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Map of Morrell L.L.0 Oregon L.L.0
filed in the Suffolk County Clerk's Offi=e
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Survey of Lot 7
Oregon L.L.0 MEETS AND BOUNDS: DRAWN BY: JD
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Map of g BUILDING #1 6000 SQ. FT.
filed in the Suffolk County Clerks Office
on 11/14/2006 as Map No. 11463, LAND SURVEYING 11�8�2�19
. actuate at Mintoville@aol.com
SUBDIVISIONS BUILDING #2 2400 SQ. FT. SCALE: SEE PLAN
Cutchogue TITLE 4 MORTGAGE SURVEYS
TOPOGRAPHIC SURVEYS
Town of Southold SI LANBNERg DRIVEWAY PARKING 11400 SQ. FT. SHEET NO:
Suffolk County, New York
1 �i 1 JOHN t11NT0, L.S. PHONE: (63U'124-4832
Tax Map IOOO�V3�O2—12�� uCeNsm Pt K 6TArnwL LAND SURVEYOR FAX: (631)124-5455
�s � NEW YORK 8TA1E LIG.NO.49866 DEER FENCING 2400 LF
August 1, 2019 scale 1'ir 501 S3 SMITHTOWN BOULEVARD SMITHTOWN, N.Y. 11191
Suffolk County Farmland Committee
January 23,2020—Staff Report(Application#2020001)
EXHIBIT A
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January 23,2020—Staff Report(Application#2020001)
EXHIBIT A(Continued)
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FORM NO. 3
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD,N.Y. �.. . .m ... ..,m . w
NOTICE OF DISAPPROVAL
DATE: February 14, 2020
TO: WJF Farms LLC
8405 Cox Lane
Cutchogue, NY 11935
Please take notice that your application dated February 14, 2020:
For permit to: con eruct w w!��_s;grienitn�ai_.pole bare and abed at:
Location of property: ml 2595 Or as ,ad C utclaca ._i Y.:.Y
County Tax Map No. 1000— Section 83 Block 2 Lot 12.7
Is returned herewith and disapproved on the following grounds:
Theproposed_wshed „on,,,this,,,,conforming.50$,127mmsq_.fft..lot in the AC District is not
.v.v.umm_....
lace aitt fwla lr let a..Bofk S hoc Tic_wrylll�, mr ue a_n inimurnmsfd yLjrd Meq P. of C
feet__The proposed shed has a ininimuni side mu:—si N! ,of 10 feet.
Adcftt..lonal. pu s ant_p_Article ;1..11 Section 280_i_ 7., the lit:o ca ed arses r�cl��rawe ?tc
plan_approval from the Southold TownwwPlanning_Board.
You may now ala ly to these agencies directly,
Autlacam .. ig�aature
Note to Applicant: Any change or deviation to the above referenced application,
may require further review by the Southold Town Building Department.
CC: file, Planning Board, ZBA
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FOR INTERNAL_ USE ONLY
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H1 2020 anning PLAN USED ETERCVCC[�f�TCOCoi
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Initia'uDeterminati2a
Date Sent-
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-proposect use or uses si�ould tie scat�t�"tttted.)
ination as to whether use is l ermittt d:
-Ir►itial DetetYn
Initiai-Petr as to whether site plan is required,-SI-4.
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mature of Building It�tspeetoer
Planning Dep�artm
ent (.P.D-) Referral,:
Date of`DOcntettt:��--
��_Hate Received: _---
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` � � Signature ofi Planning De' ;•• tafi"Reviewer
Final Det611111nation
Date l
c,*- nfifrP c)f Ririi"Lina._. _-,nPc_to ,_.... ,
COUNTY OF SUFFOLK ,
FEB 1 0 2020
Steven Bellone
SUFFOLK COUNTY EXECUTIVE
Department of
Economic Development and Planning
Natalie Wright
Acting Commissioner Division of Planning and Environment
SUFFOLK COUNTY FARMLAND COMMITTEE
February 7,2020
Mr.W.Jonathan Fabb
WJF Farms,LLC
8405 Cox Lane
Cutchogue,NY 11935
Re: YYJF Farms, LLC, 12595 Oregon Road, Cutchogue, Town of Southold
Suffolk County Tax Map No.: 1000-083.00-02.00-012.007
Application No. 2020001
Permit#:PFC2020001 and PFC2020002
Dear Mr.Fabb:
The Suffolk County Farmland Committee, at its regular meeting on January 23, 2020, reviewed your
application for an Agricultural Development Permit for the installation and maintenance of one(1)Morton
barn and associated electric and water utilities, one (1)crushed stone driveway and parking area, one (1)
pole barn,one(1)underground irrigation main,one(1)irrigation well,one(1)irrigation pump,and one(1)
auxiliary diesel engine, and a Special Use Permit to conduct a site disturbance associated with the
installation of the water utility/irrigation infrastructure and electric utility infrastructure,in association with
a nursery stock, fruits,and vegetables operation.
The application was approved,subject to the conditions outlined in the enclosed resolution and permit.
If you have any questions,please feel free to contact me at(631) 853-4863.
Sincerely,
Andrew Amakawa
Senior Planner
Enclosures
Cc: Sarah Lansdale,Director of Planning& S.C.Farmland Committee Chairwoman
August Ruckdeschel,Farmland and Open Space Coordinator,S.C.Div.of Planning and
Environment
Suffolk County Div. of Real Property Acquisition and Management,Inventory Unit(email copy)
Heather Lanza,Planning Director,Town of Southold(email copy)
Melissa Spiro,Land Preservation Coordinator,Town of Southold(email copy)
H.LEE DENNISON BLDG wa 100 VETERANS MEMORIAL HNY,2nd FI 0 P.O.BOX 6100 a HAUPPAUGE,NY 11768-0099 a(631)853-5191
RESOLUTION NO. FC-02-2020 OF THE SUFFOLK COUNTY
FARMLAND COMMITTEE, PURSUANT TO CHAPTER 8 OF
THE SUFFOLK COUNTY ADMINISTRATIVE LOCAL LAWS,
APPROVING MODIFICATION TO THE WJF FARMS, LLC
PROPERTY (1000-083.00-02.00-012.007), TO WHICH THE
COUNTY OF SUFFOLK OWNS THE DEVELOPMENT RIGHTS
WHEREAS, pursuant to Chapter 8 of the Suffolk County Administrative Local Laws ("Chapter 8"), a
proposal to modify the property currently owned by WJF Farms, LLC has been received by the Suffolk
County Farmland Committee ("Committee"), where such proposal is known by application number
2020001;and
WHEREAS,the property owned by WJF Farms,LLC is located on land situated north of Oregon Road,in
the hamlet of Cutchogue, Town of Southold, identified by Suffolk County Real Property Tax Map
("SCRPTM')number 1000-083.00-02.00-012.007("premises");and
WHEREAS,the applicant seeks an Agricultural Development Permit for the installation and maintenance
of one (1) Morton barn and associated electric and water utilities, one (1) crushed stone driveway and
parking area, one (1) pole barn, one (1) underground irrigation main, one (1) irrigation well, one (1)
irrigation pump,and one(1)auxiliary diesel engine,and a Special Use Permit to conduct a site disturbance
associated with the installation of the water utility/irrigation infrastructure and electric utility infrastructure,
in association with a nursery stock,fruits,and vegetables operation operation;and
WHEREAS,said application was considered by the Committee at its meeting on January 23,2020;now,
therefore,be it
1"RESOLVED,that the Committee hereby finds and determines that this proposal constitutes a Type II
action pursuant to 6 NYCRR§617.5(c)(4),which completes the SEQRA review;and
2°d RESOLVED,that the Committee hereby approves and adopts the report of its staff,as may be amended;
and be it further
3`d RESOLVED,that the Committee hereby approves said application,subject to the following conditions:
1. The proposed one(1)Morton barn shall measure approximately 100 feet in length,60 feet in width,
30 feet,in height(to the peak of the roof)and 16 feet in height(to the eave of the roof),and shall
be located on the southern portion of the property. It shall consist of a wooden frame,steel siding
and roof,and concrete foundation and footings;and
2. The barn shall be utilized for agricultural storage of seed and produced crop, as well as, an
employee/farm hands area with a break room and office area;and
3. The barn shall be serviced by a proposed underground electric utility line measuring approximately
200 linear feet from the southeast comer of the property,and shall be installed at minimum depth
of 30 inches below surface grade;and
4. The barn shall also be serviced by a proposed underground water utility line measuring
approximately 185 linear feet and shall be installed at a depth of 4%feet from the southeast comer
of the property;and
5. The proposed employee bathrooms/sanitary_system infrastructure identified on the site plan are
not included in this approval. Said infrastructure will be reviewed at a subsequent SC Farmland
Committee meeting.
Note: Under new protocol as of January 27,2020, requests for proposed sanitary system
hiftstructure on County Farm PDR land shall first be reviewed by the SC Farmland Committee
(SCFC)and any approval by the SCFC would be subject to obtaining Suffolk County Department
of Health Services (SCDHS)review and approval. Any substantive changes to the system
required by SCDHS might require re-review by the SCFC, and
S.C. Farmland Committee Meeting 1/23/2020—Reso. No.FC-02-2020 Page 1 of 3
6. The proposed crushed stone driveway from Oregon Road shall measure approximately 30 feet in
width at the entrance and consist of approximately 3,400 square feet. The driveway shall connect
to a proposed crushed stone parking area for farm employees. The parking area shall measure
approximately 80 feet in width by 100 feet in length and consist of approximately 8,000 square
feet. The driveway and parking area shall total approximately 11,400 square feet and shall
consist of 3-inch thick natural crushed stone material;and
7. The proposed one(1)pole barn shall measure approximately 60 feet in length,40 feet in width,
25 feet in height(to the peak of the roof)and 14 feet(to the eave of the roof)and shall be located
on the western middle portion of the property. The bam shall consist of a wood frame and steel
siding and roof. The footing shall consist of wood poles insetted into the ground and shall have
concrete floors. The bam shall be utilized for storage of agricultural equipment;and
8. The proposed 6-inch diameter PVC underground irrigation main shall run approximately 337
linear feet from east to west to provide required water supply. It shall be installed at a depth of 4
'/s feet. A disposable drip irrigation tape shall be utilized for crop irrigation;and
9. The proposed 250 GPM 8-inch diameter irrigation well and associated turbine pump,and an
auxiliary diesel engine with a footprint measuring 5 feet by 8 feet shall be located on the west
side of the property;and
10. All of the aforementioned proposed improvements shall be located on the property,as depicted in
the site plan-survey received by the County on November 21,2019 and entitled"WJF Farms,
LLC: 12595 Oregon Road,Cutchogue,New York"dated November 8,2019 and attached as
Exhibit A to the Department of Economic Development and Planning,Division of Planning and
Environment Staff Report Application No.2020001;and
11. The landowner shall submit to the Suffolk County Department of Economic Development and
Planning,Division of Planning and Environment within one(1)year of permit issuance the as-built
survey depicting the aforementioned improvements including the labeled respective dimensions of
the irrigation main,well,pump,and auxiliary diesel engine;and
12. The landowner shall prepare and implement a stormwater mitigation plan in consultation with
Suffolk County Soil and Water Conservation District and/or Natural Resources Conservation
Service to address any and all stormwater runoff issues associated with the aforementioned
improvements;and
13. The landowner shall submit to the Suffolk County Economic Development and Planning
Department,Division of Planning and Environment within one (1)year of this letter the Suffolk
County Soil and Water Conservation District- and/or Natural Resources Conservation Service-
approved stormwater mitigation plan;and
14. The landowner shall be responsible for compliance with all conditions of Farmland Committee
Resolution#FC-02-2020,the deed of development rights,the contract of sale,and all applicable
federal,state,county,and town regulations, rules and statutes.
Motion by: Stephen Mudd Seconded by: Alfred Kilb,Jr.
Committee Vote: Ayes 12
Nays 0
Abstentions 0
Recusals 1
S.C. Farmland Committee Meeting 1/23/2020—Reso. No. FC-02-2020 Page 2 of 3
Committee Member Appointment Yes No Recused Not
Present
BALSAM,Alex Town of East Hampton ✓
BIONDO,Vincent Town of Babylon ✓
BUSH,Ronald At-Large ✓
CORWIN,Nate At-Large ✓
FOSTER,Lee Town of Southam ton ✓
JOHNSON,Howard Town ofHuntington ✓
KILB Alfred J. Jr. Town of Shelter Island
KRUPSKI Al S.C.Legislature ✓
LANSDALE, Sarah S.C.Dir.of Plannin ✓
MOYER,Dale D. At-Large ✓
MUDD,Ste hen Town of Southold ✓
MURPHY,Eu ene Town of Isli ✓
NOLAN Bob Town of Brookhaven ✓
ROTTKAMPJeffre Town of Riverhead ✓
RUCKDESCHEL,August Ex-Officio,SCEDP ✓
SCHEER,Charles F.,Jr.. At-Large ✓
SCHMITT,Albert At-LELe ✓
STROBEL,Herb At-L e ✓
ZAWESKI,Mark At-LTje ✓
Totals 12 0 1 6
Date: January 23,2020
Location: Kermit W. Graf Cornell Cooperative Extension Building, I" Floor Conference Room, 423
Grilling Avenue,Suite 1p0,Riverhead,NY 11901
S.C.Farmland Committee Meeting 1/23/2020—Reso. No.FC-02-2020 Page 3 of 3
COUNTY OF SUFFOLK
Steven Bellone
SUFFOLK COUNTY EXECUTIVE
Department of
Economic Development and Planning
Natalie Wright
Acting Commissioner Division of Planning and Environment
SUFFOLK COUNTY FARMLAND COMMITTEE
Application#: 2020001
Meeting Date: January 23,2020
Resolution#: FC-02-2020
Permit#: PFC 2020001
Date Issued: February 7,2020
Property Address: 12595 Oregon Road,Cutchogue,Town of Southold
Tax Map#: 1000-083.00-02.00-012.007
Pursuant to Chapter 8 of the Suffolk County Administrative Local Laws,permission is hereby granted to
W3F FARLI LLC W,Jonathan F"abb
To install and maintain
1) QNE 1 M RTON BARN AND ASSOCIATED ELECTRIC AND WATER.
UTILITIES;
2) ONE 1 RUSHED UQNE DRIVEWAY AND PARKING AREA;
3) ONE 1 POLE II
4) ONE 1 UNDERGROUND IRRIGATION MAIN;AND
5) ONE 1 IRRIGATION WELL ONE 1 IRRIGATION PUMP AND ONE 1'
AUXILIARY DIESEL ENGINE
On the above-captioned property,subject to the following conditions:
1. The proposed one(1)Morton barn shall measure approximately 100 feet in length,60 feet in width,30
feet in height(to the peak of the roof)and 16 feet in height(to the eave of the roof),and shall be located
on the southern portion of the property. It shall consist of a wooden frame, steel siding and roof, and
concrete foundation and footings;and
2. The barn shall be utilized for agricultural storage of seed and produced crop, as well as, an
employee/farm hands area with a break room and office area; and
Page 1 of 3
Agricultural Development Permit#PFC 2020001
Page 2 of 3
3. The barn shall be serviced by a proposed underground electric utility line measuring approximately 200
linear feet from the southeast corner of the property, and shall be installed at minimum depth of 30
inches below surface grade;and
4. The barn shall also be serviced by a proposed underground water utility line measuring approximately
185 linear feet and shall be installed at a depth of 4 %feet from the southeast comer of the property;
and
5. The proposed employee bathrooms/sanitary system infrastructure identified on the site plan are not
included in this approval. Said infrastructure will be reviewed at a subsequent SC Farmland
Committee meeting.
Note: Under new protocol as of January 27, 2020,requests for proposed sanitary system
infrastructure on County Farm PDR land shall first be reviewed by the SC Farmland Committee
(SCFC)and any approval by the SCFC would be subject to obtaining Suffolk County Department of
Health Services(SCDHS)review and approval. Any substantive changes to the system required by
SCDHS might require re-review by the SCFC,and
6. The proposed crushed stone driveway from Oregon Road shall measure approximately 30 feet in
width at the entrance and consist of approximately 3,400 square feet. The driveway shall connect to a
proposed crushed stone parking area for farm employees. The parking area shall measure
approximately 80 feet in width by 100 feet in length and consist of approximately 8,000 square feet.
The driveway and parking area shall total approximately 11,400 square feet and shall consist of 3-
inch thick natural crushed stone material;and
7. The proposed one(1)pole barn shall measure approximately 60 feet in length,40 feet in width,25
feet in height(to the peak of the roof)and 14 feet(to the eave of the roof)and shall be located on the
western middle portion of the property. The barn shall consist of a wood frame and steel siding and
roof. The footing shall consist of wood poles inserted into the ground and shall have concrete floors.
The barn shall be utilized for storage of agricultural equipment;and
8. The proposed 6-inch diameter PVC underground irrigation main shall run approximately 337 linear
feet from east to west to provide required water supply. It shall be installed at a depth of 4'/s feet. A
disposable drip irrigation tape shall be utilized for crop irrigation;and
9. The proposed 250 GPM 8-inch diameter irrigation well and associated turbine pump,and an auxiliary
diesel engine with a footprint measuring 5 feet by 8 feet shall be located on the west side of the
property; and
10. All of the aforementioned proposed improvements shall be located on the property,as depicted in the
site plan-survey received by the County on November 21,2019 and entitled"WJF Farms,LLC:
12595 Oregon Road,Cutchogue,New York"dated November 8,2019 and attached as Exhibit A to
the Department of Economic Development and Planning,Division of Planning and Environment Staff
Report Application No.2020001;and
11. The landowner shall submit to the Suffolk County Department of Economic Development and
Planning, Division of Planning and Environment within one (1)year of permit issuance the as-built
survey depicting the aforementioned improvements including the labeled respective dimensions of the
irrigation main,well,pump,and auxiliary diesel engine;and
Agricultural Development Permit#PFC 2020001
Page 3 of 3
12. The landowner shall prepare and implement a stormwater mitigation plan in consultation with Suffolk
County Soil and Water Conservation District and/or Natural Resources Conservation Service to address
any and all stormwater runoff issues associated with the aforementioned improvements;and
13. The landowner shall submit to the Suffolk County Economic Development and Planning Department,
Division of Planning and Environment within one(1)year of this letter the Suffolk County Soil and
Water Conservation District- and/or Natural Resources Conservation Service- approved stormwater
mitigation plan;and
14. The landowner shall be responsible for compliance with all conditions of Farmland Committee
Resolution#FC-02-2020,the deed of development rights,the contract of sale,and all applicable
federal,state,county,and town regulations,rules and statutes.
This permit shall expire on February 202.1 unless the authorized improvements have been
commenced;a building permit,where required by the Iocal town or village,has been secured by the
agricultural land owner or the Suffolk County Farmland Committee has granted the agricultural land
owner an extension.
Andrew Amakawa
Senior Planner
COUNTY OF SUFFOLK
Steven Bellone
SUFFOLK COUNMY ERECUTM
Department of
Economic Development and Planning
Natalie Wright
Acting Commissioner Division of Planning and Environment
SUFFOLK COUNTY FARMLAND COMMITTEE
SPECIAL USE PERMIT
Application#: 2020001
Meeting Date: January 23,2020
Resolution#: FC-02-2020
Permit#: PFC 2020002
Date Issued: February 7,2020
Property Address: 12595 Oregon Road,Cutchogue,Town of Southold
Tax Map#: 1000-083.00-02.00-012.007
Pursuant to Chapter 8 of the Suffolk County Administrative Local Laws,permission is hereby granted to
W F FARMS LLC .Jonathan Fabb
To conduct a site disturbance for the installation and maintenance of
WATER UTILITYARRIGATION INFRASTRUCTURE AND ELECTRIC UTILITY
INYMSTRUCIVRE.
On the above-captioned property,subject to the following conditions:
1. The landowner shall be responsible for compliance with all conditions of Agricultural
Development Permit #PFC 2020001, Resolution #FC-02-2020, the deed of development rights,
the contract of sale, and all applicable federal, state, county and town regulations, rules and
statutes.
This permit shall expire on FebruarX 7 2021 unless the authorized improvements have been
commenced;a building permit,where required by the local town or village,has been secured by the
agricultural land owner or the Suffolk County Farmland Committee has granted the agricultural land
owner an extension.
Andrew Amakarva
Senior Planner
Page 1 of 1
MA&RJAhtQUOTE
SUPPLY COMPANY
www.marjato.com
Building Materials:Drywall-Acoustics-Lumber-Tools-Flowing , NO,
Adhesives-Doors-Windows-insulation-Siding-Roofing 000000 02/07/20 16078031-00
'R k10 A ,
CUST* 1035922 SONO TUBES 1
SHIPTO: SHOP - JON - 516-807-2575
5005 DEPOT LANE
CUTCHOGUE, NY 11935 CORRESPONDENCE TO: MARJAM - RIVERHEAD
58 MILL RD
(631)354-2000
RIVERS EAD, NY 11901
BILLTO: TWIN FORK LANDSCAPE
5005 DEPOT LANE
CUTCHOGUE, NY 11935
Yfi;,ri /G%l/y//%� ///� r, rt1,,r✓1� /
DEL IF APPROVED �( COD
MARJAM - RIVERHEAD WILL CALL
;fl. c .r r ya,j"r/� F r ,, ,, / ,,,,, r- r r ,/ �r i i rr r, ✓/i r
Nom.. ✓�r ,v,ht - 9cll�k �',,, a, �„ 'a, �
1 SON018 14 PCE 152.00 2128.00
18"x12' SONOTUBE COATED CARAUSTAR
1 Lines Total Total 2128.00
SURCHARGE 30.00
Taxes 186.13
Invoice Total 2344.13
This quote is valid for 30 days on standard material 6
24 hours on any Lumber products unless otherwise stated in
writing 6 is subject to manufactures price increases
Last Page
Last Page
TOWN OP SO TITOLD BUILDING PERIVIIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before apply;ng?
TOWN HALL Board of Health
SOUTHOLD,NY 11972 4 sets of Building Plans
TEL:(631Y765-1802 .' �- ``' � �. Planning Board approval
FAX:
-031)763-9502 Su:Fev
Southo.ldt6vrinv.gir_ :RN!ft ;._ Check
Septic Form
N.Y.S.D.E.C,
Trustees
C.O.Application
Flood Permit
Examined 120 Single&Separate
Truss Identification Form
Storm-water Assessment Form
contact: k1•�C Mg� fl`Y�J ? �
Ae protiecd20 Mail to: W�r
Disapproved a c _ 05 {'/t"N
Prone:5-1
-2
Expiration 20
Building Inspector
JAN 2 Q 2020 APP'bCATION FOR BUILDING PERMIT
Date0-
INSTRUCTIONS
r
a.This applicdtidi I1L{ST law cbmbletely filed in by ry ewriter or m ink and sular^itted to the B'ilding Inspector with d
sets of pians,accurate plot plan to scale,Fee according to schedule.
b.Plot plan showing-location of lot and of buildings on premises,relationship to adioining premises or public streets or
areas,and waterways.
c.The work covered by this application'may not be commenced before issuance of Building Permit.
d.Upon-approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit
shall be kept on the premises available for inspection throughout the work,
e,No building shall be occupied or used in whole or;ir,part for any purpose vvl;at so ever until the Building Inspector
issues a Certificate of Occupancy,
I.Every building permit shall expire i,tine work authorized has not commenced within 12 months after the data,of
issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months.Thereafter,a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or
Regulations,for the construction of buildings,additions,or alterations or for removal or demolition ash described.The
applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and r anon-and to admit
authorized inspectors on premises and in building for necessary inspections.
(Sig tune of applicant or name,if a corporation)
cif t3�i 6n LN Cu�r�ttot
(Mailing address of applicant) ft
State whether�applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
,N�
Name of owner of premises �� ..-' q:� �
(As on theto roll or latest deed)
If a ,}1' t° oratio .signature of duI authorized officer
f
'amc and title of corporate of C }
Builders License No.
Plumbers License No,
Electricians License No,
Other Trade's License No. Rn-
I-
` •I. Location of land on which proposed work will be done:
IV
urc
House Number Street Hamilet.
County Tax Map No. 1000 Section 0-1- �_Bloctc L DI— Lot 11-
Subdivision Filed Map No 0 Lot /2.*
2. State existing use and occupancy of premises and intended use and occupancy of pro used construction• ,
a. Existing use and occupancy Lk6r— j [ L—
b. Intended use and occupancy t616jN3
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling;number of dwelling units Number of dwelling units on each floor
If garage, number of cars
b It business-,commercialor mixed occupancy,specify nature and extent of each type of use. � A Py��"��°
,Dimensions of existing structures,if any:Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction:Front 401
Height 7 1 Number of Stories
}. Size of lot:Front Rear Depth
10.Date of Purchase Z _ Name of Former Owner .. r
11.Zone or use district in which premises are situated
12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO?4
13.Will lot be re-graded?YES NO
Will excess fill be removed from premises?YES NO.
- ]i - �
14.Namne
Names of Owr of premises Address t3 Phone No. 6, 71& 9 2.
Name of Architect Address
ine No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO
*IF YES SOI;`"HOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED.
b.Is this property within 300 feet of a tidal wetland?*YES NO
*IF YES,D.E.C.PERMITS MAY BE REQUIRED.
lb.Provide survey,to scale with accurate foundation plan and distances topro arty lines.
17.If elevation at any point on property is at 10 feet or below,must provide topographical data uryvey.
18 A're'there`any covenants and'restrictions with respect to this property?*.YES NO
*.IF•YES,PROVIDE A COPY,
STATE OF NEW YORK)
SS:
COUNTY OF#
:being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the
(Conti tor,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 we will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
�9?'�) day of tE.{Lf 20
Nota Public A`H.TANDY
Notary `,Signature of Applicant
Notary Pu01ic;Stam Of New York
No. 01 TA6086001
Qualified In Suffolk County
Commission Expires 01/13120 i�