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Home My WebLink AboutTR-3765 GFBoard Of $outhold Town Trustees-- SOUTHOLD, NEW YORK PERMIT NO .... 3,2',6.5 ......... DATE: ...J.:u. ly.28,_.1989 ISSUED T°, .. , JAME~ J,...C,~.~ELL ........... Authorization Pursuant to fha provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the SoufhoJd Town Ordinance en- fitled "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 wi+h the Resolution of The Board adopted afa meeting held on 19. ~.., and in consideration of the sum of $ ....................... peld by of ........................................................................... N. Y. and subject fo the Terms and Conditions llsfed on fha reverse side hereof, of Soufhold Town Trustees aufhorlzes and permits the following: To construct and attach to bulkhead, 3 x 10' ramp, 6~ x 20' float, and install 2 pilings. all in accordance with fha detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ~fs Corporate Seal fo be affixed, and these presents fo be subscribed by a majorlfy of said Board as ils date. Trustees ALL MOORINGS AND STAKES MUST DISPLAY VI~,IBLE MOORING NUMBERS ALL DOCKS AND BULKHEADS MUST DISPLAY VISIBLE PE~IT NUMBERS Board Of Southold Town Truste es ' Mooring # ~AOUTHOLD, NEW YORK ....... PERMIT NO ...... .z...9...4..6....i ............ DATE: May~l, 1985 -'1 U John'C. W. Campbell SS ED TO .................................................................................................................................... "': ::'::z:"Pursuan~' {.o ~'he provisions of Chap"er 615 of {'he Laws of '" 'the S{'a'i'e of New York, 1893~ and CLapt'er 404 of fhe Laws of "$'i'a{.e of New York 1952; and the Soufhold Town Ordinance en- ti{.led "REC-ULATINC= AND THE PLACIN® OF OBSTRUCTIONS ':"~': IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, SRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERSi" and in accordance wlth the Reso]uflon of The Board adop{.ed afa mee4'ing held on ?~aY.....k~ ........ 19....~.~., and in consideraHon of ~he sum of $......~.~..Q.Q ......... pald by ;..: - dohn C. W. Campbell .... .~-. o{ ......... S.Q~hQ.i.d ................................................... N. Y. and su~[ec% eo ehe Terms and Condi~[on~ li$~ed on ~he reverse $,de hereof,' '"' o~ Sou~hold Town Tru~ee~ aufhor[ze$ and permif$ ~he Application approved under the Grandfather C To secure a permmt for a ramp( lea~$~g ~o a :'~':-d~ 9i%'~';~h~ee~n~i~'~: 'D3ck'k ;¥: "~1'1' ~[h"- :'" mae application submitted in Willow Point all in accordance wifh %he de~ai[ed specifications a[ pre$en~e~ '"" {he orig[na~ing application.' ..... .~ ~...._.: · IN WITNESS WHEREOF, Th'e '~ai8 Board of Ttu~ee~ kere- .... 5y ~ause$ [~$ Corporate Seal ~o be affixed, a~d }here pre[en}$ ~o ";' be subscribed by a majority of %he of FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPHONE ¢516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, $3095 Main Road P.O. Box 728 Southold, New York 11971 August 4, 1989 John Geideman PO Box 416 East Marion, N.Y. 11939 Re: Application No. 5-7-89-71-2-11.1- Campbell Dear Mr. Geideman The following action was taken by the Board of Town Trustees during their regular meeting held on July 27, 1989 regarding the above matter: WHEREAS, John Geideman on behalf of James Campbell applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated May 12, 1989 and, WHEREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a public hearing was held by the Town Trustees with respect to said application on July 27, 1989 at which time allinterested persons were given an opportunity to be heard, and,/ -~ WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW, THEREFORE BE IT RESOLVED that John Geideman ON BEHALF OF James Campbell BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: Construct and attach to bulkhead, 3' x 10' ramp, 6' x 20' float, install 2 pilings. Property located at 350 Harbor Lights Drive, Southold, 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 return to the Building Department for a determination on the need for any other permits which may be required for this project. Permit will be issued upon payment of the following fees for work to be done below Mean High Water Mark: $ 45.00 ramp 180.00 float 50.00 2 piles $275.00 Total fees Very truly yours, Frank A. Kujawski, Jro President Board of Town Trustees FAK: jas cc: Bldg. Dept. Conservation Advisory Council file FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER. III JOHN L. BEDNOSK1, JR. HENRY P. SMITH TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 15, 1989 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. 5-71-2-11.1 for a Wetland Permit submitted by James Campbell. Please prepare a written report of findings and recommendations with respect to this application. FAK: jas Very truly yours, Frank A. Kujawski, Jr. President Board of Town Trustees cc: Bldg. Dep't. 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, $3095 Main Road P.O. Box 728 Southold, New York 11971 May 15, 1989 To Whom It May Concern: Attached hereto is a Short Environmental Assessment Form submitted by James Campbell for a wetland permit to construct float and ramp at property located on canal at Harbor Lights Drive, Southold, N.Y. Frank A. Kujawski, Jr. President Board of Town Trustees Posted: May 15, 1989 TELEPHON~ (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, $3095 Main Road P.O. Box 728 Southold, New York 11971 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLAI~DS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN~ PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF APPLICATION No. ;'-F??-Y/' APPLI CANT ' S NAME AGENT: J~. THE ISSUANCE ~F oF SOUTHOLD.ii· TEL NO. dT~ PERMIT REQUESTED TO: ~-fZ~a~/' aha~ //~ca al a ~a/~ada~ LOCATION OF PRoPER~ FOR REQUESTED PE~IT: O~ /~ ~ ~ HAMLET:- ~ ~~ TaX ~P NO: ~.000- '7/- Z-l/ i CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE OF PROPOSED WORK: LENGTH: WIDTH: YDS. TO BE EXCAVATED: ~ YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: /~ DEPTH AT LOW TIDE: _~ AVER. RISE IN TIDE: 2~ DISTANCE TO NEAREST CHANNEL: ~/ DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS tN AREA: ~ AREA ZONING: ~, IS PROJECT FOR PRIVATE OR BUS. USE: ~ DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: ~ ~ HAS ANY PRIOR LICENSE OR PERMIT BEEN TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: ~ DESCRIBE FULLY THE REHABILITATION OF PROPERTY: DESCRIBE PROPOSED CONDITION O~F PROPERTY AFTER WORK IS COMPLETED. INCLUDE ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: ~ WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: 0~ ~9-0864 L NtA Under the Environmental Conservation Law I Article 15. Title 3; 6NYCRR 327. ! 328, 329: Aquatic Pesticides --i Article 15, Title 5: __J Proteclion of Water i Article 15, Title 15: Water Supply ~" [ Article 15, Title 15: L__J Water Transport F~ Article :~5, Title 15: Long Is'~'~nd Wells q Article 15, Title 27: I Wild Scenic and Recreational Rivers 6/6?89 6/30/91 ~-~ 6NYORR 608: Water Ouatity Certification ~ ~-'-~ Articte 17, Titles 7, 8: SPDES ~ [-~ Article 19: Air Pollution Control' ~-~ F----~ Adicle 23, Title 27: Mined Land Reclamation ~ F----~ Article 24: Freshwater Wetlands ~ N--New, R--Renewal, M--Modification, ~ C--Construct (*only), 0--0Derate (*only) Article 25: Tidal Wetlands Article 27, Title 7; 6NYCRR 360: Solid Waste Management* Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management Article 34: Coastal Erosion Management Article 36: Floodplain Management Articles 1, 3. 17. 19. 27, :37; 6NYCRR 380: Radiation Control 3ames & Patricia Campbell 350 Harbor Lights Dr., Southold, NY t197] AG£N~ ~OR PERMITIEEICONIACT PERSON J.H. Geideman, Box 416, East Marion, NY 11939 TELEPHONE NUMBER Harbor Lights Dr. - Canal off Southold Bay LOCATION OF PRe. ECTtFACILIYYBayview J coumY Suffolk j TOWN~CiT~,VILL^C~ Southold j UTM COORDIN^TES D~SCRIPTIONOFAUTHORIZEDAgl¥1TY Construct a 3'xl0' ramp and 6'x20~ float, install one anchor pile as per attached NYSDEC approved plan. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that the permit is contingent upon stric~ compli- ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto. lion resulting from the said proiect. wed heretofore bv the Department or any of the terms, conditions, or teaulrements contained in ;/89 Christine J. Costopoulos ~AT~ ~I~8ITY resources of the State, the owner may be ordered by the Department to modification of the watercourse hereby authorized shall not be com- plated, the owners, shall, without expense to the State, and to such and flood capacity of the watercourse. No claim shall be made against 11: That the State of New York shall in no case be liable for any damage no claim or right to compensation shall accrue from any such damage. bility of obtaining any other permission, consent or approvaJ from the U.S. Army Corps of Engineers, U.S~ Coast Cuard, New York State 13. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, tendency to cause damage to navigahJe channels or to the banks of a waterway. 15 There shall be no unreasonable interference wi~ navigation by the work heroin authorized. 16. If upon the expiration or revocation of this permit, the proiect hereby authorized has not been compJeted, the ap~k:ant shaJl, without expense to the State. and to such extent and in such time and manner as the Department of Environmental Conservat2on may require, remove all or any portion of the uncompleted structure or fill and restore the site to it~ former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 17, If granted under Article 36. this permit does not signify in any way that the project will be free from flooding. 18. If granted under 6 NYCRR Part 60~, the NYS Department of Environ- mental Conservation harebv certifies that the subiect protect will not contravene effluent limitations or other limitatkms or standards under Sections 30'1, 302, 303, 306 and 307 of the Clean Water Act of 1977 (PI 95-217} provided that all of the conditions Hsted herein are met. 19. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the app~cant or his agent as part of the permit application. Such approved plans were prepared by ,l.i~I. Gelde~lan SPECIAL CONDITIONS Docks may not' (a) extend laterally beyond property lines; (b) be placed so ' that docked boats extend over adjacent property lines; (d) interfere with navigation; (d) interfere with other landowners riparian rights. There shall be no dredging associated with this project. Supplementary Special Conditions (A) through (J) attached. 10-89-0864 I/A Page 2 of 3 DEPARTMENT OF THE ARMY NEW YORK DISTRICT CORPS OF ENGINEERS JACOB K. JAV TS FEDERAL BU LD NG August 10, Ig89 Regulatory Branch/Eastern Permits Section SUBJECT: Application No. ~q-~61g-L2 by ,)ames Campbell SEE ATTACHED MAILING LIST Ladies and Gentlemen: We have received a request for Department of the Army authorization for the following activity: ACTIVITY: Install a 2 foot wide hy 10 foot Tong ramp and a 6 foot by 20 foot timber float secured by one timber piling; IN: Southold Bay, Shelter Island Sound AT: Southold, Suffolk County, New York APPLICATION BY: James Campbell 35~ Harbor Lights Drive So~thold, New York 11971 As this work is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing work in navigahle waters of the United States. To accomolish the coordination reouired, prior to the issuance of a Letter of Permission, your review of the enclosed drawings is requested. Pursuant to Section 3~7(c) of the Coastal Zone )!anagement Act of 1~72 as amended (16 U.S.C. 1456(c), the applicant has certified that the activity complies with and will be conducted in a manner that is consistent with the approved state coastal zone management program. To allow for the timely processing of the subject application, your comments are requested within 15 days of the date of this letter. Sincerely, W. Haggerty xC-~iief, EastJ~n Permits Section Enclosure MAILING LIST FOR LETTER OF COORDINATION FF1R APPLICATION NO. Bg-o619-L2 APPLICANT: JAHES CAr~PBELL U.S. Fish and Wildlife Service Brookhaven National Laboratory Building ~13~ UPton, NY 11973 U.S. Coast Guard Captain of the Port, New York Governors Island New York, NY 1~ POST OFFICE Southold, New York 11971 "PLEASE POST FO.R PUBLIC VIIEW" Board of Town Trustees Town of Southold Town Hall 53n~5 :~a,i~ Road, Box 728 Southold, NY 11971 U.S. National Marine Fisheries Service Environmental Assessment Division 212 Rogers Street Milford, CT ~6460 James Campbell 350 Harbor Lights Drive Southold, NY 11971 U.S. Environmental Protection Agency Harine & Wetlands Protection Rranch 26 Federal Plaza New York, NY 1027B J.H. Geideman Box ~16 East Narion, NY 11939 New York State DEC Regulatory Affairs Building ~40 - SUNY Stony Brook, NY 117qA V. Romboli 1319 Madison Road IsliD, NY 117~6 New York State Department of State Division of Local Government - CZM 162 Washington Avenue Albany, NY 12231 V. Robollo Harbor Lights Drive Southold, NY 11971 Harold Reese R~H Sunrise Highway Lynbrook, NY llgG3 J. Reese lVindjammer Road Southold, NY 11563 iOO,O ,< .h B16-477-2421 JOHN H. GEIDEMAN Consult#zg £)~gbzeer O'vil-lndustrial-Maffne F'.O. [lox 410 East Marion, New York 11939 To Whom Tt May Concern, * John ~. Gei~deman, ~LS to act ~7_m,: ag.hr in j~pplying for permit° to conotruct a State Lic. Land Surveyor COUNTY OF SUFFOLK ) STATE OF NEW YORK ) AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. __ature of Applicant SWORN TO BEFORE ME THIS /~5-~ DAY OF UNDA J, COOPER Nora r~ Public, State of New York 6/ NOTARY PUBLIC- ~* --ecern~r~L~ .... ~7 r~A , 19 EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 · . ~ '14-1b;~ [2187)--,. _ -~ - ';.. ' 617.21 Appendix A State Environmental Quality Review - FULL ENVIRONMENTAL ASSESSMENT FORM SEC Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a proje, or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequen ly, there are aspects of a project that are subjective or unmeasureabie. It is also understood that those who determi~ significance may have tittle or no formal knowledge of the enwronment or may be technically expert in enwronment~ ana[¥sis. In addition, man~ who have knowledge in one particular area may not be aware of the broader concerns affectin the question of significance. The full EAF is intended to orovide a method whereby applicants and agencies can be assured that the determinatio process has been orderly, comorehensive in nature, yet flexible to allow introduction of information to fit a project or actJor Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides ohiective data and information about a given project and its site. By identifying basic projec data. it assists a reviewer in the analysis that takes place in Parts 2 an~d 3. Part 2: Focuses on identifying the range of possibIe impacts that ma'F occur from a project or action It provide guidance as to whether an impact is (ikeJv to be considered small to moderate or whether it is a potentiail~ large ~mpacr. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used~/o evatuate whether or not th~ impact is actually important. DETERMINATION OF SIGNIFICANCE~Type 1 and Unlisted Actions Identify the Portions of FAF completed for this project: .~ Part 1 [] Part2 []Part3 Upon review of the information recorded on this EAF (Parts 1 and 2 ~nd 3 if appropriate), and any other supporting nformation ano considering both the mag~ude and im~rrance of each impact, i~ is reas~nab~v determined b`. the lead agency that: [] A. The prolec~ will not result in any large and "noortant impact(s) and, therefore, is one which will nol 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, therefore a CONDITIONED negative declaration will he prepared.* [] C. The proiect may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will he prepared. * A Conditioned Negative Declaration is only vaiid for Unlisted Actions Name of Action Name of Lead Agency I)rin~ or Yype Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer {1[ different ~rom responsible officer) Date 1 PART 1--r'ROJECT INFORIVIATION Prepared bY Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be cons, as part of the application for approval and may be subject to further verification and public review. Provide any addi information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and each instance. LOCATION OF AO:;~JC'N (include Street Address, I~unicipaliJ~,r).a, nd County) NAME OF APPLICANTJSPONSOR ~ ADDRESS CITY/PO NAME OF OWNER (if different) STATE i ZIP CODE ~USINESS TELEPHONE ADDRESS CITY/PO · I STATE I ZiP CODE BESCRIPTtON OF ACTION Please Complete Each Question--Indicate N.A. if not applicable A. Site DescriPtion Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: [Urban E~lndustrial []Commercial ~Residential (suburban) E~Forest [,~griculture r~Other 2. Total acreage of project area: ~ acres. APPROXIMATE ACREAGE ' PRESENTLY Meadow or Brushland (Non-agricultural) acres Forested acres Agricultural (includes orchards, cropland, pasture, etc.) acres Wetland (Freshwater or tidal as per Articles 24. 25 of ECL} acres Water Surface Area acres Unvegetated (Rock, earth or fiji) acres Roads, buildings and other paved surfaces acres Other (Indicate type) acres 3. What is predominant soil type(s) on project site? a. Soil drainage: ~Well drained _ 96 of site ~Moderateiy well drained ~Poorly drained % of site b. If any agricultural land is involved, how many acres Land Classification System? acres. (See 1 NYCRR 3/0). 4. Are there bedrock outcroppings on project site? ~Yes E]No /x'~-,~ ~' ' a. What is depth to bedrock? ' (in feet} / V ~/ " 2 ~]Rural (non-f~ AFTER COMPLETIO? ?$ of site ? thr6ugh 4 of the b ' ' ' ~. Approximate~rcentage of proposed project site-With slopes: [Z]0-10% '~ % [10-15% IZ]15% or greater ... % 6. ts project substantiallv contiguous to. or contain a building, site, or district, listed on the State or the Nation Registers of Historic Places? []Yes I-1No 7. Is proj ~ct substantiallv contiguous to a site listed on the Regis[er of National Natural Landmarks? []Yes J~ 8. ~¥hat is the depm of the water table? ~in feet) 9. Is site located over a primary, principal, or sole source aquifer? ~]Yes )~No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? r'qYes ,~o 11. Does project site contain any species of plant or animal life that is identified as threatened or endangerec []Yes ~r~o Accord n§ to Identify Each species 12. Are there any unique or unusual land forms on the groject site? (i.e., cliffs, dunes, other geological formation fi'lyes '~No Describe 13. Is the project si eJ~present[y used by the community or neighborhood as an open space or recreation area DYes I~No If yes, explain 14 Does the present~si~e include scenic views known to be imoortant to the commJmtv? i-lYes a. Name of Stream and name of River to whirl' it is tributary 16. Lakes. ponds, wet[and areas within or contiguous to project area: a. Name b Size :In acres) 17. Is the site served by ~xisting public utilities? DYes ~:~o al f Yes, does sufficient capacity ex~st to allow connection? ~,Yes b] f Yes. will m~rovernent_~ be necessary to allow connection? ~Yes ~No 18. Is the site located a an agricultura, al/gistnct certified pursuant to Agriculture and Markets Law, Article Section 303 and 304? ~Yes /~No - 19. s the s'te located in or subst_,~.ntiaIly contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 61/? ~lYes 20. Has the site ever been used for the disposal of solid or hazardous wastes? [Yes f~No B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acreage to be developed: acres initially; c. Project acreage to remain undeveloped ~ acres. e. If the pro~ect ~s an expansion, red,cate percent of expansion proposed fl Number of off-street parkin~ spaces existing ; proposed g. Maximum vehicular trips generated per bout h. If residenual: Number and type of bousin~ units: One Famdy Two Family Initially UI~imatelv i. Dimensions [in ieet] of largest proposed structure. (upon completion oi: projectl? /Multiple Famdy he ght; width; j. Linear feet of frontage along a public thoroughfare project will occupy i~? Condominium length. 3 2. How much~,,,ziural material (i.e., rock, earth, etc.) wdl be removed from the site? ns/cubic ,yards 3. Will disturbed areas be reclaimed? I-lYes ~No ~N/A a. If yes, for what intend,_E purpose is the ~ite being reclaimed? b. Will top~oil be stockpiled for reclamation? []Yes [~No c. Will upper subsoil be stockpiled for reclamation? fi'lYes ~]No 4. HoTM many acres of vegetation (trees, shrubs, ground covers) will be removed from site?/,/q,/~v- acres. 5. will any mature forest (over 100 years old) or other locally-important vegetation be renioved by this project? I-3Yes [:]No 6. If single phase project: Anticipated period of construction ~~nths, fincluding demolition). 7. If multi-phased: a. Total number of phases anticipated b. Anticipated date of commencement phase 1 c. Approximate completion date of final phase month d. Is phase I functionally dependent on subsequent phases? 8. Will blasting occur during construction? E~Yes '[~o 9. Number of jobs generated: during construction 10. Number of jobs eliminated by this project ~.) 11. Wi{l project require relocation of any projects or facilities? year, (including demolition) year: i--lYes E3N0" after project is complete []Yes ~No If yes, explain /, 12. ls surface liquid waste disposal involved? UlYes a. If yes. indicate type of waste (sewage, industrial,e~c.) and amount b. Name of water body into which effluent will be discharged 13. s subsurface qu d waste disposal involved? [Yes ~'~9 Type J 14. Will surface area of an existing water body inc~rease or decrease by proposal? Expfain 15. Is project or any portion of project located in a 100 year flood plain? ~Yes [~Yes Will the project generate solid waste? ti-lYes ~],No a. If yes, what is the amount per month . . tons b. If yes, will an existing solid waste faci]ity be used? [Yes [2]No c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain ~lYes ~No Will the project involve the disposal of solid waste? a. If yes. what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? Will project use herbicides or pesticides? ~Yes 17. []Yes /~o tons/month. years. 18. ~No 19. Will project routinely produce odors (more than one hour per day)? ~Yes 20. Will protect produce operating noise exceeding the local ambient noise levelsZ 21. Will project result in an increase in energy use? [Yes /~No If yes , indicate type[s) 22. If water supply is from wells, indicate pumping capacity 23. Total anticipated water usag~ per day 0 gallons/day. 24 Does project involve Local, State or Federal funding? I~Yes If Yes. explain .. gallons/minute. 4 25.' ,..Approvals ~.~quired: City, Town. ¥illage· Board ,~-~es City, Town. Village Planning Board [~Yes City, Town Zoning [3oard I"lYes City, County Health Department [~Yes Other Local Agencies F3Yes Other Regional Agencies I~Yes State Agencies ~'~ e s Federal Agencies [~es C. Zoning and Planning information 1. [~No No lNo ]No ]No E3No ~No Does 9roposed action involve a planning or zoning decision? If Yes, indicate decision required: Type ~]Yes / I~site plan Submittai Date f-lzoning amendment []zoning variance [special use permit []subdivision [~new/revlsion of master Dian [resource managem~ent plan 2. What is the zoning classification(s}of the site? f~'- ~ 4. What is the proposed zoning of the site? .~-/;~'~>~ · $. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in;adopted local land use plans? ~/~es []? 7. What are the predominant land use(s) and zonin~ classifications within a 5/~ mite radius of proposed action? 8. Is the proposed action compatible 'with adjoining/surrounding land uses within a ¼ mile? ~'~es 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? ~]Yes 11. Will the proposed action create a demand for any community provided services (recreation, education, polic fire protection)? l~Yes ~"~o a. If yes, is existing capacity sufficient to handle projected demand? ~]Yes 12. Will the proposed action result in the generation of traffic significantly above present levels? [~Yes a. If yes, is the existing road network adequate to handle the additional traffic? i-lyes F'lNo D. informational Details Attach any additional information as may be needed to clarify your project. If ther~ are or rn%¥ be any adver impacts associated with your proposal, please discuss such impacts and the measures wh_ich you propose to mitigate avoid them. E. Verification I certify that the information/!5'lov~ded ,tbov~'~ true to the, best of my k~wledge, ~(~heacti~l/n~h/~as~alArea~and¥~uare`]s~atea~enc¥~c~mp~e~e~/eC~as~alAssessment Formbeforeproceedin with th s ass~t. /'-~ Part 2--PROJECT ~')ACTS AND THEIR MA~..~ITUDE ~" Responsibility of Lead Agency · General Information (Read Carefully) .-' · In completing the form the reviewer should be guided by the question: Have my responses and determinations ~ reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significa Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 sirr asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of. impacts and wherever_ ppssible the threshok magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State for most situations. But, for any specific proiect or site other examples and/or lower thresholds may be appropr for a Potential Large Impact response, thus requiring evaluation in Part 3, · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative: have been offered as guidance. They do not constitute an exhaustive list of impacts and threshoids to answer each quest: · The number of examples per question does not indicate the importance of each question: · In identifying impacts, consider tong term, short term and cumlative effects. '-- ~ Instructions (Read 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 potentiai size of ? impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshc is lower than example, check column 1. d. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the project to a small to moder: impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. T; must be explained in Part 3. IMPACT ON LAND 1. Will the proposed action result in a physical change to the project site? liNC ~YES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the proiect 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. · Construct:ion on land where bedrock is exposed or generally within 3 f~-et of existing ground surface. · Construction that will continue for more than I year or involve more ~than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year, · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2 Will there be an effect ts...,y u¢i,que or unusual land forms found on the si~e? (i.e., cliffs, dunes, geological iormations, etc.)~NO ~'~'ES · Specific land forms: __ I '2 3 Small to PotentiaJ Can Impact Moderate Large Mitigated Impact Impact Project Chang [] [] []Yes I-]Ne [] [] []Yes FqNo L--i [] ~v~s ~No ~ ~ ~Yes ~No IMPACT ON WATER ,t. Will proposed action affect any water body designated as protected?. (Under Articles 15.24, 2.5 of the Environmental Conservation Law, ECL] E}NO []YES £xamples 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 impacts: 4. Will proposed action affect any non-protected existing or new body of water? ~]NO ~Y£S 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 ~ncrease 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 ouantitv? ~]NO []YES Examples that would apply to column 2 · Proposed Action will_require a discharge pertain · Proposed Action requires use of a source of water that does _not have approval to serve proposeo (project) ¢ctlon. · Proposed Action rec Jfres water suomv from wells with greater than 45 gallons Der minute pumping capacitY. · Construction or operation causing any contamination of a waeer supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed off the site to facilities which presenuy do not exist or have inadequate capacity. · Proposed Action would use waeer in excess ct 20.000 ga]ions per day. · Proposed Action will l/kal',, cause siltation or other discharge rotc ]n existing body of water to tr;e extent that there will be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroleum or chemical products greater than 1,100 gallons. · Proposed Action will allow residential uses in areas without water and/or sewer services. · Proposed Action locates commercial and/or industrial uses which may require new or expansion of existing waste t~eatment and/or storage facd~tie5. · Other impacts: 6 Will proposed action alter drainage ~h~w or patterns, or surface water runoff? []NO ~YES Ex,,topics that would apply to column 2 · Proposed Action would change flood w,ter flows. 7 Small to Potential Can Impact Moderate Large Mitigated Impact Impact Project Chart [] [] ~Yes [] [] j ~ves [] [] []Yes J~ [] [] []Yes ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~Yes ~N ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~Yes ~N~ ~ ~ ~Yes ~N~ ~ ~ Wes · Proposed Action ma~, cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designate(~ floodway. · Other impacts: IMPACT ON AIR 7. Will proposed action affect air quality? C']NO C]YES Examples that would apply to column 2 · Proposed Action will induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of more than I ton of refuse per hour. · Emission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million BTU's per hour, · Proposed action wilt allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial develooment within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS Will Prooosed Action affect an,, threatened or endangered species? [:]NO E]YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal llst. using the s~te, over or near site or found on the site. · Removal of any portion of a critical or sigmficant wildlife habitat. · Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. · Other impacts: 9 Will Proposed Action substantially affect nomthreatened or non-endangered species? []NO Examples that would appIy to column 2 · Proposed Action would substantially interfere with any resident or m~gratory fish, shellfish or wildlife species. · Proposed Action requires the removal of more than 10 acres or r~ature forest (over 100 years of age) or other locally hnportant vegetation- IMPACT ON AGRICULTURAL LAND RESOURCES 10 Will the Proposed Action affect agricultural land resources? ~]NO [~YES [:~amples that would apply to coJt~mn 2 · The proposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, etc.J 8 Small to Potential Can Impact E Moderate Large Mitigated Impact Impact Project Chani [] [] []Yes I-'IN, [] [] []Yes []N< [] [] []Yes [--INc [] [] []Yes [] [] []Yes []No [] [] []Yes I-'J N o [] [] []Yes []No [] [] []Yes []No [] [] []Yes I--]No [] [] ["']Yes I']No [] [] []Yes .[-]No [] [] [~]Yes [~]No ""'-- [] [] []Yes [] ~ []Yes EgNo [] [] [~]Yes [~]No · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District, more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems {e.g., subsurface drain lines, outlet ditches, strip cropping}; or create a need for such measures le.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources? [~NO []YES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix B.) Examples that would apply to column 2 · Proposed land uses, or project components obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the eli}nination or significant screening of scenic views known to be important to the area· · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES '~2. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? I~NO [YES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places, · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts:. IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect the quantity or quality of existing or future o[]en spaces or recreational opportunities? Examples that would apply to column 2 []NO []YES · ]'he permanent foreclosure of a future recreational opportunity. · A ma/or reduction of an open space important to the Community. · Other impacts: 9 I 2 3 Small to Potential Can impact Moderate Large Mitigated By Impact Impact Project Chang~ [] [] []Yes E3No [] [] []Yes I~No [] [] []Yes []No [] [] []Yes J--/No [] [] []Yes I-qNo ~ ~ ~tes ~No ~ ~ ~yes ~ ~ ~Yes ~No ~ D ~Yes ~No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? ENO ~YES Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods. '. Proposed Action will result in maior traffic problems, · Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? E~NO ~YE$ Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of any form of energy in the municipality· · Proposed Action will require the creation or extension of an energy transmission or supply system to serve more than 50 single or two family residences or to serve a major commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? tTNO [YES 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 operatin§ noise exceeding the local ambient noise levels for noise outside of structures. · Proposed Action will remove natural barriers that would act as a noise screen. · Other impacts: IMPACT ON PUBLIC HEALTH 17. WH[ Proposed Action affect public health and safety? []NO El]YES Examples that would apply to column 2 · Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pesticides, chemicals; radiation, etc.)in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. · Proposed Action may result in the burial of "hazardous was/es" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc. J · Storable facilities /or one mdlion or ~nore gallons of Iiquified natural gas or other flammable liquids. · Proposed acUon may result in the excavation or other disturbance w~thm 2,000 feet of a site used for the disposal of solid or hazardous waste. · Othpr ~mpacts: 10 Small to Potential I C;~n Impact Moderate Large Mitigated E Impact Impact Project Char [] [] F-~Yes [] I:] ~Yes [] [] E]Yes F'IN [] [] []Yes [] [] [2lYes UN [] [] []Yes E]N [] [] E]Yes [] ~ []Yes [] [] []Yes []N, [] [] []Yes E]N~ [] [] E]Yes- [] [] []Yes E::]N, [] [] []Yes []N, [] [] :-~Yes · .I-] [] I~yes [~]N, IMPACT ON GROWTH AND CHARACTF. R OF COMMUNITY OR NEIGHBORHOOD 18. Will prop6sed action affect the character of the existing community? [NO ]YES Examples that would apply to cotumn 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for caoital expenditures or operating services will increase by more than 5% per year as a result of this prolect, · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for. additional community services (e.g. schools, police and fire, etc.] · Proposed Action will set an ~mportant precedent for future projects. · Proposed Action will create or eliminate employment, · Other impacts: 1 2 3 Small to Potential Can Impact B( Moderate Large Mitigated By Impact Impact Project Chang~ [] [] []Yes []No [] [] ' f-lYes [] [] E3ves t-lNo [] [] []Yes []~o [] [] [-~Yes []No [] [] I-'lYes []No [] [] []Yes l-INa [] [] []Yes []No 19 Is there, or is there likely to be. public controversy related to potential adverse environmental impacts,~ E]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 IMPORTANCE OF i~JiPA.;TS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s] is considered to be potentially large, even if the impact(s) may b mitigated. Instructions Discuss the following for each redact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. D:escnbe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change(si 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irrevers~bility, including permanently lost resources of value · Whether the impact can or wdl be controlled · The regional consequence of the impact o Its potential divergence from local needs and goals · Whether known oblecuons to the project relate to this m~pact. (Continue on attachments) 11 617.21 ~- ~./Appendix B ~ Sta~a Environmental Quality Review Visual EAF Addendum This form may be used to provide additional information relating to Question 11 of Part 2 of the Full lEAF. (To be completed by Lead Agency) Distance Between 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 Ser~,ike 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 or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as scenic? · Municipal park, or ~Jesignated open space? · County road? · State? · Local road? Project and Resource (in Miles) O-V4 V4-V2 I/2-3 3-5 5+ [] [] [] [] [] [] ¸rn [] [] [] [] [] [] [] [] [] [] [] [] [] 2. Is the visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other seasons) []Yes 3. Are any of the resources checked in question 1 used by the public during the time:-pf year during which the project will be visible.~ f~Yes ~No DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally describe'the environment. Essentially undeveloped Forested Agricultural Suburban residential Industrial Commercial Urban River, Lake. Pond Cliffs, Overlooks Designated Open Space Flat Hilly Mountainous Other NOTE: add attachments as needed surrounding Wil;hin mile *1 mile 5. Are there visually similar projects within: *V~ mite i'~ Yes I-]No *1 miles [~Yes [~No *2 miles -[--[Yes [--]No -- '3 miles II]Yes E~No ' Distance from project site are provided for assistance. Substitute other distances as a~pprb~riate · EXPOSURE 6. The annual number of viewers likely to observe the proposed project is _ NOTE: When user data is unavailable o~' unknown, use best estimate. CONTEXT 7. The situat on or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work [] [] [] [] Involved in recreational activities [] [] [] [] Routine travel by residents [] [] [~ ~[] At a residence [] [] [] [] At worksite [] [] [] [] Other [] [] [] [] 2 BOARD OF TOWN TRUSTEES TOS~q OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold. New York 11971 TELEPHONE (516) 765-1801 PLEASE FILL OUT THE FOLLOWING FORM AND RETURN WITH YOUR SIGNED STATEMENT: Was the/tructure put in in accordance to the plan submitted? Yes / No If no, please explain on the reverse side. e Was structure placed on the applicant's property according to the plan submitted? ( The distance must be at least 15 feet from his neighbor's line. ) Yes v NO If no, please explain on the reverse side. 3. Is there easy access over or around the structure, so that pedestrians can move along the public's righ% of way below_ high water mark? / Yes v NO If no, please explain on the reverse side. 4. Is the structure high enough so as not to inhibit the growth of the natural grasses along or below the structure? Yes ~ NO If no, please explain on the reverse side. 5. Additional comments: S ~g na~t ure~' ~~ --__'~-- (Tear off and return) 'I,~6~-~~.~ , certify that the work as authorized in this permit has been completed and is now ready for your inspection. Also the permit number required on'this project is clearly visible.