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HomeMy WebLinkAboutVinbar Realty Corp-ZBA application Revised 6121123 TOWN OF SOUTHOLD RECEIVE' ZONING BOARD OF APPEALS 0I Phone(631) 765-1809 NOV 0 1025 APPLICATION FOR A SPECIAL EXCEPTION PERMIT FOR AN ACCESSORY APARTMENT IN AN ACCESSORY BUILDING ZONING BOARD OE APPEALS Applicant(s)Name(s) Oho C+kmo,ei eg Applicant(s)Address - (9- 4 0U7+i0L-D 0 M-1 1 Phone: l0 31 — 2c4 — 4 2.,A 1 Email: M a kamw("s l O (1��-l'•C dM• [ ] I/we are the owners of the subject property �Q I am the agent for the property owner and my Letter of Authorization and Transactional Disclosure Form is attached. Representative(if other than applicant): S&YVAIE Address Phone: Email: A. Statement of nershi and Interest: v (3r 1 w Iv l CL , " tl..l.l.fW�ONE i tie owner(s)of the property known and referred to as 12,1110 m I L.L kt--r-t-w C 14 l 101 House No. Street Hamlet Zip Code Identified on the Suffolk County Tax Maps as District 1000,Section 1 OT Block 10 Lot(s) Lot Size 7 L&&Zone District A,C as shown on the attached deed and survey The above-described property was acquired by the owner(s)on JA-K) 3 1010 I/we hereby apply to the Zoning Board of Appeals for a Special Exception Permit pursuant to Section §280-13B(13) of the Zoning Ordinance to establish an accessory apartment in an accessory building as shown on the attached survey/site plan and floor plan(s) B. Project Description: OF (IvcwolN& t (, paj T LAt,( KcTckiw i L 4'J NG- M July 2023 RECEIVED Application Page 2,Special Exception for Accessory Apartment NOV 0 5 2025 C. The applicant alleges that the approval of this special exception would be in harmony v RISIG&O4RD OF APPEALS and purpose of said zoning ordinance,and that the proposed use conforms to the standards prescribed therein and would n t be detrimental to ro rt r r M. in the nei hborhoad f r th followin reasons: `CNE kR� !t�S E�15T� caN 'T�tE I�Rr►1 TM hPP5"Ar►cS 01FIktE ?RoD. The applicant alleges that the following standards • prescribed by Section §280- 13(B)(13)(a)-(k)of the zoning ordinance will be met: a. The accessory apartment will be located in the accessory building. b. The owner of the premises shall occupy either the existing single-family dwelling or the accessory apartment in the detached accessory structure as the owners'principal residence.The other dwelling unit shall be occupied by a family member as defined in Section §280-4 of the code or a resident who is currently on Southold Town's Affordable Housing registry and is eligible for placement,evidenced by a written lease,for a term of one or more years. c. The accessory apartment shall contain no less than 220 square feet and does not exceed 750 square feet of livable floor as defined in Section§280-4 of the code d. The accessory apartment will be located on one floor of the accessory building and will contain No more than two bedrooms and No more than one bathroom. e. A minimum of three on-site parking spaces shall be provided as shown on the attached survey. f. Not more than one(1)accessory apartment shall be permitted on this parcel. g. No Bed and Breakfast facilities,as authorized by Section§280-13(B)(14)hereof shall be permitted in or on the premises for which an accessory apartment is authorized or exists. h. The accessory apartment will meet the requirements of a dwelling unit as defined in Section 280-4 of the Zoning Code. i. This conversion shall be subject to a building permit,inspection by the Building Inspector and Renewal of Certificate of Occupancy annually. j. The existing accessory building which is converted to permit this accessory apartment has been in existence and has a valid Certificate of Occupancy f r no lcs than thre ygars,and is attached hereto. k. The existing building,together with this accessory apartment,shall comply with all other requirements of Chapter§280 of the Town Code of the Town of Southold. 1. This conversion for the accessory apartment shall comply with all other rules and regulations of the New York State Construction Code and other applicable codes. E. The property which is the subject of this application(check all that apply): ] has not changed since the issuance of the attached Certificates of Occupancy [ ]has changed or received additional building permits.Certificates of Occupancy for these changes are attached or will be furnished [ ]has been the subject of a prior ZBA ticol'sion(s),copies are attached ..i Owner Signature COUNTY OF SUFFOLK) ss.: STATE OF NEW YORK) Sworn to me this S day of 4aPT(9Kt3 G(2— ,20 (Notary Public) TIMOTHY LEITCH 6121123 NOTARY PUBLIC STATE OF NEW YORK SUFFOLK COUNTY LIC.#01 LE0024350 July 2023 COMM. EXP.05/03/20 Z 1 QUESTIONNAIRE RECEIVED Sly FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premises listed on the real estate market for sale? NOV 0 5 2025 Yes ><' No ZONING BOARD OF APPEALS B. Are there any proposals to change or alter land contours? X' No Yes,please explain on attached sheet. C. 1.)Are there areas that contain sand or wetland grasses? 0 2.)Are those areas shown on the survey submitted with this application? I'Jh. 3.)Is the property bulk headed between the wetlands area and the upland building area? NJ.& . 4.)If your property contains wetlands or pond areas,have you contacted the Office of the Board of Trustees for its determination of jurisdiction? 0• A - Please confirm status of your inquiry or application with the Trustees: and if issued,please attach copies of permit with conditions and approved survey. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? N D E. Are there any patios,concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? N D Please show area of the structures on a diagram if any exist or state none on the above line. F. Do you have any construction taking place at this time concerning your premises? G, If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe: 0 -& H. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking,please apply to the Building Department to either obtain them or to obtain an Amended Notice of Disapproval. I. Do you or any co-owner also own other land adjoining or close to this parcel?� S If yes,please label the proximity of your lands on your survey. J. Please list present use or operations conducted at this parcel ex . l B.Mmy5e and the proposed use J K. (example: existing single family,proposed:same with garage,pool or other) •2 Authorized signs -6�dDate July 2023 3 RECEIVED AGRICULTURAL DATA STATEMENT Nov Q 5 2025 ZONING BOARD OF APPEALS TOWN OF SOUTHOLD ZONING BOARD OF APPEALS WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit,site plan approval, use variance, area variance or subdivision approval on Property within an agricultural district t9R tvithir Mill Leet of a fann o station Located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1 1. Name of Applicant: to(L L rJ f 0lV E LLC n1C Cell"' C Lh PS) 2. Address of Applicant: 223U MLL- , L"E MA- t-tTUCk4 . 3. Name of Land Owner(if other than Applicant): S A m.E. 4. Address of Land Owner: S*rA IF 5. Description of Proposed Project: AQCe SS A-PT • MJ EKt�gT• SAKrq 6. Location of Property: (Road and Tax map number 2230 M ILA, LANe 1000+ 10 7."10—� 7.. Is the parcel within 500 feet of a farm operation?A Yes { } No 8. Is this parcel actively farmed? X 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). NAME and ADDRESS 1. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) 6 / / / 2S Signature of Apt t Date The Suffolk County Tax Map numbers may be obtained in advance when requested from the office of the Zoning Board of Appeals at 631-765-1809. Note: 1.The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. July 2023 �Fftt; Town of South(,--- ' 12/29/2017 53095 Main Rd RECEIVED Southold,New York 11971 s a NOV 0 5 2025 F OrG PRE EXISTING CERTIFICATE OF OCCUPANCY No: 39425 Date: 12/29/2017 THIS CERTIFIES that the structure(s)located at: 6300 Wickham Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 107.-10-9 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- 39425 dated 12/29/2017 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: w one fa.p&dwelling with coves o ae sa wed ara e 30.4 20.4 a w b rn 0.5 xc 0.3 aqqgs§qy wood frame barn dila idat l 17.7 x 50.5 accessoKy wood frame. shed dilapidated,C2LO x 10 and accessory l s 8 x 6 . ' The certificate is issued to Mill Lane One LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 107-10-9 PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. A d Signature BUILDINGDEPARTAMNT RECEIVED �M � TOWN OF'SOUTHOLD NOV U 5 2025 HOUSING CODE WSPECTLON PORT ZONING BOARD OF APPEALS LOCATION: 6300 Wickham Ave,Mattituck SUFF.CO.TAX MAP NO.: 107.40-9 SUBDIVISION: NAME OF OWNER(S): Mill Lane One LLC OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Mill Lane One LLC DATE: 12/29/2017 DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION: brick CELLAR partial CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: covered DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING: TYPE HEAT: oil WARM AIR: HOT WATER: radiator #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: metal shed,wood frame shed SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: 2 wood frame barns VIOLATIONS,, accessory wood frame barn 50.5 x 17.7 dilapidated accessory wood frame shed 20 x 10 dilapidated RE �"�S: INSPECTED BY: JOHNJ DATE OF INSPECTION: 11/13/2017 TIME START: 10:22am END: 10:45am ' Fat/f Town of Southold '01 P.O.Box 1179 S� 53095 Maus Rd NOV Southold,New York 11971 5 Z��S O -PEALS CERTIFICATE OF OCCUPANCY No: 40721 Date: 9/24/2019 THIS CERTIFIES that the building ADDITION/ALTERATION k Location of Property: 6300 Wickham Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 107.40-9.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/24/2018 pursuant to which Building Permit No. 42778 dated 6/12/2018 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 AND ALTERATIONS INCLUDING-COVERED PClRC1IES TO AN E STINO ONE I�A11:IL DWELLING AS APPLIED FOR The certificate is issued to Vinbar Realty Corp G of the aforesaid building. m SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42778 08-04-2019 PLUMBERS CERTIFICATION DATED 08-23-2019 land Burner rri d Aut o Signature �llt'f Town of Southold 11/6/2020 P.O.Box 1179 53095 Main Rd RECEIVE® �, _�g S Southold,New York 11971 NOV 0 5 2025 CERTIFICATE OF CCU ". ►.NCJ?NING BOARD OF APPEALS No: 41581 Date: 11/6/2020 THIS CERTIFIES that the building ELECTRICAL Location of Property: 6300 Wickham Ave., Mattituck SCTM#: 473889 Sec/Block/Lot: 107.-10-9.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/20/2020 pursuant to which Building Permit No. 45351 dated 10/20/2020 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: 00A overhead electric service to existing accessM barn. The certificate is issued to Vinbar Realty Corp of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45351 10/21/2020 PLUMBERS CERTIFICATION DATED Authorized Signature s Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 sean.dev1in@town.southoId.ny.us Southold,NY 11971-0959 RECEIVED BUILDING DEPARTMENT TOWN OF SOUTHOLD NOV 0 5 2025 CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Vinbar Realty Corp Address: 6300 Wickham Ave city:Mattituck st: NY zip: 11952 Building Permit#: 45351 Section: 107 Block: 10 Lot: 9.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: East County Electric License No: 1005ME SITE DETAILS Office Use Only Residential Indoor Basement Service X X X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Barn X INVENTORY Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel 200A A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Faxtu Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment: Notes: New Service for Barn w/ Feed Out to Old Panel Inspector Signature: Date: October 21, 2020 1 S.Devlin-Cert Electrical Compliance Formals TOWN OF SOUTHOLD p; BUILDING DEPARTMENT RECEIVED TOWN CLERK'S OFFICE SOUTHOLD, NY NOV U 5 2025 yca", BUILDING PERMIT ZONING BOARD OF APPEALS (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 46129 Date: 4/26/2021 Permission is hereby granted to: Vinbar Real Cor 450 Snug Harbor Rd Green port, NY 11944 To: alter portion of an existing barn into a farm stand as applied for. At premises located at: 6300 Wickham Ave. Mattituck SCTM # 473889 Sec/Block/Lot# 107.40-9.1 Pursuant to application dated 4/6/2021 and approved by the Building Inspector. To expire on 10126/2022. Fees: FARM BUILDING ALTERATIONS $150.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $200.00 Building Inspector SURVEY OF' PROPER'rY S17VATE MAWTTUCK TOWN OF SQUTHOV: SUF70LA COUNTY, NEW YORK S.C. TAX N. 1000-10-0-09 Sc. 1-109,OCTOO ER 20,20I7 -L LANE ONE,LLC Pn RECEIVED NOV 0 5 2025 P 1p, ZONING BOARD OF APPEALS, % X� 41 W S,0,1- Nathan Taft Corwin Ill Land Surveyor ar . .......... ...... -- _� r� vt>erM ADDS BARN 4230 _ ANE A N.Y,vWAS �v NE --?_38 A 6S RECEIVED NOV 0 5 2025 ZONING BOARD OF APPEALS r _ 617.20 RECEIVED Appendix B �$S� Short Environmental Assessment Form NOV p 5 2025 Instructions for Completing ZONING n,! ARD OF APP�L41_S Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Respon become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on 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 MILL I-ANe7 Orlie L_LC v Ifuce"7 CLAK'S Name of Action or Project: 2 2 36 M I UL, LASE- In A TrfiTW_ <_ P gxaZL 6306 wlCKHA-h AVE Project Location(describe,and attach a location map): Brief Description of Prop d.Actid -M t^..UW v c�'r L o 2^'p FL. OF 6-KkST• 13AP-N -M �N lt-��S• �� Name of Applicant or Sponsor: Telephone:W l_7A ¢244 EMil Ctl�hn� S - a • MLA. 1.1 L.vc o e w ai .ctlen Address: W) City/PO: State: Zip Code: 'Skyah)L9 I N l c q-1/ 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that x may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: x �OUTkk 'iD uU nl 3U LuD L nSG T>E 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban JCRural(non-agriculture) ❑ Industrial ❑ Commercial Residential(suburban) ❑ Forest Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, RECEIVE® NO YES N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? Nov 0 5 '✓ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ZONING BOARD O 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmen Area? NO YES If Yes,identify: V 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? 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: 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? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? X b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 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 A Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO YES 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? 19-NO ❑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 18.Does the proposed action include construction or other activities that result iMCEpdment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? cq-�g If Yes,explain purpose and size: 19.Has the site of the proposed action or an adjoining property been lAl NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: T.1D • ZS 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 enM 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 �1 "I No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail, identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. RECEIVED 2T WV 0 5 2025 ZONING BOARD OF APPEALS a Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 Town of Southold RECEIVED LWRP CONSISTENCY ASSESSMENT FORM NOV 0 5 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#J_QQ 0 _ [Q 7- - t 0 " 9 The Application has been submitted to (check appropriate response): Town Board Planning Dept. E] Building Dept. 297' Board of Trustees 0 Z-S^ R1 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: -M alJ IN o FL - o P- Location of action: 2 0 t LL— J_A- (E Site acreage: rj'4' 0 5 2025 Present land use: S LN 6-LeE • FAf M a6t ®il11iVG Bd�99�p Present zoning classification: C ��� 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: J D hdJ (L. L h 0 n E Lt-C (b) Mailing address: pD • 1' -40( IS6 0Tttow N l l q'-7 I (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 agency? Yes ❑ No VN If yes,which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes Ej No 0 Not Applicable N 0'C 9 ice' Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes 1:1No 9rNot Applicable 0410 (NCI- L . Board of Zoning AgpealsARplication RECEIVE® D OWNER'S AUTHORIZATION NOV 0 5 2025 (Where the Applicant is not the Owner) Z0NING 80Ai?1)OF APPE ALS C L.A-PS residing at 9,2,3 U M 11.L LANE- (Print property owner's name) (Mailing Address) VK A--M 7-uctz-- do hereby authorize OMJ Q4(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 HERE,IN. Failure to comply in a timely manner may result in the denial by the Building Department of a Certificate of Occupancy, nullify the approved variance relief, and require a new variance application with public hearing before the Board of Appeals c (Own 's Sign e 91 (Print Owner's Name) July 2023 RECEIVED IOU APPLICANT/OWNER NOV 0 5 2025 TRANSACTIONAL DISCLOSURE FORM ZONING 110A C , LS The th ' Ethicst t ofint rest_o fil ers and to 1 t i m b 12 RK211de Information wbich can alert the toM2 91 p9lsible,conflicts of interest jud allow it to take whatever Icti,op is necessary to avoid same. YOUR NAME: 1Q G L A- (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 V If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this + a of ,20 Signature Print Name July 2023 AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The f th 1 'EQ&qf.KLh_fU grobibit w .o fl f int est qu Abe gart f 19NI,officer!anJAM of 1hil f rm v de in nrmat o it a he LMn qj pQssjhIe conflicts,of IMIgryst'nd allim i Whatever actiog is nggssaa to avoid sa:m . YOUR NAME : Nov 05 S� (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.) ZOBV96�IC BOARD OF APPEALS TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone g 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 Submitted this�_day of�,20 1-5 Signature (! II Print Name V d CA±AfVk1B63S July 2023 � - -C-(-RJ C�. CD Q N LL _ o u o o m z 0 AM\'a�-,� 3t _ a d i9 >r s < t� t Eh uj u� d ... - a. LUC1i a f WON '7777, a. _ r; 1 i 0 r `' low a,- r s SCTM # TOWN OF SOUTHOLD PROPERTY RECORD CAR ��' a�• �5 s OWNER STREET VILLAGE DIST, SUB. LOT o �= - ACR. REMARKS . TYPE OF BLD. zqq z p �r PROP GLASSiv LAND IMP. TOTAL DATE / e —� / Lz 42 } U ca CJ - f Cl) O FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL - - �,r� TOWN OF SOUHLD PROPERTY RECORD CARD ' OWNER STREET r- �_ VILLAGE DIST ' —SU LOT t,-' FORMER OWNER � � N � E AC �w S - W TYPE OEUILDING RES 1 SEAS. 1 VL. rARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS f , I 3 i Y u e� 3 s 3 _ r AGE BUILDING CONDITION , 5e _ �. NEW BEW - - F FARM Acre Value Per Value n Acre P. l ole 1 1 ,Av J� Tillable D - l Tillable 3 /D r Woodland �a Swam P land '0 GE6N VAT R z _ 0 e GE ON �AAD � ? y Brushland I l .7 House Plot J PTO _ ..,_ ¢ � G L j g Total cn (, tLu CL Aw- d � Q - LU CN` LL Uj w COLOR 1� f a 1 .- TRIM 71- i P j # t a @ 3 M. Bldg. Foundation Bath D T� € i nette Extension I � Sasemer t F e e loors Extension ' Interior Finish LR. Ext. Walls r Extension ;_ T;\��' �, Fire Place Heat DR. \ i / 'Type Roof - Rooms 1st Floor , 'BR. Porch `_ r 'Recreation Room' j Rooms 2nd FloorE FIN. B. Porch ``� - � ��y � Dormer - — - - Breezeway f �- Driveway Garage r Patio O. B. I Total AOL r i. -J IN COLOR TRIM ti 4 a R g 'Cfp x e a ` e a t e_ v a y y {_r$ �`. ®. . c' i 107.10-9.1 1/31/2020 1 1 L - l SQ. FT. Fin"B" 1 st fl / ' 2nd fl L`€ 5 TOTAL �,1 5 Q mT7�ag, v /,t5 � _ �✓ �JrPC CS 3 (� Foundation j3VJ€G# oeHER Bath o�. Dinette COMBO FUL _ Basement s PARTIAL Floors / Kit. l 1 ` Ktension Finished B. Interior Finish L.R_ Extension FP/WBS — Heat J . D.R. g - a. Ext. Walls �. BR.Garage x 0 �" t Porch Pe;r Oq% / + 7 Dormer - I �� a ,�, Baths LL I z rc r, Roof LU cv n Fam. Rm. Pool Solar o Foyer 4 A.C./GEN cD Laundry - -- - 77-7 Library/ 105,111 0 Study �L4—, s L J C� RECEIVED J oA w - 2G2 ZONING AD OF APPEALS mbi W C� M v Nww� � " � X W Q/1 ► �- dtr i W �• N pp p ' o v J G Wv %" 0 golife STATEMENT OF INCORPORATOR IN LIEU OF ORGANIZATION ME ( . ���1GE, OF VinBar Realty Corp. NOV 0 5 2025 Zr;"y�C CA R D The certificate of incorporation of the above-named corporation having been fl eFdTNklibs Office of the Secretary of State of the State of New York, the undersigned, being the incorporator named in said certificate, does hereby state that the following actions were taken on this day for the purpose of organizing this corporation: 1. By-Laws for the regulation of the affairs of the corporation were adopted by the undersigned incorporator and were ordered inserted in the minute book immediately following the copy of the certificate of incorporation and before this instrument. 2. The undersigned hereby resigns as incorporator of the corporation as of the date set forth below. The following are hereby elected as the director(s) of the corporation to hold office until the first annual meeting of the corporation or until their successors are elected and qualified: Vincent A Claps Dated: Upon filing date Bruce B. Hubbard Incorporator President, Hubbard Inc. d/b/a Hubco Incorporation Services CERTIFICATE OF INCORPORATIONSr OF RECEIVED NOV 0 5 2025 '`mar RealtyCorp. ZONING BOARD OF APPEALS Under Section 402 of the Business Corporation Law IT IS HEREBY CERTIFIED THAT: (1)The name of the Corporation is: VinBar Realty Corp. (2) The purpose of the Corporation is to engage in any lawful act or activity for which corporations may be organized pursuant to the Business Corporation Law of the State of New York.The Corporation is not to engage in any act or activity required any consents of approvals by law without such consent or approval first being obtained. For the accomplishment of the aforesaid purposes, and in furtherance thereof, the Corporation shall have, and may exercise,all of the powers conferred by the Business Corpo- ration Law upon corporations formed thereunder, subject to any limitations contained in Article 2 of said law or in accordance with the provisions o .ny other statute of the State of New York. (3) The number of shares which the Corporation shall have the authority to issue is 200 Shares at no par value. (4) The corporation is to be located in the County of Suffolk,State of New York. W =� (5)The Secretary of State is designated as agent of the Corporation upon whom process against it may be served.The post office address to which the Secretary of State shall mail a copy of any process against the Corporation served upon him is: VinBar Realty Corp1�. Vincent M.Claps ECEIVE 450 Snug Harbor Road NOV Greenport,NY 11944 0 5 2025 ZONING BOARD OFgpFEALS The undersigned incorporator is of the age of eighteen years or older. IN WITNESS WHEREOF,this certificate has been subscribed this 30th day of March,2005 by the undersigned who affirms that the statements made herein are true under the penalties of perjury. vc - �6 . 77 East John Street, Hicksville,NY 11801 Bruce B. Hubbard, Incorporator Address President, Hubbard Inc. d/b/a Hubco Incorporation Services RECEIVED BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS (INDIVIDUAL OR CORPORATION) NOV 0 5 2025 STANDARD NYBTU FORM 8007 CAUTION:THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND ZONING BOARD OF APPEALS PURCHASER BEFORE SIGNING. THIS INDENTURE,made the 34 day of January,201$ between MILL LANE ONE LLC,a domestic limited liability company with offices located at 2230 Soundview Avenue,Mattituck,New York party of the first part,and VINBAR REALTY CORP,a domestic corporation with offices located at 450 Snug Harbor Road,Greenport,New York party of the second part, WITNESSETII,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 SCHEDULE A ATTACHED(DESCRIPTION OF PREMISES) The grantor herein being the same party as the grantee and the premises same as described in deed recorded in Liber 12885 page 396 TOGETHER with all right,title and interest,if any,of the party of the first part 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 whatever,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 the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: Eu ne Krupski,managing member NYSBA Residential Real Estate Fors on HotDocs®(9/00) Copyright Capsoft®Development ao. Nov 0 5 202 ZONING BOARD OF4PPILS State of New York) SS: County of Suffolk On this 3 day of January 2018, before, the undersigned, personally appeared, EUGENE KRUPSKI, personally known to me or proved to me on the basis of satisfactory evidence to the be 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), and that by his/her/their signature(s) on the instrument,the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument, ublic PATRICIA C.MOORE Notary Pubiic,State of New Yoric Suffolk County-No.486166 _ Commission Expires June 16, 0 NYSBA Residential Real Estate Forms on HotDoc!e(9/00) Copyright Capsoft'Development -2- Westcor Land Title Insurance Company SCHEDULE A RECEIVED DESCRIP"I"[!4N OF PREMISES Title No. W602985 Policy No. OP-22-NY1159-6256867 AMENDED 12/22/2017 ZONING BOARD OF APPEALS ALL that certain plot piece or parcel of land,situate,lying and being at Mattituck, in the Town of Southold, County of Suffolk and State of New York,bounded and described as follows. Northerly by Middle road a/k/a(Old Middle Road)Wickham Avenue(so called);easterly by lands formerly of John M.Lupton and now or formerly of Martin Sidor;Southerly by Middle Road C.R.48 a/k/a North Road;and westerly by the Mill Lane(so called),which said parcel Is also described according to a survey prepared by Nathan Taft Corwin III,Land Surveyor,dated 10/28J2017. BEGINNING at the corner formed by the intersection of the southerly side of Wickham Avenue(a/k/a Middle Road)(a/k/a Old Middle Road)and the easterly side of Mill Lane; RUNNING THENCE easterly along the southerly side of Wickham Avenue(a/k/a Middle Road)(a/k/a Old Middle Road)the following two('2)courses and distances: 1.Along an arc of a curve bearing to the right and having a radius of 614.83 feet and a length of 156.34 feet,; 2.North 58 degrees 25 minutes 20 seconds east,526.81 feet to lands above-mentioned on the east THENCE along said lands the following four(4)courses and'distances: 1.South 34 degrees 59 minutes 40 seconds east,455,34 feet; 2.South 34 degrees 46 minutes 10 seconds east,396.48 feet; 3.South 34 degrees 13 minutes 10 seconds east,208.50 feet;. 4.South 33 degrees 29 minutes east 5.50.86 feet to the northerly side of Middle Road-C.R. 48 THENCE southwesterly along the northerly side of Middle Road—C.R.48 the following two(2)courses and distances: 1.Southwesterly along an arc of a curve bearing to the right having a radius of 1,902.16 feet and a length of 311.11 feet; 2.South 4.6 degrees 03 minutes 10 seconds west,365.08 feet; THENCE along an arc of a curve bearing to the right having a radius of 50.00 feet and a length of 88.04 feet to the easterly side of Mill Lane a/k/a Mill Road; THENCE northerly along the easterly side of Mill Lane a/k/a Mill Road North 33 degrees 03 minutes 29 seconds west 1,711.83 feet to the point or place of BEGINNING. SCHEDULE A A.L.T.A 2006 OWNERS POLICY TP-584(4/13) New York State Department of Taxation and Finance Recording office time stamp Combined Real Estate Transfer Tax Return, Credit Line Mortgage Certificate, and RECEIVED Certification of Exemption from the 9 ' a - Payment of Estimated Personal Income Tax U� � 10V 05 20a5 See Form TP-5f14-1,Instructions for Form TP-534,before completin this form,Print or t e, -d 0r APPEALS Schedule A—Information relating to conveyance Grantor/Transferor Name(of individual,last,first,middle initial)(IR check if more than one grantor) Social security number ❑x Individual MILL LANE ONE LLC ❑Corporation Mailing address Social security number El Partnership 2230 SOUNDVIEW AVENUE cK ❑Estateffrust City State ZIP code Federal Ethel ❑Single member LLC Mattituck NY 11952 ❑Other Single member's name if grantor is a single member LLC(see instructions) Single member EIN or SSN Grantee/Transferee Name(if individual,last,first,middle initial)(x check if more than one grantee) Social security number R Individual VINBAR REALTY CORP ❑Corporation Malling address Social security number ❑Partnership 450 SNUG HARBOR ROAD 171 Estate/Trust aty Stake ZIP code Federal EIN - El Single member LLC GREENPORT NY 11944 Other Single member's name if grantee is a single member LLC(see instructions) Singia member EIN or SSN Location and description of property conveyed Tax map designation- SWIS code Street address City,town,or village County Section,block&lot (six digits) (include dots and dashes) 107.00-10.000-009.000 6300 WICKHAM AVENUE Mattituck Suffolk 473889 Type of property conveyed(check applicable box) 1 ❑X One-to three-family house 5 ❑Commercial/Industrial Date of conveyance Percentage of real property 2 ❑Residential cooperative 6 ❑Apartment building conveyed which is residential 3 ❑Residential condominium 7 ❑Office building ay 201 real property 100% 4 ❑Vacant land 8 ❑Other month any year (see instructions) Condition of conveyance(Check all that apply) f.❑Conveyance which consists of a 1.❑Option assignment or surrender a. 0 Conveyance of fee interest mere change of identity or form of ownership or organization(attach Form TP-584.1,Schedule F) m.❑ Leasehold assignment or surrender b. ❑Acquisition of a controlling interest(state percentage acquired %) g.❑Conveyance for which credit for tax n.❑Leasehold grant previously paid will be claimed(attach c. ❑Transfer of a controlling interest(state Form TP-584.1,Schedule G) o,❑Conveyance of an easement percentage transferred %) In.❑Conveyance of cooperative apartment(s) p.❑Conveyance for which exemption d.❑Conveyance to cooperative housing I.❑Syndication from transfer tax claimed(complete corporation Schedule e,Part NO j.❑Conveyance of air rights or q.ElConveyance of property partly within e. El conveyance pursuant to or in lieu of ,development rights and partly outside the state foreclosure or enforcement of security k.❑Contract assignment r.❑Conveyance pursuant to divorce or separation interest(attach Form TP-584.1,Schedule E) s.❑Other(descrdbe) For recording officer's use Amount received Date received Transaction number Schedule 8, 'Part t $ Schedule B„Part.11 Page 2 of 4 _TP-5841-9) Schedule B—Real estate transfer tax return Eax Law,Article 1) Part I-Computation of tax due 1 Enter amount of consideration for the conveyance(f you are claiming a total exemption from tax,check the exemption claimed box,enter consideration and proceed'to Part ill)............................. ❑ Exemption claimed 1. 1150000 00 2 Continuing lien deduction(see instructions if property is taken subject to mortgage or lien)......................................... 2, 0 3 Taxable consideration(subtract line 2 from line 1)................................................................................................... 3, 1150000 00 4 Tax:$2 for each$500,or fractional part thereof,of consideration on line 3....................................................... 4. 4600 00 5 Amount of credit claimed for tax previously paid(see instructions and attach Form TP-584.1,Schedule G).............. 5.11 0 00 6 Total tax due'(subtract line 5 from line 4)................................................................................................................ 6. 4600 Part II-Computation of additional tax due on the conveyance of residential real property for$1 million or more 1 Enter amount of consideration for conveyance(from Part 1,line 1)..............................................................i'. ;... 1. 1 1 00000 00 2 Taxable consideration(multiply line 1 by the percentage of the;rrrengses which is residential real property,as shown in Schedule A... 2.1 1150000 oo 3 Total additional transfer tax due'(multiply line 2 by 1%4,01))............... ». ,„.. ................. 3.1 11500 00 Part III-Explanation of exemption claimed on Part I,line 1 (check any boxes that apply) The conveyance of real property is exempt from the real estate transfer tax for the fgflowving reason: a. Conveyance its to the United Nations,the United States of America,the state of New York,or any of their instrumentalities, politicalagencies,or ation,including a public corporation created pursuant to agreement or . compact with another state ate or Canadasions(or any ..Public corpor.................................................................................................................... a b. Conveyance is to secure a debt or other obligation......:.................................................................................................................... b ❑ c. Conveyance is without additional consideration to confirm,correct,modify,or supplement a prior conveyance............................ c El realty as bona fide efts...rty is and not in connection with a sale,including conveyances conveying d. Conveyance of reels property is without consideration. :.................................................................................................................... d ❑ e. Conveyance is given in connection with a tax sale.„.„..„„ .. »,...„„........... ......„„ ...,.„..,.,,,., a �❑ f. Conveyance is a mere change of identity or form of ownership or organization where there is no chhange in beneficial ownership,(This exemption cannot be claimed for a cry-nveyance to a cooperative housing corporation of real property comprising the cooperative dwelling or dwellings.)Attach Form TP-584.1,Schedule F. f r❑ g. Conveyance consists of deed of partition................................. ..„„„.».»„»»..„„..,..,.„...,.,„„..,,.„..„„........ g LJ I h. Conveyance is given pursuant to the federal Bankruptcy Act....................... .,....... ...„.___ ......... ......... , ..........— In ❑ i i. Conveyance consists of the execution of a contract to,sell real property,without the use or occupancy of such property,or the granting of an option to purchase real property,without the use or occupancy of such property.............................................. i ❑ j. Conveyance of an option or contract to purchase real property with the use or occupancy of such property where the consideration is less than$200,000 and such propertyjwas used solely by the grantor as the grantor's personal residence and consists of a one-,two-,or three-family house,anlindividual residential condominium unit,or the sale of stock in a coopidualerative housing tial cooperative e corporation apartment with the grant or transfer of a proprietary leasehold covering an ❑ P 9 P P ...„,.,., k. Conveyance is not a conveyance within the meaning o¢Tax Law Article 31 section 1401(e)(attach documents supporting such claim),.„„.. ,, ..„..... ...... .... ......... ......... k 'The total tax(from Part I,line 6 and Part II,line 3 above)is due within 15 days from the date conveyance.Please make check(s)payable to the county clerk where the recording is to take place.Ifjthe recording is to take place in the New York City boroughs of Manhattan, Bronx,Brooklyn,or Queens,make checks)payable to the NYC Department of Finance.If a recording is not required,send this return and your,check(s)made payable to the iNYS Department.of Taxation and Finance,directly to the NYS Tax Department,RETT Return Processing,PO Box 5045,Albany NY 12205-5045. S� RECEIVED NOV 0 5 2025 ZONING BOARD OF APPU'LS v� Page 3 of 4 TP-584(4/13) Schedule C--Credit Line Mortgage Certificate(Tax Law,Article 11) Complete the following only if the interest being transferred is a fee simple interest. I(we)certify that:(check the appropriate box) 1. ❑X The real property being sold or transferred is not subject to an outstanding credit line mortgage. 2. ❑ The real property being sold or transferred is subject to an outstanding credit line mortgage.However,an exemption from the tax is claimed for the following reason: ❑The transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in the real property(whether as a joint tenant,a tenant in common or otherwise)immediately before the transfer. ❑The transfer of real property is(A)to a person or persons related by blood,marriage or adoption to the original obligor or to one or more of the original obligors or(B)to a person or entity where 50%or more of the beneficial interest in such real property after the transfer is held by the transferor or such related person or persons(as in the case of a transfer to a trustee for the benefit of a minor or the transfer to a trust for the benefit of the transferor). ❑The transfer of real property is a transfer to a trustee in bankruptcy,a receiver,assignee,or other officer of a court. ❑The maximum principal amount secured by the credit line mortgage is$3,000,000 or more,and the real property being sold or transferred is not principally improved nor will it be improved by a one-to six-family owner-occupied residence or dwelling. Please note:for purposes of determining whether the maximum principal amount secured is$3,000,000 or more as described above,the amounts secured by two or more credit line mortgages may'be aggregated under certain circumstances.See TSB-M-96(6)-R for more information regarding these aggregation requirements. ❑Other(attach detailed explanation). 3. ❑ The real property being transferred is presently subject to an outstanding credit line mortgage.However,no tax is due for the following reason: ❑A certificate of discharge of the credit line mortgage is being offered at the time of recording the deed. ❑A check has been drawn payable for transmission to the credit line mortgagee or his agent for the balance due,and a satisfaction of such mortgage will be recorded as soon as it is available. 4. ❑ The real property being transferred is subject to an outstanding credit line mortgage recorded in (insert liber and page or reel or other identification of the mortgage).The maximum principal amount of debt or obligation secured by the mortgage is .No exemption from tax is claimed and the tax of is being paid herewith.(Make check payable to county clerk where deed will be recorded or,if the recording is to take place in New York City but not in Richmond County,make check payable to the NYC Department of Finance.) Signature(both the grantor(s)and grantees must sign)' The undersigned certify that the above information contained in schedules A,B,and C,including any return,certification,schedule,or attachment,is to the best of his/her knowledge,true and complete,and authorizee p-erson(s)submitting such form on their behalf to receive a copy for purposes of recording the deed or other instrument effecti tom Grantorslgnat re Title Gx sAgraattwte Title Grantor signature Title Grantee signature Title Reminder:Did you complete all of the required information in Schedules A,B,and C?Are you required to complete Schedule D?If you checked e,f,or g in Schedule A,did you complete Form TP-584.1?Have you attached your check(s)made payable to the county clerk where recording will take place or,if the recording is in the New York City boroughs of Manhattan,Bronx,Brooklyn,or Queens,to the NYC Department of Finance?If no recording is required,send your check(s);made payable to the Department of Taxation and Finance, directly to the NYS Tax Department,RETT Return Processing,PO Box 5045,Albany NY 12205-5045. RECEIVED NOV 05 2025 ZC:,,'(NC BOARD OF APPEALS Page 4 of 4 TP-5841- "^ Schedule D-Certification of exemptlon from the payment of estimated personal income tax(Tax I.a ,Article 22, section 663 Complete the following only if a fee simple interest or a cooperative unit is being transferred by an individual or estate or trust. If the property is being conveyed by a referee pursuant to a foreclosure proceeding,proceed to Part II,and check the second box under Exemptions for nonresident transferor(s)/seller(s)and sign at bottom. Part I-New York State residents If you are a New York State resident transferor(s)/seller(s)listed in Schedule A of Form TP-584(or an attachment to Form TP-584),you must sign the certification below.If one or more transferors/sellers of the real property or cooperative unit is a resident of New York State,each resident transferor/seller must sign in the space provided.If more space is needed,please photocopy this Schedule D and submit as many schedules as necessary to accommodate all resident transferors/sellers. Dertifloation of resident#ransferor sI/seiler(s) This is to certify that at the time of the sale or transfer of the real property or cooperative unit,the transferor(s)/seller(s)as signed below was a resident of New York State,and therefore is not required to pay estimated personal income tax under Tax Law,section 663(a)upon the sale or transfer of this real property or cooperative unit. Signature Print full name Date Signature Print full name Date ,Signature Print full name Date Signature Print full name Date Note:A resident of New York State may still be required to pay estimated tax under Tax Law,section 685(c),but not as a condition of recording a deed. Part II-Nonresidents of New York State If you are a nonresident of New York State listed as a transferor/seller in Schedule A of Form TP-584(or an attachment to Form TP-584) but are not required to pay estimated personal income tax because one of the exemptions below applies under Tax Law,section 663(c), check the box of the appropriate exemption below.If any one of the exemptions below applies to the transferor(s)/seller(s),that transferor(s)/seller(s)is not required to pay estimated personal income tax to New York State under Tax Law,section 663.Each nonresident transferor/seller who qualifies under one of the exemptions below must sign in the space provided.If more space is needed,please photocopy this Schedule D and submit as many schedules as necessary to accommodate all nonresident transferors/sellers. If none of these exemption statements apply,you must complete Form IT-2663,Nonresident Real Property Estimated Income Tar Payment Form,or Form IT-2664,Nonresident Cooperative Unit Estimated Income Tax Payment Form.For more information,see Payment of estimated persotral income far;on page 1 of Form TP-584-I. Exemption for nonresident transferors)/seller(s) This is to certify that at the time of the sale or transfer of the real property or cooperative unit,the transferor(s)/seller(s)(grantor)of this real property or cooperative unit was a nonresident of New York State,but is not required to pay estimated personal income tax under Tax Law, section 663 due to one of the following exemptions: ❑The real property or cooperative unit being sold or transferred qualifies in total as the transferor's/seller's principal residence (within the meaning of Internal Revenue Code,section 121)from to-(see instructions). Date Date ❑The transferor/seller is a mortgagor conveying the mortgaged.property to a mortgagee in foreclosure,or in lieu of foreclosure with no additional consideratlon. ❑The transferor or transferee is an agency or authority of the United States of America,an agency or authority of the state of New York,the Federal National Mortgage Association,the Federal Home Loan Mortgage Corporation,the Government National Mortgage Association,or a private mortgage insurance company. Signature Print full name Date Signature Print full name Date Signature Print full name Date Signature Print full name Date ......... .....�...� .�.........,�,,,.-... .. �, RECEIVED N O V 0 5 2025 ZONNIG BOARD OF APPEALS Townships: D East Hampton 03 nic Ba y Riverhead 06 o ay Region Shelter Island 07 �ctv� Community Preservation Fund Southampton 09 Southold 10 V o �U�S Proceeds of this transfer tax are disbursed to the Townships in which the transaction takes place for its acquisition of land,development rights,and other interests in property for conservation 70NIC,G BOAPD OF APPEALS purposes. Please print or type. Schedule A Information Relating to Conveyance Grantor Name ndlvl.ua,last,first,.middlelnit%al) Social Security Number ❑Individual MILL LANE ONE LLC ❑Corporation Mailing address Social Security Number 2230 SOUNDVIEW AVENUE ❑Partnership CMty Skate ;!'lP code. Federal employer ident, mm ❑p other MATTITUCK NY 11952 Grantee Name(lndlvidual;last,first,middle Initial) Social Security Number ❑Individual VINBARY REALTY CORP M Corporation Mailing address. Social Security Number ❑Partnership 450 SNUG HARBOR ROAD ❑Other Clay State ZlPcode Fr•r9rrraM rrmnlrvunr on . GREENPORT NY 11944 Location and description of property conveyed Taxmap designation Address Village Town Dist Section Block Lot 6300 WICKHAM AVENUE MATTITUCK i 1000 107.00 10.00 009.000 Southold Type of property conveyed(check applicable box) Date of conveyance Dual Towns: ❑i Improved / ❑Vacant land 1 .Oath day vook Condition of conveyance(check all that apply) a.-Conveyance of fee interest b.-Acquisition of a f. -Conveyance which consists of a mere k.-Contract assignment controlling Interest (state change of identity or form of ownership or I. -Option assignment or surrender percentage acquired %) organization m.-Leasehold assignment or surrender n.- c.-Transfer of a controlling Interest(state g.-Conveyance for which credit(or tax Leasehold grant percentage transferred %) previously paid will be claimed o. - Conveyance of an easement p. - d.-Conveyance to cooperative housing Conveyance for which exemption is h.-Conveyance of cooperative apartment(s)I. corporation -Syndication claimed(complete Schedule B.Part II) e.-Conveyance pursuant to or in Ileu of J. -Conveyance of air rights or development q.-Conveyance of property partly within and foreclosure or enforcement of security rights partly without the state interest r. -otherltdascriba'9 Schedule B - Community Preservation Fund Part I-Computation of Tax Due 1.Enter amount of consideration for the conveyance(from line 1 TP584 Schedule B) 1 1,150,000.00 2.Allowance(see below) 2 150,000.00 3.Taxable consideration(subtract line 2 from line 1) 3 '',1,000,000.00 4.2%Community Preservation Fund(of line 3)make certified check payable to SUFFOLK COUNTY CLERK 4 20,000.00 5.Property not subject to CPF Tax(See Schedule C) 5 ❑ For recording officer's use Amountreceived Date received Transaction number Allowance: East Hampton $250,000.00Improved $100,000.00 Vacant Land(Unimproved) Shelter Island $250,000.00Improved $100,000.00 Vacant Land(Unimproved) Southampton $250,000.00Improved $100,000.00 Vacant Land(Unimproved) Riverhead $150,000.00Improved $75,000.00 Vacant Land(Unimproved) Southold $150,000.00Improved $75,000.00 Vacant Land(Unimproved) zz-0zta..os/oi�a Schedule C (continued) Part II-Explanation of Exemption Claimed in Part I,line 1(check any boxes that apply) The conveyance of real property is exempt from the real estate transfer tax for the following reason: a.Conveyance Is to the United Nations,the United States of America,the state of New York or any of their instrumentalities, agencies or political subdivisions (or any public corporation, including a public corporation created pursuant to agreement or compact with another state or Canada) b.Conveyance is to secure a debt or other obligation El c.Conveyance is without additional consideration to confirm,correct,modify or supplement a prior conveyance d.Conveyance of real property is without consideration and not in connection with a sale,including conveyances conveying realty as bona fide gifts e.Conveyance is given in connection with a tax sale f.Conveyance is mere change of identity or form of ownership or organization where there is no change in beneficial ownership. (This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property comprising the cooperative dwelling or dwellings.) g.Conveyance consists of deed of partition h.Conveyance is given pursuant to the federal bankruptcy act I.Conveyance consists of the execution of a contract to sell real property without the use or occupancy of such property or the granting of an option to purchase real property without the use or occupancy of such property j.Conveyance or real property which is subject to restrictions which prohibit the use of the entire property for any purposes except agriculture, recreation or conservation, pursuant to Section 1449-ee (2) (1) or (k) of Article 31-D of the Tax Law. ❑ (See required Town approval,below) k.Conveyance of real property for open space,parks,or historic preservation purposes to any not-for-profit tax exempt corporation operated for conservation,environmental,or historic preservation purposes. (.Other list explanations in space below(Grandfather/Contract) m.Conveyance of real property as a primary residence where the grantee is a first-time homebuyer (attached approved application) El n.Conveyance of real property to a tax exempt,not-for-profit corporation for the purpose of providing affordable housing. ❑ o.The conveyance is approved for an exemption from the Community Preservation Transfer Tax,under Section 1449-ee of Article 31-D of the Tax law.(See j in Schedule C) Town Attorney or other designated official Penalties and Interest Penalties Interest Any grantor or grantee failing to file a return or to pay any tax within Daily compounded interest will be charged on the amount of the the time required shall be subject to a penalty of 10%of the amount tax due not paid within the time required. of tax due plus an interest penalty of 2% of such amount of each month of delay or fraction thereof after the expiration of the first month after such return was required to be filed or the tax became IV due. However, the interest penalty shall not exceed 25% in the '(\^ ED aggregate. k v NOV2025 ZCs'L;N'G CCARD OF APPEALS Signature (both the grantor(s) , and grantee(s) must sign). The undersigned certify that the above return, including any certNflcatiot schedule or attachment, is to the best of his/her knowledge,true and complete. fxrantOr rantror G,raariteb tz-0zta::ovmro INSTRUCTIONS(RP-5217-PDF-INS):www.orp. -.a...ps FOR.COUNTY USE On, New York State Department of 91.€NIIS Code i , Taxation and Finance C2.Date Deed Recorded Office of Real Property Tax Services � f f J Ma"i ---- Day Year RP-5217-PDF C3.BookJ C4.Page I I I_ I Real Property Transfer Report(8110) PROPERTY INFORMATION 1.Property 6300 WICKHAM AVENUE Location "STREET NUMBER 'STREET NAME Southold Mattituck 11952 •CITY OR TOWN VILLAGE •ZIP CODE 2.Buyer VINBAR REALTY CORP Name •LAST NAMEICOMPANY PAST NAME 1�,f LAST NAMEICOMPANY FOO TP,mm 1 V— 3.Tax Indirale where future Tax Bills are to be sent Billing if other than buyer address(at bottom of form) LAST NAANEY OMPANNY PUAST NAME Address NOW 23 � yyN STATE LP CODE f i61REET InaAMBER AMtid aWAE. CITY OR TO 4.Indicate the number of Assessment (Only if Part of a Parcel)Check as they apply: 1 9 of Parcels OR Part of a Parcel ❑ Roll parcels transferred on the deed 4A,planning Board with Subdivision Authority Exists r r"M I,i�v n� i7 OF APPE8." 'da`yd ��, �[y Pro e �' OR 26.50 4B.Subdivision Approval was Required for TransferEJ p rty 'FRONTFEET DEPTH 'ACRES Size 4C.Parcel Approved for Subdivision with Map Provided MILL LANE ONE LLC 6.Seller mLAST'N:M'RUMCNIP14" FIRST NAME Name LAST NAMEICOMPANY FIRST NAME '7.Select the description which most accurately describes the Check the boxes below as they apply: use of the property at the time of sale: 8.Ownership Type Is Condominium E.Agricultural 9.New Construction on a Vacant Land 10A.Property Located within an Agricultural District 108.Buyer received a disclosure notice indicating that the property Is in an El District SAL E IN RMA f N 15.Check one or more of these conditions as applicable to transfer: A.Sale Between Relatives or Former Relatives 11.Sale Contract Date 10/0 3/2 017 B.Sale between Related Companies or Partners in Business. C.One of the Buyers is also a Seller 12.Date of Sale/Transfer110S12 018 D.Buyer or Seller is Government Agency or Lending Institution ' E.Deed Type not Warranty or Bargain and Sale(Specify Below) F.Sale of Fractional or Less than Fee Interest(Specify Below) '13.Full Sale Price 1,150,000.00 G.Significant Change in Property Between Taxable Status and Sale Dales H.Sale of Business is Included in Sale Price (Full Sale Price is the total amount paid for the property including personal property. I.Other Unusual Factors Affecting Sale Price(Specify Below) This payment may be In the form of cash,other property or goods,or the assumption of J.None mortgages or other obligations.)Please round to the nearest whole dollar amount Comment(s)on Condition: 14.Indicate the value of personal 0 -D0 property Included In the sale AS ES MENT INFORMATION Data should reflect the latest Final Assessment Roll and Tax EI0 16.Year of Assessment Roll from which information taken(YY) 17 '17.Total Assessed Value 10,600 *18.Property Class 120 _ '19.School District Name Mattituck—Cutehogue •20.Tax Map identifler(s)IRoll Identifler(s)(If more than four,attach sheet with additional Identifier(s)) 1000-107.00-10.00-009.000 OI�RTI�dCA.TION I Certify that all of the items of Information entered on this form are true and correct(to the best of my knowledge and belief)and I understand that the making of any willful false statement of material fact herein subject me to tha nrsevMJgars of the jMn4 .lative to the making and filing of false Instruments. SELLER SIGNATURE DER CONTACT IN ORMATtON (Enter Inrormetion for Iha buyer;Note:If bruyer'ID LLC,sodety,association,corporator,joint stock company,estate or y andkythmis not an kn Mdual then a name and contact Inrormallon or an IndlviduaBresponslble NlwrAr✓�,N+ party who ran answer questions regarding the Vanivar must be entered.Type or print clearly.) gEW mylal ATime_ nM1T7C VINBAR REALTY CORP BUYER SIGNATURE ' ry •LAW'IMMaa' nNt.sr'tative y. •ARFACODE 'TELEPHONE NUMBER(EX:"MISS) yFdt SaMiAT'Ua" DATE 450 SNUG HARBOR ROAD •STREET NUMBER 'STREET NAME I S GREENPORT NY 11944 .Criv On TpaAkN 'STATE -ZIP CODE BUYER'S ATTORNEY PRICE WILLIAM H. 1 LAST NAME FIRST NAME (631) 477-1016 AREA CODE 115 EPaKNVE NUMBER WX 59e99901.....