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Home My WebLink AboutADEL, WERNER TRUSTEES John M. Brcdemeyer, III, President Henry P. Smith, Vice President Albert J. Kmpski. Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCO'I'r L. HARRIS Supervisor Town Hall. 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 April 9, 1991 Werner L. Adel, Jr. 12 Fox Meadow Lane Huntington, NY 11743 RE: 1000-115-12-3 Dear Mr. Adel: The Trustees reviewed the application submitted for the above referenced property to construct a one family dwelling. After an on site inspection by the Board of Trustees, it was determined that this project is out of Trustees' jurisdiction. Ail other approvals that may be applicable should be secured prior to the co~m~encement of the project. Very truly yours, John M. Bredemeyer, III President, Board of Trustees JMB:jt cc: Building Dept. New York State Department of Environmental Conservation Dear Thornton c. 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 I of the Environmental Assessment Form to assist you in responding. Project Name: V~J Q~nP, j- L. A {~£ / ~-(~. Project Location: WIS DEC Project Number: 1-L~-73<~00~-~-7 DEC Permits: SEOR Classification: [/X~ Type I [ ] Unlisted DEC Contact Person: L~t~ ~CoU&~--LO DEC Position: j no objection your agency or agency assuming agency DEC has to another lead status for this action, but reserves the right to comment on this action if a positive determination of significance is made. DEC has no objection to your agency or another agency assuming lead agency [] [] tot this actign, bu~ les to assume l e ~ ,osed action has ~ , we have the following OW). ' concerns regarding this pro, DEC lency status for this action. The part arel It identified by DEC as occurring wholly or ly contiguous to a critical environmental by ~partment 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 com,,,,ents below) Comments (Optional): Response: Please respond to this request within 30 days of the date of this letter. If no response is received within 30 days, we will assume that you have no objection to DECor another agency assuming the role of lead agency, and have no comments to offer regarding the proposed action at this time. If neither~c~ye~ ~ag~r any other involved agency, including DEC, has indicate~~ll- i ngness t~ag enc ywithin 30 days of t h~ _ [ ] We will petitio~issioner ot~DEC~t~o designate a lead agency for this action. ___.~~~ [ ] ~f DEC t~our agency as ~ming you. have jurisdiction. Please feel free to contact this office for further information or discussion. Enclosures Si ncerel y,. JOINT APPLICATION~ FO R,PERMIT I~ase read ALL instructions on back before cornl~etin8 thls:~ppficati~n. Please type ol L.~ARTICLE 9, TITLE 1, ARTICLE 43 6NYCR~R 6'~..~AKE GEORGE RECREATION-ZONE) LJARTICLE 15, TITLE 3 (AQUATIC PE~TICIDES.C0i~TROL) E]6NYCRR 327 (AQUATICYEGETATiON J--IARTIC[E 1S/TITLE S 6NYCRR 608 (PROTECTION O~ WATERS) : · ~r~FOr the construction, recorlstl~lctJol~, or repair of a DAM or other impoundment structure. r_~ Fox,the disturbance, of a' STRE*AM BED~0R BANKS or~excavation-'in or fill Of NAVIGABLE WAT :'RS~ ~ARTICLE ~S, TITLE ~S E]eNYCRe em ~W~TER SUPPOrt I--]eNYCRR eO; CLONe ISL~, L/ARTICLE 15, TITLE 27 6NYCRR 666 0~/ILDo SCENIC AND RECREATIONAL RIVERS) ~. J--JARTICLE 24 6NYCRR 662, 663 (FRESHWATER WETLANDS) " ' · ~l ~ sEcrIo~ ~0 CraVER ~'~e ~AR.OR ACT O~ ~) for ~-m~,.~o~ in .~i~a~e ?~ o~ e~e U.~, ~1 SECTION ~ (CLEAN WATER ACT OF 1~9~L~7) f~r disposal of dredged or tip material ~n waters of U jj []SEC,O" ~05 ~R~NE ~ROTECT~O~ ~S;×"C~ ,~ LIST PREVIOUS PERMIT/APPLICATION NUMBERS AND 2. APPLICANT IS AlAN ~J~Owner J-'loperator "J'~J/~ 3. NAME OF APPLICANT (Use Full Name) POST OFFICE 4. NAME OF one) MAILING ADDRESS POST OFFICE PROJECT/FACILITY LOCATION (/v~rk location on map, see Number la on reverse side) POST OFFICE ,~~ 7 HAS WORK BEGUN ON PROJECT? If YES, all, ch explanat~o~c~ starting worJc without J--lYes ~No ,.~ Show wod~.~:m? ~ap .as~.,:dmwings. 9 PROPOSED USE: ~..pHva~e '10. PROPOSED STARTliNG DATE: j 'lq. APPROXI/vlATE [] Public J J Commercial .13. ROJ ECT DESCRIPTION: (e.~.,quanUty and type'~i~nfateria.~. structure to be installed; height of dam; size of'~ent;'~)acit~es of proposed Water s 14 WILL THIS PROJECT REQUIRE ADDITIONA['F~DERAL STAT'E"AND/OR I:OCAL PERMITSJ [] I hereby~autho~ze the aBent named in submit this , behalf. PART 1--PROJECT IN FORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the environment. Please complete the entire form, Parts A through E. Answers to these questions will he 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. BUSINESS TELEPHONE NAME OF ACTION L~O~ATION 0~ ACTION ~¢~ S~ ~$$, M~i¢i~H~¥ ~ Cou~¥~ NAME OF APPLICANT/SPONSOR ADDRESS CITY/PO //~/./,~/'7-./~/~.-- ~-'~ ~/ rSTATE IZIP CODE ., wf,/. NAME OF OWNER (If different) I BUSINESS TELEPHONE ADDRESS CITY/PO STATE ZIP CODE DESCRIPTION OF ACTION Please Complete Each Question-Indicate N.A. if eot applicable A. Site Descril~ien Physical setting of overall project, both developed and undeveloped areas. 1 Present land use: [0rban []industrial [Commercial ~,,Residential (suburban) C1Forest []Agriculture I-IOther 2 Total acreage of project area: ~?, i-]Rural (non-farm) APPROXIMATE ACREAGE Meadow or grushland (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 so_~¥pe(s) on project site? a. Soil drainage: ~Well drained /DO % of site ,~lPoorly drained % of site PRESENTLY AFTER COMPLETION '~ O'~-4- - '~ '"~'"' acres 0 ~0+ ~'~' ~ acres acres acres acres acres acres acres acres acres acres acres acres acres E3Moderately 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 1 NYCRR 370). 4 Are there bedrock outcroppings on project site? I~Yes 'j~fNo a. What is depth to bedrock? (in feet) 5. Approx!mate percentage of proposea proiect site with slopes: ]~0-10% /~ O % E~10-15% % I-I15% or greater % 6. is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Register~ of Historic Places? I~Yes ,,~No r Is pr,,te(I subntdnlially c ()llllgU()LIg LO d bi[ti listed on th~ Register ol National Natural Landmarks? ~Ye5 ~o 8. What is the depth of the water table? /~//' (in feet) 9. Is site located over a primary, principal, or sole source aquifer? ~Yes ~o 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? ~Yes ~o 11. Does project site contain any species of plant or animal life that is identified as threaten~ 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 " I I Is the project si!e~presently used by the community or neighborhood as an open space or recreation area? [~Yes '~[No If yes, explain 14. Does the present site include scenic views known to be important to the community? E3Yes ~No 15. Streams within or contiguous to project erea: ,~? /z~:~_,~' a. Name of Stream and name of River to which it is tributary Lakes, ponds, wetland areas within or contiguous to project area: 16. a. Name 17. Is the site served by existing public utilities? ~[~'Yes [:]No a) If Yes, does sufficient capacity exist to allow connection? b) If Yes, will improvements be necessary to allow connection? b. Size (In acres) · ;[~Yes [-INo ~tYes ~'~o 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? I-lYes /~No 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 i-INo p.~'cO,,,,[l~, ,~,,e,,/ ~, ? I ~ 20. Has the site ever been used for the disposal of solid or hazardous wastes? r-lYes 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 ~) acres. c. Project acreage to remain undeveloped.';~-_~O~Z ~' ~;~-~. d. Length of project, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed ~ %; f. Number of off-street parking spaces existing. 0 g. Maximum vehicular trips generated per ~' /o h. If residential: Number and type of housing units: One Family Two Family Multiple Family ultimately / i. Dimensions (in feet) of largest proposed structure _.~ O height; ~::O width; o~ length. i. Linear feet of frontage along a public thoroughfare project will occupy is? /~'~-~ft. 3 (upon completion of project)?~.' ~:/t-,~¢-~' ~'~- / Condominium 2. How much natural material (i.e.,- rock, earth, etc.) will be removed from the site? 3. Will disturbed areas be reclaimed? ~j~es []No ~]N/A a. If yes, for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? ~Yes []No c. Will upper subsoil be stockpiled for reclamation? ]~r, Yes E]No O tons/cubic yards 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site?//O/ 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? I-lYes ~No 6. If single phase project: Anticipated period of construction /~'"' months, (including demolition). 7. 'if multi-phased: a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 month c. Approximate completion date of final phase month d. Is phase I functionally dependent on subsequent phases? I-lYes i-iNo 8. Will blasting occur during construction? I-lYes ~(No 9. Number of jobs generated: during construction/--~P~'~'g~'; after project is complete 10. Number of jobs eliminated by this project O 11. []Yes year, (including demolition). year. Will project require relocation of any projects or facilities? If yes, explain 12. Is surface liquid waste disposal involved? I-lYes a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? []Yes J~o · Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain [E]Yes 15. 16. Is project or any portion of project located in a 100 year flood plain? Will the project generate solid waste? j~Yes I-INo a. If yes, what is the amount per month' tons ~)¢/'~'.~ff, ff~,~ b. yes, will an existing solid waste facility be used? ~ii~Yes I~No If c. If yes, give name ?~z,<,/ ~_~,~./.~_.~/f~_ ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 17. 18. 19. 20. 21. 22. 23. 24 Will the project involve the disposal of solid waste? r-]Yes a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? years. Will project use herbicides or pesticides? I-lYes ~J~lo ~o tons/month. Will project routinely produce odors (more than one hour per day)? I-lYes ~]~No Will project produce operating noise exceeding the local ambient noise levels? i-lYes Will project result in an increase in energy use? LYes I-INo If yes , indicate type(s) ~'~'~-~-,~/~--/ e4/~'~,~/~ If water supply is from wells, indicate pumping capacity Total anticipated water usage per day gallons/day. Does project involve Local, State or Federal funding? f-lyes if Yes, explain gallons/minute. ;Z'No . L 4 25. Approvals Required: Type Submittal Date City, Town, Villaga Board l-lYes I~No City, Town, Village Planning Board F-lYes r-lNo City, Town Zoning Board [Yes r-INo City, County He?th Department _~[~Yes [No Other Local Agencies ~?"P~/ ~'~s~'~1~Yes []]No Other Regional Agencies []]Yes []No State Agencies I-IYes I-]No Federal Agencies []Yes ENo C. Zoning and Planning Information 1 Does proposed action involve a planning or zoning decision? ~Yes ~-No If Yes. indicate decision required: []zonin8 amendment [:]zoning variance [special use permit I-Isubdivision rqsite plan ~new/revision of master plan []-]resource management plan []other 2 What is the zoning classification(s)of the site? ~'~.~'~','~---~/X-l,,~ ~ 3 What is the maximum potentia~development of the ~ite if developed as permitted by the present zonin~ 4. What is the proposed zoning of the site? ~ C ~ ~~ ~ 5 What is the maximum potential 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? ~l~'es 7 What are the predominant land use(s) and zoning classifications within a % mile radius of proposed action? E]No 8 Is the proposed action compatible with adjoining/surrounding land uses within a ~,~ mile? 9 If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 10: Will proposed action require any authorization(s) for the formation of sewer or water districts? 12 ~es I-INo I-lYes ~'~No Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? ~'Yes '[]]No a. If yes, is existing capacity sufficient to handle projected demand? '~es [-INo Will the proposed action result in the generation of traffic significantly above present levels? [l-lYes /~No ' a. If yes, is the existing road network adequate to handle the additional traffic? r-lYes I'qNo 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 certify that the information provided above is true to the best of my knowledge. ~,ppiicant/Sponsor N/ame ~-'~'~"v/~4'~ /'"' "~ ~-) ~4.- v~-/~-- Date 'Signature ~//_,~-~-~-~/'/~' ~- z~ ~. Title I[ the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceedin~ with this assessment. 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. · identifying 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 voiumn 2 simply asks that it.be looked at further. ~ The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situatibns. 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 Iocality, 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. Instruclions (Read carefully) a Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential size of 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 If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3. e. 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. IMPACT ON LAND 1 Will the proposed action result in a physical change to the project site? E)NO E~YES 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 area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing 8round surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. o I x,'.'~ .'ttlon for mitlir~4 l,~rl'n~o~ thRt ~.¥ollJd romove mc~rf, than 1.00(I tons ol n,~tural material U e. rock or soil.) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2 Will there be an effect to any unique or unusual land forms found on the site? (i.e.. cliffs, dunes, geological formations, etc.)f-INO ~YES · Specific land forms: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] [--)Yes [] [] l--lYes []No [] [] I--lYes []No [] [] []Yes []No [] [] []Yes []No [] [] I--lYes []No [] [] []'res ,r-1 No [] [] []Yes I-1No [] [] []Yes []No [] [] I-qYes []No IMPACT ON WATER 3 Will proposed a~tion affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) E3NO 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 channel of a protected stream· · Extension of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4 Will proposed action affect any non-protected existing or new body of water? [~NO i-lYES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. · Other impacts: 5. Will Proposed Action affect surface or groundwater quality or quantity.~ CINO ~]YES Examples that would apply to column 2 · Proposed Action will require a discharge permit. · Proposed Action requires use of a source of water that does not have approval to serve proposed (project) action. · Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation 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 dischar§e into an 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 products greater 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 may require new or expansion of existing waste treatment and/or storage facilities. · Other impacts: 6 Will proposed action alter drainage flow or patterns, or surface water runoff? I--INO ~IYES Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] i-lYes I-1No [] [] [-lYes [-INo [] [] i--lYes I-f No [] [] E3Yes E3No [] [] r-lyes I--INo [] [] I-lYes I--INo [] [] i-lyes E3No [] [] i-lyes I-INo [] [] I-lYes r-INo [] [] r-lyes I-'lNo [] [] i-lYes i--INo [] [] I-lYes i--INo [] [] i-lyes E3No [] [] I-lYes i--INo [] [] i-lYes l-tNo [] [] I-lYes i--INo [] [] ~Yes E3No [] [] I-lYes [] [] i-lyes, i--lNo [] [] I-lYes ~]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? I~NO I-lyES Examples that would apply to column 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 1 ton of refuse per hour. · Emission rate of total contaminants will exceed 5 lbs. per hour or a beat source producing more than 10 million BTU's per hour. * Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species? []NO [YES Examples that would apply to column 2 · 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: 9 Will Proposed Action substantially affect non-threatened or non-endangered species? [NO ~IYES 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 affect agricultural land resources? r~NO f~YES Examples that wo'uld apply to column 2 · ~he proposed action would sever, cross or limit access to agricultural [and (includes cropland, hayfields, pasture, vineyard, orchard, etc.) I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change Fi' [] I-lYes J~No [] [] [-]Yes i--INo [] [] F-lYes J-]No [] [] ' l-lYes I'-INo [] [] I~Yes I--J No [] [] I-lYes F-INo [] [] E]Yes E]No [] [] I-lYes I--INo [] [] E]Yes I-INo [] [] E3Yes i--INo [] [] I-lYes i--INo [] [] E]Yes [] [] E3Yes E]No [] [] i-lYes E]No [] [] I'"]Yes [] [] E]Yes I~No [] [] i-lYes EiNo · 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: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources.~ I-1NO r-lYES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix B.) Examples that would apply to column 2 · Proposed land uses, or project components obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? F'INO OYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially 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 project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYe Site Inventory. · Other impacts: 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 F'INO I-lYES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Other impacts: I 2 3 I Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] i--lYes FIN• [] [] FIYes [-]No [] [] []Yes ON• [] [] OYes •No [] [] [-tYes I-IN• [] [] I-lyes []No [] [] []Yes []No [] [] · i--lYes I-1No [] [] I-lyes I--IN• [] [] I-lYes I-IN• [] [] r-lyes E3No [] [] I-lYes E3~o [] [] I-tYes i-lNo [] [] []Yes r-IN• [] [] I--lYes ON• IMPACT ON TRANSPORTATION 14 Will there be an effect to existing transportation systems? E3NO []YES Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods. · Proposed Action will result in major traffic problems. · Other impacts: IMPACT ON ENERGY .... 15 Will proposed action affect the community's sources of fuel or ener§¥ supply? []NO [YES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of any form 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 family residences or to serve a major commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS !6 Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? El-]NO [~YES Examples that would apply to column 2 · Blasting 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 exceeding the local ambient noise levels for noise outside of structures. · Proposed Action will remove natural barriers that would act as a noise screen. · Other impacts: IMPACT ON PUBLIC HEALTH 17 will Proposed Action affect public health and safety? E~NO E3YES 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 result 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 liquified natural gas or other flammable liquids. · Proposed action ma,/ result in the excavation or other disturbance within 2,000 feet of a site used for the disposal of solid or hazardous waste. o Other impacts: I 2 3. Small to Potential Can Impact Be Moderate Large Mitigated By ' Impact Impact Project Change [] [] []Yes l-]No [] [] []Yes I--ENo [] [] []Yes [-INo [] [] i--lYes I-INo [] [] [-JYes I~No [] [] E]Yes []No [] [] []Yes []No [] [] I--lYes l-]No [] [] l-lYes []No [] [] I--lYes []No [] [] []Yes []No [] [] i-lyes I-iNo [] [] EDYes E3No [] [] []Yes E]No [] [] [DYes E]NO [] [] i--lYes []No 10 Fxamples that would applyto 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: []Yes []Yes [] Yes []Yes []Yes, []Yes []Yes i--lYes []Yes []No i--INo ON• []No {-'IN• I-iN• []No []No 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts.~ I-INO IqYES 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 IMPORTANCE OF 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 impact(s) may be mitigated. Instructions Discuss the following for each impact identified in £olumn 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) ~oo , i 0 tr.,, v,/F__L L.t CES 5 P&'%5 *~_" SUFFOLK CO. HEALTH DEPT. APPROVAl_ H.S. NO, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT, OF HEALTH SERVICES. (s) APPLICANT SUFFOLK COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE: DEPT. OF HEALTH APPROVAL FOR H. S. REF. NO.' APPROVED: SUFFOLK CO. TAX MAP DESIGNATION' DIST. SECT. BLOCK PCL. OWNERS ADDRESS: :~, '~. {,,4:':L '-):*: '/ - ,' ~- -L.:.2.L.: ......... : .........., ......' _' '. .... DEED' L.£769 TEST HOLE ' CCA.~E ,L P. ~.~ ,.,~, ::,-,.,?:,,, ?":* ': .¢ th(~ ~,~:w York . ';;.Sfi '~ tH~ ~-"~': TM ., ,.. SEAL iii fE L:":'Y hie POST SEQR Negative Declaration asons Suppo~ing This Determination: Declaration) ~e 617.6(g) for requirements of th~s determination, see 617.6(h) for COnditioned Negative 1. The impacts during construction will be temporary and minor in nature. [~ addition t~e~ w~[1 ~e re~ced to non-significant [e~e[s t~rough the use o~ erosion control de~ces. ~. ~ro~ect is consistent ~ith surrdun~in~ land uses. ~ere. w~ll ~e no sign±~ican~ impact to a~c~ltural, archeo[o~ical, hi'storic'o~ cultural ~esou~ces ~s the construq~ion ~mpacts are temporary and s~te d~stur~ance is m~nor. 3. T~e Set~ac~s/~u~er zones w~ll red,ce any ~mpacts o~ wetlands endangered species were ~e~ti~ied at the site. 4.T~s pro~ect ~s not expected to ~duce any subsequent a~ea ~s c~entl~ developed w~th si~i[a~ 5. ~o lon~ term or cumulative ±mpacts w~ll result i£ constructe~ accordance to t~e aPProved plans and Il Cenditioned NegatNe Declaration, provide on attachment !he specific mitigation measures imposed. Fc~r Further information: Contact Person: Laura Scovazzo, Environmental Analyst Address: Region 1 Headquarters SUNY, Building 40 Telephone Numbe~. Stony Brook, NY 11790- 2356 516-751~-1389 Fro' ~ I Actloaa and Conditioned NegatNe Declarations, a ~ of this Notice Sent to: Commissioner, Department of Environmental Conservation, 50 Wolf Road, Albany, New York'12233-O~l Appropriate Regional Office of the Department of Environmental Conse,~,at!on Office of the Chief Executive Officer of the po{itlcal subdivision in which tt~e action will be principally Iocated~ Applicant (if any) Other involved agencies (if any) .' 617.21 '"-" Appendix F Slate Em,tr~nmental Quality ~ NEGATIVE DECLARATION Notice of D~termination of Non-Significance · SEQR Project Number I--~7qR--nO?77 /00001--0 Date Jun~_ 21~1991 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8 (State Environmental Quality Review Act) of the Environmental Conservation Law. The NYS Dept. of Environmental Conservatiom , a~ lead, agency, has determined that the proposed action described below will not have a significant effect on the environment and a Draft Environmental Impact Statement will not be prepared. Single family dwelling Adel, Jr. property SEQR Statu~: Type I [] Unlisted [] development on the Werner L. Ce~elltlelted Negative Declaration: ' ['~ Yes ~No De~'tptl~ltolA~ie~l: The appiicant proposes'the construction of a single family dwelling, deck, privatp well and septic system. The project is l'ocated more than 100 feet landward of .the tidal wetland boundary of Deep Hole Creek. Lm:atiom(Include ~reetaddmssan'dthenameofthemunicipalitylcounty. A location mapofappropd~e scaleisalsorecommended.) Deephole Drive, Lot #3 West side of Deephole Drive, 126.68 feet south.of New Suffolk Avenue Mattituck, New York Town of Huntington Suffolk County SCTM # 1000-115-12-3 ~WERNER L. ADEL JR. 12 FOX Meadow Lane Huntington, N.Y. 11743 (516) 421-1434 March 21, 1991 Town of Southold, Board of Town Trustees Town Hall, 53095 Main Road. P.O. Box 1179 Southold, New York 11971 Re: 1000-115-12-3 Dear Sir, Enclosed, please find survey of building lot located on the W/S of Deephole Drive., 126.68 feet S/O New Suffolk Avenue., Mattituck, showing the location of a proposed new dwelling. Please note that the distance between the flag- ed wetlands and the building envelope is 75 feet. Kindly let me know if this falls within your jurisdiction regarding the need for a wetlands permit. Your~ truly,~ WERNER L, ADEL JR. 12 FOX MEADOW LANE HtINTINGTON, NY 11743 ~. LJ CES5 P,',~,..~LS '"".L ROOERICK VAN TUYL. P~,C- ~..V',,.,., :/...---.~,.,-.; Su Y,o s GR'EENPORT NEW YORK ..Z'2Z SUFFOLK t.,._.. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. {S) i, APPL lica nT SUFFOLK COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE. DEPT. OF HEALTH APPROVAL FOR H. S. REF. NO APPROVED' SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: DEED: L. ,:'- V(p i ' TEIsT 'HOLE: STAMP