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HomeMy WebLinkAbout1000-123.-8-8SENDER: Complete items f ar~d/or 2 for additional services. Complete items 3, Print your name ar return this card to ye · Attach this form t does not permit. 3. Article Addr Donal P.O. ~,:t t i 5. Signature (A, 0 6. Signature (A - - PS Form 38 1 1, November 1990 . o.S~ {~P0i 1991-28~68 DOME~IIL; I~l:lUn~ n=~,~.,r, 410 4 0 TOWN OF SOUTHOLD Suffolk County, New York Phone 516-765-1801 , Southold, New York 11971 Date - ' . ~ ~) 19 ~/ ~udith T. Te~, To~ TOWN CLERK TOW:~ o~ SO~TaO[D Suffolk County, New Y.rk 516- 765-1801 N? 3 9 5 0 8 ' ~/ Spt,thola, N. ~. 1197~19 ?/ J~ith T. Terry, Tow~ ~erk, THIS PROPOSAL IS TO SET OFF A IN ACRE PARCEL FROM AN EXISTING _ ACRE PARCEL LOCATED ON SCTM# 1000- /~5-~'-~' SET OFF Complete application received Application reviewed at work session Applicant advised of necessary revisions Revised sub mission received Sketch plan approval -with conditions Lead Agency Coordination SEQRA determination Sent to Fire Commissioner ~o ~z. Receipt of firewell location Notification to applicant to include on final map Sent to County Planning Commission Receipt of County Report Review of SCPC report Draft Covenants and Restrictions received Draft Covenants and Restrictions reviewed Filed Covenants and Restrictions received Receipt of mylars and paper prints with i~~~ -~/ ~-~Health approval ,~.~.~,~ ~: Final Public Hearing Approval of set off -with conditions Endorsement of set off 14-16-2 (2/87)~7c 617.21 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FO Purpose: The full EAF is designed to help applicants and agencies determine, in an or action may be significant· The question of I.y, there are aspects of a ......... Whether an action may be · ~,,uj~c~ [nat are s ' ' ' ' ' ' Significance may have I ttle or no ~ ..... uble, ctlve or ~lgm. flcant is not always easy to answer. Frequent- ana,ysis. In addition, many who ..... ,a Know,edge of ~hnem[navSi[~or~amb~tlto/Sj~°b~ntdeec~nt ~O. cOadI ~hea~ptehr~ Onmenta, have know'edge in one particu ar area I S~n :nhv°i~etermine the question of significance, may not be aware of the broader concerns affecting The full EAF is intended to provide a method Whereby applicants and agencies can process has been orderly, comprehensive in nature, yet flexible to allow introduction be assured that the determination Full EAF Components: The fuji EAF is comprised of three parts: of information to fit a project or action· 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: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a large impact. The form also identifies whether an impact can be mitigated or redux:ed,potentially- Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. DETERMiNATiON OF SIGNIFICANCE_Type I and Unlisted Actions Identity the Portions of EAF completed for this project: [] Part 1 [] Part 2 []Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if 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. [] B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer 0f different from responsible officer) Date 1 PART 1--PROJECT iNFORMATION Prepared by Proiect Sponsor determining whether the action proposed may have a s~gndicant effect NOTICE: This document is designed to assist in A through E. Answers to these questions wiil be considered- on the environment. Please complete the entire form, Parts ~. .... ~ r~,,blic rev ew ~rov~de any addition&. as part of the application for approval and may be subject to further venHcauon ~-~ ~ information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAr will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify each instance. NAME OF ACTION LOCATION OF ACTION (include Street Address, Municipality and County) NAME OF APPLICANT/SPONSOR ~ODRESS CITY/PO NAME OF OWNER (If different) ADDRESS BUSINESS TELEPHONE ~lN ESS TELEPHONE CITY/PO DESCRIPTION OF ACTION Please Complete Each Question-Indicate N.A. if not applicabl~ A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: ~]Urban [~lndustrial I~Commercial ~esidential (suburban) ~Rural (non-farm) ~Forest ~Agricplture ~Other _ 2. Total acreage of project area: __~ ~ acres. AFTER COMPLE HON APPROXIMATE ACREAGE acres Meadow or Brushland (Non-agricultural) ~cres Forested acres Agricultural (Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres Water Surface Area Unvegetated (Rock, earth or fill) ~ Roads. buildings and other paved ~urfaces Other (Indicate type)_ ~._/-~.~ I k~a~LI¥~ 3. What is predominant soil type(s) on project site? a. Soil drainage: E}Well drained ,/t~ % of site E}Moderately well drained ...... ct site E]Poorly drained % of site b. If any agricultural land is involved, how many acres of soil are classifie~ within soil group I through 4 ct the NY~. Land Classification System? acres. (See 1 NYCRR 370). /'~ ' 4. Are there bedrock outcroppings on project site? ~Yes ~No a. VVhat is depth to bedrock? (in feet) 2 PRESENTLY .... acr(~s Approximate percentage of proposeOoject site with slopes: ~0-10% [10-15% % F115% or greater _ Is project substantially contiguous to, or ~Ntoain a building, site, or district, listed on the State or the National Registers of Historic Places? []Yes Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? [Yes []No 8. What is the depth of the water table? /~" (in feet) 9. Is site located over a primary, principal, or sole source aquifer? E3Yes ~x/o 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? I~Yes 11. Does project site ain any species of plant or animal life that is identified as threatened or endangered/ I~Yes According to ' Identify each species 12. Are there any UnmoOr unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) E3Yes Describe 13. Is the project si~presently used by the community or neighborhood as an open space or recreation area? f-lYes .I~o If yes, explain 14. Does the present~sfl:e include scenic views known to be important to the community? [Yes .j~No 15. Streams within or contiguous to proiect area: a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland are/~ within or contig~,~us to project area. 17. Is the site served by existing public utilities? [~Yes a) If Yes, does sufficient capacity exist to allow connection? [Yes b) If Yes, will improvements be necessary to allow connection? []Yes ~lNo 18. Is the site located in an agricuJtural/~istrict certified pursualnt to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? [Yes 19. Is the site located in or substantially contiguou~ to of the ECL, and 6 NYCRR 6177 I~Yes /~k'~o a Critical Environmental Area designated pursuant to Article 8 20. Has the site ever been used for the disposal of solid or hazardous wastes? [Yes B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acreage to be developed: ~ _ acres initially; c. Project acreage to remain undeveloped acres. d. Length of project, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed %; f. Number of off-street parking spaces existing __ ; proposed g. Maximum vehicular trips generated per hour (upon completion of project)? h. If residential: Number and type of housing units: Ultimately __ ~ i. Dimensions (in feet) of largest proposed structure .. ~ ~ height; width; __ j. Linear feet of frontage along a public thoroughfare project will occupy is? /~'Z7 ft. acres. acres ultimately. _ length. Condominium 2. How much natural materim (i.e., rock, earth, etc.) will be removed from the site? __~- '~--~'~c:-~tons/cubic yards 3. Will disturbed areas be reclaimed? E~Yes g~lo [N/A a. If yes, for what intendac: purpose is the site being reclaim_~t? b. Will topsoil be stockpiled for reclamation? [Yes c. will upper subsoil be stockpiled for reclamation? [~Yes ~..o · 4. How many acres of vegetation (trees, shrubs, ground covers) wiJJ be removed from site? i ~(~/~JL~ acres. 5. Will any matur~lCorest (over 100 years old) or other locally-important vegetation be ren oved by this proiect? ~lyes [~No 6. If single phase project: Anticipated period of construction 7. If multi-phased: a. Total number of phases anticipated (,~ (number) b. Anticipated date of commencement phase 1 month c. Approximate completion date of final phase month months, (incluaing demolition). year, (including ~lemolition) d. Is phase I functionally dependent on subsequent..~ses? [Yes [No 8. Will blasting occur during construction? C]Yes Z3'No 9. Number of jobs generated: during construction j~C) ; after project is complete 10. Number of jobs eliminated by this project ;,~ c~)-! ~ 11. Will project require relocation of any projects or facilities? []Yes /~o If yes, explain 12. Is surface liquid waste disposal involved? [Z]Yes []No a. If yes, indicate type of waste (sewage, i~dustrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? L~Yes [~No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain E~Yes ii'No 15. Is project or any portion of project located in a 100 y~ar flood plain? E3Yes 16. Will the project generate solid waste? ~]Yes ~;~No a. If yes, what is the amount per month tons b. If yes, will an existing solid waste facility be used? []Yes []No c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 17. Will the project involve the disposal of solid waste? [qYes a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? years. 18. Will proiect use herbicides or pesticides? ~]Yes ,~No tons/month 19. Will project routinely produce odors (more than one hour per day)? []Yes [~No 20. Will project produce operating noise exceeding the local ,ambix~t, noise levels? ~Yes 21. Will project result in an increase in energy use? ~Yes Z2No If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity 23. Total anticipated water usage per day gallons/day. 24. Does project involve Local, State or Federal funding? [Yes If Yes, explain gallons/minute . No 25. Approvals Required: City, Town, Village Board OYes ONo City, Town, Village Planning Board '~Yes ONo City, Town Zoning Board [Yes ~]No City, County Health Department OYes Other Local Agencies ~lyes ONo Other Regional Agencies [Yes []No State Agencies OYes [~No Federal Agencies ~lYes ONo C. Zoning and Planning Information Type 1. Does proposed action involve a planning or zoning decision? ~J~Yes ~No If Yes, indicate decision required: ~zoning amendment ~zoning variance ~lspecial use permit []subdivision I-]site plan [new/revision of master plan []resource management plan [~other 2. What is the zoning classification(s)of the site? ? 3. What is the maximum potential development of the site if developed as permitted by the present zoning? Submittal Date 4. What is the proposed zoning of the site? 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? I--lYes ~No 7. What are the predominant land use{s) and zoning classifications within a ~/~ mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a ¼ mile? I-lYes I~No 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization{s) for the formation of sewer or water districts? [Yes []No 11. Will the proposed action create a demand for any community provided services {recreation, education, police, fire protect on)? OYes I~No a. If yes, is existing capacity sufficient to handle projected demand? [~Yes 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? ~Yes []No D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the info~rm~,.tion p)rovided above is true to the best of my knowledge. Title If the action is in the Coastal Area, and you are a s/ate agency, complele the Coastal Assessment Form before proceeding with this assessment. 5 Par' --PROJECT IMPACTS AND TH { MAGN~TUDF Responsibility of Lead Agency General Information (Read Carefully) · In completing the form the reviewer should be guided by the question: !iaw! ms, respa, and determinations been reasonable? The reviewer is not expected to be an expert environmental analyst · Identifying that an impact will be potentially large (column 2) does not mean ti~ut it ~, ,;is, necessarily significant. Any large impact must be evaluated in PART 3 to determine signiticarlce Identifym~ ~ q~act m column 2 simply asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wt~ew, e possible the threshold of magnitude that would trigger a response in column 2. The examples are generally apphc~bk- throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresilolds may be appropriate for a Potentia[ Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will vary Therefore, the e×amples are illustrative and have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each question · The number of examples per question does not indicate the importance of each questior · in identifying impacts, consider long term, short term and cum[ative effects. Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the' potential size of the impa.ct. 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 prolect to a small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction ~s not possible This must be explained in Part 3. IMPACT ON LAND e I. Will the proposed action result in a physical change to.t~e project site~ '~NO ~YES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than 1 year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2. Will there be an effect t:. --.W ur.que or unusual land forms found on the site? (ie., cliffs, dunes, geological formations, etc )L~NO ~]YES · Specific land forms: 6 I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By impact Impact Project Change ~ [] _J Yes i] N o [] [~ UYes [JNo ~] ~] [JYes ~No [] LI []Yes ~ ~ []Yes []No ~ [] {~Yes ~No ~ '2 t :]~'es C]No ~ , IYes ill}No [] ~1 ijYes ( IMPACT ON WATER Small to 3. Will proposed action affect any water body designated as protected? Moderate (Under Articles 15, 24, 25 of the Environmental Conserva~on Law, ECL) Impact '~N 0 ~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 designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water? [3NO t:]YES 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: 5. Will Proposed Action affect surface or groundwater quality or quantity? 'J~NO I-lyES 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 (proiect) action. · Proposed Action requires water supply from wells with greater than 45 gallons per minute pumping capacity. · Construction or operation causing any contamination of a water supply system. · Proposed Action will adverse v affect groundwater, · Liquid effluent will be conve~,ed 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 cat~e siltation or other discharge into an existing body of wa~er to the exte:~t 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 existing waste treatment and/or storage facilities. · Other impacts:__ 6. Will proposed action alter drainage flow or patte r surface water runoff? ~C~ [:]YES Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 2 Potential Large Impact 3 Can Impact Be Mitigated By Project Change J~JYes []No []Yes J--JNo []Yes []No i-]Yes J~No J~]Yes [-lNo I-] Yes J~]No I-lYes []No [::]Yes r-]No [~]Yes J~]No []Yes fiqNo J=]Yes []No I-lyes []No ~]Yes ~]No J~]Yes []No I-lyes []No [~]Yes /--JNo []Yes [~]No [~Yes [~]No []Yes ~iNo J~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? I~JNO E~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 1 ton of refuse per hour. Emission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million BTU's per hour Proposed action will allow an increase in the amount of land committed to industrial use. Proposed action will allow an increase in the density of industrial development within existing industrial areas. Other impacts: IMPACT ON PLANTS AND ANIMALS Will Proposed Action affect any threatened or endang~f~red species? EJ'~NO L~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 sKe. Removal of any portion of a critical or significant wildlife habitat. Application of pesticide or herbicide more than twice a year. other than for agricultural purposes. Other impacts: Will Proposed Action substantially affect non-threatened or non-endangered species? I~NO []YES Examples that would apply to column 2 Proposed Action would substantially interfere with any resident or migratory fish, shellfish or wildlife species. Proposed Action requires the removal of more than 10 acres of mature forest (over 100 years of age) or other locally important vegetation. IMPACT ON AGRICULTURAL LAND RESOURCES Will the Proposed Action affect agricultural land re.sources? f~NO Z]YES Examples that would apply to column 2 Yhe proposed action would sever, cross or limit access to agricultural and (includes cropland, hayfields, pasture, vineyard, orchard, etc.) 8 Small to Potentiai ~.;an impact Be Moderate Large Mitigated By Impact Impact Project Change L~es OYes [~No L"~'~ e~ ~No .~ \ es ~No ~]Yes ~No .'~ Yes ~No ~Yes ~ ~7~¥es ~JNo .~'r es i( ( · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District, more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g., subsurface drain lines, outlet ditches, strip cropping); or create a need for such measures {e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES,/ 11. Will proposed action affect aesthetic resources? ~NO [3YES (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 u'ses, or proiect components visible to users of aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource. · Proiect components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: f IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure fo~istoric, pre- historic or paleontological importance? /l~NO I-lYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts:__ IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that would apply to column 2 ~[~O []YES L J The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Other impacts: 9 1 Small to Moderate Impact 2 Potential Large Impact I 3 Can Impact Be Mitigated By Project Change [~]Yes F-INo I--~Yes [~]No E~]Yes J-)No J-]Yes {-INo J~]Yes J-]No f-lyes [::]No J~]Yes E~]No I-lYes ~-'J No []Yes ~]No J~]Yes [~]No [~]Yes J~]No ~]Yes ' J~]No ~]Yes I-]No [~]Yes []No I--lYes l--]No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? ~NO F3YES Examples that would apply to column 2 · Alteration of present patterns of movement of people and/or goods · Proposed Action will result in maior traffic problems · Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? [~]-N O E]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 i6. Will there be objectionable odors, noise, or vibration as a result of the Proposed Action? ~]NO ~]YES 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 Will Proposed Action affect public health and safety~ ~NO []YES Examples that would apply to column 2 Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pesticides, chemicals, radiation, etc.) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. Proposed Action may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) Storage facilities for one million or more gallons of liquified natural gas or other flammable liquids. Proposed action may result in the excavation or other disturbance within 2,000 feet of a site used for the disposal of solid or hazardous waste. ©ther impacts: 10 ~ 2 Small to Potentiai Moderate Large Impact Impact Can Impact Be Mitigat.ed By tProject (;hang__ e L3Yes [7~ Yes ~No L_JYes ~JYes ~No L~Yes _~No !Z]Yes ~No ~}Yes ~.lNo L~Yes L~No i-lYes !Z~No ~Yes "TNo (~Yes ~No [?~Yes [~No ~Yes ~No ~'~ Yes [~No [~Yes ~NO ; I ~Yes E~No I (( IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD ~ 18 Will proposed action affect the character of the existi~/community:~ Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than'5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future proiects. · Proposed Action will create or eliminate employment. · Other impacts: I 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By impact Impact Project Change [] [] []Yes ~]No [] [] I--~Yes []No [] [] []Yes /-']No [] [] []Yes [:]No [] [] []Yes []No [] [] [:]Yes [--INo ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No 19. Is there, or is there likely to be, public controve.~/ related to potential adverse environmental impacts? ~(~O E3YES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 _£ Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources of value · Whether the impact can or will be controlled · The regional consequence of the impact · Its potential divergence from local needs and goals · Whether known objections to the proiect relate to this impact. (Continue on attachmentsl 11 14- 4-1] (2 87)--9c 617.21 Appendix B State Environmental Quality Review Visual FAF Addendum SEQR This form may be used to provide additional information relating to Question ] 1 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 overlook 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? 1[ · Any transportation gorridor of high exposure, such as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as scenic? · Municipal park, or designated open space? · County road? · State? · Local road? Distance Between Project and Resource (in Miles) 0-V. ~-V2 1/2-3 3-5 5+ 2. Is the visibility of the project seasonal? (i.e., screen'ed by summer foliage, but visible during other seasons) []Yes [No 3. Are any of the resources checked in question I used by the public during the time of year during which the project will be visible? r~Yes r-INo DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question 1, check those which generally describe the surrounding environment. Within · 1/4 mile * 1 mile Essentially undeveloped [] Forested : Agricultural Suburban residential Industrial ,-- Commercial Urban ~ ' River, Lake, Pond [] Cliffs, Overlooks Designated Open Space Flat Mountainous L~ Other k NOTE: add attachments as needed 5. Are there visually similar projects within: *Vz mile [~Yes [~No *1 miles []Yes F-iNo *2 miles [~Yes [~No *3 miles E~Yes [~] No * Distance from project site are provided for assistance. Substitute other distances as appropriate. EXPOSURE 6. The annual number Of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate. ( CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work [] Involved in recreational activities [] [] Routine travel by residents [] [] At a residence [] [] At worksite [] [] Other 2 o Southotd, N.Y. 11971 (516) 765-1938 REQUIRED DOCUMENTS SET-OFF 12 survey maps with the following: Contours, key map, and a scale of I" : 100~ indicated on the Su~ey which lot is to be set-off with square footages and metes and bounds of each proposed lot. Cou?_q~!_tax map numbers Covering letter requesting that the Board consider this Filing fee of $250 Form letter regarding drainage, grading and road construction, see enclosed. 5. Part I of Short Environmental Assessment Form, enclosed 6. Legal Description of Property, can be deed 7. Notation on existing restrictions applying to the property 8. Application, see enclosed ' 9. Questionnaire, see enclosed ,qPi , 2 6 ' PROCEDURE Submit above information and staff reviews for completeness and makes any necessary referrals. · When all is in order, schedule on next available agenda for Planning Board action. At the meet%ng the.Board my take action regardin ght set-off, any approval is subject to'Article 6 from the Suffolk County Health Department. 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 plat in accordance xvlth Article 16 of the Town Law and the Rules and Regulations of the Southold To~vn Planning Board, and represents and sta'tes as follows: 1. The applicant is the owner of record of the land under application. (If the applicant is not the oxvner 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 3. The entire land under application is described m Schedule "A" hereto annexed. (Copy of deed suggested.) 4. The Iand is held by the applicant under deeds recorded in Suffolk County Clerk's office as follows: Liber ...... ~-, ·.. Page Liber . .................. p Liber ................... Page Liber ........................ Page . Liber .................... Page as devised under the Last \Vill and Testament of ....................................... or as distributee .............................................. 5. The area Of the land is . ' ................. acrcs. ? 6. AIl taxes wblch are liens on the land at the date hereof have been paid except / '-9 7. The land is encumbered by .. /x/t) ............... ~ ..... mortgage (s) as follows: . (a) Mortg'age recorded in Liber ....... Page '' ....... · .................. in orlglna amount n£ $ .............. nnpald amonnt $ ..................... heh[ by .............. address .... (l)) Mortgage recorded in Liber ....... Pa~e " ' ....................... in orlgingl amount of ' . .... ' tm)aid amonnt $ .................. held by ........ .............. address ..... (c) Mortgage recorded in Liber .............. Page ................ in original amount of .............. unpaid amount $ ...................... held by ...................... ...................... address 8. There are no other encumbrances or liens against the land except ..... ~.x/p.q.~ ............ 9. The land lles in the following zoning use districts .[~..~.?. .............................. I0. No part of tbe land lies under water whether tide water, stream, pond water or otherwise, ex- I cept ................................................................................. 11. The applicant shalI at bis expense install all required public improvements. 12. The land (does) (does not) lie in a Water District or Water Supply District. Name or' Dis- trict, if wltbin 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 staudards will be installed by . ................................ lines. · ................ and (a) (no) charge will be made for installing said 15. Gas mains will be installed by . .............. . .......................... and (a) (no) charge will he made for installing said ma/ns. 16. If streets shown on the plat are claimed by the applicant to be existing public streets in tl~e Suff/31k Conuty Highway system, anuex Schedule "B" hereto, to show same. 17. If streets shown on ihe plat are claimed by the applicant to be existing pnbllc streets in the Town of Soutlmld lliglway system, annex Schedule "C" hereto to show same. 18. There are no ¢×isting bnildlng-s or strnctures oil tile land which are not located aud shown on the plat. ' 19. \Vhere tile plat slmws i~rolmscd streets which are extensions ~t' streets on adJoxnmtr sub- di¥is!ou maps hcret(~£t~re t'ilcd, there are no reserve strips at the end o£ the streets oll said cx~stxng maps at their coI1jtmctlons with thc pr()imsed streets. 20. hi the conrse of these prt)cecdings, tile al~pllcant will ~t'fcr pr~f of title :ts reqnirt~d by Sec. 335. nf tile Ryal Pr~)pErty Law. 21. Sulnnit a copy ,)f 1)roposed deed for lots showin~.~ all restrictim~s, covenants, tlc. :\nnbx Schedule "D". 22. The applicant estimates that the cost of g'radinff and reqnlred poblic improvements will be $ ..... ~... as itemized in Schedule "E" hereto anuexed and requests that the maturity of the Performance Bond be fixed at .............. years. The Performance Bond w/Il be xvrltten by a licensed surety company unless otherwise shown on Schedule "F'. DATE ~ ~ ........ 19.7~ ~ .~...& ........ ~.~ .............. (Sig.nature and Title) (Address) .................. STATE OF NEW YORK, COUNTY OF ~-~F~O ~_.~__~ ........ ' .......... day of... ¢ 19. before me personally came ....................... ...... to me known to be the individual described in ,.x~e~nt?d~e4foVre ~x..~ . ,p~ ~ ~.~ " , ~. and who - gom~ instrument, and acknowledged that .~... executed the same. ~m~ ~ ~. 19. ~[~otary Public , ................ ST.\TE OF NE\V ORK, COUNTY OF On the ................ day of - ' .......................... 19 ....... before me personally came ...................... to me known, who being by me duly sWorn did de- p.se and say that ......... '... resides at No. ................................ that .......................... is the .......... the c-rporation described in and wlfich executed the forcgoi g instrument- that knows thc .cai (if said corporation; that the seal affixed by order iff the [mard of directors of said corporation. :.:d dmt ............ signed .............. name thereto by like order. Notary Pnblic Southold Town Planning Board ~own Hall Southold, New York 11971 Re: Gentlemen: The following statements are offered for your consideration in the review of the above-mentioned minor subdivision and its referral to the Suffolk'County Planning Commission: (1) No grading, other than foundation excavation for a residential building is proposed. (2) No new roads are proposed and no changes will be made in the grades of the existing roads. (3) No new drainage structures or alteration of existing structures are proposed. Yours truly, / 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 (Attached is a list of the wetland grasses defined by the Town Code, Chapter 97, for your reference) 2. Are there any other premises under your ownership abutting this parcel? Yes 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 agency?(Town , State, County, etc.) 5. Is there any application pending before any other agency with regard to a different project~on this parcel? 6. Was this property the subject of any prior application to the Planning Board? 7. Does this property have a valid certificate of occupancy, if yes please submit a copy of same Yes Yes Yes No certify that the above statements are true and will be relied by t~/ ~nn~g Board in considering this application. ~iqnature of property owned/or authorized agent ~ate Attachment to questionnaire for/the Planning Board STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the ~ day of ~(~ I ' , 19~ I, before me personally to me known to be the individual described in~ and who executed the foregoing instrument, and acknowledged that~executed the same. Notary Public _L SEQF 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I~PROJECT INFORMATION (To be completed by Applicant or Project sponsori 1, APPLICANT/SPONSOR 2. PROJECT NAME 3, PROJECT LOCATION: Municipality County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) S. IS PROPOSED ACTION: ~New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY; 7. AMOUNT OF LAND AFFBCTED: r, ~ acres Ultimately ~ acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes ~No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residentia~ [] Industrial [] Commercial Describe: [] Agriculture [] ParkJForest/Open space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE.~OR LOCAL)? [] Yes [] No If yes, list agency(s) and permitlapprovals 11. j~OES ANY ASPECT OF THE ACT~O~-~ HAVE A CURRENTLY VAlID PERMIT OR APPROVAL? Yes [] No If ye~, list agency name and permit/approval 12. AS A RESULT OF PROPOSED [] Yes ,~No ACTION WILL EXiSTiNG PERMIT/APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE i If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS A:3SOGIA'FED V,'lT ~ Ti~E EOL~OWING: (Answers may be handwritten. If legible) O1. Existing air quality, surface or groundwater qualib or ~u~nbb', ¢1oi$a l~)v(~ ~, existing traffic paeerns, solid waste production or disposal, potential lot erosion, drainage or flooding pro~lem~? Explain C3. Vegetation or fauna, fish. shellfish or wildlife specres, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as offic a y adopted, or a change in use or intensity of use of rand or other natural resources? Explain briefly C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. C6, Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly. CT. Other impacts (including changes in use ot either quantity or type of energy)? Explain briefly. I( D ~S THERE, OR ISTHERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL MPACTS? [] Yes [] NO If Yes, explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) ~rreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham~ Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 December 4, 1992 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, NY 11952 Dear Mr. Swahn: RE: Set-Off for Donald Swahn SCTM~1000-123-8-8 It has been nearly a year since the environmental review of your application was completed. A final Hearing on your application cannot be set until you receive Health Department approval. Please indicate in writing to the Board if you plan to continue with your set-off, or if you wish the file to be closed. Very truly yours, Bennett Orlowski, Jr. Chairman PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Rilchie Latham. Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD scott L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 December 4, 1992 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, NY 11952 RE: Set-Off for Donald Swahn 8CTM%1000-123-8-8 Dear Mr. Swahn: It has been nearly a year since the environmental review of your application was completed. A final Hearing on your application cannot be set until you receive Health Department approval. Please indicate in writing to the Board if you plan to continue with your set-off, or if you wish the file to be closed. Very truly yours, Bennett Orlowski, Jr. Chairman PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 November 25, 1991 Donald Swahn Park Avenue P.O. Box 283 Mattituck, New York 11952 RE: Set off for Donald Swahn SCTM$1000-123-8-8 Dear Mr. Swahn: Enclosed please find a copy of the revised Negative Declaration with the corrected location. If you have any questions, please do not hesitate to contact this office. Very truly yours, Bennett Orlowski, Jrv Chairman Encl. PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 PLANNING BOARD OFFICE TOWN OFSOUTHOLD State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination of Non-Significance Fax (516) 765-1823 November 18, 1991 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: Proposed set-off for Donald and Dorothy Swahn SCTM#: Location: 1000-123-8-8 S/S of Park Avenue and Bungalow Lane in Mattituck SEQR Status: Type I (X) Unlisted ( ) Conditioned Negative Declaration: Yes ( ) No (X) Description of Action: Set off of a 22,000 square foot parcel from a 58,500 square foot parcel, each with an existing single family dwelling. Page 2 Donald and Dorothy Swahn SEQR Negative Declaration Con't. Reasons Supporting This Determination: An environmental assessment has been submitted, reviewed and it was determined that no significant adverse effects to the environment were likely to occur should the project be implemented as planned. Because there has been no correspondence received from the Department of Health Services in the allotted time, it is assumed that there are no comments or objections from that agency. Because there has been no correspondence received from the New York State Department of Environmental Conservation in the allotted time, it is assumed that there are no comments or objections from that agency. Since the applicant is not proposing to construct any new structures the project will not increase the intensity of land use, increase demand for services or further impact unique environmental resources. In addition, the project will not set an unwarranted precedent due to the fact that the uses presently exist on the site. For Further Information: Contact Person: Robert G. Kassner Address: Planning Board Telephone Number: (516) 765-1938 cc: Suffolk County Department of Health Services Suffolk County Planning Commission Robert Green, DEC Commissioner Cramer, Voorhis & Associates, Inc. Judith Terry, Town Clerk Building Department Applicant PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF $OUTHOLD November 19, 1990 Donald Swahn P. O. Box 283 Park Avenue Mattituck, New York 11952 SCOTF L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 RE: Set off for Donald Swahn SCTM#1000-123-8-8 Dear Mr. Swahn: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, November 18, 1991. RESOLVED to override the November 7, 1991, Suffolk County Planning Commission report for the following reasons (numbers correspond to numbers in report): Since the applicant is not proposing to construct any new structures, the project will not increase the intensity of land use, increase demand for services, or further impact unique environmental resources. In addition, the project will not set an unwarranted precedent, due to the fact that the two residences presently exist on the site. A ten foot wide right of way on Lot one gives Lot two access to Park Avenue. Contact this office if you have any questions regarding the above. Very truly yours, Bennett Orlowski, Jr. Chairman Encl. cc: Suffolk County Planning Commission PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OFSOUTHOLD State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination of Non-Significance SCOTF L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 November 18, 1991 This notice is issued pursuant to part 617 of the implementing regulations pertaining to Article 8 (~tate 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: Proposed set-off for Donald and Dorothy Swahn SCTM#: Location: 1000-123-8-8 N/S Route 25, across from Bray Avenue, Mattituck SEQR Status: Type I (X) Unlisted ( ) Conditioned Negative Declaration: Yes ( ) No (X) Description of Action: Set off of a 22,000 square foot parcel from a 58,500 square foot parcel, each with an existing single family dwelling. Page 2 Donald and Dorothy Swahn SEQR Negative Declaration Con't. Reasons Supporting This Determination: An environmental assessment has been submitted, reviewed and it was determined that no significant adverse effects to the environment were likely to occur should the project be implemented as planned. Because there has been no correspondence received from the Department of Health Services in the allotted time, it is assumed that there are no comments or objections from that agency. Because there has been no correspondence received from the New York State Department of Environmental Conservation in the allotted time, it is assumed that there are no comments or objections from that agency. Since the applicant is not proposing to construct any new structures the project will not increase the intensity of land use, increase demand for services or further impact unique environmental resources. In addition, the project will not set an unwarranted precedent due to the fact that the uses presently exist on the site. For Further Information: Contact Person: Robert G. Kassner Address: Planning Board Telephone Number: (516) 765-1938 cc: Suffolk County Department of Health Services Suffolk County Planning Commission Robert Green, DEC Commissioner Cramer, Voorhis & Associates, Inc. Judith Terry, Town Clerk Building Department Applicant COUNTY OF SUFFOLK PATRICK G. HALPIN SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF PLANNING ARTHUR H. KUNZ DIRECTOR OF PLANNING November 7, 1991 Mr. Bennett Orlowski, Jr., Chairman Town of Southold Planning Board Main Road Southold, New York 11971 Re: Minor Subdivision - Donald & Dorothy Swahn Southerly side of Park Avenue, 896 feet east of Marratooka Road, Mattituck, Southold, New York Dear Mr. Orlowski: The Suffolk County Planning Commission at its regular meeting on November 6, 1991, reviewed the proposed subdivision plat, entitled, "Minor Subdivision - Donald & Dorothy Swahn" referred to it pursuant to Section A14-24, Article XIV of the Suffolk County Administrative Code. The attached Resolution signifies action taken by the Commission relative to this application. Very truly yours, Arthur H. Kurtz Director of Planning Fr~nk'Dowli~g, Sr. Planner Subdivisi~ Review Division File: S-SD-91-11 FD:mb Attachment cc: J. Baler, C.E., SCDHS VETERANS MEMORIAL HIGHWAY RAUPPAUGE. L.L NEW YORK 11788 File No. S-SD-91-11 Resolution No. ZSR-91-167 of Suffolk County Planning Commission Pursuant to Sections A14-24, Article XIV of Suffolk County Administrative Code WHEREAS, WHEREAS, WHEREAS, RESOLVED, pursuant to Sections A14-24, Article XIV of the Suffolk County Administrative Code, a referral was received by the Suffolk County Planning Commission on October 3, 1991, with respect to a proposed plat entitled, "Minor Subdivision - Donald & Dorothy Swahn" submitted by the Town of Southold Planning Board affecting premises located on the southerly side of Park Avenue, 896 feet east of Marratooka Road, Mattituck in the Town of Southold, and said referral was considered by the Suffolk County Planning Commission at its meeting on November 6, 1991 and the Commission has voted to disapprove said referral, Be It Therefore That the Suffolk County Planning Commission hereby approves and adopts the report of its staff as the report of the Commission, Be It Further RESOLVED, That said proposed plat is disapproved for the following reasons: i. Creation of a subdivision with substandard lots, that is, lots whose areas are less than the minimum required by the zoning classification of the property, constitutes an overintensification of land use. Such action could establish a precedent for future subdivision of this kind which would essentially be a circumvention of the Town Board's action taken over the past years to upzone these areas. 2. The proposed subdivision will result in the creation of a landlocked parcel; that is, a parcel that does not have frontage on an existing or proposed public road. The creation of such a lot is contrary to good subdivision layout principles and creates problems as far as access by emergency and service equipment is concerned. This lack of access could result in health, safety and welfare problems for the future residents of the landlocked lot, not to mention potential disputes over the use and maintenance of any right-of-way over an adjacent parcel that may he created for the purpose of access. Motion by: Commissioner Shepard Commission Vote: 11 Present Yeas 11 Nays 0 Abstentions 0 Seconded by: Commissioner Lee Dated November 6, 1991 Hauppauge, New York Suffolk County Planning Commission DEPARTMENT OF PLANNING COUNTY OF SUFFOLK PATRICK G. HALPIN SUFFOLK COUNTY EXECUTIVE ARTHUR H, KUNZ November 7, 1991 Mr. Bennett Orlowskt, Jr., Chairman Town of Southold Planning Board Main Road Southold, New York 11971 Minor Subdivision - Donald & Dorothy Swahn Southerly side of Park Avenue, 896 feet east of Marratooka Road, Mattituck, Southold, New York Dear Mr. Orlowski: The Suffolk County Planning Commission at its regular meeting on November 6, 1991, reviewed the proposed subdivision plat, entitled, "Minor Subdivision - Donald & Dorothy Swahn" referred to it pursuant to Section A14-24, Article XIV of the Suffolk County Administrative Code. The attached Resolution signifies action taken by the Commission relative to this application. Very truly yours, Arthur H. Kunz Director of Planning Fr/ank'bowli~g, Sr. Planner Subdivisi~Review Division File: S-SD-91-11 FD:mb Attachment cc: J. Baler, C.E., SCDHS NOV I2 1991 SOil fH~t9 File No. S-SD-91-11 Resolution No. ZSR-91-167 of Suffolk County Planning Commission Pursuant to Sections A14-24, Article XIV of Suffolk County Administrative Code WHEREAS, WHEREAS, WHEREAS, RESOLVED, RESOLVED, pursuant to Sections A14-24, Article XIV of the Suffolk County Administrative Code, a referral was received by the Suffolk County Planning Commission on October 3, 1991, with respect to a proposed plat entitled, '~inor Subdivision - Donald & Dorothy Swahn" submitted by the Town of Southold Planning Board affecting premises located on the southerly side of Park Avenue, 896 feet east of Marratooka Road, Mattituck in the Town of Southold, and said referral was considered by the Suffolk County Planning Commission at its meeting on November 6, 1991 and the Commission has voted to disapprove said referral, Be It Therefore That the Suffolk County Planning Commission hereby approves and adopts the report of its staff as the report of the Commission, Be It Further That said proposed plat is disapproved for the following reasons: Creation of a subdivision with substandard lots, that is, lots whose areas are less than the minimum required by the zoning classification of the property, constitutes an overintensification of land use. Such action could establish a precedent for future subdivision of this kind which would essentially be a circumvention of the Town Board's action taken over the past years to upzone these areas. The proposed subdivision will result in the creation of a landlocked parcel; that is, a parcel that does not have frontage on an existing or proposed public road. The creation of such a lot is contrary to good subdivision layout principles and creates problems as far as access by emergency and service equipment is concerned. This lack of access could result in health, safety and welfare problems for the future residents of the landlocked lot, not to mention potential disputes over the use and maintenance of any right-of-way over an adjacent parcel that may be created for the purpose of access. Motion by: Commissioner Shepard Commission Vote: 11 Present Yeas I1 Nays 0 Abstentions 0 Seconded by: Commissioner Lee Dated November 6, 1991 Hauppauge, New York Suffolk County Planning Commission CRAMER, V~ ,~//~OCIATES ENVIRONMENT~G CONSULTANTS Mr. Bennett Orlowski, Jr. Chairman Southold Planning Board Town Hall, 53095Main Road P.O. Box 1179 Southold, NY 11971 Re: Donald and Dorothy Swahn Minor Subdivision SCTM No. 1000-123-8-8 Dear Benny: November 6, 1991 As per your request, we have completed the review of the above referenced minor subdivision in order to prowde input to the Planning Board regarding the environmental significance of this action. Tasks and completed activities are identified as follows: 1. Review Part I LEAF The parcels have been field inspected by CVA, and the LEAF have been reviewed and amended as necessary. Copies of same are attached. Prepare Part II LEAF The Part II LEAF checklist has been compl.eted for the project and is also attached. Additional information concerning our findings are included below. Advise as Necessary The parcels have been inspected and environmental references concerning the site and area have been consuIted. The project site is currently used for two single family dwelling units. The site is 1.343 acres in size. The project involves the division of the ~p,ro~perty into. o.ne 22?000 squ.are foot lot (Lot 1) and one 36,500 square foot lot (Lot z) ?r two ex~stmg single family dwelhngs. In addition, Lot 1 would contain a ten foot ngnt way on its western perimeter to provide future access to Lot 2 should it be necessary. The site is zoned R-40, requiring a lot yield based upon 40,000 square foot lots or greater. The proposed project would create two under sized lots and would require a lot size variance from the Zoning Board of Appeals. Field inspection finds that Lot 2 has approximately 100 feet of frontage on the Great Peconi~c Bay .and is in a Critical Environmental Area. The overall topography of the site is tlat with the exception of the area nearest the bay which is dominated by a s.table slope. The site is subject to human impacts presently resulting from existing site uses. The southern portion of the of Lot 2 is adjacent Great Peconic Bay and has a existing bulkhead at the base of the slope. The land in this area rises from the beach area to the top of the bank approximately 10-50 feet landward of the beach. The existing house on Lot 2 is located on fiat upland terrain, approximately 75 feet away from the top of the bank. The remainder of LOt 2 includes a common gravel driveway and 54-2 NORTH COUNTRY ROAD, MILLER PLACE, NY 11764 (516) 331-1455 P~el 3 Swahn Minor Subdivision Review of Long EAF 1.andscaped areas with accessory structures (i.e. patio) attached to the house and a ~letached storage shed. The bulkhead on this lot contains vast amounts of natural vegetation and the slope is s.table. The !ot contains landscaped areas and specimen tree thorough the front port~on of the site. The specimen trees include cedar, oak, maple and pine trees. Lot 1 is the 22,000 square foot lot and contains a single family dwelling unit. This site presently shares a common drive with lot 2. The terrain in is this area is relative flat. The site contains a lawn area with few ornamental species and specimen tree throughout the site. The trees species include as oak, maple andpine. Since the applicant is not proposing to. construct any new structures, the proje.ct will no.t increas.e the intensity of land use, increase demand for services or further ~mpact umque environmental resources. In addition, the project will not set an unwarranted precedent, due to the fact that the uses presently exist on the site. Lot 2 is the most sensitive on site, and the applicant should be aware that any activity within 75 of the mean hish water mark will require review by the Board of Trustees under the Wetlands Ordinance. If the Board is in agreement with the findings and facts of this review, we feel that a Negative Declaration is appropriate for this project. I hope .this letter provides the board witl~ the inlOrmation needto continue the review of this project. We would be pleased to provide additional input upon request. Please do not hesitate to call if you have any questions. enc: Part I/II LEAF CRAMER, V~ {,~&SOCIATES ENVIRONMENT~~G CONSULTANTS Page 2 " 617.21 R Appendix A i i.! · State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FO SOUTHOLB TOWN · . PtANNING B0,~RD Purpose: The full EAF is designed to help applicants and agencies determine, in an ~,,,~,y ,-,~nn~r, whe[ner a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge Of the environment or may be technically expert in environmental analysis. In 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 process has been orderly, comprehensive in nature, yet flexible to allow introduction of information to fit a project or action. · Full EAF Components: 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; Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially- large impact. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type 1 and Unlisted Actions Identify the Portions of EAF completed for this project: ~ Part I ~Part 2 ~lPart 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. [] B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaralion will be prepared.* [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions ,C Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Date 1--PROJECT IN FORMATIOe ., Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effec~ on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considerey as part of the application for approval and may be subject to further verification and public review. Provide an,/addition,[ information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not involw new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specif'~ each instance. LOCATION (~F ACTION (include S!reet Address Municipality and County) NAME ~F APPLICANT/SPONSOR '~//~/' ~F'~'~n~-~/'~ ADDRESS BUSINESS TELEPHONE hlTY/PO NAME OF OWNER (If different) ADDRESS  T~ ZIP CODE BUSINESS TELEPHONE ( ) CITY/PO sTATE ZIP CODE DESCRIPTION OF ACTION -7-I') c: Please Complete Each Question-Indicate N.A. if not applicabl~ A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1, Present land use: [:]Urban nlndustrial [3Forest nAgric.ulture 2. Total acreage of project area: F/'' ~/~ acres. APPROXIMATE ACREAGE 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 ~0 ~4./'A-T~__..~i~ ~/~7/'/'~-~ Unvegetated [Rock, earth or fill) A Roads, buildings and other paved'~urfaces · Other [Indicate type) I/L_-~.~ I (')~I~/'T t I~F / ~Commercial (]Other '~LResidential (suburban) [3Rural (non-farm] / ~,~RESENTLY AFTER._CJDMPLETION acres /. / I~'/ acres acres acres acres acres acres acres acres . (~)o~. ~:~' 6o acres acres acres acres ' C~ f-) ~-;~ acres acres acres 3. What is predominant soil type(s) on project site? ~'~//t,"/t~'d_.)C'T,/--/~.~'~'/~,/~"~,~ ~- ~c7C/'? f'p//.~y ~7 a. Soil drainage: [3Well drained /~-t~ % of ~ite OModerately well drained % of site . [3Poorly 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 Land Classification System? acres. (See I NYCRR 370]. ~ ~ 4. Are there bedrock outcroppings on project site? [3Yes ~?o a. What is depth to bedrock? --~,-2670~ .~,///////'~ [in feet) .... 2 5. Approximate percentage of proposed site with slopes: )~-10% ~'~'~' [~10-15 % []15% or g a building, site, or district, li~ted on the State or the National 6.IS project substantially contiguous to, or ~gntain Registers of Historic Places? I-lyes {~''. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? F]Yes 8. What is the depth of the water table? /'~ (in feet) 9. Is site located over a primary, principal, or sole source aquifer? ~Yes ~o 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? ~Yes ~o 11. Does project site c~tain any species of plant, or animal life that is identified as threatened or endangered? Identif~ each species ~ ~ 12. Are there an~ unique or unusual land forms on the project site? (i.e, cliffs, dunes, other geological formations) 13. Is the project si~resently used by the community or neighborhood as an open space br recreation area? ~Yes ~o If yes, explain 14. Does the present~e include scenic views known to be important to the community? gYes 15. Streams within or contiguous to project area: a. Name of Stream and name of River to which it is tributary ~ ~ ~ 16. Lakes, ponds, wetland are/~ within or, contigen)us to proje~t,~rea: ~ ~ 17. Is the site served byexisting public utilities? ~es ~O ~ ~ - a) If Yes, does sufficient capacity exist to allow connection? gYes ~No b) If Yes, will improvements be necessary to allow connection? ~Yes ~No 18. Is the site located in an agricultur~istrict certified pursuit to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? ~Yes ~o 19. Is the site located in or substantially contiguou~ to a Critical Environmental Area design~ed pursuant Article 8 of the ECL, and6NYCRR 6177 ~es ~o --T~ ~Ce~zT ~C,n,C c~uu~ to 20. Has the site ever been used for the disposal o~ solid or hazardous wastes? ~Yes ~o B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor I ,~ b. Project acreage to be developed: t~ acres initially; 1~.gT I c. Project acreage to remain undeveloped acres. LDT~ d. Length of project, in miles: -~- (If appropriate) e. If the proiect is an expansion, indicate percent of expansion proposed ~ %; f. Number of off-street parking spaces existing ~' ; proposed g. Maximum vehicular trips generated per hour ~ (upon completion of project)? h. If residential: Number and type of t~ousing units: //~'~q.~'- One Family Two Family Multiple Family Condominium Ultimately ^/ i. Dimensions (in feet) of largest proposed structure l'~ height; width; __ _ length. j. Linear feet of frontage along a public thoroughfare project will occupy is? ,/~ff'~ ft. acres. acres ultimately.~'~t- 2. How much natural material (i.e., ) will be removed from the 3. Will disturbed areas be reclaimed? DYes ~-No I~N/A a. If yes, for what intended purpose is the site being reclaim?? b. Will topsoil be stockpiled for reclamation? l-lYes ~[~o / c. Will upper subsoil be stockpiled for reclamation? i-lYes 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? i//O~~ . acres. 5. Will any matu?/orest (over 100 years old) or Other locally-important vegetation be removed by this project? [~Yes ~i~xN o 4 ' 6. If single phase pioject: Anticipated period of construction 0 months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated ~ (number). b. Anticipated date of commencement phase I month c. Approximate completion date of final phase month d. Is phase I functionally dependent on subsequent~/~ses? I-lYes I-INo 8. Will blasting occur during construction? DYes 9. Number of jobs generated: during construction ~0 ; after project is complete 10. Number of jobs eliminated by this project ./~, ,9~.(c.__ 11. Will project require relocation of any projects or facilities? E3Yes ,~No If yes, explain //"/'~ 131 ~__=~-ons/cu~i¢ yards year, (including~emolition). year. 12. Is surface liquid waste disposal involved? I-lYes ,~No a. if yes, indicate type of waste (sewa[~e, i~dustrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? []Yes ./1~o Type 14. Will surface area of an existing water body increase or decrease by proposal? I-lYes Explain / 15. Is project or any portion of project located in a 100 year flDod plain? DYes ./ 16. Will the project generate solid waste? DYes ,]~,No a. If yes, what is the amount per month tons b. If '/es, will an existing solid waste facility be used? [l-lYes E]No c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain ~Yes I-INo 17. Will the project involve the disposal of solid waste? I~Yes a. If yes, what is the anticipated rate of disposal? tons/month. b. If yes, what is the anticipated site life? years. 18. Will project use herbicides or pesticides? E]Yes '~No 19. Will project routinely produce odors (more than one hour per day)? E3Yes 20. Will project produce operating noise exceeding the local .ambien/~' noise 21. Will project result in an increase in energy use;~ f-lYes If yes , indicate type(s) levels? ~lYes 22. If water supply is from wells, indicate pumping capacity 23. Total anticipated water usage per day /'~,//4 gallons/day. 24. Does project involve Local, State or Federal funding? DYes If Yes, explain .? gallons/minute..~ ~"~lv'ltT-'~ l~_/,I.~_~ /¢6 ~/vt ~w-~. _-~- 'J No 4 23. Approvals Required: TypJ Submittal Date City, Town, Village Board r-lYes ONo City, Town, Village Planning Board '~J~Yes ONo City, Town Zoning Board ,~Yes [No City, County Health Department I-lYes I-INo Other Local Agencies OYes I-INo Other Regional Agencies []Yes ~No State Agencies OYes CINo Federal Agencies I-lYes [No C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? RYes I-iNo If Yes, indicate decision required: I~zoning amendment ~zoning variance Ospecial use permit ~'subdivision Osite plan Onew/revision of master plan ~lresource management plan I~other 2. What is the zoning classification(s)of the site? '!~-/--~'~/ Z~z~)~-~c/7~/"..~ 3. What is the maximum potential development of the site if developed as permitted by tee present zoning? 4. What is the proposed zoning of the site? 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? I~Yes ,,~No 7. What are the predominant land use(s) and zoning cla~sificationswithin a % mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a ~,4 mile? ,,t~es ONo 9. If the proposed action is the subdivision of land, how many lots are proposed? ~ a. What is the minimum lot size proposed? ~:;~7-/ ,~.~-'~d..~'~*~ ~/~'(z/- ~Z- ~ , ~'-"~'~ 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? ~Yes ,~'No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? ~lYes ./~No a. If yes, is existing capacity sufficient to handle projected demand? I-lYes /~-No 12. Will the proposed action result in the generation of traffic significantly above present levels? I-lYes ,,,~o a. If yes, is the existing road network adequate to handle the additional traffic? C1Yes D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification ~E'~-y//=-~-~=--~ ~.>'* c~7_ l/~-t- ,~-~.'e ~/~/~ ~ ~o~'~ Icertifytbat the information Rrovided aboveis ~rue to the best of myknowled~e.~/~/),/ If the action is in the Coastal Area, and you are a state agency, complele the Coaslal Assessmenl Form before proceeding with tEis assessment. 5 Part 2--PR IMPACTS AND THEIR Mt~iIi~TUDE Responsibility ol Lead Agency General information (Read Carefully) · In completing the form the reviewer should be guided by the question: Have my responses and determinations been reasonable~ The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily significant. Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simply asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Poten{ial Large Impact response, thus requiring evaluation in Part 3. · The impacts of each project, on each site, in each locality, will vary. Therefore, the examples are illustrative and have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to answer each question. · The number of examples per question does not indicate the importance of each question. · In identifying impacts, consider long term, short term and cumlative effects. Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there wilt be any impact. b. Maybe answers should be considered as Yes answers. c. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential size of the impa.ct. 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 I. Will the proposed action result in a physical change tot~ project site? //1~, O [~YES Examples that would apply to column 2 ' · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than I year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway. · Other impacts 2. Will there be an effect t ..... ,y un,que or unusual land forms found on the site? {i.e., cliffs, dunes, geological formations, etc.)~O [:]YES · Specific land forms: / - 6 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes [:]No [] [] [:]Yes []No L-] [] I-qYes []No [] [] []Yes I~No [] [] []Yes []No [] [] []Yes r-lNo [] [] []Yes []No [] [] []Yes []No [] [] E]Yes []No ~ ~ ~Y,s ~No IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) ;J~qO [DYES 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. · £xtension of utility distribution facilities through a protected water body. · Construction in a designated freshwater or tidal wetland. · Other impacts: 4, Will proposed action affect any non-protected existi~ng~or new body of water? .,I~N O [DYES / . 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: 5. Will Proposed Action affect surface or groundwater ~ ,,¢ quality or quantity? /~,NO [DYES Examples tha~ 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 §allons per minute pumping capaciW. · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conve'red 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 war. er to the exte:~t 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 anti/or industrial uses whicil may require new or expansion of existing waste treatment and/or storage facilities. · Other impacts: L 6. Will proposed action alter drainage flow or patte~)',or surface water runoff? ~O E3YES £xamples that would apply to column 2 · Proposed Action would change flood water flows. 7 1~ 2 3 Small Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] ~]Yes I-]No [] [] l-lYes [-]No [] [~-' []Yes I~No [] [] . []Yes []No [] [] []Yes []No [] ~ ~Yes ~No Q ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Y'es ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No · Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns. · Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7. Will proposed action affect air quality? ~O [:]YES Examples that would apply to column 2 ' · Proposed Action will induce 1,000 or more vehicle trips in any given hour. · Proposed Action will result in the incineration of more than I ton of refuse per hour. * Emission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million BTU's per hour. · Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. · Other impacts: IMPACT ON PLANTS AND ANIMALS ]. Will Proposed Action affect any threatened or en~od species~ [3YES Examples that would apply to column 2 Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site. Removal of any portion of a critical or significant wildlife habitat. Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. Other impacts: Will Proposed Action substantially affect non-threat~g~/or non-endangered species? /~NO I-lyES 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 Will the Proposed Action affect agricultural land re~g~es~ Examples that would apply to column 2 ~'~O I~YES The proposed action would sever, cross or limit access to agricultural and (includes cropland, hayfields, pasture, vineyard, orchard, etc.) 8 Moderate Impact Large Impact Can Impact Be Mitigated By Project Change E~] Yes ~No ( I~Yes [-1No I~Yes I-1No f/Yes I-3No ~]Yes I~No ~]Yes I--]No ~]Yes [No [~Yes ['~No ~-~Yes []No [:]Yes [:3No [~Yes [~]No [:]Yes I--]No I-'lYes [No [:]Yes [:]No ~]Yes [~]No [~Yes /'-]Yes [~No L""'"'"~ · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultural District, more than 2.5 acres of agricultural land. · The proposed action would disruptor prevent installation of agricultural land management systems (e.g., subsurface drain lines, outlet ditches, strip cropping); or create a need for such measures (e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCE,~ .// 11. 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 · Proposed land uses, or proiect components obviously different from or in sharp contrast to current surrounding land use patterns, whether man-made or natural · Proposed land uses, or proiect components visible to users of aesthetic resources which will eliminate or significantly reduce their enioyment of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: ~ IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure f'e~storic, pre- historic or paleontological importance? ./)~O fqYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on tile NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? '~// Examples that would apply to column 2 /[~O I-lyEs ~ The permanent foreclosure of a future recreational bpportunity. · A major reduction of an open space important to the community. · Other impacts: 9 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] I--lYes []No [] [] []Yes [-iNo [] [] []Yes I~No [] [] r-lYes I--INo [] [] ~lYes []No [] [] []Yes r'-I No [] [] [~]Yes []No [] [] []Yes ~lNo [] [] ~¥es E]No [] [] J~]Yes J~No [] [] []Yes r~No [] ~ ~Yes' ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No IMPACT ON TRANSPOIq N 14. Will there be an effect to existing transportation Examples that would apply to column 2 ./~NO [YES · Alteration of present patterns of movement of people and/or goods. · Proposed Action will result in major traffic problems. · Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sou~f fuel or energy supply? Examples that would apply to column 2 /~O []YES · 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 T6. Will there be objectionable odors, noise, or vibra~,L~s a resul~ of the Proposed Action? Examples that would apply to column 2 /~NO []YES · Blasting within 1,500 feet of a hospital, school or other sensitive facility. · Odors will occur routinely [more than one hour per dayl. · 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 7. Will Proposed Action affect public health and sal/~O [3YES 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 low 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 ~as or other flammable liquids. Proposed action may result in the excavation or other disturbance ,vithin 2,000 feet of a site used for 'the disposal of solid or hazardous Other impacts: 10 1 Small to Moderate Impact Potential Large Impact Impact ~3e Mitigated By Project Change ['-]Yes [~Yes [~]No [~]Yes [~]No [~]Yes E~]No E~]Yes I--INo [~Yes [~No ~]Yes [~No ~]Yes E~]No [~Yes [~No [~]Yes [~]No [::]Yes I-]No ~]Yes [~No I--lYes J--]No r-]Yes [~N0 I--lYes [~]No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the exis in~ommunity~ Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. Proposed action will conflict with officially adopted plans or goals. Proposed action will cause a change in the density of land use. Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future proiects. · Proposed Action will create or eliminate employment. ' Other impacts: Small to Moderate Impact 2 3 -- Potential Can Impact Be Large Mitigated By Impact Project Change [] []Yes E]No [] []Yes []No [] I--lyes []No [] []Yes E]No [] []Yes []No [] []Yes I'-INo [] []Yes [~No [] []Yes []No [] []Yes []No 19 Is there, or is there likely to be, public contro~,e=~v related to potential adverse environmental impacts? /~0 E]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 _£ f Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact,s) is considered to be potentially large, even if the impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe {if applicable) how the impact could be mitigated or reduced to a small to moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibiJity, including permanently lost resources ol~ value · Whether the impact can or will be controlled · The regional consequence of the impact · Its potential divergence from local needs and goals · Whether known objections to the project relate to this impact. (Continue on attachments) 11 PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham. Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTI' L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 October 22, 1991 Roger Evans Environmental Analyst New York State Department of Environmental Conservation SUNY Building #40 Stony Brook, NY 11794 RE: Minor Subdivision for Donald Swan SCTM# 1000-123-8-8 Dear Mr. Evans: This is in response to your request of October 8, 1991, for additional information on the above named subdivision. This project is a Type 1 action due to the fact that it is located within 500' of Peconic Bay, a designated Critical Environmental Area. This parcel is located in a one acre (R-40) district. The lots do not meet the requirments of this district. However, a variance for insufficient lot area has been granted by the Zoning Board of Appeals. It has been the Planning Board's policy to send all lead agency coordination requests to you for review. However, as you have requested, the Planning Board will change it's policy and will only send coordination letters to you for projects requiring DEC permits. If you have any questions, or require additional information, please contact this office. Very truly yours, Bennett Orlowski, Jr. Chairman 00-17-1 (5/76) ~ Formerly GA 4 NEW YORK STA PARTMENT OF ENVIRONMENTAL CONSERYATION TRANSMITTAL SLIP FROM RE: [] Please Handle [] Prepare Reply [] Prepare Reply for_ Signature [] Information [] Approval [] Prepare final/draft in _ Copies [] Comments [] Signature [] File [] Return to PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham. Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 SCOTr L. I~ARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 PLANNING BOARD OFFICE TOWN OF SOUTHOLD ,Fax (516) 765-1823 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 Environmental Assessment Form (EAF) Project Name: Requested Action: the proposal and a completed to assist you in your response. SEQRA Classification: (~) Type I ( ) Un-listed Contact Person: ( 516 )'-'765-1938 The lead agency will determine the need for an environmental impact statement (EIS) on this project. Within thirty (30) days of the date of this letter, please respond in 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). Comments: Please feel free to contact this office for further information. Sincerely, /7 ~ Bennett Orlowski, Jr. Chairman CC: Board of Appeals Board of Trustees Building'Department Southold Town Board ~Suffolk County Dept. o~Health Services NYSDEC - Stony Brook ~5. C. Dept. of Pt~ic--Works~ U.~ ~rm¥ Corp of Engineers ~ ~N~Iv.~. Dept. of Transport~tluTV * Maps are enclosed for your. review Coordinating agencies " 617.21 Appendix A ;~c{[3 .' ~ 'c~ State Environmental Quality Review , ~ ]"~ FULL ENVIRONMENTAL ASSESSMENT FO S0UZHOLDT0WN PLANNING BOARD Purpose: The fuII EAF is designed to help applicants and a~encies determine, in an J=,ly .=.r,ur whemer a projec~ or action may be significanL The question of whether an action may be significant is no~ a[ways easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have ii,tie or no formal knowledge of the environmen~ or may be technically expert in environmental analysis. 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 ~o provide a method whereby apphcants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet flexible to allow introduction of ~nformation to fi~ a project or action. Full EAF Components: The full EAF is comprised of three parts: Part 1: Provides objective data and information about a ~iven 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 identifyin~ the range of possible impacts that may occur from a project or action. It provides guidance as ~o whether an impact is bkeJy to be considered ~ma]l to moderate or whether it i5 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' ~hen Part 3 is used to evaJua~e whether or not the impac~ is actually important. DETERMINATION OF SIGNIFICANCE--Type I and Unlisted Actions Identify the Portions of EAF completed for this project: [] Part 1 [] Part 2 []Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if 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. [] B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared. * A Conditioned Negative D~claration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(If different from responsible officer) Date PART1--PROJECTINF AMATION Prepared by Proiect Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a s~gnificant effect on the environment. Please complete the entire form, Parts A through E. Answers to these questions will be considere~ as part of the application for approvaJ and may be subject to further verification and publi( review Provideanvadditiom~. information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not involw? new studies, research or investigation. If information requiring such additional work is unawdlable, so indicate and specify each instance~ NAME OF ACTION LOCATION OF ACTION (Include Street Address. Municipality and County) NAME OF APPLICANT/SPONSOR ADDRESS BUSINESS TELEPHONE NAME OF OWNER (If different) I BUSINESS TELEPHONE ADDRESS __ CiTY/PO I STARE ! Z~P CODE DESCRIPTION OF ACTION ( Please Complete Each Question-Indicate N.A. if not applicabl~ A. Site Description Physical setting of overall project, both developed and undeveloped areas. 1. Present land use: ~Urban I~lndustrial []Forest l~]Agric~J[tu re 2. Total acreage of project area: ~ ~ APPROXIMATE ACREAGE Meadow or Brushland (Non-agricultural) Forested I~Commercial ~]Other "~Residential suburban) (~Rurat (non-farm 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"~urfaces ~ Other (Indicate type) ~L-~.~ f !)~- I~ T , t~ / 3. What is predominant soil type(s) on project site? a. Soil drainage: C]Well drained /'~YG % of ~ite {~]Poorly drained % of site PRESENTLY AFTER COMPLETION ......... acres ............... acres E~Moderately well drained .... % oi s~te b. If any agricultural land is involved, bow many acres of soil are classified within soil group 1 through 4 of the NY Land Classification System? acres. (See 1 NYCRR 370) 4. Are there bedrock outcroppings on proiect site? ~Yes ~No a. What is depth to bedrock? (in feet) 51' ,Rpproximate percentage of proposed prWt site with slopes: J~0-10% D10-15% ' ' [~]15% or greater 6. Is project substantially contiguous to, or c,o,,ntain a building, site, or district, li~ted on the State or the National Registers of Historic Places? I-lyes [~Yes [No '. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? 8. What is the depth of the water table? [~ (in feet) 9. Is site located over a primary, principal, or sole source aquifer? 1'3Yes 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? I~Yes 11. Does project site ,c~tain any species of plant or animal life that is identified as threatened or endangered? ~tYes~o According to Identify each species 12. Are thereDYesany un~.q~eoOr,,~ unusualDescribeland forms on the proiect site? (i.e., cliffs, dunes, other geological formations) 13. Is the project site]presently used by the community or neighborhood as an open space or recreation area? V1Yes '~o If yes, explain 14. Does the present s~e include scenic views known to be important to the community? [Yes 15. Streams within or contiguous to project area: a. Name of Stream and name of River to which it is tributary 16. Lakes, ponds, wetland are/~ within or contig~u~us to proje~t.,~rea: a. Name t ~('" c-~ ~,~/~ C. '//.~7~- c¢ ,/' Z'~ ,~ ,/J ~ ~""~ ~'( ~aa c r e s ) 17. Is the site served by existing public utilities? I~/Yes a) If Yes, does sufficient capacity exist to allow connection? I~Yes [No b) If Yes, will improvements be necessary to allow connection? I-lYes I~No 18. Is the site located in an agriculturaij~istrict certified pursua~nt to Agriculture and Markets Law, Article 2S-AA, Section 303 and 304? [Yes 19. is the site located in or substantially contiguou~ to a Critical Environmental Area designated pursuant to Article of the ECL, and 6 NYCRR 6177 I~Yes ,~o 20, Has the site ever been used for the disposal of solid or hazardous wastes? []Yes L B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acreage to be developed: ~ acres initially; c. Project acreage to remain undeve!oped acres. d. Length of project, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed %; f. Number of off-street parking spaces existing . ;'proposed g. Maximum vehicular trips generated per hour (upon completion of project)? h. If residential: Number and type of housing units: ]~/~:~q-~:- One Family Two Family Multiple Family UItimatelYLinear feet of ~ /'~ --widtr, h; i. Dimensions (in feet) of largest proposed structure d height; frontage along a public thoroughfare project will occupy is? /~ 3 acres. acres ultimately. length. ft. Condominium 2. How much natural m~..erial (i,e., rock, earth, etc.)will be removeu from the site? 3. Will disturbed areas be rec a med? E3Yes ko []N/A a. if yes, for what intended purpose is the site being reclmme~? b. Will topsoil be stockpiled for reclamation? []Yes 1~o c. Will upper subsoil be stockpiled for reclamation~ []Yes [~No ,~ 4. How many acres of vegetation Itrees, shrubs, ground covers) will be removed from site? I', 5. Will any matur_e/forest (over 100 years old) or other locally-important vegetation be removeci bv this prolect? []Yes [~No 6. If single phase project: Anticipated period of construction t~ O months, (including demolition) 7. ]f multi-phased: a. Total number of phases anticipated ~'2 (number). b. Anticipated date of commencement phase 1 _ month c. Approximate completion date of final phase month d. Is phase I functionally dependent on subsequent~p~ses? []Yes 8. Will blasting occur during construction;~ []Yes ,~No 9. Number of jobs generated: during construction /'~0 ; 10. Number of jobs eliminated by this project .~,' ~},b.{ ~' 11. Will project require relocation of any projects or facilities,' []No yards year, (inciudmg-~emolition) after project is complete __ []Yes .,~o If yes, explain 12. Is surface liquid waste disposal involved? []Yes E~No a. If yes, indicate type of waste (sewage, i~dustrial, etc.) and amount _ b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? []Yes []No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain []Yes ~o 15. Is project or any portion of project located in a 100 y;ar flood plain? []Yes 16. Will the project generate so[id waste? []Yes Jgl,No a. If yes, what is the amoun~ per month tons b. If yes, will an existing solid waste facility be used? []Yes []No c. If yes, give name ; location d. Will any wastes nol go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain 13Yes ~_~No -( 17. Will the project involve the disposal of solid waste? []Yes ~(No a. If yes, what is the anticipated rate of disposal? _ tons/month. b. If yes, what is the anticipated site life? years. use herbicides or pesticides? ~Yes 'l~No project 19. Will project routinely produce odors (more than one hour per day)? E:JYes /~,No 20, Will prolect produce operating noise exceeding the local ~ambi~t, noise levels? []Yes 21. Will proiect result in an increase in energy use? []Yes ,J~3'No If yes , indicate type(s) .'7 22. If water supply is from wells, indicate pumping capacity gallons/minute 23. Total anticipated water usage per day gallons/day. ? 24. Does project involve Local, State or Federal funding? RYes o If Yes, explain 4 25. Approvals Required: Type Submittal Date City, Town, Village Board [Yes (No City, Town, Village Planning Board "~gYes I-lNo City, Town Zoning Board C1Yes I-TNo City, County Health Department [Yes []No Other Local Agencies [Yes C1No Other Regional Agencies I~Yes []No State Agencies []Yes ~lNo Federal Agencies [Yes []No C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? ,~Yes I-INo If Yes, indicate decision required: J-]zoning amendment ~zoning variance [~speciaJ use permit r-lsubdivision []]site plan rqnew/revision of master plan [resource management plan I-lother 2. What is the zoning classification(s)of the site? '~ 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 4. What is the proposed zoning of the site? 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? ~lYes []No 7. What are the predominant land use{s) and zoning classifications within a % mile radius of proposed action? f 8. Is the proposed action compatible with adjoining/surrounding land uses within a I/~ mile? I~Yes [~No 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? [Yes I-1No 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? I~Yes ~lNo a. If yes, is existing capacity sufficient to handle projected demand? [Yes IqNo 12. Will the proposed action result in the generation of traffic significantly above present levels? F-lYes I-INo a. If yes, is the existing road network adequate to handle the additional traffic? [Yes ~lNo D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I cert'fyth_at theinforma~io~ p, rovi, ded a. boveis t~uetothebest of myknowJedge. ~/)/, ApplicantjS~gr~sor N~,e -'-'~,/~/~/a 5~'~ '~,~v/g/-//~, Date .' ~' / Slgnature.~:::~~ ,~., .~.-//~ . ~L~..,~...~.~. Title If lhe action is Jn lhe Coastal Area, and you are a stale agency, complele lhe Coaslal Assessmenl Form before proceeding with this assessment. 5 r t 2--PROJECT IMPACTS AND EIR MAGNITUDE Responsibility of Lead Agency General Information (Read Carefully) · In completing the form the reviewer should he guided by the question: Have my responses ~ /( determinat!on~ been reasonable? The reviewer is not expected to be an expert environmental analyst. · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessardy signiticanL Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 ~impR asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wi~erever possibte the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresholds rnay be appropriate for a Potentia~ Large Impact response, thus requirin§ evaluation in Part ~ · The impacts of each proiect, on each site, in each locality, will vary Therefore, the examples are illustrative and have been offered as guidance. They do not constitute an exhaustive list of impacts and thresholds to unswer each question · The number of examples per question does not indicate the importance of each question · In identifying impacts, consider long term, short term and cumlative effects. Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact b. Maybe answers should be considered as Yes answers c. If answering Yes to a question then check the appropriate box (column ! or 2) to indicate the potential size of the ]mpa.ct. If impact threshold equals or exceeds any example provided, check column 2. If impact wilt occur but threshold is lower than example, check column 1 d, If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3 e. If a potentially large impact checked in column 2 can be mitigated by change(s) in the proiect to a small to moderate impact, also check the Yes box in column 3. A No response indicates that such a reduction is not possible This must be explained in Part 3. I 2 I 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change ~/es [.]No [] ,F~ Yes ~ JNo i L~ E! !liYes LJNo F~ ~ ~ [:~Yes [UNo ~ I rs r-] l_J~ es ~_.z No i .... nYes LJNo IMPACT ON LAND 1. Will the proposed action result in a physical change to.t,~e projec~ site? ,.J~N 0 DJYES Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicJes. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than I year or involve more than one phase or stage. · Excavation for mining purposes that would renrove more than 1,000 tons of natural material (i.e., rock or soil) per year · Construction or expansion of a sanitary landfill · Construction in a designated floodway · Other impacts 2. Will there be an effect ye....,y un.que or unusual rand forms round on the site? (i e,, cliffs, dunes, geological formations, etc )LqNO E]YES · Specific land forms: 6 IMPACT ON WATER 3. Wilt proposed action affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conservation Law, ECL) '~No []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 designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water~ [~NO []YES 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: 5. Will Proposed Action affect surface or groundwater! quality or quantity? '~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. 1[ · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conve,~.ed 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 exte:~t that there will be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroleum or chemical products 8rearer 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: L 6. Will proposed action alter drainage flow or patterns, or surface - water runoff? ~O l-lYE S Examples that would apply to column 2 · Proposed Action would change flood water flows. 7 I '~'i 2 3 Small to Potential Can impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes []No [] [] []Yes []No [] I~' I--lYes I-]No [] [] ~ []Yes ~No [] [] [Z]Yes C]No [] [] []Yes ~lNo [] [] []Yes E3No [] [] []Yes E3No [] [] C]¥es []No [] [] []Yes I~No [] [] []Yes E3No [] [] []Yes []No [] [] E3¥es []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] I~','es []No [] [] []Yes ~]No [] [] [~]Yes [--~No ~ ~ ~Y*~ ~No ~ ~ ~Y*~ ~No · Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns ' Proposed Action will allow development in a designated floodway · Other impacts: IMPACT ON AIR 7 Will proposed action affect air quality? :[~NO L~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 1 ton of refuse per hour. · Emission rate of total contaminants will exceed 5 lbs. per hour or a heat Source producing more than 10 million 13TU's per hour. · Proposed action will allow an increase in the amount of land committed to industrial use. Proposed action will allow an increase in the density of industrial development within existing industriM areas. Other impacts: IMPACT ON PLANTS AND ANIMALS Will Proposed Action affect any threatened or endangered speoes? [~NO [~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 Removal of any portion of a critical or significant wildhfe habitat. Application of pesticide or herbicide more than twice a year, other lhan for agricultural purposes. Other impacts: Will Proposed Action substantially affect non-threatened or non-endangered species? [ZINC []YES Examples that would apply to column 2 'roposed Action would substantially interfere with any resident or nigratory fish, shellfish or wildlife species. )roposed Action requires the removal of more than 10 acres ~f mature forest (over 100 years of age) or other locally important egetation. IMPACT ON AGRICULTURAL LAND RESOURCES Will the Proposed Action affect agricultural land resources? .~NO ~Y~S Examples that would apply to column 2 he proposed action would sever, cross or limit access to agricultural nd [includes cropland, hayfields, pasture, v neyard orchard, etc) 8 1 Small to Moderate Impact 2 Potential Large Impact Can impact Mitigated By C Proiect hange , ~es [.JNo LJ~es ~]Yes ~No LYes LJNo ~e~ ~No ~ ~es ~No -~Yes L~;No [~Yes E~No [~Yes CiNo ~ JYes '-~No -JYes [~No · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultutal District, more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g., subsurface drain lines, outlet ditches, strip cropping); or create a need for such measures {e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES~// 11. Will proposed action affect aesthetic resources? Z~NO I~YES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix 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 of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure q.f/historic, pre- historic or paleontological importance? ~]NO I-lYES Examples that would apply to column 2 · Proposed Action occurring wholly or partially within or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeological sites on the NYS Site Inventory. · Other impacts: IMPACT ON OPEN SPACE AND RECREATION 13. Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that apply to column 2 /[~xNO ~]YES L ~ The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Other impacts: 9 I 2 3 Small 4o Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] r-]Yes []No [] [] []Yes F'-INo [] [] []Yes []No [] [] E3Yes []No [] [] []Yes []No [] [] I--lyes []No [] [] []Yes []No [] [] []Yes []No [] [] E~Yes [~No [] [] []Yes I--{No [] [] E]Yes []No [] [] []Yes' E]No [] [] []Yes []No [] [] []Yes I-]No [] [] E~Yes []No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems? ~{~NO [~YES Examples that would apply to column 2 ~' · Alteration of present patterns of movement of people and/or goods · Proposed Action will result in maior traffic problems. · Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? E~NO ~YES Examples that would apply to column 2 · Proposed Action will cause a greater than 5% increase in the use of any form of energy in the municipality. · Proposed Action will require the creation or extension of an energy transmission or supply system to serve more than 50 single or two family residences or to serve a maior commercial or industrial use. · Other impacts: NOISE AND ODOR IMPACTS 16 Will there be objectionable odors, no se, or vibration as a result of the Proposed Action? ~]NO ~]YES Examples that would apply to column 2 ' · Blasting within 1,500 feet of a hosptal 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 Will Proposed Action affect public health and safety? ~NO ~YES Examples that would apply to column 2 ~ Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pest cides, chemicals, radiation, etc.) in the event of ~ccident or upset conditions, or there may be a chronic Iow level JiSCharge or emission. aroposed Action may result in the burial of "hazardous wastes" in any orm (i.e. toxic, poisonous, highly reactive, radioactive, irritating, n factious, etc.) ;torage facilities for one million or more gallons of liquified natural as or other flammable liquids roposed action may result in the excavation or other disturbance 'ithin 2,000 feet of a site used for the disposal of solid or hazardous aste Hher impacts: 10 1 Small to Moderate Impact Potential Can Impact Be Large Mitigated By Impact Project Change f~ ~No L.~NO IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing community? [~NO E3YES Examples that would apply to column 2 t. · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development wilt create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future projects. · Proposed Action will create or eliminate employment. · Other impacts: I 2 3 Small to Potential i Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] I-lYes [No [] [] []Yes []No [] [] []Yes I--]No [] [] lyes []No [] [] []Yes []--]No [] [] r-lyes []No [] [] t--lYes []No [] ~ ~Yes ~No ~ ~ ~Yes ~No 19 Is there, or is there likely to be, public controve, r}¥ related to potential adverse environmental impacts? [~O [~YES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s) is considered to be potentially large, even if the impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact could be mitigated or reduced to a small to moderate impact by proiect change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is imporlanl. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources oi~ value · Whether the impact can or will be controlled · The regional consequence of the impact · Its potential divergence from local needs and goals · Whether known objections to the proiect relate to this impact. (Continue on attachmentsJ 11 ,4.~4-, ~ ,~ ~7)-9c (517.21 SEQ R r * ~ ' AppendixB Slate Environmental Quality Review /~ Visual EAF Addendum This form may be used to provide additional information relating to Question ! 1 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 overlook 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 ~:orridor of high exposure, such as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake, reservoir or highway designated as scenic? · Municipal park, or designated open space? · County road? · State? · Localroad? Distance Between Project and Resource (in Miles) O-V~ '/~-]/~ V~-3 · 3-5 5+ [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] 0 [] [] [] [] [] [] [] [] [] [] [] Is the visibility of the project seasonal? (i.e., screen'ed by summer foliage, but visible during other seasons) [~Yes I--INo Are any of the resources checked in question 1 used by the public during the time of year during which the project will be visible? F-lYes E]No DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question l, check those which generally describe the surroundinc¢ environment. Within '1/4 mile *! mile Essentially undeveloped Forested [] Agricultural Suburban residential ['3 ~..! 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 *1 miles [~Yes [~No *2 miles []Yes []No *3 miles [~Yes [~No * Distance from project site are provided for assistance. Substitute other distances as appropriate.I EXPOSURE 6. The annual number of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate· CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work [] [] [] Involved in recreational activities Routine travel by residents [] [] At a residence [] [~ r - At worksite [] [] Other [] [] PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham. Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE *OWNOFSOUTHOLD Suffolk County Planning Commision H. Lee Dennison Executive Office Building - 12th Floor Veterans Memorial Highway Hauppauge, New York 11788 SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 S6uthold, New York 11971 Fax (516) 765-1823 , 97/ Attention: Mr. Frank Dowling, Senior Planner Subdivision Review Division Gentlemen: Pursuant to Section A14-24, Suffolk County Administrative Code, the Southold Town Planning Board hereby refers the following propped subdivisign to the Suffolk County Planning Commission: / / Map of-~?/~t. Z0~/~.~.~let/Locality s.c.D.P.W. ToT N01,' S.C. Tax Map No.. Major Sub. Minor Sub. f/ Site Plan __Cluster__ MATERIAL SUBMITTED: Preliminary Plat (3 Drainage Plans (1) Site Plan (1) copies) R~oadProfiles Topogroaphical Map (1) __ Grading Plan (1) (1) Other materials (specify and give nun~ber of copies) Waiver of Subdivision Requirements - See attached sheet CONTINUED REFERRAL CRITERIA: SEQRA STATUS: 1. The project is an (Unlisted~(Type II)Action. 2. A (Negative Declaration) (Positive Declaration) (Determ. of Non-Significance) has been adopted by the Planning Board. 3. E.I.S. statement enclosed. (Yes) (No). 4. The proposed division has received approval from the S.C. Dept of Health. (Yes) (No). Comments: We request acknowledgement of receipt of this referral (Yes) (No) Referral received 19 by Suffolk County Planning Commission and assigned File NO.  .B~ne~~r~.~iery truly yours// Chairman Southold Town Planning Board TOwn Hall Southold, New York 11971 Gentlemen: Re: The following statements are offered for your Consideration in the review of the above-mentioned minor subdivision and its referral to the Suffolk'County Planning Commission: (1) (2) (3) No grading, other than foundation excavation for a residential building is proposed. No new roads are proposed and no changes will be made in the grades of the existing roads. No new drainage structures or alteration of existing structures are proposed. Yours truly, PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 e~ ~ ,! SCOTT L. HARRIS i~?, ,.~ Supervisor !;.~ )~ $~'.":: Town Hall, 53095 Main Road ,' <: P.O. Box 1179 Southold. New York 11971 PLANNING BOARD OFFICE TOWN OF SOUTHOLD .Fax (516) 765-1823 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 Environmental Assessment Form Project Name: Requested Action: find a copy of the proposal and a completed EAF) to assist you in your response. SEQRA Classification: ('~) Type I ( ) Unlisted Contact Person: ~"~dO~"~/~'~. ~ 516)'2765,1938 The lead agency will determine the need for an environmental impact statement (EIS) on this project. Within thirty (30) days of the date of this letter, please respond in 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). Comments: Please feel free to contact this office for further information. Sincerely, ~ Bennett Orlowski, Jr. Chairman cc: Board of Appeals Board of Trustees Building'Department Southold Town Board ~Suffolk County Dept. of Health Services NYSDEC - Stony Brook U.S-_~ C~rp of--Engineers ~.v_~S. Dept. cf Transpozt~iloT~ * Maps are enclosed for your. review Coordinating agencies SENDER: SUBJECT: SCTMg: COMMENTS: SUBMISSION WITHOUT COVER LETTER Appendix A E~R State Environmental Quality Review ,~.P., !.ii~i Jill FULL ENVIRONMENTAL ASSESSMENT FO SOUTHOLD TOWN i · . PLANNING DOARD ] Purpose: The full E^F is designed to help applicants and agencies determine, in an ,~,,y -,~nner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequent- ly, there are aspects of a project that are subjective or unmeasureable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may be technically expert in environmental analysis. In 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 process has been orderly, comprehensive in nature, yet flexible to aJlow 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: Focuses on identifying the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially- large impact. The form also identifies whether an impact can be mitigated or reduced. Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. DETERMINATION OF SIGNIFICANCE--Type 1 and Unlisted Actions Identify the Portions of EAF completed for this project: [] Part 1 [] Part 2 []Part 3 Upon review of the information recorded on this EAF (Parts 1 and 2 and 3 if 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 im.pact on the environment, therefore a negative declaration will be prepared. [] B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* [] C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a posilive declaration will he prepared. * A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency ,£ Print or 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) Date 1 PART 1--PROJECT INFO,.,VlATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether the action proposed may have a significant effect on the environment. Please complete the entire form Parts A through E. Answers to these ques ors will be considere~ as part of theapplicatonforapprovalandmaybesubiecttofurtherverificationandpublicrevicw Prowde any addition& information you believe will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependent on information currently available and will not invotve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and spec if~, each instance. NAME OF ACTION LOCATION OF ACTION (Include Street Address, Municipaldy anct County) NAME OF APPLICANT/SPONSOR I BUSINESS TELEPHONE ADDRESS CITYIPO I STATE ! ZiPCODE NAME OF OWNER (If different) ! BUSINESS tELEPHONE ADDRESS CITY/PO ~JTAFE ] ZIP CODE DESCRIPTION OF ACTION Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed arid undeveloped areas. 1. Present land use: I~Urban I~lndustrial [~JCommercial '~J~esidential (suburban) []Forest I~Agric.ulture E3Other / 2. Total acreage of project area: ~'~ acres. APPROXIMATE ACREAGE 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'~urfaces · / Other (indicate type) ~:.'5 I Oc:,f~l J ! ,~ 1 3. What is predominant soil type(s) on project site? a. Soil drainage: [~Well drained _ /~-G % of site ~]Poorly drained % of site L~Rura[ (non farm) PRESENTLY AETER COMPLETION acres .......... acres [Moderately well drained b. if any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NY[: Land Classification System? acres. (See 1 NYCRR 370). J~ D ' 4, Are there bedrock outcroppings on project site? ~]Yes a. What is depth to bedrock? (in feet) · 5. Approximate percentage of proposed ect site with slopes: J~0-10% __ % [~10-15% % [15% or greater a building, site, or district, li~ted on the State or the National 6. Is project substantially contiguous to, or ~.9,ntain Registers of Historic Places? ~lyes '. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? l-lYes I-INo 8. What is the depth of the water table? /'~) (in feet) 9. Is site located over a primary, principal, or sole source aquifer? I~Yes ~"~o 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? f-lYes ~No 11. Does project site .co/ntain any species of plant or animal life that is identified as threatened or endangered? l~Yes~:~o According to Identify each species 12. Are there any unl~q~eoOr~ unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations) I-lYes Describe 13. Is the project site~resently used by the community or neighborhood as an open space or recreation area? []Yes '~o If yes, explain 14. Does the present s~e include scenic views known to be important to the community? fqYes ,~'N o 15. Streams within or contiguous to project area: ~ a. Name of Stream and name of River to which it is tributary .~C/~t ~ 16. Lakes, ponds, wetland are/a~ within or contig, p~us to proje~t,i~rea: 17. s the s te served by existing public utilities a) If Yes, does sufficient capacity exist to allow connection? []Yes [No b) If Yes, will improvements be necessary to allow connection? []Yes I-TNo 18. Is the site located in an agricultur_al/~istrict certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? [Yes /[~.~o 19. Is the site located in or substantially contiguou,~,to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 6177 I~Yes 20. Has the site ever been used for the disposal of solid or hazardous wastes? I-lYes ~]~o C B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor b. Project acreage to be developed: ~ acres initially; c. Project acreage to remain undeveloped acres. d. Length of project, in miles: (If appropriate) e. If the project is an expansion, indicate percent of expansion proposed %; f. Number of off-street parking spaces existing ; proposed g. Maximum vehicular trips generated per hour (upon completion of project)? h. If residential: Number and type of housing units: /~' ~i~q"T- Family Multiple Family One Two Family Ultimately C~ ~ i. Dimensions (in feet) of largest proposed structure ~ height; width; __ j. Linear feet of frontage along a public thoroughfare project will occupy is? ,/P~"~ ft. £ 3 acres. acres ultimately. Condominium length. 2. How much natural mat I (i.e, rock, earth, etc.) will be removed ,,om the site? 3. Will disturbed areas be reclaimed? [Z]Yes ko [N/A a. If yes, for what intended purpose is the site being reclaim?? b. Will topsoil be stockpiled for reclamation? []Yes ~i~o / c. Will upper subsoil be stockpiled for rec amation? OYes I~o 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? i'YO/x/~- 5. Will any matu[e/forest (over 100 years old) or other locally-important vegetation be removed bv this pro~ect? [Yes [~,No~l' ' 6. If single phase project: Anticipated period of construction _. J~' O months. (including demolition) 7. If multi-phased: a. Total number of phases anticipated ~-) (number) b. Anticipated date of commencement phase 1 _ month c. Approximate completion date of final phase month d. Is phase 1 functionally dependent on subsequent,p~,~ses? E]Yes ~No 8. Will blasting occur during construction? E3Yes )~SNo 9. Number of jobs generated: during construction ~'/~O ; after project is complete 10. Number of jobs eliminated by this project ./~,'/2,t,-( ~ / 11. Will project require relocation of any projects or facilities? OYes ?(kNo, - ¢ year. (includ m g~emolition}. If yes, explain ............... 12. Is surface liquid waste disposal involved? E3Yes E]No a. If yes, indicate type of waste (sewage, i~dustria[, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? [Yes E]No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain 15. Is project or any portion of project located in a 100 ye, ar flood plain? 16. Will the project generate solid waste? {Z]Yes ?No [~Yes {TJYes a. If yes, what is the amount: per month _ tons b. If yes, will an existing solid waste facility be used? []Yes ~No c. If yes, give name _; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e. If Yes, explain t~No 17. Will the project involve the disposal of solid waste? a. If yes, what is the anticipated rate of disposal? b. If yes, what is the anticipated site life? 18. Will project use herbicides or pesticides? []Yes E~Yes ~No __ tons/month. years 19. Will project routinely produce odors (more than one hour per day)? [Yes /~No 20. Will project produce operating noise exceeding the local .ambiQ,~t, noise levels? 21. Will project result in an increase in energy use? E~Yes If yes , indicate type(s) 22. If water supply is from wells, indicate pumping capacity gallons/minute ,* 23. Total anticipated water usage per day gallons/day. ~ 24. Does project involve Local, State or Federal funding? ~Yes o If Yes, explain 4 25. ,Approvals Required: Type Submittal Date City, Town, Village Board [Yes [lNg City, Town, Village Planning Board "~Yes I~No City, Town Zoning Board I-lYes lng City, County Health Department [Yes lNg Other Local Agencies [Yes E3No Other Regional Agencies []Yes [lNg State Agencies [~Yes I~No Federal Agencies [Yes lNg C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? ~Yes F-lNg If Yes, indicate decision required: [zoning amendment ~zoning variance []special use permit []subdivision [site plan I-Inew/revision of master plan [-1resource management plan ~lother 2. What is the zoning classification(s)of the site? ~? 3. What is the maximum potential development of the site if developed as permitted by the present zoning? 4. What is the proposed zoning of the site? 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? I~Yes ~lNo 7. What are the predominant land use{s) and zoning classifications within a ¼ mile radius of proposed action? 8. Is the proposed action compatible with adjoining/surrounding land uses within a ¼ mile? [Yes I~No 9. If the proposed action is the subdivision of land, how many lots are proposed? a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? [Yes I-lNg 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection)? [Yes I-lNg a. If yes, is existing capacity sufficient to handle projected demand? [l-lYes lng 12. Will the proposed action result in the generation of traffic significantly above present levels? I-lYes ~lNo a. If yes, is the existing road network adequate to handle the additional traffic? [-1yes I-INo D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the information Rrovided above is true to the best of my knowledge. // Applicant/$~" ~or Na e" ~/N~/~ /) ~'~'~ ~'~v/g (,/~2/~ / ,1 ,' Signature'~C'7 ~/'~ '~~ Title I[ Ihe action is in Ihe Coastal Area, a~d you are a stale age,cy, complele the Coastal Assessmenl Form wil~ l~is assessment. Pa, "--PROJECT IMPACTS AND Th R MAGNITUDE Responsibilily of Lead Agency General Information (Read Carefully] · In completing the form the reviewer should be guided by the question: Have my responses and determinations been reasonable.~ The reviewer is not expected to be an expert environmental analyst · Identifying that an impact will be potentially large (column 2) does not mean that it is also necessarily slgnificanL Any large impact must be evaluated in PART 3 to determine significance. Identdymg an m~pact m column 2 5imply asks that it be looked at further. · The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2. The examples are generally applicable throughout the State and for most situations. But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Potential Large Impact response, thus requiring evaluation in Part ~ · The impacts of each project, on each site, in each locality, will vary Therefore, the examples are illustrative and have been offered as guidance. They do not constitute an exhaustive Fist of m~pacts and thresholds to answer each questior~ · The number of examples per question does not indicate the ~mportance of each question · In identifying impacts, consider long term, short term and cumlative effects Instructions (Read carefully) a. Answer each of the 19 questions in PART 2. Answer Yes if there will be any impact b. Maybe answers should be considered as Yes answers c. If answering Yes to a question then check the appropriate box (column 1 or 2) to indicate the potential slze of the impa.ct. If impact threshold equals or exceeds any example provided, check column 2, if m~pact wdl otc:ur but threshold is lower than example, check column 1. d. If reviewer has doubt about size of the m~pact then consider the impact as potentially large and proceed to PAR7 ;J 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 ~s not possible [his must be explained in Part 3. IMPACT ON LAND ¢¢ I. Will the proposed action result in a physical chan~e to, t~ project site? ,;s~O ~ves Examples that would apply to column 2 · Any construction on slopes of 15% or greater, (15 foot rise per 100 foot of length), or where the general slopes in the project area exceed 10%. · Construction on land where the depth to the water table is less than 3 feet. · Construction of paved parking area for 1,000 or more vehicles. · Construction on land where bedrock is exposed or generally within 3 feet of existing ground surface. · Construction that will continue for more than I year or involve more than one phase or stage. · Excavation for mining purposes that would remove more than 1,000 tons of natural material (i.e., rock or soil) per year. · Construction or expansion of a sanitary landfill. · Construction in a designated floodway · Other impacts 2. Will there be an effect t,. _...y u~hque or unusual land forms found on the site? (ie, cliffs, dunes, geological formations, etc )E~NO ~YES · Specific land forms: 6 1 Small to Moderate Impact Potential !Can Impact Be Large Mitigated By Impact Project Change IMPACT ON WATER 3. Will proposed action affect any water body designated as protected? (Under Articles 15, 24, 25 of the Environmental Conserv~on Law, ECL) '[~N O [:]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 designated freshwater or tidal wetland. · Other impacts: 4. Will proposed action affect any non-protected existing or new body of water? I~NO [:]YES 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: 5. Will Proposed Action affect surface or groundwater~ ! quality or quantity? J~NO ~IYES 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. Ir · Construction or operation causing any contamination of a water supply system. · Proposed Action will adversely affect groundwater. · Liquid effluent will be conve,,.ed 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 exte:~t that there will be an obvious visual contrast to natural conditions. · Proposed Action will require the storage of petroleum or chemical products §rearer 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: L 6. Will proposed action alter drainage flow or patterns, or surface - water runoff? ?,NO I~YES Examples that would apply to column 2 [ · Proposed Action would change flood water flows. 7 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] , []Yes []No [] [] []Yes []No [] [] []Yes I~No [] [] []Yes []No [] [] []Yes CiNo [] [] []Yes []No [] [] []Yes []No [] [] []Yes [3No [] ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No ~ ~ ~Yes ~No · Proposed Action may cause substantial erosion. · Proposed Action is incompatible with existing drainage patterns · Proposed Action will allow development in a designated floodway. · Other impacts: IMPACT ON AIR 7. Will proposed action affect air qua ity? 2E]NO E~YES Examples that would apply to column 2 · Proposed Action will induce 1,000 or more vehicle trips in any g~ven hour. · Proposed Action will result in the incineration of more than I ton of refuse per hour. · Emission rate of total contaminants will exceed 5 lbs. per hour or a heat source producing more than 10 million BTU's per hour. · Proposed action will allow an increase in the amount of land committed to industrial use. · Proposed action will allow an increase in the density of industrial development within existing industrial areas. : Other impacts: __ IMPACT ON PLANTS AND ANIMALS Will Proposed Action affect any threatened or endangered species? .[2NO ~2YES Examples that would apply to column 2 Reduction of one or more species listed on the New York or Federal list, using the site, over or near site or found on the site Removal of any portion of a critical or significant wildlife habitat. Application of pesticide or herbicide more than twice a year, other than for agricultural purposes. Other impacts: Will Proposed Action substantially affect non-threatened or non-endangered species? [~NO []YES Examples that would apply to column 2 Proposed Action would substantially interfere with any resident or nigratory fish, shellfish or wildlife species ~roposed Action requires the removal of more than 10 acres Df mature forest (over 100 years of age) or other locally important 'egetation. IMPACT ON AGRICULTURAL LAND RESOURCES Will the Proposed Action affect agricultural land resources? ,.E]NO ~]YES Examples that would apply to column 2 he proposed action would sever, cross or limit access to agrictdtural nd (includes cropland, hayfields, pasture, v neyard orchard, etc.) 8 Small to Moderate Impact 2 Potential Large Impact Mitigated By Project Change LiYes [ZYes Yes Yes ~Yes ~Yes Yes ~Yes ~ J'fes ~No ~3No ~No (( r?~No Z!No riNo ~ ~No f-~$o k (-~ · Construction activity would excavate or compact the soil profile of agricultural land. · The proposed action would irreversibly convert more than 10 acres of agricultural land or, if located in an Agricultutal District, more than 2.5 acres of agricultural land. · The proposed action would disrupt or prevent installation of agricultural land management systems (e.g., subsurface drain lines, outlet ditches, strip cropping); or create a need for such measures (e.g. cause a farm field to drain poorly due to increased runoff) · Other impacts: IMPACT ON AESTHETIC RESOURCES/' 11. Will proposed action affect aesthetic resources~' ~;~NO I-lyES (If necessary, use the Visual EAF Addendum in Section 617.21, Appendix 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 of the aesthetic qualities of that resource. · Project components that will result in the elimination or significant screening of scenic views known to be important to the area. · Other impacts: IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure o~/historic, pre- historic or paleontological importance~ ,JZJNO I-lyES Examples that would apply to column 2 · Proposed Action occurring wholly or partially ~ithin or substantially contiguous to any facility or site listed on the State or National Register of historic places. · Any impact to an archaeological site or fossil bed located within the project site. · Proposed Action will occur in an area designated as sensitive for archaeolo§ical sites on the NYS Site Inventory. · Other impacts:_ IMPACT ON OPEN SPACE AND RECREATION 13 Will Proposed Action affect the quantity or quality of existing or future open spaces or recreational opportunities? Examples that would apply to column 2 .,~O t~YES _ ~._ · The permanent foreclosure of a future recreational opportunity. · A major reduction of an open space important to the community. · Other impacts: I 2 3 Small to Potentia Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] EYes I--~No [] [] [::]Yes []No [] [] E3Yes []No [] [] []Yes []No [] [] [E]Yes []No [] [] r-lYes E]No [] [] []Yes []No [] [] E]Yes I-]No [] [] E]Yes []No [] [] E]Yes []No [] [] []Yes El]No [] [] []Yes' []No [] [] []Yes []No [] [] [5Yes [] [] []Yes EE]No IMPACT ON TRANSPORTATION 14. Will there be an effect to existing transportation systems~ Ji~NO U~YES Fxample$ that would apply to column 2 · Alteration of present patterns of movement of people and/or goods · Proposed Action will result in malor traffic problems. · Other impacts: IMPACT ON ENERGY 15. Will proposed action affect the community's sources of fuel or energy supply? ~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 T6 Will there be objectionable odors, noise, or vibration as a resuJl of the Proposed Action? []NO ~YES 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 7 Will Proposed Action affect public health and safety? "EgNO E2YES £xamples that would apply to column 2 ~ Proposed Action may cause a risk of explosion or release of hazardous substances (i.e. oil, pesticides, chemicals, radiation, etc) in the event of accident or upset conditions, or there may be a chronic Iow level discharge or emission. Proposed Action may result in the burial of "hazardous wastes" in any form (i.e. toxic, poisonous, highly reactive, radioactive, irritating, infectious, etc.) Storage facilities for one milhon or more gallons of liquified natural !las or other flammable liquids Proposed action may result in the excavation or other disturbance within 2,000 feet of a site used for the disposal of solid or hazardous Other impacts: 10 I Small to Moderate Impact 2 Potential Large Impact Can Impact 8e Mitigated By , Project Chan9e ~ ~ ~¥es ~,No _3Yes L~No L~es ~JNo b~es ~JNo u ~es EJNo '~' Yes ~No ~Ye~ ~No UiYes !'EYes ~No ~JYes ~No ~Yes [7~No ~No ~Yes ~-JNO ~Yes L~No IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 18. Will proposed action affect the character of the existing community? [~NO E3YES Examples that would apply to column 2 · The permanent population of the city, town or village in which the project is located is likely to grow by more than 5%. · The municipal budget for capital expenditures or operating services will increase by more than 5% per year as a result of this project. · Proposed action will conflict with officially adopted plans or goals. · Proposed action will cause a change in the density of land use. · Proposed Action will replace or eliminate existing facilities, structures or areas of historic importance to the community. · Development will create a demand for additional community services (e.g. schools, police and fire, etc.) · Proposed Action will set an important precedent for future proiects. · Proposed Action will create or eliminate employment. · Other impacts: 1- 2 3 Small to Potential Can Impact Be Moderate Large Mitigated By Impact Impact Project Change [] [] r-lyes []No [] [] f-lYes ~No [] [] []Yes []No [] [] []Yes r-lNo [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] []Yes []No [] [] ~-IYes []No 19. Is there, or is there likely to be, public controve, r~y related to potential adverse environmental impacts? [~NO [~YES If Any Action in Part 2 Is Identified as a Potential Large Impact or If You Cannot Determine the Magnitude of Impact, Proceed to Part 3 Part 3--EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s} is considered to be potentially large, even if the impact(s) may be mitigated. Instructions Discuss the following for each impact identified in Column 2 of Part 2: 1. Briefly describe the impact. 2. Describe (if applicable) how the impact could be mitigated or reduced [o a small to moderate impact by project change(s). 3. Based on the information available, decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider: · The probability of the impact occurring · The duration of the impact · Its irreversibility, including permanently lost resources of value · Whether the impact can or will be controlled · The regional consequence of the impact · Its potential divergence from local needs and goals · Whether known objections to the project relate to this impact. (Continue on attachments) 11 617.21 SEQR Appendix B State Environmental Quality Review Visual FAF Addendum This form may be used to provide additional information relating to Question l 1 of Part 2 of the Full EAF. (To be completed by Lead Agency) Distance Between Visibility Project and Resource (in Miles) ~i. Would the project be visible from: 0'1/4 I/4'1/2 1/z-3 ' 3-5 5+ · A parcel of land which is dedicated to and available [] [] [] [] [] to the public for the use, enjoyment and appreciation of natural or man-made scenic qualities? · An overlook or parcel of land dedicated to public [] [] [] [] [] observation, enjoyment and appreciation of natural or man-made scenic qualities? · A site or structure listed on the Hational 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 gorridor of high exposure, such [] [] [] [] [] as part of the Interstate System, or Amtrak? · A governmentally established or designated interstate [] [] [] [] [] or inter-county foot trail, or one formally proposed for establishment or designation? · A site, area, lake. reservoir or highway designated as [] [] [] [] [] scenic? · Municipal park, or designated open space? · County road? · State? · Local road? Is the visibility of the project seasonal? (i.e., screen'ed by summer foliage, but visible during other seasons) []Yes []No 3. Are any of the resources checked in question I used by the public during the time of year during which the project will be visible? []Yes []No DESCRIPTION OF EXISTING VISUAL ENVIRONMENT 4. From each item checked in question l, check those which generally describe the surroundinq environment. ~ Within ,1/~ mile * 1 mile Essentially undeveloped Forested Agricultural ? ' Suburban residential Industrial Commercial Urban ~ - River, Lake, Pond r- ' Cliffs, Overlooks [] -': Designated Open Space Flat Hilly Mountainous i_ · Other ' - NOTE: add attachments as needed 5. Are there visually similar projects within: *V~ mile E]Yes {~] No *1 miles [~Yes [~No ' *2 miles [~] Yes F~No *3 miles [~] Yes E~]No * Distance from project site are provided for assistance. Substitute other distances as appropriate.i EXPOSURE 6. The annual number Of viewers likely to observe the proposed project is NOTE: When user data is unavailable or unknown, use best estimate. CONTEXT 7. The situation or activity in which the viewers are engaged while viewing the proposed action is FREQUENCY Holidays/ Activity Daily Weekly Weekends Seasonally Travel to and from work [] [] Involved in recreational activities [] [] Routine travel by residents At a residence [] [] At worksite [] [] Other [] [] PLANNING BOARD MEMBERS Bennett Orlowski, Jr.. Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD October 1, 1991 SCO'IT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, New York 11952 RE: Set-off for Donald Swahn SCTM91000-123-8-8 Dear Mr. Swahn: The following resolutions were duly adopted by the Southold Town Planning Board at a meeting held on September 30, 1991: Be it RESOLVED that the Southold Town Planning Board start the coordination process on this Type I action. Be it RESOLVED that the Southold Town Planning Board grant sketch approval on the map dated April 9, 1991. 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. Please note that five (5) paper prints of the final map, containing a current stamp of Health Department approval, must be submitted before a final public hearing will be set. Please note that the Planning Board has referred this subdivision to the Suffolk County Planning Commission for their review. You will be notified should any covenants and restrictions be required. Page 2 Donald Swahn Please contact this office if you have any questions regarding the above. Very truly yours, Bennett Orlowski, Jr. Chairman PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham. Jn Richard G. Ward Mark S, McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 CERTIFIED MAIL RETURN RECEIPT REQUESTED September 24, 1991 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, NY 11952 RE: Set-Off of Donald Swahn Park Ave. Mattituck Zone: Low-Density Residential R-40 SCTM~1000-123-8-8 Dear Mr. Swahn: This letter is a follow up to the my letter to you of July 16, 1991, (copy enclosed), in which you were informed that the Planning Board could not process your application until the environmental review fee is received. To date, the Board has not received the fee. If we do not receive the fee within one month of the date of this letter we will assume that you do not wish to proceed with this application, and close the file. If you have any questions, or require additional information, please contact this office. Very truly yours, Bennett Orlowski Jr. Chairman PLANNING BOARD MEMBERS Bennett Orlowski. Jr.. Chairman George Ritchie Latham. Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD July 16, 1991 SCOTF L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, New York 11952 RE: Set-Off of Donald Swahn Park Ave. Mattituck Zone: Low-Density Residential R-40 SCTM91000-123-8-8 Dear Mr. Swahn: The Planning Board has received your letter of June 10, 1991, indicating that you will not pay for the environmental review of your Set-Off application at the present time. The Board will hold your application until the review fee is received. Upon receipt of the review fee the Board will continue its review. If you have any questions, or require additional information, please contact this office. Very truly yours, Bennett Orlowski Jr. Chairman PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD July 16, 1991 SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York ! 1971 Fax (516) 765-1823 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, New York 11952 RE: Set-Off of Donald Swahn Park Ave. Mattituck Zone: Low-Density Residential R-40 SCTM~1000-123-8-8 Dear Mr. Swahn: The Planning Board has received your letter of June 10, 1991, indicating that you will not pay for the environmental review of your Set-Off application at the present time. The Board will hold your application until the review fee is received. Upon receipt of the review fee the Board will continue its review. If you have any questions, or require additional information, please contact this office. Very truly yours, Bennett Orlowski Jr. Chairman ARLANDA,/STOCKHOLM PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. M, cDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OFSOUTHOLD SCOTT L. HARRIS Supervisor Town Hall 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 June 27, 1991 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, New York 11952 RE: Set-off of Donald Swahn Park Ave. Mattituck SCTM#1000-123-8-8 Dear Mr. Swahn: The Planning Board has received your letter of June 21, 1991, requesting a review of the four hundred dollar ($400) review fee for the Long Environmental Assessment Form. Your property is located on Great Peconic Bay, which has been designated a critical environmental area (CEA) by Suffolk County. All lands within five hundred feet (500') of the bay have this designation. The State law requires that a Long Environmental Assessment form be completed for all properties and actions within a CEA. The Town's environmental consultants must visit the property, as well as review the data that you have provided, in order to determine the effect this project will have on the environment. I hope this explains to your satisfaction the cost of the review. If you have any questions, or require additional information, please contact this office. Very truly yours, Bennett Orlowski Jr. Chairman ~uwe 21, 1991 planning Board Town of Southold southold, New york Dear ~r. Orlowski: We are writing this letter at the suggestion of your office. We are protesting the cost of $400. as too high a price to pay for the review of the Lo~ Environmental Assessment Form. Our lot and houses (2) which we have owned for over 40 years is or~ly I 1/3 acreas and water front of 100 feet. I can't understand why by merely di- viding this lot on paper into two parcels, with mo other changes or additions, no ' occupants~ a~ded families or additional you require a ~ll Environmental Assess- ~uent Form at a charge of $400. Please reconsider this requirement and justify making such a monetary charge. Thank you. Sin~.rely yours,.~-~ ~ Plauni~ Board Town of Southold Southold, New York 11971 Box: #1179 A_~tt. Bennett Orlowski Jr. PLANNING BOARD MEMBERS Bennett Orlowski, Jr., Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L. Edwards Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall. 53095 Main Road P.O, Box 1179 Southold, New York 11971 Fax (516) 765-1823 May 8, 1991 Donald E. Swahn P.O. Box 283 Park Avenue Mattituck, New York 11952 RE: Set-off of Donald Swahn SCTM%1000-123-8-8 Dear Mr. Swahn: The Planning Board has received your application. The following must be provided before the Board can proceed with it's review: 1. A completed Long Environmental Assessment Form. 2. A check in the amount of four hundred dollars ($400). The $400 fee is for the review of the Long Environmental Assessment Form by the Town's Environmental Consultant. The above mentioned sum must be paid in full before we can authorize our consultant to proceed with the review. The check should be made payable to the Town of Southold. When the consultants complete their review, the Planning Board will consider their findings in making a determination whether the project will have a significant environmental impact. If you have any questions, or require further assistance please contact this office. Encl. Very truly yours, Chairman SUBMISSION WITHOUT COVER LETTER SENDER: ~P, % u~c~% ~k] SCT~: %L%.-~- ~ COMMENTS ~BERS ~ ?. Ooe??ger., £ hairman ~" Charles _Grigonis., ,r. f Serge Doyen, ~, · Joseph H. Sawic] i James Dinizio, J:. Telephone (516) 765 1809 BOARD OF APPEALS TOWN OF SOUTHOLD SCOTF L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Appl. ND. 3978 ACTION OF THE BOARD OF APPEALS Ugon Application of DONALD AND DOROTHY SWAHN. Variance to the Zoning Ordinance, Article IIIA, Sections 100-30A.3 and Section 100-32 for approval of insufficient lot area and width (frontage) of two proposed parcels, each with an existing dwelling, in this pending division of land. Zone District: R-40. Location of property: South Side of Park Avenue, Mattituck, NY; County Tax Map Parcel No. 1000-123-8-8. WEEREAS, a public hearing was held on November 1, 1990, and all these who desired to be heard were heard and their testimony recorded; and W~EREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and W~EREAS, Board Members have personally viewed and are familisr with the premises in question, its present zoning, the suxrounding areas; and and W~EREAS, the Board made the following findings of fact: 1. The premises in question is located in the "Low-Density Residertial R-40" Zone District and is referred to as District Page 2 - Appl. No. 3978 Matter of DONALD SWAHN Decision Rendered November 15, 1990 1000, Section 123, Block 08, Lot 008 on the Suffolk County Tax Maps, with frontage along the southerly side of Park Avenue, Mattituck and frontage along Great Peconic Bay. 2. The subject premises as exists: (a) contains a total combined lot area of 1.25+- acres; (b) was conveyed separately by deed at Liber 2760 page 475 and by deed at Liber 4521 page 343. 3. Article III, Section 100-32, and Article IIIA, Secticn 100-30A.3 of the current zoning code (as amended January 9, 1989) requires a minimum lot area per lot of 40,000 square feet in this R-40 Zone District. 4. The relief sought by this application is a variance fDr approval of: (a) proposed northerly lot referred to herein as Lot #1 with an approximate total lot area of 20,000 sq. ft., and lot width of 100.22 feet along Park Avenue; inclusive of the right-of-way/driveway area to the southerly dwelling structure, (b) proposed southerly lot referred to herein as Lo~ #2 with an approximate total lot area 39,000 sq. ft., inclusive of land under the highwater mark, and lot width at the building line of 100 feet. 5. For the record, it is noted that the immediate area of the subject premises does not lend to the grant of further variances. Under this application, the premises is improved with two dwelling structures which preexisted the zoning ordinance, which is in the Board's position sufficient for the grant of the lot lines. There will be no increase in density for the creation of the second lot since there is one dwelling existing for each. 6. In considering this application, the Board also finds and determines: (a) the relief as granted is substantial in relation to the requirements; (b) the evidence submitted and practical difficulties claimed are sufficient to warrant a Page 3 - Appl. No. 3978 Matter of DONALD SWAHN Decision Rendered November 15, 1990 grant of this variance; (c) there will be no substantial change in the character of the neighborhood, and a precedent would not be set since adjoining properties have not been held in single and separate ownership at any time since the enactment of zoning in 1957 {except as an entire tract of more than 43,560+- square feet); (d) the difficulties cannot be obviated by some method feasible to the appellant to pursue, other than a variance; (e) that in view of the manner in which the difficulties arose, and in considering all the above factors, the interests of justice will be served by granting the variance, as conditionally noted below. Accordingly, on motion by Mr. Dinizio, seconded by Mr. Goehringer, it was RESOLVED, to GRANT the relief as requested (and noted in paragraph 94, supra)~ in the Matter of the Application of DONALD SWAHN under Appl. No. 3978, SUBJECT TO THE FOLLOWING CONDITIONS: 1. That there be no further subdivision, set-off or conveyance of land other than that as applied for. 2. That a minimum of 22,000 square feet be applied to the northerly improved lot (inclusive of right-of-way ten feet in width) and the remaining lot area be applied to the southerly improved lot. 3. That a survey, prepared by a licensed surveyor, certifying the above dimensions and general layout be submitted and accepted by the Board of Appeals. Vote of the Board: Ayes: Messrs. Goehringer, Doyen and Dinizio. (Absent were Member Grigonis (out-of-state) and Member Sawicki.) This resolution was duly adopted. lk APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Grigonis, Jr. Serge Doyen, Jr. Joseph H. Sawicki James Dinizio, Jr. Telephone (516) 765- ! 809 BOARD OF APPEALS TOWN OF SOUTHOLD SCOTI~ L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 December 6, 1990 Mr. and Mrs. Donald Swahn P.O. Box 283 2100 Park Avenue Mattituck, NY 11952 Re: Appl. No. 3978- Variance Dear Mr. and Mrs. Swahn: Transmitted for your records is a copy of the determination rendered by the Board of Appeals at our November 15, 1990 Regular Meeting concerning the above application. Please be sure to return to the Planning Board Office and any other agency which may have jurisdiction for appropriate approvals. A copy of this decision has simultaneously been transmitted to the Planning Board Office for its file and update. Yours very truly, GERARD P. GOEHRINGER CHAIRMAN ~inda Kowalski Copy of Decision to: Mr. Bennett Orlowski, Jr., Chairman Southold Town Planning Board Suffolk County Department of Planning TOWN OF SOUTBOLD BUILDING DEPARTMENT TOWN EALL SOUTEOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE .............. NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ NOUSE NO. STREET DAMLET ........................... County Tax Map No. 1000 Sec:ion /.~3 Block ~ Lot .~. .... Subdivislou ....................... Filed Map ........ Lot .......... Permit No ........... Date of Permit .......... Applican: ................... Health Dept. Approval .................. Underwri:ers Approval .............. Planning Board Approval ................ Request Fee Submitted: for Temporary Certificate ....... Final Certificate rey_~ col FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19096 Date JUNE Ir 1990 THIS CERTIFIES that the building. Location of Property 2100 PARK AVENUE House No. Street County Tax Map No. 1000 Section 123 Block 08 Subdivision Filed Map No. ACCESSORY MATTITUCK~ N.Y. Lot Lot No. Hamlet 08 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16~ 1990 pursuant to which Building Permit No. 18891-Z dated MARCH 19, 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is EXISTING ACCESSORY METAL BUILDING AS APPLIED FOR. The certificate is issued to DONALD E. & DOROTHY L. SWAHN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A · t ' / //Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-19095 Date JUNE id 1990 THIS CERTIFIES that the building. Location of Property 2100 PARK AVE. House No. County Tax Map No. 1000 Section 123 Subdivision 2 ONE FAMILY DWELLINGS MATTITUCK ~ N.Y. Block 8 Filed Map No. Street Hamlet Lot 8 Lot No. conforms substantially '~o the requirements for private one family dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. Z-19095 dated JUNE id 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is 2 ONE FAMILY DWELLINGS * DONALD E. & DOROTHY L. SWAHN The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUN~ DEP~TM~NT OF HEALTH APPROVAL NO RECO~ P~ EXISTING UNDERWEITERS CERTIFICA%E NO. NO ~CO~ PRE EXISTING PLUMBERS CERTIFICATION DATED NO ~CO~ PRE ~ISTING *PL~SE SEE ATTA(~ED INSPECTION ~PORTS. / Building Inspector Rev. 1/81 ,~m~ GIT..tEAT I~/~Y h'IAP HAP LOW DECqf:!T"r' AA. ~.$LIFfi..CO.T/~4 i'dAP DATA.: tO00-12D PFdOPOSED OF MINOr?. 5UBDIVISI O M OF PI2OPEI2TY SUP. VEX/ED FOE AT. TOMN OF ~ " ..,JU-I ~-,Ol_ D NLY, ~ATTI TUCk, ~,Y TEL, ~8' 864 S AT~EA, k-3¢3 Ac, F% F,1ONUI','t ENT