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HomeMy WebLinkAboutTR-3951 Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ~51 DATE: -Qctober. ~,..199I ISSUED TO ,.-.-Mar!c.,.and I. Rs~..D. ax~is ................. Pursuant to the provisions of Chapter 615 of the Laws of fha State of New York, 1.893; and Chapter 404 of the L.ews of the State of New York 1952, a~d the Soufhold 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;" end in accordance with the Resolution of The Board adopted afa meeting held on Oc.toher 3, 19 9Z., and in conslderaflon of the ~sum of $ _.150.00 paid by ....... Land Use Company .on beh~f..o~f.~a~l....&....~..~.?gf~... of ....................................... N.Y. and subject to the Terms and Conditions llsfed on the reverse s~de hereof, of Soufhold Town Trustees authorizes and permits the following: to construct a single family dwelling with attached garage & driveway as indicated on map ~ated August 22, 1991 all in accordance wif~ the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes. ~fs Corporate. S.e. al fo be affixed, and these presents to b~ subscribed b~ ~ malonfy of the said Board as of this dat,e. TERMS -',nd CONDITIONS The Pem~ttee Mark and Lisa Davis residing ac Peconic Bay Blvd.. Mattituck N.Y., as parr of the consideration for the issuance of the Pecmi~ does understand and px~ribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Sonthold are relcased from may and aR damages, or r.l~imq for d~m~ges, of suits arising directly or indirectly as a result of any opec- ation performed pursuant to this perm/t, and the said Permittee will, ~t his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee asmmes full liabi~ty with respect thereto, to the complete exdnsion of the Board of Trustees of the Town of So~thold 2. That this Permit is valid for a period of 24 mos. which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the stmcrare or project involved, to provide evidence to anyone concerned that anth- orizatioa was originally obtained. 4. That the work involved 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 revo~ation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a remit of the work herein authorized. 6. That there shall be ne interference with the right 'of the public to pass and repass along the beach between high and Iow water ma~ks. 7. That if futare operations of the Town of Southold require the removal and/o~ alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstrucnon to free navigation, the said Permittee will be required, upon due notice, to remove or alter dais work or project herein stated without expenses re the Town of SoutholcL 8. That the said Boa~d will be notified by the Permittee et the completion of the work anth- orized. 9. That the Permittee will obtain all other permits and consents that may be required sup- plemental re this permit which may be subject to revoke upon failure to obtain same. 'O qhq 0FSQUTHOLD STATE OF NEW YORK DEPARTMENT OF STATE SECRETARY OF STATE Ja~y 28, 1992 land Use 2576 Sound Avenue Baiting Hollow, NY 11933 ~: F-91-542 U.S. District P~,,-~t Applic~ti~ -~91-0925-Za Pe~ Fakiris/(~m~ ~e Department of State is required to notify you of the status of our review of this project for its consistency with the New York State Coastal Management Program if a decision has not been issued within three months following c~L~L~mm_nt of our consistency review. We cannot complete our consistency review for this project until we conc],~ our analysis of submitted information and our coordination with the U.S. Army c~ps of m~ineers. A copy of this letter has been sent to the Corps of Engineers. Pl~e call Mohabir Persaed at (518) 474-3642 if you have any questions. Sincerel~y~ ~ _ Divi sio~ of and Waterfront Revitalization WFB/MP/mb c: COE/NY District - Roberto Barbosa NYS DEC/Region 1 - C~ristine Costopoulos Town of Southold - Valerie Scopaz PLANNING BOARD MEMBERS SCOTT L. HARRIS Bennett Orlowski_ Jr.. Chairman Supervisor George Ritchie Latham. Ir. Richard G. Ward Town/dall. 53095 Main Road Mark S. McDonald P.O. Box I179 Kenneth L. Edwards Southold. New York 11971 PLANNING BOARD OFFICE Telephone (516/ 765-1938 TOWN OF SOUTHOLD Fax (516 765-1823 February 4, 1992 UU~_-~ Tanya Lachenmeyer Land Use 2576 Sound Avenue Baiting ollow, TO ,¥N O __SOUTHOLD RE: Proposed lot line change for Mark and Lisa Davis and Brady & Kim Ulmet SCTM~ 1000-126-9-26.3, 26.2 & 18 Dear Mr. Lachenmeyer: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, February 3, 1992. BE IT RESOLVED that the Southold Town Planning Board authorize the Chairman to endorse the final surveys dated August 22, 1991. All conditions of final approval have been met. Enclosed please find a copy of the map that was endorsed by the Chairman. Very truly yours, Bennett Orlowski, Jr. Chairman Enc. cc: Board of Trustees ~/ NYSDEC Building Department Assessors Office Land Use -' /,,5 January 8, 1992 Town of Southold Planning Board Office Town Hall, 53095 Main Road P.O. Box 1179 Southold, N.Y. 1t971 Attn:Mr. Bennett Orlowski Chairman Re: Proposed Lot Line Change for ~M~ land Li~a Davis and Brady a~d K~m Ulmet Dear Mr. Orlowski: As per your letter dated 7/15~91, enclosed please find a copy of the permit recently received from the NYSDEC. Please be advised that the requested site plan indicating the increased natural buffer was sent under separate cover on November 6, 1991 to the attention of Bob Kassner. As such, kindly issue your agency's final approval of this proposed lot line change. Should you have any questions or require additional infoIm~ation, kindly contact this office at your convenience. Very truly yours, TL/cf enclosure 2576 Sound Avenue · Baiting Hollow, NewYork · '1~933 (516) 727-2400 · FAX (5'16) 727-2605 NeW York State Department of~nvironmental Conservation Building 40--SUNY, Stony Brook, Ne~ Stork 11700-2356 ....... ..... (516)-751-:t-389 ......................... Thomas C. Jorllng ............ Commissioner Dec. 31, 1991 Ma~k-C. & Lisa-C%~avis .--- ......... Box 1493 Mattituck, NY ]1952 RE: Permit #1-4738-00246/00001-0 Dear Mr. & Mrs. Davis: In conformance with the requirements of the State Uniform Procedures Act (Article 70,ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Alao enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, John Wieland Sr. Environmental Analyst JW/rw JA~I - 9 ~992 !~1 GENERAL CONDITIONS Inspections 1. The permitted site or facility, includin.o, relevant recoros, is subject to inspection at reasonable hours aha intervals by an authorized represemat~ve of the Department of Environmental Conservation (the Department) to determine whether the permittee is corn plying with this permit and the ECL. Such representative may order the .WORK suspended pursuant to ECl. 71-0301 and SAPA 401u~). A copy of this ~ermit. including ail referenced maps, drawings and special Conditions. mus[ be available for inspection by the Department. at all times at the project site. Failure to produce a cody of the permit upon request by a Department representative s a violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify suspend or revoke th s permit when a) th~ scope of the permitted activity is excee~led or a v o ation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable lawor regulation have materially changed since the permit was issued. 3. The permittee must submit a separate written application to the Department for renewa modifica- tion or transfer of.this permit. S~ch a pplication must include any [orms, fees or supplemental infor- mation the Department requires. Any renewal, modification or transfer granted by [ne Department must be in writing. 4. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System ISPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APCI and Solid Waste Management Facilities (SWMF); and bi 30 days before expiration of al~ other permit types. 5. Unless expressly~provided for by the Department. issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, con- ditions or requirements contained in such order or determination. Other Legal Obligations of Permittee 6. The permittee has accepted expressly, by the execution of the application, the full legal responsibili- ty for ali damages, direct or indirec[, of whatever nature and by whomever suffered, arising out of the project described in this permit and has agreed to indemnify aha save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. This permit does not convey to the permittee any right to trespass upon the landsor interfere with the riparian rights of others in oraer to perform the permitted work nor does it authorize the im pa~r- ment of any rights, title, or interest in real or personal proper~y held or vested in a person not a party to the permit. 8. The permittee is responsible for obtairdng any other permits, approvals, lands= easements and rights. of-way that may be required for this project. Page 2 of ~ ; 95-20-6a [10/00}-- 25c ADDITIONAL GENERAL CONDITIONS EOR ARTICLES 15 (Title S), 24, 2S, 34, 36 and 6 NYCRR Part 608 [ t 9 That if future operations by the State of N~w York require a~ al- other environmentally deleterious materials a~sociated with the teration in the position of the structure or wc;i:k Eerein authorize(~ or project. if. in the opinion of the Department of Envirdnmental Conservation 13 Any material dredged in the prosecution of the work herein Derm~tted the people of tne State or cause loss or oesrrucuon of the natural tendency to cause damage to nawgable channels or to the banks ot remove or alter the structural work. obstructions, or hazards caused 14 There shall be no unreasonable interference with nawgat~on by the work thereb~ without expense to the State. and if. upon the expiration or herein authorized. revocation of this permit, the structure, fill. excavation, or,other 15. If upon the expiration or revocation of this permit the project nere~v modification of the watercourse hereby authorized shall not hc com- authorized has not been completed, the appllcanl ,l~.dl, wi~nou[ expen~t. pleted, the owners, shall without expense to ti~e 5tale and to such to the State and to such e~tent and in such time and manner as the State of New York on account of any such removal or alteration. 16 If granted under Article 36. this permit does not signify in any way 10 That the State of New York shall In no case be liable for any damage that the project will be tree from flooding. or iniurv to the structure or work hereiri author~ed which ma~ be caused 17 If 8ranted under 6 NYCRR Part 608. the NYS Department ot Environ~ no claim or right to compensation shall accruefrom an~ such damage. Sections 301. 302. 303. 306 and 307 of the Clean Water Act of 1977 11. Granting of this permit does not relieve the applicant of the resoonsl- (PL 95-217) provided that afl of the conoitions listed herein are me[ bt[it', of obtaining any other permission, corrsen[ or approval from 18 Ali actwities authorized by this pe~rnit ~nust be tn strict conforman( the U.S. Army Corps of [ngineers U.S. Coast Guard New York State with the approved plans submitted by the applicant or h~s agent as parl Office of General Services or focal government ~vhich may be required, of the permit application. 12 AJI necessary precaubons shah be taken to Dreclude contamination 18st' revised by Peeonie Such approved plans were of any wetland or waterway Dy suspended solids sediment~. fuels. so~vents, lubricants, epoxy coatings, pamts, cor~crete, leachateoranv SuTve~or$ ~oCo 7/ ] ]/9 ] SPECIAL CONDITIONS 1. No structures shall be placed on any existing right-of-way. 2. Prior to any construction activities, the applicant shall submit to the Department (Division of Regulatory Affairs) a final plot plan showing the lot line change proposed on the plans stamped NYSDEC Approved on 12/26/91. 3. The permittee shall require that any contractor, pcoject engineer, or Dther person responsible for the overall supervision of this project reads, understands, and complies with'this permit and all its general, special, and supplementary special conditions. 4. The perm~ttee, or authorized representative, shall complete and return the top portion of the enclosed form notifying the Bureau of Environmental ProtectioD of project commencement. Upon completion of the permitted pro~ect, complete and return the bottom portion of the form, along with photos, notifying the Bureau of Environmental Protection of project completion. 5. Markers used by th~s Department to delineate/define the boundary of the wetland or the extent of the permitted structures shall be left in place and shall remain undisturbed for 1 year following completion of the permitted project. ]-4738-00246/0000 -0 PROGRAM/FACILITY NUMBER Page _3 of ~ SPECIAL CONDITIONS For Article 24 ( Freshwater Wetlands 6. Any work, disturbance, and/or storage of construction equipment and materials shall be confined to within the "limit of clearing and disturbance" shown on the approved plan and/or to upland (non-wetland) areas more than 100 feet landward of the wetland boundary. 7. Heavy equipment, including bulldozers, backhoes, payloaders, etc., shall not be operated in the buffer area. 8. A~snow fence or other temporary, project-limiting fence shall be erected prior to the commencement of any construction activitieB along the limit of clearing and disturbance in order to prevent the inadvertent intrusion of equipment into the protected area. The fence shall be maintained until project completion. 9. Prior to commencement of any construction activities, a continuous row of straw bales shall be staked end to end along the base of the snow fence (or other temporary, project-limiting fence) on the upslope or project side of the fence. The bales shall be maintained in place until all disturbed areas are permanently vegetated. Trapped sediments shall be removed to an approved upland site before the bales themselves are removed. 10. All disturbed areas where soil is temporarily exposed or stockpiled for longer than one (1) day shall be covered with a tarp. 11. Any debris, excess construction materials, or excess excavated materials shall be immediately and completely disposed of on an approved upland site more than 100 feet landward of any regulated wetland or waterbody. The materials in question shall be suitably stabilized so that they cannot re-enter any regulated water body, wetland, or wetland adjacent area. 12. During any grading operation soil shall not be placed in, graded toward, or allowed to enter the wetland, or open water. 13. The work area shall be graded to conform with the elevation and contours of the undisturbed land immediately adjacent to the work a~ea. 14. All roof and driveway runoff shall be directed to drywells located as shown on the approved plan. DEC PERMIT NUMBER I-~738-00246/000~2 I-0 FACILITY ID NUMBER J PROGR^M NUMS~R JPage __4 of -'~-- SPECIAL cONDI~'iONS For Article_ 24 [ Freshwater Wetlands 15. Use of herbicide! in the wetland is prohibited, except as permitted under the prov~szons of ECL Article 33. 16. All areas of soil disturbance resulting from this project shall be seedud with an appropriate perennial grass and mulched with straw immediately upon completion o~ the project, within two days of final grading, or Dy the expiration of the permit, whichever is first. Mulcb shall be maintained until a suitable vegetative cover is established. If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed as soon as weather conditions favor germination and growth. 17. The permittee shall ~ncorporate the following language as a notice covenant to the deed: "Regulated freshwater wetlands are located in the northeastern corner of ~ne properties of Mark & Lisa Davis and their heirs, assigns or successors. This propery is subject to the provisions of ECL Article 24, and the conduct of regulated activities may occur only pursuant to ECL ~rticle 24 if prior approval is given by the New York State Department of Environmental Conservation (NYSDEC). Regulated activities include, but are not limited to, clearing of vegetation; application of chemicals; excavation; grading and filling; and erection of any structure(s)." This deed covenant shall be recorded within 90 days of the issuance of this Permit with the Clerk of Suffolk County. A copy of the covenanted deed or other acceptable proof of record, along with the number asszgned to this permit, shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager BEP, SUNY Bldg. 40, Stony Brook, New York 11790- 2356. Supplementary Special Conditions (A) thru (J) attached. 1-4738-00246/00001-0 ~ur~au of Environmental Protection - Bldg. 40, SUNY Stony Brook, New York [1790-2356 RE: Permi~ No: Issued To: Contractor's Name Contractor's Address Contractor's Phone No. To whom it may concern: Pursuant to General Condition Nut,her 1 and Special Condihion Nuamber 2 of the a~ve referenced permit, you are hereby notified that the authorized activity shall coa~aence on Submitted by: '~his notice is to be sent at least two days in advance of co~encement of the projecu. The permit sign will be posted at the site and copy o~ permit will be available at site for inspection. Failure to notify or post sign will leave owner and/or contractor subject to applicable penalties for non-compliance with permit conditions. NYSDEC Bureau of Environmental Protection Bldg. 40, SUNY Stony Brook, New York 11790-2356 RE: Permit~No: /~?--~ ~/~) / --O Issued To: ~/~ 0~ / Contractor's Name Contractor's Address Contractor's Phone No. To whom it may concern: Pursuant to General Condition Nunfoer 1 and Special Condition Nun~Der 2 of the above re~erenced permit you are hereby notified that the authorized activity was co~pleted on Submitted by~ This notice, with photos of completed work and/~r completed survey, is to be sent to above address promptly upon completion of project. Failure to notify will leave owner and/or contractor subject to applicable penalities for non-compliance with permit conditions. NO¥1CE OF INCOMPLETE APPLICATION - THIS IS NOT A PERMIT MARK & LiSA C DAVIS BOX 1493 MATTITUCK NY - 1952 APPLICATiON ID 1-4738-0024600001-0 U;',TC Nt~M~t:R 086426 PL=Rt~rrS ~o ~ &RTICLE 24: ~RESHWATER WETLANDS FAOIL~Y/PROJECT DAVIS PROPER'~ PROJECT IS [~AT~D IN SOUTHOLD ~a SUFFOLK Y~r ~¢~ad~ [~ P~l~t is Inc~¢ete. tt~ FCbwing ~ems ~e Required: 'a Project p~ans 4 coo~es PL~SE SEND A REVISED SURVEY PLAN SHE WING TFIE FINAL , qOT PROPOSED LOT / LINE CHANGE AND GUARANTEEING NO EXISTING RIGHT-OF WAY ON LOT~ NO FURTHER ACTION C~ BE T~EN UNTIL ~L OF THESE MATE CEllO CONTACTPER~N JOHN A WIE~ND SIGNA~IR& ___ Sou OLO is of Town Trustees m~o~ring taken bY the Board ring the above actiOn was on october 3, 199% held USE ~stees ~u~ ~ ~o~thol~, ~ To~ o~ - ndat~O~ tion was re'er To~ Trustees w~th appIica . ~uncil ~o< A&Vis°rY ~ ~ bY the .~ch time a%~ ~ntere 'c hea~Z~ w~er 3, ~99~ a.ea=a, ama,_~ a=e ~z~' atiOU ~"~ortUn~ ZoonallY v~ area, ~oa~ me~~ ~;on an~ ~% +~e testZm~ '~ '~ =rd has u~ ~icat~, ~. nro]~U~ = +he peo~ ~F OF ~' O~IN~C - it is si' th~ ~ within from two..~arS=~d De~it ~= =ions are =~' -~o inspeCU $ sail :.led upOn TRUSTEES John M. Bredemeyer, III, President H SUPERVISOR SCOTT L. HARRIS enry P. Smith, Vice president Albert J. Kmpskii~Jr. John L. Bednoski. Jr. Town Hall John B. Tuthitl 53095 Main Road P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1 t23 TOWN OF SOUTHOLD September t0 1991 Land Use Com any 2576 Sound A enue Baiting Hollcw, NY 11933 RE: Mark and Lisa Davis SCTM %1000-126-9-18 Dear Mr. Bow an: The followin¢ actions were taken by the Southold Town Board of Trustees at ne regular meeting of September 5, 1991: RESOLVED that the Southold Town Board of Trustees DENY the waiver to construct a one family dwelling and request a full application. _ As a full application and fee are in the file, it was RESOLVED that the Sout~old Town Board of Trustees grant a negative declaration for the above referenced application. If you have any questions, please do not hesitate to contact this office. Very truly yours, JMB: jmt cc: CAC enc. TRUSTEES John M. Bredemeyer, III, President SUPERVISOR Henry P. Smith, Vice President SCOTt L. HARRIS Albert J. Krupski, Jr. John L. Bednoski, Jr. Town Hall John B. Tuthill 53095 Main Road P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. 126-9-p/o26.2 & 26.3 NAME: Mark and Lisa Davis DATE: September 6, 1991 RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as Lead Agency for the action described below, has determined that the project will not have a significant effect on the environment. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. TYPE OF ACTION: unlisted DESCRIPTION OF ACTION: to construct a one family dwelling located off Peconic Bay Blvd., Mattituck. LOCATION: Tax map No. i000-126-9-p/o 18, 26.2 & 26.3 REASONS SUPPORTING THIS DETERMINATION: 1. An on site inspection has been conducted by the Board of Trustees. 2. An environmental assessment, submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as planned. cc: Building Dept., Applicant TRUSTEES John M. Bredemeyer, III, President SUPERVISOR Henry P. Smith, Vice President SCOTT L. HARRIS Albert J..Kmpski, Jr. John L. Bednoski, Jr. Town Halt lohn B. Tuthill 53095 Main Road P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD September 6, 1991 The following action was taken by the Southold Town Board of Trustees at their regular meeting of September 5, 1991: RESOLVED that the Southold Town Board of Trustees will no longer grant wetland waivers under Chapter 97 for the construction of single family dwellings. The Trustees feel that a full permit application process must take place in order to fully review each application and provide for public comment. cc: CAC Building Dept. Town Clerk's Bulletin Board Land Use September 5, 1991 Board of Town Trustees Town of Southoid Town Hall, 53095 Main ROad P.O. Box 725 $outhoid, N.Y. 11971 Attn: Mr. John Bredemeyer Re: Davis - Mattituck Dear Mr. Bredemeyer: Enclosed please find (2) copies of a site plan for the project as referenced above which have been revised as follows: The wetlands line has been labelled as follows: "N.YoS.D.E.C. Freshwater Wetlands Line as delineated by Diane Goetke on 5/1/91". 2.) Increased buffer area and indicated limit of clearing and disturbance. 3.) Indicated (2) drlrwells 100' from wetlands for roof runoff and driveway drainage. Should you have any questions, please don't hesitate to contact this office. I remain, Very truly yours, Charles W. Bowman CWB/tl Eric. Hand Deliver 2576 Sound Avenue · Baiting Hollow, NewYo~ ° 11933 (516) 727-2400 ° FAX (516) 727-2605 PLANNING BOARD MEMBERS ~ ¢o ~ ~ SCOTT L. HARRIS Bennett Orlowski. Jr.. Chairman .., C.~ Supervisor George Ritchie Latham. Jr. Richard G. Ward Town Hall. 53095 Main Road Mark S. McDonald P.O. Box 1179 Kenneth L. Edwards Southold. New York 11971 PLANNING BOARD OFFICE Telephone 1516) 765-1938 TOWN OF SOUTHOLD Fax (516) 765-1823 LandTa ny a LaCheuse nme yet I~~ 2576 Sound Avenue Baiting Hollow, New York 11933 RE: Proposed Lot-line change for Mark and Lisa Davis and Brady & Kim Ulmet SCTM=1000-126-9-26.3 & 18 Dear Ms. Lachenmeyer: The following took place at a meeting of the Southold Town Planning Board on Monday, July 15, 1991. The final public hearing, which was held at 7:35 P.M., was closed. The following resolution was adopted; WHEREAS, Mark and Lisa Davis and Brady & Klm Ulmet are the owners of the property known and designated as SCTM~1000-126-9-26.3 & 18, located on a private road north of Peconic Bay Boulevard and east of Bray Avenue in Mattituck; and WHEREAS, this lot-line change, to be known as proposed lot line change for Mark & Lisa Davis and Brady & Kim Ulmet, is for a lot line change adding 13,832 square feet from a 23,288 square foot parcel to a 14,936 square foot parcel; and WHEREAS, the Southold Town Planning Board, pursuant to the State Environmental Quality Review Act, (Article 8), Part 617, declared itself Lead Agency and issued a Negative Declaration on May 13, 1991; and WHEREAS, a final public hearing was closed on said subdivision application at the Town Hall, Southold, New York on July 15, 1991; and Page 2 Mark & Lisa Davis and Brady & Klm Ulmet WHEREAS, all the requirements of the Subdivision Regulations of the Town of Southold have been met; and be it therefore, RESOLVED, that the Southol~ Town Planning Board grant conditional final approval on the surveys dated September 4, 1990, and authorize the Chairman to endorse the final surveys subject to fulfillment of the following conditions: 1. Department of Environmental CQnservation permit for freshwater wetlands. 2. Revised maps showing the location of the undisturbed natural vegetative buffer, between the flagged wetlands and the limits of construction. The above conditions must be met prior to the Chairman signing the final maps. Please contact this office if you have any questions regarding the above. Very truly yours, Bennett Orlowski, Jr. RS Chairman / New York State Depadment of Environmental Conservation Wolf Road, A~bany, New York 12233 50 ~mmlsslo~r RE: _EAD AGENCY COORDINATIDN REQUESI ~:, 6 Th~ purpose of this re~ues~ is ~o determine under Art ~ NYC mental Quality Review- SE~R) of ~ne Environmental Conserv~ ~R Pan~ 6!? cne following: our agenc3 s ~,~e~es~ ~n acting as lead agency; 2'. Your ~gency's jurisdicti~ =~ the action described below; dna 3. ~ssues of concern which your agency believes should De evaluated. Eno oseo ~s a comy of mne permi~ application aha a comple~ed~ar~ 1 of ~ne DEC Projec~ Num~e~: SEqR Ciassificazion: __ Type I [~Un~is~ea DEC Contact Person: DEC Pos~:~cn: _ _ DEC nas no cb~ac~or ~o ~our ~genc~ o~ ano&he~ ~genc~ zssum~ng lead agenc~ a ocsi:ive determination 3¢ significance is made. -2- ~_ DEC has no objection To your agencj agency or another assuming lead agency s~a~us for this action, but we nave the following concerns regarding this project see "commen~s" below). [ i BEC ~ishes to ~ssume lead agency status for this action [ ' The 3rODOSe~ action nas peen identified Dy DEC as occurring wholly or oartially within or sucstantiaily contiguous to a critical environmental area (CEA) tna~ was oes:gnated by It is ~ne oosition of this Department that your agency, if it has a juris- diction over ~ne action, should assume the lead agency ~ole based cn the exiszence of the CEA and the fact ~nat the anticiDated imoacts are or'imarily ~f local signif~can.ce. - - Other. See comments below) if no response :s received within 30 days, we w~i- assume :na~ you have no oo3ecz~on to DEC or ~no .... r agency assuming cne ro = of lead agency, and have no commengs go of:er regarding 2ne proDose~ acgion AE this time. [f neither your agency nor ~ny ozner involved agency, including DEC, has ~ndicated a will- ingqess ~o serve as lead agency w, thin 3C days of this letter: ~we wil- oetition gne Commissioner of 3EC 2o designate a lead agency fo~ th~s ~czion. [ ] We wi" ~atition the Commissioner of 3EC 2o designaze your agency as lead. ~resuming you nave jurisdiction. Please feel free 2o conzact this off,ce for further ~nformation or aiscuss~on. cc: (see a:stribuzion Certified/Return Receipt ~P8537~1t3 ~jjjj~ NEW YORK STATE DEPARTMENT OF £NVI'i~*i~MENTAL CONSERVATION /-- /--/ ~ ~ · ~' JOINT APPLICATION FOR PERMIT Unknown Mark C. and Lisa C. Davis Box 1493 I i 734-7824 POST OmCE STATE Zm CODE M~t%ituck N.Y. 11952 Tsnya Lachenm~yer/Land Use ComDany 2576 Sound Avenue i 727-2400 POST OEEICE STATE J ZiP COOE Baitinq Hollow N.~. 11933 Co..~v Suffolk Town o~ ci~. Southold Town J geconic Bay Blvd. POST OFFICE STATE [ ZiP CODE Mattituck N.Y.J 11952 ITn-n ame(] FWW [] Public L Commercial ASAP 6 months from commencement Applicant proposes to construct a single family dwelling, attached garage and drive,way. Southold Town Trustees, S.C.D.H.S. ~ Southold Town Building Department 15. CE KTIFJCATION 1/2/91 /~'~;Ft\~)~,ktk~\~' ~q~J~-~Liq_~r'[ ~fx~r~k~,n I~ /t _~roject Manager DAte ' ,~. ~' 5tGNATURE il/ -- TITLE ~4-16-4 (2JB7)--Text 12 PROJECT LD. NUMBER 617.21 SEQR [; , _ 4f ? ~c.-C~,C2 ~)_ c/ 6' Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTION~ Only PART I--PROJECT iNFORMATION (To be completed by Applicant or Project spot,sot) 1. APPLICANT/SPONSOR Tanya nacheY)Toeyel-y/T_~nd USe 2. pROJECT NAME Co. For Mark & Li~a Tmvis Private Residence 3. PROJECT LOCAQ;~ON: Mu[~icipai y Mattituck County Suffolk . S.C.T.~f. ~ p/o 1000-126-09-18, p/o 26.2 & 26.3 (lot 2) ~ - i Applicarit proposes to COnstruct a single family dwelling, attached 9'arage and driveway. 9, V~T IS PRESENT LANO USE IN VICINITY OF PROJECT? DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STA E.OR LOCAL)? ~Yes [] NO If yes. list ~.gency(s) arid permit~approYat$ Southol~ To~ Trustees, S.C.D.H.S. & Southold To%n1 'Buildin~o Department CERTIFY THAT THE NFORMATION PROVIDED ABOVE l$ TRUE TO TH£ BF. ST OF MY KNOWLEDGE Tanya Lachenmeyer/Land Use for ~rk & Lisa ~vzs ~: 1/2/91 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 super~iso; ,. 53095 Main Road LANIqEqG BOARD MEMBERS P, ': tr ,C~ p.O. Box 1179 efinett Or~oWs~t, r Southold, New York 119V 1 B · · ~ th~; Jr. G~e REeh~e ~a ~ichard G. War&, Kenneth L. ~a~'~ pLANNING BOARD OFFICE t516) 765-1823 TO~ oF soUTHOLD ~eleph°ne(5'~6~ state ~nvir°~ental QuaZ~tY Review ~EGATI~ DEcL~TTONNoB- Signi~ icance Notice of Dete~inati°n o~ ' MaY [3, 199[ :, . · , ed ~rsuant to ?art 6T7 o~ th su P . . Article B [state ~Q~ not~Ce ~s ~s - ~rta~n~ng to_ ~xr[ro~ental LaW. %mp%~a1 Quality ~=~ a~enoY, has ra' that the proposed actiOn descrlbed belOW will not icant effect on the enviro~ent and a Draft impaCt statement will not be prepared- proposed Lot-line change ~or :.~ ActiOn: Mark C. & Lisa C. DaviS & Brady S. & Klm ulmet SC~%: 1000-1~6-9-26 · 3 & -18 private road north o~ ?econiC Bay Boulevard ,~ : and east of Bray AvenUe SEQR status: Unlisted [X } " No (X) Cofi~itioned Neqative DeclaratiOn: yes ( DescriptiOn o~ Action: Lot-line change subtracting 11,132 square feet from a 34,420 s~are ~oot parcel and adding it to a ~7,636 square foot parCel. Page 2 Mark C. & Lisa C. Davis & Brady S~ & Kim Ulmet SEQR Negative Declaration Con"t. Reasons Supporting This Determination: An Environmental assessment has been submitted, reviewed and it was determined that no significant adverse effects to the environment were likely to occur should the project be implemented as planned. For Further Information: Contact Person: Robert G. Kassner Address: Planning Board Telephone Number: (516) 765-1938 cc: David Morrell, DEC Commissioner Judith Terry, Town Clerk Building Department Board of Trustees J Applicant New York State Department of Environmental Conservation Building 40--SuNY, Stony BrOok, New York 11~9~-~356 Commissioner THOL£ June 7, [991 Land Use Co. 2576 Sound Av.e Baiting Hollow, N.Y. ]]933 Attn: Tanya Lachenmeyer ~: Application #]-4738-00246/0000]-0 Mark & Lisa Davis Dear Ms. Lachenmeyer: I recently discussed the above referenced application with Bob Kassner of the Town of Southold Planning Department. I understand that the "right-of-way" on lot number 2 ~s co be eliminated. Please send documentation To this Department of the "right-of-way" elimination on lot number 2. Bob Kassner asks that you send the same documentation to him. Thank you for your cooperation. Very tr~y yours,~ ] ~n~'E~entat Ana!vst JAW/rw cc: M. & L. Davis file Land Use Bureau of Regulatory Affairs, Room 219 Bldg. 940, SUNY Stony Brook, N.Y. 11790-2356 Attn: Mr. John Wieland Re: Application No. 1-4738-00246 Davis - Mattituck Dear Mr. Wieland: As per the "Notice of Incomplete Application" dated 5/16/91, enclosed please find (4) copies of a survey which we have revised to reflect the FWW line as delineated by Diane Goetke on 5/1/91. Additionally, we have relocated the leaching pools so they are now 100' from the FWW boundary. Furthermore, we have incorporated a vegetative buffer area between the FWW boundary and proposed dwelling. Should you have further questions or require additional information, kindly contact this office at your convenience. Very truly yours, Tanya Lachenmeyer TL/cf enclosure Certified/Return Receipt %P617149130 cc: Southold Town Trustees 2576 Sound Avenue · Baiting Hollow, NewYork · Ii933 (516) 727-2400 * FAX [516) 727-2605 Page 2 ~ neighbors navigation and dock. Vote of Council: Ayes: All On a motion by Bruce Louckar seconded by Cynthia Sturner, it was RESOLVED to recommend to the Southold Town Trustess disapproval of ~Wetland Application No. 50-3-6 of James Bitses to construct a small flood control gate; small semi-circular berm penetrated by a four inch pipe with gate valve , six feet in diameter and two feet high. The Council recommends disapproval until an engineers report is submitted to determine the results of 2", 3" etc. of rain (will it flood the road?). Vote of Council: Ayes: All Motion carried. On a mo~tion by Stephen Ang~ellt seconded by Margaret Feeney, it was RESOLVED to recommend to the Southo/d Town Trustees approval of Wetland Application No. 111-1-16 by Frank Curran to replace (within 18" 101 I.f. of existing timber bulkheadj install one 10" mooring pile and dredge a 21' x 25' boat basin to 41 below MLW. Vote of Council: Ayes: All Motion carried. On a motion by John Holzapfel~ seconded by Bruce Loucka, it was RESOLVED to recommend to the Southold Town Trustees approval of Wetland Application No. 116-6-24 submitted by Kinogenor Point Company to replace ~within 18) 135+ I.f. of existing bulkhead. Vote of Council: Ayes: Ail Motion carried. On a motion by Stephen AngeH, seconded by Cynthia Sturner, it was RESOLVED to recommend to the Southold Town Trustees approval with suggestions of Wetland Application No. p/o 122-3-14(Iot 1~ of Alan Cardinale to construct a catwalk, platform, ramp and float to piles. The Council suggests the applicant extend the catwalk and send the ramp from the catwalk to float and eliminate the stairs. Vote of Council: Ayes: All Motion carried. On a motion by Stephen AngeH, seconded by John Hoizapfel, it was RESOLVED to recommend to the Southold Town Trustees approval with suggestions of Wetland Application No, p/o 122-3-14 (Lot 2) of Alan Cardinale to construct a catwalk, platform, ramp and float to piles. The Council suggests the applicant extend the catwalk and send the ramp from the catwalk to float and eliminate the stairs. Vote of Council: Ayes: All Motion carried. Application No. p/o 122-3-14 CLot 3) was tabled pending further information from environmental experts concer6ing the length of catwalks over wetlands. On a motion by Margaret Feeney, seconded by John Holzapfel, it was RESOLVED to recommend to the Southold Town Trustees disapproval of Wetland Application No. 126-9-p/o19, 26.2 and 26.3 of Mark and Lisa Davis toconstruct a single family dwelling with garage and driveway. The Council feels this should not be subdivided, it is no! a buildable lot. The Council recommends denial because of environmental concerns and to uphold zoning. Vote of Council: Ayes: All Motion carried. Town Hall. 53095 Main Road P.O. Box 1179 Telephone Southold. New York 11971 (516) 765-1801 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL To: Southold Town Trustees From: Southold Town Conservation Advisory Council Dated: February 13, 1991 Re: Recommendation of Wetland Applications The following recommendations were made by the Council at its meeting held Thrusday, February 7, 1991: On a motion by Stephen Angell, seconded by Margaret Feeney, it was RESOLVED to recommend to the Southold Town Trustees approval with limitations on Wetland Application No. 1'11 - 1 of Thomas Samuels to maintenance dredge a channel 30+' x 1~40+' to maximum depth 6' below MEW with spoil to be used as beach nourishment on southwest side of Fisherman's Beach. The CAC approves if the dredc~in~l depth is limited to 4'. The Council feels that 6' is too big, 4' is adequate for most pleasure crafts in the area and the Council is concerned that the 6' depth would create potholes and problems to the surrounding water and shellfish. Vote of Council: Ayes: All Motion carried. Application No. 12-2-90-78-5-16 of James Grathwohl was tabled pending receipt of the landscape plan, buffer zone and placement of a retaining wall as requested by the Board of Trustees. On a motion by Stephen Angell, seconded by Bruce Loucka, it was RESOVLED to recommend to the Southold Town Trustees approval with su~lc, lestions of Wetland Application No. 12-4-90-123-10-1 of Panagiotis Gazouleas to construct a single family dwelling, attached decking and associated sanitary system. Construct a 4' x 30' fixed dock, 3' x 10' ramp and 6' x 20' float. The Council approves the house as submitted with the stipulation that the applicant i'ollow the checklist the CAC submitted to the Trustees in a letter dated February 9, 1990 which requires roof gutters and drainpipes, no runoff by grading, straw bales during construction, no planting requiring fertilization and heavy watering within 75' of wetlands, etc. The Council approves the dock with the suggestion that the two floats be turned 90© to plan so it would be in line with the last adjacent dock. Vote of Council: Ayes: All Motion carried. On a motion by John Holzapfel, seconded by Cynthia Sturner, it was RESOLVED to recommend to the Southold Town Trustees approval with stipulations of Wetland Application No. 24-2-11 to remove existing dilapidated docking facility and replace in-kind, in-place, a 4' x 28' fixed timber dock, 3' x 16' aluminum ramp, 6' x 20' float dock and two 2-pile float support dolphins, The Council approves provided the project does not interfere with the adjacent TRUSTEES SCOTt L. HARRIS John M. Bredemeyer, III. President Supervisor Henry P. Smith. Vice President Albert J. Kmpski. Jr. Town Hall, 53095 Main Road John L, Bednoski, Jr. P.O. Box 1179 Southotd, New York 11971 John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516/765-1823 Telephone (516/765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 TO: Planning Board FROM: Board of Trustees RE: Mark and Lisa Davis SCTM ~1000-t26-9-p/o26.2 DATE: February 7, 1991 The $outhold Trustees have before them a wetland permit application in the above referenced matter. The Trustees do not have a problem with a subdivision of this parcel given the apparent 75' (Seventy Five Foot) wetland set back, but can only process a wetland permit application after the appropriate subdivision approvals have been obtained from the Planning Board and/or Zoning Board of appeals. Please let this office know when the necessary approvals have been obtained. JMB:]mu eric. cc: Land Use Company ZBA TRUSTEES SCOTr L. HARRIS John M. Bredemeyer, III. President Supervisor Henry P. Smith. Vice President Albert J. Kmpski. Jr. Town Hall. 53095 Main Road John L. Bednoski. Jr. P.O. Box 1179 Southold. New York 11971 John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 January 28, 1991 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.126-9-p/o19, 26.2 & 26.3 for a wetland application submitted by Land Use Co. on behalf of Mark and Lisa Davis. Please note that this property is not subdivided and we will not grant any approvals until such time that it is given the proper Planning Board approvals. Please prepare a written report of findings and recommendations with respect to this application. Very truly yours, John M. Bredemeyer, III President, Board of Trustees JMB:jt TRUS~tEES SCOTI' L. HARRIS ? Sup~rwsor John M. Bredemeyer, II1, President Henry P. Smith. Vice President 53095 Main Roa,~ Albert J. Krupski, Jr. Iohn L. Bednoski, Jr. New York 1197! John B. Tuthill BOARD OF TOWN ~ (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLb~ -~-~ ~'~ '~= O~ SOL~f~OLD ~3-la0~ APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNR~f, NEW YORK, FOR THE ISSUAlqCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOlrERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF TIlE CODE OF THE TOWN OF SOUTHOLD. APPLICANT'S NAI4E: Mark C. & Lisa C. Davis TEL. NO. 734-7824 MAILIlqG ADDRESS: Box 1493, Mattituck, N.Y. 11952. AGENT: Tanya Lachenmeyer/L~nd Use Company TEL NO. 727-2400 AGF~NT ADDRESS: 2576 Sound Avenue, Baiting Hollow, N.Y. 11933 PERMIT REQUESTED TO: Applicant proposes to construc~ a single f~unily dwelling, attached garage and driveway. LOCATION OF PROPERTY FOR REQUESTED PERMIT: peconic Bay Blvd. ~ Mattituck TOWN: Sn~fhn]~ T~n. Mattituck TAX MAP NO: 1000- ~26-09 p/n ]8. p/o 26.2 & 26.3 CREEK, BAY OR HARBOR FRONTING PROPERTY: N/A SIZE '3F PROPOSED WORK: LENGTiq~. Max. 66' WIDTH: Max. 47' YDS. T~) BE EXCAVATED: n/a YDS. TO BE FILLED: n/~ MANNER IN WHICH MATERIAL' WILL BE REMOVED OR DEPOSITED: n/~ WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERT~f: n/a DEPTH AT LOW TID. E: n/a AVER. RISE IN TIDE: n/a DISTANCE TO NEAREST CHANNEL: n/a DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN AREA: n/a bJlEA ZONING: Residential IS PROJECT~ FOR PRIVATE OR P~US. USE: Priva%e INTENDED USE OF PROPERTY: Sinqle Family dwellinq DESCRIBE KNOWN PRIOR OPER3tTIONS CONDUCTED ON PREMISES: Unknown HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISE~: no HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVEiINMENTAL no AGENCY: DESCRIBE FULLY THE REHABILITATION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: Property shall be improved with a single family residence. ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: no WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: enclosed COUNTY OF SUFFOLK STATE OF NEW YORK Tan!fa Lachenmeyer/Land Use for Mark C. & Lisa C. Davis BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND ~T ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING {: OR BY' VIRTUE OF SAID PERMIT, IF GRANTED. APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR HY ~ROPERTY TO INSPECT THE PREMISES PHIS APPLICATION. NOTARY P B IC -'"" ~0. 4<;:s:,3s s~,,.:~, Cou. EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 PROJECT LD. NUMBER ~ 617.21 SEQR 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) I 1. APPLICANT/SPONSOR Tanya Lachenmeyer/Land Use 2. PROJECT NAME Co. For Mark & Lisa T~vi s Private Residence 3. :ROJECT LOCATION: MumcioalRy Mattituck County Suffolk 4. =REC[SE LOCATION [Street address and road intersections, prominent landmarl<s, etc., or provide map) S.C.T.H. ~ p/o 1000-126-09-18, p/o 26.2 & 26..3 (lot 2) 5, IS POSED ACTION: F~New [] Expansion [] Modifica, tionlalteration 6. DESCRIBE PROJECT BRIEFLY: Applicanf proposes ~o construct a single family dwelling, attached garage and driveway. 7 AMOUNT OF LAND AFFECTED: nit/ally .66 acres Ultimately · 66 acres 8 Wr~a~ PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ,~Yes [] No Jf No, describe briefly 9. WHAT IS PRESENT LAND USE iN VICINITY OF PROJECT? Residential [] Industria [] Commercial [] Agriculture [] Park/Forest/Open space [] Other Describe: 10, DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STA E,OR LOCAL)? T~Yes [] No If yes. us[ agency(s) and permitlapprovals Southold To~ Trustees, S.C.D.H.S. & Southold To~,m Buildin_o Department 11 DOES ANY~S~FSPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [~ No If yes, list agency name and permit/approva~ 12. AS A RESULT (~F~PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [ CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sgonsol ~amTe?l'lya Iachenmeyer/Land Use for Mark & Lisa D~vis Date: 1/2/91 I~ the action i~ in the Coastal Area, and you ar.~.~ state ageno¥, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II--ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 if yes, coordinate the review process and use the FULL EAF. 13. WILL ACTION RECEIVE COORDINATED REVIESN AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 6t 7.67 If NO, a negative dectara~ti~ may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, sogd waste production or disposal, potential for erosion, drainage or flooding problems? ExplAin briefly: C5. Growth suDseauent development, or related activities likely to be induced by the proposed Action? Explain briefly. C6. Long term. snort term. cumulative, or other effects not identified m 01-C57 Explain briefly. 07_ Other impacts Unc~uamg changes in use of either auan[~[y or type of energy)? Explain briefly. D. IS THERE. OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] NO if Yes. exolain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To De completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should De assessed in connection with its Ia/ setting (i.e. urban or ruralf; (b) probability of occurring; lC) duration: irreversibility; /e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts nave been identified and adequa[e~y 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 posttive 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: Print or Type Name or Responsible Officer in Lead AGency Title of Resoons~bte Officer 2 Land Use } TOWN OF To ~11 regulatory agencies: I hereby authorize Land Use Company %o apply for approvals necessary %o comple%e my pro~ect. Lisa C. Davis 2576 Sound Avenue · Baiting Hollow, NewYork · 11933 (,516) 727-2400 ,, FAX (516) 727-260,5 SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply ~o all permits: A. If any of the permit conditions are unclear,the permitte tact the Division of ReguLatory Affairs at the address and telephone noted below. B. A copy of this permit with supplementary conditions and approved plans shall be available at the project site whenever authorized_ work is in progress. C. The permit sign enclqsed wi~ the permit or a copy of letter of approval shall be protected from the weather and posted in a col]- splcuous location at the work site until completion of authorized work. D. At least 48 hours prior to commencement of the project, the permittee shall complete and return the top portion of the enclosed receipt form certifying that he is fully aware of and understands all provisions and conditions of this permit. Within one week 6f completion of the permitted work, the bottom portion of that form shall also be com- pleted and returned. E. For projects involving activities to be accomplished over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing a~ least 48 hours prior to the commencement of resumption of work each year. F. If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes fo~ approval by the Regional Permit Administrator prior ~o undertaking any such modi- fications. The permittee is advised that substantial modification may require submission of a new application for permit. G. All necessary precautions shall be taken ~o preclude c~ntaminatio~] of any wetlands or waterway by suspended solids, sediment, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project work. H. Any failure to comply precisely with all of the terms asd conditioas of this.permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. I. The permittee 'is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, NY District, 26 Federal Plaza, New York, NY 10278, (Attention: Regulatory Functions Branch), prior to commencement of work authorized herein. J. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany~ NY 12242, which may be.required for any encroachment upon State-owned lands underwater. Regional Permit Administrauor NYS Dept. of Bnvironmental Conservation Bldg. 40, SUNY-Room 219 Stony Brook, NY 11790.-2356 (516) 751-;3~ Page ~ of ~