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HomeMy WebLinkAboutTR-1-6-89-80-3-16THIS PERMIT IS CC~DITIONED AGAINST THE USE OF TBT OR OTHE. ~DRGANO-TIN BOTTOM PAINTS EXCEPT WHERE EXPRESSLY PERMITTED IN WRITING BY THE~TOWN TRUSTEES. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 1=6=8.9=80=3=16 ISSUED TO .....HEN-R.Y...ARBEEN.Y ............... . DATE: March. 8,...1,989 uthodzation :' Pursuant fo the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; 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 wifh the Resolution of The Board adopted afa meeting held on .F~b..,..;~8 ..... 89 19 ............ , and in consideration of the sum of $ .......................paid by .. l~n=.CQnault~nts Southampton . of ........................................... : ................................. N. Y. and subject to the Terms and Cond~hons listed on the reverse side hereof, of Soufhold Town Trustees aufhorizes and permits the following: Remove and replace bulkhead, dredge, backfill, remove existing dQck and replace with 3' x 12' hinged ramp and 6' x 16' float secured by 2 two-pile dolphins, property 19cared on, Lake D~'... Sou,thold, N..Y. ,. a. ~n accoraance w~n ?~e aeta~leaspec~ficar~ons as presented ~n the originating appllcafion. ' IN WITNESS WHEREOF, Th'e said Board of Trustees h.ere- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this dat,e. Please tear off and return to the Trustee Office. Board Of Southold 'Town Mooring Permit No. ~3oring No. Trustees SOUTHOLD, NEW YORK Date: certify that the-work as authorized in this permit~has been completed and is now ready ' for your inspection. Also, the number required on this project is clearly visible. I further understand this permit is not'valid until'this tear off sheet is returned to the Trustee Office.':... TERMS and CONDITIONS The Permittee HENRY ARBEENY ~e~mmgat Lake Drive~ Southold, NiY. par~ of' the comideradon for the issuance of the Permit doe* under~tand and p~ to ~e rol- l-lng: ~. That the Southold Trustees Permit must be prominently displayed on the premises effected thereby during the period of ."v,', ~at ~e s~d B~d of T~s ~d ~e To~ of ~u~old ~ ~l~ed from ~y ~d work ' ":'.-,t ~ ~age% or d~im~ for damage, of ~ ~g ~y ot ~y ~ a r~t of ~y o~- uncle: :.. ~n ~zfo~ p~t to ~s ~g ~d ~e ~d P~ ~ at ~ ~ her own ~g ~ "~'defend ~y ~d ~1 su& ~ ~t~ ~ ~d p~, ~d ~e ~d Pe~ ~ ~ ~ pe~i~ wi& r~pect ~areto, m ~e ~mplete ~d~ion of ~ ~d of Tme~ of ~e To~ of ~old 3~ That this Permit is valid for a period of ~r~r 24 mos. which is conside, t~ to be the sufficient time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later dam : ' 4.~ That ,h;~ Permit should be retained indefinitely, or as long as the said pemaittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that anth- orization was originally obtained. 5'- That the work invol~ed will be mbject ro the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application, may be cause for ~-vocation of this Permit by resolution of the said Board. 6. That there will be no unreasu~able interference with navigation as a result of the wink herein authofized. · 7. That the~e' shall be no interference with the fight of the public to pass and repass along the beach between high and Iow water marks. 8. That if future operations of the Town of Southold requite the removal and/or alterations in the location of the work herein author/zed, or if, in the opinion of the Board of Tru~ee~ work shall cause unreasonable obstruction to free navigation, the said Permittee will be requlred~ upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 9. That the said Board will be nodfied by the Permittee ot the completion of the work anth- orized. (See tear off sheet.) 10. That the Permittee will obtain all other pe.m~ts and comenu that may be requited mp- plementai to this permit which may be subject to revoke upon failmm to obtain same. FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, $3095 Main Road P.O. Box 728 Southold, New York 11971 March 9, 1989 En-Consultants for Reydon Shores property owners, 1329 North Sea Road Southampton, N.Y. 11968 / Re: Applications of Henry ArbeenY~,John Van Vladrichen, Lake Drive, Reydon Shores, Southold, N.Y. Dear Mr. Haje: The following action was taken by the Board of Town Trustees du~ing their regular meeting held on February 28, 1989 regarding the above matter: WHEREAS, En-Consultants on behalf of above mentioned property owners applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated September 12, 1988, 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 February 28, 1989 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 Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW, THEREFORE BE IT RESOLVED that En-Consultants ON BEHALF OF Henry Arbeeny, John Van Vladrichen BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: Remove and replace bulkhead, dredge, backfill remove existing dock and replace with 3' x 12' hinged ramp and 6' x 16' float secured by 2 two-pile dolphins, property located on Lake Drive, Reydon Shores, Southold, N.Y. This permit will expire two years from the date it is signed if work has not commenced by said date. Fees must be paid and permit issued within six months of the date of this notification. ~o inspections are required and the Trustees are to be notified upon completion of said project. Please take notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. Permit will be issued upon payment of the following fees: 36.00 96.00 100.00 10.00 $242.00 Ramp Float 2 two-pile Dolphins Wetland Inspection fee for each property owner, listed above. Total due Very truly yours, , A. Kujawski, Jr. ~h~ Frank President / ~ ) Board of Town Trustees '-~ / FAK: jas cc: Bldg. Dept. Conservation Advisory Council file as Telephone (516) 765-1801 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL To.' F rom: Dated: Re: Southold Town Trustees Southold Town Conservation Advisory Council February 22, 1989 Recommendation of Wetland Applications The following recommendation were made by the Southold Town Conservation Advisory Council at its meeting held Thursday, February 16, 1989: RFSOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 11-88-78-2-42 of Joseph J. Verwayen to construct a private boat dock consinting of fixed elevated (3' above grade of marsh) catwalk, hinged ramp and two floats secured by pilings. RESOLVED to recommend to the Southold Town Trustess approval with stipulations of Wetland Application No. 11-88-113-6-11 for Gerald Wood to cpnstruct a timber dockconsisting of a 4' x 104' fixed elevated (min. 3.5') walk with outer 5' x 36' "/" to west. Inner end of dockwill be approximately in line with two existing timber pilings and 15' west of them. Propsoed dock will extend a distance equal to exising adjacent dock to east. The Council recommends approval with a further recommendation that natural plantings in the area to be filled behing the railroad ties to avoid runoff into the creek. RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 1-1-89-127-68 of John and Eleanor Bastone to construct a floating dock and landing. RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 10-88-123-4-5 of Thomas Palmer to replace a 53' x 3' catwalk and 16' x 8' float and additioanl work to dwelling consisting of a 12' x 37' wood deck to rear of dwelling, 8' x 37' extension and 11' x 22' garage to front of dwelling and move existing 8.4' x 8.4' shed to west side of lot (further from HWM). RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 1-3-89-56-5-36 of Mateo Lettunich to reinforce westerly concrete and rock seawall, includein returns and reconstruct easterly rock revetment with additional rocks and filter cloth. The Council recommends approval since the work needs to be done but they would like to go on the record that if the work was a new project they would have recommended disapproval. Page 2 RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 12-3-88-98-3-17 of Margaret McGwire to erect a two-story garage 22'x28' and an adjacent 12' x 12' storage shed. RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 1-5-89-80-3-16 of Henry Arbeeny to remove and replace (in same location and configuration) 60 I.f. of timber bulkhead, dredge a manimum of 10 c.y. (to 3' below MLW) from an area 10' in front of bulkhead and use spoil fro backfill, remove existing dock and replace with 3' x 12' hinged ramp and 6' x 16' float secured by (2) 2-pile dolphins. RESOLVED to recommend to the $outhold Town Trustees approval of Wetland Application No. 12-88-80-3-17 of John Van Vladrichen to remove and replace in same location and configuration, 60 I.f. of timber bulkhead~ dredge a maximum of 10 c.y. infront of bulkhead and use spoil for backfill~ remove existing dock and replace with 3' x 12' hinged ramp and 6' x 16' float secured by (2) 2- pile dolphins. EN-CONSULTANTS, INC. ENVIRONMENTAL SERVICES 1329 NORTH SEA ROAD, SOUTHAMPTON, NEW YORK 11968 516-283-6360 FAX NO. 516-283-6136 March 6, 1989 Board of Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Henry Arbeeny SCTM #1000-80-3-16 Dear Sirs: Attached please find a copy of the New York State Department of Environmental Conservation permit for the project referenced above. Would you please add to your file and proceed with processing of the application pending before you. Should you reqiure any additional information please do not hesitate to call. Yours truly, /khs Enc. 10-89-0159 N/^ NEW'YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT Under the Environmental Conservation Law 2/24/89 2/28/91 Article 15, Title 3; 6NYCRfl 327, 328, 329: Aquatic Pesticides Article 15, Title 5: Protection of Water Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island Wells -- Article 15, Title 27: __ Wild, Scenic and Recreational Rivers [-~"] 6NYCRR 608: Water Quality Certification I-'----] Article 17, Titles 7, 8: SPDES ['~---'1 Article 19: Air Pollution Control* ~ Article 23. Title 27: Mined Land Reclamation [-'----]Article 24: Freshwater Wetlands N--New. R--Renewal, M--Modification, C--Construct (*only), O--Operate (*only) Article 25: Tidal Wetlands -- Article 27, Title 7; 6NYCRR 360: __ Solid Waste Management* -- Article 27, Title 9; 6NYCRR 373: __ Hazardous Waste Management -- Articte 34: __ Coastal Erosion Management Article 36: Floodplain Management Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control ISSU[D TO Henry Arbeeny 11968 TELEPHONE NUMB[R P.O. Box li99, Southold, NY 11971 En-Consultants, Inc. 1329 North Sea Rd., Southampton, NY Southold Bay - Lake Dr. - Southold LOCATION or PROiECT/F^CILITY COUNTY TOWN/CITY/VILLAGE UTM COORDINATES Southold Suffolk Southold DESCRIPTION OF ^UIHORIZED ^CTI~IIY Reconstruct in-kind~ in-place 60' timber bulkhead~ dredge to 3-' mean low water. 10 cubic yards of spoil to be used as backfill. Remove existing dock and replace with ramp (3'x'12') and float (6'xl6') secured by two 2 pile dolphins. Ail work shall be in accordance with the NYSDEC approved plan (attached). GENERAL CONDITIONS By acceptance ot this permit, the permittee agrees that Ibe permit is contingent upon strict compU~ ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto. The permittee shall tile in Ihe olnce ot the appropriate regiona{ permit administrator, o¢ other office designated in the special conditions, a notice ot intention to commence work al least 48 hours in advance of the time of commencement and shall also notily him/her promptly in writing of the completion ot the work T he permitted work shall be subiect to inspection by an authorized representative Ihe public interest so requires pucsuant to ECL §7¥0301 and SAPA T he perm,tree has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature, and by whomever suftered, arising out of the ptoiect described h~rein and has agreed to indemnify and save harmless the State from stats, actions, damages and cosL~ of evew name and descrip- PERMIT ISSUANCE DATE J P~'~I~M~'~S~A~' ADDRESS REGION I BUILDINO 40 2/24/89 [ Christine J. Costopoulos STONy ~ROO~ N~ TORK It?~, ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 51, 24, 25, 34, 36 and 6 NYCRR Part 608 [ tO That if future operations by the State of New York require an al- teration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation 14 it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people ol the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused 15 thereby without expense to the State. and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other 16 modification of the watercourse hereby authorized shall not be com- pleted, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse No claim shall be made against the State of New York on account of any such removal or alteration. 11 That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may he caused 16 by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage '~2 Granting of this permit does not relieve the applicant of the responsi- bility of obtaining any other permission, consent or approval from 19 the U.S Army Corps of Engineers. US Coast Guard, New York State Office of General Services or local government which may be required 13 All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels. solvents, lubricants, epoxy coatings, paints, concrete, leachate or any ) other environmentally deleterious materials associated with the project Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway of floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway There shall he no unreasonable interference with navigation by the work herein authorized If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration If granted under Article 36. this permit does not signify in any wa,,, that the protect will be free from flooding If granted under 6 NYCRR Part 608, the NYS Department of Environ- mental Conservation hereby certifies that the subiect project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303. 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application Roy Hale Such approved plans were prepared by on I/19/89 SPECIAL CONDITIONS Any debris or excess material from construction of this projec~ shall be completely removed from the adjacent area (upland) and removed to an approved upland ara for disposal. No debris is permitted in tidal wetlands. Ail dredging shall be conducted so as to leave a uniform bottom elevation free of mounds or holes. Supplementary Special Conditions (A) thru (J) attached. Additional Supplementary Special Conditions (0) (R) attached. 10-89-0159 PROGRAM/FACILITY NUMBER N/A Page 2 of ~ SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all permits: If any of the permit conditions are unclear,the permittee shall con- tact the Division of Regulatory Affairs at the address and telephone noted below. A copy of this permit with supplementary conditions and approved plans shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit or a copy of letter of approval shall be protected from the weather and posted in a con- spicuous location at the work site until completion of authorized work. At least 48 hours prior to commencement of the project, the permittee shall complete and return the top portion of the enclosed receipt form certifying that he is fully aware of and understands all provisions and conditions of this permit. Within one week of completion of the permitted work, the bottom portion of that form shall also be com- pleted and returned. So For projects involving activities to be accomplished over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to the commencement of resumption of work each year. If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modi- fications. The permittee is advised that substantial modification may require submission of a new application for permit. Ail necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended solids, sediment, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project work. Any failure to comply precisely with all of the terms and conditions of this permit~ unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, NY District, 26 Federal Plaza, New York, NY 10278, (Attention: Regulatory Functions Branch), prior to commencement of work authorized herein. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242, which may be required for any encroachment upon State-owned lands underwater. Regional Permit Administrator NYS Dept. of Environmental Conservation Bldg. 40, SUNY-Room 219 Stony Brook, NY 11794 (516) 751-7900 AS APPLICABLE BY THE REGIONAL PERMIT ADMINISTRATOR Ko Po Ail dredging shall be conducted so as to leave a uniform bottom elevation free of mounds or holes. Ail spoil material shall be disposed of either in the Atlantic Ocean or at an approved U.S. Government Dumping Ground, as directed by the District Engineer, U.S. Department of the Army Corps of Engineers. Any spoil material not intended for such water disposal shall be removed from the site and disposed of at an approved upland site. All necessary precautions shall be taken to prevent contamin- ation of the tidal wetlands and/or waters of New York by silt, sediment, fuels, solvent, lubricants, epoxy coatings, concrete leachate and any other pollutant associated with the project work. Ail fill shall consist of "clean gravel" and soil (not asphalt, slag, flyash, broken concrete or demolition debris). Ail dredged material shall be disposed of on an upland site and be suitably retained so as not to re-enter any water body or wetland area. During the dredging operation, the permittee and his con- tractor shall make every effort to restrict spillage of sediment during excavation and haulage. Dredging shall be accomplished with a clam shell or other closed "bucket" equip- ment. Excavated sediments shall be placed directly into the dis- posal site or conveyance vehicle. NO sidecasting (double dipping) or temporary storage of dredge material is author- ized. Ail peripheral rip-rap, berms, cofferdams, rock revetments, gabions, bulkheads, etc. shall be completed prior to placement of any fill material behind such structures. Ail repairs to existing structures shall be confined to replacement of existing structural elements with no change in design, dimension, or materials, unless specifically author- ized herein. REGIONAL PERMIT ADMINISTRATOR Division of Regulatory Affairs NYSDEC Bldg. 40, SUNY, Rm. 219 Stony Brook, NY 11794 (516) 751-7900 DATE: DEC #: NYSDEC DATE .... "1 FRANK A. KUJAWSKI, IR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 February 7, Mr. John Holzapfel, Chairman Southold Town Conservation Advisory Council Southold Town Hall Main Road Southold, New York 11971 1989 TELEPHONE (516) 765-1892 Dear Mr. Holzapfel: Transmitted herewith is application No. 1-6-89-80-3-16 for a Wetland Permit submitted by En-Consultants for Henry Arbeeny. Please prepare a written report of findings and recommendations with respect to this application. FAK: jas Very truly yours, , Frank A. Kujawski, Jr. President Board of Town Trustees cc: Bldg. Dep't. FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPI~ONE (516] 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 February 7, 1989 To Whom It May Concern: Attached hereto is a Short Environmental Assessment Form submitted by En-Consultants on behalf of Henry Arbeeny for a wetland permit to remove and replace 60' of timber bulkhead, dredge 10 cu. yards, remove existing dock and replace with hinged ramp and float. Property is located at Lake Drive, Southold, (Reydon Shores). Posted: February 7, 1989 Frank A. Kujawski, Jr. President Board of Town Trustees I-O',VN OF SOUl ttOLD N~w~ H~II. ~309~ Mum Road 1' O. BDX 72~ ~OllllH~ld NeW York 11971 I DEr4T I J y O[ APPL I CANT Henuy Arbeeny by En-Consultants, Inc. Pt{ON[ 734-7078 ADD~C:SS OF A~'PL~C^r~T 1329 North Sea Road, Southampton, New YOrk 11968 TAX ~AP NO. 1000-80-3-16 ^O~NT En-Consultants, ~nc. 283-6360 PHONE r~o. P/i~r,~l% REQUESTED TO SEE ATTACHED ~^r~,~, Lake Driyg, SoB_thold Post Office Box 1199, Southold, New York 11971 L~k~ D-r i~ ........ ~ Cr~EEK. SAY O;¢ HAI~gO,~ rRON1 t r4c. ~',~oP,:,e~v Bgsin of¢ Southold Bay . . . See attached See attached PROJI~CT I)ESCR] P'I'iON Remove and replace (in same location and configuration) 60 linear feet of timber bulkhead. Dredge a maximum of 10 cubic yards (to 3' below mean Iow water) ~rem an area 10' ~n ~ont of bulkhead and use spoil ~o~ backfiJl. Ncmow~ existing dock and rep]ace with 3' x i2' hinged ~ amp anti 6' x 16' f]oa~ so(?ul ed by (2) 2 p~ ]c dolphins . To po~ e 4 Next to Van Vladricken. DEPTH BELOW LOW WATER see attached YARDS TO mE EXCAVATED l0 cubic yards none DISTANCE PROJECT EXTENDS []EYOND SIMILAR PROJECTS IN THE AREA 0 At{EA ZONING Residential A 'dANr4ER IN WHICH MATERIAL WILL ,~,~[r~¢[u u:~: o, pr,'o~,,:,~.'~', res%dep_t~al.- no c_h_An_ge None known AGENCY NQne known "' _ See attached. None known PROJECT LO. NUMBER I ' ' 617.21 Appendix C Slate Environmental Quality Review SHORT ENVIRONMENTAL ASSESS?~IENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (TO be corn[Heteci by Applicant or Pro)cc! sponsor) Henry Arbeeny by En-Consultants, IncL uu~,c,~,,i,y Southold co,,,, Suffolk Lake Drive, Southold, SCTM #1000-80-3-16 New York 11971 SEE ATTACHED ,m,~.,vll,734 s.f. u, .......11.734 s.f. j~,~.~ Low density f~¥,~ r3~.. ,, .....= '.' <.' ,.:. ......:: ...... .. NYSDEC COE DOS ! !,,.. ¥~.. .... ;,~,:,. ........ Henry Arbeeny by En-Consultants, lnc. ]/20/89 ADJACENT OWNERS John Van Vladricken 26 Cherry Lane Upper Saddle River, NJ 07458 Frederick Rapp 291 Paramus Road Paramus, NJ 07652