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HomeMy WebLinkAboutTR-5796 r / J¢� - U ' R� .moj�•Y.l -. v5 - LL �E-r�-•t `rf•F.�C� %/{ �\ 'yl`\ W'.�'Tin � 2 'F r'S7� _ "'f`� /.af.'Q:'.Y] �'� � �.eo� 1'�',•*r`'/ACil£p�� •: An Q,: ,� � � ;.L: � •, ems_ � �� �;,� . v Board Of Southold Town Trustees - :a > � SOUTHOLD, NEW YORK 2g , 00 I _ PERMIT NO. ... �� DATE: . .... ..................... Au ust 20 3 ORIENT WHARF COMPANY...INQ.,..................................... . ISSUED TO .................................. . x , .`.Y '• Pursuant to the provisions of Chapter 615 of the Laws of. tir " 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- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS ' f 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 r ' ' Au ust 20 s ' Resolution of The Board adopted at a meeting held on .........9. .....-- 9 ip I� 250.00 aid b 2003 and m consideration of the sum of ............................. p Y z2 `" Costello Marine"Contracting._.Corp......fox:...Qrjexit...Wharf....Co.- ....................................... 4' 3 ��. Green .......... N. Y. and, subject to the . z Terms and Conditions listed on the reverse side hereof, .. ' of Southold Town Trustees authorizes and permits the following: x• Wetland Permit & Coastal Erosion Permit to saw between 12 to 15. k 3'X3' inspection ports in the exist. concrete floor in order to - w inspect and evaluate the exist. foundation then repair as needed - ` and as depicted on the site plan. prepared by Costello Marine :s all in accordance with the detailed specifications as presented in the originating application. J ='r ' Contracting Corp. dated June 12, 2003. IN WITNESS WHEREOF, The said Board of Trustees here- ts Corporate Seal to be affixed,by causes iixed, and these presents to 1 be subscribed by a majority of the said Board as of this date. o Trustees 'r `> .�.. r .�-- , �.w- ��'t � : •,ham _ TERMS and CONDITIONS The Permittee Orient Wharf Co. Inc. residing at P.O. Box 243, Orient NY 11957 N. Y, as part- of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: i. 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 raid Permittee will, at his or her own expense, defend any and all such suits-initiated by third parties, and the said Permittee assumes fall liability with respect thereto, to the complete'exclusion of the Board of Trustees of the Town of Southold 2- That this Permit is valid fora period of 24 rum which is considered to be the estimated time•required to complete the work involved, but-should.drcthaismces 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. 6. That there shall be no interference with the right of the public to pass and repass 'along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the.removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the. work shall cause unreasonable obstruction to free navigation, the said Permittee will be requltrd, upon due notice, to remove or alter this work or project herein stated without expenses to the Town . of Southold S. 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. Albert J.Krupski,President 0�� C� Town Hall O James King,Vice-President /� 'yam 53095 Route 25 Artie Foster y P.O.Box 1179 Z Southold,New York 11971-0959 Ken Poliwoda Peggy A.Dickerson 1i ��� Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 20, 2003 Mr. John Costello Costello Marine Contracting Corp. P.O. Box 2124 Greenport,NY 11944 RE: ORIENT WHARF CO. INC. 2110 VILLAGE LANE, ORIENT SCTM#24-2-28.1 Dear Mr. Costello: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 20, 2003 regarding the above matter: WHEREAS, Costello Marine Contracting Corp. on behalf of ORIENT WHARF CO.INC. applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 25, 2003, 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 August 20, 2003, 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 standards set forth in Chapter 97 of the Southold Town Code, 2 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 approve the application of ORIENT WHARF CO. INC. to saw between 12 to 15, 3'X 3' inspection ports in the existing concrete floor in order to inspect and evaluate the existing foundation then repair as needed, and as depicted on the site plan prepared by Costello Marine Contracting dated June 12, 2003. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$5.00 per inspection. (See attached schedule.) Fees: None Very truly yours, i f ; ' Albert J. Krupski, Jr. President,Board of Trustees AJK/lms i SUFFO��- Albert J.Krupski,President 0�0 CD Town Hall James King,Vice-President � Gym 53095 Route 25 Artie Foster p P.O.Box 1179 013 = Southold,New York 11971-0959 Ken Poliwoda Peggy A.Dickerson ifi O`er Telephone(631) 765-1892 Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT Permit#5796 Date: August 20, 2003 SCTM#24-2-28.1 Name of Applicant/Agent: Costello Marine Contracting Corp. Name of Permittee: ORIENT WHARF CO. INC. Address of Permittee: P.O. Box 243, Orient,NY 11957 Property Located: 2110 Village Lane, Orient,NY 11957 DESCRIPTION OF ACTIVITY: To saw between 12 to 15, YX 3' inspection ports in the existing concrete floor in order to inspect and evaluate.the existing foundation then repair as needed, and as depicted on the site plan prepared by Costello Marine Contracting dated June 12, 2003. Permit to construct and complete project will expire two years from the date the permit is signed. SPECIAL CONDITIONS: (apply if marked) Bluff restoration through a re-vegetation plan is a necessary special condition of this permit. A relocation agreement is attached hereto and is a necessary special condition of this permit. _A maintenance agreement is attached with application and is a necessary special condition of this permit. 2 Albert J. p , President,Board of Trustees AJK/lms cc: DEC r s . N aB M O a A Z 7em• a ' ` s s tm p O• •• en i is a xwa i 2 7 p Yacht Clue ama • " �' ORIENT _ O !_ re ro •. 01 is HARBOR Project Q F LOG'dtlOro _ 7 7 we 3rA18 Project 011? n n tmN AY ffAtt • Location A ro r Pets '9iQe GARDINERS 's BAY O'4 Referenced from NYSDEC-NYS 7.5 Minute Quadrangle Images Referenced from S.C.T.M. VICINITY MAP LOCATION MAP SCALE:1"=2060' SCALE:1"=300' ADJACENT PROPERTY OWNERS: O FLOYD F.KING,JR.ET AL O DAVID AND CLAIRE AIR O TIMOTHY AND DAVID FROST REVOC TRUST 315 8th AVENUE APT 12B P.O.BOX 636 C/O SUSAN KING NEW YORK,NY 10001 ORIENT,NY 11957 99 CYUGA STREET (2072 VILLAGE LANE) (2190 VILLAGE LANE) HOMER,N 13077-1235 SCTM: 1000-24-2-27 -•-SCTM:1000-24-2-28.1 (225 BA LANE) SCTM: 1000-24-2-26 DECEITE- J U L 2 5 2003 .. ` PROPOSED: TO SAW BETWEEN 12 TO 15,3'xT INSPECTION PORTS I h EXISTIN Southold uste f Truste CONCRETE FLOORS IN ORDER TO INSPECT AND EVAL oard o EXISTING FOUNDATION REPAIR AS NEEDED. ACCESS: BY ROAD(VILLAGE LANE) Sheet 1 of 3 PREPARED BY: JOB/SITE ADDRESS APPLICANT: COSTELLO MARINE CONTRACTING CORP. ORIENT WHARF COMPANY, INC. P.O. BOX 2124 GREENPORT, NY 11944 P.O. BOX 243(2110 VILLAGE LN.) ORIENT WHARF 631-477-1199 ORIENT, NY 11957 COMPANY, INC. ORIGINAL:6/12/03 S.C.T.M. 1000-24-2-28.1 H ORIENT HARBOR mm o0 Fqm d n�� °00c 0 THE ORIENT WHARF PROPOSED WORK AREA (INSIDE EXISTING BUILDING) r 1 1_ _ FLOAT FWA7s RqI yE a�iLD�Nc _ nns0 E 7bEPE -NED �c s sNft ASPHALT SURFAce OVER STONE FW7FDRM11 ORIENT .. HARBOR SITE PLAN SCALE:1°=40' Sheet 2 of 3 PREPARED BY: JOB/SITE ADDRESS APPLICANT: COSTELLO MARINE CONTRACTING CORP. ORIENT WHARF COMPANY, INC. P.O.BOX 2124 GREENPORT, NY 11944 P.O. BOX 243(2110 VILLAGE LN.) ORIENT WHARF 631-477-1199 ORIENT, NY 11957 COMPANY, INC. ORIGINAL:6/12103 S.C.T.M. 1000-24-2-28.1 1 k k FLOAT 5' J 10, 10, / 10' r 10' J 10' r J J I 5' J /EXISTING J J CONCRETE — r r FLOOR � J / 18' TIMBER DECK ON STONE PIER SHED DECK T-6" TIMBER SHED TxT INSPECTION PORTS (TYP FOR APROX.14 PLACES) PLATFOF PARTIAL PLAN SCALE:1"=16 Sheet 3 of 3 PREPARED BY: JOB/SITE ADDRESS APPLICANT: COSTELLO MARINE CONTRACTING CORP. ORIENT WHARF COMPANY, INC. ORIENT WHARF P.O. BOX 2124 GREENPORT, NY 11944 P.O. BOX 243(2110 VILLAGE LN.) COMPANY, INC. 631-477-1199 ORIENT, NY 11957 ORIGINAL:6/12103 S.C.T.M. 1000-24-2-28.1 ELIZABETHA. NEVILLE TOWNHALL, 53095 MAINROAD TOWN CLERK P.O. BOX H79 REGISTRAR OF VITAL STATISTICS SOUTHOLD NY 11971 MARRIAGE OFFICER FAX.• 631-765-.6145 RECORDS MANAGEMENT-O 'CFI ER--- TELEPHONE: 631-765-I800' FREEDOMOFI ' 0RMATIONOFFICER southoldtown.northfork.net r j 1. l ' 6 +OP IOUIy � OCT 2 2 2008 ;; F Southoid ''� Board of 10tFIC_E OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR PUBLIC ACCESS TO RECORDS INSTRUCTIONS: Please complete,section I of this - f=nanrl ive to Town Clerk's Office (agency Freedom of Information Officer). One copy w'11'be returned to you in r onse to your request, or as an interim response. SECTION I. (� c.LO C 0j&4—).: e �bf') ,o�aa 108 TO _OQ (Department or Officer, if known, that has the informatio are requesting). RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, supply date, file title, tax map number, and any other pertinent information). Z11, (N« �SoX Z�3 , ©��S�JT., Nil \\yS� �1J1J ��14�1��9JNA`�r L`l ��1�T0►� �v,�l�, i A� +�Ar\O►z �G— Signature of Applicant: Printed Name 0— Address: k)\A \g)1�o l Mailing Address (if different from above): UAz) bZO O b2 Telephone Number: �c 3�� 3Z� - 3�oco0 Date: [ ] APPROVED [ ] DENIED* [ ] APPROV I IH DELAY* RECEIVED Elizabeth A. Neville Date OCT 2 ZQ08 Freedom of Information Officer Accepting Clerk's Initials Southold Town C1erl *If delayed or denied, see reverse side for explanation. cz Town Hall, 53095 Main Road sh `Ti P.O. Box 1179 Telephone O Southold, New York 11971 (631) 765-1892 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, August 12, 2003, the following recommendation was made: Moved by Nicholas Dickerson, seconded by William Cook, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit application of ORIENT WHARF CO., INC. to saw between 12 to 15, TX 3' inspection ports in the existing concrete floor in order to inspect and evaluate the existing foundation then repair as needed. Located: 2110 Village Lane, Orient. SCTM#24-2-28.1 The CAC recommends Approval of the application to inspect the foundation, and recommends an application for an amendment to the permit for specific repairs. Vote of Council: Ayes: All Motion Carried i R77W ice.. rAL- k t 1� 4 � � Q ent Ya ht Club "Foundation Repairs Within Existing Building 7/22/03 I..` dA I t Orient Yacht Club Foundation Repairs Within Existing Building 7/22/03 o. oil frlilt � Orient Yacht Club Foundation Repairs Within Existing • • 1 ^� o 71 /N STATE i7 - +- t e \ sr. LAJ / j l '' /N y i O 2 1 C is tN f 4 ��F ' �aa/�� / "s •�' a �j' - 17 sa s6c xe nx / `. 1 P - ti — -- — -- — NOTICE COUNTY OF SUFFOLK Q Y s SOUTHOLD ECTION NO c — `zU - ;;.r„�, —_ _ L = fled Property Tax Service Agency r I 6 - w - — =a _ Y ... —_— .w�-..... —_.— —_ —_ — Cuntf'Cant.r NT It901 y _ ux.w 24 ....w f m u- m�s Trustee Inspection File Report Name Address SCTM# 1St Insp 2"d Insp 3rdlnSp Final Insp Notes r ';: O�OSVFFO(�-CO Town Hall Albert J.Krupski,President h� Gy 53095 Main Road 79 James King,Vice-President c .fit P.O.Box 11 ti.. = Southold, New Yorkk 11971 Henry Smith Artie Foster • Telephone (516) 765-18-92 Ken Poliwoda y�f01 �aO! Fax(516) 765-1823 'BOARD OF.TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only .oastal Erosion Permit Application Wetland Permit Application Grandfather Permit Application Waiver/Amendment/C an es /Received Application: 7 4103 c�1 tif2eceived Fee: $ AOO T N� ' �`• ompleted Application 7 c.?3 Incomplete D C E B SEQRA Classification: Type I Type II Unlisted - Coordination: (date sent) JUL 9r 2003 CAC Referral Sent: 11 33 to of Inspection: 1 Receipt of CAC Report: Southold Town Lead Agency Determination: Board of Trustees Technical Review: _ZPublic Hearing Held: g O1 Resolution: Name of Applicant Address Phone. Number: 43() 38C�f- Suffolk County Tax Map Number: 1000 - a ^v�U• SOX 03 An Akin ri Property Location• l (provide LILCO Pole #, distance to cross streets, and location) AGENT: N-Alb U (If applicable) KY 1"r"I`'I DO 1(y� Address: ' � t l7fePaA �(� . Phone• FAX# : (o;1 dZ"'1 - CXnO) 1 __ard of Trustees Applicati__ GENERAL DATA/ Land Area (in square feet) : 11z. acre) Area Zoning: 554- 200-1 G alzaTw Previous use of property: tt Intended use of property: Prior permits/approvals for- site improvements:' Agency Date n E C E V E Southold Town Board of Trustees No prior permits/approvals for site improvements. r Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attacliments if necessary) : Aal PPY1 1 to 115 - 3'X 3' M7'De 1AA Ins e)(14 CI Mhrfeft flood order in a&� evaluate= -V,AP_ exist�,wG �MAda.-W AW-y" ae:;;, heejec[ _ i a i i Boa of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: e Iknlk QYA ffinko QDJi(S ko �� nficn;l Area of wetlands on lot: square feet Percent coverage of lot: (� Closest distance between nearest existing structu ind edge of wetlands: 0 feet . Q 0 V E Closest distance between nearest proposed struct nd upland edge of wetlands: D feet JUL r� 2003 Does the project involve excavation or filling? Southold Town No Yes Board of Trustees If yes, how much material, will be excavated? cubic yards How much material will be filled?••` cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations:CIA Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate) : o VX aMM► V f61R,Ade-, a r 3 0�JP_YLJ VV►nox 1-3 1 VW 1V6 y rd of Trustees Applicatio]z._,' COASTAL EROSION APPLICATION DATA Purposes of proposed activity: p Inv 1QQ anAITTAkf GM ezalAQ �UnGfUhnyl Are wetlands present within 75 feet of the proposed activity? x No Yes Does the project involve excavation or filling? x No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? . �.) (cubic yards ) Manner in which material will be removed or deposited: Describe the nature and- extent of-.the envir.onmental_...impacts._. . reasonably anticipated resulting .;from implementation of the project as -proposed:- (Use-attachments. if--necessary) 1 horn vV11 I bP 'flmgni� twI kdez ©y► -Nne_ enyironiiyle 4 . } -r 4 Albert J.Krupski, President Town Hall 0�0 C� James King,Vice-President `Z` G 53095 Route 25 y.� P.O.Box 1179 Artie Foster cz y x Southold,New York 11971-0959 Ken Poliwoda v, �'►� Peggy A.Dickerson O1i �� Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of �' -1-0--At llJ _�v_� �(1C_�------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, A• C 0 residing at /2 /o Alb.,Zr" Ao sD Z'2 Ova being duly sworn, depose and say: That on the II day of Art&at. , 200*3 I personally posted the property known as 02 jLt N-r— W 14.4.2,�c 4 o2la nrr Y,4c 4r C L" by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior�joNthe date of the public hearing. Date of hearing noted thereon to be held lJ e Qd•k {C�1 .�^`�Q Of %00 . Dated: 8— !S -O 3 ature) • Sworn to before me this /5 day of Av3• 200 pECEDWE �1 otary Public 61 AUG 1 8 2003 BARBARA K TAMy B Board oflT Town s is No. DTi 608M_ _ CWMGd In SuNk Cotes COMMs�loA E*rn 811ftla Y� ,�Lt j >_ E PRIVATE PROPERTY 'i f �� . . .c. uE1rc.°•.. E �� Vlnlarvt< . NOTICE OF HEARING PRIVATE ' NOTICE IS HEREBY GIVEN Ihot hearing"III be held by the pRWW-LIMITED ! SOUTHOLD BOARD OF TRUSTEES o1 the Town Hall,53095 Main Road, _ RaRKING IS Southold,New Yak,cm—mg Ihis prop" — TO MEMBERS OF THE ORIENT Ya CHT CLUB 6 RENTERS OF BOAT� OWNER(S)OF RECORD:ONant wrcu*CD.):'tx j Mo w.m wln — _.p■Kwc SUBJECT OF PUBLIC HEARING=nSP—,000ILm4,L j vlourORs wut eE ' TOWED TT FIR, C1'a���V15ttn9'�W ti'ECl{iop,OS �WNE FNSE ' TIME&DATE OF PUBLIC HEARING: needs! -.- -' u>ea,nuqua+FtGrADG3 on or abut-'cG Pm. B you hove an�nmresl n Ihis prgecl,yo m th u orc inn 1 ra v,ew the Town Kkl+l whkh 5.w 6, p«ri p br m e day u(the Iwnnng dudm nam I bu- d bewec Ihosh ed a1 J BOARD OF TRUSTEES TOWN OF SOUTHOID'16311 765 1892 Orient Yacht Club Trustees Sign Posting �, 8-11-03 L D � 11 i �- ZG Southold Town Beard of Trustees NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: (� `f &0,y� . SCTM 1000- JUL 2 5 2003 YOU ARE HEREBY GIVEN NOTICE: Southold Town 1 . That it is the intention of the undersigne 8o fTownsa Permit from the Board of Trustees to: IZ. to (AAspec{iov'\ e i�Sf W� . co►ncre f�, Floor yin order unspec4- aid eValual-, f he exts�to ftLkVdu cj4 tkeh repatY as needed 2 . That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows : 21 1 o V�l lad, lo,,vAL Ne.tq , NY 11957 3 . That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment. You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: MAILING ADDRESS: PHONE ## : Enc . : Copy of sketch or plan showing proposal for your convenience. s PROOF OF MAILING OF NOTICE :_ATTACH - CERTIFIED MKIL .RECEI:PTS. 7001 2510 0000 1246 24 7001 2510 0000 1246 2418 mD m �; ° Co. co m� m 510 0000 1246 2425 ' orn in � oD� • m x N; o Z m ?o m�„9 m :.`', N� o z�! m �a 3.a 1 „" o m y^ ym_ U; o m m to m m � • +. 71=- 31° +� N m 9= JJO cZ c_r. n • c 2 c R a m a w ao O -n m m w m T -n w M m m m m m `D w 'm m m <° m M a n z • O m am AM m m m am am m m • w a� �� a y X ffl d' v O ff? E» m M m-n -n tl N > CD 0 CD �c �o` ti zCD NN n \e 2 cu IY CD ti STATE OF NEW YORK # ^7 T, 2M e i COUNTY OF SUFFOLK � ANA i1 residing at H001 � being duly sworn, depos tha on the -r-i _ day of ,;i�'ac deponent mailed a true copy of the Notice set forthAn . .the Board of Trustees j Application, directed. to each of the. above named. persons at the addresses set opposite there respective .names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that aid Notic s wer mailed at the United States Post Office at , that said Notices were mailed to each of said perso s by (certi ed egistered) mail. wo n t of e me this of 3 Veronica F. Cidone Notary Public, State of New York No: 52-4661406 Nota ublic Qualified in Suffolk County commission Expires ®ec.31,-Q�D—c6 b 6 Hoard of Trustees Applicat�WAA County of Suffolk State of New York ")Me, A*�J �..�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 REPRESENTATIVES(S) , TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ign ture SWORN TO BEFORE ME 'PHIS c�3 DAY OF E C E U JUL 2 5 2003 Notary Public .,a-1r1 Town Veronica F. Cidone Notary Public, State of New fork No: 62-4661406 Qualified in Suffolk Count Commission Expires Dec.31, 7 RIEN T 'WHARF C 9 INCORPORATED 1851 — BOX 243, ORIENT, NY 11957 APO JUI: Southold Town Board of Trustees Sze- 617.20 SEQR PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by A)plicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME Costello Marine Contracting Corp. Orient Wharf Company, Inc. &PROJECT LOCATION: Southold Town Suffolk Municipality County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 2110 Village Lane, Orient, NY 11957 SCTM 1000-24-2-28.1 5.IS PROPOSED ACTION: ❑ New ❑Expansion 0 Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: Saw between 12 to 15-3'x3'inspection ports in the existing concrete floor in order to inspect and evaluate the existing foundation,then repair as needed. ® ECE E FLJU2 5 2003 7.AMOUNT OF LAND AFFECTED: Southold - Initially 0 acres Ultimately 0 acres own 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ❑✓ Yes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ❑Residential ❑Industrial a Commercial ❑A{griculture ❑Park/Forest/Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) Yes ❑No If yes, list agency name and permit / approval: NYSDEC, Southold Town 11.DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes a No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E]Yes Z No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Jan onal h Permit Manager @ CMCC Date:July 16,2003 Signature If the action is a Costal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? 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 pattern,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 C1-05? Explain briefly: C7. Other impacts(including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL A (CEA)? If yes,explain briefly: 7 Yes No E. IS THERE,OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ex lain: Yes No 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; (a) 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. If question d of part ii was checked yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. 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 actin WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Print or Type Name of Responsible Officer In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead-Agency Signature of Preparer rent from responsible officer) SURVEY OF PROPERTY "THE ORIENT WHARF" 51TUATE: ORIENT TOWN: 5OUTHOLD 5UFFOLK GOUNTY, NY SURVEYED Oe1-08-qG, UPDATED 06-25-01 ELEVATIONS SHOWN HEREON ARE 'V REFERENCED TO M.S.L. N6VD'2G 5UFFOLK GOUNTY TAX # [c 1000 - 24 - 2 - 28.1 L� k� �0�� Southold Town o • Board o of 3rustees _ � F'Xea .• I : � t Timber _ l® 1 / rn Docks • 1 p I• r 6 � /tl_/• � • I I r ( — I l � lyl • I I II 1 I v • Io I-VI • IIQt Iql - - L I I _ Float LL Pr LE MI _ I n' �_SC Ma•kE�73 Timber 3 �'•� �ovit r(_ —,_ — J • I III I I • / / // b,/ Stone on she _� V ,` I II = I _ _ e pier b 9' m I I • T — I — i / / / ( O. 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