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TR-6937
James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0366C Date October 8, 2008 THIS CERTIFIES that the 4'X 20' fixed dock with fiberglass decking and 6" dia. piles, 3'X 14' seasonal ramp. and 6'X 20' floating dock with two (2) 6" dia. piles At 3575 Wells Rd., Peconic Suffolk County Tax Map #86-2-10 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 5/30/08 pursuant to which Trustees Wetland Permit #6937 Dated 8/20/08 was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the 4'X 20'fixed dock with fiberglass decking and 6" dia. piles, 3'X 14' seasonal ramp, and 6'X 20' floating dock with two (2) 6" dia. piles. The certificate is issued to JOSEPH MELCHIONE owner of the aforesaid property. Authorized Signature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE __ Pre-construction, hay bale line __ 1st day of construction ½ constructed __ Project complete, compliance inspection. A)/~/e ~ 7 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION, FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ¼ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6937 DATE: AUGUST 20~ 2008 ISSUED TO: JOSEPH MELCHIONE PROPERTY ADDRESS: 3575 WELLS RD.~ PECONIC SCTM#86-2-10 AUTHORIZATION Pumuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on Aueust 20, 2008 in consideration of application fee in the sum of $250.00 paid by Joseph Melchione and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a 4'X 20' fixed dock using fiberglass "FIo-thru" decking with 6" dia. piles, install a 3'X 14' seasonal ramp, and a 6'X 20' seasonal floating dock with two (2) 6" dia. anchor piles, with the condition the seasonal ramp and floating dock are installed no sooner than April 1st and removed no later than Itst of each year, and as depicted on the plan prepared by Sea Level Mapping last dated December 27, 2007. 1N WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD August 20, 2008 Mr. Joseph Melchione 4 Mountain View Court Fort Salonga, NY 11768 RE: 3575 WELLS RD., PECONIC SCTM#86-2-10 Dear Mr. Melchione: The Board of Town Trustees took the following action during its regular meeting held on Wed., August 20, 2008 regarding the above matter: WHEREAS, JOSEPH MELCHIONE applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance, application dated May 30, 2008, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policies 6, 6.2, 6.3 and 9.4 of the Local Waterfront Revitalization Program to the greatest extent practical through the imposition of the following Best Management Practice requirements: the use of "Fie-thru" decking on the fixed dock and 6" dia. piles, the reduction in the amount of piles from four (4) to a total of two (2) to secure the floating dock, and a seasonal ramp and float to be installed no sooner than April 1st and removed no later than December 1st of each year, and, 2 WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on August 20, 2008, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, 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 for the mitigating factors and based upon the Best Management Practice requirements imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of JOSEPH MELCHIONE to construct a 4'X 20' fixed dock using fiberglass "FIo-thru" decking with 6" dia. piles, install a 3'X 14' seasonal ramp, and a 6'X 20' seasonal floating dock with two (2) 6" dia. anchor piles, with the condition the seasonal ramp and floating dock are installed no sooner than April 1st and removed no later than December 1st of each year, and as depicted on the plan prepared by Sea Level Mapping last dated December 27, 2007. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $776.00 Very truly yours, Board of Trustees JFK:lms James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Please be advised that your application dated ~-~ been reviewed by this Board at the regular meeting'o~- and your application has been approved pending the completion of the following items checked off below. has __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) ½ Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as ~et forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ Oq(~, 00 BY: James F. King, President Board of Trustees Donald Wilder, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765 - 1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., July 16, 2008, the following recommendation was made: JOSEPH MELCHIONE to construct a 4'X 20' fixed dock using fiberglass "FIo-thru" decking and 6" dia. piles, install a 3'X 14' seasonal ramp, and a 6'X 20' seasonal floating dock with 6" dia. anchor piles. Located: 3575 Wells Rd., Peconic. SCTM#86-2-10 The CAC did not make an inspection, therefore no recommendation was made. James F. King, President Jill M. Doher~y, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. P.O. Box 1179 Southold. NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~PH MELCHION,,E. reques,,ts a Wetland P,e, rmit to construct a 4',X 20', fixed sing fiberglass FIo-thru decking and 6" d~ install a 3 × 14 seasonal ~r~'"~-E~and a 6'X 20' seasonal floatir~d~ith 6" dia. anchor piles. Located: 3575 Wells Rd., Peconic. SCTM#86-2-10 Type of area to be impacted: ~'altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ~hapt.275 __Chapt. 111 other Type of Application: V/Wetland __Coastal Erosion __Administrative__Emergency Pre-Submission __ ~Amendment Violation Info needed: M °d ilicat'° n s: ~/.~¢~ ~..~¢,_~.>p_'c'~//~'/'~~.A/~ Conditions: . ~ ~l.C~/-, ;C (~ X~ ~ I~ Present Were: ~.King ~.Dohe~y ~ickerson ~. Bergen ~.Ghosio, Mailed/Faxed to: Date: Environmental Technician Review- New York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY@ Stony Brook, 50 Circle Road, Stony Brook NY 11790-3409 Main Phone: (631) 444-0365 Website: www.dec.state,nv.us Fax: (631)444-0360 January 2, 2008 Mr. Joseph Melchione 4 Mountain View Court Fort Salonga NY 11768 RE: Permit # 1-4738-01529/00007 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6 NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. 3 0 2008 Enclosure Very truly yours, Matthew R. Penski Env. Analyst 1 DEC PERMIT NUMBER 1-4738-01529/00007 FACILITY/PROGRAM NUMBER{S) CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE January 2, 2008 EXPIRATION DATE(S) January 1,2013 TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] Article 15, Title 5: Protection of Wa- ters [] 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 [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation E] Article 24: FmshwaterWetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO Joseph Melchione ADDRESS OF PERMITTEE 4 Mountain View Court, Fort Salon~la NY 11768 CONTACT PERSON FOR PERMITTED WORK NAME AND ADDRESS OF PROJECT/FACILITY Melchione Property, 3575 Wells Road, Peconic ITELEPHONE NUMBER (516) 803-5327 TELEPHONE NUMBER LOCATION OF PROJECT/FACILITY SCTM # 1000-86-2-10 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Richmond Creek E:714.5 N:4545.6 Description of Authorized Activity Construct a 4 foot by 20 foot "FID-Thru" dock, 3 foot by 14 foot seasonal ramp, and a 6 foot by 20 foot seasonal float. All work shall be performed in accordance with the plans prepared by Sea Level Mapping last revised on 12127/07, and stamped NYSDEC approved on tl2/08. permittee agree~.th~ the perrfiit, ~ contingent upon strict compliance with the ECL, all applicable part of this permit. Circle Road - SUNY, StonE Brook, NY 11790-3409 DATE I Page 1 of 4 2, 2008 1. The storage of construction equipment and materials shall be confined within the project work area and/or upland areas landward of the bulkhead. 2. The dock or timber catwalk shall not exceed 4 feet in width and shall be a minimmn of 2 ½ feet above grade* over tidal wetland areas (* as measured from ground to the bottom of the dock/catwalk decking). 3. Dock/ramp/float shall not a) extend laterally beyond property lines, b) be placed so that docked vessels extend laterally over property lines, c) interfere with navigation, interfere with other landowner's riparian rights. 4. No Permanent structures shall be installed on dock/ramp/float without first obtaining written Department approval (permit, modification or amendment). 5. Float and ramp may not rest on or be stored in any vegetated tidal wetlands. 6. The authorized ramp and float must be installed and removed seasonally. These seasonal structures may not be installed prior to April 1st of each calendar year and must be removed by December 1st of each calendar year. 7. No dredging, excavating or other alteration of the shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 8. The use of wood treated with pentachlorophenol or other wood treatment not specifically approved by the Department for use in wetlands and/or marine waters, is strictly prohibited in the construction of structures that will be in contact with tidal waters. 9. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 10. Any debris or excess material from construction of this project shall be completely removed from the adjacent area and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands or protected buffer areas. 1-4738-01529/00007 I PAGE 2 OF 4 ! Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee~ excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Consarvatinn of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indenmificatinn does not extend to any claims, suits, actions, or damages to the extent aRributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permilXee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, 50 Circle Road - SUNY, Stony Brook NY 11790-3409 General Condition 4: Permit Modifications, Suspensions and. Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds for modification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERMIT NUMBER I PAGE 3 OF 4 1-4738-01529/00007 ADDITIONAL G~ ~~D 6 NYCRR PART 608 (TIDAL WETLANDS) 1. If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation 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 of 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 thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, 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. 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 be caused 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. 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 conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across or along the bed of a waterway or floodplain, deposits within any regulatory floodway, or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 5. There shall be 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 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject 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. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 9. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or their designated agent as part of the permit application. Such approved plans were prepared by: Sea Level Mannine last revised on 12/27/07 and stamped NYSDEC annroved on 1/2/08. DEC PERMIT NUMBER 1-4738-01529/00007 IPAGE 4 OF 4 RETURN THIS FORM TO: NOTICE OF COMMENCEMENT OF CONSTRU.~ COMPL~-'~E OR FAX TO: 631-444-0297 Madne Habitat Protection NYSDEC 50 Circle Road - SUNY /'.,/~..~..,,,..Stony Bro.~ok, ..N.Y ljl790-235,6 PERMIT NUMBER: /~' ~'~/J~&¥'~*F'"~/'~" y~'~ ~)~) 7 PROJECT LOCATiON/ADDRESS: CONTRACTOR NAME: ADDRESS: TELEPHONE: Dear Sir: Pursuant to General Condition # 9 of the referenced permit, you are hereby notified that the authorized activity shall commence on · We certify that we have read the referenced permit and approved plans and fully understand the authorized project and all permit conditions. We have inspected the project site and can complete the project as described in the permit and as depicted on the approved plans. We can do so in full compliance with all plan notes and permit conditions. The permit sign, permit and approved plans will be available at the site for inspection in accordance with general Condition No. 1. (Both signatures required) PERMITEE DATE CONTRACTOR DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS A T LEAST TWO DA YS PRIOR TO COMMENCEMENT OF THE PROJECT AND /OR ANY ASSOCIATED REGULATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE THE PERMIT AND APPROVED PLANS AVAILABLE A T THE WORK SITE FOR THE DURA TION OF THE PROJECT MA Y SUBJECT THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS. Cut along this line ~< ~ ~< ~ ~ ~ ~ ............................................................................ NOTICE OF COMPLETION OF CON~¥i~'0'~J¥i6i(l' .......... RETURN THIS FORM TO: PERMIT NUMBER: COMPLIANCE Madne Habitat Protection NYSDEC 50 Circle Road - SUNY Stony Brook, NY 11790-2356 OR FAX TO: 631-444-0297 ISSUED TO: PROJECT LOCATION/ADDRESS: CONTRACTOR NAME: ADDRESS: TELEPHONE: Dear Sir: Pursuant to General Condition # 9 of the referenced permit, you are hereby notified that the authodzed activity was completed on · We have fully complied with the terms and conditions of the permit and approved plans. (Both signatures required) PERMITEE DATE CONTRACTOR DATE. tHIS NOTICE, WITH PHOTO(~t<A~-,~ ut- i ~ (.;UMHL~' I ~'U WL)I~t~ AlllU/UI'~ A (.;uMPLETED SURVEY, .AS APPROPRIATE, MUST BE $ENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COMPLETION OF THE PROJECT. 95-~0-1 (11/03) New York State Department of Environmental Conservation NOT.ICE The Department of Environmental ConserVation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of the apProved work and any Department conditions applied to the approval, contact 'the Regional Permit Administrator listed below. Please refer to the permit numb~ shown when contacting the DEC. 0o0'7 Regional Permit Administrator Permit Number Expiration Date ROGER EVANS NOTE: This notice is NOT a permit ELIOT SPITZER GOVERNOR F STATE OF NEW YORK DEPARTMENT OF STATE ONE COMMERCE PLAZA 99 WASHINGTON AVENUE ALBANY, NY 12231-0001 LORRAINE A. CORT~S-VAZQUEZ SECRETARY OF STATE March 13, 2008 Mr. Joseph Melchione 4 Mountain View Court Fort Salonga, New York 11768 Re; F-2008-0048 U.S. Army Corps of Engineers/New York District Permit Application - Joseph Melehione DEC # 1-4738-01529/00007 Construction of a dock, seasonal ramp, seasonal float. Richmond Creek, Town of Southold, Suffolk County Dear Mr. Melchione: The Department of State received your Federal Consistency Assessment Form and consistency certification and supporting information for this proposal on January 16, 2008 & February 4, 2008. The Department of State has determined that this proposal meets the Department's general consistency concurrence criteria. Therefore, further review of the proposed activity by the Department of State, and the Department's concurrence wilah a.n incl|¥iduM consistency certification for the proposed activity, are not required. This General Concurrence is without prejudice to and does not obviate the need to obtain all other applicable licenses, permits, other forms of authorization or approval that may be required pursuant to existing State statutes. When communicating with us rega~rding this matter, please co~_t~,,t usat (51~)474-6000 and refer to our file #F-2008-0048. JZ/dc Sincerely, Supervisor of Consist~.cy Review Division of Coastal Resources COE/New York District ~ Michael Vissichelli DEC/Region 1 - Matthew Penski WWW.DOS.STATE.NY.US · E-MAIL: INFO,DOS.STATE.NY.US OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: From: Date: Jim King, President Town of Southold Board of Trustees Scott Hilary, LWRP Coordinator July 16, 2008 AUG - 5 2008 Southold Tov~ ~e~rd o~ Trustees Re: Proposed Permit to Wetland Permit for JOSEPH MELCHIONE SCTM#86-2-10 JOSEPH MELCHIONE requests a Wetland Permit to construct a 4'X 20' fixed dock using fiberglass "Flo-thru" decking and 6" dia. piles, install a 3'X 14' seasonal ramp, and a 6'X 20' seasonal floating dock with 6" dia. anchor piles. Located: 3575 Wells Rd., Peconic. SCTM#86-2-10 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with LWRP policy standards and therefore is INCONSISTENT with the LWRP. The proposed dock is in a Critical Environmental Area nominated by the Town of Southold as worthy of protection~ (see Critical Environmental Areas § 275-2 Definitions below). Any proposed action in a Critical Environmental Area may be subject to more stringent requirements such as denial of certain operations~ and shortening, or reducing the size of the structure pursuant to § 275-11 Construction and operation standards. Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. § 275-2 Definitions; word usage. CRITICAL ENVIRONMENTAL AREAS -- All sites previously nominated by the Town of SouthoM and designated by the New York Sate Department of state as Critical Environmental Areas worthy of protection including: Cutchogue Harbor Wetlands, Hallock's Bay, Dam Pond, Downs Creek, Orient Creek, West Creek, Richmond Creek and Beach, Brush's Creek Cedar Beach Cree~orey Creek Deep Hole Creek GoldsmitOl~let, Halls Creek Goose Creek Little · Creel~ Mill Creek and Pipes Covl~eek. § 275-11 Construction and operation standards· (7) Critical environmental areas'. At the discretion of the Board of Trustees, any operations proposed in critical environmental areas (§ 2 75-2) may be subject to more stringent requirements than detailed in this section. Such requirements may include, but are not limited to, denial of certain operations, shortening or reducing the size of structures, and increasing the width of nondisturbance buffers. The proposed dock float location is at an average water depth of 2.3 feet calculated from the plan view provided by the applicant. The use of a vessel associated with the proposed dock could have potential adverse impacts to the public trust bottomland from sitting of vessel and prop dredging from the vessel. Pursuant to § 275-11 Construction and operation standards no part of the floating dock will contact the bottomlAnd during a normal Iow tide. It is recommended that the potential impacts to the public trust bottomland from the vessel be I considering when reviewing the proposed action (dock). § 275-11 Construction and operation standards. (2) Docks. Regulations for the placement and configuration of docking facilities. [1] Residential docks. [Amended 10-11-2005 by L.L. No. 17-2005] [b] If any part of a residential dock structure includes afloat or floating dock, the float or floating dock portion shall be designed so that, with the exception of the pilings: [ii] No part of the floating dock will contact the bottomland during a normal Iow tide. Furthermore the proposed dock is in Richmond Creek within LWRP Reach 7~ a Significant Coastal Fish and Wildlife Habitat (SCFWH) recognized by the Town as worthy in protecting (see Richmond Creek and Beach SCFWH Narrative below). 6.2 Protect and restore Significant Coastal Fish and Wildlife Habitats. The Town of SouthoM is rich in habitats that support diverse and often large wildlife populations, many of which are of commercial or recreational value. The importance of these habitats has been recognized through the state designation as Significant Coastal Fish and Wildlife Habitats in Southold. These habitats cover the full range of habitats typical on the East End of Long Island and include dunes, beaches, wetlands, islands and open water. The Town of Southold recognizes the importance of protecting and enhancing these wetlands and habitats. NEW YORK STATE SIGNIFICANT COASTAL FISH AND WILDLIFE HABITAT (SCFVOt) Richmond Creek and Beach LOCATION AND DESCRIPTION OF HABITAT: Richmond Creek and Beach is located just west of Great Hog Neck with an inlet into Little Peconic Bay, Town of Southold, Suffolk County (7.5' Quadrangle: Southold, NY). The fish andwildlife habitat is approximately 135 acres in size consisting of a sand peninsula, salt marsh, and tidal creek. The New York Natural Heritage Program has documented the occurrence of seaside plantain, a rare plant species, at Richmond Creek. There is moderate residential development along the borders of the creek, portions of which have been dredged and bulkheaded. Much of the creek is lined by Spartina alterniflora (smooth cordgrass). The creek itself tends to be muddy. The creek/beach/marsh ecosystem at Richmond Creek is similar to other creeks in the area but serves as an important habitat to several vulnerable wildlife species. Policy 9-Provide for public and recreational use of, coastal wate~l~ublic_lands, and public resources of · the Tgwn of Southold. The proposed action is private~ noncommercial and will not support a pattern of development that enhances community character nor preserves "PublicV access or public recreational activities Policy Standard-9.4 Assure public access to public trust lands and navigable waters. A. Provide free and substantially unobstructed passage along public trust shoreland~'. E. Provide access to, and reasonable recreational use o,~; navigable waters and public trust lands under water. 2. Permit limited obstruction of public use, including navigation, in navigable waters: 3. Obstruction of navigable waters and underwater lands is limited: b. to the minimum necessary for access to navigable waters. The minimum is determined t~v evaluating the Jbllowing factors : (ii) the range of'tidal water level fluctuation, The water depth within the location of the proposed dock (float) is approximately 2.3 feet (average) of water which is limiting for many types and sizes of power boats. (vi) whether or not alternative means to gain access are available. The applicant presently has a means of access to the resource via stairs attached to bulkhead (see figure #1 below). The applicant also has two additional alternate means of access to Richmond Creek via the Town's boat ramp off Parkers Road and Wells Road, are #2 next Figure #1 Buikheaded property on Richmond Creek of Joseph Melchione SCTM# 86-2-10 COASTAL FISH & WILDLIFE HABITAT ASSESSMENT FORM Name of Area: Designated: Date Revised: County: Town(s): 7½' Quadrangle(s): Richmond Creek and Beach March 15, 1987 May 15, 2002 Suffolk Southold Southold, NY Assessment Criteria Ecosystem Rarity (ER)--the uniqueness of the plant and animal community in the area and the physical, structural, and chemical features supporting this community. ER assessment: Tidal creek, undeveloped sand peninsula, and salt marsh unusual in Suffolk County, but rarity diminished by dredging and development along the creek. Species Vulnerability (SV)-the degree of vulnerability throughout its range in New York State of a species residing in the ecosystem or utilizing the ecosystem for its survival. SV assessment: Least tern (T) nest in the area. Piping plover (E, T-Fed) have nested in the area, but the importance of the colony is not adequately documented. Human Use 0tU)- the conduct of significant, demonstrable commercial, recreational, or educational wildlife-related human uses, either consumptive or non-consumptive, in the area or directly dependent upon the area. HU assessment: Crabbing and clamming of local importance. Population Level (PL)-the concentration of a species in the area during its normal, recurring period of occurrence, regardless of the length of that period of occurrence. PL assessment: No unusual concentrations of any fish or wildlife species occur in the area. Replaceability Oi)--ability to replace the area, either on or off site, with an equivalent replacement for the same fish and wildlife and uses of those same fish and wildlife, for the same users of those fish and wildlife. R assessment: Uncertain of ability to replace. 25 1.0 Habitat Index = [ER + SV + HU + PL] = 25.0 Significance = HI x R = 25.0 Page 1 of 6 NEW YORK STATE SIGNIFICANT COASTAL FISH AND WILDLIFE HABITAT NARRATIVE RICHMOND CREEK AND BEACH LOCATION AND DESCRIPTION OF HABITAT: Richmond Creek and Beach is located just west of Great Hog Neck with an inlet into Little Peconic Bay, Town of Southold, Suffolk County (7.5' Quadrangle: Southold, NY). The fish and wildlife habitat is approximately 135 acres in size consisting of a sand peninsula, salt marsh, and tidal creek. The New York Natural Heritage Program has documented the occurrence of seaside plantain, a rare plant species, at Richmond Creek. There is moderate residential development along the borders of the creek, portions of which have been dredged and bulkheaded. Much of the creek is lined by Spartina alterniflora (smooth cordgrass). The creek itself tends to be muddy. FISH AND WILDLIFE VALUES: The creek/beach/marsh ecosystem at Richmond Creek is similar to other creeks in the area but serves as an important habitat to several vulnerable wildlife species. Diamondback terrapin nest on the beach. The tidal creek and salt marshes provide feeding areas and cover for terrapins during this period (April - July). This area may provide important breeding habitat for horseshoe crab, but additional documentation is required. The beach has historically been a nesting area for least terns (T) and piping plover (E, T-Fed). Least tem nested annually at this site between 1987 and 1996 in variable abundances. A peak number of 52 nesting pairs occurred in 1989, and numbers have declined during the 1990s. Piping plover nested in small numbers at Richmond Beach during the late 1980s, but have been documented only twice since that time (in 1995 and 1997). Further information on the importance of this beach to the piping plover population is needed. Two pairs of cornmon tem (T) nested on Richmond Creek Beach in 1988. Waterfowl species observed overwintering in the Richmond Creek area include Canada goose, American black duck, mallard, oldsquaw, buffiehead, red-breasted merganser, surf scoter, and common goldeneye. Richmond Creek is also a productive habitat for finfish, shellfish and crustaceans, including blue claw crabs, clams and scallops. The creek is one of the top two creeks for crabbing in the town and is also important for clamming. Richmond Creek is seasonally closed to shellfishing from April 1 through October 31. Page 2 of 6 IMPACT ASSESSMENT: Diamondback terrapin are vulnerable to disturbance by humans from April 1 through August 15. Nesting shorebirds inhabiting Richmond Creek and Beach are highly vulnerable to disturbance by humans, especially during the nesting and fledging period (March 15 through August 15). Significant pedestrian traffic or recreational vehicle use of the beach could easily eliminate the use of this site as a breeding area and should be minimized during this period. Recreational activities (e.g., boat and personal watercraft landing, off-road vehicle use, picnicking) in the vicinity of bird nesting areas should be minimized during this period. Predation of chicks and destruction of eggs or nests by unleashed pets (e.g., dogs, cats) and natural predators may also occur, and predator control should be implemented where feasible. Fencing and/or continued annual posting of shorebird nesting areas should be provided to help protect these species. Control of vegetative succession, through beneficial use of dredged material or other means may improve the availability of nesting habitat in this area. Elimination of salt marsh vegetation, through loss of tidal connection, landfilling, dredged material disposal or excavation would result in a direct loss of habitat area. Alterations of tidal patterns in the marsh (e.g., by modifying the inlet) could have major impacts on the fish and wildlife species present. Construction ofbuikheads, breakwaters, revetments, and other "hard" shoreline structures negatively impact tidal wetland habitats. Alternative strategies for the protection of shoreline property should be examined, including innovative, vegetation-based approaches. Control of invasive nuisance plant species, through a variety of means, may improve fish and wildlife species use of the area and enhance overall wetland values. Any activity that would substantially degrade the water quality of Richmond Creek would adversely affect the biological productivity of this area. All species offish and wildlife are affected by water pollution, such as chemical contamination (including food chain effects as a result of bioaccumuiafion), oil spills, sedimentation, excessive turbidity, stormwater runoff, and waste disposal (including boat wastes). Impacts to water quality in the creek should be minimized or eliminated to enhance locally important shellfish and crustacean populations. Barriers to fish migration, whether physical or chemical would have a major impact on the fisheries in Richmond Creek. Unrestricted use of motorized vessels including personal watercraft in the protected, shallow waters of bays, harbors, and tidal creeks can have adverse effects on aquatic vegetation and fish and wildlife populations. Use of motorized vessels should be controlled (e.g., no wake zones, speed zones, zones of exclusion) in and adjacent to shallow waters and vegetated wetlands. Page 3 of 6 KNOWLEDGEABLE CONTACTS: Habitat Unit NYS Department of State Division of Coastal Resources 41 State Street Albany, NY 12231 Phone: (518)474-6000 NYSDEC--Region 1 State University of New York, Building 40 Stony Brook, NY 11790-2356 Phone: (631) 444-0354 Wildlife Manager NYSDEC--Region 1 State University of New York, Building 40 Stony Brook, NY 11790 Phone: (631) 444-0310 Bureau of Marine Resources NYSDEC 205 N. Belle Meade Road, Suite 1 East Setauket, NY 11733 Phone: (631) 444-0430 Finfish and Crustaceans NYSDEC 205 N. Belle Meade Road, Suite 1 East Setanket, NY 11733 Phone: (631)444-0436 New York Natural Heritage Program Wildlife Resources Center 700 Troy-Schenectady Road Latham, NY 12110 Phone: (518) 783-3932 Town of Southold Town Hall 53095 Main Road; P.O. Box 1179 Southold, NY 11971 Phone: (631) 765-1801 Page 4 of 6 Office of Ecology Suffolk County Dept. of Health Services Bureau of Environmental Management County Center Riverhead, NY 11901 Phone: (631) 852-2077 Paul Stoutenburgh 4015 Skunk Lane Cutchogue, NY 11935 Phone: (631) 734-6605 Page 5 of 6 =LITTLE ./ ipECONIC Page 6 oJr 6 Joseph Meichione SCTM# 86-2-10 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application --~etland Permit Application __ Administrative Perrmt Amendmenffl'rans let/Extension -..-'Received Application.'~ ~"~eceived Fee:$ ~,~t'~" ' '--CSmpleted Application t~ __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent) ,.,'~WRP Consistency Assessment Form ~./e~l · -.'~AC Referral Sent: t0 [ ;1'1 [ ~ ~Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination:__ Technical Review: ~--"Vublic Hearing Held: t") __Resolution: MAY 3 0 2~B Name of Applicant ~ Address q ~,.~1-~ :.,, t].'~ Phone Suffo~ County Tax Map Nmber: 1000 Prope~yLocation: ~7~ ~ I~ (provide LILCO Pole #, distance to cross streets, and location) A GENT: (If applicable) Address: Phone: Lrd of Trustees Applicati~ GENERAL DATA Land Area (in square feet): .~ Area Zoning: Il. ca ;' Previous use of property: Intended use of property: ~ Covenants and Restrictions: Yes ~ No If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a govemmental agency? ~ No Yes If yes, provide explanation: Project Description (use attachments if necessary) of Trustees Applicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: square feet cubic yards cubic yards Area of wetlands on lot: Percent coverage of lot: ~ % Closest distance between nearest existing structure and upland edge of wetlands: ~-~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ feet Does the project involve excavation or filling? / No Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): ~rd of Trustees Applicati, COASTAL EROSION APPLICATION DATA Purposes of proposed activity:. Are wetlands present within 100 feet of the proposed activity? No I/ Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? .(cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ___. COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POST1NG I, dole,ab. /q~&~,b,~¢. , residing at being duly sworn, depose and say: That on the ,/~ day of ,J~ty ,200~, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held (Llod._~4t ~ e~3. cv~00~ - Dated: 4~,t,~ 1.$ t ~'~'g Sworn to before me this day of0ol~t 200~/ ~ (si~ture) SHEILA J GALANTE Notarv Pu0tic. State o! New York No 01GA5055841 Quali~iecl m Nassau County My ¢omm~m~on I~xp~res 02/20/2010 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: *dY~VK~;t'r~? ..... , emg u y sworn, deposes ~d says that on the ]~ ~ day of ~o~ ~ ,20~ g, deponent mailed a tree copy of ~e Notice set fo~h in the Bo~d of Trustees Application, directed to each or,he above n~ed persons at the ad&esses set opposite there respective n~cs; ~at the ad&esses set opposite the n~es ofs~d persons ~e ~e ad&ess ofs~d persons as sho~ on the c~em ~sessment roll of the To~ of Southold; that said Notices were mailed at ~e United States Post Office at ~ ~2 ~g~ ~ ~. ~ , ~at said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this ] ~'"~ Day o£-(~o~ ,20 SHEILA J GALANTE Notary public. State ol New York No 01GA5055841 Qualit~e~.~ ~n ~lassau County My Comrr.ss~on Expires 02/20/2010 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: SCTM# That it is the intention of the undersigned to request a Permit from the Board of Trustees to: 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: J,rep k MAIL1NGADDRESS: q ~.~,u~.~l.~ ~,~a PHONE #: Enc: Copy of sketch or plan showing proposal for your convenience. IPROJECT ID NUMBER ~ART 1 - PROJECT INFORMATION 61720 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 1 APPLICANT / SPONSOR LOCATION: Municipality ~ .¢ SEQR 2. PROJECT NAME , ..., cou.ty ir. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: E~ew [] Expansion [] Modification / alteration 6 DESCRIBE PROJECT BRIEFLY: 7, AMOUNT OF LAND AFFECTED: ~¢//ri~" Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXiSTiNG ZONING OR OTHER RESTRICTIONS? E~Yos [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~esidential E~] Industrial ~ Commercial . [~]Agriculture E~] Park / Forest / Open Space ]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGEN Y (Federal, State or Local) ~es r-]No If yes, list agency name and permit / approval: ~Y.~ O~ ~- ~ bet~' 11 DOES ANY ASPECT Of THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? E~es E~No If yes, list agency name and permit / approval: ~,}~a,~ I~'~- ~e,r~%~' ~ec~.;e~ 12. AS A RESU[.T OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ~'~ ~M,~.. ~ ~,~, ~t I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY I~NO~LE~DGE ~1 Applicant / Sponsor Name ~4~'.~, Date: Signature ~ ~ If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc)/) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 6t 7.4? If yes, coordinate the review process and use the FULL EAF. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1 Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potentiai for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3 Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5~ Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: I C7. Other impacts includin~ chan~)es in use of ~!t~er quantit7 or t~j~e of energy? _Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. [~]HyEeRsE, O~_~ NToHEI~E LIKELYTO BE CON]~ROVERSY RELATEDTO POTENTIAL ADVERSE ENVI~O~NMENTALIMPACTS? Ifa{es ex~lain:1 PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therWisesigni~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (t') magnitude, if necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significa nt adverse impacts which MAY occur. Then proceed directly to the F UL L 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 actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons suppoding thi.~ determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from responsible officer) oard of Trustees Applicat~n County of Suffolk State of New York ,/o4ep k e [ ¢ e BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF FIlS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS .'¢~ DAY OF t~Ata ~ ,20 o f Notary Public FRED J. KUNZ N(X~/Public, StYe of New YmlC Oomml~lon ~plm~ blardn APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town 6ffleers and emolovees. Thc vuruose of thi~ form is to orov de information which can alert the town of ~ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: pJ[~'[~..~.~a'~, · ~l~..~'l~ ~_ : (Last name, firsi name, ~nid31e initial, uffless you are applying in the name of someone else or other entity such as a company. If so, indicate, the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other Of"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Basines~ interest'~ means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ lfyou answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title Or position of that pemon Describe the relationship between yourself(the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): ___A) the owner of greater than 5% of the shares of the corporate stock of the applic0nt (when the applicant is a co~oration); B) the legal or beneficial owber of any interest in a non-corporate entity (wh6n the applicant is not a corporation); ___C) an officer, director, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submilted this day of 200 Signature Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (wkich includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suvoortin~, facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# o$~ 01- - ~(,a The Application has been submitted to (check appropriate response): Town Board ~ Planning Board [] Building Dept. ~ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) ~-~ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent Location of action: Site acreage: . Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code ~/'~ (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~ No ['-] If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ~-~es [-~ No [~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria I ~'-Yes [~ No [~ Not Applicable Attach additio necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria Yes ~-~ No ~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria Yes © No I~Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Yes [] So Sot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Ap~able Attach additional sheets if necessary .... r . ' ' Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. Yes ~ No ~'rNot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria· I~Yes ~ No [-~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~ Yes~ No ~Not Applicable Attach additional sheets if necessary WORKING COAST POLICIO Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [5-~Yes [] No ~'] Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~Yes ~ No [] Not Applicable Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ~-] Yes ~-~ No ~/'Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [] Yes ~] No ~'Not Applicable PREPARED BY~~Tm~~~ TIILE~ DATE / ~ ~ V-- May 30, 2008 Board of Trustees Town of Southold Town Hall 53095 Ronte 25 Southold, New York 11971-0959 To Whom It May Concern: I am the owner of 3575 Wells Road, Peconic, New York, 11958, and am hoping to construct a dock, seasonal ramp and seasonal float for use by my family. Attached are the following documents: · Completed Board of Trustees Application · Approval Permit from the New York State Department of Environmental Conservation - Permit # 1-4738-01529/00007 · Approval letter from the Department of State - Federal Consistency Assessment Please note that on May 29, 2008, Ms. Sophie Ettinger, Supervisor at the U.S. Army Corps of Engineers-New York District, communicated to me that my proposed project was approved, and a formal "Letter of Approval" is being processed. Ms. Ettinger noted that I should receive the document within two to three weeks. Lastly, please note that all correspondence should be send to my attention at: 4 Mountain View Court, Fort Salonga, New York 11768 Thank you for your time and consideration. Sincerely, oe~e ~elchione Lat.. N 41-02-15 Long. 1,,I -/2-26-1~ N A O Location Diagram NTS N APPROVED AS PER 'TERMS ^~o CONmT,oNs or o ~' 0 Plan View Proposed: Dock, Ramp & Float Purpose: Private Mooring Applicant: Joe Melchione Prepared: October 9, 2007 Amended: October 24, 2007 Amended: December 27, 2007 SCT# 1000-86-2-10 Town: Southold Suffolk County, NY Datum: A L W Tide 2.5' +/- 1' = 3(~' · 0~~ gAY 3 0 2008 I Se uti~elc~ Town ¢o3rd e( Trustees Section Jomn Proposed Dock Fiberglass "FIo-Thru" Decking 4' x 20' (2.5' abv. gr. & hw) exist.. blkd. 6' dia. l~et:land5 posts at: bulkheod 10' oc R. Fox Oct:. 'O'l "t:r'eot:ed" posf~ oll hcrc~c~e golvc~lzed Seasonal Float LIN Prepared by: SEA LEVEL MAPPING 631-722-3390 P.O. Box # 366 Aquebogue NY 11631 From:26XHO5642 UU/U//ZUU~ U~; IZ FUUb F,UUI/Uld DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORP8 OF ENGINEER8 JACOB K. JAVI'[$ FEDERAl. BUILDIN(~ NEW YORK~ N.Y. 10278-0090 R~LY~ Regulatory ~ranoh-Eastern' Permits Section SUBJECT AUG - 8 2008 f I]rl~ t e~i~ Application Number NAN-2008-458-EET by Joseph Melchione Joseph Melchi.one 4 Mountain view Court Port Salonge, NY 11768 'Dear Mr. Melchione: We have completed our review of Application Number NA,N-2008- Pursuant to Section {33 USC 403), Army: ACTIVITY: 10 of the Rivers and Harbors Act of 1899 you are hereby authorized by the Secretary of the Install a 4-foot-wide by 20-foot-long pier with fiberglass "Flo-Thru" decking, elevated a minimum 2.5 feet above grade~ a 3-foot-wide by 14-foot- long seasonal ramp and a 6-foot wide by 20~foot- long seasonal float. All work shall be done in accordance with the attached plans, subject to Special Condition 1, which are hereby made part of this permi%. WATERWAY: Richmond Creek LOCATION: Peconic, Town of Babylon, Suffolk County, New York The activity authorized herein must be completed within three years of the date of this permit. This authorization is subject to the enclosed conditions. Please find. enclosed two forms to be used to submit tO this office,.as required, the dates of commencement and completion for the authorized activity. Attached to this verification that your project is authorized by LOP is an approved jurisdictional determination. If you are not in agreement with that approved JD, you can make an administrative appeal under 33 CFR 331. This letter contains an initial proffered permit for your activity. If you object to this permit decision because of certain terms and. conditions therein, you may request'that the permit be modified accordingly under Corps regulations at 33 CFR 331. Enclosed you will find a combined Notification of Appeal PrOcess (NAP) and Request for Appeal (RFA) form. If you object to this permit decision you must submit a completed RFA form to From:26XH05642 u /u//zuu tz r'.uuz/uzo the New York District Office Richard L. Tomer Chief, Regulatory Branch New York District Corps of Engineers 26 Federal Plaza, Room 1937 New York, New York 10278-0090 In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal under 33 CFR Part 331.5, and that it has been received by the District Office within 60 days of the date of the NAP. Should you decide to s~bmi~,~n,~F~orm, it must be received at. the above.address by Ub/U~/,~J~, . It is not necessary to submit an RFA form to the District Office if you do not objec~ to the permit decision in this letter. The authorized activity must be performed in accordance with the. enclosed plans. If any material changes in the location or plans of 'the subject work are found necessary, revised plans should be submitted to the District Engineer. These plans must receive the aPProval required by law before work begins. Notice is hereby given that the permittee should recognize that a possibility exists that the structures permitted herein may be subject'to wavewash from passing vessels. The issuance of this permit does not relieve the permittee from taking all proper steps to insure the integrity.of the structures permitted herein a~d the'safety of boats moored thereto from damage by wavewash and.the permittee shall not hold the United States liable for any such damage. .If any questions should arise concerning this ma~er,.please contact Sophie Ettin~er, of my staff, at (917) 790-8514. Enclosures Sincerely, 'FO~ kND !# ~EHALF Aniello 5'. Tortora Colonel, U.S. Army District Engineer krom;Zb~HUbb4Z uo/u//zuuo u~.zo euu~ r.uuo/uto P~P.M~TT~: ~ossph Ma~chione PERMIT CONDITION~ NOTE: The term "you" an~ its derivatives, as used in this permit means the'permlttaa or any future transferee. The term "this office" refers to the appropriate district or division office of the Corps of ~ngineers having jurisdiction over the permitted activity or appropriate official of that office acting under the authority of the commanding officer. 1. The time limit for completing the work authorized ends within three years of the date of this permit. If you find that you need more time to complete the authorized activity, submit your request for a =ime extension to this office for consideration at leas= four months before the date is reached. 2. You must maintain the activity authorized by this permit in good condition and in conformance with the terms and conditions of this permit. You ara not relieved of this requirement if you abandon the permitted activity, although you may make a good faith transfer to a third party upon written notification ko this office. Should you wish to cease to maintain the authorizsd activity or should you desire to abandon it without a good faith transfer, you must obtain a modification of this permit from this office,.which mayrequire restoration of the area. 3. If you discover any previously unknown historic or aroheological .remains while accomplishing the activity authorized by this permit, you must immediately notify this office of what you have found. Wa will initiate the Federal and state coordination required to determine if the remains warrant a recovery effort or if the site is eligible for listing in the National Register of Historic Places. 4. You must allow representativss from this office to inspect the authorized activity at any time deemed necessary to ensure that it is being or has been accomplished in accordance with the terms and conditions of your permit. Special Conditions: 1) The permittee understands and agrees that, if future operations by the United States re~/uire the removal, relocation, or other alteration, of the structure or work hsrein authorized, or if, in the' opinion of the Secretary of the Army or his authorized representative, said structure or work shall cause unreasonable obstruction to the ~ree navigation of the navigable waters, the permittes will be required, upon due notiue from the ~rom;Xb~HUbb4X UU/UI/ZUU~ U~:i~ ~Ub H.UU4/UI~ P~F,.~TTEE~ ~osaph ~etchtone Corps of Engineers, to remove, relocate, or alter the struotural work or obstruetlons caused thereby, without expense to the United Stat~s. No claim shall be made against the United Btates on account of any such removal or alteration. ~urther Information~ 1. Limits of authorization. a. This permit does not obviate the need to obtain other Federal, state, or local authorizations require~ by law. b. This permit does not 9rant any property rights or exclusive privileges. c. This permit does not authorize any injury to the property or rights of others. d. This permit does not authorize interference with any existing or * propose~ Federal project. 2. Limits to Federal Liab~lity. In issuing this permit, the Federal G~vernment does not assume any liability.for the following: a. Damages to the permitted project or uses thereof as a result of other permitted or unpermitted activities or from natural causes. Damages to'the permitted project or uses thereof as result of current or future activities undertaken by or on behalf of the United States .in the public interest. Damages to persons, property, or to other permitted or unpermitted activities or structures caused by the activity authorized by this permit. d. Design or construction deficiencies associated with the permitted work. e. Damage claims associatedwith any future modification, suspension, or revocation of this permit. 3. Reliance on Applicant's Data: The determination of this office that issuance of this permit is not contrary to the public interest was made in reliance on the information you provided. 4. Reevaluation of Permit Decision: This office may reevaluate its decision on this permit at any time the circumstances warrant. From:26XH05542 US/U//2UU8 US: P,UUb/UI PERMIT NO.= NAN-2008-458-~ET ' AU6 Circumstances that could require a reevaluation include, but are not limited to, the following: a. You fail to comply with the terms and conditions of the permit. The information provided by you in support of your permit application proves to have been false, incomplete, or inaccurate (See 3 above). c. Significant new informaticn surfaces which this office did not consider in reaching the original pLfolic interest decision. Such a reevaluation may result in a determination that it is appropriate to use the suspension, modification, and revocation procedures contained in 33 CFR 325.7 or enforcement procedures such as those contained in 33 CFR 326.4 and 326.5. The referenced enforcement procedures provide for the issuance of an administrative order requirin~ you.to comply with the terms and conditions of your permit and for the initiation of legal action where appropriate. You will be .required to pay for any corrective measures ordered by this office, and. if you fail to comply with such directive, this office ~ay in certain situations .(such as those specified in 33 CFR 209.170) accomplish the corrective measures by contract or otherwise and bill you for the cost. 2. Extensions. General condition 1 establishes a time limit for the completion of the activity authorized by this permit. Unless there are circumstances requiring either a prompt completion of the authorised activity or a reevaluation of the public interest decision, the Corps will normally give favorable consideration to a request for an extension of this time limit. T From:26XH05642 08/07/2008 09:18 ~05 P,008/018 · Location Diagram NTB Section Proposal Dock Fiberglass "Fio Thru" Decking 4' x 20' (2.5' abv. gr. & hw) NYaD.e¢ //// Plan View Proposed: Dock, Ramp & Float Purpose: Private Mooring Applicant: Joe Melchione Prepared: October 9, 2007 Amended: O~ober 24, 2007 Amended: December 27, 2007 8C? 1000.-86-2-10 lown: ~outhold Suffolk ~U~, NY Datum: A L W ./ Tide 2,5' +/- 1" '-- 30' ~ Seasonal Float B' x 20' "l;reof~d" (4) 6" dia. anchor · bf. fzn. oll plies w~ cross ~lvonlzed braoes to keep flo~t. min. 2.5' off bottom PrepareO by: SEA LEVEL MAPPING 631-7~2-3390 P.O, BOX # 866 Aquebogue NY 11931 ......... ; .;-;,;---.~,~;1~.~-.,~~. ~. ~.¢ From:26XH05642 US/U//ZUUS U~:I4 ¢JUb P,UU//Ut~ R~LYYO A~TENTION OF; C~NAN-0P-RH DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB I~ JAVIT~ FEDERAL BUILDING NEW YORK~ N.Y. 10278-00g0 . ,ZMPORTA~ This letter must he completed and mailed to the Harbor Supervision & Compliance Section at the above addreRs prior to commenuement of ~n¥ Work authorized under the permit. , permit=es= Joseph Melohione' Per, it No. NAN-2008-458-EET Waterway: Richmond Creek C$ty & State: Peconic, Town of Babylon, NY Work will commence on or about: Name, kd~reas &'Telephone Number of Con=fao=or: Signature of Fermi=tee Date Fold this form into thirds, with the bo=tom ~hird facin~ outward. Tape together and mail to the address below or FAX =o (212) 264-4260. Place Stamp ~ere Department of the Army New York District Corps of Ehgineers Jacob K. Javits Federal Building ATTN: CENAN~OP-P.H New York, New York 10278-0090 Fror,.'25XHUbE42 u~/u/fzuuo u~. ~,~ ~uuo r .uuoz u,o CENAN-O~-RH DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAvn~ FEDERAL BUILDING NEW YORK~ N,Y. 1027B4}0~0 ~MPORTANT This lc=ret'must be completed and mailed :o the Harbor Supervision & Com91iance Section at the above address following completion or cancellation of work authorized under the permit. Joseph 'Metchione Per,it No. NAN-2008-456iEET 'Waterway: Richmond Creek City & State: Richmond, Towrn of Babylon, NY Check and complete applicable item(s} listed below: Work was completed on W~rk will not be performed o~ the project. Deviation from work authorized in permit is explained below, Other (e~lafn) For dredging projects, list the volume of material dredged, and the amount placed at each disposal location {if more than one). cubic yards ~laced at cubic yards placed at Signature of Permit=es Date Fold this form into thirds, with the bottom third facing outward. Tape it together and mail to the address ~alow or ~a~ to (212')' 264-4260. Place Stamp Here Department of ~he Army New York District Corps of Engineers Jacob K. Javits Federal Building ATTN: CENAN-OP-RH' New York. New ¥~ 1~-~9~ From:26XH05542 U~/Ut/ZUU~ U~:14 ~ub v,uuv/u~5 NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND! ', REQUEST FOR APPEAL Attached is: See Section Below X INITIAL ?ROI~I~RED PI~RMIT (standard Pmnit or Letter of Permission) A PROi. 1. i~I.F_,D PERMIT (Standard Permit or Lcu~ of P~mission) B PERIvIIT DENIAL . C A!oPR(~VED JrURISDICTIONAL DETfiP. MINATION D PIL~L1MI~Y .IURISDICTIONAL DETERMINATION eleCTION I - 'l"n e follovang ~dent~§es your rights end options r~s.,,~,~$ an admim~h..tlve appeal of 0!o above decision. Additional information !nay be found at hlll: .Y/usane,urmy,mil/in ciffun ction s/cw/ce cwoA'eg or Corps r~"~ulsgons at 33 CFR. Prat 3.31. A: INITIAL PROFFERED PERMIT: You may accept or obJeo~ to thc permit. · ACCEFT: If you reoeived a $~mda~d Permit, you may sign the parfait document and tatum it to the New York District Bniinccr for final authorization. If you received a Letter of Pm~ission (LOP), you may accept the LOP and your work ia authorizcd, Your signature on the Standard Permit or acceplm~ce of the LOP m~ans that you accept the pormi~ in its oi~k~:y, and waive all fights to appeal the p~'rrdt, mcludin~ its ~r~ and condmons, and approved j unsdicllonal d~.nminahons (.ID) ~socmted w~th the pernut, · OBJECT: If you objeot to thc pcrmit (Standard or LOP) because of c~rmin tm-ms and conditions therein, you may requ~'I thst the p~,,,,it be modificd accordingly, You must complete Seo~ion II of this form end retom the form to the New York Diairici Engineer. Your objections must be recetx;ed by the New York District Enl~ineer within 60 days of the date of this notice, or you will forfeit your right to appeal vile p-.~,ll in thc futor~. Upon receipt of your lol~er, the New York Disiric~ l~gineer will evaluate your objecQons and may: (s) modifythe perrrat to eddres~ all of your concerns, (b) modify the permit to ~dress some of your objcc~ons, or (c) n t modify the p ermithavin~ determh!od that',he pcrmit should be issued az previously wrir~c~, ~ evaluating your objections, the New York Die. ct Bnt, incer will scud you a proffered permit for y~ur rcconsideration, as indicated in Section B be]°w. B; PROFF'BR.ED PERMIT: You may acccpl or appeal the p~rmit. · ACCEPT: If you roccivcd a Standard Permit, you may Sl~ thc pcrmit document and retom it to the New York Die.ct Engineer for final authorization. If you received a Lc'a~r of Pm'mission (LOP), you may accepI the LOP and your work is authorized, Your signature on the Standard PermiI or accepvincc of thc LOP meons that you accept the p~lfi',it in its ~ntit'~ty, and waive all rights to appeal the permit,, incl-din$ its ~cms and conditions, and approved j urisdic'gonsl detcrmmations associated with the perm's. · APP,BAL: If you choose to d~cline tho proffered p~rrait (Standard or LOP) bceauan of ccrtaln terms and conditions therein, you may appeal llle doglin~ permit under the Corps of Bn~in~r~ Adminimative Appeal Process by cornpl~in~ Scclion II of this form and sending the form to the North Atlantic Division Bnginczr, ATI'N: CENAD-BT-O, Fort Hamilton Military Cornrnunity, Building 301, General L~ Argus, Brooklyn, NY 11252-6700. This form must be r~ccivcd by the Division Engineer within 60 days of the date of this n~ce. ',. C: PERMIT DENIAL: You may appcal the daniel of a permil under thc Corps of Engineers Adminisirative Appeal Process by complcting Section II of this form and sendin~ the form to thc North Atlantic Division E~gineor, ATTIq; CENAD-ET-O, Po~t Hamillon Milila~Communt~y, Butlding301, Gcn~ral LceAvmue, Brooklyn, NY 11252-6700. This formrnustbereceivedbythe Division Bnilnocr within 60 days of the date of this notice. D: APPROVED IUR.ISDICTIONAL DETERMINATION: You may acoepl or appeal thc approved ID or provide new information, From:26XH05642 U~/Ut/ZUU~ U~: ~4 ~u~ ~.u~u/uza ~A~CEPT: You clo not necd ~ notify thc Corps to accept an approved .ID. Failure to notify the Corps within 60 days of th notice, means that you accept the approved .ID in its entil~y, and waive all rights to appeal the approved .ID. · APPEAL: If yon dias~me with the approved ~D, you rosy appeal the approved ID under the Corps of Engineers Adminislrative Appeal Process by completing Section II of this form and sending the forth to the division engineer. This form muSt be rec~ved by the North Atlantic Division Engineer within 60 days of the date of this notice with a copy flrmished to the New York Dislzict Engineer. E: PRELIMIIqARY JURISDICTIONAL DETI~RMINATION: You do not need to respond to the Corps regarding the preliminary JD. The l~relirdinary.ID is not appealable, If you wish, you may req}iast an approved .ID (which may be appealed), by contacting the Corps district for further instruction, Also ye- imy provide new infonmstion for further consideration by the Corps to r~evaluate the ID. SECTION H - REQUEST. FOR'APpEAL or OBXECTIONS TO AN INITIAL PROFFERED YERMIT RP.,ASON$1~01~. APPEAL OR OB]ECTION$: (Das~n'ba your reasons for appealing the decision or yo~;r objections to ~ initial proffered pmmit in olear co~cise statements, yOu may attach additional information to tl~s fdnn to ~lazify where your reasons or objections are adclroased !n thc administrative reset.) ADDITIONAL INNORMATION: The appeal is limited to a review of thc adrnlnistrativ~ record, th~ Corps memorandum for the reoord of the appeal conference or meetinv, a~d any supplemental inform~on that the review officer has determined is needed to clarify the administrative ~ N~ithm' the sppcllant nor the Corps may add new information or analyses to tho record. However, you may provide additional inlr~rmatlon to clarify the location of information that is a]readyin the edministrative re~ord. OF CONTAC~'FOR QIYESTION : "" ' ' : z, oner s oR m'VOmU. TZON; ', It' you have questions re~arding this decision an(I/or thc appmfl process you If you only have questions resettling thc appeal process you may eontaol: may also contact: Richanl L Tomer James W. Ha~erty, Regulatory Appe~.l s ~,oview Offie~l' U.S. Army Corps ofl~ngineers, New York District North Atlantic Division, U.S. Army Engineer Division .lacob K..~avits Federal Building Fore Hamilton Military Commtmity New York, NY 10278-0090 Gcocral Lee Avenue, Building (917) 790-8510 Brooklyn, NY 112~2-6700 (718) 765-?~50 ILmall: Jamas.W.Haggerty~ned02.usace.srmy.mil P, IGHT O1~ I~NTR. Y: Your si~aturo below grants the right of enixy to Corps ofEn~eors personoel, and any gov~arn~nt consultants, to con. duct investigations of tho project site dining the course of the appeal process. You will bc provided a 15 day notice of any si~e investigation, ~ will haw the opportunity to parQcipate i~ all site investigations. Date: Telephone number: ~{ gna. tore of appel]ant or From:26XH05642 UU/UI/ZUU u :t4 ¢rdub Y.Utt/Ute APPROVED JURISDICTIONAL DETERIVIINATION FORM U,S. Army Corps of Englnoors This form should be comploted by following be instm~ions provided in Section IV cf the .ID Form Instructional Guidebook. SECTION I: BACKGROUND INFORMATION ~9~.1 A. REPORTCOMFLETIONDATEFORAFPROVEDJURISDICTIONALDETERM1NATION(JD):C')~ ~7~ B. DISTRICT OFFICE, FILE NAME~ AND NUMBER: NY, .Ieseph Molchloum, 2008.4S/-EET PROJECT LOCATION AND BACKGROUND INFORMATION: S2te:lqY County/parish/borough: Suffolk City: Poconio Canter ooordinatos of site 0at/long in degree decimal format); Lat. 41.034° '.N.', Lung. -72.447° .~.. Univ~,sal Transv~rso Mnrcaton Name ofnearesl watcrbody; Richmond Creek Nato of nearest Tr~itienal N~.vigable Water (TNW) into which the aquatic resource flows: Name of water;hod o; Hydrololiu Unit Code (HUC): Long Island {Check ff map/dmz-am of review area and/or po~ontial Jurisdiotional areas 's/ere ava'labl~ upon r~uas~. Chock if other sites (e.g., off$/l~ miglation ares, disposal sites, eta...) are associated with this aotion and are recc~dod on a different .ID form. D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY): O ffice (Desk) Determine. lion. Dot~; May 7, 2008 Fluid Determination. Dat~(s}: SECTION Il: SUMMARY OF FIND1NGS A. R,HA SECTION 10 DETERMINATION O1~ JURISDICTION. There ~'~,4 "navig,m&le v/atars o,/'{he U.S." within ~ve~ and H~Sors Aot ~) jurisdiction (~ de~n~ by 33 ~ p~ 329) in ~e r~iow ~ Watts subJect'm'th~ ~bb and flow of ~ fid~ . . ' ~ Wa~s ~ p~s~tly u~, or ha~ be~ used in the p~t, or ~y b~ sus~tibl~ for use ~ ~o~ mter~ate or forei~ oommar~, gxpl~q: B. CWA SECTION 404 DETERMINATION OF JURISDICTION. There ~ "wator$ of tho U.$," within Clean Water A~ (CWA) judsdlctlon (as defin~ by 33 CFR part 328) in the review area. [Requir~ 1. Woter~ of the U.S. a. Indicate presence of waters of U.S. tn r~view area (check nil that npply)~l TNWs, including ~rrttorial seas Wetlands sclja~ent to TNWs Relattvoly pennanant wat=sm IRPWs) that llow directly or indlreotly into TNWs Non-RPWs that flow dir~tiy or indirectly into TNWs Wetlands directly abutting RPWs that flow directly or indir~,'tly into TNWs Wetlands adjacent to but not dlrecfly abut'ting RPWs that flow directly or indirectly into TNWs Wetlands adjacent te non-RPWs '~at flow directly or indirectly into TNW$ Impoundmegts ofjudsdlctlonal waters Isolated (interstate or {ntr~rnte) waters, including isolated wetlands b. Identif~ (estimate) size of waters of the U.S. In the r&vlew area: Non-wotland wet, i-s: linear feat: width (f~) end/or 0.1 acres. Wotlands: acres. c. Limits (boundaries) ol~Jurlsdl~lon based on: Elevation of esuthlished OHWM (if known): Non-regulated watere/wetlands (check if np~licable):3 [] .Potentially jurisdictional waters and/or wetlands wore assessed within the review arco and determined to be not jurisdictional, Explain: Boxe~ checked below shall be supported by completin$ ~he appropriate sections in Section I11 below, For p~l'poscs of this form, an RPW is deiln~d as s trlbutGry ~hat zs not a TNW and that typ~csi/y fiuws ycur-round or has contmuous flow al least scusonally (e g, typ tally 3 months). From:26XHOSB42 u~/u//zuu~ uo:~4 ~uu ~,u~z/u~o SECTION III: CWA ANALYSIS A. TNWs AND WETLANDS ADJACENT TO TNWs 1. TNW Identify TN-W: P. ici'anond Summarize rationale supporting determination: Waters' of the U.S. present on-site ate s~bject to the ebb and flow of the tide. 2. Wetland adjacent to TNW Summarize rationale supporting conclusion ~hat w~tland B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS. ADJACENT WETLANDS (IF ANY) - N/A ' C. SIGNIFICANT NEXUS DETERMINATION - N/A D. DETEP. MINATIONS OF JLrRISDICTIONAL FINDINGS. THE SUBJECT WATEKS/WETLANDS ~ · 1. TNWs and Adjacei~t W~tlamds. Check ~11 that apply and provide size estimates in ~ri~v area~ [ X ] TNWs: linear feet, width (ft), Or, 0.1 acres. [ ] Wetlands adjacent to TNWs: a~res. E. ISOLATED [INTERSTATE OK INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE, DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCtt, INCLUDING ANY SUCH WATERS - N/A F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS - N/A From:26XH05642 uu/u//zuuu ud; 14 ,%JUb i-'.UIO/UIO Provide extimatea forjurJsdietional waters in the review area (check all that apply): Tributary waters; linear feet width (fl). . . Other non-watlaM waters: anrea. Identify vype(s) of waters: ~ Wetlands: acres. NON-JURISDICTIONAL WATER~, INCLUDING WETLANDS (CHECK ALL THAT APPLY): [~ IfpoI~ntial wetlands were aSSessed within the review area, fi~e{e areas did not meet the criteria in thc 1987 Corps of Engineers Wetland Delineation Manual and/er appropriate Regional -qupplcmen~. [] Rev{mw area included i~oleted waters with no substantial nexus to interstate (or foreign) commerce. [] Prior to the Jan 2001 Supreme Court decision in "$~F,4NCC," thc r~view area would have been regulated based ran{ely on the .... Migratory Bird Rule" (MBR). Waters cio not meet the "$ignlf{cam Nexus" standard, where such a find/n/is required for jurisdiction. Explain: Other; (cxp!aln, ifa? covered above): . Provide~ nerea4~q estimates for non-$ur sd ct onal waters n the rev ew area, where the sole potent al ba~s ofjunsd~chon is :he MBR Fasters (i.¢., presence of migratory birds, presenoe of endongered ~sciea, use of water for irrigated agriculture), using best profess/one{ gment (check all that apply): · Non-wed~d waters (i.¢., rivsre, streams): linear ~et width Lakes/ponds: acres. ' Other non-wetland waters: morea. List type of aquatic resource: . Wetlands: ac-tea. Provide aereag~ estimates for non-jurisdictional waters in the review area that do nut meet ~he "Significant Nexus" standard, where such a finding is required for jurisdiction (chack all that apply): Non.wetland wa:ers (i.s,, dyers, strean~): linear feet, . wid~ (fl). Lakes/ponds: · Oth~' non-wetland waters: acres. List type of aquatic resource: i Wetlands: ar. rea. SECTION IV: DATA SOURCES. A. $UPPORT]3~G DATA. Data reviewed for J'D (cheek ail that apply - checked iten~{ sl~all be {ecluci~ in oas~ file and, where checked terlucstcd, appropriately referonce souroea below); Maps, plans, plot~ or plat submitted by. or on behalf niche applic~nt/consultanu Data sheets prepared/submitted by or on behalf of the applicanffconsuham. . . {-} CY~ce concur! wi~ da~. sheats/dalineatlon report. [] Office does not ~oncur with data she~/del{nestion r~port. 1~ Data sheets prepared by the Corp~{: Corps navigable waters' study: U.S. Geological Survey Hydrologic Atlas: [] USGS NHD da~a.' [] USGS 8 end t2 digit HUC. maps. i U.S, Geological Survey map(s). Cite ~ale & quad. name USDA Natural Reaouroes Cunservstion Sendcs Soil Survey. Chafion: National wetlands invento~map(i). Cite Sate/Local wot{end inventory map(s): F~IVlAYFIP,.M maps: . 100-year Flood~lain Elevation is; 0q'ation~.l Oeodsetic Vertical Damrn of 1929) Photographs: [] Aerial 0qemm & Date): . or }-~ Other (Name & Date): . Previous determination(s). File no. and date of response letter: Appiicab{s/suppordng ¢~e {aw: B A pplicab{dsuppor:}ng soie~gi.qe literature: Other information (p{ceae specify): B. ADDITIONAL COMMENTS TO SUPPORT JD: