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HomeMy WebLinkAbout5928 t{~, :Z=~-~-~,,~-_:LA/)eJ m_m ___u Yt~oo~h~,o'\~ * F9d-i ~s S''(s!3 -Ilf/A '1> li1..l~ :; '- APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. Goehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman Mail~: Southold Town Hall 53095 Main Road · P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex/First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 http://southoldtown.northfork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 · ]Fax (631) 765-9064 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF SEPTEMBER 14, 2006 ZB File No. 5928 - JAMES and JANET D'ADDARIO Property Location: 8960 Peconic Bay Boulevard, Laurel CTM 126-5-6 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. PROPERTY FACTS/DESCRIPTION: the applicant's property contains 29,612 square feet with 50.40 feet along Peconic Bay Boulevard. The property is improved with a 1-1/2 story, single-family dwelling and accessory garage, all shown on the September 29, 1986 survey, amended March 13, 2006 by John T. Metzger. BASIS OF APPLICATION: Zoning Code Section 280-124 (100-244), based on the Building Inspector's March 6, 2006 Notice of Disapproval, amended August 1, 2006, for the reason that the side yard is 12'4" instead of 15 feet. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on August 31, 2006, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: The applicants are requesting a variance for an addition, a portion of which will encroach within the 15 ft. side yard at the northeasterly corner of the dwelling. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The applicant's 13.8 by 16.2 ft. addition will result in setbacks of 15 feet and 12'4" at its closest measurement with the side property line, as shown on the site plan dated 10/20/05 prepared by Ellen Roche, Architect. (Note: The architect for the applicant confirmed that the roof alterations will meet the minimum 15 ft. side yard setback and minimum 35 ft. total side yards.) 2. The benefit sought by the applicants cannot be achieved by some method, feasible for the applicants to pursue, other than an area variance. 3. The variance granted herein is not substantial, representing only +/- 21 square feet of the addition that does not meet the code setback requirement. ~age 2 - September 14, 2006 ZB File No. 5928 - J. and J. D'Addario CTM No. 126-5-6 4. The difficulty has been self-created, base on the requested size of the addition and its closeness to the property line. 5. No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. 6. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an addition, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Chairwoman Oliva, seconded by Member Weisman, and duly carried, to GRANT the variance as applied for, as shown on the site plan dated 10/20/05 prepared by Ellen Roche, Architect. Any deviation fi.om the variance given such as extensions, or demolitions which are not shown on the applicant's diagrams or survey site maps, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the dght to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board: Ayes: Members Oliva (Chairwoman), Goehringer and Weisman. (Absent were: Member Ruth D. Oliva 10/~/06 Approved for Filing DEPARTMENT OF PLANNING COUNTY OF SUFFOLK s . / Nov I zoos TEVE LEVY / SUFFOLK COUNTY EXECUTIVE/ November 8, 2006 ES, AICP PLANNINg Ms. Ruth Oliva, Chair Town of Southold ZBA 53085 Main Rd., P.O. Box 1179 Southold, NY 11971 Dear Ms. Oliva: Pursuant to the requirements of Sections A 14-14 to 23 of the Suffolk County Administrative Code, the following application(s) submitted to the Suffolk County Planning Commission is/are considered to be a matter for local determination as there appears to be no significant county-wide or inter-community impact(s). A decision of local determination should not be construed as either an approval or disapproval. Applicant(s) -Segouin, Stephan Engelke, George & Sandra FHV, LLC Butz, Mary Jeffries, Michael & Susan Palmeri, Philip D'Addario, James & Janet Cavanagh, Thomas Zannikos, Nicholas Tyler, Rita & Greg Rosenbaum, Leonard Peconic Bay Materials Cutchogue-New Suffolk Library Peocnic Landing The Laurel Group/Redman Volpe, John David Howell Design/AC LaChance Wiederlight, Marc Peter Soutenburgh/Fisher Isabella, Barbara & Joseph Drake, Charles Mumcipal File Number(s) 5766 5895 5919 5920 5924 5925 5928 5932 5934 5936 5938 5940 5945 5949 5956 5964 5965 5966 5967 5969 5971 Very truly yours, Thomas Isles, AICP Director of Plauning CSW:cc S/s Christopher S. Wrede Environmental Planner LOCATION MAILING ADDRESS H. LEE DENNISON BLDG. - 4TH FLOOR · P.O. BOX 6100 · (631] 853-5190 100 VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NY 11788-0099 TELECOPIER (631) 853-4044 LEGAL NOTICE SOUTHOLD TOWN ZONING BOARD OF APPEALS THURSDAY, AUGUST 31, 2006 PUBLIC HEARING NOTICE IS HEREBY GIVEN, pursuant to Section 267 of the Town Law and Chapter 100 (Zoning), Code of the Town of Southold, the following public hearing will be held by the SOUTHOLD TOWN ZONING BOARD OF APPEALS at the Town Hall, 53095 Main Road, P.O. Box 1179, Southold, New York 11971-0959, on THURSDAY~ AUGUST 317 2006: 10:35 A.M. JIM and JANET D'ADDARIO #5928. Request for a Variance under Section 280-244 (formerly 100-244), based on the Building Inspector's March 6, 2006 Notice of Disapproval concerning additions/alterations which will be less than the code required 15 feet on one side and less than 35 feet for combined side yards, at 8960 Peconic Bay Boulevard, Laurel; CTM 126-5 -6. The Board of Appeals will hear all persons, or their representatives, desiring to be heard at each hearing, and/or desiring to submit written statements before the conclusion of each hearing. Each hearing will not start earlier than designated above. Files are available for review during regular business hours and prior to the day of the hearing. If you have questions, please do not hesitate to contact our office at (631) 765-1809, or by email: Linda. Kowalski@Town. Southold.ny.us. Dated: August 1, 2006. ZONING BOARD OF APPEALS RUTH D. OLIVA, CHAIRWOMAN By Linda Kowalski AU~ 01 '~6 O~:4?PP! ~OUTHOL~ B'_IIL~IN~ 631 ?65 FORM NO. 3 NOTICE OF DISAPPROVAl, DATE: March 6, 2006 Amended: 8/1/06 TO: Ellen Roche for J & J D Ack~anc, 1~ We~t lV[mn S~r~ Oyster Bay, .NY 1 Please take notice that y~ur application dated March 3, 2006 AUG For a pemiif for a~ addition to an existing single family dwelling at L~fion of propc, rty: 8960 Peeonic Bay Bird,, Laurel, NY County Tax Ma[; No, 1000 Is returned herewith an~ riisapproved on the following grounds: The prooosed con_~s~31W ~.gmgle family.al_welling on a non-eon£ormi~- ~7,875 s~. fl ._~_p~4_0 ~,on~]~lot Permi,/~P--ur-~ttR~-X---XIV' 100-294 which states: ~to._~$~'¢lcie v~m~raum standards for ~rantmg of a bml&ng pernu f_oLtlD¢ prmcmal_~[lot~ whi¢[~ oeo re~oggized bY the town ~!nder 100-3~4, are _T ? min' ra re u rac~ ~ide ~ck t0r th~s parcel ~s~_5 . The ~rtmoged ~ide yard 3 2006 Authorized Signature Note to Applicmtt: Any c~ange, or desiation to the above ret~rence~ application may require flu'thor re"Aew by the Southol6 Town Building Department APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS Fee:$ Sl}'~ Filed By: ~. '~$ For Office Use Only ~,'~t~/r ~ Date Assigned/Assignment No. Office ~otes: ~ Parcel Location: House No~ Street~y lvd Haml~tfl. aOr'~l' SCTM 1000 Section 12.O Block ~ Lot(s) ~ Lot Size ~.7/l:?~J?one District 1~4 o I (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED: ~ - 7- OO Applicant/Owner.__~fs): ._J i~ '~ Mailing Address: Telephone: 7 dd 2rio Telephone: O)22-24701 Please specify who you wish correspondence to be mailed to, from the above listed uames: Applicant/Owner(s) ~Authorized Representative [3 Other: / ! WHEREBY THE BUILDING INSPECTOR DENIED AN APPLICATION DATED ~ FOR: / / ~uiiding Permit D Certificate of Occupancy 12 Pre-Certificate of Occupancy [] Change of Use © Permit for As-Built Construction [] Other: Provision of the Zoning Ordinance Appealed. Indicate Article, Section, Subsection and paragraph of Zoning Ordinance by numbers. Do not quote the code. Article X'~ [~] Section 100-~ 44 Subsection Type of Appeal. An Appeal is made for: ~ Variance to the Zoning Code or Zoning Map. [] A Variance due to lack of access required by New York Town Law-Section 280-A. [] Interpretation of the Town Code, Article Section [] Reversal or Other A prior appeal 12 has]3(l~as not been made with respect to this property UNDER Appeal No. Year Page 2 of 3 - Appeal Application Part A: AREA VARIANCE REASONS (attach extra sheet as needed): (1) An undesirable change will not be produced in the CHARACTER of the neighborhood or a detriment fo nea.rby propertiesI if granted, because: ~ ~_~C_.~1 (2) The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to. pursue, other than an are~ variance, because: (3) The amount of relief r~qvested is not substantial beja~,~: (4) The variance will NOT have an adverse effect or impact on the,physipal or.gnvironmental~ cgndili~ns in the neighborhood,or distdct~?ause: ~ i~ ~On~l~ ~ 4h<~ I pua, vie (5) Has the vanance been self-created? (~ Yes, or ( ) No. If not, is the construction existing, as built? ( ) Yes, or ( ) No. (6) Additional information about the surrounding topography and building areas that relate ia the dlfficul~ in meetina the code requirements: Xattach. extra sheet as needed) .l. ] / this ~s the ~INI~U~ fh~f is necess~w ~nd ~dequ=fe, ~nd ~f the s~me fi~e prese~es =n~ protects the character of the neighborhood ~nd the he~lfh, communi~. ( ) Check this box and complete PART B, Questions on next page fo apply. USE VARIANCE STANDARDS. (Please consult your attorney.) Othe/rwise, please proceed fo the signature and notary area below. ~"-"" '~,1,~. 3- ~',,OC~.~ Signc~ure of Appellant or Aufhonzed Agent /~Sworn to before me this (Agent must submit Authorization from Owner) BERNICE TI WINTJEN Notary public, State of New York Reg. No. 01Wl4782407 Qualified in Nassau County My Commission Expires Aug. 31, ZBA App 9130/02 Page 3 of 3 - Appeal Application Part B: REASONS FOR USE VARIANCE ('r~ requested~: I~OT Each and Every Permitted Use under the Zoning Regulations for the Particular District Where 'rojecf is Located (please consult your afforney before completing): 1. A ~f cannot realize a reasonable return for each and every permitted use under the zoning ions for the particular district where the properly is located, demonstrated by coral: cial evidence. The applicant CANNOT realize a REASONABLE RETURN because: (describe on a ~rafe sheet). 2. The alleged I fo the property is unique because: 3. The alleged hardship because: apply fo a substantial portion of the district or neighborhood 4. The request will not alter the haracfer of the neighborhood because: 5. The alleged hardship has not been because: 6. This is the minimum relief necessary, while at the character of the neighborhood, and the health, safely explain on a separate sheet if necessary.) time preserving and protecting the velfare of the community. (Please 7. The spirit of the ordinance will be observed, public safely and substantial justice will be done because: (Please explain on a separate will be secured, and necessary.) ( ) Check this box and complete PART A, Questions on previous page ~pply AREA VARIANCE STANDARDS. (Please consult your attorney.) Otherwise, please proceed fo the sl.qnafure and notary area below. Sworn fo before me this day of ....................200_. Signature of Appellant or Authorized Agent (Agent must submit Authorization from Owner) (Notary Public) APPLICANT'S PROJIECT DESCRIPTION (For ZBA Reference) Applicant:_~_--//~.t~ ~)~' Alr'~-Jliq~'qL Date Prepared: I For Demolition of Existing Building Areas Please describe areas being removed: EStl'e-~f II. New Construc{Ron Areas ~ew Dwe~ng or New Add~fions~x~ensions): Dimensions offirst floor extension: I~,~ ~ ~ /~.~{ Dimensions of new second floor: ~ ~ Dimensions of floor above second level: Height (from finished ~-ound to top of ridge): Is basement or lowest floor area being cons~mted? If yes, please provide height (above ~ound) measured from na~ral existing ~-ade to first floor: III. Proposed Alterations or Interior Structural Changes without enlargement/extension (attach extra sheet if necessary) - Please describe building areas: . Number of FIoors and Genera,1 Characteristics BEFORE Alterations: ~tl'~qtlt'~ Number of FIoors'and Changes WITH ~lterations: ~{~[~ ~~+~ ~. Calculations of building areas and lot coverage (from surveyor): Existing square footage of buildings on your prope~: ~, 6~ g ~.~. Proposed increase of bmldmg coverage: D~ ~_g+ Square footage of yom-lot: ~. O I~ ~.~. ~ ' ' ' Pel-ceBtage of coverage of yom- 10t by bmldmg area: q. ~ ~ Vh Please describe the land contonrs (flat, slope %, etc.~ as exifit and. how it relates to the difficulW iu meeting the code requirement(s): ~0 dl Please submit seven (7) photos, labeled to show all yard areas of proposed construction after staking corners fro' new coustruction), or photos of existing building area to be altered (area of requested chauges). ~__ 6:k_~tC~JQ,~d. 7/2002; 2/2005; 1/2006 '~ ~ SOUT/'/OLD SURVEY OF LOT 6 ( FLORENCE G. DOWNS) "MAP OF PROPERTY OF,4. L. DOWNS" FILED AUG. 14,1929 .4SMAPNO. 21 A T LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000- ~26- 05-06 SCALE, 1"=40' SEPT. 29, 1986 ~9, 1993 (founds/ion) ./f~1l~.,994 ( Tie Dislonce) PECONIC 5~, ' , P. O, BOX 909 ~ 1250 TRAVELER STREET ~OUTHOJ..D~ N.Y. 1192'1 02. AREA = 29,612 sq. ft. to tie line CERTIFIED TO: THE MORTGAGE CENTER, INC. CHICAGO TITLE INSURANCE COMP,4NY PEG,4$US ABSTRACT, INC. 86-523 CAST IRON FRAME & COVER (IF UNDER PAVED AREAJ PVC PIPE SEE DRAINAGE PIPING NOTES PRECAST CONC. DOME PRECAST CONCRETE DR'ANELL RING BACKFILL AREA UNDER & AROUND THE DRYWELL WITH GRANULAR MATERIAL CONTAINING LESS THAN 15% FINE SAND, SILT & CLAY. (SILT & CLAY FRACTION NOT TO EXCEED 5%). GROUND WATER LINE Bra [] I~1 [] [3ri firs Fq r~ [] Bt1 BIq F3 I~ [] or1 Bt3 I~ ~1 r-1 n E3 ~1 ~ [~ FIO DRYWELL DETAIL SCALE N.T~ LOT 5 LOT 7 LOT 6 AREA = 30,917 SQ. FT. (~ SITE PLAN SCALE' 20' - 1L0" Diffusion Well Table New Drywell Total roof area of Proposed Kitchen & New Roof Area - 1004 sq.ft. 1004 sq.ft, x .333 ft. (4" rainfall) x 1 (runoff factor) - 334 cu.ft. Requires ( 1 ) 8'-O"diameter x 8" high d[ywell. total capacity of this drywell = 338 cu.ft. Drainage Piping Notes: 1. Drainage piping to drywells located under grass areas shall be 6" dia. SD (White PVC, crush resistant to foot traffic). 2. Piping from catch basins to drywells located under paved or brick areas shall be 6" dia. SDR (Green PVC, Schedule 35, crush resistant to vehicular traffic). Site plan of Lot 6 Map of. PROPERTY OF A.L. DOWNS at Laurel Town of Southold Suffolk County, New York 1000 - 126 -05 - 06 based on survey by: Peconic Surveyors, P.C. Sept. 29, 1986 Dec. 29, 1993 (Foundation) Feb. 16, 1994 (Tie Distance) Ellen Roch ARCH I T £CT 15 W. Main Street Oyster Bay New York, 11771 leL 516-922-2479 Fax 516-922-2179 < DRAWING NUMB[R- SP-01 WOOO DECK DEN BEDROOM ~^Nq~V (~ FIRST FLOOR PLAN SCALE' I/4"- 1'-0" ROOM BEDROOM CLOS~I FOYER ~ K~CHEN CAB 16' 0~ PORCH A R C,H I T E C T 15 w. MaJn Street Oyster Bay New¥ork, 11777' Te~ 516-922-2479 Fax 516-922-2179 0 © o< A'OI MASTER BEDROOM CLOr~I MASTER BATHROOM CLOSET EIALLWAY CLOSET CLOSET BEDROOM DOWN TO (~ SECOND FLOOR PLAN SCALE 1/4"- 1'~0" / RRST FLOOR CE]LiNG LINE NEWROORNG TO MATCH E~ (~ FRONT ELEVATION SCALE' 1/4"- luO" NEW W1NDOW (~ LEFT SIDE ELEVATION SCALE- 1/4"- 1'-0" (~) REAR EL~,E~,ATION SCAL,~ 1/4" ,1 ...... ~ ROOF APEX /SECOND FLOOR UNE IL~V. +10~-0' E ROOHE ARCHIT~. PAGE 02 August 8, 2006 Ellen Rocn AR CH ]T£ CT To:Southold Town Zoning Board of Appeals 53095 Main Road Southold, N.Y. 11971 Re: D'Addario Residence 8960 PeconJc Bay Boulevard Laurel, N,Y. Sec. 126 BIk. 05 Lot6 Dear Zoning Board of Appeals: This letter is to state that the west~de-yerd is 25'-0" and the east side yard/~s 12'~"]'a~inn for variance on this side) giving a tota~f 37'~,,) (~.._._.........~-" ° If you require any other information, please contact our office immediately. Regards, Ellen Roche, RA. Architecture · Interior Design West Main Street · Oyster Bay, NY 1177! · Tel 516-922-2479 · Fax 516-922-2179 TOWN. OF SOUTHOLD L~k~5~NG DEPARTMENT "TOWN HALL - , ~,\ -~.-',- - ~,. SOUTHOLD, NY 11971 ., . .,. TEL: (631) 765-1802 : :,, i' ?,..,v ~ . FAX: (631) 765-9502 www. northfork.net/Southold/. PERMIT NO. Examined ,20__ Approved , ,20 Disapproved a/c 4 '[ .' 5.5; '~':' BUILDIN~ERMIT APPLICATION CHECKLIST · Do you have or need the following, before applying? Board of Health 4 sets of Buildthg Plans planmng Board approval - Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Expiration ,20__ Buildi2g Inspector : "' :· APPLICATION FOR BUILIMI'~G PERMIT , :, ~.. ;,':~' '.'~ ' Date ~ ~*- ~ ,..,...~ ........ INSTRUCTIONS ,20 O~ .... ' "" ~ ' ' typbwrderg( ,m ink and submltt{d tg.the'Bmldmg Inspector wit a. This apphcatmn M.~S~.b.~cq.mpl~tely filled in by . ".' ' .... ~ ' ' .... sets of plans, accurate plot plan to scale. Fee according to schedule· b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this appl~ca~,q0ay not 1o,9 ~o~enc. ed before ~ssuance of Braiding Perm~ . d. Upon approval of this appficati4n, '~[~Bui'lding InslSeet6r will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be ocofipied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. , f. Every building permit shall expire if the work authorized has not commeni:ed within 12 months after the date of issuance or has not been completed within 1 8 months from such date. If no zoning amerkd~, e33.ts or other regulations affecting the prope~'Xy have been enacted in the interim, the Building Inspector may authori'~e~in ~fihg, the extension of the permit for an ad/kti~n.~'.rx, rqqntl~s,,~geafter, anew. pe.rnq>.t~h:~,[~,~.,.e,~_~n~d. 'C'. ~ .5. ~7 (:.C~: : . · ' ' A~PI~I~ATION iS HEREBY MADE to the Building Department for the issuance o~ a Bmldifig Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructio~l of buildings, additions, or alterations or for removal or demolition as herein described· The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized-2n:sveetor-s-o~ in building for necessary inspections· ~' ~ '! t' (~gn4t~of applicant or name, ifa corporation) I, . I : ,.,,.. ~,: i.: ,, , (Mailing addrests ofa!~plicant) L ,::"",~. ".':....~, .__j State whether applicant is owner, lessee, agent~ engineer, general contractor, electrician, plumber or builder .E//,'n d. ',oeA . ' Name of owner of premises · (As on the tax roll or l%est deed),. , If applicant is a corporation, signature of duly authorized officer ; -, ;.,~.,. ':_ ~ ', ': ,,..,~ ...... (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: z3ay /vd .- /aura~, A/.Y. Hous~ N~ber ' S~eet -- ' H~let County Tax Map No. 1000 Section Subdivision (Name) Block O~ Filed Map No. Lot Lot b. Intended use and occupancy. ~l'rq~/a:~ /~t-~7i5 ~I:;~,~i~7/~.r.j~. 3. Nature of work (check which applicable): New Building Addition 7 Alteration Repair Removal Demolition Other Work Estimated Cost If dwelling, number of dwelling units Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor If garage, number of cars ~. ~ Y'oCf~,~ I 54~'/_~. · If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ,,2/~ ..~1 Rear 4~'Q. / I Height ,.~ I Number of Stories 11~ Depth 4 .1t Dimensions of same structure with alterations or additions: Front Depth Z[~. [ ~ Height ;3 ~5 I 8~,. 1}Simensions of entire ~e~& c. onstruction: Front 2~. ~1 Height ,.::G¢~ t Number of Stories 9. Size oflot: Front ,.,.~.~O' Rear I ' Rear 42 .Iw Number of Stories Rear 4ce~- I ~ Depth '4~. [ I Depth ~'4, 201 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated. 12. Does proposed construction violate any zoning law, ordinance or regulation? YES d NO 13. Will lot be re-graded? YES NO ,/' Will excess fill be removed from premises? YES NO 14. Names of Owner ofpr.emises T)'AdeqJ,,rjlf. l'~D Address Phone No. Name of Architect .~'l .~'~. Name of Contractor Address Phone No. ' 15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES_V NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES v/' NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Pro,f!de survey, .to so~al~, with.a, ccurate foundation plan and distances to property lines. 17. If elevanon at ,any point on property is at 10 fe& or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY OF ,.,. ~ ...,. ~ ~.' ..... · l - '.~' ~ :. k '\ ~~',~ ? ' ¢ % ' :lf ' '''"": .. i5..~ .: ,beg~g d~ly sworn del~*es a, ndlgys that (s)he is the applicant (Name o£individual signing contract) .... ' "' ' above nanled, ...... ', ' ~ /,~(Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the Inarmer set forth in the application filed therewith. Sworn,to before me tb./m ,, /?~ day of '~g/~,~_ 20~ '" Notary Pt~bli: ' ' ~" ' BERNICE T. WINTJEN Notary Public,-*State of New York Reg. No. 01WI4782407 Qualified in Nassau County /q ~ My Commission Expires Aug. 31,20_~.~_