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Home My WebLink AboutTR-1619 ~ ~-~ ~'.D uu~:~DS :.~USm ~-~r-,z ~ ....... ~.._~ ~ ~ .-~- . ................ ._ _ . .. .: -~ ..... ~ . ~,.,. ~ ~* ~ ....-, , ;/, ,< .~.. .. _ _ 5OU~HOLD, NEW YORK ~OO~Zt.:G ~0. N/A ' ':~=~"' PERMIT NO 1619 nZT~. June 13, 1983. ISSUED TO Ja~es Bitses "~':'; "~' "~ Pursu~nf fo f~e prov;s~cns o~ C~epfer 615 oF f~e Laws o~ fha Sfafe oF New Yor[, 1893; an~ Cha=fer 404 o~ fee Laws Sfafe o¢ New Yar~ I .... aha fha Soumo[d Town Or~[nanc~ LANDS UNDER TOWN WATm,~; and in accordance w;fh fha Resolufian of Th~ Boar~ ad · ' , ~,ea afa m~efMg het~ on -.~Z....3..,. ...... 19. 83, en~ ~n .... of fha sum of $ 67. 50' .. pa~a by .............................................. ~...~.~ ....................................................... ' of ......... Sou~aZ~.. . N Y ~n~ ' ~' -, ~.,. ' ........ ; .......................... SUD ~G~ TO T~e Terms .an~ Ccncmons Isle4 ~- *L .I, . ~ c~_zL' ~J m ~ . ~ ~,~ ~ne reverse s~de hereo~ ~,_ ~uuma~a ~own lruszees aufhorizes an~ ~er~[:- zk~ z_~ · ' does not go onto the wetlands,that the dock will .... a catwalk over the top of ths'wetlands, out into ~he water and no dredging - Dock i ' , +h~--:-' .: ,. .: ...... =,,-a specmcat OhS as oresenf~d ~n IN 9FITNESS WH .... OF, The said Board of lrusfees here- · by ceuses frs Cor~arefe Seal fo be affixed, and fhe suoscnoea by a ma[or[fy of ~e said Board as date. Board Of Southold Town Trustees SOUTHOLD, NEW YO~K MOOP. Ii.~G NO. N/A PERMIT NO ............ ..1.619 ..... ' DATE: ....... June...~..3,: 1983 ISSUED TO James Bitses I, in ~ , certify that the work as authorized ~,,_s permit has been ccmsle~ed and ~s no;¢ ready for your Cns~ec- .tion. Also, the number rec'~ired on th~ · - - - - I further und~st~n~ k~;~ --_ .~. ..~s ~rO3ect is cleartv visible. · - ......... - ~erm~= is not valid until IS reuurned to the T~ '~ =bls =ear sheet ~ us =ees. TER~S ,and CONDITIONS %-ne Permi~,~ James Bitses r~iding at Main Road, Southold part of the consideration for the i.sw,~ce of ~e P~t d~ ~de~d ~d p~ to ~e fol- lowing: 1. Tha~ %he Southold Trustees Permit must be prominently displayed on the premises effected thereby durin~ the period of 2~ ~Ha: ~e ~d ~ff of T~s ~d ~e Town of ~u~ofd ~ ~ed from ~ =d work ~ damages, or da~ for d~ag~, of ~ ad~g ~y or ~r~A~ adon ~rfo~d p~t to ~s ~ =d ~e ~d Pe~ ~ at ~ ~ her own a~ the defend any ~d MI su~ ~ ~t~ b~ third pa~, and ~e ~d Pe~ wi~ respec: ~ereto, to ~ ~mpl~e ~cl~ion of ~e ~=d of T~e~ of ~e Town of ~01dpe-mlC''' 3. That rhi~ Pe~: ~ ~d for a ~ of ~5~ ~ wM~ sufficient ~e r~uired to comDiete ~e work ~volv~ but should ~o~m~c~ w~ for ~ e~e~ion ma)' be ~de to ~e B~d at a later dam. 4. ~aat ~s Petit shoed be retaM~ ~def~tely, or as long to maintain the s~e or p~je~ involve, to provide e~dance to =)'o~e ~ncern~ a~- orkadon w~ ori~lly obt~ned. fi. ~at ~e work Mvolved wflI be mbj~ to ~e ~sp~on =d approv~ of ~e ~d or i= agents, and non-comFHance ~th ~e prov~io~ of ~e ori~ga~g appEmdo~ may ~ ~,,~e for revocation of this Pe~it by r~olufion of the said B~rd. 6. ~at there w~l he no ~r<sonable interf~ence wi~ na~don herein author~ed. 7. That ~ere shall ~ no ~tederence ~ the Hght of ~e ~bEe to p~s ~d rep~ ~oag ~he beach be~,eea high and low water 8.. Tha: H furore oper~io~ of ~e Town of ~old r~u~e ~e' r~oval ~d/or in the location of ~e work her~n au~o~ or ~, ~ ~e opi~ of work sh~ muse u~e~onable obs~on to free navigation, ~e s~d Peewee u~n due notice, to remove or alter ~is work or project herein stated of 9. ~ar ~e smd Board will ~ nodfi~ by the Peewee ox ~e c~pleffon of ~e work ~- o~ed. {See tear off sheet.) ~at the Permirzee will obt~a ali o~er perm and co~en= plement~ to ~is pe~t whi~ ~y ~ ~b]~ xo revoke upon f~e to LAW OFFII~S JAME~ EIIT~ EEl MAIN ROAD c~DUTHOLD, N.Y. 119771 77 6.'~-5 77 CIO November 26, 1984 Southold Town Trustees Main Road Southold, N. Yo 11971 Re: Bulkhead Permit Corey Creek Property _ARp.licant- James Bitses Gentlemen: I respectfully request an extension of the above bulkhead permit for an additional period of one year. This extension is necessary because the Department of Environmental Conserva- tion has requested a new survey for the subject property. The mere fact that this matter has been before the said department for eighteen months seems to be of no importance to the said department. Last month, out of the blue, they asked for a new survey. Accordingly I would appreciate it if you would kindly extend my permit for an additional year. Thanking you for your courtesy, I am JB: ~h Yours truly, ames Bitses BOARD OF TOWN TRUSTEES TOWN O1~ SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 January 2, 1985 Mr. James Bitses Main Road Southold, New York 11971 Re: Permit NO. 1619 Corey Creek, Southold Dear Mr. Bitses: Your recent request to extend the above referenced permit has been reviewed at the Trustee Meeting held on December 26, 1984. It was the consensu~ of the Board not to grant this extention; therefore, reapplication will be necessary. I have attached the necessary applications for your convenience. Very ~ruly yours, for Henry P. Smith, President Board of Town Trustees Attachment BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 1, 1984 TELEPHONE (516) 765-1892 Mr. James Bitses Main Road Southold, New York 11971 Re: Permit No. 1619 Dear Mr. Bitses: Your recent request to extend the above referenced permit has been reviewed at the Trustee Meeting held on April 26, 1984. Your request has been approved by resolution, adopted at this meeting, for a period of six months. Your permit will expire on December 13, 1984. This letter is an amendment to the origional permit and as such, shall be attached thereto. All other terms and conditions remain as written in the origional permit. Very truly yours, Henry P. Smith, President Board of Town Trustees HPS:ip cc: Town Clerk Trustees LAW ri FFll3ES dAMES BITSES // April 25, 1984 Trustees of Southold Town Town Hall Main Road, Southold, N. Y. 11971 Re: Dock Permit #1619 Gentlemen: I was issued the above permit on or about the end of May, 1983 and was advised that it had a one year duration. I have filed the necessary applications for a DEC and the Corps of Engineers. Some time ago the DEC replied stating that because of their workload the DEC permit for the dock would not be issued until some time this summer. Accordingly I respectfully request the permit which will expire at the end of May be extended for one full year so that we may accommodate the DEC workload. Thanking you for your courtesy, I am Yours truly, Bitses JB: ah BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 June 15, 1983 TELEPHONE (516) 765-1801 Mrs. Ruth Oliva N. F. Enviormental Council P. O. Box 311 Southold, New York 11971 Re: James Bitses Dear Ruth: As per our conversation on June 14, I have enclosed a copy of the recommendation that the Board of Town Trustees past on, to the Town Board, in reference to the aforementioned. Very truly yours, Board of Town ~rustees Ilene Pfifferling Clerk Attachment BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hail, $3095 Main Road P.O. Box 728 Southold, New York 11971 June 10, 1983 TELEPHONE (516) 765-1801 Mr. David DeRitter Department of Environmental Conservation Local Tidal Wetlands Permit Admin. Stony Brook, New York 11794 Dear Mr. DeRitter: The Board of Southold Town Trustees thought that ~he attached information would be beneficial to you, in reference to the DEC permits. Very truly yours, Board of Town Trustees Paul Stoutenburgh President PS/ip Attachments BOARD OF TOWN TRUSTEES TOI~7~I OF SOUTIfOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 4, 1983 COFY TELEPHONE f516) 765-1892 Mrs. Judith T. Terry Southold Town Clerk Southold Town Hall Southold, New York 11971 Dear Mrs. Terry: Transmitted herewith is the action taken by the Board of Southold Town Trustees at a regular meeting held on May 3, 1983: RESOLVED to recommend to the Southold Town Board approval of the application 9136 for a wetland permit submitted by James Bitses with the provision that the retaining wall is placed above the present MHW and that a catwalk goes across the meadow and there is to be no dredging. Very truly yours, Board of Town Trustees Paul Stoutenburgh President PS/ip BOARD OF TOWN TRUSTEES Town al $outhold ~%lain 'Road $outhold,+ New York ! 1971 ~¢OTIC~ OF ACTION - NOT A PEP~.~IT To: ........ J. fl4?~...~.}.~.¢.~ .... ~.a.~.g .Roa~.~. ~.outhold~ New York 11971 ]. ¥cur opplicati0n~ do,ed ..ADril..12.,...Lg.83 ..................................... h~- ~een reviewed ~y rhi~ Board, at c~ meeting of the Trustees held on ........ bla¥...2,.,...]~9~.3 ......................................................... and resultin~ in the action, as indicated be!ow: (.....xx..) ( ............ ) { ............ ) Application approved. Application denied. Application tabled. 2. Comments and remarks: Approved with the provision that the retaining wall does not go onto the wetlands and that the dock will be a catwalk over the top of the wetlands, out into the water, there is to be no:dredging/ Should the dock. go further out into the water than the 15' shown on the diagram, a fee of .25 will be levied per sq. ft., if additional pilings are used a fee of $5.00 per additional piling will be levied also. A PER,lIT FEE 3. !~ ~,c',:r ep~n is agD. r2..y_¢~~.rt.~,~ ~ no~e~, an~ :hou[d be mode to t~ order ~t the ~oard of Southoid Town Tru:rees. Th s fee ~s com~uted bela.,,/ accordinc ts ~h~Fhedffi~of R~LeS t~s sat forth in the gm~,uctio,, Chee~ t~rm /~', '~his , ~n= term t . ee ~s oo~o in person to the becrefc~'y at ~he ~oord, -J'he Permit will De cbi'aincoJe or ~he some *ime. I~ the 'fee is paid by moil, the permit wilt be moiied m realy. Computation of Permit Fee: 15' X 6' 6 pilings @ Dock = 90 sq. ft. @ .25 sq. ft.= $22.50 $5.00'per piling= 30.00 Total amount due $52.50 Total Fee far this application ..... , 52.50 Pres. Board a~ ~outhcld /awn Zrustee~. ~ ' .... ................... ........... BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 June I0, 1983 TELEPHONE (516) 765-1801 Mr. James Bitses Main Road Southotd, New York 11971 Dear Mr. Bitses: The Board of Town Trustees request that you notify them when you begin construction of your retaining wall and dock. This will make certain that there is no misunderstanding as to the location of the retaining wall. Our most sincere thanks, for your co-operation, in regard to this matter. Very truly yours, Board of Town Trustees Paul Stoutenburgh President PS/ip JUDITH T. TERRY TOWN CLERK REGISTRAR OF V1TAL STATISTICS OFFICE OF THE TOWN CLERK TO~N OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1801 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT Dated: May 24, 1983 Pursuant to Article 8 of the Environmental Conservation Law State Environmental Quality Review and 6NYCRR Part 617, Section_ 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Board, as lead agency for the action described below, has determined that the project, which is unlisted will not have a significant effect on the environment. DESCRIPTION OF ACTION Application of James Bitses for a Wetland Permit to construct a bulkhead, dock and dredge at The south side of Main Bayview Road, on Corey Creek, Southold, New York. The project has been determined not to have a significant effect on the environment for the following reasons: An environmental assessment has been submitted which indicated that no significant adverse effect to the environment are likely to occur should the project be implemented as planned. Because there has been a response, from the Board of Southold Town Trustees and Southold Town Conservation Advisory Council indicating that this project would not have a significant effect to the environment. Because there has been-nb response in the allotted time from the New York State Department of Environmental Conservation and the Southold Town Building Department, it is assumed that there are no objections nor comments from those agencies. Further information can be obtained by contacting Mrs. Judith T. Terry, Southold Town Clerk, Southold Town Hall, Main Road, Southold, New York 11971. Copies to: David DeRidder, DEC, Stony Brook Commissioner Williams, DEC, Albany Southold Town Building Department Southold Town Trustees/ Southold Town Conservation Advisory Council Town Clerk's Bulletin Board James Bitses A regular meeting of the Southold Town Conservation Advisory Council was held at 7:30 p.m. Tuesday, April 26th, 1983 at Southold Town Hall, Main Road, Southold. Present were: Frank Cichanowicz, Chairman John Tuthill Betty Wells Rachel Duell Robert Hood John Plock William Rutand On motion made by John Plock, seconded by John Tuthill RESOLVED to recommend to the Southold Town Board approval of the wetland application ~132 submitted by Philip J. Van Bourgondien to construct a platform, ramp and floats. Southold. On motion made by John Tuthill, seconded by Robert Hood RESOLVED to recommend to the Southold Town Board approval of the wetland application ~133 submitted by Enconsultants Inc. on behalf of Benjamin Kowalchuk to construct dock, catwalk, ramp and float. Peconic. On motion made by Rachel Duell, seconded by John Plock RESOLVED to recommend to the Southold Town Board approval of the wetland application ~134 submitted by The Land Use Company_on behalf of Robert Wendell to install timber bulkhead. Southold. On motion made by Rachel Duell, seconded by John Plock RESOLVED to recommend to the Southold Town Board approval of the wetland application ~135 submitted by The Land Use Company on behalf of Winds Way Building Corporation to construct bulkhead. Southold. On motion made by Frank Cichanowicz, seconded by John Tuth~ RESOLVED to recommend to the Southold Town Board disapproval of the wetland application #136 submitted by James Bitses to erect bulkhead, attach dock or dredge. Southold. The following comments were made by the Council: Rachel Duell - Don't feel that there is an erosion problem, whatever dredging done would fill in the existing wetlands. If we were to O.K. this it would set a bad precedent, there would be no way to undo it. The natural growth is holding back erosion. There is no valid reason for doing this. Frank Cichanowicz - The whole area on the East side (Corey Creek) is an important wetland area, very fragile we would not want any additional bulkhead in that area. Would like it to remain in its natural state. John Plock - The adjourning area is 100% wetlands and we should not allow anything to cover the wetlands. Nothing should be done but a walkway and floating dock. Robert Hood - If this is covered in its natural state you defeat the purpose. Destroying the existing wetlands where proposed bulkheading would exist would be elimating wetlands and therefore should not be done. Betty Wells r This property is nea~ and healthy and there are no signs of erosion, shouldn't be disturbed. John Tuthill - This is a perfect piece of wetlands, should not be endangered or destroyed. I see no indication of erosion in that area, for this reason we will not approve this application. On motion made by Frank Cichanowicz, seconded by Rachel Duell RESOLVED to recommend to the Southold Town Board approval of the wetland application #137 submitted by Charles Zahra & Alfred Grassklaus. to improve existing driveway and install retaining wall. Cutchoque. There are conduit pipes that lead from this property under-Eugene Road to Eugene Creed that are in very bad disrepair and this Council would like to write to the Town and the County to make sure these pipes are properly maintained and stay in good shape. Mr. Dean will be notified along with the Mosquito Control to check these pipes under the road. On motion made by John Plock~ seconded by John Tuthill RESOLVED to recommend to the Southold Town Board approval of the wetland application ~138 submitted by Edward R. Yanke to construct a dock with ramp and float. Southold. On motion made by Rachel Duell, seconded by'John Tuthill RESOLVED to recommend to the Southold Town Board approval of the wetland application ~139 submitted by Roger Stoutenburgh to build a dock. Cutchogue. On motion made by John Tuthill, seconded by Rachel Duell RESOLVED to recommend to the Southold Town Board approval of the wetland application ~140 submitted by Annette Golden and Nicholas Carnes to construct stone revetment. Excavated material will be used for backfill. Greenport. Respectfully submitted, Jane Moffatt, Secretary ~X J 3lain Road APPLICATION FOR A BULKHEAD. DIKE, OR JETTY 1. Does this pro.~ect involve the use of WETLANDS os defined in the Southo]d Town Wet!ands Ord nonce? YES or NO. If it does, you must file through the Town Clerk% Office. 2. Is the proposed work entirely within the boundaries of y. our own property as substantiated by your Deed or Survey? YES or NO. If it is, o Permit is NOT required from thb Board, but the Town Building Inspector should be contQcted For full details. 3. Applicant's name and address: ............ ,,T/~.i~q..~;imT. S~.~ ............................................................ ..... t~a-~ rt..Re a4.. ~ ht~h.oZkd.,...?j. ,X: ,..?.,l 9.73, ........................................... Tel 265:.-.~700 z.. Contro~'k)r's nome and address: ....... ,~,&r~.~g..~i:~..Qg~..Z,~ ............................................................ ........... R-i. ehrao~...~oa4..~ot;th~.q, ct~..~,.,Z.~..a,a,g.y3, ......... ~ .......... '[ .............. ?..e..Z...~.6..~._.2h9.7. ..... 5. Explain briefly the purpose of this application: ........................................................................ ........ ~..e..q.e....k.u..Z...v,.h..e...a..a....~.o....r..e.a.%..a.$:m.....e.~.o..q- .9~. Zana 4/3-~ ~ ) 6. After issuance of Permit,work must be completed within one year. I~ARGE 7. Secure the' correct Area Mop From the Clerk of this Bcar~, and by using a/ X WtTIqIN A C~RCLE as a mark, indicate as ctosetv as possible the location of this project. On the reverse side, provide-a SCALE DRAWING which will show Ordinary High Water Mark as well as the size and shape of the structure or work to be done~ Also include all dimensions for portions which extend offshore from the O. iq. W. M. State ~djacent properey owners. 8. Provide the follov~ing documents: A Licensed Engineer's Survey of the property involved. (b)A copy of the Contractor's Plan and Specifications. (c)Short Env±ronmentak Assessment Form. 9. Does this project extend into Town YVoters beyond an imaginary line or boundary formed by existing works of o similar nature along this area's shoreline?~r NO. If it does, state thee eparox mote distance beyond .... .Z..e.~.O. fk V/ill this constructior~ require the Filling of any [and offshore of the Ordinary High Water Mark or the Dredging of any material from Town Lands under woter?'~ 8~ ~ ~ If it does, Form, A/4 (Application for Dredging/Filling) must be completed and attached as part of this application, gplo!ioat:ion .2az' alT'edging go be a~;tachecl hez, e~:o In requesting approval of this application, I submit thor: the information presented herein is true and correct to the best of my knoMedge and belief; I am the person occuuntable for the performance of the work in accordance wilh the plans end soecfficatioos attached; I have read or am familiar with the orovisions of any SouthoJd Town Ordinance pertinent to the work involved; and further, ~ inten~ to adhere to and abide by the Terms and Conditions of the Permit, when and if issued to me. A/3 Rev. 2/82 L. 'S. I0. It. I~AME OF CREEK % BOAPd3 OF TOWN TRUSTEES Town 0£ Soufhold - llain Road Southold. New York 11971 APPLICATION TO DREDGE and or FILL 1. Does th s proje, ct~involve the use of WSTL}kNDS 0s define.d in the S. outho, ld .Town n WetJonds~ ;f'F_S'/or NO If it does, your application must be filed through the /own Off ice.' :. ~ ' ~',,~.~ ,/~//q~l~ ~--'~,-~. · a~d ~ant'~ ,~ame and address' .......~(...d~.../..,f./..' .... .,...umw..*. ............. : .... ............ ......... . . . . . . . ¢. . .:: .:. . z:. :. . : ...... . . . : ...... ...... ., 5. After issuance of Permit, work must b~ ~ompleted within one year. 6. Secure the correct Area Map from the Clerk of th,s Board, and by using a/X. WITHIN A CIRCLE as a mark, indicate as clearly !6s possible the location of this work, On th,e r,~,~?rse s de of this map, provide a SCALE DP, AWING which will show the Ord nary High' Water Mark and the size and shape of the s;i'ucture or Work. A dimensions offshore .'of the ' O. H. W. M. should also be shown and incluJe any free standing pilings which will remain at completion. State adjacent property owners. ' 7. Provide the following documents: (a) A Licensed Eng.ineer's Survey of the proper~y .involved. ~_~ (b) A copy of the. Contracto.r's P ~ns and Specif. ic~ipns.. _ Short Envzronmen~al ~ssessmen~ ~:anemen:., - s. s ....: . any previous opplicati0n for this work beeh denied ay any other government acjenc¥'? "'~?) ~ the 2 ~ · YES or/No./If it has-be,n, name ag.ncy. ......................................... ..... Date of denia. I ..~.'.."...:. ............................ 9. If dredging is contemplated, give your estimate of the following. : (a) Average depth of water at M. k. W.where dredging, ..~....'7/.~..]:~ · ft;" (b) Maxi.mum depth of dredging below the bottom,. ........... ; .......................................... ;L.. ft. (C) Maximum length of dredged area .: ......................... , ............................................ ft. (d) ' Maximum width of dredged area ........................................................ re) Maximum amount of matenat to be dredged ,.,...,.;..,.;.../~. .......... ;: ....... ,.. ,c. yd.. . (f_) Method and' location of dis, pos'a- Oz ctreacje ma~zerza-.' 10. l~ fi,ing is expected, give your estimate' ar the.:foilowin§: (a)' Maximum amount of material required,....: ......... -...~,~:;.;.!,.i ..... lb) Explain how fill will be obtained and where it will be placed. " 11. In requesting approval of this application, I subm t that: I am the persor% accountab e for' the .perfo.rman. ce o, th,e work rn accord w~th t~e plans and specifications attached heretQ.; I nave read or am familiar with the provisions of any Southold Town Ordinance pe~tiner~t to the work involved; and further, I intend t " ' o~aonere to and abide by the Terms and Canal tJons of the Permit. ' r A/4 Rev. 2/82 NA~-LE OF CP~EEK COREM CR~E~ BOARD OF TOWN TRLTSTEES Town Of Southold thlaln Road Southold, New York 11971 ALL DOCKS AND BufK:HEADS. MUST DISPLAY VISIBLE pEP, MiT NUMBERS APPLICATION FOR FIXED and "or FLOATING DOCKS 1. Applicant's nome and address: .............. ,.~.,Z~g..~zr. sn.~3~,.,q.v ......................................................... 2. Contractor's nome and address: ..... ?..4.?..~...~.~,..0..,~.~.~.~ .............................................................. B..zchmGnd no[~ Sg..g~ho. ld~ ~.A-~-~ 11921 Tei 6 -2 ........ : .................. ............... t .................................................................. ..... 3 Briefl exp] in th ur asa of this o lication' ·-~. Y !~/:)~O ~) p p . PP , ........... ~ ............................................................. ..... ..... ........ 4. After issuance of a Permit, work must be completed within one year, ~-~"~" - - I~A RGE ' (x 5./~ecure thee correct Area Map from the C. lerk of this Board, and by using aZx WITHIN ~ A CIRCL~ indicate os closely as possible the rocor[on of this dock. On.the..!everse s de of th s map, provide o SCALE DRAWING which will show Ordinary High Water Mark,' the shape and size of the dock end any supplemental pilings which are needed to hold a floating deck. or tie-ua n bent. Give all dimensions necessorv~to determine the area of the dock surface WiqICH EXTENDS~ OFFSHO~ fromm,the O. H. W. M. If adjacenc property owners have dock~-, specify loc~tion and !en~th to scale. 6. Will any port[on of this constrt]ction extend offshore into Town Waters beyond on imaginary ~ line or, boundary formed by other similar st,ructures along the areo's shoreline?: "' aY NO.~'yCc6') If it opes extend beyond this so<ailed doc:~ line indicate by how far, opproximate~r,. ....... fl'. ~ r 7 Provide the following documents' ~ (a) A L,censed Engineer s Survey of prooerry involved. ~ ~'~~b) A copy of the Contractor's Plans the and Specifications. (c) Short Environmental Assessment ~orm. .(.d) .Wetlands Application 8. Will this constructioh require t~e Filling of any lona offshore at the ~ary' High Water Mark or the Dredging of any material, from Town Lands under water?/~ES)or NO. if it does, Form A/4 (Application for Dredging/Fihing) must be completed and ot~'f~ as port of this application. 9. In reouesting approval of this application, I sub.it that: the information ~'resented herein is true and correct to the best of mv knowledge and belief; I om the oerson accountable for the performance of ~he work in accordance with the plans and specifications attached; I hove read or am fomiiior with the provisions of any SoothoJd Town Ordinance pertinent to the work involved; and further, I intend to adhere to and abide by the Terms and Conditions of the ~ Permit, when and if issued ro me. ' .29 ..-.'-...¢::;..'.. ...... '.. Y ' g eraporary marker£ TOWN OF $OUT'I:IOLD SHORT ENVIRONMENTAL ASSESSi'~{ENT FORM }NSTRUCTIONS: (a) In order to answer the questions in this short EAF it is assume that the preparer will use currently available information concerning the project and the likely impacts of the action. It is not expected that add£tionai studies, research or other investigations will be undertaken. (b) If any question has been answered Yes the project may be significant and a completed Environmental Assessment Form is necassary. (c) If all questions have been answered No it is likely that this project is not sign&ficant. (d) E~vironmentol Assessment 1. WiL~ projec¢ ~esu~t in a large physical change to the p~oject site or phys±ca~ly alte-r more than lO acres of land? ........................ Yes × No 2. Will the~e be a major change to any unique or -unusual land form found on the site? .......... Yes ~ No 3, Will project alter or have a large effect on exis%ing body of water? ....................... . Yes ~ No 4. Will project have o potentially large impact on groundwater quality? Yes X:No 5. Will project signiffcantly effect drainage flow on od3ocent sites? ........ % ............... Yes X No 6. Will project affect any threatened or endangered plant or animal species? ........... Yes X No 7. Will project result in o major adverse effect on air quality? ............................... Yes X NO 8. Will project have o major effect on visual character of the community or scenic views or vistas knosvn to be important to the community? Yes No ~. Will project adversely impact any site or structure of historic, prehistoric or paleontological importance or any site designated as o critical environmental oreo by a local agency? ............. ~..-v~.v-.-~-.v-;..v. Yes X No 10. Will project have a bajor effec~ on existing or future recreational opportunities? ......... Yes X No 11. Will project result in major traffic problems or cause a major effect to existing transportation syslem's? ....................... . Yes X No 12. Will project regularly cause objectionable odors, noise, Glare, vibration, or electrical disturbance as a result of the project's opera.tion? .................................... Yes X No 13. Will project have any impact on public health or.safety? ..................................... Yes X No 14. Will project affect the existing community by directly causing o gro%vth in permanent popul6t'ion of more than 5 percent over a one year period or have a major negative effect on the character of the community or neighborhood? ................................. Yes ~ No 15. Is there public controversy concerning the project? ..................................... ~ Yes X No PREPARER'S SIGNATURE REPRESENTING Goose 'Creek