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Home My WebLink AboutTR-4008 Michael J.Domino,President � of SUUTyolo Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G • Q Telephone(631) 765-1892 Greg Williams �OOU 'O Fax(631) 765-6641 NT`I,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 14, 2018 Richard &Alice Rubinstein 27 W 55th Street, Apt. 71 New York, NY 10019 RE: 470 GOOSE CREEK LANE, SOUTHOLD SCTM# 1000-79-1-5 Dear Mr. and Mrs. Rubinstein: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, February 14, 2018: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#4008 from Virginia Rumpler to Richard & Alice Rubinstein, as issued on May 1, 1992. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, a Michael J. Domino, President Board of Trustees MJD/dd Michael J.Domino,Presides o�QSqEFQI�I'�oG Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 Glenn Goldsmith co P.O.Box 1179 A.Nicholas Krupski 0 07 Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �, 1,0 d Completed in field by: RICHARD & ALICE RUBINSTEIN request a Transfer of Wetland Permit#4008 from Virginia Rumpler to Richard & Alice Rubinstein, as issued on May 1, 1992. Located: 470 Goose Creek Lane, Southold. SCTM# 1000-79-1-5 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2'. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested 'modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other Page 1 of 2 Michael J.Domino,Presid." \'ofF04411O Town Hall Annex John M.Bredemeyer III,Vice-President �� yJ, 54375 Route 25 Glenn Goldsmith ra z P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: RICHARD & ALICE RUBINSTEIN request a Transfer of Wetland Permit #4008 from Virginia Rumpler to Richard &Alice Rubinstein, as issued on May 1, 1992. Located: 470 Goose Creek Lane, Southold. SCTM# 1000-79-1-5 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment--* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams E. Cantrell D. Di Salvo Other Page 2 of 2 Richard & Alice Rubinstein 27 W55th Street (Apt. 71) New York, NY 10019 D � � � 0 V � DEC 2 7 fly f December 21,2017 Southold Town Board Trustees— Southold Town Board of Trustees P.O. Box 1179 Southold,NY 11971 RE: Transfer of permit#4008,5049 &9106 SCTM# 1000-79-1-5 LOCATION: 470 Goose Creek Lane, Southold,NY 11971 Dear Board of Trustees: Please let this letter serve as written request to transfer permit#'s 4008 & 5049 certified to Virginia Rumpler, and permit# 9106 certified to John Rumpler to Richard&Alice Rubinstein, new owners of 470 Goose Creek Lane, Southold,NY 11971. SCTM# 1000-79-1-5. Enclosed is a copy of the signed deed as proof of ownership along with a check in the amount of $150.00 representing$50 for each transfer. I give the Southold Town Board of Trustees permission to enter the property to do the necessary site inspection in order to transfer permit#4008, 5049 &9106. Sincerely, Richard Rubinstein Owner Alice Rubinstein Owner Michael J.Domino,President ��0� SU!/r�o Town Hall Annex John M.Bredemeyer III,Vice-President �� l� 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski O! • Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1426C Date: December 5, 2017 THIS CERTIFIES that the installation of 7511 of timber bulkhead to connect to each adjoining properties existing bulkheads Approx. 80 c k of clean fill will be trucked in; At 470 Goose Creek Lane, Southold Suffolk County Tax Map#1000-79-1-5 (incorrectly permitted as 75-1-5) Conforms to the application for a Trustees Permit heretofore filed in this office Dated March 16, 1992 pursuant to which Trustees Wetland Permit#4008 Dated May 1, 1992,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the installation of 7511 of timber bulkhead to connect to each adjoining properties existing_bulkheads Approx. 80 c.v. of clean fill will be trucked in. The certificate is issued to VIRGINIA RUMPLER owner of the aforesaid property. Authorized Signature McCarthy Management, Inc. November 13, 2017 Town of Southold, Board of Trustees P.O. Box 1179 RE: Certificate of Compliance Southold,NY 11971 Location: 470 Goose Creek Lane, Southold Dear Diane: Per our telephone conversation,please let this letter serve as written request to inspect the above mentioned property to comply with permits 4008 & 5049. Attached please find a check for$100.00 and the necessary affidavits giving permission to enter the property. Sincere DL� Ruthie Love I NOV 2 7 2017 L— Soud',6,,d Town Board rf Tru teems 46520 Route 48 Tel. 631.765.5815 Southold, NY 11971 Fax.631.765.5816 office@ thomasjmccarthy.com �pF S0(/l Michael J.Domino, President � y�lO Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25� � P.O.Box 1179 Charles J. Sanders Southold,New York 11971 Glenn Goldsmith • a� Telephone(631) 765-1892 A.Nicholas Krupski �lif'�+oUNTI Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: L C Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction V2 constructed Project complete, compliance inspection. INSPECTED BY: ckok- gy F�-V1 COMMENTS: a CERTIFICATE OF COMPLIANCE: Board of Trustees Application AFFIDAVIT John Rumpter BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORD WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERNIIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of ProperVf Owner 7� SWORN TO BEFORE ME THIS DAY OF 4KU V , 20 lic THOMAS J.h°cCr`•F„; ,, N to Public,Sly a of N2vJ York �omr 0047 .Suffolk ounty n scion Pire s fYov CO�g� Board of Trustees Application AFFIDAVIT'' Cynthia Swiskey BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF 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 REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. ignature o r perty Owor SWORN TO BEFORE ME THIS ✓ )AY OF V�U —'20 '17 Notar tic ;V � nop uo;ssru;rn� THOMAS J,MCCARTHY Notary Public,State of blew York Ins•08 ;' No.5004790-Suffolk County N to Commission Expires Nov_23.12-2— d017 3,1422017 i�i®/V11�41� l0 a a_M Y M_V!!i—t4i/a 1L' INC. - - - ®�` '' a 4•J•- • _ - 'f.`c.•"f 0�® a 0 46520 COUNTY ROAD 48 SOUTHOLD, NY 11971 DATE / JOB NO (931) 765-5815 FAX (631) 765-5816 ATTENTION TO lid i $ RE t 1 , C IVI Iu NOV 2 7 2017 '+ WE ARE SENDING YOU ❑ Attalhedl ❑ Under separate co�✓er vi the following items: > ❑ Shop drawings ❑tPrints Si::E' "tyA ❑ Plan ElSamples ❑ Specifications ElCopy of letter ge oor"&er` •• n e LID LA 0 ® o i� pr , s THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: If enclosures are not as noted,kindly notify us at once. r J /��• /� 4 ---- �`'-r-' '�: it'•�;!'w',,'�+i ,�ry �1Ti%'•Rr�a �i�i y'�"i'��'��itri;�;�i�'^.T';r�'�• Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT No. 4008 DATE: May 1, 1992 ISSUED TO Virginia Rumpler N I L\ K Z.I Pursuant to the provisions of Chapter 615 of the Laws of 1( mos. the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952: and the Southold Town Ordinance 'en- fifled "REGULATING AND THE PLACING OF OBSTRUCTIONS ai 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 April 30 19 92 , its and in consideration of the sum of $ 150.00 paid 6y L Costello Marine on behalf of Virginia Rum ler its of N. Y. and subject to the i Terms and Conditions listed on the reverse side hereof, ` 30• ti of Southold Town Trustees authorizes and permits the following: t.t:, To install 75 1.f. of timber bulkhead to connect to each adjoining properties existing bulkheads. Approx. 80 c.y. of clean fill will be trucked in. �i all in accordance with the detailed specifications as presented in .11 the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- 6y causes its Corporate Seal to 6e affixed, and these presents to be subscribed by a majority of the said Board as of this date. U-3 A Trustees J1. 12 AM ° c - - Albert J. Krupski, President p� OG Town Hall John Holzapfel, Vice President =� y1 53095 Main Road William G. Albertson y Z P.O. Box 1179 Martin H. Garrell O Southold, New York 11971 Peter Wenczel y�j�! ��0� Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 3, 1994 Stephen Mudd 3938 County Road 48 Southold NY 11971 Sear Mr. Mudd, I have reviewed the file of Virginia Rumpler at your request, and these are the conditions which cannot be followed in grading and landscaping within 75 ' of tidal waters or wetlands. These recommendations are standard conditions on any permit that the board grants, in response to our concerns of water quality. 1. There shall be no turf (maintained lawn grass) within 15-20' of the retaining will. 2. Within this "buffer" area, a swale shall be graded in to prevent runoff of water from the maintained lawn area from directly discharging into the creek. The buffer area may be kept as clean sand or gravel, oz be planted with indigenous species which do not require fertilization of pesticide applications. This buffer serves to protect the creek's water quality. Thank you for your concern. Very truly yours, 2A11bJ. ou p 4i, r. �01 President, Board of Trustees AJK/dj h TRUSTEES �� SUPERVISOR " � � SCOTT LI I k ' J�Itit�l�I:-,Hzedetneyer, III, President L.t - =�,y , . RRIS, &rt J.-Ki-upski, Jr.,Vied President Heng? Smith Town Hall Joan B. Tuthill � ® � 53095 Main Road William G. Albertson ®�� °�� P.O. Box 1179 Southold, New York 11971 lblepP one (516) 765-1892 Fax (516) 765-1923 BOARD OF TOWN TRUSTEES TOWN OF SOtTf'HOLD July 30, 1992 Ms. Virginia L. Rumpler 30 Hofstra Drive Greenlawn, NY 11740 Dear Ms. Rumpler Your request to build a home as ger Van Tuyl survey slated' July 6, 1992 will not require a permit from this office as it is greater than 75' from wetlands The improvement of your lawn area in front of y9ur home should be limited to a lora fertilizer requiring seededt lawn of fescue grasses. You may present a capy-of this letter to other agencies ,for their use in your perTait needs a . Sincerely yours, �< g ; John Aid Bredemeye President, Board of Trustees' dc. Building Dept JMB/djh �g�fFO [PY TRUS'T'EES �. Q `e' U0 SUPERVISOR John M. Bredemeyer, III, President _�� Gym SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President H Henry P. Smith Town Hall John B. Tuthill �y �� 53095 Main Road William G. Albertson �Oj �'a� P.O. Box 1 179 Telephone (516) 765-1892 Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 6, 1992 Costello Marine P.O. Box AK Greenport, NY 11944 Re: Virginia Rumpler SCTM #1000-75-1-5 Dear Mr. Costello: The following action was taken by the Board of Town Trustees during its regular meeting held on April 30, 1992 regarding the above matter: WHEREAS, COSTELLO MARINE ON BEHALF OF VIRGINIA RUMPLER applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated March 16, 1992 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 April 30, 1992 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 COSTELLO MARINE ON BEHALF OF VIRGINIA RUMPLER BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: install 75 l.f. of timber bulkhead to connect to each adjoining properties existing bulkheads. Approx. 80 c.y. yards of clean fill will trucked in. This permit will expire two years from the date it is signed. Fees must be paid, if applicable, 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: No fees Very truly yours, John M. Bredemeyer, III President, Board of Trustee JMB: jt cc: Conservation Advisory Council file S®UTHOLD TOWN C-ONSLRV. ATION ADVISORY'COUNCIL Southold, N. Y. To: Southold Town Trustees From: Southold 'Town Conservation Advisory Council Dated: April 29, -.1992 Re: Recommendation of Wetland Applications The following recommendations were made by'-the CAC at its meeting held Tuesday, April 28, 1992: On a motion by Bruce Loucka, seconded by Stephen Angell, it was RESOLVED to recommend to the Southold Town Trustees approval with stipulations the application of Virginia Rumbpler 75-1-5 to install a bulkhead and backfill. The CAC recommends approval provided the applicant plant an appropriate vegetative buffer. Goose Creek Lane, Southold Vote of Council: Ayes: All Motion carried. On a motion by Bruce Loucka, seconded by Stephen Angell, it was RESOLVED to recommend to the Southold Town Trustees approval with stipulations the application of Michael Maher 111-9-3 to construct bulkhead, stairs, etc. The CAC recommends approval provided the applicant install a drywell for draining the hot tub and, if not being done already, install a drywell for the swimming pool. 3485 Nassau Point Road, Cutchogue Vote of Council : Ayes: All Motion carried. On a motion by Stephen Angell, seconded by John McCormick, it was RESOLVED to recommend to the Southold Town Trustees approval with stipulations of the application of Savvas Milienos by Sidney Olmstead 114-7-14.1 to construct a dock, ramp and float. The CAC recommends approval provided the project does not impinge the neighbor's navigation. 1240 Westphalia Road, Mattituck Vote of Council- Ayes: All Motion carried. On a motion by Stephen Angell, seconded by John McCormick, it was RESOLVED to recommend to the Southold Town Trustees approval of application of Murray Klapper 83-2-6.6 to remove and replace a bulkhead and backfill. Oregon Road, Cutchogue Vote of Council: Ayes: all Motion carried. On a motion by Stephen Angell, seconded by Bruce Loucka, it was RESOLVED to recommd to the Southold Town Trustees approval with stipulation the application of Salvatore Passalacqua 83-2-4 to construct a stone armored timber retaining wall, returns, backfill, and construct stairway. The CAC recommends approval provided the applicant keeps the bulkhead landward of the huge boulder at HWM. Oregon Road, Cutchogue Vote of Council: Ayes: All Motion carried. EFS -^ _ _ . + {.6~rr;'1�+;�'!K""�''"'• '4�'"_ � .fyJ. f L.L�11�'':Jj T�I...J JI .n1� �Y ? � , • - Issued To : ! . � Date `�•��®� Address THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 TRUSTEES ®�' ®G John M.Bredemeyer,III,Presidents SUPERVISOR Henry P. Smith,Vice President eSCOTT L.HARRIS Albert J.Krupski,Jr. 1;ro John L.Bednoski,Jr. `� ®�� Town Hall John B.Tuthill �1 53095 Main Road P.O.Box 1179 Telephone(516)765-1892 BOARD OF TOWN TRUSTEES. Southold,New York 11971 Fax(516)765-1823 TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT' APPLICATION TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Only: Coastal Erosion Permit Application rr N°Wetland Permit Application 15 V Trustee Lands Permit Application nr randfather MAR 16199 Completed Apps. Date: A�l, ariance Required, AA Neighbors notified D te: �' ) +� TI 1IqF 4HOLD SEQRA Type WL-ISP5b ;,r- e °`��(' v/ Coord. mand 5Itisp. comp. /date: '3 "� SEQRA Determin. /date: 3�� Public Hearing/date: Findings: WR 1 61M Permit Vote: (YIN) : Special Conditions: (also see file) Application Number; SCTM 41000- 7S- /- 5- Project - SProject Name (If any) ' U► ra 1niQ _Ru ,plef Date Prepared: r Applicant: C,0s e fp cxri 2e a6+rac`�fjq Carp . Address: ? oX ,�Iay Gre-enQc,c: - Iggq 'Phone (S!, ) Interest: (owner, consultant,lessee,etc. ) A aPh� Owner of Property: 'r ia. Rumpler- Address a s1'r eA I l? Phone (SI ) Subject Property Location: Cbose. Creek_ So )t a 1 8. i O c a 1 19 7 I (Provide LILCO Pole #, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT m Yds. to be excavated: po m E Yds. to be f i lled: 20 Manner in which material will be removed or deposited: oc t6o-e_ Bo :Zru Width of canal, creek or bay fronting property: Depth at low tide: Q Aver. rise in tide: p Distance to nearest channel: Distance project extends beyond similar projects in area: Co N N CcT i►J G Area zoning: 'esic�w,`�ca� Land area in acres: I Coy oon sa- S4. Is project for private or business use: Intended use of property: 1�esi -en+Q l mapr� �1 Describe known prior operations conducted od preMises: N )N3 E. Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises: NO Has any license or permit ever been revoked or suspended by a Governmental Agency: No Project Description The project description must also include plans for reclamation of lardy,,disturbed-.during_construction of the principle and accessory structures-$,';and-,#underground structures (i.e. , pipeline and seyyptic,"`system;-mak9e` additional attachments if necessary) . 5n x k y rt 5 _ — Authorization (Where the applicant is not. the owner) ;�VWE � I residing at (Print-owner of subject property) (Mailing address-phone) do hereby authorize to apply for Coastal Erosion permit( s) from the Southold Town Trustees Signature THIS IS NOT A PERMIT r I County of Suffolk ) State of New York ) C)'--0r-5!L h , Sr, BEING DULY SWORN DEPOSES AND AFFIRMS TVAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OP 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 ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. 8'1NATURE SWORN TO BEFORE ME THIS ID h DAY OFq , 193 a=, SUSAN E.LONG Notary Public,State of New York No.014.04958343 Qualified in Suffolk County NOTARY PUBL C Commission Expires November6,111...3 Suggested space for location Map THIS IS NOT A PERMIT 24x/2d�it•� E � 1 �X 6 Cl.4NP I 'O0000e� S�'c77Lu/S L�o.C. I g G/Sa7'1',r Com!• ( I A�GRtZ! 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I 75.0 �lll /'PicQt-EC5,`.,C.IE ;^, ^'f ,F ";�'°` IEw ! so 'fi 1 G HT C:h W,11\! � rte- P rf ah?13 rsrsay mea not baRr3 t� f si.,Rcr3zl se,r:•gyor'o inked 8621 cc ydseat shaU not beconsidemd sa ba a valid true Cagy. - fs^c;^ranacss indfrated hemnn shaatMtS i# �r"� ti cnty ra th3 person for whom VII smsc f { NE and on hls hel'alg.o - ,s�`�•C� \ i( V,q� '�'O�`a ..a:,�w:rv.A�ao,^ernsn©Heal W^-,w�`"s,'�:�7 �l�ft��O�PG„•A �, °�� c•= -,,o��:'s^ut't�rt lir?�;J h�;r�n � - •i , -di is are 4iCiLiw li:.S��'::3 2p S 25 0� n � s LAND •' - ,..-..,-- � , ! •fey• .. SUI=F..��. A�r•Ni�;;�eCr'�'S��' tU�t�-7 I S � , : ;;-_ ;. T4''! ;r'' s a SUFFOLK = _ C „ _, CO. HEALTH DEPT. Aa O.VA ,,: i L`._T-dam Y _l • ,t_ t MAP- PQOPEJZT� F";1 _ _ STATEMENT OF INTENT a; I; flRD!!ti}ARY L41GH WATER I A -~ I THE WATER SUPPLY AND SEWAGE DISPOSAL i { SYSTEMS FOR THIS RESIDENCE WILL 1`--- — ---=----- L 7-77-1 -' L�:'• - ��_ •- - = - — -- ' NT -- _ CONFORFv9 T THE STANDARDS 'OFF 'f1�E SUFFOLK 9(--.,,DEPT. O E TFI SERVICES. f^ �r`.� 'uj <., U f �t. AIBP CANT SUFFOLK COUNTY DEPT. OF HEALTH 2- SERVICES — FOR APPROVAI.'`.FOR ' CONSTRUCTION ONLY I _ DATE: H. S. REF. NO.: S!Ef`( _._ .. f___.___ -�, cv Y APPROVED: LLI P2o p`b!Out k - . SUFFOLK CO. TAX MAI? DESIGNATION: DIST. SECT. BLOCK PCL. 7r' ` :0 ! g ?. �� Q�►stalG ' -ter-, i �' OWNERS ADDRESS: I ,Q,_— WEU CdL' . - _i / { _ U ra r. -N- -� r 1�'J ;• 30 H0F5T2A UF2ivF- \ N!liuJ: N.Y. t(740 l V) ° = 5,-ALS - p I:, i - '_. •, � �•.'�' ' ��' .C,n ,' AQ E,4� I G. e' F DEED: L. 4(D41 P. aG - i "��o W:e�rs Di i TEST HOLE STAMPur i - P ----- - --- .-•?�,'sr-•,' ray,; I V,-Int�on of v.C3,h. iG3LF f t�iLG•-dV>� P--.SCH219•t�vLs:. ? `- .-FEIQCE AT LiNe FENCEC.6N _ �. o (`2C•�! tv�l. t"J.BA_�_�_�_!} �rJ �• -- ' m na°ta ar',2 rkedsealV, P Otnm? rd s�,t shall no:�ca €l�erai an be a valid tree copy,75, 5�5, TQ I 20 f<i:,�� `F }a -.4 8✓t Y ��n ese tnn:ated hereon chc4P rnci � WAY 5 Ea as � j , cmv person for -- --------—------—- ----- - -- — PA x.F Ic t ran .ed,and on his beha9$2a,hl ' ------ ------ -- ___- 8�:!_c�--^an'/.9otiemrnsnta?-• er,Mtr,:^d fi Fz o sN hi �z�{tu•' e n:er►listed hcrcon e-t;3 I FU45 TO :c {,e�V:{r�. ,of the iondin3;rcq- i, .:oRPSE tc •- �ccsorerattr_::�`srs?-?o s r'1 f:F,`: v vi i i fv•" -' ' A `•-'cn�irstitutiont:or sub eluse, SEAL ROT E �LEV�.rt'JQNIS 2EFE4; TC MEAti E3E/', �.E�,�cLgN.G�/D. `'�o�7TT��,�- , co• LICE�4$ED LAND SURVEYORS 1'7' GREENPO.RT NE ' 0190)-25c NEW YO ATE DEPARTMFNT Or ENVIRONMENTAL CONSFRVAT IC PERMIT NUMBER ® EFFECTIVE DATE 1-4738-00497/00001-0 � April 7, 1992 IACILITYIPROGRAM NUMBER(s) PERMIT FXPIRAIION DATE Under the Environmental Conservation Law (ECL) April 30, 1997 t O TYPE OF PERMIT(Check All Applicable Bores) ®New ❑Renewil ❑Modification ❑Pernnt to Construct El Permit to Operate Art cle 15, le Article Article 27, Proltection of Water eWat r SPDES 17, Titles 7, 8: Hazardous Waste Management e 9, 6NYCRR 3 Article 15, Title 15: � Article 19' � Article 34' Water Supply Air Pollution Control Coastal Erosion Management Article 15, Title 15: � Article 23, Title 27. � Article 36: Water Transport Mined Land Reclamation Floodplain Management Article 15, Title 15: Article 24: Articles 1, 3, 17, 19, 27, 37, Long Island Wells Freshwater Wetlands Ej 6NYCRR 380. Radiation Control Article 15, Title 27: x Article 25: Other: Wild, Scenic and Recreational Tidal Wetlands Rivers Article 27, Title 7; 6NYCRR 360: F6NYCRR 608: Solid Waste Management Water Quality Certification PERMIT ISSUED TO I LFPHONF NUMBER Virginia RLmpler ( ) ADDRESS OF PERMITIEE 30 Hofstra Rd. , Greenlawn, NY 11740 CONTACT PERSON FOR PERMITTED WORK TFI_FPHONF NUMBER Susan Long, Costello Marine P.O. Box 2124 Greenport, NY 11944 ( ) NAMF AND ADDRESS OF PROJECTJFACII ITY Goose Creek Lane, Southold ' SCM No. 1000-75-1-5 LOCATION OF PROJECT/FACILITY COUNTY TOWNS WATERCOURSE/WETLAND NO NYIM COORDINATES Suffolk I Southold Goose Creek E _ N4 C.fonstlruc�F a r��RTit)ne Tleet timber bulkhead extending from the end of the existing bulk- head on the west to a point that is 151 landward of the face of the bulkhead on the east. Add new timber return to connect the two bulkheads to replace slate/concrete wall which must be removed. All work must be in accordance with attached plans stamped approved by NYSDEC. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL,all applicable regulations,the General Conditions specified(See Reverse Side)and any Special Conditions included as part of this permit. ;n�,r^rsmsa�,tm� PFRMIT ADMINISTRATOR ADDRESS �fii3ft'J SS"L�R'K1!1.7'. E�^!1T®ph;�a AUTHORIZED SIGNATURE DATE ZIA&rk April 7, 1992 Page 1 of 4 20 6a(10190)-25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized, or project if, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles,ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State,the owner may be ordered by the Department to a waterway remove or alter the structural work, obstructions, or hazards caused 14 There shall be no unreasonable interference with navigation by the work thereby without expense to the State, and if, upon the expiration or herein authorved revocation of this permit, the structure, fill, excavation, or other 15 If upon the expiration or revocation of this permit,the project hereby modification of the watercourse hereby authorized shall not be com- authorized has not been completed,the applicant shall,without expense pleted, the owners, shall, without expense to the State, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Environmental Department of Environmental Conservation may require,remove all or Conservation may require,remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to its former condition the navigable to its former condition No claim shall be made apamst the State of and flood capacity of the watercourse Nn claim hall he made arainct Nv%% Yoik on ac(ount of am su(h rr•nu+�,rl or ,Iteration the State of New York on account of any such removal or alteration 16 If granted under Article 36, this permit does not signify in any way 10 That the State of New York shall in no case be liable for any damage that the project will be free from flooding or injury to the structure or work herein authorized which may be caused 17 If granted under 6 NYCRR Part 608, the NYS Department of Environ- by or result from future operations undertaken by the State for the mental Conservation hereby certifies that the subject project will riot conservation or improvement of navigation,or for other purposes,and contravene effluent limitations or other limitations or standards under no claim or right to compensation shall accrue from any such damage Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 11 Granting of this permit does not relieve the applicant of the responsi- (PL 95-217)provided that all of the conditions listed herein are met bility of obtaining any other permission, consent or approval from 18 All activities authorized by this permit must be in strict conformance the U S Army Corps of Engineers, U S Coast Guard, New York State with the approved plans submitted by the applicant or his agent as part Office of General Services or local government which may be required of the permit application 12 All necessary precautions shall be taken to preclude contamination Costello Marine of any wetland or waterway by suspended solids, sediments, fuels, Such approved plans were prepared by solvents,lubricants,epoxy coatings,paints,concrete,leachate or any Contracting on 3/92 SPECIAL CONDITIONS 1. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands. 2. All fill shall consist of "clean" gravel and soil (not asphalt, slag, flyash, broken concrete or demolition debris) . 3. Equipment operation below mean high water is strictly prohibited. 4. Bulkhead constructed directly adjacent to vegetated tidal wetlarx shall be jetted in with minimal disturbance to the tidal wetland. Trenching is strictly prohibited. 5. All peripheral rip rap berms, cofferdams, rock revetment, gabions, bulkhead etc. shall be completed prior to placement of any fill material behind such structures. 6. Within 30 days of permit issuance, the slate-concrete wall on east side of property must be removed. Supplementary Special Conditions (A) thru (J) attabhed. w DEC PERMIT NUMBER 1-4738-00497/00001-0 PROGRAM/FACILITY NUMBER Page 3 of 4 r• SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all permits : A. If any of the permit conditions are unclear , the permittee shall con- tact the Division of Regulatory Affairs at the address and telephone noted below. B. A copy of- this permit with supplementary conditions and approved plans shall be available at the project site whenever authorized work is in progress. C. The permit sign enclosed with the permit or a copy of letter of approval shall be protected from the weather and posted in a con- spicuous location at the work site until completion of authorized work . D. At least 48 hours prior to commencement of the project , the permittee shall complete and return the top portion of the enclosed receipt form certifying that he is fully aware of and understands all provisions and conditions of this permit. Within one week of completion of the permitted work, the bottom portion of that form shall also be com- pleted and returned: E. For projects involving activities to be accomplished over a period of more than one year , the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to the commencement of resumption, of work each year . . F. If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modi- fications . The permittee is advised that substantial modification may require submission of a new •application for permit . G. All necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended solids, sediment , fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project work. 11. Any failure to comply precisely with all of the terms and conditions of this permit , unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. I . The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers , NY District, 26 Federal Plaza, New York , NY 10278, (Attention: Regulatory Functions Branch) , prior to commencement of work authorized herein . J. The granting of- this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242, which may be requited for any encroachment upon State-owned lands underwater . Regional Permit Administrator NYS Dept . of Environmental ,Conservation Bldg . 40, SUNY-Room 219 Stony Brook , NY 11790-2356 ( 516) 753 -1-j89 r1 ' I\ �GlfvTT'�C CII iYo.PZ. AS�11`fiLV I I I E I vim: o +ay�Y C I ZxBx /per sy"S,a71111,v� i � '— ALkl_ I /Y07Z�f APPU��W/SI 'O/ O T/til JSI�IXiS<<�Qf T0) �/rc/ �iFiiyyq$APPX�E.D f�,P TU�6�.CE/S�{�9 f/.G�6 .IU�P/'rI�/CT/oiC� e7— e,-- 4r/err/ �Ar�/oy--7B1G1/.4—S4!v/� �.PJyO� .4i�aLlG2C/i /*I�S�Lsitols�Lr/fJ7�� 30 /YCdF5T2A ,P�� /�.41L�c7" SiTF 5G1�5E G2EE� AlY 11577i Tcam- 1;oa7-ygfj! if-C1 elX-7 3y�-'�' 2 4�2 .treaPcv /992 95.20-1 (8187)-9d New York State Department of Environmental Conservation Ask oboeNOTICE v � a The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number Expiration Date 4/54 /97 NOTE: This notice is NOT a permit w New York State Department of Environmental Conservation Imhof Nokh,�er 30 ) Sou_ hold _j0L_3Y\� n M Thomas C. Jorling 11 J % V KOCommissioner D Dear_ Brdekf ff o N d� 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 toi assist you in responding. Project Name: �fsPAh+�� ?1rafer$1 Project Location: G60;e C(70-e,k %Ly\e, S 0wk� A& ) N I M-7`7 I DEC Project Number: DEC Permits: SEQR Classification: WType I [ ] Unlisted DEC Contact Person: Lc ,vrc,' S co\J az:2-0 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—toouur agency or another agency assuming lead agency status for tHisjactionbtui e,_have7�the following concerns regarding this project (see comments bel_ow),.P ' [ ] DEC wishes to` a'ssume_;l ead ag,ncy status for this action. r _ [ ] The proposed -action -has been__identified by DEC as occurring wholly or partially withi-n 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 ) : On I-Med Ca, l 4 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 cy nor any other involved agency, including DEC, has indicate a-91'11- serve serve as lead agency within 30 days of this lette . [ ] We wi11 pe rt• the Comm'ss' "r r�o DEC to designate a lead agency for this action. [ ] We wiyl a ition the Commissioner o Df to designate your agency as presuming you have jurisdiction. Please feel free to contact this office for further information or discussion. Sincerely, Lau, re, SCo\JOxZZco Enclosures Sr, Zvi roM",,fi ,i ) "Ylodys+ cc: (see rrdistribution list) -j-)qa(+Nof o F #oi rez Y ( 95-19-3(8/89)-7e DEC AP LjreTrrlN; _ NEIN YORK STATE DEPARTMENT AF E 5NMENTAL•CONSERVATION.Y• -" NUMB R j 'SEC 7 •D - D LATS _ JOINT APPLICATION 'FOR PERMIT, U'S ARMY CORPS-OF.ENGINEERS APPLICATION NO Please read ALL instructions on back before completmg this apphcation.-Please type,or print clearly,in in Attach additional-information as,needed. - ❑ARTICLE-9,'TITLE 1,ARTICLE 43 6NYCRR 646(LAKE GEORGE RECREATION ZONE)-, i, :r ••a,;;' +•^i;''v',n',i' a ❑ARTICLE 15,TITLE 3(AQUATIC PESTICIDES CONTROL) 116NYCRR 327(AQUATIC VEGETATION) 116NYCRR 328(FISH) J V❑6NYCRR 329(INSECTS) .,❑•ARTICLE 15;TITLE 5 6NYCRR 608'(PROTECTION'OF WATERS)', +, A ❑'For the construction,reconstruction,or repair of a DAM or'other-impoundment structure. T ` For the disturban6e`6f a'STREAM BED OR,BANKS'or excavation in or_fill'of NAVIGABLE WAfkE - 0,401 WATER QUALITY CERTIFICATION, E ❑ARTICLE 15,1--TITLE 15.' •=❑6NYCRR-601%(WATER SUPPLY) 1:16NYCRR 602(LONG ISLAND WELL`)-= �• I.- Z r ❑ARTILLE 15,TITLE 27'6NYCRR•666(WILD, SCENIC AND RECREATIONAL RIVERS) ❑ARTICLE 24,6NYCRR 662,663(FRESHWATER WETLANDS) ❑ARTICLE 25 6NYCRR 661 (TIDAL WETLANDS) - ❑ARTICLE 34 6NYCRR'505.(COASTAL' EROSION) tis' ----------------------------- r ---= - - --------------- -------- - ---------- F ---------------c------=------=------- U ❑SECTION 10(RIVER AND'HARBOR ACT OF 1899)for structures and work in navigable waters of the U S. ❑COASTAL CONSISTENCY CERTIFICATION.- . ❑SECTION 404(CLEAN WATER ACT OF,1977)for,disposal,of-dredged or fill material in waters of the U 5., „ ❑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 AN ;;_ r ,•,_ Owner „ ❑Operator ❑Lessee ❑Municipality/Governmental'Agency (Check as many as apply)., 3. NVVOF APPLICANT(Use,Full Na e). v MAILING MAVREJS -TELEPHONE(Where can,be reached aurin day) POST FF{CE )+ U�- _ i, — F STATE ZIP COD 4 NAME OF Owner ❑Agen Contact Pe on (Check one) ;•p, �_ _ �r� - j ri F'' jo MAILING ADDRESS --- " ;a, = „. TELEPHONE(Where can be reached during day)- ( r ) POST OFFICE - -, STATE ZIP CODE .5. PROJECT/FACILITY'LOCATION(Mark location on map,see Number 1a on reverse side) County' I �rent Town of cityI Village STREET ADDRESS(I pplicant) _ POST O C - - ST TE ZIP CODE_. NV 6; NAME bF STREAM OR BODY OF WATER_. r 7 HAS WORK'BEG UtyON PROJECT? If YES, attach explanation,on starting without permit, i6clude dates. 8 WILL PROJECT UTI ZE STATE'LAND� ❑Yes No Show work on map'and/or drawings. s r ❑Yes No 9 :PROPOSED USE 10'-PROPOSED STARTING DATE•. 11. APPROXIMATE COMPLETION DATE_ 12 FEE.OF(NYS_Permit Only) ' Private - ❑ Public ❑ Commercial. A/45 a Y oG� L $ Enclosed 13. PROJECT DESCRIPTION- (e g quantity and type of material to be excavated,dredged or used-for fill or rip rap,location of disposal sites,type of structure to be installed; height of dam,size of impoundent, capacities of proposed water sources,extent of distribution system,etc) 14 WILL THIS PROJECT REQUIRE ADDITIONAL FEDERAL, STATE AND/OR LOCAL PERMITS? �y �ry /`1] /J L / _I y� Yes ❑ No If yes,'p�llee)ise list'://�P/� F y�.. t ' �Vr°L�"I VLI��•/i � r/,VV I�+! /1I f ' 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 21045 of the'Penal Law Further, the applicant accepts full responsibility for all damage, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project 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 provides for a fine of not more than$10,000 or imprisonment for not more than five years, or both, where an applicant knowingly and willfully falsifies,cone Is,or covers up a material fact;or knowingly makes or uses a false,f•ctitous or fraudulent statement. ❑I hereV aut raze the agent named in Number above to submit this ap licatio on my behalf- ATE SIGNATURE' � TITLE PLEAS READ ALL INSTRUCTIONS ON REVERSE SIDE _ nrnUrT°-DMINISTRATOR PART 1—PROJECT INFORMATION Prepared by Project Sponsor NOTICE. This document is designed to assist in determining whether the action prop o ed f t on the environment Please complete the entire form, Parts A through E. Answers to V�ill I i d as part of the application for approval and may be subject to further verification and pi e 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 NAM F�OP ACTION r ?-Lt7 e r )^ p e r`Iv `^ oil art C1 S n 4 J 2' t rri % Jn9 LOCATION OF ACTT (Include Street Address, Mun+c+pal� and County) �� I I I , NAM OF APPLICANVSPONSO ) j BUSINESS TELEPHONE ADDRESS ^� CITY/ STATE ZIP CODE /1 �C w moi. 1) '7 NAW F OWNER(If different) BUSINESS TELEPHONE ADDRESS CITY/Po STATE ZIP CODE DESCRIPTION OF ACTION �CnS�rur� lion L�� Sfr1c� �� c�rni�lc; Please Complete Each Question—Indicate N.A. if not applicable � �� A. Site Description ��D�c Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: ❑Urban El Industrial ❑Commerciai ❑Residential (suburban) ERRural (non-farm) ❑Forest ❑Agriculture ❑Other 2. Total acreage of project area: less 777a, //A acres. APPROXIMATE ACREAGE :7 ` PRESENTLY AFT R CCjMf'LETION Meadow or Brushland (Non-agricultural) acre �a i '/� acre 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) acres acres Roads, buildings and other paved surfaces acres acres Other (Indicate type) acres acres 3. What is predominant soil ype(s) on project site? a. Soil drainage: Well drained 100 % 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? acres. (See 1 NYCRR�370) 4 Are there bedrock outcroppings on project site? ❑Yes L9'N70o a What is depth to bedrock? (in feet) 2 5 Approximate percentage of proposed project site with slopes:- .&0-10% % 010-15% �� % Ell 5% or greater % 6. Is project substantially contiguous to, or con a building, site, or district, listed on the State or the National Registers of Historic Places? Dyes ENO 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? ❑Yes ❑1Qo 8 What is the depth of the water table? 'Lo(in feet) 9. Is site located over a primary, principal, or sole source aquifer? []Yes Lilo 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? 12/'es ❑No 11. Does project sitegot ain any species of plant or animal life that is identified as threatened or endangered? ❑Yes According to Ti Identify each species 12 Are there any uniqu or unusual land forms on the project site? (Le, cliffs, dunes, other geological formations) ❑Yes No Describe 13 Is the project site p�r ently used by the community or neighborhood as an open space or recreation area? ❑ ^Yes �, O If yes, explain 14. Does the present sit include scenic views known to be important to the community? ❑Yes o 9�/ 15 Streams within or contiguous to project area: A 0,17 a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetlag areas withi or contiguous to project area: a. Name c ' C- b Size (In acres) 17. Is the site served b existing public utilities? Yes ❑No � d // Y g p �!!GU �/iii ha ve 1r1�1a7"/� a) If Yes, does sufficient capacity exist to allow connection? D es ❑No � tile 1% a G e s5 Pco b) If Yes, will improvements be necessary to allow connection? []Yes ©No 18 Is the site located in an agricultural 7strict certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? ❑Yes 1alNo 19. Is the site located in or substantially contiguous o a Criti.cal Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617? ❑Yes Nd 20. Has the site ever been used for the disposal of solid or hazardous wastes? ❑Yes "10 B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or contr Iled by project sponsor L'� acres. b. Project acreage to be developed:Je» ? - acr f initially; Sam � acres ultimately C. Project acreage to remain unde�v/�el ped r 1 acres. d Length of project, in miles. 411.4 (If'appropriate) '/ e. If the project is an expansion, indicate percent of expansion proposed If /4 %; f Number of off-street parking spaces existing ; 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 �— Ultimately i Dimensions (in feet) of largest proposed structure height, wi th, 0 length j Linear feet of frontage along a public thoroughfare project will occupy is? �1 ft 3 . 2 How much natural material (i e , rock, earth, etc) will be removed from the site? tons/cubic yards 3 Will disturbed areas be reclaimed? ❑Yes ❑No El N/A a�' �'&ev e- a tee`" a If yes, for what intended purpose is the site being reclaimed? /'l ae 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? G acres 5 Will any mature Brest (over 100 years old) or other locally-important vegetation be removed by this project? ❑Yes No 6. If single phase project Anticipated period of construction _ months, (including demolition). 7 If multi-phased: 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 phas s? [--]YesZX0 8. Will blasting occur during construction? ❑Yes t2<0 9. Number of jobs generated: during construction after project is complete 0 10 Number of jobs eliminated by this project /y 11. Will project require relocation of any projects or facilities? ❑Yes QPQo If yes, explain 12. Is surface liquid waste disposal involved? ❑Yes 040 a If yes, indicate type of waste (sewage, industrial, etc) and amount b. Name of water body into which effluent will b discharged 13. Is subsurface liquid waste disposal involved? Yes ❑No Type 14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes o Explain 15. Is project or any portion of project located in a 100 yea flood plain? ❑Yes No 16 Will the project generate solid waste? ❑Yes o 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 i 17. Will the project involve the disposal of solid waste? ❑Yes NNo a. If yes, what is the anticipated rate of disposal? tons/month b. If yes, what is the anticipated site life? y ars 18. Will project use herbicides or pesticides? ❑Yes ©No 19. Will project routinely produce odors (more than one hour per day)? ❑Yes E34N o % 3 20 Will project produce operating noise exceeding the loc I ambient noise levels? ❑Yes L—J- o 21 Will project result in an increase in energy use? MYes ❑No r If yes , indicate type(s) i 22. If water supply is from wells, indicate pumping capacity 5 gallons/minute 23 Total anticipated water usage per day ?C7 45 gallons/day 24 Does project involve Local, State or Federal funding? ❑Yes 1]411 0 If Yes, explain 4 25. Approvals Required: Submittal Type Date City, Town, Village Board []Yes ❑No City, Town, Village Planning Board ❑Yes ONO City, Town Zoning Board El es ONO City, County Health Department 'FL]Yes ONO S� �. �,. erl" l,;737� Other Local Agencies Yes ONO - c� 7A�,ld /°w.� �� rm�� 4�Sovn tc ( r' Other Regional Agencies ❑Yes ❑No State Agencies 10-Y es []No �f Federal Agencies El Yes ENO 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 mana ement plan ❑other 2 What is the zoning classificationSs)of the site? y � 3 What is the maximum potential development of the site if developed as permitted by the present zoning? h _ - 4 What is the proposed zoning •f the site? 5 What is the maximum potential development of th s e if developed as permitted by the proposed zoning? i 6 Is the proposed action consistent with the recommended uses in adopted local land use plans? (des ONO 7 What are the predominant land use(s) and zoning classifications within a '/4 mile radius of proposed action? / 8. Is the proposed action compatible with adjoining/surrounding land uses within a '/4 i� es ❑No 9. If the proposed action is the subdivision of land, how many lots are proposed? 411/9- 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 w o 11 Will the proposed action create /mand for any community provided services (recreation, education, police, fire protection)? ❑Yes El a If yes, is existing capacity sufficient to handle projected demand? ❑Yes ❑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 ❑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 the informa on provided above is true to the best of my knowledge Applicant/Sponsor ame- , `r /nl c- 1 - ?-7) Q1.,J-1 Date • ' �9 Signature /C.:%�t,��"i�' i.�rz �-� Title if the action is in the( oastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. 5 39 =:. ,: 40 .F`ti. P ;s I S,'.' /r Y 5 r!. 42 .1- '"�" . YYre F: ..1t-'(:tl�.'..,r ,y, ': 'il (��,j.::,", .• R. ��!•.'i,• SY= -.,.ts.'';3}},, 'i.. �\: - ��r,---r. ;z<,.,�a::r_ i :i ;:i';'�''i�:'•o..- n r• � rte•.. ,i:. •r."•:'v^ ,•Y v '4a .S - .J` ;Yic �7i+_,a J,...��,r-i w.5;Kti, c's-< r+^• '-�)'� "2:� .r•'. %ir:.N„,.v.`j, 1:l �'1•j •1 Y r ':.+> `,ton - ti`•' ...,alt1r..i` _t•J �'I;', Yn {ti.c ... iTl+c q� 4.t.v.. ... ,.,,,.: - '%c..r..- J 50�u .4' .!:- _ r ' ^�y-x'1:4 y• >�ht:•ua''.S*i 'S`.:' fgw.,3;.-., y'/�,Tn:. 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OVAL. 02 j`__� _ 7 STATEMENT`OF'�ii`1TEf+IT' `fit N.:,J --t,� � ) - THE,WAT1�R,SifLl� At�t®SE4+YAGE•#�ISP'C�SI.' = 1' r` 5fElNS ��JR Ti iS. �n :=WILL 2ESLEisICE . -W ON :STAIa;DARDS; IF,, fou ?-;HC {} SuFF6LK`C0.• D T, ciF ' EA T_R"SERVICES. -�i ;,`�.t�i.J-�,•�=rf'ff. i� i�_c-, .- - f.��'� r, . ,t' ,� •••-;� _T�._.- - ,. r, - CAN SUFFOLK -C®LINTY" .DEPT` 'Ott 7AEALTH, COW'STRUCTOON OfNI. r DkTE• _ _ REF:,NQ::=, - SUFFOLK,CO. TA , ,-, AP-DE l4ilSIT1` SE 9L 01NNER_:ADDRESS: - r�-�j,. �.� ` � , r � -.� _ :`�• au,, -..� _'_yt?,i-'.:�yy!S'}�-'r{•'�"t.:'-C-.: n SX, — - . '�: - , Ate DEEW 4C J _ - ,j _;�`` t.'�SY tyr,�'j:��ay'7 �'Nbi' i•:. ', ' n _.? " - VA,tdCj:Yt' :'c sa,scs.s:rrveyor's irsget;seaFo;r • - - _ � •1s'�$FlfCY`' '" - • ,'em;.a=�s_d,sssl-shall,ncY`E�•`conside. j' to be 3.rmiiQ'Yrud,Yibpvag &:4Vd W, Gua:untses indicated li`eceo.1 shalt u� a 14 `,_ orgy m vne person-tor iuhgr^'Y�o,su a� is pr*�Az�rsd.and cn his`El alf;o't ---- t�;:.:.,"i-,n.ny.Governrrentn!2C V-,- w71& _':,%-ir:iQlltson ,15jz ovi N - 'o z0a C JP;f3Cs Cf Yi:3 lorivia�,dr. - .u;cn L:: amc s are nat irnv !t;o �7Nj rQ. J cCQ':ipnti Ir"S:i*17tiens Cts subsoq gni ---4EVEa_�u�s ' ;Z,1b 399z, , SEPT EP�'—_��_v�?} a t xre% CK Y, r=S 5LJQVEYEP MAY 13 t' 2rz RORERl�fC VAN .ler f..._, �r p�`:'`vQ->s •e�-�r.°'��{r'/ - ', LICENSED LAND SURVEYORS GREENPORT NEW YORK _ _ (1/&q&2ia -2. d?umpty, 30 r4o f sta TWc7e, !9zsenLawn, )VFw % k 11740 �"l� • '91R7- f /&!Fr 4co �acor_ • lam, ��L�L�'GO'�-�-'" J r %� T � a �>� �� , �� ',� �: `- �x -, �, � New York State Department of Environmental Conservation Building 40—SUNY, Stony Brook, New York 11790-2356 (516) 751- 1389 C(Oply Thomas C. Jorling Commissioner - April 7, 1992 Virginia Rumpler 30 Hofstra Rd. Greenlawn, NY 11740 RE: 1-4738-00497/00001-0 Dear Ms. Rumpler: In conformance with the requirements of the State Uniform Procedures Act (Article 70,ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours3 Robert Thurber Sr. Environmental Analyst RNT/nw enclosure /90)-25c NEW YORK STATE DFPARTMFNT Or FNVIRONMFNTAI CONSFRVATION EC P0000 ERMIT NUMBER FFTF(IWE DATE 1-4738-00497/00001-0 April 7, 1992 FACILITYIPROGRAM NUMBER(s) PERMIT EXPIRATION DATE Under the Environmental Conservation Law (ECL) April 30, 1997 TYPE OF PFRMIT(Check All Applicable ROWS) ®New ❑Renewal ❑Modification ❑Permit to Construct ❑Permit to Operate F-1 Article 15, Title 5: Article 17, Titles 7, 8* Article 27, Title 9, 6NYCRR 373 Protection of Water El SPDES Hazardous Waste Management EArticle 15, Title 15: Article 19. Article 34. Water Supply Air Pollution Control Coastal Erosion Management Article 15, Title 15: Article 23, Title 27: Article 36 Water Transport Mined Land Reclamation Floodplain Management Article 15, Title 15* Article 24: Articles 1, 3, 17, 19, 27, 37, Long Island Wells Freshwater Wetlands 6NYCRR 380* Radiation Control Article 15, Title 27: Article 25. Other Wild, Scenic and Recreational Tidal Wetlands Rivers Article 27, Title 7, 6NYCRR 360. 6NYCRR 608: Solid Waste Management Water Ouality Certification PERMIT ISSUFD TO IEIFPHCINF N11M8lR Virginia Rumpler ( ) ADDRESS OF P1 RMITTEF 30 Hofstra Rd, Greenlawn, NY 11740 CONTACT PERSON FOR PERMITTED WORK IEIFI'II0NF NUMRFR Susan Long, Costello Marine P.O. Box 2124 Greenport, NY 11944 ( ) NAMF AND ADDRESS OF PROTECT/FACILITY Goose Creek Lane, Southold SCTM No. 1000-75-1-5 LOCATION OF PROIECTIFACILITY COUNTY TOWNS WATERCOURSE/WFTLAND NO NYTM COORDINATES Suffolk I Southold Goose Creek E — Na_ — D SCRIPTION F AUT RI FjD ACTIVIT ConsITa �� 'linear eet timber bulkhead extending from the end of the existing bulk- head on the west to a point that is 15' landward of the face of the bulkhead on the east. Add new timber return to connect the two bulkheads to replace slate/concrete wall which must be removed. All work must be in accordance with attached plans stanved approved by NYSDBC. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL,all applicable regulations, the General Conditions specified(See Reverse Side)and any Special Conditions included as part of this permit. t ��r5, AgvF;es yqqTn PERMIT ADMINISTRATOR ADDRESS TSIc7_1. 4sn , MI Davi(I T)PRi dripr st�reJ mt'srTs, My. 11770;%-VO AUTHORIZED SIGNATURE DATE ,Toe April 7, 1992 Page 1 of 4 -10-6a(101901-25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34, 36 and 6 NYCRR Part 600 9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized,or project if, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles,ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State,the owner may be ordered by the Department to a waterway remove or alter the structural work, obstructions, or hazards caused 14 There shall be no unreasonable Interference with navigation by the work thereby without expense to the State, and if, upon the expiration or herein authorl7ed revocation of this permit, the structure, fill, excavation, or other 15 If upon the expiration or revocation of this permit,the project hereby modification of the watercourse hereby authorized shall not he com- authorized has not been completed,the applicant shall,without expense pleted, the owners, shall, without expense to the State, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Environmental Department of Environmental Conservation may require,remove all or Conservation may require,remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to its former condition the navigable to its former condition No claim shall be made against the State of and flood capacity of the watercourse No claim shall be made against New York on account of any such removal or alteration the State of New York on account of any such removal or alteration 16 If granted under Article 36, this permit does not signify in any way 10 That the State of New York shall In no case be liable for any damage that the project will be free from flooding or Injury to the structure or work herein authorized which may be caused 17 If granted under 6 NYCRR Part 608, the NYS Department of Fnviron- by or result from future operations undertaken by the State for the mental Conservation hereby certifies that the subject protect will not conservation or Improvement of navigation,or for other purposes,and contravene effluent limitations or other limitations or standards under no claim or right to compensation shall accrue from any such damage. Sections 301, 102, 303, 306 and 307 of the Clean Water Act of 1977 11 Granting of this permit does not relieve the applicant of the responsi- (PL 95-217)provided that all of the conditions listed herein are met bility of obtaining any other permission, consent or approval from 10 All activities authon7ed by this permit must be In strict conformance the U S Army Corps of Engineers, U S Coast Guard, New York State with the approved plans submitted by the applicant or his agent as part Office of General Services or local government which may be required of the permit application 12 All necessary precautions shall be taken to preclude contamination Such approved plans were prepared by Costello Marine of any wetland or waterway by suspended solids, sediments, fuels, solvents,lubricants,epoxy coatings,paints,concrete,leachate or any Contracting on 3/92 SPECIAL CONDITIONS 1. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands. 2. All fill shall consist of "clean" gravel and soil (not asphalt, slag, flyash, broken concrete or demolition debris) . 3. Equipment operation below mean high water is strictly prohibited. 4. Bulkhead constructed directly adjacent to vegetated tidal wetlar �shall be jetted in with minimal disturbance to the tidal wetland. Trenching is strictly prohibited, 5. All peripheral rip rap berms, cofferdams, rock revetment, gabions, bulkhead etc. shall be completed prior to placement of any fill material behind such structures. 6. Within 30 days of permit issuance, the slate-concrete wall on east side of property must be removed. Supplementary Special Conditions (A) thru (J) attached. DFC PERMIT NUMBER 1-4738-00497/00001-0 PROGRAMIFACILITY NUMBER Page 3 of 4 SUM ENTAR SPECIAL CONDITIONS " The following conditions apply to all permits: A. If any of the permit conditions are ulear , theat theaddresstandshall con- tact the Division of Regulatory Affairs noted below. B. A copy Of this permit with supplementary conditions and approved plans shall be available at the project site whenever authorize work is in progress . C. The permit sign enclosed with the permit or a copy of letter of approval shall be protected from the weather and posted in a con- spicuous location at the work site until completion of authorized work . D. At least 98 hours prior to hem�eoncemr�ionfofhtherenclosedf�receipttforrn shall complete and return t P Po certifying that he is fully awahenoonenWeekdofscompletionpofvtheons and conditions of this permit . Wit permitted work , the bottom portion of that form shall also be com- pleted and returned. E. For projects involving activities to be accomplished over. a period of more than one year , the permittee shall notify the Regional Permit Administrator in writing at .least 48 hours prior to the commencement of resumption of work each year . the F. If project design modificationrotriatke elplan lace achangfter esrissuance,mit for approval by permittee shall submit the aPP P ior to undertaking any such modi- the Regional Permit Administrator pr fications . The permittee isadvised thatosubstantial n for modification may require submission of a PP G. All necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended saints , concrete, ,leachate or solvents, lubricants, epoxy coatings, p eleterious materials associated with the any other environmentally d project work . H. Any failure to comply precisely with all of the terms and conditions of this permit , unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. I . The permittee is advised to obtain any permits or approvals that may ers , NY be required from the U.S. Department of Army Corps ttentionf1eRegulatory District , 26 BrancFederh) , prior commencement ofNew York , NY 2work 78, ( author i.zed herein. Functions Branch) , p this permit does not relieve the permittee of the J . The granting of I a grant, easement, or other necessary responsibility of obtainin approval from the Division of renStatelPlaza, AlbanyCeNYf12242 , which Services, Tower Building, Cmpi may be required for any encroachment upon State-owned lands underwater . Regional Permit Administ;'rator NYS Dept . of Environmental Conservation Bldg . 40, SUNY-Room 219 Stony Brook , NY 11790-2356 ( 516) 751-1389 i /.-��O AA,A)-7/ lig/ / 95201 (8187)-9d New York State Department of Environmental Conservation NOTICE v The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number / Expiration Date x`"/56 I97 NOTE: This notice is NOT a permit ISO �(��".;.�� ...� •�: `tel:f�k F3' `q.1¢✓:•_'1 ��' ``f'�,A.:7 �'^�•k!�' S �'ap! Ps: k n�` myv,' ,jr 't rtg,�4,v � R••+4 �','� `nR�'. _) a.�o, .:�') � 7y�W:q�F� ' c r�y� � 1 :"':i a�N� ;� r i .fG•i. J•%y `'� � �.�+*4f?a_ fe� �i. ��/ .i .�./ice- ��i i .��. _.,�•n,. _ r hm,.c� '72i Py r „r a 33� �i i •.��Y. 1Board Of Southold Town Trustees SOUTHOLD, NEW YORK K, �, �, Ips • ` 4008 Ma 1 1 2 E �^ ��• :� PERMIT NO. DATE: M.ay 99 ISSUED TO Virginia Rumpler "`• Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1193; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- I,< ' t{i titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the ji r REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM P. . LANDS UNDER TOWN WATERS;" and in accordance with the 4 Resolution of The Board adopted at a meeting held on April 30 ' ' ! 19 92 , and in consideration of the sure of $ 150.00 paid by `* Costello Marine on behalf of Virginia Rumpler o°f N. Y. and subject to the , Terms and Conditions listed on the reverseside hereof, �'` •,� 5' � �.f •� of Southold Town Trustees authorizes and permits the following: A! To install 75 1.f. of timber bulkhead to connect to each 6 adjoining properties existing bulkheads. Approx. 80 c.y. of clean fill will be trucked in. i • � ail iE, i �- 1� all in accordance with the detailed specifications as presented in - ' ' ;ii the originating application. °a� IN WITNESS WHEREOF, The said Board of Trustees here- ` . by causes its Corporate Seal to be affixed, and these presents to j' § "al be subscribed by a majority of the said Board as of this date. T ustees t 1 r'a .i P ,>^aN r i N.i,�r...r ,f S^''i-zap" 1 's.r�� iJ �a r •t±e.',f":�f •..[ 'a"�; a• r , •\�• � `�'ud'.'....m✓fiu.A'•..+.4•., �.'.�.u.M✓.�....+�...,� �_�a��&'+:_6.e..�.o...w=• 'm�.,�Pr.-.�' �,.di..✓Graau .a`13`.... ', �mp��r t i; f/.••ter- :�*��.�„ . •J�1 125!i 3Y °aa. ar :.•T/0 � •+ ,•.':a.' „f :.' .?' (F .i^'�}, 9-'� ;,.T •j•,\• `,T'µ�..a-�' "/!:: <s�c3m W �+W" � �,3� , `• �\.}r f �'AW�;�,> �p5 E.z.�... � �1.;,.,� �q7,.�� N i. - ! �' �`\�','��'F \ti.' sr;/,ti�W _ � ..�•' �at' '.i' %'".mow'',`':� a TRUSTEES ;;; ®� SUPERVISOR John M. Bredemeyer, III, President ®� SCOTT L. HARRIS Albert J. Krupski, Jr., Vice Presidentae ' Henry P. Smith Town Hall John B. Tuthill ®� ® '' 53095 Main Road William G. Albertson ®,( r� ��® P.O. Box 1179 Telephone (516) 765-1892 Southold, New Fork 11971 Fax (516) 765-1823 BARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 6, 1992 Costello Marine - P.O. Box AK Greenport, NY 11944 Re: Virginia Rumpler SCTM *1000-75-1-5 Dear Mr. Costello: The following action was taken by the Board of, Town Trustees during its regular meeting held on April 30, 1992 regarding the above matter: WHEREAS, COSTELLO MARINE ON BEHALF OF VIRGINIA RUMPLER applied to the Southold Town Trustees for a permit under tlie' provisions of the Wetland Ordinance of the Town of Southold, application dated March 16,' 1992 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 April 30, 1992' 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 COSTELLO MARINE ON BEHALF OF VIRGINIA RUMPLER BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: install 75 l.f. of timber bulkhead to connect to each adjoining properties existing bulkheads. Approx. 80 c.y. yards of clean fill will trucked in. This permit will, expire two years from the date it is signed. Fees must be paid, if applicable, 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. P R 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: No fees Very truly yours, John Mo Bredemeyer, III President, Board of Trustee JMB: j t cc: Conservation Advisory Council file F®t� TRUSTEES u, ®'�® SUPERVISOR John M. Bredemeyer, III, President SCOTT L. HARRIS. Albert J. Krupski, Jr., Mice President u Henry P. Smith coo aF r Town Hall John B. Tuthill �.�, �� 53095 Main Road William G. Albertson �� ® 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. 1000-75-1-5 NAME: Virginia Rumpler DATE: April 6 , 1992 RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617., Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as Lead Agency for the action described below, has determined that the project will not have a ' significant effect on the environment. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. ` TYPE OF ACTION: Type I - Peconic CEA DESCRIPTION OF ACTION: to install 75 l.f. timber bulkhead to connect to each adjoinging properties existing bulkheads. Truck in approx. 80 c.y clean sand fill. LOCATION: Tax map No. 1000-75-1-5 REASONS SUPPORTING THIS DETERMINATION: 1. An on site inspection has been conducted by the Board of. Trustees. 2 . An environmental assessment, submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as planned. cc: Applicant, CAC e %1C Fat F '�` :'IF.::�'��U71 L'l�'�_ 7 ,. .. ;:t;._.. ., ''�v, •�' - ;s'^<,,•!,-\" ��;��7r�;,.. - - •_ _.. -_- - - John M.Bredetneyer;III,President' ® �_ SUPERVISOR Henry P.'S",Vice President :y SCOTT L.HARRIS Albert J.Krupski,Jr. John L.BednosM,Jr. ��®� ;, Town Hall John B.Tuthill 53095 Main Road P.O.PBox 1179 Telephone(516)765-1892 BOARD OF TOWN TRUSTEES Southold,New York 11971 Fax(516)765-1823 TOWN OF SOUTHOLD March 19, 1992 Mr:- John Holzapfel, Chairman = Southold Town Conservation Advisory Council Southold Town Hall Main Road _ Southold, New York 11971 Dear' Mr. Holzapfel: Transmitted herewith is application No. 75-1-5 for a: wetland application submitted_ by Costello Marine on behalf of Virginia Rumbpler. - - 9 Please prepare a written report of findings and recommendations with respect to this application. Very truly yours,' 4hnM. Bredemeyer, III President; Board of Trustees JMB:jt 611.20 _ -- " Appendix C State Environmental Ouallty Review SHORT ENVIRONMENTAL ASSESSMENT FORM- For UNLISTED ACTIONS Only PART I Project irilormation (To be completed by Applicant or Project sponsor) 1 Applrcanlrspohsot 2 Protect Name (u, t +'\ Project location. ((''''�� Municipality 300-K6 I c] County Ro I k - a is proposed action 1 +1 New ❑ Expansion ❑ Moddreationlalleration s Destrrbe prol€ct briefly n p �iU � ..w� eve 6 Precise loiatron(road mlettectiont• prominent landmarks etc or provide map) 7 Amount of land affected: ��— —Initially acres -'-Ultimately _ ,acres --- - e Will proposed action tomply with existing toning of other exitting land use rettrictionst Yet " ❑ No If No.tlettribe briefly 9 What is preient laird use in vicinity of project► ,Residential ❑ Industrial ❑ Commercial_ ❑ Agriculture ❑ Parklandiopen space ❑ Other Describe! W Ill) Doei action 16014 1 permit approval, or funding, now or ultimately, from any other governmental agency(Federal, state or local)? Yes ❑ Uo It yes• list agencv(s)and permit;approvals 11 Does fhv 1ibk(,61 ih!Woolf have 1 currintiv valid permit or approval► Yet ` , j k8 If iii:lift i@enev name-and permiLepproval ttpfj 12 At risult al prdp$ied Abion still t iritinif permit approval require modrf itation) ❑ Yesd I CERTItY THAT THE INFORMATION PROVIDED ABOVE IS TRUE 10 THE BEST OF ml KKOwLEDCE• ' Applicaniapontor ttama. \��IB�JWCXA Date 0L0gZ Sfgnatui! ' It the action Is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 - PART 11 Efts UbfilfibAlAl Asi3aishiifiq (To be completed by Agency) A Does acildn 410rl-dl100 UTA I lhresk 6 N1CRR, Part 617121 If VIPs,,cosNdmate the review process ano use the FULL EAF y ❑ yei ❑ ivb _ 9 will Aclion•tetefv!66tdrti/ted It tr`0bWddd ibi unfitted Actions in 6 NVCRft,Pirt 617 71 It No,a negative declaration may be superceded bs another involved irt)dfi _ ❑ Yet ❑ Na C Could ittion feiult A ANY idveise effects on, to or atising from the following (Answers may be handwritten, if legible) C1 tasiting ifi bdllf .Wilact bt ir6undwiter duality or cluanuty.noise levels.existing iialtic patterns,solid waste production or disposal,potential for trot-an drainigi 61 Ilobdihi pfoblemsf taplam briefly C2. Aesthelle.ierieuliutal,licheological, historic or other natural or cultural retourcet,or tommunity or neighborhood character? Explain briefly C] Vegt iuon bf IAuni.,movement of fish or wildlife species significant habitats. or threatened or entlanpered species? [%plam briefly Ca A communetv'i editing plans or goals as officially adopted, or a change in use or intentuv of use of land or other natural resources? Esplam brielly CS Growth,subittiluent development,or rel6led activities likely to be induced by the proposed action? Explain briefly' C6. Secondary,a iTit,1 f114.tit other htfects not identified in C7•C6? Explain briefly, C: A change in use til eithii QuAntstV or type of energy? Explain briefly IP" PART 111 bitairttlIHM16A all Signiticalica (To be completed by Agency) IN5TKUttIIjN$l, •,,6 iiieh 5dverle Oki identified above, detethiine whether it is substantial, large, important or otherwise sigfillkii itt ��t hlfki lhotild be Asseised in connectloii with It3(a)letting (i e. urban or rural), (b) probability of occurring, (t)di.AMIdf#;(d110Ni8llsibiilt`;(e)gettgraphit scope; and(1)rt agnitudl; It necessary, add attachments or reference supporting malkilfilki W64 thili ekplahiltidhl toritaih SUf(icifint detail to Show that all relevant adverse impacts have been identified and 4dpdusio1y,Addi6is6d. ❑ Chea thil b6i it V6U liayi identified one or more poteritfally large of significant adverse impacts which MAY occur Then wot od 64610 IH thi GULL EAE and;ot ptepare a poildoe,declbriation. ❑ ChoCk this b6i it VbU hio det6rhilied, based on the InforMatl6h and analysis above and any supporting documentation. Chit the 06008'9616h Will Ndf IelUlt tri any S(gh(ficant gdvoir fi environmental impacts AND provide here, and on attethtii�nts illi hik6lWy. the tfirisons lupportng this determination: Agency\ame Agency PripArer s Name Prepareri Siiniture.lide Date 2 j �L Int • t r a rw ,.1 _ C 0-YA •" _ \I` tens IE:t� ,3,0 C o •1.. •v a w i _ 1 /•sq Y �y ,p � •1� •� _ _ • � O'M A y V _ _ / 'Y Y ' Id aY o �"• — -•" �A J A N s'• - � 4 � _ J 14 N_ / •4 , 4a yr m THIP r- 1• O i � r, � J i ,i 'y' y ar � „� _ ,y. Y • • i'y v �•• .y Al ! t o Y AUHItlilljAjj6N LLIIEII Da te I , — __ UWtIeI' U� eo J f Name - - _ / o - �2=-1 • u'sine'ss7proper[y-n located it � ��' do harsh r f�eSS � � a y give Costello Nsrihe Cdfltfticting Corp, tl,e autl�urlty to Ott as ageht In my behalf lrr epplylr,q for A11 h"3s" � y PO in order for work to be done on my property described above, Igndture