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1000-70.-10-37
-SUBJECT PREMISES KEY MAP SCALE 1"=600' OF WILLIA51 F. SITUArt~D A T PINE N CK TOW4~ OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1" 30' ~$¢,;A. LF -- "~'~B'I:~.)~,RY 4, 1997 MARCH 6, 1997 REVISED LOT SIZES M"ARCH 7, 1997 REVISED LOT SIZ:EE~ ~,¢;L,Y 23, f997 ADDED PROPOSED CESSPOOLS & WELL MAY ¢~ ~ 1999 Southold Town . Planning Board THIS SUBDIVISION WILL APPEAR IN DISTRICT 1000 SECTION 70 BLOCK 10 OWNER AND APPLICANT. ESTATE OF WILLIAM F. GOUBEAUD C/O PATRICtA C. MOORE, ESQ. P.O. BOX 183 MATTITUCK, MY 11952 BUILDING ZONE DISTRICT~ R'-40 SCHOOL DISTRICT: SOUTHOLD FIRE DISTRICT: SOUTHOLD RECEIVED SUFFOI K COn!!'i"y IgO~H3,Y13 PH3:17 BEPT 0F I4EAI.TH 2,1RVICEB OFFICI~ iD, S1 EY!A[EFi HGH [ JOCKEY CREEK PARCEL oAD ~A DATA PAIRCEL 2 40,000.00 sq. fl. 0.918 oc. TOTAL 63.638.03 sq. fl. 1.461 oc, I HEREBY CERTIFY THAT THIS MAP WAS MADE BY US FROM ACTUAL SURVEYS COMPLETED FEBRUARY 4, 1997 AND THAT~[LL CONCRETE MONUMENTS SHOWN TNUS,~ ACTUALLY EXIST AND THEIR PQ~ir~ONB CORRECTLY SHOWN AND ALL DIMENSIONAL AND GEODETIC DETAILS ARE CORRECT, THIS IS TO CERTIFY THE SUBDIVISION PLaN HAS SEEN APPROVED BY THE PLANNING BOARD OF THE TOWN OF RIVERHEAD BY RESOLUTION OF APPROVAL DATED BY CHAIRMAN PLANNING BOARD SUBJECT TO CONVENANTS & RESTRICTIONS: UBER 11964 PAGE 307 6 SUFFOLK COUNTY DEp~ OR ~E~LTH SERVICES PAGE TEST HOLE DATA ©? TYPICAL SEWAGE DISPOSAL SYSTEM (NOT TO SCAb[) ORADE / LEACHING POOL dj 158.59' GOOSE CREEK NOTE: ELEVATIONS SHOWN THUS:~ARE REFERENCED TO AN ASSUMED DATUM. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. N.Y.S. Uc, No. 49888 Joseph A. Ingegno Land Surveyor PHONE (516)727-2Q90 PLANNING BOARD MEMBEI~ BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE RITCHIE LATi~IAM, JR. RICHARD G. WARD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 June 15, 1999 PLANNING BOARD OFFICE TOWN OFSOUTHOLD Patricia Moore, Esq. 51020 Main Rd. Southold, NY 11971 Re: Proposed minor subdivision for the Estate of William Goubeaud SCTM# 1000-70-10-37 Dear Ms. Moore: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, June 14, 1999: BE IT RESOLVED, that the Southold Town Planning Board authorize the Chairman to endorse the final surveys dated February 4, 1997. Conditional final approval was granted on May 3, 1999. All conditions have been fulfilled. Enclosed please find a copy of the map 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 you have any questions regarding the above. Sincerely, owski, Jr. Chairman enc. cc: Building Dept. Tax Assessors DECLARATIO~OF COVENANTS AND RE STRICTI~S TH/S DECLARATION made by Estate of William F. Goubeaud this,~' - ~,~ day of¢0MhoM April, 1999, by Philip J. Goubeaud, Executor, residing at P.O.Box 5, Nog Pine Neck Road, New York 11971 hereinafter referred to as the DECLARANT, as the owner of premises described in Schedule "A" annexed hereto (hereinafter referred to as the PREMISES) desires to restrict the use and enjoyment of said PREMISES and has for such purposes determined to impose on said PREMISES covenants and restrictions and does hereby declare that said PREMISES shall be held and shall be conveyed subject to the following covenants and restrictions: DECLARANT has made application to the Southold Town Planning Board for approval of a subdivision or development on the PREMISES. WHEREAS DECLARANT appeared before theTown requesting subdivision approval and the Planning Board granted sketch approval on Map dated July 23, 1997, with the following condition: Parcel 2 (the 40,000 square foot parcel) shall be subject to a covenant to be filed with the Suffolk County Clerk that will prohibit future subdivision, THEREFORE, DECLARANT, its successors, heirs or assigns, agrees that Parcel Number 2 shall not be further subdivided, and These covenants and restrictions shall run with the land and shall be binding upon the DECLARANT, its successors and assigns, and upon all persons or entities claiming under them, and may be terminated, revoked or amended only with the written consent of the Planning Board. Estate~f, William F. Goubeaud Philip 3'. G~)~eau~l,~ Schedule A DESCRIPTION OF PROPERTY DECLARANT:Estate of William F. Goubeaud H.D. REF. NO. S10-97-005 TITLE NUMBER: PAC-3067 AMENDED 3/2199 SCHEDULE A DESCRIPTION ALL THAT CERTAIN PLOT, PIECE OR PARCEL OF LAND, SITUATE, LYING AND BEING AT PINE NECK, IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK AND STATE OF NEW YORK, BOUNDED AND DESCRIBED AS FOLLOWS: BEGINNING AT A POINT ON THE SOUTHERLY SIDE OF PINE NECK ROAD DISTANT 91.94 FEET WESTERLY FROM THE EXTREME WESTERLY END OF THE ARC OF A CURVE CONNECTING THE WESTERLY SIDE OF PARK WAY WITH THE SOUTHERLY SIDE OF PINE NECK ROAD; THENCE SOUTH 06 DEGREES 45 MINUTES 50 SECONDS WEST 534.52 FEET TO LAND NOW OR FORMERLY OF SUYDAM; THENCE ALONG SAID LAST MENTIONED LAND, SOUTH 87 DEGREES 58 MINUTES 10 SECONDS WEST '~58.59 FEET; THENCE NORTH 02 DEGREES 01 MINUTES 50 SECONDS WEST 110.00 FEET; THENCE NORTH 82 DEGREES 37 MINUTES 10 SECONDS EAST 68.16 FEET; THENCE NORTH 06 DEGREES 40 MINUTES 30 SECONDS EAST 406.16 FEET TO THE SOUTHERLY SIDE OF PINE NECK ROAD; THENCE ALONG THE SOUTHERLY SIDE OF PINE NECK ROAD, NORTH 82 DEGREES 37 MINUTES 10 SECONDS EAST 111.47 FETTOTHE POINT OR PLACE OF BEGINNING. i1964 367 UN-ITORM FORM Or ACt<ENOW-LEDGMENT FOR ACtQNOWI. EDGMENTS TAKEN INSIDE NEW YORK WITH RESPECT TO CONVEYANCES OR OTHER INSTRUkMENTS AFFECTING REAL PROPERTY LOCATED liN- NEW YORK (effective September 23, 1998) Stare of New York ) County of ) ss.: Onthe ~3r''t' dayof 8P~.tc- - intheye~l~2 beforeme, the undersi_o~_.ed, personally appearedp8 ~,_~ ~, ,T., 6-o,~ B~0t~l~ personally known to me or proved to me on the basis of sa~facrory evidence to be the individual(s) whose n~me(s) is (m-e) subscribed to the within instrument and acknowledged to me tbs?. he/she/they executed the same Ln Ns/her/theif capacity(ies), and that by Ns/her/the'if sig~_.a,.na.-e(s) on the [nsu-ament, ~e individual(s), or the person upon behalf of wh/ch the individual(s) acted, executed the 'msunment..___., ,~..~ff. (Signature and o~_=Sce of individual r~k':~g acknowtedg~nent) STATE OF NEW YORK COUNTY OF SUFFOLK SS: I EDWARD P. ROMAINE, CLERK OF THE COUNTY OF SUFFOLK AND CLERK OF THE SUPREME COURT OF THE STATE OF NEW YORK IN AND FOR SAID COUNTY (SAID COURT BEING A COURT OF RECORD) DO HEREBY CERTIEY THAT I HAVE COMPARED THE ANNEXED COPY OF DEEDLIBER /]~//~E/' ATPAGE .30-7 RECORDED S--2/-~ AND THAT IT IS A JUST AND TRUE COPY O¢ SUCH ORIGINAL DECLARATION AND OF THE WHOLE THEREOF. IN TESTIMONY WHEREOF, I HAVE HEREUNTO SET MY HAND AND AFFIXED THE SEAL OF SAID COUNTY AND COURT THiS o~/ $¢- DAY OF ~/~ ~) ~ 199~ CLERK 11964 307 'lumber of pages TORRENS Serial fl Certificate # Pilot Cfi. # l)ccd / Mortgage hlslrtancHt 41 Deed / Mortgage Tax Stamp FEES Page / Filing Fcc I ,9' l landlillg !') TP-58,1 Notation E,,\-52 17 (County) EA-5217 (State) R.P.'I .S.A. Conao. of Ed. ^llidavit Reg. Copy Olhcr Sub Total .__5 O0 Sub GRAND TOTAL Real Properly Tax Service Agency Verification Section 13 lock C" -~C~', c,(~ iC;', oC? I 6 EDWAh' -, '. ~ .... · ':', .-,..~ E S,,.ut-~(!~. · urFOL,K RccoEdiug/I:iliHg SlaillpS Morlgage Ami. I. Basic Tax 2. Additional Tax Sub Total Spcc./Assil. Or Spec./Add. TOT, MTG. 'lAX Dnal To;vn__ I)ual C(!unty__ I lcld Ikn AppolliOlllllClll Transfer Tax Mansion Tax The property covered by Ibis nlurlgage is or will be hnproved by a one or two fimlily dwdling only. YES m NO If NO, see aPl~roprhHe tax clause on page __ oflhis hlslmnmnl. ConllllUllity Preservation l:Ulld (TPI: Tilx Duc $ hHpl oved Vacalll Land TI) TD '1 s [ Title Company Int~rmatim~ ITitle Suffolk County Recording & Endorsement Pa e 'lhis page Ibm~s prat of the altachcd ___'_~ (SPECIFY TYPE OF INSTRU~NI' ) ~lhe prcnfiscs hercin is situated in SUFFOLK COUNTY, NEW YORK. In tho Township of _So tx--'//O/O Iii lhe VILLAGI£ TO or l IAMi,ET oI' I/OXI.~S 5 TI IRU 9 MUST I?,F, TYPISD OR Iq~,INI'ED IN I',I,ACK INK ONI,Y I'ltlOl,( TO I,',I.;COI~,I)ING OP, HI ,ING, (OVER) Dear Taxpayer, Your satisfaction of mortgage bas been filed in my office and I am enclosing the original copy lbr your records. If a portion of your monthly mortgage payment included your property taxes, you will now need to contact your local Town Tax Receiver so that you may be billed directly for all future property lax bills. Local property taxes are payable twice a year: on or before January I0~h and on or before May 31~t. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town 'Fax Receiver with any questions regarding property tax payment. Babylon Town Receiver of Taxes 200 East Sunrise Highway North Lindenburst, N.Y. 11757 (516) 957-3004 Riverhead Town Receiver of Taxes 200 }lowell Avenue Riverbead, N. Y. 11901 (516) 727-3200 Brookhaven Town Receiver of Taxes 250 East Main Street Port Jcfllzrson, N.Y. 11777 (516) 473-0236 Shelter Island Town Receiver of Taxes Shelter Island Town Hall Shelter Island, N.Y. 11964 (516) 74%3338 East I lampton Town Receiver of Taxes 300 Pantigo Place East Hampton, N.Y. 11937 (516) 324-2770 Smithtown Town Receiver of Taxes 99 West Maiu Street Smitbtown, N.Y. 11787 (516) 360-7610 Huntington Town Receiver of Taxes 100 Main Street lhmtington, N.Y. 11743 (516) 351-3217 Soutbampton Town Receiver of Taxes 116 Hampton Road Southampton, N.Y. 11968 (516) 283-6514 lslip Town Receiver of Taxes 40 Nassaa Avenue lslip, N.Y. 11751 (516) 224-5580 Southold Town Receiver of Taxes 53095 Main Road Southold, N.Y. 11971 (516) 765-1803 aw 2/99 Sincerely, Edward P. Romaine Suffolk County Clerk LAW OFFICES F1gORE ~'Ac~E 03 ~Y.~L.s LAN ~F~CES r"IOQRE PAGE 05 Tills PROI~DA-L IS'TO SET OFF A ACRE PARCEL FROM AN EX1STI ACRE PARCEL LOCATED ON IN SCTM# 1000- SET OFF Complete application received Application reviewed at work session Applicant advised of necessary revisioos Revised sub mission received ~Sketch plan approval //-/~" -with conditions t~__~nead Agency Coordination RA determination t to Fire Commissioner / ec ipt of firewell location ~ //~Notgication to applicant to i~ude on ~map ~ to County Planning C~mmis~p. eview of SCPC report Draft Covenants and Restrictions ~eceivea /Draft Covenants and Restrictions reviewed Filed ~oven~nts and Restrictions received ~Eeipt of mylars and pap~rints with~ ~Health approval ~t ~ ~ S~ ~Final Public Hearing ~ Approval of set off --~ ~/ -with conditions ,! b--I.Bt c~ Endorsement of set off g}t /9 Set Off APPLICATION FOR APPROVAL OF PLAT To the Planning Board of the To~vn of Soutbold: '" The underslgoed applicaut hereby applies for (tentative) (final)approval of a subdivision plat in accordance with Article 16 of the To~vn Laxv aud tbe Rules and Regulations of the Soutbold Towu Planaing Board, and represents and states as folloxvs: 1. The applicant is the owner of record of the land under 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 Estate of William F. Goubeaud 3. The entire land under application is described in Schedule "A" hereto annexed. ~Copy of deed suggested.) 4. The land is held by the applicant under deeds recorded in Snffolk County Clerk's office as follows: Liber .7.2.7.~. ................. Page ..5.2.9 ................ On 10/ 1/ 51 Liber ..5.2.4..1 .................. Page 585 On 10/4/ 62 Liber .................... Page ...................... On ... ' ................ ; Liber ........................ Page ...................... On ....................... ; Liber ........................ Page ...................... On ........................ · as devised under the Last ~,Vill and Testament of AD,qe..I~IAr. $.~...O..o.u..b?.a..u.d...(..d....o...d...1972 ) and William F. Goubeaud (d.o.d. 1980) distrlbntee ' 5. The area of the land is .........&80' 17.....8 acres. 6. All taxesll,Xvblch are liens on the'land at the date hereof have bee~' paid except ............ 7. The land is enenml)ered by ...... .~. ~.'q.~. ................. mortgage (s) as folloxvs: ................................ (a) iX. fortgage recorded in Liber .............. Page .................. in original amount of $ .............. nnpaid amount $ ........... : ......... behl by ...................... .............. address ................................................................ (b) Mortgage recorded in Liber ......... Page ....................... in original amoont of .............. uopaid amount $ ...................... held by ...................... .............. address ............................................................... Southold Town Planning Board Town Hall Southold, New York 11971 Re: Set. Off of Lot Gagen's Landing Road Pine Neck Road and 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. ~,,6 2 [2187)--7c 617.21 SEQR Appendix A Slate Environmental Quallly Review FULL ENVIRONMENTAL ASSESSMENT FORM Purp(~se: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subiective 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 anal csis. In addition, man,/who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. ] he full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination proc.?~s has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. Full EAF Componenls: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focoseson identifying the range of possible impacts that ma,/occur from a project or action. It provides guidance as to whether an impact is likel,/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 an,/impact in Part 2 is identified as potentially-large, then Part .3 is used to evaluate whether or not the impact is actual[,/ important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Idem~flfy Ihe Portions ol EAF completed for this project: [] Part I [] Part 2 []Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead 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. EJ B. Although the project could have a signif'icant 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 envirogment, therefore a positive declaration will he prepared. * A Conditioned NeglJtive Declaration is only valid for Unlisted Actions Set Off Planning Board of of Goubeaud Lot NameofAction the Town of Southold Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency 5i!~nature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer (If different from responsible officer) Date 1 INFORMf~ON, · ,// ' Prepared by Project Sponsor ' " // IOTICE: This document is designed to assist in determining whether the act on proposed may have a significant effect _~/ n the environment. Please complete the entire form Parts A through E. Answers to these questions will be considered~-- // s part of the application for approval and may be sub ecl to further ver f cat on and public review. Provide any additiona~ / lformation you believe w II be needed to complete Parts 2 and 3. ' ~' : is expected that completion of the full E^F will be dependent on information currently available and will not involve ew studies, research or investigation. If information requiring such Additional work is unavailable, so indicate and specify ach instance. NAME OF ACTION of Ooubeaud LOCATION OF ACTION (lnclude Street Address, Municipality and County) Pine Neck Road and Gagen's Landing Road, Southold,County of Suff NAME OF APPLICANT/SPONSOR BUSINESS TELEPHONE Estate of William F. Ooubeaud c/o Pat Moore (516)298-5629 ADDRESS 315 Westphalia Road CITY/PO Mattituck NAME OF OWNER (it d~fferenl) ADDRESS IsTATENY ' f[~gC~ BUSINESS TELEPHONE CITY/PO STATE I ZIP CODE DESCRIPTION OF ACTION of 80,000 sq,ft, parcel for two beneficiaries of the Estate of William Goubeaud ease Complete Each Question-Indicate N.A. if not applicable f. Site Description ysical setting of overall project, both developed and undeveloped areas. I Present land use: ~]Urban E31ndustrial r~Commercial I~Forest I~Agriculture [~Other 2 Total acreage of project area: 1 + acres. APPROXIMATE AC Ri[j,AG E Meadow or Brushland (Non-agricultural) Forested Agricultural (Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) Water Surface Area Unvegetated (Rock, earth or fill) Roads, buildings and other paved surfaces Other (Indicate type) e×istina residence 3 What is predominant soil type(s) on proiect site? a. Soil drainage: E]Well drained _.100 % of tire [~Poorly drained % of site I~Residential (suburban) [~Rural (non-farm) · 10 PRESENTLY AFTE.~,~OMPLETION"~ 0 acres 0 acres 0 acres 0 acres 0 acres 0 acres 0 acres 0 acres 0 acres 0 acres · ~,5 acres · 5 acres [:]Moderately well drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group I through 4 of tile NYS Land Classification System? 0 .acres. (See I NYCRR 370). 4. Are there bedrock outcroppings on project site? [~]Yes a. What is depth to b,edrock~ (in feet) 2 ,F~/J,~/pproximate percentage of prol d project site with slopes: (~0 10% ~ % ~10-15% : _ % , ' ~15% or ~ater . % / /6 Is project substantially contiguous to, or contana building site or distrct sted on th~ (~-~'~- ,k National ~. ~egisters of Historic Places? ~Yes ~No ........... e ~/~ 7. rs project substantially contiguous to a site listed on the Register of National Natural Landmarks1 ~Yes ~No 8. What is the depth of the water table? (in feet) 9. s site located over a primary, principal, or sole source aquifer? ~Yes ~No 10 Do hunting, fishing or shell fishing opportunities presently exist in the project area? ~Yes ~No 11 Does project site contain any species of plant or animal life that is identified as threatened or endangered? ~Yes ~No According to Identify each species 12 Are there any unique or unusual land fo[ms on the project site? (i.e., cliffs, dunes, other geological formations) ~Yes ~No Describe 13 Is the proiect site presently used by the community or neighborhood as an open space or ,recreation area? C~]Yes J~JNo If yes, explain 14 Does the present site include scenic views known to be important to the community1 E3Yes '~]No ' 15 Streams within or contiguous to project area: a. Name of Stream and name of River to which it is ?ibutary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name b. Size (In acres) 17. Is the site served by existing public utilities? J~Yes E]No a) If Yes, does sufficient capacity exist to allow connection? DYes ONe b) If Yes, will improvements be necessary to allow connection? i~Yes ONe 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? E]Yes ~No 19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article cfi the ECL, and 6 NYCRR 6177 ~]Yes ~No 20. Has the site ever been used for the disposal of solid or hazardous wastes? EYes ~No B. Projec! Descripliort 1. ! ~ysical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor ~7 acres· b. Project acreage to be developed: , ~"" acres initially; '~'"' acres ultimately· c. Project acreage to remain undeveloped ' ~ acres. d. Length of project, in miles: ~v//~J (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed ~) f. Number of off-street parking spaces existing /,//,4 ; proposed i~"~lZ) · g. Maximum vehicular trips generated per hour /V/~ (upon completion of project)? h. If residential: Number and type of housing units: One Family Two Family Multiple Family Condonqnium Initially __ / Ultimately · Dimensions (in feet) of largest proposed struCture ~,2,~' height; ~..~"O width; ~'~:~ length. · Linear feet of frontage along a public thoroughfare project will occupy is? //O ft. 3 Number of jobs generated: during construction -~' Number of jobs eliminated by this project 0 Will project require relocation of any projects or facilities? much natural material rock, earth, etc.) will be removed frorr site? ~4/~/~ Will disturbed areas be rech C~Yes E~No [~N/A a. If yes, for what intends,, purpose is the site being reclaimed? b. Will topsoil be stockpiled for reclamation? I-lYes ~No c. Will upper subsoil be stockpiled for reclamation? E]Yes E]No How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? ~ acres. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by th s project;' E~Yes ~No ' If single phase project: Anticipated period of construction ~ months, (including demolition). If multi-phased: a. Total number of phases anticipated I (number). b. Anticipated date of commencement phase 1 month c. Approximate completion date of final phase month d. Is phase 1 functionally dependent on subsequent phases? CIYes I~No Will blasting occur during construction? I-qYes I]lNo tons/cubic yards year, (including demolition). year. ; after project is complete ~]Yes [~'No If yes, explain 1.. Is surface liquid waste disposal involved? ~Yes [:]No a. If yes, indicate type of wast~ndustrial, etc.) and amount ~lb . b. Name of water body into which effluent will be discharged '~2. tk/.,qrT~ C.r. I . Is subsurface liquid waste disposal involved? ~Yes E3No Type I . Will surface area of an existing water body increase or decrease by proposal? q-lyes Explain ~No 1'. Is project or any portion of proiect located in a 100 year flood plain? rqYes ~No I . Will the project generate solid waste? ~Yes [~No a. If yes, what is the amount per month I~¢,.S[~. tons b. If yes, will an existing solid waste facility be used? J~.Yes [:3No c. If yes, give name ~DUTI'tO~J~ ~-~rK.1D~ILL. ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain E3Yes Will the project involve the disposal of solid waste? ~ilYes a. If yes, what is the anticipated rate of disposal? I~&"~U3 . b. If yes, what is the anticipated site life? years. 11~ Will project use herbicides or pesticides? (:]Yes J~No 19 Will proiect routinely produce odors (more tban one bout per day)? E3Yes ~i~No ' 2(! Will project produce operating noise exceeding the local ambient noise levels? [qYes ~]No 21 Will project result in an increase in energy use? [~Yes ~],No If yes , indicate type(s) E3No tons/month. 2;' If water supply is from wells, indicate pumping capacity ~ gallons/minute. ~::"~ I~) · 2~: Total anticipated water usage per day ~O gallons/day. 24 Does project involve Local, State or Federal funding? [:]Yes If Yes, explain ~qNo -~~~Appruvals Required: lily, Town, Village Board ,/es ,~No it'/, Town, Village Planning Board ~Yes ~No iP~, Town Zoning Board ~Yes ~No ltv, County Health Department ~Yes ~No 'ther Local A~encies ~Yes ~No ther Regional A~encies ~Yes ~No ate A~encies gYes ~No ~deral A~encies ~Yes C. Zoning and Planning Information 1 Does proposed action involve a planning or zoning decision? If Yes, indicate decision required: Ezoning amendment 'l~zoning variance Oype I~Yes I-Ispecial use permit I-INo ~subdivision El, site plan [new/revision of master plan ~lresource management plan Eother What is the zoning classification(s)of the site? [~)- L/0 What is the maximum potential development of the site if developed as permitted by the present zoning;' one residence per one acre - Submittal Date 4 What is the proposed zoning of the site? r-40 5 What is the maximum potential development of the site if developed as permitted by the proposed zoning? one residence in subdivided lot 6 Is the proposed action consistent with the recommended uses in adopted local land use plans? []Yes 7 What are the predominant land use(s) and zoning classifications within a ¼ mile radius of proposed action;' residential r-40 · UNo 8 Is the proposed action compatible with adjoining/surrounding land uses within a ¼ mile? I~Yes 9 If the proposed action is the subdivision of land, how many lots are proposed?1 a. What is the minimum lot size proposed? 180 × 120 lot 1(1 Will proposed action require any authorization(s) for the formation of sewer or water d stricts~ ~lyes ~]No 11 Will the proposed action create a demand for any community provided services (recreation, education, police, fire protect on)? []Yes [~¢qo minimal a. If yes, is existil]g capacity sufficient to handle projected demand? I~Yes ENo 12 Will the proposed action result in the generation of traffic significantly above present levels? i-lYes XE]No a. If yes, is the existing road network adequate to handle the additional traffic? EYes [3No D. Informational Details ^ttach any additional information as may be needed to clarify your project. If there are or may be any adverse iml acts associated with your proposal, please discnss such impacts and tire measures which you propose to mitigate or aw: id them. E. Verification I certify Lhat the information provided above is true to the best of nry know edge. . Ap~licant/Sp~-~t~arne j--9~hili~) J Ooubeaud ~ r/-7/~_7 S,g, ature ~ ~ ... ' % ~ ~tle ........ If ti e aclion is in Ihe C~S~~ou are a slale agency, compl~le Ihe Coaslal Assessment Form belore proceeding wilt this assessmenl. Part 2--PROJECT IMPACTS AND THEIR_MAGNITUDE Responsibilily of Lead Agency · General Informatio~ (Read Carefully) , ,, // ° l~a;o°nma~ll;t~?h~hree~Ter~etrh~ ~eoV~;~cS~e~Ultd° ~ee ~a~ltxd[ by the question: Have my responses and determinations been pert env ronmental analyst - t ' ' dentifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simply asks that it be looked at further. ° The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, roi' any specific project or site other examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrat'ive 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. Inslruclions (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 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 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 1 Will the proposed action result in a physical change to tbe project site? FINO OYES Examples that would apply to column 2 · ~,ny construction on slopes of 15% or greater, (15 foot rise per 100 ~oot of length), or where the general slopes in the projecf area exceed · Construction on land where the depth to the water table is less than : feet. · Construction of paved palr~ing area for 1,000 or more vehicles. · Construction on land where bedrock is, exposed or generally within : feet of existing ground surface. · Construction that will c~ntinue for more than I year or involve more hah one phase or stage. · [ xcavation for mining purposes .that would remove more than 1,000 t)ns of natural material (i.e., rock or soil) per year. · (onstruction or expansion of a sanitary laudfill. · (onstruction in a designated floodway. ·(Ither impacts 2. Will tbere be an effect t, _..~yum(lUe or unusual land torms found on he site? (i.e., cliffs, dunes, geological formations, etc.)lqNO OYES · .$oecific land forms: 6 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] ~]Yes [~]No [] [] OYes I-]No 0 [] OYes ONo [] [] ~Yes E~No [] [] E~Yes ~No [] O OYe~ ONo ~ ~ ~Yes O ~ ~s O~o O ~ ~Yes ~No ~ ' ~ ~Yes ~No C IMPACT ON WATER Will proposed action affect any water body designated as protected;r (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) [3NO C]YES Examples that would apply to column 2 ~ 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 design, areal freshwater or tidal wetland. * Other impacts: Will proposed action affect any non-protected existing or new body of water? ENO EYES Examples that would apply to column 2 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 area. Other impacts: Will Proposed Action affect surface or groundwater quality or quantity~' C~]NO [~YES Examples that would apply to column 2 Proposed Action will require a discharge permit. Proposed Action requires use of a source of water that does not have approval to serve proposed (project) action. Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. Construction or operation causing any contamination o~ a water supply system. Proposed Action will adversely affect groundwater. Liquid effluent will be conveyed 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 tbere 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 Action locates commercial and/or industrial uses which may require new or expansion of existing waste treatment and/or storage facilities. Other impacts: Will proposed action alter drainage flow or patterns, or surface waler runoff? (~]NO (~YES I~xa~nples that would aplrly to column 2 Proposed Action would change flood water flows. 7 II to Potential ,Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] I~]Yes [~No [] [] [~]Yes [~No [] [] [~Yes [~]No [] [] E]Yes []No [] ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~No ~ ~ ~Yes ~ ~ ~Yes ~ ~ ~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 ; Will proposed action affect air quality? ~NO I~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 $ lbs. per hour Or a heat source producing more than 10 million BTU's per hour. o 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 Will Proposed Action affect any threatened or endangered species? E]NO E]YES 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. ·Removai 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: ii Will Proposed Action substantia yaffect non-threatened or non-endangered species? E]NO E]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 1 . Will the Proposed Action affect agricultural land resources? [~NO FIYES Examples that would ~pply to column 2 · The proposed action wo[dd sever, cross or limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, etc.) ~nI 2 3 all to Potential Can Impact Be Moderate' Large 'Mitigated By Impact Impact Project Change [] [] []Yes ONo [] [] []Yes []No [] [] l'lYes []No [] [] OYes ONo O O []Yes I-iNo O O OYes []No [] [] []Yes E3No O O []Yes []No O O OYes []No E] [] []Yes []No O [] E]Yes ONo O O OYes ONo O O E]Yes []No I-I [] OYes []No [] O []Yes []No O [] OYes []No O [] OYes []No onstruction activity would excavate or compact the soil profile of i;ric~ltural land. he proposed action would irreversibly convert more than 10 acres ~ agricultural land or, if located in an Agricultutal District, more ~an 2.5 acres of agricultural land he proposed action would disrupt or prevent installation of agricultural nd management systems (e.g., subsurface drain lines, outlet ditches, rip cropping); or create a need for such measures (e.g. cause a farm ' eld to drain poorly due to increased runoff) · ther impacts: IMPACT ON AESTHETIC RESOURCES Will proposed action affect aesthetic resources~ [:]NO I-lYES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix B.} Examples that would apply to column 2 · ~ 'oposed land uses, or project components obviously different from in sharp contrast to current surrounding land use patterns, whether ; an-made or natural. · ~ ~oposed land uses, or project components visible to users of ~ ~sthetic resources which will eliminate or significantly reduce their ,' ,joyment of the aesthetic qualities of that resource. · ? oject components that will result in the elimination or significant ~ reening of scenic views known to be important to the area. · ~ ther impacts: IE~PACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12 Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance~ ~INO [:]YES tlxamples that would apply to column 2 · f"oposed Action occurring wholly or partially within or substantially ~ ,~ntiguous to any facility Il)' site listed on the State or National Register ~:~ historic places. · ^r~y impact to an archaeological site or fossil bed located within the f:~ ~ject site. · t'~ ~posed Action will occur in an area designated as sensitive for a~chaeological sites on the NYS Site Inventory. · (:~lher impacts: IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect tile quantity or quality of existing or future open spaces or recreational opportunities~' Examples that would apply to column 2 I:JNO [:]YES C · lhe permanent foreclosure of a future recreational opportunity. · A major reduction of an open space i~nportant to the community. · [' her impacts: ~1 2 3 Small to" Potential Can Impact Be Moderate Large Mitigated By impact Impact Project Change [] [] C~]Yes []No [] [] []Yes []No [] [] []Yes [] [] []Yes []No [] [] []Yes []No [] [] i-lYes []No [] [] []Yes [:]No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] [:]Yes 1:3No [] [] []Yes [::}No [] [] []Yes []No IMPACT ON TRANSPORTATION . Will there be an effect to existing transportation systems? OHO FIYES Examples that would apply to column 2 Alteration of present patterns of movement of peopl'e and/or goods. Proposed Action will result in major traffic problems. Other impacts: IMPACT ON ENERGY · Will proposed action affect the community's sources of fuel or energy suppJy~ [~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 ,. Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? ' DNO OYES Examples that would apply to column 2 Blasting within 1,500 feet of a hospital, school or other sensitive facility. Odors will 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 will remove natural barriers that would act as a noise screen. Other impacts: IMPACT ON PUBLIC HEALTH r. will Proposed ActionlJ~ffect public health and safety? DNO DYES 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 tile 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 tire 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 3 Small lo Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change ( [] [] E]Yes r-lNo [] [] J~Yes [:]No [] [] I~Yes J~]No [] [] i-lYes []No [] [] . E3Yes i--INo [] [] []Yes E]No [] [] [~Yes [:]No [] [] I-qYes []No [] [] []Yes []No [] [] []Yes []No [] [] f-lYes i--INo [] [] E]Yes []No [] [] OYes E]No [] [] [:]Yes [:]No [] [] []Yes E3NO [] [] E]Yes ~lNo IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD Will proposed action affect tile character of the existing community? DNO DYES Fxamples that would apply to column 2 he permanent population of the city, town or village in which tile 'oject is located is likely to grow by more than 5%. he municipal budget for capital expenditures or operating services ill increase by more than 5% per year as a result of this project· 'oposed action will conflict with officially adopted plans or goals. *oposed action will cause a change in the density of land use. 'oposed Action will replace or eliminate existing facilities, structures areas of historic importance to the community. e~ elopment will create a demand for additional community services g. schools, police and fire, etc.) oposed Action will set an important precedent for future projects. oposed Action will create or eliminate employment. ther impacts: "' 1 2 3 Small lo" Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes [] ' [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] ~]Yes []No [] [] []Yes []No [] [] E~]Yes []No [] [] []Yes []No 19. Is there, or is there likely to be, public controversy related to potential adverse environmental impacts? DNO [~]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 · Pad 3 must be prepared if one or more impact(s) is considered lo be potentially large, even if the impacl(s) may be mi*i: aled. Insh rclions Di~: ss the following for e~l~h impact identified in Column 2 of Part 2: 1. [! iefly describe the impact. 2. ~i :scribe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change(s). 3. i!; ~sed 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 · Tile regional consequence of the impact · Its potential divergence from local needs and goals · Whether known objections to the project relate to this impact. (ti(: Itinue on attachments) 11 C 617.2! Appendix I] State Environmental (,)ilJati:l, Rewew Visual FAF Ad(J ' dum This form may be used to provide additional infor ~ t~: ~ the Full EAF, SEQR ~ I > c;u~stion II of Part 2 of (To be completed by Lc mJ ,,~ ~ Visibility I. Would the project be visible from: · A parcel of land which is dedicated to and availa to the public for the use, enjoyment and appreciati:- of natural or man-made scenic qualities? · An pverlook or parcel of land dedicated to pul01 observation, enjoyment and appreciation of natu al or man-made scenic qualities? · A site or structure listed on the National or Registers of Historic Places? · State Parks? · The State Forest Preserve? · Hational Wildlife Refuges and state game refuges? · Hational Hatural Landmarks and other outstandi~ natural features? · Hational Park Service lands? · Rivers designated as Hational or State Wild, Seen or Recreational? · Any transportation corridor of high exposure, su(J as part of the Interstate System, or Amtrak? · A governmentally established or designated interstat~ or inter-county foot trail, or one formally proposed fr establishment or designation? · A site, area, lake, reservoir or highway designated scenic? Il, · Municipal park, or designated open space? · County road? · State? · Local road? ~-. Is the visibility of the project seasonal? (i.e., screened b~ !m~ ~ seasons) ~ OYes f-INo ;~ml R¢:~ource (in Miles) ': ~ ' ~ 3-5 5 + E] [] L] [] L C3 [] I E] [] I ],r, mt vmiblo during other Are any of the resources checked in question I usec I~ ' during which fire projc~:t will he visible? []]Yes OHo DESCRIPTION OF EXISTING VISUAL EHVIROHMENT 4. From each item checked in question 1, check those which generally ~describe the sui:rounding environment. Within · i/,~ mile *1 mile Essentially undeveloped [] [] Forested [] [] Agricultural [] [] Suburban residential [] [] Industrial [] [] Commercial [] [] Urban [] [] River, Lake, Pond [] [] Cliffs, Overlooks [] [] Designated Open Space [] , [] Flat [] [] Hilly [] [] Mountainous [] [] Other [] [] NOTE: add attachments as needed 5. Are there visually similar projects within: *V;~ mile []Yes []No '1 miles []Yes []No *2 miles L_~ Yes []No *3 miles []Yes []No * Distance [rom 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 HOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation ~,r activity in which the viewers are engaged while viewing the proposed action is Activity Travel to and from work Involved in recreational activities Routine travel by re~idents At a residence At worksite Other _ FREQUENCY Holidays/ Daily Weekly Weekends Seasonally [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] $ iJ~T 'Y $outhold, 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 ~ 2. Are there any other premises under your ownership abutting this pa. rcel? Yes 3. Are there any building permits pending on this parcel? Yes e concerning this property before any other department or 9~en~cy?(Town , State, County, 5. Is there any appllcatzon pending before any other ~gency with regard to a different project on-this parcel? Are there any other applications pending etc.) No 6. Was this property the subject of any prior application to the Planning Board? Yes ~ Yes ~ 7. Does this property h~ve a valid certificat~ of occupancy, if yes pleas.e submit.a copy of same No I ce~fy that the above statements are true and will be relied on b~,%~e ~P~nning,.B~ard in considering this application. Signature of p~p~ ow~_~ or authorized agent %da~e Attachment to questionnaire for:/the Planning Board STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the ~ day of ~__, 19~_~, before me personally , ~ ~Lm~ to me known to be the individual described in.~and who executed the foregoing instrument, and acknowledged that ..~ execute~t~ame. N~t~y P~blic PATRICIA C. MOORE Notary Public, State of New Yo~ Suffolk County - No. 4861 Commission F-xpirea June 16, ~. 41' LU SCALF.: , : , This indenture, z?t , and by virtue of tho Laws o~' tho Lt, at~ ~5f Lc,~.~ York, having its priBctpal office and place of bus!~osc at i~attltuck, Cuff elk NoW York, as Successor to ;f,ank of ~outbold, lgILL~I'~ F. GOUB~ and A~A ]~A~IE GOUBFAUD, his ~ifo, seth residing at Southold, 8off elk Count~, New York, who~ee~, ~LL~I.I F. GOU~ and ANi~ i.~I;~ GOUBFA~, his / paqe 1~2 ~E ~ .... ~,,, l~th orepaft, untc ~[ ~ ~OUTH0~, p~odoooeso~ of tho part~ of first part herein, ......... ONE (~1.00) ......... tho To~ of Southold, Oo~ty of 8~folk and State of ]',ow 5~ork, he.dOd and described as folio%m:- BEGIN:;IN(3 ~t a ~o3_~t m~rked by an ~on pipe at the northwesterly corner of tho promises hnro~ don- cribod (which point is ]:orth 82 de~reos 37 a dist~ce of ~8.16 foot from a point ~rkod bi{ a concrete monument on tho easto~ly line of Oagon~s L~d~ Head 50.22 feet :~mAthorly alO~g said line from its intersection ~ith tho northerly line So,th Street); r~n~g thence l;orth 82 degrees 37 m~utos 10 seconds EaS~ a dist~co of 110.82 feet to Lot No. 3 on a certain rmp on- tit%ed gap of Southwood" filed in tho Suffolk County ~lerk's Office a~ Map No. 2~1; r~ning thence in a southwesterly di~,o[:tio~ pa~'tl[ along said Lot No. 3 on [.~ap of Southwood and ~nrtly alon~ Lot SOhth 6 degrees ~5 minutes 50 seconds 'Jest, a distance o[ 2'$9.79 feet to · po~t ~rked by a concrete monument and land now or fo~m~erly Gag~; running thence along said land now or formerly of '.;aEon, 1;orth 88 degrees Oh minutes 10 seconds Jest, a distance of ~07.~6 feet to a p~t marked by a concrete monument; runnL,g thence alonf; tho easterly li~O of land heretofore convoyed by Charles A. ,laKes to William F. Go~beaud ~d Ann ~ml~rio Goubeaud~ his wif,., by deed 26~ 1962 (Libor 5241 cp 585), l~orth 6 do~ro.s 40 ~,~inutoc 30 seconds East, a distance of 231.~8 feet to the point or place o~ ~og~ning. t'0 have and to hold the lands and premises hereby released ond qultclalmed to the patty c~f the ~e*~Ji~'~ft,. t-~, . thoir hoirs and ass,g.s.' to t~O~ and thei~ aw~ proper use. ~efit a~d behoof farever, free, clear and d~scharged of and from all lien and claim under a~d by vletue ol I~den~ure ~ mortgage aforesaid, j~f~es~.,Whereof, the pa~ of the flrs~ part has signed and sea'ed Ih.~e presents t~e day a~d yeas ~e ~r~e., ~ . TIi,~ NORTtt FOR~ lANK AI, D .t :~UST COthA~ ,-~ 'l~i,; NOHTH FORI~ ~i;J. AND TRUST u" :' '' '~'~ ~' ' /~ c,, On the day O~ . ' 19 v~ ra,~ L~awn to bu H)e individuql described in emu ~ ",.. M-IOU1 'l'It~ O~ft[ FOP~ ~Ifk & THUST CO~'A~, ;) as L;uccossor to Bank of Southo~ · '~ TO ~, WIL~tM F. GOUB~UD and ANNA MJ~IlE (iOUP~'~AUD, his ~/tfo 4-1700b THIS INDENT-gR~made the~ BETV~N CMAMLES A. New York, r , nineteen hundred end sixty-two, Southold, Suffolk County, (' l:~xrty of the first pm't end WILLIAM F. ~,0UBE&UD and ANN MAP. IE GOUBEAUD, his wife, as by the entirety, both residing at Southold, Suffolk County, tenants New York, party of tho second port, wrrNESSETIt, that the l:X:nty of the first part, in consideration of Ten Dollars end other valuable ct>n- stderatfon patd by tho party of the second part, does hereby grant and release unto the party of the second part, the helm or successors and assigns of the party of tho second p<n't forever, ALL that tract or parcel of land situate, lying and being at Southold, in the Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a concrete monument on the easterly line of Gagen's LandinF. Road 50.22 feet southerly along said line from its inter- section with the northerly line of South Street; running thence on the extension of the southerly line of South Street, North 82 de- ~rees 37 minutes l0 seconds East a dj.stance of 68.16 feet to other land of said P, oubeaud; thence alon~, the last described land South 6 de,tees 40 minutes 30 seconds West a distance of 231.78 feet to a concrete monument; thence on the extension westerly of the southerly line of land of Goubeaud, North 88 deT. rees 0~ minutes l0 seconds Wes~ a distance of 32.8~ Ceet to said e~sterly line of Gagen's Land- in~ Road; thence alon~r the last described line, North 2 defrees O1 ~Innte 50 seconds West s distance of 220.47 feet to the point of be- ~inninE. SUBJECT, however, to tho following, covenants and restrictions: 1. That every dwellin~ house erected on said premises shall cost not less than Eiqht Thousand ($8,000.) Dollars; 2. No fowl and/or animals othe~ than the usual type of household pets are to be kept on said oremises. TOGETHER with all right, title and tntsrest, if any, of the party of the fi-mt pa~ of, in and to etreets end reade abutilncj the above-described premtses to the center lines thereofI TOGETHER wit[~ the appurtenances and all the estate and rights of the first part In end to said premtses~ TO HAVIt AND TO HOLD the premises herein granted unto the party of the ~cond part, the heint or suo- cessors and a~sfgns of the party of the second part forever. iAND the party of the first part covenants that the party of the first ~ has not done or i~uffered any, thing whereby the said premtses hcrve been encumbered In any way whatever, except a~ aforesaid, 2~ID the party of the first part, in compliance with Section 13 of tho Lien Law, covenants that thC party of tho flint lx~rt will receive the consideration for this conveyance end will hold tho right receive such consideration as a trust fund to be applied first for the purpose of paying the cost of th~ improvement and will apply tho same first to the payment of the cost of the Improvement before using {my part of the total of the same for any other purpose. The word "party" shall be construed as If it read "parties" whenever tlie eerme of ti-ds Indenture so requires. IN W1TNF, SS WItEREOF, flue party of the first part has duly executed this deedfluej~ay and flint above written. S A. Ga~en) / / STA~E OF N£W YORr, COUNTY OF ~LT~'i~OLK me personally c~ne CHAMPS A. CACEN, to me known to be ~he individual described th and who executed the foregoing fnst~ment, ~d ac~owl- ~ged ~at he exe~t~ ~e s~me. ~o~ary Public. RENSSELAER ~, TERR?, Re:~din~ iff Suffolk ~ufl~ No, 52-3954850 ~Y ~mmission Expires March ~ me ~o~, w~, ~g b~ ~e ~d ~ ~ ~ ~ldes ~ 'No. of , ~e ~on des~l~ ~ ~ which ex~t~ ~e for~oinq ~s~ment~ he kn~s ~e s~l of said ~ra~on~ affix~ to said ths~ment is such ~rate s~ ~at tt was so affix~ by ~der of ~e ~ of d~tors of ~td ~iatton, ~d ~ he si~ h n~e ~e~to by like o~er. STATE OF NEW YOItK, COUNTY OF (Da the dny ot me personolly co, me 19 to me known to be the individual described in and who execuied the foregoing instrument, and acknowl- edged that executed the same. On Gte day o[ 19 , helots* me' personall~r cume wi~ whom I ~ ~onally ~fnt~, whc, berg ~ me d~,sw~ ~d de~ ~d ~d~ at No. to be ~e thdi~u~ des~ ~ and who executed ~e foregoing ment; ~at he, said s~scribinq witness, wes present ~d saw ex,ute ~e ~me; ~d ~at he. s~d wf~ess, at ~e same time s~s~ h ~ wi~ess ~e~to. o BETWEEN }~ W. ~'~0~ ~d I,I~DRED D.. ~'~0LD, hie .wife, both resid~g at Southold, Suffolk County~ New Xork, party o! the firtt part, and . WZLLIAI/[ F.. GOUB~L~UD and ~NA ~RIE GOUBEA~.~ hic wife, as tenants by the entirety, both residing at SOUthold, Suffolk County, Nmv York, party of the second part, ' ...... :-*r ..... WITNESSETH, t~t the Pa~'y o~ the first p~.rt, |a c~nsideratton of - :.:- -~ the s~ or ~a~ ($~0) hy the p~ty of the s~o.d Part. does hereby gr~t ~d rcl~se ~to the ~y o[ ~e s~nd ~, their heirs : ALh that certain tract or parcel of land, situate, lying and at Pine Neck, near South~ld,. in tho To~m of Southcl~ Cowry S~folk, ~d State of New York, bounded Nortllerly by P~ Neck Road, 100 feet; ~sterly by l~d fo~erly of ~ily G. 'S~ons (now believed to be of Roon~ as far es her l~d r~; Southerly'by l~d fo~erly of ~drew ~gen 100 feet, on a l~e parallel to the ~orth l~e; Westerly by l~d fo~erly of ~dr~ Oage~ o~ a 'parallel t0 the easterly l~e, supposed to conta~ about one acre ~d a ~lf, be the s~e~ more or less. TOGET~ with ~1 the right, title ~d ~terost of the pa~y 0f f~st p~ ~ ~d to P~e Neck Road, ~ front of ~d abutt~ said praises to the center BE~G.~d ~tended to be the s~e prorates eonveyed~ I~M~ Ter~ ~d L. Ma~ N~vbold to Max W. Newbold by deed dated April 192?, ~d recorded-~ the Suffolk cowry Clerk's 0ffioo on April 7, 1927, ~ Liber '1261 of Deeds at page 175. of tho scco:~G par%~ t'mir heirs a.n,1 assicas forever~ AND the party of the first parl. eovetlant,i a,~ folh)ws: FIRsT--That the part), of the first part ha~ ~ot done or suffered anything whereby the ~ai~ premises ]~ve S~:cos~That, in cnmpllance with Section 13 of tl~e Lien [~w, tbe party o~ the first pa~ will receive'fl~ consideration for lbi~ conveya,ce a.d will bnl,1 tllc right to r~eive such consxlcrahon a~ a trust fund tO ~ applied first for the purp.se of payMg the co~t of lhe Imprm-e~nent nad tint the pa~y of the first part :~ill apply 1he same first to the pax~ent of e cost of the imptovenlent b~ fore ~5mff any pa~ o~ the total o[ tli~ same for any other pUrl,OSe. , I~ WlYN[$$ W~ER[O~, Ihe ~y of the first pa. ha5 executed tld5 deed the day a.d year first nl~e STATE O~ NEW YORK, COUNTY OF SIT, C:,'OLlf. On the l~trsb (lay of October . .Mctcen hu,tdred and fifty-one, to me known to fie the in,tlvld.al ~ described ]n and who executed the foregoing ~nowled~ed that the y executed the ~ame. , /o:01¢. M-2339 GTD No. 07-5010~',~ CONSULT YOUR LAWYER BEI~ORE MO iN I UM U~2Sg USE~I¥ RE 0 L~ B£T%%T:FAq WILLIAM F. GoUBEAUD and ANNA MARIE GOUBEAUD, his wi~a, both residing at Southold, Suffolk County, New York, .'i; V~r~y,~l d~c first part, and DAVID M. GRIGONIS and NANCY J. GRIGONIS, h~~, wife, as tenants by the entirety, both residing at Southold, Su~fO~!i County'. New York, party of the ~econd parL ~ITNF~SETH, that tile party o ,tile fir,t part. in consideration o{ ....... ($10.00) - ';I', lawful money of the L:nlted State,. and other good and valuable considel:a:~L~n, pal t AL~ that cerlain plot. piece ur l,arccl of land. ~X~F'~I~geli~'~K~'ar~ ~ituatc. lying andbeing~X~e at Southold, in the Town of Southold, Coun(:Y 0if Suffoll and State of New York, bounded and described as follows: BEGINNING at a point on the easterly line of Gagen'S La~l~ing Road, 160.22 feet southerly along said easterly line from its running along land of william F. Goubeaud and Anna Marls ~ his wife, North 87 degrees 58 minUteS l0 seconds East, a ,t~.~.tance 158.59 feet to Lot 4 as shown on "Map of Southwood" filed ~ the Suffolk Coun:y Clerk's office as Map No. 2141; - runnin~ thence along said Lot 4, South 6 degrees 45 m~n%t~as 50 seconds West, a distance of 121.60 feet to a monument and %~d fount of Gagen and now believed to be of Taplin; running thence along said land formerly of Gagen, No~th 88 dsgre~ 04 minutes 10 seconds West, a distance of 140.33 feet Co'C~..easCer! line of Gagen's Landing Road; running thence along said easterly line of Gagen's Land~ Road, North 2 degrees 01 minute 50 seconds West, a distance of 1~0,47 feet to the point or place of beginning. SUBJECT to covenants and restrictions set forth in Deed.!:scorded in Liber 5241 cp 585. with ,'ill rig'ht, lltlr nml interest, if any, olr the 1Jartv -fthe Iqr,~! parl iii and I- a~. q~,,,t, ,m,I the ~r~ pa~ will r~eive the c~nsi~l~rnt~on f~r this conYeyance nmi will hold the right lo r~elve m~ch eration l~ a trust [und to be npplJed first for the pur~e o~ pa~ing the ~t of lhe improvement n~d will applr an7 other ~e wold "pa~7' shall I~ m~nstrtled ns ii ~t te~d IN ~ ~OFp the party of the first wri~en has duly execut~ this deed the day and y~r first a~ve (Willi~ F. g~u0eaud) "k ( ' t~nna Marze Oo~eaud) STA~ OF ~W YORK, COUN~ OF SU~OLK (SS: O~ the ~day of July, 1969, before me personall7 c~e WILL~ F. OOUB~AUD and ~A ~RIE GOUBEAUD, h~s wtfe~ to me k~o~ to be the ~nd~v{dUals described tn and who executed the w{th~n ~nstr~ene, and they ~e~nowledged to me that ~hey ex~d the STAll OF NIEW ~Olll[, (:OUNTT OF On the~ dl~ of per~onally came 19 oF ~rOK OU -0~ ' , , before me to me known to be the individual described in and who executed thc foregoing instrument, and acknowledged that executed the came. On the day of 19 , before me personally came to me known, who, being by me duly sworn, did depose and say that he resides at No. that he is the of , the ~orporation described in and whleh/execoted the foregoing instrument; that he knows the .~al of Bald corporation; that the seal affixed to sa'd 'nsf fo' merit's such corporate seal; that ~t was so affixed by order of the board of directors of said corpora- tion, and that he signed h~ name thereto b7 like order, On ihs day of 19 , [~fore me. persanally, an~e to me known to be the individual deseribed in and who executed the foregoing instrument, and acknowledged that exeeuted the ~me. STATE OF NEW YOLK, COUNTY OI On tile day of 19 , before mc personally came to me kuown, wbo, being by me duly sworn, did depose and say that he resides at No. that he is the of , the corporation dcscrlbcd in and which executed the foregoing instrument; that he knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that. it was affixed by order of the board of directors of sa~d corpora- tion, and that hc signed h name thereto by like order. WILLIAM F. GOUBEAUD and ANNA b~RIE GOUBEAUD, his wife DAVID M. GRIGONIS and NANCY J. GRIGONIS, his wife rile TITLE GUARA~fTEE COMiSINY SECTION BLOCK LOT COUNTY OR 'IOWN RENSSEtAER G. TEI~RY, AFI'ORN£Y - AT · LAW SOU~HOLD, N. Y. Z,p RECORDED PATRICIA C. MOORE Attorney ~t Law 510Z] Msin Rosd $ouchold, New York 11971 Tel: (516) 765~,330 Fax: (516) 76~-4643 The pages comprisin9 this facsimile transmission contain confidential informasion from Patricia C. Moore. This in[ormation is intended solely for use by the individual entity ~amed as the recipient hereof. If you are not the intended reciDient, be aware ~ha~ any disclosure, ~opyin~, distribution, or use of the contents of this transmission is prohibited. If you have received this ~ransmiss~on in error, please notify us by telephone immediately so we r~ay arrange to retrieve this transmission a~ no cost tO you. TO: RE:_. TOTAL NL~4BER OF PA~ES INCLUDING COVER IF TRANSMISSION IS FAULTY OR INCOMPLETE, PLEASE CALL BACK AS SOON AS POSSIBLE. CLIE~'T NAME: OPEP, ATOR: Southold Town Planning Board Submission Without a Cover Letter SCTM#: 1000- Southold '[own plam~ing Board ~IiATI:::IICIA C. MOOI:::IL~ MAIN I::IOAD, SOLITHOLD, NY I 1~)71 (~I1~) 71~5.~,,,,-:1~0 L Southold Town Planning Board PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold, N.Y. 11952 Tel: (516) 765-4330 Fax: (516) 765-4643 Margaret Rutkowski Secretary Bennett Orlowski, Jr., Chairman Southold Town Planning Board Town Hall 53095 Main Road P.O.Box 1179 Southold, NY 11971 Re: Subdivision of William Goubeaud Dear Chairman Orlowski; Enclosed please find the following for your records: 1. 5 paper and 2 mylars of the Final Subdivision maps for the above referenced subdivision. The Declaration of Covenants and Restrictions were submitted to the Town Attorney for review, he approved same, and they were forwarded to Peconic Abstract for recording at the Suffolk County Clerk. As soon as the recorded C & R's are returned to me, I will provide a copy of the recording information for your file. Thank you for your anticipated cooperation in this matter. Very truly yours, ~a C Mool MAY 2 6 1999 Southold Town Plann}ng Board PLANNING BOARD M~MBERS~ BENNETT ORLOWSKI, JR. Chairrnan WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE RITCHIE LATHAM, JR. RICHARD G. WARD 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 May 4,1999 Patricia Moore, Esq. 51020 Main Rd. Southold, NY 11971 Re: Proposed minor subdivision for the Estate of William Goubeaud SCTM# 1000-70-10-37 Dear Ms. Moore: The following took place at a meeting of the Southold Town Planning Board on Monday, May 3, 1999: The final public hearing, which was held at 7:30 p.m. was closed. The following resolution was adopted: WHEREAS, the Estate of William F. Goubeaud is the owner of the property known and designated as SCTM# 1000-70-10-37, located on Pine Neck Road in Southold; and WHEREAS, this proposed minor subdivision, to be known as minor subdivision for the Estate of William F. Goubeaud, is for 2 lots on 1.461 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 July 14, 1997; and WHEREAS, the Southold Town Planning Board, pursuant to Chapter 58, Notice of Public Hearing, has received affidavits that the applicant has complied with the notification provisions; and WHEREAS, a final public hearing was closed on said subdivision application at the Town Hall, Southold, New York on May 3, 1999; and Page 2 Proposed minor subdivision for the Estate of William Goubeaud May4, 1999 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 July 23, 1997, 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: The submitted 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, , Bennett Orlowski, Jr. Chairman BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS ~ gIgNNETH L. EDWARDS ~- GEORGE RITCHIE LATHAM, JR. RICHARD G. WARD 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 TO: FROM: RE: DATE: Gregory Yakaboski, Town Attorney Robert G. Kassner, Site Plan Reviewer ~ Proposed Site Plan for Estate of William F. Goubeau(] Pine Neck Drive, Southold SCTM# 1000-70-10-37 April 26, 1999 Please review the attached for legal sufficiency. The Board plans to grant final approval on May 3, 1999, i~ would be appreciated if you could return your comments in advance of this date. Enel. ~TRICIA C M 51020 MAIN I=:IOAIZ}' SOLITHOLIZ), NY 119'~1 Southold Town Planning Board DECLARATION OF COVENANTS AND RESTRICTIONS THIS DECLARATION made by Estate of William F. Goubeaud this day of April, 1999, by Philip J. Goubeaud, Executor, residing at P.O.Box 5, No# Pine Neck Road, New York 11971 hereinafter referred to as the DECLARANT, as the owner of premises described in Schedule "A" annexed hereto (hereinafter referred to as the PREMISES) desires to restrict the use and enjoyment of said PREMISES and has for such purposes determined to impose on said PREMISES covenants and restrictions and does hereby declare that said PREMISES shall be held and shall be conveyed subject to the following covenants and restrictions: DECLARANT has made application to the Southold Town Planning Board for approval of a subdivision or development on the PREMISES. WHEREAS DECLARANT appeared before theTown requesting subdivision approval and the Planning Board granted sketch approval on Map dated July 23, 1997, with the following condition: Parcel 2 (the 40,000 square foot parcel) shall be subject to a covenant to be filed with the Suffolk County Clerk that will prohibit future subdivision, THEREFORE, DECLARANT, its successors, heirs or assigns, agrees that Parcel Number 2 shall not be further subdivided, and These covenants and restrictions shall run with the land and shall be binding upon the DECLARANT, its successors and assigns, and upon all persons or entities claiming under them, and may be terminated, revoked or amended only with the written consent of the Planning Board. Estate of William F. Goubeaud BY Philip J. Goubeaud, Executor Schedule A DESCRIPTION OF PROPERTY DECLARANT:Estate of William F. Goubeaud H.D. REF. NO. $10-97-005 TITLENUMBER:PAC-3067 AMENDED3/~99 SCHEDULE A DESCRIPTION ALL THAT CERTAIN PLOT, PIECE OR PARCEL OF LAND, SITUATE, LYING AND BEING AT PINE NECK, IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK AND STATE OF NEW YORK, BOUNDED AND DESCRIBED AS FOLLOWS: BEGINNING AT A POINT ON THE SOUTHERLY SIDE OF PINE NECK ROAD DISTANT 91.94 FEET WESTERLY FROM THE EXTREME WESTERLY END OF THE ARC OF A CURVE CONNECTING THE WESTERLY SIDE OF PARK WAY WITH THE SOUTHERLY SIDE OF PINE NECK ROAD; THENCE SOUTH 06 DEGREES 45 MINUTES 50 SECONDS WEST 534.52 FEET TO LAND NOW OR FORMERLY OF SUYDAM; THENCE ALONG SAID LAST MENTIONED LAND, SOUTH 87 DEGREES 58 MINUTES SECONDS WEST 158.59 FEET; THENCE NORTH 02 DEGREES 01 MINUTES 50 SECONDS WEST110,00 FEET; THENCE NORTH 82 DEGREES 37 MINUTES 10 SECONDS EAST 68.16 FEET; THENCE NORTH 06 DEGREES 40 MINUTES 30 SECONDS EAST 406.16 FEET TO THE SOUTHERLY SIDE OF PINE NECK ROAD; THENCE ALONG THE SOUTHERLY SIDE OF PINE NECK ROAD, NORTH 82 DEGREES 37 MINUTES 10 SECONDS EAST 111.47 FETTOTHE POINT OR PLACE OF BEGINNING, ~ UNTFOI~M FORUM OF ACIGNOWLEDGMENT FOR ACt<LN'OWLEDGM. ENTS T?OLEN 12qSIDE NEW YORK WITH RESPECT TO CONVEYANCES OR OTHER 1-NSTRUMENTS AFFECTING REAL PROPERTY LOCATED IN NEW YORK (effective September ~ -~, 1998) State of New York ) County of ) ss.: On the day of in the yew . before me, the undersigned, personally appeared , personally knowu to me or proved to me on the basis of sa~factory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument a~d ackaowiedged to me th~.t he/she/they executed the s~me in his,rher/their capaciry(ies), and r. hat by kis/'aer/the'ff: sig~atm-e(s) on the i.us'w~ment, the individual(s), or the person upon behalf of which the individual(s) acted, executed the 57_srrument. (Si=m-~amre and office of individual r~'Uing ac!smow!ed~enr) PATRICIA C. MOORE Atto~'n~ at Law 51020 Main Road Southold, New York 11971-4616 Tel: (516) 765..4330 Fax: (516) 765-4643 April 15, 1999 Planning Board of the Town of Southold Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, NY 11971 Re: Estate of William Goubeaud Dear Melissa: Enclosed please find the Affidavit of Posting and Affidavit of Mailing with Certified Mail receipts for the above referenced matter. Also enclosed are the six Return Receipt cards received to date. PCM/mr Encls. P.S. Also enclosed please find my client's check in the sum of $2,000.00 payable to Town of Southold. Also enclosed is an additional Affidavit of Mailing because Barbara Ringewald advised that she sold her property to Betty Constaintin. Southold Town Planning BOard ,.,-FIDAV~IIT OF POSTING This is to serve notice that I personally posted the property known as by placing the Town's official poster notices(s) within 10 feet of the front property line facing the street(s) where it can be easily seen, and that I have checked to be sure the poster has remained in place for seven days pdor to the date of the public hearing on 1999. I have sent notices, by certified mail, the receipts of which are attached, to the owners of record of ever'/property which abuts and every property which is across from any public or private street from the above mentioned property on ~,~-~.- IG/ 1999. Your name ~4~rint) Address Date Notary Public PLEASE ,~ETUI~N THIS AFFIDA VIT AND CEt~TIF 0,~ AT THE PUBLIC HEAI~INC SCT-M Date of Hearing:. PS Form 3800, April 1995 PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold, New Y~,t.~71 ~';??'.,~?~ ' Z 4112 780 295 and Laura Leonard ~ 680 Cedarfields Drive Greenpor t, NY 11944 9~°'02-98° AF' ~ '~99 I 8 7 5 MAILED F:RO~ SOUTHOLD Nv ~ 7 1 IPerm~tN°'e'l° I yo.~.No.o-lO Ilusts i .................... · Print your name, address, and ZIP Code in this box · ox · Datricia C, Moore, Esq. 51020 Main Road Southold, NY 11971 Goubeaud AFFIDAVIT OF POSTING This is to serve notice that I personally posted the property known as by placing the Town's official poster notices(s) within 10 feet of the front property line facing the street(s) where it can be easily seen, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the public hearing on ¢/IZ./ 1999. I have sent notices, by certified mail, the receipts of which are attached, to the owners of record of every property which abuts and every property which is across from any public or private street from the above mentioned property on 1999. Signature Address Date Notary 15ubllc¢ PLEASE RETURN lFil$ AFFIDAVIT AND CERTIFIED MAIL RECEIPTS ON TNE DAY OF. O~ AT THE PUBLIC HEAl'lNG Re: ~/rv.J~au ~ SCTM#: ilO- io-S? Date of Hearing: AFFIDAVIT OF POSTING This is to serve notice that I personally posted the property known as by placing the Town's official poster notices(s) within I0 feet of the front property line facing the street(s) where it can be easily seen, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the public hearing on . 1999. I have sent notices, by certified mail, the receipts of which are attached, to the owners of record of every property which abuts and every property which is across from any public or private street from the above mentioned property on /~- I '~2 1~' ........... ; ~; SENDER: ;~ ', _~. Ite.~ 1 an~Cm' a for .ddltkx~l ..~ee. I ahlo wl~h to receive the YOUr name ~rin~) ~ .~ ..... ~_~ ~.~.~. a.B ~.~l.~ . ~, ' ~ , ~ ~er for ~. Sig~tur~ o } Frederick Mazzaferro & wf. ~.~~ ~~ ~, ~ { so.~hoZ~, ~ ug~ I I~~ '-') D~.-~& Address { ~,~,~ , . ~ N~ Public ~ P~ Fo~ ~, D~r ~ ~ ~m~ Domestic Return Receipt Nollflr PlddlO, 8Ual d Nmv Ya~ ~Hfolk Comity - No. 4~01~ PLEASE £ETU£N THIS AFFIDAV/T AND CE/ 0£ AT THE PUBLIC HEA£1Nu"' Re: G~t~.z,u & SCTM#: ilO- 10-5~/ Date of Hearing: PATRICIA C. MOORE Atton~ a~ Law 51020 Ma/a Road S°Uthold, New York 11971-4616 Tel: (516) 7654330 Fax: (516) 765-4643 Planning Board of the Town of Southold $OUthold Town Hall 53095 Main Road P.O. Box 1179 SOUthold, NY 11971 April 15, 1999 Dear Melissa: Re: EState of William Goubeaud Enclosed please find the Mailing with Certified Mail Affidavit of Posting and matter. Also enclosed are the r~ceipts for the Affidavit of date. above referenced slx Return Receipt Cards received to PCM/mr Encls. urs~ ~---~tricia C. Moore P.S. Also enclosed please find my client's payable to Town of Southold. Also en-~ = check in the Sum of $2,000.00 Mailing because Barbara Rin~ewa~= - c&vseu is an additional Affidavit of Betty Constaintin. o gu aUvised that she sold her property to APf 19 1999 Southold Town Planning Board PLANNING BOARD MEMBERS BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE RITCHIE LATH/MM, JR. RICHARD G. WARD Yown 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 Apd16,1999 Patdcia Moore, Esq. 51020 Main Rd. Southold, NY 11971 Re~ Proposed minor subdivision for the Estate of William Goubeaud SCTM# 1000-70-10-37 Dear Ms. Moore: The following resolution was adopted by the $outhold Town Planning Board at a meeting held on Monday, Apdl 5, 1999: BE IT RESOLVED that the $outhold Town Planning Board set Monday, May 3, 1999 at 7:30 p.m. for a final public headng on the maps last revised on July 23, 1997. Please refer to the enclosed copy of Chapter 58, Notice of Public Headng, in regard to the Town's notification procedure. The sign and notification form are enclosed for your use. Please return the endorsed Affidavit of Posting and the signed green return receipts from the certified mailings on the day of, or at the public headng. 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 dollars per vacant lot in the subdivision.) Payment is required pdor to any final endorsement of the subdivision. Please contact this office if you have any questions regarding the above. enc. Notice of Hearing A public hearing will be held by the Southold Town Planning Board at Town Hall, 53095 Main Road, Southold, New York, concerning this property: OWNER(S) OF RECORD: Estate of William F. Goubeaud NAME OF APPLICATION: Minor subdivision for above REFERENCE/TAX MAP #: 1000-70-10-37 SUBJECT OF I4EARING: This minor subdivision is for 2 lots on 1.461 acres TIME & DATE HEARING: Monday, May 3, 1999 at 7:30 p.m. If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the hearing during normal business days between the hours of 8 a.m. and 4 p.m. PLANNING BOARD - TOWN OF SOUTHOLD - (516) 765-1938 Southold Town Plannin~ Board Notice to Adiacent Properly Owners You are hereby given notice: That the undersigned has applied to the Planning Board of the Town of Southold for a minor subdivision. That the property which is the subject of the application is located adjacent to your property and is described as follows: Proposed lot line change for the Estate of William Goubeaud, SCTM#1000-70-I 0-37, located on Pine Neck Road. That the property which is the subject of this application is located in the R-40 zone. 4. That the application is for 2 lots on 1.461 acres. (See enclosed map.) That the files pertaining to this application are open for your information during normal business days between the hours of 8 a.m. and 4 p.m. Or, if you have any questions, you can call the Planning Board office at (516) 765-1938. That a public hearing will be held on the matter by the Planning Board on Monday, May 3, 1999 at 7:30 p.m. in the meeting hall at Southold Town Hall, Main Rd., Southold; that a notice of such hearing will be published at least five days prior to the date of such hearing in the Suffolk Times, published in the Town of Southold; that you or your representative have the right to appear and be heard at such hearing. Petitioner/Owners Name(s): Date: sTREET © 0 APPEAR IN 70 BLOCK 10 lAM F. GOUBEAUD :. MOOEE, ESQ. 11952 -40 OUTHOLD OUTHOLD ~'pINE NECK )AD PATRICIA C. MOORE At~raey at Law 51020 Main Road Southold, New York 11971 Tel: (516) 765-4330 Fax: (516) 765-4643 Marga~ Rutkowski March 25, 1999 Hand Planning Board of the Town of Southold Att:Melissa Southold Town Hall Southold, NY 11971 Re: Minor Subdivision Estate of Goubeaud SCTM# 1000-70-10-37 Dear Melissa: Enclosed please find 4 Mylar prints and 2 survey prints of the above subdivision which was stamped by the Health Department on March 19, 1999. Please set this matter on for final public hearing. BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS ~ GEORGE RITCHIE LATHAM, JR. RICHARD G. WARD 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 November 17, 1998 Patricia C. Moore, Esq. 51020 Main Rd. Southold, NY 11971 RE: Minor subdivision for the Estate of William F. Goubeaud SCTrvI~ 1000-70-10-37 Dear Ms. Moore: The following resolution was adopted by the Southoid Town Planning Board at a meeting held on Monday, November 16, 1998: BE IT RESOLVED that the Southold Town Planning Board grant sketch approval on the map dated July 23, 1997, with the following condition: Parcel 2 (the 40,000 square foot parcel) shall be subject to a covenant to be filed with the Suffolk County Clerk that will prohibit future subdivision. Sketch plan 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, six (6) paper prints and two (2) mylars must contain a current stamp of Health Department approval and must be submitted before a final public hearing will be set. The sketch plans also have 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. Page 2 Proposed minor subdivision for the Estate of William F. Goubeaud November 17, 1998 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 $2000.00. Payment is required prior to any final endorsement of the subdivision. Please contact this office if you have any questions regarding the above. Sincerely, Bennett Orlowski, Jr. //.... Chairman ~ ~'"-~ DEPARTMENT OF PLANNING COUNTY OF SUFFOLK SUFFOLK COUNTY EXECUTIVE STEPHEN M JONES, A I.C.P DIRECTOR OF PLANNING October 26, 1998 Mr. Bennett Orlowski, Jr., Chairman Town of Southold Planning Board Main Road Southold, New York 11971 Minor Subdivision: Tax Map No.: SCPD File No.: Dear Mr. Orlowski: Estate of William F. Goubeaud 1000-70-10-37 1333-NJ-98-08 Please be advised that pursuant to Section A 14-24, Article XIV of the Suftblk County Administrative Code that the above captioned plat is not within the jurisdiction of the Suffolk County Planning Commission. Sincerely, APF:cc Stephen M. Jones, AICP Director of Planning Principal Planner OCT g ,9 1998 LOCATION MAILING ADDRESS H LEE DENNISON BLDG - 4TH FLOOR · P. 0 BOX 6 I O0 · (5 I 6) 853-5 I 90 I O0 VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NY I 1788-0099 FAX (5 I 6) 853 4044 APPEALS BOARD MEMBERS Gerard E Goehringer, Chairman James Dinizio, Jr. Lydia A. Tortora Lora S. Collins George Homing BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 ZBA Fax (516) 765-9064 Telephone (516) 765-1809 Pi~nning Board F~ND][NGS, DEL/BERAT~ONS AND DETERMINATION REGULAR MEETING OF SEPTEMBER 30, 1998 Appl. NO. 4598 - ESTATE OF WILL/AM F. GOUBEAUD PARCEL 1000-70-10-37 STREET & LOCALITY: 2950 Pine Neck Road, Southold. DATE OF PUBL/C HEARING: September 24, 1998 FI'NDING$ OF FACT PROPERTY FACTS/DESCR[P'I'[ON: The subject property consists of a total area of 63,638.03 sq. ft., with 111.47 ft. frontage along the south side of Pine Neck Road and 110 feet along the eastedy side of Gagen's Landing Road, Southold. The July 23, 1998 survey map prepared by Joseph A. Ingegno, L.S. confirms that the property is improved with one single-family, one-story frame dwelling situate approximately 74 feet from the northerly front property line along Pine Neck Road AND AN ADJACENT FRAME GARAGE. The property Is in the R-40 ResidenUal Zone Dlsbict. BASIS OF APPEAL: Building Inspector's July 23, 1998 NoUce of Disapproval of application to subdivide the property. The reason for disapproval is that the proposed subdivision would create a nonconforming lot of 23,638 sq. ft. in the R-40 ResidenUal Zone District where a minimum of 40,000 sq. ft. is required. AREA VAR/ANCE REL/EF REOUESTED BY APpL/CANT. The request made by applicant is for approval of a division of the property into Parcel 1 of 23,638 sq. ft. fronting Pine Neck Road, and Parcel 2 of 40,000 sq. ft. with 110 ft. frontage along Gagen's Landing Road. The existing single-family dwelling would be situated on proposed Parcel ! with a rear yard setback of more than 90 feet. The building area (envelope) is not shown on proposed Parcel 2 at this Ume. REASONS FOR BOARD ACT/ON: Page2 - Appl. No. 4.598 ~ Re: 1000-70-10-37 (Gou~ ZBA September 30, 1998 Determination The property was acquired by Mr. and Hrs. William Goubeaud in 1951, and the family home was built in the northern section at about that time. The Gouboauds' son .]eft Goubeaud has lived in that home all his life. Testimony was given that the family believed that the property had been divided into two lots in about 1966. William Goubeaud, believing there to be two lots, bequeathed one to his son .left and the other to the daughter of his deceased son. But this testamentary intent cannot be carried out because the property in fact comprises only one lot. Because neither legatee is in a position to purchase the other's nonconforming lot containing the home, to be transferred to .]eft Goubeaud, and an unimproved 40,000 sq. ft. conforming lot to be transferred to the other legatee. TesUmony was heard to the effect that the need for County health approvals for future construction on the unimproved lot dictated that such lot be sized at no less than 40,000 sq. ft. On the basis of testimony presented and personal inspection, the Board made the following findings: Grant of the requested vadance is the only means by which the Estate of William Goubeaud can accomplish his testamentary intent of leaving the family home to 3eft Goubeaud and a buildable lot to the other legatee. Grant of the requested variance will not produce an undesirable change in the character of the neighborhood or detriment to nearby properties because the character and appearance of the improved lot fronting Pine Neck Road will not change, and a conforming lot, larger than most in the area, will be created fronting on Gagens Landing Road. The requested vadance is not substantial because the improved lot will be approximately the same size as surrounding lots and the unimproved lot will be substantially larger. 4. There are no factors present to indicate that the requested area variance will have any adverse impact on physical or environmental conditions. The requested variance is the minimum necessary and adequate to enable the applicant Estate to carry out decedents wishes, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTZONIACl'ZON: On motion by Member Collins, seconded by Member Tortora, it was RESOLVED, to GRANT the variance as applied for, SUB.iECT TO THE CONDITZON that Parcel 2 (the 40,000 sq. ft. parcel) shall be subject to a covenant, to be filed with the Suffolk County Clerk, that will prohibit future subdivision. Grant of this Variance for Parcel I is in consideraUon of and conditioned upon the imposition of such covenant. (A copy of Page 3 - Appl. No. 4598 ~ Re: 1000-70-10-37 (Goub~tl) ZBA September 30, 1998 Determination the filed Covenant(s) shall be furnished for the permanent records of the Board of Appeals.) VOTE OF THE BOARD: AYES: MEMBERS GOE~.[~NGER, DINIZIO, TORTORA, COLLINS, .ORNING. Th,s Resolution was du,v a~pt~.., ih/~ / · 'GE~RD P. GOEH~NGER, CHAIRNAN / Appmv~ for Filing 1000-70-10-37 BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS ~ GEORGE RITCHIE LATI-IAM, JR. RICHARD G. WARD 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 TO: FROM: RE: DATE: Gerard p. Goehringer Bennett Orlowski, Jr., Chairman ~ Request for Planning Board Comments William Goubeaud Pine Neck Road, Southold SCTM# 1000-70-10-37 September 22, 1998 The Planning Board is not in favor of creating a non-conforming lot. However, ff the Board of Appeals grants the variance, this Board would prefer to see two lots equal in area. SOUTHOLD FIRE DISTRICT P.O. BOX 908, SOUTHOLD, N.Y. 11971 (516) 765-4305 FAX (516) 765-5076 October 15, 1998 Chairman Bennett Orlowski, Jr. Southold Tow~ Planning Board PO Box 1179 Southold, NY 11971 Re: Estate of William Goubeaud, 1000-70-10-37 Dear Ben: The Southold Fire District has reviewed the above mentioned map and has found that there is adequate fire protection at this time. This decision is valid for one year from the date of this letter. Sincerely, Cynthia Caprise Fire District Secretary 2 0 Southold Town Planning 8Card PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, .Ir. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOU~OLD Suffolk County Planning Co~ision H. Lee Dennison ~ecutive Office Building - 12th Floor Veterans Memorial Highway Hauppauge, New York 11788 Attention: Gentlemen: Mr. Frank Dowling, Senior Planner Subdivision Review Division SCO'I'r L. HARRIS Supervisor Town Hall. 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 · Z%z Pursuant to Section A14-24, Suffolk County Administrative Code, the Southold Town Plannlng Board hereby refers the following proposed subdivision to th~ Suffolk County Planning Commission: ~? ~ Map of- ~~/~~amlet/Localit~ ,/~_r~ S.C.D.P.W. Topo No.: Zoning ~p~f~~_~O S.C. Tax Map No.: 3~oc~ 70 - /~ _ t/ 3~ Major Sub. Minor Sub. / Site Plan _ Cluster MATERIAL SUBMITTED: Preliminary Plat (3 copies) _~Road Profiles (1) Drainage Plans (1) Topogroaphical Map (1) Site Plan (1} Grading Plan (1) Other materials (specify-and give nund~er of copies) Waiver of Subdivision Requirements - See attached sheet CONTINUED REFERRAL CRITERIA: SEQRA STATUs: The project is an (Unlisted) (Type 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) (No). The proposed division has received approval from the S.C. Dept of Health. (Yes) (No). We request ackn6wledgement of receipt of this referral (Yes) (No) Referral received 19 by Suffolk County Planning Commission and assigned File NO. Very truly yours, _ //~./ CSairman / cc: Lydia Tor tora Submission Without a Cover Letter Southold Town Planning Board PLANNING BOARD MEMBEI~ BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE RITCI-IIE LATHAM, JR. RICHARD G. WARD 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 ~pr-2_q- , 1998 Cynthia Capris~, Secretary Southotd Fire District P.O. Box 908 Southold, NY 11971 Dear Ms. Caprise: Enclosed please find one (1) survey dated for SCTM# 1000 '70- The enclosed site plan is being referred to you for fire access review and for your recommendations as to whether any fire- wells are needed. Please specify whether firewells are shallow or electric. The enclosed subdivision is being referred to you for your recom- mendaUon at [o whether any firewel]s are needed. Please specify whether firewells are shallow or electric. Please reply by eoopera[ion. 1998. Thank you for your Sincerely, Bennett Orlowski, Jr. Chairman eno, off/c~ of BOARD OF APPEALS 765-18o9 ZB.~ tel. 765-9o64 Z~ telefax. MEMORANDUM TO: FROM: DATE: SUB~: Planning Board ~ ..~,f~ Board of Appeals~/~v September 17, 1998 Southotd Town Planning Board Preliminary Recommendations Planning/Zoning Projects Re: Prom)sed Subdivision/W. Goubeaud 1000-70-10-37. Our record shows that SEQRA has been coordinated by the P.B. Recommendations or suggestions should be sent for the applicant to consider before September 23~. Thank you. Re: Lieb Cellars (with Palmer) Prooosed Winery 1000-97-1-11.4. As an update to the file, Attorney Gall Wickham confirmed that Lieb is in contract to purchase property from Palmer. Gall has indicated she will be submitting more information at the hearing. Re: Interoretation Reauest of Buildinq Department- Generic/Town Wide. Question: Does Section 100-2S9 - Land Clearing apply to vacant land in all zones? .Comments on prior actions by Department(s) would be apprec;ated to show how projects have bcc, n previously decided, and each Department's recommendations should be submitted before September 24, 1998. Re: Reauest to Reverse Decision of B.i./Interpretation 1000-35-5-4 Schroeder Property, Main Road, East Marion (near Greenport) This is a carryover from July meeting and comments may be submitted until September 24, 1998 (hearing date). Thank you. Albert J. Krupski, President John Holzapfel, Vice President Jim King Martin H. Gan'ell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 R. G. Kassner Planning Board FROM: Board of Trustees DATE: August 26, 1997 RE: William F. Goubeaud The Southold Town Board of Trustees reviewed the survey of William F. Goubeaud dated and received in this office June 13, 1997 and found that the proposed sub division is clearly out of the Trustee Wetland jurisdiction. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. PLANNING BOARD 1VIEMBERS BENNETT ORLOWSKI, Chairman WILLIAM g. CREMERS tGgNNETH L. EDWARDS GEORGE RITCItlE LATH2MM, JR. RICHARD G. WAleD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 July 15, 1997 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Patricia C. Moore, Esq. P.O. Box 483 Mattituck, NY 11952 Re: Proposed minor subdivision for the Estate of William F. Goubeaud SCTM# 1000-70-10-37 Dear Ms. Moore: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, July 14, 1997: BE IT RESOLVED that the Southold Town Planning Board acting under the State Environmental Quality Review Act, assume lead agency, and as lead agency make a determination of non-significance and grant a Negative Declaration. Enclosed please find a copy of the Negative Declaration for your records. Please contact this office if you have any questions regarding the above. Sincerely, enc. PLANNING BOARD MEMBERS BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE RITCHIE LATHAM, JR. RICHARD G. WARD 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 State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination Non-Significant July 14, 1997 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8 (State Environmental Quality Review Act) of the Environmental Law. The Southold Town Planning Board, as lead agency, has determined that the proposed action described below will not have a significant effect on the environment and a Draft Environmental Impact Statement will not be prepared. Name of Action: SCTM#: Location: SEQR Status: Proposed minor subdivision for the Estate of William F. Goubeaud 1000-70-10-37 Pine Neck Rd., Southold Type I ( ) Unlisted (X) Conditioned Negative Declaration: Yes ( ) No (x) Description of Action: This minor subdivision is for 2 lots on 1.461 acres. Page 2 SEQR Negative Declaration -The Estate of William F. Goubeaud July 14, 1997 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 Department of Health Service 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 New York State Department of Environmental Conservation in the allotted time. Therefore, it is assumed that there are no comments or objections from that agency. The applicant will have to comply with the requirements of the Suffolk County Sanitary Code (SCSC) and all relevant standards of water supply and sewage disposal systems. Design and flow specification, subsurface soil conditions and site plan details will have to be approved by the Suffolk County Department of Health Services (SCDHS). This impact is not considered significant due to the anticipated project compliance with established requirements of the SCSC and the SCDHS and the required relevant permits. For Further Information: Contact Person: Robert G. Kassner Address: Planning Board Telephone Number: (516) 765-1938 cc: John P. Cahill, DEC Albany Suffolk County Dept. of Health Suffolk County Water Authority Judith Terry, Town Clerk Southold Town Building Dept. Southold Town Board of Appeals Applicant BENNETT ORLOWSKI, JR. ~ .~:~- .-~ Ch airman ~~ '~°.--~ /.~.- :~,~,~ ~: WILLIAM J. CREMERS ~ KENNETH L. EDW~DS 2 GEORGE RITCHIE ~TH~, JR. ~J %~ ~ RICED G. WARD ~- ~ ~ ~: 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 Re: Lead Agency Coordination Request Dear Reviewer: The purpose of this request is to determine under Article 8 (State Environmental Quality Review Act-SEQRA) of the Environmental Conservation Law and 6 NYCRR Part 617 the following: 1. Your jurisdiction in the action described below; 2. Your interest in assuming the responsibilities of lead agency; and 3. Issues of concern which you believe should be evaluated. Enclosed please find a copy of the proposal and a completed Environmental Assessment Form (EAF) to assist you in your response. fP?~?~.~f f ~,,,",~4 ~,.~>.~,';~',~"7'?'~'4 T/~'': Project Name: ~.~..', ~-. ~/~ ,~ ~'. _:~c~ ~ .~ £ ~ ,4? Requested Action: oF SEQRA Classification: ( ) Type I 0'9 Unlisted Contact Person: (516) 765-1938 Page 2 Lead Agency Coordination Request The lead agency will determine the need for an environmental impact statement (ELS) on this project. Within thirty (30) days of the date of this letter, please respond in writing whether or not you have an interest in being lead agency. Planning Board Position: (/~) This agency wishes to assume lead agency status for this action. ( ) This agency has no objection to your agency assuming lead agency status for this action. ( ) Other (see comments below) Please feel free to contact this office for further information. ~Si~cerely, / ,/" ~ Bennett Orlowski, Jr. "' Chairman cc;~Board of Appeals Board of Trustees Building Department Southold Town Board Suffolk County Department of Health Services -N-Y-SDEC--S teay-B rook - NYSDEC - Albany _S_uf~,_C ou nty- Department- of-Public Works U.S. Army Corp of Engineers New-Yo~'k-State- Department-of Transportation Thomas Cybulski~Greenport Public Utilities Raymond VanEtten, Greenport Village Administrator Suffolk County Water Authority *Maps are enclosed for your review rev. 4/94 PLANNING BOARD MEMBERS BENNETT ORLOWSKI, JR. Cha~rnnan WILLI.~VI J. CREMERS t~ENNETH L. EDWARDS GEORGE RITCHIE LATYIAM, JR. RICHARD G. WARD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 June 10,1997 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Patricia C. Moore, Esq. P.O. Box 483 Mattituck, NY 11952 Re: Proposed minor subdivision for the Estate of William F. Goubeaud SCTM# 1000-70-10-37 Dear Ms. Moore: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, June 9, 1997: BE IT RESOLVED that the Southold Town Planning Board start the lead agency coordination process on this unlisted action. Please contact this office if you have any questions regarding the above. Sincerely, / Bennett Orlowski, Jr. Y ~ Chairman PATRICIA C. MOORE .attorney at Law 315 Westphalia Road P.O. Box 483 Matlituck, New York 11952 Tel: (516) 298-5629 Fax: (516) 298-5664 May 20,1997 Bennett Orlowski,Jr., Chairman Southold Town Planning Board Town Hall 53095 Main Road P.O.Box 1179 Southold, NY 11971 Re: Estate of William F. Goubeaud SCTM#1000-70-10-37 Dear Chairman Orlowski; Enclosed please find 5 prints of the minor subdivision for the above referenced property. The subdivision line has been modified from our original submission in that Mr. Goubeaud, who lives in the residence, is willing to give the larger lot to the other distributee. We are simultaneously submitting this plan to the health department. Please advise me when you place this matter on your agenda, and please begin the SEQRA process with regard to this map. Thank you for your anticipated cooperation in this matter. Patricia C. Moore PLANNING BOARD MEMBERS RICHARD G. WARD GEORGE RITCHIE LATHAM. JR. BENNETT ORLOWSKI, JR. WILLIAM J. CREMERS 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 April 25, 1997 Patrica Moore Esq. 315 Westphalia Road Mattituck, NY 11952 RE: Goubeaud Minor Subdivision Pine Neck Road, Southold SCTM# 1000-70-10-37 Dear Mrs. Moore, This letter will confirm our conversation of this day that the application for the above mentioned client, submitted on January 8, 1997, will be held by this office pending receipt of new plans for a minor subdivision. If you have any questions, or require assistance, please contact this office. Site Plan Reviewer PATRICIA C. MOORE A~me~ at Law 315 Westphalia Road P.O. Box 483 Mattimck, New York 11952 Tel: (516) 298-5629 Fax: (516) 298-5664 Margaret Rutkowski Chairman, Southold Town Planning Board Town Hall 53095 Main Road P.O. Box 1179 Southold, NY 11971 Dear Chairman Wa~d: RE: Goubeaud Set-Off Enclosed please find the following documents referenced set-off: January 8, 1997 for the above Filing fee in the amount of $250.00. Three prints of a survey prepared by Roderick Van Tuyl, P.C. on which I have highlighted the subject parcels to be set-off. Copies of the deeds with the legal description of the property. To help identify the different deeds which create the entire parcel, enclosed is a diagram showing the transfers of title. Application for plat approval. Form letter regarding drainage, grading and road construction. 6. Part I of the Full E.A.F. 7. Copy of tax map. 8. Planning Board Questionnaire. 9. Disclosure pursuant to General Municipal Law Section 809 If there is anything further you need, please do not hesitate to contact me. Very truly yours, ~. Moore PCM/mr Encls. cc: Philip J. Goubeaud Submission Without a Cover Letter SCTM#: 1000- ~)-/~ ~0 A D CALE: iO0:~i 0 0 ~ D IvlA2 .DF LAND I'vl ~.'x. ~ ~ FrO Z~. _ ~,ViLL!AM F. GO/)BE~L~D ~E~~ Y~K :'-'- OF SOUTHOLD OPERTY. RECORD CARD ;~'-~ - ?~ -/~-a:" TOWN,:,' / - ': VILLAGE: -t' ' DISTRICT SUB~ LOT ; FOP,.MER OWNER UILDING :.~., . RES, _.~) SEAS. ~ ~,~RM COMM. IND. CB. I MISC, Est, LAND IMP. ;: ': TOTAL DATE REMARKS /,¥~, ~, ,3, NEW NORMAL Farm Acre ~,_, :, Va ue PeP 'AdZe Tillable I Tillable 2 Tillable 3 Woodland Swampland Brushland .... House, J~Ot,~. .... iotol FRONTAGE ON WATER ABOVE Value FRONTAGE ON ROAD BULKHEAD DOCK Foundation B~;e~ent' E~<t. Walls " Paho, ~ -' Bath Floors Interior FinisK Heat Roof Type Rooms;, 1st Floor APPEALS BOARD MEMBERS Gerard p. Goehringer, Chairman James Dinizio, Jr. Lydia A. Tortora Lora S. Collins George Homing BOARD OF APPEALS TOWN OF SOLFI~OLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 ZBA Fax (516) 765-9064 Telephone (516) 765-1809 Southotd Town PJanning Board FINDINGS, DELIBERATIONS AND DETERMINATION REGULAR MEETING OF SEPTEMBER 30, 1998 Appl. No. 4598 - ESTATE OF WIL PARCEL 1000-70-10-37 LIAM F. GOUBEAUD STREET & LOCALITY: 2950 Pine Neck Road, Sou . DATE OF PUBLIC HEARING: September 24, 1998 thold , .,,o :,q. r~., wlt~ 111.47 ~ n.,.,~_ sub. j.'ect ~,,uF,ertry consists of a total area of feet along the ... ,,u.u~ge along me south side of Pine Neck Road and 110 easterly Side of Gagen's Landing Road, Southoid. The July 23, 1998 survey map prepared by Joseph A. Ingegno, L.S. confirms that the property is improved with one single-family, one-six)fy flame dwelling situate approximately 74 feet from the northerly front property line along Pine Neck Road AND AN ADJACENT FRAME GARAGE. The property is in the R-~O Residential Zone District. B_ASI$ OF APPEAl Building Inspector's July 23, 1998 NoUce of Disapproval of application to subdivide the property. The mason for disapproval is that the Proposed subdMsion WOUld create a nonconforming lot of 23,638 sq. ff. in the R-40 ResldenUal Zone District where a minimum of ~0,000 sq. ft. Is required. ~ V, N ELIEF E a.pplK:ant is for a ¥ ' .Th_e_ request made by and Parcel 2 of ~0,000 sq. ft. with 110 ft. frontage along Gagen's Landing Road. "---',. v~.~.,y ,,to ~arcel 1 of 23,638 sq. ft. fronUng The existing single-family dwelling would be situated on Proposed Parcel I with a _r~__r yard setback of more than 90 feet. The buliding area (envelope) Is not shown on propo~ Parcel 2 at this ~Ime. REASONS FOR BOARD ACTXOI R_--.%_ "~. I~lO. 4598 ZBA Septem~. ~,' L~_°u~ ~-- ~u, 1~J98 DeterminalJon home was bull.t in .the northern section at a The PrOperty .wa.s acquired by Hr. and H~I William Gouboaud ~G~o~u~b?ud has lived in that h,,m~ -,, ~ bout that I~,-~ ~.n 1951, and the family -,aL me prooerfv h=,~ :.__ '""c a, nis life. Te----- lll~: i ne Gouh~.,-:_, · ---, ..,u ueen divid,~-t ~,~- L ,-~.u,,ony was o/yen ~k .... ~-,-_-uu~ SOn Jeff be/t~ae~evingphrotecg there to be two lots, bequeathed one to his SO,-]eft and the other ---,, .-tu cwo lots in ah,~.,~ ~,L;''a~ [ne tamily beliew,~ r of his deceased SOn. But this testamentary intent can · William Goubeaud, ~ petty in fact comprises to the purchase the other's only one lot. Because neither ,not .be carded out because nonconforming lot containing the home, to be transferred to Jeff ~egatee is in a POsluon to Goubeaud, and an unimproved 40,000 sq. ft. conforming lot to be transferred to the other legatee. Testimony was heard to the effect that the need for County health apProvals for future construction on the unimproved lot dictated that such lot be sized at no less than 40,0O0 sq. ft. On the basis of testimony Presented and personal inspect/on, the Board made the following findings: L Grant of the requested variance is the only means by which the Estate of William Goubeaud can accomplish his testamentary Intent of leaving the family home to .]eft 2. Goubeaud and a bolldabie lot to the other legatee. Grant of the reque .s~. variance will not produce an u · reproved lot frontin, pi.~ :,__~:~ ,_i~ro.es because the and a co.forming lot, larger than most in the area, will be created fronting on Gagens 3. The requested variance is not substantial because the improved lot will be appro×imately the same size as surroundlng lots and the unimprOved lot wilt be substantially larger. 4. There are no factors present to Indicate that the requested area variance will have any adverse Impact on phys~al or e.vlronme.tal conditions. S. The requested variance is the minimum necessary and adequate to enable the applicant Estate to carry out decedents wishes, character of the neighborhood while preserving and PrOtecueg the R~O--~ON A~: am the health, safety and welfare of the community. it was On motion by Hembar Collins, seconded by Member Tortora, RESOLVED, to GRANT the variance as app/ied for, SUBJECT TO THE CONDCI'ION that Parcel 2 (the 40,000 sq. ft. Parcel) shall be subject to a covenant, Suffolk County Clerk, that will PrOhibit future subdivision, to be filed with the ! is in consideration of and conditioned upon the imposition Variance for Parcel Grant of this of such covenant. (A copy of OWNER TOWN OF SOUTHOLD FORME~, OWNE~, LAND IMP. VL. STREEI -/~ ~ $ FARM TOTAL AGE NEW FARM illable ¥oodland Aeadowland louse Plot oral NORMAL Acre DATE BUILDING CONDITION BELOW ABOVE Value Per Value Acre co! PROPERTY RECORD CARD VILLAGE ! CB. MICS. M~.t. Value REMARKS DIST. SUB. TYPE OF BUILDING LOT FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK COLOR G;,,~/~ ,7/ TRIM M. Bldg. Extensiort, ~xtensio'~ Extension Jorch 'arch ~reezeway _;arage 'atio Iotal :57/) 9(, Foundation Basement Ext. Walls Fire Place Type Roof Recreation Room Dormer Bath F oars Interior Finish Heat Rooms ]st Floor Rooms 2nd Floor DriveWay I Dinett )FIN. E '2 ( /8 )--7c 2 7 617.21 SEQR Appendix A State Environmental Quality Review · FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an ordeHy 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, th~re 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 anaJy~ is. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination proce,,s has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. Full E,%F Components: The full EAF is comprised of three parts: Part 1: Provides obiective data and information about a given project and its site. By identifying basic project data, it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part :2: Focuses on identifying the range of possible impacts that may occur from a proiect or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially- large impact. The form also identifies whether an impact can be mitigated or reduced· Part 3: If any impact in Part 2 is identified as potentially-large, then Part3is used to evaluate whether or not the impact is actuaily important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Idenlify the Portions of EAF compleled for this project: 12] Part 1 [] Part 2 C]Part 3 Ijpo~ review of the information recorded on this EAF (Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magitude and importance of each impact, it is reasonably determined by the lead agency that: [] A. The proiect 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. ~J B. Although the proiect could have a signif'icant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* ~] C. The project may result in one or more large and important impacts that may have a significant impact on the enviro?ment, therefore a posilive dec aralion will be re ared ' A Conditioned NeglJ,~ive Declaration is only valid for Unit 'P P ' sted Actions Set Off of Goubeaud Lot Nameof Action Planning Board of the Town of Southold Name of Lead Agency Print cr Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer (If different from responsible officer) C)ate 1 NO.T, 1CE: 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 quest oas will be considered,..-- as part of the application for approval and may be subject to further ver f cation and public revew Provide anyadditiona~. information you believe will be needed to complete Parts 2 and 3. I~ is expected that completion of the full EAr will be dependent on information currently available and will not involve few studies, research or investigation. If information requiring such ~dditional work is unavailable, so indicate and specify each instance. NAMe.' OF ACTION of Goubeaud LOCATION OF ACTION (Include Slree! Address, MuniclpaUly and County) Pine Neck Road and Gagen's Landing Road, Southold,County of Suft NAME OF APPLICANT/SPONSOR Estate of William F. Goubeaud c/o Pat Moore 315 Westphalia Road BUSINESSTELEPHONE (516)298-5629 Hattituck NySTATE . ~/AME OF OWNER (ff different) J BUSINESS TELEPHONE ADDRESS I ( ) CiTY/PO I STATE ZIP CODE '~)ESCRIPTION OF ACTION of 80,000 sq,ft, parcel for two beneficiaries of the Estate of William' Goubeaud Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: [-IUrban Olndustrial ~Commercial ~Residential (suburban) [3Rural (non-farm) E3Forest F'lAgriculture C]Other 2. l'otal acreage of proiect area: 1+ acres. APPROXIMATE ACR~,AGE 10 PRESENTLY Meadow or Brushland (Non-agricultural) ' acres Forested 0 acres Agricultural (Includes orchards, cropland, pasture, etc.) 0 acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) O acres Water Surface Area 0 acres Unvegetated (Rock, earth or fill) f~ acres Roads, buildings and other paved surfaces .7~ acres Other[IndicaIe type)~c'istina residence 3. What is predominant soil type(s) on proiect site? a. Soil drainage: E]Well drained 100 % of site acres acres 0 acres 0 acres 0 acres 0 acres 0 acres · 5 acres [:]Moderatety well drained % of site i-]Poorly drained % of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? 0 .acres. (See I NYCRR 370). ~' Are there bedrock outcroppings on project site? [:]Yes [~No a. What is depth to bedrock? (in feet) ~' ,~pproximate percentage, of proposed project site with slopes: ~0-10% % [~10-15% ' % uP/ ~//6. _s project substantially contiguous to, or contain a building, site or district, listed on the State or the National //,~.., (egistersof HistoricPlaces? E]Yes ,No ?. s project substantially contiguous to a site listed on the Register of National Natural Landmarks~ EYes J~No 8. Nhat is the depth of the water table? (in feet) 9. s site located over a primary, principal, or sole source aquifer? ~Yes C3No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? EYes ~No 11. Does proiect site contain any species of plant or animal life that is identified as threatened or endangered? EYes ~No According to Identify each species 12. Are there an,/ unique or unusual [and forms on the project site? (i.e., cliffs, dunes, other geological formations) {~Yes [No Describe 13. Is the 14. 15. project site presently used by the community or neighborhood as an open space or ,recreation area? E]Yes ~i~]No If yes, explain Does the present site include scenic views known to be important to the community? E:]Yes UNo Streams within or contiguous to proiect area: NO a. Name of Stream and name of River to which it is !ributary 16. Lakes, ponds, wetland areas within or contiguous to project area: a. Name b. Size (In acres) 17. rs the site served by existing public utilities? I~Yes C]No ~) If Yes, does sufficient capacity exist to allow connection? I~Yes ENo b) If Yes, will improvements be necessary to allow connection? I~Yes I~No 18. s the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Art)cie 2S-AA, :;ection 303 and 304? EYes []No 19. :s the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 i--lYes ~No 20. Has the site ever been used for the disposal of solid or hazardous wastes? OYes ~,No B. Project Descriptiort, 1. Physical dimensions and scale of proiect (fill in dimensions as appropriate) 5. Total contiguous acreage owned or controlled by project sponsor :~. Project acreage to be developed: ~"' acres initially; ,:. Project acreage to remain undeveloped · ~ acres. d. Length of proiect' in miles: ~v/,,~ (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed t. Number of off-street parking spaces existing ../'///:~ ; proposed [~. Maximum vehicular trips generated per hour h. If residential: Number and type of housing units: One Family Two Family acres. acres ultimately. (upon completion of project)? Multiple Family Condominium length. Initially Ultimately __ i. Dimensions (in feet) of largest proposed structure ~2,~' height; ~ ,~'o width; . j. Linear feet of frontage along a public thoroughfare project will occupy is? //O ft. 3 · /~;Ho uch atural material (i.e., rock, earth, etc.) will be removed from the site,~ ~,/0A/~, tons/cubic yards ,ii/~3 Will disturbed areas be reclaimed~' OYes ONo [~/N/A ,, / a. If yes, for what intend..,~ purpose is the site being reclaimed~ . ___ ~/ b. Will topsoil be stockpiled for reclamation~ 0-1Yes ONo / c Will upper subsoil be stockpiled for reclamation~ ~]Yes F-INo 4 How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? ~ acres. 5 Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? [:3Yes ~No 6 If single phase proiect: Anticipated period of construction ~' 7 If multi-phased: a. Total number of phases anticipated I (number). b. Anticipated date of commencement phase 1 c. Approximate completion date of final phase d. Is phase 1 functionally dependent on subsequent phases~' g. Will blasting occur during construction~ OYes i~No 9. Number of jobs generated: during constr~Jction ~ lt. Number of jobs eliminated by this project O 11. Will project require relocation of any projects or facilities~ months, (including demolition). month year, (including demolition]. month year. OYes ~No ; after project is complete C:) OYes [~No If yes, explain Is surface liquid waste disposal involved~ OYes ONo a. If yes, indicate type of wast~ndustrial, etc.) and amount ~1~ b. Name of water body into which effluent will be discharged Is subsurface liquid waste disposal involved~ BYes ~]No Type Will surface area of an existing water body increase or decrease by proposal~ 0-1yes Explain 15 Is project or any portion of project located in a 100 year flood plain? 16 Will the project generate solid waste.~ ~tlYes a. If yes, what is the amount per month I~1~,_~1~. tons b. If yes, will an existing solid waste facility be used~ [~Yes I~No c. If yes. give name ~.~.~.~.~.~.~.~.~.~OUTHo/_.D ~..,~ID~.~- ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill~ e. If Yes, explain OYes ~No ~vT~HOeU~ OYes 17 Will the project involve the disposal of solid waste~ ~Yes a. If yes. what is the anticipated rate of disposal[ l~lJ~ , b. If yes. what is the anticipated site life~' years. 18 Will project use herbicides or pesticides~ ~]Yes ~]No tons/montb. 19. Will project routinely produce odors (more than one hour per day)~ OYes J~No 20. Will project produce operating noise exceeding the local ambient noise levels~ ~Yes ~No 21. Will project result in an increase in energy use? ~Yes If yes , indicate type(s) 22. If water supply is from well% indicate p,~mt)ing capacity 23. Total anticipated water usage per day., ~i1~ gallons/day. 24. Does project involve Local, State or Federal funding? ~lYes ~No If Yes, explain ~'INo · :'T/Approvals Required: ~// City, Town Zoning Board [~.Yes I-1No CRy, County Health Department EgYes Other Local Agencies [Z]Yes I~lNo Other Regional Agencies I-IYes S.:ate Agencies [Z]Yes ~lNo Federal Agencies OYes ~]No Type C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? (~Yes I-'lNo · If Yes, indicate decision required: i-lzoning amendment '~zoning variance r'lspecial use permit ~subdivision [~site plan []new/revision of master plan [-]resource management plan {~other 2. What is the zoning classification(s)of the site? .. ~- JO 3. What is the maximum potential development of the site if developed as permitted by the present zoning? one res±dence per one acre Submillal Date 4. What is the proposed zoning of the site? r-40 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? one residence in subdivided lot 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? ~lYes 7. What are the predominant land use(s) and zoning classifications within a % mile radius of proposed action? residential r-40 F'lNo 8. Is the proposed action compatible with adjoining/surrounding land uses within a ¼ 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 180 x 120 lot mile? F~Yes [~No 10. Will proposed action require any authorization(s) for the formation of sewer or water d strictst Ciyes ' ~No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? r-lYes (]~Jqo minimal a. If yes, is existil~g capacity sufficient to handle projected demand? [~Yes ~No 12. Will the proposed action result in the generation of traffic significantly above present levels? []Yes ~No a. If yes, is the existing road network adequate to handle the additional traffic? I-lYes ~]No D. Informational Details Attach any additional information as may be needed to clarify your proiect. 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 ~at the information provided above is true to the best of my knowledge. _ . Applicant/Spc~o~am~ ~,'4%hilip J Goubeaud ~ -~- ~ u ~ ' ' ' ' uate ~ / wilfl Iflls assessmenl. 5 ~!~ '? Part 2--PROJECT IMPACTS AND THEIR MAGNITUDE ~ Responsibilily of Lead Agency · ,J/General Informaho~ (Read Carefully) ' ,, .~ji~F/./· In completing the form the reviewer should be guided by the question: Have my responses and determ nat •ns been ~'~/ reasonable~ The reviewer is not expected to be an expert environmental analyst. ~'/ ' ,dentifying that an impact will be potentially large (column 2) does not mean that it is also necessary significant. / Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact n column 2 simply asks that it be looked at further. · the Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and tot most situations· But, for any specific project or site other examples and/or lower thresholds may be appropriate tot a Potential Large Impact response, thus requiring evaluation in Part 3. · '-he impacts of each project, on each site, in each locality, will vary· Therefore. the examples are i[lustrat'ive and -~ave been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each question. · Yhe number of examples per question does not indicate the importance of each question. · In identifying impacts, consider long term, short term and cumlative effects. Ira. Itu(ti•ns (Read carefully) a. &nswer 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. f 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 hut threshold is lower than example, check column 1. d. 'f 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. im~,act, 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. '/Viii the proposed action result in a physical chanse to the proiect site? kiN• E]YES Examples that would apply to column 2 · Any construction on slopes of 1.5% 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 paCking 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 ci)ntinue for more than 1 year or involve more ti'bin one phase or stage. · Excavation for mining purposes.lhat would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Cc, nstruction in a designated floodway· · Other impacts 2. Will there he an effect t(. --.W un~(lue or unusual land forms fotmd on the site? (i.e., cliffs, dunes, geological formations, etc.)L~NO ~IYES · Specific land forms: 6 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By impact Impact Project Change [] [] OYes J-~No [] [] []Yes []No E] [] OYes •No [] [] []Yes kiN• [] [] OYes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes ~]No C IMPACT ON WATER 2. Will proposed action affect any water body designated as protected? {Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) FqNO ~IyES Examples that would apply to column 2 · Developable area of site contains a protected water body. · Dredging more than 100 cubic yards of material from channel of a ~rotected stream. · Extension of utility distribution facilities through a protected water body. · Construction in a desigr~ated freshwater or tidal wetland. · Other impacts:' 4. Will proposed action affect any non-protected existing or new body of water~ ONO I-IYES Examples that would apply to coiumn 2 · A 10% increase or decrease in the surface area of any body of water 3r more than a 10 acre increase or decrease. · Construction of a body of water that exceeds 10 acres of surface area. ~* Other impacts: 5. will Proposed Action affect surface or groundwater quality or quantity~' (~]NO E]YES Examples that would apply to column 2 · Proposed Action will require a discharge permit. · Proposed Action requires use of a source of water that does not have approval to serve proposed {project) action. ' Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination o~ a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conveyed 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 Action locates commercial and/or industrial uses which may require new or expansion of existin~ waste treatment and/or storage facilities. · Other impacts' 6, Will proposed action alter drainage flow or patterns, or surface water runoff~ ONO OYES Exz~nples that would apply to column 2 ' Proposed Action would change flood water flows. 7 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change O O [:]Yes ~]No [] O OYes I-1No O [] OYes ONo O O [~Yes ONo O O OYes E]No O [] OYes E]No [] O OYes ONo [] O OYes E-]No [] O []Yes E3No O O []Yes EE]No O O OYes ONo [] O FIYes FINo O O []Yes f-INo [] [] I-lYes ONo O O []Yes r-INo [] O OYes ONo O [] OYes ONo [] O OYes ONo [] O OYes ONo [] O OYes ONo O O OYes /' Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designated floodway. · ~ther impacts: IMPACT ON AIR 7. Will proposed action affect air quality~ UNO I-lYES Examples that would apply to column 2 · ~roposed 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 !~eat source producing more than 10 million BTU's per hour. · Proposed action will allow an increase in the amount of land committed :o industrial use. · Proposed action will allow an increase in the density of industrial Jevelopment within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS 8. Will Proposed Action affect any threatened or endangered species~ [~NO I-lYES Examples that would apply to column 2 · :~eduction of one or more species listed on the New York or Federal Jst. using the site. over or near site or found on the site. · :,'emoval of any portion of a critical or significant wildlife habitat. · ~pplication of pesticide or herbicide more than twice a year, other ~han for agricultural purposes. · Other impacts: ii 9. Will Proposed Action substantia y affect non-threatened or non-endangered species~ E]NO C]YES Examples that would apply to column 2 · F'roposed Action would substantially interfere with any resident or ufigratory 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 ~ egetation. IMPACT ON AGRICULTURAL LAND FI£SOURCE$ 10 Will the Proposed Action affect agricultural land resources? [~NO f~YES Examples dlat would ~pply to column 2 · 1 he proposed action would sever, cross or limit access to agricultural I~md {includes cropland, hayfields, pasture, vineyard, orchard, etc.) I 2 3 Small to Potential Can Impact Be Moderate· Large ' Mitigated By Impact Impact Project Change [] [] I-lYes []No [] [] {'-]Yes [] [] []Yes []No [] [] []Yes r-'~ No [] [] []Yes []No [] [] []Yes []No ,J--I [] []Yes []No [] ~ ~Yes ~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 ~t~ricbltural land. · 1 ~e proposed action would irreversibly convert more than 10 acres cl agricultural land or, if located in an Agricultutal District, more t~an 2.5, acres of agricultural land · I he proposed action would disrupt or prevent installation of agricultural land management systems (e.g.,. subsurface drain lines, outlet ditches, svip cropping); or create a need for such measures (e.g. cause a farm f,~:ld to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES 1'1. Will proposed action affect aesthetic resources? nNO I-lYES (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 will eliminate or significantly reduce their enjoyment ol' the aesthetic qualities of that resource. · Proiect components that will result in the elimination or significant screening of scenic views I¢nown to be important to the area. · O~her impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, pre- historic or paleontological importance~ [-]NO DYES [xamples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility I~,r 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. Witl Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities;~ ~Examples that would apply to column 2 ~]NO OYES · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Ot~er impacts: 1 2 3 Small to" Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes []No [] [] []Yes []No [] [] [~Yes []No [] [] l-lYes C]No [] [] I-lyes []No [] [] []Yes F1No [] [] E]Yes E]No [] [] I--lYes []No [] [] t-lYes []No [] [] EE]¥es C]No [] [] []Yes []No [] [] [~]Yes E]No [] [] []Yes []No [] [] I-lyes []No [] [] E]Yes C]No ~: ' d. Will there be an effect to existing transportation systems? (~NO E3YES Examples that would apply to column 2 ,, · Alteration of present patterns of movement of peopl'e and/or goods. · Proposed Action will result in major traffic problems. · Other impacts: IMPACT ON ENERGY 1E, Will proposed action affect the community's sources of fuel or ener§y supply? I-)NO OYES 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 maior commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16. Will there be obiectionable odors, noise, or vibration as a result of the Proposed Action? - ONe OYES Examples that would apply to column 2 · Blasting within 1.500 feet of a hospital, school or other sensitive facility. · Odors will 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 will remove natural harriers that would act as a noise screen. · Other impacts' IMPACT ON PUBLIC HEALTH 1'7. Will Proposed Actionl~ffect public health and safety? [~)NO OYES Examples that would apply to column 2 o' 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 distorbance within 2.000 feet of a site used for the disposal of solid or hazardous waste. "Other impacts: 10 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes (-"] No [] [] []Yes []No [] [] []Yes I-1No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes [-]No [] [] []Yes [=]No [] [] []Yes J--]No [] [] []Yes J-lNo [] [] []Yes []No [] [] []Yes [-]No [] [] []Yes []No [] [] []Yes []No [] [] F-lYes []NO [] [] I=]Yes []No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18, Will proposed action affect the character of the existing community? ONO ~YES Examples that would apply to column 2 · 1 he permanent population of the city, town or village in which the )roject is located is likely to grow by more than 5%. · ! he municipal budget for capital expenditures or operating services ,,ill increase by more than 5% per year as a result of this proiect. · ~roposed action will conflict with officially adopted plans or goals· · ~roposed action will cause a change in the density of land use. · 3~oposed Action will replace or eliminate existing facilities, structures o,' areas of historic importance to the community. · Oe~ elopment 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. · P'oposed Action will create or eliminate employment. · (3ther impacts: I 2 3 Small to" Potential Can Impact Be Moderate Large Mitigated By Impact Impact I Project Change O O OYes ONo 0 ' 0 OYes ONo O O OYes I-]No [] O []Yes []No O O OYes ONo O [] OYes E]No [] O OYes ONo O O OYes ONo [] [] OYes ONo 19. Is there, or is there likely to be, public controversy related to potential adverse environmental mpacts1 ONO I-lYES 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 C Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibilily of Lead Agency · Par~ 3 must be prepared if one or more impact(s) is considered Io be potentially large, even if the impact(s) may be mili:galed. Inslrucllons Discuss the following for e~lJ~h impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. I~escribe (if applicable} how the impact could be mitigated or reduced to a small to moderate impact by project change(s). 3. ~ased on the information available, decide if it is reasonable to conclude that this impact is important. 1o answer the question o~ importance, consider: ' /he 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:rt4ence from local needs and ~oals · Whether known ohjection~ to the proj~!ct relate to this impact. (Continue on attachments) 11 617.21 Appendix B State Environmental Quality Review Visual FAF Addendum SEQR C C This form may be used to provide additional information relating to Quest!ch !! of Part 2 of the Full EAF. (To be completed by Lead Agency) Visibility 1. Would the project be visible 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 qualities? · An pverlook 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 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 designation? · A site, area, lake, reservoir or highway designated as scenic? Il, · Municipal park, or designated open space~ · County road? · State? Distance Between Project and Resource (in Miles) 0- V4 V4 % V,- -3 3-5 5 + [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] · Local road? · . [] [] [] [] [] 2. Is the visibility of the project seasonal? (i.e., screened by summer foliage, but visible during other []Yes []No 3. Are any of the resoorces checked in question during wi~ich Ibe project will be visible.:) ~]Yes ONo used by the public during the time of year DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally describe the sui:rounding - environment. Within *t/4 mile * 1 mile Essentially undeveloped [] [] Forested [] [] Agricultural [] [] Suburban residential [] [] Industrial [] [] Commercial [] [] Urban [] [] River, Lake, Pond [] [] Cliffs, Overlooks [] [] Designated Open Space [] , [] Flat [] [] Hilly [] [] Mountainous [] [] Other [] [] NOTE: add attachments as needed 5. Are there visually similar projects within: *V2 mile []Yes []No *! miles E~Yes []No *2 miles OYes []No *3 miles [--]Yes F]No * Distance from project site are provided for assistance. Substitute other distances as appropriate EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation hr activity in which the viewers are engaged while viewing the proposed action is Activity Travel to and from work Involved in recreational activities Routine travel by residents At a residence At worksite Other FREQUENCY Holidays/ Daily Weekly Weekends Seasonally [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] $outhold. N.Y. 11971 (616) 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 ~ 2. Are there any other premises under your ownership abutting this parcel? Yes 3. Are there any building permits pending on this parcel? Yes 4. Are there any other applications pending concerning this property before any other department or age~cy?(Town , State, CouD~¥, etc.) ~ No 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 ~ 7. Does this property have a valid certificat~ of occupancy, if yes pleas.e submit.a copy of same ~ No I ce~fy that the above statements are true and will be relied on b~.%~el~a, nning~B~ard in considering this application. Attachment to questionnaire for:.'%he Planning Board STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the ~ .day of __~__, 19~_~, before me personally came 2~,/~ ' · ¥ ~ ~~ to me known to be the individual described in."and who executed the foregoing instrument, and acknowledged that ~ execute~ame. N~y P~btic PATRICIA C. MOORE Notary Public, State of New York Suffolk County - No. 486166~ ~, CemmisNon Expires June 16, ~',,}' -SUBJECT PREMISES ROAD SCALE 1"=600' ESTATE SET-OFF PREPARED FOR OF WILLIAM F. SITUA TED A T PINE NECK TOWN OF PLAN GOUBEAUD SOUTHOLD SUFFOLK COUNTY, NEW YORK SCALE 1 ~30 FEBRUARY 4, 1997 THIS SUBDIVISION WILL APPEAR IN · DISTRICT 1000 SECTION 70 BLOCK 10 OWNER AND APPLICANT: ESTATE OF WILLIAM F. GOUBEAUD C/O PATRICIA C, MOORE, ESO. P.O. BOX 185 MATTITUCK, NY 11952 BUILDING ZONE DISTRICT: R-40 SCHOOL DISTRICT; SOUTHOLD FIRE DISTRICT: SOUTHOLD D" E JOCKEY CREEK 104, A~EA DATA PARCEL 1 45,791.96 sq. fl, PABCEL 2 19,846.07 sq. ff. 0,456 ac, TOTAL 65,658.03 sq. ff. TYPICAL PLOT PLAN (NOT TO SCALE) DOte I HEREBY CERTIFY THAT THiS MAP WAS MADE BY US FROM ACTUAL SURVE~S COMPLETED FEBRUARY 4, 1997 AND THAT ALL CONCRETE MONUMENTS SHOWN THUS · HEREON ACTUALLY EXIST AND ARE CORRECTLY SHOWN AND GEODETIC CORRECT THIS IS TO CERTIFY THE SUBDIVISION PLaN BAS BEEN APPROVED BY THE PLANNING BOARD OF THE TOWN OF RNERHEAO BY RESOLUTION OF APPROVAL DATED BY CHAIRMAN PLANNING BOARD $oUTI-t © > DWELLING N B2'37' 0 E B PAR GOOSE CREEK HOUSE TYPICAL SEWAGE DISPOSAL SYSTEM (NOT TO SCALE) TEST HOLE DATA NOTE; ELEVATIONS SHOWN THUS:~ARE REFERENCED TO AN ASSUMED DATUM, SEPTIC lANK (!) LEACHING POOL 17, N.Y,S, Lic. No, ,4-9668 Joseph, A. Ingegno. Lar~d SUrveyor RHdNE (518)7~?-20g0 Fax (516)72~%5093 -SUBJECT PREMISES MAP SCALE 1"=600' ESTATE MINOR SUBDIVISION PREPARED FOR OF WILLIAM F. SITUA TED A T PINE NECK TOWN OF SOUTHOLD SUFFOLK ........ ". :! -: ..t, ?, GOUBEAUD COUNTY, NEW SCALE 1" =,50' FEBRUARY 4, 1997 MARCH 6, 1997 REVISED LOT SIZES MARCH 7, 1997 REVISED LOT SIZES YORK AREA DATA PARCEL 1 4B,210.75 sq. ff. 0.923 ac. PARCEL 2 25,427.28 sq, ff. 0,538 ac. TOTAL 63,658,05 sq, fi. 1.4,61 THIS SUBDIVISION WILL APPEAR IN DISTRICT 1000 SECTION 70 BLOCK 10 OWNER AND APPLICANT: ESTATE OF WILLIAM F. GOUBEAUD C/O PATRICIA C. MOORE, ESQ. P.O. BOX 183 MATTITUCK, NY 11952 BUILDING ZONE DISTRICT: R-40 SCHOOL DISTRICT: SOUTHOLD FIRE DISTRICT: SOUTHOLD I HEREBY CERTIFY THATTHIS MAP WAS MADE BY US FROM ACTUAL SURVEYS OOMPLETED FEBRUARY 4, 1997 AND THAT ALL CONCRETE MONUMENTS SHOWN THUS:I HEREON ACTUALLY EXrST AND POSfflONS ARE CORRECTLY DIMENSIONAL AND TYPICAL PLOT (NOT TO SCALE) PLAN THIS IS TO CERTIFY THE SUBDIVISION PL&N HAS BEEN APPROVED BY THE PLANNING BOARD OF THE TOWN OF RIVERHEAD BY RESOLUTION OF APPROVAL DATED BY CHAIRMAN PLANNING BOARD X JOCKEY CREEK oAD ,,,,, PARC i r~ Dote ©? © 68A6' PARCEL(~ N/O/~ 158.59' GOOSE CREEK TYPICAL SEWAGE DISPOSAL SYSTEM BAFFL~ SEPTIC TANK (1~ LgACHING POOL. TEST HOLE DAtA (TEST HOLE DUG Ely McDONALD GEOSCIENCE ON FEDRUARY 12, 1997) NOTE' ELEVATIONS SHOWN THUS:C~'ARE REFERENCED 17, THE EXISTANCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED, TO AN ASSUMED DATUM,. NY.S, Lin. No 49668 Joseph A. Ingegno Land Surveyor PHONE (516)727-2090 Fax (516)722-5093 OF~CES LOCATED AT MAIUND ADDRESS 97-122-2 -SUBJECT PREMISES MAP SCALE 1"=600' r ESTATE MINOR SUBDIVISION PREPARED FOR OF WILLIAM F. SITUA TED A T PINE NECK TOWN OF' SOUTHOLD COUNTY, NEW SCALE 1"--30' FEBRUARY 4, 1997 MARCH 6, 1997 REVISED LOT SIZES 7 REVISED LOT SIZES SUFFOLK GOUBEAUD AHEA DATA PARCEL I 22,838.03 =q. ff. 0.542 PARCEL 2 40,000.00 sq. fl, 0.918 TOTAL 62,655.02 sq. ft. 1.461 ac. YORK THIS SUBDIVISION WILL APPEAR IN DISTRICT 1000 SECTION '70 BLOCK 10 ~.o~-3'~ OWNER AND APPLICANT: ESTATE OF WILLIAid F. GOUBEAUD C/O PATRICIA C. MOORE, ESQ. P.O. BOX 185 MATTffUCK, NY 11952 BUILDING ZONE DISTRICT: R-40 SCHOOL DISTRICT: SOUTHOLD FIRE DISTRICT: SOUTHOLD [ HEREBY CERT{FY THAT THIS MAP WAS MADE BY US FROM ACTUAL SURVEYS COMPLETED FEBRUARY 4, 1997 AND THAT ALL CONCRETE MONUMENTS SHOWN THUS' HEREON ACTUALLY EXIST AND TH POSITIONS ARE CORRECTLY SHOWN AND LL DIMENSIONAL AND GEOD~ORRECT. TYPICAL PLOT (#0T TO ~A~:) PLAN THIS IS TO CERTIFY THE SUBDIVISION PLAN HAS BEEN APPROVED BY THE PLANNING BOARD OF THE TOWN OF R~VERHE~D BY RESOLUTION OF APPROVAL DATED BY CHAIRMAN PLANNING BOARD JOCKEY CREEK i Rte soUT~ STREET © > / t4 B2'37 10" E ~ GOOSE CREEK TYPICAL SEWAGE DISPOSAL SYSTEM (NOT TO SCALE) GP~DE / TEST HOLE DATA (TEST HOLE DUG BY McDONALD G£OSCIENCE ON F~BRUARY 1o97) NOTE: ELEVATIONS SHOWN THUS: ~ ARE REFERENCED TO AN ASSUMED DATUM. SEPTIC TANK (1~ N.Y.S. Uc. No. 49668 Joseph A. Ingegno Land Surveyor PHONE (5!6)727-2090 Fax (516)722-5093 ESTATE KEY MAP SCALE 1" -600' MINOR SUBDIVISION-- PREPARED FOR OF WILLIAM F. SITUA TED A T PINE NECK TOWN OF' SOUTHOLD GOUBEAUD SUFFOLK COUNTY, NEW YORK SCALE 1"=30' FEBRUARY 4, 1997 MARCH 6, 1997 REVISED LOT SIZES MARCH 7, 1997 REVISED LOT SIZES JULY 23, 1997 ADDED PROPOSED CESSPOOLS & WELL Southold Town planning Board AREA DATA PARCEL 1 25,658.05 sq. fi. 0.545 PARCEL 2 40,000.00 sq. fl. 0.918 ac. TOTAL 63,65B.03 sq. ff. 1.461 THIS SUBDIVISION DISTRICT 1000 SECTION O~NER AND APPLICANT: ESTATE OF WILLIAM F. OOUBEAUD C/O PATRICIA C. MOORE, P.O. BOX 183 MATTITUCK, NY 11952 BUILDING ZONE DISTRICT: R-40 SCHOOL DISTRICT: SOUTHOLD FIRE DISTRICT: SOUTHOLD PARCEL(~) THIS IS TO CERTIFY THE SUBDIVISION PLAN HAS BEEN APPROVED BY THE PLANNING BOARD OF THE TOWN OF RIVERHEAD BY RESOLUTION OF APPROVAL DATED BY CHAIRMAN pLANNING BOARD TEST HOLE DATA O'EST HOLE DUG BY ~ ON FEBRUARY 12, 1997) SO~JTH > E ~'~ © PARCEL 158.59' 17, H~JSE TYPICAL SEWAGE DISPOSAL SYSTEM (NOT TO SCALE) / BOTTOM A~D TO~ ~HNJ- ~ON~N, REINF~INI~ TO RESI~'T N~ /~PPUE9 FORCE OF :]CO p~f, GOOSE CREEK NOTE: ELEVATIONS SHOWN THUS:~ARE REFERENCED TO AN ASSUMED DATUW. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. Joseph A. Ingegno Land Surveyor Fox (516)722-5093 97-122! KEY MAP SCALE 1 "=600' ESTATE MINOR SUBDIVISION PREPARED FOR OF WILLIAM F. SITUA TED A T GOUBEAUD PINE NECK TOWN OF SOUTHOLD SUFFOLKCOUNTY, NEWYORK SCALE FEBRUARY 4, 1997 MARCH 6, 1997 REVISED LOT SIZES MARCH 7, 1997 REVISED LOT SIZES JULY 23, 1997 ADDED PROPOSED CESSPOOLS A WELL AREA DATA PARCEL 2 40,000.00 iR, ft. 0.918 TOTAL 63,9~.0.T sq, ff. THIS SUBDIVISION WILL APPEAR IN DISTRICT 1000 SECTION 70 BLOCK 10 O~/NER AND APPLICANT: ESTATE OF WILLIAM F. GOUBEAUD C/O PATRICIA C, MOORE, ESQ. P.O. BOX 183 MATTITUCK, NY 11952 determ{na~[on ~b~te~ .. BUILDING ZONE DISTRICT: R-40 SCHOOL DISTRICT: SOUTHOLD FIRE DISTRICT: SOUTHOLD THIS IS TO CERTIFY THE SUBDIVISION PLAN HAS BEEN APPROVEO BY THE PLANNING BOARD OF THE TOWN OF RIVERHEAD BY RESOLUTION OF APPROVAL DATED CHAIRMAN PLANNING BOARO 0 JOCKEy .C. RF,~ ~OA? x CK PARCELED TEST HOLE DATA HOLE DUO SY~ O~ ~ 12, 1997) TYPICAL SE WA GE (gOT TO SCAL~) - flNISH~ GRAD~ DISPOSAL SYSTEM PARCEL (~ ,v/o~ 58.59' GOOSE CREEK NOTE: ELEVATIONS SHOWN THUS: ~ ARE REFERENCED TO AN ASSUMED DATUM. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. Joseph A. Ingegno Land Surveyor OF~CESLOCATEDAT Fox (516)722-5093