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HomeMy WebLinkAboutTR-5406 Board Of Southold Town Trustees SOUTHOLD, NEW YORK Sz`. PERMIT NO. SyC? . ..: DATE: .........ept 24,2001...... .......... ROBERT & RITA PELLEGRINI ISSUED TO .............................................................._.......... ..... ....... ............................. Authorization Pursuant to the provisions'of Chapter 615 of the Laves of � +he State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS•,•..': and in accordance with the Resolution of The Board adopted at a meeting held onAu�. 29, 2001 ; 614.00 paid by . ............ and in consideration of the sum of ...-..................... ..- Robert & Rita Pellegr lli..............................................................................._..... a of .............Cutchogue. ............................................. N. Y. and. subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: s' Wetland Permit to remove a 5'X 5' section at the seau.v I .nd of an ^mating, 5'X 65' y catwalk, to repairtrecoustl'uct remaining 5'X 60' c:.twalk and :xisting 41X a0' ramp, to install a 32"X 20' aluminum ramp onto the existing cat,,xdK, a 3B W float,. 6'X 20' float and to install three two-pile dolphinr. 'Chtire e enincluding the vessel, =hill not ,,,"d mor, than 1/3 th:• vid:h of D!,. w:�Ln-wav� all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this data. Fco z � tri apt }, TERMS and CONDITIONS The Permittee Robert & Rita Pellegrini reswitag at 4515 Stillwater Ave. , Cutchogue N. yY as parr of the consideration for the issuance of the Permit does uetdercund and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or daims for damn^ of stairs arising directly or indirectly as a result of any open ation petfotmed pursuant to this permit, mad the said Pantireee wlll, at his at hes ora expense, defend any mrd all such suits'ldtiated by third parties, and the said Petmitsee assures fall liabllily with respect thereto, to the complete exclusion of the Board of Trustees of the Towel of Southold 4 That this Permit is wulid for a period of : 24 tens, whidr is considered to be the estimated time'regmired to complete the wodt involved, but should circumstances warrant, request for as extension may be made to the Board at a later date, 3. Thu this Permit should be retained indefinitely, or as long as the said Permiaee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that an& orizuion was originally obaiaed. 4. That the work involved will be subject to the inspection and approved of the Board or its agents, and non-oompliance with.the Provisions of the originating application,any be ause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the wodt herein saidwraed. 6. That then shall be to interference with the right of the public to pass and repass eloug the beach between high atd low water marks. 7. That if future operations of the Town of Southold require theremoval and/or alterations is the loadoo of the wodc herds unthodzed, or if, in the coal= of the Board of Trustees, the. work shall cause unreasonable obstruction to free navigation, the said Permittee will be requited, upon due notice, to remove or alter this work or project betdn sated withotat espeata to the Town Of Southold 8. That the said Board will be notified by the Permittee of the comptetloa_of the work atth- orized. 9. That the Permittee will obtain all other permits and contents that tmy be requited asp- plemenal to this permit which tiny be subject to revoke upon failure to obtain same. 0 0 Albert J. Krupski, President g�FFO(,( Town Hall James King,Vice-President o�O CO 53095 Route 25 Henry Smith =�' Gy� P.O.Box 1179 Artie Foster y Southold, New York 11971-0959 Ken Poliwoda Z Dy • �. Telephone(631) 765-1892 dol � Sao Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 24, 2001 Mr. Glenn E. Just J.M.O. Environmental Consulting P.O. Box 447 Quogue,NY 11959-0447 RE: ROBERT &RITA PELLEGRINI 1205 Point Pleasant Rd., Mattituck SCTM#114-1-4 Dear Mr. Just: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 29, 2001 regarding the above matter: WHEREAS,J.M.O. Environmental Consulting on behalf of ROBERT & RITA PELLEGRINI applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 7, 2001, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on August 29, 2001, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, 2 NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of ROBERT & RITA PELLEGRINI to remove a 5'X 5' section at the seaward end of an existing 5'X 65' catwalk, to repair/reconstruct remaining 5'X 60' catwalk and existing 4'X 20' ramp, to install a 32"X 20' aluminum ramp onto the existing catwalk, a 3'X 6' float, 6'X 20' float and to install three two- pile dolphins. The entire structure, including the vessel, shall not exceed more than 1/3 the width of the waterway. BE IT FURTHER RESOLVED that this determination 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. Permit to construct and complete project will expire two years from the date it is signed. 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: $414.00 Very truly yours,, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms DEC ACE Dept. of State SCALE 1`20- SFD 1 � EX STEPS 13)PROP PROP 2-PILE Z� 3'X 6' DOLPHINS 3exRSR -0 FLOAT E;(4XajRPMP EX �(EO C;�yrALK RAMP FLOAT = �o LIRIH.W 0 3 � s co 1 Applicant: Robert Pellegrini 1 y zl6' QOTTOM ! o Q) Location: Home Pike, Mattituck EX I AMP CATWALK TO EE o - Purpose: Private Recreational Docking REPA)RI/Q PE CONSTRUCTED = Datum: Appparent Low Water Locus: 723' 41`00' o S.C.T.M.No. 1000-114-01-4 F-L Applicant proposes to remove a 5'x 5' section at the seaward end of an "ULUexisting 5'x 65' catwalk, to repair/reconstruct remaining 5'x 60' catwalk and existing 4'x 20' ramp, to install a 32"x 20' aluminum ramp ontoThe existing catwalk, a 3'x 6' float, 6'x 20' float and toInstall three two-pile dolphins. S N nn `I`o �lJ lv ` I\Sou! o� SHEET 2 OF 2 . -- Cv Pew YorkState Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 • FAX: (631)444-0360 _ Website: www.dec.state.ny.us Erin M. Crotty Commissioner July 23, 2001 Robert & Rita Pellegrini 4515 Stillwater Avenue Cutchogue, NY 11935 RE: 1-4738-02871/00002 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621 ) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely, j1W, Vx)/X-e Matthew R. Penski EnCon Program Aide MRP/Is Enclosure NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DCC PERMIT NUMBER EFFECTIVE DATE 1-4738.02871/00002 in July 23, 2001 NOW FACILITY/PROGRAM NUMBER(5) PERMIT EXPIRATION DATE(S) Under the Environmental Conservation Lau July 23, 2004 TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate ❑ Article 15, Title 5: Protection ■ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPOES ❑ Article 27, Title 9; 6NYCRR supply 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Robert 8 Rita Pellegrini 1 (631) 734-6346 ADDRESS OF PERMITTEE 4515 Stillwater Avenue, Cutchogue NY 11935 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER JMO Environmental Consulting, P.O. Box 447, Quogue, NY 11959-0447 (631) 653-0607 NAME AND ADDRESS OF PROJECT/FACILITY Pellegrini property, Home Pike Mattituck, NY LOCATION OF PROJECT/FACILITY SCTM # 1000-114-1-4 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Mattituck Creek E:706.4 N:4541.3 DESCRIPTION OF AUTHORIZED ACTIVITY: Reconstruct the existing 4 foot by 20 foot ramp and 5 foot by 65 foot catwalk in the same location and install a 32 inch by 20 foot aluminum ramp, 3 foot by 6 foot Float, 6 foot by 20 foot float, and three(3) 2-pile dolphins.All work shall be performed in accordance with the attached plans stamped NYSDEC approved on 7/19/01. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 8 3) and any Special Conditions included as part of this permit. PERMIT AZetldnd Sk RATOR: ADDR S Joh (MRP) Bldg. #40, SUNY, Stony Brook, NY 11790-2356 ) AU 0 1 ED SIGNATUREDATE / 0 C July 23 2001 Paq? 1 of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. All repairs to existing structures shall be confined to replacement of existing elements with no change in design, dimension, or materials, unless specifically authorized herein. 2. No dredging,excavating or other alteration of shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 3. Docks/catwalks/floats may not(a)extend laterally beyond property lines,(b)be placed so that docked boats extend over adjacent property line, (c) interfere with navigation, (d) interfere with other landowners riparian rights. 4. No permanent structures maybe installed on dock/catwalk/float without first obtaining written Department approval (permit, modification, or amendment). 5. Pilings may not: (a)extend beyond property lines, (b) be placed so that docked boats extend ovE r property lines, (c) interfere with navigation, (d) interfere with other landowners riparian rights. 6. No structures are to be constructed on pilings without further authorization of the Department. 7. Dock or timber catwalk shall be a minimum of 3%:feet above grade"over tidal wetland areas(*as measured from ground to bottom of dock sheathing). 8. Floats and ramps may not rest on or be stored in any vegetated tidal wetland. 9. The use of wood treated with pentachlorophenol in the construction of structures that will be in contact with tidal waters is strictly prohibited. 10. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. S DEC PERMIT NUMBER PAGE 4 OF 4 1-4738-02871/00002 0 9 | m C4 § ' K . x & kZrn - �9 © - o R © ri \ 2 a� 0 « S � m � e E� J2 '_ � § f $ > ® -0 C14 �Qt « -7� - J ; 0 B _ ƒ ■ . u 21 220 $ ■ r _ U CL4 A ' RCC ,§ c , � q Q $rl � ° [ ! 2 `- $ � . . .s % i Albert J.Krupsld,President �QS�fFOL,�'CO Town Hall James King,Vice-President h�0 Dy 53095 Main Road Henry Smith - ` P.O.Boa 1179 Artie Foster C* Southold,New York 11971 Ken Poliwoda - T Telephone(516) 765-1892 Fax(516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: /IC�i'(}Q L� 4 �jCrtl l'Q Ll4('e :U alt Please be advised that your application, dated �?{7/I7/. has been reviewed by this Board, at the regular meeting of _3 9/C _ and the following action_ was taken: ( ✓) Application Approved (see below) ( ) Application Denied (see below) ( 1 Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees . The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessarv. COMPUTATION OF PERMIT FEES : `� OCT 1 2 ��, TOTAL FEES DUE: $ 714 SIGNED: �• / � �i PRE_S/IDENT, BOARD OF TRUSTEES BY: to r?aw Ia CLERK, BOARD OF TRUSTEES FROM : FRX NO. : W 25 2001 12:31PM P1 Q.M.O. Environmental Consulting Services Phone (631) 653-0607 • Fax (631) 653-3348 121 Jessup Ave - 2nd Floor - P.O. Box 447 9uogue, New York 11959-0447 Y�x FAX COVER SHEET TO:_ Date: 7 Z 5 O f Company Name ... (A -4-hold )Dwn T'l)S�e �S Attention —.-- Fax Number �b 5 3 (� -- ._...._. . .. -- Number of Pages Including Cover-, . - — -- .......... — n Ll FROM: ..._ _.. .._.—_ ...... -- RE: Jae 75- Ll2LTck..- — ---- ------ MESSAGE: —..,. p�� Gnn �4�7USS 4 Ifyou do not receive the comwt number ofpgv4 please call our office as soon as possible i SUFfotk�o� UO3Town Hall. 53095 Main Road P.O. Boz 1179 Telephone (631) 765-1892. O,y� Southold.New.York 11971 �g�l � .�1a�� SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, July 17, 2001, the following recommendation was made: Moved by Bill McDermott, seconded by Bret Hedges, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit Application of ROBERT & RITA PELLEGRINI 114-1-4 to install a 32"X 20' aluminum ramp onto an existing catwalk, a TX 6' float, 6'X 20' float and to install three (2) pile dolphins. 1205 Point Pleasant Rd., Mattituck Vote of Council: Ayes: All Motion Carried • i ,I i4 9 etl � pF tl - - f Yt .9 'LL t P Y y .e 01 -3 zY s' y e I €s b a.� ai3 �say W I �i 8411 �, ' tiffs► e '-�Q ' i1f ' , . 3 IstEil IO III C-1 e,. 1 I I I W wzo II.III I.LHI.LI1.l IL .l l- J A, ee 4O'F r f P� +x ' CAPTAIN KID ESTATES_ =OL` �.i �• dDAY ?t oa eW 'Y M MATITUCK \ 11901 , v OL JI [%PWY LAN '} .___ ..L Lake ccfrel 11952 ,..,. e .. pWN4' FX. � !A N.YS. �l1111O RYA al= I, AURiI m'!Or r 194 sIS! fir° T P` b 6R 1 vo. p fiilu[4 (I Ilk r.. OAUpNIFA[ � Of AMd1CA L� fl• [L ll ` tib o n 34 35 ., 36 J . M.O. Environmental Consulting Services September 13, 2001 Mr. Albert Krupski, President Board of Town Trustees - Town of Southold t' ` P.O. Box 1179 Southold, N.Y. 11971-1179 SEP RE: Application for Robert Pellegrini I Home Pike, Mattituck Dear Mr. Krupski: I am currently writing you as a follow up to our discussion at the last Board of Trustees meeting regarding this project. As agreed upon, enclosed please find copies of the revised plans. As you may recall, we have modified the plans to depict that the seaward most 5' of the existing catwalk shall be removed prior to the installation of the approved 32"x 20' aluminum ramp, 3' x 6' float, 6'x 20' float and (3) two-pile dolphins. As always, should you have any questions please feel free to contact our office. Sincerely, J Glenn . Just Phone (631) 653-0607 • Fax (631) 653-3348 121 Jessup Ave • 2nd Floor • P.O. Box 447 Quogue, New York 11959-0447 � a Albert'J. Krupski,President O0.0FFO1.tc Town Hall &mes King,Vice-President �y��. 63096 Route 26 Henry Smith 33 P.O. Box 1179 Artie Foster r7S Southold,New York 11991.0969 Ken Poliwoda Gy ! Telephone(631) 766-1892 Fax (631) 766-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD O11ice Use Only _Coastal Erosion Permit Applicat' _Wetland Permit Application _Major 'n Waiver/Amendment/ h ges +i- Received Application: I O _Received Fee:S JUN T 311 _Completed Application —Incomplete _SEQRA Classi£cation: Type I_Type 11—Unlisted - _Coordination:(date sent _CAC Referral Sent: r71Z.16 Date of Inspection: !Receipt of CAC Report: Lead Agency Determination: —Technical Review: —Public Hearing Held: L Resolution: NameofApplicant Robert and Rita Pellegrini Address 4515 Stillwater , Cutchogue , N.Y. 11935 Phone Number:( ) 734-6346 Suffolk County Tax Map Number: 1000- 114-01-04 R Property Location: Home Pike , Mattituck - -P1 ems rRd • ft& 4P4 OF (provide LILCO Pole#, distance to cross streets, and location) AGENT: Glenn E . Just/ J .M. O. Environmental Consulting (If applicable) Address: P . O . Box 447 , Quogue , N.Y. 11959-0447 YXt a Phone: 653-0607 n Board of Trustees Application GENERAL DATA Land Area(in square feet): 94 , 798 . 97 Area Zoning: Residential Previous use of property: Single family dwelling Intended use of property: same _ Prior permits/approvals for site improvements: Agency Date Southold Town Trustees 1983 No prior permits/approvals for site improvements. Has any-permit/approval ever been revoked or suspe ded by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): Applicant proposes to install a 32"x 20 ' aluminium ramp onto an existing catwalk , a 3 ' x 6 ' float , 6 ' x 20 ' float and to install three (2) pile dolphins . *card of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Private recreational docking Area of wetlands on lot: ±400 s . f. square feet Percent coverage of lot°/a % Closest distance between nearest existing structure and upland edge of wetlands: 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? n/a cubic yards How much material will be filled? n/a cubic yards Depth of which material will be removed or deposited: n/a feet Proposed slope throughout the area of operations: n/a Manner in which material will be removed or deposited: n/a Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): As proposed, project shall have no negative impacts upon the waters or wetlands of the Town of Southold . 14-164 nzre7;--a SEAR PROJECT ID NUMBER 617'20 APPENDIX C STATE ENVIRONMENTAL DUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1--PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME Robert and Rita Pellegrini Private recreational docking 3. PROJECT LOCATION: municipality Mattituck County Suffolk e. PRECISE LOCATION:(Street address and road intersections,prominent landmarks,etc.,or provide map) Home Pike Location map and survey enclosed S . C. T . M. No . 1000-114-01-04 5. I ROPOSED ACTION: New 0 Expansion 0 Moddicstion/anerallon 6. D SCRIBE PROJECT BRIEFLY: Applicant proposes to install a 32"x 20" eluminium ramp onto an existing, catwalk , a 3 ' x 6 ' float , 6fx 20 ' float and to install three (2) pile dolphins . 7. AMOUNT OF LAND AFFECTED: Initially 4 aeras Ultimately � acres B. WILL PROPOSED ACTON COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? yes 0 No N no,describe brie6y 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential 0 Industrial 0 Commercial 0 Agriculture O Perk/ForestlOpen Space. O Other Describe: Single family dwellings 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(Federal,Slate or Local)? 1,4 Yes 0 No 11 yes•list agency(*)end permlUapprovab N. Y. S . D. E . C . , N.Y. S . D. O. S . , U. S . D.O.A. & Southold Town Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? 0 Yes Ik No If yes,list agency name and pemrlt/approvid 12. AS A RESULT�OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? '1\ 0 Yes No I ERTI THAT T INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor Name 1 n E• J ll t agent Date Signature If the action Is In he Coastal Area, and you are a state agency, Fcomplete the Coastal Assessment Form before proceeding with this assessment OVER FROM JmO CONSULTING 0 PHONE NO. : 653 0607 • May. 07 2001 10:39W P03 board of Trustees Application AUTU(*IZATICN r' (where the applicant is not the owner) I, �, ) •Y" �A r 1 yy/ re6lding at (print owns of' prppty) (mailing add re o /,�-1-C'�lir� A)!y I -33 do hereby authorise Glenn E. Just/ (Agent) J.M,O. Environmental Consu],AL" to apply for permit(s) from the Southold Hoard of Town Trustees on My behalf. A 20M SmO CONSULTING • PHONE NO. : 653 0607 Wy. 07 2001 10:39AM P03 board of Trustees Application AUTHORIZATION r (where the applicant is not the owner) 1, lV i �I residing at (print owns of prerty) (mailing addre s) alb do hereby authorize Glenn E. Just/ 0 (Agent) J.M,O, Environmental Consulting to apply for permit(s) from the Southold Board of Town Trustees on My behalf. Own s s gna e) A FROM JmO CONSULTING PHONE NO. : 653 0607 �ay. 07 2001 10:39RM PO4 Board of Trustees Application ` County of Suffolk State of New York j �) • N l/EGl j^I.�) ) BEING DULY SWORN DEPOSES AND AFFIRMS PIAT HE/SHE IS THE PPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S) , IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZ$ THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S) , TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNC'T'ION WITH REVIEW OF THIS APPLICATION. Sig tore SWORN TO BEFORE ME THIS DAY OF ,JUNE E.SAYR E *Wy p *,Stria d Neu l�adt No.4948605 n *Albd in SudA CMW lJYr,4w4,4ftB �3ro1Q3 Notary Pub c 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 1-4738-00229/00001- PERMIT UNDER THE ENVIRONMENTAL CONSERVATION LAW 8 ARTICLE 15, (Protection of Water) ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) ARTICLE 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO Dr. Norbert F. Falzon ADDRESS OF PEKMITTEE RRl Box 187A Wes is 1a�ad MattitUCk NY 11952 LOCATION OF PROTECT(Section of stream, tidal wetland,dam, building) Mattituck Creek DESCRIPTION OF PROJECT 1imove by hand the tidal grasses fr m an area of beach 50' to the east of open pile cock and 15' to the west of said dock along Mattit+rk Creek COMMUNITY NAME(City, Town, Village) TOWN Mattituck outhold COUNTY t FIA COMMUNITY NO. DAM NO. PFaMIT EXPIRATIQVp�_ Suffolk 7/16�2w._ GENERAL CONDITIONS 1. The permittee shall file In the office of the appropriate Regional 8. That the State of New York shall in no case be liable for any damage Permit Administrator, a notice of Intention to commence work at least 4a or Injury to the structure of work herein authorized which may be caused by o hours In advance of the time of commencement and shall also notify him result from future operations undertaken by the State for the conservation or promptly In writing of the completion of the work. Improvement of navigation, or for other purposes, and no claim or right It ' 2. The permitted work shall be subject to Inspection by an authorized compensation shall accrue from any such damage, representative of the Department of Environmental Conservation who may 9. That If the display of lights and signals on any work hereby authorizer order the work suspended if the public Interest so requires. Is not otherwise provided for by law, such lights and signals as may be pre. 3. As a condition of the Issuance of this permit, the applicant has ac- scribed by The United States Coast Guard shall be Installed and maintained cepted expressly, by the execution of the application, the full legal respon- by and at the expense of the owner. sibility for all damages, direct of Indirect, of whatever nature, and by whom- 10. All work carried out under this permit shall be performed In accor- ever .suffered, arising out of the project described herein and has agreed to dance with established engineering practice and In a workmanlike manner. Indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from the said project. 11. If granted under Articles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due notice and hearing to 4. Any material dredged In the prosecution of the work herein permitted continue, rescind or modify this permit In such a manner as may be found to shall be removed evenly, without leaving large refuse piles, ridges across the be just and equitable. If upon the expiration or revocation of this permit, the bed of the waterway or flood plain or deep holes that may have a tendency to modification of the Welland hereby aulhorized has not been completed, the cause Injury to navigable channels or to the banks of the waterway. applicant shall, without expense to the Stale, and to such extent and in such 5. Any material to be deposited or dumped under this permit, either in time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or 1111 and restore The the waterway or on shore above high-water mark, shall be deposited or dumped site to Its former condition. No claim shall be made against the State of New at the locality shown on the drawing hereto attached, and, It so prescribed York on account of any such removal or alteration. thereon, within or behind a good and substantial bulkhead or bulkheads, such as will prevent escape of the material Into the waterway. 12. This permit shall not be construed as conveying to the applicant any 6. There shall be no unreasonable interference with navigation by the right to trespass upon the lands or Interfere with the riparlan rights of others to perform the permitted work or as authorizing the Impairment of any rights, work herein authorized. title or interest in real or personal property held or vested In a person not a 7. That if future operations by the Slate of New York require an alteration party to the permit. In the position of the structure or work herein authorized, or if, In the opinion 13. The permittee is responsible for obtaining any other permits, ap. of the Department of Environmental Conservation If shall cause unreasonable provals, lands, easements and rights-of-way which may be required for this obstruction to the free navigation of said waters or flood (lows or endanger project. the health, safety or welfare of the people of the State, or loss or destruction of the natural resources of the State, the owner may be ordered by the Depart- 14, If granted under Article 36, this permit Is granted solely on the basis menf to remove or alter the structural work, obstructions, or hazards caused of the requirements of Article 36 of the Environmental Conservation Law and thereby without expense to the State; and If, upon the expiration or revocation Part 500 of 6 NYCKR(Construction In Flood Plain Areas having Special Flood of this permit, the structure, fill, excavation, or other modification of the Hazards — Building Permits) and In no way signifies that the project will be watercourse hereby authorized shall not be completed, the owners shall, free from flooding. without expense to the Slate, and to such extent and In such lime and manner 15. By acceptance of this permit the permittee aghes that the permit as the Department of Environmental Conservation may require, remove all or Is contingent upon strict compliance with the special conditions on the any portion of the uncompleted structure or fill and restore to Its former reverse side. condition the navigable and flood capacity of the watercourse. No claim shall `r be made against the State of New York on account of any such removal or alteration. cc: Law WOloestp21t 95.20.4(9/75) y�,,�� �""Y corPS Of E,,3ilLeer3 (SEE REVERSE SIDE) SPECIAL CONDITIONS 16. Applicant shall be liable for any damage to adjacent waterway resulting from any phase of the permitted construction. 17. We reserve the right to comment at a later date concerning other environmental aspects of this project. 18. The granting of this permit does not relieve the .permittee of the responsibilit of obtaining any permits, licenses, or other authorization which may be require by other State, Federal or local agencies. 19. The applicant shall only remove vegetation by hand, no mechanical devices used. PERMIT ISSUE DATE PERMIT ADMINISTRATOR ADDRESS -- 7/16/91 DANIF3, J. LARD ' S,,." BLDG. 40 SUNY MM BWOK o�%C�Ff Lft'.c TELEPHONE ' ! (516) 1659892 BOARD OF TOWNTRUSTEES TOWN OF SO(Tr110LD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 September 27 , 1983 v 3 Mr. Norbert F. Falzon c/o Mr. Russell Nine P. o. Box 1106 Mattituck, New York 1.1952 Dear Sir: Transmitted herewith is your.. Permit which was granted under. the Grandfather Clause, fol- your st.ruct-ure. Please post your permit number on your structure•, so that it can be seen from the water. Thank you for your co-operation, in regard to this matter. Very truly yours , Board of Town Trustees Ilene Pfif£erling Clerk to Trustees Attachment r I '' •t7_ ..=.J •.LJL DLJ:�'..L •JL:�J.:. l:CG.'.l.,V -5rL•lY `IIS1JL P ? '!IT N ABED • ALL DC•Cv A: D euL.:;Li:.ICS Il;,T Di.r A}{ , � ,C ✓ +^ El ?•t- EI ,' T l ,,i ;_^f 1 1 ../,mr)ti^I 1 rl,�`Y"i ,n 1 .t o '..� �' } ��� ,-,tl•J ltr. ..w. .l ..' C. J=::, i '� � .C.Y� �.I:7� C,ll7E1�� I�tIIS`r.: t' is?J^C)oard Of 5out�1o! d Town Trustees >Vn j SCUTHCLU, NcW YORE. /r t c bICCRI_IG NO.N/A _ t ; i 14 9.. ... ...... DATE: ...$ePt.r ...27.r 198EijE \s PERMIT NO. .. 1.67...., i J .3 �• ISSUED TO ••-•--•• I Norbert F. Falzon r • � 1 l }, �.LII1IIIi iIi�21 s� �V: . Fes_. :•.i SRI Via+. t Pdrsuant to the provisions of Chapter 615 of the Laws of _ `�• fhe State of New York, 1843; and Chapter 404 of the Laws of the .: ': State of New Yoric 1452; and Lhe ScuihoW Town Ordinance en- �,�' •'= tided "REGULATING AND THE PLACINC— OF OBSTRUCTIONS s l tf f `atp IN AND ON TOWN WATERS AND PUELIC LANDS and the { \C �S.'• REMOVAL OF SAND, GRAVEL OR OTHER MATERIALSFROM �y 't^ LANDS UNDER TOWN WATERS;' and in accordance with the �p i 7 Resolution of The Board adopted of a meeting held on •.Sept.••,_13F r.; t 1 G 19....83., and in consideration of fhe sum of $........ 00 Paid by .l Norbert F. Falzon i 1 ,f ...................................................................................................... ..................................................... l E Mattituck _:..... '" ` of ........_...._................................... .. ... N. Y. and su6'Iect to the = Terms and Condifions listed on the reverse side hereof, 41E of Soufhold Town Trustees aufhorizes and permits the following: Application approved under the Grandfather Clause ttu to secure a permit number for a dock in Mattituck Creek. y• _ C ,: i 11 \ , a +:;. all in accordance with the detail=d epeeiiications as presented in f.+I:_.'.- fhe originating application. .1 IN WITNESS WHEREOF, The said Board of Trustees here- 11 ts�_1• J ' by causes its Corporate Seal to be affixed, and {hese presents to 1% fWs \ c= L I:S be su6scri6ed by a majority of the said "Board a of this date. rr o —� t.. 1. 1- z.. . V� �Y =j �/ •,' ..... ... . .. N. ... ..� ��'-��' .C• tee --.rte � " ( �"'."`�!T 'ijli �` 1�'H' ��."-i'olJl-i� �`!ir.�rr"Z�� �n' - •Y�yY'l�'i(�i nl "tirr�E :.��'��,,;,'srrl �'s� r� " .�."S+tis^',s,`"''r^�,.1 iesrm:3?.,h _ wr+•s. +. /P J4k� M`_� :JTtr �. �.I .ili t"vr/ F rir-.`a•c.s., iiE i ,`.?' }pl' R3:''•',fE."•"'� tRl O ,`: �.�+!�='?, .r:J"+�� e, d1=.. �..r AYI �.,,-h/t� :.".,orf r• �����^•• ' �-t41.cr,,,��:: .;�ay,�-.. ^tr•dy- Jr_"•w"'-^"'L,� 3y�,,. �r ��C. � -...`... w_:..w..^:p-•y '3 � 'r ti..5:! 1 41�:^ '�\ AFF ^•••��'� a^ _=^=�___ _ -� ..—.••./�.�•�� �_•.`� . , ---- -------im. _—_..___^____—_____.TEa i.1_SEIICi."'�_–rrllSa.. __�_____._...- ' I it sevNr4 .. BOARD OF TOWN TRUSTEES Town of Southold bInin Rand Southold, New York 11971 NOTICE OF ACTION - NOT A PEW41T To: ....Nar.>assi:..k r... lzon........................................................................................................... 1. Your application, dated .......9J N.................................................. has been reviewed by this Board, at a meeting of the Trustees held an •.... ....................................................... and resulting in the action, as indicated below: (.XXXXN Application approved. (............) Application'denied. (............I Application tabled. 2. Comments and remarks: At a regular meeting held on Sept. 13 , 1993 your application was approved under the Crandfather Clause. Your permit ; will follow shortly. Please pest your permit number, once you have received it. Thank You . A PERMIT FEE 3. Ifycur e� li nHnn rc nn�r .•aa above. ?F- mrt sr� is n w dui and should be made payable to the oreer of the Board of Southold Town Trustees. This fee is computed below according to the,Schertul of fi tes s aet forth in the Instruction Shee Fa rm I 1 . This ust be paid wit -in �d r 'ays or re-applying and ,A h ' fee wLTT Te necessa; If the Permit Fee is paid in person to the Secretary of the Board, The Permit will be eb aincbla at the some time. If the fee is paid by mail, the permit will be mailed in reply, Computation of Permit Fee: Total Fee_ for this cpplication .............................:.............................. S ........................................ Signed .. ........ .. Pres. Board of Southold Tcwrt Trustees. by ... ........... -4r2a c , 14Ai-11E OF CREEK : P.u � K a �ka�c 51 r BOARD OF TORN TRUSTEES rn . 3' ' Town Of Southold Ice 4 /7 Main Yor `v�/ y� Southold, New York 11911 MA r APPLICATION FOR FIXED and/or FLOATING DOCKS /40 k00 PIT F FAt-zom d l� Applicant's name and address: ............. .. ...:..... ....................TP�.:...2..4.��.:.s9g1 2. Contractor's name and address: ..................._..................r............................................................. .......................................r........................................................................................Te 1.:......................... 3. Briefly explain the purpose of, this application: ...................... .............. . .................. �f° ,r / ...4�! !.... .....`.�.5..... . ... ... :c,ta. N�• ...............................................................................� " '�. ................. 4- After issuance of a Permit, work must be completed within one year. LARGE 5. Secure the correct Area Mop from the Clerk of this Board, and by using a/X WITHIN A CIRCLE indicate as closely as possible the location of this deck. On the_reve.rse side of this map, provide a SCALE DRAWING which will show Ordinary Hialt Water Mark; the shape and size of the dock and any supplemental pilings which are needed to hold a floating deck or tie-uD n bant. Give all dimensions necessary to determine the area of the dock surface WHICH EXTENDS OF_FSHO.RE from the 0. H. W. M. if adjacent property owners have docks , specify location and length to scale. 6, Will any portion of this construction extend offshore into Town Waters beyond on imaginary line or boundary formed by other similar structures along the area's shoreline? YES of NO. If it does extend beyond this so-called deck line indicate by how for, approximately...........ft. 7. Provide the following documents: (a) A Licensed Engineer's Survey of the property involved. (b) A copy of the Contractor's Plans and Specifications. (c Short Environmental Assessment Form. (d.1 Wetlands Apnplicat ' B. Will flu; constructio require t e Filling of any land offshore of the Ordinary High Water Mark or the Dredging cf any material from Toven Londs undar water? YES or NO. If it does, Form A/4 (Application for Dredging/Filling) must be completed and attached as part of this application. 9. In renuesting approval of th:s ivplicction, I submit that: the information presented herein is true and correct to the best of my knov.ledge ar.d helief; I am the person accountable for the performonre of the work in accordance with the plans and specifications attached; I have read or om familiar with the provisions of any Southold Town Ordinance pertinent to the work involved; and further, I intend to adhere to and abide by the Terms and Conditions of the Permit, when and if issued to me. 10. To expedite finding specific location for inspection, indicate by using a temporary markers � Q ' 14-16-2 (9/95)-7c • 617.20 SEOR 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 project or action may be significant.The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not be technically expert in environmental analysis. In addition,many who have knowledge in one particular area may not be aware of the broader concemi 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 enough to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially. large Impact The form also Igentifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 Is used to evaluate whether or not the impact is actually Important. DETERMINATION OF SIGNIFICANCE—Type 1 and Unlisted Actions Identify the Portions of EAF completed for this project: ❑ Part 1 ❑ Part 2 ❑Part 3 Upon review of the information recorded on this EAF(Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magnitude 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 impact on the environment, therefore a negative declaration will be prepared. ❑ B. 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 negative declaration will be prepared• ❑ C. The project may result in one or more large and Important Impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. •A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer In Lead Agency Signature of Preparer(if different from responsible officer) i Date 1 PART 1—PROJECT INFORMATION i Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the enviroiment. 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 additiona 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. PE OF ACTION roposed ramp , float and dolphins at an existing LOCATION OF ACTION(Include Street Addreee,MmIcipellty and County Home Pike , Mattituck , Suffolk Count NAME OF APPLICANTISPONSOR BUSINESS TELEPHONE Glenn E. Just/ J .M. O . Environmental Consultin 163b 653-0607 ADDRESS P .O . -Box 447 , 121 Jessup—Avenue uo ue elle NY TE ITP9�E0447 NAME OF OWNER 01 dllfereop ( 6UStNESS TELEPHONE Robert and Rita Pellegrini 6319 734-6346 ADDRESS 4515 Stillwater Avenue Cfry" STATE ZIP CODE Cutcho ue DESCRIPTION OF ACTION Applicant proposes to reconstruct existing 4 ' x 20 ' and 5 ' x 65 ' catwalk in same location and install a 23"x 20 ' aluminum ramp, 3 ' x 6 ' float and (3 ) 2-pile dolphins , Please Complete Each Question—Indicate N.A. if not applicable A. Site Description ' Physical setting of overall project both developed snd undeveloped areas. 1. Present land use: OUrban Olndustrial OCommercial OResidential(suburban) )Rural(nor?-farm) OForest OAgriculture OOther 2. Total acreage of project area: > 2 acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland(Non-agricultural) acres acres Forested acres +1 .0 acres Agricultural (Includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) +0. 5 acres +p s acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) acres acres Roads, buildings and other paved surfaces acres acres Other (Indicate type- lawn & dirt drive +0 . 5 acres T_ acres 3. What is predominant soil type(s) on project site? • Fd-filled land a. Soil drainage: tl`Welf drained I nn % of site OModerately well drained % of site OPoorly drained % of site b. If any agricultural land 1s involved,how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? acres.(See 1 NYCRR 370). ) 4. Are mere bedrock outcroppings on prol Ot site? OYes No a at is depth to bedrock? �b0 (in feet) 2 S. Approximate percentage of proposed project site with slopes: *00-10% P % 010-15% % 015% or greater % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of Historic Places? OYes P4No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? OYes YANo 8. What is the depth of the water table? n/a (in feet) 9. Is site located over a primary, principal, or sole source aquifer? kes ONo 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? Oyes ONo 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? Oyes PNo According to self Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) OYes WNo Describe 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? OYes QNo . If yes, explain 14. Does the present site include scenic views known to be important to the community? OYes MNo 15. Streams within or contiguous to project area: Mattituck Creek a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name Mattituck Creek b. Size (in acres) n/a 17. Is the site served by existing public utilities? OYes 14No a) If Yes, does sufficient capacity exist to allow 4onnection? OYes ONo b) If Yes, will improvements be necessary to allow connection? OYes ONo 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? OYes i09No 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 6171 OYes tallo 20. Has the site ever been used for the disposal of solid or hazardous wastes? Dyes PDNo 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 � 2 acres. b. Project acreage to be developed: 0 acres Initially; 0 acres ultimately. c. Project acreage to remain undeveloped n/a acres. d. Length of project, in miles: n/a (If appropriate) e. If the project Is an expansion, indicate percent of expansion proposed n/a %; I. Number of off-street parking spaces existing 0 ; proposed 0 g. Maximum vehicular trips generated per hour 0 (upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Condominium Initially n/a Ultimately n/a 1 1. Dimensions (in feet) of largest proposed structure 0 height; 0 width; _ 0 length. j. Linear feet of frontage along a public thoroughfare project will occupy is? 0 ft. 3 2. How much natural material (i.e.. rock, earth, etc.) will be removed from the site? tons/cubic yards 3. Will disturbed areas be reclaimed? OYes ONo SIN/A a. If yes, for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? Oyes ONo c. Will upper subsoil be stockpiled for reclamation? OYes ONo 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed4rom site? .p acres. 5. Will any mature forest(over 100 years old) or other locally-important vegetation be removed by this project? Oyes 1g)No 6. If single phase project: Anticipated period of construction 1/4 months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated n/a (number). b. Anticipated date of commencement phase 1 n/a month n/a year, (including demolition). c. Approximate completion date of final phase n a month n/a year, d. is phase 1 functionally dependent on subsequent phases? OYes RNo 8. Will blasting occur during construction? OYes ONo 9. Number of jobs generated: during construction 0 ; after project is complete tl 10. Number of jobs eliminated by this project -1 0 11. Will project require relocation of any projects or facilities? OYes OgNo If yes, explain 12. Is surface liquid waste disposal involved? OYes P]No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal Involved? OYes RINo Type 14. Will surface area of an existing water body increase or decrease by proposal? OYes ®No Explain 15. is project or any portion of project located In a 100 year flood plain? (Ayes ONo 16. Will the project generate solid waste?* OYes EDNo r a. if yes, what is the amount per month tons b. If yes, will an existing solid waste facility be used? Oyes ONo c. If yes, give name -- location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? OYes ONo e. If Yes, explain 17. Will the project involve the disposal of solid waste? OYes WINO a. If yes, what is the anticipated rate of disposal? tons/month. b. If yes, what is the anticipated site life? years, 18. Will project use herbicides or pesticides? OYes 1PNo 19. Will project routinely produce odors (more than one hour per day)? OYes MNo 20. Will project produce operating noise exceeding the local ambient noise levels? OYes PONo 21. Will project result in an increase in energy use? OYes •gNo If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity _ n/a gallons/minute. ' 23. Total anticipated water usage per dayy gallons/day. ) 24. Does project involve Local. State or Federal funding? Oyes ItNo If Yes, explain _ 4 Part 2—PROJECT IMPACTS AND THEIR MAGNITUDE Responsibility of Lead Agency General Information (Read Carefully) • In.completing the form the reviewer should be guided by the question: Have my responses and determinations been reasonable? The reviewer is not expected to be an expert environmental analyst. • The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part 3. • The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative and have been offered as guidance.They do not constitute an exhaustive list of impacts and thresholds to answer each question. • The number of examples per question does not indicate the importance of each question. • In identifying impacts, consider long term, short term and cumlative effects.' Instructions (Read carefully) a. Answer each of the 20 questions In PART 2. Answer Yes If there will be any Impact. b. Maybe answers should be considered as Yes answers. c, If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential size of the Impact. If Impact threshold equals or exceeds any example provided, check column 2. If Impact will. occur but threshold Is lower than example, check column 1. d. Idenilfying that an Impact will be potentially large(column 2)does not mean that It is also necessarily significant. Any large Impact must be evaluated In PART 3 to determine significance.Identifying an Impact In column 2 simply asks that it be looked at further. e. If reviewer has drTubt about size of the Impact then consider the Impact as potentially large and proceed to PART 3. I. If a potentially large Impact checked In column 2 can be mitigated by change(s)In the project to a small to moderate Impact, also check the Yes box In column 3. A No response Indicates that such a reduction is not possible. This must be explained In Part 3. 1 2 3 Small to Potential .Can Impact Be IMPACT ON LAND Moderate Large Mitigated By Impact Impact Project Change 1. Will the proposed action result Ina physical change t_o the project site? r ONO OYES Examples that would apply to column 2 • Any construction on slopes of 1S% or greater, (15 foot rise per 100 ❑ O OYes ❑No foot of length), or where the general slopes in the project area exceed 10%. • Construction on land where the depth to the water table Is less than ❑ ❑ OYes ONO 3 feet. • Construction of paved parking area for 1,000 or more vehicles. ❑ ❑ OYes ONO • Construction on land where bedrock is exposed or generally*within ❑ ❑ OYes ONO 3 feet of existing ground surface. • Construction that will continue for more than 1 year or involve more ❑ ❑ OYes ONO than one phase or stage. • Excavation for mining purposes that would remove more than 1,000 ❑ ❑ OYes ONO tons of natural material (i.e., rock or soil) per year. • Construction or expansion of a sanitary landfill. ❑ ❑ OYes ONO • Construction in a designated floodway. ❑ O OYes ONO • Other Impacts ❑ ❑ Oyes ONo 1 2. Will there be an effect to any unique or unusual land forms found on the site?(i.e.,cliffs,dunes,geological formations,etc.)ONO OYES • Specific land forms:, O ❑ Oyes ONo 6 25. Approvals Required: Submittal Type Date City, Town, Village Board ❑Yes OINo City, Town, Village Planning Board OYes (9190 City, Town Zoning Board ❑Yes ®No City, County Health Department OYes KNo Other Local Agencies OYes I)3No Other Regional Agencies. MYes ONO N• Y• S . D.O . S . State Agencies MYes ❑No N•Y• S .D. E.C , copy encl Federal Agencies f2Yes ❑No U, S . D . O.A. C. Zoning and Planning Information 1 . Does proposed action involve a planning or zoning decision? OYes ipNo If Yes, indicate decision requid3 Ozoning amendment Ozoning variance Ospecial use permit Osubdivision Osite plan Onew/revision of master plan OFesource management plan Oother 2. What is the zoning classificationls)of the site? residental 3. What is the maximum potential development of the site if developed as permitted by the present zoning? Yes 4. What is the proposed zoning of the site? same S. What is the maximum potential development of the site if developed as permitted by the proposed zoning? n/a 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? $IYes ONO 7. What are the predominant land uses) and zoning classifications within a '/ mile radius of proposed action? n/a 8. Is the proposed action compatible with adjoining/surrounding land uses within a 1/tt mile? Itlies []No 9. If the proposed action is the subdivision of land, how many lots are proposed? n/a a. What is the minimum lot size proposed? _ 10. Will proposed action require any authorization(s)for the formation of sewer or water districts? Oyes PNo 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? Oyes WNo a, If yes, is existing capacity sufficient to handle projected demand? OYes ONO 12. Will the proposed action result in the generation of traffic significantly above present levels? OYes' PNo a. If yes, is the existing road network adequate to handle the additional traffic? OYes ONO 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 1 certify that the Infnormation provided above is true to the best of my knowledge. / Applicant/Sponsor Na tp@ enn Date 7` 3/ 01 Signature Title Agent If the action is in the Coastal Area,and y u a e a state agency,complete the Coastal Assessment form before proceeding with this assessment. 5 1 2Elmpact IMPACT ON WATER Small to Potential Be By 3. Will proposed action affect any water body designated as protected? Moderate ImpaLargect ng(Under Articles 15,24,25 of the Environmental Conservation Law, ECL) Im aCl Im act nge ONO DYES Examples that would apply to column 2 • Developable area of site contains a protected water body. ❑ ❑ OYes ONo • Dredging more than 100 cubic yards of material from channel of a ❑ ❑ OYes ONo protected stream. • Extension of utility distribution facilities through a protected water body. ❑ O OYes ONo • Construction in a designated freshwater or tidal wetland. ❑ O Oyes ONo • Other impacts: O ❑ Dyes ONo 4. Will proposed action affect any non-protected existing or new body of water? ONO OYES Examples that would apply to column 2' • A 10% increase or decrease In the surface area of any body of water ❑ O OYes ONo or more than a 10 acre increase or decrease. • Construction of a body of water that exceeds 10 acres of surface area. ❑ O Dyes ONo • Other impacts: ❑ O OYes ONo S. Will Proposed Action affect surface or groundwater quality or quantity? IONO OYES Examples that would apply to column 2 • Proposed Action will require a discharge permit. ❑ O OYes ONo • Proposed Action requires use of a source of water that does not ❑ O OYes ONo have approval to serve proposed (project) action. • Proposed Action requires water supply from wells with greater than 45 O O OYes ONo gallons per minute pumping capacity. • Construction or operation causing any contamination of a water ❑ O Dyes ONo supply system. • Proposed Action will adversely affect groundwater. ❑ ❑ OYes ONo • Liquid effluent will be conveyed off the site to facilities which presently O ❑ OYes ONo do not exist or have inadequate capacity. • Proposed Action would use water in excess of 20,000 gallons per O O OYes ONo day. • Proposed Action will likely cause siltation or other discharge into an ❑ O ❑Yes ONo existing body of water to the extent that there will be an obvious visual contrast to natural conditions. • Proposed Action will require the storage of petroleum or chemical ❑ O Oyes ONo products greater than 1,100 gallons. • Proposed Action will allow residential uses in areas without water O O OYes ❑No and/or sewer services. • Proposed Action locates commercial and/or industrial uses which may O O OYes ONo require new or expansion of existing waste treatment and/or storage - facilities. • Other impacts: ❑ O OYes ONo 6. Will proposed action alter drainage flow or patterns, or surface water runoff? ONO DYES Examples that would apply to column 2 • Proposed Action would change flood water flows. ❑ ❑ OYes ❑No 7 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change • Proposed Action may cause substantial erosion. O O OYes ONo • Proposed Action is incompatible with existing drainage patterns. O ❑ OYes ONO • Proposed Action will allow development in a designated floodway. ❑ ❑ OYes ONO • Other impacts: O O ❑Ye! ONO IMPACT ON AIR 7. Will proposed action affect air quality? ONO OYES Examples that would apply to column 2 • Proposed Action will Induce 1,000 or more vehicle trips in any given ❑ O' OYes ONO hour. • Proposed Action will result in the incineration of more than 1 ton of O O OYes ..ONO refuse per hour. ' • Emission rate of total contaminants will exceed 5 lbs. per hour or a O O Oyes ONO heat source producing more than 10 million STV's per hour. • Proposed action will allow an Increase in the amount of land committed O O OYes ONO to industrial use. • Proposed action will allow an increase in the density of industrial ❑ O OYes ONO development within b-*-sting industrial areas. • Other impacts: O O, OYes ONO IMPACT ON PLANTS AND ANIMALS B. Will Proposed Action affect any threatened or endangered species? ONO OYES Examples that would apply to column 2 0 Reduction of one or more species listed on the New York or Federal O O OYes ONO list, using the site, over or near site or found on the site. 0 Removal of any portion of a critical or significant wildlife habitat. O O OYes ONO Application of pesticide or herbicide more than twice a year, other ❑ ❑ OYes ONO than for agricultural purposes. Ofher impacts: O O Oyes ONO 1. Will Proposed Action substantially affect non-threatened or non-endangered species? ONO OYES Examples that would apply to column 2 Proposed Action would substantially interfere with any resident or O O OYes ONO migratory fish, shellfish or wildlife species. Proposed Action requires the removal of more than 10 acres O O OYes ONO of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10. Will the Proposed Action affect agricultural land resources? ONO OYES Examples that would apply to column 2 The proposed action would sever, cross or limit access to agricultural O O Oyes ONO land (includes cropland, hayfields, pasture.' vineyard, orchard, etc.) 8 1 2 3 Small to Potential Can Impact E Moderate Large Mitigated 8� Impact Impact Project Chan( • Construction activity would excavate or compact the soil profile of ❑ ❑ Dyes ON. agricultural land. • The proposed action would irreversibly convert more than 10 acres ❑ O OYes ❑N, of agricultural land or, if located in an Agricultutai District, more than 2.5 acres of agricultural land. • The proposed action would disrupt or prevent installation of agricultural ❑ ❑ OYes ON, 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: O ❑ OYes ON. IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesth tic resources? ONO OYES (If necessary, use the Visual EAF Addendum in Section 617.20, Appendix B.) Examples that would apply to column 2 • Proposed_land uses, or project components obviously different from ❑ O OYes ❑Ni or in sharp contrast to current surrounding land use patterns, whether man-made or natural. • Proposed land uses, or project components visible to users of ❑ ❑ OYes ❑N( aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. • Project components that will result in the elimination or significant ❑ ❑ OYes ❑N( screening of scenic views known to be Important to the area. • Other impacts: ❑ ❑ OYes ON( IMPACT ON HISTORIC AND ARCHAEOL061CAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological Importance? ONO OYES Examples that would apply to column 2 • Proposed Action occurring wholly or partially within or substantially ❑ O OYes ON( contiguous to any facility or site listed on the State or National Register of historic places. • Any Impact to an archaeological site or fossil bed located within the O ❑ OYes ❑N( project site. • Proposed Action will occur In an area designated as sensitive for ❑ ❑ OYes ON( archaeological sites on the NYS Site Inventory. • Other impacts: ❑ ❑ ❑Yes ❑N( IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that would apply to column 2 ONO OYES • The permanent foreclosure of a future recreational opportunity. ❑ O Oyes ❑N' • A major reduction of an open space Important to the community. O O Ot es ON, • Other Impacts: ❑ O OYes ON' 9 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change IMPACT ON CRITICAL ENVIRONMENTAL AREAS 4. Will Proposed Action impact the exceptional or unique character- istics of a critical environmental area (CEA)established pursuant to subdivision 6 NYCRR 617.14(g) ? ONO DYES List the environmental characteristics that caused the designation of the CEA. Examples that would apply to column 2 f Proposed Action to locate within the CEA? ❑ ❑ Dyes ❑No Proposed Action will result in a reduction in the quantity of the resource? ❑ ❑ Dyes ❑No Proposed Action will result in a reduction in the quality of the resource? ❑ ❑ ❑Yes ❑No Proposed Action will impact the use, function or enjoyment of the ❑ ❑ []Yes ❑No resource? Other impacts: ❑ ❑ []Yes ❑No IMPACT ON TRANSPORTATION 15. Will there be an effect to existing transportation systems? ONO DYES Examples that would apply to column 2 r Alteration of present patterns of movement of people and/or goods. ❑ ❑ ❑Yes ❑No r Proposed Action will result in major traffic problems. ❑ ❑ ❑Yes ❑No r Other impacts: ❑ ❑ ❑Yes ❑No IMPACT ON ENERGY 16. Will proposed action affect the community's sources of fuel or energy supply? ONO DYES Examples that would apply to column 2 r Proposed Action will cause a greater than 5% increase in the use of ❑ ❑ ❑Yes []No any form of energy in the municipality. r Proposed Action will require the creation or extension of an energy ❑ ❑ (--]Yes ❑Mo transmission or supply system to serve more than 50 single or two family residences or to serve a major commercial or industrial use. 4 r Other impacts: ❑ ❑ Dyes ❑No 10 NOISE AND ODOR IMPACTS , 2 3 Small to Potential Can Impact Be 17. Will there be objectionable odors, noise, or vibration as a result Moderate Large Mitigated By of the Proposed Action? ONO DYES Impact Impact Project Change Examples that would apply to column 2 • Blasting within 1,500 feet of a hospital, school or other sensitive ❑ ❑ ❑Yes ❑No facility. • Odors will occur routinely (more than one hour per day). ❑ ❑ ❑Yes ONO • Proposed Action will produce operating noise exceeding the local ❑ ❑ ❑Yes ONO ambient noise levels for noise outside of structures. • Proposed Action will remove natural barriers that would act as a ❑ ❑ ❑Yes ONO noise screen. • Other impacts: ❑ ❑ Dyes ONO IMPACT ON PUBLIC HEALTH 18. Will Proposed Action affect public health and safety? ONO DYES Examples that would apply to column 2 • Proposed Action may cause a risk of explosion or release of hazardous ❑ ❑ ❑Yes ONO substances(i.e.oil,pesticides,chemicals, radiation,etc.)in the event of accident or upset conditions, or there may be a chronic low level discharge or emission. • Proposed Action may result in the burial of"hazardous wastes"in any ❑ ❑ ❑Yes ONO form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) • Storage facilities for one million or more gallons of liquified natural ❑ ❑ ❑Yes ONO gas or other flammable liquids. • Proposed action may result in the excavation or other disturbance ❑ ❑ Dyes ONO within 2,000 feet of a site used for the disposal of solid or hazardous waste. • Other impacts: ❑ ❑ ❑Yes ONO IMPACT ON GROWTH AND CHARAQTER OF COMMUNITY OR NEIGHBORHOOD 19. Will proposed action affect the character of the existing community? ONO DYES Examples that would apply to column 2 • The permanent population of the city, town or village In which the ❑ ❑ ❑Yes ONO project is located Is likely to grow by more than 5%. • The municipal budget for capital expenditures or operating services ❑ ❑ ❑Yes ONO will increase by more than 5% per year as a result of this project. • Proposed action will conflict with officially adopted plans or goals. ❑ ❑ ❑Yes ONO • Proposed action will cause a change in the density of land use. 13 ❑ ❑Yes ONO • Proposed Action will replace or eliminate existing facilities, structures ❑ ❑ ❑Yes ONO or areas of historic importance to the community. • Development will create a demand for additional community services ❑ ❑ ❑Yes ONO (e.g. schools, police and fire, etc.) • Proposed Action will set an Important precedent for future*projects. ❑ ❑ ❑Yes ONO • Proposed Action will create or eliminate employment. O ❑ ❑Yes ONO • Other impacts: ❑ ❑ ❑Yes ONO 20. Is there, or is there likely to be, public controversy related to potential adverse environmental Impacts? ) ONO OYES If any action In Part 2 Is Identified as a potential large Impact or It you cannot determlm the magnitude of Impact,proceed to Pad 0 11 Part 3--EVALUATION OF THE IMPORTANCE Or IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impac(fs) may be mitigated. Instructions 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 mitigated or reduced to a small to moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is Important. 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 value • Whether.the impact can or will be controlled • The regional consequence of the impact • Its potential divergence from local needs and goals • Whether. known objections to the project relate to this Impact. ' (Continue on attachments) i 12 a14 N 11 (9195)-9c 617.20 SEAR Appendix B State Environmental Quality Review Visual EAF Addendum This form ,may be used to provide additional information relating to Question 11 of Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between Visibility Project and Resource (in Miles) 1. Would the project be visible from: 0-114 1/.-1/2 1/2-3 35 5+ • A parcel of land which is dedicated to and available ❑ O O ❑ ❑ 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 ❑ ❑ ❑ ❑ O observation, enjoyment and appreciation of natural or man-made scenic qualities? • A site or structure listed; on the National or State O Cl O ❑ ❑ Registers of Historic Places? • State Parks? ❑ ❑ O ❑ ❑ • The State Forest Preserve? ❑ ❑ ❑ ❑ ❑ • National Wildlife Refuges and state game refuges? O ❑ ❑ ❑ ❑ • National Natural Landmarks and other outstanding O O ❑ ❑ ❑ natural features? • National park Service lands? ❑ O O ❑ O • Rivers designated as National or State Wild, Scenic O O O ❑ O or Recreational? • Any transportation corridor of high exposure, such O O O O O as part of the Interstate System, or Amtrak? • A governmentally established or designated Interstate ❑ O O ❑ ❑ or inter-county foot trail, or one formally proposed for establishment or designation? • A site, area, lake, reservoir or highway designated as O O O ❑ O scenic? • Municipal park, or designated open space? O ❑ ❑ ❑ O • County road? ❑ O ❑ ❑ ❑ • State? ❑ O ❑ O ❑ • Local road? O O ❑ ❑ ❑ 2. Is the visibility of the project seasonal?(i.e., screened by summer foliage, but visible during other seasons) ❑Yes []No 3. Are any of the resources checked in question 1 used by the public during the time bf year during which the project will be visible? t Oyes ONO 1 DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each Item checked in question 1, check those which generally describe the surrounding environment. Within "/4 mile •1 mile Essentially undeveloped E) ❑ Forested ❑ ❑ Agricultural ❑ ❑ 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: •V2 mile ❑Yes ❑No •1 miles ❑Yes ❑No •2 miles ❑Yes 11 No '3 miles ❑Yes ❑No ' Distance from project site are provided for assistance.Substitute other distances as appropriate EXPOSURE 6. The annual number of 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 FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work ❑ ❑ ❑ ❑ Involved In recreational activities ❑ ❑ Cl ❑ Routine travel by residents ❑ ❑ ❑ ❑ At a residence ❑ ❑ ❑ Cl At worksite ❑ ❑ Cl ❑ Other ❑ ❑ ❑ ❑ — 2 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name : Address : CERTIFIED MAIL RECEIPT 0 -a T T l r IT ID 0959 Postage $ S uT 1.90 Ln Certified Fee Postmark E3 Retum Receipt Fee `1 (Endorsement Required) Clerk' Kwm , O Restricted Delivery Fee G (Endorsement Required) /OB)01 C3 Total Postage&Fees ru Ill N e(plea Int Clearly) To be completed by mailer) M P 111Yi{.... -.--------------------------------------------------- Er 0. C3 .. ..Street, ....Apt. .�or PO c ..__ -i S .. i. it�j/� M1 C , STATE OF NEW YORK COUNTY OF SUFFOLK residing at sem, "o '--Q- , b ng duly sworn, deposes and says that o the day of ;N eLD1, deponent N mailed a true copy of the ce set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment " - '` ^'•*h^�r�' that said Notices were mailed at that. p Complete items 2,a d 3.gNso Complete ns by (certified) 1, item 4 if Restricted Delivery is desired. Rec9ived by lease print C)eedy) S.bet o D ivery Print your name and address on the reverseso U S O • Atttachtwe can this cardeturn the card to o the back of the mailpiece, Sig ture ^ _ or on the front if space permits. X ' O Agent 1. Article Addressed to: D. Is deliveryadd Q Addressee different from item I? Q Yes Sohf YES,enter delivery address below: ❑No P• o • 3v r�7Z 3. service Type Y Gi Q Certified Mail ❑ Express Mail Q Registered Q Rete•,-'^-Rec@i.^Vor Merchandise Q Insured Mail Q C.O.D. 4. Restricted Delivery'!(Extra Fee) Article Number(Copy from service label) 74M yes 7199 32Z ) OD/D 55y� l�t� S Form 3$11,July 7999 Domestic Return Receipt PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address : CERTIFIED MAIL. RECEIPT M 0.34 UNIT IU: 6959 ..D Postage $ 7 � 1.90 Certified Fee C3 Return Receipt Fee '51— Postmark (Endorsement Required) Clerk: KbJ & G Restricted Delivery Fee C3 (Endorsement Required) @@ 06/06/01 C3 Total Postage&Fees $ R1 rU Name(Please Print Cl�)(To be completed by mailer) M y� n [f' �I �, yF.N;`o-oo Bw .se!+ ---------------------------------... Cr C3 al pT ��_-----------------------ab - L 3390 STATE OF NEW YORK COUNTY OF SUFFOLK residing at tL being duly sworn, deposes and says that o the �_ day of ;�3 MI, deponent mailed a true copy of the N ce set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are r+f said persons as shown on the current assessment MMMMMENNEMMNL - u^}+^mss were mailed at SEN & , that. ns by (certified) ■ Complete items 1,2,and 3.Also complete A. R eived b item 4 if Restricted Delivery is desired. y(Please P^^r ice - 8..D�atec,�of Delivery 66 ■ Print your name and address on the reverse L �L " 5o that we Can return the card t0 you. C. Signa n o/ ■ Attach this card to the back of the mailpiece, 'F✓//(/ or on the front if space permits. X ,�G fol Agent ❑A asses 1. Article Addressed to: D. Is sry address different from Rem 1? es If ES,enter delivery address below: ❑No �o us/aS tarns �,�C� MATTITO CK---N ' 3. Service Type 3 3 90`1 ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise f]insured Mail ❑ C.O.D. 4. Restricted Delivery?WmVa pW ❑yes 2. Article Number(Copy tram service label) 0 3aza oao s5e16 PS tl Receipt F PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Addresst m CERTIFIED MAIL RECEIPT 0.34 UNIT ID: 09139 •n Postage $ S in 1.90 Lll Certified Fee 1.50 p Return Receipt Fee Postmark (Endorsement Requi"xil Clerk: KW&% C3 Restrlcted Delivery Fee Z3 (Endorsement Requirf4 p Total Po�eBa&Faee $ 06/08/01 ru ru (Please Print Clearly)jra omplew by mailer) M Er p ..4-....-.....:_ k..-...1- ---------- - ---------------------------------- r` r I . \ 5 STATE OF NEW YORK COUNTY OF SUFFOLK -(N V residing at _ZS ,( k--.q� W be, ng duly sworn, deposes and says that ort' the _ ' day of ;",eMI, deponent mailed a true copy of the N t ce set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons ase r - &L_ ---.rent assessment SENDER: COPOI11EIE THIS SECTION i were mailed at that. ■ Complete Items 1,2,and 3.Also complete A. Race' ed b (Please.Pnn ea e. Date of el—'iv�ery l8 by (certified) item 4 if Restricted Delivery is desired. �r. J ■ Print your name and address on the reverse C. Signature / so that this can return the card to you. P X " v�I 1 p Agent ■ Attach this card to the.Wck of the mail iece, �/ II✓•"�F"/•��"—� ❑Addressee or on the front if space porn l%, D. Is delivery address different from Rem 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: 13No y�� rxX' I q 52 3. Service Type ❑Certified Mail ❑Express Mail f 110 Registered ❑ReturnReceipt for Merchandise C3 Insured Mail C.O.D. 4. Restricted Delivery?(Extra Fee) 1 1 ❑ Lk III 2. Article Number(Copy from service label)--t l"�aC g .�y1 �+�y�1 O SSLA� I Lk 1 I, PS Form 3811,July 1999 I DDomestic`Return R`ecei`pt`! `--`J 102595-00-M-0952 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES TOWN OF SOUTHOLD In the matter of applicant: Robert and Rita Pellegrini SCTM#1000114-01-04 YOU ARE HEREBY GIVEN NOTICE: 1 . That it is the intention of the undersigned to reluest a Permit from the Board of Trustees to: Install a 32"x 20 ' aluminium ramp onto an existing catwalk , a 31x 6 ' float , 6 ' x 20 ' float and to install three (2 ) piles dolphins 2 . That the property which is the subject of Environmental Review-,is located adjacent to your property and is dosr.ribed as follows : Home Pike , Mattituck 3. That the project which is subject to Environment') Review under Chapters 32, 37, or 97 of the Town Code is opon to public comment on: call office You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustejes of the Town of Southold and does not refer-n— any other, agency that might have to review same proposal. . OWNERS NAME: Pellegrini c/o JMO Environmental Consulting MAILING ADDRESS: P .O. Box Quogue , N.Y. 11959-U441 PHONE - PHONE # - - Enc. : Copy of sketch or plan showing proposal for your convenience. S B S 64-S '� �IV A4 27 ,• F ``� Cy' Iz_ _ eyou+v,l S B7 C� — — '�5���� �`' �ii'B h\"fir , k'Ht• \\\\\\o\\\`\�• 06- 24— -- _ _ - - .b � r - \ 58. 2s2 26- - —ww or / — Si336 DI9R7mAAILE t0 oe 5IIK6C WIM HA ml I5LT P8NCE x S 6 '0,9, 36 30— —i - - -- - -— ---__ .1� � � v , ` �� 1A. 03, 5 60. 1D.1 �\ CCC u5 \\`� , � \ \ 'Y 9 3 "W6\ INed 1Ra� B4 P �p'Q' / E�+ �1 �� AAv � � AA�IAV SAV \ 'l�t 4 ,O.AV u' p '0'2G� f„ 1111\ Do I <11 ,. � � �S rr ; � �' 4a'.zl II 1 11111 \ \ \ \"• \ nW. �\ 1'y ,rpQ,o lyD• � POOL o\iy'ZS OR r .' ' � ) `'Jr� ,• ' � ' y I off' i i r :; ,� ) ''' g 1 \ 1\ \ 111 \11 \�' \ $� 3� '� O � x.1Q1 ,�. M .i �+ •��. . � � ` I 4 )�� '. / �NL � 1 1 \ ���N� ••, pldyCWAV �/� •' 2z5 I Nry /r 4 ••.• /' / w.,3a3 o'0J1,00�F d$y15 2 r .•. � Ap � 1 PM�HEAp P gyp, Oil FUND p p N 0.6E coWC. Ma+. S S3•16y 'OD' PKE HOME I 39:5 ��o S if°"ypa - ad 4 251 0 ul J S O 4m 0^ M ad C� SURVEY OF PROPERTY SITUATED AT MATTITUCK W TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK O S.C. TAX No. 1000- 114-01 -04 SCALE 1 "=30' NOVEMBER 1 , 1999 JULAUGUST 00 T 0 LOCATED WETLAND GS 3,, 2000LOCATED TREES APRIL 2, 2001 ADDED PROPOSED HOUSE AREA = 94,798.97 sq. ft. (TO TIE LINE) 2.176 cc. CERTIFIED TO, 8 ROBERT PELLEGRINI r 11 tiV t� TEST HOLE DATA NOTE: (RST HOLE DUG BY McDOH.ln GEDSC!A2E ON .IANUARY 5, ZOO?) 1'J'•A.D - 1. LOT NUMBERS SHOWN THUS: LOTO REFER TO ' r+�y MAP OF POINT PLEASANT FILE IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY .,• 9y5 ON MAY 17, 1916 AS FILE No. 720 2. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM 6 EXISTING ELEVATIONS ARE SHOWN THUS: laD ;• ' . �450� EXISTING CONTOUR LINES ARE SHOWN THUS: - - - - -1D- - - - - - N6 4. FLOOD ZONE INFORMATION TAKEN FROM: "�•�*� FLOOD INSURANCE RATE MAP No. 36103CO481 G ZONE AE: BASE FLOOD ELEVATIONS DETERMINED • A • L=18.8 ZONE Xe; AREAS OF 500—YEAR FLOOD; AREAS OF 100—YEAR FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN •. 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100—YEAR FLOOD. ZONE X: AREAS DETERMINED TO BE OUTSIDE 500—YEAR FLOODPLAIN. " ,E 4. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1 ,000 GALLONS. ✓' 1 TANK; 8' LONG, 4'-3" WIDE, 6'-7" DEEP 5. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. 1 POOL; 12' DEEP, 8' d1E. C) PROPOSED EXPANSION POOLORFAED ALTMYON OR ADDITION rTRIS SURVEY I6 A AOIATON OF 72I0AWOF THE NEW YORK STATE mUUTO " ® PROPOSED LEACHING POOL COPIES OF THIS SURVEY MAP NOT SPRING THE LAND SUIVEYDR'S INKED SEAL 00 EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY, O ® PROPOSED SEPTIC TANK ONLY TO THE INDICATED HEREON SHALL RUN ONLY ro E THPERSON FOR CM THE SURVEY eT9 15 PREPARED. AND ON HIS BEHNF TO THE Y 6. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD �mLNEDHwMP T,rNME HEREON,Y AND 'd OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. TO THE FBSIONEES OF THE LENDING INNR- 7. THE EXISTING SANITARY SYSTEM SHALL BE PUMPED AND REMOVED. TUTION. CERTFlCASION6 ARE NOT TRANSFERABLE. 8, NO SIGNIFICANT GRADING OF THE SITE SHALL OCCUR EXCEPT FOR THE DEMOLITION OF THE EXISTING HOUSE h SEPTIC SYSTEM AND THE CONSTRUCTION OF THE NEW HOUSE, THE %ISTENCF W RIGHT OF WAYS SEPTIC SYSTEM AND DRIVEWAY, env, x lHOMWNTS OF FN O RECORD IINTEED. PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TTE Sul AS EBTABUSHED OP SUCH 119E Moo EW YORK STA wID Joseph A. Ingegno ITE AS9DU) Lr Land Surveyor s n TIV4 SUNPy1 — Subdivision, — SRO Plane — Conetructlan Layout PHONE (631)727-2090 Fax (631)727-1727 OFFICES LOCATED AT ANILINC ADDRESS -' N.Y.S. LID. No. 49808 1380 ROANOKE AVENUE P.O. Box 1931 RIVERHEAD New York 11901 Riverhead, New York 11901-0965 99-680 n. ` iGi yOv� IN KID F M A/ C� r G� r(. \CDI. / OP' V ��5� J'1 MA TI TUCK d Suffolk County / Hagstrom Map 25 / Scale V'= 3,000' hFo Air' 5A� BOAkrr) 1 ., i �� _x• TOWN Of SC;U � I:,t:.:, -. ExP� 0 'O _ y iv of DATE 6 0 T \\ i4e v21 y \ Q N Applicant proposes to remove a 5'x 5' section at the seaward end of an existing 5'x 65' catwalk, to o Toe repair/reconstruct remaining 5'x 60' catwalk and existing ° tiQ �g F cA 4'x 20' ramp, to install a 32"x 20' aluminum ramp onto Q s / yi q, The existing catwalk, a 3 x 6 float, 6'x 20 float and to e pQ OJT V y RFC Install three two-'Pile dolphins. 1 � r w SEP ; a 2,001 J '`TWL. AHKALWaDFPTHSL-OCATED 6Y GA)UST I-7NIAY'01 �t�Oj h A LI A R BER ELL RIN LOCAT ON : HOME PIKE, MATTITUCK w \ 44W PURPO5E305.C.T.M.NO• PRIVATE RECREATIONAL DOCKING GJ DNA W N BY GATE: 17 MAY'OI 1000 -114- 01 - 4 REVIBEDLQ��I '�l� DATUM : APPARENT LOW WATER 11$Et-1'01 LOCUS ; 733' <00' l J.M.O.ENVIR NMENTAL CON5ULTING DRAWING NUMBER BASED 01 SURVEY BY J , INGEGNOLS. 2 APR01 SERVICES, 0,000UE, N.Y. G31 - 053-0007 I OF 2