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HomeMy WebLinkAbout1000-99.-3-13PLANNING BOARD MEMBERS JERILYN B. WOODI:tOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND PLANNING BOARD OFFICE TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd~ & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 September 13, 2007 Patrida Moore, Esq. 51020 NYS Route 25 Southold, NY 11971 Re: Proposed Standard Subdivision for the Clemente Family Holdings, LLC. SCTM# 1000-99-3-13 Zoning District: R-40 Dear Ms Moore: The Planning Board is in receipt of an application for a two lot subdivision of the above- referenced property. The Board reviewed the proposal at their work session on September 4, 2007 and determined that the application cannot be processed at this time. It appears that the surveyor did not exclude all of the land seaward of the Coastal Erosion Hazard Area line for the purposes of establishing yield. Once this additional land is excluded, there will be insufficient area to yield two lots. Accordingly, we are returning the check you submitted for the application fees. Please contact this office to if you have any questions regarding the above. PATRICIA C. MOORE 50-791/214 6 3 9 3 ATTORNEY BUSINESS ACCOUNT 4224010969 51020 MAIN RD 765-4330 SOUTHOLD, NY 11971 L)^,, (~//~ >7 North Fork Bank ' www. northforkbank.corn i ~ PATRICIJJ~ C. MOORE, ATTORNEY AI~ LAW 51020 Main Road, Southold, NY 11971 (631) 765-4330 TO SUBJECT ~[~Town o~' Southold .> LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within 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 Waterfront 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", then 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 making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot 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 Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# F_~ (5~ -/~ 6/y~/t4d~/~2~ The Application has been submitted to (check appropriate response): Town Board [~ Planning Board [~ Building Dept. [-~ Board of Trustees Category of Town of Southold 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: o7.7 Location of action: Site acreage: Present land use: ~?~z/~z'4~w~d Present zoning classification: ~. ~¢9 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: ~'/~'r'~erT/~ :~Fc729*~g~[ /~/r)/c~//~cT~', /__L.~ a / z (b) Mailing address: ~//o /~-~ ~'(-~c-- ~c~'//~'~'?f~ /??af, /ICl?/ (c) Telephone number: AreaCode( ) ~:9~/- ~¢1'2 ~,~ ~:~ tD (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] Uo[~ ifyes, which state or federal agency? ~ .~tlh:w'C~$/~r') 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 Atlach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~ Yes ~ No [] Not Applicable Attach additional sheets il' oeccssm y Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No [~ Not Applicable Atlach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria --IH Yes [-~ No [~ Not Applicable / Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Sonthold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria [] Yes ~ No ~Not Applicable 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 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. ~-~ Yes ~ No [-~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold 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 III - Policies; Pages 47 through 56 for evaluation criteria. ~ Yes ~ No L 1 Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary aud Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. I}Q 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 [~ No ~ Not Applicable Created on 5/25/05 11.'20 AM PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLONON PLANNING BOARD OFFICE TOWN OF SOUTHOLD MAILING ADDRESS: ILO. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 Application for Sketch Approval APPLICATION IS HEREBY MADE to the Town of Southold Planning Board for SKETCH APPROVAL for the subdivision describcd herein: 1. Name of Subdivision 2. Suffolk County Tax Map ~ 3. T~e off Subdivision 4. Hamlet 5 m Street Address/ 7. 8. 9. 10. Project Location Acreage of Site Proposed Yield Number of Lots Proposed Zoning District Date of Submission c~ /-0,'% / F- 11. Please provide the names, addresses and phone numbers for the following people: ~lgcnt: Property Owner(s): Engineer: 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. 13. Has a pre-submission conference been held with the Planning Board? If so, provide date. ~- ;27- D7 14. Has the owner/applicant met with Land Preservation? If so, provide date. a/o ' 15. Is any part of the property in agricultural use? ,A,'9 16. Is there an existing or proposed sale of development rights on the property? ,/Va 17. Does the owner own any adjacent properties? If so, please indicate the properties by SCTM#. ,/FO 18. Are there any building permits currently pending on this property? if yes, please provide permit nnmbcr(s). 19.The site will be serviced by the fblloxving special districts or utility companies: Fire District Post Office School District Water 20. Has LIPA or Kcyspan been notified of the proposed subdivision? If so, please provide proof that selwice will be provided.__ /SXl~/~a --~44,4Z~. 7 2l. Please indicate the type of open space proposed and how it will be managed? 22. Are there any existing structures on the property'? If so, please indicate the type of structure and its use(s). Will these stmcturcs remain, be removed or altered? 23. Based on the parcel yield and thc affordable honsing 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. A//,~ 24. Application completed by [ ] owner Signature of Prepare~ ~ agent [ ] other Date ~.~ ~o~. 0 ~7' Applicant Transactional Disclosnre Form The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of tox~ officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. last name, first name, :~ddle initial / unless you are applying in the name of someone ehe or other entity, such as a company If so, indicate the other person '3 or company's name. Natnre of Application: (Check all that apply) Tax grievance Building Variance Trustee Special Exception Coastal Erosion Change of zone Mooring Subdivision Plat - X Planning Site Plan Other (Please name other activity) Do you personally (or through yonr cmnpany, spouse, sibling, parent or child) have a relationship with any officer or employee of the Town of Southold? "Relationship includes by blood, marriage or business interest. "Business interest" means a business, including a pannership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns ~nore than 5% of the shares. Yes N%X~ If you answered "Yes" complete the balance of this form and date and sign where indicated. Name of the person employed by the Town of Sonthold Title or position of that person Describe thc relationship between yourself(the applicant) 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 souse, sibling, parent or child is (check all that apply): A. the owmer of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B. the legal or beneficial owner of any interest in a noncorporate entity (when the applicant is not a corporation); C. an officer, director, partner or employee of the applicant; or D. thc actaal applicant Description of Relationship: Submitted this !~3a~ f~M004 Summary of the Subdivision Process Each application to the Town of Southold Planning Board fbr approval of a subdivision of land shall be submitted and reviewed in the following stages, except as indicated: I1. III. Sketch Approval Preliminary Plat Approval (for Standard Subdivisions only) Final Plat Approval Sketch Approval The Planning Board accepts the general design of the subdivision map by granting Sketch or Conditional Sketch Approval. It is generally during this early stage in the process that the Planning Board refers the plans to the other regulatory agencies for their comments, including local fire departments, the Suffolk County Planning Commission, thc Town Trustees and the Town Engineer (for a preliminary review). Often, the comments and/or recommendations made by these agencies are incorporated into the proposed subdivision design. The Planning Board will advise an applicant on how to proceed and if there are any major concerns which need to be addressed prior to the issuance of any approvals. The general procedure for sketch approval is as follows: A. Sketch Application B. Coordinate SEQRA C. SEQRA Determination for Conservation Subdivisions D. Referral to County Planning Commission and Local Fire District and coordination with the Suffolk County Department of Health Services, the New York State Department of Transportation and/or the Suffblk County Department of Public Works E. Sketch or Conditional Sketch Approval II. Preliminary Plat Approval Preliminary plat approval is required of STANDARD SUBDIVISIONS ONLY. (Proposals for Conservation Subdivisions will skip this step entirely and go from Sketch Approval directly to Final Plat Approval). This process involves a preliminary heanng, which will be set AFTER the environmental review has been completed, the preliminary maps are prepared (and found acceptable by the Board) and the preliminary road and drainage plans have been reviewed by the Town Engineer. The overall layout of the subdivision will be determined and most of the issues ~vith respect to design and environmental impact will be addressed. The Planning Board may require that the proposed subdivision incorporate some or all of the recommendations made by the other regulatory agencies. The general procedure for Preliminary Plat Approval is as follows: A. Preliminary Plat Application B. Referral of Preliminary Road and Drainage Plan to Office of the Town Engineer C. Referral of Draft Legal Documents, if any, to the Town Attorney's Office D. Set Preliminary Hearing E. Preliminary or Conditional Preliminary Plat Approval 1II. Final Plat Approval A final public hearing will be scheduled upon submission of the final plat with the Health Department stamp of approval, a letter of water availability or a valid water contract with the Suffolk County Water Authority, final Declaration PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold, N.Y. 11952 Tel: (631) 765-4330 Fax: (631) 765-4643 Margaret Rutkowski Betsy Perkins Secre 'taries Authorization Letter Southold Town Planning Board Southold Town Zoning Board Suffolk County Health Department New York State Department of Environmental Conservation and any and all Town, County, and New York State Agencies Re: Clemente Property SCTM# 1000-99-3-13· i Jonathan D. Clcmente, Trustee on behalf of [t°/O~"~' ~O~' i>", a.s the owners of the above referenced property authorize our attorney, Patricia C. Moore to act as our agent and handle all necessary work involved in the subdivision process with the Southold Town Plann ng Board, and 7' any other Sign ature: x-"-.~x"~_~/~..~--~ ~ . Jonathan D. Clemente Swom.~before me this day olLlt~ , Not ,ary / ~ ~ARBARA M. COLIE A Nota[y Public of New Jersp/ I~ Commission Expires March II., ZDll ~'d E:b'9~ C:gL l[~9 aOTJ.,4-O me"1 a,.4ooN dSlt~:~,O ~O ET un(' 617.20 Appendix A State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether s project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequently, there are aspects of a project that are subjective or unmeasurable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not 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 project or action. Full EAF Components: The full EAF is comprised of three parts: Pert 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. THIS AREA FOR LEAD AGENCY USE ONLY DETERMINATION OF SIGNIFICANCE -- Type 1 and Unlisted Actions Identify the Portions of EAF completed for this project: ~ Part1 [] Part2 []Part 3 Upon review of the information recorded on this EAF (Parts I and 2 and 3 if appropriate), and any other supporting information, and considering both the magnitude and importance of each impact, it is reasonab[y determined by the lead agency that: 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. 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.* 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 o/VAction / / Name of Lead Agency Print or Type Nome 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) website Data Page 1 of 21 PART 1--PROJECT INFORMATION Prepared by Project Sponsor NOTICE: This document is designed to assist in determining whether ~he action proposed may have a significant effect on the environment. 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 aay additional information you belJ eve will be needed to complete Parts 2 and 3. It is expected that completion of the full EAF will be dependenl on information currently available and will not involve new studies, research or investigation. It information requiring such additional work Is unavailable, so indicate and specify each instance. Name of Action Location of Action (include Street Address, Municipalily and County) Name of Owner (if differeot) Address City/PO Business Telephone State Zip Code Description of Action: Page 2 of 21 Please Complete Each Question--INdicate N.A. if not applicable A. SITE DESCRIPTION Physical setting of overall project, both developed and undeveloped areas. 1. Present Land Use: [] Urban [] Industrial [] Commercia, D Forest D Agriculture DOther [~ Residential (suburban) ~] Rural (non-farm) Total acreage of project area: ~, 7~_~ acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushlend (Non-agricultural) __ 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 SuCace Area Unvegetated )Rock, earth or fill) ~ acres acres Roads, buildings and other paved surfaces __ acres acres Other (Indicate type) ~ ' /~ ~ acres acres 7 8. 9 What is predominant soil type)s) on project site? a. Soil drainage: ~'~Well drained //-.22'~/o of site Are there bedrock outcroppings on project site? Ir, ,t Yes a. What is depth to bedrock (in feet) []Moderately well drained __% of site. ~Poorly drained % of site If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? acres (see 1 NYCRR 370). r~7]No Approximate percentage of proposed project site witb slopes: M0-10% % ~,0-15% % [] ,5% o~greater ' , to, or contain a building, site, or district, listed on the State or National Registers of OYes ~No Is project substantia~ontiguous Historic Places? ~ Yes ~ No Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? What is the depth of the water table? ~¢ (in feet) ls site located over a primary, principal, or sole sourqe aquifer? 10. Do hunting, fishing or sbe[I fislfing opportunities pres~rltly exist ~n tile project area? r~l Yes [] No ~Yes ~o Page ;3 of 21 1 1. Does project'site contain any species of plant or animal life that is identified as threatened or endangered? According to: Identify each species: 1 2. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations? [~Yes DNo DYes DNo Describe: 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? If yes, explain: I 14. Does the present site include scenic views known to be important to the community? DYes I , 15. Streams within or contiguous to proioct area: 16. a. Name of Stream and name of River to which it is tributary Lakes, ponds, wetland areas within or contiguous to proiect area: Size (in acres): Page ,I of 21 17. Is the site served by existing public utilities? [] Yes [] Ho a. If YES, does sufficient capacity exist to allow connection? []Yes b. If YES, will improvements be necessary to allow connection? DNo DYes .~No 18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 2B-AA, Section 303 and 304? BYes 19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Articla 8 of the ECL, and 6 NYCRR 6177 []Yes r'~No 20. Has the site ever been used for the disposal of solid or hazardous wastes? B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate). 3. Will disturbed areas be reclaimed DYes Di'lo a. If yes, for what intended purpose is the site being reclaimed? BYes ~No a. Total contiguous acreage owned or controlled by project sponsor: b. Project acreage to be developed: ~ acres initially; c. Project acreage to remain undeveloped: ! ~2- ~ acres, d. Length of proiect, in rniles: ~"~1' (if appropriate) e. If the project is an expansion, indicate percent of expai~sion proposed. f. Number of off street parking spaces existing '~ ; proposed g. Maximum vehicular trips generated per hour: h. If residential: Nember aud type of housing units: One Family Two Family Initially Ultimately i. Dimensions (in feet) of largest proposed structure: __ ~'~'"' height; j. Linear feet of frontage along a public thoroughfare project will occupy is? How much natural material (i.e. rock, earth, etc.) will be removed from tile site? ~N/A acres ultimately. ~'~ (upon /'completion of project)7 Multiple Family Condominium width; '~:~ tons/cubic yards. length. b. Will topsoil be stockpiled for reclamation? []Yes [] No ' c. Will upper subsoil be stockpiled for reclamation? [] Yes [] No Page 5 of 21 5. Will any mature forest (over 100 years old) or other Iocarlydmportant vegetation be removed by this project? r.~ Yes r~No 6 If single phase project: Anticipated period of construction: 2 months, (including demolition) 7. If multi-phased: a. Total number of phases anticipated (number) b. Anticipated date of commencement phase 1: month year, (including demolition) c. Approximate completion date of final phase: __ month __ year. d. Is phase 1 functionally dependent on subsequent phases? ~ Yes ~"~ No 8. Will blasting occur during construction? [] Yes ~ No 9. Number of jobs generated: during construction /D ; after project is complet~ ~ 10. Number of jobs eliminated by this project /~///~ 11. Will project require relocation of any projects or facilities? ~ Yes [] No If yes, explain: 12. Is surface liquid waste disposal involved? [] Yes []No a. If yes, indicate type of waste {sewage, industrial, otc) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? ~Yes ~No 14. Will surface area of an existing water body increase or decrease by proposal? []Yes r~No if yes, explain: 15. Is project or any portion of project located in a 100 year fJood plain? [] Yes 16. Will the project generate solid waste? [] Yes a If yes, what is the amount per month? __~ tons~ ~'~4f~¢.~¢,~ b. If yes, will an existing solid waste facility be used? [] Yes [] No c. Ifyes, givename ~/~..~/~ ~.~,~. ; location d. Will any wastes not go into a sewage disposal system or tnto a sanitary landfill? ~Yes [] Parle 6 ,~f 21 e, if yes, explain: 17. Will the project involve tbe disposal of solid waste? a. If yes, what is the anticipated rate of disposal? __ tons/month. b. If yes, what is the anticipated site life? years. Will project use herbicides or pesticides? DYes 1 8. 19. Will project routinely produce odors (more than one hour per day)? ~Yes 20. Will project produce operating noise exceeding the local ambient noise levels? DYes/[~No 21, ~Vill project result in an increase in energy use? [] Yes [] No If yes, indicate typels) 22. If water supply is from wells, indicate pumping capacity ,~"- gallons/minute. 23, Total anticipated water usage per day gallons/day. 24. Does project involveLiicaJ State or Federal funding? []Yes [] No If yes, explain: Page 7 ~ff21 25. Approvals Required: City, Town, Village Board E~Yes [] No Type Submittal Date City, Town, Village Planning Board ~Yes E]No City, Town Zoning Board ~Yes [] No City, County Health Department r'~ Yes ['~ No Other Local Agencies [~Yes r~ No Other Regiona Arencles []Yes ~ No State Agencies [~Yes [] No Federal Agenc es ~Yes ~ialo Zoning and Planning Information Does proposed action h~volve a planning or zoning decision? [~Yes ~ No If Yes, indicate decision required: ~Site plan r~ Zoning variance ~ SpeCial use permit E~ New/revision of master plan D Resource management plan ~ Subdivision ~ Other Page 8 of 21 What is the zoning classification(s) of the site? What is the maximum potential development o( the site if developed as permitted by tho present zoning? 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 tile recommended uses in adopted local land use plans? ~Yes []No 7. What are the predominant land use(s) and zoning classifications within a V* mile radius ol,'proposed action? Is the proposed action compatible with adjoining/surrounding land uses with a ¼ mile? ~Yes [] No If the proposed action is the subdivision of land, t~ow many lots are proposed? ~ a. What is th~ minim~m lot size r~ropo~,c]? / ~ ' Page 9 of 21 Will proposed action require any authorization(s) for the formation of sewer or water districts? [] Yes D Ho Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection? 12. a. If yes, is existing capacity sufficient to handle proiected demand? Will the proposed action result in the generation of traffic sigoificantly above present levels? a. If yes, is the existing road network adequate to handle the additional traffic. DYes I ~'Yes [] No D, Informational Details / Attach any additional information as may be,~eededto clarify your project, If there are or may be any adverse impacts associated with your proposal, please discuss ~]ch 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, Signature (/// '~'~//~g/'/~-' ~ Date If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. Page 10 of 21 fy T COUNTY OF SUFFOLK (~) K eal Proper ox Service ency SOUTHOLD ]000 SECTION NO PROPERT? MAP LASER FICHE FORM SUBDIVISIONS Project Type: Standard Status: Returned SCTM #: 1000 - 99.-3-13 Proiect Name: Clemente Family Holdings, LLC Location: Bailie Beach Road, Mattituck Hamlet: Mattituck Applicant Name: Clemente Family Holdings, LLC Owner Name: Clemente Family Holdings, LLC Zone 1: R-40 Approval Date: PLAT Signed Date: I¥/~:: ~ ~On~ ~ OPTIONAL ADDITIONAL INFORMATION A date indicates that we hove received the related information Zone 2: C and R's · Homeowners Association ' R and M Agreement: Address: County Filing Date: Zone 3: SCAN Date: LOCATION MAP N / / / \ \ ) / : / i / N W E S BO 0 40 80 160 NO'I'B5 LEGEND TCPIGAL PLOt PI,AN UCE HOUDE PLANNING BOAF~> GE~TIPIGAT ON SUFFOLK GOUNt'f D~:PAt~.'n',4ENT OF: HEALTH DE'P-,VIC, E,5 HAUPPAUGE, N.Y. 400 Young & Yo'~g ~l'f'~ ~ATA TOT/M- AJ;~A = 2007 ENG INEE~,,'5 GE~,TIt=IGATION 5UF~Vt~YO~'~ CEI~.TIFIGATION G/Ehd~NTI~ PAMIL'I'* HOLdiNgS, O/O PATm--IC..IA (... MOO'R.E, ~1020 MAIN ~OA~ 5OgTHOLD, NE~ ¥O~.1<::: IIq~l r SUB, DIVISION MAP GL~MEN"I~ P:AMILh" HOL~IN®5, LLG. Al, Mc~'cl;It:uck, To~n o~ ~out:hold 5uH'olk Gount~l, Ne~,I York