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HomeMy WebLinkAboutTR-6418A James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6418A Date of Receipt of Application: August 17, 2006 Applicant: Candice Vadala SCTM#: 139-3-29&139-3-30.1 Project Location: 465 Farmer's Rd. & 725 Farmer's Rd., Mattituck Date of Resolution/Issuance: August 23, 2006 Date of Expiration: August 23, 2008 Reviewed by: Trustee James King Project Description: To install a water line under existing roadway from Grant Blvd./Conklin Rd. to dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated in the application dated August 17, 2006 Special Conditions: None If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. J lng, P mt Board of Trustees I SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrumaent: EASEMENT/DOP Number of Pages: 9 Receipt Nua%ber : 06-0068756 TRANSFER TAX NIIMBER: 05-46078 District: 1000 Deed Amount: Recorded: At: LIBER: PAGE: Section: Block: 139.00 03.00 EXAMINED AND CHARGED AS FOLLOWS $0.o0 07/17/2006 02:06:49 PM D00012459 700 Lot: 029.000 Received the Following Fees For Above Instruraent Exempt Page/Filing $27.00 NO Handling COE $5.00 NO N-YS SRCHG TP-584 $5.00 NO Notation Cert.Copies $5.85 NO RPT SCTM $0.00 NO Transfer tax Co~um. Pres $0.00 NO Fees Paid TRANSFER TAX N-U~BER: 05-46078 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL $5.00 $15.00 $0.00 SS0.00 $0.00 $1 2.85 Exempt NO NO NO NO NO Judith A. Pascale County Clerk, Suffolk County TORRENS Serial # Celtificate ff Plior Ct[. # Deed / Mortgage Instrument Page / Filiog Fee I landling TP-584 -~ [5 Deed / Mortgage Tax Stamp FEES Notation EA-52 17 (County) Sub Total EA-5217 (State) R.P.T.S.A. ~-~C") (:)(-~- Comm. of Ed. 500 Affidavit Certified Copy Reg. Copy Olher Sub Total GRAND TOTAL Real Property Tax Service Agency Verification Dist. [ Section I Block [ 1000 13900 0300 029000 Slamp /r_~/'~Sx,, 1000 13900 0300 030001 Date (~' F-~p .~) hfitials ~" j Satisfactions/Discharges/Release~ ,~ ...... r- RECORD & RETURN ~O: Deborah Doty, Esq. 670 West Creek Avenue P.O. Box 1181 Cutchoguo, NY 11935 91 This page fonm p~'m of the attached LINDA PASCA TO CANDICE V~DgI~ Lot ddress Recording / Filing Stamps Mortgage Amt. 1. Basic Tax 2. Additional Tax Sub Total Spec./Assit Or Spec./Add. TOT, MTG. TAX Dual Town Daal County__ ___ Held for Apportiomnent fransfer Tax Mansion '"fax The property covered by this mortgage ~s or will be improved by a one or two family dwelling only YES__ or NO If NO, see appropriale tax clause on page ~ of this instrument 6 Con~aauniW Preservation Fund Consideration Amount $_ CPF Tax Due $ hnproved _ k'' Vaca.t Land TD TD TD Fitle Company Information Suffolk County Recording & Endors[ment Page Easmont (SPEOFY ~E OF ~S~ ) ~le prenfises herein is si~ted ii~ S~FOLK CO~', NEW YO~ Ill the T0~hip 0f Sou~old In the VILLAGE Or [~ET 0f ~ttituck made by )XES 5 TIqRU 9 MUST BE TYPED OR PR1NIED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (OVER) EASEMENT THIS AGREEMENT made this [4~'day of ~t[h'f ,2006, by and between LINDA PASCA, residing at 725 Farmer Road, Mattituck, NY 11952 (" PASCA"), and CANDICE VADALA, residing at 200 Rector Place, Apt. 26H, New York, NY 10280 ("VADALA'). WHEREAS, PASCA is owner in fee of the parcel of land located and designated as 725 Farmer Road, Matfituck, NY 11952 (SCTM #1000-139-3-30.1), hereinafter referred to as Parcel 1 and more fully described in Schedule A attached hereto; and WHEREAS, VADALA is owner in fee of the parcel of land located and designated as 465 Farmers Road, Mattituck, NY 11952 (SCTM # 1000-139-3-29), hereinafter referred to as Parcel 2 and more fully described in Schedule B attached hereto; WHEREAS, the "Amended Map of Mattituck Heights property of Gustav Bayer at Mattituck, Suffolk Co., N.Y. surveyed by Otto W. Van Tuyl, Greenport, New York on July 10, 1935," and filed in the Office of the Clerk of the County of Suffolk on July 24, 1935, as Map No. 1184, a copy of which is attached hereto as Schedule C, depicts a roadway referred to as "Farm Road;" WHEREAS, said Farm Road as depicted on Schedule C traverses Parcel 1 from Grant Boulevard (a/k/a Conklin Road) to Parcel 2 ("easement area"). WlTNESSETH NOW, IN CONSIDERATION OF TEN DOLLARS ($10.00) each paid to the other, and the receipt of which is hereby acknowledged, and other good and valuable consideration, PASCA hereby grants and conveys unto VADALA, her heirs, successors and/or assigns who shall come into title to said Parcel 2, a permanent and perpetual easement that runs with the land for the purpose of placement, installation, maintenance, repair, inspection and replacement of water lines under the easement area, and VADALA, her heirs, successors and/or assigns shall restore the easement area to its original condition after the installation, maintenance repair, inspection and replacement of such service utility over the easement area. The cost of installation, maintenance and repair of said water line and to restore the area shall be borne by VADALA, her heirs, successors and/or assigns unless PASCA, her heirs, successors aM/or assigns shall utilize the water line in which case the cost of any shared portion of said water line shall be shared equally. VADALA further agrees to indemnify and hold PASCA harmless from and against any and all liability, loss, costs, damages, attorneys' fees and expenses of whatever kind or nature which PASCA may sustain or incur by reason or in consequence of VADALA's use of the easement provided for herein. The installation of said water line within the easement area for the benefit of Parcel 2, must be with the consent of the Suffolk County Water Authority and any other governmental entity with regulatory jurisdiction. Prior to commencement of any work on the easement area, VADALA will provide PASCA with at least seven (7) days' notice of commencement of the work, which notice shall include copies of all permits, approvals, letters of "non-jurisdiction," or the like from the Suffolk County Water Authority, New York State Department of Environmental Conservation, Southold Town Trustees, and any other regulatory governmental entity. VADALA will take reasonable efforts to ensure that any work on the easement area is completed promptly, safely, and with the least amount of disturbance to PASCA's use and enjoyment of her premises. Such efforts shall include placement of temporary materials to protect any holes or trenches that are not yet permanently back-filled, and to ensure access to PASCA's driveway. Except in the event of an emergency, no work shall be performed between Memorial Day and October I of any given year. PASCA, her heirs, successors and/or assigns, retain unto herself all rights to fully enjoy Parcel 1 except for the purposes herein granted to VADALA. This grant of easement shall at all times be deemed a continuing covenant that runs with the land and shall be binding upon, and inure to the benefit of heirs, successors and/or assigns of all parties to this agreement. This grant of easement shall not be terminated or extinguished without the prior written approval of the Suffolk County Water Authority, its heirs, successors and/or assigns. 2 IN WITNESS WHEREOF, the parties hereto have set their hands and seals on the day first written above. STATE OF NEW YORK, COUNTY OF SUFFOLK SS: On the I q t~ day of the year 2006, before me, the undersigned, a Notary Public in and for said State, personally appeared LINDA PASCA personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed same in her capacities, and that by her signature on the instmmem, the individual, or the person upon behalf of which the individual acted, executed the instrumem. ~_ ~ Notary Public ANTHONY C. PASCA Notary Public, State of New York No. 02PA5055606 St fro k County Commission Expires Feb, 12, 20.~ STATE OF NEW YORK, COUNTY OF SS: On the /ga' day of in the year 2006, before me, the undersigned, a Notary Public in and for said State, personally appeared CANDICE VADALA personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed same in her capacities, and that by her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. Notary Public PASCA TO VADALA EASEMENT 3 LEGAL DESCRIPTION SCHEDULE A All tb~t cer~i~ lot, pie. r~ or par~l of land, situate, lying and being at Mattituck, in the. Town of Sonthold' County bt Suffolk and State of New York, known and designated ~s Lots 69 and 70 ~ thc anat~rly portions of Plots D and E on a o~rtain nmp entitled, "Amended Map of M'~.tiluek Height~, property of Oustav BaT~r" and filed iu the Offi~ of the Clerk of the County of Suffolk on July 24, 1935, a~ Map No. 1184, which said lots and Plots D and E on said map, when take~ log~tl~r an: bounde~i and described a~ follows: BEOINNING at a monet set in tim we, sterly line of Couklin Road, also known as Grant Boulevard, at the division line Ix:tw~:n Lots 58 and 70 on said map, said poim of begin~dng b~ing distant 232.51 feet southerly, when measured along th~ westexty line of Couldin Road (Grant Boulevard) from the southerly line of Bayer Road: RUNNING THENCE South 14 dcg~e~ 02 minutes 50 r~eoeds East, along the westexly linc of Conklin Road (Grant Boulevard), 269.60 fset Io land of th~ County of Suffolk; THENCE South 24 deg~es 47 minute~ ~0 ~-conds West along said last m~ntion=d land, 193.62 feet to land formexly of Potloek later of Susie H. Cookn; THENCE North 19 d~gmes 32 minutes .50 seconds West along said last mentioned land, 306.43 feet to the southerly line of Lnt 69 on said map; THENCE South 75 d~gm~s 57 minutes 10 seconds West along said southerly line, 35.0 feet to tt~ southeestea~ty lix~ of Lot 61 on said nmp; THENCE North 31 dcgr~ 04 minutes 30 seconds East along ~he southeasterly llan of Lots 61 and 60 on said map, 70.86 fe~t to a monument; TH.r~CE North IS degr~s 40 minut~ 40 seconds East along th~ southanster]y lin~ of Lots 60 and 59 on said map, 75.32 f~t to a monument ~ on the division line b~twean tots 58 and 70 on ~aid map; THENCE North 75 d~gree~ 57 minutes 10 seconds East 'along sam division linc, 98.23 feet to thc point or place of BEGINNING. -~6G-E~I~ ~i~ tfigS~g~? ~'r[~ J~}~ ~ght r~t wi~ to ~d rmm Wickh~ Avan~ to ~ng Cmk, a b~h of ~tfituck Bay to p~s ~d mp~s oa f~ only; s~d fi~t of way ou~ncing at ~ northly juectinn of Middle Road ~d Wic~ Avenue, m a ~nmte monu~nt, running in a westerly di~ion aight ~ RULING in a no~ly d~on 130 f~t p~H~l with the ~und~ ~e of ~ay of Hula W. ~ein ~d ~smv Ba~r. to m~ hi~ s-ater of ~ng C~k; T~CE RUinG ~ a ans~ly di~on along ~ng C~k to land of W~tem ~d~ pm~Y of Hub~ W. ~in. i30 f~t to a con~t~ monument, t~ no~erly ju~fion of Mille Road ~d Wickham Avenue, th~ point or plac~ of TO~ wi~ th~ u~ of a right of way known ~ F~ Ro~ to p~ ~d ~ ~m O~t ~ul~v~d to Wic~ Avenue; ~ wi~ MI right, titl~ ~d intc~st o~ th~ p~ies of ~ ~t ~ of, in ~d to l~d l~ng within ~ ~u~s of"F~ Ro~" ned ~mnt Boulev~, ~j~nt m ~d ~s. SCHEDULE B ALL that certain plot, pier or parcel of land, situate, lying and being at Mattituek, in the Town of Southold, County of Suffolk and State of New York, being end bounded and described as follows: BEGINNING at a monument, sat in the aoutheMy line Of Lot No. 64, as shown on a certain map entitled, "Amended Map of Mattituck Heights, Property of Gistav Bayer, at Mettituck, Suffolk County, New York surveyed by Otto W. Van Tuyl~ Greenport, New York, on 3u1¥ ;~0th !935", and flied in the Of~ce of the Clerk of the County of Surfak on 3uiy 24, 1935, es Map No. 1184 where said southerly line of Lot ~10.64 on satd map is intersected by the d~vlsion line between Plot "C" and Plot "D'r as shown on the aforesaid map> P, UNNING THENCE North 3:~ degrees 04 minutes 30 seconds East along the sou~erly line of Lot Nos. 54, 63, 62 and 6:L, as shown on said map 123.52 feet to an iron pipe; THENCE North 75 degrees 57 minutes ~.0 seconds East~ 35 feet to an iron pipe; THENCE South 19 degrees 32 minutes 50 seconds East crossing Farm Road 303.40 feet to land now or formerly of Conklin; PUNNING THENCE along said land now or formedy of ConkJin, along the center line of gutter having a tie line South 59 degrees 38 minutes ZO seconds Wast, 130.60 feet, to land now or formedy of Comiskey~ THENCE North 20 degrees O0 minutes 30 seconds West, along s~Jd land now or formerly of Comiskey, and again crossing Farm Road and through a monument a distance of 252.90 feet: to t. he monument at the point or piece of BEGINNING, TOGETHEP, with t~e use of a right of way 8 feet wlde t~ and from Wickham Avenue to Long Creek, a branch of Mattfcuck Bay to pass and r~pass on foot only~ said right of way commencing at the Northerly Junction of Middle Road and Wickham Avenue, at a concrete monument, running in a Westerly direction 8 feet; THENCE running in e Northerly direction 130 feet parallel with the boundary line of property of Hubert W. Klein and Gustav Bayer, to mean high water mark of Long Creek~ THENCE running in an Easterly direction along Long CiTeek to land of Hubert KJein THENCE running in a Southerly direction along the Westerly bounda~/of property of Huberc W. Klein, ~.30 feet, to a concrete monument, the Northerly juncJ:ion of Middle.Road and Wickham Avenue, the point or pJa~ of BEGINNING, ,ZIMENDBD ZAP 4/1,47-7'1TUCK HEIGH7-~ CUSTA V ~AY~ PASCA TO VADALA EASEMENT - SCHEDULE C Page Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only __Coastal Erosion Permit Application __Wetland Pern'fit Application ~'Administrative Permit Amendment/Transfer/Extension ~eceived Applicatinn:~_ ~----~Received Fee:$ FO. ~' ~ompleted Application __Incomplete __SEQP~ Classification: Type I Type II Unlisted __Coordination:(date sent). __LWRP Consistency Assessment Form __CAC Referral Sent: ~Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination:__ __~uChnical Review: blic Hearing Held:~ ZResolution: ' ' AUG ] 7 2006 Name of Applicant Address Candice Vadala 200 Rector Place, Apt. 26H, New York, NY 10280 Phone Number:( ) 212-979-5988; 631-298-1184 Suffolk County Tax Map Number: 1000- 139-3-29 and 30.1 (owned by Linda Pasca) Property Location: 465 Farmers Road, Mattituck and 725 Farmer Road, Mattituck (owned by Linda Pasca) Granr Boulevard (a/k/a Conklin Road), Mattituck (provide LILCO Pole #, distance to cross streets, and location) AGENT: Deborah Doty, Esq. (If applicable) Address: 670 west Creek Ave, PO Box 1181, Cutchogue, NY 11935 Phone: 631-734-6648; 631-734-7702 (FAX) oard of Trustees Applica~ Land Area (in square feet): Area Zoning: R-40 Previous use of property: Intended use of property:. GENERAL DATA 10-+ ft x 200_+ ft (area of road to 465 Farmers Rd single family dwelling(s) same with underground water line service Prior permits/approvals for site improvements: Agency Date x No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No Yes If yes, provide explanation: Project Description (use attachments if necessary): Installation of underground water lines under existing roadway from Grant Blvd/Conklin Rd to dwelling at 465 Farmers Rd of Trustees Applica~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Installation of underqround water lines under existing roadway from Grant Blvd/Conklin Rd to dwelling at 465 Farmers Rd Area of wetlands on lot: 9,000+_ (est.) square feet of phracjmites Percent coverage of lot: 23_+ % Closest distance between nearest existing structure and upland edge of wetlands: * 50_+ feet * phracflaites Closest distance between nearest proposed structure and upland edge of wetlands: feet underground water lines Does the project involve excavation or filling? No x Yes If yes, how much material will be excavated? * cubic yards How much material will be filled? * cubic yards Depth of which material will be removed or deposited: * Proposed slope throughout the area of operations: none Manner in which material will be removed or deposited: trencher * enough to trench for line & fill to replaced feet * per SCWA requir~n~nts Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if apP~0priate): NO effect. Underground water to be installed and then land restored. PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1 ~PPL[,C~,NT / SPQ,N,~,OR 2. PROJECT NAME ~anc~ce Vadala by Deborah Doty, Esq. Underground water line 3 PROJECT LOCATION: Municipality Mattituck, Southold County Suffolk 4 PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc - or provide mad 465 Farmers Road (SC'i'M # 1000-139-3-29) & 725 Farmer Road (SC'TM # 1000-139-3-30.1) between Wickham Ave & Conklin Rd (a/k/a Grant Blvd) 5. IS PROPOSED ACTION: r~ New ~ Expansion r-~ Modification / alteration SEQR 6. DESCRIBE PROJECT BRIEFLY: Installation of underground water line under existing roadway from SCWA main on Conklin Rd/Grant Blvd to dwelling at 465 Farmers Rd 7. AMOUNT OF LAND AFFECTED: Initially °04 acres Ultimately .04 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? xL~Yes L.J No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~-~ Residential [] Industrial [] Commercial [--']Agriculture [] Park/Forest/Open Space [] Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) E~Yes [-~No If yes, list name and permit / agency approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes ~-~No If yes, list agency name and permit I approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQU RE MODIFICATION? [-'-]Yes ~']No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Cadice Vadala by Deborah Doty, Esq. Date: Signature~~------~ 08/17/2006 If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, a negative dec[aration may he superseded by another involved agency r~Yes r~No C COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwdtten, if legible) C1 Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, ' ' ' ' ' " '" archaeological, hlstonc, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegeta on or fauna fish she fish or w~ldhfe species srgmficant habitats or threatened or endangered species? Explain bnefly A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5.G[owth, subsequent development, or related activities likely tetra induced by t~.e~ropose?.action? Explain briefly: C6.Long term, short term, cumulativel ~r 0thor effects not identified in CI-C5'~ Explain ~riefly: c7. Other impacts (including chan~es in use of either quant t~ or type of ener~¥:'~ Explain btiefl~': D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA fCEAI? if yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If },es explain' PART Ill - 1)~: I t=I,(MINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ec~identifiedab~ve'determinewhetheritissubstant~a~~~arge~imp~rtant~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacls have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA 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 I1~ determined, based On the information and ~naly~is ~bove and any ~uppor[ing document~ti0ffi that ih~ proposed actiol WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Title of Responsible Officer Pdnt or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) CONSENT RE: 465 Farmers Road, Mattituck, NY 11952 (SCTM # 1000-139-3-29) I, CANDICE VADALA, residing at 200 Rector Place, Apt. 26H, New York, NY 10280, the owner of the above-referenced premises, consent to her representatives including, without limitation, DEBORAH DOTY, ESQ., to make applications necessary for the approval of placement and installation of a water line across and under that portion of "Farm Road" which traverses my property from such entities as, including but limited to, New York State Department of Environmental conservation, Suffolk County Department of Health Services, the Town of Southold, and all matters relating thereto. Dated: CANDICE VADALA CONSENT RE: 725 Farmer Road, Mattituck, NY 11952 (SCTM #1000-139-3-30.1) I, LINDA PASCA, residing at 725 Farmer Road, Mattituck, NY 11952, the owner of the above-referenced premises, consent to our neighbor, CANDICE VADALA, and her representatives including, without limitation, DEBORAH DOTY, ESQ., or either of them, to make applications necessary for the approval of placement and installation of a water line across and under that portion of "Farm Road" which traverses my property from such entities as, including but limited to, New York State Department of Environmental conservation, Suffolk County Department of Health Services, the Town of Southold, and all matters relating thereto. Dated: LINDA PASCA Board of Trustees Application County of Suffolk State of New York DI~OPd~I IX)WY BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF IllS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~ignature-- J ~ SWORN TO BEFORE ME THIS 17~h. DAY OF August ,20 O6 o'ta~ Publie/ / '' LORRAINE KLOPFER Notary Public, State of NewYo~ No. 4828373 Qualified in Suffolk County Commission Expires Nov. 30, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics vmhibits conflicts of interest on thc nar~ of town officers and cmnlovccs. The nurpo~ of this form is to nrovide information which can aler~ the town of nossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Vadala, Candice (Last name, first name, ~iddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate thc other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" ianludes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a paaial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% oftbe shares. YES NO x lfyou answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of grealer than 5% of the shares of the corporate stock of the applica, nt (when the applicant is a corporation); __B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this 17~hd.ayof August 200 6 FL__. _ ~--...T~.x~ Signature ~f~'~,~ A., e~._D/,~,~.~ t~ ~ PrintName Csndi~ Vada~ hy ~rnh ~ty, Esq. Town of Southold LWRP CONSISTENCY ASSESSM]BNT FORM A. INSTRUCTIONS All applicants for perm/ts* including Town of Southold agencies, shall complete this CCKF for proposed actions that are subject to the Town of Sonthold Waterfront Consistency Review Law. Tiffs assessment is intended to supplement other information used by a Town of Southold agency in making a detem2mation of consistency. *Except minor exempt actions including Building Permits a~d other mi~iszerial permits xot located withi~ the Coastal Erosion Hazard Area, Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Water~ont Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", tlien the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to malting a determination that it is consistent to the maximum extent practicable with the LWtLP policy standards and conditions. If an action caunot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office,' the Plann/ng Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION A'dG 1 7 2005 SCTM# 1000 - 139 3-29 & 30.1 The Application has been submitted to (check appropriate response): Town o ra [] .d g,ept. o rdo[Tru tees [] Category of Town of S outhold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Installat-5 on c~f nnd~r?rnnnd wa~-~-c 1 ~ n~ nnc]~r oarJ .qt5 ng roadway frortl Grant Blvd/Conklin Rd to dwelling at 465 Farmers Rd Location of action: Site acreage: Present land use: 465 Farmers Rd & 725 Farmer Rd, Mattituck lot #29 = 0.90 acres; Lot #30.1 = 1.10 acres single family dwelling Present zomng classification: R-40 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: CandJ. ce Vadala ¢) M~lingad&ess: c/o Deborah Doty, Esq., PO Box 1181, Cutchogue, NY 11935 (c) Telephone number: Area Code ( ) 631-734-6648; 631-734-7702(FAX) (d) Application number if any: Will the action be directly m~dertaken, require funding, or approval by a state or federal agency? Yes ~ No [] If yes, wl-rich state or federal agency?. C. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [~Yes [~ No [--~ Not Applicable ant o~permit--~llows homeowner to connect to public water system rather than rely on old well. No chanqe is Dro_Dosed to existing Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Sonthold. See LWRP Section III - Policies Pages 3 through 6 for evalnation criteria ~--] Yes ~ No ~'~ Not Applicable Attach additional sheets ~f necessar Policy B, Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section IIl- Policies Pages 6 through ? for evaluation criteria ~ Yes ~ No ~-~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section IH -Policies Pages 8 through 16 for evaluation criteria ~-~ Yes ~ No ~-~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section Iii - Policies Pages 16 through 21 for evaluation criteria ~ Yes [~ No ~-~Not Applicable Installation of underground water main to existinq residence will provide public water to dwellinq currently served by old well and will not precipitate uncontrolled Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. [-~ Yes ~-~ No [] Not Applicable Installation of underground water main will have no adverse impact on ecosystem Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~-~ Y es ~ No ~ Not Applicable A~ach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Sonthold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~ Yes ~'~ No ~-~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes ~ No [] Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section llI- Policies; Pages 47 through 56 for evaluation criteria. Attach additional sheets i£necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 5'1 through 62 for evaluation criteria. ~ Yes [~ No ~-~ ]Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town' of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ~ Yes ~-~ No ~-~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [-~ Yes ['-3 No [~ Not Applicable Created on 5/25/05 Ii .'20 AM DEBORAH DOTY ATTORNEY AT LAW 670 WEST CREEK AVENUE P.O. BOX 1181 CUTC~OGVE, NY 11935-0876 F^x 631-734-7702 631-734-6648 BY HAND August 17, 2006 Board of Town Trustees Town Hall Annex 53095 Route 25 PO Box 1179 Southold, NY 11971 RE: Candice Vadala 465 Farmers Road, Mattituck, NY (SCTM # 1000-139-3-29) AUG 2006 Dear Members of the Board: I represent Candice Vadala the owner of the above-referenced property. Ms. Vadala wishes to hook up to the public water system which is available on Grant Blvd/Conklin Road. Per agreement with the neighbor to the east, the main will be installed under the existing road bed. There are phragmites within 50+ feet of the installation site. Therefore, Ms. Vadala requests the Board's permission to install an underground water main from Grant Blvd/Conklin Road under the existing road to her dwelling. Enclosed for the Board's review are an original and one copy of the following: (1) the application form, (2) the short environmental assessment form, (3) the transactional disclosure form, (4) LWRP consistency assessment form, (5) consents from Ms. Vadala and the easterly neighbor, Linda Pasca, and (6) the recorded easement between the parties. Also enclosed is my check #5878 payable to the Southold Town Clerk in the amount of $50.00 for the application fee. Thank you for your consideration. Respectfully submitted, Deborah Doty Encls. cc: Candice Vadala