HomeMy WebLinkAbout1000-97.-8-6 OFFICE LOCATION:®r S® �® MAILING ADDRESS:
Town Hall Annex �® �� P.O. Box 1179
54375 State Route 25 d�6 Southold,NY 11971
(cor. Main Rd. &Youngs Ave.)
Southold, NY 11971 ® Telephone: 631 765-1938
C®UNTV,�
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: Leslie Weisman, Chair
Members of the Zoning Board of Appeals
From: Mark Terry, Assistant Town Planning Director
LWRP Coordinator
Date May 16,2024
Re: LWRP Coastal Consistency Review for ZBA File Ref DIANA FALKENBACH#7909
SCTM# 1000-97-8-6.
DIANA FALKENBACH #7909 - Request for a Variance from Article XXIII, Section 280-124; and the
Building Inspector's December 28, 2023 Notice of Disapproval based on an application for a permit to
construct additions and alterations to a single family dwelling; 1) less than the code required minimum
front yard setback of 55 feet; located at: 3650 Eugenes Road, Cutchogue,NY. SCTM No. 1000-97-8-6.
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of
Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards.
Based upon the information provided on the LWRP Consistency Assessment Form submitted to this
department, as well as the records available to me, the proposed action is EXEMPT from LWRP review
pursuant to:
§ 268-3. Definitions. MINOR ACTIONS item "F"which states:
R. Granting of individual setback, lot line and lot area variances, except in relation to a
regulated natural feature or a bulkhead or other shoreline defense structure or any activity
within the CEHA.
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
1
BOARD MEMBERS ��OF SOUr�o Southold Town Hall
Leslie Kanes Weisman, Chairperson h0 1p 53095 Main Road• P.O. Box 1179
Southold,NY 11971-0959
Patricia Acampora Office Location:
Eric Dantes �pQ Town Annex/First Floor,
Robert Lehnert,Jr. 54375 Main Road(at Youngs Avenue)
Nicholas Planamento yCOU01 Southold,NY 11971
http://southoldtownny.gov
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
February 12, 2024 Tel. (631) 765-1809
Mark Terry, Assistant Town Planning Director RECEIVEDlSoutholdITVown
LWRP Coordinator
Planning Board Office EB 13 2024
Town of Southold
Town Hall Annex
Southold,NY 11971 Planning Board
Re: ZBA File Ref. No. # 7909—Falkenbach, Diane
Dear Mark:
We have received an application to construct additions and alterations to an existing
single family dwelling. A copy of the Building Inspector's Notice of Disapproval under
Chapter 280 (Zoning Code), and survey map,project description form, are attached for
your reference.
Your written evaluation with recommendations for this proposal, as required under the
Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this
letter.
Thank you.
Very truly yours,
Leslie K. Weisman
Chairperson
By:
Encl.
Site Plan/Survey: AMP Architecture, last dated January 10,2024
Public Hearing Date:June 6, 2024
FORM NO.3
TOWN OF SOUTHOLD i 0
BUILDING DEPARTMENT
SOUTHOLD,NX:
NOTICE OF DISAPPROVAL
DATE: December 28,2023
TO: Falkenbach, Diane
116 Riverside Dr
Riverhead,NY 11901
Please take notice that your application received November 29, 2023:
For permit to: Construct additions and alterations to an existing single-family.dwelling at:
Location of property: 3650.Eugenes Road, Cutchoue
County Tax Map No. 1000—Section 97 Block 8 Lot 6
Is returned herewith and disapproved on the following grounds:
The proposed new construction on this non-conforming 72.432 sq.ft.parcel in the
Residential R 80 District is not permitted pursuant to Article XXHI Section 280-124
which states: lots measuring between 66.000 and 79.999 square feet in total size require a
minimum front yard setback of'55 feet_
The proposed construction will have a front yard setback of 1.0.6 feet.
thorized Sign6re
Note to Applicant: Any change or deviation to the.above referenced application may
require further review by the Southold Town Building Department.
CC: file,Z.B.A.
Fee:$ Filed By: Assignment No.
APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS
AREA VARIANCE
House No. 3650 Street Eugenes Road Hamlet Cutchogue
SCTM 1000 Section 97 Block 8 Lot(s) 6 Lot Size 1.7 ACRES Zone R-80 NC.
I (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR
DATED 12/28/23 BASED ON SURVEY/SITE PLAN DATED 10/05/2021
Owner(s):Diana Falkenbach
Mailing Address:3650 Eugenes Road, Cutchogue, NY 11935
Telephone:917-826-7674 Fax: Email:dfalkenb@gmail.com
NOTE:In addition to the above,please complete below if application is signed by applicant's attorney,agent,architect,
builder,contract vendee,etc.and name of person who agent represents:
Name of Representative:AMP Architecture for(X)Owner( )Other:
Address:PO Box 152,Mattituck,N.Y.11952
Telephone: 631-603-9092 Fax: Email:APORTILLO@amparchitect.com
Please check to.specify who you wish correspondence to be mailed to,fro►n the above names:
( )Applicant/Owner(s), (>0 Authorized Representative, ( )Other Name/Address below:
WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN
DATED 10/05/21 and DENIED AN APPLICATION DATED 11/15/23 FOR:
(X) Building Permit
( ) Certificate of Occupancy ( ) Pre-Certificate of Occupancy
( ) Change of Use
( )Permit for As-Built Construction
( )Other:
Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by
numbers.Do not quote the code.)
Article: XXIII Section: 280 Subsection: 124(B)&(C)
Type of Appeal. An Appeal is made for:
(x) A Variance to the Zoning Code or Zoning Map.
( )A Variance due to lack of access required by New York Town Law-Section 280-A.
( )Interpretation of the Town Code,Article Section
( )Reversal or Other
A prior appeal( ) has, (x)has not been made at anV time with respect to this property,UNDER
Appeal No(s). Year(s). .(Please be sure to research before
completing this question or call our office for assistance)
Name of Owner: ZBA File#
REASONS FOR APPEAL (Please be specifte, adclitional sheets rnav be used with preparers
signature notarized):
1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby
properties if granted,because:
There are other existing houses in the area that have encroached on the front yard setback including a
neighboring building. The proposed addition will remain within the existing,character of the neighborhood.
2.The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to pursue,
other than an area variance,because:
The existing house is non-conforming due to the fact that the existing dwelling is already largely located within
the minimum front yard setback of 55ft and was constructred before the implementation of contemporary
zoning requirements.Additionally, the home is located on a corner lot where it is compliant on one front yard but
not on the other--which is the subject of this request for variance.
3.The amount of relief requested is not substantial because:
A majority of the proposed work lies within the existing footprint of the home with the proposed addition being
enlarged by 5ft in the direction of the side yard and not any farther toward the front property line at issue.The
only proposed work that encroaches farther into the front yard setback is the exterior basement egress stair
which lies 3.9ft closer to thenfront yard line and is primarily below-grade asside from the,required railing and
couple inches of wall above grade.
4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the
neighborhood or district because:
The proposed addition and stairs will have gutters/drains leading to dry-wells to control rainwater runoff.
Dry-wells will be located away from any protected wetlands per state and local requirements.
5.Has the alleged difficulty been self-created? { } Yes,or VNo Why:
The existing dwelling is already non-confomring.
Are there any Covenants or Restrictions concerning this land? VNo { } Yes(please furnish a copy)
This is the MINIMUM that is necessary and adequate,and at the same time preserve and protect the character of the
neighborhood and the health,safety and welfare of the community.
L::�2�
Signature of Applicant or Authorized Agent
(Agent must submit written Authorization from Owner)
Ja
Sworn to bieZfore me this J* ay
o �J
w.
otaty Public
BAR13ARA H.TANDY
Notary Pubilo,State Of New York
No. 01 TA6086001
Qualified in Suffolk County '
Commission Expires
APPLICANT'S PROJECT DESCRIPTION
APPLICANT: AMP Architecture DATE PREPARED:01/15/24
1. For Demolition of Existing Building Areas
Please describe areas being removed:Existing 1 story addition is being removed so that basement can be dug and new addition
be constructed above.
II.New Construction Areas (New Dwelling or New Additions/Extensions):
Dimensions of first floor extension: Please see attached.
Dimensions of new second floor: Not applicable(see attached)
Dimensions of floor above second level: Not applicable(see attached)
Height(from finished ground to top of ridge): 12'-0"proposed addition.
Is basement or lowest floor area being constructed?If yes,please provide height(above ground)
measured from natural existing grade to first floor: Basement and first floor are being constructed with first floor height of 1'-10"a.g.
III. Proposed Construction Description (Alterations or Structural Changes)
(Attach extra sheet if necessary). Please describe building areas:
Number of Floors and General Characteristics BEFORE Alterations: Existing 2 story frame dwelling
Number of Floors and Changes WITH Alterations: Existing 2 story frame dwelling with renovated interior,reconstructed
1 story addition with new basement and exterior egress stair.
IV. Calculations of building areas and lot coverage(from surveyor):
Existing square footage of buildings on your property: 3,432.2 S.F.
Proposed increase of building coverage: 385.6 S.F.
Square footage of your lot: 72,432 S.F.
Percentage of coverage of your lot by building area: Existing 4.7%;Proposed 5.3%
V.Purpose of New Construction: Reconstruct and expand 1 story addition as well as add exterior egress stair to proposed
basement.
VI.Please describe the land contours(flat,slope %,heavily wooded,marsh area,etc.)on your land
and how it relates to the difficulty in meeting the code requirement(s):
The land throughout the property is typically flat,only gradually sloping around the fresh-water pond.
Please submit 8 sets of photos,labeled to show different angles of yard areas after staking corners
for new construction, and photos of building area to be altered with yard view.
4/2012
QUESTIONNAIRE
FOR FILING WITH YOUR ZBA APPLICATION
A. Is the subje premises listed on the real estate market for sale?
Yes No
B. Are there any proposals to change or alter land contours?
No Yes please explain on attached sheet.
C. l.) Are there areas that contain sand or wetland grasses?Potentially, pending wetlands flagging.
2.) Are those areas shown on the survey submitted with this application?Pond is shown but grasses are not.
3.) Is the property bulk headed between the wetlands area and the upland building
area?Yes
4.) If your property contains wetlands or pond areas, have you contacted the Office of the Town
trustees for its determination of jurisdiction?Pending Please confirm status of your inquiry or
application with the Trustees:waiting for wetlands delineation to be added. 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 Existing single family residence,
existing 2 family residence,and pool. and the proposed use Same with reconstructed 1 story addition&
basement/stair at the existing single family residence. (ex: existing single family, proposed: same
with garage, pool or other)
Authorized signature and Date
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, NEW YORii
CERTIFICATE OF OCCUPANCY No. Z11910
NONCONFORMING PREMISES September 9, 1983
THIS IS TO CERTIFY that the
/X/ Land
Building(s)
Use(s)
3650 Eugene's Road
located at 2500 Bay Avenue Cutchogue
Street Hamiet
shown on County tax map as District 1000, Section 097 Block 08
Lot 006 does not conform to the present Building Zone Code of the
Town of Southold for the following reasons:
The dwelling has insufficient front yard setback, facing
Eugene's Road There are accessory buildings in the sideyard,
facing Bay Avenue. The property has insufficient area.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /X/Land /X/Building(s)-
/_/Use(s) existed on the effective date the present Building Zone Code of the
Town of Southold, and may be continued pursuant to and subject to the appli-
cable provisions of said Code.
IT IS FURTHER CERTIFIED that, based upon information presented to
the Building Inspector's Office, the occupancy and use for which this Certifi-
cate is issued is as follows: a private two-family dwelling with
attached screen porch, one accessory barn, and three accessory
buildings (outhouse; potting shed; bee-hive shed) . The barn
includes an attached duck & chicken shed.
The Certificate is issued to ESTATE OF MARY"ZENESKI
(owner,lessee-ortenmft)
of the aforesaid building.
Suffolk County Department of Health Approval no retard
UNDERWRITERS CERTIFICATE NO. no record
Building Inspector
I
s �
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24577 Date August 16, 1996
THIS CERTIFIES that the building addition
Location of Property 3650 Eugene's Road, Cutchogue
House No. Street Hamlet
County Tax Map No. 1000 Section 97 Block B Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated August 14, 1995 pursuant to which
Building Permit No. 22972-Z dated August 28, 1995
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-a one story addition to an existing one family dwelling as
applied for.
The certificate is issued to Mary Elizabeth Gilbert
(owner, lessee or tenant)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N 379906 dated March 11, 1996
PLUMBERS CERTIFICATION DATED N/A
Bi lding Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31862 Date: 09 26 06
THIS CERTIFIES that the building ADDITION
Location of Property: 3650 EUGENE'S ROAD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 8 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 22, 1990 pursuant to which
Building Permit No. 18759-Z dated JANUARY 26, 1990
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 PORCH ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MARY E. GILBERT
(OWNER)
of the aforesaid building.
SUFFOLR COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. NSA
PLUMBERS CERTIFICATION DATED N/A
on d Si nature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall l
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32232 Date: 03/08 07
THIS CERTIFIES that the building
Location of Property: 3650 EUGENE'S ROAD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 8 Lot 6
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. 18265-Z dated JULY 6, 1989
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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to MARY E. GILBERT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMOT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-2358BO 05 15 92
PLUMBERS CERTIFICATION DATED N/A
A Zori�,edignature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32233 Date: 03/OB 07
THIS CERTIFIES that the building ALTERATION
Location of Property: 3650 EUGENES RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 97 Block 8 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 27, 2007 pursuant to which
Building Permit No. 32756-Z dated FEBRUARY 27, 2007
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 RECONSTRUCT AN EXISTING PORCH ROOF OF AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to MARY E GILBERT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
r
thorized Signature
Rev. 1/81
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): Diana Falkenbach
4. Address of Land Owner: 3650 Eugenes Road, Cutchogue, NY 11935
5. Description of Proposed Project: Please see attached.
6. Location of Property: (road and Tax map
number) 3650 Eugenes Road, Cutchogue, NY 11935; SCTM 1000-97-8-6
7. Is the parcel within 500 feet of a farm opera on? V Yes { } No
8. Is this parcel actively farmed? Yes V 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 Albert J Krupski Jr. 195 Little Neck Road TM#1000-097.00-08.00-031.002
2. A. Nicholas Krupski 115 Little Neck Road TM# 1000-097.00-08.00-031.005
3. Albert J Krupski Jr. 2790 Skunk Lane TM# 1000-097.00-08.00-031.004
4. Colleen Krupski 2760 Skunk Lane TM# 1000-097.00-08.00-031.006
5.
6.
(Please use the ck of this page if there are additional property owners)
l i 19 i Zo2q
Signature o p 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.
61'7.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part 1 based on infonnation 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:
Falkenbach Addition
Project Location(describe,and attach a location map):
3650 Eugenes Road, Cutchogue, NY 11935
Brief Description of Proposed Action:
Renovation of existing home interior, reconstruction & enlargement or 1 story addition with the inclusion
of a full height basement and exterior egress stair.
Name of Applicant or Sponsor: Telephone:631 603 9092
AMP Architecture E-Mail:
msmith@amparchitect.com
Address:
PO Box 152, Mattituck, NY 11952
City/PO: State: Zip Code:
Mattituck N Y 11952
1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES
If Yes,list agency(s)name and permit or approval:
Southold Town Building Department, Zoning Board, & Trustees/DEC
3.a.Total acreage of the site of the proposed action? 1•7 acres
b.Total acreage to be physically disturbed? 0.026 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 1.7 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban Rural(non-agriculture) ❑Industrial ❑Commercial VResidential (suburban)
❑Forest ❑Agriculture ❑Aquatic ❑Other(specify):
❑Parkland
Page 1 of 4
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations? , /
b.Consistent with the adopted comprehensive plan?
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape?
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify:
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
b.Are public transportation service(s)available at or near the site of the proposed action? _
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? VV
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies:
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water:
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment:
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places?
b.Is the proposed action located in an archeological sensitive area? V
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency?
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? _ /
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: V
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
❑ Shoreline ❑ Forest ❑Agricultural/grasslands ❑ Early mid-successional
Wetland ❑Urban VSuburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered? _ /
16.Is the project site located in the 100 year flood plain? NO XVE_17.Will the proposed action create stone water discharge,either from point or non-point sources? NO
If Yes,
a.Will storm water discharges flow to adjacent properties? 'VNO ❑YES
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: ❑NOIVYES
Gutters will be installed to catch runoff.
Page 2 of 4
18.Does the proposed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size:
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: /
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: V
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:
Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?"
No,or Moderate
small to large
impact impact
may may
occur occur
1. Will the proposed action create a material conflict with an adopted land use plan or zoning
regulations?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the character or quality of the existing community?
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological,
architectural or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and
cumulative impacts.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Name of Lead Agency Date
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
Page 4 of 4
Board of Zoniniz Appeals Application
AUTHORIZATION
(Where the Applicant is not the Owner)
residing at �Cdo
(Print property owner's name) (Mailing Address)
"*-Le—
Il�1f do hereby authorize
� (Agent)
AMP Architecture (Anthony Portillo) to apply for variance(s) on my behalf from the
Southold Zoning Board of Appeals.
(Owner's Signature)
�,talvt Feouk �
(Print Owner's Name)
APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this
form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME : � h�lq.
/
(Last name,first name,mi dle initi l 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 X Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or
employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"
means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or
employment by)a corporation in which the town offs crr or employee owns more than 5%of the shares.
YES NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either
check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted th' O da f ,2Q
Signature //��
Print Namb
AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of
this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME : AMP Architecture - Anthony Portillo
(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 V Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer
or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business
interest"means a business,including a partnership,in which the town officer or employee has even a partial
ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the
shares.
YES NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.
Either check the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
ii 't T
Submitted this I day of 20 Z�
Signature
Print Name Anthony Portillo
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# 97 _ 8 _ 6
The Application has been submitted to(check appropriate response):
Town Board 0 Planning Dept. 0 Building Dept. V Board of Trustees 0
1. Category of Town of Southold agency action(check appropriate response):
(a) Action undertaken directly by Town agency(e.g. capital
construction,planning activity, agency regulation, land transaction)
(b) Financial assistance(e.g. grant,loan,subsidy)
(c) Permit, approval, license, certification:
Nature and extent of action:
Existing 2 story frame dwelling with renovated interior, reconstructed 1 story addition with
new basement and exterior egress stair.
Location of action:3650 Euegenes Road, Cutchogue, NY 11935
Site acreage: 1.7 Acres
Present land use: Residential
Present zoning classification: R-80 Nonconforming
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
(b) Mailing address: PO Box 152 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.
®Yes ❑ No [—] Not Applicable
Proposed work is small in area and situated on side of house away from wetlands, therefore it will not create an adverese
affect on the environment and will enhance the community character.
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 ❑ No ® Not Applicable
There are no historic or archaeological resources on this property.
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Photo Looking Southwest—Right Elevation Photo looking Southwest—Right Elevation Towards Rear
Falkenbach Residence— 3650 Eugenes Road,Cutchogue, NY 11935
Owner:Diana Falkenbach
Applicant:AMP Architecture
All Photos Taken:July 21,2022
2
�: TOWN OF SOUTHOLD PROPERTY RECORD
OWNER STREET ` �' ' VILLAGE DIST.
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SURVEY OF PROPERTY
SITUATED AT
CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-97-08-06
• A. SCALE 1"=20'
e)•3A 10 �' a OCTOBER 5, 2021
.4
/ •/ 's G
•. A / / i °. 0
AREA = 72,432 sq. ft.
1.663 ac.
VIP
�� •.' _'' / / CERTIFIED TO,
DIANA FALKENBACH
A .;• / // '7, WESTCORG LAND L TITLE EIINSURANCE CPMPANY
dv / / ROUNDPOINT MORTGAGE SERVICING CORPORATION
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D.R S 50'57'00" W
35.00'
N.Y.S.Lto.No.50167
To
TI05 ' �e�S
� �IAIE Nathan Taft Corwin III
`"��""" Land Surveyor
M WaA�R,RYDRI I. ;UOR
To�5[n swuq RE OpaaE.�¢o SU-,To:SUN;J.kaloen,J,LS.
.bxpfi I Ingeyno LS.
DnY To T1'""a,E P'"Txs°r''DN roe N�NOND"THE wx�uNry 0,samr-SeWWi ;.,-ste Pl—- Cmsv e.Lp d
To
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p Oy�o,"pEp,y Ayp PHONE(631)727-2090 ( )
I,E ASPpNaS Or ENE IENOmc Nm- OFFICES LO TED AT MIRING ADDRESS
OFRmn�ors ARE'�iRAvs<EmO� P.O.Bo.16
THE EYISIENm OF RIGHT OF WAYS Jam¢sporL lot Yam Rood PO M.11917 Jomat L Nee Yoh 11947
A D/OR WE—OF RECORD,D'
ANY,NOT S_ARE NOT GUARANTEED. E-Wl NC—i0ft.l.-
4-
RECENED
FEB 12 2a24
ZONING SOARD or APPEALS