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Home My WebLink About1000-126.-6-18pL:ad~NrING BOARD MEMBE BENNETT ORLOWSKI, JR, Chairman WILLIAM J. CREMERS KENNETH L. EDWAP-.D$ GEORGE RITCHIE LATHAM, JR. RICHARD G. WARD PLANNING BOARD OFFICE TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Tolephone (516) 765-1938 Date Received Date Completed Filing Fee APPLICATION FOR CONSIDERATION OF xNew Change of Use Re-use Extension Revision of Approved Site Plan IlAR - 3 200 Southold Towrl Planni ~oard Name of Business or Site: SCTM#: Location: Address: VETERANS PARK-MATTITUCK PARK DISSTRICT q000- 126 6 18 9233 Peconic Bay Boulevard, Mattituck NY 11952 Name of Applicant: Address of Applicant: Telephone: 631-734-7492 Owner 0f Land: Mattltuck Park District Agent or Person responsible for application: Address: Telephone: Site plans prepared by: License No, Address: Telephone: Warren A. Sambach Sr. P.E. Box IN3q 7675 Cox Lane. Cutcbogue, NY 11935 Warren A. Sambach Sr~ P.E. P.O. ~ox 1033 7675 Cut oue, 631-734-7492 Warren A. Sambach Sr. P.E. 23779 NY 11935 P.O. Box 1033 7675 Cox Lane, Cutchogue, NY 11935 631-734-7492 The Town of Southold's Code of Ethics prohibits conflicts of interest on tile part of town officers asd employees. Ths up~ose of this form ia to provide lllformstton which can alert the town of possible collflicts of interest and allow it to take whatever action is necessary to avoid same. YOHN NAME: Warren A. Sambach Sr. (Lsat name, first name, middle initial, unless ?ax grievance ~P~°~ o~,° [ ro~la t_~- (Si~e Plan) YES __ NO X If you answered "YES," complete the balance of this form Name of person employed by the Town of Southold Title or position of that persom Describe the relationship between yourself (tile applicant) and the town officer o~ employee. Either che~k the appropriate line A) through D) and/or describ~ in the space p~ovided. The town office~ or employee or his or her spouse, parent, or ch[id is (check all that apply). DESCRIPTION OF RELATIONSHIP Page 3 Plannln~ Board Site Plan Application 3.1 Ac .Total Land Area of Site (acres or square feet) R-80 Zoning District Existing Use of Site Public Park · Proposed Uses on Site. Show all uses proposed and existing. Indicate which buildh,g will have which use. If more than one use Is proposed per building, indicate square footage of floor area that will be reserved per use. 1633 SF Storage of Equipment (Tractors, Trucks, Lawn Movers, etc 210 SF Office, 210 SF Meeting Room, 208 SF Kitchen, 190 SF Bathrooms, 156 SF Boiler & Locker Room Gross Floor Area of Existing Structure(s) (To be removed) 2940 Gross Floor Area of Proposed Structure(s) 0 - 067 Percent of Lot Coverage by Bulldlng(s) 0 - 17 Percent of Lot for Parking (where applicable) _F_~Percent of Lot for Landscaping (where applicable) Has applicant been granted a vadance and/or special exception by Board of Appeals - Case # & date Board of Trustees - Case # & date Letter, 11-22-2002 NY State Department of Environmental Conservation - Case # & date 1-4738-01147/00005 Suffolk County Department Health Services - Case # & date ~,-e_-,_d Pe_-',-it 12-16-02 Case Number Name of Applicant Date of Decision .Expiration Date Other NO Will any toxic or hazardous materials, as defined by the Suffolk County Board of Health, be stored or handled at the site? If so, have proper permits been obtained? Name of Issuing agency Number and date of permit Issued. NO ACTION (EXCAVATION OR CONSTRUCTION) MAY BE UNDERTAKEN UNTIL APPROVAL OF SITE PLAN BY PLANNING BOARD, VIOLATORS ARE SUBJECT TO PROSECUTION. Site Plan Applications Public Hearings Under the current site plan application procedure, the process for reviewing a site plan application is: a public hearing is not scheduled and held by the Planning Board until after, among other things, the site plan has received a stamped Health Department approval. The applicant shall now have the following options; 1. To follow the established procedure, or To have the Planning Board schedule and hold a public hearing on the site plan application and have the Planning Board vote on the proposed conditional site plan prior to the applicant receiving Health Departn[~ent approval subject to the following conditions: The applicant hereby agrees and understands that if the site plan which receives stamped-Health Department approval differs in any way from the proposed conditional site plan on which the Planning Board held a public hearing and voted on, then the Planning Board has the right and option, if the change is material to any of the issues properly before the Planning Board, to hold a public hearing on this "revised" site plan application and review its conditional approval. The applicant agrees not to object to a new public hearing and Planning Board review of the revised application. Applicant Agreement on Site Plans. The applicant is aware of the terms of this approval and certifies to these terms by his/her signature below. Re: SCTM#: 1000- l~-~-lR NARREN A. SAMBACH SR. P.E. 02-14-03 Applicant Date Page 2 Planning Board S~te Plan Application APPIlCANI~ AFFIDAV[F SI-ATE OF NEW YOR~ COUNIY OF SUFFOLK WARREN A. SAMBACH SR. being duly sworn, deposes and says that he resides at 7675 COX LANE, CUTCHOGUE, NY 11935 in the State of New York, and that he Is the owner of the above properS, or that he is the APPLICANT of the MATTITUCK P{RK DISTRICT (Title) (Specify whether Partnership or Corp.) which Is hereby making application; that there are no existing structures or Improvements on the land which are not shown on the Site Plan; that the title to the entire parcel, Including all rights-of-way, has been clearly established and is shown on said Plan; that no part of the Plan Infringes upon any duly filed plan which has not been abandoned both as to lots and as to roads; that he has examined all rules and regulations adopted by the Planning Board for the filing of Site Plans and will comply with same; that the plans submlL'ted, as approved, will not be altered or changed in any manner without the approval of the Planning Board; and that the actual physical ImprovementS will be Installed In strict accordance With the plans submitted. APPLICANT Signed (Partner or Corporate Officer and Title) Sworn ~o me this/~ 14 dayof ~;'~)~1(~'< ~ 2003 (Notary Public) [ ~R~GORY ~. S~O~ND ~ Public, ~tate of N~ Yo~ LETTERHEAD MATTITUCK Prk district Etc I,,,~ ~/v/~, ~/<-, /~/F'/~//~ommissioner of the Mattituck Park Districtowners of t~e Veterans Park, Mattituck, NY SCTM: 1000-126-6-18, hereby authorize Warren A. Sambach Sr.,P.E to act as my agent and handle all necessary work involved in filing of appli~a~_t, ions and s~j~ring aDDroval of Plot Plan. // ~,~.-~ ~Commi s s ioner ~w~rrn before me t, his ~ day of Notary February, 2003. Stamp 14-16-2 (9/95)-- 7c 617.20 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM SEQR Purpose: '[he full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer, Frequent- I¥, 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 envirqnment or may no.t 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 enough to allow introduction of information to fit a protect 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. Par! 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 rids project: [~ Part 1 [] Part 2 E]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 magnitude and importance of each impact, it is reasonably determined by the lead agency that: [] A. The protect 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. D B. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because ~e mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared,*' The project may result in one or more large and important impact~ that may have a significant impact on the envlronmenL therefore a positive declaration will be prepared. r'l c. * A Conditioned Negative Declaration is only valid for Unlisted Actions Erect one story 42' x 70' Building with 42' x 20' Name of Action Name ot Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency $[gnature of Preparer (If different from responsible officer) Date PART 1--PROJECT INFORI~,~ON Prepared by Proiect Sponsor NOTICE: This document is designed to assist in determining whether tbe action proposed may have a significant effect on the enviroqment, Please complete the entire form, Parts A through E. Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional 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 involve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify each instance. NAME OF ACTION Erect one story building 42' x 70' w/ 42' x 20' overhang LOCATION OF ACTION (Include Streel Address, Municipality and Count~ 9233 Peconic Bay Boulevard, Southwest corner Bay Avenue ~AMEOFAPPLICANT/SPONSOR - DUSIHE~ST£LEPHONE Warren A. Sambach Sr. P.E. 631 )734-7492 ADDRESS P.O.. ~ox 1033 7675 Cox Lane, J STATE J ZiP CODE c6~%°ch~ g u e NY : 11935 NY 11935 · I SUSINE8~ TELEPHONE NAME OF O~NNER (If different) 1631) 298-9103 Mattituck Park District ADDRESS P.OL Box 1413 Main Road STATE J ZiP COOE Cl~mO NY 11952 Mattituck DESCRIPTION OF ACTION Erect 42' x 70' one story building w/42' x 20' overhang- Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both' developed ~nd undeveloped areas. R-80 1. Present land use: rlOrban I-Ilndustrial rlCommercial ~jLgesidential (suburban) I-1Rural (non-fan nForest C)^griculture C]Other 2. Total acreage of project area: 3.1 acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agrlcultural) acres acres Forested acres acres Agricultural (includes orchards, cropland, pasture, etc.) acres acres Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) acres acres Water Surface Area acres _ acre~ .- acre5 Unvegetated (Rock, earth or fill) acres Roads, buildings and other paved surfaces ___!1 _1'1 acres ' 1.0 __ acre: __ acre~ Other (indicate type) acres 3. What is predominant soil type{s) on project sitel a, Soil drainage: Ej~Well drained nn- % of site OModeratelywell drained % of site I-1Poorly drained % of site b. If any agricultural land is involved, how many acres o[ soil are classified within soil group 1 through 4 of the i' Land Classification System~ acres. (See 1 NYCRR 370), 4. Are there bedrock outcroppir~gs on project site? OYes I~'No a What is depth to bedrock? (in feet) 2 S Approximate percentage of proposed project site with slopes [~ 10% . % · C315% or greater % 6 Is proiect substantially contiguous lo, or contain a building, s~te, or district, listed on the State or the National Registers of Historic Places? OYes ]~No 7~ Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? OYes [No 8. What is the depth of the water table?'-/_.O (in feet) 9~ Is site located over a primary, principal, or sole source aquifer? C]Yes 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? 11, Does project :site contain any species of pi.ant or animal lite that is identified as threatened or endangered? I~Yes ]~]No According to Identify aa.ch species 12 Are there any unique or unusual land forms on the project site? (ie, cliffs, dunes, other geological formations) OYes C]~o Describe 13. Is the project site presently used by the community or neighborhood as' an op~}~ space or re~:reation area? [~Yes []:]No If yes, explain MA,P,PT,PFI't~R" p]~]] i'~TR~PI~TP~P_VI~'PI~'~I~I*~ P~,]~i~ 14. Does the present site include scenic views known to be important;tO the cbmmunit~? ~Yes ~No 15. Streams within or contiguous to project area: N/~ - a. Name of Stream and name of River to which it is tributa~ 16, Lakes, ponds, wetland areas within or contiguous to project area: a. Name b, Size (In acres) 17. Is the site served by existing public utilities? EjjYes ENo a) If Yes, does sufficient capacity exist to allow ~onnection? J~es rlNo b) If ¥.es, will improvements be necessary to allow connection? E]Yes 1~o 18. Is tl~e site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25*AA. Section 303 and 304? I-lYes ]J~Jiqo 19. Is the site located in or substantially contiguous to a Critical Environmental A~ea designated pursuant to Article 8 of the ECL, and 6 NYCRR 6171 r-lyes llano ' 20. Has the site ever been used for the disposal of solid or hazardous wastesi' CiYes lrlNo acres; acres ultimately. B. Project Description 1. Physical dimensions and scale of pro)ect (fill in dimensions as appropriate) a. Total contiguous acreage owned or controlled by project sponsor 5.70 b. Project acreage to be developed: :3.1 · 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 40 g. Maximum vehicular trips generated per hour h. If residential: Number and type of housing units: One Family Two Family Multiple Family Initially Ultimately i. Dimensions (in feet) of largest proposed structure 20 height; 42 width; '70 length. j. Linear feet of frontage along a public thoroughfare project will occupy is? N/R ft. 3 ; proposed . (upon' completion of project)? Condominium 2 How much natural matePal . rock, earth, etc ) will be removed irorn lltsite? N~ONE ~ons/cubic yards 3 Wiil disturbed areas be reclaimed? :X][Yes ONo [:]N/A a If yes, tor what intended purpose is the site being reclaimed? R&I"R' I~'TT.T, b. Will topsoil be stockpiled for reclamation? .~Yes ONo MOSTLY SAND c will upper subsoil be stockpiled for reclamation? ~Yes {~No 4 How many acres of vegetation (trees, shrubs, ground covers) will be removed-from site? ~ acres. S Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this projecU EYes (~No 6. If single phase project: Anticipated period of construction months, (including demolition). 7. If multi-phased: a. Total number of phases anticipated ONE (number) b. Anticipated ~Jate of commencement phase I ~t~.~li,.P~-- month ~ year, (including demolition) c. Approximate completion da~e o[ final phase month year. d Is phase 1 functionally dependent on subsequent phases~ ~Yes ~o & Will bias.tin8 occur during construction~ ~Yes ~o 9. Number o~ jobs generated: during construction ~T~ ; ~fter project is complete ~ 10~ Numb~-bf jobs eliminated by this project ~O~ 11. Will project require relocation of ~ny projects or f]cilities~ ~Yes ~No If yes, explain 12. Is surface liquid waste disposal involved? nYes [~'No a. If yes, indicate type of waste (sewage, industrial, etc.) and amount, b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? OYes I~No Type 14. Will surface area of an existing water body increase or decrease by proposal? Explain OYes ][]No 15. Is project or any portion of project located in a 100 year flood plain? ~]Yes 16. Will the project generate solid waste? EYes ][]No a. If yes, what is the amount per month tons b. If yes, will an existing'solid waste facility be used? OYes ONo 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 []No OYes ONo :IZ. 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? 1§. Will project use herbicides or pesticides? [3Yes rlYes 7~]No tons/month. years. 19. Will project routinely produce odors (more than one hour per day)? [Yes ]~o 20 Will project produce operating noise exceeding tile local ambient noise levelsl C]Yes 21. Will project result in an increase in energy use? [3Yes If yes , indicate type(s) 22 If water supply is from wells, indicate pumping capacity . gallons/minute. 23. Total anticipated water usage per day V_~_~¥ gallons/day. 24. Does project involve Local, State or Federal funding? [3Yes ~No If Yes, explain ~No 25. Approvals Required: Type Submiltal Dale City, Town; Village Board ~Yes ~]No City, Town, Village Planning Board [~Yes UNo City, Town Zoning Board OYes ONo City, County Health Department ~}Yes ONo Other Local Agencies ~]Yes 'E3No Other Regional Agencies OYes [:]No State AgenciesNYSDEC C]Yes UNo Federal Agencies C~Yes ONo SANITARY DRAINAGE TOWN TRUSTEES-APPROVED JOINT PERMIT-APPROVED NOV/2000 NOV/2002 5/01 C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? I~Yes ONo If Yes, indicate decision required: ~zoning amendment FIzoning variance E3special use permit '[~subdivision ~)site plan C]new/revision of master plan C]resource management plan ~other 2. What is the zoning classification(s)of the site? p. 80 rOW -nENCJTTY 3~ What is the maximum potential development of the site if developed as permitted by the present zoning? 20% LOW DENSITY · 4 :;,.'~What: is4he 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? ~]Yes 7. What,are the predominant land use(s) and zoning classifications within a % mile radius of proposed action? RESIDENTIAL ClNo 8. Is the proposed action compatible with adjoining/surrounding land uses within a % mile? ~]Yes E]No 9. If the proposed action is the subdivision of land; how many lots are proposedIN/R a. What is the minimum lot size proposed? 10. Will proposed action require any authorization(s) for the formation of sewer or water districts~' I-lYes 11. Will,the proposed action create a.dema;~d' for any community providbd services (recreation; education, police, fire protection)? E]Yes ~]No EXISTING a. If yes, is existing capacity sufficient fo handle projected demand? I~Yes I-INn 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? OYes [:)No D. Informational Details a- ./L/~:~/ .~, ~ ~/.~ ~ - Attach any additional information as may be needed to clarify your project [[ there are or may be any adve~e impact~ 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 provided above is true to the best of my knowledge. Applicant/Spo~ Name W~. LAMBACH SR. P.E. Date2-14-2003 Signature ~ Title CO~rlT.TTN¢. ENGINEER If the action Is In the Coastal Area, and you are a slate agency, complete Itle Coastal Assessment Form before proceeding with this a~sessment. D. INFORMATIONAL DETAILS AND WATER SUPPLY NARRATIVE REQUEST Attach any additional information as may be needed to clarify your project. [f there are or may be any adverse impacts associated with your proposal please discuss sucl/impacts and the measures which you propose to mit gate or avoid them. 1. Provide explanation of existing site use, occupancy, structures, sanitary flow, water use; compare to proposed use, occupancy, structures, sanitary flow, water use. EXISTING P.~RK 2. Indicate the source of water supply, nearest public water main, nearest public well field, and adjacent private wells (if known). SCWA-PECONIC BAY BOULEVARD If pnbli'c water supply is proposed, indicate the ability of the water utility to provide water supply to the project. Provide letter of water availability or detailed explanation of status of review by water utility. If private water supply is proposed, indicate the well specifications, water quality based on on-site water quality data. Provide Suffolk County Department of Health Services approval or detailed explanation of status of review by agency. 5. Indicate proposed water conservation measures that will mitigate for unavoidable adverse impacts (If any). Conservation measures should include, but not be limited to: a. The use of drought tolerant plants for landscaping. b. The preservation of existing native vegetative buffers. c. The conservation of existing open space areas. d. The implementation of "natural" stormwater management practices (grass swales, filter strips, created wetlands, etc...). E. VERIFICATION I certify that the information provided above is true to the best of my knowledge. Applicant/Sponsor Name ~I/~RRIEN i~.. SAMB~_CIt SR. P. }E. Date 0'2--14-03 Signature ~~l~~ Title CONSIILTING ENGINEER If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. Sender: Subject: Sub~nission Without a Cover Letter Comments: ~,PR - 3 ~outhold To~ Plarmin :Board S~tb~m, tssio~ Wil, houl a Cover LeHer SuOject: LASER FICHE FORM Planning Board Site Plans and Amended Site Plans SPFile Type: Project Type: Site Plans Status: Incomplete Application - In Active SCTM #: 1000- 126.-6-18 Project Name: Mattituck Park District Address: 9233 Peconic Bay Blvd., Mattituck Hamlet: Mattituck Applicant Name: Mattituck Park District Owner Name: Mattituck Park District Zone 1' Approval Date: SCANNED OCT 2OO8 6 Records Management OPTIONAL ADDITIONAL INFORMATION End SP Date: Zone 2: Location: SC Filing Date: C and R's: Home Assoc: R and M Agreement: A date indicates that we have received the related information Zone 3: SCAN Date: