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TR-7836
i Nunemaker, Amanda From: Christian McGugan <christian@gwenmor.com> Sent• Tuesday, November 19, 2013 3:09 PM To: Nunemaker,Amanda Cc: 'Peter Crisp (crisppo@me.com)'; 'office@docko.com' Subject: Emailing: balcom4 - Sender is forged (SPF Fail) Attachments: balcom4.pdf,WP_000531 jpg;WP_000529 jpg;WP_000528 jpg Lucille Balcom , PERMIT#7836&7836C D V NOV 1 9 2013 Dear Ms. Nunemaker, R i Following up on our conversation on the above referenced permit: La u;;rf,;• ,_ "balcom4" is a Docko, Inc. permit drawing. I would like to request please,on behalf of the permit holder,to remove and dispose of the 142' long by 6' wide WESTERN leg of the "U"shaped pier. The 142'X 6' Eastern leg was repaired last spring.The permit holder does not wish now,or in the future,to repair or maintain the WESTERN leg,which is in serious disrepair. Please see 3 attached "WP" photos,which show East (repaired) &West(deteriorated). All terms and conditions of the permit will be observed, and I would notify your office and provide photos upon completion.Work would be performed this winter. At your convenience, please let me know if it is within your scope of authorization to allow this work to be done. Thank you. Best regards, Gwenmor Marine Contracting. Inc. Christian McGugan,V.P. 860 608 9905 c r .�� o (rn in `f d hne I� Gwenmor Marine Contracting, Inc. 12 Roseleah Drive Mystic CT 06355 1 �� r,:r�r , � - - - �� P � � . ._._ ___._..._._. �' �r i _ _. �� — — - � � — r s _ _. __ ' p `� _ � __ _ _. — __.s. u � _._.._—..._ � '. "'- s' � _ .�. � .., _ _..cr_.._ __ fFti - - _—.__ ___ 1 - - __ � _ _ f J=.i./�a�r� ii _ _ .. D _ NOV 9, R 1pv-4w � � � a 1 y�I �•-�,�/�%%� _- �_� /tel- _�;�?�-_-��'.�—_ � --�� s� �`'1. � -: 1 1 sr r -i • 1 `ri. y 4a FF James F.King,President pp�� c0 Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President P.O.Box 1179 Dave Bergen e7i ,= Southold,NY 11971 John Bredemeyer • Telephone(631)765-1892 Michael J.Domino yI'Oj .�`sa 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 % constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7836 & 7836C DATE: JUNE 20, 2012 ISSUED TO: LUCILLE BALCOM PROPERTY ADDRESS: PRIVATE ROAD, FISHERS ISLAND SCTM# 4-4-15 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 June 20.2012,and in consideration of application fee in the sum of$500.00 paid by Lucille Balcom 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 repair 142 linear feet of 6' wide pile and timber pier and boat lift waterward of the apparent high water line; and as depicted on the site plan prepared by Docko, Inc., last dated November 11, 2011, and stamped approved on June 20, 2012. IN 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. ��o�g11FF0(,�co N O .tc TERMS AND CONDITIONS The Permittee Lucille Balcom residing at Private Road Fishers Island,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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 Permittee 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. 2. 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. 3. That this Permit should be retained indefinitely,or as long as the said Pernittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. 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. 7. 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. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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. • • James F.King, President ��q so�ryo Town Hall Annex Bob Ghosio,Jr.,Vice-President ,�O l� 54375 Main Road Dave Bergen P.O.Box 1179 Southold,New York 11971-0959 John Bredemeyer G Q Michael J.Domino % �O Telephone(631) 765-1892 ��.`,oUNTi Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT COASTAL EROSION PERMIT #7836C Applicant/Agent: Docko, Inc. Permittee: Lucille Balcom SCTM#: 4-4-15 Project Location: Private Road, Fishers Island Date of Resolution/Issuance: June 20, 2012 Date of Expiration: June 20, 2014 Reviewed by: Board of Trustees DESCRIPTION OF ACTIVITY: To repair 142 linear feet of 6' wide pile and timber pier and boat lift waterward of the apparent high water line; and as depicted on the site plan prepared by Docko, Inc., last dated November 11, 2011, and stamped approved on June 20, 2012. INSPECTIONS: Final Inspection SPECIAL CONDITIONS: (apply if marked) In accordance with Chapter 111-15 Erosion Protection Structures: N/A A maintenance agreement is attached hereto and is a necessary special condition of this permit. BY: A�� 04 Jam6s F. King, Presi nt Board of Trustees • 0 James F. King, President �apF sooryo Town Hall Annex Bob Ghosio,Jr.,Vice-President 1110 54375 Main Road Dave Bergen P.O.Box 1179 Southold,New York 11971-0959 John Bredemeyer 4 Q - Michael J. Domino Telephone(631) 765-1892 1VIVO Nc� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 20, 2012 Kieth B. Neilson, PE Docko, Inc. P.O. Box 421 Mystic, CT 06355 RE: LUCILLE BALCOM PRIVATE ROAD, FISHERS ISLAND SCTM# 4-4-15 Dear Mr. Neilson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 20, 2012 regarding the above matter: WHEREAS, Docko, Inc. on behalf of LUCILLE BALCOM 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, and Chapter 111 of the Southold Town Code, Coastal Erosion Hazard Areas, application dated April 9, 2012, 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 Hearing was held by the Town Trustees with respect to said application on June 20, 2012, 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, 2 0 9 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 and Chapter 111 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 LUCILLE BALCOM to repair 142 linear feet of 6' wide pile and timber pier and boat lift waterward of the apparent high water line; and as depicted on the site plan prepared by Docko, Inc., last dated November 11, 2011, and stamped approved on June 20, 2012. 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: $50.00 Very truly yours, o� James F. King President, Board of Trustees JFK/eac 0 0 James F. King,President O�gpFF01.f Town Hall Annex Bob Ghosio,Jr.,Vice-President 54375 Route 25,P.O. Box 1179 Dave Bergen Southold,NY 11971 John Bredemeyer �7 Telephone(631)765-1892 Michael J. Domino 1�a Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: LUCILLE BALCOM Please be advised that your application dated April 9, 2012 has been reviewed by this Board at the regular meeting of June 20. 2012 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 st Day of Construction ($50.00) '/z Constructed ($50.00) XX 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 set 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: Final Inspection Fee - $50.00 TOTAL FEES DUE: $ 50.00 BY: James F. King, President Board of Trustees /41ar �Pd 713112 o�gpFFO(�.c Peter Young,Chairman - Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O. Box 1179 •�C Southold,NY 11971 Telephone(631)765-1892 1 # Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., May 9, 2012 the following recommendation was made: LUCILLE BALCOM to repair 142 If. of 6' wide pile and timber pier and boat lift waterward of the apparent high water line. Located: Private Rd., Fishers Island. SCTM#4-4-15 The CAC did not make an inspection, therefore no recommendation was made. Docko, Inc. Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:permits@docko.com April 30, 2012 Ms. Laura J Scovazzo NYSDEC Suny@ Stony Brook/50 Circle Road Stony Brook,NY 11790 Re: Balcom Property Appl.No. 1-4738-00329/00003 Dear Mr. Scovazzo: We are transmitting herewith the requested drawing revision for Mrs. Lucille Balcom located off Private Road on Fishers Island for your review and comment. Sheet 4 of 4 has been revised to show the attenuation boards at the appropriate distance above the bottom grade. I trust that you will find the revision adequate to complete your review so that the requested permit can be issued. Please let me know if further information is required. Your assistance as always is appreciated. Yours truly, DOCKO,INC. �a Iv'v F Keith B.Neilson,P.E. KBN: cb Cc: Mrs.Lucille Balcom Town of Southold NYSDEC NYSDOS File: 11-5-2283 BALCOM BOAT LIFT MECHAMSM TO BE REPARW and RESTRAC 0-FT W1DE WAJD PER TO SE REPARED INGLUDINO DSXIVS Ord DECK 57PLli REPAR/REPLACESPL?CLAo 0 AS NECESO Y(/YP) I APPARENT HIGH WATER LINE — — _ (SPRING HIGH WATER)-ELENA I APPARENT LOW WATER LINE REPAR/REPLACE CRO-55 BRAIAS Nl5CE55MY(R'PI NOTE GRADEA7END OF RER I: TIE4FFFILES NOT SHOWN IIT l FORCLARITYOFVIEW II PIVD �/I�W GRAPHIC SCALE 1 INI;30 FIT 10 5 0 10 NOTE:DECKING-NOT GGA TREATED, HARDWOODS MUST BE CERTFIED BY FOREST STEWARDSHIP COUNCIL BOAT UFT TO BE REPAJRED 6-FT WIDE PIER TO BE REPAIRED INCLUDING PILE REPLACEMENT,DECKING, APPARENT HIGH WATER LINE STRINGERS,DAMAGED WAVEA77ENUAT ION (SPRING HIGH WATER)ELF 4 BOARDS,LADDERS AND BRACING AS NECESSARY AT BOTTOM OF STRINGERS APPARENT LOW WATER LINE E 5.8 ELEV O.O ` BOTTOM SEDIMENTS SAND,GRAVEL,AND BOJIUftLDERS PROF=ILS �/IE\7�/ SURVEY: by GME ASSOCIATES ENGINEERING,LAND GR"IC SCALE 1 IN=20 Fr SURVEYING It ARCHITECTURE,PLLC 20 0 0 2O PROJECT: PIER AND BOATLIFT REPAIR OF N REVISED 4-30-12 DEC LOCATION: FISHERS ISLAND-TOWN OF SOUTHOLD WAVE ATTENUATOR SUFFOLK COUNTY,NEW YORK O�KFt Ty WATERWAY: EAST HARBOR DATE: NOVEMBER,11,:20n D 0 C x 0 • APPLICANT LUGILLE BA-COM cc AGENT: SHEET 4 OF 4 • _ ING. fF 088692• ��� Kehh B.NNIson,PE p90FESS10NP� Mystic,CT 06355 0 P 0 860 572 8939 FAX 860 572 7569 DWG 11-5-2283EMAL WITIfts®docko.com Keith Neilson, Docko Inc. 4/30/2012 9:16 AM Balcom_Cdwg OgUFFD( James F.King,President �pV C� P.O.Box 1179 Bob Ghosio,Jr.,Vice-President h y Southold,NY 11971 Dave Bergen Telephone(631 765-1892 John Bredemeyer ,y T Fax(631)765-6641 Michael J. Domino Southold Town Board of Trustees Field InspectionMorksession Report Date/Time: lygn 2- v ,oft Docko, Inc. on behalf of LUCILLE BALCOM requests a Wetland Permit and Coastal Erosion Permit to repair 142 If. of 6' wide pile and timber pier and boat lift waterward of the apparent high water line. Located: Private Rd., Fishers Island. SCTM#4-4-15 ,eh aF' Type of area to be impacted: _Saltwater Wetland _Freshwater Wetland 'Sound _Bay Distance of proposed work to edge of wetland Part of Town Codi proposed work falls under: ✓Chapt.275 _Zhapt.. 111 _other Type of Application: ✓ Wetland �oastal Erosion _Amendment —Ad ministrative_Emerge ncy_Pre-Submission Violation Info needed: _ Modifications: Conditions: Present Were: ✓J. King B. Ghosio D. Bergen, !l J. Bredemeyer ✓ Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: c Date: LUCILLE WCOM—PIER AND BOAT LIFT 10AIR EAST HARBOR,FISHERS ISLAND NARRATIVE STATEMENT &SUPPLEMENTAL INFORMATION FEBRUARY 2012 APR - 9 2012 GENERAL Mrs. Lucille Balcom owns parcel 1000-004-4-15 on a private road located along the shore of East Harbor on Fishers Island. The site is generally moderately sloped, sandy gravel earth materials and moderately landscaped with shrubs and naturally occurring stone (which has been supplemented) along the shore. The frontage of the property is approximately 100 feet along the harbor abutted by Ms. Kim Campbell's home to the east and the Fishers Island Development Corporation to the west. The waterfront consists of an armored shore with a long-standing wood pile and timber pier with a boat lift and a shoreline landing railway forming the operations and response facilities of the historic east end Life Saving Station. It is Mrs. Balcom's desire to repair this wood timber and pile supported pier landing and boat lift facilities, which were damaged in recent storms. All work is waterward of the apparent high water line. The repaired facilities will be to the same limits and dimensions as the existing structures with decking at the same height. This supplemental narrative has been prepared in accordance with the requirements of Town of Southold, Ordinance No. 6, 2004, as well as the local Waterfront Redevelopment Plan related to docks and shorefront improvements. In addition, various coastal policies under the New York State Coastal Management Act are addressed herein for review by the New York State Department of State. Section 661 of the NYS DEC Regulation pertaining to work in or adjacent to Tidal Wetlands is also addressed in this narrative. This project is eligible for the US ACOE Nationwide Permit Number 3. Past permits, for this site includes NYS DEC 1- 4738-00329/00002-0 dated 1/16/1992, ACOE letter dated 10/25/1991 and Town of Southold letter dated 12/6/1991. DESCRIPTION OF WORK As mentioned in the introductory paragraph, this project is to repair an existing, long- standing fixed wood pile and timber pier, shore landing, and boat lift as depicted in the attached application drawings and described in the application documents. All work is allowable under zoning and will be prosecuted in accordance with existing guidelines set forth in the Town of Southold ordinance No. 6, 2004. This is a continuance of a lawfully existing, historic structure, which has been a subject of previous permits for the boat lift back to the 1990's. The residential use of the property and the use of the structure for recreational boating access are also lawful and in compliance with the Coastal Zone Management Act of the State. It is envisioned that the repairs will be conducted as soon as all permits are received, scheduled to suit any seasonal restrictions and utilizing the following general sequence and methodology. ➢ The marine contractor will arrive by barge with deck-mounted crane and push boats. The damaged and deteriorated sections of the existing dock facilities will be - 1 - disassembled as r�sssary, removed from the site, and disd of in accordance with applicable laws, AM, and ordinances. ➢ New piles will be driven where necessary or as deemed prudent, starting at the landside end of the pier landing and proceeding waterward toward the boat lift end. Piles will be driven by double-acting air hammer to a bearing resistance of approximately 20 tons. This generally results in about ten feet of embedment of the pile in the bearing stratum. These piles will be 14-inch nominal diameter measured at the butt. Large piles are needed because of the size of the structure and its exposure to Nor'easters and other storm driven waves, which arrive at the site from the northeast, north, and northwest. ➢ After the piles are replaced, split caps (split clamps) consisting of pressure treated Southern Pine timbers ranging from 3 x 10 to 4 x 12 nominal dimension, will be bolted to the piles transversely. Stringers will be then laid on the split caps parallel to the length of the pier. In all likelihood, stringers will be 3 x 10 or double 2 x 10 pressure- treated Southern Pine. ➢ The outer stringer on each side will be bolted or spiked to the pile to secure the deck against uplift forces that this pier might be exposed to. ➢ After the stringers have been connected to the piles and split caps, the decking will be installed. In accordance with Town of Southold's Ordinance No. 6, 2004, this decking will not be pressure-treated Southern Yellow Pine, but rather oak, fir, cedar, etc. Decking could also be Timber Tech or similar plastic composite material with the brushed side mounted up. The synthetic decking can be either gray, brown or natural in color. Decking will in any case, be attached to the stringers utilizing galvanized nails or stainless steel flathead square-drive wood screws about 4 inches long and will be set with a 1/8" to 1/d' gap between members. The decking will run at an elevation to match existing. ➢ The alignment of the pier will match the existing structure throughout its length running over the non-vegetated bottom sediments that currently exist in the intertidal zone and between patches of eel grass on both sides of the existing structure. ➢ The piles will extend to 42 inches above the deck surface and maintain horizontal rail members. A horizontal handrail will be installed on the top of the rail system. ➢ Water and electricity lines will be installed on the pier in the space between the stringers so that trickle chargers on the boat may be powered during tie-ups and, of course, to run the boat lift. In addition, the water will allow boats to be rinsed off after usage. A power post with an internal light will be mounted to the end of the pier with receptacles to provide power to the boats from extension cords. The power post will also have a coiling arm for storage of the hose between uses. Because the dock may be used during the hours of darkness, low-intensity lights will be mounted on staggered piles or dock rail posts to illuminate the walking surface. This system will be manually and radio controlled so that the lights will only be on when necessary for safety of the users or may be low wattage solar powered lights. REQUIREMENTS OF SECTION 97-25 OF THE WETLANDS LAW The permittee acknowledges that the validity of this permit is subject to the approval of other governmental or municipal authorities. The permittee does, by the acceptance of this permit, assume all responsibility for operations undertaken pursuant to this permit, and shall take all precautions for the prevention of injuries to persons and property resulting from such operations. - 2 - The permittee giv onsent to the Town and its officers, loyees and agents to enter upon the premises wherMch operations are being conductedlnake such inspections to determine whether said operations are being conducted in conformity with the permit. The permittee will notify the Trustees in writing one week prior to initiation of any and all operations. The permittee will notify the Trustees in writing upon completion of operations such that the site can be inspected for issuance for a certificate of compliance. In response to Sub-section 2a and the General Rules for Standards of Residential and Commercial Docks, the following additional information is offered. 1. Permits for the work are being applied for through the Town, US ACOE, NYS DEC and a coastal zone consistency determination by the NYS DOS. 2. The new piles to be installed will be of sturdy, durable, and stable materials; in all likelihood, CCA pressure-treated Southern Yellow Pine piles with new framing of the same materials. These members will be a minimum of 3 x 8's and more often, 3 x 10's with two 3/4" bolt per connection, or in sever cases a single 1 inch diameter bolt. All connection fasteners will be galvanized bolts, spikes or nails, or in the case of deck screws, stainless steel. This pier is a fixed, pile-supported timber structure and therefore does not adversely affect the free circulation of water or reduce the effects of fluctuating water levels in the harbor. Even the wave attenuator boards are only shallow projections in to the top 3-feet or so of the water column. In addition, this project is the repair of an existing long-standing structure in the same location and of the same dimensions. It does not present any adverse modification of the shoreline, which has already been crossed by the existing dock facility. The pier's elevation is such that in extreme high flood tides the pier and landing of the structure might be flooded. The structure timber materials are specifically grown for this purpose and represent the standard of the industry. With the connections described above, this structure will be able to survive repeated inundations and prevailing climate waves. 3. It is respectfully requested that the use of CCA pressure-treated piles and timbers be approved for this project. 4. The pier will not be decked with CCA pressure-treated Southern Pine. This pier/ walkway provide a safe pedestrian surface for access to the boat lift and berthing area. 5. The 15-foot clearance specified in this paragraph are not applicable to this long standing historic structure and might not be met because the existing facilities were built to the edge of the narrow piece of land. The property was in fact joined with the Campbell property when it was an active "Life Saving Station" so the facilities pre-date the offset regulations. However, they are clear of structures on adjacent property. 6. Upon receipt of the permit for this project, appropriate permit numbers will be affixed to the most seaward face of the pier for identification from the water. - 3 - 7. With thetion of the boat lift and rails, whic ere previously authorized, there are rennanent structures located above IWpier decking nor are any planned at this time other than the power post, lights and railing. 8. The existing pier and landing is built right to shore, in fact to the back of the house. There is little room to walk under the pier at low tide. Foot traffic does not and will not exist in this area; pedestrian access is non-existent because of the impassable rocky shorefront characteristics of this and adjacent properties. The shoreline armor stone forms a steep transition from the shallow sub-tidal sediments to the upland and all of the property along this part of East Harbor is privately owned. U.S. Army Corps of Eneineers Permits This project is also covered under Nationwide Permit #3 of the US Army Corps of Engineers. NYS DEC Tidal Wetlands Reeulations—Sections 6615 and 6619 This project represents the repair of existing dock facility components at the Balcom property at the south shore of East Harbor. The dock facilities to be repaired include a pier over the intertidal zone as well as a boat lift accessed by ramps from the pier. The restraint piles hold the boat lift in place as shown in the application drawings. Piers for recreational boating at residential properties on the waterfront are considered to be generally compatible use in an adjacent area (AA) with a permit being required under Section 661.5 (b) (1), 15 and 24. This pier, landing, and floating dock facility was repaired in the 1990'x. The DEC permitting at the time determined that no permit was necessary for that minor reconstruction/ restoration work. Under Section 661.9, the standards for issuance of permits of NYS DEC regulations, the following are considered to be pertinent considerations. ➢ The policies are created to preserve and protect tidal wetlands and prevent their despoliation and destruction. Regulated activities will not have an undo adverse impact on the present or potential value of the affected tidal wetlands. It should be noted that this project is the routine repair of a long-standing dock facility. There are no tidal wetlands on the project site. The existing pier landing deck represents the weighs for the "Life Saving Station" rescue boats and is regularly maintained in its modified form. Tidal wetlands vegetation does exist sporadically, as individual plants or small clumps west of the site at the shore interface between the existing exposed rock-covered, shore and sandy bottom sediments in the intertidal zone. This vegetation however, does not constitute a tidal wetlands. This pier and boat lift facility repair project is compatible with public health and welfare policies of the State. ➢ The project complies with development restrictions contained in Section 661.6 as this is repair of an existing long-standing facility that has previously undergone review by the Department in rendering the permit for the boat lift 15 years ago. Furthermore, the project is a restoration of a long-standing historic waterfront dock facility structure and is compatible with the use of the site, zoning, and the long-standing use of the site. - 4 - ➢ This project will rave an undo or adverse impact on th*sent or potential value of nearby tidal wetlands vegetation. There are no tidal wetlands on the site. The shoreline would be most appropriately referred to as "working coast' based on the existing structure. Town of Southold—Local Waterfront Revitalization Pro ram These application documents include a copy of the Federal Consistency Assessment Form utilized for the New York State Coastal Management Program under the jurisdiction of the New York State Department of State. The following policies from the Local Waterfront Revitalization Program are appropriate. Policy 2 —Water Dependent Uses — This project is to repair a fully functional water dependent use, a docking facility for recreational boating at this waterfront site. Policy 5 — Use of Existing Developed Shorefront — This project will be primarily to repair vintage dock facility to a logical shoreward point of origin, clear of sensitive habitat or tidal wetlands and restore it to be safe and reliably usable in all weather conditions. Policy 7 — Significant Fish & Wildlife Habitat — Protection of significant fish and wildlife habitat has been considered in the development of this project layout. The existing pier begins at the back of the house connected to the modified weighs and deck. Four feet and more of height will continue to be maintained above bottom sediments at the mean low water line. The intertidal zone is large to moderate-sized stone all along the shore at this site and both adjacent sites. Policy 8—Protection& Preservation of Habitat—Protection and preservation of habitat has also been considered in this project and the dock structure is being kept to its existing configuration, and will be repaired consistent with standards of the industry and restrictions set forth in the Wetlands Law, No. 6, 2004 set forth by the Town of Southold. The pier alignment allows sunlight to reach the bottom sediments beneath from the east in the morning and the west in the early afternoon. Policy 11 — Minimize Damage to Natural Resources - The pier repairs will be conducted in such a way so as to minimize damage to natural resources as identified in Policy 7 above by alignment and elevation. The point of landfall is the back of the house. There are no tidal wetlands in the inter-tidal zone at this site. There is submerged aquatic vegetation on both sides of the piers but due to barge access at the highest tides, damage to eelgrass should be minimal if any. It is envisioned that the barge will be spudded down beyond the area of eel grass growth. The duration of the project will be a matter of days only. Policy 14 — No Measurable Increase in Flooding - This project consists of repair of an open wood pile and timber pier that will in no way adversely affect water flow and circulation in the harbor or flooding potential of the area. Flood levels all around Fishers Island are dictated by water levels in Long Island Sound, Fishers Island Sound and Block Island Sound and this structure will have no adverse influence on those flood levels. Policy 15 — No Dredging — Dredging is not required in this project. The existing dock system was laid out and configured to avoid dredging requirements more than 100 years ago. The pier end and boat lift are in 4 to 5 of water at mean low water. The water in this harbor (cove) does get appreciably deeper further out. - 5 - Policy 19 — Impact on PuWk Access — Public access will not be j ardized or impeded as a result of this project. As s tter of fact, there is almost no publiWess usage of the public trust lands or waters at this site and public trust lands consist of large and moderately sized stones making passage and beaching a boat dangerous. The shallow sub-tidal waters do not present any opportunity or enticement for public access in the area. Thus, public access to the State's lands and waters will not be adversely affected by the project. Policy 20 — Public Trust Compatibility with Existing Adjoining Properties and Land Uses- Public Trust compatibility with existing adjoining properties and land uses has also been considered in this project. Ms. Campbell's property to the east has a docking facility similar to this one. There is no dock or boating access from the FIDCO property. This docking facility will not interfere with these existing facilities on immediately adjoining properties nor will it impact navigation along the shoreline. Policy 21 — Water Dependent Recreation — This project is consistent with water-dependent recreational opportunities policies set forth in this section. The dock system will be used for boating and water recreation without adversely affecting waterfront access by Ms. Campbell's facility or access to or from Fishers Island Development Company property. Policy 24 —Scenic Resources, hnpairment or Loss - This policy is designed to prevent impairment or loss of scenic resources. The reconstruction of the inland section of the structure, the fixed wood pile and timber pier, will not represent any new encroachment or structure, which would create a loss of scenic resources. Rather, this project maintains a long-standing, historic pier, which has long been a landmark on the Island for a hundred years. Policy 25 — Enhance Overall Scenic Quality - The "Lifesaving Station" dock structure will be consistent with the scenic quality of the area that has existed for decades and will not adversely affect scenic resources as described in Policy 24 above, and will not adversely impact the scenic quality of East Harbor; the structure is visible to the public from most points in easterly Fishers Island Sound. Policy 44 — Preserve and Protect Tidal Wetlands — There are no tidal wetlands on this site: nonetheless, the height of the repaired pier will match that of the long-standing dock facility at this site and should allow the continued health of the sporadic tidal vegetation adjacent to the wood pier. SUMMARY This project will repair an existing, long-standing fixed pier for recreational boating access for the Balcom's property on Fishers Island. A copy of the US Army Corps of Engineers, NYS DEC and Town of Southold applications are attached as substantiation for this project. This project is consistent with regulations for this work at this location. No mitigative or compensatory measures are required. This pier repair project complies with applicable standards of the New York State Coastal Management Act and Local Ordinance No. 6, 2004 and its approval is respectfully requested. Respectfully submitted, DOCKO, INC. Keith B. Neilson,P.E. - 6 - PIER AND BOAT LIFT REPAIR Lucille Balcom November 112011 PHOTOGRAPHS APR - 9 2012 This photograph shows the two existing piers, which were part of the former Life Saving Station at the Balcom property on Fishers Island. The pier on the right was damaged to extent during tropical storm "Irene" necessitating the requested repairs. This picture shows parts of the deck stringers and decking blown away by the storm needing replacement. The decking is attached to the deck stringers, which are doubled four by timbers, which makes the sections removable. In some cases some sections of the structure disappeared during the storm others were salvaged after the storm and brought back but are not usable in their current form. + • PIER Af BOAT LIFT REPAIR Lucille Balcom November 112011 PHOTOGRAPHS 9 _ . This photograph shows the end of the east dock looking in a southeasterly direction with Campbell's dock structure in the background. The damage to the end of the dock was slightly more extensive then the inner section obviously due to the exposure to somewhat greater fetch and more diverse wave directions. PIER AND BOAT LIFT REPAIR Lucille Balcom November 112011 PHOTOGRAPHS APR - 9 2012 This photograph shows the end section looking from the main walkway approximately 20-feet south of the end. Some of the damaged decking still remains in place and the diagonal bracing and stringer framing is clearly visible beneath the decking. The boatlift support pile from the northeasterly corner of the lift is visible in the lower corner of the photograph. PIER AND BOAT LIFT REPAIR Lucille Balcom November 11 2011 PHOTOGRAPHS APR - 9 2012 This photograph shows the inner section of the pier where approximately a third of way out some of the deck structure and support framing was damaged during the storm. All of the repair work shown is of a relatively minor nature. It is likely that during this rehabilitation process some piles will be discover to be in need of replacement but the photographs clearly document that more than half of the piles are still in reasonably good condition and can be left in place. LOCA MAP "'r'`ONO4"BLa* �nnr Project: "PIER AND BOAT LIFT REPAIR" bo' ----- --------__-_- Location: FISHERS ISLAND,TOWN OF SOUTHOLD i 6 SUFFOLK COUNTY,NEW YORK Waterway: EAST HARBOR Date: NOVEMBER 11,2011 CV?/ Applicant: LUCILLE BALCOM j w�y0gg 70 Agent: DOCKO,INC. 62 I MI tll � 35 60 18- 40 /( 3F A\O.7� 42 pock - u (\ j8-- x-12 Br X00 22 in Ifo pry 0� Ed . Har �'. � 30 10` Jit �i11 A O rt x, pmptlrv�. ` sort �,\j :oo� ❑ � / '8 � __ _ _ 9� A IA8 nd\ C f 1 1 it P nd �. r' •. _ �' � �'��-�`- '!ate r%6 '/i'/ r 21 go 25 57 ��. i i 98 __. i 120 .. 137 ASSESSOR'S MAP 0044-15 8 Project: " PIER AND BOAT LIFT REPAIR" O Location: FISHERS ISLAND,TOWN OF SOUTHOLD FISHERS SUFFOLK COUNTY,NEW YORK Waterway: EAST HARBOR Date: NOVEMBER 11,2011 Applicant: LUCILLE BALCOM+- Agent: DOCKO,INC. 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Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:permits@docko.com February 22, 2012 NYS DEC Environmental Permits Building 40, SUNY ;'"u - 9 2012 Stony Brook, NY 11790-2356 Re: Lucille Balcom, Fishers Island Pier& Boat Lift-Repair East Harbor, Fishers Island To Whom It May Concern: On behalf of Mrs. Lucille Balcom, we request a Tidal Wetlands Permit including Water Quality Certifications, as necessary, for pier and boat lift repair in East Harbor on Fishers Island, New York. We enclose the following in support of this permit application: ❖ Four prints each of plans titled: Project: "Pier& Boat Lift Repair" Waterway: East Harbor Location: Fishers Island, Town of Southold Suffolk County,New York Applicant: Lucille Balcom Date: November 11, 2011 ❖ Four copies of the NYS DEC Joint Application, including the Short Environmental Assessment Form, Tax Assessor's Map, Photographs Location Map and Site Survey One copy of each application submitted to other regulatory agencies I trust that you will find this application package complete and acceptable; please let me know if the need for further information arises. Very truly yours, DOCCKOINCC. `, tP-4 "Crc--� KBN:cb Keith B. Neilson, P.E. Enclosures CC: Lucille Balcom US ACOE NYS DOS Town of Southold: King File: 11-05-2283 BALCOM • JOINT APPLICATION FORM • For Permits/Determinations to undertake activities affecting streams, waterways, FM waterbodles,wetlands, coastal areas and sources of water supply. New York You must separately apply for and obtain separate Permits/Determinations from US Army Corps of state each involved agency prior to proceeding with work. Please read all instructions. Eng nears(USACE) APPLICATIONS TO 1. NYS Department of Environmental Conservation 2. US Army Corps of Engineers 3. NYS Office of 4. NYS Depart- Check all permits that apply: Check all permits that apply: General Services ment of State ❑Stream Disturbance ❑ Coastal Erosion ❑ Section 404 Clean Water Act Check all permits that Check If this E3 Excavation and Fill in Managementapply: applies: ❑ Section 10 Rivers and Harbors (3 Navigable Waters 11 Wild, Owned Lands Wlld,Scenic and Act n Coastal m Docks,Moorings or Recreational Rivers Under Water Consistency 9 m Nationwide Permlt(s) -Identify Q Utility Concurrence Platforms E3 Water Supply Number(s): Easement 0 Dams and Impoundment ❑ Long Island Well (pipelines, Structures ❑Aquatic Vegetation Control conduits, 0 401 Water Quality ❑Aquatic Insect Control cables, etc.) Certification Preconstructlon Notification- ❑Docks, ❑ Freshwater Wetlands ❑ Fish Control ❑ Y / ❑ N Moorings or ❑Tidal Wetlands ❑Incidental Take of Endan- Platforms gered/Threatened Species 13 I am sending this application to this agency. [3a I m sending this application n I am sending this 131 am sending to this agency, application to this this applkation agency. to this a en S. Name of Applicant(use full name) Applicant must be: 6. Name of Facility or Property Owner(if different than LUCILLE BALCOM m Owner Applicant) ❑Operator Mailing Address P.O.BOX 6o5 ❑ Lein Mailing Address (check all that apply) Post Office City FISHERS ISLAND Taxpayer ID(If applicant Post Office City is NOT an individual): State NY Zip Code06390 FState Zip Code Telephone(daytime) Email ime) Ercall (631)788-7602 7. Contact/Agent Name S. Project/ Facility Name Property Tax Map Section/Block/Lot Number KEITH B.NEILSON,P.E. Balcom Property. 1000-004-4-15 Company Name Project Location- Provide dlrectlons and distances[o roads,bridges and bodies of waters: DOCKO,INC. PRIVATE ROAD Mailing Addi; .O.BOX 421 Street Address,if applicable Fps�t- fBLATiD State Zip Code NY 06390 Post Office City MYSTIC Town/Village/City County FISHERS ISLAND SUFFOLK State Zip Code Name of USGS Quadrangle Map Stream/Water Body Name CT 06355 NEW LONDON,CT-RI-NY EAST HARBOR Telephone(daytime) Location Coordinates: Enter N In kilometers,OR Latitude/Longitude (860)572-8939 Email NYTM-E NYTM-N Latitude Longitude permits®docko.com 41°17"01"N 71°SW 41 W r , � h 30INT APPLICATION FORM 09/10 This is a 2 Page Application Application Form Page 1 of 2 Both Pages Must be Completed •JOINT APPLICATION FORM- PAGE 2 DO Submit this completed page as part of your Application. 9. Project Description and Purpose: Provide a complete narrative description of the proposed work and its purpose. Attach additional page(s) if necessary. Include: description of current site conditions and how the site will be modified by the proposed project; structures and fill materials to be Installed; type and quantity of materials to be used (i.e., square R of coverage and cubic yds of fill material and/or structures below ordinary/mean high water) area of excavation or dredging, volumes of material to be removed and location of dredged material disposal or use; work methods and type of equipment to be used; pollution control methods and mitigation activities proposed to compensate for resource impacts; and where applicable,the phasing of activities. ATTACH PLANS ON SEPARATE PAGES. REPAIR 142(+/-)LF OF 6-FT WIDE FIXED PILE AND TIMBER PIER AND BOAT LIFT WATERWARD OF THE APPARENT HIGH WATER LINE. Proposed Use: m Private ❑ Public ❑Commercial Proposed Estimated Start Date: 20'12 Completion Date: 2012 Has Work Begun on Project? ❑Yes m No If Yes,explain. Will Project Occupy Federal, State or Municipal Land? ❑Yes m No If Yes, please specify. 10. List Previous Permit/Application Numbers(if any)and Dates: 1-0738-00329/00002-0, 1/16/92 11. WIII this project require additional Federal, State, or Local Permits Including zoning changes? m Yes ❑No If yes,please list: TOWN OF SOUTHOLD BOARD OF TRUSTEES 12. Signatures.If applicant Is not the owner, both must sign the application. I hereby affirm that information provided on this form and all attachments submitted herewith is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and agrees to Indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said project. In addition,Federal Law, 18 U.S.C., Section 1001 provides for a fine of not more than $10,000 or Imprisonment for not more than 5 years, or both where an applicant knowingly and willingly falsifies, conceals,or covers up a material fact; or knowingly makes or uses a false,fictitious or fraudulent statement. 1 LeeII-L E Iea{A S Sr§natum of Applicant Printed Name Title Dat Sign of n r Print ame Title y �� _ /Dyattee/� a. n n Signature of A ent Printed Name Tlile Date 91"Mmmollt OF NO PERMIT 3REIk VA i ?'� JOINT APPLICATION FORM 09/10 Application Form Paget of 2 PROJECT ID NUMBER 81720 APPENDIX A SEQR STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 7 -PROJECT INFORMATION (To be completed by A plicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME Lucille Balcom Pier and Boat lift Repair &PROJECT LOCATION: Fishers Island, Town of Southold Suffolk Municipality County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map Private Road, Fishers Island 5.IS PROPOSED ACTION: 11 New Expansion ©Modification/alteration B.DESCRIBE PROJECT BRIEFLY: Repair 142(+/-)LF of 6-ft wide pile and timber pier and boat lift waterward of the apparent high water line. 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Eyes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ❑✓ Residential 11Industrial E]Commercial DAgdculture 1:1 Park/Forest/Open Space Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ©Yes nNo If yes, list agency name and permit / approval: 11.DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ©Yes MNo If yes, list agency name and permit / approval: NYS DEC#1-4738-00329/00002-0, 1/16/92,ACOE Letter 10/25/91 ,Town Southold letter 12/6/91 12. AS A R ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? es d No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Data: Signature � &3 C If the action is a Costal Area,and you are a state agency, J Complete the Coastal Assessment Form before proceeding with this assessment 0 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 FAR Yes ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another involved agency. El Yes E]No 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,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 a intensity of use of land a other natural resources?Explain briefly: C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: C6. Longterm,short term,cumulative,or other effects not identified in C1-05? Explain briefly: C7. Otlter ire (including changes in use of either quantity or type of ere ? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA)? If yes,explain briefly: E] Yes ❑No 17 . IS THERE,OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ex Iain: Yes E]No F PART 111•DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important orotherwisesignificant. 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(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 chocked yes,the determination of significance mustevaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box ifyou have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL FAF 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 actio 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 Name-7ge—sponsigre Officer in Lead Agency Tide of Responsible Officer Signature of ResponsibleOfficer in ea ncy Signature of Preparer different from responsr e o cer 0 0 Docko, Inc. Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:permits@docko.com February 22, 2012 NYS DOS Department of Coastal Resources One Commerce Plaza APa - 9 2012 99 Washington Avenue Albany,NY 12231 Re: Lucille Balcom,Fishers-Island Pier&Boat Lift Repair - East Harbor, Fishers Island To Whom It May Concern: On behalf of Mrs. Lucille Balcom, we submit the attached Federal Consistency Assessment Form for pier and boat lift repair in East Harbor on Fishers Island, New York. We enclose herewith the following in support of this permit application: ❖ Two prints each of plans titled: Project: "Pier& Boat Lift Repair" Waterway: East Harbor Location: Fishers Island, Town of Southold Suffolk County,New York Applicant: Lucille Balcom Date: November 11, 2011 ❖ Two copies of Corps of Engineers, NYS DEC and Town of Southold Application forms, Location Map, Tax Assessor's Map and NYS DOS Coastal Management Federal Consistency Assessment Forms. I trust that you will find this application package complete and acceptable: please let me know if the need for further information arises. Very truly yours, DOOC,KKO,,QINC. Keith B. Neilson, P.E. KBN:cb Enclosures CC: Lucille Balcom NYS DEC: Regulatory Affairs US ACOE Town of Southold: King File: 11-05-2283 BALCOM s • NEW YORK STATE DEPARTMENT OF STATE COASTAL MANAGEMENT PROGRAM Federal Consistency Assessment Form An applicant,seeking a permit,license,waiver,certification or similar type of approval from a federal agency which is subject to the New York State Coastal Management Program(CMP),shall complete this assessment form for any proposed activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to assist an applicant in certifying that the proposed activity is consistent with New York State's CMP as required by U.S. Department of Commerce regulations(15 CFR 930.57).It should be completed at the time when the federal application is prepared. The Department of State will use the completed form and accompanying information in its review of the applicant's certification of consistency. A.APPLICANT (please print) LUCILLE BALCOM 1.Name: 2.Address:P.O. BOX 605, FISHERS ISLAND, NY 06390 3.Telephone: Area Code(6:W)788-7602 B.PROPOSED ACTIVITY 1.Brief description of activity: REPAIR 142 (+/-)LF. OF 6-FT WIDE FIXED WOOD PILE AND TIMBER PIER AND BOAT LIFT WATERWARD OF THE APPARENT HIGH WATER LINE 2.Purpose of activity, T-1 115 IS A PRIVATE Bee(FeR REeREATIONAL BOATING. 3. Location of activity: SUFFOLK FISHERS ISLAND OFF PRIVATE ROAD County City,Town,or Village Street or Site Description US ARMY CORPS OF ENGINEERS 4.Type of federal permittlicense required: NOT YET KNOWN 5.Federal application number,if known: 6.If a state permit/license was issued or is required for the proposed activity,identify the state agency and provide the application or permit number,if known: NYS DEC, NYS DOS C.COASTAL ASSESSMENT Check either"YES"or"NO"for each of these questions. The numbers following each question refer to the policies described in the CMP document(see footnote on page 2)which may be affected by the proposed activity. 1.Will the proposed activity result in any of the following: YES/NO a.Large physical change to a site within the coastal area which will require the preparation of an environmental impact statement? (11,22,25,32,37,38,41,43). . . . . .. .. . . .. . . . 13 IM b.Physical alteration of more than two acres of land along the shoreline,land under water or coastal waters? (2, 11, 12,20,28,35,44).. .... .. .. . . . .. . . . . . . . .. . . E3 0 c.Revitalization/redevelopment of a deteriorated or underutilized waterfront site? (1) . ... .. Q im d.Reduction of existing or potential public access to or along coastal waters? (19,20). . . .. . Q is e.Adverse effect upon the commercial or recreational use of coastal fish resources? (9,10). . . Q f. Siting of a facility essential to the exploration,development and production of energy resources in coastal waters or on the Outer Continental Shelf? (29). . ... . .. .. .. .. . . .. . Q im g. Siting of a facility essential to the generation or transmission of energy? (27). . . . . . . . .. . Q h.Mining,excavation,or dredging activities,or the placement of dredged or fill material in coastal waters? (15,35). . . . . . . . . . .. .. .. . .. . . . . . . . . Q . ... . . . .. ... .. . .. .. .. .. . . L Discharge of toxics,hazardous substances or other pollutants into coim astal waters? (8, 15,35) Q im j.Draining of stormwater runoff or sewer overflows into coastal waters? (33).. .. .. . . . . .. Q k.Transport,storage,treatment,or disposal of solid wastes or hazardous materials? (36,39). Q 1.Adverse effect upon land or water uses within the State's small harbors? (4). . . . . . . . .. .. Q 2.Will the proposed activity affect or be located in,on,or adjacent to any of the following: YES/NO a.State designated freshwater or tidal wetland? (44). . .. .. .. . . .. .. .. . . . . .. .. . . . . . . .. 0 0 b.Federally designated flood and/or state designated erosion hazard area? (11, 12, 17,). . . .. Q c.State designated significant fish and/or wildlife habitat? (7). .. ... . . . .. . . .. .. .. . . .. . d. State designated significant scenic resource or area? (24). . . . . .. . . . . .. .. . . . . .. . . .. . J e. State designated important agricultural lands? (26). .. . .. . . . . . . . . . . .. . . . . . . . . . . .. . Q f.Beach,dune or barrier island? (12). . . . . . . . Q . . . . .. . .. . . ... . . .. .. . . .. .. . . . . . . . . . g. Major ports of Albany,Buffalo,Ogdensburg,Oswego or New York? (3). . . . .. . . . . . . . . . Q h. State,county,or local park? (19,20). . . . . . . .. . i.Historic resource listed on the National or State Register of Historic Places? (23). . . .. . . . 3.Will the proposed activity require any of the following: YES/NO a.Waterfront site? (2,21,22).. . .. .. ... . .. . . . . .. .... .. . .. . .. .. .. .. .. . . . . . . . . .. ® 13 b.Provision of new public services or infrastructure in undeveloped or sparsely populated sections of the coastal area? (5).. . . . . .. . . . . . . . . . ... . . . . .. .. . .. . . .. . ... ... . . . . 13 c.Construction or reconstruction of a flood or erosion control structure? (13, 14, 16). . . . . . . Q d. State water quality permit or certification? (30,38,40).. . . .. ... . . . . .. . .. ... . . . . . . . Q e. State air quality permit or certification? (41,43)... . .. . .. . .. . .. . . . . .. . . . . .. . . .. .. Er It 4. Will the proposed activity occur within and/or affect an area covered by a State approved local waterfront revitalization program? (see policies in local program document) 0 D.ADDITIONAL STEPS 1.If all of the questions in Section C are answered"NO",then the applicant or agency shall complete Section E and submit the documentation required by Section F. 2.If any of the questions in Section C are answered"YES",then the applicant or agent is advised to consult the CMP,or where appropriate,the local waterfront revitalization program document*. The proposed activity mustbeanalyzed inmore detail with respect to the applicable state or local coastal policies. On a separate page(s),the applicant or agent shall: (a) identify,by their policy numbers,which coastal policies are affected by the activity,(b)briefly assess the effects of the activity upon the policy; and,(c)state how the activity is consistent with each policy. Following the completion of this written assessment,the applicant or agency shall complete Section E and submit the documentation required by Section F. E.CERTIFICATION The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the approved local waterfront revitalization program,as appropriate. If this certification cannot be made,the proposed activity shall not be undertaken. If this certification can be made,complete this Section. "The proposed activity complies with New York State's approved Coastal Management Program,or with the applicable approved local waterfront revitalization program,and will be conducted in a manner consistent with such program." LUCILLE BALCOM Applicant/Agent's Name: Address:P.O. BOX 605, FISHERS ISLAND, NY 06390 Telephone: Area Code(631 )788-7202 Applicant/Agent'sSignature: X. Date:. qax.4 C7 I 2e-)12 F. SUBMISSION REQUIREMENTS 1.The applicant or agent shall submit the following documents to the New York State Department of State,Office of Coastal,Local Government and Community Sustainabi ity,Attn:Consistency Review Unit,1 Commerce Plaza,99 Washington Avenue-Suite 1010,Albany,New York 12231. a.Copy of original signed form b.Copy of the completed federal agency application. c.Other available information which would support the certification of consistency. 2.The applicant or agent shall also submit a copy of this completed form along with his/her application to the federal agency. 3. If there are any questions regarding the submission of this form,contact the Department of State at (518) 474-6000. 'These state and local documents are available for inspection at the offices of many federal agencies,Department of environmental Conservation and Department of State regional offices,and the appropriate regional and county planning agencies. Local program documents are also available for inspection at the offices of the appropriate local government. _ Docko, Inc. Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:pertnits@docko.com February 22,2012 U.S. Army Corps of Engineers Jacob Javits Federal Center, Room 1937 APR ' 9 2012 New York, New York 10278-0090 Re: Lucille, Island Pier&Boat Lift Repair East Harbor,Fishers Island To Whom it May Concern: On behalf of Mrs. Lucille Balcom, we request a Department of the Army Permit for pier and boat lift repair in East Harbor on Fishers Island, New York. We enclose herewith the following in support of this permit application: d• Two prints each of plans titled: Project: "Pier&Boat Lift Repair" Waterway: East Harbor Location: Fishers Island, Town of Southold Suffolk County,New York Applicant: Lucille Balcom Date: November 11, 2011 Two copies of Corps of Engineers and NYS DEC Application Forms, Location Map, Tax Assessor's Map, photographs and NYS DOS Federal Consistency Assessment Form. •� One copy of the Town of Southold application, and the NYS DOS Consistency Review Form. I trust that you will find this application package complete and acceptable; please let me know if the need for further information arises. Very truly yours, DO /L G rL—� Keith B. Neilson,P.E. KBN:cb Enclosures CC: Lucille Balcom NYS DEC:Environmental Permits Town of Southold: King File: 11-05-2283 BALCOM ArrLIVAXION FOR DEPARTMENT OF THE ARMY PERMIT (33 CFR 323) OMB APPROVAL N0.0710-003 Public`�01 Mnde I Por 11:111 mucction of is mtinned b aveta s hoots EXPIRES: 31 AUS 2012 so'rca 6alMme am maintaining I n data me"and oompletinq and � Pa rt'Pome mclu�ng the tame I'w rev in Mxdom ward esistmj data Other aspect Of this collection of iofamaeon,irclndlvg sMMiet aWostions far�eA Waell the co)lection of fi*f eatioo.. Seed mmmms r�tdin8 this Nader atm4 of any of Infatmatiea Opemma and Reports,1215 Jeliet"e Davie Highway,Suite 1204.Arlhtgtraat,yp A � s&I D e,of to P'laswotk Re6xdm Rojeet(0710-M).Waddogbu,DC 20503. Please DO NOT MROBP t and Budget, submitted b the District Eoghem having ju juktion over the basion of the RETURN Your farm b cine &Mof mad&mm Completed applications must be PtWMW activity. Authority:33 USC 401,SeWm 10;1413.Sectim 404, PRIVACY ACT STATEII4?NT time Prharipl Pmptaa The"taws mW'm pm as a of hedged a Bit tmlerim tato watrss of the United Swat, u�'gor the u in.a of III ie watea of a,the tamed L Routine Una: l lmmtion povided m the Form will be used m mal and thi tr'osPortatbo o[dnslged etalerial 6x We pulpae of dumptag h tab Doan water, is volumuY. If Wbnm m is Dot povided,however,de pvodt appl�tloMention n Por a per- Dbdome Facessed"I cm a m of�ed W"stim is be Oro set" PW dtawhtgs a goodmpodtetblecol im wbicb show the lecadon aedcMracser of the proposed activity MM be attached to the application (sin sample dtawipp and imtrnctiom)and be stdammed b the DisMU Enghen'bavmg jeaixNctlao oftM in Bdl will be mtmned, Rolsaed activity. An appiiatim drt is eat MMIcsad II MCI 47D BE FJLLED BY 771E 2.FMLG OFFICE CODE 3.DATE RHCE1yEp 4DATE App,CobagM® 5.APPI.ICpN7g NAMH f7FMlS BELOW 7D BEFMIM BYAPPLICANT LUM R BALCOM R.AUTHOR M D AOl?H 13 NAME d TTTLE DOCKO,INC. 6.APPLICANTS ADDRESS KEITH B.NEIISON,P.E P. O.BOX 605 9.AGENTS ADDRESS FISHERS ISLAND,NY 06390 P. O.BOX 421 7.APR.[GNT 1 PHONE NOSW/AREA CODE MYSTIC,CT 06355 Reddeoa (631)788-7602 10.AGENTS PHONE NGS W/AREA CODE L Reaidenoa b.Busmet b.Busbm= (860)572-8939 1 hereby auft ft DOCKO,INC.b acs u MaybebaHat 11.STAT'BMH4T OFAUTHOION supplementalh Itamadeeta support Of 111111 pmoit applictaim tame pecetatag of&b amamdon and to AwI upm«quest, APPLICANTS SIGNATURE LUCILLE BALCom ATE 12.PROIIR'!'N NAM$LOCATION AND DESCRINTION OF PROJECT OR ACT[VT1'y AMB OR TITLE(Sea inm'ocdow) PIER AND BOAT LWTP REPAIR 13.NAMB OP WATFRBODY,W Al40W 0f appBabb) EAST HARBOR 14.PRofHCrsTRBB'rADDRp�g(N4pp0cwm) PRIVATE ROAD 15.LOCATION OF PROJECT LATITUDEON410 IT 51"N LONGII'UDg°W 710 56'40-W 16.OT'HERLOCATMDESCRIPTIONS,INpgOWN. (Seeishuctlma) TO THE WEST OP THE OLD COAST GUARD STATION AT EAST n.DEtEcrtoNs TO THE SITE TAKE FERRY TO FISHARBOC FISHERS ISLAND,NY (DRIVEWAY)PRIOR TO FISHERS ISLAND GOLP COURSE.TURN LEFT END ROAD SP IT& LAST LEFT, WHERE DRIVEWAY SPLITS. ENO FORM 4345.SEPT.2009 EDRIO for 2004 IS OBSOIBTg PtoPooes:CECW-0R 19.Nature of Activity(Description ofpmjeMi femmes) Addhk REPAIR 142(+/-)OF 6-FT.WIDE FEM WOOD PILE AND TIMBER PIER AND BOAT LIFT WATERWARD OF THE APPARENT HUGH WATER LINE. 19.Plojed Purpose(Describe the mum ofparpow of the project,ace iuskuctiao) THIS IS A PRIVATE DOCK FOR RECREATIONAL BOATING. 20.Rom(a)for Discharge USE BLOCKS 20.21 Qt DAEDGEp AND/OR PML MATERIAL 19 TO BE DISCHARGED N/A 21.Type(a)of Material Being Dbdwgorl ad the Amount of Each N/A Type in Cubit Yards 22.Surface Anes in Acus of Wdlsmds or otba was=FdW(ore instructions) ACRES or N/A LINEAR FEET 23. Description afAvoidsore,Madaimlioo and Conversation(we iusnta:tiaus) PIER REPAIR WILL BE UNDERTAKEN WITH CUSTOMARY SEASONAL RESTRICTIONS AND SPECIAL CONDITIONS OF THE PERMITS FROM THE ACOS,NYSDEC AND TOWN OF SOVITIOLD 24.M Any Paden of We Work Ahesdy Coa4kte_ Ya g No V YES,describe the amplded work 25. Ad&mm o'Adjoidog Pmporty Owore,Lesee,Etc.,whole Property Adjoin she Wafer6 Pww aftach a suppkmeaal IMt), ody(Vonore tltm cm be ataadherq WEST 06390&SOUTH:FER ISHS ISLAND DEVELOPMENT CORP.C/O F.I.umxrY CO.,DRAWER B,FISHERS ISLAND,NY EAST: KIM K.CAMPBELL„ 106 GOMEZ ROAD.HOBE SOUND,FL 33455 26.List of Oche Ceram mm as of AppwslyDmieh RaceivM Pidesal.Ela!Or Local Agencies for Work Decribadiol%AR*mdm AGENCY TYPE APPROVAL* (DENT.NUMBER DATE APPLIED DATE APPROVED Town Of Southold DATE DENIED Board ofTrusteea Tidal Wetlands Pending Feb.2012 NYS DEC Pending Feb.2012 Pending Feeding 'Would meltde but M net resaided to mdog.b0dift and fioodphda permit. 27. Appliedoo in hereby mak for a poeords min m authorim the work deam'hedm@h appfiestlm, Cosoplem and arMaOG IOmthC entity that 1paaesthe �dot the idmmalion in dit appewdon in a�kYto rmdertale the wait deambed bwdn oramacting as the � iCK6d/lei 1/ (�.1 � "'tlagmtarde appBaos. SIGNATURE OF APPLICANT DA LUCI LE BALCOM SI@(ATUREOFAGMT DAKErM TE T�aPP dmrmetbeal�edbytAePeaoaw>ndoheteu dr B.NEI SON,P.E. DOCKO,INC. sta4meotmblodcllWsbaoROedadandsigned lsopaea'daaiviry(aPpticeat)aRmaybeaipedbyado19aa1kwhedagnoti[the TSU.S.C.Section 1001provides dot VA"a r,manyroamerw'iddathejmitlk.'dmof and MftdiyfaMine.woceab.acovaauPaoynickachme.a Ldp°�taageot7dtseUnited shEelmowmgh, a makes a uses any fablewritingadocreaeat ti AMWWWormakes any Wfictitious orft"kasoWsvasarepeaeodcrr or impMoned nd mete than five yens or both seatm �AM VMe,fictitiousafi'ardulet�ser"notsorenIFY•shalt be fired ant more d=$10,000 ENO PDRM 4345.SEPI'2009 ENVIRONMENTAL UE T1ONNA/R This /s Intended to su*ment ENG Form 4345, Applice for Department of the Army Permit, or the Joint Application for Permit used In the State of New York Please provide complete answers to all questions below which are relevant to your project Any answers may be continued on separate-sheets) of paper to be-attached to this form. PR/VACYACT STATEMENT The purpose of this form Is to provide the Corps of Engineers with basic Information regarding your project This Information will be used to facilitate evaluation of your permit application and for public dissemination as required by regulation. Failure to provide complete information may result In your application being declared Incomplete for processing, thereby delaying processing of your application. GENERAL-APPLICABLE ICAQ/ E rn ALL PROJECTS 1. Explain the need for,and purpose of, the proposed work. Repair 142 (+/-)LF of 6-FT. wide fixed wood pile and timber pier and boat lift waterward of the apparent high water line. Z. Provide the names and addresses of property owners adjacent to your work site(H not shown on the application form or project drawings). To the wrest F./. Development Corporation, C/O F. 1. Utility, Drawer E, Fishers Island, NY 08390 and to the south- Ms. Kim X Campbell, 108 Gomex Road, Hobe Sound, FL 33455. (Please note that depending upon the nature and extent of your project, you may be requested to provide the names and addresses of additional property owners Proximate to your project site to ensure proper coordination.) 3. Photographs of the protect site should be submitted. For projects in tidal areas, Photographs of the waterway vklMty should be taken at low tide. Using a separate copy of your plan view, Indicate the location and direct/on of each photograph as W611 as the date and time at which the photograph• was taker provide a suHlclent number of photographs so as to provide a clear understanding of conditions on and proximate to your project site. 4. Provide a copy of any environmental Impact statement, or any other environmental report which was prepared for your project See attached narrative 5. Provide a thorough discussion of alternatives to you roposal. This discussion should include, but necessarily be limited to, the W action" alternative and alternative(s) resultingn less disturbance to waters of the United States. For filling projects In waters of the United States, including wetlands, your alternatives discussion should demonstrate that there are no practicable alternatives to your Proposed filling and that your project meets with current mitigation policy (l.e-, avoidance, minimization and compensation). DREDGING PROJECTS Answer the following M your project involves dredging. 1. Indicate the estimated volume of material to be dredged and the depth (below mean low water) to which dredging would occur. dredging? Would there be overdepth There Is no dredging associated with this project. 2. You can apply for a ten-year permit for maintenance dredging. H you wish to apply for a ten-year permit, please provide the number of additional dredging events during the ten-year life of the permit and the amount of material to be removed during future events 3. Indicate of your drawings the dewatering area (If applicable) and disposal site for the dredged material (except landflll $Iles). Submit a suff/clent number of Photographs of the dewatering and disposal sites as applicable so as to provide a clear indication of exlst/ng conditions. For ten-year maintenance dredging permits, Indicate the dewatering/dleposal sites for future dredging events, If known. 4. Describe the method of dredging(I.s. clamshell, draglins, etc.)and the expected duration of dredging. S. Indicate the physical nature of the material to be dredged(I.e. sand, silt, clay, etc.) and provide estimated percentages of the various constituents N available. For beach nourishment projects, grain size analysis data Is required. 6. Describe the method of dredged material containment hay bales, embankment, bulkhead, etc.)and whr return flow from the dewatednApposel site would reenter any waterway. Also Indite N there would be any barge overflow. MOORING FACILITIES Answer the following N your project includes the construction or rehabilitation of recreational mooring facilities. 1. It la generally recommended that any fixed piers and walk ramps be limited to four feet In width, and that floats be-limited to eight feet in width and rest at least two feet above the waterway bottom at mean low water. Terminal floats at private, non. commercial facilities should be limited to 29 feet In length. N you do not believe your proposal can meet with these recommendations,please provide the resson(s). The pier Is part of the historic Lifesaving Station dock facility with piles driven straight to support this pier. 2. Using your plan view, show to scale the locatlon(s), position(s) and size(s) (Including length, beam and draft) of vessels) to be moored at the proposed facility, Including those of transient vessels)N known. 3. For commercial mooring styes such as marinas, Indicate the capacity of the facility and Indicate on the plan view the location(&) of any proposed fueling and/or sewage pumpout facIO Nea N pumpout facilities are not planned, please discuss the rationale below and Indkate the distance to the nearest available pumpout station. Not applicable - There are no pump-out facilities proposed and no fueling facilities at this site. Those functions are taken care of elsewhere on Fishers Island such as Pirate's Cove Marina or the Mobile dock in West Harbor. IL Indicate on your plan view the distance to adjacent marine structures, N any are Proximate and show the locations and dimensions of such structures u. ulsauss me now ror wave protection at the proposed cllity. Please be aav►seal that If a permit is 1 ou would be required to recog4V that the mooring facility may be subject toWdW action from wakes of passing vessels, whose operations would not be required to be modified. Issuance of a permit would not relieve you of ensuring the Integrity of the authorized structure(s) and the United States would not be held responsible for damages to the structure(s) and veasei(s) moored thereto from wakes from passing vessels. BULKHODEGMANK STABILIZ4 770NIFILLINGACT/VIITES Answer the following N your project Includes construction of buikhead/ng (also - retaining walls and seawalls) with backfill, filling of watsralwetlands, or any other bank stablih milon fills such as Mprap, revetments, gablons, etc. 1. Indicate the total volume of fill (Including backfill behind a structure such as a bulkhead) as well as the volume of fill to be placed into waters of the United States. The amount of fill In waters of the United States can be determined by calculating the amount of fill to be placed below the plans of spring high tide In tidal areas and below ordinary high water In non-tidal areas. The shoreline will remain stabilized landward of the spring high tide line which is an armored slops and where existing salt-tolerant species grow to a limited extent and assist with soil retention. Z Indicate the source(s)and type(*)of fill material. No material is to be placed 3. Indicate the method of fill placement (l.s. by hand, bulldozer, crane, etc.). Would any temporary Illi* be required /n waterways or wetlands to provide access for construction equipment? H a% please Indicate the area of such waters anaVor wetlands to be fi/W and show on the plan and sectional views. This question Is not applicable to the project. The foregoing requests basic Information on the most common rypes of prulrc.a requiring Department qWe Army permits. It Is lnl*ndec& obviate or reduce the need for requesting addMonal Information; however, add nal Information may be requested above and beyond what Is requested in this form. Please feel free to add any additional Information regarding your project which you believe may facilitate our review. See attached LWRP and EFH Assessment worksheets and project narrative for additional detailed discussion. EFH ASSESSMENT WORKSHEET FOR FEDERAL AGENCIES (modified 08/04) PROJECT NAME: PIER AND BOAT LIFT REPAIR DATE: FEBRUARY 2012 PROJECT NO.: LOCATION:_Balcolm Prooertv, Fishers Island, NY PREPARER: DOCKO. INC.. Keith B. Neilson. P.E Step 1. Use the Habitat Conservation Division EFH webpage,Guide to Essential Fish Habitat Designations in the Northeastern United States to generate the list of designated EFH for federally-managed species for the geographic area of interest(http:/Avww.nero.noas.gov/hcdAndox2a.htm). Use the species list as part of the initial screening process to determine if EFH for those species occurs in the vicinity of the proposed action. Attach that list to the worksheet because it will be used in later steps. Make a preliminary determination on the need to conduct an EFH Consultation. jtai= EF14 081gnatibnsii�4. Yeiu 'NQK Is the action located in or adjacent to EFH designated for eggs? x Is the action located In or adjacent to EFH designated for larvae? x Is the action located In or adjacent to EFH designated for Juveniles? x Is the action located in or adjacent to EFH designated for adults? x Is the action located In or adjacent to EFH designated for spawning adults? x If you answered no to all questions above,then EFH consultation Is not required -go to Section 5. If you answered yes to any of the above questions proceed to Section 2 and complete remainder of the worksheet. Step 2.In order to assess impacts,it is critical to know the habitat characteristics of the site before the activity Is undertaken. Use existing information,to the extent possible,in answering these questions. Please note that, there may be circumstances in which new information must be collected to appropriately characterize the site and assess impacts.�[ .y: .Q,x •x��iyA�ytai �?ya '-,sv us. . . 0A11*�jppr, � 'w Site Characterlstloar,' Descriptlotr ;^ : Is the site Intertidal, sub-tidal, or This project is to repair a fixed pier. The project will encompass parts water column? of the shoreline,the inter-tidal zone and shallow sub•tldal zone approximately 0.1 acres In size. See attached narrative What are the sediment The existing inter-tidal and shallow sub-tidal sediments are fine- characteristics? grained sand and approximately 25%gravel with occasional exposed stone. Is Habitat Area of Particular The site is an existing shallow cove protected from prevailing climatic Concern(HAPC) designated at conditions but wide open to north and northeast winds. The bluff that or near the site? If so what surrounds the cove Is eroding due to exposure to normal tidal and type, size, characteristics? climatic conditions,despite the moderate to heavy vegetative cover. Is there submerged aquatic There is a 10 to 30 foot wide strip of eel grass(SAV) In the shallow vegetation (SAV)at or adjacent sub-tidal waters out to 50 feet beyond the mean low water line but to project site? If so describe there Is no SAV detritus on the foreshore. The pier is configured to the spatial extent clear the SAV. What is typical salinity and Salinity varies somewhat seasonally but Is typically In the 25-30 ppt temperature regime/range? Temperature varies seasonally from approximately 30 degrees In the winter to 70 degrees in the summer. What Is the normal frequency of Varies seasonally but there is regular boating access to and from the site disturbance, both natural six dock facilities In the cove. Most boating activity is between April and man-made? and November and Is attributable to recreational boating. Storm disturbances are 5 to 10 per year and are usually moderate, occasionally severe. What is the area of proposed Approximately 1110 acre will be directly impacted by this recreational impact(work footprint&far dock project afleld)? Step 3. This section Is used to describe the anticipated impacts from the proposed action on the physical/chemical/biological�yio(logical environment at the project site and areas adjacent to the site that maybe affected. d� M RAO—FU 4��t �'1`�SI�� IMPIi '4 ..,,xara+ ��+ �A -!r ^v'. • v :�`' ,,k .'+' `' Impacts Y Descriptiom Nature and duration of ) It is anticipated that the adverse impacts from this project will activity(s) be small because of the nature of the work. The project can take place in as little as a week but will likely take a month-tide g and weather permitting. Barge access will beat high tide. The pier will remain open wood pile and timber structure. Will benthic community be X The benthic community will be only marginally disturbed by disturbed? the marine construction barge repairing the dock facility. No excavation or"in water" filling is proposed. Will SAV be impacted? X SAV, eel grass has been observed in the project area but the pier spans the SAV fringe bed. Will sediments be altered and/or X Sedimentation rates In the shallow sub tidal zones will not sedimentation rates change? Increase as a result of this project. Will turbidity Increase? X Turbidity, on a day to day basis,will not change significantly from existing conditions.(See attached Narrative Statement) Will water depth change? X No changes In water depth are proposed by or for construction equipment access or for boating operations. Will contaminants be released X plies treated with CCA will release small amounts of arsenic into sediments or water and copper into the water column however the NYS DEC Study column? from 2000 finds those releases acceptable and warranted in view of the need to protect and preserve the marine construction timbers. Will tidal flow,currents or wave X No. The pier is open-pile and timber construction. patterns be altered? WIII ambient salinity or X This project will have no Impact on water-flow and temperature regime change? circulation or drainage and will not affect salinity. Will water quality be altered? X Water quality should not change as to a significant extent as a result of this project beyond the bottom sediment disturbances resulting from marine equipment repositioning. Step 4. This section is used to evaluate the consequences of the proposed action on the functions and values of EFH as well as the vulnerability of the EFH species and their life stages. Identify which species from the EFH species list (generated in Step 1) will be adversely impacted from the action. Assessment of EFH impacts should be based upon the site characteristics Identified in Step 2 and the nature of the impacts described within Step 3. The Guide to EFH Descriptions webpage(httpJ/www.nero.noaa.gov/hcd/list.htm)should be used during this assessment to determine the ecological parameters/preferences associated with each species listed and the potential impact to those parameters. Functions and Vafuest: PF `DcscrfliR habMat type speclesl and IifE stages to be advelx ':' t WIII functions and values of EFH be Impacted for. Spawning The shallow sub-tidal zone and Intertidal zone are currently sandy X gravel strewn with stones and boulders and will remain so without regard to this project No alterations of the benthos or underwater habitat are proposed. This project should have no Impact on submerged aquatic vegetation. Nursery X The shallow sub-tidal zone and inter-tidal zone are currently sandy gravel with a nearby eel grass fringe colony and will remain so as a result of this project No alterations of the berdhos or underwater habitat are proposed or anticipated. Nursery function should remain unchanged. Forage X The shallow subtidal zone and intertldalzone are currently sandy gravel and will remain so as a result of this project No adverse Impact to submerged aquatic vegetation is anticipated If it does exist in nearby waters. The pier structure plies spanning the water column should provide new habitat and foraging opportunities as barnacles and algae colonize the structure In the water column. Shelter X The shallow subtidal zone and Intertidal zone are currently sandy gravel and will remain so as a result of this project No adverse Impact to submerged aquatic vegetation is anticipated. Will impacts be temporary or M It Is envisioned that any construction Impacts experienced as a resultof this project will be temporary and not permanent but the new structure permanent? spanning the water column will be. The area of coverage of the proposed piles is small compared to the area of the cove and of no consequence compared to the overall fringe habitat and coastal shoreline of Fishers Island. WIII compensatory mitigation be X No compensatory mitigation is proposed for this dock repair project Approximately 300 SF of land will be covered by a structure. used? Approximately 500 SF of intertidal and shallow subtidal,stony, ravel gravelly sand sediments will be covered by the pier. All of these features are natural and similar to adjacent shoreline characteristics along Fishers Island's coastal perimeter. The pier has existed at this site for approximately 100 years. Step S. This section provides the Federal agency=s determination on the degree of impact to EFH from the proposed action. The EFH determination also dictates the type of EFH consultation that will be required with NOAA Fisheries. 40, ':ti 0- _ f.....t !"' T( .k� b _ .'fin x t Federal Apirtepa EFH Deteiminattortr X There is no adverse effect on EFH Overall degree of EFH Consultation is not required adverse effects on EFH (not Including The adverse effect on EFH is not substantial. compensatory mitigation)will be: This is a request for an abbreviated EFH consultation.This worksheet Is being submitted to NMFS to satisfy the EFH (check the appropriate Assessment requirement. statement) The adverse effect on EFH Is substantial. This Is a request for an expanded EFH consultation. A detailed written EFH assessment will be submitted to NMFS expanding upon the impacts revealed in this worksheet. Step 6. Consultation with NOAA Fisheries may also be required if the proposed action results In adverse impacts to other NOAA-trust resources,such as anadromous fish,shellfish,crustaceans,or their habitats. Some examples of other NOAA-trust resources are listed below. Inquiries regarding potential Impacts to marine mammals or threatened/endangered species should be directed to NOAA Fisheries' Protected Resources Division. 0121'11Z FIE 11111111 1 1 111 1, 0,11111 1;, � xk Soo'clie6 kno"fal occuw gibe habitat impact type(►et phYsti chemtcaf#or tliotogicaCx t �= stat[ (lisfottt ifia d[srupttano4spawnirf and/aeggdeveibpmenthe a%l4!snititnuteary' mayappiv andfor�adultfeedfri}oemtgrattonhabifat)g;v, Pollock blueback herring rainbow smelt Atlantic sturgeon Atlantic menhaden American shad American eel Physical Changes, not disruptive American lobster Physical Changes, not disruptive blue mussels Physical Changes, not disruptive soft-shell clams quahog Physical Changes,not disruptive,no adverse impact Otherspecies: Ak SL N MAP vnviaw�Ny �ur t Project: "PIER AND BOAT LIFT REPAIR^ — - / `' �` s - Location: FISHERS ISLAND,TOWN OF SOUTHOLD i SUFFOLK COUNTY,NEW YORK /.s Waterway: EAST HARBOR Date: NOVEMBER 11,2011 tCUT✓ )U Applicant: LUCILLE BALCOM - C�� E q tris Agent: DOCKO,INC. <, - 1 /,5:7C wo p IN = a ■ 0* rr..e. v u 14* r - ., iso i �M �--'�f � U. 41c CS o 111 N CY* N 4�s / Is ad m md i -`kriN M / A90, ---Y Q + ASSESSOR'S MAPJJJV4NW-4-IS ' 8 - Project. " PIER AND BOAT LIFT REPAIR" O 1 Location: FISHERS ISLAND,TOWN OF SOUTHOLD FjSyEgs SUFFOLK COUNTY,NEW YORK s Waterway: EAST HARBOR Date: NOVEMBER 11,2011 •. 1 Applicant: LUCILLE BALCOM+- Agents DOCKO,INC. ...Eby o.80 R.O.es V H �P s.Y lY LY xu v Lix v 1] Y aY r.Y lu 'gym til IN LY U � Is � 1 nYwa ua 4 6S O b rn..w aY L,l• • �rCY a ow.l.wu ; � 1 yi1Fv S.Y } y,�� +a54ir'a �wrar•ri � av A O 6 Y R 11LI ,.+ YYOF/Mw'Cm LMp 0.Y 9awrr a� I. TJ xY T.. .e.rtl s Gi .TO' y0 V l u •� Lai h.Y � 1, �w Y ontmsL rl •vam K u mw• SECTION 1 NOTICE COUNTY OF SUFFOLK C SOUTHOLD — �° :"^ uwr,•w4arzY ntsly�+ Red Property Tax Service dgency Y °"" ssrsmrws a wn lannar v Tm •11+Q o 004 O ^ •a r�s,1� W"caw"Tv Yr a m:m CawtY Cats aserhm4N T 1170 a s• °w `i •rm•9 wrmrt wTTv raYusr o M S[wf w T6n N mn 'r rx wwrun TY sz1R mx• P rw mmv■ low PROPERTY mrvmIDl ftm <, . l � t� �� �-- � �_ �. � f '� � r �, ,� . ,� � � � r j / j s �� �. } V � � � �I -� 9 ...__. r . , ` • ,�-- W,> , _. � � � � .. � ,��� ������ 1��� � �� J 111 � • . � 11 Docko, Inc. Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:permits@docko.com June 5, 2012 Mr. James King, President Southold Board of Trustees P.O. Box 1179 Southold,NY 11971 Re: Mrs. Lucille Balcom I JUN 2012 Town of Southold Board of Trustees Meeting Dear Mr. King: Due to a scheduling conflict on June 20,2012 I will be unable to attend the Town of Southold Board of Trustees Meeting in regard to Mrs. Lucille Balcom. I believe that there are no concerns with the project and you can proceed in my absence. If there any other issues that need to be addressed or if you have any reservations on the Ba com project please feel free to give me a call. Yours truly, DOCKO, INC. Keith B. Neilson, P.E. KBN: cb Cc: Mr. Peter Crisp File: 11-5-2283 BALCOM OFFICE LOCATION: OF S0(/TyO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 * Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) co Southold, NY 11971 Q Telephone: 631 765-1938 .4` Fax: 631765-3136 ��y00UNT1,N0 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: May 14, 2012 Re: Proposed Wetland Permit and Coastal Erosion Permit for LUCILLE BALCOM SCTM#1000-4-4-15 Docko, Inc. on behalf of LUCILLE BALCOM requests a Wetland Permit and Coastal Erosion Permit to repair 142 If. of 6' wide pile and timber pier and boat lift waterward of the apparent high water line. Located: Private Rd., Fishers Island. SCTM#4-4-15 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 CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney BOARD OF TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application _Administrative Permit Received Application�llx Received Fee: $ APO — 9 2��2 kC Completed Application 1'� Incomplete SEQRA Classification _ Type I_ Type II_ Unlisted Coordination Date:(Date Sent) LWRP Consistency A ss en t Form i CAC Referral Sent 1 Date of Inspection We Receipt of CAC Report Lead Agency Determination: Technical Review: Public Hearing Held Resolution: Name of Applicant: Lucille Balcom Address: P.O. Box 605 Fishers Island NY 03690 Phone Number: ( 631 ) 788-7602 Suffolk County Tax Map Number: 1000-004-4-15 Property Location: Private Road, Fishers Island (provide LILCO Pole#, distance to cross streets, and location) AGENT: Docko Inc. (If applicable) Address: P. O. Box 421 Mystic, CT 06355 Phone: (860) 572-8939 1 Gard of Trustees Applicatle GENERAL DATA Land Area(in square feet) : 0.65 ACRE Area Zoning: Previous use of property: RESIDENTIAL Intended use of property: RESIDENTIAL Covenants and Restrictions: _ Yes X No If"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes", please provide copy of decision Prior permits/approvals for site improvements: Agency Date NYS DEC January 9. 1992 _ACOS Letter October 25, 1991 Town of Southold letter December 6. 1991 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No _Yes If yes, provide explanation: Project Description (use attachments if necessary) : Repair 142 (+/-) LF of 6-ft wide pile and timber pier and boat lift waterward of the apparent high water line Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:_Repair and existing longs—standing pier and boat lift at the Balcoms home the former life saving station at East Harbor. Area of wetlands on lot: NA square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: NA feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling: —2L—No _yes If yes,how much material will be excavated? NA cubic yards How much material will be filled? _NA_ 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: 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): There will be no adverse affect on existin s radic tidal wetlands vegetation at the site or tidal wetlands ve etation which might exist near by Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: This a private dock for recreational boating. Are wetlands present within 100 feet of the proposed activity? X No Yes Does the project involve excavation or filling? --X—No Yes If Yes, now 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 to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features.(Use attachments if necessary): Town of Southold Y Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.g: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 's-t,-. ���) o(' LJ /!j STORM•WATER,GRADINGr DRAINAGE AND EROSION CONTROL PLAN T - -gi+T �_�— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK" SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (This item will include all runoff created by site F/1–,/ ir Id. What is the Total Area of Land Clearing clearing and/or construction activities as well as all .s and/or Ground Disturbance for the proposed _O_ Site Improvements and the permanent creation of constmction activity? Impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Prodds Aaduoael Peso mNmded) Drainage Structures Indicating Size 8 Location?This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Water Flow. luy ILio2C t_/_lLG L 1`tt /1102 3 Does the Site Plan and/or Survey describe the erosion J� n t � and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Lk Construction Period. ik nAA n Dia _ iU" IL)AIL f L-L/1L 4 Will this Project Require any Land Filling,Grading or ❑ — i U Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? § Will this Application Require Land Disturbing Activities El / Encompassing an Area in Excess of Five Thousand I/ (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction — General DEC SWPPP Requirements: or within One Hundred(100')feet of a Welland or Submission of a SWPPP Is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 WIII there be Site preparation on Existing Grade Slopes ❑ are part of a larger common plan that wit ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to including Construction activities involving sol disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has detemgned that a SPDES permit is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious ❑ for Storm Water Discharges from Construction activity-Permit No.GP.&l0.001.) Surfaces be Sloped to Direct Storm-Water Run-Off �- 1.The SWPPP shall be prepared prior to the submittal of the NOI.The NOI shag be into and/or in the direction of a Town rightof-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, — required,post-construction storm water management practices that wit be used and/or Removal of Vegetation and/or the Construction of any ✓ constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terns and conditions of this permit.In addition,the SWPPP shag Area?other Item will NOT Include she Iasrellubm m Driveway Aprem.) identify potential sources of pollution which may reasonably be expected to affect the quality of stem water discharges. NOTE: It Any Answer W Questions Ons 0r ugh Nina Is Answered wm,a Chsolr Mark 3.All SWPPPs that require the postconslmctlon storm water management practice in a Box and the constrwUm she disturbance is between 5,000 S.F.81 Am in area, component shag be prepared by a qualified Design Professional Licensed in New York a Storm-Wen Grading,Drainage S Erosion Control Plan In Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior to issuance of Any Building Permit (NOTE: ACh Mak(.V)anNWMsvmrforeadr West Is Requite WaCmnpiate Appgn I S1-A1'E OF NEA'*ef if; C T / COUMT IOF....AZelW...lwSW.P.R.& SS That 1,...K.� ..A ...........................being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) And that he/she is the .............................. �.i ............................................. (Owner,Contractor,Agent,Caryoreto Officer,etc) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be performed in the manner set forth in die application filed herewith. Sworn to before me tit is; M�7 r^�1 .................P..f.J..r�..(..,-........day of.......l...lGtt `. �....... ... ,`10.LCT NotaryPublic: . . .... .... ..... ..... . ... ... ............................................................. .]j..... •••� (Signature of APPicanl) / FORM - d6f10 PART It- IMPACT ASSESSMENT To be completed by Lead Agency) A DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 6,17.4? If yes,coordinate the review process and use the FULL FAF. ❑Yes ❑✓ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR PART 617.6? If No,a(legative declaration may be superseded by arroNler involved agency. nYes Q No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten.N legible) C1. Existing ah quality,surface or groundwater quality or quantity,noise levels,existing tratfic pattern,solid waste production or disposal, potential for erosion,drainage or flooding prohlems7 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,stnellfish or wildlife species,sig cent habitats,a threatened or endangered species?Explain hdefly C4. A community's existing plans or goals as oradally adopted,or a change in use or intensity of use M land or Omer natural resources?Explain briefly: C5. Growth,subsequent develupmenL 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 CI-CS? Explain briefly: LlC7. Omer impacts including changes in use of either quantity ort a of energ air briefl D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA)? If es,a lain briefl Yes ❑✓ No E. IS THERE,OR IS THERE UK—ELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL ENTAL IMPACTS? N 0 Yes No _ yes emialn: E 7777 PART NI-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) . INSTRUCTIONS: Foreachadvense~ldentAeci above,delarmikewheawkissubstentlak1111W,importantoroftntI[seelgnificanL Each ~Should be assessed In contledion with its(a)setting Q.e.urban or lump;(b)probabik of ooaurMlg,(c)duration;(d)Mheverskhifrly (e) NaograPhic scope;and(Q m9g11ibrde. If necessary,add attachments or reAerence atrppor ft"U"dala Ensure fltNt e)Vlerlagoga contain suff4 tdetallIIIdm hataklelavarhtadvemaknpadshavebeenIdenoliedamad"tiatelyaddreseed, Nggesgonddpadgwaschedaad yeeede fhtemhinatlondsigMficarwamustevaluatethepotankaNmpaddthepxopoeedaWononNlee Virmirnerltaldharaclarreft0ftheCEk Check#aboxlfycuhmWMMWOrleOrmOrePOWEAF afd/arprepare dedara6on. a eorelgnlGmrltadvelsehyladswfddllNAYooau.Thenproeeedcreckytofhe Check Nile box If you have detemdned,based on Nle Mlfonmaft and analysis above and any auppo ft decumentagen,that the proposed a WILL NOT rasa in any significant adverse environmental Mnpacs.AND provide,on attachments as necessary, the reasons suppondng determination. - Board of Trustees A 01C d 0 2— Z D /Z Name or Lead Agency /�/ Oahe JA `� h� / (T President Print of Type Name oroesponemie Dmcer In Lelad Agency Title of Responsible Officer i agnarµye o]nesponsloie Officer m Lead nq Signature of parer(If different from responsible officer) ` �ayFFOl,�c James F. King, President Town Hall,53095 Main Rd. Bob Ghosio,Jr. ,Vice-President T P.O.Box 1179 Dave Bergen Southold,NY 11971 John Bredemeyery�0 ,, ,, .aa Telephone(631)765-1892 Michael J. Domino i T y' Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of LUCILLE BALCOM COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, 'A-SK`C k LXUZY\k N residing at/dba uSfiLC inns being sworn depose and say: That on the day of 201 , I personally posted the property known as 1 tet_ kite_ �1 ,r��v� - FGS-� )�a� 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., May 16,2012. Dated: S_7 r F )LS7� (signature) worn to before me this ,s day of/42�20P;L C � jq/�41?ublic �` - aiv""�''�,rA,, X0. .• f3:; x NOTICE OF HEARING y - OWNER(S) OF RECORD LLLC%U bak-M + HEARr.loqW PA C t _ Docko, Inc. Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:permits@docko.com June 4, 2012 Ms. James King, President Southold Board of Trustees P.O. Box 1179 t J N o 2012 Southold,NY 11971 Re: Mrs. Lucille Balcom Certified Mailings Dear Mr. King, We are transmitting herewith the original copies of the certified mailing for Mrs. Lucille Balcom located off of Private Road in East Harbor on Fishers Island. Please let us know if further information is required. Yours truly, DOCKO, INC. Keith B. Neilson, P. KBN: cb Enclosure File: 11-5-22833 BALCOM April 23, 2012 Mr. James King, President Southold Board of Trustees P.O. Box 1179 Southold,NY 11971 Re: Mrs. Lucille Balcom East Harbor, Fishers Island I/We have reviewed the draft drawings titled "Pier and Boat Lift Repair" in East Harbor dated November 11, 2011, prepared for Lucille Balcom by Docko, Inc. and I have no objection to the proposed project whether it is built of wood or steel with wood fender piles. Signed: Ms. Kim K. Campbell Date l April 23, 2012 Mr. James King, President Southold Board of Trustees P.O. Box 1179 Southold,NY 11971 Re: Mrs. Lucille Balcom East Harbor, Fishers Island I/We have reviewed the draft drawings titled "Pier and Boatlift Repair" in East Harbor dated November 11, 2011,prepared for Lucille Balcom by Docko, Inc. and I have no objection to the proposed project whether it is built of wood or steel with wood fender piles. /J� / Signed: �44'i��,O�/ oo �o-2 - F.I. Development Corp. Date 4koard of Trustees AppliCatioa County of Suffolk State of New York LUCILLE BALCOM 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 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 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 REPRESENTATIVE(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 _ 20 ZNotary Public U • Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Lucille Balcom residing at P.O. Box 605 (print owner of property) (mailing address) Fishers island NY 06390 do hereby authorize_DOCKO. INC (Agent) MYSTIC. CT 06355 the to apply for permit(s) from Southold Board of Town Trustees on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The ouroose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: L u..C r I h 6�t CChem (Last name,first name,middle initial,unless 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 (If"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."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 the town officer or employee owns more than 5%of the shares. YES NO I 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 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 applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP X4 Submitted t i of lug 2042 Signature r. _ Print Name l(a_1 k) i1 c, i 6_". tk ; Form TS I A Lt«; • 617.20 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer, Frequently, there are aspects of a project that are subjective or unmeasurable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not be technically expert in environmental analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet Flexible enough to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially-large impact. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. THIS AREA FOR LEAD AGENCY USE ONLY DETERMINATION OF SIGNIFICANCE -- Type 1 and Unlisted Actions Identify the Portions of EAF completed for this project: ✓❑Part 1 ❑Part 2 Part 3 Upon review of the information recorded on this EAF(Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magnitude and importance of each impact, it is reasonably determined by the lead agency that: ❑� A. The project will not result in any large and important impact(s) and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration wil be prepared. B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDMONED negative declaration will be prepared.' C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. 'A Conditioned Negative Declaration is only valid for Unlisted Actions PIER AND BOATLIFT REPAIR-LUCILLE BALCOM Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) website Date Page 1 of 21 PART 1--PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the environment. Please complete the entire form,Parts A through E. Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable,so indicate and specify each instance. Name of Action PIER AND BOATLIFT REPAIR Location of Action(include Street Address,Municipality and County) PRIVATE ROAD,FISHERS ISLAND,TOWN OF SOUTHOLD,SUFFORK COUNTY Name of Applicant/Sponsor LUCILLE BALCOM Address PRIVATE ROAD,P.O.BOX 605 City/PO FISHERS ISLAND State NY Zip Code 06390 Business Telephone (631)-788-7602 Name of Owner(if different) Address City/PO State Zip Code Business Telephone Description of Action: REPAIR 142(+/-)LF OF 6-FT.WIDE FIXED WOOD PILE AND TIMBER PIER AND BOATLIFT WATERWARD OF THE APPARENT HIGH WATER LINE. Page 2 of 21 Please Complete Each Question--Indicate N.A. if not applicable A. SITE DESCRIPTION Physical setting of overall project, both developed and undeveloped areas. 1. Present Land Use:❑Urban ©Industrial ©Commercial ®✓ Residential (suburban) Rural (non-farm) 13 Forest Agriculture ©Other 2. Total acreage of project area: 0.1 acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) 0.2 acres .02 acres Forested acres acres Agricultural (Includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24,25 of ECL) 0.1 acres 0.1 acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) 0.1 acres 0.1 acres Roads, buildings and other paved surfaces 0.35 acres 0.35 acres Other(Indicate type) acres acres 3. What is predominant soil type(s) on project site? a. Soil drainage: ©✓ Well drained 90%of site ❑Moderately well drained_%of site. Poorly drained 10 %of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? acres (see 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? ElYes El No a. What is depth to bedrock (in feet) 5. Approximate percentage of proposed project site with slopes: M0-10% 90% 1:110- 15%_% 121 15% or greater 10 % 6. Is project substantial) contiguous to, or contain a building, site, or district, listed on the State or National Registers of Historic Places? 11 Yes © No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? IEYes ❑No 8. What is the depth of the water table? 0 (in feet) 9. Is site located over a primary, principal, or sole source aquifer? Yes ED No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? Yes E]No Page 3 of 21 11. Does project site contain any spec•f plant or animal life that is identified as thre'aled or endangered? ©Yes EINo According to: Identify each species: 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations? QYes No Describe: THE SHORELINE OF THE PIER IS A COASTAL BLUFF 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? ®Yes QNo If es, explain: 14. Does the present site include scenic views known to be important to the community? ElYes []No THIS WAS THE BOAT HOUSE AND DOCK FACILITY ASSOCIATED WITH THE FISHERS ISLAND LIFE SAVING 7 STATION. 15. Streams within or contiguous to project area: NONE a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: NONE b. Size(in acres): Page 4 of 21 17. Is the site served by existing public utilities? Yes ©No a. If YES, does sufficient capacity exist to allow connection? Yes No b. If YES, will improvements be necessary to allow connection? ElYes ONo 18. Is the site located inan agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? bYes ❑� No 19. Is the site located in or substantial)Y contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617? ®i ^ Yes L._i No 20. Has the site ever been used for the disposal of solid or hazardous wastes? ©Yes ©i No B. Project Description 1. Physical dimensions and scale of project(fill in dimensions as appropriate). a. Total contiguous acreage owned or controlled by project sponsor: acres. b. Project acreage to be developed: NO acres initially; NO acres ultimately. c. Project acreage to remain undeveloped: NA acres. d. Length of project, in miles: NA (if appropriate) e. If the project is an expansion, indicate percent of expansion proposed. NA % f. Number of off-street parking spaces existing 3 ; proposed 0 g. Maximum vehicular trips generated per hour: NA (upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Condominium Initially 1 Ultimately 1 L Dimensions (in feet) of largest proposed structure: 6-FT height; 6FT width; 142-FT length. j. Linear feet of frontage along a public thoroughfare project will occupy is? 100 ft. 2. How much natural material (i.e. rock, earth, etc.)will be removed from the site? 0 tons/cubic yards. 3. Will disturbed areas be reclaimed ©Yes E]No �N/A a. If yes, for what intended purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? ©Yes No c. Will upper subsoil be stockpiled for reclamation? ©Yes El No 4. How many acres of vegetation (trees, shrubs, ground covers)will be removed from site? 0 acres. Page 5 of 21 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? ®Yes [H] No 6. If single phase project: Anticipated period of construction: 1 months, (including demolition) 7. If multi-phased: a. Total number of phases anticipated (number) b. Anticipated date of commencement phase 1: month year, (including demolition) c. Approximate completion date of final phase: month year. d. Is phase 1 functionally dependent on subsequent phases? ❑ Yes ❑ No 8. Will blasting occur during construction? El Yes El No 9. Number of jobs generated: during construction 3 ; after project is complete 10. Number of jobs eliminated by this project NONE 11. Will project require relocation of any projects or facilities?❑Yes EINo If yes, explain: 12. Is surface liquid waste disposal involved? 1:1 Yes IF]No a. If yes, indicate type of waste (sewage, industrial, etc) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? ©Yes E]No Type 14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes El No If yes, explain: 15. Is project or any portion of project located in a 100 year flood plain? E]Yes 1:1 No 16. Will the project generate solid waste? © Yes E No a. If yes, what is the amount per month? tons b. If yes, will an existing solid waste facility be used? 0 Yes C1 No c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? DYes © No Page 6 of 21 e. If yes, explain: 17. Will the project involve the disposal of solid waste? r1Yes F±]No a. If yes, what is the anticipated rate of disposals tons/month. b. If yes, what is the anticipated site life? years. 18. Will project use herbicides or pesticides? ©Yes ❑� No 19. Will project routinely produce odors (more than one hour per day)? ❑Yes IDNo 20. Will project produce operating noise exceeding the local ambient noise levels? G3Yes©No 21. Will project result in an increase in energy use? ®Yes E No If yes, indicate type(s) 22. If water supply is from wells, indicate pumping capacity gallons/minute. 23. Total anticipated water usage per day gallons/day. 24. Does project involve Local, State or Federal funding? ©Yes [i] No If yes, explain: Page 7 of 21 25. Approvals Required: Type Submittal Date TOWN OF SOUTHOLD FEB 2012 City, Town, Village Board �Yes ❑No BOARD OF TRUSTEES City, Town, Village Planning Board ❑Yes ❑ No City, Town Zoning Board 1:1 Yes ❑ No City, County Health Department ❑Yes ❑ No Other Local Agencies ❑Yes ❑ No Other Regional Agencies ❑Yes ❑ No ' State Agencies ayes ® No NYS DEC FEB 2012 US ARMY CORPS FEB 2012 Federal Agencies ayes 1:1 No OF ENGINEERS C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? ❑Yes a No If Yes, indicate decision required: ❑ Zoning amendment ❑ Zoning variance ©New/revision of master plan ❑ Subdivision ❑ Site plan ❑Special use permit ❑Resource management plan ❑ Other Page 8 of 21 2. What is the zoning classification(s) of the site? RESIDENTIAL 3. What is the maximum potential development of the site if developed as permitted by the present zoning? RESIDENTIAL 4. What is the proposed zoning of the site? RESIDENTIAL-NO CHANGES ANTICIPATED 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? N/A 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? Yes ©No REPAIR OF AN EXISTING FIXED PIER AND BOATLIFT. 7. What are the predominant land uses)and zoning classifications within a A mile radius of proposed action? RESIDENTIAL LAND USE EXISTS TO THE EAST OF THE SITE. THE PROPERTY TO THE WEST IS OWNED BY THE FISHERS ISLAND DEVELOPMENT CORPORATION.THE LAND IMMEDIATELY SURROUNDING THE SITE IS THE FISHERS ISLAND GOLF COURSE. 8. Is the proposed action compatible with adjoining/surrounding land uses with a /4 mile? ElYes ❑No 9. If the proposed action is the subdivision of land, how many lots are proposed? N/A a. What is the minimum lot size proposed? Page 9 of 21 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? 1:1 Yes M No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection? ©Yes G] No a. If yes, is existing capacity sufficient to handle projected demand? ®Yes No 12. Will the proposed action result in the generation of traffic significantly above present levels? ❑Yes El No a. If yes, is the existing road network adequate to handle the additional traffic. ❑Yes No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the information provided above is true to the best of my knowledge. Applicant/Sponsor Name LUCILLE BALCOM Date Signature Title APPLICANT/OWNER If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. Page 10 of 21 Town of Southold LWRP CRSISTENCY ASSESSMENT FORM• A. INSTRUCTIONS 1. 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 for minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. 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(which includes all of Southold Town) 3. 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 supporting 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# 1000—0044-15 PROJECT NAME: Pier and Boadift Repair—Lucille Balcom The Application has been submitted to(check appropriate response): Town Board Planning Board Building Dept. Board of Trustees X 1. Category of Town of Southold agency action(check appropriate response): a) Action undertaken directly to 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: X 1 Nature and extent of action: • 0 Repair 142 (+/-) LF of 6-ft. wide fixed wood pile and timber and boatlift all waterward of the apparent high water line. Location of action: Property off of Private Road Site acreage: Parcel = .065 Present Land use: Residential Present Zoning Classification: Residential 2. 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: Lucille Balcom b) Mailing Address: P.O. Box 605,Fishers Island. NY 06390 c) Telephone number: Area Code (631) 788-7602 d) Application number, if any Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes X No_ If yes, which state or federal Agency? US ACOE. NYS DEC C. Evaluate the project to the following policies by analyzing how the project will further support of 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. X Yes _No _Not Applicable The pier repair project makes appropriate use of an existing waterfront site and complies with environmental design factors published by the NYS DEC and the DOS Coastal Management Program. Southold Local Law No. 6. 2004 and the Southold LWRP The pier will maintain a 4- foot deck heieht over the bottom sediments until passing the apparent mean low water line Rails will be 42 inches above the deck There will be no impairment of waterflow or navigation. Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Page 3 through 6 for evaluation criteria. Yes No X Not Applicable 2 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 X Not Applicable The proposed work is the repair of an existing., long-standing dock facility and will not change the scenic resources or aesthetics of the site. 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 X Not Applicable These proposed pier repairs will take place in East Harbor and is acknowledged to be in a flood- prone area: there is wave exposure at this site. The pier repairs will be designed to accommodate complete submersion and resist hydrostatic and hydrodynamic uplift pressures due to flooding. 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 _ No X Not Applicable This project will not have any affect on suitability of or availability of drinking water on Fishers Island. 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. X Yes _ No Not Applicable 3 This project is consistent with this policy because it proposes to maintain the elevation of the pier extension at an acceptable height above the bottom sediments through which adjacent tidal wetlands vegetation may spread The dock site however, is so rocky and so heavily shaded that the tidal vegetation along the shoreline is minimal No adverse impact on tidal or submerged vegetation is anticipated as a result of the proposed project In addition the NYS DEC prepared a study showing that the proposed pressure-treated Southern Pine timberproducts construction materials are suitable for this type of protect in this location except for decking which will be of untreated woods or composite (or plastic) materials 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 X Not Applicable There are no air quality issues related to this project No emissions will be generated by the dock facility. 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. Yes _ No X Not Applicable There is no solid waste or hazardous substances to be generated from this project The pressure treated wood trimmings from the dock construction will be collected and disposed of in accordance with current regulations so as to minimize any harmful affect 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 X Not Applicable This proiect is being built emanating from private land The public trust lands and waters constitutes the area between the mean high water line and mean low water line and the resources are from the high tide line out These environmental resources are being protected by the design standards dictated by the NYS DEC and the town ordinances There is virtually no Dublic use of the waterfront in this area and the repair of the pier is not likely to influence or change this fact 4 WORKING COAST POLICI16 • 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. X Yes No Not Applicable This project is pier repair for water-dependent, recreational and transportation boating. This usage is defined as water-dependent in the LWRP because the pier extension will for recreational boating and provide boat transportation access to the mainland The pier to shore is to provide access while spanning and thus protecting existing habitat 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 X Not Applicable This pier is not used for commercial fishing or shellfish industries or enterprises Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III – Policies; Pages 62 through 65 for evaluation criteria. Yes No X Not Applicable This pier is not used for or in support of any agricultural or aquaculture industries or entgMrises Policy 13. Promote appropriate use and development of energy and mineral sources. See LWRP Section III–Policies; pages 65 through 68 for evaluation criteria. Yes No X Not Applicable This pier is not used for or in support of any energy or mineral mining or processing operations PREPARED BY Keith B. Neilson, P.E. Docko Inc TITLE Agent DATE February, 2012 5 Dooko, Ino. Serving the waterfront community since 1987 P.O.Box 421,Mystic,CT 06355(860)572-8939 Fax:(860)572-7569,email:permits@docko.com l ' brt ry 27 2,f 12 Mr. James King, President f _ Southold Board of Trustees APR 9 r P.O. Box 1179 Southold,NY 11971 ; Re: Lucille'Balcom, ierrskand_,,... Pier&Boat Lift Repair East Harbor, Fishers Island Dear Mr. King: On behalf of Mrs. Lucille Balcom, we enclose herewith the following in support of his permit application for pier and boat lift repair in East Harbor on Fishers Island. ➢ Two prints each of plans titled: Project: "Pier& Boat Lift Repair" Waterway: East Harbor Location: Fishers Island, Town of Southold Suffolk County,New York Applicant: Lucille Balcom Date: November 11, 2011 ➢ Two copies of the Southold Board of Trustees permit application, SEQR-Part 1, LWRP Consistency Assessment Form, Tax Assessor's Map, site photographs and location map and topographic and boundary survey of the site as well as a copy of the deed.. ➢ Check in the amount of$250.00 payable to the Town of Southold. ➢ One copy of each of the other applications to regulatory agencies. I trust that you will find this application package complete and acceptable; please let me know if the need for further information arises. Very truly yours, D O, INC. cam,( 3dt- . Keith B.Neilson,P.E. KBN:cb Enclosures CC: Lucille Balcom US ACOE NYS DEC: Environmental Permits NYS DOS File: I1-05-2283 BALCOM NOTES; FISHES ISLAND 2V cni�77'�i�m� 1 N 1. ELEVATION DATUM 15 NGVD29. `dVum a ,o t 2 TIDE DATA 15 TAKEN FROM 2011 NOAA TIDE n 19 yy2 TABLES REFERENCE;NEW LONDON-SILVER r EEL COVE. 11 ,9 / 3.PROJECT DESCRIPTION: ° REPAIR 142 sLF OF 6-FT WIDE FDCED WOOD PILE �� °-t>R•S 1 r•-\ c+O F\ " AND LIMBER PIER INCLUDING WAVE BOARDSblj AND A BOAT LIFT,WATERWARD OF THE HIGH = 1 , WATER LINE, s 4.PROJECT PURP05E a 3 •t C �o� t Jlb THIS 15 A PRIVATE DOCK FOR RECREATIONAL BOATING. 5.THESE APPLICATION DRAWINGS REPRESENT '" r^ �:•>, rw j A COMPILATION OF SURVEYS FOR ENVIRONMENTAL PERMIT PURPOSES.THEY ARE D Q • .. NOT CONSTRUCTION CONTRACT DOCUMENTS.A _ w , t1 4 L� TOW WGRY BUILDING PERMIT MAYBE REQUIRED. r4 of .i -:..: s a a = 6.ADJOINING PROPERTY OWNERS: © a WEST: SOUTH: LOGATIOIV I"I,AP REFERENCEF.I.DEVELPMENT CORP Ms.KIM K.GAMBELL CHART:123M G/O F.I.UTILITY 106 GOMEX RD scAUk DRAWER E HOBE SOUND,FL GRAPHGRAPHIC33455 1ppp p t000 YARDS F95HERS ISLAND,NY 06390 PROPERTY OF PROJECT AER EAST EALCOM RECONSTRUCTION HARBOR APR - 9 2012 N/F PROPERTY OF CAMSELL .. .^^^' •�>.iT' :('\,s y.Ln::.: 'iii'=ti.\i<:'. . 4r_ Via'.'. ..:M`. ::`"i.•}: ''\'f'�l� il,T'�•' �::Y.'. _:'t.'. •iYi v`6%�'. .'-5-E.2]y: $t'... u`1 t.w:� :. i14ns '�\Y1. 3Y•e'�\.S 'e�'�t}Fa�r2Y'r ''4 FI HE 5 R ISLAND f , , DEVELOPMENT o t SURVEY: . . .. O�/�P 1 L PL AIV by CME ASSOCIATES ENGINEERING,LEWD G�SGVJ: I 10 FT SURVEYING¢ARCHITECTURE,PLLG . 10 s 0 10 PROJECT: PIER AND SOATLIFT REPAIR LOCATION: RSHERS ISLAND-TOWN OF SOUTHOLD pF NS SUFFOLK COUNTY,NEWYORK K WATERWAY: EAST HARBOR co `5 9� DATE NOVEMBER TI,201 • D O C �O APPLICANT WCILLF BALCOM „c r � m uj AGENT: SHEET 1 OF 4 f _ - 1D0G<0, INC. ,yq 068892.N fit' Kelth B.NeWn,PE CMYsft CT O S4 9OFESSIONP� 860860 572 69395 FAX 860 572 7569 DWS 11-5-2263 EMAIL :, r He®docko.corn Keith Neilson, Docko Incorporated 1/16/2012 4;29 PM Balcom_1.dwg N J IO \ BOAT p \ LIFT �« 0 WAVE DISSIPATER T DOCK RET•Wf�S (// \ DAMAGED DECKNG EXISTING SUBMERSED WAVE DISSIPATER BOARDS PILES W) \ ELC-G. LADDER FASTPANEL HARBOR F UMf1'S OF NEW DECKING EDGE OF -5 = NO DECKING EEL GRASS EXFIO,SED -3 FI EC /" 5 EDGE OF APPRO)V ATE MEAN UNE ? z 1 - EEL GRASS LOW WATER P-EV�.0) 1 NZ;0OW 70.00 ear w wwutx l w wnw _ N70WOCW 21.00 _ _ '— T18.70 SPRING HIGH WATER UNE-'`1' -' ALONG STONES(4 APPARENT HIGH TER UNE XLEV=4.0) _ \7 COASTAL EROSION H4LV2D UNE EDGEOFEKSTING NC EDGEOF PEWE F.F�.6r ,at.:�;.,.,�•. � STONES EDGE OF " -LN \. ELECTRICAL WO©D DESK' DECK - 1 �3QOE: "?\ EASEMENT - :,. SITS � ee r s PROPERTY OF ��:..;x;�.:::;a;,: . ,' ..•:.�::.`;:.:,:.^y.'.,.. 4C BALC.OLM I �� N/F PROPERTY.' GAMBELL . E=?LISTINCF; COIVOITION�— SURVEY: by CME ASSOCIATES ENCANEERING.LAND GRAPHIC E 1 IN=50 Pi SURVEYING$ARCHITECTURE,Pi 50 40 30 20 10 0 so PROJECT: PIER AND SOATLIFT REPAIR LOCATION: FISHERS ISLAND-TOWN OF SOUTHOLD K��� SUFFOLK COUNTY,NEW YORK A`P pN 9 9 WATERWAY: EAST HARBOR G7 �.°) f DATE NOVEMBER 11,2011 D 0 C If 0 . * Y 9 APPLICANT: LUCILIJ=BALCOM ¢ t F W M - ? AGENT: SHEET 2 OF¢ \ 0686 A" OOGIGO, INC. \I Kekh B.Nef6i PE O ROFES SIONP� Mystic,Cr 06355 0 P0 S 860 572 8939 FAX 860 572 7569 DWG; p_5-2283 EMAIL Pennmft6docice.corrl Keith Neilson, Docko Incorporated 3/30/2012 12:00 PN Balcom_2.dwg N BOAT LIFT TO eE REFURBISHED 9 BRACED GUIDE PILE / To BE REraNED RETAIN EXSTiTNG \6 FT W DE PIER RETAIN EXISTING WAVE GUIDE PILE CLUSTER ATTENUATOR TO BE RETAINED i s REPAIR WAVE ATTENUATOR \ BOARDS AS NECESSARY EXISTING SUBMERSED \P11 Fs ` - PAN PFIRC? BY _ LADDER-REPLACE HAS OF -S S TOWN OF H _;. 5 6-FT WIDE PIER TO BE REPAIRED *�' PLACE MIDDLE STRINGER AND DATE JDA e, ` RE-SET DECKING EEL GRASSo l ° a DPOSED ELECTRIC UNE V 1 ,7 EDGE OF / EEL GRASS / APMEAN -1 -- PROXIMATE LOW WATER(ELEV. 0.0)� N8719OCrWy` 3 70.00 / _, d4 --2 ROCKY SHOREFRONT B \ HEAVY VEGETATION BOLT IN BOULDER S 549.51 2_— \ UPPER _ II iI NON-TURF BUFFER W 3047.00 COORDINATES — CME PLAN �/1 EW SURVEY:by GME ASSOCIATES ENGINEERING.LAND c4liAllW x42 I IN=W Fr SURVEYING 4.ARCHITECLIRE,PLLC 30 >5 0 30 PROJECT: PIER AND BOA7-IFT REPAIR LOCATION FISHERS ISLAND-TOWN OF SOUTHOLD A OF EN✓) SUFFOLK COUNTY,NEW YORK pa KE WATERWAY: EAST HARBOR fry y5 �. DATE: NOVEMBER 11,ton 9 Q C $ O +u APPLICANT: LUGILLEBALGOM w AGENT: SHEET 3 OF 4 DC)l INC. � ��4 A 068692 ��r l B.NihilL.PE O S gOFESS��NP MYstic,CT 06355 P 0 860 572 8939 FAX 660 572 7569 pWG p-5 2283 EMAIL wmNs®docko.wm Keith Neilson, Docko Incorporated 3/30/2012 12:11 PM Balcom_3.dwg BOAT LIFT MECHANISM TO BE REPAIRED cad RESTR A5 6-FT WIDE W0CV FIER TO BE REPARED INCLUDING DECKING and DECK 5TRLim REPAR/REPLACE SPUT CLAAS NECESSARY(TYP) APPARENT HIGH WATER LINE (-SPRING HIGH WATER)-ELEV 4 I APPARENT LOW WATER UNE ELEV 0..0 REPAJW REPLACE GR055BRACING AS NEGE5SARY(TYP) NOTE. GRADEAT END OF PER '.� TIE-0FF PLES NOT 394-0" FOR CLARITY 0F NEW END \/IEV\/ GRAPHIC SCALE 1 IN=30 FT 10 5 O 10 NOTE DECKING-NOT CGA TREATED, HARDWOODS MUST BE CERTIFIED BY FOREST STEWARDSHIP COUNCIL BOAT LIFT TO BE REPAIRED 0-FT WIDE PIER TO BE REPAIRED INCLUDING PILE REPLACEMENT,DECKING, APPARENTHIGH WATER LINE STRINGERS,DAMAGED WAVE ATTENUATION (SPRING HIGH WATER)ELEV 4 BOARDS,LADDERS AND BRACING AS NECESSARY AT BOTTOM OF STRINGERS APPARENT LOW WATER LINIF EL.5.8 ELEVO.O I iii lr lu BOTTOM SEDIMENTS SAND GRAVEL,AND BOULDERS Iit;.. I�IZOF=LLE �/IEW SURVEY: by GME ASSOCIATES ENGINEERING,LAND GRAD IC SCALE 1 IN=20 FT SURVEYING&ARGHRECTURE,PL-C 20 10D I PROJECT: PER AND BOATLIFT REPAIR NLOCATION: FISHER'5 ISLAND-TOWN OF SOUTHOLD �r SUFFOLK COUNTY,NEW YORK WATERWAY: EAST HARBOR DATE NOVEMBER 11,201 9 0 C X 0 # 9 * APPLICANT: LUCILIE BALCOM ,r rcc 2 AGENT: SHEET 4 OF 4 f _ 4 DOGKO ING. Keft B.Ndlson,PE SS10NMYstic.CT 06355 P 0 860 572 8939 FAX 860 572 7569 DWG 11-5-2283 EMAIL permVt @docko.wm Keith Neilson, Docko Incorporated 3/30/2012 12:24 PM Balcom_4.dwg