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Home My WebLink AboutTR-5910Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO .... ~9~0... DATE: ..A.p.~iL.Z[.... ~004 ISSUED TO RICHARD BLAIR Pursuant to the provisions of C:hepter 61S of the I.~ws of the State of New York, 1893; and Chapter 40~ of the L~ws of the State of New York 1952; and the Southold Town Ordinance titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC: LANDS end the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;-?. and in accordance with the Resolution of The Boerd adopted at · meeting held on ~.~..., and in consideration of the sum of $....~.~.~.~.0~.... peld by Richard Blair of Cutchogue N Y. and subject to the of Southeld Town' Trustees authorizes and perm11~ the following: Wetland Permit to install a 4'X40'. fixed pier, 3'X15' ramp, and a 6'X20' float to he accessed by a 3'X16' ramp, and as depicted on the plan prepared by Alpha Consulting last dated. 4/22/04. all in accordance wlth the detai~ecl specifications as presented in the odg'mafing application. IN W~TNESS WHEREOF, The said Board Of Trustees here- ~ causes ifs (~,orposate Seal ~o be affixed, and these..~senfs to sul~se~qoed by ~'majodty of the said Board .as of this dafs. TERIdS and CONDITIONS Richard Blair 900 Mason Dr., .CutchoKue . .... N. ¥~ ~ ~. ~mt d~h Pem~t h' valid for ~ pedod of 24 mos. ~,tdcb Is ~ m be dee for ~m ,'~'~oo m~y be rome to the Bo~d ~ · !~'~, ~ ~. That fl~ l~rmlr ~ould be ~,a i~deflaitely, or ~ loog m' ~ ~he m,~,e or project iavolved, to provide evidence which may 'he mblect to revoke up(m f~ to ~-~--~,, .me. 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) 765-6641 # 0044C At BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE Date July 8, 2005 THIS CERTIFIES thatthe fixed dock, ramp, and floating dock 900 Mason Dr., Cutchogue Suffolk County Tax Map # 104-7-4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 3/31/04 pursuant to which Trustees Permit # 5910 Dated 4/21/04 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a fixed dock, ramp, and floating dock The certificate is issued to aforesaid property. Richard M. Blair Authorized Signature owner of the Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda PegKy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 7~5-1892 Fax (631) 765-1366 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE __ Pre-construction, hay bale line 1st day of construction ¼ constructed ~'"""Project complete, compliance inspection. Albert J. Krupski, President James King, Vice-President Artie Poster Ken Poli~voda 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 April 21, 2004 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Theodore Angell Alpha Consulting P.O. Box 447 Greenport, NY 11944 RE: RICHARD M. BLAIR 900 MASON DR., CUTCHOGUE SCTM#104-7-4 Dear Mr. Angell: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 21,2004 regarding the above matter: WHEREAS, Alpha Consulting on behalf of RICHARD M. BLAIR applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 31, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on April 21,2004, 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 th~ 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 RICHARD M. BLAIR to install a 4'X 40' fixed pier, 3'X 15' ramp, and a 6'X 20' float to be accessed by a 3'X 16' ramp, and as depicted on the plan prepared by Alpha Consulting last dated April 22, 2004. 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: $725.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/Ims Albert J. Krupski, President James King, Vice-President Artie Fester 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 TO: ~iOh(!-t~ m ~.)O-~c Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: ( V~)Application Approved (see below) ( ) Application Denied (see below) ( ) Application Tabled (see below) has been and the 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: bem_~,~ c~-t~u_~-~: ~-'Z~ ~,ed dt)O. ~ ~.~ ~ ~1~0,(~ ~1~ ~ ~q~' ~3.0~ ~ ~I~S,~ TOTAL FEES DUE: $ SIGNED: PRESIDENT, BOARD OF TRUSTEES Telephone (631) 765-1892 Town 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, April 13, 2004, the following recommendation was made: Moved by Don Wilder, seconded by William Cook, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of RICHARD M, BLAIR to install a 4'X 28' fixed pier, 3'X 15' ramp, and 6'X 20' float to be accessed by stairs from grade to 4' level above vegetated areas. Located: 900 Mason Dr., Cutchogue. SCTM#104-7-4 The CAC recommends Approval with the Condition a non-turf buffer is maintained. Vote of Council: Ayes: All Motion Carried ,il ALPHA III CONSULTING PHOTO KEY Looking WEST Looking EAST '~L.A.t t~ '"F~o':F'¢__. c.."F ..~Z Looking SOUTH PO BOX 447 · GREENPORT, NY 11944 · (631) 477-0,4.44 · FAX (63t) 477-3933 ALPHA ~11 CO.SUL~.G SITE PHOTO PO BOX 447, GREENPORT, NY ! 1944~ (631) 477-0444 - FAX (631) 477-3933 ,Il ALPHA ~11 CONSULT~.G SiTE PHOTO PO BOX 447 . GREENPORT, NY 11944 . (631) 477~0444 · FAX (631) 477~3933 aLPHa ~11 CONSvLTING PO BOX ~7, G REENPORT, NY !19~, (63! } 477 04~, FAX (63!) ~77~3933 Itagstrom Map Company Suffolk County Atlas Map #29, L 41o00'43" Lo 72°27'24" ALPHA CONSULTING I { I PO Box447.Greenport, NY 11944 AJbert J. ¥~upski, President James I~ng, Vice-President Artie Foster Ken Poliwoda PegKy A. Dickerson Towu Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (681) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office UseOnly .,.,,~, ..stal Erosion Permit Application Wetland Permit Apphcation ,,-"qvlajor Waiver/Amendmenr/Chanees 2~Cd'eive d Application:~,~l~[~ ~eceived Fee:$ ~Completed Applicadon~ __Incomplete __SEQKA Classification: Type l___.Type II Unlisted Coordmatiom(~ate sent) ~.~GAC Referral ~ent: _~ate of Inspection:~[~L_~~ __Receipt of CAC Report: Lead Agency Determination:__ Technical Review: .~l~rrbli¢ I-Iea~g Held: Resolution: Minor MAR 3 4 Southoid Town Board of Trustees , _ NameofApplicant RICHARD M. BLAIR Address 900 Mason Drive, Cutchogue, New York 11935 Phone Number:( ) (631) 734-7071 Suffolk County Tax Map Number: 1000 - 104-07-004 PropertyLocation:900 Mason Drive, Cutchogue, NY 11935 East of intersection with Haywaters Drive (provide LILCO Pole #, distance to cross streets, ~nd location) AGENT: ALPHA CONSULTING (If applicable) Address: PO Box 447, Greenport NY 11944 Phone: (631) 477-0444 Board of T~ustees Application GENERAL DATA Land Area (in square feet): 2 2,5 51 Area Zoring:. Residential ( ) Previous use of property: Residential Intended use of property: Residential Board of Trustees Prior permits/approvals for site improvements: Agency Date __ 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): Install 4 ' x50' fixed pier, 3'x15' ramp and 6'x20' float to 'be accessed by 3'x16' low incline ramp from existing footpath. 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 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) Southold Town Board of Trustees w being duly sworn, depose and say: ./-I , That on the~ day of ~I~V.~ , 20~, I per. ally p~d the prop~y ~o~ ~ . z by placing the Bo~d of Trustees o~cial poster wher~it c~ easi~be seen, ~d that I have checked to be sure the poster h~ remained in place for eight day~ p6or to thc date of the public he~ng. Date othe~ng noted thereon to bc held ~.. ~ ] Ri, ~ ~ Dated: ~ ~ ~ . '~a~9 Pffi. < Swom to be~re me this C~day of C~200 ~L N~y ]~b~i¢ ' JOYCE M. WlLKINS Notary Public, State of New York No. 4952246, Suffolk County Term Expires June 12, ~ ~) p. 1 Beard of Trustees Appl~catlon 5"a' 4, ',:,. %½ < Richard H. Blair BEINGDULY SWORN DEPOSES AND AFFItUVIS THAT H~/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN .~;UE TRI ~ TO THE BEST OF HIS/HER KNOWLEDGE AND BELII~F, AND I'HAf .M..L WOPdk WI'[.[. BE DONE IN THE MA1NrN-ER 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 TRU bl~ES IqAP. MI .ESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING I~rDER OR BY VIRTUE OF SAID PERMIT(S), I]F GRANTED. IN COMPLETING ISIS APPLICATION. I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGEN'I (S) OR REPRA~SENT.a. IIVFS(S), TO ENq~ER ON'ID MY PROPERTY TO INSPECT THE PRFMISES IN CONJUNCTION WITH REVIEW OF 'iq-liS APPLICATION. SWORN TO BEFORE ME THIS__ DAY OF_~/_[/. 20. O// MONICA I. II~IrARI.ANE State of Neqv ~ 01ldC~5841~ APPLICANT/AGENT/REPRESENTA I'IVE TR_4,NSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics erohibits conflicts oflntere~t on the cart of town officers and emplove~:s. Tr~c oart~se of ~hi~ form is to provid.e_~,forination v,,hich ran alert the town of ~ossible gonflicts ofi~ter~t and allgw it to t~ke whatever action is YOURNAIvlI::: Richard H. glair (Last name, first name, ~niddle initial, tmlass you are applying in the name of ~omerme else or other entity, such as a company. I f so, indicate thc other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) ! ax grievance .... Buitdmg Vanancr truste¢ Change of Zone Coastal Eld, irt: .Approva! of p:at Mooripg Exemption i?om plat or official map Pl~aing (~her (1 f"Othef', n~e the activin,.} WE%LANDS Do you personally (or through your company, spouse, sibling, parent, or child) have a mlatio,ship with any offi~r or ampk,>,:e of the Town of $outhold? "Relationship" includes by bl~ork nlarriage, or hush,ess interest. "Business interest" means a businas,% including a earmership, in v, hich the tou, n officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NC) XX If you ansx~¢red "YES". complete the balance of this form anc~ date and sign where kndk. ated. Name of porson employed DS, the Town of Southold T{tle or position of that Ix:fao, Describe tho relationship between yourself (the applicanrffagent/repmsentativc) and ~h¢ town officer or employee. Either check the appropriate line A) through D) and/or rlescr~be ia the space pru~ ided. The tov. m c~fficet or employee or his or her spouse, sibling, paregL or child is (check all ;hat appl> 1. .... _A) the owner of greater than 5% or' the shares of the corporate stock o£ the (when the applicant is a corporation); ----- B) the legal or 'bensficial owner of any interest th a non-corporate entity (~,h,a th~; applicant is not a corporatmn); _ ___C) an officer, director, parmer, or empthye~ of the applicura; or ..... Dy the acta~t a~plicant. DESCRIPTION OF RELA'I'IONSHIF Form TS; I PrintName_Rie~l:d M. glair Board o~ Trustees Application I, Richard ~I. Blair (print owner of property) Cutehogue, NY ALPHA CONSULTING Southold Board o~ Town Trustees om my behalf. AUTHOI~IZ~'I~ON (where the applicant is not the ow/ler} __residing at 900 >lason D~lve (mailing address) do hereby authorize (Agent) to apply for permit(s) ~rom =he (Owner ' s sigI~ature ) PROJECT ID NUMBEP. PART 1 - PROJECT INFORMATION I. APFLICANT / SPONSOR Richard M. Blair 6t7.20 SEQP. APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSM :-NT FORM 3.PRCJECT LOC~TION: Mu~cipalRy Cut chogue for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME Blair Project cou.~ Suffolk 1 Southold 4. PRECISE LOCATION: S~z'aet addess and Road Intersections. Prominent landrn~{ks etc -or provide ma~ 900 Mason Drive,Cutchogue, New York l1935-Intersect Haywaters Drive SCRIBE PROJE~ BRIEFLY: Install 4'~50' fixed pier, ~'xlS' ramp and 6'x20' float to be accessed 'by a 3'x16'low inclin~ ramp from existing footpath 7. AMOUNT OF LAND AFFECTED: Initially i acres Ultimately i acres B. W~LL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR O~ER RESTRICTIONS? [~es [] NO Il' no, d*scrib* bSe~y: B. WHAT IS PRESENT LAND USS tN VICINITY OF PROJECT? (Chmose as many as apply.) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCy (Fede~aJ, Sate or Local) E~es [] No If yes, list agency name and permR /approvaI: [q~SD'~,C ~ AEOn, 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? []Yes [~[No if yes, list agency name and pecmit I approval: 12. AS A RESULT OF PROPOSED ACT[OR WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? { CERTIFY THAT THE INFORMATION PROVIDED ABOVE JS TRUE TO THE BEST OF MY KNOWLEDGE Applicant $ Sponsor Nam~ .,//~ha Cons~rlting-AGENT Da~:a: 2-27-04 iflhe a/~/(sn is a Costal Area, and you are a state agency, PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 7 ~. APPLICANT 1 SPONSOR Richard M. Blair 3.PROJECT LOC~.T~O N: MunidpalRy Cutchogue SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Appticant or Project Sponsor) 2. PROJECT NA~,fE Blair Project Icou.~ Suffolk PRECISE LOCATION; Street Addess and Road Intersections. Prominent landmarks etc -or orovide mad SEQR 900 Mason Drive,Cutcho~ue, New York !1935-Intersec't Haywaters Drive 5. IS PROPOSED AGTION: ~ New ~] E~pansion [] Mod~cat~on t a~eraiJon DES~IBE PROJECT BRIEFLY: Install 4'~50' fixed pier, ~'x15' ramp and 6'x20' float to be accessed by a 3'x16'low inclin~ ramp from existing footpath 7. AMOUNT OF LANO AFFECTED: inRiaily 1 acres Ultima[ely 1 acres 8. W~LL PROPOSEC ACTION COMPLY WiTH E~ISTi~K~ ZONING OR OTHER RESTRICTIONS? [-~es ~ NO tf ,o, des~be bdefl~ 9. WHAT IS PRESENT ~ND US~ Jh~ VJCJNI~ OF PROJECT? (Ch~se as ~y as apply.) ~Rasiden[ial ~[ndus~aJ ~Co~e~ial ~Agdcul~re ~P~k/Forest/OpenSpace ~O~er (describe) 10. DOES ACTION INVOLVE A P~MIT ~P~OVA~ OR FUNDING, NOW OR UL~L? FROM ANY O~ GOVERNMENTAL AGENCY (Federal. S~te ~r Lo~l) ~es ~N~ If y~, list ageacy name and pe~R / app~va[: 11. DOES A~ ASPECT OF THE ACTION ~VE A CURRE~Y VALID P~1T OR APPROVAL? ~Yes ~o If y~. I~t age~ ~ame and pe~ I spprovai: 12. AS A RESULT OF PROPOSED ACTION ~'ILL ~STING PERMITf APPROVAL REQUIRE MODIFICATION? ~Yes [ CERTI~ THAT THE INFORMATION PROVIDED ABOV~ ~S TRUE TO THE BEST OF MY KNOWLEDGE Appilcant I S~onsor Name ..-A~h_a CTzlting-AGENT Date: 2-27-04 / if the a/c'tion is a Costal Area, and you are a state agency, PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR Richard M. Blair 3.PROJECT LOCATION~ Municipality Cutchogue 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by AppEcant or Project Sponsor) 2. PROJECT NAME Blair Project Coun~ Suffolk SEQR 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmass etc -or orovide mad 900 Mason Drive,Cutchogue, NetWork l~,35-Intersect Haywaters Drive Ia~etsalsled4.;;28s'ta~irsxe3d,P~:{;R3'~5'., ~mp~nd//%~% a'b~/e6'aX2n~'/°rflv°ae;ett~t~n' InRially 1 acres Ultimately 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes [] No If no, describe bdefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~Residential []industrial [~Commercia, ~---]AgricuRure ~'~Park/Forest/OpenSpace [~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal. State or Local) [~es r"~No If yes, list agency name and permit I approval: ~YSD]~C, ACO~ 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~'-'-~Yes ~[No If yes, llst agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION W,LL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ~es ~No [ CERTIFY THAT THE INFORMATION PROVIDED ALCOVE IS TRUE TO THE BEST OF MY KNOWLEDGE If the a,~on is a Costal Area, and you are a state agency, complete the Coastal~ ' Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 if yes, coordinate the review process and use the FULL FAF. B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a cegative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste producfJon or disposal, potential for erosion, drainage or flooding problems? Explain btiefly: C2. Aesthetic, agdoultural, arol~eeological, histodc, or other natural or cultural resources; o~ community o~'~eig~h'l~od~o~'d chamcter~ ~.. plain briefly: Ca. Vegetation or fauna fish shellfish or w~ldhfe ~peo~ee, ~gnificent hah~tat~ or thmateced or endangered species? Explain bnefly C4. A community s ex,sting plans or 9Dais as officially adopted or a ci~ange in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth. subse(~uent development, or Celated aciiviues likely to be indUced by the proposed action? Explain'briefly:' C6. Long term, shod'term, cumulative, or~ther effe~t~ not i~id/~u~e~"i~ c~'-c~' ~tain bd~fly: ' ' ' O. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITIC.~ ENVIRONMENTAL AREA/CFAI? IIf yes, eXF~lain bdefl},: E. iS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If),~es explain'. PART III - DETERMINATION OF SIGNIFICANCE (To be cornpleted by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~deterrninewhetheritissubstantia~~~arge'imp~~anter~therwisesigni~csnt~ Each effect should be assessed in connection with its (a) seffJng (i.e. urban or rural); (b) probability of occurring; (c} duration; (d) irreversibility; (e} geographic scope; and (f) magnitude. If necessary, add attachrnents or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of par[ii was checked yes, the d etermthat[on of signil~cance must evaluate the potential impact of th epropos ed action o n the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or s[gnificant adverse im pacts which MAY occur. Then proceed directly to the FULl FAF 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 actJo~ WILL NOT result in any significant adverse envirnnmeota[ impacts AND provide, on attachments as necessary, [he reasons supper[lng thi~ Name of Lead Agency Date Title of Responsible Officer Prinl or Type Narne of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) TRANSACTIONAL DISCLOSURR FORH The Town o~ S~u~hold's Code of Ethics prohibits c0n{ltcts of interest on the part of town 0f.ficgrs any emplo,y_~s. The purpose of this form is. to provide information ~h-~-~-~ can alert the town of po~'sible conflicts of interest and allow it to take whatever action is necessary ko avoid same. ('bast name, first name, midd.le initi~i, u~iess you are applying in the name oF someone else or other entity, such ~s a company. If so, indicate the ether perso~s or company's name.) · i ... .:. ~ ?..~.:... :. = ...... NATURE OF APPL~CATION~ (Check all that apply.) Tax grievance Variance Change of zone Exemption from plat or official map Other (If "other," name th~ activity.).tL]m.~l~lLJ~.S Do you personally (or through yoa~ company, ~po~e~, sibling, parent, or child} have a relattoneh{p with any officer or employee Of tile Town of Southold? 'Relationship' by blood, marriage, or business interest. interest" means a bunineee, including a partnernhip, in which the to~n officer or employee has even a partial ownership of (or employment by) a corporation in ~hlch the town officer or employee owns more than 5% of the If you anewere~ "~ES,#. complete the balance of ~hls""~'orm and date and sign ~here indicated. Name or person employed by the Town of Southold Title or position o~ that person Describe the relationship between yourself (She applicant) and the town officer or employee. Either check the appropriate line ~) through D) and/or describe in the apace provided. The parent, town of~leer or employee or his er her ~peus~; sibling, or child is (check all that apply}, the owner of grester tha~ ~% of the shares of the corporate stock of the applicant (when the applicant' is a corporatton}~ __B) the legal o.r b~neficial owner of any interest in a noncorporate'entity (when the applicant is not a corporation); .. C) an o~fioer, director, part,er, or employee of the applicant~ or __D) the a~tual applicant, DESCRIPTION OF RELATIONSHIP ~.;. ~ . submitted th~ 'Print name SITE PLAN - .~L,~I~ --~R.~C.'T' APR 2 9 2304 Snuthold Town Bo~rd of Trustees Prepared by: ALPHA Ill CONSULTING Date: 2- SCTM# l-I AYWA.-FE ~. C_oV'E · CROSS SECTION PROJECT DESCRIPTION: Construct a 4'x~O' fixed pier, beginning seaward of the line of wetlands vegetation, a 3'x15' hinged ramp, a 6'x20' float-secured by three (3) 8" float piles. Fixed pier to be accessed from 3'x16'low incline ramp from existing footpath. BLAIR PROJECT Richard Blair, Owner 900 Mason Drive Cutchogue, NY 11935 Prepared by: ALPHA qJ CONSULTING Date: 2-27- Scale: SCTM# 10oo- 1o4- P. Evts, g~, '. 4 'Zz.' o4 SITE PLAN -" .1E>L~,I Y-.. ~~C'T' ~ ~, ~t~.~pm:~J~1 ,11 Prepared by,' ALPHA qJ CONSULTING Date: Scale: J #= ~:}0! SCTM~ Ioo6- , ~ AYWA.-TF_ t~ .CROSS SECTION PROJECT DESCRIPTION: Construct a 4'x~O' fixed pier, beginning seaward of the line of wetlands vegetation, a 3'x15' hinged ramp, a-6'x20' float'secured by three (3) 8" float piles. Fixed pier to 'be accessed from 3'x16'low incline ramp from existing footpath. BLAIR PROJECT Richard Blair, Owner 900 ~ason Drive Cutchogue, NY 11935 ,il Prepared by: ALPHA qJ CONSULTING Date: 2-27-c~ Scale: SCTM# lC, mC:, - lo4- SITE PLAN --. ,'E>LAI Y-. ~O:'-'-'-'-'-'-'-'-'~C~ ,il Prepared by: ALPHA ql CONSULTING Date: Scale: SCTM# IOoo - I o,~- o7 -DcM f-4 AYWA.TE P-. · CROSS SECTION PROJECT DESCRIPTION: Construct a 4'x~0' fixed pier, beginning seaward of the line of wetlands vegetation, a 3'x15' hinged ramp, a 6'x20' float secured 'by three (3) 8" float piles. Fixed pier to be accessed from 3'x16'low incline ramp from existing footpath. Prepared by: ALPHA ~lJ CONSULTING Date: 2 -27'- Scale: SCTM# BLAIR PROJECT Richard Blair, Owner 900 Mason Drive Cutchogue, N-Y 11935 MASON Et. 6 ~.~ c,o~c.~ ~ --38 6'-- EL 6 ~ CHAIN LINK FENCE DRIVE \ FLOOD ZONE AE EL 8 WETLANDS DELIN~AFED BY EN--CONSULTANTS ', ON MARCH 26, 2002 $ 7.743'41~.'~ 'i824' S 7g'26'45"W~ 16.55' HAYWATER COVE DESCRIBED PROPERTY ;UTCHOGUE, TOWN OF SOUTHOLD SUFFOLK COUNTY,' N.Y. SURVEYED FOR: RICHARD M. BLAIR, JR. GUARANTEED TO: R~CHARD M. BLAIR, JR. F~DELIF7 NATIONAL TITLE INSC. CO. WASHINGTON MUTUAL HOME LOANS, INC. TM# 1000-104-07-004 ELEVA DON9 SHOWN ARE IN 1929 NCVD FLOOD ZONE DATA IS FROM MAP NUMBER J610JCOI64 G, EFFECTIVE DATE MAY 4, 1998 PANEL 164 OF 1026. FOR SCDH5 USE ONLY TEST HOLE DUG BY McDONALD OEOSCIENCE ON 11 APRIL 02 ORIGINAL GROUND BROWN LOAMY SAND SM PALE BROWN FINE TO MEDIUM SAND SP __ 6 2' (WATER.) WA TER IN PALE BROWN FINE TO MEDIUM SAND SP I lJ' I. 12 Apr 02 ADD FLOOD ZONE, ELEVATIONS, WETLANDS. SURVEYED: 26 MARCH 2001 SCALE I"= 40' AREA = 22,550.86 S.F. OR 0.518 ACRES