Summary AI
The Riverhead ZBA held a lengthy public hearing on a proposed ambulance center and mobile stroke unit garage at the Staples Plaza shopping center on Old Country Road. The board closed testimony, left the record open for written comments until April 23, and reserved a decision for May 14.
Key actions
- A one-year extension was granted for appeal 2025-003 (36 Kirby Lane, Jamesport), extending relief to April 10, 2027.
- A one-year extension was granted for appeal 2024-026 (55 Jacobs Place, Aquebogue), extending relief to March 27, 2027.
- A reserved decision for a property at 47 Bayside (appeal 2025-032) was moved to the April 23 meeting.
- An applicant seeking a variance to post a freestanding daycare sign at 189 Trout Brook Lane agreed to instead affix a code-compliant nameplate to her house, making a variance unnecessary; the board directed her to submit a sign sketch to staff and then withdraw the application.
- For appeal 2025-042 (1099 Royal LLC, 1087 Old Country Road), the board closed public testimony, left the written-comment record open through April 23, 2026, and scheduled a reserved decision for May 14, 2026.
Public hearings & comment
- The applicant for the ambulance center asked the board to interpret the shopping center zoning definition to allow the use as-of-right, or alternatively to grant a use variance, for a proposed Stony Brook ambulance garage and mobile stroke unit in the rear of Staples Plaza.
- Applicant witnesses testified that the roughly 14,000-square-foot rear space has been unsuccessfully marketed to retail tenants for about three years due to lack of parking visibility, no loading docks, and excess warehouse depth, and that annual property taxes and maintenance costs are substantial.
- A traffic engineer testified the proposed use would generate approximately 44 daily vehicle trips and 14 parked cars, compared to an estimated 900 daily trips and 35 parked cars for a comparable retail use.
- A Stony Brook physician presented clinical data arguing the mobile stroke unit saves lives by enabling on-scene CT imaging, immediate clot-busting medication, and faster routing to the appropriate stroke center.
- Opposing counsel representing Peconic Bay Medical Center and a nearby property owner argued the applicant failed all four required use-variance factors, that the shopping center district code unambiguously excludes emergency vehicle garages, and that granting the interpretation could affect more than 40 shopping center parcels totaling roughly 163 acres town-wide.
- Physicians affiliated with Peconic Bay testified the hospital is weeks away from opening a thrombectomy-capable suite across the street, raising concern that the MSU would transport patients to Stony Brook rather than the local facility, and that past experience with other Stony Brook MSU locations showed limited patient sharing.
- Multiple community members spoke in opposition, citing traffic safety around the shopping center, narrow access lanes at the rear of the building, pedestrian hazards, and zoning-precedent concerns; a petition with approximately 100 signatures in opposition was submitted.
Affects residents
- Written public comments on the ambulance center application (appeal 2025-042) will be accepted through April 23, 2026; the next ZBA meeting is April 23 and a decision is expected no earlier than May 14, 2026.
- Residents near 189 Trout Brook Lane should be aware that any daycare business sign at that address must be a code-compliant nameplate affixed to the house, not a freestanding front-yard sign.
Auto-generated from an unofficial, machine-made transcript. It may misstate names, figures, or votes. Verify against the agenda and the full transcript below.
Full Transcript
Thank you.
Heather, you want to start, please? Sure. We have two extension requests. The first is appeal number 2025-003 Barbara Capone, 36 Kirby Lane and Jamesport. They were originally granted relief on April 10th of 2025 with an expiration date of April 10th, 2026, and they are requesting their first one-year extension, thus expiring April 10th of 2027. So moved. Second. Thank you. Mr. Barnes. Aye. Mr. Poynter. Aye. Mr. Gazillo. Aye. And I vote aye, so that extension has been granted. Go ahead. And the second is appeal number 2024-026 Maya Fernquist, 55 Jacobs Place in Aquebog. They were granted March 27th of 2025 with an expiration date of March 27th of 2026, and they are requesting their first one-year extension, thus expiring March 27th of 2027. So moved. Can I get a second? Second. Thank you. Mr. Barnes. Aye. Mr. Porsche. Aye. Mr. Gazillo. Aye. And I vote aye. So that extension has been granted. All right. Is the reserve decision? Go ahead. So I believe the chairman had asked if we could move the reserve decision for 47 Bayside, appeal number 2025-032, to the next meeting, which is April 23rd of 2026. So moved.
1st, Jessica Acevedo, 189 Trout Brook Lane, Aquebaugh, Suffolk County Tax Up Number 600-85-2-95.12, Residence A40 Zoning for a Proposed Freestanding Sign, Applicant Request Variances and a Relief from Town Code Chapter 301-254C where Proposed Freestanding Sign is not permitted. Is that person available? Are they in the here? Anybody here regarding this? Come right up. Come right up, please.
And we do have the mailing receipts and the affidavit posting the mailing. Go right up to the podium there. Thank you. Please raise your right hand. I do solemnly swear to tell the truth, the whole truth, and nothing but the truth. So help me God, yes. Please state your name and address. My name is Jessica Leila Almonacita Acevedo. My address is 189 Trout Brook Lane, Riverhead 11901. Okay. Tell us what you're here for. So I'm here for the purpose to post a little sign 4x4 in front of my property, in my front yard, who I make sure is no blocking traffic or blocking view for the traffic. I totally respect and I'm aware to his zoning residential area. And that is why I thank the ladies. And the second floor, they help me with the process for the apply variance, the variance application. So the reason why I want to put it posting a little post in front of my front yard is because I have a business to use a child care service. And I would like to show you, so it's not just any business. I think so it's one of the more important business in life. Very proud. I'm proud to say it. I'm a daycare provider. I'm a professional. I'm not any babysitter who just work from home. And I work for taking care of little children. I have a license from New York State. And I pass all my inspections in order to keep my license. I work for Sioux Falls County DSS, Department of Social Service, in order to give child care service for foster children in the community of Riverhead. Okay. And disability. And I work for the Children's Special Needs. And the purpose of why I want my posting is many of my, again I have here, many of my children, foster children and disability, it's when they are looking for a place to where they can receive child care service. They cannot find it because they just see it's a little house is where I resident. Also over there, I work with public schools. Okay. Oh, thank you. for the disability kids, special needs. And again, they cannot find my address because it's a daycare with license, but I don't have a little sign, at least in my front yard, so they can see it. That is the purpose. I want to show you my another proof. I don't know if they can see it. I can bring it up. This is a proof. I work with the Department of Social Services, Suffolk County. And again, as you can see, they are standing in front of my residence, and they cannot find it because they don't see a little sign over there. Again, my posting is going to be, and I made a specification, it's going to be four by four, and it's in my front yard, and I make sure I'm not disturbing anybody. I follow the right steps according to the procedures to send six emails. And I posted a sign in front of my yard to let know the people around in the street they can see for the meeting today. Even if they need it, I have here another neighbor who lives across the street who, he support me too. I believe I got the emails between, I believe between 8.30 and 4.30 was the last time to send in the emails. Just to let you know, I work also with therapists in my business in order to support and be a plus in the town of Riverhead. This is the Riverhead School District Psychology is who I work in order to give childcare service in my daycare program, also with therapists. Also, I work, I work for Hampton Psychology Society. I work for Hampton Psychology Society, and I work for the school district too. And again, it's professional people who help here little kids with disability and foster kids in order to give service to the little ones. They cannot see it because they just see another house, but when they don't see the little post, they get kind of lost. Again, I want to apologize if anybody to live around my house, I totally apologize if I'm disturbing you. I don't want to bother you. I don't want to disturb you. I don't want to disrespect anybody. I just want to put it a little post for the people, buses, psychologists, therapists, school district psychologists, they can come and find my daycare service in my residence. And this is just the proof. I can show you I work Monday to Sunday from 6 in the morning to 7 p.m. It's open for any children with disabilities. I'm [transcription gap]
a benefit to the community but a four by four freestanding sign in a yard in a residential neighborhood obviously as you know that's why you're here is not permitted under the code okay can you tell me if there are any other residences in the vicinity of your house that have proposed business signs four by four posted in their front yard well i i can be uh very specific with that um no i didn't see any any of that but i also i saw it in my same street like a 16 foot a skeletal over there front yard in the same street where i live and i see there since i live there and i don't see anybody has an issue with that also i totally respect uh you know the signs for political uh the presidency so i'm very open minded very flexible if you want me to make it one two by two you know if you want if you if this is about the size and you want me to make something two by two that's okay i just needed to put in a little sign in order to uh professional people in suffolk county department of social service can find um my daycare again i just want to give you a little i understand from what you're stating that you're not seeking the sign to advertise for new customers since you obtain um clients through the department of social services special needs department i understand that but according to the code uh in this residential neighborhood uh freestanding signs are not allowed to be posted in the neighborhood not permitted they do permit name plates attached to a building wall and the name plate could be uh two by two square feet two square feet sorry two square feet that's permitted it has to be attached to the residence okay so i can so i could that's that's that's why i thought that's the point to apply for a variance i understand it's a resident zone but that is the purpose why i apply for a variance just to make an exception to put it something small in my front yard and again i'm not blocking any view any street i'm not causing traffic my daycare program the only way i can be approved to having my dator program in my house is because it's a residential place it's not a center the only way i can be approved to having my dator program the only way i can be approved to having my dator program in my house is because it's a residential place. It's not a center. A center is in a commercial street where it can be over 100 kids. Mine is a very minimum capacity kids, and the only way to be is in a residential house. That is the reason why I just needed to put it up. If you tell me if it can be two by two, that's okay. I can be flexible with the size. But, again, I hope in the order, that's why I applied for a variance. That's acceptable to you, that you would withdraw your application, I presume? Shall I? Yes, please. Can I just note, we did receive an email from Claire Conforti, who lives at 201 Trout Brook. She couldn't attend, but she said she's okay with a sign being posted. I don't know if there are other members. He is unable to present here. We'll get to you. Who he's present to approve to, just as a witness. Justin, can you resume in on those?
It's a small sign, but it will identify your business. Okay. If you give me your permission, just as a fun. The zoning board is recommending that... That you possibly reconsider conforming to the code. But you could do it in a way where you could hang the placard. You simply have to affix it to the house. But you could extend the placard out so it hangs out. And see the pictures that they put up? Yes. I would like to show you my survey. And in my survey, my property is almost one acre. So the house is very, very deep in the front yard. We've all seen the house. We've all been to the house. Oh, okay. And you submitted the survey with the application. That's what I have it. So it can be posted in the mailbox? Not the mailbox. That's the attached to the house. Okay. All right. Okay. So I will put it in my... Thank you. I can put it there. It works for me. So if I can put it... Just give me the right measurements and I can make it customized and put it attached to my house. If that's it, I can get it in order. Essentially. So if you did that, you would be able to withdraw your application to the zoning board. And you would not require zoning board relief. Okay. I have one question. Can I paint it on my house in the outdoor? Can I paint it? The name? The name of my daycare? On the outside of your house? On the outside if I can paint it. You mean a sign? No. Put the name if I can paint it. You mean instead of a sign? Or just... It's got to be two foot square. You want to say paint it two foot square? Is that what you're talking about? No. Oh, just a big sign? Yeah, paint. I don't think I'd do that. She wants to paint the side of the house like a mural for the business. It's going to be a wall sign. That's what it will be. It's going to be on my wall. Now, under our sign code, you may not do that. Okay. So I will work with that. That's okay for me. Thank you. Do we want... There was somebody else that wanted to be heard? No. Anybody want to be heard? Step up. I'm good with that. Okay. You've got to step up and say, get up here. It's my name for across the street. All right. Hey. I do solemnly swear. Tell the truth, the whole truth, nothing but the truth. So help me God. Please state your name and address. My name is Edmund Makua. I live in A.U. Robert Street. Where do you live? River, New York, 11901. So I live in front of her house. I'm okay with the sign. Okay. So even if she can attach it with a mailbox or by the house. The mailbox is not allowed. Okay. So. Okay. Two by two, I think. It's not a big. Two square feet. So one by two. Yeah, I think it's not her anymore, I think. And I think she's doing a great job. Take care of the kid to the rest of the person. Go back to work. All right. Thank you. Was there someone else over here? Is there anybody that can provide a sketch that you can send to Heather so that we can look at it through an email? No. I'm really in opposition to it. So. But it was worn in. Okay. Yeah. You have to step up there, please. All right. Raise your right hand. I do solemnly swear to tell the truth, the whole truth, nothing but the truth. So help your God. Please state your name and address. 179 Trafford Lane, Ackbog.
If this is going to be totally withdrawn, I don't know if you want me to read this. I'm not sure. I don't know if you want me to read this entire, my opposition to it. I certainly will do that. I also have several affidavits of our neighbors, and I would like to, can we turn those in? Absolutely. Okay. We have Ann Louise Wade, Brittany Givinelli, Ryan Bauer, Andrea Bauer, Kenneth Nagy, and Michael Givinelli. Should I read this? Because. I'm sure you would. Yeah. We have no jurisdiction on it. Right. So it's like done? Well, if she withdraws, it's done. It's not always, it's taken away from us. Do you want to hear from me or not? I mean, if you want to talk, but it's not necessary. All right. Let's do it. All right. So good evening. Good evening. I am here to respectfully oppose the applicant's request for a variance to install a daycare center, a daycare sign in the front yard. I have a few points I'd like to make tonight, if I may. One, this is a residential neighborhood. This neighborhood is zoned and intended to maintain a residential character. A commercial style sign, especially one proposed at approximately four feet by four feet in a front yard, alters that character and changes the appearance of the neighborhood. Granting this variance would move us away from the intent of the zoning code, which is to preserve the integrity, consistency, and residential look of our community. Two, the sign will intensify an already significant impact. This property is a residential area. This property is already operating as a daycare, which is already having a significant impact on the day-to-day environment for neighboring residents, as you can see from those affidavits. Adding a visible sign will increase traffic and awareness of the business, encourage additional drop-offs and pickups, further increase the impact on neighboring properties. This is not just a sign. It is about expanding the visibility and effect of a business in a residential zone. Three. I have a question. Existing conditions are already affecting safety. Since the daycare began operating, we have experienced early morning and late evening traffic seven days a week, a steady flow of vehicles each day for drop off and pickup, multiple buses arriving several times a day from various locations, vehicles speeding through the street, one almost hit one of my neighbors, cars parking on the wrong side of the road, unsafe turning and maneuvering instead of using the cul-de-sac. We have two cul-de-sacs right there that people that drop off their kids could easily turn around in. These conditions create real safety concerns for the residents. Four, ongoing disturbances impact on quality of life. In addition to the traffic, there are ongoing disturbances that have affected our ability to enjoy our property. There is continuous noise from cars. There is continuous noise from daycare activities, including use of the adjacent tennis court. That's right, it butts right next to my backyard. We have a backyard that we invested in and take pride in, but it's no longer peaceful. We regularly hear loud activity throughout the day, and it has significantly impacted our ability to sit outside, use our pool area, and enjoy our home just in general. This is a daily disruption that has changed how we are able to use our own property. So we are property values. Six, overall impact on neighborhood character. I would also like to note that our neighborhood has been experiencing increasing pressure related to overuse of residential properties and general code compliance concerns. While those issues may fall under separate enforcement, they contribute to a broader concern among residents about preserving the residential character and long-term stability of the neighborhood. This is not an isolated request, the sign. It adds to the overall impact already being felt. Approving a front yard business sign in this context would further move the neighborhood away from its intended residential use. Seven, the variance is just not necessary. A key consideration for a variance is whether there is a true hardship. In this case, the daycare is already operating without a front yard sign. The applicant can continue operating without altering the neighborhood character. Therefore, the requested variance is not necessary to make reasonable use of the property. Eight, community input. I understand letters of support were submitted, and now I've provided maybe eight statements from other neighboring residents based on their first-hand concerns for the board's consideration. In closing, this is not just about a sign. It's about protecting the residential character of our neighborhood. I would also like to note that the board has already made a request for a variance request. For all of these reasons, I respectfully ask the board to deny the variance request. Thank you for your time and consideration. Thank you, Ms. Jennings. Thank you. Heather. Please confirm the daycare is a legally permitted use. Yes, and it's regulated by the state. And there are no violations that exist on this property that we have been made aware of, correct? Not that I know of. That's correct. I know there's an open permit. I know there's a permit that she has, so. Correct. But the daycare is a legally permitted use. Mm-hmm. It shouldn't be. It is, right? And you witnessed the applicant acquiescing to the recommendation of the zoning board to scale the sign back, affix it to the house as is required by the code. Yes. You heard her acquiesce to that. Absolutely. Thank you. Thank you for that. Could I just? Yeah. I was going to say if you could submit that. This one I have several copies for everybody. The affidavits, I did not have copies. So Ms. Acevedo, if you would be so kind, after the zoning board hearing in the next week or so, provide us with the draft of the sign. You can submit it to Heather. And then after the zoning board reviews, they'll clear it, deliver it to the building department, so you can then proceed. And then the zoning board application would be withdrawn. You wouldn't need a variance. Right. Okay. No stand? Okay. I would like to just end it up my case saying something very clear. I'm not disrupting anybody's in the zoning where I live. All the accusations a person say before, if that was true, it's not one complaint before today. It's not one complaint about all the things she said and record in the Riverhead town. So I will take it just personally. All that is false. My daycare is open from 6 in the morning to 7 PM, Monday to Sunday. Just to remind some people, school buses is not on weekends. And I don't have kids in the tennis court, what is my playground, at 6 in the morning, especially with this weather. That's all. I think you've said enough. I just kind of touched it. But it's okay. Okay. It's hearsay. It's not proof of all of this. The only thing I can prove it to you is to I serve children and the impact I make is positive. That's all. You made that point. Thank you. All right. So is it okay if I give her the sign and I actually put the sign code and the size? Yes. Can I see it? Here. You want to come up? Thank you. So here is just the measurements. That's an example and that's the size. Thank you.
Oh thank you.
how many signs are allowed on the house can she put one sign on her house one by two what she's gonna put up one okay on the front door of our house when you come to the front door the house she has like five or six placards right now that are up with all these regulations I guess whatever they are posted all down the sides of the door are they considered science I haven't seen them we've been we've been to that I didn't see the sign just we understand each other okay they might be considered for the record before the building department would ever issue a permit they're gonna inspect and they're gonna view it it may be that those signs are required by Suffolk County Department of Social Services you know we're Health Department we're not aware but from the town's code it's going to be you know we're not aware but from the town's code it's going to be one business sign that's it all right thank you thank you I appreciate it thank you anybody else so do we want to close this and then for May 14th so moved May 14th second thank you mr. Barnes hi mr. Porsche all right hi mr. Porsche all right hi mr. Porsche all right my vote aye so thank you very much Heather and the next appeal is appeal number 2025-042 which was reopened and amended 1099 Royal LLC 1087 Old Country Road Riverhead suite 1103 Suffolk County tax map number 600-108-4-14.5 shopping center zoning for a proposed ambulance center applicant requests an interpretation of Town Code chapter 301 3b definition shopping center to establish that the proposed ambulance center garage is a permitted use or in the alternative variances and or relief from Town Code chapter 301-110 a where proposed use of ambulance center garage is not a permitted use within the shopping centers owning these districts [transcription gap] So we are here tonight to reopen and continue a public hearing originally held on January 8th. The applicant continues to seek relief from the board to allow a proposed ambulance center operated by Stony Brook Clinical Practice Management Program at the subject premises at 1087 Old Country Road, Suite 1103 in the Town Shopping Center District. In as much as tonight's proceedings are a reopening of the prior proceedings, we respectfully request that the prior transcript and exhibits be included as part of the record tonight. The original application heard on January 8th sought a use variance to allow the proposed ambulance center in a portion of the former Big Lots, which occupied approximately 40,000 square feet in the existing shopping center. As the board will hear in greater detail this evening, the tenant space for which that use variance is requested no longer is viable for any use permitted in the shopping center district due to several unique factors affecting both the subject property and the tenant space itself. The applicant has hired at least four different brokers over the span of three years, attempting to lease this space, and leasing the portion of the former Big Lots to Stony Brook is the only viable option that has come across in that time. At the same time, the proposed ambulance center will not result in any change or detriment to the character of the neighborhood. Rather, the proposed use will be complementary to the surrounding area, which as I'm sure this board is aware, features a very high concentration of medical related uses, and the subject property itself will retain its essential character as a shopping center, notwithstanding this use. The project's daily operations, which will be extended, will also generate far less parking and traffic demand than if the space were leased to a traditional shopping center use. On January 8th, the board also heard arguments for why the proposed use should be deemed a permitted use in the shopping center district under the town's expansive definition of shopping center, as set forth in Town Code Section 301-3B. We have since amended the application to formally request this interpretation, and will present our argument for why we believe that is the case this evening as well. If the board rejects the applicant's interpretation, we respectfully request in the alternative that you grant the use variance originally applied for. Finally, as the board will hear, this project is essential to provide a geographically central dispatch location for Stony Brook's state-of-the-art mobile stroke unit, which is capable of delivering immediate and life-saving treatment to suspected stroke victims before they reach a hospital. It does not replace a hospital. The project will allow Stony Brook's MSU to cover the Riverhead community, as well as areas to the east and to the forks, and back west as well. The medical outcomes in situations in which a stroke victim is transported by MSU to the nearest equipped stroke center are significantly better than when a patient is transported to hospital by a traditional ambulance. And because every single minute counts when it comes to stroke treatment and recovery, the public benefit of having the MSU in this community cannot be understated. The project will also provide a storage and restocking location for up to eight ambulances that are already serving the Riverhead community and the east end of Long Island. Importantly, as you will hear, those ambulances will not dispatch from the Stony Brook hospital, rather they will report to off-site locations before they begin their tour each day. The proposed use is strictly as a storage location for them to be restocked before they begin each daily tour. I have up on the board a marked copy of our site plan, which shows the location within the existing center that would be occupied by the ambulance center. As you can see, it is located in the rear of the property away from Old Country Road. The means of access would be to go into the property, and then go around the back. If you're looking at the property from Old Country Road, you'd go off to the right, circle around the back of the building, and that's how you'd arrive at the center. For anyone who's physically been to the property, you'll know that this side of the center is off to the right, and directly behind another existing third-party shopping center, which means that this location is not visible from Old Country Road or from any other public vantage point. The shopping center itself is 9.3 acres, located in the shopping center district. It's improved with a one-story shopping center known as Staples Plaza, which contains approximately 110,000 square feet of gross floor area. The center features a mix of retail and restaurant uses, including Staples, Harbor Freight, West Marine, Aboff's Paint Subway, two Asian-style eateries, and there's also a four-leaf credit union formerly Bethpage. The space formerly occupied by Big Lots is located in the west side of the center, as I mentioned, situated behind the adjoining property. Staples Plaza is about 300 feet west of the traffic circle at Old Country Road, and Roanoke Avenue. As the board knows, this corridor along Old Country Road is characterized by a very diverse mix of commercial uses, which include big box retail stores, retail campuses, sit-down and take-out restaurants, and professional and medical office seat campuses spread across several zones that include the retail center, business center, and shopping center districts. Roanoke Avenue, south of Old Country Road, is primarily zoned professional business and features a heavy concentration of medical and professional offices. There's a city M.D. on the southeast corner of Old Country Road and Roanoke Avenue, and of course there's Northwell-Piconic Bay Medical Center at the northeast of the same intersection. Other medical-related uses in the area include Riverhead Commons, County Seed Professional Complex, Acadia Center for Nursing and Rehabilitation, Harrison Square, and there's actually a non-exhaustive list of all the other medical-related uses at Exhibit 1 in the packet that I handed out this evening. In 2003, I was able to get a copy of the book, and I'm happy to share it with you. I'm going to read it to you now. In 2003, Big Lots announced that it would be closing its store at the center. Accordingly, the applicant began marketing Big Lots tenant space to be re-let. The applicant retained at least four different brokers to market the former Big Lots space over a period of about three years. Copies of the marketing materials from each of those brokers are provided at Exhibit 3 in the materials I circulated. Those efforts unfortunately were not successful, for several reasons beyond the applicant's control. Eventually, the decision was made to split the Big Lots space into two spaces, a street-facing tenant space that has access to the public space, and a public space that is not accessible. The space would be a space that would be used for parking, visibility from Old Country Road, and a rear tenant space consisting of the warehouse space that prospective tenants consistently told them was in excess of their needs and unusable. The proposed ambulance center would occupy the latter portion of the former Big Lots. This space contains approximately 14,000 square feet and would include nine ambulance bays, an office space, a break room, a training room, and lavatory facilities. Actually, I'll put up the floor plan for the board. [transcription gap] plan or to the floor plan of this project since the last hearing just so the board is aware. Eric Nigelberg from Stony Brook will provide specific details regarding the center's daily operations. However, the project would of course serve two primary functions. First it will be the storage and dispatch location for the MSU which is intended to serve Riverhead and communities in Eastern Suffolk and the Forks. The second use will be to serve as the overnight storage for the eight Stony Brook ambulances that I mentioned previously. Those ambulances again would not dispatch from this location, would rather be stored overnight, restocked before the following day's tours. There will also be no fueling, washing, or auto body work on site. In terms of staffing, four individuals comprising MSU's crew would be stationed in the center during the 12-hour shift each day. The MSU does not does not respond to calls overnight so it's a day shift only. All other employees would be on site in the morning and in the evening when picking up and returning their respective ambulances for storage and restocking. The center will also provide training and training and a break room for the MSU employees. As Mr. Nigelberg will will attest along with our traffic expert, Kian Cody, the proposed center will generate very little traffic and parking demand especially when compared to a traditional shopping center use. Addressing first the applicants request for the interpretation, we respectfully submit that the proposed ambulance center should be deemed permitted in the shopping center district because it fits within the expansive definition of the shopping center. As the name indicates, the shopping center district permits shopping centers as a principal permitted use. Town code section 301-3B, which is provided at exhibit 2 in your exhibits, states that a shopping center is quote a use of lands, buildings, or structures by two or more stores or business establishments where the proposed use occupies a site of one or more acres. The current use of the subject property is plainly a shopping center which features at least seven operating retail and restaurant businesses and a credit union, the latter of which is more akin to an office use. The opening of the proposed ambulance center will not offer the property's essential character as a shopping center because it will be located in a relatively small portion of the center compared to the overall 110,000 square feet and will be in the rear of the property where it is not visible from the public or another vantage point. The street facing portions of the center will continue to consist of traditional retail stores, restaurants, and shopping center uses. Furthermore, because the term business establishment is not defined in the town code, that term is subject to this board's interpretation. And there is a general proposition in zoning law that when a code is susceptible to interpretation or ambiguity, it has to be construed in the favor most favorable to the property owner. In this case, a common definition of a business is an organization that is engaged in commercial, industrial, or professional activities including the buying and selling of goods or the provision of services. The proposed ambulance center will be engaged in activities that are associated with professional medical care including the operation of the MSU and the management of Stony Brook's local ambulance fleet. To that end, the center will further include an administrative office and small training room for personnel and these activities are administrative or office activities in nature clearly related to Stony Brook's business of providing medical services. Notably, the Riverhead branch of the Suffolk County Department of Social Services is located in the BJS shopping center to the east of the Suffolk County Department of Social Services. The center will be engaged in activities that are associated with professional medical care, [transcription gap] several years and has compelled shopping center owners to expand tenancies to less traditional shopping center tenants including medical related uses. Therefore we respectfully request that the Board consider this interpretation and deem this use to be permitted under the shopping center district definition. Turning to the use variance, if the Board disagrees with our interpretation we request in the alternative that you grant the use variance originally applied for. As the Board may know, pursuant to Town Law 267-B2B, the applicant must demonstrate that enforcement of the Town Zoning Code against it will result in unnecessary hardship is the terminology. This is a four factor test that asks the following. That the applicant cannot realize a reasonable return provided that the lack of return is substantial and demonstrated by competent financial evidence. That the alleged hardship relating to the property is unique in nature and does not apply to a substantial portion of the district. Or the neighborhood. That the requested use variance if granted will not alter the essential character of the neighborhood. And that the alleged hardship is not self-created. In this case the applicant meets all of these criteria. With respect to the lack of a reasonable return, the applicant will establish through the sworn testimony of its representative, Michael Hakimian, and one of its Board brokers, Gary Brody, that it has been unable to lease the affected portion of its center for retail, restaurant, or any other permitted use in the shopping center district. This hardship has persisted. Since the space became available at the end of 2023, despite the applicant's diligent efforts to re-tenant that space. The applicant will further establish through the 8% testimony that the hardship is unique to its property because the affected portion of the shopping center is in the rear of the property and does not have access to parking, window exposure, or visibility from any public road. The absence of these qualities makes the affected portion of the center highly undesirable to retail, restaurant, and other businesses that rely on visibility and access to attract patrons. The proposed ambulance will be available at the end of 2023. The proposed ambulance center will also not alter the essential character of the shopping center, which as I mentioned, will still be a forward-facing shopping center with all of the retail and restaurant uses remaining. As this Board will also recall, it issued a use variance in 2019 to permit an Aspen Dental in the shops at Riverhead Shopping Center, which is located in the destination retail zone. A copy of that decision was previously provided as Exhibit 8 in the materials provided on January 8th. Moreover, the presence of the ambulance center will not change the state of the area. The proposed ambulance center will also not alter the essential character of the shopping center. The proposed ambulance center will not alter the strength of the building, but the !
works and how it will deliver immediate life-saving treatment and diagnosis to stroke victims and how it will work collaboratively with area hospitals to achieve markedly better outcomes for stroke patients. As I mentioned, the goal and purpose of the MSU is not to supplant hospitals. As the Board will hear, the MSU will also not be delivering patients solely to Stony Brook centers. Rather, it will transport a patient to the near stroke center that is capable of treating the stroke that is diagnosed in the MSU prior to transit. Inasmuch as this information is not relevant to the Board's interpretation of the Town Code nor to the factors relevant to use variance, it is highly relevant to understanding the importance of this project and the significant public benefit that will be achieved by having the MSU in the Riverhead community. Before calling up our live witnesses for testimony, I will now read the affidavit of Michael Hakimian who could not be here this evening because he is observing the ongoing holiday. So I've provided in your materials the following documents. Exhibit 3. So just reading into the record for the benefit of everyone in the audience and anyone watching, Michael Hakimian being duly sworn deposed in states under penalty of perjury. I am over 21 years of age and have a business address at 825 Northern Boulevard 1st Floor, Great Neck, New York. I am the managing member of the applicant 1099 Royal LLC and as such I have first-hand knowledge of the facts and information set forth herein. I make and submit this affidavit in support of the applicant's request for an interpretation of Town Code 301-3B or in the alternative for a use variance from Town Code 301-110A. As a real estate professional, I currently oversee the management and operation of approximately 1 million square feet of retail, restaurant, and Class A office space in New York and elsewhere in the United States. As a result, I am experienced in commercial and commercial business and I am also an expert in the leasing of retail, restaurant, and office space and I am very familiar with national and local market trends affecting commercial real estate. I am specifically familiar with commercial real estate trends on Long Island and in the town of Riverhead. The applicant acquired fee title to the shopping center at 1087 Old Country Road on or about February 2nd, 2007. It consists of 9.3 acres improved with a one-story commercial building containing approximately 110,000 square feet. The center's current tenants include Harper Freight, Staples, ABOFS, West Marine, and a Subway sandwich shop and two Asian-style eateries. The tenants' respective lease terms vary from five to ten years. The annual taxes and expenses for the center are significant. For the 2024 to 2025 tax year, the applicant paid $437,582 in property taxes. For the calendar year of 2024, the applicant spent $312,000 on common area maintenance. The applicant's expenditures for CAM in 2025 are still being finalized but expected to be paid in the year after the
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from traditional brick and mortar retail and food establishments brought on by online shopping and food delivery services and exacerbated by the copin 19 pandemic these market factors made tenant space in traditional shopping centers less attractive in general although this trend is now easing in some markets that has not been the case in riverhead which has seen several large commercial tenant spaces remain empty the unique factors affecting the center made releasing the big lot space that much more difficult for the applicant retailers and other commercial businesses that have expressed interest in the big lot space have said that they do not need the entire 40 000 square feet and they are only interested in the portion of the space with direct access to the parking lot and visibility from old country road consequently the rear portion of the form of big lots is essential essentially unmarketable to traditional shopping center tenants because it does not have parking visibility window exposure or direct access to old country road these are all qualities that commercial tenants and specifically large retailers require at one point we marketed the form of big lot space at a rate of 20 21 per square foot with property taxes and cam fees included that rate is well below the rate for comparable shopping center space in riverhead which is comparably currently around 26 per square foot with property taxes and cam fees included even at that drastically reduced rate we were still unable to attract a tenant for the former big lots for these reasons the decision was made to divide the former big lots into smaller tenant areas and market the rear portion of the premises to professional medical or educational uses that do not rely on parking visibility or direct frontage like traditional shopping center tenants in my opinion the only viable path to reactivating the former big lot space is to place a non-retail non-restaurant user in the rear portion thereby allowing the front portion which has the necessary parking field access visibility and frontage to be separately marketed to traditional shopping center tenants for these reasons we respectfully request that the zoning board grant this application i told you i was going to talk for a long time um so with that i would like to call up uh gary brody who is our our broker or was one of the brokers at the uh the shopping center who attempted to release the um the space uh he's going to corroborate the uh affidavit of mr akimian and also talk about some general real estate trends in uh in riverhead in general so with the zoning board just permit me a few questions uh for mr butler so um you've got a question for the zoning board um we've talked about you believe or opine that these uses are consistent with shopping center zoning uh did you review and you can you provide to me any recitation out of the town of river had a comprehensive plan from 2003 or the recent update in 2024 regarding intent purpose and description of shopping center zoning and the use of the zoning board as a comprehensive plan for the town of riverhead gary
a more expansive use or a rather more expansive definition of shopping center is appropriate in this case and I did cite another instance where this board relatively recently in 2019 granted a use variance to have an atypical quasi medical use allowed in what is very clearly a shopping center so that's that's really what I would be but you would agree that the town's comprehensive master plan is the blueprint for zoning and it supports all the zoning in the code and if it didn't support the zoning in the code you would have to do probably a FEIS I don't know what it would adopt any portion of a code that wasn't consistent with the comp plan I will agree with the statement that a comp plan is the blueprint for zoning in a you know a ! generally as a general proposition I don't know that I would agree with the statement next you also mentioned that the owner of the property this past year did three hundred and twenty thousand dollars I believe in maintenance three hundred and three hundred and twelve I think was the number twelve so the maintenance that was done was that to address the items and violations were cited in the open Supreme Court case the cam charge excuse me cam fees that were spent in 2024 are actually detailed as an attachment to the affidavit for Mr. Hakeem in so I think that document speaks for itself and it does detail what what the expenses were for various things that were done in the center okay so is it true that we are not able to do the ! the!
open items of violation many of which have been addressed but five remain some of the items that were addressed is handicapped parking in front of the fry pan restaurants were removed now they've been reinstalled handicapped signage for the spots were missing we have the missing stop signs still outstanding by route 58 there are outstanding items regarding the loading dock etc okay well I don't have any personal knowledge of violations or a Supreme Court case nor do I necessarily think they're relevant to the use variance or or the request for interpretation to the extent that the board is interested in the resolution of those things I am of course happy to take them back to my client but I'm not retained by them to resolve any open code violations what I will say is that a bigger detriment I would think to the community is to have large vacant storefronts rather than missing stop signs and parking in front of the parking lot and I think that's a good point um those things are important but I think derelict shopping centers are a bigger blight than you know missing handicapped spaces and signs nonetheless I'm very happy to take those back to my client on the first plan that you presented and put up on the board you showed a route how the ambulance would Traverse through the property so you don't think it's significant that there's a Supreme Court action for violation of site plan on that
I'm not saying it's not significant what I'm asking is what the relevance is to the use variance or to the interpretation that's before the board tonight I've already represented that we will take that back to the client but you're actually asking about a pending lawsuit in Supreme Court which if I were representing the applicant I probably wouldn't be authorized to discuss this evening anyway well you were making reference to to property maintenance and right and the point I have an indication that unfortunately the property needs this space that's such a maintain as well why don't you speak at a time please sorry and I have an indication coming out of the office of the town attorney and code enforcement that there are issues and were issues that deviated from an approved site plan and are still not addressed and corrected I see so is the is the concern being expressed that the approval of this application would somehow exacerbate those issues well I think clean hands is always important to consider sure so again as the attorney who is now representing them in those matters I will nonetheless take it back to my client as something that needs to be addressed but I do feel very strongly that those issues are not necessarily relevant to the inquiry before the board this evening and I would like to call on the attorney to speak respectfully so if I may continue the presentation I would like to call up Mr Brody I don't think so okay you're not an attorney are you you're not an attorney are you sorry you're not an attorney are you do you tell him I swear to tell the truth tell the truth nothing but the truth please state your name and address Gary Brody 270 Spagnoli Road Melville New York go ahead good evening all my name is Gary Brody I'm a licensed real estate broker in New York for 47 years I'm a commercial real estate broker with expertise in retail industrial investments I've worked the Riverhead Market for nearly 30 plus years leasing property selling property that's land and improvements shopping centers
some of the properties that I've worked on over time is the 20 acre Anderson farm across the street which I sold to the developers for Target a five acre parcel on the corner of Harrison and Route 58 that is now Laundry Palace and most recently the former Blockbuster property right in front of this shopping center
I've leased over a hundred thousand feet in the past two years primarily in Riverhead Plaza which is the former Walmart Center which is previously Caldor put leases together for Restaurant Depot Ollie's bargain outlet and Fifth Avenue furniture previous to that I leased the supermarket to Gallifresh and most of the retail stores in that Center Red Wing shoes bagel Etc Etc also was instrumental leasing most of the medical space adjoining has he ever testified in court I'm sorry have you ever testified in court no okay I keep going leased space at County seat Professional Complex primarily medical tenants and insurance as well. Recently leased Pella Windows.
I'm familiar with Staples Plaza back in, I believe it was 07. I was instrumental in selling the property to the current owners, the Hakimian family. And I leased most of the stores initially in that center, which I guess if we go back, people recall, I believe it was Pergament and Wallbounds. I'm dating myself. I actually represented Hampshire Properties, the previous owner of the property prior to that. So many of the tenants in that center were leased by me, initial tenants prior to, and not including the big lot space. Prior to that was a furniture and a fitness center. I leased the West Marine space in that center, previously leased the West Marine space in that center, previously leased the West Marine space in that center, previously the Harrow space and all the small tenants I leased, Frypan, Sakura, Bethpage Credit, Subway, et cetera.
So with regard to trying to lease the 40,000 foot space there, one of the primary pitfalls of that space is that there is no loading area. Previously they used side doors, which proved ineffective, but there's no loading docks or space available to adequately supply a 40,000 foot retail space. And that is primarily why they decided to open themselves up to dividing the space. Parking in the front of the center doesn't really complement the 40,000 feet because part of the space is set back and the visibility is also set back. Most major retailers are already found a home in Riverhead on Route 58. And again, the detriments are the visibility, the access to parking, and the lack of loading. We did try to work with some healthcare providers, but they were not able to provide the [transcription gap] up couldn't rent it to a large box the owner divided into three spaces Dollar Tree and Planet Fitness moved in and then the third space which I represent has been vacant for since Sports Authority left so probably about three years that they could print that space again visibility being a negative somewhat similar to to this space I marketed this space to many supermarkets to name a few Trader Joe's I I listened to what the locals would like to see there and I've heard about supermarkets so we went to Trader Joe's we went to Sprouts we went to North Shore Farms, Junters Meat Farms couldn't get anybody to bite on the space whether it be 40,000 feet or even smaller space than that furniture stores similar scenario there's only a few large furniture stores you can't get a lot of space in there and I think that's a good thing I was instrumental in leasing the Bob's furniture in the Walmart Center many years back also went to different type retailers Tractor Supply and a couple of other tenants who were in the market to try to relocate to this center without much traction we thought that children's play groups like a Dave and Buster's some of the daycare centers they were all contacted with no real response I advertised with signage on the center on what we have loop net and also did mailing specific mailings with with not a lot of response I worked on this for between two and three years with no success so it was divided up because so large tenant would want it and quite ahead of the traction on that so even dividing it and being available for resale space for the back or warehouse space didn't work got some interest but they weren't they weren't fighting on the fact that it had these other detriments I would say we did originally offer the space at a market rate which was approximately $26 per square foot inclusive of taxes and common area maintenance with the 21 is that correct and we reduced it to about $21 okay I would say my opinion is in order to attract someone you'd probably have to get maybe two or three hundred thousand dollars in the space and then you would have to pay two thirds of that rent today if you could get a tenant that's pretty much it thank you thank you
okay our next witness will be mr. Eric Nigel Berg he is the assistant VP of operations for Stony Brook he's going to discuss the day-to-day operations of the B proposed Center as well as a bit about the MSU okay we're attorney sir are you returning are you an attorney all right raise your right hand please I just always swear to tell the truth the whole truth nothing but the truth so help you out please state your name and address Eric Nigel Berg one night fine wood court in this concert New York one one seven six seven are you listening to me I'm not going to lie to you I'm not going to lie to you [transcription gap] N-I-E-G-E-L-B-E-R-G. Thank you. As Mr. Butler indicated, I'm one of the assistant vice presidents at Stony Brook, and one of the areas that I oversee is our EMS service. And I just want to take the opportunity to briefly give you our operational overview of what we envision at this new ambulance station, because it's a fairly unique type of operation. Clearly you can't drive around and look at ten other ambulance stations. They just don't exist. Our goal is to have eight ambulances in the building plus the mobile stroke unit, which would be nine vehicles in total. The reason that we have selected this area is because it's centrally located to, obviously, the Riverhead area, but very important to us also the North Fork and the South Fork. If you look in the handout that Mr. Butler provided to you in Section 4, there is a map of Long Island that identifies not only our current two locations of the mobile stroke unit, which we just referred to as MSU 1 and MSU 2, it identifies the third location that we're looking for. And very important to us is it also identifies the eight emergency vehicles that we have on the North Fork and the South Fork every day. And we need the ability to have a location that is set up in the middle of the road, centrally located to provide the shift change for our personnel, and a location where we have spare vehicles in the event the vehicle needs to go into service, and also have the opportunity for the vehicles to restock as they use their medical supplies. Over the course of the day, we anticipate that we'll have five ambulances in total that are coming in and out of that location. I'm not speaking of the MSU. I'll get to that in a minute. I'll get to that in a second. None of those five are responding to calls from that location. The five ambulances each are staffed with one EMT and one paramedic, which means that over the course of the 24-hour period, there will be ten employees coming to the new ambulance center, and two of them check their ambulance, and then they go to their assigned location. In Section 5, we've actually broken out exactly where the ambulances are going and the time of day. But briefly, at 7 o'clock in the morning, we have an ambulance that would be picked up at the ambulance center and would go out to East Long Island Hospital in Greenport and is stationed there for a 12-hour shift. Another ambulance at the same time goes out to Southampton Hospital, and they're also stationed there for a 12-hour shift. And a third ambulance goes out to the East Hampton Emergency Department, and they're there for 12 hours. A few hours later at 11 o'clock in the morning, our fourth crew starts. They pick up an ambulance for a 12-hour shift at Southampton Hospital. And then at 7 o'clock in the evening, we have one ambulance crew that starts up, and they go out to the East Hampton Emergency Department because that's the only site that we have those ambulances stationed 24-7. The other four ambulances are all coming back. In addition to those vehicles, we have three other emergency responders on the North Fork, one in the Cutrog area, one in the Greenport area, and one on Shelter Island. Those emergency vehicles are staffed 24-7 at those locations. They don't come back to this ambulance center as proposed. But in the event that a vehicle had a mechanical problem, they can bring the vehicle back, pick up a spare, get back in service quickly. We all recognize that in emergency services, time is pretty critical. There's no maintenance that will be done in this facility. If a vehicle is being taken out of service, whether it's for routine maintenance, or a check engine light comes on, the vehicle will be parked, spare vehicle taken and put into service, and then we will bring the vehicle that needs service to our contract repair facility, which is in Brookhaven Town. So, as I said, no repairs would be done there. The mobile stroke unit would also be based there. The mobile stroke unit, as I'm sure you've heard at your prior hearing and you'll hear tonight, is a pretty unique vehicle, but it's also staffed with four people. It's staffed with an EMT, a paramedic, a critical care transport nurse, and a radiology technologist. So between the ten staff members that are coming in and out each day for the five ambulances, there's four additional staff members that will be reporting to work every day. So it's 14 people in total coming in and 14 people in total going out. The mobile stroke unit is staffed from 8 a.m. to 8 p.m. seven days a week. There's no overnight service by the mobile stroke unit. All of the vehicles, when they leave that shopping center, would be leaving to the north as the illustration that Mr. Butler put up at the traffic light. We would not be driving through the parking lot to try to get out to Roanoke Avenue. We would just be going right to Old Country Road at the traffic light. All of those five ambulances that are going out to their designated locations every day, they're not responding on calls, they're not driving lights and sirens, they're driving just like a regular bus. They're driving just like a regular car would be driving. The mobile stroke unit would average about three calls per day, and they would also be exiting at that traffic light. The mobile stroke unit would not be using lights and sirens until they got to Old Country Road. We surely don't want them driving through a parking lot where there might be pedestrians with lights and sirens. As we said, it's three calls per day on average. Currently, more than 50 percent of the calls the mobile stroke unit responds to do not result in a patient being transported. And the reason for that is we are dispatched with the local 911 agency. And when you look at Section 4, that shows you our response area. The response area is a 10-mile radius. So in any of that geography, if someone dials 911, the dispatcher attempts to determine what the medical emergency is. It might be chest pain, it might be an injured leg, it might be a potential stroke. If the dispatcher feels the patient might be having a stroke, they dispatch the local 911 ambulance, and they also dispatch the mobile stroke unit. If that EMS agency gets there before the stroke unit does, after assessment, if they don't think it's a stroke, they cancel the mobile stroke unit. In addition, if they get to the scene and they're ready to transport the patient and the mobile stroke unit is not there yet, they leave the scene with the patient and they cancel the mobile stroke unit. So for that reason, about half of the time, we're not even bringing a patient to a hospital because we're canceled before we have really made patient contact and evaluated the patient.
The only other vehicles, so to speak, that might come and go are probably about once, maybe twice a month, we would have our contracted oxygen delivery vendor, which is called General Welding, deliver some spare oxygen. We have oxygen cylinders, and that's a Monday to Friday daytime operation. At least once, maybe twice a month. And medical supplies that are needed would be brought from Stony Brook University Hospital in one of our first responder vehicles, which is an SUV like a Ford Expedition. And we anticipate that that would probably be no more than once or twice every two weeks or so. It's not a huge use of medical supplies, but we do need to bring medical supplies there. We're not going to have outside vendors delivering directly to that location. My last piece is, and I know I think you've taken a look at that geography, the critical nature of the location, aside from supporting the north and the south fork operations that we're currently doing every day, is that our mobile stroke unit deployment was designed to be able to have a little bit of an overlap because if you have one emergency vehicle and they're on a call and it's a unique vehicle, that means you can't provide the service in that geography. By having some overlap, there's the ability in many, but not all, situations that if mobile stroke unit one, which is based right off the expressway at exit 58, is on a call, if another call comes in and it's a little bit east of them, but in their general attachment area, the second mobile stroke unit can back them up. The second mobile stroke unit is located right off the expressway about a block off of the south part of the expressway that is at 68. And when you look at the 10-mile radius on the map, you'll also see that the projected location for mobile stroke unit three has a perfect overlap for mobile stroke unit two, so that when MSU2 is on a call, depending upon where the next call comes in, they can each provide a little bit of backup service. This is a little bit of a different story. This is not a vehicle that is being parked in Riverhead only to respond in Riverhead. You can see from the map that its coverage area is quite extensive. It extends basically water to water north to south and east to west by 10 miles. And one of the benefits of this location, similar to our other locations, is we need ready access east, west, north, south. And this is a great location for that, whether the call, wherever the call is, the roadways out here are well designed for our use. As I indicated, the call volume is very, very minimal in the overall scheme of things, about three calls per day, and the quantity of staff coming in and out, as I said, is 14 people per day. I believe the traffic engineer will speak to that. Not a very, very large number, at least I don't think it's a very large number, you know, in a shopping center. And the location is ideal for us. So operationally, it works out very, very well. Thank you. Yeah. Our next witness will be Kian Cody. He's a traffic engineer with R&M Engineering. Okay. And I'll just raise your right hand. I do solemnly swear to tell the truth, the whole truth, and nothing but the truth, so help me God. Yes. State your name and address. Kian Cody with the firm of Robinson & Muller Engineering, office at 50 Elm Street in Huntington, New York. Before I begin, we did prepare a report, which I'd like to make part of the record. Sure. And you provided Exhibit 9 as well in the packet? Oh, is it in there? Yeah. All right. Just in case. Sorry. How did it do? It worked. All right. So thank you. Oh, thank you.
insignificant traffic and parking impact on site and within the surrounding area. Additionally, when compared to a retail use of a similar size, the proposed project has a much lower impact on the traffic activity on the surrounding roadway network. To further elaborate in greater detail, I'd like to start with parking. The proposed project is an ambulance storage and resupplying warehouse associated with Stony Brook. The site allows for eight normal ambulances and then the one mobile stroke unit, or the ambulance, though only five of the ambulances are planned for normal use. Shifts on site would be approximately 12 hours, typically running from about 7 or 8 to around 7 or 8 in the evening. From a parking requirement standpoint, via the town code, the project represents a decrease of 10 parking spaces compared to the current mix of warehouse and retail to now a greater size of warehouse and office space. From the town's perspective, this project represents a reduction. The project also represents a reduction in the overall parking requirement on site. To further reinforce that point, we took a look at the parking activity we expect at the site. We first looked at the information provided by the applicant, and that would be for the number of ambulances and the expected calls. Each ambulance is expected to have two crews, with the MSU having a crew of four, or two people per crew, and the MSU having four people per crew. Therefore, we can expect two parked cars per ambulance and four parked cars for the MSU. Thank you. And with five operating ambulances, we can expect ten parked cars and then four more for the MSU, leading to 14 total parked cars. No other personnel is expected to be on site during normal operations. To compare, we looked at the industry standard data provided by the Institute of Transportation Engineers or the ITE and their parking generation manual, sixth edition. The ITE collates data from studies performed across the country and has organized that data into specific land use categories. use codes which then develops rates based off different variables in this case we looked at land use code 821 which is defined as a shopping plaza between 40,000 and 150,000 square feet which we think adequately suits the proposed site based off the average rates provided by the IT we would expect the roughly 14,000 square feet retail use to generate 35 parked cars at its average demand comparing this to the proposed 14 parked cars it's about twice what we would expect so if the space was to be occupied by retail space it would generate about double the parking that we'd expect for the proposed use based off these factors we believe more than adequate parking space would be provided on site and that it actually represents a decrease from reoccupying the shopping center with retail space we also looked at potential traffic activity associated with the proposed project the pre-designed option was the !
stay on site until they called effectively during the peak hour which will say is the 8 a.m. period and then the 8 p.m. period we'd expect three trips for ambulance at four ambulances which is 12 trips and then four for the MSU for a total of 16 trips during the peak hour in total once you had everything up we only expect about 44 daily traffic trips entering or exiting the site in the same vein as what we did with the parking we looked at what the IT would say for a retail use of the same size about the site is about 14,000 square feet for the tenant space the minimum traffic that we expect in a one hour period would be 23 trips with the maximum being up to 73 trips so even during its least active time retail space in this site would generate more than with the MSU would or MSU and ambulances would essentially you know even as least busy it's still not as busy as shopping center this also isn't taking account that if you added more retail there it would generate the peaks at the same time as retail adding on to the existing activity during the commuter periods and the Saturday midday period where the proposed project generates only activity in the morning and then in the evening and then slightly overnight due to the sporadic peaks we also wanted to compare the total traffic like the total daily traffic using the IT and using the same language code the a retail use is about 900 trips per day compared to the you know roughly 40 trips that this would be so it's about twenty times greater in terms of traffic impacts are twenty times less than what the retail space would be so it basically shows that this is a decrease from what retail space would be I lastly want to discuss the traffic along old country road itself and the relative traffic impact of the site as I Like I said earlier, the traffic activity for the total day is about 40 trips or so for this site based off the nearby state count location, which is just to the west on Oak Country Road. Oak Country Road experiences about 21,500 vehicles a day. Therefore, the 44 additional trips is only about a 0.2% increase in overall traffic on the road. This is a de minimis impact and should not be felt by anyone on the road. Additionally, if you look back pre-COVID in 2017, the AADT, or the average daily traffic on Oak Country Road, was 32,000 vehicles, and then in 2020 was 30,000 vehicles. Currently it's dropped down to 21,000, so the road has already seen about a 10,000 vehicle drop in daily traffic, furthering that this road has in the past handled much higher levels of traffic. So, in essence, this is sort of a twofold. Less retail space means less traffic. Cars on the road and a much less impactful use when compared. Based off that, we believe that the proposed project represents a decrease in both traffic and parking activity when compared to a retail use. What do you attribute that decrease to in traffic? Obviously, COVID was a big impact. But after that, maybe a decrease in commercial property along Oak Country Road, as we know, as it has been discussed, brick and mortar stories are sort of... Going down. And I know just in this general area, Oak Country Road is sort of the big... Where you go to do your shopping, it has all the big box stores, so the decrease in commercial activity here could attribute to the decrease in traffic. So, essentially, you don't see it going the other way either? Not with the current climate of Amazon and things like that taking big box retailers. Thank you.
Before I introduce Dr. Fiorella to give his presentation and leave the strictly legal portion of this presentation, I do want to go back to two things that were mentioned. So, first, as I think was described, the staff that will be on this site consists primarily of EMTs, nurses, and MRI techs or CT techs. That doesn't sound a lot more like a medical office use, of which there are a significant number in the shopping center district already. So I think that speaks to the consistency of the use with the area overall. I also want to say that the... Thank you. I want to go back to the question that was raised by council about the comp plan. I know the town of Riverhead just adopted a new comp plan, and I know they worked very hard on it. It was years in the making. But the relief that we're seeking tonight is the use variance, which is inherently contrary to the zoning. It's inherently contrary to a comp plan because you're requesting permission for a use that, under the interpretation that was offered in the denial that we received, is not a permitted use in this district. So if the concern, which I'm assuming here... Is that this use would be somehow contrary to the comp plan update that was just adopted. I don't think that's determinative of the board's analysis, because if that were the case, if the fact that a use is not contemplated in the comp plan means you cannot get a use variance, that means there's never an instance where a use variance can be granted when there's a comp plan in place. So again, if the concern was that this use is somehow contrary to what the comp plan may say about this specific district or even this specific property... Okay. I think the point remains that that's almost an inherent acknowledgement because of the relief that we're seeking from the board. So I just wanted to make that point before we talk more about the MSU, which is more of a medical presentation than it is relevant to the use variance standard. Call Dr. Olue. Yes. Dr. Firo. Thank you. Okay. I guess we're going to swear you in, Doc. Sure. You saw me swear, tell the truth, the whole truth, nothing but the truth, so help you God. Oh, thank you.
I've been practicing neurointerventional surgery now for over 20 years and lecturing about stroke. I never thought that it would take me to lecturing at a town zoning board, but I think once we get the presentation up, you'll find it interesting. Oftentimes when you're lecturing about stroke and medical topics, you're thinking about things that are always shades of gray, and it's very rare that you get to talk about something where there's a black and a white situation, a true and a false. And here it's a good opportunity, and it's a lecture that oftentimes you're excited to give because there's a clear black and a white. And it's clear that the mobile stroke units and the mobile stroke unit program saves lives, and I'll be able to show that once we get our... Justin, would you be able to bring up the PowerPoint on the remote laptop? You should have the mouse there, so you should be able to... I do, yes. It's right over here.
Thanks so much. You can just put us in presenter mode. That would be great.
Great. Oh, yeah. So this is just a picture of the mobile stroke unit. So it's just a little bit larger than a typical ambulance. When you look inside the mobile stroke unit, you can see that... The slides aren't advancing.
You can go forward. I don't know if you can do it on your... No, it actually... Exit out of my Zoom. Okay.
It's not on there anymore.
Okay.
That's working there. Can you get it to work? It looks like it's scrolling through.
Modern technology. We could put the guy go around the moon. Yeah, yeah, exactly.
Justin has it up, so you should be able to advance the slides. Yeah. What do I do to advance it, I guess? There, it's free. Yeah. I see it. And I'm hitting the buttons on the mouse, and the mouse doesn't seem to be doing anything. In fact, you may have to wing it. What's that? You may have to wing it. Yeah, that's okay. You could... Yeah, you can just... This is good. Do you want us to advance the slides as I tell you to? I don't have it on my laptop. Okay, great. Yeah, so I'm going to talk about the mobile stroke unit today, what it is, and how it saves lives. And in order to understand that, you have to understand a little bit about stroke. And so let's go forward one. So this is the inside of the mobile stroke unit. You can see there's the bed where the patient lays in the center there. And then there's the CT scanner, which actually moves forward and is able to do a CAT scan of the patient. There are cameras in the mobile stroke unit where our stroke neurologists who are stationed at Stony Brook and on call for stroke, specifically for the mobile stroke unit, can examine the patients while they're in the unit and do a full neurological exam on the patients. So these patients, as they're in the unit, are getting care from one of Stony Brook's... Okay.
So the mobile stroke gets ahead of the patient quite teleradiology, so that's a neurologist who can see this, teleradiology, so we can transmit these scans to one of our Stony Brook radiologists who can read those and then issue a report on those immediately. It's got a CT scanner and a contrast injector, so we can not only take a picture of the brain right in the ambulance, right where the patient is, but we can inject dye and get a picture of the blood vessels, and we can see if the blood vessels are occluded in the brain, and that's critically important, and I'll explain why. On the unit, we have key medications, TPA, which is a clot-busting medication, so if there's a blood vessel blocked, we can give TPA to these patients after we do the CAT scan. We also have case centroid, which thickens up the blood, so if a patient's had a hemorrhage in the brain and they're anticoagulated, we can reverse that anticoagulation and stop that hemorrhage before it expands and destroys more brain, and so it's staffed by a critical care nurse, a paramedic, an EMT, and a CT tech, so we have a [transcription gap] full-service in the mobile stroke unit. It's basically a mobile emergency room for stroke on wheels that comes to where the patient is, rather than the patient having to come to the emergency room. So some quick information about strokes, if you go forward again, so it's estimated that if you have an occluded blood vessel, a large vessel, going to the brain, that you're losing more than two million neurons a minute. That's how important the mobile stroke unit is in time is in acute ischemic stroke, so two millions of neurons a minute are dying, and the only way to stop that ongoing death of neurons, if the large blood vessel is occluded, is to remove the clot and restore flow to the brain. So if you go forward again, so the problem is there are two types of stroke, and they can look exactly the same clinically. So when you see the patient, they're hemiplegic, say they can't move one side of their body, they can't talk, and that could be because of one or two different types of stroke. You can either be having a brain hemorrhage, where a blood vessel bursts into the brain and starts causing brain damage from leaking or bleeding into the brain, and in that situation, you want the blood pressure low, because you don't want to have a blood pressure that's too high, and you want to have a hemorrhage, you don't want that bleeding to continue, and you want to thicken up the blood so that the blood can clot and stop leaking into the brain. So that's a hemorrhagic stroke, a bleeding stroke. The other type of stroke is an ischemic stroke. In an ischemic stroke, a blood vessel is blocked and the brain is not getting blood and oxygen. In those cases, you want the blood pressure high, not low. You want to have blood pressure encouraging blood to go to that area where there's an occlusion. In addition, you want to thin out the blood with a clot busting medicine to try to dissolve up that clot, dissolve up that blockage, and restore perfusion. So although these two types of stroke can look exactly the same clinically when you see the patient in a regular ambulance, in the mobile stroke unit, we can differentiate these two and immediately start treatment where the patient is. So rather than waiting until they get to the ER door, we're initiating treatment at the patient's door, where the patient is, when we move forward again. Who makes that determination? Neurologists? Yes, yeah, yeah. So the neurologist can participate in the patient's care. So it's like a stroke neurologist. Yeah. My question is, he does it from Stony Brook as opposed to the two EMTs they don't make. Right. They're administering the medications at the direction of the realm. It's just like in the ER, like a nurse gives you a TPA or a nurse gives you a case center, a nurse gives you the medicine to get your blood pressure down, but a doctor is advising them as to what to do. So if you come in, remember stroke, it can be two types, a bleeding stroke or an ischemic stroke. And so we can do a CAT scan on the ambulance. So if you go forward to, so their CT is done, and say it gives you a picture like this. Not only do our neuroradiologists get this picture immediately transmitted, it's going to be transmitted from the MSU. I can get this on my phone. So they'll call and say, Dave, there's a patient in the mobile stroke unit. I can check my phone and I can see that there's this white part here. That's a hemorrhage in the brain. So we want to get this patient's blood pressure down. And if they're on something like Coumadin, perhaps we want to reverse that blood thinning and stop this hemorrhage from advancing and hurting the brain. So go forward again. So in a hemorrhagic stroke, those patients need to get to a comprehensive stroke center. If you go forward another slide. A comprehensive stroke center is a center that is certified to take care of not only ischemic strokes and can do thrombectomies, but they're also certified to take care of hemorrhagic stroke. So they have multiple experts in both of these hemorrhagic and ischemic stroke care formats that can take care of all these. And they're certified to do that. If you go forward again. And so there's just these different types of certifications that you get at a thrombectomy capable center. A thrombectomy capable center focuses on doing thrombectomy, treating the ischemic type of stroke. Comprehensive stroke center treats all type of stroke, ischemic stroke and hemorrhagic stroke. So go forward again and then go forward again. And so let's go forward again. So again, CT scan is going to tell us, keep going forward, whether there's a bleeding stroke and allows us to start treatment immediately and informs a transport decision, get the patient to a comprehensive stroke center, get the patient to the right hospital the first time. What if this happens? So let's go forward again. We do a CT scan and we see, go forward again, this picture. So on this picture, there's no brain hemorrhage here. So we look through, there's no brain hemorrhage, but the patient looks like they're having a stroke. We're assuming that isn't the ischemic stroke, a blood vessel is blocked. And so if that patient satisfies all the criteria to get a clot busting medication right there in the ambulance, right there at the patient's door, we can give TPA or TNK to dissolve up that clot and reperfuse the brain and stop this ongoing brain damage that's occurring. Keep going forward. So keep going forward again. So we do the CT scan. If there's no brain, no bleed, we assume there's ischemic stroke. We can give TPA or TNK if it like they're having a stroke and then we can inject contrast and do a CAT scan angiogram and look at the blood vessels. So let's go forward a couple more. So we have an ischemic stroke now. There's no hemorrhage. We've treated them with TPA and then we inject contrast. And what is that going to tell us? Well, we can see the blood vessels. It's going to tell us if there's a large blood vessel that is occluded and blocked or if there's not. If it's a small blood vessel blockage, one that we can't see on the CTA, then that patient gets TPA. They're treated medically and they're taken to the local primary stroke center. It's like Peconic Bay Medical Center or South Hampton Hospital or Eli, wherever they are. So their families can get to see them. They can get worked up for their stroke there. Keep going forward a little bit. However, if we see that there's a blocked large blood vessel in the brain and that that's the cause of the stroke, that patient not only needs the clot busting medication, that patient needs an interventional procedure called thrombectomy. And there have been multiple recorded randomized controlled trials that show us without a doubt this is like a black and white thing that we know in medicine. If you have a large vessel occlusion, you need to get a thrombectomy. You need to get that clot taken out mechanically as soon as possible because we know that that benefits you in terms of reducing your risk of being disabled by stroke or dying from stroke. So it's absolutely critical that we know is it a bleeding stroke or a non-bleeding stroke. We can determine that in the MSU. And then it's critical that if it's an ischemic stroke, we know is this a large vessel occlusion stroke or not so that we can get you to a place that can perform a thrombectomy or a thrombectomy capable center or a place that can perform a thrombectomy capable center. So that's the first thing we need to do. not. So if you keep going forward again, so we can diagnose and initiate stroke treatment at the patient's door rather than the ER door. Like in stroke care, we're always talking about like door to needle time, door to revascularization time. The door with the MSU is the door of the MSU or the patient's door versus the ER door. So the benefit of this, the great benefit of this, especially for us at Stony Brook, at Connick Bay Medical Center, at Southampton Hospital, at Southside Hospital, all these places. Southside Hospital, I mean Good Samaritan Hospital, all the places in Suffolk County that deliver thrombectomy care is that we can see that there's a large vessel occlusion in the field. So what does that mean? That means I can mobilize my team. I can call my techs and nurses who are going to help me do the case. I can have anesthesia notified and know that there's a case coming in. So if this case happens at 6 o'clock at night or 10 o'clock in the morning on a Saturday, my team can be driving into the hospital to meet the patient. So that's the first thing we need to do. And then the second thing we need to do is to get the patient to the hospital. So if we have a patient that's in a hospital, we need to get the patient to the hospital. And then we need to get the patient to the hospital. And then we need to get the patient to the hospital to meet the stroke patient as they come to that comprehensive stroke center. And then the patient can skip the emergency room and go right into the OR for an immediate thrombectomy. That saves a tremendous amount of time because typically this is the way it works. In the past, before we had mobile stroke units, an ambulance brings a patient, think they have a stroke, to Stony Brook. They do a CAT scan. They get looked at by the ER guys. They get a CTA. Hey, there's a large vessel occlusion. Call Dr. Fiorella. Call Dr. Fiorella's team. And then they're not in the hospital at that time. They have to get in their cars, drive into the hospital. Once they get in the hospital, they've got to set up the room, get the patient over from the ER, and then we do the intervention. You can imagine the time that that takes versus if we're driving and getting everything ready while the ambulance is taking the patient to us. And so how do we operate in medicine? Well, we operate under guidelines. Well, who makes the guidelines for stroke? The American Heart Association stroke section makes the guidelines for stroke. Well, how do they make the guidelines? Well, they have a group. a group of experts and those experts look at all the available medical data and they update this every single year and they publish it in stroke we are bound to practice under these guidelines if you're a doctor or a health system and you go outside of the guidelines you're basically committing malpractice you're not following expert opinion in the field so the American Heart Association has looked at mobile stroke units and then the most recent version of their guidelines what they say is that mobile stroke units enable the rapid identification and treatment of thrombolytic eligible patients with acute ischemic stroke recent studies have highlighted the benefits of the MSU over conventional emergency medical services based on their safety and benefit so the AHA guidelines recommend the use of mobile stroke units whenever they are available these are the guidelines that govern how stroke care is done in the United States of America based on a group of experts evaluating all of the medical literature that exists you ! this was recently published in the journal stroke if you go forward again they based their opinion on multiple concordant meaning they agreed randomized control trials and meta-analysis of previous data so they looked at all the prospective randomized control trials all the previous data they put all this together they convene the panel and they look at it and they looked at MSUs and they saw that they improved functional outcomes at 90 days what does that mean it reduces the chances that you're gonna be disabled from your stroke when they follow you at 90 days it reduced onset to treatment time so they showed that MSUs were getting patients treated earlier when they compared them to just standard ambulances taking patients to emergency rooms it increased the proportion of patients getting intravenous therapy within 60 minutes so we're getting to these people earlier so you can only get TPA up to about four and a half hours after your stroke so if the mobile stroke units come into your door and we're able to get you that medication say an hour earlier than an ER would there are gonna be many more patients who are eligible to get that clot-busting medication in the ambulance right when you get it. And the earlier you get the clot-busting medication, the better it works. And the number needed to treat, the number of patients that need to get that clot-busting medication goes down, comes smaller to see a benefit as time gets shorter. We can go forward again. Again? Yeah, keep going. I had anticipated it, so this is good. Oh yeah, forward? Yeah, you're doing great. So there are multiple studies that have looked at this. Chen reviewed this data in Frontiers in Neurology. And again, he said a comprehensive analysis of current research suggests that MSUs compared to conventional EMS, so that's comparing mobile stroke units to a regular ambulance, results in better performance and time metrics, better safety, more long-term benefits, and it's cost-effective. Keep going forward. You don't have statistics on that? Yeah, I do. I'll get to them in a second. Yeah, yeah. I have our actual statistics. And so the Riverhead community will directly benefit from this service that Stony Brook provides, and it is free of charge to the patients. We don't charge for the TPA or TNK or the imaging or the consults that our neurology system does. This is all free of charge to the patients. The patients do not see a bill from the MSU. So the community is benefiting, and there's really no local cost to the people who are benefiting from this service. Keep going. So these are the spheres in general, or operation of the three mobile stroke units that we propose. And I think that if we get the third unit in Riverhead, the majority of Suffolk County would be covered by MSU services. And I think if we can do this, we could have the lowest rate of death and disability from stroke of any county in the entire country because we would be blanketed completely by MSU services. Keep going forward. So the keys to success of the mobile stroke unit, collaboration and communication, as Eric talked about, we respond with the local units in collaboration with the local units. We cannot make this work if the local units don't participate with us, if REMAC doesn't participate with us, if local units don't participate with us, if local EMS doesn't participate with us, if local hospitals resist this or don't participate with us or don't feel comfortable. So the only way our program can be so successful, and we responded to over 10,000 calls with these two units since they've been in operation, is by working together with all the hospitals, all the primary stroke centers, the comprehensive stroke centers, and all of local EMS. You keep going. And so that's what we do. And in terms of the comprehensive stroke centers, so if you look at Suffolk County right now, there's a couple of comprehensive stroke centers, Stony Brook, Southside Hospital, Good Samaritan Hospital. The mobile stroke unit has brought thrombectomy-needing patients, patients with large vessel occlusions, to all of those hospitals, whether within the Stony Brook system or without. We take the patients to the correct hospital the first time. We take them where they can get a thrombectomy or whatever care they need the fastest. Not necessarily a Stony Brook hospital. We take them where they can get the care the fastest, regardless of network. Our mission, if you go back one, sorry. Justin, can you go back one? Yeah, is that possible? So our mission is to get patients diagnosed and to start appropriate treatments immediately and to get the patient to the correct hospital the first time. So what happens if a patient with a large vessel occlusion goes to a primary stroke center that can't deliver interventional care? They're there and waiting for a diagnosis, and then they have to get transferred to a comprehensive stroke center. That's called door-in, door-out time. Door-in to the primary stroke center, door-out time to get them to a comprehensive stroke center. That time is well over an hour, averaging sometimes two hours at many of these centers that are primary stroke centers. So if an ambulance takes a patient with a large vessel occlusion to a non-interventional center that's not certified to do thrombectomy, that patient oftentimes will sit there for hours while they're losing two million neurons a minute that never regenerate, that never grow back, waiting to be transferred to a comprehensive center for the care that they need and go forward. And that's why it's so important to get patients to the right hospital the first time. So what happens? When we have a mobile stroke unit in action. So you can go forward again. So this is a case. This is a picture I get on my phone. This is a CTA done in the mobile stroke unit. You can see on the right side here, you see a vessel coming all the way out to the side. And on the left side of the picture, you see that blood vessel stops. And this uses AI as well, and it shows us a shading where the blood vessel is not present. And again, I can get these pictures. Our radiologists see these pictures. This is a right middle cerebral artery occlusion. So you can go forward again. So I see this picture. I call my staff in. They come in from wherever they are into the hospital. And my anesthesia is there. We meet the patient right at the door, take them right into the angio suite. So this is the picture at 410 p.m. And you can see there's a blood vessel that comes up. That's the internal carotid artery, a blood vessel that comes off to the side. That's the middle cerebral artery and it just stops. So if you go forward again, I go up with my catheters. I can grab that clot and pull it out. And if you go forward one more time, what you can see here is that the difference in time, these are time stamped. The Siemens machine has time stamp on it. The first picture, the last picture is four minutes. So it's not a problem to get the clot out. We can get that patient to a comprehensive center that has people who know how to do these types of procedures. We can get these vessels open in a few minutes. The whole thing is getting them there fast enough before their brain is dead. Because if that whole right hemisphere is already irreversibly injured, I could pull the clot out and reperfuse that, but it's not going to do the patient any good. So go forward again. So this is the patient's MRI. I scanned a post-operative day one. They had a large vessel occlusion. And right after that, the next day we do an MRI. Any irreversible brain damage on this picture will be bright, bright white. And you can see there's nothing there at all. This patient had no stroke at all. So if you go forward again, you can just hit play here if it's possible. I don't know if you guys have sound. But this is the patient and his wife talking about their experience in the mobile stroke unit. And you can see he's perfectly neurologically intact. I don't know if you're able to play this. But basically... All of a sudden, he's leaning against... the car and he's slurring. And I'm like, what are you doing? And then I look at him and his whole face drooped on the left side. And I just said, oh my God, he's having a stroke. Within seven minutes, this mobile stroke unit came in like the cavalry. They got him into the vehicle and told me they were doing a CAT scan. I'm like, in the vehicle? In the vehicle. And they were like, oh, I guess we have one.
I woke up in the recovery room and I was asked to raise my left arm, push against the fellow with my left leg, okay, and he said, that's really good, okay, because an hour or two ago, you didn't have any control over that. And that's essentially it. I mean, for me, it was no different than sitting on this couch, falling asleep, taking a nap, and waking up and everything was the same as when I went to sleep. What was remarkable to me was every step of the way, the communication level to me, and again, later on, finding with my wife also, okay, was just beyond the charts. Everything was, was broken down right on my level that I could understand, okay, moving forward. That was one of the most remarkable things to me. The staff in the mobile stroke unit deserve a great big thanks. I never met them. I planned to. Dr. Fiorella, his assistant, his nurses. It seems to me the value of having Stony Brook have these stroke units is priceless. And this is why it's such a great privilege to practice this, this type of medicine, because you get the opportunity to do something like this every week. We do more than 200 thrombectomies a year at Stony Brook, and it's an opportunity to do a miracle almost every single day that you drive into work. And that's why I love my job so much. And I love my team so much. But the thing that I don't love is if patients end up at the wrong hospital and wait for three hours and get to me, and I revascularize them and do the case, and they're still irreversibly injured because they just spent too much time, because the ambulance brought them to the wrong place, or because they, they had a delay at the other hospital. And that's what the mobile stroke unit avoids, and that's why it's so important, and that's why it's of such a benefit. You can go forward again. Female Speaker 1 All of a sudden, he's leaning. Dr. Steven Bernthal Just keep going forward. Yeah. So when we look at our own statistics, and these are statistics you were asking for, I think some of them. So there's a bunch of metrics that we use for stroke. And what we can do is we can take the mobile stroke unit statistics and compare them to New York, Suffolk County. And so we've already demonstrated a marked reduction in last known well to IV, TPA, and TNK administration, either within two hours or within three hours. Getting it much faster in the mobile stroke unit than in the door to needle time in the ERs. So they actually, MSUs are faster giving TPA than the emergency departments in Suffolk County in general. And so same thing, the reduction in door to needle time, again, is demonstrated here over to the right side. MSU average is 38 minutes versus New York, Suffolk County, 44 minutes. You can keep going. If we look at reduction in door to femoral puncture, so if you have large vessel occlusion and you need to have a procedure, again, within one hour, 86% of MSU patients are getting into the cath lab and getting their groin punctured and getting a procedure versus New York, Suffolk County, it's only about 1 in 3, 37%. Keep going forward. If you look at door to reperfusion time, again, much higher in the MSU treated patients than in general New York, Suffolk County average. You can keep going forward. But the holy grail here is how are the patients doing? And so if you go forward again, our rates of discharge to home compare MSU to transfer much higher on a percentile basis. You look at MRS less than three, so patients who aren't disabled at 90 days, higher in the MSU than in the transfer patients. And then death in hospitals, so people who die from their stroke in the hospital, it's about half as much if an MSU brings you to the hospital versus if you're brought by a transfer. And so in conclusion here, MSU provides us with faster diagnosis of stroke, faster treatment of stroke, an accelerated revascularization, and improved outcomes in terms of more patients being discharged to home. So you come in with a stroke, so that guy that was talking there, right, if he doesn't get treated, he's gonna spend the rest of his life on the left side, can't move his arm or his leg. He's gotta have other people take care of him, right? We want better functional outcomes, and that's what this gets us. Keep going, and a less chance of in-hospital death. I keep going forward. So it's good for patients. It's good for all the participating hospitals, including Peconic Bay Medical Center, because my colleagues who are gonna practice there eventually when they set up their center and they start doing thrombectomies at Peconic Bay and they get certified, they don't wanna do that either. Like I don't wanna do it where they're seeing a patient who spent a long time in another hospital that comes to them and waited a long time, and they have a large area of completed stroke, and then they're doing a thrombectomy, and it's not gonna benefit the patient. So hospitals will benefit from this. They're gonna now receive a patient coming from the mobile stroke unit with a report from our neurologist who's evaluated the patient with a CT and CTA already completed, telling them what's going on with the patient and what needs to happen, and readings from those things. And so anyway, earlier diagnosis, faster treatment, nationwide in all these studies, and in our specific system, it's led to better outcomes. It's better for the patient first and foremost. It's better for all the participating hospitals, reduces death and disability costs for the community and the people of Rarehead. So this is a rare situation in medicine because there's always these competing things, and I think you're probably gonna hear some of this stuff tonight, where people see everything as a competition. This is a rare situation where we're all rowing oars in the same direction, trying to get better outcomes for patients with this new and amazing technology that we have. And I would ask you not to deprive the people of Riverhead of this type of service, because if that happens, they will have worse outcomes from stroke. I think so. Can I just ask you? Yeah, yeah, please. Right now. Where are the comprehensive stroke centers for suffering? Currently Stony Brook. Right. Southside Hospital and Good Samaritan Hospital. Okay, thank you. Yeah, so there's three. And we brought patients with large vessel occlusions to all of these locations. So if the patient get a thrombectomy faster at a Catholic healthcare system like Good Samaritan, we bring them to Good Samaritan. If the patient get a thrombectomy faster at Southside Hospital, a Northwell hospital, we bring them to that Northwell hospital. This is to benefit the patients. Okay. Could I ask you a question? Yeah, yeah, please do. How many MSUs are there currently located in Riverhead? And will be at the proposed facility? Zero, zero. This is the first one. So we only have two. So you're proposing, you only have one stroke unit? There's only gonna be one in Riverhead. So we have three mobile stroke units in Suffolk County, but that's a very unique situation. I don't know of any other county that's got three that serve it. And so that's why this is really unique. And the mobile stroke unit works best in these large suburban and exurban areas. And I always describe kind of Suffolk County as like the world's largest suburb, or like one giant suburb. It's not like a big city here. And so we have a disparate population distributed across a large geography with multiple primary stroke centers and just a few comprehensive centers. And so it's very easy for these patients with a large vessel occlusion or a brain hemorrhage, patient who need care at comprehensive centers to wind up at one of these primary centers waiting for hours because local guidelines mandate that patients with stroke are brought to the nearest hospital in the absence of something like an MSU or in the absence of REMAC giving them permission to bypass a stroke center because they have a very, very high suspicion. Okay, thank you. Thanks. Dr., just for the record, we want to have the PowerPoint. Do you have like a printed out, the PowerPoint printed out? Yeah, yeah, I'll get you guys a PDF of it. I think, yeah, that's easy to do. Thank you. Yeah, sure.
So we're wrapping up, I promise. But I do want to say, you know, why did we put the board through this lengthy presentation about the MSU when it really doesn't have anything to do with the use variants and the use of the interpretation question? So as the board knows, a letter was submitted after the initial close of the public hearing on, I guess this was February 4th, from the president of the Conakry Medical Center. And to quote, it says, our nearly complete Bill and Ruth Harnish Neuroscience Center, a $7 million capital investment is specifically designed to perform thrombectomies. The vital treatment for LVO cases that Stony Brook suggested would require external transport. Patients experiencing a stroke, experiencing any stroke symptoms, should be transferred directly to PBMC for immediate care as per ASA recommendations, rather than experiencing delays in our transport out of our community. So this was one of the bases, I believe, as to why this board reopened this public hearing is because there seemed to be some miscommunication or misunderstanding about how the MSU would interact with non-Stony Brook institutions, including the Conakry Medical Center in Northwell. What I think has been made abundantly clear through this presentation is that the MSU is actually designed to work collaboratively with any hospital that is within reach that has the necessary capabilities to treat the stroke that is being experienced by the patient. So I'm sure we're going to hear at length from individuals from Northwell. There seem to be a few of them in the audience tonight. But what I think has been made clear is that this is not a supplant of Peconic Bay Medical Center or any other hospital. Rather, this is a complimentary service that will greatly benefit the outcome of patients, including in this community. So I just want the board to take that into consideration as we proceed through this. So thank you very much for your time. MR. Do we have anybody else? You're finished. MR. Nope. I'm done. MR. All right. MR. So we're happy to answer any other questions from the board. Otherwise, we'll conclude. MR. I was going to ask, there's so many numbers here. It's almost like going to class first year college or something. But these ambulances that you're going to have stored in the facility here in Riverhead, there's eight of them. MR. That's correct. MR. And when they go out in the morning, they're not going to calls. They're going to assigned areas on the north and south fork. MR. So actually, what we did for you, if you look at it. MR. Oh, I saw the map. MR. Well, I'm just going to make sure that that's the way I understand it. MR. That's correct. And if you look at exhibit four, we actually pinpointed exactly the locations that those ambulance would be going to. MR. So when they pick up a patient somewhere, let's say in Noyak or somewhere, where do they take them? Not the stroke guy, just the regular ambulance. MR. Well, that's a great question for a medical person in the room, because I don't know what the hospitals out there are. But the answer is they take them to the nearest hospital unless it's a stroke situation. And I imagine they take them to a primary or a comprehensive stroke center as appropriate. Is that correct? MR. Yeah. MR. In the stroke machine or the stroke vehicle if they pick up someone in South Hole or somewhere, where would they take them? MR. It depends. So they do the imaging. MR. Well, isn't Piconic Bay Medical a stroke center? MR. Not. I think it's a primary stroke center currently. But ultimately, I think they will get thrombectomy capable or even comprehensive designation at some point. But currently, yeah, I think they just have a primary stroke center designation. So the ambulance will do the imaging and bring the patient to the most appropriate hospital where they can get the care that they need the fastest. MR. I got you. OK. Thank you. MR. And where is the mobile stroke unit stored? Is it stored with the other ambulances? MR. Yeah. So if you look at the floor plan that we provided.
MR. It's the largest. MR. It's the larger of the spaces that's here. So if you're looking at it in this direction, it's the, oh wait, we don't have it up on the monitor. MR. You got it. MR. OK. There we go. So it's this space here. MR. So. MR. And this is the, here's the garage doors. MR. Perfect. And so it simply exits for a call, returns from a call, and it's back in the bay. MR. That's correct. They're not treating patients in this facility. They're not going to have patients in this facility at any point.
Thank you. MR. Thank you. Thank you very much. MR. All right. MR. So. MR. Here's the next sticker. MR. Anybody wish to be heard? MR. Yes. Alfred Amato from Amato Law Group. Can I ask for a five minute recess? We're probably going to take a couple hours to present. So maybe it's a good time for a restroom break. MR. Sure. I'm going to take a walk. MR. Me too. MS. Justin, can we do that? Take a five minute break? MR. Yeah. MR. Everybody, a little breather.
Thank you.
MR. Do you want to say something? MR. Yes. If I may, members of the zoning board, Mr. Butler requested just a short statement and request prior to Peconic Bay presenting. MR. Thank you again for hearing this application. I was made aware that a submission has been made to this board in the nature of a legal brief from Mr. Amato's office, which I'm assuming he's got that to present on. Obviously, we were not provided with a copy of that paperwork in advance of this meeting. Therefore, we respectfully request the opportunity after the close of the public record to rebut that evidence or documentation, which as the applicant on this matter is our right. I was further advised that Mr. Amato's suggestion to this board would be to keep the record open after this evening. Ostensibly, the matter was reopened at the behest of Northwell so that they could comment on the record, which I believe they're about to be provided amply with that opportunity this evening.
As a former judge would know, this is not a court of law. This is not a place where two parties litigate a matter to its end. This is a situation where you have an applicant present their case, you have public comment provided, and then you have a decision. This matter has already been pushed several months since the initial hearing on January 8th. It was reopened so that they could make their statements and make their case against us, presumably, which they're about to do. Once that is completed, I respectfully request that the record be closed, that we be given the opportunity to rebut their statements, and that a decision be rendered promptly. So that's my request for the board, and thank you again for hearing. Thank you. So I'm a bit confused by the request. So he's going to make comments to what we submit, but the record's closed, so his comments will not go into the record then. That's what that means. And I'm fine with that. But if it's going to be kept open for comments, it should be kept open for both sides. First and foremost, you should have served with the papers. Do you acknowledge that? My papers were completed at 3 o'clock. That's a yes or no question. Well, he didn't serve me with his papers. I served papers on us, but not on him. Is that correct? I handed it to counsel. But you didn't serve it to him. Is that correct? That is correct. OK. Next. Please. Your attorney, state your name and address, please. Alfred L. Amato of Amato Law Group, 666 Old Country Road, Garden City, New York, 11530. I'm here this evening on behalf of Peconic Bay Medical Center, located at 1 Hero's Way. Also, on behalf of Riverhead Motors, the owner of 1076 Old Country Road, which is located directly across the street from the subject property. As the board has heard for the past 90 minutes, 1099 Royal LLC is requesting an interpretation of the code, specifically of code section 301-3B and the alternative use variance pursuant to code section 301-1. Thank you.
headhead
We will pro-offer to this honorable board, the applicant has failed to meet each and every legal requirement that is before them. First, I'd like to start with the interpretation. The interpretation that is requested by the applicant is an absolute direct conflict of the plain language of the code. The New York State Appellate Division has ruled as follows. An interpretation that runs counter to the clear wording of a code is given little weight. It is well established that an ordinance is construed as a whole, reading all of its parts together to determine the legislative intent and to avoid rendering any language superfluous. Further, if the language of an ordinance is clear and unambiguous, courts must give effect to its plain meaning. The applicant alleges that the proposed use is permitted by giving the definition of shopping center an overly expansive reading. Basically, the applicant is arguing that... The words business establishment, which are in fact included in the definition of shopping center, should be very broadly interpreted by this board to confirm that an ambulance garage qualifies as a business establishment. However, this is completely contrary to the plain meaning of the code. Article 22, Section 301.09 is clear and unambiguous. And I actually have that before the board, if I could approach, please. Give it to Helen, please.
So, if you go to section, I'm sorry, Exhibit A, four pages in, where it says, Purposes intent of the... Shopping center district. The intent of the shopping center zoning use district is to provide adequate locations for moderate-sized convenience shopping centers, mainly in Route 58 and central locations that are accessible from adjacent neighborhoods by car, transit, walking, and biking, where residents may purchase daily necessities, such as groceries. Retail development is intended to be arranged in a shopping center layout, with large-scale stores complemented by ancillary small... stores. Professional office buildings are intended to be arranged in a campus-style outlet. So, it's pretty clear here that business establishments are allowed, provided they have this retail nature as demonstrated by the intent of the section. The ambulance garage is, one, not open to the public, two, not a place where there are daily necessities and groceries which may be purchased, three, where there is a retail development, four, where there is large-scale, a small-scale, and a retail development, five, where there is a retail development, four, where there is large-scale, a small-scale, and a retail development, five, where there is large-scale, a small-scale, and a retail development, six, where there is large-scale, a small-scale, and a retail development, six, where there is large-scale, and a retail development, or five, where there is a professional offices. The code is clear, as well, that on the code section 301-112.4 , also at the end of Exhibit A, that garages for parking and storing of emergency vehicles are allowed in the hospital district. The hospital district. So, you have one zone where the applicant is going, right, which is right along with the town's website. It's clear and unambiguous. That you cannot park emergency vehicles. And you have another district, which happens to be right across the street, where they are permitted as of right. So, on December 16, 2025, the town board amended the shopping center district to expand its permitted uses. And that's also at the bottom of Section 301-110, again, in Exhibit A. And so, the expanded uses are shopping center, shopping centers with a minimum of 50,000 square feet, office campuses, health clubs and spas, restaurants, cafes, banquet facilities and ice cream parlors, indoor sports and recreational centers, retail stores, personal services, health clubs and spas, banks, bakeries with retail sales on premises, and specialty food stores. So, I believe that the town board was pretty clear in terms of what the intent of this district is. But, in essence, what the applicant is asking this honorable board to do is de facto act in excess of its authority to amend the very code that the town board amended back in December. New York courts have ruled that the Z-based power to interpret does not extend to actions that would effectively amend the zoning code. This expansive definition of business establishment is requested by the applicant, not only in contravention of the contract, but also in contravention of this board's authority and would have sweeping town-wide impacts. If this board was to adopt such an interpretation, it's really an acknowledgment that the shopping center district could absorb, okay, any use. So, what's to separate this use from other permitted uses in the town, which happens to be a very common use in the town. So, what's to separate this use from other permitted uses in the town, which happens to be a crematory, a commercial testing lab, glass, a glass manufacturer, a printing manufacturer, a canned good manufacturer, an animal shelter or a kennel. These are all permitted uses in the town. So, basically, you have a hospital district where it's permitted. You have these other districts where these other uses are permitted. You have a town code that's adopted by a town board specifically delineating, you know, and expanding what the uses are, but none of them afford the ability of an emergency vehicle to be used in the town. And so, you have these other areas where you have these other uses that are permitted, but none of them offer the ability of an emergency vehicle to be parked and stored and utilized in a shopping center district. So, what I would also refer the town board to is exhibit B. And this is a very interesting exhibit because essentially, if you give this use interpretation, you'd be expanding this use, not only the ambulance use, but possibly all other permitted uses into the shopping center district. with a shopping center district 163 acres so so when you look at this one site and if any decision this board renders it's going to no doubt only have a precedential effect not to this one shopping center but to 40 other shopping center districts across the town constituting 163 acres so you will see here an aerial outlining all those properties and the section block and lot all under sector exhibit B basically demonstrating what the town-wide impact would mean if this use of this interpretation is granted next I'd like to go through the use variance and as I know this board knows but you know just for the sake of the public I just like to go through the standards and also council did you know did thoroughly go through the upward recitation of them so tick 267 b2b states no such use variance shall be granted by a and by the council of the district council and by the council of the district council and by the board of appeals without a showing by the applicant that applicable zoning regulations and restrictions have caused unnecessary hardship in order to prove such a necessary hardship the applicant must demonstrate that has met for statutory factors for each and every permitted use that we dis rate off that's allowed in the shopping center district so the other thing that's very important here failure to meet any one of the four factors you don't have to fail or for you fail one out of the four that is a denial of a use variance as this board knows we will pro office of the board that is that the applicant has you know very clearly failed every single one of these factors first I'd like to get into the fact that there's no in my opinion no proof of competent financial evidence to demonstrate a lack of reasonable return so and much of the quotes that I'm giving you is a straight from the appellant division it is not sufficient to merely submit proofs that attempts have been made to rent out the shopping center with no success but instead the law provides the applicants provide dollar and a sense proof that no permissible use could use a reasonable return council did offer some affidavit of a person who was not here to testifying person who's allegedly has knowledge of the center about one year of perhaps expenses for the site it's not multiple years the council has raised the question as to the camp costs of over three hundred thousand dollars with those one-time extraordinary expenses is that an average is that an average year so I would say we need multiple years we'd like to copy to look at that but also it's not demonstrated for every potential permissible use for instance what if it was a use that rendered six dollars a foot seven dollars a foot the brokers have said they marketed this for twenty two dollars a foot so you have to demonstrate substantial evidence that no reasonable reason return can be yielded all pro offer that the applicant has fallen short of that so I will also refer the board to exhibit C exhibit C is a printout from CoStar which shows 73 retail spaces have at least in the town of Riverhead along old country road these spaces range in size from a couple thousand feet to twenty or thirty thousand plus feet okay so there's pretty good evidence here that if appropriately marked to the right size tenhead that there is leasing activity so you will see that the listing for this property is attached as exhibiting and as as council has stated and as the broker stated they offered to divide the space into two spots for 45,000 feet divided into two spaces hey I guess this is 14,000 and the rest of have to be 30,000 their brochure says well they will divide down to 25,000 a good amount of the leasing activity is for much smaller spaces so we took the trouble and exhibit e to subdivide the otherwise demise the praise this the empty space and if you look at figure one if you fold it out that shows the space is divided into eight eight portions central hallway down the middle averaging 5,000 square feet per space no one has stated that they try to market this to a five thousand square foot table and they're not going to be able to do that because they're not going to be able to do that because they're not going to be able to do that because they if you look at figure two you will see it divided into seven spaces there's a central hallway accessing for the spaces and the other three spaces would be exterior doors one of them would use the exterior frontage of the big lots if you look at the figure three it's divided into six spaces for its for internal through a hallway and two that would have exterior frontage now [transcription gap] signage and you'll see that in both portions of the plan. If you go to Exhibit G, there is a huge marquee sign on the public roadway. I don't know the exact size, but it has to be 20 plus feet tall, maybe 10 feet wide. It seems that any space in the center could give visibility from the public roadway based upon this marquee sign. But wait, there's more. If you go to the next photo, there's a 100-foot facade and part of it is the big lot where they had their signage. In fact, you can see on it, big lots, there's a little impression of it. You can practically put up multiple billboards on this, which clearly could be visible from the shopping center parking lot and from the roadway. So when we say that there's no signage, there's no signage. There's no signage. There's no visibility and there's no tenants interested. Well, okay, so the marketing was only for large spaces. It was not for any small spaces, at least where we could gather, and we haven't heard any testimony otherwise. I'd like to go to what the broker had spoken about. He said one of the problems is no loading zone. Well, if you go to the rear of this building, there's a lot of loading zones back there. If there's a complaint about dead space in the back of the building, there's a lot of loading zones back there. If there's a complaint about the 45,000, well, you can make some of it a loading zone that could feed that space. I don't understand the statement about there's no parking. I mean, we've heard here there's a very large parking lot that all the tenants of the shopping center can access. He addressed visibility. I believe I just addressed visibility. So I think that my take on this is that it was marketed to, you know, I don't know how well it was marketed, but it was only marketed to a very select set of people. So I think that's a very large parking lot. I don't know [transcription gap]
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However, general conditions common to many shopping centers are not sufficient. The applicant alleges the hardship, in quotes, based upon their application, is unique to its property because the affected portion of the shopping center is in the rear of the center and does not have frontage or visibility in any public road. Okay, so I think we just handled the visibility part. And that the alleged condition of having a large space, a portion of which faces the rear property line, I'd pro-offer to this board, every shopping center has this. Every shopping center is full of big box stores that when they go out, right, or other large pharmacy or anything of substantial size, of course there's a portion of it which faces the rear. Okay, the applicant here chose on its own to subdivide that, only that, back space so they could then get prime money for the front space, maybe at some dollar cost averaging or whoever they want to attract to get more dollars in. So by the way they chopped up the space, also by the fact that many shopping centers have rear portions of large spaces, basically we do not believe this is unique. Also by acknowledging, and this is a statement again, that the hardship is due to the ongoing, in quotes, real estate trends that have negatively impacted the marketability of traditional brick and mortar commercial space. In other words, this is a general market condition. It's not unique to this center. Basically they're saying, okay, the retail market is down for big box spaces, therefore you should give us a use variance, but it has to be unique to the center. So that's a tacit admission that it is a unique market condition. That it is not unique because it applies to every shopping center throughout the town of Riverhead and perhaps Long Island, if you take the applicant based upon their words. Next I'd like to go through the third fact there, which is whether or not, and we will pro offer that this ambulance garage alters the essential character of the neighborhood. So first, I think it's a little unreasonable to assume that a large scale emergency vehicle, rate, traveling, or even a large scale accident, is going to cause a huge amount of damage to the neighborhood. I'm assuming at a high speed because every second counts. I think we heard 2 million brain cells die every minute. So I have to believe the driver of that stroke unit has to, even though they don't have the lights on, which is probably another hazard, is moving at a pretty rapid pace to their shopping center. So basically, who do you have in shopping centers? You have regular folks going to shop in their motor vehicles. You have pedestrians. You have moms pushing carriages. You have people shopping. They're not expecting an emergency vehicle basically accelerating through a shopping center to get to a stroke victim. So I'd like to get to Exhibit H now.
Which if you fold this out, I think that the applicant showed you a site plan going around the back of the building, to the west, going through the shopping center, and traversing through it, and only going out the signalized intersection. However, in fact, if they do a straight run through, there's no signal there. So I think it's suspect to believe that an emergency responder is going to choose to go through an extra area of the shopping center, and then sit there to wait at a light, as opposed to going straight, as this figure demonstrates, and to make a right of the pork chop to head east on Old Country Road. You also see here, there's multiple other ways to go out. If they need to go south on Rowan-Oakland Avenue, they would traverse two shopping centers to make the right to go out. There's also another, through the other shopping center, another right out. You would also have to, you could also go through the back of the building. So there's multiple ways that this vehicle could exit, and I would assume, right, that anyone with common sense would assume they're going to take the path of least resistance that is going to save the time for an unfortunate stroke victim. If you could, if you flip through the next exhibit, I'd like to also offer to you, there's another risk that's happening at this site. Okay, and this is not necessarily involving pedestrians, but you will see that around the back of the building, there are multiple blind spots and multiple tunnels that would only handle one way direction. So if you look at the exhibit, you'll see that although it's 24, 8 feet wide, there are multiple pinch points around the building where, and this is where the ambulances are going to go through and the MSU, where it's been narrowed to 15 feet. And you see a truck coming in and an emergency vehicle, which could be an ambulance. It's one lane. It's head to head. So, this has not been addressed whatsoever. The hazards there are just pulling these vehicles around the building. And you'll see, and this is on both sides of the building if you flip through the exhibits. Finally, I have for you an aerial and photos going around the building. And you'll see nine photos driving around the building. And if you look at photo number one, this is heading west. Making the left going south. And you'll see a blind spot coming around. You can't see anything coming around that corner. When you head down, you see how narrow it is. That's number two. If you go to number three, well, here's the pinch point. You have an emergency ramp here. And you're approaching, well, here's a bulldozer. And also garbage and recycling areas. So you're going to have conflicts with delivery of goods, delivery trucks, garbage trucks, perhaps service vehicles. Just clearly, going around the back of this building is not designed for two-way traffic. So if you look at number five, that's also heading south. And if you look at number six, that is heading east. And number seven is making the turn west. And number eight has made the turn on yet another blind corner. And number eight, you can see how narrow it is. And number nine how narrow it is. So the earlier two-dimensional exhibit showed you that there is not enough room for two vehicles here to maneuver around this building. Again, MSU unit, and rightfully so, moving at a high rate of speed to save a stroke victim, now has to deal with oncoming head-to-head, a garbage truck or perhaps a delivery truck or something else. So, So I would once again pro offer that the applicant, this would alter the essential character of this shopping center. But then when you combine this decision with the precedential effect of 40 parcels spanning 163 acres, that by definition will alter the essential character of the neighborhood. For the fourth factor, it's self-created, and I think this application is the poster child for self-created. So a property owner buys a piece of property, knows the physical configuration, knows the zoning code, and then chooses a tenant that basically has a use that's not committed. So by selection of that very tenant, which we believe there's many other tenants out there, it is a self-created situation. And my final point for the moment will be... The town's comprehensive plan. So as council has pointed out for the board, September 4th, 2024, the town of Riverhead updated its comprehensive plan. If I may quote from that comprehensive plan. Page 24 states, the SC district allows for a moderate-sized convenience shopping center, mainly in Route 58, in central locations that are accessible from adjacent neighborhoods. Retail development is intended to be arranged in a shopping center layout, with large-scale stores complemented by ancillary small-scale stores. Professional office buildings are intended to be arranged in a campus-style layout. Page 58. The Route 58 corridor is a major commercial corridor for Riverhead, also known as Old Country Road. This corridor serves as a primary retail district, hosting an array of businesses, shopping centers, and restaurants. So respectfully, I would like to thank the board for their support. Thank you. I would pro-offer that any action by this board to authorize the ambulance garage is in clear contravention of the comprehensive plan, the town code, and established law. And to follow up on the board's council point, 6 NYC RR 617.7 , the creation of a material conflict with a community's current comprehensive plan requires the preparation of a draft environmental impact statement. Page 59. The Route 58 corridor is intended to be arranged in a shopping center layout, with large-scale stores complemented by ancillary small-scale stores complemented by a residential neighborhood. This would not be possible without the implementation of the !
to override the town board's legislative intent in the town code and they have not offered what we see any substitute for the element by element requirements under under the use variance we have a number of people to call I know I disbanded the board a lot but do you have any questions first question yes why is the hospital against us it would seem that they'd be in favor of something that's gonna save lives well are you here to vindicate the town code well first I mean I I think there is a separation here I will I will answer your question sir that would be good um that this is a legal matter and the public benefit is not even one of the legal factors we've combed case law secondly they are not against the use at all they think that in the right setting an MSU is appropriate and I'm not going to put words in there that I'm not going to put words in there that I'm not going to [transcription gap] quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite quite
It's a yes or no question. They like the concept, they just don't like the site. Is that correct? Am I wrong? They don't like the geographic area that it's being placed in, and they think the site doesn't make any sense. Okay. Yes. You cited a lot of cases. Do you have any case law that controls that says an ambulance garage is not a business establishment? Is there any controlling law on this? Not specifically on that. There's no case on all fours in this. It's not decided. On the no stretch of the definition, is it retail? It's not open to the public. This is a retail shopping center district. It's not open to the public. My question is, do you have a case that's on all fours that says that? I'd be more than happy to brief the question for you. So you don't have it now? I think I have cited cases to that extent. I do not have a case that specifically says an ambulatory use in a shopping center district doesn't fit. You have a case? I do not have that very specific set of facts. Any questions?
I'd like to say, though, it is specifically permitted in the hospital district. Right? So the town board knew what they were doing. They put specific uses in specific areas. The hospital district calls out ambulances to go there.
Let me ask another question here.
Has Peconic Bay ever thought of having a stroke vehicle? Again, I would ask Peconic Bay to answer that question. I would be way over my skis if I started answering medical questions, which I believe council said the same thing as well. Okay. I don't have anything yet. Okay. Go ahead. Okay. If I may. Say a few words? Yes.
Attorney? He's one of our clients. Not presently. Good job. Did you answer that yes or no? No. You're right. I just always swear to tell the truth. The whole truth is nothing but the truth. So help me God. Please state your name and address. Leo Sternlich. 28. Watts Hollow Road, Port Jefferson, New York. Thank you. Can you spell your last name please? S-T-E-R-N-L-I-C-H-T. Right.
My family and I own Riverhead Motors, Inc., which owns the property directly across the street from this subject premises, 1076 Old Country Road, the building where Enterprise Rent-A-Car is. Take the call. I must say, I was very confused about the name. I was very concerned when I heard that there were going to be nine ambulances positioned in this property. But the presentation from Stony Brook relieved a lot of my concerns about traffic in that eight of the ambulances will not be dispatched from this location. They'll be stationed out on the east, on the North Fork and the South Fork. I still don't really understand why they couldn't put two or three ambulances in Greenport. And two or three in South Hampton instead of having this big facility here. But that's neither here nor there. And I am still concerned a little bit about these large stroke unit roaring through the shopping center, which I don't frequent that much, but I do go to Staples once in a while, as far as traffic interfering with my tenants across the street. Riverhead Motors also operates in Stony Brook. It operates Riverhead Ford and Riverhead GMC, which are located about one mile west of the subject property. We have about 80 employees. And while I've got to say the doctor gave a beautiful presentation about the benefits of the mobile stroke unit, I really, when he said that they don't get paid, by any of the patients, I don't know if that also means they don't get paid by the insurance of any of the patients. No, there's no bill. They don't get paid in any way, no bill at all. I got to say I have a concern as to whether or not Stony Brook would be doing this unless they were getting a very substantial portion of the medical care that came from this unit at their facility. I know the doctor mentioned that there's a lot of work going on. I know there's a lot of work going on. There are other mobile stroke units further west have taken patients to Stony Brook, to the south shore, and to... I understand why. If you're interested... But just let him... This is not a conversation between you two. Well, I am curious. And I have no idea, and the doctor didn't give any kind of numbers as to whether it was 90% going to Stony Brook and 5% to each of the other hospitals. I don't know what that is. But my skepticism and concern... about my 80 employees and myself at age 72 you never know when you could have a medical event stroke or otherwise just it's a real concern that people be taken to the appropriate location and I would like to know based on some history with other other units that have been out there whether or not there's been a history of consistent patient transport to the most appropriate closest facility thank you anybody else I'm sorry yes Amy
please raise your right hand do you tell me swear to tell the truth the whole truth nothing but the truth the truth so help you God thank you state your name and address thank you for the time this evening I am the president of your local hospital here in Riverhead and I'm here today to answer your question uh judge gazillo around concerns yes for safety public safety in the shopping center but also for for public health i was concerned following the january 8th hearing which i did listen to and i have concerns following that and that's why we're here i do understand this board's position and concern for the welfare of this community i very much share that concern it's why i do what i do and what what the team does uh and so i hope you'll hear me out so for 75 years this year this hospital has served the community and we have worked really really hard to bring services to the community trauma stemmy care right that's heart attack care critical care that we've increased significantly soon women and infants care that's coming and most recently stroke care because we recognize that although we discharge more than 350 stroke patients every year we do have to transfer a good number of them and as dr furella pointed out that is not what we want to do because often we look a patient in the eye and say we're going to have to transfer you for a thrombectomy that's that big stroke that large vessel occlusion we're worried about and patients say to us please don't transfer me it's going to be really hard for my family and we don't want to have to do that and so we have invested heavily with the support of the harnesses and this community in a thrombectomy capable center so we have built a center we have hired the team and we just cut the ribbon maybe you saw it in the newspaper just last week and we're going to be doing a lot of work on this the mobile stroke unit is a really really cool unit there's no doubt technologically speaking and there are areas of this island that are not served by a thrombectomy capable center take for example the south fork and east there is no thrombectomy capable center so when you think of a thrombectomy capable center you're going to be looking at a number of different areas and you're probably quite familiar with the gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead gheadhead
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unit a couple hundred yards from a hospital that will be from back to me capable in a matter of weeks is frankly it seems wasteful in terms of health care resources and my concern is that is actually made to lay care that's correctly grow they're not putting a stroke facility there there's just garaging the cause the trucks there that's my understanding the unit is not going to be it's just the vehicles the mobile stroke unit that's the ambulance with the cat scan in it is going to be housed as far as I understand it across the street from the hospital serving said pardon me but you said that they gonna have the mobile stroke unit of course no they're just gonna pocket them their service area is 10 mile radius around where they park it that's next to the hospital so what I'm suggesting is that we may see delays in care related to that because because an ambulance can pick up a patient and bring directly to a hospital a mobile stroke unit is not a hospital but an ambulance is not equipped with so many equipment that the mobile stroke unit has is that correct the hospital is and it's within 10 miles you're within 10 miles they could be on the scene right but what if it's not a stroke we can what if all night we can and then the regular we don't need this but you know what if nobody people that people didn't have strokes no I'm sorry yeah we all agree time is brain we all agree with that okay there is no no debate about that there was no debate about the value of a mobile stroke unit however in an area directly adjacent to a thrombectomy capable center, which was not recognized even in this presentation tonight, okay? We recognized primary, and we recognized comprehensive. We will be thrombectomy capable, okay? That is a very important distinction, and the American Stroke Association speaks very, very clearly that patients should be brought directly to a thrombectomy capable center. Those are the guidelines. That's what they will do. They will take you to the center if you were the center. I have concerns that that will happen, and that's for a couple of reasons. One, if there's a mobile stroke unit going across the street from the hospital imminently, they've bought the vehicle. I have not heard from Stony Brook's team about this. We don't share images. The phone call that was referenced or getting images on the phone, we do not receive those. That's a great question, and history shows us that that has not been the model in our other hospitals.
This thing about the critical time, I get confused. I'm old.
there get the patient a tree and whatever and then they got to run them back to the hospital that's time while the stroke unit when they're there from what the doctor says they're applying some of the technology that's available like right now that's that's why I can't get my arms around it I mean I don't and they got to be I mean if they're picking up somebody with are you a set of where they would drop that person off okay so what of weeks yes so what so what so Matt attack you mentioned Matt attack so someone calls 9-1-1 in Matt attack Matt attack volunteer goes to the house picks up the patient and drives to Pagani Bay Medical Center or someone in Matt attack calls on 1 1 they wait for the mobile stroke unit from Riverhead to get to Matt attack to be stationary in the driveway you can't even see the patient's face because they're there to do a CAT scan to have the CAT scan read and the evaluation done and then they decide where to go or Matt attack can drive the patient directly to Poconic where they can come to an emergency department with physicians with a cat scan time is going you know time is moving to get there to pick them up and evaluate and then they're gonna take them to the hospital the time is moving whether when the patient gets a pap smear or a pap smear or a pap smear or a pap smear or a pap smear or a pap smear or a pap smear or a pap smear or a pap smear or a pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear pap smear
building a center and you're building a high quality center you need you need to do the work you need to do it well our stemmy center okay which by the way was opposed or heart attack center was opposed okay hundreds of lives saved we opened this in october of 2017. by 2022 we were top 100 in the country why because we do it a lot and it's important you know the example that the chairman gave about what manitowoc i think there was three different options that you said about when the ambulance they just want that third option that's all why don't you why don't you want to give them that third option give who that third option it's the uh it's stony brook why don't you give them the third option of having the the vehicle there i don't understand the question i don't understand why there was three options with the ambulance without the ambulance et cetera and they just want to have one of those helmets what option i i don't i don't know what the third option is what what i what i said the option is that they use their vehicle and you say no you don't want this available in other words stroke center is available as an option it's not a stroke sensor it's a mobile stroke unit right that can do a cat scan yes it's and it's it's very very different it's and as i mentioned there are areas of long island that need that sort of service because they lack close access to a thrombectomy capable center
riverhead is a stroke center the hospital is a stroke center we're not debating that i don't i don't understand that i'm just asking um !
who does this every day good thank you god i want to have a cramp here tonight please raise your right hand do you tell me swear to tell the truth the whole truth and nothing but the truth so help you god i do please state your name and your address my name is uh jeffrey katz uh my address i guess it'll be one of my office addresses uh 270 east main street in bay shore new york so i have i have i have the whole statement i was going to make but uh just to go back to your point because i think it's been late already um first of all i think there's some misunderstanding and i think misunderstanding stems from how this is being portrayed to this committee and of course you're making decisions on a zoning rule not on the medicine but i think you're making that decision based on a community need you believe that the community would benefit from a mobile stroke unit so we should alter the zoning rules just to allow some community benefit and i applaud that in a way um i think the challenge is is that there have been some misleading statements about the capabilities of peconic bay medical center made by my colleague tonight and also back in january that i think makes it seem that only stony brook could handle these large stroke patients which is in fact what was said back in january that the patients that are in a mobile stroke unit are going to be taken by the hospital and then taken to a center and he said it tonight that could treat the patient as quickly as possible peconic bay is a thrombectomy capable center not certified yet program opening in two weeks we've invested a ton of money in creating this program what you need to have a thrombectomy cable this is for the surgeries where we go in and i do these procedures as well as uh our colleague here dr fiorello we go in and we pull blood cuts out of people's brains you can't do that in a mobile stroke unit right so the mobile stroking is meant specifically to give intravenous medication to bust a clot usually for smaller blood vessels there's two million brain cells per minute is meant really for those larger strokes so the patients that have a really big blood clot that we need to do an operation we need to do a procedure where we pull that blood clot out of the patient's head the challenge here and again i think everyone's coming from a good place i think that a mobile stroke unit certainly has its place but to have a mobile stroke unit operating within a few miles of a hospital that can actually provide the care and to bypass that hospital take them to stony brook which is what they're going to do and i can tell you i've had experience with this i've run the stroke program at south street university hospital and when we became now we're a comprehensive stroke center but when we became a thrombectomy capable stroke center back in 2020 we approached the stony brook team including dr fiorello and i were on a phone call together on zoom and i approached them saying hey listen we're a thrombectomy capable joint commission new york state certified center you know we want you to start bringing those patients to south street university hospital we you know obviously have the capabilities now to treat those patients those large vessel occlusion patients and dr fiorello basically ended the phone call and said we're not going to have this conversation and that was the end of it now yes now we do get some patients from the mobile stroke unit i don't know the numbers i was told a couple patients we get a few we are now comprehensive stroke center but what you got to understand is to treat an ischemic stroke which is a blockage type stroke with a blood clot to treat an ischemic stroke there's only two ways of doing it there's intravenous thrombolysis and there's the claw retrievals yes you want to do everything as quickly as possible but to get a patient to take a patient from this area let's say a patient down the block has a stroke the mobile stroke units dispatch they go to the patient they do the imaging they bring that patient to stony brook 40 minutes away from here that's very different than bringing them to paconic bay and our fears are not going to be the paconic bay because of our past experience with this mobile stroke unit dr fiorello was very careful tonight under oath to say to you that well we'll bring it to the center that could treat the patient the quickest you know not too soon sharing their data we're not sharing our data I don't know how they know who's gonna do the patients treat the patient to quickest but we have a team that has more than 15 years experience doing thrombectomy we have a biplane room the biggest biplane the biggest suite in the entire Long Island state-of-the-art just just installed within the last couple months they're not going to bring those patients to us and those patients are going to be taken to story wrote that when when it was asked before what's the motivation here if they're not charging for the patient you're not charging the patient for the TPA they're not charging the patient for the imaging why is Tony Brook do it is this a pure altruism is it some you know big grant that they got to do this no the goal is to get patients to your hospital it is to treat patients it's to treat them as quickly as possible there's definitely benefits they have hospitals further out east you should put your mobile stroke unit further out east you should put your mobile stroke unit further out east where you could actually make a difference for those patients because they're not within a few miles of a stroke center that could do a thrombectomy and then take the patient to the closest thrombectomy capable stroke center they're very careful they would not take this patient to a thrombectomy cable stroke center before and our opinion is they're still not going to do it even though they're saying something different tonight a few questions if I could so aren't there American medical standards acceptable practice for ambulance services and quote treatment at the nearest certified facility for that type so I understand maybe six months ago you weren't I'm gonna mispronounce it for I'm not to be capable but you were I'm gonna mispronounce it for I'm not to be capable but you weren't I'm not to be capable but you weren't I'm gonna mispronounce it for I'm not to be capable but you weren't were now so even if a ambulance Riverhead volunteer ambulance the Stony Brook Medical Unit that we're talking about any patient if it's a stroke right I would think they would have to bring it to the nearest hospital that certified and if you failed to do that if you failed to do that if you failed to do that I would think the amount of litigation that that would think the amount of litigation that would ensue for lives either lost or compromised the health compromised of a patient you would pay
I can't imagine that these standards don't exist and that they're not a requirement. Those standards do exist. Patients are supposed to be brought to the nearest stroke center. There was actually an argument a few years back with me and Dr. Fiorello in front of where he was positing taking patients away from a primary stroke center and transferring them only to the comprehensive stroke center at Stony Brook. And there was argument over evidence and literature, and there's always two ways to read articles, and we all have our opinions. But you're right. That's how it should be. But the reality is no one's policing that. And I will tell you that the mobile stroke unit can be close to South Street University Hospital, and they do not take a patient to us for thrombectomy. The other problem for us is when they don't take a patient- Well, you just got certified for that. True. Like, how long? How long has that portion of the hospital been certified up and running? South Street University Hospital in Beecher has been up and running since 2020. Peconic Bay. The Peconic Bay, they're starting to do some simple angiograms now. The room is being approved by New York State within the Department of Health within the next two weeks. That is when the program will start. They're not yet certified. Sorry? They're not yet certified. It's not. Well, it's not yet certified by the Department of Health, not yet. That's in the next two weeks. They just did a ribbon cutting within the last two weeks. It's a beautiful room. Everyone should come see it. But that program will be starting in the next couple weeks. And the problem is for this community, because this program is built for this community. This program is not built for patients in this community to be taken 40 minutes away from here. This program is built for this community to have excellent stroke care. And I've been doing stroke on Long Island longer than anybody. I've been here since 2006 before the Stony Brook program even started with thrombectomy. And I will tell you that a lot has changed on Long Island and a lot has changed in the country in terms of stroke care. But the goal of stroke now is to democratize this entire thrombectomy procedure by having more centers, invest in centers to do thrombectomy. Not just have, in the beginning, when I first got here, North Shore University Hospital in Manhasset was the only hospital in Queens. Brooklyn and Long Island to do thrombectomies. We got patients from Stony Brook for a few years when I first started. Now you have three comprehensive stroke centers on Long Island. You have, I mean, in Suffolk County. You have a couple more in Nassau County. You have a thrombectomy-capable stroke center now opening up in Riverhead. And I hope Stony Brook opens one in one of their hospitals out east. This is great for the community. And the mobile stroke unit is great. But it's not necessary for this area right now. It may have been necessary in this area five years ago or even two years ago. But now, with a state-of-the-art thrombectomy-capable stroke center right in your neighborhood, it's not necessary. And that's just the reality. Well, can I ask you a question just by way of example? If I was suffering an incident and testing was done in the mobile stroke unit and they were, were able to determine whether I was having a massive bleed, a blockage, right then and there, they would be able to administer. Let's say it's a blockage. They're going to thin my blood immediately. That's true. And then they're going to be able to take me to Peconic Bay Medical and treat me. So isn't there something? I mean, to be said for that procedure where potentially I haven't lost, you know, potential brain capacity and injury when I recover. I don't know. And I think, I think we all want patients to be treated as quickly as possible. The question is, is there really a community need to have a mobile stroke unit operating within 10 miles of Peconic Bay Medical Center, which now can pull that clot out, whereas before they weren't able to. Now they can. Now you can get there more quickly than you can get to Stony Brook and you can be treated more quickly than you can get to Stony Brook and you're not going to be taken to Peconic Bay by this unit, most likely given the past history that we've experienced and I've experienced again through both South Shore Hospital and we're anticipating at Peconic Bay. But you're right. The medicine, by the way, doesn't open up the big clots usually. The medicine is good for the smaller clots. So yes, there are certain proportion of stroke patients that do benefit from the tenecteplase, which is the IV medicine. But the large blood clots, these large strokes that you need a surgery for, those medicines are not very effective for that. We still give it, but the treatment has to be that surgical procedure and that's the same thing. You want to have that done as quickly as possible. So just a quick question. Assuming, arguendo, that every ambulance, including the mobile stroke unit, followed, I don't want to misstate it, but American, American-based, American-based, American-based, American-based. So are the�� is they do not share their films with us. So for South Shore, for instance, if they bring a patient to us, which there have been a couple in recent history, we have to repeat the imaging because we can't see their imaging. In order for us to make a decision on what we're going to do, we need to see the imaging. And they don't share their imaging. We also don't have their stats. They don't share their data with us. So we're trusting what's going on. I don't know what stroke neurologist is seeing the patient in the ambulance. So yeah, our team still has to evaluate the patient when they come to the hospital. We have to repeat the imaging. Imaging is CAT scans. CAT scans carry radiation. Radiation carries cancer risk. CAT scans with contrast site, there's a risk of kidney damage from contrast site. So we don't like to repeat imaging. We don't want to have to repeat imaging. Certainly if Stony Brook wants to say, yeah, sure, we're in the catchment area of Pathonic Bay and we'll share our imaging, we'll share our stats and our data. We'll send the patient, we'll bring the patients to your center and not, you know, there's a little equivocation. Well, only, you know, who could treat them the quickest? Without knowing our data, without knowing their data, then, you know, it might not be an issue. But that's not been our practice with them. And that, you know, the same thing, you know, when we were in front of REMAC, we had these conversations, NYU, Catholic Health, Northwell, were on one side and Stony Brook was on another because they're pretty aggressive with this, with these situations. Because they've been the only game in town for a long time in this area and now other game, and they should build more stroke centers, put other biplane rooms in your other hospitals and have thrombectomy capable centers. And we could really help more stroke patients even, you know, more than we can now, because driving from like East Hampton to either us or to Stony Brook is actually pretty far. Even, you know, for us, you know, Northwell has a helicopter. So if it's a critical patient that has a ruptured brain aneurysm or something, they're at Peconic Bay Medical Center, they have to come to a comprehensive center. We fly them with a helicopter to North Shore, to South Shore, I mean, which is about nine minutes away. So yeah, there's, we have a network. Unfortunately, the hospital, the systems do not, they don't share. So that's been the challenge that we've had in Bayshore and South Shore Hospital. And I'm afraid that's what would happen here. And that's why I think, you know, from a trauma standpoint, I don't think the patients are gonna benefit overall from this MSU. So if there was an agreement or a requirement of share of information, would that make a difference? If you got the shared information, we'd be good, right? Yes. If they would share their imaging and they would take the patients to, you know, they would be in the area and they would take the patients to Peconic Bay, to our program, then sure. You indicated that their goal is to get patients to their hospital. Right. Sounds to me like you have the same goal. We all have the same goal. These are, we wanna get the patients, but we have the, but the difference is, our goal is to do it in this community, with these people, you, people living here, are in this community. Right. That's our goal. Our goal, we've invested money in patients in this community, not 40 minutes away where Stony Brook is. Doc, forgive me, my background with medicine, don't be offended, I used to teach medical malpractice. Well, something I'm more familiar with, there's this fentanyl going on now, and I understand, correct me if I'm wrong, there's a drug that you can give to counteract the fentanyl. Only some strokes. Well, I'm talking fentanyl, you're talking strokes. I'm talking about fentanyl. Are you listening? No, I can't hear you, I'm sorry. Oh. This drug, fentanyl. Oh, okay. There's a drug, I understand, that the police officer can administer at that time? Yes. Yes, a shot. Right. Yeah. What they're saying is, when someone has a stroke, for lack of a bit of analogy, we have that drug in the ambulance, and it's there. You may have it in the hospital, but they have it on the scene. Yes. One, it takes about 15 minutes to do the imaging, and then they can give it on the scene. Two, that medicine, it's not for all ischemic, stroke patients. I think that's a misunderstanding. That is for a very select few stroke patients. There's a very certain limited time window for the administration of that medication, and that medication's great in certain patients, but it doesn't work the most. This intravenous medication, is that what they do? It's called tenecteplase, the one for stroke. Whatever you call it. Tenecteplase, T and K. Yeah, I don't care what you call it, but they can do it on the scene. Yes. As opposed to transporting the person to get it done. That's what. Yes. That is what. That is the difference. That's why the data is that you could treat a patient more quickly with thrombolysis, which is the IV medicine with a mobile stroke unit in certain circumstances, for sure. All right, you made your point. Okay, listen, doctor, thank you. Mr. Mitchell, I think you want to speak too. Thank you very much, doctor. Good evening. So, I'm here to swear you in. Oh, yes, right. I do. So, I'm here to swear you to tell the truth, the whole truth, nothing but the truth, so help you God. I do. Please state your name and address. Andrew Mitchell, 50 Laurel Way, Laurel, New York. Thank you. Good evening. It's been a long night. It's getting longer. This might be the longest one, I think. I'm not here for signed variances like I was in the past. I'm here tonight partly because I was the 25-year president of Peconic Bay Medical Center, and I'll give a little Stony Brook history to that briefly. But I'm really here because I was asked to voluntarily serve for three years, because that's how long it took. We had a few hiccups along the way, on the comprehensive plan update. And I took that role very, very seriously. I was semi-retired at that point, and I spent a lot of time with it. And as you've heard tonight, and by the way, not to be obnoxious, but I thought this was the Zoning Board of Appeals, not the Medical Board, right? I'm sorry. The Zoning Board of Appeals. We're not. So I appreciate all the medical stuff tonight, which I don't believe a lot of, but I appreciate it. But this is really the Zoning Board of Appeals, right? And what we're really talking about tonight is whether this shopping center is the right location for a mobile stroke unit and eight other ambulances. The comprehensive plan was a very thorough process. We went out to the community. We held community forums. We invited everyone in the community, all the shopping centers, all the people that lived in the town, to provide comments. And they did. We got tons of comments. Not one comment from this shopping center owner. You would think if they were contemplating the need to revise the facilities there, it would have been discussed and possibly reviewed. And it was possibly included in the comprehensive plan. After the comprehensive plan was updated, the broader issue of big box retail was addressed by the town board. And as you heard from the lawyers, by the way, the definition of a hospital administrator is a lawyer and a doctor practicing without a license. So the town addressed that. And they allowed broader uses, none of which involves putting ambulances in the back of some parking lot that, as you heard, you can't get in and out of. You know why they couldn't rent the place? Have you guys ever been in there? So I spent a fair amount of time in Harbor Freight. I spent a lot of time in West Marine. My wife yells at me about that all the time. And I banked at Beth Gage, a federal credit unit. For up until August of this year, that spaceship we have, up there shooting the moon, could have shot the parking lot because the lunar craters on the moon are smaller than what was in that parking lot. Nobody could go into that parking lot. And no one was going to lease in there. It was a disaster. And you've heard that a lot of other places have subdivided. And that's what they need to do there. This isn't the place for an ambulance center. Come on, guys and gals. It makes no sense. You've heard all the reasons. It's the zoning board of appeals. That's what we're talking about here. You want the mobile stroke unit and aid ambulances, there are plenty of other places to put it. So you may know I also helped the Riverhead Volunteer Ambulance Corps raise a lot of money for their new ambulance center. I asked the folks there, why don't we just move it over to the New York State? Ambulance Center? I said, why don't we just put a mobile armory on 58? The town owns it. You know what the answer was? Are you kidding me? Put the ambulances on 58? We'll never be able to get up and down the road. It's too congested. And that isn't even by the circle, with four things going around in circles. Put the MSU in, you'll save a stroke patient, but you're going to cause about three more traumas to come in. I don't know how you get a mobile stroke unit out of that facility. I have to turn on the lights and siren, because when I go in there, I wait two traffic lights just to make a left-hand turn to get out. There's one entrance, one exit with the traffic light. This is not the place to put this. I could sit here and give you all the reasons why the mobile stroke unit doesn't make sense. And I'll give you one. Just in the Riverhead area. By the way, I think it's a great program. I don't know why in God's name Stony Brook's putting it in Riverhead. You know, closer to Greenport, or put it out on the South Fork where it makes sense to put it. But you've got a thrombectomy unit about to open. OK, so I'm not going to pick on a restaurant on 58. I'll take a vineyard. Vineyard in Ackerloch. Sorry, Charles. Person's sitting there having a nice glass of wine. All of a sudden, heels over in the patio, and is on the ground. First impression is? The guy drank two. He drank too much. Let's dial 911. Nobody's thinking stroke. Everyone's thinking he's had too much alcohol. So the Riverhead Volunteer Ambulance Call gets there in seven minutes, you think? From headquarters? Down 58? Let's give them seven minutes. They get there. They assess the patient. They said, wait a minute. We think this patient could be having a stroke. OK, let's call the mobile stroke unit in. OK, let's say it's located in the shopping center, which is where they're going to locate it all the time. It's not going to be out driving around. It's going to be in the shopping center. All right? Another seven minutes to get to the winery. OK, now we've got to get the patient into the back of the mobile stroke unit. Hope the damn thing's working, because it's just gone over 15 potholes on its way out there. Now we're going to spend 15 minutes doing a CAT scan. OK, so total time elapsed 15, 15, 30 minutes. Oh, patient's got a stroke. Oh, wait a minute. It's a big stroke. All right, we've got to get the patient to the hospital. I won't argue where they're going to take the patient. OK? 15, 10 minutes back to the hospital. 25 minutes. 30 minutes. Whereas if Riverhead Volunteer Ambulance just picked up the patient, took them to the hospital, and they're not going to be able to get the patient back to the hospital, they're going to be in the hospital for a long time. So the patient gets送headed to the hospital. The 35 minutes or 40 minutes becomes 10 minutes. whole stroke ready team ready to go they assess them they've got three cat scanners that aren't banging around on the road and bingo it's done that's the medical side but you're not the medical board you're the zoning board the question is does this qualify for a use standard i would argue based on the comprehensive plan all of the arguments the high-priced lawyers are making no it doesn't find another location for it if they're so convinced that this thing should be in riverhead there's got to be other locations and why would you want to open up the zoning board in the town to the potential for 40 other properties along 58 to come to you and say well you granted a use variance for that we want to use variance for this it's not medical it's a garage it's not a dental center there's no doctors there there's no dentist there it's a garage find out the place for the garage i rest my case and i came all the way up from florida first thank you thank you folks uh if i made dr we should
that not a lawyer i just saw this way to tell the truth the whole thing nothing but the truth state the name and address jeff zilderstein z-i-l-e-e-r-o-s-t-e-i-n one hero's way i'm the chief medical officer at the comic bay medical center um i just want to focus on one thing and and it actually piggybacks on what andy was talking about we love the idea of bringing care to patients and the mobile stroke unit does that so we are very much in favor of that and the questions that you are asking about the medicine and i'm not going to talk about the legal i'm not going to talk about the zoning just talk about the medicine are really apropos somebody has a stroke in matatuck so that's what we're talking about somebody has a stroke in matatuck they have stroke-like symptoms they have an ambulance come to them and they have the mobile stroke unit if they're lucky enough to have a stroke during the day okay 8 a.m to 8 p.m right so they're lucky enough to have a stroke during the day then the mobile stroke unit is deployed and the local ambulance is deployed right it will take some time for the mobile stroke unit to get to matatuck the volunteer ambulance at that point is already there can pick up the patient and bring the patient to a hospital that can perform all of these different procedures but wait we're going to wait for the mobile stroke unit the mobile stroke unit is going to take a certain amount of time it's going to take a certain amount of time can then uh once once they get there they're going to have to then spend a certain amount of time getting the imaging right talking to the telehealth specialist so the teleradiologist tell the radiologist so it's not as though we can just administer narcan the way that you guys were asking before about fentanyl we want to be able to provide the fastest stroke care because every minute is two million hours so we're going to be a [transcription gap] stroke center today, going to be a thrombectomy center in the next several weeks we're going to be applying for that. So that's the point here is that, yes, we want fast, but I would let you know that if you're in Matatuck or if you're 10 miles away from here, or if somebody, God forbid, has a stroke this moment, would you rather have the mobile stroke unit come here and pick you up and actually treat you there or just bring you down the road to Peconic Bay Medical Center? If it's me, don't wait. Just get me to the nearest hospital that can treat me. Don't do this stuff in the driveway. Get me to a safe place where they can manage my airway and they can do all of the other things. That's what I want to say. Thank you very much. Ann Marie, excuse me. It's 9 30. We've heard a lot of information. Do we need any more? We have the community, I think, would like to speak. We don't have anything else from our end. How much more are you going to pick? It's not me. You have community members. Do you have any idea how much longer it's going to take? I don't know. A few minutes. I don't remember the committee yet. I'm Italian. I can go fast. Yeah. Let's go. Don't speak with your hands, remember.
Okay. You solemnly swear to tell the truth, the whole truth and nothing but the truth. So how have you got? Please state your name and address. My name is Carrie Nijen. I live at 1131 Ostrander Avenue in Riverhead, New York. Very good. Welcome. Thank you. Good evening, board members. My name, like I said, is Carrie Nijen and I reside on Ostrander Avenue, more specifically the first house south of Morton Drugs. So I am well versed on how bad decisions, especially those impacting high traffic areas, can profoundly affect our community's quality of life. I want to make it clear that I'm not opposed to an ambulance, barn or mobile stroke unit. I'm opposed to a car accident, but why can't they locate it in an area of town where the use is permitted and won't negatively impact the community? Several years ago, the charter school wanted to build next to their existing building on Middle Country Road, but it was zoned light industrial. During town board work sessions that were televised, the town board said that they would not be amenable to grant a change of zone to the charter school and that they should research areas of town that were appropriately zoned for them. It took several years, but they did find one. The proposed ambulance was located in the area of town, but it was not able to be used. The proposed ambulance use is not permitted use within a shopping center zoning use district. They too should go find an area of town that is appropriately zoned for them. As I stated, I live on Ostrander Avenue across the street from Gala Fresh and Restaurant Depot. It is zoned shopping center. So if the ZBA starts granting interpretation variances to allow ambulances and MSUs into every shopping center in the town, I will never be able to get out of my driveway. Which already is an issue because of the BJ's gas station. The BJ's gas station and the shopping center where Gala Fresh is located. An operation including eight full-size ambulances plus a mobile stroke unit that looks more like a heavy rescue truck than an ambulance and the associated staff vehicles will generate traffic in an already very busy shopping center, which I frequent. The parking lot is already a hot mess with three shopping centers sharing cross access along with five ingress and egress areas that lead to confusion, bottlenecks, accidents, near misses. Local traffic is also not available. The parking lot is already a hot mess with three shopping centers sharing cross access along with five ingress and egress areas that lead to confusion, bottlenecks, accidents, and near misses. Along with adding congestion along Route 58 and that circle and Roanoke Avenue with these five entrances and exits. It is reported that they will be servicing ELIH south and east Hampton areas. Well then they should move closer to those locations rather than planting themselves 1500 feet from a state recognized stroke center with new neuroscience center capable of performing cerebral mechanical thrombectomies. Taking patients away from this center to any Stony Brook facility 40 miles in either direction of PBMC is not an easy task. I would like to thank the staff for their support. Thank you. [transcription gap] minutes for an area variance application. When I watched the ZBA hearing for Stony Brook for this use variance, which has a much tougher threshold than an area variance, I was shocked to see the board hardly asked a question and quickly concluded it after 15 to 20 minutes. And I'm only pointing this out because there was an obvious disparity in treatment by this board between a local organization that had been in the community for over 100 years for an area variance versus a huge corporation trying to, who's just showing up in this town asking for a use variance. And watching the January meeting, it was easy to see that Stony Brook's application did not at all address any zoning criteria. And I respectfully implore that the town board use the same level of review that you use for other variance applications and the devastating precedents that you may set by allowing similar relief for healthcare systems in shopping centers all over Route 58 when they are not zoned for such uses. You can say that each application has its own merits, but when you open that floodgate, it will be hard to close. And I appreciate your time. Before you go, it's N-A-J-D-Z-I-O-N. I got that right? Yes. Thank you very much. Thank you. I just wanted to make sure that there was a petition with 100 signatures opposed in the application. Do you have two different ones? No, I have one. You have one. So these are different? Yeah, they're different. And also, someone who left a willy. Willie Walker was a resident and asked us to submit that on her behalf. I think this is one remaining member of the community that would like to say a few words. I'll say it. All right.
I do solemnly swear to tell the truth, the whole truth, nothing but the truth, so help you God. I do. Please state your name and address. Jennifer. J-E-D-L-I. C-K-A. Excuse me. 3 Green Ash Street, Calverton. I want to reiterate some of the points that have already been made. The mobile stroke unit, great idea, in the wrong place. The garage is in the wrong place. I came out here about 10 years ago from Huntington for quality of life issues, for safety issues. And I have to tell you that this project. It's a big negative. Safety issues alone. Conditions on Route 58. Sometimes bumper to bumper traffic. And the conditions within the traffic circle on Roanoke. Where we have accidents once or twice a week. And ambulances flying around to get out of that shopping center. With the traffic light. They're not going to sit there at that traffic light. They're going to take a break. They're going to take other exits. I've been to that site in terms of the building itself. And I can tell you, I drove around the back. And you heard what Andy said. It's a nightmare back there. You can't get two vehicles through at the same time. Another thing that's also very essential in this community is to recognize the makeup of the community. We have a lot of elderly citizens that go into that parking lot for the various services in that shopping center. If they see an ambulance coming, they're immediately, intuitively going to move out of its way. Some of them are not so stable on their feet. Some of them are on walkers and canes and fat. They could fall. They could fall right in front of that ambulance. And there could be total chaos. And that individual could wind up in the emergency room. It's a duplication of the reality. It's a duplication of effort as well. We have a wonderful Riverhead Ambulance Squad, a volunteer squad. They've been serving the community for years. They're in the process of expanding. They're right here. They quickly get patients to the hospital for whatever the needs are, stroke, cardiac issues, pulmonary issues, whatever. You heard me. You heard. We will soon have an incredible center here which can serve stroke patients. We have a wonderful team of doctors who are capable of first-class medications and first-class techniques. And there is no need to transport a patient to and from various hospitals. If we have it right here in town. We also have to recognize that our stroke center here has a five-star rating from health grades. And it's one of 158 hospitals in this country that has received a commitment to quality award for stroke care. So I would say to you, and I'm not going to go on with some of the other points that I've said, but I would say that we have a great community. We have a great community of doctors.
And I'm not going to go on with some of the other points I've made, but I would say to you that this is not in the community's best interest to have a garage basically with ambulances coming in and out of a shopping center. It is also not in the community's best interest to have additional traffic and potential chaos at certain times of the day when traffic is more severe. And what do we do? at 8 o'clock at night when this unit is not operating. We're going to go back to Riverhead Ambulance Corps, taking our residents to the local hospital for their stroke care or whatever the other health issues might be. So I would say to you that public safety, it has a tremendous impact on that. I'd also say to you that I don't want to see a garage in the shopping center on a main thoroughfare in this town, which violates code regulations anyway. I don't want to see that exemption. I don't want to be in a position in this community as a taxpayer to be solving the problems of a landlord or an owner who can't rent the space as it now exists. That's not our problem. And I would say to you that we need to be more flexible. We need to be more flexible. We need to be more flexible. We really need some time to investigate this project more thoroughly, investigate the resources that we have in this community, and get more input on this project. So I would offer the thought that the Riverhead Zoning Board of Appeals should either table this for further inquiry or should deny the application. Thank you. Thank you. I'm going to make a suggestion that we close this meeting tonight and we'll leave it open for two weeks until April 23rd for written comment and then place it for a reserved decision for the first meeting in May. Between you and the board and everyone else here, we've heard a lot of information. We will digest all this. We'll leave it open for two weeks. We'll look into it, just like the lady just said. We'll investigate and we'll come out with a decision. Mr. Chairman, unfortunately, we were accused. We've got to talk over there. The applicant was accused of making misstatements, and that was the reason that this board reopened this hearing, I believe. And I know personally from having discussed this at length with my client for the last month and a half that there were material misstatements just made on the record by almost every single witness that they put up here. I would like the opportunity to have my client get up here and correct those misstatements on the record. Most notably of which is that you heard several times that they will transport patients to Peconic Bay Medical Center. And I think at least three of their witnesses got up here and said that they're lying. Flatly said they're lying. So those are statements made under oath, by the way. So I would very much appreciate just a couple more minutes of this board's time so that Mr. Fiorella, Dr. Fiorella can address this. I only have just a couple of minutes. I'm sorry. We've heard enough on this. I think we can make a decision, all right? I believe that you can. So thank you quite a lot.
that it's going to close the hearing but you have two weeks you can submit whatever you want for zoning board consideration I understand that but while statements are fresh and memories are fresh I think it would behoove the board to listen to what we have to say now I'm not in the mood for that I'm sorry okay I appreciate it and I think everybody did a nice job in their presentations thank you for the doctors that are servicing our community mr. chairman can we have a motion just mr. chairman can we have a motion to close the hearing allow written comments until April 23rd and reserve decision for May 14 so moved mr. Barnes mr. Parchetta all right I vote aye I vote aye so we'll see you guys on May no no minutes the next meeting date is April 23rd 2026 motion to favor aye aye
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