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1000-114.-1-1
OFFICE LOCATION: �� soyo MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 • Q Telephone: 631 765-1938 coum,� ' LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry,AICP Assistant Town Planning Director LWRP Coordinator Date December 13,2021 Re: LWRP Coastal Consistency Review for ZBA JOSEPH AND DEBORAH POLIDORA#7583 SCTM#1000-114-1-1. JOSEPH AND DEBORAH POLIDORA#7583-Request for Variances from Article XXIII, Section 280-124; and the Building Inspector's September 13,2021 Notice of Disapproval based on an application for a permit to construct a one'story addition connecting an existing single family dwelling to an existing detached garage; at 1) located less than the code minimum required side yard setback of 15 feet on two sides; 2)located less than the code minimum required combined side yard setback of 35 feet; located at: 1055 Point Pleasant Road,Mattituck, NY. SCTM No. 1000-114-1-1. The proposed action has been reviewed to Chapter 268,Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program(LWRP)Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me,the proposed action is EXEMPT from LWRP review pursuant to: § 268-3. Definitions.MINOR ACTIONS item"F"which states: F. Granting of individual setback, lot line and lot area variances, except in relation to a regulated natural feature or a bulkhead or other shoreline defense structure or any activity within the CERA; Pursuant to Chapter 268,the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: William Duffy,Town Attorney BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson ®F $®U��i 53095 Main Road• P.O.Box 1179 Dantes Southold,NY 11971-0959 Patricia ra Office Location: Eric antes Town Annex/First Floor, Robert Lehnert,Jr. aO 54375 Main Road(at Youngs Avenue) Nicholas Planamento l ycouED http://southoldtownny.gov p.//southoldtownny.gov SEP 12021 ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Sout old Town Planning Board Tel.(631)765-1809•Fax(631)765-9064 September 21, 2021 Mark Terry, Assistant Town Planning Director LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold,NY 11971 Re: ZBA File Ref. No. #7583 Polidora, Joseph Dear Mark: We have received an application to construct a one story addition connecting existing house to existing detached garage. A copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning Code), and survey map, project description form, are attached for your reference. Your written evaluation with recommendations for this proposal, as required under the Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Leslie K. Weisman Chairperson By: Encl. Survey Site plan: AJC Land surveying PLLC, dated August 31, 2021 FORM N0.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: July 1, 2021 Renewed: September 13,2021 TO: Nigel Robert Williamson,RA(Polidora) PO Box 1758 Southold,NY 11971 Please take notice that your application received June 23, 2021: For permit to: Construct 1 story addition connectingexisting xisting house to existing detached garage: Location of property: 1055 Point Pleasant Road, Mattituck,NY 11952 County Tax Map No. 1000—Section 114 Block 1 Lot 1 Is returned herewith and disapproved on the following grounds: The proposed construction, on this nonconforming 29,985.57 sq. ft. parcel in the Residential R-40 District, is not permitted pursuant to Article XXIII Section 280-124 which states: lots measuring between 20,000 and 39,999 square feet in total size require a minimum side yard setback of 15 feet with a combined side yard setback of 35 feet. The proposed site plan shows a minimum side yard setback of 1.6 feet(east) and an existing side yard setback of 11.2 feet(west),with a combined side yard setback of 12.8 feet. Authorized Signature Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file,Z.B.A. .r Fee:$ Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No. 1066' Street P;,oT .�AxPJT- QLP& Hamlet HArrl rua-_ SCTM 1000 Section J L4 Block O 1 Lot(s) 00 I Lot Size 0.688 Ac, Zonej?AD I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED Tut,y 1, 2o'Ll BASED ON SURVEY/SITE PLAN DATED_; USE 17y,2021 . P-L&19Q 0 '54rimalm J.3, 202,1 Owner(s): ►MR. kwooQA Mailing Address: 2 VAEDLEu bill dlEf 11x HILLS t,.l.Ve /1746 Telephone: 63).4`II. 5477 Fax: Email: d-0,1i J ro, S'S- J 14,C 1.Irl . NOTE:In addition to the above,please complete below if application is signed by applicant's attorney,agent,architect, builder,contract vendee,etc.and name of person who agent represents: Name of Representative: 414EL P49W hl)t.t.l"rgJ for n Owner( )Other: Address: P.0. &0A 17S$, SOUTNaL0 �•W. 11971 Telephone:631-834-1740 Fax: Email: n'ge1—cvcA tett@ �atmz� l-wm Please check to specify who you wish correspondence to be mailed to,from the above names: ( )Applicant/Owner(s), 14 Authorized Representative, ( )Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED TiJE Ir,2b24 and DENIED AN APPLICATION DATED UuW 1 . 7.02-1 FOR: JK uilding Permit kcoeoff S risco i g]L ( ) Certificate of Occupancy ( )Pre-Certificate of Occupancy ( ) Change of Use ( )Permit for As-Built Construction ( ) Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do not quote the code.) Article: XX I i 1 Section: 2.13 O Subsection: 124 Type of Appeal. An Appeal is made for: A Variance to the Zoning Code or Zoning Map. ( )A Variance due to lack of access required by New York Town Law-Section 280-A. ( )Interpretation of the Town Code,Article Section ( )Reversal or Other A prior appeal( ) has, K has not been made at any time with respect to this property,UNDER Appeal No(s). Year(s). . (Please be sure to research before completing this question or call our office for assistance) Name of Owner: ZBA File# REASONS FOR APPEAL(please be specific, additional sheets may be used with preparer's signature notarized) 1. An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted, because: The existing house 11.2' from the west property line and the existing garage 1.6'from the east property line have been in existence since prior to 1957 and have framed part of the character of the community. The request for a variance is not based on the property addition other than the fact that the proposed 4.8' x 8.9'addition between the existing house and existing garage change the structure from a principal structure with an accessory garage to a principal structure. (dwelling and garage). 2. The benefit sought by the application CANNOT be achieved by some method feasible for the applicant to pursue, other than an area variance, because: To achieve the required 15' side yard setback one side and a combined 35' setback to the side yard. The existing dwelling would have to be either cut back 3.8' to conform with the 15' setback or 8.8' to conform to the 20' setback to the existing garage could have to be either cut back 13.4' to confirm with the 15' setback or 18.4 to confirm to the 20' setback. Either option would produce a situation hardship for my clients to remove the west side of the dwelling or the east side of the garage. The amount of relief for the proposed connection is 1.9' or 40% based on a 35' total side yard setback. 3. The amount of relief requested is not substantial because: The amount of relief based on a new principal structure would be enormous. 11.2' to 15' =25% or 1.6' to 20' = 92% relief or 11.2' to 20' =44% or 1.6' to 15' = 89.4% relief. However, the structures are existing since prior to 1957 on a pie shaped site where the East to West dimension and the face of the structure to the front yard is tight. To conform to the present day zoning the existing garage would have to be removed and part of the existing dwelling 3.8' at minimum would have to be removed. All based on the connection of the existing dwelling to the existing garage.The amount of relief in the proposed request of the existing dwelling to the existing detached garage is minimal. 4. The variance will NOT have an adverse effector impact on the physical or environmental conditions in the neighborhood or district because: The existing dwelling and existing detached garage alreadyform part of the physical and environment conditions in the neighborhood. The 4.8' x 8.9' enclosed connection between them will have no adverse effect. 5. Has the alleged difficulty been self-created? {X}Yes, or ( ) No why: The existing house and existing detached garage were built prior to zoning. Are there any Covenants or Restrictions concerning this land? { X } No { }Yes(please furnish a copy) This isthe MINIMUM that is necessary and adequate, and at the same time preserve and protect the character of the neighborhood and the healthy, safety, and welfare of the community. Sworn to before this 20 day Of SrpTg-moo— ,2021 . F_ Notary Public DAVID J.JANNUZZISi ature of Applicant or Authorized Agent NOTARY PUBLIC,STATE OF NEW YORK (A nt must submit written Authorization from Owner) Registration No.02JA6052585 Qualified in Suffolk County Commission Expires February 13,900 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26485 Date: 05/28/99 THIS CERTIFIES that the building DWELLING Location of Property 1055 PT PLEASANT RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 0001 Lot 001 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 26485 dated MAY 28, 1999 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 ONE FAMILY DWELLING WITH ENCLOSED FRONT PORCH, OPEN REAR PORCH, AND ACCESSORY TWO CAR GARAGE.* The certificate is issued to DOUGLAS & JANE SEETH, TRUSTEES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REP Building In pector Rev. 1/81 APPLICANT'S PROJECT DESCRIPTION APPLICANT: Irlic�EL BEp� I�i c_t is}M�c� DATE PREPARED: /9 SEO�ti( 20 LI 1.For Demolition of Existing Building Areas Please describe areas being removed: F-x isTtJ Q 9,8' . 24.4' OPEL1 P:wpetW iJ/ STE:PS (a Gxtrru)c- �IJFl.t_ta� .o' omoo2 sl•'009R Ex tSTiJ� FRO'JT- fie-ap 01". SIE P&4CjM 1A.1 kIAID . U.New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: 4.6x to-S' Com UX .6-7 380 pkwc AVIDIT10j . Dimensions of new second floor: Dimensions of floor above second level: 13/4 Height(from finished ground to top of ridge): 15- Is 5Is basement or lowest floor area being constructed?If yes,please provide height(above ground) measured from natural existing grade to first floor:¢,& ' M.Proposed Construction Description(Alterations or Structural Changes) (Attach extra sheet if necessary).Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: 1-5 S7o/Lu L2sro ,} DJELLIt1 r, r��r>a ��tYKvilAu G ACA geek) jK"H tabn&oR. sHP0EQ . CEu.A,z f'J�rQ cr: EC Number of Floors and Changes WITH Alterations: I.S s 'ZS'ro D�Er_i.tJ 0 /$.67 z 38.t1p Aga, ,J To DOF-L- i >a � s£ 4U"M -CCE 01�WIJ/ 4.o',eto.S Cov"rrD Eg7ea.1m f2gct44�8'•c 8.9� Co4JVic-Tw4 _ J r0Et-I-I 4 To EY,4.s7134 IV. Calculations of building areas and lot coverage(from surveyor): Existing square footage of buildings on your property: 171 S.S 2 SQL. . Proposed increase of building coverage: $79. 89 kL K - 2% IeJaasE Square footage of your lot: 2-9, R95.5-7 Percentage of coverage of your lot by building area: 7. (o' •- sE0 5-6°.-F-x t r1J V.Purpose of New Construction: Codo= "OZA E pms-t 960 Pe 41TULA QA-[E. 4SIC 8-Y G,3lLOT]03 a busnk Z)OE" lk TD Exl.s12J4Q4QcE - I&AirMLz J>3.6-7'x 38.0' Swa.E, Sr2W ]-IV 1/3Cr I0M - I-1"FTAQ VI.Please describe the land contours(flat,slope %,heavily wooded,marsh area,etc.)on your land and how it relates to the difficulty in meeting the code requirement(s): Tc+>✓ a Co►J Do uar Rzwrg TO fir: n c v . 72r, 1ssuE OCISES B -SE; 4E 6 Ra Xtt -4-8'x8-9' Coxlt3Ec ,34 DIJEIL14- 11.2 SBCr-1� Tb Tyg A;tLEr1 Jq9 t'akgagE 1.6' SE`r&KJc- WHICH A0 Ca i1 M#- 84+-is Mit Exvsr,Jc Gia�E & 1 U441.o ( S79,jC-We6 80T A100 M IMS 11- A Please submit 8 sets of photos,labeled to show different angles of yard areas after staking corners for new construction,and photos of building area to be altered with yard view. 4/2012 QUESTIONNAIRE 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? No Yes please explain on attached sheet. Nc EA� BEN WD THE PQopos6D I,)Ar�gwF I_E.Tn►J14( ► 1�"L. CorJTU'alJr, THE60 1/;} OWTS 5LfSTEM W)"_ 8F_ L.E V61-. PA4r eF I-Mg 20' C007n02 4 22,E Coil rov2 W,LA� $E @ 24.24'�EE e�E . C. 1.)Are there areas that contain sand or wetland grasses? )1,s 2.)Are those areas shown on the survey submitted with this application? Yu 3.) Isthe roperty bulk headed between the wetlands area and the upland building area? / 0. 4.) If your property contains wetlands or pond areas,have you contacted the Office of the Town trustees for its determination of jurisdiction? FS Please confirm status of your inquiry or application with the Trustees: Peg- Appw c n,0*3 ),3sXcTw L3_ and if issued,please attach copies of permit with conditions dan 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? Mo E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? AL__ __- _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? Mo If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe: M/4 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? �J o . If yes,please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this parcel S1a4L'6 �I1 L-y D�J ELL/4.)4' and the pr posed use S AJLE 1 b 1)E L.L (J� 5J kg ATJ-pr- ED- (ex: existing singe family, roposed: same with garage,pool or other) 'S & a� 2021 . JAthoiiized Date Name of Action or Project: Polidora Residence Project Location: 1055 Point Pleasant Road, Mattituck,N.Y. 11952 S.C.T.M. 1000-114.00-01.00-001.000. Brief Description of Proposed Action: • Demolish the existing single story entrance & construct a new single story entrance with basement under (same footprint). • Construct a new 4.8' x 8.9' enclosed addition connecting the existing dwelling & existing garage. • Construct a new 4.0' x 10.5' covered entry porch. • Construct an enclosed outdoor shower open to the sky. • Demolish the existing 8.8' x 24.4' covered porch at rear & construct a new 18.67' x 38.80' single story addition with basement under & 4.0' x 4.0' egress window. • Construct a new stone patio between the new addition & existing garage. • Remove the existing cesspool • Install a new I/A OWTS system with a new waterproof retaining wall. gational Flood Hazard Layer FIRMette FEMA Legend 293'10"W 41°0'4"N SEE FIS REPORT FOR DETAILED LEGEND AND INDEX MAP FOR FIRM PANEL LAYOUT Without Base Flood Elevation(BFE) zone A.V.A99 SPECIAL FLOOD With BFE or Depth zone AE.AO.AH,VE.AR HAZARD AREAS Regulatory Floodway 0.2%Annual Chance Flood Hazard,Areas of 1%annual chance flood with average depth less than one foot or with drainage areas of less than one square mile zone X Future Conditions 1%Annual Chance Flood Hazard zo-x i OnF l�f- Area with Reduced Flood Risk due to E�Y$�Ft3@t} OTHER AREAS OF Levee.See Notes.zone x FLOOD HAZARD Area with Flood Risk due to Leveemne D NOSCREEN Area of Minimal Flood Hazard zonex }r Q Effective LOMRs w. OTHER AREAS Area of Undetermined Flood Hazard zone I GENERAL -—-- Channel,Culvert,or Storm Sewer STRUCTURES I I I I I I I Levee,Dike,or Floodwall s zO� Cross Sections with 1%Annual Chance OMAN • 17.5 Water Surface Elevation � 40 1011,11 0 011tfY01+� w- - - Coastal Transect —sn— Base Flood Elevation Line(BFE) Limit of Study Jurisdiction Boundary Coastal Transect Baseline -•- OTHER _ Profile Baseline FEATURES r , Hydrographic Feature r Digital Data Available N r._. No Digital Data Available MAP PANELS Unmapped AREA OF MINIMALFLOOD l-1AZARD The pin displayed on the map is an approximate ZU1JE?. point selected by the user and does not represen ti.* an authoritative property location. This map complies with FEMA's standards for the use of digital flood maps If It is not void as described below. / The basemap shown compiles with FEMA's basemap accuracy standards �} The flood hazard Information Is derived directly from the w 'r authoritative NFHL web services provided by FEMA.This map ^r r. was exported on 9/19/2021 at 7:48 PM and does not reflect changes or amendments subsequent to this date and time.The NFHL and effective Information may change or become superseded by new data over time. This map Image Is void If the one or more of the following map elements do not appear:basemap imagery,flood zone labels, legend,scale bar,map creation date,community Identifiers, 72°32'32"W 40°59'37"N FIRM panel number,and FIRM effective date.Map Images for Feet 1.6 00o unmapped and unmodernized areas cannot be used for 250 500 1,000 1,500 2,000 regulatory purposes. o..�...,,...,.nccc n,...I---Inn,...n.a..r.,,...r......n..t...,s.....ti...�n.....ti.,, onon --- _�NAT'1"tTV G1��_ -1�1.-K.--t_l4S2-------------- - --- - --- - - -- --- - 1 CREEK TIME :_-t1-:56-A.M._____ oWARD S N79°17'28"E 107.26 IV LOW WAR W 0 r O 0 i ERTID VEGETATION r Lq U) FLAG-,... WATER•__. .. MSN HIGH `..mac'+__ T r i STEPPING STONES ot s Opp TIDAL WETLAND BOUNDARY AS FLAGGED Y,�__�• �__ ti,_ _, ,;_ ^;.�:-`•__ BY SHAWN M.BARRON,M.S.ON JUNE 22,2020 _ I y--- 10X10 DECK WI - GAZEBO• 0 6 1832 NATURAL VEGETATION LINE O ro J pp 0 9 50' ADJACENT = $p WELL RADIUS APPROX.CESSP EOL g 2�' _ ! - d R U LOCATION AS P ADJACENT SURVEY = • = _ - .. .-•-- _ •-•--.-- (TO BE PROPERLY ABANDONED) 150' ADJACENT CELLAR M PORCH WELL RADIUS - ENTRANCE 4. F 1-1 — r VENT 16.0 1.5 STORY FRAME q ADJACEi\ - --- - -- -—- - - ADJACENT �N � 1 I RESIDENCE D '� �•-_ - , RESIDENCE STORY RESIDENCE N "_I" ' ="-.'`' ERESIDEN( #1055^ 1 .1 _Sfl„=29.5.. 20.3 -� 1.5 tC 24.6 ^ STORY PLAT. - -r Sl' _ �t FRAME PAT. ``� N GARAGE G.FL.=29.3 l� — -. ���'F< I00'ADJACENT v \ WELLRADIUS uj -- WELL I _ LOT 3 t EXISTING WELL �T -_•=':..� -� ` :�,';;i•- Z 4- TO BE ABANDONED - - - O 014n <r Z i -I L 0 0 G u - UTILITY', > POLE`'Q UTILITY I„ O _ - POLE - o z WELL o L i W � r � Q a� Q w U = YHO . ('n u TEST HOLE, � N ¢O J ELEV.29.16: c m � b W OD > O ° :A Z A102.00 MON.FND. MON.FND. - MON.FND. MON.FND. ■ ■-- --- - ------ --- •- --- -- - --- - -•---• - ---`51 .00 S83°16'00"W_ V ` .....-.....*px................_.............•...._...... 2, .......... 9? _ GRAVEL ROAD ..............�x........................... ................ .......... HOME PIKE ( POINT PLEASANT ROAD ) Policlora Residence Point1055 PleasantRoad, 11952 1000-114.00-0001-001.000 1 A..s. Looking •WA—WW .. rB. LookingNorth Polidora Residence 1055 Point Pleasant Road, Mattituck, N.Y. 11952 S.C.T.M. 1000-114.00-0001-001.000 1th August, 2021 11:56 a.m. r• C. Looking North ` D. Looking South ------------- i ; 2 of 7 Polidora Residence 1055 Point Pleasant Road, Mattituck, N.Y. 11952 S.C.T.M. 1000-114.00-0001-001.000 1th August, 2021 11:56 a.m. E. Looking North I I F. Looking West k cqy_ 3 3 OF 7 Policlora Residence 1055 Point Pleasant Road., 11952 S.C.T.M. 1000-114.00-0001-001.000 • . G. Looking East H. Looking East s Policlora Residence 1055 Point Pleasant Road, 11952 S.C.T.M. 1000-114.00-0001-001.000 IthAugust, 2021 • J. Looking South �t K. Looking South n, :,.,axe'° � '• f r s Polidora Residence 1055 Point Pleasant Road, Mattituck, N.Y. 11952 S.C.T.M. 1000-114.00-0001-001.000 1th August, 2021 11:56 a.m. L. Looking West A yc� yp' M. Looking East 6 of 7 Polidora Residence 1055 Point Pleasant Road, Mattituck, N.Y. 11952 S.C.T.M. 1000-114.00-0001-001.000 1th August, 2021 11:56 a.m. N. Looking Southwest k 7 of APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. I ` YOUR NAME: to 1 AD fa, �Q/�U�Gt ►"� (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tag grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) 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 NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP 4 Submitted this day of J 1X4632 20?. Signature Print Name APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. 1 e YOUR NAME : {� ?0LW1LA0L J 0:5�4 k (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance ) Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) 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 NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submittedt day fS, .c 20� !� Signature Print Na e Afl�� 0LL>,q AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The Durpose 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. t ' YOURNAME : �1LLIAMSOO N1CGL 19CV-1— (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATIQN: (Check all that apply) Tax grievance I Building Permit Variance X. Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) EA 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 NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold /A Title or position of that person A Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. Th town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP ' [ / Z� Submitted this day of 20 2 Signature i11I Print Name I - � EST W I L,LA A&AJOJ Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) I, 3066 k9De-�t�DQ� residing at )_ �& , �_Z>4_ (Print property owner's name) (Mailing Address) 1-6LGS do hereby authorize �o G E L Po QV_P_T_ 11 ,, (Agent) W)LL l A kA Soli to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. Signature) & 0.6& (Print Owner's Name) Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) I, ,�(j�Gt Vt �� J d 6 - residing at �0(dl&l (Print property owner's name) (Mailing Address) DIN t f lit —do hereby authorize /J I GGL Pa sewn (Agent) 6 LLIAi4 Sod to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. z� (Owner's Signature) ✓��y(0-k TO (I d 0�a. (Print Owner's Name) AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval, use variance, area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: J. i GEL P019W IBJ iGL i AMso#� 2. Address of Applicant: P o. Sox I71Sod LZ nl• 1971 3. Name of Land Owner(if other than Applicant): tfg, u tZoPA 4. Address of Land Owner: 2 9-aD DQi dF- I D I x H l L wS . Il 74 4 5. Description of Proposed Project: r,S c rains,' ►iF-D s1tFrET 1 6. Location of Property: (road and Tax map S.G.T:M. 1000-114-00 - 0001 - 001-000 number) l OSS kijl T DL.,r-asA,J-r Row MH r-n ng4L , #J.�k 119S')- 7. 19527. Is the parcel within 500 feet of a farm operation? { )Yes) YeEr PQ No 8. Is this parcel actively farmed? { } Yes fA No 9. Name and addresses of any owner(s) of land within the agricultural district containing active farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning Board Staff, it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office (765-1937) or from the Real Property Tax Office located in Riverhead. NAME and ADDRESS 1. 2. 3. 4. 5. 6. (Please use the back of this page ifKere are additional property owners) l9 S�p7L)q 2,1 . Signa 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. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. Name of Action or Project: Polidora Residence Project Location: 1055 Point Pleasant Road, Mattituck,N.Y. 11952 S.C.T.M. 1000-114.00-01.00-001.000. Brief Description of Proposed Action: • Demolish the existing single story entrance & construct a new single story entrance with basement under (same footprint). • Construct a new 4.8' x 8.9' enclosed addition connecting the existing dwelling & existing garage. • Construct a new 4.0' x 10.5' covered entry porch. • Construct an enclosed outdoor shower open to the sky. • Demolish the existing 8.8' x 24.4' covered porch at rear & construct a new 18.67' x 38.80' single story addition with basement under & 4.0' x 4.0' egress window. • Construct a new stone patio between the new addition & existing garage. • Remove the existing cesspool • Install a new I/A OWTS system with a new waterproof retaining wall. rc , Y,OV1 N OF SC�UTHOLD R'PROPERTY=';�t�C�7 OWNER STREET ` ,VIL`LfGE',° 'DIST SUB "f".LOT FORMER OWNER N :E: r' ' » ACR: ' 64 " S W ,-TYPEaOF-B.UILDING �'.-ry—:—�^P��.t»„..1� F R Y _� —__-- _____"_ ._ ___� � f ..,.. Kw`�d. u+ �F.s.Ra'"`� C.d 'a"�+A•",i. ..=. 'RES:' SEAS. VL. FARM COMM'.. CB;, MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 6 e � 4 _ / y o �F: i �!�ka i`%. ' ' j aw3' x.3"w" µ "yam, 6-7 2 .a AGE BUILDING CONDITION }, - � f � ,1i) mb ov i�W ° '� NEW - NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 a Tillable 2 Tillable 3 Woodland Swampland O .'O-VC!ATERz:�: Brushland FRONT,GE'QWRQAD`V': ��� House Plot DEPTH ' " ; Al Total „ .., m'xFsnrxe-,�.:* s+c"7`a Y:'=ov :.#,^t s4 ..,h•'�s"a n.=u`.�°.,.'>- a,2?`�,`'"^�>^''r'r�z�"4;3A,�.'m",m, '.+a«y-?",mom ..'"� : Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 114,00 - Ol.00 - 001.000 The Application has been submitted to(check appropriate response): Town Board © Planning Dept. © Building Dept. VN Board of Trustees JeLlsl 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) (c) Permit,approval,license, certification: Nature and extent of action: 8y1L,1DI13Q T�EDA(L'rM�t�T — N�TIGE r� �IS pQIP�Jgt- -5[aS TM.�g - Pei &Pw cA�rwJ Location of action: 1055 P0161- PLEA SAJ T 12oAV) HArn 1-Uc k- IJ.t4 11952 Site acreage: 0.688 Acmes C29 985. 57 srt , r�r1 Presentlanduse: cSjOrfLE FAM a DOF—LUOr< Present zoning classification: R40 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: �j C EL RQBWj- (b) Mailing address: _ P-0. &oL 17,5B Soy rl.W LD , 1 .1,j /1971 (c) Telephone number:Area Code( ) 6,31, 834-9740 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes x No❑ If yes,which state or federal agency? &J d 1 W O MEJ3T*1- GO&I.SEPZUATto� Cly.6•G.)- LETTER d " 000 r ju also 1G'r1'o" . 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. S Yes ❑ No ❑ Not Applicable IT IS 1► EEPIa4 of fH T14E 'F-j&.oyjZ1'jQ Ajoc"loep-Q4D Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes 11 No Z Not Applicable .l 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 Q Yes Q No Not Applicable 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 KZ YesEl No 0 Not Applicable E J V6 oJ heOkgps NA-S )#-JrR--T1a AL ✓€ E Tt-oJ- ca- hapaureb 6 9xisrfJ< J 0EL1.,S' X 1,C fl 04L E Ata. pp, Inc- t1 L} In1TS -A- Attach l 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 v'v Yes 0 No []Not Applicable A; tJCW 1A 001rS Sy-rTEM !s to BE; /�IST�u.ED � THS �XiSTi�Cr GESSRsio L ]S 7�D �E DuMOE� 1�M.o 1/E[] 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. IKZ Yes 0 No 0 Not Applicable 09 A.)0J I/jq 01JTS SgrlM 1S m $1✓ IeJ.tnw4,9b 'y H1: eX1S`r1rJ- L • A �JEink RyGFEp 1S To RE lt1f7?}L, K' NCEIS THE i�kEk� eeq- iOlJ4 4 THE STgvn1J6- 17RJE.r 1—. kpOAet..s Ce-err-k- 7-pe 2erk.7-pe 1l1E O i� F_K1Sf► Cr ST2jcrr o QF,S W 1 L-L .0S 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 R Not Applicable 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 A oew ILA oor1 tnlS EM )s ro BE JAjsjpc.L_j n+E £xisTiJ(, CESSADoL IS To BE JPVm0m ftnoliEo 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. ❑ YeO No in4 Not Applicable Pr 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 0 No � Not Applicable 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 rJ 4007-S s IS To 86 1,W-jr4 iED 17/C jT► G6ss L isBEED �MoJEb Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III— Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No Z Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LV;" Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No R Not Applicable Created on 512510511:20 AM y 617.20 Appendix B Short Environmental Assessment Forth Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: P0LI_D02.A kE,S{DE0GE Project Location(describe,and attach a location map): 1055 Poiur PLE:ASA/.JT POO, N4Arrlruck Brief Description of Proposed Action: DE mo wpq THE Ex r s r rt14 5 a tL STV ��Da-: t C-arre 1 c r 4 1JFW SW4L-L S7v" E6TP,oZef $A}sEa1"r V�3b&e- lca4" T ►2�.Jr Gras a NErJ 4.8'.c g.q' Eaups>ry Ar04r�oJ� Cr�uJlrC.1rr6Q- coA3'4Ec1-'-J E �Exrs 1J Q0Ec,�,r EXIS'r/44 Q0444Er C,o.3l'M�cT- A- AJk1J 4.o' ,L 1.o.S' Couk,¢F.7 eA.irr per. CpA1s?4J�r MJ o0Tao02 SkaAJEX VFEA� 'rte 774x. Sky. l7EAWLISH T-RF_ Exrs-rrc14 9.8'x 24.4 GavE,2m P094J-e (� 9&19- � caysra206-r A vErJ It,.6-7' X 38 ev' S/�kr.E s`*fl►Z AnnITw,J w AAfF-M63 r UAZIM� 1' 4.0' v- 4.0' E4 Ess O►Jo.C,�J. Co,ds G•r A 4eO )toll£. puna B Ti1ra_J TNa jagJ �Drpflo l 4 EoUST/,a 4-"Aq 29m,gvE $Mf✓ 1.STr�.� CrS1 t- /r1S?iQ1.L t� AJE- J 11AJ D,JTS aLfrTEM k)/ .4 N•E1� Name of Applicant or Sponsor:, I Telephone: 63). $34.9 74 0 NI,F-L PO-Rep-1, 01LLtAMSO J E-Mail:nr P�_atr�h� t {w !• r1 Address: Q 4, Jlox 1750 City/PO: State: Zip Code: sovrr-cow . 1J.y . 11952. 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 'rp,�r, S-6o-r wLo 1�2vr-rrx.S 'rO W 4 of So✓9�1-D 8 V I LD I J 4 DEPWL17.� .7- SvFFot.k 6PvJ rY a AEr"gOr Of HE0,1-Tk WAsTE O"Ce> Ma�ay ��r 3.a.Total acreage of the site of the proposed action? 0.68$ acres b.Total acreage to be physically disturbed? 0.027 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 19. 68IB acres 4. Check all-land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial X Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic Other(specify): T'rDA- WCfLAJDS ❑Parkland Page 1 of 4 r 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? I>� 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: /J_k) 9bek Ste► EaE�;U tea£ tb2 roFrJ7'4AL ,�T> civ s 10. Will the proposed action connect to an existing public/private water supply? i Slr l4 y WELL. NO YES !,o $E d}gq. OOZE Cmo ccs rE 'Tz� Ex►rrnJS q' PKopa1'Ea 1'qnc.' If No,describe method for providing potable water: /JEW 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: IA 00-T's ,Su STEM 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? 1400A¢v`S Co-"E i HaT-r1roc4c-, M. 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: C.Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional $Z Wetland ❑Urban M Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? JKNO ❑YES _X b.Will storm water discharges be directed to established conveyance systems(run ff and storm drains)? If Yes,briefly describe: }� (run El YES ALL ST V—m W.A-r£� .h i2JM Lx,t.sn Jc, !e pgopos STQ►LTuQ£S NULL D►SCd AP.C-E To �1E.Q PR000seb M2u ►JF-u.s. Page 2 of 4 t 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO I YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO 1. YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO TAE BEST OF MY KNOWLEDGE Applicant/sponsor name: T.0 C;L 90,8 EX i k ;LL I AMXO J Date: 19 seemmm, 2.0y 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 occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact 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. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 . PI���SDrb . I - {I _ 38 CL <) l .I.�• �i W°�vJ � IrbJEtL -� � 9 ! RooM pa-rt® of 13. ® ti J) E0 ARCy�� WilLL%AMSON �, Ro �� PR.opaMD �, D2o EXT-cr. k&roe- OUToodp- -COVS04M Pow ENcL-.-- SHOwim Coag 0• I Sa 557-1 Tq F F N ��O 1®ss P®lWr .pXCA,,Se.MT Rc)AD t-14TT ITUC LI O,Y I1952. SkF-T-c-w Dare: 24'�H- A9r-.a 2.,o21 N - O Z H Z c11 rH Qp H O -n o m D N a".-UYVSV31d r rye od- 5501 _ �a� -. 7.jV ,�Waj,,j� sew -a-w �M �dO� � I J 1b39p�l3©tfV a a3 i o Cd co 7 � J _ C�0 � I i I oa � - o -72 El O -- 1S I of L4 FFR TH 11 - - - I hiTl _ 1- -PO os Ro S popos� �'GLoSEP CA NETfol)-VTU®OR-7-9 OW F-R GOVL?-M poRG"SOUTH ELEVATION 1 v � tEz i o Z It -14 - ----T iA • / ri 43 w- EAST ELEVATION PROPOSED -APPIT-10 � � o a �r 8 L NORTH ELEVATION w S10z J� � o 1 � i DIJ1'DOO. SFiL� EIS-. - poVE¢� o ��-t� �.. PWR ALLOTIOW. - W EST ELF-1lATroh{.. Revisions 11-13-98 SEE SEC.NO.107 m 05-05-99 �y „� 8 O RD 10-04-99 NW6682 P' MATCH 7 LINE 4 11-28-00 W -----a�--------� TL 01-22-01 z ' - 03-1407 115A •T 05-09-01 O J I \ t•r 1�' x ge 11-01-01 01-16-02 T7-62 0-2 06-20.03 1048-03 rn =i \ r v oI l 04-09-04 Yr 05-78-05 04.17-0607-07-06 .A✓ la,m �-_-- I�V�I r r 1 fi 03-22-07 06-28-07 05-03-13C ti 1 y 33 10-13-16 N 12-30-16 24A(c} -" (r �y� a $ a/ 9,OA(c) <t.yvf—fin 17Aic1-----Ps- s O 712 2- 753 SA(c) a __ rm TOWN OF SOUTHOLD %• r' ryME WA RNAM 1 .J >>-, e� j ,r `� m- ,ate •\ - '� $ i•• 7 a�. /•^ ®Y 9 7406 •\ ,�- 10. �'F STp S7 as "° r 3 113 (c) a 0g ''' �6'�c \ •4 /1 73 � 'o't(PJ ° ZOq a 143 n / to , ,0 h O c. W i 4 � •' � 1 b 11 A a 14 r v w 7I s.`1 �soJ6pP'('• 6 ry� P h try 8 a� X18 �O 5D� FOR PCL NO. SEE SEC NO. p I 113-12-015 Fo( m( h i s, ll mit s RO• f gU 1 • \72-01' 1tl� rr N 30ZBM L APGa,a or(+NtYy SWMwm ltl lav ^a em lay •---•Oyrtf Lve --SCN-- Mayy p.ym y� --ry-- ytyE550My1NOMERMSE/LLI.PROPERTES E Dmam fane.on Onm, ��— Seemam BEra9v0.,4 (21) !bl No- O Fm Pawl,k --F-- ReW.e Da,vlav --q-- NTIE 4btlOW Cp5111iCf5 SEN£R_ G SueOevmle�lav — ----_ OaN OnmWv v VLNr Oawf lav --W-- 1Wvd D.mvlav--,4'T-- RRE ll, NVPRANT NS.e.mlSM1ae �^-^' -�"` SnkC Oaeavm u E>tiyT lac �— LqM O9hl liv --1-- MnOinv Oat.a Wv--A-- VyR <6 RENSE D Pana NP 23 0.w Pma 121 A(E)IX 12 IA TO'^ly'° -- PK 6wa4v --P-- Wayaom IXwulae--WN-- wxat,l/vsE WKTEW>R fabdaN l4ea 121 A(c) SURVEY OF PROPERTY - LOT 3- MAP OF POINT PLEASANT FILED: MAY 17, 1916-MAP NO.720 SITUATE " MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. TAX MAP NO.: 1000-1 14.00-01.00.001.000 LOT AREA: 29,985.57 S.F.(0.688 ACRES) DATE SURVEYED:JUNE 29,2020 PROPOSED ADDITIONS:JUNE 17,2021 REVISED:AUG.31, 2021 ELEVATIONS REFER TO NAVD88. i 0 30 60 Feet SCALE: 1 INCH= 30 FEET RDI s GREEK HOWA EXISTING LOT COVERAGE: RESIDENCE= 930.39 S.F.OR 3.1% 1 O7.26 8 GARAGE=489.25 S.F.OR 1.6% 7901-71 2 „E �.- OPEN PORCH= 214.30 S.F.OR 0.7% MFgN GAZEBO=81.58 S.F.OR 0.3% WAR W TOTAL=1,715.52 S.F.OR 5.7% LOW O o PROPOSED LOT COVERAGE: 1. Io RESIDENCE= 930.39 S.F.OR 3.1% L f� INTER-TIDAL VEGETATION O GARAGE=8 .58 S.F.OR 1.6% SEP 12021 GAZEBO=81.58 .F.OR 0.3% (n REAR ADDITION=709.46 S.F.OR 2.4% FLAG•�` WATER -c COVERED PORCH=42.00 S.F.ORO.1% TZ , M�N HIGH -cam"", • . 7pP'*NG '?0�•�D OF F'F�' ENCLOSED ADDITION=42.73 S.F.OR 0.1% `-- TOTAL=2,295.41 S.F.OR 7.6% � a . I lop O STEPPING STONES p TIDAL WETLAND BOUNDARY AS FLAGGED ;, BY SHAWN M.BARRON,M.S.ON JUNE 22.2020 l - - DECK WITfj {I i GAZEBO 0 011 NATURAL VEGETATION LINE Cal . ._ � n • �:.L.. ,,;_ � ;{� .-..� -- --2223 __... ,LO.a� , g 150' ADJACENT APPROX.CESSPOOL �.pl 2�. { 1 ±- a0UL p� `, WELL RADIUS LOCATION AS PER C`� '� . r _`:.; ,_ R. ALL ADJACENT SURVEY ! - (TO BE PROPERLY I 1 ABANDONED) ^ / �y12 Ic0 OPEN 150' ADJACENT-' CELLAR M PORCH WELL RADIUS ENTRANCE 24.4 D� S/�N. 9 - -- -S� VENT 16.0 1.5 STORY ADJACENT Lp A 1 FRAME 0 _ ADJACENT RESIDENCE M' RESIDENCE �STORYI #1055 n RESIDENCE s 11.2' 1 F.FL.=29.6. 20.3 O ,.5 - 16 24.6 N STORY STQNE j FRAME PAT. <NGARAGE r...'j G.FL.=29.3 / ff, 100, 1 00'ADJACENT J ~ S WELLRADIUS I '� L:J �;,• , . 'la.r ..�� II WELL \ „I •II V U ,I \\ j WELL n LOT 3 :\ O O EXISTING WELL L TO BE ABANDONED � .. l"I 7 <. i I i O O � I O < <t 1 o � 1 0 I ` u a Ly S UTILITY PPOLE`� UTILITY POLELL Q E2-1 WLL O ? D Z >_ 0 C) W Q, Y - TEST HOLE: N tJ r J 3: ELEV.29.16. M O p N c ° M c TEST HOLE (NOTTOSCALE) O o SHAWN M.BARRON.M S. ~ DATE:JUNE 19.2020 Z GRADE ELEV.29.16 SM SANDY LOAM W/GRAVEL 102.00 MON.FND. MON.FND. MON.FND. _.. _ '•COARSE SAND W/GRAVEL ;004 MON.FND. 5' -- SW COA /1 ® 5 1 .00 Sa3°1 6'00"W U \+ 2920x..................:..............'........922M......... GRAVEL ROADZ MIXED SAND W/GRAVEL ............1x............................................ x 151- HOME PIKE NO WATER ENCOUNTERED ( POINT PLEASANT ROAD ) . rt t� AJC LAND SURVEYING PLLG LAND SURVEYING & PLANNING 77 S. COLEMAN ROAD, CENTEREACH, NY 1 1720 G / PHONE: 631 .846.9973 - EMAIL: AJC246@OPTONLINE.NET ANGELO JOSEPH CECERE PROFESSIONAL LAND SURVEYOR <. w ... . ..,.- .. ..�. a .•. .. �. <.. i;