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HomeMy WebLinkAbout#8070-Touhey ZBA Application FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. Received NOTICE OF DISAPPROVAL OCT 0 7 2025 DATE:March 4,20oning Board of Appeals Renewed: July 18, 025 Revised/Renewed: October 2,2025 TO: Evan Touhey 1955 Albertson Ln Greenport,NY, 11944 Please take notice that your application dated November 20, 2023: For permit to: le line an "as built" Doo ouse acces^so to are existi:ng si le-famil dwelling_at: Location of property:195 5 Albertson Lane, Greenport,NY County Tax Map No. 1000—Section 52 Block 5 Lot 56 Is retumed herewith and disapproved on the following grounds: The 327 s . ft. p ool house on this 32.146.88 saft. parcel, in the'Rlesidential R-80,is not ermined pursuant to Article 111 Section 280-15 which states accessory buildin s and structures on logs between 20,000 and 39 999 s ..ft. shall mainta"n minim rear and side and setbaclrs of 10 feet. Thepool house has a side yard setback of 8.9 feet. C) Authokized 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,ZBA WO APPLICATION TO THE SOI.I'I"I-IOLD TOWN BOARD OF AIW •ved AREA VARIANCE OCT 0 7 2025 House NoA55 Street AL5E9_,Tc5O N L.Wr,; Hamlet too Ord of Ap �81: SCTM 1000 Section: 52 Block: S Lot(s) S� Lot Size:3z '* Zone K" tt, I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED rA AMtfr 41 20 kj__BASED ON SURVEY/SITE PLAN DATED bcr• 2 2023. Own er(s):_ "fit N 700 H E Y Mailing Address: 20 q W• -1 Z 1*l Sr. ^1 5 10025 . t-qt?-6�F8-� • . e_40V ke_ nrLai l . Corn Telephone. ax: 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: -�0AIIJ C E r� S for(Owner( ) Other: Address: ?.O - 5 0 k '4• °� SOU Tj_WI,D M (,a-I I Telephone -Sk 4 Fax: Email: "jCngi arrAoe_q 60 C ,nXL;(.Cam Please check to speck who you wish correspondence to be mailed to,from the above names: ( )Applicant/Owner(s), JKAuthorized Representative, ( )Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED 1 0.2 - 2 3 and DENIED AN APPLICATION DATED 10.2D.23• FOR: ( )Building Permit Certificate of Occupancy ( )Pre-Certificate of Occupancy ( ) Change of Use N Permit for As-Built Construction ( )Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do not quote the code.) Article: Section: 'LSO-I';' Subsection: Type of Appeal. An Appeal is made for: 01 A Variance to the Zoning Code or Zoning Map. ( )A Variance due to lack of access required by New York Town Law-Section 280-A. ( )Interpretation of the Town Code,Article I'llSection ( ) Request for Reversal or Overturn the Zoning Officer's Denial Other A prior appeal ( )has, 0 has not been made at agy time with respect to this ro nr UNDER Appeal No(s)._ Year(s). (Please be sure to research before completing this question or call our office for assistance) 'F L El6 E 5 Ee Page 2, Area Variance Application 1 3� At-4- Revised 6/2023 t {deceived REASONS FOR APPEAL OCT 0 7 2025 (Please be specific,additional sheets may be used with preparer's signature notarized): 1.An undesirable change will not be produced in the CHARACTER of the neighborZwr2ird9trftn"tof Appeals nearby properties if granted,because: 2. The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to pursue, other than an area variance,because: 3. The amount of relief requested is not substantial because: 4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: 5. Has the alleged difficulty been self created? { }Yes, or { } No Why: m Are there any Covenants or Restrictions concerning this land? { }No { )Yes(please furnish a copy) + This is the MINIMUM that is necessary and adequate,and at the same time preserve and protect the character of the neighborhood and the health,safety and welfare of the community. 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 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 HEREIN. Signature of hcant or Authorized Agent (Agent must submit written Authorization from Owner) Sworn to before me this oQ(o* - day of Ava u,5+ ,20 o2 Tr ACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 Notary is n'J!.LIFIEO IN Slit=FOLK COUNTY COMNSSION EXPIRES JUNE 30, A'cTA<L+-rWe N-r -W-I 1955 Albertson Lane Received G • -10 Southold OCT 0 7 2025 1000-52-5-56 7.16.25 Zoning Board of Appeals 1. An undesirable change will not be produced in the character of the neighborhood or a detriment to nearby properties if granted, because: The Certificate of Occupancy for this property that was issued on November 24, 1992 was for an "Accessory Storage Shed" and although the old survey that accompanied this CO does not show the setback dimensions it is clear that the shed was very close to the east side property line. The CO and Survey are included in this application as "Attachment#2". There was a Pre Existing Certificate of Occupancy issued on September 17, 2003 that did not mention the accessory structure but a rudimentary survey was included that shows a rectangular garage along the East property line. The CO and Survey are included in this application as Attachment#3. There is a Certificate of Occupancy issued July 15, 2023 that does not list the accessory structure but the Site Plan that accompanied the application for that CO includes dimensions to the east property line from the accessory structure of 8.3' and 8.5'.The CO and Site Plan are included in this application as Attachment#4. It appears that there has been an accessory structure in that location for thirty three years without any noticeable detriment to the adjacent property. It should also be noted that the property is well landscaped and maintained and the neighbors are afforded privacy and a pleasant view from their yard. 2. The benefit sought by the applicant cannot be achieved by some other method feasible for the applicant to pursue, other than the area variance because: The current accessory structure was placed in the location of the prior structures assuming that it was within the zoning code requirements and to relocate it would cause a significant financial burden on the homeowners. 3. The amount of relief requested is not substantial because: The required setback is 10'-0" and the current setback at its closest point is 8'-10"which means that the structure is 14 inches too close. 4. The variance will not have an adverse effect of impact on the physical or environmental conditions in the neighborhood or district because: The neighborhood has similar homes with accessory structures and there is no impact on the environment noted. 5. Has alleged difficulty been self created? The difficulty was self created in the contractor assuming that the prior accessory structure was located correctly. Zoning Board of Appeals AQ), APPLICANT'S PROJECT DESCRIPTION TOAQ C 44MFE(ZS FOR Received APPLICANT: OVA N -Touoe"'r SCTM No. �00` 52 -Vk'I V 1.For Demolition of Existing Building Areas Zoning Board of Appeals Please describe areas being removed: N 'rz onl II.New Construction Areas (New Dwelling or New Additions/Extensions): ACCE 50 X-t ST lUCCURE �/ Dimensions of first floor sien: ( '-q 2-t1F 201-q 2- u Dimensions of new second floor: 0 ZIJO F L . Dimensions of floor above second level: No, a Height(from existing natural grade): t l -3 Is basement or lowest floor area being constructed? If yes,please provide height(above ground)measured from natural existing grade to first floor: 0 AGEr+ C-41iT 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: l-f A� Number of Floors and Changes WITH Alterations: N IV. Calculations of building areas and lot coverage,sky plane (From Surveyor,Design Professional): Existing square footage of buildings on your property: 1 qT.53 Proposed increase of building coverage:_ 3," !*_ Square footage of your lot: 1 2 J 1 Percentage of coverage of your lot by building area(lot coverage) 6.7V P 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): r4 )k For Residential lots, is project within the allowable Sky Plane?(Please refer to Chapter 280, Section 280-208 of the Town Code): 1nEET5 K W co fZREri'r LO C'kT10rd V.Purpose of New Construction: F00(_ nou6e 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: FLAT 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 e A. Is the subject premises currently listed on the real estate market for sale? Yes _V No OCT 0 7 22 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?_ N V 2.)Are those areas shown on the survey submitted with this application? NA 3.)Is the property bulk headed between the wetlands area and the upland building area? A 4.)If your property contains wetlands or pond areas,have you contacted the Office of the BOARD OF TRUSTEES for its determination of jurisdiction? Please confirm status of your inquiry or application with the Board of Trustees: bJQT C-ke Q 0(1REo - 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? N V E. Are there any patios, concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? N 10 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? N a 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? N o 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 It-.;Ktt:dT- r3 k n1G 'P`I (A tt-. R mace ft)OLw J. (examples:existing single family,proposed:same with Aarage,pool or other) 'POOL- KUVWF- -7.VI. 20 257 Authorized sig al Date A-CTACti M FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Received Office of the Building Inspector Town Hall OCT 0 7 2025 Southold, N.Y. Zoning Board of Appeals CERTIFICATE OF OCCUPANCY No Z-21180 Date NOVEMBER 24 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 1815 ALBRRTS+ON LANE GRR iERT N.Y. House No. Street Hamlet County Tags Map No. 1000 Section 2 Block 5 I,ot 56 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOB"ER, 6 1992 Pursuant to which Building Permit No. 21012-Z dated OCTOBER 9 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY STORAGE SBED AS APPLIED FOR.. The certificate is issued to MARIE CASSIDY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ALA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N A Building Inspector Rev. 1/81 , � o Received �. GCI T 07,12025 M r .. atiIC( till" " ,.° 1 -77777 V— " , " " _ " a " rq " , P P r w e A x5.l a. r .a �, r t .•.3F a"W "'"r;rC�C ��w�'v r r 1, FORM NO. 4 A-TTP,,-c{-t Ma\ t 4 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Received Town Hall Southold, N.Y. OCT 0 7 2025 PRE EXISTING Zoning Board of Appeals CERTIFICATE OF OCCUPANCY No! Z- 29717 Date: 09 17 03 THIS CERTIFIES that the building DWELLING (aka 1815 Albertson Lane) Location of Property 1955 ALBERTSON LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 052 Block 0005 Lot 056 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 29717 dated SEPTEMBER 17, 2003 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 ONE FAMILY DWELLING WITH OPEN FRONT PORCH SIDE SCREENED PORCH AND SIDE DECK.* The certificate is issued to CAROLE M CASSIDY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N/A PLUMBERS CERTIFICATION DATED _N/A *PLEASE SEE ATTACHED INSPECTIO P T. CIO" . Au hors ed Sign re Rev. 1/81 i r - i r . '� • , Uwihwmdmhm Nahum Art � .rrmac P j v j p a r3 .. N.ss•se w, vAacea ri MA P of LAND ' TWO +_ (6.60S MARIE CASSIDY •• � N At �` � AQ sSH,fie+gO,ti4A6uE �i � TOWN GF .50tJ7'/•la�p� N, Y. 9 b - b ` •. �� 1 � h !� s. OCD rifle Na. IZ91-480 n � 1 —' C® €3 O • wets to r1ye Tr 1e aumvillee 4co . , I976 } t 6r�aart N.y. BUILDING DEPARTMENT TOWN OF SOUTHOLD L0USk.1j CODE INSPSC'E ON REPORT (aka 1815 Albertson Lane) LOCATION: 1955 ALBERTSON LA GREENPORT ........ Received SUBDIVISION: NAP NO.: LOT (S) NAME OF OWNER (S): CAROLE M CASSIDY OCT O 1 ZOZJ OCCUPANCY: SINGLE FAMILY CAROLE M CASSIDY ADMITTED BY: MARGARET - HOME HEALTH AID ACCOMPANIED BY: SAME Zoning Board of Appeals KEY AVAILABLE: SO". CO. TAX MAP NO.: 52.-S-56 4 CASSIDY SOURCE OF REQUEST; CAROLE M LASS DATE: 09 17 03 DWELLING: TYPE OF CONSTR17CTTON: WOOD FRAME N STORIES: 2.0 $ EXITS: 4 FOUNDATION: BRICK CEI•TaR: PART CRAWL SPACE: TOTAL ROOMS: IST FLR.: 4 2ND FLR.: 4 3RD FLR.: _.0 BATHROOM(S): 2.0 TOILET ROOM7(S): 0.0 UTILITY ROOM(S): PORCH TYPE: FRONT OPEN/SIDE SCREENED DECK TYPE: SIDE PATIO TYPE: BREEZEMIAY: FIREPLACE: ®Ao GARAGE. DOMESTIC HOTWATER; A TYPE BEATER: OFF BOILER AIRCONDITIONING: TYPE BEAT: OIL WARM AIR: HOTWATER: X OTHER: ATTIC. SIDCO CELLAR ENTRANCE ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.. mm_ STORAGE, TYPE CONST_: SWIMING POOL: GUEST, TYPE CONST.: OTHER: ..... VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. I I I I � N I N I I N � I I IN I I I I p, I N L k ! I i I fl I I N p I I RE24ARKS: s:P 2 12 ED =211.80 Re-inspected 9/12/073. INSPECTED BY: DATE ON INSPECTION: 08 01/03 7LN M BODFIS TI!!E START: 9:35AM END: 10:15AM A-t-t-�crtme•r� 4- 1 Town of Southold 7/15/2023 P.O.Box 1179 53095 Main Rd Southold,New York 11971 m Received CERTIFICATE OF OCCUPANCY OCT 0 7 2025 Zoning Board of Appeals No: 44290 Date: 1/15/2023 THIS CERTIFIES that the building ADDITION/ALTERA.TION Location of Property: 1955 Albertson Ln.,Greenport SCTM#: 473889 Sec/Block/Lot: 52:5-56 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit,heretofore filed in this office dated 6/1/2022 pursuant to which Building Permit No. 48036 dated 7/l/2022 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: additions 'on to existing sinel family dwelling attic is ruon-Iaab'table non-else in ditioned s space lied f r The certificate is issued to Bluebird NF LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 23-90054 6/21/2023 PLUMBERS CERTIFICATION DATED 6/12/2023 rlo uaham th0 � t�F i14�° TOWN OF SOUTHOLD BUILDING DEPARTME TOWN CLERK'S OFFINeQef ved SOUTHOLD, NY BUILDING PERMIT OCT 0 7 2025 (THIS PERMIT MUST BE KEPT(9 1PpE Ml WITH ONE SET OF APPROVED PLANS AND SPE'DIFIICAWR UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 47173..._.� Date: 12/3/2021 Permission is hereby granted to; Dinizio,John 722 Brown St _. _. ... � . .—...._. -_. qTenpqM NY 1.—.. 944 To: Construct in-ground gunite swimming pool at existing single family dwelling as applied for. At premises located at: 1955 AltaertsrI Ln , wnprt__....••' SGTM#473$89 Se1I3(ocls/ t�t# '.,-5 56 Pursuant to application dated 11/15/2021 and approved by the Building Inspector, To expire on 6/4/2023. Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $250.00 CO-SWIMMING POOL $50.00 Total: .�. �.. ...$300......._ 00 ti Building Inspector..��-.......�_�..........._,. AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS Received TOWN OF SOUTHOLD %1) WHEN TO USE THIS FORM: This form must be completed by the applicant for aHyCTPPCtl 1W permit,site plan approval, use variance, area variance or subdivision approval on pro erty within an agricultural district OR within 50,O feet of a farm operation,located in an Am Appeals ppeals All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. �►" 1, Name of Applicant: OMJ �wovk'Beyz IFO(i _E� AN -T 42 VHE—y 2. Address of Applicant: q �5 b QUO t 01-1 1 3. Name of Land Owner(if other than Applicant): 4. Address of Land Owner: 20 o(-1T+<sT, APr- IP 01 NJ 100z5* 5. Description of Proposed Project: A,,5 B V l L 012 Y K1 6. Location of Property: (Road and Tax map Number) 1000— 5 2^ 5- 5to 7. Is the parcel within 500 feet of a farm operation? {7f Yes { } No 8. Is this parcel actively farmed? {,. } Yes { } 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 2. C"G6(Z0AOs �Tt✓�rn c "C cl w 57T%rr. FL45 N-t NJ 1 a°► cl 1 1000- 52- - 5'-59. 7 4. C 'G6(-0h05 A-TLtq C, L-LC. Q WS11-"B'f Vt,.49- tS-t N`l tOOkQ 5. 1000 _ -52 - S - &0• Z fE-u--a Vem139,0wsr-1 ' vuipt-M vcn•a Dario," _ IT OUD 43Kt � e't 6. Wit .. N 1 7,-.-, ._ (Please use the back of this page if there are additional property owners) Signature of Applican Date Note: 1. The local Board will solicit comments fiom the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 Appendix B /0 Short Environmental Assessment Form Rece iv Instructions for Completing OCT 0 7 2025 Part 1-Project Information. 'The applicant or project sponsor is responsible for the completion of Pert I 'R s on es become part of the application for approval or funding,are subject to public review,and m4dJ*A: . l 1 kation. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information 0��i� �EcSlpE4�1C (� Name of Action or Project: 10155- ALl6eVTcS60 LANE �OUT�OL:U Project Location(describe,and attach a location map): Brief Description of Proposed Action: , TO ©eT-AC( rJ C.© . �v fi Pt CC 4ESSO�2`-I STtiv cTU RI✓ (,t J+OuSE) Name of Applicant or Sponsor: Telephone:6 31-2A4-4 2A I TO C t7l 4Al l 13 tF . E-Mail: cQtartybexs @ A ond.60 Address: 120 SoK 4 City/PO: State: Zip Code: soy I✓o N ��-1 r 1.Does the action only involve the legislative adoption of a plan,local law,ordinance, NO YES proposed Y 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: lou iLOW& FeP-MtT �50 UTttOLD -CD IAJAI x 3.a. Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? O acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? •�c� acres 4. Check all land uses that occur on,adjoining and near the proposed action. op ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? Received „ b. Consistent with the adopted comprehensive plan? 0 C T 0 7 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? Zoning Board of Appeals 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? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 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: NA L) Nk 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: N &YO rt-vu ffx t ,G• 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: UQ P 1M t M Cr 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? x b.Is the proposed action located in an archeological sensitive area? X 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? IC 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. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑ Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban JWSuburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create stone water discharge,either from point or non-point sources? NO YES If Yes, K a.Will storm water discharges flow to adjacent properties? ONO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ❑YES Page 2 of 4 m 18.Does the proposed action include construction or other activities that result in the impo" ent of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? � elVeC If Yes,explain purpose and size: 19.Has the site of the proposed action or an adjoining property been the location of an 84r a—mi t YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: C- 4� S Date: s Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer-should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available eneEg conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 e Moderate mall to large ° Io 5 impact may (i�,, o ccr occur o ur 10. Will the proposed action result in an increase in the potential for erosion,flooding or oar problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. * Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. * Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 d Receive Board. Of Zoning Apgeals Application OCT 0 7 202� OWNER'S AUTHORIZATION Zoning Board of ,appeals (Where the Applicant is not the Owner) I E Vk n/ -r6 u H e—( residing at Z D 6l W• q 7T'*-rT- A P'r.79 (Print property owner's name) (Mailing Address) N'l NY I00 2S do hereby authorize (Agent) ;TOAJ G4Pt(Y�,"3ef` 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 MODE RE IRED TIME FRAME DESCRIBED HEREIN. (Owner's Signature) 6"k �2N� (Print Owner's N e) RECORDED Number of Eagcs 2023 Sep 28 08.06:20 RK Vincent Puleo CLERK OF 1�e eCelVe This document will be public SUFFOLK COUNTY P L o00013220 record. Please remove all P 179 OCT 0 7 2025 Social Security Numbers DTti 23-06662 prior to recording. Zoning Board of Appeals Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Mortgage Amt. Page/Filing Fee 1, Basic Tax Handling 20`00 2. Additional Tax TP-58�0) I D Sub Total Notation Spec./Assit. or EA-52 17(County Sub Total Spec./Add. EA-5217(Sto TOT.MTG.TAX Dual Town Dual County_ R.P.T.S.A. Held for Appoiago Comm,of Ed. 5. 00 Transfer Tax Affidavit ~ Mansion Tax DThe property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00 � family dwelling only. Sub Total YES or NO Other Grand Total 10 If NO,see appropriate tax clause on page# of this ins a e�et. P 4 1 Dist.W 1 r„ 5 Community Preservation fund i000 05200 osoo ose000 Real Property P T Consideration Amount$ Tax Service Agency R DTY p I� I CPF Tax Due $ Verification 24-JUL-23 .__ M. ._.w.. Improved .�n 6 Satisfactions/Discharges/Releases List Property Owners ailing Address RECORD&RETURN TO: Vacant Land TD Mail to:Vincent Puleo, Suffolk County Clerk 7 Tithe Company Infer' ation 310 Center Drive, Riverhead, NY 119U1 M www.suffolkcountyny.gov/clerk Title# _LL Suffolk County Recording & Endorsement This page forms part of the attached 1 d made by: (SPECIFY TYPE OF INSTRUMENT) �r 66 h orti. L.l.�— The premises herein is situated in SUFFOLK COUNTY,NEW YORK. \ TO In the TOWN of t1.�f� k Ar� -r6u+AeQ In the VILLAGE Ck Nrr— "re- or HAMLET of BOXES 6 THRU S MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-01a..10m9kt (over) Received BARGAIN AND SALE DEED with Covenant against Grantor's Acts OCT 0 7 2025 THIS INDENTURE, made the`L� `" day of June, 2023 BETWEEN Zoning Board of AppeaJF BLUEBIRD NORTH FORK LLC., with an address at 16615 New Suffolk Avenue,New Suffolk,NY 11935, party of the first part and EVAN TOUHEY and KAYCE KERR, as husband and wife,with an address 6970 Indian Neck Lane, Peconic,NY 11958,party of the second part. WITNESSETH, that the party of the first part in consideration of ten dollars and other valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part, forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the (see attached schedule"A"). BEING AND INTENTED TO BE THE SAME PREMISES AS DESCRIBED IN DEED DATED 10/14/2021 AND RECORDED 12/27/2021 IN LIBER 13135 PAGE 552 AT THE OFFICE OF THE COUNTY CLERK, COUNTY OF SUFFOLK, STATE ON NEW YORK. Suffolk County Tax Map 0 1000-052.00-05.00-056.000 TOGETHER with all right, title and interest, if any, of the party of the first part of, in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatsoever, except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. Received OCT 0 7 2025 w IN WITNESS WHEREOF, the party of the first part has duly exec&BI k�i Sexed of Appeals the day and year first above written,. IN PRESENCE OF: Lucinda Barne "° ole Mana ember STATE OF NEW YORK COUNTY OF SUFFOLK On the day of June, 2023 before me, the undersigned, personally appeared LUCINDA BARNES, personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), that by his/her/their signature(s) on the instrument, the individua ) acted, executed the instrument before notary in Suffolk County and State of New Nota P lie #' imaw oi ww%W ti tt a GM 2oQB 4r STEWART TITLE INSURANCE COMPANY Received Title No.: 3136334-S-NY-RP-EB OCT 01 2025 Schedule A Description - Zoning Board of Appeals.. ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold,County of Suffolk and State of New York, bounded and described as follows: BEGINNING at the point marked by an iron pipe in the southerly line of Albertson Lane where a hedge intersects said line and which point is 1,991.18 feet westerly from the corner formed by the intersection of the southerly side of Albertson Lane and the westerly side of N.Y, S. Route 25(Main Road); THENCE along the southerly line of Albertson Lane, South 82 degrees 55 minutes 00 seconds East, 161.98 feet to a monument; THENCE South 06 degrees 10 minutes 00 seconds West, 215.83 feet; THENCE North 85 degrees 58 minutes 00 seconds West, 130.80 feet; THENCE North 01 degree 48 minutes 00 seconds West,225.46 feet to the point or place of BEGINNING. File No.: 3135334-S-NY-RP-EB NY Certificate of Title--Schedule A Description INSTRUCTION RP-.r217�r OF-INSI:www. s.sta*.nyzs FOR COUNTY USE ONLY � � Now York Bme pePWftMW of C1.SWIS Coda Taxation and Finance Racmded � Office of Real Properly Tau services C2.Data Dona �" of RP-5217-PDF Receive C3,Book 6 C*.Page L 1 1 Roo]Plop"TransbrRoppr(VIC'') PROPERTY INFORMATION OCT 0 7 2025 N1•P-party .955 A_beitnon Tone Location "b'wLL"wmrmr "atw8a.e rvtA;. Zoning Board of Appeals, GY2nnport !' 'CT OR r0r1'r VL4:1 •:�'A� I LSuyer i'cu eel ivan Name ";WXa4 MMaw�r'C. Mfl"' Filal•IN1L Kerr Kit y:e 4NRf»rt�.„"Jfx%wr+K'Ar Cp!y�rWti.. 3,Tax Im9 whom harp Tax Site are 1a he sent Bfflbv Addition d other than buyer atltlrargalbodomofform) .A5-wwncoMrvw.• riRar•sesa 0 sraasr>anaeR.•eMwsn urvw a+nw mna :oero: 4.IMs9este tiNr aamkaaaf AsewsoaMeas - Pan d e Perod (Dny ty Psd of a Ponta i Check"thg appllr: Roll parch ba don on the deed - a ofPsrtds OR ❑ 4A,planning Doofd widr Srbdnwlen Wholly Edps s.Dead \ OR 0.75 49.SubdMdonApgod won Regramd far Tramfor Prop ry reovrnsr •u.,•m •1e1la 511s 4C.Paid Approved for Subt9womn with Mop Prodded Bli,.eh1.'ra No'_:1 Fork :.,1.: LSelMr 1✓aTW Brd�bWMW Rn'NWL Name .oe:wvFXeeruwr- ,F+xrr++iw �7.Soled the daay. .. which moat accurately Meribaa the Chock th hors below l s they aPpM use oftho p apmy at On Ow of sale: It.Ownership Type is CmmoWrum A.(.")r.!l am(Ir Rt•drl,-m ial 1.Now Conanx.7bn an a Vann Lond 19A'Pmpay Looted s itldn an AukdAural t>turk7 G 198.eayta toothed a dationsum ride's " thin#in pop"le 0 an ❑ tl S&E INFOAWT 1s.Chock ants her mars of tlrese rxMrMdWens as app9eabW to b-, r..... A.Salo 9eheaon Raledwa or Fannon Rald)wes 11.sw Conrad Date C;/12/2 0 2 3 9•Sw tMKaaen R41ded Canpedes a PaCmrs In audness. C Ons d the Buyrse le dao a Seam •1Z Dole of Solef7rarwater 06/1q/7_323 Lending ImAnslon D. Type notWom��Solingen te $Weil Belem) F Sole d Rndiaiwt of Less tiro Rose kAaaa<operdy Asked 47.Fue Site Prlos 1,665,OC 0.00 G.Significant Charge In Pmpsdy across Taxable STerm and Sale Dew H Sale d ausnaw a Inekded let Sde Pdce I Fua Sits Pnco a On talessinnual add for lbe p db'g mpany Ind Pend Plap". + t.Ocher Unusual Favors Affecting Sale Pnco(Speedy Sohm) Thwpoyrmnllm be In On(4tmalanah.00 ePops.yv9ooft-theason40Md J None nwnaopes at other Xbsashona)Rom rand a the narsd whole ddara mint +OarrXertomla)on Crtasa'Mltooc 14.Indicate the value at personal pr openly Included Intlrwk ti•I� A SSIESWRT I "I .Colic 111109 Final A'9M SM'M M R011 And TAX INS 1a.Year olAsooasttant Rag bran which Idcor atim bdum(YY) •17.TOW Assessed Yahtp 5,20C -ILPwpvyCWao 2tu 1s.Schad DlerletKim 1-0 - Crea:epozz *2L Taa Nap-' —rlshd Men9Rerlal(If mom anon four,oeach shaatwkh oaa9lmul IdedRrpll 1000-05�.00-0[,.UO-03o_06C IFICATION l r'9kttoAdl'AMaarmaa# I twx off1hishttm my '(p*asaa100161).sadl undhmWxWVWV4 tankingarmy walful khm shlaemart of datatat loe1.heroin so ma to tl Wools Po bil Nov MAW"to,00 ousMlall sml.MAO of Is lm ,� 'lam BUYER CONTACT INFORMATION ffrrar rfawatan trsA try.Nets a errrrn elCsodrry.asmaral ewpus4r)apse sad mrTorw.ssensar q„ � shad/UIL'a rase n v�hard awns Arad®r.Fen a rrw nla pDrlar:o0aveaNr d m wa•w..aRan�Y OarN raamaawrawrearrt•�rory 7twntr rxW nerretl yelps wprka crrlyJ NUICR9IONATUQE 1auhcy Zva:t •rlw"Ndhp rFe"Wis 10 23 - DS v�'.F.w char. .,,.('" 'as`wv�nrue t"gum"raw: rr l N L. " I HLU=$.AMRNgL V l bdhadmi a Sawa Wl Nww• FRS:ti (VI) 594-5400 .,.as ¢.s�, Receive OCT 0 7 2025 11111111111111 IN Zoning Board of AppealF. I 11111 IN IN SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 09/28/2023 Number of Pages: 4 At: 08:06:20 AM Receipt Number : 23-0125043 TRANSFER TAX NUMBER: 23-06662 LIBER: D00013220 PAGE: 179 District: Section: Block: Lot: 1000 052 .00 05 . 00 056.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $1, 665,000.00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20 .00 NO Handling $20.00 NO COE $5.00 NO NYS SRCHG $15.00 NO EA-CTY $5.00 NO EA-STATE $125.00 NO TP-584 $10 .00 NO Notation $0.00 NO Cert.Copies $0.00 NO RPT $200.00 NO Transfer tax $0.00 NO Comm.Pres $0.00 NO Fees Paid $400.00 TRANSFER TAX NUMBER: 23-06662 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL Vincent Puleo County Clerk, Suffolk County APPLICANT/OWNER Received TRANSACTIONAL DISCLOSURE FORM OCT 0 7 2025 The To n of th ld's Coda of Ethfe r hihits conflict of ntcros on the ar f town officers and c l 1'he ur ose of tWj f2Km11,ig argyidgInformation which can alert th t u of vgsgWy conflistsf interest is ar aygid Sam, YOUR NAME : E V -r b U y (Last name,fist 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 ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP IT Submitted this u day of A)&- ,20 Zs Signature Print Name 01L) G Recei\fcds 0 AGENT/REPRESENTATIVE OCT7 202�,,l TRANSACTIONAL DISCLOSURE FORM Zoning Board of Appeals The Town of S t , e f Et'hic prohibits conflicts of interest on the art of t w o employees. n o;a of this fww Is t de information which can alert the t_owa gloossible conflicts of jutcEe t d tiow it to take whateaer action is necessaw a to avoid same.. YOUR NAME : 'J o l -tj eq-5^ (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 ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this 1-7 day of �i''`� .20 25' Signature Print Name C4(-PuWS Town of Southold Received ° � " ; LWRP CONSISTENCY ASSESSMENT FORM 1 OCT 0 7 2025 A. INSTRUCTIONS Zoning Board of Appeals 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# l 00 0 . 52-- _ 5 5 The Application has been submitted to (check appropriate response): z $ft q Town Board 0 Planning Dept. 0 Building Dept. R Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation, land transaction) ] (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit,approval,license, certification: Nature and extent of action: Location of action: geceived Site acreage: . 7 3 f° OCT 0 7 2025 Present land use: CZC—a1)01\ r PrV S VIJ G(.,E �=AM4?% Board of Appeals g 9 — 8 D Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: SCUT LO ( l q —1/ (c) Telephone number: Area Code ( ) (o 31 2 A (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No� If yes,which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LVWRP Section III—Policies; Page 2 for evaluation criteria. E]Yes No XNot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria 11 Yes E] No Not Applicable t C( LBog--Vsc�rj cA,"j(f JUL,�( 2� 2S COOL HDUs� INT Co(ZS z \c. \ \ \ \\\ a Tp- o� d w \\\ , \ � y t7, L N A;A�@ti All 116 Al _ O O `\vime 1 R 6 - PALE E(zTs o4\j EF c JUL'-{ rLo 25 CD ^E TOWN OF SOUTHOLDPROPERTY RECORD, OWNERI A- - � SUB, LOT a STREET VILLAGE_.. FORMER OWNER i N - E - ACR. t - I S W _ TYPE OF BUILDING RES. SEAS. VL. I FARM COMM. CB, MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS « i - - a - < s v .- E - r < t .t AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre I Value Per Value i r� 1 `E. °Acre - _ 5 ._ Tillable FRONTAGE ON WATER CD < I r ® (� Woodland FRONTAGE ON ROAD o Meadowland g 1 DEPTH E House Plot BULKHEAD CD Total DOCK SCTM # 3/a��� TOWN OF SOUTHOLD PROPERTY RECORD CARD 0 R STREET VILLAGE: __ _ OtST, -SUR_ _ _ _LOB ACR. REMARKS r TYPE OF OLD f /y PROP. CLASS LAND IMP. TOTAL DATE ) CD CD FRONTAGE ON 'WATER HOUSE/LUT BULKHEAD TOTAL COLOR TRIM Ar f� I a ss� I I I lie . I I ' - a � I I E t P. . 3 I M. Bldg - i a y • 3 Extension I f t - _ 8 Extension -- , E t Extension - E Both Dinette �pundotion Porch o s �cfisement 1 Floors K. Porch Walls Interior Finish Breezeway I iFire Place Heat dl . Garage a Type Roof Rooms 1st Floor I Patio ;Recreation Room Rooms 2nd Floor ' - FIN. B i 0. 68 i �� ;Dormer 1 Driveway i Total g .a - E - - COLOR 1 s 4 .' - T IF TA _ _ - -- ..' 20, a, - - = _ 52,-S-S6 311S/2024 1 ti !86 2w M R44g - foundalron r B 6atPe �� C1cr tt$a Extension 3a9ernea�tC floors Kit Extension - 8 � ltetersS�r Finish �- � L R Extension � Fire Plate � hest �# ,�� D R [�ara e n r Exi Waltz RED a— () Dormer I Deck F ri Ic R E rra - R � Pow A.G. r _ L �•�dry } t 3 { + tit in