HomeMy WebLinkAboutTR-394TOWN OF SOUTHOLD
OF'SOUTHOLD TOWN TRUSTEES
$OUTHOLD, NEW YORK
WETLANDS PERMIT
This Wetlands Permit No....3..9..4. ............ has been granted by the Town Trustees accordin§ to
information furnished in Application NO....4..4.~ ............ filed by Applicant ...........................
Grace K. Bourgin August 8~ 19,..8..6. .... A map of the proposed work will be kept
on file in the Trustee Office under the application number given.
work To construct a bulkhead 100 lin. ft. . .................
Permit granted to do the following ............................................................... '- ...............
and to fill with 125 cu. y. ds. of~fill to ..b..e...p..1..a..c..e..d...~p..e..h_i..n..d.,.~9,..l%~l~,ILC~d, ..................
515 Watersedge W.a.%, South. old.. ..................
Location of property on which work to be done ...............................................................
Peconic Ba~ ...................................
Creek, Bay or Harbor fronting property .................................................... ~ ........
Size of work: Length ..... .1..0..0....1..i.n..:...f..t.... .................................................................................................
Width .........1_8.~. ............................................................... '. ..............................................
Height Above High Water ...2..5...;. ..................................................................................
Depth Below L~w Water .......................... ; ......................................................................
yards to be Excavated .....................................................................................................
Yards to be Filled .......... .1..2..5...-c-.u.:.-.Y-.d..s.;--.9-.f.--.s..a.-n-.d ........................................................
Manner in which material is to be removed or deposited .................................................... ; ....................
Residential
Intended use of property .........................................................................................................................
Conditions if any .....................................................................................................................................
Expiration Date October 30, 1987 if work has not commen.c..e..d....b.y...~g~.~..Ja[g .....................
Liability Policies in the Amount of .........................................................................................................
The validity of this permit is or may be subject to the approval of other governmental or municipal
authorities. The Town accepts no responsibility in applying for or obtaining such approval. In the
event that such approval is necessary, the holder of this permit shall not commence operations here-
under until such approval has been obtained in writing. The failure to obtain such other approval when
required shall subject this permit to immediate revocation by the Trustees upon receipt by the
Trustees- of written notice from such other governmental or municipal authorities of its refusal or
disapproval.
The applicant does by the acceptance of this permit, assume all responsibility for operations under-
taken pursuant to this permit, and shall take ali precautions for the prevention of injuries to persons
and property resulting from such operations· By such acceptance, the applicant also agrees to indemni-
fy and save harmless the Town, and its officers, agents and employees from any and a I claims arising
from operations under this permit and any and all acts or-Gmissions of applicant, his agent and
em ployees.
The applicant and th e owner and occupants of the premises upon which the operations authorized by
this permit are being conducted; do, b~/ the acceptance of this permit, give consent to the Town, and
its officers and empJoyees to enter upon the premises where such operations are being conducted to
make such inspections as the Town may deem necessary'to insure that such operations are being con-
ducted in conformity with this permit.
This operation will not substantially: A. Adversely affect the wetlands of the town.
B. Cause damage from erosion, turbidity or siltation.
C. Cause saltwater intrusion into the Tresh water resources of the town.
D. Adversely affect fish, shellfish or'Other beneficial marine organisms, aqua~ic wildlife and vege-
tation or the natural: habitat thereof.
E. Increase the dangerof flood and storm-tide damage.
F. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town.
G. Change the course of any channel or the natural movement or flow of any waters.
H. Weal<eh or Undermine the lateral support of other lands in the vicinity.
I. Otherwise adversely affect the health, safety and general welfare of the people of the town.
Board of Southold Town Trustees
HENRY P. SMITH, President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN ~i. LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box ? 28
Southold, New York 11971
November 7, 1986 ~.
TELEPHONE
(5161 765-1892
Mrs. Grace K. Bourgin
515 Watersedge Way
Southold, New York 11971
Re: Wetland Application No. 442
Dear Mrs. Bourgin:
The fbllowing action was taken by the Board of Trustees during their
regular meeting held on October 30, 1986 regarding your wetland application
referenced above.
WHEREAS, Grace K. Bourgin applied to the Southold Town Trustees for a permit under
the provisions of the Wetland Ordinance of the Town of Southold,
application dated August 25, 1986 , and
WHEREAS said application was referred to ~he Southold Town Conservation
Advisory Council for their findings and recommendations, and
WHEREAS, a public hearing was held by the Town Trustees with respe, ct
to said application on. October 30, 1986 at which time all interested persons
were given the opportunity to be heard, and
WHEREAS, the Board members have personally viewed and are familiar
with the premises in question and the surrounding area, and
WHEREAS, the Board has considered all the testimony and documentation
submitted concerning this application, and
WHEREAS, the Boa'rd has determined that the project as proposed will not
affect the health, safety and general welfare of the people of the Town,
NOW, THEREFO_RE, BE IT
RESOLVED that Grace K. Bourgin BE AND HEREBY IS GRANTED PERMISSION UNDER THE
PROVISIONS OF THE WETLAND ORDINANCE OF THE TOWN OF SOUTHOLD' TO: construct a
bulkhead 100 lin. ft. and 18" wide, and to fill with 125 cu. yds. of sand
behind the bulkhead. Property is"located at 515 Watersedge Way, Southold.
This permit will expire on.October 30, 1987 if work has not commenced by said date.
There are two inspections required and ~he Trustees are to be notified upon the
completion of the work. Prior to the issuance of said-permit by the
Board of Trustees - Grace K. Bourgin
Page 2.
Clerk, the applicant shall file with the Clerk a certificate that he
has public liability insurance policies insuring against any liability
which may arise in the performance of the operations pursuant to such
permit in such amount as shall be fixed by the Trustees, which said
policies shall name the Town as~a name insured. Please take further
notice that this declaration should not be considered a determination
made for any other department or agency which may also have an applicatio~
pending for the same or similar project.
Upon remittance, your permit will be forwarded by mail.
HPS:ip
CC:
Very truly yours,.
Henry P. Smith, President
Board of Town Trustees
Rober~-A. Greene, D.E.C., Stony Brook
Commissioner Henry G. Williams, D.E.C., AAbany
Stephen Mars, Army Corps of Engineers
Thomas Hart, Coastal Management
Conservation Advisory Council
Bldg. Dept.
Board of Appeals
File -
THIS CERTIFICATE ~S ISSUED AS A MATTER OF INFORMATION ONI~Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES NOT AMEND. EXTEND OR A[~ER TH~COVERAGE AFFORDED BY THE POLICIES LISTED BELOW.
NAME AND ADDRESS OF AGENCY
PROIOS & ULLRICH INC
I523 MAIN ST
PRT JEFFERSON STA NY
NAME KD ADDRESS OF INSURED
F&R RICHARDS
PECONIC PAINTING
MAIN RD
SOUTHOLD
11776
NY 11971
COiVIPANIES AFFORDING COVERAGES
COMPANY A
LETTER MERCHANTS INSURANCE
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
This is to certify that policies of insurance isted below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or con-
dition of any contra~ or other document w~h respect to which this certificate may be issued or may 3ertain. the insurance afforded by the policies described herein is sub act to
Terms, excius,ons 9no uu,,u,uu,~ u, ~uu,, ~ ........ L~mits of Liabi~it~ in Thousands (000) "~
POLICY
EXPIRATION DATE OCCUR~NCE
GENERAL L~AmLITY LA0575439537 6/26/87 ~o~,~,.~u~ * *
~ co~..~.~.s,v~o.~ Inception date 6/26/8(
~ X ~Em~SES~PERAT~ONS PROPERTY DAMAGE $ $
' EXPLOSION AND COLLAPSE
~ HAZARD
UNDERGROUND HA~RD
PRODUCTS/COMPLETED
~ OPERATIONS HAZARD BODILY INJURY AND
~NT~ACTUAL iNSURANCE PROPERTY DAMAGE $ 5 0 0 $
-- BROAD FORM PROPERTY COMBINED j
~ DAMAGE
INDEPENDENT CONTRACTORS
PERSONAL INJURY , PERSONAL INJURY $
AUT~O~ILE L~AB~LI~ BODILY INJURY $ ~
(EACH PERSON)
OWNED (EACH OCCURRENCE)
PROPERTY DAMAGE $ - ~
EXCE~ LIABILITY ~
~ BODILY INJURY AND $
WORKER'S COMPENSATION STATUTORY
EMP[OYEfl'~ LIABILITY
OTHER
RIPTION OF OPERATIONS/LOCAT~ONS/VEMICLES
PAINTING
CancellatiOn: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail I 0 days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or Hability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER
TOWN OF $OUTHOLD
MAIN RD
SOUTHOLD NY 11971
JOHN A PROI -
BOARD OF TOWN TRUSTEES .
TOWN OF SOUTHOLD
58095 Main Road Phone 765-1892 . ·
BOA~ OF TO~ ~RUSTEES
HENRY P. SMITH, President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN M. LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Halt. 53095 Main Road
P.O. Box 728
Southold, New York 11971
November 7, 1986
TELEPHONE
(516) 765-t892
Mrs. Grace K. Bourgin
515 Watersedge Way
Southold, New York 11971
Re: Wetland Application No. 442
Dear Mrs. Bourgin:
The following action was taken by the Board of Trustees during their
regular meeting held on October 30, 1986 regarding your wetland application
referenced above.
WHEREAS, Grace K. Bourgin applied to the Southold Town Trustees for a permit under
the provisions of the Wetland Ordinance of the Town of Southold,
application dated August 25, 1986 , and
WHEREAS said application was referred to the Southold Town Conservation
Advisory Council for their findings and recommendations, and
WHEREAS, a public hearing was held by the Town Trustees with respect
to said application on-October 30, 1986 at which time all interested persons
were given the opportunity to be heard, and
WHEREAS, the Board members have personally viewed and are familiar
with.the premises in question and the surrounding area, and
WHEREAS, the Board has considered all the testimony and documentation
submitted concerning this application, and
WHEREAS, the Board has determined that the project as proposed will not
affect the health, safety and general welfare of the people of the Town,
NOW, THEREFO~tLE, BE IT
RESOLVED that Grace K. Bourgin BE AND HEREBY IS GRANTED PERMISSION UNDER THE
PROVISIONS OF THE WETLAND ORDINANCE OF THE TOWN OF SOUTHOLD TO: construct a
bulkhead 100 lin. ft. and 18" wide, and to fill with 125 cu. yds. of sand
behind the bulkhead. Property is located at 515 Watersedge Way, Southold.
This permit will expire on October 30, 1987 if work has not commenced by said date.
There are two inspections required and the Trustees are to be notified upon the
completion of the work. Prior to the issuance of said permit by the
Board of Trustees - Grace K. Bourgin
Page 2.
Clerk, the applicant shall file with the Clerk a certificate that he
has public liability insurance pol£eies insuring against any liability
which may arise in the performance of the operations pursuant to such
permit in such amount as shall be fixed by the Trustees, which said
policies shall name the Town as a name insured. Please take further
nonice that this declaration should not be considered a determination
made for any other department or agency which may also have an application
pending for the same or similar project.
Please remit a $5.00 Wetland Inspection fee at this time.
Upon remittance, your permit will be forwarded by mail.
Very truly yours,
Henry P. Smith, President
Board of Town Trustees
HPS:ip
cc: Robert ~. Greene, D.E.C., Stony Brook
Commissioner Henry G. Williams, D.E.C., Albany
Stephen Mars, Army Corps of Engineers
Thomas Hart, Coastal Management
Conservation Advisory Council
Bldg. Dept.
Board of Appeals
File
YELEPHONE
~.516) 765-1801
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
October 22, 1986
To: Ilene Pfifferling
From: Linda Cooper, Secretary CAC
The following recommendations were made by the Southold Town
Conservation Advisory Council at the regular meeting held Thursday,
October 16, 1986:
Wetland Application NO. 435 - Robert N. Durso - Table - no
cesspool system shown on plans.
Wetland Application No. 436 - Irene and Danie McKasty - Approve
with stipulations
Wetland Application No. 437 - Stanley Chase
Wetland Application No. 438 - Stanley Chase
Wetland Application No. 439 - Stanley Chase
The Council approves only one application (may be the applicants
choice) but cannot approve all three. Need is not shown
for all three.
Wetland Application No. 440 - J. Lane Curry - Approve
Wetland Application No. 44] - J, Lane Curry - Approve .~
wet and ~(pplllcatz.0n No. 4~2 ~ '~raCe 'K. BoUrg n- Approve ~;
Wetland Application No. 443 - Grace A. Finora - Table - Cesspool
system is not shown.
Wetland Application No. 444 - Helen Reiter - Approve with stipulations.
Wetland Application No. 445 - David Merz - Approve with stipulations.
Wetland Application No. 447 - Brewer Yacht Yard - Approve with
stipulations
Wetland Application No. 448 - Carloe and Albert Roke - Approve
with Stipulations.
Wetland Application No. 449 - Louise Tashjian - Approve with
stipulations.
~ ~':', 'LEi3AL' NOTICi~
'i:(,'~.I~O~ICE 0F HEARING i:
· ':~b~ *'-":~'q0N WETLAND
- ti~¢ N~ICE IS HEREBY GIV-
~.~[E~ ,THAT. POBLIC
' :THE mWNOF
HALL, MAIN . ROAD
. O~ THURSDAY; OC~BER
30, 1986, ON THE FOL~W-
~ING APPLICATIONS
COUNTY OF SUFFOLK
STATE OF NEW YORK
SS.'
Patricia Wood, being duly sworn, says that she is the
Editor, of THE LONG ISLAND TRAVELER-WATCHMAN,
a public newspaper printed at Southold, in Suffolk County;
and that the notice of which the annexed is a printed copy,
has been published in said Long Island Traveler-Watchman
once each week for ........................... weeks
successively, commencing on the ~ z:a/
· ..: .... .......
Avenue Fishers Island.
~q~v York. 085) -'~' .\-'? ~
OF THE NATURE?(
VANCY c/o ANDREW;
WALKER to construct a board:
,'~:'2walk and obse/-vatiod deck
;. Yacht Club, Mattituck.
Horton Creek. -:.
.';: 7:34 P.M.- IN THE ]
OF RICHARD A.
constrtict a 3' X 50'
10~ X 8'cramp and a 4' X
..;~_.~. floating dock in:James Creek,,
,~ ,Property is located at'360 North,
Riley Avenue. Mattituck. (429)
~: -<7:36 P.M.- IN THE MATTER
OF-MAGDALEN
construt:t ,wooden ~tairs
Sworn to before me this ..................... day of
BA~A~ FO~ES ' qWay, Southold4 6n Pecbnic B~v.
No~ Public, State of New Y~k (~2)
. No ~ 4,.7, ',.:u2Z; -: :.: 2:.,~:::::;,..
..... ' ~,, ;54 EM:INTHE:MA~ER
~uanfi~ in S~olk Co~ ..
~mmission Expires ~
~th~n ~8 d30
the top of the bluff to the beach ':
on_~I nno,, Island Sou,,,t.._. Pr~,.r~, .... , ~aradi~e.. Point. South'_ ._ d._"(440. )
ty is located on the Long Way, ~ ' <7:48 P.M> IN THE MATTER
East Marion. (432) < ~, :-.,,.~,~,~.[ 6GRA(~E-:A. FINOR~
7:38 P.M~ IN ~E MAWR ,'; gonstruct a,single family ~elb
OF IRENE & DANIEL ~ '-~ng'~d ~ociated septic syst~-
MCKASTY to construct a ' provegvislocatedo~he:dorth ,
garage (34' X 22~) and a pool '~ ' east corner of E~st.. ~gion
20'X~'onp~ro ~yol catedat : Avenue ........ Mattituck 'Jan, es,.
132-20 Main Road, _East' Creek. (~3) . '
Marion. Orient Harbor(436):' -.'~:7~:56P. M.-iN THE MA~ER
7:40 P.M.- IN THE MATTER
OF STANLEY CHASE to con-
struct a fixed dock 130' X 4' a
ramp 3' X 16' and a float dock
6' X 20' on Mattituck Creek.
Property is located on Home
OF'HELEN REITER..{THE
ORIGINAL BARGE) to con-
struct within 30" of existing
storm damaged structure, ap-
proximateIy 27' of timber retain-
mg wall. East side shall hh{~e an
8' return and west side :shall have
a 12' retui'n~$aid ~tructure shall
then be backfilled with approx-
imately 5 cu. yds o£clean sand
to be trucked in from an uplaad
~ource, Southold Bay: Property
Pike Road, Mattituck, on Mat-
ti~uck ~2[eek. (437)
7:42 P.M.- IN THE MATTER
OF STANLEY CHASE to con-
struct a 4' X 140' fixed dock, a
~l:,.~J_~6'. ramv and a 6' X 20'
and to b~l~f, ill..with ii0 cu?yds
-of upl~fi '~di~'.'Pec0ni~,~ay.
Property is located on paradise,
4 7:/6;P.M.:iN,THE M~E~
~vegetatio~ on ~r~perty located
at 3135 Main Bavview Road.
Southold, ~Est Cre~-<(~5}
aLL PERSd g:?
*:RES D Sil.
TERS SHOULD APPEAR
T E TIME AND. P~CE
ABOVE :. ~PECIFIED AND
WILL BE' GIVE~ AN ..OP-
PORTUNITY. TO' BE
HEARD. COM~ENTS MAY
BE SUBMITTED
WRITING PRiOR:;~'~HE
riTE OF mE
: Henry P. Smith, ~Ot
.'" Boa~ of Town Trds{~s
Dated: Octob{r 3, 19~6:2¢':'
LEGAL NOTICE
NOTICE OF HEARING ON
WETLAND APPLICATIONS
NOTICE IS HEREBY GIVEN
THAT PUBLIC HEARINGS
WILL BE HELD BY THE
TOWN TRUSTEES OF THE
TOWN OF sOUTHOLD, AT
THE SOUTHOLD TOWN
HALL. MAIN ROAD. SOUTH-
OLD. NEW YORK, ON
THURSDAY, OCTOBER 30,
1986 ON THE FOLLOWING
APPLICATIONS FOR PER-
MITS UNDER THE PROVI-
SIONS OF-THE WETLAND
ORDINANCE OF THE TOWN
OF SOUTttOLD:
7:30 P,M. - IN ~HE MAT-
TER OF GEORGE D. F. LAM-
BORN to pump water from a
spring fed non-wetland" pond to
higher level man made pond,
Property is located on Ocean
View Avenue, Fishers Island.
New York. ~385~
7:32 P.M. - IN THE MAT-
TER OF TIlE NATURE CON-
SERVANCY c/o ANDREW B.
WALKER to construct a
boardwalk and observanon deck
for observme wddfowl on Hor~on
Creek. P~'operty is located on
the East side of Peconic Bay
Blvd.. opposite thc Mattituck
Yacht Club. Mattituck. 14081
Herren Creek
7:34 1' 5L - tN TIiE 51Af-
TER f RICHARD A.
LUHRS ~,,.=onsLruct a 3' x 50'
catwalk a t0' x 8' ramp and a 4'
x 28' floating dock in James
Creek. Property is located at
360 North Riley Avenue, Mat.
tituck. (429l
7:36 P.M. - IN THE MAT-
TER OF MAGDALEN
LEVAS to construct wooden
stairs ,from the top of the bluff to
the beach on Long lstand Sound.
Property is located on the
Long Way, East Marion.~4321 .
7:38 P.M. - IN THE MAT-
TER OF IRENE & DANIEL
MCKASTY m construct a gar-
age (34' x 22') and a pool 20' x
40' on property located at 132-
20 Main Roa~.. East Marion.
.Orient Harbor (436)
7:40 P.M. -. IN THE MAT-
TER OF STANLEY CHASE to
construct a fixed dock 130' x 4' a
ramp 3' x 16' and a float dock 6'
x 20' on Mattituck Creek. Prop-
erty is located on Home Pike
Road, Mattituck, on Mattituck
Creek. (437)
7:42 P.M. - IN THE MAT-
TER OF STANLEY CHASE to
construct a 4' x 140' fixed dock,
a 3' x 16' ramp and a 6' x 20'
float dock. Property is located
on Home Pike Road, Mat-
tituck, Mattituck Creek. (438)
7:44 P.M. - IN THE MAT-
TER OF STANLEY CHASE to
construct a 4' x 45' fixed dock
leading to a 3' x 16' ramp leading
to a 6' x 20' float dsck. Said dock
will be a minimum of 4' over
existing marsh which shall be
secured by two 8" spiles, Mat-
tituck Creek. Property is lo-
cated on South Drive, Mat-
tituck. (439)
7:46 P.M. - IN THE MAT-
· TER OF J. LANE CURRY to
armor 210' of existing bulkhead
with 1-2 ton of rock at 2-3 tons
per foot. Properxy is located at
Paradise Point, Southold.
~440l
7:48 P.M. - IN TIlE -MAT-
TER OF GRACE A. FINORA
to construct a single family
dwelling and associated septic
system. Property is located on
the north east corner of East
Legion Avenue, Mattituck.
James Creek. 1443)
7:50 P.M. - IN THE MAT-
TER OF HELEN REITER
(THE ORIGINAL BARGE) to
construct within 30" of existing
storm damaged structure~ ap-
proximately 27' of timber retain-
mg wall. East side shall have an
8' return and west side shall
have a 12' return. Said structure
shall then be backfilled with ap-
proximately 5 cu. yds. of clean
sand to be trucked in from an up-
land source. Southold Bay.
Property is located on Main
Road, Sou/hold. ~444)
7:52 P.M. - IN THE MAT-
TER OF GRACE K. BOUR-
GIN to construc~ a bulkhead to
be 100 lin. ft. andre fill with 125
cu. yds. of fill behind same.
Property is located ;it 515
watersedge Way, SoU'~'%ld
on peigonic Bay. t442)
7:54 P.M. - IN THE"~iAT-
TER OF J. LANE CURRY to
repmr within 1~"-130 lin. ft. of
deteriorated and broken timber
bulkhead with (2) 27' returns'
and to backfill with 110 cu. yds.
of upland sand, Peconic Bay.
Property is located on
Paradise Point, Southold.
(441l
7:54 P.M. - IN THE MAT-
TER OF MARK BAXTER to
mow vegetation on proper~y
cated at 3135 Main Bayv~ew
Road. Southold, West Creek.
~405)
ALL PERSONS IN-
TERESTED IN SAID MAT-
TERS SHOULD APPEAR AT
THE TIME AND PLACE
~ ABOVE SPECIFIED AND
WILL BE GIVEN AN OPPOR-
TUNITY TO BE HEARD. COM-
MENTS MAY BE SUBMITTED
IN WRITING PRIOR TO THE
DATE OF HEARING.
Henry P. Smith, President
Board of Town Trustees
DATE: October 3, 1986
1TO9-5378
STATE OF NEW YORK )
) SS:
COUNTY OFSUFFOLK )
Carol Sqarlata of Groenport, In
said County, being duly sworn, says that he/she is
Principal Clerk of THE SUFFOLK TIMES, e Weekly
Newspaper, published at Greenport, in the Town
of Southold, County of Suffolk and State of New
York. and that the Notice of which the annexed is
a printed copy, has been regularly published in
said Newspaper once each week for ~
weeks successively, commencing on the
dayof October 19 86
Sworn to before.~n, e~ this ~
RESOLUTION -
Lead Agency Declaration - Peconic Contracting for
Grace K. Bourgin.
RESOLVED that the Southotd Town Trustees declare itself lead/·
agency in regard to the State Environmental Quality Review
Act in the matter of the application of Peconic Contracting for
Grace K. Bourgin
for a Wetland Permit on certain property located
at 515 Watersedge Way, Southold.
HENRY P. SMITH, President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN M. LARSEN
TELEPHONE
¢516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
S.E.Q.R.A.
" NEGATIVE DECLARATION'
NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT
DATE: Sept. 26, 1986
APPLICATION NO. 442
NAME: Gra'ce K. Bourgin
This notice is issued pursuant to the provisions of 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 give~ that the Southold Town Trustees, as lead
agency for the action described below has determined that the project will
not have a-significant effect to the environment.
Please take further notice that this declaration should not be
considered a determination made for any other department or agency which
may also have an application pending for the same or similar project.
TYPE OF ACTION: Unlisted
DESCRIPTION OF ACTION:" Applicant proposes to construct 100 Lin.
Ft. of bulkhead and to fill with 125 cu. yds. of fill to be
trucked in.
LOCATION OF PROJECT: 515 Watersedge Way, Southold, N. Y.
REASONS SUPPORTING THIS DETERMINATION:
1. An environmental assessment form has been submitted which indicated that
there would be no adverse effect to the environment should the project
be implemented as pianned.
2. Because there has been no response in the allotted time from the Southold
Town Building Dept. and the N.Y.S.D.E.C. is is assumed that there are
no objections nor comments from those agencies.
LEGAL NOTICE
NOTICE OF HEARING ON WETLAND APPLICATIONS
NOTICE IS HEREBY GIVEN THAT PUBLIC HEARINGS WILL BE HELD BY THE
TOWN TRUSTEES OF THE TOWN OF SOUTHOLD, AT THE SOUTHOLD TOWN HALL, MAIN
ROAD, SOUTHOLD, NEM YORK, ON THURSDAY, OCTOBER 30, 1986 ON THE FOLLOWING
APPLICATIONS FOR ~ERMITS UNDER THE PROVISIONS OF THE WETLAND ORDINANCE
OF THE TOWN OF SOUTHOLD:
7:30 P.M. - IN THE~MATTER OF GEORGE D. F. LAMBORN to pump water from
a spring fed non w tland pond to higher level man made pond. Property
is located on Ocean~ View Avenue, Fishers Island, New York. (385)
7:32 P.M. - IN THE ~MATTER OF THE NATURE CONSERVANCY c/o ANDREW B. wALKER
to construct a boardwalk and observation deck for observing wildfowl on
Horton Creek. PrOperty is located on the East side of Peconic Bay Blvd.,
opposite the Mattituck Yacht Club, Mattituck. (408) Horton Creek.
7:34 P.M. - IN THE MATTER OF RICHARD A. LUHR$ to construct a 3' x 50'
catwalk a 10' x 8'~ ramp and a 4' x 28' floating dock in James Creek.
Property is locate~d at 360 North Riley Avenue, Mattituck. (429)
7:36 P.M. - IN THE MATTER OF MAGDALEN LEVAS to construct wooden stairs
from the top of the bluff to the beach on gong Island Sound. Property is
located on the Long Way, East Marion. (432)
7:38 P.M. - IN THE MATTER OF IRENE & DANIEL MCKASTY to construct a
garage (34' x 22') and a pool 20' x 40' on property located at 132-20
Main Road, East Marion. Orient Harbor (436)
7:40 P.M. - IN THE MATTER OF STANLEY CHASE to construct a fixed dock 130'
x 4' a ramp 3' x 16' and a float dock 6' x 20' on Mattituck Creek. Property
is located on Home Pike Road, Mattituck, on Mattituck Creek. (437)
7:42 P.M. - IN THE MATTER OF ~ANLEY CHASE to construct a 4' x 140'
fixed dock, a 3' x 16' ramp and a 6' x 20' float dock. Property is located
on Home Pike Road, Mattituck, Mattituck Creek. (438)
7:44 P.M. - IN THE MATTER OF STANLEY CHASE to construct a 4' x 45' fixed
dock leading to a 3' x 16' ramp leading to a 6' x 20' float dock. Said dock
will be a minimum of 4' over existing marsh which shall be secured by two 8"
spiles, Mattituck Creek. Property is located on South Drive, Mattituck. (439)
7:46 P.M. - IN THE MATTER OF J. LANE CURRY to armor 210' of existing
bulkhea~ with 1-2 ton of rock at 2-3 tons per foot. Property is located at
Paradise Point, Southold. (440)
7:48 P.M. - IN THE MATTER OF GRACE A. FINORA to construct a single family
dwelling and associated septic system. Property is located on the north ease
corner of East Legion Avenue, Mattituck, James Creek. (443)
7:50 P.M. - IN THE MATTER OF HELEN REITER (THE ORIGINAL BARGE) to
construct within 30" of existing storm damaged structure, approximately 27'
of timber retaining wall. East side shall have an 8' recur, n and west side shall
have a 12' return. Said structure shall then be backfilled with approximately
5 cu. yds. of clean sand to be trucked in from an upland source, Southold Bay.
Property is located on Main Road, Southold. (444)
7:52 P.M. - IN THE MATTER OF GRACE K. BOURGIN to construct a bulkhead
to be 100 lin. ft. and to fill with 125 cu. yds. of fill behind same.
Property is located at 515 Watersedze Way, Southold, on Peconic Bay. (442)
7;54 P.M. - IN THE MATTER OF J. LANE CURRY to repair within 18"-130 lin.
ft. of deteriorated and broken timber bulkhead with (2) 27' returns and to
backfill with 110 cu. yds. of upland sand, Peconic Bay. Property is located
on Paradise Point, Southold. (441)
Public Hearings
Page 2 - October 30, 1986
7:54 P.M. - IN THE MATTER OF MARK BAXTER to mow vegetation on
property located at 3135 Main Bayview Road, Southold, West Creek. (405)
ALL PERSONS INTERESTED IN SAID MATTERS SHOULD APPEAR AT THE TI/~E AND
PLACE ABOVE SPECIFIED AND WILL BE GIVEN AN OPPORTUNITY TO BE HEARD.
COMMENTS MAY BE SUBMITTED IN WRITING PRIOR TO THE DATE OF THE HEARING.
Smith, Presiden
Board of Town Trustees
DATE: October 3, 1986
PLEASE PUBLISH ONCE, OCTOBER 9, 1986 AND FORWARD ONE AFFIDAVIT OF PUBLICATION
TO HENRY P. SMITR, PRESIDENT, BOARD OF TOWN TRUSTEES, SOUTHOLD TOWN HALL,
MAIN ROAD, SOUTHOLD, NEW YORK 11971~
Copies to the following:
L. I. Traveler-Watchman
Suffolk Times
George D. F. Lamborn, John H. Thatcher, Jr., Richard A. Howard, Steve Malinowski
Raymond Edwards, Frank Burr, Attorney Michael J. Hall
Andrew Walker c/o Nature Conservancy
Richard A. Luhrs
Magdalen Levas
Irene & Daniel McKasty
Land Use Company for Stanley Chase (3)
Costello Marine Contracting Corp. for J. Lane Curry (2)
Land Use Company for Grace Finora
Helen Reiter
Peconic Co~ntracting Inc. for Grace K. Bourgin
Mark Baxter
Town Clerk's Bulletin Board
Trustees
file
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
TELEPHONE
(5161 765-1892
APPLICATION IS HEREBY 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 WETLANDB, 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,
TA× MAP No.___~- 6'-- ~ 0
AGENT
.~.M,~ .~=~= ~o_~~_ ~_~o~.,~_~__~p,_ ~,~_~~,~_~
~% (~ ---~ ....
LOCATION OF PROPERTY FOR WHI(:H PERMIT WANTED_b--._L.~'--___~__O._~&~d_~e~.._~_~. _T-
..... %_~_~ ~ oA_d_~_:-i_~_,: ~~_ .
HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION
WIDTH
HEIGHT ABOVE HIGH WATER
*iNTENDED USE OF PROPERTY .... .fi_.~._~_..,~_ ......
DESCRIBE ANY KNOWN PRIOR OPERATIONS CONDUCTED ON THE PREMISE
AND WHETHER ANY PRIOR LICENSE 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 B~ A GOVERNMENTAL
DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE
PREMISES AFTER THE WORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF
THE PROJECT SITE IF NECESSARY
WRITTEN CONSENT~'- ~----~ , IF NOT THE SAME AS THE
OF TI~E OWNER OF THE PROPERTY
APPLICANT. _ .....
ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD
PROHIBIT THIS PROJECT?
BOARD OF TOWN TRUSTEES.~- -
TOWN.OF. SOUTHOLD .....
SHORT ENVIR'ON ENTAL ASSESSMENT FORM
Project Information [To be completed by Applicant or Project sponsor)
1. Applicant/sponsor
~ New ~ Expansion ~ Modification/alteration
I2. Proiect Name
5. Describe proiect briefly:
6. Precise location {road intersections, prominent landmarks, etc. or provide map)
7, Amount of land affected:
Initially
acres Ultimately acres
8 Will prgposea ac[ion compw with existing zoning or other existing land use restrictions?
~es [] No If No, describe briefly
9. What is present land use in vicinity of project?
[~Residential [] Industrial [] Commercial
Describe:
[] Agriculture [] Parkland/open space [] Other
10. Does acti~nvolve a permit/approval, or funding, now or ultimately, from any other governmental agency [Federal state or local]?
~ [~ Yes [] No If yes, list agency(s) and permit/approvals
11. Does any aspect of ~L~'action have a currently valid permit or approval?
[] Yes [~ No If yes, list agency name and permit/approval type
12. As result of ~ropl~,d.~ction will existing permit/approval require modification?
[] Yes L~' No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicantjsponso ...... :~-O j~t~l'~- ~ 0~)'/~>"~% -~--~¢' Date:
Si~at .... ~ ~ /~
PART II Environmental ~"~'
ssessment (To be completed by Agency)
~old in 6 NYCI~R, Part 617.12~' If yes, coordinate the rewew process
[] Yes ~'N~ .............. an(] use the FULLJLONG FORM EAF.
B. Will actioa receive c~a~e~s provided for Uaiisted Action~ in 6 NYCRR, Pa~ 617.7~
C. Could action result in ANY adverse effects on. to, or arising from the following: {Answers may be ha~dwritten: if legible)
C1.drainageEXisting airorqUality,floodingSUrfaCeproblems~or groundwaterExplain briefiy:eualitY or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosior
C2. Historic, archeological, visual or aesthetic, or other natural or cultural resources; agricultural districts; or COmmunity or neighbbrhood character? Explain brie
C3. Vegetation or fauna, movement of fish or wildlife species, signifi(~ant habitats, or threatened or endangered species? Explain briefly:
C4. A communitY's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly.
C5. Growth. subsequent development, or related activities likely to be induced by the proposed action~' Explain briefly.
/do
C6. Secondary, cumulative, or other effects not identified in C1-C67 Explain briefly.
C7. ,~ change in use of either quanuty or type of energy? Explain briefly.
PART III Determination of Significance (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise
s~gnificant. Each effect should be assessed i~ 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 relevac t adverse impacts have been identified
and adequately addressed. .
[] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Tl~en
proceed directly to the FU[ L/LONG FORM EAF and/or prepare a positive declaration.
[] Check this box if you have determ ned, based on the information and analysis above and any supporting documentation,
that the proposed action WH.L NOT result in any significant adverse environmental impacts AND provide here, and on
attachments as necessary, the reasons supportng this determination:
Date
COUNTY OF SUFFOLK )
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 TH'iS 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 or representative to enter onto my property to inspect the
premises in con]unction with review~of this application.
Slc RE O~ APP lc
NOTARY ~UBLIC
_ :..4~zz563, Suffolk County
'erin eXl~'res Dec.rnber 31,
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
Approved 2/27/85
Telephone: 765-5381
PECONIc CONTRACTING, Ine.
General Contractors.. Constrttction
Main Road, ~ou .... n/~/a~tagetttettt ~
taota, New York 119;; ~otl~it~tltl~
"al,
· ,.. ,.. ...... _ , . .~ -, t~ ~ . --~ . ':.
" ' , 3'~'f~2' ' ' L '
HENRY P. SMITH, President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEALTD
ALBERT KRUPSKI, JR.
ELLEN M; LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF SOIYfHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York i 1971
Date: August 25, 1986
TELEPHONE
(516) 765-1892
To Whom it May Concern:
Attached hereto is a Short Environmental Assessment Form submitted
by Peconic Contracting, Inc. on behalf of Grace K. Bourgin in connection
with her application for a wetland permit to construct 100 lin. ft. of
bulkhead and to fill with 125 cu. yds. of fill to be trucked in. Property
is located at 515 Watersedge Way, Southold.
Henry P. Smith, President
HP S: ip
Posted: August 25, 1986
Board of Town Trustees
HENRY P. SMITH, President
JOHN M. BREDEMEYER. Vice-Preg.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN M. LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
August 25, 1986
TELEPHONE
(516) 765-1692
Mr. Charles T. Hamilton
Alternate Regiohal Permit Administrator
N'.Y.S. D.E.C.
Building 40, SUNY - Room 219
Stony Brook, New York 11794
Dear Mr. Hamilton:
Transmitted herewith is wetland application no. 442
submitted by Peconic Contracting, Thc. on behalf of Grace K. Bourgin.
We would like to coordinate with yo~ in our role as
lead agency regarding this application. May we have your
comments on same by September 17, 1986.
Thank you for your input.
Very truly yours,
Henry P. Smith, President
Board of Town Trustees
Ilene Pfifferling
Secretary to Board
Attachments
cc:
Commissioner Williams
Southold Town Building Dept.
file
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 1197t
August 25, 1986
TELEPHONE
(516) 765-1892
Mr. Martin Garrell, Chairman
Southold Town Conservation Advisory Council
Southold Town Hall
Southold, New York 11971
Dear Mr. Garrell:
Tr~ns_mitted herewith is application no. 442 for
a wetI'~nd' permit submitted by Peconic Contracting on behalf of
Grace K. Bourgin.
P/ease prepare a written report of findings and
recommendations with respect to this application.
Very truly yours,
Henry P. Smith, President
Board of Town Trustees
Secretary to Board
Attachment
HENRY P. SMITH, President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI. JR.
ELLEN M. LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
' Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
TELEPHONE
(516) 765-1892
DATE: Sept. 26, 1986
S.E.Q.R.A.
: NEGATIVE DECLARATION'
NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT
APPLICATION NO. 442
NAME: Grace K. Bourgin
This notice is issued pursuant to the provisions of Article 8 of
the Environmental Conservation Law State Environmental Quality Review and
6NYCKR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of
Southold, notice is hereby given that the Southold Town Trustees, as lead
agency for the action described below has determined that the project will
not have a~significant effect to the environment.
Please take further notice that this declaration should not bi
considered a determination made for any other department or agency which
may also have an application pending for the same or similar project.
TYPE OF ACTION: Unlisted
DESCRIPTION OF ACTION:' Applicant ~ropcses to construct 100 Lin.
Ft. of bulkhead and to fill with 125 cu. yds. of fill to be
trucked in.
LOCATION OF PROJECT: 515 Watersedge Way, Southold, N. Y.
REASONS SUPPORTING THIS DETERMINATION:
1. An environmental assessment form has been submitted which indicated that
there would be no adverse effect to the environment should the project
be implemented as planned.
~. Because there has been no response in the allotted time from the Southold
Town Building Dept. and the N.Y.S.D.E.C. is is assumed that there are
no objections nor comments from those agencies.
Further information can be obtained by contacting Henry P. Smith, Pres.,
Board of Trustees, Town Hall, Main Road, Southold, NY 11971, or by
calling (516) 765-1892.
HPS: ao
CC: Bldg. Dept.
C.A.C.
Planning Bd.
DEC - Albany
DEC - Stony Brook -_
Army Corps
Aran Terchunian, Coastal Mgmt.
Town Clerks Bulletin Bd.
Zoning Board
Trustees
File
Very truly yours,
· Smith, President'
Board of Town Trustees
HENRY P. SMITH, President
JOHN M. BREDEMEYER~ Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN M. LARSEN
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
Date: August 25, 1986
TELEPHONE
(516) 765-1892
To Whom it May Concern:
Attached hereto is a Short Environmental Assessment Form submitted
by Peconic Contracting, Inc. on behalf of Grace K. Bourgin in connection
with her application for a wetland permit to construct 100 lin. ft. of
bulkhead and to fill with 125 cu. yds. of fill to be trucked in. Property
is located at 515 Watersedge Way, Southold.
Henry P. Smith, President
Board of Town Trustees
HPS:ip
Posted: August 25, 1986
BOARD OF TOWN TRUSTEES-..
TOWN OF SOUTHOLD
SHORT ENVIRONMENTAL ASSESSMENT FORM
Project Information {To be completed by Applicant or Project sponsor)
1. Applicant~sponsot
3. Project Iocaton . ~'~ ~- %,_~C~,._~-e._~,.o., L-~C~,i
Municipality ~ O~L ~
4. Is proposed action:
~New ~ ~xpansion ~ Modification/alteration
5. Describe project briefly:
j2. Project Name
6. Precise Iocabon [road intersections, prominent landmarks, etc. or provide map)
7. Amount of land affected:
Initially acres Ultimately
8. Will proposea action comply with existing zon ng or other existing land use restrictions1
J~es [] No If No. describe briefly
9. What is present land use in vicinity of project?
[[~'esidential [] Industrial [] Commercial [] Agriculture
Describe:
[] Parkland/open space [] Other
10. Does acuon involve a permit~approval, or funding, now or ultimately, from any other governmental agency (Federal, state or local)?
[] No If yes. list agency[s) and permit/approvals
11. Does any aspect of the action have a currently valid permit or approva[?
[] Yes ~]/No If yes, list agency name and permit/approval type
12. As result of pro~s~.action will existing permit/approval require modification?
[] Yes LIL~ No
i CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
ApDJicanUsoonsor name:
PART Il Environmental Assessment ITo be completed by Agency) . ~
,4,. Does action exceed a~,y Type I threshold in $ NYCRR. Part 617.127 It~yes. coordinate the review process and use'the FULL]LONC FORM
L.-] Yes ~ No
B. Will action receive coordinated review as provided for Unlisted Actions in 6 NYCRR, Part 617.77 If No. a negative declaration may be superceded by anott~
involved action.
[] Yes [~No
C. Could action result in ANY adverse effects on, to, or arising from the following: (Answers may be handwritten, if legible)
C1. Existing air quality, surface ot groundwater qualit7 or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosior
drainage or flooding problems? Explain briefly:
C2. Historic. archeological, visual or aesthetic, or other natural or cultural resources; agricuZtural districts; or community or neighborhood character? Explain brie
C3. Vegetation or fauna, movement of fish or wildlife species, s~gnificant habitat~, or threatened or endangered species? Explain briefly:
C4. A communitY's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly.
C5. Crowth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly.
C6.. Secondary, cumulative, or other effects not identified in C1-CG? Explain briefly.
C7. ^ change in use of either quantity or type of energy? Explain briefly.
PART III Determination of Significance (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise
significant. Each effect shoutd be assessed in connection with its Ia) 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 adequateiy addressed.
[-~ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then
proceed directly to the FULL/LONG FORM EAF and/or prepare a positive declaration.
[] Check this box if you have determined, based on the information and analysis above and any supporting documentation,
that the proposed action WILL NOT result in any s~gnificant adverse environmental impacts AND provide here, and on
attachments as necessary, the reasons su ~portng this determination:
Date