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HomeMy WebLinkAboutTR-4186 Special PermitBoard Of Southold' Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 4186. (.Special Permit) DATE: ...6.L2.4193 ......... ISSUED TO ........ BL~EPQ~S...CO .... lNG .... ................................ ntl nri atinn Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Soufhold Town Ordinance en- flfled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted afa r~eeting held on ..... 6 19. , and in consideration of the sum of $ ........... paid by of ......................................................................................... N. Y. and subject to the Terms end Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Special Permit 1:o place a 2' X 3' floating seed tray under~ the finger dock at Southold Park Dist. in Mattituck. To shellfish growth rates. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this dat, e. TRUSTEES John M. Bredemever. IIL President Albert J. Krupskk Jr., Vice President Henry P. Smith John B. Tuthill William G: Albertson Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Office Use Only: DATE REC.: Coastal Erosion Permit Application ' Coastal Erosion Variance Application Wetland Permit Application ' . Waiver from Chapter 97(ApPlicati0n/perm~)t Trustee Lands Permit APplication '~ ~¥ Grandfather Permit ApplicatiOn Completed Apps. Date: ' Inspection date: ' CAC comments-Date: Sent Rec. Variance Required: (Y/N) Neighbors notified-Date: SEQRA Type Coord.: Date sent SEQRA Determin./date: Public Hearing/date: Findings: Approved (Y/N) Special Conditions: (Y/N) (see file) Permit(s) issued-date: Application Fee: Application Number;SCTM~lO00- ~-~--I,~ Applicant: Address: Interest: Owner of Property: Address ~0~ ~ Date: { owner, consultant, lessee ~ etc. Phone Subject Property Location: (Provide LILCO Pole 9, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Page 1 Yds. to be excavated: ~ Yds. to be filled: ~t~ Manner in which material will be removed or deposited: Width of canal, creek or bay fronting property: ~ Depth at low tide: ~c Aver. rise in tide: ~ Distance to nearest channel: ~- Distance project extends beyond similar projects in area: ~ Area zoning: ~%~ Land area in acres~' ~ Is project for private or business use: ~~ Intended use of property: ~ Describe known prior operations conducted on premises: Has any prior, license or permit been issued to erect structures, dredge, or deposit fill on said premises: ~ Has any license or permit ever been revoked or suspended by a Governmental Agency: ~ l~ Project Description The project description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e., pipeline and septic system; make additional attachments if necessary). THIS IS NOT A PERMIT .PaEe 2 7' .. 1~-[6-4 {2/87~--Text 12 · '~;" l PR~)JECT LD. NUMBER Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by App"lica. nt or Proiect Sponsor} APPLICANT/SPONSOR 3. REJECT LOCATIOn- ~ ,~ ' ~ ' 4. PRECISE LOCATION (Street address aoa roaa intersections, prominent lanclmarks, etc., or provide mapJ o~ ~qiddle R~- - 5. IS PROPOSED ACTION: r-]New [] Expansion S. DESCRIBE PROJECT BRIEFLY: ~ Mod/f/cat/oh/alteration 7. AMOUNT OF LAND APFECTED: 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE REST,qlCTIONS? ~Yes [] NO If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICIN TY OF PROJECT? [] Residential [] !ndustnal [] Commercial Describe: [~Forest/ODen space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING..NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Iqo If ye~, llst agency(s) and permit/approvals ~ DOES ANy ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL.'/ ~ Ye~ ~No ~f ye~, iist agency name and permidapproval AS A RESULT OF PRO~ AG~ION WILL EXISTING PERMITIAPP~OVAL R~OU~E MODIFIGATION* ~Yes I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicanl/sPOnsor name: B[~ ,,~ ~,$ l~'~J*' ~ Coastal Assessment Form before proceeding with this assessment If the action is in the Coastal Area, and you are a state agency, complete the OVER 1 SEQF A. DOES~yesACTiON EXCEED~No ANY TYP~HRESHOLD~,.~ IN 5 NYCRR. PART 617.127. If yes. c~}na.,,,, o the review proces~ an~ u~e t~e ~U~~ ' B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UHLISTED ACTIONS IN 6 NYCRR. PART 617.67 " may be superseded by another involvea agency. II No, a negative aeclara~ C. COULD ACTION RESULT IN ANy ADVisE EFFECTS ASSOCIATED ~ITH THE FOLLOWING: (Answers may be handwritten, it leq~ble) Ct. Existing air qoallty, surface or groundwater quality or quantity, noise levels, ex,sting tranic patterns, 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 COmmumw or neighborhood Character?. Explain briefly: C,3. Vegetation or fauna, fish, shellfish or wildlife scenes, significant habitats, or threatened or endangered spemes? Explain briefly:. C5. Growth. s'~b~equeQ! d~elo~t,-~r re~ated~-~rcl~vities likely fo ~ reduced by'~he p~(~p~sed action.~ Exmain Dr:ally· C6. Long term, snort term, CUmulative, or omer elfecis not ~de~titied in C1-C57 Exolain briefly. C7. O[her imoac[s (inClUding changes re. use of either quanhly or type of energy)? Explain briefly. O. PS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain brieJly PART Ill--DETERMINATION OF SIGNIFICANCE [To be completed by Agency) - ~ INSTRUCTIONS: For each adverse effect identified aOove, determinewnether il is substantial, large, important or otherwise significant. Each eltect should be assessed in COnnection with its (a) setting (i.e. urban or rural); (b) probability ol OCCurring; (c) duration; [d) irr~vers b ly; [e] geographic scc 2e; and {f) magnitude. It necessary add attachments or referer__.e supporting materials. Ensure that explanations contain sufficient detail to ' show mat all relevant adverse Impacts have been degtdLe~ a,~,~ adre~.(&~gy addressed, [] Check this box if you have identified ohe or more Potentially large or sfgnificant adverse impacts which MAY ' occur. Then proceed directly to the FULL EAF and/or prepare a POsitive declaration. [] Check this box il' you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result JR any significant adverse environmental impacts AND provide on attachments a s necessary, the reasons supporting this determination: 2 County of Suffolk ) State of New York ) ' ~ BEING DULY SWORN DEPOSES AND AFFIRM~THAT HE/~H~ IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THA~ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT 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 SOUTHOLDAND THE TOWN TRUSTEES HARMLESS ANDFREE 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 ONTOMY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS ~/~ W©TARY PUBLIC State of New York Ne, 46~9585, Suffolk Cou~f DAY OF Su'ggested space for location Map THIS IS NOT A PERMIT MATTITUCK PARK DISTRICT P.O. BOX 1413 · MATTITUCK~ NEW YORK 11952 June 16, 1993 Board of Trust~ Town of Southold Main Road Southold Re: Shellfish Seed Raft in l~attituck Bi~ Use Pi )ecial Lane Very truly Madel ine Haas GROVfI~RS & SHIPPERS Qu~r.I~'Y SE~OOD SINCE 1888 TEL: (516) 589-0123 Atlantic Avenue FAX: (516) 589-1096 P.O. Box 8 West Sayville, New York 11796 June 7, 1993 Board of Town Trustess Town of Southold PO Box 1179 53095 Maifi~Rd SOUthold, NY 11971 Dear Sirs: Please include this Short En~ironmental Assessment Form with our application to place a shellfish seed raft at the Mattituck Park District dock area. Thank you. Sincerely, ~ Vice-President enc. __A Subsidary of... THE FIRST REPUBLIC CORPORATION OF AMERICA