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HomeMy WebLinkAbout1000-5.-2-10.8 n / i I ' O V_ -- ---- 51TE R. 6S66„w I WINIP POLEMON/ /K �-os` APPROVED BY I 595 SBO2s r LOT 8 PLANNING BOARDWN ROAD Nzs°o4'od'w ;�'• ` ` 562,97'40' TOWN OF SOUTHOLD Max. '� 5.63 a1f� \ \ 29160 E — 9 64°04'10”E Mnx m r �/ / / / / / / l a LOCAl10N MAP ' S03°54�50��W �I6604 ♦ / p 5.00 x zze ar s N 25°04 W::W i I woL w \ E nese '� 56.77 I / ronSE 1. m�ro, M NL» \ 3 E au.°r 0 m \S 05°32;42��E / ', fi00 300 0 600 GRAPHIC SCALE IN FEET �r•; �° \\E%ISTr. WELL r:r ., 909°12'40° W Z NOTES: 0� 37.46 DR G Q y l L� ' ; ,; \\` / �/ �// g,� 1) OWNERS: LOT #9 HENRY L. KING & MARGARET G. KING °v� FISHERS ISLAND, NEW YORK P t,;;: ,.,r,: v, �u N' 06390 LP LOT #10 SUSANNA VON DER SCHULENBURG a 21 TITE ST / AUGUSTUS COURT FLAT G LONDON SW3 ENGLAND AREA TO 6E DEEDED FROM LOT 10 2) LOTS ARE LOCATED IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, STATE TO LOT 9 = 075Y- ACRES OF NEW YORK, DISTRICT 1000, SECTION 005, BLOCK 2, LOTS 10.8 & 10.9. 3) UTILITIES ARE EXISTING ON LOT #9. LOT #10 IS TO BE SERVICED BY MUNICIPAL 1 n +, " WATER & ON SITE SEWAGE SYSTEM. �p N I N I �° 1 ° p ' / 4) PROPERTY IS LOCATED IN ZONING DISTRICT R-120. �o tP'� i /� r S 45°3745"W y 3 1 5) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC SURVEY TRIANGULATION STATION "EAST END 2". i 0 �o Ec1\0� °� off/ Q �Ft�OFH SN'Yo9 6) LOT AREAS: BLOCK & LOT EXISTING PROPOSED 00, 5 2�p �pC` oPPe _ roNr r r �0 pc A 8 55 2/ 6 BILK 1, LOT 9 3.241 AC. 3.991 AC. of joy / /Mp 0 DID "� � +I ELK 1, LOT 10 4.21 AC. 3.46± AC. ,'. <F�j p n i �O m s4sF4° 049ANI s?� f � 9 66°46'20"W � 73.16 "W100950i LOT LINO! GH,ANde PREPARED POR f' HENRY L. KING 4 MARGARET 6. KING AND SUSANNA YON DER SGHULENBUR6 100 50 0 100 GRAPHIC SCALE IN FEET BLOCK I, LOTS 9 4 10 LEGEND: FISHERS ISLAND, NEW YORK 1.P. IRON PIPE REVISIONS _ M A CHANDLER, PALMER de KING DESCRIPTION MON. MONUMENT DATE N/F NOW OR FORMERLY 7 r05 94 REVISIONS 11D IIINe°hre, Engineering CT and Surveying Ar hitect r .engine er eland Serve ing FM 2°Y4M—)G01 S.F. SQUARE FEET I�uI 'EXIST, EXISTING I„S AC. ACRE DATE: MARCH 1, 1994 IIJIu SEP 2 1 1994 SCALE: 1" = 100' SOUIHOLD TOWN SHEET 1 OF 1 PLANNING BOARD 3FFat�� , 'PLANNING 80ARD MEMBERS �� Richard G.Ward, Chairman on Town Hall, 53095 Main Road George Ritchie Latham,Jr. a+� " P. 0. Box 1.179 . Sou971. Matic S. McDonald (5 6)76,5-3136 Kenneth L.Edwards Telephone-(516)765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD March 2&, 1995 a Stephen L. Ham, Ilf Matthews and Ham 45 Hampton Rd. Southampton, NY 11968 Re: Proposedlotline change for Susanna von der Schulenburg and Henry L. King & Margaret King SCTM# 1000-5-2-10.8 & 10.9 I Dear Mr. Ham: ' The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, March 27, 1995, BE IT RESOLVED that the Southold Town Planning Board authorize the Chairman to endorse the final surveys dated July 5, 1994. Conditional final approval was granted on October 24, 1994. All conditions have been fulfilled. Enclosed please find a copy of the survey which was endorsed by the j Chairman. Please contact this office if you have any questions regarding the above. Sincerel ichard . Ward Chairman enc. cc: Tax Assessors Building. Dept. PLANNING BOARD MEMBERS ry Richard G.Ward, Chairman ,Via _ Town Hall,5305 btatn Road George Ritchie I a#ham,Jr p O 1 13ennettOrlowski,Jr Soothold,P w Yom 1:1971 Mark S.McDonald: Fax{596)7653136 Kenneth L.Edwards, Tele Rhone j515) 'x-1'938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD October 25, 1994 Stephen LHa.m, III Matthews and Ham 45 Hampton Road Southampton, NY 11968 Rex Proposed lot line change for Susanna von der Schulenburg and Henry L. icing & Margaret King SCTM# 1000-5-2-10.8 & 10.9 Dear Mr. Ham: The following took place at a meeting:oP the Southold Town Planning Board on Monday, October 24, 1994: A final public hearing for the lot line change for Susanna von der i Schulenburg and Henry L. King &Margaret King was closed. WHEREAS, Susanna von der Schulenburg and Henry L. King and Margaret King are the owners of the property known and designated as SCTM# 1000- 5-2-10.8 &10.9 located on Oriental Ave. on Fishers Island; and r WHEREAS, this lot line change is to subtract 0.75 acres from a 4.21 acre parcel and add it to a 3.24 acre parcel; and WHEREAS, the Southold Town Planning Board, pursuant to the State Environmental Quality Review Act, (Article 8), Part 617, declared itself lead agency and issued a Negative Declaration on August 22, 1994; and WHEREAS, a final public hearing was closed on said lot line change application at Town Hall, Southold, New York on October 24, 1994; and Page 2 Lot rine change for Susanna von der schulenburg&Henry L King and Margaret King 'October 25, 1994 C I I NHEREAS, all the requirements of the Subdivision Regulations of the Town FSouthoid have been met; be it therefore RESOLVED, that the Southold Town Planning Board grant conditional final approval on the surreys dated July 5, 1994 and authorize the Chairman to I eflsjineofu �nFlwing condition fhts coptlitibin'irlust,be met within six i6); months of the date of this .resolution. 1. Tire filing.Of new,deeds pertaining to the merger of the 0.75 acres from ttie 44.21 Were parcel SCTM# 1000-5-2-10.9 with the 3.24 acre parcel SCTM# 1000-5 2-10:8: A copy of the recorded deed must be presented to the;Planning Board prior to',endorsement .of final survey. Please contact this office if you have any questions regarding the above. Sincerely, Richard G. Ward Chairman THIS LOT LINE' A N G E 6 MWO is hr, st:Ltrm "sac KA Aram a $2 t ouc.parcel t ajd if jv a loco fc.4 or. M Fsi rs3s tnd SCTM# 100 - LOT LINE CHANGE Complete application received Application reviewed at work session _ '"ro ox i t ro eK Applicant advised of necessary revisions Revised submission received ro.`I 0 EL' oL OK IM, Lead Agency Coordination gf�Iq`F SEQRA determinationk 1� Nr-aa Sent to County Planning Commission '"ro•uo•� oK OK inro. Review of SCPC report Draft Covenants and Restriction's received t n.` Draft Covenants and Restrictions reviewed —[TEl Filed Covenants and Restrictions received Final Public Hearing (iv13 s t )oP 9 Approval of Lot Line — ! -with conditions Endorsement of Lot Line J IA� L ms 1/1/90 I r 1-4-1672 (2y87)-7c SEQR ApPertdix A "�3 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 I or action may be significant;The question of whether aniactiesp,mayib�esignificant-is not always easy to answer- Frequent tly there are aspects of a project.that are subjective or unr?easuteable: It i als©;understood that those who determine significance may,have little or'no formal knowledge of the environment or may be technically expert in environmental analysis.l,n addition,many who have,knowtedge in•one particular area.may not be aware of the broader°concerns affecting,' the question of significance: The fill] EAF isintended to�provide.a method whereby applicants and agencie,can be assured thatthe determination procdss has been ciide'rly,compkehensive in nature,yet flexibleto allow introduction of information to feta projector action. I i : Full EAF Components The full EAP is comprised of three parts: pPart 1; es Providobjective,data and information abo"i a given project and its site,.. By identifying basic project data, it a�stists a reviewer in the analysis that takes place in Parts 2 and 3: 4 Part 2: focuses on identifying the range of possible impacts that may occur from a project or action. It provides gpyi ance as to wether an impact is likely to be considered small to moderate or whether it is a potentially- targe impaot. The form also identifies whether an impact can be mitigated or reduced. jPart 3. tf any impact in Part 2 is identified as potentially large, then Part 3 is used to evaluate whether ornot the impact is actuaby important. DE TERMINATION —Type OF SIGNIFICANCE T e 1 and Unlisted ted Actions Identify the Portions of EAF completed for this project: %I Part�1 Part 2 ❑Part 3 Upon review of,the information recorded on this.EAF(Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead a ency 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 effectfor 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 i Name of Action Name of Lead gency Printoi Type Nate of Responsible Officer in LeadAgency. Title of,Responsible Officer "C Signature of Responsible Officer in Lead Agen y Signature of Preparer(If different from responsible officer) cry -PDate P � 1 r--TART 1—PROJECT INFORMATI 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 may be subjectto further verification and public review. Provide any additlonalt information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAP 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 .Lot Line Chane for HenryL. King & Margaret G. King and Susanna von der Schulenbur LOCATION-OF ACTION(Include Street Address, Municipality.and County) - East End RoadFishers Island Town of Southold, Count of Suffolk NAME OF APPLICANT/SPONSOR BUSINESS TELEPHONE Ste hen L. Ham III as authorized agent (516 )283-240o .ADDRESS 45 Hampton Road CITYlPO STATEZIP CODE - Southampton NY 11968 NAME OF OWNER(If different). BUSINESS.TELEPHONE Susanna von der Schulenburg (516 )283-2400 ADDRESS c/o Matthews & Ham, 45 Hampton Road CITY/PO - STATE ZIP CODE Southampton NY 11968 DESCRIPTION OF ACTION lot line change between two properties (SCTM Vs 1000-5-2-10.8 & 10.9) to be effected by the transfer of_a .75-'acre parcel from tax lot 10.8 to tax lot 10.9 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 ❑Undustrial ❑Commercial QResidential(suburban) Mural (non-farm) ❑Forest ElAgriculture OOther 2. Total acreage of project area: .75 acres: APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) .75 acres 75 acres Forested - acres acres; Agricultural(Includes orchards, cropland, pasture, etc.) acresacres; Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) acres acres Roads, buildings and other paved surfaces acres acres' Other (indicate type) acres acres 3. What is predominant soil-type(s) onproject site? Riverhead sandy_loam a. Soil drainage: ❑Well drained 10 % of site DModerately well drained % of site OPoorly drained' % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? N/A acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site?. []Yes IBNo a. What is depth to bedrock? c. 6no (in feet) 2 55 , =7' S Ap roziimate etcentage of preclproject site with slopes ❑01d% % 01015% )�1$;°/m Or gf cer % z: 6. Is project substantially contiguous to or contain a bU'-Hdmg,. site, o'r district; listed- on the State or the National Registers of Historic Places? � []YesCXNo � '� - r7. Is project substantially contiguous to asite listed on the Register of National Natural Landmarks? ❑Yes ❑No 8. What is the depth of the water table? 47 fin feet) I 4. Is site located over a primary1principaI,'or sole source aquifer? Eyes ❑No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? ®Yes ❑No i � k '-11. Does m,. project site contaany species of plant or animal life that as identified as threatened or endangered? ❑Yes VNb 'k '` AcCo'iaing�to Identify each species _ 12. Are there any unique or unusual Land farms on the .project site? (Le., cliffs, dunes, other geologicaJ formations) ®Yes ❑No Describe cliffs ' 13. Is the project site presently used by the community or neighborhoodas an open space or recreation area? Dyes KINo if yes, explain 14. Does the present site include scenic views known to be important to the community? ❑Yes CANo 15. Streams within or contiguous to project;area: none a. Name of Stream and name of River to which it is tributary N/A 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name none b. Size (In acres) 17. Is the site served by existing public utilities? Xyes ❑No a) If Yes, does sufficient capacityexistto allow connection? [MYes ❑No b) If Yes, will improvements be necessary to allow connection? ❑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 ®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? EXYes . ❑No 20. Has the site ever been used for the disposal of solid or hazardous wastes? Dyes r`CNN 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 7.45 acres_ b. Project acreage to be developed: 0 acres initially; 0 acres ultimately. c. Project acreage to remain undeveloped. 7.25 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 ofoff-street parking spaces existing N/A ;.proposed N/A g. Maximum vehicular trips generated per hour N/A (upon completion of project)? h. if residential`. Number and type of housing units: One Family Two Family Multiple Family Condominium Initially one J� Ultimately two* i. Dimensions fin feet) of largest proposed structure N/A height; N/A width; N/A length. p j. Linear feet of frontage.along apublic thoroughfare project will occupy is? 4* ft. *on both contiguous parcels (tax lots 10.,8 and .10.9) 2. How much natural material (i t' ;oek, earth, etc.) will be removed from the ,, r' 0 tons/cubic yards 3. Will disturbed areas be reclaimed? ❑Yes ❑No ON/A a. If yes, for what intend., purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? ❑Yes K]No C. Will upper subsoil be stockpiled for reclamation?. ❑Yes R]No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0 acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? ❑Yes )ONo 6. If single phase project: Anticipated period of construction N/A months, (including demolition). 7, If multi-phased; a. Total number of phases anticipated N/A ` (number). b. Anticipated date of commencement phase 1 N/A month N/A year, (including demolition). c. Approximate completion date of final phase N/A month N/A year. d. Is phase 1 functionally dependent on subsequent phases? ❑Yes ❑No N/A 8. Will blasting occur during construction? ❑Yes - 1XNo 9. Number of jobs generated: during construction N/A after project is complete N/A 10. Number of jobs eliminated by this project N/A 11. Will project require relocation of any projects or facilities? Dyes LNo If yes, explain 12. Is surface liquid waste disposal involved? ❑Yes ®No 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 ZNO Type. 14. Will surface area of an existing water body increase or decrease by proposal? ❑Yes XJNo Explain 15. Is project or any portion of project located in''a 100 year flood plain? UYes ❑No 16. Will the project generate solid waste? ❑Yes I@No a. If yes, what is the amount per month tons b. If yes, will an existing solid waste facility be used? Dyes ❑No c. If yes, give name location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes El No e. If. Yes, explain 17. Will the project involve the disposal of solid waste? ❑Yes [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? ❑Yes LINo 19. Will project routinely produce odors(more than one hour per day)? ❑Yes E�No 20. Will project produce operating noise exceeding the local ambient noise levels? Dyes [NNo 21. Will project result in an increase in energy use? ❑Yes nNo If yes , indicate type(s) 22. If water supply is from wells; indicate pumping capacity N/A gallons/minute. 23. Total anticipated water usage per day N/A gallons/day. E 24. Does project involve Local, State or Federal funding? ❑Yes %)No If Yes, explain l 4 25. Approv'als Required: ' + "• Submittal Date City, Town, Village Board, ❑yest1, City, Town, Village Planning Board f%Yes ONO lot lime change 7-2$-94 City,Town Zoning Board El Yes ONO f City, County Health Department Dyes WNo ' Other Local Agencies DYes MNo Other Regional Agencies Dyes MNo St3 ..ate Agencies ❑Yes CXNo federal Agencies Dyes ANO, C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? Cies ONO If Yes, indicate decision required:1 ❑zoning amendment ❑zoning variance ❑special use permit ❑subdivision osite plan - ❑new/revision of master,plan ❑resource management plan bother lot line change 2. What is the zoning classification(s)of the site? R-120 single family residential 3. What is the maximum potential development of the site if developed as permitted by the present zoning? one single-family dwelling w/ accessory structures .on each of tax lot 10.8 and 10.9 4. What is the proposed zoning of the site? same 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6 Is the proposed action consistent with the recommended uses in adopted local land use plans? Ayes ONO 7. What are the predominant land use(s) and zoning classifications within a 1/ mile radius of proposed action? R-120 single-family residential 8. Is the proposed action compatible with adjoining/surrounding land uses within a '/4 mile? LYes ONO 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? Dyes ENO 11 . Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? Dyes )ON0 a, If yes, is existing capacity sufficient to handle projected demand? Dyes ONO 12. Will the proposed action result in the generation of traffic significantly above present levels? Dyes LNo a. If yes, is the existing road network adequate to handle the additional. traffic? ❑Yes ONO D. Informational Details Attach any additional information as maybe 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 rovided above is true t th best of m knowledge. i Henry E. King & Margaret°G. eI{ing Y1991 Applicant/Sponsor Name Susanna von der Schulenburg Date July 22, Signature L Title authorized agent 3 ep en 17. nal1r, 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 MQ'I''VITUDE' 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. Anylarge impact must be evaluated.in PART to determine significance.'Identifying animpactin 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 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. e. 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 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 IMPACT ON LAND Moderate Large Mitigated By Impact Impact Project Change 1 - Will the proposed action result in a physical change to th rip project site.? NO DYES 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 ❑ ❑ El Yes ❑No 3 feet. • Construction of paved parking area for 1,000 or more vehicles. ❑ ❑ ❑Yes ❑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 ❑ ❑ ❑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. ❑ ❑ 1:1 Yes ❑No • Other impacts ❑ ❑ ❑Yes ❑No 2. Will there be an effect ts. ... y unique or unusual land forjens found on the site?(i.e., cliffs, dunes,geological formations, etctKNO ❑YES • Specific land forms ❑ ❑ ❑Yes ❑No j 2 3 So ' S to. Potential Can Impact Be Moderate' Large Mitigated By r; f s ,del Impact Impact Project ;Change • Proposed Action may cause substantial erosion. ❑ ❑ El Yes QNo '• Proposed Action is incompatible with ex istingdrainage patterns: ❑ ❑ ❑Yes. ❑No Proposed Action will allow deuY6iopmentiin a designated #loodway.' Q Q' ❑Yes ONO Other impacts ❑ ❑ ❑Yes QNo I IMPACT ON AIR 7. Will proposed action affect air quality? XNO DYES Examples that would apply to column 2 f3 + Proposed Action will induce 1,000 or more vehicle trips in any given ❑ ❑ []Yes QNo hour. '+ Proposed Action will result.in the incineration of more than 1 ton of ❑ [--]Yes QNo refuse per hour. • Emission rate of total contaminants will exceed 5lbs. 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 amountof land committed ❑ ❑ El Yes []No to industrial use. • Proposed action will allow an increase in the density of industrial ❑ ❑ El Yes QNo development within existing industrial areas. • Other impacts: ❑ ❑ ❑Yes []No IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action.affect any threatened or endared y species? O DYES Examples that would apply to column 2 \\ Reduction of one or more species listed on the New York or Federal Q Q El Yes El No list, using the site, over or near site or found on the site. Removal of any portion of a critical or significant wildlife habitat., ❑ ❑ ❑Yes ❑No • Application of pesticide or herbicide more than twice a year, other ❑ ❑ ❑Yes ` QNo than for agricultural.purposes. Other impacts: ❑ ❑ Dyes ❑No 9. Will Proposed Action substantially affect non-threatened or non-endangered species? NO OYES' Examples that would apply to column 2 \ • Proposed Action would substantially interfere with any resident or ❑ ❑ Dyes ❑No migratory fish, shellfish or wildlife species • Proposed Action requires the removal of more than 10 acres ❑ ❑ Dyes 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? �O DYES Examples that would apply to column 2 • The proposed action would sever, cross or limit access to agricultural Q ❑ ❑Yes ❑No land (includes cropland, hayfields, pasture, vineyard, orchard, etc.) 8 1.; 2 31 Small to Potential .Can Impact Be IMPACTON'WATER 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 Conservati n1aw, EGL) O DYES Examples that would apply to column.2 • Developable area of site contains a protected water body. El El El Yes 1:1 No • Dredging more than 100 cubic yards of material from channel of a ❑ ❑ El Yes ❑No protected stream. • Extension of utility distribution facilities through a protected water body. ❑ ❑ Dyes ❑No • Construction in a designated freshwater or tidal wetland. ❑ ❑ ❑Yes El No • Other impacts: ❑ ❑ []Yes ❑No 4. Will proposed action affect any non-protected existing new body of water? 3(Nr DYES Examples that would apply to column 2 • A 10% increase or decrease in the surface area of any body of water ❑ ❑ ❑Yes ❑No or more than a 10 acre increase or decrease. • Construction of a body of water that exceeds 10 acres of surface area. ❑ ❑ []Yes ❑No • Other impacts: ❑ ❑ ❑Yes ❑No 5. Will Proposed Action affect surface or groundwater quality or quantity? NO DYES Examples that would apply to column 2 � O\ • Proposed Action will require a discharge permit. ❑ ❑ ❑Yes ❑No / • Proposed Action requires use of a source of water that does not ❑ ❑ ❑Yes ❑No have approval toserve proposed (project) action. • Proposed Action.requires water supply from wellswith greater than 45 ❑ ❑ El Yes ❑No gallons perminute pumping.capacity. • Construction or operation causing any contamination of a water ❑ ❑ ❑Yes ❑No supply system. - • Proposed Actionwill adversely affect groundwater. ❑ ❑ []Yes ❑No" • Liquid effluent will be convey-,off the site to facilities which presently ❑ ❑` ❑Yes ❑No do not exist or have inadequate capacity. • Proposed Action would use water in excess of 20,000 gallons- per. ❑ ❑ El Yes ❑.No day. • Proposed Action will likely cause siltation or other discharge into an ❑ ❑ Dyes` ❑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 ❑ 0 []Yes ❑No products greater than.1,100.gallons. -. • Proposed Action will allow residential uses in areas without water ❑ ❑ El Yes ❑No and/or sewer services: • Proposed Action locates commercial and/or industrial uses which may ❑ ❑ ❑Yes []No require new or expansion of existing waste treatment and/or storage I facilities. • Other impacts: ❑ ❑ []Yes ❑No 6. Will proposed action alter drainage flow or patte,�nsj or surf,-- water,runoff? {ANO DYES Examples that would apply to column 2 • Proposed Action would change flood water flows. ❑ ❑ I ❑Yes El No 7 l sa.. 2 3 a •��i, 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 i '''• The proposed action would' irreversibly convert more than 10 acres ❑ 11 ❑Yes []No rt: 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 El El ❑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 l IMPACT ON AESTHETIC RESOURCES 11. Will proposed action afflect aesthetic resources? NO OYES (If necessary, use,the Visual EAF Addendum in Se tion 617.21, Appendix 6J Examples that would apply to column. 2 • Proposed land uses, or project components obviously different from ❑ ❑ - El Yes ❑No 'or in sharp contrast to current surrounding land use patterns, whether man-made or natural. • Proposed land uses, orproject components visible to users of 1:1 1:10Yes ❑No aesthetic resources which will eliminate or significantly reduce their 1 enjoyment of the aesthetic;qualities of that resource: • Project components that will result in the elimination or significant ❑ ❑ ❑Yes ❑No screening of scenic views known to be important to the area. • Other impacts: ❑ ❑ []Yes El No IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12- Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? O ❑YES Examples that would apply to column 2 i • Proposed Action occurring wholly or partially within orsubstantially ❑ ❑ ❑Yes ❑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 El No project site • Proposed Action will occur in an area designated as sensitive for ❑ ❑ ❑Yes ❑No archaeological sites on the NYS Site Inventory. i • Other impacts: ❑ ❑ ❑Yes ❑No I 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 ytrv0 OYES • The permanent foreclosure of a future recreational o�ppoO�tunity._ ❑ ❑ ❑Yes ❑No • A major reduction of an open..space important to the community. ❑ ❑ El Yes ❑No • Other impacts: ❑ ❑ ❑Yes ❑No 9 - j 2 3� IMPACT ON TRrcNSPORTATION Small to Potential Can Impact Be"' 14. Will there be an effect to existing transportation ste s? Moderate Large Mitigated By` NO ❑YES 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. ❑ ❑ Dyes ❑No • Other impacts: ❑ ❑ El Yes ❑No IMPACT .ON ENERGY 15. Will proposed action affect the community's sou„rcs of fuer or energy supply? '}(JNO ❑YES Examples that would apply to column 2 � • Proposed Action will rause a greater than 5% increase in the use of ❑ ❑ Dyes ❑No any form of energy in the municipality. • Proposed Action will require the.creation or extension of an energy ❑ ❑ 1:1 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 vibratio as a result of the Proposed Action? NO OYES Examples that would apply to column 2 • Blasting within 1,500 feet of a hospital, school or other sensitive ❑ ❑ F-1 Yes ❑No facility: • Odors will occur routinely (more than one hour per day). ❑ ❑ ❑Yes_ []No • Proposed Action will produce operating noise exceeding the local ❑- ❑ El Yes ❑No ambient noise levels for noise outside of structures. • Proposed Action will remove natural barriers that would act as a ❑ ❑ ❑Yes ❑No noise screen. • Other impacts: ❑ ❑ ❑Yes ❑No IMPACT ON PUBLIC HEALTH ' 17. Will Proposed Action affect public health and safety? � O OYES Examples that would apply to column 2 • Proposed Action may cause a risk of explosion or release of hazardous ❑ ❑ ❑Yes ❑No substances(i.e. oil, pesticides, chemicals, radiation, etc. in the event of accident or upset conditions, or there may be a chronic low level discharge or emission. •. Proposed Action mayresult in the burial.of "hazardouswastes" in any ❑ ❑ 1:1 Yes ❑No form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) • Storage facilities for one million or more gallons of liquified natural ❑ ❑ 1:1 Yes []No gas or other flammable liquids. • Proposed action may result in the excavation or other disturbance ❑ ❑ Oyes EJ NO within 2,000 feet of a site used for the disposal of solid or hazardous waste. • Other impacts: ❑ ❑ ❑Yes []No 10 i x. 2 3 IMPACT ON GROWTH,AND CHARACTER Small to Potential Can Impact Be OF COMMUNITY, OR NEIGHBORHOODt Moderate Large Mitigated By 18. Will proposed action affect the character of he existing commdnity? Impact Impact Project Change NO ❑YES i Examples that would apply to column 2 * - I, • The permanent population of„the city, town or village in which the ❑ ❑ []Yes ❑No . i” project is located is likely to grow by more than 5%. •^ The municipal budget for cap jtal expenditures or operating services El 1:1 ❑Yes ❑No wilt increase by more than 5�." per year as a result of this project. < Proposed action will cpnflic.with officially adopted plans or goals. ❑ ❑ ❑Yes El No will causer a chane in,the density of land use. El El Dyes ❑No Proposed action;wr g Y Proposed Action will replace or eliminate existing facilities, structures ❑ ❑ ❑Yes ❑No or areas of historic 'importance to the.community. Development.Wil'P;create a demand for additional community services ❑ ❑ ❑Yes, ❑No (P—g. schools, police and fire, etc.) - Proposed Action will set an`importafit.precedent for future projects. ❑ ❑ El Yes El No • Proposed Action will create or eliminate employment. ❑ ❑ El Yes ❑No • other impacts: El El ❑Yes ❑No 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? 6J0 ❑YES If Any Action in Part 2 Is Identified as a Potential Large Impact or !. If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 i 1 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(ifappl.icable)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) I II ; r r 14-14-1-1 lz's�l sr 617.21 - SEOR' < Appendix .B e Bnvirdnntenfat Qpallty Rgiew Visual EAS' Addendum This form may be used to provide additional information relating to Question 11 of Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between Visibility Project and Resource (in Miles) 1. Would the project be:visible from: D-'/a 1/a-1/2 1h-3 3-5 5+ • A parcel of land which is dedicated to and available ❑ ❑ ❑ ❑ El to the public for the use,enjoyment and appreciation of natural or man-made scenic'qualities? • An overlook or parcel of land dedicated to public ❑ ❑ El Q : ❑ observation, enjoyment and appreciation. of natural or man-made scenic qualities? • A site or structure listed on the National or State ❑ ❑ ❑ ❑ ❑ Registers of Historic Places? • State Parks? ❑ ❑ ❑ ❑ ❑ • The State Forest Preserve? ❑ ❑ ❑ ❑ ❑ j • National Wildlife Refuges and state game refuges? ❑ ❑ ❑ ❑ El • National Natural Landmarks and other outstanding ❑ ❑ ❑ ❑ ❑ natural features? • National Park Service lands? ❑ ❑ ❑ ❑ ❑ • Rivers designated, as National or,State Wild, Scenic ❑ ❑: ❑ ❑ ❑ or Recreational? • Any transportation corridor of high exposure, such ❑ ❑ ❑ ❑ ❑ as part of the Interstate System, or Amtrak? • A governmentally established or designated interstate ❑ ❑ ❑ ❑ El or inter-county foottrail, or one formally proposed for establishment or designation? • A site,area, lake, reservoir or highway designated as ❑ ❑ ❑ ❑ ❑ scenic? • Municipal park, or designated open space?. ❑ ❑ ❑ ❑ ❑ • County road? ❑ ❑ ❑ ❑ ❑ • State? ❑ ❑ ❑ ❑ ❑ • Local road? ❑ ❑ ❑ ❑ ❑ 2. is the visibility of the project seasonal?(i.e., screened by summer foliage, but visible during other seasons) ❑Yes ❑No 3. Are any of the resources checked in question 1 used by the public during the time of year during which the project. will be visible? ❑Yes ❑No 1 DESCRIPTION OF EXI81%A,-VISUAL,,ENVIRONME6T 4. From each item checked in question 1, check those'which generally, describe the surrounding* environment. Within *'[4 mile. *1 mile Essentially undeveloped ❑ ❑' Forested El El Agricultural ❑ El Suburban residential Industrial El El Commercial ❑ El Urban ❑ River, Lake,, Pond Cuffs, Overlooks ❑ _ 0` Designated`.Open Space El FlatEl ❑ ❑' Billy E Mountainous El Other ❑ ❑ NOTE: add attachments as needed 5. Are there visually similar projects within: "/z mile ❑Yes El No •1 miles F-1 Yes No '2 miles ❑Yes El No '3 miles []Yes El No ' Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, usebest estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Holidays/ ' Activity Daily Weekly Weekends Seasonally Travel to and from work ❑ ❑ ❑ ❑ Involved in recreational activities ❑ ❑ ❑ El Routine travel by residents -1❑ ❑ ❑ At a residence ❑ ❑ ❑ ❑ { At worksite ❑ ❑ ❑ ❑ Other ❑ ❑ ❑ El I { 2 i 4 APPLICATION FOR APPROVAL OF PLAN' To the Planning Board of the Town of Southold: agent for the The undersigned/apl licantsheieby applies for (43EiSLL4,�7[ ) (final) approval of a subdivision platin accordance with Article 16 of the ]Town Law and the Rules and Regulations of the Southold Town Planning Board-, and represents and states as follows: 1. The applicant fs"the owner of record of the land under application. (If the applicant is not the owner of recbrd of the land under application, the applicant shall state his interest in said Iand,}ruder application.) 2. The name of the subdivision is to be, Lot, Line Change for Henry L King and `Margaret G King and Susanna von der Schulenburg _. .......... .... .. ........ . . ....... ... ` 3. The"entire land under application is described in Schedule "A" hereto annexed. (Copy of deed suggested.) 4. The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as follows Liber . .....11346. .. . . .. .. .. . Page ... ..251. . . .. . . . . .. .. . On .N9.ve.049>. 8..1991... ; Liber 11683... ....'.. ... Page . . . ..273. .. .. .. . . ..... On .June 29, 1994 Liber . .... .... .. . . . . .. ... . .. . Page . .. .. .... . On Liber . .... ... . . . .. .. .. .... . . . Page . .. .. . On ... .. .. ... 1, Liber . ........ .... ........... Pae On axa �xecxlaata�is #x3al ilKxx TaR I e x�k . .. . . .. .... ... .. .. .. ... . .. .. . . . . .... .... oXxac )d# k. ...... .. .. .. .... .... .. .. .. .. . . .. .. . . .. .. . ... .. .. . . .. ..... . . . . .... .. .. .. .... . . .... .. .. .......... ..... 5. The area of the land is ... .7...45• .. .. . acres. . of which .75 acre is the subject of the lot line change. 6. All taxes which are liens on the land at the (late hereof have been paid.Xxgeggxxx... .. .. . . . 7. The land is encumbered by .... no, • . , .... . . . . .. . . . .. . . . .. . . .. .. .. . ... .. .:.... . .. .. . .. ... . mortgage (s)_xKlodowxxx (a) Mortgage recorded in Liber . . . .. .. . . . . .. . Page . .. . . . . . . . . .. . . ... in original amount of $... .... .. . . .. . unpaid amount $ . .. .. . . . . . . . . . .. .. .. . held by . .. .. .. .. .... .. .. . . . address . .. ...... ... . . .. .. . . . . r (b) Mortgage recorded in Liber ..�. .. .. g inoriginal amount of unpaid amount $. .. . . . ... . . .. .. . . .. .. . held by . .. . ... .......... . address . .. .... ..... ,.. F (c) Mortgage recorded in Liber .. ... .. . . ! . . . . Page . . . .... .. . . .. .. . in original amount of . .. ..... .. . ... unpaid amount $. . .. .. . . . , . . . ..,.. . . . . held by ...... . ...... address . .... .... . . .. .. ... .. . ., .. . . .. .... .. . . ... .. ... ..... .. 3. There are no other encumbrances or liens against the land xxx , ... .. .. .. . . .. . .. . .. .. .. . . .. . . .. . . .. .. . . .. . . .. . . . . . . . . .. .. . . .... . . .. ..... . .. ... ....... 9. The land lies in the following zoning use districts . .. Residential R-120', 10. No part of the land lies under water whether tide water, stream, Bond water or otherwise;_ {- Xd'e'1]F .. . .. .... .... .. ... . .... .. .. . . .. . . . .. . . .. .. .. .. . . . . .. . . ...... ....... . . ..... .. .. .. . .. . 11. The applicant shall at his expense install all required public improvements. 12. The land (does) (MsY;Y4 lie in a Water District or Water Supply District. Name of Dis- trict, if within a District, is WQ2`kp.. _ ,, , , ,,, , ,,,,,,, , 13. Water mains will be laid by :.. . . existing. . .. . .. . . .... and (a) (no) charge will be made for installing said mains. 14. Electric lines and standards will be installed by . .. .. existing, , , ,, ,.,. .„„. , , ,, .,, , ,, 4 f ... .. .. .. . . .. .. .. . . . . .. .. . . . . . . . . . . .. and (a) (no) charge will be made for installing said lines. 15. Gas mains will be installed by . . .•. . . VA.. . and (a) (no) charge will be made for. installing said mains. l hi 16. If streets shown on the plat are claimed by the applicant to be existing public streets in the Suffolk County Highway system, annex Schedule "E" hereto, to show same. 17. If streets shown on the plat are claimed by the applicant to be existing public streets in the Town of Southold Highway system, annex Schedule "C" hereto to show same. C 13. There are no existing buildings or structures on the land which are not located and shown on the plat. , 19. Where the plat shows proposed streets which are extensions of streets on adjoining sub- division maps heretofore filed, there are no reserve strips at the end of the streets on said existing maps at theirconjunctions with the proposed streets.' 20. In the course of these proceedings, the applicant will offer proof of'title as required by See. 335 of the,Real Property Law. ti 21. Submit a copy of proposed deed for lots shot';ing all restrictions, 'covenants, etc. Annex Schedule "D» i 22. The applicant estimates that the cost of grading and required public improvements will be NIA,,'„ , as itemized in Schedule "E' hereto annexed and,requests that the maturity of the Performance Bond be fixed;at ... .NIA.. . . ... years, The Performance Bond will be written by a licensed surety company unless otherwise shown on Schedule "F". ¢ Henry L. King'& Margaret G. King and Susanna von der Sehulenburg J 94 . i DATE ... .UIY 22 ..: ..... : .. .. .. .. 19. . . . . .... .. . . ...... .. ................. .... . .... .... .... . .... " (Name of Applicant) }. By . .... YL . :. .` .:� ..... . . .... (5igaature and Title} Stephen L_ Hazy, III, authorized agent: 45 Hampton Road, Southampton, NY 11968 . .. .. . . . . . . . . . ...... . .... .. ...I.. ... .. ... ...... .. (Address) fST.NTE OF NEW YORK, COUNTY OF . . .. .. . . . . SUFFOLK.... . . .. .. .. .. ss: i fOn the . . . .. . ;5A.. . ... . day of. .. .. .. . . . . . .July. .. . . .. .... .. 19.94 . . ., before me personally came • .• .. • . .. -Stephen L. Ham; ISI to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that . . . ..he.. .. . executed the same. f Notary PCblic y ESTATE OF NEW YORK, COUNTY OF . . . .. . . . . .. .. .. .. .. . . .. ... .. . ss: h . �.:.. On the day . . . .. .. .. .. . of . .. . . . . . . . ... . ... 19. .... ., before me personally came . .. . . .... • • • • ... . . . ...... .to me known, who being by me duly sworn did de- , ' pose and say that . . . .. . . .. .. . resides at No. .. . .. . . . . . . . . . .. . . . .. . . .. .. .. . . .. ..... .. . ... .. . .. .. . } . . . . ... . . . . . . . . . .. . .... .. . . . . .. .. . that ... .. . .. . . .. .. . . .. .. . is the ... . . . . .. . .. . . . .. .. .. . . .. .. . of . .. .. .. . . . . .. . . .... . . .. . the corporation described in and which executed the foregoing instrument; that .... knows the seal of said corporation; that the seal affixed by order of the board of directors of said corporation. and that . . . . . .. .. . . . signed . .... .... .. .. . name thereto by like order. . .. . . . . .. . . . . .. .. .. .. .. .. .. .. .. . ... . . ... ..... Notary Public PLA;-i N1 G1�3'O"ARD T0�S'v O SOU HOLD SLk'FO /LOyQ „ TY Southold, N.Y. 11971 (516) 765-19$3 1 QUESTIONNAIRE TO BE COMPLETED AND) SUBMITTED WITH YOUR APPLICATIONSFORMS TO THE PLANNING BOARD Please complete, sign. and return to the Office of the -Planning Board with your completed applications forms . If your answer to any of the following. questions is yes , please indicate these on your guaranteed survey or submit other appropriate - evidence: 1. Are there any wetland grasses on this parcel? Yes No 1 (Attached is a list- af the wetland grasses defined by the Town Code, Chapter 97, for your reference) 2. Are there .any other premises under your ownership abutting this parcel? Yes No 3. Are there any building permits pending on this parcel? Yes No 4. Are there any other applications pending concerning this property before any other 6 department. or agency? (Town ,, State, County, etc. ) Yes No n 5. Is there any application pending before any other agency with regard to a different project on this parcel? Yes No 6. Was this property the subject of any prior. application to the Planning Board? Yes No 7 . Does this property have a valid certificate of occupancy, if yes please submit a copy of same Yes ' No I certify that . the above statements are true and will Abe relied on by the Planning Board in considering this application. 1, July 22, 1994 Signature of_ property owner or authorized agent date Stephen L,. Had agent m, III, authorize r Attachment to questionnaire for;.-the Planning Board STATE OF NEW YORK, COUNTY, OF SUFFOLK, ss; On the 0_101 day of �july 19 94, before me personally came. Stephen L. Ham, III to me known to be the individual described in and who executed the foregoing instrume and acknowledged that he executed the: same. f- OAF AM Q Gam- Four J Nota Public ' $a#* s G 14-1b-j (2187)-7c 611.21 SEQR APpenaix`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 ,y ;, or action.-mai+-be sigmficalrt.tThe questip'mof whethe�'an action maybe sagnrfaeant`is not always easy to answer.Tr"' uen tw ly, there aretaspectg of ;project that:are subjective or.unmeasureable- tt •alsa upderstood,that those who,determine significance may haire little or no fom*1 knowled'g'e of the environment or may,be technically expert•in'environmental- analysis; In addi#ton,'many whq.have•knotvledge in one partic4lar area may not be aware of thebroader concerns affecting a '`the question of significant-e. The full EAF isAi tended to provide„a method whereby applicants and agencies can.l3e assured ttxat't�ie determination G+bcess Has been drelerfy coinprebensivein nata`re,ye flex ble=to allow infroduct+ontof info'rmi tion to�f- a'project or action. �� full EAF,CognponenYs Thi fu}i EAF is comprised of three parts: li i_ P�ctt1 ob cline,data, and information about a'giverr project ancfi its srte.�6p uc enyvng=Erasic;project, �� data; its a r@Viewer m the analysts that takes place in Parts and % ��- part 2 'Fp L I3s, 484#ntifying the range of possible impacts that may ocGxar°jfrom ,project or act an..1R provides gu4dahittaOto whether an impact is likely to be considered smal(tp Yr derat orwbethertt¢s a pofentaally- la ge-ir p','�Ct"Th fort also-identifies whether an i pact can be m t gaffed or recftrced' P art 3 any �wnj Port 2 is identified as potentially-large, then Pact B3j§(used to evaluate whether or noQ the �uTf*d5 important. i 9MINATION OF SIGNIFICANCE—Type 1 and Unlisted Actions, Identify the Portions of EAFcompleted for this project: ❑ Part 1 ❑ Part 2 E]Part 3, Upon review of,the information recorded on this EAF(Parts 1 and 2 and 3 of appropriate),and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined ,by the lead agency that: ❑ A. The project will not result in any large and important impact(s)and, therefore, is one which will not have a,significant impact on the environment, therefore a negative declaration will lie prepared. ❑ B. Although the project could have a significant effect on the environment, there will not be a significant effect fVf this Unlisted Action because[the mitigation measuresdescribed in PART 3.hade'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 env-irorrment, therefore a positive declaration will be pre ared. *.A Conditioned Negaons tive Declaration is only',valid for Unlisted Acti p Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer` •.r Signature of Responsible Officer in Lead Agency Signatureof Preparer(lf differentfrom responsible officer) _ Date 1 I _ PART 1—PROJECT iNFORMAI,.)N 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 thesequestions willbe considered as part of the application for approval and may be 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 .Lot Line Chane for HenryL. King & Margaret G. King and Susanna von der' Schulenbar LOCATION OF ACTION(include.Street Address, Municipality and County) East End Road Fishers Island Town of Southold County of Suffolk NAME OF APPLICANTfSPONSOR BUSINESS.TELEPHONE Stephen L. Ham III as authorized agent 1516 )283-2400 ADDRESS - - 45 Hampton Road CITY/PO STATE' .ZIP CODE - Southampton NY 11968 NAME OF OWNER(if different) BUSINESS TELEPHONE.. Susanna von der Schulenburg (516 )283-2400 ADDRESS c/o Matthews & Ham," 45 Hampton Road cRY/PO STATE ZIP CODE. Southampton NY'` 11968 DESCRIPTION OF ACTION - lot line change between two properties (SCTM Vs 1000-5`2-10.8 & 10.9) to-be effected by the transfer of a .7'5-acre parcel from tax lot 10.8 to tax lot 10.9 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) #Rural (non-farm) ❑forest ElAgriculture 00ther 2. Total acreage of project area: .75' acres: APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) 75 acres -75 acres Forested acres acres Agricultural (Includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) acres acres ( Roads, buildings and other paved surfaces acres acres Other (indicate type) acres acres 1 3. What is predominant soil type(s) on project site?. Riverhead sandy loam a. Soil drainage: %Well drained 100 % of site %Moderately well drained % of site ❑Poorly drained % of site i 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. (See1 NYCR.R 370). l 4. Are there bedrock outcroppings on project site? ❑Yes. (KNo a_ What is depth to bedrock? c- bon (in feet). � 2 5 AbPrbzimate percentage of ipra Project site'with slopes:' O0<10% ' % ❑1045%- /o T5% or g{�ater % 6. Is project substantially contiguous k 'q, or contain a bufldin g, site, or dist r t, listed on the Slate or the National Registers of Historic Places? []Yes LXNo 7. Is project substantially contiguous to a site listed on the Register of National,Natural Landmarks? f]Yes ❑No 8. What is the depth of the water table? '>I7 (in feet) 9. fs site located over a primary, principal, or sole source aquifer? LKJYes ❑No 10. Do hunting, fishing or,shell fishing opportunities presently exist in the project area? X]Yes ]No is 11. Does,ipr©ject` site contain any species of plant or animal life that is identified as threatened or endangered? DYes X7N6 . According to Identify each species 1.2. Are.there nany gmvque,or upusual land forms on the project site? (i.e., cliff; dunes, other geological formations.) f&Yes 7YNo Describe Cliff's 13. is the project,site presently used by the community or neighborhood as an open space or recreation area? I]Yes X]No If yes„ explain 14. 'Does the present site include scenic views known to be important to the community? Dyes CNo 15. Streams within or contiguous to project area: none a. Name of Stream and name of River to which it is tributary - NZA 16. Lakes, ponds, wetland.areas within or contiguous to project area: a. Name none b. Size (In acres) 17. Is the site served by existing public utilities? MYes El No a) If Yes, does sufficient capacity exist to allow connection? XYes I]No b) If Yes, will improvements be necessary to allow connection? ❑Yes 129No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law. Article 25-AA, Section 303 and 3042 Dyes DONo 19. Is the site located in or substantially contiguous to acritical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617? IXYes ONo 20. Has the site ever been used for the disposal of solid or hazardous wastes? ❑Yes INNo 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- 7.45 acres. b. Project acreage to be developed: 0 acres initially; 0 acres ultimately. c. Project acreage to:remain. undeveloped '7.29 acres. d. Length of project, in miles:;_N[A _(If appropriate) e. If the project is an expansion, indicate percent of expansion proposed NIA %; f. Number of off-street parking spaces existing N/A proposed N/A g. Maximum vehicular trips generated per hour N/A (upon completionof project)? - h. If residential: Number and type of housing units: One Family Two Family lutultiple Family Condominium Initially one* Ultimately two* i. Dimensions (in feet) of largest proposed structure N/A, height; N/A width; N/A length. j. Linear feet of frontage,along a public thoroughfare project will occupy is? 400*_ ft. *on both contiguous par cels (tax lots 10_8 and 10.9)' 2. How much natural material (i.6 ock, earth, etc.) will be removed from tL-site? n tons/cubic yards 3. Will disturbed areas be reclaimed? ❑Yes ❑No ON/A a. If yes, for what intend,v purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? ❑Yes K]No c. Will upper subsoil be stockpiled for reclamation? Dyes KINo 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0 acres, 5. Will any mature forest (over 100 years old) or other focally-important vegetation be removed by this project? Dyes X]No 6. if single phase project Anticipated period of construction N/A months, (including demolition). 7. if multi-phased a. Total number of phases anticipated N/A (number). b. Anticipated date of commencement phase 1 N/A month N/A year, (including demolition). c. Approximate completion date of final phase N/A month N/A year. d. Is phased functionally dependent on subsequent phases? Dyes ❑No N/A 8. Will blasting occur during construction? Dyes LXNo 9. Number of jobs generated: during construction N/A ; after project is complete N/A 10. Number of jobs eliminated by this project N/A 11. Will project require relocation of any projects or facilities? Dyes IXNo If yes, explain 12. is surface liquid waste disposal involved? ❑Yes, ®No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. is subsurface liquid waste disposal involved? Dyes 93No Type 14. Will surface area of an existing water body increase or decrease by proposal?` Dyes nNo Explain 15. Is projector any portion of project located in a 100 year flood plain? )Dyes 11 No 16. Will the project generate solid waste? " Dyes 1$No a. If yes, what is the amount per month tons b. If yes, will an existing solid waste facility be used? Dyes QNo c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? Dyes ❑No e. If Yes, explain 17. Will the project involve the disposal of solid waste? Dyes 9No a. If yes, what is the anticipated rate of disposal? `tons/month. b. If yes, what is the anticipated site life? years. 18. Will project use herbicides or pesticides? Dyes MNo 19. Will project routinely produce.odors (more:than one hour per.day)? Dyes 9No 20. Will project produce operating noise exceeding the local ambient noise levels? ❑Yes 9NIQ 21. Will project result in an increase in energy use? Dyes nNO If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity N/A gallons/minute. �.. 23. Total anticipated water usage per day N/A gallons/day. a ro ?Does 24. project involve Local, State or Federal fundis 9 P 1 g- ❑Yes. JDNo If Yes, explain 4 25 Approvals Requited- �1'' � submittal r'+ - 1 ype Date City,,Town, Village Board f ❑Yes NNo City, Town, Village Planning Board ®Yes ONO lot line change 7-25-94 City, Town Zoning Board ❑Yes LINO City, County Health Department ❑Yes. [7No Other Local Agencies ❑Yes MNo Other R`egion69 Agencies - Dyes [9No State Agencies ❑Yes MNo Federal Agencies ❑Yes [%No. C. Zoning, anIJ Planning information 1. Does proposed action involve a plannrng;or,zoning decision? CN(es ONO If Yes, indicate decision required: ❑zoning amendment Ozpning'variance ' Elspecial use permit ❑subdivision Osite plan Onew/revision of master plane ❑resource management:plan Bother ,,lot line. change.. 2. What is the zoning classification(s)of the site? R-1 20 single family residential 3. What is the maximum potential development of the site if developed as permitted by the present zcning? one single—family dwelling w/ accessory structures on each of tax lot ld-8 and 10.9 4. What is the.proposed zoning of the site? same. 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6 Is the proposed action consistent with the recommended uses in adopted local land use plans? dyes ONO 7. What are the predominant land use(s) and zoning classifications within a T/r mile radius ofproposed action? R-120 single-family residential 8. is the proposed action compatible with adjoin ing/�surrounding land uses within a '/4 mile? IfYes ONO 9. If the proposed action is the subdivision of land, how many lots are proposed? NIA 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? Oyes ENO 11 . Will the proposedaction create a demand for any community provided' services (recreation, education, police, fire protection)? Dyes )ONo a. if yes, is existing capacity sufficient to handle projected demand? Oyes ONo 12. Will the proposed action result in the generation of traffic significantly above present levels? Oyes dNo a. If yes, is the existing road network adequate to handle,the additional traffic? ❑Yes ONo D. Informational Details Attach any additional information as may be needed to clarify your project. if there are or may 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 rovided above is true to th best of my knowledge. Applicant/Sponsor Name Henry a. King & Margaret G. eking July ,22; 19911 f Susanna von der Schulenburg pate Signaturet�°�E.ffamZX7 Title authorized agent `3 ep en ;"I1T— 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 Part 2—m9OJECT IMPACTS AND THEIR,,'AGNITUDE 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 PARTS 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 aPotential 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? ENO OYES Examples that wouldapply to column 2 • Any construction on slopes of 15% or greater, (15 foot rise per 100 ❑ ❑ El 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 El No 3 feet. • Construction of paved parking area for 1,000 or more vehicles. ❑ ❑ ❑Yes ❑No • Construction on land where bedrock is exposed or generally within ❑ ❑ E'Yes []No 3 feet of existing ground surface. • Construction that will continue for more than 1 year or involve more ❑ ❑ El 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- ❑ ❑ Dyes ❑No • Other impacts ❑ ❑ 11 Yes ❑No t 2. Will there be an effect t=. :,.ry w. que or unusual land forms found on I the site?(i.e., cliffs, dunes, geological formations, etc )DNO DYES i • Specific land forms: ❑ ❑ 11 Yes ❑No B .� 2 3 e [Small to Potential Can Impact Be oderate Large Mitigated By m!pact Impact Project Change 0 Proposed Action may cause substantial erosion: ❑ ❑ ❑Yes Elf-4o " • Proposed Action is incompatible with existing drainage patterns., ❑ ❑ ElYes- ❑No • Proposed Action will allowdevelopment in a designated floodway, ❑ ❑ ❑Yes,, ❑No » Other impacts;' ❑ ❑ ❑Yes ONo IMPACT,ON AIR 7 Will proposed action affect air quality? ONO DYES Examples that would apply to columns 2 4 Proposed,Action,will induce 1,000 or more vehicle trips in any given ❑ ❑ El Yes ❑No- il hour ! Proposed Action will result in the incineration of more than 1 ton of ❑ ❑_ ❑Yes ❑NO. it refuse per hour. 14 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 �1 to industrial ose. h • Proposed action will allow°an increase in the density of industrial ❑ ❑ ❑Yes []No i development within existing industrial areas. 4 • Other rmpacts: ❑ ❑ EJ Yes ❑No IMPACT ONPLANTS AND ANIMALS 8 Wiil.Proposed Action affect any. threatened or endangered species? LINO OYES 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 hear site or found on the site. • Removal of any portion of a critical or significant wildlife habitat. ❑ ❑ ❑Yes []No • Application of pesticide or�berbicide more than twice a year, other ❑ ❑ ❑Yes ❑No than for agricultural purposes. • t Other impacts: ❑ ❑ ❑Yes 1:1 No 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. j • Proposed Action requires . the removal of more than 10 acres ❑ ❑, ❑Yes ❑No of mature forest (over 100°years of age) or other locally important vegetation. I IMPACT ON AGRICULTURAL LAND RESOURCES 10'. Will the Proposed Action affect agricultural land resources?. ONO DYES Examples that would apply to column 2 The proposed action would sever, cross or limit access to agricultural ❑ ❑ El Yes El No land (includes cropland, hay€fields, pasture, vineyard, orchard, etc.) i 2 & 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 Conservation1aw, ECL) ONO DYES Examples that would apply to column 2 • Developable area of site contains-a protected water body. ❑ ❑ 11 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 DYES ` Examples that would apply to column 2 • A 10% increase or decrease in the surface area of any of water ❑ ❑ Eyes ❑No or more than a 10 acre increase or decrease. • Construction of a body of water that exceeds 10 acres of surface area. ❑ ❑ ❑Yes []No • Other impacts; ❑ ❑ ❑Yes ❑No 5. Will Proposed Action affect surface or groundwater quality or quantity? 0N DYES Examples that would apply to column 2 • Proposed Action will require a discharge permit. ❑ ❑ # ]Yes ❑No • Proposed Action requires use of a source of water that does not ❑ ❑ El Yes []No haveapproval to serveproposed (project) action. • Proposed Action requires water supply from wells with greater than 45 ❑ ❑. ❑Yes ONO gallons per minutepumping capacity. • Construction or operation causing any contamination of a water ❑ ❑ ❑Yes; []No supply system. • Proposed Action will adversely affect groundwater. ❑ ❑ ❑Yes ' El No •. Liquid effluent will be conveyed off the site to facilities which.presently ❑ ❑' ❑Yes ❑N.o donot exist or have inadequate capacity. • Proposed Action would use water in excess of 20,000 gallons per ❑ ❑ El Yes []No day. • Proposed Action will likely cause siltation or other discharge into an ❑ ❑ ❑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 ONO products greater than 1,100 gallons. • Proposed Action will allow residential uses in areas without water ❑ ❑ []Yes El No and/or sewer services. • Proposed Action locates commercial-and/or industrial uses which may ❑ ❑ []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 ii water runoff? ONO DYES Examples that would apply to column 2 • Proposed Action would change flood water flows. ❑ ❑ ❑Yes ❑No 7 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 'i of agricultural land or, if locatedin an Agricultutal District, more than 2-5 acres of agricuit&ral land. j; • The.proposed action would disruptor prevent installation of.agricultural ❑ ❑ ❑Yes. ❑No land rrianage7neht systems(e.g., slubsurface drain lines, outlet ditches, j strip croppA); or create a1 need for such measures (e.g. cause a farm l field to drain, poorly due to increased runoff). i` • Other imparfs: ❑ ❑ ❑Yes ❑No 4� y 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 ctantrast to current surrounding land use patterns, whether man-made or, natural. • Proposed lard uses, or project components visible to users of ❑ ❑ E-1 Yes ❑No aesthetic resources which will eliminate or significantly reduce their enjoyment o� the aesthetic qualities of that resource. Ic • Project components that Will result in the elimination or significant 11 El El Yes ❑No screening of tcenic views known to be important to the area. • Other impacts-. ❑ ❑ El 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 th�t would apply to column 2 • Proposed Acton occurringii wholly or partially within or substantially ❑ ❑ Dyes []No contiguous tojang facility or site listed on the State or National Register - of historic places. • Any impact tq an archaeological site or fossil bed located within the ❑ ❑ Dyes ONO project site. • Proposed Acton will occur in an area designated as sensitive for El El Dyes ❑No archaeologicasites on the NYS Site Inventory. • Other impa ts: ❑ ❑ ❑Yes ❑No IMPACT ON OPEN SPACE AND RECREATION 13: Will Proposgd Action affect the quantity or quality of existing or future openspaces 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; ❑ ❑' Dyes ❑No 9 2 3, IMPACT ON TRANSPORTATION Small to Potential Gan Impact Be- 14. Willtherebe an effect to existing transportation systems? Moderate Large Mitigated By' ONO OYES Impact Impact Project Change Examples thatwould 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. ❑ ❑ Dyes ❑No • Other impacts: ❑ ❑ El 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 ❑ ❑ El Yes ❑No. transmissionor 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 or other sensitive ❑ ❑ ❑Yes No facility, z • Odors will occur routinely(more than one hour per day)., ❑ ❑ ❑Yes 1:1 No • Proposed Action will produce operating noise exceeding the local ❑ ❑ ❑Yes QNo ambient noise levels for noise outside of structures. (I • Proposed Action will remove natural barriers that would act as a ❑ Q QYes ❑No noise screen. • Other impacts: ❑ ❑ El Yes []No IMPACT ON PUBLIC HEALTH 17, Will Proposed Action affect public health and safety? ONO" OYES Examples:that would applyto 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 fn the burial of"hazardous wastes" in any ❑ Q QYes ❑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 ❑N6 within 2,006 feet of a site used for the disposal of solid or hazardous waste. • Other impacts: ❑ Q QYes 11 No 10 . t 2 3 IMPACT ON GROWTH AND CHARACTERSmall 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 LINO OYES Examples that would apply to column 2. • The permanent population of Ahe,city, town or village in which the El ❑ C]Yes. ❑No project is located is,likely to grow by more than 5%. • The,municipal budget for capital expenditures or operating services ❑ ❑ DYes- ❑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. 0 11 ❑Yes ❑No • Proposed action will cause a cha ge in the density of land use. ❑ ❑ ❑Yes E]No • Proposed Action will replace orelimihate existing facilities, structures. ❑ ❑ [--]Yes []No ar,areas of historic.importance to.the community. i • Development.will create a demand for,addit4onal community services ❑ -E] ❑Yes El No (e,g khdols, police'A firs etc.) • Proposed Action will set an -important precedent for future projects. ❑ ❑ Dyes ❑No • Proposed Action will create or eliminate employment. Q ❑ ❑Yes 0N • Other impact& _ ❑ ❑ ! ❑Yes []No 19_ Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? ONO ❑YES If An Action in Part 2 is. Identified as a Potential Large Impact or Y 9 P If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 P — Part 3 EVALUATIOiV'OE THE IMPORTANCE 01= IMPACTS it 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 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) _T 11 - 3414-31 (2187) 9c 617.21 ( F{ Appendix B State Environmental Qivality i view Visual EAF Addendum This form may be used to provide additional information relating to Question 11 of Part 2 of the Full EAF. (To be completed by Lead Agency), Distance Between Visibility Project and Resource (im Miles) 1. Would the project be.-visible from: 0-1/4 1/4-1/2 1/2-3 3-5 5+ • A, parcel of land which is dedicated to and available ❑ ❑ ❑ ❑ ❑ to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? • An; overtook or parcel of land dedicated to public ❑ ❑ 0 ❑ ❑ . observation, enjoyment and appreciation of natural dr man-made scenic qualities? • A site or structure listed on the National or State ❑ ❑ ❑ ❑ 11 Registers of Historic Places? • State Parks? ❑ ❑ ❑ ❑ El • The State Forest Preserve? ❑ ❑ ❑ ❑ ❑ • National Wildlife Refuges and state game refuges? ❑ ❑ ❑ ❑ ❑ • National Natural Landmarks and other outstanding ❑ ❑ ❑ ❑ ❑ natural features? • National Park Service lands? ❑ ❑ ❑ ❑ ❑ • Rivers designated as National or State Wild; Scenic ❑ ❑ ❑ ❑ ❑ or Recreational? • Any transportation corridor of high exposure, such ❑ ❑ ❑ El 0 as part of the Interstate System, or Amtrak? • A governmentally established or designated interstate ❑ ❑ ❑ ❑ ❑ or inter-county foot trail, or one formally proposed for establishment or designation? • A site, area, lake, reservoir or highway designated as ❑ ❑ ❑ ❑ El scenic? • Municipal park, or designated open space?. ❑ ❑ ❑ ❑ ❑ • County road? ❑ ❑ ❑ El El • State? El El El 11 El • Local road? ❑ ❑ ❑ ❑ ❑ I 2. Is the visibility of the project seasonal? (i.e., screened by summer.foliage, but visible during.other 9 seasons) 11 Yes ❑No Pr's 3, Are an of the resources checked in g y ii Y question 1 used by the public,Burin the time of year -Y during which the project will be visible? 'I ❑Yes ❑No AIN i AFFIDAVIT STATE OF NEW YORK ) ss. . COUNTY OF SUFFOLK ) STEPHEN L. HAM, III, being duly sworn, deposes and says: 1. I am the authorized agent of Susanna von der Schulenburg and Henry L. King & Margaret G. King, owners of premises designated on the Suffolk County Tax Map as District 1000, Section 5, Block 2, Lots 10.8 and 10.9, respectively, which premises are the subject of an application to the Planning Board of the Town of Southold for a lot line change. The foregoing lots are shown on a certain map prepared by Chandler, Palmer & King and submitted to the Planning Board of the Town of Southold in connection with such application. 2. The proposed lot line change will be effected by the transfer of an approximately . 75-acre portion of tax lot 10.8 now owned by Susanna von der Schulenburg to tax lot 10.9 now owned by Henry L. King and Margaret G. King. 3. I hereby affirm on behalf of the owners that, upon approval of the lot line change and upon the property transfer described above, the portion of tax lot 10.8 transferred to tax Sot 10. 9 will merge with and become a part of tax lot 10. 9. Such portion of tax lot 10.8 so transferred will not at any time constitute a separate buildable parcel. 4. . I make this affidavit in order to induce the Planning Board of the Town of Southold to grant its approval to the proposed lot line change in accordance with the application therefor. Stephet L. Ham, III Subscribed and Sworn/,to Before Me this JS`--CX Day of July, 199 DNMRE 3.VENAKM N&02YE499MI NOTARY DUMC,Wift of Nair Virg } QmVid in 8 ft*Cwnq Notary Public ` r July 22 : 1994 j Southold Town Planning Board Town Hall ' Southold,'- New York 11971 Re: proposed. Lot Line Change for Henry L. King & Margaret G. Ying_ and Susanna von der Schulenburg. Gentlemen: _ (SCTM Vs 1.0001:5-2-10.$ &. 10.9)x"; The following statements are offered for your consideration in the review of the above-mentioned minor subdivisionand its referral �to the. 5uffolk County Planning Commission: (1) No grading, other than foundation excavation for a residential building is. proposed. (2) No new roads are proposed and no changes will be made in l the grades of the existing roads. i (3) No new drainage structures or alteration of existing structures are proposed. Yours truly, 71-7 Stephen L. Ham, III, authorized agent i Henry L. King Margaret G. King 960 Park Avenue New York, NY 100.28 July ` , 1,994 :Planning Board ;Town of Southold Town Hal Main Road 'Southold, NY 11971 Re: Proposed Lot Line Change for Premises at Fishers Island (Block 1, Lot 9, Map of Fishers Island Development Corporation) Dear Board Members: The undersigned, Henry L. King and Margaret G. King, as owners of premises situate at Fishers Island, NY known as Block 1, ,Lot 9, Map of Fishers Island Development Corporation (SCTM 1000-5-2-M-59) hereby authorize Stephen L. Ham, III of Matthews & Ham, 45 Hampton Road, Southampton, New York 11968, to act as our agent in making such applications to your Board and in taking any and all incidental actions' in regard thereto, including without limitation, completing and executing the required affidavits and forms, giving any required notices and appearing 4 any public hearings, as he shall deem necessary or advisable in order to obtain approval of the proposed lot line change with respect to such premises and those adjoining on the southwest in accordance with the Map prepared by Chandler, Palmer '& King, dated March 1, 1994, as the same may be revised from time to time. Very ruly yours H my L. King Margt5qt G. King I, is II i Susanna von der Schulenburg 21 Tite Street - Augustus Court (Flat G) London SW3 England June 28, 1994 Planning Board ?Town of Southold `Town Hall `Main Road Southold, ICY 11971 Re: Proposed Lot Line Change for Premises at Fishers Island (Block 1, Lot 10, Map of Fishers Island Development Corporation; SCTM # 1000-5-2-10.8) Dear Board Members: The undersigned, Susanna von der Schulenburg, as owner of premises situate at Fishers Island, NY known as Block 1, Lot 10, Map of Fishers Island Development Corporation (SCTM # 1000-5- 2-10.8) hereby authorizes Stephen L. Ham, III of Matthews & Ham, 45 Hampton Road Southampton, New York 11958 to act as my agent in .making such applications to your Board and in taking any and all incidental actions in regard thereto, including without limitation, completing and executing the required forms, giving any required notices and appearing at any public hearings, as he shall deem necessary or advisable in order to obtain approval of the proposed lot line change with respect to such premises and those adjoining on the northeast in accordance with the Map prepared by Chandler, Palmer &King, as the same may be revised from time to time. Very truly yours, i Susann o der Schulenburg` `jJrr. y roY. wC6'x. 3randxd"N`Y 6 T3i?.Form 90V _g«sgaia and Silt`Deed.',Ai&C`oveMmt agate Cine- s Acts—lad`widoal or Carposadaa(single 1 ' .r ra4 Al, . d` '^ IRW' 14 a3 'l!Y !, CONSULT YOUR LAWYER BEFORE'SIGNING THIS INSTRUMENT—THIS INSTRUMENT SHOULD AN A&b VtAWYERt OHL'l/. 1130��'251 l THIS INDENTURE,made the 30`.h day of ^-:t.ri;e r , nineteen hundred and niTrety–one TIETWEEN fli`\ -C(.i...^•.. 4 1C i r.. :'�: . r2— r a -most i.c corporation having ..r —J.r-iC `lll.'']r"..'V, • i(OC1CV 111r ,'('r.n�.-n, Ne W }York&-1157(]". . r., wm party,f"the first part, and HENRY L. KING- and MARGARET G. KING, his=: wY*fie, botharesid ng a-E960 Park Avenue, New York, New York 10028 ., tx ., ;` " party the sernnd part, ' s11Vi f1VF SEfElyithat the party of thi first part,in consideration Of Ten Dollars and other valuable consideration r I „ paid by the party of the second part, does hereby giant and release unto the party of the second part the heirs Yor succorsand assigns of the party of the second part forever, ' '' ALL,tliat certain plot, piece or parcel of land, with the buildings and improvements thereon"erected, situate, ;yorioa«; „ `tying and being in the a «xn o ♦A, )U • � C�n vt .. See Schedule "A" Annexed Hereto. xse= r_ K . OT ,yam �d TOGETHER with,all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all,the estate and rights of the party of the first part in and to said premises; TO HAVE,AND TO HOLDAhe premises herein granted unto.the party of the second part,the heirs or successors and assigns of ` t the party of the second part forever. N_ ; AND the party of the first part covenants that the party of the first part has not done or suffered anything - whereby.the said premises have beenencumberedin any way whatever,-except.as.aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consid- eration as a trust fund to be applied first for the purpose of paying the cost of the improvement:and will apply N the same first to the payment of the cost of the improvement before using any part of the.total,4 the same for any other. purpose. . The word party" shall be construed as if it read "parties" whenever the,'sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed written, the day and year first above . a> IN PRESENCE OF: HUNTING N & KILDARE I C (� By i Alicia H. Metz,i,,Pres.' tit,-•' Imo__ t STA-4' G( NEW YORK, COUNTY OF ss: .STATE OF NEW YOCOUNTY OF ss: On the personally cameday of 19 before me Ori the day,of 19 before me came to me known to`'bethe indiViduai described in and who to me known to bethe individual de`s&ihed' in and who execnted4rtheforegoiggiinstrument,'and,acknowledged that executed theioregoitsgi"instrument;Yand,ackno�ledged that executed the same. executed the 'same. < S7NEW YORK, NEW fdS.RK;COUNTY O'F u: STATE OF NEW YORk, COUNTY OF 'On the 30th day*$nf+ ' tober, 19 91 before me On�the day of 19 before me ;personally came , ALICIA H. METZ stn me kin igho;being bq me dulyy sworn did depose and hes subslcrlbcing,witness to the foregoing, say that ,Sbe resides at fii. t 57th Street g g instrument, with whom I am personally acquainted, who, being by me duly New.,York, New York t11,1 sworn, did depose and:say that ,he resides.at No. that She,is thu gPresi,dexft of -` -dRTINGTON! & ,KILDARE, INC. , that he knaves ' the corporation described ' 4- in,and'w�ltich execu`tg3 thea foregoing instrument; that she to be,the indiroidual mows the seal of said corporation;,that the seal;affixed ,described in �and 'who executed the foregoing,instrument; to said+istrument`s' sup,q cazporate,tseal that ,it was so that he,,safd subscribing witness,- was,present and saw affixed byr6rder of'the board 'of ,direttors\of said corpora- .execute the same;and that , '.(;he, said witness, tion,:and that She"Bigned lteexttame thereto by like order. at the safne time subscsibed 'h` name as=witness thereto. MICWIEI CLARKE HOMY PUbHo,Stift of Nm Yolk' No.644766662 QuaI red in Warren County Com1n"rasion jrea May$1.1992 t y QR 411 sit yaeLb SECTION 5 WIIH COVENANT AGAINST GRANIOR's ACls O TITLE BLOCK 2 - LOT 10.9 "HUNTINGTON &*KILDARE, INC. COUNTY16Acafg,#Y Suffolk Te,W-1 of anti fold ATO w. '. y�1 i HENRY .i . KING-'-,e3nd MARGARET G. Recorded At Request of KING First American Title Insurance Company of New York RETURN BY MA1L'�TO STANDARD NJRN OF NEW YORK BOARD Or TITLE UNDERWRITERS I PIETER J. de .SONG, ESQ. Ins DAVIS POLK & WARDWELL i Frr;! .1mr-rirlln Till(- ln�:irrnlre (Bra prnl J 1 Chase Manhattan Plaza of New York F::;0 717" York, New York LSIC -,Cf INC - 32 ,t z 10005 J, E_.S a � ;;n S . MP Na NES YOLK, BEET 599-2170 10016 >r v W 4 W C '253:. � OP PFU ,III. DIST., 1000 SDC, 5`TM= 2,PARC OF LDP 10.9) s, Ai,L ti at certain plot, pieces or parcel of;larn3„ situate, tying arid' being in the of Southold, County} of Suffolk and State of New York, being a part 'of t8at portion of Fishers Island now or formerly belonging�,to,'Fi; ers Islard kCorpotationl,which portion is' hereinafter called the' "Park") , lying-:easterly of T`the-following Iline,=viz. r 4.ING at: the southeasterly corner of land owned by the United State's, known a5 ,the,Fort N.G. Wright Military Reservation, .Mount Prospect Tract, on the j she i'e#'t fa&lock Islarid:,SaUnd-or the Atlantic Ocean; :and ' rn sa'4jand,,bf the Statesyto thesoutherly nine pf EastEndRoad, (sometimes called Oriental ue ',a 4d which poEnt is the northeasterly corner; pf larx3 of thekunited States; THFSICE`crossing the East End, Road and following -the. same course as;the,last to the store of,West flaibor 'or rishers' Island Sound; said lots or parcel of land bea�r .'�oundEeI and described as follows. �I EDGTNNim at,a stone,,monument set on the southerly side of a road forty feet wide,-'said monument being twohundred and twenty-nine and ninety-hundredths feet.:,Ji`orth of.a point,which:is nine hundred' and seventy-five an d,=-sixty-nine hundredths�1eet east"of another monument marking the U.S.%,Coast- ana:Geodetic Surye Triatxiulation;3tation„"East End 2" (whidiflsaid "East Errl 2"_„-monument is . located ,on” the summit of the'highest hill east of East on'•Fishers Island N.Y: a°ndIli�es,south fifty-four minutes west of Latimer Reef Light, in Fishers Island }Sound) ; and RUNNING THEtrc Eastwardly, along the southerly side of.the road (and following. the arc of a eurve.to the left whose radius is one hundred and,eighty-five and sixty six:tiundredths,.€eet and the directiorn of whose radius at that point is north fiueFdegrees fifty-five minutes and, fifty seconds east), 'thirty-one' and thcee �hundreilths £eet'to a stone monumentf TIE=41South. four degrees thirty-three minutes and fifteen seconds,west fifty- s1x.�and twenty-six.hundredths feet to a stone monument; and , Tt ,lNorth' twenty-five ,degrees and four,minutes west sixty-twd! and sikty hur0redths feet to the ;pint or plate of BEGIM4114G. 4 "��a 1136554 ;av tPA , 3I ((1}IST 1000 S-BLOCK Z PART OF LOT 10.9) , ATd,,drat certain Lr1oL,glpiece or, parcel of land, 'sits aAe,' }lying arcl;tieing" in,r e Itnii'or:�^,onthold,. crAuity of: Suffolk aixl S ate oL NevrYork; being la t of that Por .,bri of Ushers, Ir1aril now or�fo�merly,belo�ging ' EisheKs Eslarlri ('orlror.aLum ,(wtrii;h txttLion' is hereinafter called they"Pak"), ly1rn� eFasE of the , rol.Ujw.inrl line,gvlJ.:'. a " 11PUINWING -at- the sout-h6sterly corner of the land oianedz by the United States, known a the Fort II.G. ?Wright• Military Reser vation,�Mouflt ProspecVTract, on I_M:he=thor aUlock:Isl d -,Sound or the Atlantic oceanl and A.BU Northerly L-ollo ing the east boundary of :the said lard of'the E1nrt cl; t teS to the southerly line of„Eabt End Road '(sometimes called,oriental ( vetnueR)� r>d;whrd�” point is-the northeasterly corner-of ~land of the United � �-pl�teVh tJa4 m ssing the East ErSd ,Road and follolving the.same course as the,last to the she­1. f West,Harbor or-Fishers Island.Sound, saidjots or parcel, of,lard tgtedR,and described as follows BfGTIJi�ING at a stone minume.nt.set`on'the'souEherly `s de'of a road, 40 feet wide, said moiiuriient beirg eleven hundred .and Fifty-seven and.'forty-seven }iuiidredths fee0balstoor: a point which :is fitee,hundred,and twetity four„and ninety-onto hUnCli^,.1Uls .feet north or, another imonument markingfrthe U.S, Coastiand�IGeodetic. Survey ' riinguLal ion StciLioti "East End;2n'"(whi6h,s&id "East' [id 2'",>monument. is loea ed ithe,summitof the highest, hill least of'�East(IIarbor on Fishers Island ,�, Cctt ids south, fifty-four minutes west of Latimer Tteef Llght in Fishers Isl : fi�txl); :arid 10NhY(iNTIITCE Sotith 'fatty-eig hty degrees twenty s Xge iodLe%and forty seconds eas i bh&hundred and 'five an d 'fid sixteen-hundredths feet toa stake; F � TIASK!E""th eighty-two degrees forty-seven minutes and forty seconds east two hundredand ninety-one arca eighty-hundredths feet to.0e shore of Block Island Sound; TIIFSICF withr the meanders of said Sound, south twenty-five degrees thirteen minutes.,anl ten seconds west, eighty-two feet south nine degrees twelve minutes and 'forty seconds west, thirty-seven and forty-eight hundredths feet, south nineteenzdegrees thirty-nine minutes and ten seconds west eighty-nine and twenty-hnndredths feet, south' thirty-two degrees twenty-two minutes and thirty secondsrwest two hundred and twenty-nine .and seventy-one hundredths.Feet and south forty-five degrees thirty-seven minutes and forty-five seconds'' west;. twenty'=nine and sixty-two hundredths feet to a stake; TMrX. "North forty-two degrees twenty-three minutes``and ten seconds,west four hundred anis seventy-three ,and fifty-nine huridredths?fet to a stakes"e ; ^— MiNC13North four degrees thirty-three minutes ancl 'fifteen seconds east fifty- six andetwenty-six hundredths feet to a stake Iset on the southerly side of said road; and j R[INN]NG 'i1TENCL NortheasteKwardly along the southerly side of said road (folldwicg the arc ofa curve to_ the left whose radius is one hundred an, l4' , eighiy 't?.ve and sixty-six,hurOredtlAs feet and;the direction of who�:`radius at thaekpoint is north,three degrees thirty-eight minutes and forty-eight, ' seconft'` iest) , •one hundred and eighty-six and twenty-six hundredths feet to , the point or place of BBGINNiNG. , . 2094 EXHIBIT 6 `. 2 L i ~, 130X1 S 5 IHRU J MUS L III I YPLDt„"s YLUN td+U'„1N1 til ACK INh1UALY+..y,J101t 10'7Rt ,COIWING,Oil 1011 ING f I SUFFOLK COUNTY,CLERK ''2'. j l3 J55-� it �i [` r� ii Irw► 11V0J1;4 3 .,crv2t) Number of pages tORRL,YS 5"'r�Jlil 19 1994 t' 4! ` Serial it r `'.`°• �1`•CLE' � -_ Certificate Ct?t1Pl'11%. - rt 552 r , , 'heed'/1lioi tl Ike fYislriuilcul =` "keit T4ni'tj a{;e Tax Stamp 1„ itecorUinl lWWStamijspq i'* �'�' • ' sM# I x itS i.iq. Mortgage Anil. Page Filin17ll ' F -- -rl ii:mdling ' �• ' 1. Ilasic'1'ax — TP-584 __ 2.SUNYIVIA — Sub Total ' i Notation _ —' EA-5217(County�MW Sub Total 3.Spec./Add — EA-5217(State) TOT.MTG.TAX RP.T.S.A /J Dual Town_Dual County — Held for Apportionment_ Comm.of Ed. o �� zoes Transfer Tax . Affidavit Mansion Tax Certified Copy The property covered by this mortgage is or will be Impruvwl bq a one or two RegCopy” rz _ Sub Total, family,dwellmg only. �,p Other 1", GRAND TOTAL V, if NO,see appropriate tax clause on ;page of this instrument. 5 _ Kcal ProperlyTax Service Agency Verification 6 Title Congtauy hd'urnlaliun P ..• 9� Dist _ eclion Illock Lnl - � YI, lyra va v v o d , vy D/D o , i Comm 1 Name 6 7-d —.._. 1' y Dale Title Number.,.' 4 Cash Jl° Check Charge ti Pa''er,same as R&R v 1 15k o&. xpeic-,1r/ tt �R7iovyi : - –fl io>o.✓ .rry } iif 6 ~,. �',RECOItiI,&RETUR O 11ADDRFSS V SuffoWk ounty� Recordingr�&A��ndorsemerit gage This page forms part of the attached made,by. " ` (Deed,+Mortgage, etc.) r � . V.,S6kV' The premisekbercin is situated ini 'SUFFOLK COUNTY,NEW YORK ' .S�',�L/CSL /� G.'' '• . ,.. {; _ .. ...Ci rrfa , TO In the TOWN of �D In thet VILI AGE. /v4 i'Vur /�E�i' Scf/��£N3f2� orIIAMLETofSy£es Lsc✓i�� .. - 12.4104.,.5/93 _ � * a..a Standnd N.Y.B.T.U.Foam 800? Began and$al-Deed.Wkh Covenant 10Mf G"nmr,Ac NdMctual ar CorpQ{,,t; I f pir,Sfiee,) t CONSULT YOUR LAWBEFORE SIGNING THIS INSTRUMENT TRISRUMENT SHOULD BE USED BY LAWYERS ONLY. ' THIS'fNI7EI%TC1RE,maite the , j ?'of„ June ''nineteeu hundt'ed" 94 4 1 P I _ 1 ' BETV1> E[iI gTwo Lincon,Advisory Seivicos, Inc: ;t- •,P1att A, Paine.Hoftse 'I P.d.;:Box '600 P1L'4LM1kt"4t ZSS 'Mille'rton,+New`.York -12546., 't f * • f' # fiK i party oP❑e : r.i pari xntl A dCIM i EES a t ti Southold New York 11968 i 1 k rpartj�of the second part. o WITNESSETH, that the paryiof the first part, in consideration of ten dollars and other valuable consideration �, paid by the party of the secotfd part,;dces hereby grant and releaseunto.the partyro£ thel'semnd part,the setae orsuccessors and assigns.of the party of the second pant forever, n } u• , ' ... .3cdk rrr 4rh.r ,}yy zx�yyq1 .L ALL that certain plot piece r parcel of land withfthe`bmldmgs and uttprovementithereon erected, situate, ti .r„ rv.awi. yhying and being in the Towr} of Southold, County„ofa,Suffolk, described,.on.Schedule A ` f ww>-W.5 t W b• �Y+ '+�5.`^'v�jC4 Y^ YstiK3i^• . A •In:n - 3i , ly { SI Section 5 •s� r BTockar�2 s(Ell .. T.G .�0.C"s a , ¢ r smn '. R E j6�'t`aF�.e1. Iyer TOGETHER with all right, title and interest, if any, of the,party of the first part in,and to•any streets and roads abutting the above described premises to the center lines thereof;TOGETHER with the appurtenances -and=all the;estate'`andlrights'of the party of the first part in and,;to said,premises;;MHAVE_AND TO HOhD'tbepremises herein granted unto the'party of�the second part, the heirs or successors and assigns of ' the*party of'the.smond part.forever. H ., -z 'AND the panty of the`first part covenants tliat the party of the first lar, nas not doneor suf.'ered :in- E Ir art ,whereby the said piemises`have°been]encumbered in am v. v c«r except as aforesnid. AND the party::lof the first part,'in compliance with Section 13 of the Lien Lata, covenants that the party of the,first art will receive the consideration for this conve ance`and will tto�d° re'right to receive such consid- eration y eratign as a Ernst fund to be applied first for the purpose oY payln9 t e cost of the improvement and will apply r: the same first to the payment of the cost of the improvement,beforenising atryj#art of the total of the same for any other purpose. ;a:rso_A e dY:-r1 .svi4: The word "party” shall be construed as if it read "parties' whenever the sense of this indenture so requires. IN WITNESS WHEREOF,'the party of the first part has duly'executed thisjdeed the,day,And year-first above written. � IN PRESENCE 6F: ._ . Two Lincoln Advisoiy'7Sewires; Inc. 14 K l 4t. x CSS'.' fL"�fF b� 01pt. C01lNTY OP sst STATS OF "i* YOA$, CDOY OF s sl i'Ont`tlte a s , day of .' 19 before nm Ott tUe 16 day of�� 19� fore rt'e ` jFersotially Cattie personally came to me known to be thell1dividual described in and who to me known to be the individual escrilmd�Yn a,nd who executed the foregoing�,instrunrrat, and acknowledged that executed the foregoing •instrulnen , and acknowledged that executed the sanies- . executed the sanies, DOR Y RARNALE No ary Public tate of New York N 4625644 Qoal!fied n purchase COU k:.5 t. .< ''' `sa�z.•° (ra r " -cri"i iss' nExpiresJon 311 : 'TAtC OF •11514 vn"w, rMnbv nT +,�A•�l�Jr �� �. ,���� Yv tt On Irl & d'n o ' rv+u ' 19pn !v,•fn:er') I Thr .... da). of ... I') .. .. r rc!•:6 : herorc`me 7 :i,r•oru:!Ir cmill• :t•i Bat•,+(:n: ulr.:ri,'i:cila U nic duly .x r,;u. t!i,l drl o :, a :d ' tj; a:r• •.runes to the rnn•,-;•m: I,tslriil;:eld, with r t I h;• res u . 't N1 [�! � ! MC f(Al_i /i. ' r � trv! /fLrttaEf r/C <n Pf��.�'+ `� nh,;:: I rnl hClca ::; n;lul ;rJ :rl r nt tg by n:c (hit) - he She a thei /ec erci� tL r: IJLa a .\o sof lwo� > !'itco�n Advit�soxy 5eryaces��SFick 'kfi '" that l he knows the corp dscrtUed� .•' «, +,� �I III lift which 0 CCn+ed 'tV '+TCjr^aP'°1nntT11!PCIII, tliat 111 - n�•ice . '� r a ".1._.__.• ���:. I I . Ur t!Ic i:idreiduaf in as+l ubn l'YCl'llll+l Jhe fmcgoinjr instrument'; —grid •1r•t 111... t '- ++,rlr�� 1 rrte—«.nl_.<,;,M—ir—"- =erl Ihm liv, Enid �I:hs:libu!g :Innesti. u•ati present Sand saw al''i m•1 'IY r. rlrti•-rlf�11P•liilr .} rf dimer r�r f—•Bi1F<nrlr.,rn execm! Ills .arae; and Iha 1 ant' tint, •ht 5 gnen 11 Im le. tl a ri try 11like'orrli•r: 1 + ,• , I - t he, said witness; f L:c .a:ue• nu .u:r<tibed h rumir as witness thereto. + ii r. r rltrri Irr r I I + '' r' . e � �,y s rKENYCiH JACbr S • ;' x Nornry PNo. 3S.e..o of Nra Ounlllled In New Yore Cr7j�" a ' e Ter^I F.xDlrbs JrOy 31, +' i IC-NNETH JACOBS ' of e e$•• <oe:Ci Ppjoc'314725572.ew ♦!I IC[ir111i d11I1 a.11IP ;IfCtt e�ei;hl:cd In Now York ot f}EY ••m EKPlrou July 31,;19+ •'5ECTION $. 'I \11111 ( n1 :1N'r 1, 1IN�I t L1�unio-'.tr"r BLOCK 2 LF Vn LOT 10 x, 'a COUNTY OR TOWN SbtlthOld f a i ,i,f, y " _ III 5t 4�� �•. 'ly,. $ 'rP :J;'��.� '�` ': CA .. •lh a x , i. - — cRET[TRN BY MAR TO;, o: STANDARD FORM OF NEW YORK BOARD OF TIFLF IINDFRWRIrERS I " I r,tEOen IL3B1,Nsq- Ma g�. !tat 5ECCRITYT'17'1_F,dNDC,UARAATYC'OdfPAN'S' I '1 • Itnrll,+t, or• R +.;1 :.%t, Now York 1 i916l{ „ CNAq TFR[D 1070 _�IN NEW YORK Try {V, SY gijT( II V F,• ;a nt I r A +w,i�mr-xmw+pc��r- Aw+va-tel? j S'CHED'ULE A 68 7,14, 1 l � ' �x� � 11 1 ,:dlal[ •cc.l.nn t • I _ I !Sh.,IS bland now i� h-re;nafLe.r celled tl . ; ! M ( INNINGwn: the s )tlricLs!:::'1\ M Iel (11 nd 'O\\ O ,(1['Ill(tI\ OV '1 d f)\ :ham l'llll�d Vorl:C ll.G. 11 :kdii Mi!ILar • li'i:S.,f 1'i hl Util HCl' 1:2I/C[, d y., Ort `the` S110I'e 'of Block Island solind Or rl!C :11ia11pC` Uc !Lln (as Salld 1 !'iiC[, N'i:s co >iiuted prior to the extension thereof' by t?le -acgtRisifion of addtnrnaT landsaa'in ,,cond&innation rmc. dir:!_s i !slituted in 1942)'and RUN ING 'T Ifi\CI:. N', l:r::rh Ihllowino-1 t!1:: La!sL li:i .iida!'y of Il . s:,ld n,i ;i'i)i`land npw, ,yor i formed\ I', I tIG, Unitd blades 'ate N tS C611S[IILIIdd'pio to til!(. , C+CS 'Sla)n thereof) ,tP the sou ilerk, ' 1" ol,l a!s: l lid 120: (I%.I.Sonicl Mlles cailed C)I L Illdl 1\CIIIIW d11C' x', lAndi',point ,.is M. TIO IE110a!Sa^II\ ,(,rlrl : :OI ' ,aI .;,II-PL[tfl11:111(I,IIDN :)'r:f(111111.11)',0! if l,nliai': S.:.!es (..:S iMile V ,.ons ILln-1'rlOr' lo'st1.:I1 Cal�'17SIOII'Lilia::O11;;%'� .M ', f>,; ." • N v .l ;THENCE crossing the East End Road and followin!l IIISI1•e COU:-:;C i!S '1,, i C,;I 1 IIIC � •shore of.West Harbor or FishersIsland Sound'; Said Iot or pacel"of land being boumled and described as £ol aivs ". BEGINNING at a point. on the southerly side of a road "said point being'241 77 feet ..r north hof a Dint which ,is 813.01 fees East of a !uonunlent i!':a:'. nn 1, P ll _ Ilie i?:1ucd Slate Coast6h Geodetic ,Survey Triangulation Station "Gall i ixl 2"' r\\•hi,:h said "I{r.s: I3nd mOnllmenC 15 1DC3ted On the .summit' Of the ilial' sI hillI Iii 11i l a'S' llarb:Ii. On Fishers`..Island, :N.Y., and lies South 54 minutes West or Latimer Reef'Ligllt,in,f'ishers Island ' Sound ) said point of beginning also being located Sou ' `3!de reel P g g g thx, I g 54 mj>iutes,50 seconds West, 5 feet from a stone monument set on the formerly soutlteilysjde,of said road RUNNING` THENCE along the newly established southerly side of said road, South'84 degrees 4 minutes 10 seconds East, 156.04 feet; THENCE South 25 degreese 4 minutes 00 seconds East' 56.77 feet. to a, stone monument; THENCE South 42 degrees 23 minutes 10 seconds East 473.59 feet gr to the shore of B1ock°lsland Sound; THENCE with the meanders of said Sound, South 56 de'rees 23 minutes 00 `seconds g �. Rc� ' West, a 385.26 feet and South 68 degrees 48 minutes 20 seconds West 73.18'feet to a stake,,,,_, ' THENCE North 14 degrees 29 minutes 50 seconds West, 519.63 feet to a stone monument; and THENCE .North 3 degrees 54 minutes 50 seconds East, 155.29 feet to the point or place,of BEGINNING x r a �1 T�GIETHER.with all the right, title and interest of the party of the first part, of, in and to the land lying in,the street in front of and adjoining said premises. S I x I 1 'i MATT=WS &. HAM ATTORNEYS AND COUNSELLORS AT LAW 48 HAMPTON ROAD SOUTDAMPTON,N.Y.11968 516-288-2400 THMP B MATTHESYs TR=GOPEER 510-287-1076 11812-1fl821 STEPHEN L.HAM,M March 17, 1995 z„ Planning Board Town of Southold 530951 Main Road P.O. Box 1179 t Southold, NY 13971 Re: Lot Line Change for von der Schulenburg and King SCTM # 's 1000-5-2-10.8 & 10.9 Dear Board Members I have enclosed a certified copy of the deed by which the referenced parties effected their lot line change that you approved on October 24, 1994. In satisfaction of the condition set forth in your resolution, the deed contains language providing for the merger of the .75-acre parcel with other premises of the Kings adjoining on the east. , Please now endorse the final map and mail me an it original print of the same. i Very truly }yours, Stephen L. Ham, III SLH:cc Enclosure 1 y Igo_ 4� 10 P� a WR zor ; Jv1�L fsq i. eC,A'2 '�ir yP�tl ai�1��E §C,A'2 _.. .. BS 5 TI37911TJST BE TYPED O NTEAN$LACKI1st;K ONLY PRxTO IIECtRDI1wG OR FIGT•PYG. j I ��S'UFFOLI COUNTY CLFI2K 2" ' 4 L!P# ���`���� I • �� t TS 72 Number of pages ,.. a .7 OR `) RENS z FEB 1 S 4o Serial#Certificate# L.=TAX r� ' 220'72 Prior CIM Deed J M,urtgage Instrument Deed f<Mortgage Tax Stamp Recording/Fi ing Stamps 4 I FEES; Mortgage Amt. Page/Filing Feer Handling I.Basic Tax _ TP-584 Lp .^ 2. SONYMA _ Notation Sob Tata[ EA=5217'{County) ._ Sub Total 3.Spec./Add. _ EA-5217(State) 5 TOT. MTG.TAX �o b RP.T.S.A: Dual Town_Dual.County— Held for Apportionment Comm.of Ed. 5 .,00 �m Transfer Tax ._ Affidavit Mansion Tax Certified Copy The property covered by this mortgage is-or will be improved by a one or two Reg. Copy _ Sub Total _ family dwelling only. YES or NO— Other O_Other GRAND;TOTAL .; If NO,see appropriate tax clause on page# of this instrument. e �+"9ty Real Property Tax Service Agency Verification b Title Company Information x Dist Section Block Lot 1000 005.00 02.00 oim—lh Fidelity National Title Insurance Co. x-144-v Company Name Dates 2012189 Title Number FEE PAID BY: X Davis, Polk & Wordwell, Esqs. � Cash_Check Charge 450 Lexington Avenue �j Payer same as R&R New York, New York 10017 OR: Fidelity National Title Insurance Co. Att: Patricia. Doran, Esq. S. RECORD& RETURN TO Suffolk County Recording chi Endorsement Page This page forms part of the attached DEED' made by: (Deed, Mortgage, etc.) Susanna von der Schulenbarg, as nominee The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of Southold Henry L. King and Margaret icing husband and wife G In the VILLAGE or HAMLET of Fishers island page 1 of 4 pages �" 12.tl10d.,5/93 Forrn 8002--Bargain and Sale Deed,with Covenant against Gran! Acts Indiv�dted or Corporation (single'.sheet) CONSULT YOUR LAWYER BEFORESIGNINGTHIS INSTRUMENT—THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY. THIS INDENTURE made the / S day of � nineteen hundred and BETWEEN SUSANNA von der SCHULENBURG, as nominee, now residing at 21 Tite Street, Augustus Court , Flat G, London SW 3, England: party of the first part; and `I HENRX.L . KING and MARGARET G. KING, husband and wife, now residing 1 � at 960 Park Avenue, New York, New York 10028 I r a, ' party of the second part, I : WITNESSETH,that the party of the first part,inconsideration of Ten Dollars and other valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever, i ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being ikxbox- at Fishers Island, Town of Southold, County of Suffolk j ' and State of New York, as more particularly bounded and described on Schedule A hereto. BEING AND INTENDED TO BE a portion of the same premises conveyed to the party of the first part by deed, dated June 16, '1994 and j recorded in the Office of the Suffolk County Clerk on June 29, 1994 in Liber 11683 page 273 • By accepting this deed, the party of the second part agrees that, upon the recording' of this deed, the premises conveyed hereby will merge with and become a part of other premises owned by the party of the second part adjoining on the east and will not constitute a separate building lot under the Zoning Ordinance of the Town of Southold, said other premises having been acquired by the party of the second part by deed, dated October 30, 1991 and recorded in the Office of the Suffolk County Clerk on November 8, 1991 in Liber 11366 page 251 and bearing the Suffolk County Tax Map designation of District 1000, Section 005. 00, Block 02. 00, Lot 010 . 009 . SUBJECT TO the following covenant and restriction: The party of the second part, their successors and assigns may not build any structure on the premises conveyed hereby, with the exception of a tennis court and/or a swimming pool and other customary improvements ancillary to a tennis court and/or swimming pool, without the prior written consent of the party of the first part , her successors or assigns . It is the specific intent of the parties hereto that suchconsent shall not be required with regard to such tennis court and/or swimming pool and such I customary ancillary improvements . TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the -- "�--and assims-of the party of the J STATE OF NEW YORK - COUNTY OF SUFFOLK SS. t} I,EDWARD P.ROMAINE,CLERK OF THE COUNTY OF SUFFOLK AND CLERK OF THE SUPREME COURT OF THE STATE OF NEW YORK.IN AND FOR SAID COUNTY(SAID COURT BEING A COURT OF RECORD)DO HEREBY CERTIFY THAT I HAVE COMPARED THE ANNEXED COPY OF DEED AT PAGE_j�RECORDED :;2 S 9Y- AND THAT 11 ISA JUST AND TRUE COPY OF SUCH ORIGINAL EE AND OF THE WHOLE THEREOF. IN TESTIMONY WHEREOF,I HAVE HEREUNTO SET MY HAND AND AFFIXED THE SEAL OF SAID COUNTY AND COURT THIS As:DAY OF 199 QV— CLERK ACKNOWLEDGMENT STATE OF NEW JERSEY ) ss. : COUNTY OF MERCER ) On this day of February, 1995, before me personally came G. Nicholas Miller, to me known and known to me to be the attorney-in-fact of Susanna von der Schulenburg, the individual described in and who by her said attorney-in-fact. executed the foregoing instrument, and duly acknowledged before me that he executed the same as the act and deed of Susanna von. der Schulenburg therein described, and for the purposes therein. mentioned by virtue of a power of attorney duly executed by the said Susanna von der Schulenburg dated the 14th day of November, 1983 to be recorded in the Office of the Suffolk County Clerk simultaneously herewith. otary Public CA1'.LI.N-A 14. SAWYER NOTA-zyU'�:,IC OF NEW JERSEY My Commission Expires Apr. 16. 1996 z z 0 O U w LL W N J O LL W U Q 6 N _N H W W N W ¢ ^ttkr9YFe ... .v v wn.,xwmx 7 _„..,,r -"- Win.. '-3`fi�"•- +!�,:<... 0 117-14M866 SCHEDULE A TO DEED Party of the First Part: Susanna von der Schulenburg i' Party of the Second Part: Henry L. King and Margaret G. King r Deed Dated: reBROAky 1, 1a9 S ALL that certain plot, piece of parcel of land, situate, lying and being at Fishers Island, in the Town of Southold, County of Suffolk and State :,of New York, being more particularly bounded and described as tollowss . BEGINNING at a point on the southerly side of a road, said, point being 224.61 feet north of a point which is' 978.16- feet East of a monument marking the United StatesCoast and Geodetic Survey . Triangulation Station "East End 2" (which said "East End 2" monument is locatdd on. the summit of the highest hill . East of fi East Harbor on Fishers 'Island, N.Y. , and lies South 54 minutes West of Latimer Reef Light in Fishers Island Sound), ; RUNNING THENCE South 05 degrees 32 minutes 42 seconds East, 52..86 feet; THENCE South 29 degrees 52 minutes 28 seconds East, 478..52 feet to the shore of Block Island Sound; THENCE with the meanders of said Sound, North 56 degrees 23 minutes 00 seconds East 120.00 feet; THENCE North 42 degrees 23 minutes 10 seconds West, 473 .59 feet to a stone monument; and THENCE North 25 degrees 04 minutes- 00--seconds East, 56.77 feet, to the point or place of BEGINNING. "s y y y Yd' 1 y a�F. Submission Without A Cover Letter Date: 3��7lg5 a Sender: Subject: �Ghu02nf3ur - Ki d SCTM#' 1000- S--2- tG. ? -t 10 ,7 Comments. (e.c.o`cO dee4 I flXES 5 T-HRU 4 MUST BE TYP ! JOR FUNTGD.IN 11L-kKJNIt ON PRIOR TORECORD t� iZ.1 II 1[VG, I S IT'VOLK COTJNTY CLE% . 2 '' 3 : 2207 11114 t NumberoEpageq l REAL $3ri9 cE i J t rlf P � . TQURFNS FEB 15 1995 Serial#` ? JO ft '� tJftltj� COLIJiTy Certificate# ' F Prior..' tf}l ilreii i'lfortM1al: Tnsirunicut'' t ' Tlct it/ bort age Tax Stamp ` Recorrbnit Flbn,�t, 4 — FEES a Pagel Filiug Fee _ _ l4 Mortl a�e.Amt. Handling .` 95 i 1 L Basic Tax TP-584 ._ 2.SONYMA cot HOLfa OWN Notation 9LAt# if G 9� r"v Sub Total. F' EA-5217(County) Sub Total 3.Spec./Add. EA-5217(State) r TOT.MTG.TAX R.P.T.S.A. �S' ® Daal Town_Dva6 County— s ley held for Apportionment_ Comm.of Ed. 5_._00_ a D - Transfer Tax 1^' 2 �,,"ND INDFQ Mansion Tax Certified Cupy �''� The property covered by this mortgage is or will be improved by a one or two z, Reg. Copy Sufi Total _- family dwelling only. _ YES_ or NO Other GRAND TOTAL� _� If NO,see appropriate tax clause on page# of this instrument. ;5 iv- - Real Property Tax Service Agency Verification Ile Company information Dist Section Block Lot '•x i 000 005.00 02.00 OHO,o!/ — Fidelity National Title Insurance Co. 2-14-95 NEW 1V UHl6E/Z Company Name Date 2012189 Title Number FEE PAID BY: X Davis, Polk& Wordwefl, E=Doran, Cash Check Charge 450 Lexington Avenue Payer same as R&R_ New York, New York 1001 AttOlt; Fidelity National:Title Insurance Co. 8' RECORD & RETURN TO Suffolk County Recording & Endorsement Page f h This page forms part of the attached DEED made by: (Deed, Mortgage, etc.) Susanna von der Schulenbctrg, as nominee The premises herein is Situated in { SUTFOLK COUNTY, NEW YORK, TO In the TOWN of Southold Henry L. King and Margaret/King husband and wife G• In the VILLAGE or HAMLET of Fishers Island MORDED EDWARD P ROMAINE FEB 15 1995 CLERK OF SUFFOIX COOta7Y :Fon 8002'—Bargain and Sale Deed,with Covenant against GtnntorsActs—]ndrvidual or Corporanon..tvngleshce0 Foran �. CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY.. THISINDENTURE,, made the /d day ofJk, !% nineteen hundred and BETWEEN- SUSANNA' von der SCHULENBURG, as nominee, now residing at 21 Tite Street, Augustus Court, Flat G, London SW 3, England , „ i v party of the first part, and j HENRY L. KING and MARGARET G. KING, husband and wife, now residing j at. 5,60 Park AVenue, New `fork, New York 10028 is i party of the second part, WITNESSETH,that the-party of the first part,in consideration of Ten Dollars and other valuable consideration paid by the party of the second part,does hereby grant and release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever, ALL that certain plot, piece or parcel of land,with the buildings and improvements thereon erected, situate, lying and being 1'Axlsrx, at Fishers Island-, Town of -Southold, County of Suffolk and State of New York,, as, more particularly bounded and described on ' Schedule A hereto . BEING AND INTENDED TO BE a portion of the same premises conveyed to the ,party of tie .first: part by deed, dated June 16, 1994 and: recorded in the Office of the Suffolk County Clerk on June 29, 1994 it Liber 11683 page 273 . By accepting this deed, the party of the second part agrees that, upo the recording of this deed, the premises conveyed hereby will merge w: j and: 'become a part ofotheir premises owned .by the party of the second part ad,joining .on the east and will not constitute a separate buildinz lot under the 4aning Ordinance of the Town of Southold, said other Premises having been acquired by the party of the second part by dee: dated October 30, 1991 and recorded in the Office of the Suffolk Coun Clerk on November 8, 1991 in Liber 11366 page '251 and bearing the Suffolk CountyTax Map, designation of District 1000, Section 005 .00, Block 02.00, Lqt 010.. 009. SUBJECT TO the following covenant and restriction: The party of the second part, their successors and assigns may not build any structure on the premiseslconveyed hereby, with the exception of a tennis court and/or a swimming pool and other customary improvements ancillary to a tennis court „and/or swimming pool;, without the prior written consen of the party of" the first part, her successors or assigns . It is the specific intentof the parties hereto that such consent shall not be required with regard to such tennis: court and/or swimming pool and. suc customary ancillary improvements. TOGETHER with all right, title and interest,if any,of the party of the first part in and to any streets and roads abutting,the above described premises to.the center lines thereof; TOGETHER.with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVEANDTO HOLD the premises herein granted unto the party of the second part,.the heirs or successors andassignsof the party of.the TAX MAP second part forever: -DESIGNATION : - out.100 0 AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever, except,as aforesaid. sec.005 • 00 AND the party of the first part, in with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration alk.02 . 00 as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. p $-80-6, The word "party" shall be construed as if it read "parties” whenever the sense of this indenture so requires. /D'• O/� IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day.and;year first above written: -IN PRESENCE OF; //A Susann von de _S ule rg tJ FED 15 1945 EflwaRaF ROMAINE C3 FRK AF CI IFl•('NK'(Y11NTY �QMN856 SCHEDULE A TO DEED Party of the First Part.: Susanna von. der Schulenburg , Party of the Second Part: Henry L. King and Margaret G. King - Deed Dated: r8690AaY 1, 199,5 ALL, that certain, plot, piece„ of parcel of land; situate, lying and beim at Fis rb; Island, 'in the- Town of Southold,, =County of. SUffolkf an State- of New 'Yorkx being more particularly 'bousrded and d'escrsbed, a`s`follows BEGINNING, at. ,a point on the southerly side, of a road, ;said point being 224;.51 feet ,nbrth of a point which is 978 16 feet East oP a mohume� `ImarkingIthe United States Coast and Geodetic Survey Triangulation Station ''"East End 2.11 (which said.. °East End 211 r..onu cont is located' on the summit, of the highest hill East of East Harbor on Flsliers; Island, N.Y.. , and-'lies 'South `54 minutes West of Latimer Reef, Light in• Fishers Island Sound) ; RUNNING, THEhtE South 05 degrees 32 minutes. 42 seconds East, 52.86, feet; THENCE South 29 degrees 52 minutes 28 seconds East, 478«52 feeto , t `the shore of Block Island Sound; THENCE with the, meanders of said Sound,.. North 56 degrees 23 minutes 00':seconds East 120.00 feet; THENCE North 42 degrees 23 minutes 10 seconds West, 473.59, feet to a stone monument; and THENCE North 25= degrees- 04 minutes 00 seconds East, 56.77 feet to the r: oint> or place of BEGINNING. P f: f.V ,1 -- - RECORDED FED 15 ,995_. CLERK P ,V - 4 _ ..�:.. ,«--.xze..eJa-.ri'+e-3vr^?^_^'.n'sba-mm•«-«xMu}6:.A+Weve�hvr.,v¢.'a�- Yn. rtcssm msm¢rvw_.mz^.a��-atc**+a-mmme,�-.ca. mrca�-.- y }�Yx ,J lur ..a s. . .. x • i M1v" ba.y[n -.r . vi. . . ,...>.a+.. FILE NUMBER: N1473800-0090ff. =fiawn Of SOUTHOLD; SIIFFO>i;t"County LEAD ",GFNCY: 473800 'form of SOUTHOLD, SUFFOLK County � OFf TCI: or BOARD: Planning Board CLASS:. T Unlisted 111'12: S. von der Schulenburg Type 1 1;1:SCl?:::P-'ION: Lot Line change to subtract .75 of an ac Lrom a 4 . 21 ac parcel « ' j add to 3 . 24 ac parcel l.oc E End Rd. BATE 1UHCE1VED:' - y Negative Declaration 10/14/9" ,TAIL'S: N ?!` Normal. Void . Z 'e Conditioned Rescinded IMPORTANT» File Number: N1-473800-00908 00 Use the above number in all correspondence about this action! LTo the Lead Agency: The above information. confirms that filings on the described ard, Ant4g1 ed, , "1,1'1P T SEQR Repository on^the date(s) shown in the box headed DATE RECEIVED above. The date and time ,in the second line show when this document was printed. Please check the information above carefully. For corrections or questions contact Charles Lockrow, (518) 457-2224, or write to: SEQR Repository NYSDEC Division of Regulatory Affairs 50 Wolf Road, Room 514 Albany, NY 12233 GC o� 1 Town of SOUTHOLD 1`8 " e � Planning Board 53095 Main Road-P.O. Box 1179 Southold, NY 11971r.3YE PUBLISHER'S CERTIFICATE State of Connecticut ) i County of New London, ss. New London On this 19th day of October A.D. 1994, personally appeared before the undersigned, I is a Notary Public, within and for said County and State, EGAL , "59d Tov3n of Seo hold I' J. L. Zielinski, Legal Advertising Rep. V. M 77t! " of THE DAY; a daily ::A ; : :::I21 newspaper published at New London;County: of New i' New London, State of.Connecticut, vvhoibeing duly sworn, i states on oath, that the Order of Notice in the case of � Legal Ad. # 594 t— Ems, a true copy of which is hereunto annexed, was published in said newspaper in its issues of the 13th days of October A.D. 1994. Subscribed and sworn to beCe me this 19th day of October A.D. 19,94; ,.� Notary Public. Ci ulz�v'D a^`�,nzi $ YANNOULA T. 'BALLASSI Ptno":(� fUa P6, NOTARY PTT$LIC I MY COMMISSION EXPIRES DEC. 31, 1897 i STATE OF NEW YORK) ) SSr COUNTY OF SUFFOLK ) \blli�i ofPidiliilw .. � � � \ r'. !• ! ! !n , �1 \ � of Mattttuck, :1 I• , ! .'.: in said County,being duly sworn,says that he/she is .. ' !•.I�! : . IIS b. .In.• ..:L:L..,! I,i„:1 !!. II:.:! !!.•...! .. Principal Clerk of THE SUFFOLK TIMES, a Weekly A.\, }. ! ,,, , , Newspaper; published at Mattituek, in the Town of Y, ! ! Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly public ed in said w! , ! Newspaper once each week for weeks commng on the day of Inl.!nru.'I 6:u;iuo.., 'L:n.rl:•” - {,`HR!ISTINAVOLLINSKi �I' 1 ' II II :, 1'i •'i•I:i:j r' Notary Public,State o New York ! ! W. a . •I 11•: : .:: No.5004884 Principal Clerk �\ I 1 !1. 11 ! •'I lila: Qualified in Suffottkk County { Ai/. Commission Expires November 23,t 1� .!1 .. .. .• i 1.: , ..'.:.1.1:.••i �' Notary Public .�. !. 1 A 1•,. } r� r .., Sworn to efore me this u .rl'j rr ,, 1�1: Ir h�unl ,k; i}}dG4'\,ynl Poh.(;pr:;n day Of�� 9 19•rA. .l;!l:.•h l vl!gh iA !A4\i:q!\!.11.1'ar �a vxvnxVt• 111L'.s t m>':�^• �-^•'•v.s��x: .,<.•..+�m. �...-R. � _.__ - PLANNING BOARD v' Richard G.Ward 4 chairman i � 8099•-tT013" - s•.;•� COUNTY OF SUFFOLK I., vOI Cli� p g" sbodreei rII (:\ } f STATE OF NEW YORK ss:, \ol I1a o: 11011:': 1leal 1113ollill :1(11'11+� t)iCr).11Z liIn 1111 ar.': h� Iund F \01 ICF Is I IEh1 M u u" (`ill61Inel1, ol• 6,1% u•: �f CI1Li\ ,Thin (iirnla!luulilb> P, om R.1>: Patricia Woad , being duly sworn, II(?hG-bol IIIA ION II I.iHa.'b. .1i lha)(o•I h) laird a(w• says that she is the Editor, of the s', a IlIt h Il u:In- N ill i+a held l u 1111 11cI 1"111 Pan i:. TRAVELER-WATCHMAN, a public ' h) I.la, izotil1old IuNn,Pl,n Hold nul+Iia newspaper, printed at Southold, in Io; Suffolk Count ;un 11;11+i (" 11,1111 I y and that the notice H dl V 1111 hull Suu:huld „ of which the annexed is a printed' \1 + lolk insaid ,ltmn uu ,. r1 c 111 'a! 1\ of OCI p1+ I " 1'1111(1 511•+.:111 I l(•Id de. Copy, has d>aen published in said Int Traveler- atcfiinan once each week 1111 nhio " on I I�h:a, • Itil Incllu(an of nonl +ol I for �. . . . . . . , . .weeps 6, 111 I.\I ,MIIMA,lN4ll',I '�: -vilw iu I ':1 1, of"u, d 1"�� r ► �1 I \umhal succe vely, commencing on the wi"minui .0 d a I4ro r� Iy+I " (1:Il1aaI • soul', ,Ilh'�>pI`oluiIl.r:il N ISS I lulm I I' In 1511( ;I Y '. a u-01h ... Ii hi u i I Ild till! I nol(I. 1oN 11 0l>ou u)J' t I((t11 ''; 111)1 b, 'I r <I lkM ol. da of . � � (1+11'llla 01 1 IIl Sid 1 r)l i�l liy 11 M1'°Ia JI for', I\•; a)II Illy y . „ I til N lurk. SI 111111 ('uu,i,i �• nr yd •111111 ('1,1 b, Rhr k 1y'I , \111 �\ In h I II �I liid �,arnn I ou Iha 1000 i.�. I ; p moil hl+ :'i bl I lfd ,u l+ o- { h (yup la I I? )ululd ; ' I{Iullill'ol�\1•II r.'ai I .11111 on 1h:.,Iiol h b) I'wii ,l uic 14)11 I ( i,'iuoll'IiN1�b h, ;,an1l 7.':i+I IJIII Jl> l"l lir a)'I III ii .ha " I. { IfuiN„ (SII fonn111a ail \Illlar. land I oN aI a ulnafl 1)111((11,<) 111111 AC. 1991 4l) u>uu11n. I l III ' ru N"' Glil tOI:I)1 It'1',)I I"I'll. "I(ilnlalla ul I luull ,un. ; a9 11101 I) I('A% Swo to before me on this it l d-litm i Iolluuh'o. \:: �1'I f✓ �,da of nuns ! . Ian( I7oN uI l'oi ll el • ' y I � s h'Ia ill loin'. ha 1 1111 IIQN'lo t, L!i4f �'I(il 11111, it l I1ll hak 1 r • ' I\ III 'I 9111) v ) r'I'Lrd ' nuN uI 10 111 'fla"dp,,� . . . . . . . . . . . . .� . . . . . . . . , 19�/ •\nn oi:kum I rd ,)I Solllllold: oll Ilia"ailNl Ii \luill li;l)IIdN Ro;iNild M land nomL',?1 Rind nua • orloloi to < t✓ 1 %,tiuu:holda ile:!)i,l: `:,I. • • • • • . on lhapa:I h> tiou;h;llu'ho Notary Public o Bund. F bh; BARBARA A. SCHNEIDER uc•lw NOTARY PUBLIC,State of New York h(u m 1111 I 1111 uryl(i'ti d I( No. 4.306846 Qualified in Suffolk Col •.\�,u) .111,1. \, (x)11:.11•\L.I Commission Expires 6' 31 96 Iii,Iitei l6t%n ,oi ;io,i.huld;. (;ou11l\.uf lu;'t i)!A: (11111 jo l' R:1\aN VA'. Sli:'li+fk'.(,ir.u! a lax Nli n \u i1,`•I• gg�s gg?� y 11)1111I2(i �-_ ,\° :x. Rdt¢ S LS T r ( c� I' 11 U OU I A 1994 11 1 ( ' I S0J3Bi0LO T0S'tff ` i ANN➢N6 60AR0 ' PLANNING BOARD MEMBERS ,.; Richard G. ward, Chairman Town Hall,53095 Main Roa i Georga Ritchie Latham,Jr. r P. O.Box 1179 i< Bennett Orlowski,Jr. r !W1 Southold,t4ew York 11971 Mark S.McDonald <� Fax(516)765-3165 Kenneth L Edwards Telephone.(516),765-1938 i PLANNING BOARD OFFICE I. TOWN OF SOUTHOLD ti October 4, 1994 i r . Stephen L. Ham, III Matthews and Ham 45 Hampton Rd. Southampton, NY 11968 Re: Lot line change for Susanna von der Schulenburg and Henry L. King & Margaret 0. King SCTM# 1000-5-2-10.8 & 10.9 Dear Mr, Ham: The following-resolutions were adopted by the Southold Town Planning Board at a meeting held on Monday, October 3, 1994: BE IT RESOLVED that the Southold Town Planning Board, acting under the State Environmental Quality Review Act, established itself as lead agency, and as lead agency makes a determination of non-significance and grants a Negative Declaration on this Type I action. BE IT RESOLVED that the Southold Town Planning Board set Monday, October 24, 1994 at 7: 40 p.m. for a_final public hearing on the maps.dated July 5, 1994: Enclosed please find a copy of the Negative Declaration for your records. Sincerel Richard G: Ward Chairman enc. PLANNING BOARDMEMBERS 44 Richard G.ward, Chairman , Town Hall,53095 Main Road George Ritchie Latham,Jr_ P.O.Bpx.1179 Bennett Orlowski„Jr. Southold,hlewXork 11971 Mark S McDonald � ,` ri• . :�,� Fax(516)7653136 . Kenneth L Edwards Telephone(516)765-1938. PLANNING BOARD OFFICE' TOWN OF SOUTHOLD State Environmental,Quality Review NEGATIVE,DECLARATION Notice of°:Dei ermination Non-Significant October 3, 1994 This notice is issued pursuant to Part 617 of the implementing ,regulations,. pertaining to Article 8 (StateL Environmental Quality Review Act) of the Environmental Law: The Southold Town Planning. Board, as lead agency, has determined that the proposed action described below will not have a_signifiicant effect on the environment and a Draft Environmental'. Impact Statement will not be prepared. Name of Action: Proposed lot fine change for Susanna von der,Schulenburg and Henry L. King & Margaret G. King SCTM#: 100075-2-10.8 & 10.9 Location: East End Rd., Fisher's Island i' SEQR Status: Type I ( X ) Unlisted, ( ) Conditioned Negative Declaration: Yes ( ) No ( X ) Description of Action: This proposed lot line change is to subtract .75 of an acre from a 4.21 acre parcel; and add it to a 3.24 acre parcel. Page 2 SEQRA Negative Declaration-von der Schulenburg & King October 3, 1994 Reasons Supporting.This Determination: Both lots are conforming in area. This change will, increase the size and width of the smaller conforming lot so they both are more in keeping with the R420 zoning in this area. There has not: been any,correspondence from the New York State Department of Environmental Conservation in the allotted time. Therefore, it is 'assumed that there are no comments or objections from that agency. The applicant witl,.have to comply with the requirements of the,Suffolk County Sanitary Code (SCSC) and all relevant standards of water supply and .sewage disposal systems_ Design and,flow specification, subsurface soil conditions and site plan details will have to be approved by the Suffolk County Departmentof Health Services (SCDHS). This, impact is not con si dered,significant due to the anticipatedproject compliance with establishedjequirements of the SCSC and the "SCDHS and the required relevant permits. For Further Information: Contact Person: Robert G. Kassner Address* Planning Board Telephone Number: {516) 765-1938 cc: Langdon Marsh, DEC Albany Suffolk County Dept. of Health Suffolk County Planning Commission Judith Terry, Town Clerk Southold Town Building Dept. Southold Town Zoning Board of Appeals Fishers island Water Company Applicant F.'I.D. C.O. CHANDLER, PER & KING LETTEROF eTR1%HN&NV&1 y� R Architecture, Engir' Ing 5. Surveying. 110 BROADWAY NORWICH CONNECTICUT 06360-4452JOeNn g� — PH. 203-889-3397 FAX 203-886-790T 9SePt . 16, 1994 ATT��nl!T�ION Robert Kassner Planning Board TO Town of Southold VonderSchulenberg/King, Main Road Fishers Island, NY Southold, NY 11971 i' 3 WE ARE SENDING YOU ® Attached ❑ Under separate cover via the following items: �` ❑ Shop drawings ❑ Prints ❑ Plans h [I Samples ❑ Specifications �{ ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 6 Prints of Lot Line Change Plan THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit_copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return_ corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS These are sent at the request of Steve Ham. r f Liu E " s ° �y}±OCGTzt 4l sus Aa ROARD,'.ROARD COPY TO i SIGNED: Richard H. Strouse it N B00298].FDB B4038.EP5 ffendosures are not as noted,immynotfy us at once. '. . i %z PLANNING BOARD MEMBERS Richard G.Ward, Chairman R � } �_ " Town Hall,53095 Main Road George Ritchie Latham„Jr. P. o. Box 1179 Sennett Orlowski,Jr: , Southold, New York 11971 Mark S McDonald ` f` Fax(516)7653136 Kenneth L Edwards Telephone(516)765-1936 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Re: Lead Agency Coordination Request Dear Reviewer: The purpose of this request is to determine under Article 8 (State Environmental Quality Review Act-SEQRA) of the Environmental Conservation Law and 6 NYCRR Part 617 the following: 1. Your jurisdiction in the action described below; 2. Your interest in assuming the responsibilities of lead agency; and 3. Issues of concern which, you believe should be evaluated. Enclosed please find a copy of the proposal and a completed Environmental Assessment Form (EAF) to assist you in your response. Project Name: ST v,,if ice. 04, 71CiYRXL.YJV7'6 ozr?P.-gl C—. tCir/ Requested Action: o7- SEQRA Classification: ( Type I O Unlisted Contact Person: !�% Ssi-1,e5l�F (516) 765-1938 Paget Lead Agency Coordination Request The lead agency will determine the need for an environmental impact statement (EIS) on this project, Within thirty (30) days of the date of this letter, please respond in 111 writing whether or not you have'an interest in being lead agency. Planning Board Position: I ( } This agency>wishes.to assume lead agency status for this action_ ( ) This agency has no objection to your agency assuming lead agency status for this action. Other (see comments below) Comments: Please feel ee to contact this office for further information. $iQc rely, !/ ar G.-"Ware Chairman cc: Beefd--ef-Appeals `Board of Trustees Building Department Southold Town Board Suffolk County Department of Health Services NYSDEC - Stony Brook NYSDEC - Albany Suffolk-County-gepartrrteat-of-Public-Works U-.S---A-rmy-C-orp-of-Engineers. New-York-State-Department-of-T-ransportation- *Maps are enclosed for your review rev. 4/94 e 1416-2 (2187)-7c 617.21 � SEQR 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 acttonrtray be'significa�t is hot always easy toanswen Fieque)rt-. ly, there are aspects of a project that, aresth ubjece or unmeasufeable= If is a(sp'understood thatthose who determine ignificance may have little or no formal knowledge of the ehvlronmerft or may be technically expel Sri efivironmental analysis.In addition,many who have kq"kOge in one partfculaX.atea rjaya of eaware of hehraader concfam affectjhg the question of significance. The fall EAF is intended to,provide,a method whereby applicants and agencies can be assured that-,the determination` processha`s beenbrd'er`ly;comprehensive in nature,yet flexible to allow introducd6h of informatton toflte projector action. - -Full EAF Compornents The full EAF is comprised of three parts: I, f Pat] ,Pnrvtdes obaect ve da as and information about a given project,arfdfits site, By Mentif mg �t 5 e,project I daEa;rC a° QCs a°reviewer in the analysis that takes place in Parts 3 and 3. Part? Focuses on: id"tifyrng the range of possible impacts that may oddur from a:project or acfiorr tt provides guidance as to whether an impact is likely to be considered small s knod`crate orWbetfiJtisa.potenttaily- large,.7fir`pa.ct, Thg £obm.also,identifjes whethet. an impact can b "1,rifigaitedioreducel?;. fa e • r Part 3, If An airtpact in Part,2 is identified as potentially large, then Part03i used to eya uate et,or.not the impact rs acteally 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 magitude and importance of each impgct, it is reasonably determined by the lead agency that: ❑ A. The project will not result in any large and important impact(s)land, 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 notbe 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 legative 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 Agerncy Signature of Preparer(If different from responsible officer) i !I �. Date -PART 1—PROJECT iNFORMATi,, `N 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 may be subject to further verification and public review. Provide any additionaic information you believe will be needed to complete Parts 2 and 3. 4 It is expected that completion of the full EAF will be dependent on information currently available and will not involve j new studies, research or investigation. if information requiring such additional workisunavailable, so indicate and specify each instance. NAME OF OFACTION .Lot Line Chane for HenryL. King & Margaret G. King and Susanna von der Schulenbur LOCATION OF ACTION(Include Street Address, Municipality and County) - - East End Road Fishers Island Town of Southold County of Suffolk NAME OF APPLICANTISPONSOR BUSINESS TELEPHONE. Stephen L. Ham III as authorized agent (516 )283-240o ADDRESS 516)28 -2400 ADDRESS - - 45 Ham ton Road CITY/PO .STATEZ1P CODE Southampton NY 11968 NAME OF OWNER(if different) BUSINESS TELEPHONE Susanna von der Schulenburg (516 )283`-2400 ADDRESS c/o Matthews & Ham, 45 Hampton Road CITY/PO STATE ZIP CCO'E Southampton NY 11968 DESCRIPTION OF ACTION - lot line change between two properties (SCTM`#`s 1000-5-2-10.8 & 10.9) to be effected by the transfer of a .75-acre parcel from tax lot 10.8 to tax lot 10.9 i Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and Undeveloped areas. l 1. Present land use: ❑Urban ❑industrial ❑Commercial ❑Residential (suburban) ®Rural(non-farm) ❑Forest ❑Agriculture ❑Other 2. Total acreage of project area: 75 acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) .75 acres 7F acres Forested acres. acres - Agricultural (Includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres Water Surface Area acres acres Unvegetated (Rock, earth or fill) acres acres Roads, buildings and other paved surfaces acres acres Other (indicate type) acres acres 3. What. is,predominant soil:,type(s) on project site? Riverhead .sandy loam - a. Soil drainage: ❑Well drained 100 % of site ❑Moderately well drained of site ❑Poorly drained % of site - - b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? NZA_ acres. (See 1 NYCRR 370). 4. Are there bedrockoutcroppings on project site?. EYes EXNo ,_a.. What Is depth to bedrock? c- 6nn (in feet) r 2 5. Approximate percentage of.,pro ry,. dprol' t' � `i � uh-slopes °/a,..: .''Olo ' C1-€095^/n' off:greater - - % a- em. 6. Is project substantially contiguous to, or, contain ,a budding,= site, or. distract, listed on the State or the National Registers of HistoricPlaces? 'OYes C'No 7. 45 project substantially contiguous to a site listed on the Register of National Natural Landmarks? Oyes ONO 8. What is the depth of the water table? ?17 (in .feet) y 9. Is site located'over a primary, p ridpal, or sole source aquifer? - Eyes ONO 10. Do hunting, fishing or shelf fishing opportunities presently exist in the project area? ®yes ONO 11. Does project^sitecontain any„species of plant or animal life that is identified as threatened or endangered? OYes X]No According to Identify each species 72. Arg these any, unique-or unusu�k la.n Jorms on the project site? (i.e,, cliffs, dunes, Other geological formations) IXYes Dt4p Describe - cliff's 11. Is the project site presently used by the community or neighborhood as an open space or 'recreation area? Dyes X]No If yes, explain 14. Does the present site include scenic views known to be important to the community?, Dyes ffN0 15. Streams within or contiguous to project area: none a- Name of Stream andnameof River to which it is tributary N 16. Lakes, ponds, wetland areas within or contiguous to project area: - a. Name none b. Size (in acres) 17. Is the site served by existing public utilities? Eyes ONO a)if Yes, does sufficient capacity exist to allow connection? ®Yes ONO b) If Yes, will improvements be necessary to allow connection? OYes ONO 18. is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? OYes MNo 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 ONO 20. Has the site ever been used for the disposal of solid or hazardous wastes? OYes 1ZNo 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 7.45 acres. b. Project acreage to be developed: 0 acres initially; 0 acres ultimately. c. Project acreage to remain undeveloped 7:25acres. d. Length of project, in miles: N/A (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed N/A %; C Number of off-street parking spaces existing ----NZA—; -proposed N/A g. Maximum vehicular trips generated per hour N/A (upon completion of project)? h. If residential Number and type of housing units; One Family Two Family Multiple Family . Condominium initially one* to Ultimately two* i. Dimensions (in feet) of largest proposed structure N/A height; NIA width; N/A length. j.Linear feet.of frontage along a public.thoroughfare project will occupy is? 400* ft. *on both contiguous par cels (tax lots 10,8 and 10.9) �e� 2. How much natural material (i e:,_ock, earth, etc.) will be removed from ttre'Site? n tons/cubic yards 3. Will disturbed areas be reclaimed? Dyes ONo QN/A a. If yes, for what intend— purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? Dyes K]No c. Will upper subsoil be stockpiled for reclamation? ❑Yes klNo Ill. 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? 0 acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? Dyes 41No 6. If single phase project: Anticipated period of construction N/A months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated N/A (number). b. Anticipated date of commencement phase 1 N/A month N/A year,lincluding demolition). c. Approximate completion date of final phase N/A month N/A year. d. Is phase 1 functionally dependent on subsequent phases? ❑Yes ONo N/A 8. Will blasting occur during construction? ❑Yes [No 9. Number of jobs generated: during construction N/A after project is complete NIA 10. Number of jobs eliminated by this project N/A 11. Will project require relocation of any projects or facilities? Dyes L2No If yes, explain 12. Is surface liquid waste disposal involved? ❑Yes 21No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount II b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? ❑Yes rClNo Type 14. Will surface area of an existing water body increase or decrease by proposal? Dyes UNo Explain 15. Is project or.any portion of project located in a 100 year flood plain? XJYes ONo 16. Will the project generate solid waste? ❑Yes ®No i j.: a. Ifyes, what is.the amount per month tons b. If yes, will an existing solid waste facility be used? ❑Yes ❑No c. If ryes, give name location - d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ❑Yes ❑No i, e. If Yes, explain 17. Will the project involve the disposal of solid waste? Dyes [No a. If yes, what is the anticipated rate of disposal? tons/month. b. If yes, what is the anticipated site life? years. a 18. Will project use herbicides or pesticides? Dyes MNo 19. Will project routinely produce odors (more than onehour per day)? Dyes L�No 20. Will project produce operating noise exceeding the local ambient noise levels? Dyes ONo 21. Will project resultin an increase in energy use?. Dyes nNO I If yes , indicate type(s) 22. If water:supply is from wells, indicatepumping capacity N/A gallons/minute. 23. Total anticipated water usage per day N/A gallons/day. 24. Does project.involve Local, State or Federal funding? Dyes X)NO - If Yes, explain i- 4 25. Approvals lZe4 red: Submittal Type Date City, Town, Village Board Dyes ONO City, Town, Village Planning Boaid ®Yes ONO lot line change 7-25-94 City, Town Zoning Board Dyes NNo _ City, County Health Department',' Dyes 1XN0 Other Local Agencies OYes ERNo Other:Regional Agencies Dyes MNo State Agencies Dyes fNINo Federal,Agencies, ❑Yes ❑No C, Zoning and, Planning Information- 1 _ Does proposed action involve a paan ing or zoning:decision? CAes DNS If Yes, indicate decision required' ❑zoning,amendment ❑zoning variance Ospecial use permit_ ❑subdivision Osite plan ❑new/revision of master plan. ❑resource management,plan Uother lot line change 2. What is the zoning,classification(s)of the site? R-120 single family residential 3. What is,the maximum potent?;al development of the site if developed as permitted by the present zoningi one single-family dwelling w/ accessory structures on each of tax lot 10.8 and 10.9 4. What 'is the proposed iopning of the site? same 5. What is the maximum,potentttal development of the site if developed as permitted by the proposed zoning? 6.- Is the proposed'acffon consistent with the recommended uses in adopted local land use plans? 9Yes ONO C' 7_ What are the predominant lard use(s) and zoning classifications within a 1/ mile radius of proposed action? R-120 sYii'gle=family residential 8- Is the prop©sed action compa0bfe with adjoining/surrounding land uses within a 1h mile? [ Yes ONO 9. If the proposed action is the subdivision of land, how many lots are proposed? N/A a. What is the minimum got size proposed? N/A 1 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? Dyes _M]No 11 . Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? Dyes X']No a. If yes, is existing capacity sufficient to handle projected demand? Dyes ONO 12. Will the proposed:action result in the generation of traffic significantly above,present levels? ❑Yes LNNo a. If yes, is the existing road network adequate to handle the additional traffic? Dyes ONO 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 andthe measures which youpropose to mitigate or avoid them. E Verification I certify that the information rovided above is true to th best of my knowledge. Henry E King & Margaret G. Ing Applicant/Sponsor Name Sus"aLa von der Schulenburg Date July 22, 19914 Signature L• [Tt2c ZZ- Title authorized age �3Tepnerr v. na¢, nt llt 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 Part 2—F'�DJECT IMPACTS AND THEIR r-7 NITUDE 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 anaIvsL •-Identifying that an impact will be potentially large (column 2) does not mean that itis also necessarily significant. Any large impact must beevaluatedin 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 examoies 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. Answereach 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 butthreshold 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 isnot possible' This must be explained in Part 3. - - ' 1 . 2 3 Small to Potential Can Impact Be IMPACT ON LAND Moderate Large Mitigated By Impact Impact Project Change 1 . Will the proposed action result in a physical change to the project site? ENO DYES Examples that would apply to column 2 • Any constructionon slopes of 15% or greater, (15 foot rise per 100 ❑ ❑ Dyes ❑N'o footoflength), or where the general slopes in the project area exceed l0% { • Construction on land where the depth to the water"table is less than ❑ ❑ Dyes ❑No 3 feet. • Construction of paved parking area for 1,000 or more vehicles. ❑ ❑ Dyes ❑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 ❑ ❑ 1:1 Yes ❑No than one phase or stage. • Excavation for mining purposes that would remove more than 1,000 ❑.. ❑ El Yes El No tonsof natural material(i.e., rock or soil) per year- Construction or expansion ear.Constructionorexpansion of a sanitary landfill. ❑ ❑ ❑Yes ❑No `, • Construction in a designated floodway. ❑ ❑ Dyes ❑No. j • Other impacts ❑ Q Dyes ❑No 2. Will there be an effect t.. _..ry u;:.que or unusual land forms found on the site?(i.e., cliffs, dunes, geological formations, etc.)ONO ❑YES' • Specific land forms: ❑ ❑ El Yes ❑No 6 a4, i I ^, Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact i Project Change •' 9 '4r6posed Action may cause substantial erosion. ❑ ❑ ❑Yes No • Proposed Action is incompatible with ,existing drainage patterns. ❑ ❑ PYes ONO t-'s "Proposed Action will allow devehopment in a designatedI fl'oodway. EJ ❑ El ONO • Othet impacts: ? '' ❑ ❑ ❑Yes, ONO IMPACT ON AIR 7: Will proposed action affect air cjuality? ONO DYES Examples that would apply to column.2 __ • Proposed Action will indooe 1"t30, or^more vehicle trips in any given ❑ ❑ El Yes ❑No' hour. • Proposed Action wilt resdlt in the incirfferation of more than 1 ton of ❑ ❑ ❑Yes [I No refuse per hour. • Emission rate of total contaminants wlfl exceed 5 lbs. per hour or a ❑ 0 El Yes ❑No heat source 'Producing more than 10 million BTU's per hour. • Proposed acfian will allowian increase in the amount of land committed ❑ Q ❑Yes ONO to industrialf'use. • Proposed action will allow an increase,in the density of industrial ❑' ❑ ❑Yes []No idevelopment within existing industrial areas. • Other impAts: ❑ ❑ El Yes 13 No I (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 o one or more species listed on the New York. or Federal ❑ ❑ El Yes ❑No list, using the, site, over on near site or found on the site. • Removal of any portion of a critical or significant wildlife habitat. ❑ ❑ ❑Yes ONO 1 • Application of pesticide or herbicide more than twice a year, other ❑ ❑ Dyes ❑No than for agricultural purpdses. • Other impacts: ❑ ❑ ❑Yes El No i I 9. Will Proposjd Action substantially affect non-threatened or non-endang ed species? 1 ONO DYES Examples th t would appfjy to column 2 • Proposed Acon would substantially interfere with any resident or El ❑Yes ENO migratory fish shellfish or 'vildlife species. • Proposed Action requires. the removaf of more than 10 acres ❑ ❑ OYes ❑No of mature 1`4,st (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES' 10. Will the Prosed Action affect agricultural. land resources? ONO DYES Examples the t would apply to column 2. The proposed action would sever, cross or limit access to agricultural ❑ ❑ Dyes ❑No land (includes Icropland, hayfields, pasture; vineyard, orchard, etc.) ` 8 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) ❑NO DYES Examples that would apply to column 2 • Developable area of site contains a protected water body. ❑ ❑ C1 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. ❑ ❑ El Yes ❑No • Construction in a designated freshwater or tidal wetland. ❑ ❑ []Yes ❑No • Other impacts: ❑ ❑ El Yes El No 4. Will proposed action affect any non-protected existing or new body of water? ONO DYES ` Examples that would apply to column 2 • A 10% increase or decrease in the surface area of any body of water El El ❑Yes [:]No or more than a 10 acre increase or decrease. • Construction of a body of water that exceeds 10 acres of surface area. ❑ ❑ ❑Yes ❑No • Other impacts: ❑ ❑ ❑Yes []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 discharge permit. ❑ ❑. ❑Yes ❑No C • Proposed Action requires use of a source of water that does not ❑ ❑ ❑Yes ❑No have approval to serve proposed (project) action. • Proposed Action requires water supply from wells with greater than 45 ❑ ❑ ❑Yes ❑No gallons per minute pumping capacity. ". Construction or.operation causing any contamination of a water ❑ ❑ ❑Yes ❑No. l supply system, f; • Proposed Action will adversely affect groundwater. ❑ ❑ ❑Yes ❑No • Liquid effluent will be conveyed off the site to facilities which presently ❑ ❑ El Yes ❑No do not exist or have inadequate capacity. • Proposed Action would use water in excess of. 20,000 gallons per ❑ ❑ ❑Yes ❑No t day. ' • Proposed Action will likely cause siltation or other discharge into an ❑ ❑ El Yes ❑No t, 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 productsgreater than 1,100 gallons. • Proposed Action will allow residential uses in areas without water ❑ ❑ Dyes ❑No and/or sewer services. 'r Proposed Action locates commercial and/or industrial uses which may ❑ ❑ ❑Yes ❑No require new orexpansion of existing waste treatmentand/or storage facilities. M, • Other impacts: ❑ ❑ El Yes ❑.No a 6. Will proposed action alter drainage flow or patterns, or surface water runoff?. LINO ❑YES Examples that would apply to column 2 *'Proposed Action would change flood water flows. ❑ ❑ ❑Yes ❑No w„ 1 2 3 Small to Potential Gan Impact Be Moderate Large Mitigated By " Impact ' Impact Project Change • Construction activity would excavate or compact the soil profile of ❑ ❑ ❑Yes ENO agricultural land., ',e The proposed ackion would irreversibly convert more than 10 acres ❑ ❑ QYes ❑No of agro-cuttural land=or, if located in an.Agricultutal District; more than 25 acres ofagriculturalfared II • The proposed act"fon would disruptor prevent installation of agricultural ❑ ❑Yes []No k land management systems,(e g., subsurface drain lines, outlet ditches, strip croppingl; or create;a,need for such measures(e.g. cause a farm field to dr; m poorly duel.to increased runoff) • Other im n❑ El ❑'Yes [:]No1 . per . . IMPACT ON AESTHETIC RESOURCES, 11. Will proposed action affect aesthetic resources? ONO DYES (If necessary, use thevV-sual EAF Addendum in Section 617.21, Appendix,8:). -.... Examples,that would appiy to column 2 • Proposed land uses, or pSotect components obviously different from ❑ ❑ ❑Yes ❑No or in sharp contrast to current surrounding land use patterns, whether man-made of natural. E • Proposed land uses, or,project components. visible. to users of ❑ ❑ 1:1 Yes ❑No aesthetic resources which{,will eliminate or significantly reduce their enjoyment of the aesthetij qualifies of that resource. • Project components that Evill result in the elimination or significant ❑ ❑ ❑Yes ❑No screening of scenic views known 'to be important to the area. • Other impacts: ❑ ❑ []Yes ❑No r i I IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will:Proposed Action in�pact any site or structure of historic, pre- historic or paleontological importance? ONO DYES Examples that would aply to column'2 Ifi]} 1 • Proposed Ac ion occurrin wholly, or partially within or substantially ❑ ❑ Dyes ❑No contiguous to,anyfacility of site listed on the State or National Register of historic places i4 • Any impact to an archaeological site or fossil bed located within the ❑ ❑ ❑Yes ❑No it project site. h • Proposed Action will occur in an area designated as sensitive for ❑ ❑ ❑Yes' ❑No archaeological sites on the NYS Site Inventory.. - - f • Other impacts: ❑ ❑ El Yes ❑iuo 1 r' IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantityorquality of existing or future open•.. spaces or recreational opportunities? Examples that would.apply to column 2 ENO DYES C • The permanent foreclosure^of a future recreational opportunity. ❑ ❑ El Yes ❑No • A major reduction of an open space important to the community. ❑ ❑ ❑Yes []No • Other impacts- ❑ ❑ ❑Yes ❑No 9 4 i u� 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 thecharacterof the existing community? 1[npact Impact Project Change ONO OYES y Examples that would apply to column 2 • The permanent population of the city, townor villagein which the ❑ ❑ ❑Yes 11 No project is located is likely;,to grow by. more than 5%_ • The municipal budget for capital,expenditures or operating services 11 fl []Yes ❑No will increase by more than 5p'a per year as a result of this project. • Proposed action will conflict wftb'officially adopted plans or goals. ❑ ❑ El Yes ONO • Proposed action Will cause a change in the density of land use. ❑ ❑ ❑Yes []No • Proposed Action will replace or eliminate existing facilities, structures ❑ ❑ []Yes ONO or areas of hfsWric",importance tome community; • Development*will:createa demartdforadditionalcommunity services ❑ ❑ ❑Yes ❑No (etg. schools, poJite and flue,-etc) • Proposed Actiot),wild set an important precedent for future projects. ❑ ❑ El Yes El No • Proposed fiction will create or eliminate employment. ❑ ❑. ❑Yes ONO • Other'., impacts,, - ❑ ❑ ❑Yes 0 N 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? ONO OYES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 Part 3—EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be:prepared if one or more impacts) is considered to be potentially targe, even if theimpact(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 • Itspotential divergence from local needs and goals • Whether known objections to the project relate to this impact. (Continue on attachments) 17 a F 1414?i(2187) 9c6 1721 Appendix rid 1 � un , A3 StEririr�oe�rrr , enai Quality Kiev%ew Visual EAS Addendum This form may be used to provide additional information relating to Question 11 of Part 2 of the Full EAF. (To be completed by LeadAgency) Distance Between Visibility Project and Resource (in Miles) 1. Would the project be.-visible from: 0-1/4 1/a-%2 1/2-3 3-5 ' 5+ • A parcel of land which is dedicated to and available ❑ ❑' ❑ ❑ ❑i to the public for the use, enjoyment and appreciation `of natural or rrYdn made-scenic qualities? • An overlook or.'parcel of land dedicated to public ❑ Q Q ❑' ❑, .: o-o'`"rvatian, enjoyment and appreciation of natural or man-made scenic qualities? • A, site or structure,listed on the National or State El El El E]Riegisters of Historic Places? • State Parks? ❑ ❑ ❑ ❑` ❑ • The State Forest Preserve? ❑ ❑ ❑ [Q ❑ • National Wildlife Refuges and state game refuges? ❑' ❑ ❑ Q ❑ • National Natural Landmarks and other outstanding ❑ ❑ ❑' ❑ ❑ natural features? • National Park Service lands? ❑ ❑ ❑ 0 ❑ • Rivers designated as National or State Wild, Scenic ❑ El El 0` C7 or Recreational? • Any transportation corridor of high exposure, such ❑ ❑ ❑ C7 ❑ as part of the Interstate System, or Amtrak? • A governmentally established or designated interstate ❑ ❑ ❑ ❑ or inter-county foot trail, or one formally proposed for establishment or designation? A site, area, lake, reservoir or highway designated as ❑ ` ❑ ❑ ❑ ❑ f scenic? • Municipal park„or designated open space?. ❑ ❑ ❑ Q ❑ • County road? ❑ ❑ ❑ ❑ ❑ • State? ❑ ❑ ❑ F-1 El • Local road? ❑ ❑ ❑ ❑ 2. Is the visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other seasons) ❑Yes ❑No 3. Are anyof the resources checked in question I used by the public during the time of year during which the project will be visible? ❑Yes ❑No i - T i DESCRIPTION OFEXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally describe the surrounding- ' environment. Within r *J/a mile *I mile \ @ Essentially undeveloped ❑ ❑ Forested ❑ ❑ Agricultural ❑ ❑ Suburban residential ❑ ❑ Industrial ❑ Commercial ❑ ❑ Urban ❑- ❑ River, Lake, Pond ❑ ❑ Cliffs, Overlooks ❑ Designated Open Space ❑ ❑ Flat ❑ ❑ Hilly ❑ ❑ Mountainous ❑ ❑ Other ❑ NOTE: add attachments as needed 5. Are there visually similar projects within: *1/2 mile EJ Yes ❑No *1 miles ❑Yes ❑No j *2 miles ❑Yes ❑No r *3 miles ❑Yes ❑No * Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is G FREQUENCY � Holidays/ Activity Daily Weekly Weekends Seasonally I Travel to and from work ❑ ❑ ❑ El Involved in recreational activities ❑ ❑ ❑ El Routine travel by residents ❑ ❑ ❑ At a residence ❑ ❑ ❑ ❑ ' At worksite ❑ ❑ ❑ El E' Other ❑ ❑ ❑ ❑ y k7 `. 2 z;! PLANNING BOARD MEMBERS Richard G ward, Chairman r Town Hall,53095 Main Road George Ritchie Latham„Jr. P.O, Box 1179 Bennett Orlowski,Jr. Southold,New York 11971 �t Mark S:ti McDpnald,- "4 � Fax{515)7653136 Kenneth L.Edwards Telephortz`(51S)765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD August 23, 1994 Stephen L. Ham, III Matthews & Ham 45 Hampton Rd. Southampton, NY 11968 Re: Proposed lot line change for Susanna von der Schulenburg and Henry L. King & Margaret G. King SCTM# 1000-5-2-10.8 & 10.9 I' Dear Mr. Ham: The following resolution was adopted by the Southold Town Planning Board at a meeting on Monday, August 22, 1994: BE IT RESOLVED, that the Southold;Town Planning Board, acting under the State Environmental Quality Review Act, start the coordination process on this Type I action. This is a Type I action because the property is located on Fishers Island. Please contact this office if you have any questions regarding the above. Sincerely, I Richard G. Ward It Chairman I �� 0UN7Y O"F SUFFOLK I p . {{' ROBERT J. GAFFNEY I SUFFOLK COUNTY EXECUTIVE fF DEPARTMENT OF PLANNING STEPHEN M. JONES. A.LC.P. - DIRECTOR OF PLANNING August 22, 1994 I Richard Ward, Chairman ' Town of Southold Planning Board JJJ Main Road. Southold, NY 11971 Plat Name: Subdivision Lot Line H & M Ring & S. Von Der Schulenburg Tax Map No. : 1000-5-2-10.8 & 10.9 SCDP File No.: S-SD-94-10 Dear Mr. Ward: Pursuant to the requirements of Section A14-24, Article %IV of the Suffolk County Administrative Code, the above captioned proposed final plat which has been referred to the Suffolk County Planning Commission is considered to be a matter for local determination; however, this shall not be construed that the Commission has either approved or disapproved this particular plat. Very truly yours, Stephen M. Jones Director of Planning SIB Frank Dowling, Principal Planner Subdivision Review Division FD:mb U9 2 31994 FUNNING BOAdi�l H.LEE DENNISON BUILDING ■ VETERANS MEMORIAL HIGHWAY ■ HAUPPAUGE. NEW YORK 11788 ■ ISIS) 653-5192 FAX (516)853-4044 i Fishers Island Development Corporation P.O. Drawer E Fishers Island, New York 06390 Robert B Calhoun,Jr. Thomas F. DoheItF, Jr. President Manager i August 8, 1994 Mr. Kenneth Edwards Southold Planning Boardn Southold TowHalf Southold, NY 11971 Re: King/Von Der Schulenburg-Lot Line Change Dear Ken, The Fishers Island Development Corporation has no objection to the proposedd`'lot` line change'6etween Henry & Margaret King and Susanna Von Der Schulenburg, per the plans of Chandler, Palmer & King, dated March 1, 1994. Shouldyou require any additional information, or have any questions or comments, please feel free to contact us at any time. Sincerely, Thomas F. Doherty Jr. Manager cc: R. Calhoun H. King 'S. Von Der Schulenberg CPK So'uthoki 'Plennmg Board I Ate 1 1 NK f Ox7rm"NG200AWMAD x PLANNING BOARD MEMBERS ` - i Richard G.Ward, Chairman Town Hall,53095 Main Road' �,` ,,+ r`� . + r Georgy Ritchie Lytham,Jr. ':� � _ P. 0,.:Box 1179 g Bennett Orlowski,Jr: Southold New Pori( 11971 ` Mark S.McDonald �{ Fax(516J 765-3136 Kenneth L. Edwards Telephone(5IE)75-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD 1 � 1,994 Suffolk, County Planning Commission H. Lee Dennison Executive Office Building - 12th Floor Veteron's Memorial Highway Hauppauge, NY 11788: Attention; Mr. Frank bowling, Senior Planner Subdivision Review Division Gentlemen: Pursuant to'Section A14-24, Suffolk County Administrative Code, the Southold Town Plannin' g' Board hereby refers the following proposed subdivision to the Suffolk County Planning Commission: �ussetre vast dot se ✓� YE�> :coicrc cf+ory�g,65 ' , Map of r �R7 G rn��v, � i to•P�Fr G Hamlet/Locality Y/Sl�6e S.C.D.P.W. Topo No.: Zoning to:Y_71l sirX rril KJ_/-z a S.C. Tax Map No.' 1000 - S - - [0 43 ri-- 16F / Major Sub. Minor Sub. Site Plan Cluster Lot Line Change ✓ MATERIAL SUBMITTED: Preliminary Plat (3 copies) I Road Profiles (1) Drainage Plans (1) Topographical Map (1) Site Plan (1) Grading Plan (1) Other materials (specify and give number of copies) Waiver of Subdivision Requirements - See attached sheet i/ Page 2 Southold Town Planning Board Referral Referral Criteria: SEQRA STATUS: 1. The project is an ( ) Unlisted Action ()C) Type I Action ( ) Type It Action 2. A ( ) Negative Declaration ( ) Positive Declaration ( ) Determination of Non-significance has been adopted by the Planning Board. 3. E.I.S. statement enclosed. ( ) Yes. ( ) No Comments: Ld S /•s 1 S L rE, aiy f"5/j1'e.CS .L 5 0 19- del l-1C`o•4L i'yYllXely.yFiril _e,2E (,L-, s 14� We request acknowledgement of receipt of this referral ( ) Yes ( ) No Referral received 1994 by the Suffolk County Planning Commission and assigned File No. Sincerely, `Q RicFiartl G. and t Chairman cc: Frank Cichanowicz rev. 6/94 i - July 22, 1994 I = I - Southold Town Planning Board Town Hall Southold; New York 11971 r Re: Proposed Lot Line Change for Henry L. King & Margaret G. King;, and Susanna von •der Schulenburg Gentlemen: (SCTM 9's 1000'-5r-2-10.8 & 10.9) The following statements are offered for your consideration in the review of the above-mentioned minor subd wisjon and its referral 'to the Suffolk County Planning Commission: (1) No grading, other than foundation excavation for a residential building is. proposed. (2) No new roads are proposed and no changes will be made in the grades of the existing roads. (3) No new drainage structures or alteration of existing structures are proposed. Yours truly, 77T- Stephen L.. Ham, III, authorized agent `I. MATTH WS & HA-Sf p ATTORNEYS AND COUNSELLORS AT LAW 45 HAMPTON ROAD SOUTHAMPTON,N.Y.11968 516-280-2400 PE 11.XATT8EN5 TELROONIER 516-287-1076 19 tt9t21HBEl �11 ri� Snr=B L.HAja - � .. a� a . July 25, 1994 Planning Board � Town of Southold XL2 C99 � Main Road 1-11 1 Southold, NY 11971 Re: Proposed Lot Li'n'e' Changc Proportes of Susanna von der Schulenburg and Henry L. King & Margaret G. King (SCTM #'s 1000-5-2-10.8 & 10.9) Dear Sirs: In connection with the referenced application for a lot line change, I have enclosed the followings, 1. Letters of authorization for Stephen L. Ham, III to act as agent for the applicants, Susanna von der Schulenburg and Henry L. King and Margaret G. King. 2 . Letter approving the lot line change and setting forth its purpose, executed by Stephen L. Ham, III. 3. Affidavit regarding merger, executed and sworn to by Stephen L. Ham, III. 4. Photocopies of deeds recorded in Liber 11366 page 25, and Liber 11683 page 273, I 5. Form letter regarding drainage, roads, etc. 6. Long Environmental Assessment Form. 7. Application for Approval of Plat. 8. Our check to the Town of Southold in the amount of $50. 9. Questionnaire, duly acknowledged, together with copies of three Certificates of Occupancy for tax lot 10.9. 10. Eight prints of the plan showing the proposed lot line change. Please review the enclosed documents and notify me immediately if, any further information or documentation will be required before you can begin your review of this application. Very truly yours, Stephen L. Ham, III Enclosures MATI!UEWS & HAWS ATTORNEYS AND COUNSELLORS AT LAW 45 HAMPTON ROAD SOUTHAMPTON,N.Y.11968 516-283-2400 - PHIETPB.MATTHEWS TRLEOOPIER 516-287-1076 11012tBBY1 �. STEPHEN L.HAx,III July 25, 1994 Planning Board Town of Southold Main Road Southold, NY 21971 Re: Proposed Lot Line Change for Henry L. King & Margaret G. King Susanna von der Schulenburg (SCTM #'s 1000-5-2-10.8 & 10.9) Dear Board Members: As authorized agent of Henry L. King and Margaret G. King (the "Kings") and of Susanna von der Schulenburg ("Mrs. von ,der Schulenburg") , I have submitted an application to you for approval of a proposed lot line change. The lot line change will be effected by the, transfer of a .75'-acre portion of Mrs. von der Schulenburg's property (SCTM # 1000-5-2-10.8) to the Kings property (SCTM #' 1000-5-2-10.9) The purpose of the lot line change is to provide the Kings with additional protection for their existing home on tax lot 10.9 from any new construction that may take place on tax lot 10. 8. The Rings also desire to acquire fee title to the land on which is located an existing well that services their property. r' The Kings and Mrs. von der Schulenburg have entered into a contract of sale pursuant to which the .75-acre parcel will be transferred after approval of the proposed lot line change by your Board. This will confirm that the Kings and Mrs. von der Schulenburg approve the proposed lot line change and, upon your approval, will be legallybound to carry it out. Finally, I wish to point out that, while both lots are conforming under existing zoning, the smaller of the two (tax lot 10.9) exceeds the minimum area requirement for this R-120 Zone District by 21,134 square feet or about 17.6%. If the lot line change is carried out, the smaller of the two lots will be tax lot 10.8 less the .75-acre parcel to be transferred to tax lot 10. 9 ; that new lot will have an area of 3 .46 acres or 150, 718 square feet which will exceed the minimum area requirement by 25. 6%. The larger of the two resulting lots (tax lot 10.9 plus the .75-acre parcel) will have an area of 3.99 acres or 173,804 square feet which will exceed the minimum area requirement by 44.8%. Very truly yours, Step en L. Ham, III i x I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY i No Z-20317 Date OCTOBER 29., 1991 THIS CERTIFIES that the building ADDITION Location of Property EAST END PRIVATE ROAD FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 5 Block 2 Lot 10.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16, 1988 pursuant to which Building Permit No. 17489-Z dated AUGUST 16, 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING DECK The certificate is issued to KATHLEEN METZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A I Building Inspe torA Rev. 1/81 �I f I I i FORM N0. 4 i TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the 'Building Inspector Town Hall ` Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20316 Date OCTOBER 29, 1991 THIS CERTIFIES that the building ADDITION- Location of Property EAST END, PRIVATE ROAD FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 5 Block 2 Lot 10.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 1986 pursuant to which Building Permit No. 15272-Z dated SEPTEMBER 17, 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to KATHLEEN METZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Insj5eftok Rev. 1/S1 I' s TOYnd. OF SCUVIOLD, a. Y. F:OUST.:G CODs. I iS=__ZTIOiv RI?CRT Location EAST END, PRIVATE ROAD FISHERS ISLAND, N.Y. tnumoer 6, streec) li-iun jcioality) Subdivision man No. Lot(o) Name. of Owner(s) KATHLEEN NETZ -Occupancy R-1 (type. (Owner-cenanL Admitted by: SELF Accemparied by: Key available Suffolk Co. Tax No. Source of request. BAGLEYBEID Data OCT. 28, 1991 DI: LLDM— Type of construction VOOD FRAMED lstories 2 Foundation CONCRETE Cellar 1/2 Crawl space Total rooms, 1st. F1 9 2nd. Fl 10- 3rd. F1 Bathroom(s) 6 Toilet rocra(s) L Porch,. type. OPEN Deck, type Patio, type HAEONARY Breeze,,-Nay Garage ATTAODED Utility room Type Heat OIL FIRED Warm Air Xx Fotwat_r Fireplace(s) 1 No. E:cits 5' Arconditioning Domestic hotwater YEB.. Type heater OIL FIRE Other ACCESSORY STRUCTURES: Garage, type const. Storage, type const. Swimming pool 1 WITH PENCE Guest, type Const. Other POOL CABANA 5 ATTACHED DECKS VIOLATIONS: CRAPTER 45--N.Y. STATE UNIFORM FIRE. PREVENTION 6 BUILDING CODE Location Descrinticn IArt. 1 , Sec. NO.VIOLATIONS I I THIS INCLUDES BUILDING PBRNIT #15272-Z I 1. CO Z-20316 FOR A DECK, BUILDING PERMIT #17489-2 CO Z-20317 FOR AN ADDITION TO EXISTING DECK. I i I L I I ) I Remarks: Inspected by: ROBERT E_ WALL Date of Insp. OCT•28, 1991 -Time start end FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20318 Date OCTOBER 29, 1991 THIS. CERTIFIES that the building ONE FAMILY DWELLING Location of Property EAST END, PRIVATE ROAD FISHERS ISLAND, NY House No. Street Hamlet County Tax Map No. 1000 Section 5 Block 2 Lot 10.9 III Subdivision Filed Map No. Lot No. conforms substantially to the Requirements fora One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF i OCCUPANCY NUMBER Z-20318 dated OCTOBER 29 1991 ` was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ACCESSORY SWIMMING POOL FENCE POOL CABANA & ATTACHED DECKS. ' The certificate is issued to KATHLEEN METZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERW CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. w.t � J� Building sec Rev. 1/81 t Page 2 Southold Town Planning Board Referral i I Referral Criteria: SEQRA STATUS: 1. Thpa project is an ( ) Unlisted Action (j<) Type i Action ( ) Type 11 Action 2. A ( ) Negative Declaration ( .) Positive Declaration ( ) Determination of Non-significance has been adopted by the Planning Board. 3. E.I.S. statement enclosed. ( ) Yes, No Comments: Tlfrs t< 13 T-yP 02r� 1t�7-1a-2� 9 c,14r,�e �r ! S Z a C"g r�&_(') C,/-/ I` We request acknowledgement of receipt of this referral ( ) Yes No Referral received 1994 by the Suffolk County Planning Commission and assigned File No. Sinceriis arand Chairman it cc: Frank Cichanowicz . � 1 If � rev.-6/94 R I le i :LASER FICHE FORM Project Type: Lot Line Changes j SCTM # 1000 - 5.-2-10.8 � Proiect,Name: fur I Sag t��n� i- j�rn�'t MVV' rse4 �. ICS "k i J r I Location: End End Road, SI M Atc Von by icc�e� �ic�r I Applicant Name: Susanna vonder Schulenburg and others y9wrier_Name: Susanna von der Schulenburg one,1:.R-1,20 Zone 2; Zone 3; � Mbaaftion Received Date: L+ I " ADDITIONAL SUBDIVISION INFORMATION A date indicates that we have received the related information i' C and R's :, Homeowners Association : j Rand M Agreement: } i; ,4 I' II i ' i, -. -- - ----------- _-_-_ - SITE '9 w tp I N/F ss I Wl`I W Ali f MOfY BLOC J `FOSS` ase Sss K LO s rs ROAD N25°0400'W Jaya \ _ saz°4Y4o"E _MON. _ 29 ___ A• 5.83 t � BO $ 84-000" MOH +y ' 4 04'10" .ca E \ \ 3 503°54'50"W166.04 WLOCATION MAPN.\`, , 500 N u9.6r 1, @ N 25°04'00W1 77 \ E 9)e'le 56.77 � 1 / Nouse 1. // / ro 600 300 0 500 E 1301 m m S05-3242 E / ' MDN. `� / p as3 GRAPHIC SCALE IN FEET \0 — \%ISL/ WELL Z �., ; S09°12'40° W NOTES: O 37.49 \ \ \ a'r r / / 4i°° i of ISI Aust v mon. 1\ \ ` / / e 9 °� 1) OWNERS: LOT #9 HENRY L. KING & MARGARET G. KING - 6 �O� mm FISHERS ISLAND. NEW YORK O P;:Nn;t;;;' v) a // �° 't' . LP jz.- / O v LOT 10 SUSANNA VON DER SCHULENBURG e 21 TITE ST / AUGUSTUS COURT FLAT G �3 LONDON SW3 ENGLAND - 13 N� , /��/ "r 2) LOTS ARE LOCATED IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, STATE CIO,Ir r AREA TO BE DEEDED FROM LOT 10 OF NEW YORK, DISTRICT 1000, SECTION 005, BLOCK 2, LOTS 10.8 & 10.9. To LOT 9 = o.75'Y- ACRES + I / MZc 3) UTILITIES ARE EXISTING ON LOT #9. LOT #10 IS TO BE SERVICED BY MUNICIPAL WATER & ON SITE SEWAGE SYSTEM. a° m e°dA - jj� �oa ' .<� ':,'" - 4) PROPERTY IS LOCATED IN ZONING DISTRICT R-120. `.A v rlf' O�•iP' / // r'.. $ 45°3745°W Gcpi,s QEµet / // jam ,,,, / 25.6 O 5) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC `A AT' `/ // / / / / SURVEY TRIANGULATION STATION "EAST END 2 . o °.t n TP � 50 \p ct�°�\ / ,�/ 6) LOT AREAS: o //Lp 5E / °o `O BLOCK & LOT XS IN PROPOSED Co0. 0 6 0 2.y �P\ /pp \ct S/y� y g -� r � // g� 05t�,A2/2jy BLK 1, LOT 9 3.243 AC. 3.99E AC. 9A A /ow q\-° BLK 1, LOT 10 4.21± AC. 3.463 AC. 5 �0F NEW YO f s se°ae'zo"w yqP 73.15 Va C.W 1 o °FtiSe^O� 4 , P,� PROPOSED LOT LINE GHANde PREPPIRED POR aur HENRY L. KING 4 MARGARET 6: KJNO- AND 5U5ANNA YON DER SGHULEOM 100 50 0 100 GRAPHIC SCALE IN FEET BLOCK 1, LOTS a 8 10 FISHERS ISLAND, NEW YORK LEGEND: REVISIONS w — CHANDLER, PALMER da KING 1.P. IRON PIPES� DATE DESCRIPTION . 7/05/94 REVISIONS Architecture, Engineering and 6urveying MON. MONUMENT � 110 MpAOWAY mawm m ex3xe e,V SOl-NF>� N/F NOW OR FORMERLY S.F. SQUARE FEET pp EXIST. EXISTING AC. ACRE it DATE: MARCH 1, 1994 I , SCALE: 1" = 100' 1 SHEET 1 OF 1 SOUTHOLD TOWN