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HomeMy WebLinkAboutPawlowski, PaulELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER �o�ogu�Foc�r�o� �y�ypl � dao Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971. Fax (631) 765-6145 Telephone (631) 765-1800 www.southoldtowiiiiy.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD June 23, 2015 Re: Change of Zone Application Paul Pawlowski Post Office Box 1086 Westhampton Beach, New York 11978 Dear Mr. Pawlowski; The Southold Town Board and the Southold Town Planning Board met in a Joint Work Session to discuss your charge of zone application at 9:30 AM, Tuesday, June 16, 2015. The review and recommendations of your application are enclosed. Please complete your application in accordance with these requirements and submit it to my office. A public hearing cannot be noticed for this application until such time as a complete application in conformance with these requirements is received from you together with all items listed on the Checklist for Petition and Survey & Map Checklist. Please do not hesitate to call if you have any questions. Very truly yours, Eliza eth A. Neville Southold Town Clerk Enclosures (4) cc; Supervisor & Town Board Town Attorney Planning Department PLANNING BOARD MEMBERS DONALD J. WILCENSKI Chair WILLIAM J. CREMERS PIERCE RAFFERTY JAMES H. RICH III MARTIN H. SIDOR PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM 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: 631 765-1938 www.southoldtow-xmy.gov RECEIVED JUN 1 g 2015 To: Elizabeth A. Neville, Town Clerk From: Donald J. Wilcenski, Chairman 04P, Southold Town Clerk Members of the Planning Board Date: June 18, 2015 Re: Change of Zone Application (Rezoning Petition) of Paul Pawlowski The Planning Board has reviewed the Rezoning Petition (change of zone) application referenced above for completeness. There are several items that must be added and/or corrected to make the application complete. Please see attached Checklist for Rezoning Petition for the complete list and notations about which are missing. With regard to the maps needed, the survey submitted is sufficient, except not all the copies had the surveyor's seal. Six copies with the surveyors seal are needed to make the application complete. A key map on the survey showing the property in relation to the Southold/Riverhead town boundary would also be helpful. Six copies of the Sketch Plan are needed to make the application complete. The Sketch Plan submitted is not in accordance with the map checklist (see attached). Below is a list of the items that must be included in the Sketch Plan, with notes about this specific application. A. All property owners within 500 feet of the boundary of the parcel which is subject to the zoning action shall be shown. B. All existing buildings within 200 feet of the boundary of the parcel which is subject to the zoning action and their current use(s) including the name of the business. Southold Town Planning Board Page 2 June 18, 2015 C. All street names within 500 feet of the boundary. D. The hamlet location of the subject property, and the Suffolk County Tax Map (SCTM) Number. E. Zoning classification of the subject parcel and the surrounding area. (A copy of the zoning map can be substituted.) F. Name and address of person making map. G. Scale 1" = 100' or 1" = 200' H. The name of applicant and his address. Where applicable, a line indicating the boundary of the jurisdiction of the Suffolk County Planning Commission shall be shown (this line shall be 500 feet when measured at right angles to and parallel with parcel to which zoning action has been considered). Not applicable. State Rt. 25 is adjacent, which makes it clear that this application must be referred to Suffolk County Planning Commission. J. A suitable title for purposes of identifying the application. e.g. Pawlowski Rezoning Petition Sketch Plan K. North Point shall be indicated by an arrow. (Note if magnetic or tone) L. Seal from licensed surveyor, engineer or architect The Sketch Plans (pages 1 and 2) that were previously submitted would work well as subsequent pages in the map package because they provide additional details that may be helpful to the Town Board and the public viewing this application. All pages should reference the same project title. Encls: Checklist For Rezoning Petition Survey & Map Checklist cc: Scott Russell, Town Supervisor Members of the Town Board William Duffy, Town Attorney NAME OF APPLICATION: FEB0 201 DATE: a I I South1 5 old Town— ❑ Check means item is complete Circle means item not complete Planning Board e CHECKLIST FOR REZONING PETITION TC TA PB S �-- � C Q2h G c�� U.. G 4 c, Q 7e(..t h o��/Z Zx- ❑ El (4) complete copies of petition with Town Clerk with original signatures. Each set MUST be ordered as follows: ❑ ❑ Fee of $1,000.00 ($500.00 for AHD) ❑ ❑ ❑ Written notice to all property owners within 200' of property; mailed within 5 days preceding filing of petition ❑ ❑ File proof of mailing of notices to adjacent property owners in a sworn statement with Clerk's office and submit all original certified mail postal receipts NOTICE MUST CONTAIN: • Statement Of Proposal (as presented in zoning petition) • Description Of Property • Present Zone And Proposed Zone • Petition Will Be Filed Within 5 Days • Petition Can Be Reviewed In Clerk's Office gW Public Hearing Must Be Held • Adjacent Owners Right To Be Heard @ Hearing • 10 Days Before Hearing Notice Published ❑ ❑ ❑ Meet all requirements for submitting zoning action pursuant to section 239 L & M of General Municipal Law attached hereto --❑ R- If applicable, file waiver of notice from property owner w/the clerk's office ❑ ❑ ❑O Six (6) rUlaPs drawn at the 1" = 100' scale in accordance with attached information sheet. ❑ ❑ Q Six (6) sketch plan maps at the 1" = 100' scale or the 1" = 20' scale in accordance with attached information sheet. ((�� 1 )V() i Z (7,01' C`h'i "-• 7r'rr.� (,j y� nb+cam; Z�J The procedural requirements appear to have been met by this application: Town Clerk Town Attorney Planning Board Signature Signature Signature Date Date Date I . I 0 GcLVI v Wf k SURVEY & MAP CHECKLIST `.l'he following information must be shown on the survey and map submitted with a change of zone petition: 1. Town Boundary line 2. Village Boundary line 3. State Park 4. County Park 5. State Road 6. State Parkway or Expressway 7. County Road 8. County Parkway 9. County Drainage Channel 10. State Public Building; 11. County Public Building must submit the :following: Survev Showing: A. Accurate description of the property by metes and bounds. B. Surveyors Seal. Viae Showing A. All property owners within 500 feet of the boundary of the parcel which is subject to the zoning; action shall be shown. B. All existing; buildings within 200 feet of the boundary of the parcel which is subject to the zoning action and their current use(s) including; the name of the business. C. All street names within 500 feet of the boundary. D. The hamlet location of the subject property, and the Suffolk County Tax Map (SCTM) 'Number. E. Zoning classification of the subject parcel and the surrounding area. (A. copy of the zoning map can be substituted.) 1�. Name and address of person making; snap. G. Scale I "= 100' or 1" = 200' I-1. The name ofapplicant and. his address. L Where applicable, a line indicating the boundary of the jurisdiction of the 5ufiolk County Planning Commission shall be shown (this line shall be 500 feet when measured at right angles to and parallel with parcel to which zoning action has been considered). J. A suitable title for purposes of identifying the application. K. North Point shall be indicated by an arrow. (Note if magnetic or tone) ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax(631)765-6145 Telephone (631) 765-1800 www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Stephen Kiely, Assistant Town Attorney Heather Lanza, Planning ctor From: Elizabeth A. Neville Re: Change of Zone Application of Paul Pawlowski Date: March 23, 2015 Enclosed is the Revised Amended Boundary Line Alteration submitted by the applicant to my office on March 20, 2015. Please review it and send me your comments and recommendations. Thank you. Cc: Supervisor & Town Board Members OH // D 5�1€• 0 € 1 REPUTED OWNER: / MONUMENT FOUND j r 0.4 I € € € I Q II :SHED Z2E I € I N I € I i E t € s I s t CONC ABRAHAM GARCIA & t t t s z SHARON RODRIGUEZ I t { I I { I t it t I � € 3 f52' LINE I f j ; € € j € m i €€ Q N { � ;! € � € I Z I I",l I I I S { t 4 { / 4 t t t t osll } t t t} f I I ! { € t •— I i I i I€ € ( € € € € f € € € ti € \ \ i € i \\ \\\ € 0 t \ i t o I a I Ir I i ILi 10, l 1 STAKE ' I JD if tt t I � t t I € } t € I I I I I { I I ) I I I ! { € € 1 { t t t t { t t { { t { t t { { t t € I 1 Il tt i 1 � I l I t € t i t � t k t t t t t ! I I € I ! t € t € € { € ! t It t k t t t I t i t t t t t t t t t t t t € I I I t € t € ! t CNNr1 NNT4iyFR it t t { 4 { t € I I Q I I € I € I f t I { 1 { I { { I 1 { 1 { J { t 1 { { { t r1 f { { t { { f { { { 0 { { 1 { w ! 1 � 1 { 0 !c/ la! �o! 1 1 { I { i { { { f { 1 { { { € € € { I { { 1 I { { I i { t { r , 0 J J W In 01 C9 ap W � F- O J i x O W L 0 - LU fY LM: SURVEY VIEW: SURVEY ka14tA140502}DWGtA140502.dwq, 3/19/2015 9:01:57 AM, Adobe PDF <� g b.< 3 ROVE zs x MAIN RO c \ o OR 1l/y i OH / ' F — — 25, 141.34' + 504 Y�S' pOV �Q 00.96 SOI, BDX PA 8'WNT O ��� J� ARVENUE �10 10 60. CO C PSN � I M SIM ECT D N E/ 51GN I z i W PAS. DD vnit W SECTION 143 W OVERHE^ Of BLOCK 1 LOT 1 ON Q a + tn REPUTED OWNER: .+ 5 N 53�3�900 ON M N 5�•9 M Z MAY do TONY INC. N ON E ROLACE E Z`� �ARTLEY PLACE SIGN I mZ� ROAD y r IC V unw wru 10-- MONUMENT 0--MONUMENT FOUND 0.6'N 0.4'E PROPOSED ZONE "B" GENERAL BUSINESS DISTRICT (3.7806 ACRES) 5*8•95+ / / 5331+00~ S ZONE OR -80" RESIDENTIAL DISTRICT TO BE PRESERVED (77.0404 ACRES) INCLUDES 6 ACRES TO BE UTILIZED FOR APARTMENT SANITARY YIELD ON GENERAL BUSINESS DISTRICT PARCEL TRAILS & PATHS THROUGHOUT NOT SHOWN (NO BUILDINGS) WOODED FOUND — — W F R W 0.3'E Y UO W FE N �` ON ., LINE W 0) FqQ N zi FE 0.2'E ! SECTION 143 OLU lz 'f SECTION 143 FE I� 00 BLOCK 1 LOT 6 a.1'w IC N REPUTED OWNER: D N t0 ALFRED CILETTI JR. o IL FE FE ON BLOCK 1 LOT 4.1 0 REPUTED OWNER: I I 1 I MARGARET NOONE r SECTION 143 BLOCK 1 LOT 5 a W REPUTED OWNER: :SHED Z2E DEBRA TIMPONE --- OLU lz 'f SECTION 143 FE I� 00 BLOCK 1 LOT 6 a.1'w IC N REPUTED OWNER: D N t0 ALFRED CILETTI JR. o IL FE FE ON 7'E I SECTION 143 BLOCK 1 LOT 8 REPUTED OWNER: JAMES HINES MONUMENT FOUND WALL 0.6'W W — — FE 0.7' W K W �WU LL FE Ia. o o.a'wSECTION 143 BLOCK 1 LOT 9 REPUTED OWNER: DOREEN SIDOR NUMENT J6 — — 'OUND � • •'J SECTION 143 BLOCK 1 LOT 10 REPUTED OWNER: SOURAVLIS do ANNA HRISOVALANTIS I SECTION 143 BLOCK 1 LOT 11 FE I ❑— REPUTED OWNER: 1.2'W MARY BERNINGER FE < 0.5'W U — — E i PIPE FE FOUND I LONE 0.4'W I SECTION 144 BLOCK 1 LOT 1 REPUTED OWNER: J. MORENO PIPE FOUND 0.6'W SECTION 144 BLOCK 1 LOT 2 111 t21 REPUTED OWNER: JOHN AND POND MARGARET TONER 1.3'W MONUMENT TREE FOUND I ROW W SECTION 144 a BLOCK 1 LOT 3 .f O REPUTED OWNER: 0 0) JOHN AND OMARY FETZKO I N MONUMENT U) — — FOUND FE 0.3'E W SECTION 144 W BLOCK 1 LOT 4 � O o REPUTED OWNER: FELIX AND o LINDA MULE N FE 0.5'W MONUMENT — — FOUND SECTION 144 BLOCK 1 LOT 5.2 REPUTED OWNER: HOPE HERGRUETER MONUMENT — — FOUND SECTION 144 BLOCK 1 LOT 6.2 REPUTED OWNER: J. SARNO SHED SECTION 144 D BLOCK 1 LOT 7 REPUTED OWNER: HED ELIZABETH CITTI E SECTION 144 eLDc. BLOCK 1 LOT 8 41 2'E REPUTED OWNER: D c JAMES do VERA TAHENY *22' 2' 1.2 E I t FE } ; 1.0'E t� k t tt ( t t t MONUMENT FEFOUND o.§'E S 69'31'00" W 577.68FE t t o.a'E kt TAX LOT 8.9 t REPUTED OWNER: MEGA STYLE LLC SECTION 144 BLOCK 1 LOT 9 REPUTED OWNER: ELIZABETH CASSIDY SECTION 144 BLOCK 1 LOT 10 REPUTED OWNER: PAUL RENNER do MAUREEN ROCHE Y qC IZ U H U_ O a w 0 Z w t The offsets or dimensions shown from structures to the property lines are for a specific purpose and use, and therefore, are not intended to guide in the erection of fences, retaining walls, pools, patios, planting areas, additions to buildings and any other construction. Subsurface and environmental conditions were not examined or considered as a part of this survey. Easements, Rights -of -Way of record, if any, are not shown. Properly corner monuments were not placed as a part of this survey. KEY MAP N. T.S. NOTES: 1. LOT AREA = 20.8211 ACRES. 2. SUBSURFACE & ENVIRONMENTAL CONDITIONS WERE NOT EXAMINED OR CONSIDERED AS PART OF THIS SURVEY. 9300 ROUTE 25, INC. FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC. FARM CREDIT EAST, ACA, SUCCESSOR BY MERGER TO FIRST PIONEER FARM CREDIT, ACA, ITS SUCCESSORS AND/OR ASSIGNS) 4.5'W '.1 •, BLDG. SECTION 143 t34' BLOCK 1 LOT 7 REPUTED OWNER: 41 CONC ABRAHAM GARCIA & O'q'W z SHARON RODRIGUEZ J f52' LINE •; m 7'E I SECTION 143 BLOCK 1 LOT 8 REPUTED OWNER: JAMES HINES MONUMENT FOUND WALL 0.6'W W — — FE 0.7' W K W �WU LL FE Ia. o o.a'wSECTION 143 BLOCK 1 LOT 9 REPUTED OWNER: DOREEN SIDOR NUMENT J6 — — 'OUND � • •'J SECTION 143 BLOCK 1 LOT 10 REPUTED OWNER: SOURAVLIS do ANNA HRISOVALANTIS I SECTION 143 BLOCK 1 LOT 11 FE I ❑— REPUTED OWNER: 1.2'W MARY BERNINGER FE < 0.5'W U — — E i PIPE FE FOUND I LONE 0.4'W I SECTION 144 BLOCK 1 LOT 1 REPUTED OWNER: J. MORENO PIPE FOUND 0.6'W SECTION 144 BLOCK 1 LOT 2 111 t21 REPUTED OWNER: JOHN AND POND MARGARET TONER 1.3'W MONUMENT TREE FOUND I ROW W SECTION 144 a BLOCK 1 LOT 3 .f O REPUTED OWNER: 0 0) JOHN AND OMARY FETZKO I N MONUMENT U) — — FOUND FE 0.3'E W SECTION 144 W BLOCK 1 LOT 4 � O o REPUTED OWNER: FELIX AND o LINDA MULE N FE 0.5'W MONUMENT — — FOUND SECTION 144 BLOCK 1 LOT 5.2 REPUTED OWNER: HOPE HERGRUETER MONUMENT — — FOUND SECTION 144 BLOCK 1 LOT 6.2 REPUTED OWNER: J. SARNO SHED SECTION 144 D BLOCK 1 LOT 7 REPUTED OWNER: HED ELIZABETH CITTI E SECTION 144 eLDc. BLOCK 1 LOT 8 41 2'E REPUTED OWNER: D c JAMES do VERA TAHENY *22' 2' 1.2 E I t FE } ; 1.0'E t� k t tt ( t t t MONUMENT FEFOUND o.§'E S 69'31'00" W 577.68FE t t o.a'E kt TAX LOT 8.9 t REPUTED OWNER: MEGA STYLE LLC SECTION 144 BLOCK 1 LOT 9 REPUTED OWNER: ELIZABETH CASSIDY SECTION 144 BLOCK 1 LOT 10 REPUTED OWNER: PAUL RENNER do MAUREEN ROCHE Y qC IZ U H U_ O a w 0 Z w t The offsets or dimensions shown from structures to the property lines are for a specific purpose and use, and therefore, are not intended to guide in the erection of fences, retaining walls, pools, patios, planting areas, additions to buildings and any other construction. Subsurface and environmental conditions were not examined or considered as a part of this survey. Easements, Rights -of -Way of record, if any, are not shown. Properly corner monuments were not placed as a part of this survey. KEY MAP N. T.S. NOTES: 1. LOT AREA = 20.8211 ACRES. 2. SUBSURFACE & ENVIRONMENTAL CONDITIONS WERE NOT EXAMINED OR CONSIDERED AS PART OF THIS SURVEY. 9300 ROUTE 25, INC. FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC. FARM CREDIT EAST, ACA, SUCCESSOR BY MERGER TO FIRST PIONEER FARM CREDIT, ACA, ITS SUCCESSORS AND/OR ASSIGNS) WM DATA LOTAREA ........................................ CURRENT ZONING ............................ CURRENT USE ................................. PROPOSED USE ............................... BUILDING FOOTPRINT ....................... LOTAREA ........................................ LOT WIDTH ....................................... LOT DEPTH ...................................... FRONT YARD SETBACK ................... REAR YARD SETBACK ..................... 164,682 SF R-80 (RESIDENCE) VACANT B (GENERAL BUSINESS) RETAIL W/ APARTMENTS 15,600 SF (TOTAL) PER CODE (B) 30,000 SF 150' 150' 100' 35' SIDE YARD SETBACK ....................... 25'/50' BOTH LANDSCAPE / NATURAL AREA ...... 35X LOT COVERAGE BY BUILDING ......... 307E HEIGHT OF BUILDING ..................... 35'/2 STORIES LM: SKETCH VIEW: SKETCH X1140502\DWG\A140502.dwg, 3/19/2015 9:02:57 AM, Adobe PDF INCLUDES 6 ACRES TO BE UTILIZED FOR APARTMENT SANITARY YIELD ON GENERAL BUSINESS DISTRICT PARCEL WELL/PIPE PARCH CALL L ATM rQ �W �y U Z f lL O a- PARKING REQUIRED: 1 RETAIL: 8,000 SF X 1/200 SF GFA — 40 SPACES f RESTAURANT. 6,000 SF X 1/100 SF GFA — 60 SPACES APARTMENT OVER STORE: t 1 / APARTMENT — 12 SPACES TOTAL REQUIRED: 132 SPACES r r' PROPOSED 137 TOTAL PROVIDED 1 t ALL STALLS MINIMUM 9'x19' WITH MINIMUM 22' WIDE AISLES 164,682 SF / r 549' 1 r DENSITY CALMALATIM 312' f r GROUNDWATER MANAGEMENT ZONE IV, 600 GPD/ACRE / f 99' ALLOWABLE FLOW. 3.7806 ACRES X 600 GPD/ACRE — 2,268 GPD PROPOSED FLOW (RETAIL): 8,000 SF X .03 GPD/SF — 240 GPD 100'/219' (STORAGE): 2,000 SF X .04 GPD/SF — 80 GPD 4370 I f 8.57E TOTAL PROPOSED FLOW: 2120 GPD 2 STORIES DENSITY CALCULATION FOR APARTMENTS ALLOWABLE FLOW. 6 ACRES X 43,560 SF/ACRE X .75 X 600 GPD/ 40,000 SF — 2,940 GPD PROPOSED FLOW. / f r / r r / r r r t 1 f / f I / t t LOTAREA ........................................ CURRENT ZONING ............................ CURRENT USE ................................. PROPOSED USE ............................... BUILDING FOOTPRINT ....................... LOTAREA ........................................ LOT WIDTH ....................................... LOT DEPTH ...................................... FRONT YARD SETBACK ................... REAR YARD SETBACK ..................... 164,682 SF R-80 (RESIDENCE) VACANT B (GENERAL BUSINESS) RETAIL W/ APARTMENTS 15,600 SF (TOTAL) PER CODE (B) 30,000 SF 150' 150' 100' 35' SIDE YARD SETBACK ....................... 25'/50' BOTH LANDSCAPE / NATURAL AREA ...... 35X LOT COVERAGE BY BUILDING ......... 307E HEIGHT OF BUILDING ..................... 35'/2 STORIES LM: SKETCH VIEW: SKETCH X1140502\DWG\A140502.dwg, 3/19/2015 9:02:57 AM, Adobe PDF INCLUDES 6 ACRES TO BE UTILIZED FOR APARTMENT SANITARY YIELD ON GENERAL BUSINESS DISTRICT PARCEL WELL/PIPE PARCH CALL L ATM rQ �W �y U Z f lL O a- 141.34' Q �0 I jw .mco PARKING REQUIRED: RETAIL: 8,000 SF X 1/200 SF GFA — 40 SPACES BASEMENT STORAGE: 2,000 SF X 1/200 GFA — 10 SPACES RESTAURANT. 6,000 SF X 1/100 SF GFA — 60 SPACES APARTMENT OVER STORE: 1 / APARTMENT — 12 SPACES TOTAL REQUIRED: 132 SPACES PROPOSED: 131 STANDARD 6 HANDICAP PROPOSED 137 TOTAL PROVIDED ALL STALLS MINIMUM 9'x19' WITH MINIMUM 22' WIDE AISLES 164,682 SF 549' DENSITY CALMALATIM 312' GROUNDWATER MANAGEMENT ZONE IV, 600 GPD/ACRE 100' 99' ALLOWABLE FLOW. 3.7806 ACRES X 600 GPD/ACRE — 2,268 GPD PROPOSED FLOW (RETAIL): 8,000 SF X .03 GPD/SF — 240 GPD 100'/219' (STORAGE): 2,000 SF X .04 GPD/SF — 80 GPD 4370 RESTAURANT): 180 SEATS X 10 GPD/SEAT — 1800 GPD 8.57E TOTAL PROPOSED FLOW: 2120 GPD 2 STORIES DENSITY CALCULATION FOR APARTMENTS ALLOWABLE FLOW. 6 ACRES X 43,560 SF/ACRE X .75 X 600 GPD/ 40,000 SF — 2,940 GPD PROPOSED FLOW. [APARTMENTS) 12 X 225 GPQ/UNIT or 2-700 GPD/600— 4 ACRt=S (FROM RESIDENTIAL DISTRICT TO BE PRESERVED) 141.34' Q �0 I jw .mco ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Martin D. Finnegan, Town Attorney Heather Lanza, Planning Director 1✓ From: Elizabeth A. Neville / '� Re: Change of Zone Application of -Paul Pawlowski Date: February 10, 2015 Enclosed is the Amended Boundary Line Alteration submitted by the applicant. Please review it and send me your comments and recommendations. Thank you. Cc: Supervisor & Town Board Members ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o�®gUFFO(,�coG C Z OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Martin D. Finnegan, Town Attorney's Heather Lanza, Planning Director From: Elizabeth A. Neville Re: Change of Zone ApplLidf Paul Pawlowski Date: February 10, 2015 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 www.southoldtownny.gov Enclosed is the Amended Boundary Line Alteration submitted by the applicant. Please review it and send me your comments and recommendations. Thank you. Cc: Supervisor & Town Board Members Date: 02/10/15 Quantity 1 Notes: Payment Type CK #10720 Transactions Petition ***RECEIPT*** Amount $1,000.00 Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Pawlowski, Paul 9300 Route 25 Inc Po Box 1086 Westhampton, NY 11978 Receipt#: 181240 Reference Subtotal 122-7-9 $1,000.00 Total Paid: $1,000.00 Paid By Pawlowski, Paul 9300 Route 25 Inc Clerk ID: BONNIED Internal ID: 122-7-9 NAME OF APPLICATION: 1 QW, j�( I V DATE: a N15 ❑ Check means item is complete ❑ Circle means item not complete CHECKLIST FOR REZONING PETITION TC TA PB ❑ ❑ ❑ Four (4) complete copies of petition with Town Clerk with original signatures. Each set MUST be ordered as follows: ❑ ❑ ❑ Fee of $1,000.00 ($500.00 for AHD) ❑ ❑ ❑ Written notice to all property owners within 200' of, property; mailed within 5 days preceding filing of petition ❑ ❑ ❑ File proof of mailing of notices to adjacent property owners in a sworn statement with Clerk's office and submit all original certified mail postal receipts NOTICE MUST CONTAIN: • Statement Of Proposal (as presented in zoning petition) • Description Of Property 0 Present Zone And Proposed Zone • Petition Will Be Filed Within 5 Days • Petition Can Be Reviewed In Clerk's Office • Public Hearing Must Be Held • Adjacent Owners Right To Be Heard @ Hearing • 10 Days Before Hearing Notice Published ❑ ❑ ❑ Meet all requirements for submitting zoning action pursuant to section 239 L & M of General Municipal Law attached hereto ❑ ❑ ❑ If applicable, file waiver of notice from property owner w/the clerk's office ❑ ❑ ❑ Six (6) maps drawn at the 1" = 100' scale in accordance with attached information sheet. ❑ ❑ ❑ Six (6) sketch plan maps at the 1" = 100' scale or the 1" = 20' scale in accordance with attached information sheet. The procedural requirements appear to have been met by this application: Town Clerk Date Signature Town Attorney Date Signature Planning Board Date Signature Proposed Change Of Zoning 9300 Main Rd. , Mattituck If you were to look at an aerial photograph of Mattituck dating back to the 1980's and compare it to a current picture what you would see is a significant loss of wooded lands due to home construction and commercial development. The fact is that there are very few untouched tracts of land in Mattituck on the scale of the subject property and arguably not one that is located in a more sensitive development space. The 20.8 acre property runs approximately 600' along Main Rd. with businesses to the east, west and across the street at the former Capital One Center. From Main Rd. it stretches south 1487', abutting the rear yard of 25 homes along the west side of Sigbee Rd. and a commercial equestrian center to the west. Clearly there are many parties interested in the future of this property. There is also an equal number of potential development outcomes. The former owner originally planned to clear the property for agricultural production and place a farm stand along the road front A more likely scenario would be a single family sub -division with an agricultural reserve . Most recently I proposed moderate -income housing development . All of these plans would inevitably disturb large areas of the property. What I would like to propose is the following. I would like to change the road frontage area from R80 zoning to "General Business" zoning. I would ask that the front 3.8 acres becomes general business area and the rear 17 acres remains preserved, as I would gift this property to the town. In this change of Zoning proposal 17.04 acres would be preserved and gifted to the Town of Southold while allowing a mixed-use development of 3.78 within Zone B. The structure would house retail business on the first floor with residential apartments on the second floor. The plan has numerous benefits that puts aside many of the concerns that were voiced in opposition to previous proposals. It would insure the privacy of residents along Sigbee. It would provide a sizeable water recharge area. It would add tax revenue with a minimal impact to the school or government services. It would provide needed rental apartments in the community where there is a shortage. It would also create more jobs locally. Finally , I believe the zoning change I am proposing just makes good sense from a planning perspective. It conforms more closely to adjacent uses and adds needed business property to Mattituck where inventory in very tight and opportunities for business development are limited. If the zoning change is approved I would work closely with the planning board to insure that the development is keeping with the character of Southold town and improves the look of the area entering the town of Mattituck. We could do campus style buildings were it has a nice look without even realizing there are apartments on the second floor. I feel the apartments will offer people a legal affordable opportunity. Thanks in advance for all your time and efforts with this proposal Regards Paul Pawlowski Southold Town CIerh ELIZABETH A. NEVILLE TOWN CLERKS REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork. net RECEIVED REQUEST FOR AMENDMENT AND/OR CHANGE OF ZONE Southold Town Clerk APPLICATION NAME: ��Li e •? S //�G ����( - (Name under which application dhall be known) SUFFOLK COUNTY TAX MAP NO.: 1000 - _ �� C7 _ - �z 2 - — — District Block Parcel A. SUBMISSION INFORMATION: Application is hereby made to the Southold Town Board for amendment to Chapter 280 {Zoning) of the Town Code and/or a change in the zoning classification of the Zoning Map in accordance with the Section 280 - 6 of the Zoning Law of the Town of Southold and Section 265, Town Law. Further, the following are submitted herewith (check those appropriate, write N/A where not applicable) 1. Four (4 ) sets of the completed application form and petition. Each set shall contain one (1) complete set of cover letter forms, affidavits, project description, surveys, plans, and EAF and any supplemental information as maybe be needed or requested. 2. Fee in the amount of $1,000.00 ($500.00 for AHD). Applicant is also responsible for any fees incurred in the Environmental Review Process. _Survey map, accurately drawn to appropriate scale, showing the proposed zone district boundary changes, property lines, the calculated areas affected, in acres or square feet, the Suffolk County Tax Map designations, the street rights-of-way in the immediate vicinity and lands, land uses and names of owners immediately adjacent to and extending within five hundred (500) feet of all boundaries of the property to be . amended. 4. Metes and bounds description of the proposed amendment. 10/1/2008 Appropriate Environm ental Assessment Form (EAF). All Unlisted and Type I Actions require either a Short or Full EAF to be prepared. See Chapter 130 of Town Code and Part 617 NYCRR (SEQR), or check with the Town Attorney and/or the Planning Department. ---"6. Other information deemed necessary for review by the Town Board, the Town Planning Board and/or the Suffolk County Planning Commission (i.e. site plans, subdivision maps). Please note items submitted: B. GENERAL INFORMATION: 1. Name Of Applicant(s):o Address: bo e /V R4 L.J zo-) X r/ S 7 Telephone No. Z 11 g If the applicant does not own the property, is a contract vendee, or if the owner is a Corporation or a Partnership, prepare endorsement at the end of this form establishing owner's authorization of the applicant's request. 2. If the applicant is contract vendee, give name. If the applicant is a corporation (or partnership), give the name and title of the responsible officer: Name �� � 4 Title: XzLe6d2te / Address:(if different) Telephone No.: Landowner(s): Title: Address: Telephone No.: 4. Name of licensed architect, landscape architect, civil engineer and/or surveyor who prepared the plan: Name:/ v �%iZ� �^� Title: vz,.7 Name of Firm: IX2 l/ . Address:�� �,� C', ���� G 1i/1.d2 A&GDe,-ye d -e !�v� /l7g'Y Telephone No.: 2i_ �stil� 5. Name of Attorney, or Agent authorized to represent the property owner and/or applicant: Name: Title: ~,f Name of Firm: &41w e,S 7W,ct LZ, Address: Telephone No.: ,j- 0 3 0 10/1/2008 2 6. All. communications with regard to this application shall be addressed to the following person until further notice: Name: 74E L 4wty ' S c,' ` Title: A1191116 - Address: Qa 4VX !0C4 (2 L145e400l /�P,•�F1' N� //�T�3 Telephone No.: ytt� �/z c/0 C. SITE/PROJECT DATA: 1. Location of Property or road) (north/south/east/west) feet side corner of ,eoWN (street) (north/south/east/west) of 0&3-e� . /i1.f-Tf%n&e-/c (nearest intersecting street) (hamlet) 2. Existing zoning district(s) .Q 9' Special Overlay District(s), if applicable 3. Requested zoning districts) �i��.l�tiefS 4. Lot area: sq. ft or acres ';V , qZ/1 5. a. The latest deed(s) describing this parcel(s) is (are) recorded in the County Clerk's Office as follows: DATE LIBER 5e -e 4 e- -e PAGE b. A copy of the(se) should be attached to the application: 6. There are no a umbrances or liens against this land other than mortgages? YES NO 7. All buildings and structures are shown on the survey? YES NO (The Town Board reserves the right to request a complete survey showing all existing structures.) 8. Existing: Building Area sq. ft. Lot coverage IW 9. Please attach a detailed typewritten description of the project, the proposed use and operation thereof, including a detailed explanation of the design concept, the reason for the particular design, objective of the developer or project sponsor and how or why the project is (or is not) in compliance with the Town Code and the Master Plan. Explain what benefits will accrue to the community by the proposed rezoning. Document reasons 10/1/2008 3 why proposed project can not be built under current zoning regulations and pursuant to the current zoning map. D. AGENCY COORDINATION AND SEQRA (See Part 617, NYCRR and Chapter 130 of Town Code) 1. Does the site Front on a Town, County of ate Rog . (circle one) Name and number of the road (i.e. County Roa 48, State Road 25) y' �sPN 2. Is the site within any other areas of review of the Suffolk County Planning Commission? YES NO. If yes, the referral requirements of the Suffolk County Planning Commission should be examined to assure a complete application. 3. Is the site in a designated critical environmental area as per the New York State Environmental Quality Review Act (SEQRA) and Chapter 130 of the Town Code? YES ,,NO. If yes, what area? 4. Type I, Type II or Unlisted Action (circle one) An environmental Assessment form must be completed for Unlisted and Type I actions. 5. Has an Environmental Assessment Form or Draft Environmental Impact Statement been prepared? _ C YES NO. If yes, copies should be submitted with the application. E. I hereby depose and certify that all of the above statements of information, and all statements And information contained in the supporting documents and drawings attached hereto are true and correct. APPLICANT'S SIGNATURE ,4 Sworn bef re me this J _ day of T7 0 1-S . NOTARY PUBLIC CAROL HYDELL NOTARY PUBLIC - STATE OF NEW YORK' NO. 01 HY6189695 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 06/30/20l 10/1/2008 4 G. DISCLOSURE AFFIDAVIT State of New York County of Suffolk j /•t-r.E�/��`'S being by me duly sworn, deposes and says: 1. I am an applicant for a project or an owner of the land which is the subject of a pending application before the Southold Town Board for amendment and/or change of zone. 2. The project name is: g&o 3. 1 reside at S'�� Lk�l�yN /* 4. The Officers of the applicant corporation or owner corporation are as follows: NAME TITLE /�� / �,F,✓�v-wsCt/P�LeS r 5. 1 make and complete this affidavit under the penalty of perjury and swear to the truth herein. 6. 1 am aware that this affidavit is required by General Municipal Law 809 and that I shall be guilty of a misdemeanor as provided by General Municipal Law 809 should I knowingly or intentionally fail to make all disclosures herein. GL 7. During the 12 months before the filing of this application, have any of the following individuals made campaign contributions exceeding $100 in total, in cash or in kind, to members of the Town Board or political conunittees designated to accept donations behalf: Yes No 1. Owner 2. Applicant 3. Agent for owner or applicant �G 4. Attorney 5. Other 10/1/2008 6 NY 005 - Bargain and Sale Deed with Covenant against Grantor's Acts Individual or Corporation (Single Sheet) (NYBTU 8002) CONSULT YOUR LAWYER BEFORE SIGNING TIM INSTRUMENT - THIS INSTRUNIENT SHOULD BE USED BY -LAWYERS ONLY THIS INDENTURE, made the 7th day of January , in the -year 2015 BETWEEN JOSEPH PERINO and LETITIA NASTASI, now known as LETITIA C. PERINO, both residing at 2125 Harbourside Drive, Longboat Key, Florida, 34228 party of the first part, and 9300 ROUTE 25, INC., a New York corporation, with an office at 114 Old Riverhead Road, Westhampton Beach, New York, 11978 party of the second part, WITNESSETH; thatthe.party of the first part, in consideration of Ten Dollars and other valuable consideration paid by the party of the second.part, does hereby grant and release unto the partyof the second part, the heirs or successors and assigns of the party of the second part forever, ALL that certain plot; piece or parcel of land, with the buildings and improvements thereon erected, situate; lying and being in the SEE SCHEDULE A ANNEXED HERETO BEING AND INTENDED TO BE the same premises as described. in deed made by Joseph Perin and Letitia Nastasi and Joseh E. Perino and Patricia Perino to the party of the first ,part, recorded 06/1:9/07 at Liber 12510, Page 074. TOGETHER with all right, title and interest, if any, of the party of the first part of, in and to any streets and roads abutting the above-described premises to the center lines thereof; TOGETHER with tie appurtenances acid all the estate and rights,of the party of the first,part in and to said premises, TO HAVE AND TO TOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of tie second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything. whereby tie said premises have been incumbered in any way whatever, except as aforesaid. AND the party, of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first -to. the payment of the cost of the improvement. before using any part of the total of the same for any other purpose. The word "party" shall be construed as if it read "patties" whenever the sense of this indenture. so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written, IN PRESENCE 0r: a I Fidelity National Title Insurance Company TITLE NO.114-7404-96134-SUFF SCHEDULE A-1 (,Uescriptiolt) Amended 01/06/-I5 ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, at Mattituck, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a concrete monument set for a bound in the South line of Main road distant 141.34 feet westerly as measured along the South line from its intersection with the West line of Sigbee Road; RUNNING THENCE South 20 degrees 29 minutes 00 seconds East by and with the Westline of Amended Map of Mattituck Park Properties, Inc., Suffolk County Map No. 801, 1652.84 feet to a concrete monument; TFIENCE South 69 degrees 31 minutes 00 seconds West, 577.68 feet to a concrete monument; THENCE. North 20 degrees 29 minutes 00 seconds West, 1487.19 feet to a concrete monument set for a bound in the South line of Main Road; THENCE North 53 degrees 31 minutes 00 seconds East by and with the South line of Main Road, 600.96 feet to the concrete monument and the point or place of BEGINNING. THE POLICY TO BE ISSUED under this commitment will insure the title to such buildings and improvements on the premises which by law constitute real property. FOR C, ONVE, RANCING ONLY.- Together with all. the right, title and interest of the party of the first part, of in and to the land lying In the street in front of and adjoining said premises. SCHEDULEA-1 (Description) Rev. (03/04) USEACMVO1VL9DGMENTFORMBE1OW wiTH&NElVYORYSTATE-ONLY. State of New York, County of Suffolk } ss.: On the 7 day of January in the year 2015 before JOSEPH PL+ 1 O the undersi onally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose names) is (are) subscribed to the within instrument and acknowledged to. me that he/shelthey executed the same in .his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individuals acted, ex uteri the instrument. �'� , Y KOLAKOWSKI Notary Public,. State of New Yi No. 01KO4870006 Qualified in Suffolk County Comm. Exp. Sept. 2, 20_.L, ACAvowLEDGMENTFoRMPOR USE WrININNE{VYORKSTATEONLI,. [New York Subscribuig Maness Aclo:owledgment Certificate] State of New York, County of } ss.: On the day of in the year before, me; the undersigned, personally appeared the subscribing witness to the foregoing instrument, with whom I atn Personally acquainted, who, being by me duly sworn, did depose and say that he/she/thcy .reside(s) in (if the place of residence is in city, include the street and street number, if any, thereo,�; that he/she/they latotv(s) to be the individual described in and who executed the foregoing, instrument; -that, said subscribing witness was present and saw said execute the same; and that said witness at the same time subscribed his/her/their name(s) as a witness thereto. BARGAIN & SALE DEED WITH COVENANTS AGAINST GRANTOR'S ACTS TIMEN0. JOSEPH PERINO and. LETITIA NASTASI, 'nfk/a LETITIA C. PERINO TO 9300 ROUTE 25, INC. FIDELITY NATIUNAt TITLE 0 INSURANCE COMPANY 1NCORPOMIED 1928 Member New York &am I.W 7ineiUratarton USEACrOVOiiLEDGMENTFORMBELOW IWHRVNEWYORKSTATBONLY: State of New York, County of 'S J �'Fra l k } ss.: On the 7 day of January in the year 2015 before me, the undersi ed,,personally a eared LETITIA, NASI ASI n/k!a LE IIIA C. PERINO , personally known. to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is'(are) subscribed to the within instrument and acknowledged to me that hielshe/they executed the satire in his/her/their capacity(ies), and that .by histher/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individuals) acted, ted the instrument. MARY KOWSb Notary Public, Stat© of New York No. 01K04870006 Qualified .in Suffolk County Comm. Exp. Sept. 2,20-1 ACKNO1VMGMENT 1,onf POR USE OUTSIDENEiV YORKSTATL ONLY: (Out of State or Foreign Gencral Acknoviedgm€nt CertificateI ........}ss:: (Complete Veiue with State, Country, Province orMttnicipalhy) On the day of in the year before me, the undersigned, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribedto the within instrument and acknosvledged to me that helshelthey executed the same in his/her/their capacity(ies), that by his/her/ their signatures) on the instrument, the individual(s), or the, person upon aeltalf of winch the individual(s) acted, executed the instrument, and that such -individual made such appearance before the undersigned in the (Insert the city or other political subdivision and lite state or country or other place the acknoivledgmentreas taken). DISTRICT SECTION BLOCK LOT COUNTY OR TOWN RECORDED AT REQUEST OF Fidelity National Title.Insurance Company RETURNB.I'MAIL TO AJl �� A171' 7e, ?-7-r /S /tel �StiD I'a Z `Mv47'l Full Environmental Assessinent Form Part 1- Project and Setting Instructions for Completing Part I' Part I is to be completed by the applicant or project sponsor. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part i based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information; indicate whether missing information does not exist, or is not reasonably available to the sponsor; and, when possible, generally describe work or studies which would be necessary to update or fully develop that information. Applicants/sponsors must complete all items in Sections A & B. In Sections C, D & E, most items contain an initial question that must be answered either "Yes" or "No". if the answer to the initial question is "Yes", complete the sub -questions that follow. If the answer to the initial question is "No", proceed to the next question. Section F allows the project sponsor to identify and attach any additional information. Section G requires the name and signature of the project sponsor to verify that the information contained in Part 1 is accurate and complete. A. Project and Sponsor Information. Name of Action or Project: © aftnpe �S Project Location (describe, and attach a general location map): Brief Description of Proposed Action (include purpose or need): Name of Applicant/Sponsor: f��oo le~7r qs Telephone: l_ 14er�� E -Mail: Address: . �1c A 76 City/PO: Gv�srt/��✓ �y State: Zip Code: 9 7 Project Contact (if not same as sponsor, give name and title/role): Teleph ne: E -Mail: Address: City/PO: State: Zip Code: Property Owner (if not same as sponsor): Telephone: . E -Mail: Address: Q City/PO: State: Zip Code: Page 1 of 13 1 RESET FORM B. Government Approvals B. Government Approvals Funding, or Sponsorship. ("Funding" includes grants, loans, tax relief, and any other forms of financial assistance.) Government Entity if Yes: Identify Agency and Approval(s) Application Date Required (Actual or projected) a. City Council, Town Board, ❑YeQKo I]Yes o or Village Board of Trustees b. City, Town or Village ❑Yes�Vo c. Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, or an adopted municipal farmland protection plan? If Yes, identify the plan(s): Planning Board or Commission c. City Council, Town or 0Yes0No Village Zoning Board of Appeals d. Other local agencies ❑Yes No e. County agencies []Yes( f. Regional agencies Eiyeq2lo g. State agencies [Ye o h. Federal agencies ElYesElAo i. Coastal Resources. 1. Is the project site within a Coastal Area, or the waterfront area of a Designated Inland Waterway? ❑Yesl oo If Yes, U. Is the project site located in a community with an approved Local Waterfront Revitalization Program? ❑Ye M. Is the project site within a Coastal Erosion Hazard Area? ❑ YesNo C. Planning and Zoning C.I. Planning and zoning actions. Will administrative or legislative adoption, or amendment of a plan, local law, ordinance, rule or regulation be the only approval(s) which must be granted to enable the proposed action to proceed? • If Yes, complete sections C, F and G. • If No, proceed'to question C.2 and complete all remaining sections and questions in Part 1 [Y o C.2. Adopted land use plans. a. Do any municipally- adopted (city, town, village or county) comprehensive land use plan(s) include the site where the proposed action would be located? If Yes, does the comprehensive plan include specific recommendations for the site where the proposed action would be located? es❑No ❑Yes b. Is the site of the proposed action within any local or regional special planning district (for example: Greenway Brownfield Opportunity Area (BOA); designated State or Federal heritage area; watershed management plan; or other?) If Yes, identify the plan(s): I]Yes o c. Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, or an adopted municipal farmland protection plan? If Yes, identify the plan(s): ❑Yes o Page 2 of 13 RESET FORM C.3. Zoning a. Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. Yes❑No If Yes, what is the zoning classification(s) including any applicable overlay district? /Z 87O b. Is the use permitted or allowed by a special or conditional use permit? ❑ Yes❑No c. is a zoning change requested as part of the proposed action?i'es❑No If Yes, / I What is the proposed new zoning for the site? CA. Existing community services. a. In what school district is the project site located? b. What police or other public protection forces serve the project site? -, Sarce4YETID ; 2 P lc P c. Which fire protection and emergency medical services serve the project site? d. What parks serve the project site? D. Project Details D.I. Proposed and Potential Development a. What is the general nature of the proposed action (e.g., residential, industrial, commercial, recreational; if mixed, include all components)? o _ 2 a� G�-,-�zG�i•� �D � i�s2�ri.���/' �— b. a. Total acreage of the site of the proposed action? / acres b. Total acreage to be physically disturbed?^ acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? v acres c. Is the proposed action an expansion of an existing project or use? ❑ Y L If Yes, what is the approximate percentage of the proposed expansion and identify the units (e.g., acres, miles, housing units, square feet)? % Units: d. Is the proposed action a subdivision, or does it include a subdivision? ❑Yes Mo, If Yes, L Purpose or type of subdivision? (e.g., residential, industrial, commercial; if mixed, specify types) A Is a cluster/conservation layout proposed? ❑Yes ❑No lil. Number of lots proposed? iv Minimum and maximum proposed lot sizes? Minimum Maximum e. Will proposed action be constructed in multiple phases? ❑Ye o i. If No, anticipated period of construction: 1E months H. If Yes: • Total number of phases anticipated • Anticipated commencement date of phase 1 (including demolition) month year • Anticipated completion date of final phase month year • Generally describe connections or relationships among phases, including any contingencies where progress of one phase may determine timing or duration of future phases: Page 3 of 13 1 RESET FORM f. Does the project include new residential uses?es❑No If Yes, show numbers of units proposed. One Fa_ mFamily ilt' Two Family Three Multiple Family four or more Initial Phase At completion of all phases g. Does the proposed action include new non-residential construction.(including expansions)? Yes❑No If Yes, / L Total number of structures ii: Dimensions (in feet) of largest proposed structure: _,.?D height; e! �width; and '.?g length M. Approximate extent of building space to be heated or cooled: Z4 oyo nes "V square feet h. Does the proposed action include construction or other activities that will result in the impoundment of any ❑Yes o liquids, such as creation of a water supply, reservoir, pond, lake, waste lagoon or other storage? If Yes, L Purpose of the impoundment: U. If a water impoundment, the principal source of the water: ❑ Ground water ❑ Surface water streams []Other specify: M. If other than water, identify the type of impounded/contained liquids and their source. ix Approximate size of the proposed impoundment. Volume: million gallons; surface area: acres v. Dimensions of the proposed dam or impounding structure: height; length vi. Construction method/materials for then proposed dam or impounding structure (e.g., earth fill, rock, wood, concrete): D.2. Project Operations a. Does the proposed action include any excavation, mining, or dredging, during construction, operations, or both? ❑Yes o (Not including general site preparation, grading or installation of utilities or foundations where all excavated materials will remain onsite) If Yes: i. What is the purpose of the excavation or dredging? U. How much material (including rock, earth, sediments, etc.) is proposed to be removed from the site? • Volume (specify tons or cubic yards): • Over what duration of time? M. Describe nature and characteristics of materials to be excavated o cadged, and plans to use, manage or dispose of them. iv. Will there be onsite dewatering or processing of ex cav ed materials? Yes No If yes, describe. v. What is the total area to be dredged or vated? acres vi. What is the maximum area to be worked at any one time? acres vii. What would be the maximum depth of excavation or dredging? feet viii. Will the excavation require blasting? ❑Yes❑No ix Summarize site reclamation goals and plan: b. Would the proposed action cause or result in alteration of, increase or decrease in size of, or encroachment ❑Ye into any existing wetland, waterbody, shoreline, beach or adjacent area? If Yes: L Identify the wetland or waterbody which would be affected (by name., water index number, wetland map number or geographic description): Page 4 of 13 RESET FORM H. Describe how the proposed action would affect that waterbody or wetland, e.g. excavation, fill, placement of structures, or alteration of channels, banks and shorelines. Indicate extent of activities, alterations and additions in square feet or acres: M. Will proposed action cause or result in disturbance to bottom sediments? ❑ Yes❑No If Yes, describe: iv. Will proposed action cause or result in the destruction or removal of aquatic vegetation? ❑ Yes❑No If Yes: • acres of aquatic vegetation proposed to be removed • expected acreage of aquatic vegetation propose a removed • purpose of proposed removal (e.g. beach ring, invasive species control, boat access): • proposed method of plant remov • if chemical/herbicide treatment will be used, specify product(s): v. Describe any proposed reclamation/mitigation following disturbance: c. Will the proposed action use, or create a new demand for water? es ❑No If Yes: i. Total anticipated water usage/demand per day: /doe, c7 gallons/day A Will the proposed action obtain water from an existing public water supply? If Yes: • Name of district or service area: Sect R "-Oyes❑No • Does the existing public water supply have capacity to serve the proposal? ;fTYes❑No • Is the project site in the existing district? OYes❑ No • Is expansion of the district needed? ❑ Yes o • Do existing lines serve the project site? M. Will line extension within an existing district be necessary to supply the project? ❑ YesBIW ❑Yeses If Yes: • Describe extensions or capacity expansions proposed to serve this project: • Source(s) of supply for the district: iv. Is a new water supply district or service area proposed to be formed to serve the project site? If, Yes: ❑ YesQ6o • Applicant/sponsor for new district: • Date application submitted or anticipated: • Proposed source(s) of supply for new district: v. If a public water supply will not be used, describe plans to provide water supply for the project: vi. If water supply will be from wells (public or private), maximum pumping capacity: gallons/minute. d. Will the proposed action generate liquid wastes? Yes If Yes: MOZ SLr"'77C L Total anticipated liquid waste generation per c� Ilons/day H. Nature of liquid wastes to be generate g., sanitary was , industrial; if combination, describe all components and approximate volumes or proportions of ea M. Will the proposed action use any existing public wastewater treatment facilities? If Yes: oyes o • Name of wastewater treatment plant to be used: • Name of district: • Does the existing wastewater treatment plant have capacity to serve the project? ❑Yes❑No • Is the project site in the existing district? ❑Yes❑NO • Is expansion of the district needed? ❑Yes❑No Page 5 of 13 1 RESET FORM • Do existing sewer lines serve the project site? E]YesEgo • Will line extension within an existing district be necessary to serve the project? ❑ es o If Yes: • Describe extensions or capacity expansions proposed to serve this project: iv. Will a new wastewater (sewage) treatment district be formed to serve the project site? ❑Yes o If Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • What is the receiving water for the wastewater discharge? v. If public facilities will not be used, describe plans to provide wastewater treatment for the project, including specifying proposed receiving water (name and classification if surface discharge, or describe subsurface disposal plans): vi. Describe any plans or designs to capture, recycle or reuse liquid waste: e. Will the proposed action disturb more than one acre and create stormwater runoff, either from new point Yes❑No sources (i.e. ditches, pipes, swales, curbs, gutters or other concentrated flows of stormwater) or non -point source (Le: sheet flow) during construction or post construction? If Yes: L How much impervious surface will the project create in relation to total size of project parcel? 51k Vd)s)� Square feet or acres (impervious surface) $fpr an O Square feet or ao• g acres (parcel size) U. Describe types of new point sources. _ %P G*�?..&G W. Where will the stormwater runoff be directed (i.e. on-site stormwater management facility/structures, adjacent properties, groundwater, on-site surface water or off-site surface waters)? 19 '" l7Te Zce "_Pn� eA- —!:C a s opt `S� • If to surface waters, identify receiving water bodies or wetlands: • Will stormwater runoff flow to adjacent properties? ❑Y iv. Does proposed plan minimize impervious surfaces, use pervious materials or collect and reuse stormwater? es❑No f. Does the proposed action include, or will it use on-site, one or more sources of air emissions, including fuel ❑Y o ' combustion, waste incineration, or other processes or operations? If Yes, identify: L Mobile sources during project operalii e.g., heavy equipment, fleet or delivery vehicles) U. Stationary sources during cons on (e.g., power generation, structural heating, batch plant, crushers) iii. Stationary sources duri perations (.& process emissions, large boilers, electric generation) g. Will any air emission sources named in D.2.f (above), require a NY State Air Registration, Air Facility Permit, ❑Yes o or Federal Clean Air Act Title IV or Title V Permit? If Yes: i. is the project site located in an Air quality non -attainment area? (Area routinely or periodically fails to meet ❑Y� ambient air quality standards for all or some parts of the year) ii: In addition to emissions as calculated in the application, the project will generate: • Tons/year (short tons) of Carbon Dioxide (CO2) • Tons/year (short tons) of Nitrous Oxide (N20) • Tons/year (short tons) of Perfluorocarbons (PFCs) • Tons/year (short tons) of Sulfur Hexafluoride (SF6) • Tons/year (short tons) of Carbon Dioxide equivalent of Hydroflourocarbons (HFCs) • Tons/year (short tons) of Hazardous Air Pollutants (HAPS) Page 6 of 13 1 RESET FORM h. Will the proposed action generate or emit methane (including, but not limited to, sewage treatment plants, oyes o landfills, composting facilities)? If Yes: i. Estimate methane generation in tons/year (metric): H. Describe any methane capture, control or elimination measures included in project design (e.g., combustion to generate heat or electricity, flaring): L Will the proposed action result in the release of air pollutants from open-air operations or processes, such as []Yes quarry or landfill operations? If Yes: Describe operations and nature of emissions (e.g., diesel exhaust, rock particulates/dust): j. Will the proposed action result in a substantial increase in traffic above present levels or generate substantial ❑Y o new demand for transportation facilities or services? If Yes: L When is the peak traffic expected (Check all that apply): ❑ Morning ❑ Evening ❑Weekend ❑ Randomly between hours of to U. For commercial activities only, projected number of semi -trailer truck trips/day: M. Parking spaces: Existing Proposed Net increase/decrease iv. Does the proposed action include any shared use parking? ❑Yes❑No v. If the proposed action includes any modification of existing roads, creation of new roads or change in existing access, describe: vi. Are public/private transportation service(s) or facilities available within %z mile of the proposed site? ❑Yes❑ No vii Will the proposed action include access to public transportation or accommodations for use of hybrid, electric ❑Yes❑No or other alternative fueled vehicles? viii. Will the proposed action include plans for pedestrian or bicycle accommodations for connections to existing ❑Yes❑No pedestrian or bicycle routes? k. Will the proposed action (for commercial or industrial projects only) generate new or additional demand es❑ No for energy? If Yes: L Estimate annual electricity demand during operation of the proposed action: �.,oEw.� •c.S,e ii. Anticipated sources/suppliers of electricity for the project (e.g., on-site combustion, on-site renewable, via grid/local utility, or other): iii. Will the proposed action require a new, or an upgrade to, an existing substation? ❑Yes o 1. Hours of operation. Answer all items which apply. e9;qS/,vess 1_'K�s i. During Construction: A During Operations: • Monday - Friday: • Monday - Friday: • Saturday: • Saturday: • Sunday: • Sunday: • Holidays: • Holidays: Page 7 of 13 1 RESET FORM in. Will the proposed action produce noise that will exceed existing ambient noise levels during construction, ❑Yes operation, or both? If yes: L Provide details including sources, time of day and duration: H. Will proposed action remove existing natural barriers that could act as a noise barrier or screen? Describe: ❑ yepavo n.. Will the proposed action have outdoor lighting? If yes: ❑Yes❑No i. Describe source(s), location(s), height of fxture(s), direction/aim, and proximity to nearest occupied structures: ,(— c o D.e ii. Will proposed action remove existing natural barriers that could act as a light barrier or screen? ❑ Yes Describe: o. Does the proposed action have the potential to produce odors for more than one hour per day? ❑ Yes No If Yes, describe possible sources, potential frequency and duration of odor emissions, and proximity to nearest occupied structures: p. Will the proposed action include any bulk storage of petroleum (combined capacity of over 1,100 gallons) ❑ Yes No or chemical products (185 gallons in above ground storage or an amount in underground storage)? If Yes: i. Product(s) to be stored U. Volume(s) per unit time (e.g., month, year) M. Generally describe proposed storage facilities: q. Will the proposed action (commercial, industrial and recreational projects only) use pesticides (i.e., herbicides, ❑ Yes o insecticides) during construction or operation? If Yes: L Describe proposed treatment(s): H. Will the proposEd action use Integrated Pest Man ement Practices? ❑ Yes ❑No r. Will the proposed action (commercial or industrial projects only) involve or require the management or disposal ❑ Ysll-� of solid waste (excluding hazardous materials)? If Yes: i. Describe any solid waste(s) to be generated during construction or operation of the facility: • Construction: tons per (unit of time) • Operation : tons per (unit of time) H. Describe any proposals for on-site minimization, recycling or reuse of materials to avoid disposal as solid waste: • Construction: • Operation: M. Proposed disposal methods/facilities for solid waste gene on-site: • Construction: • Operation: Page 8 of 13 1 RESET FORM s. Does the proposed action include construction or modification of a solid waste management facility? ❑ Y e Ko If Yes: i. Type of management or handling of waste proposed for the site (e.g., recycling or transfer station, composting, landfill, or other disposal activities): A Anticipated rate of disposal/processing: • Tons/month, if transfer or other non-combustion/thermal treatment, or • Tonsthour, if combustion or thermal treatment M. If landfill, anticipated site life: years t. Will proposed action at the site involve the commercial generation, treatment, storage, or disposal of hazardous ❑Yes o waste? If Yes: L Names) of all hazardous wastes or constituents to be generated, handled or managed at facility: H. Generally describe processes or activities involving hazardous wastes or constituents: M. Specify amount to be handled or generated tons/month iv. Describe any proposals for on-site minimization, recycling or reuse of hazardous constituents: v Will any hazardous wastes be disposed at an existing offsite hazardous waste facility? Yes If Yes: provide name and location of facility: If No: describe proposed management of any hazardous wastes which will not be sent to a hazardous waste facility: E. Site and Setting of Proposed Action E.I. Land uses on and surrounding the project site a. Existing land uses. W VC9 J. Check ill yses that occur on, adjoining and a the project site. �,Hrban CfIndustrial 15Zommercial residential (suburban) ❑ Rural (non-farm) ❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other (specify): ii. If mix of uses, generally describe: b. Land uses and covertypes on the project site. Land use or Covertype Current Acreage Acreage After Project Completion Change (Acres +/-) • Roads, buildings, and other paved or impervious surfaces • Forested zRo 61 • Meadows, grasslands or brushlands (non- agricultural, including abandoned agricultural) C7 • Agricultural (includes active orchards, field, greenhouse etc.) (� • Surface water features (lakes, ponds, streams, rivers, etc.) • Wetlands (freshwater or tidal) • Non -vegetated (bare rock, earth or fill) O p • Other Describe: Page 9 of 13 1 RESET FORM c. Is the project site presently used by members of the community for public recreation? L If Yes: explain: ❑ Yes o d. Are there any facilities serving children, the elderly, people with disabilities (e.g., schools, hospitals, licensed day care centers, or group homes) within 1500 feet of the project site? If Yes, ❑Yes o L Identify Facilities: e. Does the project site contain an existing dam? ❑Yes If Yes: L Dimensions of the dam and impoundment: • Dam height: feet • Dam length: feet • Surface area: acres • Volume impounded: gallons OR acre-feet U. Dam's existing hazard classification: W. Provide date and summarize results of last inspection: f. Has the project site ever been used as a municipal, commercial or industrial solid waste management facility, ❑Yes o or does the project site adjoin property which is now, or was at one time, used as a solid waste management facility? If Yes: L Has the facility been formally closed? El Yes[] No • If yes, cite sources/documentation: U. Describe the location of the project site relative to the boundaries ofthe solid waste management facility: W. Describe any development constraints due to the prior solid waste activities: g. Have hazardous wastes been generated, treated and/or disposed of at the site, or does the project site adjoin property which is now or was at one time used to commercially treat, store and/or dispose of hazardous waste? If Yes: ❑ Yes o 1. Describe waste(s) handled and waste management activities, including approximate time when activities occurred: h. Potential contamination history. Has there been a reported spill at the proposed project site, or have any remedial actions been conducted at or adjacent to the proposed site? If Yes: ❑Y No L Is any porton of the site listed on the NYSDEC Spills Incidents database or Environmental Site Remediation database? Check all that apply: ❑ Yes — Spills Incidents database Provide DEC ID number(s): ❑ Yes — Environmental Site Remediation database Provide DEC ID number(s): ❑ Neither database ❑Yes❑No U. If site has been subject of RCRA corrective activities, describe control measures: M. Is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? Ifyes, provide DEC ID number(s): ❑Yes❑No iv. If yes to (i), (ii) or (iii) above, describe current status of site(s): Page 10 of 13 1 . RESET FORM v. Is the project site subject to an institutional control limiting property uses? ❑Yes • If yes, DEC site ID number: • Describe the type of institutional control (e.g., deed restriction or easement): • Describe any use limitations: • Describe any engineering controls: • Will the project affect the institutional or engineering controls in. place? ❑Yes❑No • Explain: E.2. Natural Resources On or Near Project Site a. What is the average depth to bedrock on the project site? % feet b. Are there bedrock outcroppings on the project site? 11Y7o If Yes, what proportion of the site is comprised of bedrock outcroppings? % c. Predominant soil type(s) present on project site: % % d. What is the average depth to the water table on the project siteT Average: ?tD— feet e. Drainage status of project site soilT-M<l Drained: % of site ❑ Moderately Well Drained: %of site ❑ Poorly Drained % of site f. Approximate proportion of proposed action site with slop %: % of site ❑ 10-15%: % of site ❑ 15% or greater: % of site g. Are there any unique geologic features on the project site? ❑Yes o If Yes, describe: h. Surface water features. i. Does any portion of the project site contain wetlands or other waterbodies (including streams, rivers, ❑Yes ponds or lakes)? U. Do any wetlands or other waterbodies adjoin the project site? ❑Yeso If Yes to either i or ii, continue. If No, skip to E.21 HL Are any of the wetlands or waterbodies within or adjoining the project site regulated by any federal, ❑ 0 state or local agency? iv. For each identified regulated wetland and waterbody on the project site, provide the following information: • Streams: Name Classification • Lakes or Ponds: Name Classification • Wetlands: Name Approximate Size • Wetland No. (if regulated by DEC) / v. Are any of the above water bodies listed in the most recent compilation of NYS water quality-impaired ❑Y 1:1 I0 waterbodies? / If yes, name of impaired water body/bodies and basis for listing as impaired: i. Is the project site in a designated Floodway? ❑Yes j. Is the project site in the 100 year Floodplain? ❑Yes, k. Is the project site in the 500 year Floodplain? []Yes 1. Is the project site located over, or immediately adjoining, a primary, principal or sole source aquifer? s o If Yes: i. Name of aquifer: Page I 1 of 13 1 RESET FORM m. •Identify the predominant wildlife species that occupy or use the project site: n. Does the project site contain a designated significant natural community? ❑Ye o If Yes: L Describe the habitat/community (composition, function, and basis for designation): H. Source(s) of description or evaluation: W. Extent of community/habitat: • Currently: acres • Following completion of project as proposed: acres • Gain or loss (indicate + or -): acres o. Does project site contain any species of plant or animal that is listed by the federal government or NYS as ❑ Y o endangered or threatened, or does it contain any areas identified as habitat for an endangered or threatened species? p. Does the project site contain any species of plant or animal that is listed by NYS as rare, or as a species of El Yel'1111 special concern? q. Is the project site or adjoining area currently used for hunting, trapping, fishing or shell fishing? ❑Y o If yes, give a brief description of how the proposed action may affect that use: E.3. Designated Public Resources On or Near Project Site a. Is the project site, or any portion of it, located in a designated agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? 1f Yes, provide county plus district name/number: b. Are agricultural lands consisting of highly productive soils present? ❑Yes o 1. If Yes: acreage(s) on project site? A Source(s) of soil rating(s): c. Does the project site contain all or part of, or is it substantially contiguous to, a registered National ❑Yes Natural Landmark? If Yes: i. Nature of the natural landmark: ❑ Biological Community ❑ Geological Feature A Provide brief description of landmark, including values behind designation and approximate sizelextent: d. Is the project site located in or does it adjoin a state listed Critical Environmental Area? ❑Yes o If Yes: L CEA name: H. -Basis for designation: W. Designating agency and date: Page 12 of 13 1 RESET FORM e: Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district ❑ Ye o which is listed on, or has been nominated by the -NYS Board of Historic Preservation for inclusion on, the State or National Register of Historic Places? If Yes: L Nature of historic/archaeological resource: ❑Archaeological Site ❑Historic Building or District U. Name: M. Brief description of attributes on which listing is based: 24 f. Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for ❑Yes o archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory? g. Have additional archaeological or historic site(s) or resources been identified on the project site? od ❑Yes o If Yes: L Describe possible resource(s): U. Basis for identification: h. Is the project site within five miles of any officially designated and publicly accessible federal, state, or local ❑Yes o scenic or aesthetic resource? If Yes: L Identify resource: ff Nature of, or basis for, designation (e.g., established highway overlook, state or local park, state historic trail or scenic byway, etc.): iii. Distance between project and resource: miles. i. Is the project site located within a designated river corridor under the Wild, Scenic and Recreational Rivers ❑ Ye o Program 6 NYCRR 666? If Yes: i. Identify the name of the river and its designation: fl. Is the activity consistent with development restrictions contained in 6NYCRR Part 666? ❑Yes❑No F. Additional Information Attach any additional information which may be needed to clarify your project. If you have identified any adverse impacts which could be associated with your proposal, please describe those impacts plus any measures which you propose to avoid or minimize them. G. Verification I certify that the information provided is true to the best of my knowledge. Applicant/Sponsor Name 1/YiL P/ J�rr4L, Date Signature o / l% Title PRINT FORM I Page 13 of 13 1 RESET FORM Full Environmental Assessment Form Part 2 - Identification of Potential Project Impacts Part 2 is to be completed by the lead agency. Part 2 is designed to help the lead agency inventory all potential resources that could be affected by a proposed project or action. We recognize that the lead agency's reviewer(s) will not necessarily be environmental professionals. So, the questions are designed to walk a reviewer through the assessment process by providing a series of questions that can be answered using the information found in Part 1. To further assist the lead agency in completing Part 2, the form identifies the most relevant questions in Part 1 that will provide the information needed to answer the Part 2 question. When Part 2 is completed, the lead agency will have identified the relevant environmental areas that may be impacted by the proposed activity. If the lead agency is a state agency and the action is in any Coastal Area, complete the Coastal Assessment Form before proceeding with this assessment. Tips for completing Part 2: • Review all of the information provided in Part 1. • Review any application, maps, supporting materials and the Full EAF Workbook. • Answer each of the 18 questions in Part 2. • If you answer "Yes" to a numbered question, please complete all the questions that follow in that section. • If you answer "No" to a numbered question, move on to the next numbered question. • Check appropriate column to indicate the anticipated size of the impact. • Proposed projects that would exceed a numeric threshold contained in a question should result in the reviewing agency checking the box "Moderate to large impact may occur." • The reviewer is not expected to be an expert in environmental analysis. • If you are not sure or undecided about the size of an impact, it may help to review the sub -questions for the general question and consult the workbook. • When answering a question consider all components of the proposed activity, that is, the "whole action". • Consider the possibility for long-term and cumulative impacts as well as direct impacts. • Answer the question in a reasonable manner considerine the scale and context of the uroiect. 1. Impact on Land Proposed action may involve construction on, or physical alteration of, ❑NO S the land surface of the proposed site. (See Part 1. D. l ) I "Yes'; annver questions a -1 I "No ", move on to Section 2. - - - - - - - - -elevant No, or Moderato ua:.i:ii .._.._..............................•::__•,....::::��..�:=si:'.isiii::iC�,:i::-::::e::.::r<::�•_... .. _._....._a:.:c�_... _- • _..__. .._..... �:�•--'::��:..__....._._...., ,�:rc.._r.:n. ... ....._".:: .._.mss: :.: •:. art I small to large :t::r•=�:....__:_::�;.:..:....5-_.:=�z-:�:��_F�.:�.-•.>.-:>r:.._.:��...._... = - - - - - -- - -- - — _ _ = echo impact .._.. __......... --e:-ass...:::-....,.,_ ......,....-........_...._..«:-�.�::::::::::;:-:-��::-.:.:=•::::_.._,..;_.:...._...._._..._.......__........_..,.._.__-_....._::::::___:::_:�:::.:::.•:_-���=w may occur occur E2d ❑ a. The proposed action may involve construction on land where depth to water table is less than 3 feet. b. The proposed action may involve construction on slopes of 15% or greater. E2f ❑ c. The proposed action may involve construction on land where bedrock is exposed, or E2a ❑ generally within 5 feet of existing ground surface. d. The proposed action may involve the excavation and removal of more than 1,000 tons D2a r / I� ❑ of natural material. e. The proposed action may involve construction that continues for more than one year D le ❑ or in multiple phases. f. The proposed action may result in increased erosion, whether from physical D2e, D2q ❑ disturbance or vegetation removal (including from treatment by herbicides). g. The proposed action is, or may be, located within a Coastal Erosion hazard area. Bli ❑ h. Other impacts: ❑/ ❑ Page 1 of 10 1 RESET FORM 2. Impact on Geological Features The proposed action may result in the modification or destruction of, or inhibit �NO❑YES access to, any unique or unusual land forms on the site (e.g., cliffs, dunes, J minerals, fossils, caves). (See Part 1. E.2.g) I "Yes'; answer questions a - c. I "No' ; move on to Section 3. Relevant Relevant No, or Moderate ::::...............................<:.:.....:::::..:.......... .. ...:::::..._;......_.... �:=� a small e t01 large ...._..___................,.::'..�....<:_.._......._._...._..........._.__.........._..__..,...._..._.._.. ..._... ...L....._... Qu n(s) impac mpac may --•---=::,.�:�..........___ _:::__-.::-::::::: �; .:::;_.::-::;� � � �:: � ;:_;= ;_,:� _:__:::= =::-:_:_-:::__<:_ :�_:>� �===�u._��.::__�? T��:��, ma occur may occur occur a. Identify the specific land form(s) attached: E2g ❑ ❑ D2b b. The proposed action may affect or is adjacent to a geological feature listed as a E3c ❑ ❑ registered National Natural Landmark. c. The proposed action may involve dredging more than 100 cubic yards of material D2a Specific feature. ❑ from a wetland or water body. c. Other impacts: ❑ ❑ ❑ 3. Impacts on Surface Water The proposed action may affect one or more wetlands or other surface water E]YES bodies (e.g., streams, rivers, ponds or lakes). (See Part 1. D.2, E.21) I "Yes", answer questions a -1. I "No' ; move on to Section 4. Relevant 7 or Moderate - - - - - - _ - - _ rt P I a small t a e o l r i' ... :. _._:...:-: .:.: :..t..:i::f�.:_-.. ......._.� •....___... .. �•_ :.. :..:.:. �.:.::"_:: iii:-:._'•::� � :..� :'e: �`.t.......�� +'%'•'.. •-•-- ' �==�=`-' _...— .. __.,..:.c.•.—,.,.•.:.a:,:r.--.-_::r:_:r;:s::��_::�=Isis:�:-_.._._........i—:_::::::rt — --___ eStlO Qu n{s) impact mpactmay _ ................. _.._.::n:i�•rr::::::^�:.�_.-4^' :'::'? 'r;r= :e�:=:;:.::�_::: ':i�;ir•i::::::::::'t;:::'.:.:::::: .:::::%:•__.._..........•1. =:z^ :•� vi::^ .T ma occur occur a. The proposed action may create a new water body. D2b, DIh ❑ ❑ b. The proposed action may result in an increase or decrease of over 10% or more than a D2b ❑ ❑ 10 acre increase or decrease in the surface area of any body of water. c. The proposed action may involve dredging more than 100 cubic yards of material D2a ❑ ❑ from a wetland or water body. d. The proposed action may involve construction within or adjoining a freshwater or E2h ❑ ❑ tidal wetland, or in the bed or banks of any other water body. e. The proposed action may create turbidity in a waterbody, either from upland erosion, 132a, D2h ❑ ❑ runoff or by disturbing bottom sediments. f. The proposed action may include construction of one or more intake(s) for withdrawal D2c ❑ ❑ ofwater from surface water. g. The proposed action may include construction of one or more outfall(s) for discharge 132d ❑ ❑ of wastewater to surface water(s). h. The proposed action may cause soil erosion, or otherwise create a source of D2e ❑ ❑ stormwater discharge that may lead to siltation or other degradation of receiving water bodies. i. The proposed action may affect the water quality of any water bodies within or E21i ❑ ❑ downstream of the site of the proposed action. j. The proposed action may involve the application of pesticides or herbicides in or D2q, E2h ❑ ❑ around any water body. k. The proposed action may require the construction of new, or expansion of existing, DIa, D2d ❑ ❑ wastewater treatment facilities. Page 2 of 10 RESET FORM 1. Other impacts: 4. Impact on groundwater 1--= The proposed action may result in new or additional use of ground water, or FINO MS may have the potential to introduce contaminants to ground water or an aquifer. (See Part 1. D.2.a, D.2.c, D.2.d, D.2.p, D.2.q, D.2A) If "Yes answer questions a --h. If "No move on to Section 5. :D! Relevant No, or Moderate Part I Part I small to large Question(s) Question(s) impact impact may may occur may occur occur a. The proposed action may require new water supply wells, or create additional demand D2c IJ ❑ on supplies from existing water supply wells. 11 El c. The proposed action may result in development within a 500 year floodplain. b. Water supply demand from the proposed action may exceed safe and sustainable D2c ❑ ❑ withdrawal capacity rate of the local supply or aquifer. 0 ❑ patterns. Cite Source: e. The proposed action may change flood water flows that contribute to flooding. c. The proposed action may allow or result in residential uses in areas without water and DI a, 132c E] ❑ sewer services. d. The proposed action may include or require wastewater discharged to groundwater. D2d, E21 ❑ e. The proposed action may result in the construction of water supply wells in locations D2c, Elf, ❑ ❑ where groundwater is, or is suspected to be, contaminated. Elg, Elh f The proposed action may require the bulk storage of petroleum or chemical products D2p, E21 over ground water or an aquifer. g. The proposed action may involve the commercial application of pesticides within 100 E2h, D2q, feet of potable drinking water or irrigation sources. E21, D2c h. Other impacts: El 5. Impact on Flooding The proposed action may result in development on lands subject to flooding. NO [-]YES (See Part 1. E.2) I f "Yes'; answer questions a - g. if "No move on to Section 6 Re levant No, or Moderate .......... Part I small to large Question(s) impact impact may may occur occur a. The proposed action may result in development in a designated floodway. Eli 0 IJ b. The proposed action may result in development within a 100 year floodplain. E2j 11 El c. The proposed action may result in development within a 500 year floodplain. Elk 11 ❑ d. The proposed action may result in, or require, modification of existing drainage D2b, D2e 0 ❑ patterns. e. The proposed action may change flood water flows that contribute to flooding. D2b, Eli, 11 E] E2j, E2k f. If there is a dam located on the site of the proposed action, is the dam in need of repair, Ele 0 ❑ or upgrade? Page 3 of 10 I RESET FORM g. Other impacts: 6. Impacts on Air The proposed action may include a state regulated air emission source.4><NO []YES (See Part 1. D.2.f., D,2,h, D.2.g) If "Yes answer questions a -f If "No move on to Section Z Relevant Relevant No, or Moderate . ...... ... . .... .. Part I small to large Question(s) Question(s) impact impact may ma occur mayoccur occur a. If the proposed action requires federal or state air emission permits, the action may ❑ a. The proposed action may cause reduction in population or loss of individuals of any threatened or endangered species, as listed by New York State or the Federal also emit one or more greenhouse gases at or above the following levels: government, that use the site, or are found on, over, or near the site. i. More than 1000 tons/year of carbon dioxide (CO2) D2g b. The proposed action may result in a reduction or degradation of any habitat used by ii. More than 3.5 tons/year of nitrous oxide (N20) D2g ❑ any rare, threatened or endangered species, as listed by New York State or the federal iii. More than 1000 tons/year of carbon equivalent of perfluorocarbons (PFCs) D2g 0 13 iv. More than .045 tons/year of sulfur hexafluorlde (SF6) D2g E3 13 El v. More than 1000 tons/year of carbon dioxide equivalent of D2g El species of special concern or conservation need, as listed by New York State or the hydrochloroflourocarbons (HFCs) emissions Federal government, that use the site, or are found on, over, or near the site. vi. 43 tons/year or more of methane D2h 11 ❑ b. The proposed action may generate 10 tons/year or more of any one designated D2g [3 El hazardous air pollutant, or 25 tons/year or more of any combination of such hazardous the Federal government. air pollutants. c. The proposed action may require a state air registration, or may produce an emissions D2f, D2g 11 13 rate of total contaminants that may exceed 5 lbs. per hour, or may include a beat source capable of producing more than 10 million BTU's per hour. d. The proposed action may reach 50% of any of the thresholds in "a" through 'V', D2g 13 E3 above. e. The proposed action may result in the combustion or thermal treatment of more than 1 D29 11 ❑ ton of refuse per hour. f. Other impacts: 13 ❑ 7. Impact on Plants and Animals The proposed action may result in a loss of flora or fauna. (See Part 1. E.2. m. -q.) No ❑ YES I f "Yes". answer questions a J. if "No", move on to Section & . ... ....... Relevant No, or Moderate Part I small to large Question(s) impact impact way ma occur occur 132o 11 ❑ a. The proposed action may cause reduction in population or loss of individuals of any threatened or endangered species, as listed by New York State or the Federal government, that use the site, or are found on, over, or near the site. b. The proposed action may result in a reduction or degradation of any habitat used by E2o 11 ❑ any rare, threatened or endangered species, as listed by New York State or the federal government. c. The proposed action may cause reduction in population, or loss of individuals, of any E2p 13 E3 species of special concern or conservation need, as listed by New York State or the Federal government, that use the site, or are found on, over, or near the site. d. The proposed action may result in a reduction or degradation of any habitat used by 132p any species of special concern and conservation need, as listed by New York State or the Federal government. Page 4 of 10 I RESET FORM e. The proposed action may diminish the capacity of a registered National Natural E3c ❑ ❑ Landmark to support the biological community it was established to protect. o orModerate _..... _...._. __......__::::_..-�:: �••�__ .... 1-c-:.a!::..._.:•.r...»._-.:....._...._._...,.._._.: ti:. ti: mss_: �...._....-...•' Part I small to large e_.._..:.._;..._......,....._-.::•'�^.:::-:�.:.......:::'':r,:.--=-�::s:_.:::;..;":._._.....:._..... z :r:��_.:�a• �-, r^.'•�:i::wi^.i�:==i3:..-..__—:.��••=x..•M1:=:--:' _.` ..__..r_........._.-::..._.__........,.._.....:a•_.,.r :_.... ..._..._._<.: ...__....v _. ..._.......__.. ..._.-•::r::ra_ -__ _ - - C The proposed action may result in the removal of, or ground disturbance in, any E2n ❑ ❑ portion of a designated significant natural community. maoccur occur a. The proposed action may impact soil classified within soil group 1 through 4 of the Source: ❑ ❑ NYS Land Classification System. g. The proposed action may substantially interfere with nestingtbreeding, foraging, or over -wintering habitat for the predominant species that occupy or use the project site. Elm 13 ❑ h. The proposed action requires the conversion of more than 10 acres of forest, grassland or any other regionally or locally important habitat. E 1 b ❑ ❑ Habitat type & information source: c. The proposed action may result in the excavation or compaction of the soil profile of L Proposed action (commercial, industrial or recreational projects, only) involves use of D2q ❑ ❑ herbicides or pesticides. d. The proposed action may irreversibly convert agricultural Iand to non-agricultural j. Other impacts: ❑ ❑ ❑ 8. Impact on Agricultural Resources The proposed action may impact agricultural resources. (See Part 1. E.3.a. and b.) YES I "Yes", answer questions a - h. I "No ", move on to Section 9. ._,.:...:._....: - - ..._..[��::::- :::� �-:::::_:� ':.,...:.. • ,_� -::-: ,::�:::<:-:::=:::- is �� ��� [:�� _ =:::_,:= �--•.: _._:.._�_.::_��__. •..: -:,-..r:::: �:=i:�:: '_ _ ,..: :. Relevant o orModerate _..... _...._. __......__::::_..-�:: �••�__ .... 1-c-:.a!::..._.:•.r...»._-.:....._...._._...,.._._.: ti:. ti: mss_: �...._....-...•' Part I small to large e_.._..:.._;..._......,....._-.::•'�^.:::-:�.:.......:::'':r,:.--=-�::s:_.:::;..;":._._.....:._..... z :r:��_.:�a• �-, r^.'•�:i::wi^.i�:==i3:..-..__—:.��••=x..•M1:=:--:' _.` ..__..r_........._.-::..._.__........,.._.....:a•_.,.r :_.... ..._..._._<.: ...__....v _. ..._.......__.. ..._.-•::r::ra_ -__ _ - - estl� Qu n(s) impact impact may :;7; -- .:4...J ._. ......� .. ....._,.t....[.:......:: •._'I.... r....t._..f......................:.....��-^: _ti�.�::: i:.:':'�.:::� ...._.._...,t1:::Y.�: :.:...._ ._ -.....•.,'•w :. _ ...........:..._.._..�,_....::::::::::_:-�:,:,::....._..._ :.._...,,,-...__.,..�..:.W..__:...w...:�-��� r;w maoccur occur a. The proposed action may impact soil classified within soil group 1 through 4 of the Etc, E3b ❑ ❑ NYS Land Classification System. b. The proposed action may sever, cross or otherwise limit access to agricultural land Ela, Elb ❑ ❑ (includes cropland, hayfields, pasture, vineyard, orchard, etc). c. The proposed action may result in the excavation or compaction of the soil profile of E3b ❑ ❑ active agricultural land. d. The proposed action may irreversibly convert agricultural Iand to non-agricultural Elb, E3a ❑ ❑ uses, either more than 2.5 acres if located in an Agricultural District, or more than 10 acres if not within an Agricultural District. e. The proposed action may disrupt or prevent installation of an agricultural land El a, Elb ❑ ❑ management system. f. The proposed action may result, directly or indirectly, in increased development C2c, C3, ❑ ❑ potential or pressure on farmland. D2c, D2d g. The proposed project is not consistent with the adopted municipal Farmland C2c ❑ ❑ Protection Plan. h. Other impacts: ❑ ❑ Page 5 of 10 1 RESET FORM 9. Impact on Aesthetic Resources The land use of the proposed action are obviously different from, or are in NO [:]YES sharp contrast to, current land use patterns between the proposed project and a scenic or aesthetic resource. (Part 1. E. La, E. Lb, E.31.) I f "Yes "j answer questions a - If "No Jzo to Section 10. V.77 Relevant ---tevant No, or Moderate US Part I small to large ......... ... V11 s Question() impact impact may may occur ma occur occur a. Proposed action may be visible from any officially designated federal, state, or local E3h 11 ❑ scenic or aesthetic resource. nominated by the NYS Board of Historic Preservation for inclusion on the State or b. The proposed action may result in the obstruction, elimination or significant ED, C2b 11 ❑ screening of one or more officially designated scenic views. b. The proposed action may occur wholly or partially within, or substantially contiguous c. The proposed action may be visible from publicly accessible vantage points: E3h C3 to, an area designated as sensitive for archaeological sites on the NY State Historic L Seasonally (e.g., screened by summer foliage, but visible during other seasons) 13 ❑ ii. Year round 11 ❑ d. The situation or activity in which viewers are engaged while viewing the proposed 133h 0 to, an archaeological site not included on the NY SHPO inventory. action is: E2q, Source: i. Routine travel by residents, including travel to and from work I 13 I ii. Recreational or tourism based activities Elc 11 E3 e. The proposed action may cause a diminishment ofthe public enjoyment and E3h 11 El appreciation of the designated aesthetic resource. f There are similar projects visible within the following distance of the proposed Dla, Ela, 13 ❑ project: Dlf, Dlg 0-1/2 mile V2,-3 mile 3-5 mile 5+ mile g. Other impacts: 10. Impact on Historic and Archeological Resources The proposed action may occur in or adjacent to a historic or archaeological NO ❑ YES resource. (Part 1. E.3.e, f and g.) Y "Yes answer questions a - e. If 'No", go to Section IL Relevant No, or Moderate Part I small to large .... ....... Qestio) un(s impact impact may may occur occur a. The proposed action may occur wholly or partially within, or substantially contiguous Me 13 13 to, any buildings, archaeological site or district which is listed on or has been nominated by the NYS Board of Historic Preservation for inclusion on the State or National Register of Historic Places. b. The proposed action may occur wholly or partially within, or substantially contiguous E3f 11 C3 to, an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory. c. The proposed action may occur wholly or partially within, or substantially contiguous E3,Cr, El 0 to, an archaeological site not included on the NY SHPO inventory. Source: I I I I Page 6 of 10 RESET FORM d. Other impacts: The proposed action may result in a loss of recreational'• opportunities or a []YES ❑ ❑ (See Part 1. C.2.c, E.I .c., E.2.q.) e. If any of the above (a -d) are answered "Yes", continue with the following questions No, or Relevant No, or to help support conclusions in Part 3: -- - __•=- = -- - --- - -- - --_- :�;:�:�-.-:.::_�::::::::�--w:: r -- = = -- = -_"' =�= �"`= _•==-=r�=°�'.' ' �:; 'w: ��5 .'� w L.^._:::::-.-..�_L:_i^:.:.- �.0 � w Part I small L The proposed action may result in the destruction or alteration of all or part E3e, E3g, ❑ ❑ of the site or property. E3f ..-. r...._._.,................._ ........::...............::...............:........................::::::_-: - -may ii. The proposed action may result in the alteration of the property's setting or Be, E3f, ❑ ma occur integrity. E3g, Ela, D2e, Elb ❑ ❑ Elb E2h, b. The proposed action may result in a reduction in the quality of the resource or iii. The proposed action may result in the introduction of visual elements which E3e, EM, ❑ ❑ are out of character with the site or property, or may alter its setting. E3g, E3h, E2n, E2 c. Other impacts: C2, C3 C2a, Elc, ❑ 11. Impact on Open Space and Recreation The proposed action may result in a loss of recreational'• opportunities or a []YES reduction of an open space resource as designated in any adopted municipal open space plan. (See Part 1. C.2.c, E.I .c., E.2.q.) I "Yes ", answer questions a - e. ff 'No ", o to Section 12. No, or Relevant No, or Moderate -- - __•=- = -- - --- - -- - --_- :�;:�:�-.-:.::_�::::::::�--w:: r -- = = -- = -_"' =�= �"`= _•==-=r�=°�'.' ' �:; 'w: ��5 .'� w L.^._:::::-.-..�_L:_i^:.:.- �.0 � w Part I small to e larg rt��� �. _ _aSi... _T—^.•-.L-.:�� �'ti_ __ _ _ _ ,,,.•. _ _ = _ vc;•::�;,.. �� _ - Question(s) impact impact may P Y - - - ..-. r...._._.,................._ ........::...............::...............:........................::::::_-: - -may •• ---•••- --•-_ -. occur ma occur occur a. The proposed action may result in an impairment of natural functions, or "ecosystem D2e, Elb ❑ ❑ services", provided by an undeveloped area, including but not limited to stormwater E2h, b. The proposed action may result in a reduction in the quality of the resource or E3d storage, nutrient cycling, wildlife habitat. E2m, Ego, characteristic which was the basis for designation of the CEA. E2n, E2 c. Other impacts: b. The proposed action may result in the loss of a current or future recreational resource. C2a, Elc, ❑ ❑ C2c, E2 c. The proposed action may eliminate open space or recreational resource in an area C2a, C2c ❑ ❑ with few such resources. Elc, E2q d. The proposed action may result in loss of an area now used informally by the C2c, Ele ❑ ❑ community as an open space resource. e. Other impacts: ❑ ❑ 12. Impact on Critical Environmental Areas The proposed action may be located within or adjacent to a criticalNO ❑ YES environmental area (CEA). (See Part 1. E.3.d) I "Yes' ; answer questions a - c. 1 "No' ; o to Section 13. .:._,....,,._.._..:....__._......_....._.._........_............_.. _ _. _ Relevant No, or Moderate _ - R Part I small to large ,.-..:.__..._.,:x,,....:...».�_..<=-..:.......................-.:._....w�.._..._ ........:_�::>:-...._,._. ._..��: �•a;�?�=:::� :rs:'�:� �t: Question(s) impact act ma P impact ... ....... . ,. ..-. r...._._.,................._ ........::...............::...............:........................::::::_-: - -may occur occur a. The proposed action may result in a reduction in the quantity of the resource or EM ❑ ❑ characteristic which was the basis for designation of the CEA. b. The proposed action may result in a reduction in the quality of the resource or E3d ❑ ❑ characteristic which was the basis for designation of the CEA. c. Other impacts: ❑ ❑ Page 7 of 10 RESET FORM 13. Impact on Transportation The proposed action may result in a change to existing transportation systems. NO r ES (See Part 1. D.2 j) 1 "Yes ", answer questions a - g. I "No ", o to Section 14. . Relevant o or N Moderate - - Partl small to large _::�:,....._.....,....:::�_::_-:::::-:•:.__._..:._.:,:. .._ ''z• .... _,.._........:- ...._._......,: --:._...::::{._...,,:r ::_: L...ca_. ', 1_ ..::::::::.:..'T ter:'::^:::.:.:.::::: _i�_ r;• _ _ Question(s)impact impact " """ •. - 1•_'.•_-•�.�.�:t.:._._.........�}•:•_.3......_._-:ir :�'•--. \L ......, r.. _.. __._ . ... .gags.. :.._Li.1..:i.•, :: - - - ....i .....-e4. ._ L-._1.... .... .. ..._..:�::.__>.. .: _, .• ..._..._..._....._.... i::'::i.':::�......._.::..; .. .. _..._i.... _S..i•..._.�: 1" S.:t=.�il::-.=f� __- ...._ ._.. C.I._.....:: •:!':'::'::.:':•�� ,.t.:,::C_._....___::.!::':::.L`..__._1....,'�.:_..-7. :': -: _.:fes-::':Y.:!:U:L•?:._ �::: - - .. _. _..lam_..;'-:: •_ i..>.—...::t.._._. .. t.....:3:ri.._.. ... .................. u'..._...L. 1 ::........ t:::.�.Y....!: i� tl - - - -. r:>..- ;:=�:��r�_:.:: •.,.... _ u::r �;:::::_:::°>~;�1' may opeur occur a. Projected traffic increase may exceed capacity of existing road network. D2j Its, ❑ b. The proposed action may result in the construction of paved parking area for 500 or D2j DIf, ❑ more vehicles. or supply system to serve more than 50 single or two-family residences or to serve a / c. The proposed action will degrade existing transit access. D2j 132m, Eld ❑ d. The proposed action will degrade existing pedestrian or bicycle accommodations. D2j D2k ❑ e. The proposed action may alter the present pattern of movement of people or goods. D2j DI g ❑ f. Other impacts: feet of building area when completed. ❑ 14. Impact on Energy The proposed action may cause an increase in the use of any form of energy. O [:]YES (See Part 1. 13.21) I "Yes'; answer questions a - e. I "No ", o to Section 15. - - - elevant N o or Moderate ode aril small to lar e .._ ''z• .... _,.._........:- ...._._......,: --:._...::::{._...,,:r ::_: L...ca_. ', 1_ ..::::::::.:..'T ter:'::^:::.:.:.::::: _i�_ r;• _ _ Question(s)impact impact impact may 1•_'.•_-•�.�.�:t.:._._.........�}•:•_.3......_._-:ir :�'•--. \L ......, r.. _.. __._ . ... .gags.. :.._Li.1..:i.•, :: - - - ....i .....-e4. ._ L-._1.... .... .. ..._..:�::.__>.. .: _, .• ..._..._..._....._.... i::'::i.':::�......._.::..; .. .. _..._i.... _S..i•..._.�: 1" S.:t=.�il::-.=f� __- ...._ ._.. C.I._.....:: •:!':'::'::.:':•�� ,.t.:,::C_._....___::.!::':::.L`..__._1....,'�.:_..-7. :': -: _.:fes-::':Y.:!:U:L•?:._ �::: - - .. _. _..lam_..;'-:: •_ i..>.—...::t.._._. .. t.....:3:ri.._.. ... .................. u'..._...L. 1 ::........ t:::.�.Y....!: i� tl - - - -. r:>..- ;:=�:��r�_:.:: •.,.... _ u::r �;:::::_:::°>~;�1' may occu occur a. The proposed action will require a new, or an upgrade to an existing, substation. D2k ❑ ❑ b. The proposed action will require the creation or extension of an energy transmission DIf, ❑ 0 or supply system to serve more than 50 single or two-family residences or to serve a DIq, D2k commercial or industrial use. 132m, Eld ❑ c. The proposed action may utilize more than 2,500 MWhrs per year of electricity. D2k ❑ ❑ d. The proposed action may involve heating and/or cooling of more than 100,000 square DI g ❑ ❑ feet of building area when completed. e. Other Impacts: ❑ ❑ 15. Impact on Noise, Odor, and Light The proposed action may result in an increase in noise, odors, or outdoor lighting. []NO YES (See Part 1. D.2.m., n., and o.) I "Yes ", answer questions a -f I "No'; o to Section 16. - - - elev n R a t N o or Moderate ode Part I small to large - - - - - -- i - - - - - -Question(s) impact impact may -- - - tee..:::=:' -.-:l° _ ».... =:::..._........-..._-.:::e•�:r•::.:_�":i.L::.�c:�:__^:,:,__..cts..�:.�^�'' ..............:._.......__._....:..-.,:::•�:::,.�:;.,.:::::::_:�:::::w�:::.�:--'i::-•—,._..Y,. _..:z:-.�: R ma -v occur occur a. The proposed action may produce sound above noise levels established by local D2m ❑ regulation. b. The proposed action may result in blasting within 1,500 feet of any residence, 132m, Eld ❑ hospital, school, licensed day care center, or nursing home. c. The proposed action may result in routine odors for more than one hour per day. D2o ❑ Page S of 10 RESET FORM d. The proposed action may result in light shining onto adjoining properties. D2n to new or existing sources of contaminants. (See Part I.D.2.q., E.1. d. f g. and h.) ❑ e. The proposed action may result in lighting creating sky -glow brighter than existing area conditions. D2n, Ela Noor ❑ f. Other impacts: Part I small ❑ ........... ............ . .. . 16. Impact on Human Health The proposed action may have an impact on human health from exposure 0 ❑YES to new or existing sources of contaminants. (See Part I.D.2.q., E.1. d. f g. and h.) I f "Yes answer questions a - m. if "No go to Section 17 Relevant Noor Moderate Part I small to large ........... ............ . .. . Question(s) impact impact may . .. ..... may eccur occur a. The proposed action is located within 1500 feet of a school, hospital, licensed day Eld care center, group home, nursing home or retirement community. b. The site of the proposed action is currently undergoing remediation. Elg, Elh El 13 c. There is a completed emergency spill remediation, or a completed environmental site Elg, Elh 11 11 remediation on, or adjacent to, the site of the proposed action. d. The site of the action is subject to an institutional control limiting the use of the Elg, Elh 11 11 property (e.g., easement or deed restriction). e. The proposed action may affect institutional control measures that were put in place Elg, Elh 0 El to ensure that the site remains protective of the environment and human health. f The proposed action has adequate control measures in place to ensure that future 132t 11 El generation, treatment and/or disposal of hazardous wastes will be protective of the environment and human health. g. The proposed action involves construction or modification of a solid waste D2q, Elf 1:1 ❑ management facility. h. The proposed action may result in the unearthing of solid or hazardous waste. D2q, Elf 1:1 ❑ L The proposed action may result in an increase in the rate of disposal, or processing, of D2r, 132s 11 ❑ solid waste. j. The proposed action may result in excavation or other disturbance within 2000 feet of Elf, Elg 0 ❑ a site used for the disposal of solid or hazardous waste. Elh k. The proposed action may result in the migration of explosive gases from a landfill Elf, Elg El El site to adjacent off site structures. 1. The proposed action may result in the release of contaminated leachate from the D2s, Elf, project site. D2r m. Other impacts: ❑ D Page 9 of 10 RESET FORM 17. Consistency with Community Plans The proposed action is not consistent with adopted land use plans. [:]NO YES (See Part 1. C.1, C.2, and C.3.) If "Yes ", answer questions a - h. If "No ", go to Section 18. _._....:......... _......_..._..__.....-.... e event No or Moderate ...,.....:s::S:T•Fc:::_:a:>:�:...r::�_:,:�z'c-::u::�e:.:::,:::,r•.:::-�,._a:::::�::_:s; :'«.::i::::::.._....:. -._,s: �. a ___ - Part I small to arge _.__..._..... _.._._..._:z::..,,_.: _ Question(s) ns impact impact p �•-: -::::-:::::�::::::.::::::.�•:•_:« «;:::::<::.:::: _::::::::::-_::::::;.- ;::�::::_ :_:<:.-=::::-:-:: ::-:-:� :- _:_ �::_:_ icor occur C2, C3, Dla ❑ a. The proposed action's land use components may be different from, or in sharp contrast to, current surrounding land use pattem(s). Ela, Elb ❑ b. The proposed action will cause the permanent population of the city, town or village C2 j�' ✓ ❑ in which the project is located to grow by more than 5%. C4 \ ❑ c. The proposed action is inconsistent with local land use plans or zoning regulations. C2, C2, C3 ❑ d. The proposed action is inconsistent with any County plans, or other regional land use C2, C2 1�- ❑ plans. Dlg, Ela e. The proposed action may cause a change in the density of development that is not C3, Dlc, Dld, Dlf, ❑ supported by existing infrastructure or is distant from existing infrastructure. r e. The proposed action is inconsistent with the predominant architectural scale and Dld, Elb ❑ f. The proposed action is located in an area characterized by low density development C4, D2c, D2d ❑ that will require new or expanded public infrastructure. D2j ❑ g. The proposed action may induce secondary development impacts (e.g., residential or C2a ❑ commercial development not included in the proposed action) E2g, E2h h. Other: PT /— ❑ l8. Consistency with Community Character The proposed project is inconsistent with the existing community character. QNO 'ES (See Part 1. C.2, C.3, D.2, E.3) I "Yes ", answer questions a - g. I "No ",proceed to Part 3. ::—......;.:..—:.._.....—_'\!:::::.:x:•_'_'L::......_r..:Y_..._c..J:^�:___. •:::.ii::S•�:_ T`i^:^moi. �.����, �'«, �.,�.•.tu.1.4 �._".e:.•::•: ::=...L« ...CL ��.;G:�•�: - .,:.� --- = - - -- _- - - --"�•� - - ::�:�-_:�•=-= - ---- - _r__�., _ - Rel event No or , Moderate ...,.....:s::S:T•Fc:::_:a:>:�:...r::�_:,:�z'c-::u::�e:.:::,:::,r•.:::-�,._a:::::�::_:s; :'«.::i::::::.._....:. -._,s: �. a ___ - Part I small to large ::,-_:,_,::.� ..........._ -.:::r.::_= -=..r.:_.... ._.': .._......::. .._. ..,,..::.:_=_",-:-:_:r _:= :r ::.•:-__. ::..__.. •• �:l tri-_:_:.i_=C:'e �=�:':1�:..:_ Question(s) impact impact may s_ ... ..._�_;. occur occur •_:......._,..._.......::.:........_..._ ::-�..__...n::..,....._....._._ _•;. :::��_ _ H12Y a. The proposed action may replace or eliminate existing facilities, structures, or areas 133e, E3f, E3g ❑ of historic importance to the community. b. The proposed action may create a demand for additional community services (e.g. C4 X71 ❑ schools, police and fire) c. The proposed action may displace affordable or low-income housing in an area where C2, C3, Dlf 1�- ❑ there is a shortage of such housing. Dlg, Ela d. The proposed action may interfere with the use or enjoyment of officially recognized C2, E3 ❑ or designated public resources. r e. The proposed action is inconsistent with the predominant architectural scale and C2, C3 ❑ character. f. Proposed action is inconsistent with the character of the existing natural landscape. C2, C3 ❑ Ela, Elb E2g, E2h g. Other impacts: ❑ PRINT FULL FORM I Page 10 of 10 1 RESET FULL FORM LM: SURREY VIEW: SURVEY -4-- - - So ORA," __ 0" 141.,34' "0��52�5)� 0 BpXSIGN PAVEMENT �6096 0O4.E'W O 6/FfCROQ MP / SiGS W I F I pN wges � SECTION 143 ((J ONERNErO BLOCK 1 LOT 1 °" REPUTED OWNER: • 1,00. E p"� Z MAY & TONY INC. p" PIE II m �F -- SECTION 143 C; ; MONUMENT a 4 1 1 FOUND DEBRA TIMPONE 1 0.4'N III FE 0.2'E SHED I i I �I ' °Uj z it I I 1 1 t 1 t FE I 00 BLOCK 1 LOT 6 N I� 1 � to REPUTED OWNER: 1 1 Ul o r a ON FE UNEI 3.4' it 1 CONC. I ( 1 It 1 BLDG. °,4r' KO It +34• BLOCK 1 LOT 7 1 I 1 CONC ABRAHAM GARCIA & O•fl'W '; i SHARON RODRIGUEZ I I I I 1 1 j I I 1 ON 2' LINE m FE 'N 1 5.7'E f BLOCK 1 LOT 8 I 1 r I JAMES HINES m f r i I 1 j I I I / II I 1 1 I I �I I II Ij 1 I 1 1 II 1 1 1 o�ll 1 1 I Piz Ij 1 �I • I I � t �II I I 1 ' III U' 1 I I I I 1 I 1 I I I 1 1 I I 1 1 1 \ I \ I \ \ I \ ` I \ \ I \ \ \ 1 \ 1 \ \ \ to \ 10 1 \ \\ I a \\ \ Io l \ \ STAKE i 1 \ \ FOUND I f \ ,• 1 i 1 1 1 1 1 � 1 I ► 1 1 r ! 1 i I J 3 1 I i w N + i i V MLU O \ r W x \ OW \\ \\ 1 I Q \\ \\\ 1 1 I \\ I \ I \\ i \\ 1 1 t t I i 1 1 I 1 I I I I 1 I I I 1 1 1 I 1 1 1 1 1 t �1 1 1 1 \ \ \ 1 l I 5 Co I 1 I 1 I 1 Q I I I I 1 I 1 1 1 I I I I I r I I 1 1 ! 1 1 I I 1 I I I I 1 f 1 I 1 I I i i I 1 I I ' ! 1 lal (Ir WLr Iai to / 1 I /o / I 1 I I 1 t / /a/ I I lol I I ) 1 I 1 1 1 I 1 r I i I I 1 I I 1 1 1 I I 1 1 I I I 1 TRAILS & PATHS THROUGHOUT NOT SHOWN (NO BUILDINGS) WOODED 3 I t` 1\ \\ 11 �It �1 11 MONUMENT S 6931'00" W 577.68' + 1 FOUND �1 0.6'N y 0.4'E TAX LOT 8.9 REPUTED OWNER: MEGA STYLE LLC li SECTION 143 BLOCK 1 LOT 4.1 REPUTED OWNER: MARGARET NOONE ( <; SECTION 143 C; BLOCK 1 LOT 5 t20' a 4 REPUTED OWNER: SHED DEBRA TIMPONE _ 2.2•E FE 0.2'E SHED o.a•E °Uj z it SECTION 143 FE I 00 BLOCK 1 LOT 6 N I� to REPUTED OWNER: °° t0 ALFRED CILETTI JR. Ul o r a ON FE UNEI 3.4' CONC. f4.5'W i' 1 BLDG. °,4r' KO SECTION 143 +34• BLOCK 1 LOT 7 REPUTED OWNER: CONC ABRAHAM GARCIA & O•fl'W '; i SHARON RODRIGUEZ CONC .: g ON 2' LINE m FE 'N 5.7'E SECTION 143 BLOCK 1 LOT 8 REPUTED OWNER: JAMES HINES I MONUMENT FOUND WALL 0.6'W 0 -W FE � — — 0.7'W � �Z FE o.aw a � 0. SECTION 143 BLOCK 1 LOT 9 REPUTED OWNER: DOREEN SIDOR MONUMENT i — — FOUND SECTION 143 BLOCK 1 LOT 10 REPUTED OWNER: SOURAVLIS & ANNA HRISOVALANTIS SECTION 143 BLOCK 1 LOT 11 FE I o— REPUTED OWNER: 1.2'w MARY BERNINGER W 1 FE < 0.5'W PIPE FE FOUND I LONE 0.4'W I SECTION 144 BLOCK 1 LOT 1 REPUTED OWNER: J. MORENO PIPE FOUND 0.6'W SECTION 144 BLOCK 1 L07 2 f21' REPUTED OWNER: JOHN AND POND MARGARET TONER 1.3'W MONUMENT TREE FOUND I Row Lv SECTION 144 O BLOCK 1 LOT 3 Q REPUTED OWNER: O) JOHN AND _ I MARY FETZKO I N MONUMENTIN Cn — — FOUND FE 0.3'E W SECTION 144 W BLOCK i LOT 4 < 0 REPUTED OWNER: FELIX AND o LINDA MULE FE 0.5•w MONUMENT — FOUND SECTION 144 BLOCK 1 LOT 5.2 REPUTED OWNER: HOPE HERGRUETER MONUMENT FOUND SECTION 144 BLOCK -1 -LOT 6.2 REPUTED OWNER: J. SARNO SHED SECTION 144 D BLOCK 1 LOT 7 1 W REPUTED OWNER: SHED ELIZABETH CITTI 13 E SECTION 144 12' DG. BLOCK 1 LOT 8 *E REPUTED OWNER: K JAMES & VERA TAHENY E E SECTION 144 BLOCK 1 LOT 9 FE °'E REPUTED OWNER: ELIZABETH CASSIDY MONUMENT FE —FOUND 0.9'E FE 0 8'E SECTION 144 BLOCK 1 LOT 10 REPUTED OWNER: PAUL RENNER & MAUREEN ROCHE Y Q (L Y U i tL O CIL Q O W Q t t x The offsets or dimensions shown from structures to the property lines are for a specific purpose and use, and therefore, ore not intended to guide in the erection of fences, retaining walls, pools, patios, planting areas, additions to buildings and any other construction. Subsurface and environmental conditions were not examined or considered as a port of this survey. Easements, Rlghtsaf-Way of record, if any, are not shown. Property comer monuments were not placed as a part of this survey. NOTES: 1. LOT AREA = 20.8211 ACRES. 2. SUBSURFACE & ENVIRONMENTAL CONDITIONS WERE NOT EXAMINED OR CONSIDERED AS PART OF THIS SURVEY. CERTFIED TO: 9300 ROUTE 25, INC. "FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC. - FARM CREDIT EAST, ACA, SUCCESSOR BY MERGER TO FIRST PIONEER FARM CREDIT, ACA, IT'S SUCCESSORS AND/OR ASSIGNS) , I r � PLANNING BOARD MEMBERS DONALD J. WILCENSKI Chair WILLIAM J. CREMERS PIERCE RAFFERTY JAMES H. RICH III MARTIN H. SIDOR PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Elizabeth A. Neville, Town Clerk From: Heather Lanza, Planning Director .Date: July 7, 2015 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: 631765-1938 www.southoldtownny.gov Re: Change of Zone Application (Rezoning Petition) of Paul Pawlowski In reference to your memo dated July 6, 2015 in regards to the above referenced application, the application is now complete. Thank you. Cc: Supervisor & Town Board Members William Duffy, Town Attorney ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: William Duffy, Town Attorney Heather Lanza, Planning Director From: Elizabeth A. Neville Re: Change of Zone Application of Paul Pawlowski Date: July 6, 2015 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 www.southoldtownny.gov Enclosed is the Revised Amended Boundary Line Alteration submitted by the applicant to my office today. Please review it and send me your comments and recommendations. Upon your approval, Mr. Pawlowski would like to send out the "Notices to Adjacent Property Owners" and have a date set for the public hearing by the Southold Town Board. Thank you Cc: Supervisor & Town Board Members ♦ � w Z �) Q LOT 28 LOT 16 LOT _-- i—` -T= i T o �I0 I L07 7 0 LOT 12 ar �i —, ` r •� 13 USE: MARINE LOT 8 SALESNORTH ` SHORE YACHT L07 9 SALES I LOT 11 LOT 27 USE: .� MIXED / LOT 28 U5E: BANK/OFFICE BUILDING ,.- LOT 25 i �,14r REPAR O - — 4 �Ea �,, •''� � RES cM N CU ICP"p ) r �LPEjPIV LOT 26` woo.�v, I ` ( o A 600 9 [�Q1�TONY'SQ��1,00„ SSTAURAN UE:RE FUSION T LOT 27 LOT 2 USE! RETAIL \ NORTH FORK LOT 4.1 POOL SUPPLY LOT LOT 6.4 ,* 5 -� OD F i C4I F W) LOT 6 LOT 6.6 I 0 I It I OD LOT 7 I} LOT 6.7 I LOT 8 p I I:a _Lor 10 E] o LOT 11 10 LOT 9 1 ° $ 1 �• `L...2 iI �LOT I \ I LOT 8.9 I O w t L S s i I N Iv 0 I i Z N 0 IN lf! 600' OWNERS LIST I I I I I � I I S 69*31'00" W 577.68' �0 ti '<—LOT 10 USE: RESTAURANT MAGIC FOUNTAIN ,`LOT 30.2 1 USE: RETAIL 1 CVS STORE J / I i Lo n oa •� t-ar 12 h L \ i I _ 1 1 I i 122-6-6 122-6-22.1 143-1-6 143-2-17 144-1-3 144-1-17 144-2-15 MARY RAY 9025 MAiN ROAD LLC ALFRED M CILETTI JR SAL CIANI JOHN FETZKO DIANE K STERN JM WOLCZOK ASSET MANG TRT 375 FACTORY AVE 9025 RTE 25 BARBARA J SELTZER LUNN C CiANI MARY E FETZKO 2110 SIGSBEE RD 1905 SIGSBEE RD MATTITUCK NY 11952 MATTITUCK NY 11952 420 SIGSBEE RD 1015 SIGSBEE RD 1120 SIGSBEE RD MAT77TUCK NY 11952 MATTITUCK NY 11952 MAILING ADDRESS: MAILING ADDRESS: MATTITUCK NY 11952 MATTITUCK NY 11952 PO BOX 499 MAILING ADDRESS: MAILING ADDRESS: PO BOX 507 10095 MAIN RD UNIT 4 MAILING ADDRESS: MAILING ADDRESS: MATTITUCK NY 11952-0499 3443 BAY FRONT DR 32 5TH AVE MATTITUCK NY 11952-0507 MATTITUCK NY 11952 PO BOX 1040 114 GANNET DR BALDWIN HARBOR NY 11510 FARMINGDALE NY 11735 � PETITION SKETCH PI EL Caplessoof f this this survey map not bearing the land surveyor's embossed seal and signature shall AOUEBOGUE NY 11911-1040 COMMACK NY 11725 144-1-4 O 2015 BBV PC 122-6-8 122-6-25 Project No. FELIX MULE 144-1-18 144-2-16 HERMAN H HUBBARD MARK FARINA 143-1-7 143-2-18 LINDA MULE NANCY MCTAGUE DOUGLAS STEARNS JUDY AYTULIN DEBORAH FARINA ABRAHAM A GARCIA ANNE N CAROLAN 1220 SiGSBEE RD 2130 SIGSBEE RD JEAN E STEARNS 195 FACTORY AVE 355 HOBSON DR SHARON A RODGRIGUEZ 930 MARLENE LN MATTITUCK NY 11952 MATTITUCK NY 11952 1975 SiGSBEE RD MATTITUCK NY 11952 MATTITUCK NY 11952 540 SIGSBEE RD MATTITUCK NY 11952 MAILING ADDRESS: MAT71TUCK NY 11952 MATTITUCK NY 11952 MAILING ADDRESS: 15 LITTLE NECK RD 144-2-3 122-6-9 122-6-26 MAILING ADDRESS: 8 MARIE CT DOUGLASTON NY 11363 ROBERT L DEMERT 144-2-18 KOCH HOLDING CORP MARK A FARINA 21 WILSON PL HICKSVILLE NY 11801 LUCILLE M DEMERT STEVEN E CROM 95 FACTORY AVE 185 HOBSON DR FREEPORT NY 11520 144-1-5.2 1175 SIGSBEE RD SABINE N BECKMANN MATTITUCK NY 11952 MATTITUCK NY 11952 143-2-20.1 HOPE S HERBRUETER MATTITUCK NY 71952 2075 SIGSBEE RD MAILING ADDRESS: MAILING ADDRESS: 143-1-8 GREGORY B WOOD 1330 SIGSBEE RD MAILING ADDRESS: MAT71TUCK NY 11952 840 N OAKWOOD DR 355 HOBSON DR JAMES A HINES BARBARA WOOD MATTITUCK NY 11952 45 OLD MiLL RD MAILING ADDRESS: LAUREL NY 11948 MATTITUCK NY 11952 620 SIGSBEE RD 840 MARLENE LN MAILING ADDRESS: MANHASSET NY 11030 325 E 41ST ST UNIT 601 MATTITUCK NY 11952 MATTITUCK NY 11952 PO BOX 642 NEW YORK NY 10017-5916 122-6-10 122-6-28 MAILING ADDRESS: MAILING ADDRESS: MATTITUCK NY 11952 144-2-4 JAMES J KREH FAMILY TRUST 9025 MAIN ROAD LLC 333 E 43RD ST APT 709 181 BELLMORE ST BRIAN HEATH 144-2-31 9825 RTE 25 2235 HOBSON DR NEW YORK NY 10017 FLORAL PARK NY 11001 144-1-6.2 PATRICIA A HEATH ALAN J LOTITO MATTITUCK NY 11952 MATTITUCK NY 11952 J T & P J SARNO TRUST 1225 SIGSBEE RD SUZANNE M L071TO MAILING ADDRESS: MAILING ADDRESS: 143-1-9 143-2-21 1380 SIGSBEE RD MATTITUCK NY 11952 2020 MARLENE LN 1500 CHALLENGER AVE 10095 MAiN RD UNIT 4 DOREEN SIDOR GREGORY C DICKERSON MATTITUCK NY 11952 MAILING ADDRESS: MATTITUCK NY 11952 DAVENPORT FL 33897 MATTITUCK NY 11952 730 SIGSBEE RD DERBORAH CARRIG MAILING ADDRESS: PO BOX 584 MAILING ADDRESS: MATTITUCK NY 11952 780 MARLENE LN 519 DALLAM CT MATTITUCK NY 11952-0584 1109 EUSTON RD 122-6-11 122-7-6.4 MAILING ADDRESS: MATTITUCK NY 11952 BEL AIR MD 21014 GARDEN CITY NY 11530 ANTHONY J ANTOGEORGI WILLIAM M GREMLER 645 MILL CREEK OR 144-2-5 9705 RTE 25 MARY ANN GREMLER SOUTHOLD NY 11971 143-2-22.1 144-1-7 FELIX MULE 144-2-32 MATTITUCK NY 11952 8700 RTE 25 BRYCE ROMER ELIZABETH CITTI DIANE MULE EAMON T TUBRIDY MAILING ADDRESS: MATTITUCK NY 11952 143-1-10 STEPHANIE ROMER 1480 SIGSBEE RD 1295 SIGSBEE RD KATHLEEN H TUBRIDY 3175 RTE 48 MAILING ADDRESS: HRISOVALANTIS SOURAVLIS 550 MARLENE LN MATTITUCK NY 11952 '•MATiITUCK NY 11952 1930 MARLENE LN MATTITUCK NY 11952 PO BOX 173 ANA SOURAVLIS MATTITUCK NY 11952 MAILING ADDRESS: MATTITUCK NY 11952 MATTITUCK NY 11952-0173 820 SIGSBEE RD MAILING ADDRESS: 144-1-8 15 LITTLE NECK RD MAILING ADDRESS: 122-6-12 MATTITUCK NY 11952 340 E 57TH ST JAMES TAHENY DOUGLASTON NY 11363 97 ELTON RD CAPT RED'S MARINE SALES MAILING ADDRESS: NEW YORK NY 10022 VERA TAHENY STEWART MANOR NY 11530 9605 RTE 25 122-7-6.7 21-36 38TH ST 1530 SIGSBEE RD 144-2-8 MATTITUCK NY 11952 WILL WOODWORDS PAULSON ASTORiA NY 11105 143-2-22.2 MATTITUCK NY 11952 SHIPLEY MURPHY 144-2-33 MAILING ADDRESS: 1795 OLD MAIN RD HENRY ROES MAILING ADDRESS: 1305 SiGSBEE RD RACHEL ALYWARD PO BOX 528 MATTITUCK NY 11952 143-1-11 STEPHANIE ROES 1548 212TH ST MATTITUCK NY 11952 RUTHANNE PIGOTT MATTITUCK NY 11952-0528 MAILING ADDRESS: MARY L BERNINGER 620 MARLENE LN BAYSiDE NY 11360-1110 1820 MARLENE LN 7 PENNANT LN 910 SIGSBEE RD MATTITUCK NY 11952 144-2-7 MATTITUCK NY 11952 122-6-13 E OUOGUE NY 11942 MATTITUCK NY 11952 MAILING ADDRESS: 144-1-9 KATHERINE GALLAGHER MAILING ADDRESS: MICHAEL HUGHES 3 WILLOW LN ELIZABETH A CASSIDY 1325 SIGSBEE RD 406 2ND ST APT 2 THERESE HUGHES 122-7-6.8 143-2-5 CARLE PLACE NY 11514 1600 SiGSBEE RD MATTITUCK NY 11952 BROOKLYN NY 11215 9625 RTE 25 JODAN HOLDING CORP NORTH FORK HORIZONS LLC MATTITUCK NY 11952 MAILING ADDRESS: MATTITUCK NY 11952 ATTN: SRISOTII & WILKWORTH INC 225 SIGSBEE RD 143-2-23 MAILING ADDRESS: PO BOX 15 144-2-34 MAILING ADDRESS: 8400 RTE 25 MATTITUCK NY 11952 VALERiANO AZZARA 12560 SiGSBEE RD MATTITUCK NY 11952-0015 JOHN KNOWLES 605 SAYSHORE RD MATTITUCK NY 11952 MAILING ADDRESS: PATRYCiAEES AZZARA MATTITUCK NY 11952 NANCY KNOWLES GREENPORT NY 11944 MAILING ADDRESS: 925 N SEA DR 470 MARLENE LN 144-1-10 144-2-8 1690 MARLENE LN PO BOX 1448 SOUTHOLD NY 11971 MATTITUCK NY 11952 PAUL J RENNER KATHERINE M GALLAGHER MATTITUCK NY 11952 122-6-14 MATTITUCK NY 11942-1448 MAILING ADDRESS: MAUREEN ROCHE COURTNEY E GALLAGHER MAILING ADDRESS: MICHAEL HUGHES 143-2-6 38 OLD MILL RD 1690 SiGSBEE RD 1345 SIGSBEE RD 67 WILLOW ST THERESE HUGHES 122-7-8.9 DAVID F HAAS MERRiCK NY 11566 MATTITUCK NY 11952 MATTITUCK NY 11952 GARDEN CITY NY 11530 9475 RTE 25 MEGA TYL LLC SUSAN M HAAS MAILING ADDRESS: MATTITUCK NY 11952 1150 OLD MAiN RD 275 SIGSBEE RD 143-2-24 144-1-11 PO BOX 15 144-2-35 MAILING ADDRESS: PO BOX 56 MATTITUCK NY 11952 ALAN E RICHARDS GEORGE J MALTESE MATTITUCK NY 11952-0015 MICHAEL A KELLY PO BOX 528 MATTITUCK NY 11952-0056 LOUISE M RICHARDS 1790 SIGSBEE RD MAUREEN T KELLY MATTITUCK NY 11952-0528 143-2-10 400 MARLENE LN MATTITUCK NY 11952 144-2-9 1450 MARLENE LN 122-7-9 CHRISTINE HENRY MATTITUCK NY 11952 KEVIN R MC CLEAN MATTITUCK NY 11952 122-6-15 9300 ROUTE 25 INC 535 SIGSBEE RD MAILING ADDRESS: 144-1-12 MARY A MC CLEAN MICHAEL HUGHES 9300 RTE 25 MATTITUCK NY 11952 22-36 36TH ST NOFOLAND LLC 1475 SIGSBEE RD 144-2-36 9487 RTE 25 MATTITUCK NY 11952 ASTORIA NY 11105 1830 SiGSBEE RD MATTITUCK NY 11952 STEVEN SZCZESNiAK MATTITUCK NY 11952 MAILING ADDRESS: 143-2-11 MAT77TUCK NY 11952 MAILING ADDRESS: 1400 MARLENE LN MAILING ADDRESS: PO BOX 1086 NELLA KHANiS 143-2-25 MAILING ADDRESS: 5102 N 32ST PL UNIT 418 MATTITUCK NY 11952 605 SAYSHORE RD MATTITUCK NY 11952-1086 VICTOR MARTEN LiSELOTTE M URIST 1537 REDDING RD PHOENIX AZ 85016 GREENPORT NY 11944 575 SIGSBEE RD 300 MARLENE LN FAIRFIELD CT 06824 144-2-37 142—i-26 MATTITUCK NY 11952 MATTITUCK NY 11952 144-2-10 JOHN J ROBERTSON MATTITUCK PLAZA LLC MAILING ADDRESS: MAILING ADDRESS: 144-1-13 DAREN KiNG ANTOINETTE ROBERTSON 122-6-16 10095 RTE 25 169-15 35TH AVE PO BOX 1436 JOHN G WOLCZOK 1515 SiGSBEE RD 1300 MARLENE LN THERESE HUGHES MATTITUCK NY 11952 FLUSHING NY 11358 MATTITUCK NY 11952-1436 JANICE ALOISIO MATTITUCK NY 11952 MATTITUCK NY 11952 9849 RTE 25 MAILING ADDRESS: 1800 SiGSBEE RD MAILING ADDRESS: MAILING ADDRESS: MATTITUCK NY 11952 PO BOX 77 143-2-12 143-2-26 MATTITUCK NY 11952 1330 FACTORY AVE 1350 MARLENE LN MAILING ADDRESS: MATTITUCK NY 11952-0077 HEATHER MAE GUNTHER LISELOTTE M URiST MAILING ADDRESS: MATTITUCK NY 11952 MATTITUCK NY 11952 605 BAYSHORE RD 615 SIGSBEE RD 230 MARLENE LN 32 6TH AVE GREENPORT NY 11944 142—i-27 MATTITUCK NY 11952 MATTITUCK NY 11952 FARMINGDALE NY 11735 144-2-11 144-2-38 GAMA PROPERTIES—DEERINC MAILING ADDRESS: SYLVIA APPENZELLAR RALPH M PALMIOTTO 122-6-17 9945 RTE 25 143-2-13 PO BOX 1436 144-1-14 CHRISTINE E APPENZELLAR CAROL A PALMIOTTO KEIL FARMS LLC MATTITUCK NY 11952 BETH C SANTILLO MATTITUCK NY 11952-1436 PATRICK CAREY 1625 SIGSBEE RD 1250 MARLENE LN 9425 RTE 25 MAILING ADDRESS: JOSEPH K SANTiLO VALERIE CAREY MATTITUCK NY 11952 MAT77TUCK NY 11952 MATTITUCK NY 11952 320 FRONT POND RD 685 SIGSBEE RD 143-2-30.2 1930 SIGSBEE RD MAILING ADDRESS: MAILING ADDRESS: OLD BROOKVILLE NY 11545 MATTITUCK NY 11952 SCP 2005—C21-051 LLC MATTITUCK NY 11952 13310 N 95TH WAY 144-2-39 30 EASTGATE DR C/O CVS CORPORATION MAILING ADDRESS: SCOTTSDALE AZ 85260 THOMAS A DUFFY HUNTINGTON NY 11743 143-1-1 143-2-14 ATTN: PROP TX DEPT STORE 3105 9 DEVONSHIRE DR JANICE L DUFFY MAY & TONY INC STANLEY C MICKALIGER 9870 RTE 25 NEW HYDE PARK NY 11040 144-2-12 1100 MARLENE LN 122-6-18 9650 RTE 25 FRANCES C MICKALIGER MATTITUCK NY 11952 SYSAS BARBARO MATTITUCK NY 11952 MARIUSZ JACHiMOWICZ MATTITUCK NY 11952 765 SiGSSEE RD MAILING ADDRESS: 144-1-15 MARY ELLEN BARBARO MAILING ADDRESS: 9395 RTE 25 MAILING ADDRESS: MATTITUCK NY 11952-0918 ONE CVS DR SAMUEL i BAIL 1675 SIGSBEE RD 191 ALLEN AVE MATTITUCK NY 11952 1 W MAiN ST WOONSOCKET RI 02895 JEAN SAiL MATTITUCK NY 11952 OCEANSIDE NY 11572 HAMPTON BAYS NY 11946 143-2-15 1980 SIGSBEE RD MAILING ADDRESS - 122 -6-19,11 STANLEY C MICKALIGER 144-1-1 MATTITUCK NY 11952 61 CASTLETON CT 144-2-40 DOROTHY SAUNDERS 143-1-4.1 FRANCES C MICKALIGER J A & C MORENO REV TRUST MAILING ADDRESS: OCEANSIDE NY 11572 LAWRENCE A HERMAN ATTN: MURIEL WiLSON MARGARET NOONE 815 SIGSBEE RD 990 SIGSBEE RD 40 BiG BEAR PATH C.O MARILYN GILROY 9255 RTE 25 210 SIGSBEE RD MATTITUCK NY 11952-0918 MATTITUCK NY 11952 ORMOND BEACH FL 32174 144-2-13 1000 MARLENE LN MATTITUCK NY 11952 MATTITUCK NY 11952 MAILING ADDRESS: BARBARA A CONDON MATTITUCK NY 11952 MAILING ADDRESS: 143-2-16 2301 ASPEN WAY 144-1-16 1755 SiGSBEE RD MAILING ADDRESS: PO BOX 642 143-1-5 TONER PREMISES TRUST BOYNTON BEACH FL 33436 DIANE K STERN MATTITUCK NY 11952 58 EASTFIELD LN MATTITUCK NY 11952-0642 DEBRA J TIMPONE 875 SIGSBEE RD 2110 SIGSBEE RD MELViLLE NY 11747 122-6-19.2 360 SIGSBEE RD MATTITUCK NY 11952 MATTITUCK NY 11952 MAILING ADDRESS: 144-1-2 JOHN P TONER MATTITUCK NY 11952 MAILING ADDRESS: 144-2-14 BARBARA CONDON 9255 MAiN RD LLC MAILING ADDRESS: PO BOX 362 MARGARET K TONER 3443 BAY FRONT DR 1825 SIGSBEE RD 9255 RTE 25 PO BOX 155 MATTITUCK NY 11952-0875 1060 SIGSBEE RD BALDWIN HARBOR NY 11510 MATTITUCK NY 11952 � - MATTITUCK NY 11952 LAUREL NY 11948 MATTITUCK NY 11952 MAILING ADDRESS: MAILING ADDRESS: MAILING ADDRESS: 1755 SIGSBEE RD PO BOX 645 PO BOX 362 MATTITUCK NY 11952 MATTITUCK NY 11952-0645 MATTITUCK NY 11952-0362 LM: SURVEY VIEW: SUMEY The offsets or dimensions shown from structures to the property lines are for a specific purpose and use, and therefore, ore not intended to guide in the erection of fences, retaining walls, pools, patios, planting areas, additions to buildings and any other construction. Subsurface and environmental conditions were not examined or considered as a part of this survey. Easements, Righ" Way of record, if any, are not shown. Property corner monuments were not placed 03 a part of this survey. I I I I i LOT 28 III LOT 25 I LOT 24 LOT 23 ALL BUILDING ALONG SIGBEE ROAD ARE II RESIDENCES AND ASSOCIATED ACCESSORY BUILDINGS UNLESS OTHERWISE INDICATED. "1 LOT 22.1 LOT 22.2 LOT 21 I I(`# LOT 20.1 I� LOT 16 I I I Ill LOT 40 ( Z LU I ,,,r1 LOT 39 LOT 38 I i I e LOT 37 t 4 LOT 36 l LOT 35 -----II I LOT 34 ag I LOT 33 I LOT/32 � I LOT 31 RECEIVED JUL 7 2015 Southold Town Clerk APPLICANT PAUL PAWLOWSKI P.O. BOX 783 MATTITUCK, N.Y. 11952 7/7/15 A.V.R. BUILDING USES Date By Revision Surveyed by: -- Drafted by: A.V.R. Checked by: M.A.R. Ba rrett Bonacci & Van Wee I e, PC Civil Engineers 175A Commerce Dr. Surveyors Hauppauge, NY 11788 T 631.435.1111 Planners F 631.435.1022 www.bbvpc.com Tax Map No.: DISTRICT 1000 SECTION 122 BLOCK 7 LOT 9 Certifications prop indicated hereon oniwas this plat of of the property depicted hereon was made in P PE RTS accordance with the existing Code of Practice for Land Surveyors adopted by the New York Stole Association Professional Land Surveyors. This SITUATE of certification is only for the lands depicted hereon and Is not certlficalion of title, zoning or freedom OF encumbrances. Said certifications shall run I AD E R only to the persons and/or entities listed hereon and aro not transferable toadditional persons, entities or subsequent owners. / TOWN OF SOUTHOLD SUFFOLK COUNTY N.Y. P/r O KI REZO 1IN G Unauthorized alteration or addition to this survey is a violation of Section 7209 of New York Stolelaw � PETITION SKETCH PI EL Caplessoof f this this survey map not bearing the land surveyor's embossed seal and signature shall riot be considered to be a hue and valid copy O 2015 BBV PC Date Scale Project No. Sheet No. a� JUNE 29, 2015 1" = 200' A140502 n . .... . .... I I I I I a ludulmul 1 0 11 lu u Ulu 7015 0640 0007 5,060 5138 C- F ;FIFFC820 u u Z :1>1 m (A 1111,11, 11 HIII) I I 11111111i I Ili I I I I'll tv LP (5- Z. 751 -Z� Q 4J C=) I III I TOWN BOARD, TOWN OF SOUTHOLD In the Matter of the Petition of to the Town Board of the Town of Southold.: Qel YOU ARE HEREBY GIVEN NOTICE: NOTICE TO ADJACENT PROPERTY OWNERS 1. That it is the intention of the undersigned to petition the Town Board of the Town of Southold to request a C> 1 A_l 2. That the property which is the subject of the Petition is located adjacent to your property and is described as follows: Suffolk County Tax Map # 1000- -7 Property Address: ct> 3. That the property which is the subject of such Petition is located in the following zoning district: 4. That by such Petition, the undersigned will request that the above-described property be placed in the following zone district classification: Fee rn V_R C) 1-0 -7 � 6 5. That within five days from the date hereof, a written Petition requesting the relief specified above will be filed in the Southold Town Clerk's Office at Main Road, Southold, New York and you may then and there examine the same during regular office hours. 6. That before the relief sought may granted, a public hearing must be held on the matter by the Town Board; that a notice of such hearing must be published at least ten days prior to the date of such hearing in the Suffolk Times newspaper published in the Town of Southold and designated for the publication of such notices; that you or your representative have the right to appear and be heard at such hearing. Dated:, 20 Petitioner Mailing Address: �. � -7 9 -mak- PY tt95c? yWvM C,t- ciao l p e c, A, Nit; ADDRESS STATE OF NEW YORK SS COUNTY OF SUFFOLK �Z;� l�ulBwS � �� � ,residing at �b being duly sworn, deposes and says that on the — 7 day of t�� , 20 deponent mailed a true copy of the Notice set forth on the reverse side hereof, directs to each of the above-named persons at the addresses set opposite their respective names; that the addresses ,set opposite the names of said persons are the addresses of said persons as shown on the current assessment roll of the Town of Southold, that said Notices were mailed at the United States Post Office at registered receipt mail. Sworn before me this day � _off � �► that said Notices were mailed to each of the said persons by certified, JASON SI®® Majaev Public a stow of MEM U0* NORM -in Suffolk cn � ADDRESSES MEGA STYLE LLC PO BOX 56 MATTITUCK NY 11952 ELIZEBETH CASSIDY 1560 SIGSBEE ROAD MATTIUCK NY 11952 JAMES TAHENY 1548 212TH STREET BAYSIDE NY 11360 ELIZEBETH CITTI 1480 SIGSBEE RD MATTITUCK NY 11952 SARNO JT TRUST 519 DALLAM CT BEL AIR MD 21014 HOPE HERGRUETER 642 MATTITUCK NY 11952 FELIZ MULE 15 LITTLE NECK RD DOUGLASTON NY 11363 JOHN FETZKO 1120 SIG BEE RD MATTITUCK NY 11952 ( Bnrx �ACA9 per u5 FS) MARGARET TONER PO BOX 362 MATTITUCK NY 11952 MORENO TRUST 2301 ASPEN WAY BOYNTON BEACH FL 33436 MARY BERNINGER 910 SIGSBEE RD MATTITUCK NY 11952 ANNA SOURAVLIS 21-36 38TH STREET ASTORIA NY 11105 DOREEN SIDOR 645 MILL CREEK DR SOUHTOLD NY 11971 JAMES HINES 620 SIGSBEE ROAD MATTITUCK NY 11952 ABRAHAM GARCIA 21 WILSON PL FREEPORT NY 11520 ALFRED CILETTI 1040 AQUEBOGUE NY 11931 DEBRA TIMPONE 155 LAUREL NY 11948 MARGARET NOONE 210 SIGSBEE RD MATTITUCK NY 11952 uS p5� MAY/TONY INC 1 WEST MAIN STREET HAMPTON BAYS NY 11946 (1 w' Y1��r �k �Pry ANTHONY ANTONGEORGI 3175 ROUTE 48 MATTITUCK NY 11952 CAPT REDS MARINE SALES PO BOX 528 MATTITUCK NY 11952 MICHEAL HUGHES 605 BAYSHORE RD GREENPORT NY 11944 KEIL FARMS 30 EASTGATE DR HUNTINGTON NY 11743 MARIUSZJACHIMOWICS 9395 ROUTE 25 MATTITUCK NY 11952 9255 MAIN RD LLC 645 MATTITUCK NY 11952 9025 MAIN ROAD LLC 10095 MAIN RD MATTITUCK NY 11952 r - M O -n M Ln r - C3 C3 1:3 O M Lr) rq O 4 D Af, , I) &�� �J�- HMRTQNjAYS.,MW1-1'T46 U-,' Certified Mail Fee $ i3l. 45 0952�-�--� 1� Extra Services & Fees (check b=, add fee as approjodate) 05, El Return Receipt (hardcopy) ❑ Return Receipt (electronic) Postmark ❑ Certified Mail Restricted Delivery Here ❑ Adult Signature Required $ .00 []Adult Signature Restricted Delivery $ -U, aWs' Postage $ $0.71 Total Postagi V" Sent To M A* Ifb N Y INC StreetandAp 1 WEST M*Hf 5678Ftate,2------1 HAMPTON BAYS NY 11946 7 ANK 37 Er - A Certified Mail Fee 0952 NZ, Lr) Extra Services & Fees (check box, add fee as riate) tC 05 El Return Receipt (hardcopy) $ "CIO E] Return Receipt (electronic) $ Postmark [--3 w E-3 [3 Certified Mail Restricted Delivery $ Hers r3 E] Adult Signature Required []Adult Signature Restricted Delivery J M Postage $ $0.71 Total Postage C', M 19 Ln Sent To ANfl'h'&NY ANTONG tdAol 3175 ROUTE 48 err MATTITUCK NY 11952. 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U-31 Extra Services & Fees (checkbox, eas datq);� -tb 05 kp Ln Extra Services & Fees (ChOCKDOX, &M r as app, te) approp $ E] Return Receipt fha�—nvl El Return Receipt (hardcopy) rl— -et— Postmark C3❑ Return Receipt (electronic) -t 0 ❑ Return Receipt (elactron1c) Imark Restricted Delivery Here Delivery C3 ❑ Certified Mall Restril 015 0 Postmark rk i V 0 Certified Mail Restricted Dative Adult Signature Required []Adul[i Sgnature Required $ Signature Restric,led Delive []AdultSi ry $ O C OPostage $0 E] Adult Signature Restricted Deliv Postage .71 ICU -n $ $0.71 ',�4A7t`22015 E3 Total Posstagr Total Posta $6.96 7/07/2015 $ elf �r 5tV5 o 0 $ ALD a. 5 Sent To Ln Sent To U-) DOREEiN SIDO JAMES HINES e-1 to OL m Siii5iana-AF 645 MILL CREEK DR E3 j5faia 620 SIGSBEE ROAD 'City State, 2, SOUTHOLD NY 11971 MATTITUCK NY 11952 ----- T V, ,v ED 117 " Ilk— IED EREPOR!T n _ Certified Mail F gg� _n �7, ea E3 AQU GUE, V, C-� -13 Certified Mall Fee $ ej3.45 .092 r, Extra Services Fees (checkbox, acdf,ees,,npfs, E:3 $ $3.45 09-52 1 U-) 11, Return Receipt (hardcopy) $1, 05 Extra Services & Fees (check box, add fee as p na 05 $ Return Receipt (hardcopy) 9 El Return Receipt (electronic) * E3 El Certified Mail Restricted Dellvery $ CU C-3 E] Return Receipt (electronic) $ ', ,L' Postmark --3 El 1Adult Signature Required POStMarkHere 1-3 [1 Certified Mail Restricted Delivery $ Here El Adult Signature Restricted Deliver ---- V) TRY E:3 El Adult Signature Required Postage Adult Signature Restricted Delivery $ L -J $ & $0.71 0 L Postage $0.71 C3 Total Post, 96 C3 Total Postage Sent To 07/07/2,015 '7/20 5 M GARCIA Ln Ln VMABRAHAALMD CILETTI Sent To 21 WILSON PL ------ rq --- EM and PO BOX 1040 pp Cif} Stale FREEPORT NY 11520 ------ r -- --------------- AQUEBOGUE NY 11931 --- I city, state, A _7 171-1 Y D C3 Li nj Er E=j 10 )AUR L46� -B Certified Mail Fee C3 F 461AIGM, 52- U -S 0 n V -n Certified Mall Fee Ln $ $3,.04.5 3 i C3 Extra Services & F sAp. ;� 0 $ ees c� box, add ic rupdatell 0952eta p Ln y) $ ❑Return Receipt (hardcopy) mqw ap�ovvpdate) o 05 Extra Services & Fees (checkbox, add 05 CP E] Return Receipt (hardcopy) Return $ r Receipt (electronic) C.-', tat Pos .1k (elect onto) $ O El Certified Mall Restricted Delivery $ E] Return Receipt (a[ Postmark Here C3 :ad Delivejy $ Adult Signature Required $ ❑ Certified Mall Restrict Ej Adult Signature Restricted Delivery$ I r_3 L] Adult Signature Required $ F =r-3 Postage "tyi N '�Orl 1-0-1 _]Adult Signature Restricted Delivery $ $ $0.71 M Postage 17 _r Total Post- - I r'l I �n $ $ $6.% it E3 Total Post; Ln Sent To DEBRA TIM $6.96 0 -7015,--, r-zl PO E RON Lr) S 0r -q Sent To MARGARET NOONE r- PO BOX 155 C3 Street and210 SIGSBEE RD LAUREL NY 11948 r- aii-Staitz,, MATTITUCK NY 11952 25 oft 17-71 nj Rill)= 'j 52, 11" LMLE'�NECK,4r. 0-1.363 MATTITUCKv, VV 19 Z3), _a Certified Mail Fee " , V -Certified Mail Fee If $ $3.45 092 S. 45 - 175 1 Lr) Extra Services & Fees (check boy add fee as appropriate, 1. 05 Lrl Extra Services & Fees (check box, add fee as appropriate) 05 El Return Receipt (hardcopy) $ • E3 Return Receipt (hardcopy) ' $ r*- . � $2.930— --$M. 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