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I(':- , ' - a - - , 1 r t +rvY b q >« a tr• a '-"m « hat ?ho awyeitem1rus gyand n�gg O�6*yy.1 ►r &tom�, ' � k&i thwv .N"P k0 ^ tai `;K c ' ',+n` , 6` " po$ palest i &# un �e'P'` � - r, � 3 u �x !'t t t;. 5 9- F r « CI x .p 4 7 r MAY24 . ._ � e 1i; FoLa TO��€ �r .Ll NG OAR z s7 o sties y �° M3N r: Unauthorimd eMeratfori oradditfcq 4o this survey is a violation of , Section 720f1-of the New Ydrk State Education l aw. } Copies of this survey mn")r,<171,rnq �.` °- • - the land surveyors inho ; embossed seat shal!i to be a valid true copy, .°- Guaranteesindidated .^r only to the per on fcr ey Is prepared and c`�di title Company qry - lending institu c i udr �d (err t s 3 6 t 7 y to the.assi n.o;!Of ti? L l tutlon.Guars fees ars not trnsisrable g _?`^ :�``F"!C 9 f?.iY� k�d'� f r, 'C.'S'F: 9 2 lest �P4 insti- r�Y' !`f to additional institutions or subsequenC JtJIl l. l's�& f!pts e r p owners. ec l t`2 Mo r , t /I r � , r h � AZ M +1 t y y.. of i t rY f �1 r, til 4� v• - ` r`" w' � G. 41 ... �' +.<. �� r .. l • ., .. ''� « - �'�, 7+ra � � '�.r - ! fir` f Y. `M of 9 ¢+ + r ,wry :1- (.`7U1t11f" "✓L' : 3 �X pyA ;Ole':. ,�i"•"':..;r"w N '" v-.. NJ It 7 IF i` r 7 op ' F -•SAA ! �P�•yN �uJ +�(i_� a ,pf '.ry la�wt�yr� � a� �+,�w { ��..K7�N 4•»�� r>V�C � �' Af•Mj,��'�` k�• + ,� � x'' -.� _ �� i N 7 1 e , ! / j ��• „��t c''�Mlc'x f �,,.�yt7C.� Jam'�,.1 r'"✓��C►Y I� t f � 5,. - --- Ty- 1 Ty_, OF,MM-Tiiai R a A �m Amah#101 Hwjppaugev Mew rL JL a-ram 7 This to to c omy that the prgx*W amVemem for we ;�jpply in mm the `', Q_S� $�_ �►��i r + t ,t ---- >� r yy� G-,ad U' .S;E ►,?.: c�x G►tnl W 1 �� ;,g,b50f t on. This i ' i r apppyo sti a if beot opftfd `. �" ► I , ptbi i one yew i IN (�:]j��j�,++,yamy�.� �f:j ISr' :•.t hIrr) i�.V[/7�,i t y�. i rn� �•�wi• - -7 j`,i i Se tYM.� \I �' w'Gs.,l 1 S:Q..t t p.` '� p wNch Ws andorsef, T all Coot* if it? Y`!,. h t,_, ;i I i L.�ai'rnl i r s v✓ do Director, of ammmmw ouamy SC.It�lVr�,'�3r! r S �E"�*3 f•�1+7r't �`� ? � �� '-"'� � ��'"�-""�".�-�.�:,','"„�� � 't t C*) C7t" 'r7 , �-r ez* 'f'lY t� t?!ltll�ji t1edl5 fT T Z!' 6tj s l"e r fattt [ G � ✓� t>" 1� Cnir+rE d' Mat , a 1C) a r`td' #Fsn►t �C,�-f c�-��� �r,��t�c,�rrr�r�t� i�r � b����r ',�. "' � • 7 if� �- .. - 1,.,.•.,.-. ��` ;• ,rte � �,� w�.•-«�� � .tc��ti�ca� L car►� r����� �, �. �, # � ,� New 'Y'ot-E;, '` r r rfL ' - v 63 MAY 2 SOUTHOLD TO4��tIV PLANNING BOARD ...,-.brown }. a o > sf ' ' O i �Y10 i"4�T+ O titin-A 0" _- Unauthorized alteration or addition -- '. fo this survey is a violation of "`^-• Section 7208 of the New York State 1 , ,•,r a �.` "�j Education Law. �•• }ti..ti^�.., iii Copies of this surveyrn s `5, "f,r�, ~•...,�� n r.ng the land surveyors embossed seal shat!r .:� '. Yrt: •' s, 'M fr�y�'1{`` ° to be a valid true copy, ,�« ,,, �, • Guarantees indicate) only to the person t r s is prepared.and title G'ampar:y,qa1 lending institulc u i ; ' Yard A ©hc ldro-f-rbtt O f C4yEst tdI't�'$ �•.., to the assi n r } g ees c.tits lent;,;>g ins'ti- orld NL'-5ft-te41 ot75 vvh Gil ad f eC4' 645 !m'i 4tS ;'y* tution.Guaranis are not trnste A j� ' to additional institutions or subsequent= `'" "�`-•.,,, t 5ubdiVt`siort Exx5 been filed trr -ffr� �atk 4 owners. ' Vim., • . i Co. C/erks office ih L �4�•wru..iMv.>..., ,....rN.,:«s,.:.n .. :i'...,..'N.vx+.•.,"1v�..:y1:..eT vJ,..,. .. .N�4w•.. - ... .. 6 W. .:Y . .+s..:-.,�.�,...y�.y,..w�yp.ry,,,,.,.»«..r�-•^,N a:y;r,,.,7y!}A,+.:...•f fey,:,µ. .: •w+..�..,M.+F-Mlta.!'/w.�h`�Irf✓+Ik'Me Vi^rrhl A«..'�.,g• ...,,.., ,,.., 1 : N..v yr 4...t♦»•.Y.'.,61,q%4W'�tY•.h.,.h.,�w•-M,•l/+vY'.f��..'..M^MRe�1�l.M'Ma•'�M�.'+Yi.v,-MIMr'Y�YF♦1^bMM'•Y►K nr ! 7 .,y,..- ,i .,. _ YM#h•e t`+f„y'Ifi�a,A•��+..wvn.:...•..:�,y�wWe�+.r^ti•Swtw+,r+iiy+arw•mr+� itr+h9u�ra'�•M^'�04RItc.w'..�°. erwM^'nM,..,�. .w.w»'-,.ne�..•►....•r,A-.,.,r wr.w.•,.v�•.,.+,anr-,a�..e, , PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett Odowski, Jr. Mad~ S. McDonald Kenneth L. Edwards Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-3136 Telephone (516) 765-1938 December13, 1994 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Steve and Donna Dzugas-Smith 2475 Tuckers Lane Southold, NY 11971 Re: Proposed set off for Steve and Donna Dzugas-Smith SCTM# 1000-59-10-6,1 Dear Mr. and Mrs. Dzugas-Smith: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, December 12, 1994: BE IT RESOLVED that the SouthoM Town Planning Board authorize the Chairman to erlclorse the surveys dated March 15. 1994. Conditional final approval was granted on Apri! 18, 1994. All cofx~itions have been fulfilled. Enclosed please find a copy of the survey which was endorsed by the Chairman. The mylar maps, which were also endorsed by the Chairman, must be picked up at this office and filed in the office of the County Clerk. Any plat not so filed or recorded within sixty (60) days of the date of final approval, shall become null and void. Please contact this office if there are any questions regarding the above. Sincerely, Richard O. Ward Chairman enc. cc: Tax Assessors Building Department PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett Orlowski, Jr. Mark S. McDonald Kenneth L. Edwards PLANNING BOARD OFFICE TOWN OF SOUTHOLD Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765 -3136 Telephone (516) 765-1938 April 19, 1994 Steve and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 Re: Proposed set off for Steve & Donna Dzugas-Smith S/w corner of C.R. 48 and Tucker Lane Southold SCTM# 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: The following took place at a meeting of the Southold Town Planning Board on Monday, April 18, 1994: The final public hearing which was held at 7:30 P.M. was closed. WHEREAS, Donna Dzugas-Smith is the owner of the property known and designated as SCTM# 1000-59-10-6.1, located at the southwest corner of County Road 48 and Tucker Lane in Southold; and WHEREAS, this clustered minor subdivision is for 2 lots on 29.042 acres; 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 December 13, 1993; and WHEREAS, a final public hearing was closed on said subdivision application at the Town Hall, Southold, New York on April 18, 1994; and Page 2 Dzugas-Smith Minor Subdivision April 19, 1994 WHEREAS, all the requirements of the Subdivision Regulations of the Town of Southold will be met upon the fulfillment of the following conditions; be it therefore RESOLVED that the Southold Town Planning Board grant conditional final approval on the surveys dated March 15, 1994, and authorize the Chairman to endorse the final surveys subject to fulfillment of the following conditions. All conditions must be met within six (6) months of the date of this resolution. 1. The draft Declaration of Covenants and Restrictions must be reviewed by the Planning Board and the Town Attorney. Once approved, the document must be filed in the office of the County Clerk and the Liber and Page number of the recorded document must be noted on the final map. Final maps , (5 paper copies and 2 mylars) all containing a valid stamp of approval from the Health Department, and the Liber and Page number of the recorded Declaration must be submitted Please contact this office if you have any questions regarding the above. Sincerely, Richard G. Ward Chairman DECLARATION OF COVENANTS AND RESTRICTIONS DECLARATION made this 10th day of May, 1994, by Donna Dzugas-Smith residing at 27 Carver Boulevard, Bellport, New York 11713 hereinafter referred to as the "Declarant". WITNESSETH: WHEREAS, the Declarant, is the owner of real property at Southold, Town of Southold, Suffolk County , New York, a metes and bounds description of which is shown on "Schedule A" annexed hereto and made a part hereof, and referred to herein as the "Premises", and WHEREAS, Declarant intends to subdivide said premises. ' ' WHEREAS, The Southold Town Planning Board has agreed to allow and to grant the subdivision of the premises provided that the following covenants and restrictions are imposed. Declarant agrees to the imposition of the covenants and restrictions required by the said Planning Board and in consideration of said approval hereby agrees to restrict the use and enjoyment of said PREMISES. NOW, THEREFORE, it is declared that the said premises are hereby held and shall be sold and conveyed subject to the following covenants and restrictions: 1. No further subdivision of Lot No. 2 shall be allowed until an acceptable yield map and development plan for the overall property has been provided. The development plan for the property shall take into account the recommendations of the proposed Special Groundwater Protection Area plan for the Town of Southold showing the amount and location of the farmland to be preserved. 2. No new driveway or access road shall be located on Middle Road, C.R. 48. for any present or future residential use of either Lot Number 1 or Lot Number 2 as shown on map of the Dzugas-Smith subdivision. 3. All stormwater runoff resulting form the development and improvement of this subdivision or any of its lots shall be retained on the site by adequate drainage structures so that it will not flow out onto the right-of-way of Middle Road, C.R. 48. 4. These covenants and restrictions can be modified only at the request of the then owner of the premises with the approval of the Planning Board of the Town of Southold after a public hearing. Adjoining property owners shall be entitled to notice of such public hearing but their consent to such modification shall not be required. IN WITNESS WHEREOF, the Declarant has duly executed this Declaration on the day and year first above written. STATE OF NEW YORK, COUNTY OF SUFFOLK SS: On the /O'~ day of May 1994, before me personally came DONNA DZUGAS-SMITH to me known to be the individual described in and who executed the foregoing instrument, and acknowledge that she executed the same. "SCHEDULE A" ALL THAT CERTAIN PLOT, PIECE OR PARCEL OF LAND, SITUATE, LYING ~ND BEING AT BOUTBOLB IN THE TOWN OF SOUTNOLD, COUNTY OF SUFFOLK AND STATE OF NEW YORE, BEING MORE PARTICULARLy BOUNDED AND DESCRIBED AS FOLLOWS~ BEGINNING AT A POINT ON THE SOUTHWESTERLY SIDE OF TUCKER LANE AT THE EASTERLy END OF A LINE HAVING A LENGTH OF 33.37 FEET WHICH LINE BEARS SOUTH 80 DEGREES, 07 MINUTES, 00 SECONDS EAST AND CONNECTS THE SOUTEASTERLy SIDE OF. MIDDLE ROAD (COUNTY ROAD 48) WITH THE SOUTHWESTERLy SIDE OF TUCKER LANE; THENCE SOUTH 21 DEGREES, 50 MINUTES, 30 SECONDS EAST ALONG THE SOUTHWESTERLy SIDE OF TUCRER LANE; 1036.66 FEET TO LAND NOW OR FORMERLy OF JURKOVICH; THENCE SOUTH 68 DEGREES, 09 MINUTES, 30 SECONDS WEST ALONG LAST MENTIONED · LAND, 200.00 FEET; THENCE SOUTH ~1 DEGREES, 50 MINUTES, 30 SECONDS EAST ALONG LAST MENTIONED LAND AND ALONG LAND NOW OR FORMERLy OF STRCICIL, 200.00 FEET; THENCE SOUTH 21 DEGREES, 54 MINUTES, 20 SECONDS EAST ALONG LAND NOW OR FORMERLy OF MONTGOMERY, 100.84 FEET; THENCE SOUTH 22 DEGREES, 0S MINUTES, 00 SECONDS EAST ALONG LAND NOW OR FORPIEALy OF ST~NF~WICZ, PURICE ;%ND SZAWALUK, 300.00 FEET; THENCE NORTH 67 DEGREES, 35 MINUTES, 00 SECONDS EAST ALONG LAST MENTIONED LAND, 200.00 FEET TO TRE SOUTHWESTERLy SIDE OF TUCKER LANE; THENCE SOUTH 22 DEGREES, 05 MINUTES, 00 SECONDS EAST ALONG THE SOUTWESTERLy SIDE OF TUCKER LANE, 50.00 FEET TO LAND NOW OR FORMERLY OF FABIJANICH; THENCE SOUTH 67 DEGREES, 55 MINUTES, 00 SECONDS WEST ALONG LAST MENTIONED LAND, 200.00 FEET; THENCE SOUTH 22 DEGREES, 05 MINUTES, 00 SECONDS EAST ALONG LAST MENTIONED LAND AND LAND NOW OR FORMERLy OF MAGASIC, 197.60 FEET TO THE NORTHWESTERLy SIDE OF LAND NOW OR FORMERLy OF THE LONG ISLAND RAILROAD COMPANy; THENCE SOUTH 71 DEGREES, 27 MINUTES, 50 SECONDS WEST ALONG LAST MENTIONED LAND, 850.65 FEET TO LAND NOW OR FORMERLy OF DONOHUE; THENCE NORTH 44 DEGREES, 48 MINUTES, 50 SECONDS WEST ALONG LAST MENTIONED LAND, 358.25 FEET TO LAND NOW OR FOPa~ERLy OF CH~d~4EWS; THENCE NORTH 33 DEGREES, 19 MINUTES, 40 SECONDS EAST ALONG LAST MENTIONED LAND NOW OR FOR/~ERLy OF KAELIN, 718.08 FEET; THENCE NORTH 28 DEGREES, 07 MINUTES, 10 SECONDS WEST ALONG LAST MENTIONED LAND AND ALONG LAND NOW OR FORMERLy OF HUFE, 858.26 FEET TO THE SOUTHEASTERLy SIDE OF 2'~iDDLE ROAD; TBENCE NORTHEASTERLy ALONG THE SOUTHEASTERLy SIDE OF MIDDLE ROAD ALONG A CURVE BEARING TO THE RIGHT HAVING A RADIUS OF 1861.86 FEET A DISTANCE OF 716.63 FEET; THENCE SOUTH 80 DEGREES, 07 MINUTES, 00 SECONDS EAST ALONG A LINE CONNECTING THE SOUTHEASTERLy SIDE OF MIDDLE ROAD WITH THE SOUTHWESTERLy SIDE OF TUCKER LANE, 33.37 FEET TO THE POINT OR PLACE OF BEGINNING. FOR INFOR~ATION ONLY DISTRICT 1000 SECTION 059.00 BLOCK 10.00 LOT 006.001 !!681E874 Ntl,! ct or jm§c~ /~ Sm mi # Cerfilicalc # Deed / Morlgage Tax Stamp I/ee(I / Morlgage lusfrumc. I Recording / Filing $1amlls Page / lrill,g Fee llandli,g 'rP-584 EA-5217 (Counly) EA-5217 ($1ale) Comm. of Ed. Affidavit Reg. Copy Other 1000 Sub 'rulal /7._. Sub 'lolal GIb~ND TOTAL Ileal Properly Ttu Service Agency Verificaliun 059.00 10.00 006.001 Mortgage Amt. 1. Basic Tax 2. $ObtYMA Sub Total 3. Spcc./Add. TOT. MTG. TAX Dual Town Uual'Couuty. Held for Apporflonme,t_. - Transfer Tax Mansion Tax The properly covered by aris ~rlgage is or will be Improved by a one or two family dwellh~g only. YES _. or NO ~ NO, ace ap~'roprlala I~ ~lause on '. page ~_of tiffs insimm~nL' Tlile Company Information N/A Company lNaiue Tllle N~mber OR: FEE PA/D lly: Cash. Check. X Charge Payer same as D, & R Edson and Bruer Main Rd. P.O. Box 1466 Southold, NY 11971 RECOILD & 1LETURN TO Suffolk County Recording & Endorsement Page This page roi'illS part o£ the allached ,Covenants & Restr±ction~ made by: (Deed, Mortgage, etc.) DONNA DZUGAS-SHITH The premises herein is situaled i, SUFFOLK CO UNTT, NEW YORK. TOWN of , $outhold Il, Ihe VILLAGE or IIAMLET of SUFFOLK COUNTY CLERK'S Edward P, ,~oma:ih'~., COUNTY C PHONF:852-2000 OFFICE Town of Southold Assessor ~/~Uown of Southold PJanning Board , Chie£ Deputy County Treasurer To Whom This May Concern: The S,,bdtvislon Nap Of: ~)F--M~O.S-~-~F~I,~'~\ - Se_~-OfF- TownshSp , Southo~d %6UJhold 5'~I'10-(,· I Stove t bonna Very huly yours, Mai) I'~eDar hnerl! Counly Clerk ~ THIS PROPOSAL 15 TO SET OFF A O.~ ~c<~_ ~ARCSL FROM AN EXISTING .~,o~ ACRE PARCEL LOCATED (~N-~ ~W co<~ ~ C.~. ~ ~ L~ IN ~o~ . S~M~ 1000- ~- ,o-~. ~ Complete applica)ion received Application reviewed at work session Applicant advised of necessary revisions Revised sub mission received Sketch plan approval -with conditions Lead Agency Coordination SEQRA determination Sent to Fire Commissioner Receipt of firewell location Notification to applicant to include on final map Sent to County Planning Commission Receipt of County Report Review of SCPC report Draft Covenants and Restrictions received Draft Covenants and Restrictions reviewed Filed Covenants and Restrictions received Receipt of mylars and paper prints with Health approval Final Public Hearing Approval of set off -with conditions Endorsement of set off 14-16-2 (2/g71_7c 617.21 .~ Appendix A · State Environmenta* ~,'~ : SE FULL ENVIRONME~ .... I Quality Review , ~ . ,,,, OR Purpose: The full EAF is · ~//4L ASSESSMENT !~: . or action may be significadnt~sxgned to help applicants and a~en · FORM . ly. there are aspects of a r The question of whether an ~ c~es determine, in an orderl~ner . _ Signff~cam~e may have I *~ °lect that are su~ie~*~.. · ~2..~ ' ' urinal knowledge action may be ,~e or no f ~.ve ' , Whether a project significant is not always analysis, ln addition, many who have knowledge . or Unmeasureable It is a- - easytoanswer Frequent. the question of Significance of the environmen'~ ~. ~°, Unnerstood that those ' . ~ ~, may Oe techniCaly exper- ' who determine m One particular area may not The full EAF is intende be aware of the broader COncerns affecting process has be~- ~ ~ , d to provide a m~ ~ - t m environmental ~- uruerly, COmprehensive i ....... ou Whereby applica . n nature, yet flexible to =nnfs ~nd agencies Can be assur Full EAF Components: The full EAF is COmprised of three parts: m_..~, ro r*t a project or action. Part 1: Provides objective data . and reformation about a given project and its site. By identifying basic data, it assists a reviewer in the analys,s that takes p~ace in Parts 2 and 3. Part2: Foct~ses on identifying the rangeof project guidance as to Whether a- :~ possible impacts that may OCCur from large impact T~ . -.,upact~shkeb,,~k~ .. a project "art 3: ff an,, i~- - --v form a/st identifies ~;~ ttn~'aered small to moder .... or action. It provides . ~ ,-pact m Part 2 is iden*;~;~ ~n ~mpact can be mit o-*~e°rwnetheritis a ooten* ~mpact is actually important~'-''~u as POtentially-large, t~ _ . ~u or reduced. - ...... pen ~art 3 ~s Used to evaluate whether or not the DETERMINATioN OF SIGNiFiCANCE_Type 1 and Unlisted Actions Identify the Portions of EAF COmpleted for ~his project: Upon review of the infOrmation recorded on .,~ Part 2 ~}Part 3 information, and Considering this EAF (Parts 1 and 2 and 3 if appropriate), and any Other supporting lead agency that: both the magitude and importance of each ~" A. The project will not result in any , impact, it is reasonably determined by the have a large and important impact(s) and, therefore, is one which will o0t Significant impact on the environment, therefore a negative declaration will §e prepared. [~ B. Although the project could have a '" effect for this Unlisted ACtion because the mitigation measures described in not be a Significant stgnff~Cant effect on the environment, there will therefore a CONDITIONED negative declaration will be PART 3 ~ C. The project may result in One or more large and prepared.* have been required, · on the environment, therefore a posilive important impacts that may have a si pi" declaration will be prepared, g hCant impact A ConditiOned Negative Declaration is only valid for Unlisted Actions Sig~lture of Preparer P nsJble officer) Date !~PART i~PROJECT iNFORM/~.-JN Prepared by Proiect 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 additiona!~ · . ' iii be needed to complete Parts 2 and 3. currently available and will not involve reformation you bebeve w. · .k^ ~-[I EAF will be dependent on. information indicate and specify It is expected that completion or u~c ,u new studies, research or investigation- If information requiring such additional work is unavailable, so each instance. Street Address, Municipality and County) NAME OF APP~~CANTISPONSOR NAME OF OWNER (if different) ADDRESS CiTY/PO DESCRIPTION OF ACTION -- BusINESS TELEPHONE Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall proiect, both developed and undeveloped areas. 1. Present land use: E3Urban ~lndustria[ ~Commercial ~Residential (suburban) ~Rural (non-farm) ~Forest I~Agriculture [~Other 2. Total acreage of project area: --~' 0~- _ acres. PRESENTLY APPROXIMATE ACREAGE _ acres Meadow or Brushland (Non-agricultural) ~ _ acres Forested ~o~. 0_~'~ _ acres Agricultural (includes orchards, cropland, pasture, etc.) acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECl.) ~ -- Water Surface Area ~ Unvegetated (Rock, earth or fill) acres Roads, buildings and other paved surfaces ~ acres Other (Indicate type)_-- AFTER COMPLETION ~-0 H~ acreS 3. What is predominant soil type(s) on project site? well drained ~ % of site dralna e ~'~VVe J dra ned _ ~ % of s. ite E~Moderately a. Soil ' g : t % of s te . 4 of the N~ Poorly dra ne( ~ ~ ' W many acres of soil are classlhed within soil group 1 through If any agricultural land is invowed, no h. q acres. (See 1 NYCRR 370). Land CJassdication System? ~ 4. Are there bedrock outcroppings on project site? ~Yes ~;~No _ (in feet) a. What is depth to bedrock~' 2 B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. TOtal contiguous acreage Owned or COntrolled by project initially; St ApProximate percentage of propC project ~itewiths/opes: ~0 10% ~ 6..Is proiect SUbstantially contiguous [~15% or ,re~-~- o ~10 ]5% o ~ Registers of HiStoric P/aces/ ~y~o, or COntain a building, g ater ~7 ISproec ' s ~No site or di ' ' ~ ~ ' S[nct, listed on the State or the National IU. DO hunting iisi[ ~ C~pal, or Sole SOUrce a~ '~ ~ o 1~. Does nfo; .... ng or shell fishing Opportunities ~- ~mrer~ ~Yes ~w~ Sffe contain any Species o~ . ~esently ex~st m the project ar ~Yes ~No ACCordS' ' plant or animal bfe tha~ ' · ea ~Yes ~aentffy each - umg to -~~ ~ ~s ~dentdled as tk~..tened or - 12 Are there an- - - ~ ~ gered? ~ umque or Unusual land f ~~ ~~~ ~Yes ~No Describe I ct Site~ . . [ .e., chffs, dunes, o- ~ ther geological formations) 13. is the pro)ect ~ite DresentlV used by the COmmunity or neigBborhood as an Open space or recreation area~ ~Yes ~No I[ yes, explain 14. Does the present Site include SCenic ~Yes ~No views known to be important to the community~ 15. Streams within or ContigUous to pro~ect a. Name of St · area: ream and name of River~ 16. Lakes, ponds, wetland areas within or contiguous to project area: a Name ~ q0~ 17.Is the Site served by existin~ public utilities~ ~Yes ~No b. Size (In acres) a) ff Yes, does sufficient Capacity exist to allow COnnection~ b) If Yes, will improvements be necessary to allow COnnection~ ~Yes ~No 18. Is the Site located in an agricultural district certified ~Yes ~No Section 303 and 304~ ~Yes ~No pursuant to Agriculture and Markets Law, Article 25~AA, 19. Is the Site ~OCated in or substantially contiguous to a Critical Environmental Area designated of the ECL, and 6 NYCRR 617~ ~Yes ~No ~ ~m ~ GV~ pursuant to Article 8 20. Has the site ever been used for the disposal of solid or hazardous wastes~ ~Yes ~No C. Project acreage to remain undeve!oped ~ a d. Length of project, in miles. /~[~_ ' - cres. ~~ acres ultimately. ~ (If appropriate) e f;;t ~ 'nd,cate percent of °Xpansion r g. Maximum vebi g 'Paces existin , ,~t~ P oposed [k~ o CUlar trips . , g ~N~_.~, ~ ~em rated ')e- ~ 3,- , Proposed h. If residentiah Number and type of ~ · hour ~(Upon core--elect)? Initially One Family housing units: Two Family Ultimately , ~ ~ 2uhiple Famdy Condominium i. Dimensions un feet) of largest propose~ J. Linear feet of frontage along ~ height: ~ width: a public thoroughfare project will OCCupy si/?~-L_~ ft.~ length 2. How much natural material ~ock, earth, etc.)will be removed fron ~kite? ~(~-~ . tons/cubic yar~]s 3. will disturbed areas be reclaimed? [Yes /No ~N/A a. if yes, for what intend.-~- purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? E~Yes E~No c. Will upper subsoil be stockpiled for reclamation? [~Yes 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? ~~fl~---~- acres. 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this proiect? ~No 6. If single phase project: Anticipated period of construction ---~' '~ months, (including demolition). 7. I[ multi-phased: (number). a. Total number of phases anticipated ~ -- month b. Anticipated date of commencement phase 1 ~ c. Approximate completion date of final phase ~ d. is phase 1 functionally dependent on subsequent phases? [~Yes E3No 8. Will blasting occur during construction? ~lYes ~.No after proiect is complete -- .-- 9. Number of iobs generated: during construction -~ -- 10. Number of iobs eliminated by this project ~ ~-' 11. will proiect require relocation of any projects or facilities? [~Yes E~4o year, (including demolition). year. 12. Is surface liquid waste disposal involved? a. Ifr yes, indicate type of waste (sewage, industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? [~]Yes ~No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain 15. Is proiect or any portion of proieot located in a 100 year flood plain? [~]Yes BYes []No ~_~_~xo3d~oOS~ .-- _ [~Yes ~No 16. Will the project generate solid waste? E~.Yes ~]No a. If yes, what is the amount per month ~z~('w~ ~*~- tons \ ~oo3(~- C'~s&3r~n.~ b. If yes, will an existing solid waste facility be used? ~Yes E3No C. If yes, give name ~.v~'~x'~'~ ____; location d. will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 17. will the project involve the disposal of solid waste? a. If yes, what is the anticipated rate of disposal? - b. If yes, what is the anticipated site life? ~ - ~Yes tons/month. years. 18. Will proiect use herbicides or pesticides? rE]Yes 19. will proieot routinely produce odors (more than one hour per day)? ~}Yes [~No 20. will project produce operating noise exceeding the local arnbient noise levees? 21. will proiect result in an increase in energy use? I~Yes If yes , indicate type(s) 22. if water supply is from wells, indicate pumping capaciW ~]-~ ~ gallons/minute. 23. Total anticipated water usage per day ~~ gallons/day. 24. Does project involve Local State or Federal funding? E3Yes [~No If Yes, explain -- 4 E3Yes ~No 25. Approvals Required: C~,ty, TOWn, ~, liable Board ~Yes ~No City, Town, Village Planning Board ~;Yes [No City, Town Zoning Board []Yes City, County Health Department ~Yes ~No Other LOCal Agencies DYes Other Regional Agencies State Agencies ~Yes Federal Agencies ~Yes E3Yes ~No C. Zoning and Planning Information 1. Does proposed action involve a or zoning decision~ . If Yes, indicate decision requirePdlarming }~'Yes ~No [zoning amendment [ZOning variance n~;pecial use permit ~subdivision Els" ' [new/revision of master plan []resource ma gement plan [ . ~ ~ lee ptanx 2. What is the ZOning classification{s)of the s teZ 3. What is the maximum potential development of the site if developed as permitted by the present ZOning? 4. What is the proposed zoning of the s te~ 5. What is the maximum potential development of the site if developed as permitted by the proposed Zoning~ 6. Is the proposed action COnsistent with the recommended uses in adopted lOCal land use plans? ~Yes [No 7. What are the predominant land Use{s) and zoning classifications within a ¼ mile radius of proposed action~ 8. Is ~~ng/surroundmg land uses within a ¼ mile~ 9. If /he proposed action is the subdwls~on of land how ~ a. What is the minimum lot size many lots are proposed? ~ ~, ~Yes · ~ 10 ~ . . proposed~ q .~ ~}¢ . ~ ~ _ 11. ~i;,' ~P°sed act'°n reqmre any authorization(s) f~ __~ proposed acbon create a dem=~.~ ~ ~ lion of sewer or water district~i ~Yes ~No fire protection)? ~Yes ~o ~.u ~or any COmmumty provided Serwces (recreation, education, police, a. If yes, is existing Capacity sufficient to handle projected demand? ~Yes ~No 12. Will the proposed action result in the generation of traffic significantly above present levels? ~Yes ~o a. if yes, is the existing road network adequate to handle the additional traff cZ D. Informational Details ~Yes ~No Attach any additiona~ information impacts associated with your proposal, as may be needed to Clarify your project. If there are or may be any adverse avoid them. please discuss such impacts and the measures which you propose to mitigate or E. Verification I certify that the inform,~n provic ab ~ APPlicant/Sponsor Name "'2% ~i~,.above~s true to the best If the aclion is in the Coaslal Area, and you are a s~ale a~ency, replete the Coaslal Assessment Form be wilh Igis assessmenl. 5 ~roceeding Submittal Date Part 2 ,OJECT IMPACTS AND THEIP ~GNITUDE '~ Responsibility ot 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 iewer is not expected to be an expert environmental analyst, it is also necessarily significant. ( · Identifying that ~Vimpact will be potentially large (column 2) does not mean that in column 2 simply Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact asks that it be looked at further, e eneraily applicable thr°ugh°ut the State and Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of ' r a res onse n coiumn 2. The examples ar g__a~,., I,~er thresholds may be appropriate · The Pnec ftc project or site other exampmS for most situations. But, tot ,~,w ,- . . for a Potential Large Impact response, thus requmng evaluation in Part 3. magmtude that would tng~ge .~,, s are illustrative and thresholds to answer each question. · The impacts of each proiect, on each site, in each locality, will vary. Therefore, the examples have been offered as guidance. They do not constitute an exhaustive list of impacts and · 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. Maybe answers should be considered as Yes answers. . .~ or b. If answering Yes to a question then check the approprlaL¢ box (column 1 2} to indicate the potential size of the c. 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. 13 1 Small to Moderate impact IMPACT ON LAND 1. Will the proposed action result in a physical change to the proiect site? ~NO E3YES Examples that would apply to column 2 · Any construction on Mopes of 15% or greater, (15 foot rise per 1OO foot of length), or where the general slopes in the proiect area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will c'ontinue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes ti~at would remove more than 1,000 tons of natural material (i.e., rock or soil} [)er year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2. Will there be an effect t~. --Y umque or unusual land forms found on cliffs dunes geoogicaiformati°ns'etc')LqNO ~YES the site? (i e, , , · Specific land forms: 6 2 ~otential Large Impact Gan Impact Be Mitigated By Project Change ~Yes []No ~Yes []No [~Yes []Yes ~No [~Yes [~]No []Yes []No []Yes E~1No ~Yes []No []Yes []No []Yes []No Part 2--r'"OJECT iMPACTS AND THEiR t GNITUDE Responsibility of Lead Agency General Information (Read Carefully) · In completing the form the reviewer should be guided by the question: Huve my responses and determinations been reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simply asks thalt, 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 proiect' on each site, in each Ioca ty, 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 identi[ying impacts, consider long term, short term and cumlative effects. Instructions (Read carefully) a. Answer (;ach 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 I 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 proiect 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. IMPACT ON LAND 1. Will the proposed action result in a physical change to~_e, project site? ~,~O E3YES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will c~ntinue for more than I year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2. Will there he an effect t(...,y un;que or unusual land forms found on the site? (i.e, cliffs, dunes, geological formations, etc~),~NO []YES · Specific land forms: 1 2 3 Smallto Potential Can Impact Be Moderat~ Large Mitigated By Impact Impact Project Change [] [] [:]Yes [:]No [] [] [~Yes []No L~ [] []Yes []No [] [] [~Yes []No [] [] []Yes []No [] [] ~Yes ~]No [] ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No '~ Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7 Will proposed action affect a r quality? ~i~kNO [Z]YES Examples that would apply to column 2 · Proposed Action will induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of more than I ton of refuse per hour. · Emission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million BTU's per hour. · Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PI~ANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species? ~NO [~YE$ Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. · Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. · Other impacts: 9. Will Proposed Action substantially affect non-threatened or non-endangered species? ~,~NO I-lYE S Examples that would apply to column 2 · Proposed .Action would substantially interfere with any resident or migratory fish, shellfish or wddlife species. · Proposed Action requires the removal of more than 10 acres 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 [~YES Examples that would apply to column 2 · ]-he proposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, etc.) 2 3 Small to Potential Can Impact Be Moderate Large 'Mitigated By Impact Impact Project Change [] [] [~Yes []N( [] [] [~]Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes I--1No [] [] [~]Yes []No ~ ~ ~Yes ~No ~ ~ ~Yes ~No U ~ ~Y~s ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District, more than 2.5 acres of agricultural land · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g., subsurface drain lines, outlet strip cropping); or create a need for such measures (e.g. cause a fa field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources? ~TNo [~YES (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 or in sharp contrast to current surrounding land use patterns, whether man-made or natural. · Proposed land uses, or project components visible to users of aesthetic resources which wil! eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views Imown to be important to the area. · Other impacts: IIVIPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? _~NO []YES Examples that would apply to column 2 - · Proposed Action occurring wholly or partially within or substantially 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 project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportun t es? C Examples that would apply to column 2 '~NO [~YES · The permanent foreclosure of a future recreational opportunity. ' A major reduction of an open space important to the COmmunity. · Other impacts: 9 1 Small to* Moderate Impact 2 Potential Large Impact 3 Can Impact Be Mitigated By Project Change [Yes [~]No I--lYes [~No [:]Yes /~N( []Yes [No []Yes [No [=]Yes ['qNo I~Yes [=]No [Yes [=]No [:]Yes ~]No [~Yes [~No ~Yes [~3No /~]Yes [No [:]Yes E~No []Yes [No ~Yes [~No IMPACT ON TRANSPORTATION ~ Small to .14. Will there be an effect to existing transportation ? Moderate Examples that would apply to column 2 ~.~m~ EYES Impact · Alteration of present patterns of movement of People and/or goods. · Proposed Action will result in maior traffic problems. · Other impacts: IMPACT ON ENERGY 15. Wiff proposed action affect the community's Sources of fuel or energy supply~ EXamples that would apply to column 2 '~NO ~YE.S · Proposed Action will cause a greater than 5% increase in the use of any form of energy in the municipality. · Proposed Action will require the Creation or extension of an energy 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: NOISE AND ODOR IMPACTS 16, Wil~ there be objectionable odors, noise, or vibration as a result of the Proposed Action? ~ Examples that would apply to column 2 "~NO [~YES · 13lasting within 1,500 feet of a hospital, school or other sensitive facility. · Odors will OCcur routine}y (more than one hour per day). · Proposed Action will produce operating noise exceeding the local ambient noise levels for noise outside of structures. · Proposed Action will remove natural barriers that would act as a noise Screen. · Other impacts: IMPACT ON PUBLIC HEALTH 17. Will Proposed Action affect public health and safety.~NO Examples that would apply to column 2 . J~YES · Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pesticides, chemicals, radiation, etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. · Proposed Action may result'in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) · Storage facilities for one rrlilJion or more gallons of llquified natural gas or other flammable liquids. · Proposed action may result in the excavation or other disturbance within 2,000 feet of a site used for the disposal oi~ solid or hazardous waste. · Other impacts: 10 2 Potential Large Impact 3 Can impact Be Mitigated By Project Change lyes []No lyes []No []Yes []No lyes [~No [Yes [No [Yes [No [Yes ENo ENo [No ~Yes []No []Yes ~No [Yes [Yes [No [~] Yes []No ~]Yes []N0 [Yes [No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the exis~,community~ Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future projects. · Proposed Action will create or eliminate employment. · Other impacts:_ 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes ~]No [] [] ~]Yes ~]No [] [] ~]Yes []No [] [] [~]Yes [~No [] ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No 19 Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? ~1~O [~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 Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change{s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources of value · Whether the impact can or will be controlled · The regional consequence of the impact · Its potential diw~rgence I'rom local needs and goals · Whether known objections to the project relate to this impact. (Continue on attachments) 11 617.21 Appendix B State Environmental Quality Review V sual EAF Addendum SEQR This form may be used to provide additional information relating to Question ! 1 of Part 2 of the Full EAF. (To be comp!eted by Lead Agency) Visibility Distance Between Project and Resource (in Miles) 1. Would the project be visible from: 0-V4 ~/4-V2 V2-3 3-5 5+ · A parcel of land which is dedicated to and available [] [] [] [] [] to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public [] [] [] [] [] observation, enjoyment and appreciation of natural or man-made scenic qualities? · A site or structure listed o~ the National or State [] [] [] [] [] Registers of Historic P aces? · State Parks? [] [] [] [] [] · The State Forest Preserve? [] [] [] [] [] · National Wildlife Refuges and state game refuges? [] [] [] [] [] · National Natural Landmarks and other outstanding [] [] [] [] [] natural features?' · National Park Service lands? [] [] [] [] [] · Rivers designated as National or State Wild, Scenic [] [] [] [] [] or Recreational? · Any transportation corridor of high exposure, such [] [] [] [] [] 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 des gnation? · 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 []Yes []No Are any of the resources checked in question 1 used by the public during the time of year during which the project will be v sible? []Yes []No DESCRIPTION OF EXIS'[iNG VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally'describe the surrounding environment. 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: *V2 mile E~] Yes [~No * 1 mi~es ~[~Yes []No *2 miles ~]Yes [~]No *3 miles [~Yes I~No Within *V4 mile *1 mile * Distance from project site are provided for assistance, Substitute other distances as appropriate EXPOSURE 6. The annual number of viewers likely to observe the proposed project is __ __ NOTE: When user data is unavailable or unknown, use best estimate. -- CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Activity Travel to and from work Involved in recreational activities Routine travel by residents At a residence At worksite Other _ Holidays/ Daily Weekly Weekends Seasonally 14-16-2 (2/87)-- 7c 617.21 Appendix A NOV,, 5 i SEeR State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The fuji YAF is designed to help applicants and agencies determ ne, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may be technically expert in environmental analysis. In add t on, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. l:ull EAE Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given proiect and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: FocL~ses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially- large impact. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part2 is identified as potentially-large, then Part3 is used to evaluate whether or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify the Portions of EAF completed for this project: [] Part 1 [] Part 2 []Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropr ate), and any other supporting informaticm, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: [] A. The project will not result in any large and important impact(s) and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prepared. [] g. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* [] C. The proiect 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 l'~ame of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Eead Agency Title of Responsible Officer Signature of Preparer (If different-from responsible officer) Date 1 PART 1--PROJECT INFORMA', ~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 additiona!~ information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full FAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such ~dditional work is unavailable, so indicate and specify each instance. NAME OF ACTION LOCATION OF ACTION (Include Street Address, Municipality and County) NAME OF APPLICANT/SPONSOR BUSINESS TELEPHONE ADDRESS STATE ZIP CODE CITY/PO NAME OF OWNER (If different) ~USINESS TELEPHONE ( ) ADDRESS CITY/PO STATE ZIP CODE DESCRIPTION OF ACTION ~, e.'~- oq'~' 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 [and use: [~Urban r~lndustrial ~Commercia] ~;.Residential (suburban) I-IRura[ (non-farm) E~Forest [~Agriculture I~Other 2. Total acreage of project area: _~0~. 0~ acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) acres acres Forested acres acres Agricultural {Includes orchards, cropland, pasture, etc.) ~,~ Oq'q~ acres '~) ,0~"~ 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? a. Soil drainage: [~'Well drained % of site C3Moderately well drained __ % of site E3Poorly drained % of site b If any agricultural land is iRvolved, how many acres of soil are classified within soil group 1 through 4 of the NYSe. Land Classification System? q acres. (See 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? F3Yes ~'No a. What is depth to bedrock? {in feet) 2 5'. Approximate percentage of propc ~ project site with slopes: ~i~0-10% ~__ --_ % ~10-15% % ~15% or greater .... % , 6. Is project substantially contiguous to, or contain a bullring, site, or district, listed on the State or the National Registers of Historic Places? [~Yes ~No ~'~7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? ~]Yes [~fNo 8. What is the depth of the water table? '~ (in feet) 9. Is site located over a primary, principal, or sole SOurce aqL fer? [~Yes ~No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? OYes ~No 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? [~Yes 'l~No According to Identify each species 12. Are there any unique or unusual land forms on the proiect site? (ie., cliffs, dunes, other geological formations) [Z]Yes ~No Describe 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? ~Yes l~No If yes, explain . 14. Does the present site include scemc views known to be important to the commun ty~ -- E~Yes '~No · 15. Streams within or contiguous to proiect area: ~f)lt~. a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland areas within or contiguous to project area:-- -- a. Name qOq~. __ b. Size (In acres) 17. Is the site served by existing public ut res? t~Yes [~No a) If Yes, does sufficient capacity exist to allow connect on? ~]Yes ~No b) If Yes, will improvements be necessary to allow connection? C]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? Z]Yes [~No 19. Is the site located in or substantially contiguous to a Critical Enviromnental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 ~.Yes E]No I_.~-~'~:~ ~,~ 20. Has the site ever been used for the disposal of solid or hazardous wastes? ~]Yes ~No B. Project Description 1. Physical dimensions and scale of project {fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor ~c],(] I~"~ b. Project acreage to be developed: J _ acres initially; c. Proiect acreage to remain undeve!oped _ ~g_. _ acres. - d. Length of proiect' in miles: /~ __ {if appropriate) e. If the project is an expansion, indicate percent of expansion ro)os _ f. Number of off-street parking spaces existing [~ P D se g. Maximum vehicular trips generated per hour ~/~ ---~ -- [upon completion of project)? h. If residential: Number and type of }lousing units: One Family Two Family Multiple Family Initially I Ultimately -- I - i. Dimensions (in feet) of pr ed structure height; ~. _ width; _ __ length. j. Linear feet of frontage P thoroughfare project will occupy is?.!~'~[ _ ft. _ acres ultimately. Condominium 2. How much natural material (i.c ock, earth, etc.) will be removed from t ~ite? /~lXe' 3. will disturbed areas be reclaimed? [Yes []No ~N/A a. If yes, for what intend_~ purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? []Yes [No c. will upper subsoil be stockpiled for reclamation? []Yes ~lNo 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? ,%~t~ e~ acres. 5. Will any mature forest (over 100 years old) or other Iocallydmportant vegetation be removed by this project? ][]~es I~No 6. If single phase project: Anticipated period of construction _ ~1~ months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated (number). b. Anticipated date of commencement phase 1 month c. Approximate completion date of final phase month d. Is phase1 functionally dependent on subsequent phases? IqYes [qNo 8. will blasting occur during construction? I-lYes [~No 9. Number of iobs generated: during construction N~e, ; after project is complete 10. Number of jobs eliminated by this project 11. Will project require relocation of any projects or facilities? []Yes E~No If yes, explain tons/cubic yards year, (including demolition). year. 12. Is surface liquid waste disposal involved? ~Yes ~lNo 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? E3Yes ~gNo Type 14. will surface area of an existing water body increase or decrease by proposal? Explain [Yes E~No 15. Is project or any portion of project located in a 100 year flood plain? E3Yes 16. will the project generate solid waste? ~Yes []No a. If yes, what is the amount per month ~5~',~t\ tons \ ~o~9~ e~Y~53r~n~ b. If yes, will an existing solid waste facility be used? ~Yes [No c. If yes, give name ~,~lt(,~,~_ ~,~2~ ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 1~No [Yes ~No 17. Will the project involve the disposal of solid waste? a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? . 18. Will project use herbicides or pesticides? [Yes I~Yes ~4o tons/month, years. 19. will project routinely prc~duce odors (more than one hour per day)? [Yes 20. will project produce operating noise exceeding the local ambient noise levels? []Yes 21. Will proiect result in an increase in energy use? []Yes ~No If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity ~ gallons/minute. 23. Total anticipated water usage per day gallons/day. 24. Does prolect involve Local, State or Federal funding? [Yes ~'No If Yes, explain Part 2--"~OJECT IMPACTS AND THEIR ~'~,GNITUDE Responsibility of Lead Agency General ~nformation (Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations been reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simply asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in col~Jmn 2. The examples are generally applicable throughout the State and for most situations. But, for any specific proiect 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 Iocalty 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, f mpact threshold equals or exceeds any example is lower than example, check column 1. provided, check column 2. If impact will occur but threshold 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. IMPACT ON LAND I Will the proposed action result in a physical change to the project s Examples that would apply to column 2 [~]NO ~]YES · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will c~ntinue for more than I year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfilh · Construction in a designated floodway. · Other impacts 2. Will there be an effect t, _..~y m!,que or unusual land forms found on the site? (i.e, cliffs, dunes, geological formations, etc.)~NO ~YES · Specific land forms: 6 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Ghange [] [~ ~Yes ~]No [] [] ~]Yes ~]No ~J [] ~Yes ~No ~ ~ ~Ves ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No Submittal 25. Approvals Required: Date C City. Town, Village Board [~Yes City, Town, Village Planning Board ~¥es [Z]No City, Town Zoning Board ~]Yes [~No City, County Health Department RYes Other Local Agencies J~Yes [~No Other Regional Agencies []Yes [~No State Agencies [Yes ~No Federal Agencies []Yes [~No 'lype C. Zoning and Planning Information I. Does proposed action involve a planning or zoning decision? [~Yes If Yes. indicate decision required: []zoning amendment ~]zoning variance []special use permit [~ubdivision f [[3site plan\ [new/revision of master plan []]resource management plan []]]other __.~:~,,k,~.~. 2. What is the zoning classification(s)of the site? ~k 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 4. What is the proposed zoning of the site? ~1~ 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? RYes []No 7. What are the predominant land use(s) and zoning classifications within a ¼ mile radius of proposed action? 8. Is the proposed action compatible with adioining/surrounding land uses within a 1/~ mile? ~Yes []No 9. ~f the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? _ I~'~;q.!'~ 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? []Yes vg3'No 11 Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? [Yes E~o a. If yes, is existing capacity sufficient to handle proiected demand?[]YesfqNo 12. Will the proposed action result in the generation of traffic significantly above present levels? i-lYes 1~o a. If yes, is the existing road network adequate to bandle the additional traffic? [Yes []No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the inform~i)on provi~l above~.s~true to the best of my knowledge. Applicant/Sponsor Name /~- '/~'~ ~'/~-p~ ~'" - Date ,/.~/.c~.~ Signature_ ~on4~ ~0~~x~ ~itle_ O~n~ If the action is in the Coastal Area, and you are a state agency, complele the Coastal Assessment Form before proceeding wi~h this assessment. 5 1 2 IMPACT ON WATER Small to Potential 3. Will proposed action affect any water body designated as protected? Moderate Large {Under Articles 15, 24, 25 of the Environmental Conservation Law, ECl_) Impact Impact Examples that would apply to column 2 [NO EYES · Developable area of site contains a protected water body [] [] · Dredging more than 100 cubic yards of material from channel of a protected stream. [] [] · Extension of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water? Examples that would apply to column 2 []NO ~YES · A 10% increase or decrease in the surface area of any body of Water or more than a 10 acre increase or decrease · Construction of a body of water that exceeds 10 acres of surface · Other impacts: area. 5. Will Proposed Action affect surface or groundwater quality or quantity? Examples that would apply to column 2 E3NO [YES · Proposed Action will require a discharge permit. · Proposed Action requires use of a source of Water that does not have approval to serve proposed (proiect) action. ' Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination of a water SUpply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveye J off the site to facilities which presently do not exist or have inadequate capacity. · Proposed Action would use water in excess of 20,000 gallons per day. · Proposed Action will likely cause siltation or other discharge into an 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 products greater than 1,100 gallons. · Proposed Action will allow residential uses in' areas without water and/or sewer services · Proposed A, ction locates COmmercial and/or industrial uses which may require new or expansion of existing waste treatment and/or Storage facilities. · Other impacts:_ C 6 Will proposed action alter drainage flow or patterns, or surface water runoff? I~xatnples that would apply to column 2 ~NO [~YES · Proposed Action would change flood water flows. Impact Mitigated By Project Change ~Yes []No []Yes []No [~] [~ ~Yes []No [] [] []Yes CINo [] [] []Yes [~No [] [] []Yes [~]No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes UNo [] [~ []Yes []No [] [] [~]Yes []No [] [] []Yes []No [] ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~] [] []Yes ~No [~ [] []Yes []No [] [~ ~Yes [~No []Yes []No []Yes []No · Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7 Will proposed action affect air quality? []NO E3YES Examples that would apply to column 2 · Proposed Action wi[I induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of more than 1 ton of refuse pet' hour. · Emission rate of total contaminants will exceed S lbs. per hour or a heat source producing more than 10 million BTU's per hour · Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS 8. will Proposed Action affect any threatened or endangered []NO ~YES species? Examples that would apply to column 2 · Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. · Removal of any portion of a critical or significant wildlife habitat. · Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. · Other impacts:-- 9. Will Proposed Action substantially affect non-threatened or non-endangered species? C~NO ~]YES Examples that would apply to column 2 · Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species, · Proposed Action requires the removal of more than 10 acres 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? ~NO []YES Examples that would apply to column 2 · The proposed action would sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, etc.) 8 Small to Moderate impact 2 3 Potential Can impact Be Large Mitigated By Impact Project Change [] []Yes [~]No [] [-']Yes []No [] []Yes ~lNo [] []Yes []No [] ~]Yes [~]No [] []Yes []No [] [-JYes []No [] []Yes []No [] []Yes []No [] []Yes []No [] [~]Yes []No [] []Yes J-]No [] ~]Yes []No [] E]Yes []No [] [~]Yes []No [] [~]Yes [~] No [] []Yes E]No Small to~ PotentialCan Impact Be Moderate Large Mitigated By Impact Impact 'Project Change of [] [] []Yes []N~ [] [] []Yes ~]No re al [] [] ~]Yes r-]No m -- -- [] [] [~Yes [~No S I, [] [] []Yes [~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Ves ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Ves ~No · Construction activity would excavate or compact the soil profile agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District, more than 2.5 acres of agricultural land · The proposed action would disrupt or prevent installation of agricultural land management systems (e g, subsurface drain lines, outlet ditch, strip cropping); or create a need for such measures (e.g. cause a farr field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 11. Will proposed action affect aesthetic resources? [~NO [y (If necessary, use the Visual EAF Addendum in Section 61721 Appendix B) Examples that would apply to column 2 · Proposed land uses, or project components obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural · Proposed land uses, or project components visible to users of aesthetic resources which will eliminate or srgnificantly reduce their enjoyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: INiPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance? line ~]YES Examples that would apply to column 2 · Proposed ,Action occurring wholly or partially within or substantially contiguous to any facility or site listed on tile State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project sit(!. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inwmtory. · Other impacts:_ IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect the quantity or quahty of existing or future open spaces or recreatioual opportunities? Examples that would apply to cohm~n 2 E~NO [~YES · The permanent foreclosure of a future recreational opportunity · A major reduction of an open space important to tile Community. · Other impacts: 9 IMPACT ON TRANSPORTATION 14~ Will there be an effect to existin8 transportation systems? E~NO []YES Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods. · Proposed Action will result in major traffic problems. · Other impacts: IMPACT ON ENERGY 15, Will proposed action affect the community's sources of fuel or energy supply? E~NO []YES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of any form of energy in the municipality. · Proposed Action will require the creation or extension of an energy 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: NOISE AND ODOR IMPACTS 16 Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? - [~NO E~YES Examples that would apply to column 2 · Blasting within 1,500 feet of a hospital, school or other sensitive facility. · Odors wi][ occur routinely (more than one hour per day) · Proposed Action will produce operating noise exceeding the local ambient noise levels for noise outside of structures. · Proposed Action wii] remove natural barriers that would act as a noise screen. · Other impacts:_ IMPACT ON PUBLIC HEALTH 17. Will Proposed Action affect public health and safety? E~NO E3YES Examples that would apply to column 2 · Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pesticides, chemicals, radiation, etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. · Proposed Action may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) · Storage facilities for one million or more gallons of liquified natural gas or other flammable liquids. · Proposed action may result in the excavation or other disturbance within 2,000 feet of a site used for the disposal of solid or hazardous waste. · Other impacts: 10 1 2 Small to Potential Moderate Large Impact impact 3 Can Impact Be Mitigated By Project Change ~[Yes [~]No ~]Yes I~No E~]Yes [~No [~Yes [-]No [~]Yes I~No E~Yes [~No I~Yes ~]No E~Yes [~No ~]Yes [~No E~Yes I~No [~Yes [~No E~Yes E~No [~Yes [~No [~Yes []No I~Yes [NO OYes ~No IMPACT ON GROWTH AND CHARACTER 1 OF COMMUNITY OR NEIGHBORHOOD Small Modera 18. Will proposed action affect the character of the existing commun tV? Impact C ~NO E~Y£S Examples that would apply to column 2 · The permanent population of the city, town or village in which the [] project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services [] will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. [] · Proposed action will cause a change in the density of land use. [] · Proposed Action will replace or eliminate existing fact t es structures or areas of historic importance to the community. · Development will create a demand for additional COmmunity services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future projects. [] · Proposed Action will create or eliminate employment. · Other impacts:_ [] 2 3 Io Potential Can Impact Be te Large Mitigated By t Impact Project Change [] []Yes []No [] [~] Yes []No [] ~Yes []No [] []Yes [~No [] []Yes ~]No [] []Yes ~No [~ ~]Yes ~]No [] {~]Yes [~No [] [~Yes []No 19 Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? []NO ~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 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 il~ the impact{s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact could be mitigated or reduced to a small to moderate m~pact by pro~ect 3. Based on the information available, decide if it is reasonable to conclude that this impact is imporlant, change(s). To answer the question of importance, consider: · The probability of the inti')act oCCUrring · The duration of the impact · Its irreversibility, including permanendy lost resources of value · Whether the impact can or will be controlled · The regional consequence of the impact · Its potential divergence (rom local needs and goals · Whether known objections to the proiect relate to this impact. {Continue on attachments) 11 617.21 Appendix B Environmental Quality Review ______Visual EAF Addendum SEQR This form may be used to provide additional information relating to Question ! ] of Part 2 of Lhe Full EAF. (To be comp!eted by Lead Agency) Visibility ][. Would the project be visine from: · 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 qua ties? · An 0verlook or parcel of land dedicated to public observation, enjoyment and appreciation of natural or man-made scenic qualities? · A site or structure listed on the National or State Registers of Historic Places? · State Parks? · The State Forest Preserve? · National Wildlife Refuges and state game refuges? · National Natural Landmarks and other outstanding natural features? · National Park Service ands'~ · 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 or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as scenic? · Municipal park, or designated open space? · County road? · State? · Localroad? Distance Between Project and Resource (in Miles) 0-Y4 ~A.]/2 Y2-3 3-5 5+ 2. Is the visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other seasons) ~¥es 3. Are any of the resources checked in question ! used by the public during the time of year during wi~ich the project will be visible? ~Yes ~No DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally 'describe the surrounding environment. Essentially undeveloped Forested Agricultural Suburban residential Industrial Commercial Urban River, Lake, Pond Cliffs, Overlooks Designated Open Space Flat Hilly ntainous Other NOTE: add attachments as needed 5. Are there visually similar projects within: *V~ mile []Yes ~No '1 miles [~Yes []No *2 miles []Yes UNo Within *V4 mile '1 mile *3 miles []Yes []No * Distance from project site are provided for assistance. Substitute other distances as apl EXPOSURE {5. 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. Thesituationoractivityin whichtheviewersareengaged whileviewingtheproposedactionis FREQUENCY Holidays/ Daily Weekly Weekends Seasonally Activity [] [] [] [] Travel to and from work Involved in recreational activities [] [] [] [] Routine travel by residents [] [] [] [] At a residence [] [] [] [] At worksite [] [] [] [] Other APPLICATION FOR APPROVAL OF PLAT To the Planning Board of the T0xvn of Southold: The undersigued applicant hereby applies for (tentative) (final) approval of a subdivision plat in 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 is the owner of record of the land onder application. (If the applicant is not the owner of record of the land under application, the applicant shall state his interest in said land under application.) 2. The name of the subdivision is to be ....~A~..~.. Y'..~. .~'.-.?..~.~.O..~...-~.q..,q .~O.5y.~..~! .~.~. ......... 3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed 4. The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as Liber ........................ Page Liber ........................ Page ...................... On ....................... ; Liber ........................ Page ...................... On Liber ........................ Page ...................... On Liher ... Page as devised under the Last Will and Testament of or as distributee .................... . .................................................... 5. The area of the land is ..~3.-~.~ ...... acres. 6. All taxes which are liens on the land at the date hereof have been paid ,:x~q:t ............ 7. The land is encumbered hy .... ~.9. mortgage (s) as follows: ..................................................... (a) Mortgage recorded in Liber .............. Page .................. h~ oriR'inaI amonnt of $. unpaid amount $ ............. - .................. hehl by ................. .............. address (b) M~,rtga~c recorded in Liber ......... Page ....................... in orij~inal amount of ' ' nnpaid amotmt S ...................... held )>v ................. .............. address (c) Mortgage recorded in Liber .............. Page ................ in orig.inal amount of .............. unpaid amount $ ...................... held by ...................... ...................... address 8. There are no other encumbrances or liens against the Iand.~z:::7: ........................ 9. The land lies in the folloxving zoning use districts ~:~-&.c kk-o-,'e,h - e~,s.r~Se vt\lc4 o~ (~-Q '~ ' i0. No part of tile land lies under water xvhether title water, stream, pond water or other\vise, ~ 11. The applicant shall at his expense install all required public improvements. 12. The land (does) (de .... ~'~) lie in a \Vater District or Water Supply District. Name of Dis- trict, if within a District, is ~rtt'"~o,~-¥ ............................................. and (a) (no) charge will be made for installing said mains. 14. Electric lines and standards v&:kk-be-installed 1~ .~o~..~.p. gx.~.~.~2.q.~ ...................... ..................................... and (a) (ilo) charge will be made for installing said lines. 15. Gas mains will be installed by ......... O.q.k7...~3.~e. 3~-~... and (a) (no) charg'e will be made for installing said mains. ~Ifstreets shownon the plat arc claimed h¥ the applicant to be existing public streets in the Snffolk Cmmty Ilighway system, annex' Schedule "Il" hereto, to show same. ~lf streets shown o~x~hc plat are claimed by the applicant to be existinff pubI~c streets in the Town of South,ld l tighxvay system, annex Schedule"C" hereto to stow same 18. There are no exlsthlg' I)uildings {,r structures on the lall{l which arc not located and shown on the plat. 19. 20. \Vhcrc tile plat shoxxs proposed streets which are extensions ~f streets tm adjoilfimg sub- d/vision mal)s hcreto£~rc filed, there arc m> reserve strips at thc end of the streets {m said cxisting maps at tllcir conjunctions with the pr{q)osed streets. .3.35 of the R,.al Pti,perry Law. Submit a copy of proposed deed for lots shoe:ir]Z all l'cstricti~ms, covenants, cie. :\nn~:x Sc}lcd u h~' "D". 22. The applicant estimates that the cost of grading and required poblic improvements will be $- · · .-~. .... as itemized in Schedule "E" hereto annexed and requests that the matority of the Performance Bond be fixed at .............. years. The Performance Bond xvill be written by a licensed surety company tlnless otherwise shmvn on Schedule "F". (Name of Applicant) ...................... ' (Address) STATE OF NEW ~ORK, COUNTI OF .- ....... ~ .................... ss: On .... .... .., ' ' · - ..... .... before me persooally came executed the fore~oinz instrnmenL and acknowledged that ~T'~ ...... executed tlm Notary PubI~ J ~ .............. , ~YCE M. ~INS ~W ~bl~ ~y~ No. ~5~, Su~ ~TAT~ O~ N~Y YO~K, COUNTY O~ ............................ On the ................ day ............ of .............. , 19 ....... before tne personally came ................... to me known, who heing by me duly sworn did de- pose anti sa), that ......... '... res/des at No. ............................. that .......................... is the .......... .................. of .... ..................................................................... the corl)oration descrihed in and which executed the fm'egoing htstrument; that ............ knoxvs thc >eal or said corporation; that thc seal affixed by order of thc board of directors of said corporath,n. ar;d ~l~:tt ............ signed .............. name thereto hy like order. Notary Public Southold, N.Y. 11971 (516) 765-1938 QUESTIONNAIRE TO BE COMPLETED AND SUBMITTED WITH YOUR APPLICATIONS FORMS 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? (Attached is a list of the wetland grasses defined by the Town Code, Chapter 97, for your reference) Yes Q 2. Are there any other premises under your ownership abutting this parcel? Yes ~ 3. Are there any building permits pending on this parcel? Yes N~ 4. Are there any other applications pending concerning this property before any other department or agency?(Town , State, County, etc.) Yes 5. Is there any application pending before any other agency with regard to a different project: on this parcel? Yes ~ 6. Was this property the subject of any prior application to the Planning Board? Yes N~ 7. Does this property have a valid certificate of occupancy, if yes please submit a copy of same ~ No I certify thaL the above statements are true and will be relied on by the Planning Board in considering this application. Sign/~ture o/~]ope~ty owner or ~'~'~ '~/~/~'~ Attachment to questionnaire for the Planning Board STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the ~-- day of individual described in and who and acknowledged executed [~e same. , 19 , before me personally to me known to be the executed the foregoing instrument, JOYCE M. WILKINS Notary Public, Stata of New York No, 4952246, Suffolk Country Term Expi;e~ June 12, CONSUL! yOUR L~WYER IEFORE SIGNING THIS INSTRUMENT - THIS iNSTRUMSNT SHOULD lB USED BY LAWYERS ONLY THIS INDENTURE, made the off ~ day of Septo--mt~r , nineteen hundred and 1993 BETWEEN NFB DEVELOPMENT CORP., a domestic corporation, having a principal place of business at 9025 Main Road, Mattituck, New York 11952, )artyofthefirstpart, and DONNA DZUGAS-SMITH, residing at 27 Carver Blvd., Bellport, N.Y. 11713 Dist 1000 Section 059.00 Block 10.00 Lot 006.001 party of the second part, WlTNESSETH, that the party of the first part, in consideration of ten dollars and other valuable consideration the party of the second part, does hereby grant and release unto the party of the second part, the heirs ~r 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 in the · - alon last mentioned land 200.00 f~e% ~o the Being and intended to be th~ s~ premises conveyed to the party of the first part by deed dated 9/23/93 recorded in Liber cp ~ That this conveyance is n~nde in the us,~a], ordinary course of business of the party of the first part. TOGETHER with all right, title lind interest, if any, of the party of the first part in and to any streets and roads abuniog the above described premises to the center lines thereof; TOGETHER with the appurtenances he estate and risrbts of the party of the first part in and to said premises; TO HAVE AND TO ~l~[~ tthc premises her~n granted unto the party of the second part, the heirs or successors and assigns of thc party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered aiD'thing whereby the said premises have been encumbered in 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 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. The word "party" shall be construed as if it read "parties" whenever the sense of this indentpre so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. _ Title: 'ot~ d!7 I£6II Moo% a~N 'pIoq~nos 99~I xoM 'O 'd MMQM~ 9 NOSQM q~TmS-s~BnzG euuo~ 0£- 'd/oD · ola.taq; ssauH~ se atueu q paq!.osqns am9 awes aql le 'ssaul!~ p!es 'aq 1~ql pue: ames atN alnaaxa ~es pue luasa.~d se*t 'ssaul[~ amquasqns p!es 'aq ~eql :luamn.:lsu! ~u}o~a~o} aql ~alnaa~a'oqt~ pue u! paq!.osap lenp!t~!pu! aql aq ol 'awes aql palnaaxa leql pa~pa[~ou~ae pue 'luamn~lsu! ~u!o~a~oj aql palnaaxa oqt* pue u! paq!~sap lenp!a!pu! aql aq ol u~ou~ atu ol aw a.~ojaq ' amea ~(lleUOsaad 61 ~o ,(ep aq~ u0 dO Jd, NflOO 'XIOA /AIN dO ILYL$ .~a~/I,g/gO Sgl~ldXg ~tNnO3 ~qod~nS- L~L~ 'ON 3~8 '~ VlOl~Vd pax~e leas aql 1~tll '.uo}leJ~Jo~ p~ ]o leas aq) s~ou~ aq leql '.luamnJlsu~ ~u~o~aJoj aql paln~axa tp~q~ pu~ u, paq~J)sap uopeJodJo~ aql ' pue asodap p}p u:o~s X[np om ~q~u?q 'oq~ 'u~om{ mu tq :SS ~O~n~ dO ~NAO~ ']]OA MIN dO llVAi · awes aql paln.~axa leql pa~pal~OUqae pue 'iuatun3lsu! ]u!o~aaoI aql oq.,* pue u! paq!aasap [enp!^!pu! aql ,~q al u*~ou~ .mi m aw a.lojaq ' atuea ~lleUOsJad 6I ~o ,(ep aq; dO /~LNIIO:, ~111OA /Alii dO Southold Town Planning Board Town Hall Southold, New York 11971 Gentlemen: The following statements are offered for your consideration in the review of the above-mentioned minor subdivision 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, FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building hlspector Town Hall Southold, N.Y. Certificate Of Occupancy z~ 3625 Date ........... ~..~.Zy. 2.o .............. 1985 alteration. THIS CERTIFIES that the building 2745 Tuckers Lane & 42300 C.R. 48 Southold Location of Property .............................. 'S't/e31 ....................... h3r~ie~ House No. 59 qo 6 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision x .Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated January 9 195.5.. pursuant to which Building Permit No. '~ 366~Z dated .... J..a..n.u.a.~.~....'1.O. ............ 19.85, was.. issued, and conforms to an of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... .~??.~. ~..~?..~..<a..~.??.~.~.~., ?~:.~.~.~. ~. ~).~..~..~?!z.~..<~.. .............................. DAVID The certificate is issued to ..................... [o~n'o'r'~) ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... N/A ........... UNDERWRITERS CERTIFICATE NO ...................... 1J..6.9.8.0. q..8 .................... Building Inspector Rev. 1/81 TOWN OF SOUTIIOLD OFFICE OF BUILDING INSI'ECTOR TOWN IIALL SOUTIIOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PRI,MISES TttIS IS TO CERTIFY that the /--/ Land /~-/ [luilding(s) Use(s) # Z12345 Date March 13, 1984 located at ..2745 Tucker Lane & 42300 Middle Road Southold Street Hamlet shown on County tax map as District 1000, Section0_59, l~lock 10 Lot 6 _, does(not)conforn~ to the present Duilding Zone Code of the Town of 5outhold for the following reasons: Insufficient front yard setbacks Accessory barn and two sheds in front yard area On the basis of information presented to the lluilding Inspector,s Office, it has been determinccl that the above noncont'vrming /~/i,;md ~/~{uitdia~(s) /~/Use(s) existed on the effective date the present Building Zone Code of the To~ of Southold, and may be continupd pursuant to and subject to the apph- cable provisions of said Code. IT IS FURTHEi% CERTIFD~D that, based upon in£ormation presented ti~e Building Inspector's'Office, the occupancy and use for which th~s Certifi- cate is issued is as folIows:..A-Residential_Agricultural Zoned The Certificate is issued to of the aforesaid buildinR. -- David L. Mudd (Owner, lessee or tenant) Suffolk County Department of Health Approval N/A UNDERWRITERs CERTIFICATE NO. _ N/A NOTICE IS HEREBY GIVEN that the owner of the above Premises [LAS NOT CONSENTED TO AN INSPECTION of the premises by the tiullding !nspec- tot to determine if the pren-~ises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspectio. has been conducted. This Certificate, thcr(;fore0 does not, and is not In;ended to certify that the premises comply with all other applicable codes and refula- tio.n..s. J3uilding inspector 14,16'4 (?J87)--Text 12 I PROJECTLD. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEQR 1, APPLICANT/SPONSOR 2. PROJECT NAME 3. PROJECT LOCATION: Municipality .~ -~ ~'~ ~.~ County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 5. IS PROPOSED ACT[ON: [] New [] Expansion [] Modificationtalteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially '~c~ ~ O ~-~ ~ acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] industrial [] Commercial [] Agricutture [] ParklForestiOpen space [] Other Describe: T'~. 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] No Il yes, Jist agency(s) and permit/approvals 11· DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAL D PERMIT OR APPROVAL? [] Yes ~,No If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION W~LL EXIST,NG PERMIT/APPROVAL REQUIRE MODIFICATION? []Yes ~No CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE I If the action is in the Coastal Area, and you are a state agency, complete the I Coastal Assessment Form before proceeding with this assessment OVER 1 3ART II--ENVIRONMENTAL ASSESS ~IT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD iN 6 NYCRR, PART 617.127 If yes, coordinate the review process and use the FULL EAF. [] Yes [] N o B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 may be superseded by another involved agency. [] Yes [] No No, a negative declaratJon C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns;[~S~olid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Exptaln brief C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain bdefl C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain brielly. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] NO If Yes, explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For e~ch adverse effect identified above, determine whether it is substantial, targa, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessa~, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. [~ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed act[on WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the'reasons supporting this determination: Name of Lead Agency 2 PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett OHowski, Jr. Mark S. McDonald Kenneth L Edwards PLANNING BOARD OFFICE TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 May 31, 1995 Steve and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 Re: Set-off for Steve and Donna Dzugas-Smith SCTM# 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: Enclosed please find a copy of the map dated March 15, 1994 which was re- endorsed by the Chairman at a work session on May 31, 1995. The mylar maps, which were also endorsed by the Chairman, must be picked up at this office and filed in the office of the County Clerk. Any plat not so filed or recorded within sixty (60) days of the date of final approval, shall become null and void. Please contact this office if you have any questions regarding the above. Sincerely, Richard G. Ward Chairman eric. Submission Without A Cover Letter Date: SCTM#: 1000- ~- ~o - ~,'.1 Comments: DATE: SENDER: SUBJECT: SCT~#: SUBMISSION WITHOUT COVER LETTER COZ.E-lENTS: PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett Odowski, Jr. Mark S. McDonald Kenneth L. Edwards Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-3136 Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD October 25, 1994 Steve and Donna Dzugas-Smith 2745 Tuckers Lane Southold, NY 11971 Re: Proposed set off for Steve and Donna Dzugas-Smith SCTM# 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, October 24, 1994: BE IT RESOLVED that the Southold Town Planning Board grant a ninety day extension of conditional final approval. Conditional final approval was granted on April 18, 1994. The 90 day extension will expire on January 1995 unless all conditions of approval have been fulfilled. Please contact this office if you have any questions regarding the above. Sincerely, Richard (:3. Ward //~ Chairman ~ I~, ?qqHi Edson and Bruer ATYORNEYS AT LAW ROAD-P.O. BOX 1466 SOWIHOLD, NEW YORK 11971 (516) 76~-1222 (516) 765 2500 FAX: (516) 765-2752 July 13, 1994 Planning Board Office Town Hall, 53095 Main Rd PO BOX 1179 Southold, N.Y. 11971 ATT: Richard G. Ward Re: Steve and Donna Dzugas Smith SCTM tt 1000-59-10-6.1 Dear Mr. Ward: In connection with the above matter, enclosed please find copy of Covenants and Restrictions dated May 10th, 1994 which were recorded in the Suffolk County Clerk's Office on June 20, 1994 in Liber 11681, page 874. Should you have any questions, please let me know. --~RRB~//~pI~. Bruer Enc. PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett Odowski, Jr. Mark S. McDonald Kenneth L. Edwards Town Hail, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD FROM: RE: Laury Dowd, Town Attorney Melissa Spiro, Planner ~ Draft Declaration of Covenants and Restrictions Set-off for Steve and Donna Dzugas-Smith SCTM~ 1000-59-10-6.1 DATE: April 19, 1994 Enclosed please find a copy of the draft Declaration of Covenants and Restriction for your legal review. In letters dated February 1, 1994 and March 29~ 1994, the Planning Board outlined the covenants and restrictions required for the subdivision. All of the Planning Board requirements have been included in the document. enc. =LANNING BC', ~ ~ ~] Richard G. V~ George Ritcl Bennett C Mark S. Kenneth PLANNING BOARD OFFICE TOWN OF SOUTHOLD Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-3136 Telephone (516) 765-1938 March Steve 27 Cas Bellpc RE: ~ Dear The fo Planni BE IT Januar County 1 la ]:zugas-Smith ' ['113 ,~,:1. -of f for I h:nna Dzugas-Smith ~]' (:f C.R. 48 and Tucker Lane 9-10-6 · 1 :, l:zugas-Smith: r~!s~lution was adopted by the Southold Town t ~1; a meeting held on Monday, March 28, 1994: Itl]at the Planning Board amend 9,~,, in regard to the January 6, Commission report as follows: its resolution of 1994 Suffolk ,e:: 2 of the report shall be revised as follows: · .e:; :~riveway or access road shall be located on .]{~ Road~ C.R. 48 for any present or future ~ d(mtial use of either Lot Number 1 or Lot Number 2 ;: h(~;n on map of the Dzugas-Smith subdivision. The ab~ ' , the P1, Please the ab~ Sincer~ Richar: Chairm! ioned amendment is the only change being made to ;oard's January 31, 1994 resolution. t:h[s office if you have any questions regarding cc: S, ::t n~:y Planning Commission F: h~ n )wicz PLANNING BOARD MEMBERS Richard G. Wand, Chairman George Rltchle Latham, Jr. Bennett Orlowskl, Jr. Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF $OUTHOLD scott L. HARRIS Supervisor Town Hail, 53095 Main Road P. O. Box 1179 Southo[d, New York 11971 Fax {516) 765 - 1823 February 1, 1994 Steve & Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 Re: Proposed set-off for Steve & Donna Dzugas-Smith S/w corner of C.R. 48 and Tucker Lane Southold SCTM~ 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, January 31, 1994: BE IT RESOLVED to adopt the January 6 1994 Suffolk County Planning Commission report. ' Numbers 1-3 of the report, in addition to the items listed below, must be presented in a Declaration of Covenants and Restrictions in proper legal form. A copy of the draft Declaration of Covenants ~nd Restrictions must be submitted for review by the Planning Board and the Town Attorney. Once approved, the document must be filed in the Office of the County Clerk, and the Liber and Page number of the filed document must be noted on the final map. The following paragraphs must be included in the Declaration of Covenants: Page 2 Proposed set-off for Steve and Donna Dzugas-Smith February 1, 1994 A. If Lot Number 2 is subdivided in the future, the yield shall be determined after first subtracting 31,808 square feet in area from the total lot area, because said land represents the clustered open space for Lot 1 of this set-off application. B. These covenants and restrictions can be modified only at the request of the then owner of the premises with the approval of a majority plus one of the Planning Board of the Town of Southold after a public hearing. Adjoining property owners shall be entitled to notice of such public hearing but their consent to such modification shall not be required. Please contact this office if you have any questions regarding the above. Sincerely, Richard G. Ward Chairman enc. cc: Suffolk County Planning Commission Frank Cichanowicz DEPARTMENT OF PLANNING COUNTY OF SUFFOLK ROBERT J. GAFFNEy SUFFOLK COUNTY EXECUTIVE STEPHEN M. JONES, A.LC,P. DIRECTOR OF PLANNING January 6, 1994 Mr. Richard Ward, Chairman Town of Southold Planning Board Main Road Southold, NY 11971 Dear Mr. Ward: Re: Minor Subdivision - Stephen & Donna Dzugas-Smith S/w/c of North Road, C.R. 48 and Tucker Lane, Southold The Suffolk County Planning Commission at its regular meeting on January 5, 1994, reviewed the Subdivision - Stephen & Donna proposed subdivision plat, entitled, "Minor Dzugas-Smith" referred to it pursuant to Section A14-24, Article XIV of the Suffolk County Administrative Code. The attached Resolution signifies action taken by the Commission relative to this application. File: S-SD-93-13 FD:mb Attachment cc: S. Hayduk, Comm., SCDPW J. Ba5er, C.E., SCDHs by Very truly yours, Stephen M. Jones Director of Planning . oy ing, / Fincip n anner H. LEE OENNtSON BUiLDiNG File No. S-SD-93-13 Resolution No. ZSR-94-03 of Suffolk County Planning Commission Pursuant to Sections A14-24, Article XIV of Suffolk County Administrative Code WHEREAS, pursuant to Sections A14-24, Article XIV of the Suffolk County Administrative Code, a referral was received by the Suffolk County Planning Commission on December 1, 1993, with respect to a proposed plat entitled, "Minor Subdivision - Stephen & Donna Dzugas-Smith" submitted by the Town of Southold Planning Board affecting premises located on the s/w/c of North Road, C.R. 48 and Tucker Lane, in the Town of Southold, and WHEREAS, said referral was considered by the Suffolk County Planning Commission at its meeting on January 5, 1994, and WHEREAS, the Commission has voted to approve with certain changes said referral, Be It Therefore RESOLVED, That the Suffolk County Planning Commission hereby approves and adopts the report of its staff as the report of the Commission, Be It Further RESOLVED, That said proposed plat is approved subject to the meeting of the following conditions that are deemed necessary to help preserve the farmland designated in the Special Groundwater Protection Area Plan and the traffic & safety carrying capacity of the country road. 1. No further subdivision of Lot No. 2 shall be allowed until an acceptable yield map and development plan for the overall property has been provided. The development plan for the property shall take into account the recommendations of the Special Groundwater Protection Area plan for the Town of Southold showing the amount and location of the farmland to be preserved. 2. No new driveway or access road shall be located on Middle Road, C.R. 48. The driveway or access road on Tucker Lane shall not be located within fifty (50) feet of the short radius curve connecting the right-of-way of Middle Road, C.R. 48 with Tucker Lane. Ail stormwater runoff resulting from the development and improvement of this subdivision or any of its lots shall be retained on the site by adequate drainage structures so that it will not flow out onto the right-of-way of Middle Road, C.R. 48. Motion by: Commissioner Cichanowicz Seconded by: Commissioner Rosavitch Commission Vote: 9 Present Yeas 9 Nays 0 Abstentions 0 Dated January 5, 1994 Hauppauge, New York Suffolk County Planning Commission DECLARATION OF COVENANTS AND RESTRICTIONS DECLARATION made this day of April, 1994, by Stephen Dzugas Smith and Donna Dzugas-Smith both residing at 27 Carver Boulevard, Bellport, New York 11713 hereinafter referred to as the "Declarants'. WITNESSETH: WHEREAS, the Declarants, are the owners of real property at Southold, Town of Southold, Suffolk County, New York, a metes and bounds description of which is shown on "Schedule A' annexed hereto and made a part hereof, and referred to herein as the "Premises", and WHEREAS, Declarants intend to subdivide said premises. WHEREAS, The Southold Town Planning Board has agreed to allow and to grant the subdivision of the premises provided that the following covenants and restrictions are imposed. Declarants agree to the imposition of the covenants and restrictions required by the said Plahning Board and in consideration of said approval hereby agree to restrict the use and enjoyment of said PREMISES. NOW, THEREFORE, it is declared that the said premises are hereby held and shall be sold and conveyed subject to the following covenants and restrictions: 1. No further subdivision of Lot No. 2 shall be allowed until an acceptable yield map and development plan for the overall property has been provided. The development plan for the property shall take into account the recommendations of the proposed Special Groundwater Protection Area plan for the Town of Southold showing the amount and location of the farmland to be preserved. 2. No new driveway or access road shall be located on Middle Road, C.R. 48. for any present or future residential use of either Lot Number 1 or Lot Number 2 as shown on map of the Dzugas-Smith subdivision. SOUTHOLD TO~VN PtANNING BOARD 3. All stormwater runoff resulting form the development and improvement of this subdivision or any of its lots shall be retained on the site by adequate drainage structures so that it will not flow out onto the right-of:way of Middle Road, C.R. 48. 4. These covenants and restrictions can be modified only at the request of the then owner of the premises with the approval of the Planning Board of the Town of Southold after a public hearing. Adjoining property owners shail be entitled to notice of such public hearing but their consent to such modification shall not be required. IN WITNESS WHEREOF, the Declarants have duly executed this Declaration on the day and year first above written. DONNA DZUGAS-SMITH STEPHEN DZUGAS-SMITH STATE OF NEW YORK, COUNTY OF SUFFOLK SS: On the day of April 1994, before me personally came DONNA DZUGAS-SMITH and STEPHEN DZUGAS-SMITH to me known to be the individuals described in and who ,executed the foregoing instrument, and acknowledge that they executed the same. Notary public "SCHEDULE A" ALL THAT CERTAIN PLOT, PIECE OR PARCEL OF LAND, SITUATE, LYING AND BEING AT SOUTHOLD IN THE TOWN OF SOUTNOLD, COUNTy OF SUFFOLK AND STATE OF NEW YORK, BEING MORE PARTICULARLy BOUNDED AND DESCRIBED AS FOLLOWS: BEGINNING AT A POINT ON THE SOUTHWESTERLy SIDE OF TUCKER LANE AT THE EASTERLy END OF A LINE HAVING A LENGTH OF 33.37 FEET WHICH LINE BEARS SOUTH 80 DEGREES, 07 MINUTES, 00 SECONDS EAST AND CONNECTS THE SOUTEASTERLy SIDE OF MIDDLE ROAD (COUNTY ROAD 48) WITH THE SOUTHWESTERLy SIDE OF TUCKER LANE; THENCE SOUTH 21 DEGREES, 50 MINUTES, 30 SECONDS EAST ALONG THE SOUTHWESTERLy SIDE OF TUCKER LANE; 1036.66 FEET TO LAND NOW OR FORMERLy OF JURKoVICN; THENCE SOUTH 68 DEGREES, 09 MINUTES, 30 SECONDS WEST ALONG LAST MENTIONED LAND, 200.00 FEET; THENCE SOUTH 21 DEGREES, 50 MINUTES, 30 SECONDS EAST ALONG LAST MENTIONED LAND AND ALONG LAND NOW OR FORMERLy OF STRCICIL, 200.00 FEET; TRENCE SOUTH 21 DEGREEs, 54 MINUTES, 20 SECONDS EAST ALONG LAND NOW OR FOP~RLy OF MONTGOMERY,100.84 FEET; THENCE SOUTH 22 DEGREES, 05 MINUTES, 00 SECONDS EAST ALONG LAND NOW OR FORMERLy OF $TANKEWIcz, PURICH AND SZAWALUK, 300.00 FEET; THENCE NORTH 67 DEGREEs, 35 MINUTES, 00 SECONDS EAST ALONG LAST MENTIONED LAND, 200.00 FEET TO THE SOUTHWESTERLy SIDE OF TUCKER LANE; THENCE SOUTH 22 DEGREEs, 05 MINUTES, 00 SECONDS EAST ALONG THE SOUTWESTERLy SIDE OF TUCKER LANE, 50.00 FEET TO LAND NOW OR FORMERLy OF FASlJANICH; THENCE SOUTH 67 DEGREES, 55 MINUTES, 00 SECONDS WEST ALONG LAST MENTIONED LAND, 200.00 FEET; THENCE SOUTH 22 DEGREES, 05 MINUTES, 00 SECONDS EAST ALONG LAST MENTIONED LAND AND LAND NOW OR FORMERLy OF HAGASIC, 197.60 FEET TO THE NORTHWESTERLy SIDE OF LAND NOW OR FORMERLy OF THE LONG ISLAND RAILROAD COMPANy; THENCE SOUTH 71 DEGREES, 27 MINUTES, 50 SECONDS WEST ALONG LAST MENTIONED LAND, 850.6~ FEET TO LAND NOW OR FORMERLy OF DONOHUE; THENCE NORTH 44 DEGREES, 48 MINUTES, SO SECONDS WEST ALONG LAST MENTIONED LAND, 358.25 FEET TO LAND NOW OR FOR~RLy OF CH~RMEWS; THENCE NORTH 33 DEGREEs. lQ u~, ..... Southold Town Planning Board 2 April 18, 1994 PUBUC HEAEINGS Mr. Orlowski: 7:30 P.M. Stephen and Donna Dzugtas-Smith - This proposal is to set off a 0.73 acre parcel from an existing 29.042 acre parcel located on the southwest corner of County Road 48 and Tucker Lane in Southold. SCTM# 1000- 59-10-6.1. We have proof: of: publication in the local papers and at this time everything is in order for a public hearing. I'll ask if there are any objections to this set off? Hearing none, is anyone in favor of this set off? Hearing none, is there anyone out there, neither pro nor con, who may have information pertaining to this set off that would be of: interest to the Board? Any questions from the Board? Mr. Latham? Mr. Latham: No Mr. Orlowskh Mr. McDonald? Mr, McDonald: None. Mr. Orlowski: Mr, Edwards? Mr. Edwards: No. Mr. Orlowski: Valerie? Ms. Scopaz: No. Mr. McDonald: Mr. Chairman, I make a motion to close the hearing. Mr. Latham: Second. Mr. Orlowski: Motion made and seconded. All in favor? Ayes: Mr. McDonald, Mr. Edwards, Mr. Latham, Mr. Orlowski. Mr. Odowski: Opposed? So ordered. Mr. McDonald: I'd like to make a f:urther motion that WHEREAS, Donna Dzugas-Smith is the owner of the property known and designated as SCTM# 1000-59-10-6.1, located at the southwest corner of County Road 48 and Tucker Lane in Southold; and WHEREAS, this clustered minor subdivision is for 2 lots on 29.042 acres; 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 Southold Town Planning Board 3 April 18, 1994 Negative Declaration on December 13, '1993; and WHEREAS, a final public hearing was closed on said subdivision application at the Town Hall, Southold, New York on April 18, 1994; and WHEREAS, all the requirements of the Subdivision Regulations of the Town of Southold will be met upon the fulfillment of the following conditions; be it therefore RESOLVED that the Southold Town Planning Board grant conditional final approval on the surveys dated March 15, 1994, and authorize the Chairman to endorse the final surveys subject to fulfillment of the following conditions. All conditions must be met within six (6) months of the date of this resolution. 1, The draft Declaration of Covenants and Restrictions must be reviewed by the Planning Board and the Town Attorney. Once approved, the document must be filed in the office of the County Clerk and the LJber and Page number of the recorded document must be noted on the final map, 2, Final maps, (5 paper copies and 2 mylars) all containing a valid stamp of approval from the Health Department, and the LJber and Page number of the recorded Declaration must be submitted, Mr. Edwards: Second the motion. Mr. Orlowski: Motion made and seconded. Any questions on the motion? All those in favor? Ayes: Mr. McDonald, Mr. Edwards, Mr. Latham, Mr. Orlowski. Mr. Orlowski: Opposed? So ordered. MAJOI~ MINOR SUBDIVISIONS, LOT UNE CHANGES AND SET OFF APPUCATIONS Final '~' ' Determln~tiq~s: Mr. Orlowski: West Mil~S~bc~ivision (M, Paul Friedberg) - This major subdivision is for 9 lots on 22.105 acres Io~n the.west side of West Mill Rd,; 1102.15 feet south of Naugles Drive in Mattituck, -~---[M# 1000-106-9-4. Mr. McDonald: Mr. Chairman~ I'd like to make tl~-following motion that WHEREAS,~Qe-So~tI~old Town Planning Board granted con~iti6hat in the major cluster subdivision known as West M II Subdivis' d~, .al approv_~to Ion on May 3; (1993; DECLARATION OF COVENANTS AND RESTRICTIONS DECLARATION made this day of April, 1994, by Stephen Dzugas Smith and Donna Dzugas-Smith both residing at 27 Carver Boulevard, Bellport, New York 11713 hereinafter referred to as the "Declarants". WITNESSETH: WHEREAS, the Declarants, are the owners of real property at Southold, Town of Southold, Suffolk County , New York, a metes and bounds description of which is shown on "Schedule A" annexed hereto and made a part hereof, and referred to herein as the "Premises", and WHEREAS, Declarants intend to subdivide said premises. WHEREAS, The Southold Town Planning Board has agreed to allow and to grant the subdivision of the premises provided that the following covenants and restrictions are imposed. Declarants agree to the imposition of the covenants and restrictions required by the said Planning Board and in consideration of said approval hereby agree to restrict the use and enjoyment of said PREMISES. NOW, THEREFORE, it is declared that the said premises are hereby held and shall be sold and conveyed subject to the following covenants and restrictions: 1. No further subdivision of Lot No. 2 shall be allowed until an acceptable yield map and development plan for the overall property has been provided. The development plan for the property shall take into account the recommendations of the proposed Special Groundwater Protection Area plan for the Town of Southold showing the amount and location of the farmland to be preserved. 2. No new driveway or access road shall be located on Middle Road, C.R. 48. for any present or future residential use of either Lot Number 1 or Lot Number 2 as shown on map of the Dzugas-Smith subdivision. 3. All stormwater runoff resulting form the development and improvement of this subdivision or any of its lots shall be retained on the site by adequate drainage structures so that it will not flow out onto the right-of-way of Middle Road, C.R. 48. 4. These covenants and restrictions can be modified only at the request of the then owner of the premises with the approval of the Planning Board of the Town of Southold after a public hearing. Adjoining property owners shall be entitled to notice of such public hearing but their consent to such modification shall not be required. IN WITNESS WHEREOF, the Declarants have duly executed this Declaration on the day and year first above written. DONNA DZUGAS-SMITH STEPHEN DZUGAS-SMITH STATE OF NEW YORK, COUNTY OF SUFFOLK SS: On the day of April 1994, before me personally came DONNA DZUGAS-SMITH and STEPHEN DZUGAS-SMITH to me known to be the individuals described in and who executed the foregoing instrument, and acknowledge that they executed the same. Notary public "SCHEDULE A" ALL THAT CERTAIN PLOT, PIECE OR PARCEL OF LAND, SITUATE, LYING AND BEING AT SOUTHOLD IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK AND STATE OF NEW YORK, BEING MORE pARTICULARLY BOUNDED AND DESCRIBED AS FOLLOWS= BEGINNING AT A POINT ON THE SOUTHWESTERLY SIDE OF TUCKER LANE AT THE EASTERLY END OF A LINE HAVING A LENGTH OF 33.37 FEET WHICH LINE BEARS SOUTH 80 DEGREES, 07 MINUTES, 00 SECONDS EAST AND CONNECTS T~E SOUTEASTERLY SIDE OF. MIDDLE ROAD (COUNTY ROAD 48) WITH THE SOUTHWESTERLY SIDE OF TUCKER LANE; THENCE SOUTH 21 DEGREES, 50 MINUTES, 30 SECONDS EAST ALONG THE SOUTHWESTERLY SIDE OF TUCKER LANE; 1036.66 FEET TO LAND NOW OR FORMERLY OF JURKOVICH; THENCE SOUTH 68 DEGREES, 09 MINUTES, 30 SECONDS WEST ALONG LAST MENTIONED LAND, 200.00 FEET; THENCE SOUTH 21 DEGREES, 50 MINUTES, 30 SECONDS EAST ALONG LAST MENTIONED LAND AND ALONG LAND NOW OR FORMERLY OF STRCICIL, 200.00 FEET; T~ENCE SOUTH 21 DEGREES 54 MINUTES, 20 SECONDS EAST ALONG LAND NOW OR FORMERLY OF MONTGOMERY,lO0.84 FEET; THENCE SOUTH 22 DEGREES 0S MINUTES, 00 SECONDS EAST ALONG LAND NOW OR FORMERLY OF STANKEWICZ, PURICN AND SZAWALUK, 300.00 FEET; THENCE NORTH 67 DEGREES 35 MINUTES, 00 SECONDS EAST ALONG LAST MENTIONED LAND, 200.00 FEET TO THE SOUTHWESTERLY SIDE OF TUCKER LANE; THENCE SOUTH 22 DEGREES 05 MINUTES, 00 SECONDS EAST ALONG THE SOUTWESTERLY SIDE OF TUCKER LANE, 50.00 FEET TO LAND NOW OR FORMERLY OF FABIJANICH; THENCE SOUTH 67 DEGREES 55 MINUTES, 00 SECONDS WEST ALONG LAST MENTIONED LAND, 200.00 FEET; THENCE SOUTH 22 DEGREES 05 MINUTES, 00 SECONDS EAST ALONG LAST MENTIONED LAND AND LAND NOW OR FORMERLY OF MAGASIC, 197.60 FEET TO THE NORTHWESTERLY SIDE OF LAND NOW OR FORMERLY OF THE LONG ISLAND RAILROAD COMPANY; THENCE SOUTH 71 DEGREES, 27 MINUTES~ 50 SECONDS WEST ALONG LAST MENTIONED LAND, 850.63 FEET TO LAND NOW OR FORMERLY OF DONOHUE; THENCE NORTH 44 DEGREES, 48 MINUTES, 50 SECONDS WEST ALONG LAST MENTIONED LAND, 358.25 FEET TO LAND NOW OR FORMERLY OF CHARMEWS; THENCE NORTH 33 DEGREES, 19 MINUTES, 40 SECONDS EAST ALONG LAST MENTIONED LAND NOW OR FORMERLY OF KAELIN, 718.08 FEET; THENCE NORTH 28 DEGREES, 07 MINUTES, 10 SECONDS WEST ALONG LAST MENTIONED LAND AND ALONG LAND NOW OR FORMERLY OF HUFE, 858.26 FEET TO THE SOUTHEASTERLY SIDE OF MIDDLE ROAD; THENCE NORTHEASTERLY ALONG TME SOUTHEASTERLY SIDE OF MIDDLE ROAD ALONG A CURVE BEARING TO THE RIGHT HAVING A RADIUS OF 1861.86 FEET A DISTANCE OF 716.63 FEET; THENCE SOUTH 80 DEGREES, 07 MINUTES, 00 SECONDS EAST ALONG A LINE CONNECTING THE SOUTHEASTERLY SIDE OF MIDDLE ROAD WITH THE SOUTHWESTERLY SIDE OF TUCKER LANE, 33.37 FEET TO THE POINT OR PLACE OF BEGINNING. FOR INFORMATION ONLY DISTRICT 1000 SECTION 059.00 BLOCK 10.00 LOT 006.001 STATE OF, ~ YORK) ) SS: ~~ of Mattltuck, in SMd County, being du/y SWOrn, says that he/she is Pr/nc/pal Clerk of THE S[~FFOLK TIMES, a Wee]dy Newspaper, published at Mattituck, in the Town of SOUthold, County of SUffolk and State of New York, and that the NOtice of Which the annexed is a Printed Copy, has been regular. ly published in said f~r ~ Newspaper Once each ~_~Weeks SUccessive! week the d Y, commen CHRISTINA VOUNSKI No. ~004~4 ~._,~_u~,??.in s ...eo~ c...~ G/(/ f~..~.-,.,~.m.v.a~m~ No.ember 23, 1 t~Z.T S-orn/~o l~e~'orn me PLANNING BOARD OFFICE TOWN OF SOUTHOLD LEGAL NOTICE Notice of Public Hearing NOTICE IS HEREBY GIVEN that pursuant to Sec- tion 276 of the Town Law, a public hearing will be held by the Southold Town Planning Board, at the Town Hall, Main Road, Southold, New York in said Town on the 18th day of April 1994, on the question of the following: 7:30 P.M. Public hearing for the proposed get off for Steve and Donna Dzugas-Smith, in Southold, in the Town of Southold, County of Suffolk, State of New York. Suffolk County 2h.x Map Number 1000-$9-10-6.1. The property is bordered on the northwest by Middle Road, County Road 48; on the east by 'lhcker Lane, by land now or formerly of Jurkovich, by land no~v. or .formerly of Peros, by land n6w or former- ly of Montgomery, by land now or formerly Of Falkowski, by land now or formerly of Purich, by' fand now or formerly of Cotsouros, by land now or formerly of girinicie, and by land now or formerly of Magasic; on the south by Long Island Railroad; on the southwest by land now or formerly of Akscin; and on the west by land now or formerly of Charnews, by land now or formerly of Pudge and by land now or formerly of Gormell. Any person desiring t6 be heard on the above matter should appear at the time and place specified. Dated: April 1, 1994 BY ORDER OF THE SOUTHOLD TOWN PLANNING BOARD Richard G. Ward Chairman 1X-4/7/94(5) COUNTY OF SUFFOLK STATE OF NEW YORK Patricia Wood, being duly sworn, says that she is the Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, a public newspaper printed at Southold, in Suffolk County; and that the notice of which the annexed is a printed copy, has been published in said Long Island Traveler-Watchman once each week for ..................... ~ ..... weeks successively, commencing on the ...................... day ...... ....... 9 Sworn to before me this ........... .". ........ day of Notary Public BARBARA A. SCHNEIDER NOTARY PUELfC, ?rte cf Ee',v York APR 8 1994 ,SOUTHOLO TOWN PI. ANNING BOARD PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett Odowski, Jr. Mark S. McDonald Kenneth L. Edwards Town Hall, 53095 Main Road P. O. Box 1 t 79 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD March 29, 1994 Steve and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 Re: Proposed set off for Steve & Donna Dzugas-Smith S/w corner of C.R. 48 and Tucker Lane Southold SCTM# 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, March 28, 1994: BE IT RESOLVED that the Southold Town Planning Board set Monday, April 18, 1994 at 7:30 P.M. for a final public hearing on the maps dated March 15, 1994~ The draft Declaration of Covenants and Restrictions must be submitted prior to the date of the hearing. If there are any questions, please do not hesitate to contact this office. Sincerely, Richard G. Ward Chairman cc: Richard Caggiano, Greenport Village Administrator Gerald Hickson, Asst. Superintendent, Greenport Public Utilities PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Ritchie Latham, Jr. Bennett Odowski, Jr. Mark S. McDonaJd Kenneth L. Edwards Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD March 29, 1994 Steve and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 RE: Proposed Set-off for Steve and Donna Dzugas-Smith S/w corner of C.R. 48 and Tucker Lane Southold SCTM# 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, March 28, 1994: BE IT RESOLVED that the Planning Board amend its resolution of January 31, 1994, in regard to the January 6, 1994 Suffolk County Planning Commission report as follows: 1. Number 2 of the report shall be revised as follows: No new driveway or access road shall be located on Middle Road, C.R. 48 for any present or future residential use of either Lot Number 1 or Lot Number 2 as shown on map of the Dzugas-Smith subdivision. The above mentioned amendment is the only change being made to the Planning Board's January 31, 1994 resolution. Please contact this office if you have any questions the above. Sincerely, Chairman regarding enc. cc: Suffolk County Planning Commission Frank Cichanowicz DATE: SENDER: SUBJECT: SCTM#: COMMENTS: SUBMISSION WITHOUT COVER LETTER Io-L,.I .,.fl~- ~ p~,~t~ ,..//-/-Lb PLANNINC BOARD MEMBERS Richard G. Ward. Chairman George Rltchie Latham, Jr. Bennett Orlowskl. Jr, Mark S. McDonald Kenneth L, Edwards Tclepho ne (516) 765 - 1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTt L. HARRIS Supervisor Town Hall. 53095 Main Road P, O. Box 1179 Southold, New York 11971 Fax (516) 765 - 1823 February 1, 1994 Steve & Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 Re: Proposed set-off for Steve & Donna Dzugas-Smith S/w corner of C.R. 48 and Tucker Lane Southold SCTM~ 1000-59-10-6.1 Dear Mr. & Mrs. Dzugas-Smith: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, January 31, 1994: BE IT RESOLVED to adopt the January 6, 1994 Suffolk County Planning Commission report. Numbers 1-3 of the report, in addition to the items listed below, must be presented in a Declaration of Covenants and Restrictions in proper legal form. A copy of the draft Declaration of Covenants and Restrictions must be submitted for review by the Planning Board and the Town Attorney. Once approved, the document must be filed in the Office of the County Clerk, and the Liber and Page number of the filed document must be noted on the final map. The following paragraphs must be included in the Declaration of Covenants: Page 2 Proposed set-off for Steve and Donna Dzugas-Smith February 1, 1994 A. If Lot Number 2 is subdivided in the future, the yield shall be determined after first subtracting 31,808 square feet in area from the total lot area, because said land represents the clustered open space for Lot 1 of this set-off application. B. These covenants and restrictions can be modified only at the request of the then owner of the premises with the approval of a majority plus one of the Planning Board of the Town of Southold after a public hearing. Adjoining property owners shall be entitled to notice of such public hearing but their consent to such modification shall not be required. Please contact this office if you have any questions regarding the above. Sincerely, Richard G. Ward Chairman enc. cc: Suffolk County Planning Commission Frank Cichanowicz DEPARTMENT OF PLANNING COUNTY OF SUFFOLK ROBERT J. GAFFNEY SUFFOLK COUNTY EXECUTIVE STEPHEN M. JONES. A.I.C.P. DIRECTOR OF pLaNNING January 6, 1994 Mr. Richard Ward, Chairman Town of Southold Planning Board Main Road Southold, NY 11971 Re: Minor Subdivision - Stephen & Donna Dzugas-Smith S/w/c of North Road, C.R. 48 and Tucker Lane, Southold Dear Mr. Ward: The Suffolk County Planning Conanission at its regular meeting on January 5, 1994, reviewed the proposed subdivision plat, entitled, "Minor Subdivision - Stephen & Donna Dzugas-Smith" referred to it pursuant to Section A14-24, Article XIV of the Suffolk County Administrative Code. The attached Resolution signifies action taken by the Commission relative to this application. File: S-SD-93-13 FD:mb Attachment cc: S. Hayduk, Comm., SCDPW J. Baler, C.E., SCDHS by Very truly yours, Stephen M. Jones Director of Planning l~rank Dowling,/ P~in¢±pal Planner Subdivision Rd'~ew Dfv±sion File No. S-SD-93-13 Resolution No. ZSR-94-03 of Suffolk County Planning Commission Pursuant to Sections A14-24, Article XIV of Suffolk County Administrative Code WHEREAS, pursuant to Sections A14-24, Article XIV of the Suffolk County Administrative Code, a referral was received by the Suffolk County Planning Commission on December 1, 1993, with respect to a proposed plat entitled, "Minor Subdivision _ Stephen & Donna Dzugas-Smith" submitted by the Town of Southold Planning Board affecting premises located on the s/w/c of North Road, C.R. 48 and Tucker Lane, in the Town of Southold, and WHEREAS, said referral was considered by the Suffolk County Planning Commission at its meeting on January 5, 1994, and WHEREAS, the Commission has Voted to approve with certain changes said referral, Be It Therefore RESOLVED, That the Suffolk County Planning Commission hereby approves and adopts the report of its staff as the report of the Commission, Be It Further RESOLVED, That said proposed plat is approved subject to the meeting of the following conditions that are deemed necessary to help preserve the farmland designated in the Special Groundwater Protection Area Plan and the traffic & safety carrying capacity of the COUntry road. 1. No further subdivision of Lot No. 2 shall be allowed until an acceptable yield map and development plan for the overall property has been provided. The development plan for the property shall take into account the recommendations of the Special Groundwater Protection Area plan for the Town of Southold showing the amount and location of the farmland to be preserved. 2. No new driveway or access road shall be located on Middle Road, C.R. 48. The driveway or access road on Tucker Lane shall not be located within fifty (50) feet of the short radius curve Connecting the right-of-way of Middle Road, C.R. 48 with Tucker Lane. 3. Ail Stormwater runoff resulting from the development and improvement of this subdivision or any of its lots shall be retained on the site by adequate drainage structures so that it will not flow out Onto the right-of-way of Middle Road, C.R. 48. Motion by: Comm/ssioner Cichanowlcz Seconded by: Con~nissfoner Rosavttch Commission Vote: 9 Present Yeas 9 Nays 0 Abstentions 0 Dated January 5, 1994 Hauppauge, New York Suffolk County Planning Commission DEPARTMENT OF PLANNING COUNTY OF SUFFOLK ROBERT J. GAFFNEY SUFFOLK COUNTY EXECUTIVE STEPHEN M. JONES, A.LC.P. DIRECTOR OF PLANNING January 6, 1994 Mr. Richard Ward, Chairman Town of Southold Planning Board Main Road Southold, NY 11971 Re: Minor Subdivision - Stephen & Donna Dzugas-Smith S/w/c of North Road, C.R. 48 and Tucker Lane, Southold Dear Mr. Ward: The Suffolk County Planning Cotmnission at its regular meeting on January 5, 1994, reviewed the proposed subdivision plat, entitled, "Minor Subdivision - Stephen & Donna Dzugas-Smith" referred to it pursuant to Section A14-24, Article XIV of the Suffolk County Administrative Code. The attached Resolution signifies action taken by the Commission relative to this application. File: S-SD-93-13 FD:mb Attachment cc: S. Hayduk, Comm., SCDPW J. Baler, C.E., SCDHS by Very truly yours, Stephen M. Jones Director of Planning Subdivision ReW~iew Division File No. S-SD-93-13 Resolution No. ZSR-94-03 of Suffolk County Planning Commission Pursuant to Sections A14-24, Article XIV of Suffolk County Administrative Code WHEREAS, pursuant to Sections A14-24, Article XIV of the Suffolk County Administrative Code, a referral was received by the Suffolk County Planning Commission on December 1, 1993, with respect to a proposed plat entitled, '%finor Subdivision - Stephen & Donna Dzugas-Smith" submitted by the Town of Southold Planning Board affecting premises located on the s/w/c of North Road, C.R. 48 and Tucker Lane, in the Town of Southold, and WHEREAS, WHEREAS, said referral was considered by the Suffolk County Planning Commission at its meeting on January 5, 1994, and the Commission has voted to approve with certain changes said referral, Be It Therefore RESOLVED, That the Suffolk County Planning Commission hereby approves and adopts the report of its staff as the report of the Commission, Be It Further RESOLVED, That said proposed plat is approved subject to the meeting of the following conditions that are deemed necessary to help preserve the farmland designated in the Special Groundwater Protection Area Plan and the traffic & safety carrying capacity of the country road. I. No further subdivision of Lot No. 2 shall be allowed until an acceptable yield map and development plan for the overall property has been provided. The development plan for the property shall take into account the recommendations of the Special Groundwater Protection Area plan for the Town of Southold showing the amount and location of the farmland to be preserved. 2. No new driveway or access road shall be located on Middle Road, C.R. 48. The driveway or access road on Tucker Lane shall not be located within fifty (50) feet of the short radius curve connecting the right-of-way of Middle Road, C.R. 48 with Tucker Lane. 3. Ail stormwater runoff resulting from the development and improvement of this subdivision or any of its lots shall be retained on the site by adequate drainage structures so that it will not flow out onto the right-of-way of Middle Road, C.R. 48. Motion by: Commissioner Cichanowicz Seconded by: Commissioner Rosavitch Commission Vote: 9 Present - Yeas 9 Nays 0 Abstentions 0 Dated January 5, 1994 Hauppauge, New York Suffolk County Planning Commission SOUTHOLD FIRE DISTRICT P.O. BOX 908, SOUTHOLD, N.Y. I1971 Dece~aber 16, 1993 Mr. Richard G. Ward, Chairman Town of Southold Planning Board Office PO Box 1179 Southold, NY 11971 Re: Dzugas-Smith Dear Mr. Ward: This is to notify you that the Southold Fire District Board of Commissioners has reviewed the survey for the above mentioned parcel. At this time, there is no need for fire- wells on this property. The Board of Commissioners feel that there is adequate fire protection for that area. Sincerely, Cynthia Caprise Secretary PLANNING BOARD MEMBERS Richard (3. Ward. Chairman George Ritchle Latham. Jr. Bennett Orlowskl. Jr. Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTF L. HARRIS Superv/sor Town Hall, 53095 Main Road P. O. Box 1179 Southold. New York 11971 Fax (516) 765 - 1823 December 14, 1993 Steven and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 Re: Proposed set-off for Steven and Donna Dzugas-Smith S/w corner of C.R. 48 and Tucker Lane Southold SCTM~ 1000-59-10-6.1 Dear Mr. and Mrs. Dzugas-Smith: The following resolution was adopted by the Southotd Town Planning Board at a meeting held on Monday, December 13, 1993: BE IT RESOLVED that the Southold Town Planning Board, acting under the State Environmental Quality Review Act, assumes lead agency, and as lead agency makes a determination of non-significance, and grant a Negative Declaration. Enclosed please find a copy of the Negative Declaration for your records. Sincerely, Richard G. Ward Chairman enc. PLANNING BOARD MEMBERS Richard G. Ward, Chairman George Rltchle Latham, Jr. Bennett Orlowski, Jr. Mark S. McDonald Kenneda L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination Non-Significant SCOTT L. HARRIS Supem~sor Town Hall. 53095 Main Road P. O. Box 1179 Southo]d, New York 11971 Fax (516) 765 - 1823 December 13, 1993 This notice regulations Revlew Act) is issued pursuant to Part 617 of the implementing pertaining to Article 8 (State Environmental Quality of the Environmental Law. The Southold Town Planning Board, as lead agency, has determined that the proposed action described below will not have a significant effect on the environment and a Draft Environmental Impact Statement will not be prepared. Name of Action: Set-off (Clustered Subdivision) for Steven & Donna Dzugas-Smith SCTM~: 1000-59-10-6.1 Location: Southwest corner of C.R. 48 and Tucker Lane, Southold SEQR Status: Type I ( X ) Unlisted ( ) Conditioned Negative Declaration: Yes ( ) No (X) Description of Action: Set-off (Clustered Subdivision) of a 0.73 acre parcel from an existing 29.042 acre parcel. The parcel is located in the Agricultural-Conservation District. A restriction has been placed on Lot No. 2 stating that when Lot 2 is subdivided, the yield shall be determined after first subtracting 48,192 square feet in area as this represents the clustered open space for Lot 1. Page 2 SEQRA Negative Declaration - December 13, 1993 Steven & Donna Dzugas-Smith Reasons Supporting This Determination: An Environmental Assessment Form has been submitted and reviewed, and it was determined that no significant adverse effects to the environment were likely to occur should the project be implemented as planned. There has not been any correspondence received 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. There has not been any correspondence received from the Department of Health Services in the allotted time. There- fore, it is assumed that there are no comments or objections from that agency. For Further Information: Contact Person: Melissa Spiro Address: Planning Board Telephone Number: (516) 765-1938 CC: Thomas Jorling, DEC Albany Suffolk County Planning Commission Suffolk County Dept. of Health Judith Terry, Town Clerk Richard Caggiano, Greenport Village Administrator Gerald Hickson, Greenport Public Utilities DEPARTMENT OF PLANNING COUNTY OF SUFFOLK ~:~OBERT J. (~AFFNEY SUFFOLK COUNTY £XE:CUTIVE ._nEC 2 :,:: STEPHEN M. JONES, A.I.C.P. DIRECTOR OF- PLANNING November 30, 1993 Mr. Richard Ward, Chairman Town of Southold Planning Board Main Road Southold, NY 11971 Plat Name: Cluster Subdivision Map of Property Surveyed for Steve & Donna Dzugas-Smith Tax Map #: 1000-59-10-6.1 SCPD File No.: 1333-INC-93-33 Dear Mr. Ward: Please be advised that pursuant to Section A14-24, Article ×IV of the Suffolk County Administrative Code, the above referral will not be reviewed by the Suffolk County Planning Commission because of noncompliance with requirements for notice and maps as stipulated in Informational Bulletin #9 of the Suffolk County Planning Commission. The staff has checked the above referenced referral and find that it is incomplete and that the following items are required: 1. Copy of the E.A.F. 2o Any additional information on compliance with the Southold S.G.P.A. Plan Recommendations. Very truly yours, Stephen M. Jones Director of Planning FD:mb S/s Frank Dowling, Principal Planner Subdivision Review Division NOTE: Please consult Suffolk County Department of Planning Informational Bulletin No. 9 for complete referral requirements. PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham,'Jr. Richard G. Ward Mark S. McDonald Kenneth L Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Frederick R. Weber, Secretary Southold Fire District Main Road Southold, New York 11971 SCOTI' L. HARRIS Supervisor Town Hall 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 Dear Mr. Weber: Please notify this office as to whet any firewells are needed. Please specify whether shallow wells or electric wells will be needed. Please reply by~~ 1993. Thank you for your cooperation. ' enc. PLANNING BOARD MEMBERS Richard O. Ward, Chairman George Ritchie Latham, Jr, Bennett Orlowski, Jr, Mark S. McDonald Kenneth L. Edwaa-ds Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOW L, HARRIS Supervisor Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516} 765 - 1823 Attention: Suffolk County Planning Commision H. Lee Dennison Executive Office Building 12th Floor Veterans Memorial Highway Hauppauge, New York 11788 Mr. Frank Dowling, Senior Planner Subdivision Review Division Gentlemen: Pursuant to Section A14-24, Suffolk County Administrative Code, the Southold Town Planning Board hereby refers the following proposed subdivision to the Suffolk County Planning Commission: Map of - S.C.D.P.W. Topo No.: S.C. Tax Map No.: I000 - 5~ Major Sub. Minor Sub. ~ Site MATERIAL SUBMITTED: Dreli,,in~ry Plat (3 copies) ~_~Road Profiles (1) Drainage Plans (1) Topogroaphical Map (1) Site Plan (1) ~ Grading Plan (1) - /o - d.I __Clusterx Other materials (specify and give number of copies) Waiver of Subdivision Requirements - See attached sheet CONTINUED REFERRAL CRITERIA: ~EQRA STATUs: Comments: The project is an (Unlisted) (~e~--~i) (Type II)Action. A (Negative Declaration) (Positive Declaration) (Determ. of Non-Significance) has been adopted by the Planning Board. E.I.S. statement enclosed. (Yes) (~ The proposed division has rece~i~ed approval S.C. Dept of Health. (Yes) ~. from the We request acknowledgement of receipt of this referral (Yes) (No) Referral received 19 by Suffolk County Planning Commiss~on and assigned File NO. Very truly yours, Richard G. Ward Chairman PLANNING BOARD MEMBERS Richard G. Ward. Chalinnan George Ritchte Latham, Jr. Bermert Orlowskl, Jr. Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD ScoTT L. HARRIS Supervisor Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax {516) 765 - 1823 November 16, 1993 Steven and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 RE: Proposed Set-off for Steven and Donna Dzugas-Smith S/w Corner of C.R. 48 and Tucker Lane Southold SCTM~ 1000-59-10-6.1 Dear Mr. and Mrs. Dzugas-Smith: The following resolutions were adopted by the Southold Town Planning Board at a meeting held on Monday, November 15, 1993: Be it RESOLVED that the Southold Town Planning Board start the lead agency coordination process on this Type 1 action. This action is classified as a Type 1 action since it is located within the Special Groundwater Protection Area. Be it RESOLVED that the Southold Town Planning Board grant sketch approval on the map dated November 9, 1993 with the following condition: This subdivision has been designed in accordance with Section 281 of the Town Law and Article XVIII of the Code of the Town of Southold. If Lot Number 2 is subdivided in the future, the yield shall be determined after first subtracting 31,808 square feet in area from the total lot area, because said land represents the clustered open space for Lot 1 of this set-off application. / Page 2 Dzugas-Smith Set-off November 16, 1993 Sketch approval is conditional upon submission of final maps within six months of the date of sketch approval, unless an extension of time is requested by the applicant, and granted by the Planning Board. The final maps (2 mylars and 5 paper prints) must contain a current stamp of Health Department approval, and must be submitted before a final public hearing will be set. The sketch plans have been referred to the Suffolk County Planning Commission for review. You will be notified upon receipt of the Commission's report. The Planning Board may require covenants and restrictions upon review of the report and review of the final maps. You will be notified if covenants and restrictions are required. The sketch plans have also been referred to the Southold Fire Department for their recommendation as to whether a firewell is necessary for fire protection. The Planning Board has reviewed the property and has decided that it is inadequate in size for a reservation of land for park and playground use. Therefore, a cash payment in lieu of land reservation will be required as per Section A106-38 (E) of the Town Code. The amount to be deposited with the Town Board shall be $2,000.00 (two thousand per lot for each vacant lot in the subdivision.) Payment is required prior to any final endorsement of the subdivision. Please contact this office if you have any questions regarding the above. Sihcerely, ~ ~ic~ard,G. Ward / Chairman CC: Richard Caggiano, Greenport Village Administrator Gerald Hickson, Asst. Superintendent, Water Utility Dept. Southold Town Planning Board Town Hall Southold, New York 11971 Gentlemen: Re: The following statements are offered for your consideration in the review of the above-mentioned minor subdivision 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, PLANNING BOARD MEMBERS Richard G, W~uxt. Chairman George Ritchle Latham. Jr. Bennett Orlowskl. Jr. Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTt L. HARRIS Supervisor Town Hall, 53095 Main Road P. O. Box 1179 Southold. New York 11971 Fax (516) 765 - 1823 November 16, 1993 Steven and Donna Dzugas-Smith 27 Carver Blvd. Bellport, NY 11713 RE: Proposed Set-off for Steven and Donna Dzugas-Smith S/w Corner of C.R. 48 and Tucker Lane Southold SCTM~ 1000-59-10-6.1 Dear Mr. and Mrs. Dzugas-Smith: The following resolutions were adopted by the Southold Town Planning Board at a meeting held on Monday, November 15, 1993: Be it RESOLVED that the Southold Town Planning Board start the lead agency coordination process on this Type 1 action. This action is classified as a Type 1 action since it is located within the Special Groundwater Protection Area. Be it RESOLVED that the Southold Town Planning Board grant sketch approval on the map dated November 9, 1993 with the following condition: This subdivision has been designed in accordance with Section 281 of the Town Law and Article XVIII of the Code of the Town of Southold. If Lot Number 2 is subdivided in the future, the yield shall be determined after first subtracting 31,808 square feet in area from the total lot area, because said land represents the clustered open space for Lot 1 of this set-off application. Page 2 Dzugas-Smith Set-off November 16, 1993 Sketch approval is conditional upon submission of final maps within six months of the date of sketch approval, unless an extension of time is requested by the applicant, and granted by the Planning Board. The final maps (2 mylars and 5 paper prints) must contain a current stamp of Health Department approval, and must be submitted before a final public hearing will be set. The sketch plans have been referred to the Suffolk County Planning Commission for review. You will be notified upon receipt of the Commission's report. The Planning Board may require covenants and restrictions upon review of the report and review of the final maps. You will be notified if covenants and restrictions are required. The sketch plans have also been referred to the Southold Fire Department for their recommendation as to whether a firewell is necessary for fire protection. The Planning Board has reviewed the property and has decided that it is inadequate in size for a reservation of land for park and playground use. Therefore, a cash payment in lieu of land reservation will be required as per Section A106-38 (E) of the Town Code. The amount to be deposited with the Town Board shall be $2,000.00 (two thousand per lot for each vacant lot in the subdivision.) Payment is required prior to any final endorsement of the subdivision. Please contact this office if you have any questions regarding the above. Sihcerely, ~Ric~ard'.'G. Ward Chairman cc: Richard Caggiano, Greenport Village Administrator Gerald Hickson, Asst. Superintendent, Water Utility Dept. SUBMISSION WITHOUT COVER LETTER SCTM~: ~-- /0-- ~o-/ Novemb.'r 4, 19 3 Town Pl.an ~in~ To'~n ,L~ll, 53095 [.~ia [toad Southol~, Ne'" York 11971 ~1 ~se ~ c~ et the ~ttaehed re' ue t for ~ ~lic tion for ~ Set-OFf of the e~:istin~ ~]wel!ing kuo~.n ~s 24~5 Tu:~kers Lan~. The vre:~ent taz number is; 1)OO The re;~zou for thia~ ~e ue'~te~ -~et-O?'f is to cre~to ~ -:eo. r~te ~n l~rger 9,reel for ~e ~nd my f mily to build a ho~c ~d f~rm. The ~resent ~arcel i~ 29 :cres ith ~:even cres of est bli~hed vinay.~rU . This oul ~er ~it us to be~in our ,]ream of fir t b~ildi~ ~o~:; ~r to the vl~.ey~rd= ~..~d then be:q~l~ to ?/ork the l~nd bY z:~rm~nr or more vlmevares. ?e hove to moi~',tain most o~~ th.~: laud ir: a ,~ricultt~r~l use. ~,le~se ~'eel free to ,~11 me :~t 286-5810 if you ~esire more Sincerely, "7 ; rv¢;~ ~q.';'~ ;e]l. :o'-t '.1.7-% SUBMISSION WITHOUT COVER LETTER DATE: SENDER: SUBJECT: SCTM#: COMMENTS: NOV 5 ,.,.~ Dr,O~rowfl Loam Br. Loa~y Sand Pale Br. Fine 1o Coorse Sand KENNEY RoAD C.R. 48 ~ n e s ( MIDDLE ROAD ) eP edge of p=veme~ - _ ~ ~ ~ DRA~ edge of p=Vemenf pavement ~ pAVE TO / ~/~ / ~ ~ / / ~ ~ / ~ ~/~ bh~ ~ / / / I / / / / / / / / / I I I / / / / / / / / / / / / / / / / ? / J " ~ , ', ,' ,, SCALE: 1"= 20' NO D O.R. 48 (_~M/DDZ£ /?D.J L=476.63' 0. R=186t. 86~ oF ~r J KEY MAP scale oouN~ O. ~Tu LIGHTING SCHEDULE SHIELDED FLOOD HP5 / ToM .. ' /~ -- Boring ¢, ~ //.~o ROOF DRAINAGE ~ Loam ~ 0 i/ ROOF AREA: g52 sq. ft. ~ ~ . ~o 952x 0.42 = 400 cu. ft. 400/422 = I0 ~ s~ ~' so,, ~' ~ , ~ ' ~ Provided 2 Lp.s 8'¢ 5 deep ?n ~ "~ ~' ~ING C~IT~I~ . ~: ~.,~,::'~ ~ :~. ~ ~ SALES, lO",q H. 1200=5 spaces SANITARY REQUIREMENTS ~~ ~ ~.,..~~ 7 , ~. ~ PLAN OF EMPLOYEES 2 spaces DZUGAS WINERY , Provided 8spaces GROUND WA TE~ MANAGEMENT ZONE [V ~ ~~ -~"'~' ~ ~ :~, .~ SURVEY . ~.~, ~c~, .~ ~.~.,.,~-~ = ~,~ ,.~.,. ~ ~ .~,, ~ ~ --. ~ sc~,~. ,"= ~oo, A T SOUTHOLD We, S,ore (no kilchen) 10,6 sq.,t. ~ = ~... ~" '~'?'~ '~* ~ TO WN OF SOUTHOLD ¢, ~,. SUFFOLK COUNTY, N ~ q~phc T~nk - 2 doys flow = 102g.p.d. q/ g,p. d. , ~ ~ ~ NO. DA T~ REVISION ,," ' ,_ ,, .. . , ,, ,.... ' ANY AL TERA TION OR ADDITION TO THIS SURVEY'IS ,4 VIOLA TION OF SECTION 7209 OF THE NE~ YORK STA~ LOT COVERAGE BUILDING = 0.01~ LAND$CAPIN~ = 0.17~ TRAFFIC DIRECTION EL.59.1,= EXISTING ELEVATION ~ PROPOSED ELEVA T/ON AND ELEVATIONS ARE REFERENCED CONTOUR LINES APPLICANT~ DONNA DZUGAS~SMITH 2745 TUCKERS LANE SOUTHOLD~ N.Y, 119~1 NO. 49618 ADDITIONALLY TO COMPLY ~l~f ,~Ai~._LA_ W ~/fE. ~I~_~ _TE~J~O__~I~Y' P, O, BOX 909 ~UST . ~ .Y a ~~ 1.30 TRAVELER STREET n 4 6 E • -" r a'• -' �*=$.ice y•^, . fi"' .. .,. t �,� "' �a''::n x '1 �...+ , • a , j n � t , a» t � 4 r l.. t t t� - .V' dr VIP wmyis IJ 8 r C�,rrfr - r • f �, 5 r +''.•` .,.y.x` oa V&-' 6" G , 0.! ..^ F�»7 Tv _ >~trT + <3°��•^ rre�rtl° i -� t� .. �:�e� �ate-#-•,. x ,. . �-� .r�� � w _ � ,4 ,,. �S � 7•'"^r.&.;,; '0' ,°_~ ,nr' ., •' F::, ¢.f`'xl" ... DECiz• .t. 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