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HomeMy WebLinkAboutTR-4493Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 4~93 DATE: ... J~nl¥ 28, 1995 ISSUED TO .... Me, zT~in ~.,. B.ar~,c~oft, ~r .... Authorization 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; end the Southotd 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 19 c)~, and in consideration of the sum of $ !$0.00 paid by of N.Y. end subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: to enlarge/enhance an existing freshwater pond in width with a 25' buffer on the Nortl~_side of the pond. all in accordance with the deteiJed specifications as presented in the originating application. by IN WITNESS WHEREOF, The said Board of Trustees here- ceuses its Corporate Seal to be affixed, and these presents to subscribed by a majority of the said Board as of this date. :::::::::::::::::::::::: Trmtees Albert J. Kmpski, President John Holzapfel, Vice President William G. AIbertson Martin H. Gan'ell Peter Wenczcl BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 Office Use Only Coastal Erosion Permit Application ~-Wetland Permit Application Grandfather Permit Application Trustee Lands Permit Application Waiver _~_Recei~ved Applicat~o~:~/~/~' ~Clerical Review: Completed Applica~io~ Incomplete TOWN OF SOUTHO/[; SEQRA_Classification: Type Ix Type II Unlisted ~_Coordination:(dat~.eDt)~7~'~-~ '~ CAC Referral Sent: ~/~/~' ~ ' ~--Date of Inspection: [' ~q~/~ Y-'-Receipt of CAC Report:(~ate7 TLead Agency Determination; echnical Review:(date) Public Hearing:(datek --'Decision: Approved ~_~N~ (date) ~'Application Fee:$/~. ' Name of Applicant~l~ Address ~b~ ~\ Suffolk County Tax Map Number: 1000 Prop~y Loo at ionfi_~Cc3 ¢.,~ I~LN 1 . ~, (provide LILCO Pole #, distance to cross streets, and location) Agent: (If applicable.) Address: Phone: Bud of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: 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? Yes If yes, provide explanation: Project Description (use attachments if necessary): ~.~j Bo, of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:~'~ ) Area of wetlands on lot: Percent coverage of lot: square feet Closest distance between nearest existing structure and upland edge of wetlands: ~)Oo(~). feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ ~ ~ feet the project involve excavation or filling? ~00~ cubic yards cubic yards / Does No ~/~es If yes, how much material will be excavated? How much material will be filled? ~ Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations:A~ ~ Manner in which material will be removed or deposited: Statement o~ tAe e~ect, &~ an~, o~ tAe ~etla~s a~ ti~al waters of the town that may result by reason os such proposed operations (use attac~ents if appropriate): B~ of Trustees ApplicationO County of Suffolk State of New York 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 UN'DER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS Signature Notary Public PECONIC WELL & PUMP, INC. TEST HOLE RESULTS FOR NORTHEAST CORNER OF POND WERE RECORDED AS FOLLOWS: 0 3 feet - Dark brown coarse sand and gravel. 3 - 8 feet - Dark green clay and bog. 8 -12 feet - Coarse pale sand and gravel. 12-20 feet - Medium brown sand and gravel. GROUND WATER AT 3 FEET New York State Department of Environmental Conservatio~'~ Building 40. SUNY, Stony Brook, Now York 11790-2356 Phone (516) ~ 0365 Fax # (516) J~ne 27, 1995 Mr. Martin J. Bancroft, Jr. 1411 York Avenue, New York, NY 10021 RE: NYSDEC App. $1-4738-01137/00001-0 Narrow River Road - Platt Road, Orient, NY Dear Mr. Bancroft: The Town of Southold Board of Trustees has requested and been granted lead agency status on this matter. Please contact the lead agency, if you have not already done so, to learn what needs to be done to satisfy the SEQR requirements on this matter. When the lead agency has provided this office with a final determination, the DEC will resume processing of this application. Thank you for your cooperation. Very truly yours, ROBERT N. THURBER Environmental Analyst RNT/ls cc: Town of Southold Board of Trustees Albert I. Krupski, President John Hohapfel, Vice President William G. Albertson Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 28, 1995 Martin J. Bancroft, 1411 York Ave. 5A New York, NY 10021 Jr. Re: Martin Bancroft SCTM # 27-2-2.3 Dear Mr. Bancroft: The following action was taken by the Board of Town Trustees during its regular meeting held on July 27, 1995 regarding the above matter: WHEREAS, applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 9, 1995, and, WHEREAS, said application was referred to the Southold Town Conservation Advisor~. Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on July 27, 1995, at which time all interested persons were given an oppor~m~ty to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, W/~m~S, the Board has considered all the testimony and documentation submitted concerning this application, add, WHEREAS, the structure complies with the standard set forth in Chapter 37-18 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approves the application of MARTIN J. BANCROFT, JR. to enlarge/enhance an existing ~_ freshwater pond in width with a 25' buffer on the Nort~s-~ae of the pond. Located Platt Road, Orient. Permit to construct project will expire two years from the date it is signed if not started. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. FEES: None. Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees A K/jmU cc: CAC Bldg. Dept. Albert J. Krupsld, President John Hohapfel, Vice President William G. Albertson Martin H. Gan:ell Peter Wenczel Town Hail 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD S.E.Q.R.A. NEGATIV~ DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON T-w. ENVIRONMENT APPLICATION NO. 1000-27-2-2.3 NAME: MARTIN J. BANCROFT DATE: June 29, 1995 Chapt. 97 - Wetlands Chapt. 37 - Coastal Erosion 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: Type: I DESCRIPTION OF ACTION: Applicant requests permit to enlarge and enhance an existing freshwater pond in width. LOCATION: SCTM %1000-27-2-2.3 REASONS SUPPORTING THIS Dm£~/NATION: 1. An on Site inspection has been conducted by the Board of Trustees. 2. An environmental assessment, submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as pln-ned. cc. CAC DEC June 21, 1995 1 to construct 95~ x 3~ fixed dock; 15' x 3' ramp; 6~ x 201 float. No dredging or filling. The CAC recommends approval of the project but not the scope of the plans. The length of the catwalk is an excessive intrusion. The Council recommends the catwalk be shortened, but, cannot determine the length because there are no accurate soundings. The CAC suggests the Bay Constable do soundings to determine a proper length. The CAC also recommend the width of the catwalk be held to 31 as shown on the plans. Also the Council suggests that a 10' non-turf buffer be installed. Indian Neck Road, Peconlc Vote of Council: Ayes: All Motion carried. No. 1273 Moved by Bruce Loucka, seconded by John Hagerty, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH STIPULATIONS of the Wetland Application of BORIS GRZIC 50-2-19 to construct a one family dwelling, decks, sanitary system, bluestone (or similar pervious) driveway, all landward of crest of bluff. Construct a series of platforms and ~,' wide stairs above, at and below crest of bluff for pedestrian access to beach. The CAC recommends approval with the following stipulations: 1. Keep all construction, including septic system, over 100~ landward of the Coastal Erosion Hazard Line. (Stairs excluded) 2. Be sure the stairs end at the toe of the bluff. 3. Elevate stairs 3~ above the slope of the bluff. Sound View Avenue, Southold Vote of Council: Ayes: All Motion carried. No. 127~, Moved by Stephen Angell, seconded by Allan Connell, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH STIPULATIONS of the Wetland Application of WILLIAM ar:AL OR PAUL CACIOPPO 116-3-18 to build a single family dwelling. The CAC recommends approval wlth the stipulation that there be NO DISTURBANCE OF A 50~ BUFFER FROM THE WETLAND LINE and that hay bales and silt fence be used landward of the buffer at the toe of the fill line during construction. New Suffolk Avenue, New Suffolk Vote of Council: Ayes: All Motion carried. No. 1275 Moved by Bruce Loucka, seconded by Allan Connell, it was RESOLVED to recommend to the Southold Town Board of Trustees APPI~OVAL of the Wetland Application of II&RRTIN J. BANCROFT. JR. 27-2-2.3 to enlarge/enhance existing freshwater pond (only in width) to 300~ x 2~0~ from June 21, 1995 300~ x 100~. New pond to be connected to old pond (on northern edge), connector, with a ~,0' berm in the middle as shown on submitted plans. Narrow River Road and Platt Road, Orient Vote of Council: Ayes: All Motion carried. 20~ No. 1276 Moved by Bruce Loucka, seconded by Stephen Angell, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH CONDITIONS of the Wetland Application of DAVID CICHANOWlCZ 66-3-16 to construct a fixed open walkway 3~ x 35'; hinged ramp 3~ x 16'; two floating docks, each 6~ x 20'; and install three 2-pile dolphins to secure floating docks. The CAC recommends approval provided that application reduce the project to ONLY ONE 6' x 20~ FLOAT. Also the catwalk should be 3' wide and elevated to 3' above the grade. Vote of Council: Ayes: All Motion carried. RECOMMENDATION OF AMENDMENTS A-15 Moved by Stephen Angell, seconded by Betty Wells, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Amendment Request of RICHARD MAUTNER 53-~-12 to construct a 20~ x 35' deck addition to existing home. The Council recommends disapproval of this as an amendment. The project does not amend and is out of the scope of the permit issued. The Council recommends that the Trustees require that Mr. Mautner apply for a permit for the deck. The CAC would recommend approval for that permit. 2055 Bayshore Road, Greenport Vote of Council: Ayes: All Motion carried. STATE OF NEW YORK DEPARTMENT OF STATE ALBANY, NY 12231-0001 .TOWN OF SOUTHOLD ALEXANDER F. TREADWELL SECRETARY OF STATE J~e13,1~5 Mr. Albert J. Krupski, Jr., President Board of Town Trustees Town Hall P.O. Box 1179 Southold, New York 11971 Re: Lead Agency Coordination Request for Proposal by Martin Bancroft, Jr., Narrow River Road, Orient, (Tax Map #1000-27-2-2.3). Dear Mr. Krupski: Thank you for submitting the above mentioned Lead Agency Coordination Request to the Department of State (DOS). From review of the submitted information, it appears that the proposed project may be adjacent to the designated Long Beach Bay Significant Coastal Fish and Wildlife Habitat. We have attached a copy of the habitat narrative for your use during the review of the proposed project. Please note that DOS does not Ob'lect to Southold Town Trustees assuming Lead Agency status. If durin~ the course of your review it is determined that a federal permit or federal fund'mg is required for any portion of the proposed project, please instruct the applicant to submit a Federal Consistency Assessment Form (FCAF) and supporting information to the U.S. ACOE/NY with a copy to Ms. Diana Boos at the Department of State. Upon receipt, we will determine if the submitted information is adequate to commence a formal review of the project. If you have any questions, do not hesitate to call me at (518) 474-6000. Sincerely, /' Walter F: Meyer Coastal Resources Specialist Consistency Review Unit Division of Coastal Resources Attachment c. U.S. ACOE/NY - Sophie Ettinger Martin J. Bancroft, Jr., 1411 York Ave., 5A, New York, NY 10021 file COASTAL FISH & WILDLIFE HABITAT RATING F0i Na~e of Area: Long Beach Bay County (les): Suffolk Town(s): Southold 7.5' Quadrangle(s): Orient, NY-CT (is) (R) (~s:u~) Individual Replace- Final Score ability Score ECOSY~ RARITY (ER): Large undisturbed coastal wetland and beach ecosystem, ra~e in New ~Y~rk State. 64 x 1.2 = 76.8 -~SCIES ~UL~EI~J~ILITY (SV): 33 x 1.2 = 39.6 Osprey (T) and d~---ndbeck terrapin (SC); additive division: 25 + 16/2 = 33. tg~2qN USE (HU): 27 x 1.2 Commercial shellfiahing area of significance in the northeast region of the United States. Various fish and wildlife recreational activities including c~-"-.ing are important to Suffolk County residentsI additive division: 25 + 4/2 = 27° POPULATION LEVEL (PL): Number of nesting osprey is unusual in the State. Concentrations of scallops unusual in northeastern United States. = 32.4 25 x 1.2 = 30.0 REPLACEABILITY (R): Irreplaceable 1.2 [(ERxR) + (SVxR) + (HUxR) + (PLxR)] SIGNIFICANCE = = 178.8 ***SIGNIFICANT COASTAL FISH AND WILDLIFE HABITAT*** PROJECT DESCRIPTION LONG BEACH BAY LOCATION AND DESCRIPTION OF HABITAT: Long Beach Bay is located on the northeastern fork of Long Island, one mile east of the hamlet of Orient, in the Town of Southold, Suffolk County (7.5' Quadrangle: Orient, N.Y.-Conn.). This approximately 1,300 acre habitat includes Long Beach Bay the adjacent tidal salt marsh areas, and Orient Beach State Park, which is comprised of a long, narrow, sand peninsula protecting the bay area. Most of the open water area of Long Beach Bay is less than 6 feet deep at mean low water. FISH A}~ WILDLIFE VALUES: Long Beach Bay and Orient Point Marshes comprise a large and relatively undisturbed coastal estuarine ecosystem. Areas such this are rare in New York State, and provide habitat for a diversity of fish and wildlife species. In 1984, approximately 15 pair of osprey (T) were reported nesting in the Long Beach Bay area. This is one of the largest nesting concentrations of osprey in New York, and the potential exists for additional nesting pairs at this site. Almost all of the nests are located on man-made platforms placed around the perimeter of the bay. A variety of seabirds, shorebirds, and wading birds use this area for feeding or for stopovers during migration. This area is especially significant as a feeding area for herons, egrets, and ibis which nest on Plum Island. Long Beach Bay is also an important waterfowl wintering area in Suffolk County. Aerial surveys of waterfowl abundance in January for the ten year period 1975-1984 indicate average concentrations of over 300 birds in the bay each year, including approximately 240 scaup (900 in peak year), and 70 black ducks (300 in peak year), along with lesser numbers of mergansers, bufflehead, goldeneye, and mallard. Diamondback terrapin (SC) are frequently observed in the marsh. Fish and wildlife recreational activities in the area important to the residents of Suffolk County include waterfowl hunting, fishing, and birdwatching. Bay scallops are abundant in Long Beach Bay, contributing to a commercial shellfishery of significance in the northeastern United States. Also, the bay is one of the top three areas for clams in the Town of Southold, of significance in Suffolk County. IMPACT ASSESSMENT: Any activity that would degrade water quality, disrupt tidal patterns, increase sedimentation, or eliminate wetlands would adversely affect the birds and shellfish found in this area. It is essential that high water quality be maintained in the bay to protect the bay scallop and hard clam fishery. Development of harbor facilities and construction of breakwalls or bulkheads would result in the loss of productive areas which support the fish and wildlife resources of Long Beach Bay. Ospreys nesting in the area may be affected by human disturbances, especially during the nesting and fledging period from March through mid-August. KNOWLEDGEABLE CONTACTS: Tom Hart or Andrew Milliken N.Y.S. Department of State Division of Coastal Resources Waterfront Revitalization 162 Washington Avenue Albany, NY 12231 Phone: (518) 474-3642 Harry Knoch, Wildlife Manager or Michael Scheibel, Fish and Wildlife Technician NYSDEC - Region 1 Building 40, SUNY Stony Brook, NY 11790 Phone: (516) 751-7900 Pieter VanVolkenburgh, Chief Bureau of Shellfisheries NYSDEC - Region 1 Building 40, SUNY Stony Brook, NY 11790 Phone: (516) 751-7900 NYS DEC - Significant Habitat Wildlife Resources Center Delmar, NY 12054 Phone: (518) 439-7486 Unit Paul Stoutenburg, Martin Garrell, or Jim McMahon Town of Southold Town Hall, 53095 Main Road P.O. Box 1179 Southold, NY 11971 Phone: (516) 765-1801 Chris Smith NYS Sea Grant Extension Service Cornell University Laboratory 37 Sound Ave. Riverhead, NY 11901 Phone: (516) 727-3910 Louise Harrison Suffolk County Department of Health Services Bureau of Environmental Management County Center Riverhead, NY 11901 Phone: (516) 548-3064 0 L D ~ a~ .T 247oloGo J 17'3o" BOUNDARIES: County ........................................................... _ Pr~r~d and published in 198~ by the New York State Deplrtment d TrBn~rt~t~n. in c~rition ~th the U.S. ~p~t~nt of Tr~ns~ltio~ F~er~l Highway ~mini~Ultion. Mort r~isiofls mode ulifla 39~ Ilriif ohoMlrlphy, cofl~iofl Quad: PL~.i Area Name: LONG DEACH DAY Ilabitat ~oundary- . Pa~e 2 o£ 3 I~£W '~O~K- 6UFFOLti ~. 7.5 MINUTE SERIES 2470000 ~3~-i.I ,~4~0 ~[ ~ ~'~o" I ' DEC APPLLQATION NUMBER U.S.ARMY CORPS OF ENGINEERS APPLICATION NO. ~]ARTICLE 9, TITLE 1, ARTICLE 43 6NYCRR &4~ [LAKE GEORGE RECREATION ZONE) I'~ARTICLE 15, TITLE 3 (AQUATIC PESTICIDES CONTROL) Y~6NYCRR 327 [AQUATIC VEGETATION} E~$NYCRR 32B (FISH) ~]bNYCRR ]2~INSECTS) ~ARTICLE 15, TITLE 5 6NYCRR ~8 [PROTECTION OF WATERS) ~ARTICLE 1S, TITLE 1S ~6NYCRR ~1 (WATER SUPPLY} ~6NYCRR ~2 (LONG ISLAND WELL} ~ARTICLE 1S, TITLE 27 6NYCRR 6~ (WILD, SCENIC AND RECREATIONAL RIVERS) RTICLE 24 6NYCRR ~2, ~3 [FRESHWATER WETLANDS) ~ARTIC~ 36 6NYCRR 5~ (FLOOOP~IN MANAGEMENT] RTICLE 25 6NYCRR ~1 [TIDAL WETLANDS) ~ARTIC~ 34 6NYCRR SOS [COASTAL EROSION) ~SECTION I0 (RIVER AND HARBOR ACT OF ~8~) for structures and wo~ in naviBable wate~ of the U.S. ~COASTAL CONSIS~R~IF~TION. SECT ON ~ [CLEAN WATER ACT Of 197~ for d s~sa of dredged or f material in waters of the U S gSECTION 10~ (MARINE PROTECTION, RESEARCH AND SANCTUARIES ACT)~or ,he ir, ns,orr,lion of d~i POSTOFF NAME OF ~'.Clwner r~AgentJContact Person (Check one) Mu nicipatii¥/Governmental A~ency~ TEL[PHONE (Where can be mach~ during day) MAILING ADDRESS ( 5. PROJECT/FACILITY LOCATION (Ma~ I~ation on map, ~ Number 18 on teve~e'lide) S~T ADDRESS (If different Jro~licant) &. NAME OF STREAM OR 8OOY OF WA~ER TELEPHONE (Where can be reached during day) '~ 9. PROPOSED USE: .~ Private 10. PROPOSED STARTING DATE: 11. APPROXIMATE COMPI.~IqON DATE: 12. FEE OF (NYS Permit Only) 14~'S PROIECT REQUIRE ADDITIONAL FEDERAL. STATE AND/OR LOCAL PEak?S? ~ ~o If yes. please hst: ~ ~0 Albe~ $. Krupski, President John H01zapfel, Vice President William G. Albenson Martin H. Garell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hail 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 LEAD AGENCY COORDINATION REQUEST TO: WHOM IT MAY GONGERN DATE: 6/9/95 Enclosed is a permit application and a completed part I of the Environmental Assessment Form. Southold Town Trustees are interested in your ageny's comments in acting as SEQRA Lead Agency for: NAME: MARTIN BANCROFT, JR. LOCATION: N.E. corner Narrow River Road, Orient TAX MAP: 1000-27-2-2.3 PEI~MIT # Pending DESCRPTN: ('See attached) Pv.~ze R~.0U~R~.D.'--~) TOW~ W~TL~m ( ) SEQRA CLASSIFICATION: ~) Type I ( ) Type II () UNLISTED ( ) CEA Please contact .~lbert J. Krupski, 3r.,.Trustee President w~0 days and be advised that the Southold Town Trustees~(WANT)~(DO NOT WANT) to assume-lead agency. s~ eOT Dos,~<)L DEc~Q DOH ~) PH ( ) ZEA ( ) B~ ( ) '/"l'"' Please complete, detach and return this form to expedite processing. Involved Agency: Project N~e: Location: 'SC~: We at (Have/No) objection to Southold To~ AG~CY Trustees ass~ing Lead Agency. Comments/Reasons: ACE ( ) CAG ~)~) Signature of Authorized Representative MAR ~8 ~ r$.$~' TOWN OF SOUTHOLD /! MAR 88 '95 11:36 TO 516 .823 FROM MCDONALD/RICH~ T-864 P. 81 McDONALD/RI CHARDS, INC. 156 FIFTH AVENUE, SUfl'E 222. NEW YORK, NEW YORK 10010 [212) 627-3100 FAX NF, il~F.~: 1-212-627-7295 DATE TOWN OF SOUTHOLD THIS TRAN'$MI$$ION' CObI$IST$ OF ..~ PAGF.,$ IbiCLUDIbIG THIS SHEET. ~ DIFFICIZLTIE$ I~ TRAI~3MISSIO~ SHOLILD BE RF..PORTED TO U~ AT (212) ~2~-3100. New York State Department of Environmental Conser~ation Thomas C. Jodlng Commlsslofler 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: 1. 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: Project Location: DEC Project Number: DEC Permits: SEQR Classification: DEC Contact Person: ~-o~J? DEC Position: DEC has no objection to your agency or another agency assuming lead agency status for this action, but reserves the right to comment on this action if a positive determination of significance is made. E] DEC has no objection to your agency 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. FI 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 It is the 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: .... P_tease r&e~n~ ~ phis request within 30 days of the date of this letter. If no'~r~sl~n~e~ ~ ved within 30 days, we wilt assume that you have no obje~Llu,,[~lJl,~ 'her agency assuming the role of lead agency, and have no comments to offer r~ ~mm ding the proposed action at this time. If neither your agenc¥}~o~r anymothel~olved agency, including DEC, has indicated a will- ingnes~s ~T6~lU agency within 30 days of this letter: _ ~on the Commissioner of DEC to designate a lead agency ...... TOP ~nls ac=lon. [ ] We will petition the Commissioner of DEO to designate your agency as lead, presuming you have jurisdiction. Please feel free to contact this office for further information or discussion. Enclosures Sincerely, cc: (see distribution list) IART 1--PROJECT INFORMAT~I Prepared by Project Sponsor NOTICE: This documeht is designed to assist in determining whether the ac.tion proposed may have a significant effect on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional[ 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 involve new studies, research or investigation~ If information requiring such additional work is unavailable, so indicate and specify each instance. NAMF.~= ACTION  TION OF ACTIO~ (include Stmel ~dms~, Munlc~llty ~d ~unty) ~ NAME OF OWNER (If different) BUSINESS TELEPHONE ADDRESS BUSINESS TELEPHONE ( ) C~TY/PO STATE I ZIP CODE Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: OUrban I-Ilndustrial CIForest r-lAgriculture 2. Total acreage of project area: ,JLL- 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 ECL) Water Surface Area Unvegetated (Rock, earth or fill) Roads, buildings and other paved surfaces. Other (Indicate type) 3/What is predominant soil type(s) on project site? ~')A~,, a. Soil drainage: r"lWell drained % of site /~Poorly drained I ~'~ % of site i-ICommercial ~Other r-lResidential (suburban) ~ural (non-farm) PRESENTLY AFTER COMPLETION acres ~ acres acres 0 acres acres 0 acres acres C~ ' acres acres (~ acres acres ~ acres acres ~) acres r-lModerately well drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group I through 4 of the NYS Land Classification System? ~ acres. (See I NYCRR 370). 4. Are there bedrock outcroppings on project site? Q-lYes ~4o a. What is depth to bedrock? (in feet) 5. ~¥PJ'o×i'mate percentage of prop, t project site with slopes: ~'~/JCLO-10% 0 % ~10-15 o~ --_ . o.2o 715% or greater % b. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of Historic Places? ~lYes ~o 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? [Yes '~No 8. What is the depth of the water table? [~ (in feet) 9. Is site located over a primary, principal, or sole source aquifer? [~Yes 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? [Yes ~No 11. Does proiect site contain any species of plant or animal life that is identified as threatened or endangered? [Yes ~,o According to Identify each species 12. Are.there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) [Yes ~o Describe 13. Is the project site presently used by the community or neighborhbod as an open space or recreation area? F'lYes [~o If yes, explain 14. Does the present site include scenic views known to be important to the community? I--lYes '~l.~q o 15. Streams within or contiguous to project area: a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wefla~ areas within or contigueus to project area: a. Name ~'(~K~J~:t~ ~ ~ ¥~'C)~'~ '~ ~ b. Size (In acres) 17. Is the site served by existing public utilities? ~lyes ~'No a) If Yes, does sufficient capacity exist to allow connection? r-lyes r-INo b) If Yes, will improvements be necessary to allow connection? I-lYes [No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? E]Yes ~o 19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 []Yes ~o 20. Has the site ever been used for the disposal of solid or hazardous wastes? I-lYes ~,~o B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor -~r acres. b. Project acreage to be developed: ~. acres initially; acres ultimately. c. project acreage to remain undeveloped ,~ acres. d. Length of project, in miles: (If appropriate) e, If the project is an expansion, indicate percent of expansion proposed i C)(~ %; f..Number of off-street parking spaces existin8 ; proposed g. Maximum vehicular trips generated per hour (upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Ultimately i. Dimensions (in ~eet) of largest proposed structure height; - width; '-length. - j. Linear feet of frontage along a public thoroughfare project will occupy is? ~-~ ft. Condominium 2. How, 'much natural material (i.e., )earth, etc.) will be removed from 3. Will disturbed areas be reclaimed? DYes DNo ~/A a. If yes~ for what intended purpose is the site being reclaimed~ b. Will topsoil be stockpiled for reclamation? ~.es DNo c. Will upper subsoil be stockpiled for reclamation? ~,Yes DNo ~J,~ 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site?~c~- acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project.7 DYes No 6. If single phase project~ Anticipated period of construction [ months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 ~---'-~- month \ Gl c~. year, (including demolition). c. Approximate completion date of final phase ('~C'-? month ~.C~c~ year. d. Is phase 1 functionally dependent on subsequent phases? DYes F'INo 8. Will blasting occur during construction? DYes '~o 9. Number of iobs generated: during construction ; after project is .complete 10. Number of jobs eliminated by this project 11. Will project require relocation of any projects or facilities? DYes ~o If yes, explain 12. Is surface liquid waste disposal involved.7 ~ l-lYes ~.~1o 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.7 DYes ~t::~o Type 14. Will surface area of an existi~qL, water body increase or decrease by proposal.7 ~.es DNo 15. Is project or any portion of project located in a 100 year flood plain? ~Yes l-]No 16. Will the project generate solid waste? ~Yes ~,No a. If yes, what is the amount per month tons b. If yes, will an existing solid waste facility be used? ~Yes i-]No c. If yes, give name --~ ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? DYes e.'lf Yes, explain 17. Will the project involve the disposal of solid waste.7 F'lYes '~No a. If yes, what is the anticipated rate of disposal.7 tons/month. b. If yes, what is the anticipated site life.7 years. project use herbicides or pesticides.7 I-lYes ~o 18, Will 19. Will project routinely produce odors (more than one hour per day)? F'IYes '~o 20. Will project produce operating noise exceeding the local ambient noise levels.7 DYes 21. Will project result in an increase in energy use.~ 'r-lYes ~[o If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity gallons/minute. 23. Total anticipated water usage per day gallons/day. 24. Does project involve Local, State or Federal funding.~ DYes ~qo If Yes, explain 4 25. Approvals Required: City, Town, Viliage 8oard I--lYes Go City, Town, Village Planning Board .~es f-INo City, Town Zoning Board l:]Yes .~No City. County Health Department E~Yes ~l~No Other Local Agencies [3Yes Other Regional Agencies VIYes State Agencies ~Yes-~/No Federal Agencies []Yes C. Zoning and Planning Information 12. I, Does proposed action involve a planning or zoning decision? OYes ~:~o If Yes, indicate decision required: I~zoning amendment I-Izoning variance E~special use permit []subdivision I-Isite plan F'lnew/revision of master plan I-lresour~e ~,anagement plan~ ~other 2. What is the zoning ciassification(s)of the site? '~ 3. What is the maximum ootential development of the site if developed a~ permitted by the present zoning? 4. What is the proposed zoning of the site? 5. What is the maximum i~,tential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? ~.es [No 7. What are the predominant I~a~ use(s) and zoning classifications within a ~/, mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a 1/4 mile? '~es ~No 9. If the proposed action is the subdivision of land, how many lots are p~oposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? [Yes ~Jo 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? [Yes ~.~o a. If yes, is existing capacity sufficient to handle projected'demand? I-lYes I~No Will the proposed action result in the generation of traffic significantly above present levels? [Yes ~o 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 clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I c~rtify that the information provided above.i~ true to the best of my knowledge, ~ ~ I If the action is(in the Coastal Area, and you are a sta~agency, complete the Coastal Assessment Form before proceeding with this assessment. 'I,l-lIJ-2 ., 617.21 . SEQR 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 proiect · or action ma',/be significant. The question of whether an action may be significant is not always easy to answer. Frequent- Iy, there are aspects of a proiect that are subiective 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 analysis, In addition, many who have knowledge in one particular area ma,/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 £AF is comprised of three parts: Part 1: Provides'0biective data and information about a given prolect'and its site. By identifying basic project : data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. ~art 2: :ocuses on identifying the range of possible impacts that ma,/occur from a proiect or action, It provides ~:uidance as to whether an impact is like'y to be considered small to moderate or whether it is a potentially- large impact. The forr~.also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 isid~ntified as potentially-large, then Part 3isused to evaluate whethe~ or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify Ihe Porlions df EAF completed for this projecl: [] Part I [~] Part 2 [~Part 3 Upton review of the information recorded on this EAF iParts I and 2 and 3 if appropriate), and any other supporting infbrmation, and considering both the magitu.de 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(s) and, therefore, is one which will not have a significant ira.pact on the environment, therefore a negalive declaration will be prepared. [] g. Although the project could have a significant effect 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 declaralion 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 D~claration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Tide of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (I f different from responsible officer) Date .. 1 PART 1--PROJECTINFOL ,ATION Prepared by Project Sponsor NOTICE: This doc~men~ is designed to assist in determining whether the action proposed on the environment. Please complete the entire form; Parts A through E. Answers to these questions wdl be consider, as part of theapplicationforapprovalandmaybesubjecttofurtherver,ficationandpublic~ev~ew Provide any addition information you believe will be needed to complete Parts 2 and It is expected that completion of the full EAF will be dependent on information currently available and will not invol, new studies, research or investigation. If informaQon requiring such additional work is unavadabie, so indicate and spec~ each- instance. ._CATION OF ACTION (tnclucle {~lreet Address, Municipality and County) NAME OF OWNER d erent~' ADDRESS CiTY/PO DESCRIPTION OF ACTION STATE ZIP CODE Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical-setting of overall project, both developed add undeveloped areas. 1. Present land use: I-IUrban ~lndustrial ~CommerciaJ ~Residential (suburban) I~Rural (non-farn I-IForest ~Agriculture [3Other 2. Total acreage of project area: ~ acres. APPROXIMATE ACREAGE ~.~ PRESENTLY AFTE~ZOMPLETION Meadow or grushland (Non-agricultural) acres ' acres Forested . acres ~ acres Agricultural (Includes orchards, cropland, pasture, etc.) ~ acres ~ acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) I~ acres ,~ ~ acres Water Surf.ace Area ~ acres ~ acres Unvegetated (Rock, earth or fill) ---'----" acres -~ acres Roads, buildings and other paved surfaces .... acres -- -- -- __ acres Other (Indicate typeJ acres ' acres 3. What is predominant soil type(s) On project site./ a. Soil drainage: [3Well drained __ % of site E]Moderately well drained_____ % of s~te ,[~..Poorly drained ~C~ % of site b. If any agricultural land is involved, how many acres of soil are classified wdim~ soil group I ti~rougb .1 of the NY Land Classification System? ~ . acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project s te,~ [:]Yes ~i~No a. What is depth to bedrock.~ (in feet) 2 ·, ~4.~4-. c =m-9c SEQR Appendix B .,. Slate Environmental Quality Review Visual EAF Addendum This form may be used to provide additional informatidn relating to Question 11 of Part 2 of the Full EAF. (To be completed by Lead Agency) Visibility 1. Would the project be visible from: · A parcel of land which is dedicated to and available to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public observation, enjoyment and appreciation of'natural or man.made scenic qualities? ' · A site or structure li~ted on the National or State [] Registers of Historic Places? · State Parks? [] · The State Forest Preserve? [] · National Wildlife Refuges and state game refuges? . [] · National Natural Landmarks and other outstanding [] natural features? · National Park Service lands? [] · Rivers designated as National Or State Wild, Scenic [] or Recreational? · Any transportation ~:orridor of high exposure, such [] as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate [] or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as [] scenic? · Municipal park, or designated open space9 [] · County road2 [] · State2 [] · Local road? [] Distance Between Project and Resource (in Miles) O-V4 1/4 - V2 '/2-3 3-5 5+ [] [] [] [] [] [] [] [] [] [] [] '0 0 [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] Is the visibility of tim project seasonal? (i,e., screen'ed by summer foliage, but visible during other ~eason?) []Yes []]No 3. Are any of the resources checked in question I used by tim public during the time of year during which the project will be visible? []Yes . ONo DESCRIPTION at EXISTING VISUAL ENVIRONMENT 4. From each i,tem checked in question 1, check those which generally describe the environment. surrounding Within *V~ mile ~'1 mile Essentially undeveloped [] [] Forested Agricul~hral Suburban residential [] Industrial [] [] Commercial [] Urban River, Lake, Pond Cliffs, Overlooks [] Designated Open Space [] Flat [] Hilly [] Mountainous [] Other .-: [] NOTE:: add attachments as needed 5. Are there visually similar projects within: 'Vz mile i--lYes E~]No *1 miles E~] Yes [~]No '2 miles []Yes []No '3 miles []Yes [~No Distance from project site ar~ provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number 0f viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate, CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is Activity Travel to and from work Involved in recreational activities Routine travel by residents At a residence At worksite Other FREQUENCY Holidays/ Daily Weekly Weekends Seasonally , ' L~15 °,f, ~'"'grea tar °,6 6. Is project substantially contiguous to, or contain ~l building, site, or district, listed on the State or the National of Historic Places? [:]Yes ~'No ,~, Registers ~" Is proiect substantially contiguous to a site listed on Register ~No the National Natural Landmarks? [:]Yes & Wh,~i is the depth of the water table? ~ (in feet) 9. Is site located over a primary, principal, .or sole source aquifer? {::]Ye~ 10. Do hunting, fishing or shell fishing opportunities presently exist in {he project area? []Yes 11. D~es project sit~ c,~ntain any species of plant or animal life that is identified as threatened or endangered? [Yes'~o According to Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e.. cliffs, dunes, other geological formations) E]Yes ~o Describe 13. 14. 15. Is the projnc:' sit~.' ?resently used by the community pt neighborhood as an open space or recreation .area? [:]Yes I~o If yes. explain-'___ ~ Does the presen? s~e include scenic views known to be important to the community? .. [:]Yes ~.,N o Streams within or contiguous to project area; ~. . , a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland area~,within or contiguous to project area: a. Name ~ V~,Ik~J)~ b, Size (In acres) 17. Is the site served by existing public utilities? [:]Yes a) If Yes, does suffiUent capacity' exist to allow connection? ~Yes [~No b) If Yes, will improvements be necessary to all0w connection? [~]Yes INa 18. Is the site located in an agricultur,~district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? F'IYes 19. Is the site located in or substantially contiguo.~to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 [:]Yes 20. Has the site ever been used for the disposal of solid or hazardous wastes? [:]Yes o B. Project Description 1, Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acreage to be developed: [ acres initially; ' .' c. Project acrqage to remain undeveloped ~:~ acres. d. Length of project, in mires: ~ (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed acres ultimately. [ c30 %; f. Number of off-street parking spaces existing -- g. Maximum vehicular trips generated per hour "---"---' ' h. If residential: Number and type of housing units: / One Family Tw~ Initially ~ . Ultimately I / i. Dimensions (in feet) of larg'est proposed structure . height; width; j. Linear feet of frontage along a public thorou§hfare proiect will occupy is? _ ; proposed (upon completion of proiect)~ length. 3 2. ~Iow much natural mate ti.e, rock, earth, etc.) wdl be rt, rnoved 3. Will disttubed areas be reclaimed? []Yes []No a. If yes, fo( what intended purpose is the site being reclaimed? _ _ b. Will topsoil be stockpiled for reclamation? ~Yes [3No " c. Will upper subsoil be stockpiled for reclamation? 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? "~.~, . acres. 5. Will any mat~r~orest (over 100 years old) or other locally-important vegetation be r,.~rn,~v,~d by this project? [Yes ~Xlo t 6. If single phase project: Anticipated period of construction ~ months, linciuding demolition). 7. If mulGphased: a. Total number of phases anticipated b. Anticipated date of commencement phase 1 c. Approximate completion date of final phase d. Is phase I functionally dependent on subsequent phases? 8. Will bias!lng occur during construction? []Yes ~No 9. Number of jobs generated: during construction ~ 10, Number of jobs eliminated by this project (~ (number). 11. month year, (including demolition). month year [3Yes []No ; after prolect ~s complete Will project require relocation of any projects or facilities? []Yes ~No If yes, explain 12. Is surface liquid waste disposal involved? [3Yes a. If yes, indicate type of waste (sewage, industrial, etc.) and amount h. Name of water body into which eftluent will be discharged 13. Is subsurface liquid waste disposal involved? I-lyes 14. Will surface area of an existing wa~er body increase or decrease by 15. Is project or any portion of project located in a 100 year flood plain? ~Yes 16. Will the proiect generate solid waste? IZ]Yes ~o a. If yes, what is the amoun't per month tons b. If yes, will an existing solid waste facility be used? [Yes [~No c. if yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 17. Will the project involve the disposal of solid waste? E3Yes a. If yes, what is the anticipated rate of disposal? b, If yes, what i~ the anticipated site life? Will project ase herbicides or pesticides? [3Yes tons/month Type proposal? ~l~' e,s, [3No \ K o' 'To Loo' .) ~No 19. Will project routinely produce odors (more than one hour per day)? []Yes ~ 20. Will project produce operating noise exceeding the local ambient noise levels? ~Yes 21. Will project result in an increase in energy use? []Yes ~o If yes , indicate type(s) 22. If water supply' is from wells, indicate pumping capacity ~ gallons/minute 23. Total anticipated water usage per day gallons/day. 24. Does proiect involve Local, State or Federal funding? [3Yes '~o fi Yes, explain []No 4 City, Town, Village Board City, Town, Village Planning Board · City, Town Zoning Board City, County Health Department Other Local Agencies Other Regional Agencies State Agencies · Federal ^gencies [:3Yes [:]No [3Yes [3No [:]Yes [No {~]Yes E:]No J~Yes [~]No [~Yes [:]No [~Yes [:]Yes [No Type ~SuJ)miltal Dale C. Zoning and Planning Information %/ 1. Does proposed action involve a planning-or zoning decision? []Yes /~o · If Yes, indicate decision required: E]zoninR amendment ~zoning variance ~}special use permit E~]subdivision ~ [site plan ~]newjrevision of master plan ~resource manaqement plan ~other 2. What is the zonin~ classification(s)o~ the site? ~l ~ ~ 3. What is the maximum potential development of the site if developed as permitted by the present zoning? .4. What is the proposed zonin~ of the site? ~lx.~ . . 5. What is the maximum potential development of the site iJ developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? ~es ~ 7. What ar~he pr~dommant land use(s) dnd z?n.n~j classifications within a % mile radius of proposed a~tion? 8. Is the proposed action compatible ~vith adioinin~/surroumlin~ land uses within a ~; mile? ~e~ ~, 9. If the proposed action is the ~ubdivi~ion of land, how many lots are proposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for he formahou of~e~er orwater districtsf ~Yes .~Nc' 11. Will the proposed action crea~a demand for any community provided services (recreation, education, police fire protection)~ ~Yes ~ a. If yes, is existing capacity suJ[icient to I~an(lle prell:tied demand? ~Yes ~No 12. Will the proposed action result in the l:e er, Ion et traffic si~:nificantly above []resent levels? ~Yes o a, l[ yes, is the existing to,id ]etwork adnquate to handle the additional trafiic? OYes ~No D. Informational Details Attach any additional infornlalion a~ may J)l, need~,d to cJ.uify your pr¢~ject. If tlmre ,~re or may be any adverse avoid Ihem, E. Verification I certify th,l? Ih~' information pu]vi(h,d Il Ihe .~clio~ is in Ihe ~sfal Mea~uul gon .1re ~ale al:l~llCy, (,~mplele Ihe Coaslal Assessmcnl rot ~>e*o e proceeding ~ilh Ibis assessmenl. Par' --PROJECT IMPACTS AND TH,_,R MAGNITUDE General Information (Read Carefully) · In completing the form the reviewer should he guided by d~e que~[~on: ~lnve my responses and determinations reasonable~ The reviewer is not expected to be an expert env.ronmental analyst e, Identifying that an impact will be potentially Mrge (column 2) do~,s not mean [h,~t it is ~lso necessardy signilicanL Any large impact must be evaluated in PART 3 to determine, si~miicance. Ident~fvmg an impact m column 2 simp; asks that it be looked at ~urther. · The E~amples pr6vided a~e to assist the reviewer by showim; wpes at impacts and whereve~ ~oss~ble the threshold c magnitude t~at would trigger a response in column 2. The example~ are generally apphc~bie [hrourhout the State an tar most ~ituations. ~ut, for any specific pro~ect or site other examples and/or lower thresholds may be appropriat for a Potential Large Impact response, thus requiring evaluation in Part ~ · The impacts of each project, on each site, in each Iocahty. ~vill vary Therefore. ~he eram01es are dlustra~ve an, have been offered as guidance. They do not constitute an exhn~s~we Ji~t al impacts and thresholds :o answer each que~tJo~ · The number of examples per question does not indicate the importance o~ each question · In identifying impacts, con,)der long term, short term and cumla~ive effects. Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes d there wdl he any b. Maybe answers should be considered as Yes answers c. I~ answering Yes to a question lhen check the appropnate box lcoiumn I or 2) ~o mc~ca~e the ooten~k~l s~ze impact. If impact threshold equa~ or exceeds any examole provided, cf~ock colun~n 2 I~ ~moac~ ~ ,il occur but ~hresholc is lower than example, check co}utah 1. d. If ~eviewe~ has doub~ about size of ~he i~pac[ [hen consider d~e ~mo~c[ as po[Qfl[l~liv iar~e and p~oceed to P,~RT 3 e. I~ a potentially large impac~ checked in column 2 can be m~tu~d[ed bv chonqe~s) m ~be Drolec~ to 8 small to moderate impact, also check the Yes box m column 3. A No response md~cates [hat suc~ a meuc~on ~s 7must be explained in Part 3. IMPACT ON LAND 1. Will lhe proposed action result in a physical change Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project a~ea exceed 10%. ' Construction on Ipnd where the depth to the water table is less than 3 feet. ' Conslruction of paved parking area for 1.000 or more vehicles. ' Construct)anon land where bedrock is exposed or 8en('r,dly wdhin ~ ~ ~ ~JYes ~No 3 feet al existing ground surface. * Construction that will c~ntinue for more dian 1 year or involvu more than one phase or stage. ' Excavation ~or mining purposes lhat would r~m~we m(~ro than 1,000 tons of natural material (i,e,, roc~ or soil) per yudr. ' Conslruction or expansion of a s,~nitary landfill ~.~ ' Constr~Jction in a designated floudway ' Oth~,r imp,mots 2. Wdl Ihere I)e an ('f(ecl l~. -..W u;:.que or ~musu,d I.Inrj~(l~lls ~(jlllllj off the site? (i e, Cliffs. dunes, geoloFjcal founaliotis, t~tC ~0 []YES "5pecdic land forms: ~ ~ ~Yes ~No 1 2 3 Small ~o Potenl~al Can impact Be Moderate Larqe Miligat~ed By Impact Impact Pro eot Change .. IMPACT ON WATER 3. Will proposed action affect any water body designa!~d as protected? (Under Articles 15, 24, 25 of the Environmental Conse[va~jon Law, ECL) ' ~O E3YES Examples that would apply to column 2 · Developable area of site contains a protected water body. · Dredging more than 100 cubic 'yards of material from channe~ of a. protected stream. · Ex{~nsion of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 1 Small .to Model:ate Impact O [] O [] [] Potential Large" Impact O .O [] O [] 3 Can impact Be Mitigated By Project Change []Yes [-'[No []Yes I-]No []Yes I-]No OYes ''FINo OYes I--IN• 4. Will proposed action affect any non-protected exist!n~or new body of water? ' '~NO OYES Examples that would apply to column 2 .. /~' .- · A 10% increase or decrease in the surface ~trea 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: 5. Will Proposed Action affect surface or groundwater. / quality or quantity? ~.~O OYES Examples that would app[y to column 2 · Proposed Action will require a discharge permit. · Proposed Action requires use of.ia source of water that does not have approval to serve proposed (project) action. · Proposed Action requires water supply from wells with greater than gallons per minute pumping capacit'r'. · Construction or opera, tion causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed off the site to facilities which presently do not exist or have inadequate capacity. · Proposed Action would use water in excess of 20,000 gallons per day. · Proposed Action will likelY/ cause siltation or other discharge into an existing body of wa~.er to the exte;:t that there will be an obvious visual contrast to natur~.i conditions. · Proposed Action will require th~ storage of petroleum or chemical · 'products great? than 1,100 gallons. · Proposed Action will allow residential uses in areas without water and/or sewer services. · Proposed Action locates commercial and/or industrial uses which ,,ay require new or expansion of existing waste treatment and/or storage facilities. · Other impacts: O [] O [] [] [] [] [] [] O [] [] O [] [] [] [] O O [] [] [] O [] F1Yes I~No [-]Yes ONo []Yes ONo OYes ON• OYes ON• [~Yes i--IN• OYes ON• OYes ON• []Yes •No OYes []No ~]Yes "FIN• []Yes F~No OYes [~]No F1Yes E]No ~Yes ON• L 6. Will proposed action alt~r drainage flow or patt~ernjs, or water runoff? Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 surface i-lYES O []Yes ~]No - Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns - Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7. Will proposed action affect air quality? UNO F~YE$ Examples that would apply to '~:olumn 2 · Proposed Action will induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of more than I ton of re~use per [~our. · E~lission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million' [3TU'$ per hour, · Proposed action will al(ow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development w~thin existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS Will Proposed Action affect any threatened or endangered species? ' ~,[~]NO [3YES Ex,~mples that would apply to column 2 ' '7"-- Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. Removal of any portion of a critical or significant wildlife habitat. Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. Other impacts: Will Proposed Action substantially affect non-threatxen~ed or non-endangered species? /~NO I~YES Examples that would apply to column 2 Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. Proposed Action requires the removal of more than 10 acres of mature forest {over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES Will the Proposed Action affer;t agriculturaJ Lind resources? {~NO [3YES E~ampies that would apply to column 2 [he proposed action would sever, cross or limit access to agricultural :and [includes cropland, hayfields, pasture, vineyard; orchard, etc.) 8 Small to Moderate Impact 2 Potential ' Large Impact Can impact k3e MitigCted By Project Change [Z]Yes ~No C [~Ye~ [~No [~Yes [~ Yes [~No ~]Yes ~Yes [~No ~No {~ Yes [L~Yes Z]No [~Yes {~Yes {~]No ~]Yes [~] Yes [~No {~Yes ~No ~-~Yes l~No E2Yes ~No ' · Construction activity would excavate or compact the soil profile of ' agricultural 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.g., 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: .. Smalr t'o Moderate Impact O O 2 Potential" Large Impact O O 3 Can Impact Be Mitigated By. Project Change []Yes [~No I~]Yes []No []Yes ONo I-lYes [~No C IMPACT ON AESTHETIC REsOuRcEs .. 11. Will proposed action affect aestf~etic resources? '~NO E]YES (If necessary, use the Visual EAF Addendum in'SeCtion 617.21, Appendix B.) Examples that would apply to column 2 · Proposed land uses, or proiect components obviously different from or in sharp contrast to current surrounding land use patterns, whether ' man-made or natural. · Proposed land uses, or proiect components visible to users of aestheuc resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Proiect components that wiU result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: [] O [] O [] [] OYes ON• []Yes FiN• []Yes ~]No [-]Yes ON• IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structur~e o~-historic, pre- historic or paleontological importance? '%~NO OYES Exarnples that would apply to column 2 * Proposed Action occurring wholly or partially within or substantially contiguous to any facility oF site listed on the State or National Register of historic places. * Any impact to an archaeological site or fossil bed located widdn the project site. · Proposed Action wiil occur in an area designated as sensitive for archaeological si'tes on the NYS Site Inventory. . Other impacts: O O O O O [] [] [] OYes ONo []Yes ON• OYes ONo OYes' ON• IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quu~ntity or quality of existing or future open spaces or recreational opportunities,~ ~,' Examples that would apply to column 2 ~NO OYES L of a future recreational opportunity, Tile permanent foreclosure · A major reduction of an open space important to the community. · Other impacts: [] 0 [] O OYes ONo O OYes []No O OYes []]]No ~ 2 3 IMPACT ON TR,,.~SPORTATION Small to Potential Can Impact Be 14. Wilt there be an effect to e.xisting transportation sy~s? Moderate Large Mitigated By · ~.,~0 I~YES Impact Impact Prolect Char]ge Examples that would apply to column 2 · Alteratior; of present patterns of movement of people and/or goods [~ [] []Yes · Proposed Action will result in maior traffic problems. E~ [~ [~Yes · Other impacts: [] [] L~Yes []No IMPACT ON ENERGY 15, Will proposed action afl~ect the community's so~rc~ of fuel or energy supply? · ~I~NO E~YES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of [] any i~orm of energy in the municipality. · Proposed Action will require the creation or extension of an energy [] transmission or supply system to serve more than 50 single or two famdy residences or to serve a major commercial or industrial use. · Other impacts: [] NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, noise, or vibrc,;.t~9~ as a result of the Proposed Action? ~4D ~YE5 £xamples that would apply to column 2 · Dlastin8 within 1,500 feet of a hospital, school or other sensitive [] facility, · Odors will occur routinely (more than one hour per day). [] · Proposed Action will produce operating noise exc~edin8 the local [] ambient noise levels for noise outside of structures. "Proposed Action will remove oatural barriers that would act as a [] noise screen. "O~her impacts: [] [] ~Yes []No IMPACT ON PUBLIC HEALTH 7. Will Proposed Action affect public health and safety. Nc3 E) Y[S Examples that would apply to column 2 Proposed Action may cause a risk of explosion or release of hazardous [] substances [i.e. oil, pesticides, chemicals, radiation, etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. Proposed Action may resuit in the burial of "hazardous wastes" in any [] form (i.e. toxic, poisonouS, highly reactive, radioactive, irritating, infectious, etc.) Storage facilities for one million or more gallons of liqmfied natural [] !:as or other flammable liquids. Proposed action may result in the excavation or other disturbance [] .v~thin 2,000 /eel of a site used for the disposal of solid or hazardous OIhet impacts: [] 10 [] []Yes []No [] {]Yes []No [] [~JVes E]No [] []Yes L2N0 [] EJYes [~No IMPACT ON GROWTH AND CHARACTER OF COMMU'NITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existj~m~;4~mmnnity;~ 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 5%. · 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 projects. · Proposed Action will create or eliminate employment, · Other impacts: I 2 3 Small'~o Potential,' Can Impact Be Moderate Large Mitigated By. Impact Impact Project Change [] [] []Yes r-iNo [] [] I-qYes F~No [] [] ~Yes i-'l ND [] [] []Yes []No [] [] []Yes J-lNo [] [] ['-lYes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes I--INn 19. Is there, or is there likely to be, public controversy related to potential adverse environment.al impacts,~ E~NO E]YES 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~/IPORTANC,': OF IMPACTS Resp0nsihilily of Lead Agency Pad 3 musl be prepared ii one or more impacl(s) is considered Io he polentially large, even ii Ibc impact(s) may be mitigated. Inslructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. ' 2. Describe (if applicable} how the impact could be mitiga[ed or reduced to a small [o moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that Ibis impact is imporlanh To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources of vah,e · Whether the impact can or will be controlled · rile regional consequence of tile impact · Its potential diw;rgence from IL)cai needs and goals · Whether known objections to the proiect relate to this impact. Continue on attadhments) 11 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART J--PROJECT INFORMATION (To be completed by Applicant or Project spbnsor) 1. PLICANT/SPONSOR 2. PR CT NAME 3. PROJECT LOCATION: 4. PRECISE LOCATION (Street address and road~ntersections, prominent lendmarks, etc., or provide map) ~ 5. IS PROPOSED ACTION: [] New ]~xpanslon [] Modification/alteration T. AMOUNT OF LAND AFFECTED: Initially ~ acres Ultimately I~ acres 8. IL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? V~es [] NO If NO, describe briefly g. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? .~Resldentlal [] Industrial [] Commercial Oescribe: [] Agriculture [~Park/ForestlOpen space [--]Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? 12. AS A RESULT~)F/PP PROPOSED ACTION WiLL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes ~L~. o ~;: I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: ~,~[1~'~'-,~.~ ~"*~-='"--. ~~~, Dale: II the action is in the Co,sial Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this a.~essment OVER 1 PART Pi--ENVIRONMENTAL SESSMENT (To be completed by Agency. A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 If yes, coordinate the review process anc~ use the FULL DAp'. E] Yes E] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED PeR UNLISTED ACTIONS IN 6 NYCRR, PART 617.87 if No, a noganve declaranon [] Yes [] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwrlllen, it legil~le) potential for erosion, drainage or flooding problems? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or e~dangered species? Explain Prlelly: C4. A communJ y's exJstl,qg plans or goals as otfJclaUy adopted or a change in use or intensity et use of land or other r~atural resources? Explain briefly C5. Growth, subsequent development, or related activities likely to be induced by the proposed ac[ion? Explain briefly. C6. Long term, short term, cumulalive, or other etfecls not identified in Cl-C57 Explain briefly. C7. Other impacts (inclUding changes in use of either quantity or type of energy)? Explain briefly. O. IS 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 othecwise significant. Each effect should be assessed in connection with its fa) selling (i.e. urban or rural); (b) probability ot OGCLg~'Jng; (C) duration; rd) Irreversibiltly; re) geographic scope; and (t) magnitude. If necessary, 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 ORe 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 OR 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 determination: I 6]0 6'.9' ~ 00.