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Home My WebLink AboutBALCOM, LUCILLE DEPARTMENT OF THE ARMY NEW YORK DISTRICT CORPS OF ENGINEERS TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 June 21, 1991 Keith B. Neilson Docko, Inc. RD2, P.O. Box 420A Stafford Street Mystic, CT 06355 RE: Balcom Property, Fishers Island Boat Lift Installation Dear Mr. Neilson: Trustee President John M. Bredemeyer reviewed the application submitted for the above referenced property to install a boat lift. As this structure is proposed for Fishers Island Sound, which is beyond the jurisdiction of Chapter 97 of the Town Code "Wetlands" at this time the Board, will have no jurisdiction in this matter. Ail other approvals that may be applicable should be secured prior to the commencement of the project. Very truly yours, John M. Bredemeyer, III President, Board of Trustees JMB: jt cc: Building Dept. TRUSTEES John M. Bredemeyer, HI, President Henry P. Smith, Vice President Albert J. Kmpski, Jr. John L. Bednosld, Ir. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOT1' L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 December 6, 199! ~eith Neilson Docko, Inc. RD2 Box 420A Stafford St. Mystic, CT 06355 RE: Applications on Fishers Island Dear Mr. Neilson: Confirming our conversation this date, some of the applications you recently referred to this office for wetland permits as "grandfathered" structures are presently beyond the jurisdiction of the Southold Town Trustees under the Town wetland ordinance. Generally, the only tidal wetland areas considered jursidictional on Fishers Island are those of West and Hay Harbors. All open sound areas and unprotected/non-vegetated coves are considered non-jurisdictional. Shortly, when the "Sound" areas are returned to the wetlands ordinance and we implement the recently approved Town Coastal Erosion Hazard Act the owners may wish to grandfather their structures. In Summary: Christopher Roosevelt - Non-jurisdiction on "Sound" Lucille Balcom - Non-jurisdiction on "Sound" Fishers Island Ferry District - Non-jurisdiction as greater than 5" below mean low water. The $100.00 fees received for the Balcom and Roosevelt applications will cover the field inspection for all three applications. I hope this answers some of your questions. Enclosed for your information is a copy of the Town Wetland Ordinance, Chapter 97. Sincerely, President, Board of Trustees / Docko, Inc, RD2 Box 420A, Stafford St., Mystic, CT 06355 (203) 572-8939 September 27, 1991 Mr. John Bredemeyer, President Southold Board of Trustees PO Box 728 Southold, NY 11971 Re: Balcc~ Property, Fishers Island Dock Reconstruction Permit Dear Mr. Bredemeyer: On behalf of our client, we request a "Grandfather" Permit for the reconstruction of an existing fixed wood dock on the hcme of Mr. and Mrs. Ronald Balccm on Fishers Island. We enclose the following doc%m~-nts in support fo this permit application: - Two prints of application drawings titled: "Dock Reconstruction" In: Fishers Island Sound, East Harbor At: Fishers Island, Town of Southold Suffolk County, New York Applicant: Lucille Balcc~ Date: September 27, 1991 - Two copies of the Southold Board of Trustees "Grandfather" application, Corps and DEC applications, Tax Assessor's Map and location map. I trust that you will find this application package complete and acceptable; please let me know if the n~d fo~.~ more information arises. Yours truly, Docko, Inc. Keith B. Neilson, PE Eaclosures cc Cook/Balccm Jim Haggerty, CE Christine Costopoulos, DEC John Clavin, Fishers Island Harbor Master File 91-08-236 TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEE5 TOWN OF SOUTHOLD GRANDFATHER APPLICATION SCOTT L. HARRIS Supervisor 'I'OWN OF SOU/HOLD Town Hall, 53095 Main P.O. Box 1179 Southold, New York 1197 Fax t"~l~) 765-1823 765-180(1 Name of Applicant: Ms. Lucille Balcom Mailing address: c/o Fiduciary Trust, Mr. Francis Shepherd 2 World Trade Center, NY, NY 10048 Tel. No: Address of Property: Old Coast Guard Bqat House, East Ha~b~r, Fishers Islandt NY 06390 Tax Map Number: 1000- 004-~-- ~ Approx.¥r.of construct: 1935 5. Prior owner if known: US Governmentt US Coast Guard e Diagram of existing structures, included with this application: See Attached including all dimensions, must be mis project is for the reconstruction of the pile supported decking and porch system adjacent to the house, all of which w-as damaged or destroyed in Hurricane "Bob" on August 19, 1991. There will also be routine maintenance to the existing dock system, mainly redecking over existing decking Indicate on attached map: Location, ie; reference point, telephone pole number, adjscent pro~.,Owne~~~ ~1~/~ Signature of applicant: ,/ /~/~'~-'~ Date: Please note, there is a one time fee of $50.00 for filing this application. 02 diff~e~ fo~ ~ ~r of E~.y ~sim4 by ~e parle. ~m~, · HO~ ~[J ~g~ b~ ~tgt ~rt~g~tS, whlc~ are intended lo co~tltu~e a G~N~RA~ POW~ O~ A~ORN~ pur~u~n~ go Article $. ~itle 15 oi g~e New Yor~ General Oblig~tlons · ~tl Ronald B. Balcom o~ Fishers Island, Ne~ Yo~k do~e~ebyappoinl *He,oldE. Cook, Su~e~n~epde~ of A. ~ghn Gada Gene~al Contracting, Inc. of Fishers Island, Ne~ Yo~k my arJorn, ey(s)-in.£act TO ACT In my name, place with respect to the loJlow~ng ma~ters as eac~ Gene:~ OblJgatJons Law to the extent that ~ am pprmitted by ~ to a;t through an agent: To strike nut any subdivision the principal .m. ust draw a line through the text of that subdivision AND write his initials in the box opposite, (,a.,¢ ...,,~,~t.~ ~-.~,m~/~,t-: .......................................... [ ] (B) chattel and goods transactions; ............................ [ ]. (~9,~u~m~,~: .............................................. [. ~ ] (,,1:,¢ .,~,~,,~.,o, pa~a~'u,j,.t.,ra-.t,~t,~,u'- ......................... [ , ,' ] (H;i m/~u'=- a,,a- ~/dg~ ~. .............................................. [ ] (i¥: :p~s~naf:~ag~,~/~ ~0~:ma# ~a~s~ .................. [ ] (j~ :~n~s:~m~m~/tw.~ r,~ ............................. [ (l~.t~e,~d.~,~p~taa~ta~a~ ......................... [ ] (¥¢a~M~,~a~ ..................................................... [ ] · wo;la.ro]aqa oq,~ pa= 'ul p;ql;osop ~ LOJ. J. nS or[ ;sql am ol po,gpa[~aou;o~: ~i p~z~ ';uauzn,~l~u! · lodloul.~cl ail: fo aauatadutooul ,~o ~!lJqm~P tuanbatqn: att: ,Cq pal~afft~ aq tou Ilml: ,Ou~ottpfo ~a~od ~tll DEPARTMENT OF THE ARMY NEW YORK DISTRICT CORPS OF ENGINEERS JACOB K. JAVIT$ FEDERAL BUILDING NEW YORK. N.Y. 10278-0090 Eastern Permits Section June 28, 1991 SUBJECT: Application No. 91-0612-L2 by Lucille Balcom To Whom It May Concern: The New York District, Corps of Engineers has received a request for Department of the Army authorization for the following activity: ACTIVITY: Install four piles to support a boat lift. IN: Long Island Sound AT: Fishers Island, Suffolk County, New York APPLICATION BY: Lucille Balcom, c/o Fiduciary Trust 2 World Trade Center New York, New York 10048 As this work is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing work in navigable waters of the United States. To accomplish the coordination required, prior to the issuance of a Letter of Permission, your review of the enclosed drawings is requested. Pursuant to Secton 307 (c) of the Coastal Zone Management Act of 1972 as amended [16 U.S.C. 1456(c)], the applicant has certified that the activity complies with and will be conducted in a manner that is consistent with the approved Coastal Zone Management Program of the State of New York. To allow for the timely processing o~f~-t~he-subject application, your comments are requested within 15 days of ~he date of this letter. Sincerely, C~,,James W. Haggerty Chief, Eastern Permits Section Enclosure 48 20 41 35 5O 65 42 PROJECT: ~::;3~K L~ATION: 5U~O~ WATERWAY: ~S~ DATE: ~8M~e~ APPLICANT: C~ *~E.T- S.~E~ I O~ DOCKO, INC. P.O. ~X 42]. ~C, ~55 203 572 8939 F~ 572 7~ .t ~ Docko, Inc. .~~--~ RD2 Box 420A, Stafford St., Mystic, CT 06355 (203) 572-8939 ABOVE: Balccm hcme looking westerly frc~ 500' BELOW: East dock to be redecked with longitudinal 2 x 8's approximately 4 feet in total width. RD2 Box 420A, Stafford St., Mystic, CT 06355 (203) 572-8939 ABOVE: Dock conditions Prior to Hurricane "BOB". House with deck and fixed dock and undecked section in foreground. BELOW: Fixed dock and undecked section looking to the northwest toward section of 6 FT wide dock which was destroyed by the storm. Oocko, Inc. RD2 Box 420A, Stafford St., Mystic, CT 06355 (203) 572-8939 ABOVE: Decking and stringer system, as well as the porch/deck support syst~, substantially damaged by Hurricane "BOB" and needing reconstruction. BELOW: Inner section of the west dock, demolished by the hurricane, needing to be totally rebuilt. Docko, Inc, RD2 Box 420A, Stafford St., Mystic, CT 06355 (203) 572-8939 September 27, 1991 Ms. Christine Costopoulos NYS DEC, Regulatory Affairs Building 40, SUNY Stony Brock, NY 11790-2356 Balccm Property, Fishers Is. Dock Reconstruction Permit Dear Ms. Costopoulos: On behalf of our client, we request a Tidal Wetlands P~_rmit, including Water Quality Certifications, as necessary, for reconstruction of a fixed dock at the hcme of Mr. and Mrs. Ronald Balccm on Fishers Island, New York. We enclose the following in support of this permit application: - Four prints of application drawings titled: "Dock Reconstruction" In: Fishers Island Sound, East Harbor At: Fishers Island, Town of Southold Suffolk County, New York Applicant : Lucille Balc~n Date: Sept~nber 27, 1991 -Four copies of the DEC Joint Application, including the Short Environmental Assessment Form, SAAF, site photographs, Tax Assessor's Map and location plan. I trust that you will find this application package c~lete and acceptable; please let me know if the need for further information arises. Very truly yours, Docko, Inc. Keith B. Neilson, P.E. Enclosures Cook/Balccm Jim Haggerty, CE John Bredemeyer, Town of Southold John Clavin, Fishers Island H~rbor Master Tc~ Law, Sandy McGugan File 91-08-236 JOINT APPLICATION FOR PERMIT US.ARMY CORPS OF ENCINEERS APPLICATION NO Please read ALL instructions on back before completing this application Please type or print clearly in ink. Attach additional inlormatio~ as needed ['-1ARTICLE 9, TITLE 1, ARTICLE 43 6NYCRR 646 (LAKE CEORCE RECREATION ZONE) r~ ARTICLE 15, TITLE 3 JAQUATIC PESTICIDES CONTROL) [] 6NYCRR 327 (AQUATIC VEGETATION) [] 6NYCRR 328 (FISHJ [] 6NYCRR 32cJ(INSFCTS) r--JARTICLE 15, TITLE S 6NYCRR 608 IPROTECTION OF WATERS) [-~For the construction, reconstruction, or repair of a DAM or other impoundment structure. r-]For the disturbance of a STREAM BED OR BANKS or excavation in or fiji of NAVIGABLE WATERS [~401 WATER QUALITY CERTIFICATION 1. LIST PREVIOUS PERMfT/APPLICATION NUMBERS AND DATES (If any) None known; the site was once a US Coast Guard Station boat house and dock system. 2, APPLICANT IS A/AN ~]Owner [--~Opera~or [] Lessee [~]MunicipalitytGovernmenlal Agency (Check as many as apply) 3. NAME OF APPLICANT (Use Full Name) Lucille Balcc~ c/o Fiduciary Trust, Mr. Francis Shephard ( ) 2 World Trade Center, New York, NY 10048 4. NAME OF []Owner [-~AgenUContact Person (Check one) Docko, Inc. Keith B. Neilson, PE MAIL)NG ADDRESS P.O. Box 421 TELEPHONE (Where can be reached during day} ( 203~ 572 8939 POST OFFICE STATE I ZIP CODE Mystic C~ I 06355 5. PROJECT/FACILITY LOCATION (Mark location on map, see Number la on reverse side) County Suffolk I TO .... City Southold I vi,lage Fishers Island STREET ADDRESS (If different from applicant) [:~'±vate Road POST OFFICE STA~'E ZIP CODE Fishers Island NY 06390 6, NAME OF STREAM OR BODY OF WATER Fishers Island Sound, East Harbor []--lYes iX]No Show work on map and/or drawings []:]Yes r~No [] Public [] Commercial Immediately November 1991 I $ $210 Enclosed Remove sections of the existing dock damaged in Hurricane "Bob" and install new stringers, decking and supports as shown in application drawings. US Army Corps of Engineers, Nationwide General Permit Southold Board of Town Trustees, "Grandfather" Permit 15 CERTIFICATION: I hereby affirm that under penality of perjury that information provided on this form and all attachments submitted herewith is true to the best of my knowledge and babel. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210 45 of the Penal Law Further. the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said project. In addition, Federal Law. 18 US.C. Section 1001 provides for a fine of not more than $10,CCO or imprisonment for not more than five years, or both. or uses a false, fictitous or udulent statement ~here~na~p~icantkn~w~ng~¥andwi~fu~i~fa~s~fies~ncea~s`~rc~versupamater~alfact;~rkn~w~ng~¥makes [~31 her/¥ author~e the agent named in Number 4~e to submit t~ apphc/l~,Je~my behalf e.E^sE .E^o ^LL ,.STRUC ,ONS ON REVERBE S,O 14-16-4 (2/87)--Text 12 I PROJECT I.D. NUMBER Balcom 91-08-236 September 27, 1991 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEQR 1. APPLICANT/SPONSOR iriS. Lucille Balcom 2. PROJECT NAME Fiw~ Dock ~nstruction 3. PROJECT LOCATION: Mullicipality Fishers Island County Suffolk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) The p~oject site is located on a private road on the north shore of Fishers Islar~ at the ~est end of E~st Harbor, adjacent to Fishers Island Seu~d. 5. IS PROPOSED ACTION: [] New [] Expansion [] Modification/alteration Modification of an existing dock system. 6. DESCRIBE PROJECT BRIEFLY: Remove sections of the ex~sting dock damaged in Hurcicar~ "~ob" a~d install ne~ stringers, decking and supports as shown on the application drawings. 7. AMOUNT OF LAND AFFECTED: Initially --0-- acres Ultimately --0-- acres 8~ WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] NO If NO, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial [] Agriculture ~--~ Park/Forest/Open space [] Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] No If yes, list agency(s) and permit/approvals US Az~q Corps of Engineers Nationwide General Permit Town of Southold, Board of Trustees Grandfather Permit. 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] NO If yes, list agency name and permit/approval ~e existing dock vas bt~.lt in the 1930's and preezists s~ate and local pe~t t~oc~ams; the s~-uctu~e is considered "9~:ar~fathered" by t_he Co~)s of ~'~ineers. 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERM[T/APPROVAL REQUIRE MODIFICATION? [] Yes [] No Not Applicable I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE // ~ Applicant/sponsor name~, ~Lucille B~.~ccm ~_ Date: I// If the action Is in the Coastal Area, and you are a state agency, complete the I I Coastal Assessment Form before proceeding with this assessment I OVER PART II--ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 If yes, coordinate the review process and use the FULL EAF. [] Yes [] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 Il No, · negative (~eclaration may be superseded by another involved agenoy. [] YeS [] NO C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS A~OClATED WITH THE FOLLOWING: (Answers may be hsndwrinen, If legible) C1. Existing aft quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or ¢lisDosal, potentia~ for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natura; or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or thraatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officialry adopted, or a change in use or intensity of usa of land or other natural rasources? Explain brief C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explahl briefly. C6. Long term, short term, cumulative, or other effects not identified in Cl-C§? Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibiiity; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. [] Check this box if you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Asency Pr~n! ow Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Asency Date 2 ~-20-?(10/90) Balc~m 91-08-236 September 27,1991 New York State Department of Environmental Conservation Supplement to Application for Permit ~TRUCTURAL-ARCHEOLOGICAL ASSESSMENT FORM (SRAF) PART ] - APPLICANT COMPLETES Applicant Information 1. Applicant Name 2. Applicant Address T.,,milleBalcx~ll C/O FiduciazyT:ust, I~. r:ancis Shepha:d 2 World Trade Center. New Yorkr NY 10048 Project Information 3. Project/Facility Name Fixed Dock Reconstruction 4. Project/Facility Location Fishers Island Sound. East Harbor 5. Is the proposed project adjacent to, or does it contain a building or structure listed in the State or National Register of Historic Places? Yes No Are there any buildings or structures built prior to 1940 adjacent to or within the proposed project area? e Yes x No If the answer to question 5 and/or 6 is yes, provide the following information for each building and structure (use attachments if necessary): a. name of structure The site is the dock system for the former East Harbor Coast C%,ard Station Boat House. b. 10cati0nThe Boat House is located on a private road on the north shore of Fishers Island's east end. c. type of structure (ex: house, outbuilding, barn, bridge, dam, ruins) The boat house has been converted into a residence. d. approximate age or date of construction · Approximate ag~: 60 ~ec~r.s Might the proposed project nave any impact (physical/visual) upon any buildings or structures listed in the State or National Register of Historic Places o__~rbuilt prior to lg40? Yes No If yes, describe briefly (use attachments if necessary): -- -- Balcom - Cont'd Provide photographs of every building and structure that may be impacted by the project as described in number 7, above. The following standards are recommended: o 0 minimum of two photographs minimum size 4" x 4" prints from negatives preferred; polaroid photos are acceptable photos must be clear and focused clearly label photos so it is obvious what is being illustrated; key photos to map or plan, if possible photo 1: show both the entire front and side of the structure in a single shot from as close to the building as possible. Be sure the structure is not partially or fully blocked by trees or other obstructions photo 2: show relationship of building or structure to roadway or surroundings Has the land within the proposed project area been' previously disturbed or altered (excavated, landscaped, filled, utilities installed)? Yes x No If yes, describe briefly, including depth of disturbance (use attachments if necessary): The project site was originally disturbed when the dock system was originally built circa 1935; the proposed work will be similar in nature, although far less in scope. 10. Approximate percentage of proposed project area with slopes: 0-10% % 10-15% % 15% or greater 11. Approximate percentage of proposed project site-with the following drainage characteristics: well drained moderately well--d-~i~ed poorly drained Prepared by Date % ~ u--__. Dockd~ Inc., Keith B. Neilson, PE September 27, 1991 SAAF1.LK/G ]O/gO Balcom 91-08-236 September 27,1991 STRUCTURAL-ARCHEOLOGICAL ASSESSMENT FORM (SAAF) PART 2 - DEPARll4ENT OF ENVIRONMENTAL CONSERVATION (DEC) COMPLETES Applicant/Project Information 1. Applicant Name 2. Project/Facility Name 3. DEC Number T,~ill~]anm - Fixed Dock Reconstruction Buildings and Structures Might the proposed project have any impact (physical/visual) upon any buildings or structures listed in the State or National Register of Historic Places o~r built prior to 19407 Yes No If yes, DEC must consult with the Office of Parks, Recreation and Historic Preservation (OPRIIP). The DEC must, request a determination of eligibility for the State Register of Ilistoric Places and/or comments regarding project impact. Include information supplied by the applicant in response to questions 5, 6, 7 and 8 of Part 1 of this form. Archeological Sites Does the proposed project area coincide with a circle, square or stippled area on OPRHP's Statewide Archeological Inventory Map? Yes No Is the proposed project area outside of a circle or square, but one for which information has been provided (ex: documented reports of known sites) that suggests the area is archeologically sensitive? Yes No If yes, what is the nature and source of information? 7. Is the proposed project area apparently undisturbed? Yes #o 8. Will the proposed action include a physical disturbance of the project area? Yes ~ No g. Is the slope in the area characteristically less than 15% (unless on limestone/flint escarpments)? Yes No 10. Is the proposed project area characteristically moderately well or well drained? Yes No If the answers to 5, 7-10 are yes, an archeological survey should be performed by the applicant. Provide the applicant with a copy of Reoort Format for Cultural Resource Investiaations and list of archeological consultants. If the answers to 6-]0 are yes, DEC must consult with OPRHP before requiring that the applicant perform an archeological survey. Results of Evaluation No buildings, structures or archeological sites identified at the project location (SHPA-I) Buildings, structures or archeological impacts will occur, no survey required. resources review required (SHPA-2) sites identified, but no No further cultural Consultation by DEC with OPRHP required structures archeology Archeological survey required Prepared by Date SAAF2.LK/G 10/90 Oocko, Inc, RD2 Box 420A, Stafford St., Mystic, CT 06355 (203) 572-8939 July 17, 1991 Mr. Jim Haggerty, Regulatory US Ar~y Corps of Engineers Jacob Javits Federal Building, Roc~ 1937 New York, NY 10278-0090 Re: Balccm Property, Fishers Is. Dock Reconstruction Permit Dear Mr. Haggerty: On behalf of our client, w~ request a Depazb,~nt of the Army Nationwide General Permit for reconstruction of the fixed dock at hc~e of Mr. and Mrs. Ronald Balcc~ on Fishers Island, New York. We enclose the following in support of this permit application: - Two prints of the application drawings titled: "Dock Reconstruction" In: Fishers Island Sound, East Harbor At: Fishers Island, Town of Southold Suffolk County, New York Applicant: Lucille Balcc~ Date: September 27, 1991 - Two copies of Corps of ~gineers, Town and DEC Application Forms - Two copies of site photos, Tax Assessor's Map, and location map. I trust that you will find this application package c~,~lete and acceptable; please let me know if the need for further information arises. Very truly yours, Docko, Inc. Keith B. Neilson, P.E. Enclosures cc: Christine Costopoulos, DEC John Brede~eyer, Town of Southold John Clavin, Fishers Island Harbor Master Tom Law, Sandy McGugan File 91-08-236 APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT I OMB APPROVAL NO. 0702.0036 ~.;= c.,'R "=") I E. zpires 30 June 1989 The De~rtment ot the Azmy pern~t pto~mn~ i~ authorized by Section l0 o[ the River and'H~bor Act of 1899, Section 404 o~ the C~ Wirer Ac[ and Se~ion 103 of the Mazine, [~otection, Research ~nd S~nctuariea Act. The~e I~s require permiL~ authodzin~ ~cti~tilm in or a~ec~nl na~i~bie wa~e~ of the United S~t~ the d~ of dr~ or fi~ mtl~ in~o ~e~ of the U~t~ ~d ~e ~ of d~ m~ for the p~ of d~p~ i~ ~o oce~ ~ ~fomtion provid~ on t~ fo~ wffi be ~ ~ e~lt-~i-~ ~ appii~oa for a ~ ~formtioa in th~ appli~tioa ~ rode · ~tt~ o~ pubic r~ ~ i=~ of pubic ao~. D~os~ o~ the infomtion ~u~ ~ vo[~; how~, ~e dam ~u~d ~ n~ In o~ to ~i~ ~ ~ a~t ~d to e~ the ~t apportion. H n~ i~omtiou ~ not ~d~, the ~t apportion ~ot be Oas ~t of ~ ~ or ~ ~u~bk ~pi~ w~ ~ the [~tion ~d c~ of ~e ~ a~i~ty m~ a~ ~ t~ apportion (~ee ~ dm~ ~ ~) ~d be sub~t~ ~ the D~ Enter ~n~ j~i~ion the l~oa ot ~e Wo~ a~t~. ~ app~tion t~t ~ ~t ~mplet~ ~ fu~ ~ ~ ~t~. ;. NaME ANO AOO"E~ OF AFFLICAN? Lucille Balcom c/o Fiduciary Trust, Mr. Francis Shephard 2 World Trade Center New York, NY 10048 Contact: H.arold Cook, Gada ConstrUction ~/c(516) 788 7~21 ro~) Docko, Inc., Keith B. Neilson, P.E. P.O. Box 421 Mystic, C~ 06355 ^/c(203) 572 8939 ~o~flc., Remove sections of the existing dock damaged in Hurricane "Bob" and install new stringers, decking and supports as shown on the application drawings. The dock syst~ is and will continue to be for the use of the Balcc~s; private recreational boating. Not Applicable. ENG FORM 434~, Apr 86 EOITION OF APR 83 IS OlB$Ot. ETE (;,,.k~..--.~. OAEN..C~NCl N; NAMES ANO AOOIqES$I:S Oil Aa JOINING PROPERTY OWNERS. LESSEES, ETC.. WHOSE PROPERTY ALSO &OJOINS THE WATERWAY MS. KLm K. Combe11 West: fishers Tsland Develot:~ent 257 Dunba: Road PO D~a~r E Palm Beach, FL 33480 Fishers Island, NY 06390 WATER.SOY ANO I,OCATION ON WATERIOO¥ WHERE ACTIVITY EXISTS ON IS PROPOSES The site is located in waters of Fishers Island Sound at the west end of Bast Harbor. The Balcom's prOperty is located on the north shore of Fishers Island on a private road identified additionally as the Boat House for the old Bast Harbor Coast (~,ard Station. Suffolk County New York 06390 Southold Board of Trustees UOCAU aOVER.,,Na SOO* W,T. JUR,EO,CT,ON ave. s,~E ISSUING AG.NCY TYP~ A..ROVA~ IOENTIPlCATION NO. OXTE O' APPLICATION OATe OF AP~*OVAL OATI OF O~NIAL NY DEC Wetlands Pending September 27,1991 Pending Permit Southold Grandfather Bd of Trustees Pending September 27,1991 Pending Harold ~k f~ Lucille ~1~ ~, Inc., Kei~ B. Neil~n, ~, of atto~ev ~tion m~t be l~ed b~ the ~on who de~; to ~k4 the ~d .uthor~ ~4nt if the statement in Block 3 ~ been [il~ out ~d 18 U.S.C. ~ion lOOt ~d~ t~t: ~. in ~y ~ within t~ j~i~ion of ~y de~t or k~o~y ~d ~fuHy ~,. ~n~ or ~ up by any ~. ~me. or de~ a m~ fa~ or ~ any ~. flctttio~ or ~ul~t s~tmmen~ or ~p~n~tio~ or ~ or ~s any fa~ ~ting oe do~ment kno~n~ ~me ~ ~n~in ~y ~ ~i~o~ or ~udulent m~nt or en~. ~ll ~ ~ ~t ~ t~ $10.000 ~ imp~n~ ~t ~ t~ five y~. or ~th. ~ ~t ~ a ~it ~n~ f~ with th~ applimt~n. The app~ r~ wiH be John M. Bredemeyer, 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 SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Ro; P.O. Box 1179 Southold, New York 1197 Fax (516) 765-1823 Telephone (516) 765-1800 GRANDFATHER APPLICATION Name of Applicant: Ms. Lucille Balcom Mailing address: c/o Fiduciary Tr~st, Mr. Francis Shepherd 2 World Trade Center, NY, NY 10048 Tel. No: Address of Property: Old Coast G~ard Boat House, East Harbor, Fishers Islandt NY 06390 Tax Map Number: 1000- 004~-i~ Approx.yr.of construct: 1935 Prior owner if known: US Government, US Coast Diagram of existing structures, included with this application: See Attached including all dimensions, must be This project is for the reconstruction of the pile supported decking and porch system adjacent to the house, all of which was damaged or destroyed in Hurricane "Bob" on August 19, 1991. There will also be routine maintenance to the existing dock system, mainly redecking over existing decking Indicate on attached map: Location, ie; reference point, telephone pole number, adjacent pro~wne~~~ ~/~ Signature of applicant: ,/ /~/~-~\ Date: Please note, there is a one time fee of $50.00 for filing this application. / Oocko, Inc. RD2Box 420A, Stafford St,, Mystic, CT 06355 (203) 572-8939 Mr. John. Bredemeyer, President Southold Board of Trustees PO Box 728 Southold, NY 11971 September 27, 1991 - 7 199~ tOWN OF SOUTHOLD Re: Balccm Property, Fishers Island Dock Reconstruction Permit Dear Mr. Bredemeyer: On behalf of our client, we request a "Grandfather" Permit for the reconstruction of an existing fixed wood dock on the hcme of Mr. and Mrs. Ronald Balccm on Fishers Island. We enclose the following documents in support fo this permit application: - Two prints of application drawings titled: " Dock Reconstruction" In: Fishers Island Sound, East Harbor At: Fishers Island, Town of Southold Suffolk County, New York Applicant: Lucille Balccm Date: September 27, 1991 - Two copies of the Southold Board of Trustees "Grandfather" application, Corps and DEC applications, Tax Assessor's Map end location map. I trust that you will find this application package c~lete and accep~hie; please let me know if the need fo:.~ more information arises. Yours truly, Docko, Inc. Keith B. Nellson, PE Enclosures CC Cook/Balccm Jim Haggerty, CE Christine Costopoulos, DEC John Clavin, Fishers Island Harbor Master File 91-08-236 Natlee: 11m power~ Irented blt thl~ document am ~ end .w~pln$ They ~r~ deigned in New Yodr General different form of power of sttamey de~lmd by the part,ce ~,ot~ It{l! a~Irn ~ ~,~ ~rlli~. whlc.b Ire intended to constitute a 0~' ATTORIV~Y pursuant go Article 5. Title 15 oi the New York General Ohligat$on$ ~'hat:~ Rona]d B. Ba]com of Fishers Island New York doberebyai~point 'Harold £. Cook, SuDerJn~e.ndellt of A. John Gada Con'crac'ciug, Inc. of Fishers Island, New York my attorn, ey(a)-in.£act TO ACT In my name. place a. nd stead in any way which I myae]! could do, # wlth re,peet to the [ollow~n~ matter~ ar each of ~em i~ df~ned J~ T~de ~5 of Article J o/the ~cw Yor~ General Obligations Law to the extent that I am pprmltted by ~aw to act through an agent: To stdke nut any subdivision the principal m~sl draw a line through the texi of lhal subdivision AND wrlfe his initmls in ~ box (.~d -~ ~/.ee ~-~.~e~ ~e~ r.' ........................................ '.. [ (Bi chattel and goods transaetlons; ............................ (¢~ -be~d,,e&~e,ee$ e mwm mfe'$,~,~'a~e~/e~ ~; ......... [. (~) -~.k~.~,e~#'~,e: .............................................. [. (~d ,./~ ~,~,~ .op~ra~',,$ .l, ra~u~ l.i~,u -' ......................... [ (~',~./~.~u~r~, ~ra,~-~. ........................................... [ (~;~ ~s~s~:~r~u~/ee~; .................................................. [ (b";I ==~,,,t and:U~g~fi~;- ............................................. [ (/:)= =~na~=~a~n~=~rn~ =~m'~s~ .................. [ ¢~r~ .ra~rd~, ~*,~u,~ am~ ata~a~ ......................... [ ( ¥d a~l ~ a~s~ ..................................................... [ Tht~ power of attorney #hall not be affected by the subsequent disability or Incompetence of the principal. To induce any thlrd party to oct hereunder, ! hereby agree that any third party receiving a duly executed copy or facsimile of this instrument may act hereunder, and that revocation or termination hereof shall be ineffective at to such third party unless and untll actual not ice or knowledge of such revocation or termination shall have been received by such thlrd party, and l for my~e~and for my httr~, txecutor~, legal representatives and attig~, hereb~ agree to indemn~y ~d bom barmiest any tuch third part~from and against any and all claim~ that may ar~e agai~t ~ch thlrd party by reaton of sucb thi~d party having relied on the prov~lons af thl~ t~trument. ~ ................................................ ~~ . ~...~.~ . day o .... ............... c ..o STAT~, OF Ney York COUNTY OF o.t . 1.9 d. o, to me known, and kno~'n to me to be the indlvldoel tr~trumento and fie acknowledged to me that he Suffolk aa.: described la, and who eze~at~d the foregoing No. 52-950918.5 AGENT - SHEET DOCKO, INC. KEITH B. NEILSON, P.E. P,O. BOX 42L MYSTIC, CT06355 203 572 8939 FAX 572 7569 WATERWAY: ,/~l~ ~,~S DATE: ~s~c~'~ ,~.. APPLICANT: t,. f./~lt.,f.,~ A~ENT- S.EET DOCKO. INC. KEITH B. NEILSON. P.I~. P.O. BOX421, MYSTIC, CT 06355 203 572 8939 FAX 572 7569 1 of 2 pages NOTE: APPLICATION CHECKLIST APPLICATION MUST INCLUDE: STANDARD FORMS - Appropriate Application for Permit. Short Environmental Assessment Form, Structural Assessment Form. NOTE: For all projects requiring Wild, Scenic & Recreational Rivers Permits and for commercial, industrial or multi-residential pro- jects, submit a long Environmental Assessment Form. APPLICATION FEE: Refer to enclosed fee schedule $10.00 minimum, Check or Money Order payable to NYS DEC. You will be notified of additional fees, if any. NA 3. Authorization letter from the owner where the applicant is not the owner. X 4. Staking and labeling of the seaward/wetland side of the proposed structure or fill area. X 5. Photographs of the staked project area mounted on a separate and labeled page. ~ 6. County Tax Map Numbers: Photo of Tax Bill will suffice. Suffolk: Dist. Sect. Blk. Lot Nassau: Sect. Blk. Subblock Lot × 7. Project Plans (four copies) - Plans must clearly show the pro- posed project and include all appropriate dimensions, elevations and must be at a scale of 1" to 100' or larger. X 8. Address of project location (if vacant land; telephone pole # or other identifying landmark). MINIMUM PLAN REQUIREMENTS (FOUR COPIES REQUIRED) PROJECT: Alterations and/or Extensions New House Construction Accessory Structures Repairs to Existing Structures Dredging *Catwalks and Docks Subdivisions Bulkheads Groins and Jetties Filling 1, 3, 5, 6, 7, & 8 1, 3, 5, 6, 7, & 8 1, 3, 5, & 6 2, 3, & 4 2, 3, 4 5, & 6 2, 3, 4 & 5 1, 2, 3 5, & 6 1, 2, 3 4, 5, 6, 9, 2, 3, 4 5, 9, & 10 1, 4, 5 & 6 & 10 KEY: 1. Stamped Sealed Survey *2. Plot Plan *3. Location Map *4. Sectional View *5. Wetland Line or Mean High Water, as appropriate 6. Fill and Clearcut Area 7. Sanitary System Location 8. Test Hole and Data 9. Profile View 10. Distances from fixed structures IF YOU WISH CONFIRMATION OF RECEIPT OF YOUR APPLICATION, PLEASE SUBMIT A SELF-ADDRESSED, STAMPED POSTCARD. NOTE: THE PERMIT PROCESS TAKES AT LEAST EIGHT (8) WEEKS.