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HomeMy WebLinkAboutTR-673BOard Of Southold Town Trustees SOUTHOLD, NEW YORK .... P'~I~IT N~.-6:z/ ............... L_].7~- -- DATE: Marcb'30T----t$89 ISSUED TO ..DJk-¥-ID-..G....4Z-I~EA:.T.© ............................................................................. Xnll]nri ali n · Pursuant to the provisions of C~apfer 615 of the Laws of the State of New York, 1893; and Cha~'er 404 of the. 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 at a meefincj held on Mar-eh..--2-~..- 19._..8...9...., and in consideration of the sum of $ .......................... paid by of ......................................................................................... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the followlncj: Restore pond filled in by runoff and silt, property located 35.3~ Cox Ne'c'k...Rd.,.:Mattituck, N.Y. all in accordance wlfh the detailed specifications as presented ~n the originating application. IN WITNESS WHEREOF, Th'e 'said Board of Trustees h,ere- by causes ifs Corporate Seal to be affixed, and these presents to be subscribed by a majority of the as of this date. Please tear off and return to the Trustee Office. Board Of SoutI 31d'Town Trustees' · SOUTHOLD, NEW yORK No. _ Date: Mooring Pe~t Mooring No. I, certify that'the-work as "' authorized in thi~ per~ has been completed and is now ready for your inspection. Also, the number required on this project is clearly visible. I further understand this permit is not-valid until'this tear off sheet is returned to the.Trustee 0ffice. TERMS and CO ,.~ __ ~-----~AV~D~;-~R-E~O parr of' the comid~don for ~e ~ce of ~e Pe~t d~ ~de~d ~d p~ to ~e fol- lowing: 1. That the SouLhold Trustees Permit must be prominently ,displayed on ~e premises effected thereby during the period of -['~['~[~ '-. .... - .:. ~as ~ smd B~d of T~s ~ ~e To~ o~ ~u~o14 ~ ~l~d ftom ~y ~d work - '-;..~,f ~ ~ga% or d~;~, fo~ ~, 0f ~ ~ ~y oz ~y ~ ~ z~: of ~y 0~' unde] [ ~6on ~fo~ p~ for ~ ~ension may ~ ~de to ..... 4.2 That this Permit should be ret,;-ecl indeflnitel¥, or as long as the said Permittee wishes - to maintain the structure or ptojecr involved, to provide evidence to anyone concerned that anth- orlzation was originally obtained. 5 ~- That' Bae work h3volved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board. 6. That there will be no mareaso~able interference with navigation as a result of the work herein authotized ..... 7.. That the~e'shall be no interference with the right of the public to pass and repass along the beach between high and low water mar~. f 8. That if future operations of the Town of Sonthold require the removal and/or alterations in the location of the work berein authorized, or if, in the opinion of the Board of Trustee% the work shall cause uarea$onable obstmoaon to free navlgadoo, the said Permittee will be required, upon due notice, to remove or alter this work or projec~ herein stared without expenses to the Town of Southold. 9. That the said Board will be notified by the Permittee or the completion of the work am:la- orlzed. (See tear off sheet.) 10. That the Permittee will obtain all other permits and consents that may be required nap- plementai to this permit which may be subject to revoke upon failure to obtain same. 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 March 28, 1989 David C. Creato 3539 Cox Neck Road PO Box 1149 Mattituck, N.Y. 11952 Re: Application No. 673 Dear Mr. Creato: The following action was taken by the Board of Town Trustees during their regular meeting held on March 23, 1989 regarding the above matter: WHEREAS, David C. Creato applied to the Sou~hold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated October 4, 1988, 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 March 23. 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 David C. Creato BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: Restore pond filled in by runoff and silt, on property located at 3539 Cox Neck Road, Mattituck, N.Y. 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: 10.00 wetland Inspection fee FAK:jas cc: Bldg. Dept. Conservation file Very truly yours, Frank A. Ku3awski, Jr. President Boar~ ef ~o~n ~rustees Advisory Council r CAS~OESCR,PT~N , ' ~/'7 CLASS COOE I CASE TYPE 1 O A NER ST~ NAME I N 516-765-2600 El CRIMINAL CASE t~NON CRIMINAL REPORTED DIR APT. SECTOR COUNTRY CLUB/GROUNDS M - MISSING PERSON R - REPORTING PER~ON O - OWNER S * SUSPECT ADDRESS OCCUPATION EYES H~JR COMPLEXION DOS HGT RACE CODES p A- ASIAN~ORIENTAL E - BLACK E LAST NAME R S O HOME PHONE S H - HISPANIC .FIRST MI I - AMERICAN INDIAN ADORESS 0 - OTNE R W - WH OCCUPATION HOMEPHONE OCCUPATION EYES HAIR COMPLEXION FRANK A. KUJA~VSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-PresidenT JOHN M. BREDEMEYER. III JOHN L. BEDNOSKI, IR. 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 I4AR I 2 990 PLEASE COMPLETE WITH DATE OF INSPECTION AND SIGNATURE IN SPACES PROVIDED: o Was the structure completed in accordance with submitted plan? Yes ~/ No If not please explain on reverse side. Was the structure situated on the applicant's property in accordance with submitted plan? (Distance must be at least 15' from property line) Yes ~/ No If not please explain on reverse side. Will pedestrians have easy access over or around the for the public right of way below high water mark. Yes t~/~ No If not please explain on reverse side. structure Is the structure high enough that so it will sot inhibit growth of nauural grasses along or below it? Yes A~ No ADDITIONAL COMMENTS: Date Signature of B~ e FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI. JR., Vice~President JOHN M. BREDEMEYER. IIl JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPHONE (516~ 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD l~own Hall, 53095 Main Road P.O. Box 728 Southold, New Yl~[~v~aqJ~$r l, Mr. Robert A. Greene / Alternate Regional Permit Administrator New York State D.E.C. Bldg. 40, SUNY, Room 219 Stony Brook, New York 11794 1988 Re: David Creato 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. V~ery truly yours, Frank A. Kuj~wski, Jr. President Board of Town Trustees FAK:jas / cc: C.A.C./ Board of Appeals/ Bldg. Dept.~" Army Corps of Engineers/ Planning Board ~ 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 Halt, 53095 Main Road P.O. Box 728 Southold, New York 11971 October 14, 1988 TELEPHONE ¢516~ 765-1892 Mr. John Holzapfel, Chairman Southold Town Conservation Advisory Council Southold Town Hall Main Road Southold, New York 11971 Dear Mr. Holzapfel: Transmitted herewith is application No. 673 Permit submitted by David C. Creato. Please prepare a written report of findings recommendations with respect to this application. for a and Wetland Very truly yours President Board of Town Trustees FAK:hk Attachment cc: Bldg. Dept. FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI. JR., Vice-President JOHN M. BREDEMEYER, IIl 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 t 1971 October 14, 1988 TELEPHONE (516} 765-1892 To Whom It Kay Concern: Attached hereto is a Short Environmental Assessment Form submitted by David Creato in connection with his application for a wetland permit to resnore a small pond (filled in by run off from area farms) & reduce flooding of road on property located an 3539 Cox Neck Road, Mattituck. ~ ~~ President Board of Town Trustees FAK:hk posted October 14, 1988 NOTICE Police Dept. - Bay Constable TOwn of So~fhold ~ Peconic, New York 11958 WOLAT ON Date:--- , 19 h~-~-- To: --- ....... k_ __C_ .................................. (Owner or author~[zed agent of owner) Addr~s~ ..... ~ - J-~i~L~Y~ -~- - -~-~- -' (address of owner Or ~hor~-~55f-~-~O~ ........... Please taks-notice there exists a Violation o~ the Code of the Town of Southotd, Chapter 97 Article at premises %hereinafter described in that---~--~--=-~-~-~-~=O-~--b-'~-~LL~-~z- You are therefore directed and .ordered uo co~ply with the followinG: .... -~!'~%-~- ~-~- - -~--&- '-~ - -~-%~2 -R~=~Q~ -~2-- ~-~- = ---~C-~3 ~ i~ _%_ ~ _ _ ~_~ ~ ~ ..... on or before ----~-' ...... day of '~ ~ The premises to which this Notice of Violat~icn refers are situated at: ----~-~-~---~m~--~-~'r--±u-~-U-=~U/~L-~J% .................. _Town of Southold, Suffolk County, N:¥. (Suff. County Tax Map Designation: Dist. Sect ion: ---~-~-~---Block: ---~-- =-Lot: - ~m---b Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or impr~son~uent or botk. NOTICE: You haVe the right to apply for-a hearing b~fo~e the Board ~tees.of the Town of Soub~old~ provided that you fil~a written r~quest with the Cler~iof the Trustees within ~10 days afte%/service of the Notice.of Violation..Such request shali have annexed ~eretb a copy of the Notice Of Violation upon which a Hea~ing is requested and shall Set forth the reasons why such notice of violation sh0ul~b~ modified or rescinded,. . .~ B~y C~nstable, Town,of Southot~d, NY Board Of lown lr ustees lown of So.hold Town Ha11,53095 Main Rd So.hold,N.Y. 11971 Dear Sirs: I wish to restore a pond,which has filled in with material ( soi'l from area properties and farms,to red~e or eliminate flooding of the road leading into my property during heavy rains.'An added be nifit would be an increase in wildlife at, the pono site. lhe following Exhibits are included for your assistance. 1. Survey done Dy Young and Young for preliminary site plan for "S~set Knolls" Section 2 Shows pond approximately 1~'x65'-restoration will b-e approximately lO0'x25'with an average depth of 2,5'. Location and size are pretty much dictated by low area remaining as result of run off of soil onto the site. 2, Adjacent properties with existing marsh. 3, Enlarged tax maps showing site and surro~din§ proper- ties, 4. List of names and addresses of s~rounding property owners ~, 5.Area Flood Plain FIRM Map~ 360813 0t12D t also req ~st that I be able to join the inspection of this property a's I have first hand knowledge of the area which may De helpful to the Board. Sincerely, Davi~ C. Creato P.O.Box 11~ Mattit ~k,N,¥, 11952 298-9106 BOARD OF TOW~ T~USTEE$ TO~ OF SO.HOLD 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 REGULATION~ GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF THE TO~N OF SOUTHOLD, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE ~ODES OF THE TOWN OF SOUTHOLD, IDENTITy OF APPLICANT~/~'Z/./t-L/ DATE.OF APPLICATION /~'-~ PHONE NO___ PERMIT~ ~E~UESTED TO ~E LOCATION OF PROPERTY FOR WHICH PEP. MIT WANTED HOME ADDRE~ OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION CREEK~ BAY OR HARBOR FRONTING PROPERTY SlZE OF PRoposED wORK . HEIGHT AIaOVE HIGH WATER DEPTH BELOW YARDS TO BE YARDS TO BE DEPTH AT LO~/-TIDE D,STA.CE TO T.E .EAREST DISTANCE PROJECT EXTENDS BEYOND SIMILAR P~OJECTS IN THE A~EA DESCRIBE AH¥ ~OWN PRIOR O~ERATION$ 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. ~M~ SUSPENDED OR REVOKED BY A GOVERNMENTAl DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE PREMISES AFTER THE WORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF THE PROJECT SITE IF NECESSARY ~t~ WRITTEN CONSENT OF THE O~NER OF THE PROPERTy, IF NOT THE SAME AS THE APPLICANT. ARE THERE ANY COVENANTS OR RESTRICTIONS PROHIBIT THIS PROJECT? ~'~;~- IN YOUR DEED THAT WOULD ext 12 NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) I1 ' APPLICANT/SPONSOR J /~,,~Z.,Z-./ ~ ~:~.~'-~,~-7-~ 2. PROJECT NAME 3. PROJECT LOCATION: ~E 3TO~E ~ Municioality ~/~ 'County ~ ~a ~/~ PRECISE LOCAT ON (Street address anc~ road intersections, prominent landmarks, etc~ or p[ovt~e map! = ~ao~s~oA~ ON ~ New ~ Expansion ~odi~icationlalterazlon BRIEFLY: :iS. DESCPJRE PROJ E~i' 7. AMOUNT OF LAND AFFECTED: . Initially · ~',~-! ~ acres Ultima[e]y ~ O.J-'/J"- acres WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ~-Yes [] No J! No, aescrlbe briefly g. WHAT IS PRESENT LAND UE~ IN VICINITY OF PROJECT? [] Residential [] [ndu~trim [] Commercm~ [] Agriculture [] ParkJForestlOpen space 10. DOES ACTION INVOLVE A PERMIT APPROVA~ OR FUNDING. NOW OR ULTIMATELY PROM ANY OTHER GOVERNMENTAL AG~Cy (FEDE~ STATE_.~, R LOCAL)? ~es [] NO If yes, list agency(s) and permit/approvals ~"~. 11. DOES ANy ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes ~'HO If yes, list agency name and permit/approval t2. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? Signalure: ~~ CERTIFY THAT THE INFORMATION PROVIDED ABOVE t$ TRUE TO THE BEST OF MY KNOWLEDGE If the action is in the CoDstal Area. and you are a state agency, complete the Coastm Assessment Form before proceeding with this assessment OVER 1 ''~ .... -~ART II--ENVIRONMENTAL A~S~SESSMENT [To be completed A. DOES ACTION EXCEED ANY T'l~ THRESHOLD IN 6 NYCRR. PART 617.1Z? [] Yes [] No the review process and use th, B. WILL ACTION -- RECEIVE COORDINATED REVIEW AS PRO~NLI'$TED ACTIONS I'~-~-~CRR. PART 617.67 tt No may be supetsesed by another in¥otveu agescy. [] [] No C. COULD AOTION R~$ULT IN ANy ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Ans-~ers may be ban~wrirfes Cl. Existing air quality, surface or'groundw~er quality or Quantity, noise levels, existleg traffic patterns, solid waste potential for erosion, drainage or flooding problems? Explain briefly:. - C2. Aesthetic, agricultural, arcD~eelogical, historic, or other natural or cultural resources; or community or neighborhood oharacter~ C3. Vegsta. tJon Or lAufla, fish, shellfish or Wildlife species, significant habitats, or threatened Or endangered species? Explain C4. A community's existing plans or goals es officially adopted, or a change in use or intensity of use of land Or ets el' naturat C6. Growth, subsequent development, or related ~ctivilies likely Te DS Induced dy the DrODOSeD action? Exclalfl briefly. C6. Long term, snort term, cumulative, or other effects not identified in C1-C57 Explain briefly. C7. Other irnDacts IJncl~ding changes m use of e~ther quantity or Iype o1 energy)? Explain briefly. ~E LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADV~RONMENTAL IMPACTS? [] Yes [] NO If Yes. explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) )NS'TRUCTIONS: For each adverse effect idenl~fie~l above, determine whether it is substantial, large, important or otherwise significant. Each eftecl should De assessed in connecllon wile its Ia) setting {i.e. urban or rural); Th) proea~ility of occurring; (c) duration; iq) Irreversibility; Is) geograohic scope; anci If) magnitude. If necessary, acid attachments or reference supporting materials. Ensure that' explanalions contain sulficient detail to show that all relevanl adVerse impacts have been identJfie~ anci adequately acldressed~ [] Check this box if you have identil~ied one or more potentially large or significant adverse im r~acts which MAY occur. Then proceeo directly to the FULL EAF ancl/or prepare a positive declaration. [] Check this box df you have determinecL based on the information and analysis above and any supporting documentation, that the proposed action ~,VILL NOT result in any significant a~verse environ.r~_qtal impacts AND provide on a~tachmems as necessary, the reasons supporting this determination: 2 ! (2187~--7c 617.21 Appendix A' SEQR State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The fuji EAF is des gned 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 a wa seas ~¥ t.h,.ere are aspects of a project that are subject ve or unmeasureab e It - .i;,. _..a~.. ,~Y .~ y.to answer Frequent- · no formalknow edEe of thepnvlrnnmo,~* __ ~__ L____~' · o ",~,~ u.u~SLCOo mat those ~ho determine the question of significance . t the broader concerns The fuji EAF is intended to provide a method whereby applicants and a encies c process has been orderly, comprehensive in nature, vet flex bI,~ ~,, =n~,.,; .... ~_,g ~. ~ .an.be ass.umd.tl~at the determination ....... ,,~, muuuucrJon or Iprormatlon to fit a project or action. Full EAF Components: The full EAF is comprised of three parts: " Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 an~J 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 a~ impact is likely to be considered small to moderate or whether it is a potentially- large mpact The form also identifies whether an impact can be mitigated or reduced. Part 3:impactlf any impaCtis actuallyin Partimportant.2 is id~nufied., as potentially-large, then Part 3~is used to evaluate whether or not the Identify lhe Portions of EAF completed for this project: [] Part I [] Part 2 ' []Part 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 impacL it is reasonably determined by th~ lead agency that: ~] A. The project will not result in any large and important impact{s) and, therefore, is one ~vhich 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 ~ot be a significant ,effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, ~erefore 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 Leaa Agency Print or [ype Name oi Responsible Officer in Lead Agency Title of Responsible Oriicer Signature oi Responsible Officer m Lead Agency Signature of Preparer{Ii: different from responsible officer) Date PART 1-'PROJECT INFO~.~ATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed on the environment. Please complete the entire form, Parts A through E. Answers to these as part of the application for approval and may be subject to further verification and public review information you believe wiJ be needed to complete Parts 2 and 3. It is expected that completion of the full CAF will be dependent on information currently available and new studies, research or investigation, if information reqmring such additional work is unavailabl~ each instance. NAME OF ACTION LOCA'~O-~O~ ACTION ([n~tude Street Address~ Munic~p.~ality a~d County N E OF APPLICANTISP~SOR NAM~ OF OWN~ Of differ~t) ADDRESS CITY/PO DESCRIPTION OF ACTION STATE 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: []Urban {]Industrial I-IForest [],~griculture 2. Total acreag~e of project area: . ~f~w ~ APPROXIMATE ACREAGE Meadow or t3rushland [No?agricultural) Forested {]Commercial i-lOther {]Residential (subur~ban) acres. PRESENTLY acres Agricultural [Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24, 25 of Water Surface Area Unvegetated (Rock, earth or fill) Roads. buildings and other paved surfaces Other (I ndicate type}. 3. What is predominant soil type(s) on proiect s~te? ~l~Rural (non-fart AFTER COMPLET ON acres - acres a, Soil drainage: {}Well drained % of site {}Moderately well drained . _ % of site ~'~oorJy drained ./ZD~::) % Oi site b. If any agricultural la nd is involw_~a, how man~ ac~es oi soil are classified within soil group 1 through 4 of the N~ Land C ass f cation System~ _ acres, (See 1 NYQRR 370). 4. Are there bedrock outcroppings on project site? ~Yes ~o -' a. What is depth to bedrock? .. (in feet) _. 2 pv,.~ sed project site with slopes: '1~O-1 [-115% or greater % Is project substantially contiguous to, or contain a building~ si~;e, or district, listed on the State or the National sters of Historic Places? I-lyes 4~4'4o 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? i-lyes [~No 8~: What is the depth of the water table? ~ {in feet}~ °w ' ?-- A/~-) :9: Is site located over a primary, principal, or sole source aquifer? f-lyes 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? F:IYes ~]No ~11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? IqYes ~No According to ~ ~' r~,~- · '~,'t ~/.~,,,~: ~D~ ' Identify each species 12. Are there any unique or unusual land forms on the pro~ect site? (i.e.. cliffs, dunes, other geological formations) r'IYes ~No Describe 13. Is the project site presently used by the community or neighborhood as an open space or r~creation area? I-lYes :~No If yes, explain 14. Does the present site include scenic views known to be important to the community? t-lyes [;~No 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 ~--~'~-- ~'?7-~--,~'E~) ~ ~3(/4-//.~t~-',~¢2, 17. Is the site served byTexisting pub c utilities? -~]Yes [3No b. Size (In acres) a) If Yes, does sufficient cal~acity exist to allow connection? ~Yes [3No b) If Yes, will improvements be necessary to allow connection? r-lyes ,5'1No ~' 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets La~v. Article 25-AA, Section 303 and 304? ~Yes ~No 'Z)~,,~, ~'~- 19. Is the site Iocateo in or substantially contiguous to a Critical EnwronmentaJ Area designated pursuant to Article of the ECL, and 6 NYCRR 6177 EYes [3No -z~,~4.~ ~7- 20. Has the site ever been used for the disposal of solid or hazardous wastes~ r-lYes . B. Project Description 1. Physical dimensions and scale of project {fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled b.y project sponsor -~/~ b. Project acreage to be developed: ~ ~j-z~-' acres initially; _ c. Prolect acreage to remain undeve!oped ~t¢/~- acres. d. Length of project, in miles: _~',/J~ (If appropriate) e If the prolect is an expans on, indicate percent of expansmn proposed . f. Number of off-street parking spaces existing ~ ~:~ g. Maximum vei~icuJar roDS generated per t~our ~,~ h. If residential: Number and type of housing units: One Family Two Famdy Initially Ultimately ~/'~" ~ i. Dimensmns [m feetl of largest proposed structure _.~:~ ' height; c~) width; ¢:~ length_ j. Linear ieet oi frontage along a public thoroughfare prolect will occupy i~? 3 acres. acres ultimately. ; proposed ~- (upon corn pletion of project)? Multiple Family Condommmm 2. How much natural mat~al (i.e.. rock, earth, etc.l will be remove~rom the site? 3. Will disturbed areas be recla reed? I~-es I-INo, C1N/A a. If yes, for what intend,.= purpose is the site being reclaimed? .~E'J 7"~_-~ b. Will topsoil be stockpiled for reclamation? ~]Yes C1N c. Will upper subsoil be stockpiled for reclamation? ~LYes r-INo 4. How many acres of vegetation (trees. shrubs, ground covers) will be remov~J from site? --- ~- 5. Will any mature forest {over 100 years old) or other locally-important vegetation be removed b' I-lyes [)No - - 6. If single phase project: Anticipated period of construction _ ~ ~-~mont]'~ {includin 7. If multi-phased: a. Total number of phases anticipated , [number). b. Anticipated date of commencement phase 1 ,,, month year, (in~t~din c. Approximate completion date of final phase ,. month year, d. Is phase 1 functionally dependent on subsequent phases? l-lyes i-INo" & Will blasting occur during construction? I-lyes E~No 9. Number of jobs generated: during construction ~ ~ -- ; after project is complete ~ 10. Number of jobs eliminated by this project _ ~ ~:~ ~ 11. Will project require relocation of any projects or facilities? l-lyes E~No If yes, explain 12. 15 surface liquid waste disposal involved? I-lYes a. If yes, indicate type of waste lsewage, industrial, etc.) and amount b. Name of wa~er body into which effluent will be discharged 13. Is subsurface liquid waste disposa[ involved? [~Yes i~-No Type. 14, Will surface area of an existing water body increase or decrease by proposal? Explain [qYes ~No 15. 16. Is project or any portion of project located in a 100 year flood plain? ~t'Yes Will the project generate solid waste? I--lyes ~o a. If yes, what is the amoun~ per month tons b. If yes, will an existing solid waste facility be used? ~Yes l-INo c. If yes, give name ; location ~. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 17. Will the project involve the disposal of solid waste? I-IYes a. f yes, what is the anticipated rate of disposal? b. If yes, ~vhat is the anticiuated site life? years. l&. Will prolect use herbicides or pesticides? I-lYes ~-No ~No tons/month. nYes [:3No 19 Will prolect routinely produce odors (more than one hour per day)? I-lYes qgLNo 20 Will project produce operating noise exceeding the local ambient noise levels? I'-lYes 21. Wi[J prolect result n an increase ~n energy use? ~Yes ~o If yes indicate type(s} 22. If water supply is from we] s, indicate pumping capacity-,~a,~'~;"'/~ulu,% [Iailons/minute. 23. Total anticipated water usage per day .D,,,,~,~-,,c,oo,.,,. gallons/day. 24. Does prolect Involve Local, State or Federal funding? L-:lYes If Yes, explain ~Approv,~ls Required: 8nard I-lyes t~No Town, Village Plannin8 Board I-lYes ~ELNo City, Town Zoning Board FlYes ~No !~Cit¥, County Health Department I-lyes po Other Local Agencies i~Yes I-1No :O~ther Regional Agencies I-lYes li~No 5~:ate Agencies f-lYes ~No Federal .Agencies l-lYes 1E~No C. Zoning and Planning Information Type 1. Does proposed action nv01ve a planning or zoning decision? I-lyes l~No -~ ' If Yes; indicate decision required: I-lzoning amendment rlzoning variance Especial use permit r-lsubdiws~on I-lnew/revision of master plan F-lresource management plan F'lother 2~ What is the zoning classificat on(s)of the site 3. What is the maximum potential development of the site if der.eloped 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? SubmiUal 6. Is the proposed action consistent with the recommenoed uses in adopted local land use plans? ClYes I'qNo 7. What are the predominant land useisJ and zoning classifications within a % mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a N mile? l~Yes i-INn 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? [3Yes ~tNo 11. Wilt the propQsed action crea:e a demand for any community provided services (recreation, education, police. fire protection)? ti)Yes E~No am If yes, is existing capacKy sufficient to handle projected demand? I-lYes r'lNo 12. Will the proposed action result in the generation of traffic significantly above present levels? ayes IJ~]No a. If yes, is the existing road network adequate to handle the additional traffic? I--lyes r"lNo D. Informational Details Attach any additional information as may he needed to clarify your project. If there are or m,~y 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 informa uon provided above is true to the best of mg,~knowledge. If the aglion is in the Coastal Area, and you are a state agency, Complete the Coastal As~ssment Form before pr~ee~g with thJ~ asses~ent. 5 2--PROJECT IIVIPACTS AND EIR MAGNITUDE Responsibility of Lead Agency General Information (Read Carefully) ·In completing the form the reviewer should be guided by the question: Have my response: reasonablel The reviewer is not expected to be an expert env ronmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily Any large impact must be evaluated in. PART 3 to determine significance. Identifying an impact i asks that it be looked at further. ·The Examples provided are to assist the reviewer by showing types of impacts magnitude that would trigger a response in column 2. The examples are generally for most situations. But, for any specific project or site other'examples and/or lower threshold., 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 have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to · The number of examples per question does not indicate the importance of each question. · In identifying ~mpacts, consider long term, short term and cumlative effects. Instructions CRead carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column I or 2} to indicate the potential! size of t: impact. If impact threshold equals or exceeds any example provided, che?ck column 2. is lower than example, check column 1. If impact will occur but.thresho d. If reviewer has doubt about size of the impact then consider the impact as potentially large and ~)roceed~to PART e. If a potentially large impact checked in column 2 can be mitigated by change(s) n the prolect to a sm impact also check the Yes box ............ all t~ modera , ,. ,.v,,~,,,. ~. ,-~ mo response lnmcates that such a reduction is not pc~ssible. Th must be explained in Part 3. IMPACT ON LAND 1. Will the proposed action result in a physical change to the project site? i-INO fi]YES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot ~f 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 withi~ 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 mimn~ 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 m a designated floodway. · Other impacts 2 Will there be an ~'ffect t:...,.y uh~que or unusual land forms found on the site.~ li.e, cliffs, dunes, geological formations, etc.)~NO ~YES · Specific land forms: 6 Small to Potenitiat ,C~t B Moderate Large Impact Impact ~ ~ ~Yes. ~' gNo IMPACT ON WATER · Will proposed action affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conservation Law. ECL) [~NO ~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. · Extension of utility distribution facilities through a protected water body. '· Construction in a designated freshwater or tidal wetland. · ? Other ~mpacts: Small to Moderate Impact ~,. Wil proposed action affect any non-protected existing or new body ' of water? [3NO ~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. Will Proposed Action affect surface or groundwater quality or quantity? F'iNO ~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 a pprovaJ to serve proposed (project) action ' Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or Operation c~.using any contamination of a water s~opply system. · Proposed Action will adversely affect groundwater. · L~iquJd effluent w I1 be conveyed off the sit d: ' ~ e to facilities which presehtly o not ex~st or have inadequate capacity. · Proposec~ Action would use water in excess of 20,000 gallons per d~ay. · Proposed Action wil likely cause siltation or other discharge into existing body of water to tr;e ext~-nt that there will be an obvious visual contrast to natural conditions. · Pi'oposed Action will require the storage of petroleum or chemical products greater than 1,100 · Proposed Action will allow residential uses in areas withou~ warer and/or sewer serwces. ' Proposed Action locates comm~,rc~al and/or industri,~,l uses which may require new or expansion of ¢~XIStUi.[[ waste treatment and/or storage facJhties. · Other impacts:_ 6. Will proposed action alter drainage flow or patterns, or surface water runoff? [:]NO ~ ' EXamples that would apply to column 2 · Proposed Action would change flood water flows. 7 2 Potential Large Impact Project CJ3aage [] []yes [] ' ~Yes ~Y~s ~Yes ~Yes ~es ~ ~Yes ~No ~ ~Yes ~o ~ ~Yes ~No ~ ~Yes ~No ~ ~Yes ~No ~ ~Yes ~o [] i-lYes [] /-]Ve~ . C3~o []Yes [:]No []' ~yes []N0. ~Yes · 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? E]NO ~YE$ Examples that wou~d apply to column 2 ·hour.Prep°sad Action will induce 1,000 or more vehicle trips in any given · Proposed Action will result in the incineration of more than 1 ton of refuse per hour. · Emission rate of total contaminan~ will exceed $ lbs. per hour or a heat source producing more than 10 miIJion BTU's per hour. · Proposed action will allow an increase in tt~e 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 g. WiJJ Proposed Action affect-any threatened or endangered species? E3NO [~YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal hs£. using the site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. · APPJic~tion~ .el pest cide or herbicide more than twice a year, other than for a§ncuJtural purposes, · Othe, r impacts:., 9 Will Proposed Action substantially affect non-threa [ened or non-endangered species? ~NO [~YES Examples that would apply to column 2 ' Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. ' Proposed Action reqmres the removal of more than 10 acres of mature forest [over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURC~.S 10 Wdl the Proposed Action affect agricultural land resources? ~qNO J'qYE$ Examples that wouJ(] apply to col um n 2 · The proposed action would sever, cross or limit access [o agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, e~c.) 8 [] [] [] [] [] [] [] ~]No ~¥es ~ []No C'JYes ~ .E]No []Yes []Yes~ - []Yes ~No Construction activity would excavate or compact the soil profile of would irreversibly convert more than 10 acres ricultural [and or, if located in an ^gricultutal District, more 2.5 acres of agricultural land. would disrupt or prevent installation of agr cultural 'stems e.g., subsurface drain lines, outlet ditches, or create a need for such measures (e.g. cause a farm n poody due to increased runoff) ,~Dther impacts: .... IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesmeuc resources? E3NO I-lYES (if necessary, use the Visual E^F 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-'INO I-lYES Examples that would apply to column 2 · Proposed Action bccumng wholly or partially within or substantially contiguous to any facility or s~te listed on the State or National Register of historic places · Any impact to an archaeological site or fossil bed located within the prolect site. · Proposed Action wiJJ occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other ~mpacts:.. IMPACT ON OPEN SPACE AND RECREATION 13 Wil Proposed Action affect the quantity or quality of existing or future open spaces or recreauonal opportunities? Examples that would apply to columz~ 2 ONO ~YES · The permanent foreclosure of a future recrea[ional opportumty. · A major reduction of an open space ,mportant to [ne community. · Other ~mpacts: Small to potentl~ ~d~rate Large I ]~mpact Impacl~ , ~ ~ ~Yes ~No Yes ' ~ ~ : ~Ye} ' ~No ~ ~ ' ~ Yes ~ No ~ ~ ~Ye~ ~No Yes Yes Yas IMPACT ON TRANSPORTATION 14. Will there be an effect r,o existing transportation systems? E]NO EYES 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? FqNO OYES 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. .Acti°n will require the creation or extension of an energy rtre~(~em~l~;Tn,, ?,r~su?~p..l.y_ syste~ to serve more than 50 single or two family · ~- ~,~ *=,ye a major commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, no,se, or vibration as a result of the Proposed Action? C1NO EYES 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. · Prooosed Action will remove natural aarners that would act as a noise screen. · Other impacts: IMPACT ON PUBLIC HEALTH 17. Will Proposed Action affect public health and safety? E3NO ~]YES Examples that would apply to column 2 · Proposed Action may cause a risk of explosion or release of hazardous substances fi.e. oil, pesticides, chemicals, radiation, etc.)in the event of accident or upset conditions, or there may be a chro~ic Iow level discharge or enussion. · Proposed Action may result in the burial of "hazardous ~vastes" in any form Ii.e. toxic, poisonous, bi~hJy reactive, radioactive, irntatmg. infectious, etc.) Storage facilities for one million or more gallons of tiquified natural gas or att' er flammable liquids. Proposed acuon may result in the excavation or other disturoance w~thm 2.000 teet of a site used for the disposal of solid or hazarnous Other Impacts: 10 E3 [] [] [] [] [] [] [] r-lyes ~Yes F'INa l-lYes E~No tqm'es -.- E]No t-lyes ~]Yes- . C'INa I~No I'lyes I--INo E]Yes [::]No IMPACT ON GROWTH AN D CHARACTER OF COMMUNITY OR NEIGHBORHOOD 38. Will proposed action affect the character of the existing community? rqNO E]YE5 Examples that would apply to column 2 · The permanent popular on of the city, town or village n wh ch the . project is located is likely to grow by more than 5%. ~e 1'he municipal budget for capital expenditures or operating services .e 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. i Proposed ^ctidn wdl replace or e~iminate 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 wiU se[ an important precedent for future projects. ;~' Proposed Action will create or elimina[e employment. ~ Other impacts:.. 1 2 ' 3' Small to Potential Can Impact Be Moderate Large Mitigated By Impact impact Project Change ' [] [] [::]Yes [:]No [] [] ' /-]Yes' "[]No · [] []. []Yes []No [] [] []Ye~ []No [] [] []Yes i-]No : [] E]' []Yes EIFo Dyes D,No , 19 Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? I-(NO []YES 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 i~J1PORTANCE OF ii~iP~CTS Responsibility of Lead Agency mitigated.Part 3 musl~ be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s} may be InstructiOns Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe fif applicable) how the impact could be m~tigated or reduced to a small to moderate impact by project chan,~e~s}, 3. Based on the information available, decide if it is reasonable [o 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 trreversibihty, including permanently lost resources of value · Whether the impact can or wilJ be controlled · The regional consequence of lhe impact · Its potential divergence from local needs and goals · ~,Vhether known objections to the project reLlte to this nrlpact. (Continue on attachments) 11 617.2I Appendix B State Environmental Quality Review V suaI EAF Addendum This form may be' used to provide additional information relating to Question tl the Full FAF. (To be completed by Lead Agency) 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 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 Seri, ice lands? · Rivers designated as National or State Wild, Scenic or Recreational? · Any transportation COrridor of high exposure, such as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate. s~ or inter-county foot trait, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as scenic? Project [] [] [] [] D [] [] [] · Municipal park. or designated open space.) * County road? · State? · Local road? [] [] 3. Are any of the resources checked n question 1 used by the public during the time of year during which the project will be v s~ble? L-~Yes 2.seasonsilS the visibility of the project seasonal? (i.e., screenea by summer foliage, but visible during other [] Yes [] No [] [] [] [] [] [] [] [] [] D" [] [] [] [] [] DES£RIPTIOH O~ EXISTIHG VISflAL EHVIROH~4EHT 4. From each item checked in question 1, check those which generally describe the environment. - Essentially undeveloped Forested Agricultural Suburban residential Industrial Commercial Clrban River, Lake, Pond Cliffs, Overlooks Designated Open Space Flat Hilly t'4ountainous Other IIOTE: add attachments as needed Within 5. Are there visually similar projects within: *V2 mile i-'lYes {-'~ i"lo '1 miles }-~ Yes []Ilo *2 miles -r-'lYes [[]HO '3 miles }-']Yes ['"]Ho * Distance from project site are provided for ~ssistance. Substitute other distances as ap · EXPOSURE 6. The annual number of viewers likely to observe the proposed ~NOTE: When user data Is unavailable or unknown, use best estimate. COHTEXT 7. The ,~ituation or activity in which the viewers are engaged while viewing the proposed ~ Activity Travel to and from work Involved in recreational activities Routine travel by residents At a residence At worksite Other Daily FREQUENCy Holidays/ We[~]kly Weekends 2 COUNTY OF SUFFOLK STATE OF NEW YORK )SS: AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED ~ERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, THAT THE ~ORK WILL BE DONE IH THE MANNER SET FORTH IN THIS APPLICATION AND AS MAy BE APPROVED BY VIRTUE OF SAID PERMIT, IF GRANTED, in completin~ this a~ ..... ~ ~ ~u~u~ ~ ne~e~y authorize the Trustees. agent or representative to enter onto my property to inspect the premises in conjunction with rev~w of t~i~ aDplicat, ion. EXAMINED .., ARY PUBL 1 C CLAIRE L GL oten/ ublm, State of · N~ 4879~A~ New Yor~ APPROVED~.~-W'EiTLAND,E," PERMIT (CHAPTER 97) APPROVED BOAT,DOCkS, ~HARVES'' PERMIT (CHAPTER 32) DISAPPROVED "~ETLANDS ~ERMIT" ~CHAPTER 97) DISAPPROVED "BOAT~DOC~S, WHARVES" PERMIT (C~APTE~ 32) EXAMINING BOD~ SIGNATURE OF CHAIRMA~ COMPUTATION OF FEE~ Approved 2/27/85 NOTICE Police Dept. - Bay ~onstabte Town of Southold Peconic, New York 11958 NOTICE OF VIOLATION To: (Owner or authorized agent of owner) Address: - ---~Ad~ss of owner or authorized agen.~ 6f owner) ....... Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article---~r ...... Section---~ ........ at premises hereinafter described in that---~9-G~---~d~Z~-~LO~- You are therefore directed and ordered to co~ply with the on or-before ___3_~ ..... day of ----~TO-~--~-----, 19--~--- The premises to which this Notice of. Violation refers are situated at: _ _ _ _(~92F,,. _ _A~'.~.~.~.~.~.~.~.~.~--_ _~ _ ~'~ r _ _ .~_ _{'%_ ~_ ._ _"f2~Y_ _C-_I~ ..................jYown o~ $outhold, Suffolk County, NL¥. (Suff. County 7'ax Map Designation: Dist. Section :---3-O-~-~---Block:---~ .... Lot: - ~J---k Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisorkment or both. NOTICE: You have the right to apply for a hearing before the Board of Trustees of the Town of Southold, provided that ~ou file a written request with the Clerk of the Trustees within 10 days affer service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of violation should be modified or rescinded.. Bay C~nstable, Town,of Southo~, NY 114 Names and locations of owners of adjacent properties. See attached enlar§ement of tax maps- Suffolk Cty lax Map 1000-106-8-50.4 Frixos PolyKarpou ~-17 Ditmars Blvd. 'Astoria,N.Y. 11105 2. 1000-106-8-52.2 3. 1000-1D6~8-53.1 4. t000-113-3-2.3 5. 100D-113-2-22 6. 1000-113-2-23 7. 1000-113-2-24 Charles F.Sch~ert 239C BreaKwater Rd. Mattit uck,N.Y. 11952 Barbara l.Roesch 239 B BreakwaTer Rd. Mattit ~k,N.Y. 11952 Leonard Simons 9 Cottonwood,Ave. Port Jefferson StatiDn,N.Y. Richaro Strzepek P.O. Box 109D Mattit uck,N.Y. 11952 Donald ~ilce~)sKi 1200 Rosewood Dr. Mattitock,N.y. 11952 Pla ygrouno Rose Koroleski So u~o Ave. Mattit~k,N.y. 11952 11776 ZON~B ZONE A7 {ELI'J~ ZONE .C ZONE B