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HomeMy WebLinkAboutTR-4415 DiSalvo, Diane From: DiSalvo, Diane Sent: Wednesday, September 20, 2017 3:19 PM To: 'cathydonnellyl6@gmail.com' Subject: 790 Willis Creek Drive, Mattituck With respect to your request to transfer permit#4415 into your name,we had spoken after last month's Board hearing on August 16, 2017 and I advised you that we needed you to provide us with a "scaled" drawing showing the 5'x20'fixed dock in a "T" configuration in order for us to transfer and amend the permit into your name. We are not able to prepare our Resolution without same. D tut VeDt 6fWo Southold.Towti 'Frustees Town Hall .=nnexTirst Floor 54375 Route 25 P.O. Box 1179 Southold. NY 1.1971.-0959 (631) 765-1892 Tax: (631) 765-6641 i r . r pal Q �oe�✓le/� 1699 r�JQ�/o Coh1 y y fl CEIVE JUN 1 '5 2017 a a r) 0 �� u e Southold Town Boar o Tr Qe 11971 , y ZJ�, o m L f .e-ra y C'o ne-e-f 1749 5 1 p Y ; -.4�J-f ___a'='/��A'—r�_—.__. ._ __` �`. �_ •r'..._ �' P!RM �'nTcil�N'w "_.�' F✓—C, T .� - ...IF 1� Board Of Southold Town Trustees1�1 Ceii ti SOUTHOLD, NEW YORK I'• } tJ�I DATE 2/28/95 �T ! �. _ \ .; •., PERMIT NO. ... .......... ... ............. .... .............. t_ 30 CY ISSUED TO .......NA1V...........L......FOO.TE FOQIZ..................... Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York .1952; and the Southold Town Ordinance en- ! +' ,I titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the f REMOVAL OF SAND GRAVEL OR OTHER MATERIALS FROM F `' LANDS UNDER TOWN WATERS;" and in accordance with the 1y Resolution of The Board adopted at a meeting held on ....2/.28/.95..... ' 19....9.5..., and in consideration of the sum of $..450...00 ... ... paid by ` / YOun Young fox.....N..A.NCY..L FOOTE.................................................. a! Mattituck 1,4. ~ of ............................................ .......................................... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, a of Southold Town Trustees authorizes and permits the following: �« Constr. a single fam. dwell. swim. pool, deck, walk. , drivew �`: sanit. sys. , water ser.., 3' X 60' catwalk, & 5' X 20' float, as per survey dated' 1/18/95 and"that no fill be placed within 75' jurisdiction, and a 'no disturbance buffer' area, -& that it be ` all in accordance with the detailed specifications as presented in the originating application. consistent with neighbors to south. . `.. ` + IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Aca ....... ....... ... I 1 ... .y ............... . ......... .. ... . ...... ............ Trustees t aar�,:,fir.�,.:•.8,'i,. '� ✓.fi,.��.:rt.,�..C:.'rr�..� ,:,�3.��`° �r ..w.".:r.s',o:.: �+ro 's y.ram.: �'ir- �y�r�-�.,am t.awt r a j 1 j , \- OF A �„ �A ►� A`ti 'Y ,moo► Ah r �r .eta► A <5 ��g�FFO�,�-�O Albert J. Krupski,President Z Gy Town Hall John Holzapfel, Vice President c 53095 Main Road William G. Albertson nZ�, P.O. Box 1179 Martin H. Darrell y �� Southold,New York 11971 Peter Wenczel ��l �`a� Telephone (516)765-1892 Fax (516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 28, 1995, 1995 Young & Young Thomas C. Wolpert 400 Ostrander Ave Riverhead, NY 11901 Re: NANCY L. FOOTE SCTM #115-17-17.13 Dear Mr. Wolpert, The following action was taken by the Board of Town Trustees during its regular meeting held on February 28, 1995 regarding the above matter: WHEREAS, Young & Young on behalf of NANCY L. FOOTE, applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 8' 1994, 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 February 28, 1995, 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 structure complies with the standard set forth in Chapter 37-18 of the Southold Town Code, which will be listed on a separate page, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approves the application of NANCY L. FOOTE to construct a single family dwelling, swimming pool, deck, driveway, sanitary system, water service, walkway, a 3 ' X 60 ' catwalk, .and a 5 ' X 20 ' float as per survey dated 1/18/95, and that no fill be placed within the 75 ' jurisdiction, and that there be a 'no disturbance buffer' area and that it be consistent with neighbors to the south. Located Willis Creek Drive, Mattituck. Permit to construct project 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, Tre__a�a- -notified upon completion of said project. .F• FEES: 5' X 20.' float = 100 ' X $3 = goo Very truly yours, 09 Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. CAC Michael J. Domino, PresidentO�QS; C� ' y,, Town Hall Annex John M. Bredemeyer III, Vice-President—_ �� �� 54375 Route 25 Charles J. Sanders y a P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski � �pR Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 6�16/7' e,, 1-5 Completed infield by: �o��br,s f �`► CATHERINE DONNELLY requests a Transfer of Wetland Permit #4415 from Nancy L. Foote to Catherine Donnelly, as issued on February 28, 1995. Located: 790 Willis Creek Drive, Mattituck. SCTM# 1000-115-17-17.13 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary.Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative, Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 0. cc�•' Cory�l 4`/.1CA�t O n i flp� 0. T 104� Gti.� ��0.��d O+'� ��M e Present were: J. Bredemeyer M. Domino \,/G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 Michael J. Domino, President0�0 G Town Hall Annex John M. Bredemeyer lll,Vice-President 4 ti� ya 54375 Route 25 Charles J. Sanders ro z P.O. Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ?� ® p� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: CATHERINE DONNELLY requests a Transfer of Wetland Permit #4415 from Nancy L. Foote to Catherine Donnelly, as issued on February 28, 1995. Located: 790 Willis Creek Drive, Mattituck. SCTM# 1000-115-17-17.13 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely,affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values,'existing erosion protection structures and natural resources: D. <_25% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 NouSE F.F.=13.0 EL.=11•3 LOT COVERAGE: F_L.=10.4 E 4 UPLAND AREA =36500 S.F. AREA OF HOUSE ,DECKS a POOL = 5500 S.F. 1•E,=q,, ASPHALT DRIVEWAY = 1550 S.F. I.E•8.(�� I.E.=8.4 Id MIu. S EFrK TANK MIN.8� �{ _zo' M1AL_ TOTAL PERCENT OF- — - - UPLAND COVERAGE = 19.3 %# m � GR.WATEZ EL=1.4 PRoPoSED SANITARY SYST>=M USE (3) POOL SYSTEM Q O 9�O 9Q v Sn l � LO o 25�G � E� �`V• p PEO I V \E0 4 0 <( 0 J „ � 1 TggS 1 / IN(� V, G opt I o42�p5 E' o \ $� 1\ eo NINE- o 4 G� >t 2, . ZO �.5/ 1 gyp, 9 1 i �I 1131 1 �0. L • , c P ` , J 1n I `ao\ F m fg ��ic9-0g z s�.4I pl� lid `y . I- II m zWizL I5 m tm l 1 1ul go wW ar l3 A\ep L 7m .0 0O \5 \�g 059 w LL 1- N oL 41 I 8 �\ I �mm r _ y Lu 0209 w H i�OP�o� 1 `e I�o1NGf ? loo.o3prol5 ' w c w i �JQ dl pRIV EEO�E z "a IAt'w TA 05 I_ •, � e ,( t 04 5 c e3 p9 ? N yPp F124 '3OE MN4(3F V D vJAL K ve) * D boo C'R o j 4 Q ego VA EVA a' o LOB o TEST HOLE ADD DATE: 10-to-94 O JGJ�R Oa 'TIME :OD P.M. O Y*Je�a�(\O EL.-9.2 0.0' rq� py TOP 501L �aop � NOD LOAM 5.0, SAnI� NOTE: 6L.= 1.4 7'S' GROUN77 WAYER I.SOUNDINGS SHOWN THUS: ( 3.2) ARE REFERENCED TO MEAN LOW WATER SA/1G 2.ELEVATIONS SHOWN HEREON ARE FROM ACTUAL SURVEY e 4 AND ARE REFERENCED TO N.G.V.D. ( MSL 1929). 3.FIRM ZONE "A4" BASE EL.=8.0 CONTIGUOUS WITH 8 CONTOUR. 4.AREA = 45 744 S.F 5. . III =NUMBERED LATH SET SURVEY FOR NANCY L. FOOTE JAN. 18, 1995 LOT NO.13 'HARBOR VIEW AT MATTITUCK� NOV. 22,1994 R (09 IJ ; I OCT. 11 1994 AT MATTITUCK DATE: JUNE 10, 1994 TOWN OF SOUTHOLD SCALE: I°= 501 JAN 2 4 1995 Li SUFFOLK COUNTY, NEW YORK NO. 94-0305 N UNAUTHORIZED ALTERATION OR ADDITION TO THIS �OYtlOF S�� I���p � SURVEY 1S A VIOLATION OF SECTION 7209 OF THE N Y Y E v ay—L B 9 NEW YORK STATE EDUCATION LAW el SURVEYOR'S INKED S NE *COPIES OF THIS Y O EALOREMBOSSED SEAL SHAT BEARING THE LLL v NOT BE CONSIDERED TO BE A VALID TRUE COPY �� 5�1 F. XGUARANTEES INDICATED HEREON SHALL RUN ONLY TO co G�'lc HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED ! AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- 1N NEAREST WATER MAIN_MI.± *SOURCE OF WATER: PRIVATE—PUBLIC MENTAL AGENCY AND LENDING INSTITUTION LISTED ♦7 O M SUFF CO. TAX MAP DIST 1000SECTION 115 BLACK 17 LOT 17.13 HEREON,AND TO THE ASSIGNEES OF THE LENDING !*THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS *DISTANCES SHOWN HEREON FROM PROPERTY LINES WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC OF HEALTH SERVICES, t5F � APPLICANTS PURPOSE ANIO ARE NOT TO BE USED TO ESTABLISH + i�r' <j PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS TEL. YOUNG a YOUNG R400 ERHEAD, NEW YORKOSTRANDER E NOTE: •=STAKE FOUND 0= STAKE SET SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N.Y.S.LICENSE NO.ALDEN W.YOUNG,PROFESSIONAL ENGINEER EER SUFFOLK COUNTY ON AUGUST 21,1987 AS FILE NO.8377. 12845 HOWARD W.YOUNG, LAND SURVEYOR VITHE LOCATEN OF WELL(W),SEPTIC TANK(ST)SCESSPOOLS(CP)SHOWN HEREON 41 N.Y.S.LICENSE NO.45893 ARE FROM FIELD OBSERVATIONS AMID OR DATA OBTAINED FROM OTHERS BRANDIS & SONS INC. z.a. Albert J. Krupski,.President Q�OSUFF�( �,4 Town Hall G John Holzapfel, Vice President �� SA 53095 Main Road William G. Albertson P.O. Box 1179 Martin H. Garrell 5 �� Southold, New York 11971 Peter Wenczel '11p1 �.aQ Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. 1000-115-17-17.13 Chapt. 97 - Wetlands NAME: NANCY L. FOOTE Chapt. 37 - Coastal Erosion DATE: JANUARY 26, 1995 RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as Lead Agency for the action described below, has determined that the project will not have a significant effect on. the environment. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. TYPE OF ACTION: Type: I DESCRIPTION OF ACTION: Applicant requests permit to construct a single family dwelling, swimming pool, deck, driveway,- sanitary system, water service, walkway, a 4' X 60' catwalk, & a 5 ' X. 20 ' float as per survey dated 6/10/94. Located Willis Creek. Drive,. 964' south of Meadow Beach Lane, Mattituck. LOCATION: SCTM #1000-115-17-17.13 . REASONS SUPPORTING THIS DETERMINATION: 1. An on site inspection has been conducted by the Board of Trustees. 2. An environmental assessment, submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occur should the following mitigation measures be implemented. YOUNG & YOUNG PLANNING, ENGINEERING &LAND SURVEYING [JAN 2 4 1995400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK 11901-469 rt Telephone516-727-2303 Facsimile51&727-0144 L WN 9 HOB F, January 23 , 1995 ATTN: Ms. Diane Herbert Board of Trustees Town of Southold 53095 Main Road P.O. Box 1179 Southold, New York 11971 RE: NANCY L. FOOTE at Mattituck, T/O Southold, New York (94-0305) Dear Ms. Herbert: Enclosed are five (5) prints of the survey for Nancy L. Foote, last dated January 18, 1995, amended to indicate the locations of numbered lath set at the seaward corners of the proposed house and pool, as requested. If you have any questions regarding this application, please advise. Very truly yours, Thomas C. Wolpert, P.E. TCW/sjt Encl. cc: Mrs. Nancy L. Foote + 1 Print ALDEN W.YOUNG HOWARD W.YOUNG THOMAS C.WOLPERT KENNETH F.ABRUZZO Professional Engineer Land Surveyor Professional Engineer Land Surveyor &Land Surveyor Albert J. Krupski, President p�► OG Town Hall John Holzapfel, Vice President �� y` 53095 Main Road William G. Albertson y = P.O. Box 1179 Martin H. Garrell $ Southold, New York 11971 Peter Wenczel y�j�l �a Telephone (5I.6) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD . LEAD AGENCY COORDINATION REQUEST TO: Whom It May Concern, DATE: 12/9/94 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: Nancy L. Foote - LOCATION: Willis Creek Drive, Mattituck TAX MAP: 1000-115-17-17.13 PERMIT # Pending DESCRPTN: single family dwelling, etc. PERMIT REQUIRED: ( X) TOWN WETLAND ( ) OTHER SEQRA CLASSIFICATION: ( X) Type I ' ( ) Type II ( ) UNLISTED ( ) CEA Please contact ,Albert J. Krupski,, Jr. Trustee Pres.• . within 30 days and be advised that the Southold Town Trustees (WANT) /(DO NOT WANT) to assume lead agency. SENT TO:' DOS (x) DEC ()f) DOH ( () PB (`,,) ZBA (,X) BLD (�[) ACE ( ) W.lne � Fi.d , CAC ( ) /4 l 'a iG b�Qy f4y Please complete, detach and return this form' to expedite processing. Involved Agency: Project Name: Location: SCTM: We at (Have/No) objection to Southold Town AGENCY Trustees assuming Lead Agency. Comments/Reasons: Signature of Authorized Representative- ALL DOCKS AND BULKS MUST DISPLAY VISIBLE JMIT NUMBERS. ALL MOORINGS AND STAKES MUST DISPLAY VISIBLE MOORING NUMBERS. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD MAIN ROAD SOUTHOLD, NEW YORK 11971 NOTICE OF ACTION - NOT A PERMIT TO: NANCY L. FOOTE Please be advised that your application, dated December 8, 1994 has been reviewed by this Board, at a meeting of the Trustees held on February 28, 1995 and resulting in the action, as indicated below: ( XXX) Application Approved. ( ) Application Denied. ( ) Application Tabled. COMMENTS AND REMARKS: Application Fee: $150.00 Paid ® � 5' X 20' float = 100' X $3 = $300 ull a r7 IF YOUR APPLICATION IS APPROVED ABOVE, A PERMIT FEE IS NOW DUE, AND SHOULD BE MADE PAYABLE TO THE ORDER OF THE BOARD OF SOUTHOLD TOWN TRUSTEES. THIS FEE IS COMPUTED BELOW ACCORDING TO THE SCHEDULE OF RATES AS SET FORTH IN THE INSTRUCTION SHEET (Form 1/1) . THIS FEE MUST BE PAID WITHIN 90 DAYS OR REAPPLICATION AND ADDITIONAL FEE WILL BE NECESSARY. IF THE PERMIT FEE IS PAID IN PERSON TO THE CLERK OF THE BOARD, THE PERMIT WILL BE OBTAINABLE AT THE SAME TIME. IF THE FEE IS PAID BY MAIL, THE PERMIT WILL BE MAILED IN REPLY. COMPUTATION OF PERMIT FEE: 5' X 20'• float X $ _ $300 ,- TOTAL FEE FOR THIS APPLICATION: $ 450.00 Signed: ' President, Board of Trustees By: erk, .board c own Trustees 10/87 ;. SOUTHOLD TRUSTEES No. low/ 4/ Issued T Date ±t r AddressOALIS 0,c°& i THIS NOTICE MUST BE DISPLAYED DURING . CONSTRUCTION TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD SOUTHOLD. N.Y. 11971 TEL.: 765-1892 Meeting of December 19, 1994 No. 1215 Moved by Robert Keith, seconded by Patricia Isaksen, it was RESOLVED to recommend to the Southold Town Board of .Trustees APPROVAL WITH PROVISIONS of the Wetland Application of NANCY L. FOOTE 115-17-17.13 to construct a single family dwelling, swimming pool, deck, driveway, sanitary system, water service, walkway, and dock: The CAC recommends approval provided 1 . The dock is located so it is not less than 15' from the property line. 2. The project description states that "No offsite fill is required." but plans call for 250 c.y. of fill. The CAC is concerned about the discrepancy and feels the Trustees should seek clarification. 3. Wetland limits remain undisturbed because of runoff. Willis Creek Drive, Mattituck Vote of Council: Ayes: All Motion carried. RECOMMENDATION OF WAIVER REQUESTS WR21 Moved by Bruce Loucka, seconded by Jack Hagerty, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Waiver Request of PORT OF EGYPT ENTERPRISES 56-6-4 & 6.1 to install a swimming pool, terrace and cabana facilities instead of boat storage building which a permit was issued but never used. The CAC feels this project needs to go through the permit process.: Main Road, Southold Vote of Council: Ayes: All Motion carried. RECOMMENDATION OF AMENDMENTS TO PERMITS A11 Moved by Bruce Loucka, seconded by Jack Hagerty, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH CONDITIONS of the request for an amendment to a permit by MICHAEL LEAHY 64-3-4 to extend his walkway and ramp reach suitable water depth. The Council has concerns about the length and recommends that the float be turned so it is parallel to the shore and that the ' length of the project does not interfere with the navigation of others. Hobart Avenue, Southold Vote of Council: Ayes: All Motion carried. Al2 Moved by Robert Keith, seconded by Bruce Loucka, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the request for an amendment to a permit by BLUEPOINTS COMPANY INC. 140-1-23.1 to eliminate the 2000 gallon per minute pump enclosed in a 5' x 5' structure and replace with two 1000 gallon per minute submersible pumps to be P placed at the end of the 100' x 4' open pile pier. Two davits to be installed at the end of the pier for pump servicing. 1240 Love Lane, Mattituck Page 2 STATE OF NEW PORK FEB 91995 DEPARTMENT OF STATE g= ALBANY, NY 12231-0001OL a- k ALEXANDER F. TREADWELL SECRETARY OF STATE February 3, 1995 Mr. Albert J. Krupski Town of Southold Town Hall P.O. Box 1179 Southold, New York 11971 Re: Application N41000-115-17-17.13, Nancy L. Foote, Willis Creek Dr. Dear Mr. Krupski: With regards to the above mentioned application, please note that the New York State Department of State's Coastal Management Program has yet to receive a Federal Consistency Assessment Form (FCAF) and supporting information for the project. From the submitted project description, it appears that a permit from the U.S. Army Corps of Engineers/NY (ACOE) may be required for the catwalk and float. Therefore, if a federal permit or federal funding is required for any portion of this project, please instruct the applicant to submit a completed FCAF and supporting information to ACOE/NY with a copy to Ms. Diana Boos at the Department of State. Upon receipt, we will determine if the submitted information is adequate to commence a formal review of the project. If you have any questions, do not hesitate to call me at (518) 474-6000. Sincerely,: WalteOF. Meyer Coastal Resources Specialist c: ACOE/NY - Sophie Ettinger file v..*printed on recycled.paper New York State Department of Environmental Conservation Town 0& Soy1k014 ��� ad � coan / Negl�-� �e �, D a DEC 1 6 1994 Thomas C. Joriln� Commissioner TOWN OF SOUTHOLD ecQ_M a ( �j l I g4- Dear SiCS RE: LEAD AGENCY COORDINATION. REQUEST The purpose of this request is to determine under Article 8 (State Environ- mental Quality Review - SEQR) of the Environmental Conservation` Law and 6 NYCRR Part 617 the following: 1. Your agency's interest in acting as lead agency; 2. Your agency's jurisdiction in the action described below; and 3. Issues of concern which your agency believes should be evaluated. Enclosed is a copy of the permit application and a completed Part 1 of the Environmental Assessment Form to assist you in responding. Project Name: fJaracy oo'fie �s'o Pe('i� / Pr ' Q& Project Location: (,vil' -Is. C re-eK Z�`'ive/ ✓VCLt ;,, cl� ScT-m /oho - lIE - 17 - 17. 13 - DEC Project Number: DEC Permits: as cvd41 (}Je'�{4v�c ) SEQR Classification: dC] Type I [ ] Unlisted DEC Contact Person: MCO`K C0.,-i-o,rR Senior E�AV, &"\ysrt- DEC Position: [� DEC has no objection to your agency. or another agency assuming lead agency status for this action, but reserves the right to comment on this action if a positive determination of significance is made. -2- [ ] DEC has no objection to your agency or another agency assuming lead agency status for this action, but we have the following concerns regarding this project (see "comments" below) . [ ] DEC wishes to assume lead.agency status for this action. [ ] The proposed action has been identified by DEC as occurring wholly or partially within or substantially contiguous to a critical environmental area (CEA) that was designated by It is the position of this Department that your agency, if it has a juris- diction over the action, should assume the lead agency role based on the existence of the CEA and the fact that the anticipated impacts are primarily of local significance. [ ] Other. (See comments below) Comments (Optional ) : Response: Please respond to this request within 30 days of the date of this letter. If no response is received within 30 days, we will assume that you have no objection to DEC- or another agency assuming the role of lead agency, and have no comments to offer regarding the proposed, action at this time. If neither your agency nor any other involved agency, including DEC, has indicated a will- ingness- to serve as lead agency. within 30 days of this letter: [ ] We will petition the Commissioner of DEC to designate a lead agency for this action. [ ] We will petition the Commissioner of DEC to designate your agency as lead, presuming you have jurisdiction. Please feel free to contact this office for further information or discussion. Sincerely, Enclosures �``�K C CccrrtLrG cc: (see distribution list) AQ i(OA M9Ai't li✓'a\Ysrr DEC 1 6 1994 �x-'S10- STATE OF NEW YORK DEPARTMENT OF STATE ALBANY, NY 12231-0001 GAIL S. SHAFFER SECRETARY OF STATE Mr. Albert J. Krupski, Jr., Trustee December 12, 1994 Board of Town Trustees Town Hall P.O. Box 1179 Southold, New York 11971 Re: Lead Agency Coordination Request for Proposal by Nancy L. Foote, Willis Creek Drive, Mattituck. Dear Mr. Krupski: With regards to the above mentioned Lead Agency Coordination Request, please note that the New York State Coastal Management Program does not object to Southold Town Trustees assuming Lead Agency. However, the Department of State has yet to receive a Federal Consistency Assessment Form (FCAF) and supporting information for the dock portion of the proposed action. Please instruct the applicant to submit a completed FCAF and supporting information to the U.S. Army Corps of Engineers/New York with a copy of the FCAF and supporting information to Ms. Diana Boos at the Department of State. Upon receipt, we will determined if the submitted information is adequate to begin review of the proposed project for consistency with New York State's Coastal Management Program. If you have any questions, do not hesitate to call me at (518) 474-6000. Sincerely,,, Walter F. Meyer Coastal Resources Specialist c. 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D,M d.«,la, az Y1D DD Real Property Tax Service Agency nLLAGE OF I I 5 N 1.r.[.[I«f N 11S XALE IN PEEI 1 Cn,.11r, « YS[I.I,Iw L.L.I. ____- Y:Iba•LIIN -� LyA,d,NIn L,« __.L•—_ el«L W. O2 S<n.c Dl••„I.� .al'a COVOIy I.enlOr gSTRICT No. IOOO P..,nl...l. DNNN,L►. _ ..r. .. P«a.1 I Riverhead,L.I.,New York PROPERTY MAP Yww t,L..l d,•I,I L,+, _—SCII.-__ Mw,DI.NI„Ln+ __.•.�_ W•<aN.elw\M.. Itll er<anr Y„ UAeI DAN•I GNPI.IIY Albert J. Krupski,President ��� 00, Town Hall 53095 Main Road John Holzapfel, Vice President �� , ' ` ,'�� 7,. William G. Albertson y �� ``� 5� P.O. Box 1179 Martin H. Garrell �� x f. Southold, New York 11971 Peter Wenczel � Telephone (516) 765-1892. 1 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only G1®'H1'�0S JO NM01 Coastal Erosion Permit Application X Wetland Permit Application Grandfather Permit Application V661 8 _ 33G Trustee Lands Permit Application 4 /- Waiver IA nn �I IF-It We'Received Applicati n: �" W Clerical Review: " ,.--Completed Applicati n Incomplete - SEQRA .Classification: e I. X Type II Unliste Coordination: (date se t �� q r/CAC ;Referral Sent: 1-411t ate of Inspection: 'JAZZEE of CAC Report: ((date) i r. F--- Lead Agency Determination: echnical Review: (date) ,.-Public Hearing: (date) Decision: Approved (Y/ ) (date) Application Fee:$/j"O. l- _ C7 Name of Applicant Nancy L. Foote Address 29 Baiting Drive, Baiting Hollow, New York 11933 Phone Number: (. 516) 369-5590 Suffolk 'County Tax Map Number: 10 Q0 - 115-17-17.13 Property Location: Willis Creek Drive, at Mattituck, 964' south of Meadow Beach Lane (provide LILCO Pole #, distance to cross streets, and location) Agent: Young & Young ATTN: Thomas C. Wolpert, P.E. (If applicable) Address: 400 Ostrander Avenue, Riverhead, New York '11901 Phone: (516) 727-2303 • o 1 , )ard of Trustees Applicat: GENERAL DATA Land Area (in square feet). 45,744 sq. ft. Area Zoning: Residential (A-C Agricultural Conservation) Previous use of property: vacant Intended use of property: Single Family Residence Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary) : Construct a single family dwelling, swimming pool, deck, driveway, sanitary system, water service, walkway, and dock. No offsite fill is required. 2 BOARD OF TRUSTEES APPLICATION County of Suffolk State of New York NANCY L. FOOTE BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S) , IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVE(S) , TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. l.. ignature SWORN TO BEFORE ME THIS 3 d DAY OF N U yelkz'{kLl'JI , 19 Notary Pub is SUSAN J.TOPPING Notary Public.State of New York No.4900150-Suffolk County(-? Commission Expires July 20, 19_{ >ard of Trustees Applicatj WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Single family dwelling Area of wetlands on lot: 9,244 square feet Percent coverage of lot: 19.3 Closest distance between nearest existing structure and upland edge of wetlands: N.A. feet Closest distance between nearest proposed structure and upland edge of wetlands: 75 feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? 250 cubic yards How much material will be filled? 250 cubic yards Depth of which material will be removed or deposited: 2 ft. feet Proposed slope throughout the area of operations: 10 o max. Manner in which material will be removed or deposited: Backhoe Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason os such proposed operations (use attachments if appropriate) : No adverse impact on the wetlands and tidal waters is anticipated (refer to 25' non-disturbance buffer, 75' min. setback to proposed structures, and proposed line -of hay bales or silt fence shown on survey) .;- 6 14-la(2187)—Text 12 y 617.21 SEAR PROJECT I.D.NUMBER Appendix C State Environmental Duality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 2. PROJECT NAME 1. APPLICANT/SPONSOR Young & Young ATTN: Thomas C. Wolpert, P.E Nanc L. Foote 3. PROJECT LOCATION: County Suffolk Municipality Mattituck, T/O Southold 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) Willis Creek Drive, at Mattituck, T/O Southold, New York (refer to location map) 5. IS PRf N: Modification/alteration K Expansion 6. DESCBRIEFLY: system, Coningle family dwelling, swimming pool, deck, driveway, saitary y wate, walkway, and deck. No offsite fill is required. 7. AMOFFECTED: 1.1 acres Initially 1.1 acres Ultimately 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ®Yes ❑No If No,describe briefly g. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Park/ForesVopen space ❑Other ®Residential ❑Industrial ❑Commercial Agriculture Describe: New residential community 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL. STATE OR LOCAL)? [R Yes ❑No If yes,list agency(s)and permit/approvals SCDH - Sewage Disposal & Water Supply NYSDEC - Tidal Wetlands T/O Southold - Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes 99 No It yes,list agency name and permit/approval 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 ApplicanUsponsor name: Youn & Youn ATTN: Thomas C. Wol ert P.E. Date: r�or s1. 1 A�34 Signature: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II—ENVIRONMENTAL ASSESSm&JT(To be completed by r gency) 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, noise 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 C1-CS?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 Lea Agency Title of Responsible O icer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from responsible off icer) Date 2 14-16-2 (2I91)-7c 617.21 SEAR Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant.The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not 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 enough 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: ❑ Part 1 ❑ Part 2 El 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 magnitude and importance of each impact, it is reasonably determined by the lead agency that: ❑ A. The project will not result in any large and important impact(s) and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prepared. ❑ B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.' ❑ C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of.Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(If different from responsible officer) Date 1 PART 1—PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the application for approval and maybe subject to further verification-and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the.full EAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable,so indicate and specify each instance._ NAME OF ACTION Nancy L. Foote LOCATION OF ACTION(Include Street Address, Municipality and County) Willis Creek Drive, Mattituck, T/O Southold, County of Suffolk NAME OF APPLICANTISPONSOR BUSINESS TELEPHONE Young & Young, ATTN: Thomas C. Wolpert, P.E. ( 516) 727-2303 ADDRESS 400 Ostrander Avenue CITY/PO STATE ZIP CODE Riverhead N.Y. 11901 NAME OF OWNER(If different) BUSINESS TELEPHONE Nancy L. Foote ( ) 369-5590 ADDRESS 29 Baiting Drive CITYIPO STATE ZIP CODE Baiting Hollow N.Y. 11933 DESCRIPTION OF ACTION Construct a single family dwelling, swimming pool, deck, :driveway with drainage leaching pool, sanitary system, water service, walkway, and dock. No offsite fill is required. Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: ❑Urban ❑Industrial ❑Commercial ❑Residential (suburban) ERRural(non-farm) ❑Forest ❑Agriculture ❑Other 2. Total acreage of project area: 1.1 acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) . 0.1 acres 0.1 acres Forested ' 0.8 acres 0.5 acres Agricultural (Includes orchards, cropland, pasture, etc.) 0 acres 0 acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) 0.2 acres 0.2 acres Water Surface Area 0 acres 0 acres Unvegetated (Rock, earth or fill) 0 acres 0 acres Roads, buildings and other paved surfaces 0 acres 0.15 acres Other (Indicate type Lawns & landscaping 0 acres 0.15 acres PIC — Plymouth loamy sand 8-15% slope 3. What is predominant soil type(s) on project site? PTA 231po it b I-AMY and, 0-3% sln� a. Soil drainage: [RWell drained 80 % of site $]Moderately well drained _LQ % of site MPoorly drained 1— % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? N A. acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? ❑Yes IRNo a. What is depth to bedrock? N•A• (in feet) 2 5. Approximate percentage of proposed project site with slopes: N0-10% go % Ci10-15% 20 % Dt15% or greater 0 % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the ,National Registers of Historic Places? ❑Yes E,No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? []Yes KlNo 8. What is the depth of the water table? 0'-8' (in feet) 9. Is site located over a primary, principal, or sole source aquifer? ®Yes ❑No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? '❑Yes ZNo 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? ❑Yes INNo According to Youn & Younrl Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) []Yes (RNo Describe 13. Is the project site presently used by the community,or neighborhood as an open space or recreation area? ❑Yes ®No If yes, explain 14. Does the present site include scenic views known to be important to the community? ❑Yes ®No 15. Streams within or contiguous to project area: Dredged Creek (Willis CrPPk) a. Name of Stream.and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name Great Peconic Bay b. Size (In acres) N A 17. Is the site served by existing public utilities? ®Yes []No a) If Yes, does sufficient capacity exist to allow connection? KYes ❑No b) If Yes, will improvements be necessary to allow connection? 93Yes ❑No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? ❑Yes C$No 19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617? L9Yes ❑No 20. Has the site ever been used for the disposal of solid or hazardous wastes? ❑Yes ®No B. Project Description 1. Physical dimensions and scale of project(fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor 1.1 acres. b. Project acreage to be developed: 1.1 acres initially; 1.1 acres ultimately. c. Project acreage to remain undeveloped 0 acres. d. Length of project, in miles: N.A. (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed N.A. %; f. Number of off-street parking spaces existing 0 ; proposed 2 g. Maximum vehicular trips generated per hour 2- (upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Condominium Initially 1- Ultimately 1 ' i. Dimensions (in feet) of largest proposed structure 35' height; 33' width; 73 length. 144 j. Linear feet of frontage along a public thoroughfare project will occupy is? ft. 3 2. How much natural material (i.e., rock, earth, etc.) will be removed from the site? 0 tons/cubic yards 3. Will disturbed areas be reclaimed? MYes ❑No ❑N/A a. If yes, for what intended purpose is the site being reclaimed? Lawns & Landscaped Areas b. Will topsoil be stockpiled for reclamation? IQAYes ❑No c. Will upper subsoil be stockpiled for reclamation? LXYes ❑No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0.3 acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? []Yes ®No 6. If single phase project: Anticipated period of construction 6 months, (including demolition). 7. If.multi-phased: N.A. a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 month year, (including demolition). c. Approximate completion date of final phase month, year. d. Is phase 1 functionally dependent on subsequent phases? ❑Yes ❑No 8. Will blasting occur during construction? ❑Yes CRNo 9. Number of jobs generated: during construction 6 ; after project is complete 0 10. Number of jobs eliminated by this project 0 11. Will project require relocation of any projects or facilities? ❑Yes ®No If yes, explain 12. Is surface liquid waste disposal involved? ❑Yes KINo a. If yes, indicate type of waste (sewage, industrial, etc.) and amount ..b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? Yes ❑No Type Sanitary 14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes ®No Explain 15. Is project or any portion of project located in a 100 year flood plain? RYes ❑No 16. Will the project generate solid waste? NYes ❑No a. If yes, what is the amount per month 0.2 tons b. If yes, will an existing solid waste facility be used? MYes ❑No c. If yes, give name Southold Transfer Station location Cutchogue d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes X'No .e. If Yes, explain 17. Will the project involve the disposal of solid waste? ❑Yes K]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? 'K]Yes ❑No ie. Lawn Care 19. Will project routinely produce odors (more than one hour per day)? ❑Yes NNo 20. Will project produce operating noise exceeding the local ambient noise levels? ❑Yes $]No 21. Will project result in an increase in energy use? $]Yes ❑No If yes , indicate type(s) Electric 22. If water supply is from wells, indicate pumping capacity N.A. gallons/minute. 23. .Total anticipated water usage per day 300 gallons/day. 24. Does project involve Local, State or Federal funding? ❑Yes ®No If Yes, explain 4 - I t .25. Approvals Required: Submittal Type Date City, Town, Village Board ❑Yes ESNo City, Town, Village Planning Board ❑Yes 9No City, Town Zoning Board ❑Yes f1RNo City, County Health Department LAYes ❑No Sewaae D s ispoal & Wat er Supply 6/94 Other Local Agencies ®Yes ❑No Building Permit 10/94 Other Regional Agencies []Yes NNo State Agencies NYSDEC ®Yes ❑No Tidal Wetlands 6/94 Federal Agencies Army Corp ( Yes ❑No River & Harbor Act 6/94 C. Zoning and Planning Information 1 . Does proposed action involve a planning or zoning decision? Dyes ®No If Yes, indicate decision required: ❑zoning amendment ❑zoning variance ❑special use permit ❑subdivision ❑site plan ❑new/revision of master plan ❑resource management plan ❑other 2. What is the zoning classification(s)of the site? A—C Agricultural — Conservation 3. What is the maximum potential development of the site if developed as permitted by the present zoning? N.A. 4. What is the proposed zoning of the site? No Change 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? N.A. 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? INYes ❑No 7. What are the predominant land use(s) and zoning classifications within a '/, mile radius of proposed action? Land Uses: Residential; Zoning: R-40 A—C 8. Is the proposed action compatible with adjoining/surrounding land uses within a ' mile? LNYes ❑No1/4 9. If the proposed action is the subdivision of land, how many lots are proposed? N.A. a. What is the minimum lot size proposed? N.A.. 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? ❑Yes MNo 11 . Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? CYYes ❑No a. If yes, is existing capacity sufficient to handle projected demand? MYes []No 12. Will the proposed action result in the generation of traffic significantly above present levels? ❑Yes ONo a. If yes, is the existing road network adequate to handle the additional traffic? ❑Yes ❑No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the information provided above is true to the best of my knowledge. Oct. 18, 1994 Applicant/Sponsor Name Youna & Young Attn• Thomas C. Wolpert Date X � Professional Engineer s*-� - Title Signature If the action is in the Coastal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. 5 i Part 2—PROJECT IMPACTS AND THEIR 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 been 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 simply 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 of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part 3. • The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative and have been offered as guidance.They do not constitute an exhaustive list of impacts and thresholds to answer each question. • The number of examples per question does not indicate the importance of each question. • In identifying impacts, consider long term, short term and cumlative 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 the impact. If impact threshold equals or exceeds any example provided,check column 2. If impact will occur but threshold 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 3. e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the project to a small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible. This must be explained in Part 3. 1 2 3 Small to Potential Can Impact Be Moderate Large- Mitigated By IMPACT ON LAND Impact Impact Project Change 1. Will the proposed action result in a physical change to the project site? ❑NO OYES Examples that would apply to column 2 • Any construction on slopes of 15% or greater, (15 foot rise per 100 ❑ ❑ []Yes ❑No foot of length), or where the general slopes•in the project area exceed 10%. • Construction on land where the depth to the water table is less than ❑ ❑ ❑Yes []No 3 feet. • Construction of paved parking area for 1,000 or more vehicles. ❑ ❑ ❑Yes El No • Construction on land where bedrock is exposed or generally within ❑ ❑ []Yes ❑No 3 feet of existing ground surface. • Construction that will continue for more than 1 year or involve more ❑ ❑ ❑Yes ❑No than one phase or stage. • Excavation for mining purposes that would remove more than 1,000 ❑ ❑ El Yes []No tons of natural material (i.e., rock or soil) per year. • Construction or expansion of a sanitary landfill. ❑ ❑ ❑Yes ❑No • Construction in a designated floodway. ❑ ❑ ❑Yes ❑No • Other impacts ❑ ❑ []Yes El No 2. Will there be an effect to any unique or unusual land forms found on the site?(i.e., cliffs, dunes, geological formations, etc.)❑NO OYES []Yes ❑No • Specific land forms: ❑ ❑ 6 1 2 3 IMPACT ON WATER Small to Potential Can Impact Be Moderate Large Mitigated By 3. Will proposed action affect any water body designated as protected? Impact Impact Project Change (Under Articles 15,24,25 of the Environmental Conservation Law, ECL) ONO OYES Examples that would apply to column 2 • Developable area of site contains a protected water body. ❑ ❑ ❑Yes ❑No • Dredging more than 100 cubic yards of material from channel of a ❑ ❑ []Yes No protected stream. • Extension of utility distribution facilities through a protected water body. ❑ ❑ ❑Yes []No • Construction in a designated freshwater or tidal wetland. ❑ ❑ []Yes ❑No • Other impacts: ❑ ❑ []Yes []No 4. Will proposed action affect any non-protected existing or new body of water? ONO OYES Examples that would apply to column 2 • A 10% increase or decrease in the surface area of any body of water ❑ ❑ ❑Yes El No or more than a 10 acre increase or decrease. • Construction of a body of water that exceeds 10 acres of surface area. ❑ ❑ El Yes El No • Other impacts: ❑ ❑ ❑Yes El No 5. Will Proposed Action affect surface or groundwater quality or quantity? ONO OYES Examples that would apply to column 2 • Proposed Action will require a discharge permit. ❑ ❑ El Yes ❑No • Proposed Action requires use of a source of water that does not ❑ ❑ El Yes El No have approval to serve proposed (project) action. • Proposed Action requires water supply from wells with greater than 45 ❑ ❑ []Yes El No gallons per minute pumping capacity. • Construction or operation causing any contamination of a water ❑ ❑ ❑Yes []No supply system. • Proposed Action will adversely affect groundwater. ❑ ❑ ❑Yes ❑No • Liquid effluent will be conveyed off the site to facilities which presently ❑ ❑ []Yes El No do not exist or have inadequate capacity. • Proposed Action would use water in excess of 20,000 gallons per ❑ ❑ [I Yes El No day. • Proposed Action will likely cause siltation or other discharge Into an ❑ ❑ D.Yes No existing body of water to the extent that there will be an obvious visual contrast to natural conditions. ' • 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 commercial and/or industrial uses which may ❑ ❑ El Yes ❑No require new or expansion of existing waste treatment and/or storage facilities. • Other impacts: ❑ ❑ ❑Yes ❑No 6. Will proposed action alter drainage flow or patterns, or surface water runoff? ONO DYES Examples that would apply to column 2 • Proposed Action would change flood water flows. ❑ ❑ []Yes ❑No 7 i 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. ❑ ❑ []Yes No • Other impacts: ❑ ❑ []Yes []No IMPACT ON AIR 7. Will proposed action affect air quality? ONO OYES Examples that would apply to column 2 ❑ []Yes ❑No • Proposed Action will induce 1,000 or more vehicle trips in any given ' ❑ hour. • Proposed Action will result in the incineration of more than 1 ton of ❑ ❑ ❑Yes ❑No refuse per hour. • Emission rate of total contaminants will exceed 5 lbs. per hour or a ❑ ❑ ❑Yes ❑No heat source producing more than 10 million BTU's per hour. • Proposed action will allow an increase in the amount of land committed El ❑ ❑Yes []No to industrial use. • Proposed action will allow an increase in the density of industrial ❑ ❑ ❑Yes []No development within existing industrial areas. • Other impacts: ❑ ❑ []Yes [I No IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species? ONO DYES Examples that would apply to column 2 • Reduction of one or more species listed on the New York or Federal ❑ ❑ ❑Yes []No list, using the site, over or near site or found on the site. ❑Yes ❑No • Removal of any portion of a critical or significant wildlife habitat. ❑ ❑ . • Application of pesticide or herbicide more than twice a year, other ❑ ❑ []Yes ❑No than for agricultural purposes. ❑Yes ❑No • Other impacts: ❑ ❑ 9. Will Proposed Action substantially affect non-threatened or non-endangered species? ONO DYES Examples that would apply to column 2 • Proposed Action would substantially interfere with any resident or ❑ El []Yes ❑No migratory fish, shellfish or wildlife species. • Proposed Action requires the removal of more than 10 acres ❑ ❑ ❑Yes QNo of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES 10. Will the Proposed Action affect agricultural land resources? ONO DYES Examples that would apply to column 2 El ❑Yes ONO • The proposed action would sever, cross or limit access to agricultural ❑ land (includes cropland, hayfields, pasture, vineyard, orchard, etc.) _ 8 , i - 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: ❑ ❑ ❑Yes ❑No IMPACT ON AESTHETIC RESOURCES 11 . Will proposed action affect aesthetic resources? ONO 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 that resource. • Project components that will result in the elimination or significant ❑ ❑ []Yes El 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? ONO DYES Examples that would apply to column 2 • Proposed Action occurring wholly or partially within or substantially ❑ ❑ []Yes [I No contiguous to any facility or site listed on the State or National Register of historic places. • Any impact to an archaeological site or fossil bed located within the ❑ ❑ ❑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, ONO DYES • The permanent foreclosure of a future recreational opportunity. ❑ ❑ ❑Yes ❑No • A major reduction of an open space important to the community. ❑ ❑ ❑Yes ❑No • Other impacts: ❑ ❑ ❑Yes. []No 9 1 2 3 IMPACT ON TRANSPORTATION Small to Potential Can Impact Be 14. Will there bean effect to existing transportation Systems? Moderate Large Mitigated By LINO DYES Impact Impact Project Change Examples that would apply to column 2 • Alteration of present patterns of movement of people and/or goods. ❑ ❑ ❑Yes []No • Proposed Action will result in major traffic problems. ❑ ❑ ❑Yes [I No • Other impacts: ❑ ❑ ❑Yes ❑No IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? - ONO 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 ❑ ❑ ❑Yes ❑No transmission or supply system to serve more than 50 single or two family residences or to serve a major commercial or industrial. use. • Other impacts: ❑ ❑ []Yes ❑No NOISE AND ODOR IMPACTS 16. Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? ONO OYES Examples that would apply to column 2 Blasting within 1,500 feet of a hospital, school of other sensitive ❑ ❑ ❑Yes ❑No facility. • Odors will occur routinely (more than one hour per day). ❑ ❑ []Yes [I No • Proposed Action will produce operating noise exceeding the local ❑ ❑ ❑Yes []No ambient noise levels for noise outside of structures. • Proposed Action will remove natural barriers that would act as a ❑ ❑ ❑Yes El No noise screen. • Other impacts: ❑ ❑ ❑Yes []No IMPACT ON PUBLIC HEALTH 17. Will Proposed Action affect public health and safety? ONO DYES 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 Yes ❑NO within 2,000 feet of a site used for the disposal'of sofid.or hazardous waste. • Other impacts: ❑ ❑ []Yes ❑No 10 1 2 3 IMPACT ON GROWTH AND CHARACTER Small to Potential Can Impact Be OF COMMUNITY OR NEIGHBORHOOD' Moderate Large Mitigated By 18. Will proposed action affect the character of the existing community? Impact Impact Project Change ONO DYES 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 ❑ ❑ []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 []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. ❑ ❑ ❑Yes ❑No • Other impacts: ❑ ❑ ❑Yes ❑No 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? ONO DYES 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 Part 3—EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) 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 • The duration of the impact • Its irreversibility, including permanently lost resources of value • Whether the impact can or will be controlled • The regional consequence of the impact • Its potential divergence from local needs and goals • Whether known objections to the project relate to this impact. (Continue on attachments) 11 - 14-16-2 (2/91)-7c 617.21 Appendix A SEAR 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 not 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 enough to allow introduction of information to fit a project or action. d 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 projector 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 7 and Unlisted Actions Identify the Portions of EAF completed for this project: ❑ Part 1 ❑ Part 2 ❑Part 3 F . 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 magnitude and importance of each impact, it is reasonably determined by the lead agency that: ❑ A. The project will'not result in any large and important impact(s) and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prepared. ❑ B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, the a CONDITIONED negative declaration will be prepared.* ❑ C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of.Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(If different from responsible officer) ! Date 1 � PART 1—PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the environment. Please complete the entire form, Parts A through E as part of the application for approval and may be subject to further verifi. Answers to these questions will be considered cation and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable,so indicate and specify each instance. NAME OF ACTION Nancy L. Foote LOCATION OF ACTION(Include Street Address, Municipality and County) Willis Creek Drive, Mattituck, T/O Southold, County of Suffolk NAME OF APPLICANT/SPONSOR Young & Young, ATM: Thomas C. WOl BUSINESS TELEPHONE .ADDRESS pert, P.-E. ( 516) 727-2303 400 Ostrander Avenue CITY/PO Riverhead STATE ZIP CODE NAME OF OWNER(if different) N.Y. 11901 Nanc L. FOOte = 369-55goNESS TELEPHONE ADDRESS ) 29 Baitin Drive CITYIPO Baiting Hollow srarE ZIP CODE DESCRIPTION OF ACTION N.Y. 11933 Construct a single family dwelling, swimming pool, deck,:driveway with .drainage leaching pool, sanitary system, water service, walkway, and dock. No offsite fill is required. Please Complete Each Question—Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: ❑Urban ❑Industrial ❑Commercial ❑Residential (suburban) [RRural non-far❑Forest ❑Agriculture ❑Other ( m) i 2. Total acreage of project area: 1.1 acres. APPROXIMATE ACREAGE Meadow or Brushland (Non-agricultural) 0.1 PRESENTLY AFTER COMPLETION Forested acres 0.1 acres 0.8 Agricultural (Includes orchards, cropland, pasture, etc.) acres 0.5 0 acres i Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) 0.2 acres 0 acres 0.2 acres Water Surface Area 0 acres Unvegetated (Rock, earth or fill) acres 0 acres it 0 acres 0 Roads, buildings and other paved surfaces 0 acres Other (Indicate type)Lawns & landscaping acres 0 15 acres 0 acres 0.15 acres 3. What is predominant soil t project PIC — Pl i s) on site? PTA — p1 OUth i°a Y sand 8-15% slope type(s) a. Soil drainage: (RWell drained 8_0 % of site $]Moderately well drained Poorly drained 10 % of site __JD_ �� of site { b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS ;I Land Classification System? N.A acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? ❑Yes CRNo a. What is depth to bedrock? N.A. (in feet) 2 5. Approximate percentage of proposed project site with slopes: NO-10% An % WO-15% 20 EX15% or greater 0 % 6. Is project substantially contiguous to, or contain a building, site, or district, listed on the State or the National Registers of Historic Places? []Yes ENNo 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? ❑Yes K]No 8. What is the depth of the water table? 0'-8' (in feet) 9. Is site located over a primary, principal, or sole source aquifer? ®Yes ❑No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? .❑Yes K]No 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? ❑Yes INNo According to Youncr & Young Identify each species 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) ❑Yes IRNo Describe 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? ❑Yes ®No If yes, explain 14. Does the present site include scenic views known to be important to the community? ❑Yes INNo 15. Streams within or contiguous to project area: Dredged Creek f Wi 11 is C ePk? a. Name of Stream.and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name Great Peconic Bay b. Size (In acres) N_A 17. Is the site served by existing public utilities? RJYes ❑No a) If Yes, does sufficient capacity exist to allow.connection? X]Yes ❑No b) If Yes, will improvements be necessary to allow connection? X]Yes ❑No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? ❑Yes (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? IXYes []No 20. Has the site ever been used for the disposal of solid or hazardous wastes? []Yes ®No B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor 1.1 acres. b. Project acreage to be developed: 1.1 acres initially; 1.1 acres ultimately. c. Project acreage to remain undeveloped 0 acres. d. Length of project, in miles: N.A. (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed N.A. %; f. Number of off-street parking spaces existing 0 proposed 2 g. Maximum vehicular trips generated per hour 2 (upon completion of project)? 3 h. If residential: Number and type of housing units: One Family Two Family Multiple Family Condominium Initially 1 Ultimately 1 i. Dimensions (in feet) of largest proposed structure 35' height; 33' width; 73' length. j. Linear feet of frontage along a public thoroughfare project will occupy is? 1441 ft. 3 i 2. How much natural material (i.e., rock, earth, etc.) will be removed from the site? 0 tons/cubic yards 3. Will disturbed areas be reclaimed? MYes ❑No . El N/A a. If yes, for what intended purpose is the site being reclaimed? Lawns & Landscaped Areas b. Will topsoil be stockpiled for reclamation? IINYes ❑No c. Will upper subsoil be stockpiled for reclamation? [NYes ❑No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0.3 acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? ❑Yes ®No 6. If single phase project: Anticipated period of construction 6 months, (including demolition). 7. If multi-phased: N.A. a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 month year, (including demolition). c. Approximate completion date of final phase month_ year. d. Is phase 1 functionally dependent on subsequent phases? Dyes ❑No 8. Will blasting occur during construction? ❑Yes ERN 9. Number of jobs generated: during construction 6 ; after project is complete 0 10. Number of jobs eliminated by this project 0 11. Will project require relocation of any projects or facilities? ❑Yes ®No If yes, explain 12. Is surface liquid waste disposal involved? ❑Yes KINo 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? IN Yes ❑No Type __Sanitary 14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes LNNo Explain 15. Is project or any portion of project located in a 100 year flood plain? OYes ❑No 16. Will the project generate solid waste? gYes ❑No a. If yes, what is the amount per month 0.2 tons b. If yes, will an existing solid waste facility be used? W'iYes ❑No c. If yes, give name Southold Transfer Station location _Cutchogue d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes KNo e. If Yes, explain 17. Will the project involve the disposal of solid waste? ❑Yes KJNo 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? MYes ❑No ie. Lawn Care 19. Will project routinely produce odors (more than one hour per day)? ❑Yes ®No 20. Will project produce operating noise exceeding the local ambient noise levels? ❑Yes K]No 21. Will project result in an increase in energy use? K]Yes ❑No If yes indicate type(s) Electric 22. If water supply is from wells, indicate pumping capacity N.A. gallons/minute. 23. .Total anticipated water usage per day 300 gallons/day. 24. Does project involve Local, State or Federal funding? ❑Yes ®No If Yes, explain 4 25. Approvals Required: Submittal Type Date City, Town, Village Board ❑Yes MNo City, Town, Village Planning Board Dyes No City, Town Zoning Board ❑Yes UNo City, County Health Department MYes ❑No Sewage Disposal & WatPr sii ply 6/94 Other Local Agencies ®Yes ❑No Building Permit 10/94 Other Regional Agencies []Yes NNo . State Agencies NYSDEC ®Yes ❑No Tidal Wetlands 6/94 Federal Agencies Army Corp IJYes ❑No River & Harbor Act 6/94 C. Zoning and Planning Information 1 . Does proposed action involve a planning or zoning decision? ❑Yes ®No If Yes, indicate decision required: ❑zoning amendment ❑zoning variance ❑special use permit ❑subdivision ❑site plan ❑new/revision of master plan ❑resource management plan []other 2. What is the zoning classification(s)of the site? A—C Agricultural — Conservation 3. What is the maximum potential development of the site if developed as permitted by the present zoning?. N.A. 4. What is the proposed zoning of the site? No Change 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? N.A. 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? NYes ❑No 7. What are the predominant land use(s) and zoning classifications within a '/4 mile radius of proposed action? Land Uses: Residential; Zoning: R-40, A—C 8. Is the proposed action compatible with adjoining/surrounding land uses within a '/4 mile? INYes []No 9. If the proposed action is the subdivision of land, how many lots are proposed? N.A. a. What is the minimum lot size proposed? N.A.. 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? ❑Yes K]No 11 . Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? Wes ❑No a. If yes, is existing capacity sufficient to handle projected demand? EXYes []No 12. Will the proposed action result in the generation of traffic significantly above present levels? ❑Yes 5]No a. If yes, is the existing road network adequate to handle the additional traffic? ❑Yes ❑No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the information provided above is true to the best of my knowledge. Applicant/Sponsor Name Young & Young Attn: Thomas C_ Wolraert Date Oct. 18, 1994 Signature XI'Age- CcO ". (i(/� Title Professional Engineer If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. t 5 , YOUNG & YOUNG PLANNING, ENGINEERING &LAND SURVEYING 400 OSTRANDER AVENUE,.RIVERHEAD, NEW YORK 11901.-4694 Telephone 516-727-2303 Facsimile 516-727-0144 December 6, 1994 Board of Trustees Town of Southold 53095 Main Road P.O. Box 1179 Southold, New York 11971 RE: NANCY L. FOOTE at Mattituck, T/O Southold, New York (94-0305) Dear Members of the Board: Enclosed are the following items for your review of our application for a wetland permit to construct a single family dwelling and related structures at the above referenced site: 1. five (5) prints - Survey for Nancy L. Foote, last dated November 22 , 1994; 2 . one (1) original and four (4) copies - Wetland Permit Application, including Authorization Form and Data Sheet; 3 . five (5) copies - Location Map (portion of USGS Quad Map) ; 4 . one (1) original and four (4) copies - four (4) representative photographs of the project area and surroundings; 5. one (1) copy - survey, dated June 10, 1994 showing the view direction of the photographs; 6. one (1) original and four (4) copies - Short Environmental Assessment Form; 7 . one (1) original and four (4) copies - Long Environmental Assessment Form; and 8 . application fee - our check in the amount of One Hundred Fifty Dollars ($150. 00) payable to Southold Trustees. If you have any questions regarding this application, please advise. Very truly yours, Thomas C. Wolpert, P. E. TCW/nas Encls. cc: Mrs. Nancy L. Foote + Encls. ALDEN W.YOUNG HOWARD W.YOUNG THOMAS C.WOLPERT KENNETH F.ABRUZZO Professional Engineer Land Surveyor Professional Engineer Land Surveyor &Land Surveyor