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Home My WebLink AboutTR-7274 72 Jill M.Doherty,President ��QF SO(/ryO Town Hall Annex James F.King,Vice-President 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 Bob Ghosio,Jr. G John Bredemeyer O Telephone(631) 765-1892 Fax(631) 765-6641 �yIrOUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 11, 2010 Mrs. Lori Luscher Marion Lake Restoration Committee Bay Ave. East Marion, NY 11939 RE: MARION LAKE RESTORATION COMMITTEE BAY AVE., EAST MARION SCTM#31-17-1&31-7-9 Dear Mrs. Luscher: In accordance with Wetland Permit#7274 issued on April 21, 2010, your proposal to use a small amphibious vehicle and/or boat using an overhead sprayer"high volume" spraying process, as well as a.backpack applicator"low volume or direct spray" process, to control the phragmites is an acceptable method used in the Town of Southold. Please don't hesitate to contact our office if you have any further questions. Very truly yours, M. II M. Doherty, Pre ent oard of Trustees JMD:Ims Page 1 of 2 Standish, Lauren From: Jill Doherty oilid927@optonline.net] Sent: Tuesday, June 08, 2010 5:28 PM To: Standish, Lauren Subject: FW: RE: Marion Lake-Pesticide Spraying. Ask me about this, please. -------- Begin forwarded message -------- Subject: RE: Marion Lake - Pesticide Spraying. Date: 6/8/10 4:27:57 PM From: "Maureen Fisher" To:"'Jill Doherty"' Cc:smarino@timmillerassociates.com Jill, If you could write a letter allowing us to do the following work, that would be great. We are proposing to use the process of spraying pesticides for the purpose of controlling the phragmites. To conduct the spraying we will be using a small amphibious vehicle and/or boat using an overhead sprayer "high volume" spraying process, as well as a backpack applicator "low- volume or direct spray" process. Thanks for your help, Maureen From: Jill Doherty [mailto:jilld927@optonline.net] Sent: Monday, June 07, 2010 6:06 PM To: mfisher@timmillerassociates.com Subject: RE: Marion Lake - Pesticide Spraying. Yes, no problem. On Mon, Jun 7, 2010 at 11:04 AM, Maureen Fisher wrote: Jill, I received your email address from Lori Luscher with the Marion Lake Restoration Committee. We are working with Lori to obtain an application spray pesticides from the NYSDEC. We recently sent in the application package but received a denial letter for a few reasons. One reason was that the letter we received from the Town of Southold was not specific enough, regarding the application of the pesticide. 6/9/2010 Page 2 ot-2 If I were to send you some language would you be willing to put it in a letter addressed to Lori again, if the language was ok with you and town? Please let me know. Thank you for your help in this matter, Maureen Sacchetti Fisher Environmental Scientist Tim Miller Associates, Inc. Planning · Landscape Design · Traffic· Wetlands& Ecology Hydrogeology · Economics· Project Management· Permitting ---------------------------------------------------------------------------------- 10 North Street, Cold Spring, N.Y. 10516 845.265.4400 voice 845.265.4418 fax url: www.timmillerassociates.com email: mfisher@timmillerassociates.com 6/9/2010 Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 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 Ist day of construction ~ constructed Pr6ject complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7274 DATE: APRII, 21~ 2010 ISSUED TO: MARION LAKE RESTORATION COMMITTEE PROPERTY ADDRESS: BAY AVENUE~ EAST MARION SCTM# 31-17-1 & 31-7-9 AUTHORIZATION Pursuant 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 April 21,2010, and in consideration of application fee in the sum of $250.00 paid by Marion Lake Restoration Committee 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 for the cutting, wicking and the removal of phragmites surrounding Marion Lake, and as depicted on the application received March 22, 2010. 1N WITNESS WHEREOF, the raid 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. TERMS AND CONDITIONS The Permittee Marion Lake Restoration Committee, residing at Bay Avenue, Mattituck, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittec will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-enmpliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Pennittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Brederaeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 April 21,2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ms. Lori Luscher Marion Lake Restoration Committee 163 West 23rd Street Deer Park, NY 11729 RE: MARION LAKE RESTORATION COMMITTEE BAY AVENUE, EAST MARION SCTM# 31-17-1 & 31-7-9 Dear Ms. Luscher: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, April 21,2010 regarding the above matter: WHEREAS, MARION LAKE RESTORATION COMMITTEE applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 22, 2010, 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 issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on April 21, 2010, 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, 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 the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of MARION LAKE RESTORATION COMMITTEE for the cutting, wicking and the removal of phragmites surrounding Marion Lake, and as depicted on the application received March 22, 2010. 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: $0.00 Very truly yours, J~. Dohert~ President, Board of Trustees JMD/eac Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 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., April 14, 2010, the following recommendation was made: Moved by Anne Trimble, seconded by Peter Young, it was RESOLVED to SUPPORT the Wetland Permit application of MARION LAKE RESTORATION COMMITTEE for the cutting, wicking and the removal of phragmites surrounding Marion Lake. Located: Bay Ave., East Marion. SCTM#31-17-1 & 31-7-9 Inspected by: Anne Trimble Vote of Council: Ayes: All Motion Carried Jill M. Dohedy, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr, John Bredemeye~ 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: MARION LAKE RESTORATION COMMITTEE for the cutting, wicking and the removal of phragmites surrounding Marion Lake. Located: Bay Ave., East Marion. SCTM#31-17-1 & 31-7-9 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 __Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: __&King __J.Doherty __J. Bredemeyer B.Ghosio, D. Dzenkowski other Form filled out in the field by D. Bergen__ Mailed/Faxed to: Date: Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mamh 19, 2010 Mrs. Lori Luscher Marion Lake Restoration Committee Bay Ave. East Marion, NY 11939 RE: MARION LAKE RESTORATION COMMITTEE BAY AVE., EAST MARION SCTM#31-17-1 & 31-7-9 Dear Mrs. Luscher: In response to your recent request, the process of wicking phragmites is an accepted method used in the Town of Southold. Please feel free to contact our office if you have any further questions, Very truly yours, Jill M,] Doherty, President Board of Trustees JMD:lms Page 1 of 2 Standish, Lauren From: Jill Doherty [jilld927@optonline.net] Sent: Tuesday, March 16, 2010 7:21 AM To: Standish, Lauren Subject: FW: RE: Marion Lake Can you print this email for me. I need to write a letter this am. I will see you this am ........ Begin forwarded message ........ Subject: RE: Marion Lake Date: 3/16/10 7:05:10 AN From: "lori luscher" To:"jill doherty" Thanks Jill, They can address it to Marion Lake Restoration Committee, Bay Avenue, East Marion, SCTM#31-17-1., 31-7-9. This way it'll look the same as the original, my DEC contract # is C303599, not the permit #. Owner #1524772. Federal id #112879916. ! hope that helps as ! can't locate the actual permit this morning. You can reach me on my cell if yu need anything else 631-495-8579. As always, thank you ! Lori Luscher Date: Mon, 15 Mar 2010 19:54:37 -0400 From: jilld927@optonline.net Subject: RE: Marion Lake To: I_luscher@hotmail.com I am going in the office tomorrow. Who do I address it too and what is your DEC permit # so T can reference it on the letter. ! will just reference our first letter and state that it is still in effect and ! will make sure ! mention the chemicals are o.k. as well. On Mon, Mar 15, 2010 at 7:25 PM, Iori luscher wrote: Hi Jill, ! hope asll is well, winter was tough, let's hope it's really over ! We're gearing up for spring and the DEC has thrown another bump in the road. They want a letter from the town giving permission to chemically treat the lake even though they agreed to it before, they want it now in writing. !t would need to be on their 3/16/2010 Page 2 of 2 letterhead stating they have agreed to the cutting and checmical application to rid the lake of the Phragmite. They can state that we'll be using environmentally safe chemicals if it makes them feel better about it. Hopefully this is the last thing they'll ask for before they give the permit. Can you handle this for us or is there someone else ! should be asking ? Lori Luscher Hotmail has tools for the New Busy. Search, chat and e-mail from your inbox. Learn ~4ore. Hotmail: Trusted email with Microsoft's powerful SPAM protection. ~.ign up.pow. 3/16/2010 Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-664I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only __~weaStal Erosion Permit Application tland Permit Application Administrative Permit Amendment/Transfer/Extension ~4(eceived Application: ,'~[~ .~Received Fee:$ ~J~ - ' ~;,Gompleted Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent)_ LWRP Consistency Assessment Form ~_~C~iC Referral Sent: qloM LDate of Inspection: q/I t/fO Receipt of CAC Report: Lead Agency Determination:__ Technical Review: ~q~'-ublic HearingHeld: ~,[e~[ ft 0 Resolution: Address /~ Phone Number:(~3)t Suffolk County Tax Map Number: 1000 - Property Location: fi~/~/~'.4//~/9~ ~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: OBoard of Trustees Applica~n Land Area (in square feet): Area Zoning: GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: Yes t/ 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 governmental agency? t/No Yes If yes, provide explanation: Project Description (use attachments if necessary): //-/~- ~Board of Trustees Applica~n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: '"7~ ~?~ 5~7~o,,~f_~ '~/~/~ ~L- Area of wetlands on lot: .square feet 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? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ~'ft~£ C'w//'-fr~/.n/~ 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): Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 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 MARION LAKE RESTORATION COMMITTEE COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING residing at/dba I[,-~ V,~,*Z-=3~-D being duly sworn, depose and say: Thatonthe t~dayof ~[~ L- ,2010, 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 Wed., April 21, 2010 on or about 6:00 PM. Dated: ~~re~_..~ __~ Sworn to before me this day oflSfr; 120~ {D ~'q~tar~ ~ubt/c-~ ~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Nanle: Address: STATE OF NEW YORK COUNTY OF SUFFOLK , residing at /~.5 ~. 2 $~o Gr. , being duly sworn, deposes and says that on the ,20 / ~, deponent mailed a true copy of the Notice 749 day of set forth, in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~ -~ se t~t~,-~.. , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this ~ Dayof. /ds~cn ,201 0 ' t Notary Public ELOISE GERV1N Notary Public, State of New York Qualified in Suffolk County Reg, No. 01GE6128679 My Commission Expires June 13, 2013 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: SCTM# YOU ARE HEREBY GIVEN NOTICE: 1. 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 96,111 and/or 275 of the Town Code is open to public comment on: DATE: 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. PROPERTY OWNERS NAME: MAILING ADDRESS: PHONE #: AGENT: MAILING ADDRESS: PHONE #: Enc: Copy of sketch or plan showing proposal for your convenience. PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1.APPLICANT/SPONSOR 617.20 SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME 3.PROJ EC_Z.-.EOCATION: t 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or ;)rovide ma;) f 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PRO~.~ ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? r-~Yes i'1 No If no, describe briefly: 9. WHAT tS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) r'~Residential r~ Industrial r-~ Commercial [~]Agriculture ~ / 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) ~s [] No If yes, list agency name and permit / appreval: 11. DOE~- ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~es r~No If yes, list agency name and permit / approval: 12. AS A R~.~ESUL~T OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~'es L_e o I CERTIFY THAT THE iNFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant , Sponsor. /~~ 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 Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. [~Yes r'lNo B. 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, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, amhaeolngical, historic, or other natural or cultural resoumes; or community or neighborhood character? Explain briefly: 03. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain bdefly: I 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 bdefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6, mulative, bdefly: . C7, D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL L~ E. IS THERE, OR IS TH~E LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL iMPACTS? If ~,es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reechadvereee~ectidenti~edab~ve~determinewhetheritissubstantiaI~~arge~important~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (Le. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (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. If question d of part ii was checked yes, the determination of significance must evaluate the potential i m pact of the proposed action on the environmental characteristics of the CEA. 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 acflor WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. Name of Lead Agency Date Print or Type Narhe of Responsible Offi~el'in Lead Agency gnature of Responsib~ Offi~r in,ad Agen~ Title of Responsible Officer Signature of Preparer (if different from responsible officer) PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, ~oordinate the review process and use the FULL EAF. [--'~ Yes r~-i No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative dedamlton may be superseded by another inve~v~l agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If Inglble) Cl. F-~dating air quaffiy, surface or groundwater quality or quantity, doise levels, existing traffic paifem, solid waste pnxluc~on or disposul, potential fer erosion, drainage or flooding poYolems? Explain briefly: C2. Aesthetic, agflsultural, archaeological, historic, or other natural (;r cultural resoumes; or cummufltiy or nstghbsnhoad character? Explain b~iefly: C3. V,=~[,~[;on er fauna, ltsh, shellfish er wlidl'fe species, significant habitats, or threatened or endangered spec.~es? Explain briefly: I"° I C4. A ,~,,,,,,unity's existing p~ans or goals as oft-mially adopted, or a change in use or Intensity of use of land er ofhor natural resources? Explain bdefly: Cfi. Growth, s~b~=,~uent development, or related activities likely to be indese~:l by the proposed action? Explain brielty: No C6. Long term, sh0~t term, cumulative, or other effects not Idenltrk.~:l in Cl-C57 Explain bdelty: ~ No D. VVlLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE, OR IS THERE LIKELY TO BE~ CONTROVERSY RELATED TO'POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? if)ms ex{)laln: PART III - DETERMINATION OF SIGNIFICANCE (1'o be completed by Agency) IN$'I~UCTIONS: For each adverse effect identified above, determine whether it is substantial, large, importentor othenetse significant. Each effec~ should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occun~ng; (c) duration; (d) irmversibility; (e) geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient deteil to show that all relevant adverse impacte have been identiited and adequately addressed. If question d of pe~t Ii was checked yes, the determination of signfficanco reust evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box If you have identllted one or more potentially large or significant adverse Impacts which r4AY occer. ~ proceed directly to the FULL FAF and/er prepare a positive declaration. C ecl( this box if you have detefm~nad, based on the information and ana ysis above and sfly supporting documentation, that the proposed acllor WILL NOT result in any significant adverse environmental Impacts AND provide, on aifach~etas aa necessary, the reasons supporting thl~ determination. Board of Trustees Name of Lead Agency Date Jill M. Doherty President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signalure of Preparer (If different from responsible officer) Board of Trustees Appli~ion County of Suffolk State of New York (' a;~ ! Zv'5£/4 f/~ BEING DULY SWORN DEPOSES AND AFFIRMS mAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WlT~~. . ~ION. Signature SWORN TO BEFORE ME TinS ~Q0 DAY OF /L{mr( fl 20 / 0 Notary Public ELOISE GERVIN Notary Public. State of New Oua,m~ m Suffolk County M ~ R~9. No 01GE6128679 Y ~,,omm~$$~on Expires June 13, 2013 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Thc Town of Southold's Code of Ethics nrohibits conflicts of interest on the nm1 of town Officers and cmolovces. The ouroose of this form is to nmvidc information which can alert thc town of unssible conflicts of interest and allow it to take whatever action is ay id (Last name, fu~ name, ~aiddle initial, unless you am applying in the name of someone else or other entity, such as a company. If so, indicato the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax gricvance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Othcr-, 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- "Business 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 thc town officer or employee owns more than 5% of the shares. YES NO ~ · If you 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 person Describe the relationship between yourself(the applicant/agent/representative) and the town officer or employee. Either cheek 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): __~,) thc owner of greater than 5% of the shares of the corporate stock of the applicont (when the applicant is a corporation); __B) the legal or beneficial ownqr of any interest in a non--corporate entity (when the applicant is not a corporation); __~2) an officer, director, par~er, or employee of the applicant; or __O) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Subm~ed this ~ay of //lff~4t,~¢ ~t-tt 200/O Signature ~ ~ Print Name ZOO/ Marion Lake Restoration Committee 163 West 23Rd Street Deer Park, N.Y. 11729 March 19,2010 Town of Southold Board of Trustees Town Hall Annex, 54375 Route 25 P.O. Box 1179 Southold, N.Y. 11971-0959 Dear Jill Doherty, Enclosed please find a new application for the permit to clear Marion Lake. I apologize for letting our last permit lapse and hopefully this year will be the last we need one. We hope to complete the project before 2011. I have included the $250 fee associated with the new permit as not to slow down the process. Please alert me to anything I have left out that will delay the process. As I explained we are on a tight schedule in order to comply with the DEC for another pending permit. If at all possible, we also ask the board of trustees to draft a permission letter to go along with the permit allowing us to wick, enviromnentally safe method of chemical application, the stalks of Phragmites which was our initial intent. The DEC has asked that we get this in writing from the town to go along with the initial permission letter they had given us allowing for the cuttings. Thank you very much for all of your help and the expedition of this permit. Lori Luscher Pr~iT~