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Home My WebLink AboutZBA # 8038 622 Church Lane LLC-Harbes r f BUILDING E , T�EN"T`. SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL - J DATE: March 20, 2025 TO: Dr. Dom Morreale(622 Church Ln LLC) RECEIVED 20 Highland Avenue St. lames,NY 11780 JUN 2 5 2025 Please take notice that your application dated August 6, 2024: ZONING BOARD OF APPEALS For permit: to construct a single—family dwelling at: Location of property 1645 Nau les Drive Mattituck N County Tax Map No. 1000— Section 99 Block 4 Lot 18 Is returned herewith and disapproved on the following grounds: The proposed construction on this conforming 129,800 s . ft. rcel (92,823 s . f1:. buildable land in the R-80 District is not permitted pursuant_to the Bulk schedule which re wires 80.000 sci. ft. per use. The pMosed.sing-le-family dwelling will constitute as a second use on this lot. Pre-eLdi in seasonal costa es constitute the pringipal use., Authorize signature Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: ZBA, file f °J PATRICIA C. MOORE : 3q Attorney at Law RECEIVED 51020 Main Road Southold,New York 11971 JON 2 5 2025 Tel: (631) 765-4330 Fax: (631) 765-4643 ZONING BOARD OF APPEALS April 29, 2025 B,y`Hand Southold. Town Zoning Board of Appeals Town Hall Annex, 54375 Main Road, Southold, NY 11971 Owner: 622 Church Lane LLC Premises 1625 Naugles Drnve, Mattituck SCTM#1000-99-4-18 Lot Size 129,800 (92,823 SF buildable) Dear Chairperson Weisman and Board: Enclosed is an application to reverse or overturn the building department's notice of disapproval with respect to their determination that the principal use of the property is "seasonal cottages''"requiring 80,000 SF, and the proposed addition to the existing dwelling is a second use which requires an additional 80,000 Sly. We intend to show that the building department's determination is wrong on the facts and law. There are currently three preexisting residential buildings on the property. Since 1970 two of the three preexisting residential,dwellings, built as seasonal cottages, were converted into single ffimily dwellings as evidenced by their certificates of occupancy. The owner wishes to build an addition to one of the pre-existing single family dwellings, convert the,second preexisting single family dwelling to storage,and retain the preexisting seasonal cottage. The principal use of the property will be one single family dwelling and one preexisting seasonal cottage. Consequently, the notice of disapproval was issued in error. If the Board agrees with the building department's notice of disapproval, then an application for an area variance is included. Zoning Board staff was directed to ask the owner to submit a"Use Variance"application. That is wrong, the property is residential,and the applicant has submitted a request to construct an"addition"to the existing residential dwelling. No"use variance" issue is raised under the facts of this case. .V ry tru yours, tricia C. Moore i AP 'LICA T'10N TO THE SOUS III) OWN B+L/ARD+ A�PE RECEIVED- ANZr,A�QL AJ.4 CE �� House No.1625, Street Nau les Drive_ 2 5 2025 g Hamlet Mattituck SCTM 1ppp Section: 99 Block: 4 ZONING BOARD OF APPEALS Zone R-80 Lot(s) 18 Lot Size: 129,800 SF(92,823 SF Buildable) I(WE)APPEAL THE WRITTEN DETIJ DATED March 20,2025 ATIOI"�i OF THE BUILDING INSPECTOR BASED ON SURVEYISITE PLAN DATED 10-16-24 Owner(s): 622 Church Lane LLC Mailing Address: P-O.Box 961,Mattituck NY 11952 Telephone:631-275-3013 I'ax; Email:eharbes@gmail.com NOTE:In addition to the above please complete below if application is signed by applicant's alto architect,builder,contract vendee,etc and name of person who agent represents: attorney,agent, Name of Representative:Patricia,C.Moore for(X)Owner( ) Other: Address:51020 Main Road Southold NY 1.197:1 Telephone:�631) 765-433n Fax:_(631)765-46d3 Email: °rcmoore ,mooreat s,cont Please check to specify who you wish correspondence to be walled for from the above names: O Applicant/Owner(s), ( X)Authorized Representative, ( ) Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SIT E PLAN DATED X24-25 and DENIED AN APPLICATION DATED August 6,2024 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 by numbers.Do not quote the code.) on of Zoning Ordinance Article:R-80 Bulk Schedule 280-15 for: Subsection: Type of Appeal. An Appeal is made (X )A Variance to the Zoning Code or Zoning Map.If necessary-a single-family dwelling is proposed. ( )A Variance due to lack of access required by New York Town Law-Section 280-A. O Interpretation of the Town Code,Article Other: The proposed Section Re ,oast for Reversal or Overturn the Zor�in Officer's Menial p posed addition and alteration to an existing preexisting single-family dwellingi a second use on the property. The existing dwelling since 1966 (BP 3168) has been a single-family dwelling and continues to meet the definition ofasingie-family dwelling. The property s not Preexisting single-family dwellings(one dwelling became a single-family dwellinghe other dwelling on the property became a dingle-family dwellingin p p contains 2 (no change), The proposed use is one single family dwelling and 1 seas to nal and the 1970)and one seasonal dwelling. single-family dwelling will be a storage building), oval dwelling(one preexisting A Prior appeal(X ) has, ( ) has not been trade a� Cany time with res act to this ro ark, UNDER Appeal No(s).2833Year( ), 198,1,Docking and mooring of commercial boat for maintenance and repair of the barge(Northville Industries Corp.) Use Variance for a commercial use in residential zoned parcel-denied ('Please be sage to research before completing this question or call Page 2, Area Varianceour ofce for assistance) RECEIVED � tal� a�irrn Berrascd W0 3 JUN 2 5 2025 REASONS FOR APPEAL ZONING BOARD OF APPEALS (Please be specific, additional sheets ma be u n0tw i, ed) .Y sed with preparer's signature ." SAND",EVERSAL BUILDING DEPARF _") TMENT�NOTICE OF DISAPPROVAL DETERMINATION DIRECTING ISSUANCE OF BUILDING PERMIT OR GRANTING AREA VARIANCE Factual Back round: The subject property is a 3.1 acre parcel improved with t which were constructed prior to the enactment of the Southoldfree structures, all of three structures were built and used as residences on the Town Zoning Code. All have Certificates of Occupancy from the ' of you Property. Two of the structures one family dwellings. The third stmcture remains o oiled establishing each of them as residence which has a pre-existing use certificate issued , existing seasonal cottage structures are designated on the drawings used by the building Town. These three separate structures (Residenc;ial Structure 1, Residential Structur mg department to identify the structure 3 respectively. e 2 and Residential The existing structures, shown in the photographs in the follows: attached Exhibit A, are as Residential Structure I (aka Cottage 1) is the small This Preexisting structure was 53,,x l3" ' The Tow et of the pre ex,istirrg structures.. for an addition measuring l l ' 1 x 1X l3 n issued a building permit in 1969 completion o the addition. the Tower issued a Cc �� (Exhibit 1 Building Pern�rit�4 +� ion structure was described as a ``one family dwelling,,.Certificate of Occupancy in which the This dwelling included a separate bedroom, a bathroo g . (Exhibit B Certificate of Occupancy utility room with hot water heater. The owner ro m' living room and :litchen, and convert the structure to stoa-a e. o rs t extin uish fired ollin, use and Residential Structure 2 (aka Cottage ) is the largest is the,Principal structure (address 16 l�agles Drive g t of the structures on the property. It dwelling consisting of one and stories. In 1966 the, Mattituc and it is a pre-existing an "addition to an exist in dwellin Town issued a building P ,� g � g permit for (Exhibit C uzldin Permit 316$ . The building permit drawings show the addition as 14' x 2'. (fin the 19 a "single-family 66 building Permit application the existing dwelling was described a, sire le-fan�il dwe story dwelling ( x 3 ) and the,addition (2 2' x 1 ' y Ming>� 'f"he original one.and meet tie current code definition of "dwelling"in that family, (See South it is a minimum of 850 SF and contains the housekeeping for one old Town Code §280-13) This house was was continuously maintained as a single-family dwelling. occupied Year-round and This dwelling originally included both electric baseboard heat and a wood fireplace. The electric baseboard heat, is in the pictures had been updated by the prior owner(2 peconic S (See Exhibit D). The electric baseboard heat Was heated and ilisulated, the interior finishes Road LLQ. This single-family dwelling (1966 oldersheetrock and paneling) were standard finishes in older homes 2021 - Attached pictures taken by Harbes oil April 20, , of the electric baseboard heating in the living room (the 21 floor loft is also in this Picture), the large fireplace and full kitchen, The picture was taken when Edward and Shannon Harbes toured the house prior to their structure with a 1111, 1 Purchase. The owners intend for fb 11,111i i Dosed attached addition to serve as the ir , mai residence on the Residential Structure 3 (aka COttage 3) is It is a 480 square foot cot located On the northeast side of the property. 44seasonal" use cottage tage which includes a bedroom, bathroom and kitchen. It is a which Predates the �Town's zoning. A Pre-Existing Certificate of occupancy was issued by the Town for this structure structure was updated confIrming its legal status. This with building Permits and electrical Permits but remains as it was originally constructed prior to zoning. The owners intend t as the seasonal cotta 0 continue and maintain this L Building Permit Application 6MEM0 60-2-6 The owners Prepared plans for this property which would do theMIR JUN 2 5 2025 Cottage#1 to a storage ,MW use only accessory building 1; (2) construct an attached ffl%*S addition to pottage #2 making it the Principal, single family dwelling 0 the propert ; and (3) maintain Cottage#3 as, a pre 11 y -existing seasonal cottage. The plans were the subject of lengthy review with the Southold Town Building Department staff to determine that tile construction of the addition to the principal single_Tamil dwelling could be done without the necessity of any variances while achieving the above-described plan for each of the three structures Oil the Property. 2. Buildin De artment Notice of Disa roval The Town Building Department issued a "Notice of Disapproval"dated March 20, 2025 denying the building permit application submitted On the grounds that "the Proposed construction on this conforming 129,800 sq. ft parcel (92 land) in the R-80 District is not permitted pursuant to 823 sq. ft. buildable the Bulk schedule which requires 80,000 sq. ft. per use. The proposed single-family dwelling will which second use on this lot. Pre-existing seasonal constitute as (sic) a Cottages constitute the principal use. The Owners are Willing to surrender the residential use of this recognized this property. single-family dwelling as Part of their development plan for RELIEF REQUESTED FROM SOUTHOLD 1. a b TOWN ZONING BOARD�uildn eartnent'sFidnin In the Notice of l ira royal The Southold Town Zoning Board is author ized `' �and decide appeals from and review any order, requirement, decision Inspector-" Southold Tdwn "ode - � a Tl or deteraton made by the Building� . , ' Notice of Disapproval and dir e Owner .reversal ol�tlae Department issue�� buildin ectaon fi- t Board fleet the Building Permit as applied for by fire Owner. RECEND Ownefs use o ro ert does not constitute ... .SUN 2 5 2025 residentialTile Notice o.l�.disapproval states seasonal residential �; 1% . ��.., use constitute two separate ease under the Town zoningc Department's characterization is wren, . The sub" ,: Purposes which, when first built were ode. The wilding J t property � used for residential: either heating or insulation making them unsuited or seasonal. �� because the structures lacked. issued building perrnits in 1966 and 1969 for Cottagesor #1 an and oc is any . structures to year-round single-fancily dwell in p The Town �#� and which converted fire Certificates of Occupancy which were issued statin is evidenced by the gs. Tlris conversion dwellings. Since 16 , the property has been used the structures were single lainily single family dwellings and one seasonal cottage, or residential purposes with two, At no time in the 66 years this Property has been used in this manner has the Town ever-co "two" uses. The property has been taxed by the To considered this to constitute Assessor.elY with three residences according to the records o Southold and is listed as The Assessor's "�P'ro ert type classification code Southold Town Tay "three airily dwelling constructed for Year-round n their properly card i s a occupancy'. The proposed addition to orie Pre-existing single-family the second pre-existing single-family dwelling i family dwelling and conversion o second use. The principal use of tits proper into storage does not constitute ar create noire with one preexisting seasonal pottage and err accessory p arty is single- airily residence in the Board should confirm this gird direct the Building0 essory storage: building. This Permit:for the property s applied for by the Owner. epartinent to, issue the building USE VARIANCE: The proposed addition to the existing single- anvil The property is residentially zoned and the use t dwelliir„�is NOT a " Ise Variance".use on a residential parcel, The Board's stta was on the property is Permitted, residential "use Variance application. "That is absurd and does directed to have the owner submit a not require l`iirther discussion.. AREA VARIANC RECENED E. JUN 2 5 2025 6)3 The So+uthold Town Code does not re_-quire 0 00 for each use. ZONING BOARD OF APPEALS Assuming, arguendo that a propertyco with a seasonal r•esidenee constitutes `two uses" of single-family residences together is wrong to declare that each, of these "use uses"of the property,,, the Building l.�e Notice of Disapproval) s requires 80,000 square feet g Department per use (See There is only one zoning district in requirement that "each use's on the c i the Town.of Southold which sets forth a fi; This is found in the Town's ath 1 property rty n that district requires80,000square feet:. Code 28! -5 which states, "'In the 1, District zoning that requirements. Southold Town. �1 13itrict, no building or premises shall g hall be erected or altered which is arranged, d used intended or designed to be used, in whole or in a done use per , square feet of land above g p for any uses except the following "tied")�ernphas�; .added g , sped . mean high water, unless There is no such requirenaet is Otherwise in which the subMect ro ell is located. the l - Bonin district 2. Area variance for property with uses requiring (),000sgaaare feet for each use Again, as; uln,ing arguendb, that this ; a year-round residential use o, that this constitute agrees that a "seasonal"reside Property two separate uses requiring80,000,ntial use and Square feet for each use, the Owner seeps an area 'variance requirement, from this dimensional If a variance is applicable: 1• An undesirable neighborhood o change will not be produced ' r a detriment to nearbyIn the CHA Properties if granted,beta pro of the se. The property is very large, and the proposed use is one single family Preexisting seasonal dwelling remains in place. T single family residences. The use of the property dwelling. The p perry is �r of the community is not a second use. The building in Spector s notice building permit ,should have been is nforning to zoning and sued'. of disapproval is wrong, and a regarding the largest dwellin and not seasonal. (see E l ib, (Cottage 2). This dwelling is a year-round dwelling Prior to construction the property contains cottage. After proposed constructions the property� single family dwellings and one dwelling and a seasonal cottage. p petty would contain I single family 2. The benefit sought by the applicant CANNOT feasible for the applicant to pursue, other th,T be achieved b The Proposed use is one single than y some method an an area. variance, because: seasonal dwelling. The Town of Southold haswith one preexisting numerous properties throughout the Town, which have a px`inci al us with one preexisting seasonal dwelling. P e of single-family dwelling That is one rind al residential s. The amount of relief requested is n compliance with the ou n not substantial because: The property "seasonal cottage" g• e p�ncipal use is single family dwelling.ill be used g as a use on the property is wrong g The certificates of occupancy. Since 1969, there have gas �s proven b The the Property and one seasonal co tta e w y the existing been two single family,dwellings on year`-round occu g which happened to be occupied year-round. their NYS developedpa.nc of the existing residences is also notes b 1e property class code for the assessment roll• t y Assessors in Property classification being 230 (three family year-round occupancy Assessment RECENED 4• The variance will NOT have an adverse effect Physical or environmental conditions in the or impact n the "1UN 1�� because: Single Family,O neighborhood or distri0.63 y welling is a Permitted use in - Q zoning, parcel is larger the BOA OF AVP9A § g than. the minirnun7 two acres, the existingdwelling g as cottage#2 was retained and additions and alterations comply ellmg Gown with Boninare proposed to addition are connected to �eetlling, the proposed pool and the house 5. Has the alleged difficulty been self-created? t Yes, or fx } No contains preexisting residential structures. One o VUh family as their principal residence. he residences will be e�y. the property nlarged for the a• Are there any Covenants or Restrictions b• f X}No concerning this land? c• f } Yes (please furnish a copy) d. This is the A41N A4 that .s necessat an d adequate, and at the same time preserve and protect the character of the neighborhood and the health, ,safety and welfare of the community. n�ty. By signing this document, te "R+OP`lR°T' Pursuant to Chapter 280. 1h 'Y OWNER understands that (B) of the Code of the Town of Southold an y variance granted b where a Certificatey the Board of Appeals hall "occupancy becomen,utl and void subdivision rr��l y has 'lot been Praeured, and/or a three p his not been filed with the S�"®t� County ( ) years from the date uch v�rta�c Clerk was granted. The oar ina upon written request Prior to the variance of�x to exceed three expiration, grant extension�y� � '� ( consecutive one 1 rtc►t f��"p" .�year teri�ls� " " '� �""� PROFERT THE CODE REQUIRED WITH RIBED REIN. Sig (Agent mustsubmit licant o Aut Authorized Agent Sworn to before me this day orization from Owner) _ y a9� of 20 on o r ta.Apc .. RE ' MADISON rN J U N 2 5 2025 Nft F NEW YORK 'TQ53led es ffolk County �. ZONING BOARD OF APPEALS Exhibit A , R1 aN � C F �o 1 N t�7 r-� r r r Fr,,ur Io„ RECEIVE® T UN 2 5 2025 f BOARD OF APPEAL( II liYl��V 1 o,i ya r �V i,rrrrrrrrrr� i r �w RECEIVED I' JUN 2 5 2025 ZONING BOARD OF APPEALS 00 y ilk , u ` r u f m,�s , so . w �.,„ i �� ,, ��<, „1 �`�A t, �„ `�,,, %.; f;,�. ,;, �; �` �,"; �F.: �r y' "" r' r.- y%: 4; , �,. ��T ��.;. hp,, f„ ��r. J ��, ;�, i�jiiii /,, ��%'' /,i„ ii/�� f, ��/��, i�/f l� ,��i� i % rl/� ��j,�/�� 1��/ ,�/ i// J ii i i iiiiiii �% % � ,f��//�� Jai %%� �� J�/��i/��/�� li, fp r �`%/ �io ,1,� �� , � h f� ' � a�� o l l,� � � ; 1 �� lJr Q` N jF > 00 IZ C to i ; r f� nI r r u' aii „ y RECEIVED JU 'ZONING BOARD.OF APPEALS i I I�� y�� Ifi � i �i i� Ipiiii III IIIIIIIIIIIIIIIIIVII °�I, 1l �` " '"' Y ii ��IIIIII�III O�. n � i✓ N � r � l „li r / �i/ f s744 RECEIVED at Z y ' 202 JUN 2 5 5 ®1 eJANb lr )' I OF APPEALS ry ZONING BOARD m •� ��f/' � ''� erg!�' ', r1,7" 1 �r , � h , %i G/ l ' %/ Od � IBM ji / a r ryl von it / w w L r r r a w V� , w e , w. �z ILS I+'OBM NO. 4 RECEIVED TOWN OF SOUTHOLD BUI'LD44a DEPARTMENT JUN 2 5 2025 TOWN CL941K•S OFFf+CS SOUITMHOW, N.Y. ZONING BOARD OF APPEALS CERTIFICATE OF OCCUPANCY No. .9392 ............... Date ... .................... THIS CERTIFIES � '�• ••. 19..E that the building located at , . I "..; „U62*2-. *......... Street Map No. .a=.... ......... Block No. ........=........ Lot No. ,.......yAft •................ .... conforms substantial) to the Application for Building permeretofore ••••�'T .............. filed y pp it h led in this office dated •••••••••••., 19...1 pursuant to which Building Permit No. er �t dated ••• Aug.......I........•••••.. 19....J69 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 ......•• �"�"'M� IM....., .. • ......»................. The certificate • ^••• �s issued to .,fie„fie„ bra......... ,�.......................... of the aforesaid building. lessee or tenant) ]IOU" 525 ..Building Inspector•� "................. FORK NO.,j TOWN OF SOUTHOLD RECEIVED BUILDING DEPARTMENT TOWN CLERKS OFFICE SOMOLD, H..Y. JUN 2 5 2025 ZONING BOARD OF APPEALS BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 4445 Z Dote......................... .. 19.. Permission is hereby granted to; ...........�� y��w w ..........I.............................. .................... ' fie"ill"}t................................... ................. ....wtatw ..................I................ ......... .........w .........................••.•.••.............................. ......... ......I.. ......... ...4......,. ......... ................ at premises located at .....................z ....x .08--O>F............ .............................. . ..............,........ ....................................................... t ..,..........., .,r ................................................................... ...........................:........................................................*.................N.............4............................................... Pursuant to application doted .......................AuS..........$.................. 19... .69WW approved by the Building Inspector. Fee $..... XQ........ ......... ;.::: ....... *w Building Inspector ..�.*•"......• ig TOOMIl tea i '/ t /✓c.. ✓ !/s„a`-o, �` WILDING DDEP »�.r�' 3 TOWN CLERK'S ONCE flo SOUTHOLD,N. Y. �3+r7 o Examined. .. ...... (!C .. ..».»., 19........ Application No ..» . r 6 Approved ......» <................ 19. t... Permit No b .r— . !... ....... ... ,"mac Disapproved a/c....................... ...»,». »».....» ......... ................. RECEIVED (7C ■///y/�27 n .....iw.a........................................ ...»..M»4» .s�..N..»...e. �,/V✓ JUN 2 5 2025 "Illulidl i ......,».........»....... ZONING BOARD OF APPEALS APPLICATION FOR RUILDINO PERMIT Gi n Dote ............................ .»»r».........»w 19...fig. to INSTRUCTIONS b C a. This application must be completely filled in Inspector. P by"writer or In ink and submitted in duplicate to the llulldlrrg b. Plot Ian showin location of[at and of buildings an prern rekrtio nship to adjoining premises or public streets or areas,and g ving a data ed description of layout of pr Xrty must be n*wn on"diagram,which is,port of this oplicotion cr c. The work covered by this application nsayw not be commenced before Issuance of Building Permit. d, ll opprovol of this application, the Build,ng Inspecuw will issue Building Pework. it to the applicant.Such permit shall be t on the premises available for inspection throughout the e. No building sholl be occu�,pled or used In whole or in part far any purpose whatever until a Certificate ft or r shall have been granted by the eullding I of Occup APPLICATION IS HEREBY MADE to the Building rtrment for the Issuance of a BuildingPermit Building Zone Ordinance of the Town of Southold ik County, New York, and other applicable Laws,ix+�ant thees Regulations, for the construction of building ves s iWiitions or alterotim", or for removal or lltion, os herein described. The applicant ogreens to comply with all app�lcoble la , ordinances,building code, housing code and, regulations. d.W•Chambers ." applicant,or name,if" "a gat e)"...... ,,,,Mattituck N.Y. .................... .............. ...!Address of 1*»ora ............................... State whether applicant is owner, lessee,agent,architect,engineer, general contractor, electrician, plumber or builder. ......................................... ..I.........« Name of owner of premises»..aT»..»lifm.«. 7LL.».w »...... ..,... ».»...... ...». »...»,»«. ...»..».. If oPPlicarrt Is a corporate, signature of duly authorized office .....................I.,.,.... . .•.••••..»~..... (Nome mid title of corporate officer) 1. Location of land on which Proposed work will be done. Mop ........ ............... . Street and Number ....................R/S....�1 leg..D01*9...... Lot No.: ..»�.. .»»»..,.». T/ - /S'�5 ...»..»l ill t"I »...« ................................. . ........ ........ umiclpal'Iwt+�, 2. State existing use and occupancy of promises and Intended use and oceupnrrcy of Proposed construction: a. Existing use and b. Intended use and occupancy ..... ..,.»...., �..V;Ltb�S �. ........., " 'm 3. Nature of work (check which applicable): New Buildin g .................. Addition ....... $. Alteration ..=.. Repair .................. Removal .................. Demolition.................. Other Work (Describe) ...... ....................... 4. Estimated Cost 31yL1QQ.In83....................................Fee .5..01D .. .. ..........,,.... (to be paid on filing this application) S. If dwelling, number of dwelling units ..........one...........Number of dwelling units on each floor Ifgarage, number of tors ......... .................. 6. If business, commercial or mixed occupancy, specify nature and .„......."" extent of each type of use ............... 7. Dimensions of existing structures,if any:Front.................. ........ ..... . . .. Height ........................ Number of Stories .................... Rear ... Depth .................... Dimensions of same structure with alterations or R�..r . . .. . additions• Front .................................... Rear .... Height ........,„,. Depth ............................ .................... .Number of Stories 8. Dimensions of entire new construction: Front ..... ..„a> ,;Qn,,,,_, p.............. Height .................... •Reor...1.�- ...............Depth...�2.4........... 9 Number of Stories ...........Ql .................... 9. Size of lot: Front.....24Q.f........... Rear............ ,,»... .....................................................................,.. 10. Date of Purchase ....................... Depth....3�1� :../....�}QQ , .Name of Fortner Owner ...............»....................................... 11. Zone or use district In which premises are situated•...........W,AU3 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises .J.eW.Cbgg�.........gdd ......� ............A,p.......................................... Name of Architect ......................................................Address ...........��. gll................ Phone No. .................... Name of Contractor ......same....................................Address ..................... .....................Phone No. .................... ....................... Phone No. .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and Indicate all set$oc property lines. Give street and block number or description acGarding to deed, and show from whether Interior ar corner lot. lcate JUN 2 5 2025 + ZONING BOARD OF APPEALS ,rye vii" L N^ N !y - f Atot LJ I�� Ises s I LO OF NV COUNTY Of .................. ...4A..W w Q7�d� ,being duly sworn, deposes and so that he is the a (Name"of Individual signing allatian)'µ """""" says pplicont above named. He Is the ...................... t�,� ;.... ....... (Con;;;�r, agent, corporate officer, etc.).,.... .'.... of said owner or owners and Is duly authorized to perform or haveperformed this application; that ails stotemerrts contained In this aq�plicatIOW are to the best of hisknowledge to make and file that the work will be perf in the manner set forth In the applIcation filed therewith, and belief; and Swain to before me this ...,...... ...... ..... day of ........ ....August .......... 19.6.9.. ,Notary Public, » .. "r.. .... ... q ... at!r" ;„, ...... .............It (Signature of�P �"lI No52 0618l0i30.0tis . g Ilcant COMMIS an Eaalfo6 Exhihit r �/- .COIL, I—) FOUN No. 2 TOWN OF SOUT'HOLD RECEIVED BUILDING DEPARTMENT 0'? TOWN CLEWS OPl~10E JUN 2 5 2025 SOUTHOLD, N. Y. ZONING BOARD OF APPEALS BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3168 Z Date ,...,. » .. . ........... : ..... ....... .....j 9A.6. Permission is hereby granted to: ..... ...... ............................................. to Rui . ...aa••a • si� ••a •• n•• •� 3 �•• �, Ql -fig..... .................................................. ctpremises located at .... ,+'••,s^.�.cZA... ..................................................... ................................... ................................................ y.....AW.Yo................................................................ ,.......•.. pursuant to application dated .............................. .. Tra ........2 ......... 19f 6..., and approved by the Building Inspector Fee $»•, .+. }. ...,..,.. i a FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE `e /,, SOUTHOLD, N.Y. Examined .. �..... ........ 19` ... / { Afikp �..........., f P b Application No. . .�.b..rr.,........ rov . ..., 19........ Permit No. . Disapproved a/c '" ........................................................... I.................. .. RE t INFO . ON ,..........,�Buil�d g pec ............. ................. J 2 2025 APPLICATION FOR BUILDING PERMIT ZONING 130ARID OF APPEALS Date .................................Jux.... Pi....., 19F?6....... INSTRUCTIONS a. This application must be completely filled in by typewrlter or in Ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on Premises, relationship to adjoining prerni'ses or public streets or areas,and giving a detailed description of layout of property must be drown on the diagram which is part p c. The work cowered by this application may not be commenced before issuance of Building Permit.f'his application, d. Upon approval of this application, the Building Inspector will issue a Building Permit to,the applicant. Such permit shall be kept on the premises available for Inspection throughout the progress of the work.. e. No,building sholl be occu��aled or used in whale or In part for any purpose whatever until a Certificate of Occupancy shall'have been granted bar the Building Inspector. APPL ON o the ing Bu dinglZonel Ordinance off the T�off Southold, uu, of Counteartrnent y, New "r the Fork, and otherssuance of a Bapp�cable Lawii,O��aoncestor Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations, (Signature of applicant,or name, if a corporation)...,.... .... �rq �. 1#11 .......... (Address of applicant) . State whether applicant Is owner, lessee,agent,architect, engineer, general contractor, electrician, plumber or builder. ...........................................Contv"to3r.............................................................................................................................. Name of owner of premises ,..... If applicant Is a corporate, signature of duly authorized officer. #.............................................................*Mrµ ................................................................................................ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........ . 1�.. .......................Lot No.:..�,.�....�............... Street and Number ,,, .. 7C .'1119tf....� utuA .6 Municipality ... .. . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.......ORGIUM&........»............... . .....................,.,............... b. Intended use and occupancy ........................................................................ / ^ | ~` Na | | 5. If elling, number of dwelling units ......Me.......... (to a pqi4 W filing th ....... 7. Dim nsions of existing structu cupancy, specify nature and extent of each type of use ......................... .. HeIf 2 .... � .'- | 2. 1 TProPosed construction violate any zoning laws otdin,once or regulation? ...... PLOT DIAGRAM Locat clearly and distinctly all buildings, whether existing or proposed.. and Indicate Oil Set-back dimensions fr property Ii es. Give street and block number or description occording to deed, and show street names and indlo to whether injerlor or corner lot. 603(8 RECEIVED ZONING BOARD OF APPEAL COUNTY F S.S. Name at Individual signing Opp g duly sworn, deposes and says that he Is the Qpp,lit n,t of sold er or owners, and, Is duly, outhorized to perfo (Contractor, agent, corporate officer, etcj his ti nn or hove Performed the sold work and to make ond le tl0n; that 01i statements contained in this application are true to the best of his, t at oU k will be performed In the manner set knowledge and belief; d Sworn to-b 'fore,me this forth In the application filed therewith. Tom born Match 3% 1977 RECEIVED i J U N 2 5 2025 ` co ZONING BOARD OF APPEALS 1 J9 up i i / rm f f/f RECEIVED JUN 2 5 2025 8 ZONING BOARD OF APPEALS , 441 r; P A;; a I �1 o/i ........... IMP; ✓i a� 1 ifr% li i„ Pv !!f r1%//Glf!m MP� !!C➢1� - �Y *0000 ow YY V ni 4 f,MCEIVE UN 2 5 2025 ti ZONING BOARD OF APPEALS Alljif �l Al I I iry I f r i RECEIVED JUN 2 5 2025 ZONING BOARD OF APPEALS owfiYwnWai�a7rFW/fu wi�'ruf�en>>r �rim r �,NAk i; nr rl mc/ t r rr, tp r n n , r RECEIVED 3, --- JUN 2 5 2025 cb O ZONING BOARD OF APPEALS t rr obi / �(pll�yarVYmi,�r/rg1��VPv // / �� f flvlw�l� Urfiwryrw�/orroiir��ru�rr�iDy ��(tv,NRf�ilf�laJ��fymr�//ail%oyiri��vviyt o a ��, � � �-- O „� 1 �,,� �i%,/'' �� %%1 ii�i m' ,% ,; '" /; k a ,�' �,' 1 � - , � � �"� it f�, rr7�� o /�i ��i �� y�%, �� r/, � '/ � '�r� �� r �r �; a � �� , / f :,� %i G �1 ;,��lw r `��v t ��, ;g, I� �f, ��,� ��1 ,� �� ,, �i� „��, °� � � ` �� % ;, ,,,. ,,, ,. �, �,ii„ y% "�,. �� I,y�, ,;/,/„ �� r� i��in 1�EIVE�M JUN 2 5 2025 ZONING BOARD OF APPEALS i s. x , 1 RECENED �63 JUN 2 5 2025 0 AL c l% 1 1 V 1 yyll / I / ��arorytr��nrw �, y>x I&I /i/'/� ��I�� r°,` yr,✓ �, � �' 2�,„, .. �'1 025 APPEALS ' �(5F A A I t i o I v/ l rr � r n„ r .........,I c� �." '�� ,� � � ,.,. �,o „� �, ��„�, � �� ,; �� , i� �� i �,, �� ,� � / V �, �� m�� , - ��, �,� �� " W 1 �' /� °% �; � �� r y /i ��' ,�,� � �; ,, � �� i r� �A�<< ;�i "�r r% i//�/ � � r� ,. %��i/ �, d °� �� rui �". nw Diu mam,,, 1, J` i ff1f rWWI r� ul�iiw wr rrrr r r > f KAP a � r', D "1 Jnr��,�mrwu,5�mrogAiwru,�19�K��k1lF��'7�g7j,`w�µ 1VIMJO��J�w1,�rm nu,�i mnw�itnw r�r�ra lisle IN % g�yypp �TI"�� I 1 Yy hei IT i j WV�nra I ,,,ter r, fY�ff?�/Arta' sr- %r7ir ' i i M, � I � i i 1 r�lo m I � ON ' NIN �I Wu" r ql i / �oC/��l�r;r��r✓�F��,�wv„rrr�ra�ir�al�ilwl,,,r,,, /ii j0 r RECEIVED JUN 2 5 2025 �� `%��/ � riOUl rlFi i/eGr/Gr�iia�G ZONING BOARD OF APPEALS r r rr io� r„r ' ihii.fig iu u i 1 y uu or li /r RECEIVED Zoning Board of Appeals JUN 2 5 2025 OjM APPLICANT'S PROJECT DESCRIPTION APPLICANT: 622 Church Lane LLC ZONING BOARD OF APPEALS SCTM No. 1000 099 Block 4 Lot 018 I. For Demolition of Existing Building Areas Please describe areas being removed: Portionnce of i :kiwi id ard re i e c snore c in f , nao f Ilse on reside st ide of E is in H.New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: L-shaped 57'x 19'sand 41 x 14'-1" 1,741 square feet L-sha Dimensions of floor above seDimensions of new second cond level: 54-8 x t -0 3,752 square feel Height(from existing natural grade)vel. Average N/A Grade to slpd roof ridge: 27.17 feet Is basement or lowest floor area beingconstructed? natural existing grade to first floor: If Yes,please provide height(above ground)measured from Yes - Lower Level "Grotto" & Hall. 12'- 7" lower level to 1 St floor 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, O e.Family Wood Frame Residence: One floor w/Mezzanine-situated on lowest part of western ladrtion Single F arse to new New Ground Flo / New"Grotto"& Hall &Stair connecting existing House Number of Floors and Changes WITH Alterations: sement Stai New fool beck w/exteriorSstairs connection to Loweor& new Gara lrolevel and Ground Floor s paces 'V- Calculations s of building areas and lot coverage,sky plane(From Surveyor, Design g qyour property: 1,759 gn Surfaes p increase of building coverage, 4,288 Buildlrrg f b1,1897 sf of Impermeable s�lrnper le Surfaces Pro osed � Square footage of Your lot: 129 800 sf Actual Lot Size. 92 828 sf Buildable Ar� Surfaces Percentage of coverage of your lot by building area (lot coverage) g,34 % Total Covers g f Buildable Area gross Floor Area t�FA of single.farnily dwellingincluding;the attached garage and/or habitable detached 7 408 sf W/ Douse(Gara e& Cottage )' accessory structure: Please refer to Chapter 28 Section 2 0-207 of the Town Code For Residential lots,,is project within the allowable S Plane?(Please refer to Cha t the Town Code). Yes-See Drawing Z-1 for SkyPlane Diagrams per 2 0,Section 110-20 of V. Purpose of New Construction: Single Farnily Residence and Attached Garage wrv/new gravel drive . New Pool & beck sp ace. 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): Describe on separate page if needed: -Sloped site-slo a va No work slo es of 20%or rester. Partiall wooded'on i fp round. Ex stin easonaN cottage on Rawer ort ern portion si a near rstrng oc and shore rne. Please submit 8 sets of photos,labeled to show different angles of yard areas after staki new construction, and photos of building area to be altered with yard view. c s for Revised 6/2023 QUESTIONNAIRE RECEIVED FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premises currently listed on the real estate market for sale? JUN 2 5 2025 Yes _XNo ZONING BOARD OF APPEALS B. Are there any proposals to change or alter land contours? p p p Minor cut and fill for pad No Yes lease explain on separate sheet. C. 1.)Are there areas that contain sand or wetland grasses? Not to be disturbed 2.)Are those areas shown on the survey submitted with this application? Yes 3 Is the property bulk headed between the wetlands area and the upland building area? O 4.)If your property contains wetlands or pond areas,have you contacted the Office of the BOARD OF TRUSTEES for its determination of jurisdiction? Yes Please confirm status of your inquiry or application with the Board of Trustees: Pending If issued,please attach copies of your permit listing conditions of approval with a copy of the 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, Waterfront is more than 75 'from proposed E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? No If any of the aforementioned items exist on your property,please show them on a site plan. F. Are there any construction projects currently in process on your property? NO If yes, please submit a copy of your building permit and survey as approved by the Building Department and please describe scope of work: G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If none exist,please apply to the Building Department to 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 and identify the Suffolk County Tax Map No. I. Please list present use or operations conducted at your property, and/or the proposed use Single Family Residence and Seasonal Cottage J. (examples:existing single family,proposed:same with garage,pool or other) 4/28/2025 Authorized signature Date RECEIVED JON 25 3 025 ZONING BOARD OF ApF o m ceo u .: as w l x�i � � ✓ ^r � 1� z��'i 3 sell'; IRS co mom^" - H '-1 CP VFuV � W oEll 5 <W t � �. s. DR '' � o _ w 41 F • x ICON h 0 o a A p om ? c � p r q� L O O u D F A n e ui ` G t,ItFFOt Town of Southow 12/20/2022 53095 Main Rd RECEIVED Southold,New York 11971 �636 Sm JUN 2 5 2025 ZONING-AWARD OF ME S PRE EXISTING CERTIFICATE OF OCCUPANCY No: 43696 Date: 12/20/2022 THIS CERTIFIES that the structure(s)located at: 1625 Naugles Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 99.4-18 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 43696 dated 12/20/2022 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame non-habitable cottage with concrete patio.* (#1 The certificate is issued to 622 Church Ln LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Aoiur or, re BUILDING DEPARTMENT RECENEO TOWN OF SOUTHOLD 90N 2025 HOUSII�' CODE�NSPECTON REP'O:RT ZONING BOARD OF LOCATION: 1625 Naugles Dr,Mattituck APPEALS SUFF.CO.TAX MAP NO.: 99.4-18 NAME OF OWNER(S): 622 Church Ln LLC SUBDIVISION. OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Lupovici,John DATE: 12/20/2022 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block BATHROOM(S): 1 CELLAR: CRAWL SPACE: PORCH TYPE: TOILET ROOM(S): UTILITY ROOM(S): DECK TYPE: BREEZEWAY: PATIO TYPE: concrete FIREPLACE: GARAGE: DOMESTIC HOTWATER: TYPE HEATER: TYPE HEAT: none WARM AIR: A CO►1�'DITIONING: -° —Y -- — #BEDROOMS: 1 #KITCHEN HOT WATER: IRS: OTHER: BASEMENT TYPE: ACCESSn,RY S DTi S; GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL:OTHER: GUEST,TYPE OF CONST: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 10/31/2017 TIME START: 12:45pm END: 1:0vOpm LOCATION; (number&s reel) ( runigiPadi ) SUBDIVISION: MAP-NO.: LOT(S): NAME OF OWN CA 2025 0•CCUPANCY: (type) ( eager- rur:t) ZONING BOARD OF APPEALS ADMITTED BY: ACCOMPANYED BY: KEY AVAILABLE: SURF,CO.TAR O. tYC►Iy • SOURCE OF REQUEST: D WELLING TYPE OF CONSTRUCTION; 5T0R1ES: #EXITS: FOUNDATION: ` 18AZMENT:_'CRAWL SPACE: #OF BEDROOMS: 1ST FLR: " 2NDi FLR: _ 3RD PLR: TOILET AOOM(S): BATHRO'OM(S): � UTILITY RQ0'11 : PORCH TYPE: DECK,TYPE: PATIO;TYPE: BREEZEWAY:' FIREPLACE: QARAGE: DOMESTIC HOTWATER: TYP9 HEATER: AIRCONDITIONING:_ TYPE HEAT: WARM AIR: HOTWATER: #OF KITCHENS: FINISHED BASEMENT: YES_ NO OTHER: In (CIO 0 M CC S ORY STRUCTURE GARAGE;TYPE OF CONST.:_ . ;. STORAGE,TYPE CONST.: M SWIMMING POOL:. _ ---- _ GUEST,•TYPE CONST: OTHER: VIOLATIONS:. CHAPTER 144&N,Y,STATE:UNIFORM FIRE PREVENTION&BUILDING CODE LO-C TIN C IPTION ART. SEC. REMARKS: INSPECTED BY. DATIr OF'INaP�OTIONw ` - TIME START, AID: . Town of Southo►.. 12/20/2022 53095 Main Rd Southold,New York 11971 9 REC El"1EC JUN 2 5 2025 PRE EXISTING ZONING BOARD OF APPEALS CERTIFICATE OF OCCUPANCY No: 43697 Date: 12/20/2022 THIS CERTIFIES that the structure(s)located at: 1625 Naugles Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 99.4-18 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 43697 dated 12/20/2022 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: cement block and wood frame seasonal cottage with concrete atio* 42 The certificate is issued to 622 Church Ln LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. w A th za d Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD RECEIVED OUSING CODE INSPPC11ON REPORT JUN 2 5 2025 LOCATION: 1625 Naugles Dr,Mattituck SUFF.CO.TAX MAP NO.: 99.4-18 SUBDIVISION: ZONING BOARD OF APPEALS NAME OF OWNER(S): 622 Church Ln LLC OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: 622 Church Ln LLC DATE: 12/20/2022 DWELLING: #STORIES: 1.5 #EXITS: 1 FOUNDATION: slab CELLAR: CRAWL SPACE: BATHROOM(S): l TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: concrete BREEZEWAY: FIREPLACE: x GARAGE: DOMESTIC HOTWATER: TYPE HEATER: AIR CONDITIONING: TYPE HEAT: none WARM AIR: HOT WATER: #BEDROOMS: I #KITCHENS: I BASEMENT TYPE: OTHER: ACCE SORY S"TRUCT ES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 12/20/2022 TIME START: 12:15pm END: 12:40pm 4 �►"" NZ;EAL e)0000� IA LOCATION: Cor- --- - m (ttrosmber r street) (rr:unigip lity SUBDIVISION: MAPWO.: LOT(S� 3 NAME OF OWNER(S): t t�+C OCCUPANCY: Co ► (type) (owner-tenant) ADMITTED BY: ACCOMPANIED BY: B' KEY AVAILABLE: SUFF.'CO.TAX MAP"' SOURCE OF REQUEST: DATE: 0 DILIN ; `« TYPE OF CO STRU CTION. w STCt S: IA/ #EXITS: CRAWL S. FOUNDATION: � °?�ASI;MENT:� PACE: #OF BEDROO-DQ: 1ST FLA:, 2ND FLA: _ 3RD FLA: BATHROOIVI(S): n TOILET�,OOM(S): ., UTILITY PORCH TYPE: DECK,TYPE: PATIO;TYPE; BREEZEWAY:• FIREPLACE: Q.ARAGE: DO TI�HOT" ATiP- TYP9 HEAT R: AIRCONDITIONING: TYPE HEAT: WARM AIR: HOTWATER: # OF KITCHENS; A LA.- FINISHED BASEMENT:- YES NO OTHER: ACCESSORY S RI.JCTURES GARAGE;TYPE OF CONST.: STORAGE,TYPE CONST:: SWIMMING POOL: GUEST,'TYPE CONST: OTHER: VIOLATIONS:. CH PTER,144&N.Y.STATE:UNIFORM FRB PREV$NTdON&BUILDING CODE LOCATION D CPJPTlOrj ART. SEC,. REMARKS: n.rnnnn^rTl �nIT I L ilt Town of Southoat 12/20/2022 53095 Main Rd " IT Southold,New York 11971 RECEM JUN 2 5 2025 PRE EXISTING -ZONING BOARD OF APPEALS CERTIFICATE OF OCCUPANCY No: 43698 Date: 12/20/2022 THIS CERTIFIES that the structure(s)located at: 1625 Naugles Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 99.4-18 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 43698 dated 12/20/2022 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood fram seasonal c e with loft andAeck. *L#3 The certificate is issued to 622 Church Ln LLC (OWNER) of the aforesaid.building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. lh*riz(7ature BUILDING DEPARTMENT RECEIVED TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT JUN 25 205 LOCATION: 1625 Naugles Dr,Mattituck ZONING BOARD OF APPEALS SUFF.CO.TAX MAP NO.: 99.4-18 SUBDIVISION: NAME OF OWNER(S): 622 Church Ln LLC OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: 622 Church Ln LLC DATE: 12/20/2022 DWELLING: #STORIES: 1 #EXITS: 1 FOUNDATION: cement block CELLAR: CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: wood frame PATIO TYPE: BREEZEWAY: FIREPLACE: wood stove GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONING: TYPE HEAT: none WARM AIR: HOT WATER: #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: OTHER: APSESSORY STRU S: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 12/20/2022 TIME START: 1:05pm END: 1:20pm dly-,j 4y�/ LOCATION: RECEWEd � (number fr et) (r t:nigipality) 603 SUBDIVISION: _ _ 'P•PV'O.: LOT(S):.. JUN 2 5 2025 NAME OF OWNERS); t Vol OCCUPANCY: (tyP (a aer-tersest)• ZONING'BOARD OF APPEALS e ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUIaF.CO.TAR MAP`N0 1000- _ SOURCE OF GUEST: DATE: DWELLING TYPE OF CONSTRUCTION: #STO'IUES: #E)aTS:„ FOUNDATION'' ,BASEMENT:_,,:=—CRAWL SPACE:, -- ON BEDRO MS: 1ST FLR: 2NI7 FLIT: _ 3RD FL17:-- BATHRO`OI+ S': TO( �. JET VjpOOM(S):_UTILITY R009Vl: . . PORCH TYPE: mm DECK PE: "' PATIO;TYPE: BREEZEWAY:" FI PLA(E;(AOt Sj5f QARAGE: DOMES C H'OTWATER:+IW TYPE HEATER: _ AIRCONDITIONING: TYPE HEAT: 9 ARM AIR: HOTWATER: #OF KITCHENS: L/ �''�� 1 e -FINISHED BASEMENT:- YES NO, OT HER: ° ACCESSORY§JUCTURES GARAGE;TYPE OF CONST.: STORAGE,TYPE CONS'.: SWIMMIN11G POOL: GUEST,'TYPE CONST: OTHER: 1 VIOLATIONS:" CHAPTER 144&N.Y.STATE°UNIFORM FX PREVENTION&BUILDING CODE LOCATIO A 4 DBSCIUPTION ART. SEC. f)mjvlv.4& 90 REMARKS: ° � r " SPECTED BY. "' DATE OF INSPECTION: TIME START: %off END: 0 Form No.6 RECEIVED TOWN OF SOUTHOLD 803� BUILDING DEPARTMENT TOWN HALL JUN 2 5 2025 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCYONING BOARD OF APPEALS This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept.of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of l%lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00,Commercial$15.00 Date. / Q— l 7' j New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. Street r Hamlet Owner or Owners of Property: A 't �no 1 C /� Suffolk County Tax Map No 1000, Section [ Block Lot l� Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ Applicant Signature RECEIVED CONSENT TO INSPECTION JUN 2 5 2025 ZONING BOARD OF APPEALS Jo VV*j LkkpoV lC., V L ' the undersigned, do(es)hereby state: Owner(s)Names) Southoldh located adersigr�ed(is) (ar�the owner(s) �the premises� n the Town of which is s wn and designa �one Suffolk unt Tax Map as Distract 1000, Section j , Block ,Lot__Lr That the undersigned(has) (have)filed, or cause to be filed, an application in the Southold 'rnwn_Rllll it dlng Inspector's nsector p s Office for the following: n That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property,including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws,ordinances,rules and regulations of the Town of Southold. The undersigned,in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances,rules or regulations of the Town of Southold. Dated: U C (Signature) c� tD Vic. n Vie) .- %( t (Print Name) r q TOWN OF UTHOLD BUILDING DEPT-- 765-1802 RECEIVED RA JUN 2 5 2025 I. NSPECTION ZONING BOARD OF APPEALS FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] NSUL.ATIOWCAULI ING [ ] FRAMING / STRAPPING [ FINALV0&v� [' ]. "FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION " FIRE RESISTANT.CONSTRUCTION , [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ].. ELECTRICAL (FINAL) CODE VIOLATION PRE C/0 ate o:rp- km REMARKS- !Xw- Mllvo 4 Uo o C&M r t ' ," DATE' ' INSPECTON. RECEIVED JUN 25 e ONING BOARD OF APPEALS TOWN. OIL' SOUTHOLD BUILDING DPT ca ,� 765-1802 IN-SPECT-ION �7 [ j FOUNDATION 1ST [ ] ROUGH PLBG. ( ] :FOUNDATION,2ND. [ ] INSULATION/CAULKING ] FRAMING / STRAPPING' [ ] FINAL j FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION : [ ] FIRE RESISTANT CONSTRUCTION [ j FIRE RESISTANT PENETRATION [ ] 'ELECTRICAL (ROUGH) [ ] PCTRICAL NAL [ ] CODE VIOLATION [ PRE C/O �, )�� r C c RE IS'■ a4 k.0000, G�k Avv RoAvicoll wr r DATE INSPECTOR JP4� 4vdA,ol� 4 s1irv° � RECEIVED�o MAA� Y 80' '36 CA JUN 2 5 2025 TOWN OF SOUTHOLD BUILDING DEIRIL BOARD OF APPEALS 765-1802 INSPECTION, [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION ] FRAMING / STRAPPING [ ] FINAL FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ _ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) RE ARCS:of 0 �L. " T . t ,. DATE 3 f INSPECTOR wv� JOREGEIUEI cot Z 5 2025 ZONING BOARD OF APPEALS', TOWN OF ,' ODTNOLD BUILDING DEPT. 765-1802 IN'SPECTION * . . [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] .INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAleg F REMARKS: S: Ap- cl t,044 Go oe d �5 , h -"W I aAgk WSW 6 DATE ' INSPECTOR IMy� , A 4OWN OF 0U'THOLD BUILDING D PT 681-765-1802 RECEIVED JUN z 5 2025 [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. ZONING BOARD OF APPEALS [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ECTRICAL (FINAL) [ ] CODE VIOLATION [ PRE C/0 [ ]' RENTAL REMARKS: Qw 07 DATE INSPECTOR RECEIVED ' JUN 2 5 2025 ZONING BOARD OF APP- t � / / lY � A�� r�l , rh/ l✓ l�i f � r 0 ��'lN / /✓ F �'l d„w,,n` y �/ my i"W l�� n r ., l✓^r1Y � �� % rlr�III,��( 1!!f® rJ, �/�� rs i,aJta Ire „„, %!�im✓ii �t✓//j� x A � G 41„� TOWN OF SOIITHOLD, NEW YORI{ DATE 10-�8 ^Ct�� ACTION OF THE ZONING BOARD OF APPEALS vG'Y LD Appeal No. 2833 by application Dated May 12, 1981 ACTION OF THE ZONING BOARD OF APPEALS JUN 2 5 2025 OF THE TOWN OF SOUTHOLD To Northville Industries Corp, P.O. Box 111 ZORWraAPARD OF APPEALS Riverhead, NY 11901 at a meeting of the Zoning Board of Appeals on October 2, 1981 was considered and the action indicated below was taken on your the appeal ( ) Request for variance due to lack of access to property ( ) Request for a special exception under the Zoning Ordinance (X)t Request for a variance to the Zoning Ordinance Art. III, Section 100-30 ( ) be d granted denied pursuant to Article ..M ( ) be ...,.., Section subsection .........,, Of the Zoning Ordinance and the decision of the Building lns for paragraph confirmed because Public Hearing held '8/6/81. i>ec ( ) be reversed ( ) br# Industries cor ., P.O., BOX 111, Riverhead, NY 11901,Applicationfor oa Var ancele to t:he ioninq Ordinance, Article III, Section 100_30 (A & B) for per- mission to use part of premises for Commercial docking and mooring. Location of Property: 10 Naugles Drive, MattittlCk, N"' bounded north by Petersen and Robinson; wrest by Naugles Road.; SOuth by McXenna; east by Mattituck Creek; County Tax Map it" No. 1000- 99-4-18. (owners of subject premises: Mr. and Mrs. m No M1000- - ney) . (SEE REVERSE SIDE) 2. VARIANCE,By resolution of the Board it was determined that (a) Strict applicatiinn of the Ordinance (would) (would not) produce practical difficulties hardship because or unnecessary (SEE REVERSE SIDE) (b) The hardship created (is) (la not) unique and (would) (would not) be shared by all properties alike in the immediate vicinity of this property and in the same use district because (SEE REVERSE SIDE) (c) The variance (does) (does not) observe the spirit of the Ordinance and (would) (would not) change the character of the district because (SEE REVERSE SIDE) and therefore, it was further determined that the requested variance ( ) be granted ( ) be denied and that the previous decisions Of the Building Inspector ( ) be confirmed ( ) be reversed. CG:lk FORM ZS4 ZONING BOARD OF APPF.ALgq In this appeal, Appellant seeks a variance to the provisions of Section 100-30 A & B of the Zoning Code to permit the use of property located in the A Residential and Agricultural District. for the purpose of docking its maintenance barge and work boat and; the use of the upland for the performance of maintenance and repair work.. All of the members of the Board have personally visited the site and are familiar with the property as well as the surround- ing neighborhood. The property in question is shown on the Suffolk County Tax Map as District 1000 Section 99 Block 4 Lot 18. It comprises 3.1 acres, is bounded westerly by Raugles Road. 240 feet and easterly by the shoreline of Mattituck Creek. its +Er �I7 frontage on Mattitupk Creek is approximately 500 feet. The northerly boundary line of the property line between C--1 Industrial done and the A Residential andoA riul- tural Zone. The Appellant has entered into a lease with the owners of the subject premises to lease approximately lQ0 feet of the shorefront for the mooring of its 85 foot by 40 foot.ZONING barge and its 65 foot work boat and parcel of upland adjacen ' OF A +p thereto (50' by 100") for vehicle parking and the performance of repair and maintenance operations consisting of machinery repairs, ,painting, acetylene cutting, welding and sand blasting. The remainder of the subject premises has located thereon three cottages and two trailers. The Appellant operates an off-shore tanker-berthing operation in Long Island Sound for the reception of petroleum products for its extensive petroleum tank farm. This operation is located in the Town of Riverhead, a considerable distance from the subject property. The variance sought by the Appellant is a use variance and, accordingly, unnecessary hardship must be demonstrated before this Board may grant such a variance. The hardship must relate to the property for which a use variance is sought. The courts have held that before a use variance may be granted upon the grounds of unnecessary hardship„ the record must show, by dollar and cents proof, that the land in question cannot yield a reason- able return if used only for a purpose allowed in the zone district in which it is located. No such proof has been presented. Ap- pellant s statements that mooring facilities are required for the conduct of its oil terminal operations at a site in the Town of Riverhead does not meet this requirement. Accordingly, on motion by Mr. Grigonis, seconded by Mr. Douglass, it was RESOLVED, that the appeal must be denied, without prejudice. Vote of the Board: Ayes: Messrs. lass Goehringer. Absent were: Messrs. Sawicki land 1Doyen ug(Fishersd Island) . APPROVED 0 RECEIVED _yND FILED BY Chairman Bard papeals THE SOUTHOLD TOWN CLERK DATE1%7/91 HOUR 'I.'3'/A hJ O Town err, Town of uthold • ..,e � <• � ..vim � COUNTY OF SUFFOLK " ' l4q)V11C DEPARTMENT OF PLANNING LEE E.KOPPELMAN DIRECTOR OF PLANNING October 8, 19KCEIV Mr. Charles Grigonis, Jr. , Chairman Town of Southold Zoning Board of Appeals JUN 2 5 2025 Main Road Southold, New York 11971 ZONING BOARD OF APPEALS Re: Application of "Northville Industries Corp." (#2833) , Town of Southold (SD-81-9) . Dear Mr. Grigonis: Pursuant to the requirements of Sections 1323 to 1332 of the Suffolk County Charter, the Suffolk County Planning Commission on October 7, 1981 reviewed the above captioned application and after due Study and deliberation Resolved to disapprove it because of the following: 1. Sufficient information has not been submitted to demonstrate compliance with applicable "use variance" criteria; 2. It constitutes an apparent circumvention of legislative powers exclu- sively delegated to the Town Board; 3. It would result in the further degradation of the character of the area surrounding Mattituck Creek; 4. Ample industrial zoned lands are available along Mattituck Creek; 5 It is inconsistent with the Long Island regional element of the N.Y.S. Coastal Zone Management Plan which identifies Mattituck Creek as a rAPC (C-eneral Area of Particular Concern) and designates this area for low density single family residence development; and 6. It is inconsistent with the Town of Southold Development Plan which designates this area for suburban single family residence development. Very truly yours, Lee E. Koppelman Director of Planning by GGN:jk Gerald G. Newman Chief Planner VETERANS MEMORIAL NIG.WAY • HAUPPAUGE.L.1.,NEW YORK 979-2920 6I Z20 � RECEIVED g ,.30Appendix B Short Environmental Assessment Form JUN 2 5 2025 Instructionv for Cotes actin. ZONING BOARD OF APPEALS Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part.L 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 neededto fully respond'to any item.,please answer as thorou,gbly as possible based can 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 an7_49l sor Information �" Naar eo Action Project: " 1 etaot'A La,"7'P d „'l Project Location describe,and attach a location map): Z BriefDescriptiorr of Proposed Action: qn GZ �/L ON/5 /0-t pexj Nbf 117 t�oP s� vi'i� S� �� a � � ey cz Use va Name of Applicant or Sponsor: Telephone: /" S El. Address:Address: City/PO: q / �lG State: Z de:. 1.Does the Proposed action only involve the legislative adoption of a plan,local lawn ordinance, admin istrative rule„ or regulation? NO YES If Yes,attac h a narrative description of the intent of the proposed action and the environmental may be affected in the municipality and proceed to Part 2. If no, continue to question 2 resources t hat 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; 3.a.Total acreage of the site of the proposed action? b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned acres or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. 9 Urban 9 Rural(non-agriculture) 9 Industrial 9 Commercial 9 Residential suburban . 9 Forest 9 Agriculture 9 Aquatic 9 Other(specify): 9 Parkland ( p ')' Page 1 of 4 RECEIVED CKI�' 5. Is the proposed action, NO YES rN/A a.A permitted use under the zoning regulations? JUN 2 5 2025 b. Consistent with the adopted comprehensive plan? y 6. Is the proposed action consistent with the predominant chara a ?Igmg ui t or natural NO I 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: 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? 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: X 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: X 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? 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? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. ldrtlfy the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: oreline ❑ Forest ElAgricultural/grasslands El Early mid-successional Wetland ❑ Urban ❑ Suburban 15.Does the site 1.of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO YES 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? &'NO ❑ YES b.Will storm water discharges be directed to established conveyance systems(run' f and storm drains)? If Yes,briefly describe: 2N0 ❑ YES Page 2 of 4 118,Doe ,Does the proposed action include construction or other activities that result if)tile impoundment of NO YES o r water or other liquid's(e,g,retention pond, waste lagoon,dam)? ther y a 'se If Yes,explain purpose and size: RECEIVED -21 25- 19,Has the site o e proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ZONING BOARD OF APPEALS 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing Dr No completed)for hazardous waste? YES If Yes,describe: I Ith I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Signature: Date: 40,J/ Part 2-Impact Assessment, The Lead Agency is responsible for the completion of Part 2. Answer all of tile fo owing questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or n 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 L Will the proposed action create a material conflict with an adopted land use plan or zoning occur occur regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 1 Will the proposed action impair the character or quality of the existing community? 4. Will the proposed actiave an impact on the environmental characteristics that caused the establishment of a Criticaon h l Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of trafficor affect existing infrastructure for mass transit,biking or walkway? ti. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasocaal ly available energy conservation o,renewable energy Opportunities? 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, archae ological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources quality, flora and fauna)? Page 3 of 4 No,or Moderate 0039 small to large JON 2 5 2025impact impact may may p occur � occur 10. problems?ro osed action result in an increase m the otential for erns. , a9 rV L Will the proposed p ion �cr � 11. Will the proposed action create a hazard to environmental resources or human health? Part -�eteorminawtlon+af'signi�icance. °°�""he Lead Aertcy is responsible for tfle completion of Part question in hart that tivas a,�swered"moderate to large impact may occur",or if"there is a need to explain whya attic . For eve ry eletmettt of the propo,sect act%on mayor will not result in a significant adverse r i environmental is al need act please particular Part should,„ in sufficient detail, identify the impacts including any measures or design elements that have been included b impact,p se complete Part: , the project sponsor to avoid or reduce impacts. Part should also explain how the lead agency determined may or will not be significant. Each potential impact should be assessed consideringits settin y duration, irreversibility, p g probability of occurring, that th Y geographic scope and magnitude, Also consider the potential for short-termon�g-term andring, cumulative impacts. 9 Check this box if you have determined, based on the information and analysis above,and an supporting that the proposed action may result in one or more potentially large or significant adverse impacts and an Y pp ng documentation, environmental impact statement is required. 9 Check this box if you have determined,based on the information and analysis above,and an supporting that the proposed action will not result in any significant adverse environmental impacts. Y pp mg documentation, 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 g Y Signature of Preparer(if different from Responsible Officer) Page 4 of 4 Board of i!,ii A eats A 11*.I O� RECEIVED 3 JUN 2 5 2025 (Where the Applicant is not the Owner) ZONING BOARD OF APPEALS I, residing at e AM4.,// kyll?j-z (Print property owner's name) (Mailing Address) do hereby authorize 61kt I CIO E `Ct- (Agent) I r -MA E&D. to apply for variance(s)on my behalf from the Southold Zoning Board of Appeals,. By signing this document,the Property Owner understands that pursuant to Chapter 280- 146(B)of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration,grant an extension not to exceed three(3)consecutive one 1 )year terms. IT IS TIIE PROpERTY OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE KITH T'HE CODF RF CIVET%TIME,FRAMP nrer—MBE HHP�I.N. nl. (Owner's Signature) BARBARA H.TANDY Notary Public, State Of New York No. 0 6001 �d Qualified Inn Suffolk Suffofolk Cvun'Ilr Commission Expires 7 (Print Owner's Name) APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORN90NING BOAft OF The Town of outhold's Code of Ethics rahibits conflicts of interest n the art of town officers and em le► ees.The PI oA S this form is to rovide information which can alert the town of neces ar to avpid same. ossible conflicts of interest and allow it to take whatever action is YOUR NAME : (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 Variance Building Permit Change of Zone Trustee Permit Approval of Plat Coastal Erosion Other(activity) Mooring 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 shares. officer or employee owtls more than 5'a/",of the YES NO _Z If you answered"YES",complete the balance of this form a d date and sign where indicated. f it 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 emplo ee. Either check the appropriate line A)through D)and/or describe in the space provided', y 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 day of ��t!G tl �- Signature '" BARBARA H'.TANDY Q 1 TASi)860 New York Notary Public,State Of Print Name �� .-G, allfled d f Commission Expires a Cotlr�ta�r '/S.NaO Town of Southold LAB RECEIVED 0,,,3f3 A. INSTRUCTIONS JUN 2 5 2025 L All applicants for permits* including Town of Southold agenciesF""proposed actions that are subject to the Town of Southold Waterfront Consistency his 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 Pe and other minister ial permits not located within the Coastal Erosion osi n fla, ard, r e units 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations ofeach 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 oi'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, determination that it is consistent to the maximum extent practicab eowiith t ei L VW pol ar 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# The Application has been submitted to(check appropriate response): Town Board ❑ Planning Dept. ❑ Building Dept. ❑ Board of Trustees ❑ 1• Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation,land transaction)❑ (b) Financial assistance (e.g. grant, loan, subsidy) ❑ (c) Permit, approval, license, certification:❑ Nature and extent of action. P i 7 Location of action: Site acreage: . RECEIVED Present land use: ✓' ," ir Present zoning classification: 0 PE,ALE 2. If an application for the proposed action has been filed with the Town of Southold information shall be provided: hold agency, the following (a) Name of applicant: -Z ' (b) Mailing address: : j�� , �� (c) Telephone number:Area Code( (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal ag ency? Yes ❑ No" If yes, which state or federal agency9 I EWl L+1 DPP,n d-nASLP-0 11CYY Policy 1. Foster a pattern of development in the Town of Southold that enhances communitycharacter, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal ocation,and Minimizes adverse effects of development. See LWItp Section III—Policies; Page 2 for evaluation criteria. RYes ❑No ❑Not Applicable , ' Attach additional sheets if n cessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. S LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ee 0 Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No ❑ Not Applicable oo Attach additional sheets if necessaryJUN 5 2025 NATURAL COAST POLICIES ZONING BOARD OF APPEALS Policy 4. Minimize loss of life,structures, and natural resources from flooding and erosion. Section III—Policies Pages through 1.6 for evaluation criteria See LWRP Oycs El NO ❑Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes ONO ❑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. g ❑Yes ONO XNot Applicable Policy 7. Protect and improve air quality in the Town of Southold. See LWRP S Pages 32 through 34 for evaluation criteria. ection III — Policies Dyes ❑No Not Applicable Attach additional sheets if necessary ZONING BOARD OF APPEALS Policy S. Minimize environmental degradation in Town of Southold from solid waste substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation c criteria. hazardous ❑Yes ❑ No eria. Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III —Policies; Pages 38 through 46 for evaluation criteria. ❑Yes ❑ No xNot 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. 0 Yes ❑ No Not Applicable Policy 11. Promote sustainable use of living marine resources in Lon lslan d Sound,I'ecouic lstuary and Town waters. See LWRP Section III—Policies; Pages 5 through 62 for evaluation criteria. ❑Yes ❑ No ` Not Applicable RECEIVED Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Sectio Pages 62 through 65 for evaluation criteria. n III—Policies; ❑Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No Not Applicable Created on 5125105 11:20 AM RECEIVED IJUN 2 5 2025 a ow w j I l i 1 f � Jpk f i I'r i 1, fr, it E ✓ q r I „ M 1 ': ,' },. 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