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v ' ~ ~OgpFFO(,~c MAILING ADDRESS: ~;`G ~,,~
PLANNING BOARD MEMBERS h~~ ~G,y P.O. Box 1179 ~al~''~
JERILYN B. WOODHOUSE C ~ Southold, NY 11971
Chair y
OFFICE LOCATION:
• '~` Town Hall Annex
KENNETH L~EDWAADS y~~.( `~.aO~ 54375 State Route 25
MARTIN H. SIDOR (cor. Main Rd. & Youngs Ave.)
Southold, NY
GEORGE D. SOLOMON
Telephone: 631 766-1938
Faze: 631 76b-3136°"Q'
~, PLANNING BOARD OFFICE ;~ ¢
~~~~~ ~o~ ~\~A TOWN OF SOUTHOLD ~a,a.~4~' 7
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Application for Sketch Approval ~u~4 ~ ~ 2ooa
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APPLICATION IS HEREBY MADE to the Town of Southok),Planing Board fai_---
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SKETCH APPROVAL for the subdivision described herein. ',
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1. Name of Subdivision hj,p u n ~ ~( t'4 ~/~ f ~ ~m ~~ (~ ~ (y~~-~-
2. Suffolk County Tax Map # ~~~j 5 - Q S - 6 3 U~,~ le~o -b 3- I-as
3. Type of Subdivision Standard [ ] Conservation [ ]
4. Hamlet ~ Q u { h
D ~ C~
5. Street Address/ `
~j22-S Yb~thGiS 7`CV2~ ~
Project Location
6. Acreage of Site
7. Proposed Yield ~
~
8.
Number of Lots Proposed /
11
/y /-1
9. Zoning District
10.
Date of Submission ~/
U ~ Z-0O b
11. Please provide the names, addresses and phone numbers for the following
people:
Applicant: ~~~rll~~ Qh~ I6Y11 Ntirl~~ 7(os-I~~Z-
Agent: ~ ,~ ~ S Al1l A~,>7
. e. )3aK 14~,
Scrn-r}IcsLh ~'Y l147t
~~~-rv9e3 a~'~`lbs- Iq'1~
Property Owner(s): fir' LEON IL ~../~6V~ ~ uS ~~ S ~fr`f~ SH~/~L
~ C NAnv®ro,u RD P. d i3o~c 177io
63r ~3~3_/ 9 ~s~~'L? z ~ /
surveyor: pC~atitN Su~~~'~Qs PC.
~.o. fox goy' /z~~9~~~~~ S7~[~T
Sou7,IoLD NV /ly'7/
~(vS-S c7Zt~•~~
Engineer.'
Attorney: iQU DoLPN B~(.([-'(Z
hrA,N ;20~ n
~ o u'7}1~~ it
7(oS ~? ZZ
12. Has an application for subdivision ever been filed for this property? If so, please
indicate when and whether or not approval was granted by the Planning Board.
.in
13. Has apre-submission conference been held with the Planning Board? If so, provide
date. LrJITf-~ i~~~~~
14. Has the owner/applicant met with Land Preservation? If so, provide
date.
15. Is any part of the property in agricultural use?
16. Is there an existing or proposed sale of development rights on the property?
17. Does the owner own any adjacgnt properties? If so, please indicate the properties by
SCTM#. /V D N / /~
18. Are there any building permits currently pending on this property? If yes, please
provide permit number(s). ,
19.The site will be serviced by the following special districts or utility compuries:
Fire District ~D t D
Post Office ~u'~-l c t p
School District Souil-I o L D
Water {1! / ~
20. Has LIPA or Keyspan been notified of the proposed subdivision? If so, please
provide proof that service will be provided. ~~
21. Please indicate the type of open space proposed and how it will be
22. Are there any existing structures on the pr ~ If so, please indicate the type of
structure and its use(s). Will these structures emain, be removed or altered?
ray~deY,-F i a ~ hamP
23. Based on the parcel yield and the affordable housing requirement of the Town Code,
how many Moderate Income Family Dwelling Units are proposed? If the number that
will be built is less than 25% of the yield, please indicate how you intend on satisfying
the requirement.
24. Application completed by [~ owner [ ]agent [ ]other
Signature of Preparer Date / D O
617.20
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I -PROJECT INFORMATION (To be comoleted by Aoolicant or Protect Soonsorl
1. APPLICANT/SPONSOR
NC~Y1-F aa~ i~,~ mA~A 2. PROJECT NAME
fIMA~A Lo i LINF ~'~G
3. PROJECT LOCATION:
Municipality ~.l O Z.. ~ County SI~~O
4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map)
5. PROPOSED ACTION IS:
New ~ Expansion Modification/alteration
6. DESCRIBE PROJECT BRIEFLY: ~ a / y00 '~~_ r•cd; Qwl+ul ,,.4-J
'./oo J.~
"
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d
x,
)
,
t"~ SPP'
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~o~- ~~n~ c~.urq,~ a~Q
7 ~`^~ a d ~ Gcn y ~'}.
7. AMOUNT OF LAND AFFECTED: ~+
Initially ' `l oe l/_ S.t.~~5•t • Ultimately ~_ acres "
8.
,._.....
WILL PROPOSED ACTION COMPLY WITH F~CISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? .;
M...,~.
Yes ~ N
If N
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M
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escr
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e
.A .. 11 ~I ~"~
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9. _.
WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? r r -
Residential ~ Intlustdal ~ Commercial ~gnculture ~ Park/ForesVOpen Space ~ Other
Describe: JL~ ~ ~ r~~)~~
..
-~`_
~~t rt . - ... -
} _
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY THE GOVERNMENTAL AGENCY
(FEDERAL, STATE OR LOCAL)? ~ . -
Yes t~No If Yes, list agency(s) name and penniVapprovals: `~ „x,.~~^"'"'~
,w,`.;.~
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
Yes ~ No It Yes
list agenc
(s) name and
ermiVa
rovals
,
y
p
pp
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
Yes 'Flo
I CERTIFY THAT THE INFOr^R~MATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE / p
A
li
V
AS
pp
can
Sponsor name: ~ HO WI
'V, m Date: ~.- Ib `60
Si
t
~~
gna
ure:
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 ,, .,. ...; ..4
PART II • IMPACT ASSESSMENT To be com leted b Lead A enc
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 8 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF.
Yes ~No
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? fl No, a negative
dectaration may b superseded by another involved agency.
Ves ~No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers maybe handwritten, if legible)
C1. Existing air quality, surtace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
poten/ItAAAilaVll1f~or erosion, draiNage or Flooding problems? Explain bdefly:
C2. Aesthetic, a~ ultural, archa~logical, historic, or other natural or cultural resources; or community or neighbomood character? Explain briefly:
Nl~ N~,
C3. Vegetation or fauna, fsh, shellfsh or wildlife species, signifcanl habitats, or threatened or endangered species? Explain briefly:
N~
C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly:
N~
C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain bdefly:
C6. Long term, short term, cu~~m)ulative, or other effects not identified in C1-C5? Explain briefly:
ly/ :l
C7. Other impacts (including changes in use of either quantity or type of energy)? Explain bdefly:
N~
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTA AREA (CEA)?
Yes ~NO If Yes, explain briefly:
E. IS THERE, OR IS HERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
Yes ~No I1 Yes, explain briefly:
PART III -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) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, atld attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part 11 was checked
yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
Checkthis box if you have identifed one or more potentially large or signifcanl adverse impacts which MAY occur Then proceed directly to the
EAF andlor prepare a positive declaration.
Check this box if you have determined,basetl onthe information and analysis above and any supporting documentation, that the proposed action
NO7 result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determir
Name of Lead Agency
Print or Type Name of Responsible icer in Lead Agency
Signature of Responsible Officer in Lead Agency
Title of Responsible Officer
Signature of Preparer (If different from responsible offcer)
PLANNING BOARD MEMBERS
JERILYN B. WOODHOUSE
Chair
KENNETH L. EDWARDS
MARTIN H. SIDOR
GEORGE D. SOLOMON
JOSEPH L. TOWNSEND
ho~aOF SO[/lyo~
• ~~o,~
~y00UM'r,~"~''
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
MEMORANDUM
To: Accounting
From: Planning Department
Date: July 17, 2008
Re: Pavments
MAILING ADDRESS:
P.O. Box 1179
Southold, NY 11971
OFFICE LOCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
Southold, NY
Telephone: 631 765-1935
Fax: 631 765-3136
Attached are the checks listed below. Payments are for deposit into a deferred
account.
Applicant/Project Name &
T e Tax Mnp
# Amount Check Date/No.
Amara Lot Line 55-5-3 $500 7/16/08 - 353
Reiters 7-Acre Farm SP 45-5-2 $500 7/17/08 - 993
Encs.
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