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#8041-Varello ZBA application
v e d FORM NO. 3 ,JUL, 01 2025 TOWN OF SOUTHOLD BUILDING DEPARTMENT ZorlifIg Board of AppPa�S SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: May 29,2025 REVISED: June 17,2025 REVISED: June 24,2025 TO: John Bracco, Architect(Varello) 111 Railroad Avenue Sayville,NY 11782 Please take notice that your application received April 22, 2025: For permit to: Construct additions to an existirj4p sin le f61A1i_1Y4±_W11C1li110 aL Location of property: 1130 Oak Avenue.._Souftold NY County Tax Map No. 1000—Section 77 Block 1 Lot 8 Is returned herewith and disapproved on the following grounds: The rgonoqs�edcoi�st zx oh phis nonconfbrqi 1 j._,200 qq. f(,_parcel in the Residential E.40 Qistr�ic is npA t rsuant to Article XX�1115, ection 28-0-124whicb.,states: —, _ lots rraeascirin 7 less then 0 t}Q0 sc�ua°e feet into sizc_x ui�r a znir in us lz nt ar+ setback of 35 feet. The site plan shows flig_p,rpp front 9§,gd additions to have a setback of 32.9 feel from the ya 142�q line. Additionally the construction is not permitteoTussuant to Article XMI Section 280-- 207A( ), which stags; "the toss floor area shall not exceed calculaLed as follows, Lots coiftinii , 101 t100 sq iar feet of lot area-, 2.100 sQuare feet maximum. Yhis parcel sqMaLJ4!j a_buildable area of QLAq ft,the existing hornebasaGFAof.3,269 Lastly.pursuant Xol�Lc located within the 5,jk- plane. The,building Ian$ind—i—ca—te—a—portion-of_the structure to toe beyond the,limits plane. Authorized Signature Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file,Z.B.A. *Town of Southold Trustees Administrative Wetlands Permit is additionally required for the project Received APPLICATION TO THE SOUTHOLD TOWN BOARD OF AMAt 2025 AREA VARIANCE, �', g f Appea% House No. 030 Street 04 —Hamlet 6 -4 IV,5,- Gee 0 SCTM 1000 Section:11 Block: -,Qcr U - _t_LoJ(s)__P Lot Size. d 4 S zone I (WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR .DATED BASED ON SIJ.RVEV/Sl'['.E PLAN DATED Owner(s): 0.�by //V / O JO 4,W41 7.7f e 111171 q d ;p-- el,y Mailing Address: 4_s /# 'Telephone: N� 7 Fax:-- Email: 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: for Owner Other. Address: J I I QCL,,I (-vac j)e- Scuff U C. A,)tj Q-7192-1, Telephone: Gs I.5 X: Email.,_�Okv\txctcc bo, _W a Please check io.spec?fy P41h' ynu h -evpandence M,be mailed tofronj the above narnes. kpplicant/Owner(s), Authorized Representative, Other Name/Address below: Willi'RE BY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED 9L,5- and DENIED AN APPLICATION DATED FOR: uilding Permit O Certificate of Occupancy O Pre-Certificate of Occupancy O 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.) Section-, 9y)-ou Subsection; Type of Appeal. An Appeal is made for: ( 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 Request for Reversal or Overturn the Zoning Officer's Denial Other A prior appeal has, (0/h�as not been made at any time with respect this f9roperty, UNDER Appeal No(s).___4el_j)r Year(s). Al A- (Pleose be siere to research before completing this question_or f'1711 Our 0)fice fin,assistante) Page 2,Area Variance Application Revised 6,%2023 :> I REASONS FOR APPEAL (Please be specific,additional sheets may be used with preparer's signature notarized): J U L 01 2025 1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted,because: Zoning Board of Appeals `Provo-s.EG( POPy ►u5 0.66t'-v ►o,� (ive 1 I gt ew Ltr.® 2.The benefit sought by the applicant CANNOT be achieved by sonic method feasible for the applicant to pursue,other than an area variance,because: -b-, PCB V5z e S a E t -e-c�y C 6®S-oe +C) &t^-L o�.1-- y ovrd �.e4 3.The amount of relief requested is not substantial because: --Fn4L ? 4CO f o S-eeP LDO o o c, 4- T r®p rr ►-,.y L_v e_ - v► -t�-`- 4_The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: . We-- v y s M C�,1i r`-3-at V` Cl d V►-OV'7 s S.Has the alleged difficulty been,self created? 4 Yes,or ( ) No Why: ft)? ® .Are there any Covenants or Restrictions concerning this land? h4No ( } Yes(please furnish a copy) 9 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. 41 By signing this document,the PROPERTY OWNER under. ®at pursuant to Chapter 280- 146(B)of the Code of the Town of Southold,any variance ` by the Board of Appeals shall become null and void where a Certificate of Uceupancy een procured,and/or a subdivision map has not been filed with the Suffolk County CIcr1� ' hree(3)years from the date such variance was granted. The Board may,upon writte t prior to the date of expiration,grant an extension not to exceed three(3)consecutive on ,,a.p_.—� r terms. IT IS THE P.ROP.ERTY OWNER'S RESPONSIBILITY TO ENSURE COi ONCE WITH THE CODE REQUIRED TIME FRAME'DESCRIBED HEREIN. Signat4mst pplicant or Authorized Agent (.Agent ubmit written.Authorization from Owner) Sworn to before me this I�7 day of Notary Public NANCY L. CAMP )VOTARY PUBLIC My Commission Expires May 31,2026 Zoning Board of Appeals Received APPLICANT'S PROJECT DESCRIPTION JUL 0 12025 APPIACAN'r- V6 SCTM No. q �.Kqli 17v) "),1'-"--/1'--KQ L011111Y LJ �'- 1.For Demolition of Existing Building Areas Please describe areas being removed: 11. New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: —/A - --- Dimensions of new second floor: &h. CL -C>O<C',4er. -To4af� -131 9 Dimensions of floor above second level- /V* Height(from existing natural grade):... Is baseawrit or lowest floor area being C01IStrLWtCd'?If yes, please provide licl_d, it(above ground) measured from natural existing grade to first floor: Al P 111. Proposed Construction Description(Alterations or Structural Changes) (.Attach extra sheet if necessary). Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: -C' Number of Floors and Changes WITH. Alterations: -seco—ck - r—loor -Sked Mart--n,ew5 -to4--Y,11%nA P4- IV. Calculations of building areas and lot coverage,sky lane(From Surveyor, Design Professional): Existing square footage of buildings on Your property: Proposed increase of building coverage: _ 0 Square footage of your lot:_j 100 S / AXI_Percentage of coverage of your lot by building area(lot coverage) 410 76 Gross Floor Area(GFA)of single family dwelling including the attached garage and/or habitable detached accessory structure: (Please refer to Chapter 280, Section 280-207 of the Town Code): For Residential lots,IS PFOjCCt Within the allowable Sky Plane? (Please refer to Chapter 280, Section 280-208 of the Town Code): V. Purpose of New Construction: I0 A'110o -Coy- n 1 ,4414 04"—seca'd Htcw fV 0 r" CX'r,0 -T0 st-% I cw-ct 'e, �x Is 00 V- E2 aj-h-z�-- Vt. Please describe the land contours(flat,slope 'Yo, 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: LZvCj C-�o"4our5_jarr-r— v) cA- zA,t-'-C' :11te- p 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. Revised 6/2023 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION Received A. Is the subject premises currently listed on the real estate market for sale'? JUL 0 12025 Yes No B. Are there any proposals to change or alter land contours? Zoning Board of Appeals, No Yes,please explain on separate sheet. C. 1.) Are there areas that contain sand or wetland grasses? plic 2.)Are those areas shown on the survey submitted with this application'?__1 3.) Is the property bulk headed between the wetlands area and the upland bAding area'? Wz 4.) If your property contains Actlands or pond areas, have you contacted the Office of tile BOARD QFTRIJs,rEES for its determination of jurisdiction? Please confirm status of your inquiry or application with the Board of Trustees: I k 4 we If issued,please attach copies or your permit listing conditions of approval with a*copy of Q Ify i the approved survey. ft moo OF D. Is there a depression or sloping elevation near the area of proposed construction at or rv-L)_S+ea below five.l.'ect above mean sea level`? /1'D B. Are there any patios.,concrete barriers,, bulkheads or fences that exist that arc not shown on the survey that you are submitting?_ IV'd If any of the aforementioned items exist on your property,please show them on a site plan. K Are there any construction projects currently in process on your property? 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 prerniscs. 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.? If yes, please label the proximity of your lands on your survey and identify the Suffolk County'Fax Map No. 1. Please list present use or o,�erations conducted at your property, and/or the proposed use 'gy,_V9;4^cj i k-)CyLe_ IV -Zes e cpen,ae fo Seell S' _e__ J. (examples:existing_simg<—family,proposed:same with garage,pool or other) Authorized signature Date TOWN OF SOUTHOLD Received BUILDING DEPARTMENT office of the Building Inspector Town Hall JUL. 0 12025 Southold, N.Y. Zoning Board of Appeals, CERTIFICATE OF OCCUPANCY Not 2-24188 Date; 03/05/96 THIS CERTIFIES that the building DWELLING Location of Property: 1130 OAK AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax map No. 473889 Section 77 Block I Lot 8 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1995 pursuant to which Building Permit No. 22880-Z dated JULY_12_L 1995 w&8 issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is REPLACE EXISTING SEASONAL DWELLING WITH A NEW SINGLE FAMILY DWELLING AS APPLIED FOR & To THE CONDITIONS OF THE TOWN TRUSTEES, DEC & HEALTH DEPT. The certificate is issued to ROBERT J & PATRICIA NELCHIONE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RI0-95-0050 10/18/95 ELECTRICAL CERTIFICATE NO. N-379398 03/05/96 PLUMBERS CERTIFICATION DATED 02/28/96 FRANK MEYER Building llnispptor Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT Received d Office of the Building Inspector r Town Hall Southold, N.Y. .JUL U 12025 CRRTIFICATE OF OCCUPANCY Zoning Board of Appeals No: 2-26564 Date: 07/15/99 THIS CERTIFIES that the building ALTERATION Location of Property: 1130 OAK AVE SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 77 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Buildings Permit heretofore filed in this office dated JUNE 1, 1999 pursuant to which Building Permit No. 25768-Z dated JUNE 2, 1999 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is SECOND FLOOR ATTIC ALTERED To BEDROOM "AS BUILT" AS APPLIED FOR. The certificate is issued to ROBERT J & PATRICIA MELCHIONL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE No. 28840^ 06/30/99 PLUMBERS CERTIFICATION DATED N/A Building Ins9ector Rev. 1/81 AGRICULTURAL DATASTATEMENT ZONING BOARD OF ARP EALS TOWN OF SOUTHOLD Received WHEN TO USE THIS FORM: This form must he completed by the applicant for any special use l permit, site plan approval, use variance, area variance or subdivision approval oil p er M11 * an agricultural district OR within 500feet of ajarm operation located in an agricultural istrict. All applications requiring an agricultural data statement must be referred to the Suff olk Cou q,, p )A' Ls ea le P Lam 1. Name ofApplicant: '73;ov-,0 P)Caaz� 2. Address of Applicant: I I I Rar I ru--Cl (Avg-- ISO-1114 LA 3. Name of .and Owner(if other than Applicant): -V 4qx"-1 to 4. Address of Land Owner: X)D DC -+-- 'FQ"-k- -7 S L 5. Description of Proposed Project: 6. Location of Property: (Road and Tax map Numbcr) nCL-K Atle— Oc4 PO - -7'7-1- 5 7. Is the parcel within 500 feet of a farm operation? { .} Yes VINO 8. Is this parcel actively farmed? 1 1 Yes tl'(No 9. Name and addresses of any owner(s) of land within the agricultural.district containing active .farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning Board Staff, it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office(765-1937) or from the Real Property Tax Office located in Riverhead. NAME and ADDRESS 1. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) Signatt e of Applf ant, Date Note: I. 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. F,-ieceived 0 Board JUL 0 12025- OWNER'S AUTHORIZATION Zoning Board of Appeale (Where the Applicant is not the Owner) residing at (Print property owner's.name) (Mailing Address) V do hereby authorize -Jel 0 (Agent) 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 THE PROPERTY OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE WITH THE CODE REQUIRED TIME FRAME DESCRIBED fIEREIN. Ake (0 �n_Ys Signature) (Print Owner's Name) Received JUL. 0 12025 �,u A� APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORINyoning Board of AppeaW- The Town of Southold's Code of Ethics prohibits conflicts of interest on the Dart of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflict-.;of interest and allow it to take whatever action is necessary to avoid same. YOURNAME : (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.APPLICA.11 ION: (Cheek all that apply) 'Fax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes- by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(of employment by)a corporation in which the town officer or employee owns more than.9%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 applicantiigent/i-epresentative) 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(,%Yhcn the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Z . , Submitted this day o Signature Print Name Receiver! JUL 0 1 2025 4�A� Zoning Board of Appeals AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrobibits conflicts of interest on the vart of town officers and emplolves The purpose of this form is to provide information which can alert tile town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same, YOUR NANJE V�YO TL (.Last name,first name,middle Initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance -----� Trustee Permit Change of Zone _ Coastal Erosion .Approval of Plat Mooring Other(activity) Planning _ Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial nwnership 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(late and sign where indicated. Nance of person.employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/ageiit/representative)and the town officer or employee. Either check the appropriate line A)through D) alit(/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 mvmer of greater that 3��i of the shares of the corporate stock of the applicant(when the a licatiI is`a w�. rpp'-_r_ { lip 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 Or RELATIONSHIP _ cc n I.A-ecx- submitted this day of Mfg( ,20 01*51 Signature fi 6:", Print Name �b hn L 61Z20 Appendix B Short EnWronmental Assessment Form Received Instructions for complel!UI JUL, 0 12025 Part I -Project Information. The applicant or project sponsor is responsible for the cornplC Va"r&VOAPPealc- become part of the application for approval or funding,are subject to public review, and may be sIXt t6further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fillty 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 I -Project and Sponsor I nformation Name of Action of Project: VCA Crn Project Location(describe,and attach a location map): llq?l t3riet'Description of Proposed Action: L 11 7, 5cl P Name of Applicant or Sponsor: Telephone: �To E-Mail: Address: i / I Ra t'I Tz-ocd Aw- City/PO: Zip Code: SQLW1 (r?B-z- 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: i k1 I/I ei Tell-(n a.kTotal acreage of the s ite of the proposed action? acres b.Total acreage to be physically disturbed? acres c Total acreage(project site and any contiguous properties)owned . V of controlled by the applicant or project sponsor? acres 4. Clieck all land uses that occur on,adjoining and near the proposed action, 0 Urban 0 Rural(non-agriculture) El Industrial 0 Commercial /Residential(suburban) r-1 Forest F1 Agriculture quatic ri Other(specify): 11 Parkland Page I of 4 5, Is the proposed action, NO YES N/A a. A permitted use tinder the zoning regulations? h.Consistent with the adopted comprehensive plan 6, is proposed the ro action consistent --- — — -- ---- --- �-� ` — ---- _ — --�—— p p ent with the predominant character of the existi , (8 �,t NO YES landscape`? X 7. Is the site of the proposed action located in,or does it adjoin,a state listed Criticaljutvioptf,,M Area? NO YES If Yes, identify: --- _ — c 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? K 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; 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable eater: 11, Will the proposed action connect to existing wastewater utilities? NO YES If tio,describe method for providing wastewater treatment: ------ -- ---- 12. a.Does the site contain a structure that is Listed on either the State or Rational Register of Historic NO YES Places? h..Is the proposed action located in an archeological scnsitivc area? 13, a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody" 1 If Yes,identify the wetland or waterbody and extent ofalterations in square feet or acres: i 14. Identify the typical habitat types that occur on,or are likely to be found.on the project site. Check all that apply: 0 Shoreline 0 Forest ® Agricultural/grasslands ® Early mid-successional 14 Wetland 0 Urban AStiburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered'? 16.Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create stone water discharge,either from point or nota-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? C NO 0 YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: 0 NO EJ YES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment1� 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: Zoning Board of App2a 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: _ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Z, ^ � C)b Date: b //0 Signature: y Part 2-Impact Assessment. The Lead agency is responsible for the completion of Part 2, Answer all of the following questions in.Part 2 usin.g 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 te, 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? t Will the proposed action result in a change in tite 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 hnvironmental Area(C'FAV 5. Will the proposed action result in an adverse change in the existing level of traffic oi- 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, watcrbodies,groundwater, air quality,flora and fauna)? Page 3 of 4 No,or Moderate Recelved, t small to large impact impact may may y: occur occur 10 Will the proposed action result in an increase in the potential for erosion,'lo�odiint �or�d#Pwe problems 11. W ill 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 fart 3. For every question in Fart 2 that was answered"moderate to large impact may occur",or if there is a need to explain why it 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 redtice impacts. Part 3 should also explain hove 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. o 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 detennined, based on the infonnation and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Flame of Lead Agency hate Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Prepares GC different from Responsible Officer) Page 4 of 4 Town of Southold r Pi V aR , A 1,WRP CONSISTENCY ASSESSMENT FORM JUL 0 12025 A. INSTRUCTIONS Zoning Board of AppeaI6 1. All applicants for pen-nits* 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 inchidim Building Permits and other ministerial pennity 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 rriaking 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 (soutlik)ldtowti.northfor.k.iiet), 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#V=- -) '7 - / - L The Application has been submitted to(check appropriate respon Town Board [] Planning Dept. Ed Building Dept. K� Board of Trustees I 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) Pen-nit, approval, license, certification: Nature and extent o faction: . -poildin Location of action;— Site acreage: Receiv d Present land use: 44 2025 Present zoning classificatlon.:-A) - Zening Beam-of Appeals 2. If an application for the proposed action. has been filed with the Town of Southold agency, the following information shall.be provided: y_1a5O q (a) Name of applicant (b) Mailing address: `_"11 1,6 6%ollel-lew (c) Telephone number:Area Code 6j�-�— -;Iel 3 04P �719 (d) Application number, if any: 63) Will the action be directly undertaken,require funding, or approval by a state or federal agency? YeSEI Nob& If yes,which state or federal agency? DENTUDPED COAST POIACY 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 Ill -Policies; Page 2 for evaluation criteria, Yes No V-tot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section Ill-P icier Pages 3 through 6 for evaluation criteria Yes D No LV Not Applicable /V Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III— Pages 6 through 7 for evaluation criteria H' ved D Yes F No Applicable ecei /r� JUL 0 i LUO Zoning Board of Appeals Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. NlinhWze loss of life, structures, and natural resources from flooding and erosion. See LW RP Section III—Policies Pages 8 through 16 for evaluation criteria Yes [] No P Not Applicable A/ ............ Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section [it Policies Pages 1.6 through 21. for evaluation criteria Yes R--- No T Not Applicable 'V V 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 LW RP Section III —Policies; Pages 22 through 32 for evaluation criteria. Yes 0 No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Rec i I I D Yes R No Not Applicable AlI JUL 0 1202) Z A Zoni ng 603-1 Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section :III —Policies; Pages 34 through 38 for evaluation criteria. E] Yes 1:1 No Not Applicable A2 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. D YeLl No Not Applicable ,N Attad)additional sheets if necessary WORKING COAST POLICIES Poliev 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 [:1 NoEl Not Applicable .—A Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long IslanC-SWMA (th6WM6ic Estuary and Town waters. See LWRP Section It —Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes 1:1 NOr Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for eval 91jon criteria. E] Yes 1:1 NVVrNot Applicable lu Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LW RP Section III—Policies; Paces 65 through 168 for evaluation criteria. El Yes 1:1 No Not Applicable Created oti 5125105 11:20 AM THE VAREUEO RESIDENCE Receive(' \ 1130 Oak Avenue Southold, New York JUL 01 2025 ; Zoning Board of AppealF o- I = My TJ�S f a� 7 a i rst f he4_ •. C 1 � `� art 7 '^' ' �.�`6 N 6.* of c x TOWN OF SOUTH OLD PROPERTY RECORD CARD STREET VILLAGES - - -DISTRICT _SUB, f LOT _ FORMER OWNER N ; E ! ACREAGE I z �I r S W TYPE OF BUILDING ly - _ ` , f SE/�S� VL. rRM comm. _ IhID CB, MISC. Est. Mkt: Value LAND IMP. TOTAL DATE REMARKS r r r, �. Ln I r 3 6 r , NEW „ N© tAl=- iz oV '� i ''ABOVE ' FRONTAGE ON WATER r� sF E Farm Acre l Value Per Acre Value FRONTAGE ON ROAD Tillable I f I BULKHEAD Tillable 2 i DOCK i . Tillable 3 Woodland Swampland Brushl'and ( o �,.� 'r�., ._ " r•3 � �: . �t 6 r t _- __- -___ ___—_-- . __ _.. _._.__-- __. ........ — House Plot $ _ y :........._...._ .. .. .. ... -__-.—_-_—... 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