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HomeMy WebLinkAboutTR-3748Dear Sir/Madam, My husband and I recently purchased a home in Laurel, NY: 1810 North Oakwood Drive, 11948 There are three permits that need to be transferred from the seller's name (Martin Sendlewski) into our name (Richard and Jill Collins) When we purchased the property, the permits were not in the seller's name...they actually had to be transferred to our seller's name from the previous seller. Included is the board approval to have the permits transferred from seller 1 (Bastone) to seller 2 (Sendlewski). This was taken care of in December, 2011 At this time, we would like to have the permits transferred from seller 2 (Sendlewski) to us (Collins) The permits in question are: 1) Wetland Permit #3748 2) Wetland Permit #6609 3) Permit # 7699A We would appreciate it if you could put this on the agenda for the next board meeting. Should you need to contact us, our address and phone number are as follows: Richard and Jill Collins 10 Stuyvesant Oval Apt. 12B New York, NY 10009 Ph: 646-371-9199 Kind Regards, - 048579 ,I d ~ m ~ Do lars $ ~=~ _ _ James F. King, President Bob Ghosio, Jrt, Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mamh 14, 2012 Mr. & Mrs. Richard Collins 10 Stuyvesant Oval Apr. 12B New York, NY 10009 RE: SENDLEWSKI/COLLINS WETLAND PERMIT #3748 1810 OAKWOOD DR., LAUREL SCTM#127-6-8 Dear Mr. & Mrs. Collins: The Southold Town Board of Trustees reviewed your application dated March 9, 2012 and APPROVES the request for a Transfer of Wetland Permit #3748 from Martin Sendlewski to Richard & Jill Collins. as issued on April 27, 1989. If you have any questions, please contact our office at (631) 765-1892, Jame~ F. King, Presid~ Board of Trustees JFK:lms [2/29/2011 15:50 63[7651856 KEVIM40-ALJ~HLIN P;~E 03 December 14, 2011 TOW~ OF 8OUTHOL~ 8outhold, New York 11g71-0969 TebJ~me (~31) ?e6-1~2 Mr. Jerry Clbulski Century 21 Albeltson Realty P,O. Box 598 Southold, NY 11971 RE: BASTONE/SENDLEWSKI WETLAND PER~IT 83748 1810 OAKWOOD R., LAUREL $C'1'~127~-8 Dear Mr. Cibulskt: The following a~lon was taken al the Souti~:~ld Tow~ Board of Trustees Regular Meeting held on Wed., December 14, 2011: RESOLVED, that the Southold Town Board of Trdstees APPROVES the requeat for a Transfer of Wetland Permit #3748 from John & Eleanor Beato~e t~ Martin Sendlewski, as issued on April 27, 1989. If you have any questions, please ~ontact our office at (831) 765-1892. Sincerely, JMD:ImB $outhold Town-TrUstees NEW YORK Anthartzattan tbs Stets efNew Yed~ 1~3, e~ ~ ~ ~h ~:~ h IN AND ~ TO~ WA~S ~D ~B~ ~ :~ h ~V~ OF~D, G~L OR O~GR ~ ~OS ~ ~ WA~' ~ h ~ ~ th 19...~.., aK in ~e~ ~.h ~ ~ L....~. ................... ~ ~ ~ 6~z 46t ~, 3~ z 1~~r~, 6' x lZ~ 181~ ~ ~ve, ~ N.Y. . Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 December 14, 2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Jerry Cibuiski Century 21 AIbertson Realty P.O. Box 598 Southold, NY 11971 RE: BASTONEISENDLEWSKI WETLAND PERMIT #3748 1810 OAKWOOD R., LAUREL SCTM#127-6-8 Dear Mr. Cibulski: The following action was taken at the Southold Town Board of Trustees Regular Meeting held on Wed., December 14, 2011: RESOLVED, that the Southold Town Board of Trustees APPROVES the request for a Transfer of Wetland Permit #3748 from John & Eleanor Bastone to Martin Sendlewski, as issued on April 27, 1989. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Jill M.(~herty ~ President, Board of Tms~es JMD:lms Jill M. Doherty, President Bob Ghosio, .h, Vice-President Jmnes F King Dave Bergen John Bredemeye~ P.O Box 1179 Southold, NY 1 I071 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: )"~ -'~ "~' l/ Jerry Cibulski on behalf of MARTIN SENDLEWSKI requests a Transfer of Wetland Permit #3748 from John & Eleanor Bastone to Martin Sendlewski, as issued on April 27, 1989. Located: 1810 Oakwood Dr., Laurel. SCTM#127- 6-8 Type of area to be impacted: ~Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 __Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Administrative__Emergency Pre-Submission __ __Amendment Violation Info needed: Modifications: Conditions: Pres.gnt Were: P'J. Doherty . Ghosio vj. BredemeyeE D. Dzenkowski Form filled out in the field by ~/di'King ~D. '/ooth~ Bergen, Mailed/Faxed to: Date: November 04, 2011 Town of Southold Trustees Re.: TR-3748 Permit Dock 1810 N. Oakwood Laurel, NY Request is hereby made by Jerry Cibulski, agent for homeowner, Martin Sendlewski, to change the name on the above referenced permit from former owner Bastone, to Martin Sendlewski. Anything that can be done to schedule this item to be accomplished by the next Trustees meeting would be appreciated. Sin.ce,~y, ~ Jerry Cibulski attachmenl CENTURY 21 Albertson Realty 54280 Main Road - PO. Box 598 · Southold · NY 11971 Bu$ine$$631.1&$.380~ · Fax631.765,3803 · www.albertsonrealty.com ~I, Each office is independently owned and apelated ! Board Of $outhold Town Trustees SOUT.HOLD, NEW YORK PERMIT NO. 3..?...~.& ................. DATE: .A.. lq.~!!...;~.8..~,....~ ~ 8 9 Au 'horiza io Pursuant to the provisions of Chapter 615 of the Laws 0f the State of New York, 189~1; and Chapter 4.04 of fha Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND .ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted afb meeting held on ...A..P.~!....~7...~... 19....8.9.., and in consideration of the sum of $ .............................. paid by of .......................................................................................... N. Y. and subiect fo the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Construct 6' x 46' catwalk, 3' x 14' ramp, 6' x 12' floating dock, install 10 pilings. Property located at 1810 Oakood Drive, Laurel, N.Y. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes 'ifs Corporate Seal fo be be subscribed by a majority of fl~ affixed, and these presents to said Board as of this dat,e. FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 17, 1989 Mr. and Mrs. John Bastone 1810 Oakweed Road Laurel, N.Y. 11948 Re: Application No. 1-1-89-127-g~- Dear Mr. and Mrs. Bastone: The following action was taken by the Board of Town Trustees during their regular meeting held on April 27, 1989 regarding the above matter: WHEREAS, John and Eleanor Bastone applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated January 1, 1989, 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 April 27, 1989 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 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, THEREFORE BE IT RESOLVED that John and Eleanor Bastone BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: Construct 6' x 46' catwalk, 3' x 14' ramp, 6' x 12' floating dock, and install 10 pilings to secure same. This permit will expire two years from the .date it is signed if work has not commenced by said date. Fees must be paid 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. Please take 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. Permit will be issued upon payment of the following fees: 3' x 14' ramp ..................... $ 63.00 6' x 12' floating dock ............. 108.00 4 pilings below MHWM .............. 100.00 Total fees due .................... $271.00 Very truly yours, Frank A. Kuja~ski, Jr. President Board of Town Trustees FAK:jas CC: Bldg. Dept. Conservation Advisory Council file Telephone (516) 765-1801 Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL To: From: Dated: Re: Southold Town Trustees Southold Town Conservation Advisory Council February 22, 1989 Recommendation of Wetland Applications The following recommendation were made by the Southold Town Conservation Advisory Council at its meeting held Thursday, February 16, 1989: RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 11-88-78-2-42 of Joseph J. Verwayen to construct a private boat dock consinting of fixed elevated (3' above grade of marsh) catwalk, hinged ramp and two floats secured by pilings. RESOLVED to recommend to the Southold Town Trustess approval with stipulations of Wetland Application No. 11-88-113-6-11 for Gerald Wood to cpnstruct a timber dockconsisting of a 4' x 104' fixed elevated (min. 3.5') walk with outer 5' x 36' "L" to west. Inner end of dockwill be approximately in line with two existing timber pilings and 15' west of them. Propsoed dock will extend a distance equal to exising adjacent dock to east. The Council recommends approval with a further recommendation that natural plantings in the area to be filled behing the railroad ties to avoid runoff into the creek. RESOLVED to recommend to the Southoid Town Trustees approval of Wetland Application No. 1-1-89-127-68 of John and Eleanor Bastone to construct a floating dock and landing. RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 10-88-123-4-5 of Thomas Palmer to replace a 53' x 3' catwalk and 16' x 8' float and additioani work to dwelling consisting of a 12' x 37' wood deck to rear of dwelling, 8' x 37' extension and 11' x 22' garage to front of dwelling and move ekisting 8.4' x 8.4' shed to west side of lot ('further from HWM). RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 1-3-89-56-5-36 of Mateo Lettunich to reinforce westerly concrete and rock seawall, includein returns and reconstruct easterly rock revetment with additional rocks and filter cloth. The Council recommends approval since the work needs to be done but they would like to go on the record that if the work was a new project they would have recommended disapproval. Page 2 '~ RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 12-3-88-98-3-17 of Margaret McGwire to erect a two-story garage 22'x28' and an adjacent 12' x 12' storage shed. RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 1-5-89-80-3-16 of Henry Arbeeny to remove and replace (in same location and configuration) 60 I.f. of timber bulkhead, dredge a manimum of 10 c.y. (to 3' below MLW) from an area 10' in front of bulkhead and use spoil fro backfill, remove existing dock and replace with 3' x 12' hinged ramp and 6' x 16' float secured by (2) 2-pile dolphins. RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 12-88-80-3-17 of John Van Vladrichen to remove and replace in same location and configuration, 60 I.f. of timber bulkhead~ dredge a maximum of ~' 10 c.y. infront of bulkhead and use spoil' for backfill~ remove existing dock and replace with 3' x 12' hinged ramp and 6' x 16' float secured by (2) 2- pile dolphins. 217-72 77th Ave. Bayside~ N.Y. 11364 April 14, 1989 Ms. Joan Schneider, Clerk Southold Board of Town Trustees Town Hall Main Road Southoldf N.Yo 11971 Re: Matter of Eleanor & John Bastone to construct floating dock at 1810 No. Oakwood Road, Laurel, N.Y. Dear Mso Schneider: As requested in our last telephone conversation, I am enclosing herewith the following: copy of the new sketch which gives more details than the original one o copy of survey showing the approximate location of the dock and catwalk Please note the approximate height above the water grade is This is ~scheduled for the hearing of April 27, 1989. If there is anything further you may require prior to that date, please let me ~OWo You can call me at the following telephone numbers: office: 516- 437-1020 home : 718- 468-8427 Very ,~ruly your~, Eleanor Bastone encls. FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 January 6, 1989 Mr. John Holzapfel, Chairman Southold Town Conservation Advisory Council Main Road Southold, New York 11971 Dear Mr. Holzapfel: Transmitted herewith is application. No. 1-1-89-127-68 for a Wetland Permit submitted by John and Eleanor Bastone. Please prepare a written report of findings and recommendations with respect to this application. Very truly yours, F~: j as Attachment cc: Bldg. Dep't. Frank A. Kujawski, Jr. President Board of Town Trustees FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 January 6, 1989 Mr. Robert A. Greene Alternate Regional Permit Administrator New York State D.E.C. Bldg. 40, SUNY, Room 219 Stony Brook, New York 11794 Re: Mr. and Mrs John Bastone-App. No. 1-1-89-127-6-8 Dear Mr. Greene: Please be advised that this office has received a partial application in the above referenced matter~. Pursuant to the Code of the Town of Southold, the Board of Town Trustees will not act upon an application until it is deemed complete by the submission of documentary proof that all other necessary permits and approvals have been received. Please keep this office informed of your progress in this matter. We wish to be involved in your environmental review under the S.E.Q.R.A. Legislation. Feel free to contact this office at (516) 765-1932 should you have any questions in regard to this matter. Very truly yours, Frank A. Kujawski, Jr., Pres. Board of Town Trustees FAK: jas cc: Mr. and Mrs. John Bastone C.A.C. Board of Appeals Building Dep ' t. Army Corps of Engineers FRANK A. KUJA~/SKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 To Whom It May Concern: January 6, 1989 Attached hereto is a Short Environmental Assessment Form submitted by John and Eleanor Bastone for a wetland permit to construct walkway, floating dock and landing. Property is located at 1810 Oakwood Drive, Laurel, .N.Y. ., j i, Jr. /~ President Board of ~,~Town Trustees Posted: January 6, 1989 FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH TE LEP H O NE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 December, 9, 1988 Mr. and Mrs. John Bastone 1810 No. Oakwood Rd. Laurel, N.Y. 11948 Re: Wetland Application No. 11-88-127-68, property located at 1810 No. Oakwood Dr. Laurel, N.Y. Dear Mr. and Mrs. Bastone: On December 8, 1988 the Board of Trustees inspected above referenced property and it was determined that we need a better sketch of dock, how far will it go out into the water, etc. We will need this information by our next meeting on December 15, 1988. When you come into the office to submit necessary information, would you please pick up a Public Notice sign to be posted on property. Thank you. FAK: jas Very truly yours, Frank A. Kujawski 'Board of Trustees BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 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 WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF THE TOWN OF SOUTHOLD, AND THE ISSUANCE' OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODES OF THE TOWN OF SOUTHOLD. TAX MAP NO.. AGENT PHONE NO. f")SIZEOF PROPOSED WORK ~ ~pr/ ................ PERMIT REQUESTED TO w- - LOCATION OF PROPERTY FOR WHICH PERMIT WANTED ...... _ _ HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION DEPTH.BELOW LOW WATER YARDS TO BE EXCAVATED YARDS TO BE FILLED WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY DEPTH AT LOW: TIDE AVERAGE RISE IN TIDE ~~__, ~ ~ DISTANCE TO THE NEAREST CHANNEL FT. DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE AREA IS THIS FOR' PRIVATE OR BUSINESS USE? :~ ~ AREA ZONING FT. MANNER IN WHICH MATERIAL WILL BE REMOVED OR' DEPOSITED ,NTENDED USE OF pROPERTy 5/ 6Ce ' 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 BY A GOVERNMENTAL AGENCY 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 OF THE OWNER OF THE PROPERTY, IF NOT THE SAME AS THE APPLICANT. ~ ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD PROHIBIT THIS PROJECT? / / / 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 HEI~EIN ARE TRUE T.O THE BEST OF HIS KNOWLEDGE AND BELIEF, THAT THE WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION A~D AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPL HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE F~OM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PER~IT, IF ~ANTED. in completing this application I hereby authorize the Trustees~ agent or representatmve to enter onto my property to inspect the premises in conjunction wihh revie~~pp~ ~[N~D~E SIGNATURE OF APPLICANT SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC EXAM]NED 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 14-16-4 (2/87)--Text 12 "~RbJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project spbnsor) FORM SEQR 3. PROJECT LOCATION: Municipality ~'//~ L County '~U F FO/~=-K 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) , , , ). 5. IS PROPOSED ACTION: [] New [] Expansion ~Modificationlalteration s N& s DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres L c-ss f; # t Ae. R C- 8. WILL__~OPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? U~Yes [] No If No, describe briefly 9. ',V~,~S PRESENT LAND USE IN VICINITY OF PROJECT? ~ Residential [] !ndustrial [] Commercial Describe: [] Agriculture [] Park/Forest/Open space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE Q_?I LOCAL)? [] Yes [] No If yes, list agency(s) and permit/approvals _ 11. DOES ANY ASr_~ OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes I__~No ~f yes, list agency name and permit/approval 12. AS a RESULT ~/FROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes ~ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE tS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Signature: J If the action is in the Coastal Area, and you are a state agency, complete the ..~ Coastal Assessment Form before proceeding with this assessment OVER 1 ~ view A. DOES ACTION EXCEED ANY TYPE ~"~RESHOLD IN 6 NYCRR, PART 617.127 If yes, coordinate the re ' process and use the FU. LL'B~.~. [] Yes [] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. [] Yes- [] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air cuality, surface or-greundwater quality or quantity, noise levels,' existing traffic patterns, solid waste production or potential for erosion, drainage or flooding problems? Explain briefly: C2.=Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood .character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant 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 briefl c5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly. C7. Other impacts (ihbl~ding changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR I~,~F-.F{E LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes ~ No If Yes, explain briefly PART Ill--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 should be assessed in 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 delail to show that all relevant adverse im pacts 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. Then proceed directly to the FULL 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 significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency Print or type Name ot Responsible Officer m Lead Agency Signature of F~espons~bJe Officer m Lead Agency Title of Responsible Officer Date Signature of Preparer (If different from responsible officer) . 2 14~165~2 (2/87)-- 7c 617.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEQR Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, Whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of .a 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 be technically_ e.xpert in environmental analysis. In addition, many who have knowledge in one particular area may ~n/ot be awareof the broader concerns affecting the question of significance. / The full EAF is intended to provide a method whereby applicants ~f~ agencies can be assured that the determination process has been orderly comprehensive in na~. et flexible to a~,~ntrod~ction of information to fit a project or action. Full EAF Components: The full EAF is comprisedof~,~ree pa.~ . Part 1: Provides objective data and i_nf'ormationX~bou/t a given project and its site. By identifying basic project data, it assists a reviewer in the analysis t~(~/t~kes place in Parts 2 anal 3. · Part 2:' Focuses on identifying the range of possibl/i~h~acts th~at may occur from a project or ~ct'ion. It provides guidance as to whether an impact is likely/t'o be c~nsid~'red small to moderate or whether it is a potentially- large impact. The form also identifies/~ether an~,~act can be mitigated or reduced. Par't 3: If any impact in Part 2 is identified as potentially-large,"~n 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 I [] Part 2 I-lPart 3 Upon review of the informatio~ recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude 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 ~viil 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 ~ot be a significant ......... eff~ect 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 onty valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer ( f different from responsible officer) Date ~'~' PART 1--PROJECT INFORr~ATION Prepared by ProjeCt Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effe( on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considere as part of the application for approval and may be subject to further verification and public review. Provide any addition~ 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 involv new studies, research or investigation. If information requiring such additidnal work is unavailable, so indicate and specif each instance. NAME OF ACTION LOCATION OF ACTION (Include Street Address, Municipality and County) NAME OF APPLICANT/SPONSOR I BUSINESS TELEPHONE I ( ) ADDRESS CITY/PO .~ STATE I ZIP CODE NAME OF OWNER (If different) ADDRESS BUSINESS TELEPHONE ( ) CITY/PO STATE I ZIP CODE DESCRIPTION OF ACTION 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: I-IUrban il. Industrial E3Commercial ilResidential (suburban) I-'lRural (non-farrr l-lForest i-t ~Agriculture ilOther 2. Total acreage of p~oject area: acres. APPROXIMATE ACREAGE 'PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) acres acres Forested acres acres Agricultural (Includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) acres acres Roads, buildings and other paved surfaces acres : acres Other (Indicate type) acres acres 3. What is predominant soil type(s) on project site? a Soil drainage: F1Well drained % of site [-]Modbrately well drained % of site ~Poorly drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group I through 4 of the NY~ Land Classification System? acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings_on project site? l-lYes [-]No _ a. What is depth-to bedrock? (in feet) 2 5. 'A~proximate percentage of p,,~,posed project site With slopes: 1-10-J0S.~.~ % Z/10-15% % I--[15% or greater % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of H storic Places? E~Yes r-]No 7. Is project substantially contiguous to a~site listed on the Register of National Natural Landmarks? [Yes r-iNo 8. What is the depth of the water table? (in feet) -. 9. Is site located over a primary, principal, or sole source aquifer? r-lYes l-lNo 10. Do hunting, fishing or ~hell fishing opportunities presently exist in the project area? []Yes I-1No 11. Does project site contain any species of plant or an'imal life that is identified as threatened or endangered? I-Wes [-]No According to Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) Z/Yes i-qNo Describe 13. Is the project site presently used by the community or neighborhood as an open space or 'recreation area? I-lYes i-lNo If yes, explain 14. Does the present site include scenic views known to be important to the community~ l-lYes I-INo ' 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 within or contiguous to project area: a. Name b. Size (In acres) 17: Is the site served by~xisting public utilities? E]Yes Z/No a) If Yes, does sufficient cap~acity exist to allow connection? [Yes [~No b) If Yes, will improvements be necessary to allow connection? []Yes E3No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, AYticle 25-AA, Section 303 and 304? I-lYes I-iNo 19. Is tt~e site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 E3Yes l--INo 20. Has the site ever been used for the disposal of solid or hazardous wastes? l-lYes I-1No B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acreage to be deYeJoped: acres initially; c. Project acreage to remain undeveloped acres. d. Length of project, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed %; f. Number of off-street parking spaces existing ; proposed g. Maximum vehicular trips generated .~er hour (upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Initially Ultimately · Dimensions: (in feet)' of largest proposed structure height; width; j. Linear feet of f~.ontage along a public thoroughfare project will occupy ii? ft. acres· acres ultimately. Condominium . length. 2. How much natural materia~.e., rock, earth,, etc.) will be removed fr he site? 3. Will disturbed areas be reclaimed? I-lYes [:]No i-IN/A a. If yes, for what intend~c~ purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? I-lYes I-iNo c. Will upper subsoil be stockpiled for reclamation? []Yes I-INo 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 locally-important vegetation be removed by this project? [:]Yes F-INo ' ' 6. :If single phase project: Anticipated period of construction 7. If multi-phased: a. Total number of phases anticipated 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? i-lYes l-INo 9. Number of jobs generated: during construction 10. Number of jobs eliminated by this project 11. Will project require relocation of any p~ojects or facilities? (number). months, (including demolition). tons/c~bi'c ,yards month month . year: I-lYes ; after project is complete year, (including demolitioni. r-lYes -1No If yes, explain 12. Is surface liquid waste disposal 'involved? I-lYes l-INo 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? I-lYes []No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain E3Yes I-1No 15, 16. Is project or any portion of project located in a 100 year flood plain? I--lYes Will the project generate solid waste? I-lYes []No a. If yes, what is the amount per month tons b. If yes, will-an existing solid waste facility be used? I-lYes I-INo c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain I-1No r-lYes I-INo 17. 18. 19. 20. 21. Will the project involve the disposal of solid waste? [:]Yes a. If yes, what is the anticipated rate of disposal? b. f yes, what is the anticipated site life? years. Will project use herbicides or pesticides? l-lYes 71No l-INo tons/month. Will project routinely produce odors (more than one hour per day)? I-lYes Will project produce operating noise exceeding the local ambient noise levels? Will project result in an increase in energy use? [-]Yes [:]No If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity 23. Total anticipated water usage per day gallons/day. 24. Does project'involve Local, State or Federal funding? []Yes If Yes, explain F-1No E]Yes I-lNo gallons/minute. r-lNo 4 252t.Approvals Required: Type Submittal Date City, Town, Village Board l-lYes t-INo City, Town, Village Planning Board I-lYes f-iNo City, Town Zoning Board l-lYes I-INo City, County Health Department I-lYes I-INo Other Local Agencies I-lYes i-lNo Other RegionalAgencies f-lYes I-INo State Agencies I-lYes I-1No Federal Agencies I-IYes i-lNo C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? r-lYes CINo If Yes, indicate decision required: r-lzoning amendment I--Izoning variance i-lspecial use permit [-Isubdivision r-lsite plan r-lnew/revision of master plan E3resource management plan r--iother 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 zoni6g 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? I-lYes I-1No 7. What are the predominant land use(s) and zoning classifications within a ~¼ mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a ~,4 mile? t-lYes []No 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What"is the minimum lot size proposed? 10. Will proposed action require any authorization(s} for the formation of sewer or water districts? r-]Yes Fl-]No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? I--lYes [] No a. If yes, is existing capacity sufficient to handle projected demand? r-lYes F-INo 12. Will the proposed action result in the generation of traffic significantly above present levels? []Yes Fl-]No a. If yes, is the existing road network adequate to handle the additional traffic? i-lYes []No D. 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 ybu propose to mitigate or avoid them E. Verification I certify that-the information provided above is true to the best of my knowledge. Applicant/Sponsor Name Date Signature . :_. litle If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment, r , ...... 5 Par~PROJECT IMPACTS AND TH~ MAGNITUDE Responsibility .of Lead Agency General Information (Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations been reasonable? '[;he reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance, identifying an impact in column 2 simply asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable'tl~'roughout the State ann for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site,,in each locality, will vary. Therefore, the examples are illustrative 'and have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each question. · The number of examples per question does not indicate the importance of each question. · In identifying impacts, consider long term, short term and cumlative effects. ~ ~ Instructions (Read carefully) ' · a. Answer each of the 19 questions in PART '2. Answer Yes if ther(~will be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential size of the impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshold is lower than example,r check column 1. d. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3. e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the project to a Small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. This must be explained in Part 3. IMPACT ON LAND 1 Will the proposed action result in a physical change to the project site? []]NO F-lYES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length}, or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2. Will there be an effect t.'. .... ,y ur, que or unusual land forms found on the site? (i.e., cliffs, dunes, geological formations, etc.)F-1NO E3YES · Specific land forms: 6 I 2 ~3 Small to Potential Can impact Be Moderate Large Mitigated By Impact Impact Project .Change [] [] I-qYes I--INo [] [] i-lYes I'-]No L--] [] I-lYes I-]No [] [] [--]Yes I-]No ' [] [] []Yes []No [] [] []Yes []No [] [] ~" [--]Yes []No [] [] []Yes []No []- [] []Yes []No [] [] []Yes []No IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? {Under Articles 1.5, 24, 25 of the Environmental Conservation Law, ECL) [NO I~YES Examples that would apply to column 2 · Developable area of site contains a protected water body. · Dredging more than 100 cubic yards of material from channel of a protected stream. · Exten sion of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water? I-]NO E:]YES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body of water or more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. · Other impacts: 5. Wil.I Proposed Action affect surface or groundwater quality or quantity? r-]NO []YES Examples that would apply to column 2 · Proposed Action will_require a discharge permit. · Proposed Action requires use of a source of water that does not have approval to serve proposed (project) action. · Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed off the site to facilities which presently do not exist or have inadequate capacity. · Proposed Action would use water i~' excess of 20,000 gallons per day. · Proposed Action will likely cause siltation or other discharge into an existing body of water to the extent that there will be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroleum or chemical products greater than !,100 gallons. · Proposed Action will allow residential uses in areas without water and/or sewer services. · Proposed Action locates commercial and/or industrial uses which may require new or expansion of existing waste treatment and/or storage facilities. · Other impacts: 6. Will proposed action alter drainage flow or patterns, or surface water runoff? I-]NO EYES Examples that Would apply to column 2 · Proposed Action would change flood water-flows. ..... ' I 2 3 ' Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change '" [] [] []yes []No [] [] : I--lYes E~]No [] [] i-]Yes []No [] [] I-'lYes .I-1No [] [] ~ I-lYes · [-INo [] [] I-Ives ,I-1No [] [] [-']Yes 'l--INo [] [] []Yes i--INo [] [] I-lYes I--1No [] [] []Yes I-[No [] [] I-lYes '[]No [] [] []Yes I--INo [] [] [-]Yes i-]No [] [] I--[Yes .J?lNo [] [] r-'lyes- [] [] I-lYes E3No [] [] E3Yes- . []No [] [] [-'[Yes []No [] ..- E3~ I-IVes I-1No [] [] []Yes E3No .... [] ; [] F"]Yes l-lNo · Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7. Will proposed action affect air quality? r-lNO I-lYES Examples that would apply to column 2 · Proposed Action will induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of' more'than 1 ton of refuse per hour. .. · Emission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million BTU's per hour.' · Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species? ENO r-lYES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. · Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. · Other impacts: 9. Will Proposed Action substantially affect non-threatened or non-endangered species? []]NO EYES Examples that would apply to column 2 · Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. · Proposed Action requires the removal of more than 10 acres of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10. Will the Proposed Action affect agricultural land resources? FqNO E]YES Examples that would apply to column 2 · The proposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields; pasture, vineyard, orchard, etc.) Small to Potential Can Moderate Large ~Mitigated By Impact Impact Project-Change [] [] I-lYes I-]No ~J--J . [] []Yes r-iN0 . [] [] l--JYes ,[]No. [] []- []Yes ENo j [] [] . r-lyes I-INo [] [] ' [-7lYes "[]No [] [] r-]Yes F-JNo [] [] []Yes I--INo [] [] ' []Yes []No [] [] r-lYes []No [] , [] I-lYes I-]No [] [] r-lyes tDNo [] [] []Yes [] [] I-lYes I-qNo 1 [] [] []Yes l-lNo [] [] J--JYes J:'lNo ' · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricuJtural land or, if located in an Agricultutal District, more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g., subsurface drain lines,, outlet ditches, strip cropping); or create a need for such measures (e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources? []NO [YES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix B.) Examples that would apply to column 2 · Proposed land uses, or project components obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources-which will eliminate· or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that Will result in the elimination or significant screening of scenic views known to be important to the area. · Other Impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? I--]NO I-lYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any ~mpact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantity or quality of existing or future Qpen spaces or recreational opportunities? Examples that would apply to column 2 [-]NO [:]YES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Other impacts: 9 I 2 - 3 '~. Small to ~ Potential Can ImpaCt Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes []No · r-I [] []Yes I--JNo [] [] []Yes [-]No [] I--I. []Yes []No [] [] f-lYes []No [] [] []Yes []No [] [] I-lYes []No [] [] []Yes []No [] [] [-']Yes []No [] [--1~ [] Yes . . [] No [] [] [--[Yes []No [] [] l--lYes []No [] [] [-]Yes ~F-INo [] [] [-]Yes []No [] [] · I-lYes l--INo IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? FqNO E]YES Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods. · Proposed Action will result in major traffic problems. · Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel .or energy supply? I-ENO I-lYES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of any form of energy in the municipality. · Proposed Action will require the creation or extension of an energy transmission or supply system to serve more than 50 single or two family residences or to serve a major commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? I-qNO I-lYES Examples that would apply to column 2 · Blasting within 1,500 feet of a hospital, school or other sensitive facility. · Odors will occur routinely (more than one hour per day). · Proposed Action will produce operating noise exceeding the local ambient noise levels for noise outside of structures. · Pr'0posed Action will remove natural barriers that would act as a noise screen. · Other impacts: IMPACT ON PUBLIC HEALTH 17. Will Proposed Action affect public health and safety? E:]NO E:]YES Examples that would apply to column 2 · Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pesticides, chemicals, radiation, etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. · Proposed Action may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, .radioactive, irritating, infecti:ous, etc.) · Storage facilities for one million or more gallons of liquified natural gas or other flammable liquids. · Proposed action-may result in the excavation or other disturbance within 2,000 feet of a site used for the disposal of solid or hazardous waste, · Other impacts: 10 Small to Potential Can Imp~.Ct Be Moderate Large Mitigated By Impact Impact Project Chang~ ~ [] [] i-lYes "F-INo , [] [] r-lYes '[-1NO [] ' 'E~ I-lYes I-]NO, [] '[] []Yes · ID~O [] : [] []Yes J-'IN~ [] [], I-lyes []No [] [] [-~Yes J-]No [] [] []Yes J--JNo [] [] J--JYes J-]No [] [] []Yes []No [] [] : []Yes J-JNo [] [] J-qYes-.. J--JNo [] . J~]~ []Yes []No [] [] []Yes []No [] [] []Yes []NO -'-[-'] , [] []Yes FT]No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing community? []NO E~YES Examples that would aPply to column 2 · The permanent population of the city, town or village in which the project is located .is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures. or areas of historic importance to the community. · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future projects. · Proposed Action will create or eliminate employment.- ' Other impacts: I 2 3 Small to Potential Can Impact Be Moderate L~rge Mitigated By Impact ImpaCt !Project Change [] [] l--lYes [--]No [] [] ' [-]Yes i-[No [] [] r-]Yes i--[No [] [] []Yes [-1No [] ~ I-']' []Yes I--1No [] [] ' i-lYes [-INo [] [] []Yes I--INo [] [] I-lYes [-INo 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? II, NO I-lYES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 Part 3--EVALUATION OF THE IMPORTANCE OF iI"VlPACTS -.- Responsibility of Lead Agency.:. Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by projectehange(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources of value · Whether the impact can or will be controlled -" · The regional consequence of the impact · Its potential divergence from local needs and goals · Whether known objectIons to the project relate to this ~mpact. (Continue on attachments) 11 Appendix B State Er vironmental QUality Review V sual EAF Addendum This form may be' used to provide additional information relating to Question 1 1 of Part 2 of the Full EAF. Visibility 1. Would the project be visible from: · A parcel of land which is dedicated to and available to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public [] F-]~ [] [] [] observation, enjoyment and appreciation of natural or man-made scenic qualities? ... · A site or structure listed on the National or State [] [] [] [] [] Registers of Historic Places? · State Parks? [] [] [] [] [] · The State Forest Preserve? [] [] [] [] [] · National Wildlife Refuges and state game refuges? [] [] [] [] [] · National Natural Landmarks and other outstanding [] [] [] [] [] natural features? - · National Park. Ser~zi~e lands? [] [] [] [] [] · Rivers designated as National or State Wild, Scenic [] [] [] [] [] or Recreational? (To be completed by Lead Agency) Distance Between Project and Resource (in ~Miles) 0-1/4 1/4 - 1/z I/2-3 3-5 5 + · Any transportation corridor of high exposure, such [] [] - [] [] [] as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate [] [] [] [] [] or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as [] [] [] [] [] scenic? · Municipal park, or designated open space? · County road? -~ · State? · Local road? Is the visibility of the p~oject seasonal? (i.e., screened by summer foliage, b~t visible during other seasons) []Yes []No 3. Are any of the resources checked in question I used by the public during the rime'of year during which the project will be visible? .[~ Yes [] No- OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally describe the surrounding environment. Within '1/4 mile * 1 mile Essentially undeveloped [] [] Forested [] [] Agricultural [] [] Suburban residential [] [] Industrial [] [] Commercial [] [] Urban [] [] River, Lake, Pond [] [] Cliffs, Overlooks [] [] Designated Open Space [] E~]' Flat - ~~ [] [] Hilly [] [] Mountainous [] [] Other [] [] NOTE: add attachments as needed 5. Are there visually similar projects within: '1/2 mile []Yes []No *1 miles []Yes []No *2 miles -E~Yes [] No *3 miles []Yes []No * Distance from project site are provided for assistance. Substitute other distances as appropriate EXPOSU RE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while ~iewing the proposed action is FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work [] [] [] [] Involved in recreational activities [] [] [-- [] Routine travel by residents [] [] [] [] At a residence [] [] [] ~[] At worksite [] [] [] [] Other [] [] [] [] 2 .f SEP 2 ewn,~e dfHpofinl a-..d v,*er suppl~ .ttie-~ f'or I.hfa l,~,~,.~on hove been Chief of Genern~ ~BJneerJ~ DEPART MENT ..DATA FOR APPROX,,~d.. TO CONSTRUCT wAT~ IAIN__MI. -~ M SOURCE OF WATER* p~IVATE J( PUBUC m TAX MAP DIET ~SECTION~ BLOCK O~ . LOT O _ ARE NO I~/ELLINIS WITHIN tOO FEET QF THiS PROPERTY ., I'NAN THOLE SHOWN HEREON EUPI't.Y AND SEWAGE DIIPO~AL SYSTEM FOR THIS REIIDENC~ 'ORN TO THE STAND~JIOS O1' THE SUFPQLK COUNTY DEPARTMENT TH IERV ICES. SURVEY FOR JOHN BA$1'ONE AT LAUREL TOWN OF SOUI'HOLO ELEANOR BAS TONE 'SUFFOLK COUNTY, NEW YORK · ~I~UNAUTHORIZED ALTERATION OR AOOITION TO THIS · *'SURVEY BA VIO~ATiOH ~ SECTION T~OII Q~ THE NEW YORK STATE EDUCATION LAW ~ COPIEE ~ THIJ SURVEY NOT ~JEARIHD THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT lie CONSIDERED TO SE A VALID TRUE COPY NGUARAHTEEI INDICATED HEREON SHJU_L RUN ~'ILY 1~ THE PERSOH FOR WHOM THE SURVEY IS PREPARED ANO (iN HIS GEIIALF JO THE TITLE COMPANY, GOVERN- MENTAL AGENCY AND LENDING INSTITUTIONLISTEO HEREOH~ AND TO ~IJE &SSIG#EES OF THE*I~*ENGJNG INSTITUTION. gUARANTEES ARE NOT TRAtlSFERAIJLE _TO ADOITIOHAL INSTITUTIOtlS OR SUBSEQUENT ")OWN Ir R S R DISTANCES SHOWN ,HEREON FROM PROPERTY UHES TO EXISTINIi STRUCJURES ARE FOR A SPECIFIC PURPOSE AN0 ARE HOT TO lie USED TO ESTABLISH PROPERTY LINES OR FOR THE ERECTION OF FENCES YOUNG e, YOUNG RIVERI~A£ ALDEN W. YOUNG+PHOF£$SlONMt ENGINEEH - AND LAND SURVEYOR N.Y.$. UCENSE NO. IZl145 HOWARD W. YOUNG~ LAND SURVEYOR C_,~%% '%.