HomeMy WebLinkAbout1000-115.-11-4.1 (2) OFFICE LOCATION: o��OF SU!/r�,Ol MAILING ADDRESS:
Town Hall Annex P.O. Box 1179
54375 State Route 25 [ J�t Southold,NY 11971
(cor. Main Rd. &Youngs Ave.) N ,e
Telephone: 631 765-1938
Southold, NY 11971
coUNTY,�
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: Leslie Weisman, Chair
Members of the Zoning Board of Appeals
From: Mark Terry, Assistant Town Planning Director
LWRP Coordinator
Date December 18, 2018
Re: LWRP Coastal Consistency Review for ZBA File Ref FRANK AND PAULA DOKA#7229SE
SCTM# 1000-115-11-4.1.
FRANK AND PAULA DOKA#7229SE— : Request for a Special Exception under Article III, Section
280-13B(13). The Applicants are the owners of subject property requesting authorization to legalize an
"as built"Accessory Apartment in an existing accessory structure, at: 755 Lupton Point Road, (Adj. to
Deep Hole Creek) Mattituck,NY. SCTM#1000-115-11-4.1.
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of
Southold Town Code and the Local Waterfront Revitalization Program(LWRP) Policy Standards.
-Based upon the information provided on the LWRP Consistency Assessment Form submitted to this
department, as well as the records available to me,the proposed action is recommended as
INCONSISTENT with the below LWRP policies.
Policy I Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,
and minimizes adverse effects of development.
Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem.
The as built accessory apartment unit was constructed in the accessory building without obtaining
regulatory permits.
A ZBA variance(6711) was issued in 2014 on the property that required the installation of a 20' wide
perpetual, landscaped buffer landward of the tidal wetland line. The submitted plans and surveys do not
show the buffer. Verify if the buffer is in place. If it is not in place, it is recommended that it is
constructed.
The location and function of the sanitary system has not been provided and is unknown. Past plans
submitted to the Town only identify"area of septic systems" and provide no further details.
In the event the application is approved it is recommended that landowner is required to replace the
existing sanitary system with an I/A On-site Wastewater Treatment System due to the proximity to Deep
Hole Creek. Funding may be available to replace existing systems through
littp://www.reclaimourwater.info//._
Pursuant to Chapter 268, the Southold Town Zoning Board of Appeals shall consider this
recommendation in preparing its written determination regarding the consistency of the proposed action.
Cc: William Duffy, Town Attorney
BOARD MEMBERS Southold Town Hall
Leslie Kanes Weisman,Chairperson �� SQUrif� 53095 Main Road•P.O.Box 1179
!O Southold,NY 11971-0959
Patricia Acampora Office Location:
Eric Dantes CM Town Annex/First Floor,Capital One Bank
Robert Lehnert,Jr. COQ 54375 Main Road(at Youngs Avenue)
Nicholas Planamento ��yCC'nUM Southold,NY 11971
http://southoldtownny.gov
ZONING BOARD OF APPEALS E C Ee nn V E
TOWN OF SOUTHOLD
Tel.(631) 765-1809•Fax(631)765-9064 A U G 2 018
Southold Town
Plammnq Board
August 28, 2018
Mark Terry, Principal Planner
LWRP Coordinator
Planning Board Office
Town of Southold
Town Hall Annex
Southold,NY 11971
Re: ZBA File Ref. No. # 7227 ᰽SE Doka, Frank and Paula
Dear Mark:
We have received an application to legalize "as built" addition/alteration to an existing
single family dwelling, and legalize "as built" accessory apartment in accessory garage:
A copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning
Code), and survey map, project description form, are attached for your reference.
Your written evaluation with recommendations for this proposal, as required under the
Code procedures of LWRP Section 268-51) is requested within 30 days of receipt of this
letter.
Thank you.
Very truly yours,
Leslie K. Weisman
Chairperson
By:
Encl.
Survey/site plan: Peconic Surveyors P.C. Dated November 21, 2013
TOWN OF SOUTHOLD
ZONING BOARD OF APPEALS
Phone(631)765-1809 (63t)765-9064
APPLICATION FOR A SPECIAL EXCEPTION PERMIT FOR AN
ACCESSORY APARTMENT IN AN ACCESSORY BUILDING
Application No.: 7,�a4q �J
Date Filed:
Applicant(s)Name(s) mn �1All
Applicant(s)Address
(House No., Street,Hamlet,Zip Code and mailing address if different from 1 liysi al address)
Applicant(s)phone number(s) C�1 4 -L-A,LA 3 2-
1
-1 Uwe are the owners of the subject property
[ ]I am the agent for the property owner and my Letter of Authorization and Transactional
Disclosure Form is attached.
A. Statement of Ownership and Interest:
is(are)the owner(s)of the property
known and referred to as
-1 CES C___�' UP 400 Pr PIA aii 41) y
House No. ' Street '' Hamlet j Zip Code
Identified,on the Suffolk County Tax Maps as District 1000, Section Block-1-1
Lot(s) 4 e @ Lot Size Zonp District_R40 as shown on the attached deed and survey
0 Q'- iC) 4y f
The above-described property was acquired by the owner(s)on
l
Uwe hereby apply to the Zoning Board of Appeals for a Special Exception Permit pursuant to Section
§280-13B(13)of the Zoning Ordinance to establish an accessory apartment in an accessory building as
shown on the attached survey/site plan and floor plan(s)
B. Project Description: r
C. The applicant alleges that the approval of this special exception would be in harmony with the intent
and purpose of said zoning ordinance,and that the proposed use conforms to the standards prescribed
therein and would not be detrimental to property or persons in the neighborhood for the following
reasons:
D. The applicant alleges that the following standards prescribed by Section §280-
13(B)(1 3)(a)-(k)of the zoning ordinance will be met:
a. The accessory apartment will be located in the accessory building.
b. The owner of the premises shall occupy either the existing single-family dwelling or the
accessory apartment in the detached accessory structure as the owners' principal
residence.The other dwelling unit shall be occupied by a family member as defined in
Section §280-4 of the code or a resident who is currently on Southold Town's Affordable
Housing registry and is eligible for placement,evidenced by a written lease,for a term of
one or more years.
c. The accessory apartment shall contain no less than 450 square feet and does not exceed
750 square feet of livable floor as defined in Section §280-4 of the code
d. The accessory apartment will be located on one floor of the accessory building and will
contain only one full bathroom.
e. A minimum of three on-site parking spaces shall be provided as shown on the attached
survey.
f. Not more than one(1)accessory apartment shall be permitted on this parcel.
g. No Bed and Breakfast facilities,as authorized by Section §280-13(B)(14)hereof shall be
permitted in or on the premises for which an accessory apartment is authorized or exists.
h. The accessory apartment will meet the requirements of a dwelling unit as defined in
Section 280-4 of the Zoning Code.
i. This conversion shall be subject to a building permit,inspection by the Building
Inspector and Renewal of Certificate of Occupancy annually.
j. The existing accessory building which is converted to permit this accessory apartment
has been in existence and has a valid Certificate of Occupancy issued prior to January 1,
2008,and is attached hereto.
k. The existing building,together with this accessory apartment,shall comply with all other
requirements of Chapter§280 of the Town Code of the Town of Southold.
1. This conversion for the accessory apartment shall comply with all other rules and
regulations of the New York State Construction Code and other applicable codes.
E. The,property which is the subject of this application(check all that apply):
[ ]has not changed since the issuance of the attached Certificates of Occupancy
[ ]has changed or received additional building permits. Certificates of Occupancy for
these changes are attached or will be furnished
`[ has been the subject of a prior ZBA decision(s),copies are attached
cQ
Owner Signature
COUNTY OF SUFFOLK)
ss.:
STATE OF NEW YORK)
Sworn to before me this 2_,� day of ,20(,V
(Notary Public)
Revised 06/2011
CHRISTINE ROMANO
Notary Public,State of New York
No.01 R06197036
Qualified in Queens County
Commission Expires November 24,2020
QUESTIONNAIRE
FOR FILING WITH YOUR ZBA APPLICATION
A. Is the subject premises listed on the real estate market for sale?
Yes __v/ No
B. Are there any proposals to change or alter land contours?
�No Yes please explain on attached sheet.
C. 1.) Are there areas that contain sand or wetland grasses? no
2.)Are those areas shown on the survey submitted with this application? ' U
3.) Is the property bulk headed between the wetlands area and the upland building
area? �3<5
4.) If your property contains wetlands or pond areas,have you contacted the Office of the Town
trustees for its determination of jurisdiction? kqC Please confirm status of your inquiry or
application with the Trustees: CLI"r,Ju Anc t)zect ta41,40'Mid if issued,please attach
copies of permit with conditions and appr-dved survey.
D. Is there a depression or sloping elevation near the area of proposed construction at or
below five feet above mean sea level?
E. Are there any patios, concrete barriers,bulkheads or fences that exist that are not shown
on the survey that you are submitting?Please show area of the structures on a diagram
if any exist or state none on the above line.
F. Do you have any construction taking place at this time concerning your
premises? --, If yes,please submit a copy of your building permit and survey as approved
by the Building Department and please
describe: t,
G. Please attach all pre-certificates of occupancy and certificates of occupancy for the
subject premises. If any are lacking,please apply to the Building Department to either obtain
them or to obtain an Amended Notice of Disapproval.
H. Do you or any co-owner also own other land adjoining or close to this parcel? If
yes,please label the proximity of your lands on your survey.
I. f Plgase list present use or operations conducted at this parcel t n 1 1
�4 Li t and the proposed use �S i\ l-e
. �-Qt Cc l c,�,a�_(ex: existing single family; roposed: same
with garage,W61 or other)
Iss is 0
Authorized signs re and:Date-
APPLICANT'S PROJECT DESCRIPTION
(For ZBA Reference)
Applicant: N�Y O L rl�b k0. Date Prepared: l� I
I. For Demolition of Existing Building ATeas
Please describe areas being removed:
R. New Construction Areas (New Dwelling or New Additions/Extensions):
Dimensions of first floor extension- �' x &—09 Cc UR
- Dimensions o�new second floor: T Yo1� '' `
Dimensions of floor above second level:
Height(from finished ground to lop of ridge): ' a m'
Is basement or lowest floor area being constructed? If yes,please provide height(above ground)
measured from natural existing grade to first floor: Cj CCS
III. Proposed Construction Description(Alterations or Structural Changes)
(attach extra sheet if necessary)- Please describe building areas:
Number of Floors a d General Characteristics BEFORE Alterations:
�—
Number of Floors and Changes WITH Alterations:
IV. Calculations of building areas and lot coverage(from surveyor):
Existing square footage of buildings on your property: a S
10 S�
Proposed increase of building coverage. 1 S-�-
Square footage of your lot: &yjo S
Percentage of coverage of your lot l(y building area: � Si 1
V. Purpose of New-Constructio : tU2, -e A- _-gac.y--M) on t- c-olt24��
�G1'1 C-� G0R pct
VI. Please describe the land contours(flat,slope%, heavily wooded,marsh area, etc.) on your land
and how it relates to the difficulty meeting the code requirement(s): 1
no rin(all �0ax, all
Please submit seven(7) photos,labeled to show different angles of yard areas after staking corners
for new construction),and photos of building area to be altered with yard view.
7/2002; 2/2005; 1/2007 �` Q �
AGRICULTURAL DATA STATEMENT
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use
permit, site plan approval,use variance, area variance or subdivision approval on property within
an agricultural district OR within 500 feet of a farm operation located in an agricultural district.
All applications requiring an agricultural data statement must be referred to the Suffolk County
Department of Planning in accordance with Section 239m and 239n of the General Municipal
Law.
1. Name of Applicant: _
2. Address of Applicant:` 5l_V�-her, �� .. �lG`I �'h�CiK 1195 2
3. Name of Land Owner(if other than Applicant):
4. Address of Land Owner:
5. Description of Proposed Project: 4C4cko C ,jNC;;2, �, � C1C�e5'�CS'L#
. �l - Cj a .r -�,�' �J J
6. N Location of Property: (road and Tax map
number)
7. Is the parcel within 500 feet of a farm operation? k Yes } No
8. Is this parcel actively farmed? { } Yes P�J No
9. Name and addresses of any owner(s) of land within the agricultural district containing
active farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning
Board Staff, it is your responsibility to obtain the current names and mailing addresses from the
Town Assessor's Office(765-1937) or from the Real Property Tax Office located in Riverhead.
NAME and ADDRESS
Ir� n ��11
^ I " e e,f" `Farms 4-
2. s o Y` M�� ' t7 52-
3.
4.
5.
6.
(Pie e u b of t ' e if there are additional property owners)
r _Si re of Applic c.._Date
1. The local Board will solicit comments from the owners of land identified above in order to
consider the effect of the proposed action on their farm operation. Solicitations will be made by
supplying a copy of this statement.
2. Comments returned to the local Board will be taken into consideration as part as the overall
review of this application.
3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property
owners identified above. The cost for mailing shall be paid by the Applicant at the time the
application is submitted for review.
Frank and Paula Doka
755 Lupton Pt. Rd.
Mattituck, N.Y. 11952
July 30, 2018
Town of Southold
Zoing Board of Appeals Special Exception Dept.
54375 NY-25
Southold, N.Y. 11971
To Whom it May Concern,
This letter is to inform you that only our own family members(parent and child)will be planning
to occupy the accessory apartment located on the second floor level of the detached garage at
755 Lupton Pt. Rd., Mattituck, N.Y. 11852, D:1OOO,S: 115, B: 11, L:4.1.
You may contact me with any questions or concerns at(914)443-1589.Thank you for your time
with this matter.
ur (e.l Dok& �o eft
�i --11 '? 13�s s' e
Frank Doka (:5")
Homeowner
County of Suffolk)
State of New York)
Sworn to before me this 30th day of July, 2018
(Notary P(Nic)
ANGELA A. MANGELS
Notary Pu biic State of New York
No.01 MA610'044
Qualified in Si.'fc,;k County
Commission Expires iviarc��15,2011
Frank and Paula Doka
755 Lupton Pt. Rd.
Mattituck, N.Y. 11952
July 30, 2018
Town of Southold
Zoing Board of Appeals Special Exception Dept.
54375 NY-25
Southold, N.Y. 11971
To Whom it May Concern,
This letter is to inform you that only our own family members (parent and child)will be planning
to occupy the accessory apartment located on the second floor level of the detached garage at
755 Lupton Pt. Rd., Mattituck, N.Y. 11852, D:1000,S: 115, B: 11, L:4.1.
You may contact me with any questions or concerns at(914)443-1589.Thank you for your time
with this matter.
(AO 'e(
06o-� Ijr+VA -� 3 6 Sincerely,
Paula Doka (D""3lA der If, 1 om)
Homeowner
County of Suffolk)
State of New York)
Sworn to before me this 30th day of July,2018
AA
(Nota �u+blic)q n1lpp �+
ANNGELA A. IF'tAN"117,LS
t'jt«ry Pub114 5-^'. -v York
v. „ ,i3iGlifLAjaidb match i.,GQo
Town of Southold Annex 2/25/2013
�yofFot,t`�a t
u 54375 Main Road
Southold,New York 11971
PRE EXISTING
CER'T'IFICATE OF OCCUPANCY
No: 36140 Date: 2/12/2013
THIS CERTIFIES that the structure(s) located at: 755 Lupton Pt Rd, Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.-11-4.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 36140
dated 2/12/2013 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling with two finished rooms in basement and concrete patio.*
Note:BP 35523 deck replacement COZ34386.
The certificate is issued to Drobet,Michael&Drobet,Peter
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF IIEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
A o ed gnatu e
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 755 Lupton Pt Rd,Mattituck
SUFF.CO.TAX MAP NO.: 115.-11-4.1 SUBDIVISION:
NAME OF OWNER(S): Drobet,Michael&Drobet,Peter _
OCCUPANCY: _
ADMITTED BY: John DeReeder _
SOURCE OF REQUEST: Drobet,Michael&Drobet,Peter DATE:^2/12/2013
DWELLING:
#STORIES: 1.5 #EXITS: 4
FOUNDATION: cement block CELLAR: full CRAWL SPACE:
BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE: small cement
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: X HOT WATER:
#BEDROOMS: _ ~ #KITCHENS: 1 BASEMENT TYPE: 2 rms finished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: small shed
SWIMMING POOL: GUEST,TYPE OF CONST: _ �^
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: GARYF DATE,OF INSPECTION: 2/6/2013
TIME START: 9:30am END: 10:30AM
SUFFnjq.�' Town of Southold
2/2/2017
P.O.Box 1179
o P" 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38809 Date: 2/2/2017
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 755 Lupton Pt Rd.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.41-4.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/25/2016 pursuant to which Building Permit No. 40720 dated 5/25/2016
was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
ADDITIONS AND ALTERATIONS INCLUDING COVERED FRONT ENTRY WITH DECK ABOVE AND
REAR SECOND STORY DECK TO AN EXISTING ONE FAMILY DWELLING PER ZBA DECISION#6711
DATED 01-23-2014,AS APPLIED FOR
The certificate is issued to Ameen,Carolyn
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38830 12-09-2015
PLUMBERS CERTIFICATION DATED 01-10-2017 H y Plumbing
4
Ohoed Signature
��o�X.-A=A
uFFOt,��OGy Town of Southold 2/2/2017
0
P.O.Box 1179
o + 53095 Main Rd
'y,1j01 �ao�' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38810 Date: 2/2/2017
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property: 755 Lupton Pt Rd.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 115.-11-4.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/25/2016 pursuant to which Building Permit No. 40720 dated 5/25/2016
was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
UNHABITABLE ACCESSORY TWO-CAR GARAGE AS APPLIED FOR
The certificate is issued to Ameen,Carolyn
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38830 12-09-2015
PLUMBERS CERTIFICATION DATED
s
ho '.ed Signature
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34386 Date: 06/04/10
THIS CERTIFIES that the building DECK
Location of Property: 755 LUPTON PT RD MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 115 Block 11 Lot 4.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 3, 2010 pursuant to which
Building Permit No_ 35523-Z dated MAY 3, 2010
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is REPLACEMENT OF AN EXISTING DECK ON AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MICHAEL & PETER DROBET
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ N/A
PLUMBERS CERTIFICATION DATED N/A
i
Aut46rized Signature
Rev. 1/81
1111111 IIII IIIII IIIII 11111 IIIII IIIII IIIII IIIII IIII IIII
I Illill IIIII IIIII IIII IIII
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 05/31/2017
Number of Pages : 3 At: 09:42 :52 AM
Receipt Number : 17-0090746
TRANSFER TAX NUMBER: 16-32362 LIBER: D00012914
PAGE : 558
District: Section: Block: Lot:
1000 115.00 11.00 004.001
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $1,350,000.00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $15.00 NO Handling $20.00 NO
COE $5.00 NO NYS SRCHG $15.00 NO
EA-CTY $5.00 NO EA-STATE $125.00 NO
TP-584 $5.00 NO Notation $0.00 NO
Cert.Copies $0.00 NO RPT $200.00 NO
Transfer tax $5, 400. 00 NO Mansion Tax $13;'500. 00 NO
Comm.Pres $24,000.00 NO
Fees Paid $43,290.00
TRANSFER TAX NUMBER: 16-32362
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
oa
Numbel of pages
-31 RECOP.DED
2017 Ilay 31 09:42:52 Ali
JUDITH A. PASCALE
This;document will be public CLEW, OF
ce=oid, Please remove of, SUFFOLK'COUtITY
Social Security Numbers L D00012914
P 558
prior]to recording. DT# 16-32362
I
Decd/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1 ,
FEES
Page/FJling Fee 5-- Mortgage Amt.
1
Hand1.Basic Tax
Nrig 20. pO
' 2. Additional Tax
TP-584SubTotal
I"
Notatlon Spec./Assit.
EA-52 17(County) �-j: or
SubTotal Spec./Add.
EA-5217,(State) TOT.MTG.TAX
R.P.TS.A, Dual Town• Dual County
( Held forAppointment
"Comm.of Ed. :5. 00 "
s Transfer Tax•
Affidavit! � Mansion TaI . x
Certified Copy �� The property covered by this mortgage is
or wilt be Improved by a one or two
NYS Surcharge 15, 00
Sub Total family dwelling only.
i
Other YES orNO
Grand Total If No see a
y , pproprlate tax clause on
page' of this'Instrument.
T3 Z
4 Dlst. 170176/9 5 Community Preser+;ation Fund
11 I
1'000 11500 1100 .00•4oal
• T
Real Property
Tax Serv12d R DHO A11�11j111�111����lfl��p1�1111111i1111llllllll Consideration Amount'$
Agency 26-MAY-1 T' ax Due
$
Verification, CPT —
Satisfactions/Discharges/Releasds List Propp�erty Owners Mailing lddress aC! Improved
6 RECORD&RETURN T0:
Vacant Land
SC-.d I. I•eel Kztr%eTO
Re TD
I TD
Mall to:Judith A.Pascale,Suffolk County Clerk
i 310 Center. Drive, •Riverhead„; Title Company information i
NY 11901•
Co.-No "
www.suffolkcountVnY.gov/Llerlc LL N v✓; S
Title# r�ps �-� •� S
$ S'uffo.ik couriji,:Recording &- Endorsement Page
This page forms part of the attached
bY' (SPECIFYTYPE OF INSTRUMENT)- made
The promises herein Is situated in
Fv� SUFFOLK COUNTY,NEW YORK.
/^ TO in the TOWN of-��,
In the VILLAGE
orHAMLEf'of
BOXES 6 THRU 8 MUSTdE TYPED OR PRIMPED IN DLACK INK ONLY PRIORTO RECORDING OR FILING.
Standard N Y.B T.0 Form 8002-Bargain and Sale Deed,wnlh Covenant against Grantors Acts—Unlfonn Acknowledgment
Form 3290
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE,made the Ia day of May,2015
BETWEEN
CAROLYN R.AMEEN AND DEANEAL CARLTONY FORBES,each as to an undivided 50%interest,
residing at 755 Lupton's Point Road, Mattituck,New York 11952,party of the first part, and
FRANK DOKA AND PAULA DOKA, husband and wife,residing at 2750 Glenn Road, Southold,
New York 11971,party,of the second part,
WITNESSETH,that the party of the first part,in consideration of Ten and 00!100--($10.00)--Dollars,and
other good and valuable consideration paid by the party of the second part, does hereby grant and release
unto the party of the second part,the heirs or successors and assigns of the party of the second part
forever,
All that certain plot,piece or parcel of land,situate, lying and being on Lupton's Point in Mattituck,Town of
Southold,County of Suffolk and State of New York,bounded and described as follows:
BEGINNING at a point on the northerly side of a 20 foot right of way distant 720 feet easterly as measured
along the northerly side of said right of way from the corner formed by the intersection of said northerly
side of right of way with the,easterly side of Marratooka Road;
RUNNING THENCE along the,land now or formerly of Manus, North 4 degrees 03 minutes 40 seconds
West,208.48 feet to the southerly side of a 15 foot right of way;
THENCE along the southerly side of said right of way and through a monument North 78 degrees 47
minutes 10 seconds East 110.79 feet to the mean high water line of Deep Hole Creek;
THENCE southeasterly along Deep Hole Creek measured on a tie,line bearing South 49 degrees 00
minutes 57 seconds East,44.78 feet to land now or formerly of Kreiling;
THENCE along said land now or formerly of Kreiling the following two(2)courses and distances:
(1) South 28 degrees 44 minutes 00 seconds West, 98.24 feet;
(2) South 10 degrees,14 minutes 50 seconds East,100.00 feet to the northerly side of the said 20 foot
right of way;
THENCE along the northerly side of said 20 foot right of way the following,two(2)courses and distances:
(1) South 79 degrees 45 minutes 10 seconds West,95.24 feet;
(2) Thence North 73 degrees 28 minutes 50 seconds West,4.76 feet to the point or place of
BEGINNING.
TOGETHER WITH a right of way over the 20 foot wide private road to and from the premises hereby
conveyed to Marratooka Road,and,to and from Deep Hole Creek at the end of,said 20 foot private road
where it adjoins Deep Hole Creels on the easterly end of Lupton's Point.
BEING AND INTENDED TO BE the same premises conveyed to the party of the first part by deed in
12823 page 155,the graritors herein being the same persons as the grantees in said deed recorded in
Liber 12823 page 155.
TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and
roads abutting the above described premises to the center lines thereof;TOGETHER with the
appurtenances and all the estate and rights of the party of the first part in and to said premises.
TO HAVE AND TO HOLD the premises herein granted unto the party of the second part,the heirs or
successors and assigns of the party of the second part forever.
AND the party of the first part covenants that the party of the first part has not done or suffered anything
whereby the said premises have been encumbered in any way whatever, except as aforesaid.
AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of
the first part will receive the consideration for this conveyance and will hold the right to receive such
consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and
will apply the same first to the payment of the cost of the improvement before using any part of the total of
the same for any other purpose.The word"party"shall be construed as if it read"parties"whenever the
sense of this indenture so requires.
IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first
above written.
IN PRESENCE OF: Q
Caroly R A n
//deedameen2017 De Carttony Forbes
1.
BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN New York STATE
State of New�Y'ork,County of Suffolk,ss: State of New York,County of 1'p"3A- ,ss:
On the 10 day of May, in the year 2017 On the T' day of May, in the year 2017
before me,the undersigned,personally appeared before me,the undersigned,personally appeared
CAROLYN R.AMEEN DEANEAL CARLTONY FORBES
personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s)whose name(s)is satisfactory evidence to be the individual(s)whose name(s) is
(are)subscribed to the within instrument and acknowledged to (are)subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their me that he/she/they executed the same in his/her/their
capaciry(ies), and that by his/her/their signature(s) on the capacity(ies), and that by his/her/their signature(s) on the
instrument, the individual(s),bl(s), / the arson behalf a instrument,the individual(s),or the person upon behalf of which
#—dual(s) ed,executed the instrument.
which the individual(s) I c the in ent.
(signature and office of individual taki cknowledgmenl) ce ifindiviCheryv mores JAME3�CKOSKY
Notary Public Notary Public,State Of New York No.31-4970341 Notary Public,State of NewYork
Oualified In Suffolk County No.01CH6N5671Commission Expires February 4,20� t]uafiffed In Rlchmond County
Commission f� lres January 7,2019
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUT!WE'NeIVreffl,
State(or District of Columbia,Territory,or Foreign Country)of County of ss:
On the day of in the year before me,the undersigned,personally appeared
personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s) is (are)
'subscribed,to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies),and
that by his/Iterltheir signature(s)on the instrument,the individual(s),or the person upon behalf of which the individual(s) acted,
executed the Instrument,and that such Individual made such appearance before the undersigned in the
in
(insert the City or other political subdivision) (and insert the State or Country or other place the acknowledgment was taken)
(signature and office of Individual taking acknowledgement)
Notary Public
BARGAIN AND SALE DEED SECTION 115
WITH COVENANT AGAINST GRANTOR'S ACTS BLOCK 11
Title No. LOT 4.1
COUNTY OR TOWN Southold
CAROLYN R.AMEEN AND DEANEAL
CARLTONY FORBES,each as to an undivided
50%interest
TO
FRANK DOKA AND PAUL DOKA,
husband and wife
STANDARD FORM OF NEW YORK BOARD,OF TITLE UNDERWRITERS a J /k; €'Q
NN /0803
W
LL
0
[7
2
O
C
O
U
W
K
LL
W
N
7
R'
LL
W
U
Q
a
h
_H
z
w
N
W
Idi
}71
Mi
�* { .
-
Ni
Rgw
F>U�1K;'+.'i•`i., yge`�^Fry tf.,�,y �__.z- 'U�-�yav,„ F'.; It•"---'-ls•;! _,
��"��"�^'"" U'a mt�,�kpF,;?ry��V ,t�';•`��Y;�CI"- Lnjl,�rl1���!�ii�''na aT ;,s�i%7�'�'il�
t_fi'u;3•. "'; y",'t AIM
f ''fit�.` �'-•`• ""::fit. "� :..'o\%.\; •�;t,�• /l���/;�� ''%
p A `r4, �; � � �. ,,:. tai r',� //'•� d
R.1•tv s=ue �'fs�'-' �;'"= ,t>�_-'� �.a 't''s //'N
�:�,•" � :j; T f. �;.�inr {Y�J:i7=`v.'.'`„ �..,"p'i�ff.t.�,IYc�'r-.-�3i� wlt!1''� `?..fes
a vuifjm x�.
�ri•�yS,y ,.7s Mr'_ " w A'9A,� -�Yl4i, ,jr
:'�3k�t,f�,=�1�5 ,st.. `�'��'`.r��°pie/r..:,i;,�'""'ty,,°,wa��;+��\�•��
G? L'#'•,�,'iti,A$k, ,§. r.,,'K,?�'1}h: 5 ,a'v+'f .,i`•. .'y,' 00049 00049 00 0 0 0000000 00000000000 1
10
Preference Plus Account
For more information or MetLife or your Service Representative
to address any inquiries P.O. Box 10356 SPENCE JEFFREY P
regarding your Annuity Des Moines, IA 50306-0356 Tel: 1—(631)851-5700
Tel: 1—(800)560-5001 DATE 05/12/2018
write or call: ACCOUNT # 073-740-888
Or visit us online at PARTICIPANT PAULA DOKA
https://eservice.metlife.com MARKET TSA
EMP GROUP # 0836007
PAULA J. DOKA
755 LUPTONS POINT RD
MATTITUCK, NY 11952
A change to the Allocations for Future Contributions was processed effective 04/30/2018.
Contributions made after this date will be allocated as follows:
ACCOUNT/DIVISION PCT. ACCOUNT/DIVISION PCT. ACCOUNT/DIVISION PCT.
VTR SYCMC V PRT 7% BH/WELLBALANCED 15% FIXED INTEREST 15%
BH/ART MDCPVL 5% HARR OAK INTNL 15% MFS VAL PORT E 35%
TRP MC GROWTH 3% LMSSSMCAPGRWTH 5%
MetLife
Pension&Savings Cenb
PST095.SCRE(04109)
Department of Taxation and Finance 768001 11-17-17
NNE Resident Income Tax Return I�® 1
STA E New York State•New York City®Yonkers O MCTMT
2®17 For the full year January 1,2017,through December 31,2017,or fiscal year beginning...
and ending...
For help completinn vourreturn seethe instructions Form IT-201-1.
Your first name MI I Your last name(for a Joint return,enter spouse's name on line below) Your date of birth(mmddyyyy) Your social security number
FRANK J DOKA 04261962 096604520
Spouse's first name MI Spouse's last name Spouse's date of birth(mmddyyyy) Spouse's social security number
PAULA J DOKA 07051959 050509161
Mailing address(see instructions,page 13)(number and street or PO box) Apartment number New York State county of residence
755 LUPTONS POINT ROAD SUFF
City,village,or post office State I ZIP code Country(f not United States) School district name
MATTITUCK INY1119522250 I MATTITUCK
Taxpayer's permanent home address(see Instructions,page 13)(number and street or rural route) Apartment number
School district 382
code number
City,village,or post office state I ZIP code Taxpayers date of death(mmddyyyy) Spouse's date of death(mmddym)
NY
DeInformationcedent
Di Did you have a financial account ❑
A Filing El Single located in a foreign country?(seepage 14) . .... Yes No ,-,..,
status
(mark anMarried filing joint return D2 Yonkers residents and Yonkers part-year residents only: m
X in one k�J' X (enter spouse's social security number above) (1) Did you receive a property tax relief credit?
box): (see page 14)„•. ... . Yes ❑ No ❑
❑ Married filing separate return •"'"'•"•" '"'.
(enter spouse's social security number above)
(2) Enter the amount .00
® ❑ Head of household(with qualifying person) W
D3 Were you required to report,under P.L.110-343,Div.C,
§801(d)(2),any nonquallfied deferred compensation i0
Q ❑ Qualifying widow(er)with dependent child on your 2017 federal return?(see page 14) ..... Yes ❑ No ❑X y
B Did you itemize your deductions on
your 2017 federal income tax return? „•, Yes ❑X No ❑ quarters in NYC during 2017?(see page 14)Yes 1:1No ❑X IT!
C Can you be claimed as a dependent (2) Enter the number of days spent in NYC in 2017
on another taxpayer's federal return? ...... Yes ❑ No ❑X (any part of a day spent in NYC is considered a day)... 0 x
F NYC residents and NYC part-year
residents only(see page 14J Z
l (1) Number of months you lived in NYC in 2017...... . ...... ❑
r r r r r r r r r r r r ti
r r r r r r r r r r r r r (2) Number of months yourspouse
❑
1f r r r r r r r r r r r r lived in NYC in 2017 .............................. ........ . ...... Z
I G Enter your 2-character special condition
code(s)if applicable(see page 14).................... 0 0
H Dependent exemption information see a e 15 �
First name MI Last name Relationship Social security number Date of birth mmdd
y
Z
VJ
If more.than 7 dependents,mark an X in the box. ❑
201001171019
91 IIIA 11111111111111111 1 For office use only
P
DOKA,FRANK,J ;
755 LUPTONS POINT RD
1 MATTITUCK NY 11952
I
000c
�p ,h � , -\ �'/1/,/� 1'tl� •"i ",,..y s .ggsy,,.. '`�?`+5 6"" l6 6 '1r.•. t�,vd tpd°a.C:,� 95 d�I`�i'" 6"''¢ rd d�J/q�j5`'"3�aa�`Z a=�14t6 d P
MINE
L t�
T e;and'Identdication.No. Year Maker Model;Code Body/Hull• Document No..
JW
2018 FIRE 584'3'0.4L
d Color 1lUtJSts./t gth. Fuel CyLTProp, -'New`or;bsed= Type,of title Date Issued , J
' . 31 GAS OUT ' ) . NEW<<"' 'r BOA 5, :0;1. 18 • '�:
Name and Address of Owner(s) 5' =
;-;
DO,KA,FRANK,J
® 755 LUPTONS POINT RD , �-
� ' MATTITUCK NY 119'52
.x
This docurnen-t is.yo`li"r,prvof o1—bWpersftip1or- le, boat or•'manufactured.home. KZ-ep +1�
it In-a safe,place,`not witf,'your9,icetiset`or._retaZian or in,y' " veh'icid•or boat. To4ispose I
- of your vehicle, bob ,or,manr�fail1w od�home, FompCete the Transfer section on the back'antl
this title to;the rlew-oinrrier._'
Li,enholder R;, -;L enholder f' '
�.i� �3-y.__ �_� _ —{ ,,;•.i: ze=:' 'i:``.:r. 'e.�`B: ^'v,;4i..f:=Z iti,i 'r' '- � �>
Llenholde, _ Lienholder
MV-999'(1/1,5)
W11111'01'2— Oe 81d J .
ACTION OF THE ZONING BOARD OF APPEALS DATEJ%ar 19,?,. 1959
Appeal No. 140 Dated February 269 1959
ACTION OF THE ZONING BOARD OF APPEALS OF TOWN SOUTHOLD
Harold R. Reeve & Sons
To a/c Blanche L. H. Weese Appellant
Mattituck, New York
at a meeting of the Zoning Board of Appeals on March 13, 1959 the appeal
was considered and the action indicated below was taken on your
(X) Request for variance due to lack of access to property
( ) Request for a special permit under the, Zoning Ordinance
(X) Request for a variance to the Zoning Ordinance
1. SPECIAL PERMIT. By resolution of the Board it was determined that a special permit ( ) be
granted ( ) be denied pursuant to Article......................Section .................... Subsection....................
paragraph...................... of the Zoning Ordinance, and the decision of the Building Inspector ( )
be reversed ( ) be confirmed because
2. VARIANCE. By resolution of the Board it was determined that
(a) Strict application of the Ordinance (would) ( ) roduce undue hardship because
the lot is larger than needed for one resEdence and just tindersize
in area to make two lots.
(b) The hardship created (is) XK3MM unique and ( ) (would not) be shared by all properties
alike in the immediate vicinity of this property and in the same use district because of the shape
and contour of the lot.
(c) The variance (does) ( ) observe the spirit of the Ordinance and %==(would not) change
the character of the district because other lots in the area are ehnsiderably
smaller.
and therefore, it was further determined that the requested variance (R ) be granted ( ) be denied
and that the previous decisions of the Building Inspector ( ) be confirmed (g) be reversed.
The Board unanimously grants application as applied for with 15 ft.
right-of-way on the east property line for access to the rear lot.
Location of property: North side Lupton Point Road, Lupton Point,
Mattituck, New York. (Private road)
ZONING BOARD OF APPEALS
At
r
T Judith T. oken
Secretary
tman hoard � Appeals
Q��
LOT COVERAGE
EXISTING SURVEY , O PROPERTY
sq
N .DECK - '386s .f14. A TTI
BRICK - `360 6q.ff. r v ��L lI y�+
SHED - J1386 sq.ff. '11 ® 9'61 d� Off° O�J a� ®LD
1866 sq.lf
t�65T0 � f3:3�S
PROPOSED SUFFOLK CO V�r NT Y
HOUSE - 1570 aq.fl. 1000-115-11-4.1DECK - 386 sq.fl. b
BRICK - 360 sq.ff. SCALE. 1 m30D
POOL - 630 sq.11. f,
GARAGE — 700 sq.ff. MARCH 12, 201.3
3646 a .fl.
3646/22370 a 16.1% AUG. 14, 2093 (PROPOSED ADD T1V5)
AUG. 28, 2013 (ADDTIVS) �
OCTOBER 22, 20133&Togrqphs�) .
D
N� ®F S(�FF®®69N70 L9
*
AY
,IGHT OF
\o co
2 C,OQyc
\` 0,� ��sr� `♦` PROP. 2nd. Er �Oa� `
♦ FLR DECK (8)
ry
STY. OVER EXISTNG 1,9 4 SNF <ocq� '
g� cb ao
PROP.`
26.3'
SO
2STY- Cr VL
� � 15.2' ,,�\ ,`� ♦+ '`,� �� ��``�' �
I° 18.0 ` 6_
e \
PROP.
STY
- — - - — o� ,ADDITION �,Ns — - - - -
RAIN RUNOFF CONTAINMENT: o, p ��g Dw yfi�
r1i -�
DWELLING: 1,52B Sq. Ft. �
1,528 x 0.17 x 1 260 Cu.Ft. -��e_ 8� 0
Provide 2 DWs. 6 fZ(x 6 Deep z tt1 �
Connected by Gutters & Leaders C '
1 Q 200 lu
-71 )
�'`•.� o 17
-ARAGE "' C Bldg Dept copy from ZBA
- GRA > Final reviewed documents
VE
DRI 00,�` ® ® ZBA File #
P 7n
a�, o
L P
a,
� 1E D IBA
9ROAD E, Ct N
EDGE OFF P PAVEMENT A� g g
® ®�da ® 6
RIGHT ®F WAY
20 M!I _
CERTIFIED TO:
CAROLYN R. AMEEN ELEVATIONS AND CONTOUR LINES ARE REFERENCED
FIRST AMERICAN TITLE INSURANCE COMPANY
TITLE # SP 29126'-5 ` TO N.G.V.D. DATUM.
FLOOD ZONE F AP MAP NUMBER 36103C0482H
AREA=22570 SO. FT. SEPTEMBER
TO 'flE LINE
e
100% OF LOT CLEARED N.YS. LIC. NO. 49616
ANY AL TERA 77ON OR ADDI T70N TO THIS SURVEY IS A WOLA 77ON /C EYORS, P.C. A-1,
OF SEC710N 72090F THE NEW YORK STATE EDUCATION LAW. 765-5020 FAX (631) 765-179
EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS LAND .0. BOX 909
HEREON ARE VALID FOR THIS MAP.AND COPIES THEREOF ONLY IF 1230 TRAVELER STREET
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 13--12 9
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N, Y. 1197y
THE DOKA RE5/DENCE, oF��
755 LUPTON POINT ROAD, MATTITUCK, N. Y.
5: l 15, B: l l , L: 4.
110.79'
N78°47'10 -
` s'sr
MAINTAIN.-
N BASEMENT EXTENSION
I W WITH COVERED PORCH
AT FIRST FLOOR ON
SEPARATEAPPLICATION /
0
38°,
I
O /
EXISTING TWO STORY
I
26.3' FRAMEDWELLING
o�
15.2' 18.0'
I
o EX 0- I o
M POOL MAINTAIN:DETACHED
0
z GA RA GE WITHA0ESSORY o
I
APARTMENTABOVE m
I
20.0' 25.01 CAR CAR I
C-41 CAR I - -EX.- x o #1 #3
GARAGE
I
_ o
GRAVEL DRIVEWAY o
0
I CAR#5
CAR I
�
CAR oESTIMATED CAR SIZE,•9X18' #6
�-A # o
O I
°, _ �� ` 95,24'
�y 79°45'10"W
�UPTON POINT ROAD
s
F LOT F L-AN SCALE.-P=20'
SITE INFORMATION
NOTE.-
THIS
OTE.
THISS/TEPLANISNOTALEGALSURVEYITIS ��•
DIS- 1000,
FOR ILL US TRA TION PURPOSES ONL Y.ALL
SEC.- 115
DIMENS/ONS,SETBACKS,LOCATIONS&
&K.• 11 STRUCTURES WERE TAKEN FROM SURVEY "-f/
LOT- 4.1 PREPARED BY'LICENSED LAND SURVEYOR
AREA: 22,570 SQ.FT. JOHN T.METZGER,PECON/C SURVEYORS, \\�, ®� $1 •"
1230 TRAVELER STREET,SOUTHOLD,NY 11971
LOTAREA COVERED: 3,646 SQ.FT. TEL:(631)765-5020,FAX(631)765.1797
L0TAREA%COVERED. 16.1% DATED:NOV 21,20 f3
Board of Zoning Appeals Application
AUTHORIZATION
(Where the Applicant is not the Owner)
1, TI-cc K -fi- Vek�-XLG`. tokQresiding at-�55 Lup+o 4 Rte/ .
(Print property owner's name) (Mailing Address)
�119 G Zdo hereby authorize
(Agent)
Q
n c S , rc�(� Po�to apply for variance(s) on my behalf from the
Southold Zoning Board of Appeals.
O-wner's-Signature)
(Print Owner's Name)
A-C�T/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this
form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME:
(Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a
company.If so,indicate the other person's or company's name.)
TYPE OF APPLICATION: (Check all that apply)
Tax grievance Building Permit
Variance Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat - Mooring
Other(activity) S Planning
r\
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or
employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"
means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or
i
employment by)a corporation in which the townpfficer or employee owns more than 5%of the shares.
YES NO � c
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.
Either check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
i
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
I
Submitted this d f 01-1 ,20
aSignature,.
'Print Name ; Yqf) d CL
j
,i
I
i
�I
APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM
.I
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this
form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME•
•(Last name,first name,iniddle initial,unless you are applying in the name of someone else or other entity,such as a J
company.If so,indicate the other person's or company's name.)
TYPE OF APPLICATION: (Check all that apply) `
Tax grievance Building Permit V
Variance Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) SD&.Q eu\ CNCUS'1S0 Planning
—I�e y Q4_ •}sof\
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or
employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"
means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or
employment by)a corporation in which the town officer or employee owns more than 5%of the shares.
YES NO IJ
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either
check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted thi -� day of ® � ,20 �$
Signature a I
Print Name �( Ai rX O G�
AGENT` !PRESENTATIVE
ACTI - AL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose
of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever
action is necessary to avoid same.
YOUR NAME : ricing1fis f\r)ote ICk__ A
(Last name,first ifame,middle initial,unlesh you are applying in the name of someone else or other entity,such as a
company.If so,indicate the other person's or company's name.)
TYPE OF APPLICATION: (Check all that apply)
Tax grievance Building Permit
Variance Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Z P42 CA np'' .S' Planning
vDIQM()r�
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer
or employee of the Town of Southold?"Relationship" includes by blood,marriage,or business interest."Business
interest"means a business,including a partnership,in which the town officer or employee has even a partial
ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the
shares.
YES NO
If No,sign and date below. If Yes,complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person /1 :;Q
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.
Either check the appropriate Iine A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted this ) day,of .A)a QS4,20 I$
Signature ( -a^
Print Name c,, (VIC,A1� LS
r
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area(which includes all of Southold Town).
3. If any question in Section C on this form is answered "yes",then the proposed action may affect the
achievement of the LWRP policy standards and conditions contained in the consistency review law.
Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a
determination that it is consistent to the maximum extent practicable with the LWRP policy
standards and conditions. If an action cannot be certified as consistent with the LWRP policy
standards and conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: online at the Town of Southold's
website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM#
The Application has been submitted to(check appropriate response):
Town Board 0 Planning Dept. [�?( Building Dept. Ed Board of Trustees 0
1. Category of Town of Southold agency action (check appropriate response):
(a) Action undertaken directly by Town agency(e.g. capital
construction,planning activity,agency regulation, land transaction) Ed
(b) Financial assistance(e.g.grant, loan, subsidy)
(c) Permit, approval, license,certification: 19/
Nature and extent ofaction: /kcCF, 5 SvC-i Apar}�� kcql 4
V
Location of action: -7'55 Lu r-1 P- •
Site acreage: 5-�C) 1 f
Present land use: k=.S y�en'�C�-
Present zoning classification: ` 71
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicantgr(�(� �1�r� �1�t�1 j o,- _ -
(b) Mailing address: � �j, Lkj4nn !` '2,4. �() f� jj q52
(c) Telephone number: Area Code( ) 91 Id -- L4 L4 89
(d) Application number, if any:
Will the action be directly undertaken,require funding,or approval by a state or federal agency?
Yes 11No`L� If yes,which state or federal agency?
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and
minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation
criteria.
QCs ❑ No ❑ (Not Applicable- please explain)
C kO,( aL+-r
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section III-Policies Pages 3 through 6 for evaluation criteria
Vyes ❑ No ❑ (Not Applicable-please explain)
tS bisby ' cv A 01�� �-e5 oV rcp
J
i
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
LWRP Section III-Policies Pages 6 through 7 for evaluation criteria
Yes 0 No 0 (Not Applicable-please explain)
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP
Sectio III-Policies Pages 8 through 16 for evaluation criteria
Sectio
D No D (Not Applicable-please explain)
7hg: e. LOJI 1� 1) e 1 oSs
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
-Policies Pages 16 through 21 for evaluation criteria
Yes D No (Not Applicable-please explain)
�- "r- qua Cm-e- Cl 1-
On f
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III-Policies; Pages 22
throu h 32 for evaluation criteria.
Yes 0 No D (Not Applicable-please explain)
weg n k
v
s
Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria. See Section III—Policies Pages; 34 through 38 for evaluation
criteria.
dyes ❑ No❑ (Not Applicable—please explain)
WQ� is Y) C, ct
quo
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
I''I Yes ❑ No ❑ (Not Applicable—please explain)
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation
criteria. ��
YeD No V (Not Applicable—please explain)
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suits a locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria.
Yes ❑ No ❑ (Not Applicable—please explain)
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria.
5Yes ❑ No ❑ Not Applicable—please explain
Lies Wl� Iva Sv5- 0akPCQ
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages
62 through 65 for evaluation criteria.
E/Yes ❑ No❑ Not Applicable—please explain
�E'S e-� �S 1c 1mOQc i-
01 C\ c u, (4-1-) ,
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III—Policies; Pages 65 through 68 for evaluation criteria.
Yes ❑ No ❑ Not Applicable—please explain
lks, im Qct run, e(1P_rY --A C)< rn2k n2 OLA av C CQ,o
SCTM #
TOWN OF SOUTHOLD PROPERTY RECORD CARD J4 !/o
OWNER STREET r7 SS VILLAGE DIST SUB. LOT
Ph P-d c,K cl
ACR. , 52- REMARKS
TYPE OF BLD.
PROP. CLASS 1e7�
,
LAND IMP. TOTAL DATE 3 � �,Z,j — (,Z CCS S2-3
3 DD /0/ 00 /��� ,� �� �� /S � 9���-• � � � �.��? — ms's.
,� 3 0 / 3 0 7 l q-1- � ern Gogo $2-1
, f
1300 700 / 00C)J 311 SL-,-,4t—man
�---T-
—7
L(O�-1 I l� ". � ��(�(c` cel cr r'Uc.M�� r / -
FRONTAGE ON WATER HOUSE/LOT
BULKHEAD
TOTAL
f, }t'.� �,-� .-g � `a se:�►T�+�$dc.t.i.- tom.
}�!� 'n• rr"�i•moi o\btyJ / `{ �M,
• +� .. u ,' e...:.y k�� ._:.•z:.:w+'.x••'u.+/�'1,.Q�om�,��,__ s Y74 i
` ay�lt'�f�+K.kb'+k T E# •`A m .i.kyr,r.t � V
♦ p\Y 'f ii 4 �} T 1y3++ ` �l ifi Y r; J mom
fit
■■■■■■■■■■■■■■■■■■■■
ion
• -..}'S .,Y �'if i "! �T. ,�} �1�41•� �� +T,vw:t'+[ ik�+-..i, f ���.� �■_ �����8
moll EMINOMMMEMEMEMS-0
Basem
.t J f� .l � �•k1 Y�=•f'�\i0' � � ^+ss--r..p.•. � T""r..`.f-_-C`'7" � .r������.1����1�t
,�.+s„`s',T r+:'�°,�` '��t.: ��'� �� n..k ti•.,.= �� -�� � � ■■■ilk■■■■r■■�1■■■■■■■
�. �a�=� `� .�4, �.�.-��� ,�{s��:��;�� ��<�,� ��„����. '��1 �I�'�1■■■■■■■■�i■■Its'■■■■■
n
+ r
• !All I
e
r
NEW YORK STATE INSURANCE IDENTIFICATION CARD THIS ID CARD MUST BE CARRIE
Policy Number IN THE INSURED VEHICLE FOR
633 Cincinnati Insurance Co A01 0910442 PRODUCTION UPON DEMAND
Name&Address of Issuer. 212-344-2444 Effective Date Expiration Date WARNING:Any person who issues
Crystal IBC LLC 05/31/2018 05/12/2019 orproducesan ID card knowing that
32 OLD SLIP 12 01 am 12.01 am an Owner's Policy of insurance is not in
NEW YORK, NY 3.0005-3500 effect may be committing a misdemeano
(Not acceptable to obtain registration In addition,a person who presents
An authorized NEW YORK insurer has issued an Owner's Policy of after 45 days from effective date) an I D card if insurance is not in
Liability Insurance complying with Article 6(Motor Vehicle Financial Applicable with respect to the following effect may be committing a
Security Act)of the NEW YORK'Vehicle and Traffic Law to: MotorVehicle: misdemeanor.
2017 BMW The name of the registrant and the
Frank J Doka Year Make name of the insured must coincide
Paula Doka
755 LUPTONS POINT RD WB10A13028Z399500 REPLACEMENT VEHICLE NOTATION:
MATTITUCK NY 11952-2250 Vehicle Identification Number DMV WILL ONLY PROCESS A VEHICL
CHANGE(RE-REGISTRATION)USING
THE REPLACED VEHICLES CURREN
REGISTRATION.
ti t ■
r '
FS
'_ 't`.`';z �:5�•?I amu•1n;,'%.p`'}i: V „s" _ t -
'Y ,.-. e^ ., , ... ._ ._ - , n � 'h°,, _�Y)S. - •rS'-, ... _,. w'^-'7F">}a,. '. 'r,' _• �. `,ji�A,,,rr�txa y,,,r,
i by attics "
1111 STEWART AVENUE
BETHPAGENY11714-3581 000
69957839 LN RP 22 20180722 NNYNNNNY 0005286 0026
+ CHANGE SERVICE REQUESTED FAQ O Q. fir'-;E<';•
f� #BWNHGYM You've:got questions.
#PGHCICGDDEPPE8# We've got answers +.r rrmr
r L. rlrllr rhlrlr IJlrlrlr I. r ^ '`r" �ts�.�;:r,'-� ,'r "
l III hl I I I dd I I I nl 1 1 1 1 1 1 Illh III �-sry`;�.;y;
i� -MS PAULA DOKA
756 LUPTONS POINT RD i Lectrin
MATTITUOK NY 11952-2260 `
C-i:,,,k' 't. - - "',i° ^.i ";v'r�4r>s.•,,,!r r', ..r,.. ,1 rrl t.t�T;;#�,,d;,,:y :�
'`YI•' '�;,,'it �:%z^ ;i2 'yew=i:'
"tri, t, ,2 s, t ':;fo.rc�:' „gd'r,. :,'a•r"=, ,�,- d{.
.{{- ',r,^ iirn::, .t^ a t'{ '•J„•y :c +4':, k'f`, •"ti', J<c:'i7=rtr";,r ::x
t
,t„ 'j': ^•V•e °i' ;P1-'iw f';�;• ;"F� ,aa•",l. d f,^; "JL'"h' .r±",�," (t ,v�, .'9 �'i
a.,rYt:,
;:;3'i,. o�`,''r`.--' ;=r"" -t ti,✓ - •,'f°E`�� :ri': ..r*'+ `;=S'.,."1:,a�. .n�ry.'>L.r-': 'a,.:,ri7'''' I`f .,moi<. w��1f< rt
Ff - ^�F:'ff,r.,•rw--, r'F.4.�.arJ ...�,.J"c .'"k. f:�•' :x.?t� �;}a,s<•?-r,`,,,v ,za'*t �+': t,?r,c l ier,-•r ,s:�%.Yr.. ,,,te.•.�pS..J y..
-4•"`�';',4:' <,rtz;;.'?,,j,. r_D,,,�.:_ti', Jr,-,;n:, `i'.'-1 'z � ^,. u;;' •ri-'°i#, ..t 5`.- f, %'J.-o,^,. _.3.`v :'•�.iv,t•,r�:try%n,xl%Ev`.4x• - ,1;s^T-<t"�rl "r. .r'+"�1
-,--k-.'.•r,`•,..Ar-, ;,�afr t, .T�-`. .rz,„#�,_ ,.y;,.'?., te.x.r -;��`s'.r'nr Pi.. .{rrx. t1•..��i°+:-•t• .fr:-%RY-::>•T a•C.cu.`-..,r;f'i%'; ^y�c{�(vi'c,'/,^�,#r<.*,3°i.l - +•:'t.,!_t,'r ,,7 „Jr.
;S,r,'>1,'-'",,r.o.9yC;�t„n.`'.,.:n.'`d F`"�°'r':f.�r,•(R'f,�,i+^,i��e^:,...:%�s,_aj^"',"rv'."hr,.5T',�l�i.:r=,;:.;,Ki$:',•'::,.'�§;?,J.!N%„r'A.?t*fr?.'.'+}k',_=xt;.iyv-'3 f,�,',y.,r,,!y,?,f.Uy�.7,"r>�s,,i-.;i''`'`y;��r"`•i`I�.z'-?-,•S,tclr,`._'•.;l.r.;.a,q'��',,_.3".�''..,.°"F;"-.'.n,...v'Jl:.`rr•rr1`r•"f+.,:�>c.;:',`Rr:Fr.,;.h•r'.,.G,,?ar.4K t.j f✓d'c<+s1 r{-r'i.",Y•t.:t"G'"'a=r""r.'�a•',..,tf,'"f.r;�.'-y-.,r•.„te.v,'Ac-.r,:,r^,,.Y_.y„M.n,.;L,,,,t,.,tlt"„r�xv'`.s,•:•.Y:)>.,:•,:•,;i''�#''v„r..Y-�r';r,,':,"f•Y,".,n;.y�'^,{Pra,K.t',5�toa^°ir�''^„{�+.c`-3»rr.''C,"-,.r:,3i=s.;ri'^,.i r.i^,afU'r",.t,z,+r,"1',.rf'.„r,',',-Sr,si:•r�,t..`;._,z„,!,r{f„,:'ti"•xi?.a,,+,%<'L.3'w,=Kr.r^'a4,.-.,�Y P:J:t_'"�,r,',,a�:4-�.w'l,,1-'bJ,+-e:-i-T',dY.arf:-'"r R?,..rSoe+F..,,rk"'.'$�d.i"^5v,=w.,-.-c%+r7c�w.�te�,r:.,W•,.pfr.,xr;•�"',.c.,y am.f-s:,a4`"•;,.::"`�>,.ir°,,l r;:.tufa^.rr«",:t'Y3�N✓.fr.fi,-,Y.�,t,c�`w;-.v-£'.^-'Y'ar.-t.h6f rcr7';.,�:..,+,t-,•j'-,`s+`v_.t•;,t+,,,len',�,<."�,r,i.,..i@,Ri-"§.fia.nr;,�7.-r"yrv.01;,��
.„i.�^.?:c..•'PTF,3,�r,y,"'eY--"`-°,x�:w'n:+✓'�r
.
5ayti
;?f . a*.n,.rs;. • rSs9 l,ytp? � .4`
i,
•,•
,.�.1r ;;3:. i»xj:'•., d .9.:e,.,.- hti'_,�;�' _ ,r«, F,,.,r�„;;+ r:,,' i�,"y,� r:,r...�•.,..,-.
- ;tr :%ice ,K;, •+$Pix - !a t_ ut;:r,,r „i�r':;-L.;,.F..,;."�''!;,"A•r-„Y;. .,rr'•.Z., :�v'�!• J>�a
i:f:,l'{. - -r'iW r- ;r�,�'s•,:• '•:^4,••¢,.. „1'a>4`,. ,!�•.•- •-9-rt,- - SF .1vN. a .Jr„
- - �'fiU;` r.�:4:-._a.r,a• .y'�;,�':`..,..,y::- »r,J i7 a'r•'` .,J' ! ..r -.n ,-hv� ^e ,'. .�,•9'.
•'.fir t -r.'.r- �:{`i h- ',Y'. .t..•<N'�Y-,i• )' ',Y:,t,,..e,rS
"'1'' .r n Y.r ,✓•"r"' s f'il'`•y .!' r,.,-., ,SrGF,
"J"y f^+h r`rYr [[ .,fir:*• 'f
'-�'. r•�'
•YS 3+' •4 v
-
'� w ' ter„ fFr, =l J.•.
r�: - •ry i'+ hit '�., •�` .,z, f„ ,y,„3 ,.•�-•.%1+":l .P
rr .r, v' 'r a' ct. i` ;y... ,r, / •,.r7';t#' ,a."� :a.: •",- .� �'. ;:o:'�
-,t:'rf .{:;;i�;�E JF 'il'�*', .�'„',a»rtt�, ,tu ''!', ".53't&,:.I, t+', '1l„i<."','t;fi:h ,:'iS, i�r'�•,"'SN .,,W, Jr":.'4? .r, „+
,�" a,-.r` r,'L;:!} >'��,.`T�s,,, r,3+"-;'a'�;rs> ,�,', x, ',Y4':x°,7,:; .�',r°.>,k'r ,a.e.,,J.,:"ir".�,r •{�!„ t�,� �1 - .,"r,,. ir^i"s5r"a��
";,t;s -,4, a�.'hi ,,�; r.r?^ "°'}"'•' ;.a'a"3 '.�,tY. :"�r�`';Yn;:r.+,, r);`` .�;�`.3rt. r^^,L,. .,J C�••,Y? ;yi:.J ,,Yk,�i,S.r`,';?:�n.e. 'ru'^"'n''J. .t
,:-•r•,. .:.' 1-r -r. -..d":E° `yJ,r '^":'(r'r�,..t_F l',..q, t'aJ, r�r...=fr,,y +:4 r,l.,,,, 4r.."`,snow a,-s,y",ij"r�,Ji �n�.'..,• Ott`[,,c3 "r, J +r ,.r• i
;i",� .fig''`' -s.",'4; `P rl �a„,.�¢.,,.,; ;.'t�"i;'�,`,i:`{� r,'{,rr .eg ��S.n.a._r+,r...�,.a5'7Ji x• 1y� -i��s�., '}c-. 1`�Ps�f.J<1,
- - �,. -ti f ti''A' .f. ,S-"r ,,,�.- Y'r ,G�nv, L._-'v�,� � <rs..T ,..f.z.fo:r`�=.i'."�-i.Y•,- �:'>'v,YMr .ta .,: r:'{'�fa
`ivh„ „`r,,,/,_ •t 'r,r -"�r')rr 7_ 7 »,,,�'�=� ,��., FJx'ar4�r'>'^�`-:`',t,a. .r,tfi;-�"",,,,,z.,._.� rrx'� a>:r-h, "J"'l.'r.,.,, �.,...tsr..•"3+.g,.
'r�Y, ^'F. `_fr•:"'J:': yl;x,"' ~,>.•'z;f, r.'f=F• `"t`..�Y,^ f^. .-,/>�F "- ,r'Y'�.,„--, ,iVS. ..fq .'{.�3,..�r.R�Jx...:.�.G4�"�-.F, .ek, ,,r,•,J�- F'1
:f: :,`r- :y;� .1.".,'a:e .P r. {,. -,y,.,i.• �`+Nr, i•'r'kz,,,t ,f,�'f;,r..ar;.3-�'"` r.7"-eX}�, "h''`r. ,�,,;r _r,t".:�-S-,F•.e-':%;:.;4r„ :vr...;l•`1 k
',,�t'r i r ��;. - „F>„°br+`;>,'�i" � r-,:, J• r 1.',- Ai'ry�^ >.r^w•r 3,,•• :JsKy- �J,
te�rr' -":K" %E:-" :^�4>"•'acs�- >,,y,f-_.�r.. x ,rr,,>a"' - t;<?.L r.,- f '-h l'N,,.r.,;s;n
•'r^ ,,5': <,.,k•, ,fid.. ,3;P^:^,,•.• �, .,Yr•` „i`=_ ,r•- .G K:;,m- '1Ar•^.Y'rru`
rP� "1W` ���r': s. -1" •�„•�; t. •�� w 4a..,r�:�c�'%i`ii;Yr ,c r u•+.r u,s,,L�,dr'.,e..<r-r'^r�t= ry "?r `�"ewe,, f.'�r.;,!�.„^<.r ,t
sre. :,, ti-t„� _ r a'. ..i',7„r..w:,•Y",;�%-n,;r ;c x ".{;' ,'J`J,r"� uu,}d [Y,,:. , ;,fin,
;.r ,t.,(fE..,y•{r, ,K„ --1+,,, •.95..x,5..:..>-iw ,or,:., �fi,=r•.• i r'.a 1'
rv., ,S•
.o. ,',>�' '-�.(:r+'• -,a u, r„r^J, Yf..,f,•, +, f'�a"f it ,c ^,Y..
1'r'+t,E{, n t'+.�: ,r,.,, „r.a 3 ,•�', „rzf.,.,;,;�,,,, .,t:. .•� '�,,. ,,,r„i' r-n r .r, .�"
rs�,J.t.+� „'i° Ali,' J•. a�.:�,. '„, aF',3 n ,,t •.�.,
:�i•,, ,:+i� i:" f•: ,Y✓'7", r.,,r ? �C✓k{., �l'�_.,: rsv" ^'rx �:• .n',m._3w rr.: "1,, ct�.
:r5 :'J `,l' t'^s"''" n'>;,+", P t, � g :r _,1+•""•n kr, ,•r�
-i-• e"f"' •"fl, - si_ r,Y:``L^„i "'A;�
-r;��'t'"?r,N:+..i-.�''F'�r•;'7�_:.'.=-Jt�F.d'f,:.:;-,,'1f.,f',,-'�r,a::J,_'"�t:-�.i,"s_>'.�'-Y:o`,^'f"",�,.=`i,rcr-'Yr''.-':-3ir•�s�`^'`�''ucrr-r.v4:^�,%f-.-.:":r,'.="^5i^.�„�'=•"s`f;`'--"=',r-�.{:v�,i�a,,"r�;„:Yr,^.ti"-;^,".�`nw.,":,-_�>h,,}u_r:_'^SA�.e;`'R.°�a-;„`.:f,°'%:..R.+--.•r;1�.1•r.iiJ''f,°^•t'','I{-1,t`,RE•'�,c;,,,:..:r<•`'''"t^�r_',_„i,-.r3,;�Yt_:i�q._""r`,t.'.;.�.".J.z:r•`•S.r,m•.%+,rs,,,°j, ,r°.r`-r4,(r.>,�"?..;,kt"',•.,r;u--,x,•}:_.',-,f,'_.H,.1�4,,r,,,':�r`•'t:... "p,
`.i.',,z,rr+,"t,�7�/•'r°''•a..t.�.',,::.-y�_wW�-,,a,'.;.,n_'nfa4,�3:••yEri'ir.��"7C::o,'Ar^Frx,':•=':==t'rH',.an„..��nr':r :�1„y,-Y,,`v.`r"'Y��i,,`-n<.,�.rIcP•,X,.,,,�.'`•-t-;;�;„+'J.T"",if,sti,,:.d rEwl-i,,i<f,:'r7••'2•fi(Ytt`,•r,,C"1✓-•Fr"r�K,„i.:
c-s>^":%:'n:.s-.u>h.�'t;"'=''v.f•.z>;"a"�:.,.,'n.-„Gr,y�,�,Hd
..j'
tiJ.,•':x.J.S,ah';'`•=>,}`;,s'y.�,f.;;r'',::;z�,.�tN1•s
:,.r.»,t:��,:a•
�.M 5:•Fn.".'�r,c,,..;Y, .e:fJre,f+- ,�r.F
p``;.Mavl:;.r-.'i _ r�7: s,. :! :J; r. .,d 1.j,rt' r ifri„-.`: - :P' :irt� 3.,{`-•`s:.,4,-,;. .''rl,,, S .b
`17,,,. `�{T'• - ,,�Yi W ,.1� t Jx4,^ f.h:SWn i"E` FI r J� 6,.„^f,5w r '.`-r9.. ,'
,9''x�:: x :;•;%i.t- ,r,rr„ 1.,. "�':yri t4 >a -r , rsir'.
'�. ;,,r;,, �„tr._ ,p, _ (,,,;, >}A,,,.f='•5^:` `(?•+•ljtY , i.'., 'lj;5t "f"• . afC•r:i' •x5., y
�`o-, - - '..s, a't'rw, «nr x.rr +y;•i "t"sr':,5..,;re i`• 3. ,;�, .tP a,i. ;r}:r J .':. ,=:,
✓ �•,e r f.s,;:P•n, y}� „�;�t
°,r3xp,t,{;^u.•.; +.%:'�, lA" . est ':� '.t f' <. .nia t�, f,'. '`�tl.:•r �.1
,:li>" Po%w^. ",U"> :,`4i. !,rt ,.h-.,, :•�,,,. lrA,,r' /..ti •r�. ,.r,;r ',di•.-.:-,. >, h,,,,,,y.,,r }� u ;•^,t",-v
t r, J,r"rr '; :F':' ;,,i,• .3„k:..a'"' VW' -fi - ..•4r't r-�,,,,,;'.;, t.,,^ ,..y. -r7^ r ,
,.3'.; �7t %i;•.>~-4,_-i}r£,e r<
„r,J'H. r'i;r�,{,�'•-sy: ii`r ;;�'%« ."'?,»alb, ,� .'s•1'. .F_""�'•,?:'�+> ;.Sn,t,=t"„� .i,':t .�5• „K'r.tY;�,;.�ar;:y,4-.1c., _ ,2�mr-`�lG: .d:.c _ .p �'x, +�••�; rt'
.•Y^ _Sw:Y9-
r`-fT.; - „h •;���y IS. �O.n �'sl�'+�Y,,. '�` k'`Y•..rij �^ ?f-t.
rr'!r: '."J`,:�: 'it'd- }k. ...::`r_ „n*r=. r'--- } s„a: -„',S' l• ';,•`-r'!;r^.=n-^r- =r.. k,b y,�-;. .7„e. .k,
£,.:'i:,Y. -f• ,S;r..,....v fC t!•i�i�y ,`�rt`y,.f'J.,�Y�:.,s 3173- ,y$'�::C; "a' �f_ -e`.J.. - i:, f.�v ,��"r�`.'�,P.A. H,. §J+, •J rj
'=i^"". 1';.` ,;�:Y,`- r� !"r. s't'y ':7,':,'J^.,.•. fr.�-�r• r�',..1: .T-. m'. .,)J'=,...•,..,;,.ru::,, �fr-�-,.^'(^;Sf"�3_k,'2f,`-'F^.'.,'r •;�,.,,I,�>., �, ,.
rt,., ,F,. �•?;:,tr ,•¢. ,s.='i� �'>z', v'tt. - o-,•r=:�,r _ �, _.Y„' -��. r:1_, .C+.' ,.s.rt, �,•t. v."J`,�,r,,c_ r�tr,ry....v+ K„3
tt +:y.: .+N, '.fin. ih< M, ��i1AYr. - t, R' .t<.- •:'J' i^3k tix's"i'i,^�P..tr rC„t,'~.r it,=s'.kro,^-r",'tq ,�y,a'al,.r,�+}' tr,��-Y
�'•t,'!i-^-• ^`�i'•' fr:l+�.�,�,,} Y3in�r .XJi,I'. mak• .t. ,` h'':i•. "�.� '�." f,�Y^�'YJ,S^.1,, Y.- T 2^g ",.•',K. ,c�i'•"v` �,T}._
_n�r>' x+.•,'.°•`,;�, `.7 ,3a>+t nn�'�� .+,r � rr ,t,•1� .,ry r, �_ru, - ,^.r• �%�. .r'sc rrw+�,,.�, ,f -.v�< >vfi^f1 .,.i.�,
.w, � t'•7 ,Si'^ �''✓.'1^ 1. .v,, �'y'� -•,`::f:a''"':'t ,•p,n +✓' ,1 G:•.w 'rj,�r.''�s!'V'K,' ..y .r,�
t(,c;. `'nt'^ .�`, , '`,r �ri?`�C .,�" „fi f!° a, .,`L :':i;:x 3. t(., .� srn,..a,,.F,r„ J ,.+.,,,.. -,a.L-•,ttif Y c.,7,F,:..
h, ',,h„1,a'. - '••sr9A",`r'a, 'r{l, rrer n,rw., „!'^::,'.'•;: £ :c',�+� Y'8" r}:. '�.{, ,;-�.,"J ';.i t'a.>d;d}•,a
'r�:a'� ,k4'. S� x ,r1i'.s,.2'i'.iG''tp":7f!ni',tr;':,x"<`,,i^,+'+' r rl'•s!'.F. 7w' ,pr ,�.;.,;...,c'{r,•'t,•Y,'x,s. :Mr Y.:.s _ ,.v�,v;,': ,t. 5
.,r;��:•4z� ;-rc• `�7,�+'`r-J,•„ ,,.,rt.,,n,,:.Y,nn,,, .tr"-;r'" "�.�:, ,� ,a„a .u�'-krx"t r, ,vv,,r"" „f'r.�.Z1.,•,.t,rrr...,T.,'�fr�` ";t,r z' ^;-+a, rra'�
".y,Ari{ ':d�,t'a ,.�,.r r,,.."`-`sas ,`i3.^e,ry'y,r, L - wA}Nrrt.s- ,»,tY .,w-;�',l,X--'�, P« .,xs. ,'v,J_ a, Jrr"' - •'��5'i ;_5:-:'j
��.£ r:t?'};'Y J .La;' ,t'i� �,,, ,y.�l; P, 1,-.w;:<r" ;b.r,�.f��,'.�.nr7'..S''•'ki,._ <`. ,3`^,•r v.cr.:""-'1rP.L>�., i�;,'rr."e6v,
,x_tE _ ;.•t r� �'{a, •,r', =l h.J[c-:r•.,ta:^.i.' .,�''�Y'k;`=.�: t�rl;i.`�.,.,. ,;et '�"':.::�. �r _r �,r ,:�'.'.f1„ t�f* s n., yJ�„
.r>+,s• `�`✓;.` _ ..,•'"^ ^:if' _ ,a .1 ��' :'� `- �.r "=S'e�,r, ra..-,,.,._ ,y.,r-,. s.9' r> (�.t-r,�t.--C,r,,,,.,� -..�.et�r ��'��,,..
,h}„r - it,. =ra.>Tf,i �'"" _I,t,,r, "�'✓, ,'i�'1 vJd �....�,14 fiY.i'�,�44 e"r�,"rlr. .���'^'.a it r'1:Si,.SC1r, �h:-1� .^-J;'�..ri -8,-,-�
>�>:� •,.J.z'.'.` - -°r�•,ri:-= - '%�*`, tu..ss ,ay:•, ,R„c-;!:"' s:' .� 'b '�:z,:n 5 r:z•"_"�-n,-~_.
"�r r.�7, e.y%`'�.t`� - aF� ^.?:r,'''.,,., ">�se,r �:=1�"f:�.•.,.r :n5'n-. a+v,-s;•-:a�:• moi, .r" ..h`r
- `'X<^' .�• >s •,G-�,`" _ �- A,r,>.,y f M1 f _w+. -�"Y .,.-y 4";.es'!:s r!r
- t'�'A - >e ri�' ext+ ,.,.y ..Ya, 1 �.,� s'.xr.,,, w ^•Y3^; f.=:'^r' 'h:'
"�.2t,k., !ti'r'-': rs ,v.,- ,n��'� ,Bary" `yf'..:,, n:,:,,,,,,:,._�?i;•`�;:'iS�:','._., a •.s<� i ,�-,,,r :'1rS.,".;,, a �a �Y' e
„f: sl. ,+Y" {.i 7t"�J�;7 s 5'p •4F.,..F "n^+ � S.R,'rS`."^1' ♦ .E',v e Ni„5..a Y,•
.k`t`r+'_ tr-•",t'.:`'r,. 'a-s,.�'t"`•9`"�, srx•'t; S;•'F"t'i r' 'tx•^'i J, `R .r ^vs. '':;%>; ,t .?„-r+'r+a,•rr,">._r _ ,J.._;T;. .,.�,,,.. 't.;.:1
a�M=. "t.-/,t,,..rr:q_ .+ ..,- - �,r,a>'�}"x2''? ^7tr'rt -'r,� „vs ,'M, ran`.' ,4*;s•a•-; .�1-,.,. „r.ti` �� .f„^ .:T„ ',,,r a=�. �:„ ,.f
,.M;' .. r'f.,,,,,._ ^".':F. h. t rti�,• 'z, «„,rrr ,.t'>tv. „f �„�,°•*'.., ,.r „l+.',",.,.:' d°'�"^+'x,,. ,ct,'�Y, -r/:.,,.
8;�i.',"Y�°:.,'7','tNv �x - ,,. „yrr;>, t'?rt,,f.'.s,'3:i,'v; L`�.., iq°�'.;��';, ''v',i"''`'� ,F'.'- - M ,.:��ti, ,Y^.'C>?�u f...ry^�.W�.+1y�ai,vAh�°'n.�.,...w:f.:.:�?r?:,•Ju.,new,^..t..,,tY'cr',�..rw..>c.,,.,.,.xS,�es;sr:}ST:.�"„
�J,ttNS,.a.:F.. `i%au,r;.a.�'1?i,,':4e'7'y r+._..-" ,r .,r;h,rr,�.".,m,Y�','r,» r„;r.�"P'•:%;�;�7Pr•..,,,.sF>ia;},7,s,�, _r.d:1>`I�iL .r."ta�'•.M:t'fr•:�r*r..: ,�u....a a
44
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item.
Part 1-Project and Sponsor Information
`_r n 1,/- Ckf)& kJ..
Name of Action or Project:
bo G0. Reg') /LCt'.
Project Location(describe,and attach a location map):
Brief Description of Proposed Action:
TA
Name of Applicant or Sponsor: Telephone:
S
q,, � 8 g2f3Z
P Y1 1e ( � qn /N E-Mail:. M��i` A Pe ds 4' Ll
Address:
PO
City/PO: State: Zip Code:
Cc-" I /17 TZ
1.Does the propos d action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES
If Yes,list agency(s)name and permit or approval: Town o f L oiA o )d S t�_
3.a.Total acreage of the site of the proposed action? a s ��UJJ
b.Total acreage to be physically disturbed? r'j acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ./Residential(suburban)
❑Forest ❑Agriculture ❑Aquatic ❑Other(specify):
❑Parkland
Page 1 of 4
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations?
b.Consistent with the adopted comprehensive plan?
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YE
landscape?
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify:
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
b.Are public transportation service(s)available at or near the site of the proposed action?
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? J
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies:
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water:
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment:
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places?
b.Is the proposed action located in an archeological sensitive area?
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency?
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody?
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
.f
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional
q/Wetland ❑Urban ❑Suburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered?
16.Is the project site located in the 100 year flood plain? NO YES
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO❑YES
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: ❑NO❑YES
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size:
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: _V®'
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe:
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name. Date:
Signature:
Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?"
•' �rh?•v3v-^ �;. vl`3'`'4'�. ' i Cr' G'J• ICU -��'j E A 1�•tl�'•'.' r• '?`
ig A�; i .: � "4. No,or Moderate
�.,p re " ,• ��: a`�< +-,3`a :�'`. _ ;•� _' r.. �+O_�,'4rM ,�,, /�S`_,� :4 small to large
` �- "{,S`�1,. ` '' '3i. ?-1� a - •r b
impact impact
'�,r+} :rS,. v .y" ;1�` uf' �^'.sr;�{�t l. „rh. {;' fr1 [_ 5"5lty,{� •��?t�,-�'L�ia _ 1,'h3ir'13�r`µ .1u
i.y 7.•,. ;:.�Sbl4 , <f�; � +•.t,Crf•r, ,, ,y}'.t Y, f- c.. ar�� 5.
.f+T^��,3- '�;��t'�'`•F�''i,�i�'�'4'=`fit��'j•'1'',� :F-"`'Ij�Ar�}`�tse''.Ecl`^��,+'in'�'�•'st�' i7�s`e z''����`+�iT4� �p ��Y^ �' may may
occur occur
1. Will the proposed action create a material conflict with an adopted land use plan or zoning
regulations?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the character or quality of the existing community?
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological,
architectural or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
No or Moderate
small to large
impact impact
.}:. ' --�, , _ - _ - ' .":- :;".�-•'`',�:,a�}'f;-�...:•r,'z-:�-,.:�yr•��'�u?��,tmay may
occur Occur
' - - •t•rid "i^:si'^a';f`+f:7:'{e!'•'x�rd�. 4�an
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and
cumulative impacts.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Name of Lead Agency Date
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
Page 4 of 4
IIIIIII 0111111
A
rA
Aimud.,.e
` op
-.
tx.
r.
;s
e'+
1 �..� iR.�„►.•�... .,may
•she —
t,y,
t y�
' .-ate '�' '*�` .,�,ete- ,+_ - ... .d.; '� �►...� -i,4a^:`�t
4 -e
-
E
rx.r+-.. P'e'r�� � r - -' •gym
v r
• s
t t r 7
x_
� L
i
gq
a _ -
ti
7v
r _
k P
,
i
r
r
•w.�I T
yAU P
Yi
P
t
�'4.
1'
^� - ti
.. .-
� �., �_ .�
�,' `
... � �
i+I
1
..,�
i ;
�.
4 i�
J
�r
� „ �
i
;�
.,
�� + .
..;,
�.
_ �.
•;� .
..�--
��..,-
}. � ,.:r
t � �, ; � �
�:� � � _
� .. .
r
�-
��
� � 11 ��
���.
�� -
��-,.
� . .
__ "�
_,
•v
Page 2 of 3—January 23,2014
ZBA#671 I—Ameen
s C"rM#1000-115-11.4 1
FINDINGS OF FACT/REASONS FOR BOARD ACTION:
The Zoning Board of Appeals held a public hearing on this application on January 9,2014 at which time written
and oral evidence were presented. Based upon all testimony,documentation,personal inspection of the property
and surrounding neighborhood,and other evidence,the Zoning Board finds the following facts to be true and
relevant and makes the following findings:
1. Town Law X267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of
the neighborhood or a detriment to nearby properties. The Lupton Point Rd., area consists of approximately 22
described lots which predate zoning. The subject dwelling on the property has been in existence since prior to
zoning with no evidence of adverse impacts.
2. Town Law 4267-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible
for the applicant to pursue, other than an area variance. The present home has been in existence prior to zoning
and is located within the 75 foot bulkhead setback.
3. Town Law &267-b(3)(b)(3). The variance granted herein is not mathematically substantial, representing 15%
relief from the code. However, the proposed second floor deck is proposed above an existing deck and will
maintain the same setback that presently exists.
4. Town Law 4267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential
community will have an adverse impact on the physical or environmental conditions in the neighborhood. The
applicant must comply with Chapter 236 of the Town's Storm Water Management Code and shall comply with the
determination made by the LWRP Coordinator.
5, Town Law 4267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the
Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the
limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase.
6. Town Law 4267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the
applicant to enjoy the benefit of additions and alterations while preserving and protecting the character of the
neighborhood and the health, safety and welfare of the community.
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under
New York Town Law 267-B, motion was offered by Member Weisman (Chairperson), seconded by Member .
Schneider,and duly carried,to
GRANT,the variance as applied for, and shown on the plans prepared by Charles Thomas, Architect,pages 1-5,
dated 7/13/2013and the survey dated March 12, 2013, last updated November 21, 2013 prepared by John T.
Metzger,LLS. Subject to the following conditions;
CONDITIONS:
1. Proposed second story deck shall remain open to the sky.
2. A perpetual 20 foot wide landscaped buffer shall be installed landward of the tidal'wetland line as shown
on the survey.
That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued.
Any deviation from the survey,site plan and/or architectural drawings cited in this decision will result in delays and/or a
possible denial by the Building Department of a building permit, and may require a new application and public hearing before
the Zoning Board of Appeals.
Page 3 of 3—January 23,2014
ZBA#6711—Ameen
SCTM#1000-115-11-0 I
Any deviation from the variances) granted herein as shown on the architectural drawings, site plan and/or survey cited
above, such as alterations, extensions, or demolitions, are not authorized tender this application when involving
nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other
feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are
expressly addressed in this action.
The Board reserves the right to substitute a similar design that is de minima in nature for an alteration that does not increase the degree of
nonconformity.
Vote of the Board: Ayes:Members Weisman(Chairperson),Schneider, Dantes, Horning. Absent:Member Goehringer, This
Resolution was duly adopted(4-0).
1-4
Leslie Kanes Weisman, Ch&j'rperson
Approved for filing/ /a Y/2014
Office Location: �O"�,Of$Q�jyo� Mailing Address:
Town Annex/First Floor,Capital One Bank 53095 Main Road
54375 Main Road(at Youngs Avenue) P.O.Box 1179
Southold,NY 11971 0- • Southold,NY 11971-0959
i
http://southoldtown.northfork.net RECEIVED
BOARD OF APPEALS l D
TOWN OF SOUTHOLD FEB 1 0 -:14
Tel.(631)765-1809 Fax(631)765-9064 Southold Town Clerk
FINDINGS,DELIBERATIONS AND DETERMINATION
MEETING OF JANUARY 23,2014
ZBA FILE 6711
NAME OF APPLICANT: Carolyn R.Ameen SCTM#1000-115-11-4.1
PROPERTY LOCATION: 755 Lupton Point Road(adj,to Deep Hole Creek)Mattituck,NY
SEQRRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this
application and determines that this review falls under the Type II category of the State's List of Actions, without
further steps under SEQRA.
SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk
County Administrative Code Sections A 14-14 t o 23, and the Suffolk County Department of Planning issued its
reply dated December 30, 2013 stating that this application is considered a matter for local determination as there
appears to be no significant county-wide or inter-community impact.
LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency
review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. The LWRP Coordinator issued a recommendation dated December 23, 2013. Based upon the
information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the
records available to us, it is our recommendation that the proposed action is INCONSISTENT with LWRP policy
standards and therefore is INCONSISTENT with the LWRP.Based upon the mitigating conditions imposed in this
decision,the Board finds the application CONSISTENT with the LWRP.
PROPERTY FACTS/DESCRIPTION: Subject property is improved with a two story frame dwelling with
attached porch and patio. It is located in the R-40 zone district and is non-conforming with 22,570 sq. ft. It has
95.24 feet of frontage on Lupton Point Road (20' Right of Way), 208.48 feet along the western property line,
110.79 feet along the northern property line, 44.78 feet on Deep Hole Creek and 198.24 feet along the eastern
property line as shown on the survey dated March 12, 2013, last updated November 21,2013 prepared by John T.
Metzger,LLS.
BASIS OF APPLICATION: Request for Variance from Article XXII Section 280-116B and the Building
Inspector's October 10, 2013 Notice of Disapproval based on an application for building permit for additions and
alterations to existing single family dwelling,at; 1) less than the code required bulkhead setback of 75 feet.
RELIEF REQUESTED: The applicant requests a variance for additions and alterations to the existing home,
including a second floor deck that is proposed at 63.4 feet from the bulkhead where the code required a 75 foot
bulkhead setback.
ADDITIONAL INFORMATION: During the hearing the applicant's agent was asked to provide information on
the condition of the septic system and its location. On January 10, 2014 the ZBA received the requested
information.
a• 14" , as
u, p
jo
o
• - al 164
L' X19
1 " 7
m
's
' Ni s w
Nrb O o y 5
1 1
t,n om o o
M, P - m
,X al5- r�� s o
,m
X15 - 11• a� \
.0 � ,•y9� I,eo 23
13 y� .A
,14JIG
C 24
k cs 20. x
� R
,1M ffi
jgl Co. AOF" u
pAftKS.RELRFA71oR
6 aCONSH01AT10N $ Pn 19 pI" 31.1 PI 8
v
16.E
1 f O $ cn 14 g $ 27 m an s
jm
1
15 28
I.» P a
� " B �_ I e cm Xg $ �
e /
y Z9 s
185 3,.3 e m ,mom ,m . 18 g wl 16 -$" PI
1.BA s .9 " 9 �% 36A(c) x.s
• 18.4 9.1 33.5 1184 y ,a t�� p,l 17 � � g Ts
at 2-13A 1,gA(c) 31 0
19 " 29
t 3A(c) 92 x m ,m , 25
x as ,auo „s m on ... 24 25
5 s rm g q- 7 2 1 8 8 8 p9 s m
=
g 11 2a
9 28 34.1 '� a• w 3 "v ,s° pw 23 m s 2 'A1 ,m
,so N
SUFFOLK Q -rOWN OF SOU7t+0 , m = r •23;
O 3 tel ,sa
al $ 4 72
re
t 1 Ra z,
�
_ a o
"y 7 15.1A(c) .I r 5 8 4 x tm z+
9 A 6.5 2.3A(c) Z
y 3.OA(c)
20 p s
7 so m
7J� s
I O� 1 2 6ax to >lm to
12 "0 � -
g 10 s 7 18 7 =P1
g 12 8
,m- 8 17 " 9 rn eco
t 13 w, ,+ w m z - ,�, 9 13
OR 1 5A(c) �tea.,` � � $ uaPo s`8"" on 16
PARCELNO. 1 - 4 v �'" 6 4' m �p4..+�'m " 14 as ,n
SEC-NO. ,n � X 0 2 3 4-1 5" 6 ,m ,10 e g
-0022 •.. 90 O • $ ,m ° 12 11 m 10 t"� 15 11 PI
8.1 �° ?2 21 \,°° iUPTot ',4 13 _ 15 '•8 8 ,� d
15
19 1g-1 $ 1 .w µ �0 16 e rm ^p , 12
9 dM1
172 17- $ m 13
10
M1
OR PARCEL NO � � b ppep/pia GeaYl
EE SEC-NO-
23-01-002.1 g 12 26 FOR PCL NO. 8 8 ��Qlc'l ryo� - 4' n
� f'g 22A(c) SEE SEC.NO. ,� `�- 19d on 4'
$ 123-03028 ry34 0 ,0 16
t LINE MATCH ----- LINE
,g-
I �
�5?dGW'd Wn =-SGH-- H�ErW BaMtl Um --H-- UMFSS OVAVM OTmM15E 11 'n"'RnES
araE wTwNTIe TnLowNOlssTwcls. NOTICE COUNTY OF SU
NAINMMICE,ALTERATIONS EOR Real Property Tax S
WI�CNN18� -W-- li+md OWdlb--MST-- MAE �a�n H/ppNlf
Wmo.mt,un --L-- � -- tJWrt Lsw DISTRIBUnON OFANY PORTION OF THE
Roeif ILe——• rwR. ' County Center RlverhuC
�HISE SUFFOLK LOUNTY TAX MPP IS PROHIBITED
Peh R9iELM --P-- YLiwrlerQ,Wtl Ler--VM/-- MpUlw, —TIT.g R WTHOUTVIRI NPERMISSIONOFTHE
Ss�rtlwaLl. —5-- REAL PROPERTY TAX SEFMCEAGENCY
{I
f
OFA
SOP ,t F�"PA
31:0" 4"V.T.R. IL gk ROOF L U
� 000 � —��'•'�=:-� �--�=='`'r�-- — — — — — — — — — — — — — � �
;r-- =- � 4,� ., - - - - - - - - - - - - I CEILING L PATHMOM " I x LAU1'1DFY AREACie
1107 s r I I I I 1112 1112 0 Q
78
C-
MAINTAIN: I I SHOWERW.C. LAV. I I � � Lf
N
BASEMENTEXTENSION
WITH COVERED PORCH I I I W D Q
VENT TO Q
AT FIRST FLOOR ON
SEPARATEAPPLICA TION / I I I I I EXT. gk SECOND FLOOR
8"P.C.FOUNDATION WALL I � Lr)
A NO POO TING%�, I ( UNEXOAV I"ED AWF_A BELOWGR,40ETOBEM/N.36" I h 04
II
4"
6 P.C.SLAB OVER 6 MIL.POL METHENE I I CO' '-
I
VA POR BA RRIER ON WELL COMPACTED Imk CEILING
/ I I POROUS FILL.
Q I Note:
` n�i 23 I I I All waste lines above slab
60 `s ` , ` height to be PVC and below
a; EXISTING TWO STORY I I grade to be cast iron to code.
N I 26.3' FRAME DWELLING I I - — - I All water lines to be copper to
/ code, insulated
Wj
• �s{p, p �`� I — — I FIRST FLOOR
� o 0
I � �O�
CO. I 41, Existing House trap
15.2' 18.0' 24-0"
7-0'
31'0" To existing approved
septic system
I
o EX ? Q
z
�* POOL MAINTAIN. DETACHED ffOUNIDATION FLAN FLU1''(i )ING �15D� 1DIAGFAM
M SCALE.•1/4^=fro" N.T.S � o
d GARAGE WITHACCESSORY "'
APARTMENTABOVE m ALL PLUMBING PER NYS BUILDING CODE AND OR LOCAL MUNICIPALITIES O
"J
20.0' 25.0' CAR CAR
CAR #3
EX.
2 � o
I #1
GARAGE" o
Rs U
GRAVEL DRIVEWAY
0
[DATED
FAA P o 0
0
I
CAR#5 'rD �' X14
CAR ISION
#6?� CAR ESTIMATED CAR SIZE. 9X18L__ / 1�
;Eo #4
X2001
v
'W 31'-0" �V 31'0"
— o 45' 10 .,
TR %
J30�8s0y S 79 oAU ELL'PTICAL WIN.�J6+� �UPT�N PDIV N
\—CEDARSIDING 3'0 WALL HT. 6,8x
TYVEKHOUSE WRAPSCALE.' � -70 WINDOVOPENING AREA c, h
%2"CDX PLYWOOD SHEATHING ON 2'X6 BU/L T IN REF.
6"
L— I �1 "- '
WOOD STUDS @ IF 0..C. "� COINTER
5'OCLG.HT. 4'8"WALL HT.
ft—OT (Zs �h z 'n
z 5'-97P�ElD/50FA
j
0 o Q NOTE.THIS SITE PLAN IS NOTA LEGAL SURVEY.IT IS W a r-A � 28URNERGASCQKTOPW/DIS.' 1000 �' c� 28"DOOR QFOR ILLUSTRATION PURPOSES ONLY.ALL HOODM/CROWAVlICON.OVEN
SEC.' 115 DIMENS/ONS,SETBACKS,LOCATIONS& )2X14 ML.HDR " ___ w Q ni
BLK.' 11 STRUCTURES WERE TAKEN FROM SURVEY o " �i — o �J w
PREPARED BY.•LICENSED LAND SURVEYOR `= z q' a N 12"ML RIDGE T 8 CLG HT ® o vi N
LOT.' 4.1 JOHN T.METZGER,PECONIC SURVE TORS, � `a � o m _ ,w� q ` � �
AREA:--- 22,570 SQ.FT '` � COUNTER V WALL � `` T Q
1230 TRAVELER STREET,SOUTHOLD,NY 11971 o _
LOTAREA COVERED.' 3,646 SQ.FT. TEL:(631)765 5020,FAX(631)7651797 v — — —
o a DATED.' NOV.21,2013 °� M� o z— �ti ? N
LOTAREA /o COVERED.' 16I%o � TWO Of GWAGE fEA r-N1"i.'Y �
L 546 SO..FT. o �\ I I I \Gql! i=OY EF
�^
z 30-2"
m 5'-9"WALL H . o
AREA \ o
�p 3-4, " 10E11" �\
W ,
MAINTAIN NOTES.' o I J ARcrnrECT EAL:
/ J 3'O'WALL HT.
IN
I. THEPURPOSEOFTHESEDRAWINGSARETOMAINTAINANEXISTINGCONDITION. XXN
5T0K. � q ARCH WIN.
2X8@ 6x O.C2NO PL UMB/NG WORKAT THIS TIME. 2X8RR@1O.
3ALLELECTRICALWORK TOBEDONEBYALICENSEDELECTR/CIAN. THE ELECTRlC/ANTOPROVIDE THE Z l�`,,'_L.�,� h •' .,'.;; r�.•, Y',��
t�-\l•
,-•,\�1
HOMEOWNER WITHAN UPDATED ELECTRICAL APPROVAL CERT/FICATEAT THE COMPLETION OF THE JOB. 8 CT4 PROV/DEFLASH/NG& �? I
v � CLG.SLOPE � CL G.SLOPE DN
�. ���
4. DIMENSIONS HAVEPRECEDENCEOVER SCALE. (3)2X12HDRW/6X6POSTBOTHS/DES. (3)2X12HDR.W/6X6POSTBOTHSIDES. (2)2X12ML.HDR. b STEPPEDFLASHING
5. ALL CONCRETE TO BE3500PSI. r'?; ^'
6. ALL LUMBER lNCONTACT WITH CONCRETE TO BE PRESSURE TREATED. OVERHEAD DOOR OVERHEAD DOOR ' 1
DECORA TI VE L CA BEARING
7. ALL WORK TO REDONE INACCORDANCE W/TH THE CURRENT RESIDENTIAL CODE OFNYSTATE. DH DH IH
8. THESEPLANS REPRESENT EXISTING CONDIT/ONSAS BEST COULD BE DETERMINED BY VISUAL 244" T-0" COLUMN DOWN TO FOOTING
INSPECTION. ELEMENTSOFCONSTRUCTIONCONCEALEDDURINGTHE/NSPECT/ONAREIND/CATEDASMIN.36"BELOWGRADE. 24 0" 7'-0"
REQUIRED BY CODEAND STANDARD CONSTRUCTION PRACTICES. OWNER TO UPGRADEAS REQUIRED 31'-0"
31'-0"
511ETT#.•
fF5T FL_001� FLAN 5ECOND fL_OO1� #2t-AN
SCALE 1/4'=1'-0"
ASSESSORYAPARTMENT SQ.FT. =632 SQ. FT. OF
2
"O1dTNG WVAR{?lJf�f ipE�L./SEL LQV
pQ
EU
T.0.RIDGE
775
o ,
12 ASPHALT SHINGLES ASPHAL T SHINGLES OVER
15#ROOF FEL T ON%?'CDXPLYWOOD
SHEATHING,ZYBRR@ 16"0C.
GUTTER&LEADERS GUTTER&LEADERS
C
CEDAR S1DWG CEDARSIDING
0
N
DECORATIVELOADBEA RING o N
COLUMN DOWN TO FOOTING CEDAR SIDING
MIN.36"BELOWGRADE. N
z
GRADE GRADE
8"P.C.FOUNDATION WALL AND FOOTING TO SE MIN.36"BELOW GRADE. i 8"P.C.FOUNDATION WALL AND FOOTING TO BE MIN.36"BELOW GRADE.
l�._
----------------------------------------------------- ----------------------------------------- - --------------------•------------------------------------------------•--------------------------------J
�tVhh,
O
ff A5T 511D E E LEV VST I O N SCALE 1/4"=1'-0" W r—5T 5 I1D E ELEVATION SCALE.•1/4"=1'-C L
oKfo
- z
88
m
ElEl
0 0
j O
_ N
ElEl ® FINAL MAP v
REVIEWED BY ZBA �..
SEE DECISION # -7-
D
7- �'S�-
DATED I /= /-._Z
ASPHALT SHINGLES ASPHALT SHINGLES
v
GUTTER&LEADERSO
GUTTER&LEADERS � V
CEDAR SIDING CEDAR SIDING
�C w
v o
CEDAR SIDING CEDAR SIDING
ARCHITECTSEAL:
GRADE GRADE
8"P.C.FOUNDATION WA,L AND FOOTING TO BEMIN.36"BELOW GRADE. d 8"P.C.FOUNDATION WALL AND FOOTING TO BE MIN.35"BELOW GRADE.
L--1------------------------------------------------------------------------ ---------------------------------------------------------------------------'
N O FT M 511D E E.LEVAT I O N SCALE 1/4"=1�o' 50 UT H 511D E E L-EV AT I O N SCALE 1/4"=1' SKEET#'
2
OF
2