HomeMy WebLinkAboutBORNSCHEIN, GEORGEFRANK A. KUJAWSKI, JR., President
ALBERT J. KRUPSKI, JR., Vice-President
JOHN M. BREDEMEYER, III
JOHN L. BEDNOSKI, JR.
HENRY P. SMITH
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
June 27, 1988
TELEPHONE
(516) 765-1892
Mr. George W. Bornschein
1750 Stevens Ave.
North Merrick, New York
11566
Re: Waiver- 1000-136-01-044
Dear Mr. Bornschein:
The following action was taken by the Board of Town Trustees regarding
the request for a Waiver of the Wetland Ordinance for the construction to be
done on your residence located at 560 Oak Street, Cutchogue.
RESOLVED that the Southold Town Trustees approve the request for a Waiver
of the Wetland Ordinance for the construction of two 507 additions to the back of
property located at 560 Oak Street, Cutchogue, all in accordance with the plan
submitted. --~
Please be advised that th'ere is a $25.00 fee for this waiver due at this
time.
Very truly yours,
~rank A. awski, Jr.
President
Board of Town TrusTees
FAK: ip
cc: Bldg. Dept.
file
TELEPHONE
[516~ 765-1801
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
SOUTIIOLD TOWN
CONSERVATION ADVISORY COUNCIL
To: Southold Town Trustees
From: Southold Town Conservation Advisory Council
Dated: June 22, 1988
Re: Wetland Application Recommendations
The following recommendations were made by the CAC at its regular
meeting held Thursday, June 22, 1988:
No. 625 - Clifford Eginton - Recommend disapproval. No major
need is shown, CAC suggests applicant revegetate the
slight problem area.
No. 628 - Anthony Panzarino - CAC divided the application into
parts A and B. It recommends approval of Part A which
is to repair existing deck; constuct a timber dock
with a fixed elevated walk; hinged ramp; float; and
construct an additon ot w/s of beach house.
The CAC recommends disapproval of Part B which consists
of a retaining wall with returns; backfilling; additions
to existing wood decks; construct concrete pads on
n/s of beach house. The CAC feels that the applicant
has shown no need for the retaining wall and additional
deck would be too close, and as a result wetlands would
filled. The land is stable, further work would destroy
wetlands.
No. 629 - Linda Wilton- Recommend:disapproval. Property is wetlands.
Check for possible violation.
No.
Andrew and Bernice Lettieri - Recommend disapproval.
Not enough space for prosposed project, presents a
navigational hazard.
Recommend approval of Waiver Requests of Henry Smith, Joseph
Policano, George W. Bornschein, Venetia McKeighan and
Jon Mulholland.
~roadwater.
-o~i~
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hail, 53095 Main Road
P.O. Box 728
Southold, New York 11971
TELEPHONE
[5161 765-1892
APPLICATION IS HERESY MADE TO THE TOWN TRUSTEES OF THE TOWN OF
SOUTHOLD, SUFFOLK COUNTY, NEW YORK FOR THE ISSUANCE OF A PERMIT
'PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE
COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS
OF THE TOWN OF SOUTHOLD, AND THE ISSUANCE OF PERMITS PURSUANT
TO CHAPTER 32 OF THE CODES OF THE TOWN OF SOUTHOLD.
APPLICATION NO. DATE OF APPLICATION
PHONE NO
ADDRESS OF APPL I CANT.J_7__~_C2_- ~._~._~_~_~__~__A~__~) ~__.(~_~_~_.__~'/'~ ~ ~C~--__6~_~ ....
LJ_~6~
AGENT
PHONE NO.
HOME ADDRESS OF PERMIT APPL ICANT IF DI FFERENT FROM AFORESAID LOCATION
_] ~o__~r~~_~_y~v_(__3 /go./~ 6 ~ ~, c~, _M__Y_!/.c6 ~
LENGTH _.~_ ~
WIDTH
DEPTH BELOW LOW WATER
YARDS TO BE EXCAVATED
YARDS TO BE FILLED
WIDTH OF CANAL. CREEK OR BAY FRONTING PRCPERTY
!
DEPTH AT LOW TIDE
DISTANCE TO THE NEAREST CHANNEL
FT.
DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE AREA
.IS THIS FOR PRIVATE OR BUSINESS USE?_____ q~ ~"~. .....
AREA ZONING .i~___ ~_~_~ [ ~ ~___~_T~_~
MANNE~ IN WHICH MATERIAL WILL BE ~EMOVED O~ DEPOSITED
DESCRIBE ANY KNOWN PRIOR OPERATIONS CONDUCTED ON THE PREMISE
AND WHETHER ANY PRIOR LI CENSE OR PERMITS HAVE BEEN ISSUED TO ERRECT
STRUCTURES OR TO DREDGE OR DEPOSIT FILL ON SAID PREMISES AND WHETHER
ANY PERMITS OR LICENSES WERE EVER SUSPENDED OR REVOKED BY A GOVERNMENTAl
$o,,,r~_kL!~_~_i?e~ ' " " " - m" l___ ~o~ /~- ~- ~_
DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE
P~EMISES AFTE~ THE ~ORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF
WRITTEN CONSENT OF THE OWNER OF THE PROPERTY, I F NOT THE SAME AS THE
APPLICANT.
ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD
PROHIBIT THIS PROJECT?
t4-16-2 (2/87)-- 7c
617.21
Appendix A
State Environmental Quality Review
FULL ENVIRONMENTAL ASSESSMENT FORM
SEQ:
Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a projec
or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequem
ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determin
significance mav have little or no formal knowledge of the enwronment or may be technically e.xpert in environmenta
analysis. In addition, man'/who have knowle(~ge in one particular area may not be aware of the broader concerns affectin
the question of significance.
The fu I EAF is intended to provide:a method whereby al~pJicanfs ah~l:a~&n~ik~k,~,be assured that the determinatio~
process has been orderly, corn prehensive ir~ nature, yet flexible to allow introduction of information to fit a project or action
Full 'EAF Components: The full EAF-is ~co'mpris'ed'~f ;tfiree parts:
~art 1: Provides objective data and inform,~tion- ~bbut ~ gi~/en:prbj~/~t:and i~si~e. 'B~/'i~dttfying basic projec
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 th~ ma,/occur fr(~m a pr(~je~:t or action. It provide:
guidance as to whether an impact is likely to be considered small t9 moderate o~';~.hether it is a potentially
large impact. The form also identifies whether an impact c;~h be ~,~tig~ted 'of reduced
Part 3: If any impact in Part 2 is identified as potent a Iv-large, then Part 3 is used to evaluate whether or not th(
imF~act is actually ~mportant.
DETERMINATION O[~'$1G~I~=IC-~N~I~--Typ~e,1· and Unliste! Actions
Idenfi~yI the P~.r~ion~ o'f~,.E,AF ~:om'p4.eted;f~r thi~ pro,~ect'~::-~3, ,:"~ ',Pa~t i ~ [:}' ~P~f::2 ': :~' []Part 3
Upon review of the informatio~ recorded on this EAF (Parts 1 and 2 and 3 ~f appropriate); andr a;ny~other supporting
information, and considering both the magitude and importance of each impact, it is reasonablv determined by the
lead agency that:
A The prciect will not result in any large and Important impact(s) and. therefore, is one which will not
have a s~gniticant mpact on the environment, therefore a negative declaration will be prepared.
~. 13. 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 h ave been required,
therefore a CONDITIONED negative declaration ~ill be prepared.*
[] C. The project may result in one or more largeand important impacts tha~ may have a significant impact
on the environment, therefore a positive ~leclaration will be prepared.
' A Condit Dned Negative Declaration is only valid for Unlisted Actions
Name of Action
Name of Lead Agency
Print or Tvoe Name of Resoonsible Officer nLeadAgency,
Signature of Responsible Officer ~n Leao Agency
Title ot Responsible Otricer
Signature ol Preparer f f different from responsible officer)
Date
1
PART 1--PROJECT INFORMATION ·
Prepared Dy Project Sponsor
NOTICE: This document is designed to assist in determinin8 whether the action proposed may have a significant ef
on the environment. Please complete the entire form, Parts A throu§h E Answers to these questions will be consid~
as part of the application for approval and may be subject to further verification and public review. Provide any additi¢
information you believe wil be needed to complete Parts 2 and 3.
It is expected that completion of the full EAF will be dependent on informatio~ currently available and will not inv(
new studies, research or investigation. If information requinn§ such additional work is unavailable, so indicate and spe
each instance.
NAME OF ACTION
LOCATION OF ACTION(include Street Address, Municipality and County)
ADDRESS
BUSINESS TELEPHONE
CITY/PO
ZIP CODE
¢
NAME OF OWNER Jif different)
BUSINESS TELEPHONE
(
ADDRESS
CITY/PO
STATE ZiP CODE
DESCRIPTION OF ACTION
gt. .
oF oF NoOsE' AbbtAJ
Please Complete Each Question-Indicate N.A. if not applicable
A. Site Description
Physical setting of overall project, both developed and undeveloped areas.
1. ?resent land use: V1Urban l~lndustrial ~]Commercial ]~esidential ~suburba~) l~Rural (non-fa
I~Forest E~Agriculture r~Other
2. Total acreage of project area: ~)A acres.
APPROXIMA~TE ACREAGE PRESENTLY AFTER COMPLETION
Meadow or Brushland (Non-agricultural) acres acres
Forested acres acres
Agricultural (Include.s orchards, crcoland, pasEure, etc.) acres acres
Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres - acres
Water Surface Area acres acres
Unvegetated (Rock, earth or fill) acres acres
Roads. buildings and other paved surfaces acres acres
Other (Indicate type)_ acres acres
3. What ~s predominant soil type(s) on project site?
a Soil drainage: ~Well drained ! I~{~ % of site ~Moderately well drained % of site ·
~Poorlv drained % o[ site
b. If any agricultural land is revolved, how many acres of soil are classified within soil group 1 through 4 of the N
Land Classification System,( acres. {See I NYCRR 370).
4. Are there bedrock outcro:)pmgs on project site? ~]Yes '~No
a. What ig depth .to bedrock? ~in feet)
2
5'. 'Approxima~te percentage of ~fbposed project site with slooes: [0-10%~' % [10-15%
~' ~J~,15% or greater %
6. Is aroject substantially contiguous to, or contain a building, site, or district, listed on the State or the Nationa
Registers of Historic Places? I~Yes
7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? I~Yes
8. What is the depth of the water table? ~i~ [in feet)
9. Is site located over a primary, principal, or sole source aquifer? ii-lYes ~No
10. Do hunting, fishing or shell fishing opportunities oresently exist in the project area? ~Yes
11. Does project site contain any ~s'Decies of plant or animal life that is identified as threatened or endangered
[]Yes ~o According to
Identify each species
12. Are there any unique or unusual land forms on the project site? li.e., cliffs, dunes, other geological formations
~Yes ~,No Describe
13. Is the pro'ect site presently used by .the community or neighborhood as an open space or recreation area
[Yes ~]No f yes, explain~,,,~
14. Does the present site include scemc views known to be important to the community? I-lYes ~JJ~No
15. Streams within or cont,guous to project area: ~/~I~
a. Name of Stream and name of River to which it is tributary
16. Lakes, ponds, wetland areas within 9r conti~uous to project area:
17. Is the site served by~xisting public util ties? ~,Yes [No
a) If Yes, does sufficient cap-acity ekist to allow connection? ]~,Yes [No
b) If Yes. will improvements be necessarv to allow connection? [Z]Yes ,~No
18 [s the site located 'n an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA
Section 303 and 304? r3Yes [No
19 Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8
of the ECL. and 6 NYCRR 6177 [~Yes
20. Has the site ever been used for the disposal of solid or hazardous wastes? F1Yes ~No
B. Project Description
1. Physical dimensions and scale of project (fill in dimensions as appropriate}
a Total contiguous acreage owned or control ed by project sponsor
b. Proiect acreage [o be develope~: acres initially;
c. Project acreage to remain undeve!oped acres.
d. Length of pro~ect, in miles: ~'lf appropriate)
e. If the prolect'is an e~Dansion, indicate percent of expansion proposed --
.f. Number of off-street parking spaces existing proposed
g. Maximum vehicular ~rlps generated per hour (upon completion o~ proie~:t)?
h. If residential: Number anu typ~ of hoLsmg uni:s:
One Family Two Fami y Multiple Family
UltJma[:elv t ~
I. Dimensions (in feet) of largest proposed structure2,~':~O' height; :2-~" width:
j Linear feet of frontage along a public thoroughfare project will occupy i~?
3
acres
acres ultimately.
?'~ "~ ' length.
ft.
Condominium
2. How much natural mat'4fffa (i.e.. rock earth, etc.] will be removed from the site? ~
3. Will disturbed ~reas be reclaird~ed? E]Yes [2]No ~,N/A
a. If yes, for what intend_,; purpose is the site~being reclaimed?
b. Will topsoil be stockpiled for reclamation? E]Yes I-TNo
c. Will upper subsoil be stockpiled for reclamation? E3Yes FqNo
4. How many acres of vegetation (trees, shrubs, grouna~vers) will be removed from site? &)~ acres.
5. Will anv mature f~)rest (over 100 years o]d) or other locally-important vegetation be removed by this project?
FIYes ~4o . .
6. If single phase project: Anticipated period of construction ~'
7. If multi-phased:
a. Total number of phases anticipated (number).
b. Anticipated date of commencement phase 1
c. Approximate completion date of final phase
d. Is phase 1 functionally dependent on subsequent phases?
8. Will blasting occur during construction? I-lYes ]~ii~No
9. Number of jobs generated: during construction /am
10. Number of jobs eliminated by this project /~/J~
11 Will project require relocation of any pY~,j'ei:ts or facilities?
months, (including demolition).
tons/cubic yards
month year, (including demolition).
month year..
I-lYes I-]No-
; after project is corrplete
[]Yes ~No If yes, explain
12 Is surface liquid waste disposal involved? IX]Yes
a. f yes, indicate type of waste (sewage, industrial, etc.! and amount
b. Name of water body into which effluent~will be.dfsch~rged
13 Is subsurface liquid waste disposal involved?~ EEYes j~No Type
14 Will surface area of an existing water body increase or decrease bv proposal?
ExPlain
[~Yes IZJNo
15. Is project or anyportion of project located in a 100 vear flood plain? ~Yes
16. Will the project generate solid w~,ste? FqYes ~]No
a. If yes, what is the amount per month tons
b. If yes, will an existing solid waste facility be used? IZ]Yes I~No
c. If yes, give name ; location
d. Wil any wastes not go into a sewage disposal system or into a sanitary landfill?
e If Yes, explain
/~No
E~Yes ~No
17. Will the project involve the disposal of solid waste? EE]Yes ' ~]No
a If ,/es, what is the anticipated rate of disposal? tons month.
b If yes, what is the anticipated site life? years
18 Will prolect use h~:rbicides or pesticides? FlYes )!0No
19 Will project routinely produce odors (more than one hour per day)? F1Yes
20. Will project Droduceoperating nmse exceeding the Ioca ambient noise levels?
21. Will prolect result in an increase in energy use? [Yes
If ves. indicate type(s)
XNo
[Z]Yes
J~JNo
22. If water supply is from wells, indicate pumping capacity /J~
23. Total anticipated water usage per day /~/~ gallons/day.
24. Does'project involve Local, State or l~de?~:l: funding? [Yes
If Yes, explain
gallons,, minute.
25.'~pprovals Required:
City, Town, Village Board j~Yes []No
City, Town, Village Planning Board t-lYes E}No
City, Town Zoning Board ~,Yes E3No
City, County Health Department I~Yes ~lNo
Other Local Agencies E3Yes F-INo
Other Regional Agencies []Yes E3No
State Agencies ~Yes [No
Federal Agencies E:]Yes '[]-]No
Type
Submittal
Date
C. Zoning and Planning Information
1 Does proposed action involve a planning or zoning decision? ~;]Yes_ E]No _
[f Yes, indicate decision required:
I--Izoning amendment j~oning variance E3special use permit E]subdivision
l-lnew,rrevision of master plan []resource management plan l-'lother
2. What is the zon.ng classification(s)of the site?
plan
3, What is the maximum potential development Of the site if developed as permitted by the present zoning?
4. What is the proposed zoni6g of the site? ,~i~14,~'
· 5. What is the maximum potentia development of the site if developed as permitted by the proposed zoning?
6 Is the proposed action consistent with the recommended uses in adeoted local land use plans? ,~Yes
7 What are the predominant land use(s) and zoning classificatior, s within a ~,4 mi e radius of proposee action?
8. Is the proposed action compatible with adjoining/surrounding land uses within a ~A mile?
9. [f the proposed action is the subdivision of land, how many lots are proposed?
a. What is {he minimum lot size proposed?
10. Wil proposed action require any authorization(s) for the formatio~ of sewer or water di3tricts?
~Yes
[Yes
11 Will the proposed action create-a demand for any community provided services (recreation. education, potic
fire protectior~)? ~Yes ~No
a. If yes, is existing capacity sufficient to handle projected demand? E~Yes [No
12. Will the 0roposed action result in the generation of traffic significantlv above present levels? I~Yes ~N
a. If yes, is the existing road network adequate to handle the additional traffic? [Yes [No
D. Informational Details
Attach anv additional information as may be needed to clarify your project. If th.ere are or mav be a~v advers
~mpacts associated with ,/our proposal, please discuss such Imoac~s and the measures which you propose to mitigate
avoid them.
E. Verification
I certify that the information provided above is true to the best of mv knowledge.
If the action Is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceedin
with this assessment.
5
.~r-~. rt 2--PROJFCT IMPACTS AN~,_~HE]R ~IAGNITUDF:.
Responsibility of Lead Agency '
General Information (Read Carefully)
· l~;~9~'~!~?g-'d~'~°~m,,';i,t, he;re~,k~g~et,~ould be guided ~by the question: .Have my responses and determinations be
reasonabl~.~ The reviewer is not expected to be an expert environmental analyst.
· Identifying that an imp,~ct wil. l be, potentially large (column 2) does not mean that it is also necessarily significan
Any large impact m~j~t [~e-~:[d~te~l in PART 3 to dete}mine significance· Identifying an impact in column 2 simF
asks that it be looked at further.
· The Examples provided are to assist the reviewer by showing types of 'mpacts and wherever possibie the threshold
magnitude that would trigger a response in column 2. The examples are generally applicable'tHroughout the State a~
for most situations. But. for any specific project or site other examples and/or lower thresholds may be appropria
for a Potential Largb, I;~p'a,c,t.,¥esp~hS~, thus requiring e~;aluation in Part 3.
· The impacts of each project, on each site, in each locality, will vary. Therefore. the examples are illustrative ar
have been offered as guidance· They do not constitute an exhaustive list of impacts and thresholds to answer each questic
· The number of examples per question does not indicate the importance of each question.
· n identifying impacts, consiSbr long term, short term and cumlative effects. ~ _
Instructions (Read carefully)
a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact.
b. Maybe answers should be considered as Yes answers. -
f answering Yes to a~,q,u~es~"o.n th~ti~h, eck'~'~'appropriate box (co]utah 1 or 2) to indicate the potential size of tf
impact. If impact thr~sh'oid ~qua'l~ ~r exceeds any exam pie provided, check co] umn 2. If impact will occur but thresho
is lower than example, check column 1.
d. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART
e. If a potentially large impact checked in c0tuPnn2,can be mitigated by change(s) in the project to a small to modera:
impact, also check {he Yes box in column 3. A No response indi:ates that such a reduction is not possible. T~
must be explained in Part 3.
IIViPAOT ON LAND
1 Will the proposed action result in a physical change to the project site?
E}NO .~YES
Examples tha~ would apply to column 2
· Any construction on slepes of 15% or greater, (15 foot rise per 100
foot of length), or where the general slopes in the project area exceed
10%
· Construction on land where the depth to the water table is less than
3 feet.
· Construction of paved parking area for 1,000 or more vehicles.
· Construction on land where bedrock is exposed or generally within
3 feet of existing ground surface.
· Construction that will continue for more than 1 year or Involve more
than one phase or stage.
· Excavation for mining purposes that would remove more than 1.000
tons of natural material (Le., rock or soil) per year.
· Construction or expansion of a sanitary landfill.
· Construcuo~ m a des]gnat-ed floodway.
· Other ~mpacts
Will there oe an effect t.'. .... ~v umque oi~.u,~u~ ,~.,a/,lhndt:fb~:rms t~ound
the site?. .¢ . ~(i'e",~, ~'c!'i f~s, dun,es,,: -, ~.ge°lpgical~, ~ . format on~. ~et.c.~Q .
Specific and forms:
6
I 2 3
Small to Potential Can Impact B~
Moderate~ · ,Large Mitigated By
· 'l~A'(~t': ':l;mpact Project Chang,
[] [] I~Yes [~No
[] [] E~Yes' ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ' ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
IMPACT ON WATER
3. Will proposed action affect any water body designated as protected?
(Under Articles 15, 24, 2.5 of the Environmental Conservation Law, ECL)
,J~NO F1YES
Examples that would apply to column 2
· Developable area of site contains a protected water body.
· Dredging more than 100 cubic yards of material from channel of a
protected stream.
· Extension of utility distribution facilities through a protected water body.
· Construction in a designated freshwater or tidal wetland.
· Other impacts:
4 Will 3roposed act on affect any non-protected existi~or new body
of water? )~NO I-lyES
Examples that would apply to column 2
· A 10% increase or decrease in the surface area of any body of water
or more than a 10 acre increase or decrease.
· Construction of a body of water that exceeds 10 acres of surface area.
· Other impacts:
5. Will Proposed Action affect surface or groundwater
quality or quantity? XNO []YES
Examples that would apply to column 2
· Proposed Action will_require a discharge permit.
· Proposed Action requires use of a source ot water that does not
have approva to serve proposed (proiect) action.
· Proposed Actio~ requires water supply from ~ells with greater than 45
gallons per minute pumping capacity.
· Construction or operation causing any contamination of a water
supply system.
· Prooosed Action will adversely affect groundwater.
· Liquid effluent will be conveyed off the site to facilities which presently
do not exist or have inadeoua[e capacitv.
· Proposed Action would use water in excess of 20,000 gal]ohs per
day.
· Proposed Action will like(',, cause si]ration or other discharge into an
existing body of water to the extent that there will be an obvious visual
contrast to natural conditions.
· Proposed Action will require the storage of petroleum or chemical
products greater than 1.100 gallons.
· Proposed Action will allow residential uses in areas without water
and/or sewer services.
· Proposed Action locates comr:.ercial and/or industrial uses which mav
requwe new or expansion of ex sung waste treatment and/or storage
facilities.
Other impacts: .....
6. Will prooosed action alter drainage fh;w or ~}atterns, or
water runoff? ~,~NO
Examples that would apply to column 2
· Proposed Aobon would change flood water flows.
7
surface
.~ ES
1 2 3
Small to Potential Can Impact
Moderate Large Mitigated E
Impact Impact Project Char
[] [] []Yes
[] [] []Yes
[] [] []Yes []t'
[] [] F-lYes
[] [] []Yes []I'
[] [] . E~]Yes
~ ~ ~Yes
~ ~ ~Yes
~ ~ ~Yes
~ ~ ~Yes ~N
~ ~Yes ~N
~ ~ ~Yes ~N
· Proposed Action may cause substantial erosion.
· Proposed Action is incompatible with existing drainage patterns.
· Proposed Action will allow development in a designated floodway.
· Other impacts:
IMPACT ON AIR
7. Will proposed action affect air quality? ~NO l-lYES
Examples that would apply to column 2
· Proposed Action will induce 1,000 or more vehicle trips in any given
hour.
· Proposed Action will result in the incineration of more than 1 ton of
refuse per hour.
· Emission rate of total contaminants will exceed 5 lbs. per hour or a
heat source producing more than 10 million BTU's per hour.
· Proposed action will allow an increase in theamount of land committed
to industrial use.
· Proposed action will allow an increase in the density of industrial
development within existing industrial areas.
· Other imoacts: '~
IMPACT ON PLANTS AND ANIMALS
8. Will Proposed Action affect any threatened or endan, gered
species? ~'NO [Z]YES
Examples that Would apply to column 2 \
· Reduction of one or more species listed on the New York or Federal
list, using the site, over or near site or found on the site
· Removal of any portion of a critical or significant wildlife habitat.
· Application of pesticide or herbicide more than twice a year, other
than for agricultural purposes.
· Other impacts:
9 Will Proposed Action substantially affect non4hreatened or
non-?ndangered species? ~]NO r~YES
Examples that would apply to column 2
· Proposed Action would substantially interfere with any resident or
m~gratory fish, shellfish or wildlife species.
· Proposed Action requires the removal of more than 10 acres
of mature forest (over 100 years of age) or other local v important
vegetabon.
IMPACT ON AGRICULTURAL LAND RESOURCES
10 Will the Proposed Acbon affect agricultural land resources?
-' ,/~NO []YES
Examples that would apply to column 2
· The proposed action would sever, cross or limit acce-ss to agricultural
Mhd (includes crooJand, hayfields, pasture, vineyard, orchard, etc.)
Small to
Moderate
._ Impact
2
Potential
Large
Impact
[] [--[Yes
[] I-lYes
[] ~Yes
[] - I-lYes
Can Impact Be
Mitigated By
Project Change
[-1No
I--INo
[-INo
[-'[Yes I-1No
IT]Yes [-]No
['-[Yes l=lNo
l--lYes [-INo
I--lyes I-[No
[~]Yes I-[No
[] []Yes ~]No
[] [~]Yes I-]No
[] I-lYes [~No
[] [~]Yes [~]No
[] []Yes
[] []Yes [~No
[] []Yes I-[No
· Construction activity would excavate or compact the sol ;rofile of
agricultura land.
· The proposed action would irreversibly convert more than 10 acres
of agricultura land or, if located in an Agricu]tutal District. more
than 2.5 acres of agricultural land,
· The proposed action would disrupt or prevent installation of agricultura[
land management systems (e.g., subsurface drain lines, outlet ditches,
strip cropping); or create a need for such measures [e.g. cause a farm
field to drain poorly due to increased runoff}
· Other impacts:
IMPACT ON AESTHETIC RESOURCES
11. Wiil proposed action affect aesthetic resources.~ ~]NO []YES
(If necessary, use the Visual EAF Addendum in~ection 617.21,
Appendix B) .
Examples that would apply to column 2
· Proposed land uses, or project components obviously different from
or in sharp contrast to current surrounding land use patterns, whether
man-made or natural.
· Proposed IEnd uses. or proJect components visible to users of
aesthetic resources which will eliminate or significantly reduce their
enjoyment of the aesthetic qualities of that resource.
· Project comoonents that will result ih the elimination or s~gnificant
screening .of scenic views known to be important to the area.
· Other mpacts:
IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES
12. Will Proposed Action impact any site or structure~o~f historic, pre-
historic or paleontological importance? J~JNO []YES
Examples that would apply to column 2
/\
· Proposed Action :occurring wholly or partially within or substantially
contiguous to any facility or site listed on the State or National Register
of historic places.
· Any impact to an archaeological site or fossil bed located within the
project site.
· Proposed Action will occur ~n an area designated as sensitive for
archaeological sites on the NYS Site Inventory.
· Other impacts:
IMPACT ON OPEN SPACE AND RECREATION
13~ Will Proposed Action affect the quantity or quality of existing or
future open spaces or recreational opportumties.~
Examples that would apply to column 2 ~;~NO [YFS
· The permanent foreclosure of a future recreational opportuhitv.
· A major reduction ot an open space ~mportant to the community.
· Other impacts:
1 2 3
Small to Potential Can Impact
Moderate Large Mitigated By
Impact Impact Project Chang,
[] [] E~]Yes i-'~ No
[] [] [-qYes I"-J N o
[] [] ~-[ Y e s I--I No
[] El. []Yes I-1No
[] [] l-lYes []No
[] [] l~Yes r-lNo
[] [] []Yes [No
[] [] []Yes [h~o
[] [] []Yes F-Ihto
[] [] []Yes.. []No
[] [] , []Yes []No
[] [] []Yes []No
[] [] []Yes
[] [] []Yes
[] [] []Yes [No
ir~ PACT ON TRANSPORTATION
14. Will there be an effect to existing transportation sy_stems?
Examples that would apply to column 2 ~NO ~]YES
Small to Potential Can lmpact
Moderate Large Mitigated
Impact Impact Project Chal
[] [] l-lYes ~]l
[] [] : [-]Yes
[] ~1~ [-]Yes l--Il
~ ~ ~Yes
~ ~ ~Ves
-o Alteration of present patterns of movement of people and/or goods.
· Proposed Action-will result in major traffic problems.
· Other impacts:
IMPACT ON ENERGY
15. Will proposed action affect the community's sources of fuel or
energy supply? /~NO []YES
Examples that would apply to column 2
· Proposed Action will cause a greater than 5% increase in the use of
an'/ form of energy in the municipality.
· Proposed Action wi[I require the creation or extension of an energy
transmission or supply system to serve more t.han 50 single or two family
residences or to serve a major commercial or industrial use.
· Other Impacts:
NOISE AND ODOR IMPACTS
16. Will there be objectionable odors, noise, or vibration as a result
of the Proposed Action? j~NO []YES
Examples that would apply to column 2
· Blasting within 1,500 feet of a hospital, school or other sensitive
facility.
· Odors will occur routinely [more than one hour per day).
° Proposed Action will oroduce operating noise exceeding the local
ambient noise levels for noise outside of structures.
· Proposed Action will remove natural barriers that would act as a
noise, screen.
· Other impacts:
IMPACT ON PUBLIC HEALTH
17. Will Prcposed Action affect public health and safety?NO
F~Y-ES
Examples that would apply to column 2
· Proposed Action may cause a risk of explosion or release of hazardous
substances (i.e. oil, pesticides, chemicals, radiation, etc.) in the event of
accident or upset conditions, or there may be a chronic low level
discharge or emission.
· Proposed Action mav result in the burial of "hazardous wastes" in any
form (.e. [oxic, poisonous, highly reactive, radioactive, irritating,
infectious, etc.j
· Storage facilities for one million or more gallons of liquified natural
gas or other flammable liquids.
· Proposed acuon may result in the excavation or other disturbance
within 2,000 feet of a s~te used for the m~posa'l of solid or hazardous
· Oth~,r impacts:
10
IMPACT ON GROWTH AND CHARACTER
OF CO~tMUNITY OR NEIGHBORHOOD
18. Will proposed action affect the character of the exist~,~ community?
,~NO ,~YES
£xamples that would apply to column 2
· The permanent population of the city, town or village in which the
project is located is likely to grow by more than 5%.
· The municipal budget for capital expenditures or operating services
will increase by more than 5% per year as a result of this project.
· Proposed action will conflict with officially adopted plans or goals.
· Proposed action will cause a change in the density of land use.
· Proposed Action will replace or eliminate existing facilities, structures
or areas of historic importance to the community.
· Development wil create a demand for additional community services
(e.g. schools, police and fire, etc.)
· Proposed Action will set an important precedent for future projects.
· Proposed Action will create or eliminate emplo,/ment.
· Other impacts:
1 2 3
Small to Potential Can Impact B,
Moderate Large Mitigated By
Impact Impact Project Chang
[] [] []Yes []Nc
[] [] ' ~]Yes []Nc
[] [] []Yes E]Nc
[] [] []Yes E]Nc
[] [] []Yes []Nc
[] -. []' []Yes ~Nc
~ ~ ~Yes ~No
~ ~ ~Yes ~No
~ ~ ~Yes ~No
19. Is there, or is there likely to be, public controversy related to
potential adverse environmental impacts? ~i~NO FIYES
,\
If Any Action in Part 2 Is Identified as a Potential Large Impact or
If You Cannot Determine the Magnitude of Impact, Proceed to Part 3
Part 3--EVALUATION OF THE IMPORTANCE OF IMPA,..;TS
Responsibility of Lead Agency
Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may b~
mitigated.
Instructions
Discuss the following for each ~mpact identified in Column 2 of Part 2:
1. Briefly describe the impact.
2. Describe (if applicable) how the impact cou]d be mitigated or reduced to a small to moderate im pact bv project change(s)
3. Based on the information available, decide if it's reasonable to conclude that this impact is important.
To answer the question of mportance, con~ider:
· The probability of the impact occumng
· The duration of the mpact
· Its irreversibil ty, including permanent y lost resources of va ue
· Whether the mpact can or will be controlled
· The regional consecuence of the impact
· Its potential divergence from local needs and goals
· Whether known object~ons to the oro'ect relate [o this unpact
(Continue on attachments)
11
6 ! 7.21 SF. QR
Appendix B
Environmental Quality Review
Visual EAF Addendum
This form may be used to provide additional information rdadng to Question 11 c~f Part 2 of
the Full lEAF.
(To be completed by Lead Agency)
Visibility
1. Would the project be visible from:
· A parcel of [and which is dedicated to and available
to the public for the use. enjoyment and appreciation
of natural or man-made scenic qualities?
· An overlook or parcel of land dedicated to public
observation, enjoyment and appreciation of natural
or man-made scenic qualities?
· A site or structure listed on the National or State
Registers of Historic Places?
· State Parks?
· Th s State Forest Preserve?
· National Wildlife Refuges and state game refuges?
· National Natural Landmarks and other outstanding
natural features?
· National Park Servi'ce lands?
· Rivers designated as National or State Wild. Scenic
or Recreational?
· Any transportation corridor of high exposure, such
as part of the Interstate System. or Amtrak?
· A governmentally established or designated interstate
or inter-county foot trail, or one formally proposed for
establishment or designation?
· A site, area, lake, reservoir or highway designated as
scenii:?
Distance Between
Project and Resource (in Miles)
0-1/~ 1/4-1/2 1/2-3 3-5 5 +
[] [] [] [] []
[] [] [] [] []
[] [] [] [] []
[] [] [] [] []
· Municipal park. or designated open space?
· County road?.
· State?
° Local road?
2. Is the visibility-of the project seasonal? (i.e., screened by summer foliage, but visible during other
seasons)
[]Yes ~'No
3. Are any of the resources checked ie question 1 used by the public duripg the time of year
during which the project wil be visible?
?Yes ~No
DESCRIPTION OF EXISTING VISUAL ENVIRONMENT ~
4. From each item checked in question 1, check those which generally describe the surrounding
environment.
Essentially undeveloped
Forested
Agricultural
Suburban residential
Industrial
Commercial
Urban
River, Lake, Pond
Cliffs, Overlooks
Designated Open Space
Flat
Hilly
Mountainous
Other
NOTE: add attachments as needed
5. Are there visually similar projects within:
*l/z mile [~] Yes ]--[No
'1 miles [--[Yes }--]No
~2 miles -[~ Yes [~No
*3 miles I-lYes [~No
Within
'1/4 mile * 1- mile
* Distance from project site are provided for assistance. Substitute other distances as appropriate
EXPOSURE
6. The annual number of viewers likely to observe the proposed project is
NOTE: When user data is unavailable or unknown, use best estimate.
CONTEXT
7. The situation or activity in which the viewers are engaged while viewing the proposed action is
FREQUENCY
Holidays/
Activity Dafty Weekly Weekends Seasonally
Travel to and from work [] [] [] []
Involved in recreational activities [] [] [] []
Routine travel, by residents [] [] ~ ~
At a residence [] [] "-[] ~}
At worksite [] [] [] []
Other ~ [] [] []
COUNTY OF SUFFOLt~' )
STATE OF NEW YORK )SS:
BEING DULY SWORN DEPOSES
AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS,
AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST
OF HIS KNOWLEDGE AND BELIEF, THAT THE WORK WILL BE DONE IN THE
MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY
THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO
HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND
FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY
VIRTUE OF SAID PERMIT, IF GRANTED.
in completing this application I hereby authorize the Trustees,
agent 6r representatzve to enter onto my property to inspect the
premises in conjunction with review of thi~ applica~on.
~-~tlG~ATURE OF APPLICANT
SWORN TO BEFORE ME THIS
EXAMINED
APPROVED "WETLANDS" PERMIT (CHAPTER 97)
APPROVED "BOAT,DOCKS, WHARVES" PERMIT (CHAPTER 32)
DISAPPROVED "WETLANDS PERMIT" (CHAPTER 97)
DISAPPROVED "BOATS.DOCKS, WHARVES" PERMIT (CHAPTER 32)
CONDITIONS, IF ANY
EXAMINING BODY
SIGNATURE OF CHAIRMAN
COMPUTATION OF FEES
Aporovet] 2/27/85 "