HomeMy WebLinkAbout1000-117.-10-5 OFFICE LOCATION: ®��®F so MAILING ADDRESS:
Town Hall Annex P.O. Box 1179
54375 State Route 25 A [ Southold, NY 11971
(cor.Main Rd. &Youngs Ave.)
G ® Telephone: 631765-1938
Southold, NY 11971
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LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
To: Leslie Weisman, Chair
Members of the Zoning Board of Appeals
From: Mark Terry, AICP
Assistant Town Planning Director —
LWRP Coordinator
Date January 3, 2024
Re: LWRP Coastal Consistency Review for ZBA File Ref ANDREA TESE/800 JACKSON
STREET, LLC#7862SE
SCTM#1000-117-10-5.
ANDREA TESE/800 JACKSON STREET, LLC #7862SE—The applicant requests a Special Exception
under Article III, Section 280-13B(13). The Applicant is the owner of the subject property requesting
authorization to establish an Accessory Apartment in an existing accessory structure at 800 Jackson
Street, (Adj. to the Great Peconic Bay)New Suffolk,NY. SCTM#1000-117-10-5.
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 variance is CONSISTENT with the
LWRP.
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: Paul DeChance, Town Attorney
BOARD MEMBERS if soy Southold Town Hall
Leslie Kanes Weisman, Chairperson O�� Ty�l 53095 Main Road•P.O. Box 1179
Patricia Acampora h O Southold,NY 11971-0959
Eric Dantes Office Location:
Robert Lehnert,Jr. Town Annex/First Floor
Nicholas Planamento �Q 54375 Main Road(at Youngs Avenue)
Irou `I,� Southold,NY 11971
http://southoldtownny.gov
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
Tel. (631) 765-1809
October 25, 2023 RECEIVED
Mark Terry, Assistant Town Planning Director 0 C T 2 5 2023
LWRP Coordinator L_- --
t)outhoid own
Planning Board Office Planning Board
Town of Southold
Town Hall Annex
Southold, NY 11971
Re: ZBA File Ref. No. # 7862SE
Dear Mark:
We have received an application for an accessory apartment in an accessory garage. A
copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning
Code), and survey map, project description form, are attached for your reference.
Your written evaluation with recommendations for this proposal, as required under the
Code procedures of LWRP Section 268-51) is requested within 30 days of receipt of this
letter.
Thank you.
Very truly yours,
Leslie K. Weisman
Chairperson
By:
Encls
Survey/Site Plan : Anthony Portillo Architect Date : 5/2/23
e
TOWN OF SOUTHOLD � J E
ZONING BOARD OF APPEALS
Phone(631)765-1809 (631)765-9064
APPLICATION FOR A SPECIAL EXCEPTION PERMIT FOR AN
ACCESSORY APARTMENT IN AN EXISTING ACCESSORY BUILDING
Application No.: SCTM:No:
Date Filed:
Applicant(s)Name(s) AMP Architecture, Anthony Portillo
Applicant(s)Address 10200 Main Rd Unit 3A Mattituck NY 11952
(House No.,Street,Hamlet,Zip Code and mailing address if different from physical address)
Applicant(s)phone number(s): 631-603-9092
Applicant(s)e-mail address: msmith@amparchitect.com
[ ]I/we are the owners of the subject property -- - --
[X]I am the agent for the property owner and my Letter of Authorization and Transactional
Disclosure Form is attached.
I. Statement of Ownership and Interest:
Andrea Tese is(are)the owner(s)of the property known and
referred to as
800 Jackson St. New Suffolk 11956
House No. Street Hamlet Zip Code
Identified on the Suffolk County Tax Maps as District 1000,Section 117 Block 10
Lot(s) 5 Lot Size2.6 acresZoniiig District R-40 as shown on the attached deed and survey
The above-described property was acquired by the owners)on(date) X
I/we hereby apply to the Zoning Board of Appeals for a Special Exception Permit pursuant to Section§280-13B(13)of
the Zoning Ordinance to establish an accessory apartment in an existin accessory building as shown on the attached
survey/site plan and floor plan(s)
Q. ProiectDegcription:
Proposed accessory aparmtent in existing accessory building w/ at-grade patio
& gravel parking area for the required 3 parking spaces.
III. The applicant alleges that the approval of this special exception would be in harmony with the intent and purpose
of said zoning ordinance,and that the proposed use conforms to the standards prescribed therein and would.not
be detrimental to tirop_erty or persons in the neighborhood for the followingreasons:
The applicant will not be expanding the footprint of the existing accessory building (3 car garage).
Proposed 746 S.F. accessory apartment to remain entirely within the existing garage
structure and as such will not encroach on the existing side yard setback. The intended use
of the apartment will remain within Southold Code requirements for an accessory apartment.
Page 2—Application—Special Exception—Accessory Apartment in existing Accessory Structure
IV. The.applicant alleges that the following standards prescribed by Section §280-13(B)(13)(a)-(k)of the zoning
ordinance will be met:
a. The accessory apartment will be located in an existing accessory building.
b. The owner of the premises shall occupy either the existing single-family dwelling or the accessory
apartment in the detached accessory structure as the owners'principal residence.The other dwelling
unit shall be occupied by a family member as defined in Section§2804 of the code-or a resident who is
k..
currently on Southold Town's Affordable Housing-registry and is eligible for placement,evidenced-lby a
written lease,for a term of one or more years.
c. The accessory apartment shall contain no less than 450 square feet and does not exceed 750 square feet
of livable floor as defined in Section§280-4 of the code.
d. The accessory apartment will be located on one floor of the accessory building and will contain only
one full bathroom.
e. A minimum of three on-site parking spaces shall be provided as shown on the attached survey.
f. Not more than one(I)accessory apartment shall be permitted on this parcel.
g. No Bed and Breakfast facilities,.as authorized by Section§280-13(B)(I4)hereof shall be permitted in or
on the premises,for which an accessory apartment is authorized or exists.
h. The accessory apartment will meet the requirements of a dwelling unit as defined in Section 280-4 of
the Zoning Code.
i. This conversion shall be subject to a building permit,inspection by the Building Inspector and Renewal
of Certificate of Occupancy annually.
j. The existing building,together with this.accessory apartment,shall comps with all other requirements, _
of Chapter§280 of the Town Code of the Town of Southold.
k. This conversion for the accessory apartment shall comply with all other rules and regulations of the
New York State Construction Code and other applicable codes.
V. The property which is the subject of this application(check all that apply):
[ ]has.not changed since the issuance of the attached Certificates of Occupancy
[ ]has changed or received additional building permits.Certificates of Occupancy for
these changes are attached or will be furnished
[ ]has been the subject of a prior ZBA decision(s),copies are attached
List Certificates of Occupancy/Building Permits,and dates of issuance below:
CO #Z-3083; 05/21/68 Private One Family Dwelling: CO #35965; 09/25/12 Additons/Renovations
CO #Z-32141 01/16/07 Accessory Garage in front yard w/ZBA approval #3492; 04/09/86
By signing below,I certify all information is true and correct to the best of my knowledge.
Own ature
COUNTY OF SUFFOLK)
ss.:
STATE OF NEW YORK)
Sworn to before me this day of Se �C 1 r ,20 aL
D
(Notary Pu Ii )
_ _._.. Revised 1211812019
EVE L.GATZ-SCHWAM13ORN
VOTARY PUBLIC,STATE OF NEW YORK
Registration No,OIGA6274028
Qualified in Suffolk County
Commission Expires Dec.24,20 94
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AMENDED AND RESTATED
LIMITED LIABILITY COMPANY AGREEMENT
OF
800 JACKSON STREET LLC
A NEW YORK LIMITED LIABILITY COMPANY
This Amended and Restated OPERATING AGREEMENT of 800 Jackson Street LLC
(the"Comnanv")is entered into,as of January 1,2013,by Joyce Tese,Andrea J.Tese and
Lauren S.Tese-Warwick as the Members of the Company.
WHEREAS,the Company was formed under the New York Limited Liability Company
Law,Part II of the New York Corporation Law(the "Act"),on November 27,2012,for the
purposes and on the terms and conditions set forth in this Agreement.
NOW,'THEREFORE,in consideration of the agreements and obligations set forth
herein and for other good and valuable consideration,the receipt and sufficiency of which are
hereby acknowledged,the Members hereby agree as follows:
ARTICLE ONE
Definitions
The defined tenors used in this Agreement shall,unless the context otherwise requires,
have the meanings specified in this Article One.
"Act"shall have the meaning set forth in the Preamble.
"Agreement"shall mean this Operating Agreement of 800 Jackson Street LLC,as
amended,modified,supplemented or restated from time to time.
"Articles of Organization" shall mean the Company's Articles of Organization,as filed
with the Secretary of State of New York,as it may be amended,supplemented or restated from
time to time.
"Code"shall mean the Internal Revenue Code of 1986,as amended from time to time
(or any eorresponding,provisions of any succeeding law).
"Comnany"shall have the meaning set forth in the preamble.
"Fair Value"of an interest in the Company,as of the effective date of a purchase
pursuant to a right of first refusal as provided in Article Five,unless expressly provided to the
contrary herein,shall paean the"fair market value"as such term is defined in Section 20.2031-3
KL2 283937S.2
9.12. Additional Remedies. The rights and remedies of the Members shall not be
mutually exclusive,and the respective rights and obligations hereunder shall be enforceable by
specific performance,injunction or other equitable remedy,but nothing herein contained is
intended to,nor shall it limit or affect,any other rights in equity or any rights at law or by statute
or otherwise of any Member aggrieved as against the other Member(s),for breach or threatened
breach of any provision hereof,it being the intention of this section to make clear the agreement
of the Members that their respective rights and obligations hereunder shall be enforceable in
equity as well as at law or otherwise.
9.1 3. No Reliance by Third Parties. The provisions of this Agreement are not for the
benefit of any creditor or other Person other tan h .a Member to whom any losses,debts,claims,
expenses or encumbrances are owed by,or who otherwise has any claim against,the Company
or any Member.
IN WITNESS WHEREOF,the parties hereto have duly executed this Amended and
Restated Operating Agreement of 860 Jackson Street LLC,to be effective as of the date first
above written.
.jv�
1
J ce T,
APdrea J.Tese,Member
Lauren S.Tese-Warwick,Member
KMMMS.2 13
`raw. Town of Southold Annex 9/25/2012
npf FQL :
' P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35965 Date: 9/25/2012
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 800 Jackson Street,New Suffolk,
SCTM#: 473889 Sec/Block/Lot: 117.40-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/19/2011 pursuant to which Building Permit No. 36640 dated 8/19/2011
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
Additions&Alterations to a Single Family Dwelling which include:
4 Bedrooms 3 Baths Powder Room Sitting Room,Corridor, Laundry.
Sun Room Hall Mechanical Room Balcony Unfinished Basement.
The certificate is issued to Tese,Joyce
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-11-0003 9/19/12
ELECTRICAL CERTIFICATE NO. 36640 8/7/12
PLUMBERS CERTIFICATION DATED 7/31/12 K Rempe Plumbing&Heating
�trizqA Si ature
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32141 Date: 01/16 07
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property: B00 JACKSON ST NEW SUFFOLK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 117 Block 10 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated pursuant to which
Building Permit No. 15058-Z dated APRIL 2, 1986
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 ACCESSORY GARAGE IN THE FRONT YARD'AS APPLIED FOR & AS PER CONDITIONS
OF ZBA #3492 DATED 04/09/1986
The certificate is issued to JOYCE TESE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-841823 11/04 87
PLIINIDERS CERTIFICATION DATED N/A
ut riz Signature
Rev. 1/81
Southold Town Board of Appeals
MAIN ROAD- STATE ROAD 25 SOUTHOLD, L.I., N.Y. 11971
TELEPHONE(516)765.1809
ACTION OF THE ZONING BOARD OF APPEALS
Appeal No. 3492
Application Dated April 9, 1986 (Public Hearing 5/22/86)
To: Mr. Donald A. Denis,A. I.A. [Appellant(s)]
as Agent for JOYCE TESE
Main Road, Box 565
Aquebogue, NY 11931
At a Meeting of the Zoning Board of Appeals held on June 25. 1986,
the above appeal was considered, and the action indicated below was taken
on your
[ ] Request for Variance Due to Lack of Access to Property
New York Town Law, Section 280-a
[ ] Request for Special Exception under the Zoning Ordinance
Article , Section
[X] Request for Variance to the Zonin Ordinance
Article III , Section 100-32(C
[ j Request for
Application of JOYCE TESE for a Variance to the Zoning Ordinance,
Article II1, Section 1 - or permission to locate accessory three-
car garage in the frontyard area, at 800 Jackson Street, New Suffolk,
NY; County Tax Map District 1000, Section 117, Block 10, Lot 5.
WHEREAS, a public hearing was held and concluded on May 22,
1986 in the Matter of the Application of JOYCE TESE under Appeal No.
3492; and
WHEREAS, the board members have personally viewed and are
familiar with the premises in question, its present zoning, and
the surrounding areas; and
WHEREAS, at said hearing all those who desired to be heard
were heard, and their testimony was recorded; and
WHEREAS, the board has carefully considered all testimony
and documentation submitted concerning this application; and
WHEREAS, the board made the following findings of fact:
1 . The premises in question is located along the south side
of Jackson Street, in the Hamlet of New Suffolk, with a total
acreage of 2.25 acres and road frontage of 127 feet, and is more
particularly identified on the Suffolk County Tax Maps as District
1000, Section 117, Block 10, Lot 5.
2. The subject premises is located in the "A-80" Residential
and Agricultural Zoning District and is presently improved with a
single-family, 21-story frame house-and-garage structure, set back
approximately 390t feet from the front property line, 37± feet
from the line delineated "top of bluff" as shown on survey prepared
March 2b, 1986 by Peconic Surveyor & Engineers, P.C. , and minimum
sideyards of 64 feet. Also existing is an accessory gazebo structure
shown on the subject survey to be in the rearyard area a distance of
18.8' from the westerly side property line.
(CONTINUED ON PAGE TWO)
DATED: June 25, 1986. CHAIRMAN, SOUTHOLD TOWN ZONING BOARD
OF APPEALS
Form ZB4 (rev. 12/81)
Page 2 - Appeal No. 3492
Matter of JOYCE TESE
Decision Rend-eyed June 25, 1986
3. By this application, appellant requests permission to
locate a 24' by 40' three-car garage accessory to the residential
use of the premises for storage purposes and having setbacks from
the front property line at not closer than 61 feet and not closer
than five feet to the westerly side property line.
4. It is the opinion of the board that therd is no other
alternative available for applicant to pursue other than a
variance, and the board agrees with the reasoning of the appli-
cant, as noted below.
In considering this appeal, the board also finds and
determines: (.a) that sufficient practical difficulties have
been shown; (b) that the circumstances of the premises are
unique; (c) there will be no substantial change in the character
of the neighborhood or detriment to adjoining properties; (d)
that the relief requested is not substantial ; (e) the difficulty
cannot be obviated by some method feasible for appellant to pursue
other than a variance since the rear.yard "building envelope" is
within 75' of a tidal water body; (f) that the variance will
not in turn cause a substantial effect of increased population
density or be adverse to the safety, health, welfare; comfort,
convenience and order of the town; (g) that in view of the manner
in which the difficulty arose and in consideration of all the
above factors, the interests of justice will best be served by
allowing the variance, as conditionally noted below.
Accordingly, on motion by Mr. Douglass, seconded by
Mr. Goehringer, it was
RESOLVED, that permission to locate a 24' by 40' accessory
three-car garage in the frontyard area applied under Appeal No.
3492 in the Matter of the Application of JOYCE TESE, BE AND HEREBY
IS APPROVED SUBJECT TO THE FOLLOWING CONOITI.ONS:
1 . That this accessory structure be located no closer
than 10 feet from the westerly side property line and no closer
than 70 feet from the front property line;
2. That this accessory structure be used only for
storage and garage purposes incidental to the principal use
of the premises, and not to be operated for gain, rental ,
sleeping or living quarters.
3. All water on the property shall be retained on site,
and if necessary, storm drains or drywells shall be installed
on the south and west sides of this building.
Vote of the Board: Ayes: Messrs. Goehringer, Grigonis,
Douglass and Sawicki . (Member Doyen was absent. ) This resolu-
tion was duly adopted.
c:URD GM H IN R, N
July 15, 1986
KECEIVED AND FILED gy
THE SOUTHOLD TOWN CLEF
DATE)-/ -� HOUR7-/S-X
Tows er4 T wa of
Southold
f
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IIINII IIII IIIII IIIII IIII IIIII III(!IIIII IIIII II(!(II!
Illlll IIIII IIIII IIII IIII
SUFFOLK COUNTY CLERK
J RECORDS OFFICE
i
RECORDING PAGE
Type of Instrument: DEED Recorded: 01/25/2013
Number of Pages: 3 At: 02:36:15 PM
i Receipt Number : 13-0010121
I
TRANSFER TAX NUMBER: 12-14052 LIBER: D00012718
PAGE: 637
District: Section: Block: Lot:
1000 117.00 10.00 005.000
i
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0.00
Received the Following Fees For Above Instrument
jExempt Exempt
i Page/Filing $15.00 NO Handling $20.00 NO
i 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 $60.00 NO
Transfer tax $0.00 NO Comm.Pres $0.00 NO
Fees Paid $250.00
TRANSFER TAX NUMBER: 12-14052
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
t
i JUDITH A. PASCALE
County Clerk, Suffolk County
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1 2
RECORDED
2013 Jan 25 02:36:15 Pm
Number of pages JU M R. PPMALE
CLERK OF
SUFFOLK COUNTY
This document will be public L D00012719
record.Please remove all P 637
Social Security Numbers 6T8 12-14052
prior to recording.
Deed/Mortgage Instrument Deed%Mortgage Tax Stamp Recording/Fling Stamps
3 FEES
Mortgage Amt.
Page/Filing Fee 1.Basic Tax
Handling 20. 00
2. Additional Tax
Tp.584 Sub Total
Notation Spec/assit.
or
EA-5217(County) Sub Total Spec./Add.
EA•S217(5tate) TOT.MTG.TAX-
R P TSA. A n r Dual Town Dual County
'(�/ Held for Appointment
Comm.of Ed 5. 00 � Transfer Tax
Af9davit • • Mansion Tax
Certified Copy The property covered by this mortgage is
or will be improved by a one or two
NYS Surcharge 15. 00 family dwelling only.
SubTotal YES or NO
Other
Grand Total If N0,see appropriate tax clause on
f page 1 of this instturr�nt
/ d r/O�•
a Dinj�O 13001936 1000 21700 1000 005000 5 Community Preservation Ftmd
pTS
Real Property RSMI A Consideration Amount$
Tax Service t64AN-1
Agency CPF Tax Due S
Verification
�— — Improved_.
6 Satisfactions/DischargestReleases List Property Owners Mailing Address
�f ' ' TO: Vacant Land
1(I� Afe- `� C row_,
N� 4 1 00P TD
a'�k &fL-n 51W -
Mail to.Judith A.Pascale,Suffolk County Clark 7 Title Company Infot'm260111
310 Center Drive. Riverhead, NY 11901 Co.Name F
www.suffolkcountyny.gov/deck Titles
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached DDA made
by: iSPECiFYM OF INSTRUMENT)
The premises herein is situated in
SUFFOLKCOUNTY.NEW YORK
TO IntheTOWNof /f J
FtWt e-WLLAGE
or HAMLET of
BOXES 6 THRU a MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
CONSULT YOUR LAWY USED BY LAWYERS ONLY
THIS INDENTURE,made the day D)LC 2012
BETWEEN'
Joyce Tese,having an address at 130 East Ire Street,Now York,New York 10021
party of the fast part and
800 Jackson Street LLC,with an address at 130 East 74th Street,New York,New York 10021.
party of the second part,
WITNESSETH,that the party of the first part,in consideration of ten dollars and other valuable consideration
dollars
paid by the party of the second part,does hereby grant and release unto the party of the second part,the heirs
or successors and assigns of the party of the second part forever,
ALL that certain plot,piece or parcel of land,with the buildings and Improvements thereon erected,situate,
tying and being in the County of Sutfelk.Town of Southold,State of New York and being more particularly
bounded and described as fellows:
BEGINNING at a concrete monument set on the southerly side of Jackson Sheet at the northeasterly comer of
the premises herein described and the northwesterly comer of the land formerly of Richert,now of Morgan;
running thence South 8'Or 50'West along the westerly side of land formerly of Richert, now of Morgan,
545.71 feet to Great Peconic Bay;running thence westerly along Great Peconte bay to a point distant North
81'20'2W West 217.50 feet tram the terminus of the last mentioned course and land now or formerly of J.G.
DOI,running thence along sold last mentioned land,two courses and distances as follows:(1)North B'17 5(r
East 45 feet more or less,to a concrete monument;thence(2)North 16'21'00-East 520.00 feet to a concrete
monument on the southerly side of Jackson Street;running thence a"the southerly side of Jackson Street,
South 73'39'00"East 127.00 feet to a point or place of BEGINNING.
TOGETHER with all right title and interest of the party of the first part of,in and to the land below the high
watermark and under the water of Peconle Bay adjacent to said premises.
BEING AND INTENDED TO BE the same premises described in the Dead to the party of the first part by Deed
dated&23183 and recorded in the Suffok County Clerk's Ofte on 716183 In Uber 9382 at Page 209
TOGETHER with all dgh%title and Interest,If any,of the party of the Oust part in and to any streets and roads
abutting the above described premises to the center tines thereof;TOGETHER with the appurtenances and all
the estate and rights of the party of the first part in and to said premises;TO HAVE AND TO HOLD the
premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of
the second part forever.
AND the party of the first part,In compliance with Section 13 of the Lien Law,covenants that the party of the
first part will receive the consideration for this conveyance and will hold the right to receive such consideration
as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same
first to the payment of the cost of the improvement before using any part of the total of the same for any other
purpose. The word'party'shall be construed as if it read'parties'whenever the sense of this Indenture so
requires.
IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above
written.
IN PRESENCE OF:
V
,� ce se
. t
Standard N.Y.B.T.U.Fees 8001-eary¢in and Sale Deed,wfout Covenant against Graataes Acts—Unitarm AdenowtedV=t
Form 3264
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENTTAKEN IN NEW YORK STATE
State of New York.Coumy of as: State of New York Corday of sr.
On the gl day of in the year 2012,before On Ike day of in the year before
me,the undersigned,personally appeared joy-Tess me,the undersigned.personally appeared
personally known to me or proved to me on the basis of ,personally known to me or proved b me on the bads of
satisfactory evidence to be the individuals)whose names)is(are) satisfactory evidence to be the individuals)whose name(s)is(are)
subscribed to the within instrument tend acknowledged to me that subscribed to the within instrument and acknowledged to me dot
l dshdthey executed the same in h erhheir eapacity(les),and that by holdiehhey executed the same in hislhcrhheir cgiaeity(ies}and that by
hislherhltdr signatore(s)on the' current,the Individual(s),or the hisrherAheir signattm(s)on the inslnmtent,the Indivkdual(s),or the
person opo beha o hk the dividual(s)acted,executed The person upon behalf of which the btdividual(s)acted,executed the
instrument. insuumedl.
L GOLDBERG
Boric otNtltrYt7llt
GW451W
NmYtMtOplln�
'ttOmrtbdo May3l.
� ARYL. 16. (�t_it3�Jt�
ACKNOW L EDG EM ENT BY S UBSCRI BIN G WITNESS TA KEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK
IN NEW YORK STATE STATE
State orNew York,County of , ss: 'State of County of , ss:
'(Or insert District orColumbia.Territory.Possession cr Foreign
On the day of in the year .before me,the County)
undersigned,a Notary Public in and rot said Store,personally appeared
.the subscribing witness to the foregoing instraneni.with whom On the day of in the year ,before me the
1 am personally aequaWK who,being by nor duly sworn,did depose undersigned pamnally eptuared
and any that hdatchlicy resides)in
Personally known to me or proved to me on the basis of ntisfanoty
GhMptmdreddraoaisIn.city.imtd.me Ord ad9ftMals6w(I.er.maeorh evidence to be the indMdual(s)whose name(s)Is(ore)subscribed tothe
that bdsbdthey krtow(s) within instrument and acknowledged to me that he"dthey exewled she
samein hislhet/dreirrapadty(ies),dratbyhisAterAheirsignaturc0on
to be the individual described in and who executed the foregoing the insinmtcat,the individed(s)or the presort upon behalf ofwbieh the
insutmtmq that sold subscribing witness was presem and saw said individual(s)acted.executed the Irumtmeny and that such Individual
make such appearertce before the undersigned in the
exeente the same,and that said witness at the same time subscribed
hisrherAhcir name(s)as a witness thereto (add the city or political s belivislon and the state or country or other
place the aeknowlcdgtsaem was taken).
Bargain and Sale Deed
Without Covenants
SECTION:t17.00
BLOCK:10.00
'Title No. LOT:M.=
COUNTY OR TOWN:Suffolk
JOYCE TESE
TO
=JACKSON STREET LLC
RETURN BY MAIL TO:
DISTRIBUTED BY Krarm Levin N*fWb&Fnnhl U.P
I Avemmof Amcdes e
Newew York.NY 10036
YOUR TITLE EXPERTS Aoa.Gordon Smm.Zq
The Judkbi 71de Insunaee Agency LLC
M2111 TITLE(SM FAX:906-FAX 9396
TOWN OF SOUTHOLD PROPERTY REC01tv �.��$
OWNER STREET LLAGE SUB. LOT
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Town of Southold
P.O.Box 1179
Southold,NY 11971
RE:Tese Residence
800 Jackson Street
New Suffolk,NY 11956
To Whom it May Concern:
Tr ii, h ,6AQ0 L-'St-' ,the property owner of 800 Jackson Street,New Suffolk,NY,live
at this address full time and this is my principal residence.
Thankyou
�9 2
ILI—
��r-SonCIIIL3
qiL &% 0 F Sep--�ember
ncl�e 'Test
EVE L.GATZ-SCHWkM- BOR.Y
VOTARY PUBLIC.STATE OF NEW YORK
Re.aistration No.OIGA6274028
Qualified in Suffolk County /f
Commission Expires Dec.24,20�1
a'f Y;7)' b:•'f ?Ll31. 7c`3 '^., FEI>ER'F}t
P 1�P,65ES':
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r
SOUTHOLD-TAXES 2022-2023
FISCAL YEAR: 12/1/2022 to 11/30/2023 WARRANT DATE: 12/6/2022 5TATE AID:CNTY$325,403,852 TWN$3,611,200
MAKE CHECKS PAYABLE TO: BANK RILL TAX MAPNl1MRFR
Kelly J. Fogarty
15509 473889 117.-10-5
KELLYJ. FOGARTY TO PAY IN PERSON: PROPERTY INFORMATION:
53095 ROUTE 25 Mon-Fri 8:00 AM to 4:00 PM ACCOUNT#: 23
DIMENSION: 2.25 Acres
P.O. BOX 1409 (631) 765-1803 Fax: (631) 765- ROLL SECTION: 1 CLASS:210-1 Family Res
SOUTHOLD, NY 11971-0499 5189 LOCATION: 800 Jackson St
MUNICIPALITY: Southold
SCHOOL: 473815 New Suffolk Sch
PROPERTY OWNER: FULL MARKET VALUE: 5,371,429
UNIFORM% VALUE: 0.70
800 Jackson Street LLC LAND ASSESSMENT: 8.500
Joyce Tese C/O Lisa Giammona TOTAL ASSESSMENT: 37,600
195 Beach 132nd St EXEMPTION VALUE FULLVALUE TAXPURPOSE
Belle Harbor, NY 11694
%CHANGE FROM. TAXABLE VALUE
L•EVY'DESCRIPTION TOTAL TAX LEVY pRIOR'Y,EAR LEVY OR UNITS RATE , TAX AMOUNT
SUFFOLK COUNTY TAX 49,036,632 0.0 37,600.00 20.23700000 760.91
SC COMMUNITY COLLEGE 5,250,467 0.0 37,600.00 1.84700000 69.45
MTA PAYROLL TAX 71,941 10.2 37,600.00 0.63900000 24.03
OUT OF CTY SCCC 94,493 64.0 37,600.00 0.83900000 31.55
NYS REAL PROP TAXLAW 718,162 -53.8 37,600.00 6.36500000 239.32
SOUTHOLD TOWN TAX 37,709,857 0.9 37,600.00 337.94700000 12,706.81
NEW SUFFOLK SCHOOL 995,000 7.0 37,600.00 396.45200000 14,906.60
NEW SUFFOLK LIBRARY 1,770,189 2.9 37,600.00 87.17800000 3,277.89
CUTCHOGUE FD 2,022,529 3.4 37,600.00 97.88800000 3,680.59
CUTCH-NEW SUFF PARK 135,796 0.4 37,600.00 6.59200000 247.48
SOLID WASTE DISTRICT 2,105,934 -4.0 37,600.00 19.70000000 740.72
RECEIPT:
Received: 01/10/2023
1st Installment Individual Receipt#: 113520 via Mail from:Vincent Tese
Tax Amount $18,342.67 Check#2261 $18,342.67
Total Paid: $18,342.67
Received: 05/23/2023
2nd Installment Individual Receipt#: 121141 via Mail from:800 Jackson Street LLC
Tax Amount $18,342.68 Check#2562 $18,342.69
Total Paid: $18,342.68
Received: 05/31/2023
Voided Bounced Check Individual Receipt#: via Mail from:800 Jackson Street LLC
Tax Amount -$18,342.68 Check#2562 -$18,342.68
Total Paid: -$18,342.68
Received: 05/31/2023
2nd Installment Individual Receipt#: 124241 via On-Line from:Vincent tese
Tax Amount $18,342.68 Cred.Card#231761 $18,342.68
Total Paid: $18,342.68
Printed On:10/05/2023 At:12:26:10 PM
SERVICE FOR r BILUNO PERIOD
♦ JOYCE TESE PAGE 1 of 3
n at'o n a I g r'd 800 JACKSON AVE,HSE2 Jul 19,2023 to Aug 18,2023
NEW SUF FOLK NY 11956 ACCOUNT NUMBER
43544-67006 Sep 14,2023 $713.00
www8nat6n6ig1rdusisom' YOUR PAYMENT THIS MONTH PLAN STATUS
`EUSTUtiifEtiSERVICE`.:'
,i J800-S30c5ob3.c". ;i =: Budget Plan Amount 713.00 Budget Plan-Started Feb 72
Atonda`ii_ q f�BAAfePM= ''' Accumulated Budget Plan charges •4,991.00yF
SMO DIE Amount Due 00 accumulated Actual Charges a•713.45AF $713. Amount in Customer Favor
24.'l?o-umppy '7;Dey`s)I!Yeek ;.aa.;; 'y;} ' S27755
-',(Do"es'nol:Yep1ace!8f:1.einergericy'%-
after paying this bill
iPARA:E�il i,NOL°-
:1 800e930=5i63.. :, ACCOUNT ACTIVITY
cbAAESPONDENCE:ADpRESS', 4
Aaaou 6,e-,rncessngl l bL_1.-•':r=, Previous Balance 713.00
TwoHarisol► payment Received on AUG 7(Direct Deposit) THANK YOU -713.00
;;ili ok-ii)1(7127:Z=47117
Current Charges + 139.40
;,PAYMENT ADDRESS ...
DO NOT PAY. Your Automated Payment Transfer will occur on September 6, 2023.
�PQAOX^371382;ri'�� hr°•,. y p
PITSQURC(I�,PA 15250=7382'';:�'� ,
'UA7E 81LL,ISSIIED 1
Aug'21y'2023 SUMMARY OF CURRENT CHARGES
DELIVERY SUPPLY
` - SERVICES SERVICES TOTAL
;'- Gas Service 108.73 30.67 139.40
Total Current Charges $108.73 $30.67 $139.40
0 Save time and money! Sign up for paperless billing and receive a$0.41 credit on
your monthly bill. Visit our website to enroll today. T
Utility Worker Safety Reminder:State laws are in place to help protect utility n
workers while they are performing their job duties.Causing physical injury to,or
GAS•USAG.6WST6RY(Mprms) assaulting,a utility worker is punishable by law,and penalties include potential jail 7
7,250'
1,006� - time. C.
0)
0 750'
°o
`0 2P0
0 0
q AS'ONDJFMAMJ'JA
22 23
o Dally Averages Aug 22 Aug 23
Therms 2.4 3:2
Cost $5.75 $4.64
4
m
Actual ❑Estimated KEEP THIS PORTION FOR YOUR RECORDS.
RETURN THIS PORTION WITH YOUR PAYMENT.
♦ ACCOUNT NUMBER = •
n at i o n a l g r i d 43544-67006 Sep 14, 2023 7713.00
Accounts Processing KEDLI
Two Hanson Place
Brooklyn NY 11217
1022671 01 AV 0.490 -AUTO TO 0 11,3 11-6.91-- —01-P22693-1 23
II�I��I�'�I�Ii111'11111�111�11�11�1111"I�IIII��I�I��I'll"��I�I
JOYCE TESE Please do not mail payment
800 PO BOX 155 of 1029 Your account is set up for
NEW SUFFOLK NY 1 1 956-01 55 automatic payment.Thank you.
000013940 43544670064000071300257
I, Andrea Tese, owner and resident of 800 Jackson street in New Suffolk, NY, certify that
Matthew Warwick, my brother-in-law and the tenant named in the lease agreement, is
married to my sister Lauren Warwick.
Signed
Date
�crsonall� a P . of `oa3
� jlnd►'ea Tese•
EVE L.GATZ-SCHWA-\4B0RN
NOTARY PUBLIC.STATE OF NEW YORK
Registration No.0IGA6274029
Qualified in Suffolk County rILL
Commission Expires Dec.24,20
A
FNIATTIHEW
DAVID WARWICK
`AUREN SARA TESE
130 EAST 74TH STREET
NEW YORK,NY 10021
LUnited States
i� �n-.x�e.r m,rn++ nwmrn =n�amn-� nrnn ..+nneY+�uxx�n+rnzr�-e�
THE CITY( -I EW YORK '-- = = License Number
OFFICE �F-THE EITt CLERK
K
M 2023-8 MARRIAGE L'ICENSE BUREAU M-2008-1868
(ate 0
Z► - _ _ —
==This Is:T=Certify'That .
C .:MATTHEw DAVID WARWICK
residing at A 862 UNION STREET Apartment#9F,BROQKLYN yNY_1"121'5;-United'States:
born on 0 210611965 at NEW YORK New"York United States=_
and LAUREN'SARA TESE New Surname:TESE-WARWICK
resrding_at :'604_EAST=11_STREET Apartment#3,NEW YORK, NY 10009,United States
-E n or: - 051140976. at NEW YORK New York United States = =Were )fHattiea
on 02;09l2008 at _ _ =_130_E:=74th Street
By EUGENE L NARDELLI
I'
-as_-shown=bv-the duIy_registered.license and certificate of marriage of said persons on file in this-ofFic€. -- _
- _ = CERTIFIED THIS,DATE AT THE CITY CLERK'S OFFICE
'Manhattan N N.Y. June 07, 2023 �
7_7
-
PLEASE.NOTE:Facsimile Signature = -
and spal are printed pursuant
to Section 11-A,Domestic Mi e1 McSweeney
Relations Law of New York. "
' ty Cler of the City of New York
.. -.....v.�eenfmu .v......�._....Vew .v..,._.. .......vsy;�.-.-".....�.,..—..,�....y >•,.. ..�v.�u +uv,.....�.
CET-F
M673511
LEASE AGREEMENT
LEASE AGREEMENT made this , ,between Andrea Tese, "Landlord" and Matthew
Warwick, "Tenant".
IT IS THEREFORE AGREED:
1. The Landlord shall lease to the Tenant the premises located at: 800 Jackson Street,New Suffolk,NY
11956
2. The term of this lease shall be for a period of(=)year(s), commencing .and
terminating . The lease term can be extended only by mutual agreement of the parties.
3. The Tenant shall pay to the Landlord an annual sum of Twelve Thousand Dollars ($12 000.00 to lease
the property. Rental payments shall be paid in monthly payments, each of which shall be in the amount of
($1.000.00), and each of which shall be paid on the 15t day of the month.
*
*One Thousand Dollars
4. OPTION TO RENEW: The Tenant shall have an option to renew this lease on the premises for a(N/A)
year period upon the following terms and conditions:
The Tenant's option to renew must be exercised in writing and must be received by the Landlord no less
than(1�A) days before the expiration of this lease or any extensions.
5. Any controversy or claim arising out of or relating to this lease agreement or the breach thereof shall
be settled by arbitration in accordance with the rules then obtaining of the American Arbitration
Association, and judgment upon the award rendered may be entered and enforced in any court having
jurisdiction thereof.
6. The Landlord and the Tenant warrant and represent each to the other that the performance of this
agreement does not violate any laws, statutes, local ordinances, state or federal regulations, regarding
controlled substances, or otherwise, or any court order or administrative order or ruling, nor is such
performance in violation of any loan document's conditions or restrictions in effect for financing,whether
secured or unsecured.
7. This agreement shall be binding upon and inure to the benefit of the parties hereto and their legal
representatives, successors and assigns.
8. Any notice required or desired to be given under this agreement shall be deemed given if in writing sent
by certified mail to the addresses of the parties to this lease agreement as follows:
Landlord: Andrea Tese, 800 Jackson Street,New Suffolk,NY 11956 (Name &Address)
Tenant:Matthew Warwick, 60 St. Marks Avenue, Brooklyn,NY 11217(Name&Address)
9. Captions are used in this agreement for convenience only and are not intended to be used in the
construction or in the interpretation of this agreement.
10. In the event any provision of this agreement is held to be void, invalid or unenforceable in any respect,
then the same shall not affect the remaining provisions hereof,which shall continue in full force and
effect.
11. This agreement contains the entire understanding of the parties.It may not be changed orally. This
agreement may be amended or modified only in writing that has been executed by both parties hereto.
12.This lease agreement shall be interpreted under the laws of the State of New York
Landlord Date
Andrea Tese
Tenant Date 8/9/2023
Matthew Warwick
M.af{I,u,w WA.vw&
LEASE AGREEMENT
LEASE AGREEMENT made this ,day of May, 2023, between 800 Jackson Street LLC, "Landlord"
and Matthew Warwick, "Tenant".
IT IS THEREFORE AGREED:
1. The Landlord shall lease to the Tenant the premises located at: 800 Jackson Street, New Suffolk, NY
11956
2. The term of this lease shall be for a period of(one)year(s), commencing June 1, 2023, and terminating
May 31,2024. The lease term can be extended only by mutual agreement of the parties.
3. The Tenant shall pay to the Landlord an annual sum of Twelve Thousand Dollars ($12 000.00 to lease
the property. Rental payments shall be paid in monthly payments, each of which shall be in the amount of
($1 000,00),and each of which shall be paid on the 1'day of the month.
1' ne Thou san o ars
4. OPTION TO RENEW: The Tenant shall have an option to renew this lease on the premises for a(N/A)
year period upon the following terms and conditions:
The Tenant's option to renew must be exercised in writing and must be received by the Landlord no less
than(N/A)days before the expiration of this lease or any extensions.
5. Any controversy or claim arising out of or relating to this lease agreement or the breach thereof shall
be settled by arbitration in accordance with the rules then obtaining of the American Arbitration
Association, and judgment upon the award rendered may be entered and enforced in any court having
jurisdiction thereof.
6. The Landlord and the Tenant warrant and represent each to the other that the performance of this
agreement does not violate any laws, statutes, local ordinances, state or federal regulations, regarding
controlled substances, or otherwise, or any court order or administrative order or ruling, nor is such
performance in violation of any loan document's conditions or restrictions in effect for financing, whether
secured or unsecured.
7. This agreement shall be binding upon and inure to the benefit of the parties hereto and their legal
representatives, successors and assigns.
8. Any notice required or desired to be given under this agreement shall be deemed given if in writing sent
by certified mail to the addresses of the parties to this lease agreement as follows:
Landlord: 800 Jackson Street LLC, 130 East 74 h Street,New York,NY 10021 (Name&Address)
Tenant: Matthew Warwick, 60 St.Marks Avenue, Brooklyn,NY 11217 (Name &Address)
9. Captions are used in this agreement for convenience only and are not intended to be used in the
construction or in the interpretation of this agreement.
American LegalNet,Inc,
www.FormsWorWow.com
10. In the event any provision of this agreement is held to be void,invalid or unenforceable in any respect,
then the same shall not affect the remaining provisions hereof,which shall continue in full force and effect.
11. This agreement contains the entire understanding of the parties. It may not be changed orally. This
agreement may be amended or modified only in writing that has been executed by both parties hereto.
12. This lease agreement shall be interpreted under the laws of the State of New York.
g 2
Lan lord Date
800 Jackson Street LLC
'it"
we'Mi& 8/9/23
Tenant Date
Matthew Warwick
American LegalNet,Inc.
www.Forms Work17ow.com
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EXIST. 1ST FL. INTERIOR LOOKING SOUTH EXIST. 1ST FL. INTERIOR LOOKING NORTH
Application: Tese Accessory Apartment 800 Jackson St, Mattituck, NY 11952
Applicant: AMP Architecture
Photos Taken: April 5, 2023 2 OF 2
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?
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? N/A
4.)If your property contains wetlands or pond areas, have you contacted the Office of
the Town trustees for its determination of jurisdiction? No 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 single family residence
and the proposed use same with proposed
accessory apartment in exist. accessory building .(ex:existing single family,proposed:same with
garage,pool or other)
P6,4&
,& 10/19l23
Authorized ignature and Date
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:AMP Architecture
2. Address of Applicant: PO Box 152 Mattituck, N.Y. 11952
3. Name of Land Owner(if other than Applicant): Andrea Tese
4. Address of Land Owner: 800 Jackson Street New Suffolk, NY
5. Description of Proposed Project: Accessory Apartment in detached building
6. Location of Property: (road and Tax map
number) 800 Jackson Street; 1000-117-10-05
7. Is the parcel within 500 feet of a farm operation? { } Yes W No
8. Is this parcel actively farmed? { } Yes �C} 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 if there are additional property owners)
, 9Z'/L P&4& e 10 19 23
Signature of 4plicant 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.
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part 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:
Tese Accessory Apartment
Project Location(describe,and attach a location map):
800 Jackson St, New Suffolk, NY 11956
-BriefDescriptiorrofProlsosed Action: _._._ .___-. __-._. __ _ __ ___ .. _ - _..-• -- _----- _._.__._ _.__ -- --
- Proposed accessory aparmtent in existing accessory building w/at-grade patio
& gravel parking area for the required 3 parking spaces.
Name of Applicant or Sponsor: Telephone: 631-603-9092
AMP Architecture, Anthony Portillo E�Mail: bepperson@amparchitect.com
Address:
10200 Main Rd Unit 3A
State: Zip Code:
City/PO:
Mattituck NY 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 X
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:
X
3.a.Total acreage of the site of the proposed action? 2.6 acres
b.Total acreage to be physically disturbed? 0.022 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 2•6 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial }(Residential(suburban)
❑Forest ❑Agriculture (Aquatic ❑Other(specify):
❑Parkland
Page l of 4
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations? X
b.Consistent with the adopted comprehensive plan? X
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? X
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:
X
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
X
b.Are public transportation service(s)available at or near the site of the proposed action? X
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X
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:
X
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water.
11,Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: new separate I/A OWTS X
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? X
b.Is the proposed action located in an archeological sensitive area?
X
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? X
b.Would the proposed action-physically alter,or encroach into,any existing wetland or waterbody? X
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: �4
� Z
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
Shoreline 0 Forest 0 Agricultural/grasslands 0 Early mid-successional
0 Wetland 0 Urban X 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? X
16.Is the project site located in the 100 year flood plain? NO YES
X
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? 0 NO 0 YES X
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? :
If Yes,briefly describe: ❑NO 0 YES
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size: X
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: X
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:
X
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name: AMP Architecture,Anthony Portillo Date:
Signature: 14 6
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?"
`3,•,t r:•= a± f�H ''-'�go :a:�'d�.ia �. Trt S,a.'?�'+ct ^f�"i 4'' r."'' ;,', - - v. ;a= .
Y _ . F3.,�•' ..�: �✓:� '•- ��; :><z "�- �=,�..` :�, �'�:{;�� �; i No or Moderate
G::y.,3 :;y t '.�5" + :,'�T?$^ �l.%,z�.. i1?i:'Sr�-i:•_.ci .�'``'i'. r.. F y .iu
."«�=1;j „rr7.'� � ry;✓`'al rF%DES`' �-y' 'S .�.res.•"4••.,y ,^6•k- i ef;. ` x. � g.�r y.
small to large
N:.+, �
7Fc s,.�c `+..i` ; ��,i��yt'.. �. ? �. ?3' ;'ioa.t:iki3,.y�t':i7a 'fl%11..: ^�•. .."PS -e,1�i'"�^ tag•„
t `?.`, _ :7+"*�. •i'61 �ti-, d.•` S' `t1va <di' � � ,� impact impact
..f ? .c,:Z,fi'Stila.:.•._.., s4 .•�,T;�4-. ;b: &a ct�'rL-i�*'... "4 a.-- � -§_ U{"a"ram-"`, F',Y :,-E_ °`
arw—�f e...z rr{'x.,P':-y,� y; c ems;-l : , i��ft�, :yt'•�' &.
may may
�}_4���' �';ti� �:ii- Li`rJ ryr�}T'•".ry:-Y���s!'r,.�<� 5�.•�,
OCCUC 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. WilI 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
.,•�;. ,. t�2- , . _ ��°l'r �,.,.�: ,�, ,�.�jai impact impact
may may
r •ii`' �.tr1 - t�2 Ly r - - .I�=-..t' �'. d.n o^'i:3;:l;rf'oH, .,�,tr^:;.,"
s _ - - ,;�: ^. ::%r:. >a,.�r•�::..,.. 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 ofthe 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 ofoccurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short tern,long-tern 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
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# 117 _ 10 _ 5
The Application has been submitted to(check appropriate response):
Town Board 0 Planning Dept. ® Building Dept. 0 Board of Trustees 0
l. Category of Town of Southold agency action(check appropriate response):
(a) Action undertaken directly by Town agency(e.g. capital 0
construction,planning activity, agency regulation, land transaction) 0
(b) Financial assistance(e.g. grant, loan, subsidy)
(c) Permit, approval, license, certification: 19
Nature and extent of action:
- Proposed accessory aparmtent in existing accessory building wl at-grade patio
& gravel parking area for the required 3 parking spaces.
Location of action:800 Jackson St, New Suffolk, NY 11956
Site acreage: 2.6 acres
Present land use: Single Family Residence
Present zoning classification: R-40
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: AMP Architecture, Anthony Portillo
(b) Mailing address: 10200 Main Rd Unit 3A Mattituck NY 11952
(c) Telephone number: Area Code( ) 631-603-9092
(d) Application number, if any:
Will the action be directly undertaken,require funding, or approval by a state or federal agency?
Yes ❑ No® If yes,which state or federal agency?
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation
criteria.
MYes 1-1� No Not Applicable
PROPO ACCESRY APARTMENT IS LOCATED ENTIRELY WITHIN AN EXISTING ACCESSORY STRUCTURE.AS SUCH,THE
PROPOSAL MAKES EFFICIENT USE OF EXISINTG INFRASTRUCTURE,PRESERVES OPEN SPACE,AND MINIMIZES THE ADVERSE EFFECTS
OF DEVELOPMENT.ADDITIONALLY,THE PROPOSED IMPROVEMENT OF THE EXISTING ACCESSORY STRUCTURE WILL ADD CHARACTER
TO THE NEIGHBORHOOD
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 ® 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
Yes 0 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
E Yes E 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
0 Yes 0 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.
R Yes [:d 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
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 rL/_2N 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.
❑ YesEl 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 ❑ No 2 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
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® 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.
0 Yes ❑ No ® Not Applicable
Created on 5125105 11:20 AM
Board'of Zoning Appeals Application
-AU ORIZA►.TION
(Where ifie Applicant is not the Owner)
I, A o C,eP ES 6 residing at .800 Jackson Street
(Print property owner's name) (Mailing Address)
New Suffolk, NY do hereby authorize
(Agent)
AMP Architecture-CAntfiony Por "ilfo)to,appiy for variance(s)on my behalf from the
Southold Zoning Award.of Appeals.L Ilk <1
(Owner's.SipaWre)
(Print Owners Name)
APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of intereston-the ggef'of town officers and emnloveea.The_nur ose
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 neeessary to avoid same. _
YOUR NAME. V I�—K f 0\�K , (es C
(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) Special'Exception;Acc.Apartment 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
YES NO . .
If No,sign and date below.If YES,complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or-position'of-that person
Describe.the relationship between yourself(the applicanVa!gent/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,oe child is(check all that apply)
A)the owner of greater that 5%df 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
k
Submitted thisday of > 20
Signature
Print Name • ��'�
A GENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics•prohibits conflicts ofinterest im-the cart of town officers and employees The purpose
of this form is1mor6aide.information which can alert the town of:possible-conflicts of interest and allow it tatake whatever.
action is necessary to.avoid':same,.
YOUR NAME: Portillo, Anthony
(Fast name,first name,middle initial,unless you are applying in the name of someone clse`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) Special Exception;Acc. Apartment 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
--------shires:---- -- ----- -- — - - -- ---
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 the Town of Southold
Title of position•,04hat person
Describe the relationship between yourself(the applicant/agenttrepresentative)and the town officer,or employee.
Either check the appropriate line A)through D)and/or describe in the space provided,
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted this da of ;20-2/0—P
Signature
Print Name Anthony Portillo
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--- SITE LAYOUT NOTES:
TAX MAP# 1000-II-7-10-05 SOUTHOLD TOWN GORE 289- `_, I. THIS 15 AN ARGHITEGT'5 SITE PLAN 8 15
SUBJECT TO VERIFICATION BY A LICENSED
ZONING DISTRICT R-40 CONFORMING SURVEYOR.THE INFORMATION
EXIST. PROPOSED COMPLIES REPRESENTED ON TH15 51TE PLAN 15 TO THE
LOT AREA 2h ACRES ARCHITECT'S BEST OF KNOWLEDGE.
GofO-ACCESSORY GARAGE Z-32141;OI/I6/200� MAXIMUM HEIGHT 22, Iq.5' Iclh' YE5(EXIST) 2.SURVEY INFORMATION WA5 OBTAINED
FROM A SURVEY DATED JULY 20,2012 AND
MINIMUM SIDE YARD 25.0' 15.0' 15.0' NO(EXIST) PREPARED BY:
VARIANCE APPROVAL -GARAGE #54g2;06/25/Ig56
JOHN T.METZGER
MINIMUM REAR YARD 25.0' 405.5' 405.5' YES(EXIST) � Lo
FEMA FLOOD ZONE X PEGONIG SURVEYORS,P.G. (L 0)
MAX.SQUARE FOOTAGE 3345 S.F. q(60.0 S.F. g60.0 S.F. YE5(EXIST.) N.Y.STATE LAND SURVEYOR Q N ei
SUFFOLK COUNTY HD APPROVAL PENDING 1 BED LIC.#04%le, }
P.O.BOX q0q W � ZO Z
1250 TRAVELER STREET
SOUTHOLD,N.Y. Ilq'71 W � J
LOT COVERAGE' TOTAL LIVABLE FLOOR AREA (651)-765-5020 H- N 0 0
— -- -- OF ACCESSORY APT. 746 S.F. w c =
SOUTHOLD TOWN G0177�2&D=124 U O U)
00
% LOT Q W
DESCRIPTION(FOOTPRINT) AREA COVERAGE j ----_., _
Z
TOTAL LOT AREA I115g2 S.F. ~—i 'r. g cn
_ 44 a
=' �:.y'��;li;•f ;i;l, �� s'� d
EXISTING DWELLING 4,545 S.F. 3.q%
f� ;,,-
EXISTING GARAGE/ g .g 60 S.F. 0 % OCT 2 .:j!.l^ r�
PROP05ED ACCESSORY APT. ZO23f.'•
EXIST.GREENHOUSE 554 S.F. 0.5%
�1
EXIST.GAZEBO Igo S.F. 0.2%EXIST.DECKS b STEPS 5217 S.F. 0.5% O
m
b�
G .�'t�;
TOTAL AREA OF ALL STRUCTURES 6560 S.F. 5.-I% ��yt. __ � �' N
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a
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TOTAL LIVABLE FLOOR AREA
OF ACCESSORY APT. -146 S.F. i _ NVER-
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AI'-191YV2" LAUNDRY — — — !
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S.C.D.H.S. REFERENCE NUMBER R10-11-0603 i
N T SURVEY OF PROPERTY
AT NEW SUFFOLK
TOWN OF SOUTHOLD
SUFFOLK 'COUNTY, N,Y.
1000-117-10-05
SCALE.' 1'=30'
OCTOBER 13,2010
FEBRUARY 4.2011(TOP OF BANK&N.V,QD.DATUM)
DULY 5,2012(FINAL ON ADD/BON)
'JULY'20,2012(Nn.9
BETC,p C,P(D,yL.CLINC
ENDE,V�,(oµELUNO
TEST HOLE DATA c W47B-R
M00NALD OEOSClENCE
9/21/10 It
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SEPTEMBER-5, 2009
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EL£YA710NS?Ef£R£NCED TO N.G.V.D. �k tWit
■_MONUMENT a 1A IC. NO.-49618
•ANY ALIERAROA OR ADDIRON TO THIS SURVEY IS A WOLARON ECONIC YORS, P.C.
AREA=2.5618 ACRES TO OF SECTION 72690E-THE NEW PORK STATE EDT CAROV LAW. (631) 765- 020 fAX(631) 765-1797
EXCEPT AS PERSECDO4 7209-SUBDIWSIO4 2,ALL CERRFICADONS P.O.BOX 909
TIE LINE HERE04 ARE VAUD,FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR CVP/ES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 86-193
WHOSE SIGVATWE APPEARS HEREON. SOUTHOLD, N.Y.. 11971
OAK
2_8 38 4 SpSg MATCH --_-- _--_
FOR PCL NO.
SEE SEC.NO.
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