adverse impacts which MAY occur. Then preceed directly to the FULL EAF and/or prepare a positive declaration. [] Check this box if you have determined, based on the information and anatysis abo~e and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessapJ, 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) Date 2 Project Description concerning the KELLER Property Situate: 380 Knoll Circle; East Marion; Town of Southold, NY SCTM #: 1000- 037- 05 - 011 Applicant proposes to construct various additions to the existing dwelling within subject property. Applicant proposes to construct the following: O) Attached Garage/Addition (w/porch & decking) situated off the northern side of the existing dwelling, measuring 855.0 square feet :1: ("footprint"); (2) Attached 2nd Story Addition situated off the northwestern side of the existing dwelling, measuring 72.0 square feet ~:; (3) Removal of the existing gravel driveway situated within the northeastern section of subject property; and (4) Installation of a replacement gravel driveway situated within the northern section of subject driveway. Suffolk Environmental Consulting, Inc. Newman Village. Main Street, EO. Box 2003, Bridgehampton. New York 11932-2003 16311537-5160 Fax: (631 ~ 537-5198 Bruce Anderson, M.S.. President August 4, 2004 Mr. Albert J. Krupski, President Town Hall 53095 Main Road P.O. Box l 179 Southold, NY 11971 Re,' Situate: SCTM #: KELLER Property 380 Knoll Circle East Marion; Town of Southold, NY 1000 - 037 - 05 - 011 Dear Mr. Krupski, This Firm represents Robert Keller who is seeking improvemems to the above referenced property. In order to do so, a Wetland Permit fi.om your Board is required. Enclosed herewith please find a completed Wetland Permit Application. Application coments are as follows: (1) Town of Southold Trustees Wetlands Permit Application: (2) Short Environmental Assessment Form; (3) Photographs of subject property, indicating the location of all existing and proposed structures, and the location of the wetlands thereon; (4) Location Map for easy reference (two [2] copies); (5) Survey prepared by Joseph A. In~.legno, L.$., last revised on June 2, 2004, indicating all existing and proposed structures, and wetlands (two [2] surveys); and (6) Check made payable to the Town of Soutbold in the amount of $200.00 covering the requisite application fee. Hammarth/ 2 By way of this correspondence, and on behalf of Mr. Keller, I request that you commence review of this application. 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. lvans enc. cc: R. KeHer