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Home My WebLink AboutTR-3815 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD January 23, 2013 Mr. David Page & Ms. Barbara Shinn 2000 Oregon Road Mattituck, NY 11952 RE: DAVID PAGE & BARBARA SHINN 1854 NORTH BAYVlEW ROAD, SOUTHOLD SCTM# 70-12-39.3 Dear Mr. Page & Ms. Shinn: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, January 23, 2013: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit #3815 from Edward Fergus to David Page & Barbara Shinn, as issued on September 28, 1989. If you have any questions, please contact our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK:amn .lames I: King, President Bob (ihosio, .Ir, Vice-Presidenl Dave Bergen .John Bredemeyer Michael J. Domino PO Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time:/tb,..-,._ / ~', ¢9-~1 ~ DAVID PAGE & BARBARA SHINN request a Transfer of Wetland Permit # 3815 from Edward Fergus to David Page & Barbara Shinn, as issued on September 28, 1989. Located: 1854 North Bayview Road, Southold. SCTM# 70-12-39.3 Type of area to be impacted: Saltwater Wetland Freshwater Wetland __Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 __other Type of Application: Wetland __Administrative__Emergency Coastal Erosion Amendment Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: ¢~J. King ,'~. Ghosio ¢'/D. Bergen, v/J. Bredemeyer. ,-~ Michael Domino D. Dzenkowski__ Form filled out in the field by Mailed/Faxed to: Date: other Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 3815. ISSUED TO ..,....,Ed.~,'a~d F~rg:u...~ ................... ! ~.~., Aut'h.r zati fl- Pursuant to the provisions of Cha the State of New York. '1~ Sfa~ of New Yo~ 19~ ~own eh- 'titled "RE~U~TIN~ AND THE ~INGr OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS a~ REMOVAL: OF S~ND. G~VEL~' ~ O~HER UATERIALS FROM LANDS U~DER TOWN WA~RS~' and in accordance with the Resolution of ~he B~rd adOpted at a meeting held on 19 89 , and in consideration of the sum of $ paid by ~8 DEC - 5 2012 of .................................................. N. Y. and subject to the Terms and Conditions listed on the reverse side hereof. of Soufhold Town Trustees authorizes and permits the 'following: To construct 4' X Z0' fixed dock. 4' X 16~ ramp, two 6' X 16' floats, instal/ 9 pilings on property located on R.O.W. off Nc~th Bayvzew Road, Southoldo all ;n accordance wlth the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be at,xed, and these presents to be subscribed by a majority of the send Board as of this date. -/ _/ N IZ' ORAV~L FRENCH DRAIN (!60' (380 A~EA CF WETLANDS=3,,362 SQ. FT. ~,302 SQ. FT. - ~,362 SQ. FT, =59,g~0 SQ. FT. LOT CO~RAGE 3,228 SQ. FT. PE~CENT LOT COVERAGE 3,228 / 59,9~0=5.~ DRIV~ T~ST HOLE DA TA 1989 'LOOD ZONE LINES FROM FIRM J6/oJCO166 0 MA Y 4, ~998 LEVA PONS REFERENCED TO N.G. Y.D. Ol~ fotT?///<Tr w/th the STANDARDS FOR APPROVAL ND CONSTRUCT/ON OF SUBSURFACE SEWAGE /SPOSAL SYSTEMs FOR SINGLE FAMILy RESIDENCES ~d ~#/ obMe b/ ~he oosd/Uons se~ forth ~here/n and on ~rm/t ~o cosstrucL 7e /coot/oD of we//~ odd cesspoo/s shown hereon ore om f;e/d observoUoas odd or from data obtained from others, ~Y AL~AU~ OR ADD/DON TO ~IS SURly IS A WOLADON ~ SECDON 7209 OF ~E NE~ ~K STA~ EDUGAU~ '~PT AS PER SECUON Y2Og-SUBDIW~ON Z AiL OEBDFICADONS 'FE~ A~ VAUD FOR THIS MAP AND COP/ES ~f~f~ ONLY IF ,ID MAP ~ C~/ES BEAR ~E IMPRESSED SEAL ~ ~E SU~YON IO~ S/GNA ~RE APPEARS HEREON. 'EA' 3, J02 SQ. FE =LA SEt TO DE LINES A=WETLAND FLAG CERTIFIED TO: DAVID C, PAGE BARBARA SHINN STEWART TITLE INSURANCE COMPANY ~) =DRY WELL [] ...... =PROPOSED CONTOUR_. SEPT. 5, 2006 (REVISIONS) OCT. 15, 2006 (REPLOT HSE.) DEC. 19, 2006 (FRENCH DRAIN, CONTOUR, FILL CALC,) OCT. 17, 2007 (REPLOT HSE.) OCT, 50, 2007 (DRYWELLS) SEPT, 11, 2008 (SPOT ELS) OCT. 6, 2008 (REViSiONS) APRIL 20, 2010 (CERTIF$CATIONS) OCT, 7, 2011 (,REPLOT HSE.) JUNE 1. 2012 (NEW SANITARY SYSTEM DESIGN) JUNE 15, 2012 (SANITARY REVISION) JULY 14. 2012 (NEW SANITARY SYSTEM DESIGN) AUGUST 17, 2012 (REVISED BUFFER DESCRIPTION) SURVEY OF PROPERTY A T BA YVIE~r TO ~rN OF SOUTHOLD SUFFOLK COUNTY, N. 1000- ?0-1Z'-$9.?, $CAL~: 1'--50' FEBRUARY 20, 2004 JANUARY 6, 2005 SEPTEMBER 9, 2005 (Loc. wetlond$ flags, revi$$ prop. hou$$, NOV. g, 2005 (REVISIONS) FEB, 2, 2006 (ADDITIONAL LATH) MARCH 22, 2006 (ADDITIONS) MAY 18, 2008 (REVISIONS) \ \ PROPOS'EO ~'~FIAC¢. DISPOSAL SYSTEM.(2 BEDROOMS) f¢/ ~'D£EP LEACHING POOLS WITH 3' SAND COLLAR BOTTOM OF LEACHING POOLS TO BE 2' ABOVE GROUND WATER APPROXIMATELY 152 cu. ff. OF FILL REQUIRED. SUBSURFACE SEWAGE DISPOSAL SYSTEM DESIGN BY: EDWARD ARMUS ENGINEERING 56 DEER RUN WATERMILL, NY 11976 /t~EOON/C ~SL)'t~'EYORS, P.C. (631) 765-5020 FAX (631) 765- P.O. BOX ..°,09 1230 TRAVELER STREET SOUmOLO, N,~ ~97~ U~--~ Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 3.815 DATE: _.S.epi. 2.8.,...1989 ISSUED TO .......~d.~d...f~rgus .................................................................. Pursuant to the provisions of Chapter 615 of the Laws of the State of New York 1.893 and Chapter 404 of the Laws of the State of New York 952, and ~e SoLthold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS:" and in accordance with the Resolution of The Board adopted at a meeting held on .$_e~1:. ?~8. 19...8.9. and ~n consideration of the sum of $ ......... paid by of .................................................... N. Y. and subject fo the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: To construct 4' X 20' fixed dock, 4' X 16' ramp, ~wo 6' X 16' floats, install 9 pilings on property located on R.O.W. off Nc~th Bayv~ew Road, Southold. all in accordance wlfh the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate S.e. al to be affixed, and these presents to be subscribed by a majority of the said Board as of this dat, e. TERMS and CONDITIONS- residing at 5 Haig Drive, Dix Hills, NY 11746 N.Y., as par of the consideration for the issuance of the Permit does understand and p~escribe to the fol- lowing: 1. That the said Board of Ttosteas and the Town of Southold are released from any ami aU damages, or claims for damages, of suits arising directly or indirectly as a result of any opea- aden performed pursuant to this permit, and the said permiircee will, ~t his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full llthility with respec~ thereto, to the complete exclusion of the Board of Trustees of the Town of Sou~old 2. That this Permk is valid for a period of ~ ~t mos. which is considered to be the earimared time required to complete the work involved, but should circumstances warrant, request for an exreuslon may be made to the Board at a later dat~ 3. That this Permit should be retained indefinitely, or as long as the said Permittea wish~ to maintain the structure or project involved, to provide evidence to anyone concerned that anth- orizadon was origimlly obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the origina 'ting application, may be cause fo~ revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work here~ authorized, or if, in the Opinion of the Board of Trustees, the work shall cause unreasonable obstructton to free navigation, the said Permlttee will be requi~ed~ upon due notice, to remove or alter this work or project herein stated without ex~ases to the Town of Southold. 8. That the said Board will be nodfied by the Permittee or the completion of the work auth- orized. 9. That the Permittea will obtain all other permits and consents dmt may be required sup- plemental re this permit which may be subject to revoke upon f~e to obtain sam~ TRUSTEES John M. Bredemeyer. 121I. President Albert J. Krupski. Jr.. Vice President Henry E Smith John B. Tuthill Will/am G. Albertson Telephone (516) 765-1892 Fax (516) 765-1823 December 22, 1993 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road RO. Box 1179 Southold. New York 11971 Edward Fergus 5 Haig Drive Dix Hills, NY 11746 RE: SCTM ~1000-70-12-39.3 Permit ~3815 Dear Mr. Fergus: The following action was taken by the Southold Town Board of Trustees on Tuesday, December 21, 1993: WHEREAS, the Board of Trustees have received concerns of possible navigation problems from neighbors, and WHEREAS, the current dock does not meet the requirement of not more than 1/3 the distance of the channel, It is RESOLVED that the Southold Town Board of Trustees require the catwalk to be moved landward eight feet (8~). If there are any further questions, please do not hesitate to contact this office. V0~hnMtruly yours, · Br President, Board of Trustees JMB: jmd cc: Eh-Consultants TRUSTEES '--~. John M. Bredemeyer, IH, President Albert J. Kmpsld. Jr. Vice President Henry P. Smith John B. Tuthill William G. Albenson Teleplmne (516) 765-1892 Fax (516) 765~1823 BOARD OF TOWN TRUSTEES TOV~2q OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS T~wn Hall 53095 Main Road P.O. Box 1179 Southold, New York October 23~ 1992 Roy L. Haje EnLConsultants, Inc~ 1329 North. Sea Road Southampton, ~f 11968 Re: Edward Fergus Permit ~3815 Dear Mr.. Haje The following action was taken by the Board of Trustees at their regular meeting of October 22, 1992: Resolved that the Southold Town Board of Trustees grant a one year extension for the construction of a dock to expire Sept. 28, 1993. This is the last extension on permit 93815. If you have ap~g questions please contact our office. yery truly yours~ ~ John M. Bredemeyer, Iii President, Board of Trustees Jl~:djh FRANK A. KUJAWSKI, JR- President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER. III JOHN L. BEDNOSKI, .IR. HENRY P. SMITH TELEPHONE (5161 765-1892 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Yown Hall, 53095 Main Road P.Q Box 728 Southold, New York 11971 June 23, 1989 To Whom It May concern: Attached hereto is a Short Environmental Assessment Form submitted by En Consultants on behalf of Edward Fergus for a wetland permit to construct a timber dock consisting of a 4'x20' fixed, Elevated (4' above grade of marsh) walk; 4' x 16' ramp; (2) 6' X 16' floats; house, deck, pool, and sanitary system on property located North Road, Southold. Posted: June 23, 1989 Frank A. Kujawski, Jr. President Board of Town Trustees FRANK A. ~(UJAWSKI, JR., President ALBERT Jl ~UPSKI, JR., Vice-President JOHN M. B~EDEMEYER, III JOHN L. BEDNOSKI, JR. TELEPHONE (516) 765-1892 Ma: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main P, oad P.O. Box 728 Southold, New York 11971 June 23, 1989 Chairman Town Censervation Advisory Council )ld Town Hall Road lld, New York 11971 De~ Holzapfel: ?ransmitted herewith is application No. 6-6-89-70-12-39.3 for a Permit submi=ted by En Consultants on behalf of Edward %f~lease prepare a written report of findings and recommendations wi~:~espect to this application. Very truly yours, Frank A. Kujawski, Jr. President Board of Town Trustees cc Dep't. TRUSTEES John iX& Bredemeyer, III, President Henry P. Smith, Vice President Albert J. Krups/d, Jr. John L. ~ Jr. John B. T~ithill 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 June 11, 1991 En-Consultants, Inc. 1329 North Sea Raod Southampton, NY 11968 RE: Edward Fergus Permit ~3815 Dear Mr. Haje: The following actions were taken by the Southold Town Board of Trustees on June 6, 1991: RESOLVED that the Southold Town Board of Trustees approve the request for an extension to permit ~3815 to expire on September 28, 1992. If you have any questions, please do not hesitate to contact this office. Very truly yours, John M. Bredemeyer, III President, Board of Trustees JMB:jmt FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, IH JOHN L. BEDNOSKI, JR. HENRY P. S~TH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 October 16, En Consultants 1329 North Sea Road Southampton, N.Y. 11968 1989' TELEPHONE (516) 765-1892 RE: SCTM 1000-70-12-39.3 Dear Mr. Haje: The Trustees reviewed your application submitted on behalf of Edward Fergus to construct a single family dwelling with associated sanitary system, deck and pool outside of 75' from wetlands on property located on Goose Creek, Southold, NY. After an on site inspection by the Board of Trustees it was determined that this project is out of Trustees jurisdiction. All other approvals that. may be applicable shouldbe secured prior to the commencement of the project. FAK:jas cc: Bldg. Dept. file Very truly yours, Frank A. Kujawski, Jr. President Board of Town Trustees FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI, JR. HENRY P. SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 October 10, 1989 En Consultants 1329 North Sea Road Southampton, N.Y. 11968 Re: Application No.6-6-89-70-12-39.3 Edward Fergus Dear Mr. Haje: The following action was taken by the Board of Town Trustees during their regular meeting held on September 28, 1989 regarding the above matter: WHEREAS, En Consultants on behalf of Edward Fergus applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 23, 1989 and, WHEREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a public hearing was held by the Town Trustees with respect to said application on September 28, 1989 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW, THEREFORE BE IT RESOLVED that En Consultants ON BEHALF OF Edward Fergus BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: Construct 4' x 20' fixed dock, 4' x 16' ramp, two 6' x 16' floats, install 9 pilings on property located on R.O.W. off North Bayview Rd., Southold, N.Y. ' ' ~ ......... This permit will expire two years from the date it is signed if work has not commenced by said date. Fees must be paid and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Permit will be issued upon payment of the following fees for work to be done below Mean High Water Mark: 4' x 14 catwalk $ 84.00 4' x 16' ramp 96.00 6' x 16' float 144.00 6' x 16' float 144.00 9 pilings 225.00 total fees $693.00 FAK: jas ce: Bldg. Dept. Conservation Advisory Council file Very truly yours,, Frank A. Kujawski, Jr. President Board of Town Trustees 765-!892 BO..%III) (IF I'OWN TRISTE[ TOWN OF SOUqrHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 APPLICATION IS HEREBY MJkDE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUAIqT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. APPLICANT'S NAME: Edward Fergus TEL. NO. 586-6095 MAILING ADDRESS: North Road, Southold, New York 11746 AGENT: En-Consultants, /nc. TEL NO. 283-6360 AGENT ADDRESS: 1329 North Sea Road, Southampton, New York 11968 PERMIT REQUESTED TO: SEE ATTACHED LOCATION OF PROPER~ FOR REQUESTED PERMIT: North Road, Southold HAMLET: Bayview TAX MAP NO: 1000- 70-12-39.3 CREEK, BAY OR HAP~BOR FRONTING PROPERTY: SIZE OF PROPOSED WORK: LENGTH: See project description. Goose Creek WIDTH: YDS..TO ~g EXCAVATED: 0 YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: Trucked in, dumped and graded 300 WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: 300+ DEPTH AT LOW TIDE: 2.5' AVER. RISE IN TIDE: 2.5' DISTANCE TO NEAREST CHANNEL: 100+' DISTANCE PROJECT EXTENDS BEYOND SIMIL~R PROJECTS IN AREA: AREA ZONING: Residence A IS PROJECT FOR PRIVATE OR BUS. USE: INTENDED USE OF PROPERTY: Residence DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: Site appears to have been used for spoil in the pas~. Private HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, ~OR DEPOSIT FILL ON SAID PREMISES: None known~- HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: No DESCRIBE FULLY THE REHABILITATION OF PROPERTY: None proposed. DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: N/A ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: None known. W/RITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: See aqtached. ' l, PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To De completed by AoDlicant or Project sponsor) 1~ APPLICANT/$PONSOe 2 PROJECT NAME Edward Fergus by En-Consultants, I~c. J3 PROJECT L~ ........ Munictoallly North Road, Southold Suffolk SEO 'h North Road, Southold $CTM 1000-70-12-39.3 [] Ex.anslo. 6..~CRIBE PROJECT BRIEFLY: See Attached 7. AMOUNT OF LAND AFFECTED: '~,"aH¥ 53,000 Sq, ~C~e~ UJlJmalo'. 53,000 sq.ft~e/~// 9. WHAT IS PRESENT LAND US;: tN ¥1CINIT~ OF PROJECT~ [] Agriculture DEC, COE, DOS ~. ODES ANY ASRECT OF THE ACTIOn4 HaVE A cuneENTL¥ VALID PEe~T O~ APPROVAL? [] Yes J~l~o II */es. I,st agency name and Del'mtllaooroval I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST CF MY KNOWLEDGE ~ ~E rgus: by Eh-Consultants, Inc. 6/16/89 Slgnalure' ~f~,} . ~ PA. ~S J_dE:~l'l L If the action is in {he Coastal Area, and you are a state agency, complete /he Coastal Assessment Form before proceeding with this assessment OVER 1 PROJECT DESCRIPTION Construct a timber dock consisting of a 4' x 20' fixed, elevated (4' above grade of marsh) walk; 4' x 16' ramp; (2) 6' x 16! floats. Owner also intends to construct a house, deck, pool, sanitary system, etc., all as shown on attached site plan. However, it is our belief that these are all in excess of 75' from water/wetland and, therefore, Trustees jurisdiction. Please confirm'by letter or process with request for dock should you disagree. COUNTY OF SUFFOLK STATE OF NEW YORK BEING DULY SWORN DEPOSES AND SAY~ THAT HE IS THE ;%PPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND T~tAT ~L~sTATEMENT$ CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THATWORKWILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANTAGR~ESTOHOLDTHETOWNOF SOUTHOLDANDTHE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN,COMPLETING THINS APPLICATION, I HEREBY AUTHORIZE: THE TRUSTEES, THEIR" AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS DAY O~ i9 NOTARY PUBLIC EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRM3%N COMPUTATION OF FEES Approved 2/27/85 No. Issued T Date -._~.~.~ THIS. NOTICE MUST BE DISP~¥ED DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 EDWARD T. FERGUS 5 Haig DriVe Dix Hills, NY 11746 April 3, 1990 Mr. Frank A. Kujawski, Jr. President Board of Town Trustees Town of Southold Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 Dear Mr. Kujawski, Jr.: Attached.is my check of $693.00 in payment of the fee due your office in connection with the dock permit covered in the attached october 10, 1989 correspondence from your office. Thank you. ETF:pd cc: En Consultants - c/o Mr. Sincerely, Roy Haje EN-CONSULTANTS, INC. 1329 NORTH SEA ROAD, SOUTHAMPTON, NEW YORK 11968 ENVIRONMENTAL SERVICES 516-283-6360 FAX NO. 516-283-6136 September 16, 1992 Board of Trustees Town of Southold 53095 Main Road Southold, New York 11971 RE: EDWARD FERGUS - Permit No. 3815 Dear Board Members: The above-referenced permit will expire on September 28, 1992. Due to various delay, work has not commenced on ~his project. We, therefore, request an extension of at least one year. Thank you for your anticipated cooperation. yetruly yours, RLH:KD ¢ i 8 199i TOWN OF,,SOUTHOLI EN-CONSULTANTS, INC. 1329 NORTH SEA ROAD, SOUTHAMPTON, NEW YORK 11968 ENVIRONMENTAL SERVICES 516-283~6360 FAX NO. 516-283-6136 April 24, 1991 Mr. John Bredemeyer Southold Town Trustees Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 RE: Edward Fergus Permit ~ 3815 Dear Mr. Bredemeyer: Due to financial constraints, Mr. Fergus will be unable to construct his dock before the above referenced permit expires on September 28, 1991. We respectfully ask for an amendment to the permit extending in for one year from its expiration (September 28, 1992). Thank you for your consideration. Yours truly, Roy Haj e President cc: Edward Fergus ~ 39 1C/.:~13. FF:OH EN~, CC L-- ,~l BF~[]~i ~ew Ye. rk State D~p~mont o~ Enwronmentat - Commissioner ~- r-- qua;]~y Review - SEQR) ~f the Envi~'¢. +'~ ,,,¢n~ , ,.,~men..~, Conservation LaW a~a 6 NYCRR /OL~r egency's jurisdiction in.%me action described below; anc l%u~ of concern which year-a~e'.~cy believes ~.,odld evatuate~. Enclosed ;~, a cop~ of the sermit ~o]icatior ~nc- ' a ¢_omp,~e~l-~ ~ Part =~ of Environmente' Pssessman~ Form t,o .... ' ~ in ' DEC Prqjec; Number: DEC Cunt~ct Perscn;~p¢..~L) ~ k~;,.,.A}:~-i DEC Position: -2- [] OaC nas no objection to ..... ~ y or ~-~+' ,.h~,s action, but we:.~a.ve, tSqe following ~ ~ .... ~ ~-=.- :n _~us for ' ' ~o,.~ ..... ~:rd,.g this pro3ect ,m~e ~,,~m~nts below). DEC .vishes ~-.. assume ~eae a~encv, status for. this action. The urosose~ action has oeen identifieo oy DEC as o:curring wholly or partially w~thin or substantially conci;uous co a critical environmental area (CEA) that was designated by -{~('¢~)!~ ~t is the ~osltion of this Department ~au ynur agency, if it has a j~r~s- ~ict~en eve~ the action, should assume ~ne lead agen:y role ~esed on existence o¢ the CEA and the fact that tee ~nticioa~ec imoacts are ¢rimaff!y of local significance [ ] Other. (See cmmmen~s below' ~esDoDSe: Please rssscnd so tqis reouess wisnin 33 zays of the date off ~n:s l&tter, response is received within 30 days, we wil~ assume that you nave no obOection no DEC o*anctner agency assum~n~ the ~oie of lead agency, and kave con:ments to offer ,~eg~rding the c, rooose~ action az this time. %ngn~ser~ve-as s~eed ag~~-~ ~ays~'~Ss- letter:- for th'i~, acti mq<'¢ ~ [ ] 4e V,,l!~pa~:t~on the Comm~ss!oner cf D~t~designat6 your agePcy as l eao~nresLl~IQng you Itave d[s.zussio~. 95-19-2 (1/85) ~ . APPLICATION FOR PERMIT ~ ARTIC~ 25 ~IOA~ WET~NDS Edwa:d Fer~us b~ Eh-Consultants, Inc. ~. N,~E AND TITL~ ?F OFFICIAL ~CN[NC APPL~ATION PHONE ' Roy L. ~a~e, PresiSent 516-283-6360 1329 Nor:th Sea Road ~ ~Fld~ ~TATE ZiP CODE Sout~pton N.Y. 11968 Edward 'F~r gus 516 -586-6095 STREET ~DR~SS/~ST OFFICE 5 ~aig D~i~e Dix Hills~ N.Y. 11746 North Raad, So thold Town Southold Goose Creek Suffolk ~ P~,c ~ com~e,da~ ASAP 1 year SEE ATTACHED ~ Dam ~ ExcavatJ~lFiJ] ~ Stream Disturbance ~ 5POES/NPDES ~ Water 5uppJy ~ L.E WeJJs ~ Freshwater WetJand LONG ISLAND TRAVELER-WATCH~N, Traveler Street, Southold, New York 11971 14 IS ANY PORTION OF THE ACTIVI~ FOR WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETED? herein a~ ag,~s to i~emni~y a~ ~ve ha,mless the State fr~m ~., ac~ns. ~a~ages and costs of eyeu nam and desc;iptio, resuJting from Rid project. ~ Roy L. %Haje, ~r~esiden~ --SEE REVERSE SID~-- INSTRUCTIONS 1. Prepare and submit four (4) copies of this application. Use typewriter or print clearly in ink. 2. Submit with the aDelication three copies of a drawing showing location and extent of work to be done. 3 Aepncatlons by counties, cities towns and villages shall be signed by the chief executive officer thereof or the head of the depar[ment or agency undertaking the proiect. 4. The appEcant may be required to publish a "Notice of Application" as provided by the Regional Permit Administrator. 5 If other~than:o~ner chak'es application, written consent of the owner r~Jst accom 0any application. 6 Ac(~ept~nc~ of'a oermit subiects permittee to restrictions, regulations or obligations stated in application and/or permit 7. If a public hearing rs necessary, the applicant may be required to furnish the names and addresses of ail adjacent landowners and all known claimants to water rights. 8. Applications for the construction. ,econstruction or repair of a earn o~ other impoundment structure must be accompanied by SuoDlement 0-1 9 Applications for a water supply 3ermit must be accompanied by Supplement W-~. special instrucbons on which SUPERCEDE certain of the above instructions. See "Water Supply" handbook. 10 Applications for a permit to apply a chemical to control or eliminate aquatic vegetation must be accompanied by Supplement A-1 A-2. or A 3 11 Ques[~on ~o. 12 Der[ams to prolec[s involving two or more aDDlicants. One tvoica[ example is a new subdivision requiring a Wetlands Perr~it for the developer, the proiect to be within a water district extension, requ~rm8 a Water SUODW Permit for tlne [own 12 Be sure to enclose proper application fee. noted accordingly in item '1£. see Part 621 Uniform Procedures Rules Rule 621.4 {If in doubt discuss with Regional Office before submitting application). 13. INCOMPLETE OR INACCURATE INFORMATION MAY DELAY PROCESSING! INFORMATION Application for permit to the New York State Department of Environmental Conservation is authorized by Environmen- tal Conservation LaW. Article 15 [Tide 3-Control of Aquatic Insects. Weeds or Undesirable Fish: Title S-Stream Protection. Title 1S-Water Supply). and Article 24 (Freshwater Wetlands) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION REGIONS ReB[on 6 (Su6.Office] State Office Building 207 Genessee Street, Utica. N.Y. 13501 Attn: Alternate Regional Permit Administratol (31S) 428~497 [716] 226-2466 Hi,torlc PI: p~, 'qYes EX, No -.tn~tan!iaH\ - Iguouh [o a site hsted on the Re~ dpr ot ~atJona Natural Landma'ks, '._2Yes ~No k,mi~ o~ ~:- ',~ater tabJe~5+ un feeL) over a nrm~ar~ 0tine ~a[. or sole source aquifer? ~Yes ~No fNhm~ , ~]~(,][ fi,hin~ cm)ortunities ~resentN ex~st in the orolect area? ~Yes ~No ~m ~o:~tmn any species ot giant or anim.fl lite that ~s ~dentified as threatened Or endangered? According to X"-" Describe nroDo<ed Drowcl site with slot)es i0-10% 100 9,~'~~) ~!0-15% % onnguous to or contain a Duuomg, site. or district listed on the 5tote or the National cliffs, ounes, other geological formations) ,- lrflmtarv a Name Goose ~k b. Size (In acres) 17 1~ m, site ~;(,rYpd n\ ,",~,,tin2 t)ub]ic utilities? ~,Ye'~ ~'TKNo >r '~',~ ECl an~ ,- NS; RR h17~ ~Yes 2No B. Project Description Prote~t ,lt'rpdgp ' t~, de~ulooee, _ . 45 acre~ mitiai],. . d5 ~cre, ulfimah,J~ Length ot mroie "" ...... N/A (If appropnate~ '' ....... ~-,,~,~- '- ' - ' ' arue~ ProPosed s~ructure ~_ he,gat; _ 42 ' w~dth _ 50 ~ length How much natural mamr~al :i.e rock. earth etc.) will be removed from the site? 3 Wd disturbed areas be reclaimed! [~Yes EJNo [3k'N!A a iT yes for what intended purpose is the site being reclaimed? ~ Nil] i~msoil h~. q~wl<~i[ec t~r r~clamation? ~Y~s ~No 4 How 7~anv acres of vegetationftrees, shrubs, ground covers will be removed from site? 5 tons/cubic , aros .35 acres Will an'. mature forest over 100 ,'ears old) or Diner Iocallvqm~ortant vegetation be removed bv this Droiect? 8 Wi masting occur during construction? []Yes o Nurn}mr nf ioh~ generated- during construction JO INun/bpr ol job, elimmdted [~v this ~)roject 0 . ~Yes X~.No 'singie phase Drolect ~,nbc~pated period of construction Ii multi-phased: ~/~ a lota numner of nnases anticipated b. Antlopated date ol commencement Dbase 1 c Aooroxlmare completion date of final Dbase d. Is Dbase I functional]v dependent o~ suosequent phases? ~No ;]2 ]_2 months fincluding demolition). E3Yes ~No atter nroiect ¢ complete Erolect require /e]ocation of any projects or facilitie~ L~Yes ~No If yes. explain I .i 12 I~ surface [iouid waste disoosal involved? ~Yes X~No a. t yes. indicate EVDe of ¥¥agte sewage industria, etc. and amount D. Name of water nde'- into which effluent will be discharged 13 Is subsurface liqmd waste disoosal in\7olved? XJYes ~No Type 14 Will surface area ot an ex,song water bod~ increase or decrease by proposal? Exphun ~Yes ~No 15 Is Dro~ect or any oorbon of 3roiect located in a 100 vear flood plain? ~Yes L~No Wil n,, i~r(nec~ generate solid waste? ~Yes L~No a. l~ yes what ~s the amount Der month _ 01 tons b. "ve~. will an existing solid waste facility be used? X~ es ~No c ve~. gwe name ~qcmt-hc~l d 'Pc~wn 1 ~nr~t:3 1 I location Putc*ho~ue o Will any wastes not go into a sewage disposal system or into a sanitark landfill? ~Yes e ~ Yeq. explain '~ Will me proiect involve the disposal ot solid waste? a If ves. wnat is the anticipated rate of disposal? b f yes. what ~s the antic Dated site life? 18. Will prolecr use herbicides or pesticides? ~Yes E;Yes X~Nc ~No 19 Will oromcr routine[', nroduceodors more than one hour Der day)? LqYes [~No 20 Wi protec~ 3roouce operating no~se exceeding me local ambient noise levels? ~Yes 21 Wil Drolect result n an increase In energy use? ~JYes {~No 24 Doe, nroi.~ct involve Local State or Federal funding? If ~,~,~ explain :l~No f ves. reD,care ~vDefs Oil and electricisy Total an~lcmamo waler usage per Day 300 ga[hms/dav gallons/minute ~No 4 ~25. Approvals Requirec~.~, ~*~' Submittal Date Type CitY. Town Village Boarc []Yes liNe ('ltv 1-own Village Planning Board ~!Yes --~No (-it~. County Health Deuarn'nent ~X:fes iNn Other [o¢al Agencies ~XYes E~No Other Reeiona/Agencles 2}Yes [~No State Agencies E~Yes ~No Federal Agencies ~IYes ~No -- - wetlands Section 10 COE 6/89 -- 8/89 6/89 C. Zoning and Planning Information I Does £)rooosed action involve a planning or zoning decision? ~Yes ~No H Ye*. indicate decision required: L zonmg amendment EJzoning variance ?special use permit E]subdivision new reviglon Ot ma~ter elan ~resource ma'nagement plan ~other ~]site plan What . the Zonln~ cla*~ification(s)of the site? ,Vhal is the maximum ootenna~ developmen[ of the site if devel 3pod as permitted by the present.z~ning? ~t What ,, the proposed zoning of the site? N/A R What i~ the maximum 3()tentla~ deve[opmen[ of the site i~ teveJoped as permitted by the proposed' zoning? (l) one-family dwell'lng 6 Is ihe :)roDosed action cons]stent with the recommended uses m adopted Inca land use plans? ~Yes E]No What are rne ')redommant land use(s) ann zoning classifications within a V~ mile radius of proposed action? one-family dwellings 8 Is the proposed action comnatible wit[" adioining surrounding land uses within a '~ mile? ~]Yes E]No 9 If the proposed action is the subdivision of /and. how man,. lots are proposed? N./A a What ~s the mm~mum lot site proposed? _ 10 Wilt uroposed action require any authorization(s} for the formation of sewer or w~ter districts? ~Yes ~]No 11 Wit the oronosed action create a demand for am community provided services (recreation education police, fire nrotectlon~? '~Yes F.~X'.~ o a If yes. s ex~stmg capacity sufficient to handle projected demand? FJYes E3No 12 Will rne :)rooosed action rest]it m the generation o[ traffic significantly above present levels? E3Yes ~]No a It yes. s the ex]sung road network aaequate to handle the additional traffic? []Yes E~No D. Informational Details Attach anv addJtiona nformation ]~ max be needed to clarifv xour oroiect. If there are or may ne any adverse ImDaCIS a*sociated with your nrooosa 3lease discuss suc? imnacts and the measures which vou propose to mitigate or E. Verification I cerht'. that the inform,4m/3n prov*asd above ms true to tne best of m~ knowledge &DoiicantSnonsor Name ~Oy ]~'./ ~Ia~e, En-Co~sultants, Zgc:. Date 7/19/87 If the action is in the Coastal Area, and you a~e a state.agency, complete the Coastal Assessment Form before procee~eg with this assessment. 5 '~ FART I~PROJECT INFORMATION , Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a signifi,;ant. on the environment. Please complete the entire form, Parts A through E, Answers to these questions will be consi as part'of the application roi approval and may be subject to further verification and public review. Provide any addi information you believe will be needed to complete Parts 2 and 3. It is expected tha~ 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 sc each instance, . . NAME OF ACTION LOCATION OF ACTION Ilnclu~le Street Address, Municipality and County) ~, ? :.Nor, th Road~ Southold NA~E .OF APPUCANTISPONSOR · R~y ~, Bale, President ADDRESS t32~:L~No~L~ Sea Road BUSINESS TELEPHONE (516) 283--6360 STATE ZIP CODE N.Y. 11968 t516~ ~ CITY/PO Dix~ Hills DESCRrPTION OF STATE ZIP CODE N.Y. 11746 SEE ATTACHED Please Complete Each Question--indicate N.A. if not applicable A. Site Description Physical setting of overall prolec[, both develoned and undeveloDeo areas 1. Present land use: [:]Urban E~lndustrlai [:]Forest [~Agriculture 2. Total acreage of project area: 1.5--+ acres APPROXIMATE ACREAGE Meadow or grushland [Non-agricultural) Forested Agricultural (Includes orchards, cropland, pas(ute, etc.} Wetland (Freshwater or tidal as Der Articles 24. 25 of ECL} Water Surface Area Unvegetated (Rock. earth or tdI) Roads. buildings aha other paved surfaces Other [Indicate type) Landscaping E]Other Sand ~Restdenuai suburban) ~Rura) mon-t PRESENTLY AFTER CO.MPLETIO; 1 · 5 acres 1.3 acre acres _ acr~ [~Well drained 90 _ % of ~.~te a. Soil drainage: ~XPoorl,. drained 2 o~ ol site ~Moderatelv ,.'..ell drained 8 ?G o~ s,te ~. A:pprax~mate percentage or proposed prolect site with slopes: ~:0-i0% 100 __ % .~10-15% ~q15% or greater 6. ts project substanlmJJy coati~uous to. or con,am a building, s~[e. o~ district, lisled on ~he Stale or the Re'~iste~ of Historic Places? ~Yes ~No 7. ls Prolcc[ subs~anti~Ilv conuguous [o a s~te h~ted on rile Re~ster ot National Natural Landmarks? ~Yes & What is the depth ot ~he water table~ 5 _ (in ~eet~ 9. Is site located over a pnmaw, principal, ot sole source a~uifer? ~Yes 10 Do hunting, fishJn~ o~ shell fishing opportunme~ pre~enHy ex~st m the prolect area? ~Yes 11. Does project site contain any species o~ plant or animal life that is identified as threatened or endangere, ~Yes ~o According to Identify each species . . 12. Are there any unique or unusual land forms on the prolect site? [i.e., cliffs· dunes, other geological formati~ ~o Describe 13. Is the project site presently used by the community or neighborhood as an open space or recreation are~ ~Yes ]~lNo If yes. explain 14 Does the present site include scenic views know~ to be important to the commumty? I~Yes ~rlNo 15 Streams within or contiguous to project area: a. Name of Stream and name or River to wmcn it ~s tr[Dutar, a. Name GOOSe Creek 17 Is the s,te served by ~xisting public utilitms? [~Yes 12~No a) If Yes, does sufficient capacity exist to allow connecbon~ b) If Yes. wilt imorovements be necessary to allow connection? b. Size tin acres) f-lyes I-tNo ~Yes ~No I;~. Is the s~te located m an agricultural district certified pursuan~ to Agriculture and Markets La~v. Article Section 303 and 304;~ ~Yes [~No of ne ECL ano 6 NYCRR 6177 [~'Yes ~No 20 Has the s~te ever been used for the disposal ot sohd or hazardous wastesZ [~Yes B. Project Description I. Physical dimensions and scale of project (fill in dimensions as appropriate) 1.5 a Total cont~ ~'uous acreage owned or controlled bY prolect sponsor .2 b Prol ~'ct acrea~:e to be developed: .2 acres initially. c. Project acreage io remain undeveloped ~. 3 acres o Lengtb of prolect, m m~les: Jif appropriate) e. I~ the prolect is an exoans~on, indicate percent of expansion proi]osed -- f Number o[ olt-stree[ parkirl~ spaces ex~st~ng 0 3 mual~. 1 Ulumatulv 1 L Dimensions hn teed of la,Rest proposed structure 35 height; 30 w~dth: j. Linear feet ot frontage along a public thoroughfare prolect wdl occupy i~? -~ · proposed (upon comple[~on ot prolect}? 5O length ft. 3 How moth natural mater~al li.e,, rock, earth, etc.} will be removed from the site? _ 0 Wa disturbed areas be reclaimed a. Il: yes, for what intend...~ purpose is the ~ite being reclaimed? b. Wilt topsoil be stockpiled for reclamation? OYes [~No c. Wdt upper subsoil be stocl~ piled for reclamation./ ~Yes 4. How many a'cres of vegetation (trees. shrubs, ground covers) will be removed from site? ~_.~_ acres 5. W'it! any ma~ure forest {over 100 years old~ or other locally-important vegetation be removed by this project? ~Yes ~]No ' - 6. if single phase protect: Anticipated period of construction 8 months. [including demolition). If multi-phased: a. Total number of. phases anticipated: N/A b. ^nticipated date of commencement phase 1 c. ^pproximate completio, n date of final phase fnumbe4. , month year. (including demolition. month . year. %¥ill project require relocation of any projects or facilities? ~. Is phase t functionally dependent on subsequent phases? I~¥es 8. Will blasting occur during construction?, l-lYes [~No 9. Number Of jobs generated: during construction ]-2 ; after project is complete 0 10. Number of jobs eliminated by this project 0 11. ~Yes ~No If yes, explain 12. ls surface i~quid waste disposal invoJved~ E]Yes [~No a tf ves. indicate type of waste (sewage. industrial, etc.) and amount b. Name of water body into which effluent will be discharge~ 13, Is subsurface liquid waste disposal involved? I~Yes {2]No Type . Sewaqe 14. Will surface area of an existing water body increase or decrease by proposal? E3Yes Explain 3;3No 15. Is prolect or any portion of pro{cc[ located in a 100 year flood Blain? I~Yes [~No 16 Will the protect generate solid waste? ~Yes ~No a If yes, what is the amou~qt per month . ] tons b f yes, wi[[ an ex~stmg solid waste facility be used? [~Yes ~No c. If yes, give name _~outhold ~a~dt:J_ll location d. Will any wastes not go into a sewage disposal system or into a samtary landfill? e. If Yes, explain 17¸ Mattituck OYes Will the pro{eot involve the disposal of solid waste? a. If yes. what is the anuc~pated rate of disposal? b. Ii yes, what ~s the anuc~ateo site life? WilJ prolect use herb~mdes or pesticides? ~]Yes [~]Yes [~o . tonsimomh. years. 18. 19. Wi prolect routinely produce odors (more than one hour {],er day)? I-lYes [~No 20. Will prolec[ produce operadng noise exceeding the local ambient no,se levels? OYes 21. %Viii prolect result ~n an increase tn energy use? ~Yes ~No If yes . indicate tyne(s} Domestic oi-1 and electricity ~No 22 Il water suppl/ ,s from wells, indicate pumping capacity 3 23 Total anuopateo water usage per day__ 300 g,~llons/day 24. Does project revolve Local. State or Federal funding? C]Yes If Yes. expla,n gallons/m:nute. ~No 4 23.',A ppro,,,ais Required: Submltt~ Type Date i Cit¥~ Town. Village Board f-lYes E]No City. Tow~ {tillage Planning 13card ~Yes J~]No City_ Town Zoning Board [~]Yes inn City, County Health Deparrment ~][Yes E]No Other Local Agencies []Yes ~No Other Regional Agencies E]Yes .r"lNo State Agencies [~Yes i'-INo Federal Agencies [~es ENo SCDH, .Sanitary system 6/89 DEC TW 6/89 COE, Section l0 6/89 C. Zoning and Planning Information 1. Does proposed action involve a planning or zomng decision? C]Yes ~No ~'f Yes, indicate decision required: E]zoning amendment r'lzoning variance E]special use permit Elsubdivision E]site plan C]new/revision of master: plan C]resource management plan I-Iother 2 What is the zoning ctassification(s]of the site? Residence A 3. What is the maximum potential development Of the site if developed as permitted by the present zo0ing? One hou se 4 What is the 3roposed zoning of the site? N/A $. What is the maximum .3otential development of the site ; oevelc bed as permitted by the Droposeo zoning? N/A 6. Is the proposed action ~onsistent with the record mended uses m adonted local land use plans? ~. What are the predominant land use{s) and zoning classifications within a % mile radius of proposed action? Residence 8 Is the proposed action compatible with adjoining/surrounding land uses w~th,n a '/, mile~ 9 F toe [~ro~osea acNon s the subdwis~on or Jane now man~ {ors are proposed? a. What ~s toe m,mmum Jot size proposed? 10 Will prooosed action require any authorization{s) for the formation of sewer or water districts? ,-~Yes 11 Will the proposed achon create a demand for any commumty provided services [recreation. education, polk fire protection)? [~]Yes ~]No a. If yes, is existing capacity sufficient to handle prolected demand? r-lYes ~No 12 Will the proposed action result in the generation of traffic significantly above present levels) ~]Yes a. If yes, is the existing road network adequate to handle the additional traffic? ~]Yes C]No D. Informational Details o Attach any additional informauon as ma,,, be needed to clarify your prolect. If there are or m%v be any adver avoid them. E. Verification certify that the ,nformauon prow<h_,(l ,~bow~ ~s true to the best ot mvknowled~e Apphcant;Sponsor Name Edward Fergus by En-Consultants,Zncj Date 6/1%89 Signature Title President Roy L. Hale If the action is in the CoaslaJ Area, and ~ou are a stale agency, complete lite Coastal Assessment Form before proceedin wilh this assessment. ~) WH(IM IT MAY I 'authori~ze En-Oo~ultants, Inc. to apply for 'SU~#bLI~Cb. H~LTH DEPT. APPROV'AL H S. 'NO, : THE W A~E SYSTEMS FOR THIS, R'E~ID~ NeE ' CO DEPT ~ HEALT:H SERVICEs SuF~OLK ' SUFFOLK ~0, TAX ~AP DESI~ATIDN: ·EST HOLE )