Loading...
HomeMy WebLinkAboutLL #06 2016 v ELIZABETH A.NEVILLE,MMC ��� 4• oFo Town. .4�G Town Hall,53095 Main Road TOWN CLERK - • ti ; P.O.Box 1179 cm Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ; p �1 Fax(631)765-6145 MARRIAGE OFFICER ` #4, ° ° • '^' •17-011 Telephone(631)765-1800 I RECORDS MANAGEMENT OFFICER : " 4 �.�� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER - ,;,,,,, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Planning Director Heather Lanza Town Attorney William M. Duffy From: Town Clerk Elizabeth A. Neville Re: Change of Zone Application of ADF entures, LLC Date: April 8,2016 Please find additional information relating to the above referenced application submitted by William Kelly in response to the March 21, 2016 letter of the Planning Board Office. • 'r rite MORTON BUILDINGS/ INC• www.mortonbuildings.com _ ® Cox Lane Industrial Park•22355 County Rd. 48, Unit 4 Office:631/734-4060 Cutchogue, New York 11935-1159 Fax:631/734-4061 To: RECEIVED 4-08-16 Southold Town Board FR: APR 8 2016 Bill Kelly Owners Authorized Agent Southold Town Clerk Ref: ADF Ventures _ SCTM#1000-48-2-44.2 620 Corwin St,Greenport, NY To the Members of the Board, We recently received a memorandum,from Heather Lanze, Planning Director Town of Southold, in reference to the completeness of our application for zone change to the above referenced property. Included with this letter is additional information requested: Radius map: Showing 200'and 500' radius with all zone boundaries indicated. Made subject property and request for zone change note more prominent and obvious to the casual observer. 6) Copies of list of property owners within 500'radius. List indicates all property owners with in the 200' in bold face. Memorandum from Southold Town Planning Board,from James H. Rich III,Vice Chairman of the Planning Board,dated 3-24-15 to the ZBA.At this time we were requesting front and rear yard setback relief in order to construct a commercial building in an LI zone. I have only included the part of the letter that outlines the history and the zoning of the property. Please not that prior to 1971 the subject property was zoned residential, currently it is in the LI zone and we wish to convert it back to residential R-40. Respectfully William Kelly Authorized Agent Excellence—Since 1903 S C:TM. OWNERS NAME I CU ENTI USE j BUSINESS NAME _ 1000-48-1-9 Frederick E. Gagen 1000-48-1-10 Annette E. Ray 1000-48-1-11 James Richter RECEIVED 1000-484-12 James Richter _ 1000-48-1-13 Colin VanTuyl _ AP-S--8-2016 ",', 1000-48-.1-14 David Zellerford _ 1000-48-1-15 Shawna MacNamara Southold T 1000-48-1-16 Holly A. Weingart& Sharon C. Bogden _ —1000-48-1-17 Peter F. Inzerillo, Cheryl R. Inzerillo 1000-48-1-18 John J. Kostal Jr. &Anne S. Kostal _ 1000-48-1-19 Ethel Singleton _ - 1000-48-1-20 Bridgehampton National Bank 1000-48-1-21 Christopher P. Wachtel&Marianne W. Wachtel 1000-48-1-22 635 Wiggins St, LLC I 1000-48-1-25 Nicholas Gallery 1000-48-1-26 Erin L. Young 1000-48-1-27 Bruce Berger&Irina Marticovich 1000-48-1-29.1 Donald M. Lucas &Faye L. Lucas 1000-48-1-30 Dylan Croke&Morgan P. Croke 1000-48-1-31 Morgan P. Croke 1000-48-1-32 Tonia Wachtel &Donald E. Wachtel 1000-48 _ . .. .___- , _, .___..._...... _. 1-33 ' Peter Pirillo I Private Residence 1000-48-1-34Robert N. Harvey, Paula Harvey 1000-48-1-35 Jill A. Murphy ' Private Residence 1000-48-1-36 Kristian Iglesias : 1000-48-1-37 Ural Tal,„.at Private Residence ; 1000-48-1-38 Michael Greene Private Residence 1000-48-1-39 Jennifer Kennedy, James W. Kenned . Private Residence 1000-48-1-40 ' Michael Greene ' Private Residence 1000-48-1-41 i Rosemai G. Maceiras i Private Residence I 100048-1-42 Richard A. Fiedler& Judith Li>ht Private Residence 1 1000-48-1-43 Joan L. Dinizio&Robert J. IIeaney Private Residence 1000-48-1-44.2 Eugene A. Mazzaferro & Mary P. Mazzaferro _1000-48-1-47.1 ! Lillian Vishno 1000-48-2-6 Yira Tejada — 1000-48-2-7 _ Yira Tejada 1000-48-2-9.1 Timothy Clark ., 1000-48-2-10 I Peter m. Clark Private Residence i U0_00-48-2-11 ; Peter Manwaring Private Residence 11000-48-2-12.1 I Wayde T. Manwarin Julia Manwarin Private Residence =_ =. s -� . v ...�-_ ..-.. _ _ ..- _ _ 1000-48-2-1 5 7 Joseph Angevine Private Residence I 1000-48-2-15 8 f Dawn Zurek , Private Residence 1000-48-2-16 Vanessa D. Minis 1000-48-2-17 J — — Frances H Minis --- — -- ------ -- ____ 1000-48-2-18 ___ — 560 Flint Street, LLC — — 1 1000-48-2-19 _______� `Ian McCu_ Ilei--_ _ -- -�1 --- ----------------- 1000-48-2-20 Alyssa Ashley Prior i - -- - ---- - --------------------- --- -- ----- —------ --- r 1000-48-2-23Gloria Murrain _ RECEIVED a 1000-48-2-24 David A. King&Deborah A. King 1000-48-2-25 Joshua Alton Whitecavage, et al APR 8 2016_ 7 1000-48-2-26 Robert VanBtunt 1000-48-2-27 _ Monique Reed &Violet A. Reed - rt 1fie1c l rrCterk 1000-48-2-36.1 _ 305 Linnet St., LLC -- 1000-48-2-37 Seledonio Villareal _ 1000-48-2-38 Mercedes Alvarez&Enrique Alvarez 1000-48-2-39 County of Suffolk 1000-48-2-41_ Jackson A. Taylor 1000-48-2-42 Daisy N. Crenshaw 1000-48-2-44.2 _Subject Parcel t 1000-48-2-44.3 , Lewis Family Pro•erties Partnership LTD ' Commercial I_ Lewis Marine Su .ly I 1001-6-1-1 _ St. Agnes Church 1001-6-1-5.3 St. Agnes Church 1001-6-3-1 James Concannon Jr. & Wendy Concannon 1001-6-3-2 I Marek Matlak Private Residence 1001-6-3-3 ' Maureen Caoue_tte Private Residence111111111111111111.11111111 1001-6-3-4 Debra Riva Private ResidenceIIIIIIIIIIIIIIIIIIIIIII 1001-6-3-S , Enri.ue Alvarez Private Residence ; /001-6-3-6 1 Brett D Stephenson � Private Residence ; � 1001-6-3-7 ' Enrique Alvarez Private Residence I 1001-6-3-8 -Teresa Schiavoni 1001-6-3-9 Mary Wade 1001-6-3-10 Mercedes Alvarez 1001-6-3-11 Nicholas Ridolfi &Maria Ridolfi 1001-6-3-12 Realty 3 515,LLc 1001-6-3-14 Michael Bandow 1001-6-3-15 Elgio Lopez 1001-6-3-16 Andrew Galasso &Bernard Miny 1001-6-3-17 Linda Oliver 1001-6-3-18 _ Paul Kamaiko 1001-6-5-1 __ David Tonsmeire _ 1001-6-5-2 _ James Kalin 1001-6-5-3 1 Lisa Feuerherm _ 1001-6-5-4 _ Chris McManus & Baju Wijono 1001-6-5-5 Robert W Laub 1001-6-5-6 _ Carlos DeJesus _ ___ 1001-6-5-7 John Dinizio Jr. &Patricia A. Dinizio 1001-6-5-8 Ta ie of Gree221 Public Works ( Road De�rxr.tmmmeyit 1001-6-5-9 - -- GJC Partnership _---_ 1001-6-5-10 Mercedes Alvarez 1001-6-5-11Alvarez DeJ esus _1001-6-5-12 —�__ Charles Harvim— - _---- _ _ _ _ _ 1001-6-5-13 Anthony -- __ Antongeorgi, Steven Sweeney, et al - ---_ -- _ _-_— 1001-6-5-14 - Margaret M. Campbell & MaryEllen Campbell -- __ 1001-6-5-15 _-_ David Tonyes - . ______ _ _____ 1001-6-5-17.2 Commerce Bank, NA 1(1(11-A-C-I'7 1 \/i l l n rrr, n{'e(11•nr'ti1ir t•t • 1001-6-5-18 Robert E. Chute -- 1001-6-5-19 Jeffrey P. Clark & Laura L. Clark 1001-6-5-20 Lorraine Petrigliano 1001-6-5-.21 GJC Leasing Corp. _ 1001-6-7-1 Frank Lyburt Jr. 1001-6-7-2 Christina Kempner —� 1001-6-7-3 Barbara Strokoff INote; Parcels in highlighted rows are within 200' of the subject property boundary RECEIVED APR 8 2016 Southold Town Clerk OFFICE LOCATION: � MAILING ADDRESS: Town Hall Annex jy P.O.Box 1179 54375 State Route 25Q ° j Southold, NY 11971 ter.. car.Main Rd. &Youngs Ave.) a }('y, '"T - Southold,NY 413 •7( Telephone: 631 765-1938 ' 7; www.southoldtownny.gov 14/ +v r PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Elizabeth Neville, Town Clerk cc: William Duffy, Town Attorney From: Heather Lanza, Planning Director Date: March 21, 2016 Re: ADF Ventures Change of Zone Application SCTM#1000-48-2-44.2 Thank you for the opportunity to review this application for a Change of Zone for completeness. The application is nearly complete, however, a crucial element is missing from the plan. The surrounding zoning districts are not shown, nor is the proposed new zone shown on the plan. The zoning district boundaries and the proposed new zoning district boundary must be shown on the 500' Radius Area Map. This map incorrectly states that the sqbject parcel is surrounded by residential zoning. The parcel adjacent is in the Light Industrial Zone. Also, the map must have a notation that states which zoning district, specifically, is being proposed. Currently, the application illustrates the applicant's request to be able to build a house on the subject parcel, but doesn't specify what new zoning district they are requesting to achieve that goal. If the Town Board does eventually approve this zone change, a legal description of the newly zoned area will need to be provided (this is the metes and bounds description of the proposed amendment item on the checklist). „ ,„, ”'�- MAILING ADDRESS: PLANNING BOARD MEMBERS rrr BOE SO(/j�,' P.O. Box 1179 rr - O Southold,NY 11971 DONALD J.WILCENSKI r ,® �, l® Chair z x .: ', g , OFFICE LOCATION: WILLIAM J.CREMERS rt' Town Hall Annex PIERCE RAFFERTY ® fit *'��rl 54375 State Route 25 JAMES H.RICH III (fir rr� (cor. Main Rd. &Youngs Ave.) MARTIN H.SIDOR : C®UNTV,�rr�rr Southold, NY ,,S... •iii Telephone: 631 765-1938 www.southoldtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD fi l MEMORANDUM To: Leslie Weisman, ZBA Chairperson Members of the Zoning Board of Appeals From: James H. Rich III, Vice Chairman Members of the Planning Board dP4' Date: March 24, 2015 October 27, 2015 AMENDED Re: Request for Comments for ADF Ventures/Fragola SCTM#1000-48.-2-44.2 ZBA# 6850 At the request of the Zoning Board of Appeals, the Planning Board has re-reviewed the proposal to construct a commercial building for an electrical contractor's yard on SCTM 1000-48.-2-44.2 in Greenport. To the north(across Corwin Street) and to the east the properties are improved with single family residences and zoned Residential 40 (R-40 and R-2 (Village of Greenport Zoning)). To the south is the Long Island Railroad, then single family residences in the R-40 zoning district. To the west the parcel is improved and zoned Light Industrial. The lot is located within a small area of Light Industrial (LI) zoning embedded within a residential neighborhood. The industrial zoning of the lot can be attributed to its proximity to the Long Island Railroad and historical need to have access to this transportation mode. Prior to the LI zoning, the property was zoned C-Light Industrial Zoning and prior to that, residential use. The subject lot was created as a residential use per Town Laserfiche records "Map Showing Properties of the Greenport Milling Co. at Greenport,New York” dated October 19, 1918, prepared by Halsey and Van Tuyl (Figure 1). The lot is comprised of Lots 50 and 51 in the subdivision(red circle). Southold Town Planning Board Page 2 October 27, 2015 �.�... �,/ ,�-n .f 0 .n s o J 0 n .I i' �J;; / • c Vvi, J... _ tr� z 1 �Jo �Hy / t � y3 9rtlt ' .. , /ft i 'dam ''� 7 S60N6 310. 1-0'. 60 ' y $ 50 . • i+ 0 19:4" ro CO' i,4, ' s-1 /13" S0 0-11 5 0 SA r' S' 5-0 6-0 y wl t rF * Al \ AA 7.� 11, Hb `ys 1-e4.---m-----It n i - tD 5E. ;,;,r e Sa TO TO l u p :bx s :l` i ,J cmc. "-4-.. ",4;,5 Lr-r-- �.�S.F'�.,' '1 '�-�s��i•,�:.,$fr-.�'3 7�yt Ae sr,-.-'.:- 4;,,r,. 47 �r /tot' /} - , 'rl�' .--,•'.xaal� 4 -2-...!:, )'- 44.,,,.,1;:',?; 4,,. ,L.T' �•,:f:.. ' ' - 'n • -``..' / /�✓T' ',G• i { I �'•�F,.j' ' .�:�xt' 7•fi k .:f_r '� ::�.�.-++°•s-ity a.i~� :bv�'�� �~ ,`y' .`'�•: `_�~`f"1 Gl' .�i'it-� `S"- :m ,:-..,4-,,,.:y.. �}r.:wl, .•i. '<7,: i s (�. ��-..: �.y..;2.r_i',`7i•4:.',_-,r_fAll.' {,�t 7 _-'r-'1,-..,< :17-.,.:: ... Y^ l !+� -c_+."' K �i�✓•S!-' 1 Y-'i:'•�h nn• }�`'"1��'µ.lit••i '„Z'?�'L ✓ `:� - b.`-.r+f,..:.- - •.`)R j• r i �v. a_ t� xiwy:�ae°` tnaftMBr� �=.. /v.. ' , ;t••, r } S Yi> ,.c4� x i Figure 1. "Map Showing Properties of the Greenport Milling Co. at Greenport,New York" dated October 19, 1918 There is no indication at the time of lot creation that it was intended to support an industrial use. The zoning history in Town records shown below indicates that zoning of the parcel changed from residential to C-light Industrial in 1988: Map Zoning/Use 1. 1956 Suffolk County Approved Building Zone Map Residential 2. 1957 Zoning Map Residential 3. 1971 Zoning Map Residential 4. 1988 Zoning Map C-Light Industrial 5. 1989 Zoning Map LI-Light Industrial 6. 1994 Zoning Map LI-Light Industrial The basis of the change is unknown. The transition from residential use to C-Light Industrial, then LI did not seem justified due to the parcel size which cannot support the LI zoning district purpose or the setbacks needed to accommodate light industrial uses. The purpose of the LI district substantiates this observation stating: The purpose of the Light Industrial(LI) District is to provide an opportunity for business and industrial uses on smaller lots than would be appropriate for the LIO Light Industrial Park/Planned Office Park District. 500' RADIUS AREA MAP Ea�FMERD,4ARENOTGUAAN CERTIFIED TO:ADF VENTURES,LLC UNLESS P4F`RECORUlD EN EF,FMENT ADARE NOT GUARANTEED EO FOR UNLESS EH rR CALLY EVIDENT A7 THE DUE OFSURVEY ADF VENTURES LLC ARE O4SETENDED1 GUIDE THONN PROPERTYPROR UN R VEN DOR A SPECIFIC PURPOSE AND USE AND UIDETH S ARE ERECTION OFFENCES RETAI mE PROPS T ITU A T AREAS ADDIoNS7D RETAINING R y S A waus POOLS_,PAT/CA PLANTING GREENPOR AREAS aDwNsro9ur�N<;s 4ND ANY OTHER CONS*PLAN ON UNAUTHORGED ALTERATION OR ADDITION TT)THIS RURVFYISAVIOLATION OF JOB NO.:2014-214 EDUCATION DrN LqW OF mE NEW rorrc STATE TOWN OF SOUTHOLD COPIESO MIS MAP NO.: 548 COSIES OF MIS SURVEY MAP NOT BEARING SUFFOLK COUNTY, NEW YORK AL OR EMGOSEDDEALSHAL HOTS cONC FILED:DECEMBER 23, 1930 EHE LAND SURVEYORS S CONSIDERED ro BE AVAUD nTLECOEY S.C.T.M. DIST.: 1000 SEC,:48 BLK. 02 LOT 44.2 CERTIFICA710NSINDICATEDHERONSHALLRUN REVISIONS: — ONLY 7O mE EERDONSI RJR WHOM mE SURVEY ISPREPARED ANDONH:SBEHALF TOTHE EILECOMOANY GOVERNMENTALAGENCYAND fENWNG M5RNT10N US iFD HEREON,ANO REV.500'RADIUS MAP, ADD ZONING 10 mE4SSIGNEES OF mELENWNO INSn- - � ., 50 25 0 50 100 150 200 250 300 350 400 450 >%ONDERnF�aT�NRARENDT7RANRFERABLE DISTRICTS 3/29/16 ro aDanouaL lNsnTUTroNs oR suBSEevENr i SCALE: 1"= 100' DATE:DECEMBER 23, 2015 OWNERS REV. PER TOWN COMMENTS 4/6/16 ; SEE SEPERATE TABLE FOR PROPERTY OWNERS OF PARCELS I I :;:7 '. WITHIN 500'OF SUBJECT SITE. RECEIVED ' . l ` �~ ///60 7/77- CURRENT OWNER OF RECORD: ADF VENTURES,LLC APR 8 � a r f . FREDERICK FRAGOLA : , 138 OREGON AVE. N., :' .���, -VP - MEDFORD N.Y. 11763 Southold Town Clerk - LICENSE NO.: 050363 • • HANDS ON SURVEYING 26 SILVER BROOK DRIVE M FLANDERS, NEW YORK .��" , SUBJECT PROPERTY IS CURRENTLY ZONED LIGHT INDUSTRIAL (LI) TEL (631)-369-83129 FAX(631)-369-8313 101 WITH THE SURROUNDING AREA ZONED R-40 • MARTIN D. HAND LS • COPIES OF THIS SURVEY MAP,EITHER PAPER OR ELECTRONIC,NOT BEARING SUBJECT PARCEL REQUESTED TO BE REZONED AS R-40 THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID COPY AND SHALL NOT BE USED FOR ANY PURPOSE. ANSIONNII REC Kf_ Oil° STfig° OUTS 25 STATE R gOA0 p # , MO 9 4a 4a O0 �' —a 5!)1 IIIIIIIIII w II lili to ' 48-1.16 �_ zo s, \\ cf) 0 48.1.11 - � 6-3-12 / o 6-3-11 N CD Up • E ET ':' m Jp 6-3-1 6-3-10 \ 6-3-14 WIGGS N -1-36 0 �, \ �" °' C� \ 6-3-15 01 III WI 48-1-18 / w o 6-3� ''� o / o �' 48-1-37 0 ,1 0 6-3-8 o, O0XI = \ 6-3-16 m co 1 J 1 W -i _1. W W ..i rn 6.3 '="' o w so -a 6-3-3 m 6-3-7 \ 6-3-18 Ti / , "' m 111D 48-1-38 1 ......16-3-17 co Ci'' 15 ...4. \I ......1 0 XEr—: \ 1 ____ CT 0�,5 rn 6-3-4 6-3-6 HE)) ,, Mp, 48-1-41 48-1-40 0 '48-1-21 m /ry ' .. m w 0 , 6-3-5 1 \ I 0 j7 I484 4 7.1 'V 1._,,. �• SITE I 6-5-9 �' .8 48.2-44.2 f oN j� `` a,:.. 0 6-5-8 6-5-10 6-5-20 I riI I 3 I" Y 0 0 4 / 6-5-19 48-2.44 • Y 6-5-11 Li ► A 48-2.15.8 6-5-12 / 6-5-18 48,2.12.1 48-2-15.7 / GISI°. 48-2.11 0 Loc4 (I6-5-6 6-5-13 9)111111 48-2.g.1 .8-2.1 5" / 6-5-17.2 8.2-1 1►= _....-- 6-5-15 \ 4g.2-6 6-5-14 / \ LINT STREE 6-5-5 48218 o 065-4FLINSTr ininimmill Ls Oo N N III N N iNv N na N � 48-2-19 � Z,' ,: w 6-5-3 ,� 48-2-40 6-5-2 / mill11.11 I) Co 1 1 PI 111111111 •co N ••••.. ~ w o N Ti N 2:6-1 I �IiIo�IV CO N CA 111 l'1 O vn ` �_ ' i�''�' / s 11111111 1111.1111CDLINNETSTREt —hl MIIIII"li1 — W 1111111111111 IP ' Olt a - rm a 0 Lig. MI6 6A,NSTREE 1 BROW fig OFFOLAr I"N ELIZABETH A.NEVILLE,MMC y® Gy Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 � H Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ; * * * RECEIPT * * * Date: 01/22/16 Receipt#: 198952 Quantity Transactions Reference Subtotal 1 Petition 48-02-44.2 $1,000.00 Total Paid: $1,000 00 Notes: Payment Type Amount Paid By CK#1794 $1,000.00 ADF, Ventures Llc Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: ADF, Ventures Llc 138 Oregon Avenue Medford, NY 11763 Clerk ID: BONNIED Internal ID 48-02-44 2 irk MORTON BUILDINGS, INC. www.mortonbuildings.com `® Cox Lane Industrial Park•22355 County Rd.48, Unit 4 Office:631/734-4060 Cutchogue, New York 11935-1159 Fax: 631/734-4061 To: 1-21-16 Southold Town Board FR: Bill Kelly, RECEIVED Owners Authorized Agent Ref: JAN 2O ADF Ventures SCTM#1000-48-2-44.2 fOff 620 Corwin St, Greenport, NY South own (Jeri To the Members of the Board, ADF Ventures, LLC had recently filed applications with Town of Southold Building Dept.,Town of Southold Planning Board and Town of Southold ZBA,to construct an electrical contractors shop/ warehouse at the above referenced property. Please note the property is zoned LI (Light Industrial) Which is the proper zoning for such a use. As we proceeded through the permitting process there was opposition from the neighbors against allowing such a use to be permitted in this predominantly residential neighborhood. During the process many of the opposed neighbors stressed that this property was incorrectly zoned for the area and should be zoned residential in order to conform to the rest of the properties in the area.After careful consideration and not wanting to move into a friendly neighborhood that was angered by the proposed use of the property,ADF Ventures, LLC elected to with draw their application to construct an electrical contractors shop/warehouse. At this time ADF Ventures, LLC Formally request a zone change from the current LI Zone to that of the neighborhood R-40.Although a non-conforming lot for the zone this lot conforms to the other preexisting lots in this area that are in the R-40 zone. It should be noted and is evident on the area map that all the residential lots within a 500' radius are of similar size and configuration.As part of our application we have provided the required area map, metes and bounds survey per deed description and a survey prepared for the Suffolk County Health Department showing the location of a proposed single family dwelling with sanitary system that conforms to other residences in the area. Respectfully William Kell 41111 Authorized Agent Excellence—Since 1903 OP_ L '4 , - •, '�*pFS00/2,- , ELIZABETH A.NEVILLE 0 �4 of Town Hall, 53095 Main Road TOWN CLERK �t� _ : P.O. Box 1179 REGISTRAR OF VITAL STATISTICS E Southold, New York 11971 MARRIAGE OFFICER G ' 4 ,1� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER . a� 1) Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER 1� southoldtown.northfork.net �y�4UM`I,�;,��' 1 ... I OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD . _ _- RECEIVED REQUEST FOR AMENDMENT AND/OR CHANGE OF ZONE JAN 2 iii ., Southoli : Clerh APPLICATION NAME: ADF u us L_LC- (Name under which application shall be known)" SUFFOLK COUNTY TAX MAP NO.: 1000 - 'i$ . - (7z. -_ 44 . Z 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) 7 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. V3. 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 i and extending within five hundred (500) feet of all boundaries of the property to be amended. 4. Metes and bounds description of thep Pro osed amendment. 10/1/2008 1 V 5. 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: 621E_ liAki LEr e einr- kuk-C B. GENERAL INFORMATION: 1. Name Of Applicant(s): Address: r3 c ?p4i P4L 1\4, D IMLs Telephone No. „31-3)Z--- 11 1 , 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: f)(A Title: jAG Mk rriz, Address:(if different) 1111/44,_, Telephone No.: ,5/Ad ( 3. Landowner(s): SAN.At. Title: t Address: 5ALktE_ Telephone No.: LLQ, 4. Name of licensed architect, landscape architect, civil engineer and/or surveyor who prepared the plan: Name:_ &10 Title: Name of Firm: gAtz6, f )aV�i-ft4J Address: 2.4 SV_V EtZ Beocie. X0 SUC1_ Ind I Telephone No.: %,9- 8312 5. Name of Attorney, or Agent authorized to represent the property owner and/or applicant: Name: Title: t.n Name of Firm: N GiO 't--L- .5, . Address: Ci( LAA ( 1E1 i4 arZGMoncUIL 14L1 {15js- Telephone No.: c,31-Zs5 -q84 10/1/2008 2 6. All communications with regard to this application shall be addressed to the following person until further notice: Name: !tL( A k4LLL. _ Title: X � Address: Z23SS C47� Lel vil k 4 1 C-0-mtL4oGLt,ALE-1 1 MSS Telephone No.: 6.51,-z -rjg 4G.tc) r.ty i ltiAtyt. I lX1.1 a mort4,o"i 1ICii AssnLc>ry C. SITE/PROJECT DATA: 1. Location of Property .. 01.7-T1,-1 side corner of C ILLI (north/south/east/west) (street) feet 54'Y 5a.rn4 OF SEVi..krill �1 or road) (north/south/east/west) ofVEEJ-1 ST (nearest intersecting street) (hamlet) 2. Existing,zoning district(s) Special Overlay District(s), if applicable 3. Requested zoning district(s) 410 4. Lot area: 9.51-4 1 sq. ft or acres CJ.219 5. a. The latest deed(s) describing this parcel(s) is (are) recorded in the County Clerk's Office as follows: DATE LIBER PAGE Nc�c. 2c� nt.7 z?8 b. A copy of the(se) should be attached to the application. 6. There are no encumbrances or liens against this land other than mortgages? YES - )C NO 7. All buildings and structures are shown on the survey? X YES NO (The Town Board reserves the right to request a complete survey showing all existing structures.) 8. Existing: Building Area d sq. ft. Lot coverage Q 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 State Road? (circle one) Name and number of the road (i.e. County Road 48, State Road 25) 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 o' nliste. • ', c'r- le one) An environmenta • ssessment orm must be completed for Unlisted and Type I actions. 5. Has an Environ ental Assessment Form or Draft Environmental Impact Statement been prepared? YES NO. If yes, copies should be submitted with the application. CCC E. I hereby depose and certify that all of the above statements of'a formati s. , and all statements And information contained in the supporting d i ments a i i rawings attached hereto are true and correct. . 1 'PLI f'S SII ATURE Sworn before me this day of'1�-C bei , 20/c. ai SLA ! . NOTARY PpLIC AMANDA JEAN LUKASCZYK NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 FR6293126 Qualified in Suffolk County Commission Expires Nov.25.2017 10/1/2008 4 F. OWNER'S ENDORSEMENT (To be signed if applicant is not the owner or if the owner is a corporation or partnership) State of New York County of Suffolk ALIL(F being duly sworn, deposes and says that he/she resides at OakeLod &kik V) e.,r '..u.' 1 (-7 in the County of S+ 14? and the State of i1/41L1 and that he/she is (the owner or the officer of the corporation or partnership which is the owner in fee (circle)) of the premises described in the foregoing application and that he/she has authorized L to make the foregoing application for amendment and/or chv Of zone as Acribed here in. ,12211 ''firt,L Cd 41 171> NAS RE If a corporation, name of corporation and Officer's title Sworn before me this a Day of iCeinhec20 1� Ounzu(g/&*,61-tipal./4NOTARUBL AMANDA JEAN Lt1KASC7YK i E NOTARY PUBLIC,S m OI.NEW YORK Registration No.0I PR6293126 Qualified in Sul7olk County Commission Expires Nov.25.2017 10/1/2008 5 J G. DISCLOSURE AFFIDAVIT State of New York County of Suffolk Ab V Tca► 'S 21—L.C._ -Fo: , o being by me duly sworn, deposes and says: Vida. ciL /1,& 1. I am an applic t for a project or an owner of the 1 nd 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: ADF V eu'ce.- 3. I reside at 4 Cetaxi M, I 4. The Officers of the applicant corporation or owner corporation are as follows: NAME TITLE 5. I make and complete this affidavit under the penalty of perjury and swear to the truth herein. 6. I 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. 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 committees designated to accept donations behalf: Yes No 1. Owner 2. Applicant 3. Agent for owner or applicant 4. Attorney 5. Other )(, 10/1/2008 6 If the answer to Question 7 is yes, Town Code Chapter 26 require that the information be provided below: Name Title (Owner, Agent, Attorney, other) Amount ** ************************************************************************** For the purpose of this disclosure, an official or employee or either the Town of Southold or the County of Suffolk, shall be deemed to have an interest in the applicant and or owner when that official or employee, their spouse, brothers, sisters, parents, children, grand children or the spouse of any of them: a. Is the applicant or owner b. Is an officer, director, partner, or employee of the applicant or owner c. Legally or beneficially owns or controls stock of a corporate applicant or owner, or is a member of a partnership or association applicant or owner, or d. Is a party to an agreement with the applicant or owner, express or implied, whereby said official or employee may receive any payment or other benefit— whether or not for services rendered, dependent or contingent upon the favorable approval of such application. Ownership of less than five percent of the stock of a corporation whose stock is listed on the New York Stock or American Stock Exchanges shall not constitute an interest for the purposes of this disclosure ****************************************************************************** YOU MUST ANSWER THE FOLLOWING QUESTION YES OR NO Do any of the followin ind.viduals have an interest in the applicant or owner, as defined above? YES NO 1. Any official New York State YES NO 2. Any official or employee of Southold Town or Suffolk County? YES yNO If the answer above is yes, to any of the questions, General Municipal Law Section 809 requires that you disclose the name and residence and the nature and extent of the Interest of said individual (s) in the applicant or owner. NAME RESIDENCE NATURE OF INTEREST 10/1/2008 7 /1/r;ATU Sworn before me this c . Day of Pezeorther 20 t5 arm-Lrelft NOT Ay'l PU IC fAr AMANDA JEAN IAJKASCZYK NOTARY PUBLIC.STATE OF NEW YORK Registration No (III R6293126 Qualified in Sulliilk County Commission Expires Nov.25.2017 10/1/2008 8 ` l 6 ! S C T.M. OWNERS NAME 1 CURRENT USE LBUSINESS NAME_ 1000-48-1-9 Frederick E. Gagen "�_ 1000-48-1-10 Annette E.Ray 1000-48-1-11 James Richter RECEPLFD 1000-48-1-12 James Richter _ 1000-48-1-13 I Colin VanTuyl 1000-48-1-14 David Zellerford JAN 2 2 Mb _ 1000-48-1-15 Shawna MacNamara 46 1000-48-1-16 Holly A. Weingart& Sharon C. Bogden a")',' 1000-48-1-17 Peter F. Inzerillo, Cheryl R. Inzerillo 1000-48-1-18 ; John J. Kostal Jr. &Anne S. Kostal 1000-48-1-19 Ethel Singleton ` 1000-48-1-20 i Bridgehampton National Bank _ 1000-48-1-21 Christopher P.Wachtel&Marianne W. Wachtel 1000-48-1-22 635 Wiggins St,LLC 1000-48-1-25 Nicholas Gallery 1000-48-1-26 IErin L. Young 1000-48-1-27 Bruce Berger&Irina Martkovich _ 1000-48-1-29.1 , Donald M. Lucas&Faye L. Lucas 1000-48-1-30 Dylan Croke&Morgan P. Croke _ _ 1000-48-1-31 Morgan P. Croke _ 1000-48-1-32 ,Tonic Wachtel&Donald E.Wachtel 1000-48-1-33 ! Peter Pirillo , Private Residence 1000-48-1-34 ! Robert N.Harvey,Paula Harvey 1000-48-1-35 Jill A. Murphy Private Residence 1000-48-1-36 I Kristian Iglesias 1000-48-1-37 I Ural Talgat Private Residence 1000-48-1-38 j Michael Greene Private Residence 1000-48-1-39 !Jennifer Kennedy, James W. Kennedy Private Residence 1000-48-1-40 j Michael Greene Private Residence 1000-48-1-41 1 1 Rosemary G. Maceiras Private Residence ` 1000-48-1-42._ ___ ; Richard A. Fiedler&Judith Light Private Residence 1000-48-1-43 1 Joan L. Dinizio&Robert J. Heaney Private Residence ! 1000-48-1-44.2 Eugene A. Mazzaferro&Mary P. Mazzaferro 1000-48-1-47.1 Lillian Vishno 1000-48-2-6 Yira Tejada 1000-48-2-7 Yira Tejada 1000-48-2-9.1 Timothy Clark 1000-48-2-10 • " Peter m. Clark Private Residence 1000-48-2-11 Peter Manwaring Private Residence _ 1000-48-2-12.1 Wayde T. Manwaring, Julia Manwaring Private Residence 1000-48-2-15.7 Joseph Angevine Private Residence 1000-48-2-15.8 Dawn Zurek Private Residence _ 1000-48-2-16 Vanessa D. Mims 1000-48-2-17 Frances H. Mims _ 1000-48-2-18 560 Flint Street,LLC ' 1000-48-2-19 Ian McCulley ' 1000-48-2-20 Alyssa Ashley Prior ' 1 nnn.aa.,-�� 1 JAmeS I3rennvn 1 , • 1000-48-2-23 Gloria Murrain 1000-48-2-24 David A. Kin:&Deborah A. Kin: 1000-48-2-25 Joshua Alton Whitecavage, et al 1000-48-2-26 Robert VanBrunt 1000-48-2-27 Moni I ue Reed&Violet A. Reed 1000-48-2-36.1 305 Linnet St.,LLC 1000-48-2-37 Seledonio Villareal 1000-48-2-38 Mercedes Alvarez&Enri sue Alvarez 1000-48-2-39 County of Suffolk 1000-48-2-41 Jackson A. Taylor 1000-48-2-42 Daisy N. Crenshaw 1000-48-2-44.2 Subject Parcel 1000-48-2-44.3 Lewis Family Properties Partnership,LTD Commercial Lewis Marine Supply 1001-6-1-1 St. Agnes Church 1001-6-1-5.3 St. Agnes Church 1001-6-3-1 James Concannon Jr. &Wendy Concannon 1001-6-3-2 Marek Matlak Private Residence 1001-6-3-3 Maureen Caouette Private Residence 1001-6-3-4 Debra Riva Private Residence 1001-6-3-5 Enrique Alvarez Private Residence 1001-6-3-6 Brett D. Stephenson Private Residence 1001-6-3-7 Enrique Alvarez Private Residence 1001-6-3-8 Teresa Schiavoni 1001-6-3-9 Mary Wade 1001-6-3-10 Mercedes Alvarez 1001-6-3-11 Nicholas Ridolfi&Maria Ridolfi 1001-6-3-12 Realty 3 515,LLc 1001-6-3-14 Michael Bandow 1001-6-3-15 Elgio Lopez 1001-6-3-16 Andrew Galasso&Bernard Miny 1001-6-3-17 Linda Oliver 1001-6-3-18 Paul Kamaiko 1001-6-5-1 David Tonsmeire 1001-6-5-2 James Kahn 1001-6-5-3 Lisa Feuerherm 1001-6-5-4 Chris McManus&Baju Wijono 1001-6-5-5 Robert W. Laub 1001-6-5-6 Carlos DeJesus 1001-6-5-7 John Dinizio Jr. &Patricia A. Dinizio 1001-6-5-8 Village of Greenport Public Works Road Department 1001-6-5-9 GJC Partnership 1001-6-5-10 Mercedes Alvarez 1001-6-5-11 Alvarez DeJesus 1001-6-5-12 Charles Harvey i 1001-6-5-13 Anthony Antongeorgi, Steven Sweeney, et al 1001-6-5-14 Margaret M. Campbell &MaryEllen Campbell 1001-6-5-15 David Tonyes 1001-6-5-17.2 Commerce Bank,NA lnnl_F,_5_17 Z yin arip nf'ferpPnnnr$ ii • ,9 i 1001-6-5-18 Robert E. Chute 1001-6-5-19 Jeffrey P. Clark&Laura L. Clark — 1001-6-5-20 Lorraine Petrigliano _1001-6-5-21 GJC Leasing Corp. _ 1001-6-7-1 Frank Lyburt Jr. 1001-6-7-2 Christina Kempner _ 1001-6-7-3 Barbara Strokoff Note: Parcels in highlighted rows are within 200' of the subject property boundary RECEIVED • • JAN 222016 . ,.. . ., , , . ,,,,ir Southold Town "'erg t 11111111 III!11111 IIIII 11111 DIII 111111111111111111!liii . 1111111 IIIII 11111 IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 08/11/2014 Number of Pages: /S At: 11:54:22 AM Receipt Number : 14-0104882 TRANSFER TAX NUMBER: 14-00936 LIBER: D00012784 PAGE: 408 District: Section: Block: Lot: 1000 048.00 02.00 044.002 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $75,000.00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20.00 NO Handling $20.00 • NO COE $5.00 NO NYS SRCHG $15.00 NO EA-CTY $5.00 NO EA-STATE $250.00 NO ,- TP-584 $5.00 NO Notation $0.00 NO Cert.Copies $0.00 NO RPT $60.00 NO Transfer tax $0.00 NO Comm.Pres $0.00 NO Fees Paid $380.00 TRANSFER TAX NUMBER: 14-00936 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County • RECORDED 1 2 2014 Pug 11 11:54:22 P11 JUDITH A. PASCALE CLERK OF [� SUFFOLK COUNTY Number of pages r L DOOOI2724 • P 408 PT# 14-00936 This document will be public record.Please remove all Social Security Numbers prior to recording. • Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Page/Filing Fee cap �l Mortgage Amt. p.- 1.Basic Tax Handling 20. 00 2. Additional Tax P-5� S Sub Total Notation _ Spec./Asslt. — ED or EA-5217(County) ��3_ Sub Total Spec./Add. qq EA-5217(State) act)_ TOT.MTG.TAX `,;;, " Dual Town Dual County R.P.T.S.A. ___ .: i 1``• '�', Held for Appointment Comm.of Ed. 5. 00 144 :. Transfer Tax p cti ( SO) Affidavit ' ltipl J ` Mansion Tax i0,..' The property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00 33o family dwelling only. Sub Total YES or NO Other 2 Grand Total J0 If NO,see appropriate tax clause on page If of this In trrumen 4 4 Dist. 1 C 14.020153 1000 04800 0200 044002 0.? 5 Community Preservation Fund 9 Service RAcy pOL A II Real Property Consideration Amount$ I 000 Tax Verification 08-AUG-1 111111111111111111111111111 CPF Tax Due S -19— Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address / RECORD&RETURN TO: Vacant Land X V Larry R.Davis,Esq. TD /dao Davis&Prager,P.C. TD 175 Oak Street • Patchogue,NY 11772 TD Mail to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name Venture Title Agency,Inc. www.suffoikcountyny.gov/clerk Title ii VA-16103-S • 8 Suffolk County Recording & Endorsement Page This page forms part of the attached DEED made by: (SPECIFY TYPE OF INSTRUMENT) Linda M.Springer,as Executrix of the Last Will The premises herein Is situated In and Testament of Virginia 0.Jemick SUFFOLK COUNTY,NEW YORK. - TO In the TOWN of Southold ADF Ventures.LLC In the VILLAGE or HAMLET of 4 f'e-e•4pD(4-" BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) . • vA- - lbto- - -Oco1ov EXECUTOR'S DEED(INDIVIDUAL OR CORPORATION) ��QD1Q eUt STANDARD NYBTU FORM 8010 Vo..(c I 0 3 -5 0'611 '(‘-‘k CAUTION: THIS AGREEMENT SHOULD BE PREPARED BYTT R ANA O NEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORE SIGNING. • THIS INDENTURE, made the tV ' day of July, two thousand and fourteen, between Linda M. Springer, as Executrix of the Last Will and-Testament of Virginia 0. Jernick,deceased November 4, 2012, Suffolk County Surrogate's Court File No. 2013-660, Letters Testamentary issued March 15, 2013, residing at 2 Linda Court, Shelter Island, New York.1 1964 party of the first part,and ADF Ventures, LLC, 138 Oregon Avenue, Medford,New York 11763 party of the second part, WITNESSETH, that the party of the first part, by virtue of the power and authority given in and by said last will and testament, and/or by Article 11 of the Estates, Powers and Trusts Law,and in consideration of Seventy-Five Thousand Dollars($75,000.00), lawful money of the United States, paid by the party of the second part, does hereby grant and release unto the party of the second part, the distributees 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 Town of Southold, County of Suffolk and State of New York, bounded and described in"Schedule A"annexed hereto. Said premises also known as 620 Corwin Street, Greenport,New York (SCTM# 1000- 048.00-02.00-044.002). BEING AND INTENDED TO BE the same premises as described in by deed made by Alice Olsen Hulse dated 10/06/1967, recorded 11/30/1967 in Liber 6265 Page 278(PART OF PREMISES) and by Certificate of Abandonment filed 08/26/1981 in Certificate No. 2328, Abstract No. 9138. TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appurtenances, and also all the estate which the said decedent had at the time of decedent's death in said premises, and also the estate therein, which the party of the first part has or has power to convey or dispose of, whether individually, or by virtue of said will or otherwise, NYSBA PRACTICE FORMS 3/03 RET067.I I Schedule A Description Underwriter No. 618-03110 Title Number VA-16103-S Page 1 ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Village of Greenport, Town of Southold and State of New York, bounded and described as follows: - • BEGINNING at a point on the southerly side of Corwin Street distant 625.84 feet easterly from the corner formed by the intersection of the easterly side of Ninth Street with the southerly side of Corwin Street; RUNNING THENCE along the southerly side of Corwin Street, South 88 degrees 38 minutes 20 seconds East 174.13 feet to land now or formerly of Enrique Alvarez; RUNNING THENCE along said land South 7 degrees 17 minutes 40 seconds West 43.97 feet to land of the Long Island Rail Road; RUNNING THENCE along said land, South 84 degrees 11 minutes 40 seconds West 177.65 feet to land now or formerly of Lew Family Properties Partnership LTD.; RUNNING THENCE along said land North 7 degrees 09 minutes 00 seconds East 66. 24 to the southerly side of Corwin Street at the point or place of BEGINNING. Continued On Next Page • 4 Schedule A Description- continued Underwriter No. 618-03110 Title Number VA-16103-S Page 2 SCHEDULE OF COVENANTS AND RESTRICTIONS NO COVENANTS AND RESTRICTIONS OF RECORD .. 'P r iff fY 1 � r' r • 7 Y t� 3.• TO HAVE AND TO HOLD the premises herein granted unto the party of the second . part, the heirs or successors and assigns of the party of the 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 the said premises have been encumbered 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 costs 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 "parties" 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 OF: • r.141- 2iithlyA) Lin a M. Springer, as Eke rix Acknowledgment by a Person Within New York State(RPL §309-a) STATE OF NEW YORK ) ) ss.: COUNTY OF SUFFOLK ) On the aryday of July in the year 2014 before me, the undersigned, personally appeared Linda M. Springer, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity,and that by her signature on the instrument, the individual, or the person upon behalf of which the individual'acted,executed the instrument. QQ Qt (0?.11eL (signfture and office of individual taking acknowledgment) SUSAN LA CONTI Notary Public,State of New Yak No.011.A6105518 Ouafffled M Nassau County RET067.I I Commission Expires Feb.09,2016 NYSBA PRACTICE FORMS 3/03 2 r . . . ._ . . , . . , . . .. . . SURVEY OF , _ LOCKING CAST IRON COVER TO GRADE DESCRIBED PROPERTY 1/4%FTPITCHMIN / 1PrrCH1NG RADF S{jia'ijiATPROP FF 15 5' % 1P-17(2' 2')/a MAX SLOPE 21�) REPRT or .�o `� ;--= -..-----6`. c (2 TOWN OF SOUTHOLD INV 11.9' / S T 'X 6'DEEF ( DEPTH INV 11.7' INV 11.2' LP.'S - SUFFOLK COUNTY,NEW YORK INV 10.9 3'MIN S.C.T.M. DIST.: 1000 SEC.:48 BLK.:02 LOT::44.2 -- - ---- --- - - - — - --- -- . - - - -- ---- -- 15 '8 0 15 30 45 60 75 90 105 120 135 GROUNDWATER SCALE: 1"=30' DATE:JUNE 25, 2014 PROPOSED SANITARY CROSS SECTION PARCEL ALSO KNOW AS PART OF SEVENTH STREET& - LOTS 50&51 ON A MAP ENTITLED"PLAN OF THE S. BUEL CORWIN ESTATE" FILED IN THE OFFICE OF CLERK OF THE COUNTY OF SUFFOLK ON DECEMBER 23, 1930 I• AS MAP NO.:548144 METES AND BOUNDS DESCRIPTION PER DEED LIBER 6265 PAGE 278 AS RECORDED NOV.20,1967 S.C.D.H.S.ENDORSEMENTS LOT AREA:9,541 SQ.FT. =0.219 ACRE S ELEVATIONS HEREON REFER TO NAVD 1988- ��C�6��� - NO SURFACE WATER EVIDENT WITHIN 300' - CO ALL PROPER/ES WITHIN 150'ARE IMPROVED - - _ AND SERVICED BY PUBLIC WATER S JAN 2 2 Zai ` ! ltti .Southold Towr . 111 lid IMPROVED f IMP ROVED � I IMPROVED _. I - -- - W ;67477FIEDM:114DFVENTUFEENTURE (I1 # nOVERHEADV�IRESnnnUT111TYP0lE U7IDTYPOLE4-4 TITLE AGENCY, INC. / i LI - f; I 1 EXISTINGWAI R•MAIN NSiR�E7 • • ---- • • • • � Com , CUR SIZ G LOCATION TO BE DETERMINED BY OTHERS ` WL " t. • STREN EP tao' \ : Q. JOB NO.:2014-214 J EDGEOFPAVEMENT EP127' — — EP14fi,\ ; 0 MAP NO.:548 o W < W� / FILED:DECEMBER 23, 1930 o , W I W W REVISIONS: .� a� muTYPOLE ASPHALT o'wa S 88°38'20"E 17123' - ADD ROAD ABANDONMENT 4/03/15 625.84' �' 25.1• -. : a 12, 25 , , —1—"------ - ` - - \ O PREP FOR SCDHS APPLIC. 12/23/15 ,� !i o,o, I^ 149.001 � _ CO ••, `� - O� 41 • /11.4 Tv I c \ 150' "� Cr 1.14 �� NO f �� O 0? \ 7 - / __�� ~ ti 1 W ITEST HOLE rWn¢ W ',I 1 ., Al1l $�,' / PROVIDE R¢ o: X 6'DEELP:3tlac PROPOS \ agoFOR50iEI ! 36' \ EXPANSIOP ! I LLON S T`r ° °,4 / l: W w y— \ l (67AX4BEDROOMS) / \ w !r QZ y -p l-1 z 1,908 SQ.FT. / \w �] N- I (y gj Q IQ .t 4 BEDROOM I ,! 4 OLl g 1 DWELLING / 1-�.i` i / cli COLU I ll! 0 . l FF:•15.5'+/- / ,•. , to.---' /- O /� to =Q Z I'I ° 0;a ' I / /f0 i �=r:_i ti / LOT 51 EL138' Co TEST HOLE DATA Z Cq Tc 1 ' O: oD 1 4 h� 1c // I O 5" --- MILL �� I 7// o CONC. EMMETTANDER SUBSURFACE LICENSENO.: EL 12 0' O a Q o e o 5'M1N 152.01 ___s® STRUCTURES RECORDED OR • • srcn�l�AM W 1 25.65 12 rye' // 177.66 ) TINE rGGRAH,EE° IP o UNLESSFHYS'GLLYEVIDENTAT THE sM MDN S 84°11'40iTH:BEim _--- iNEDFSUgVEY� HANDS ®N_SURVEYING 3 7' I 25.65' E. _ _� _ _____ PURDFFSETOR EN 12�' s HEDA fRDNTHESA UDTO iME AR E NOT SANDY SILTAS• I. e'E mOPERTYLINESMEFORASPECIFIC vl TOPURPOSE AND USE DGN �26 SILVER BROOK DRIVE N (SMJ 84' — RAIL �� AREAS ADDnoruro ERLD"TiON OF FECES,�uN�S® wAus,Pori,vanes,FwmNoSECTION 7209 OF THE NEW YORK STATE FLANDERS, NEW YORK COARSE SAND tt ' MAUTHO ANY IZED ALHsmuCTION ONORw� ¢ W/GRAVEL ® ISL• romuSURVEYISAvrouTIONOF f uNAunrowtED utERAnonOR AcaRaN T - - 11901 _ /1- RA11TEL03' LO T.A. --___--����-----� EDUCATIONIAW RYEYMMnoreEAwND EL:(631) 369 8312-FAX.•(631)-369 8313 EMBGSSED BEALSHALLNVTBECDNSDEREO • MARTIN D. HAM L.S WATER IN H.E G.W 2 0' E E SSEDSEALSHALINOT Eco SI �s� TO BEA VALID TITLE COPY. COARSE SAND CERTIFICATIONS NERDNSHPLLRUN 3 I ����������� RAIUiOAD TRACK LSPAEPAAEDAND DICAT E iIERON mE COPIES OF THIS SURVEY MAP,EITHER PAPER OR ELECTRONIC NOT BEARING IN/GRAVEL -18 0' RILEGOA/Rua GOVERNMEyTALAGw°YAND OmY ro rHEPERsaN Fan xtlDne mesuRVEr I '---_-_-_-_- IMPROVED LErmnDlNsnTilnoNLlsrEDHEREON,AND TRANSFERABLE THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE TEST HOLE BORING BY TomEASSIONEESDPmEIENLUNGINsn- owila CERTIFICATIONS uExr CONSIDERED TO BE A VALID COPY AND SHALL NOT BE USED FOR ANY PURPOSE. SHAWN M.BARRON,M 7/6/14 SURVEY OF EASEAEENTASICALLYMOTAT STRULn/RES RECORD®OR METES AND BOUNDS DESCRIPTION PER DEED LIBER 6265 nu" "°T°GARANTEHA LIME OS PNYSICAILYENOENTATTNE DESCRIBED PROPERTY PAGE 278 AS RECORDED NOV.201967 HEREON SE ONSETM THESTRUCTU ED TO SITIATE I ' AREEON(MEWI GUIDE N ronE PROPELYLINES ARE FOR A SPECIFIC ARE OSEAND OED ODEELEE AREN07/Nn3E0EO TO GIAOE iXE ERECCONOPFENCES REVILIN° ENPORT AND WALL POOLS.CONK RANRNG AREAS AOOInONS ro B0N/NOS AND ANv ODOR corrsrnLcnoN TOWN OF SOUTHOLD �I SEAImg00NE ME NEW YORXSTATE ronussuRV t A gAT DF SECTION rmc of ME NEw roRN STATE ECLunON LAW COPIES OF PO SURVEY MAP NOT MARINO SUFFOLK COUNTY, NEW YORK THE IANC SURVEYORS INKED SEM.OR -- - rower S SEALS NOTBE CCNSL Rm S.C.TM. DIST.: 1000 SEC.:48 BLK:02 L07:44.2 ' LERnFILAnDNB INWCATID HFRON SNNLR9 IMI ONLYTOTEEPERSONDI FORWHOMTNESURVEI' - ® � ISFREPARED AND ONws BENAIF10 nIE MI TNLYZLEANr,GOVERNNENTALAGEN°YAN° 15 8 0 15 30 45 60 75 90 105 120 135 LOUSINGRS71nR ON MSIDNEREGq AN° ro nE AS90NEES OF THEWIDINGINSAI• TVnON CERnR°ADONSARENOr7RANSFERABIE SCALE 1"=30' DATE:JUNE 25, 2014 1OADCmUNALINSYMOVS ORLUOSEOUENT �I II OWNERS PARCEL ALSO KNOW AS PART OF SEVENTH STREET& , , � - LOTS 50&51 ON A MAP ENTITLED "PLAN OF THE S.BUEL CORWIN ESTATE" IIII FILED IN THE OFFICE OF CLERK OF THE COUNTY OF SUFFOLK ON DECEMBER 23, 1930 AS MAP NO.:548 �, 1 (� : li44441 1 1111.1.44.41. 4 'Jr �^ LOT AREA:9,541 SQ.FT. =0.219 ACRE n n UTILITYPOLE OVERHEAD IxIRES A A UTILITXPOLE0 r CERTIFIED TO:ADF VENTURES, LLC / < VENTURE TITLE AGENCY,INC. �t30 r COR WI N S TREET , • J EDGE OF PAVEMENT EP 12T —- — EP 14 6' g 0< \ (/ UTILTTYPOLE \ I JOB NO.:2014-214 fEP.4tro.w S 88°38'20"EMAP NO.: 174.13 _548 625.84' 25.1 ; EL.128'25.1 ' _ FILED:DECEMBER 23, 1930 149.00 ) t coEi REVISIONS: ll Ll CO I • cur 1 \ L160' k ak, . ADD ROAD ABANDONMENT 4/03/2015 ��9 LAND SUR 1:1:1 i \V '- ' kg, c) \v�r�`� .DONqZoy�Lo � n " om � � i��\ I \ \ 1 k Q I I \ ....,,,,,f/ 77,....../74;„., ./may/- ��a � � ~ lio _lath-�� \\ I / \ � � , ; 12 Q. cf. C/") ^^^ ��� I co g �Il I / 1 / o� vJ 3IZ I c 1 u, ,/ I / LOT 51 LOT 50 I / coNc ��,yT�O 0503���Q� Q 4Q\\ �/,/,LOT I 152.01' / _____._ SOF NES 6 \ / ..--..-S _ — s=— ----� S 84°11'40"W "Ir177.66' _ C— MON _ I 25.65' = E 12.0• 25•6J' 1 EgRTH BER.1; _ LICENSE NO.:050363 ASP e'E l — _• RgIL ROAD HANDS ON SURVEYING - LONG M.T.A., _ ___-- 26 SILVER BROOK DRIVE N FLANDERS, NEW YORK - + p ',_E ___________________R_AI—LROAD TTRACKS - 11901 --____ TEL:(631)-369-8312-FAX:(631)-369-8313 • MARTIN D. HAND L.S COPIES OF THIS SURVEY MAP,EITHER PAPER OR ELECTRONIC,NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEA VALID COPY AND SHALL NOT BE USED FOR ANY PURPOSE. 500' RADIUS AREA MAP EASEMENTANDRENOT`URFACE CERTIFIED TO:ADF VENTURES,LLC S7RUC7URES RECORDED OR UNRECORDEDARENOTGUARAN7EE0 RLCLl` ED TIME OF OUR HE ALLYEYIDENTATNE C TINEOF SVRVEY ADF VENTURES LLC "E aM R D sroE PROPERTY ONES ARE FORA SPECIFIC RIRPLLS E AND USE AND THEREFORE ERECTION FFENC S RETAINING PROP ITU AT 2016 IWDA/IVOIER CESRUCTIW JAN 2 2 WALLS,POOLS PA17O PLANTING AREAS ADOnIDNS ro eU1LDINGS F WILLS LWo RN G�� UNAUnpR0TED AL7ERAnONOR001770l P ;, 15AVIOLATION WYOR� JOB NO.:2014-214 EDU A77URVEYITHE NEWYORK STAlE TOWN OF SOUTHOLD WPIES-7HRJURVEYMVNO"EARMG MAP NO.: 548 THE LAND SUP VEYORS NLKED SCALDS SUFFOLK COUNTY, NEW YORK Southold Tow (ler IrEszonnYTBECONSIDERED FILED:DECEMBER 23, 1930 AND ON MIS SEHALU 7D7N S.C.T.M. DIST.: 1000 SEC.:48 BLK. 02 LOT 44.2 CERnRGTION5INSDDHEA77EOHERO" SRALLRUN REVISIONS: rum E� Y r TITLE COMPANY GOVERNMENFAL AGENCY AMS ""'• �"" 50 25 0 50 100 150 200 250 300 350 400 450 IEADDITINALINSI7TUn7EDHEREGN,AND roDING 1N1GNEESOF OTEEHEREON,AN j Y �•„7 =' 4i• '_ nm0N CERRFICA7IONSAHENOT7RANSFERAME /-'^""`�..,y•• SCALE: 1"= 100' DATE:DECEMBER 23, 2015 aro AUERDa�aruwsnTu rousoasuASEouEHr ;• ```_`,.C\.Z•n 7,,� • ,,, SEE SEPERATE TABLE FOR PROPERTY OWNERS OF PARCELS RI 's::,` •.WITHIN 500'OF SUBJECT SITE. _ il CURRENT OWNER OF RECORD: ADF VENTURES,LLC . .�,, , �J,,V.� �. �f FREDERICK FRAGOLA R --.� ,., ,j 138 OREGON AVE. r,„_.- ,'., MEDFORD N.Y. 11763 w � SUBJECT PROPERTY IS CURRENTLY ZONED LIGHT INDUSTRIAL(LI) WITH THE SURROUNDING AREA ZONED RESIDENTIAL. LICENSE NO.: 050363 • • HANDS ON SURVEYING 26 SILVER BROOK DRIVE N FLANDERS, NEW YORK •...4;1 E 11901 fr,W TEL: (631)-369-8312-FAX::(631)-369-8313 _ • MARTIN D. HAND L.S • COPIES OF THIS SURVEY MAP,EITHER PAPER OR ELECTRONIC,NOT BEARING i THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEA VALID COPY AND SHALL NOT BE USED FOR ANY PURPOSE. 5 1R5 f g..n10 SASE ROTE 2 5 MAROAD 11.11111111111 -- i 7, 7, - ' i ?7,- �' w Will 90 7.:.......) ...._ .0...7,1 ...... .........;1......—-....................... $ 07 e4 sizo ............. a. °° 0 li / 484 1111 // cr o • m lit 48-1.17 ! • 6-342 .i, / to p o 6-3-11 \ o+ / c 4 81-18 \ -► ioTREETm01 N Sx. 6-3-1 0, -/ -WIGGIS -1-36 \ '="(y c 6-3-9 Cl) o 1 6-3� 6-3-15 1"--' o El 4t. cc 48-= �`� 6-3-8 \ 6-3-16 rn 00 L. ca w ti .[1 � N ----- rn i 6-3-3 4=. r`4' o w T c° i M 6-3-7 \ 6-3-18 /L7 ! 9 - N rn 48-1-3 ..,,,,' 6-3-17 N CTl 1 6-3-4 Lrj] \ 6-3-6 IX .p ,QP 48-1-41 `.'1 48-1-40 rn 07. • IEZ1 1 /48.1-27 „, m w a =: ' i 6-3-5 1 L 1 • sTREEsiiT 0 6.5.21 48-1-47.1 I I6-5-9CORWIN • 48-2-44.2 1 I 6-5-8 / 6-5-10000° 6-5-20 t MfA 0 PQ / LI\ 6-5-19 . .44,3RO 6-5-11 l 48 2 PA- r ��V48.2.15.81 - 6-5-18 6-5-12 SL 48-2-12.1 0 48-2-153 1 48-2'1LONG 6-5-6 6-5-13 48-2.g,1 ,0.1 , • 6-5-17.2 48-2-7 _ - _ 6-5-15 48-2-6 6-5-14 T STREET 6-5-5 FLIN FL�N,�' STREET ,A, 48-2-18 0 6-5-4 t, OO N N li st \ '” w °D ro ro ..1 I rn 6-7-2/ \ N►:, ^' N " 48-2-19 1 w N 6-5-3 N 48-2-40 T 6-5-2 siiiiill , rn N /V /III \ co .0. / w CO �'� 6-5-1 ,,. Nrn m N , 0 ..titi Z rse ; MI" ti I. 111 U iip i 0 MIll LINNETSTTT \_ \ 1 .4, 1„, , . Z T ' ` T_ _ _ `r/ �.--• 617.20 Appendix A - JAN 2 2 2016 • State Environmental Quality Review FULL ENVIRONMENTAL ASSESSMENT FORM jp,/ Southold To ,clert Purpose: The full EAF is designed to help applicants and agencies determine, in an orderly manner, whether a project or action may be significant. The question of whether an action may be significant is not always easy to answer. Frequently, there are aspects of , a project that are subjective or unmeasurable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not be technically expert in environmental analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The full EAF is intended to provide a method whereby applicants and agencies can be assured that the determination process has been orderly, comprehensive in nature, yet flexible enough to allow introduction of information to fit a project or action. Full EAF Components: The full EAF is comprised of three parts Part 1: Provides objective data and information about a given project and its site. By identifying basic project data,it assists a reviewer in the analysis that takes place in Parts 2 and 3. Part 2: Focuses on identifying-the range of possible impacts that may occur from a project or action. It provides guidance as to whether an impact is likely to be considered small to moderate or whether it is a potentially-large impact. The form also identifies whether an impact can be mitigated or reduced Part 3: If any impact in Part 2 is identified as potentially-large, then Part 3 is used to evaluate whether or not the impact is actually important. THIS AREA FOR LEAD AGENCY USE ONLY DETERMINATION OF SIGNIFICANCE -- Type 1 and Unlisted Actions Identify the Portions of EAF completed for this project: ri Part 1 1"1Part 2 ®Part 3 Upon review of the information recorded on this EAF(Parts 1 and 2 and 3 if appropriate), and any other supporting information, and considering both the magnitude and importance of each impact, it is reasonably determined by the lead agency that: riA. The project will not result in any large and important impact(s) and, therefore, is one which will not have a significant impact on the environment, therefore a negative declaration will be prepared. riB. Although the project could have a significant effect on the environment, there will not be a significant effect for this Unlisted Action because the mitigation measures described in PART 3 have been required, therefore a CONDITIONED negative declaration will be prepared.* 1]C. The project may result in one or more large and important impacts that may have a significant impact on the environment, therefore a positive declaration will be prepared *A Conditioned Negative Declaration is only valid for Unlisted Actions Name of Action Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency — Signature of Preparer(If different from responsible officer) website Date Page 1 of 21 • PART 1--PROJECT INFORMATION Prepared by Project Sponsor NOTICE* This document is designed to assist in determining whether the action proposed may have a significant effect on the environment Please complete the entire form, Parts A through E Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review. Provide any additional information you believe will be needed to complete Parts 2 and 3 It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies, research or investigation If information requiring such additional work is unavailable,so indicate and specify each instance Name of Action i;e16)GL Location of Action(include Street Address, Municipality and County) Name of Applicant/Sponsor rff't�°-Cf[G ,C 0,�Alj7_ L,Le 6,t/ e / Address /3 j �� City/PO /*.edkState ►^� j Zip Code /1% 3 Business Telephone (p 3( — 65-1- Name s1 Name of Owner(if different) Address City/PO State Zip Code Business Telephone Description of Action /5017,0(.747.,,,,L7e fee,e/a.eni Page 2 of 21 Please Complete Each Question--Indicate N.A. if not applicable A. SITE DESCRIPTION Physical setting of overall project, both developed and undeveloped areas. 1. Present Land Use:ElUrban n Industrial Commercial ; Residential (suburban) El Rural (non-farm) riForest Li- Agriculture ;"Other 2. Total acreage of project area: -2.1-acres. APPROXIMATE ACREAGE PRESENTLY AFTER COMPLETION Meadow or Brushland (Non-agricultural) 4 - acres acres Forested 0-21''/acres D acres Agricultural (Includes orchards, cropland, pasture, etc.) Aft- acres acres Wetland (Freshwater or tidal as per Articles 24,25 of ECL) d IA' acres acres Water Surface Area /Jacres acres Unvegetated (Rock, earth or fill) 1/A acres acres Roads, buildings and other paved surfaces 0I4 acres acres 1,- - Other(Indicate type) acres acres 3. What is predominant soil type(s) on project site? a. Soil drainage: i <Well drained S® %of site Moderately well drained %of site. [1 Poorly drained %of site b. If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? 0 acres (see 1 NYCRR 370). 4. Are there bedrock outcroppings on project site? >>Yes �No a. What is depth to bedrock (in feet) /14/:(4- 5. Approximate percentage of proposed project site with slopes: 0-10/o /01) /o :10- 15% L,_,, 15%or greater 6. Is project substantially contiguous to,,or ntain a building, site, or district, listed on the State or National Registers of Historic Places? ri Yes No 7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? 11 Yes i No 8. What is the depth of the water table? -� (in feet) 9, Is site located over a primary, principal, or sole source aquifer? f Yes No 10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? } 1 Yes Lif<lo Page 3 of 21 11. Does project site contain any species of plant or animal life that is identified as threatened or endangered? ;Yes ko According to: i i Identify each species: p _ 3 J i i 12. Are there any unique or unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations? []Yes No , Describe: 5 13. Is the project site presently used by the community or neighborhood as an open space or recreation area? ri Yes E__No If yes, explain: „ 14. Does the present site include scenic views known to be important to the community? riYes No i 15. Streams within or contiguous to project area: a. Name of Stream and name of River to which it is tributary Y yy 16. Lakes, ponds, wetland areas within or contiguous to project area: s 3 i i R b. Size (in acres): 5 1 a Page 4 of 21 17 Is the site served by existing public utilities? -es T No a. If YES, does sufficient capacity exist to allow connection? I Yes -No b. If YES, will improvements be necessary to allow connection? a Yes 18. Is the site located in an agricultural illsct certified pursuant to Agriculture and Markets Law, Article 25-AA, Section 303 and 304? r Yes No 19. Is the site located in or substantially co iguous to a Critical Environmental Area designated pursuant to Article 8 of the ECL, and 6 NYCRR 617? ri Yes F—a'"o 20. Has the site ever been used for the disposal of solid or hazardous wastes? ri Yes r.✓'No B. Project Description 1. Physical dimensions and scale of project (fill in dimensions as appropriate). a. Total contiguous acreage owned or conttr�olled by project sponsor: e'-2-I I acres. b. Project acreage to be developed: 0"Z( / acres initially; 0-20 acres ultimately. c. Project acreage to remain undeveloped:J0 acres. d. Length of project, in miles: AId4 (if appropriate) e. If the project is an expansion, indicate percent of expansion proposed. Al/N f Number of off-street parking spaces existing 0 ; proposed 4- g. Maximum vehicular trips generated per hour: (upon completion of project)? h. If residential: Number and type of housing units- One Family Two Family Multiple Family Condominium Initially f11 - Ultimately 1 i. Dimensions (in feet) of largest proposed structure: height; 36 ( width; 53 length. z 7 j. Linear feet of frontage along a public thoroughfare project will occupy is? �L`f' 43 ft. 2. How much natural material (i.e. rock, earth, etc.)will be removed from the site? D tons/cubic yards. 3. Will disturbed areas be reclaimed IT. •Yes 1"'o il N/A a. If yes, for what intended purpose is the site being reclaimed? 1 I b. Will topsoil be stockpiled for reclamation? 'Ices n No c. Will upper subsoil be stockpiled for reclamation? 11 Yes No 4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? -_Z( acres. Page 5 of 21 5. Will any mature forest (over 100 years old) or other locally-important vegetation be removed by this project? -I Yes V 'No 6. If single phase project: Anticipated period of construction. months, (including demolition) 7. If multi-phased. ✓jamba. Total number of phases anticipated (number) 64/14- b. . Anticipated date of commencement phase 1: month _ year, (including demolition) I/A c. Approximate completion date of final phase month year. Ai/A- d. Is phase 1 functionally dependent on subsequent phases? Yes I No 4 nh o fu 1 « �.... A 8. Will blasting occur during construction? Yes "No 9. Number of jobs generated: during construction 0 ; after project is complete 10. Number of jobs eliminated by this project 0 . 11. Will project require relocation of any projects or facilities? ri Yes No If yes, explain: 1 12. Is surface liquid waste disposal involved? I Yes 19l< a. If yes, indicate type of waste (sewage, industrial, etc) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? `, Yes Type 14. Will surface area of an existing water body increase or decrease by proposal? ri Yes o If yes, explain: Y 2 15. Is project or any portion of project located in a 100 year flood plain? El Yes J , o 16. Will the project generate solid waste? riYes F '"1 No a. If yes, what is the amount per month? tons b. If yes, will an existing solid waste facility be used? 17 Yes No c. If yes, give name ; location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? ElYes t o Page 6of21 e If yes, explain• • 17. Will the project involve the disposal of solid waste? r'Yes No a. If yes, what is the anticipated rate of disposal? tons/month. b. If yes, what is the anticipated site life? years. 18. Will project use herbicides or pesticides? ' YesNo 19. Will project routinely produce odors (more than one hour per day)? ri Yes 1,4o 20. Will project produce operating noise exceeding the local ambient noise levels? ri Yes aNo 21. Will project result in an increase in energy use? [Yesri No If yes, indicate type(s) 1 1 _...1 . . . ._ __ • 22. If water supply is from wells, indicate pumping capacity �/� gallons/minute. 23. Total anticipated water usage per day /%7 - gallons/day. 24. Does project involve Local, State or Federal funding? ; Yes �No If yes, explain: Page 7 of 21 25. Approvals Required: Type Submittal Date City, Town, Village Board Yes r"-9/No City, Town, Village Planning Board 4Yes ; No City, Town Zoning Board r'7',Yes 1-1 No City, County Health Department Yes ri No Other Local Agencies ; Yes i No Other Regional Agencies ,~v- Yes ? `<No State Agencies Yes .j No Federal Agencies I Yes No C. Zoning and Planning Information 1. Does proposed action involve a planning or zoning decision? Yes No If Yes, indicate decision required: „„ Zoning amendment 1„Zoning variance 11New/revision of master plan I_ ' Subdivision Site plan Special use permit j Resource management plan [1 Other Page 8 of 21 , 2. What is the zoning classification(s) of the site? I 3. What is the maximum potential development of the site if developed as permitted by the present zoning? s 3 4. What is the proposed zoning of the site? I 5. What is the maximum potential development of the site if developed as permitted by the proposed zoning? (1 t-1 0,1,1,47, the f47 6. Is the proposed action consistent with the recommended uses in adopted local land use plans? r9<ires No 7. What are the predominant land use(s) and zoning classifications within a Y/4 mile radius of proposed action? ,arilla-,—)%44C- ri"../Tle ��kJ, /ICc/e-/A4j((— E I } f i i j = E I 1 E 9 i 8. Is the proposed action compatible with adjoining/surrounding land uses with a 1/4 mile? l'ti/es ? No 9. If the proposed action is the subdivision of land, how many lots are proposed? /" a. What is the minimum lot size proposed? /114- Page 9 of 21 10. Will proposed action require any authorization(s) for the formation of sewer or water districts? riYes INo i 3 1 1 i E 11. Will the proposed action create a demand for any community provided services (recreation, education, police, fire protection? , -Yes �o a. If yes, is existing capacity sufficient to handle-projected demand? g - Yes IT No a I 12. Will the proposed action result in the generation of traffic significantly above present levels? ®Yes ':---"<o a. If yes, is the existing road network adequate to handle the additional traffic. Yes 11 No i i D. Informational Details Attach any additional information as may be needed to clarify your project. If there are or may be any adverse impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or avoid them. E. Verification I certify that the information provided above is true to the best of my knowledge. ! / Applicant/Sponsor Na j / / L Date , / i. 4C-V ,dee-L , LLL . Signature . • 47" Title \Aa..ig _ If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. Page 10 of 21 PART 2 - PROJECT IMPACTS AND THEIR MAGNITUDE Responsibility of Lead Agency General Information(Read Carefully) In completing the form the reviewer should be guided by the question Have my responses and determinations been reasonable? The reviewer is not expected to be an expert environmental analyst The Examples provided are to assist the reviewer by showing types of impacts and wherever possible the threshold of magnitude that would trigger a response in column 2 The examples are generally applicable throughout the State and for most situations But, for any specific project or site other examples and/or lower thresholds may be appropriate for a Potential Large Impact response,thus requiring evaluation in Part 3. The impacts of each project,on each site,in each locality,will vary Therefore,the examples are illustrative and have been offered as guidance They do not constitute an exhaustive list of impacts and thresholds to answer each question The number of examples per question does not indicate the importance of each question. In identifying impacts, consider long term,short term and cumulative effects. Instructions (Read carefully) a. Answer each of the 20 questions in PART 2. Answer Yes if there will be any impact. b Maybe answers should be considered as Yes answers c. If answering Yes to a question then check the appropriate box(column 1 or 2)to indicate the potential size of the impact. If impact threshold equals or exceeds any example provided,check column 2. If impact will occur but threshold is lower than example, check column 1 d Identifying that an Impact will be potentially large(column 2)does not mean that it is also necessarily significant Any large impact must be evaluated in PART 3 to determine significance. Identifying an impact in column 2 simply asks that it be looked at further e. If reviewer has doubt about size of the impact then consider the impact as potentially large and proceed to PART 3. f. If a potentially large impact checked in column 2 can be mitigated by change(s)in the project to a small to moderate impact, also check the Yes box in column 3 A No response indicates that such a reduction is not possible. This must be explained in Part 3 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change Impact on Land 1. Will the Proposed Action result in a physical change to the project site'? NO fl YES -J Examples that would apply to column 2 • Any construction on slopes of 15%or greater, (15 foot E ® n Yes 'No rise per 100 foot of length),or where the general slopes in the project area exceed 10% • Construction on land where the depth to the water table ® Yes F9'No is less than 3 feet • Construction of paved parking area for 1,000 or more ® ® F Yes r9/No vehicles • Construction on land where bedrock is exposed or ® j YesNo generally within 3 feet of existing ground surface. • Construction that will continue for more than 1 year or ® Yes KNo involve more than one phase or stage • Excavation for mining purposes that would remove n Yes Wo more than 1,000 tons of natural material(i e,rock or soil)per year Page 11 of 21 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change • Construction or expansion of a santary landfill El 0 rlYes F 1 No • Construction in a designated floodway El ri nYes F1No • Other impacts ® El EKes ri No 4 2. Will there be an effect to any unique or unusual land forms found on the site? .e,cliffs,dunes,geological formations,etc) 0 AYES • Specific land forms. 17 FT IlYes FINo I Impact on Water 3. Will Proposed Action affect any water body designated as protected? (Under Articles 15,24,25 of the Environmental Conservation Law, ECL) JO 0 YES Examples that would apply to column 2 ® ® • Developable area of site contains a protected water body Yes 179.‘, • Dredging more than 100 cubic yards of material from channel of Fl rj Yes rq.Ko a protected stream • Extension of utility distribution facilities through a protected water ® 0 ii Yes Er-No body. • Construction in a designated freshwater or tidal wetland. ® El ri Yes EK/lo • Other impacts. f ® Il Yes No ` 4. Will Proposed Action affect any non-protected existing or new body of Ovate r� NO OYES Examples that would apply to column 2 • A 10%increase or decrease in the surface area of any body of El 0 Yes . , No water or more than a 10 acre increase or decrease • Construction of a body of water that exceeds 10 acres of surface El El ri Yes rqleo area • Other impacts- i t""" Yes `' to , , _ ,__,,, , __, ,_ ___: I— Page 12 of 21 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change 5. Will Proposed Action affect surface or groundwater quality or quantity? No fl YES Examples that would apply to column 2 • Proposed Action will require a discharge permit ® ® , n Yes �No • Proposed Action requires use of a source of water that does not ® ® Yes R No have approval to serve proposed(project)action • Proposed Action requires water supply from wells with greater El w n Yes RNo than 45 gallons per minute pumping capacity • Construction or operation causing any contamination of a water ® ® Yes 19rNo supply system. , • Proposed Action will adversely affect groundwater. ® ® ri Yes No • Liquid effluent will be conveyed off the site to facilities which D El �Yes17.1,;: presently do not exist or have inadequate capacity • Proposed Action would use water in excess of 20,000 gallons ® ® ri Yes No per day • Proposed Action will likely cause siltation or other discharge into ® ® Yes 1 o an existing body of water to the extent that there will be an obvious visual contrast to natural conditions • Proposed Action will require the storage of petroleum or ® in Yes l No chemical products greater than 1,100 gallons. • Proposed Action will allow residential uses in areas without ® ® Yes {-7(lo water and/or sewer services • • Proposed Action locates commercial and/or industrial uses '' ' 0 Fri Yes E9No which may require new or expansion of existing waste treatment and/or storage facilities • Other impacts El ® Yes r i Page 13 of 21 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change 6 Will Proposed Action alter drainage flow or patterns, or surface water runoff? N O fl YES Examples that would apply to column 2 - • Proposed Action would change flood water flows El riYes ffiNo • Proposed Action may cause substantial erosion ® El f Yes 191.-lo • Proposed Action is incompatible with existing drainage patterns I 1 I IYeso • Proposed Action will allow development in a designated El ® Yes "No floodway. • Other impacts: El U Yes 10 3 , IMPACT ON AIR 7 Will Pro sed Action affect air quality NN O ni YES Examples that would apply to column 2 • Proposed Action will induce 1,000 or more vehicle trips in any El Yes No given hour • Proposed Action will result in the incineration of more than 1 ton ® ® ri Yes No of refuse per hour. • Emission rate of total contaminants will exceed 5 lbs per hour El El Yes J No or a heat source producing more than 10 million BTU's per hour • Proposed Action will allow an increase in the amount of land ® ®Yes ri—No committed to industrial use • Proposed Action will allow an increase in the density of El El nYes r No industrial development within existing industrial areas. • Other impacts I YesNo I F IMPACT ON PLANTS AND ANIMALS ' 8. Will Pro ed Action affect any threatened or endangered species'? NO YES Examples that would apply to column 2 • Reduction of one or more species listed on the New York orj Yes Re Federal list, using the site,over or near the site,or found on the site. Page 14 of 21 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change • Removal of any portion of a critical or significant wildlife habitat El El r- Yes o • Application of pesticide or herbicide more than twice a year, ® Yes other than for agricultural purposes • Other impacts. ® ri Yes no a , 9 Will Proposed Action substantially affect non-threatened or non- ! endang ed species? NO "" YES Examples that would apply to column 2 • Proposed Action would substantially interfere with any resident ® ri Yes 1-9-‹o or migratory fish,shellfish or wildlife species. • Proposed Action requires the removal of more than 10 acres of ® ri Yes mature forest(over 100 years of age)or other locally important vegetation • Other impacts ® El ri Yes 7 t IMPACT ON AGRICULTURAL LAND RESOURCES 10. Will Pro sed Action affect agricultural land resources'? NO YES Examples that would apply to column 2 • The Proposed Action would sever,cross or limit access to ® Yes L-No agricultural land(includes cropland, hayfields, pasture,vineyard, orchard,etc) • Construction activity would excavate or compact the soil profile of El ElYes KNo agricultural land • The Proposed Action would irreversibly convert more than 10 ® riYes o acres of agricultural land or, if located in an Agricultural District, more than 2 5 acres of agricultural land Page 15 of 21 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change • The Proposed Action would disrupt or prevent installation of ® [ [1 Yes 4o agricultural land management systems(e g.,subsurface drain lines,outlet ditches,strip cropping),or create a need for such measures(e g.cause a farm field to drain poorly due to increased runoff) • Other impacts. LI 0 f l Yes _No IMPACT ON AESTHETIC RESOURCES 11. Will Proposed Action affect aesthetic resources?(If necessary, use the Visu AF Addendum in Section 617.20,Appendix B.) NO OYES Examples that would apply to column 2 • Proposed land uses,or project components obviously different [1 Yes No from or in sharp contrast to current surrounding land use patterns,whether man-made or natural. • Proposed land uses, or project components visible to users of El El El Yes [ N° aesthetic resources which will eliminate or significantly reduce their enjoyment of the aesthetic qualities of that resource • Project components that will result in the elimination or r El ®Yes tNo significant screening of scenic views known to be important to the area. • Other impacts ® ® ®Yes rYNo � t IMPACT ON HISTORIC AND ARCHAEOLOGICAL RESOURCES 12. Will Proposed Action impact any site or structure of historic, prehisto c or paleontological importance? NO OYES Examples that would apply to column 2 • Proposed Action occurring wholly or partially within or ® ® 0 Yes Ll No substantially contiguous to any facility or site listed on the State or National Register of historic places • Any impact to an archaeological site or fossil bed located within LI ® 1 Yes No the project site • Proposed Action will occur in an area designated as sensitive ® E Yes No for archaeological sites on the NYS Site Inventory Page 16 of 21 1 2 3 Small to Potential Can Impact Be 1 Moderate Large Mitigated by Impact Impact Project Change • Other impacts El ri Yes '�No 3 IMPACT ON OPEN SPACE AND RECREATION 13. Will proposed Action affect the quantity or quality of existing or future open s ces or recreational opportunities? O fl YES Examples that would apply to column 2 • The permanent foreclosure of a future recreational opportunity. [ ® n Yes 9 No • A major reduction of an open space important to the community EJ ® ri Yes .�No • Other impacts ® Yes [.' o • 1 I IMPACT ON CRITICAL ENVIRONMENTAL AREAS 14. Will Proposed Action impact the exceptional or unique characteristics of a critical environmental area(CEA)established pursua o subdivision 6NYCRR 617 14(g)? NO e � YES List the environmental characteristics that caused the designation of the CEA ___.._. . , i i Examples that would apply to column 2 • Proposed Action to locate within the CEA? El El ri Yes 7,9No • Proposed Action will result in a reduction in the quantity of the ® ® ri Yes rillo resource? • Proposed Action will result in a reduction in the quality of the El El ri Yes No resource? • Proposed Action will impact the use,function or enjoyment of the ri � ® El Yes �11/JNo resource? • Other impacts0 ® FlYes , JNo Page 17of21 I 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change IMPACT ON TRANSPORTATION 15. Will they be an effect to existing transportation systems'? NO f YES Examples that would apply to column 2 • Alteration of present patterns of movement of people and/or ® El nYes LJ No goods • Proposed Action will result in major traffic problems El El riYes Ko • Other impacts ['Yes .No I 1 J i IMPACT ON ENERGY 16. Will Proposed Action affect the community's sources of fuel or energy supply'? EKO fl YES Examples that would apply to column 2 � • Proposed Action will cause a greater than 5%increase in the El 11 1 D Yes No use of any form of energy in the municipality • Proposed Action will require the creation or extension of an ® ® Yes o energy transmission or supply system to serve more than 50 single or two family residences or to serve a major commercial or industrial use • Other impacts 0 ® 0 Yes 11.110 . . NOISE AND ODOR IMPACT 17. Will there be objectionable odors, noise,or vibration as a result of the Proposed Action'? O 0 YES Examples that would apply to column 2 / • Blasting within 1,500 feet of a hospital,school or other sensitive El ® IlYes TT No facility. • Odors will occur routinely(more than one hour per day). El 0 Yes F9Nlo • Proposed Action will produce operating noise exceeding the __ 0 0 Yes F11No local ambient noise levels for noise outside of structures • Proposed Action will remove natural barriers that would act as a El El f i Yes f'I No noise screen • Other impacts El El ElYes f_--,j No Page 18 of 21 ' 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change IMPACT ON PUBLIC HEALTH 18. Will Pro sed Action affect public health and safety'? ` O fYES t. • Proposed Action may cause a risk of explosion or release of _; D [j]Yes 1_7_(o hazardous substances(i e oil,pesticides,chemicals,radiation, etc)in the event of accident or upset conditions,or there may be a chronic low level discharge or emission • Proposed Action may result in the burial of"hazardous wastes" 7-1 r1Yes No in any form(i e.toxic,poisonous, highly reactive,radioactive, irritating,infectious,etc) • Storage facilities for one million or more gallons of liquefied ® ®Yes . . No natural gas or other flammable liquids • Proposed Action may result in the excavation or other t . E f Yes1711:-Io disturbance within 2,000 feet of a site used for the disposal of solid or hazardous waste • Other impacts. 0 El ilYes ...�No r I IMPACT ON GROWTH AND CHARACTER OF COMMUNITY OR NEIGHBORHOOD 19. Will Prop sed Action affect the character of the existing community? O YES Examples that would apply to column 2 • The permanent population of the city,town or village in which the ® ® ilYes P "I No project is located is likely to grow by more than 5% • The municipal budget for capital expenditures or operating ..„. IW Yes ruillo services will increase by more than 5%per year as a result of this project. • Proposed Action will conflict with officially adopted plans or ® ® ®Yes 19'No goals • Proposed Action will cause a change in the density of land use ® El ®Yes f_1 No • Proposed Action will replace or eliminate existing facilities, 17El Yes 191<o structures or areas of historic importance to the community • Development will create a demand for additional community , _ % _ Yes =- No services(e g.schools, police and fire,etc) Page 19 of 21 • - I - 1 2 3 Small to Potential Can Impact Be Moderate Large Mitigated by Impact Impact Project Change • Proposed Action will set an important precedent for future T Yes E o projects • Proposed Action will create or eliminate employment Yes o • Other impacts ® Yes i — No 3 ' 20 Is there,or is there likely to be,public controversy related to potential advers nvironment impacts? flNO OYES If Any Action in Part 2 Is Identified as a Potential Large Impact or If you Cannot Determine the Magnitude of Impact, Proceed to Part 3 Page 20 of 21 Part 3 - EVALUATION OF THE IMPORTANCE OF IMPACTS Responsibility of Lead Agency Part 3 must be prepared if one or more impact(s)is considered to be potentially large,even if the impact(s)may be mitigated Instructions (If you need more space,attach additional sheets) Discuss the following for each impact identified in Column 2 of Part 2 1 Briefly describe the impact. 2 Describe(if applicable)how the impact could be mitigated or reduced to a small to moderate impact by project change(s) 3 Based on the information available,decide if it is reasonable to conclude that this impact is important. To answer the question of importance, consider ! The probability of the impact occurring ! The duration of the impact ! Its irreversibility,including permanently lost resources of value ! Whether the impact can or will be controlled ! The regional consequence of the impact I Its potential divergence from local needs and goals I Whether known objections to the project relate to this impact 1 � f i I I i } Page 21 of 21 mµ. r ___.:_.. °fit