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J Office Location: so Mailing Address: h O Town Annex/First Floor,Capital One Bank 53095 Main Road 54375 Main Road(at Youngs Avenue) P.O. Box 1179 Southold,NY 11971 • y0� Southold, NY 11971-0959 C4UNT`1,� http://southoldtown-northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel: (631) 765-1809 Fax (631) 765-9061 COVER'SHEET WITH ZBA FILE STATUS OF FILE ZBA# —7qo`� Name : Sh,e:l blg +_V !4U6( s_JYIC Tax Map #: A)00- -7(a ICS 3®1 Location : bl-i O- 0 . [ Refund issued : CANNOT activate or reactivate file (Applicant has withdrawn application). [ ] NO REFUND DUE, based on time spent for Town to process application and hearings. [ j] Obsolete & expired; CANNOT reactivate this file: NEW APPLICATION NECESSARY: Extensive time has passed; Zoning Code changes are now in effect and this application expired. NOTE: Applicant may apply for a new application with Building Inspector for a new Notice, of Disapproval and submit NEW application with all documents and current maps to ZBA, or modify plan to conform to the current code. This Town file based on applicant's previous year requests has expired, [ ] No forms to be scanned; FILE # VOID: APPLICATION RETURNED. (All forms were returned to applicant early in process, as requested by applicant.) U p OITI DR Q By Arrucawrr =--------------------------------------------------------------------------------------------------------- Shefbe,vt Inc. -70 10q!;" SM -A, C 1190 c54ix bn\p ��c lcf /0th -Ujjeaf lot �� m� � - dd zenf'l o� 3Q Ads J -ik Wit- -76,a-i® Ari- 11 secfi rn ak .-1® P4 6/ 1 W rn+D A) 3Ia31aa,-�O J �7 CHECK BOXES AS COMPLETED ( } Tape this form to' to o a O ( ) Pull ZBA copy of ( ) Check file boxes � cn ( ) Assign next numk o outside of file fol( Cn ( ) Date stamp entir( m - � -° w °� 4 o :7m x0 � w � D c" rs file number T. Z o Cn D cn ( ) Hole punch entirE co cl X 9 (before sending t I z o CD ( ) Create new index co CL:Ecn m ( ) Print contact info m cr CO m C) N Q 0( ) Prepare transmitt -c ( ) Send original appl to Town Clerk ( ) Note inside file fo 0 and tape to inside ° -n c� ( ) Copy County Tax P 3 it neighbors and AG ( ) Make 7 copies an( ( ) Do mailing label Nei AP A6 12- -s BRIAN A. ANDREWS PLLL Attorney at Law 13235 MAIN ROAD • P.O. Box 43 • MATTITUCK, NEW YORK 1 1952 631.298.5400 • FAX 631.298.4214 BANDREWSESQUIRE@YAHOO.COM March 23, 2020 Southold Town Zoning Board of Appeals 53095 Main Road Southold,NY 11971 Attn: Kim Fuentes, Board Assistant Re: Selbert Ventures, Inc. Premises 1180 Smith Drive South, Southold,NY SCTM No. 1000-076.000 02.00 032.00 Dear Ms. Fuentes: Please be advised that the Application to Un-Merge the above referenced properties is hereby withdrawn. If you have any questions, please do not hesitate to contact the undersigned. Very tr ly yours, Brian A.Andrews.' BAA/mff Cc: Russ Kipperman �sorrct�oG �� s� RESOLUTION 2020-351 0 ADOPTED DOC ID: 16202 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2020-351 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 16, 2020: RESOLVED,that the Town Board of the Town of Southold hereby grants a refund to the following applicant; as the Zoning Board of Appeals has been,notified that the applicant has withdrawn his application. Brian A: Andrews PLLC 13235 Main Road Mattituck,NY 11952 $750.00 ZBA# 7404 For Shelbert Ventures, Inc. 01j&w?. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:James Dinizio Jr, Councilman AYES: Nappa, Dinizio Jr, Doherty, Ghosio, Evans, Russell 005 1--v MCI = I� rn COUNTY OF SUFFOLK-- fin' RECEIVED mys MAR 121 2020 011 II,, OFFICE OF THE COUNTY EXECUTIVE t�l� Zoning rcarci Of/, pea!s Steven Bellone �l �� SUFFOLK COUNTY EXECUTIVE r G4 Natalie Wright , Department of Commissioner Economic Development and Planning March 5, 2020 Town of Southold Zoning Board of Appeals 53095 Main Road P.O. Box 1179 Southold,NY 11971-0959 Attn: Leslie Weisman Dear Ms. Weisman: Pursuant to the requirements of Sections A14-14 thru A 14-25 of the Suffolk County Administrative Code, the following application submitted to the Suffolk County Planning Commission is to be a matter for local determination as there appears to be no significant county-wide or inter-community impacts. A decision of local determination should not be construed as either an approval or disapproval. Applicant Municipal File Number Smith,Erik # 7400 d" DeVito, Joseph #7401 J vK Lim, Phillip #7402 J Shelbert Ventures, Inc. #7404 Milito, Gerard ,#7405 .- Very truly yours, Sarah Lansdale Director of Planning Theodore R. Klein, Principal Planner TRK/cd Division of Planning&Environment H.LEE DENNISON BLDG ■ 100 VETERANS MEMORIAL HWY,11th FI ■ P.O.BOX 6100 ■ HAUPPAUGE,NY 11788-0099 ■ (631)853-5191 rb i I REi~EIVE� FEB 9 2020 FORM NO. 3 TOWN OF SOUTHOLD Zohirig Bowra Of Appeals BUILDING DEPARTMENT i SOUTHOLD,N.Y. _ NOTICE OF DISAPPROVAL j s x DATE: December 16,2019 t TO: Shelbert Ventures Inc. 125 East Main Street,Unit 132 -•-• Kings Park,NY 11754 -- k Please take notice that your application dated November 18,2019: r For merger determination at: i Location of property: 1095 Smith Drive South. Southold,NY County Tax Map No. 1000—Section 76 Block 2 Lot 32 4 i Is returned herewith and disapproved on the following grounds: i The subiect lot has merged with an adiacent lot to the north (SCTM # 1000-76-2 10) i pursuant to Article II Section 280=10 which states.• "Merger. A nonconforming lot shall merge with an adjacent conforming or nonconforming lot which has been held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with the barcel for a common course of tifty(50)feet or more in distance Nonconforming lots shall - - merge-until the total lot size conforms to the current bulk schedule requirements � s s, S i i p d � F Au -i gnature i a t r CC: file,Z.B.A. t ` { f 5 2 r1 Y i f s3{ , i f { i SYMBOL LEGEND ❑ MONUMW f FND ©GAS METER 0 j;--sNt♦11 ILP/LB FND ®WA1ER METER RECEIVED P B 04 GAS VALYL SPOT ELEVATIONS WATER TRAFFIC SIGNA.POLE TEST POLE CO2 f' UTILITY POLE TREE GUYTYP ®SHRI.B FEB 1 9 2020 UTILITY POLE ANGH7 • ROLLAND L'GN7 PGE S YETLAND FLAG SIGN 0 C DEPRESSII/CURB FIRE NYORANT FE FENCE y� p ® MAWC,E MAS MASONRY ZOl ling Board Or �L�'Y ®'A'-INLET PLAT PLATFORM '-1 l� `Ppea,S� Hut b'-NLET vi V? WINDOW WELL ®'E'-INLET B/W BAY K N30W ®YARD INLET C/E CFILAR ENTRANCE ®YARD INLET 0/M OYE3MANC (�CABLE TY BOX R/0 ROOF OAR A/C UNIT L SA LANDSCAPED AREA , ®ELECTRIC METER CANT CANTILEVER TH SMI DH DRIVE _`- ND R (50 E '�� F FM LOT 1p3 LGFM LOT f04 \ � TAX r T f0 — 200.72' .m\ � � °' \ pOTAX LOT 9 UdA F11W6r,80 5 \� �\ p 0 FM LOT 102 TAX LOT f1 , A 162 yV] '3010D"w \ lw 27775 AGAc� N c ' 6 FFM FM LOT 116 �1� 1 TAX LOT s2 �Ol \ FN LOT 115 \ �^- Q, TAX L(yl ss PO FSf LOT 117 c TAX IAT sl �\ o. VACANT LOT1 \ 75.00 — T1-- TH"DRIVE SOUTH S5M WIDE) LOT AREA GRAPHIC SCALE 20,0 47 A SF 0 47 AC 30 0 1s 30 GUARANTEED TO: SHELBERT VENTURES INC IN FEET FIRST INTERNATIONAL TITLE INSURANCE AGENCY 1 loch = 30 fL OFNEWy0 SCALICE LAND SURVEY OF PROPERTY �F P.O. LOTS 117,102,104, �P EL J s P SURVEYING P.C. AND LOTS F03,116 * * Always On Point GOOSENECK 99-105 Wert No1Ma0 Avenue, UM,M—% New Yoh .757 FILE DATE- 11/22/1948 MAP NO, 1663 ma Eil MlSul-@mpla'd—VC Phonr 6314957-2400 Fax.6312261400 "1 40 1a 2 SITUATE cFysED LAND ��o DR.MC CREW.AL SCALE: 1° = 30' SUFFOLK TAX MAP NO SOUTHOLD, TOWN OF SOUTHOLD DATE SURVEYED 09/19/2018 JOB NO 61B-2103 1000-07600-0200-10 AND 3 SUFFOLK COUNTY, NEW YORK Irl iwon®uw,v u w�ro�nra1,w,am,.��1.,00.1 r..u,.,O.m,>sscm,r.�s,m-v.w�2 0,v.oil m mn. u.y o..ew.,..r cm2 wn aw,.c c�unv..omsaMsua Nc mm2 mx.m ov..m m.es rc nc amown aaN,u.mruo�n0A1�m 7al.oKm ,w vo.1%rw-m1j.a=m0Oro90 SURVEY OF y�----- LOT 1031 P/0 LOTS 102.104 a TSI MAP OF DRIVE 1�OR GOOSE NECK ° MITH �" �„ FILE N0. 1663 FILED NOVEMBER 22, 1948 i; `�' ? 129'00 ,44Q SITUATE c---m " xIII CIO BAYVIEW N 80-300 00 E x '4ss 1 TOWN OF SOUTHOLD 15x EpGE PA HW HW 24SUFFOLK COUNTY, NEW YORK ! ' HW2-15• �� yu ' 1 S.C. TAX No. 1000-76-02-10 ,HW 0• HW 15- HW 13• r 1 SCALE 1"=30' JAMf�ioT los wcA FEBRUARY 2, 2019 Hw z-,o ; ; a ;w ; � , 2p0 -712 N HW 12" N DIRT 1 I 14' O � TN DRIVEWAYWi1�1+•',11yw 0 '1 II/Hw 11• p y a ' ,1 �Hw 35� AREA = 12,154.5 sq. ft. r, 32•d Ila 3.5 METAL FENCE 0.279 4C. ,' d0' �aME HOUSE w t� d` HW 30• P/0 LOT 104 NO 1180 rJeFlLL_9__ 121. 1�u 1 ♦ l0 3STEPS H 15• 142!'• Ib CO,LC '1 H 19' O P/0 LOT i 02 Akaz 9 19 X5, 1 1Z O x 2- 1 T x S�DOP BRICK 11,1¢ Uc '�` HWVER 12• la O HW 2-15 1 L111 ALM 1 HW 1 • STOCKADE FENCE L i `1HW 24• FE.,S'S CQ. 1 ` 12• x FE 08 5 +aye 1 09S.85W LOT 115 FE- CE LOT QE) 113.99 30 00 NOTE LOCATIONS AND EXISTENCE OF ANY LOT 11'I 5 Boa SUBSURFACE U71UTIES AND/OR STRUCTURES NOT READILY VISIBLE-ARE NOT CERTIFIED METES AND BOUNDS SURVEYING KART' 65UB ECf TO/NY ElSEN FAC aF Tscarm,wO ANr OTxEs rErDINENr ENT wxkx A,TRE sDvlcx ulOxr OacLDSE 53 PROBST DRIVE %RWIT,OMM N-TERADDN W AOODgN TD A SHIRLEY, NY 11967 SURVET WSEWK A UCE1aED LM SURVE OR'S SEAL IS A VIOLAnaw OF ARnCLE 134.SECTION PHONE (516) 972-581272".SU9pNSION 2.OF THE NEM YORK STATE EDUCATION IAN' surveydude@optonline.net •Ccp,n from the eng—I of this survey map not marked with an original of the land LOTS: 10 BLOCK: 02 SECTION: 76 DISTRICT. 1000 ehal�not be kconndered a wild btrue wpy MAP OF 'Certification Indicated hereon signify that GOOSE NECK rvry as prepared In accordance with the ezlaUng Code s/Practice for Land Surveys adopted by Ne New York State Aaeoeiatwn of SITUATED AT: BAYVIEW Profem,onal Land S., s. Said NOTES' r HARDWOOD certifications shall run only to the parson TOWN OF SOUTHOLD, SUFFOLK CO., N.Y. for whom the.—y Isppreepared,and on his agenlry lo the and lanitle dtngcinatitutlon.ovammental 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM `+� UTILITY POLE CartdicaDane are not transferable to EXISTING ELEVATIONS ARE SHOWN THUS: -10 additional Institutions or subsequent owners.- x o WATER METER CERTIFIED LAMP POST TO JOB NO.: 19-122 DATE: FEBRUARY 2, 2019 SURVEY OF LOT 116, P/0 LOT 117 y MAP OF GOOSE NECK ` a I C"J FILE N0. 1663 FILED NOVEMBER 22, 1948 =, t= LOT 103 , LOT 104 SIT UA TE iJ f �� s0°30 00„ E gs.24 BAYVIEW c.; N LL- i R RECEj\/ED For Office Use Only Fee, Date Assigmied/ZBA File P Filed b}: ot)e_als g Ci 0 A, LZoning B081 -_ Office Notes-_ �o tp PC WAIVER TO UNMERGE PROPERTY APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS THIS APPLICATION IS BASED ON THE WRITTEN DETERMINATION OF THE_ BUILDING INSPECTOR DATED Udc. 16, 2019 WHEREBY THE BUILDING INSPECTOR DENIED AN APPLICATION DATED Nov. 18. 20LIL9der Tm\,ri Code Chapter 280 (Zoning), Article 11, Section 250- for: Building Permit Permit for As-Built Construction-t CCI-tifiCatC of Occupancy ' Pre-Certificate of Occupancy X_ Other merger determinatift Owner ot'Parcel for Waiver: -Shelbert Ventur.Pq,__.Inc.____ Owner of Adjacent Parcel: —S'helbert Ventures, Inc. Note: Kapplicant is not the owner, state if applicant is owner's attorney, agent, architect, builder, contract vemlee, etc. klailim, Address: 125 East Main Street. Unit A-132,_-Kings -Park, _NY_11754 Telephone No: (516) 314-0352 Fax/Emai I_ Agent rbr owner. --Brian A. Andrews, Esq. Address: 13235 Main Rd. , P.O. Box 43, Mattituck, NY 11952 Telephone No: .(631) 298-5400 Fax/Email:Bandrewsesquire@vahoo.com Please specify who you wish correspondence to be mailed to, from the above: Owner, or Authorized Representative I, Brian A. Andrews request that the Zoning Board of Appeals waive the merger and recog'ni'ze the original lot lines underunderthe provisions of Article 11, Sections A0-9, 280-10. 280-11 of the Southold Town Zoning Code, for Surrolk County Tax Map District 1000. Section W6_0AD,0 Block02Lot 010.00 containing 12,202 square feet located at -_OLg 47 --- - 11118 StreetSmith Dr. North and for District 1000 Section 076*000 Block 02.010ot 032.00 containing square feet. The property is located in the R-40 Residential Zone District. Page 2—APPLICATION FOk rr'AIVER TO LAN fERGE PROPERTY 7_t3ArZo2ning PE EIVED -7404 B 19 2020 Board 0�Appeais The lot to be unmerged was originally created by deed dated 7/3/1953 , is vacant, and has historically been treated and maintained as a separate and independent residential lot since the date of its original creation. The lot to be unmerged has not been transferred to an unrelated person or entity since the time the merger was effected. This application is an alternative to that provided for under other Town Code provisions available for an area variance. APPLICANT'S REASONS: (1) The waiver would recognize a lot that is comparable in size to a majority of the improved lots in the neighborhood because: Smith Drive South and Terry Place are of comparable size. Five out out of eight of said lois are under .25 acres. (2) The waiver would recognize a lot that is vacant and has historically been treated and maintained as a separate and independent residential lot since the date of its original creation because: The lot in question (032) consists of lot number 116 and one half of lot number 117 on a map entitled "Map of Goose Neck..."which was approved by the Town Board of the Town of Southold and filed with the Suffolk County Clerk on 11/22/1948. (3) The proposed waiver and recognition will not create an adverse impact on the physical or environmental conditions in the neighborhood or district because: The lot in question and the single family dwelling proposed to be constructed thereon is consistent with the character of the neighborhood and will meet or exceed all applicable enviromental regulations. Please check one or more of the following that apply to the lot to be unmerged: 0 This lot was fonnerly approved by the Southold Town Planning Board on (attach copy). ;KI This lot was approved or shown on a map approved by the Southold Town Board during 1948 (attach copy). 0 This lot was approved by the Board of Appeals on (please attach). 0 A search of Town records found no approvals or other action by the Town of Southold, except for Application 4 in the Year (please attach copy). r RES.EI VED 7LID Page 3—APPLICATION FOR WAIVER TO UMMERGE PROPERTY ZBA 4._____FEB 19 L020 Zon:ng Board 01 F ppeals � F/A search of Town records found a Certificate of Occupancy was issued f 1 fora dwelling or other purpose on SCTM Lot 9_j2/0 (please attach copy). (Attach additional streets if needed). Owner(Parcel 1) Sworn to before e t ` day f �,P6(k� , 20p 14 L 4s Notary Public,State of New York Qualified in Suffolk County LIC.#01 FU4811709 C®tnmis8l®n Ex fires April 30Z)-D 2 ONkne�l 2) Sworn to before me this day of ,200 Notary Public Z13A 12195;3(06; 11108C- �4t0 FEB 19 2020 QUESTIONNAIRE Zoning Board Of Appea s FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premises listed on the real estate market for sale? Yes X No B. Are there any proposals to change or alter land contours? X 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? n/a 3.)Is the property bulk headed between the wetlands area and the upland building area? no 4.)If your property contains wetlands or pond areas,have you contacted the Office of the Town trustees for its determination of jurisdiction? Please confirm status of your inquiry or application with the Trustees: n/a and if issued,please attach copies of permit with conditions and approved survey. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? NO E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? NO 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? NO If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe: 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? NO If yes, please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this parcel Ginngl a—fermi 1 y residence w adT. vacantp arc-el and the proposed use gi n¢1 P fermi 1 v residence to colAructed on varantTarr-el , (ex existing single family,proposed same with garage,pool or other) z3" Aut rized signature and Date 1 / x.a LOT WAIVER QUESTIONNAIRE What are the square footage and dimensions of this lot (subject of building department }' merger application): 8,060.5 s.f. 80 ft. by loo +- ft. R VED ECEI Date of first deed which created this lot: 7/2/1953 _ 1)f bq FEB 19 2020 Date of current deed to present owner: 10/31/2018 g zon', ng Board Oi Appeals Owners names of lot at current time: Shelbert Ventures, Inc. `�--��-®-- Date and name of subdivision (if any): Goose Neck Size of remaining lot in the merger: _ 12,202 s.f. Were there any building permits issued in the past for this lot: Yes x No If yes, please provide copy of former permit and map approved. W ,ere there any County Health-Department approvals in the past for either lot? Yes x No If yes, please provide a copy. Were they any vacant land Certificates of Occupancy requested in the past? Yes No x . If yes, please provide a copy. Were there any other Town actions (approvals or denials) in the past regarding this - property (such as a pre-existing Certificate of Occupancy for a preexisting building, a variance, lot-line change, Trustees approval, or other type of application to build or use the property in any way)? Yes No I . If yes, please provide copy (if available), or explain: Is there any building or structure, such as a patio, driveway, or other, overlapping the deeded lot line which separates the two merged lots? No. _x Yes If yes, please explain. How many other vacant lots are on the same block and immediateTheighborhood? Three Please note other approvals or other information about common ownership of these lots: I am an owner of the subject lot and the above information is provided to the best of my knowledge. (Copies noted above are attached.) Dated: 7/1 [�I20 Z a , Owner's Signature ZBA5127199 RRFCt£VF D FEB144 9 2020 _ AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS Zoning Board ©;g0i'eo(s TOWN OF SOUTHOLD b WHEN TO USE THIS FORM: The form must be completed by the applicant for any special use permit;site plan approval, use variance, or subdivision approval on property within an agricultural district OR within S00 feet of a farm operation located in agricultural district:All applications requiring an agricultural data " statement must be referred to the Suffolk County Department of Planning in accordance with sectiouis 239- ` m tend 239=n of the General Municipol Law. 1)Name of Applicant: Shelbert Ventures, Inc. 2)Address of Applicant:125 East Main St. , Unit 132, Kings Par , 3)flame of Land Owner(if other than applicant) 4)Address of Land Owner: 5)Description of proposed Project:Construction owo story, wel:11 ge and basement 6)Location of Property(road and tax map number): 1095 Smith Dr. South 1000 076-06-0 -072—.0-0-02.0 7)Is the parcel within an agricultural district? ®No ❑Yes If yes,Agricultural District Number 8)Is.this parcel actively farmed? 0 No D Yes 9) Name and address 'of any owner(s) of land within the agricultural district containing active. farm operation(s) located 500 feet of the boundary of the proposed project. (Information may be available through the Town Assessors Office, Town Hall location (765-1937) or-from any public computer at the Town Hall locatioris by viewing the parcel numbers on the Town of Southold Real Property Tax System. Name and Address 2. 3. _ 4., 5. 6. (Please use back side of page if more than six property owners are identified.) the lot numbers may be obtained,in advance,when requested from the Office of the Planning Board at 765- 1938 or the Zoning Board of Appeals at 765-1809. Z 1 1 -2,0 Sijiature of Applicant Date Note: 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.Solicitation will be made by supplying a copy of this statement. 2:Comments returned to the local board will betaken into consideratiop as part of the overall review of this application. 3.The clerk to the local board is responsible for sending copies of the completed Agricultural Data Statement to the property owners identified above.The cost for mailing shall be paid by the applicant at the time theapplication is submitted for review.Failure to pay at such time means the application is not complete and cannot be acted upon by the board- 1-14-09 1 I • s D e ` RECEIVED 617.20 Appendix �, /,,, Appendix B FEB ? Short Environmental Assessment Forn: Instructions for Comaletin� Zoning Board 0;p,ppo,ls 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 I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. 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 Name of Action or Project: Construction of a single family dwelling with basement and one—car 'gara-ge. Project Location(describe,and attach a location map): 1095 Smith Drive South, Southold, NY Brief Description of Proposed Action: Construction of a single family dwelling with basement and garage. Name of Applicant or Sponsor: Telephone: 631-298-5400 Brian A. Andrews E-Mai1$andrewsesquire@yahoo.com Address: 13235 Main Rd., P.O.Box 43 City/PO: ]!!���Code: Mattituck 1952 1.Does the proposed 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 X eq permit,approval or funding from any other governmental Agency? NO YES If lest lit'o ffency(s)name and permit or approval: County Dept. of Health, Sanitary X 3.a.Total acreage of the site of the proposed action? 0.18 5 acres b.Total acreage to be physically disturbed? 0.030 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0-4 7 0 acres 4• Check all land uses that occur on,adjoining and near the proposed action. 'o Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial AResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 RECEIVED 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? FEB 194 910 q 020 V/b.Consistent with the adopted comprehensive plan? n , ��el Qi'Appeals 6. Is the proposed action consistent with the predominant charac raftlre�xishn-g built or naturalNO YES 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? 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: Public, SCWA 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Septic tank/cesspool ✓ 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: 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 ❑Agrlculturallgrasslands ❑Early mid-successional ❑ Wetland ❑Urban C(Saburban 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 stone water discharge,either If Yes, from point or non-point sources? NO 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 i 18.Does the proposed action include construction or other activities that resu t--int-ci its oundmenro NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? r-�l\�-p If Yes,explain purpose and size: E B B a I 19.Has the site of the proposed action or an adjoining property been theto f on of�an ac o�closed NO YES solid waste management facility? 2etliin oar ppeals If Yes,describe: I/ 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 r.� r \J e Applicant/sponsor name: ,Q Date: Z//4 f lb 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?" No,or Moderate small to large impact impact may may a N4 occur occur L 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)? S. 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 1 I ;_, [ ��. :',iy-.';'�"',y,'�S:yi4��.:,!•��.`7�r•�`-74fY�d:.:. �t�t!i hto,or Moderate small to large ;'.+r``'i;+: - - . - •. - ,_ �- 's.. �-•r ,,,j< <�-.�.n..�; .�^,ez:� rr w.-,s*?�'. ..''`'*M:. ,sem ?�i�' $1, r impact impact �r��§'S' '•�;,.=•�y, �r� 'r a'..,� :.'<,r'., xis�,'_ .''M1'{ nfC.�t�'Sh.drY�."' may may occur occur 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. [ZoniREl- !\'ED ng EB 19 2020 Board O.Ap�eais 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. o 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 I RECERiED 0 2 0 APPLICANT/OWNER FEB1 TRANSACTIONAL DISCLOSURE FORM Zoning Board OfAppeals 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: Andrews, Brian A. (Last name,first name,middle initial,unless you are applying in the name orsomeone else or other entity,such as a company.Ifso,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) Waiver of merger Planning 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 X 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 Andrews Brian A Title or position of that person Board of As sesment Review, Member Describe the relationship between yourself(the applicant/agent/rcpresentative)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) S)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 , Retained-as attorney/agent for applicant Shelbert Ventures, Inc. Submitted this day of '20 20 Signature Print Name Brian A. Andrews C2 FcgjB FEBAPPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM FP_p'alsJ The Town of Southold's Code of F thics prohibits conflicts of interest on the nart 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: . Wbert yeriturea Inc. (bast name,first name,middle Initial,unless you are applying in the name of someone else or other eotity,suckas 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)waiver of mer ger Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with Buy 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 X 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 tate Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agenYrepresentative)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 tate 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 or the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSEUP Submitted thi d �/ol d 20 Signatu / Print Name By Ws Kipperman, Pres. ti D 4 Town of Southold RECEIVE -4D LWRP CONSISTENCY ASSESSMENT FORM FEB 19 2020 A. INSTRUCTIONS Zoning Board Oi/`-ppoa!s� 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# 1000 - 076.000 - 02.00 -032.00 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ® Board of Trustees ❑ 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) ❑ (b) Financial assistance(e.g. grant, loan,subsidy) cPermit, approval, license, certification: --- - Nature and extent of action: Dental of building permit/merger determination Location of action: 1095 Smith Dr. South, Southold, NY 11971 Site acreage: 0.185 RECEIVED I "4� Present land use: Vacant residential FFR 1 9 2090 Present zoning classification: R-40 ! iniQ, arr Lp , eals 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 applicant: Brian A. Andrews (b) Mailing address: 13235 Main Rd, P.O. Box 43, Mattituck, NY 11952 (c) Telephone number: Area Code( ) (630298-5400 (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No x❑ If yes,which state or federal agency? C. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary —�ohcy pec and preserve is orbicand archaeological resources of theTown o outhold. See LWRP - Section III-Policies PAges 3 through 6 for evaluation criteria - ---------------- - - - - - - --- -- -- - - --- - - -- - ❑ Yes ❑ No Not Applicable 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 F] Yes [:] No ❑ �, Not Applicable FC-- Ifs, f, 1 40"[ 1 Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable 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 ❑ No ❑Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant_Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III — Policies; Pages 22 through 32 for evaluation criteria. - -- - F-1--'- - -------------- ------------------------ --- --- ---- --------- -------- --- --- ❑ Yes ❑ No❑ Not Applicable Attach additional sheets if necessary Policy 7. Protect 'and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable RNFrc40 X020 17onin� Board Ot Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yes❑ No❑ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. " Yes Hwo ❑ otAppdicable ----- ----- - ---- r 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. ❑ Yes ❑ No ❑ Not Applicable :E-EIVED P Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LVVRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable Created on 5/25/0511:20 AM RE��EI� FEB((19 2020 Zoning Board Oi p opeals Board ot'ZoninQ Anpcals Annficution AUTHORIZATION (Where the Applicant is not the Owner) Shelbert Ventures Inc. by T, RUSS KIPPERMAN residing at 125 East Main Street. Unit 132 (Print property owner's name) (Mailing Address) Kings Park, NY 11754 do hereby authorize Brian A. Andrews (Agent) to apply for variance(s)on my behalf from the Southold Zoning Board of Appcals. Shel rrt enture Inc. BY; �r SS K7PERMAN, gnature) RUSS Kres. (Print Owner's Name) MRHI NO. 4 TOWN OF SOUTHOLD RECEIVED BUILDING DEPARTMENT TOWN 'CLERK'S OFFICE i SOUTHOLD,' N. Y. FEB9 2020 Zort?na Soarc; 01 1jP-,ppj=ais . CERTIFICATE OF OCCUPANCY No ..Z..145.9........... Date ...................'AO7=bfiW-2........... .. 19-61:i . THIS CERTIFIES that the budding located at . �U ?..Dr•.f... 4r i.. ................. .. Street Map NdG aRT 1 Block No. ......................**wLot No. ...............103 & h102, � 104 .................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................March..............................................., 19........x. pursuant to which Building Permit No. .................�'G�� dated ....... . ............................1 19.. .fR, 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 ........ PRIVATE ONE FAMILY DW L37G The certificate is issued to ................................ i'113.iamm-Greet •4v*na c....... ........................... (owner, lessee or tenant) of the aforesaid building. ................................................................ ............... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD V BUILDING DEPARTMENT �ZO TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Zorn_ or �� p�as BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1667 , Z Date .....................JLPri ...... ................. 19.62. Permission is hereby granted to: G.W.SMI-th-4..S.©Us.....A/C....Wm.Grg-et................. ................................................................I................ to Bu3a.s• .aa..addlticin...pn..an..ex.isting...dwel-l-i rg. ....................................................... ................................................................................................................................................................ at premises located at ..14)+. ....--Go08e--ZWQk. ................................. ...........................................smith—Drive-North Seuth*ld................................................. ................................................................................................................................................................. pursuant to application dated .................................XaWch. ...30.........l ;62. ., and approved by the Building Inspector Fee $.5,.00.............. . ............................................. Building Inspector 3 Nature of work (check which applicable): New Building .................. Addition .x.......... Alteration Repair .................... Removal .................... Demolition.................... Other Work (Describe) ................. . .... r\E'CE1VFD 4. Estimated Cost ......... ..........JR... ...............Fee .. ........(to..be..paid. . .a.n filing.ling.this. .. ..a.p.p.lica.tion) ............... . - FEB 19 5. If dwelling, number of dwelling units ........../.......... .. ..Number of dwelling units on each floor ........ I L Ifgarage, number of cars ...................................... ...... ... .... ..... . .. ......................................................T*.��:*.*.�:..:..:.'.: Zoning Board 0,'A,,pp—ais 6 If business, commercial or mixed occupancy, specify natureand extent of each type of use............ 7. Dimensions of existing structures, if any Front ..��.Ze..... ... Rear .../7-:T.............. Depth Z`<7.4................... Height .....�4................. Number of Stories ......e� ........ .......I..... ...................................................................I...... Dimensions of some structure with alterations or additions- Front .................. Rear J�.................. Depth ............. Height ............/....................Number of Stories ........................................ 8. Dimensions of entire new construction: Front.........1/0... ....... .... Rear ... Depth ... ............. Height .......A�............... Number of Stories....../......................... 9 Size of lot: Front .............. Rear ............. Depth ... e..C). ...................... 10. Date of Purchase ....... ........... ................Name of Former 11. Zone or use district in which premises are situated....X5...................... .............................................................. 12. Does proposed construction ji.alcite low, ordinance or regulatiorl? ... ........... ..... . ..... ... 13 Name of Owner of premises Address .. . . .......... ....... Ph Name of Architect . . .......... Address ............................................ Phone No. .................... or�...... .......... Name of Contract ..... . .... A K6ddress .1)6.�. .......... Phone No.sq.4 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot T 0 pb. STATE OF NEW Op,. S S. COUNTY 0 .............. . ... .......being duly sworn, deposes and says that he is the applicant ............ ... ...... ... (Name of individual signing application) above named. He is the .......................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in tJgVINaormKMt forth in the application filed therewith. Sworn 7 e me this Rattly public,state of New York �52-0544196 'SU1,101K County I �'C' ............ day of ....... . ......A e Ma,c cj�Kk� ................................... ................. CoNotary Public, Cunty (Signature of applicant) } FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. •Y. RECO-jti F:D EB 9 2020 CERTIFICATE OF OCCUPANCY( Zoning Board r- �--_-_ -.'�-Ppeals No. ........4. 669.... Date ...............................iJ.1.DA,A� . .... .. 19A.Q. THIS CERTIFIES that the building locatedat . ? ,:. '. ' �'..�`F,7 ` 3a...# !',�1& t . Street Map No. Block No. ......**. .......... Lot No. .. ..X wl, ... M... ..44....................... conforms substantially to the Application for Building Permit heretofore filed in this office dated + t7 �:;Y'... .................. 195.P..., pursuant to which Building Permit No. ...`Z.. RR... .................. ......... dated ..................`..�nZ� .�).................... 19....�9,was issued, and conforms to all of the requirements of the applicable provisions of the low. The occupancy for which this certificate is issued is ................ ............................................................... ia�rC' i1 „gm..RT;A:K4Tq................................ This certificate is issued :....... ...I.................................................... (owne•r, lessee or tenant) of the aforesaid building. .................................................... .......... ...... .... ....{ .: .... Building Inspector a i FORM-NO. 2 TOWN OF SOUTHOL® L- 5oa BUILDING DEPARTMENTTOWN! CLERK'S OFFICESOUTHOLD, N. Y. rd Of PIPPeZz�? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 552 Z Date ...........Jc1nuaT.jt'..........2.................. 19,5.9... Perm}tissiccon is hereby granted to: ( ytYy G.W.i:)yrith & �6rcids..•..A/.(�.7.�.•..V']im.......W.i..1 e.t.............................. ...........t�-..i•n�: fdZ�Q:Et.�i.................................................. ............ ... .......s'4 1-Y"or............................................... to an...0a is.ting. .d.vzel'J'ang. ...................................................... ................................................................................ ...............................................................1................ of premises located at ....LOU... 0 2.q... T3.r..Cxr..ES atas................. ..................................... .. .ou.tAix3Cld-5. .. .a .........._..................................................................... pursuant to application dated ............ ...t. _... ............... and approved by the Building Inspector Fee $.. 00.....paid Building inspector 3. Nature of work (check which applical';, _ New Building....................Addition ...... ...,.., , _ Iteration .................... Repair ................. .Removal ....................Demolition....................Other Work (Describe) .................... :. c;,a 4. Estimated Cost........ y.`�.�.�. .................................Fee .. .:77:7.................................,......................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units................................Number of dwelling units on each floor............................ Ifgarage, number of cars............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.............................. 9 Y' . ......... Depth 7. Dimensions of existing structures if an Front........... ............. Rear.........,,�.�.. .......!:?................. Height ............................Number of Stories ............Cya::k^rx:,...................... ................................................. Dimensions of some structure with alterations or additions: Front ...............�/..4....... Rear ................................ Depth .............................. Height ........................ ..Nurnber of Stories ............................... A�w .(cc iv � � •V RECEIVi D 8. Dimensions of entire new construction: Front...........1.. C......... Rear ...,......1..e,.......... Dept a�,-..�?. . x.147L.11 f q Height ............................ Number of Stories ......tr�:'�'..... 9. Size of lot: Front ............................ Rear ............................ Depth ...................... FEB 19 2020 10. Date of Purchase ......................................... ..............Name of Former Owner ........................ ............................. 11. Zone or use district in which premises are situated........,.....vlS't�s.:.: ................................. ------Zoning...Board di F.ppeal5 12. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of prem ........Address ............................................Phone NO. .................... Nameof Architect........................................................l Address ................................,...........Phone NO. .................... Nameof Contractor. .�7_1n .. r• P:.............Address ............................................Phone NO. .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. 1 1� I r A STATE OF NEWO ,tt ) S S. COUNTY OF ,...... ...... ...) /I s ....... "'�..� /// r......................... ..r. ) '(-'`'�•`�j "`�`''t•" ,being duly sworn deposes and says that he is the applicant r 9 Y � p Y (Name of individual signing ap ication) abovenamed. He is the......................... ..... ....`........r...t--.................. .. ......... ...................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann ,jrytkj8ct Ah fUWU�e application filed therewith. Sworn to before me this ... day of ��..'�...::"`"� Y e;''� n o°;fO/Auc u,v York (Signature of applicant) nt �p 1r„lJ�U1B0U � ' Notary Public, . Gr.Qrh ..r e.... ..... County :..b:�o, ts ', .vt- C/� L 3' o�p �oG Town of Southold 6/24/2T1�38cIVFD 3 y� P.O.Box 1179 co o r St 53095 Main Rd FEB 19 2020 Southold,New York 11971 Zoning Board Of A nor,7fl-, m CERTIFICATE OF OCCUPANCY No: 40464 Date: 6/24/2019 THIS CERTIFIES that the building VnNDOWS Location of Property: 1180 Smith Dr N.,Southold SCTM#: 473889 Sec/Block/Lot: 76.-2-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/15/2018 pursuant to which Building Permit No. 43251 dated 11/28/2018 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: ADDITION AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Shelbert Ventures Inc of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43251 04-22-2019 PLUMBERS CERTIFICATION DATED c AAAthQ 1z Signature F mmv SYMBOL LEGEND ❑ MONUMENT FND ©CAS METER 0 IP /I B.FND m WATER METER B IP/I B SET OQ GAS VALW, w1�SPOT ELEVATIONS (;�WATER VALVE _ �-� TRAFFIC SIGNAL POLE 0 TEST HOLE '0a UTIUTY POLE IB TREE RECEIVE--D GUY 1MRE ®SHRUB UTILITY POLE 19/IJGXT a BOLLARD ' A UGlli POLE A t4ETWR1 FIAG -�(,+ �-- SIGN 0 C DEPRESSED CURB ye; �/ FIRE HYDRANT FE FENCE FEB S 9 (��0 ® MANHOLE MAS MASONRY Ea:A'INLET PLAT PLATFORM M•B'-INLET WW WINDOW WELL m'E•-INLET B/W BAY VdNOOW {] nn ®YARD INLET CA CELLAR ENTRANCE [Zoning L�Oara u,-P,p P,�0YARD INLET0/H OVERHANG Y'F' CABLE N BOX R/0 ROOF OVER ��- 0 A/C UNITLSA LANDSCAPE°AREA ®ELECTRIC METER CANT LAN11LEl'ER TH SMITDIVE - No (50 WIDE) 0. "rrso°3o'0 S o A� o w _ 20��Y. .\\ a N TAX LOT 10 , °' P OTA$LOT 9 F LOT 04 72 r A M O 34 4:M=ALS._ U� W\ FM PO LOT 102 a A \ TAX LO 1f °30'00"ly s 27.75. co \ 116 TAX \' oM1 e m � FFM LOT T1T 32 p `�\': 1 BOG •'� LOT 1j5 ('� 17 TAX LOT 99 w 11 \BOG FM LOT 117 P TAX LOT 81 �\ a It VACANT LOT '7- Tem L •/ O e 0o w 75:00 S8 __r_�_'' TH"DRIVE sou,1 rl" (60Y' WIDE) LOT AREA 20,26250 S F GRAPHIC SCALE 047 Ac 30 0 15 30 GUARANTEED TO: SHELBERT VENTURES INC. IN FEET FIRST INTERNATIONAL TITLE INSURANCE AGENCY 1 inch = 30 fL oFNEW SCALICE L1�I�D SURVEY OF PROPERTY �- Yp PO. LOTS 117,102,104, PEL SQf AND LOTS 103,116 SURVEYING P.C. MAP OF * * Always On Point GOOSENECK 99 1°5 Weft H°Ffm-Avenue, 4ndeM—;, N—Y.I. =•151 Emad M15carmepamplands° -n rveycom Ph-631.9512400 Fac 636-14°0 FILE DATE 11/22/1948 MAP N0. 1663 l�cFy NO{0508�p �YDR MC CREW AL SCALE: 1° = 30 SITUATE sf4 LAND 5SUFFOLK TAX MAP NO. SOUTHOLD, TOWN OF SOUTHOLD DATE SURVEYED 09/19/2018 JOB N. S18-2103 1000-07600-0200-10 AND 3 SUFFOLK COUNTY, NEW YORK `« gym" _�.`4Q.ax>�-..:r,T a.a .�"`,a.m' ,.:..,:•""� aUwon w,"°µ ou�m,'a`µ°q° R":.M�. win,u oxe,�.°e�aa°.°.a�c i� ,wG'�Ixra��o ccu a.,..�on,.0s:"„w ""• _ ��n`9."�' ;� .�; :� �l ,��0 \'�`'.aKIWI �•, �� 8 �� �4�Q �p�s7rr��•�i�,�ir � � l!`�.� ��,� ..® i.i__Fiwi� ����� t t �•�rys�����fff.. 1 T ,' ? ' ® •.,oma ait� 4 I �llq r'F�l� a��i ai1 `�` t �It, �P 1 �' i t V. ¢ 1 cts'� y e ��. �c � � ,S' a. • f�:� � � � � �►,� �, �7. Z7 \r. ix� may. ,Qs �, !, iR�,/���q, •�o '! t li, /o a. ���b�ae�����t'�`� �°?#�� .C ® ,, j�+�/ til.� a���/� 7 � z'• M �•�� ,A :� �L. .t ` ��• +� ¢ B �• 1 s ��.! 1 a, c 1 ���i 1! R, : ! t. .'� �� �r +�.,��1 rc � � �� y • moi- a�."�.�r _. �tQ'M'��►. • � ��' F'� �1��1I!'�c-•CR 11���' `Y`��s P lift ��� �i ''�\\ ~ �"ei�n��; ��,'' , ��ri �' "�.•• ''� ( `h s e Aff R I b . �q )R+�c, �� s`w i�go �� � � � ! t•'r�_ t i� � t y ?y '. `� .S, ! ,�•am 51;{ r � F 4 Sri C a T lq Aho* r or Am -'C_ -:�§�"f` t-f++� �� �'Tj�-�,✓�,�.-..s/✓f'_ } -'f fes' �, r ' /- '� ---� 5'� �F �i 'rCyy' . a s3"'`:: (�-:,k��- is '� � •+:. ye'.z-�:�*r `� �- 7 � r' - � `;. _ ft[ I L �� �� r .�� lF r �" '� t 4'rs•i` .�� ���)� � �F��F .� t„r �� :Trn �rte`Y,� �'�.yc't. .>-v- ��T�r,Yy..- �- .. -'s •q'�.��F��Z r��L `ri.'"-- _ - - _ f r t��Y.�C�'r!_ .�'�,�; .�..Ti.�� _ rilm, Ahw . PYA !N� lkl c �d�. - i ii _� •..rl{>t �' t %- -� P'i f r e�.i,�I�,r r y���{{yy� s�� � •. �Jr � fAFt\.�' ..,fir � LrP'- i�„�',` eItt Y R�+c YfT 11 if SNS i! �:~ y1� Z e . �� Jai•.�., ��c9��- t+ � �Q'i{r ;. arA.s.�s'��+ ,f ,� �,t y � i •.•+r�s� ` MW ''fie= �•'" � � y,j I �:-,� � s _ a l7��'ra w ;�� � _ �'" ; •+r. � Y�> � °� '� .mow -�` .. ��� _ �.. - _ -- » �.` �tr�-•�:. sem-.. t� rr _ r ...:$"� - `N .=.RIAN A. ANDREWS, PLLC Attorney at Law 13235 MAIN ROAD • P.O. BOX 43 • MATTITUCK, NEW YORK 1 1952 631.298.5400 • FAX 631.298 4214 BANDREWSESQUIRE@YAHOO.COM February 17, 2020 Southold Town Zoning Board of Appeals 53095 Main Road RECEIVED Southold,NY 11971 "� � FEB � Zn2 Attn: Kim Fuentes, Board Assistant Re: Selbert Ventures,Inc. Zoning Board Of Appeals Premises 1180 Smith Drive Sout , Southold,NY SCTM No. 1000-076.000 02.00 032.00 Dear Ms. Fuentes: Enclosed please find the original and eight copies of the following: 1. Notice of Disapproval; 2. Application to Un-Merge Property; 3. Surveys; 4. Single and Separate Search;, 5. Original and current deeds; 6. ZBA questionnaire; 7. Short Environmental Assessment; 8. Town Property Assessors cards; 9. LWRP Form; 10. Photographs of property; 11. Owner Authorization; 12. Owner transactional Form; 13. Agent Transactional Form; 14. A check in the sum of$750.00. If you have any questions, please do not hesitate to contact the undersigned. Very truly yours, Brian A.Andrews BAA/mff Encls. • . e i RECEIVED p 1111111 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11IN11I1 -lgaq FEB 19 2020 IIIIIIIIIIIIIIIIIIIIIILII L �'��°� �1 � py is SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 11/21/2018 Number of Pages: 4 At: 10:02 :35 AM Receipt Number : 18-0217531 TRANSFER TAX NUMBER: 18-13119 LIBER: D00012988 PAGE: 216 District: Section: Block: Lot: 1000 076.00 02 .00 010.000 EXAMINED AND CHARGED AS FOLLOWS , Deed Amount: $203,500.00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20.00 NO Handling $20 .00 NO% COE• $5.00 NO NYS SRCHG $15•.00 NO EA-CTY $5.00 NO EA-STATE $125.00 NO TP-584 $5.00 NO Notation $0.00 NO Cert.Copies $0.00 NO RPT $400.00 NO Transfer tax $814 .00 NO Comm.Pres $1,070.00 NO Fees Paid $21,479.00 TRANSFER TAX NUMBER: 18-13119 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE 'x `F County Clerk, Suffolk County 1 2 Number of pages y RECORDED - 2018 ilov 21 10:02:35 All RE'--E1D JUDITH A. PASCAL£ CLERThis document will be public" of ® record.Please remove all SUFFFOLKOLK COUNTY FEB 19 2020 L D00012988 Social Security Numbers P 215 prior to recording. DT# 18-13119 Zoning Board O.'P.ope,)js Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee �— Mortgage Amt. Handling 20. 00 1•Bask Tax 2. Additional Tax TP-584 � 5— SubTotal Notation SPec./Assit- or . EA-5217(County) I -- SubTotai Spea/Add. EA-5217(State) 1 1TOT.MTG.TAX R.P.T.S.A. �"- Dual Town Dual County Held forAppointrnent Comm.of Ed S. 00 Transfer Tax '- Affidavlt + Mansion Tax CertifiedCopy The property covered try this mortgage Is or wig be Improved by a one or two NYS Surcharge 15. 00 ( I _ family dwelling only. Sub Total `� Other yes orNO Grand Total If NO.see appropriate tax clause on page p ofthis instrument. 3rlt 4 5 Community Preservation Fund 8039850 Real Property Consideration Amount$ ( Tax Service FTS NI�Qlllllll�l�lll�l�ll�lQl�II��II� Agency R DTY A CPF Tax Due $ Verification 18-NOV-1 Satisfacins/Dha � l&sUry0ueManAaar Impro 6 og � ReO d TD 37v,h5- 3b/ TD Mail to:Judith A.Pascale,Suffolk County Clerk Title Company Information 310 Center Drive, Riverhead, NY 11901 Name wwwsuffolkcountyny.gov/clerk FIRST INTERNATIONAL TITLE ' rides NY_ N--D/ B Suffolk County Recording & Endorsement Page This page forms part of the attached C ��� S :Jf£� made by: (SPEKIFYTYPEOFINSTRUMOM ( D� 4--4—RSG'f1 H s,�jrEC,c�B�l � The premises herein is situated In F SUFFOLK COUNTY,NEW YORK. ��l!�� J/TO In the TOWN of ���/6F�fy�(l��R �-nC• In the VILLAGE or HAMLET of L a BOXES 6 THRU 8 MUST SE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. aver • pT S Doc ID: 18039850 R DTY A 19-NOV-18 Tax Maps District Secton Block Lot School District Sub Division Name 1000 07600 0200 010000 1000 07600 0200 032000 SOUTHOLD RE"-ErIIED -7Ljoq FEB 19 2020 Z 'ng Board OP/ppea!s —Executor's Dad- hul or Cosponanon(single shoet) CONSULT YOUR LAWYER BEFORE SIGNING T TRUMENT-THIS LNSTRUMENr SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE,made the_3/'-_i day of 1*d&R in the year2018 BETWEEN GEORGE MARSICH RECEIVED residing at 260 Parsons Boulevard,East Marion,New York 11939 I as executor of the last will and testament of GRACE DOROTHY GREET,late of 1180 SMITH DRIVE NORTH, FEB 2020 SOUTHOLD,NEW YORK 11971,deceased,party of the first part,and SHELBERT VENTURES INC,with offices located at 125 E Main Street,Unit 132,Kings Park,New York 11754 Zoning BoarO 01 E=•i G�r�;5� party of the second part, ---- — '� WITNESSETH,that the party of the first part,to whom letters testamentary were issued by the Surrogate's Court of the State of New York for the County of Suffolk on August 16,2018, and by virtue of the power and authority given in and by said last will and testament,and in consideration of TWO HUNDRED THREE THOUSAND FIVE HUNDRED($203,500.00).......................dollars, paid by the party of the second part,does hereby grant and release unto the patty 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,with the buildings and improvements thereon erected,situate,lying and being in the SEE SCHEDULE A-A(PROPERTY DESCRIPTION)ANNEXED HERETO AND MADE A PART HEREOF BEING AND INTENDED TO BE the same promises conveyed to William Greet and Grace D.Greet,his wife,by Deed from, George W.Smith &Sons, Inc., filed July 16, 1953 in Ser#41169,which Celificatepw lransfe ed to the_oClleerrg's Office in Liber 12060 cp708(as to p/o premises); by Deed dated August 27, 1952, ftledRJanu I n Ser#834664, which Certificate was transferred to the Clerk's Office in Liber 12069 cp 041(as to p/o premises);by Deed dated December 24, 1953 filed February 8, 1954 Ser#45295,which Certificate was transferred to the Clerk's Office by Liber 12061 cp 756 (as to p/o premises);by Deed from,George W Smith,Daniel T.Smith,George Herbert Smith and William D.Smith dated April 13, 1950 file April 14, 1950 in Ser#22038,which Certificate was transferred to the Clerk's Office by Liber 12051 cp 178(as to p/o premises). PREMISES KNOWN AS: 1180 Smith Drive North,Southold,New York DISTRICT:1000 SECTION:076.000 BLOCK:02.00 LOT:010.00 and 032.000 TOGETHER with all right, title and interest, if any, of the party of the first part of, in and to any streets and roads abutting the above-described premises to the center lines thereof; TOGETHER with the appurtenances,and also all the estate which the said decedent had at the time of decedent's death in said premises,and also the estate therein,which the party of the first part has or has power to convey or dispose of,whether Individually,or by virtue of said will or otherwise; 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 incumbered in any way whatever,except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the Improvement before using any part of the total of the same for any other purpose The word"party"shall be construed as if it read"paries"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 OF: _ - GEOR E MARSICH,EXECUTOR n ACKNOWLE HENT TAKEN IN NEW YORK STATE ACKNOW ;EMENT TAKEN IN NEW YORK STATE State of New York,County of Suffolk,ss: State of New York,County of ,ss: On the 3ls¢ day ofg&46- to the year 2018,before On the day of in the year before me, the me, the undersigned, personally appeared GEORGE undersigned, personally appeared personally known to MARSICH, personally known to me or proved to me on the me or proved to me on the basis of satisfactory evidence to be basis of satisfactory evidence to be the individual(s) whose the individual(s)whose name(s)is(are)subscribed to the within name(s) is (are) subscribed to the within instrument and instrument and acknowledged to me that he/she/they executed acknowledged to me that he/she/they executed the same in the same in his/her/their capacity(ies), and that by his/her/their his/her/their capacity(ies),and that by his/her/their signature(s) signature(s) on the instrument, the individual(s), or the person on the instrument,the individual(s),or the person upon behalf of upon behalf of which the individual(s) acted, executed the which the indivi al(s)acted,executed the instrument, instrument. NOTARY PUBLIC NOTARY PUBLT -74.04' .0 ARLEEN STEWART � NOTARY PUBLIC-STATE OF NEW YORK FEB 19 2020 No.01ST6289218 Qualified In Suffolk County MyCommisalonExpires 09-23.2021 Zon:ng LOarcl 01 Pppea!S ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK TAKEN IN NEW YORK STATE STATE State of New York,County of ss: Stale of County of ss: On the day of in the year before me, the On the day of in the year before me, undersigned,a Notary Public in and for said State,personally the undersigned personally appeared personally known to appeared , the subscribing witness to the foregoing me or proved to me on the basis of satisfactory evidence to be instrument,with whom I am personally acquainted, who,being the individual(s)whose names)is(are)subscribed to the within by me duly sworn,did depose and say that he/she/they reside(s) instrument and acknowledged to me that he/she/they executed in (if the place of residence is in a city,include the street the same in his/her/their capacity(ies), that by his/her/their and street number if any,thereof);that he/she/they know(s) signature(s) on the instrument, the individual(s) or the person to be the individual described to and who executed the upon behalf of which the individual(s) acted, executed the foregoing instrument;that said subscribing witness was present instrument, and that such individual make such appearance and saw said execute the same;and that said witness at before the undersigned in the (add the city or political the same time subscribed his/her/their name(s) as a witness subdivision and the state or country or other place the thereto. acknowledgement was taken). NOTARY PUBLIC NOTARY PUBLIC Executor's Deed COUNTY:SUFFOLK TOWN/CITY:TOWN OF SOUTHOtD GEORGE MARSICH,EXECUTOR TO PROPERTY ADDRESS.1180 SMITH DRIVE NORTH,SOUTHOLD,NY 11971 SSHELBERT VENTURES,INC SECTION.076.00 Title No.NY2884-01 BLOCK.02.00 FIRST INTERNATIONAL TITLE AGENCY LOT 010000&03200 RETURN BY MAIL TO: SAPIENZA&FRANK,ESQS. DISTRIBUTED BY SALVATORE SAPIENZA.FSQ 5550 Merrick Road Massapequa.NY 11758 JUDICIAL TITLE T:800-281-TITLE F:8o0-FAX-9396 First International Title Agency FFEB Ft;ED File# NY2884-01 /n 9 2020 SCHEDULE A-1 (Description) zoning Board O. AMENDED 9/25/2018 ALL that certain plot,piece or parcel of land,situate,lying and being at Bay View,near Southold,in the Town of Southold,County of Suffolk and State of New York,being known and designated as Lots 103,116 and p/o Lots 102,104 and 117,on a certain map entitled,"Map of Goose Neck",situate at Bay View, Town of Southold,Suffolk County,NY,owned by G.W.Smith&Sons,made by Otto W.Van Tuyl,Licensed Surveyor,Greenport,NY,and filed In the Suffolk County Clerk's Office on November 22,1948 as and by File No.1663,which said lots and part of lots when taken together are bounded and described as follows: BEGINNING at a point on the southerly side of North Smith Drive distant 200.72 feet easterly along the southerly side of North Smith Drive from the corner formed by the intersection of the southerly side of North Smith Drive and the easterly side of Terry Place; RUNNING THENCE North 80 degrees 30 minutes 00 seconds East,along the southerly side of North Smith Drive,129.00 feet; THENCE South 11 degrees 38 minutes 51 seconds East,300.11 feet; THENCE South 80 degrees 30 minutes 00 seconds West,27.75 feet; THENCE South 13 degrees 47 minutes 21 seconds East,100.28.feet to the northerly side of South Smith Drive; THENCE South 80 degrees 30 minutes 00 seconds West,along the northerly side of South Smith Drive, 75.00 feet; THENCE North 20 degrees 07 minutes 11 seconds West,203.49 feet to the southerly side of North Smith Drive,at the point or place of BEGINNING. r 1 t' rI f t Y�. 2f-�: +i -v.,y`,'zx x _ f.`i�•`xt.`a:"'ry~"" r'e.k.+.:,.Y• "...rw`,„a,f'a=y`�••m�h-:�;=i�•r#�=�*:z..�,:x.,,e..:•t",a;-:�;;.;w,si.-we,,,as.•'- ;,zfr+j I - ;+?''fix=Z•;2.'1`�"^.�^} l.�.l,tai'#'.`:�'�;i�i"' :fit^� __ -x'.=,'r.,r F'7-_ __ -_ _ _-_ _ - 1` - �:-'�=^, •`t,,,^ a __ „ya..,tV'{�' -- 4G tit... -_ �' - _ ��..,'-`1 -.t �_ '�(-'l.ak.`f:�.. +T � ,a,2, '�.-;:= `•�;.:'" `,`r;:,I s, ,t,. �'1'e::.• _ - �'�r. r :Ass,s'7i { 'e1'-;r'-v:;c�_l '2-:'r.;�`5i•' _ :rs- U}ss_ry^,,,y.CS. ,,g;- 1;�yPq.1`�y _ •,(` vL->`.�A4��-t TUTUSYj f1SM•XA. 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Zon rr Ppeals TITLE NUMBER:NY3087-01 Town of Southold, New York Gentlemen: FIRST INTERNATIONAL TITLE AGENCY, INC, hereby certifies to the Town of Southold that it has searched the records of the Suffolk County Clerk for deeds affecting the captioned property and properties immediately adjoining and finds: SEE ATTACHED And the records of the Suffolk County Clerk disclose no otherfurther conveyance of any of the foregoing lots other than as set forth. FIRST INTERNATIONAL TITLE AGENCY, INC.certifies that a search of the above captioned property has been made from 1980 and that the premises have been in single and separate ownership of Shelbert Ventures, Inc. and his/her predecessors in title and has not been held in the same name or title as any adjoining lot since prior to 1953. (See attached chains of title) - No searches have been made other than stated above.This Company's liability shall only be to the party to whom it is certified and liability shall,under no circumstances,exceed the amount of$25,000.00.No policy of title insurance can be issued based upon the information contained herein. Dated:December 9,2019 FIRST INTERN TITL AGENC C. Andrea Williams Sworn to before me this 9th day of December,2019 Notary Public JUNE sco'ff Notary Publlo,State of Nev'York NO,01SO47793043 Ctuallttad in Suffolk Coun� Term Expires May 31,20 3 PAGE 1 633 East Main Street,Suite 3, Bldg.2, Riverhead,New York 11901(631)953-4885 Fax(631)953-4889 Title Number NY3087-01 RFrE�vr-� 1 746 � 9 STATE OF NEW YORK)ss: FEB L9020 COUNTY OF SUFFOLK) coning Board 01-/, Andrea Williams, being duly sworn deposes and says: That he/she has had a search made of the records of the County Clerk of Suffolk County with reference to an application for a variance affecting the following premises: SCTM: 1000-076.00-02.00-010.000&032.000 That the said records indicate the following chains of title as to premises and adjoining lots since priorto 1980. SUBJECT PREMISES: 1000-076.00-010.000 George W.Smith&Sons, Inc. Dated: 8/27/1952 To Rec'd: 12/30/1952 William Greet and Grace D.Greet,his wife Liber 3456 cp 325 Filed: 1/9/1959 Ser#83464 Cert#41778 which Certificate was transferred to the Clerk's Office in Liber 12069 cp 041 (part of premises) FIRST INTERN Y TITLE AGEN C. Andrea Williams Sworn to before me this 9th day of December,2019 Notary Public iWiE SCOL, Notary Public,Stato of New fork NO.0 c;(-X?V3043 Qualliiod:n ouiroik County Term Expires May 31,20 1 3 PAGE 2 633 East Main Street,Suite 3, Bldg.2, Riverhead, New York 11901(631)953-4885 Fax(631)953-4889 -No I FEB 20 Title No.NY3087-01 L2f7 George W.Smith,Daniel T.Smith, Dated: 4/13/195070'_`?_80ard 0 �+,� eai ~-�-s George HerbertSmith and William B.Smith Filed: 4/14/1950 To Ser#22038 Cert#14137 William Greet and Grace D.Greet,his wife which Certificate was transferred to the Clerk's Office by Liber 12051 cp 178 (part of premises) George W.Smith and Sons, Inc. Dated: 12/24/1953 To Filed: 2/8/1954 William Greet and Grace D.Greet, his wife Ser#45295 Cert#25483 Which Certificate was transferred to the Clerk's Office by Liber 12061 cp 756 (part of premises) William Greet died a resident of Suffolk County on 11/2/1993. Grace Dorothy Greet died a resident of Suffolk County on 5/20/2016. George Marsich, Executor of the Last Will and Testament of Dated: 10/31/2018 Grace Dorothy Greet,deceased Rec'd: 11/21/2018 To Liber 12988 cp 216 Shelbert Ventures Inc. (Tax Lot 010.000&032.000) LAST DEED OF RECORD SUBJECT PREMISES: 1000-076.00-02.00-032.000 George W.Smith &Sons, Inc. Dated: 7/2/1953 To Filed: 7/16/1953 William Greet and Grace D.Greet,his wife Ser#41169 Cert#23512 which Certificate was transferred to the Clerk's Office in Liber 12060 cp 708 FIRST INTERNA O ITL AGENC A a 'Harris to before me this 9th day of December,2019 Nota Public "s SCOTT Notary Notary Public,State of New York NO.Olt S04793043 Qualifled in Suffolk CounW PAGE 3 Term Expires Mai+ 31,20 3 633 East Main Street,Suite 3,B'li3g.2,Riverhead, New'York MOI(631)953-4885 Fax(631)953-4889 Title No. NY3087-01 RECEIVED -Nod William Greet died a resident of Suffolk County on 11/2/1993. FEB 19 2020 Grace Dorothy Greet died a resident of Suffolk County on 5/20/2016. Zoning Board 0;/Ip;pea!s George Marsich, Executor of the Last Will and Testament of Dated: 10/31/2018 Grace Dorothy Greet,deceased Rec'd: 11/21/2018 To Liber 12988 cp 216 Shelbert Ventures Inc. (Tax Lot 010.000&032.000) LAST DEED OF RECORD PREMISES EAST: 1000-076.00-02.00-009.000 William W.Smith Dated: 5/10/1969 To File: 5/23/1969 Anthony Greco and Aida Greco, his wife Ser#177316 Cert#77792 Anthony Greco died a resident of Suffolk County on 9/11/1972. Aida Greco Dated: 8/28/1984 To Filed: 10/18/1984 Louis J. Profera, 1/3 interest; William Ser#307155 Cert#124031 O'Connor,1/3 interest and William D. Podmore,1/3 interest Louis J. Profera,William O'Connor and Dated: 10/26/1987 William D.Podmore Filed: 11/19/1987 To Ser#346204 Cert#126101 John J.Carway and Jacqueline S.Carway Jacqueline S.Carway Dated: 5/14/1996 To Filed: 6/5/1996 John J.Carway Ser#456952 Cert#136101, LAST DEED OF RECORD which Certificate was transferred to the Clerk's Office by Liber 12025 cp 801 FIRST INT AL ITLE AG ,INC. And a Williams Sworn to before me this 9th day of December,2019 Notary Public JUNE SCO-17 Notary F!ubllc,Btato of New Yorh NO.04,1.R=93043 Qualified in 8111,10Ik County -remi Expires May 31,20_,_3 PAGE 4 633 East Main Street,Suite 3,Bldg.2, Riverhead, New York 11901(631)953-4885 Fax(631)953-4889 i<E'--E1 Ur'� Title No. NY3087-01 I FEB 19 210,20 PREMISES NORTH: North Smith Drive LcWflln g i?aarc 0, ' Ppeals PREMISES SOUTH: South Smith Drive PREMISES WEST: 1000-076.00-02.00-011.000 Henry Trautman and LeRoy Randel Dated: 7/26/1958 To Filed: 7/29/1958 Henry Trautman and Estelle L.Trautman,his wife Ser#79572 Cert#40276 Henry Trautman died a resident of Suffolk County on 4/30/1989, Judith T.Carrick, Executrix of the Estate of Dated: 2/25/2000 Estelle L.Trautman, deceased Recd: 3/9/2000 Probate#204P1999 Liber 12026 cp 950 To Kevin Montgomery and Kathleen Doyle Montgomery, his wife Kevin Montgomery and Kathleen Dated: 11/26/2013 Doyle Montgomery Rec'd: 1/23/2014 To Liber 12761 cp 141 Kathleen Doyle Montgomery LAST DEED OF RECORD PREMISES SOUTH &EAST: 1000-076.00-02.00-033.000 George W.Smith&Sons, Inc. Dated: 5/17/1952 To Filed: 5/19/1952 Charles F. Holmes and Emma Holmes, his wife Ser#31088 Cert#16241 Charles F. Holmes died a resident of Suffolk County on 5/17/1978. FIRST INTE7RA-f TIT AGEN !�g. re Williams Sworn to before me this 9th day of December,2019 Nota Public UNG SD07-1 Notary JUNE Public,Sta{e of New York NO.01=L793043 Gualinod in Su talk County PAGE 5 Terni Escpires Mair 31,20 633 East Main Street,Suite 3, BW Riverhead,New York 11901(631)953-4885 Fax(631)953-4889 RECEIVPD Title No. NY3087-01 r . Fng 9 2020 Emma Holmes,as surviving tenant Dated: 6/15/1996 I To Filed: 6/28/1996 C; r�PEaIs J r Rita Duran Ser#457964 Cert#158362 Rita Duran Dated: 11/25/2016 To Recd; 2/28/2017 Rita Duran and Martin Gitlin, Liber 12902 cp 600 Wife and husband LAST DEED OF RECORD PREMISES WEST: 1000-076.00-02.00-031.000 George,W.Smith&Sons, Inc. Dated: 7/3/1953 To Filed: 7/16/1953 Marguerite C.Trautman and Ann E.Jagnow Ser#41170 Cert#23513 Marguerite C.Trautman died a resident of Suffolk County on 1/21/1984. Ann Jagnow Crommelin a/k/a Ann E.Jagnow Dated: 3/5/1982 To Filed: 3/15/1982 Henry Trautman Ser#286033 Cert#117123 Judith T.Carrick,as Executor of Estelle L. Dated: 5/9/2001 Trautman,specific devisee of Henry Trautman Recd: 5/21/2001 To Liber 12119 cp 518 Schembri Homes, Inc. Schembri Homes, Inc. Dated; 4/1/2002 To Recd: 4/22/2002 Basilio Esposito and Marie Esposito, his wife Liber 12181 cp 705 Basilio Esposito and Marie Esposito, his wife Dated: 5/28/2003 To Recd: 6/17/2003 Eugene Fulda and Darlene Fulda, his wife Liber 12256 cp 456 LAST DEED OF RECORD FIRST INTER T TIT AG NC Andrea Williams Sworn to before me this 9th day of December,2019 Nota Public I4 sco'ry rY Notary Public,Shate of Nevj Yor'.t NO.04SC4793043 Qualified in Suffolk Coun:' PAGE 6 Term Expires May 39,7_0 0 633 East Main Street,Suite 3, Bldg.2, River ieaa New York 11901(631)953-4885 Fax(631)953-4889 F 7 RECL:i l/FD First International Title Agency, Inc. 46 �4 11 633 East Main Street,Suite 3, Bldg.2 I FEB 2020 i Riverhead,New York 11901 L�Onia S o a r o 0 TITLE NUMBER:NY3087-01 Town of Southold, New York Gentlemen: FIRST INTERNATIONAL TITLE AGENCY,INC.hereby certifies to the Town of Southold that it has searched the records of the Suffolk County Clerk for deeds affecting the captioned property and properties immediately adjoining and finds: SEE ATTACHED And the records of the Suffolk County Clerk disclose no other further conveyance of any of the foregoing lots other than as set forth. FIRST INTERNATIONAL TITLE AGENCY,INC.certifies that a search of the above captioned property has been made from 1980 and that the premises have been in single and separate ownership ofShelbert Ventures,Inc. and his/her predecessors in title and has not been held in the same name or title as any adjoining lot since prior to 1953. (See attached chains of title) No searches have been made other than stated above.This Company's liability shall only be to the party to whom it is certified and liability shall,under no circumstances,exceed the amount of$25,000.00.No policy of title insurance can be issued based upon the information contained herein. Dated:December 9,2019 // FIRST INTERNAT ,I7LEAG EN I C. ndrea Williams 'Xili Sworn to before me this 9th day of December,2019 Notary Public JUNE scow Notary Public,State of MebvYoriz NO.015C47'93043 Quairried in Suffolk County Term Expires May 31,20 a 3 PAGE 633 East Main Street,Suite 3,Bldg.2,Riverhead, New York 11901(631)953-4885 Fax(631)953-4889 X240 Title Number NY3087'01 FEB 19 2020 Zoning Board OrApp_als STATE OF NEW YORK)ss: COUNTY OF SUFFOLK) Andrea Williams, being duly sworn deposes and says: That he/she has had a search made of the records of the County Clerk of Suffolk County with reference to an application for a variance affecting the following premises: SCTM: 1000-076.00-02.00-010.000&032.000 That the said records indicate the following chains of title as to premises and adjoining lots since prior to 1980. SUBJECT PREMISES: 1000-076.00-010.000 George W.Smith&Sons, Inc. Dated: 8/27/1952 To Rec'd: 12/30/1952 William Greet and Grace D.Greet,his wife Liber 3456 cp 325 Filed: 1/9/1959 Ser#83464 Cert#41778 which Certificate was transferred to the Clerk's Office in Liber 12069 cp 041 (part of premises) FIRST INTERN f0 Ai.TITLE AGENCY NC. Andrea Williams Sworn to before me this 9th day of December,2019 Notary Public JUNIE SCOTT Notary Public,State of NeJAJ York NO.01 SC4793043 011alifiad in Suffollc Counw fenm Eyoiras May 31,20_3 PAGE 2 633 East Main Street,Suite 3, Bldg.2,Riverhead, New York 11901(631)953-4885 Fax(631)953-4889 "L�® � . Title No.NY3087-01 FEB 2020 George Daniel T.Smith, Zon'n coarc ' g � Dated: 4/13/1950 ._._� I G!"� George Herbert Smith and William B.Smith Filed: 4/14/1950 To Ser#22038 Cert#14137 William Greet and Grace D.Greet,his wife which Certificate was transferred to the Clerk's Office by Liber 12051 cp 178 (part of premises) George W.Smith and Sons,Inc. Dated: 12/24/1953 To Filed: 2/8/1954 William Greet and Grace D.Greet,his wife Ser#45295 Cert#25483 Which Certificate was transferred to the Clerk's Office by Liber 12061 cp 756 (part of premises) William Greet died a resident of Suffolk County on 11/2/1993. Grace Dorothy Greet died a resident of Suffolk County on 5/20/2016. George Marsich, Executor of the Last Will and Testament of Dated: 10/31/2018 Grace Dorothy Greet,deceased Recd: 11/21/2018 To Liber 12988 cp 216 Shelbert Ventures Inc. (Tax Lot 010.000&032.000) LAST DEED OF RECORD SUBJECT PREMISES: 1000-076.00-02.00-032.000 George W.Smith&Sons, Inc. Dated: 7/2/1953 To Filed: 7/16/1953 William Greet and Grace D.Greet,his wife Ser#41169 Cert#23512 which Certificate was transferred to the Clerk's Office in Liber 12060 cp 708 FIRST INTE /'0ALTI E AGE ,INC. ndrea Williams Sworn to before me this 9th day of December,201 J :oma.SCOTT NotaryPublic Notary Public,Shite of New York NO.01SC4793043 Qualified in Sufrolk County Torre Expires May 31,20 c9-3 PAGE 3 633 East Main Street,Suite 3, Bldg.2,Riverhead,New York 11901(631)953-4885 Fax(631)953-4889 04 Title No. NY3087-01 FEB 19 2020 William Greet died a resident of Suffolk County on 11/2/1993. Zonmo Board O(t.,.r p E l5 Grace Dorothy Greet died a resident of Suffolk County on 5/20/2016. George Marsich, Executor of the Last Will and Testament of Dated: 10/31/2018 Grace Dorothy Greet,deceased Rec'd: 11/21/2018 To Liber 12988 cp 216 Shelbert Ventures Inc. (Tax Lot 010.000&032.000) LAST DEED OF RECORD PREMISES EAST: 1000-076.06-02.00-009.000 William W.Smith Dated: 5/10/1969 To File: 5/23/1969 Anthony Greco and Aida Greco,his wife Ser#177316 Cert#77792 Anthony Greco died a resident of Suffolk County on 9/11/1972. Aida Greco Dated: 8/28/1984 To Filed: 10/18/1984 Louis J. Profera,1/3 interest,William Ser#307155 Cert#124031 O'Connor,1/3 interest and William D. Podmore,1/3 interest Louis J. Profera,William O'Connor and Dated: 10/26/1987 William D. Podmore Filed: 11/19/1987 To Ser#346204 Cert#126101 John J.Carway and Jacqueline S.Carway Jacqueline S.Carway Dated: 5/14/1996 To Filed: 6/5/1996 John J.Carway Ser#456952 Cert#136101, LAST DEED OF RECORD which Certificate was transferred to the Clerk's Office by Liber 12025 cp 801 FIRST INTERN TIT E AGE C. ndrea illiams Sworn to before me this 9th day of December,2019 Notary Public JUH.E SCOTT Notary Public,State of New York NO.OiS C4%793-043 Qualified in Su r bfl:County Term Expires-May 31,21 -2- 3 PAGE 4 633 East Main Street,Suite 3, Bldg.2,Riverhead, New York 11901(631)953-4885 Fax(631)953-4889 Title No. NY3087-01 PREMISES NORTH: North Smith Drive -7g04 � FEB 2020 PREMISES SOUTH: South Smith Drive PPeals PREMISES WEST: 1000-076.00-02.00-011.000 ` Henry Trautman and LeRoy Randel Dated: 7/26/1958 To Filed: 7/29/1958 Henry Trautman and Estelle L.Trautman, his wife Ser#79572 Cert#40276 Henry Trautman died a resident of Suffolk County on 4/30/1989. Judith T.Carrick,Executrix of the Estate of Dated: 2/25/2000 Estelle L.Trautman,deceased Recd: 3/9/2000 Probate#204P1999 Liber 12026 cp 950 To Kevin Montgomery and Kathleen Doyle Montgomery,his wife Kevin Montgomery and Kathleen Dated: 11/26/2013 Doyle Montgomery Rec'd: 1/23/2014 To Liber 12761 cp 141 Kathleen Doyle Montgomery LAST DEED OF RECORD PREMISES SOUTH &EAST: 1000-076.00-02.00-033.000 George W.Smith&Sons, Inc. Dated: 5/17/1952 To Filed: 5/19/1952 Charles F.Holmes and Emma Holmes, his wife Ser#31088 Cert#16241 Charles F.Holmes died a resident of Suffolk County on 5/17/1978. FIRST INTERN TITLE 7%j, (� GEN ndrea Williams Sworn to before me this 9th day of December,2019 Notary Public JUNSsDal a Notanj Public,State of New Yor3; NO.04 SC4793043 Quall i-d in Su olic Coun� PAGE 5 633'East� ainreef Iite' 0B1-d g. ,Riverhead, New Yotk 11901(631)953-4885 Fax(631)953-4889 L FFEB Eiu_7 1 i Title No. NY3087-01 202EmmaHolmes,as surviving tenant Dated: 6/15/1996TO goard RiRi Filed: 6/28/1996 Rita Duran Ser#457964 Cert#158362 Rita Duran Dated: 11/25/2016 To Rec'd; 2/28/2017 Rita Duran and Martin Gitlin, Liber 12902 cp 600 Wife and husband LAST DEED OF RECORD PREMISES WEST: 1000-076.00-02.00-031.000 George W.Smith&Sons, Inc. Dated: 7/3/1953 To Filed: 7/16/1953 Marguerite C.Trautman and Ann E.Jagnow Ser#41170 Cert#23513 Marguerite C.Trautman died a resident of Suffolk County on 1/21/1984. Ann Jagnow Crommelin a/k/a Ann E.Jagnow Dated: 3/5/1982 To Filed: 3/15/1982 Henry Trautman Ser#286033 Cert#117123 Judith T.Carrick,as Executor of Estelle L. Dated: 5/9/2001 Trautman,specific devisee of Henry Trautman Rec'd: 5/21/2001 To Liber 12119 cp 518 Schembri Homes, Inc. Schembri Homes,Inc. Dated; 4/1/2002 To Rec'd: 4/22/2002 Basilio Esposito and Marie Esposito,his wife Liber 12181 cp 705 Basilio Esposito and Marie Esposito, his wife Dated: 5/28/2003 To Recd: 6/17/2003 Eugene Fulda and Darlene Fulda, his wife Liber 12256 cp 456 LAST DEED OF RECORD FIRST INTERN I TIT AGEN drea illiams Sworn to before me this 9th day of December,2019 Nota Public SCOTT N Notary Public,State of New York NO.01SC 793043 Qualified in Suffolk County PAGE 6 Term Expires h1lay 31,20---a 633 East Main Street,Suite 3, Bldg.2, Riverhead,New York 11901(631)953-4885 Fax(631)953-4889 l Town Hall Annex Telephone(631)765-1802 54375 Main Road e� Fax(631)765-9502 P.O.Box 1179 ® �� roger.rich erto_town.southoId.ny.us Southold,NY 11971-0959 F(VPD �1-f BUILDING DEPARTMENT FEB 1 9 2020 TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANC Zoning �°ard OPP,ppea fq SITE LOCATION Issued To: Shelbert Ventures Inc. (Kipperman) Address: 1180 Smith Drive North city.Southold st: New York zip: 11971 Building Permit#: 43251 Section: 76 Block: 2 Lot: 10 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor. "AS BUILT" DBA: License No: SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Only Commerical Outdoor X 1st Floor X Pool New Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph 150A Heat OIL Duplec Recpt 29 Ceiling Fixtures 3 HID Fixtures Service 3 ph Hot Water OIL GFCI Recpt 6 Wall Fixtures 4 Smoke Detectors 4 Main Panel 150A AIC Condenser 1 Single Recpt Recessed Fixtures 26 CO Detectors Sub Panel AIC Blower 1 Range Recpt 20A Fluorescent Fixture Pumps Transformer Appliances JDW I Dryer Recpt 30A Emergency FixtureSH Time Clocks Disconnect 150A Switches g Twist Lock Exit Fixtures TVSS Other Equipment "As Built" "Electrical Survey" "No Visual Defects" Notes: 1- Combination Smoke/ CO Detector, 2- Bath Fans, 1- Paddle Fan. Inspector Signature: Date: April 22, 2019 0-Cert Electrical Compliance Form.xls RECEIVED 54'-5" y F FEB 9r Ro:s - -0• — c 02� Ilo r emm L„ on. (u I of Y BEDROOM p3 p DINING qMI` ZOnlrl Boar b II It U °ISIoced CeiLno2 N (Stopes OeJmo) It I''II�IIIII ��III 9 a O��'t Cd�S — — - - II(Slopedd Cenral A= SD es of —_ -- -- — II_—_-- -- -- w me`im _— —O3�dm� T I E:isbnn I LIVING RM I FP in on mon �I AM _ F- -Hallway 'e—_____ ____—_— IIA- (Sloped CellNgl II.yy F4 II BEDROOM41 (Sloped Coling 1 vD _-9,8. €-I OBD b'• ❑ PR W IIr Ic y v) n .b KITCHEN O L ++ T 0�.r z O FO v) aoil- Ewsime peel to house butt with cermd Floor Area=1225 SF CO-Issued _ D FIRST FLOOR PLAN E• J LL Ensimg edge to be supporl0d by22't,W Slr..,M.dgc Newt;•COLLAR TIE C& post to girder below 16'6 C NAIL WI(0)100 ore p�'II COMMON NAILS Evlshng 2'se•Root Renters covrncresuo V Ij - to be at,pparted by now New roof Y x 6'Sister Rahersto 2 v6'RR 16'oe Sister nmh R 21 Insulation r7 T relied Mir,IDd Ila.a1111—ridge rads Nle _ p '---'-- R New 2-2'x 6*Tie is ly es h.we on Un C 3 aZ ---- �Ensnng 2•x6'C°Ao JOIst to Cenreoved /—Ensong 2'x4'wa0s I �(Mowau londge) 1; Z wllh New R-151-1.1on dow220ed.,1.posts -__—_ ___—_ L down to(mer lm tool ��- _— R �U o suppm e g Crewl Space w i n - L :9 mxcmxe UNFINISHED CELLAq �� y. JOB NO 11.9-I9 ` 5�^xuy,}vawp•�_ _ ewrs�a^nruvaru�snswxarwa. �� Crawl Space New fl-30lnsulalon DRAWN BY. Ml (Wend down Joisl CHECKED BY FJp CONC SLAG (lurted down ter bviness) QEDAP.rL- --- REVISION M �W yY •I DATE. 0I-I1-3019 ROOF REPAIR SECTION \JSTFT ,e`1�0 SCALE AS NOTLD CRAWL SPACE FOUNDATION PLAN op,,,p n 2 0 1"ECEIVED 746 I ' CERTIFICATE OF INCORPORATION FEB'FEB 192020 ov ZO-'1111(4 B o a r ai Cs'P Shelbert Ventures Inc Under Section 402 of the Business Corporation Law 1,the undersigned, a natural person of at least 18 years of age,for the purpose of forming a corporation under Section 402 of the Business Corporation Law of the State of New York hereby certify: FIRST: The name of the corporation is: Shelbert Vent.ures 10 SECOND: may corporation is formed to engage in any lawful act or activity for which a corporation may be organized under the Business Corporation Law,provided that it is not formed to engage in any act or activity requiring the consent or approval of any state official, department,board, agency or other body without such consent or approval first being ,obtained. THIRD: The county,within this state, in which the office of the corporation is to be located is NEW YORK, FOURTH: The total number and value of shares of common stock which the corporation shall have authority to issue is: 200 SHARES WITH NO PAR VALUE. FIFTH: The Secretary of State is designated as agent of the corporation upon whom process against it may be served. The address within or without this state to which the Secretary of State shall mail a copy of any process against the corporation served upon him or her is: Berrios& Associates Inc PO BOX 2349 RIVERHEAD,NY 11901 SIXTH: The corporation designates the following as its registered'agent upon whom process against it may be served within the State of New York is:, Rpss Kipperman 24 Neil Drive Smithtown, NY 11787 SEVENTH: The existence of the corporation shall begin upon filing of these Certificate of Incorporation with the Department of State. EIGHTH: The corporation shall have a perpetual existence. DUs-1239-f-1 I(Rev.02/12) FILE NUMBER: 180516010221;DOS ID:5342506 Page I oft D ` FEB 19 2020 Zor,ing Soarci Qi Appeals ! NINTH: No Director of this corporation shall be personally liable to the corporation, or its shareholders for damages for any breach of duty in such capacity,provided that this provision shall not limit the liability of any director if a judgment or other final adjudication, adverse to him,establishes that his act or omissions were in bad faith or involved intentional misconduct or a knowing violation of law or that he personally gained in fact a financial profit or other advantage, to which he was not legally entitled or that his acts violated Section 719 of the New York Business Corporation Law. TENTH: The holders of any of the corporation's equity shares shall be entitled to preemptive rights in accordance with the provisions of BCL section 622. I certify that I have read the above statements, I am authorized to sign this Certificate of Incorporation, that the above statements are true and correct to the best of my knowledge and belief and that my signature typed below constitutes my signature. MAUREEN BERRIOS.(signature) MAUREEN BERRIOS, INCORPORATOR PO BOX 2349 RIVERHEAD,NY 11901 Filed by: Maureen Berrios PO BOX 2349 RIVERHEAD,NY 11901 FILED WITH THE NYS DEPARTMENT OF STATE ON: 05/16/2018 FILE NUMBER: 180516010221; DOS ID: 5342506 Page 2 of 2 N.Y.S. DEPARTMENT OF STATE DIVISION OF CORPORATIONS AND STATE RECORDS ALBANY, NY 12231-0'00,1 ONLINE FILING RECEIPT ENTITY NAME: SHELBERT VENTURES INC DOCUMENT TYPE: INCORPORATION (DOM. BUSINESS) COUNTY: NEW FILED:05/16/2018 DURATION:PE'RPETUAL CASH#:180516010221 FILE#:180516010221 DOS ID:5342506 FILER: EXIST DATE ------ ---------- MAUREEN BERRIOS 05/16/2018 PO BOX 2349 ' RIVERHEAD, NY 11901 -- 1,'+ECEiVED ADDRESS-FOR-PROCESS: ""] s /h 4 BERRIOS & ASSOCIATES INC FEB 192020 PO BOX 2349 RIVERHEAD, NY 11901 1Zo( n!nc! Baarcf REGISTERED AGENT: --------------- RUSS KIPPERMAN 24 NEIL DRIVE SMITHTOWN,' NY 11787 +�©•iia�•o• STACK: 200 NPV ••••i Of N'Egilyy;'•® c i �) • a • • 'r'°a tyl ; The EN T DACE YLSiv1� ! a �j • The corporation is required to file a Biennial Statement with the Department of State every two years pursuant to Business Corporation Law Section 408. Notification that the Biennial Statement is due will only be made via email. Please go to www.email.ebiennial.dos.ny.gov to provide an email address to receive an email notification when the Biennial Statement is due. SERVICE COMPANY: ** NO SERVICE COMPANY ** SERVICE CODE: 00 FEE: 130.00 PAYMENTS '130.00 FILING: 125.00 CHARGE 130.00 TAX: 0.00 DRAWDOWN 0.00 PLAIN COPY: 5.00 CERT COPY: 0.00 CERT OF EXIST: 0.00 DOS-1025 (04/2007) - Authentication Number: 1805160226 To verify the authenticity of this document you may access the Division of Corporation's Document Authentication Website at http://ecorp.dos.ny.gov �M ��� �, � -- TOWN OF SOUTHOLD PIiOPERTY RECORD CARD OWNER STREET l/ VILLAGE DISTRICT SUB. LOTS d .Zl� �2� FORMER OWNER N E ACREA r ,�^ S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value AND IMP. TOTAL DATE REMARKS 06 1 00 , �9 f G W V' R. YP—masse .�' P✓ u -7o6 of 0 0 / 3 0 / '70 ZP7 W t 1 ►czm lc ea S'j •cam ✓f id, 4 AGE BUILDING CONDITION 9 Y�joc)— NEW NORM& BELOW AB0 F _ `{7J � S _, �7-0&1 756 Farm )--&cre Value Per Acre Value FRONTAGE ON ROAD / ,' C zM16 -G-a 6luf N nI Tillable 2 , Cn G �� Tillable, 3 i «' ' o LJ Woodland w _ L «, r Swampland Brushland House PkA -�' ,� FEB d Total J Cz N G 1m' a/ W00 I I I I 1'7 Jr ;..x;� �^ ' *.,3�•f��a-+,.�, r rti3 ,,:. •��'•~ ""� �''` 1 f i � i i I I I I � � _I 'Y.ry i .f' ..�� + ...t+' .y'yw�, >, w •�'. �} f � I I I I I I .- *. ,,tee''� "'s::,� »:';•�,S.e��'dt��fa."cx_=3€="44 �iz.,'*e_• I ✓ i - I•' I i i I _ M. Bldg. I r Foundation '; Bath f Extension Basement `" Floors Ex ionI %�.�� •� , 3 .3,00 p E alts VY 'N 4 Interior Finish 4� { t , `' wl Extension t� F �" a +,� ! 3 ' Fi Pllace " , f Heat Jj f/• ' r Porch Roof Type , d A ' f f Porch Rooms 1 st % 4' LSL4 Breezeway Patios ;i ' r ' Rooms 2nd Floor a r Garage Driveway r Dormer O. B. , , TOWN OF SOU'THOLD PROPERTY RECORD CAR® OWNER STREET VILLAGE DISTRICT SUB. LOT 4 _ FORMER OWNER N E ACREA� E 1 f n � !_ S W TYPE OF BUILDING RES. SEAS. VL.3 1/ FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS will fo 03,rl-ece-qj-S"�;Irl r&6, 3-A "r f IL� AA1610`-(]dflezffe(:y �-1 .n s- L /zo607off P41l0 3� �Lt G� a�to - ,rem G •� � � ,.,�� - AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD 7j- ' g t" S" Tillable 1 BULKHEAD Tillable 2 ®� ®vl DOCK -vnwoTillable, 3 12 I �, Woodland f c� 1-11 Swampland Brushland a House Plot f Tota I ELIZABETH A.NEVILLE MMC h.�o�o �OG,y Town Hall, 53095 Main Road TOWN CLERKo P.O.Box 1179 y Z Southold,New York 11971 REGISTRAR.OF VITAL STATISTICS p • Fax(631)765-6145 MARRIAGE OFFICER �� o� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Zoning Board of Appeals FROM: Elizabeth A.Neville DATED: February 24, 2020 RE: Zoning Appeal No. 7404 Transmitted herewith is Zoning Appeals No. 7404 Brian A. Andrews PLLC Attorney at Law for Shelbert Ventures Inc.: The Application to the Southold Town Zoning Board of Appeals Applicant's Project Description Questionnaire _,Agricultural Data Statement Short Environmental Assessment Form Applicant/Owner Transactional Disclosure Form(s) Agent/Representative Transactional Disclosure Form(s) �LWRP Consistency Assessment Form Notice(s) of Disapproval Board of Zoning Appeals Application Authorization Certificate(s) of Occupancy Findings, Deliberations and Determination Meeting(s) Action of the Board of Appeals Photos �+ Correspondence- L4-+¢tJ �c a-4 - ro.o,-- &ra.r.3� A • i9+^ �S Copy of Deed(s) Building Permit(s) _-Property Record Card(s) Survey/Site Plan Maps- ,Drawings Misc. Building Dept. forms (Certificate of Compliance, Housing Code Inspection, ect.) �/ Misc. Paperwork- fty-L4. c4v.+` CAr4;-F-t caio-- a9�r.co ZBA TO TOWN CLERK TRANSMITTAL SHEET (Filing of Application and Check for Processing) DATE : February 20, 2020 ZBA # NAME OF APPLICANT CHECK # AMOUNT TC DATE STAMP Brian A. Andrews PLLC Attorney at Law 7404 for : 1573 $750.00 SHELBERT RECEIVE® VENTURES.INC. F E B 2 4 2020 outhold Town Clem TOTAL $750.00 , Sent via Inter-Office to Town Clerk by: ES Thank you. _l,f• �_-..._. . . ._ . - � _-- - ` `-�. - '�-•3.5=7 - - ` -�,RIAN.yA AU WS'-FELE P�TORNEY ATFL W . = �i323 06 1-2 "' .- - - - y _ :MAIT TUC_W,N'7 119 l 22 a2ses` DATE 1`� /! AY �- - -• - -= - - - - . �.. ,. • - --'i •TOPTHE 41 f ,_Q ORDER OF DOLLARS• u CHAS_ E-.G - JPMargan ChS_Bank,NAww"wp.'Chase.cbm FOR 'I - Town of Southold P0Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 02/24/20 Receipt#: 267475 Quantity Transactions Reference Subtotal 1 ZBA Application Fees 7404 $75000 Total Paid: $750.00 Notes: Payment Type Amount Paid By CK#1573 $75000 Brian A. Andrews PLLC Attorney at Law Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 "I Name: Shelbert Ventures, Inc 125 East Main St# 132 Kings Park, NY 11754 Clerk ID: JENNIFER Internal ID•7404 t 1 BOARD MEMBERS *OF SO!/jy0Southold Town Hall Leslie Kanes Weisman,Chairperson ,`4 l0 53095 Main Road•P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora Office Location: Eric Dantes G iQ Town Annex/First Floor, Robert Lehnert,Jr. 'O 54375 Main Road(at Youngs Avenue) Nicholas Planamento 1yCOU , Southold,NY 11971 http://southoldtowmy.gov ZONING BOARD OF APPEALS TOWN OF SOUTHOLD February 20, 2020 Tel.(631)765-1809•Fax(631)765-9064 Ms. Sarah Lansdale, Director Suffolk County Department of Planning P.O. Box 6100 Hauppauge, NY 11788-0099 Dear Ms. Lansdale: Please find enclosed the following application with related documents for review pursuant to Article XIV of the Suffolk County Administrative Code: ZBA File * 7404 Owner/Applicant: Shelbert Ventures Inc. Action Requested : Merger determination. Within 500 feet of: ( ) State or County Road (X) Waterway (Bay, Sound, or Estuary) ( ) Boundary of Existing or Proposed County, State, Federal land ( ) Boundary of Agricultural District ( ) Boundary of any Village or Town Within one (1) mile (5,280 feet) of: ( ) Boundary of any airport If any other information is needed, please do not hesitate to call us., Thank you. Very truly yours, Leslie K. Weisman ZBA Ch ecrson By: ` ✓�i Encls. Survey/Site Plan : Scalice Land Surveying P.C. Dated : 9/19/2018 ' n l� '-�•.; :x iYl <..`-.lam^ 'r.:r'!y Fs a��:r^i;`` ^' ...`•�^', �''^u 'r; ..-,i- 4.t=:�-`'.tir,. r;IS�e 1,:��tl "-�"' �': _�+ J1max- ��f• � fiF�r �•.'.. - - -:'f' �S,u-�Ll�`.M�•YT^�.��y'�'='r'+...,.,'e,�,_^+'y lK�,.rjs✓wi+.r-.z. 'rte'6w-3';r.:�.�z�.r.t-`acrd= �.�� t7-*-u.-.. 3i�4><i� � i _ - r_ ,.�.. "=_..SL-;-Asa."^'.^,^ _ r'.r-. •i': •�..t at•`<'::'` �r _�- e,.,y.. 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