HomeMy WebLinkAbout#8020-Figliozzi application FORM NO. 3 11eceived
TOWN OF SOUTHOLD MAY 0 6 2025 e02-:0
BUILDING DEPARTMENT
SOUTHOLD,N.Y. 'Zoning Board of Appeals
NOTICE OF DISAPPROVAL
DATE: February 26,2025
TO: Figliozzi PJ Family Trust
39 Osborne Rd'
Garden City,NY, 11530
Please take notice that .your application received October 23, 2024:
For permit to: demolish existing decks and construct a kitchen addition to an existin
single-family dwelling at:
Location of property: 120 Caiola Court Greenport,NY
County Tax Map No. 1000—Section 33 Block 3 Lot 19.15
Is returned herewith and disapproved on the following grounds:
The Droposed construction on this nonconforming 28.271 s . f . parcel in the Residential
R-40 is nat ermitted pursuant to Article XXXVI Section 280-207 lots cont ainin u to
30 000 s .ft.can have a maximum GFA of 3,350 s .ft.plus 10%of the lot area in excess
of 20,000 sq.ft.
The sate lan shows a GFA of 5,008 s .ft. exceeding the permitted amount of 4,177 N.R.
by 831 sq.ft.
A&horized Signatmij-
Note to Applicant: Any change or deviation to the above referenced application may
require further review by the Southold Town Building Department.
CC: file, Z.B.A.
APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS
AREA VARIANCE
House No. i ;W Street C1a10L/A Gcxk'k2.T Hamlet G►Zf-C)J
�ceived �gU
SCTM 1000 Section: 6�� _Block- 0_�' Lot(s) !94 t Lot Size: 0 to MAYLo toWD
I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDI$pE "S YY.4X*815
DATED Z 6 F� A 5 BASED ON SURVEY/SITE PLAN DATED a 8]-•►o-4 _i 4-
Owner(s): e5_� 1~14L,1022.1
Mailing Address: 3 ci 0,5►P op—W l_ 12o la's y_.0 tA x C.% i-Aj 1 153 0
Telephone: 51to lo'5b1$�Fax: Email: Pr1C400ZY.1 e_ 1~iCtl.lvZzrk [-ot-v►
NOTE:In addition to the above,please complete below if application is signed by applicant's attorney,agent,
architect,builder,contract vendee,etc.and name of person who agent represents:
Name of Representative: for(A Owner( )Other:
Address: 2 1 G1GIJ T)2�%Z S,M C%' , PCALTi 6, 11-16 6
Telephone: 4,31 e4l"1110 Fax: ~- Email: W\Vt%U1AP./_VN e 1'►'►i;•60fy�
Please check to specify who you wish correspondence to be mailed to,from the above names:
( )Applicant/Owner(s), 914 Authorized Representative, ( )Other Name/Address below:
WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN
DATED_ 2 k.1CT4 ,t4_ and DENIED AN APPLICATION DATED i,uOi'N FOR:
Building Permit
O Certificate of Occupancy O Pre-Certificate of Occupancy
( ) Change of Use
( )Permit for As-Built Construction
( ) Other:
Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance
by numbers.Do not quote the code.)
Article: XY7(N I Section: f,'O Subsection: ;k v7
Type of Appeal. An Appeal is made for:
( A Variance to the Zoning Code or Zoning Map.
( )A Variance due to lack of access required by New York Town Law-Section 280-A.
( )Interpretation of the Town Code,Article Section
( )Request for Reversal or Overturn the Zoning Officer's Denial
Other
A prior appeal( )has, ((has not been made at anv time witb respect to this property,
UNDER Appeal No(s). Year(s).
(Please be sure to research before completing this question or call our office for assistance)
Page 2,Area Variance Application Received
Revised 6/2023
MAY 0 6 2025 L
REASONS FOR APPEAL
(Please be specific,additional sheets may be used with preparer's signature notarized): Zoning Board of APP®RIg
1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to
nearby properties if granted,because: -MTr- auk STOR-/ 7 9 s'F PP-Ofb S► O kC'T µ W
f-10viTt► t S ILA TNf. FaAt- c 0V- TV& O XA5,'F-- , P%ZT v►St r-S t,JF- vf-om Ate,/
kot1-11 uC1 F4UGlA�72• rft-k10 r�� w4 k +ft T�1 P�f�a�+FrO rent LK.
nD
WL,L � PLAc.� t S c►dtz VL1E XTL`y Lo�l VMO uut l� �u a.lf io� .
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: Pfkofo 3tA:) /a'001 VQi -� t S W fMr—
1"c-`Fi5DL4 f1 FCIM SUZ-14 'TOOT VAYrAtt�-
y [r14°1lAiFi2luG3 YAT `R
IwSs LL LL SV- f>x> f- 1; 1�-T✓ r3�.
3.The amount of relief requested is not substantial because: "nAjlj�-Qr,0fj5f,0 '7 4 S K nrM1 O L)LJ
is q 1.(, % luuz.C*A51E 0\1E4Z '114f- C'PlsnuCj qFL05S FLCOYt r+aA -% of
l�l5l�-
4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in
the neighborhood or district because:'ham ?V-Oft 5*,0 K I-TLVW U ra �ft a w 1E.S WoT
%LtSe op- ►guy r4co,V43UPA�
S'f�(LM °lTi� ♦,?.U►101:T-- kT l s OE.:1LlC., R,W U ' 0-LQ1- /1",-k r4L L*A1>/
ty')?P.,"1;,.r7 rsrzf p dPr TN' r- ()9-0 PE,(Lj`j.
5.Has the alleged difficulty been self created? ( }Yes,or{A No Why: jW116 P F-0c'E,?--"t7 U.tA S
P.�tul w t•l�, ���> �r 1 or' CX- r-!1rU� VO L-A L.t
IL-osmuc, "OLA-ecur-Qtzrr,tuC, Pt�u-�u4 tea- f4t:10VA:%• we Rczf--
• Are there any Covenants or Restrictions concerning this land? { No { }Yes(please furnish a !A Sytockk 1-'
1 t.AULFiYaS C�
copy)
• This is the NENEVIUM 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.
Yjcs ►s 1 s
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.
L•1
Signature of AppKant or Authorized Agent
(Agent must submit written Authorization from Owner)
Sworn to before me is 9 1 _day
of r'sPR-A - 20�_
Notary Public
JE'FF THALHEfMBA
Notary Public.Sate of Nrw M
No UITN4976813
(-�ratiftcd in S*fttk(otwy
(rrnmissi.m Flea hmuafY 21. 2021
i
Zoning Board of Appeals Received
APPLICANT'S PROJECT DESCRIPTION
MAY 0 6 2025
APPLICANT: FtU&C r 1 G L-I L7 ZZ,i SCTM No. l 0(00 ' `'52�"03- I y' S 1s
Zoning Board o
1.For Demolition of Existing Building Areas
Please describe areas being removed: 21'►%X-� OV V'q IST7u Ot e-K 1�11 P►a5
K► 1A'kA--a t vC--
H.New Construction Areas (New Dwelling or New Additions/Extensions):
Dimensions of first floor extension: S i A 79 S V-
Dimensions of new second floor:
Dimensions of floor above second level:
Height(from existing natural grade):
Is basement or lowest floor area being constructed?If yes,please provide height(above ground)measured from
natural existing grade to first floor:
III.Proposed Construction Description (Alterations or Structural Changes)
(Attach extra sheet if necessary). Please describe building areas:
Number of Floors and General Characteristics BEFORE Alterations: e4 i 5r)U CI 7- STUAR)!
S►u L-V-- V-ntNA► r7 ."U t vt -TN 2 o
Number of Floors and Changes WITH Alterations: Wo p-'O uCtE I Lk ULIM 6 V 2 vr- 'F--CaQs.
rVDCbS*,t? rati-LI f-Y0V1riJt OVi -795V 1J TU RQ5 R"-V-
Y'►R�--P to Sao 6 s i=
IV. Calculations of building areas and lot coverage,sky plane (From Surveyor,Design Professional):
Existing square footage of buildings on your property: S 3-�'5 5 1�
Proposed increase of building coverage: 0e-f-9.�-MSNS 0 -703.S1= wi v S IAOvt Ai[1-S
Square footage of your lot: _2 5 ;t-I1 .5 V= � � 9-�ovM- ov ti?rA►s� b� ��
i
Percentage of coverage of your lot by building area(lot coverage) 10.4 90
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):
b8 .5f pf-ofzSf'o w111A YNPO TLOILJ
For Residential lots,is project within the allowable Sky Plane? (Please refer to Chapter 280, Section 280-208 of
the Town Code): i%S
V.Purpose of New Construction: K2225 1 NVV
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:
V--UqT
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 Received
FOR FILING WITH YOUR ZBA APPLICATION
A. Is the subject premises currently listed on the real estate market for sale? MAY 0 6 2025
Yes
No
Zoning Board of App19ai®
B. Are there any proposals to change or alter land contours?
�No Yes,please explain on separate sheet.
C. 1.)Are there areas that contain sand or wetland grasses? hlo
2.)Are those areas shown on the survey submitted with this application?
3.)Is the property bulk headed between the wetlands area and the upland building area?
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:
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?
E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown
on the survey that you are submitting?_W o
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? y ie$
If yes,please submit a copy of your building permit and survey as approved by the Building
Department and please describe scope of work.
-1 ut5la 0'r— pJ1451EM 1�+..L� AUI-•►t.l't'F�tofZ+�o12K
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? VAO_
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
641 gn u 4 51.1c L*- I-Avl,l LAI QU*Lue.r'cc
J. (examples:existing single family,proposed:same with garage,pool or other)
X A/ 4- Q;;� 21 AMIL1
Authorized sigma Date
l/ 17(lf rzv- t:50-2 04��n JL'�
Town of Southold 3/17/2022
P.O.Box 1179
53095 Main Rd Received gp�
, Southold,New York 11971
MAY 0 6 2025
CERTIFICATE OF OCCUPANCYzoning Board of Appeals
No: 42929 Date: 3/17/2022
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 120 Caiola Ct.,Greenport
SCTM#: 473889 Sec/Block/Lot: 33.-3-19.15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/11/2020 pursuant to which Building Permit No. 45004 dated 7/21/2020
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:
siLigle-family dwelling with unfinished basement,covered front enn, rear deck with partial roof over and attached
gygge with rear deck as applied for.
The certificate is issued to Wyandanch RE Corp
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-19-0010 2/17/2022
ELECTRICAL CERTIFICATE NO. 45004 12/16/2021
PLUMBERS CERTIFICATION DATED 2/17/2022 Car s Sander
0
on d ignature
Town of Southold 4/1/2022
s; P.O.Bog 1179
53095 Main Rd Received �D�A
❑ jQl ��p� Southold,New York 11971
MAY 0 6 2025
CERTIFICATE OF OCCUPANCY Zoning Board of Appeals
No: 42958 Date: 4/1/2022
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 120 Caiola Ct,Greenport
SCTM#: 473889 Sec/Block/Lot: 33.-3-19.15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/11/2020 pursuant to which Building Permit No. 45005 dated 7/21/2020
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:
accessory in-UQund swimming pool fenced to code as applied for.
The certificate is issued to Wyandanch RE Corp
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45005 1 6/2021
PLUMBERS CERTIFICATION DATED
tthizerignat�are
TOWN OF SOUTHOLD
�� 5UFF4t
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE �O
o �e SOUTHOLD, NY
oaf 4N
Received
BUILDING PERMIT
MAY 0 6 2025
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFIC AT Board of Appeals
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 45006 Date: 7/21/2020
Permission is hereby granted to:
120 Caiola Ct LLC
7675 Cox Ln
Cutchogue, NY 11935
To: construct accessory pool house as applied for.
At premises located at: \ I � - `�� ��
120 Caiola Ct., Greenport
V p�
SCTM #473889 �.�.-a
Sec/Block/Lot# 33.-3-19.15
Pursuant to application dated 5/11/2020 and approved by the Building Inspector.
To expire on 1/20/2022.
Fees:
ACCESSORY $240.40
CO -ACCESSORY BUILDING $50.00
Total: $290.40
Buil Inspector
� TOWN OF SOUTHOLD v_
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
Received
o�g SOUTHOLD, NY
BUILDING PERMIT MAY 0 6 2025
(THIS PERMIT MUST BE KEPT ON THE PREMISES zoning Board of Appeals
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 47953 Date: 6/13/2022
Permission is hereby granted to:
INyandanch RE Corp
1325 Locust Ave
Bohemia, NY 11716
To: install deer fence as applied for.
l e C �CJVLCe d
no-- re C e l0
At premises located at:
120 Caiola Ct., Greenport
SCTM#473889
Sec/Block/Lot#33.-3-19.16
Pursuant to application dated 5/12/2022 and approved by the Building Inspector.
To expire on 12/1312023.
Fees:
DEER FENCE $75.00
Total: $75.00
(L
Building Inspector
s'--1 f� y Town of Southold 1/10/2023
P.O.Box 1179
4-11 53095 Main Rd Received
Southold,y } Southold,New York 11971 fl
MAY 0 6 2025
CERTIFICATE OF OCCUPANCY Zoning Board of Appeals
No: 43750 Date: 1/10/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 120 Caiola Ct,Greenport
SCTM#: 473889 Sec/Block/Lot: 33:3-19.15
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/20/2022 pursuant to which Building Permit No. 48423 dated 10/20/2022
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:
electric for automatic pool cover, as heater and salt water chlorinator.
The certificate is issued to Figliozzi PJ Family Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 22-86937 12/28/2022
PLUMBERS CERTIFICATION DATED
4
Au o ize S nature
r TOWN OF SOUTHOLD
=ateSA
BUILDING DEPARTMENT
S 3 TOWN CLERK'S OFFICE
SOUTHOLD, NY
Nvv* V
BUILDING PERMIT Received }G�
(THIS PERMIT MUST BE KEPT ON THE PREMISES MAY 0 6 2025
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORJIM) Board of Appeals
Permit#: 50826 Date: 6/18/2024
Permission is hereby granted to:
EqCflozzi PJ Family Trt _
39 Osborne Rd
Garden Ci , NY 11530
To: Construct alterations to finish a basement to include an HVAC system to a single-family
dwelling as applied for.
At premises located at:
120 Caiola Ct, Greenport
SCTM # 473889
Sec/Block/Lot# 31-3-19.15
Pursuant to application dated 4/26/2024 and approved by the Building Inspector-
To expire on 12/18/2025.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $1,277.50
CO-ALTERATION TO DWELLING $100.00
Total: $1,377.50
Building Inspector
o��art soury6�o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE Received "YSOUTHOLD, NY V
MAY 0 6 2025
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#: 51619 Date: 02/07/2025
Permission is hereby granted to:
Figliozzi PJ Family Trt
39 Osborne Rd
Garden City, NY 11530
To:
Construct a pool cabana with outdoor shower accessory to an existing single-family dwelling as
applied for per SCHD approval. Must maintain a minimum rear and side yard setback of 10 feet.
Premises Located at:
120 Caiola Ct, Greenport, NY 11944
SCTM#33.-3-19.15
Pursuant to application dated 12/12/2024 and approved by the Building Inspector.
To expire on 02/07/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $579.00
CO Accessory Structure $100.00
Total $679.00
�� Building Inspector
AGRICULTURAL DATA STATEMENT
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
WHEN TO USE THIS FORM: This form must he completed by the applicant jar an use 1 e�
permit,site plan approval,use variance,area variance or subdivision approval on pro ee 0/1,
an agricultural district OR within 500feet of afarm operation located in an agricultural district
All applications requiring an agricultural data statement must he referred to the Suffolk 9R." 6 2025
Department of Planning in accordance with Section 239m and 239n of the General Municipal
Law. Zoning Board of Appeals
1. Name of Applicant: 9f TtA- (�1( LA )2Z1
2. Address of Applicant: Q,LAir-- 94:n J q 11 + 1 15,30
3. Name of Land Owner(if other than Applicant):
4. Address of Land Owner:
5. Description of Proposed Project: (b.Ao Kt vw 6U rAvP,11w 1a-Lo
AI-N-�f LOW
6. Location of Property: (Road and Tax map Number)_ I X u Ua t LX,^- CSC . G IZ-F.�1-►�bRT
1 ow - 315 - n 3 - 19.115'
7. Is the parcel within 500 feet of a farm operation? { )Yes {x No
S. Is this parcel actively farmed? { }Yes {)Q 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.
3.
4.
5.
6.
(Please the back of this page if there are additional property owners)
/A{ 1 L .2erLI—
Si afore of A�lic o Date
Note:
1.The local Board will solicit comments from the owners of land identified above in order to consider the
effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of
this statement.
2.Comments returned to the local Board will be taken into consideration as part as the overall review of
this application.
3.Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners
identified above. The cost for mailing shall be paid by the Applicant at the time the application is
submitted for review.
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completine
Part I -Project information. The applicant or project sponsor is responsible for the completion of Par!). Responses
become part of the application for approval or funding,are subject to public review,and may RK&W® er 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. MAY O 6 2025
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. Zoning Board of Appeals
Part 1-Project and Sponsor Information
Name of Action or Project:
Project Location(describe,and attach a location map):
17,0 Cn►OL-n coy1LT, CIrC Pa+ZT W►/
Brief Description of Proposed Action:
ptnor"O ".YJ l'rrr_1A-tU IAiJP f A21J Ip,�y Ilr .9
Name of Applicant or Sponsor: Telephone: S� 13353
PfA-CAV__ V-14L1o27_% E-Mail: 9t=\4L-1�2Z1
Address: FV c4 L\k--3 27—\ , eorh
39 b580V.>'..te V-orvo
City/PO: State: Zip Code:
G AV,Qf'0 e l T7 V-A-/ 11°s30
1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES
If Yes,list agency(s)name and permit or approval:
ToLk4_1 uf' Soa-Tv%-O� ChuI ur]t"C,t C iZ-"C 11n it t�'T x
3.a.Total acreage of the site of the proposed action? ��acres
b.Total acreage to be physically disturbed? 0 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 0-re r acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial '(Residential(suburban)
❑Forest ❑Agriculture ❑Aquatic ❑ Other(specify):
❑Parkland
Pagel of 4
` 5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations?
b.Consistent with the adopted comprehensive plan? >r-
6. Is the proposed action consistent with the predominant character of the existing buut or natural NO YES
landscape? ceived � X
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environ
MAY enta
ZOZS 0 NO YES
If Yes,identify:
8. a.Will the proposed action result in a substantial increase in traffic above p rd of 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? k
9.Does the proposed action meet or exceed the state energy code requirements? NO YES
If the proposed action will exceed requirements,describe design features and technologies:
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water:
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: YZ
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?
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? W
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 K.5uburban
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
k
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO ❑YES A
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 in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon,dam)?
If Yes,explain purpose and size:
i ed
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility? MAY 6 2025
If Yes,describe: Znajr X
Saar i of. ppeal
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: x
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
ApplicanUspvns eC V1 C,l�L o Z`L t Date: 21 lT�
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?
i
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological,
architectural or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
No,or Moderate
small to large
impact impact
Z�m$y 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 complenanPf PW31, ObApp8alS
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.
Cl 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
101,0
Board of Zonin A eals A lication Re
�"
OWNER'S AUTHORIZATION
(Where the Applicant is not the Owner) MAY 2025
Zoning Board of Appeals
3 9 05%SOI VJC R.,on D
L PEEMe FtGl.1 22.1 residing at e4rAyA-)eA.i c-At4 ," it
(Print property owner's name) (Mailing Address)
do hereby authorize Sew
(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 HEREIN.
(Owner's S ignature)
PE'�[XL V-A to l.a o VLA
(Print Owner's Name)
If�l�J
APPLICANT/OWNER Received
TRANSACTIONAL DISCLOSURE FORM
MAY 0 g 2P
The Town of Southold's Code of Ethics rahibits conflicts of Interest an the art of town officers and employees.The u se o
this form is to p rovide information which can alert the town of Uomible conflicts of interest and allow i o take whatever action is
aecessary to avoid some. ❑ard of Appeals
YOUR NAME: 5 ICti.\v LZ.1 PSIV?—
(Last name,fast 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 7C 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
Submitted this S day 1 L 20_Z�C
114 Signature
Print Name " Aq A
145 ?Rv /2� (o✓L ?C 26A "r�'I�3 'Xi
IEFF T14ALNEIIMBA
' etary bbtit:.State of NOW Twin
Ho OITH4 70813 J
Qualified in SN*tk t-Mty
C lmmiss m finof A 1 cowry 12. ��
AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM Received
The Town of Southold's Code of Ethics orohibits conflicts of interest on the part of town officers and employees.The eurposc of
this form is to p rorzde information which can alert the town of R assible conflicts of interest and allow 1#JA Me RIB t ction is
necessary to avoid same.
YOURNAME : "i"r-4- A'CA 'v1FXL Zoning Board of Appeals
(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 7C 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
Submitted this 20 zj
Signature
Print Name T%A1-L.11A 1VM
BRAN SHORE
Noun Pi blkC,$tale of Now York
ft.30409M
0U"W in t *MU CWMf
Canw*mon IFxoties 11 amh 3t1,2o3_7
• Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM 0 1 V -' 1 D
A. INSTRUCTIONS MAY 0 6 2025
1. All applicants for permits* including Town of Southold agencies, Zb8JP9 IAeoth&IT!AF 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# 3'> 05 - l 9 o 1'5
The Application has been submitted to (check appropriate response):
Town Board 0 Planning Dept. 0 Building Dept. ® Board of Trustees
1. Category of Town of Southold agency action(check appropriate response):
(a) Action undertaken directly by Town agency(e.g. capital 0
construction,planning activity, agency regulation,land transaction) 0
(b) Financial assistance(e.g. grant, loan, subsidy)
(c) Permit, approval,license, certification:
Nature and extent of action:
Location of action: I Ac, [.p1 CUA r�3g--T 1, e49-k.�.LR.9OV-*T ived
J
Site acreage: 0-
MAY 6 2025
Present land use: Lt r ►'''+
Zoning E30arc3 of Appeals
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: 9V-M'V- r-A V to tD2-Zi
(b) Mailing address: 3 C75rxz �� P_� rY7 Cr�a'J'r'_.0 &I p4 t I s,3L>
(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 ❑ Nov If yes,which state or federal agency?
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location, and
minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation
criteria.
❑Yes ❑ No N Not 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
13 Yes ❑ No � Not Applicable
Received '
mAY 0 6 2025
Zoning Board of Appeals
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