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Home My WebLink AboutTR-4286 AmendAlbert J. Krupski, President John Holzapfel, Vice President William G. Albertson Martin H. Garrell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hail 53095 Main Road P.O. Box 1179 Southold. New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 July 6, 1994 J.M.O. Consultants P.O. Box 447 Quoque, NY 11959 RE: Kim K. Campbell SCTM 94-4-16 Dear Mr. Just: The following action was taken by the Southold Town Board of Trustees on Thursday, June 30, 1994: RESOLVED that the Southold Town Board of Trustees grants an amendment to permit 94286 to construct garage, pool, decking, pool backwash filter, drI~ells and gutters on garage and regrade garage and pool area. As per survey dated June 7, 1994. Located Fishers Island. If you have any questions, please do not hesitate to contact this office. Sincerely, Albert J.~Krupski, Jr. ' President, Board of Trustees AJK:jmd cc: Building Dept. Zoning Board Board Of Southold Town Trustees SOUTHOLD. NEW YORK PERMIT NO. 4286 DATE: .F~b. ~5, .],.9..c)4 ISSUED TO ........... K~m...K.....g.~m:p.b,~]! ............................. Pursuan+ fo +he provisions of Chaplet 615 of +he Laws of +he S'J'afe of New York, 1893; and Chaplet 404 of +he L.aws of +he Sfa+e of New York 1952; and fhe Soufhold Town Ordinance eh- rifled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and +he REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance wi+h +he ResoJu+ion of The Board adop+ed afa meeting held on ~b~..~ ..... 19 ..9.~, and in consJdera+ion of +he sum of $..~50.,..q.0 paid by ...... ~,m~ .~,. Big.h~.~. b.~?~!~ ~ ~m.g.,,, .~,~mp.1~ ..... of N.Y. and sub. jec+ fa +he Terms and Conditions Ils+ed on the reverse side hereof. of Southold Town Trusfees au+horizes and permi+s +he following: '~o recozzstruct a wood. £rame ~est cot'ca[e ~vith ad.ctJ_tiorz o~ side ~zith ~ew seg'~ic system. House w~L1 be moved. ].5~ £rom pre- exi$~i=~ locatio=. Old. fo~datio~ ~vi]! be removed, re~r~d.e reseed. ~aybale$ & Silt £e~ce wil] be ~-tsect. ct,~riT~ CO~S~. all in accordance wlfh +he de+ai~ed speciflcafions as presenfed in +he origlnM'ing application. A ~oz~-t~£ ~0~ lo~££er ~[]] be plaza+e, at interface of wetland and law~. IN WITNESS WHEREOF, The said Board of Trus+ees here- by causes ifs Corporate Seal fo be affixed, and +hese presen+s fo be subscribed by a majority of +he said Board as of +his ............. Albert J. Ktupski, President lohn Holzapfel, Vice President ' v,~ Jim King Martin II. Gan'ell Peter Wencz¢l BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P,O. Box 1179 Southold, New York 11971 Telephon~ (516) 765-1892 Fax (516) 765-1823 January 8, 1998 J.M.O. Consultants Inc. P.O. Box 447 Quogue, NY 11959-0447 RE: ROLA B. CAMPBELL SCTM ~4-4-16 Dear Mr. Just, The Southold Town Board of Trustees reviewed your survey, dated and received 12/1/97, and determined that ~our project to construct a 27' X 59' addition onto the west side of existing house and a boulder retaining wall and driveway, is out of the Wetland jurisdiction under Chapter 97 of the Wetland Code. However, this determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees cc. Bldg. Dept. Albert J. Kmpski, President John Holzapfel, Vice President William G. Albertson Martin H. Gan'ell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hail 53095 Main Road P.O. Box 1179 Southold.. New York 11971 Telephone (516) 765-1892 Fax (5161 765-1823 March 3, 1994 James Volney Righter Arch. 58 Winter Street Boston, MA 02108 Re: Klm K. Campbell SCTM ~1000-4-4-16 Dear Mr. Righter: The following action was taken by the Board of Town Trustees during its regular meeting held on Thursday, February 24, 1994 regarding the above matter: WHEREAS,James V. Righter, Arch. on behalf of Klm Campbell applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated January 20, 1994 and, W}{EREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recomlnendations, and, WHEREAS, a public hearing was held by the Town Trustees with respect to said application on Thursday, February 24, 1994 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in qnlestion 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 the Board of Trustees approves the application of James V. Righter, Arch. on behalf of KIM CAMPBELL to reconstruct a wood frame quest cottage with addition on landward side with a new septic system.. House will be moved 15' from pre-existing location. Old foundation will be removed,regraded and reseeded. ~aybales.and silt, fence will be used during construction. A 10' non-turf buffer area will be planted at interface of wetland and lawn. Permit will expire two years from the date it is signed. Two inspections are required and the Trustees are to be notified' upon completion of said project. Very truly yours, President, Board of Trustee AJK:jd cc: CAC Albert J. Krupski, President John Holzapfel, Vice President William G. Albertson Martin H. Garrell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. 1000-4-4-16 NAME: KIM K. CAMPBELL DATE: January 27, 1994 Chapt. Chapt. 97 - Wetlands 37 - Coastal Erosion RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of 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: Type: I DESCRIPTION OF ACTION: Applicant requests permit to reconstruct a wood frame guest cottage with addition on same site as pre-existing cottage, with new septic system. No change to existing grades, and ground will return to existing condition following this construction. Located East Harbor, Fishers Island. LOCATION: SCTM $1000-4-4-16 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 following mitigation measures be implemented~ -- cc: CAC Albert J. Kmpski, President John Holzapfel, Vice President William G. Albertson Martin H. Garrell Peter Wencze] BOARD OF TOWN TRUST1Z. ES TOWN OF SOUTHOLD Town Hal 53095 M~n Road P.O. Box 1179 Soufl~old, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 Ja~ua~ 24, 1994 Chairman Southold Town Conservation Advisory Council Southold Town Hall Main Road Southold, NY 11971 ~Dear Chairman, Transmitted herewith are the following applications for a twetland permit: KIM CAMPBELL SCTM 94-4-16 Please prepare a written report of findings and recommendations with respect to these applications. Very truly yours, ,.~ ~.,-~,; . _./ . .--, ~ Albert J. Krupski, Jr. President, Board of Trustees AJK/djh TRUSTEES John M. Bredemeyer, III, President Albert J. Kmpski. Jr.. Vice President Henry P. Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 December 29, 1993 Certified Receipt Klm K. Campbell 257 DurlDar Road Palm Beach, Florida 33480 Re: SCTM 94-4-16 Dear Mrs. Campbell, An inspection of the remains of your guest cottage on Fishers Island at SCTM 94-4-16 made on December 17, 1993 by the Southold Town Trustees revealed that you have demolished the original structure. Consequently~your project is viewed as a substantial restoration which is fully subject to the requirements of both the Town Coastal Erosion Hazard Area Ordinance (Chapter 37) and the Town Wetland Ordinance (Chapter 97). The previous waiver granted for the minor additions is not operative and the fact that you are replacing more than 50% of the value and surface area of the original structure mandates that minimum bluff setbacks of 50' be established for th~s site. Any proposal for a structure closer to the bluff than this will require a variance application under the Coastal Erosion Ordinance (Chapter 37). Please complete the attached application form and submit a licensed land survey of what you propose. Your proposed setback will affect the jurisdictions involved and the application fees which will be set by the clerk. For bluff setbacks in excess of 50' the Board of Trustees may only require a Town Wetland Permit or Waiver. These requirements are separate from and in addition to other permissions which may be required byother agencies. Thank you for your cooperation. Yours truly, ~hn M Bredemeyer, III ~President, Board of Trustees CC. Jim Volney Righter Building Department Zoning Board of Appeals New York State DEC Coastal Erosion: Attention: Bill Southard JMB/djh TRUSTEES John M. Bredemeyer, III, President Albert J. Krupski, Jr., Vice President Henry P. Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road 'P.O. Box 1179 Southold, New York 11971 May 4, 1993 James Volney Righter Arch. 58 Winter Street Boston, Ma. 02108 RE: Kim Campbell Cottage SCTM %t000-4-4-16 Dear ~ir. Albert: The following action was taken by the Southold Town Board of Trustees on Thursday, April 29,11993; RESOLVED that the Southold Town Board of Trustees grants a waiver to make additions to existing quest cottage as per revised plans dated March 25, 1993. Please note that approvals from other agencies might be necessary. If you have any questions, please do not hesitate to contact this office. Very truly yours, Bredemeyer, President, Board of Trustees JMB: jmd cc: Bldg. Dept. County of Suffolk State of New York THE BEST OF HIS/HER K/~OWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM A~Vf AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(s) OR REPRESF~NTATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW ~OF THIS APPLICATION. SIGNATHRE SWORN TO BEFORE ME THIS NOTARY PUBLIC Suggested space for location Map THIS IS NOT A PERMIT TRUSTEES John M. Brederneyer, III, President Albert J. Krupski, Jr., Vice President Henry P. Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fax (516) 765-1823. I (we) BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30 year Maintenance Agreement Erosion Protection Structures Chapter 37 Southold Town Code Southold Trustees as Administrator type or print name(s) the owners of record of uproperty at: SUPERVISOR SCOTT L. HARRIS Town Hall · 53095 Main Road P.O. Box 1179 Southold, New York 11971 (type or print street address) SCTM ~1000- Ooq-~-~G in applying for a Coastal Erosion permit for an Erosion Protection Structure do hereby agree to a 30 year maintenance programof ~Y'~f°r~'a structure conu~oniy known as a ~o~ C~ as shown on the attaqhed ~ feet of length licensed survey of the as-built structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 .years and or equivalent to the original approved structure and that for any maintenance which involves more than 5% in length of this structure we are to give prior written notice to the administrator, waiting for their approval in all but true emergenc~ situation's which would seriously endanger life,~ property and important coastal natural resource features Such as bluffs or wetlands. We further understand that fail*.~re to maintain the structure could result in a requirement r0ypost k bond and or have the repairs ordered as a lien against~the property upon a finding by the Trustees that said lack Sf maintenance would risk life, property or important natural resources features including protected, rare or threatened animals and plants.Notarized ~[~~ S¢ nat~u~e~o?~ ~ I1 'g ~wner of record Please submit three copies of a licensed land survey made within one year of the original construction. This maintenance agreement shall only be valid upon the final approval of the administrator. Subsequent owners may apply to the Southold Town Trustees to re-authorize this maintenance agreement. Telephone (516) 765-1501 Town Hall, 5309.5 Main Road P.O. Box 1179 Southold, New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL TO: FROM: DATED: RE: SOUTHOLD TOWN BOARD OF TRUSTEES SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL FEBRUARY 22. 1994 RECOMMENDATION OF WETLAND APPLICATIONS AND WAIVER REQUESTS The following Town Conservation February 17. 1994. recommendations were passed by the Southold Advisory Council at its meeting held Thursday. WETLAND APPLICATIONS No. 1111 Moved by Allan Connell. seconded by Jack Hagerty, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH RECOMMENDATIONS of the Wetland Applications of FRANK MONTELEONE 57-1-30 to replace, in-kind, in-place. approximately 100+' bulkhead. Backfill with approximately 30 yards of clean fill from an upland source. The CAC recommends approval provided the applicant maintain a 10~ buffer with beachgrass, coastal panicgrass or some like material, Blue Marlin Drive, Southold Vote of Council: Ayes: All rvlotion carried. No. 1112 The CAC did not make an inspection of the project, therefore, it is unable to make a recommendation for the Wetland Application of KlM CAMPBELL ~-~-16 to reconstruction of wood frame guest cottage with addition to same site as preexisting cottage with new septic system. Addition is on landward side of old cottage site. Fishers Island. ALL DOCKS AND BULKHEADS MUST DISPLAY VISIBLE PERMIT NUMBERM. ALL MOORINGS AND ST,~K[ MUST 'DISPLAY VISIBLE MOO~ ~fG NUMBERS. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD MAIN ROAD SOUTHOLD, NEW ,YORK 11971 NOTICE OF ACTION - NOT A PERMIT TO: James V. Righter, Arch./ Kim Campbell Please be advised that your application, dated 1/20/94 has been reviewed by this Board, at a meeting of the Trustees held on 2/24/94 and resulting in the action, as indicated below: ( xxxx ( ( .) Application Approved. *** Application Denied. Application Tabled. COMMENTS AND REMARKS: ***SUBJECT to receipt of revised plans showing the following: House moved landward 15~ from pre-existing location, old foundation will be removed, regraded and reseeded, haybales and silt fence will be used'during construction, 10' non-turf buffer area will be planted at interface of wetland and lawn. IF YOUR APPLICATION IS APPROVED ABOVE, A PERMIT FEE IS NOW DUE, AND SHOULD BE MADE PAYABLE TO THE ORDER OF THE BOARD OF SOUTHOLD TOWN TRUSTEES. THIS FEE IS COMPUTED BELOW ACCORDING TO THE SCHEDULE OF RATES AS SET FORTH IN THE INSTRUCTION SHEET (Form 1/1). THIS FEE MUST BE PAID WITHIN 90 DAYS OR REAPPLICATION AND ADDITIONAL FEE WILL BE NECESSARY. IF THE PERMIT FEE IS PAID IN PERSON TO THE CLERK OF THE BOARD, THE PERMIT WILL BE OBTAINABLE AT THE SAME TIME. IF THE FEE IS PAID BY MAIL, THE PERMIT WILL BE MAILED IN REPLY. COMPUTATION OF PERMIT FEE: TOTAL FEE FOR THIS APPLICATION: 10/87 Z 0>/3- ¢ Signe~l: - ' President, Board of Trustees By: (~t'er .'~oa;d of Town Trustees TRUSTEES John M. Bredemeyer, III, President Albert J. Krupski, Jr., Vice President Henry P. Smith John B. Tuthill William G. Albenson Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Office Use Only: DATE REC.: ~/Coastal Erosion Permit Application Coastal Erosion Variance Application Waiver from Chapter 97(Application/per~}~.~ _ Trustee Lands Permit Application Grandfather Permit Application Completed Apps. Date: InsPection date: J~-/?-~ -- CAC comments-Date: sent~J~c/f~Re~.~ ~'_~ t~ Variance Required: {Y/N)~ ~ ' ~ Neighbors notified-Date: SEQRA Type 'Coord.: Date s~ht ~EQRADetermin./date:~,~ ublic Hearing/date: ~q ~ Findings: Approved (Y/N) Special Conditions: (Y/N) (see file) Application Fee: Permit(s) issued-date: Application Number;SCTM~1000- O~- q- IG Date: Applicant: ~&~$ ~/0~.~ ~9 ~ ~~+~' ~' Interest: Owner of Property: Address ~o~ .gll (owner, consultant,lessee,etc.) Phone Subject Property Location: (Provide LILCO Pole location map) Distance to cross Streets if nor on THIS IS NOT A PERMIT Page 1 Yds. to be excavated: ~ ~- Yds. to be filled: o Manner in which material will be r~moved or deposited: Width of canal, creek or bay fronting Depth at low tide: ,~,~. Aver. rise in tide: ~,~ ~. Distance to nearest channel:, ~ ~ Distance project extends beyond similar projects in area: Area zoning:~$~.-~. Land area in acres:~% Is project for private or business use: Intended use o~ property: $~. ~2% Describe known prior operations conducted on premises: Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises:~(~~j~, Has any license or permit ever been revoked or suspended by a Governmental Agency: F~ ~ ~ c~ ~,'~ c~_. '~%£u~ ~ro~ ect Description' The project description must also include plans for recitation of land disturbed during construction of the principle and accessory structures and underground structures (~.e., pipeline and septic system; make additional attac~ents if necessary). THIS IS NOT A PERMIT ,Page Authorization (Where the applicant is not the owner) I residing at (Prinn-owner of subject property) (Mailing address-phone) do hereby authorize 'to apply for Coastal Erosion permit(s) from the Southold Town Trustees Signature THIS IS NOT A PERMIT Page 3 Mrs. RoIla Campbell 1530 A Cypress Dr. Jupiter FL 33469 16 DecemBer 1992 To whom it may concern: James Volney Righter Architects, Inc. have my permission to apply on my behalf for permission to build an addition to an existing guest cottage on my property at Fishers Island, Suffolk County Tax map no. 1000-0044-16. Very truly yours, Kim K. Campbell TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Kmpsld, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 COASTAL EROSION MANAGEMENT PEtlMIT APPLICATION TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Only: woastal Erosion Permit Appl~c&tign Wetland Permit Application/~/~J ~Trustee Lands Permit Application ~randfather ~CompletedApps. Date:~/~/~ ~';arianC~Required, ~Neigh~0~s notified Date: C rd. -R-e._~x. r ,-.--~- ._~nsp. comp./date:-~2~ ~SEQRA Determin./dateS- ~__~Public~earing/date: Findings: Permit Vote: (Y/N): Special Conditions: (also see £ile) SOUTHOLD Date Rec. by Office Application Fee:~ plic& io= 000- Project Name (If any) Date Prepared: ~O ~~ Phone Interest: (Owner, consultant,lessee,etc.) Owner of Address Phone Subject Property Location: ~?$+ ,.~J~'v~. ~k~_.~ I~,.~ ~3y (Provide LILCO Pole ~, Distance to cross Streets i~ not on location map) ~qIS IS NOT A PERI, IT Yds. to be excavated:~%~ Yds. to be filled: CD Manner in which materla~ wltl be removed or dep slted:~. ~~ Width of canal, creek or bay fronting property: ~ ~.~ Depth at low tide: ~J.~. Aver. rise in ~ide: ~.~ Distance to nearest channel: ~..~.~ Distance project extends beyond similar projects in area: Area zoning: ~-~. Land area in acres:~-,4~% Is project for privJte or business use: Intended use of property: ~.~ Describe known prior operations conducted on premises: Has any prior license or permit been issued to erect ~structures, dredge, or deposit fill on said premises: ~;{~j~ ~ ~ Has any license or permit ever been revoked or suspended by a Governmental Agency: ~ Project Description The project description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures. (i.e., pipeline and septic system; make additional attachments if necessary). ~ ~'~'. Authorization (Where the applicant is not the owner) I residing at (Print-owner of subject property) (Mailing address-phone) do hereby authorize --to apply for Coastal EroSion permit(s) from the Southold Town Trustees Signature THIS IS NOT A PERMIT County of Suffolk ) State AFFIRMS THAT HE/S~IE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOAtLD OF TRUSTEES. THE APPLICANT AGREES TO HOLD TEE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS-ARISING UIqDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(s) OR REPRESENTATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Suggested space for location Map THIS IS NOT A PERMIT 1-¢-!6-4 (?J87)--Text 12 ., , RbJECT i.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only =ART I--PROJECT INFORMATION (To be completed by Applicant or Project spbnsor) SEQR APPLICANT/SPONSOR PROJECT LOCATION: PRECISE LOCATION (Street ~ddress and road [~tersections, prominent landmarks, etc., or provide map} IS PROPOSED ACTION: ~ New ~ ~pansion ~ M~ification/alteration DESCRIBE PROJECT BRIEFLY: Initially O acres Ultimately ~ acres 2. PROJECT NAME ' ' K.~II WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes '~4~o if NO, describe briefly [] Residential [] !ndustrial [] ~ommerctal [] Agriculture [] Park/Forest/Open space ~ Other ~] Yes [] No If yes, list agency(s) and permit/approvals ~ Y~ ~ No R yes, list agency name and permitlapprovat 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ~ Yes ~ ~o : Signature: If the action is in the Coos[al Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II--ENVIRONMENTAL ASS[' MENT ( o be compIeted by Agency) A. nOES ACTION EXCEED ANY TYPE I THRESHOLD iN 6 NYCRR, PART 617.127 If yes, coordinate the review process and use the FULL ~¢.?. - [] Yes [] No WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, A negative decIaraUon may be superseded by another involYed agency. [] Yes [] No C. COULD ACTION RESULT tN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if Iegible) C1. Existing air quality, surface or grou'ndwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C3_ Vegetation or fsuna, fish, shellfish or wgdlif9 species, significant,habitats, ?r threatened or endangered s~ecies? Exptain briefly: C4, A communit ¢'s existing plans or goaJs as of ficia[ly adopted, or a change in use or intensity of use of land or other natural resources? Explain brieflyt C5. Growth, s~beequent deve opment, or re ated ac v t es ~ke y to be reduced by the proposed action? Explain briefly. C6. Long term, short term,,cumuta[ive, or other etfedts not identified in (~'~57 Explain briefb;. C7. Oiher impacts ([nc[bding changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO RE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly PART Ill--DETERMiNATiON OF SIGNIFICANCE (To be completed b,y Agency) , , . iNSTRUCTiONS: For eact~ adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a} setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e} geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations sontain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or sigQificant adverse impacts which MAY occur. Then proceed directly to the FULL,EAF and/or'prepare a positive declaration. [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in Any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: 2 4'4- --~c 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 unmeasureab]e. It is also understood that those who detetmin significance may have little or no formal knowledge of the environment or may be technically expert in environment; analysis. In addition, many 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 provide a method whereby applicants and agencies can be assured that t~e determinatio process has been orderly, comprehensive m nature, yet flexible to allow introduction of information to fit_a project or actior Full £AI: Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given project and its site.'By identify/lng basic projec data, it assists a rewewer in the analysis that takes place in Parts 2 and 3. ' Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action.. It provide: guidance as to whether an impact is likely to be considered small to moderate or wbetherit is a potentiall', large impact. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Parr 2 is id;ntified as potentially-large, then Part 3 is used~/o evaluate whether or not th~ impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions ldehtify the Portions o'f EAF completed for this project: [:] Part I [] Part 2 - [:]Part 3 Upon review of the informatioh recoroed o'n this EAF (Parts 1 and 2 ~:nd 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably-determined by the lead agency that: [] A. The project will not result in any large and important impact(s) and. therefore, is one which will not have a significant impact on the environment, therefore a negative dedaratiou will be p~epared. [] i3, A~though the project could have a significant effect on the environment, ther~ 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 be prepared.* [2] C. The project ma',, result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or type Name of Responsible Officer in Lead Agency Signature oi Responsible Officer in Lead Agency Title of Responsible Otiicer Signature of Preparer If different from respoos~bie officer--~ PART 1--PROJECT INF,oRMAT]ON Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may bare 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 reviet~. 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 in new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and each instance. NAME OF ACTION BUSINESS TELEPHONE NAME OF OWNER (If different) ADDRESS BUSINESS TELEPHONE CiTY/PO j .STATE ZIP CODE DESCRIPTION OF ACTION Please Complete Each Question~lndicate N.A. if not applicable A. Site Description Physical setting of overall project, both develop, ed and undeveloped areas. 1. Present land use: lZ]Urban ~lndustrial []Commercial ~Residential (suburban) I~]Forest l~,~griculture ~]Other Total acreage of project area: ~4.~ acres. APPROXIMATE ACREAGE ' PRESENTLY Meadow or grushland (Non-agricultural) '~ !.'~ -- acres Forested ~ acres Agricultural (includes orchards, cropland, pasture, etc.) ~ acre~ Wetland (Freshwater or tidal as per Articles 24. 25 of ECL) P-- ~ .~- acres Water Surface Area O acres Unvegetated (Rock, earth or fill) ~; O,'~- acres Roads, buildings and other paved surfaces ~ ~,~- acres Other (Indicate type). ~ ['~ acres E~Rural [non-fy AFTER CO,M PLETIO,~ acre _ aEre acre. o 0.~. ~ acre~ ~, 3 acre: 4. Are there bedrock outcroppings on project site? a. What is depth to bedrock? What is predominant soil type(s) on project site? ~"~-V'~[ ~ -~ ~ a. 5oil drainage: ~tWel[ drained {aa - % of :tire [~Moderateiy well drained % of si~e ~Pooriy drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 thr"~Su.gh 4 of the N Land Classification 5ystem? acres. (See I NYCRR 370). 'f~No (in feet) 2 'Approximate percentage ot p'~bposed project s~te with slopes: ~0:10G4/ % [~I10-15% __ ~ ~15% or greater __ . 6. ls proiect su.bstantially contiguous to, or contain a building, site, or district, listed on the; State or the Nation: Registers of Historic Places? [E]Yes ii, No Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? CIYes ~Vhat is the depth of the water tab/e? ~ J'~ (in feet) Is site located over a primary, principal, or sole source aquifer? ClYes t~lNo Do hunting, fishing or shell fishing opportunities presently exist in the project area? I~Yes Does project site contain any species of plant or an'imal life that is identified as threatened or endangered C]¥es t~lNo According to Identify each species 12. Are there any unique or unusual land forms on the project site? {i.e., cliffs, dunes, other geological fori'natiom I-lYes [iillNo Describe 8. 9. 11. 13. Is the project site presently used by the community or neighborhood as an open space or recreation area I-lYes ~No-. If yes, e~plain 14. Does the present site include scenic views known to be important to the community? 15. Streams within or contiguous to proiect area: a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name ~--~.~"P .~1'~']~'. ~'$[~,e~ t~..~ S~'x,~ b. Size On ~cres) 17. IS the site sewed by~xisting public utilities? ~Yes gNo a] If Yes, does sufficient capacity exist to allow connection? ~Yes gNo b) If Yes, will improvements be necessary to allow connection? ~Yes ~No 18_ ts the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA - Section 303 and 304z ~Yes ~No 19. Is t~e site located'iq ot substantially contiguous to a Critical Environmental Area designated-pursuant to Articie ~ of the ECL, abd 6 NYCRR 6177 ~Yes ~No All ~ Ff~ Ilkl 20. Has the site ever been used for the disposal of solid or hazardous wastes? ~Yes ~No 13. 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. kJ, ~, acres initially; d. Project acreaRe to be deveJoped: Project acreage to remain undeveloped . ~ *~, acres. Length of project, in miles: IkJ, ~ (If appropriate) ¢ ~ $~,. e. tf the project is an expansion, indicate percent of expansion proposed f. Number of off-street parking spaces existing __ ~,I, ~L_._; proposed g. Max/mum vehicular trips generated per hour I',,/, ~. h If msidenual: Number and type of l~ousing umts: One Family Two Family Initially Ultunat~,Jv ~ i. Dimensions fin teet} of largest proposed structure jgl _ height; ~--I~ width: __ J. Linear ieet of frontage along a public thoroughfare project wdl occupy i~,? ,I,,Z,~ ._ ft. 3 , I0'~' acres ultimately. (upon completion of project)? /vhdtiple Fanuly Coodominmm 2. How much natural mat~ .al (La., rock, earth, etc.) will be removed trom the site? O tons/eubi~z.,~,~rds 3; Will disturbed areas be reclaimed? ~i~Yes [~No ~]N]A a. If yes. for what intend:~: purpose is the site being reclaimed? S~ ~ ~ ~. ' .~'~-~ b, Will topsoil be stockpiled for rec amation? ~Yes ~No c. Will upper subsoil be stockp led for reclamation~ ;~Yes C]No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? . ~) zcres. $. Will any mature forest (over 100 ?'ears old) or other locally-important vegetation be removed by this project? I~Yes ~No · 6. If single phase project: Anticipated period of construction ~ months, (including demolition). ~'. If multi-phased: a. Total number of phases anticipated I~, ~1. (number). b. Anticipated date of commencement phase I month __ year, (including demoiition) c. Approximate completion date of final phase month year: d. Is phase I functionally depend~nt on subsequent phases? i-lYes ~]No-' 8. Will blasting occur durin~ construction? E]Yes I~No 9. Number of jobs generated: during construction '~' ~._~_~_~; after project is complete 10. Number of jobs eliminated by this project __ ~) _. 11. Will project require relocation of any pFoject~ or facilities? F'3Yes ~;~No If yes, explain 12. Is surface liquid waste disposal involved? [~]Yes Ii'No' a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? [~Yes ~i~No.. Type 14. Will surface area of an existing water body increase or decrease by proposal~ Explain [~Yes ~No 15. ts project or any portion of project located in a 100 year flood plain? ~Yes 16. Will the project generate solid waste? ~Yes ~ti'qo ~ '"~'~-~" a. If yes, what is the amount per month tons b. If yes, will an existing solid waste facility'be used? ~Yes ~]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 [=]Yes ~No 17. Will the proiect involve the disposal of solid waste? r-lYes a. If yes, what is the anticipated rate of disposal? _ b. If yes, what is. the anticipated site life? years. 18. Will proiect use herbicides or pesticides? ~Yes ~]No ~No ~-~ tons/mort th. 19. Will project routinely produce odors (more than one hour per day)? I~Yes 20. Will project produce operating noise exceeding £he local ambient noise levels? 21. Will proiect result in an increase in energy, us~? l~Yes If yes , indicate type(s) ~]Yes J~]No 22, If water supply is from wells, indicate pumping capacity _ . ~,~. ~,. gallons/minute. 23. Total anticipated water usagJ per day gallons/day, t'~¢~.~-~ ~ 24 Does prolect involve Local. State or Federal funding? ~Yes ~No If Yes, explain 4 · '25/,Approvals~Required: City, Town, y!llage Board igYes City. Town, Village Planning Board F-lYes tine City, Town Zoning Board []Yes [No City, County Health Department ~Yes [No Other Local Agencies [Yes f'lNo Other Regional Agencies [Yes [No State Agencies E~Yes Federal Agencies ~Yes [No Type Submittal Date C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? E3Yes ~No If Yes, indicate decision required: - . F"lzoning amendment f-lzoning variance I-Ispecial use permit f-lsubdivision Cisite plan [new/revision of master plan []resource management plan [other. 2. What is the zoning classification(s)of the site? 3. What is the maximum potential develo~m9nt of the site if developed as permitted by the present zoning? 4. What is the proposed zoning of the site? t,~o · 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in-adopted local land use plans? ~Yes I~ 7. What are the predominant land use(s) and zoning classifications within a ¼ mite radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a ¼ mile? l~Yes 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.,' ti-lYes 11. Will the proposed action create a demand for any community provided services (recreation, education, polic fire protect/on)? I~Yes .~No 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? l-lYes a, If yes, is the existing road network adequate to handle the additional traffic? I-lYes I-INo D. Informational Details Attach any additional information as may be needed to clarify yoor proiect. If there are or m~a¥ be any adver. impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate avoid them. E. Verification I certify that the information provided above is true to the best of my knowledge. Signature ~~~ Title If the actio~ in ~he Co~stal Are~ and you with this assessment. Date are a state agency, complete the Coastal Assessment Form before proceedin 5 P--:t 2--PROJECT IMPACTS AND :EIR MAGNITUDE - -", - Responsibility of Lead Agency General Information (Read Carefully) * In completing the form the reviewer should be guided by the question: Have my 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 necessardy significa Any large impact must be evaluated in PART 3 to determine significance, identifying an impact in column 2 siF~ asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of. impacts and whereve( possible the threshol( magnitude that would trigger a response in column 2. The examples are generally applicable t~roughout the State for most situations. But, for any specific project 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 proiect, 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 thresholds to answer each questi · The number of examples per question does not indicate the importance of each questiont · In identifying impacts, consider long term, short term and cumlative effects. - ~ Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as ~es answers. c. If answering Yes to a question then check the appropriate box (column I or 2) to indicate the potential size of t impact. If impact threshold equals or exceeds any example provided, chick column 2. If impact will occur but thresh( is lower than example, check column 1. d. If reviewer has doubt about size of the impact then consider the impact as potentially largb and proceed to PART e. If a potentially large impact checked in column 2 c~n be mitigated by change[s) in the proiect to a small to moderz impaq:t, 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 I. Will the proposed action result in a physical change to the project site? C]NO ~YES Examples that would apply to column 2 · Any construction on sJopes of 15% or greater. (.15 foot rise per 100 foot of len~thj, or where the general sJobes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 f~et of existing ground surface. '" Construction that will continue for more than 1 year or involve more than one phase or stage. · E~cavation 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 tr. _.,,y u;~que or un~sua[ land forms round on t~e site? !i.e.. chffs, dunes, geological formations, etc.).~'NO · Spec,ftc land forms: 6 1 Small to Moderate Impact 2 Potential Large Impact 3 Can Impact B( Mitigated By Project Chang, []Yes []No []Yes []No [~Yes []Yes [~]No EYes ~]No ~Yes J~No [~Yes []No Eyes [:]No []Yes []NO J~]Yes ~No IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) E~NO []YES Examples that woutd 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.~ f~NO F1yES Examples that would apply to column 2 · A 10% increase or decrease in the surface area of any body' of water or more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. · Other impacts: 5. Will Proposed Action affect surface or groundwater quality or quantity? I-1NO []YES Examples that would apply to column 2 · Proposed Action will_require a discharge permit. · Proposed Action requires use of a source of water that does .not have approval to serve proposed (proiect} action. - Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely atfect groundwater. · Liquid effluent w/Il be conveyed off the site to facilities which presently do not exist or have inadequate capacity. · Proposed Action would use water in excess of 20,000 gallons per day. · Proposed Action wilt likely cause siltation or other discharge lute an existing body of water to tr:e extc-nt that there witt be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroJuum 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 comrr,,ercia] and/or industrial uses which may reqmre new or expansion of existing waste treatment and/or storage facd~des. "Other impacts: water runorf~ ~NO ~YES Ex=topics that would apply to column 2 7 I 2 3 Small to Potential Can Impact Moderate Large Mitigated Impact Impact Proiect Chart [] [] DYes [] [] I~Yes ~ ~ Wes ~ ~ ~ves Z ~ ~Yes ~N, ~ ~ ~Yes ~Nc ~ ~ ~Yes ~Nc ~ ~ ~Yes ~ Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designated floodway_ · Other impacts: IMPACT ON AIR 7. Will proposed action affect air quality? ~NO [Z]YES Examples that would apply to column 2 "Proposed Action wdl 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 miJIion BTU's per hour. ' Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS Wil! Proposed Action affect any threatened or endangered species? ~tNO [~YES Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list. using ~he site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. ' Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. · Other impacts: 9 Will Proposed Action substantially affect non-threatened or non-endangered species? [:]NO [:]YES Examples that would apply to column 2 '.Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. · Proposed Action requires the removal of more than 10 acres pt mature forest (over 100 years of age) or other locally important IMPACT ON AGRICULTURAL LAND RESOURCES 10 Will the Proposed Action aifect agricultural land resoorces? ~NO C]YES Examples that would apply to column 2 land (includes cropland, hayiields, pasture, vineyard, orchard, etc.) Smell to Potential Moderate Large Impact Impact [] [] Can Imp&ct E Mitigated B,.. Project Chan~ [~]Ves []N~ []N~ [~]Yes [~N¢ E~Yes [~Yes [~No [~Yes []No ~Yes ~]Yes [~Yes [~]Yes ~No [~Yes [~]No []Yes .[~]No [~]Yes [~]No C3Yes [~Yes []No [~Yes ['-'[No 8 · 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 (e.g, cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources? C]NO []YES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix 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 oi~ aesthetic resources which wilt eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Proiect components that will result in the ehmination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance.~ UNO fqYES 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 wkhin 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 SPAC~ AND RECREATION 13 Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational oppo~mnitms? Examples that would apply to coiumn 2 [~]NO []YES The permanent foreclosure o{ a future recreational o~porttmiW. A malor reduction o~ an open space important to the COmmumty Other impacts: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] ' I--lYes []No [] E] []Yes E3No [] [] E3Yes F'iNo [] []. []Yes r-iNo [] [] [~Yes []No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes' ~No ~ ~ ~Y~ ~No ~ ~ ~Yes ~No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? ~NO E/YES Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods. '- Proposed Action will result in major traffic problems. o Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? E/NO I~YES 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 ma}or 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? [~NO [-]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 wilt produce operating noise exceeding the local ambient noise levels for noise outside oi: structures. · Proposed Action will remove natural barriers that would act as a noise screen, · Other impacts:~ IMPACT ON PUBLIC HEALTH 17. Will Proposed Action affect public health and safety? E]NO EYES 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 low level discharge or emission. - Proposed Action may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating. infectious, etc.) o Storage facibties for one mdlion or inure gallons of ]iquilied natural gas or other flammable hqmds. o Proposed action may result in the excavation or other disturbance wnhm 2,000 feet of a site used for dm di-,pasal of solid or hazardous * Oth~t ~mpacts: 10 1 3mall to Vloderate Impact Potential Can impact ' Large Mitigated t3 Impact 'Project Chan [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] -.D [] [~Yes- . E~Nc ~Yes []Yes :-~Yes [],NO ~Yes [~No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing community? ENO E]YES Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by moro than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action wilt cause a change in the density of land use. · Proposed Action will replace or eliminato existing facilitios, structures or areas of historic importance to the communiW. · Development will create a demand for additional community services (e-g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future projects. · Proposed Action will create or eliminate employment. · Other impacts: , I 2 3 Small to Potential Can Impact B( Moderate Large Mitigated By impact Impact Project Chang~ [] [] E]Yes E]No [] [] ' r-lYes ENo [] [] E]Yes J-lNo [] [] I-lYes f--iNo [] [] [-]Yes []No [] I~' I-IYes ElNa [] [] E]4es r']Nc [] [] [-TYes E]Nc [] [] []'/'es rqNc 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? ENO EYES 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 ID1PA,.;'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 impact identified in Column 2 of Part 2: 1. Griefly describe the impact. 2. Dbscribe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change(s ~1. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources of value · Whether the Unpact can or will he controlled · The regional consequence of the impact · Its potential diw~r~ence from local needs and goals · Whether known obB:ctmns to the project relate to this m~pact. 11 7 't,1-t4-11:2:87)~9c ;~-' 617.21 ~ ./ SEQR ~-~ . Appendix B Stata Enwronmental Quality Review ., ViSual EAF Addendum This form may be used to provide additional information retat.ing to Question 1 1 0f Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between Visibility 1. Would the projecI 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 SerVice 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 designated open space? , · County road? · State? · Local road? Project and Resource (in Miles) 0-1/4 l/4.1/z 1/2-3 3-5 5 + [] [] [] [] [] · [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] E] [] [] [] [] [] [] [] [] '0 [] Is tile visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other [~}Yes []Mo Are any of the resources checked in question l during which the project will be visible? ~Yes used by the public during the timeTpf year DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally describe the surrounding 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 5, Are there visually similar projects within: '1/2 mile ~] Yes E~No Within '1/4 mile *1 mile *1 miles [~Yes ~JNo *2 miles -~] Yes [~No ' -, *3 miles ~-} Yes ~No * Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: Whe~ user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is Activity Travel to and from work Involved in recreational activities Routine travel by residents At a residence At worksite Other FREQUENCY Holidays/ Daily Weekly Weekends Seasonally 2 New York State Department of Environmental Conservation Region 1 Headquarters SUNY, Building 40, S~ony Brook, NY 11794 Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the parcel ~ project is: Greater than 300' from inventoried tidal wetlands. Landward of a substantial man-made structure greater than 100' in length which was constructed prior to 9/20/77. Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the ]0' contour or topographic crest without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic crest and the project (i.e. a 15' to 20' wide construction area) or erection of a temporary fence, barrier, or hay bale berm. Please note that any additional work, or modification to described, may require authorization by this Department. this office if such are contemplated. the project as Please contact Please be further advised that this letter does not relieve you of the responsibility of obta]nin9 any necessary permits or approvals from other agencies. (~V~'rY'l:~truly~ic~y°urs" ~: Deputy Regional Pe~it AdmJn~st:at.o: New York State Department of Environmental Conservation Region 1 Headquarters SUNY, Building 40, Stony Brook, NY 3.1790-2356 Thomas C. Jorling To: Representing: In response to your request for a freshwater wetlands determination for the property identified below, the New York State Department of Environmental Conservation has determined that the parcel is more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24;of the New York State EnviroD~ental Conservation Law). Location: Tax Map Number: Please be advised that this letter does not relieve you of the responsibility of * ~ ' ob~a~nzng any necessary permits or approvals from other agencies. Very truly yours, Christine J. Costopo.~s Deputy Regional Permi%~dministrator cc: ~ COMLOG [] PAPLOG [~ PLAP ~j C~2RD FILZ Mrs. Rolla Campbell 1530 A Cypress Dr. Jupiter FL 38469 16 December 1992 To whom it may concern: James Volney Righter Architects, Inc. have my perrpAssion to apply on my behalf for permission to build an addition to an existing guest cottage on my property at Fishers Island, Suffolk County Tax map no. 1000-004-4-16. Very truly yours, Kim ~ Campbell New York State Department of Environmental Conservation Building 40--SUNY, Stony Brook, New York 11790-2356 Notice Thomas C. Jorling Commissioner As required by law, the Department of Environmental Conservation is hereby pro~dd;.ng you with notice of an alleged v',olafion of the Enviro~mentaI Conservation Law which occurred within your municipality. THIS NOTICE DOES NOT REQUIRE ANY RESPONSE OR ACTION BY YOU. Please be advised that the DeparUnemr has sufficient e,~idenc~ to commence an enforcement action agains; /~. ~ t/*,,~¢~/~/, for a violation of Article(s) 25 and/or 15 of the Environmental Cor~rvation L~/w of the State Of New York. NOTICE PROVIDED TO: The Honorable Thomas wickham Address: Supervisor Town of Southotd Main Road Southold, ATY 11971 NOTICE PROVIDED BY: Name: Title: Louis A. Chiaretla Regional Manager - Bureau of Marine Habitat Protection Date: New York State Department of Environmental Conservation Building 40--SUNY, Stony Brook, New York 11790-2356 Date: May 31, 1994 Notice of Violation Thomas C. Jorling Commissioner Addressee: Katheryn A. Campbell 125 Broad St. New York, NY 10004 Date of Violation: On or before 10-29-92 Location of Violation: Hippodrome Dr. & Rogers Road, Southold Permit # (if applicable): Tax Map (SCTM) ID# 1000-66-2-12 Dear Ms. Campbell: Records of this Department indicate that you are in violation of the Environmental Conservation Law (ECL): I I Article 15. Protection of Waters Section 6NYCRR ~ Article 15, Wild, Scenic and Recreational Rivers Act Section 6NYCRR I Article 23, Mined Land Reclamation Law Section 6NYCRR I Article 24, Freshwater Wetlands Act Section 6NYCRR ~-X-~ ~-X-~ Ardcie 25, Tidal Wetlands Act Section 0401.1 6NYCRR 661 I Article 19, Air Pollution Control Act (Restricted Burning) Section 6NYCRR In that you caused, or permitted to be caused: the installation of: a 24' long catwalk 2'4" over grade in a regulated intertidal and high marsh wetland; a 4'4" X 6' terminal platform 3' over grade in an regulated intertidal marsh wetland; and the installation of leaves, evergreen trees, bushes and other landscape debris in a regulated high and intertidal marsh wetland allegedly without benefit of DEC permit. Contravention of this/these Article(s) of the ECL is a violation and/or a misdemeanor punishable by a f'me of nc more than 510,000/15,000 per day. Penalties may be assessed for each day that the violation continues. Please be further advised that violations of the ECL which are not resolved may be the subject of an administrative hearing pursuant ro Title 6 of the Official Compilation of Codes. Rules & Regulations of the State of New York (6NYCRR, Part 622). You are hereby advised ro cease your operation at the referenced location immediately. Please contact the following office within thirty (30) days of receipt of this letter, so that we may attempt to resolve this matter. Failure to contact this office within this time period will result in this matter being referred to the Department's Regional Attorney for further enforcement action. To schedule an appointment for a compliance conference in th/s matter, please contact Ms. Kay Worker ar (516) 444-0295. Office of Legal Affairs Att. n: Kathleen Shea Assistant Regional Attorney CC' Very truly yours, Charles T. Hamilton Regional Supervisor of Natural Resources Stony Brook Regional Attorney Dr. Christopher S. Mallery, ACOE ECO Enright, Law Enforcement K. Du Bois, BMHP Certified Mail NOV #94KD52 J.M.O~ Consulting P~O., Box 447 Quogue, N.Y~ i!959 5i6-653-0607 June 1994 Mr~ Albert Krupski~Jr:~ Presmoent Board of Town Trumtees Town of Southold -own Hail, 53095 Main Road P.O. Box 1!79 Southold~ N.Y. ii971-t!79 RE: Permit for Re!ia B. Campbell ~=ishers island S.C:T.M~No~ 1000-4-4-i6 Dear Mr~ Krupski: issued by the Board of Trustees., The requested mod£fication ~.s to allow the applicant to construct a garage, pooi~ decking, pool backfish filter and to regrade the area of pool and garage censtruction~ Ail of the proposed modifications shall be located greater than 75~ from the Tidal Wetlands line~ For the Board's review, I have enclosed 4 sets of the revised survey as prepared by Chandler, Palmer & King dated 6/7/94~ As aiways~ should you or any member of the Board have nay comments or questions pertaining to this request~ GEJ~ar enci. Environmental r- , ,onsukmg Services November 24, 1997 Mr. Albert J. Krupski, President Board of Town Trustees Town of Southold 53095 Main Road, P.O. Box 1179 Southold, N.Y. 11971-1179 RE: Property of Roia B. Campbell No #, East End Road, Fishers Island S.C.T.M.Noo 1000-004-4-16 Dear Mr. Krupski: At this time, we are seeking to obtain a determination of jurisdiction for this project. The proposed project consists of the construction of a 27'x 59' addition onto the west side of the existing single family dwelling, a boulder retaining wall and driveway, All of the proposed construction activities shall be located greater than 150' landward of East Harbor. I believe that Mr. James King had visited this site as a pre-application inspection during his last trip to Fishers Island. For your review, enclosed please copies of the survey for this site as prepared by Chandler, Palmer & King (17 Nov 97). As always, should you have any comments or questions regarding this material, please feel free to contact our office. GEJ:arh Most. sincere,ly, Phone (516) 653-0607 ~ Fax (5t6) 653-3348 121 jessup Ave · 2nd Floor ~ P.O. Box 447 QUogue, NewYork 11959-0447 James Votney Righter a r c h ~ t e c t s i n c Board of Town Trustees Town of Southold 53095 Main Rd. Southold NY 11971-1179 Re: Klm K. Campbell guest SCTM ~1000-4-4-16 Fishers Island NY Attention: Jill cottage TOWN OF $OUTHOLD 10 February 1994 To the Town Trustees: Enclosed is our check for S150 fee for wetlands permits. in paymenL of the application Very truly yours, Jacob Albert 58 Winter Street o Boston - Massachusetts - 02108 o telephone - 617 ~ 451- 5740 James Volney Righter a r c h i t e c t s i n c 17 January 1994 Board of Town Trustees Town of Southold 53095 Main Rd. Southold NY 11971-1179 Re: Klm K. Campbell guest cottage SCTM ~1000-4-4-16 Fishers Island NY To the Town Trustees: Enclosed is an application for permission to reconstruct the guest cottage with an addition on the property of Klm K. Campbell on Fishers Island. We had received a waiver from you dated 4 May 1993 allowing the construction of the addition to the guest cottage. (Copy attached) As construction began last month, it immediately became apparent that the wood structure of the existing cottage was seriously rotted and that using it as the basis for an addition was inappropriate. The wood structure was removed. The block foundation walls still remain. However, as it was discovered that these block walls lack footings, we now see that they, too, are inadequate for reuse. A new foundation with footings is called for. Because of these structural deficiencies in the old building, the project has become one of new construction rather than an addition. We are asking permission to rebuild the cottage exactly in its old location and exactly according to the plans that were approved by all the relevant agencies. This reconstruction will entail no change to the uses that have existed on the property for many years. Even if the cottage were not rebuilt on its old site, the site would still be in a disturbed condition, with an existing old foundation wall in place and lawns surrounding it. We request that the project be allowed to continue as before. Very truly yours, 58 Winter Street · Boston - Massachusetts - 02108 · telephone , 617, 451- 5740 JAMES V. RIGHTER ARCHI, ~TS 58 Winter Street BOSTON. MASSACHUSETTS 02108 (617) 451-5740 WE ARE SENDING YOU r- Attached [] Under separate cover [] Shop drawings [] Prints [] Plans ATTENTION m ~ gDeciflcations [] Copy oi letter [] Change order [] COPIES DATE NO. DESCRIPTION THESE ARE TRANSMI'FrED as checked below: [] For approval [] For your use [] As requested [] For review and comment [] FOR BiDS DUE ~ Approved as submitted []' Approved as noted [] Returned for corrections [] 19 [] Resubmit__ [] Submit [] Return .copies for approval copies for distribution corrected prints __ [] PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO_ N~¢~____-~--~ New York State Department of Environmental Conservation Region I Headquarters SUNY, Building 40, S~ony Brook, NY 11794 Thomas C. JOrling Commissione~ A review has been made of your proposal to: ~~~-~-~ Based op::~he:~!~nforma~f~m:%~O~.~submitted, the.:NewYorkS~at~Department of Envir0n~'~htal Coh~va~fl~!~etermined that ~he '--pa~e~-'~' .~ project is: Greater than 300' fr~m inventoried tidal wetlands. Landward of a substa'ntial man-made structure greater than 100' in length which was constructed prior to 9]20/77. Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental ConServation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest without a permit. It is your responsibility to e~sure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to-the ground surface or vegetation in this area as a result of your project, SuCh precautions may inCi~de pr0viding adequate work area between the t0' contour or topographic!Crest and the project (i.e. a 15' to 20' wide construction area) or e~eCtion of a temporary fence, barrier, or hay bale berm. Please note that any additional wdrk, or modification to the project as described, may require aulthorizati0n by this Department. Please contact this office if such are Contemplated. Please be further advised that this letter does no[ relieve you of the responsibility of obta]ni!ng any necessary permits or approvals from other agencies. Very truly yours,. . [? Deputy Regional Pe~it ~dmi~ist~ato: New York State Department of Environmental Conservation Region 1 Headquarters SUNY, Building 40, Stony Brook, NY 11790-2356 Thomas C. Jorling Commissioner To: PcF~H'- hl~..J/~co~ P. Av~.T Dear Me-Al'l~f : in response to your request for a freshwater wetlands determination for the property identified below, the New York State DeDartment of Environmental Conservation has determined that the parcel is more than t00 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24;o~ the New York State Environmental Conservation Law). Location: Tax Map Number: Please be advised that this responsibility of obtaining from other agencies. letter does not relieve you of the any necessary permits or approvals Very truly yours, Christine J. Costopou~S Deputy Regional Permi~dministrator cc: ?Sa~d,~ o~ ~HVl~..o~-A-b g~-.tT?~r~otq [] COMLOG ~PAPLOG ~MAP [~CA~ FILE James Volney Righter a r c h ~ t e c t s i n c TOWN OF SOUTHOLDj 9 December 1993 Board of Town Trustees Town of Southold 53095 Main Rd. Southold NY 11971-1179 Re: Klm K. Campbell guest cottage SCTM ~1000-4-4-16 Fishers Island NY To the Town Trustees: We received a waiver from you dated 4 May 1993 concerning the proposed addition to the guest cottage on the property of Klm K. Campbell at Fishers Island NY. (Copy attached) As construction began last month, it immediately became apparent that the wood structure of the existing co5sage was seriously rotted and that using it as the basis for an addition was inappropriate. The wood s~ruc~ure was removed. The block foundation walls ssilt remain. However, as it was discovered that these block walls lack footings, we now see that they~ ~oor are inadequate for reuse. A new foundation with footings is called for. Because of these structural deficiencies in the old building, the project has become one of new construction rather than an addition. To continue the projecE, we musk apply for a new building permit and a zoning variance. The Building Department Notice of Disapproval that necessitates the varzance also mentions that action may be required by the Town Trustees. (See copy of Notice of Disapproval.) We are asking permission to rebuild 5he co55age exactly in its old location and exactly according to the plans that were approved by all the relevant agencies. This reconstruction will entail no change ko the uses that have existed on the propersy for many years. We request that your waiver be revalidated Lo allow The pro]ec5 to continue as before. Very Lruly yours, ~: Ri;hter 58 Winter S,feet ~ Boston . Massachusetts · 02108 - ~e!ephone - 617- 451. 5740 TOWN O F SOUTtlO LD BUILDiNG DEPART¢,I ENT TO~WN CLERK'S OFFICE $OUTI{0LD. NOTICE OF DISAPPROVAL Date ..... ~I01~tOIF, R .la, ................ .58 .~g~r Str~t P~ASE TAKE NOTICE that your application dated ... ~g. [~ for pe~it to ~.. ~CONS~UCT ~A~ ~ Location of Property ~js;~o~Y. ~R FIS~ I~. County Tax Map No. 1000 Section ..... ~ ........ Block . .{.. ' ..... Lot Subdivision ................. Filed Map No ................. Lot No ~s returned herewith and disapproved on the following grounds...~$8.~[ .~ SECTIO~-lO~243 NON~O~G B~GS WI~ NON~O~NG ~SES~BtBUYL~G D~OLI~ {~R ~A~SgS) TO ~ E~ OF ~ ~ 50Z OF ITS FAIR Rv 1/80 James i Voiney Righter 3O 1992 Board of Town Trustees Town Hall 53095 Main Road P.O. Box 728 Southold NY 11971 Attention: John Bredemeyer Gentlemen: We would like to reintroduce a project for Mrs. Klm K. Campbell on Fishers Island. Two years ago, we applied for permission to build a new garage for the Campbells. But the project was dropped before the application materials were complete. Wenow hope to proceed with another project, an addition to the existing guest cottage. In 1990 the D.E.C. issued letters of no jurisdiction for the project. (See attached.) We are now seeking to renew their earlier decision. We believe the project is outside the coastal erosion hazard zone. However, it may fall within your area of fresh water wetlands jurisdiction. We are seeking either a permit, waiver, or ruling of no jurisdiction, as you find appropriate. We have now gotten Chandler, Palmer, & King to complete the contours in the project area. Please let us know if there is any further information we should supply. Thank you for considering this application. Very truly yours, Jacob Albert Enclosures: Application forms (3 pages), Short Environmental Assessment Form, Long Environmental Assessment Form, D.E.C letter 4-18-90, D.E.C. letter6-27-90, Owner's authorization letter, Site photographs, Location map, Suffolk Co. Tax Map, Project plans, Survey, Fee $35. 58 Winter Street - Boston ,Massachusetts . 02108 . telephone . 617 ~ 451o 5740 James Vol[ney Righter a r c h i t e c t s i n c 25 March 1993 Tom Shillo Z & S Contracting Fishers Island NY 06390 Dear Tom: We have enclosed some new sketches for the Rolla Campbell guest cottage addition. They are ready to go ahead again. We have gotten started again with the D.E.C and Town Trustees. The D.E.C. has signed off. But in response to the Town Trustees' opinion, we have redesigned the whole scheme so that the addition is all towards the driveway. That is why it will not look familiar to you. They have given an indication that they will approve this scheme. We'll have to give you more than the attached sketches before you can come up with even a ball-park price. But the Campbells will want a price before going ahead. Before we do that, could you give the Campbelts an idea of when you might be able to fit this job into your schedule? Sincerely, Jacob Albert 58 Winter Street o Boston · Massachusetts · 02~08 · telephone · 6~7. 45~o 5740 PART II--ENVIRONMENTAL ASSESSMENT To oe completed $~ Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRF PART 617 12o Ii yes. coor¢ hate the review orocess and use [ne FULL EAF, E3 Yes [] ~o $. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS N 6 NYCRR. PART 617,67 It NO. a negative declaration may be superseded by another involved agency. C2. Aesthetic, agricultural archaeological, historic, or other natural or cultural resources; of community or neighborhood character? Explain briefly: C4. A community's existing plaus oRgoals as officially adopted, or a change tn use or mteusity o[ use ct land or othe~ natural-resources? Explain briefl C5. Growth, subsequent ~evelopme~t, or related activities likely to be.induced by the .proposed action?~.Exptaln brief y. c6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly. C7. Other impacts (including changes in use of either quantity or wpe of energy)? Explain briefly; D. iS THERE OR tS THERE UKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL iMPACTS? [] Yes [] No If Yes, explain briefly PART III--~.DETERMINATION OF SIGNIFICANCE ~To be completed by Agency) INSTRUCTIONS: For each adverse ~ffsst identified above, determine whether it is substantial, large, Important or otherwise significant. Each effect should be assessed l¢~'_co, nnect.lon ~'ith its fa) setting (i.e. urban or mrai);_~"b) probability <)f. occutring; (c) duration; (d) irre,,~rs~t~ility;, (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 have _l~en Identified and adequately addressed. I~ 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 FAF and/or prepare a positive~declaration. - [] Check this box if you have determined, based on the information an~ a~alysis above and any supporting documentation, that the proposed action WILL NOT result in any significa_nt adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this~etermination: OJECT I.D. NUMBER 617.2I Appendix C State Environraental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM~ For UNLiSTED'ACTIONS Only PART I PROJECT INFORMATION (To be completed by Applicant or Project sponsor) : 1 APPLICANT /SPONSOR 2. PROJECT NAME J~-~ rot*c-h l~'qk~. A~P~, L~_.. m;~ K. ~pk~ ~t ~t~ 3. PROJECT LOCATION: 4. PRECISE LOCATION (Street ~ddress and road inters~tions, prominent t~ndm~rks, etc., or provide map) c SEQR 5. IS PROPOSEB ACTION: [] New [] Expansion [] Modification/alteration ' ' ' 6, DESCRIRE PROJECT BRIEFLY: Initially -- acres Ultimately 8. WILL PROPOSED ACTION COMPLY WITS EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No ¢ No. describe briefly 9- WHAT tS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industfia ~ Oommerci& [] Agriculture [] Park/Forest/Open space 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. Ngw OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY [FEDERAL, STATE OR LOCAL)? ~rYes_ E~ No If yes, list ~le~lcy{s} and permi~appro~, Is 11. ~ES &~ ASD~ ~ ~E A~ION HAVE'A ~LY VAUD PE~IT OR ~PP~VAL? ~Y~ ' ~ ~ "~ ' Ifyes, li~ age~c~ na~ aha ~itlappmval I2. AS A SESULT ~ ~O~ED ACTION WI~ ~IN6 P~mAPPROVAL REQUI~ ~pDIFIOA~ON? ~ Y~S ~ No [ CERTI~ THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO ~E EEST OF ~ KNOWL~E If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 -ti Solthozd Town Trustees Field inspection Report Project Applicant/Number /~/~z'/C~;~/' ~-/~ f~/ site contains the following important natural features (Beach, Bluff, DuKe, Secondary Dune, Escarpment, Kettle holes, Erratics or Significant Habitats, Rare, T_~reatened, Endangered or species of special concern° ~ ~ ~ Extent proposed activities are at varmance from established standards of Coastal Erosion Projection; is supplemental engineering or advisory opinion indicated? Refer to CAC?~ Can impacts be moderated by s~mp~e project change? Should FF~ZA Regs. be checked Prior to Permitting?. $ Application complete~ assement form provided/complete Public services landward of Structure. Non-movable structures/additions prohibited. Permanent foundations not attached to movable structures Nonmovable structure within 25' of landward limit of Bluff. Nonmovable structure placed so excessive ground loading placed within 50' of point of inflection. Relocation agreemenu required/acceptable. Surface water not directed to/over bluff face. The Activity is: Reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location. __ Not likely to cause a measurable increase in erosion at the proposed site and a~ other locations. Prevents or minimizes effects on natural protective features and their functions and prouectlve values existing erosion protection structures and natural resources. Trustee signafure / Date inspected: -1'4q a-~2 (2/87}-- 7c 617.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEC Purpose: The full FAF is designed to help applicants and agencies dftermlne, n an orderly manne~'.'whether a Drew or action may be significant_ The questioo of whether an action may be significant is not always easy to answer. Frequef, Iy, there are aspects of a proiecr, that are subjective or unmeasureable. It is also understood that those who determ~ stgnificance mae have little or no formal knowledge of the environment or may be technicaihg expert in env~ronmem, analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affect{r the question of significance. The full FAF is intended to provide a method whereby applicants and agencies can be assured that the de~erminatic process has heen orderly, comprehensive in nature, yet flexible to allow introduction of information to fita project or actio Full EAF Components: The full FAF is comprised of three parts: Part 1: Provides objective data and information about a given pro]ecl and its site.'B¥ id;e~tii~n~'¢asic projec data. it assists a reviewer in the analysis that tal?_s place in Parts 2 anti 3. Part 2: Focuses on identifying the range of possibl~ impacts that may occur from a pro]ecl m' action.. It provide guidance as to whether an'impact is likely to be' considered small to moderate or whether it is a potentiall~ barge impact. /he form also identifies whether an imlSact can be mitigated Part ~:,.lf any impact in Part 2 is ~dentified as potentia fY-large, then Part ~ ' *~; ' ri~pact is actually important. - mr or not th~ DETERMINATION OF SIGNIFICANCE--Type I an'd Unlisted Acti'ons Idehtify the Portions of EAF .completed for thig project: [] Part 1 [] Part' 2 - I~]Part 3 Upon review of the informatio~'i recorded o'n this FAF [Parts 1 and 2 ~t:nd 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each ~meacr ~r is reasonably determineo by the lead agenc,, that: A. The ~rc ecr will not result i~ any large and important impact(s) and. therefore, is ope which ~vill not have a s*gnificant impact on tt~e environment, therefore a negative declaration Will be prep ared. B. Although the project could have a significant effect oo the environment, ther~ will hot be a significant effect tot this Unlisted Action because fhe mitigation measures described in PARI 3 have been required. therefore a CONDITIONED negative'declaration will be prepared.* [] C. l'he project may result in one or more !~a~rge and important impacts that may have'a significant impact on the environment, therefo're a posltlv~ declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name o{ Action Name of Lead Agenc'¢ Print or type Name et Responsible Officer in Lead Agency Signature of Responsible Officer tn Lead Agency Title et xe~ mnstbte Otilcer PART 1--PROJECT INFORt~fATION : ~ Prepared by Pr0iecf Sponsor NOTICE: This document is designed to assist in determinms whether the action proposed mayhave a si~nificam on the environmeht. Please c~mpieLe the entire form Parts A through E. Answers ~o these qu~don~ will be con: as p~rt of the application for approval and may be subject (o [urther verl[ication and public revi~. Provide any ~aa information you believe wii be needed to complete P~rts 2 and 3. [t is expected that completion of the full EAF will be dependent on information currently available and will not ir new studies, research or investigation. If informat~on requirin~ such additional work is unavailable. ~ indicate and s each instance. NAME OF: AG'I'ION ] 81'ATE[ Please Complete Each Question--lnd~cate N.A. if not * eplicabte A. Site Description Physical setting of overall project, both develop, ed and undeveloped areas. 1. Present land use: I~Urban [~lndustrial ~]Commercial ~Residential (suburban) EIRural (non-t U]Forest []]Agriculture IDOther 2_ Total acreag~ of project area: ~'Jt,~ acres. APPROXIMATE ACREAGE - PRESENTLY AFTER COMPLET10~ Meadow or 8rush~and (Non-agric~altural) ~ t. ~ acres .. 1'~ acre FOrested [!i o acres o _ acre Agriculturql..(l~cludes orchardL cropland, pasture, etc.) ~ acres . O acre Wetland {Fi'~bSVater or tidal as per Articles 24 '~5 of ECL} '~' I -"~ acres . ! '~ ~ acre Water Sud:ace Area o- acres o acre Unvegetalf~:'{Rock. earth or fill} ~ 0.7, acres O.7-*__ acrc goads, buildings and other paved' satiates ~' O,'L. acres o~'t,___ acre Other (indicate type}_ ff- !-~ acres I · 3 acre 3. What is predominant soil type(s) nn project s,te~ ~_~-[ / -q ~ a. Soil drainage: I~Well drained __~,o -- % of xite ~,Moderateiy well drained ?; or site ~PoorJy drained % of s~te b. If any agricultural land is involved, how many acres oi soil are classified within soil grouo 1 thr~ttgh 4 of the; Land Class~ficauon System? acres See 1 NYCRR 370). 4. Are there bedrock outcroppings on project s~te? ~Yes ~No a. What is depth .to bedrock? ,' n feetl 2 '" ' 'S_ -A'aproximate percentage of proposed proiect site with slopes: ~]~0-10% -- ~ __ % []10-15% _ .-, ~ OI5% or grea~er & Is project subst3ntiallv contiguous to, or contain a building, site, or district, listed on the 5Late or the Nador Register~ of H~storic Places? ~Yes ~No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks~ ~Yes 8. What is [ne depth of [hewater table? ~ ~ (in feet} 9. [s site located over a primary, principal, or sole source aquifer? ~Yes ~.No i0. Do hunting, fishing or shell fishing opportunities presently ex~st in me project area? ~Ye5 ~No 11_ [Does prolec~ site comain any species of plant or animal life that is identified as threatened or endangere ~Yes ~No According to Identify each species 12. Are there any unique or unusual land forms on the pro~ect site? {i.e., cliffs, dunes, other ge6logical formatio ~Yes ~No Describe 13. Is the project site presently used by the community :ps'neighborhood as an open space or recreation are, E~Yes I~No. If yes, e~plain 14. Does the present site : to the community? a. Na~ne of Stream and name of River to which .it is tributary 16. Lakes. ponds, wetland areas within or contiguous to proii:ct area: a. Name'S-St ~--,~, ~Sl~,e'f [,$~,.,~ ~ b_ Size (In acres} 17_ Is the site served by~xgting public utilities~ ~Yes ~No al If Yes. does sufficient capacity exist to allow connectiont ~Yes ~No b} f Yes, wd[ ~mprovements be necessary to allow connection? ~Yes ~No 18. ,is the s~e ~ocateo in an agricultural district certified pursuant ~o Agricu{ture and ~-~arke~s Law, Article 25 A Section 303 and 304? ~Yes ~No 19 Is the sim located i~ or substantially conuguous to a Critical Environmental Area designated pursuant to Article of the ECL. ahd 6 NYCRR 6177 ~Yes ~No ~l ~ ~ ~'~ IS~ 20. Has the site ever been u~ed ~ the disposal of ~id or ~zardous w~stes? ~Yes ~No B. Project Description 1. Physical dimensions and scale of proiec~ (fill io dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acrea~te to be developed: 10. ~1, acres initially; c. Project acreage to remain undeveloped ~ '~. acres. d. Leng{h of project, in miles: ~' ~ {if appropriate} e. If the Drolect is an exoans on, indicate percent of expansion proposed f. Number of off-street parking spaces existing ~. ~, : p~oposed g. Maximum vehicular trips generated per hour ~.~. [upon completion or project}? U[t unarm. Iv i, Oim~-ns~ons [m ~ect) of largest proposed structure g~he~ght: ~ ~ width._ i, Linear ice( of frontage along a public thoroughiare proiect wdl occupy i~? acres ultimately. Condominium 3 2. How much qatural material' (£e.. rock. earth, etc.) will be removed from the s~te? 3. Will disturbed areas be reclaimed? ~Yes ~No ~N/A a. If yes. ~or what inte~d~.Z purpose is the site being reclaimed? 5~ ~ b. 'Will toosoi[ be stockpiled for reclamation? ~Yes ~No c. Will upper subsoil be stockpiled for reclamation? ~Yes ~No 4 How many acres of vegetation (trees. shrubs, ground covers] will be removed from sit~? _ ~__ acres. 5. Will any mature forest [over 100 yea~ old) or other [oc~[[y-lmportant vegetation be removed by this project? ~Yes ~No - 6. if sin~te phase pro[ec~ Anticipated period of construction ~ months. (including demolition). 7. If multi-phased: a. Total number of phases anticipated ~. ~- (number). b~ Anticipated date o[ commencement phase 1 month c. Approximate comp[etlon date of final phase month d. I~ p~ase 1 functionally depend~nt on s~equent phases? ~Yes 8. Will bi,ting occur d~rin~ cons~ction? ~es . ~ ' ' 9. Number of jobs ge,e~ted: duri,g const~io" 3-~ L ;.after project g complete ~. Will p~oj~t.require relo~on of an~'~rojec~ or facd~t~e5~ ~Y~ ~No If yes. ~plam 12. Is sufia~e liquid w~te disposal ~nvol~ a~ If Yes. indicate ~pe of ~te (se~a~e~ . ~nd amount b. Name of water body into which e~fluent Will be discharged 13. Is subsurface liquid waste disposal involved? ~Yes ~Ng. Type 14 wi surface ama of an existing water body increase or decrease by proposaN ~Yes ~No Explain year, [including demolitior, ,/ear: t5 ]s prolect or any 3ort~on of prolect located in a 100 year flood plain? C]Yes 16 Will the project generate solid wa~te~ E~Yes [[~No 'b.}e.-,.O a. If yes, what is the amot:nt pet month . tons b. If yes. will an existing solid waste facility'be used? [~lYes l~]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 OYes I~]No 17. Will the project involve the disposal of solid waste? I-lYes a. If yes. what is the anticipated rate of disposal? b. If yes, what is. the anticipated site Ii{e? years. 18_ Will project use herbicides orpesticides? [~]Yes ~]No i~No .~ ~1.,-,~_. tons/month. 19. Will project routinely produce: odors {more than one hour per day)? OYes J~No 20. Will project produce operating noise exceeding the local ambient noise levels? l~lYes 21_ Wdl project result in an increase in energy, us;et ~]Yes ~}No If yes indicate type[s] ~No 22. If water supply is from xvelJs, indicate pt4mpmg capacity 23. Total anuopated water usage per day gallons/day. 24 Does prolem revolve Local. State or Federal funding? ~Yes ~No If Yes. explain 4 .. ~~ 2S.',.Approvals Requ red: City, Town, yillage Board I~Yes E]~4o C~ty. Town, village Planning 8pard [:]Yes E]No City. Town Zoning Board I~Yes [:]No City. County Health Department ~Yes [3No Other Local Agencies [~Yes []No Other Regional Agencies E:]Yes [::]No State Agencies dyes [3No Federal Agencies [:]Yes [3No Type Submittal Date C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning de~:ision? [~Yes ,~No ~ If Yes, indicate decision required: ' · []zoning amendment ~]zoning variance []special use permit []subdivision []]site plan []new/revision of masterplan I~]resource manageme? plan' Elother _ ' _ 2. What is th~ zoning Classific~on(slof the Stte? '~ t.~ct~.~,;~,J . 6xi w~'r.~ [ ~ 3.. What'~s the maximum PotentiaI development of the site if developed as permitted by the present zoning? 4. What is the proposed zoning of the site? I~ ~kt~. * . 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6 Is the proposed action consistent with the recommended uses m"adopted local land use plans.-' d~Yes 7 What are the predominant land use[s) and zoning classifications within a V, mile radius of proposed action? 8. Is me proposed action compatible with adjoming/surroundlng land uses within a ¼ mile? ~Yes 9. If the proposed action is the subdivision pt 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 d stricts? []]Yes 11. Will the proposed action create a. demand far any community provided services [recreation, education. fire protection]? [~Yes .'[~Nb ' · a. If yes, is existing capacity sufficient to handle prelected demand? I-lYes UNo 12. Will the proposed action mst/Ir'in the generation of traffic significantly above present evelsl ClYes a. If yes, is the existing road network adequate to handle the additional traffic? [2l~'es ENo D. Informational Details Attach any additional information as may be needed to clarify your proiect. If ther~ are or may be any adve impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate avoid them_ E. Verification [ certHy that the information providect above is true to the best of my knowledge. H.~e acho~ ;n the Coastal Are~ and You a~e A stA~e ~Aency, comp ere ~he CoAs~] Assessment 5 F ~r F .< Consultant Project Ns=me SCT~! ~10O0- Date The Southold Town Trusuee office has determined that your application for a coastal erosion/wetland permit is non-jurisdictional/incomplete, please consider the following information in this regard for any required return submissicn: / ~_/~fustee Represen~ati'4e- cc: Building Dept. -Z~r~ _ ~ ~ ,. . ~ -_~ -~- C~s~-.,eticn A~vi~cr~ This notice makes no claim with respect to otker jurisdictions within or outside the Town of Southo!d with respect to permits, permission required. 4/92 o '~ ,/ ~ 0 0 D~ZW£~JAy