HomeMy WebLinkAboutTR-99-3-1 TRUSTEES
John M. Bredemeyer, III. President
Albert J. Krupski. Jr.. Vice President
Henry E 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
COASTAL EROSION MANAGEMENT PERMIT
Permit Number: 99-3-1
Name of Applicant/Agent:
Name of Permittee: Virginia Meyran
Address of Permittee: 175 Soundview Avenue, Mattituck
Property Located: same
DESCRIPTION OF ACTIVITY: to construct 106 1.f. of timber
retaining wall plus 20' return on w/s. the e/s wall will connect
to adjacent bulkhead. Approx. 375 c.y. of clean sand will be
trucked in via Bailie Beach Road to west. A 3' wide stairway
from west of bluff to beach will be repaired/replaced as
appropriate.
Date of permit issuance: June 24, 1993
This permit is valid for a period of two years from the date of
issuance.
SPECIAL CONDITIONS:
NA Bluff restoration through a re-vegetation agreement is
attached hereto and is a necessary special condition of this
permit.
NA A relocation agreement is attached hereto and is a
necessary special condition of this permit.
NA A maintenance agreement is attached hereto andis a
necessary special condition of this permit.
John M. ~redemeyer, III
President, Board of Trustees
Board Of $outhold' Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 4198
DATE: ....~-ne Z-~.~..~:993
ISSUED TO
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of the
State of New York 1952: and the Soufhold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, ~=RAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with +he
Resolution of The Board adopted at a meeting held on 2June ~
19. 9.3., and in consideration of the sum of $.. !SQl.0.0. paid by
En-Consultants. pn behalf of V. Me~f.'~g: .............................
of N.Y. and subiec+ to the
Terms and Conditions listed on the reverse side hereof,
of Soufhold Town Trus'~ees authorizes and permits the following:
~o construct 106 l.f, of timber retaining wall plus 20' return
on w/s. the e/s wall ~ill connect to adjacent bulkhead. Approx.
375 c.¥, of cleand sand will be trucked in. 3' wide stairway
from west of bluff to beach will be repaired/replaced as approp.
ail in accordance with the detalJed specifications as presented in
the originating appJication.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes ifs Corporate Seal to be affixed, and these presents
be subscribed by a majority of said Bo. gs~eL, as
TRUSTEES
John M. Bredemeyer. III. President
Albert J. Krupski. Jr.. Vice President
Henry P. Smith
John B. Tu/hill
William G. Albertson
Telephone (5t6) 765-1892
Fax I516) 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 30, 1993
Eh-COnsultants, Inc.
1329 North Sea Road
southampton, NY 11968
Re: Virginia Meyran
sCTM g1000-99-3-1
Dear Mr. Haje:
The following action was taken by the Board of Town Trustees during
its regular meeting held on Thursday, June 24, 1993 regarding the
above matter:
wHEREAS, Roy Haje on behalf of Virginia Meyran applied to the
Southold Town Trustees for a permit under the provisions of the
Wetland Ordinance of the Town of southold, application dated April
26, 1993 and,
application was referred to the Southold Town
wHEREAS said
Conservation Advisory Council for their findings and recommendations,
respecu
and,
WHEREAS, a public hearing was held by the Town Trustees with
to said application on Thursday, June 24, 1993 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 the Board of Trustees approves the application of
Eh-COnsultantS on behalf of Virginia Meyran to construct 106 1.f.
of timber retaining wall pluS 20' return on w/s. The e/S wall will
connect to adjacent bulkhead. Approx. 375 c.y. of clean sand will
be trucked in via Bailie Beach Road to west. A 3' wide stairway
from west of bluff to beach will be repaired/replaced as appropriate.
permit will expire two years from the date it is signed. Fees must
be paid, if a::licable 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.
Permit will be issued upon payment of the following fees for work to
be done below Mean High Water Mark:
No fees
Very truly yours,
John M. Bredemeyer, III
President, Board of Trustee
JMB:jd
Page 6
source via Anderegg parcel. Replace 3' wide stairway form top of
bluff to beach.
The CAC recommends approval provided the work is done in kind and
in place and not placed in front of the existing bulkhead.
Nassau Point Road, Cutchogue
Vote of Council: Ayes: All
Motion carried.
Moved by Patricia Isaksen, seconded by John Holzapfel. it was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
of Wet~and Application of THOMAS P. LOSEE. SR. 118-4-2 to
remove and replace {in same location and configuration) 100 I.f. of
retaining wall and 3~ wide stairway. Approximately 200 c.y. of clean
fill will be trucking in from areas upland.
7425 Nassau Point Road. Cutchogue
Vote of Council: Ayes: All
Motion carried.
Moved by Patricia Isaksen, seconded by John Holzapfel. it was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
of the Wetland Application of JOHN TOBIN 118-4-3 to remove and
replace (in same location and configuration} 100 .f. of retaining
wall and 3' wide stairway. Approximately 200 c.y. of clean fill will
be trucked in from areas upland.
7525 Nassau Point Road. Cutchogue
Vote of Council: Ayes: All
Motion carried.
Moved by Stephen Angell, seconded by Bruce Loucka, it was
RESOLVED to recommend to the Southold Town Trustees
DISAPPROVAL of the Wetland Application of VIRGINIA MEYRAN
99-3-1 to construct 1(16 l.f. of limber retaining wall plus 20'
return on west side. On east side. wall will connect to adjacent
bulkhead. Approximately 375 c.y. of clean sand wilt be trucked in
via Bailie Beach Road to west. A 3' wide stairway from west of bluff
to beach will be repaired/replaced as appropriate.
The Council recommends disapproval because the retaining
wall/bulkhead is not warranted. Also there is no established policy
concerning the bulkheading of property along the Long Island Sound.
the long range effect on the Sound must be considered.
The Council approves the repair of the stairs.
175 Soundview Avenue. Mattituck
Vote of Council: Ayes: All
Motion carried.
lohn M. Bredemeyer, m~ p~.. ident
I4,nry P. Smith, Vice President
Albert I. K_mpski, Sr.,
lohn B. Tuthill
Telephone (5 I6) 765-1892 BOARD OF TO~VN T~v-JST]~ES
Fax ($16) 765-1823 TOWN OF SOUTHOLD
SUPI~RVISOR
SCOTT L. HARRIS
TownHall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
COASTAL EROSION MANAGE~m~T PERMIT APPLICATION
TOWN WETLANDS PERMIT APPLICATION
TRUSTEE LANDS PERMIT APPLICATION
/eO:i l Office
Erosion Permit Application
Permit ApplicatiOn
~rustee Lands Permit Application
~Grandfather
Completed Apps. Date :' ~ 1%%1~3 ~,,L
~ariance Re~ired, ~
~eig~ors notified Date:
SEQ~ ~e ~
~Coord. Revlew opt.,m~d.
~ SEQ~ Dete~n./date. ~/~
P~lic Hearing/date: ~
- ~ Findings:
Permit Vote: ~N): ~
Special Conditions:
( also see file )
OWN OF SOUTHOLD
Application Numbe~ SCTM %1000-99-3-1
Project ~aro. e (If any)
Date Prepared: ~April 16, 1993
Applicant: EN~CONSULTANTS, INC.
Address: 1329 North sea. Road,
SouthamPton. NY 1196R Phone ~]6 ) 2~3-6368
Interest: (owner, consultant,lessee,etc.) Consultant
Owner of Property: VIRGINIA MEYRAN
Address 175 Soundview Avenue
Mattituck, NY
Subject Property Location:
(Proviae LILCO Pole
location map)
11952 Phone 516 ) 298-5139
175 Soundview Avenue
Mattituck~ NY 11952
Distance to cross Streets if not on
THIS IS NOT A PERMIT
Yds. to be excavated: 0 Yds. to be filled: 375 cy__
Manner in which material will be removed or deposited:
_ Trucked in, dumped &qraded
Width of canal, creek or bay fronting property: 15 miles
Depth at low tide: 0 Aver. rise in tide: 2'-6"
Distance to nearest channel: N/A Distance project
extends beyond similar projects in area: N/A
Area zoning: R-40 Land area in acres: 1.13
Is projeet for private or business use: private
Intended use of property: no change
Describe known prior operations conducted on premises:
-- None known
Has any prior license or permit been issued to erect .structures,
dredges or deposit fill on said premises: Unknown
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).
See attached
Authorization (Where the applicant is not the owner)
I VIRGINIA MEYRAN residing at 175 Soundview Avenue
(Print-owner of subject property)-- (M~g address-phone)
Mattituck, NY 11952
~o hereby authorize En-cnn~,]]~nts. Inc. to apply for
Coastal EroSion per~it(s) from the So~thold Town Trustees
~ Signature ~
THIS IS NOT A PERMIT
County of Suffolk')
State of New York )
ROY L. ~AJE
BEING DULY SWORN DEPOSES AND
AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED
PERMIT(S) AND THAT ALL STATEMENTS CONTAINED h~IN ARE TRUE TO
THE BEST OF HIS/~RR KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE
DONE IN THE FiA1TNER 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 ANY 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 REPRESEnTATIVE(s), TO F/gTEK ONTO MY PROPERTY
TO INSPECT TEE PREMISES IN CONJUNCTION WITH REVIEW OF THIS
APPLICATION.
swoRN To BEFO THIS OF
~p~. - - ~ KAY M, ~UOH~R~
~ [ ': U NOTARY PUBLIC, St~ of New York
~ No. 01~q~1, Suffotk Oou~
Suggested space for location Map
· £nIS IS NOT'A PERMIT
TRUSTEES
John M. Bmdemeyer, 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
SUPERVISOR
SCOTT L. HARRIS
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
30 year Maintenance Agreement
Erosion Protection Structures
Chapter 37 Southold Town Code
- S, outholcl~Trustees as Administrator
type or print name (s)
the owners of record of property at: /7~%/~Jc/~y
(type or print-~reet address) SCTM 1000-
in applying for a Coastal Erosion permit for an Erosion
Protection StruCture do hereby agree to a 30 !~ear maintenance
program for a structure commonly known as a
of / 0 p as shown on the attached
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
emergency situation's which would seriously endanger life,
property and important coastal natural resource features such as
bluffs or wetlands. We further understand that failure to
maintain the structure could result in a requirement to post a
bond and or have the repairs ordered as a lien against the
preperty upon a finding by the Trustees that said lack of
maintenance would risk life, property or important natural
resources features including protected, rare or threatened
animals and plants.
Notarized Signature ~f owner of record
SWORN TO BEFORE ME THIS
NOTARY PUBLEC
i,~.ANIE V.
N~. 4908712
Commission Expires Ocl. 19,19~
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.
!' ~t " ' ~ ~'" ' ' ~
~'~ I C ~ ~'t~ - -~' --~
/A I~
/
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SULTA ? ~
-I
EN-CONSULTANTS IN(:;.
1329 NORTH SEA RD,
SOUTHAMPTON N, ¥. 11968
516-283-63,80
,e4(2167)—Tbxt 12
PROJECT I.D.NUMBER 61 SEAR
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only w,
PART I—PROJECT INFORMATION (To be completed by, Applicant or Project sponsor)
1. APPLICANT/SPONSOR2. PROJECT NAME
VIRGINIA MEYRAN by En-Consultant
3. PROJECT LOCATION:
Municipality Town of Southold County Suffolk
4. PRECISE LOCATION(Street address and road Intersections,prominent landmarks,etc.,or provide map)
175 Soundview Avenue
Mattituck, NY
SCTM: 1000-99-3-1
5. IS PROPOSED ACTION:
❑New ❑Expansion ❑Modlficationlalteration
6. DESCRIBE PROJECT BRIEFLY:
SEE PROJECT DESCRIPTION
7. AMOUNT OF LAND AFFECTED: ,
Initially acres Ultimately acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
l_TYea ❑No If No,describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
Residential ❑Industrial ❑Commercial ❑A riculture
Describe g ParklForeat/Open space ❑Other
10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL,
STATE OR LOCAL)?
®Yes ❑No If yes, list agency(s)and permit/approvals
DEC, DOS, COE
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? 44 1
❑Yea 9No If yes,flat agency name and permit/approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
C1 Yes 'U No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
VIRGINIA MEYRAN by En-Consultants
Applicant/sponsor name: Date: APri 1 19;, 1 9 3
Signature:
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
14-16-2 (2/87)-7c
617.21 SEAR
Appendix A
State Environmental Quality Review
FULL ENVIRONMENTAL ASSESSMENT FORM
Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project.
or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent-
ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine
significance may have little or no formal knowledge of the environment or may be technically expert in environmental
analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting
the question of significance.
The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination
process has been orderly, comprehensive in nature,yet flexible to allow introduction of information to fit a projector action.
Full EAF Components: The full EAF is comprised of three parts:
Part 1: Provides objective data and information about a given project and its site. By identifying basic project
data, it assists a reviewer in the analysis that takes place in Parts 2 and 3.
Part 2: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides
guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially-
large impact. The form also identifies whether an impact can be mitigated or reduced.
Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the
impact is actually important.
DETERMINATION OF SIGNIFICANCE—Type 1 and Unlisted Actions
Identify the Portions of EAF completed for this project: ❑ Part 1 ❑ Part 2 ❑Part 3
Upon review of the information recorded on this EAF(Parts 1 and 2 and 3 if appropriate), and any other supporting
information, and considering both the magitude and importance of each 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 declaration will be prepared.
❑ B. Although the project could have a significant effect on the environment, there will not 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.*
❑ C. The project may result in one or more large and important impacts that may have a significant impact
on the environment, therefore a positive declaration will be prepared.
* A Conditioned Negative Declaration is only valid for Unlisted Actions
to
Name of Action
Name of Lead Agency
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from responsible officer)
Date
1
PART 1—PROJECT INFORMV_:()N
Prepared by Project Sponsor
NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect
on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered
as part of the application for approval and may be subject to further verification and public review. Provide any additional
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 involve
new studies, research or investigation. If information requiring such additional work is unavailable,so indicate and specify
each instance.
NAME OF ACTION
LOCATION OF ACTION(Include Street Address, Municipality and County)
NAME OF APPLICANTISPONSOR ,,o BUSINESS TELEPHONE
:�'rANIS INC.
ADDRESS °•ifs
�-:_�.,�itS7-?`dP�I NV. 11468CITY/PO ,_., STATE ZIP CODE
283-6360
NAME OF OWNER If different)� BUSINESS TELEPHONE► r !tii 4 W���i�w c ra-i� (Slee, ) o2S�r57/3
ADDRESS
CITY/PO STATE ZIP CODE
DESCRIPTION OF ACTION
Construct 106 l.f. of timber retaining wall plus 201
return on w/s. on e/s wall will connect to adjacent
bulkhead. Approximately 375 cy of clean sand will be
trucked in via Bailie Beach Road to west. A 3' wide
stairway from west of bluff to beach will be repaired/
replaced as appropriate. Project is necessitated by
damage caused by 12/11/92 storm.
Please Complete Each Question—Indicate N.A. if not applicable
A. Site Description
Physical setting of overall project, both developed and undeveloped areas.
1. Present land use: ❑Urban ❑Industrial ❑Commercial 5IResidential (suburban) ❑Rural (non-farm)
❑Forest ❑Agriculture ❑Other
2. Total acreage of project area: ;L acres.
APPROXIMATE ACREAGE ,PRESENTLY AFTER QQMPLETION
Meadow or Brushland (Non-agricultural) �5 acres y 4 Acres
Forested acres acres
Agricultural (Includes orchards, cropland, pasture, etc.) acres acres
Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres
Water Surface Area acres acres
Unvegetated (Rock, earth or fill) • 3 _ acres acres
Roads, buildings and other paved surfaces '�5 acres .b S� acres
Other (Indicate type) 4"0,0 s`q Yy acres `EG acres
3. What is predominant soil type(s) on project site?
a. Soil drainage: ®Well drained d % of site []Moderately well drained % of site
❑Poorly drained % of site
b. If any agricultural land is involved how many acres of soil are classified within soil group 1 through 4 of the NYS
Land Classification System? Ni/+ acres. (See 1 NYCRR 370).
4. Are there bedrock outcroppings on project site, ❑Yes ❑No
a. What is depth to bedrock? 'Y'60f (in feet)
2
5. Approximate percentage of prc,, -A project site with slopes: (n0-10% S� % 12110-15% a %
1615% or greater o? r %
6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National
Registers of Historic Places? ❑Yes 13f4
7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? ❑Yes JE1No
8. What is the depth of the water table? 3 (in feet) r ��-►Grk 5�f`c�
9. Is site located over a primary, principal, or sole source aquifer? G6Yes ❑No
10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? ®Yes ❑No
11. Does project site contain any species of-pl t or animal Life that is identified as threatened or endangered?
❑Yes ErNo According to
- Identify each species
12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations)
EVYes ❑No Describe Eli 1CP
13. Is the project site presently used by the co unity 9righborhood as an open space or recreation area?
4Yes ❑No If yes, explain QT<et �rd7i r
14. , Does the present site include scenic views known to be important to the community?
MYes ❑No
15. Streams within or contiguous to project area:
a. Name of Stream and name of River to which it is tributary
16. Lakes, ponds, wetland are s with in,or4onti pus to,pr ject area:
a. Name �Dij 5 �`' Z aA4/' "' b. Size (In acres)
17. Is the site served by existing public utilities? ❑Yes 710
a) If Yes, does sufficient capacity exist to allow connection? ❑Yes ❑No
b) If Yes, will improvements be necessary to allow connection? []Yes ❑No
18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA,
Section 303 and 304? []Yes E�SNo
19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8
of the ECL, and 6 NYCRR 617? ®Yes ONO
20. Has the site ever been used for the disposal of solid or hazardous wastes? ❑Yes [Tlo
B. Project Description
1. Physical dimensions and scale of project (fill in dimensions as appropriate) t
a. Total contiguous acreage owned or con rolled by project sponsor ,' acres.
b. Project acreage to be developed:�G 11 C acres initially; acres ultimately.
C. Project acreage to remain undeveloped N, ti"S C acres.
d. Length of project, in miles: K 1/1 (If appropriate)
e. If the project is an expansion, indicate percent of expansion proposed /y � %;
f. Number of off-street parking spaces existing,49> C-40t`' e : proposed
g. Maximum vehicular trips generated per hour Ao (upon completion of project)?
h. If residential: Number and type of housing units:
One Family Two Family Multiple Family Condominium
Initially K/A
Ultimately
i. Dimensions (in feet) of largest proposed structure height; r' width; 16'� length.
j. Linear feet of frontage along a public thoroughfare project will occupy is? N 01 ft.
3
i
2. How much natural material ( rock, earth, etc.) will be removed iron_,.__.'? site? tons/cubic yards
3. Will disturbed areas be reclaimed? Dyes ❑No IN/A
a. If yes, for what intended purpose is the site being reclaimed?
b. Will topsoil 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 site? acres.
5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project?
Dyes tbNo
6. If single phase project: Anticipated period of construction months, (including demolition).
7. If multi-phased: N M
a. Total number of phases anticipated (number).
b. Anticipated date of commencement phase 1 month year, (including demolition).
c. Approximate completion date of final phase month year.
d. Is phase 1 functionally dependent on subsequent phases? ❑Yes ❑No
8. Will blasting occur during construction? ❑Yes MNo
9. Number of jobs generated: during construction ; after project is completed
10."Number of jobs eliminated by this project
11. Will project require relocation of any projects or facilities? ❑Yes )JNo If yes, explain
12. Is surface liquid waste disposal involved? ❑Yes E�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 EpNo Type
14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes TONo
Explain
15. Is project or any portion of project located in a 100 year flood plain? InYes ❑No
16. Will the project generate solid waste? Dyes 7No
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? ❑Yes ❑No
e. If Yes, explain
17. Will the project involve the disposal of solid waste? Dyes 17�40 i
a. If yes, what is the anticipated rate of disposal? tons/month.
b. If yes, what is the anticipated site life? years.
18. Will project use herbicides or pesticides? Dyes rNo
19. Will project routinely produce odors (more than one hour per day)? ❑Yes I$No
20. Will project produce operating noise exceeding the local ambient noise levels? Dyes XNo
21. Will project result in an increase in energy use? ❑Yes JNo
If yes , indicate type(s)
22. If water supply is from wells, indicate pumping capacity gallons/minute.
23. Total anticipated water usage per day �Ifllq gallons/day.
24. Does project involve Local, State or Federal funding? ❑Yes rNo
If Yes, explain
4
25. Approvals Required: Submittal
Type Date
City, Town, Village Board []Yes ❑No
City, Town, Village Planning Board []Yes ❑No
City, Town Zoning Board Dyes []No
City, County Health Department ❑Yes. El No _
Other Local Agencies ]Yes []No �YI ��'`ts �S «/y� z//5 3
Other Regional Agencies []Yes ❑No
State Agencies OYes O No 'C-C Art oZ(^ Y 3
-Federal Agencies ❑Yes ❑No
C. Zoning and Planning Information
1 . Does proposed action involve a planning or zoning decision? ®Yes ❑No
If Yes, indicate decision required:
❑zoning amendment ❑zoning variance ❑special use permit ❑subdivision ❑site plan
❑new/revision of master plan ❑resource management plan ❑other
2. What is the zoning classification(s)of the site? R-qd
3. What is the maximum potential evelopment of the site if develgped as permitted by the present zoning?
b o A"C 1C:�cth,r' d C--//.7
4. What is the proposed zoning of the site? IV/A
5. What is the maximum potential development of the site if developed as permitted by the proposed zoning?
A t/}
6. Is the proposed action consistent with the recommended uses in adopted local land use plans? BTLes ❑No
7. What are the predominantnd use(s) and zoning classifications within a 1/. mile radius of proposed action?
0- 'Vv 0C—a1'S.
8 Is the proposed action compatible with adjoining/surrounding land uses within a 1/s mile? ®Yes ❑No
9. If the proposed action is the subdivision of land, how many lots are proposed?
a. What is the minimum lot size proposed?
10. Will proposed action require any authorization(s) for the formation of sewer or water districts? ❑Yes C1l0
11 . Will the proposed action create a demand for any community provided services (recreation, education, police,
fire protection)? 13 Yes JNo
a. If yes, is existing capacity sufficient to handle projected demand? ❑Yes ❑No { 4
12. Will the proposed action result in the generation of traffic significantly above present levels? ❑Yes P�Io
a. If yes, is the existing road network adequate to handle the additional traffic? ❑Yes ❑No
D. Informational Details
Attach any additional information as may be needed to clarify your project. If there are or may be any adverse
impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or
avoid them.
E. Verification
I certify that th informa 'o provided above is true to the best of my knowledge.
Applicant/Sponso me V 4 Date y/Y
Signature Title
If the action is in the Coastal Area, nd you are a state agency, complete the Coastal Assessment Form before proceeding
with this assessment.
5
TRUSTEESoo SUPERVISOR
John M. Bredemeyer, III, President ,�� Gy SCOTT L. HARRIS
Albert J. Krupski, Jr., Vice President c
Henry R Smith * ,? Town Hall
John B. Tuthill 53095 Main Road
William G. Albertson y'�1p1 �.��� P.O. Box 1179
Telephone (516) 765-1892 Southold, New York 11971
Fax (516) 765-1823 BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
S.E.Q.R.A.
NEGATIVE DECLARATION
NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT
APPLICATION NO. 1000-99-3-1 Chapt. 97 - Wetlands
NAME: Virginia Meyran Chapt. 37 - Coastal Erosion
DATE: May 26, 1993
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 II
DESCRIPTION OF ACTION: Applicant proposes to construct 106 l.f. of
timber retaining wall plus 20 ' return on w/s. On e/s wall will
connect to adjacent bulkhead. Approx. 375 c.y. of clean sand will
be trucked in via Bailie Beach Road to west. A 3 ' wide stairway
from west of bluff to beach will be repaired/replaced as appropriate.
Project is necessitated by damaged caused by 12/11/92 storm. Located
175 Soundview Avenue, Mattituck.
LOCATION: SCTM ##1000-99-3-1
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
TRUSTEES �guFFO(�-c SUPERVISOR
John M. Bredemeyer, III, President ��. QG SCOTT L.HARRIS
Albert J. Krupski, Jr., Vice President
Henry P. Smith y - Town Hall
John B. Tuthill 0 53095 Main Road
William G. Albertson A � P.O. Box 1179
Telephone (516) 765-1892 Southold, New York 11971
Fax (516) 765-1823 BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
May 12, 1993
Mr. John Holzaphel, Chairman
Southold Town Conservation Advisory Council
Southold Town Hall
Main Road
Southold, NY 11971
Dear Mr. Holzaphel:
Transmitted herewith are the following applications for a wetland
permits:
Robert Celic 123-8-29
George Buckley 71-1-8
Schuyler Bergen 119-1-2
Marian Ales 119-1-20
Aristedes Speres 119-1-76
Joseph Mandelbaum 119-1-75
Thomas Losee 118-4-2
John Tobin 118-4-3
Virginia Meyran 99-3-1
Please prepare a written report of findings and
recommendations with respect to this application.
Very truly yours,
John M. Bredemeyer, III
President, Board of Trustees
JMB:jmd
RECULATORY AFFAIRS
REGION BUILIy3I7G -10
STAVE UT11,57EI►CITY OF. 117-11717 7.'O7I k
BTfONly ;"I'LLC5OK, I'IEW Iti'+:.iC 11790.2356
New York State Department of Environmental Conservation
-1-OW/1 6 -o c)Q-ao /cL
Boo rd 1),)0_T(,C)sur eS Thomas C. Jorilnq
7a,u,-i qu t/ ) qb R 0) f f 79 Commissioner
Dear S C-ak ('dp(-d��r-
RE: LEAD AGENCY COORDINATION REQUEST
The purpose of this request is to determine under Article 8 (State Environ-
mental Quality Review - SEQR) of the Environmental Conservation Law and 6 NYCRR
Part 617 the following:
1. Your agency's interest in acting as lead agency;
2. Your agency's jurisdiction in the action described below; and
3. Issues of concern which your agency believes should be evaluated.
Enclosed is a copy of the permit application and a completed Part 1 of the
Environmental Assessment Form to assist you in responding.
Project Name: )/ �c m� yr�� ����f
Project Location: ��J�%s�GLiq� -fG�,•>� 70u"-, Suyllw 4 //O/v62 �
i
ns .Sv�.,ct� v rw �� . , /�'►�Y�,�rr�� sc��'l /GGG� ��3��
DEC Project Number: �, �� 99Y1o0e0/__C'
DEC Permits: �Ivv
SEQR Classification: [ ] Type I Lj Unlisted
APR 2 9 1993
DEC Contact Person: Ifal 0�7 4 `/y1�2 � -
TO N OF SOUTH L
DEC Position:
[ ] DEC has no objection to your agency or another agency assuming lead agency
status for this action, but reserves the right to comment on this action if
a positive determination of significance is made.
-2-
[ ] DEC has no objection to your agency or another agency assuming lead agency
status for this action, but we have the following concerns regarding this
project (see "comments" below) .
DEC wishes to assume lead agency status for this action.
[ ] The proposed action has been identified by DEC as occurring wholly or
partially within or substantially contiguous to a critical environmental
area (CEA) that was designated by
It is the position of this Department that your agency, if it has a juris-
diction over the action, should assume the lead agency role based on the
existence of the CEA and the fact that the anticipated impacts are
primarily of local significance. -
[ ] Other. (See comments below)
Comments (Optional ) :
Response:
Please respond to this request within 30 days of the date of this letter.
If no response is received within 30 days, we will assume that you have no
objection to DEC or another agency assuming the role of lead agency, and have no
comments to offer regarding the proposed action at this time. If neither your
agency nor any other involved agency, including DEC, has indicated a will-
ingness to serve as lead agency within 30 days of this letter:
[ ] We will petition the Commissioner of DEC to designate a lead agency
for this action.
[ ] We will petition the Commissioner of DEC to designate your agency- as
lead, presuming you have jurisdiction.
Please feel free to contact this office for further information or
discussion.
w
Sincerely,
Enclosures
cc: (see distribution list)
Tow�v o� s�wi Ka��
EN-CONSULTANTS INC
1329 NORTH SEA RD,
SOUTHAMPTON N, Y. 11968
516-283-6360
1
f
I
Y.
.� �� �Iw�� C�:�df tisk;..'� �;+•;,
}-r PROJECT INFORMATION ..
PART '1 '
.,Prepared by Project Sponsor•
osed may have a NOTICE
This document is designed to assist in,determining whether the
action Answers ro the a quest ons will be cons de ed
cant
eff
on-the environment Please complete the entire form, Parts A through
as pal\.
rt of the application for approval and may be subject to further verification and public review. Provide any additions
information you believe will be needed to'complete Parts 2 and 3. and will not involve
It is expected that completion of the full EAF will be depend such addit on Int on ion currently availale work i unavailablebso indicate and specify
new studies, research or investigation. If information requiring
each instance
NAME OF ACTION
LOCATION OF ACTION (include Street Address, Municipality and County)
BUSINESS TELEPHONE
NAME OF APPLICANT/SPONSOR �j'd'Gt7f`1�,63>I T�1�T�3 INC. ( )
rF
�{y
Ty j,';�CI► T ltV Y. ���� STATE ZIP CODE
r)tf J-283-6360
BUSINESS TELEPHONE
WNER If different)
Uir It,ic. ` r re
/ /�
J 1 6u h Q Vl z / ' STATE ZIP CODE
fee 6
ON OF ACTION wall plus 20'
Construct 106 l.f. oP timbor rotaininq return on w/s ro Appron oximall ately cylofccleantto sandawillent
be
bulkhead. App
stairway iEromvia
west ioEeBeach Road bluff owest.
rucked
-to b achwillbe r repaired/
replaced as appropriate. Project is necessitated by
damage caused by 12/11/92 storm.
Please Complete Each Question—Indicate N.A. if not applicable
A. Site Description
Physical setting of overall project, both developed and undeveloped areas.
1
Present land use- ❑Urban ❑Industrial (Commercial �JResidential (suburban) (Rural (non-farm)
❑Forest ❑Agriculture ❑Other
' �� v
2 Total acreage of project area: acres ,PRESENTLY AFTER C.QMPLETION
APPROXIMATE ACREAGE '`�5 acres � q S acres
Meadow or Brushland (Non-agricultural) acres acres
Forested acres acres
Agricultural (Includes orchards, cropland, pasture, etc) acres acres
Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres
Water Surface Area acres r3 acres
Unvegetated (Rock, earth or fill) 0,5 acres •b 5 acres
Roads, buildings and other paved su faces , '( D acres •�G acres
n<
011ier (Indicate type) ---�yh S �-t---�
3. What Is predominant soil type(S) on project site? — % of site
a. Soil drainage: ®Well drained 1-66_ % of site ❑Moderately well drained
❑Poorly drained % of site
b If any agricultural land is involved how many acres of Soil
R 370)assified within soil group 1 through 4 of the NYS
Land Classification System? VA acres (See 1 NYC
RR
Are there bedrock outcroppings on proje���e? ❑Yes ❑No
a What is depth to bedrock?
(in feet)
2 -- -
r�
dprox"ate•percentage of proposed project site with slopes: ®0-10% % CN0-15% o?' %
[615% or greater a r %
6. Is project substantially contiguous to, or contain a••,building, site, or district, listed on the State or the National
Registers of Historic Places? Dyes ❑f "
7. Is project substantially contiguous to a site listed on'the Register of National {Natural Landmarks? Dyes F]No
8, What is the depth of the water table? (in feet)
9. Is site located over a primary, principal, or sole source aquifer? G6Yes ONO
10 Do hunting, fishing or shell fishing,opportunities presently exist in the project area? ®Yes ONO
11 Does project site contain any species of pl t or a imI life that is identified as threatened or endangered?
Dyes INo According to " J
Identify each species
12. Are there any unique or unusual land forrps on the project site? (i.e., cliffs, dunes, other geological formations)
®Yes ❑No Describe
13 Is the project site presently used by the con r�unity pr rpghborhood as an, open space or recreation area?
C�Yes ❑No If yes, explain QJe<e- . -r r— /-
14
14 Does the present site include scenic views known to be important to the community?
7Yes ❑No
15 Streams within or contiguous to project area:
a Name of Stream and name of River to which it is tributary
16 Lakes, ponds, wetland are .011
within or cont) u s to pr ject area.
a. Name ZOij /5/��' � a4h b. Size (In acres)
17. Is the site served by existing public utilities? Dyes 710
a) If Yes, does sufficient capacity exist to allow connection? Dyes ❑No
b) If Yes, will improvements be necessary to allow connection? Dyes ONO
18 Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA,
Section 303- and 304? Dyes E�No
19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8
of the ECL, and 6 NYCRR 617? MYes 0 N
20 Has the site ever been used for the disposal of solid or hazardous wastes? Dyes ETNO
B. Project Description
1, Physical dimensions and scale of project (fill in dimensions as appropriate) 1
a. Total contiguous acreage owned or colnrolled by project sponsor , acres.
b. Project acreage to be developed-��' "T C acres initially; acres ultimately.
C. Project acreage to remain undeveloped N� `�A"S C acres
d. Length of project, in miles: K (If appropriate)
e. If the project is an expansion, indicate percent of expansion proposed /Y 0
f Number of,off-street parking spaces existing/14> proposed
g. Maximum vehicular trips generated per hour �'� (upon completion of project)?
h. If residential Number and type of housing units.
One Family Two Family Multiple Family Condominium
Initially 'Y M
Ultimately
i. Dimensions (in feet) of largest proposed structure height; width, length.
j Lincsir (crl (if frontage along ,ri public thoroughfare project will OCCuj)y is?_ ft,
3
2. How much natural material (i e , rock, earth, etc.) will be removed from the site? V toeis/cubic yari;;f„_ '
3. Will disturbed areas be reclaimed? Dyes ❑No
5�N JA
a If yes, for what intended purpose-is the site being reclaimed?
b WWII topsoil be stockpiled for reclamation? Dyes ❑No
r-, Will upper subsoil be Stockpiled for reclamation? Dyes ON;
4, i-low many acres of vegetation (trees, shrubs, ground covers) will be removed from site? � acres,
5. Will any mature forest (over 100 years-old) or other locally-important vegetation be removed by this project?
❑Yes O�No
6. If single phase project: Anticipated period of construction / months, (including demolition).
7. If multi-phased: K M
a. Total number of phases anticipated (number).
b. Anticipated date of commencement phase 1 month year, (including demolition).
c. Approximate completion date of final phase month year.
d. Is phase 1 functionally dependent on subsequent phases? Dyes ❑No
8. Will blasting occur during construction? ❑Yes MNo
9. Number of lobs generated. during'construction4 after project is completed
10 'Number of lobs eliminated by this project
11. Will project require relocation of any projects or facilities? ❑Yes )No If yes, explain
12 Is surface liquid waste disposal involved? Dyes E�N0
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? Dyes EPNo Type
14 Will surface area of an existing water body increase or decrease by proposal? ❑Yes 'K]No
Explain
15 Is project or any portion of project located in a 100 year flood plain? 1nYe5 ❑No
16. Will the project generate solid waste? Dyes [�_N0
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 Well any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes ❑No
e. If Yes, explain
17 Will the project involve the disposal of solid waste? Dyes 17840
a. If yes, what is the anticipated rate of disposal? tons/month
If yes, what is the anticipated site life? years.
18 Will project use herbicides or pesticides? ❑Yes VNO
19 .Well project routinely produce odors (more than one hour per day)? Dyes C6No
20 Will project produce operating noise exceeding the local ambient noise levels? Dyes ' XNo
21. Will project result in an increase in energy use? Dyes JNo
If yes , indicate type(s)
22 If water supply is from wells, indicate pumping capacity gallons/minute.
23 Total anticipated water usage per day �� gallons/day.
24 Does project involve Local, State or Federal funding? Dyes rNo
If Yes, explain
___ _ 4
,,Approvals-Required: Submittal
Type Date
City Town, Village Board F3Yes ❑No
Vilkop PIRIIIIIIIH Mio, F1Mi-I - - - -- =u-
City, 1 own Zomig Board LIYes I_INo _
City, County Health Department ❑Yes ❑No _
Other Local Agencies WYes ❑No �°�'►/ � 5/2-cs L �/� �/ `i 3
Other Regional Agencies ❑Yes ❑No
State Agencies ®Yes ❑No �C r J�`t a r y S3
Federal Agencies []Yes ❑No
C. Zoning and Planning Information
1 Does proposed action involve a planning or zoning decision? ®Yes ❑No
If Yes, indicate decision required
❑zoning amendment ❑zoning variance ❑special use permit ❑subdivision ❑site plan
❑newlrevision of master plan ❑resource management plan ❑other
2--What is the zoning classification(s)of the site? R— ��
3 What is the maximum potentiOA
velopment of the site if/devel ped as permitted by the present zoning?
r c..r��,,� cr
4. What is the proposed zoning of the site?
5 What is the maximum potential'development of the site if developed as permitted by the proposed zoning?
6 Is the proposed action consistent with the recommended uses in adopted local land use plans? ETLess ❑No
7 What are the predominantnd use(s) and zoning classifications within a '/4 mile radius of proposed action?
a— L10 O Fv,s.
8 Is the proposed action compatible with adjoining/surrounding land uses within a '/4 mile? [Res ❑No
9 If the proposed action is the subdivision of land, how many lots are proposed? (A
a What is the minimum lot size proposed?
10 'Will proposed action require any authorizations) for the formation of sewer or water districts? ❑Yes filo
11 . Will the proposed action create a demand for any community provided services (recreation, education, police,
fire protection)? ❑Yes upNo
a If yes, is existing capacity sufficient to handle projected demand? ❑Yes ❑No t
12 Will the proposed action result in the generation of traffic significantly above present levels? ❑Yes pq-40
a If yes, is the existing road network adequate to handle the additional traffic? El Yes ❑No
D. Informational Details
Attach any additional information as may be needed to clarify your project. If there are or may be any adverse
impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or
avoid them
E. Verification
I certify that th informa o provided above is true to the best of my knowledge. U _/
Applicant(Spons0f-c-'k Date
Signature Title mss• :A—6A/ /x `
If the action is in the Coastal Area, Ind you are a state agency, complete the Coastal Assessment Form before proceeding
with this assessment.
5
A& NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION /t/7 �� /—In
Iowa
JOINT APPLICATION FOR PERMIT U.5 ARMY CORPS OF ENGINEERS APPLICATION NO
Please read ALL instructions on back before completing this application Please type or print clearly in ink.Attach additional information as needed
❑ARTICLE 9, TITLE 1,ARTICLE 43 6NYCRR 646(LAKE GEORGE RECREATION ZONE)
❑ARTICLE 15,TITLE 3(AQUATIC PESTICIDES CONTROL) ❑6NYCRR 327(AQUATIC VEGETATION) ❑6NYCRR 328(FISH) ❑6NYCRR 329(INSECTS)
S ❑ARTICLE 15, TITLE 5 6NYCRR 608(PROTECTION OF WATERS)
T El For the construction, reconstruction,or repair of a DAM or other impoundment structure
A
T ❑For the disturbance of a STREAM BED OR BANKS or excavation in or fill of NAVIGABLE WATERS , E1401 WATER QUALITY CERTIFICATION
E ARTICLE 15, TITLE 15 ❑6NYCRR 601 (WATER SUPPLY) 1:16NYCRR 602(LONG ISLAND WELL)
❑ARTICLE 15, TITLE 27 6NYCRR 666(WILD, SCENIC AND RECREATIONAL RIVERS)
❑ARTICLE 24 6NYCRR 662. 663(FRESHWATER WETLANDS) ❑ARTICLE 36 6NYCRR 500(FLOODPLAIN MANAGEMENT)
EiARTICLE 25 6NYCRR 661 (TIDAL WETLANDS) ❑ARTICLE 34 6NYCRR 505(COASTAL EROSION)
-------------------------------------------------------------------------- __
----------------------------------------------------------------------
F ❑SECTION 10(RIVER AND HARBOR ACT OF 1899)for structures and work in navigable waters of the U S. ❑COASTAL CONSISTENCY CERTIFICATION
E ❑SECTION 404(CLEAN WATER ACT OF 1977)for disposal of dredge;!or fill material in waters of the U S.
D
❑SECTION 103(MARINE PROTECTION, RESEARCH AND SANCTUARIES ACT)for the transportation of dredged materials for dumping into ocean waters
1 LIST PREVIOUS PERMIT/APPLICATION NUMBERS AND DATES(If any)
2 APPLICANT IS A/AN
IAlOwner ❑Operator El Lessee ❑Municipality/Governmental Agency (Check as many as apply)
3 NAME OF APPLICANT(Use Full Name)
VIRGINIA MEYRAN
MAILING ADDRESS TELEPHONE(Where can be reached during day)
175 Soundview Avenue F (516) 298-5139
POST OFFICE STATE ZIP CODL
Mattituck NY 11952
4 NAME OF 11 Owner ®A en Contact Person
g U (Check'.one)
Roy L. Haie, En-Consultants Inc
MAILING ADDRESS TELEPHONE(Where can be reached during day)
1329 North Sea Road (516) 283-6360
POST OFFICE
Southampton
STATE ZIP CODE
NY 11968
5 PROJECT/FACILITY LOCATION(Mark location on map,see Number 1B on reverse side)
County Suffolk I Town or city Town of SOuthOldl Village
STREET ADDRESS(If different from applicant)
Same
POST OFFICE _ e � )QQ�
i ANr� STATE ZIP CODE
4 _ I{
6 NAME OF STREAM OR BODY OF WATER g
Iron Island Sound ,°; '`4r;
7 HAS WORK BEGUN ON PROJECT? If YES, attach explanation on starting work without permit,' includes dates Ly 8 WILL PROJECT UTILIZE STATE LAND?
Dyes Ga No Show work on map and/or drawings Dyes GiNo
9 PROPOSED USE ® Private 10. PROPOSED STARTING DATE" 11 APPROXIMATE COMPLETION DATE 1 12 FEE OF(NYS Permit Only)
❑ Public ❑ Commercial ASAP ASAP
$ Enclosed
13 PROJECT DESCRIPTION (e g quantity and type of material to be excavated, dredged or used for till or rip rap, location of disposal sites, type of r
structure to be installed; height of dam, size of impoundent, capacities of proposed water sources;extent of distribution system,etc)
SEE ATTACHED
14 WILL THIS PROJECT REQUIRE ADDITIONAL FEDERAL. STATE AND/OR LOCAL PERMITS?
TOWN OF SOUTHOLD, DOS, COE Yes ElNoIf yes, please list
15 CERTIFICATION
I hereby affirm that under penality of perjury that information provided on this form and all attachments submitted herewith is true to the best of my knowledge-
and belief False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210 45 of the Penal Law
Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature. and by whomever surfered, ansing out or tho projo<t
described herein and agrees to indemnify and save harmless the State from suits, actions• damages and costs of every name and description resulting from said
project In addition Federal Law, 18 U S C Section 1001 rovides for a tine of not more than 510.000 or imprisonment for not more than five years, or both
%%here an applicant knowingly and willfully talsifies,con a s,o7cove s up a material fact,or knowingly makes or uses a false, fictitious or fraudulent statement
❑I hereby authorize the agent named in Number ovem is application on my behalt
April 12, 1993 President
1)1rF R IGVAME -- -- ------
nrll
PLEASE READ ALL INSTRUCTIONS ON REVERSE SIDE
PROJECT DESCRIPTION
Re: VIRGINIA MEYRAN
Construct 106 l.f. of timber retaining wall plus 20 '
return on w/s. On e/s wall will connect to adjacent
bulkhead. Approximately 375 cy of clean sand will be
trucked in via Bailie Beach Road to west. A 3 ' wide
stairway from west of bluff to beach will be repaired/
replaced as appropriate. Project is necessitated by
damage caused by 12/11/92 storm.