HomeMy WebLinkAboutTR-4487Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
ISSUED TO ......... DR ...... IsIS....BAt~.TEL S .......
Au 'horiza iou
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 So~thold Town Ordinance en-
titled ."REC~ULATING AND THE PLACINg= OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, C=RAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS:" and in accordance with the
Resolution of The Board adopted at a meeting held on ..6./.2.9./.95 .....
19~._9.5., and in consideration of the sum of $_.150..00 paid by
.J., M,..O. ..... G~n.s.u!~ing...f~r...DR. ISIS.. B.Ag,.T..E..,.L.S.. .....................................
of ....... ..F.i.~b~.s..,.!.,s.~.d., ................................ N.Y. and subiect to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
To construct a 4' X 50' fixed dock, (elev. over grade o.f
marsh), a 3' X 14' ramp and a 6' X 20' float.
West Harbor Fishers Island
all in accordance with the detailed specifications as presented in
the originating appli~caflon.
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.
Albert J. Kmpski, President
John Holzapfel, Vice President
William G. Albertson
Martin H. Gan:ell
Peter Wenczel
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765z1892
Fax (516) 765-1823
June 30, 1995,
J.M.O. Consulting
Glenn E. Just
P.O. Box 447
Quogue NY 11959-0447
Re:
DR. ISIS BARTELS
SCTM ~10-1-10
Dear Ms. Just,
The following action was taken by the Board of Town Trustees
during its regular meeting held on June 29 1995 regarding the
above matter: '
WHEREAS, J.M.O. Consulting, on behalf of DR. ISIS BARTELS,
applied to the Southold Town Trustees for a permit under the
provisions of the Wetland Ordinance of the Town of Southold,
application dated March 29, 1995, 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 June 29, 1995, at which time all
interested persons were given an opportunity to be heard, and,
WHEREAS, the Board members have personally 'viewed and are
familiar with the premises in gues. tion and the surrounding area,
and,
WHEREAS, the Board has considered all the testimony and
documentation sub_mitted concerning this application, and,
WHEREAS, the structure complies with the standard set forth in
Chapter 37-18 of the Southold Town Code,
WHEREAS, the Board has determined that the project as proposed
will not affect the health, safety and general welfare of the
people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approves the application of
DR. ISIS BARTELS to construct a 4' X 50' fixed dock (elev.
over grade of marsh), a 3.' X 14' ramp and a 6' X 20' float.
Permit to construct project will expire two years from tbs date
it is signed. Fees must be paid, if applicable, and permit
issued within six months of the date of this notification.
TWo inspections are required and the Trustees are to be notified
upon completion of said project.
FEES: None
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/dj h
cc. CAC
SECrEtA;~y Of STATE
Mr. Glenn E. Just
J.M.O. Consulting
P.O. Box 447
Quogue, NY 11959-0447
STATE Of NEW YORK
DEPARTMENT OF STATE
ALbANy, NY 12231-000!
June 20, 1995
tOWN
Re:
F-95-386
U.S. Army Corps of Engineers/New York
D/strict Permit Application
Dr. ISis A. Barrels
Town of Southold, Suffolk County
Acknowledgement of Federal Consistenc3~
_Assessment Form
Dear Mr. Just:
The Department of State received your Federal Consistency Assessment Form and
supporting /nformation on June 14, 1995 and has determined that the submitted
documentation is adequate to commence our review of your proposed project. We w/Il
contact you if additional information may be necessary for consistency review purposes.
You and the Corps of Engineers will be notified of our decision when we have completed
our rev/ew of this project for its consistency with the New York State Coastal Management
Program. The Corps of Engineers cannot issue a permit for th/s project unless the
Department of State concurs w/th your consistency certification.
Please call Kevin Viermeau at (518) 474-6000 if you have any questions.
Sincerely,
Chief, Consistency Review
and Analysis Bureau
Division of Coastal Resources
WFB/jtb and Waterfront Revitalization
cc: COE/New York District - Sophie Ettinger
NYS DEC/Region 1 - Robert Greene
Town of Southold - Albert Krupski
~LEXANDER F, TREADWELL
~ECRETARY OF ~TATE
STATE Of NEW YORk
DEPARTMENT Of STATE
ALBANY, NY 12231-0001
June 20, 1995
Mr. Albert Krupski
President
Board of Town Trustees
Town Hall
P.O. Box 1179
Southold, NY 11971
Re'
F-95-386
U.S. Army Corps of Engineers/New York
District Permit Application
Dr; Isis A. Bartels
Dear Mr. Krupski:
Enclosed is a copy of the information submitted to the Department of State for review of
the above-referenced project with respect to its consistency with the Coastal Management
Program for your information and preliminary review. Please contact Kevin Vienneau, the
DOS reviewer assigned to this project, at (518) 474-6000 to discuss your concerns, and any
additional information which may be necessary to asSist you in reviewing this project. Any
comments you may have will assist the Department in reaching a decision as to the
consistency of the proposed action with the approved NYS Coastal Management Program.
Please note, however, that if we do not hear from you within 45 days of the date of this
letter, we will presume that you have no objections to the proposed project.
Sincerely,
William F. Barton
Chief, Consistency Review
and Analysis Bureau
Division of Coastal Resources
and Waterfront Revitalization
Enclosures
WFB/jtb
~l~ RECYCLED PAPER
. DtPARIMINI OF I-NVIRONMINIAI CONS1 ~)~"ION J - ' ' ' ~ CANARY C~PY Corps cE ~ngineers
' "I US ARMY CORPS ~l' ENGINEERS APPLICA]I<' ~ WHITE COPY Permit Administrator
JOINT APPLICATION FOR R dMIT J
GOLDENROD Applicant
Plea~, rend ALL inslnlctkms on h~c~ hefo~o c~lpleling this ~pplic~li~ P~.ase I~pe or ~inl cJearl~ i, in~. Attach addili~al Jnio~mation as needed.
~ARTICLE 9, TITL~ 1, ARTICLE 43 6NYCRR 646 {LAK~ GEORGE. ~R~TI~ ~
~ARTICLE 15, lilLE 3 (AQUAHC PES11CIDES CONTROL) ~&NYCRR 327 (AQUATIC VEGETATION] ~6NYCRR 328 (FISH) ~6NYCRR 32~ NSECTS)
J~J ~ARTICLE 15, TIIL~ 5 6NYCRR 608 [PROTECTION OF WATERS)
~ J ~ For the construction, reconstruction, or repair of a DAM or other impoundn~t structurm
j~J ~ ~ For the disturbance or.sTREAM BED' OR BANKS or excavation in or fill of NAVIGABLE WATERS. ~40~ WATER QUALITY CERTIFICATION
~ARTICLE 15, 11TLE 15 ~6NYCRR ~1 (WATER SUPPLY) ~6NYCRR ~2 (LONG IS~ND WELL]
~ ~ARTICL~ 15, TITLE 27 6NYCRR 666 (WILD. SCENIC AND RECREA11ONAL RIVERS]
~ ~ ARTICLE 24 6NYCRR 662, 663 (FRESItWATER WETLANDS) ~ARHCLE 34 6NYCRR 505 (COA~AL EEOS[N)
~TICLE 25 6NYCRR 661 (TIDAL WETLANDS) ~ . '
~1 ~ SECTION 10 (RIVER AND I IARBOR ACT OF t899) for structures and work in navig~le waters of ~e U.S. ~COASTAL CONSISTENCY CERTIFICATION.
[~J ~SECTION 404 (CLEAN WATER ACT OF 1977) for disposal of dredged or fill matedaJ in waters of the U.S.
~ul ~SECTION 103 [MARINE PROTECTION. R~SEARCH AND SAN~UARIES AC~ {or t~ ~ansportation of dredged materials for dumping into ocean waters,
1. LIST PREVIOUS PERMIT/APPLICATiON NUMBERS AND DATES {If any] J IF OTHER THAN INDIVIDUAL. PROVIDE
2. APPLICANT 15 A/AN ~wner ~Operator ~Lessee ~MunicipalityjGovernmental Ag~cy [Check as many as apply]
3. NAME OF APPLICANT [Use Full Name)
J.M.O. Consulting for Dr. Isis A. Bartels
MAILING ADDRESS
Box 148
TELEPHONE (Where can be reached during day)
/q20:~-889-3397
POSTOFFICE STATE t ZIPCODE
Fishers Island N.Y. 06390
4. NAME DE []Owner. ~Ag~n~Contact Person
one}
Glenn ~. ~ust/ J.H.O, Consult±~g
MAILING ADDRESS j TE~PHONE Where can be reached during day)
P.O. Box 447 j (51~ 653-0607
POST OFFICE STATE I ZiP CODE
quogue N.Y.J 11959-0Z
5. PROJECT/FACILITY LOCATION [Mark location on map, see Number la on reverse side]
con.tv Suffolk J Townorcity Southold
Jvillage Fishers Island
STREET ADDRESS (If different from applicant)
Private Road-No#
POST OFFICE
Fishers Island
J STATE JZIP CODE
N.Y. 06390
6. NAME OF STREAM OR BODY OF WATER West Harbor
7. HAS WORK BEGUN ON PROJECT?
E~] Yes ~o
9. PROPOSED USE: E~---private -
[] Public [] Commercial
If YES. attach explanation on starting work withottt perr~[, includes dates. J 8. WILL PROJECT UTILIZE STATE LAND?
Show work on map and/or drawings. J []Yes ~No
J10. PROPOSED STARTING DATE: 11, APPROXIAdATE COMPLETION DATE: 12. FEE OF (NYS P~rmit Only)
ASAP ASAP $ '~ Enclosed
13. PAUl ECT DESCRIPTION: {e.g. quantity and tv~ of material to be excavate, dredged ~ used for fill or dp rap, location of d~posal sites; type of
structure to be installed: height of dam; size of impoundent; capacities of pro~sed wa~ ~ces; ~tent of distribution system; etc.)
~ plica ' - 50' '
~ mars~ p59~o~$ to cons~r~g~ ~O4,.~lSat fixed dock (ele. 4 over grade
, ramp an .
14 WILL THIS PROJECT REQUIRE ADDITIONAL EEDERAL, STATE AND/OR LOlL PERMITS? [] Y~ [] No
Southold Town Trustees, N.Y.S.D.O.S. & U,S,D.O.A,
If yes, please list:
15. CERTIFICATION: '.
I hereby affirm that under penality of perjury that information provided on this form and ali attachments submitted herewith is true to the best of my knowledge
and belief. False statements made herein are punishable as a Class A misdemeanor rmrsuant to SectiOu 210.45 of the Penal Law.
Further, the applicant accepts foil responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project
described herein, and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from said
project. In addition. Federal Law, 18 U,S.C. Section 1001 prov.~s fgt~a fine ,of no~ than $10,000 or imprisonment for not more than f ve years, or both,
where an applicant knowingly and willfully falsifies, concealer ~os/eJs up a n~aterj~l ]Fact; ~r knowingly makes or uses a false, fictitious or fraudulent statement.
[]1 hereby authorize the agent named in Number 4. above tot~,~]mit this~apF~lca~ion on my behalf.
March 13, 1995 / ~kLd(t~/ Agent
DAtE ~ _j~,,/ SIGNATURE /.~
PLEASE READ ALL INSTRUCTIONS ON REVERSE SIDE
7
'1.
e
SUPPL~.~I~14T TO~ ~ ~FIC-
Complete a~d su~tt~ along with ~terials requested ~lo~ and executed
F0~-63~5~ "Application for a ~ posit". If necesss~ coattnue item
additional sheet. Identify ent~ by item
'GENE~L
Period of ti~ required to c~plete the proposed ~rk. Both actual ~rk time ~nd
duration of the ~roJect are required (t.e.~ three ~ekJ of ~rk ti~ over
moa th
Info~ntion cha~acte:~sttc of nei~hborhood (i.e.) hiSh~ medt~ or 1o~ densityl
residential~ c~ercial~ or industrial).
Medium density'residential:'
Types of adjacent marine structures and approximate .distance from the project site.
Adjacent properties have stone retaining/
_sea walls.
4. Distance to noise sensitive areas (i.e.,-schoola~ hospitals, otc).
Nearest hosp. ital is greater than lO miles away and
nearest school is approx, one mile away.
5. Types of construction equipment to be used during construction and number of each
type (i.e., bulldozers, trucks, cranes, et¢)~
One workboat
Submit representative photographs, color if possible, of the project area.
Identify pictures (i.e., view from north, east,'etc., time and :aken) Out-
.lose~
Indicate on your project plans and on photographs of the site(s) the location of any
wetlands vegetation (such as cordgrass, reedgrass and e~attails)',in the construction
area. Identify phot. oEraphs as indicated~in box 6. -- Enc±osea ' '
Indicate 'the location of any known historical or archaeological site(s) within the
proJec' !.gratis.None on site
10.
Submit copy of any completed environmental studies or reports on the proposed
project. No studies have been prepa.r, ed
Discus: alternatives to the proposed p~oJect which were investigated including
alternrtive locations, disposal areas, construction techniques etc. and why they
were rejected. N.o ~!ternatives have been discussed
HANY FORtaZ01
Feb 78
...... : .,., DI~DG~N~-'-. UPLAND DISPOSAL
Il. S.:bmlt specific OhS and photoiraphs, colOr/if po~ .... blat' of the proposed
12. Describe ~he pr~mn~ I~nd use of the dimpo{ml
13.
Indicate physical nature of drmd;ed"rmterlal' (i.e., a~nd, ailS, clay sic).
percentages of the ~[arious fractions, if available.
n/a
Give' '
}'pr maintenance dredging, BA permits are generally issued for a 10 year period.
Indicate the number of times dredging is anticipated over a I0 year period and
the total capacity (cubic yards) of the proposed disposal site(s) which will be
used to accommodate the dredged uaterial.
t5,
Describe method o'f dredged material containment (i.e., embankment, bulkhead, etc).
n/a
DREI~3ING - OPEN WATER DISPOSAL
16. For maintenance dredging, DA Permits are generally issued for a 10 year period.
Indicate the number of times dredging is anticipated over a 10 year period, n/a
17. Submit required testing data (testing criteria will be furnished upon request).
~ i/ a
18. ·Discuss alternatives to open-water disposal of dredged material and why they
were rejected.
n/a
MOORING ?ACIL ITIES
19. Number of water craft using the present marina facility. Are pumpout facilities
avail~bleTNo ,
vessels presently utilizing site no pumpout.
20, Number and type of water craft which will utilize the proposed marina or docking
facility. Will pumuout facilities be provided for?
One small-medium sized pleasure boat, no pumpout.
L~ND FILL
21. Indicate type of structures tm be built on the proposed fill. n/a
22. .Type of fill to be used (i.e., sand, stone, rubble, earth, etc). n/a
Method ~f fill placement.
n/a
23.
24. l~escribe any proposed me~hods for c~ntrolltng tu'~bi~tf-y during.filling operation.
NANY FOB~-201
Yeb-T8 (back)
n/a
Ba~tels
5/17/95
1630
Private
Fishers
Island
QUOGUE>
J MO CONSULTING NY
Ba~tels
5/17/95
1630
Private
, Fishers Island
J MO
CONSULTING
QUOGUE,
NY
655-C837
A~
Albert J. Krupski, President
John Holzapfel, Vice President
William G. Albertson
Martin H. Garrell
Peter Wenczel
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 1 I971
Telephone (516) 765-1892
Fax (516) 765-1823
S.E.Q.R.A.
NEGATIVE DECLARATION
NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT
APPLICATION NO. 1000-10-3-10
NAME: Isis Bartels
DATE: May 26, 1995
Chapt. 97 - Wetlands
Chapt. 37 - Coastal Erosion
RESOLVED that 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 $outhold,
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 on 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: Type I
DESCRIPTION OF ACTION: Applicant requests a Wetland Permit to
· 3' X 14'
construct a 4' X 50' fixed dock (ele over grade of marsh),
ramp and 6' X 20' float. Located Private Road #3, Fishers Island.
LOCATION: SCTM #1000-10-3-10
REASONS SUPPORTING THIS DETERMINATION:
1. An on site inspection has been conducted by the Board of
Trustees.
2. An environmental assessment, submitted by the applicant and
reviewed and completed by the Board of Trustees, has indicated that
no significant adverse effects to the environment are likely to occur
should the project be implemented as planned.
cc. CAC
DEC
'~eting of ~/20/95
ALEXANDER HARVEY 11-1-12 to regrade top of bluff in approximately 900
sq. ft. area to create more stable slope angle. InstallatiOn qf erosion
control mat. Seeding/planting to revegetate project area. ~Underpinning of
approximat.ely 21~ I.f. of' existing foundation at corner of house. Installation
of drain line to redirect existing roof runoff to land side of hoUse. (See
submitted plans)
Fishers Island
The CAC did not inspect, therefore the Council has no recommendation.
No. 12~7
Moved by Bruce Loucka, seconded by Stephen Angell, it was
RESOLVED to TABLE the Wetland Application of THOMAS RAFFERTY
20-3-11.8 to construct a single family residence of approximately 2000 sq. ft.
with septic system as provided by code, shell covered driveway and two-car
garage.
Little Bay Road, Orient
The CAC tabled the application because the project needs staking.
Vote of Council: Ayes: Ail
Motion carried.
No. 12~8
DRy. ISIS A. BERTELS 10-3-10 to construct a L~ x 50' fixed dock (elevated
over grade or'marsh), 3' x 1L~' ramp, and 6' x 20~ float.
Fishers Island
The CAC did not inspect this application and has no recommendation.
No. 12L~9
Moved by Stephen Angell, seconded by Jack Hagerty, it was
RESOLVED to TABLE the Wetland Application of THEMIS KAROUSOS 30-2-66
to construct a new deck and beach stairs from the top of the bluff to the beach.
1~60 The Strand, East Marion
The CAC tabled the application because there drawings or plans submitted.
The Council could not make a recommendation based on the material that was
submitted.
Vote of Council: Ayes: All
Motion carried.
No. 1250
Moved by Bruce Loucka, seconded by Jack Hagerty, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL
WITH STIPULATION of the Wetland Application of JOHN A. McGUIRE 15-1-1
to reconstruct in kind, existing 12' x 30' timber ramp, place 35 c.y..of upland
fill on eroded bank which was lost during 12/9z[ storm, install 12' x 6' x 1'
gabion mat and 3' x 3' x 12' gabion cage at toe of timber ramp, install 10' x
22' x 1' Reno mat on eroded bank west of timber ramp, install two (high) 3' x
3" x 6" gabion cages on western return and install 21' x 6' x 1' Reno mat two
Page
J.M.O. Consulting
P.O. Box 447
Quogue, N.Y. 11959-0447
516-653-0607
April 28, 1995
Ms. Jill Thorp
Board of Town Trustees
Town of Southold
Town Hall, 53095 Main Road
P.O. Box 1179
Southold~ N.Y. 11971-1179
RE: Property of Isis A. Bartels
Private Road, Fishers Island
S.C.T.M.No. 1000-010-03-10
Dear Ms. Thorp:
For the Board's review and files, I have enclosed a copy
of the approval for this project which was recently issued by
the N.Y.S.D.E.C. With this, I believe a coordinated review
is not necessary. Should there be any comments or questions
regarding this matter, please feel free to contact our office
at your convenience.
Most respectfully,
GEj:ar
Glenn E. Just
New York State Department of Environmental Conservation
Building 40 - SUNY, Stony Brook, New York 11790-2356
Phone (516) 444-0365
Fax # (516) ~.~.~ 0373
April 25, 1995
Dr. Isis A. Bartels
Box 148
Fishers Island, NY 06390
RE: 1-4738-01122/00001-0
Dear Permittee:
In conformance with the requirements of the State Uniform
Procedures Act (Article 70, ECL) and its implementing regulations
(6NYCRR, Part 621) we are enclosing your permit. Please read all
conditions carefully. If you are unable to comply with any
conditions, please contact us at the above address.
Also enclosed is a permit sign which is to be conspicuouslY
posted at the project site and protected from the weather.
Very truly yours,
Janet Kolodziej ski
EnCon Program Aide
JJK:cg
enclosure
D~C PER#IT RUHBER
1-4738-0112Z/00001-0
FACILITY/PROGRAM #Ut4BER(S)
NEW YORK i~ DEPARTMENT OF ENVLRONHENTAL CONSERVATION
PE IT
Under the Enviromont. L
Conserwtimt Lau
EFFECTIVE DATE
April 25; 1995
EXPIRATION DATE(S)
April 30, 1~8
TYPE OF PERMIT · Ne~ O ReneHat [] Mndification [] Pemit to Construct [] Permit to Operate
ArticLe 15, TitLe 5: Protection
of Waters
ArticLe 15, TitLe 15: Water
SuppLy
ArticLe 15, TitLe 15: Weter
Transport
ArticLe 15, TitLe 15: Long
IsLand WeLts
ArticLe 15, TitLe 27: WiLd,
Scenic and Recreational Rivers
Other:
6HYCRR 608: Water ~Lity
Certification
[] ArticLe 17, TitLes 7, 8: SPDES
[] ArticLe 19: Air PoLLution
Control
[] ArticLe 23, TitLe 27: Hinad Land
RecLamation
[] ArticLe 24: Fresh~ater WetLands
I ArticLe 25: Tidal WetLands
ArticLe 27, TitLe 7; 6NYCRR 360:
Solid Waste Management
ArticLe 27, TitLe 9; 6NYCRR 373:
Hazardous Waste Management
[] ArticLe 3~: Coastal Erosion
Management
[] ArticLe 36: FLoodpLain
Management
[] ArticLes 1, 3, 17, 19, 27, 37;
6NYCRR 380: Radiation Control
PERMIT ISSUED TO
Isis A. BarreLs
TELEPHONE NIJHBER
(203) 889-3397
ADDRESS OF PERNITTEE
Box 148
Fishers IsLandI HY 06390
CONTACT PERSON FOR PERMITTED WORK
GLenn E. Just; JNO ConsuLting; P.O. Box 447f quogue NY 11959-044?
NAHE AND ADDRESS OF PROJECT/FACILITY
BsrteLs Property
Private Road~ Fishers IsLand
LOCATION OF PROJECT/FACILITY
SCTH 1000-010-3-10
COUNTY
Suffolk
TC)~N I WATERCOURSE
SouthoLd West Harbor
TELEPHONE NUMBER
(516) 653-0607
MYTH COORDINATES
Construct a 4 foot by 50 foot fixed dock, 3 foot by 14 foot ramp end a 6 foot by 20 foot fLoat. ALL ~ork shall be done
as sho~ on the ettschedpLans prepared by J.N.O. Cor~utting on Nsrch 13, 1995 and stamped NYSDEC approved onAprit 25,
By acceptance of this permit, the pormittee agrees that the permit is contingent upon strict compliance ~ith the
ECL, eLL appLicabLe regulations, the General Conditions spocifie~ (see page 2) ~d any Special Conditions included ss part of
this permit.
DEPUTY REGIONAL PER#IT ADMINZSTRA- ADDRESS
TOR:
George W. Hammarth BLdg. 40, SUNY, Room 219, Stony Brook, N~ 11790-2356
AUTHORIZED SIGNATURE DATE
~~ //,~~/~ April 25, 1995 Page lof4
Inspect ions ~
1. The permitted site or facility, including relevant records, is subject to in-
spection at reasonable hours and intervals by an authorized representative of
the Deparl~rent of Envirorrmntal Conservation (the Deparlment) to determine
v~ether the permittee is caTplying with this permit and the ECL. Such represen-
tat ive may order the v~rk suspended pursuant to BSL 71-0301 and S~PA 401 (3). A
copy of this permit, including all referenced maps, dra~vings and special
conditions, rrust be available for inspection by the Departrrent at all timas at
the project site; Failure to Produce a copy of the permit upon request by a
Departrrent representative is a violation of this permit.
Permit Changes and Rena~ Is
2. The Departrrent reserves the right to rrodify, suspend or revoke this permit v~en:
~ a) the scope of the permitted activity is exceeded or a violation of any
condition of the permit or provisions of the ECL and pertinent regula-
r ions i s found;
b) the permit wes obtained by misrepresentation or failure to disclose
re levant facts;
c) neNmaterial inforrration is discovered; or
d) envirorrrental conditions, relevant technology, or applicable law or
regulation have rraterial ly changed since the permit wes issued.
3. The permittee trust sul~nit a separate written application to the DeparlTrent for
renewal, rmdification or transfer of this permit. Such application trust include
any fOnTS, fees or supple-rental infon-ration the DeparlTmnt requires. Any
renewal, m~ification or transfer granted by the Deparl]Tent rrust be in writing.
4. The permittee must subnit a renewal application at least:
a) 180 days before expiration of permits for State Pollutant Discharge
El imination Syste"n (SPEES), Hazardous V~ste IV~nageTent Facilities
(l~lrf~), major Air Poi lution Control (Al=C) and Solid V~ste IVbnagement
Facilities (~/lr~); and
b) 30 days before expiration of all other permit types.
5. Unless expressly provided for by the Departrrent, issuance of this permit does
not rrodify, supersede or rescind any order or determination perviously issued by
the Departrrent or any of the terrrs, conditions or requi reTents contained in such
order or determination.
Other Legal Chi igations of Penl~ittee
6. The permittee has accepted expressly, by the execution of the application, the
full legal responsibility for all daTages, direct or indirect, of whatever
nature and by whatever suffered, arising out of the project described in this
permit and has agreed to indeTnify and save harmless the State frcrn suits,
actions, da'rages and costs of every nam and description resulting from this
project.
7. This permit does not convey to the permittee any right to trespass upon the
lands or interfere with the riparian rights of others in order to perform the
permitted work nor does it authorize the irrpairrmnt of any rights, title, or
interest in real or personal property held or vested in a person not a party to
the permit.
8. The permittee is responsible for obtaining any other' permits, approvals, lands,
easeTents and rights-of-way that may be required for this project.
Page 2 of 4
95~20-0a (7/921-- 25c
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24,
9 That if future operations by the State of New York require an al-
teration in the position of the structure or work herein authorized, or
if, in the opinion of the Department of Environmental Conservation
it shall cause unreasonable obstruction to the free navigation of said
waters or flood flows or endanger the health, safety or welfare of
the people of the State, or cause loss or destruction of the natural
resources of the State. the owner may be ordered by the Department to
remove or alter the structural work, obstructions, or hazards caused
thereby without expense to the State, and if. upon the expiration or
revocation of this permit, the structure, fill, excavation, or other
modification of the watercourse hereby authorized shall not be com-
pleted, the owners, shall, without expense to the State. and to such
extent and in such time and manner as the De partment of Environmental
Conservation may require, remove all or any portion of the uncompleted
structure: or fill and restore to its former condition the nawgable
and flood capacity of the watercourse. No claim shall be made against
the State of New York on account of any such removal or alteration.
10 That the State of New York shall m no case be liable for any damage
or injury to the structure or work herein authorized which may be caused
by or result from future operations undertaken by the State for the
conservation or improvement of navigation, or for other purposes, and
no claim or right to compensation shall accrue from any such damage.
11 Granting of this permit does not relieve the applicant of the responsi-
bility of obtaining any other permission, consen! or approval from
the U.S Armv Corps of Engineers. U.S Coast Guard. New York State
Office of General Services or local government which may be required.
12. All necessary precautions shall be taken to preclude contamination
of any wetland or waterway by suspended solids, sediments, fuels.
solvents, lubricants, epoxy coatings, paints, concrete, leachate or any
25, 34
and 6 NYCRR Par! 608 { Tidal Wetland
other environmentally deleterious materials associated with the
proiect.
13. Any material dredged in the prosecution of the work herein permitted
shall be removed evenly, without leaving large refuse piles, ridges across
the bed of a waterway, or floodplain or deep holes that may have a
tendency to cause damage to navigable channels or to the banks of
a waterway.
14 There shall be no unreasonable interference with navigation by the work
herein authorized.
15 If upon the expiration or revocation of this permit, the project hereby
authorized has not been completed, the applicant shall, without expense
to the State, and to such extent and in such time and manner as the
Department of Environmental Conservation may'req uire, remove all o}
any portion of the uncompleted structure or fill and restore the site
to its former condition No cia m shall be made against the State of
New York on account of any such removal or alteration.
16. If granted under 6 NYCRR Part 608, the NYS Department of Environ-
mental Conservation hereby certifies that the subject proiect will not
contravene effluent limitations or other limitations or standards under
Sections 301. 302. 303. 306 and 307 of the Clean Water Act of 1977
(PL 95-217) provided that all of the conditions listed herein are met.
17 All activities authorized by this permit must be in strict conformance
with the approved plans submitted by the applicant or his agent as part
of the permit application.
Such approved plans were prepared by 'JMO Corlfulting
3/]3/95 stamped NYSDEC apprd~ved 4/25/95.
SPECIAL CONDITIONS
Dock or timber catwalk 'shall not exceed 4 feet in width and
shall be a minimum of 3'~" feet above grade* over tidal
wetland areas (* as measured from ground to bottom'of dock
sheathing).
Floats and ramps may not rest on or be stored in any
vegetated tidal wetland.
No permanent structures may be installed on
dock/catwalk/float without first obtaining written
Department approval (permit, modification or amendment).
Docks/catwalks/floats may not (a) extend laterally beyond
property lines, (b) be placed so that docked boats extend
over adjacent property line, (c) interfere with navigation,
(d) interfere with other landowners riparian rights.
Supplementary Special Conditions (A) through (F) attached
DEC PERMIT NUMBER
1-4738-01122/00001-0
PROGR^M:FACILITY NUMBER
Page 3 of 4
SUPPLE~TARY SPECIAL CONDITIONS
The followlng conditions apply to all Tidal Wetlands; Freshwater
Wetlands; Coastal Erosion Management; and Wild, Scenic, and
Recreational Rivers Permits=
ae
Be
Ce
Ee
A copy of this permit, including all conditions and
approved plans, shall be available at the project site
whenever authorized work is in progress. The permit
sign enclosed with the permit shall be protected from
the weather and posted in a conspicuous location at the
work site until all authorized work has been completed.
Fo
The permittee shall require that any contractor,
project engineer, or other person responsible for the
overall supervision of this project reads, understands,
and complies with this permit and all its general,
special, and supplementary special conditions. Any
failure to comply precisely with all of the terms and
conditions of this permit, unless authorized in
writing, shall be treated as a violation of the
Environmental Conservation Law. If any of the permit
conditions are unclear, the permittee shall contact the
Division of Regulatory Affairs at the address on page
one or telephone (516) 444-0365.
If project design modifications become necessary after
permit issuance, the permittee shall submit the
appropriate plan changes for approval by the Regional
Permit Administrator prior to undertaking any such
modifications. The permittee is advised that
substantial modification may require submission of a
new application for permit.
At least 48 hours prior to commencement of the project,
the permittee and contractor shall sign and return the
top portion of the enclosed notification form
certifying that they are fully aware of and understand
all terms and conditions of this permit. Within 30
days of completion of the permitted work, the bottom
portion of that form shall also be signed and returned,
along with photographs of the completed work and, if
required, a survey.
For projects involving activities to be undertaken in
phases over a period of more than one year, the
permittee shall notify the Regional Permit
Administrator in writing at least 48 hours prior to
recommencing work in subsequent years.
The granting of this permit does not relieve the permittee
of the responsibility of obtaining a grant, easement, or
other necessary approval from the Division of Land
Utilization, Office of General Services, Tower Building,
Empire State Plaza, Albany, NY 12242 (51-6) 474-2195, which
may be required for any encroachment upon State-owned lands
underwater.
DEC Permit No. 1-4738-01122/00001-0
Page4 of 4
Albert J. Krupski, President
· John Holzapfel, Vice President~
William G. Albertson
~' - - Martin H. Garrell
Peter Wenczel
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax (516) 765-1823
Office Use Only
Coastal Erosion Permit Application
~Wetland Permit Application
. Grandfather Permit Application
Trustee Lands Permit Application
. Waiver
Re6eived Application_:.
_~__Clerical Review: : ~+/~3'
Completed Applicatio~
. Incomplete ~ .. ' '
SEQ~ Classification:
~e I__T~e It[~ Unlisted
'Coordination: ('date sept)
~CAC Referral Sent:
~Date of Inspection:
Receipt of CAC Report: (d~t~) ~/~
Lead Agency Determination; .,' '
~Technical ~Review-~ . (date
~Public Hearing: (dat~~'
~Decision: Approved ((YIN) (aate)
[ ~ Application Fee: $ ~'.
_TOWN_O SOUTHOLD
91995
Name of Applicant DR. Isis A.: Bartels
Address P.O. Box. 148, Fishers Island, N.Y. 06390-0148
Phone Number: ( 203 ) 889-3397
Suffolk County Tax Map Number: 1000 - 010-3-10
3
Property Location: Private Road, No. ~, Fishers Island
(provide LILCO Pole ~, distance to cross streets, and location)
Agent: Glenn E. Just/ J.M.0. Consulting
{If applicable)
Address: P.O. Box 447, Quogue, N.Y. 11959-0447
Phone: 653-0607
Board of Trustees Applica~n
GENERAL DATA
Land Area (in square feet): 0.203
Area Zoning: Unknown
Previous use of property: Private residence
Intended use of property: Private recreational dock
Prior permits/approvals for site improvements:
Agency Date
xx No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a
governmental agency?
xx No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
Applicant proposes to construct a 4'x 50' fixed dock (ele.4' over ~rmde
of marsh), 3'x 14' ramp and 6'x 20' fl6at.
~Board of Trustees ApplicatiOn
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: Private recreational docks
Area of wetlands on lot: 0 square feet
Per~ent coverage of lot: n/a %
Closest distance between nearest existing structure and upland
edge of wetlands: n/a feet
Closest distance between nearest proposed structure and upland
edge of wetlands: n/a feet
Does the project involve excavation or filling?
xx No Yes
If yes, how much material will be excavated?
How much material will be filled? 0
Depth of which material will be removed or deposited:
feet
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
0 cubic yards
cubic yards
0
n/a
n/a
Statement of the effect, if any, on the wetlands and tidal
waters of the town that may result by reason os such proposed
operations (use attachments if appropriate):
Project as proposed should not have any negative impacts on any wetlands
or waters of the Town of Southold.
617.21
Al~pendix, A
State Environmental Quality Review
FULL ENVIRONMENTAL ASSESSMENT FORM
SEQR
Purpose: The full EAF is designed to help applicants and agencies determine i~ an orderly manner, whether a project
or action may be significant. The question of whether an action may be signific~ is not always easy to answer. Frequent-
ly, there are aspects ora project that are subjective or unmeasureable. It is also understood that those who determine
significance may have little or no formal knowledge of the environment or may not be technically expert in environmental
analysis. In addition, many who have knowledge in one particular a~ea may not be aware of the broader concerns affecting
the question of significance.
The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination
process has been orderly, comprehensive in nature, yet flexible enough to allow introduction of information to fit a project
or action. ,
Full EAF Components: The full FAF is comprised of three parts:
Part 1: Provides objective data and information about a given project and its site. By identifying basic project
dora, it assists a reviewer in the analysis that takes place in Parts 2 and 3.
Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides
guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially-
large impact. The form also identifies whether an impact can be mitigated or reduced.
Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the
impact is actually important.
DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions
identify the Portions of EAF completed for this project: [] Part 1 [] Part 2 F~Part 3
Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting
information, and considering both the magnitude and importance of each impact, it is reasonably determined by the
lead agency that:
[] A. The project will not result in any large and important impact(s) and, therefore, is one which will not
have a significant impact on the environment, therefore a negative declaration will be prepared.
[] B. Although the project could have a significant effect on the environment, there will not be a significant
effect for this Unlisted Action because the mitigation measures described in PART 3 have been required,
therefore a CONDITIONED negative declaration will be prepared.*
[] C. The project may result in one or more large and important impacts that may have a significant impact
on the environment, therefore a positive declaration will be prepared.
* A Conditioned Negative Declaration is only valid for Unlisted Actions
Name of Action
Name of Lead Agency
Print or Type Name of Responsible Officer in Lead Agency
Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer)
Date
PART 1--PROJECT INFORMATION
Prepared by Project Sponsor
NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect
on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered
as part of theapplication for approval and may be subject to further verification and public review. Provide any additional
information you believe will be needed to complete Parts 2 and 3.
It is expected that completion of the full EAF will be dependent on information currently available and will not involve
new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify
each instance.
LOCATION OF ACTION (Include Street Address, Municip~ality and County)
ME Of APPLICANT/SPONSOR
NAME OF OWNER (If different)
CITY/PO
BUSINESS TELEPHONE
STA~TI~ ZIP CODE
ESS TELEPRONE
c 390-0/
Please Complete Each Question-Indicate N.A. if not applicable
A. Site Description
Physical setting of overall project, both developed and undeveloped areas.
1. Present land use: E]Urban E]lndustrial
I-1Forest E3Agriculture
2. Total acreage of project area:
APPROXIMATE ACREAGE
Meadow or Brushland (Non-agricultural)
Forested
I-qCommercial
E3Other
'~esidential (suburban)
E]Rural (non-farm)
acres.
PRESENTLY
AFTER COMPLETION
Agricultural (Includes orchards, cropland, pasture, etc.)
Wetland (Freshwater or tidal as per Articles 24, 25 of ECL)
Water Surface Area
Unvegetated (Rock, earth or fill)
Roads, buildings and other paved surfaces
Other (Indicate type)_
3. What is predominant soil type(s) on project site?
a. Soil drainage: E3Well drained ~C)1~ % of site
I-iPoorly drained % of site
acres ~ C'~ acres
acres I~ ~ acres
acres ~ ~ acres
acres ~ ~ acres
acres ~ ~ acres
acres tq~ acres
acres ~ acres
acres ~ ~' acres
well drained % of site
b. If any agricultural land is involved, how many acres of soil are classified within soil group 1. t. hrough 4 of the NYS
Land Classification System? r~O~ acres. (See I NYCRR 370).
4. Are there bedrock outcroppings on project site?
a. What is depth to bedrock?
I-lYes 1~No
(in feet)
2
5 Approximate percentage of proposed project site with ~lopes: , '1~-10% JOC') % FI10-15% %
I-I15% or greater %
6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National
Registers of Historic Places? E3Yes '1~,~1o
7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? E]Yes J;~No
8. What is the depth of the water table? ~ (in feet)
over a primary, principal, or sole source aquifer?. F-lYes ~No
9.
Is
site
located
10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? E]Yes I-lNo
11. Does project site contain any species of plant or animal Ij,f,e that is identified as threatened or endangered?
[:]Yes ~No According to --~ ~-~ I
I~Jentify each species
12. Are there any unique 6r unusual land forms on the prolect site? (i.e., cliffs, dunes, other geological formations)
I-lYes [:~4o Describe
13. Is the project site presently used by the community or neighborhood as an open space or recreation area?
I-lYes ~No If yes, explain
14. Does the present site include scenic views known to be important to the community? E3Yes [~No
15. Streams within or contiguous to project area:'
a. Name of Stream and name of River to which it is tributary
16. Lakes, ponds, wetland areas with. in,or co, ntiguo3&s to project area:
a. Name ~/~Q.,'_~, - ~-~--.~.O~.L."~ ~' b, Size (In acres)
17. Is the site served by existing public utilities? l~DYes E]No
a) If Yes, does sufficient capacity exist to allow connection? [:Pt'es E3No
b) If Yes, will improvements be necessary to allow connection? I-lYes Ei~No
18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA,
Section 303 and 304? [:]Yes
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 '~,¥es E3No
20. Has the site ever been used for the disposal of solid or hazardous wastes'? I-lYes E~No
B. Project Description
1. Physical dimensions and scale of pro)ect (fill in dimensions as appropriate)
a Total contiguous acreage owned or controlled by project sponsor ~ ,~,~O'~ acres.
b. Project acreage to be developed: acres initially; ~)~ acres ultimately.
c. Project acreage to remain undeveloped ~ C~" acres.
d. Length of project, in miles: Y~c'~--- (If appropriate)
e. If the project is an expansion, indicate percent of expansion proposed ~ ~ %;
f. Number of off-street parking spaces existing Y~,~ ; pro, posed ~/~ 0.._.
g. Maximum vehicular trips generated per hour _3'~C'{. (upon completion of project)?
h. If residential: Number and type of housing units:
One Family Two Family Multiple Family Condominium
Initially ~, ~
Ultimately O~ 4~
i. Dimensions (in feet) of largest proposed structure [/~)~ height; j~O,_ width; ,r~ ~ length.
j. Linear feet of frontage along a public thoroughfare project will occupy is? _~ ~'_ ft.
21 How much natural material (i.e., rock, earth, etc.) will be removed from the site?
3. Will disturbed areas be reclaimed? []Yes []No '~N-/A
a. If yes, for what intended purpose is the site being reclaimed?
b. Will topsoil be stockpiled for reclamation? E3¥es E3No
c. Will upper subsoil be stockpiled for reclamation? []Yes /No
tons/cubic yards
4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? ~ acres.
5. Will any mature forest (over 100 years old) or other Iocally-important vegetation be removed by this project?
ClYes ~
6. If single phase project: Anticipated period of construction ~ ~.--~ months, (including demolition).
7. If multi-phased: Al\ II'NO,,
a. Total:number of phases anticipated (number).
b. Anticipated date of commencement phase 1
c. Approximate completion date of final phase
d. Is phase I functionally dependent on subsequent phases?
8. Will blasting occur during construction? [Yes
9. Number of Jobs generated: during construction
10. Number of jobs eliminated by this project
11. Will project require relocation of any proiects or facilities?
month year, (including demolition).
month, year.
C]Yes I-INo
; after project is complete
[Yes ~ If yes, explain
12. Is surface liquid waste disposal involved? C]Yes ~
a. If yes, indicate type of waste (sewage, industrial, etc.) and amount
b. Name of water body into which effluent will be discharged
13. Is subsurface liquid waste disposal involved? [Yes ~ Type
14. Will surface area of an existing water body increase or decrease by proposal?
Explain
E3Yes ~o
15.
16.
Is project or any portion of project located in a 100 year flood plain? ~/-es
Will the project generate solid waste? E3Yes ~
a. If yes, what is the amount, per month tons
b. If yes, will an existing solid waste facility be used? C]Yes I-INo
c. If yes, give name ; location
d. Will any wastes nol go into a sewage disposal system or into a sanitary landfill?
e. If Yes, explain
i-INo
/j-lYes [Z]No
17
Will the project involve the disposal of solid waste? E3Yes
a. If yes, what is the anticipated rate of disposal? tons/month.
b. If yes, what is the anticipated site life? years.
18. Will project use herbicides or pesticides? /j-lYes ~o
19. Will project routinely produce odors (more than one hour per day)? I-lYes
20. Will project produce operating noise exceeding the local ambient noise levels? F-lYes
21. Will project result in an increase in energy use? [~]Yes
If yes , indicate type(s)
22. If water supply is from wells, indicate pumping capacity. ~:'~.C:~. gallons/minute
23. Total anticipated water usage per day [/"tC~ gallons/day.
24. Does project involve Local, State or Federal funding? [Yes ~4o
If Yes, explain
25. Approvals Required:
City, Town, Village Board {~Les I-1No
City, Town, Village Planning Board E]Yes
City, Town Zoning Board []Yes [~4o
City, County Health Department E]Yes
Other Local Agencies E]Yes
Other Regional Agencies [~,Yes I-1No
State Agencies '8;lYes []No
Federal Agencies l~Yes []No
C. Zoning and Planning Information
Type
Submittal
Date
I Does proposed action involve a planning or zoning decision? F-lYes ' ~No
If Yes, indicate decision required:
E]zoning amendment []zoning variance []special use permit []subdivision l-lsite plan
Iqnew/revision of master plan L3resource management plan []other
2 What is the zoning classification(s)of the site?
3 What is the maximum potential development of the site if developed as permitted by the present zoning?
4. What is the proposed zoning of the site?
5. What is the maximum potential development of the site if developed as permitted by the proposed zoning?
6. Is the proposed action consistent with the recommended uses in adopted local land use plans? F-lYes
7. What are the predominant land use(s) and zoning classifications within a 1/~ mile radius of proposed action?
8. Is the proposed action compatible with adjoining/surrounding land uses within a 1,4 mile?
9. If the proposed action is the subdivision of land, how many lots are proposed? ]"~O~
a. What is the minimum lot size Proposed?
10
11
~O
12
I-1No
Will proposed action require any authorization(s) for the formation of sewer or water districts? F1Yes
Will the proposed action create a demand for any community provided services (recreation, education, police,
fire protection)? []Yes [~o
a. If yes, is existing capacity sufficient to handle projected demand? []Yes []No
Will the proposed action result in the generation of traffic significantly above present levels? I-lYes
a. If yes, is the existing road network adequate to 'handle the additional traffic? F1Yes I-INo
Informational Details
Attach any additional information as may be needed to clarify your project. If there are or may be any adverse
impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or
avoid them.
E. Verification
I certify that the irkformclionj~rovic]ed above is tr;x~ the best of my knowledge.
Applicant/Sponsor Nar~e~//' ~'~AC'~ ~r_ ~'(~ Date
Signature ' ,J ~'~'~( ¢o~/~k ~ /Titie ' I~i? (~Y~J.? . . -
If the action is in the Coastal Area. a~ a~t=e agency, complete the~'/oasta, Assessment Form before proceedino
with this assessment. ~"~'/ 5.
Board of Trustees Applicat~O~
County of Suffolk
State of New York
BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMITIS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL
WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION
AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES.
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN
TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS
ARISING ~{DER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN
COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,
THEIR AGENTIS) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY
TO INSPECT THE PREMISES IN CONJUNCTION WITH REVI-EW OF THIS
APPLICATION.
Signature
SWORN TO BEFORE ME THIS
-JBoard of Trustees Applicat~bn
AUTHORIZATION
(where the applicant is not the owner)
(print owner of property)
~o ~ /~/~ ~ IVY {~.~o
Just/ J.M.O. Consulting
residing at
(mailing address)
do hereby authorize Glenn E.
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
( Owner ' s signature)
Telephone
(516) 765-1801
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
At a meeting of the Southold Town Conservation Advisory Counci held Monday,
December 18, 1995 the following recommendation was made:
A-33
DR. ISiS BARTELS 10-3-10 to install ~3~ +/- of revetment which shall be
placed between the still existing wails on either side. The revetment shall
consist of I - I 1/2 yard rock which shall be placed on filter fabric,
backfilled with 75 +/- c.y. of soil and then planted with native vegetation.
Fishers Island
The CAC has no recommendation because no inspection was made.
New Y~rk State Departra~'tit of Environmental
Building 40 - SUN¥. Stony Br~k. New York 11790-~56
~ Phone (5161 d4~365
O( 35o '
-- Your recent request to extend· the above permit has been
reviewed pursuant to 6NYCRR, Part 621. The expiration date-is
extended to
/Your recent request to modify the above permit has' been
reviewed pursuant to 6NYCRR, Part 621. It has been determined that
the proposed modifications will not substantially change t~·e scope
of the permitted actions or the existing permit conditions.
Therefore, the permit is amended to authorize:
This letter is an amendment to the original permit and, as such,
shall be available at the job site whenever authorized work is in
progress.
All other terms a~d conditions remain as written in the original
permit.
SCALE
o ,?%
~FLOOD
WID]-II ~'
%~7~'oLx COUNT','
HAGSTROM MAP 33
sCALE 1¢-4S00''
DECK
ROAD
J.M.O. Consulting
P.O. Box 447
Quogue, N.Y. 11959-0447
516-653-0607
November 7, 1995
Mr. Albert Krupski
Board of Town Trustees
Town of Southold
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, N.Y. 11971-1179
RE: Permit No. 4487
Barrels, Fishers Island
Dear Mr. Krupski: ~L.~l~d~t)~
At the present time, we are seeking to
permit which was issued on 6/29/95. At the present time, the
existing rock wall at the'-site is failing and the contractor
hired to construct the approved dock is concerned that the
wall should be repaired first. The repair would include the
inst-allationa ~.+_. 43' of revetment which shall be placed
between the still existing walls on ~ither side. The
revetment shall consist of 1-1 1/2 yard rock which shall be
place on filter fabric, backfilled with +~. 75 c.y. of soil and
then !planted with native vegetation.
For your review and files, we have enclosed modified
plans which depict the proposed w. ork. As always, should you
or any member of the Board have further comments or questions
pertaining to this project, please feel free to contact our
office at any time.
GEj:ar
Moist respec.~ fully,
G~enn E. ~]-~st
FROM : 3m0 ~0N~ULT IN~
CENAN- OP ~ RH
This letter mus~ be completed and mailed to the Harbor Supervision
& Compliance Section at the above addres~ prior to o.0~noe~enu of
any work authorized under the permit.
Permittee: 12~. Ii~L~ ~ne72=7_s Permit
DaCe pe~it I~ued: ~--~~_~ ......... Expiration Date:
Name, Address A Telephone of Contractor:
Signatuf% of P~cmittee Z9/2. ~&l~'/~---,~'
P04
COASTAL MANAGEMENT PROGRAM
Federal Consistency Assessment Form
JUN ~[ 4 1995
RECEiVeD
An applicant, seeking a permit, License/ waiver, certification or similar type of approval from a federal agency ~hicb
is subject to the Ne~ York state Coastal Management Program (CMP), shall cc~nplet~ this assessment form loc any proposed
activity that will occur within and/or directly affect the State's Coastal Area. This form is intended to assist an
applicant in certifying that the proposed activity is consistent with fle~ York State's CMP as required by U.S.
Department of Con~nerce regulations (15 CFR 950.57). It should be cc~lp[eted at the time ~nen the federal application is
prepared, The Department of State will use the completed form and accompanying information in its revie~ of the
applicant's certification of consistency.
.APPLICANT
1. Name:
Dr. Isis A. Bartels
2. Address:
(please print)
P.O. Box 148, Fishers Island, N.Y.
06390-0148
5. Telephone: Area Code ( )
PROPOSED ACTIVITY
1. Brief description of activity:
ramp & 6'x 20
203~889-3397
Applicant proposes to construct a 4'x 50' fixed
dock (ele. 4~ over grade of marsh), a 3'x
float.
2., Purpose of activity: .'j Private recreational docking
Location' of activity:
Suffolk Fishers Island
County City, Town or Village
Private Road No.
Street or Site Description
Type of federal permit/license required:
U.S.D.O.A. Nationwide
Federal application number, if
Unknown
COASTAL
question
proposed
If a state permit/license was issued or iS required for the proposed activity, identify the slate agency and
provide the appLicattonor permit number, if known: N.Y.S.D.E.C. , Tidal Wetland AppId No
Unknown
ASSESSMENT Check either "Yes" or "Non for each of the follcx~ing questions. The nu~ers following each
refer to the policies described in the CMP document (see footnote on page 2) which may be affected by the
aCttVi ry.
YES NO
1. Wi ll
the proposed activity resuL,t in any of the follc~ing:
a. Large physical change to a site within the coastal area which will require the preparation of
an envirore~otel impact statea~t/ (11, 22, 25, 52, 37, 5B, 41, 4-~) .............................
b. Physical alteration of ~ore than t~o acres of land along the shoreline, land under ~ater or
coastal' waters? (2, 11, 12, 20, ~S, ~5, ~41 .....................................................
c. Revitalization/redevelopment of a deteriorated or underutilized ~aterfront site? (1) ...........
d. Reductio~ of existing or potential public access to or along coastal waters? (19, 20} ...........
e. Adverse effect upon the commercial or recreational use of coastal fish resources? (9~ 10) .......
f. Siting of a facility essential to the exploration, development and production of energy
resources in coastal waters or on the Outer Continental Shelf? (29) .............................
g. Sit.tng of a facility essential to the generation or transmission of energy? (2?) ...............
h. Mining, excavation, or dredging activities, or the placement of dredged or fill materials in
coastal ~aters?' (15, ~5) ........................................................................ __
i. Discharge of toxics, hazardous substances or other pollutants into coastal waters? (15, 55) ..... __
j, Draining of stonm~ater runoff or sewer overflows into coastal wa~ers? (55) ......................
k. Transport, storage, treatment, or disposaL of solid wastes or hazardous materials/ (~6,)9) ..... __
t. Adverse effect upon land or water uses within the State's small harbors? (4) .................... __
2;
Will the proposed activity al_fact_ or be located in, on, or adjacent to any of the following:
a. State designated freshwater or tidal wetland? (44)..; ...........................................
b. Federally designated flood and/or state designated erosion hazard area? (11, 12, 17) ............
c. State designated significant fish and/or wildlife habitat? (7) ..................................
d. State designated significant scenic resource or area? (24) ......................................
e. S~ate designated tmoortant agricultural Lands? (26) .............................................
f. Beach, dune or barrier island? (12) .............................................................
g. Major ports of ALbany, Buffalo, Ogdensburg, Oswego or New York? ()) .............................
h. State, county, or Local park? (19, 20) ..........................................................
t. Historic resource Listed on the National or State Register of Historic Places? (2~) ..............
-1-
14111 the ~)FO"~ed ecti,v, ity ~ any of the following:
a. Waterfront site/ (2,,Z'l,,~2)~J., ....................................................................
'( *' * pu~l*i~'~eFv~ces or infrastructure in undeveLope~ or sparsely populated
b. Provisioti Of-new
sections of the coastal area? (5) ...............................................................
c. Construction or reconstruction of a f[cod or erosion control structure? (1], 14, 16) ............
d. State uater c~Jality permit or certification? (30, ]8, 40) .......................................
e. State air quality permit or certification? (41, 43) .............................................
Wilt the proposed activity occur, within and/or affect an area covered by a State approved Local
uaterfront revitalization program? (see policies in Local Program document") ........................
D. ADDITIONAL STEPS
1. If all of the questions in Section C are answered "No", then the applicant or agency shall complete Section E
and submit the documentation required by Section ~,
2. If any of the questions in Section C are answered "Yes", then the applicant or agent is advised to consult the
CHP, or where aPDroDriate, the local waterfront.revitalization program document*. The proposed activity must be
analyzed, in more detail with respect to the applicable state or local coastal policies. In the space provided
below or on a separate page(s), the applicant or agent shall: la) identify, by their policy nun~ers, which
coastal policies are affected by the activity, (bi briefly assess the effects of the activity upon t~e policy;
and, lc) state how the activity is consistent witheach poliCy. Following the completion of this written
assessment, the applicant or agency shall cor~olete Section E and submit the documentation required by Section F.
CERTIFICATION
The applicant or agent must certify that the proposed activity is consistent with the State's CMP or the
local waterfront revitalization program, as appropriate. If this certification cannot be made, the
activity shall not be undertaken. If this certification can be made, complete this Section.
approved
proposed
"The proposecl activity complies with New York State's .Bpproved Coastal Management Program, or with the applicable
approved local waterfront revitalization program, and will be conducted in a manner consistent with such program."
Applicant/Agent's Name: Glenn E.Just/ J.M'.O. Conau~l~ing
Address: P.O. Box 447, Quogue, N.Y. 11959-0447
.Telephone: Area Code ( )
Applicant/Agent's Signature:
F. SUBMISSION REQUIREMENTS
1. The applicant or agent shall submit the following documents to the New York State Department of State, Division
of Coastal Resources and Waterfront Revitalization, 162 Washington Avenue, Albany, New York 12231.
a. Original signed form.
b. Copy of the c~Leted federal agency application.
c. Other available information whtch would support .the certification of consistency.
2. The applicant or agent shall also submit a copy of this completed form along with his/her application to the
federal agency.
If there are any questions regar~iing the submission of this form, contact the Department of State at
474-2642.
"As proposed, project should have no adverse impacts on
New York State Department of State Coastal Management
policy nos. 2,21,22 and 44."
(518)
*These state and local doctm~nts are available for inspection at the offices of many federal agencies, Department of
Environmenta~
Conservation and Department of State regional offices, and the appropriate regional and county planning
agencies. Local progr-amdoc~nents are also available for inspection at the offices of the appropriate local government.
FCAF Revised 3/89
-2-
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