The URL can be used to link to this page

Home My WebLink AboutTR-3910 '.�. .ry.'.fib� " ti f.� '�. ► Y, £�r?�` 4 v e� . V3 d ?r "�V) 1 'V? •1yN Vl.� ! ;k r " �• V> / yy Y F4..c i r , s _y r 1' Board Of Southold Town Trustees SOUTHOLD, NEW YORK : - �. PERMIT NO. .......3.9.1..0. ..........:... DATE: ..May...3....... .9.91 �. ISSUED TO ........P.ort...a£...E.gyp t/.....C.&.h...Realty. ...................................................... A1xt � t �IftlT 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 'I State of New York 1952, and the ;Southold Town Ordinance en- !:. C. •. k titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and thek� f / REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM .r LANDS UNDER TOWN.WATERS; and in accordance with the I . sue:•. a Resolution of The Board adopted at a meeting held on ...Ma. ..2.......... _ 19....9.1..., and in consideration of the sum of $........1.5.0...00.... paid by =a Por.t....of...E t1.....C.&.. ................... .....gyp. L...lte.alty...........:.............. ................................ � 3 ........................ of N. Y. and subject to the Y i Terms and Conditions listed on the reverse side. hereof, of Southold Town Trustees authorizes and permits the following: 'I Maintenance dredge two boat basins and other locations along bulkheads as needed and as noted. by Port of Egypt on the Van Tu 1 survey dated April 4, 1989. This permit shall y j exR're May 1, 1994. Running concurrent) with NYSDEC & Ar a-II in accordance with the detailed specifications as presented in 'Corp;'" the originating application. s IN WITNESS WHEREOF, The said Board of Trustees here- ! N1� b causes its Corporate Seal to be affixed, and these resents to Y P P tif� r a be subscribed by a majority of the said Board as of this date. 3•� t ... , 1.................... .......mi ......l,.-t=..... ... . < 1 ,� y� Trustees I: -,.�., �w�--�,?5,,..x�;� .../3'�, :.,W"`:..d.�x ..m�.r�....� � ,_, 'a. a �'�✓ x �s„�,u„,,�+', s a:'i'��+-' R �,,br'�e.T.c�„'?�W,..•�:..aag'�y �i arm EM410imm 5� WNW MUT TERMS and CONDITIONS The Permittee —_Port of RgW t/ C.&T. R aalttr residing at Main Road,_ Southold N. Y., as part of the consideration. for the issuance'of the Permit does understand and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, .to the complete.-exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for .a period of mos. which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, .or as long as the said Permit-tee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that auth-' orization was originally obtained. 4. That .the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in. the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold - 8. That the said Board will be notified by the Permittee of the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents that may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. TRUSTEES ��® SUPERVISOR John M. Bredemeyer, III, President u: SCOTT L. HARRIS Albert J. Krupski; Jr., Vice'President Henry 1? Smith _ 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) 765-1923 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLID July 20, 1992 Merlon Wiggin Peconic. Associates, Inc. One Bootleg Alley -P.O. Box 672 Greenport, NY 11944 Dear Mr. Wigging With respect to the attached memoranda from the 'Town Planning Board please be mindful that any activities within 75 ' of the bay at this location will require a town wetland permit. As this site is known to be extremely stressed..with respect to drainage needs and has been the subject of prior enforcement actions of this Board, the Trustees will likely encourage a very "hard look" at any proposal to ensure that it properly addresses the wastewater/drainwater issue. If we can be of any assistance by.holding a pre-submission conference please contact this office. S'ncerel au John M. Bredemeyer III President, Board of Trustees cc: Bennett Orlowski, Chairman Southold Town Planning Board Victor Lessard, Principal Building Administrator William Li.eblein, Port of Egypt' Enterprises, Inc. 0 ,� r222'i;• i I F04 +1 ��qb 7M1... 6Ij•,/, �'.;y, II I4Jy I PLANNING BOARD MEMBERS COS SCO'IT L. HARRIS � Supervisor I; Bennett Orlowski; Jr., Chairman �,u ,$ , George Ritchie Latham, Jr. f q '� `;" a Town Hall, 53095 I+�aip, 6md; Richard G. Yard• < i' Mark S. McDonald xu - P,O. Box'1179 '!;I Southold, New Yorkt 197 V Kenneth L. Edwards PLANNING "BOARD 'OFFICE Telephone (51 Cz) 765-1938 TOth N OF SOU THOLD Fax (516) 765-1823. July 9, 1992 {. Merlon Wiggin Peconi -Associates, Inca One Bootleg Alley P.O. Box 672 G!reenpart, NY ! 11944 RE: Request for site plan waaveV, 401, 2 Port of Egypt Enterpr.Lses Route 25, Southold` Zoning District: Marine II r; (MI I) SCTM4 1000-56-6-3 0 4 Dear Mr. Wigging a ;f The Planning Board has reviewed your letter of. June 26, 1992 , in which you -request a waiver of site plan requirements, for the conversion of the two-story motel/scallop building to a marina clay room and Sea-Tow generator repair and administrative facility. The Board will not grant a. waiver for this change of. use and the renovation of this building. a . The Board feels that the area is ecologically sensitive and ! ' will .require a State Environmental Quality Review ct• (SEQRA) review of this Type i action. The renovation to the building will' be extensive due to it' s current con.dii;ion. The Board. will be required under SEQRA to review all aspects of this .proposed 01, project, including drainage and parking. JW The proposed project. will also require review by -the Suffolk County Department of Health Services. q t 41 2r y 1 t tl A!- 14 ,(:�tita,i { ,�,i !�,! •; I . '-i.r I f b L I,}��1 t i j ' Nf��r Tip It j , �a r��t �Id ji ! I 6 �� •�y'• ' I lly9�°� r �Id�.i& '�-��"' ,�YS�I e-qulge rfurther Informal on, oOL aVf � L1 St1OnS, Or soffice.pieasecn: ct thi IN Ma° � ,� I g Very truly yours, Bennett Orlowski Jr. � `d Chairman i cc: Victor Lessard e Principal Building Inspector 4 I .�liam Lieblein, Port- of EgYpt Enterprises® Inc. �I dohral Bredemeyer� III president,', Board of Trustees ✓ '' ,..;'., .i" r - �I',c��ti�+�y��.,.,ail•,,; a, I l! i jl �ji • I \ � 11 if��x}y'I M � �l'- I I f j i' � � I Ir i I dot "j�4g4,; ;II Ltitt I j3 ;� V°��nod ��s� I.,I �� ' VR� , � + t p e, �? �. t . 5 t- •; t., -1 , ii I � I I - a®�UFF64 TRUSTEES � John M.Bredemeyer,III,President �y W _ SUPERVISOR Henry P. Smith,Vice President # . ' SCOTT L.HARRIS ''. Albert J.Krupski,Jr. �� "W d John L.Bednosld,Jr. '''r��j�, �+°�� Town'Hall John B.Tuthill 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 May 9, 1991 George A. Cottral Port of Egypt Marine, Inc. Main Road Southold, NY 11952 Re: Application to dredge , Dear Mr. Cottral: The following action was taken by the Board of Town Trustees during its regular meeting held on May 2, 1991 regarding the above matter: WHEREAS, George Cottral applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated March 22, 1991 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 May 2, 1991 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 GEORGE COTTRAL ON BEHALF OF PORT OF EGYPT BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: maintenance dredge two 'boat basins and other locations along bulkheads as needed and as noted by Port of Egypt on the Van Tuyl survey dated April 4, 1989. This permit shall expire May 31, 1994. Running concurrently with NYSDEC and Army Corp. permits. 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 additional fees. Very truly yours, John M. Bredemeyer, III President, Board of Trustees JMB: jt cc: Bldg. Dept. Conservation Advisory Council file TRUSTEES John M.Bredemeyer,III,President ® �^ SUPERVISOR Henry P. Smith,Vice President sY ux ,� SCOTT L.HARRIS Albert J.Krupski,Jr. John L.Bednoski,Jr. Town Town Hall rti John B.Tuthill 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 S S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. 1000-56-6-6.1 NAME: Port of Egypt DATE: April 9, 1991 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: to do maintenance dredging at two boat basins and other locations along bulkheads as needed and as noted by Port of Egypt on the Van Tuyl survey dated April 4, 1989. LOCATION: Tax map No. 1000-56-6-6. 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 project be implemented as planned. cc: Bldg. Dept. , CAC, NYSDEC , NV V cc-'� • • - APR -2 1991 Port of Egypt Marine, �J O)MD OF TDwN 7Rk5-TcEs Tmop o F s cu-W oc-b I tCE T6 TRWr -r#F �3MAP Cotes JD5;q -ssu ice- /lmt/- £uc E: PACF 7aWW PD 5ZMITJ 72&A Co#M�CiAL— ~,Pfts VW— t-ookl-p AkrJ Yocik BST 7�s- MAIN ROAD/ROUTE 25/SOUTHOLD, LONG ISLAND, NEW YORK 11971/516 765 2445/FAX 516 765 2592 y SCOTT L. HARRIS TRUSTEES �,, �_ ?' John M. Bredemeyer, III, President Supervisor� � � Henry P. Smith, Vice President � Town Hall, 53095 Main Road Albert J. Krupski, Jr. �� n 7 P.O. Box 1179 John L. Bednoski, Jr. [hold, New York 11971 John B. Tuthill BOARD OF TOWN T Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTH 2 a��177�Vp a lephone(516) 765-1800 �- ! C4 WN OF SOUTHOLD APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR.WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. Io — —6. 1 DATE 3/za PORT GF EFyer .EaR: mvc, 3- APPLI CANT' S NAME: C+L JqEALT (SNC TEL. NO. 7k ' Z yyr MAILING ADDRESS: A,91)V RPAD $pL4THP1_j) AL V. , 11171 AGENT: TEL NO. AGENT ADDRESS: PERMIT REQUESTED TO: MigllVrEV ACE 1g1=PGIN6- of Two `'DAT �051 Ay, ANP cllgg a 4-Pe AT i oNs ► I-PAJ . l k LlcP?3)5 /� S LOCATION OF PROPERTY FOR REQUESTED PERMIT: MAIN A VAT) 509?T DL TOWN: Sy totT N 0 L`' TAX MAP NO: 1000— SLR _ IV —tp' CREEK, BAY OR HARBOR FRONTING PROPERTY: Uk ft N D SIZE --,F PROPOSED WORK: LENG73 , 2, OVAT S45W S l fD(j EA 4 WIDTH: so ' J d. Page 2. YDS. TO BE EXCAVATED: 60 YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: c.c.il m s NE'LL- R� , aAck�lOt AND Willip uwl< WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: DEPTH AT LOW TIDE: D " Z2 IX'. AVER. RISE IN TIDE: a.� DISTANCE TO NEAREST CHANNEL: .20D1 DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN AREA: Ir) AREA ZONING: M C IS PROJECT FOR PRIVATE OR BUS. USE: GfSi INTENDED USE OF PROPERTY: 1pojp%I V AT N0 C_OMAIMO.IAL RPAT IAi;. DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: M6/I11MINCE HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: 50kTf)01_P TVWN , A) YS MC A NU A kfKy CyRP.S 4 HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: tot) DESCRIBE FULLY THE REHABILLI,TATION OF PROPERTY: N �1 DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: i5'/4jILfV ,' TQ atipsa" wrrN 1 WEP, w�Q� cN t3o* " /?IFS $05 ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: NO WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: jq i 1 _ v COUNTY OF SUFFOLK ) STATE OF NEW YORK ) V`� (I� I �►� BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BE.TAIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS DAY OF ► 1 , 19 J NOT ARY PUBLIC Notary F bRcC G. KOCH State of New York No. 52-2162100 Qualified in Suffolk County Term ExAWN Janufry 31 1992 EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 I J,/ 14-6-4(2/87)—Text 12 I PROJECT I.D. EOR D.NUMBER 617.21 i Appendix C State Environmental Ouality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR yAT L,-W, f N , 2. PROJECT NAME j 3. PROJECT LOCATION: Municipality SoIPtTHUD County 5 Fr-AZ.k 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) 5. IS PROPOSED ACTION: ❑New ❑Expansion JYModificatlon/alteration 6. DESCRIBE PROJECT BRIEFLY: y�R1 AM�,4. ,� G 0� N OF TWD FCWT pr45fN5 I� ,/I .l I9NA e�TN�p lLoa�q��oNs i9taNG. �3ktK�15 �s /u'��Z� . 7. AMOUNT OF LAND AFFECTED: Initially L!, — acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? KYes ❑No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY O PROJECT? Residential ❑industrial E Commercial ❑Agriculture ❑Park/Forest/Open space ❑Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? ❑Yes KNo If yes, list agency(s)and permitlapprovals 1. • 11. DOES ANY ASPECT OF THE ACTIO14 HAVE A CURRENTLY VALID PERMIT OR APPROVAL? X-Yes ❑No If yes, list agency name and permit/approval ARIKY c012Ps /b YE}1it &1A1n4rENAe4ct . NMIC '' 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑Yes No I CERTIFY.THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name• W i L L t A'• r 14.101al Dale: ^L 2•i \I Signature: ' If the action is in the Coastal Area, and you are a state agency, complete the a• Coastal Assessment Form before proceeding with this assessment OVER PART II—ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYI HRESHOLD IN 6 NYCRR, PART 617.12? If yes,i nate the review process and use the FULL LIAF. ~ ❑Yes VNo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another Involved agency. ❑Yes IR No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,it legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,drainage or flooding problems?Explain briefly: + �uv C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources:or community or neighborhood character?Explain briefly: NO C3. Vegetation or fauna,fish, shellfish or wildlife species.,significant habitats,or threatened or endangered species?Explain briefly: No C4. A community's existing plans or goals as officially adopted,or a change in use or Intensity of use of land or other natural resources?Explain briefly. ND C5. Growth, subsequent development,or related activities likely to be Induced by the proposed action? Explain briefly. C6. Long term,short term,cumulative,or other effects not identified in C1-05?Explain briefly. C7. Other Impacts(including changes in use of either quantity or type of energy)? Explain briefly. /V D. IS THERE, OR IS THERE LIKELY TO BE.CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes KNo If Yes,explain briefly r ' PART III—DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic sc.oe; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined, based on the Information and analysis above'and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental Impacts AND provide on attachments as necessary, the reasons supporting this determination: Namr,or Ledd Agency . ------------ Nnnt or type Name or Kespons+ble UI iCer m Lead Agency title or Responsible Urffcer 5 gnature or Responsible Officer in Ledd Agency Signature or I'reparer(it different from respons-ble onccer) Date _...............__.......-.�_.— __._:_._ -- .r__.._.. ..._�.........._ ffAkuddMt •• S y�MNT --_ BMLKN`�MNT ALT , M 7t9t1AL.TV /p GR _ ,y,�s SECT8ON R411.Rehb weer LOCA7100 SootHoLD •, F"E>rT'� pisPosA o AS / �.S SHE CT tSl�1N�� 31Tt �oaeo iN/ b 6l.�cr-s N 4PAMY S y OZ5 . MOM HAG5tRVM MAP of 514FFPLX CVs \Jlc jm iTy MAP MOTE $TDItA� poc-- wr p . 1 Pvc.. REST. ,C D 1� PRoPeRv NI DRy i ^'1011AJ f.IN dr. M�RIcET d ! 1 Low IL.a1 h' s7# Its MEAN "W" P v mr RAMP Epp. / sitMMN 0� pow - - - - ' ( ; 1,o, p�A1wo..DOW y Pr7R POSE:Mn1aTENAwcE pREpl.rNa. 0fjTwr4ImLrAN sEARevt4,M€+IaNi6M r "I nIEMr1.pWTIpE t crHvlo YRRD1ec c1.0% `BuDOs Po" Ao34cErYr PRoPlAry owNc*3: ro ale prt1.' FLooD�►�C.I►ol t-�DF 1J l3 uDDS 1'oND ®aadD'S P►Nb MAPI► INc, OM, 03 PA 30@1700 0,0 ® BEVA OR! CoLL1900 366 CEDAR WILL AV&, Nt;rIR: SpKYNcL� , wyelceFp,i r1,J, enMNtybr S1AFFOLk 57191!• NY� ARMANDO CAPDA mg1N fib, APPLICATIMUOV'P+rRT of EGOT ChArW .s�saWab�Ally. ANO C FL RIALTy VO ` S H,ET I OF I DATE 3/Z z/y/ a. i �I i I. 14.15 2 (2;87)-7c 617.21 S EO F. 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 project or 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: O 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 measurerdescribed in PART 3 have been required, i therefore a CONDITIONED negative declaration will be prepared.* i ❑ 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 I Name of Action Of Name of Laid Agency j Print or Type Name of Responsible Officer in Lead Agency --- Title of Responsible Officer S' n ure of Responsible Officer in Lead,Agency Signature of Prc,parer(if different from responsible of(icer) Date 1 PART I—PROJECT IN.�,-%RMATION IL Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant eft on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be conside as part of the application for approval and may be subject to further verification and public review. Provide any additic 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 invo new studies, research or investigation. If information requiring such additional work is unavailable,so indicate and spec each instance. NAME OF ACTION VOnT OF 1�1l�T-Crt/�; S�JC• C�,� ��-� ��C.• LOCATION OF ACTION(Include Street Address,Municipality and County) F(ot_b N. 1 7) 5a;1=VL_K 1207.e oiT NAME OF APPLICANT/SPONSOR W��t•(�� '� �' � BUSINESS TELEPHONE ADDRESS v Clmxw—L (.'Sl`) 7 GS 7�/ CITY/PO �a STAT ZIP CODE NAME OF OWNER(If different) �,Y ' BUSINESS TELEPHONE ADDRESS ( ) CITY/PO STATE ZIP CODE DESCRIPTION OF ACTION V9,TP 0JC+- wr -'Wp 23P47 1�Oh�k L.DC }TtpNs ALVW, 13kLe-14605 t4-r i 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 gCommercial OrResidential (suburban) ❑Rural (non-fare ❑Forest ❑Agricultule ❑Other 2. Total acreage of project area: acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) 0 acres t� Forested acres Agricultural (Includes orchards, acres acres cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) 0 acres Water Surface Area Z., acres � Unvegetated (Rock, earth or fill) 0 acres acres acres Roads, buildings and other paved surfaces acres ` acres Other (Indicate type) acres AA ��y, acres acres 3. What is predominant soil type(s) On project site? _ J Iv C�,)l a. Soil drainage: ❑Nell drained °6 of site C-'loderately well drained —LOU— % of site ❑Poorly drained % of site b. If any agricultural land is invol e ow many acres of soil are classified within soil group 1 through 4 of the NY Land Classification System? acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? Dyes KNo a. What is depth to bedrock? (in feet) 2 5. 'Approximate percentage of prc.r,,.,.,ed project site with slopes: ❑0-1040 °b X0-1540 4 1315% or greater % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the Nationa Registers of Historic Places? ❑Yes )(No PA7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? ❑Yes 'c 8. What is the depth of the water table? (in feet) 9. Is site located over a primary, principal, or sole source aquifer? ❑YesJo 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? 0'es ONo 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered% ❑Yes >40 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 i ❑Yes I0 Describe 13. is the project site presently used by the community or neighborhood as an open space or recreation area ❑Yesyo If yes, explain 14. Does the present site include scenic views known to be important to the community? ❑Yes UNo 15. Streams within or contiguous to project area: I a. Name of Stream and name of River to which it is tributary i 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name 1�--- $pWTI PLO •b. Size (In acres) 17. Is the site served by-existing public utilities. VYes ONO a) If Yes, does sufficient'capacity exist to allow connection? Wes ❑No b) If Yes, will improvements be necessary to allow connection? Oyes v0 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA. Section 303 and 304? OYes XNo 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 N0 30. Has the site ever been used for the disposal of solid or hazardous wastes? ❑Yes WN0 B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or contr fled by project sponsor -- acres. b. Project acreage to he developed: _ acres initially; IP/T acres ultimately. c. Project acreage to remain undeveloped � acres. d. Length of project, in miles: GS (If appropriate) { e. If the project is an expansion, indicate percent !fgnsion proposed i i f. Number of off-street parking spaces existing ; proposed g. Maximum vehicular trips generated per hour 041A — (upon completion of project)? h. If residential: Number and type of housing units: One Fan ily Two F,trnily Multiple Family Condominium Initially Ultirnatuly i. Dimensions (in feet) of largest proposed structure height; width; length. j. linear feet of frontage along a public thoroughfare project will occupy is? ft. 3 2. How much natural mill. "al (i.e., rock, earth, etc.) will be remove vc'om the site? I 3. Will disturbed areas be reclaimed? Wyes ONO ❑N/A tons/cubic yards a. If yes, for what intend. purpose is the site being reclaimed? �D �6CG-e`• b. Will topsoil be stockpiled for reclamation? ',Yes ONO C. Will upper subsoil be stockpiled for reclamation? 1PYes ONO 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? S. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? Dyes ASIO 6. If single phase project: Anticipated period of construction . months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated ;17 ? (number). b. Anticipated date of commencement phase 1 month l44 year, (including demolition). c. Approximate completion date of final phase —0" Vr month 1725 year. d. Is phase 1 functionally dependent on subsequent phases? Dyes ONO 8. Will blasting occur during construction? Dyes )ZINo 9. Number of jobs generated: during construction after project is complete 14bKNDLUN 10. Number of jobs eliminated by this project _—C-1—. 11. Will project require relocation of any projects or facilities? Dyes )ZNo If yes, explain 12. Is surface liquid waste disposal involved? Dyes WO' 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 PitNo Type 14. Will surface area of an existing water body increase or decrease by proposal? Dyes , to Explain f2Zfl1d1T f7V�tiNCC Di261CvfNG— OlF MklST106- 1,t)A7 8IPPY 15. Is project or any portion of project located in a 100 year flood plain? 0 yes VNI 16. Will the project generate solid waste? Dyes *0 a. If yes, what is the amount per month tons b. If yes, will an existing solid waste facility be used? Dyes ONO c. If yes, give name I ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? Dyes e. If Yes, explain 17. Will the project involve the disposal of solid.waste? Dyes �?No , 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 XNo 19. Will project routine) y produce odors (more than one hour per day)? Dyes WNo 20. Will project produce operating noise exceeding the local ambient noise levels? Dyesj 0 21. Will project result in an increase in energy use? Dyes k�No If yes , indicate type(s) 22. If water supply is from wells, indicate pumpin j capacity I[I gallons/minute. 23• Total anticipated water usage per day _ gallons/day. 24. Does project involve local, State or Federal funding? Dyes , No If Yes, explain 4 25.'Approvals Required: Submittal Type Date City, Town, Village Board Yes ❑No City, Town, Village Planning Board ❑Yes QNo City, Town Zoning Board ❑Yes ❑No City, County Health Department []Yes ❑No Other Local Agencies []Yes ❑No Other Regional Agencies ❑Yes ❑No State Agencies .'� g ��'es ❑No �� 'I:'91NT1 Dkw.�d�s�- Federal Agencies " °` < < < L �(1''es El C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? ❑Yes o _ 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? M C 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 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? ❑Yes ❑� 7. What are the predominant land use(s) and zoning classifications within a 1,4 mile radius of proposed action? 8. Is the proposed action compatible with i adn , I b,surrounding land uses within a /< mile? ,WYes ❑N 9. If the proposed action is the subdivision of land, how many lots are proposed? _ /VA a. What is the minimum lot size proposed? AA ' 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? []Yes XN 11 . Will the proposed action create a demand for any community provided services (recreation, education, police fire protection)? Dyes Wo 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? ❑l'es WINc 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 he needed to clarify your project. If there are or may be any advers, impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate o avoid them. E. Verification I certify that the information provided above is true to the best of my knowledge. Applicant Spo, r Name *r J�C• e t� )�� Date Signature Title If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. I. >\=�'1:..,....,:�A.`v'!....i�\:�..L.�.�i_�.�•__..:.1�.....,:�_y�..t!iw,1.L.�ei:._a1......_...._..,. K...,.._.�......_Ws.........,.f.,,w..,.,..._.w......», ., aa�.,..:�:».'��xxrvaa--•-�cas rt 2—PROJECT IMPACTS AN[ HEIR MAGNITUDE Responsibility of Lead Agency General Information (Read Carefully) • In completing the form the reviewer should be guided by the question: Have my responses and determinations be reasonable? The reviewer is not expected to be an expert environmental analyst. • Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simp asks that it be looked at further. • The Examples provided are to assist the reviewer by showing types of. impacts and wherever possible the threshold magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State ar for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropria for a Potential Large Impact response, thus requiring evaluation in Part 3. • The impacts of each proje,:t, on each site, in each locality, will vary. Therefore, the examples are illustrative ar have been offered as guidance.They do not constitute an exhaustive list of impacts and thresholds to answer each questio •� The number of examples per question does not indicate the importance of each question. i • In identifying impacts, consider-long term, short term and cumiative effects. - Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact. b. Maybe answers should be considered as Yes answers. C. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential size of tl impact. If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshol is lower than example, check column 1. d. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the project to a small to moderat impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. Thi must be,explained in Part 3. KModerate 23 ntial Can Impact Be IMPACT ON LAND rge Mitigated By 1 . Will the proposed action result in a physical change to the project site? act Project Change Examples that would apply to column 2 ENO DYES • Any construction on slopes of 15% or greater, (15 foot rise per 100 ❑ foot of length), or where the general slopes in the project area exceed ❑Yes ❑No 10%. • Construction on land where the depth to the water table is less than ❑ 3 feet. ❑ El Yes ❑No • Construction of paved parking area for 1,000 or more vehicles. C7 ' • Construction on land where bedrock is exposed-or generally-within El ❑ ❑Yes ❑No 3 feet of existing ground surface. ❑ ❑Yes ❑No j • Construction that will continue for more than 1 year or involve more ❑ ❑ than one phase or stage. ❑Yes ❑No • Excavation for mining purposes that would remove more than 1,000 ❑ ❑ 1 tons of natural material (i.e., rock or soil) per year. ❑Yes ❑No • Construction or expansion of a sanitary landfill. ❑ ❑ • Construction in a designated floodway. ❑Yes ❑,yo ❑ ❑ ❑YOs ❑No • Other impacts ❑ ❑ ❑Yes ❑,yo 2. Will there be an effect r. ...jy u,,:;que or unusual land forms found on the site?(i.e., cliffs, dunes, geological formations, etc.XyO DYES ' • Specific land forms: ❑ ❑ ❑Yes ❑No 6 IMPACT ON WATER Small to Potential Can Impact B 3. Will proposed action affect any water"body designated as protected? Moderate Large Mitigated By (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) Impact Impact Project Chang *O OYES Examples that would apply to column 2 • Developable area of site contains a protected water body. ❑ ❑ ❑Yes ❑Nc • Dredging more than 100 cubic yards of material from channel of a ❑ ❑ ❑Yes ❑Nc protected stream. • Extension of utility distribution facilities through a protected water body. ❑ ❑ ❑Yes El No • Construction in a designated freshwater or tidal wetland. ❑ ❑ ❑Yes ❑Nc • Other impacts: ❑ ❑ ❑Yes ❑Ne 4. Will proposed action affect any non-protected existing or new body of water? )440 DYES Examples that would apply to column 2 • A 10"S increase or decrease in the surface area of any body of water ❑ ❑ []Yes ONo or more than a 10 acre increase or decrease. • Construction of a body of water that exceeds 10 acres of surface area. ❑ ❑ ❑Yes ONo • Other impacts: ❑ ❑ ❑Yes ON 5. Will Proposed Action affect surface or groundwater quality or quantity? t0 ❑YES Examples that would apply to column 2 • Proposed Action will require a discharge permit. ❑ ❑ ❑Yes ❑No • Proposed Action requires use of a source of water that does not ❑ ❑ ❑Yes ❑No have approval to serve proposed (project) action. • Proposed Action requires water supply from wells with greater than 45 ❑ ❑ ❑Yes ONo t gallons per minute pumping capacity. • Construction or operation causing any contamination of a water ❑ ❑ ❑Yes El supply system. • Proposed Action will adversely affect groundwater. ❑ ❑ ❑Yes ❑No • Liquid effluent will be conveyed off the site to facilities which presently El El ❑Yes ❑No do not exist or have inadequate capacity.. • Proposed Action would use water in excess of 20,000 gallons per ❑ ❑ ❑1'es ❑No day. • Proposed Action will likely cause s;!tation or other discharge into an El El ❑Yes ❑Nb existing body of water to tr: exccrit that there will be an obvious visual contrast to natural conditions. i • Proposed Action will require the storage of petroleum or -chemical ❑ ❑ ❑Yes= ❑No products greater than 1,100 gallons. • Proposed Action will allow residential uses in areas without water ❑ ❑ ❑Yes ❑No and/or sewer services. • Proposed Action locates comr..ercial and!or industri,I uses which may ❑ ❑ ❑Yes ❑No require new or expansion of existing waste treatment and/or storage facilities. • Other impacts: ❑ ❑ ❑1'es ❑No 6 Will proposed action alter drain.ige flow or patterns, or surface water runoff? Y<\O ❑YFS Examples that would appiv to column 2 • Proposed Action would change flood water flows. ❑ (❑ ❑Yes ON 7 1 2 3,, - Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change • Proposed Action may cause substantial erosion. ❑ ❑ ❑Yes ❑No • Proposed Action is incompatible with existing drainage patterns. ❑ ❑ ❑Yes ❑No • Proposed Action will allow development in a designated floodway. ❑ El• Other impacts: ❑Yes ❑No ❑ ❑ - ❑Yes ❑No IMPACT ON AIR ' 7. Will proposed action affect air quality? XN0 DYES Examples that would apply to column 2 *'Proposed Action will induce 1,000 or more vehicle trips ps in any given ❑ ❑ ❑Yes ❑No • Proposed Action will result in the incineration of more than 1 ton of ❑ refuse per hour. ❑ ❑Yes ❑No • Emission rate of total contaminants will exceed 5 lbs. per hour or a ❑ ❑ heat source producing more than 10 million BTU's per hour. ❑Yes ❑No • Proposed action will allow an increase in the amount of land committed to industrial use. ❑ ❑ ❑Yes ❑No • Proposed action will allow an increase in the density of industrial ❑ development within existing industrial areas. El ❑Yes ❑No • Other impacts: ❑ •❑ ❑Yes ❑No IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species? , O DYES Examples that would apply to column 2 • Reduction of one or more species listed on the New York or Federal ❑ list, using the site, over or near site or found on the site. ❑ ❑Yes ❑No C • Removal of any portion of a critical or significant wildlife habitat. ❑ ❑- ❑Yes ❑No • Application of pesticide or herbicide more than twice a year, other ❑ ❑ ❑Yes ❑No than for agricultural purposes. • Other impacts: ❑ ❑ ❑Yes ❑No Will Proposed Action substantially affect non-threatened or • non-endangered species? ANO -DYES Examples that would apply to column 2 • Proposed Action would substantially interfere with any resident or ❑ ❑ migratory fish; shellfish or wildlife species. ❑Yes ❑No { • Proposed Action requires the removal of more than 10 acres of mature forest (over 100 years of age) ❑ ❑ ❑1'c's ❑No or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10 Will the Proposed Action affect agricultural land resources? Examples that Would aoply to column 2 NO OYES • The proposed action would sever, cross or limit access to agricultural ❑ ❑ ds, ❑Yes ❑No land (includes cropland, hayfiel pasture, vineyard, orchard, etc.) 8 , .�s...f«la-+*:Ae:uee.«twyi..:a.e:.x::nl.:.:.riidt:f�•.3a•.s.li.wcWa.::.aio-sw Jl..:..,J.,n.... ,. -_. 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change • Construction activity would excavate or compact the soil profile of ❑ ❑ ❑Yes ❑No agricultural land. • The proposed action would irreversibly convert more than 10 acres ❑ ❑ ❑Yes ❑No of agricultural land or, if located in an Agricultutal District, more - than 2.5 acres of agricultural land. • The proposed action would disrupt or prevent installation of agricultural ❑ ❑ ❑Yes ❑No land management systems (e.g., subsurface drain lines, outlet ditches, strip cropping); or create a need for such measures (e.g. cause a farm field to drain poorly due to increased runoff) Other impacts: ❑ ❑ El Yes ❑No IMPACT ON AESTHETIC RESOURCES 11 . Will proposed action affect aesthetic resources? 'UrNO DYES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix B.) Examples that would apply to column 2 • Proposed land uses, or project components obviously different from ❑ ❑ ❑Yes ❑No or in sharp contrast to current surrounding land use patterns, whether man-made or natural. • Proposed land uses, or project components visible to users of ❑ ❑ ❑Yes ❑No aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of th at hat resource. • Project components that will result in the elimination or significant ❑ ❑ ❑Yes ❑No screening of scenic views known to be important to the area. • Other impacts: ❑ ❑ ❑Yes ❑No IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? O DYES Examples that would apply to column 2 • Proposed Action occurring wholly or partially within or substantially ❑ ❑ ❑Yes ❑No contiguous to any facility or site listed on the State or National Register of historic places. I • Any impact to an archaeological site or fossil bed located within the ❑ ❑ El Yes. ❑No project site. • Proposed Action will occur in an area designated as sensitive for ❑ ❑ ❑Yes ❑No archaeological sites on the NYS Site Inventory. ••Other impacts: ❑ ❑ ,]Yes ❑No IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that would apply to column 2 AO DYES • The permanent foreclosure of a future recreational opportunity. ❑ ❑ ❑)'es ❑No • A major reduction of an open space important to the community. ❑ ❑ El Yes ❑No • Other impacts: ❑ ❑ ❑Yes ❑No i 9 i .............es...........,,.._:1....,.,,.w.>....,...w+...,3!,.,.-.......... ......we...r,..:.T.,�.u...,:..;aSx..,ee...__..,..,.w. ...........a..,,_.w- ,..-..,.Y,�"_ ---as...._.. IMPACT ON TRANSPORTATION 1 2 3 Small to Potential Can Impact S 14. Will there be an effect to existing transportation systems? Moderate Large Mitigated By pf,40 OYES Impact Impact Project Chang Examples that would apply to column 2 • Alteration of present patterns of movement of people and/or goods. ❑ ❑ ❑Yes ❑Nc • Proposed Action will result in major traffic problems. ❑ ❑ ❑Yes ❑Nc • Other impacts: ❑ •Q ❑Yes ❑Nc IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? �NO OYES Examples that would apply to column 2 • Proposed Action will cause a greater than 5% increase in the use of ❑ ❑ ❑Yes ❑No any form of energy in the municipality. • Proposed Action will require the creation or extension of an energy ❑ 0 El Yes ❑Na transmission or supply systLam to serve more than 50 single or two family residences or to serve a major commercial or industrial use. • Other impacts: ❑ ❑ OYes ❑No NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, noise, or vibration as a result • of the Proposed Action? A DYES Examples that would apply to column 2 • Blasting within 1,500 feet of a hospital, school or other sensitive ❑ ❑ El Yes ❑No facility. • Odors will occur routinely (more than one hour per day). ❑ ❑ ❑Yes ❑No • Proposed Action will produce operating noise exceeding the local ❑ ❑ El Yes ❑No ambient noise levels for noise outside of structures. • Proposed Action will remove natural barriers that would act as a ❑ 0 El Yes ❑No noise screen. • Other impacts: ❑ ❑ ❑Yes ❑No IMPACT ON PUBLIC HEALTH. 17. Will Proposed Action affect public health and safety? gNO OYES Examples that would apply to column 2 •, Proposed Action'may cause a risk of explosion or release of hazardous ❑ ❑ ❑Yes ❑No substances(i.e. oil, pesticides, chemicals, radiation, etc.)in the event of accident or upset conditions, or there may be a chronic low level discharge or emission. • Proposed Action may result in the burial of "hazardous wastes" in any ❑ ❑ ❑Yes ❑No form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) • Storage facilities for one million or more gallons of liquified natural ❑ ❑ ❑Yes ❑No gas or other flammable liquids. • Proposed action may result in the excavation or other disturbance El El El Yes J ONO within 2,000 feet of a site used for the disposal of solid or hazardous waste. • Other impacts: ❑ ❑ ❑Yes ❑No 10 I ,...:Lb.�.L:... '``, '�':�-.:.��^.Sr.sey.�..r:,K..'.,....K...At...._i:. 4_..�..�.',ar.�....,.s..�......,.a,...i>...._..,�.;.d:�..,$.v,r_:..;ixl.ta•::._..C:rY:agiSgtin�� __Z.� ' - - � � -r IMPACT ON GROWTH AND CHARACTER 1 ` 3 Small to Potential Can Impact Be OF COMMUNITY OR NEIGHBORHOOD Moderate Large Mitigated By 18. Will proposed action affect the character of the existin community? Impact Impact Project Change NO OYES Examples that would apply to column 2 • The permanent population of the city, town or village in which the ❑ ❑ ❑Yes ❑No project is located is likely to grow by more than 5%. • The municipal budget for capital expenditures or operating services ❑ ❑ ' El Yes ❑No will increase by more than 5% per year as a result of this project. • Proposed action will conflict with officially adopted plans or goals. ❑ ❑ ❑Yes ❑No • Proposed action will cause a change in the density of land use. ❑ ❑ ❑Yes El No Proposed Action will replace or eliminate existing facilities, structures ❑ ❑ ❑Yes ❑No or areas of historic importance to the community. • Development will create a demand for additional community services ❑ ❑ ❑Yes ❑No (e.g. schools, police and fire, etc.) • Proposed Action will set-an important precedent for future projects. ❑ ❑ ❑Yes ❑No • Proposed Action will create or eliminate employment. ❑ ❑ El Yes ❑No • Other impacts: ❑ ❑ ❑Yes ❑No 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? XN0 OYES If .any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 i . I Part 3-2VALUATION OP THE RAPOPTANCc OF TS Responsibility of Lead Agency j Part 3 must be prepared if one or more im'pact(s) is considered to be potentially large, even if the impacts) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1 . Briefly describe the impact. 2. Describe(if applicable)how the impact could be- mitigated or reduced to a small to moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: • The probability of the impact occurring 4.% • The duration of the impact • Its irreversibility, including permanently lost resources of value • Whether the impact can or will be controlled • The regional consertuence of the impact • Its potential divergence from local needs and foals • Whether known obluctions to the project relate to this impact. (Continue on attachments) s i I 11 14-I4.11 i2t87)-9c • 617.21 ScCrR Appendix B i • State Environmental Quality Review "Vis, al F AF Addendum it This form may be used to provide additional information relating to Question 11 of Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between. Visibility Project and Resource (in Miles) 1. Would the project be visible from: 0 '/4 '/4-'/z '/z 3 3 5 5+ • A parcel of land which is dedicated to and available ❑ ❑ ❑ ❑ ❑ • to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? • An overlook or parcel of land dedicated to public ❑ ❑ ❑ ❑ ❑ • observation, enjoyment and appreciation of natural or man-made scenic qualities? • A site or structure listed on the National or State ❑ ❑ ❑ ❑ ❑ Registers of Historic Places? • State Parks? ❑ ❑ ❑ ❑ ❑ • The State Forest Preserve? ❑ ❑ ❑ ❑ ❑ • National Wildlife Refuges and state game refuges? ❑ ❑ ❑ ❑ ❑ • National Natural Landmarks and other outstanding ❑ ❑ ❑ ❑ ❑ -natural features? •-National Park-Service lands? ❑ ❑ ❑ ❑ ❑ • Rivers designated as National or State Wild, Scenic ❑ ❑ ❑ ❑ ❑ or Recreational? • Any transportation corridor of high exposure, such EJ ® ® ® ❑ as'part of the Interstate System, or Amtrak? • A governmentally established or designated interstate ❑ ❑ ElElor inter-county foot trail, or one formally proposed for establishment or designation? • A site, area, lake, reservoir or highway designated as ❑ ❑ ❑ ❑ ❑ scenic? • Municipal park, or designated open space? ❑ ❑ ❑ ❑ ❑ • • County road? ❑ ❑ O ❑ D • State? ❑ ❑ ❑ ❑ ❑ • Local road? ❑ ❑ ❑ ❑r ❑ y. 2. Is the visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other i seasons) ' ❑Yes ❑No 3. Are any of the resources checked in question 1 used by the public during the time of ye r during which the project will be visible? ❑Yes EN I 1 i • FESCRIPTION OF EXISTING VISUAL ENVIRONMENT From each item checked in question 1, check those which generally describe the surrounding environment. Within "A mile *1 mile Essentially undeveloped ❑ ❑ Forested ❑ ❑ Agricultural El Suburban residential ElIndustrial ❑ Commercial' ❑ ❑ i Urban ❑ ❑ River, Lake, Pond ❑ ❑ Cliffs, Overlooks ❑ Designated Open,Space • El ❑ Flat ❑ ❑ Hilly ❑ ❑ Mountainous ❑ ❑ Other ❑ ❑ NOTE: add attachments as needed ❑ ❑ 5. Are there visually similar projects within: *'h mile ❑Yes ❑I`lo *1 miles ❑Yes ❑iyo *2 miles -❑Yes L]NO . *3 miles El Yes ❑No * Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use.best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Activity Holidays/ Travel to and from work Daily Weekly Weekends Seasonally ❑Involved in recreational activities El El ❑ ❑❑ Routine travel by residents ❑ ❑ ❑ At a residence El ❑ ❑ '� At worksite El ❑ ❑ ❑ Other ❑ ❑ ❑ ❑ 2 J TRUSTEES _; SCOTT L. HARRIS vy�' rim Supervisor John Ivl. Bredemeyer, III, President Henry P. Smith, Vice President L *' Town Hall, 53095 Main Road Albert J. Krupski, Jr. ��1 P.O. Box 1179 John L. Bednoski, Jr. Southold, New York 11971 John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, . ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR-WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. DATE 3 Poxr o f E�,-ypr Err: T.JVC, q- APPLI CANT'S NAME: C*I- 1C EHLTY X-Nc• TEL. NO. 715"'2 VI r MAILING ADDRESS: /yJf)IN /ePAD $pkTNDLD 1 AJ V. i 1171 AGENT: TEL NO. AGENT ADDRESS: PERMIT REQUESTED TO: fn Nr4WANC E 1kCPGjNG- vf= Twv 1344T /V irL x1j, LOCATION OF PROPERTY FOR REQUESTED PERMIT: f1 A I N A DAD TOWN: Sy4tTMDL1/ TAX MAP NO: 1000— CREEK, BAY OR _HARBOR FRONTING PROPERTY: ,(�lt D.�s PDIV D f SIZE OF PROPOSED WORK: LENG� i: �, D1�T /�/�SIN S Orj I EAC WIDTH: App. Page 2. YDS. TO BE EXCAVATED: 60 YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: CLA/Vl s �RF.DC� , BRck�lot �N� p�snip �I�acK WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: a D0 � TO �DOI DEPTH AT LOW TIDE: D " o.yz_ AVER. RISE IN TIDE: 3' DISTANCE TO NEAREST CHANNEL: •Zopi DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN AREA: U AREA ZONING: IS PROJECT- FOR PRIVATE OR BUS. USE: INTENDED USE OF PROPERTY: r` RiVATt AND C.OrhAMS#AL ROAT• DActI�— DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: m/g/NT1V/�NCF HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: `&c5 5bk-r"W ?AWN , N y hEc ti KIO CpRP,SA HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: DESCRIBE FULLY THE REHABILITATION OF PROPERTY: N4 DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: Si4ilLf}(I; T� _ ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: No.- WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: } t_ I COUNTY OF SUFFOLK ) STATE OF NEW YORK ) W I L L I A M Hi i L I SUB I N BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND ALL STATEMENTS-CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. .J-4EAL Signature of. Applicant SWORN TO BEFORE ME THIS DAY OF ' 1 , 19 7 I • NOTARY PUBLIC ERIC G. KOCM Notary Public, State of New York No. 62-2162100 qualified in Suffolk County I term&xP'rq Jame,,31 1882 EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 r { l: 14.16-4(2/87)—Text 12 ' PROJECT I.D. NUMBER 617.21 SEAR Appendix C State Environmental Ouality Review SHORT ENVIRONMENTAL ASSESSMENT "FORM — For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR r pAl .F: &0`ylWr �', I N L � 2. PROJECT NAME 3. PROJECT LOCATION: Municipality 5'O kTH a LD County S FFDL. 4. PRECISE LOCATION(Street address and road Intersections,prominent landmarks,etc.,or provide map) 5. IS PROPOSED ACTION: ❑New ❑Expansion gModification/alteration ►j 6. DESCRIBE PROJECT BRIEFLY: M,91X tW AN.CF apt•( [T .l AND v7kve LvpA_r,bjvf ,gtoNG kLkf� ps /VE€7 . 7. AMOUNT OF LAND AFFECTED: Initially 111— acres Ultimately acres S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? KYes ❑No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY O�PROJECT? Residential ❑!ndustrial Commercial ❑Agriculture ❑Park/Forest/Open space ❑Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? ❑Yes ONO if yes,list agency(s)and permit/approvals b 11. DOES ANY ASPECT OF THE ACTIO14 HAVE A CURRENTLY VALID PERMIT OR APPROVAL? CKYes ❑No If yes,list agency name and permit/approval 49MY &VIRPS /b Yn,t r►-IAINTL �AAWE t�J��DG�►nab. j��@►wn-BSo�,cs i NMI a -------------- '` IID$ytj,ylil 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? i ❑Yes No I j I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: ""'t LL I MI H ( WC Date: 2 I \I \ Signature: qc— It . � I I the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment i OVER PART.It—ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes,coordinate the review process and use the FULL NI-IF. Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? may be superseded by another Involved agency. If No,a negative doclaratic)n ' ❑Yes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten, if leginle) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,drainage or flooding problems?Explain briefly: �uv t C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: No C3. Vegetation or fauna, fish,shellfish or wildlife species,significant habitats,or threatened or endangered species? Explain briefly: No C4. A community's existing plans or goals as officially adopted,or a change in use or Intensity of use of land or other natural resources?Explain briefly. No C5. Growth, subsequent development,or related activities likely to be Induced by the proposed action? Explain briefly. C6. Long term, short term,cumulative,or other effects not identified in CI-057 Explain briefly. ry oNt C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly. "T° �f D. IS THERE, OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes XNo If Yes, explain briefly PART III—DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring: (c) duration; (d) irreversibility: (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. ❑ Check this box if you have identified one or More Potentially large or significant adverse impacts which MAY ;o, occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and an Supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name nr Luad Agency Print or Type Name of Kespons,ble Umcer inLead Agency frtle of Responsible Ufhcer Signature or Kesponsible Officer m Lead Agency Signature or Preparerllf different from,t! onsible orrice,) , ' Date r111.fi, A J.f t`'•TRUSTEES T,{ " SCOTT L. HARRIS � s;»` .��- + � ra• '�' Supervisor John M. Bredemeyer, III, President Henry Smith, Vice President •✓ ry' `•: r Town Hall, 53095 Main Road Albert J. Krupski, Jr. `�[ t` �� P.O. Box 1179 John L. Bednoski, Jr. Southold, New York 11971 John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR.WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. j �— �o— (�• f DATE 3/22 Pony d F £-G•yPr Farr. --Enc.APPLICANT' S NAME: C+I- /C MALTY.--rNc- TEL. NO. 7kS`Z yys MAILING ADDRESS: A,91M RDAD $pLtTHPQ 1 A)J1 171 AGENT: TEL NO. AGENT ADDRESS: PERMIT REQUESTED TO: /Y1 fi11V r5V AtV C E .D r�m- rC-WG- of TWO 13 CAT �051NS ANP oINP� L.OcgTra/Vs ►9�oNG. 13��fc>f� 1Ds S A)tz LOCATION OF PROPERTY FOR REQUESTED PERMIT: MAIN IN r'VAI) TOWN: SY)�tT�'�DL7 TAX MAP NO: 1000— �� CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE ,F PROPOSED WORK: LEND+ i WIDTH: i App. Page 2. YDS. TO BE EXCAVATED: 6 YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: NEL!— !� ANo ®k+tip *tmcK WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: ..)too � r0 qpo, DEPTH AT LOW TIDE: D ^ �.�/x AVER. RISE IN TIDE: 31 DISTANCE TO NEAREST CHANNEL: 2 0dl --- DISTANCE PROJECT` EXTENDS- BEYOND SIMILAR PROJECTS IN AREA: �j AREA ZONING: MC IS PROJECT FOR PRIVATE OR BUS. USE: - IJ k S INTENDED USE OF PROPERTY: r-RiVAITC AND C.OIti1ACMIAL 13DAT DPGl+1Al;.- DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: m/ /IVT `1UANC HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: IfEc5 50tcTMd1-D TVWAI , N ys MC no A��tY Cy�Ps HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: DESCRIBE FULLY THE REHA/B�ILLI,TATION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: --51k11Lfk 'TO f 95or ' Lo rH WEr, w4%pp, tN f3o l�rts jN- ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT, THIS PROJECT: / 10 WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: A J s COUNTY OF SUFFOLK ) STATE OF NEW YORK ) W I L.L I A M Hi L. I E W I N BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF • SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER- ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS �y DAY OF , 19 v i r NOTARY PUBLIC Notary PUbllic StsteecM Of NeW No. 62-2162100 Term Qualified in Suffolk County EXAMINED BY s January 31 1992 APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 �( 14-16.412187►—Text 12 ., PROJECT I.D.NUMBER 617.21 SEO R Appendix C State Environmental Ouality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR pllT mP &GyPT' Nw. )A; 2. PROJECT NAME -- C d t1 c. jq"tTj Nc Pv�r c;�' �G,pr hiA'l14 3. PROJECT LOCATION: �! Municipality 50-,ATfT p}LD County S y F FDL.k 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) SEA /1t19� 5. IS PROPOSED ACTION: ❑New ❑Expansion I Modification/alteration 6. DESCRIBE PROJECT BRIEFLY:I� -e-rlA&tN6- TVn FV 4? C'MswS .t pNA �TN� L,oaagT�oNs i9,tont�. X3k�KHS /?s /va�� . 7. AMOUNT OF LAND AFFECTED: Initially 61 — acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? CxYes ❑No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY O PROJECTi Residential ❑!ndustrial i Commercial ❑Agriculture ❑Park/Forest/Open space ❑Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? ❑Yes KNo if yes,list agency(s)and permit/approvals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? RYes ❑No It yes,list agency name and permitlapproval AA)KY c 02 P s /b YE—A R rV1 AtNraivAnt E I')1C EDG•)nab- �A@ INS BSoo�L.5' 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes No i I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE I I 2 • Applicant/sponsor name: t LL I N IERA( Date: � r i \ Signature: �4c I It the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form beiore proceeding with this assessment I j OVER _ i PART II—ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes,coordinate the review process and use the FULL LNAF• ❑Yes fW No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration may be superseded by another Involved agency. ❑Yes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible) Ct. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain.briefly: i �uv C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: ND C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species? Explain briefly: No C4. A community's e i xisting plans or goals as officially adopted,or a change in use or Intensity of use of land or other natural resources?Explain briefly. No C5. Growth, subsequent development,or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term,short term,cumulative,or other effects not identified in C1-05? Explain briefly. p C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly, /Ufa D. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes VNo If Yes,explain briefly r � PART III—DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e)geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. ❑ Check this box if you have identified one or more potentially large or significant adverse..impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare.a positive declaration. ❑ Check this box if you have determined, based on the Information and analysis above'and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency Vent or fype Name or Re-wons.ble Uiffcer:n Lead Agency frt a of Responsible Officer Signature or!iesponsible Officer in Lead Agency Signature of Vreparer(it different from responsible orncer) Date i SCOTT L. HARRIS TRUSTEES >. o• "ter Supervisor John Iv1. Bredemeyer, I11, President ., t Henry Smith, Vice President t . n' �9 Town Hall, 53095 Main Road Li Albert J. Krupski, Jr. t P.O. Box 1179 John L. Bednoski, Jr. Southold, New York 11971 John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone 1516) 765-1900 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR.WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. DATE PO r e F sypr- Fw- 2n►c d- APPLI CANT' S NAME: C+I— RE-A1-rY z.NC, TEL. NO. 7k F- Z y414" MAILING ADDRESS: /jj 91Y XDAD SP418N=D f Al, 11171 AGENT: TEL NO. AGENT ADDRESS: PERMIT REQUESTED TO: /11R11VrAW PjCE 1kC-PCINCG- of TWO CAT _ BA:Su s ANP c-W,6e L-Ocq?/aNS 19LoNG. �4(Lkf�t 1)5 IY5 /VieE LOCATION OF PROPERTY FOR REQUESTED PERMIT: MAIN A DIET) 50gTfjVL1j ' TOWN: TAX MAP NO:. 10 0 0— tp to^3' CREEK, BAY OR HARBOR FRONTING PROPERTY: �(� DD s ftND SIZE -")F PROPOSED WORK: LEND-3: &AT 13451 N S l 0V / EAC14 WIDTH: S� I yT1C App. Page 2. YDS. TO BE EXCAVATED: 6 YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: C.Ltl Al s N ELL.. p'Ebc. ► 3Kklipt qaD blimp ` ticK WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: T4> DEPTH AT LOW TIDE: AVER. RISE IN TIDE: DISTANCE TO NEAREST CHANNEL: :ZDD � --DISTANCE- PROJECT --EXTENDS- BEYOND SIMILAR PROJECTS IN AREA: Ir) AREA ZONING: Mc IS PROJECT FOR PRIVATE OR BUS. USE: INTENDED USE OF PROPERTY: PRiVATC AND C.OMAIMCIAL !BOAT DAC-tIAbr. DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: _1Dp,era(a,lN6- HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: SbkTHdl-D TVWN , N y h C ANU A k9j CyOks, HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY: /V 6 DESCRIBE FULLY THE REHABILITATION OF PROPERTY: IV 14 DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: _5'/4jIL ftP, TD aleSmVr wrrH 1)aPak wed tN [3g?f ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: No WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: !1 ig v l._ COUNTY OF SUFFOLK ) STATE OF NEW YORK ) t/ �► BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BETIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER- ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS -- DAY OF , 19 NOTARY PUBLIC ERINotary Pubs cC Sta�o New York No. 62-216210o Gua"fied in Suf}Olk County ,. EXAMINED BY Term&*"'January 31 1992 APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 b , v 1r•16.4(2/87)—Text 12 PROJECT I.D. NUMBER 617.21 SEAR Appendix C — _ State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM — For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR jbPAT or- kc y,r rNT, 'N� , 2• PROJECT NAME 4- � d t'L. re ovc t 3. PROJECT LOCATION: ((�� ^�' "l� Municipality SQ L1 f H O LD County S !"t4 / LPL.k 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) 5 Elm of'01 S. IS PROPOSED ACTION: ❑New ❑Expansion Modification/alteration DESCRIBE PROJECT ROJECT BRIEFLY: MR11UTM1 AMCF D ��/V l� tr 0F 1'cvn FG4T 13As fN 5 .t AmD friNj�x 1.1pCA7/1>1V5 ALOPO& �3ktk�1 1V NEED" . 7. AMOUNT OF LAND AFFECTED:[t Initially om_ acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? KYes ❑No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY WO PROJECT? 0 Residential ❑!nduslrial Commercial ❑Agriculture ❑Park/Forest/Open space ❑Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? ❑Yes XNo If yes, list agency(s)and permit/approvals 11. DOES ANY ASPECT OF THE ACTIO14 HAVE A CURRENTLY VALID PERMIT OR APPROVAL? PKYes ❑No If yes,list agency name and permitlapproval /4-R)"y r o2 Ps 10 y"AR rn guar UVAAt DX PP J/V& P E*1"M 85OWLS' 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes No { I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: ""' LL l I Date: ^+ 2'� \ Signature: r 1 i If the action is in the Coastal Area, and you are a state agency, complete the t Coastal Assessment Form before proceeding with this assessment OVER v41st)I1i1AIzIgIAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes,coordinate the review process and use the FULL + El Yes fWNo ~ B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.6? If No,a negative declaration . may be superseded by another involved agency, ❑Yes 12 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible) C1. Existing air quality, surface or groundwater qualiiy or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,drainage or flooding problems?Explain briefly: "C C2. Aesthetic,agricultural,archaeological, historic,or other natural or cultural resources;or community or neighborhood character? Explain briefly: ND CJ. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: NO Cd. A community's existing plans or goals as officially adopted,or a change In use or Intensity of use of land or other natural resources?Explain briefly y. No • C5. Growth, subsequent development,or related activities likely to be Induced by the proposed action? Explain briefly. C6. Long term, short term,cumulative,or other effects not identified in C1-05? Explain briefly, j M C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE.OR IS THERE LIKELY TO©E,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes WNo If Yes,explain briefly PART III—DETERMINATION OF SIGNIFICANCE .. (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurrin irreversibility; (e)geographic scope; and (f) magnitude. If necessary, add attachments or reference Supportingg: t°) duration; at explanations contain sufficient detail to show that.all relevant adverse impacts have been identified anddequately addresserd that ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and.an su Y ppo�tcts documentation, that the proposed action WILL NOT result in any significant adverse environmental Impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Leal Agency Print ur type Name of Kesponsible Umcer inLead Agency title of Kesponsible Ulficrr Signature or Kesponsrble Officer in Lead Agency • - Signature of Preparer(If different from responsible onrcer) i Date 1 i • -rat OF BPS` 4�'MNr --- OMLKM`r�iyMT - 4a M:� 9a"MLt A'► IALTp orIf6 PVITO tr Y► le\ L.T. RAIi-RoMp ROlecT' . it*H pisP3A iILD l.Otl1TI051 MT , h ; � pD/Ke SO YMttt �� .F•EIllr?INCi 'a+ ' As / ¢s SH�rR_��"��-,` SIT"Lrt ; ►'r�°°N�r SL+ SOd�ANls's �S CNPMe, rRo*% 14065TRVM nlgp of 10 LIC O• VICIN ITy mAP STORAfi P i NTc. 0 Ir PRv .r M�� HI i aRy REST, 0 I'19R* C+LflGIDY OFFICES 4s,,,,n#4XAX- MRRkET z LOIN r 0 MEAN pw LINE p M�= RAMP S MMrJ ';,MH � •J � 61° 10'I1V TLpAru� h 1�. _ 3i�� f © • � too, . . PHRPcSE 1 Mnr w ANcLr DREAb,N&, 0kn4MIMFAN SEAL evIL,MjA#JH16N �y�=SgND BUDDrS PONQ ' MEIW"WrIAE "60 emaic YRC06 dp AUACCAM PRoPFFtry cWtvOe3l ro Ire p,�t�•b ISD'WIDF mBaOD's P►AID MAKIn,RTNc, MA#Olta s•nT,�Itp,y�, FLo0Q4�.��c88 IN (3uDD5 1'ONd ® BERTA♦ ORS CoLLISVP 368 CEDAR HILL Avg- Q N�►R: SpKT'NcL� ' WytKeFp�N.J� v CnNNTyor s4FFCLK fir: N'y APPLICAT1INdy'P•Ity of E6yp ENL1'Ait f j ARMA►Jbb CAPPA MAIN Rb, syarNud/Nay, ANO CiL REALTY =N!. • --------- _._._._._ ._ S Nc ET / o F / DgTt 3�L z/9/ ii ii. sauND -rat eF ITI'MLT,•. --. .....__.�_._�.. 4d iilt� ' - yes"OK LT M IAL TO Bi Ir6Mlf>vIT�D ,,- Lr Y.25 GR SEGTIDN l+—q •, ab' ,�.� L.=. R41LAOA-b PRolecf v.lKfA 44o0 lOt IIT 1010T • I D 8 A ;� �, DIKE SNN=S�a�il�~' SIT V e« ity� s�NTMa.D N hltts N, cNprlelry PRom HA651RD011 r4h? of SLI M.Y. Cot VICINITY MAP 40 �'' StoRAir PaEewr � O MOT JAPC <o 6PIsity � kh%t DRy REST; ^'1Al�y $.INe e+L flERVY oFFlc�s ys'inN ,`oAD McRKET s , Low � i p y 3o"M 7 1 "Will 1 I'lowc p"AL: RAMP f �p. s'i MPAW LOW • ;IDATu�G fIKK y 3j�HT ® • To' 100� PHRPDSEtMMIM1rx1ANcF ORl:AbINa• ;'' . � nA'naMIM[AN SEALlvlL,IN�PIIgN16N ';+=s�jrlp ' BUDD'S F0Np '�' mElwt-ok+Tlf� ((sso cNolc yAebO eP c�.Ay WACEV-M PRoPSOIty 0WIvfp31 To are frb 1 SD'WIDE ►r,ID MAKINATNe, M�UJRA srtitHwt01N�/, FLoDDcHB (� N m$Ubb' P l3uDDS 1'cN0 ® BERTA 00 COWSOIJ 368 ceDAt MILL AV&- N'y� N�1R' SOKTHOLQ wyeubwoN,z Vv CnNNTyoF SIANFOLK 57191'tk� f►PPLICATIb0J,8y:PORT VT-EGy/R ENtrM AkMq►JDO CAFDI� 1riAtN Rb. .SygTf1G1��Nay. ANO Gil R1ALTy Iat. �_ _ SHEET f of / DATE 3/2Z/y/ , I. �i• I' $ouND -rot dF v S 4a MST yS��MLT M TRtIAL ry ac".,e MWO .y,2s GR sE4 row 4 .4 PR iecr �T p p tw♦tpYR►u coL11TrOW PIKE So4YHo� q Rv,E.&ur �1SPbsAL ` c AS =qLE'IN MILes + 14PA; SaNtv�,p Y. A�' IMP*% 141l*5Tf? M9 n ? of ShFFvLIC Q� VIcIN 17y rv1A� MOTE STbf�Afi P jNC r - 04 PRnPERTY \:� N►♦aRy REST LINs C+L0610Y PFFiCl:S 4einl+ MA/ly Rd>AD ' ' 3odrn�►6�+ � ` �ISti ,: aMllla r Cj:: I.Phi RAMP a ol.• So'MMN rL170 lop' Oki. PtiRME;MItrNTE7u�wrr GREDQrNa.. - -- -` P DIY rA1 MEAN 5tALfvtLj ^IuMIGM r' • ..%` ,: ."''! r% /.-' mEIW Low T1 r:6o ctialc yhQbs dF cLAY�-Sq,ND < Bu DA s PoN1) A63ACE*m PROP&Ary OWNERS! ro aye bKLa0riA4 FLOOD*4+s-Ir CBBWIDF IN t3uDD5 1'cN� ®�tACDS POND MAItimATMc, A9AW RDA S*MTN010/11 y, c•.• row: S��t"HOLQ® BERTA,F ORS ColllSolJ wy�KeFF't ",ILL,AvL, CuNN?yar SWFFOLK s7 F ' N'y� j Ar � RARMANDO CAPPA MAIN 9b, A'Ak7 A4 Ny NACL IEn7y TNe SHe&T OF f Digtc` 3lzZl9l . n I CHECK OFF LIST ' 1. $150.00 APPLICATION FEE PAID 2. $35.00 AMENDMENT, WAIVER OR INSPECTION, FEE PAID: ' 3. INSPECTION DATE: 5. DATE SENT TO CAC: 6. CAC COMMENTS: 6. ASSESSMENT: �� L(_�(I Oct. C. 7. LEAD AGENCY: 8. D.E.C. PERMIT: 9. ARMY CORPS PERMIT: 10. PUBLIC HEARING 11. DETERMINATION: 12. CONDITIONS: 13. PERMIT ISSUED: :�-�-�l rt' vc& +O V-un w''41,b EL y 6"P, FEES PAID: Additional Information is kb - C`�wMrnCCCSG.( �f�G�r� Q��.�t��yec ,_ p. �• sue,6�i e t,-� {-p- .�. ` ' t�C161-1©-ins R'-my , �. tiIly *. dpc 4 y Z)V d y ec