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1� Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
i
3819 April 26, 1990PERMIT NO DATE
F.
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ISSUEDTO ..........AGNES....M......D.U.N.N................................................................:............
Pursuant to. the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of they;
4 a�l State of New York 1952; and the Southold Town Ordinance en-
titled If,
>. I�
REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
-� REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the I :
"? Resolution of The Board adopted at a meeting held on Apri1...25, t
19....9..0..., and in consideration of the sum of $.............................. paid by `� • °�
y
.E�
of .......................................................................................... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof, `
< 4: 41 of Southold Town 'Trustees authorizes and permits the following:
Demolish existing house; construct new house and �k
l � Queen 'I"a;. regrade property. Location: s/e corner of
Street and CR 48, Greenport, NY.
all in accordance with the detailed specifications as presented in
the originating application.
p IN WITNESS WHEREOF, The said Board of Trustees here-
t by causes its Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said BoaA-as-d this da
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TERMS and CONDITIONS
The Permittee Agnes M. Dunn
residing at s/e corner Queen St. & CR 48, Greenport, NY 11944 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 24 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 Permittee 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.
G. 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 SCOTT L. HARRIS
Supervisor
John M. Bredemeyer, III, President
Henry P. Smith, Vice President
Albert J. Krupski, Jr. ✓h " ' Town Hall, 53095 Main Road
John L. Bednoski, Jr. P.O. Box 1179
John B. Tuthill Southold, New York 11971
BOARD OF TOWN TRUSTEES Fax (516) 765-1823
Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800
April 27, 1990
Proper-T Services.
P. O. BOX 617
Cutchogue, NY 11935
RE: , Agnes M. Dunn
Application #3-1-90-40-3-9.3
Dear Mr. Fitzgerald :
The following action was taken by the Board of Town Trustees during
its regular meeting held on. April 25, 1990 regarding the above
matter:
WHEREAS, Proper-T Services IN BEHALF OF Agnes M'. Dunn applied to
the Southold Town Trustees for a permit under the provisions of the
Wetland Ordinance of the Town of Southold, application dated March 7,
- 1990 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 25, 1990 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 Proper-T Services IN BEHALF OF Agnes M. Dunn BE AND
HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO:
Demolish existing house; construct new house and regrade property .
Location of property is SE corner of Queen Street and CR 48,
Greenport, NY.
J'
This permit will expire two years from the date it is signed if work
has not commenced by said date. 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:
Very truly yours,
John M. Bredemeyer, III
President, Board of Trustees
JMB:jb
cc: Bldg. Dept.
Conservation Advisory Council
file
`V
f 9br
TRUSTEES ® 'li' '�� SCOTT L. HARRIS
ZF Supervisor
John M. Bredemeyer, III, President
Henry P. Smith, Vice President
Town Hall, 53095 Main Road
Albert J. Krupski, Jr.
P.O. Box 1179
John L. Bednoski, Jr.
John B. Tuthill Southold, New York 11971
BOARD OF TOWN TRUSTEES Fax (516) 765-1823
Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone(516) 765-1800 .
S.E.Q.R.A.
NEGATIVE DECLARATION
NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT
APPLICATION NO. 3-1-90-40-3-9.3
NAME: Agnes M. Dunn
DATE: March 22, 1990
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: Unlisted
DESCRIPTION OF ACTION: Demolish existing house and construct new.
house. Regrade property.
LOCATION: SE Corner Queen Street and CR 48, Greenport, NY.
Tax map No. 1000-40-3-9.3
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.
3 . Because there has been a response from the Southold Town
Conservation Advisory Council indicating that this project would not
have a significant effect on the environment.
cc: Planning Dept.
Building Dept.
Zoning Dept.
C.A.0
N.Y.S.D.E.C.
Army Corps of Engineers
TRUSTEES `�' '°u�y, rnn
SCOTT L. HARRIS
Supervisor
John M. Bredemeyer, III, President ;
Henry P. Smith, Vice President ` "4 „ Town Hall, 53095 Main Road
Albert J. Krupski, Jr.
John L. Bednoski, Jr. P.O. Box 1179
John B. Tuthill Southold, New BOARD OF TOWN TRUSTEES Fax (5 6) 765971
-823
Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800
March 8, 1990
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. 3-1-90-40-3-93 for a wetland
application submitted by Proper-T Services on behalf of Agnes M.
Dunn.
Please prepare a written report of findings and recommendations with
respect to this application.
Very truly yours,
John M. Bredemeyer, III %
President, Board of Trustees
JMB: jb
MAR1 51990
TRUSTEES SCOTTL. HARRIS
John M. Bredemeyer, III, PresiaeiiC'v 'a �" 4 } - � ® �' Supervisor
4 ®�
Henry P. Smith, Vice Presrd'ent
Albert J. Krupski, Jr. e.Tow.n ball, 53095 Main Road
John L. Bednoski, Jr. .`
.O. Box 1179
'P
John B. Tuthill Southold,:New York 11971
BOARD OF TOWN TRUSTEES Fax (516) 765-1823-
Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800.
LEAD AGENCY COORDINATION REQUEST
TO: )CQ Q, �- M�C�G» DATE: ;�- '-�0
Enclosed is a permit application and a completed part I of the
Environmental Assessment Form.
Southold Town Trustees are interested in your ageny' s comments
in acting as SEQRA Lead Agency for:
NAME:
LOCATION: v E
TAX MAP: /Cy - �0- 3-�7. PERMIT
DESCRPTN: sec e �c�G`� ��� !; `cg✓� �i
PERMIT REQUIRED: ( ). TOWN WETLAND ( ) OTHER
SEQRA CLASSIFICATION,: ( ) Type I ( ) Type II
UNLISTED ( ) CEA
Please contact John M. Bredemeyer, III; President, withi�30
days and be advised .that the Southold Town Trustees�(WANT),/ (:90-.
WA--NT) to assume lead agency.
SENT TO: DOS ( ) DEC ( l,) DOH ( ) PB ( ) ZBA ( ) BLD ( )
Please complete, detach and return this form to expedite
processing.
Involved Agency:
Project Name:
Location:
SCTM:
We atr /(Have/No) ,objection to Southold Town
AGENCY �__.___.._.......
Trustees assuming Lead Agency. tt
Comments/Reasons. �i�:o,•/c� r'�`11 r'ilS9L�P0� n: (' e�j` .Z ,Cr,� Gr' < ��
Signature of Authorized Representative
O ,�1
In t
Al ` 3 t1b,
TELEPHONE
(516) 765=1892
BOARD OF TOWN TRUSTEES MAR - 7 1990
TOWN OF SOUTHOLD
Town Hall, 53095 Main Roada�;.;�;�
P.O. Box 728 -� A
u)
Southold, New York 11971 "
APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES OF THE 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 THE TOWN OF SOUTHOLD , AND THE ISSUANCE OF PERMITS PURSUANT
TO, :CHAPTER 32 OF THE CODES OF THE TOWN OF SOUTHOLD.
APPLICATION NO.3_l-�=�O-3 g_"j_DATE OF APPLICATION_-__ Mar 5, 1990
James R.-Fitzgerald, Jr. Proper-T Services
IDENTITY OF APPLICANT_for-Agnes M.-Dunn_—,-----------------PHONE NO
734-5800
ADDRESS OF APPLICANT PO-Box 617
---- --------------------------------------------
----------------------Cutchogue,-NY-11935
----------------------------------
TAX MAP NO. 1000-40-3-9.3
AGENT (See "Applicant" above) PHONE NO.
PERMIT REQUESTED To Demolish existing house and construct new house.
Regrade property.
-------- ------------------------------
LOCATION OF PROPERTY FOR WHICH PERMIT WANTED
SE corner Queen Street and CR 48.
------------------------
HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION
(See "Address of Applicant" above)
CREEK, BAY OR HARBOR FRONTING PROPERTY-- None; DEC has designated "fresh-
water wetlands" east of property.
SIZE OF PROPOSED WORK
---------------------------------------------------
Lot is about 1/3 acre; project covers about 15%.
LENGTH
WIDTH
HEIGHT ABOVE HIGH WATER--N/A----------------------��r----
DEPTH BELOW LOW WATER N/A
-----------------=----------------------------------
YARDS TO BE EXCAVATED Approx 50 cu. yds. for new foundation
Approx 150 cu. yds. to fill old foundation and
YARDS TO BE FILLED
WIDTH OF CANAL , CREEK OR BAY FRONTING PROPERTY
DEPTH AT LOW- TIDE ___N�A_
---------- ---------------------------------------
AVERAGE RISE IN TIDE N/A
----------------------------------------------------
DISTANCE TO THE NEAREST CHANNEL N/A FT .
DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN THE AREA N/A FT .
1S THIS FOR PRIVATE OR BUSINESS USE? . . . . Private
----------------=--------------------
AREA ZONING R-40
-------------------------------------------------------------
MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED
--------------------
_____ Ordinary dr�r=land earth_moving_eguipment. ----------------------
INTENDED USE OF PROPERTY Private residence.
-------------------------------------------------
DESCRIBE ANY KNOWN PRIOR OPERATIONS CONDUCTED ON THE PREMISE
None known.
-------------------------------------------------------------------------
AND WHETHER ANY PRIOR LICENSE OR PERMITS HAVE BEEN ISSUED TO ERRECT
STRUCTURES OR TO DREDGE OR DEPOSIT FILL ON SAID PREMISES AND WHETHER
ANY PERMITS OR LICENSES WERE EVER SUSPENDED OR REVOKED BY A GOVERNMENTAL
AGENCY None known.
-------------------=-----------------------------------------------
------------------------------------------------------------------------
DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE
PREMISES AFTER THE WORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF
THE PROJECT SITE IF NECESSARY__LOt-will be_regraded and landscaaed ______
--- apropriatel_y.--------------------------------
------------------------
-----------------------------------------=-------------------------------
WRITTEN CONSENT OF THE OWNER OF THE PROPERTY, IF NOT THE SAME AS THE
APPLICANT .
--------------------------------------------------------------
See attached letter.
----------------------------------------------------------=-------------
ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD
PROHIBIT THIS PROJECT? None
COUNTY OF SUFFOLK )
STATE OF NEW YORK ) SS:
James E. Fitzgerald, Jr. 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 , THAT THE 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 -ze the Trustees
agent or representative to enter .. nto m r` two---.i. p� t tie
premises in conjunction with ,6,.i �f 1icati nf,
� 9
5j1 GNAT E OF f-L I C . T
v
SWORN TO BEFORE ME THIS S"1 kT}4
DAY OF MA 2C 4-- 1 9 9 O
JANE R. MINERVA
NO °UBLIC,State of New York
NOTARY PUBLIC No.48531U8 Suffolk County
Commission Expire,;aoruary 18,ZQ
EXAMINED
APPROVED "WETLANDS" PERMIT (CHAPTER 97)
APPROVED "BOAT, DOCKS , WHARVES" PERMIT (CHAPTER 32)
DISAPPROVED "WETLANDS PERMIT" (CHAPTER 97)
DISAPPROVED "BOATS , DOCKS , WHARVES" PERMIT (CHAPTER 32)
CONDITIONS , IF ANY
EXAMINING BODY
SIGNATURE OF CHAIRMAN
COMPUTATION OF FEES
Approved 2/27/85
A • •
��
c 4`` Town Hall., 53095 Main Road
d e
P.O. Box 1179
Telephone
(516) 765-1801 Southold, New York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
To: Southold Town Trustees
From: Southold down CAC
Dated: March 20, 1990
Re: Recommendations
The following recommendations were made by the CAC at its meeting
held Monday, March 19, 1990:
On a motion by Bruce Loucka, seconded by Margaret Feeney it r
was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
WITH STIPULATIONS of Wetland Application No. 1-18-90-53-5-12 .2
submitted by Gail Schlegel to. reconstruct an existing single
family dwelling, solid fill pier, and boat ramp. After recon-
struction, removal of concrete surfacing and installation of
native seaside planting. The CAC approves with the stipulation
that all runoff is contained on property: no runoff from house,
driveway or boat ramp ( suggest drywells) ; hay bales and filter
cloth be used during construction; the concrete debris be removed
from the parcel; and no lawn within 75 ' of wetlands .
Sage Boulevard, Greenport
Vote of Council: Ayes: All
- Motion carried. _
-- On a motion by John Holzapfel, seconded by Margaret Feeney it
was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
bf Wetland Application No. 7.-3-90-98-1-11. 1 submitted by En-
Consultants Inc, on behalf of Martin Kosmynka to construct a
timber dock consisting of a fixed elevated walk; hinged ramp;
and floats secured by pilings. Concerning the Letter of No Juris-
iAML
SOUTHOLD TRUSTEES
Issued T ANE's i (n/ D a e
Address*5,e Cowue��t �i uEaiuST .� Cie48_ (�REENPOR7 /✓y
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD
SOUTHOLD, N.Y. 11971
TEL.: 765-1892
diction, the CAC recommends the Trustees deny the request because
the construction envelope is within 75 ' of the wetlands.
Pine Tree Road, Peconic.
Vote of Council: Ayes: All
Motion carried.
On a motion by Bruce Loucka, seconded by John Holzapfel, it was.
RESOLVED to recommend to .the Southold Town Trustees DISAPPROVAL
of Wetland Application No. -3-1-90-40-3-93 submitted by Proper-
T Services on behalf of' Agnes M. Dunn to demolish an existing
house and construct a new house. The CAC recommends disapproval
because the new house would be within 75 ' of the wetlands; no
contour map was submitted; applicant does not show where grading
will occur; and members are concerned about where the runoff
would go. f
Queen Street , Greenport
Vote of Council: Ayes: All
Motion carried.
On a motion by Bruce Loucka, seconded by Margaret Feeney it
was
RESOLVED to recommend to the Southold Town Trustees APPROVAL
of the Waiver Request submitted b Deborah Edson to construct
a single family dwelling.
ROW off Main Road, Orient .
Vote of Council: Ayes: All
Motion carried.
= On a motion by Bruce Loucka, seocnded by John Holzapfel, it was
RESOVLED to recommend to the Southold' Town Trustees APPROVAL
of the Waiver Request for Paul Reilly to construct an addition.
Knoll Circle, East Marion.
Vote of Council: Ayes: All
Motion carried.
4
0 r
Y'
On a motion by Stephen Angell, seconded by Margaret Feeney, it
was
RESOVLED to recomend to the Southold Town Trustees APPROVAL
of the Waiver Request submitted by Katherine Klein to add a deck
to her house.
East Legion Avenue, Mattituck.
Vote of Council: Ayes: All
Motion carried.
Re: Waiver Request of Paul Katz
The CAC is in receipt of a letter to Mr Katz from the Trustees,
dated March 15 , 1990 stating that an application is required.
The Council will comment upon the project after receipt of the
application.
Re: Chardonney Woods
The CAC made an inspection of the project and found several problems
existed. The project will definitely need a wetland application
The road goes through the wetlands; road runoff goes into the
wetlands ; members believe that the south west corner of the marsh
(possibly lot 6 or 9 ) was filled along with the road.
Proper-T Services
POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935 (516)734-5800
March 14 , 1990
MAR 1 w:9 090
Mr. John M. Bredemever, III , President ' "1 QO
Board of Town Trustees
Town of Southold
Town Hall , 53095 Main Road
Southold, New York 11971
Re: Application for Freshwater Wetlands Permit
on Behalf of Agnes M. Dunn
Dear Mr. Bredemever:
I 'm sorry for the delay in answering your 'phone inquiry of
last Friday, but I was out of town.
The Utilities Department of the Village of Greenport has been
contacted, and they say that the property which is the loca-
tion of the proposed project is served by both public sewer
and public water lines. They would be willing to provide a
sketch showing the location of these lines on the property if
you need that information.
If there are any further questions , or if additional informa-
tion is needed, please call me.
urs truly
a es E. Fi 2 eral_ Jr.'
a subsidiary of
THE PECONIC EASTERN CORPORATION
Proper-T Services
POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935 (516)734-5800
March 5, 1990
President MAR - 7 1990
Board of Town Trustees
Town of Southold -- ---__�=---=- --_-- -`
Town Hall , 53095 Main Road _T C-`�'��%d'�� 0, ZS0U, "r -D�
Southold, New York 11971
Re: Application for Freshwater Wetlands Permit
on Behalf of Agnes M. Dunn
Dear Sir:
Attached are the documents which have been prepared in support
of the application for a permit to demolish an existing house
and construct a new house on the property of Agnes M. Dunn in
the Town of Southold, Suffolk Countv.
Proper-T Services represents Mrs . Dunn in this matter, and 'a
letter of authorization is part of the submission.
If there are any questions , or if additional information is
needed, please call me.
Y tru _
t
es E. Fit,zg ald, Jr
Enclosures : /
Application Form
Application Fee ($150)
Letter of Authorization
Notarized Statement of Applicant
Short Environmental Assessment Form
Vicinity Map
Tax Map
Survey of Property
a subsidiary of
THE PECONIC EASTERN CORPORATION
276 Concord Drive
Hereford, Pennsylvania 18056
February 2, 1990
President
Board of Town Trustees
Town of Southold
Town Hall , 53093 Main Road
Southold, New York 11971
Dear Sir:
Please be advised that I hereby designate and authorize James
E. Fitzgerald, Jr. of Proper-T Services to act in my behalf as
my agent in the submission and processing of a permit applica-
tion for the demolition of an existing house and the construc-
tion of a new house on my property located at Queen Street and
CR 48, Greenport, and designated by Suffolk County Tax Map
No. 1000-40-3-9 .3, and to furnish, upon request, supplemental
information in support of the application.
Yours truly,
Agn s M. Dunnr
14.16-4(2/87)—Text 12
PROJECT I.D. NUMBER 617.21 SEOR
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 2. PROJECT NAME
James E. Fitzgerald, Jr. Dunn residence
3. PROJECT LOCATION:
Municipality Southold County Suffolk
4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map)
SE corner Queen Street and CR 48. (see attached maps.
5. IS PROPOSED ACTION:
12 New ❑Expansion ❑Modification/alteration
6. DESCRIBE PROJECT BRIEFLY:
Demolish existing house and construct new house. Regrade property.
7. AMOUNT OF LAND AFFECTED:
Initially Approx 1/3 acres Ultimately Same acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
®Yes ❑No If No,describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
❑Residential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/Open space ❑Other
Describe:
Small- to medium-sized private residences.
10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL,
STATE OR LOCAL)?
®Yes ❑No If yes, list agency(s)and permit1approvals
Southold Board of Town Trustees. No approval to date.
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
Dyes 11No if yes,list agency name and permit/approval
12. AS A RESULT OO��FTT PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
❑Yes IANo
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
-James E erald, Jr (Proper-T Services)
Applicant/sponsor ame: fOr O es — Du Date: Mar 5 990
ww(Signature: ",-A L `
e action is in the Coastal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
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 EAF`
❑Yes ❑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)
C1. Existing air quality, surface or groundwater quality or quantity, nolse levels, existing traffic patterns, solid waste production or disposal,
potential for erosion,drainage or flooding problems? Explain briefly:
C2. Aesthetic,agricultural, archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly:
C3. Vegetation or fauna,fish, shellfish or wildlife species, significant habitats,or threatened or endangered species? Explain briefly:
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.
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-05?Explain briefly.
C7. Other impacts(including changes In use of either quantity or type of energy)?Explain briefly.
D. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? -.
❑Yes ❑No If Yes,explain briefly
PART III—DETERMINATION OF SIGNIFICANCE (To be completed by Agency) "
INSTRUCTIONS: For each adverse 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
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(If different from responsible officer)
Date
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