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HomeMy WebLinkAbout1000-113.-13-1 40 MEMORANDUM TO FILE This proposed major subdivs-ton_of Indian Brunk was—originally subhitted __ _ Oith the set-off application of Sallie Wells (also known_as_ Sterling _ Idea Ventures) . It was submitted with the intention of satisfying.- the Planning Board's regaest for an idea of how the remainder of the property would be developed once the set-off was granted. A formal application has not been made, although the application papers were submitted. The fee for a major subdivision has not been paid. Therefore this file is not to be considered an active subdivison file, but rather a supplement to the set-off file. Valerie Scopaz Town Planner June 1988 6 & P TO` cn :", H! D SL Southold, N.Y. 11971 (516) 765-1938 June 9, 1988 Robert A. Celic P.O. Box 786 Mattituck, NY 11952 RE: Proposed major subdivision of Indian Brook, Mattituck SCTM #1000-113-13-1 (Property of Sallie Wells) Dear Mr. Celic: While reviewing the set-off file for Sallie Wells' property, I notice that the application for the above-named subdivision remains incomplete. Namely, the application fee for a major subdivision has not been paid. Please indicate whether or not you intend to proceed with this application at this time. At present, this file is considered to be both incomplete and inactive. Very truly yours, Valerie Scop Town Planner jt • l MEMORANDUM TO: FILE FROM: Valerie Scopaz, Town yQPlan��ner RE: �i<dG.,kiit/ (, a-,C `"ems liC�.2-QQil�� DATE: GZ ✓ /G� �YB, er— j MEMORANDUM TO: FILE FROM: Valerie Scopaz, Town Planner �py RE: per;, wo�� '17 DATE: 71 /9 /t•a, a- �r� .� owe mac �o-�a[• a� x Y`� MEMORANDUM TO: ..-FILE FROM: Valerie /S�co�pazp, Town Planner RE: DATE: Pte✓ � � - 7`7 RE : Proposed Major Subdivision of Sterling Idea Ventures for Indian Brook at Westphalia Road , Mattituck , NY 11952 STATE OF NEW YORK) ) SS : COUNTY OF SUFFOLK) ROBERT A . CELIC , being duly sworn , deposes and says : THAT he is a partner of Sterling Idea Ventures , a general part- nership in the State of New York , and that he resides at New Suffolk Avenue, PO Box 786 , Mattituck , NY 11952 ; THAT he represents applicant, Sterling Idea Ventures , and is directed to represent same as general partner , and herein represents that the following are the only persons having an interest, direct or indirect, in this proposed subdivision : Mrs . Sally Wells ( No # ) Westphalia Avenue (Road ) Mattituck , NY 11952 , the owner of the property subject to this application , and Robert A . Celic New Suffolk Avenue Mattituck , NY 11952 Alfred O . Richards Route 48 Mattituck , NY 11952 , the contract vendees of the property subject to this application . THAT your deponent makes this affidavit in compliance with Article IV , Section A106-40 ( B ) of the Southold Town Code, knowing that the Southold Town Planning Board will rely upon the statements herein . 6Robert A .XCel?c Sworn to before me this 20th day General Partner, Sterling of August, 1987 Idea Ventures za DAVID C. CREATO NOTARY PUBLIC,State of New York No.4634451 Qualified in Suffolk County '-mmission Expires February 26, 1990 Sterling Idea Ventures PO Box 786 Mattituck , NY 11952 August 20 , 1987 Southold Planning Board Southold Town Hall Main Road Southold , NY 11971 Dear Gentlemen , I am herein requesting your approval to a major subdivision as outlined in the attached surveys . My partner , Alfred D . Richards , C . P . A . and I are under contract of sale with the current owner, Mrs . Sally Wells and are also applying for a set off on her behalf . Our preferred plan for subdivision of this property would be the one acre cluster concept. We look forward to your cooperation . rely Robert A . Celic General Partner cc : Mrs . Sally Wells RAC/rc coHSu.Y OUR utwYStS aSwn stONUSa YHu�rnuMi/fl—rHtS tHSratwwr SHOULD as UStw MY u►wrtan ONLY. NOTE: FIRE LOSSES. This form of contract contauu no express as to risk of r casual before delivery of the deed. Unless express provision is made.the prrovisions of Section 5- 31 I ofytherGenera Gor otheneral gations Law will apply. Thu section also places risk of loss upon purchaser if title Of posse"a is transferred prior to closing. THIS AGREEMENT, made the day of March nioeleea hundred and Eighty-Seven BETWEEN SALLIE W. WELLS, residing at (No #) Westphalia Avenue, Mattituck, New York 11952, hereinafter described as the seller, and STRRLING IDEA VENTURES a co-partnership with principal office at (No #) Main Road, Mattituck, New York 11952, hereinafter described as the purchaser. WITNESSETH, that the seller agrees to sell and convey, and the purchaser agrees to purchase, all that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the at Mattituck, in the Town of Southold, County of Suffolk and State of New York, and bounded and described as follows: PARCEL ONE: BEGINNING at the southwest corner of the premises hereby conveyed, at a monument set in the intersection of the easterly line of the land now or formerly of William A. Wasson and the northerly line of the land now or formerly of George H. Horton and running thence North 630 23' East 414.5 feet; / THENCE North 740 53' East 290.4 feet to a monument at the southeast corner of the premises hereby conveyed; said courses being along the land of George H. Horton aforesaid; THENCE North 270 01' West 983 feet along land formerly of Clarence Bennett to a monument set in the southerly side of the Westphalia Road at the northeast corner of the premises hereby conveyed; THENCE South 67° 23' West 53.9 feet; THENCE South 66' 13' West 263.8 feet, both of said courses being along the southerly side of said Westphalia Road; THENCE South 660 51' West 361.7 feet along land now or formerly of Lizzie Meday to a monument set in the line of the land of William A. Wasson at the northwest corner of the premises hereby conveyed; THENCE in a general course South 27° 01' East 963.3 feet more or less along the land of William A. Wasson aforesaid to the point or place of BEGINNING. Containing by survey made by D. R. Young in August 1912 15 acres. PARCEL TWO: BEGINNING at a concrete monument set on the southerly line of Westphalia Road 87.7 feet, more or less, easterly along said line from the northeasterly corner of the first parcel herein described; running 3 THENCE along land now or formerly of Arthur H. Penny on a line parallel to the easterly boundary of land of said Arthur H. Penny South 290 15' East 1,003.65 feet to a granite monument and land formerly of George H. Horton; THENCE westerly along said land formerly of George H. Horton 129 feet, more or leas, to a concrete monument at the southeasterly corner of said first parcel herein described; THENCE along said first parcel herein described, North 27° 01' West 983 feet to said southerly line of Westphalia Road; g THENCE along said southerly line of Westphalia Road, North 67° 55' East 87.7 feet, more or less, to the point of BEGINNING. Containing about 2.4 acres, be the same more or less. Excepting from the above parcels a lot in the northwest corner of the rcel containing 80,000 square feet in the approximate configuration as shown the attached sketch. The exact description of thia exce Lod arcel to be ete ined surveyy R,eeFiX1BbOas� f iggt of way from Westphalia Roa� along the easter�y ai�e of lI SUppBJECTpp`1'd So7un ry ine Agreements as set forth in Liber 5072, Page 474, and I.i�u s5enedis tc.ludeiifl rig , venue and interest, if any, of the seller in and to any land lying is the bed of any street, road or avenue opened or proposed, is front of or adjoining said premises, to the center line thereof, and all right, title and iourat of the seller in and to any award made or to be made in lieu thereof and in and to any unpaid award for damage to said titprele. or on demanof d.fdlrade of proper instruments forand the the conveyance oer will x(ute iuchau wand the assignment liver to the purchaser. on thing of any such award. gnesent and talkctios of APPLICATION FOR APPROVAL OF PLAT To the Planning Board of the Town of Southold: The undersigned applicant hereby applies for (tentative (final) approval of a subdivision platin accordance with Article 16 of the Town Law and the Rules and Regulations of the Southold Town Planning Board, and represents and states as follows: 1. The applicant is the owner of record of the land under application. (If the applicant is not the owner of record of the land under applicatio lb t shall state his interest in said land under application.) COitlj�C/gC' C`,&e �i 2. The name of the subdivision is to be �f�..��� /(!, . . . •C(� D/\ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . 3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed suggested.) 4. The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as follows: Liber . . . J� . . . . . . .1 ` .. . . . . . . . Page . . . .���� On p . . . . . . . 5!-l. . Liber . .. .t9-M5 . .. . . . . . . . Page . . . Q. Q. �. . . . . . .. . On Liber . . . . . . . . . . . . . . . . . . . . . . . . Page . .. .. . . . . .. .. . . . . .. . . . On . . . . . .. . . . . . . .. . . . . . . . . ; Liber . .. . . .. . . . . .. . . .. .. . . . . . Page . . . . . . . .. . . . . . . . . . . . . . On Liber . .. .. .. .. . . .. .. .. . . . ... . Page as devised under the Last Will and Testament of fir/ �� ) :. . . . . / . . . . . . . .. . or as distributee �(�G�. . .�.�K� ., , .�• GU C/�( �. . . . . . . . . . . . . . . . . . . . .. .. . . ... . ............... . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . I . . . . . . . . . 5. The area of the land is . ./, j f? acres. 6. All taxes which are liens on the land at the date hereof have been paid except . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. The land is encumbered by . . . .. .. ,7.Q..- . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. mortgage (s) as follows: (a) Mortgage recorded in Liber . .. . . . . . . . . . . . Page . . . . . . . . . . . . . . . . . . in original amount Of $. . . . . . . .. . . . . . unpaid amount $ held by . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . address . . . .. .. . . .. . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . (b) Mortgage recorded in Liber . . . . . . . . . Page . . . . . . . . . . . . . . . . . . . . . . . in original amount of . . . . . . . . . . . . . . unpaid amount $. . . . . . . . . . . . . . . . . . . . . . held b . . . . . . . .. . . . . . address . . . .. .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) Mortgage recorded in Liber . . . . . . . . . . . . . . Page . . . . . . . .. . . .. . . . in original amount of . . . .. . . . . . . . . . unpaid amount $. . . . . . . . . . . .. .. . . . . . . . held b . . . .. . . . . .. .. .. . . . . . . . address . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . 8. There are no other encumbrances or liens against the land except . . . . . . . . . . . . . . . . . . . . . .. . . .. . . .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . ...... .. . ... . . A, 9. The land lies in the following zoning use districts . .. . . . Q. • . • • _�"G�GI . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 10. No part of the land lies under water whether tide water, stream, pond water or otherwise, ex. 11. The applicant shall at his expense install all required public improvements. 12. The land (does) does not lie in a Water District or Water Supply District. Name of Dis- trict, if within a District, is . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 13. Water mains will be laid by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and (a) (no) charge will be made for installing said mains. 14. Electric lines and standards will be installed by . . . . . . . . . . . . . .. .. . . . . .. . . . . . . . . . . . . .. . .. . • . .• •• .. .. . . . . . . . . . . .. . . . . . . . . . . . . . . and (a) (no) charge will be made for installing said lines. 15. Gas mains will be installed by . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . and (a) (no) charge will be made for installing said mains. 16. If streets shown on the plat are claimed by the applicant to be existing public streets in the Suffolk County Highway system, annex Schedule "L'" hereto, to show same. 17. If streets shown on the plat are claimed by the applicant to be existing public streets in the Town of Southold Highway system, annex Schedule "C" hereto to show same. 18. There are no existing buildings or structures on the land which are not located and shown on the plat. 19. Where the plat shows proposed streets which are extensions of streets on adjoining sub- division maps heretofore filed, there are no reserve strips at the end of the streets on said existing maps at their conjunctions with the proposed streets. 20. In the course of these proceedings, the applicant will offer proof of title as required by Sec. 335 of the Real Property Law. 21. Submit a copy of proposed deed for lots showing all restrictions, covenants, etc. Annex Schedule "D". 22. The applicant estimates that the cost of grading and required public improvements will be v?7Soo as itemized in Schedule "E" hereto annexed and requests that the maturity of the .` Performance Bond be fixed at . . . . 3. . . . . years. The Performance Bond will be written by a licensed surety company unless otherwise shown on Schedule "B". DATE . . . . . . . . . �.0. .�. . . .. . . ., 19. . . . ��. 1/5�`r (Na Applicant) Signature and Title) c..loo,- /fsz //(Address) STATE OF NEW YORK, COUNTY OFK.r' '�L( �- // 6666 . . . . . 6666 . . . ., ss: O he . . , !+."T 6 6 6 6 day ooff.. . . . � sr. . . .. 19x6 7., before me personally came to me known to be e�the individual described in and who executed the foregoing instrument, and acknowledged that . ./1 . . . executed the same. C. ATO NOTARY PUBILIIC, S atteEof New York N0.4834451 !� c"1! `t5 � . . . . . . . . . . . . . . . . . Qualified in Suffolk CUM Notary Public P. mISS,On Expires February 87, 19fA STATE OF NEW YORK, COUNTY OF . . . . . 6 . 6 6666 . . . . . . . . . . 6 . 6 . . . ss: On the . . . . . . . . . . . . . . . . day . . . . . —6 6 6 . . . of . . . . 6 .. . . . . . . .. 19. . . .. ., before me personally came . . . . . . . . . . . . . . . . . . . to me known, who being by me duly sworn did de- pose and say that . . . . . . . . . . . . resides at No. . . . .. . . . . . . . . . . . . . . . . . . . 6 . . . . . 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . that is the . . . . . . . . . . . . . . . . . . . . . . . . . . . . of . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . the corporation described in and which executed the foregoing instrument; that . . . . . . . . . . . . knows the seal of said corporation; that the seal affixed by order of the board of directors of said corporation. and that . . . . . . . . . . . . signed name thereto by like order. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . ?Notary Public TOWN OF SOUTHOLD EAF ENVIRONMENTAL ASSESSMENT - PART I Project Information - NOTICE: This document des+.ened to assist in determining whether the action proposed may have a signific effect on the env lrc•,ment. Please complete the entire Data Sheet. Answers to these questions will be cors as girt of the application for approval and may be subject to further verification and any additional information you believe will be needed to comDletP. PARTS 2 and 3. Dublfc review. Prov • ea in St involve newutltnis exoe inat cc"leticn of the EAF will be dependent on information currently available and will not - r es g , research or investigation. so indicate and setify each instance. If information requiring such additional work is unava i(aple, NAME OF PROJECT: NAME AND ADDRESS OF OkNER (If Different) �O/ W ;;;? L� 'flGLic� �iJ GJEGGS A3OPESS AND NAME OF APPLICANT: ���/�/L✓IA' �yC� Street! S Z_e_C��/� dE.r Proms a"el RE Stat Zip) - Jfiu6 11"Wi i6 PHONE: (Scrcec to.e tp OESCRIPTICN OF PROJECT: (Briefly describe type of Project or action) tf1NTpiii ke bf r (PLEASE COMPLETE EACH QUESTIOti - Indicate N.A. 1f not applicable) ) A. SITE DESCRIPTION - (Physical setting of overall project, both develoned and undeveloped areas) 1. General character of the land: Generally uniform slope Generally uneven and rollinc or irregula 2. Present land use: Urban , Industrial Commercial Agriculture _, Other .__, Suburban Rural Forest 3. Total acreage of project area-1% Offft- Aooroximate acreage! Presently After Completion Presently After Complee Meadow or Brushland :A acresU�acres rr Ila ter Surface Area - a-acres _-p-_ac Forested E99-acres � acres Unvegetated (rock, Agricultural Ia. 7acres a7.7 acres earth or fill) —0—acres -O_at 'A•tland (Freshwater or Roads, buildings Tidal as ner Articles and other paved 1 'a• 75 nr r.C.L.) a A9ac res •�ac res surfaces ^�acres !75 at Other (indicate type) _acres A. Wit Is • aC ^edpm•pant soil types) on nrpject site? 5• a 're CnefP 1Pdrocx Outcro9olnas on nrnlPCt Sita' ___. _ — -_ /-__.-__-•—_— - - YPS y yC 's deotn to bedrock? ej • . n meet) 6. Approxina to percentage of proposed project site with slopes: 0-10.�� 10-15' %; 15; or greater - I. Is project contiguous tom or contain a buildinn or Places? _Yes site listed on tbp National Register of Historic y Ho B. What is the depth to the water table-meet 9. Do hunting or fishing opportunities presently exist in the project area? _Yes _kff:�No 10. Does project site contain ayy species of plant or animal life that is identified as threatened or _ endangered - _Yes s/ ;lo, according to - Identify each species - 11. Are there any unique or unusual land forms on the project site? (i.e, cliffs, dunes.—Other geological formations - _Yes ✓No. (Describe _ ) 12. Is the project site 9recently used by the community or neighborhood as an open space or recreation area - Yes ✓ No. 17. Does the presen site offer or include scenic views or vistas known to be important to the community? _Yes No 14. Streams within or contiguous to project area: a. Name of stream and name of river to which it is tributary &W*07�f J7j(E/ Q/�f O1' �iGis[7"'Elt Dr .19wi7`�i kt f jNl eT 15. Lakes, Ponds, Wetland areas within or contiguous to project area: a. Name ,aEA/NF7'rs -fr.�.EihI1 t b. Size (in acres) 16. What is the dominant land use and zoning classification within a 1/4 mile radius of the project (e.g. Single family rest den ial, R-2) and the scales of development (e 2 story). / S��"�9�d_. •s''•sl.Ly .C�S.of�.vYi.4G, d4de Levo B. PROJECT DESCRIPTION 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned by project sponsor —O — acres. b. Project acreage developed: W*acres initially;4-�-I'acres ultimately, c. Project acreage to remain undeveloped d. Length of project, in miles: (if appropriate) e. If project is an expansion of existing, indicate percent of expansion proposed: building square foot- age ; developed acreage f. Number of off-strut Parking spaces existina proposed _ g. Maximum vehicular trios generated per hour AIR _(upon completion of project) h. If residential: Number and type of housing units: Une Family Two Family Multiple Family Condominium Initial / Ultimate R i. It: Orientation - :'e+gnoornood-City-Regional Estimated Employment Cor ernal _ 6 Industrial "Q j. Total he+gnt of tallest rronosed structure _—A—AW .-feet. 2- 4 2. How much natural material (i.e. rock, earth, etc.) will be removed from the site - Mons Y "� //r/ cubic yard 3. How many acres of vegetation (trees, shrubs, ground covers) will be removed fror site - .7.facres. 4. Will any mature forest (D ver 100 years old) or other locally-important veaetation be removed by this project? _Yes _No S. Are them any plans for re-vegetation to replace that removed during construction? _Yes ✓ No 6. If single phase project: Anticipated period of construction Nip months. (including demolition). 7. if multi-phased oroject: a. Total number of phases anticipated No. b. Anticipated date of comriencement phase ' _month _;ear (including demolition) — c. Approximate completion date final phase month ._year. d. Is phase 1 financially dependent on subsequent phases? _Yes _No 8. Will blasting occur during construction? Yes -'No 9. Number of jobs generated: during construction —t,-; after project is complete 'V 10. Number of jobs eliminated by this project —O� 11. Will project require relocation of any projects or facilities? Yes L/No. If yes, explain: 12. a. Is surface or subsurface liquid waste disposal involved? _Yes _1--/No: b. If yes, indicate type of waste (sewage, industrial, etc.) c. If surface disposal name of stream into which effluent will be discharged 13. Will surface area of existing lakes, ponds, streams, bays or other surface waterways be increased or decreased by proposal? _Yes _LNo. 14. Is project or any portion of project located in the 100 year flood plain? Yes No 15. a. Does project involve disoosal of solid waste? _Yes ✓ No b. If yes, will an existing solid waste disnosal facility be used? _Yes 1111�10 c. If yes, give name: location d. !fill any wastes not go into a sewage disposal system or into a sanitary landfill? _Yes __No 16. Will project use herbicides or pesticides? _Yes ✓N0 17. Will project routinely produce odors (more than one hour ter day)? _Yes V/NO 18. Will project produce operating noise exceeding the local ambience noise levels? _Yes 1_-.11 No 19. Will project result in an increase in energy use? _Yes V,'No. If yes, indicate type(s) 20. If water suooly is from wells indicate pumoing capacitv N' gals/minute. 21. Total anticipated water usage per day _ /y/f gals/day. 22. Zoning: a. Ilhat .s doninant zoning classification of site? b. Current specific Zoning classification of site .. !s oroopsed use corsisten- ,aith present zon,nq? Y�S d. If no, indicate desired Zoning 26. Approvals: a. Is any Federal permit required? _Yes --e—INo b. Does project involve State or Federal funding or financing? _ Yes _V-INO c. Local and Regional approvals: Approval Required Submittal Approval (Yes, No) (Type) (Date) (Date) City, Town, Village Board City, Town, Villaqe Planning Board City, Town, Zoning Board City. County Health Department Other local agencies Other regional agencies _ State Agencies _ Federal Agencies _ C. INFORMATIONAL DETAILS Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with the proposal, please discuss such impacts and the measures which can be taken to mitigate or avoid t PREPARER'S SIGNATURE: TITLE: REPRESENTING: b�7AMA f��wTL�i�S DATE: a -a- r EAF ENVIRONMENTAL ASSESSMENT. - PART II Project Impacts and Their Magnitude General Infr= on !RFId Carefully) In completing tha fpm the reviewer should be guided by the question: Have my decisions and dete rmin. been reascr.able? The reviewer is not expected to be an expert environmental analyst. - Identifying that ar effect will be potentially large (column 2) does not mean that it is also necessa, siani•'cant. Ary large effect must be evaluated in PART 3 to determine significance. By identifying errect in column 2 simply asks that it be looked at further. _ - The Examoles provided are to assist the reviewer by showing types of effects and wherever possible the of magnituce that would trigger a response in column 2. The examples are generally applicable through State and for most situations. But, for any specific project or site other examples and/or lower thre may be more appropriate for a Potential Large Impact rating. - Each project, on each site, in each locality, will vary. Therefore, the examples have been offered as They do not constitute an exhaustive list of impacts and thresholds to answer each nuestion. - The number of examples per question does not indicate the importance of each question. INSTRUCTIONS (Read Carefully) a. Answer each of the 18 questions in PART 2. Answer Yes if there will be any effect. b. Mavbe answers should be considered as Yes answers. c. If answering Yes to a nuestion then check the appropriate box (column I or 2) to indicate the voten size of the impact. if impact threshold equals or exceeds any example provided, check column 2. I impact will occur but threshold is lower than example, check column 1. d. If reviewer has doubt about the size of the impact then consider the impact as notentially large and proceed to PART 3. - e. If a potentially large impact or effect can be reduced by a change in the project to a less than 1a, magnitude, place a Yes in column 3. A No response indicates that such a reduction is not possible. 1. 2• 3. SMALL TO POTENTIAL CAN IMPACT MODERATE LARGE REDUCED B IMPACT IMPACT PROJECT CH IMPACT ON LANG - - 1407CO YES 1, WILL THERE 9E AN EFFECT AS A RESULT OF A PHYSICAL CHANGE TO PROJECT SITE? ExarolPs that would Artily to Column 2 Any construction on slopes of 15% or greater, (15 foot rise her 100 foot of lengtn), 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. -- ronstruction of paved narking area fnr I."' or more vehicles. _ Cnnstruction on 13rd where bedrock is exposed or generally w,tnin 3 feet of existing ground surface. _ Cens.r.ichon Ira- will continue for more than 1 year or involve Mo-e than Orn gyrase or stage. ._. Exna vr.r�on ror -1ring purposes that could remove nore than 1 ,000 :OCs Of ra;u•al r_terial (i.e. rock or soil) per vear. Cpnstruttior of anv new Sanitary landfill -- -5- M 1. 3. t!'ALL TO POTENTIAL CAN VIPACT BE BERATE LARGE REDUCED BY BDA T IMPACT POOJECT CPANGP Construction in a designated floodway. Other impacts: —� — 2. WILL THERE BE AN EFFECT TO ANY UNIQUE OR UNUSUAL LAND FfIRHS-� YES FOUND ON THE SITE? (i.e. Cliffs, dunes, geological forma- tions, etc.) Snecific land forms: 111PACT ON WATER B. WILL PROJECT AFFECT ANY WATER. BODY DESIGNATED ASN-D��(( YES PROTECTED? (Under Articles 15, 24, 25 of the Envir- ,,* (y] onmental Conservation Law, E.C.L.) �Gl� Examples that Would Aoply to Column 2 ' Dredgino more than 100 cubic yards of material from channel of a protected stream. Construction in a designated freshwater or tidal wetland. _ Other impacts: �- 4. WILL PROJECT AFFECT ANY NON-PROTECTED E%ISTINO OR NFH NO YES BODY OF HATER? ............. Column ......................0,0 Ezasoles that Would Apply to Lplumn 2 — A 10t 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 In acres of surface area. Other imnacts• 5. vILL PROJECT AFFECT SURFACE. OR OROUNDYATER OIIALITY? YES Exa^pies that !!Ould Apply to Column 2 l�lr7V( Prnlect will require a discharge pe unit. Project requires use of a source of water that does not have aporoval to serve Proposed project. Prolect requires water supply from wells with greater than <5 oallons per minute pumping capacity. C.nstn c non or coeration causing any contamination Of a Public water supply system. Prolect will adversely affect groundwater. L':uid effluent will be conveyed off the site to f,c'Ilties wnlcn presently do not exist or have )haz9-Udte capacity.Project requiring a facility that would use water in e.cess of 2n-000 gallons per day. Prq'eCi ,a 11 likely y cause siltation or other discharge .o an existing czcy of water to Cne extent that there _ to an ^pnous visual contrast to natural conditions. _5. 'BILL TO POTE4TIAL CAN IMPACT +OOERATE LARGE REDUCED CY j,'i7ACT [•'PACr PPOJECT CHA Other Imoacts. - -- - - 6. SILL PROJECT ALTER DRA1RAf,F FL111, PATTEn1S OR SIIRFA�E !TATER NO YES RUNOFF? ................................................... 0 Example that 'lould Amply to Column 2 Project wnuld impede flood water flows. Proiect is likely to cause substantial erosion. _ Project is incompatible with existing drainage Patterns. _ Other impacts: IMPACT ON AIR 7. DILL PROJECT AFFECT AIR DUALITY?.......................... NO YES Fxamolez that Would Apply to Column 2 )((X�J r(1- O Project will induce 1,000 or more vehicle trips in any given hour. PrO ject will result in the incineration of more than I ton of refuse per hour. Project emission rate of all contaminants will exceed 5 _ lbs. Der hour or a heat source producing more than 10 —' million BTU's per hour. Other Impacts: LmamrT nN PI ANTS A4p 44)w5l f 8. WILL PROJECT AFFECT ANY THREATENED OP, ENDANFERED SPECIES? g YES Examoles that Would Apoly to Column 2 - /(1\—/N_1 O Reduction of one or mom species listed on the Hew York _ or Federal list, using the site, over or near site or found on the site. Removal of anv Dortion of a critical or significant wild- life h1b1t3C. A011 ication of Pesticide or he,bici de over more than L`Ice a year other ttmn fordalr:cjttura1 purpoees. _ _ Mti-r im Dacts: 9. JILL PDOJECT ECIES?;IT TALLY AFFECT MON-THREA iE:lEO OR J10 YES EYOAN,E REO SPECIES? .................................... J{`jJ•.�•7l'(O E,n+•ole that Would Apply to Column 2 rr01ect would substantially interfere with an,, resident or m,gra tory fisn or wildlife species. Project reouires the removal of more than 11 acres of -ature forest !over 100 Years in ane) or other locally — important vegetation. -- -7- l "ALL T) nCTEM T I:L CAN C'PACT .'.E 09ERATE LARGE REDUCED RY I"PACT I,rACT PPOJECT CPANrrF 1"net' C'. YI SL'eL Prc m•RCE 10. HILL THE Pon1FCT Arr-cCT Vlr:'S, °ISTAS CR T'IF "S11AL �n CHARACTER OF THE NF1GHBnR MO or, CO"w".1ITY'+ E wmpl es twat Mould Apply to Column 2 An incompatible visual affect caused by the introOuction of new materials, colors and/or forms in contrast to the surrounding landscape. — __ A Project easily visible, not easily screened,that is obviously different from others around it. Project -will result in the elimination or major screening of scenic views or vistas known to be important to the area. -- Other impacts: IMPACT OilHISTORIC RESOURCES 11. WILL PROJECT 11-PACT ANY SITE OR STRUCTURE OF HISTORIC, NO YES PP.E-11I5TOPIC nP. PALEONTOFICAL IVPOPTANCE? ................ Examples that Gould Apply to Column 2 - 00 _.._ Prciect occurino wholly or nartially within or continuous to any facility or site listed on the National Renister of historic Places. Any impact to an archeological site or fossil bed located within the project site. -_ Other impacts: IMPACT ON OPEN SPACE d P,FCREATIOH 12. HILL THE PRnJECT AFFECT THE OUANTiTY OR QUALITY OF EXISTING NO YES OR FUTURE OPEN SPACES OR RECP,EATIONAL OPPORTU'1ITIES?......y�O Examples that Would Apply to Column 2 /��1(y�) — The permanent foreclosure of a future recreational opportunity. _ — A major reduction of an open space important to the community. _ Other impacts: -- Iupnrr nN TPANSPn PTATTON 13. "ILL TuEz- EE A'I EFFECT TO EXISTING TRANSPORTATION NNOO[/ YES SYSrolps E+aryl ns / tna[ Would Anniv Co Column 2 — Alteration of present patterns of mo vement of neople and/or goocs. _ Project .+ill result in severe traffic problems. ither irpacts: A 7LAn'r�TE IMPACT C: DUCED BY JECT CHAN( IMPACT CN E"IERGY14. HILL PROJECT AFFECT THE COMMUNITIES SOURCES OF FUEL nR NO YES ENERGY SUPPLY? .Examples that Would Apply to Column 2Project causing greater than 5% increase in any form of energy used in municipality._ Project requiring the creation or extension of an energytransmission or supply system to serve more than 50 singleor'two family residences. Other impacts: IMPACT ON NOISE 15. WILL THERE BE OBJECTIONABLE ODORS, NOISE, GLARE, VIBRATION40 YES or ELECTRICAL DISTURBANCE AS A RESULT OF THIS PROJECT? ... Exaroles that Would ADoly to Column 2 Blasting within 1,500 feet of a hospital, school or other NO sensitive facility. _ — Odors will occur routinely (more than one hour per day). _ Project will nroduce operating noise exceedinn the local ambient noise levels for noise outside of structures. — Project will remove natural barriers that would act as a noise screen. Other impacts: IMPACT ON HEALTH b HAZARnS 16. !TILL PROJECT AFFECT PUBLIC HEALTH AND SAFETY. Nn- / YFS ' Examoles that Mould Apply to Column 2 /)V(�'('JC�J01 — Project will cause a risk of explosion or release of hazardous _ substances (i.e. oil, pesticides, chemicals, radiation, etc. ) -- in the event of accident or unset conditions, or there will he a chronic low level discharge or emission. Project that will result in the burial of "hazardous wastes" (i.e. toxic• Pnisonous, highly reactive, radioactive, irritating, -- infectious, etc. , includinq wastes that are solid, semi-solid, liquid or contain gases. ) Storaoe facilities for one million or more qallnns of liouified natural gas or other liquids. _ Other icoacts: _n, LL TO PGTEITIAL CSF, nN 6 i ODERP.TE LARGE REDUCED BY 71'PACT IIIPALT PROJECT CHANGE IMPACT ON GROWTH AND CHARACTFR OF COMMnJ�41TY OR tiEmpRemunn 17. WILL PROJECT AFFECT THE CHARACTER nF THE EXISTING NO YES COMMUNITY. Example that Would Apply to Column 2 The population of the City, Town or Village in which the project is located is likely to grow by more than 5: OF resident human population. The municipal budgets for capital expenditures or o?era- _ ting services will increase by more than 5; per year as a result of this project. Will involve any termenent facility of a non-agricultural _ use in an agricultural district or remove nrime-agricultural lands from cultivation. The project will replace or eliminate existing facilities, _ structures or areas of historic importance to the community. Development will induce an influx of a particular age group with special needs. Project will set an important precedent for future projects. Project will relocate 15 or more employees in one or rare businesses. Other impacts,. 18. IS THERE PUBLIC CONTROVERSY CONCERNING THE PROJECT? ...... O YES Column Examoles that Would Apply to 2 O Either government or citizens of adjacent communities have expressed OppdsiLion or rejected the pro iect or have not been contacted. Objections to the nro.ject from within the community. IF ANY ACTION IN PART 2 iS IDENTIFIED AS A POTEIITIAL LARGE IMPACT OR IF YOU CANN07 DETE RAINS THE MAGNITUDE OF IMPACT, PROCEED TO PART 3. PORTIONS OF EAF COMPLETED FOR THIS PROJECT: DETERMINATION PART I _ PART 11 — PART 3�_ Upon review of the infortration recorded on this EAF (Parts 1, 2 and 3) and considering both the magnitude and imnortance of each irPact, it is reasonably determined that: PREPARE A NEr.ATIVE DECLARATION ' A. The project will result in no major impacts and, therefore. O is one which may not cause Significant damage to the environment. B. Althouah the project could have a significant effect on the env,ronment, there will not be a significant effect in this case PREPARE A NEGaTIVE DECLARATION because the mitigation measures described in PART 3 have been O included as part of the nroposed project. C. The project will result in one or more major adverse impacts PREPARE PO<_ITIVE DECLARATION PROCEED WITH EIS that cannot be reduced and may cause significant damage to O the env,ronrent. ato Signature of R-s;onsiolz Utrnciai ,n Lead or S, nature - Agency g trema ter (,' dlffe ren[ tram reSpOnSlp 2 OtttCer) Fnnt or tyoe nate or reSPOnsloie otfnn al in Lead Agency 'I� EAF ENVIRONMENTAL ASSESSMENT - PART III EVALUATIO71 OF THE NPngTA10E OF IMPACTS INFORMATION - - Part 3 is prepared if one or more impact or effect is considered to be potentially larae. - The amount of writing necessary to answer Part 3 may be determined by answering the question: In briefly completing the instructions below have I placed in this record sufficient information to indicate the reasonableness of nv decisions? INSTRUCTIONS e Complete the followinq for each impact or effect identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact might be mitigated or reduced to a less than large imnact by a pro Jett change. 3. Based on the information available, decide if it is reasonahle to conclude that this impact is important to the minicipality (city, town or village) in which the project is located. To answer the question of importance, consider: - The probability of the impact or effect occurring - The duration of the impact or effect - Its irreversibility, including permanently lost resources or values - Whether the impact or effect can be controlled - The regional consequence of the impact or effect - Its potential divergence from local needs and goals - Whether known objections to the prnject apply to this impact or effect. DETER.°INATION OF SIGNIFICANCE An action is considered to be significant if: nne (or more) impact is determined to both larne and its (their) conseauence, based on the review above, is important. PAPT III STATE.9ENTS (Continue on Attachments, as needed) tt T LD s � Y Southold, N.Y. 11971 (516) 765-1938 QUESTIONNAIRE TO BE COMPLETED AND SUBMITTED WITH YOUR APPLICATIONS FORMS TO THE PLANNING BOARD Please complete, sign and return to the Office of the Planning Board with your completed applications forms . If your answer to any of the following questions is yes , please indicate these on your guaranteed survey or submit other appropriate evidence. 1. Are there any wetland grasses on this parcel? Yes No (Attached is a list of the wetland grasses define by the Town Code, Chapter 97, for your reference) 2. Are there any other premises under your ownership abutting this parcel? Yes No 3. Are there any building permits pending on this parcel? Yes No 4. Are there any other applications pending concerning this property before any other department or agency? (Town , State, County, etc. ) Yes No 5. Is there any application pending before any other agency with regard to a different project on this parcel? Yes No 6 . Was this property the subject of any prior application to the Planning Board? Yes No 7. Does this property have a valid certificate of occupancy, if yes please submit .a cop of a Yes No I cer hat theabove statements are true and will be relied o y t lanning o i considering this application. ignature of property owner or authorized agent ate y Attachment to questionnaire for :the Planning Board STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the �2 day of i,� , 19L71 before me personally came �A to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that L.0—�executed the same. r Notary Public AVID C. NOTARY PUBLIIC, state 01 New YQ(x No,413/46 Qualified In Suffolk kii"Iy Commission Expire Fe/ruery 61, ja I TO ,.•)F SOUTHOLD • OFFICI: OF BUILDING INSPECTOR TOWN TIALL SOUTHOLD. NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PRFMISES TIIIS IS TO CERTIFY that tite /x Land Pre C.O. #- Z- 16033 /R} L'uilding(s) Date- August t 1 , 1987 / Use(s) located at 4735 Westphalia Road Mattituck, New York Street Hamlet shown on County tax map as District 1000, Section 1 13 , Block 13 Lot 01 does�not)conform to the present Building Zone Code of the Town of Southold for the following reasons: On the basis of information presented to the Building Inspector's Office, it has been determined that the aboveionconforming / IV Land /X/ Building(s) / / Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: Property contains I story, one family, wood framed dwelling with attached porch; barn with basement; 2nd barn with attached shed; all situated in 'A' Residential Agricultural zone with access to Westphalia Road; a Town maintained highway. The Certificate is issued to SALLY W . WELLS (owner, Y�t161fXtJfiYilQlUO1C of the aforesaid building. Suffolk County Department of Ileaith Approval N/A 1JNI)FmVRITERS (7ERTIFII-:A'I'1 NO. N/A NO'1'ICI: IS 1111MEBY GIVEN that the owner of the above premises ILLS NOT Cc)'\SENTI::D TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. } :nspcctor TO THE SOUTHOLD TOWN PLANNING BOARD : RE : Indian Brook , Westphalia Road , Mattituck (Sterling Idea Ventures ) SCHEDULE " E" The following is an estimate of required improvements proposed for Indian Brook Subdivision as proposed by Sterling Idea Ventures as of August 20 , 1987 : Paving/Curbing $20 , 000 Drainage 7 , 500 Approximate Total . . . . . . $27 , 500 Re lly su mit d,�� 0000 Robert A . Celic General Partner, Sterling Idea Ventures NOTE : The above estimate is for the one acre cluster plan . RE : Proposed Major Subdivision of Sterling Idea Ventures for Indian Brook at Westphalia Road, Mattituck , NY 11952 STATE OF NEW YORK) ) SS : COUNTY OF SUFFOLK) ROBERT A . CELIC, being duly sworn , deposes and says : THAT he is a partner of Sterling Idea Ventures , a general part- nership in the State of New York , and that he resides at New Suffolk Avenue, PO Box 786 , Mattituck , NY 11952 ; THAT he represents applicant, Sterling Idea Ventures , and is directed to represent same as general partner, and herein represents that the following are the only persons having an interest, direct or indirect, in this proposed subdivision : Mrs . Sally Wells (No # ) Westphalia Avenue (Road ) Mattituck , NY 11952 , the owner of the property subject to this application , and Robert A. Celic New Suffolk Avenue Mattituck , NY 11952 Alfred D. Richards Route 48 Mattituck , NY 11952 , the contract vendees of the property subject to this application . THAT your deponent makes this affidavit in compliance with Article IV, Section A106-40 ( B ) of the Southold Town Code, knowing that the Southold Town Planning Board will rely u on the statements herein . Sworn to before me this 20th da Robert A . Cel c of August, 1987 y General Partner, Sterling �— Idea Ventures DAVID C. CREATO NOTARY PUBLIC,State of New Yad No.4834451 Qualified in Suffolk CouMY '-^,mission Expires February 2d, 1990 Sterling Idea Ventures PO Box 786 Mattituck , NY 11952 August 20, 1987 Southold Planning Board Southold Town Hall Main Road Southold, NY 11971 Dear Gentlemen, I am herein requesting your approval to a major subdivision as outlined in the attached surveys . My partner, Alfred D. Richards , C . P . A . and I are under contract of sale with the current owner, Mrs . Sally Wells and are also applying for a set off on her behalf. Our preferred plan for subdivision of this property would be the one acre cluster concept. We look forward to your cooperation . rely Robert A. Celic General Partner cc : Mrs . Sally Wells RAC/rc f713r "�►_ ...i Me"swan THIS wvausum,,�as V uwron ours. be"c6l!l��thede form of express cos. . no express r Law will 7 deed. Unku es prey provision u Dude.sine �oruw u a rule of bot b ire or other / Y. 7U section also places risk of inns u Ptovisioes Of Sec6oa$-1311 07716 Cmrral Oblige Pon purchaser if Wk es Possession u transfer prior to THIS OETWEE "' 6010 day of March LLIE W. . niO IM hsmdrad and Eighty-Seven WRLLg residing at (No #) Westphalia Avenue, Mattituck, Now York 11951, baaeisahw described AS dm seller, and ff"RLING IDEA YRNtpIS a co- Mattituck, New aork 11952, partnership with principal office at (No #) Main Road, heroisaher described as tis tsutcherer, wnVF_UVM that the seller Agrees to sell and convey. and the purchaser a at Mattituck, in theSouthold, to erected.fainin SuffolkandStetthe ealo �t certain plot, � and bounded and described as follows: Yms m f New York, PARCEL ONE: BEGINNING at conveyedthe southwest corner of the premises hereby , at a monument set in the intersection of the easterly line of the land now or formerly of William A. Wasson and the northerly line of the land now or formerly of George H. Norton and running thence North 630 23' East 414.5 feet; THENCE North 74° 53' East 290.4 feet to a monument at the southeast corner of the premises hereby conveyed; said courses being along the land of George H. Horton aforesaid; THENCE North 270 01' West 983 feet along land formerly of Clarence Bennett to a monument set in the southerly side of the Westphalia Road at the northeast corner of the premises hereby conveyed= THENCE South 670 23' West 53.9 feet; THENCE South 66° 13' West 263.8 feet, both of said courses being along the southerly side of said Westphalia Road; THENCE South 660 51' West 361.7 feet along land now or formerly of Lingle Meday to a monument set in the line of the land of William A. Wasson at the East 963.3 feet more or less northwest corner of the premisas hereby conveyed; THENCE in s general course South 27° O1' along the land of William A. Wasson aforesaid to the point or place of BEGINNING. Containing by survey made by D. R. Young in August 1912 15 acres. PARCEL TWO, BEGINNING at a concrete monument set on the southerly line no rtheWestphalia Road 87.7 feet, more or less, easterly along said line from the noasterly corner of the first parcel herein described; running or to the eaasstlerrly long land boundary ofwlandfof�$aid Arthurrly of H. PennyH. South 29oine 1,003.65 feet to a ranite parallel B monument and land formerlyof George 15' East THENCE westerly along said land formerly of George d. Horton129feet, j more or less, to a concrete monument at the southeasterly corner of said first parcel herein described; THENCE along said first parcel herein described, North 27° Oil West 983 feet to said southerly line of Westphalia Road; THENCE along said southerly line of Westphalia Road, North 67° ' East 87.7 feet more or less, to the point of BEGINNING. Containing about 254 acres, be the same more or lose. Excepting from the above parcels a lot in the northwest corner of the reel containing 80,000 square feet in the approximate configuration as shown the attached sketch. The exact description of this exec tod d d survey. gE!ebxipg0as�50 fig�otof way from Westphalia Roo alot�j[he eucerlYtsi>�e of f �r aJ12� '1'17 goon ry lne Agreements as set forth in Liber 5072, Page 474, and t FI1&r y�72 gpag 47j7. ope�me-4tpdres a�l rig=ht, ads and interest, if any, of tht seller is sad a o the seller ' °rsd OPOssd. r Gast of or adjoining said prerisss. a tlr cess" i ly is the bed of am yesq. road es " r reason a any award made me a be made r lieu thereof and in sed a tYheraof, and aN right, title yd you i ;y. er thereafter- «dept f pade Of a0y greet: sad the seller will execute y °Ag0id award for dasmge a said ashy such award. W Pr°P0r i'gnu�„u for the cosveyanee Of such atk and thfiva e qty �yd �of t, I APPLICATION FOR APPROVAL OF PLAT To the Planning Board of the Town of Southold: / accordance with Article 16 of the Town Lav and the Rules and Regulations of the SThe undersigned applicant hereby applies for (tentative (final) approval of a subdivision platin Planning Board, and represents and states as follows: outhold Town 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 applica io �h D�' t shall state his interest in said land under application.) COA ;rfyt� YE`. 6 2. The name of the subdivision is to be . . . . .. .. .. . . . . . . . . .. . . .. . . . . . . . . ... .. .. ... 3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed suggested.) 4. The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as follows: aa,, Liber . .. ,!�.. . . . . . . . Page . . . .�— S Liber . ...[.S�.Y.,!.. .. ....... Page . . . CO.t1 Liber . .. . . . . . . . . .. .. .. .. . . .. . Page . . . .. . . .. . . .. . . . . . . .. . . Liber .. .. .. .. . . . . . . . . .. .. .. . Page . .. . . .. .. .. . . . . . . .. ... On Liber . .. .... .. . . .. .... ....... Page . . . . . .. .. . . .. . . . . . . .. as devised under the Last Will and Testament of , or as distributee , ., �, "4e%L C� ` ... ....... . 5. The area of the land is . .1 2s¢ A/Yacres. 6. All taxes which are liens on the land at the (late hereof have been paid except . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 7. The land is encumbered by . ... . ., mortgage (s) as follows: (a) Mortgage recorded in Liber . .. .. .. . . . . . . . Page . . . .. . . . . . . . . . . . . . in original amount $ unpaid amount $ . .. . . . of . . . .. . . . . . . . . . . . . . . . . . . held by . . . . . . . .. . . . . . . . . . . . . . . .. . . . . .. .. .. . address ... .. . . . . . . . . . . . . . . .. .. . . .. .. . . . . .. .. . . . . . . . . . . .... . (b) Mortgage recorded in Liber . . . .. .. . . Page . . . .. . . . . .. . . . . . . . . . . . . in original amount of unpaid amount $ .. . . . . . . . . . held by . .. .. . . .. .. . . . address . . . .. .. . . .. . . . ... . . . . . . . . . . . . .. .. . . .. . . . . . . . . . . . . . . . . . . . . . . .... • (c) Mortgage recorded in Liber Page in original amount tom' of ... .. . • • • • • .. . unpaid amount . . . . held by . .. .. .. .. .. . . ..... . . .. . .... .. . . .. .... .. . . .. . address . .. .. .. .. . . .. .. . . . . ... .. . . .. . . ..... 8. There are no other encumbrances or liens against the land except . .. .. .. .. .. , ;% 9. The land lies in the followingA . zoning use districts , . .../J/ 10. No part of the land lies under water whether tide water, stream, pond water or otherwise, ex. 00 IL The applicant shall at his expense install all required public improvements. 12. The land (does) does not lie in a Water District or Water Supply District. Name of Dis. trict, if within a District, is . ., , , • , , . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . ....... . . 13. Water mains will be laid by . . . . . . . . . . . . . . . .. . . . . . . . . .. .. . . . . . . . . . . .. .. . . . . . . . . . and (a) (no) charge will be made for installing said mains. 14. Electric lines and standards will be installed by . .. . . . . .. .. . . . . . . . . .. .. . . .. .. .. . . . .. .. .. . . . . . . . . .. .. .. .. . . . . . . . . .. .. . ... lines. • • • . and (a) (no) charge will be made for installing said I5. Gas mains will be installed by . .. .. . . .. . . .. . . . . . . . . and (a) (no) charge will be made for installing said mains. .. .. . . 16. If streets shown on the plat are claimed by the applicant to be existin Suffolk County Highway system, annex Schedule "B" hereto, g public sin the 17. If streets shown on the plat are claimed by thea licant tobe existing ow same. treets st ng public streets in the Town of Southold Highway system, annex Schedule "C" hereto to show same. 18. There are no existing buildings or structures on the land which are not located and shown on the plat. 19. Where the plat shows proposed streets which are extensions of streets on adjoining sub- division maps heretofore filed, there are no reserve strips at the end of the streets on said existing maps at their conjunctions with the proposed streets. 20. In the course of these proceedings, the applicant will offer proof of title as required b 335 of the Real Property Law. Y Sec. 21. Submit a copy of proposed deed for lots showing all restrictions, covenants, etc. Annex Schedule "D", �22, The applicant estimates that the cost of grading and re a7/ quired public improvements will be c,3•o as itemized in Schedule "E" hereto annexed and requests that the maturity of the Performance Bond be fixed at . . • . . . years. The Performance Bond will be written by a licensed surety company unless otherwise shown on Schedule "F". DATE ... .. . . . 7. .. .. . . .. 19. .. . (Na Applicant) B :.� Zwo Signature and Title) y . (Address) . . v . . �. ... % ... . . STATE OF A*EW YORK, COUNTY OF �uFFL� �j ///' . .. .. . . .. ss: �O he . *C ,v/ im•... . day of. .. . , 5;5� c.(,� p Qb�/� �+ " " " •. 19 Q. 7•. before me personally came to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that . . DAVID C. CREATD •• • • • executed the same. NOTARY PUBLIC, State of No Y No.4834451 Wit Qualified in Suffolk . . . . . .. - . . . . . Exgrls FebruarywgiNQ Notary Public STATE OF NEW YORK, COUNTY OF.. . . . . . . . . . . . . . . .. .. . . . . . . .. . On the'`. .. . . . . . . . . . . .. . day . .. .. .. .. . .. of . . . . . . . .. .. . . .. 19. .. . . ., before me' personally came it ' ' ' ' ' ' • • . • • ••• • . . . . to me known, who being by me duly sworn did de- pose and say that . . . .. .. .. • . , resides at No. . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . that . .. . . . . . . .. . . . . .. . . . . . . .. . is the . . . . of . . . .. .. . . . . . . .. . . . . . . . . . . . at the corporation described in and which executed the foregoing instrument; that . .. . . . the seal of said corporation; that the seal affixed by order of the board of directors of said corpo at ns an and that . . . . . . . .. . . . signed .. • • •• • • • • • . . name thereto by like order. ac Notary Public . . . . """ " ' • • TOWN OF SOUTHOLD EAF ENVIRO;IMENTAL ASSESSMENT :*PART i Project Infamnatton NOTICE: This document �• desicned to assist in determining whether the action proposed may have a signif as effect On o the ehvir,;catio. Please complete the entire Data Sheet. Answers to these questions will be co An padditionae iltcation for aPDroval and may be subject to further verification and yublic revter. co Any ormation you believe w111 be needed to complete PARTS 2 and 3. a It is expected that caroleti0n of 1. involve new studies, reseirch or investl4ation. If Information Informrequiration scur additional work a _ the EAF will De dependent on information currently available and will not $o indicate and specify each instance. 11124vai)a01= NAME OF PROJECT: , NAME AND ADDRESS OF OWNER (If Differentl -�E:e'���iU ame, EL[S• . ADDRESS AND NAME OF APPLICANT: treat)dim tree[ r GIG M PHONE: L aTiCS tate ip fit-4P400 DESCRIPTICH OF PROJECT: (Briefly describe type of project Or action) (���• (PLEASE COMPLETE EACH QUESTION - Indicate N.A. if not applicable) A• SITE DESCRIPTION (Physical setting of overall Project, both develoned and undevelooed areas) I. General character of the land: Generally uniform slope Generally uneven and ro1)tnu or trregul 2. Present land use: Urban Industrial Agriculture __, Other Commercial ., Suburban —_. RuralFores. F 3. Total acreage of project area)/��r� Aooroximate acreage: Presently After Completion • Meadow or Brushland Presently After Comply _acres �U•'ecres Water Surface Area - Forested toacres -�'aeres :: _a EQacres Unvegetated Aaricul tural (rock, • ��7acres �a__7acres earth or fill) —0 _acres '1!tland (Freshwater or Roads, buildinns Tidal as ner Articles and other paved 'A. 'S nr r.C.L.) a/Dacres . 69-acres :_L-surfAces acres • ,_,•_ae a, .rrat if ^ dOminar[ Soii h/pe(Sl On nn tOth_e.r__(_i.n_d—ic—at.e_• type) =a ' cral S. 're :herr ect Site? 732 ae > r6t[ OULCrp,Olnaf On ^rn I!CC ilia' wn � / ••�—�����• .a t. a: •f Cny!n to Dedrecl? .� � � � . Yef ryr 9;1: _.__...............('n Beet) __ „ . . �7Morimate Percentad pester a o1 .31. Proposed proposed prsite with 7 /laceoject Contior siooes: 0-10: guous to _�_: 15: or _ Yes aro contain a buildinn or e' What Is the site listed on the Rational Register of Nistortt 9. Do hum water table ting or fishi �{eet TO ng opportunities presently exist In DOe�edc� site contain a y species the Project area? lndan _Yes �o Yes �:lo, according to Identifyanimal eache that is identified as threatened or 11, Are species e there any unique f0 .4tions _ q0e or unusual land forms �—�--�- �.�_Yes �/ 12. Is the Project —No (Describe the project site? (i.e. cliffs, on area _ site (De,Yesscribe used —�— dunes;oth 17. Does the si�offer by the community or neighborhood as an open space or S.—Other geological ) No or include scent recreation 14• c views or vistas known to be im Streams within or contiguous to portant project area: to the tomnunity? a "ame Of stream and nx? of river to which it is L tributary - N Is. lakes, Ponds, Netlandareas F ~<<7• s �'�`� �� �' within or contiguous to Project area; A. Name �E, 'y � 16. N 1's hat is the domin b. Size (in acres) single famil ant land use and Y residen fal, d the classification Si 00. �,..� R-2) and the scale within a 1/4 mil 8• PROJECT -� /Lof d�evelopment (e a radius of the DESCRIPTION y@'�' vTlA 2 story), / Project (e ✓cry t�/ g' 1. Physical dimensions and scale of Project Total contiguous (fill in e+s +• acres a dimensions 9 owned by Project as appropriate) ct sponsor b• Project a _ creage developed; acre . t. Proacres initially; acres. s' Project acreage to remain undeveloped4��acres ultimately. d• length of project, in miles: !' If project is __�(lf aPPropriate) age f• Number ° ; developednOf aceagestin {tate Percent of expansion proposed: building square { strfst parking spaces existing foot.Maximum vehicular trios generated Proposed h per hour .(� If residential: Number and type of housing units: completion of project) 2ne Family Initial / Two Family NultiPle Family � Condominium Ultimate I. if: --�- Orientation �— 'kignoornood-City-Regional Commercial ` _ Estimated Employment Industrial —_ j. Total neignt of tallest nrojosea structure ,(� . _&—it -fe — t 1. Now much natural material (i.e. rock, earth, etc,) will be removed from the site - tons cubic ya. 3. Now many acres of vegetation (trees, shrubs, ground covers) will be removed from site • •/V acres. e. Will any mature forest lover 100 years old) or other locally-important ve0etation be removed by tn,s project? Yes No S. Are there any plans for re-vegetation to replace that removed during construction? __y 1' 6. If single phase project: Anticipated period of construction�mpntet ✓ho hs, (including demolition). 7. If multi-phased Project: a. Total number of phases anticipated _No. b. Anticipated date of commencement phase ' _month year (including demolition) C. Approximate cOmoletion date final phase _ month •__year, d. Is phase 1 financially dependent on subsecuent phases? __yes S. Will blasting9 ? —_� occur Burin construction. __Yes ✓No 9. Number of jobs generated: during construction v.; after project is complete -0 10. Number of jobs eliminated by this project :1.-. 11. Will project require relocation of any projects or facilities? __Yes ✓ No. If yes, explain: 12. a. Is surface or subsurface liquid waste disposal involved? ___Yes b. If yes, indicate type of waste (sewage, industrial, etc.) C. if surface disposal name Of stream into which effluent will be discharged 13. Will surface area of existing lakes, ponds, streams, bays or other surface waterways be increased or decreased by pr000sal? __yes Lo, No. 14. Is project or any portion of project located in the 100 year flood plain? __Yes ✓NO 15. a. Does project involve disposal of solid waste? __Yes ✓ No b. If yes, will an existing solid waste disposal facility be used? __yes /,70 C. If yes, give name: 1 location d. !fill any wastes not go into a sewage disposal sy 16. Will project use herbicides or pesticides? stem or into a sanitary lanOfill? _eye __'No _Yes NO r 17. Will project routinely produce odors (more than one hour oer day)? -—Yes es &/No 18. Will project produce operating noise exceeding the local ambience noise levels? _Yes No 19. Will project result in an increase in energy use? Yes ✓ 40. If yes, indicate types) 20. If water suooly is from wells indicate Pumoing capacity *ot gals/minute. _ 21. Total anticipated water usage per dayN// _ Pals/day. ' 22. Zoning: a. What ,5 dominant zoning classification of site? b. Current soecific zoning classification of site C. !s proposed use co^s,sten- h ,, ��--•�-- - t present zon,nt? d. If no, indicate desired zor,ng Alwtww _la: a. If any federal permit required? Yes No F b. Does project involve State or Federal funding or financing? —_Yes VENO C. Local and Regional approvals: a Approval Required Submittal Approval '1■ _ (Yes, No) (Type) (Date) (Data) City, Town, Village Board City, Town, Village Planning Board City, Town, Zoning Board --- City. County Health Department fie' Other local agencies Other regional agencies State Agencies � Federal Agencies C. INFORMATIONAL DETAILS Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with the proposal, please discuss such impacts and the measures which can be taken to mitigate or avoid t PREPARER'S SIGNATURE: J TiTLE: REPRESENTING: DATE: -a- EAF ENVIRONMENTAL ASSESSMENT. - PART II - Project Impacts and Their Magnitude General lnfn13 io_ f5rad Carefully) - In completing the form the reviewer should be guided by the question: Have my decisions and determinat been reascr.aplei The reviewer is not expected to be an exoert environmental analyst. .. - Identifying that ar effect will be potentially large (column 2) does not mean that it is also necessari sionificant. Ary large effect must be evaluated in PART 3 to determine significance. By identifying a etrectin column 2 simply asks that it be looked at further. _ - The Examoles provided are to assist the reviewer by showing types of effects and wherever possible the of magnituoe that would trigger a response in column 2. The examples are generally aPolicable througho State and for most situations. But, for any specific project or site other examples and/or lower thres may be more appropriate for a Potential Large Impact rating. - Each project, on each site, in each locality, will vary. Therefore, the examples have been offered as 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. INSTRUCTIONS (Read Carefully) A. Answer each of the 18 questions in PART 2. Answer Yes if there will be any effect. b. Maybe answers should be considered as Yes answers. c. if answering Yes to a Question then check the appropriate box (column 1 or 2) to indicate the oaten; size of the impact. I-f impact threshold equals or exceeds any example provided, check column 2. 1. impact will occur but threshold is lower than example, check column 1. d. If reviewer has doubt about the size of the impact tilen consider the impact as notentially large and proceed to PART 3. e. If a potentially larqe impact or effect can be reduced by a change in the project to a less than lar magnitude, place a Yes in column 3. A No response indicates that such A reduction is not possible. 1. 2. 3. SMALL TO POTENTIAL ' CANIMPACi MODERATE LARGE REDUCED IMPACT IMPACT PROJECT C: IMPACT ON LAND ' NO, YCS WILL THERE 9E AY EFFECT AS A RESULT OFA PHYSICAL CHANGE TO (,��•�['(C)O PROJECT SITE? Exaroles that Would .Avoly to Column 2 — Any construction on slopes of 15% or greater, (15 foot rise per 100 foo: of lendtn;, or where the general slooes in the project area exceed 10:. Construction on Land where the denth to the water table is less than 3 feet. _- ronstruction of naved narkinq area far 1."n or more vehicles. _ Construction on lard where bedrock is exposed or generally witnin 3 feet of existing ground surface. Cons•;rnct,pn tra• will continue for more than 1 year or involve mo-e Char- art- ,•.ase or stage. — Er?vat,on for r,r.ny 9urnoses that would rerove nore than 1 ,000 tors rf natural r,_terial (i.e. rock or soil) per Year. — COnstrpctlor Of any new sanita,y landf41l. x � 3 ' t!!ALL TO POTENTIAL CAN IMPACT BE OERATE LARGE REDUCED BY MPA T MPACT POOJECT CHANGE Construction in a desiqnated floodway. i= Other impacts: •� 2. WILL THERE BE AN EFFECT TO ANY UNIQUE OR UNUSUAL LANG FORMS SAO YES FOUND ON THE SITE? (i.e. Cliff;, dunes, 0,010oical forms- OC H 1 I FOUND, etcfir`/ Snecific land forms: _ I1IPACT ON WATER 0. WILL PROJECT AFFECT ANY WATER. BODY DESIGNATED AS YES PROTECTED? (Under Articles 15, 24, 25 of the Envir- "**••(y) Onmental Conservation Law, E.C.L.) �pC ExamOles that Would Aoply to Column 2 Oredgino more than 100 cubic yards of material from channel of a protected stream. Construction in a designated freshwater or tidal wetland. _ 3 — Other impacts: t A. WILL PROJECT AFFECT ANY NON-PROTECTED E%!STING OR MFH NO YES I BODY OF WATER. ,•••••••••• > Ex"oles that Would Apply to Column 2 .................90 A 10% increase or decrease in the surfacearea 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: S. WILL PROJECT AFFECT SURFACE. DR GROUNDWATER 011ALITY? —�6�/ YES -- Exar'Oles that Rould Apply to Column 2 Prniect will require a discharge permit. Project requires use of a source of water that does not have Approval to serve proposed project. Project requires water supply from wells with greater than 45 gallons per minute pumping capacity. Construction Or poera Cion causing any contamination Of a public water supply system. Project will adversely affect groundwater. Liquid effluent will be conveyed off the site to fac'Irtles which presently do not exist or have Ihdcequate capacity. �• PrP]ect requiring a facility that would use water in e.cess of 2n•000 gallons per day. — Oro:ect ,,]I likel] cause siltation or Other dischar qe .o an e.lsnnq bcry of water to the extent that there _ wl�� :e An �Ovlous visual contrast to natural COndIt10nS. ,ALL TC IPATE4TIAL I CAN UVACT BE 11DEP.ATE LARGE REDUCED Gy IMPACT I-94CT PPI)JECT CNANt gther Impacts' B. '11LL PROJCCT ALTER DRAINAGE FL-01, PATTEOM OR SURFACE HATER NO YES RUNOFF? ................................................... Examnle that ':ould Anply to Column 2 _ Project would impede flood water flows. Proiect is likely to cause substantial erosion. Project is incompatible with existing drainage Patterns. Other impacts: �— IMPACT ON AIR j.pYES /Z�/( 7. HILL PROJECT AFFECT AIR QUALITY?.......................... O Fxamales that Would Apply to Column 2 Project will induce 1,000 or more vehicle trips In any given �— hour. Project will result in the incineration of more than I ton of refuse Per hour. Project emission rate of all contaminants will exceed S lbs. per hour or a heat source Producing more than 10 million BTU's per hour. Other Imoacts: IwperT nN PIa4TS Aon A41wai_S NO YES B. WILL PROJECT AFFECT ANY THREATENED OR ENDANGERED SPECIES? '90 Examples that Would Apply to Column 2 Reduction of one or more species listed on the Hew York or Federal list, using the site, over or near site or found on the site. Removal of any portion of a critical or significant wild- life habi td G. . _ ADnl ication of Pesticide or herbicide over more than — t,,ir, a veer other trim for eyr+emtual purposes. 9t)-sr impacts: 9. '.TILL PDOJECT SUBSTANTIALLY AFFECT NON-THREATENCO OR JI0 YES E119AN6ERE3 SPECIES? ....................................... O E.a*ple that Would Apply to Column 2 _ rroi"ct would substantially interfere with any resident — or migratory fisn or wildlife species. Project requires the removal of more than l^ acres of nature forest (over len years in ane) or other locally important vegetation. a. J. 7— - Other (!'PACT BE UCED NY ECT CHANGE - I"ACT O'l YI STs! or.m"RCE 19. DILL THE 0Vn7FCT ArrEC' VIE:'$, MTAS CR T!IF VtSIIAL n c CHARACTER OF THF. NFIGHBOR'nOD OR CO IIT M. YE. � a YYII y� Eaomnles roar could Apply to Column 2 An incpmoatible visual affect caused by the introauctinn Of new materials, colors and/or forms in contrast to the surroundine landscape.A project easily visible, not easily screened,that is obviously different from nthdrs around it. _Project will result in the elimination or major screening of scenic views or vistas known to be Important to the area. Other impacts: IMPACT ON HISTORIC RESOURCES 11, WILL PROJECT I1-PACT ANY SITE OR STRUCTURE OF HISTORIC. NO YES DRE-NISTOPIC OR PALEONTMCAL IITOPTANCE? ................ .1�( Eaanoles that Would Apply to Colurm 2 O Project occurino wholly or partially within or contiguous to any facility or site listed on the National Renister of historic Places. -- Any impact to an archeological site or fossil b?d located within the project site. —� Other impacts: IMPACT ON OPEN SPACE d RECREATION 12. WILL THE PROJECT AFFECT THE OUANTITY OR QUALITY OF EXISTING NO YES OR FUTURE OPEN SPACES OR RECREATIONAL OPPORTU.'IITIES?...... �O Examples that Would Aoply to Column 2 iOV(() The permanent foreclosure of a future recreational opportunity. _ A major reduction of an open space important to the Comaunity. Other imoacts: Iwcnrr nN TDANSPOPTATInN 17. !'ILL THERE BE A4 EFFECT TO EXISTING TRANSPORTATION NO - YES SY$i E".ca. O .............................. E<arples that Would Annly to Colunn 2 Alteration of present patterns of riovement of neople and/or g000S. -� Protect will result in severe traffic problems. ;trier 'reacts: SMALL TO POTMIAL CAH IMPACT MDERATE LA GE REDUCED IMPACT PiPACT PROJECT C IMPACT ON ENERGY 14. WILL PROJECT AFFECT THE COMMUNITIES SOURCES OF FUEL OR ENERGY SUPPLY? NO YES.........................................../y�/ ExamDles that Would Apply to Column 2 - Project causing greater than 5% increase in any form of energy used in municipality. _ Project requiring the creation or extension of an energy _ transmission or supply system to serve more than SO single or'two family residences. -- Other impacts: IHPArT ON NOTSE 1S. WILL THERE BE OBJECTIONABLE ODORS, NOISE, GLARE, VIBRATION No YES or ELECTRICAL DISTURBANCE AS A RESULT OF THIS PROJECT? ... t - ExamOles that Would ADDly to Column 2 O Blasting within 1,500 feet of a hospital, school or other _ sensitive facility. Odors will occur routinely (more than one hour per day). _ Project will Produce operating noiseexceedinn the local ambient noise levels for noise outside of structures. Project will remove natural barriers that would act as a noise screen. Other impacts: IMPACT OM HEALTH d HAZARDS 16. !TILL PROJECT AFFECT PUBLIC HEALTH AND SAFETY. Nn YFS Examoles that Would Apply t0 Column 2 O Project will cause a risk of explosion or release of hazardous _ substances (i.e. oil, pesticides, chemicals, radiation, etc.) in the even[ of accident or unset conditions, or there will he a chronic lqw level discharge or emission. Project that will result in the burial of "hazardous wastes" in toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc. , including wastes that are solid, semi-solid, liquid or contain gases. ) Storage facilities for one million or more gallons Of liouified natural gas or other liquids. Other irodcts: SILALL TO P TE;iTI.d. Cwh iMP91 otM MODERATE LARGE REDUCED BY ' . IMPACT IMPACT PROJECT CHANGE "IMPACT ON GROWTH AND CHARACTFR OF COMMUNITY OR IIriCHAnpurjnn 17. WILL PROJECT AFFECT THE CHAPACTER nF THE EXISTING �N_JO(/ YES Example that Would Apply to Column 2 The Population of the City. Town or Village in which the _ project is located is likely to grow by more than 51 OF resident human population. The municipal budgets for capital expenditures or opera- _ ting services will increase by more than 5% per year as a result of this project. Will involve any permanent facility of a non-agricultural _ use in an agricultural district or remove 'rime•agricultural lands from cultivation. The protect will replace or eliminate existing facilities, _ structures or areas of historic importance to the community. Development will induce an influx of a particular age group with special needs. — Project will set an important precedent for future projects. Project will relocate 15 or more employees in one or rare businesses. Other impacts: 18. IS THERE PUBLIC CONTROVERSY CONCERNING THE PROJECT? ...... NO .... ,NO YES Examples that Would Apply to Column 2 O Either government or citizens of adjacent communities have expressed opposition or rejected the Pmiect or have not been contacted. Objections to the project from within the community. IF ANY ACTION U.' PART 2 IS IDENTIFIED AS A POTEIITIAL LARGE IMPACT OR IF YOU CANNOT DETERMINE THE MAGNITUDE OF IMPACT, PROCEED TO PART 3. PORTIONS OF EAF COMPLETED FOR THIS PROJECT: DETERMINATION PART I — PART II— PART 7 Upon review of the information recorded on this EAF (Parts 1, 2 and j) and considering both the magnitude and importance of each Impact. it is reasonably determined that: PREPARE A 1IErATIVE DECLARATION A. The Project will result in no major impacts and, therefore, �\ Is one which may not cause significant damage to the environment. 0 8. Although the project could have a Significant effect on the environment, there will not be a significant effect in this case PREPARE A NEGATIVE nECLARATION because the nitigatrgn measures described in PART J have been O included AS part of the proposed project. C. The project will result in one or more major adverse impacts PREPARE POST TIME DECLARATI O:I PROCEED WITH EIS that cannot be reduces and may cause significant damage to O the environment. ate �'Ignature or ResponSIDle Signature or Drenarer (if different Iron resnonsiole orficer) Agents int or type name or responseole official in Lead Agenc.. P5�FF0(,(r T LD S ! Y Southold, N.Y. 11971 (516) 765-1938 QUESTIONNAIRE TO BE COMPLETED AND SUBMITTED WITH YOUR APPLICATIONS FORMS TO THE PLANNING BOARD Please complete, sign and return to the Office of the Planning Board with your completed applications forms. If your answer to any of the following questions is Yes, please indicate these on your guaranteed survey or submit other appropriate evidence: 1. Are there any wetland grasses on this parcel? Yes No (Attached is a list of the wetland grasses define i by the Town Code, Chapter 97, for your reference) i i j 2. Are there any other premises under your ownership abutting this parcel? Yes No 3. Are there any building permits pending on this parcel? Yes No 4. Are there any other applications pending concerning this property before any other department or agency? (Town , State, County, etc. ) Yes No 5. Is there any application pending before any other agency with regard to a different project on this parcel? Yes No 6. Was this property the subject of any prior application to the Planning Board? Yes No 7. Does this property have a valid certificate of occupancy, if yes please submit .a cop of a Yes No I cer hat the above statements are true and will be relied o y t lanning o i considering this applicatonn. gnature of property owner or auurnorrized agent date nw F • ent to questionnaire for the Planning Board P STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: �Z On the day of 19L7 before me personally k d came_ to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that &��executed the same. cr: Notary Public DAVID Q CREATD NOTARY PUBLIC,ShM of New YQ(X suRdM,01Y �►Mnwr�, ,^� 1 i Suffnl,, � OFFICE OF BUILDING INSPECTOR TOWN IIALL SOUTHOLD, NEW PORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES TIIIS IS TO CERTIFY that the Pre C.O. i- Z- 16033 Land /Tf Building(s) Date- August II . 1987 `t r/ use(s) located at 4735 Westphalia Road Nattituck , New York Street Hamlet shown on County tax map as District 1000, Section 113 , Block 13 Lot 01 does�not)conform to the present Building Zone Code of the Town of Southold for the following reasons: On the basis of information presented to the Building Inspector's Office, it has been determined that the above xltonconforming i-1( Land /x/ Building(s) / / use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: Property contains I story, one family, wood framed dwelling with attached porch; am with basement; 2nd barn with attached shed; all situated in 'A' Residential Agricultural zone with access to Westphalia Road; a Town maintains ig way. The Certificate is issued to SALLY W. WELLS (owner, �fax>i>f>o-]<aA7iJ<Ypc 1 of the aforesaid building. Suffolk County Department of health Approval N/A 1 N/A UNDERIVRITf itS CERTIFICA11: NO. NOTICE 1S 111 Itj.,BY GIVI'N that the owner of the above premises ILAS NOT CONSENTEM TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Buildin'n %one Code, and therefore, no such inspection has been conducteed. This Certificate, therefore, does not, and is not intended to certify that the: premises comply with all other applicable codes and rePula- tions. ' 4tn= _. ituiidl:: inspector s TO THE SOUTHOLD TOWN PLANNING BOARD: Idea Ventures ) RE: Indian Brook , Westphalia Road , Mattituck (Sterling SCHEDULE "E" ired improvements The following is an estimate of requIdea VentuVentures 4'. osed for Indian Brook Subdivision as proposed by Sterling as of August 20 , 1987 : Paving/Curbing $20 ,000 7 Drainage 500 i Approximate Total . . . . . . $27 , 500 ZRe 711Y su mit Robert A . Celic General Partner, Sterling Idea Ventures NOTE : The above estimate is for the one acre cluster plan . �.ee�t C Pte,�-- r���a�i,G,��,`.`��/''a�'```""�s` •�"a�.�� �- c� back - d Q - eIL l G r o4 ° m a o� p° N p Q�O �S Q � i pPVP C�0 PO 7°3510 ss 2 } I �Esjv N 6 OAZ T P H A L I A VENAE 263 g3 WE S WESTPHALIA P °2 '50E t o v'fO N N ao s o lP 66 99 1' _ �° CC 0 361 36 ' N R-25 " Ilse - co �Z = ° 58 40" E N.75 �ti6 ^ '( � 0, `°, Zd s5' / KEY MAP Z p,vd 351. A 0 b°scrrKnIr ;N5 U750 EroPJW 1 -- (p — 0tr 01 5 2 sil 535 a l / 1n w 2,00p, 00 m 10, 0 sTELLE TE�SABAT /r o , � ct N 'm 10 60 { , a5 �w 60 t o D \ 9° ZONING DISTRICT A - 8( 3 D °. a O� 0 9MATTITUCK CUTCHOGUE SCHOOL DISTRICT ' pOV OtANNONE/ ? °} FIRE DISTRICT 30 M{.iTTITUCK U I N -S o Z ,4/0 / 1�6 OIANNOgE �0 OER PCDINE m. 5� ,; � / °� 30 � a TOPOGRAPHICAL INFORMATION i, FROM - TOPOGRAPHIC MAP 10opo 1 / FIVE EASTERN TOWNS. I, X 4 8� ay O / G \ o o / w 3y 000 5Q o, OWNERS a DEVELOPERS 1- t Bal STERLING IDEA VENTURES ' tb 3550MAIN ROAD IL ° o MATT/TUCK, N.Y., 11952 NUSAK ct Ili 2y rP NI° / F nDaE"T �` �A N W IIS 5tius P,K so } Dos 5l /I 0 5 8000 � / q5 r3 �N?O NE °°O / �•-� 9°.� y 20 3 35 J '34 / 0 / F DON 140) / /l� 15 nAL15 �r,1 & µ N/ FOWL-0 � ` 5010 OQG / °�W1' i✓ 'on Jnr 35 —� C�1 429 .18' . S�. T 5 4\4 \ \ T ES LTD . - W AS500 \ 2 20 BC ANOHE 0EOP0E ` 63" 22, \O, W OF 1.000 t \ JJ g0 D I s o l f ` PN PROPOSED SKETCH PLAN NI FOR STERLING IDEA VENTURES AT MATTITUCK TOWN OF 90UTHOLp f; TOTAL AREA= 17.6769 ACRES SUFFOLK COUNTY , N . Y . - 1000 - 113 - 13 OI � I CA P . SCALE "e 100 r E�G'p .. `F Prepared in accordance with the miuin� JUNE 19, 1987 li N .Y. S. LIC. N0. 49619 eaandarda for title surv°yr as namiSiR"d hr the L I.A.1.S. and approved aed adMp" E YO R S 6 ENGINEERS P.C . for such m by The New yak Sur ly 020, Title Au°ciaYan. ��ed�{pP II 9 M AO • (5TH N.Y. 11971 87 2552 •III I Y